Thursday, July 26, 2012

Male Factor Infertility (MFI) Follow-up

I've already shared with you the basics of male factor infertility (MFI) in an earlier entry (benchmarks, tests, general options), but a recent discovery is worth revising this topic.

According to this article in Scientific America, researches have managed to decode the human genome of a single sex cell. Unlike other cells, sperm and egg cells contain only a single set of chromosomes. This discovery will enable scientists to decode the genetic makeup of your partner's sperm. The hope is that it may finally give some answers to those suffering from "unexplained infertility" and will hopefully become part of the standard testing done during RE visits.

This sequencing of a full genome from a single sex cell, like the sperm (and maybe some day the egg), is expected to become available for infertility lab uses within the next five years. In the meantime, there a few options that are worth mentioning:

  • PICSI: While ICSI is commonly used in fertility clinics, surprisingly PICSI is not as prevalent. In essence, PICSI is a sperm selection method that allows embryologists to select sperm beyond just their appearance (remember morphology and motility of the sperm?) and then be ICSIed (yes, I used it as a verb!). This method entails placing the sperm in a dish that contains Hyaluronan. This is a substance found in the cells around human eggs -- and in other tissues. The theory is that mature and most importantly sperm with good DNA will bind to the Hyaluronan, hence be selected for ICSI. For what it's worth, we used this method at our last IVF cycle at CCRM. 

  • SCSA: This is another test available, perhaps closest to this new discovery, that allows us to find out more about the DNA of the sperm. SCSA (Sperm Chromatic Structure Assay) is a sperm DNA fragmentation test. In other words, it looks to find any "breaks" in the DNA of the sperm, which can be one of the reasons behind recurrent miscarriages -- sperm and egg meet, embryo is formed but quickly dies because of fragmented DNA. Now the question is, is it worth doing this test if ultimately even if the results came back positive for high fragmentation you (a) would continue to try using your partner's sperm, or (b) you would not consider using donor sperm? Those were the questions posed to us when we inquired about it with our RE. There may be value in testing if you are near the end of your rope and need to find closure.
With every discovery we seem to be coming closer to finding some answers for the millions of couples struggling with unexplained infertility and MFI. 

But like technological advances, scientific advances are very quickly replaced with other more promising discoveries. 

Would any of the above sperm selection options give you the closure you would need to stop pursuing infertility treatments if you found out that your partner's sperm just doesn't seem to make the cut?

Friday, July 20, 2012

I'm Still Here...

It's hard to believe that it's been nearly a year since I've blogged. Hard to believe in part because this blog and connecting with all of you has been such an integral part of my life.

We talk a lot of the silence of infertility and not being able to live openly with our truths. But it seems that over the course this past year, I have also failed to speak my truths. So, in order to find my way back into this loving community, I must confess that I went through an experience I never though I would ever go through: I became pregnant, just like that. I'd heard stories of couples trying for years, finally conceiving (or adopting) and then, puff! ... another baby. I'd always shrugged off those stories as fabrications to keep our hopes alive and was infuriated when others (meaning people who'd never experienced infertility) would tell me how so-and-so stopped trying and then they had a baby. Idiots!

Imagine my surprise February 2011 when I found out I was pregnant. The feelings I went through were certainly not what I would have ever expected. I was for the most part flabbergasted. I went about my days trying to analyze how this was making me feel. Happy? No. Over-joyed? No. I suppose I was so convinced that I would never conceive again (we weren't trying, I have one tube, PCOS and MFI) that finding out that there was another being growing inside of me left me dismayed.

I took the next few months (nearly 5!) trying to process that we were going to have another baby. I was thinking of how I would break the news to my circle of women who I'd brought together as part of my peer-led support group. How I would share the news with the rest of you -- readers, bloggers, commenters. After all, this blog is not about my personal journey, it was created to bring you information from the perspective of someone who's made it to the other side. And so, I remained silent {I did obviously come out to my support group}, not wanting to hurt anyone's feelings. Perhaps also fearing that you would not feel safe anymore to share your stories with me because now I had become the "other."

As my due date approached, I decided to finally embrace my baby and needed some time to disconnect from all that was infertility. And then, in early October, my surprise baby girl was born. I have spent the last few months, mostly in complete chaos, caring for my kids, helping my son adjust to his new life as a big brother and move into a new home. It has been hectic, to say the least and yet, it all seems so "normal." It's almost as though I am living someone else's life -- like the infertile-me is looking through the mother-of-two-me in complete awe of how things turned out. So that's how others were living their lives while I was going in for daily blood work and injecting myself with countless drugs just a few years back.

I have not stopped thinking of all of you and quietly checked in with your stories. I cried for those who lost their babies and lots their hope. And jumped for joy at your birth announcements.

I'm not sure if I have any readers left. I do know that my passion for this struggle has no waned in the slightest despite my great blessings. I will continue to write with the hopes that I can help, if only in a small way, those of you who turn to me for guidance and support.

With love,
The Infertility Doula (SM).