IUI questions

I am thinking a lot about what comes next. Regardless of what it is, having a plan that I can follow makes the whole process so much smoother. There is of course the risk that the plans I make will get changed at the last minute, which seems to occur at nearly every junction. Yet, in the meantime, my anxiety is much more manageable when I can see our potential options laid out ahead of us.

Barring a miracle with this FNA MAP (which we scheduled for September 29th) we will be proceeding with donor sperm. I want to start working through some of the choices that I'll be faced with. Ultimately, I am trying to balance the emotional, physical, and financial components.  I am hoping that some of you who have been here/done that can offer your advice.

How do I choose a RE for dIUI?
There is one local RE who has a very small boutique practice. He is fairly new and only had one year worth of IVF results reported. (He'd only had 4 IVF patients and only one was successful.) It would be so much easier to have a local Dr, but I have a general distrust of our rural medical practitioners and worry about a 'one man shop' being the right fit for me. I would not do IVF with this Dr for those reasons. PROS: local, personal, less time off work, ML could be with me at all appts,  CONS: one man shop, I'd only do IUI with him

There is the big university hospital RE program in the City. I had an initial consult and ultrasound with the head of their program, they did my saline sonogram, and their geneticist reviewed our records too. It is a 3 hour drive each way to get to the City, which requires a day off of work. I trust their medical judgement and like the fact that although I'll have a primary RE, there is a team approach to every case. PROS: reputation, trust, team, consistent care if we move to ivf, CONS: travel, time off work, ML couldn't be there at every appt.

The other option would be to find a different RE in a nearby city. I might be able to cut an hour off the drive while still benefiting from the larger practice.

What questions should I ask the RE?
How much experience do you have with IUI? dIUI?
What can we expect as a IUI success rate with your office?
Do you have a preference for medicated vs unmedicated cycles?
What hours are you available? Evenings? Weekends? Holidays? Emergencies?
What lab do you use?
Where did you train/residency? Where did you work before?
What are the costs associated with dIUI? (actual procedure, monitoring, sperm prep, other?)
At what point would you recommend we switch to IVF?
What records / tests will you need from me? Do I need to repeat anything?
How quickly could we start a cycle?

How to choose sperm?
Oh My, this is a loaded question that deserves its own post.... but here goes.
Which sperm bank to use?
How do we narrow our choices and make a selection?
Are there cost differences between the banks and donors?
Which bank will give us the most information about the donor?
How do ML and I do this together? Will ML do this on his own?
Things that are important to me:
Open donor, not a CF carrier (full screening?),

What do we tell people?
Who do we tell?
What exactly do we say?
How much privacy do we maintain for the child to choose to disclose?
What kinds of reactions should we expect and how to best respond?

I think that this is a good start at organizing my questions. I am going to keep this post active and add to it as I think of other questions or topic areas. I really would love your wisdom and experience about all of this - comments, links to other posts that explore these questions, any resources that you know about!

Three cheers for the ALI community. Thank you for being here.

One Day at a Time

ML fell, or maybe he jumped, off the wagon last Saturday night. He quit drinking in January of 2001. Its been almost 10 years. I freaked out. Lost it. I had no idea how scary it would be for me to see him drink again. I guess I always figured he would someday, but I wasn’t prepared for it. 

When I met him, he drank a lot. A lot. We had a TON of fun, don’t get me wrong, but it wasn’t what I wanted for my life partner. We dated for almost a year before I decided to move on. I remember telling him that he might consider the effects that drinking was having on his life, but I never predicated our relationship on status of his sobriety. 

We stayed in close touch. Even after I had graduated, moved away, and gotten a ‘real’ job. There was a point when something changed. Over the phone in a matter of a few weeks I felt like I had grown closer to him than I had in the year that I’d known him. It was like there was a depth that suddenly appeared. It probably wasn’t the best description but it was all that I could come up with at the time - I explained to him that there was an extra layer of pie, a layer that I never knew was missing, but that was so delicious and wonderful and made the pie complete.

He’d gotten a d.ui that January after I’d left and decided that it was time to make a change. I’ve been grateful every day since then that he made that choice that allowed our relationship to grow into the beautiful thing that it is today. 

So, on Saturday night, after Mr. T poured ML a gin and tonic, I started to panic. 

We’d decided, well I should clarify that I decided and asked him to agree, that we would be sober this weekend. Don’t judge us, but there are certain occasions where ML and our friends partake in recreational, err, uhh, party favors. And with all of our investment in ML’s sperm, I didn’t want to jeopardize anything. I’ve never felt the need to partake so it wasn’t an issue for me, but I agreed to not drink all weekend so that he wasn’t the only sober one. 

It sucks that this time when we probably need to let lose and relax more than ever is the one time when we can’t. I felt awful asking him to refrain, but he would tell you that he is in full agreement.

He’d mentioned that he was thinking about having a cocktail earlier in the evening. It was the first time that I’d ever heard him talk about being tempted. He said that he felt disconnected from everyone and left out. He wasn’t having a good time. I didn’t know what to say. I mean it is his choice to make. I tried to say that it was a really big decision, one probably best made when not under temptation. I honestly didn’t think he was serious. I believed that he was tempted, I just didn’t believe that he would make the choice to have a drink. 

