Jeremiah and I knew we wanted to have children. Honestly there is no one else I could imagine having children with.
In the beginning…
In early 2018 we decided to go for it. We tried on our own for six months and didn’t have any luck. One day while I was working labor and delivery I started having a conversation with my OB-GYN at the time. I explained that “I want to get pregnant quickly” and “I feel like my clock is ticking and I don’t want to waste time”. I had no clue what we were in for.
In August we had our first clomid cycle. Clomid is a medication that can be prescribed to encourage follicle development and ovulation. Clomid cycles can be a bit obnoxious, to tell you the truth. Here is how it works; early in your menstrual cycle you start taking the medication and then as you get closer to ovulation you go to the clinic and get a vaginal ultrasound to verify a follicle has developed. Each time there was a follicle, so it seemed to be working.
Although these cycles were a piece of cake compared to what was to come, it was still exceptionally hard. I remember every month I got my period was another month of tears. One cycle I was sure it was going to work because I was “late”. During a routine trip to the bathroom I found out that my period started. I screamed and my eyes were flooded with emotion. Why is this happening to us?
After three months of clomid and no pregnancy, my doctor switched me to letrozole. Letrozole works in a similar fashion and some people have good results with the medication. We did three months of letrozole with good follicle development but never got pregnant. After six months of ovulatory stimulation, my OB-GYN suggested that it was time to be evaluated by a fertility specialist.
The fertility clinic…
After waiting nearly two months for our appointment, we were seen at CCRM in Denver. We spent nearl
y an entire day doing various tests including blood work, sperm analysis, and a not so fun procedure called a hysterosalpingogram (HSG). The goal of the test is to visualize the uterine cavity and to verify that the fallopian tubes are open. They do this by injecting saline into the uterus and capturing images at the same time. Truthfully, the HSG felt like my tubes were being ripped apart by an evil little gerbil that had moved into my body via route of my lady bits. Is this being a tad bit dramatic? Maybe, but it f***ing hurt!
At the end of the day we did a short regroup with the doctor. We really didn’t gain any insightful information. At that point everything looked okay. The doctor explained that we could try intrauterine insemination (IUI) or do invitro fertilization (IVF). Personally, I was a bit taken back at this point; wasn’t there a magic wand that he could wave to make us pregnant without all the invasiveness of advanced reproductive technologies? We explained that we would think about it while we waited for some additional sperm testing to be completed.
A couple days
after the appointment I decided to see if any of the sperm testing was back. It was and I had no idea what to do with it. The test listed things like CT, RT, ABS, AGG, pH, and TMOT to name a few. Out of the twenty-some items that were listed, I recognized pH and was able to decipher others with some Google research. Really nothing looked bad. I then came to a form that was titled, “Anti-Sperm Antibody”. These results seemed off but again, I had no idea what I was looking at. Among all of the gibberish in the document, it stated that 98% of Jeremiah’s sperm had antibodies on them. Huh? But what does that mean? Back to Google again. Shit, this isn’t looking good. I was seeing statements such as “immunological infertility” and “poor likelihood of fertilization”. I finally had to stop. We just needed to wait for our next regroup with the doctor the following week.
The diagnosis…
Okay, it was finally time to get some answers. We had spent that last several days playing out different scenarios and the “what if’s”. We got on the phone with our doctor. He went on to explain that the results from the antisperm antibody testing was abnormal. He asked Jeremiah if he had any previous testicular trauma that he could recall and he couldn’t. He was in a Jeep rollover in his early 20’s that resulted in several surgeries but that was about it.
So you might be asking what causes antisperm antibodies? Let me explain. During a trauma, vasectomy or vasectomy reversal sperm can enter a man’s bloodstream. When that happens the body recognizes it as foreign and attacks it and subsequently builds antibodies against it. In turn, sperm will contain antibodies that will reside on the tail, head, or both. This may not seem like a big deal but antibodies do funny things to sperm. To start with sperm can outright die, become damaged, or have issues with motility and speed. If sperm are able to make it to an egg, they may not be able to penetrate the outer membrane, preventing fertilization.
At the end of the conversation the doctor explained that IVF was our best bet. We wanted to take some time to process and think.
What to do???
We spent a few weeks really trying to decipher the news. I started shopping around during this time as well and doing as much research as I possibly could. The clinic where we had our initial workup would cost us a small fortune if we stayed with them. This fortune would be about 25k for the IVF itself in addition to all the meds which range from 3k to 10k depending on your protocol. OUCH!!! Our insurance did not cover anything.
I joined a Facebook group for women in Colorado who experience infertility and I started asking questions. One primary question was, “where do you all go for treatment”? Some of the responses included CCRM, University of Colorado, and Conceptions to name a few. I got on the CDC website and started researching their advanced reproductive technology data. The data that they provide is very broad. There is information on pregnancy rates, cancelled cycles, singleton or multiple rates and success rates by age to name a few. These statistics were what would guide us. We would go to the place that had highest rate of success no matter the cost.
References
Agarwal, A., & Said, T. (2009). Tests for Sperm Antibodies. Retrieved from https://www.semanticscholar.org/paper/Tests-for-Sperm-Antibodies-Agarwal-Said/60470681c9a40e8cee924eaa5eae1ebc0ab7ab0d
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