My Lazy Ovaries

In Which I Apologize

2012-03-03T11:28:00.000-05:00

For not posting more often and in greater detail about the mental contortions I am going through in the process of considering donor egg IVF versus choosing a childfree future. I feel like there are so few of us in this community who reach this branch in the road, that I ought to do a better job of representing the experience. Suffice it to say that things are difficult to articulate. And all very repetitive at any rate.

However.

My BFF came for a visit at the end of February. We hadn't seen each other in over a year and it was wonderful. I had been a little nervous because she told me last Fall that she and her husband were going to start TTC#2 in December and I was dreading a surprise announcement. To be honest, I wonder if they are trying again so soon after their first because of what she's seen me go through. She is only a couple of years younger than I am and she's no dummy. I was worrying needlessly.

We went to breakfast her first morning here and had long heart to heart about where we are/aren't with treatments and I gave her a quick rundown of the realities of donor egg IVF and some background on our consideration of a childfree future. As always she was interested, respectful and supportive. We also talked a lot about her experiences as a first time mother, all cards on the table. She didn't have it easy and unfortunately, she didn't have anyone nearby to provide a reality check, so it was probably harder on her than it needed to be. I feel sad about that... only that I couldn't be that supportive outside observer because I wasn't there day-to-day.

Her second morning here, we were sitting at the dining room table with our morning coffee and chatting. She took a deep breath and told me she'd been laying in bed thinking while she waited for me to wake up. She had decided that she wanted to talk to her husband about donating her eggs to us after she was done with Baby #2... if we would want them.

I almost fell off my chair.

I suspect my immediate response was a little lackluster, if only due to the shock. How fucking cool is THAT?! Realistically, it will probably not be feasible. But damn, she's awesome. I've talked to Prof about it and he is open to the idea, so why not feasible? Well, she is already 37 and she still wants to get Baby #2 first. That could put her at my current age before she's ready to start. Her husband may not be OK with it and that's totally his prerogative. Since we aren't blood relatives, there might be actual medical/biological impediments - I have no idea. My clinic might not go for it for any number of reasons.

But she had the idea. All on her own. She was already like the sister I never had. If I got pregnant using her eggs, we would be even more like family than we already are. It would amazing.

You know what? Even if I don't get pregnant using her eggs... it's still amazing.

How Do You Say...?

2012-02-26T15:36:00.000-05:00

It was only meant to be a quick tweet to let @IVFandMe know that I was feeling the same way she was. I'll be honest... since stopping treatment, I've filtered the number of Twitter accounts I normally see in my feed to about 15. I just can't handle any more than that. So, I forgot how many Twitter followers we had in common and suddenly we're in the middle of a whole discussion and I am reminded that once our words leave us, they are open to interpretation. Don't get me wrong, no one was upset. They were all trying to be supportive and encouraging, but the thing that startled me was just how frustrated I felt when I realized that only a few of the tweeps who joined the conversation appeared to actually understand where the original comment was coming from. And to be fair, perhaps that was just MY misinterpretation.

But it only served to highlight the point I was making in the first place.

I have reached a place where I'm not sure how I fit in amongst my IF friends. Like @IVFandMe said: Still infertile but no longer trying, no more treatments, no foster/adoption, no baby loss from which to recover. Facing the rest of my life stretched out in front of me childfree by circumstance. I am by no means alone, but let's face it. MOST of us in the IF community end up with a child one way or another. I feel bad that I have a hard time providing much support to the rest of you because I'm still working so hard to wrap my mind around my current reality and I don't know when it's going to get any easier.

I hate to come across as ungrateful for the support, but I'm not looking for sunshine and platitudes. Don't worry, I don't feel like I "gave up" and I know that even those of us who go on to hold our babies remain infertile at heart. I know I'm not alone. But the struggle I am facing right now is entirely in my head and I'm the only one that can fight it. I definitely feel like the odd man out and I'm having trouble seeing much point to being here.

Overworking It

2012-01-25T09:00:00.000-05:00

We have officially had too much time to think about this, and we're not done yet.

Our debate between Donor Egg IVF and living child-free is not centered around our comfort with using a donor. It is centered on whether or not we want to be parents.

Let me be clear, we are both uncertain. As in nearly all things, we are in complete agreement, on the the same page (even the same sentence). Our synchronicity is alarming, and not a little counterproductive at this point. This is not a situation where one of us wants to move one way and the other is pulling in a different direction. We are standing together at this intersection, hand in hand, and scared to move for fear of getting it wrong. I mean, the scenery at this particular intersection isn't that bad and the traffic is manageable...

My thoughts, feelings and desires fluctuate wildly by the hour. I am not exaggerating. If we stop now, say no to donor eggs and proceed child-free... are we robbing ourselves of a beautiful future or saving ourselves a lifetime of heartache? There are so very many things that could go wrong, and at any number of points in pregnancy or childhood. Admittedly, most people never have to confront these nightmares in person. But let's face it, we've had it rammed home again and again and again over the last three years... We are NOT Most People. God knows there are no guarantees that "overcoming infertility" means living happily ever after.

First thing in the morning, when I've just woken up but am still exhausted from a crappy night's sleep and I'm already running late only ten minutes into my day, I think there's no way I would survive parenthood with my soul intact. Same thing goes for Saturday afternoon and there are more household chores than I have energy to tackle with Prof tied to his desk working against a deadline, much less the thought of childcare. I can't even keep the dust bunnies out of my own bedroom, I'm not fit to be someone's mother.

Child-free is the path of least resistance. It is the default future should we fail to act. Is it somehow more acceptable if we didn't necessarily "choose" that future? If someone came to us and told us we had reached the end of our road and we would not be able to have children no matter what, we would be fine. It would be a relief to be off the hook and able to walk confidently into the future. Sometimes I feel like I'm focusing on the crappy parts of parenthood, just so I can convince myself it's OK not to want it, to make it hurt less to not have it.

On the other hand, when I get a moment to pause in my day and note some of the more amazing things in the world (like fireflies and spring blossoms and the first snow of the season), I think how incredible to see all of those things again through the eyes of child. When Prof starts rattling on about something science-y, as he is wont to do, I think what fun he would have explaining our world to a little one. When BFF(B)'s youngest comes running full speed to where we are chatting in her kitchen, just to ask for a hug before tearing back to the living room to play again...

If we had conceived on our own shortly after ditching the birth control, we would have been nervous but thrilled. And we would have rolled confidently into that future, certain that there was nothing we couldn't handle together. There are times when I imagine our possible child and I feel like my heart (my literal heart, not my mind or my soul) is swelling to the bursting point with pain because I might never meet him/her. It's an uncontrollable, physical pain that brings tears to my eyes no matter where I happen to be.

Infertility has stolen our innocence, our dreams, our confidence. It has also given us a bond even stronger than we imagined we could have, it has made us thrive as a team in ways we should be proud of.

One of our primary fears for a successful pregnancy is what effect it will have on our relationship. And before you ask, yes of course we considered that before we ever threw away the birth control. But this is what infertility does to you. It makes you question every little thing in much greater detail than you ever have before, in a constantly repeating loop. Our marriage, our relationship, is so incredible, even after infertility. If we can grow closer and stronger through all of this, why should it be any other way with parenthood?

The whole genetic link factor really doesn't matter to me (I suppose I should say MY genetics... I want Prof's genes represented). I see donor egg as something like baking a cake. Except at the last minute, I have realized I'm out of eggs and have to pop over to a neighbor's house to ask for a few of hers. It's still my recipe, I'm still the one baking the cake, I still get to call the end product my own. One of my personal fears, and it's not a small one, is what if my DE teenager decides I'm not their "real mom"? What if they decide they need to try to locate that "real mom", difficult though that would be with an anonymous donor? What if, in my child's eyes, those genetics end up being really important? I feel like this is just the merest tip of the iceberg that adoptive couples face.

*Light Bulb* Any good books on adoption that might help me process this particular fear?

Are you now as confused as I am?

Obligatory New Year Post

2012-01-08T13:24:00.000-05:00

I hate New Year's Resolutions. I feel strongly that any project worth committing to shouldn't need a special calendar date to launch, and most resolutions just end up making us feel like failures anyways. With that in mind, for the first year in I don't know how long, I have decided to make a few resolutions of my own. These should be fairly easy to keep, they will make my little world a better place and if I slip up... I won't have to feel TOO bad. In 2012, I am committing to:

Talk to my parents every Sunday.
Send my Grandma a card and a photo at least once per month.
Take at least one photo of Prof and myself per month.
Get myself a new job title, one way or another.

There. I've written it down. Now I just have to do it.

Issues, I Haz Them

2011-12-18T22:51:00.000-05:00

On Twitter a few days ago, I likened myself to a spoiled brat of a three year old, stomping my feet and wailing "Why meeee? Not Faaaair!"

And that terribly mature thought brought me up against a hard wall of realization. This may well be the first time in my life I that haven't been able to achieve what I set out to do by dint of hard work and perseverance... perhaps the first time I've needed to confront my motivations and the true strength of my desires.

Am I using my fears and ambivalence about parenthood to paint a child-free future into a rosier picture, just so that I can tell myself it was what I really wanted all along? Is it any wonder that I now doubt myself and my ability to be a good parent, faced with the first major failure of my life?

Nothing Owed

2011-12-07T10:30:00.000-05:00

Thanksgiving was hard.

Our parents came to visit for a few days to celebrate the holiday with us. Keep in mind that they don't know we are TTC or that we have been doing treaments. Over the years, it has become clear that they have decided that we just don't want kids. They no longer press us about grandchildren, but the subject does come up in their conversations. Not so much that they want grandkids, more the acknowledgement that there won't be any. They don't even say anything to us directly, they just mention it between them in our hearing. So there was that.

And then there was a phone call that I overheard. I don't know if my Dad even knew I could hear him from the other room. The comment I heard was:

"He said, 'Doesn't she know she OWES you a grandchild?" And I said 'She doesn't OWE me ANYTHING... that's bullshit!'" Blah, blah, blah... at which point I kind of wanted to vomit. I was so proud of my Dad, even through the red haze of outrage that he was having to field those kinds of comments. Better him than me I suppose.

I laid in bed for hours that night, with those words running round and round through my head. The arrogance and ignorance behind them is appalling. I am still incredibly angry. I don't know who said that to him, and I won't ask. If it was a close friend or family member, I prefer not to destroy my relationship with them over that knowledge. BUT. God forbid they use those words in my presence, I will not be held responsible for my reaction and it will not be pretty.

If someone were to (or has) said this to you, how would (did) you respond? How did you wish you had responded?

WTF (do we do now)?

2011-12-03T13:34:00.001-05:00

We had our WTF follow-up for the most recent failed (un)IVF cycle earlier this week. There is no more tweaking the protocol. We've tried both agonist and antagonist with the maximum dose of stimulation and DHEA to boot. The upshot is we've thrown everything we can at my ovaries and they simply failed to respond. My ovaries are cut from the team. My overwhelming feeling about this is relief.

The RE was very kind but clear. We won't be doing another cycle with my ovaries. He laid out the standard next-step options (donor eggs, foster/adoption, childfree) and gave us some information on our clinic's DE program. He let us know that if we wanted to go with DE, there is no need to hurry. The clock is effectively stopped as far as success rates go. You might even say, the clock would be wound back in time.

Prof and I have discussed all of these possibilities in the abstract over the last year, and we are in agreement that foster/adoption are not right for us. Our decision now is between donor egg and childfree. There are pros and cons to both and we will need some time to work through our feelings about them before we know which way we want to move.

I also had my first meeting with the infertility therapist this week. It was really just a get-to-know-you sort of session, background stuff, but I liked her and I hope that she will be able to help us find our way through the decision making process in front of us.

We have some thinking to do, some decisions to make.

I am OK. We are OK. We will BE OK.

POAS

2011-11-09T19:52:00.000-05:00

When we embarked on the IVF process last Spring, I decided that I would pee on a stick every day from transfer to beta, just to watch how the lines would change from one day to the next over the two week wait. So I invested in a 25pk of cheapie early detection tests from Amazon.

Since we finally managed a cycle that DIDN'T get cancelled (even if it did get converted), and since I had a feeling that I was ready to stop treatment and plan my childfree future, I decided this was my chance to pee on those sticks. For posterity, the results were as follows.

7dpIUI = BFN
8dpIUI = BFN
9dpIUI = BFN
10dpIUI = BFN... 30 minutes later, one last look. Is that a line? Hard to say... maybe.
11dpIUI = BFN... Perfectly clear.
12dpIUI = BFN
13dpIUI = BFN

Last night, I started cramping and shortly thereafter, bleeding. Even though I was still on Crinone. Ah well. Beta this morning came back negative. Obviously, this was NOT a surprise.

We have our WTF appointment after Thanksgiving. I don't know if we will continue treatment. That will depend to some degree on what kind of explanations and change of protocol the RE presents at our WTF. I'm approaching 40 years old and my ovaries are apparently done. We've talked about donor eggs, but realistically I don't think we can afford it and we don't know anyone who we would feel comfortable asking to be a known donor.

I will also be meeting with a psychologist who specializes in infertility related therapy. To say I am conflicted would be putting it mildly. Most days, I just want to walk away and get on with my life, childfree. I'm so tired of being indefinitely "on hold". I want my body, my paycheck and my LIFE back. Believe it or not, I can actually see a number of positives to this path. Then there are moments when some tiny thing brings my future crumbling down around my ears in a flurry of memories I will never get a chance to create. A photo of a friend's three year old dressed up for Halloween, the new set of Christmas lights we just bought, a birth announcement for a baby with our favorite boy or girl name.

