The moment we had been waiting for…
We sat silently in the car heading to our appointment. This is it! We can finally figure out what’s going on, and come up with a plan to fix it. I put my hand over Jimmy’s on the gear, and rode to a sense of nervous anticipation.
Our turn. I excitedly raised my eyebrows a couple of times at Jimmy, and he rolled his eyes and smiled. This is it.
The doctor sat down and started firing out our results. I had no idea what the hormone levels meant. No idea how much of each category was good or bad. There was a scale for each category and she went over the scale of what’s normal. Aside from my FSH being on the low side of normal, my prognosis sounded ok, I think?
Then Jimmy’s turn. Ok, still not really sure what these things mean. Aside from knowing the literal definition of the word, I wasn’t sure what “morphology” meant in terms of sperm. Morphology was just below normal, but other than that, everything sounded ok, I think?
We both sat there kind of stunned. When you’re waiting to find out the bad news, and you don’t hear it, it’s confusing. She started talking about treatment options, and I started to feel more confused. If there’s not a problem, how do you treat it?
I interrupted: “Wait…what are we treating? Did I miss our diagnosis?”
“You fall into the “unexplained” category.”
She went back to treatment options while I sat there, confused. What…the fuck? After all that testing, all the blood work, all the ultrasounds, the HSG, the semen analysis…nothing?
I interrupted, again: “So there’s nothing wrong with us?”
She went back to the numbers. Explained again how the FSH was on the low side of normal, and the morphology was just below normal.
“Does that mean we couldn’t get pregnant on our own?”
She went back to explaining the different methods for treatment. Boy, was it hard to concentrate while trying to dissect the information we had just been given. There was a pause in the information she was providing, and I just couldn’t let it go:
“So…how do we choose a method without a diagnosis?”
She explained that “unexplained” is a diagnosis. She explained that we didn’t fall into a certain category because of the things they test for, nothing was glaringly wrong. That didn’t mean there wasn’t something wrong, we just “passed” this round of tests.
I couldn’t wrap my head around it.
In high school you learn that if you have unprotected sex, you will get pregnant. You don’t learn that someday you may be faced with clomid, IUI, IVF, ICSI, adoption, surrogacy, years of peeing on a million different sticks just praying to see a +, or anything of the like. I felt totally unprepared to make a decision for the next step. I think I had just assumed it would be clearer; easier. But, it wasn’t and there was a lot to think about.
She recommended genetic testing. Ok, fine. Then she recommended monitored clomid with timed intercourse. Basically, coming in every day for an ultrasound and blood work until ovulation, and then they send you home to have sex.
I felt like we could do all that on our own, and I could forego the daily ultrasound and time out of work. Because, that was the other doozy. So far, aside from some preliminary blood work, all of our care was an out-of-pocket expense. We are lucky enough to live in Massachusetts where companies are mandated to have infertility coverage…but that doesn’t mean it has to be good coverage. Ours was 10% coverage after an $8,000 deductible. Yes, you read that right.
So, we decided to go with unmonitored clomid, and I would pee on some more sticks to test for ovulation. But, something was still bugging me:
“But…I ovulate regularly.”
As I had done at every appointment before, I took out my diligently mapped fertility apps. BBT faithfully recorded, showing dips and spikes in the correct places; days entered when I got a positive pee stick; little hearts on the days we had timed intercourse; and monthly, regular periods.
She began telling us how clomid works; how it effects the brain and hormone levels. By this point I was burnt out, and just started “yessing” everything so we could leave. We had more blood drawn for the genetic testing, and off we went. Confused, frustrated, and also a little glad that there didn’t seem to be anything “unfixable”. We left totally unprepared for our next chapter: Infertility – Our Story Part IX: The Clomid Crazies.