Fourth and final bullet is "Dye Test" - this refers to the HSG dye test my wife had done at Dr. S's urging to check for fallopian tube blockage. There are two separate pieces of paper in our files from Dr. S's office. One states something like "Left tube fills and spills. Right tube fills, but does not spill." (apologies for not providing verbatim, but I don't have the file with me right now) The second states "Left tube fills and spills. Right tube fills, and subsequently spills." I remember reading these notes after the procedure was done, but I had no idea if it indicated a problem or not. Dr. S. told us there was no issue, as did the Doctors who conducted the procedure, so we figured we were good to go. Dr. M., however, was a bit confused by the contradicting messages in this documentation - he could only ascertain that there may have been some disagreement between the two people conducting the procedure, or that the procedure might not have been done correctly. Perhaps this is part of the problem in switching clinics - a lot of information is lost in translation. Either way, this seems to be another area, however slight, of less than optimal clarity into the details of our procedure with Dr. S. - as noted in my last post, this bullet is not such a big deal and I really don't think there is any blame to be placed - but the fact is, based on the documentation provided, Dr. M. is unable to tell definitively if my wife's tubes are clear or not. He will likely want to conduct this test again to be sure there is no issue (this is one of those tests that is not required if IVF is deemed necessary, but as stated in yesterday's comments, Dr. M. seems to be questioning whether or not we even have to do IVF, thus his likelihood to repeat this test)
This is all very unfortunate, as my wife said the dye test was incredibly painful. After leaving the actual procedure, she was very happy it was over - upon hearing Dr. M. state that we might have to repeat, she became afraid. One final thing on this dye test ... when we did the procedure IVF Michigan referred us to St. Joseph Hospital in Ypsilanti. The insurance my wife had at the time did not cover procedures out of St. Joe's - I understand there is another clinic that we could have been referred to that DOES accept my wife's insurance. It would have been very easy for the IVF Michigan staff to look at her insurance and refer us to a clinic that accepted it, but they did not do this. I guess it is our responsibility to check on these sorts of things, but we didn't learn about the insurance incompatibility issue until the day of the procedure. Given that there was ~1 month lead time to schedule this procedure, we decided just to go ahead and pay out of pocket. The grand total was just under $1,000 ... an expense that could have been avoided if we had done our homework and checked on the insurance accepted at St. Joe's, or even better, if the medical receptionists in IVF Michigan's Ann Arbor office would have taken 5 minutes to help us out. This is not the first time I've been burned by this - so shame on me I guess, but I'm still pissed at the receptionists for not helping us out on this one. I'll give them the benefit of the doubt and assume they are capable of more than answering phones and filing papers ...
All of these little oversights have instilled in me a deep sense of distrust for Doctors and medical receptionists. You can't be sure they will do anything for you ... no matter how much of a pain in the ass it is, or how irritating you might be to the medical receptionists for second guessing each of their moves, you always have to take matters into your own hands to ensure these things are done correctly or you will be stuck holding the bill for something that should have been covered by your insurance.
I'm off for the holidays - nothing new going on other than procreation in hopes of achieving a pregnancy via natural means (imagine that) ... hopes aren't high on this front, but it's worth a shot.
Wednesday, December 19, 2007
Tuesday, December 18, 2007
Bullets 2 & 3
Today I'll address bullets 2 and 3 from our discussion with Dr. M., contrasting his opinion with that of Dr. S. - it's sort of like a boxing match between two heavyweight fighters ... if they had a physical fight, my money's on S. (he's younger, and appears to be more agile ... and Dr. M's weak handshake may be correlated to a lack of overall physical strength)
Post Coital Test
Next bullet on the list of concerns from our discussion with Dr. M. is Post Coital testing. According to my shallow understanding, this procedure assesses my wife's cervical mucus to determine if it offers a hospitable medium for the migration of my sperm to her egg. Sometimes the cervical mucus kills the sperm, making it impossible for them to reach the egg alive, thereby mitigating the chances of pregnancy. This is a test we bypassed during our first round of IVF with Dr. S. If our first round had worked, we would have been none the wiser for bypassing this test. Given that IVF didn't work, however, we now have to retrace our footsteps picking up the missing piece of information we skipped the first time.
The test requires us to have intercourse (yes!), my wife to lay down for one hour (which will be hard because she will probably have to pee), and for her to go into the office the following morning. They will pull a sample of mucus from her cervix and observe it under a microscope to see if there are living, swimming sperm in it. If there are, this is a good sign and indicates there are no issues with her cervical mucus. If there are dead sperm, then we have a problem - I'm not sure what steps are required to get around it, but I would guess they are pretty straight forward.
No Pill In Following Month
This one really burns us up. In a previous post, I cited some comments from the OBGYN Doctor my mother-in-law works for on the topic of achieving pregnancy in the month following IVF. Dr. M. echoed these sentiments exactly in yesterday's meeting when he said that he has data showing an increased likelihood of pregnancy for infertile couples in the 3 months following IVF! Given that Dr. S. placed my wife on birth control immediately after our failed cycle, we completely missed the chance to cash in on this statistical opportunity! We could get into some discussion of incentives of infertility doctors and how they are somewhat misaligned with the goals of their patients, but I'll assume that these doctors operate ethically. Dr. M. recommended that my wife cease consumption of the birth control pill and that we get busy "trying" as our window of opportunity is not completely exhausted (although 2 of 3 months are gone) Again, Dr. S. and Dr. M. offer completely opposing assessments on this aspect of infertility!
So, there you have bullets 2 & 3 - the 4th and final bullet will be revealed tomorrow (it's nothing big, so don't expect a major revelation ...)
Post Coital Test
Next bullet on the list of concerns from our discussion with Dr. M. is Post Coital testing. According to my shallow understanding, this procedure assesses my wife's cervical mucus to determine if it offers a hospitable medium for the migration of my sperm to her egg. Sometimes the cervical mucus kills the sperm, making it impossible for them to reach the egg alive, thereby mitigating the chances of pregnancy. This is a test we bypassed during our first round of IVF with Dr. S. If our first round had worked, we would have been none the wiser for bypassing this test. Given that IVF didn't work, however, we now have to retrace our footsteps picking up the missing piece of information we skipped the first time.
The test requires us to have intercourse (yes!), my wife to lay down for one hour (which will be hard because she will probably have to pee), and for her to go into the office the following morning. They will pull a sample of mucus from her cervix and observe it under a microscope to see if there are living, swimming sperm in it. If there are, this is a good sign and indicates there are no issues with her cervical mucus. If there are dead sperm, then we have a problem - I'm not sure what steps are required to get around it, but I would guess they are pretty straight forward.
No Pill In Following Month
This one really burns us up. In a previous post, I cited some comments from the OBGYN Doctor my mother-in-law works for on the topic of achieving pregnancy in the month following IVF. Dr. M. echoed these sentiments exactly in yesterday's meeting when he said that he has data showing an increased likelihood of pregnancy for infertile couples in the 3 months following IVF! Given that Dr. S. placed my wife on birth control immediately after our failed cycle, we completely missed the chance to cash in on this statistical opportunity! We could get into some discussion of incentives of infertility doctors and how they are somewhat misaligned with the goals of their patients, but I'll assume that these doctors operate ethically. Dr. M. recommended that my wife cease consumption of the birth control pill and that we get busy "trying" as our window of opportunity is not completely exhausted (although 2 of 3 months are gone) Again, Dr. S. and Dr. M. offer completely opposing assessments on this aspect of infertility!
So, there you have bullets 2 & 3 - the 4th and final bullet will be revealed tomorrow (it's nothing big, so don't expect a major revelation ...)
Monday, December 17, 2007
And Now For Something Completely Different
A very fitting title for our meeting with Dr. Mthis morning on the topic of second opinions. Where to begin ... ah, let me consult the business card in my suit pocket upon which I jotted down a few key points of disagreement between Dr. M and Dr. S. - before diving in, a little background (just the facts):
We conducted our first, unsuccessful round with Dr. S. at IVF Michigan in October 2007. As a result of many frustrations with the process at IVF Michigan, the details of which I have only touched on in previous posts, we decided to seek a second opinion from Dr. M of Oakwood Hospital (the SART data shows Oakwood to be the second largest clinic in Southeast Michigan, by # of cycles, and it is in Dearborn, where my wife works) I dropped off our files with Dr. M a week prior to our meeting so he could see where we've been, and hopefully formulate a preliminary prognosis.
We were greeted by a pregnant medical receptionist, which was a double-edged sword: My wife wasn't pleased that this girl was pregnant (the sharper of the two edges), but there was the off chance that she became that way through the services of Dr. M (an unlikely scenario, but the more preferred of the two offered) We were escorted to Dr. M's office, down a hallway covered with baby photos, where we sat for about 15 minutes looking at some flip books of mis-shapen sperm and uterine maladies. Mis-shapen sperm, for those of you who don't know, look pretty messed up (two heads, two tails, big heads, small heads, pointy heads, etc.) Scary stuff ... makes you glad you're not an egg and that you don't have to deal with these monsters viciously swimming into your sides trying to penetrate your skin. Dr. M. greeted us with a very soft hand shake, almost as if to say "Hello. I'm a gentle man and intend to treat you as such through this difficult time." He took a seat across the desk from us and his assistant assumed a position next to him (a female Doctor, whose name I don't remember) He first asked us if we had any questions for him. What a nice start! Dr. S. always rambled on for a few minutes, before finally saying "Now I am open to answer any questions you might have." We told Dr. M that we primarily wanted to focus on our first procedure, his assessment of our files and how we might adjust course in round two. From here I will follow my bulleted list from the business card upon which I took notes - each bullet highlights a key difference between Dr. M's remarks and what was done at IVF Michigan by Dr. S. There are 4 bullets in total - I will elaborate on one bullet per day (assuming sufficient time to write, which shouldn't be a problem as it's the week before Christmas and productivity in the U.S. economy is as an all time low - an unsubstantiated theory)
"Sperm Morph + Volumes = No Problem!"
Dr. M. started by commenting on the fact that our files indicated a theme of male factor infertility, due to morphology issues. He then did some high-level math on a pad of paper using the sperm count + morphology formula to show that he had a different opinion of said diagnosis. Apparently my counts are very high (hell yeah!), but my morphology is poor ( ... ) When you combine my high sperm count with my low morphology, however, the net result is, according to Dr. M., a more than adequate amount of healthy sperm to achieve pregnancy. So, his opinion (based on data provided from 4 semen analyses) was that our issue is NOT with my sperm morphology. WTF?!?!? This is in direct contrast to the hypothesis upon which Dr. S. convinced us of the necessity to do ICSI! Dr. S. told us in convincing fashion that our problem was certainly due to morphology and that our best course of action would be to proceed with ICSI. So, here we have two Doctors in direct opposition to one another in their interpretations of a semen analysis report, which by my assessment, should be one of the more elementary pieces of information available to an infertility specialist. So, in a head-to-head comparison we felt more comfortable with Dr. M's diagnosis, but not because it is the preferred solution for my own male psyche but because the results of my semen analyses, in terms of providing a diagnosis for our inability to achieve pregnancy, are at best inconclusive - they don't tell you definitively that this is the single and only source of our problem, so therefore, IVF should not be recommended until further testing has been conducted.
