I Heart My Doctor

Have I mentioned how much I love my Ob/Gyn?  She is such an awesome doctor.  After all of my frustrations about scheduling in the last post, I left a message for her to call me about the necessary IUI appointments.  I got a phone call from her nurse on Friday, saying that my doctor was on-call, but would get back to me as soon as she could.  The nurse then asked me some questions and wrote down the answers to relay to my doctor. 

My Ob/Gyn called me the next day, which was her day off and a Saturday.  We talked about hopefully getting everything set up for the IUI in January, and discussed what the RE had suggested.  She took the time to answer my questions and give me her advice over the phone, so that I wouldn’t have to pay OOP for consultation office visits all the time.  She told me that as long as there was room in her schedule and at the clinic, we’d be good to go for the IUI in January!

As of now, I’m still waiting on my Ob/Gyn to call me back with a definitive yes or no about the procedure.  If it’s a yes, she’ll call in my Clomid prescription to the pharmacy, so I can take it at the beginning of my January cycle.  Then, we’ll schedule the days for the ultrasound, sperm wash and IUI, then b/w. 

While I still want to be hopeful that maybe my husband and I can pull it off the old fashioned way in December, I’m so excited to be moving forward next month.  I can’t believe that in just a few weeks we could have a real shot at getting pregnant!        

Scheduling Frustrations

We haven’t even started a Clomid + IUI cycle, and I’m already frustrated about it.  Trying to schedule fertility procedures is a nightmare.  Obviously, everything is so cycle day (CD) specific. 

Since we’re paying out of pocket for everything, and we happen to have enough money in the bank to cover this procedure right now, we figured why wait?  We wanted to get it started sooner rather than later, since we’re aware that it can take multiple tries to be successful.  Plus, we’d rather know as soon as possible if IUIs won’t work for us, so that we can begin saving for IVF + ICSI. 

But, it just so happens that my next cycle will start at the beginning of January.  My doctor’s schedule and the clinic appointments are so hectic during the holidays, that it’s hard to get everything set up for the right days.  For everything to work out for a January IUI, I need to get my b/w redone sometime between December 31 and January 3, and I need the Clomid prescription ready for the beginning of my cycle around January 6.  Then, I need an ultrasound scheduled for somewhere between January 15 and 18.  Finally, I have to get the sperm wash and IUI procedure done around January 19 or 20.

*sigh*

I don’t have a lot of faith that everything is going to work out for January.  The good news is that February is when I’m due for my annual exam.  If I can tack on all my IUI questions, scheduling, and prep info onto that appointment, maybe I can get insurance to cover it.  Still hoping for a 2011 baby!

Time Out

I feel like TTC and our issues getting pregnant have taken over our lives (and my blog).  I know it’s something that I think and worry about most of the time.  My husband, on the other hand, is a typical guy in that if he doesn’t know how to fix it, he’d rather not dwell on it.  But, I know that he is just as frustrated as I am about our situation.

In light of the holidays though, and with Christmas upon us, I think it’s time to take a little time out and be grateful for the blessings we do have.  We may not have a baby of our own just yet, but we do have each other; and we have a lot of other things in our lives for which to be thankful, as well.

It’s also the season for miracles…so I keep hoping that maybe there’ll be one for us. 

Bank Account = Sad Face

Now that we have a plan, I feel much more in control.  I feel as if we’re working toward something again. 

Thanks to the lovely ladies on a message board that I frequent, I was not completely oblivious to the expenses involved in assisted reproductive technology (ART).  But, it still hits you hard when you hear the costs for the first time.

We’re hoping to do our first round of Clomid + IUI in January or February.  While my Ob/Gyn and local hospital are slightly cheaper than an RE clinic might be, here are the anticipated costs for EACH cycle:

Office visit:  $200

Bloodwork:  $100

Ultrasound:  $250

Sperm Wash:  $150

IUI:  $250

These are the costs without medications.  Clomid is inexpensive, but other medications such as injectables can be additional hundreds or even thousands of dollars.  And, we will pay OOP for everything.  Luckily for us, most places will negotiate a cash discount or payment plan.