I do realize that if we go the donor egg route, we could take some time off to save up. However. That would effectively still be keeping us "on hold" and in the IF game, and even if we bypass my very tired ovaries, any resulting pregnancy would still be high risk due to my age alone.

We have a lot to think about, a lot to discuss.

My Trench is Taking on Water

2011-10-29T12:05:00.000-04:00

This is probably more of a post for my peeps still in trenches with me, as it were. I kind of feel like not only am I still in the trenches, but my trench is filling with water and I'm drowning in this hole I've dug myself. Those of you currently pregnant or parenting are surely drowning in a nearby though totally separate trench and I hope you understand that I'm not actually asking anything of you here and I'm not trying to hurt your feelings. I'm also fairly certain I've seen others write posts just like this before. I'm feeling a little derivative, but this is where I'm at. I know I'm not alone, not the first infertile to visit this space. That's really what will make me hit publish. So that maybe someone else will see they are not alone.

I know "Once infertile, always infertile", but my Twitter timeline and my blog reader have made a significant and painful shift recently. Huge numbers of the internet friends I made when I first stumbled into this community have now crossed over to the pregnancy/parenting side of things. Most days, it feels like all I see is pregnancy plans and questions with a healthy dose of nursing/diaper habits. It's really starting to get me down. Like Thinking-of-Seeking-Therapy Down. Even my online support group is becoming just another reminder of the ways my body is failing and the dreams I can't seem to fulfill. I am feeling worse and worse by the day about my chances of completing an IVF cycle, to say nothing of a take-home baby. Hell, with the failure of this most recent attempt at an IVF cycle, I'm even feeling jealous of those of you who just make it to retrieval. Relieved for you, but jealous all the same.

My initial instinct is to unfollow out of self-preservation and it may yet come to that, but I don't really want to lose my connection to these women. They are still infertile, they have been supportive, they have been where I am (and where I hope to be) and they have feelings too. I don't want to hurt them by disappearing.

For those of you who have written this post before me, how did you handle this?

IVF The Remix (Conversion)

2011-10-25T12:00:00.000-04:00

For those of you not on Twitter, my Monday morning monitoring revealed only TWO viable follicles at 22mm each and estradiol holding steady below 200. Basically, fuck all.

My clinic has a 4 follicle minimum for IVF retrieval, so they recommended to convert to IUI. When I explained the situation with my FSA money, they gave me the option to move forward with IVF if I really wanted to. But. The success rate for IVF with two follicles versus IUI with two follicles is the same. Obviously, IVF comes with some risks that IUI does not have. It is surgery and there is no guarantee that they will actually collect the eggs.

There is no chance of another IVF cycle this calendar year. I called the FSA administrator and they confirmed that if the procedure is not performed before December 31, 2011, I WILL lose the money in my FSA. So we are now poring over the eligible expenses list to see what we can use the balance to purchase.

This was our choice. And we chose the IUI. As badly as I want to close the book on this process and as heartbreaking as it is to essentially get cancelled again... this feels like the right decision. Silver lining: No PIO and we get to have sex as soon as the IUI is done.

Not-Penny's Baby Shower

2011-10-24T16:00:00.000-04:00

Today is Elphaba's virtual baby shower. Everybody say "Hi" to our guest of honor and our lovely hostess Mo... Now grab yourself a drink (punch or tequila, as you please) and a tasty treat and plop your butt on the couch with the rest of us Infertiles while we celebrate one of our own as she prepares to cross the Finish Line!

According to our hostess, I'm supposed to write a little bit about what Elphaba's pregnancy has meant to me, but I'll admit to feeling slightly inarticulate just now. I've been excited for her, worried for her, relieved for her, proud of her, impressed by her (and worried for her and relieved for her again) and finally... insanely jealous of that amazing Canadian maternity leave. I will probably never be as eloquent as Elphaba, but I sincerely hope that someday, I get the chance to be as cute and feisty a pregnant lady as she is!

Elphie, I hope that these gifts will bestow upon you some peace and quiet (and a touch of sanity) here and there:

Binky Clip by ThePoshTots

Miracle Blanket

Obviously, since I'm still battling Primary Infertility, I don't have any significant personal experience with newborns. I do however, have scads of fertile friends, and they tell me these two items are life savers. So here's to Elphaba and Mr. M and Baby Girl Yolk. She will always be "Penny" in my mind!

IVF The Remix (Update #3)

2011-10-23T18:54:00.000-04:00

So yesterday sucked. That about covers it. For those of you who are playing along at home and require more in depth analysis of the game thus far...

Saturday AM monitoring revealed:

Lining: 7.2mm (Really? How did it get thinner?)
Estrogen: dropped to 164 (drop ascribed to Ganirelix)
Left ovary: 2 follicles at 14-15mm, 5 follicles at 7-8mm
Right ovary: 2 follicles at 13-14mm, 3 follicles at 5mm

This is very disappointing. Even the RE seemed a little bummed by these numbers. I'm stimming more slowly than anticipated given the total lack of suppression with this cycle and the 4 months of preparatory DHEA. We're basically looking at four follicles of viable size. Yes, there are several little ones hanging back. Yes, I know "it only takes one". But. The doctor basically dismissed the 5-8mm follicles as not viable and that abysmal AMH level from last year is haunting me. I just don't have many eggs left, and apparently all the gonadotropins in the world aren't enough to really get my ovaries in gear.

They've upped my Menopur dose to 225. Still at 300 for GonalF. And FYI, Ganirelix has a sneaky afterburn to it. At least the Menopur headaches have gone. Look at me finding a silver lining.

IVF The Remix (Progress Report)

2011-10-20T21:32:00.001-04:00

FIRST THINGS FIRST: Thank you all so much for all of your lovely comments in the last few weeks. You kept me from drowning in my own misery. At this point I'm doing pretty good to string a complete sentence together, but I need you to know how much I've appreciated your thoughts and words.

As I knew it would be, work is totally insane right now, so this is just a quick update on my monitoring this morning.

Lining 7.4mm
Estradiol: 371
Left: 11mm, 13mm, 9mm, 7mm
Right: 12mm, 12mm, 6mm

We lost a couple off the right ovary and progress is slow but steady. My dosage remains at 300 GonalF + 150 Menopur. I start Ganirelix Friday night to prevent ovulation and go in for another monitoring on Saturday morning before I go to work. For a 14 hour day. Hold me.

I'll check back in on Sunday.

IVF The Remix (First Peek Inside)

2011-10-19T11:00:00.000-04:00

For my own records as much as anything else. After three days of shots (300 GonalF + 150 Menopur), the first monitoring appointment revealed:

Left Ovary: 4 follicles (9mm, 10mm, 7mm, 6mm)
Right Ovary: 5 follicles (10mm, 10mm, 6mm, 6mm, 8mm)
Estradiol: 141

The dosage remains the same and we recheck on Thursday. For the sake of comparison, I looked back at IVF Cycle of Fail and we now have double the number of follicles with half of of those at larger sizes than last time. The nurse was pleased with this progress, so I suppose I shall be as well.

Beats the crap out getting cancelled!

The Knowing

2011-10-18T11:30:00.000-04:00

My RE's office is in a building that is dedicated solely to providers of women's health services. It is usually bustling with activity... patients and their loved ones, doctors and staff and those ubiquitous pharma reps. My midwife is in the same building, as is the breast imaging center where I've gone for mammograms in the past. I've lost count of the number of times I've visited this building over the last ten years.

But. My RE is the only provider in the building that sees patients on the weekend. In a town with limited options for infertility treatment, I'm pretty certain at least a couple of you have been to my RE. I've seen regular blog hits originating not only in my town, but in nearby smaller towns as well.

When I walk through the building on a Saturday morning and see only a handful of others (almost always couples on the weekends), all heading to or from the same door as I am, I know. We all know. The atmosphere in the building is just a little more relaxed, a little more open. People's voices are not quite as hushed as they are on weekdays. Because we all know why we're there and we're all there for the same reason. And I always wonder if I'm looking across the waiting room at someone who reads this blog, or whose blog I read myself.

That curly headed girl whose face lit up when she spied the pumpkin spice K-cups at the coffee station in the waiting room last weekend? That was me.

IVF The Remix - May I Vomit Now Please?

2011-10-15T12:13:00.001-04:00

I went in first thing this morning to get my blood levels rechecked. Just got the call. My progesterone dropped and my estradiol was right on target.

I start stims tonight for IVF The Remix: 300 GonalF & 150 Menopur. First monitoring on Tuesday.

Seriously. I may vomit.

Once More, With Feeling! (UPDATED)

2011-10-12T22:17:00.001-04:00

I called it at about 12:30 this afternoon. CD1.

Baseline appointment will be tomorrow (Thursday) just after lunch. Since the appointment is so late in the day, I probably won't get a call with my blood work results till Friday morning.

Deep breaths.

UPDATED: Same song, second verse... lovely ovaries aaaaaaaannd elevated progesterone. Retest on Saturday, but I've already given up hope. Fuck.

Is It Time to Panic Yet? (UPDATED)

2011-10-08T12:38:00.000-04:00

I have a sneaky feeling I'm fucked.

iPhone says CD1 should be Monday and I'm just now starting to get some mild cramping and backache and acne. Just like last cycle (with the wonky progesterone levels), there are a few PMS symptoms that are missing. I have been running through various scenarios in my head surrounding the beginning of IVF The Remix, and none of them are particularly good. At this point, the only possible start date that won't end badly is if my CD1 is about a week late.* Not beyond the realm of reason, but not bloody likely either.

So this is sort of like one of those "choose your own ending" stories, but much more expensive. Here are the most plausible story lines I've worked out.

OPTION ONE: If CD1 shows up between now and next Saturday, and we get the all-clear to start stims, we are nearly guaranteed that retrieval will occur around the 21st-22nd. This is, naturally, the absolute most important two days in my entire work year. Roughly equivalent to the convenience of having retrieval on Christmas morning. Please believe that I am not exaggerating.

OPTION TWO: If CD1 shows up between now and next Saturday, and we do NOT get the all-clear to stim due to a repeat of last cycle's weird blood levels, I will probably be put on BCP for suppression. This would lead to a stim cycle with retrieval likely the week of Thanksgiving, when we have family staying in our house for the holiday. Oh joy.

In this eventuality, if we start stims but do not get to retrieval... we will not be permitted to try again in December. Which means I will lose the $5,000 still sitting in my FSA for this purpose. A not-insignificant chunk of my already small salary that I have worked for and would be forced to forfeit. This would also mean another year of maxing out my FSA (and the consequential tiny paychecks).

OPTION THREE: If we are stuck with Option Two and do not get the all-clear to start, then there remains a very slim chance that we could roll with an early December cycle. But really? If it reaches that point, I have absolutely no faith that anything might go our way.

Can you tell I've given this a little thought?

*I realize there is one last option, but we're not going to discuss that here. Seriously, please don't even bring it up. I will flip my shit.

UPDATED: In response to the first comment, because my IVF meds are covered in exchange for my final, un-used, covered IUI cycle and I've already met my co-insurance for the year... any meds I order before the end of the year will be covered at 100%. While this is lovely, it means that none of that will come from my FSA. And I have already paid the remainder of the IVF cycle in full, but the insurance (and thus the FSA) don't process any claims until the procedure is actually performed. So yeah, if IVF doesn't happen before December 31, 2011, that FSA balance is forfeit.

Dream Vacation

2011-10-05T09:00:00.000-04:00

It's been quite a week in my dream life.

Last night, I dreamed that our fertility clinic was in Paris. Every time we had an appointment, we would fly over and book into the Ritz for the night. As you do. The coffee was amazing. And every time the front desk clerk gave me the bill for our stay, I exclaimed "Really? That's all? It's so reasonable..."

That doesn't take much thought to interpret. I'm starting to get the message that the cost of treatment is weighing heavily on me. What do you think?

Sabotage

2011-10-02T14:04:00.000-04:00

Realization: I've been poking tiny holes in my chances of success with IVF.

I've been slacking on my efforts to be healthy in preparation. Nothing major. A glass of wine here and there. Not as much exercise as I should be getting and I still haven't dropped the last ten pounds to get me into the "Healthy" BMI range. I'm having a cup of coffee almost every day (granted, most days it's decaf *ptooie*). Prof hasn't been taking his vitamins and I haven't been pushing him to remember.

Yeah, I'm taking my prenatals and my DHEA. I'm doing my acupuncture. But I'm also letting a lot of little things slide. I admit, I'm sick and tired of staying on top of all these details. I'm starting to wonder if I'm setting myself up with excuses for what I see is the inevitable failure of this yet-to-begin cycle.

In My Dreams

2011-09-29T10:00:00.000-04:00

As promised on Twitter...

