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Our second IVF consultation. Finding the best way of ART.

Mission completed: we got all the needed preparation tests done, and all data uploaded to the app for the 2nd consultation. It looks like our doctor even had time to check on them, because upon entering his office, I could see a folder with our names on it, and filled with printed documents. We officially have our IVF documentation.

"Does my age matter? The simple answer is: YES."

I built up so many scenarios in my mind which directions we can take from here. Being super confident at a moment, and feeling completely clueless at another. It feels like being a little girl, who is looking for an adult for help.

Let’s start with the good news (I always prefer it this way). Based on my blood test result I am very healthy, just need a bit of Vitamin D boost. Actually, I didn’t know that Vitamin D plays a key role in fertility, and its optimal level is essential for both female and male reproductive functions. My womb, and uterus lining looks perfect as well, ready to be a great home for our baby. My period is regular, and I have ovulation (which is one of the most important things). The tests didn’t find any diseases, so we got the green light for our fertility treatment.

My hormone levels look great as well. We are going to check on them a few times during the IVF cycle. Because as the doctor explains to me, our hormones have their special ‘dance’ during our menstrual cycle. All of them have to do their special moves at the right time. If everything happens according to the choreography, the performance will be great.

The only one hormone on the report, which level doesn’t change during this period, is the Anti-Mullerian Hormone (AMH). It gives information about how many potential eggs we have left for our fertile years. This also helps to answer one of the most common questions: Does my age matter? The simple answer is: YES. My AMH level is 0.732 ng/ml now, which if I compare to my level six year ago (2.41ng/mL), shows a huge drop. I won’t lie, it shocked me, and made me realize if I really want to have a child, I don’t have more time to waste.

The doctor asked me to undergo a fallopian tube test. Unfortunately, the result is still the same as 6 years ago, both of them are completely blocked. Meaning: because of the blockage, my eggs won’t be able to meet the sperms, and get fertilized. It also means that IUI (intra-uterine insemination) won’t be a solution for us (it can work with normal tube functions only).

So, we have two options left: (no1) laparoscopic surgery, and trying to unblock my tubes; or (no2) IVF.

With laparoscopy the surgeon can try to unblock the tubes by removing scars or damaged parts of the fallopian. When I ask the doctor about the chance of success, his bet is at 50-50, because we don’t have information about the cause of the blockage. BUT before making my decision, he advises to consider one more factor: the result of the semen analyses.

My husband’s result is not a disaster (he had seen lots of IVF success stories with a lot worse spermiogram), but his sperms are not as tip-top as they used to be many years ago, when he became a father of three amazing daughters. Even if we were able to unblock my fallopians, it wouldn’t be easy for us to conceive naturally.

As the doctor said: from now on, both of us play an important role in our fertility story.

The summary of our consultation:

Considering my AMH level, my husband’s sperm situation, and the fact that both of my fallopians are blocked, our best way to go is IVF. We are great candidates; the doctor cannot see any reason which should worry us. He asks us to contact and visit him again on the 2nd day of my next period, when we are going to start the stimulation, and our first IVF cycle.

A normal reaction of a healthy man: Is everything fine with me or not?

As I mentioned before, our IVF specialist didn’t give me too many things to do. The doctor gave me referrals for a blood test and the semen analysis. Two tests only, which compared to my wife’s list, was nothing.

"I won’t lie: the result hit me hard, and it was almost unbelievable for me."

Blood tests are needed for men to know if they don’t have any infectious diseases, such as HIV, hepatitis, HPV, syphilis, etc. It’s just a normal blood test, easy, nothing to worry about.

I didn’t make a big deal about the sperm test either. I knew that everything was fine with me. My confidence was based on a very strong fact. At the age of 47, I am a father to three amazing, healthy, smart, beautiful girls. I don’t need better evidence, that I am the masterpiece of creation. I couldn't see why I could not do what I have done 23, 19 and 10 years ago. (Of course, it did not even cross my mind that many years passed.) So, I was absolutely ready for testing.

