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| Click on the image for the novena text. |
The lab didn't do the semen culture on DH's sample. We have to redo the seminal fluid collection. :( :( :(
Here's the story...
Before Dr. K would decide on what treatment we might try next to combat my TEBB, she wanted to have a semen culture done to see if that would identify any other unwanted bugs that may be hanging around. Her nurse mailed us the order (written on a prescription pad) along with the collection kit (unlubricated, perforated condom and a sterile container). If ever you need a kit, you can order one from the PPVI Institute without a doctor's order for $20.
I remember how we did the semen analysis (SA) two years ago. Our city isn't that large, and there is only one clinic in town that does SAs. That clinic requires the man to make an appointment when he will drop off his sample and spend five minutes with the nurse giving his medical history. I called the clinic to make the appointment. The receptionist said they would not accept the paper order I was holding in my hand; she said the clinic had a specific order form that Dr. K would have to fill out and fax to them directly. I hoped that this extra step would ensure that the semen culture would be done because I was a bit worried they would miss that request and just perform the regular SA with counts, morphology, etc. After some back and forth with PPVI, they confirmed that they had faxed the order to the clinic here.
I called the clinic again to make the appointment. Surprisingly the receptionist asked me if DH was going to collect his specimen in the clinic or if he would be bringing it in. I guess we're not the only ones to do the collection at home, although I'm not sure how many people actually use a kit so it can be done through a "normal" act of intercourse. (Using a perforated condom is anything but normal...) The receptionist said we were to abstain for at least two days prior to collection, but no more that four days. (PPVI had told us to abstain for at least four days. I was going to follow PPVI's recommendation over the local clinic's recommendation.) The receptionist also reminded me that the specimen should arrive at the clinic within about 30 minutes and should be kept at body temperature during transportation. The clinic is five minutes away, so we figured this wouldn't be a problem.
We were ten minutes late for the appointment. The collection itself was awful. I was extremely relieved that we had a specimen to take to the clinic. We brought the paper order along that PPVI had originally sent us. I told DH to show it to the nurse and remind her that we needed a culture done. He did that. The nurse said it would be no problem and kept the paper order just in case.
We did the collection post-peak, so I decided to wait until our next cycle review to ask PPVI for the results. (Actually I did call the local clinic to see if we could get the results over the phone like I did two years ago, but the nurse said we had to get the results from Dr. K. Can't blame a girl for trying.) I suppose a little waiting never hurt anyone. ;)
When I received the cycle review e-mail, the nurse said our clinic had not done the culture. She didn't have any results to share with me--not even the sperm count, etc. She said Dr. K had spoken with the medical director at the local clinic to find out 1) why they never told Dr. K they couldn't do a culture since they had her request in their hands (on THEIR form!) far in advance and 2) why they never told DH they couldn't do a culture. The director told Dr. K that their clinic doesn't do semen cultures and that we (meaning DH or me) would have had to have coordinated with the local hospital lab (totally unaffiliated with this clinic) to arrange for the culture to have been done there. How were we to know this? Dr. K was really frustrated. DH and I are really frustrated.
I called the medical director to find out what kind of arrangements would have to be made and whom I should call at the hospital. After a few days of messages left on various voicemails and then some phone tag, the medical director called me back. It was bright and early in the morning when I wasn't exactly awake and fully lucid. (Mornings are not my best time.) He said that in his twenty years as a doctor, he had never heard of anyone ordering a semen culture. He said there's no link between infertility and infection, and a culture wouldn't tell you anything useful. He said he was under the impression that he had talked Dr. K out of ordering a culture.
No, Dr. IVF, you didn't talk her out of it! She, unlike you, actually wants to fix the underlying problem(s) in our infertility. And if you want to be intellectually lazy and not bother to investigate the newest discoveries in the treatment of infertility, that's your business. Thankfully not all doctors think like you. (I did acknowledge to him that the connection between infection/endometritis and infertility is not widely known among mainstream doctors, and he agreed.) I told him that Dr. K had helped couples conceive by treating their infections. I almost told him to look up Dr. Toth online so he could learn about how infection is related to IF. But I realized that I still needed his help if I wanted to have this culture done, so I bit my tongue and limited my comments so as not to antagonize him. I explained that I had symptoms of an on-going infection, so the culture would hopefully help identify the bacteria involved because the endometrial culture I had done was only partially helpful.
He then reluctantly shared the information he had. He had spoken with two different doctors from the hospital's microbiology lab. They have never done a semen culture. I really had no idea that this was an unusual test to order... They are unwilling to do a semen culture because they don't have a protocol to do one (and there were two other reasons that I don't remember because I wasn't really awake). He suggested that I try calling the independent lab in town to see if they could do it. I'm wasn't holding my breath, because if the hospital can't or won't figure out how to do it, the independent lab sounded even less promising. And yeah, after calling them, they won't do it either. :P
The nearest larger city where there might be a chance of getting the culture done is over an hour away. So we'd have to stay overnight in a hotel to make that happen. And that's
if I found a lab who could accommodate this request. The other option would be to try to find a lab in the even-larger city where my parents live and do the collection while visiting them. It's not ideal, obviously, but it seemed more feasible than the hotel option.
I called the big hospital's lab about twenty minutes from my parents' house that I've used for blood draws in the past. The person who answered the phone was quite knowledgeable and was able to confirm rather quickly that their lab could do the culture. I even asked her how they would do it--to double check that she understood what I was asking for. She said they'd treat it like any other "reproductive culture," let it grow on a plate for two days, and identify all bacteria that grew (if any). What was even better was that we could drop off the sample at any time 24/7. No appointment!!! Actually, DH doesn't even have to come along. I can drop off the sample myself (which will be much less conspicuous...no need to explain to my parents where I'm going.) ;) PPVI sent us another kit, so I hope everything works out this time.
After asking again, I did get the results from the first SA that was run locally. All DH's numbers were normal. They were actually better than the numbers from two years ago (which were also normal.) At least one of us has a correctly-functioning reproductive system. Although I told him he probably needs to have super sperm to overcome whatever is wrong on my end, hostile uterus included... ;)
I just wanted to post a reminder that the St. Andrew novena starts today, the feast of St. Andrew. The prayer to the right is prayed 15 times each day from November 30 through Christmas. DH and I usually pray all 15 prayers right before bed during our normal prayer time. I've found it to be a nice way to quiet my mind and really reflect on the birth of Christ as we prepare to celebrate Christmas. Even though it's a short prayer, I find myself focusing on a different phrase each day (like "in piercing cold"), which helps me imagine what it would have been like to be there. I thought the timing this year is perfect because it's also the beginning of Advent, so we'll be praying by candlelight (from the Advent wreath).