I've been having some trouble getting to sleep lately (hmmm... wonder why) and the last couple of nights, I've added nightmares into the mix. Suffice it to say I'm getting a little wacky with the lack of sleep. Anyhoo, I woke up from this particular dream very distressed and was unable to get back to sleep. It took me a good twenty-four hours of subconscious "chewing" before I had one of those ubiquitous Ah-HA moments. I'm not sure Freudian is the right word, but for what it's worth, this is for all you dream enthusiasts:

The backdrop is present day reality, and the Professor and I are due to start our IVF cycle in a week. The dream starts out moments after I've had unprotected sex with a drug dealer. Yeah, I know. He wasn't anyone familiar, just a generic composite of a vaguely nerdy guy. So I'm trying to talk to this guy and freaking out about this unbelievable thing I've done, terrified I might get pregnant, terrified I might wind up with some horrible disease. I grab my purse to go home and confess to Prof, and when I look inside it, my wallet has been stolen.

Like I said, it took me a good twenty-four hours to "get" it and when I did, I laughed out loud. Need me to spell it out?

Drug Dealer = Medical Establishment
Unprotected Sex =Infertility Treatments
My Fears = My Fears
Stolen Wallet = Cost of Treatment

Not a Happy Thought

2011-09-26T10:30:00.000-04:00

I'm in a particularly morbid place right now, so I understand if you want to skip this one. I just needed to get these thoughts out of my head and into the light. I've been doing a lot of thinking about what happens in the event of a positive beta. One unfortunate side effect of infertility is the all the extra time we spend thinking about what might happen when we finally get what we want. I'll tell you right now, I don't have answers. Only in an infertile's mind does this potential outcome spiral into a nightmare of epic proportions.

I'm putting the cart before the horse and wondering, if we do get a pregnancy out of this IVF (assuming we ever get to complete this IVF), how long do we wait to tell our friends and family? It seems like such a mundane question. Until I start to play out various possible scenarios in my mind.

Your average fertile couple seems to be sharing photos of the positive HPT within days. Cautious fertiles deem ten weeks to be the safe zone for sharing. This is clearly out of the question, but then, how long do we wait? Most of my IF tweeps seem to settle around the end of the first trimester, which seems... almost long enough. Until I consider all the things that could go wrong for a woman my age at any of the critical "seeing shit more clearly" appointments that seem to occur between 15-20 weeks. And the incompetent cervixes that seem to fail between 20-23 weeks.

And suddenly I realize, this is getting ridiculous. If I waited even as late as twenty weeks to tell, my family would be furious that I hadn't told sooner. So obviously, I would have to come clean before I felt safe. Cue epiphany.

If there's one thing I've learned from my involvement in this community in the last three years, it's that we are NEVER out of the woods. There will never be a point when we know everything will be OK. There may perhaps come a time when the fear abates, when we manage to relax or even forget about mortality for a while. Or maybe not. I'm one of those people who believes that the moment you get complacent and stop worrying about something is the moment things will go wrong. I have been told that I worry too much, that this simply isn't logical, but I'm wired this way. I don't know how to turn this off.

No parent should ever have to bury their child, but it happens all too often. As a child, one of my friends lost her little brother in a freak playground accident. As a teenager, I lost one friend to cancer and another to a car accident. In my twenties, I lost a friend to an overdose. In my thirties, a family member lost her five year old and the doctors never even found a reason. They all died too young and they all had mothers and fathers who will carry that loss for the rest of their lives.

This year, my thirty year old cousin buried her two year old son, and my eighty-nine year old aunt buried her fifty-eight year old son. We are never out of the woods.

If you made it all the way to the end of this post, I kinda feel like I should buy you a drink, or at least a cookie. I did warn you.

IVF Remix

2011-09-24T12:01:00.000-04:00

So, in the wake of my second cancellation... no change of plan.

I call with CD1 for another baseline.

Based on the series of progesterone levels they took, the clinic believes I ovulated maybe the day before I got my period last week. They tried to tell me that it was "dysfunctional uterine bleeding" and not a period, but I'm not buying that. They think I'll get my period next week. I'm betting on early in the second week of October, because that would be the absolute worst possible timing for me to be out of work for retrieval later that month (and right on schedule according to my iPhone).

Any takers?

Limbo

2011-09-19T09:00:00.000-04:00

Merriam-Webster's second definition (after the Roman Catholic meaning):

lim·bo

noun \ˈlim-(ˌ)bō\

2 a : a place or state of restraint or confinement

b : a place or state of neglect or oblivion

c : an intermediate or transitional place or state

d : a state of uncertainty

I'd say that about covers it.

Cancelled

2011-09-17T15:50:00.002-04:00

Again.

Before I even got started.

Progesterone levels are still going up. Recheck on Tuesday to try and get a better idea of what's going on. Looks like I'll have to do BCP with my NEXT CD1 and then try again. The timing really can't get much worse.

IVF The Do-Over, Please Hold

2011-09-16T13:10:00.000-04:00

Yesterday was CD1 as expected.

Yesterday I was home sick from work with a cold.

Yesterday we had a plumber in first thing to make some updates in our basement before we start our post-flood renovations. No water in the house for several hours.

I called to report to the RE right after breakfast, and they wanted me to be there for a 2pm baseline. Exactly what I wanted to do in my unshowered, snot-filled haze. I was also a little concerned that they might cancel the cycle due to excessive snot, but apparently, as long your excessive snot isn't overheated with a fever, you're OK.

The RE Himself did the scan and the ovaries look quiet. Just a few tiny follicles on the left gearing up... or perhaps I should hope they were actually settling down.

Today I am still home sick from work.

Today I missed the call with my blood results.

Turns out my progesterone is elevated. I gather from the rambling message the nurse left that this is a problem. So now I get to worry all day today that this cycle will be cancelled before it even starts and then I go in early tomorrow (Saturday, day of rest and my dreaded birthday) to have the progesterone rechecked before I can (please, please, please) start stimming Saturday night.

Thus, I am hoping those little follicles were corpus luteum (luteii?) that were just settling back down (since the scan was on CD1). If I just think that hard enough, it should do the trick, right?

Holy Self-Centeredness!

2011-09-10T11:02:00.000-04:00

Mine all mine, and I feel the need to own it.

I mentioned recently on Twitter that I've been spending a lot of time wandering in Memory Lane the last week or so. Sort of a slow motion Life-Flashing-Before-My-Eyes experience. Navel-gazing, moping, reliving good times and bad. I'm not sure where this extraordinary degree of introspection is coming from, but I'm guessing it's a combination of the changing season (Fall never fails to bring out my nostalgic side) and the impending start of IVF The Do-Over and the knowledge that I probably only have the wherewithal for this one IVF cycle. I feel like I am very near my limit with this process. I am ready for things to change. I either want my baby, or I want my life back. It's time to break out of Limbo.

In the process of this little memorial road-trip, I've also spent a lot of time contemplating the various branching points in my life that led me to my current place, and wondering where I would be and what my life would be like if I had made different choices. Wondering if it is too late to make some dramatic changes. And I know that, actually it is not too late. My mother went back to school at about age 40 to get her masters and start a new career. No reason I can't do the same.

It was thinking about my mother and some of her choices that really stopped me in my tracks this week. One of the memories that bubbled to the surface was from my early childhood, and it hit me quite hard. I guess I've never mentioned this here, but when I was about four years old, my mother had a miscarriage. I'm not sure how far along she was, but it was far enough that she was showing and everyone knew she was expecting (even me). Because I was so very young when this happened, it has always just been a piece of my family history, a simple fact of life like my grandparents divorce.

Only in this last week of soaking in memories and un-actualized potential, did the reality of my mother's loss sink in for me. And I feel horrible. How is it that in my nearly three years of struggling to get pregnant and one miscarriage of my own, I never made this connection? How is it that this was always so much a background fact that it didn't even register with me? You don't need to bother telling me in the comments, I know I'm a self-centered beast.

My mother has always been a steadfast figure of calm and caring. Who took care of her? Did my father give her the emotional support she would have needed, or maybe her sister did? Did she have close friends to help her heal? I'm not sure I could tell you who my mother's best friend was when I was four years old. I know there is one photo of my mother and I, taken just before she found out the baby was gone, and she keeps this photo out where she can see it. She has mentioned on numerous occasions that it is the only existing photo of her with both of her babies. And all I can think is, "Oh god, my poor poor mother."

On Your Mark... (UPDATED)

2011-08-18T22:37:00.001-04:00

Thursday was CD1, so I called the RE to check on my calendar and confirm my protocol for the IVF Do-Over. Turns out, when the IVF team had their planning meeting for the next round, they decided to change my plan a little.

No BCP. No Lupron. No suppression at all.

They decided that since there was sufficient possibility that the BCP contributed to my complete and utter lack of response last time and since my cycles are so quaintly regular, that they would not risk repeating the previous failure. This means that on my September CD1, I will have completed my three month course of DHEA (to boost ovarian response and egg quality) and will go straight to stims unsuppressed.

This should be interesting.

UPDATE: I suppose I should have mentioned, they are going to stick with my original IVF protocol (minus the BCP suppression), adding Ganirelix near the end to suppress the LH surge and keep the follicles from popping off on their own.

Batter Up

2011-08-14T14:02:00.000-04:00

Or something like that... I don't do sports, so I can't be 100% certain. I'm anticipating CD1 any day now (started spotting today, just ahead of schedule) which means a call to the RE to set the IVF calendar and recheck the med supply for the adjusted protocol.

Work continues to be batshit crazy, in spite of this being the down season and our busy season begins... well, this week I suppose. So much for a summer break. I think I took two whole days off all summer. Next opportunity for time off will be Thanksgiving. If you don't count the days I plan to take off for retrieval and transfer... because those should be such a refreshing break from the work week, ya know.

Hold me.

Until lift-off, I'm just taking my DHEA and drinking my wheat grass. Thrilling stuff here people, thrilling stuff.

No More Needle Naps

2011-08-06T12:40:00.000-04:00

It just occurred to me that I never updated you on my first visit to the new acupuncturist. I know you were all holding your breath waiting for that information, so you can relax now - I'll put you out of your misery. First a quick recap.

Short Story: I've been seeing the same acupuncturist for about 10 years for various ailments here and there. She occasionally tried to get me to take herbs, but I'm not going there. Just can't do it. She got pushy, so I fired her. Long Story.

Things that are different:

New acu is a man, old acu was a woman. Wasn't sure how that would play out, but it turned out fine.
New acu is in my town, not the next town over. The shorter commute is certainly nice!
New acu is a fertility specialist, recommended by my clinic. He doesn't criticize my clinic - imagine that.
He is not recommending herbs for my protocol. I asked upfront.
He is very hands-on, makes constant adjustments. He schedules one patient at a time and never leaves the room.
He doesn't take insurance. I'll have to submit claims myself, but at this point, whatever.

No more needle naps for me.

Losses

2011-08-02T21:40:00.000-04:00

Two cousins.
One uncle.
One grandfather.

All lost to my family in the last twelve months. Two long-anticipated, and yet still mourned. Two tragic and untimely, grieved in shock and disbelief. And the unspoken question on my mind (is it on anyone else's?): What next?

Living IRL

2011-07-24T19:31:00.000-04:00

I know. I've been a little low profile in bloglandia and the Twitterverse. I'm not going to apologize though. I've been making a concerted effort to get out of my own head and engage with the world around me. Major excitement (can you sense the sarcasm there?) that has kept me busy IRL for the last few days include:

Yardwork. Prof and I got out there together for a while just before the sun went down Friday. That was about the only time it got cool enough to be functional outdoors. Normally I do the yardwork by myself, but he joined me by special request and it was kinda nice!
Salon time for Slackie. I got waxed and then had a lovely spa pedicure, foot massage and all. I even broke out of my mold and tried a new color - and I love it. You should all be very proud!
Business gathering with the Professor. I usually skip out on business socializing with Prof's colleagues, but I put on my big girl pants and went to the party with him. I even talked to nearly every person in attendance. Trust me, that is a big deal for ME.
Met BFF(B) for coffee. Girl chat, catching up, a little cooperative bitching and moaning and I think we both felt better.
Housecleaning. Above and beyond the usual weekend laundry and dishes. We are planning to have dinner out with friends and there is a chance they will drop by our house afterwards. So a little extra TLC in the public spaces.
I am heading to Seattle this week for a conference. I will have a small amount of free time to myself, so I'm meeting up with BFF(3) and I'm so excited about that! I wonder if she's up for the aquarium?
The day after I get back home, I have my first appointment with the new fertility acupuncturist. I'm really looking forward to it, though I'm also a little nervous. I hope he's lower pressure than my previous practitioner with the herb situation.

I will be even more out of touch for a little while, but I promise we'll catch up when I get back. Pinky-swear!

Hi-ho, Hi-ho... Ho-hum

2011-07-17T11:40:00.000-04:00

Sorry to drop off the face of the internetz there. I feel like I owe y'all a post, but I still don't have anything to report. No news, no progress, no travel or interesting IRL adventures. I've just been slogging through my Monday-Friday and zoning out on the weekends. Work has continued to be unusually busy. Summer is normally our major down-time, and a to be honest, a little boring. Not so this year. We are still going flat out, but unfortunately, have all of our less critical, large projects that we put off till summer when we expected to have more time to work on them. Ugh.

We had intended to be traveling for a wedding out of country this weekend, but IVF and its cancellation have kinda bitched our finances. For those of you who don't have to deal with the All-American ordeal that is health insurance: We had to pay the clinic cash up front because IVF isn't covered by our insurance. I contribute pre-tax money from my paycheck to a savings account (FSA) at my insurance company that will then reimburse me for expenses that the insurance doesn't cover (up to the total amount that I contribute). The benefit is that the government can't tax me on that income. Since we got cancelled, the claim hasn't been submitted to insurance to be denied, so the FSA hasn't paid out a reimbursement. We could have had a refund, but it seemed more prudent to leave the payment as credit with the clinic so we wouldn't be tempted to frivol the cash away in our sorrow. Sometimes being responsible sucks.