Having started the meeting with Dr. M. on this note, my wife and I felt a slight sense of anger with Dr. S. (which would be the first of many during this meeting) but we also felt a sense of relief - we entered the meeting fully expecting to discuss our second round of ICSI, requiring the shifting of monetary funds, preparation for an emotionally charged start to 2008 and a great deal of angst throughout the holidays. That was not the case with Dr. M's ultimate diagnosis. In Dr. S's defense, we did have some further testing done during our first round of IVF, but the full suite of tests available to diagnose the root cause of infertility was not exhausted. This is essentially what Dr. M's final recommendation was - that we proceed through a methodical system of testing bypassed in round one to assess the true nature of our infertility issues. On this, I intend to elaborate in more detail during my remaining posts for this week with bullets 2 - 4.
We conducted our first, unsuccessful round with Dr. S. at IVF Michigan in October 2007. As a result of many frustrations with the process at IVF Michigan, the details of which I have only touched on in previous posts, we decided to seek a second opinion from Dr. M of Oakwood Hospital (the SART data shows Oakwood to be the second largest clinic in Southeast Michigan, by # of cycles, and it is in Dearborn, where my wife works) I dropped off our files with Dr. M a week prior to our meeting so he could see where we've been, and hopefully formulate a preliminary prognosis.
We were greeted by a pregnant medical receptionist, which was a double-edged sword: My wife wasn't pleased that this girl was pregnant (the sharper of the two edges), but there was the off chance that she became that way through the services of Dr. M (an unlikely scenario, but the more preferred of the two offered) We were escorted to Dr. M's office, down a hallway covered with baby photos, where we sat for about 15 minutes looking at some flip books of mis-shapen sperm and uterine maladies. Mis-shapen sperm, for those of you who don't know, look pretty messed up (two heads, two tails, big heads, small heads, pointy heads, etc.) Scary stuff ... makes you glad you're not an egg and that you don't have to deal with these monsters viciously swimming into your sides trying to penetrate your skin. Dr. M. greeted us with a very soft hand shake, almost as if to say "Hello. I'm a gentle man and intend to treat you as such through this difficult time." He took a seat across the desk from us and his assistant assumed a position next to him (a female Doctor, whose name I don't remember) He first asked us if we had any questions for him. What a nice start! Dr. S. always rambled on for a few minutes, before finally saying "Now I am open to answer any questions you might have." We told Dr. M that we primarily wanted to focus on our first procedure, his assessment of our files and how we might adjust course in round two. From here I will follow my bulleted list from the business card upon which I took notes - each bullet highlights a key difference between Dr. M's remarks and what was done at IVF Michigan by Dr. S. There are 4 bullets in total - I will elaborate on one bullet per day (assuming sufficient time to write, which shouldn't be a problem as it's the week before Christmas and productivity in the U.S. economy is as an all time low - an unsubstantiated theory)
"Sperm Morph + Volumes = No Problem!"
Dr. M. started by commenting on the fact that our files indicated a theme of male factor infertility, due to morphology issues. He then did some high-level math on a pad of paper using the sperm count + morphology formula to show that he had a different opinion of said diagnosis. Apparently my counts are very high (hell yeah!), but my morphology is poor ( ... ) When you combine my high sperm count with my low morphology, however, the net result is, according to Dr. M., a more than adequate amount of healthy sperm to achieve pregnancy. So, his opinion (based on data provided from 4 semen analyses) was that our issue is NOT with my sperm morphology. WTF?!?!? This is in direct contrast to the hypothesis upon which Dr. S. convinced us of the necessity to do ICSI! Dr. S. told us in convincing fashion that our problem was certainly due to morphology and that our best course of action would be to proceed with ICSI. So, here we have two Doctors in direct opposition to one another in their interpretations of a semen analysis report, which by my assessment, should be one of the more elementary pieces of information available to an infertility specialist. So, in a head-to-head comparison we felt more comfortable with Dr. M's diagnosis, but not because it is the preferred solution for my own male psyche but because the results of my semen analyses, in terms of providing a diagnosis for our inability to achieve pregnancy, are at best inconclusive - they don't tell you definitively that this is the single and only source of our problem, so therefore, IVF should not be recommended until further testing has been conducted.
Having started the meeting with Dr. M. on this note, my wife and I felt a slight sense of anger with Dr. S. (which would be the first of many during this meeting) but we also felt a sense of relief - we entered the meeting fully expecting to discuss our second round of ICSI, requiring the shifting of monetary funds, preparation for an emotionally charged start to 2008 and a great deal of angst throughout the holidays. That was not the case with Dr. M's ultimate diagnosis. In Dr. S's defense, we did have some further testing done during our first round of IVF, but the full suite of tests available to diagnose the root cause of infertility was not exhausted. This is essentially what Dr. M's final recommendation was - that we proceed through a methodical system of testing bypassed in round one to assess the true nature of our infertility issues. On this, I intend to elaborate in more detail during my remaining posts for this week with bullets 2 - 4.
Friday, December 14, 2007
My (wife's) Period
My wife is having her period - thought you'd like to know that. I'm going to try blogging about it. I wonder how many blogs are written on the topic of periods ... written by guys.
What's weird is, she says she's particularly uncomfortable this month, and that there are a lot of "fleshy clumps" (nasty) ... this prompts a lot of thought. Perhaps the increased pain is due to the hearty uterine wall she built up in preparation for an implanted embryo (or two), and getting it out of there requires more wrenching of the uterus. The procedure failed two months ago, and she went on the pill right afterwards, so her last period was sort of screwed up. Maybe the purge was delayed by one month? Who knows ...
What if she was really pregnant and the tests didn't detect it and this is just a miscarriage? I doubt it, but wanted to say it anyways because I'm sure those of you who read this and have experienced something similar have thought the same thing.
In our next round we're going to ask the Doctor excruciatingly detailed questions about every phase of the process. In round one we often left our Doctor's office more confused than when we arrived - not good. This was probably 80% our fault, for not asking the right questions, but come on, we're human ... we don't always think of what to ask when we're sitting in front of a visibly busy, rushed Doctor. So, this time I've got to learn about my wife's period, amongst other things, so I can push the line of questioning with our Doctor until we feel comfortable and educated.
All's I know is my wife is very uncomfortable today, she's home from work with our puppy, who is probably peeing on the bed while biting her. Somehow I have to remember to get flowers on the way home.
See you next week.
What's weird is, she says she's particularly uncomfortable this month, and that there are a lot of "fleshy clumps" (nasty) ... this prompts a lot of thought. Perhaps the increased pain is due to the hearty uterine wall she built up in preparation for an implanted embryo (or two), and getting it out of there requires more wrenching of the uterus. The procedure failed two months ago, and she went on the pill right afterwards, so her last period was sort of screwed up. Maybe the purge was delayed by one month? Who knows ...
What if she was really pregnant and the tests didn't detect it and this is just a miscarriage? I doubt it, but wanted to say it anyways because I'm sure those of you who read this and have experienced something similar have thought the same thing.
In our next round we're going to ask the Doctor excruciatingly detailed questions about every phase of the process. In round one we often left our Doctor's office more confused than when we arrived - not good. This was probably 80% our fault, for not asking the right questions, but come on, we're human ... we don't always think of what to ask when we're sitting in front of a visibly busy, rushed Doctor. So, this time I've got to learn about my wife's period, amongst other things, so I can push the line of questioning with our Doctor until we feel comfortable and educated.
All's I know is my wife is very uncomfortable today, she's home from work with our puppy, who is probably peeing on the bed while biting her. Somehow I have to remember to get flowers on the way home.
See you next week.
Thursday, December 13, 2007
Stocking Stuffers
My wife can't figure out what to get me for Christmas, and I really can't give her any ideas since I already have everything I need or want. So, let's brainstorm ... and you IVF girls can probably use some of this for ideas for your husbands.
An ideally packed stocking, in my world, would contain:
-Kodiak (that's chewing tobacco for those of you not in the know)
-Scotch (Obon, or a $50 - $100 bottle of anything else)
-Cigars (I don't smoke them because of my asthma, but I wish
-Snickers (arguably the best candy bar in production)
-Gum (just to fill space, and to repair damage from Kodiak and Scotch)
-Rubik's cube? (I just got one of these, but have enjoyed it immensely ... I'm sure a lot of other guys would too)
-Nerf dart gun (to shoot dog with)
-Nerf basketball hoop (no wife would allow their husband to put one of these up in the house, but it would be cool if they did)
-Tickets to MSU basketball game (or alma mater of your choice)
-One free pass to drop husband and his brother off at the bar, and pick up at closing time without commenting on stupid comments or scent of husband and brother, while promising to laugh at jokes
-Nintendo Wii (these are impossible to find, and might make a tight fit in a stocking, but I want one ...)
-Nintendo DS Lite (all guys should have one of these as there are a ton of old school games available for it ... and if they're embarrassed to say it, shame on them)
That's all I can think of ... apologies to my wife for a lack of ideas, but I'm sure she'll come up with something good - she always does.
An ideally packed stocking, in my world, would contain:
-Kodiak (that's chewing tobacco for those of you not in the know)
-Scotch (Obon, or a $50 - $100 bottle of anything else)
-Cigars (I don't smoke them because of my asthma, but I wish
-Snickers (arguably the best candy bar in production)
-Gum (just to fill space, and to repair damage from Kodiak and Scotch)
-Rubik's cube? (I just got one of these, but have enjoyed it immensely ... I'm sure a lot of other guys would too)
-Nerf dart gun (to shoot dog with)
-Nerf basketball hoop (no wife would allow their husband to put one of these up in the house, but it would be cool if they did)
-Tickets to MSU basketball game (or alma mater of your choice)
-One free pass to drop husband and his brother off at the bar, and pick up at closing time without commenting on stupid comments or scent of husband and brother, while promising to laugh at jokes
-Nintendo Wii (these are impossible to find, and might make a tight fit in a stocking, but I want one ...)
-Nintendo DS Lite (all guys should have one of these as there are a ton of old school games available for it ... and if they're embarrassed to say it, shame on them)
That's all I can think of ... apologies to my wife for a lack of ideas, but I'm sure she'll come up with something good - she always does.
Tuesday, December 11, 2007
Opportunity Costs
Our first round of IVF cost us about $12,000. For us, that is a lot of money. Considering that most couples can achieve a pregnancy for free, this makes for 12,000 painful reminders of the situation we are in. It's hard not to wonder what might have been ... instead of IVF you could afford to buy (revealing some interests of my wife and I along the way):
-$121,000 after 30 years (assumes 8% annual return on investment)
-3 7-day trips for two to all-inclusive Jamaican resort
-5 Precor Treadmills
-1/3 of a BMW 3-series
-1/3 annual tuition to top business school
-1/4 to 1 child via adoption (depending on cost of adoption, country, etc.)
