Wednesday, March 20, 2013

The End: Part II

UP: The most touching 9 minute love story ever.

Well it's Wednesday. Let's see if I can get through this without crying. I apologize in advance if this gets a bit rambly.

On Friday we had DH's urologist appointment. We brought in a sample with us that the doctor was going to look at before coming to see us, so we waited probably about half an hour. This whole time I was in a lot of pain. I had taken a tramadol before we left but it wasn't doing me any good. Many times I thought oh I should have just stayed home, but I'm glad I went. He comes in and says well, your semen is definitely... abnormal (read: terrible). We didn't get the exact numbers but I'm guessing they weren't any better than the last time, if anything they were worse. Apparently DH has incredibly low testosterone. Men his age should have ~827 ng/dL, men 80-100 years old should have ~241 ng/dL, he has a whopping 155 ng/dL. So yeah, that's a problem.

source
Doctor referred us to an endocrinologist and says treatment will make him sterile. After the appointment I did a bit of research and there seems there are treatments for low T that are TTC friendly, specifically Clomid and HCG. I don't know why the urologist didn't think these would be an option for us. He obviously knows we are there for infertility so less sperm isn't really what we're going for. As far as I can tell there are two reasons for low T, primary and secondary. Primary means there is a problem in the testes, whereas secondary means the problem is in the brain. Clomid and HCG may work for secondary but not for primary. See there is this loop where the pituitary gland releases LH which tells the testes to produce testosterone. A small percentage of this testosterone is converted into estrogen which signals the brain to stop producing LH. Clomid works by blocking this signal, causing more LH to be produced whereas HCG acts like extra LH. DH's LH, FSH, and estradiol are all within normal ranges. This leads me to believe that something is going on and he's not producing the right amount of testosterone for the amount of LH being released by his brain. So I don't know if extra LH would help all that much. This may be why the doctor didn't suggest trying these. We have an appointment on the 4th so I will ask more about those options then.

Anyway, with the way DH's sperm are looking he suggested we go see a fertility specialist a state over and do IVF, probably with ICSI. He didn't call it by name but he mentioned a procedure where they inject his sperm into my eggs, so I'm pretty sure that's what he was talking about. He did not see any point in trying IUI. After looking at the success rate I can understand why. IVF only costs slightly more than three IUI cycles and has a better chance than all three put together. If we had the option I know I'd rather try IVF than IUI. Unfortunately, we aren't in the financial place to do either. Once he goes on TRT doing it the old fashion way ceases to be an option and if we want biological kids he has to freeze some sperm first to later be used in IUI or IVF. There is a chance we could skimp and save over the next several months to do one IUI cycle, but it just doesn't seem worth it. I don't know if I want to put my body through even more intense drugs, more stress, more heartache, for such a small chance. For all I know I won't even respond.There is also the fact that we don't even have an RE here. There is one about 2 1/2 hours away that makes occasional visits here but trying to time a cycle around that seems like a nightmare.

So with this news and my continuing pain it looks like TTC has come to a halt. Even if we found out DH had super sperm we'd most likely be going on a break for at least three months, possibly stopping altogether because of my issues. I have an appointment on Wednesday to talk about that. For now I'm trying to come to terms with the fact that my pregnancy in October was our one, short lived miracle. I'm fairly certain at this point I qualify as being depressed. Not eating well, sleeping too much, no longer interested in my hobbies, here it is Wednesday and I haven't even watched last week's Walking Dead yet. I am considering finding some sort of therapist or other qualified person to talk things through with. Plus I took my last provera on Friday and AF still hasn't shown yet so I don't know what that's about. At least if AF never shows we don't have to decide whether to go through with one last cycle or not.

Source: my mom on Facebook.

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