All along we were looking at me...

...when we should've been looking at Aaron.

Right before we reached one year of trying to conceive, we decided for Aaron to have a semen analysis done. We figured that would completely eliminate if he was the cause of us not getting pregnant, and then once we hit the one-year mark, we could start my testing to see what may be causing our infertility.

Aaron's first semen analysis (SA) results were:

• Volume: 5.0 mL (> = 2.0 is normal)
• Count: 79.8 million/mL (> = 20 million/mL is normal)
• Motility (movement): 32% (> = 50% is normal)
• Morphology (shape): 80% (> = 30% is normal)

If you remember reading this post, I had Aaron's first SA faxed to me a couple months ago while we were conjuring up all our medical records for Dr. Weckstein (Dr. W). Up until that point, my OB-GYN had kept saying that the motility is a little below average, but that it should not affect our chances of getting pregnant. So, we kept trying for our baby for another year, thinking Aaron's sperm was good, all the while undergoing every test and treatment (other than IVF) available under the sun (Clomid, HSG, laparoscopy, hysteroscopy, IUI, ultrasounds, sonograms, etc.) for myself.

When I went over Aaron's first SA results with Dr. W a couple months ago, I was absolutely convinced the low-ish sperm movement was what was causing us to not get pregnant, since all my tests had come back absolutely perfect. But, Dr. W reassured me that the motility being below average is not the cause for us not getting pregnant. He said it could be playing a very small role and may be prolonging us getting pregnant a little bit, but there are many couples who get pregnant with a much lower sperm movement percentage. He said it isn't helping us conceive, but it's not hurting us too much either. And then he spoke those words that I'll never forget...

"If it was going to happen, it would've happened by now."

Those words still sting a little.

But now, the words I am replaying over and over in my head are, "I know why you and Aaron are not getting pregnant."

Really??? After 25 months we finally have an answer.

Aaron's second SA gave us the answer. His count is still very, very good. Motility is still in the low range, but not in an unconceivable range, but his morphology! Well...lets just say I learned a new word yesterday.

Teratozoospermia! According to Wikipedia, this is a condition characterized by the presence of sperm with abnormal morphology that affects fertility in males.

*Deep sigh*

So, here it is...99% of Aaron's sperm are abnormally shaped. Only 1% of his sperm are normal. A sperm has to be normal and healthy in order to be strong enough to penetrate an egg.

But still...we only need one sperm of the millions to get pregnant, right??? But Dr. W said the 99% poor sperm make it near impossible for the 1% good sperm to make it to the egg and fertilize.

Questions immediately flooded by mind as my eyes glazed over with tears that I knew would fall once I got off the phone. Here's how I remember our conversation going:

Question: Aaron's first SA results say he has 80% morphology. How could those results be so off?

Answer: The testing that your OB-GYN was not nearly as extensive or detailed, which is why you needed Aaron to have a second one done at our clinic. Infertility clinics have specialists who can identify semen abnormalities that a technician at Quest Diagnostics can't. This is why the count and motility measurements came back similar, but the morphology was way off.

Question: We have Ella! What happened there?

Answer: There is no telling what happened, but it is very likely that Aaron could've had the same SA results in 2005 when you conceived Ella, but you just had a super egg and miraculously a sperm penetrated it. Ella could very much be a miracle baby! (I smiled when he said that).

Question: Is there a chance Aaron had better sperm morphology five years ago (well, technically three, since starting to conceive our second child) and things have just changed?

Answer: Aaron could've had better sperm morphology a few years ago, but there is no way of knowing. Age does play a factor in a couple's reproductivity, but you are still both very young. Couples are "most fertile" in their early twenties, right around the time you two conceived Ella, so perhaps that helped.

Question: What causes poor sperm morphology?

Answer: There's no way to know, but most likely it's genetics, especially since 99% of the sperm are abnormally shaped. I wish there was a way to know, but there isn't.

Question: Aaron and I conceived Ella in the winter in Oregon. Aaron is very much a hot-blooded guy and is always sweating. He's always hot "down there." Could the hot climate we now live in be having a negative effect on his sperm?

Answer: Heat mainly plays a negative role in a man's sperm when their testicles are exposed to heat for a long period of time, such as a marathon bicyclist or a truck driver who sits on a truck's engine for hours on end. This is why hot tubbing or sitting in saunas is not advised. The testicles hang outside the body for the reason of keeping them cool. Sure, the heat could be playing a role in Aaron's sperm quality, but, again, nothing too definite. If it is playing an effect, it's not a very big one.

Question: So, what does all this mean then?

Answer: In order to get pregnant, you will need to have IVF with ICSI. But, now that we know, what I think to be, the cause of your infertility, I have even higher hopes that IVF will work for you guys. You have absolutely nothing wrong with you and if we fertilize some of Aaron's really good sperm with your egg, I'm confident we can make you a baby. (I felt really happy after hearing this, but then reality hit me).

Question: What does this mean if we wish to extend our family beyond this second child?

Answer: Unless you have another miracle baby like Ella (which could clearly happen!), you will most likely need to undergo IVF with ICSI to further your family beyond your second child.

This is when the tears started flowing, so I quickly thanked him for everything and he said he'll be in touch with me next week with the the blood work results determining if Aaron is a Cystic Fibrosis carrier.

It is a lot to take in. Am I happy we have an answer? Yes, partially. Our infertility always had a big question mark stamped all over it. But now, knowing about Aaron's sperm morphology, the question mark moves to our miracle daughter. How did we conceive such a beautiful miracle given this statistic? God is good is why! And, despite the fact that we likely won't be able to conceive naturally on our own again...God is still good.

Longest post in blogging history, I know! And I wanted to tell everyone who is supporting and praying for me...

You all mean more to me than you'll ever know!