-One hell of a shopping spree for my wife
-40 Cairn Terrier puppies
-Sell your house for even bigger loss
-2 sets of stainless steel kitchen appliances (fridge, stove, dishwasher)
-Two rooms of Pottery Barn furniture
-5 50" High Definition plasma televisions
-12 Nintendo Wiis
-6 iMacs
I'm using my year end bonus and some of our savings to cover round 2, but to make up the difference we are making a number of other sacrifices. For starters we are going to defer purchase of new vehicles. I'm driving a 2001 Ford Explorer Sport, and my wife a 2004 Dodge Stratus. Both are decent vehicles that run well, but mine has over 100k miles on it and my wife's is pushing 40k. We could theoretically make it another 5 years before there is a need to purchase a new car. It would be nice to get something newer now, but we have financial realities to deal with.
We're continuing to max out our 401(k) and Roth IRAs. This slows down our rate of savings for other things, but in my book, these are absolutely essential investments that everyone should be making before anything else. Besides, we're young - we need to take advantage of these investments and the time we have between now and retirement to accrue some wealth ... and the fact that we are young gives us the privilege of time in achieving a pregnancy. The credit crunch, imploding housing market and (likely) impending recession are enough of a scare in the short run - I hate to think about those who are opting out of their 401(k) plans and foregoing all retirement savings in favor of covering short term expenditures, or to dig themselves out of the piles of debt they are in. You think things are bad now? Wait until all of these people who have opted out of retirement savings and have screwed themselves by taking on more debt than they can afford reach retirement and have nothing to fund their lifestyles ... there's another word that ends in "ession" that may be dusted off at that point in time. I hope to be living comfortably with my wife and child(ren) if / when that happens. Nothing elaborate ... just comfortable.
We're still Christmas shopping and trying to be generous in that regard - we have been blessed with great families, and want to ensure that we sacrifice nothing with them as they have been incredibly supportive throughout this process of infertility. I must say, however, that the expense of x-mas is a bit painful to endure, but we're looking forward to a nice Christmas with the families.
One week until we meet with Dr. M.
-$121,000 after 30 years (assumes 8% annual return on investment)
-3 7-day trips for two to all-inclusive Jamaican resort
-5 Precor Treadmills
-1/3 of a BMW 3-series
-1/3 annual tuition to top business school
-1/4 to 1 child via adoption (depending on cost of adoption, country, etc.)
-One hell of a shopping spree for my wife
-40 Cairn Terrier puppies
-Sell your house for even bigger loss
-2 sets of stainless steel kitchen appliances (fridge, stove, dishwasher)
-Two rooms of Pottery Barn furniture
-5 50" High Definition plasma televisions
-12 Nintendo Wiis
-6 iMacs
I'm using my year end bonus and some of our savings to cover round 2, but to make up the difference we are making a number of other sacrifices. For starters we are going to defer purchase of new vehicles. I'm driving a 2001 Ford Explorer Sport, and my wife a 2004 Dodge Stratus. Both are decent vehicles that run well, but mine has over 100k miles on it and my wife's is pushing 40k. We could theoretically make it another 5 years before there is a need to purchase a new car. It would be nice to get something newer now, but we have financial realities to deal with.
We're continuing to max out our 401(k) and Roth IRAs. This slows down our rate of savings for other things, but in my book, these are absolutely essential investments that everyone should be making before anything else. Besides, we're young - we need to take advantage of these investments and the time we have between now and retirement to accrue some wealth ... and the fact that we are young gives us the privilege of time in achieving a pregnancy. The credit crunch, imploding housing market and (likely) impending recession are enough of a scare in the short run - I hate to think about those who are opting out of their 401(k) plans and foregoing all retirement savings in favor of covering short term expenditures, or to dig themselves out of the piles of debt they are in. You think things are bad now? Wait until all of these people who have opted out of retirement savings and have screwed themselves by taking on more debt than they can afford reach retirement and have nothing to fund their lifestyles ... there's another word that ends in "ession" that may be dusted off at that point in time. I hope to be living comfortably with my wife and child(ren) if / when that happens. Nothing elaborate ... just comfortable.
We're still Christmas shopping and trying to be generous in that regard - we have been blessed with great families, and want to ensure that we sacrifice nothing with them as they have been incredibly supportive throughout this process of infertility. I must say, however, that the expense of x-mas is a bit painful to endure, but we're looking forward to a nice Christmas with the families.
One week until we meet with Dr. M.
Monday, December 10, 2007
No Bid ...
Had a second showing on our house on Saturday - naturally, lots of excitement ensued. Just found out they put a bid on another house ... bummer ...
Friday, December 7, 2007
Title Change
I just changed the title of this blog to "IVF - A Husband's Perspective" from "IVF - A Husband's In Vitro Perspective"
The original title was no attempt at being cute or anything like that ... it was sort of an oversight (I always intended to remove the "In Vitro" part, but never actually got around to it until today) The phrase "In Vitro" is Latin for "In Glass", and implies that something happens in an artificial environment. This whole process is, by my estimation, as close to an artificial environment as I've been in my life ... the whole thing is just so completely bizarre and surreal that there's no better way to describe it. Perhaps my original title was a worthy one ... but the words would've needed to be moved around because as it was, it was confusing and stupid. I'm going to leave it as you see it above from here on out - I've always been a believer in simple messages and efficient solutions ... my new title, in my opinion, is just that: Simple and to the point.
Anyhow, that's all for now. Enjoy the weekend.
The original title was no attempt at being cute or anything like that ... it was sort of an oversight (I always intended to remove the "In Vitro" part, but never actually got around to it until today) The phrase "In Vitro" is Latin for "In Glass", and implies that something happens in an artificial environment. This whole process is, by my estimation, as close to an artificial environment as I've been in my life ... the whole thing is just so completely bizarre and surreal that there's no better way to describe it. Perhaps my original title was a worthy one ... but the words would've needed to be moved around because as it was, it was confusing and stupid. I'm going to leave it as you see it above from here on out - I've always been a believer in simple messages and efficient solutions ... my new title, in my opinion, is just that: Simple and to the point.
Anyhow, that's all for now. Enjoy the weekend.
In the garage ...
There is a bag on the workbench in our garage that contains a t-shirt. The t-shirt says "America's Next Top Mommy" The bag is a shipping bag and it sits exactly where it landed after being tossed by my wife the day we learned our first round of IVF had failed. Not sure if I'll ever move that bag for any reason other than changing oil in the car.
On an unrelated note, I'm starting to think about new years resolutions and our second round of IVF and how I might optimize my reforms by taking advantage of the overlapping objectives of each endeavor. These thoughts were prompted by another IVF blog from the male perspective in which the author described his Doctor's orders to abstain completely from caffeine, and limit alcohol intake to less than 2 drinks per week. Now, this conflicts with what we were told by Dr. S.- I asked about both substances, and how I should impede my enjoyment of them during the build up to our first round. He very casually replied that it would be okay to have a few drinks each week, so long as I didn't over do it (didn't specify "not to exceed" volume) and he actually encouraged me to drink caffeine, saying it was good for sperm (according to some study they did) My issue is with morphology, not counts or motility - perhaps this is why he didn't discourage me to partake of the substances (perhaps they have no detrimental effect on shape?) Either way, it was all very casual and ad hoc, leaving me with the feeling that the quantity of these two inputs would have little effect on the outcome of our procedure. So, I commenced with partaking in drink, but not to the point of excess. I did, however, drink a lot of coffee as the 12 hour days require it ... I'm still drinking a Venti coffee each morning and a double shot of espresso in the afternoons. If I need to quit this stuff, I need to do it soon so I can detox my system prior to leaving my sample for round 2. Perhaps I should just do it anyways, prior to receiving word from the Doctor?
Either way, I'm hoping that our next round includes some specific directions on how much (not) to drink, whether or not to drink caffeine, any vitamins I should or should not take, etc. Even if the Doctors don't have an indication on specific volumetric measurements that should be undercut, I would still like absolute, crystal clear direction from them on every variable that could impact our chances at achieving pregnancy. If they prescribe our lifestyle in such a way, at will at least be able to take solace in the fact that I have controlled those things that I could to the best of my ability.
Nothing on tap for the weekend other than a bottle of wine with my wife tonight over dinner - I can't wait ... feels like we haven't spent any time together in several weeks. I miss her very much.
On an unrelated note, I'm starting to think about new years resolutions and our second round of IVF and how I might optimize my reforms by taking advantage of the overlapping objectives of each endeavor. These thoughts were prompted by another IVF blog from the male perspective in which the author described his Doctor's orders to abstain completely from caffeine, and limit alcohol intake to less than 2 drinks per week. Now, this conflicts with what we were told by Dr. S.- I asked about both substances, and how I should impede my enjoyment of them during the build up to our first round. He very casually replied that it would be okay to have a few drinks each week, so long as I didn't over do it (didn't specify "not to exceed" volume) and he actually encouraged me to drink caffeine, saying it was good for sperm (according to some study they did) My issue is with morphology, not counts or motility - perhaps this is why he didn't discourage me to partake of the substances (perhaps they have no detrimental effect on shape?) Either way, it was all very casual and ad hoc, leaving me with the feeling that the quantity of these two inputs would have little effect on the outcome of our procedure. So, I commenced with partaking in drink, but not to the point of excess. I did, however, drink a lot of coffee as the 12 hour days require it ... I'm still drinking a Venti coffee each morning and a double shot of espresso in the afternoons. If I need to quit this stuff, I need to do it soon so I can detox my system prior to leaving my sample for round 2. Perhaps I should just do it anyways, prior to receiving word from the Doctor?
Either way, I'm hoping that our next round includes some specific directions on how much (not) to drink, whether or not to drink caffeine, any vitamins I should or should not take, etc. Even if the Doctors don't have an indication on specific volumetric measurements that should be undercut, I would still like absolute, crystal clear direction from them on every variable that could impact our chances at achieving pregnancy. If they prescribe our lifestyle in such a way, at will at least be able to take solace in the fact that I have controlled those things that I could to the best of my ability.
Nothing on tap for the weekend other than a bottle of wine with my wife tonight over dinner - I can't wait ... feels like we haven't spent any time together in several weeks. I miss her very much.
Thursday, December 6, 2007
My Turn
Tonight is my wife's work party ... I was supposed to go, but we got a call today for a showing on our house tomorrow morning, so now I'll spend the night cleaning and prepping our home (perhaps we'll get a bid?) As noted in an earlier post, our home is on the market, and the activity has been very slow. Each of the showings we've had to date has brought with it a great deal of optimism, excitement and teasing hopes that we might actually sell our house and move up North. So, this is our first showing in over 3 weeks ... we have to make it count, so I get to clean.
My wife and I used to wake up on Saturday mornings, drink coffee and spend about 2 hours in an all out joint cleaning effort prior to going about our days. My job was to dust, vacuum, wipe down stainless steel appliances, swiffer and organize while my wife cleaned bathrooms, put away laundry, cleaned the kitchen and whatever other tasks remained. This was a great system - my wife and I both appreciate a clean house, and neither of us really mind cleaning all that much, so this was a fairly enjoyable routine. That all changed when we got our puppy. Since my wife will be at her work party I will assume full responsibility for prepping our home for tomorrow's showing. I'm already nervous about how I'm going to get all of this cleaning done tonight while simultaneously watching our puppy ... anyhow, this prompts some thoughts on puppy rearing vs. child rearing.
