Follow me on the crazy, hopeful, discouraging, funny, and ultimately successful (one way or another) path to parenthood while facing infertility.

Saturday, January 11, 2014

We Are Hard To Classify

Life is strange. This journey is stranger. We keep thinking that we've figured out our bugaboo, that we finally have the answer to our issue with conceiving, and then things get turned around. Let's start with the IVF part of our journey, which is the last 3 years or so.

IVF is determined to be the best option for us as we have significant male factor in terms of counts, motility, morphology, etc. and I have proven to be less than stellar at IUI-appropriate follicle production. Our first two IVF cycles focus on my PCOS since we are doing ICSI and we have apparently compensated for the sperm issues thusly. Our first two IVF cycles are horrible failures, with low mature egg retrieval rates, low fertilization rates, and poor embryo development. No frozens.

We switch things up and move to a different doctor in the clinic. He takes the approach that maybe PCOS isn't so much the issue as egg quality. Changes the protocol to reflect this, and our mature egg retrieval rates improve significantly, fertilization rates are still low but we have more to work with, and we have frozens for the first time. ICSI continues to be the fix for the sperm, and we have our first pregnancy (ectopic freakshow, surgery, lost tube) and then a frozen, fresh, and frozen later our first uterine pregnancy (results in miscarriage). At this point 16 embryos have come and gone and we need to take a long hard look at where we are.

We switch back to our first doctor when our doctor leaves the practice for another one in a different area of the state. We decide we will do donor eggs, because obviously we have an embryo issue with 14 embryos not implanting at all and an early miscarriage, and not the best embryo development. Must be chromosomal abnormalities. We prepare for a year for a donor cycle and are devastated when it does not work. 30 eggs retrieved, 21 fertilized, 6 frozen at the 2PN stage (Day One), the remaining 15 left to culture, only 4 make it to blastocysts and 2 are frozen. Disappointing and disconcerting, but no one seems to think this is a big fat red flag. (By the way, the donor was a massively proven one, with a large number of first-cycle successes with EVERYONE ELSE. Which makes me feel just STELLAR.)

Try a new protocol for the DE FET, add Medrol and extra PIO, decide to do single embryo transfer. Find out days before thaw that this is not possible as the two blasts were frozen together. Blasts thaw, one is great quality and the other is deemed, "You can choose not to transfer that one." We transfer both because who knows, but get a negative anyway. Twice a day PIO shots after 7 previous cycles of PIO shots results in a weird nerve damage issue that plagues me still today (that was September). We are beyond frustrated.

Seek second opinions. All second opinions so far point to the failed Donor Egg cycles as evidence that the chromosomal abnormality is likely not having anything to do with the eggs. Which leaves us with the sperm. Which leaves us contemplating Donor Sperm as an option.

So now, four years into our journey with three years of IVF under our belt, different protocols and different genetic materials, we find ourselves pursuing an IVF cycle with MY EGGS again and DONOR SPERM. WHAAA? Beyond strange. We have spent time mourning my genetic contribution, soothing ourselves with the research in epigenetics. I have done a LOT of rationalizing about why it's not a terrible thing to not use my eggs. And now... we are back to my eggs. It is a lot to process. But, not nearly as much as it is to process the loss of B's sperm. There IS NO epigenetics with sperm. Biologically, that cupful is the only contribution. I should say genetically, as biologically I think can encompass the nurture aspect. The father-sticking-around aspect. The reason we're not like other mammals where the male takes off after the perfunctory penetration and the lady mammals are left to do all the raising themselves, if they even stick around too long after the cubs/pups/kittens/whatever are born. But it is a huge loss, and not one that we take lightly. We are sad. It is a lot to take in. And to add to it the weirdness of thinking I would never stim again to facing the daily shot monster and the sore ovaries and the egg retrieval (yay anesthesia I guess) and the hard toll on my body, and we are dealing with a lot right now. I am not complaining, because I know that I am getting my eggs back and that is something not a lot of people experience. Plus it seems somehow rude to talk about my difficulty wrapping my brain around the return of my genetic material when my husband is losing his outright.

It makes trying to classify this blog a little awkward, too. I used to be an IVF blog. Then I was a donor egg IVF blog. Now I'm a donor sperm blog with a history of donor egg, still IVF. It is more than a little strange (although the least of our worries). I have found it a little difficult to find other donor sperm blogs out there, particularly people who are not yet successful to commiserate with. Or to assuage B with, as he is feeling pretty low on this whole subject (but not low enough not to look under this rock and see if this is our root cause of no babies). I used to post this blog on Facebook, which had its pluses and minuses, but that ship has sailed. If I want to write about my infertility, OUR infertility (as I too often forget to include), I have to keep it semi-anonymous because of this sperm donor piece. I completely respect this wish, as I know how hard it is to grapple with the loss of genetic material. But I don't know what it's like to do that WITHOUT the epigenetics piece. And while I know what it's like to go through the emotions of loss and feelings of failure and questions of worth and worries of bonding, I now have turned around and received all that back. So while I can say "I know how this feels" to some extent, really, I don't. It's different for guys. I think it's harder both because of the contribution thing and because of how, typically, guys process things (or don't). It's tricky business.

