This post is supposed to be about November of 2013.  As a warning this post is long, but it's important. This being the understanding of November from a fertility perspective.

To adequately explain why this month was so significant in my life, I need to give some history (another purpose of this blog by the way).  Lynne and I were married on the 18th of April 2009.  It was a beautiful day, with a bit of wind and lots of Tulips. It was warm and nice for April.   About a year later, we started having discussions of having kids together.  Lynne said she wasn't sure about it, but in her mind had made plans to make it a surprise and announce that she was pregnant.

Most of the things that she did to prepare were kept hidden from me.  Thus, I don't know all the details but I do know that she started tracking her body, and all the things that you can do to try and get pregnant.  As plans didn't work out, she began expressing concern that she was really worried about taking accutane as a teen.  She was mostly worried about side affects that the accutane could have on her body and ability to get pregnant.  Some of the side affects reported have dealt with infertility.

One night in June 2010 after a negative test, Lynne and I were talking and she revealed all the things that she had been doing with tracking and trying to get pregnant.   She had been trying for months.  She said that she thought we needed to go see a fertility doctor and try and see if anything was wrong.  One of the things she said that will always be in my mind was her saying how much she wanted to surprise me and tell me that i would be a dad for Fathers Day.  I remember feeling sadness and worry, and peace all at the same time.   I was worried that she was right, sad because of her disappointment and yet faithful that everything would work out. I told her everything would be okay and that we would work through it, and things don't happen on our time line.

So we went to the doctor.  Lynne, searched around and found a reasonably priced doctor who's success rates seemed really high.  His goes by Dr. Larry Glenn Andrew, and his embryologist is Thomas Chang, we'll have more on them later.   The staff was very nice and the nurses were professional.   On our first visit they did an exam on Lynne and everything appeared normal.  There could have been some minor hormone changes or tweaks to be made.

They also asked for a sample from me, and so we brought them a sample and they ran the tests and saw a low cell count based on the results from the machine.  That was concerning so they decided to look into it further.   Upon further investigation they determined that all the cells that were found were white blood cells.   I'm not a doctor but I know that white blood cells are what fight infections and diseases so I was concerned because it was a low sperm count but a high white blood cell count.   Then I learned more about the male reproductive system then I thought that I'd ever need to know.  One thing was that it is common for there to be white blood cells, and that it was probably elevated because there was an infection which could cause a 0 sperm count.

***** The next couple paragraphs are graphic so please skip them if you don't want to know the nitty-gritty details.*****

We had several visits to the doctor during this time and two visits really stick out in my mind.  The first one was the time I had to get a prostate exam.  I didn't know this, but when a man ejaculates most of the fluid comes from the prostate and not from the testicles.   The testicles produce a little bit of fluid and millions of sperm that connect with the urethra via the vas deferen.  I have never had a prostate exam and sort of knew what it was but the Dr. didn't tell me what was going on.  He just handed me this little vial thing and said hold this below your penis.  I was like huh? Lynne was sitting in the corner laughing at me as the Dr. was like pull down your pants.  That was not unusual as I had been violated in the front by this doctor several times by now.    Then he told me to turn around and I was  mortified, and as I watched him put on his glove, then put some lubricant on it, I just wanted to throw up.  Still to this day it makes my stomach hurt.   About this time Lynne met my gaze and it was all she could do to keep from laughing hysterically out loud.  I turned around and grit my teeth and when that doctor shoved his finger in a place that is not meant for it.  It actually hurt up inside my stomach because he had to put pressure on the prostate to release some fluid.  I didn't know that's what he was doing when all of a sudden I felt fluid coming out of the front.  I put the vial down and collected it.  I just remember if felt like someone was poking the inside of me like straight through my belly button.   It was quickly over, but a moment I'll never forget.  I was violated, I had no dignity, and Lynne thought it was the funniest thing she'd ever seen.   I just wanted to throw up and still do.