Our puppy demands 100% of our attention ... look away for more than 10 seconds and he'll start chewing on cords, eating the Christmas tree or biting your feet. Then you have to bring him outside every 20 minutes so he can do his business (we estimate we brought him outside over 40 times last Sunday) He cries at night, and we have to bring him outside every 4 hours or he'll make a mess in his crate (and eat the evidence) This is all a lot of work, but it is very much worth it when he falls asleep on your lap, or tries to sleep as close to you as he can. He's a cute little guy, especially when he's sleeping, is very affectionate and very dependent on us for everything. Most importantly, he has diverted our attention from infertility to something else ... and he makes us laugh.
A baby, by my estimation, would require a similar amount of work ... I would even guess that it would be LESS work, at first. A baby sleeps more, can be left alone in a swing or baby seat for a few minutes here and there, does its business in the house (in its clothes), goes to bed early and doesn't bite. Either way, this puppy has opened our eyes just a little to how our lives will change when our parenting days begin. If we had not failed our first IVF cycle, we would not have gotten this puppy ... I shudder to think that Cooper might have ended up with some Amish family, forced to pull a plow through fields, or churn butter all day. Perhaps we needed the primer on parenting offered by puppy rearing prior to getting into the game of parenting human children. I've always heard people say that your priorities change the second you become a parent. I'm attached to my little puppy, but nowhere near what I will be to the baby we will one day have (our own, or adopted), but I can say my priorities have changed a little bit ... that small amount of attachment between me and the dog, however, has been insightful into what I expect the world of parenting to be like.
Anyways, if there are pools of blood lying around on this blog tomorrow, please don't be alarmed - it will likely be falling out of the holes Cooper will put in my body tonight while I clean. Hopefully these people will buy our house ... we need a break, and a bid would be a very welcomed one.
FYI - Prior to owning a dog I would have read this and said: Bullshit ... I feel a little differently about things now.
My wife and I used to wake up on Saturday mornings, drink coffee and spend about 2 hours in an all out joint cleaning effort prior to going about our days. My job was to dust, vacuum, wipe down stainless steel appliances, swiffer and organize while my wife cleaned bathrooms, put away laundry, cleaned the kitchen and whatever other tasks remained. This was a great system - my wife and I both appreciate a clean house, and neither of us really mind cleaning all that much, so this was a fairly enjoyable routine. That all changed when we got our puppy. Since my wife will be at her work party I will assume full responsibility for prepping our home for tomorrow's showing. I'm already nervous about how I'm going to get all of this cleaning done tonight while simultaneously watching our puppy ... anyhow, this prompts some thoughts on puppy rearing vs. child rearing.
Our puppy demands 100% of our attention ... look away for more than 10 seconds and he'll start chewing on cords, eating the Christmas tree or biting your feet. Then you have to bring him outside every 20 minutes so he can do his business (we estimate we brought him outside over 40 times last Sunday) He cries at night, and we have to bring him outside every 4 hours or he'll make a mess in his crate (and eat the evidence) This is all a lot of work, but it is very much worth it when he falls asleep on your lap, or tries to sleep as close to you as he can. He's a cute little guy, especially when he's sleeping, is very affectionate and very dependent on us for everything. Most importantly, he has diverted our attention from infertility to something else ... and he makes us laugh.
A baby, by my estimation, would require a similar amount of work ... I would even guess that it would be LESS work, at first. A baby sleeps more, can be left alone in a swing or baby seat for a few minutes here and there, does its business in the house (in its clothes), goes to bed early and doesn't bite. Either way, this puppy has opened our eyes just a little to how our lives will change when our parenting days begin. If we had not failed our first IVF cycle, we would not have gotten this puppy ... I shudder to think that Cooper might have ended up with some Amish family, forced to pull a plow through fields, or churn butter all day. Perhaps we needed the primer on parenting offered by puppy rearing prior to getting into the game of parenting human children. I've always heard people say that your priorities change the second you become a parent. I'm attached to my little puppy, but nowhere near what I will be to the baby we will one day have (our own, or adopted), but I can say my priorities have changed a little bit ... that small amount of attachment between me and the dog, however, has been insightful into what I expect the world of parenting to be like.
Anyways, if there are pools of blood lying around on this blog tomorrow, please don't be alarmed - it will likely be falling out of the holes Cooper will put in my body tonight while I clean. Hopefully these people will buy our house ... we need a break, and a bid would be a very welcomed one.
FYI - Prior to owning a dog I would have read this and said: Bullshit ... I feel a little differently about things now.
Wednesday, December 5, 2007
Next Stop: Oakwood
Just made our appointment for round two, with Dr. M. at Oakwood Hospital (technically, the clinic is called "Center for Reproductive Medicine Oakwood Hospital and Medical Center" - ironically, this is where I went for my first and second semen analysis ... when I left there last time I thought "At least I'll never see these people again!" ... how fate plays tricks on us)
Our appointment is scheduled for December 17th, so expect a report out on the 18th of what our second round will hold for us. I'm guessing it will involve shots in the leg, shots in the ass and more "doing it" with cups. Once again I'm reminded of my position in this whole thing - the receptionist made it clear that they would be "treating" my wife while I get to skate with little to no responsibility. My poor wife. She has been through so much in the past year. Our puppy hasn't made it much easier. While I'm out "consulting", getting home at 8 p.m. every night, she's dealing with all of Cooper's sharp teeth and pent up energy from spending the day in the bathroom playing with / eating his own turds. I appreciate her and everything she's going through more than she will ever know.
Oh, to top it all off, we just received an e-mail from one of my wife's cousins with subject "Coming June 2008 ..." Inside were four ultrasound photos of their baby, which is currently being assembled inside of his wife's womb. From what we know they didn't have to pay anything for this to happen, didn't have to take shots, didn't have to take the eggs out of her body and then put them back in again or anything. We're happy for them, obviously, but it's another reminder of our situation. Even better, this morning while I was filling my gas tank I saw this sign on the gas pump that read as follows:
Um - we're trying, like $10,000 - $20,000 hard, to choose life.
So anyways, we're going to commence planning for round two in just under two weeks. Actually, we're feeling pretty optimistic about our chances in round two - we just heard about another girl who successfully conceived on her 4th round of IVF. I hope it doesn't take us that long, but I do HOPE ...
Finally, I was impressed with Dr. M's receptionist. She even went so far to ask for the customer service number from my insurance provider so she could ensure our consultation will be covered. Those little things go such a long ways towards easing the process. I told her how impressed I was with the fact that she asked a question that all medical receptionists should ask, and that I appreciated it very much.
Our appointment is scheduled for December 17th, so expect a report out on the 18th of what our second round will hold for us. I'm guessing it will involve shots in the leg, shots in the ass and more "doing it" with cups. Once again I'm reminded of my position in this whole thing - the receptionist made it clear that they would be "treating" my wife while I get to skate with little to no responsibility. My poor wife. She has been through so much in the past year. Our puppy hasn't made it much easier. While I'm out "consulting", getting home at 8 p.m. every night, she's dealing with all of Cooper's sharp teeth and pent up energy from spending the day in the bathroom playing with / eating his own turds. I appreciate her and everything she's going through more than she will ever know.
Oh, to top it all off, we just received an e-mail from one of my wife's cousins with subject "Coming June 2008 ..." Inside were four ultrasound photos of their baby, which is currently being assembled inside of his wife's womb. From what we know they didn't have to pay anything for this to happen, didn't have to take shots, didn't have to take the eggs out of her body and then put them back in again or anything. We're happy for them, obviously, but it's another reminder of our situation. Even better, this morning while I was filling my gas tank I saw this sign on the gas pump that read as follows:
Children's are God's most precious gift. Please choose life.
Um - we're trying, like $10,000 - $20,000 hard, to choose life.
So anyways, we're going to commence planning for round two in just under two weeks. Actually, we're feeling pretty optimistic about our chances in round two - we just heard about another girl who successfully conceived on her 4th round of IVF. I hope it doesn't take us that long, but I do HOPE ...
Finally, I was impressed with Dr. M's receptionist. She even went so far to ask for the customer service number from my insurance provider so she could ensure our consultation will be covered. Those little things go such a long ways towards easing the process. I told her how impressed I was with the fact that she asked a question that all medical receptionists should ask, and that I appreciated it very much.
Thursday, November 29, 2007
Cooper (and next steps)
My posts to date have pretty much brought us up to the current date and time - we are ~1.5 months beyond our failed first cycle and have sort of shelved the whole discussion, temporarily. We got a puppy to occupy our time and distract us while figuring out our next move. Frankly, we haven't had as much time to discuss the whole thing as we would have liked, but the distraction has been welcomed - puppies are a lot of work! We got a Cairn Terrier (same kind of dog as Toto) He is Amish (got him from Amish country in Ohio) We named him Cooper ... cute little guy with very sharp teeth. Anyhow, he has completely taken over our lives ... there are no spare minutes to just sit around on the couch, or surf the internet. The second you do that, Cooper will bite something, or piss on the rug, or poop under the Christmas tree. Anyways ...
We're casually looking into adoption web-sites, trying to learn more about it ... and we're discussing IVF and how to handle that whole situation. Either way, my wife was told to go on birth control pills "to get rid of the cysts Dr. S. created" (his words) ... we weren't told how long she should go on the pills, when she should have started them, etc. More of the same lack of attention to detail from our clinic ... at some point we'll have to call to ask them how long she should continue. It also sucks that she has to take a medication that prohibits the very thing we are trying to achieve - PREGNANCY! We've been told from some people that the cycle immediately following a failed IVF is a great time to get pregnant through natural means since the levels of Progesterone in the woman are so high. That is not an option for us ...
I didn't do much research into IVF prior to our first round. The failed cycle prompted me to hit the internet for a crash course on the process, and to look into other clinics. I first came across the SART web-site, which contains scores of information on infertility clinics across the country. I immediately compiled all of the data for metro Detroit into a spreadsheet, and plotted all of the statistics relevant to our situation. I primarily focued on "# of cycles" and "# of live births". I've also come across TONS of blogs on the topic of IVF, mostly written by people who have not been successful (a bit discouraging) ... but, in the process, I've become more educated on infertility, and how big of an issue it really is. It's good to know there are others out there going through the same thing.
Based on the information revealed on the SART web-site, We've decided to make an appointment with Oakwood Hospital to review our documentation from cycle #1, and to see what the prognosis is from a different doctor. I'm anxious to see if this doctor will outline a plan for IVF #2 similar to that described by Dr. S. I'm doubtful that the information provided in our files from IVF Michigan will be sufficient to make a prognosis. We certainly don't want to go through the gamut of tests again, as they are expensive and time consuming ... besides, all information that can be gathered is already in the hands of Dr. S. We are looking into other clinics primarily because we want to feel comfortable with our decision to move forward with a second round. Frankly, the whole topic of how expensive this procedure is is not discussed enough. For us, the decision to spend $10k on anything is not made easily. Frankly, anything over $50 is debated and evaluated prior to executing the trade. Therefore, moving forward with another round of IVF will not happen before we fully understand, as best we can, our chances for success. If we feel confident that IVF might work for us, we'll move forward with a second round. If there is a great deal of doubt regarding our chances for success, we would opt to instead place the $10,000 towards adoption. I've heard "quotes" on adoption as high as $40,000 ... that's crazy! That's a lot of money! Good thing about adoption is, it is almost guaranteed to give you a child (especially if you go to another country, from what I understand) Again, we're at the low end of the learning curve on adoption (and IVF for that matter)
So, our plans are to talk to Oakwood and re-evaluate our options afterwards. If we leave Oakwood with a good feeling, we'll probably start scheduling or second round. If the feeling is not so good, we'll look into another clinic and further our education on the adoption process. Stay tuned - I'm going to call Oakwood right now to see when we can get in for a consultation. I hope it doesn't cost anything for such an appointment!
