Saturday, January 19, 2013

Our Story

Since our story is unique, our friends and family will recognize us by the details. However, to protect our privacy as much as possible. I am going to refer to ourselves as "he/him/his"  and "I/me/my/mine."

We are LDS and live in Utah. We have been married for almost 4 years. We have dogs and a house.

He and I  started dating when I was about 17 and he was about 18. We dated until he left on his mission in January of 2007. I wrote him throughout his mission. In early December of 2008, he was diagnosed with testicular cancer. He was sent home from his mission about 2 months early. It was all very sudden. He went to the doctor on Monday, learned he had cancer on Tuesday, flew home on Wednesday and had the tumor, and therefore his testicle, removed on Thursday.

After several tests, the doctors determined that they could not see any more cancer, but that there was a 20% chance that there was more cancer that wasn't visible. He was given the following options:
  • Monitor for 5 years and watch for more cancer: not recommended because most people don't follow through and the cancer ends up coming back unnoticed.
  • Have surgery to remove the surrounding lymph nodes: This was proposed to have a 1 in 3 chance the cancer would return if it was even there and a 10% of causing infertility.
  • Chemotherapy: this was proposed as having a small chance of the cancer returning (if it was even there) and a small chance of infertility (I don't remember the exact numbers)
We picked chemo. We were warned that that was a (very small) chance that chemo may leave him with a low sperm count. He store and froze sperm at a storage clinic-just in case.  He had 2 rounds of chemotherapy in January and February of 2009. He lost his hair. His mom and I cried because we were afraid he would be bald in the wedding photos. It was all very dramatic. We got married in May 2009. His hair had grown back enough for respectable wedding photos-Phew!

We did what most engaged couples do. I went to see the female doctor about 4 months before the wedding. The female doctor gave me a prescription for "the pill." I took the pill. My hormones were out of control and everything made me cry. Once I cried for 7 hours straight because I thought my car was broken. The pill made me feel a little nauseous at bed time. I dealt with it, it wasn't that bad.

However, soon after we got married, I stared mysteriously getting sick about once a month. It was around the same time that swine flu was a big risk. I went to the doctor and they tested for swine flu, pregnancy, and about anything else you could think of. Negative, negative, negative. After about 3 months of getting sick every month for 1 week, I figured it out. The "pill" was making me sick, or to be more specific: not taking the "pill" was making me sick. The week I took the placebos and was off the hormones I was fatigued, nauseous, dizzy, and tired. As soon as I started taking the hormones again, I was fine.

We went to 3 medical professionals before we could finally get someone to listen to me. The doctors told me it couldn't be my birth control. One finally told me it could. We tried another kind. That one made me sick every day. We tried a third kind. That one made me sick too.

Messing with my hormones so extensively also gave me secondary problems. At the height of my struggle with birth control, I had dropped out of school and quit my job. I was sick with flu-like symptoms daily for 3 months. Everything culminated and I started having intensive abdominal pain. I was on lortab and bed bound for about 10 days before we could get things straightened out.

We learned that the abdominal pain was due to an excessive amount of progesterone (the hormone that makes birth control work). They gave me some serotonin and an antispasmodic.

Since we were told there was a chance that his sperm count would be effected by the chemotherapy, they ran a semen analysis to make sure I even needed to take the pill. It came back with perfect results. I kept taking the pill.

In the mean time we kept getting bills from the storage clinic to pay for the cost of storing his sperm. We had a semen analysis that was perfect and an empty pocket book. We decided to have the samples destroyed. Why keep something that you can't afford and you don't need, right?

I had started to feel promptings to try and start our family. That seemed like a crazy idea given the position we were in. However, one day I realized I had no job, dropped out of school, took 7 prescriptions, and only felt just ok most of the time.

We decided to follow those promptings. I took my last pill in February of 2010. A few weeks of being off the pill and I started feeling like my old self again. I was just taking one prescription. It was awesome.

Since I had received so many promptings, one that was especially strong, I figured we would get pregnant right away. The idea was kind of freaky since we were so financially unstable, but we had faith we were doing the right thing. We were pretty excited.

