Did the door just close on the babymaking possibilities?

November 26, 2007 7:10 PM

My husband and I have been trying to get pregnant for a year and a half. So, we went and got checked out. Good news: I'm as fertile as the Nile delta. Bad news: my husband is not. Now what?

He had high abnormal (100%), low motility, low count. We're booked in to see a fertility specialist (we're in British Columbia, if that matters) but I'd like to know what we're in for. Is it automatically in vitro fertilization? Is artificial insemination an option? Will one or both of us go on some crazy drugs? Bonus points for personal stories from people in similar situations.

posted by anonymous to health (16 comments total)

I'm sure I won't be the first person to recommend this, but Taking Charge of Your Fertility is a great book.
posted by k8t at 7:28 PM on November 26, 2007

Donor insemination is DEFINITELY an option, and not an especially costly one--I paid something like $200 per sperm sample and $250 per insemination and got pregnant in one try both times...YMMV, obviously, but even multiple tries wouldn't be _crazy_ expensive. The special liquid-nitrogen shipping can cost $90/pop, so we bought multiple samples at once to save on shipping. If you don't have fertility problems--you're ovulating, etc--there's probably no need for drugs.

All prices in US dollars.

My reproductive endocrinologist did not do a lot of tests right up front--we didn't, for instance, confirm ovulation with an ultrasound before inseminating. We assumed that if I got an LH surge, I was ovulating. He saw those kinds of tests as something to do after a few unsuccessful tries, but since we had no reason to think I was infertile, not important to do from the start. Friends of mine had REs who did all that kind of stuff right from the start, which could be more costly if insurance doesn't cover it--most insurance in the US won't, but I have no idea what the deal will be in Canada.

Reviewing the sperm bank catalog is kind of fun, in a eugenics kind of way--all those young men, many of them graduate students, with terrific medical histories and full heads of hair! My husband didn't have any negative feelings about using donor sperm, although he has said that he sometimes feels sad that our children aren't biologically related to him, for a moment or two. Some guys might have a harder time with it.

Good luck. As the gals on the fertility boards at BabyCenter say, "I'm sending baby dust your way."
posted by not that girl at 7:35 PM on November 26, 2007

My best guess is that your doctor will recommend your husband try certain vitamins and lifestyle changes (no hot showers/tubs, eating healthy, no vigorous exercising, etc.). That may increase his sperm's motility and count. Also, I'm thinking it would be a good idea to ask for an IUI (intra-uterine insemination). They will take only your husband's good sperm and insert it into your uterus during your fertile phase. That will highly increase your chances.

I could be wrong, but you probably won't have to go the in vitro fertilization route since your fertility is good.

Drugs for one or both of you may be an option if the other things don't work.

Best of luck to you. :)
posted by susiepie at 7:40 PM on November 26, 2007

If his sperm is 100% abnormal IVF might not produce viable embryos. But then again it might, it's a complicated situation. Depending on what's not working right it might be possible to restore sperm production to normal. If you need eggs for IVF, then yes you'll have to go on crazy drugs to harvest eggs. Sperm donors are easy to get, but tons of people end up having emotional problems around a dx of infertility and using someone else's dna.
posted by a robot made out of meat at 7:44 PM on November 26, 2007

All the above is good information. Find a good book and listen to your doctors about the options. As of now, you're asking us to tell you your options and you haven't even seen the doctor yet.

As you already know, it is best to rely on a fertility specialist, rather than an OB/GYN or a urologist, who might claim expertise but probably wouldn't have the big picture.

The term "artificial insemination" (as far as I know, IANAD) is a popular term rather than a medical term. It's not clear what you mean by it here. Many people might use that term to refer to IUI (see susiepie above) with your own husband's sperm. Are you referring to that, or to donor insemination?

I believe donor insemination will almost certainly be the most hassle-free way to deal with your situation. Get counseling and join a support group, if you need help to deal with the emotional issues.

Best not to denounce drugs as "crazy" if they help you on your way to having a baby.

Best not to assume you're "fertile as ... (whatever)." You'll learn that idiopathic infertility can occur between two supposedly fertile mates, or between a "fertile" woman and a particular donor.

You're starting on a journey now, not just selecting the next step. There may be some experimentation, uncertainty and setbacks, and definitely emotional ups and downs which will come with the territory. I wish you the best of luck.
posted by JimN2TAW at 8:34 PM on November 26, 2007

i can heartily recommend an online forum. fertility or pregnancy related. pregnancy related forums have t.t.c. (trying to conceive) and a.r.t. (assisted reproductive technology) specialist areas.... with tons and tons of women in EXACTLY your situation.

i go to birth.com.au but you may be in another country.

birth is cool for americans too, though.

best of luck possum.

oooh....if you're in australia, feel free to email me.
of course you can email me if you're not.... but i'd be more use to you if you were in australia.
take care.
posted by taff at 9:06 PM on November 26, 2007

also.... from what i understand there are no drugs for him.
he'll wear boxer shorts and keep his tickle tackle cool from now on. some clinics can spin (or something like that) the semen and get only the very best out. it's being trialled at the ivf clinic a friend goes to. westmead ivf in sydney.here

i'm sure i don't have to tell you this.... but men get very distressed about their semen. when it's not super, that is. i hope your other half is ok and your doctors are supportive and understanding of him in all of this.

we're all so conditioned to thinking the difficulty will be from the woman's side, it's a bit of a shock when it's the bloke when it happens.

one anecdote that may reassure.

in my mother's group is a chick whose husband had chemo at 18 for testicular cancer. and at the time froze semen.