I'm still mulling over my career as well. Or perhaps I should say "a career" because I don't feel like I have one right now. I really need to earn more money. Which is how I got where I am. Being an artist is the thing I'm best at, the only thing I'm actually educated for. But I wasn't making a living at it, I was just keeping afloat. I wanted to make more money, so I shifted my focus to my current field and got an entry level job making more than I had been. I expected to see at least some advancement after a couple of years, but am realizing now that isn't likely. All I can see are the negative aspects of the next level positions, the many ways a promotion would add stress and impinge on my home life. So I've been contemplating my strengths and skills and trying to imagine what other field I could explore that would give me another salary boost without dramatically increasing my stress levels. The problem is finding something I'm good at and mentally suited for that actually pays but doesn't put me to sleep.

First world problems.

We did see HP7TheEnd last night. It was pretty good, but I never felt the urge to cry that so many others have mentioned. Perhaps because I know the books so well and did my crying over them (and did I ever). Perhaps because it's hard for me to get past the inconsistencies and discrepancies in the storytelling. I spent too much time in the movie thinking, "But... that never happened!" I don't know, but I can say without a doubt that Alan Rickman once again acted circles around everyone else in the movie. Gary Oldman didn't have enough screen time to give him any competition in this one. Seriously love those two. And Helena Bonham-Carter does a great Hermione-pretending-to-be-Bellatrix - you can really believe it's Emma Watson in a Bellatrix suit. Hilarious moment!

Now I need to go figure out something creative to do with last night's leftover stir fry chicken and veg. I think I'll do a faux-pho... (heehee. I kill me)

Without A Doubt

2011-07-09T23:35:00.000-04:00

I've been taking my DHEA for over a week now. The warnings on the bottle are a little alarming. There is even one that warns against use by women of childbearing age... which was, as I'm sure you can imagine, a little confusing. I had a persistent headache for the first five days or so, but that has abated now, thank goodness. I have also had VERY vivid dreams, just before waking, every day since I started taking the DHEA. Not nightmares or sexy dreams, just weird nonsense dreams that I remember clearly after waking (which is unusual for me).

I did a little online research and read some promising things about this treatment. Things that actually gave me hope. I almost wish I hadn't. Because as much as DHEA appears to increase the odds of a successful pregnancy in circumstances like mine, we all know there are NEVER any guarantees are there? There will always be someone for whom things just don't work out. If that's going to be me, it would be so much easier to go into it without much hope. I'd rather not have to deal with the crash. I wish there was some way to know in advance if I will be one of the lucky women for whom DHEA is the answer.

Our local S*bux has a Magic Eight-Ball on the pick-up counter. We stopped in on our way home this evening, and of course I just had to go there. The answer:

Without a doubt.

IVF Update (WTF)

2011-07-02T11:45:00.000-04:00

Sorry to be absent, both here and on Twitter, but we have out of town guests and I'm focusing on them right now. Since they are all sleeping in this morning, I thought I'd do a quick update.

We did have our IVF follow up consultation last Wednesday. Basically, no real answers. The IVF team was baffled by my lack of response. All of my pre-testing and my previous injectible cycles were good and gave no indication that something like this might happen. Apparently, sometimes you just have an off cycle (I did have ONE injectible round where my response was slightly lackluster). My RE feels like it was probably a fluke, but rather than waste another shot, he is tweaking the protocol just a bit.

I started DHEA on Wednesday (75mg/day)
Lupron is back on the menu (microdose flare)
BCP are optional*
I will continue to drink my wheatgrass and minimize my caffeine/alcohol consumption.

The major disappointment is in the timing of the do-over. The clinic closes for the second half of August, so that their employees can take vacation. So I would either need to start right away (not ideal with upcoming travel this month) or wait until September (not ideal as that begins our busiest season at work).

The RE is pushing for September because of the DHEA, which is starting to be used more often as a means of increasing ovarian response. Apparently all of the literature shows that its effectiveness is optimized at three months use. So we wouldn't be likely to see any benefits until September, making an immediate cycle more of a gamble in terms of "WTF was with that poor response?"

So September it is.

*The BCP are only being used to time the start of the cycle to coordinate with the clinic's IVF rotation. If it looks like my CD1 should be in the right range anyways, I won't have to take them, though this still involves a bit of a gamble. If I don't use the BCP and we miss the right timing, I have to wait till my CD1 falls into the correct window. SO... I'll probably end up using the BCP at least briefly.

Taking a Bullet

2011-06-21T21:33:00.000-04:00

So yeah, I took the statistical bullet last week. I'm pretty sure we all do at some point, but I figure someone else can have the honor next time, okay? That actually sounds kinda shitty. I don't wish this on any of you. I sincerely hope all of you who got your BFPs and excellent fertilization reports appreciate my sacrifice! (And in case it was unclear, that was intended to be humor. I'm a wee bit dry.) Unfortunately, this leaves me disinclined to blog for the moment. In keeping my Bullet Theme, you're getting a list today:

All of my meds have been refilled (at no cost to me, since I met my co-insurance in May) and are boxed up and waiting in the back of my closet for the do-over IVF. It wasn't until I started IF treatments that I even knew what co-insurance meant. If you've never been introduced, it means that I've paid my yearly limit of co-pays and for the rest of the year any covered medical expenses (excluding prescriptions) will be paid 100% by my insurance. I've spent THAT much in co-pays already this year.
The box of meds is in my closet because my mom and my MIL are coming for their annual summer co-visit. This is good. I love them both and they have a great time together.
The box of meds includes a just-in-case refill of my Crinone because next week, my employer sponsored health insurance is switching prescription coverage and Crinone will be bumped into the highest tier. I'm guessing my employer is gonna be saving some serious cash because my prescription costs are about to go up. Bastards.
These are the same Bastards that have neglected to respond to the letter I sent in honor of NIAW. I console myself with the virtue of having sent it at all.
I've fallen of the Fitness Wagon. I haven't exercised in... months. I am consistently exceeding my calorie limit for the day. Granted, my daily calorie limit is ridiculous at a mere 1,200. I AM at least maintaining. My weight has not gone back up, but the loss has plateaued. If only I could convince myself to get off my ass and back on the elliptical. It would probably also help if I could refrain from restocking the ice cream supply in my freezer.
If I have to see one more 5-6 month pregnant woman pushing a one year old in her grocery cart, I refuse to be held responsible for my own behavior. The produce section is a perfectly acceptable location to lay down and beat the floor with my fists while screaming.
Fortunately, I can avoid the produce section for the most part in the near future since our CSA box started back up last week. Dude, I LOVE garlic scapes. And having an excuse to see my BFF more often.
BFF thinks I'm depressed. She's probably not far off.

This shit sucks.

Oh FFS...

2011-06-17T19:01:00.000-04:00

I got home from work today and checked the mail to discover a small padded envelope. What could this be? What had I ordered... hmmmmm? OH right. The internet-cheapie HPTs. That I was going to use to test out the trigger shot... that I didn't get to take because my IVF cycle got cancelled.

Nice. Have a nice weekend!

Even better, I discovered this was what the envelope contained, not by reading the shipping label to see who the sender was or even by opening it to examine the contents. I knew what was in the envelope because the INSTRUCTIONS for use were in a nice clear adhesive sleeve on the OUTSIDE of the envelope. This is one medical supplier that missed school the day they taught the lesson on treating your clients with discretion.

And the best part? Apparently, they also missed the lesson on truth in advertising. These so-called midstream HPTs actually require urine to be collected in a container and then applied to the test window using a dropper. Four drops precisely. What exactly in this procedure indicates anything "midstream"?

Seriously. FFS.

Cancelled

2011-06-15T21:39:00.000-04:00

After our last monitoring appointment, it was fairly clear that we weren't going all the way to retrieval, even without knowing the estrogen level. We were obviously feeling daunted and beaten down.

The sun was shining, there was a scattering of little fluffy clouds and a light breeze. Such a beautiful day and such a disappointment. We stopped at the curb for a quick hug before heading into our respective days. Suddenly, I could not abide the thought of driving into work and sitting at my computer all day and the tears started.

My dear, sweet Professor gave me a big squeeze and suggested we go for a walk in the park that backs onto the medical complex where our RE has his office. So we walked along the tree line till we found a gap, and picked our way through, dress pants/shoes and all. We didn't go far and we didn't talk about anything in particular, but by the time we picked our way back through the brush to the parking lot, a few of the clouds had blown away and the day seemed a little less bleak.

When I texted him to let him know we were officially cancelled, he replied, "We've still got each other."

I love my husband.

IVF Monitoring #3

2011-06-13T18:43:00.000-04:00

Cancelled.

Nine days of stims.
Lining at 8mm.
Six follicles between 9mm - 11mm.
Estrogen just over 300.

Not good enough. They will not convert to IUI, as even that would require too much longer on meds. They are concerned about diminishing egg quality by stimming for so many days. So we cut and run.

Fortunately, I refilled my meds last week in anticipation of longer stimulation. Now I have leftovers for another shot at this even though our coverage is all used up. We will have a follow-up with our RE in two weeks to discuss changes to the protocol and getting back on the schedule to start over.

For tonight, I'm drowning my sorrows in junk food.

Gratitude

2011-06-12T00:15:00.001-04:00

I just wanted to say a huge thank you for all of the thoughtful comments you've been leaving this week. You are truly a balm to my spirit.

Thank you.

IVF Monitoring #2

2011-06-10T18:46:00.000-04:00

After six nights of stims, at what the nurse tells me is the highest dose they are willing to prescribe for me, my lining is at 5.7mm and I now have an underwhelming seven follicles brewing:

(L) 8mm, 7mm, 8mm, 8mm
(R) 9mm, 9mm, 7mm.
My estrogen is an equally underwhelming 75.

This leaves us in a quandary. I am making progress, seeing increasing number and size of follicles. My estrogen is increasing. Just enough to keep the RE from giving up, but not enough to be particularly promising. So we continue stims at the same dosage and re-check on Monday. At which point we will either see definitive progress or the cycle will get cancelled. At least, we hope it will be one or the other. I'm not sure how long I can stand to be caught here in Limbo.

After less than a week, I've had to refill my Menopur already. I have been on the phone with the specialty pharmacy three times this week trying to sort out billing errors that go back months. The woman I spoke with today told me that due to the complexity and frequency of the errors made on my account, I would be dealing with her exclusively from this point forward on any billing questions. That's right, I now have my own personal billing rep. She does seem to know what she's doing, and she did make one really nice comment at the end of our call.

She said, "I'm looking at the medications you're taking and you really shouldn't have to be dealing with all of this on top of what you're going through. I'm sorry."

In answer to the many inquiries that came up on Twitter, it seems that I was over-suppressed. Four weeks of BCP, no Lupron. They already have me on the highest combo-dose of GonalF and Menopur that they would give me, so not really any room to tweak or add meds. Insurance was only covering meds for this one cycle. I had one unused medicated IUI left in my coverage, so they let me use the meds credit toward this IVF cycle. Otherwise IVF expenses are not covered. We are burning through the meds and I'm worried that if we cancel, I'm going to have to come up with thousands of dollars to replenish the vegetable crisper.

To Pee or Not To Pee (UPDATED)

2011-06-09T12:18:00.002-04:00

The age old question of the Infertile in a treatment cycle. Oh hell, let's be honest. There doesn't have to have been any actual treatment. Just the possibility of an egg and the hint of a sperm together in the same room at around the right cycle day, and it's time to break out the HPTs!

So for IVF, when every little thing is so documented and "known" and there is so much riding on the cycle, the temptation to POAS is nearly unbearable. For months now, I have been debating the idea of buying a stock of internet cheapie sticks and "testing out the trigger". Right up until beta day.

But.

My Mom and my MIL will both be arriving for a visit just a few days before beta (give or take depending on retrieval date). I know, I know... what was I thinking approving that itinerary? It's going to be hard enough to keep those PIO shots under wraps, much less find a way to store and dispose of countless HPT strips.

But.

I seriously want to do this. I want to know if there is even a glimmer of a pregnancy. I need to know.

Also.

Any suggestions for hiding the PIO ritual from the Moms in a house with only one bathroom?

UPDATED: The internet cheapie sticks have been ordered! Here's hoping they get here before transfer. More importantly, I wanted to say a huge thank you for all the thoughtful comments over the last week. You guys are the best!

IVF Monitoring #1

2011-06-07T23:02:00.000-04:00

We've done three days of GonalF at 375iu. I didn't know quite what to expect, but it wasn't this. Only four follicles: 6mm, 6mm, 7mm, 8mm (two on each ovary). Even the nurse had a hard time disguising her lack of enthusiasm for this level of response to stims. When the blood work came back, my estrogen levels had actually dropped.

Sigh.

Next three nights' shots will be 225 GonalF plus 225 Menopur. Second monitoring appointment on Friday morning. Please let there be a few more follicles brewing, all at nice even sizes!

And while I was having my pity party, a whole boatload of my Twitter girls were enduring heartbreak and loss beyond reason. Please do whatever it is you do (pray, meditate, wish on a star) and send some love out to @LeLeIsMe, @MaternalTurtle, @BroodyIVFMummy and @MyCheapViolin.

