The Other Side of Infertility
A few months ago, Gretch and I decided to become advocates for infertility awareness, especially when it comes to PCOS. We had been open about it before when people brought it up, but we wanted to be more forthcoming. It started with a lengthy blog post that received some wonderful, caring, and honest responses. Since then, we have learned that many friends and family members around the country have had similar struggles. Gretch and I are honest with others about what we've gone through, what we are going through, and what we will be going through. We share our successes and our disappointments, and we have become people to whom friends and family turn to ask for advice.
We honestly didn't expect the response that we received. We knew that some of the people we knew had had experiences with miscarriages, PCOS, and infertility, but we didn't realise the extent of it.
We also didn't fully realise what we were getting ourselves into when we decided to become advocates not only for ourselves, but also for all those who are going through the same thing. We've learned a lot in the past few months, and we are learning a lot more. One of the important lessons we have learned is that being an advocate for infertility awareness does not have to consume your entire life, but it will become a big part of what you do. Neither one of us wants infertility to define us but, at the same time, we aren't going to shy away from it or pretend it isn't a big deal. Which is why I'll be writing updates from time to time on the subject, but I'll also continue to update on other things going on in our lives.
Before I go on, I want to make a point, a disclaimer, and a notice: When talking about infertility, we are, of course, also talking about human sexual reproduction. For many people, reproduction is tied directly to human sexual intercourse. For couples with infertility, this is not always the case. We are one of those cases. Everything that follows is about reproduction, not intercourse. That being said, I will be sharing about medical procedures and using accurate terminology whenever possible. That means you are about to read about uteruses, menstruation, semen, sperm, and other such things. If you'd rather not, feel free to stop reading now. Just thought I'd give a heads-up.
So where are we now? Well, after Gretch had been treated for PCOS, sub-clinical hypothyroidism and a benign polyp, we were told that we were cleared for trying for a natural pregnancy. All of the hormone levels were where they were supposed to be and they said we should go for it. In order to try to provide as suitable an environment as possible, we tracked Gretch's basal body temperature (BBT) for a few months in order to best predict ovulation. She was prescribed prometrium, which is a progesterone hormone that is used to help the uterus do what it is supposed to do. One of the side-effects of prometrium is that it postpones the menstrual cycle, so we didn't know until they did blood-work that she was not pregnant. In fact, she had not even ovulated, at least, as far as they could tell.
Because we did not have a successful natural pregnancy, it was suggested that we consider what is known as an intra-uterine insemination, an IUI or, in layperson's terms, artificial insemination. This would require Gretch to go on a medication to stimulate follicle development which would lead to ovulation, then she would take another medication that would cause her to ovulate, and then they would use a catheter to insert semen into the uterus. This makes the entire fertilization process much more controlled and, usually, more successful. We were also informed that if the procedure did not work, for whatever reason, our insurance provider would cover the cost of in vitro fertilization (IVF) after the third failed IUI.
Around this time, one of the nurses with whom we had been working noticed that, with all this focus on Gretch, I had been largely overlooked. In other words, my side of the equation was not taken into account. And so it was suggested that I have a semen analysis done so they could see what was going on. And since they were going to do an IUI, they needed to know the quality of semen being produced.
Now, I am going to jump back about 13 years or so. When I was about 16 years old, my family doctor told me I had a varicocele, and that it may cause fertility issues later in my life. He never said another word to me about it, and I never had another doctor mention it.
After the first analysis, I got a very concerned phone call from our doctor's office. They wanted to know if there had been anything unusual in my health, diet, or if I had lost some of the sample. I answered in the negative. They were confused. You see, it turns out that several of the factors they examined were well below normal range: motility (speed and length of life), volume (total volume of the sample), and count (number of actual sperm cells in the sample). They were so low, in fact, that the nurse told me, in no uncertain terms, that Gretch should not have gotten pregnant once, let alone three times. She was convinced there was an error, and so I had another analysis done, and the results were even worse. I mentioned the varicocele my previous doctor had told me about and asked if that could have had any effect on the issue. She said it probably did, and I was immediately referred to a urologist who specialises in male infertility.
We decided to go ahead with an IUI. We knew going in that, because of the infertility issues on my side, the procedure had a high risk of failure. But we also found out that, again because of me, our doctor would petition the health insurance provider to waive the usual rules and approve us for IVF if the IUI did not work. The procedure was done in two parts over two days, since the timing of pregnancy is actually a very small window. From the time a follicle in the ovaries releases an egg to the time the egg reaches the uterus and starts to break down is very short. And when we add in the sperm motility factor, that decreases the window even more. The procedure was done, Gretch started taking the prometrium again, and then we waited. For two weeks.
We waited, we prayed, we fasted and prayed, and we waited some more. And then the news came. While waiting, I saw the urologist, he confirmed I had a varicocele, and then said that I'd need to have another semen analysis thirty days after the first in order to confirm that I am indeed infertile, and then I'd be able to move forward on having the varicocele repaired, which has a high chance of also repairing the infertility. I also learned that semen is produced in "classes" once every ninety days, hence the reason I have to wait. If two analyses are done too close to each other, there is a possibility that it was just a weak class. So my next appointment is in early August.