Next time: I'm thinking of writing a post on the expense of this whole procedure. Like when do you reach the point where you can no longer afford to do another round? I mean, that point has to come sometime, right? My wife and I fortunate to have good jobs and the IVF funds can be found without damaging our retirement and savings plans, but still, it requires a bit of sacrifice in other areas. I always like to use the example of "how many Kool-Aid packets do you think you could fit into a shopping cart?" Seems like you could always put one more in ... but at some point the whole thing will crumble ... somehow this example needs to be compared to personal finance. I've got nothing ... but you probably get the point.
Thanks for your comments, and for reading. Hoping for brighter days in 2008.
Wednesday, November 28, 2007
What Happened ... / ?
I want to insert something here - I wrote this whole article and noticed a great deal of negativity about our IVF clinic and Doctor. My wife and I were displeased with the way many aspects of our IVF process were handled. I'm trying to separate the frustration and anger resulting from our failed cycle from legitimate concerns with the professionalism of the staff at our clinic. I've decided to separate out as much of the negativity as possible leaving only a few of our concerns in here. I'm opting to put the Doctor's name in, not to bash him, but to see if anyone else has had similar concerns with him. Overall I like the guy, but would consider evaluating alternatives for our second round ...
So, as noted in earlier posts, we went into the IVF process as if it would be a sure thing. In fact, I recall telling many people "If you have to have fertility problems, you want what we have (i.e. bad sperm, completely healthy female) - IVF will help us overcome the faulty, incapable sperm issue, and everything beyond that point is up to the female! No problems, right?" Wrong!
They harvested 19 follicles , of which, 9 were successfully fertilized. We arrived at the Rochester Hills office of IVF Michigan several days later for the transfer. As I was sitting next to my wife (who was stirruped) with my smock and medical garb on, Dr. S. came into the room and quickly said we had two good embryos to transfer. We had informally agreed prior to the transfer that we would like to go with two embryos, as we were somewhat excited about the option of twins, and we wanted to give ourselves a good chance at success. After briefly describing his plans to transfer two embryos, Dr. S. stated "There are some concerns with the remaining embryos, but we'll discuss that later - now, let's get you pregnant!" Then he "turkey-bastered" my wife (I could see the little jet of fluid / embryos as on the ultrasound screen as they were inserted into my wife's uterus - kind of cool) Afterwards he said "Send us pictures" as he exited the room. That was it. It all felt sort of anticlimactic, and unemotional. After a brief recovery, and my wife relieving her bladder on the bed (which was really wierd, in our opinion) we left and hoped for positive news several days later, but had that "concern with the other embryos" comment stuck in the back of our heads, and as it would turn out, for good reason.
Several days later we received our negative pregnancy results - needless to say, we were shocked. I, being a fairly optimistic person, had not prepared myself for the possibility of this procedure not working. This was partly due to lack of education, and an extremely optimistic prognosis from our Doctor (not his fault ... he was just communicating the information he had at hand) We shed some tears, bitched and allowed the feelings of hopelessness to sink in. We were devastated, at least temporarily. We wondered about the other embryos ... hopefully they would be okay and we could quickly move forward with frozen embryo transfers in the near future. We had to call the clinic to inquire about the state of our remaining 7 embryos, and were told something along the lines of oh, yeah ... your other embryos did not mature to the point where we could freeze them. Sorry." When were you planning on calling us, exactly?!?!?
There we were - out $10,000 with nothing to show for it.
We scheduled a follow-up meeting for two weeks later (that was the first time they had available) We met with Dr. S. who described to us what went wrong. Turns out my wife's follicles were not fully matured at the time of harvest. He asked us if we were certain that we administered the HCG shot exactly as prescribed - I assured him we did everything exactly as we were told to. From what I can understand based on his description, the follicles must be harvested within a ~1 hour window. Take them too soon and they won't be properly matured. Take them too late and she will ovulate, sending the follicles down the fallopian tubes, from whence they will not be recoverable. Dr. S. described the root cause of our failure as "incredibly rare" ... but then said he had another patient with what he believed to be exactly the same situation (seemed like contradicting information to me ... incredibly rare, yet he has another client with the same situation, who happens to be mid-cycle, with beautiful embryos ... hmmmmm ...) He said that on our second round he would use a different HCG medication, and might leave the embryos in my wife a bit longer. He also said that if we have the same results in round 2, we will have "a very serious issue" ... That was it ... we left his office more confused than when we entered, less confident than we hoped to be. One other thing - Dr. S. took two phone calls during our follow-up consultation, one from his wife in which he stated "Can I call you in five minutes?" - five minutes? This implied he knew he would have us out of his office in very short order. I know he's a busy guy, but we paid a lot of money, were very upset and expected nothing less than his undivided attention in a tender situation such as we were in ... after all, it was only five minutes.
Due to my frustration with the way our process was handled, I requested a copy of all our charts, files, etc. on my way out of the office. The notes on one of the documents states "Eggs polar body not completely released from cytoplasm in almost all eggs" If anyone else has experienced similar results, I'd be interested in hearing about it.
A quick disclaimer: I'm not trying to throw Dr. S. under the bus. We liked the guy very much during 90% of the procedure, and will likely go back to him for round 2, but not before exploring alternatives in the area and getting some other opinions. That's what I'm doing now. I've assembled a list of all IVF clinics in Michigan and am attempting to make sense of their ARP scores (IVF Michigan is by FAR the largest clinic in the area, in terms of number of cycles ... they are approximately eight times bigger than the second largest clinic ... they also score very well in success rates, but are not the best, primarily due to sample size - perhaps their size is part of the issue ... maybe they're TOO big ...)
Next time: Looking into other clinics - Does it make sense?
So, as noted in earlier posts, we went into the IVF process as if it would be a sure thing. In fact, I recall telling many people "If you have to have fertility problems, you want what we have (i.e. bad sperm, completely healthy female) - IVF will help us overcome the faulty, incapable sperm issue, and everything beyond that point is up to the female! No problems, right?" Wrong!
They harvested 19 follicles , of which, 9 were successfully fertilized. We arrived at the Rochester Hills office of IVF Michigan several days later for the transfer. As I was sitting next to my wife (who was stirruped) with my smock and medical garb on, Dr. S. came into the room and quickly said we had two good embryos to transfer. We had informally agreed prior to the transfer that we would like to go with two embryos, as we were somewhat excited about the option of twins, and we wanted to give ourselves a good chance at success. After briefly describing his plans to transfer two embryos, Dr. S. stated "There are some concerns with the remaining embryos, but we'll discuss that later - now, let's get you pregnant!" Then he "turkey-bastered" my wife (I could see the little jet of fluid / embryos as on the ultrasound screen as they were inserted into my wife's uterus - kind of cool) Afterwards he said "Send us pictures" as he exited the room. That was it. It all felt sort of anticlimactic, and unemotional. After a brief recovery, and my wife relieving her bladder on the bed (which was really wierd, in our opinion) we left and hoped for positive news several days later, but had that "concern with the other embryos" comment stuck in the back of our heads, and as it would turn out, for good reason.
Several days later we received our negative pregnancy results - needless to say, we were shocked. I, being a fairly optimistic person, had not prepared myself for the possibility of this procedure not working. This was partly due to lack of education, and an extremely optimistic prognosis from our Doctor (not his fault ... he was just communicating the information he had at hand) We shed some tears, bitched and allowed the feelings of hopelessness to sink in. We were devastated, at least temporarily. We wondered about the other embryos ... hopefully they would be okay and we could quickly move forward with frozen embryo transfers in the near future. We had to call the clinic to inquire about the state of our remaining 7 embryos, and were told something along the lines of oh, yeah ... your other embryos did not mature to the point where we could freeze them. Sorry." When were you planning on calling us, exactly?!?!?
There we were - out $10,000 with nothing to show for it.
We scheduled a follow-up meeting for two weeks later (that was the first time they had available) We met with Dr. S. who described to us what went wrong. Turns out my wife's follicles were not fully matured at the time of harvest. He asked us if we were certain that we administered the HCG shot exactly as prescribed - I assured him we did everything exactly as we were told to. From what I can understand based on his description, the follicles must be harvested within a ~1 hour window. Take them too soon and they won't be properly matured. Take them too late and she will ovulate, sending the follicles down the fallopian tubes, from whence they will not be recoverable. Dr. S. described the root cause of our failure as "incredibly rare" ... but then said he had another patient with what he believed to be exactly the same situation (seemed like contradicting information to me ... incredibly rare, yet he has another client with the same situation, who happens to be mid-cycle, with beautiful embryos ... hmmmmm ...) He said that on our second round he would use a different HCG medication, and might leave the embryos in my wife a bit longer. He also said that if we have the same results in round 2, we will have "a very serious issue" ... That was it ... we left his office more confused than when we entered, less confident than we hoped to be. One other thing - Dr. S. took two phone calls during our follow-up consultation, one from his wife in which he stated "Can I call you in five minutes?" - five minutes? This implied he knew he would have us out of his office in very short order. I know he's a busy guy, but we paid a lot of money, were very upset and expected nothing less than his undivided attention in a tender situation such as we were in ... after all, it was only five minutes.
Due to my frustration with the way our process was handled, I requested a copy of all our charts, files, etc. on my way out of the office. The notes on one of the documents states "Eggs polar body not completely released from cytoplasm in almost all eggs" If anyone else has experienced similar results, I'd be interested in hearing about it.
A quick disclaimer: I'm not trying to throw Dr. S. under the bus. We liked the guy very much during 90% of the procedure, and will likely go back to him for round 2, but not before exploring alternatives in the area and getting some other opinions. That's what I'm doing now. I've assembled a list of all IVF clinics in Michigan and am attempting to make sense of their ARP scores (IVF Michigan is by FAR the largest clinic in the area, in terms of number of cycles ... they are approximately eight times bigger than the second largest clinic ... they also score very well in success rates, but are not the best, primarily due to sample size - perhaps their size is part of the issue ... maybe they're TOO big ...)
Next time: Looking into other clinics - Does it make sense?
Monday, November 26, 2007
Thanksgiving
So we had an eventful long weekend with my in-laws. As noted in previous posts, I married well and thus have wonderful in-laws. My mother-in-law decided to have her entire 43-member Italian family over for Thanksgiving in their new home in Clarkston, MI. They have a beautiful home on 6 acres of wooded property ... perfect for shooting guns, playing a family game of football and breaking shoulders. That's right - one of my wife's cousins broke his shoulder while trying to return an intercepted pass for a touchdown on the last play of the game. His knees were taken out from under him by another family member, resulting in the demise of his shoulder as all 200+ lbs. came crashing down in an ugly, graceless fall (broken in two places) Ouch!
