I said that I made an appointment with "my" OB/GYN for early June. Well, not exactly. I made an appointment with the first available OB/GYN. I had actually never met her before. I had previously seen two other physicians in the same group, but none of them more than once. Let's just say that when the time comes, I'll be switiching doctors again.
The woman (let's call her Dr. S) is about my age. She listened to my TTC complaints and told me that I probably needed to relax. She looked at my temperature curves for literally less than 1 second before setting them down. I bet if I weren't a doctor too (at the same institution), she probably wouldn't have ordered anything. However, she did agree to order a semen analysis for S, and basic bloodwork for me. I was not impressed when she told me that I could get the blood drawn that very day. Ummmm....it was cycle day 30 or so, and my temperature was plummeting. I said, "Don't you want me to get that drawn on cycle day 3 since you are testing my FSH?" She said, "Uh... do whatever you want." I literally think that even with that reminder, she had no clue what I was talking about.
Unforunately, 6 months later, I am still trying to get the bill for these blood tests paid (it's over $500) because she coded the visit as "Pap smear" and didn't put down anything about my irregular cycles to justify the check of FSH, TSH, prolactin, and estradiol. I have been in frequent communication with the billing department since early October, but it still is not resolved. On the other hand, I was greatful to have normal TSH, normal prolactin, normal FSH (5.2) and normal estradiol (18).
S scheduled his semen analysis for late June. Dr. S asked for him to get it done at the offices of Dr. G, a local reproductive endocrinologist. So, he did that. It took almost a week to get the results, because Dr. G's office refused to release them to me directly. They wanted to give the results to Dr. S. Unfortunately, Dr. S had no idea how to interpret the results and she had to call Dr. G's office to speak to one of the reproductive endocrinologists to get an interpretation. (I actually appreciate that she did this). So, anyway, she finally called and the results were not good. They were:
Concentration: 25 million/mL ... OK, not great but in the low/normal range
Volume: 4 mL
Total count: 100 million
Motility: 44% rapid forward (OK, maybe a little low)
Morphology: 1% normal by Kruger strict criteria.... this is really bad. "Severe teratozoospermia."
Dr. S said that Dr. G's RE colleague said, "We like to see the morphology at 4% or so. Tell them to keep trying, and if they don't get pregnant in 4 more months, get a hysterosalpingogram (HSG) and make an appointment with us. "
I started researching everything I could about morphology, and finding very few answers. S doesn't smoke, drinks only socially, and doesn't have a habit of using jacuzzis, laptop computers, or riding a bike. He didn't have any recent illnesses, and he's actually really healthy and fit. He did have an STD during college but was treated right away. He did switch over to 100% boxers when we found out. I was hoping that maybe the poor morphology was a fluke, and that the problems would resolve. I was terrified of the notion that we might have to undergo IVF someday.
I found other people with MFI on ovusoft and clung to the stories of men with 1% morphology who had fathered children in the past or present. I found at least one blog (http://infertilityblog.blogspot.com/) in which the author (a reproductive endocrinologist) maintains that morphology is not a real problem! I hoped and prayed for a summertime pregnancy. Still, when my period showed up yet again, I scheduled my HSG... this would be completed in late August, after 1 more full cycle.
Well, my period sure enough came around again, and it was time for the HSG. The HSG itself hurt like hell (for about 1-2 minutes), but I didn't have any blockages. The radiologist blithely told me that she was reviewing HSGs with a medical student, and "a huge proportion of the women had OB first trimester ultrasounds within a few months of their HSG." I thought this was encouraging at first and clung to the hope that maybe some invisible debris was now gone, thus opening my tubes. Although, in retrospect, I wonder how many of those women had actually gone to an RE soon after their HSGs. Maybe those are all IUI and IVF babies that she is seeing.
Well, we tried another cycle and then scheduled S's second semen analysis, with a reproductive endocrinology appointment to come a few days later. I still clung to the hope that maybe, just maybe, I would get pregnant with Cycle 10 and cancel the appointment at the last minute. But... no such luck. On October 18th, we had our appointment with Dr. G, the RE.
To be continued...