I was surprised, but optimistic every month that went by with another negative pregnancy test. About six months in, my doctor gave me some clomid. Still: Negative, negative, negative. About a year in, my doctor decided she had done everything she could for me. She told me to go see a specialist.

We found a specialist that my insurance covered. We called to schedule an appointment. The first appointment she had was 3 months out. Part of us hoped we wouldn't have to go because we'd be pregnant by then.

We saw the specialist. We talked. She asked a lot of questions. She drew my blood and we scheduled a follow up appointment.

We saw her again the first week of June. She went over my lab results and told me that she couldn't see that there was anything wrong with me. She said, "usually in these circumstances when the woman looks fine, we like to check the men." We told her that wasn't necessary because he had a semen analysis done about a year ago and it was perfect. She told us she wanted to see the semen analysis.

We went home, called the clinic that ordered his semen analysis and asked them to send us a copy. A few days later we got the lab sheet in the mail. We opened it up, expecting to see the lab results from a year earlier.

To our horror, the results had been corrected. We destroyed the stored semen based on the initial results. We were never informed of the correction. His semen analysis wasn't perfect, it was the exact opposite. We called our doctor and asked her if the results were as bad as they looked. She said they were.

We had another semen analysis done. Maybe it would be better since a year had passed a year later.

Nope, still bad. We did two more. Nope, all three told the same story. They weren't pretty. He has a very low sperm count and very low motility.

(I'm going to go ahead try to nip this in the bud: we've had dozens of people advise us to take legal action. You're note the first person to think of it. There's no need for you to do so in the comments.) 

In October of 2011, we had a consult with an Andrology specialist. The Dr. showed us the results of his most recent semen analysis. One of the tests they run averages the sperm count and motility and gives you a score. A normal score is above 30 million. The Dr. told us that people who have no infertility problems have about a 20% chance each month of getting pregnant. The Dr. told us that couples who try for a year and do not get pregnant are said to have a 2-3% chance of getting pregnant. We talked a little bit about treatment options. The Dr. told us that couples who have a score of 20 million in that earlier analysis have a 10-12% chance of getting pregnant each time they try artificial insemination (AI). The Dr. said the chances drop significantly with couples who have a score of 10 million or lower. The Dr. said that couples with a score of 5 million or less will probably waste their time and money with AI. My Husband's has a score of 1 million. AI costs between $700 to $1000 a try.  We talked about in-vitro fertilization. IVF costs about $11,000 to $12,000 a try. It's very invasive and involves a lot of risks. The Dr. told us we might have success with IVF.


 The day of that Dr. appointment was probably the worst day of my life. I felt like I couldn't breath. I had no idea I would be so upset. I had always told myself when I was growing up that I would "just adopt" if I couldn't have children. I didn't think I would care about being able to bear children.

I've been even more surprised at how much pain I still feel. We're coming up on 3 years since we first started trying to get pregnant, and two years since we found out that it wasn't just going to happen for us at home.

Friday, January 18, 2013

Some thoughts...

I've been following along with several people online about their struggles with infertility, and thought I would get my story out there.  My husband and I were married at the end of 2007 (December 29 to be precise), and have been trying to conceive from the very beginning.  We had no reason to believe that it would be a struggle for us, but we were in for a HUGE awakening. I have friends who have had their struggles, but most of them have since been able to have children through various treatments, or eventually "miraculously" on their own.

Let me start by saying that for several years I had had a suspicion that it might be harder than I wanted for me to have children.  When I was in college (many years ago), I had started having weird "symptoms" with my periods.  I'm not talking about the PMS crazies.  I'm talking about cramping in less common spots (mostly my lower back down into my tailbone), hot flashes, worsening cramps, and almost passing out, just to hit the highlights.  My cycles were still regular, and as a Biology major, I knew enough to know that as women age, the nature of our periods can change.  After I graduated college, things got worse...the pain didn't necessarily get worse (although the job I had at the time screwed up my back to the point of 3 bulging discs), but now my blood sugar would bottom out and I often found myself literally crawling on my hands and knees to the bathroom.  I started getting nausea with my pain, and it started moving from my back to my abdomen.  My cycles also started to get closer together, then farther apart, then closer together.  

