Struggling to come to terms with potential IVF referral

[Grumpsy]

I finally had a gynae appointment yesterday, my partner needs to go back for a repeat semen analysis, but if the results are the same, the consultant has said our next steps will be ivf. (We have male factor only).

I’m struggling to come to terms with this. I don’t know how I’ll cope with the mental strain of going through ivf. I already feel quite broken, and I’m unsure how I’d cope if it fails.

I’ve tried speaking to my partner, who thinks I’m giving up before we’ve even begun. I’m getting frustrated as he doesn’t seem to appreciate the strain it will put me under. His part will be over in a few minutes where as I will become a hormone pin cushion and have to undergo numerous procedures.

I think I just need someone to give an honest appraisal of going through the ivf process. I also just needed somewhere to share my feelings where they won’t be brushed off as quitting, or him thinking that I’m being selfish for having concerns.

I just thought I’d add that I have a stressful high pressure career, I’m wondering how I’ll cope with this whilst undergoing ivf at the same time. I’m on what seems to be an emotional rollercoaster at the moment, one day I embrace the prognosis, the next the thought of it makes me want to curl in a ball and cry.

I felt exactly the same as you when we were told that our next step was IVF. We have make factor as well. It’s so frustrating when like you said the man has one really easy job to do and we have to go through so much. I found sitting down and talking to my partner really helped. I’ve also made him watch videos of what to expect and I bought a book for him to read as well.
After a couple of weeks I found everything easier to come to terms with and also spoke to family, friends and work about it so I didn’t bottle everything up.
It is such a shock but give yourself time to accept it.
We start our first round next month and I’m scared but also pleased the start of this part of our journey is almost here.

It's hard when there is a diagnosis which very much centres on one person.
I did 5 rounds of IVF. They were all either short protocol or natural modified IVF so the whole cycle was over in less than 2 weeks - most of the time drugs for only 9 days or so. If you are in doubt about whether you can handle 6-8 weeks of medication I would consider a milder IVF route - it's not supported by every clinic as they often prioritise numbers of eggs over quality but certain clinics like Create favour low dose drug regimes. Because I was only on drugs for a few days then I had very few side effects

Not going to lie the stress and pressure of Will it/won't it work is immense. You'll stress about follicle numbers, follicle growth, number of mature eggs, how many fertilise. I'm a strong person (been through 5 miscarriages and 2 near fatal ruptured ectopics) but I've never cried so much in the 5 days post fertilisation waiting for the various calls about day 3 quality and then what makes it to blastocyst and their quality.

I would say when it's male factor generally the chance of success is much higher than if it's "unexplained" or female factor issues.

Most male partners have no idea of the reality of it until the drugs are delivered and they see what we have to inject etc, not to mention it's us that do all the scans, blood tests, get put to sleep for the egg collection and then suffer through the transfer. They get 3 minutes of "happy" time wanking in a cup (lots of clinics also provide them reading material whilst they are in there!) and their job is done

All I can say is try one cycle - you'll never know whether you can get through it or not if you don't try it. If you partner isn't supportive through it then tell him you're unlikely to want to To do it again.

Be warned it's addictive though. That's how I ended up doing 5 rounds as you'll tell yourself that the next time will be the one that works. Thankfully i am now 17 weeks with twins but we did set ourself a budget (blew that one and spent £45k) and a maximum of 3 rounds (ended up doing 5!)

Hi Grumpsy- I am so sorry you are going through this! I know how hard it is to get your head around and I really do feel your pain. I was told last week i should start IVF (I have very low AMH) and it has come as a real shock. I keep changing my mind every two hours on whether i would keep trying naturally or go for IVF. It has taken me talking to a few different people (including asking for advice on this board) to finally get my head into accepting that starting IVF is the best choice for me. Considering I was adamant until Sunday that I didn't want to start IVF until next year it has been a real turnaround. I have booked myself in now so hopefully I don't change my mind again.. :)

In regards to your stressful job - it is likely to add additional stress to the procedure but hopefully you will be able to make it work for you. I'm hoping my job may act as a distraction from IVF (that said, i am meant to be working right now and i am writing on here). I am contemplating whether i should speak to my boss and let him know what is going on so they will be understanding of the numerous appointments i will take. I find it a bit awkward but i figure he has 3 kids so will hopefully be understanding and sympathetic. Is there anyone at work you could talk to at work in HR?

