Infertility Treatment

Joe and I went to our new patient appointment at Shady Grove Fertility Center. We met with our doctor, Dr. McKeeby, and our nurse, Beth. They looked over all of our paperwork (health history and other general information), and told us how to proceed. They did not seem surprised at all to find out about Joe’s missing vas deferens. He said that it is an easy thing to bypass—they work with a couple of urologists that specialize in male infertility and sperm aspiration/retrieval procedures.

In order to get things started, Joe needs to have some blood work done. He also will need another semen analysis, since he hasn’t had one in several years. All of this should be done before he meets with the urologist, Dr. Ratzen, on March 3.

As for me, I can’t do a whole lot until my insurance gets straightened out. Shady Grove has an insurance specialist working for them who is dealing with my employer directly. The hospital switched over health insurance administration to a new company in January, and the contract with Shady Grove is still in the works. So, I will wait to see what happens. She said she should know more by March 1. Until then, all I can do is fill my prescription for prenatal vitamins.

Dr. McKeeby went over the process with us: After all of the insurance is squared away, I get blood work done on cycle day 3 and a baseline ultrasound. Sometime between cycle days 5-10, I get a hysterosalpingogram (inject dye into my uterus and fallopian tubes while under x-ray) to check the patency of my fallopian tubes. This is done at a separate outpatient radiology clinic. Also around the same time, I go through a “mock embryo transfer” in the office so that the doctor can get the exact measurements he needs for the real thing.
The In Vitro Fertilization Cycle

1. Ovulation induction: I take subcuticular injections of hormones daily to stimulate my ovaries to produce multiple eggs. I will be monitored with ultrasounds and blood estrogen levels during this period.

2. Egg Retrieval: This happens at the same time (and the same place) as Joe’s sperm retrieval. It’s done by placing a special needle into the ovarian follicle to extract the fluid that contains the egg. It is done under moderate sedation.

3. Fertilization and Embryo Culture: During a conventional insemination, several thousand sperm are placed in a culture dish with the egg and are left to fertilize overnight. For us, since there will not be as many sperm, the embryologists will use the ICSI technique (intracytoplasmic sperm injection) where they inject a single sperm into an egg. The eggs are then monitored for five or six days until they reach the blastocyte stage.

4. Embyo Transfer: The embryos/blastocytes are placed into my uterus on days 3, 4, 5, or 6. The transfer procedure does not require any anesthesia and is very similar to the mock embryo transfer that will have already been done.
Now, the only thing we can do is hurry up and wait….