I want to start off by saying this post may be a little lengthy, but I wanted to include all I can. My blog posts aren’t just to keep our friends and family in the loop; but they are also to help anyone who may be going through this and doesn’t know where to turn. In addition, I am not a medical professional to know whether our doctors did the right or wrong thing; I am just here to share our journey and our feelings.
After contacting Missouri Center for Reproductive Medicine (MCRM Fertility) and speaking with the doctor, we began to feel a sense of hope. This doctor and her staff have been incredible. They are quick to respond to any and all questions, via email or phone. When a lab order is sent, they ensure we are contacted in a timely manner for scheduling. When at home labs are sent, they include step by step instructions and the packaging to send back along with a pre-paid label and the mail carriers address of where we need to mail (due to biohazard materials). Due to the astounding care we have received in just this short while, we know that there was a reason she was brought into our lives.
As I discussed previously, we are no longer seeing any local doctors regarding fertility and have completed most of the tests requested by our Missouri doctor. We both have one more test needing to be completed which is a genetic test; which will probably take another month or so. Since that was the only test that was pending, she requested a follow-up regarding the test results she had received.
Prior to calling us, the doctor reviewed not only the tests she required, but also any and all tests or procedures we did previously. She began discussing Juan’s results first (Don’t worry I got his approval to write about this). After reviewing all the records from our IUI’s, IVF, the semen analysis reports from our IVF, the semen analysis in 2018 and the most recent semen analysis she noticed a few red flags. She explained there were several areas of concern from motility, progression, concentration and morphology. She informed us that they were not horrible, but they were on the lower end of the spectrum. She explained that the sperm were moving, but they were only moving in place and not moving forward. The doctor stated this is most likely why our 3 IUIs were not successful.
She then moved on to me. She stated that looking at the information from our IVF that my embryos were of “fair quality” and that my follicles showed signs of developing slowly. She stated that on the day 5 transfer the embryos were in the morula stage. The morula stage, typically, is around day 3. To make a little more sense of this, here is an excerpt I found to help understand it;
*- “In an IVF cycle, a blastocyst forms in a culture system in a laboratory. Eggs are retrieved from a woman’s ovaries, fertilized with sperm, and an embryo is created. The embryo divides and multiplies its cells over 5 to 6 days to become a blastocyst. Embryos that survive to this stage of development have a high implantation potential once transferred into the uterine cavity.”
Thus, our last 2 embryos that were transferred were at the Morula stage on day 5, when they should have been at the blastocyst cycle. The Missouri doctor suggested that embryos in the Morula stage can be transferred but have a very low chance of implanting. In addition, my FSH showed to be a little high which indicates diminished ovarian reserve, which is associated with a reduced number of follicles or eggs, frequently of questionable quality. For my age, normal levels should be under 10mIU/ml, and my numbers were 9.8mIU/ml. So, although they were “within range”, they were on the higher end. Which on its own would not be a huge deal, but with all other factors it is a red flag.
To backtrack really fast, when I did my IVF I had 15 eggs retrieved, 8 matured and 5 fertilized normally. I thought this was a good number. However, this doctor stated that when they do IVF they want to see 75% of the eggs retrieved be mature, where only half of mine were. She stated that my higher FSH could be the reason only half of my eggs were mature.
There were multiple other areas tested through my blood work, 34 to be exact. However, the ones mentioned above were the ones she discussed with us due to red flags.
The doctor proceeded to say that although we have been told multiple times “there is nothing wrong” there is; our infertility is an egg, sperm and embryo factor. This in my mind means everything. My heart sank. All these years we have thought we were fine and now to be told we aren’t, it just truly blew both of our minds.
As I stated previously, our doctor mentioned that she was not only reviewing the records she obtained via her tests, but also records from previous doctors; for both of us. For a quick refresher our previous records contained results from the local fertility specialist, the 2 doctors that I did rounds of Clomid/Femara with, and the urologist for Juan. Meaning, all these doctors had our information containing these issues; primarily the fertility specialist and the urologist. As much as I want to point fingers at ALL the medical professionals we saw. I am truly upset by the two doctors who had me on Clomid/Femara and never did blood work to find these out of range numbers, shouldn’t they have? I don’t know.
