Today we had our 2nd meeting with Dr. Cotter to go over the results of the numerous tests requisitioned in May. My tests were "the surprise." Aaargh. Not in a good way.
Mr. Turtle's 2nd semen analysis:
Similar numbers to before, very few sperm with normal morphology or motility after 3 hours
Now on to me:
No tubal blockages, looks normal. I think that was the main point.
Ultrasound of uterus and ovaries:
2 Fibroids, one bigger one smaller, but they are not considered significant.
Uterine lining is good
4 follicles on the left ovary (click for more on antral follicle counts)
No follicles visible on the right ovary
Day 20: Progesterone OK, somewhat low but looks like ovulation happened
1st Day 2 bloodwork:
FSH 3, Estrogen 751
2nd Day 2 bloodwork:
FSH 19, Estrogen 63 (click for more on FSH testing)
Not sure I completely processed Dr. Cotter's explanation of what those numbers mean, but the main point was this: it looks like my ovaries not functioning well. The low number of follicles observed on the ultrasound seems to confirm this hypothesis. Poor ovarian reserve (POR). Premature ovarian failure (POF). I think I might be more "POR" than "POF"as I do still have a regular cycle, but it is short (average 25 days) and I suspect that I do have some anovulatory cycles.
IVF is still on the table, but the chances go up that I will not respond to stimulation, and therefore not produce enough eggs, or worst case, not produce any eggs. It's not hopeless, but it becomes more of a gamble. And more expensive, as I will be taking the higher doses of drugs. We would do Flare Protocol.
Possibility of IVF with donor eggs was mentioned.
IUI is not recommended due to the sperm issues.
So, our newest homework is to consider whether we want to go ahead with the fresh IVF cycle with our gametes, and what what we will do if it doesn't work, or if we decide that it is not worth the gamble. We intended to make B and C plans in the case of unsuccessful IVF attempt(s) anyway; I will not even start an IVF cycle without a B or C plan. But since IVF was the most likely path it was kind of blocking the view of anything else. Now we have to look beyond IVF, and maybe that's a good thing, although the POF is not good news.
If we decide to go ahead with IVF, I will be taking DHEA and co-enzyme Q10 for some months before the cycle starts, to try to give the ovaries some mojo.
But before any of that, I am having a karotype test to see if I'm a of carrier of Fragile X, which can be a cause of POF. Should the genetic test come back positive for Fragile X, that would pretty much preclude IVF and therefore genetically related children, as they would have to scan the eggs for the gene and I likely wouldn't produce enough to scan.The possibility is low: I think Dr. Cotter said about 1% of POF cases have Fragile X. So it's unlikely, but statistics aren't much of a comfort anymore: it seems like we're on the wrong side of them often as not.
What a maze.