Saturday, October 10, 2009

What's Good for the Goose

This story has a beginning, middle, and beginning of an end. It's kind of a choose-your-own-adventure, really.

In the Beginning: There was a meltdown of epic proportions. I spent half the day in bed and the remainder watching HGTV through tears on Wednesday. I called KB and asked him to come home early so we could have A Talk. We worked our way through all options and how they all suck rocks, even making some decisions about donor parts if it comes to that. Going into The Talk, I was afraid he would hurl some clothes in a bag and run screaming, but he proved once again that he is my perfect match, effed up sperm and all. He wants a baby as much as I do. He wants me to experience pregnancy in all its bloated, painful glory. He will do what it takes for this to happen. Money and borrowed parts are no object.

In the Middle: Dr. Dick (not his real name) tells us that KB's morphology has improved over the past year. We now have 12% normal morphology. That's per WHO criteria, so nothing to write home from camp about, but it improved nonetheless and the motile dudes are holding steady at a just-suboptimal 40%. Not stellar, but not hopeless, either. We also have a likely reason now: all the ultrasound ass-raping proved there's no blockage or anatomical anomalies, so a slight dip in testosterone is the sole culprit. Clomid to the rescue! Dr. Johnson (not his real name) thinks it may, in conjunction with a bunch of supplements, help in the months ahead for either IUI or IVF. Poor KB is concerned about weight gain as a side effect. Suck it up, soldier! And welcome to my world.

Beginning of the End: We kind of have a plan. The New RE (with whom I hope to meet ASAP if he can move my consultation up) uses minimal stimulation IVF in his practice, which may be a good option for me. I don't make large quantities of eggs with supra-physiologic stimulation, so shifting focus to quality in a smaller number of follicles with less stimulation may be the way to go. You can use Clomid with few injectables, trigger, and retrieve; then ICSI proceeds as usual. The side effects and medication costs are both greatly reduced, so the possibility of needing additional cycles becomes within physical and financial reach this way. If he thinks that medicated IUIs are a reasonable bet at this point (converting to IVF mid-cycle if needed), I am willing to go there.* KB gets a taste of frequent office visits to check hormones and sperm in the next several months, so the results of those tests may dictate our weapon of choice in Operation Baby Bump. It's requiring a huge leap of faith I didn't know I had in me to accept that moving backward to mini-IVF or even IUI might be prudent, given the hardcore IVF-is-the-only-option brainwashing I've been subjected to for months, but I am mustering all my courage to face the odds.

If all of this is tried and fails, the donor egg talk can resume. KB and I debated the merits of donor egg versus donor sperm if we get that far down the road, and if I'm being honest with myself then I would prefer donor egg. Why, the sane people ask the crazy lady? To the tune of $15,000 and giving up my DNA? Well, first, KB and I decided we will not let money determine our parentage**; and second, my family is krazy-batshit-nutz, so I would be more inclined to relinquish my half of the genetic pool if one has to go. I also feel like I could live with that sacrifice, whereas with donor sperm I think I would drive myself insane worrying that it bothers KB (though he swears it wouldn't). On the other hand, donor sperm is cheaper and requires low-tech IUI....however, it can take 4+ IUIs to get pregnant, which is not much better on the whole than one IVF cycle with an egg donor who can make a baker's dozen follicles for me. We're hoping all of this proves to be moot, anyway, but the plan is in place. I love a plan. It soothes the Type A in me.

So: Clomid; fancy vitamins; and a kinder, gentler RE. This is our Hail Mary.

* We have done medicated cycles and IUI before, but my OB/GYN, being used to treating patients AFTER they have conceived, did not add any injectables or even a trigger, so who even knows if we timed it right.

** I have offered to turn tricks on 8 Mile, but KB (being the good husband he is) says we can borrow money or try to re-fi the house if needed. He's the sensible one in this relationship.


Pundelina said...

And clomid rears it's head again! Hooray that the doc thinks that he can improve KB's SA and that it may well work with an IUI - that's great news.

And well done on braving The Talk, I'm so pleased that you did and that you've plotted a Plan Z out. I totally get what you mean about knowing that you could cope with the donor egg but not really knowing-in-your-bones whether KB would akshully really be as fine as he says. It's far easier to have more certainty about your own feelings.

Crossing my fingers you get that earlier appointment!


Lisa said...

It's amazing to hear all the options that actually exist. I'm glad you have a plan and a new course of action. Good luck with the new RE!