SA Results (Well, Sort-of)

Greg did his semen analysis on Thursday. I got a call that afternoon from a lady at the RE's office. She said, "The doctor says Greg is in the range that will work for IUI." I asked her, "What does that mean? Is he 'in the range' that will work for trying on our own as well?" She responded, "I don't know. It just says he is in the range for IUI."

Sooooo, the good news is we can go ahead with the IUI! However, I don't know if this means he has some sperm issues. I am a little frustrated with the vaugeness of the doctor's report, and I am going to ask for a copy of the results.

No word on the results of my bloodwork yet. I don't know how long those results take to come back. But I'm assuming no news is good news.

Mommy Car!

Because it has taken us some time to get pregnant, Greg and I have saved up some extra money and decided to get a mommy car! Greg drives a 1998 Civic and I was driving a 2000 Sentra, so we really wanted something with more room, but were nervous about taking on a car payment. With our decent down payment and car prices and interest rates being such a deal, we decided to take the plunge and bought a 2007 Subaru Outback with 19K miles.

I honestly still can't believe I am driving a station wagon, but I'm so psyched to have a car we can easliy fit a jogging stroller and groceries in :) Now we just need the baby to go in the back seat! In the meantime, we are thrilled to have a car we can actually put stuff in. Plus, the heated seats and all wheel drive rock!

RE Consult

Greg and I went had our consultation with the RE on Tuesday. The visit went great, and we really like our RE. He has a wonderful bedside manner and really wants us to have input on each decision. He started the appointment by listening to our concerns (my CM), and agreed that it is likely an issue.

He also stressed that we are very young and have plenty of time (I am 32 and Greg is 31). While this is probably true, I still feel that clock ticking because: 1) I am healthy now, and who knows what the future will hold; and 2) We would like to have two children, so, if it takes us a while to get pregnant, I may be approaching 40 by the time we are ready to have number two.

With that said, he is ready for us to jump right into testing, and, if everything looks good, into IUI. We could do our first IUI as soon as next week! However, we decided to wait until the next cycle because we are feeling a little overwhelmed by how fast everything is moving, and because we would like a few more weeks to save up money.

The plan is to do the following tests:

• CD 3 bloodwork. This will test for various hormones that indicate if my ovaries are in good working order. This website seems to do a good job explaining what they test for and why they test for it. My RE said I could actually do the bloodwork anytime between CDs 2 & 4. (I had it done yesterday, which was CD3.)

• Bloodwork to test my thyroid. Apparently, thyroid problems can cause early miscarriage, so the RE just wants to rule it out. (This was included with the bloodwork I did yesterday.)

• A sperm analysis, which Greg is planning to do this week.

• A Hysterosalpinogram (HSG) between CDs 6 & 10. This is an x-ray of the uterus and fallopian tubes to looks for abnormalities. Because there is some anecdotal evidence that fertility increases for the few cycles after the HSG is performed, we are going to wait until next cycle to do this so we can have it done right before our first IUI.

Our RE also spent a good amount of time explaining the various options for IUI. He said we could do unmedicated IUI, which means I would not take any medications to help my body release eggs. Or, I could take fertility drugs to induce ovulation (Clomid, or more aggressive injectibles).

Going into the consult, Greg and I already knew we wanted to try unmedicated IUI because I am ovulating on my own and we would like to minimize the risk of multiples. I had heard that some REs do not like to perform unmedicated IUI, so I was thrilled when our RE agreed right away that unmedicated IUI would be our first step.

Normally, for an unmedicated IUI, a person would just come in the day after the first positive OPK. However, I sometimes do not get a positive OPK until the day of, (or the day after), ovulation. When I explained this to the RE, he suggested we do an ultrasound on CD 14 to see if an egg is about to be released, and, if it is, perform an HCG trigger to make it happen the next day (and do the IUI the next day). This way, we will definitely know when I am ovulating, and we won't be performing an IUI for nothing.

So that's the plan! Although we are not doing our IUI this cycle, and I am excited and can't wait to see the first round of test results come in!

And here's some more info that people may find useful:

Cost - My insurance covers testing to diagnose infertility, but not the actual treatment. Luckily, this means my insurance will pay for the CD 14 ultrasounds because it is a test.

• Doctor appointments: $35 copays
  

• HSG: $300 deductible plus 15% of the remaining cost, for a total cost of about $425

• HCG shot: $44

• IUI: $565

And here are some statistics on multiples (provided to us by our RE).

• Clomid - risk of twins = 10%, risk of 3 = less than 1%, risk of 4 or more = way less than 1% (and grrrr, for some reason blogger won't let me use the "less than" symbol!)
  

• Injectibles - risk of twins = 25%, risk of 3 = 5%, risk of 4 or more =1% (YIKES!!!)

Oh, and one last thing - the doctor said I don't have to modify my caffeine intake (because I already drink less than 300 mg/day), wine drinking, or exercise - WOOOHOOO!!

CF Fertilty Webcast

Mark your calendar! On February 3 the CF foundation will be broadcasting a webcast titled "Adult Nutrition and Fertility Information for People with CF." A nutritionist, an OB/GYN, a urologist, and a CF doctor will be discussing the issues of nutrition, male fertility, and female fertility in people with CF. You may submit questions in advance. For more info & to register, please click here.

Our Consult

Greg and I had our fertility consultation with my OB/GYN on Thursday. I am happy with the way it went.

We talked to the doctor for a few minutes and I showed her my charts. She agreed I am ovulating. It was interesting - when I showed her how obvious my thermal shift has been each month, she still wanted to make sure I have been getting positive OPKs. This made me a little nervous because I have a hard time getting OPKs to work for me - I've only found one brand that consistently gives me positive readings every month, and even my CBEFM hasn’t always given me peak readings. However, when she saw that my cycle lengths have only ranged from 25-32 days she said, "Oh, if your periods are that regular, the odds are good you have been ovulating."

