Plan, Shman.

I joined J for his urologist appointment yesterday. This was a follow-up after having his first consultation and additional testing.

First, the blood work was perfectly normal, and there are no hormonal issues to worry about. Good news!

Second, the ultrasound showed a minor vericocele (a varicose vein) on the left side. It’s not severe enough to warrant surgery based on the other results. Ok news.

Third (the other results), the repeat SA showed a count of 23 million and motility of 85%! Normal count and motility - light years away from the previous results. Excellent news! (The first SA was, I found out several days after the results came in, incomplete. Meaning J missed the target a bit, and the entire sample didn’t make it into the cup.)

The not-so excellent part of the results was the morphology. It was done using Kruger’s criteria, a stricter, more conservative, method. Out of 200 sperm analyzed, 0 were normal.

But the urologist emphasized that morphology is not clearly associated with fertility. As currently performed, it’s a subjective measure, and it hasn’t been demonstrated to correlate with function (i.e. fertilization). So while it’s measured, and could potentially impact fertility, it’s an unreliable test at best.

The urologist said that if I was perfectly healthy with no fertility issues, he would see no reason not to recommend continuing to try naturally. But since I have the endometriosis and the tubal issue to deal with, I need to consult my RE again with this new information. I just went back on the pill (b/c we thought J had sperm issues to overcome, and because my cramps have become unbearable). I am going to discuss surgery for the hydrosalpinx and the endo with my RE. We may not be able to make a decision about trying naturally vs. IVF until she gets a better picture (literally) during the surgery.

The other good news is that J was able to add me as a domestic partner with his company for the purposes of health benefits, and it is effective immediately. This means that I can take advantage of the limited IVF coverage available through his plan. We just hope that it remains covered next year, as well, since we may not do IVF until then. (if at all!).