After waiting for two weeks, we finally got the results from Gretch's blood work: she was not pregnant. The IUI had not worked. We were disappointed but, knowing it was the likely result, we knew we just had to be patient and trust in the Lord. Throughout all of this, our faith has been steadfast. We firmly believe that we will have children in our family. It is simply a matter of when.
The day after getting the results, we got two letters in the mail, both from our health insurance company. The first, dated July 2, was a somewhat confusing mishmash of medical jargon that, among other things, told us that Dr. John Jarrett was our physician for continued infertility services and that services would be approved until May 2013.
For those who read our earlier post on PCOS, you may remember that our physician has been Dr. Nancy Fay. We knew of Dr. Jarrett, of course. He works primarily out of Indiana, but he also works part-time with Carle Physicians Group and performs IVF. (Dr. Fay is an OB-GYN who specialises in reproductive medicine, but she is not certified for IVF.
The second letter was apparently sent first. It was dated June 29. It was a letter informing us that Dr. Fay had referred us to Dr. Jarrett and that Health Alliance had approved us for IVF. This was super exciting news. Health Alliance had agreed to waive the requirement for two more IUIs and approved us to move forward in our treatment options, especially with in vitro fertilisation. We don't have an appointment with Dr. Jarrett scheduled yet, but we meet with Dr. Fay in a week or so and expect to know more at that point. In addition to discussing IVF, we will also be discussing the pros and cons of a laparoscopy for Gretch. While monitoring her follicle growth, it was discovered that Gretch's right fallopian tube was dilated. While in and of itself not a particular issue, there is a possibility that, in addition to everything else, she may have a form of endometriosis.
One final thought before I wrap up for today. It is estimated that female-only infertility accounts for 35-40% of infertility among couples. It is estimated that male-only infertility accounts for another 35-40%. The last 20-30% is from what is called combined infertility: cases in which both partners are infertile. We are part of that smaller class. I mentioned earlier that our doctors don't think Gretch should have gotten pregnant once, let alone three times due to our combination infertility. And yet, none of this would have happened without those three successive miscarriages. If Gretch had never gotten pregnant in the first place, we probably would not have thought to talk to a doctor about it. If she hadn't had three failed pregnancies, our doctor would not have thought to refer us to a specialist. And if we had never been referred to a specialist, we probably would have never learned about PCOS, sub-clinical hypothyroidism, and varicoceles. If none of that had happened, we would not have learned about the friends and family members who are experiencing these struggles, and we would not have been able to be a source of advice, counsel, and compassion. Am I happy that this has happened to us? Of course not. Infertility sucks and it really puts a lot of stress on us. But am I happy that, out of this miserable experience, we have been able to speak up and help others? Yes, very much so. All these things have been for our experience, and our experiences have been used for our good.
We honestly didn't expect the response that we received. We knew that some of the people we knew had had experiences with miscarriages, PCOS, and infertility, but we didn't realise the extent of it.
We also didn't fully realise what we were getting ourselves into when we decided to become advocates not only for ourselves, but also for all those who are going through the same thing. We've learned a lot in the past few months, and we are learning a lot more. One of the important lessons we have learned is that being an advocate for infertility awareness does not have to consume your entire life, but it will become a big part of what you do. Neither one of us wants infertility to define us but, at the same time, we aren't going to shy away from it or pretend it isn't a big deal. Which is why I'll be writing updates from time to time on the subject, but I'll also continue to update on other things going on in our lives.
Before I go on, I want to make a point, a disclaimer, and a notice: When talking about infertility, we are, of course, also talking about human sexual reproduction. For many people, reproduction is tied directly to human sexual intercourse. For couples with infertility, this is not always the case. We are one of those cases. Everything that follows is about reproduction, not intercourse. That being said, I will be sharing about medical procedures and using accurate terminology whenever possible. That means you are about to read about uteruses, menstruation, semen, sperm, and other such things. If you'd rather not, feel free to stop reading now. Just thought I'd give a heads-up.
So where are we now? Well, after Gretch had been treated for PCOS, sub-clinical hypothyroidism and a benign polyp, we were told that we were cleared for trying for a natural pregnancy. All of the hormone levels were where they were supposed to be and they said we should go for it. In order to try to provide as suitable an environment as possible, we tracked Gretch's basal body temperature (BBT) for a few months in order to best predict ovulation. She was prescribed prometrium, which is a progesterone hormone that is used to help the uterus do what it is supposed to do. One of the side-effects of prometrium is that it postpones the menstrual cycle, so we didn't know until they did blood-work that she was not pregnant. In fact, she had not even ovulated, at least, as far as they could tell.
Because we did not have a successful natural pregnancy, it was suggested that we consider what is known as an intra-uterine insemination, an IUI or, in layperson's terms, artificial insemination. This would require Gretch to go on a medication to stimulate follicle development which would lead to ovulation, then she would take another medication that would cause her to ovulate, and then they would use a catheter to insert semen into the uterus. This makes the entire fertilization process much more controlled and, usually, more successful. We were also informed that if the procedure did not work, for whatever reason, our insurance provider would cover the cost of in vitro fertilization (IVF) after the third failed IUI.
