Infertility Acupuncture

In addition to our infertility treatment, E and I decided that I should give acupuncture a try. I'd never had acupuncture treatment before, but I had read several good things about it online and many people seem to have excellent success with it improving fertility.

Super Skinny Needles

I'm not sure how much it can help with my FXPOI, but there is scientific proof of increased blood flow to the uterus and ovaries, improved ovarian environment, lower FSH, more balanced hormones etc. I need to get my estradiol and AMH up, my FSH down and help convincing my body it has eggs and isn't 40. So, I put the question to my RE and was pleasantly surprised with her response.

Since many infertility patients are interested in pursuing acupuncture, my RE refers her patients to a wonderful acupuncturist. She is a Certified Nurse Midwife with a degree in nursing, a masters in Acupuncture and Chinese Medicine, and something like 6 years of Acupuncture training. Because she understands fertility from both an Eastern and Western perspective, my RE is okay with me taking herbal supplements throughout my infertility treatment.  If you have any experience with infertility treatment, you will know what a high endorsement that is.

Fertility Points

I started acupuncture once a week and have had three sessions thus far. I generally feel more relaxed after after each session, and I can feel all sorts of tingly things happening during a session but I can't pinpoint what it's doing without testing. The needles are so thin you can barely feel them, and often times it's the tap of her fingers that lets me know she's put a needle in.  The other day she accidentally poked my foot with the plastic packaging the needle comes in and I was struck by how the plastic package hurt way more than the needles.  There are a couple points that twinge or ache a little when she puts the needle in, but the ache means the needle is placed correctly.

I also just finished my first week of herbal supplementation, the acupuncturists prenatals, and the acupuncture diet, and from that, I can Definitely feel the difference. It only took about 24 hours of the powdered herbal tea twice a day for me to be insanely hungry. I used to be able to go all day without eating and not notice it, but the past week I've been ravenous. I wake up hungry, I'm hungry in between being hungry, and I go to bed hungry. Basically, I've felt like shoving food into my face at all times, with both hands, and a side of more food.

As to what I'm allowed to eat, that gets a little tricky. My rules are:

• No cold food, ice, ice water, cold anything 
• No dairy 
• No cheese - this gets it's own category. I loooove cheese :(
• No raw vegetables 
• No white flour, bread, pasta, etc 
• No sugar or artificial sugar 
• No juice 
• No caffeine

This leaves me with whole wheaty options, cooked veggies, lean protein, fresh fruit, beans, and a whole lot of soup. Basically, I've been eating soup, eggs or oatmeal for breakfast, soup for lunch, and some sort of protein, veggie, and brown rice/some carby thing for dinner. Even my corn chex with almond milk are considered cold food, so while I've been pretty limited, I haven't let it stop me from shoveling food in my face.

Breakfast

When I told my acupuncturist about my need to be eating at all times, she was thrilled. Apparently my metabolism has been functionally shut down due to my lack of hormones, and the fact that I'm crazy hungry means it's turning back on. I've also been back at the gym 6 days a week, so it's a double whammy.

In addition to my weekly appointments, I have to go in more frequently around my IUI. We'll probably do the procedure around the middle of May, and I'll have to go in a day or two before, the day of, and the day after. Between the Menopur injections, the trigger shot and the acupuncture needles, I'm essentially a human pincushion.

The only downside to Acupuncture is the cost. Without counting the special appointments around my IUI, acupuncture is essentially like a car payment every month. I'm hoping that it will improve my fertility and our chances of having a healthy baby enough that we won't need to do IVF, which will should save us money in the long run. It should also make me healthier, which is always good, and which will hopefully contribute towards some weight loss, balanced hormones, and a healthy pregnancy.

Genetics Expanded

After waiting two months for an appointment with a genetic counselor, E and I finally got in to see one this morning. As expected, they had the results on E's second genetic screening which confirmed his diagnosis of Y chromosome infertility due to an AZFb microdeletion.

They were fascinated with E and the fact that he has any sperm at all. With his genetic profile, he shouldn't be able to produce any sperm but has still had counts as high as 23 million. I would have liked to talk about the particulars more, but ultimately the end result is same, 20 million or 2, his non-motile swimmers are not usable.

The counselor got more info on our families but couldn't really suss out why we both have fertility problems. For a multitude of reasons, both our families are fairly small, and with such a small sample size it's tough to draw good conclusions. We can assume that E's infertility occurred de novo, as a fluke, while mine is still unexplained. They're testing me for fragile x syndrome as a last ditch explanation, since my family consists of all girls for two generations, but it's fairly rare to have a completely silent carrier and I don't have any of the symptoms or markers for the disease aside from my lack of eggies. E was almost late for work so I couldn't get my labs drawn today and will have to go back.

The counselor was really analytical which I appreciate, I approached the situation in the same manner and it made it really easy to connect with him. He understood my desire to have 5 years of egg fertility data to look at before making a decision (sadly impossible) and suggested we come up with a wall sized algorithm to predict all possible choices.  We went over pretty much every situation from E's sperm and my egg to egg and sperm donors. I think we have a somewhat solid plan of action.