The semen or sperm analysis needed a bit of preparation. The instruction was “3-7 days abstinence”. Doing a bit research, I found that not having sex for 4-5 days can bring us the best result (if you keep the guys inside longer or shorter it can affect negatively the result). Cheating is not allowed either (you know what I mean, when no one can see you). You have to remember these rules when giving the sample for the fertilization later as well.

My wife asked me to drink plenty of water for one week prior to the test. We all know drinking enough water is essential to keep our organs, and cells functioning properly. So, it makes sense that it has the same effect on our reproductive cells: the sperms. Semen production can be reduced by not drinking enough water and causing dehydration; the semen can get thicker, and the sperms may have trouble swimming. I increased my water intake to 3 liters per day.

The day the big test arrived. I proudly produced the sample for the semen analysis as the doctor asked me to do, and I was waiting for the result without any fear or worry.

The next day I received my result via email. My numbers were not exactly what I hoped for. I jumped on my laptop, hoping that my best friend Google would help me out and I would find written evidence that my numbers might not be great but at least acceptable. “Every man kindles the fire below his own pot”, so do I. I started to create my own explanations: it’s not even so bad, it's just ‘sometimes’ a bit different than the normal numbers. The room at the Clinic was not the most ideal environment for this kind of activity either, and it must have had an effect on the result as well. If you would have been there, you would know what I mean…

I won’t lie: the result hit me hard, and it was almost unbelievable for me. On one hand, I tried to accept it, but on the other hand, I really hoped the doctor would tell me that my result is not as bad as it looks.

This was the day when the world of IVF grabbed me. I still tried to believe that everything is fine with me, and that the doctor would tell me something that can put my ego back into the ‘masterpiece of creation’ stage. But deep down, I knew that it is not only about ‘my wife’s issue’ anymore, but about mine as well. This was one more thing that would make us stronger.

How to be effective with scheduling your tests and examinations for your second IVF consultation.

We were given a lot to do before our second IVF consultation. As the doctor said, we can only schedule our next appointment when we have all our test results. Our next goal is: getting all the tests done before my next period, and start our IVF treatment by my next menstrual cycle.

"It’s clear that all the scheduling has to be around my period, because some of the examinations can be done only on specific days of my cycle. "

Both of us are on a tight working schedule, so we have to be as effective as possible, and act as pros. We don’t want to wait an additional month to start our journey, so we are going to do our very best.

Deadline of getting all the results in our hands: 5 days before my next period (reason: the treatment starts on the 1st or 2nd day of menstruation).

Here is our To-Do list (yours can be different, it depends on your personal story):

It’s clear that all the scheduling has to be around my period, because some of the examinations can be done only on specific days of my cycle.

Step No1: I set up an event for all the tests needed in the Leeaf app, but I haven’t scheduled any specific date or time yet.

Step No2: I called all the doctors and clinics which we need help from, and asked for information about:

Step No3: Based on the information from the clinics, we set up our optimal schedule:

Step No4: I grouped together the tests which can be done together in the Leeaf app, and added all the extra given information to them as notes.

Step No5: I have to wait for the 1st day of my period and call all the clinics/doctors and book all my appointments in advance.

Step No6: Set the dates and time for all the tests in the app.

It looks like all can be done in time. ☺

One thing you should know from the beginning, is how much your wife is going to do for your future baby.

We decided who is going to be our fertility specialist. We considered a few factors, but I think it’s pretty normal that the final decision was my wife’s. We chose a specialist who was recommended by her gynaecologist. After the first consultation with him, it was obvious that the treatment would be heavier on my wife, than on me. I was asked to take two tests only: a blood work, and the famous semen analysis, which compared to my wife’s list, was nothing. I think the best way to use my time and energy is to support her, and be there for her if she needs me.

"She was in so much pain from the pressure on her blocked tubes, that I could hear her yelling at the waiting room. "

It was evident that, if she wants, I am going to accompany her to all the appointments she has to go to. This is a real couple-goal. I want her to feel that we are doing this together. Support is always a good way to show you care, even if most of the time I cannot do anything else then just sit in the waiting room, and drive to and back home from the clinic.

