Praying For Hope: After the appointment

Thursday, April 9, 2009

After the appointment

I may not be the primary cause of our fertility problems. We went to my appointment with Dr. Stegman as planned. The first thing we discussed was the result of DHs last SA. Good news and bad news. The numbers were no worse than they were with the first SA - and some of them were much better - but the one thing the needed to improve, didn't. Forward progression is still 1+. On the upside, concentration improved from 40 or 45 million per mL to 93 million per mL, morphology was 94% (also an improvement), and motility was 60%. It has to be the vitamins he's taking in place of the Proxeed.

So how do we improve forward progression? What good does it do to have great concentration if his swimmers are wiggling in place? I believe 1+ means that there is occasional forward movement. Is it enough for at least one of them to get where it needs to be one day?

It's a little depressing. It seems like there's so much they can do to improve a woman's fertility, but not so much with a man's.

Dr. Stegman recommended that DH see a local urologist. He's also going to call a urologist in Philadelphia who has some interest in male infertility to see if there's anything else DH could be doing. For my part, I'm to take steps to make sure the mucus is as optimal as it can be. It's not bad now, but there's room for improvement. I'm supposed to start taking Mucinex twice a day from CD8 - P+1. I'm also going to be doing 500 mg of extended release B6 daily for two months. After that, it'll be 100 mg daily.

That's it. I was hoping for more. But if the primary problem isn't me, what can you do? My hormones are decent. Clomid won't do any good (which, by the way, Dr. Stegman said we won't be trying yet since I'm ovulating well on my own). I don't know.

I'd really rather it were me. DH is going to be down on himself now. He takes a negative view of things. Rather than using the bad news as a spur to improve the situation, he tends to wallow in it. Then he feels worse and wallows some more. That's my hubby. I love my sweet pessimist.

2 comments:

Living Advent said...: I'm so glad that I'm the pessimist in our house! DH is a total optimist and he still needs A LOT of encouragement. If he was a pessimist like me, I'd be beside myself.

I so totally get your statement "I'd really rather it were me." I'll be praying for your husband - when one of our docs remarked on the high white blood count in the SA, I saw my DH's face fall. I think as hard as all this is on us that it's harder on the men.; April 10, 2009 at 10:39 PM
the misfit said...: I know what you mean. Given my medical history (and the little b/w I've had), I'm clearly at LEAST part of the problem in my house. But I do worry that it will turn out that the DH has problems as well (actually, he smokes, so that seems likely), because I am afraid he will be both guilt-ridden and crippled by feelings of inadequacy. I am hoping that either he is fine (good) or there's a fairly even-handed diagnosis of reproductive problems (workable). You have your share of risk factors, too, right? Maybe that doesn't help...; April 11, 2009 at 9:38 AM

TTC History

9/1/2007 - Married to a perfect man.

10/28/2007 - Started the never ending road of TTC at the tender age of 37. How many other people do you know who can name the exact date they started trying for a baby?

3/12/2007 - Decided my husband and I weren't getting anywhere on our own in TTC and and that it was time to look for someone who could help.

4/10/2008 - Attended our first CreightonModel Fertility Care class and started tracking my cycle.

4/25/2008 - Had our first one-on-one session with our FertilityCare practitioner. We learned a lot. She suggested an appointment with one of the practice doctors, Dr. Mark Stegman, a skilled Napro doctor and surgeon, we took her up on the offer. We might be able to get an appointment some time in August.

4/28/2008 - Got a call from a receptionist from Dr. Stegman's office. Could I come in next week? Yes!

5/5/2008 - My first appointment with Dr. Stegman. He was very thorough in discussing our options and a potential plan of action for us. We'll begin with blood work to establish a hormone profile series in my next cycle.

5/2008 - Blood work every other day for two weeks. The nurse at the front desk knew me by sight by the time we were done. I nearly passed out at the payment desk on the day they took 10 vials of blood. That was pleasant. Did I mention that I hate needles?

5/27/2008 - Our first seminal analysis (SA). We're not keen on the special condom meant for the job.

6/30/2008 - Our follow up appointment with Dr. Stegman to learn about the results of our tests and where we go from there. My blood work looks good. My husband's SA looks good, too, except for forward progression. We scored a 1+. I believe 2+ is the preferred score. Dr. S recommends Proxeed. He also tells us he wants to schedule a selective hysterosalpingogram, a hysteroscopy, and a laproscopy some time late summer or early fall.

7/30/2008 - Being too cheap to shell out over $600 for a 6-month supply of Proxeed, my husband and I opt for the generic equivalent. It's a lot of vitamins, but it's much kinder to our wallet.

9/8/2008 - I have the preliminary exam, blood work, and tests prior to my surgery. I'm so nervous, I'm about ready to run screaming out the door, down the steps, across the parking lot, and straight home so I can hide under the bed with the dog. It's a miracle that I don't.