So right now, we’re looking at $1000 per Clomid + IUI cycle.  I hope (as does my bank account) that the first time’s the charm! 

Decisions, Decisions

After talking with my husband and feeling really down for a few days, I had to snap out of my emotional breakdown.  Normally, I’m a pretty organized person, and I do well with a plan.  So, it was time to accept what was happening and make some decisions.

First, knowing that both of us were contributing to our reproductive problems, my husband decided not to take the suggested Clomid from his urologist.  Unlike the short duration that women take it, men take Clomid for months in order to have an effect on sperm production.  While there has been strong evidence that it increases sperm count (despite not being approved by the FDA for use in men), he just wasn’t prepared to deal with the side effects.  We’ve both agreed that it is still an option, and we may revisit it later.

Second, we’ve decided to start saving up for transferring to a reproductive endocrinologist (RE).  But, there are no REs in our town, and the closest one is actually in another state.  However, we’ve already been in contact with a fertility clinic from a nearby city and had a phone consultation to discuss a course of action.  The consensus from both my Ob/Gyn and the RE was that our best initial option is Clomid for me and intrauterine insemination (IUI).

At this point, we will be doing Clomid + IUI with my Ob/Gyn here in town.  It’s closer, easier, and less expensive that way.  If that combination does not work for us, we would move forward to injectable medication + IUI under the RE’s supervision.  After exhausting those methods, our last option would be in-vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI).

Who would have thought that it would be so difficult for us to have what comes so easily to others?     

Recap

Since I put a lot of information in my last few posts, I assume that most people would just skim through anything with that many paragraphs.  I know I would :). 

To sum up, my husband and I are reproductively broken.  We’re dealing with both male and female factor infertility.  Basically, during each cycle, IF my husband had enough sperm, and IF it was of high enough quality to successfully meet an egg, the egg would be defective.  And, IF for some reason the egg was mature and IF his sperm could fertilize it, then my short LP and suspected thin lining would hinder implantation.  Finally, IF by some miracle it did implant, my (then) untreated hypothyroidism would likely cause me to miscarry.  So, there you have it:  the reasons I have never been pregnant.

After finding out all of this while I was still at work, I was dreading going home.  I didn’t want to have to tell my husband that it was even more unlikely for us to have a baby without medical assistance.  How do you tell the one you love that the odds of getting pregnant naturally are practically non-existent?   

A Little More About Me

As I’m typing this, it occurred to me that I probably should have entitled it:  A Little More Than You Ever Wanted To Know About Me!

All joking aside, this blog entry is more difficult for me to write.  Not only is it strange for me to be publishing such personal information, but simply writing out these words makes them all the more real.  It’s not that I’ve necessarily been in denial about our TTC situation; it’s been more of a naïve fog.  Every month I’d get my hopes up that this would be the month I got pregnant, and then every month I’d be disappointed and upset when we weren’t successful. 

So, now that I’ve told you about my husband’s fertility issues and our history behind TTC, I guess it’s my turn.  My TTC issues pick up where my last blog left off:

After close to a year of TTC, incorporating numerous natural elements, and with a known male fertility issue, we knew it was time to get more help.  My husband and I made an appointment with his urologist to discuss what the next steps should be.  From that appointment, we learned two things:  1) that Clomid can be used in men, and was a suggested course of action for my husband’s sperm count; and 2) that when our insurance stated they did not cover anything infertility related, they meant it.  The office visit to my husband’s urologist, even as an established patient, was not covered by insurance because the purpose of the appointment was related to infertility.  So, we are now at the point where we are paying for literally everything out of pocket (OOP). 

Knowing this, we still needed to come up with a plan and to find out how much all the office visits, testing, blood work, monitoring, procedures, and specialists would cost.  So, I made an appointment with my Ob/Gyn to discuss these things, and figure out what we should do next.  We discussed our options and she gave her medical opinion, and then ordered blood work (b/w) for me on cycle day (CD) 21 or 7 days past ovulation (DPO).  I knew we were already dealing with MFI, and the b/w was more of a precaution before moving forward with additional treatment for my husband.