I went to my primary care and he sent me to a Gynecologist, and after doing an exam and listening to my symptoms decided that birth control would help ease pretty much everything.  I wasn't married, nor in a relationship at the time, so I went ahead and took the pills, and things did start to get a little better.  I wasn't having the hot flashes, the blood pressure/blood sugar fluctuations, the nausea, or the intense gut-wrenching pain anymore.  Things were looking up! That was my first clue that something wasn't quite right and that I might have a little trouble getting pregnant, but I was still very hopeful.  After 3 months of taking the name-brand samples the doctor had given me, I went to have my prescription for my birth control filled at the pharmacy.  Big mistake--the pharmacy filled it generically because that's what my insurance would cover.  It took me 3 months to figure out that my symptoms were back because the formulation was just different enough to screw up my system.  So I called and they gave me more name-brand samples and a specific name-brand prescription, but the damage was done.  My body didn't respond to it anymore, and I found myself with worse pain and nausea than before I had been put on it.  By this point I had met and was dating my now husband, and during this transition we got engaged (keep in mind that this is only about 6 months since I was initially put on birth control).

I went back in to the doctor for my annual exam and told her about how my body seemed to be rejecting even the name-brand bcp.  She said that there were tons of different options, so we'd just change the drug.  She put me on the patch....let me tell you, it was almost like night and day!  Yay!!!  Now I could live a somewhat "normal" life.  Well, I had been on the patch about 2 months when I got married (yes, we met, got engaged, and married all within 10 months), and since we wanted to try to start having kids right away, I quit the patch.  The doctor had assured me that it would be easier to get pregnant coming off the patch than the pills because of the way the hormones are delivered.  Well, 3 months go by with no period, numerous negative pregnancy tests, weight gain, nausea, increased appetite..... The doctor (I now had a new primary care doc) ordered me an ultrasound--negative.  So he sent me to an OB/GYN to have a consultation.  I had a period before I could get in to see her, and I felt like I had been shot through the gut.  I had never had that much pain in my life!  The ER gave me some good drugs (I can't remember what they were) and told me that I had a UTI, so they gave me some antibiotics to go with the pain meds.

I went on like this for 18 months, visiting the ER every month (or every time I had a period) where they would give me IV pain meds, some nausea meds, and antibiotics for a UTI then send me home.  I had switched jobs, I had lost all the weight that I had gained (20 pounds), and I was still not getting pregnant.  My primary care doctor was getting tired of doing ER follow-ups, so he gave me a home prescription for Vicodin--talk about not trying to get to the root of the problem.  When this happened, I was about a week away from my annual GYN appt, so when I told my OB/GYN about my newest prescription, she called and scheduled me for laproscopic surgery to "have a look around" to see if what she was suspecting was true.  

Keep in mind that I was still having erratic and excruciatingly painful periods (the pain was to the point that I contemplated very seriously having a hysterectomy).  I went through every doctor in 2 ERs between the time the painful periods started and the time I had surgery.  After surgery, my doctor told me that it was amazing that I had gone so long without the horrible pain because of the amount of scar tissue she found in my abdomen.  She also said that my diagnosis was endometriosis, despite her doubt that all the scar tissue was endometrial.  (She told me that some was from my previous appendectomy 11 years prior.)  Basically (this might get a little gross, but bear with me), I had a sheet of thick scar tissue that went from the top of my bowel to the top of my pelvis, and it was so tight that my insides were very compressed.  

