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April 23, 2004

What do you what to be when you grow up? I think I’ve pretty much always known - a mom. Sure, I think I could have done a number of things, but I know in my heart I was meant to be a mom. I want to have a family with my amazing husband. Well, as things turn out, you can’t always get what you want and certainly not when you want it. As promised in an earlier post, I’m going to talk about the whole infertility thing. A little background:

- My husband and I decided to start trying to get pregnant half way through his 2nd year of law school. After 3 1/2 years of marriage and a total of 6 1/2 years together, we were finally ready to be parents.

-During my annual Drs. appt, and after 9 months of trying, we discussed whether of not I should have some fertility testing done. I decided to wait since our insurance didn’t cover it.

-Fast forward another 6 months or so of trying, many months of not so subtle hints from family about when we we’re gonna have kids, and more month after month disappointment. I went back to my Dr. during a very long cycle. My cycle is pretty regular, never longer than 30 days. I went to the Dr. on cycle day 40- no period, no positive pregnancy test. This time when I my Dr. about testing, she said it was my choice but that she thought stress could be a factor in our lack of success. She said that she saw lots of couples get pregnant after they finally left the stress-filled environment of grad school. Looking back on this, I now know how much a load of crap this was.

-After graduation and a long summer of studying for and taking the Bar, my husband started his job at a law firm in Houston. We finally had insurance that would cover infertility testing. After a couple of months fighting the HMO for our insurance cards, we both made appointments. My husband got in to see his GP pretty quickly, but I had a 3 month wait to see my OBGYN.

-My husband’s GP sent him for a semen analysis. After a couple of weeks of waiting for results, a few phone calls, we finally found out what was keeping us from getting pregnant. I remember that day so well. My husband called me from work and let me know that his test came back showing 0 sperm in the sample - that’s right zero. I remember saying to him “Is that even possible?” I had never heard of that. I spent the rest of the day and subsequent days doing some massive research on the internet (what would we do without the net?) I found that his diagnosis was Azoospermia, total of absence of sperm from the semen. We were totally blown out of the water with this one, but at least we now knew what was wrong.

-We decided our next step would be to request another test. We just needed confirmation. My husband went back for another semen analysis on New Year’s Eve day. A couple of weeks later we found out that the second test confirmed the results of the first. Our next step- get an appointment with a urologist. After some more research, I learned that one of the urologists in our plan specialized in male infertility and microsurgery. There was a 3 month wait to see him, so on to wait some more. That’s the hardest part of all of this- the waiting.

-During the wait, I went to see my OBGYN for a check up and to ask about testing. She told me that since my husband had a diagnosis, there was no need to test me and that the insurance wouldn’t pay for it anyway. What is it with all these misinformed Drs?

-We finally got to see the specialist at the beginning of March. He was great! I had done my research before going to see him, and everything he said was right on. Apparently this isn’t always the case. I’ve read online about people with the same diagnosis going to Drs. who told them they would never have biological children. This is far from the truth. Anyway, the Dr. did a physical exam, asked lots of questions, and ordered some blood tests and two more advanced semen analyses for my husband. When he asked about me, I told him about my recent appointment with my OBGYN. He let me know that what I was told was absolutely wrong and gave me the name of a Dr. who specialized in female infertility.

-We got my husbands test results back a few weeks later. The semen analyses confirmed the initial diagnosis. The blood tests came back completely normal. This is important because it means that my husband doesn’t have testicular failure. See, there are 2 types of azoospermia, obstructive and non-obstructive. As the name implies, obstructive is when there is a blockage that prevents the sperm from “getting out.” Non-obstructive is when there is something wrong, usually hormonally, that prevents sperm from being made. We always suspected my husband’s was obstructive because he had hernia repair surgery when he was 2. Apparently either Dr. error or scar tissue can lead to obstructive azoospermia.

-In the meantime I saw the Dr. who the urologist recommended. She ordered blood tests that test fertility. They’ve all come back normal, and we are thankful.

-We went back to the urologist on April 14th. He reviewed the test results and decided the next step would be a biopsy to make sure there are sperm being produced. This is an outpatient procedure performed under general anesthesia. At that time he will also do an internal ultrasound to check for a blockage. I have to admit, that during this appointment I was very nervous and pumped full of new knowledge in this area. I kept asking the Dr. ton of questions. I even brought up the ultrasound before he suggested it. I know I was probably annoying the crap out of him, but he did say that I was asking board-level questions. I think I impressed him with how much I knew about the subject. Well, since this is the most important thing in the world to me right now, I try to learn as much as I can about it. I don’t have a job in the outside world, but let me assure you, this has become a full-time job for me.

-My husband’s surgery is scheduled for this Tuesday, the 27th. I know we’re both really nervous about it, but it will give us some really important information. It will let us know whether the Dr. will be able to attempt a complicated reconstructive surgery to fix the situation or whether our next step will be IVF. We’re hoping for reconstructive surgery for a few reasons: it will most likely be covered be insurance (IVF won’t be) and if it’s successful, that will be the end of things. With IVF, we’ll have to have multiple procedures to have more than one child. Plus, unlike many people believe, IVF isn’t a sure shot. Some people aren’t successful at all with it, and many people take multiple times for it to produce a viable pregnancy. Plus, there’s the whole money thing. $15-20,000 a pop is a lot of money.

-Even though it breaks our hearts to have to go through all of this, we are fortunate to be living in a time when all this is possible. Just 10 years ago, we probably wouldn’t have been able to have biological children. Now they have a procedure used on azoospermatic men where they can aspirate sperm from the testicle or epididymus and inject individual sperm (through ICSI) into the eggs retrieved through IVF. That’s pretty amazing if you think about it. Hopefully, we won’t need to utilize this awesome technology, but it is a distinct possibility.

-This has been a very hard almost 2 1/2 years for us, especially me. Infertility is so hard emotionally. You see all these people who get pregnant without even thinking about it while you’re wanting the same thing for yourself so badly. Don’t even get me started on the people who don’t deserve to be parents that have kids. As we all know, life isn’t fair.

-On a more positive note, my marriage couldn’t be stronger. Infertility can do one of two things to a marriage: complety rip it apart or make it so much stronger. I always knew I was fortunate to have a wonderful marriage, but going through all of this has just made our relationship that much closer. I couldn’t have gone through all of this with anyone else. I know that no matter what happens in our crazy journey through the world of infertilty, I will always have the most wonderful husband in the world by my side.

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