Breaking Up Is Hard to Do

2011-06-05T12:54:00.000-04:00

I have a confession to make: I broke up with my acupuncturist in April, but I haven't told her yet. I'm thinking she'll figure it out on her own.

I've been seeing her as needed for various ailments for almost 10 years now. When I started doing fertility treatments, she told me she wanted to add a bunch of herbs to my plan. I'm not an herbal supplement kind of girl. Yes, I take my vitamins. Yes, I try to use foods where possible to improve my health. But somehow, I can't jump on the herb-wagon. So I hemmed and hawed and told her I'd think about it, and then studiously avoided mentioning herbs ever again. I did bring it up with my RE, just to see what he had to say, and what he said was, "Do NOT take any herbs while doing these treatments." Very emphatic, no room for doubt about his thoughts there.

At my last appointment back in April, my acupuncturist started in about the herbs again. She had just been to some sort of master class and had her belief in the Power-of-The-Herbs renewed, and she felt the need to push. I told her no, I haven't been taking them and wasn't inclined to do so. She questioned that, and I told her I just wasn't comfortable with it. She launched into a lecture about balance and completeness in treatment and how doing acupuncture without herbs was only half the solution and WHY wouldn't you want to do everything you can, don't you really want to get pregnant?

If I tell my doctor I am not comfortable with a particular form of treatment, I expect them to respect my feelings. They may present alternatives, or explain potential consequences of declining the treatment, but I don't expect to be judged by my doctor. So I cancelled my appointment for the following week, and never went back.

Of course, now that I'm on the brink of IVF, I'm feeling guilty for not having this particular tool in my treatment bag. There is one acupuncturist recommended by my fertility clinic. Unfortunately, he is currently booking new patient visits two months out. So... I'm moving forward without this tool.

I'm just gonna have to let that go.

Who Me... Superstitious?

2011-06-03T10:21:00.001-04:00

I am not assigning a number to my IVF cycle. I have never done IVF before, and I am currently operating under the assumption that this is the only IVF cycle I will do.

Thus, this is simply: My IVF Cycle.

First Base(line)

2011-06-01T19:32:00.000-04:00

Baseline hurdle cleared! Ovaries quiet*, lining very thin, estrogen at 16, progesterone at <.5 and my checking account is down nearly $7K.

My very own RE did my exam and a quick mock transfer (which he described as "easy"). He also complimented my choice of toenail polish. Either my normally un-pedicured feet made a massive impression on him in the past, or (for my choice) he just clearly has good taste. I mean really, who doesn't like a nice frosty orange pedicure for the summer months? Having approved my pedicure, my cervix and my ovaries, he gave me permission to reclaim my pants and meet him in the consult room to review The Plan. We looked over the calendar again, completed all the paperwork, signed our consents and were off.

One little hiccup at the checkout desk, as my debit card was declined when I went to pre-pay the (exorbitant**) bill. Turns out that thing has a $3K per day spending limit. Oops. It never occurred to me to call my bank ahead of time and let them know I was making this charge. Luckily, they had it sorted in under ten minutes so I could pay up and move on to lunch with the Professor. But for a minute there... my heart stopped. The other thing I realized this morning was that I'll be getting my 1% rebate on this charge since I used my debit card as a credit card. That will make for a nice little dinner out with the Professor!

*For the sake of comparison: my right ovary measured 30mm this morning. We're ideally looking to recruit multiple follicles on that ovary at 20mm+. I have a feeling things are gonna get a little cramped in there.

**I do actually realize that my just under $7K IVF bill is far from the level of "exorbitant" that many others have to pay, but still. It's all relative.

I'm A-Scared

2011-05-30T11:45:00.000-04:00

I admit it. I'm scared to do this IVF. I keep having this irrational urge to cancel the whole thing.

What if it works? Shit y'all, I'm nearly 39 years old. Will I be able handle such a major life change with my sanity intact? And what if it doesn't work? Will I be able to let that go? Will I feel compelled to accumulate more debt just to keep trying? Will I resent making that monthly payment on the debt we've already acquired to make this one shot possible?

And then there are the longer-term repercussions. My mother had estrogen sensitive breast cancer. I have been pumping my body full of excess estrogen for a couple of years now and IVF will raise that bar exponentially. Does that make me even more vulnerable to the same disease? My right boob was killing me the other night (it has stopped now), and all I could think was, "What if we go through all of this, and I end up with cancer like my Mom? Would it be better or worse to at least have a baby to show for it?"

I don't have an answer.

IVF Update

2011-05-28T10:54:00.000-04:00

I took another BCP this morning. Three more to go.

Dramatic stuff here.

All of the meds are in the house. Estimated retail value: $7,683.

What's For Dinner?

2011-05-25T20:45:00.000-04:00

I made a crazy-tasty dinner tonight, so I though I'd share. It wasn't from a recipe and doesn't have a name, but it was basically a Tex-Mex quinoa salad. I served it with fresh sliced avacado and a cheese quesadilla.

Recipe for the quinoa salad:

3 C quinoa, cooked
1 can black beans, rinsed well
1 medium tomato, chopped
1 fresh jalapeno, seeded & chopped
1/2 red onion, chopped
2 cloves garlic, minced
juice of two limes

Spices to taste:
salt & pepper
red chili powder (1/4 t)
ground, toasted coriander seeds* (1/2 t)
ground, toasted cumin seeds* (1/2 t)
chopped fresh cilantro (1/4 C)

Mix well and chill before serving. Makes about six cups.

You could use another grain or rice, but quinoa has been getting a lot of press lately as a superfood, and it's also a favorite of the gluten-free crowd. I was suprised how much I actually liked it!

*About ground, toasted coriander and cumin seeds... we always keep these whole seeds handy and toast as needed in a miniature skillet, for 2-3 minutes. Grind toasted seeds with a mortar/pestle. It really doesn't take much extra time, but the flavors are amazing. Toasted coriander particularly adds a nutty, citrus-y note without the acidity of lemon or lime.

Oh My Hell, or Wednesday in NYC

2011-05-21T10:55:00.000-04:00

Sorry for the delay in posting, but this week truly kicked me. Hang tight: this might take a while, but I promise it all ends up OK.

For anyone who is not yet aware, there just happens to be a national (I'm in the US) shortage of Lupron. There are still a few pharmacies here and there with stock, but it's getting incredibly hard to find. No one has been able to offer me any kind of explanation for the shortage.

I was scheduled to start Lupron injections for IVF#1 next Saturday.

WEDNESDAY

All seemed to be going quite well until mid-day Wednesday. I had a business trip to NYC that was supposed to be less than 12 hours on the ground. This was the culmination of all the work stress I've been under for the last few weeks. Big Day. I would even have ONE hour to spare after our business concluded, and I planned to meet up with @the2weekwait and @thisispersonal for coffee before heading to the airport for my flight home.

I started the day in the airport with a phone call from my RE telling me they had found a pharmacy with Lupron in stock and I should expect a call to arrange delivery AND even better, my insurance company confirmed my meds would be covered. Awesome! I boarded my plane, shut off my phone and was off to the Big Apple. When I turned my phone back on in the taxi, there was a voicemail from the pharmacy.

Long story short, they do have Lupron in stock, but are refusing to fill prescriptions for new customers unless it is part of a complete cycle order. So I'd need to order a cycle's worth of GonalF as well. In spite of the fact that I already have all I need. I escalated up the chain of command, but this company just doesn't care. Since I've never ordered from them before, they won't fill my prescription.

I called my RE and left a message explaining the Lupron situation and they called me right back. They were changing my protocol from Lupron to Ganirelix and sent in a new prescription to my usual pharmacy. I called my pharmacy thirty minutes later to get the ball rolling, only to be informed that they were out of Ganirelix. Because of the national Lupron shortage. Everyone is being switched over, just like me. Smack in the middle of this phone call, a coworker walks up to me, cell phone to his ear. He mouths, "Our flight home just got cancelled". Due to weather. And not just ours, lots of flights.

Cue full blown panic.

My IVF teaching appointment is scheduled for 9:30 the next morning. After thirty minutes of frantic googling and phone calls (God bless my iPhone), I had a new flight out. But I'm in Manhattan and need to be at the airport in an hour. It's 5:30 PM. Rush Hour. Fifteen minutes of arm waving and one burst of hysterical tears later, a rather shell-shocked cabbie is taking me to LaGuardia against his better judgement. He kept handing me kleenex and granola bars and offering to charge my iPhone. I got through security with about 10 minutes to spare. As he drove, I texted Jay and Jen to let them know I couldn't do coffee. Poor Jen had had an even worse Wednesday than I did. What a bummer. At least I got home before midnight.

THURSDAY

The first thing I did when the nurse called us back for our teaching appointment was tell her the names of everyone at the clinic that I felt the need to apologize to after the previous day. She seemed amused by that, particularly awkward since her name was on the list.

Then I told her about the out-of-stock Ganirelix (I never got a chance to relay that information the day before). To my amazement, they already knew. She had a brown bag full of Ganrelix samples that she handed me. All I will need for my cycle. The Internetz seem to put this at about a $600 value. And they just gave them to me. I *may* have cried just a little.

She then ran us through our protocol and calendar, and demonstrated each of the new meds for us (we already have experience with GonalF, Ganirelix and Ovidrel). For the record:

BCP through 5.31
Baseline 6.1 (Pay-Up Day)
GonalF (375iu) starting 6.4
Menopur starting 6.9
Ganirelix starting 6.9
Ovidrel trigger TBA
Retrieval week of 6.13
PIO (50mg) starting day of retrieval
Antibiotic & steroid starting day of retrieval

Assuming we get eggs, they will perform ICSI on all of them. Assuming embryos develop, they will perform assisted hatching the day of transfer (Day 5 if possible). The antibiotic and steroid are in aid of the assisted hatching, which can make the embryo more vulnerable to potential infection during transfer and to prevent my immune system from rejecting the embryo as "foreign matter".

TODAY

I had a phone call first thing this morning from my pharmacy. They were calling for my approval of the co-pay amount for the Menopur, antibiotic and steroid: $146. It will ship Monday. I am so lucky.

We are still waiting to get the final dollar amount to be paid at my baseline, but it's looking like right at $7K. I keep telling myself how lucky we are the price is that low and my meds/monitoring will be covered just this once.

I Need A Moment

2011-05-19T20:23:00.000-04:00

I old my Tweeps I'd post an update on the IVF prescription situation tonight, but this migraine is taking precedence. All is well & I'll fill you in as soon as I can get rid of this headache.

Can We Just Skip This One?

2011-05-15T14:30:00.000-04:00

Nothing new to report, no cycle progress, no funny stories to tell.

Work hell continues, but will let up considerably after this week. I try not to talk much about my work online, because that's not really what this space is about, but it's kinda all consuming at the moment. I've even been dreaming about work stuff and I really resent it. I have to take a day trip on Wednesday which will be exhausting and mind-numbing all at once, but at least I'll be home and sleeping in my own bed at the end of the day (technically very early the next morning, but that would be splitting hairs). I'm not a great traveler. I like being other places, but I don't enjoy the process of getting there/back. Airplanes make me anxious and nauseated. And I have to admit, as much as I appreciate my immediate coworkers, I have trouble relating to them on a personal level and this makes me feel very isolated and lonely, very "other". Throw travel into the mix, and it's not a fabulous day.

Aaaannnnddd... I have some serious thinking to do about my job. It was originally supposed to be a foot in the door, to get me in with this great employer. Now it's been two years, and I'm pretty comfortable in my position. Maybe too comfortable. I've learned a lot and built some new skills and confidence. I'm really quite lucky in the people I work with on a daily basis, but there are certainly aspects of my work that make me want to bash my head against the wall. For all that, the thought of leaving my department is scary, but it's the only way I'll be able to move up at all (if I even decide that I want to move up). But with the whole IF thing still in mid-air, do I really want to try making a big change? I just don't know, so I'll sit on it for a while and revisit the question in a few months perhaps. I have made a preliminary investigation, and didn't really find any appealing open positions elsewhere in the company, so it's not as if I feel like I'm missing out on anything in particular at the moment.

When I get up (later) Thursday morning, we'll head to our teaching appointment and get our official Plan. I'd like to just skip to that, please.

Meanwhile...

2011-05-13T19:59:00.000-04:00

I never have had any hint of acknowledgment of my NIAW letter to Human Resources requesting the addition of IVF coverage to our health plans. Crickets. Disappointing, but not surprising.

All of our pre-IVF testing came back clear. Prof deposited his back-up swim team at the clinic. Our medication teaching appointment is set for next Thursday and the IVF Team (we have a whole team!) has presumably created our plan, but no one has called yet to share it with me. I'm guessing we'll get it at the appointment next week.

I did speak with a nurse a couple of days ago, and she gave me a tentative meds list:

BCP (already taking them)
Lupron
GonalF
Menopur
Ovidrel trigger
PIO

I've already got all my GonalF (13 pens... ugh) and my Ovidrel thanks to leftovers from my covered IUIs. It only just occurred to me that the BCPs were covered by my insurance when I went to pick them up. Nice.

I also spoke to the IVF financial coordinator at my clinic in preparation for making payment arrangements, and she called my insurance for me and found they will cover my IVF monitoring appointments since I still have one unused covered IUI left on my plan. HUGE help there! She is submitting paperwork for me to find out if they will also cover the rest of my meds.