After surgery, some of my back pain went away, and I felt much better....until my next period, which sent me back to the ER, but we've concluded that was because it was only about 2 weeks after surgery and I was still recovering.  I managed to get several months of less painful periods.  About this time, we started having my husband tested for fertility issues and we were told that his sperm count was slightly low (after only one test--this is important to remember for later), so they sent him to a urologist who did all sorts of exams but could find no reason for his count to be so low.  About 6 months after my surgery, my period arrived about a week early and I passed out at a play my younger brother-in-law was in--right in front of everyone.  They rushed me to the tiny ER, where the doc gave me whatever pain med I asked for (sad that I have preferences?) and sent me on my way.  Now I'm really struggling with the realization that I may never bear children of my own.  A couple months after that incident, my husband receives orders to Okinawa, Japan, and we were a little elated--its called a "2-baby tour", everyone who leaves comes back with at least one extra (gotta work for us, right?).  In the months before our move, my OB/GYN suggest I do a HSG (I can't quite remember the long name for it) where I have a dye injected through my cervix into my uterus and up through the Fallopian tubes during an x-ray to see if there are any blockages.  Unfortunately, we were unable to get it scheduled before we moved.

I get overseas and discover that I am running out of my pain meds--let me stop here and tell you what type of treatment I was on for my endometriosis:  I was taking an NSAID twice a day, every day, for at least the 2 weeks leading up to my (expected) period.  This keeps me out of the ER every month.  So I go in to my new doctor to discuss renewing my prescription--the base pharmacy here doesn't carry that drug, so I'm stuck with 800 mg of Ibuprofen (Motrin/Advil) 3 times a day....this can lead to all sorts of nasty things, such as liver/kidney damage and migraines (and I've never had a migraine before this last year).  But its the only thing they can give me, and forget about getting Vicodin to have at home....And I'm once again sent to an OB/GYN to work out what to do.  They also order another round of semen analysis for my husband.  His analysis came back lower than the minimum normal count, but before he could be sent to the urologist again, he needed to have 3 consecutive low results (which they didn't do in the states).  He averaged the same on each of those 3 tests--75% lower than what it was when he had first been tested 3 years previously.  So he see the urologist, and again they can find no reason for his counts to be so low.  Meanwhile, I have the privilege of going through the HSG procedure, where we discover that my right tube is blocked, but they won't go in and take care of the blockage because I could get pregnant with one open tube.

At my next appointment, my OB/GYN sat me down and we once again looked at the options available to me.  (This is where it gets hard.)  Our insurance won't cover anything more than what has already been done, and IVF in Japan (while cheaper) has only a 3% success rate.  I could go back to the states, but then I'd be separated from my husband for the duration of the treatments, and even then, there is no guarantee of success with a healthy sperm count (and my husband's is less than barely optimal).  We would be looking at the most expensive IVF procedure, and even then, a good fertility doc would insist on using donor sperm.  I was flat-out told that my best chance to have a baby of my own would be to go back to the states and do IVF with donor sperm.  Talk about a slap in the face.  However, I could go back on any number of birth control options to manage my endometriosis symptoms without the liver damage and other side effects that come from long-term (we're talking 16 years at time of this post) use of NSAIDs.  To say I was in tears is quite an understatement.

Several years ago, about a year into my marriage, I "let go" of the disappointment of infertility and made the choice to let the Lord handle it.  But it wasn't until my husband's last deployment in 2010 when I prayed with such intensity (for many reasons, this just being one of them) that I truly gave it over to the Lord.  Do I still get a yearning? Yes.  Do I still feel a pang of jealousy when I see my friends having children?  Yes.  But I've learned to take my callings in the church (I just finished 5 years in Primary and now I'm in Cub Scouts), and the opportunities that I have to substitute teach and babysit as a way to fulfill my calling as a mother on this earth.  We've talked a lot about adoption, and are weighing our options in that venue, but I try to enjoy doing things alone with my husband, in our little family.  That doesn't mean that I don't want children or that I've given up on having them.  It just means that I'm trying to let the Lord's plan play out in His own time, in His own way.  

Many of the people I know/talk to struggle with PCOS, but there are many reasons for infertility--my husband and I just happen to be struggling with endometriosis and idiopathic (unexplained) male infertility.  But we don't let it stop us--we keep trying to conceive and bless the lives of the children around us.