So, today I was a driver again, and took her to the gynaecologist for HyCoSy. The doctor ordered her to take a new fallopian tube examination. Depending on this exam, we will know if we should/can go for IUI (intra-uterine insemination) or IVF. Fallopian tubes and their function is important because they lead the eggs to the womb, and it is also the place where the big meeting with the sperm happens. If the fallopian tubes are blocked, it’s impossible, and also can cause further complications.

Of course, I wanted to know a little bit more about this exam. The procedure is not too complicated. The doctor is going to inject some contrast fluid into the womb, and check by ultrasound the fluid's path journey. If the ultrasound can show the fluid passing through the tubes, it means the fallopians are clear, if not, it means they are blocked. If the tubes function well, the examination process is almost painless (they say), but if they don’t it can be painful. So, I am really worried for her, as our last information is that both her tubes are blocked.

Based on my research, I found something which gave some hope. It can happen during the examination process that from the pressure of the liquid the fallopian tubes become unblocked. Actually, one of my friends got pregnant right after HyCoSy, never before and never since then. Understandably, I had mixed feelings about the appointment.

To make it short: my wife is a superhero. She was in so much pain from the pressure on her blocked tubes, that I could hear her yelling at the waiting room. The good news: that the pain didn’t last, so she was completely fine when we left the clinic. The bad news: both of her tubes are completely blocked, so it’s more likely that our only one way of having a child is going for IVF.

How to get ready and prepared for the first consultation with your fertility specialist.

Finally, the day of the first meeting with our fertility specialist! Fortunately, the waiting list was not too long, but even the 14 day wait felt like months. I couldn’t help myself from doing a bit of google research on our doctor, but I promised myself I wouldn’t make any expectations based on other’s opinions. We prepared a few questions based on what we learned about IVF in the last few weeks, and we’re hopeful to get our answers.

"Surprisingly, he didn’t have too many questions about my husband, or about my lifestyle. "

The consultation started easy and smooth; I could tell that he saw a lot in his practice. I imagined his office with new born baby photos on the wall, but there was no sign of them, although the room was very friendly and cozy.

The consultation started with some basic medical questions, such as my age, weight, any sicknesses in my family. Speaking about weight: did you know that it’s a key factor while going under IVF? Being over- or underweight can greatly affect the outcome of IVF treatment. It’s important to face, because if you have weight issues, it usually takes a few months to fix it. So, if you think this might be an issue, take it as a first step of the preparation.

We then continued with some fertility related topics, such as questions about my period, if I have been pregnant before, and my IVF history. Having all the data handy in my Period Tracker app was super helpful. Actually, if you track your period for more than a year, you can find interesting patterns in it. Knowing your period well, will help your doctor a lot. (TIP: upload all your related data or documentation to the Leeaf app.)

Surprisingly, he didn’t have too many questions about my husband, or about my lifestyle. (I was a bit disappointed, because I could proudly tell him about my positive lifestyle changes.) But anyway, based on our answers he declared us as a perfect couple for IVF. Yeah!

After, we opened the big question: which way is going to lead us to conceive and have a baby. Based on my blocked fallopian tube situation, he offered us three possible ways to go.

  1. He had a look at my (6 years) old tube examination result. He said “6 years is a long time”, and it would be great to have a fresh exam to see the current situation. If they are still blocked, we have the option of laparoscopy.
  2. If it turns out that my fallopians are not blocked anymore, we could go for IUI (intrauterine or artificial insemination), which compared to IVF, it’s a relatively simple fertility treatment, and can be done with a much smaller amount of fertility drugs.
  3. If my tubes are still blocked, and I don’t want to go for a laparoscopy, then we can start our IVF treatment.

So, we have to make our decision based on the result of a new fallopian tube test. I have mixed feelings about doing the test again. From one side, it would be amazing if it turned out that my tubes are not blocked anymore, but from the other side, I know, if all would be good with them, we would have already conceived.

We left his office with a list of the tests and examination we needed to get done so that he could see what will be the best way for us to move forward:

We are going to have a busy month ahead!