Except…it wasn’t just a precaution.  My doctor called me back a few days later with the results, while I was still at work.  They were definitely not what I was expecting.  Even before she said anything, I could tell by her tone of voice that she wouldn’t be telling me that everything was normal.  The b/w showed that I had more than likely ovulated, but my progesterone was too low.  My doctor said that this is indicative of “weak ovulation,” meaning that I’m releasing immature eggs that are not ready to be fertilized.  She was also concerned about my short luteal phase (LP), which was usually only 10 days long.  On top of all that, she said that my thyroid stimulating hormone (TSH) had been checked, and had come back too high.  A further diagnosis confirmed that I have Hashimoto’s (or auto-immune) hypothyroidism. 

I closed the door to my office...and then I cried. 

The TTC Journey

Now that you know a little more about my husband’s background, here’s a little more about our TTC journey: 

I went on birth control pills (BCPs) when I was 18, and I took them religiously for almost 8 years.  There was no way that I was going to have a child out of wedlock (no offense intended, just a personal decision), and I wouldn’t dream of bringing a child into an unstable relationship or financial situation.  When my husband and I were married in 2006, we discussed when would be the best time to start a family.  At 21 and 25 years old, we knew that we had time on our side. 

We decided that, before having a baby, we wanted to have time alone as a couple, and to spend time just being married.  We also wanted to own our own house and build up our savings account.  Along the way, we made a plan to pay down some remaining debt, too.  These things were important to us, and we wanted to accomplish them.  We knew that my husband’s fertility issues would make getting pregnant more difficult for us when the time came, but we just weren’t in a comfortable enough position to deal with any “surprises” before we were ready. 

Finally, after almost 4 years of marriage, we made the big decision to stop using BCPs and officially start TTC.  Knowing what we did about our chances of conceiving with my husband’s fertility issues, I immediately starting charting my basal body temperature (BBT) so that we could time intercourse and maximize the possibility of getting pregnant.  By charting, I was able to tell that I had fairly regular menstrual cycles, and I seemed to be reliably ovulating.  I also had already been taking a prenatal vitamin (PNV) for more than a year when we started TTC.    

 Within a few months of TTC, I had added more remedies to my routine.  I started taking pomegranate supplements to thicken my uterine lining, which can aid in the implantation of a fertilized egg.  It also became apparent that my luteal phase (the time after ovulation and before your period) was shorter than “normal.”  So, I began taking a B6 supplement to try to naturally lengthen it.  My husband and I also decided to only use a sperm friendly lubricant, Preseed.  In addition to the things that I had been doing to increase our odds of getting pregnant naturally, my husband started taking a vitamin called Fertility Blend for Men, as well as pomegranate supplements (studies have shown that it can improve sperm quality).  Recently, I also began drinking green tea to increase my fertile cervical mucus (CM), which I seemed to be lacking.     

After close to a year of TTC with my husband’s medical issues, well timed intercourse, incorporating all of these measures, and still not pregnant, it was time to speak with his urologist about the next step.      

A Little More About The Husband

If I didn’t bore you to tears already with my first biographical post, then you’re in luck…there’s more! :)

While the first post was more a general background on my husband and I as a couple, this one and the next two will focus more on our fertility history and our TTC issues.  Thrilling, right?  Well, each of our histories plays a big part in our plans to have a family, so I feel it’s worth sharing.  I also didn’t want to write a novel in this post, so I’ve broken it up into 3 parts:  one about the husband, one about the TTC journey, and one about me.  So here goes:

My husband has been fairly open about his health issues to his family and friends.  I tend to keep my health problems to myself.  So, most people don’t know our whole story, and how it has affected our decision to TTC. 

