"Houston, We have sperm!"

Just kidding. That'd be weird.

The surgeon who performed David's VR told us to not get a semen analysis (SA) done until at least 4 months after the surgery. Apparently, sperm take about 90 days to fully complete their development in a man's body. Who knew right? I was always under the impression that men make millions of new ones every day. Which I guess in a way is true, but the ones that actually come out are about three months old.

However, we have a microscope at home (a gift from the grandparents to the homeschooled kids... don't tell the kids we used it for this) so we would periodically just take a peek at a sample for funsies. The first time we looked was kind of dismal - but granted, this was only six weeks or so post-op.

You see there are a few wrigglers, but not many, and those that are visible seem to be kind of immobile. 

But then we tried again at about 10 weeks post-op and had much better results:

This time, we saw lots of swimmers. Some still seemed to be clumping, but definitely better than the previous sample.

I had my annual exam at the gynecologist's office in June and talked to her about the VR. She's a funny woman and says whatever comes into her mind, but I trust her very much as a doctor. She was surprised but supportive and said she didn't see any reason why I couldn't get pregnant again. 

But it just wasn't happening, and my cycles were totally wonky. One would be 23 days, then 51 days... like that. So in August when I went to see my GP for a regular checkup, I told her what was going on, and she said for me to go ahead and see a reproductive endocrinologist (RE) due to my age and the other issues we have. "It's better not to waste any time, in my opinion," is what she said. I was surprised she referred me to an RE so quickly, but now looking back, I am glad. The RE's office got us in a couple of weeks later.

Since we don't exactly live in a budding metropolis, there is only one RE office here (Boston IVF), and only one doctor who works there (Dr. Griffin) along with nurses, ultrasound people, etc. The sucky thing about it is that it's located inside The Women's Hospital, so every time I go in, I have to pass pregnant women and huge glossy photos of newborn babies. The office itself is careful not to have pregnancy magazines or photos like that, but it's still a tough reminder every time. 

Our first meeting with Dr. Griffin was most information gathering. He asked us each a ton of questions. He then told us what tests he wanted to run. All David got saddled with was a SA, which we assumed. I on the other hand was signed up for a bunch of bloodwork that involved fasting (I think they took 8 vials), and an internal ultrasound on the third day of my period. Oh boy. I've had internal ultrasounds before, they are not fun, but not all that horrible once you are used to them, but I never had one during my period before. That was a whole new kind of awfulness. Also there was a student observing that day. Super awesome.

Most of my tests came back good. The one most concerning, Ovarian Reserve, came back rated "excellent," which  means that I have plenty of eggs left and am not expected to enter menopause any time soon (it does not, however, determine the quality of those eggs, which is really the issue in your 30s compared to your 20s). One test that was a bit off was my thyroid. Normal is under 3.0 and mine was 2.71, but Dr. Griffin said that for trying to conceive, he prefers it to be under 2.5. So I started a low dose of a thyroid medication to try and bring that down.

David's SA results were really great! His total count was 113 million. The motility - the ability they have to swim around - was a tad low at 29%, but Dr. Griffin said this was normal after a VR and would likely go up with time. He told him to take a vitamin E supplement in addition to a daily multivitamin, but David was already doing this. So we were relieved.

After all our tests were done, we met with Dr. Griffin again to make a plan. He proposed that we try to induce ovulation by me taking Clomid, and then do IUI (intrauterine insemination) in addition to timed intercourse. He felt this would give us the best odds. 

We had more waiting to do because first I had to wait for a period to my pre-treatment testing, and then I had to wait for another period to start our first IUI cycle. In between, I got very sick with bronchitis and a sinus infection. I had felt a cold coming on, the day David and I went to get our flu shots, but didn't feel too terrible. I believe getting the flu shot while my body was fighting an infection is what made me sick for so long. I was sick for five weeks straight - took 2 different antibiotics, 4 different cough medicines, and a steroid. I never ovulated all that time (I am in the habit of taking my temp every morning and using ovulation predictor tests every day too).

Finally in mid-November we started the cycle. I took Clomid on days 3 through 7, then started using the OPKs daily. I never got a positive so on day 16 they had me come in for bloodwork and ultrasound (yaaaay), and said I "didn't respond at all to the Clomid." Great. So I went through all that for nothing. The Clomid made me feel crazy. I felt weepy one moment, insanely angry the next. Not constantly, but at unpredictable times. I also felt a lot more tired than normal, but didn't sleep well. I got all the SIDE effects, but apparently none of the INTENDED effects.

I thought they'd say to wait for my period and try a higher dose the next cycle, but they said Dr. Griffin wanted me to start a 2nd round of Clomid at 100mg (was on 50mg) that very day. It's something called stair-step protocol. So I've now been on the 100mg for five days (last dose was last night), having all the negative side effects again. They told me not to do the OPKs myself any more and to come in on Saturday morning for blood work and ultrasound to see if I've responded, but I have so many OPKs I've just been doing them anyway.

The RE said to use Clearblue OPKs, which I do not like, for two reasons. One, they are expensive, and with long cycles like mine, that really adds up. Two, they only give you either a smiley face, meaning you are about to ovulate, or an empty circle, which to me looks like a zero. I do not like that. So I also use these cheap ones called Wondfos, that cost about 40 cents each, and give you 2 lines. When the test line is as dark as the control line, you consider it positive. Here are a few days' worth of my tests, with the most recent on the bottom:

It does look to me line the test line is getting darker, but not there yet. So I'll keep testing, and go in on Saturday.

I have to say, even though this is just cycle one, I don't know how long I can do this. The medication makes me feel crazy, and going in for these appointments all the time is really hard. If David didn't work from home, there's no way I could do it, because you aren't allowed to bring children into the office (ironic since you're in the office in order to get children).