She then went on to tell us "if the problem was just that you aren’t ovulating, I could prescribe you Clomid. But that’s about all I have been trained to do. I think it is important you see someone who has done a fellowship in infertility.” Meaning, our next step is to see an RE.

However, she also told us that she did some quick research and found only 20% of women with CF have fertility issues, and part of these issues are caused by women not ovulating due to lack of nutrition. That is not my problem. So there is an even lower probability of me having fertility issues caused by CF. Therefore, she said we could wait a little longer to see an RE. If I was 36, she would be telling us to see an RE now, and, if I was 22, she would be telling us to wait until we hit the one year mark TTC (six more months). But, I'm 32, so she said we could go now if we want to be aggressive, or wait.

Greg and I thought about it overnight and I asked the helpful women on the Nest and CF message boards for advice (everyone suggested we go now). Greg said he is 99.5% sure we are going to need IUI to get pregnant, and I kind-of agree with him. I just don’t think my CM is normal. (My OB/GYN also said IUI would likely be our next step.)

We decided to go ahead and make the appointment with the RE. We figured we could at least go to the consult and find out if the RE thinks we should begin testing now or wait a few more months.

Amazingly, I was able to get an appointment with the RE for next week! I’ve heard that sometimes it can take months to get an appointment with an RE. I guess this particular one is not that busy ;) (But he was highly recommended by my OB/GYN.) Our appointment is on the 20^th. Hopefully we will have some more answers then!

A Bad Thing About Blogging

The other night, I did a search on Google Images for pictures of EWCM. Gross, I know, but I wanted a better idea of how normal my EWCM is. The only useful pictures where the ones already in TCOYF. However, on page 17 of my search results, I found this:

Yep, there I am, right between the condom and "submit question." At least I share the honors with Desmond from Lost :P

Allergist Visit Today

Austin is one of the worst places in the country for allergies. I never had allergies until I moved to Austin. Oh, I got the occasional sniffle when I hugged my cat, but that was it.

I grew up in Maine, a place with wonderfully clean air. When I moved to Austin for graduate school, my lung function dropped 10%, I started having sinus issues, and I cultured pseudomonas aeruginosa for the first time. My CF doctor even suggested I quit grad school and move away (which I refused to do and I now see a different CF doctor).

After graduate school, I moved to Boston for a job. My lung function went back up 10%. However, I was miserable and missed Austin(oh yeah, and Greg was still here getting his PhD). So I moved back. And my lung function went back down 10% and my sinuses started killing me again.

It’s been five years since I moved back to Austin. Why did I wait this long to be tested? Because I've heard allergy shots only work about 30% of the time, and they are time-consuming. Free time is something a CFer doesn't just doesn't have. But my allergies have gotten so bad lately (night sweats, body aches, headaches), that I finally caved..

So today I had my back pricked with 48 different allergens. It turns out I am very allergic to dust mites, and pretty darn allergies to cats, cedar, juniper, and molds. The allergist prescribed me a new nasal spray and wants me to switch from Allegra to Zyrtec. He also wants me to begin allergy shots.

When I told the allergist that I am TTC, he asked, "Soooo, what do you think yours odds are of conceiving quickly?" (he didn't want to begin shots if I would just get PG right away - you can't increase the dosage of the shots while PG, and if we didn't get too far into them before I got PG, the shots would be pointless). I told him we have been TTC for over six months, about CF causing me to have thick CM, and about how we going in for a consult this week. He wants to wait and see what my OB/GYN says on Thursday before deciding to start the shots.

This was all fine, but when he handed me my sheet to checkout, I looked at the items listed under "Diagnosis": Chronic Sinusitis, Cough, Rhinitis, Cystic Fibrosis, and Infertility. That's the first time I've seen that last one. It didn't make me sad, but, at the same time, I felt like he had written it in big letters with a red sharpie across the page.

I had considered myself as "having possible fertility issues," not being infertile. I mean, we've only been TTC for 7 cycles! How could we even know if we are infertile? Seeing that word written by a doctor about me was like punch in the gut.

So that was a bit sucky. But hopefully the new meds will make me feel better!

Consult on Thursday

We had a great Christmas vacation visiting my family in Maine! We ate lots of seafood, drank yummy microbrews, and even got to go skiing (one of my favorite things in the world!). Unfortunately, AF showed her ugly face on Christmas Eve. So we are on Cycle #7.

A few months ago, I felt that six cycles TTC on our own was not enough to give us a fair shake. Now I am glad my doctor wants to see me so soon. I’ve pretty much accepted that we don’t have a good chance of conceiving by ourselves, so I feel like we will really be trying soon.

We are going to the OB/GYN on Thursday for a fertility consultation, and must admit I know almost nothing about fertility testing and treatments. My head is swimming with questions:

• What tests will they perform?
  
• What will the results mean?
  
• Is IUI our next step?
  
• If so, will we do medicated or unmedicated IUI?
  
• If it's the latter, what meds will I take?
  
• What are the odds of getting PG with unmedicated versus medicated IUI?
  
• What is risk of multiples?
• How many IUI cycles will we do?
  
• How much will it cost?
  
• Will my insurance cover anything?
  
• Should I see an RE right away?
  
• Will I have to cut back on caffeine, alcohol, and/or exercise?
  
• Will Greg?
  
• How much of my time is this all going to take?
  
• What the heck are follicles?

Hmmm...I should print out my blog so I remember to ask all of these ;)

I will definitely be updating my blog after our appointment! I am excited!