The testing regimen at C.C.R.M included the following for me:
- Standard are-you-healthy blood work
- Rubella immunity
- Cycle day 3 bloodwork
- Cycle day 3 ultrasound and resting follicle count
- Integrin biopsy 7 days after ovulation
- Uterine blood flow measurement (in between menstruation and ovulation)
- Hysteroscopy (in between menstruation and ovulation)
- Semen analysis with DNA fragmentation
Integrin Biopsy (or Endogrin biopsy? i've seen both)
The integrin biopsy samples the uterine tissue and tests for a certain protein that helps an embryo stick. The procedure consists of the doctor shoving a straw up the cervix into the uterus and then pumping the straw back and forth gathering uterine wall cells. Picture that for a second.
Results - Totally normal. They did the test at the right time and I have the proteins I need to. I totally pictured this when I was given the results:
Cycle Day 3 Tests and Ultrasound with resting follicle count
Prolactin - 26.7
TSH - 1.02 mIU/ml
FSH - 3.9 mIU/ml
E2 - 43 pg/ml
AMH - (around 3? Can't find it)
Prolactin - 11.4
FSH - 8.0 mIU/ml
LH - 6.3 mIU/ml
E2 - 45 pg/ml
AMH - 1.6 ng/ml
Rubella - immune
The ultrasound showed 6 resting follicles on the right side and 12 on the left.
3-D ultrasound with uterine blood flow measurement (CD5)
Except for that part where I had to completely abstain from all forms of caffeine for 3 days, this was no big deal. Everything looked normal. Just a little bit of less flow on the right side, so maybe that's why the right side wasn't producing as many follicles.
Hysteroscopy (CD 5)
After freaking out over being prescribed cyt.otec (gee, thanks interwebs for all the gloomy information), that was the least of my worries. It didn't make me too crampy, and I didn't need much pain medication following the procedure. Procedure went well, but hurt a lot. I have a nice clean uterine cavity.
Both S and I came out genetically normal with no issues between our genes. ($525 a pop and not covered by insurance. Doesn't feel worth it now.)
SA with DNA fragmentation
S's company changed the insurance coverage and now doesn't cover any infertility related testing. Jerks. We chose to skip this test since that's the least of our worries and it would have been $700 with the DNA fragmentation
The Final Word
We spent a bunch of money between co-pays, deductible and the karyotype test to learn jack squat.
I look pretty good for a 39 year old and it was recommended that if we pursue treatment that we do I.V.F. with genetic testing. We were given a 60-75% chance of a live birth assuming that I have some genetically normal eggs.
Over the course of the testing, we had 3-4 timed cycles using opks and not a damn thing happened. I ditched the opks when I got really stressed out over the tracking and have also thrown rhythm method out the window. Nothing has happened and it's been 5 months.
We started TTC 7 years ago and I have never been pregnant. There was one suspected chemical pregnancy and two times my acupuncturist was convinced I was pregnant, but AF showed up right on time. There may be something in my uterus that prevents implantation, or maybe most of my eggs are abnormal. These things we won't know unless we do an I.V.F. cycle, and there may not be answers even if we throw money at a cycle. During our first visit with the R.E. I asked about the rhythm method since I had been keeping track and quasi-preventing that way. She said that it doesn't work as well as you think it might. Those little swimmers sure can hang out for a long time, so even though I was "preventing", it's been so long that I probably would have gotten pregnant at some point.
This wasn't the answer I wanted or needed. S doesn't want to do a cycle, I waffle, but ultimately don't want to spend that much money on something that might not work. Not to mention that just going through the testing again took a toll on my emotional health. I can't even picture having to go to the bathroom in the middle of a work day to give myself shots, to have several appointments close together that take hours and then to have the ultimate stress-filled two week wait after transfer. Every time I think about the process I'm hit with a wave of claustrophobia and panic. It's the same as it was several years ago before we started the adoption process.
After our appointment, I picked up Baby X at day care and took him home. He played in the back yard for a while and I sat outside mulling over our unsatisfying results and everything that has transpired this summer. An overwhelming sadness and emptiness came over me as I watched Baby X happily running around. My arms ached for the weight of another baby.
This year fucking sucks.