Sneaking up on IVF, one step at a time.

Anyone?

2011-05-05T12:24:00.001-04:00

Am I the only infertile in the history of ART to walk eyes-wide-open into an out-of-pocket IVF*, fully expecting it fail? And I'm doing it anyways, because if I don't... how would I be able to live the rest of my life at peace? How would I ever be able to look my darling husband in the eyes if I didn't at least try?

*That was a lot of hyphens.

A to Z of TTC

2011-05-03T11:19:00.120-04:00

This has been making the rounds and it's kinda fun, so here you go: TMI Central!

A. Age when you started TTC: 36

B. Baby Dancing or Sex: Groovin'

C. Children wanted: Two

D. Dogs/Cats/Fill in Children: Two cats

E. Essential Oils/Vitamins/Snake Oils: Prenatals & the occasional shot of wheatgrass

F. Fertility Meds I’ve taken: Clomid, GonalF, Ganirelix, Ovidrel, Crinone, First Progesterone

G. Gain: 20 pounds since ditching the BCP (have now lost 13, looking to drop another 12)

H. HSG (Hystosalpingogram): Whooo-buddy, check it out.

I. Infertile Pet Peeves: People who complain about how long it's taking to get pregnant, after trying for all of three months. SUCK IT!

J. Job title: Director of LaundryFolding (yeah, what-of-it?)

K. Kid’s names you’re afraid will be taken by the time you can use them: Seriously? If I tell you, you'll just steal them, because they're THAT cool. Nice try though.

L. Length of time TTC: Two years, four months

M. Miscarriages: One, blighted ovum. Full story here.

N. Number of times you’ve switched OB/GYNS, REs, FSs: Assuming since TTC (not lifetime), none. Did get a second RE opinion, but went back to the first RE afterward.

O. Ovarian quality: No known problems

P. POAS or wait for AF: Varies by cycle, depends on how hopeful I am. Hope = POAS. No Hope = Why waste the money?

Q. Quote from an obnoxious fertile: Honestly, I'm very fortunate that there aren't any of these in my life. I've wracked my brain and come up with zero anecdotes. Please God let it stay that way!

R. RE, OB/Gyn or other? RE

S. Sperm: Above average in every factor

T. Time you tried naturally: 10 months to start, occasional un-medicated cycles since starting treatment

U. Uterus quality: No know problems. Once described by my RE as "beautiful".

V. Vagina: Yep. I got one of those.

W. What baby stuff do you already have? One sling.

X. X-tra X-tra Hear all about it! How many people know the ins and outs of our crazy TTC journey? Aside from us & our medical team? Maybe three or four. Oh, and thousands of people on the internet.

Y. Yearly Exam (do you still go in even though someone sees your lady parts most months?): Indeed, very compliant over here.

Z. Zits: Only with my period, and then it's worse than when I was a teenager. Which actually is still not that bad.

So now you’ve read mine. What are your IF A to Zs?

Show Me the Money (Updated)

2011-05-01T19:22:00.002-04:00

Money is such a sticky subject, and one that is constantly at the forefront of most discussions of fertility treatments. We do OK. We don't sleep on a pile of Benjamins, but we know we are better off than so many others. If you remember, we paid off our car last Fall. Turns out it was a good thing too.

Our IVF cycle is coming up soon (OH-SO-SOON) and we'll need to pay between $7,000 and $9,000 up front. I maxed out my FSA this year, so it will reimburse about $6,000 of that, but only after the fact. We have to pay UP FRONT. We have a little money saved up and a little room on our credit card, but even those two options combined are insufficient to the task. After countless calls to our bank, we determined that our only reasonable option for raising enough cash to prepay our IVF cycle was to take a personal loan using that paid-off car as collateral.

(sigh)

Fortunately, the application process was quick and easy to complete over the phone. All the bank needed was a copy of our title showing all liens paid off. Oh snap! We never ordered that when we got the release after the payoff. So a quick trip to the DMV to order the new title and then wait for it to come in the mail. After about a week, it occurred to me that we had no idea how long to expect the new title to take.

Off to the internet I went and lo and behold the DMV website states that when requesting the removal of a lien, the new title can be expected in 60-90 days. OMG OMG OMG. This was our only viable option!

(Cue panic)

After 5-6 hours fraught with the fear that our lien release would not get processed in time to get the loan pushed through before our IVF start date, I checked the mail to discover the title had been delivered that afternoon. Five days. Whatever, I'll take it.

The loan was approved, the funds are sitting in my checking account. So that's that. ~~Now we just have to wait for CD1~~. Today is CD1. Blood work tomorrow and BCP start Tuesday. Here we go!

UPDATED: What I neglected to mention above is that my leftovers of refills from my last (insured) IUI are almost all I need for meds. I will need to buy the BCP, Lup.ron and PIO. So, not too bad really for prescription expenses.

Letter to Human Resources

2011-04-29T12:54:00.000-04:00

Last year, we saw Project IF for National Infertility Awareness Week. Keiko's WhatIF video made me want to start talking about infertility to someone other than my husband and my doctor. The biggest step I could convince myself to take was to start up an anonymous Twitter account and this blog.

In honor of National Infertility Awareness Week this year, I sent the following email* to my Human Resources department. I used the template provided by Resolve and made a few edits to tailor it to my situation. It's not much and at a large employer like mine, I don't know what the impact will be. But it's not anonymous and it was time to do SOMETHING:

Dear AVP of Human Resources,

I have been an employee of This Company for over two years. This Company is a valuable asset to our community and the wider region, providing innumerable benefits to employees and community members alike. This week is National Infertility Awareness Week, and I am writing to request that you consider adding coverage for in vitro fertilization (IVF) to the health benefit packages This Company offers.

Statistics indicate that one in eight couples of reproductive age in the United States suffer from infertility. That translates to 7.3 million people suffering from a disease that receives little recognition or respect for the traumatic experience that it truly is.

Recent studies have shown that the psychological impact of infertility diagnosis and treatment is equivalent to that of cancer. According to the World Health Organization and the CDC, infertility is a disease. For many patients, IVF is the only effective form of treatment for the form of the disease from which they suffer.

Some critics of infertility treatments and insurance benefits for those treatments claim that infertility is a lifestyle choice. While it would be disingenuous to deny that some patients seek treatment as a lifestyle choice (namely to delay child rearing to a later, more stable point in their lives), those patients represent only a small fraction of the total of those in need of treatment. This criticism erroneously assumes that age is the only factor contributing to infertility. Even patients whose age might be considered a factor may only have come to seek treatment after years of trying unsuccessfully to conceive without medical intervention.

Employers often believe that adding infertility coverage benefits will increase health care costs. However, studies indicate that including comprehensive infertility coverage in a health benefit package may actually reduce costs and improve outcomes.

For example, an employer survey conducted by the consulting firm William M. Mercer found that 91 percent of respondents offering infertility treatment have not experienced an increase in their medical costs as a result of providing this coverage. For more on the survey, click here.

As proven in the following studies, the perceived cost of infertility treatment is typically overstated.

Often patients select treatment based on what is covered in their health benefit plan rather than what is the most appropriate treatment. For example, a woman having trouble conceiving because of blocked fallopian tubes or tubal scarring may opt for tubal surgery, a covered treatment, which can cost $8,000 -$13,000 per surgery. Many patients are forced to forgo in vitro fertilization (IVF) because it is not a covered service even though it costs about the same as tubal surgery and statistically is more likely to result in a successful pregnancy.Infertility as a Covered Benefit, 1997). According to William M. Mercer, “The decline in use of high-cost procedures like tubal surgery would likely offset the cost to include IVF as a benefit and provide improved health outcomes.” (William M. Mercer,

In states with mandated infertility insurance, the rate of multiple births is lower than in states without coverage. (New England Journal of Medicine, “Insurance Coverage and Outcomes of In Vitro Fertilization,” August 2002). Couples with insurance coverage are free to make more appropriate decisions with their physicians based on medical necessity rather than financial considerations which often result in multiple births and a high rate of complications during and post-pregnancy. Read more here.
Comprehensive infertility coverage may actually reduce premium expense by as much as $1 per member/per month. According to The Hidden Costs of Infertility Treatment in Employee Health Benefits Plans (Blackwell, Richard E. and the William Mercer Actuarial Team, 2000), insurance premiums now indirectly provide coverage for “hidden” infertility benefits such as surgeries to remove scarring in the fallopian tubes for women or varicose vein removal for men, were calculated to be adequate to cover more effective and often less expensive treatments such as ovulation induction, intrauterine insemination and in vitro fertilization.
The cost of infertility services as a percent of the total health premiums went down after the 1987 Massachusetts mandate. (Study by Griffin and Panak, Fertility & Sterility, 1998)
In vitro fertilization accounts for less than three percent of infertility services. According to the American Society of Reproductive Medicine (ASRM), 85%-90% of infertility cases can be treated with conventional medications.

Additional information on issues surrounding infertility can be found on Resolve.org. I hope The Company will consider extending infertility coverage to include IVF and support our family building efforts. Thank you for your consideration.

Sincerely,

Moi

Baby steps people, baby steps.

*All names changed to protect my privacy.
The internet is forever, after all.

All the Cool Kids Have One

2011-04-27T10:28:00.002-04:00

Happy NIAW!

My sweet friend Jen over at This Is More Personal is doing a fundraiser for Resolve in honor of NIAW. Go check it out and pick a little #hope for yourself!

Old Dog Searching for New Trick

2011-04-25T11:04:00.000-04:00

Depression has been a factor in my life since my childhood. Both of my parents suffered from it. My mother sought therapy and has been on anti-depressants since before I left home. My father didn't admit he had a problem till long after my mother divorced him, but he's now on anti-depressants as well.

I've never really felt like I personally had true depression. Sure, I had down times, I had periods of situational depression. Who doesn't get a little depressed every now and then? But on the whole, I feel equipped to self-manage my blues.

I made my first foray into therapy just after I finished college, returning occasionally until I completed grad school. My diagnosis was chronic anxiety and panic attacks. I was uncertain of my path in life and needed an objective listener to talk through my desires and decisions.

One day a few years ago, I started crying at work and couldn't understand why or figure out how to stop. I left work and drove straight to my GP, which led to a diagnosis of a severe vitamin D deficiency and a temporary prescription for an anti-depressant. I took the first half dose and the side-effects were so bad (heart palpitations and hallucinations) that I was unable leave the house. I threw the rest away. Fortunately, my doctor also prescribed a mega dose of vitamin D which kicked in within a week or so and my depressive symptoms abated.

There have been a handful of times in my life when a case of the blues developed into what can only be described as a Black Cloud that cast every aspect of my life in gloom and shadow. At these times, I felt that there was absolutely no point in continuing my life as I knew it and the only solution I could see was dramatic and all consuming change. In short, I would drop everything and run. Nothing like walking away from your life and reinventing yourself to force yourself into Hope for the future. Not the healthiest strategy perhaps, but a fresh start was 100% effective.

This is the first time since getting married and buying our house that I've spent so much time under my Black Cloud, and my usual tactics won't work here. Running is not an option anymore. Perhaps that's why I feel so hopeless and desperate this time. I need a new strategy and I'm at a loss. I need a new trick.

Romeo

2011-04-23T15:29:00.000-04:00

OMG y'all. So funny I just had to share.

The temps are quite lovely today, so we've got the windows open around the house. We're just hanging out and we can hear people outside talking and calling to each other down the street. All of a sudden we hear someone calling their dog:

"Romeo! Romeo! ROOMEEOOO!"

And Prof exclaims:

"How can you not finish the line!? WHEREFORE ART THOU ROMEO!"

I'm dying here. He kills me.

I Don't Know What to Say

2011-04-21T18:00:00.000-04:00

My husband asks how my day was, and I don't really have an answer.

My parents call on the weekend to catch up, and I have nothing to tell them.

My colleagues ask how my weekend was, and I can't remember what I did.

My BFF texts to check in, and I don't even know what to text back.

I read your tweets and blog posts, and I don't know how to comment.

I open a new post on my own blog, and I just don't know what to say.

Holla Georgia!

2011-04-16T18:10:00.000-04:00

Hiya! I know I have a bunch of readers in Georgia and I'm hoping you lovely peaches will head over and give my bloggie buddy Waiting Vicky the benefit of your experience. She's contemplating traveling to the United States for treatment and is looking for recommendations in Georgia, specifically in the Atlanta area.

Thanks y'all!

Much Ado & Motivations

2011-04-09T12:35:00.000-04:00

I've been lurking in the online IF community for years. After NIAW last year and Keiko's stunning What IF video, I created my IF Twitter identity and opened up a line of communication (albeit anonymous). Shortly thereafter, I started this blog. And over this last year I've "met" hundreds of you who are riding the same roller coaster I am. Hoping, trying, losing, hurting and surviving to hope again.

In the last week, so many in this community have lifted their voices in outraged response to the ignorant and disrespectful publicity stunt by PETA, and our combined voices turned out to be loud enough to bring about change. There is something inspiring about watching scores of my online friends "coming out" about their infertility in response to their outrage against this ubiquitous ignorance. And something so satisfying in seeing A Result.

When we think about the amount of effort it will require to make an impact in our governments or to change the way society as a whole views infertility, it can seem daunting and overwhelming. It can seem like too much of a fight for one person to sustain. And that's partly because we are all so accustomed to feeling alone and isolated, that it FEELS like we are fighting this alone.