Around this time, one of the nurses with whom we had been working noticed that, with all this focus on Gretch, I had been largely overlooked. In other words, my side of the equation was not taken into account. And so it was suggested that I have a semen analysis done so they could see what was going on. And since they were going to do an IUI, they needed to know the quality of semen being produced.
Now, I am going to jump back about 13 years or so. When I was about 16 years old, my family doctor told me I had a varicocele, and that it may cause fertility issues later in my life. He never said another word to me about it, and I never had another doctor mention it.
After the first analysis, I got a very concerned phone call from our doctor's office. They wanted to know if there had been anything unusual in my health, diet, or if I had lost some of the sample. I answered in the negative. They were confused. You see, it turns out that several of the factors they examined were well below normal range: motility (speed and length of life), volume (total volume of the sample), and count (number of actual sperm cells in the sample). They were so low, in fact, that the nurse told me, in no uncertain terms, that Gretch should not have gotten pregnant once, let alone three times. She was convinced there was an error, and so I had another analysis done, and the results were even worse. I mentioned the varicocele my previous doctor had told me about and asked if that could have had any effect on the issue. She said it probably did, and I was immediately referred to a urologist who specialises in male infertility.
We decided to go ahead with an IUI. We knew going in that, because of the infertility issues on my side, the procedure had a high risk of failure. But we also found out that, again because of me, our doctor would petition the health insurance provider to waive the usual rules and approve us for IVF if the IUI did not work. The procedure was done in two parts over two days, since the timing of pregnancy is actually a very small window. From the time a follicle in the ovaries releases an egg to the time the egg reaches the uterus and starts to break down is very short. And when we add in the sperm motility factor, that decreases the window even more. The procedure was done, Gretch started taking the prometrium again, and then we waited. For two weeks.
We waited, we prayed, we fasted and prayed, and we waited some more. And then the news came. While waiting, I saw the urologist, he confirmed I had a varicocele, and then said that I'd need to have another semen analysis thirty days after the first in order to confirm that I am indeed infertile, and then I'd be able to move forward on having the varicocele repaired, which has a high chance of also repairing the infertility. I also learned that semen is produced in "classes" once every ninety days, hence the reason I have to wait. If two analyses are done too close to each other, there is a possibility that it was just a weak class. So my next appointment is in early August.
After waiting for two weeks, we finally got the results from Gretch's blood work: she was not pregnant. The IUI had not worked. We were disappointed but, knowing it was the likely result, we knew we just had to be patient and trust in the Lord. Throughout all of this, our faith has been steadfast. We firmly believe that we will have children in our family. It is simply a matter of when.
The day after getting the results, we got two letters in the mail, both from our health insurance company. The first, dated July 2, was a somewhat confusing mishmash of medical jargon that, among other things, told us that Dr. John Jarrett was our physician for continued infertility services and that services would be approved until May 2013.
For those who read our earlier post on PCOS, you may remember that our physician has been Dr. Nancy Fay. We knew of Dr. Jarrett, of course. He works primarily out of Indiana, but he also works part-time with Carle Physicians Group and performs IVF. (Dr. Fay is an OB-GYN who specialises in reproductive medicine, but she is not certified for IVF.
The second letter was apparently sent first. It was dated June 29. It was a letter informing us that Dr. Fay had referred us to Dr. Jarrett and that Health Alliance had approved us for IVF. This was super exciting news. Health Alliance had agreed to waive the requirement for two more IUIs and approved us to move forward in our treatment options, especially with in vitro fertilisation. We don't have an appointment with Dr. Jarrett scheduled yet, but we meet with Dr. Fay in a week or so and expect to know more at that point. In addition to discussing IVF, we will also be discussing the pros and cons of a laparoscopy for Gretch. While monitoring her follicle growth, it was discovered that Gretch's right fallopian tube was dilated. While in and of itself not a particular issue, there is a possibility that, in addition to everything else, she may have a form of endometriosis.
One final thought before I wrap up for today. It is estimated that female-only infertility accounts for 35-40% of infertility among couples. It is estimated that male-only infertility accounts for another 35-40%. The last 20-30% is from what is called combined infertility: cases in which both partners are infertile. We are part of that smaller class. I mentioned earlier that our doctors don't think Gretch should have gotten pregnant once, let alone three times due to our combination infertility. And yet, none of this would have happened without those three successive miscarriages. If Gretch had never gotten pregnant in the first place, we probably would not have thought to talk to a doctor about it. If she hadn't had three failed pregnancies, our doctor would not have thought to refer us to a specialist. And if we had never been referred to a specialist, we probably would have never learned about PCOS, sub-clinical hypothyroidism, and varicoceles. If none of that had happened, we would not have learned about the friends and family members who are experiencing these struggles, and we would not have been able to be a source of advice, counsel, and compassion. Am I happy that this has happened to us? Of course not. Infertility sucks and it really puts a lot of stress on us. But am I happy that, out of this miserable experience, we have been able to speak up and help others? Yes, very much so. All these things have been for our experience, and our experiences have been used for our good.
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