Needs Improvement

Do you remember when you were in grade school and your teacher wanted you to know when your work wasn’t good enough? You received your paper with the words “NEEDS IMPROVEMENT” branded with the red marking pen. It is starting to feel that way each time we receive Husband’s semen analysis results. The RE noted that his endocrine tests were borderline low and referred him to a male fertility specialist, who started him on Clomid. I enjoyed joking that he was going to ovulate since I apparently wasn’t very good at it. He was told that he could expect to see a difference after three months, so we deferred starting IUI until he was optimised on the Clomid. In the meantime, Husband googled ‘healthy sperm’ and started taking whatever supplements he could find at GNC.

We anxiously waited the results of his first post Clomid WIAC (Wank In A Cup) test. I listened to the voicemail from my RE who reported that there was only a slight improvement. His total count reached his highest ever at 17 milling and it was also the best motility at 61%, but the RE only noted that his progression went from ‘2’ to ‘2+’. He might as well have written it the red marking pen. “It’s something in the right direction!” I commented, but the RE failed to laugh at my joke. He expected a better response from the Clomid –to bring his count to 30 million or more. Then he gave us his honest assessment. We could try IUI, but he didn’t have high hopes that it would work and wouldn’t advise doing more than 2-3 cycles before moving on to IVF with ICSI.

My mind shut off after hearing the acronym ICSI. It felt that in four months we went from not having a diagnosis to facing what seemed like the worst case scenario. I felt confused, “So do we now have a diagnosis?” I asked, while realising that sounded like a dumb question. He started reviewing the statistics of normal fertility starting with women in their twenties. I didn’t need to hear it. “I know the stats and I know I’m old!” I snapped. The RE cut to the chase: we are officially infertile due to male factor. Wanting to change the topic, but probably wanting more to get off the phone call, he mentioned that my insurance authorisation had expired. After Husband was started on Clomid, I sent a message to the office indicating that we would be starting our IUI treatments toward the end of the year. A few days later I received an insurance authorisation starting in August and going through October. I was a bit annoyed as it seemed that the staff member didn’t even finish reading my message to note when I would be starting treatment, but I figured I would rather the staff error on commission rather than omission. Now it was a point of contention for me. “I don’t know why the authorisation was issued during that time frame when I indicated we wouldn’t start treatment until December!” I snapped again, just in case it wasn’t clear that I was pissed off.

The IVF inevitability. Husband and I had started to accept this as we talked with each other, I just wasn’t ready to hear it in such an official context just yet. Also, I behaved petulantly in front of someone who is not only my doctor, but also a professional colleague. Not my finest moment.