Consider this my foray into now chronicling our Donor Sperm IVF journey... a completely new leg of what I never ever thought would be this complicated. EVER. I will share the feelings, I will share the realities, I will share the worries. I will share the process, because it is a little daunting. And not a little bit different from our Donor Egg process. Selecting a male donor versus a female donor is worlds apart, at least for us. I will share my new approach to using my eggs and what it's like to stim after you thought all that was behind you. I will do my best to be sensitive to B's needs for privacy while processing this the best way I know how, by writing. If you are a Facebook person who found this, I ask you to be just as sensitive. We are in new and tenuous waters that we haven't figured out how to tread yet. We have added another layer of complexity and strangeness to our already pretty strange and complex path so far.

Thank you for your continued support, thank you for your information, thank you for your patience as we figure this new thing out.

6 comments:

  1. Goodness that is a load to process. I'm sorry that you have both struggled thus far (the synopsis of past cycles and loss). I don't know the flip side of the coin either. I honestly was almost grateful it was my loss and not my husbands as you say with research and just general greater ease in connecting to the possible pregnancy and developing baby that women have. I do believe too though that men have a profound affect on the child(ren) they are father too (genetic or not). And I think that affect starts right from the beginning of pregnancy. Fathers are such a keystone in a healthy development and I hope B finds some support of other men in this position. Wishing you success in any form that it may come.

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    1. Thank you so much--it has been weighing on us for a little while and it feels good to get it out there. Yet also terrifying. I agree, I was happy to carry the load of losing the genetic piece when we went egg donor (well, maybe HAPPY isn't quite the right word). Such a hard thing. I will share what you said about fathers with B--I think that is so helpful! Thanks for the support!

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  2. Oh MAN you and I are on such similar paths. If this upcoming FET doesn't work there is the possibility of donor sperm in our future---although I just don't know if I can do it. It might be adoption if the FET doesn't work out. It is bizarre isn't it to have mourned so much biologically and to think it is over for you only to realize that it really might not be over for you? If I could have avoided all of this by spending a few hundred dollars on DS and an IUI all along---holy SHIT why didn't we just try that in the beginning? And why didn't anyone recommend that, just to see? Now I am almost 40---CAN we even use my eggs now? Or will it be DS and DE? Absurdland. Feeling you over here. I don't know of any male factor supports out there, but it is good thing to look into...

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    1. I know! It is oddly comforting to have someone else in a weird situation, as horrible as that might sound... The interesting thing is that we are not going to try IUI, because of all my issues that contribute to the infertility but may not be the root cause of why things go pffffttttt. I don't stim well with IUI, and with IVF there is just so much more control even though it's more expensive. I have a lot of information to share from my Egg Boot Camp that I am putting myself through (because I haven't used my eggs in going on two years by the time we do this thing, I am worried they are not as spry as they used to be). Lots of interesting supplements, although some are meant to address PCOS specific issues. For us, if the donor sperm doesn't do the trick, then it's down the adoption path we go. I can totally get your thoughts on adoption after FET given the losses that you've sustained--there's such a cumulative damage done with recurrent loss. We'll see where our paths take us and try to help each other along the way! :) Thanks for your thoughts!

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  3. Sorry that I'm just now catching up, but I'm in a similar place as you. We're about 99% likely going to be using DS (non-obstructive azoospermia with a failed TESE and a hail Mary varicocele-ectomy that we're giving 12 months before we do yet another TESE. Repeat SAs have shown no spe.rm, we're not hopeful, but this is how my husband is coming to terms with the loss of his bio/genetic connection). I, on the other hand, have high FSH and low AMH, indicating that I have diminished ovarian reserves. I have spent the last 12 months going through egg freeze cycles with varying degrees of success. Since we've never had sperm with which to fertilize my eggs, I don't know about the egg quality, but it's likely not great. So we might be looking at a DE situation as well. I'm in a slightly different limbo than you, but I can relate. While epigenetics gives me great comfort, but I haven't even talked about it with my husband for the very reasons you cite--males don't have that option.

    Honestly, we haven't talked about his feelings that much. Not to say that we haven't talked about it, but I haven't asked him and he hasn't said to me "this is how I feel about this." I know it's hard for him. I know that this is not what he wanted. I know that it will continue to be hard for him. I think he is ashamed (he wants us to lie to everyone about our use of DS--our families know there are problems, he wants us to tell them we got lucky). I think he might feel emasculated or that he might have done something wrong, however, this maybe feeling was surely assuaged when our dr. said it was genetic and had probably been the case since birth. I know he's worried that our child will be teased/feel ashamed/feel different. But I also know that he's excited about a possible pregnancy (I don't think he'll be disconnected from the pregnancy because it's not his genes); I know that he'll love this child with all his heart and soul. I think that he might be hurt if it's my eggs and DS and maybe resentful--but I also think we're strong enough to survive it. I think he's strong enough to survive it. I have a lot to think through, and I think we have a lot to discuss still, but we also have time; our timeline is to move forward with or without DS in May. I know this is a long comment, but I agree that it's hard to find the DS perspective and it's a scary one and I wanted to share what we're thinking/feeling/going through.

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    1. Thank you so much for your comment! I really appreciate you sharing your story. Donor is so difficult on so many levels, and uneven donor is definitely a possible bag of snakes. I hope that the surgery is helpful--I am always nervous about things that could give hope and then take it away again but without hope we really have nothing. (I mean, after all this we have nothing at the moment anyway but a kickass relationship and two cats, but without hope there's not much point in soldiering on however we end up doing that...) Talking about feelings is hard but I think necessary because it will bubble up to the surface eventually anyway. This is definitely one of the harder things we have had to do and I just hope that it is worth it. Thank you for sharing your DS perspective--it is really hard to find that! (Probably because of all the men out there begging for privacy to some extent).

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