What basic steps you will face during IVF.

After I had to omit my first plan – solving our problem in house, ‘in vivo’ instead of ‘in vitro’ – failed, and acknowledged that we are going to need medical help, I started to learn about IVF treatments. I think all of us have some idea about what it is. Everyone has a friend, family member, or a colleague who has some experience in this field (but it’s true, it isn’t something we would discuss over a beer). These days it’s also common to hear about celebrities undergoing fertility treatments as well. Meaning: IVF became an accepted way of making a baby. Even though everyone prefers to have a child in the normal (and much more fun) way, unfortunately it’s not as easy for everyone.

"Everyone has a friend, family member, or a colleague who has some experience in this field (but it’s true, it isn’t something we would discuss over a beer). "

So, here are the basics which (even) a man should know about fertility & IVF.

  1. Hopefully everyone knows how to conceive naturally. In the middle of the woman’s menstruation cycle, her ovary releases an egg. The egg (also called ovum) starts to travel through the fallopian tube in the direction of the womb. During this trip the egg meets the sperm, and if they meet at the right time and like each other, the magic might happen. The fertilized egg continues its journey to the womb, where it develops into an embryo and is going to implant into the uterus lining. BOOM! Simple as 1x1.

But ‘in vitro’ it’s not as simple:

  1. The IVF treatment is going to start the 2nd day of your partner’s period, and actually everything will be scheduled around her menstrual cycle.
  2. In a normal month (without IVF) a woman releases only 1 egg per cycle. In IVF we need more eggs. This is possible with hormone stimulation, that’s why your partner is going to need the hormone injections. Be very proud of her, because we all know how a man can react to pain.
  3. The stimulation process is controlled by the doctor regularly (it’s not lucky to have under- or overstimulation either). The doctor checks on the follicles with an ultrasound test. The stimulation phase takes approximately 10-12 days, depending on how her body reacts to the hormones.
  4. When the follicles look matured enough, your partner has to go under a minor surgery. It’s called egg retrieval, or egg collection. The doctor is going to poke all the follicles and collect the eggs from all of them. This is a very low risk surgery, so nothing to worry about, but again: it won’t be performed on you, so be supportive!
  5. At the same time of the egg collection, your major, and only one job is due as well: sperm collection.
  6. From here, there are two different ways to go:
  1. After this, the lab keeps the fertilized eggs in an incubator for 3-5 days, depending on their development. Unfortunately, not all embryos are going to make it until Day5. It’s normal.
  2. Depending on the embryo-development, your doctor is going to decide the best time for embryo transfer. You are also going to have a consultation about the optimal number of transferred embryos. This is a quick and absolutely painless procedure. The doctor is going to put back the embryo(s) into your partner’s womb.
  3. If you are lucky to have more embryos than needed for the transfer, the remaining quantity can be frozen, and used later. It's great news, because if you have to go for more IVF cycles, your partner doesn’t have to do hormone stimulation and egg retrieval again.
  4. After the transfer you have to wait approximately two weeks to know if you have succeeded.

This is the IVF process in a nutshell, but I somehow have the feeling that it won’t be as simple as it sounds, but we will see.

Our first task: picking a IVF Clinic or IVF specialist. Which criteria we had to consider to make the right decision.

Six years have passed since I was diagnosed with two blocked fallopian tubes and I was declared “infertile”. Since then, it was clear to me that having a child wouldn’t be an easy journey, but it would be absolutely possible. I also met my amazing husband (DH – as we call our Dear Husband in the fertility community), and from the beginning of our relationship, we spoke openly about the issue with my fallopian tubes. He fully accepted me and my “flaws” and we started our search for the best way to become parents together as soon as possible. I am currently 36 and he is 47, so we didn’t really want to waste any time.