The other odd thing about this doctor was one time he was going to do an exam on a Lynne, and needed a sample from me.  I was perfectly happy to wait to get home, collect a sample with my wife and bring it back.  The doctor had other ideas.  He wanted it then, while we were still there.  He handed me a collection cup and pointed to a door.  I was stunned, I looked at my wife and she went in the other door.  I just stood there for a minute or two after the nurse walked a way. The doctor was gone and it was awkward.   I guess when you deal with these kind of things all day it's just normal for the doctors and staff.   It isn't normal for me.  One thing that people don't realize is that you have no privacy.  Intimate moments are shared by more than you and your spouse.  It changes things.

*****Graphic stories are over ******

Naturally I was put on a regiment of antibiotics and told it takes about 90 days for sperm to grow into a mature state and that we would retest.  Lynne was put on some medication to make sure she her body was performing.   So time went by and we followed the orders and filled people in on what was happening.  In the beginning I was much more private about it than Lynne.  I didn't want to tell anyone and to me it felt like she was telling the whole world.  There were a lot of emotions and pride that I had to overcome to accept what was happening.    It was a big blow to my ego or man pride.  I just never thought it would be due to me.

After 90 days we went back to the doctor and he wanted  another sample and essentially it came down to the same result.   I remember getting the results for this on a hot afternoon.   Lynne and I were headed out of town and the doctor called us and gave us the news.  I remember being really sad and worried that we would never be able to grow our family.   All I could do was think to call my friend Kyle. who had been going through some of these issues with his wife.  He told me what to expect and made some jokes and we laughed a lot.  I really helped and I'll always be grateful to him for that conversation.

After all of these exams and evaluations we started thinking that there was a blockage in the vas deferen.   Then we thought that there might not be one at all.   Dr. Andrew sent me for a second opinion down to a urologist in Payson,  Dr. William T. Collins.   He gave me an exam and so did his PA, and the concluded that the only thing to do for sure was to do a surgery to find out if there existed a vas deferen or not.   There is the option of a dye test, but he essentially said that was somewhat inconclusive and would likely cause a painful infection.  

There were two types of surgeries that they could do, and honestly I don't remember the difference.  What I do know that one could be applied a little more to insurance.  We pay our bills and go on vacation once in a while, but we don't have a ton of extra and so that mattered a lot.  The other big factor was this surgery would allow us to explore to see if there was a vas deferen as well as do a sperm retrieval if in fact there was sperm to be retrieved.  Up until this point we still had no idea if it reproductive cells were being produced and if so how good were they and what options were available if there was sperm.   -- as a side note we later found out this was totally unnecessary and we could have had the same results with an in office procedure for about 15% of the cost; but more on bad doctors later --

We scheduled the surgery for January 2011.   We chose not to do a full anesthesia because it was unnecessary and really expensive.  So I did a local pain blocker and was sedated which was great, but I still puked my guts out on the car ride home from being so nauseated.   I was bit nervous going in, but really felt like everything would work out alright.  Lynne was there with me, and I honestly can say that she's been the best wife, and partner in this.  She's been so supportive of me and the issues.   So I went in for surgery and don't really remember much but feeling some pressure from the incision.  When I woke up they were pushing me back to my waiting room.  I asked the doctor how it went and he said everything was great and that I had sperm.    I felt so much relief, it meant there was a possibility of actually creating a child with my wife.  I was so happy, and still drugged up.

After the surgery in the waiting room Lynne and I were waiting for the doctor.  Some time later he came in and confirmed that they could not find a vas deferen and that was most likely cause of all the problems.  They only operated on the larger testicle.  They said that they were able to retrieve ample amounts of sperm and that from what they could tell they looked great.   This surgery required Dr. Collins to search for the vas, and Dr. Chang to do the retrieval.   Dr. Chang was no where to be found after the surgery and had to confirm that it was actually happening on the day of.  To this day I still have never spoken to him.  Dr. Collins said that we would get more information about the quality later that day from Dr. Andrew's office.

Later that day they did call and told us that everything went great.  The sperm were alive and in good shape.  They said that they couldn't find anything wrong with the formation of them and everything looked normal.  The only thing that was wrong is that they had very little or no motility, in other words, they couldn't swim.   They were frozen and in storage ready for when we wanted to start the in vitro process.

