A week of deciding

Monday: Ryan went to “watch the game” at a sportsbar, stayed for HOURS but didn’t eat or dink a thing. He came home late, raging with anger, frustration and stress over everything in life from his job to infertility to his desire to own a dog that he almost started crying.  We didn’t talk about our decision.

Tuesday: Ryan is calmer, and I show him the nice flowchart I’ve created of pros and cons for each of our options: move forward, seek 2nd opinion, or give up on IVF altogether and opt to live childfree or pursue adoption.  We both are beginning to see IVF as futile. I am leaning towards adopt, Ryan is leaning towards childfree.  I cry.

Wednesday:  I wake up with IVF on my heart.  Maybe we should throw the $15K down and take our chances, since adoption might be off the table due to Ryan’s tepid reaction. This might be my only shot at motherhood, biological or otherwise.  I email the doctor with questions about IVF/ ICSI success rates with abnormally formed sperm, and reach out to a couple other sources at Kaiser and ask their opinions, too.

Thursday: Dr. Mean responds with an honest stance.  (I’d like to post her email, but pretty sure that’s illegal.) She says YES some sperm with abnormal morphology, like headless or enlarged head, can produce healthy embryos and live births. Other abnormal forms of sperm DO NOT yield healthy embryos, even with ICSI.  There is no evidence the “bent neck” variety will work or not, but in her professional opinion she thinks it will not.  Dr. explained there is a major trend in medical research of underreporting negative study results.  She suspects the bent neck has probably been tried with ICSI in a clinical trial of sorts, the procedure was unsuccessful, and the experiment was scrapped without an official report written.

Kaiser got back to me, and no one there has ever heard of bent neck sperm.  They reassure me that with ICSI there are enough normal sperm just to do 1 per embryo, even with 0% normal morphology.  But Dr. Mean has made it clear Ryan is a special case: literally ALL of his 20-100 sperm have bent necks, further proof this results from some sort of birth defect, and it’s simply the way he’s made.

Friday: I start to listen to the writing on the wall.  I pray, although it’s hard to do.

Last Ditch Sperm Check

My phone rang just as I turned on the TV to watch some 90 Day Fiancé while stuffing a salad down my throat at lunch.  It was Ryan calling, not the doctor’s office, only Ryan told me he’d just gotten off the phone with Dr. Mean herself.

The prognosis: Ryan’s most recent sample looked a little better.  But upon very close examination they noticed the heads of Ryan’s sperm to be bent sideways, which causes them to swim in circles. The clinical term is actually “Bent Neck” or “Crooked Neck” sperm.  The doctor said Ryan most likely produces such swimmers because of a genetic mutation / congenital birth defect caused strictly by chance.

Ryan is truly one in a million, but of course I knew this already.

Dr. Mean has never seen this before.  She said she combed through medical research and studies and found nothing on Bent Neck Sperm.  If one of these guys were injected into one of my eggs via ICSI she has no idea if a healthy embryo will grow or if it will die immediately.  She’s seen studies where headless (!?!) sperm have been successful with ICSI, but nothing on bent neck.  The Dr. would not advise us one way or another if we should proceed, it is entirely up to us, totally experimental, and a $15,000 shot in the dark.

After hearing the rundown my first reaction was “Great! Do they want to pay for our procedure and conduct a clinical trial?” Ryan laughed and told me he’d already asked the Dr. that exact question, but the answer was no.

We both agreed that we had no immediate, initial leaning about what to do one way or another.  We will need some time to think and research.

According to my calendar we are supposed to be taking doxycycline for the next 5 days. Payment and signed forms are due a week from today, which is also when I am supposed to start Lupron.  I have the price list of drugs from the pharmacy order, although I haven’t bought them yet.  Nothing like being up against a deadline! Time to sleep on it.

Waiting for Bad News

Tomorrow Pearl will call with the results of Ryan’s most recent semen sample.  I’ll be at work, and am expecting bad news.  Fortunately, I’ve had time to prepare so hopefully I won’t cry at my desk or anything when I hear “I’m sorry, there has been no change since the last analysis, and IVF is not longer a medical possibility for your family.”

We still don’t know “what happened.”

The first few semen analyses Ryan got back in 2014, his count count was about 8-10 million, which is pretty low.  Morphology and motility also poor.

In the last 3 months Ryan has done a handful of semen analyses and his count has been about 10.  Not 10 million, but 10 sperm.  This is extremely low, and since motility and morphology aren’t looking good, healthy embryos are not likely.  The doctor’s natural question was “What happened between 2014 and now? Is Ryan taking any questionable men’s supplements, like testosterone or steroids?  Smoking a lot of marijuana?  What’s changed in the last year?”

The answer is nothing.  Ryan takes some multivitamins, he uses the steam room at the gym from time to time, and he could lose some weight, but none of this is new.  He’s never smoked cigarettes or marijuana, and drinks occasionally.  Why did his already low sperm count plummet to basically nothing?  None of us know.  We effectively missed our chance.