"I have an amazing gynecologist, who knows my story. It was obvious for me that I was going to ask for his recommendation. "

Our first task was picking the IVF clinic (or a doctor). There are plenty of clinic options available, and picking the right one is not an easy decision, so decided to make a list of my criteria:

  1. Waiting time. This was a key point for me. I am not the most patient human being on Earth in normal circumstances, and especially now. I would like to be a Mom as soon as possible.
  2. Success rate. A higher rate would indicate better chances. To be honest, I was a bit skeptical about the rates published on the websites. As Aaron Levenstein said: “Statistics are like bikinis. What they reveal is suggestive, but what they conceal is vital.” I definitely would check how the success rates were calculated.
  3. Doctor’s personality, and atmosphere of the clinic. I wanted to feel that I am safe, supported, and important.
  4. Price. This was a key point as well, but not the most important in my opinion. It’s not a cheap medical service, and I had to keep in mind that most probably it won’t be a ‘one-time-service’ either. More IVF cycles will multiply the cost of the whole IVF journey.
  5. Location of the Clinic. I didn’t want to travel too much, if it wasn’t necessary.

I have an amazing gynecologist, who knows my story. It was obvious for me that I was going to ask for his recommendation. He recommended to us one of his fertility specialist colleagues, who – as he said – “helped him with many babies over the years”. This is definitely a good review!

We want to take our time to consider all our options, but don’t want to spend ages on picking the clinic either. We agreed with my husband for a 7-days deadline meanwhile considering two important rules:

  1. We are going to check all the options together, but the final decision will be mine.
  2. We won’t base our final decision on google/facebook/forum reviews or personal recommendations. Every case and story are different. We would like to focus on ours. (I am not a saint, and cannot promise that I won’t read any though.)

Our decision-making deadline (make an appointment with the doctor) is scheduled in Leeaf, so it’s time to make an excel sheet, and pick the best guide for our IVF journey.

#ivfclinic #ivfjourney #art #myivfjourney

When I found out that my (future) wife had a fertility issue, and how I felt about it.

Maybe you’ve heard this sentence already: ‘“My wife cannot get pregnant naturally”. I think this sentence should be corrected to: ‘“My partner and I cannot conceive naturally”. It’s not only a more considerate and emphatic way to word it, but in many cases this is much closer to the reality.

"It’s only a ‘macho misbelief’ that infertility is a female issue, and that men cannot be infertile. "

One of the most common and natural processes, in a relationship with a strong emotional bond, is to decide to form a union or partnership together. For most people, having children together is a very evident next step too. Sooner or later, the discussions about expanding the family will become a normal topic and plans will be formulated and tested.

Well, in our case it was a bit different.

I am not 100% sure if we started to speak about the ‘child-topic’ on our first (almost a day long) date, but I am sure that it was an open-topic since the very beginning. My wife was really honest about the fact that she really wanted to have children, but based on some medical exams, she won’t be able to conceive the normal way. It’s never easy to start, and build up a new relationship, and understandably, it was a very important point for her, which she wanted to clarify right at the beginning.

To be honest, I had absolutely neutral feelings about IVF. I didn’t have any negative or positive feelings towards it. In my mind, IVF was a protocol, which solves a problem. It didn’t cross my mind for a second that I might not accept it.

My reaction was absolutely positive and supportive. I was open minded for this alternative life-solution. Firstly, because it was evident to me, if we choose each other, I would like to conceive a child with my love, and secondly, it was not an extra weight on our relationship, but a problem which we have to solve. It was even inspirational and motivational.

My first – which I consider absolutely normal – reaction was (even though she thought that IVF was the only way) that we would resolve this problem naturally without running to the IVF clinic. I thought I could solve this problem.

My confidence was based on a very strong fact. At the age of 47, I was a father of three amazing, healthy, smart, beautiful girls. I didn’t need better evidence that I am able to perform and create offspring. I couldn’t see why I would not be able to perform once again, what I have done 23, 19 and 10 years ago. Of course, it did not even cross my mind that since then many years had passed. Many years with lots of challenges, stress, problems, not to speak about some – not too smart - lifestyle choices, that had left their marks on my overall health and physical condition.