On our way back to camp after the show we passed by a local band playing a rocking bluegrass version of gin and juice. Maybe that was the sign that he needed to make the choice he did. 

So I freaked out. Totally surprised by my panic I climbed into my tent and the tears started. ML was clearly having a great time. He was happier than I’ve seen him in a long time. Smiling and talking and almost skipping around camp. I felt like a jerk climbing out of my tent and asking him to come to bed with me. He chose me and came to bed. I cried and blubbered about how scared I was and how I needed to know what ‘his plan’ was and what ‘this’ meant. He was so kind and sweet and listened and reassured me. 

The next morning we talked a little. I was calmer. It is what it is. Today is different than it was 10 years ago. We’ll take this one step at a time. 

My dad chose his alcoholism over me. It is a choice, and I would simply die if ML ever chose alcohol over me. I couldn’t take that. That is my fear. I know that he loves me, and would never want to make that choice, but my dad did, and I can’t deny that it doesn’t scare me that ML could do the same thing. 

Its not all bad. On Sunday night we both had a few drinks and talked. We talked about stuff that we really needed to talk about. He told me that he is totally on board with our family. With whatever we have to do to build our family. He assured me that I will be pregnant and that he can’t wait and that it isn’t about him or sperm, but about US. 

I told him that I’d been so unhappy for so long, that I had to grieve. That my unhappiness wasn’t about him, that my grief was real and necessary. That I too grieved over the loss of his sperm. It was SO wonderful to talk to ML about all of these things that we needed to talk about. I told him that it meant so much for me to hear him say these things, that I needed to know how he felt, and that I needed to know that he wanted this as much as I do. It was a conversation that caused tears, of happiness. 

We laughed and talked with our friends and stayed up until the party people dispersed and finally found our way into bed for the night. I love him so much and I don’t doubt for a moment that he doesn’t feel the same for me. This journey is about US and we WILL make it through it. 

I don’t know where this (the choice to drink) leaves us or where this will take us, or what it means for tomorrow. All I know is that it is happening one day at a time and all I can do is handle it the best I can one day at a time.

A trip to Australia by Diane Armitage

I've seen this posted here and there. I think it was originally written about adoption, but sure seems fitting for all of us grieving the ability to conceive naturally.


"Deciding to have a baby is like planning a trip to Australia. You've heard it's a wonderful place, you've read many guidebooks and feel certain you're ready to go. Everyone you know has traveled there by plane. They say it can be a turbulent flight with occasional rough landings, but you can look forward to being pampered on the trip. So you go to the airport and ask the ticket agent for a ticket to Australia. All around you, excited people are boarding planes for Australia. It seems there is no seat for you; you'll have to wait for the next flight. Impatient, but anticipating a wonderful trip, you wait--and wait--and wait. Flights to Australia continue to come and go. People say silly things like, "Relax. You'll get on a flight soon." Other people actually get on a plane and then cancel their trip, to which you cry, "It's not fair!" After a long time the ticket agent tells you, "I'm sorry, we're not going to be able to get you on a plane to Australia. Perhaps you should think about going by boat." "By BOAT!" you say. "Going by boat will take a very long time and it costs a great deal of money. I really had my heart set on going by plane." So you go home and think about not going to Australia at all. You wonder if Australia will be as beautiful if you approach it by sea rather than air. But you have long dreamed of this wonderful place, and finally you decide to travel by boat. It is a long trip, many months over many rough seas. No one pampers you. (Isn't that the truth!) You wonder if you will ever see Australia. Meanwhile, your friends have flown back and forth to Australia two or three more times, marveling about each trip. Then one glorious day, the boat docks in Australia. It is more exquisite than you ever imagined, and the beauty is magnified by your long days at sea. You have made many wonderful friends during your voyage, and you find yourself comparing stories with others who also traveled by sea rather then by air. People continue to fly to Australia as often as they like, but you are about to travel only once, perhaps twice. Some say things like, "Oh, be glad you didn't fly. My flight was horrible; traveling by sea is so easy." You will always wonder what it would have been like to fly to Australia. Still, you know God blessed you with a special appreciation of Australia, and the beauty of Australia is not in the way you get there, but in the place itself."

By Diane Armitage printed in the April 21, 1995 "Dear Abby" column.

Summer Plans

A girlfriend emailed me today to make plans for a girls weekend this summer. She doesn’t know about our challenges with infertility. She proposed a date in August. First thing I had to think about was where we might be in our treatment. Can I make plans for August? What if I need to stay close to home for treatment that weekend? How will I explain if I need to cancel the trip? Maybe I just shouldn’t make plans at all.

Time-Out. My plans have been on hold for so long. Trying to plan my life around the possibility that we might be moving forward with IVF on a certain date is making it impossible to live my life. I wrote back and told her that I would LOVE to plan a girls weekend and the date she proposed would be perfect.

There is a scenario in which I’ll have to cancel because of treatment, but the chances are so small. Even though I just know that we have more bad news waiting for us when we get our next SA at the end of July, I want to believe that they will find sperm and we will start IVF with my cycle that month, which would mean I couldn’t go away. Small chances, so tiny, not even worth mentioning. Its amazing how a glimmer of a chance can be enough to control my life. I sure don’t plan my summer around the chance that I could catch the flu, get laid off, break my leg, win the lottery, etc. Crazy. When I think about it like that, I feel a little bit crazy!