My husband was diagnosed with testicular cancer in 2004 that required surgery and treatment.  As a result of this, he has since been under the care of an urologist.  In 2005, he had his first semen analysis (S/A) done, and the results were not what we had expected.  In fact, they were devastating.  In 2005, my then fiancé and I had been engaged for only a year.  I was 20 years old, and he was 23.  We were too young to even be thinking about having children at that point.  And yet, it was then that we found out that he had severe male factor infertility (MFI).     

So, we knew that having a baby wasn’t going to come easily for us.  But, we also knew what was going on, and we were cautiously optimistic.  And, oh so hopeful.  Just to be sure, my husband had another S/A done after we had been married for about 3 years, in 2009.  The results improved dramatically, but still put us squarely in MFI territory.  It was better than severe MFI, though!  And then, in 2010, when we had finally decided to actively try to get pregnant, he had his third S/A done.  These results were very similar to those in 2009. 

With this knowledge, we were prepared for continued testing and necessary fertility treatment for my husband.  I felt bad for him, and for the extra effort and stress that would be required for us to achieve what we wanted:  a baby.  But, this was something that we had come to terms with together, and over the past six years, we had time to fully comprehend our situation.  And once more, through this all, we had hope…hope that maybe a miracle would happen, and it might be easier than we thought.

Figuratively Speaking

As I mentioned before, the name of my blog, Not Quite the Middle of Nowhere, is a literal translation of our current geographic situation.  But, it also has a more figurative interpretation, as all good names do.  Not quite the middle of nowhere can also be used to describe my life right now.  Well, maybe not exactly, but I am definitely feeling a little bewildered and confused…or just lost.

You know how everyone says that ignorance is bliss?  Those same people also say that knowledge is power.  If that’s true, then the more powerful I get, the more I feel that I’m losing control.  This has become especially true in our decision to begin trying to conceive (TTC).  The more information I learn about my body, fertility, and reproduction, the more I realize how little control I have over the process. 

Since you can’t have it both ways, which do you want:  happiness or power? 

Top Secret

You probably wouldn’t know it, but I’m a pretty private person.  Now, I realize that this sounds ludicrous considering that complete strangers are reading about my life on a public website.  But, I’m trying to be as anonymous as possible, if only to make myself feel a little more comfortable about sharing such personal information.  So, take that as you will.

This blog then, is not necessarily intended for close friends and family to keep up with our lives, although that may happen in the future.  For now, it is an external manifestation and creative outlet for the words and emotions that I can’t hold inside.  So many things have happened, or have been happening, that I’m unable to share with certain people.  Other things, I’d just prefer that no one knew about in “real life.”

So, if you’re reading this, you can count yourself as fortunate…or unfortunate, depending on how much I bore you with my incessant ramblings. :)  

A Brief Intro

I’m totally new to this whole blog thing, so go easy on me :). 

For right now, these are going to be anonymous posts since I’m not sure how much information I will be sharing or who might be reading it.  On that note, you can call me Fouette.  I live with my husband in a mostly obscure town in one of the square states.  It’s not quite the middle of nowhere, but it’s close…hence my blog name. 

The two of us have been trying our hardest to live our lives the right way, by making good decisions and following the rules.  My husband was in the military and I was in college when we met in 2003.  We became engaged soon after dating, but I was in no hurry to be married at such a young age.  I graduated with my B.A. in May of 2006, and we were married in June of that year.  In 2008, I went back to school to get my graduate degree at the same time that my husband decided to become a civilian and change careers.  He ended up graduating from the police academy the same month that we went under contract on our house.  We officially became homeowners that December. 

College?  Check.  Marriage? Check.  Grad school?  Check.  Buy a house?  Check.  Babies???

Which brings us to the present.  I’ve been working full time in addition to going to school, but I’m on track to graduate in May 2011.  My husband and I both have stable, well-paying jobs, and we’ve been working to reduce our debt while building our savings account.  With everything going so well and according to plan, it seemed only logical to begin taking the next step in our lives:  starting a family.  But it is at this point that we truly realized it doesn't matter how many right choices you make, or how hard you try:  life isn't fair.              

And this is where my blogging story begins…