Home Work

It was difficult to accept the infertility. There aren’t any words to describe the trauma or shock of this truth.

We decided we will head for ICSI, but were not sure with whom.

That’s exactly where an internet is handy tool. I checked with my local gynecologist for referral. She suggested a couple of names. A simple Google search popped up with details. I went on surfing about the information (assuming it’s reliable and most case it will be) on the doctor, team, experience, credentials, etc.

I sent emails to all of the doctors and some of them responded back too!!! It’s great to see how the doctor connects to the prospective patients. I am really impressed with the details and accurate information on the email. Trust me that me confident about the doctor.

I read lots of articles on the procedure and treatment; cost associated with it and the success rates.

Information I looked in their websites:

• Experience of the doctor
• qualification of the doctors
• Credentials of their clinic
• experience and profile of the team (remember embryologist are one who gets your embryos hatched)
• number of babies born
• technical devices they have

Information I asked through emails:

• I gave my basic details
• I asked which treatment is going to help me
• How much time is required (I must say a doctor gave me detailed daily plan for a month over email!!)
• how much it will cost (approx)
• any test to be conducted before seeing them

These things helped me a lot to understand what ICSI is about and knowing the doctors. The main task still remains - selecting the doctor and cycle of visit (fund wasn't a major constraint for me)

Adoption: Another view

When I think of "Adoption", I wonder 'why would somebody leave her baby?' and then...

... if 'she' had decided to leave the baby (for whatever reason), than I feel sorry, sorry for the baby.

For the time baby would have been in the womb of 'her', the baby

• must be apathy of her birth mom
• must be under the constant 'abondon' feeling from the birth mom
• feeling of neglect, hate...

Will I be able to give the baby so much love and affection that can overcome the mistreatment that baby has received?

Yes, I firmly believe "Love cures, love heals..." perhaps over the time with my love I can give the much needed affection to the little one.

Adoption or Exchange?

Its easier said than done… and yes the quote applies to “Adoption” too.
After three unsuccessful ICSI cycle, my doctor said than you can try for adoption. Yes, I wanted to adopt somebody someday but not due to my inability. I always wanted to adopt as my willingness and not as my inability.

Advise as they say is the most free available (unwanted) thing was given to me by many. They said adopt, it will help you and make somebody’s life, even lord Krishna was adopted by Yashodha mata, etc.

But there is difference, Yashodha Mata had a baby in her womb, she knew she will have her baby, seldome she knew that the babies were exchanged after they were born. For her, she was mother may be Krishna or some other baby.

The entire epic is more of “exchange of babies” than “adoption”.

Any thoughts or comments?

Things changed... but make the best out of it!!

Things weren’t the same… life had taken a cruel turn and nothings seems going right. We (me and hubby) felt shattered; news about infertility together with some personal problems was taking toll on us.

I cried every time…

• When another period starts
• When somebody announces her pregnancy
• When I see children begging on the roads
  

Things weren’t the same…

• Felt the whole world is pregnant except me
• Started avoiding social events to avoid the questions from people
• Feeling very left out when friends start comparing their pregnancy or childbirth experiences
• Waking up in the middle of the night and wishing I could hear my baby crying
• Wishing I could give your parents grandchildren
• Wanted to tell friends who just turned mom “don’t crib for sleepless nights or changing nappies or feeding problems, bcoz you have something for which I long”
• Sometimes avoiding friends who are pregnant or with newborns because I just can't handle the situation at that moment
• Getting tired of people always expecting you to do things because "You don't have any kids to worry about"
  

“…God, Grant me the serenity to accept the things I cannot change, the courage to change the things I can change, and the wisdom to know the difference."

Over the time I realized it’s perfectly fine to have any or all of these feelings, it was ideal to cry out at times, think about something positive in life and anchor on some good support.

For me, my husband was my strongest support pillar, my strength and so was I for him. Such situations makes you realize how important is your spouse for you and you for your spouse.

Well, I can’t change things which are beyond my control, but certainly make the best out of it.