Anyhow, we had a nice time in spite of our worries about being bombarded by questions about starting a family and / or IVF. My wife and I decided it would be best to notify the entire family of what we had been through a few weeks ago after several awkward scenarios involving "So, when are you guys going to start kicking out babies?" so I'm assuming almost everyone there knew about our situation. These encounters didn't bother me as much as they did my wife, but I was somewhat relieved to be free of them for a while. I can understand why people would ask (we've been married for over 2 years now, I'm about to turn 30 - starting a family is what we SHOULD be doing!) If the topic of IVF ever came up (which it often did, although often times we would just play along and say "we'll let you know when we decide to start a family") I always took the opportunity to explain that we were going through it due to my misshapen sperm. I have chosen to do this for several reasons: 1. I know people will speculate about who's fault it is if I don't tell them (I know I would!), and odds are they'll assume it's my wife's fault, 2. I like to take the pressure off my wife and assume the burden of responsibility for our unfortunate situation.
This is a big issue that may warrant its own post - if you had the ability to choose who had the problem, you or your spouse, which would you choose? If it's you that has the problem, then you know you're responsible for dealing with the emotional/psychological effects of being deficient, but you will also have to worry about your spouse's feelings towards you (will they still love you, or look at you the same knowing that a huge part of life that is free and easy for most people may not even be possible for them?) If it's your spouse who has the problem, you will have little influence over how he/she handles the emotional/psychological effects, but you know you will love them no matter what and you have a great deal of control over how you prove this to them. If I had to choose, I would choose exactly the situation we have. My sperm are misshapen, but my wife's inner workings are all in perfect order. Knowing that I am deficient sucks, and is a blow to my self-esteem as a man, but I know I can handle it, and that there are worse things that could happen. I also know that my wife would never waiver in her commitment to me, and she has done an outstanding job of demonstrating this to me.
Anyhow, Thanksgiving ended up going off without a single question about our dealings with infertility. I was thinking that our situation made for a very large elephant in the room, but as I recall, my awareness of infertiliy prior to my diagnosis was completely absent. I had NO idea that this was as large a problem as it is, nor did I care. In fact, I have a cousin who went through IVF and successfully gave birth to twin boys, but I didn't' spend a single second comprehending the fact that they had to go through IVF to achieve this. In fact, if I recall, the only thought I gave to it was about her husband and how it was probably his fault, and what a bum he was! (turns out he's a very cool guy, as are all guys with misshapen sperm) So, I'm thinking the majority of people in attendance gave our situation little thought.
So, on the note of Thanksgiving - I am thankful for my wife, for my family, for my health and for my ability to earn enough to afford the IVF / adoption process. I'm confident that some day I'll look back on our trials in infertility and be thankful for what I learned from it. I'll let you know when that happens ...
Next up: What went wrong with IVF #1 and where we go from here ...
Anyhow, we had a nice time in spite of our worries about being bombarded by questions about starting a family and / or IVF. My wife and I decided it would be best to notify the entire family of what we had been through a few weeks ago after several awkward scenarios involving "So, when are you guys going to start kicking out babies?" so I'm assuming almost everyone there knew about our situation. These encounters didn't bother me as much as they did my wife, but I was somewhat relieved to be free of them for a while. I can understand why people would ask (we've been married for over 2 years now, I'm about to turn 30 - starting a family is what we SHOULD be doing!) If the topic of IVF ever came up (which it often did, although often times we would just play along and say "we'll let you know when we decide to start a family") I always took the opportunity to explain that we were going through it due to my misshapen sperm. I have chosen to do this for several reasons: 1. I know people will speculate about who's fault it is if I don't tell them (I know I would!), and odds are they'll assume it's my wife's fault, 2. I like to take the pressure off my wife and assume the burden of responsibility for our unfortunate situation.
This is a big issue that may warrant its own post - if you had the ability to choose who had the problem, you or your spouse, which would you choose? If it's you that has the problem, then you know you're responsible for dealing with the emotional/psychological effects of being deficient, but you will also have to worry about your spouse's feelings towards you (will they still love you, or look at you the same knowing that a huge part of life that is free and easy for most people may not even be possible for them?) If it's your spouse who has the problem, you will have little influence over how he/she handles the emotional/psychological effects, but you know you will love them no matter what and you have a great deal of control over how you prove this to them. If I had to choose, I would choose exactly the situation we have. My sperm are misshapen, but my wife's inner workings are all in perfect order. Knowing that I am deficient sucks, and is a blow to my self-esteem as a man, but I know I can handle it, and that there are worse things that could happen. I also know that my wife would never waiver in her commitment to me, and she has done an outstanding job of demonstrating this to me.
Anyhow, Thanksgiving ended up going off without a single question about our dealings with infertility. I was thinking that our situation made for a very large elephant in the room, but as I recall, my awareness of infertiliy prior to my diagnosis was completely absent. I had NO idea that this was as large a problem as it is, nor did I care. In fact, I have a cousin who went through IVF and successfully gave birth to twin boys, but I didn't' spend a single second comprehending the fact that they had to go through IVF to achieve this. In fact, if I recall, the only thought I gave to it was about her husband and how it was probably his fault, and what a bum he was! (turns out he's a very cool guy, as are all guys with misshapen sperm) So, I'm thinking the majority of people in attendance gave our situation little thought.
So, on the note of Thanksgiving - I am thankful for my wife, for my family, for my health and for my ability to earn enough to afford the IVF / adoption process. I'm confident that some day I'll look back on our trials in infertility and be thankful for what I learned from it. I'll let you know when that happens ...
Next up: What went wrong with IVF #1 and where we go from here ...
Monday, November 19, 2007
Shots
This is the part I was most nervous about - not the ultrasounds, not the expense (which was a close second ... or wait, expense was the bigger deal, so scratch that first sentence and make shots the SECOND biggest cause of anxiety), not the possibility that it might not work. I was not looking forward to jabbing needles into my wife on a daily basis.
Fortunately, IVF shots start out slow and small, and work their way up in size and difficulty. The first shot was administered by the nurse at the clinic - I'm not sure what this shot was called, or what it did, but my wife claimed it didn't hurt. This shot kicked off our cycle. The next set of shots, designed to stimulate her ovaries into making piles of follicles, were pre-packaged in this little "pen" ... all I had to do was turn a dial on the end of the pen to the correct dose amount, pull out the plunger (which made a clicking sound), then plunge the pen into a pinched portion of skin on my wife's upper thigh, push the plunger and pull it out. The needle was really, really tiny (only about 1/2 inch long) and the gauge small. My wife could only feel the sting of the alcohol in the event that it didn't have sufficient time to dry. This shot (the one with the nifty pen) was delivered in the morning, and in the afternoon her friend at work would inject her with a similar sized needle filled with a mixture of powder and water (which had to be mixed prior to the shot being administered ... much easier than it sounds. Just fill the plunger with the appropriate amount of sterilized water, from a vial, inject it into another vial containing the actual medication, in powder form - watch as the powder INSTANTLY dissolves - I mean it ... it's incredible ... the powder is gone at the very second the water touches it ... pull this mixture back into the plunger, swap the needle and inject)
Next up was the HCG shot, which was to be administered EXACTLY 12 hours before the "harvest". This was a longer needle, and a more precise injection than the other ones. We were warned at the clinic to be very careful with this one, and were told about many people who screwed it up, thereby ruining their cycle. We administered this shot EXACTLY at 11:30 p.m. the evening before our harvesting .... Turns out that this is exactly where Dr. S. looked to determine the root cause of our failed 1st attempt - I assured him I administered the shot exactly as I was instructed to ... he responded by saying poor drug quality may have been to blame for our underdeveloped follicles ... that, or we have "a very serious problem". Next time around he intends to give us a different version of HCG drug - can't remember the name, or any details about this as his description was vague.
Shortly before and again after the transfer, the Progesterone shots began. These used a much larger needle than the others (similar in size to the HCG shot) My wife had a very severe reaction to this shot in terms of pain. She could barely walk for almost a day afterwards. We would rotate sides between left and right (i.e. injection site = just above her rear), but that didn't really help. The nurses, and even Dr. S. commented on how abnormal this was ... but upon further questioning of Dr. S., he dismissed it and switched her to a vaginal tablet form of the Progesterone drug immediately after the transfer (apparently IVF Michigan was extensively involved in proving out this form of administering Progesterone) So ended the shots.
I found it incredibly unfair that I was let off the hook in the shot department. The whole reason we are going through IVF is because of my abnormally shaped sperm, yet, I have do nothing other than make love to a cup and watch porn while my wife has shots, ultrasounds, surgeries and all manner of other procedures. It's good to be a guy, but I feel for my wife, and admire her for carrying this burden for the sake of our family and our marriage. She's a wonderful person and I admire her more than she knows.
What's next? Thoughts about a Thanksgiving weekend with 43 family members.
Fortunately, IVF shots start out slow and small, and work their way up in size and difficulty. The first shot was administered by the nurse at the clinic - I'm not sure what this shot was called, or what it did, but my wife claimed it didn't hurt. This shot kicked off our cycle. The next set of shots, designed to stimulate her ovaries into making piles of follicles, were pre-packaged in this little "pen" ... all I had to do was turn a dial on the end of the pen to the correct dose amount, pull out the plunger (which made a clicking sound), then plunge the pen into a pinched portion of skin on my wife's upper thigh, push the plunger and pull it out. The needle was really, really tiny (only about 1/2 inch long) and the gauge small. My wife could only feel the sting of the alcohol in the event that it didn't have sufficient time to dry. This shot (the one with the nifty pen) was delivered in the morning, and in the afternoon her friend at work would inject her with a similar sized needle filled with a mixture of powder and water (which had to be mixed prior to the shot being administered ... much easier than it sounds. Just fill the plunger with the appropriate amount of sterilized water, from a vial, inject it into another vial containing the actual medication, in powder form - watch as the powder INSTANTLY dissolves - I mean it ... it's incredible ... the powder is gone at the very second the water touches it ... pull this mixture back into the plunger, swap the needle and inject)
Next up was the HCG shot, which was to be administered EXACTLY 12 hours before the "harvest". This was a longer needle, and a more precise injection than the other ones. We were warned at the clinic to be very careful with this one, and were told about many people who screwed it up, thereby ruining their cycle. We administered this shot EXACTLY at 11:30 p.m. the evening before our harvesting .... Turns out that this is exactly where Dr. S. looked to determine the root cause of our failed 1st attempt - I assured him I administered the shot exactly as I was instructed to ... he responded by saying poor drug quality may have been to blame for our underdeveloped follicles ... that, or we have "a very serious problem". Next time around he intends to give us a different version of HCG drug - can't remember the name, or any details about this as his description was vague.
Shortly before and again after the transfer, the Progesterone shots began. These used a much larger needle than the others (similar in size to the HCG shot) My wife had a very severe reaction to this shot in terms of pain. She could barely walk for almost a day afterwards. We would rotate sides between left and right (i.e. injection site = just above her rear), but that didn't really help. The nurses, and even Dr. S. commented on how abnormal this was ... but upon further questioning of Dr. S., he dismissed it and switched her to a vaginal tablet form of the Progesterone drug immediately after the transfer (apparently IVF Michigan was extensively involved in proving out this form of administering Progesterone) So ended the shots.
