Hi all - I apologize in advance for this being a little long. I am a lurker on several threads here, but I am bad about logging in regularly so whenever I join a regular thread I always fall of the wagon and everyone forgets who I am... But anyway, I really need some tough love advice about a difficult KD situation. I just want to know what y'all would do in our shoes...
Ok, background: we have a 2-year old son we conceived via IUI with our KD. KD is a close friend of ours, we tried at home for some time and then got tested - we found out that KD's semen analysis was suboptimal - 20mil and poor morphology. After trying at home for 11 months we moved to IUI and found that only 2mil survived the wash. DP and I spent the 2ww moping, drinking, and asking a new KD... Only to find out that those 2mil swimmers got us preggo on the first IUI.
Our kid is awesome, KD sees us regularly and is awesome. Part of our agreement with KD is that his mom and grandmother get full grandparent privilege,since KD is an only child and KD's mom is the only surviving child. KD is also queer and has no plans to have his own children. We have a great relationship with KD's family and they're incredibly grateful to have our son in their lives.
So. We have been ttc #2 since 1/11. We conceived at home on our second try (surprise!!!) but unfortunately that pregnancy ended in m/c at 12 weeks. We started trying again in July and moved to IUI in October. We have done 3 IUIs and KD's counts have been **baaad**. 1.7 mil, .5 mil, and .3 mil. KD started supplements and stopped riding his bike 2 months ago, and we've only seen decline in his semen quality. These counts are low enough that most REs would recommend going straight to IVF/ICSI.
I am turning 35 in May. I haven't had a full work up but day 3 FSH is 8.6and anti-mullerian hormone is 2.83, which my doc (not an RE) interprets as saying that there's no reason to worry yet but that I probably don't have all the time in the world to mess around.
So.... What would YOU do in this shitty situation?
1. Keep doing what we're doing and hope for lightning to strike a third time?
2. Stick with KD and start saving for IVF?
3. Switch donors?
4. Some other option I haven't thought of yet?
We're in a similar situation in some ways. Our KD is great, single, has no children of his own, wants our child to have a relationship with his family (which we're happy to facilitate), etc. but also has a low count. A big difference is that we're just now ttc #1 and I'm almost 39 (I'll be carrying so we don't have time to mess around at all, really).
Having said that, we are committed to KD, at least for a while. Our KD is really important to us and the relationship we envision he will have with our child and with us trumps just about everything else.
I guess the things I would ask myself in your situation:
- How important is having the relationship with KD be a known factor? What I mean is that you may be able to find another KD with whom you also have a great relationship with. But it's a risk and might not turn out like you hope or as ideally as what you have now. Since current KD is a known quantity, how strongly do you want him to be the donor for #2?
- How much of a financially hardship would IVF be for you? IVF is just out of our price range so it's not an option for us but each person's ability to pay for and tolerance for spending that much is different (meaning, others in our same position might choose to do IVF while we have chosen not to pursue it). Where do you fall in this regard?
- Do you have any non-financial concerns or resistance to IVF in terms of the more intense medical intervention?
- Is your sense of urgency about making a decision more about the money involved or the clock ticking?
- When you imagine continuing IUI for a while longer (3 mos, 6 mos or whatever), is there a point at which stopping to save for IVF feels like it's too late? I realize it's a while before it's actually too late biologically but what I mean is does your sense of timing about things leave you feeling like you would want to make that jump sooner rather than later?
- Would you continue IVI or ICI at home while you were saving for IVF?
- Are there other donor options that you feel good about right now?
I realize this doesn't exactly answer your question in the sense that I didn't say what I would do. But all of these factors are so personal. It's hard to weigh in on someone else's situation.
Me (39), DP (45). Together since 04, married in June 07.
TTC 10/10 to spring 2012. Fall 2012--moving on to foster-adopt.
Thank you so much for your thoughts. It is good to know that others are going through something similar.
When we started this journey, we were very committed to a KD. DP has an adopted sibling that has long had issues surrounding his adoption and struggles with addiction. Now, though, the possibility of introducing a second KD makes me worry that it will compromise the relationship our family has with KD#1. I don't want there to be a weird dynamic in our family of each child feeling left out by the relationship with the other KD - I know families manage to survive with blends of biokids and adopted kids all the time and this isn't all that different, but it worries me nonetheless. We haven't talked at length about the potential second donor, but we've discussed both frozen and talking with Kd#1 about asking his partner (they have been together for 2 years). I think it is safe to say that there is not another option that we feel good about, but I think that is mostly because we are feeling tied to KD#1 as part of our family and don't want to damage that relationship.
I am not excited about IVF, medically. I don't have any specific reservations but it sounds horrible. I am also overweight and nervous about finding an RE to work with me despite having successfully conceived twice and carried to term without any complications once. Financially it will be a slow go to get to a place where we have cash in hand for an IVF. We would likely combine borrowing from our families with our savings but there is a lot of stress associated with that decision.
