The Results are In

You may remember from a month ago or so, when I said we were marching into unknown territory… man land. Well, we had our follow-up consultation with the Urologist and found out some rather interesting news. Sam has two varicoceles, both of which have probably been there since puberty. While this is not an uncommon thing for men, it can potentially cause infertility. All of Sam's tests came back to reveal, that while his numbers are high, the sperm aren't as healthy as they could be. Basically the doctor said that there survivability is diminished due to the varicoceles. This explains why we started off each IUI with such high numbers but only a small fraction survived the wash.

Good to know I guess, the question now is, what do we do about it? There is an outpatient surgery that can correct the problem. After a period of time, the issue with Sam's sperm should resolve. If there was nothing wrong with me, then after said period of time, if the surgery worked, we would have roughly a 23% chance of conceiving naturally each month. Here's the kicker… we have no idea if something is also wrong with me. If there is, then we are probably right back where we were before this interesting news… IVF. I'm thinking that there probably is something wrong with me, particularly as it's CD 31 and I still haven't ovulated. So our options stand like this:

1. Have the surgery. Wait, and pray, and hope that it works, and that the new sperm, with higher survivability, can get the job done.
2. IVF. We can skip the surgery and move straight onto IVF as we had planned. 

We haven't made a decision what to do yet, and obviously, Sam is the ultimate decision maker on this one, but I thought I'd at least put my thoughts, as they currently stand, out there. We haven't done a lot of research on this, and I of course, had about a bazillion questions as soon as we left. I wasn't expecting the tests to have found anything… I went in unprepared. So these are simply my thoughts as of now.

With the surgery, there are a couple of BIG plusses. Mostly in the financial category. We have absolutely no infertility coverage. None. Zero. Zip. I had minimal coverage for testing at first, but they were very quick to slap an "unexplained" diagnosis on me, which ended the coverage. (I personally think unexplained means just what is sounds like, not a diagnosis, therefore coverage should continue, but well, I think a lot of things and it's not going to change anything.) But the doctor thinks the test will "most likely" be covered under insurance. Plus, clearly, if it works, and we managed to get pregnant on our own, then there would be a HUGE savings in not needing IVF. Additional positives with the surgery are that we can possibly conceive naturally. Obviously, everyone intends to conceive between the bed sheets not the paper ones. It had been a while since I honestly thought that was an option for us. And lastly, it is a "one and done" procedure. It doesn't have to performed again with each new attempt at a child.

IVF still has some positives too, though. That there is no wait would be the biggest. The doctor said that it could be six months to a year after the surgery before the sperm are olympic swimmers again (he didn't actually say it like that). IVF also gives MUCH higher rates of conception per cycle.

The simple, ready available answer to me seems to be this: Contact insurance and see if the surgery is covered. Then find out what the surgery costs because we would be responsible for 20%, which could still be a nice chunk of change. If it is currently feasible, perform the surgery. We don't have the money to move on to IVF immediately, so in the mean time, the husband's swimmers can be getting in race day performance. I'm guessing that we could be ready for IVF in about 9 months, so that would give us possibly 3 months of trying with timed intercourse. If it doesn't work, then IVF is still an option.

Here's the problem with my plan. Sam just started his FINAL clinical!!! Today. Now this is CRAZY exciting because it means that he is almost done with PT school, but it also means that getting time off may be difficult or next to impossible. If we had found out in December, he could have had the surgery during his month off, but we found out Friday. The clinical is 12 weeks. If he can't get any time off, The first time the surgery could be performed would be the first week of April. That's three months in which the sperm could have been growing with new, cleaner, brighter, spiffier living conditions. I feel like if we have to wait to perform the surgery, it will delay IVF, and I'm not sure that I'm okay with that. As I've said before, patience is not my virtue.

So there it is. As I've said, we need to do some more research and ask more questions of the doctor. We didn't even get into risks or any of that. But for now, those are my thoughts. Things might be a little clearer after my follow-up consultation with me RE. If there are new findings with me that lead us to believe healthier sperm still won't get it done, then the answer becomes clearer.

What would you do?