I'm grateful to PETA for providing such a catalyst to our community. NIAW is important to us as a community, but it is OF our community. Having a common target, and one we perceived to be within our sphere of influence, was motivating in a completely different way. PETA has proven to us that we can act together and as such we can make a difference.

I am only one voice, but I know that many of you out there are also making yourselves heard. I want to say an extra Thank You to Keiko and Katie who have both been so persistent and so eloquent on our behalf for more than just the last week. This community needs people like them. Please let them know how much their advocacy means to you.

Can we be loud enough to make ourselves heard by our "elected leaders"? Can we be loud enough to make ourselves heard by our individual employers? Can we be loud enough to make ourselves heard by our friends and family?

March

2011-04-02T15:47:00.000-04:00

Now that we're in April, I can announce that I hate the month of March. It's the most miserable month for weather. Every climate I've lived in has basically sucked in the month of March. In Texas it was windstorms and pouring rain and tornadoes. In Florida, it was generally nice enough but not quite warm enough for the beach (a truly grave disappointment in my early 20s). Now that we live so far north, March wavers between more damn snow and rain that melts what snow there is, leaving everything a gloomy mud color.

The weather is the least of my dislike though. Year after year, the blasted month of March drops some kind of bombshell on me. I've grown accustomed to it. Every year, I hope this will be the year that breaks the streak even as I brace myself for whatever might be around the corner.

This year, I thought that by NOT mentioning it, I might be able to break the streak. When we had reached the second to last day of March with no disasters, I kept my mouth shut lest I jinx this seemingly brilliant luck. I should have known better.

As disasters go, it certainly wasn't dire, but on March 31st, we got our tax forms in the mail from our accountant. I then had to wave good-bye to nearly $2,000 that I'd been hoping would go towards IVF. As disasters go, I guess it could been so much worse. Other years have certainly dealt more serious blows and at least we had the cash saved up and could pay up without penalty and interest. Still.

Public Service Announcement (UPDATED)

2011-03-28T12:06:00.007-04:00

I feel like a total idiot, but I need to share this with you all just in case you are as un-observant as I am.

I was cleaning out my fridge this weekend and organizing my crisper full of Gon.alF by expiration date and I made a discovery.

The expiration date on the pharmacy's prescription sticker was NOT the same as the expiration date on the actual box the pen came in.

Big revelation, huh? I hadn't even realized there was a date on the actual box. I only saw the one printed on the pharmacy sticker. My pharmacy is part of my health insurance company. Those sneaky bastards put an expiration date FIVE FULL MONTHS earlier than the one printed on the box. And the most recent batch of meds I received... the pharmacy sticker has a date that is THIRTEEN months earlier than the date on the box.

Anyway, the moral of the story is check your prescriptions carefully to be sure of the expiration date. Don't let the insurance bastards put one over on you.

UPDATED: (re: Rx expiration vs Meds expiration) Excellent question C, and one I asked myself at first as well. But no. I know this because when I called the pharmacy in January to order a refill, they told me the Rx had expired and I would need my RE to call in a new one. The last box of medicine I had left over from the previous Rx had an expiration date of 3/01/2011 on the pharmacy sticker. More than two months after when the pharmacy told me the Rx had expired and yet five months earlier than the date printed on the box.

Siren Song of a Seed Packet

2011-03-26T13:34:00.000-04:00

The ground is still covered with a light blanket of snow. The temperatures have been topping out in the low 30's. I hate working out in the yard at any time of year.

And yet.

With the imminent change of seasons, out come the display racks filled with colorful seed packets. And I can never resist. Last year it was parsley. This year, I bought cilantro seeds because I always resent buying the huge bunches in the produce section at the grocery (seriously, who needs that much cilantro?). Whether or not I will actually PLANT the seeds is another question entirely. But I just couldn't resist the little yellow envelope. I never can.

Hope springs eternal in almost every aspect of my life. I cannot for the life of me fathom how or why.

I'm OK

2011-03-24T20:38:00.000-04:00

Just don't have anything to say at the moment.

Things to Feel Good About

2011-03-19T12:41:00.000-04:00

So now we wait. Again. There really is no end to the waiting in this game is there?

I call with my next CD1 and we do a bunch of baseline stuff & blood work. Depending on our calendars and my cycle lengths, I will probably start BCP in early May. In the meantime, I don't really have much to report. I'm trying to focus right now on the good stuff, things I can be grateful for in the midst of all that is so unfair about this situation.

Aside from the fabulous support group I've found here and on Twitter...

I already have most of the meds I will need for IVF and what I don't yet have, shouldn't be too costly.
Our cars are both paid off.
My student loans are all paid off.
Our back taxes are all paid off.
Our only remaining debts are our mortgage and one credit card (though it IS a doozy).
Prof has contracts booked through the end of 2011. This is huge!
2010 tax materials have been passed to the accountant and she said they "look good". No whammy, no whammy!
We have not yet needed to use the (tiny, tiny) savings we put away last year (knock on wood).
The weather should only improve from here on out.
My boss is back in the office, so my work stress should decrease.

These are all good things. Breathe in, breathe out. Let go.

Why Bother?

2011-03-16T16:15:00.001-04:00

DISCLAIMER: This is probably going to seem like a really random collection of thoughts, but (if you roll with it) it should all fall into place by the time I'm done.

In facing down IVF, I'm also facing down a lot of doubts and fears:

I am not psychologically strong enough for IVF.
My eggs and I are just too old for even IVF to succeed.
Once won't be enough and we'll go broke trying again. And again.
I will never feel like I can stop trying.
IVF will work and I won't be "up to" motherhood.
Prof and I will survive IVF only to be driven apart by parenthood.

The one I'm particularly stressing on at the moment is my age. I know chronological age really means nothing in this game. I know some women in their 20's are facing early menopause and some women in their 40's can still get knocked up on their own. They are the outliers.

I am 38, and 39 is approaching faster than I care to acknowledge. My FSH is 10.7 and my AMH is .33 - not good numbers for a woman trying to make a baby with her own eggs. So the clock, it is a'ticking.

In an effort to do everything possible to bring this IVF adventure to a successful conclusion, I decided to head back to acupuncture again and to hit it as hard as I can, even when the insurance coverage runs out. I hadn't been in for acupuncture since last Fall before my "second opinion" with the clinic recommended so highly by my acupuncturist. If you've read that post, you'll understand the quotation marks. If you haven't read it, you should, because it was a trainwreck of a second opinion.

As I was catching up with Dr. Needles and bringing her up to speed on the plan, she asked if I was still seeing my original RE... and I could see where she was heading with that. I explained to her that I had been for a second opinion with her recommended clinic last Fall and I gave her a brutally honest report of my experience there. She was surprised and suggested I should definitely share my thoughts with them, but frankly I don't see the point.

She explained the reason she recommends them so highly is that she has had several patients who were turned away by my clinic but then went on to achieve a successful pregnancy at the Spa. The upshot of this is that my fertility clinic won't treat just anyone who walks in the door. I suspect their higher success rates may be due in part to the fact that they will apparently turn patients away who they don't feel they can help. At the time of this conversation, I had not yet seen the newly released success rates, so I obviously didn't bring them up.

I admit I'm a little conflicted about this. It's comforting that they don't just take the payments and let people go through treatments that aren't likely to work. At the same time, it's disconcerting that they are making calls about who to help or not.

So this is one more thing that CAN give me hope, one more thing that tells me it is worth going through this ordeal. If Dr. Original didn't think he could help me, he would have said so and he probably wouldn't treat me.

So that's one reason why I bother to push forward on this path.

Watch This Space (UPDATED)

2011-03-14T12:21:00.031-04:00

My pre-IVF appointment is this afternoon, so I'm sitting at my desk biting my nails.

I'll post an update when I get home from acupuncture this evening.

UPDATED: I forgot to take my list of questions. Not the most auspicious beginning to the IVF process. I managed to remember most of them, and I'm putting them down here for my own reference as much as anything else.

We got a whole checklist to get in order before we get started and a raft of new blood tests got ordered (I call in with my April CD1). Prof has to have an extra-special-IVF-SA which they will freeze as back-up for the IVF. In the vent of his untimely demise, those sperms are to be used to get me knocked up if I so desire. It's written and signed. Beyond that, we start whenever we are ready. I think we're gonna shoot for June.

Melatonin (forgot to ask, not really worried right now)
Acupuncture On-Site: (forgot to ask, still time to check later)
Success Rates: My clinic has been improving themselves since the last batch of success rates were published! A new batch came out last week and my clinic actually had better rates than some of THE BEST clinics in NYC. They beat the pants off the Second Opinion clinic (like, triple the success rates).
My lining: Has never been of particular concern.
Egg Quality/Mature Eggs: Dr. Original said my stimulated follicular phases were textbook length, not too short and the Lu.pron is what will give us time to get the most mature eggs.
Protocol: The whole team of RE's in the practice review each patient's charts before an IVF cycle and they decide collectively what the protocol should be. Kinda cool! He thinks mine will be pretty standard, BCP/Lu.pron/GonalF/Ovi.drel/PIO. The BCP will be the same brand I always took before we started this whole baby-making gambit, so that's a comfort. I have almost enough GonalF in my vegetable drawer for IVF. I think I know how to get more. Dr. Original stated that my stimulated IUI's were relatively low-dosage for a woman my age and he thinks I'll use one pen per day during IVF.
ICSI: Yes, due to my age and our lack of real success in other cycles. Although, we will probably go with PICSI (partial-ICSI). This means they will ICSI half of however many eggs we get and let the rest fertilize naturally. We like this option because we feel like it may give us insight into what our problem might be. And if we get a baby girl, I'm totally calling her Pixie. No one ever needs to know.
Assisted Hatching: Yes. Due to my age.
PIO vs Crin.one: PIO for the 2WW. He said I could use whichever I preferred, but that HE recommends the PIO until beta. He did say they would probably switch me to Crin.one once pregnancy was established.
Financials: We've decided to do one round to see my response and what quality eggs/embryos we get. We'll revisit the B2G1Refund option if needed.

SIDE NOTE: When reviewing the success rates, Dr. Original checked my chart for my age. He said, "Age... 38? Well. I wouldn't have guessed that." Have I mentioned how awesome he is?

I've Got Mail!

2011-03-12T12:17:00.001-05:00

One of my responsibilities at work is producing the "Personal Updates" section of our organizational newsletter. This involves people sending me random emails with tidbits like:

I have a new job!
I'm relocating from Barcelona to London!
I've won a national award!
I just published a new book/article!
I got married!

And... Yes.

We just had a baby!

Great task for an infertile, huh? When I see notes come in from people who are older than me announcing the birth of twins, I just know. And I wonder how they would feel knowing a still-struggling infertile has to send all of those happy shiny congratulatory replies back to them?

Pre-IVF Consult

2011-03-10T12:30:00.000-05:00

Our pre-IVF consult is scheduled for March 14th. The nurse who set the appointment for me mentioned consent forms. We've got questions, we're hoping they have actual answers. Leave me a note in the comments if you think of any other questions we SHOULD be asking (keeping in mind I may not have listed it here because I already know the answer, in which case I'll try to post that after the appointment).

Can I continue to take the melatonin in the 2WW?
Is there anything we can do to optimize egg quality?
Is there anything we can do to ensure more mature eggs? (I seem to have a short follicular phase on injects and worry about potential immaturity)
Is there anything we can do to optimize sperm quality (already seems quite good)?
Discuss Crin.one vs PIO for luteal phase support.
Is in-clinic acupuncture available? Can I bring my own acu?
Will we use ICSI and/or Assisted Hatching?

We also have some thinking to do about the financial side of things.

Our clinic offers a very reasonable shared-risk plan. For couples in our age bracket, $17K gets you three fresh (and three frozen) cycles with 75-85% refunded if you don't take home a baby. I'm already not sure where we'll get the $7K for ONE cycle (though my FSA will reimburse most of that after the fact, we still have to pay up front somehow). But the way our luck has run, I'm really worried that one cycle won't be enough.

So... When Are YOU Going to Have Kids?

2011-03-08T13:13:00.019-05:00

Talk about a common thread! We all get this question or some variant thereof at some point. And we all know going into any major family or social gathering that we're probably about to get it again (repeatedly). So this is by way of a reference post for IF'ers prepping for a situation in which the Dreaded Question is likely to arise. Below are some examples I have previously seen shared when one of "us" has had an impending need for such resources.

When in need, revisit this list of quick & easy responses to inquiries into your reproductive life. And for maximum points, follow up your response with a very derisive "But thank you SO MUCH for asking".

If and when God chooses to bless us. My personal favorite, said with a sickly sweet intonation. No offense to you Believers out there, but this one covers all bases. If the questioner is religious, they can't really argue with God's will. If they aren't religious, you can hope they have the sense not to argue religion with you in any event. In my case at least, if they know me at all, this shuts the conversation down entirely because they begin to suspect I've lost my mind.

I'm waiting to see how yours turn out first. Good for new parents.

When the CIA clears our files. (BumpyJourney)

When you stop watching my uterus. (naturalmelnow)

The voices told me not to.

Actually, I am pregnant. I'm due in twelve months. Then walk away rubbing tummy. (carlnjessdewy)

What and spend the next 20 years fat, tired and broke?

