Thursday, February 28, 2008

Post Post Coital Follow-Up

Had our meeting with Dr. M this morning to review our Post Coital testing results, and the results of some blood work my wife had done last week. The Post Coital test indicates that my wife has, in the words of the Doctor, "perfect cervical mucus" - what a warm compliment. The pH of her mucus is a little low, but based on the fact that there were a lot of sperm swimming around in it, he said this test indicates no problems in this area. Check on that one.

My wife's blood work indicated lower than desired Progesterone levels (8.5 instead of the optimal level of 10 or higher) A low Progesterone level could result in an embryo not implanting into the uterine lining. To remedy this problem, the Doctor is placing my wife on some fertility drugs. As an alternative to Clomid, he described a new drug named "Femora", or something like that, which is typically used to treat breast cancer but is gaining popularity in fertility clinics. It is not approved for this use as a study has never been conducted, but our Doctor has used it with great success for over 3 years. So, my wife will take this pill 5 days out of each cycle to boost her Progesterone levels around the time of ovulation, hopefully allowing the embryo to properly implant. He said there should be no side effects from this pill, and that the "risk" of twins rises from 3% to 7%. He sent us on our way with prescription in hand to have a go via natural methods for another 4 - 5 months. When asked what our chances of success would be, he said about 80%, indicating that he views us as a perfectly normal, fertile couple (with the assistance of this fertility drug, of course)

If this doesn't work, he will examine my wife for endometriosis via laproscope, which freaks my wife out - she has concerns about people messing with her belly button. If that doesn't indicate a problem, we'll move on to insemination. If that doesn't work, we've got a date with IVF again.

We're feeling pretty optimistic, and slightly relieved that the news was as good as we could hope it to be. So, here's to my wife laying in bed with her feet in the air for hours on end each month with boob cancer drugs coursing through her veins. I'm thinking we need a vacation (as soon as we pay that damned $1.3k IVF bill)


Joe said...

By the way, Dr. M is fantastic - he is a kind, older gentleman who gives us an incredibly calming, reassuring feeling about this whole thing. If anyone is just starting out on the path of infertility, I recommend him very highly.

Heather said...

I think it is probably Femara...maybe?

Good luck!!

Anonymous said...

congrats! what great news... i hope you fall into the 80% category! :)

i just recently found your blog and i've really enjoyed reading. we're in metro-detroit with morph issues, too... did you ever have a krueger morph test done? Dr. M doesn't view that as an issue any longer?? what were your percentages?

i've been thinking about switching clinics, too, because they're saying all our issue are morph related... but your case has got me wondering about ours...

Duck said...

Wow, that's amazing, to go from doing ivf to natural with just a little drug. I took Femera during a medicted iui cycle, femera and puregon.
The only side effect to the Femera was a few hot flashes, but, it is also knows for causing ovarian cysts, just an FYI in case that happens.
Hopefully your wife won't need a lap.

PJ said...

I think 14 percent isn't that bad. Although I guess it depends on whether it's krueger or WHO criteria. The highest my husband's ever had was 2%, and we are still doing IUI's to start out with. My RE did say that anything under 4% is discouraging. If our 3rd IUI doesn't work, I'm wanting to move on to IVF.

Anyway, it sounds like you've got a good shot at it! Plus, the old fashioned way is SOOOO much more fun!

Good luck!

Joe said...

@heather: Yes, I think you are right - Femara is the correct name (or something like that) My wife has this stuff, whatever it is, in her blood stream as we (I) speak (type)

@anonymous: Thanks for the good wishes. I've done 3 semen analyses: The first two used what I think would be considered "traditional" criteria. Everything checked out except morphology, which was ~13 - 14% normal ... slightly below the 15% "normally fertile" cut-off established used with this assessment. I believe my third analysis used the Krueger method, where I believe my counts came in at about 4%, relative to a 5% cutoff (I could be off on this one as I don't have the papers in front of me)

Here's the catch, according to Dr. M - Even though my morphology is lower than it should be, the fact that I have a higher than average volume of sperm makes the math works out such that I have a normal volume of healthy sperm. Dr. M did some quick math and quantified this to an approximate amount of normal sperm per "load", which was as much as a guy with normal morphology and normal volume. Furthermore, the post coital test indicates that my guys are still swimming around in there ... so, the NET result indicates we're fine, according to Dr. M.

Until we're pregnant, none of this matters, but it gives us some hope.

Would be happy to discuss our experience in more detail ... there's a lot of stuff I keep off this blog as I don't want to be too cynical about the experience at our first clinic. I'm trying to remain as objective as possible ...