his first wife and he tried many times to get pregnant, and as it was 20 year old semen.... and possibly other factors.... no go...

he divorces, meets my friend. they try his frozen semen again. no go. he had been tested from time to time... and no bloody semen.

well.... they go ahead and get married.... and on the wedding night.... bob's your uncle.

she got up the duff the old fashioned way. sebastian is a perfect, gorgeous, miracle 14 month old. who looks A LOT like his dad. (in case that's what you're thinking)

so.... that's a good news story in case you were freaking out.

again, good luck and let me know if i can help. but do join an online forum. you're gonna need those chicks, believe me.
posted by taff at 9:19 PM on November 26, 2007

oops... clarification... he was tested and had no bloody sperm. plenty of semen. well, actually, i've no idea how much semen..... thankfully.... but no sperm is what i meant.


sorry... i'll shut up now.
posted by taff at 9:21 PM on November 26, 2007

Oh hi, welcome to infertility! I hope your stay here is short and fruitful.

This can vary a lot with different practitioners and the exact morphology of your husband's sperm, but I would guess you're looking at ICSI and IVF, and failing that, would be invited to consider donor sperm with IUI and then IVF again.

One of the craptastic things about male factor infertility is that even if you are a veritable fertility goddess, you still have to carry most of the physical can for fertility treatments. Both IVF and IUI have rigorous drug protocols. It really varies from woman to woman but the experience can range from "almost a breeze, aside from the shots in the ass" to very difficult.

For infertility experiences, info and support, I would recommend the articles and forums at altdotlife.com - which has a lot of supportive, smart women with - no offence to not that girl - absolutely no baby dust.

(Baby dust is very much not my personal thing, but I'm glad that the interpipes allow almost every woman to find the community that is right for her needs.)

Finally, just a tip: you are very likely about to get hit with a LOT of information. Write it down and parse it at your own pace. Ask people (online or at your practice) when you need to check in or check up or question something.

And, sincerely, good luck!
posted by DarlingBri at 10:03 PM on November 26, 2007 [1 favorite]

PS: Feel free to MeFiMail me. I promise to respect your confidentiality.
posted by DarlingBri at 10:06 PM on November 26, 2007

Adoption?
posted by Thorzdad at 6:02 AM on November 27, 2007 [1 favorite]

There are tons of blogs on infertility. They have great community support and lots of information sharing. One more 'visible' blog is Mechanical Reproduction -- written by a guy with fertility issues and the couple's quest to get (and keep) his wife pregnant.

There is a fantastic center at UBC for Reproductive Health. They do an awesome job, so if you're not happy with your chosen fertility specialist, give them a call. There are lots of options, depending on the viability of your husband's sperm - IUI, in vitro, donor sperm, etc.

And to answer your more general question in the title, the door totally did not just close on babymaking -- the door was closed for the last year and a half, and now it's finally open to finding a solution for the two of you. Knowledge is power - and now you can start finding out and making decisions based on what you know. Good luck!
posted by barnone at 6:31 AM on November 27, 2007

My wife and I are in the thick of this right now. We have male factor problems too. I have azoospermia, which means no detectable sperm, so our experience might be different from yours. I'm not aware of any drugs to treat male factors. Depending on the quantity and quality of your husbands sperm, you may be able to try IUI with his sperm. There are various things they can do to prepare it and make it more viable. There wll a drug regimen for you, but my wife hasn't found it difficult. If that doesn't work, another probable course is ICSI. The doctor may be able to isolate individual viable sperm from your husband, and inject them directly into your eggs. This requires IVF, and a much more arduous drug regimen for you. My wife hasn't found it terrible, just annoying. Other acquantances have had terrible experiences with the IVF cycle, so YMMV.

A question you will want to consider early is how important it is to use your husband's sperm. In our experience, some doctors will make the assumption that you will spare no expense, that all possible measures should be taken to enable you to use your husband's sperm. You need to decide where to draw the line. Using donor sperm can be dramatically less expensive and invasive. We found ourselves getting caught up in more and more elaborate strategies, eventually realizing that having a child with my genes simply wasn't paramount.

It is a frustrating process. Everything will take MUCH longer than you think. You're definitely moving along the right path by starting to learn as much about it as you can. Find a good doctor who is willing to take the time to explain everything, and map out the course ahead with you.

Good luck!
posted by uberfunk at 7:09 AM on November 27, 2007

Seconding adoption; having been adopted in infancy and having known about my own adoption my whole life has not diminished my feeling that my parents are as "real" as anyone else's. Same from my parents' perspective. FBOFW.
posted by not_on_display at 8:34 AM on November 27, 2007

uberfunk has an excellent response.

Don't give up hope, and no, your babymaking possibilities are not over. You actually have a huge range of options open to you and there is a lot of good information upthread.

My guess is that IUI is not a good option for you but IVF may well be, depending on what they're able to do to isolate viable sperm from your husband. First see a doctor, and then hit the message boards linked to above for emotional support and random questions. Also, my wife and I (two women) have gotten pregnant twice via IVF (we have 20-month old twin girls and one boy on the way), and I'm happy to answer any questions you may have via the donor sperm selection, IUI, IVF processes and relevant drugs. Best of luck to you!
posted by widdershins at 10:23 AM on November 27, 2007

Baby dust is very much not my personal thing, but I'm glad that the interpipes allow almost every woman to find the community that is right for her needs.

No harm, no foul. I was making a joke.
posted by not that girl at 11:27 AM on November 27, 2007