I hope you manage to get your head around it all and come to a decision that is best for you. Good luck with your partner's repeat analysis!

Thanks both.

I’ve actually just booked on to a create fertility webinar. I ovulate like clockwork every month (gave up as a waste of time and money with 6 months of opk - always positive on one of two cycle days) my cycles are textbook with a maximum 2 day variation so I’m hoping this may be an option.

If we go for the natural or natural modified route it looks like we’d have to go private though as I think all nhs ivf in our area is done at one clinic. Where I’m fairly sure they go for long protocol to try and yield as many eggs as possible. This isn’t ideal for my job, I work with contracts and have a lot of tense customer interactions, being overly hormonal wouldn’t be ideal. This will be doable for us, but we’d need to take out a loan and save like crazy for the next 6 months.

I did make my OH watch a video about egg collection and the hormone injections yesterday, he’s of the opinion that whilst it’s not great it’s needs must (coming from the man who avoids the doctors like the plague).

I’ll try and sit down with him this evening to talk things through with him, rather than arguing about his lack of understanding.

@Jane1284 I’ve actually told my boss about the fertility testing, he’s very understanding and I’ve been a bit distracted lately. I told him as I know he tried to have children with his wife, but they were not successful. I’d rather not speak to our HR managers, they aren’t the most understanding in the best of circumstances.

To be honest the actual physical side of ivf is fine. It’s just not feeling great but not awful. It’s the emotional side that is tough but given what you’ve said you’re already feeling the emotional side of ttc so I guess you need to weigh up the emotion of ivf vs emotion of not having children.

Re role of the man. I outsourced all injections and dosage etc to my husband. That helped as he had to keep track of what was due when, mix everything up and give the injection. I just came in and he injected it when everything was ready. I find that works really well. Also for my 3rd round I asked them not to tell them anything in the scans so no worrying over follicle numbers and sizes etc. I just went in had the scan and left and found out after egg collection how it had been. After all fertilised eggs is all that really matters. You can’t do anything to change your follicle number so why find out what it is. I found I was way less stressed this way so I’d highly recommend it.

I wouldn’t recommend mild ivf if you have male factor as you will get less eggs and really you need as many as possible in hopes that you will get a good sperm in them.

Also before doing ivf I strongly recommend going to a urologist and doing a dna fragmentation test. We were told oh it’s male factor ICSI is what you do. Our first round of ivf all embryos arrested between day 4-5 which indicates male issues. I got a dna frag test even though my clinic were against it. It came back 52% so crazy high. I insisted on a urology referral as my DH hadn’t been checked out and they found a varicoele which we had embolized. After that my DH frag fell to 24% and his count went from 1 million to 10 million and we got two blasts from our latest round.

So I would see what dna frag is and are a urologist before proceeding with ivf as our first round was a waste of time. Our new consultant also said that if frag didn’t improve he could do TESE as that would give us better quality sperm so do explore this before putting yourself through ivf. We also did IMSI on our last round which is better than ICSI. So they all are all things to consider to set yourself up for success.

@Grumpsy to be honest rather than paying private to go to natural modified which again I wouldn’t think is a good idea for male factor - I would pay private to go somewhere where they have things like IMSI / PICSI / MACS and actually specialise in your issue.

Your husband also needs to give up alcohol a land caffeine and overhaul his diet as well as taking supplements. This all also helped my DH numbers.