In all the research I’ve done and people I’ve talked to I’ve never heard of this: the man’s count being so low that the doctors won’t even try IVF, so I am curious to hear what the doctor says.  They stand to make a lot of money on us, and I understand the gravity of their diagnosis when they let us walk out the door without paying a dime for anything.

I’ve been coddling myself all weekend, lazing on the couch and watching movies.  Today is the last day where there is still a glimmer of hope, but life doesn’t feel very hopeful. Tomorrow the door may shut forever, and the end may come.  I know eventually I will be able to say “It is well with my soul,” but today I have a heavy heart.

When a Door Closes

Pearl called from the doctor’s office with unexpected news. Their specialist examined Ryan’s latest sperm sample not just for numbers, but quality, and quality was very poor.

She talked really fast, told me to hold off on purchasing any IVF prescriptions, and that Ryan will need to return in a few days for ANOTHER sample.

So I clarified: “Next week if Ryan produces another sample and nothing in the quality changes, does this mean we can’t do IVF?”

Pearl said cheerfully “Well you can still do IVF, but just with different sperm.”

I stopped listening after that.  Ryan called her back later and was instructed to follow a bizarre ejaculation protocol for another 5 days which might improve his sperm quality.  I’m not sure how 5 days will make any difference.  We emailed the doctor with some specific questions, namely, is it a physical or genetic issue?  Can Ryan try to improve things with diet and exercise and lifestyle, or is this a lost cause?

For now we have every reason to wait on the results of next week’s sample, and hear what the doctor has to say about our questions.  But I’m not getting my hopes up.  I am trying to look around and accept this strange landscape of no IVF and no other options as my new reality.

I’m aware this blog has been depressing, and I promise in real life I’m not such a downer.  It does not escape me that I prayed for this, I prayed many times for God to close the door, firmly, if IVF is not in His will for us.  I was not expecting such an abrupt ending, but I am trying to see the good. Perhaps being spared the costs, the physical toll, potential miscarriage and loss is for the best.

But these perks seem cheap in comparison to the loss of ever having a family. I don’t think i realized until now how deeply Motherhood is ingrained in my self worth. I suppose it’s cultural and the result of growing up in a big, family oriented household that taught raising children is the most important thing a person can do.  My life will be selfish, immature and stunted if I live out my years without ever experiencing the sacrifice of parenting.

Ryan and I cried it out the other night after talking with Pearl, and for the first time ever Ryan mentioned adoption.  This was news to me, since Ryan has been firmly uninterested in adoption from the beginning.  True, going through something like infertility can change a person.  But I’m trying not to dwell on this too much, get my hopes up about another avenue, because I know Ryan can change his mind.  And we still need to see what happens next week.

Still Waiting

On that awful Monday in the kitchen Ryan had the good sense to tell me “Don’t cancel anything. We haven’t paid any money, we haven’t signed any papers, so let’s just think about it.”

So days passed, and we talked.  Here is what we DO agree on:

  1. Scope: If we do IVF, it will happen once, not including frozen embryo transfers.  If there is an underwhelming harvest from the Egg Retrieval, no embryos make it to freeze and no pregnancy occurs, then we are done.  One valiant, exhausting, expensive try is enough for both of us.
  2. Money: We can afford this.  We might not have the cash in the bank, but we are a lot better off than most and can swing the financing.
  3. Timing: Now or never. “Wait 6 months, a year, take a break and see how we feel” is not an option. We are not getting any younger and don’t want to wait any longer.
  4. We need to reach an agreement about everything we don’t agree on before we proceed.

What we don’t agree on:

  1. Embryos are life.  I think they are, Ryan thinks they are not.  I discovered many agencies that would allow us to place any unused embryos for adoption by infertile couples, which in my mind is the perfect solution.  We won’t be forced into having 7 children and we won’t have to “destroy” those lives.  Ryan thinks it’s totally creepy.  I try to assure him we might not even have extra embryos, but he insists we “most likely” will.

Our signed consent forms and payment are due November 23rd.  We have a few more weeks to figure this out.

I like to think infertility will be the most distressing challenge I’ll ever have to tackle in my marriage.  These infertile years are truly refining our skills as a married couple.  Still, I can’t discount the fact that perhaps the birth control pills have had something to do with the emotional overload in these last couple weeks.  This is really my first time ever taking oral birth control, I’ve tried and promptly quit a few times over the years due to bleeding and nausea.  This brand, Levora, has been surprisingly benign.  I’d like to say there are no side affects at all.  However, Ryan and I are at the apex of infertility, and there have been a lot of tears in the last couple weeks.  Maybe our conversations would be easier to navigate if I wasn’t pumped full of hormones.  But maybe not.

The good news is I thrive under stress.  To relieve anxiety I’ve been running a lot, reading my bible and praying a ton, making to do lists and checking them off.  This, too, shall pass, and when it does I’ll have the physical and spiritual fortitude to endure the next phase.