However, the fertility specialist and urologist that had the information in their hands and never told us, has brought me to tears many times in the last few days.
You may ask, are you sure they knew? Yes, I am sure. The urologist had the results (the exact same result sheet sent to MO) in his hands when he sat us down to discuss the results. During that discussion the urologist informed us that the sperm analysis showed Juan to be normal/above normal in all categories. Knowing this test was done due to fertility issues; meaning even the slight abnormalities should have been mentioned. Our Missouri doctor stated on most of the areas on the sperm analysis it showed that the sperm was on the lower end of the ranges. Yes, every doctor can view things differently; however, there are ranges doctors go by to ensure the numbers are within the range of that person’s age group. When she reviewed what the ranges were in 2016 it stated the sperm showed being on the lower side.
Next, our first fertility specialist made notes in our records stating the concerns, but he NEVER told us about them. Before he even began procedures, this doctor knew I had a higher FSH (associated with a reduced number of follicles or eggs, often of questionable quality) and that Juan’s sperm showed indication of poor quality. These factors alone, per our Missouri doctor, would indicate we would not be good candidates for an IUI. Yet, he did 3 of them. After all of these cycles, this doctor still never informed us of the questionable egg or sperm quality. We were just led to believe everything was A-Okay and preceded to doing IVF which our Missouri doctor did say was the way to go with everything she saw. Thus, I am not very upset about that. However, I am upset that the local fertility doctor notated fair embryo quality, follicles showing unusual slow development, and the last 2 embryos (which were transferred) not in the stage they should have been; yet still continued with IVF.
At the end of our hour-long conversation, my mind was racing in a million different directions. All I could think was; this really is never going to happen. However, I somehow was able to hold back the tears and ask; so are we even able to get pregnant? Her response was, absolutely.
When we hung up the phone we immediately began crying. Crying because of anger, crying because of fear, crying because we finally received answers. My mind immediately went to the fear of financial worries. Knowing that IVF would be the way we will have to go, which will lead us into a large loan or debt. If you told me I could pay $100,000 and be guaranteed our own child, I wouldn’t blink an eye. However, I fear that gut-wrenching feeling of having to pay back an IVF loan knowing it didn’t work. I fear struggling financially. I fear going through everything and coming out the other end empty, again.
To say I have anger toward our past doctors is an understatement. I feel like we were failed, multiple times. Again, I do understand the local fertility doctor may have hoped these procedures would work. However, when he has this information and does not relay it to us, to give us a say or an opportunity to decide how we want to proceed, is where it hurts. It also hurts that if we could have known all of this information 4-5 years ago, we could have taken supplements or sought out treatment to help ourselves.
With all of our anger and sadness, we are also beyond thankful that we were sent to this new doctor in Missouri. The amount of time she has invested in reviewing all of our old records, the tests she has run and is still running to determine what factors are playing in our “infertility” shows us how determined she is. She has been beyond honest and blunt with us, letting us know conceiving on our own could happen, but probably won’t due to there being a male AND female problem. Instead of rushing into what she believes are procedures that will work, she wants to wait for a few additional test results and try us on supplements to see how our bodies react.
For anyone who is going through a similar journey or if you know someone going through something similar please relay this, be sure to ask questions. Ask every question you can think of. Take notes before to ensure you don’t forget anything. Ask for your records and question anything you feel is off. Do not assume the medical professional is informing you of everything. Ensure you both are tested for everything and anything, even if insurance doesn’t cover it. The truth hurts with some of the results, but it also can help lead you down the road you need to take. Having these tests done and getting results will save money in the long run. It will help pinpoint any issues, and what may or may not work for you. I unfortunately have gone down the path with many potholes and curves; thus, I hope and pray if you read this you can prevent that rough journey.
Again, I want to thank our support system. Without you all this journey would be much more difficult. I want to especially thank our family and close friends. You all have gone out of your way and helped in more ways than you know.