I found it incredibly unfair that I was let off the hook in the shot department. The whole reason we are going through IVF is because of my abnormally shaped sperm, yet, I have do nothing other than make love to a cup and watch porn while my wife has shots, ultrasounds, surgeries and all manner of other procedures. It's good to be a guy, but I feel for my wife, and admire her for carrying this burden for the sake of our family and our marriage. She's a wonderful person and I admire her more than she knows.
What's next? Thoughts about a Thanksgiving weekend with 43 family members.
Thursday, November 15, 2007
Job Changes
Sort of non-IVF related post here, but every aspect of our lives seems to be impacted by our quest for a baby, to some degree. Onward ...
Upon finding out that we had to go through in vitro I amped up my initiative of finding a new job. I had spent over two years after receiving my MBA from Michigan Business School working for one of the big three - the job was a cake walk, the pay was bad, the challenge absent, opportunity for promotion non-existent, no bonus, no rewards for effort, etc. Sounds pretty bad eh? Well I guess I'm exaggerating a bit ... I got home early every day, didn't have to travel, and could outshine my colleagues by trying just a little bit harder than everyone else (I sincerely don't intend this to sound arrogant ... it's a statement about the other people, not about myself. I really don't know what I'm doing, but I know how to work hard.) I didn't take on shit loads of student loans to sit around putting in minimal effort just to collect a paycheck. I wanted a challenge, to be rewarded for any initiative I took and most importantly to get PAID. More importantly, I wanted to be able to earn enough so that my wife could stay home with our children, if / when they arrive. Upon realizing that my job would prohibit the realization of the majority of my desires, I began to look elsewhere.
I intended to find a nice corporate job somewhere in the northern suburbs of Detroit. My wife and I have always liked it up there and had been discussing our plan to relocate from the day we got married. It was pretty exciting to actually start looking. Well, after only a few short months I landed an interview with a consulting firm. I was fairly familiar with the consulting lifestyle having attended business school with many people who chose this career path. I had decided long ago that consulting was definitely not for me. I value the life part of work-life balance a little too much to spend my time traveling and working 60 hour weeks. But, when the financial demands of in vitro were introduced to our life, consulting (primarily the increased salary) became very attractive.
I interviewed with this firm mostly for kicks - I had heard horror stories from my b-school colleagues of consulting case interviews and in a masochistic way I sort of wanted to try it. Consulting interviews were incredibly intense and those vying for them were ultra competitive - while I was in b-school, this did not appeal to me in the least. Well, my first interview went horribly wrong (or so I thought) They raked me over the coals upon discovering that I had confused revenue and profit. Not good. I left the office smiling to myself about how I had just conducted my worst interview ever. I was shocked when they called me back for a second round a few months later. I was much more relaxed in round two and actually did pretty well. The offer was extended the next day, and the terms were so good that I just couldn't say no - I would get paid more (~40% increase in salary), 5 weeks vacation, 50% 401(k) match, challenging work, exposure to executives in many companies, expense account, etc. So after much deliberation and stress about the choice I had before me, my wife and I agreed that I had to accept. The signing bonus covered our first round of IVF ... oh to think of the other things we could have done with that money!
So, we checked the "new job / increased salary" box. One thing I've been amazed by is the timing of this job offer. I had started the interview process before we knew we would have to do IVF, and the offer came during the exact week in which we discovered we'd have to do IVF. Perfect timing. We had sufficient funds in the bank to conduct the first round, but using those funds would have put us in a risky cash position (i.e. it would have depleted our savings). The terms of my new job exactly covered the incremental funds we would require to go through IVF.
On another note, I had always been interested in pursuing a challenging career such as that offered by consulting, but due to my priorities (wife and life over work and pay) I would never have accepted such a position - I would have always wondered "what if". Now I get to take on that personal challenge, delete the "what if" and accelerate my career at the same time. I'm fortunate to have a wife who is supportive of not only the financial rewards of consulting, but also the personal satisfaction that I will derive from giving it a shot. If IVF had not been introduced to our lives, I would have been incredibly tempted by the offer, but likely would have declined to avoid the travel and hours. Amazing how you are given what you need when you need it ... I'm a person of faith and believe very strongly that this was no coincidence, but I'll spare the religious details here. I accepted the job and the very next day we were meeting with our IVF nurse to commence the process, meeting with our Realtor to put our home on the market and meeting with my boss to quit my old job.
This was a difficult decision, but even if we are unsuccessful in IVF, the incremental experience I will get from my time as a consultant should open some doors and accelerate my career a bit. I just hope the travel / hours don't become too problematic. So far, the job has been fantastic ... I'm getting great experience that would've taken over 10 years to achieve in my last job and I'm getting paid more. I am, however, working a lot ... but, everyone I know works a lot. There's no free lunch - I'm fortunate just to be working in this shitty Michigan economy, and fortunate to have a wife who is so supportive.
Tomorrow: Shots
Upon finding out that we had to go through in vitro I amped up my initiative of finding a new job. I had spent over two years after receiving my MBA from Michigan Business School working for one of the big three - the job was a cake walk, the pay was bad, the challenge absent, opportunity for promotion non-existent, no bonus, no rewards for effort, etc. Sounds pretty bad eh? Well I guess I'm exaggerating a bit ... I got home early every day, didn't have to travel, and could outshine my colleagues by trying just a little bit harder than everyone else (I sincerely don't intend this to sound arrogant ... it's a statement about the other people, not about myself. I really don't know what I'm doing, but I know how to work hard.) I didn't take on shit loads of student loans to sit around putting in minimal effort just to collect a paycheck. I wanted a challenge, to be rewarded for any initiative I took and most importantly to get PAID. More importantly, I wanted to be able to earn enough so that my wife could stay home with our children, if / when they arrive. Upon realizing that my job would prohibit the realization of the majority of my desires, I began to look elsewhere.
I intended to find a nice corporate job somewhere in the northern suburbs of Detroit. My wife and I have always liked it up there and had been discussing our plan to relocate from the day we got married. It was pretty exciting to actually start looking. Well, after only a few short months I landed an interview with a consulting firm. I was fairly familiar with the consulting lifestyle having attended business school with many people who chose this career path. I had decided long ago that consulting was definitely not for me. I value the life part of work-life balance a little too much to spend my time traveling and working 60 hour weeks. But, when the financial demands of in vitro were introduced to our life, consulting (primarily the increased salary) became very attractive.
I interviewed with this firm mostly for kicks - I had heard horror stories from my b-school colleagues of consulting case interviews and in a masochistic way I sort of wanted to try it. Consulting interviews were incredibly intense and those vying for them were ultra competitive - while I was in b-school, this did not appeal to me in the least. Well, my first interview went horribly wrong (or so I thought) They raked me over the coals upon discovering that I had confused revenue and profit. Not good. I left the office smiling to myself about how I had just conducted my worst interview ever. I was shocked when they called me back for a second round a few months later. I was much more relaxed in round two and actually did pretty well. The offer was extended the next day, and the terms were so good that I just couldn't say no - I would get paid more (~40% increase in salary), 5 weeks vacation, 50% 401(k) match, challenging work, exposure to executives in many companies, expense account, etc. So after much deliberation and stress about the choice I had before me, my wife and I agreed that I had to accept. The signing bonus covered our first round of IVF ... oh to think of the other things we could have done with that money!
So, we checked the "new job / increased salary" box. One thing I've been amazed by is the timing of this job offer. I had started the interview process before we knew we would have to do IVF, and the offer came during the exact week in which we discovered we'd have to do IVF. Perfect timing. We had sufficient funds in the bank to conduct the first round, but using those funds would have put us in a risky cash position (i.e. it would have depleted our savings). The terms of my new job exactly covered the incremental funds we would require to go through IVF.
On another note, I had always been interested in pursuing a challenging career such as that offered by consulting, but due to my priorities (wife and life over work and pay) I would never have accepted such a position - I would have always wondered "what if". Now I get to take on that personal challenge, delete the "what if" and accelerate my career at the same time. I'm fortunate to have a wife who is supportive of not only the financial rewards of consulting, but also the personal satisfaction that I will derive from giving it a shot. If IVF had not been introduced to our lives, I would have been incredibly tempted by the offer, but likely would have declined to avoid the travel and hours. Amazing how you are given what you need when you need it ... I'm a person of faith and believe very strongly that this was no coincidence, but I'll spare the religious details here. I accepted the job and the very next day we were meeting with our IVF nurse to commence the process, meeting with our Realtor to put our home on the market and meeting with my boss to quit my old job.
This was a difficult decision, but even if we are unsuccessful in IVF, the incremental experience I will get from my time as a consultant should open some doors and accelerate my career a bit. I just hope the travel / hours don't become too problematic. So far, the job has been fantastic ... I'm getting great experience that would've taken over 10 years to achieve in my last job and I'm getting paid more. I am, however, working a lot ... but, everyone I know works a lot. There's no free lunch - I'm fortunate just to be working in this shitty Michigan economy, and fortunate to have a wife who is so supportive.
Tomorrow: Shots
Wednesday, November 14, 2007
The Beginning
A bit about how we got started on this crazy road of IVF. My wife and I were married in the summer of 2005, shortly after I graduated from grad school with my MBA. A new job, new house, new degree, new marriage and new lifestyle were all adopted in the span of ~2 months. Getting married is the single best thing I've ever done. I have a beautiful wife (WAY out of my league), she's my best friend, and I would do anything to make her life even a little bit better. I can't wait to get home to see her at night, to spend my weekends with her and to just enjoy the ups and downs of life with her at my side. Things were great (and they still are ...) We decided to start "trying" for a baby after about 1.5 years of marriage. We expected to have no difficulty at all. This all happened at such a rapid pace that I didn't really have much time to think about what a huge endeavor we were embarking on. When things didn't "take" as we expected them to, we began to get a little concerned (more so my wife than I ... I'm more laid back about these major life events, and was okay if it took some time to achieve success. I'm super anal about our finances, and welcomed the incremental time to save for college, 401(k), Roth IRA, student loans, etc. How do people survive financially these days?) After about a year the frustration began to grow in me as well. I stopped drinking alcohol (not that I drank that much, but my father-in-law and I like to make homebrew together, and enjoy the fruits of our labor via a sweet 4-tap kegerator that he keeps in his basement - yeah, I married REALLY well!) We did everything we thought possible to increase our chances, with no luck. After a vacation over the 4th of July this year, we decided to make some doctor appointments to see what was the matter. I was up first.
I went to my doctor, described the problem and was met with some skepticism - "What is your rush?" she said - "You're so young, just give it some time!" ... then she referred me to a urologist to have a male exam. Uh oh. I went, talked to this nice English doter (Seaman, in Ann Arbor) who examined me VERY thoroughly while a young resident watched. Not much fun having your balls cupped by an old man while another guy who's exactly your age stands by and watches - very embarrassing and during a certain part of the exam, very "lubey" and uncomfortable. Yes, he checked my prostate. Not as bad as I thought it would be, but I was counting on deferring these types of exams until my 40s. I want to make it very clear: I didn't like it ... at all - if I had a tail, it would've been between my legs when I walked out of the examination room. Anyhow, part of the process was a semen analysis. Another embarrassing stop.