Hi Grumpsy

I’m in precisely the same boat. Results of our fertility tests yesterday showed Male factor fertility and the Dr moved very quickly into IVF options and said we’d have to do ICSI. I’m 38 And my results were fine so I’m struggling between getting on the IVF conveyer belt or adopting.

Feeling hurt and bruised today but while I was awake last night I contacted a specialist in Male factor infertility in the hope my husband can have a further investigation and a more empathetic discussion around his results. I found the clinic discussion dismissive of his fertility issues. I’ve also set up some counselling sessions so I can have an outlet. I’ve not stopped crying in the last 24 hours so just know you’re not alone!

My husband on the other hand slept soundly and has piled into work. I know he’s hurting but I’m trying to give him some space to deal with it in his own way.

I too have a high pressured job and I’ve taken today off sick to lie under a duvet. My first since I started my current role. I’m lucky that I feel I can speak to my manager so I have told her what’s going on and I am going to have a further discussion when I have decided what route we want to take.

Sending you a virtual hug - crap news in a crap year!

@Racinglikeapronow my oh has motility issues. Everything else is on the low side of normal. He has 8% progressive, 6% progressive but moving in circles, the rest don’t move. He quit smoking a few months ago. And I’ve just made him quit the booze. He’s not one for coffee or caffeine, that’s usually my thing. I’ve also got him on proceive drinks (which he hates - but he opted for the powder rather than the tablets).

I hadn’t actually heard of imsi/picsi etc. I’ll look into them thanks 🙂 if natural or natural modified isn’t an option I’ll just have to think on the long protocol version 😞

@lizzleE I’d be interested to hear more about the male factor infertility specialist. I’ve looked briefly but all fertility specialists focus on the female it appears.

I wish I’d have taken today off. I spent most of yesterday crying and today I just feel intermittently numb and teary.

Sending you a big hug too. I am done with 2020 now to be honest. I agree crap news, crap year!

@Grumpsy

Not sure what part of the country you are in but in the West Midlands Create is one of the NHS providers as well as being private so your NHS funding can be used there

I took out a bank loan for the last 3 cycles of natural modified IVF with Create - £13.5k over 5 years is £275 a month.
(Hugely cheaper and much more affordable than cost of paying for a child when it hopefully arrives - min £850/mth for full time childminder)

@ivfbeenbusy I’m in south east wales (Monmouthshire). It looks like all ivf goes through one clinic in Cardiff over here. We used to live in Bristol where we could have gone with create.

@ivfbeenbusy at least that’s what it sounded like from the gynae yesterday - also no indication of wait time. I’m 31 at the moment 32 later this year, if we decide it’s for us I’d rather not wait for an undisclosed period of time to get things moving.

Hi @Grumpsy with your age and primarily motility issues I would think you have a good chance of success. I still think you should get a DNA frag test just to check what that is like before ivf.

I’m sorry to go against the previous poster but I would be very cautious about going natural. If you only get 2-3 eggs and the 2-3 sperm selected are not good you could end up with nothing. For context my friend is the same as you with motility issues and she did normal ivf. Got 12 eggs and 11 fertilised. Only 3 made it to blast the rest dropped off on day 4-5 which is when male issues come through. She now has 3 frozen embryos and has a good chance of one of them working so she won’t need to do egg collection again hopefully. Just something to consider.

I should say I have done both long and short protocol. Long protocol I was put on synarel which is a sniffer so I sniffed it 4 times a day. I did this while working and it was fine. I didn’t feel great on it but kinda like I thought I was coming down with a cold so not terrible. I did sleep really well on it though. Then did 10 days of injections also fine. And I have a phobia of needles. Honestly the physical side is not too bad. By egg collection you’re feeling pretty awful but not at the start. I took a week off two days before egg collection so I was off before it and for embryo transfer and didn’t have to worry about work. I was happy to go back afterwards for the distraction. Maybe something like that would work for you?. It really is the emotional side that’s most difficult So try not to worry about the physical side.