Its oligospermia - meaning low sperm count

We met our doctor after the test, I was tensed and she just looked at my husband’s report and said, “don’t worry, you will surely conceive, you will be pregnant… but” (the music to ears turning into a loud unbearable bang with that “but”)

Things weren’t the same after the reports. While I had normal hormones and my tubes are patent, my husband’s sperm count was just two low.
She said the I can conceive through Assisted Reproductive Technology (ART) such as IVF, ICSI or IUI… the jargons were yet to sink in the truth I just heard!!!

“But…” (I started hating this word “but”, as if more things are wrong in my way) she said, “don’t loose heart or stop trying, we have seen miracles happening, and some miracle may work with you. Go ahead with ART but also don’t stop trying”

We just realized, we are suffering from infertility due to male factor.

Some information on Semen Analysis Test:

Semen volume

• Normal: 2–6 milliliters (mL) per ejaculation
• Abnormal: An abnormally low or high semen volume is present, which may sometimes cause fertility problems.

Liquefaction time

• Normal: 20–30 minutes after collection
• Abnormal: An abnormally long liquefaction time is present, which may indicate an infection.

Sperm count

• Normal: 40 million spermatozoa per ejaculate or more
  0 sperm per milliliter if the man has had a vasectomy
• Abnormal: A very low sperm count is present, which may indicate infertility. But a low sperm count does not always mean that a man cannot father a child. Men with sperm counts below 1 million have fathered children.

Sperm shape (morphology)

• Normal: More than 70% of the sperm have normal shape and structure.
• Abnormal: Sperm can be abnormal in several ways, such as having two heads or two tails, a short tail, a tiny head (pinhead), or a round (rather than oval) head. Abnormal sperm may be unable to move normally or to penetrate an egg. Some abnormal sperm are usually found in every normal semen sample. But a high percentage of abnormal sperm may make it more difficult for a man to father a child.

Sperm movement (motility)

• Normal: More than 60% of the sperm show normal forward movement.
• Abnormal: Sperm must be able to move forward (or "swim") through cervical mucus to reach an egg. A high percentage of sperm that cannot swim properly may impair a man's ability to father a child.

Semen pH

• Normal: Semen pH of 7.2–8.0
• Abnormal: An abnormally high or low semen pH can kill sperm or affect their ability to move or to penetrate an egg.

White blood cells

• Normal: No white blood cells or bacteria are detected.
• Abnormal: Bacteria or a large number of white blood cells are present, which may indicate an infection.
  

Take a test!

I changed Doctor. It isn’t the my previous gynecologist wasn’t good, it’s just that I was loosing my patience (seldom I follow my brain than my heart, this was one of those times).

The new Doctor was recommended by my friend, who delivered healthy baby boy after 1 year of trying!!! (So you see there isn’t any logic, but we still follow our brain). And my brain proved right this time.

My doctor was like a motherly figure. She was kind and patient, she asked me questions about my menstrual cycles, relationship, etc. She said as such she doesn’t foresee any problem with me, but just to confirm it medically she asked me to conduct some blood test (to check hormones level) on particular days of my cycle and a hysterosalpingogram (HSG). And for my husband a semen analysis. After all the tests, if required, she will consult on further medication. I was really comfortable with her.

While I was leaving her clinic, she said, “don’t worry, you will surely conceive, you will be pregnant” (isn’t that music to ears?)

About the tests:
Usually hormone test such as FSH, Thyroids, LH, etc are conducted on Day 2-5 of your cycle (considering your first day of bleeding as Day 1). Most doctors suggest these tests. Consult your gynecologist or doctors before conducting this test. Its simple blood test.

HSG – a procedure in itself
During a HSG, a dye (contrast material) is put through a thin tube that is put through the vagina and into the uterus. Because the uterus and the fallopian tubes are hooked together, the dye will flow into the fallopian tubes. Pictures are taken using a steady beam of X-ray (fluoroscopy) as the dye passes through the uterus and fallopian tubes. The pictures can show problems such as an injury or abnormal structure of the uterus or fallopian tubes, or a blockage that would prevent an egg moving through a fallopian tube to the uterus. A blockage also could prevent sperm from moving into a fallopian tube and joining (fertilizing) an egg. A HSG also may find problems on the inside of the uterus that prevent a fertilized egg from attaching (implanting) to the uterine wall.