We tried to conceive naturally every month. I’m not saying that we tried everything that we could. We did not check my wife’s basal temperature every morning, we did not create excel sheets with our ‘fertility window’, we did not check the phases of the Moon either. We just did it naturally with love, hoping that somehow there would be someone who would choose us as parents.

After trying for a year, I had to admit that my wife was right (as always ☺ ), and it might be time to see a fertility specialist. I was never worried about going for IVF, I was just hoping that we could do it naturally.

One thing I am absolutely sure of, if you and your partner desire to have children together, and it turns out that it may not be as easy and smooth as you thought it would be, it’s your job, as a supporting partner, to be there for your wife or girlfriend during these turbulent times. Firstly, because this journey can be long, which can put extra weight on your relationship. Secondly, it’s only a ‘macho misbelief’ that infertility is a female issue, and that men cannot be infertile (or to think in just really rare cases, and that 100% it cannot be you). Stay open minded!

#testyourfertility #fertility #infertility #myivfjourney

How my (in)fertility story started six years ago.

I have to go back a little in time to start my fertility story. I started to feel the so-called “biological urge” six years ago, when I was 30 years old. To be honest, I never really understood how someone can be so desperate to become a mother until I had this feeling.

"I contacted my gynecologist and asked him to run a few tests for my peace of mind. "

First, I thought that this “urge” must be due to hormonal changes in my body, which would make sense considering my age - we always hear about this magical number 30, when it comes to fertility, but does this “urge” really exist? After a short research online, it turns out, studies cannot find any biological explanation of this deep rooted feeling of wanting to have a child. Experts say the root of this feeling is a learned desire from social and cultural influences. Funny enough, I never considered myself someone who cared too much about what other people thought, but it turns out, like the root of our most basic emotional needs – such as being a mother – is extremely deeply implanted.

Even though, at this point, I had not met my husband (or any potential partner in crime), I wanted to know if everything was fine and my fertility. To be honest, I was almost 100% sure that everything was OK with me. I barely saw a doctor (except the normal medical check-ups) over the last few years and my mom had five healthy children. But on the other hand, I heard stories from some of my married friends that making a baby was not as easy as I would think for various reasons.

I contacted my gynecologist and asked him to run a few tests for my peace of mind. He performed a general ultrasound test on me, and found that all my reproductive system organs were in the right places and in good condition. Great news! He also asked me a few questions about my period and confirmed that all was fine with that as well. Great, going well so far! We agreed to do a check-up on my fallopian tubes as well the following month (it can be performed only on certain days of the menstrual cycle, to make sure the patient is not pregnant), and meanwhile, he asked me to do a blood test to see how my hormone levels were.

During the next appointment, my doctor checked the blood test result. He found everything to be in order, including my anti-Mullerian hormone (AMH) level (2.41 ng/ml). This hormone isn’t given enough acknowledgement as it should be. It gives you information about your ovarian reserve (how many eggs you still have). After this consultation, we both agreed that there is nothing to worry about regarding my hormones.

Afterwards, my doctor performed an ultrasound test called HyCoSy, also known as “tubal patency test”. It checks the cavity of the uterus, and the condition of the fallopian tubes. The examination starts by performing a normal pap smear-test, then a contrast agent is injected into the uterus. The contrast agent helps to see the shape and size of the uterus first (using ultrasound). After, if the fallopian tubes are opened, the agent can be seen passing through the tubes. Well, my tubes were not letting any contract agent pass through. It turned out that both of them were completely blocked. That day, I left the Clinic with a paper stating I was officially “infertile”.

Since then (over the last six years), I learned that 30% cases of infertility are due to blocked fallopian tubes. I also learned that “being infertile” doesn’t mean that I cannot be a mother, it only means that it will be a bit more difficult for me to become pregnant than for others.

Since then, I also met my Prince Charming, who became my husband and the most supportive and loving creature on Earth. We spoke openly about my fertility issues since the very beginning of our relationship. My biggest fear over the last years was that no-one will really want me as a partner, because of my fertility issues. My fear was absolutely untrue. Both of us are 100% sure that we are going to have a child together one way or another.

#testyourfertility #fertility #infertility #myivfjourney

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