Well, 1 day earlier than expected, here are my results:
My specimen tested negative for: Mycoplasma, Aerobes, Yeast, and Trichomonads.
I tested positive for: CT and Anaerobes (under Anaerobes he wrote- "Very heavy actinomyces israelii and very heavy Proprionibacterium granulosum")
Who knew I had Israelis in my crotch?
OK, sorry... I am on the verge of puking, I just had to make a joke before I burst into tears (which I already did when I first read the letter).
Don't get me wrong, I'm definitely happy to be moving forward and getting a treatment plan that will very likely work for us... it's just never fun to hear that you have CT (there are "dirty" connotations with this disease, it doesn't matter if I received it vertically, people will assume I'm a whore).
But I digress. Back to the findings.
DH tested negative for everything except Anaerobes. He found moderate Proprionibacterium acnes in his specimen.
Then, his letter:
Dear Dr. Hilgers:
I appreciate your referring Mr. and Mrs. Blank-Blank to me for a fertility consultation.
Enclosed, you will find the results of the culture studies from 10/09/2008. The most important finding is the presence of CT in Mrs. Blank-Blank’s specimens.
I could not document the presence of CT or any other significant bacterium in Mr. Blank-Blank’s specimen. In a marital situation however we can assume that genital track flora is exchanged, especially CT.
CT can cause infertility, failure in IVF cycles and even if pregnancy takes place a miscarriage readily occurs. Infection with CT can lead to the development of pelvic infections. Lately I am looking at endometriosis as a form of CT caused PID with a significant immune component. Short of any other explanation, women with PCO conditions are born from parents where history makes me suspect a very strong intrauterine infectious vertical possibility. CT is a potent stimulant to the immune system and eventually the immune component becomes the most important issue in infertility. I see endocervical calcification so often with CT infection that in my interpretation they are analogous with the calcifications of the prostate in CT infection. Mrs. Blank-Blank’s cervix has significant calcifications and her ovaries even after the wedge resection show polycystic changes. Her endometrial lining has no structural differentiation
Mr. Blank-Blank’s prostate shows moderate lobular enlargement without change in his urination habits, at least not as of yet. Distinct scarring and calcifications are noted most prominently around the prostatic urethra suggesting causative bacteria entering through the urethra and causing damage in the surrounding structures first before jumping into peripheral zones of the prostate.
The heavily growing anaerobic bacteria recovered from the uterine represent a completely disturbed local flora due to the invading CT.
In my opinion, the Metformin therapy should be complemented with aggressive antibiotic therapy that would give the couple an improved chance. Two issues make me cautious in offering a quick fix of the physical problems and a rapid reversal of the immune issues; if my hunch of a vertical issue is correct, both the eradication of the infection and the reversal of the immune system will take longer and the course is unpredictable.
I am also enclosing a semen analysis report for you, Mr. Blank-Blank. I find all numerical parameters in the good range. The sperm quality will offer a good chance to produce a pregnancy.
Attila Toth, MD.
The SA was the best it's been yet (the only really "good" news). 89 million/mL count!! Motility was a 3 (undulating, rapid progression) and 75%. Morphology I had no idea how to read, but it had numbers in each area, with 79 under "Ovals," 5 under "tapering," 10 under "small," and 6 under "amorphous."
I called the office to see what kind of treatment is needed, and to schedule it. Dr. Toth's recommended treatment for us both is a 10-day IV antibiotic, coupled with 10 days of uterine washes for me (see, I am a dirty whore), and 10 days of prostate injections for DH. We are scheduled to begin November 10th!!!! (Note: Exclamation marks should be read as excitement, fear, hesitation, anxiety, relief, and mania.)
So, I have my answers. Still not sure if we'll be able to TTC again in 2008 (the treatment will make my cycles whacky, I was forewarned). I'm also really concerned about insurance reimbursement. I know the IV is $4,000 alone... I am stuck between a million different emotions right now. I'll be writing more on this later, just wanted to keep you all updated.