Thinking about next steps

iVillage Member
Registered: 04-05-2002
Thinking about next steps
Fri, 02-10-2012 - 1:16pm

I want to preface this post by saying that I know for many (most? all?) of you, some of the things I'm currently agonizing over are really easy decisions. And I totally get that. So please don't think I'm crazy! Most of this is just me trying to process it all. So I'm sorry if this gets long. Sometimes writing it down helps me.

So ... just to recap, here's where J and I stand right now:

- We're on our 15th cycle TTC. He's 33, and I just turned 30.

- Most of my tests have been fine--structurally, everything's normal. My progesterone is a little on the low side (and LP is 10 or 11 days--so on the short side, but not terribly so), but I'm ovulating regularly on my own. Initial thyroid test showed it was overactive, should have second round of test results on Monday or Tuesday.

- First SA was not great. I got a closer look at the results yesterday. The total count was low (84 million--they want at least 91 million), and morphology was abnormal (10.7% normal, based on the Kruger criteria, which are more strict than some other criteria--15% normal is considered within normal limits). Motility was fine. J will be retesting in a couple weeks. (Funny side note--my OB asked if he bikes a lot [which can affect sperm count]. Um, yes ... he bike commutes. Not a whole lot we can do about that, I'm afraid!)

So the recommended course of action, per my OB, is to wait on the second SA. If it comes back better, then we try 50 mg Clomid (days 3-7). She gave me a prescription for four cycles' worth. If the second SA comes back poor, then she recommends IUI with Clomid.

So here's the thing. To the best of my understanding, none of our issues are total dealbreakers. This isn't a "you'll never, ever get pregnant without medical assistance" sort of situation, it's a "your chances aren't as high as a 'normal' couple" situation. To be honest, I'm really anxious about Clomid. I know that sounds silly--tons of people use it. I'm someone who generally avoids medication unless it's really necessary--I mean I went off hormonal BC long before we started TTC, because I just didn't like messing with my body like that.

If I weren't ovulating on my own, it would be one thing. But I am ovulating, and when I asked my doctor what, specifically, the Clomid was supposed to accomplish, given that I'm ovulating naturally and she's not concerned about my progesterone levels, I got sort of a vague answer--something along the lines of "It's just supposed to help you ovulate better."

I don't like the idea of messing with my body's hormones, and to be perfectly frank, the thought of having multiples scares the heck out of me. I can wrap my head around twins (though even that freaks J out pretty badly), but triplets? Quadruplets? Quite frankly, if the choice was between no baby and four at once, for me, the choice would be no baby. I'm sorry if that sounds terrible. I totally get that for a lot of people the choice would be the opposite. And I get that it's a very slight chance. But I mean just anecdotally, we've seen it happen right on this board!

Of course, on the other hand, if I knew I could take five pills and end up with a BFP, I'd do it in a heartbeat. I mean, why not? But it just all seems so hard to predict.

I don't know ... I'm probably overthinking all this. I tend to do that. I'm just not sure I'm at a point (or even if I'll ever be at a point) where I'm ready to jump headlong into medical assistance. And I feel sort of ridiculous about that--I mean why are we even doing tests to find out what's wrong if we're not willing to do something about it? But part of me just wants to keep trying on our own, and figure it will happen if and when it's meant to happen.

Another thing that's on my mind is that J and I have talked for years about adopting. While I'd love to experience being pregnant, and we'd both like to see what a little "us" is like, it's not the most important thing for us that our child be genetically related to us. I'd say we could just keep trying naturally, while starting the adoption process--since I know it can be a long one--but my understanding is that adoption agencies want you to have sort of closed the book on your fertility issues--moved past them--before adopting. Which makes perfect sense. But in a situation like ours, where there will probably always be some hope that it could happen for us, how are we ever supposed to end the "trying" chapter? I mean, it's not like I'm going to go back on birth control, you know?

Anyway. That was a lot of words. I hope at least some of it sounds sane. If not, please forgive me. ;) Thanks for reading!

    iVillage Member
    Registered: 07-15-2003
    Fri, 02-10-2012 - 10:31pm

    Process away Rebekah! I think it's a very important, and responsible thing to do! I also don't think you're overthinking anything at all. I think you're approaching this part of your life (a MAJOR part of your life) thoughtfully and intelligently and that's a very wise thing to do.

    I have just a few random thoughts/questions to help you process further.

    Quadruplets via fertility medicine would be a deal breaker for you guys. But cutting out the bike commuting is not a deal breaker? Why? If you'd take 5 pills to get pregnant, risks and all, would you not also work on lifestyle changes (non medical) to have a shot at starting a family? You don't have to answer this at all - just a thinking point for you to explore.

