I thought I'd provide an update since I haven't posted here in awhile and a number of things have happened. Last week I met with a Reproductive Endocrinologist (RE) for a first time consultation. In light of Jon's issues (and possibly mine) I thought it would be best to meet with one and see what our next steps would be if we were to find out at Jon's urology visit that his infertility is unknown and/or "untreatable". Essentially I learned that, relatively speaking, this is going to be expensive (especially given that 90% of couples can get pregnant for free). It's a difficult concept to grasp and it's one that I'm not sure we're willing to pursue. Ultimately, we're waiting for the urologist to evaluate the degree of Jon's infertility and then Jon and I will sit down together and decide what our next steps will be (if any).
I asked the RE what he thought about my own cycles in terms of my spotting before my period shows up and he said that my progesterone level is a little low and that they like to see it higher, but that there is no generally accepted range of "normal" for progesterone. The test itself is fickle and sometimes there is no rhyme or reason as to why some get pregnant on low progesterone and some don't. He mentioned that low progesterone could be a consequence of not producing the highest quality eggs due to hormonal imbalances during the follicular phase (the time between your period and ovulation). There is no "cure" to this hormonal imbalance nor do they understand entirely why some woman have lower levels of hormones and others don't. Throughout your life you can naturally change your hormonal levels too through diet, weight loss, exercise, stress, etc. so this is not a permanent problem. He did mention that there is some evidence that high impact exercising can influence these hormones, but that there is no easy solution because if I cut back on exercising then I'll inevitably gain weight which can also compound the problem.
His plan for us would be for me to undergo the HSG test first (this is the dye test that x-rays the uterus and fallopian tubes to determine if there are any blockages) which can't be done until 7 days after my last menstrual period (so likely it would be late March or early April). If that test turns out OK, then we would undergo Intrauterine Insemination (IUI) (remember the "turkey baster" method?). Any given couple has a 20% chance of getting pregnant during any cycle. He explained to me that given Jon's semen analysis results that our chances were about 10% (assuming that nothing else was wrong for either of us) so it's just going to take a little longer but at some point, we're going to hit the odds in our favor. The question is, when? IUI would help speed the process along. He wasn't able to quantify the success rate with IUI because it depends on the underlying issues that are preventing us from getting pregnant. He did ballpark it for me and said it would be about 20%, but higher or lower depending on our unique problems. We would undergo about 3 cycles of IUI (costing $2,000 a pop) and if that didn't work then he would want to pursue other interventions. My health insurance has a lifetime coverage of $8,000 for IUI and/or IVF. I have to meet my $2,000 deductible first.
He said that IUI with Clomid would have to be started on day 3 of my cycle and since I am unable to do the HSG test until day 7 of my cycle then we would not able to undergo IUI until my next cycle (approximately mid-April to May with actual IUI procedure being in early to mid-May). This delay is OK with me because Jon and I need to think about how much money we're willing to spend on something that other people get to do for free. If we were to do it there may be some stress on me because right now I'm set to ovulate and get my period while we're in Europe in a month and I need to be home by cycle day 3--right now we're pushing it, but we likely would make it home in time. Anyway, Jon meets with the urologist this coming Friday so I'm hoping at that time we have more answers to help us make this decision.
As for me, I've had a very nasty cycle. The reason I haven't posted in a month is because TTC has not been on my mind as much this cycle given what we know about Jon's sperm. Spotting typically shows up at 9 days past ovulation and today is 10 days past ovulation. This morning I woke up and still had no spotting so I took a pregnancy test. It was definitely a negative so I didn't even bother checking it past 5 minutes. Several hours later I saw it on the counter and stared intently at it for any sign of a faint second line and I thought I saw a very faint partial line. It was so faint that if you didn't stare at it for more than 5 seconds you would immediately assume it was negative. I brought it downstairs to show Jon and he agreed with me that he thought he saw something, but wasn't sure if his eyes were playing tricks on him. I'm so used to seeing negative pregnancy tests so to actually SEE something got me cautiously excited.
The directions clearly indicate that any results viewed after 15 minutes is deemed invalid. Yet I've heard stories from some that they pull their tests out of the garbage and find it is has turned positive. Some may call it an "evaporation line" so it's really hard to say without waiting and re-testing. I left the test sitting out and went out for the afternoon. Nine hours after I tested, I looked at it again and there was definitely a line. It was faint, but you could see it. I kept my reservations and decided that I just need to wait this out and test again in the morning if spotting still hasn't shown up. I started envisioning a baby in November, and being pregnant in Europe next month (which would be so exciting) and got carried away in these daydreams.
Unfortunately, a few hours later the spotting started. I'm devastated. It's a painful reminder that this apparently isn't going to be easy for us. As I sat there absorbing the unfortunate news, all I could think about was how unfair this is. When I look around in public all I see are parents with children and they all make it look so easy. For as long as I can remember, I was lead to believe that when I was ready to have a baby I would have control over the outcome. April will mark the 1 year anniversary of us officially TTC.
Onto cycle #11--here's to hoping I find out I'm pregnant while I'm in Europe!
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