Using DS, 1 failed ICSI, 2 failed IUIs... what next?

We decided to do ICSI first with Donor Sperm (DS) sample procured by a bank suggested by MHB in Jayanagar, Bangalore. Out of 6 oocytes frozen in one straw, 5 oocytes survived after thawing process and only 3 fertilized well with DS of my DH’s blood group. All 3 were transferred and none got implanted :-(

Since we had 6 more frozen oocytes, the plan of action was to fertilize 3 oocytes with 1 DS sample of DH’s blood group and last 3 with 1 DS of my blood group and use IUI instead of ICSI.

Unfortunately, none of the 2 IUI cycles succeeded. By then, my body had taken a lot of injections and medicines and the brain was really dissatisfied, hence a break or change was required.

We decided to say Good-Bye to Manipal Hospital Bangalore (MHB) and decide another place to continue our quest. Deciding on whom to consult next in Bangalore seemed next to impossible as MHB was the ONLY last option in Bangalore.

As I had a few relatives in Delhi whom I could trust blindfolded, I chose to stay with them and take my chances in Delhi.

More about it, later.

Choosing and Transporting the Donor Sperm from Bank to Hospital

To simplify things for us and follow the guidelines for themselves, Manipal Hospital (MHB) gave us contact details of a Donor Sperm Bank in Jayanagar (operated in Bangalore, but had nation-wide samples). After speaking to the Bank, we discovered that things shown in the Bollywood Hindi Movie “Vicky Donor” was not fake, if not 100% true. People have huge demands for Donors for both the gametes.

I visited them alone, assuming that it would be little discomforting for DH to go along and ask for Donor Sperms. They had a list of donors and asked me to pick a donor on the basis of their Blood Group, Height, Weight, Complexion of Skin, Eyes and Hair, Build and Education. I selected the sample of my DH’s Blood Group. They had several huge cans (bigger than milk cans used to collect cow milk in the barns) filled with Liquid Nitrogen and Frozen Donor Gametes. Thankfully, the sample I chose were readily available and all they required was a letter from the Doctor stating the reason for purchase and of course, the money. Since our Transfer Date was after more than a month and to be used for ICSI, I told the Bank to block the sample for me. I made a junior doctor at MHB speak to the Sperm Bank to authenticate my request.

The day my ICSI date was finalized (3-Day transfer on 1^st Aug’14), 5 days prior to that I collected the sample (handed over to me in a mini flask with vials submerged in Liquid Nitrogen, hanging inside attached to a strong thread,) along with the Authentication Report (Semen Analysis, HIV, HCV, HBSAG and VDRL reports) and gave it to MHB's Lab for fertilization process. Transportation had to be done delicately; the flask had to be kept 90 degrees perpendicular to the ground. Although I had placed the flask on the co-driver's seat (seat-belt tightly fastened), driving alone with the flask was difficult.

My DH's Computer Assisted Sperm Assessment (CASA) and Semen Analysis Test Reports

Here's a copy of my DH's CASA and Semen Analysis Test Reports for reference.

The first report is of a Computer Assisted Sperm Assessment (CASA) done in Manipal Hospital Bangalore (MHB's) Advanced Andrology Laboratory in the month of Dec'12, which was 2 months prior to my DH's TESE procedure.

The next report is of a simple Semen Analysis test done in a reputed Pathological Clinic in Bangalore. It is evident that the sperm count became NIL after TESE.

My Hysteroscopy Report

After taking medication for a month, my DH got CASA done in Dec' 12. Reports showed 2% Slow Progressive Sperms in Nov as well as in Dec; Total Motility increased from 3% to 4% in Dec; Volume was 0.5ml and Sperm Concentration was 1 million/ml for both the months, but the Percentage of Live Sperms reduced from 14% to 2% after taking medication. Off those 2% Live Sperms, Percentage of Normal Sperms was Zero.

My Hysteroscopy was planned for Dec' 12 itself, and Egg Retrieval (ER) was planned for Feb' 13, so we were asked to continue with his medication and see if it has more effect by then.

I got my Pre-Anaesthesia Check (PAC) done by anaesthetist two days prior to my procedure. Since I was diagnosed of Hypertension in June' 12, they thought of getting an ECG done. MHB is very professional and they check your body thoroughly before performing any procedure. As everything seemed normal, my procedure was given a go-ahead.

Hysteroscopy took place in Dec' 12 and everything was normal and healthy. I was asked to take rest for two months and let the body recover from the internal scratches; ER was re-planned for Mar' 13.

But before my ER, Dr. Vasan S.S. wanted to get good sperms from my DH to perform ICSI in March itself. For that, he repeated CASA test and instructed his lab to freeze the sample obtained from ejaculation instead of performing test, in case good sperms were observed. Our bad, no sperms were retrieved :-(

Decided to go with ART at Manipal Hospital

After running from pillar to post, visiting so many doctors within a month's time, we zeroed in on Manipal Hospital Bangalore (MHB) with high hopes. Actually, we heard about MHB on radio while driving on one of the "doctor hopping" days. They had a dedicated ART/ IVF Dept and talked about good success rates; plus they had Dr. Bina Vasan & Dr. Vasan S.S., Urologist-Andrologist as their Team Lead.

We first met with the Uro-Andrologist in Nov' 12 to discuss my DH's Severe Oligospermia and Bilateral Varicocele Grade III and see if his suggestion was any different. He gave us enough time to understand all the reports and our fears, then prescribed two medicines for one month time period, namely Paternia and Wysolone to boost the sperm production. He asked us to do a Semen Analysis (SA) test before starting the medicines and come back with a fresh SA test after taking a month's dose. He also asked us to discuss the way forward with his wife, Dr. Bina Vasan, ART Specialist.

We met Dr. Bina Vasan, asked about the IVF procedures, their costs, etc. We were given in-depth information about all of it by her Assistant, Dr. Manju Nair. As a norm, MHB asks all their new ART patients to do expensive tests of HIV, HCV, HBsAg, VDRL and ELISA for both the partners before going ahead with any treatment. In the next consultation, they wrote down few more tests like Inhibin B and CASA for the male partner and a procedure called Hysteroscopy for the female partner. 

After meeting the doctor couple, our dimming hopes got new flight. We felt that we are in safe hands, and this might be the positivity that we were looking for. Their enthusiasm and involvement gave us confidence.

DH reports of SA in Nov'12, were just the same as conducted in Sep and Oct' 12 in the previous few "doctor hopping" visits (all of them were reputed clinics, so scope of error wasn't much) although done in different lab. 

They planned my hysteroscopy procedure in Dec' 12. Later, many doctors confirmed that conducting a hysteroscopy even before starting with an ART treatment isn't the best thing to do; makes more sense to be done after a few failed IUI/IVF attempts.

More about hysteroscopy and our journey in my next post.