The recovery was quick, but painful.  They did make vertical incision into my left testicle, which made it swell up to about the size of a baseball.  So it was wrapped in bandages to try and keep the swelling down.  The pain was mostly a dull ache, men will understand it compared to that ache you feel when you get squirrel tapped.   I didn't take many pain medicine, mostly cause I don't like them, and by keeping still and having an ice pack it did the trick.   I think the surgery was on a Thursday and I was back at work on Tuesday.   The incision on the skin and the swelling hurt the most, but it was mostly gone in a week.

We decided to wait awhile (nearly a year and a half) before moving forward with the in vitro process.  The main motivation was financial, but also the timing just wasn't right.   In the time waiting we started to hear more and more about Dr. Andrew.  What we found out was that he was a convicted felon for sexually abusing his patients.   We spoke with people who had used him had terrible experiences, and based off some of the things mentioned above we decided to change doctors.    This change meant we had to take a couple steps back to bring the new doctors up to speed.   After more research we decided to go with Utah Fertility Center, and our new doctor was Dr. Conway.

When we told her where we were at she said somethings about the process sounded a bit strange, but accepted where we were in the process and laid out our options.   One thing that we found out was that the surgery I wen through was way overkill for what they needed to retrieve sperm.   Utah infertility offered an in office extraction procedure that would have cost hundreds of dollars in stead of thousands.   We would not have ever know whether  a vas deferen existed or not, but in the end the result would have been the same.   I still haven't decided if the knowledge of the surgery was worth the money or not. 

We made financial preparations.  I sold my truck and cashed out my 401k, we saved money, and with a generous gift from my sister and brother, and gifts from Lynne's mom we were able to pay off all of our debt, and have enough to pay for the process.

One thing that is nice about doing it this way is that you can decide what month you want to try and get pregnant in.  Lynne wanted a summer baby so we picked  range of months and started preparing.  We had some weight goals that we didn't meet, which could affect things, but you never really know. Overall we didn't feel like it was really an issue.  Other than that things were on schedule.  We had started with visits and exams.  We did blood work and tests, and everything was going great.

Lynne started her hormone treatments in October for 2013 and the only left was to get the sperm from the east bay fertility center.  When I first called they had a hard time understanding what I wanted.  Finally they understood and said they'd have to find it.  I was perplexed by this idea that they would have to find it?   Basically they said that the embryologist had categorized it and he would need to be the one to get it.  They said they'd call me back when he was available and had located it.  Three days later I called back and they still had not "found it" but did say that they had it.

A few weeks later I called back and tried to schedule it for transfer up to Utah Infertility.  They said we needed a cryo container because theirs was in use.  They were very hard to work with to get this done.  The way East Bay infertility went about it was fishy.   They seemed very unprofessional and almost irritated that we would go somewhere else.  Looking back there were a lot of signs that we should have left them sooner.  I'll I can tell you is that it felt weird and I even remember having the conversation with my wife about them giving us the wrong sperm.   Something just felt off about it and it made me worried.  Eventually, after a ton of work Lynne was able to get a tank and drive it to where we needed it.

                    (This is the pic Lynne took of her transporting it from Springville to Provo.)

Alright, now that you know the history lets talk about November. We were ready, things were going smoothly accept that weird thing with the sperm.  Our doctors reassured us that everything would be fine.  As we went through the ultra sounds Lynne's egg count was great.  Her hormone levels were perfect, and egg size was spot on.  So we went for the retrieval and the were able to get 26 eggs.   TWENTY SIX.... that was a lot in my mind, we were stoked.  We knew some wouldn't make it and that was okay because there was no way we were ever going to have 26 babies.  I think they said 23 survived the retrieval process and it was time to inseminate.   I was thinking how awesome it was because certainly we'd be able to freeze some embryos and this was going to work!

