I included several 'Key" words in my title so anyone dealing with one, two or all 3 issues could get some info or could contribute something I could learn.
My husband and I have been married 10 years this June and decided...it's time to start trying. Last September I stopped using Ortho Tri-Cyclen Lo that I had been using religiously for 3 years and on and off before that. I turned 30 and my husband is turned 31. He has worked at a hazardous waste plant for 11 years now. We thought it would be smart to do all of the preconception steps. Had he not worked for so long where he works we probably would have never given preconception steps a thought. SOOO glad we did. He had a sperm analysis and we saw my OB/GYN to discuss risks, disease, etc. Turns out my husband has a low sperm count. Since he took his specimen from home to the lab his Urologist thought it would be a good idea to re-check from an on-site facility so there was no delay with driving between locations. My first thought was, "Ok, he must have taken too long or didn't keep the sample warm enough and it just needs to be done again...all will be fine". WRONG. It was still low the second time. A smidge better but low.
Next step after that was for him to get his Testosterone & hormones tested. Results showed low Testosterone as well. The rest of his hormone levels were good. His Urologist started him on Clomid 50 mg every other day and told us in 3 months to have his sperm and blood re-checked. Clomid is not FDA approved for men to use for infertility but studies have shown it's safe and it works whereas Testosterone injections kill all sperm. He was tested again in January and low and behold his T level was MUCH better. Sperm count was better but still not normal. Urologist suggested it had good counts for Intrauterine Insemination. Huh? We're already to that conclusion?
With Clomid your levels will tap off at 6 months on the drug and whatever good it has done will be all it will do. It won't get any better without lifestyle changes. Did I mention my husband smokes a pack a day and has at least 2-3 beers everyday? Also has High BP and is on 2 BP meds. All of these make TTC challenging. He has committed to quit smoking and cut back on alcohol. BTW E-Ciggs don't help sperm count. There is still nicotine in them which kill sperm. As for the BP meds...that will probably not be anything he can get off while working where he works. Oh, and he uses Fentanyl patches 25 mcg every two days for lumbar spondylosis and bulging discs. Opiates also don't help sperm live. Odds stacked against us? Maybe.
I had been having a lot of breakthrough spotting ever since going off the pill in September. I accredited it to going off the pill and my body just adjusting to no longer having the extra hormones. By February I had bled, including my period, 22 days. That is not normal. Some days when I would spot it would be bad enough that I needed a tampon. I also had started having spotting after sex and sometimes even period like cramping post coital. It was time to go to the GYN. I had a PAP done and all was normal. Every time I have a PAP done my cervix bleeds abnormally to where I need a pad in the office and then a tampon for the rest of the day. This time around with all the symptoms I had she tested for GC/Chlamydia (standard procedure) even though I knew it wasn't that. Also had a vaginal panel done including Gardnerella, Trichomonas and Candidia. She said if everything comes back normal you might just have a sensitive cervix and we can cauterize it to toughen it up if needs be. Ouch! No thank you. Turns out I had Gardnerella with no symptoms for the 2nd time. She treated me with metro gel vaginally and doxycycline orally. All meds done, tests are normal....still bleeding
Next step was a pelvic ultrasound. 2 fibroids are found the size of a marble. Maybe the cause? Maybe not. Nothing that's going to hurt me or my chances of conceiving. But...still bleeding. FRUSTRATING!
Next she sends me to an OB/GYN Fertility Specialist for a Hysteroscopy. I go to my consult and after looking over all my symptoms and ultrasound the fertility specialist concludes that I have a thin uterine lining which is due to low hormone levels. No signs of endometriosis or cysts which run in my family. My mom had a complete hysterectomy in her early 40's. She also had many issues with her pregnancy with me. Specialist tells me my hormones are too low to sustain the uterine lining consistently throughout the month. She gives me the option of Clomid or Femara 2.5 mg which is again not FDA approved for infertility but has studies that show it's safe and effective. It's actually a breast cancer drug. A little scary. I went with Femara since it has way less side effects than Clomid. Clomid can actually thin out uterine lining...a problem I already have. Also, Clomid has a 10% chance for births of twins or triplets and Femara is only 5%. I took the pill for cycle days 3-7 and so far no more bleeding! I am on day 10 of my cycle and should be ovulating towards the end of this week.
The Urologist and my Specialist both agree the next best step for us is IUI. We are planning on trying it in April's cycle. I'm looking forward to see how this all goes. She said our chances naturally with our issues and age are 5-10% a month for conception. With Femara it raises it to 16-18%. That is a huge difference considering a healthy 20 year old healthy couple only has a 20% chance to begin with.
I just wanted to put my story out there for anyone who is searching for answers or scenarios. I know I have been looking myself for months. Most people would say we're moving too quickly on this procedure since we've only been trying for 6 months but we aren't getting any younger and I keep thinking what if we never would have gotten tested.....we could have found ourselves another year or two older and no child just starting this possibly long journey...and only getting older. I thank God we didn't hold off. We did second guess ourselves the day we left the office planning on a sperm analysis. We kept thinking maybe were being overly cautious and this isn't necessary. Boy were we wrong to think that.
Please add on to this! I will be updating as we trudge forth in this TTC journey
Re: 1st Round of Femara, Thin Uterine Lining, Low Sperm Count
Good luck with your IUI and I'm looking forward to hearing how your story unfolds!
Married for 7 years, TTC for 4 years
dx: Diminished Ovarian Reserve
2 Clomid IUI's + 4 injectable IUI's= 5 BFNs and 1 mc
Yes, my specialist is an endo for infertility. She keeps a very close eye on me