A HSG is done to:

• Find a blocked fallopian tube. The test often is done for a woman who is having a hard time becoming pregnant. An infection may cause severe scarring of the fallopian tubes and block the tubes, preventing pregnancy. Occasionally the dye used during a hysterosalpingogram will push through and open a blocked tube.
• Find problems in the uterus, such as an abnormal shape or structure, an injury, polyps, fibroids, adhesions, or a foreign object in the uterus. These types of problems may cause painful menstrual periods or repeated miscarriages.
• See whether surgery to reverse a tubal ligation has been successful

This test should be done 2 to 5 days after your menstrual period has ended to be sure you are not pregnant. It should also be done before you ovulate the next month (unless you are using contraception) to avoid using X-rays during an early pregnancy. You may want to bring along a sanitary napkin to wear after the test because some leakage of the X-ray dye may occur along with slight bleeding.

Irregular Period? Check for PCOS

When my regular cycles started fluctuating and that too on higher side, I visited a gynecologist. A scan revealed that I had PCOS in my left ovary.

It isn’t scary, but if I let it loose, I was susceptible to infertility (I hate this word).

I was told to reduce weight, do some exercise regularly and some medication over three months helped me to overcome PCOS.

So what is this PCOS?
Poly Cystic Ovary Syndrome (PCOS) is a commonly seen problem among women these days. It affects women of reproductive age and statistics shows it is seen in 10% of women. Though in most cases it is minimal and won’t be even noticed, the alarm rings when difficulty in conceiving is noted leading to long periods of infertility. Unfortunately there is no universal definition for the PCOS, but we can guess it from the name itself. Poly cystic means ‘with many cysts’ and it tells you it’s a condition of the ovary having many cysts. By definition a cyst is a fluid filled sac.

The basic terms PCOS means this: It’s an endocrine disorder where the male hormones (androgens) in females increases to an abnormal level and affects the female reproductive cycles. This leads to a situation where women do not ovulate. Basically the purposes of ovaries are to produce eggs and release one of the mature or full grown eggs every month. The release of egg is called Ovulation. The high male hormone level inhibits the growth of the egg in the ovary so that it will not reach its maturity and so won’t be released. Thus the unreleased eggs remain in the ovary and become cysts over a period of time. Since ovulation is not happening the patient will not conceive leading to infertility.

The commonly seen symptoms of PCOS are:

• Acne
• Weight gain and trouble losing weight.
• Extra hair on the face and body. Often women get thicker and darker facial hair and more hair on the chest, belly, and back.
• Thinning hair on the scalp.
• Irregular periods. Often women with PCOS have fewer than 9 periods a year. Some women have no periods. Others have very heavy bleeding.
• Fertility problems. Many women with PCOS have trouble getting pregnant
  

PCOS is generally diagnosed from the symptoms stated above and confirmed using blood tests for hormone levels and ultra sound scan of the pelvic region. A gynecologist or obstetrician should be consulted for diagnosis and treatment. To diagnose PCOS, the doctor will:

• Ask questions about your past health, symptoms, and menstrual cycles.
• Do a physical exam to look for signs of PCOS, such as extra body hair and high blood pressure. The doctor will also check your height and weight to see if you have a healthy body mass index (BMI).
• Do a number of lab tests to check your blood sugar, insulin, and other hormone levels. Hormone tests can help rule out thyroid or other gland problems that could cause similar symptoms.

The absence of periods is the cardinal factor in diagnosing PCOS. The other symptoms like hirsutism and acne may or may not be present. Another interesting finding is that majority of PCOS patients who are overweight are insulin-resistant. Insulin resistance means your body is resisting the effects of insulin. Insulin is supposed to keep the blood sugar normal. So resistance to insulin causes you to become diabetic. And the drugs given for type II diabetics is effective in controlling the insulin resistance and thus PCOS.