9/9/2008 - I have the SHSG, hysteroscopy, and laparoscopy and, much to my surprise, I survive. My tubes are good (woo hoo!), and I have no adhesions. Dr. S removes three polyps and "quite a bit" of endometriosis. It doesn't look that bad in the pictures of the surgery. It's fascinating to see what I look like from the inside out.

9/10/2008 - 9/12/2008 - I look like Shamu.

10/30/2008 - We're told that everything from the surgery looks good. The scars will fade over the coming months. We're to try to make a baby on our own for the next 6 months. Dr. S calls this "the fun part."

1/30/2009 - We have another appointment with our FertilityCare practioner (we've had quite a few before this, but I haven't mentioned them). She thinks Dr. Stegman might try me on Clomid as a next step. I hope it's Femara. It's not nearly as drying.

2/3/2009 - We have our second SA. We're still not keen on the condom.

3/4/2009 - This is fun?

3/27/2009 - The scars from the laparoscopy are nearly gone. Oh, and I'm 39.

4/9/2009 - Another appointment with Dr. Stegman. We learned the results of the SA. The numbers are no worse than the first - in fact some are much improved - but forward progression is no better. Our plan of action: optimize mucus by taking Mucinex twice a day from CD8 - P+1 plus 500 mg of extended release B6 daily for 2 months followed by 100 mg daily. DH is to make an appointment with a local urologist while Dr. S contacts a urologist in Philly with an interest in male infertility to learn if there is any more we could be doing. Next follow up: August.

4/29/2009 - We - or more like DH - had our urologist appointment. Official dianosis: nothing. No varicoceles, no prostate problems. Prescription: continue doing what we're doing. For this we needed a urologist?

5/29/2009 - Dr. S is booked for the month of August! They said they'd call when August opened up for appointments. I didn't hear the phone ring. September opens up next week. An additional month of nothing. I'm 39 - Methuselah in TTC years. How many months do I have left?

7/16/2009 - Ho hum.

7/24/2009 - Another FerterlityCare appointment. Our FertilityCare practitioner, Kim Lane, suggested that Dr. S may be taking his cue from me as to how aggressively we want to pursue treatment. I need to come up with a few new cues so we can get off the wait-and-see treadmill.

9/17/2009 - Another follow-up with Dr. Stegman. Our plan starting with the next cycle: 1) Limited hormonal profile, 2) An ultrasound series to monitor follicle development, 3) Ovulation stimulation (type and amount to be determined by the u/s series), 4) Food intolerance testing (is it ALCAT?), 5) Five cycles of Amoxicillin from CD8 - CD12 to improve CM.

9/28/2009 - The beginning of another hormone profile and, a new one for me, a follicular ultrasound study. This should be interesting provided I can keep track of all the appointments.

10/4/2009 - 5th ultrasound and three follicles! Can you imagine? So what does that make FSH?

11/11/2009 - Progesterone and Thyroid support! We had another appointment with Dr. S to discuss the test results and come up with another plan of action. FSH and LH were only 5.7 and 5.1 respectively - good levels, good ratio - but TSH and Reverse T3 were slightly high and progesterone plummeted afer P+5. Ovulation looks great, so no ovulation stimulation . . . yet. Ah, well.

12/8/2009 - I am a fertility magnet. Anyone in my vicinity will, given the opportunity, become pregnant within a year, TTC or not. Whether it be a 20 year old woman or an 80 year old man, it doesn't matter. All those around me, as long as they're not actually me, will have a child. I am blessed with an awesome power. . . . How do I reverse the polarity?

1/27/2010 - BFP. Stunned.

1/28/2010 - I called Dr. S's office the moment they opened. We have blood work this afternoon, 200mg of Progesterone, and a prenatal appointment. Prenatal. With a midwife. I'm really pregnant. Me.

1/29/2010 - P+17 numbers are hCG, 472, and Progesterone, 10.2. PIO twice a week, Mondays and Thursdays. I can’t sit down, but I’m too restless to care. The HPT was right.

2/1/2010 - You do not make a desperate, hormonal woman wait for P+21 hCG results! By the way, they're 1670. I'm limp with relief.

2/11/2010 - There’s a baby in there! Our first ultrasound. Junior is measuring 6 weeks, 1 day with a heart rate of 96 bpm.

2/16/2010 - Progesterone results from the last blood draw haven’t budged, so we’re adding daily progesterone suppositories to the twice a week injections. I’ll do whatever it takes.

3/2/2010 - Progesterone has risen to 27.4, zone 3! No PIO for now, just suppositories until the next blood draw in two weeks. If it still looks good (fingers crossed), we may be able to stop the suppositories. Knock on wood, knock on wood, knock on wood . . . .

3/27/2010 - New decade: I'm 40!

4/5/2010 - No more progesterone. The level at the last blood draw is 30 which I don't think sounds particularly high. If the experts are happy, I'm happy. And the results from the Down Syndrome screening came back: we're at no greater risk for Downs than anyone else. We're breathing again, until the next milestone at least.

5/18/2010 - It’s a mobile, little girl! Keep growing, kiddo.

10/11/2010 - Welcome Kathleen Elizabeth.