Next we found about about the insemination, they were able to inseminate all 23 eggs.   The tough part was that they were very concerned about the sperm that they were using.  Dr. Conway said the lab was having a hard time finding live sperm.  They didn't know which ones were alive or dead.  She said that they were unsure about the "medium" and method in which the sperm were preserved.  She was telling us that they were stored in plastic tubes rather than metal cryotubes.   When they went to get the sperm to thaw them out.  That the tops of the tubes burst off.   This was alarming because she couldn't verify what chemicals or medium that they were frozen in.  When they examined the sperm they weren't moving.  They had to stimulate each sperm in order to see if they would move to determine if it was alive and a good sperm to use to inseminate the egg.

They found most were dead, and used the ones that they could to inseminate.  After all that we still had 12 embryos.   When we heard 12 fertilized eggs and we were still very hopeful.  At the same time I was so angry with east bay infertility.  I had so many questions, like how is this possible that they could screw this up? Should I blame East Bay Infertility? Did they even screw it up or does the plastic tubes and unidentified medium really matter?  They said my sperm was not moving when they extracted it, so had it really changed? After all that had happened was the surgery worth it?  Why didn't the new office call me down and do a new retrieval? Why didn't I listen to my feeling of anxiety when were getting the sperm and just do a new retrieval? 

The only one I actually have an answer to is why they didn't call me in, and the truth is they weren't prepared for what they found because it's so unusual to have dead frozen sperm.    Even if they called me in would it have made a difference?  (stay tuned for future blogs for an answer to that)  I want so badly to blame East Bay and the Doctors who did the unnecessary surgery and cost me all this money.  The tough part is that the question is did they even do anything wrong?   They did what I paid them to do.  They did what we thought was best at the time.  The only thing that is strange is the cryo tubes and medium and it can't be proven that there really was something so wrong that it caused only 12 eggs to be fertilized.  So along with the frustration we had a lot of hope, this was going to work and we were going to make it.

From the time of insemination to transfer day it was seven days.  To be ready to transfer or be frozen an embryo has to grow to the "blast phase" or to a phase where it is replicating cells and growing at a certain rate.  Our doctor only allows two embryos to be transferred.  Anything else can be frozen.  So each day we get an update on how the embryos are going.  The first day was tough because we dropped from twelve to six.  Only half had made it through the fertilization process.   It was more disappointment, and hope was fading...  I was trying to remain as positive as possible, and hold on to the idea that it only takes one.  Things just weren't looking good and it didn't feel good either.

Transfer day was on a Thursday.  I was supposed to be leaving to Nebraska for a hunting trip with my dad and brothers that day.  We had to push the transfer until late in the day to give the embryos as much time as possible to grow.  I lied to them and told them I had to work and that's why we couldn't leave.   The truth was we didn't tell them what was going on through all of this because we wanted to surprise them that we were pregnant around Christmas time.   The night before transfer day we received a call and learned that four of the six remaining embryos had stopped growing, and that on transfer day we would only have two embryos.

Transfer day was bitter sweet.  I was so sad because we had started at 26 and were down to 2.  We have been on this journey for over 3 years at this point and it was all coming to a pinnacle moment.   We had fought hard, and sacrificed time, tears, money  and other opportunities to try and make this work.   I was so excited because we had 2 embryos.  We had a chance.

I'll always remember the day of November 14th 2013 because of how I felt and how I saw my wife.  
We came into the clinic and sat on the couches and it wasn't long but seemed like forever.  I watch a couple couples go back and go ahead of us.  I just wanted it to be our turn.  I was so sure it was going to work, it just couldn't come fast enough.

Eventually it was our turn and we went back into larger than normal patient room.  There were several chairs and tables with an examination table in the middle. They handed Lynne a gown and told her to get ready and they would be back in a few minutes.  Lynne and I spoke for a few minutes trying to keep things light.  I nervously played on my phone cause I didn't really know what to say or how to express my feelings.  I was nervous but relieved that we had made it to this point. I was excited but yet worried it wouldn't work.  I was sad that I had to spend all the money, but didn't care about the money because nothing else was more important than this.

