Round 2

This past Sunday we went for our 2nd round of IUI. This time I forewent the US and hCG shot to force ovulation thinking that it might go better if I went with the natural rhythm of my body. I used ovulation sticks to detect my LH surge and then went in the day after my surge was detected, which was Sunday.

I did not have any ovarian pain this time around and since I elected not to do the US, I do not know how many eggs were produced. There is at least one, but I am thinking there is not much more than that since I did not have the ovarian pain and tenderness this cycle. I actually felt nothing while on Clomid this time.

On Sunday, my husband's sperm, after washing, was only 4.5 million this time. As aforementioned, below 5 million/ml is not good, but they still went ahead with the IUI since it was close to the 5 million. I was really shocked and disappointed that we went from 9 million the 1st round to half of that on the 2nd round. I know I should be thinking positively, but I am just not very hopeful this go round.

Since my period started earlier than expected this last cycle, the doctor also gave me some progesterone suppositories to give some support during the luteal phase. I am hoping that helps a baby stick!

On Monday, my husband had a follow up urologist appointment that I also attended. The physician was quite knowledgeable and helpful. Of the three repair options for the varicocele, my husband has decided on the laparoscopic procedure as it is minimally invasive and has the highest success rate over the old standard procedure of going through the muscle with a long hernia type scar or placing materials in the veins to occlude them. It is a longer surgery time - up to 4 hours - but it has the highest rate of being successful the first time, it has a faster recovery rate and it has a high success rate for increased fertility. The only drawback is that we cannot pursue any assisted fertility options for 4 months after his operation. That means that we will need to finish up these 4 rounds of IUI before he can have his surgery. This places his surgery in July of this year. The urologist also stated that it can take up 9 months to see a marked improvement in fertility but that up to 60% of patients will then go on to conceive naturally.

I am not sure what is going to happen in our future, but I really truly hope that one of these IUIs are successful and that we do not have to visit the dreaded IVF decision or hope and pray for a spontaneous, natural pregnancy 4-9 months after the varicocele repair.

So it's a varicocele?

My husband went to see a reproductive urologist this week and found out that his infertility/low sperm count is due to a varicocele in his left testicle. A varicocele is an enlargement of the internal spermatic veins that drains blood from the testicle to the abdomen and back to the heart via the renal vein on the left and the inferior vena cava on the right. This enlargement causes increased temperatures around the testicle which in turn causes decreased sperm count, decreased sperm motility and an increase in the number of deformed sperm - all of which my husband has.

Varicoceles are present in about 15% of the male population and 40% of infertile men. A varicocele develops when the one way valves in the spermatic veins are damaged causing an abnormal back flow of blood from the abdomen into the scrotum causing a hostile environment for sperm development.

Varicoceles most commonly are corrected surgically either by tying off the dilated veins around the testicles thereby diverting the blood or placing a coil or other barrier inside the vein, called percutaneous embolization, which also redirects the blood flow. Improvement in semen quality post operatively is seen in 50-90% of patients after 3-6 months. Pregnancy rates after surgery improve by 30-50%.

My husband's surgery consultation will be on 14 March. We are still going to go through with Round 2 of our IUI treatment per our RE's recommendation, but then if not successful again we will take a month off and allow my husband time to recuperate before trying again for Round 3. Hopefully with the repair our chances will increase greatly!