I think the sense of urgency is primarily arising from the horrible stress TTC puts on our relationship, our mental health, and our finances. I don't think that there is a point in the near future where it will feel too late for IVF, but it feels pointless to keep throwing what is really very significant funds towards IUI when reason suggests we have very, very bad odds. I imagine we would continue with IVI / ICI at home for a while even if we stopped the IUIs, unless we started working with another donor. I don't know how long we would keep that up, though.
I just hate all of our options.
Best of luck in your TTC journey.
We had to switch from our beloved known donor (a dear friend who would have had beloved, special, uncle privileges) due to very low post freeze counts. We went with a sperm bank donor as our second choice and have a child now. And, our
beloved (former) known donor has beloved, special, uncle privileges (very much like what he would have had, had he been the donor). It was a hard decision at the time, but he has retained his "specialness" to all of us...and it's amazing to see the relationship he has with our son. Good luck.
Two moms and two boys enjoying the truth that love always wins!!!
One thought -- Might getting trained to do IUI at home on your own (while saving for IVF) get you a way to keep trying and lay groundwork for the next step at the same time? I'm not sure if home washing is possible, but I know certainly home IUI is. Does anyone else know better what set-up would be needed for proper washing?
Also, given that you did get pregnant while TTC #2, and that your KD is so important to your family, I'd be hesitant to switch just yet. There is a really big difference between a KD and even ID-release frozen, and it sounds like you really do have a shot with your KD. So frustrating, and good you are thinking through next steps.
One other thing, is that since your relationship with KD sounds like a very good and strong one, you are in a good place to work through *with him* what next steps might make sense, communicating with him how important he is to your family, including your second kid even if that second kid is via another donor. Working with his boyfriend as KD for #2 would impact him a lot as well -- does he see that relationship as stable? Is he at a place in that relationship where he might want to include his partner more in his life with your family, and this might actually be a good thing? It sounds like it may be time to bring him into the conversation, no matter what the next step turns out to be.
Good luck. I firmly believe that when we work through the hard conversations and decisions honestly and openly (not just around donor stuff, around all the ins and outs of how we build and structure our families), we ultimately make our families stronger.
I don't have a lot of time to write but has your KD tried acupuncture? Apparently it can do wonders for sperm issues....and there is usually a time frame that they suggest for things to be balanced and improved (I just can't remember what it is).
For me, I would ask our KD (we used one too!) to try the above and whatever else he can. Get tested again in a few months (or however long you wait) and then start trying again.
Sorry for the quickie post!
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And so are the boys!
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Lyn_ftst, you are obviously right that we need to bring KD into the conversation before proceeding. Right now, though, I know he doesn't feel the same sense of defeat that we do about the current situation - he is focusing on the fact that it worked twice before and I don't think he quite has the context to realize that the odds are astronomical against so few sperm resulting in pregnancy. And who knows, maybe that he is right to think about it that way.
When we first realized how few of his sperm survived the washing process, we were reluctant but ultimately ready to ask a new KD and just figure out a way to include our friend in our child's life. I am now fearful that a second kid with a different donor will perceive the relationship with KD and his family as "less than", or that KD or his family will have a different relationship with the second, non-bio child.
I will put him onto acupuncture. As I said, he's already taking several supplements but there's been no improvement. I don't think washing at home is an option - the low tech swim up methods have a lower wash survival rate than the centrifuging they do at labs and that is defeating the purpose.
There are other idiotic logistical issues that impact finances. If we want to do IVF, we have to move to a clinic, and there aren't any in our area that will waive the 6-month quarantine. So, when we seriously start considering IVF we have to freeze a sample and wait for 6 months, and during that time we will have storage fees (less than a monthly IUI, but still not free).
The process of writing this post and responding to your questions has made it more clear that I am not anywhere near ready to move on to a new donor, yet. I still don't know if directing funds towards IUI or future IVF is less crazy.
Thanks for all of your help. Please, keep it coming if you think of anything else.
We faced similar questions, though they were related to storing sperm, accessibility of our KD's sperm, etc (he lives across the country). Ultimately, we decided that having both kiddos have the same known donor (who is definitely IN our lives) was most important.
I know that IUIs are generally thought more effective than ICI, but I wonder if there are reasons that you or your doc/midwife currently think they are most effective for you, particularly. If there's no clear reason, you might try a few more months of ICI (free, right?) and then reassess. With a low count, you want to preserve as many sperm as possible, so perhaps doing ICI and the drawbacks of that will cancel out the much lower count you get, post washing.
Just a few thoughts.
Good luck with this challenge.
Silly question, can you get some of that buffer they use for shipping it and get multiple samples before washing?
My older kids are 6&8. They have different donors, one KD and one frozen. Both kids have the same relationship with the KD.
Sera, it is good to know that your family has created a good relationship between both of your older children and your KD. It's certainly an interesting idea about the buffer, I will look into it.
We were advised to do IUI instead of ICI specifically because of the male factor. The way it has been explained to me is that when you do an ICI, the sperm survive for days going through the cervix and sort of trickle out the other side into the uterus. When you do an IUI, they all arrive at once - more of a tsunami than a trickle, so they are better able to work together to penetrate the egg. It's also my understanding that the sperm that are "lost" via washing are mostly useless in the fertilization process - they are the sperm that are misshapen, dead, not moving, etc.