6 Vials

At our consultation, the RE confirmed what we thought - ICSI. He even told us that IUI, while cheaper, wouldn't be worth it to try before the ICSI. So we talked to the nurse about what to do and when, and we talked to the financial counselor about how much to pay, and I reminded myself all the while that even though I could start with my next cycle in two weeks, I didn't have to be so quick and it would be silly to impose a meaningless deadline on myself.

Turns out I don't listen to myself very well.

Last week, with the end of my cycle looming, I laid awake trying to figure out how I was going to get all of my ducks in a row before my next cycle. I furiously wrote notes and tried to come to terms with adjusting my spending habits and eating habits all in a week. And the deadline I told myself not to set was coming up, and I was so worried about missing it. I cried to C that I was nervous about missing the deadline even as I was annoyed at myself for setting it in the first place. It felt good to articulate what the problem was.

So then I slowed down, and filled out my Flexible Spending Plan application, and scheduled a day for myself to call Arc (a fertility financing company), and just let my next cycle come. And it felt much better, doing things at a normal pace and not stressing about making imaginary deadlines. This morning I called my primary doc about getting a prescription refill for blood pressure medication and was able to get in this afternoon. While I was with him I showed him my checklist of blood tests I needed pre-IVF, and he got the phlebotomist in right away and she took six vials of blood. We chatted while she did her thing, and I commented on how odd it sounded for my blood to hit the side of the vial - it sounded like dribbling.

Today is CD4, which means I have just under a month until we're starting this for real. And I feel good about it - the only time I really freaked out was the night before I filled out the FSA application. (The whole "use it or lose it" thing got me; it almost felt as big as the day we decided to start trying to conceive, long ago, only bigger since a decision like that doesn't usually cost $12,000.) Now I really feel ready!

Consultations, DI Ramblings

I called Oregon Health Sciences University, and Oregon Reproductive Medicine, last week to schedule consultations. Tomorrow at 9am is OHSU. I'm half hoping that I like OHSU well enough that I don't feel like I have to spend $350 just to talk to the doc at ORM. But we shall see.

C and I talked last night at length about donor insemination, and the pros and cons of that particular procedure. I think we basically came to the decision that we don't want to go that route unless there's no way I can get pregnant with C. It is so much cheaper to go the donor route, and that is very attractive to us right now; but we really want this baby to be a part of us both, enough that it's worth the extra money.

I hurriedly filled out the OHSU paperwork that assumes we're going to the doctor because *I* have a problem and not C, and scribbled some questions down from here. More tomorrow.

Palm Reading

So, I'm not a big believer of palm reading or anything like that, but I thought it'd be fun to go to one while I was in New Orleans for a business trip a couple of weeks ago. (The conference that I was working had a social one evening at Mardi Gras World; it included an amazing group of drummers, palm and tarot card readers, a couple of bands, and even fireworks.) I figured since it was free, I might as well try it, since if I ever had to pay for it I'd probably never do it.

After standing in line for an hour and a half or so...

The reader sat me down and hovered her hands over my palms, stroking the air, and asked "do you have any questions for me?"

"Tell me about babies!"
"Oh! You want them? When do you want them?"
"Oh, a year ago or so, heh."
"...Well, you don't have any barriers, you should be fine."
"That's true - it's not me, it's my husband."
"Ah, yes! So what are you doing about it so far?"
"We think that IVF is probably our only option..."
"I see that being successful once; but I see you having a few babies; it looks like all your husband really needs is a little help and then he'll be fine. And then you can have a whole baseball team if you want."

She also found ovals on my palms, which I guess represent something incredibly emotionally stressful and difficult that I've been protecting myself from; and that it happened a long time ago because I had the ovals on both hands. She told me that I'm very fertile (based on the striations of the crease between my pinkie and my hand) and that I'm frustrated about something in my marriage (based on a crease between my first and middle fingers of my right hand). She attributed that to the infertility too.

The rest of the night was kind of melancholy; just talking about it with a stranger felt kind of weird and sad, and renewed my disappointment that I was hundreds of miles from my husband during that cycle's fertile time. And though I still don't really believe that palm reading is truth, it was still worth my hour and a half wait just for the experience.

The Next Step

C completed his three months of Clomid, and on Friday he submitted another sample. The changes were negligible.

Today he had an appointment with his urologist, who shared the results and said "everything looks good except for motility." That was good news; I'd thought that the count and the morphology were crappy as well. So yay for that I guess.

C said that the urologist gave us the go-ahead to search out our own RE; he suggested OHSU and said that we don't need any referrals. I have a couple of options; I just need to do a bit more research. The urologist also said we might want to try artificial insemination first if we're worried about the cost of IVF; I'm not sure that'd be worth it if the sperm can't move but we'll see what the RE suggests.

We had small tentative conversations last night and today about the money issue, too. We took a hit this year in our taxes, and having a larger rent payment than the last place and having a car payment and that kind of thing is making C a bit worried that we're not going to be able to easily pay down another ten thousand dollar chunk of debt (that's more than half of our car). I worry about having the conversation "for real;" I'm always afraid in the back of my mind that he is going to decide it's not worth it to pay that much money just for the chance to get pregnant.

So in the meantime, I'll take another look at our RE options in Portland, and then once we visit them we can see if they can allay the fears about cost. I have confidence that ICSI will work, since as far as anyone can tell I have no fertility problems. But even though I feel good about moving onto the next step, actually being pregnant still feels so far off...

31

It was my birthday today. 31 is a little boring, especially on a busy Tuesday, but I enjoyed it anyway.

Month 1 of 3 for C's Clomid is about done. Patience is a virtue.

It was only a little bit hard today, reflecting on how fast my clock seems to be ticking. I feel worse for C, who will be 37 this year. I wished a few times today that we'd started trying earlier so we could have a lot of this behind us and not be looking forward to being "older parents", but of course hindsight is 20:20 and all that.

We Have a Diagnosis.

Well, sort of.

The urologist called C back last week, about his test results. "The blood tests came back fine - your testosterone levels are fine, etc. Your semen analysis, however, looks the same as the last one so we know it wasn't a fluke. However, I have no idea why you're having issues."

So the diagnosis is Unexplained Fertility, I guess. The urologist put him on Clomid, but with the caveat that it doesn't have a very good success rate. Besides the Clomid, he doesn't know what to prescribe.

So for three months while the Clomid tries to work, we will see if we can find a reproductive endocrinologist or a urologist with a background in fertility - and someone who is in our network - as this doctor isn't sure what else to do for C.

Urologist Debrief

The urologist visit was pretty straightforward. Urine test, quick physical exam for varicocele (varicose veins in the scrotum that can hinder fertility - C doesn't have them), and an order for another semen analysis and some blood work. I tell ya, it's rather odd to watch your husband making silly faces at you when he's getting squeezed on an exam table.

The urologist said that C's analysis was actually kind of unusual in that the count was OK but the motility and morphology were low. It's too early to tell what might be wrong but C will drop off his sample on Monday and we will get results soon after that.

So it's a step forward, which is encouraging, but if they're just going to treat C it'll still be a few months after they start that before we can expect to see any results. Patience is my new mantra.