Jonathan Ramsey is the top guy for male fertility.

Hi @Grumpsy try Jonathan Ramsey - Male factor specialist.

Wishing you all the luck in the world 🌼

@Racinglikeapronow thanks we will definitely look into getting the additional tests for him. Following that i think we’ll review our options to see what realistically has the best chances of success for us.

@twinkledag & @Racinglikeapronow thanks I’m googling Jonathan now!

Thank you all, this is helping. Friends and family just haven’t been there so don’t and can’t fully understand.

Hi @Grumpsy how old are you both? If he just quit smoking then the sperm motility will improve. Can he get on proxeed for at least 4-6 months and repeat a sperm analysis? Smokers will have bad speed results in general and it takes 3 months for the sperm analysis to reflect after a healthy lifestyle. If your both young enough and your adverse to ivf, try the natural way with him quitting the bad habits. At least you can say you tried naturally before moving to IVF.

@ChicaXS I’m 31 he’s 32. He quit smoking 2-3 months ago. Going for a repeat analysis next month. I think after that we’ll leave it to the new year when I’ll be 32 and he’ll be 33 before proceed with any ivf assistance etc.

Get him on proxeed plus - it makes hell of a difference.

He’s currently on proceive plus (sachets not tablets) and moans like a baby about taking them every day.

He moans less after I yelled at him saying I may have to be injected with hormones every day so he can manage one small drink with orange juice 🙄🙈

@Grumpsy this is exactly what I went through when we were told we would need IVF due to MFI. I think I have become a little bit more accepting of it now but I'm still pretty anxious about the whole process and don't know how I will cope emotionally if it fails. I guess like most people I never thought I would be in that situation. I try to look at the positives but sometimes that is easier said than done.
I'm not sure yet when I am starting so can't give any advice from that perspective but thinking of you and feel free to message anytime xx

@Grumpsy sorry to hear this. Alternative is to smack him round the head until he gets the message (only joking lol!)

Men can be shits. I have to remind my husband twice a day and forced an alarm on his phone to take proxeed. This was even to egg collection. They just don’t get it but a thorough talk about how it’s affecting you may help. Also don’t worry for now about ivf. I had severe anxiety and was extremely low and I just finished the first cycle (egg collection is tomorrow) and it was much more easier then I expected. Your uncomfortable at the end of the cycle but it’s worth the price in getting the results hopefully

@Grumpsy

I had this with my DH - until I yelled at him one day that If I could remember to insert things in my ass several times a day (pessaries) not to mention all the injections the least he could do was take one poxy multi vitamin 🤣

(I used to take the Proceive sachets too and they tasted fine in orange juice)

Just on the quantity of eggs front that someone else raised - it is a risk going down the mild/natural route. But I got 14 eggs each time with mild IVF (over in less than 2 weeks) which was the same as my friends on long protocol IVF which took several weeks

Hi, hoping to get some advice myself too. We've recently found out (late last week) that we have male factor too. Dh's results were as follows:
25million
5million per ml
14% motility
2.3 morphology
56% vitality (normal)
4.5 volume (normal)
Everything else is lower than normal...
He had high ph too but not sure if this means too acidic or alkaline?

He is on wellman conception and has been for about 11 months but not continuously, so hoping a continuous 3 months will make the difference. As well as not smoking, binge drinking and doing some exercise. I've also bought some oranges as heard vitamin c is good too. Just looked up proxeed plus, can that be taken as well as wellman does anyone know? He'll need his repeat SA in nov so I'm hoping to see a difference and if not it's iui/ivf for us 😬 I just need my day 3's this week (which will be on day 5 due to availability) then we get our referral. I'm hoping it doesn't take too long as I'm 34 and he's 37, we initially wanted two...but after a year of trying and now this diagnosis, I don't know anymore. Any advice, anecdotal or otherwise would be appreciated. Thanks so much!