Step and Repeat: From Diagnosis to Preparing for IVF


Last week, as I sat watching Live from the E! Red Carpet before the Oscars, I was simultaneously brainstorming about what life after infertility diagnosis could be compared to. It came to me, that in my experience, it was like a step and repeat. For those of you who aren’t familiar, it’s those backdrops that all the stars pose in front of pre-show in their fancy get-ups. They go from one to the next, briefly stopping, posing, maybe answering a question or two~ at least that’s how I think they work ?! Well, anyways, in the most surface-level way, that is how I’d describe the time from which we were diagnosed with male factor infertility up until we prepared for In Vitro Fertilization (IVF). We would take a step and then repeat it, sometimes making an adjustment of some sort; other times doing the same thing to give it more time. Unlike the step and repeats on the red carpet though, the time between was dreadful. Often, it felt as if every time we took a step forward, we ended up taking two steps back. Nonetheless, we kept on strutting!

While we were given the initial diagnosis mid-October, we couldn’t get an appointment with the fertility doctor until late November (the Monday after Thanksgiving to be precise).  Thanksgiving just so happens to be the holiday we host of course. So you can only imagine how I didn’t care how the effing turkey tasted. The only thing harder than getting through that Thanksgiving was having to put on a happy face and pretend like nothing was going on. But I remember just rehearsing in my mind, at least it’s a next step. At least, we will get some more answers. At least, it will bring us nearer to starting a family.

Come that Monday we were filled with a myriad of emotions: anxiousness, sadness, excitement. Dozens of vials of blood later, we left our initial consultation with a next step. We learned that with Azoospermia, it can be obstructive (basically a blockage of some sort) or non-obstructive. In our case, the Azoopsermia was non-obstructive, in that something within my husband’s pituitary glad was malfunctioning. In turn, he wasn’t producing the two hormones, LH and FSH that make testosterone that in effect produces sperm (in the most lay terms). The next step: prescribe medication (Follistim and HCG) so that the levels would get to the point of making testosterone to make sperm and WAIT. See you in two months.

Come January, more blood, another semen analysis. No change, as anticipated. Next step: continue with medication and refer to urologist specializing in male infertility. And naturally WAIT because the urologist doesn’t have an opening for another two months.

Now we’re into March and the initial appointment with the urologist was upon us. Eager to see some improvement, we were cautiously optimistic about this appointment. Another semen analysis, additional blood work, and same result. The urologist suggested changing the regimine and dosage of the two medications initially prescribed by the fertility doctor. He is reassuring that we will get there or at least he will do everything in his power to try, and that he most certainly did. He warned us though that we needed time. The only way to possibly get there was to WAIT, afterall Rome wasn’t built in a day. Next step: re-asses the efficacy of the new regimine in May.

We left feeling like we were in good hands; that something was bound to change next time. In hindsight, the greatest advice we could give to anyone suffering from male factor infertility is to find a urologist specializing in infertility as soon as possible. While our fertility team was beyond amazing (Learn more about them in upcoming posts Name or Number and It Takes A Village), a urologist specializing in fertility is typically more familiar and has had more experience with male infertility versus a fertility doctor who tends to treat women more frequently. At this point, we began seeing the urologist every two months rather than the fertility doctor.

April showers (both literally and figuratively) brought May flowers. My husband had begun to see some physical effects from the medication which made us certain that positive news was in store for us at this appointment. Following blood work and another semen analysis there was still no significant change. Next step: Add additional medication, Arimidex, and WAIT another two months.

With little tweeks here and there, we would step and repeat both in July and again in September, with the same outcome. By now you probably catch my drift. It appeared that we were basically doing the same thing over and over and expecting a different result which is, by definition, insanity. And insanity it felt like. With each new appointment, we held on to some glimmer of hope that this would be the day we waited for, the appointment that would finally bring us some good news. Then as we’d leave the doctor’s office we would walk out feeling defeated yet again. It’s like blowing up a balloon and slowly watching it deflate over and over and over. And maybe if we had know that despite all of this waiting, we would for certain end up with our baby in the end, then it would’ve been a little more tolerable. However in the realm of infertility nothing is for sure and nothing can be promised. Therefore, we would just continue on, one step and repeat at a time, never fully losing sight of what we had set out to do.

Sensing our detriorating positivity and given that we had allowed for a valiant waiting period, the urologist suggested that at our December appointment we might discuss surgery as a next step. Surgery was something that the doctor had briefly mentioned in our first encounter back in March. At that time, it seemed like if the medication hadn’t yielded sperm within a semen analysis, surgery would be a last resort in an effort to see if some sperm be extraxted from the testicle(s). And here we were at our last resort.

I’ll never forget the exact date of our next appointment. It was December 30th, my sister, Courtney’s birthday. My sister played in integral role in shaping the person I am and life I live today. She was born normally for a five and a half months, just on the brink of meeting the developmental milestone of rolling when she fell seriously ill and had a seizure out of the blue one night. A very long story short, she was eventually diagnosed with Idiopathic Seizure Disorder, for which a cause was never determined.  She never talked, never grew out of diapering, was confined to a wheelchair and fed by g-tube at night. While doctors gave her a life expectancy of three, she lived to age twelve when she peacefully drifted off and the gates of heaven opened for a true angel on earth. While some might consider her time here lacking quality of life, given all of her physical and cognitive issues, her short life was a full one. She experienced things and places many children never get to see and furthermore she impacted the life of myself and so many others without even uttering a word. Courtney inspired me to become a speech-language pathologist because I learned at a quite a young age that communication is not always verbal. And when she passed one May day I knew she’d always be with me, especially through the tough times. Like many of us do when we lose someone, I often looked to her for strength to let me know that everything would be ok. So given that this climatic appointment was on her birthday, I saw it as a sign. However, as the urologist reviewed the results of this semen analysis, he revealed that yet again there was no sperm in the ejaculate.  The news felt like another blow to the stomach, the kind when you haven’t quite caught your breath from the one before it.

We had come to our final step and repeat all to learn we hadn’t won the “Oscar”.  In fact the “Oscar” was going to everyone else.  It had been over a year of the waiting game, while everyone else’s lives were moving onward.  There were pregnancy announcements, baby showers, births, first birthday parties galore.  There were the countless questions from unknowing acquaintances  “Are you trying?”, “Do you want children?”, or the worst one “You’re glowing-are you pregnant?” (Look for an upcoming post, How to Hurt an Infertile Couple in 10 Ways).  And even worse, from people who knew us, the questions had just stopped, albeit out of good intentions.

After that appointment, I couldn’t bare to go home.  I didn’t want to curl into a ball and cry again.  I didn’t want to be sad, angry, envious and exhausted.  I didn’t want to wait anymore.  With that, I was pulling into the Walmart parking lot when my phone rang.  It was my husband, but I could barely make out what he was saying.  He was screaming and out of breath, sounded like he was holding back tears.  I thought to myself “WTF-the dog must’ve run away now-just what I need.” But then he slowed down took a breath and said, “The doctor called.  They spun the semen analysis and found some sperm.  It’s dead, but he said they can sometimes wake it up.”  And that was the sign my sister finally gave me or as I so eloquently relayed it to my mom “The biatch finally worked!” ?

It took all that waiting and what finally seemed like hitting rock bottom to finally get to the point in our journey where IVF was a real possibility… our final STEP (and after holding my sweet, new niece this week it makes me want to REPEAT ?)!


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