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Stay positive on the journey, because it’s pretty sure you are going to face some unexpected situations.

As we got the ‘green light’ from the doctor to start our IVF treatment, we don’t have anything else to do just to wait for my period to start, and on the first day to contact the clinic.

"And BOOM! There are two famous lines, the first time in my life. "

It’s the first time in my life actually waiting for my period to arrive. I am sure you know the feeling when you are actually sure your period just started, but nothing happens. I started to have these pre-menstruation symptoms (PMS) one week prior to my normal time. Thanks to my Period Tracker, I know when she should arrive.

Four days before my expected time, I noticed some spotting, which made me super happy as it is a good sign: my period is going to start the same day or next day at the latest. But the following day nothing really changed. I was running to the toilet every 30 minutes to see if there's any change, but all the same. It’s still the same spotting or super-duper light flow, what can be my period, even though it’s absolutely unusual for me.

I don’t want to make any mistake and risk that I don’t start the stimulation in time. I don’t really care if the doctor is going to think I am an idiot and not be able to tell if I am menstruating or not, so I decided to pay a visit to the Clinic. I must be not the first one with this ‘stupid’ question, because my doctor doesn’t give me any strange look. ☺ He does a short ultrasound test on me, and confirms that it’s not my period yet, and we have to wait until the normal flow. (Hopefully I will be able to recognize what ‘normal’ means, but I will try my best.)

The next few days were nerve-wracking. The day of my expected period arrived, but still all the same, and so on the day after.

I really don’t know why, but I got a stupid idea stuck in my mind: I should take a pregnancy test. I ran to the closest pharmacy, bought a super sensitive test. I took it with absolute peace of mind, because as the doctor confirmed a week ago, there is no way that I can be pregnant. And BOOM! There are two famous lines, the first time in my life. I am shocked, and so is my husband. I cannot believe it! I know that it is almost impossible to have a false positive test, but I need a second opinion. Fortunately, there’s a lab close by, where I can get a beta-HCG blood test done today, but I have to wait for the result till next morning.

The difference between home pregnancy test and blood test is that the blood test can detect a smaller amount of HCG (pregnancy hormone) compared to a urine test. The result of the blood test is also more accurate, because the lab test result shows the quantity of HCG hormone found in the blood.

If there is something that I really cannot deal with is the: uncertainty. I never got pregnant in my life before, and now - just a few days before our IVF treatment to start - I (most likely) am.

The next morning finally, we received my result via email: I do have HCG in my blood, so I am PREGNANT, but the level is low. I called my doctor, but unfortunately, he cannot help me too much... He confirms that there is a pregnancy detected, but hormone level is low (which doesn’t mean too much). He asks me to take another test in 3 days, as the HCG should double by then, and will give us more information.

This day leaves us with more questions than answers.

How I learned that sperm analysis isn’t about getting a certificate about my fertility superbness, but showing me there’s room for improvement.

On the next consultation with our doctor, unfortunately it became official, which was only my guess until then: the result of my semen analysis is – let’s say - not ’the best’. The doctor pronounced it clearly: I am involved in our fertility journey as much as my wife is. I am the other 50% in the formula, and the reason why IVF is our only way of having a child together. It didn’t break me, but it was not a comfortable feeling either. I needed some time to digest the situation. I read a few studies about the fact that male fertility has become a bigger problem these days than female fertility. Most of the studies say that minimum 30% (some of them say up to 50%) of infertility problems come from the male side. Studies also show that men’s sperm count dropped, and the capability of fertilization decreased drastically (to its half) over the last few decades in Europe. It surprises me, because if it’s really such a big, common problem, why don't we speak / know more about this?! Knowing that I am definitely not alone with this problem helps me put my mind to ease but it still bugs my ego.

Anyway, let's see what a sperm analysis is about, and my result?

"Most of the studies say that minimum 30% (some of them say up to 50%) of infertility problems come from the male side."

  1. During the test, they measure the volume of the semen. The normal parameter is 1.5-6 ml (I had 5 ml, so I was OK with this part). This factor is important to show us how big our army will be to start with.
  2. They also check on its pH. The ideal value is 7.2 (slightly alkaline), but it is considered normal between 7.2-7.8. (Mine was 8.)
  3. They also check on the motility of the sperms, which is significant because they have to take a long way to reach their goal. If we calculate from the total sperm count, at least half of the little fighters should have good movement. In my case, the progressive motility (when the sperms move in a straight line along a large-arc circle) was 50% (this is ideal). My non-progressive motility value (when sperm moves along a small-arc circle) was 5%. 50% + 5% = 55% in total (which is ok!). I’ve never been a great dancer, but at least my spears are moving well.
  4. Sperm concentration and sperm count are also determined. Sperm concentration shows how many sperm are present in 1 ml of semen, and sperm count shows the total number in the whole ejaculation. These indicators are changing so mournfully, that an acceptable normal minimum value is no longer even set. The WHO (World Health Organization) has recently given the normal values at 15 million / ml and 39 million / sample. I had 10 million / ml and 50 million / ejaculation, which are not particularly good values.
  5. They also examine the morphology of the sperms (if the sperm head is in the right shape or size). The sperm head, for example, plays an important role in breaking through the egg wall to be able to fertilize it. According to the WHO numbers, at least 4% of the sperms should be in formal order (unfortunately, this was only 2% for me). Interestingly, I also came across a study that showed that 29% of men with 0% normal-shaped sperm were able to fertilize an egg in the natural way (not with IVF). So, sperms with abnormal head shape doesn’t mean that there’s any genetic problem with them.

The official diagnosis of seeing all my numbers together was: oligo-teratozoospermia. Meaning I have reduced sperm count and low sperm motility.

However, there is a significant advantage for men over women. While the number of eggs is given at birth, and from then this number decreases and then runs out, in men the sperms are renewed cyclically. The process of sperm formation (spermatogenesis) takes 74 days. (Because we cannot know which part of this cycle we are in, it is better to calculate with 3 months). Meaning: in most cases, men have a chance to improve their ‘sperm situation’ in three months.

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!

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

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