I went the Oakwood Hospital laboratory in Dearborn for this analysis. I've had to do this routine several times since, and it seems without fail that the staff of labs that do semen analyses are comprised entirely of women ... young women. So, you show up and say "I'm here for my semen analysis" They "prepare" the room (by fanning out a significant amount of porno magazines), hand you a cup and give you your space to provide a sample. After you're done you walk out with your sample in hand (in the cup, of course) and give it to the girls at the front desk. Incredibly humiliating, but if you can appreciate the awkwardness of it, pretty funny stuf. They put on a rubber glove and escort your sample to the lab while you get the hell out of there hoping to never run into these people in public.
The results came back to show my morphology was the issue. According to the criteria used by Oakwood's lab to assess morphology, I was 14% normal (just shy of the 15% mark separating fertile from borderline infertile, again, by the criteria used by this lab) Dr. Seaman described me as being "just on the cusp" of fertility ... very English. He was a super cool guy though, calling me personally to report my results after both tests - in my book, a sign of a very good doctor. I went in for the second assessment a few weeks later, as is procedure (to ensure adequate sample size and diminish possibilities of one-off circumstances leading to higher, or lower counts) Same results.
We took this as sort of a mixed bag: We weren't told that I was infertile, but we were told that it would be a bit more challenging for us than it would be for a "normal" couple. Bummer, but not the end of the road.
After this we tried, unsuccessfully, for a few more months via natural means. Fun for me, but frustrating for my wife. Soon afterwards we went to the IVF clinic to discuss our options, and to have my wife checked out. More to come on this in future posts ... there would be more tests, for me, for my wife, insurance screw-ups costing us several thousands of dollars, painful tests for my wife, shots, medications, flex accounts, job changes, puppies, homes for sale and all sorts of things along the way. More on this as my blog continues.
I went to my doctor, described the problem and was met with some skepticism - "What is your rush?" she said - "You're so young, just give it some time!" ... then she referred me to a urologist to have a male exam. Uh oh. I went, talked to this nice English doter (Seaman, in Ann Arbor) who examined me VERY thoroughly while a young resident watched. Not much fun having your balls cupped by an old man while another guy who's exactly your age stands by and watches - very embarrassing and during a certain part of the exam, very "lubey" and uncomfortable. Yes, he checked my prostate. Not as bad as I thought it would be, but I was counting on deferring these types of exams until my 40s. I want to make it very clear: I didn't like it ... at all - if I had a tail, it would've been between my legs when I walked out of the examination room. Anyhow, part of the process was a semen analysis. Another embarrassing stop.
I went the Oakwood Hospital laboratory in Dearborn for this analysis. I've had to do this routine several times since, and it seems without fail that the staff of labs that do semen analyses are comprised entirely of women ... young women. So, you show up and say "I'm here for my semen analysis" They "prepare" the room (by fanning out a significant amount of porno magazines), hand you a cup and give you your space to provide a sample. After you're done you walk out with your sample in hand (in the cup, of course) and give it to the girls at the front desk. Incredibly humiliating, but if you can appreciate the awkwardness of it, pretty funny stuf. They put on a rubber glove and escort your sample to the lab while you get the hell out of there hoping to never run into these people in public.
The results came back to show my morphology was the issue. According to the criteria used by Oakwood's lab to assess morphology, I was 14% normal (just shy of the 15% mark separating fertile from borderline infertile, again, by the criteria used by this lab) Dr. Seaman described me as being "just on the cusp" of fertility ... very English. He was a super cool guy though, calling me personally to report my results after both tests - in my book, a sign of a very good doctor. I went in for the second assessment a few weeks later, as is procedure (to ensure adequate sample size and diminish possibilities of one-off circumstances leading to higher, or lower counts) Same results.
We took this as sort of a mixed bag: We weren't told that I was infertile, but we were told that it would be a bit more challenging for us than it would be for a "normal" couple. Bummer, but not the end of the road.
After this we tried, unsuccessfully, for a few more months via natural means. Fun for me, but frustrating for my wife. Soon afterwards we went to the IVF clinic to discuss our options, and to have my wife checked out. More to come on this in future posts ... there would be more tests, for me, for my wife, insurance screw-ups costing us several thousands of dollars, painful tests for my wife, shots, medications, flex accounts, job changes, puppies, homes for sale and all sorts of things along the way. More on this as my blog continues.
Tuesday, November 13, 2007
Joining the Fray
My wife and I recently finished our first IVF cycle - and FAILED! We've been pretty upset, lost, confused, broke, (insert any and all appropriate descriptors here) Following the news of our negative pregnancy test, I dove into the blogging world to learn more about the IVF process (something I should have done before our first cycle), to research doctors and to find others who have gone through the same thing. I've been very impressed with the quantity and variety of blogs available on the subject, but have noticed the vast majority of these blogs are authored by women. I've been going home every night to tell my wife about the things I've read on my "IVF Girl's" blogs, and figured a male perspective was in order - the comfort we've taken from reading these blogs, knowing we're not alone has been welcomed, and spreading that philosophy from the eyes of a husband can't hurt. I'm sure there are other guys out there who have done this already, so I'm not claiming some novel idea here, but figured I'd give it a shot. So, let's get into a bit about my wife and I ...
I'm opting to remain anonymous out of respect for those family members who we have not yet told about our trials in infertility. You don't care who we are anyways - you DO care about who our doctor is, why our cycle failed and most importantly, that we FAILED (I'm convinced there are few people who read these types of blogs who've been successful with IVF - you want to hear about how much this process sucks for us, just like it sucks for you ... if not, you're probably in the wrong place)
We live in metro Detroit, and have done our first cycle with Doctor S. out of IVF Michigan (Ann Arbor office, other than the harvest / transfer, which is done in Rochester Hills) Overall, Dr. S. has been pretty cool - he's obviously a busy man (i.e every time we've been to his office we've waited at least 15 minutes past our appointment time to see him, and IVF Michigan blows away all other clinics in the area in number of cycles conducted) He's obviously a wealthy man (drives a sweet Mercedes crossover ... why not a domestic vehicle, given his proximity to Detroit??? That's another topic.) ... and he's Catholic, which is, somehow, important to us. He gave us a sense of extreme confidence during our initial consultations. My wife is young at 27 years old, and I'm not that old either at 29. We tried for a little over one year to conceive by natural means with no success. During that time it seemed every single one of my wife's coworkers got pregnant on their first or second attempts (even the old ones) This made for many conversations where my wife would come home crying or hating those friends of hers who were pregnant - something to this day I still don't understand. If they're your friend and they are happy, why would you be mad at them for achieving something they want very badly? I read some books that said this is a common misunderstanding amongst husbands of women who are dealing with infertility, so since it's in a book, I'm free to run my mouth about it!
Well, before long we grew frustrated and decided to seek medical help. Before we knew it we were wacking off into cups, jabbing my wife with needles, and preparing our finances to go through this procedure that most people never think about, or even know about (other than vague recollections of the phrase "test tube babies" from the news in the early 80s) We completed our first IVF cycle in October 2007, and got the unfortunate news that we were unsuccessful. We were shocked. Given our age and the ultra-positive prognosis from Dr. S., we didn't think it was even remotely possible that IVF wouldn't work. Now, we're trying to figure out where to go from here. First stop: Get a puppy - this has kept us distracted, and has given us reason to smile while we choose our next steps.
Anyway, I wanted to commence the blog with a short intro - I intend to write a bit more as time allows, including more on our background and the changes we've had to make in our lives to accommodate and plan for the IVF process. What you need to know right now is this: We've tried IVF one time, were unsuccessful, immediately got a puppy to compensate, are getting no sleep because the dog likes to poop and pee in his crate (and eat it), are considering bypassing a second round of IVF and going straight to adoption, are still a little shocked that we're even going through this, and are amazed at the amount of other people who are going through the same thing. It is difficult. It sucks. But we'll get through it, and I'm hoping the posts on this site can lend a little comfort to those who are in the same boat, or are about to climb aboard. I'm convinced this process looks a little different through a husband's eyes, and I intend to share that perspective in the weeks / months / (hopefully not) years ahead.
I'm opting to remain anonymous out of respect for those family members who we have not yet told about our trials in infertility. You don't care who we are anyways - you DO care about who our doctor is, why our cycle failed and most importantly, that we FAILED (I'm convinced there are few people who read these types of blogs who've been successful with IVF - you want to hear about how much this process sucks for us, just like it sucks for you ... if not, you're probably in the wrong place)
We live in metro Detroit, and have done our first cycle with Doctor S. out of IVF Michigan (Ann Arbor office, other than the harvest / transfer, which is done in Rochester Hills) Overall, Dr. S. has been pretty cool - he's obviously a busy man (i.e every time we've been to his office we've waited at least 15 minutes past our appointment time to see him, and IVF Michigan blows away all other clinics in the area in number of cycles conducted) He's obviously a wealthy man (drives a sweet Mercedes crossover ... why not a domestic vehicle, given his proximity to Detroit??? That's another topic.) ... and he's Catholic, which is, somehow, important to us. He gave us a sense of extreme confidence during our initial consultations. My wife is young at 27 years old, and I'm not that old either at 29. We tried for a little over one year to conceive by natural means with no success. During that time it seemed every single one of my wife's coworkers got pregnant on their first or second attempts (even the old ones) This made for many conversations where my wife would come home crying or hating those friends of hers who were pregnant - something to this day I still don't understand. If they're your friend and they are happy, why would you be mad at them for achieving something they want very badly? I read some books that said this is a common misunderstanding amongst husbands of women who are dealing with infertility, so since it's in a book, I'm free to run my mouth about it!
Well, before long we grew frustrated and decided to seek medical help. Before we knew it we were wacking off into cups, jabbing my wife with needles, and preparing our finances to go through this procedure that most people never think about, or even know about (other than vague recollections of the phrase "test tube babies" from the news in the early 80s) We completed our first IVF cycle in October 2007, and got the unfortunate news that we were unsuccessful. We were shocked. Given our age and the ultra-positive prognosis from Dr. S., we didn't think it was even remotely possible that IVF wouldn't work. Now, we're trying to figure out where to go from here. First stop: Get a puppy - this has kept us distracted, and has given us reason to smile while we choose our next steps.
Anyway, I wanted to commence the blog with a short intro - I intend to write a bit more as time allows, including more on our background and the changes we've had to make in our lives to accommodate and plan for the IVF process. What you need to know right now is this: We've tried IVF one time, were unsuccessful, immediately got a puppy to compensate, are getting no sleep because the dog likes to poop and pee in his crate (and eat it), are considering bypassing a second round of IVF and going straight to adoption, are still a little shocked that we're even going through this, and are amazed at the amount of other people who are going through the same thing. It is difficult. It sucks. But we'll get through it, and I'm hoping the posts on this site can lend a little comfort to those who are in the same boat, or are about to climb aboard. I'm convinced this process looks a little different through a husband's eyes, and I intend to share that perspective in the weeks / months / (hopefully not) years ahead.
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