Once they came back they told us that they would just check with the ultra sound machine to make sure everything was looking good.  We were to watch monitor and we would see a tube on the monitor and the two little glowing dots were the embryos.  We waited and watched and sure enough two little dots traveled through the tube and she said we're all done.   They asked Lynne to lie there for about 20 minutes or so and then go home and do nothing for two days.

In that 20 minutes we just shared a moment and though about what it will be like to have a baby or two. We knew for sure that Lynne had two little embryos, and we were so hopeful that they would grow and survive.  I took Lynne home and got her all situated and then left to go hunting.  I was excited to go hunting and have the distraction.   After the transfer of the embryos it takes roughly seven days to ten days for the body to recognize pregnancy.

Lynne did her very best to follow orders. The orders are to stay off your feet as much as possible and try and do nothing for two days.  You are to try and avoid all stress or anything that would be out of the normal. If anything is out of normal then call the doctors.  She did nothing for the princess days,and she started having a lot of pain.

Since doctors had just been all up in her business she thought a little discomfort would be normal, but soon she was running a fever and went into the doctor.  Turns out she had a painful bladder infection and it was causing problems.   Obviously that is not a good thing, but shouldn't have had an affect on the pregnancy chances.

I was calling in to check on Lynne a few times a day, and considering there was nothing I was going to be able to do even if I was right next to her, I just tried to enjoy my time away.  However, on Tuesday night I had passed up the the opportunity to shoot a deer cause I thought I'd have a few more days to try and get a bigger one. Everyone else on that trip took home beautiful animals that year.  I was exhausted when I got to my bed and went to sleep pretty easily.  It was about 10:30 at night when Ashton came and woke me up.  He said your wife called and is trying to get a hold of you.  Sure enough my phone had showed a couple of missed calls from her.  Panic was setting in and I immediately got up and called her.

When I called she picked up and I knew immediately something was wrong.  I asked what was happening and she told me that she was at the hospital.  I assumed it was for her, and that something was going on with the infertility, but turns out it was much worse.  My beautiful daughter had been going through a rough part of her life, and decided she did not want to do it any more.  She had taken bunch of sleeping pills.  Fortunately, Lynne had found her while she was still awake and asked what was going on.  Theresa told Lynne what she had done, and so they went to the hospital.  Theresa hadn't take enough to have lasting effects, and physically she would be fine.    The decision was made to have Theresa go to an inpatient care facility for a several days.  I'll make another post about this major event, but Theresa is doing great now!

After the end of that phone call, I booked a flight home and told my brothers and cousin with me hunting what had happened.  They still didn't know about the transfer or infertility stuff,  I had my brother spend some time and take me to the air port, for the first flight home.   Lynne picked me up at about 10 am on Wednesday morning.  I couldn't see Theresa until Friday, the doctors wouldn't let us. We spent the rest of Wednesday just trying to cope with it all.  We slept a bit because we both had been up all night.

At this point we were just heart broken.  We haven't been able to have children and the beloved child that we do have is going through really rough time.  We were all going through a rough time.  On Thursday Lynne said she was pretty sure the embryos had not worked out.  She was cramping and was feeling the first signs of her cycle.   We decided it had been 7 days and tried a pregnancy test just to make sure. All that did was confirm what we already knew, no pregnancy.

It was a sad day, and a sad time for us, still to this day the emotion is raw and hurts, but time does help.  When I think about why it didn't work, I can't say for sure.  It's a combination of all things.  It started with the poor sample of sperm, and then was compounded by an infection and stress of it all. Which in the end to me just means that it wasn't time, it wasn't the plan.

It is really a strange feeling.  The only way I can describe it is by saying that it feels like mourning the loss of something that you never had.   We were mourning the loss of hope.  Things were not hopeless but they sure felt that way.

So now what?  It has taken some time, roughly a year and the hope has returned.  Time has given us the opportunity to reflect on what happened and how we can make things better.  We've started the journey again and love an appreciate all those who are on the journey with us.  We'll do more to keep you informed. Stay tuned.