    It sounds like you guys are young and generally healthy, no major issues, it's just


    Daisypath Anniversary Years Ticker

    iVillage Member
    Registered: 02-14-2011
    Sat, 02-11-2012 - 12:27am
    Rebekah please don't feel like your over-thinkin anything, expescially when it comes to your health. I learned the hard to ask questions, ask often, and if you don't get satisfactory answers, ask again. If you still don't get an answer that is satisfactory, ask a new doc!! I say this from expierience, if I hadn't trusted my docs so much, I would have saved so many wasted cycles and so much wasted money.

    I also second IV's question about the biking. From the studies I've read biking can be HORRIBLE for the sperm count and quality. Obviously you all have your reasons, but such a simple change could make all the difference for you guys.

    Your doc seems to not really know what Clomid does. Clomid is used to help you ovulate. You may want to consider Femara, it is used to make better quality eggs, rather then more.
    iVillage Member
    Registered: 04-05-2002
    Sat, 02-11-2012 - 1:32am
    Thanks, ladies, I really appreciate the thoughtful replies. It's all good food for thought. I'm on my phone so can't make this too lengthy, but wanted to respond real quickly on the cycling thing, since I guess I just sort of flippantly mentioned it. J bike commutes because we have only one car, which I have to drive to work. His work is about 4-5 miles away, so the ride is about 15 minutes each way. The studies (at least the ones I've read) linking sperm count issues to cycling have shown it makes a difference for people who ride a ton-- like 5+ hours a week. So while it's possible that riding is affecting him, he's not riding nearly as much as the people in the studies. There are bike seats made to avoid the pressure that causes problems, so that's something we're looking into.
    Avatar for duchessdina
    iVillage Member
    Registered: 03-08-2011
    Sat, 02-11-2012 - 11:14am
    Rebekah, I don't think it's bad for you to slow down and think about your options. I think you do have some very big decisions. To one person it's a pill to another it's a huge thing that will mess with your hormones and your body. I also ovulate on my own and my doctor is giving me the Clomid to help me O earlier and help the quality of O so that I can hopefully have better chances to conceive. I was so against the Clomid and felt exactly how you did and I think for me I got so heartbroken every month and eventually it started wearing on me emotionally. When if finally came down to the decision I decided to go ahead with it and try it, but my DH's SA was not a problem.

    I do know of several families that proceeded with the adoption process and then incidentally conceived on their own when they thought it wasn't going to happen. I think you can close the book, but keep one page ear marked and still leave the possibility open. If you do adopt would you still welcome another child? If you think you would, it doesn't mean you'd love your adopted child any less then the biological child and I don't see how there is a problem with that. I would meditate on all of it and talk with J and see what you two decide as a couple. I'm so sorry that you're having a tough time with all the decisions to be made. Decisions like this are never easy, but everyone deals in their own way. I'll keep you in my thoughts and prayers as you contemplate what to do next.


    iVillage Member
    Registered: 03-21-2011
    Sat, 02-11-2012 - 1:05pm

    No need to apologize (although I do it all the time and think I have written nearly the identical first paragraph before!).

    iVillage Member
    Registered: 07-02-2007
    Sat, 02-11-2012 - 2:52pm

    Hi Rebekah:

    I'm very analytical as well so I understand.

    - Sandy (44) DS (natural) born just before my 41st birthday. TTC#2. Only issue: egg/embryo quality due to age. Clomid & multiple IUIs w/follistim &menopur = BFN. IVF#1 (Nov 2011) = 12 eggs, 9 mature & fertilized. Transferred 3 embryos (1-3BB, 2-3
    iVillage Member
    Registered: 04-05-2002
    Mon, 02-13-2012 - 1:59pm

    Thank you so much, ladies. Thank you for making me feel like I'm not completely insane. And for giving me a lot to think about.

    To answer the question about what J thinks about all this, he's basically where I'm at. Which is to say, not super eager to dive into medical assistance, but not totally ruling it out, either.

    I should get a call from my doctor today or tomorrow with the new thyroid results, so we'll see what the plan is there. We're going to go ahead and get the follow-up SA sometime after I O this cycle. But I think, after a lot of thinking and talking with J, that we're going to hold off on the clomid (or an IUI) and just keep trying on our own for now. There may come a time when we feel differently, but at this point, I just don't think we're ready for that.

    iVillage Member
    Registered: 02-13-2011
    Fri, 02-17-2012 - 5:22pm
    any update on the thyroid?
    btw, i could have written a lot of the stuff in your post too. multiples scare the crap out of me! we just want one, let alone one at a time! :)


    Expecting #1 (a boy!) on January 16, 2013

    iVillage Member
    Registered: 04-05-2002
    Thu, 02-23-2012 - 8:28pm
    Yeah, we're not sure we want more than one either. We're sort of at a "have one and then we'll see from there" point. :)

    The second thyroid test came back normal. Go figure!