The treatment of PCOS is in 2 ways depending on if you are looking for a child immediately or not. If you don’t have any plans for conceiving, then birth control pills are given to regularize the monthly cycles. But if you are keen on conceiving, then Metformin is one of the widely used diabetic drug. Usually both these drugs are given for 3 – 6 months. If the condition is persisting, then other methods of treatment should be followed like inducing ovulation taking drugs or surgery. Laparoscopic are useful for puncturing the cysts and inducing ovulation by scraping the walls of ovary which triggers female hormone production. (PLEASE SEEK DOCTOR'S GUIDANCE IN PCOS)

• Try to fit in moderate activity and/or vigorous activity on a regular basis. Walking is a great exercise that most people can do.
• Eat a heart-healthy diet. In general, this diet has lots of vegetables, fruits, nuts, beans, and whole grains. It also limits foods that are high in saturated fat, such as meats, cheeses, and fried foods. If you have blood sugar problems, try to eat about the same amount of carbohydrate at each meal. A registered dietitian can help you make a meal plan.
• Most women with PCOS can benefit from losing weight. Even losing 10 lb may help get your hormones in balance and regulate your menstrual cycle. PCOS can make it hard to lose weight, so work with your doctor to make a plan that can help you succeed

Am I pregnant?

I used to have regular cycle until it started fluctuating on the higher side. This would give me hope every month!! It may sound weird, but I used to feel (or imagine?) some of the pregnancy symptoms. Any passing additional day over due date would increase my hope until the urine pregnancy test.

Some of my symptoms during this tenure were:

• Nausea – feel like vomiting or sometime vomit too

Reasons: Erratic eating habits, combination of acidity and headache would often result for me in vomiting. All I couldn’t figure out why this vomit sensation grew stronger past my due dates – may be its psychological

• Bloated

Reasons: I am fat, that’s it!!

• Frequent urinating

Reasons: Drinking lots of water, and that too near my due dates

• Swinging moods

Reasons: If it is... it is

• Feel like pregnant

Reasons: No comments- was trying for long and hope is always alive.

My suggestions, if you feel you are pregnant:

1. Hold on for some time before a test. For me my next cycle used to begin always the next day of my pregnancy test (what a waste of money!!!).
   
2. Always used renowned, recommended (by doctors) or branded home pregnancy test

Well, it’s normal to feel or imagine some of the symptoms. Most of these are psychologically related and it’s quite common to have one or some.

that 18 hours...

I missed my period... wow, it could be positive and the next day I went for Urine Pregnancy Test (UPT) crossing my fingers for that two lines. Well, my dreams lived less than 18 hours with just one line.

We were trying for about 8 months, and for the first time, I felt helpless, thinking about my 18 hours of happiness. For that 18 hours, I would have lived a whole 9 month... deciding on everything from names of babies, colour of bedroom, toys, how stupid I was!!! I didn't lift anything heavy, didn't sleep on my tummy. In fact I couldn't sleep that night desperately waiting for the morning for my test.

I cried and cried (well that’s normal). Sometimes crying helps getting pain out of heart, try... its works for me.

I was losing patience everyday growing. That 18 hours made me live a 9 month life and realize life won’t be easy going further, better be prepared and face it.

A beginning...

I thought to share my experience on my first cycle of ICSI. Took a while to select a suitable name for this blog and came up this one “I-n(and)-fertility”. Just like "Impossible" can be spelled as "I - am - possible", so do I believe that I will have “fertility” some day!!! I feel that infertility shouldn’t get over me, instead I should overpower it (Please do carry this attitude with you as well).

The blog will provide some enlightenment on the psychological state to couples who are undergoing or will undergo IVF. The blog is about sharing my experiences, my feelings and emotions. It also describes the emotions of other people around me who are going through IVF.

I appreciate if you would leave a comment for improvement.