DH and I decided to take afternoon off this day. 1) because I was soo anxious I could hardly concentrate that morning and 2) my Dad had surgery. We arrived early as we do for all our appts. Waiting room was full of couples today, avoiding eye contact as per usual, nervous looks on faces.
Our RE called us in, it was DH's first time meeting her. Think he was relieved to finally see a woman as my last two OB/GYNs have been men. We got straight onto Blood and Semen Analysis. My Day 3 Bloods look fine apart from my Prolactin levels shooting up again. If you head back to start of blog this has been an issue before. Turns out stress is a likely factor, she asked how much stress ive been under and i laughed out loud! "Everyday" i said. DH's bloods had nothing to report, so far so good until we got to the Semen Analysis. Turns out this whole time DH has had sperm antibodies at levels of 100%. What does that mean you ask? Simplified it means there wasnt much possibility of us conceiving naturally and did 6 clomiphene cycles for nothing. Sighh. More info below...
It is possible to develop antibodies to sperm. Almost always, sperm antibodies are generated by the man producing the sperm. Most commonly, sperm antibodies are generated after vasectomy. The areas of the testicles where sperm are formed, and the entire tract that delivers the sperm as ejaculate is immunologically isolated from the rest of the body. Proteins on the surface of sperm are never in contact with the body to either be recognized as part of “self” or, under normal conditions, be deemed as foreign material. Performing a vasectomy interrupts the normal barrier between the portion of the body which produces sperm and conducts them to the exterior at the time of ejaculation. Once the barrier is breached, the body’s immune system discovers a new set of proteins, and believes them to be foreign invaders. Therefore, the immune system begins to make antibodies. Antibodies are large proteins which attach to sperm, and can interfere with motility or cover the head of the sperm, so as to interfere with the acrosome reaction. To explain the last term, the sperm head is covered by a packet of enzymes called the acrosomal cap. As part of the process the sperm undergoes to be able to fertilize an egg, the outer membrane of the acrosomal cap breaks down, releasing the enzymes. Enzymes of the acrosomal capchange the membrane covering the sperm head behind the acrosomal cap allowing the sperm head membrane to fuse with an egg cell membrane. Once fusion of these 2 membranes occurs, the boundary between sperm head and egg disappears, and chromosomes of the sperm enter the egg to fertilize it. If the sperm head is covered by antibodies, none of these processes can occur.
Trauma to the male reproductive tract can also cause a defect in the barrier between the sperm production area and the immune system.
So what that now means is we need a specialised form of IVF called ICSI. Its quite common actually, RE said the use it for at least 50% of most cycles performed. It is where they select one of the best sperm and inject it straight into the egg.
After talking about all that we had a quick run through of the timeline of the cycle, how the drugs worked, when retrieval willhappen and answered any questions DH had, she then checked her calendar.
"February, around the 23rd, how does that sound?" Marvelous! My grin was ear to ear. Even tho we were desperate to get started there was alot going on and DH and I needed to be ready. So we're all booked in.
I start my drug training as soon as my cycle starts in January so hoping thats when my workmate is back from leave, otherwise im going to be one busy girl trying not to wigg out. Then the countdown is on! Im really hoping my New Year resolution of early nights, healthy eating and no stress comes to fruition. I neeeeed this to work.
This year has been tough! I cant wait to start a fresh one. Update you when I know more.
