Monday 13 May 2013

First Appointment at Fertility Clinic

So, we had  our first appointment at The Fertility Clinic on May the 9th. Our doctor referred us to the clinic in January, after seeing the results of Mr. Turtle's first semen analysis (very low motility, insufficient for natural conception.) After cooling our heels for a few months, here we go maybe.

Incidentally, we think the low motility is likely caused by a genital lymphedema, which is causing the sperm to not develop properly. The lymphedema in turn could be caused by disruptions to the lymph system as a side effect of Mr. Turtle's Crohn's Disease. Another possibility is that a medication he took for the Crohn's in the past has had some lasting damage. We really don't know.  In the meantime Mr. Turtle is trying massage treatments and compression to see if that can reduce the inflammation and possibly increase fertility.

The Fertility Clinic is on the opposite side of town from where we live and I work. I took a bus across town on a hot spring day to meet Mr. Turtle and the car halfway. I  got a first hand look at how much traffic there is in this city.Where can everybody  be going at 12:30 on a workday? They can't ALL have appointments at the fertility clinic.

Well, we get there and check in at this very polished looking facility with huge picture windows overlooking the river. It  was soothing but also disturbing when I reflected that I was in a place that was designed to  sooth people. I complained to Mr. Turtle that there were almost no signs to the fertility clinic until you are in the door to the office, while all the other medical facilities in the building were well advertised. Seriously, do infertiles need all this self-conscious anonymity?  Pop stars make music videos in their underwear but I'm supposed to be too sensitive to press an elevator button next to a brass plate labeled "Fertility Clinic." Give me a freakin' break.

Anyway. As you  can conclude, despite being sure we were very, very ready for this, and despite being very grateful for the appointment and opportunity, it was still pretty awkward. I imagine in a  few  months I will not care less about any of the above.

After waiting for a while awkwardly in an office facing yet another picture window, we were met by "Dr. Cotter." We had each filled out a detailed  medical history, but Dr. Cotter proceeded to re-ask several of the questions. Maybe people lie on  the histories and they have to check for inconsistency.

A few things that stand out:

"You sound like you're not a good ovulator" (because my cycles are less than 27 days)

"We'll have to do some tests to see if they (the ovaries) are packing it in" (or words to that effect).  OMG did you just say I could be periomenopausal? At age 33?? Nooooooo.

"Men's sperm counts in this city vary enormously from  week to week" (no explanation why, and I didn't think to ask. Could it be our wacky weather?? Do the Chinooks cause sperm counts to go up or down?)

"We have a lot of issues with men in biker (cyclist) shorts." (Mr. Turtle was obliged to explain that he has to wear biker shorts as underwear to work because of the lymphedema.)  Dr. Cotter: "That's the reality of your life right now."

The appointment was, I imagine, typical.

Mr. Turtle was asked to do another semen analysis (already scheduled).

I have to take the following tests:

  • Pelvic ultrasound (antral follicle count, r/o cysts, polyps, fibroids, hydrosalpinges) (May 27th)
  • Hysterosalpinogram
  • Day 2 (on 2 different cycles) and Day 21 blood tests

We made a follow up appointment with Dr. Cotter for the 24th of June and registered for the IVF information session on  June the 20th. We walked away with multiple requisition forms (for me) and info and forms for IVF. We can't be accepted to IVF waitlist until seeing the info session.

I've had mixed reactions to the appointment. Prior to going I was excited and optimistic, because it was energizing to think  that finally things were moving forward for us, and we could start getting some answers and real options to start a family. Other than the comments about the ovaries "packing it in," I wasn't surprised by anything we heard. I expected to be asked to do several tests and am even looking forward to it in a way. I'm trying to not overreact to the ovary comments either. I know that was something she had to mention just based on  the preliminary data.  I believe that I do ovulate normally at least 80% of the time. (I do have some wonky cycles for sure.)  I can predict when my period will  come within a day or two based on the data of the Ovacue, and my own  fertile signs (such as cervical mucous). If my body isn't ovulating it's doing a pretty good job of pretending it is. But there's no way to know without the advanced tests, so a-testing we go, a-testing we go.

I was utterly exhausted after the appointment. Normally I devour anything fertility-related that is remotely  relevant. When we got home all I did was take the papers out of my purse.  I ate something and fell asleep on the couch.  Mr. Turtle practically had to drag me off it so I could go to band rehearsal.  Work has been busy and in addition we had a very full day Saturday with our end of year community band concert and big band dinner dance. I definitely had a good time but I've also felt a bit moody the past days. I respond well to distractions and diversions but when they are over I feel sticky gloom coming on. I feel like I have to try really hard to get stuff done at home and at work. On Sunday I finally had the energy to look through the papers and requisition forms, and I bought a binder and pocket dividers at Staples and organized all the papers from The Fertility Clinic. Small detail, but it made me feel better and in control. I think the appointment, while useful and necessary, also made me a bit depressed because it reminded me again how real infertility is and what we will have to go through to have a child. I had started to distance myself from it the past few months.

Well, to everything there is a season.


  1. I promise, it gets easier the further you are into the process. Jerry started out saying "Do not tell anyone about my low sperm count" and next thing I knew, he was telling everyone who would listen! Good luck with your journey! You took the first step :)

  2. Thanks Jenny! I have always felt the best way to deal with this was to normalize it. thanks for the optimism and wishing the best for you too as always.