where do we go from here? - update

[dandelionsrflowers]

***update at bottom***


I'm pretty new here (as far as posting goes), but I've been viewing and trying to learn from your wisdom for a while now. It is soooo hard to wade through all the #'s, test results and options.

I'll give you all some info and maybe you can help me choose the right path.

We've been ttc for over two years now. For the first year we just tried the good ol fashion way. After about the 6 mo. marker, I started thinking that there was a possibility that me feeling like pure crap all the time had something to do with us not being able to conceive so I set out on a quest to feel better. I changed my diet, started attempting to exercise, etc.

About 6mo. ago I decided to give acupuncture a try - I've been going every week since and I feel like a new person. All those years of aches, pain, & fatigue are behind me, but still no baby. Acupuncture along with diet and exercise... who would have thought after all those dr. apt. right? WestMed never once asked me about my diet!

I have regular, 26 day cycles. Ovulate on day 12 (confirmed by OPK) and chart temps. I am in my healthy weight range/bmi but could use some work on my cardio - fairly good shape I would say.

As far as the western medicine is concerned... here are the tests I have had done:
****
BLOOD TESTS-
DONE ON CYCLE DAY 9
FOLLICLE STIMULATING HORMONE 4.6
LUTEINIZING HORMONE 4.0
PROLACTIN ASSAY 17.2

DONE ON CYCLE DAY 22
FOLLICLE STIMULATING HORMONE 3.3
LUTEINIZING HORMONE 3.3
****
HSG - everything looked great
BIOPSY OF UTERUS LINING - normal
LAPAROSCOPIC SURGERY - mild endo & "not in places that would cause



problems". They had suspected that I had pretty severe endo due to all the symptoms that I have had in the past. Most of which had recently started clearing up.

Acupuncture
I had severe stagnation problems - energy and bodily functions/flow... still working on improving this, but it has gotten much better. I am also generally a cold person which doesn't help.

Our Dr. said we have a few choices… continue trying naturally, IUI, or be referred to an RE for IVF. Our heads are spinning.

Hopefully I didn’t loose you all with being so long winded - Thank you and I love you all for listening!

Please ask me questions! I know I’m not asking everything I should…

[lifeguard]

You haven't mentioned anything about your partner. Has he been checked out at all? Is he doing anything to improve his fertility?

[pinkfriend]

Has your husband been checked for male infertility? Maybe low sperm counts etc?? I guess it all depends on how quickly you want to get pregnant...I know a few people that have done IVF and now have babies, others tried for a really long time and also now have babies.

[dandelionsrflowers]

his spermies are great... average or above in everything.

i always forget to mention that cause there doesn't seem to be a prob. he keeps taking his vitamins, but that's about all...

[mischievium]

With your DH, did they do a regular semen analysis or one with a strict morphology-- you can have normal numbers as far as morphology goes, but not when a strict morphology is done. From this website:

There are two methods for performing a semen analysis. Most clinical laboratories perform a crude estimation of the percentage of sperm in the ejaculated specimen that appear to have normal shape. Only specialized andrology laboratories have trained technicians that can perform a "strict" semen analysis. Only these "strict criteria" (also known as Krueger criteria) have been studied with regard to fertilization success or failure. If a man has a decreased number of normally shaped sperm on the Krueger strict morphology analysis, he is at risk of fertilization failure or at least low rates of fertilization. However, an increased number of abnormally shaped sperm with 'non-strict' criteria may indicate a fertilization problem, but to be certain this test should probably be repeated in a laboratory that performs strict analysis. Strict morphology is a useful test to perform with couples that have unexplained infertility, even if the semen analysis and non-strict morphology are otherwise normal.

Also, your DH's numbers can be completely normal, but he could still have antisperm antibodies (<-- click the link to read about it and about risk factors). It's a somewhat rare condition, but it might be worth checking into in cases of unexplained infertility (especially since the test for it is much less invasive that much of what you have been through).

Questions about you:

1. I noticed your levels were done on CD9, usually the baseline hormone panel is done on CD3 and should include: Estradiol, FSH, LH, Prolactin, DHEA, and testosterone (free and total), here's a good site that talks about the normal ranges of results.

2. Have you had your progesterone level checked? Progesterone deficiency can be linked to chemical pregnancies/ early miscarriage. It should be done 7 days post ovulation (the test is also called "cycle day 21 Progesterone"-- but you should only do it on CD21 if you actually ovulate on CD14, for me, the first cycle I did it, I didn't ovulate until CD23 so a CD21 Progesterone would have been useless.)


Since it has been 2 years, my advice would be to go see an RE. It sounds like a little more testing is in order and REs can do that and then help you decide which path is most likely to work for you (IUI vs. IVF vs.???).

[dandelionsrflowers]

my head is just spinning with all the information i have been reading... from everywhere. it just sucks because we have limited resources and i want to make sure we do this "right". i don't want to get through 6 cycles of iui and discover it was really never going to happen.

thank you for pointing me in some more helpful directions!!!

[dandelionsrflowers]

update...

mischievium it looks like they did do the sperm test with strict morphology and everthing looked really good:
volume, liquefacation time, pH, white blood cell count, fructose - normal
sperm count - 585,000,000
sperm motility - 439,000,000
sperm morphology - 15% (i guess anything above 14% is good)

as for me, they said that the CD3 and CD21 tests were'nt something that they thought was necessary. turns out they did more tests, including thyroid, than i listed above. they said the combination of my charts and my good hsg and endometrial biopsy ( i am ov at cd12 regularly) made it unnecessary... does that sound right???

thanks for taking the time to respond to me above!