**The Plan!**
1. Get my labs done for Fragile X and possibly CMV antibody. CMV antibody status is important for picking a donor. Done!
2. Decide if E is going to have the stimulated semen analysis to confirm for sure that his sperm is unusable.
      a. If E's sperm can't be stimulated, we go with a donor
      b. If E's sperm can be stimulated and is usable, we begin proceedings for IVF with ICSI
          - If E's sperm is usable, we will gender select so as not to pass on the mutation
3. Assuming E's sperm is unusable, we need to pick the donor. I want this to be mostly E's choice. I'm thinking a local sperm bank would be best so we can order the day before it's needed and courier it over.
4. Purchase donor sperm. We need to decide how many vials we want and how many will be stored.
5. Decide whether we're doing a stimulated cycle to see how I respond and try to get a better idea of my egg reserve, or proceed directly to a medicated cycle and IUI
6. Proceed with a medicated IUI cycle
7. Hopefully get pregnant!

While I definitely still have that I might cry sensation at the back of my throat, I am feeling a little better and more prepared. My biggest concerns are that I might be pushing E and not allowing him enough time to grieve. I've been really waring with myself on what we should do next and how we can balance my time crunch with his coping and emotional well being. Today, the genetic counselor said something along the lines of "people take fertility for granted, like gravity. It's just something that's there. But the reality is that for many people it isn't". I talked about how, cost aside, I wished our rolls could be reversed because I don't care about being genetically related to my child but E does/did.

Although we already knew it, the counselor said that not being able to have biological children is horrible and devastating and may always hurt, but that's normal and okay. I think that really helped E to hear this since he's been struggling with the idea that he may never be 100% okay with not having  genetically related children. I think he understands now that it's okay for that to always hurt a little, but it doesn't have to prevent us from having a family and kids that are his in every way that matters. He doesn't have to be thrilled about it, he just has to be at peace with it. I told E the only things I need him to be 100% on are 1. That he still wants children and 2. The donor we pick. As long as he's sure about these two things, I think we'll be okay.

Two wrongs can't make it right: The 30%

I know I said we'd be getting results back by the end of the week, but it ended up taking forever to get our hands on the test results. My cortisol results came back negative for Cushings, which we weren't at all surprised about, but I suppose that is good news. Unfortunately, we did not get so lucky with E's Semen Analysis.

E's results came in last Monday and due to some fax mishaps, we weren't able to get our hands on them last Thursday. Once we did get them, I kind of wished they hadn't come in. It turns out that we are dealing with rather severe male factor infertility - low sperm count, less than 1 million, and 0 motility. It actually says 0, not low, or hey just a few are determined enough to swim, actually 0. What lazy little fuckers. E and I keep picturing them playing on a PS3 like nah, I could move but I'm much too busy.

This news puts us into the worst 30% - 30% of couples have female factor infertility, 30% have male factor infertility and 30%, including us, are unfortunate enough to have both. Basically, we have 0% of conceiving on our own. Kind of like 0% motility.

Today we had a phone consultation with a doctor at one of the local fertility clinics. I don't know the first thing about selecting a fertility clinic, but this one offered a free phone consultation so I figured it was a good first step. E and I spoke with him for a few minutes on the phone and once he heard my lab results he pretty much said, aw crap, you should have started fertility treatment yesterday, you have diminished ovarian reserve/premature ovarian failure/old and moldy eggs.  He was less worried about E's abysmal SA results since all he needs is one spermie to create an embryo, even if it's poor quality and even if he has to go in to E's testicles to get it.

He immediately booked us for the first available appointment after this cycle ends so he can ultrasound my ovaries and see if there are any follicles. There should be some, since I definitely ovulate every month, but I don't know about their quality. And of course, since we have no infertility coverage, this is all going to be out of pocket. After we hung up with him I had to call back and speak to their financial department to find out a little bit more about cost. It seems that the appointment will run us $200 and the ultrasound either $275 or $700 depending on whether it's a regular ultrasound or a fluid ultrasound. This is where I'm officially starting the tab for our infertility treatment (Plus E's SA!), if there's a higher power out there, please have mercy on my uterus and our checkbooks.

(Source)

It seems crazy to be running out of eggs at only 26 but I guess this is our new reality. Even though the doctor didn't tell us anything we weren't already expecting to hear, it still hurt like hell to hear it confirmed. I felt like crying all over again and I think it's really starting to sink in for E. I really hope this fertility clinic is a good place, because I feel a bit too fragile right now to start calling places and asking for references. I'm sure I'll pull myself together tomorrow or the next day, but for now it just hurts.

My positive spin for the day is that if E's swimmers could swim, we would already be pregnant or have a baby right now but have NO idea that I'm rapidly running out of eggs. We would have tried to have a second child in a couple years only to find that I am completely out of eggs and have no chance of having another. Because his sperm can't swim, we have the opportunity to address these problems now, while I still have eggs, hopefully enabling us to bank some embryos and have more than one child in the future.