Kids are really expensive and I'd rather... fill in the blank with your favorite pricey indulgence (travel, shopping, technology).

Why? Are you selling?

When do you need to know?

To a single person: When you get married. (amvdm23)

To a MIL/FIL: Well, I'm having unprotected sex with your son/daughter ALL THE TIME...

Are you worried about our sex life, because you don't need to be. Say it with bedroom eyes... Rowr.

I don't think our sex life is appropriate dinner conversation. (BornInABarnBaby)

I don't know, but I'll be sure and put your name on our list of people to notify as soon as we do!

If the questioner is a man... When is your next prostate exam?

If the questioner is a woman... When is your next pap smear?

And why exactly is that information that you need to know?

How do you know we aren't already trying and having trouble? (OldEggs)

When you pay for my next IVF cycle. (IVFJess & SassyNTubeless)

My darling Professor actually responded once, "So when are you planning to die?"

I saw this one on a message board (courtesy of Toxic) and I like it:

"There are thousands of couples, desperate to have a child, who struggle with infertility, mostly in silence. Every time they see smiling mommies at the playground, or go to a baby shower, it's a traumatic experience -- reminding them of the joy that they can't have.

I'm not going to tell you whether we're one of those couples or not, because it's not your business. I'm just going to tell you how hurtful your well-intentioned question is to someone who is.

Please don't ask me, or anyone else, again."

If you have any other brilliant suggestions, please leave them in the comments!

No News Is... No News

2011-03-06T12:29:00.003-05:00

I don't really have much to say at the moment.* Still in the Pre-IVF Planning stage so nothing to report IF-wise. My iPhone tells me yesterday should have been my peak fertile day (cue psychotic laughter) so Prof and I have been relating appropriately. I believe there is a saying about counting chickens or eggs or something? I confess I don't honestly believe this is baby making sex, but the intimacy feels nice.

I'm clamboring back onto the weight loss bandwagon. I was doing really well in January and kind of slacked off during our final IUI cycle and subsequent vacation. I don't think I put any weight back on, but I lost my momentum. I'm renewing my commitment to that effort. Seeing the success of my efforts and feeling my waistbands loosen up was such a boost to my self esteem and I really want some more of that! Like so many others, I feel like this is one of the few things I can really control in my life, so I want to exert that control.

Cat One had to have some dental work done a couple of weeks ago. She has had this several times, poor thing. She really got some crap genetic cards dealt to her in the tooth department. This time was much better than the last (when we almost lost her to the anesthesia) but I really lost my shit when I left her at the vet and two weeks later she's STILL licking the shaved place on her leg where they put the IV for the procedure. Hurts my heart to see her worry that spot raw.

My boss is out of the hospital and resting at home. Thank you for your thoughts on her behalf. The plan is for her to return to the office mid-month. This is a huge improvement over the initial outlook. We were warned it could be three months before she could come back. Now she'll be back after only 6 weeks out - she's turned out to be quite the rockstar in the healing department. To say we've really missed her doesn't quite cover it. Nothing to what her family must have felt.

I mentioned on Twitter recently that I've been feeling like I'm mostly just watching other people's lives go by me. I'm not doing the IF obsessive thing, I just don't feel like I'm doing much of anything. Perhaps I Let Go just a little too much? I feel like I need to live it up a little.

*That was awfully long post for not having anything to say...

Plan Y

2011-03-03T12:13:00.000-05:00

Plan A (Stop BCP)
Plan B (OPK+timed intercourse)
Plan C (acupuncture)
Plan D (Clo.mid+IUI)
Plan E (Clo.mid+triggered IUI)
Plan F (Gon.alF+triggered IUI)

We've tried so many plans and variants of plans and repetitions of seemingly successful plans, and yet. Here we are two plus years on with no baby. We are making one more plan. The next to last plan.

Plan Y (IVF)

Plan Z is taking the turn off of the IF highway to grow old with the Professor and start putting our spare income towards seeing some of the places we've always wanted to see and knocking off some of the items on our Life Lists.

Beating a Hopeless Horse

2011-03-01T14:28:00.008-05:00

I just wanted to say a quick Thank You to all of you here and on Twitter who have been so incredibly kind and supportive. You've listened to me whine, putting up with my navel-gazing and moping. And you've done it in the most caring way and with such good grace, constantly reminding me that I AM NOT ALONE, I am not the only person who ever traveled this road, felt these fears and emotions. Not one person has told me get over myself, sack up and sally forth. Y'all are a warm fuzzy blanket and a cup of coco.

Thank you for continuing to beat that particular horse for me.

Crinone

2011-02-27T13:26:00.001-05:00

If you've been reading my story for any amount of time, you know I tend towards luteal phase defect and my RE always gives me extra progesterone supplementation after ovulation. For my final IUI, he changed things up and prescribed Crinone instead of my usual suppositories. This is a progesterone gel that is delivered vaginally via pre-filled applicator like yeast infection creams.

I've seen quite a few other bloggers and tweeps who used it, but they usually just refer obliquely to ickiness, build-up and discharge. I hadn't really seen any practical suggestions for minimizing the ick. So for the benefit of anyone who hasn't taken this form of progesterone, but wants to know, here are the tips I got from my IF Twitter girls. If you have experience with Crinone, feel free to leave your own tips & tricks in the comments! For anyone else, this may be TMI in a big way. Consider yourself forewarned!

Wear all cotton underwear, and not your nicer selections.
Wear a liner if you don't mind them.
There will be build-up. Be pro-active about removing it.
You will need to go in and remove the build-up yourself. Do this in the shower.
Your insides will feel very strange indeed.
No douche allowed.
Side effects include: sore boobs, constipation, bloating, headaches and more.
You may have to wait a few days for CD1 if you get negative beta and stop taking the medicine.

Naught

2011-02-25T21:16:00.000-05:00

Not dreaming.

Not obsessing.

Not worrying.

Not planning.

Not railing against the unfairness of it all.

Not thinking positive.

Not visualizing success.

Not bargaining with the Universe.

Not feeling hopeful.

Not feeling much of anything but sad.

Reunited

2011-02-24T12:57:00.003-05:00

Obviously, we made it back from our reunion. It was totally and completely bizarre and intense. So intense, there were a few moments when I really thought I might vomit.

I saw so many people that I wish I could see every day, and a few people who I could gladly have gone the rest of my life without EVER seeing them again. There were countless places we revisited that hadn't changed a bit and whole new worlds that have been created in our absence. Previously open green spaces are now filled with (quite beautiful) buildings. We returned to our favorite boozing haunt and were greeted by bling-wearing, Benjamin-flashing, gun-toting hoods and bar room brawls. Things have definitely changed!

I was forcibly reminded of the beauty of the place, the insanity of the drivers, the harshness of the lives of the working class in a tropical destination when contrasted against the wealth of those who they work for and even a few unpleasant memories from my time there.

By far the most difficult aspect of the weekend (to no one's surprise) was seeing our old friends with their children. I thought we were doing fairly well with it, no tears or breakdowns, just a bittersweet sensation. And we were actually, up until we said goodbye to the last friend and started the drive back to the hotel by ourselves. To that point, we hadn't really had any alone time so we hadn't really had time to think too much about it. Nothing like a crowd for distraction!

As we made the drive back to our hotel that last night, Professor was unusually quiet. When I asked him what was up, he admitted that he was thinking about how adorable our friend's three year old daughter was and that he was really feeling his mortality. We talked about how hard it was to see all of our friends reproducing and replacing themselves in the world when it seems unlikely that we'll be able to manage it ourselves. I'm pretty sure we both ended up in tears.

We've got one last shot, moving to IVF. With no insurance coverage, we'll be lucky to fund one cycle. I'm realistic. Plenty of people see success on their first IVF, but it seems like an almost equal number of people get nothing (though they may see success in a 2nd or 3rd cycle). There's no way of knowing which camp we'll fall into or even if IVF will simply uncover new issues previously unidentified.

Bless My Poor Little Ovaries

2011-02-22T13:06:00.001-05:00

It's funny, having adopted my philosophy of Letting Go, my attitude about my ovaries has been shifting. For the longest time, I've been resentful of them. I've called them names and cursed them for their slacker ways. I've blamed them over and over for all of the heartache of the last two years.

But in the last month or so, I've noticed that when I do think about them* it's with a feeling more akin to pity. Bless them, the poor little things. I've been pushing them so hard, bombarding them with hormones and they really are trying to perform, and I believe now that they are actually doing their best.

Brace yourselves, dear ovaries. You ain't seen the worst of it yet!

*Seriously though, how many women actually spend any time considering their ovaries? I'm betting it's just us IF'ers.

This Is My Life?

2011-02-20T12:15:00.005-05:00

This is not Letting Go. This is Losing A Dream.

I'm numb, in shock, in denial. Mildly bitter, but still strangely calm. Utterly clueless about what my next move should be.

IVF obviously. But what do I do now? Call the clinic on CD1... but why? What will they tell me to do? I have no plan of action, no calendar in place. Another consultation to create a plan?

This can't possibly be my life. This kind of thing just doesn't happen to me. Oh sure, you hear or read about other people going through this all the time. It's so much more common than you might think. But it's always been other people. Not me. I feel like I just landed a starring role in someone else's movie.

It seems more than a little disingenuous of me after everything we've been through in the last 2+ years, that I never really believed we would have to go to such lengths to reproduce. How is it that this can still come as such a shock?

BFN. Again.

2011-02-18T17:51:00.000-05:00

Beta was negative. Not much else to say really.

Feeling well and truly fucked. I'll stop the Cri.none now and wait for CD1. I assume the clinic will tell me what happens after that.

No idea how I'll manage IVF with my boss out of the office.

In Case I Needed Just a Little More Stress...

2011-02-18T12:43:00.001-05:00

I came back from my vacation to discover that my boss is very ill. So ill that she's been hospitalized for the foreseeable future. Totally unexpectedly.

Please take a moment to send her your prayers and good thoughts. Then please say some for me as well.

To say I am unprepared for her absence is an understatement. I do not know how we are going to manage the coming weeks (possibly months, or so I've been warned). We will, but I don't know how.

One day at a time I guess.

So if I'm not here much, if I lose track of your storyline or if I seem to be AWOL from Twitter, please know this is why.

All Quiet on the Uterine Front

2011-02-16T14:03:00.002-05:00

The final IUI is done and I am in the two week wait. Everything went well. There is no obvious reason for it not to have worked. But then, there has been no obvious reason for any of the treatments failing over the past year plus. We did what we could and now we wait.

I am slightly less hopeful with each failed cycle, but not running on empty just yet. I'm still in a pretty peaceful place and I hope I get to stay there if this cycle doesn't pan out.

Funny story: The morning of the IUI, I went in with Professor to help him out in the collection room. As I always do. Keep in mind, nobody ever offered this as an option and I never asked permission. I've always just followed him in. So this time, we get into the room and he's kinda giggling. I asked him why and he tells me the new lady at the desk gave me quite the funny look when I followed him in this time. Guess I took her by surprise. Heh. God I really hope we're the talk of the staff meetings....

To My Valentine

2011-02-14T13:15:00.015-05:00

My darling Professor, love of my life:

Smart
Strong
Silly
Gentle
Protective
Supportive
Funny
Honorable
Generous
Hard-working
Hopeful

I'm so lucky to have him, so lucky that he loves me, so lucky that we are so in tune with one another. I wouldn't change him for anything.

Thawing Out

2011-02-10T09:16:00.000-05:00

We are off to Florida for our college reunion today! There will be an absolute ton of old friends on hand and I am so excited for the chance to hang out with them again. There is a core group of friends who have kept in touch and all attended one another's weddings, and I think they will all be there. Most of our college buddies that attended our wedding will be there, and several who weren't able to make it as well. BFF(H) will be there, so I'm getting to see her twice in a 12-month stretch which is beyond awesome.

Our social circle in the town where we live is pretty small. We have no family here and only a handful of friends made through our jobs over the years. None of our college friends are within socializing distance (the closest are about 5 hours away), so this weekend represents an unprecedented opportunity to reconnect with our old social network. I'm afraid when we come home, I'm going to be very sad to leave the circle again. I know I'll be sad to be returning to snow.

I haven't been back to visit the campus since 1998 and looking at the campus map, things have changed A LOT. I'm kinda freaking out about that just a little. I have such fond memories, and I know this is going to be a shock. I just hope I can be more excited about seeing the improvements than I am sad about the changes.

I'm also VERY curious to see some of the people who I haven't kept up with over the years. I'm wondering how many of them will have kids in tow, and how many will ask if we have any kids. I'm braced for the inquiry and trying to remember some of the better comebacks I've heard, but they are escaping me at the moment. Is it wrong that I'm secretly hoping that most of them are fatter, more grey and more wrinkled than I am?

"Why no, we don't have kids..." but hey, I do still get carded for alcohol at age 38. I'll take my joy where I find it!

Regret

2011-02-07T11:54:00.006-05:00

Should be a four letter word.

Seems like we all say it at some point (I know I certainly have)... I regret not starting to try sooner.

In my current (more sane and peaceful) mindframe, I can see that this is dangerous thinking. Should I have tried to get pregnant when I didn't want a kid, just in case I did someday? Should I have brought a child into the world to be parented with that lying, cheating douchebag I was living with when I was 21? Should Prof and I have jumped into marriage and parenthood while we were still in school, living in different countries?

You just can't make yourself want something you don't want. You can't force yourself to be ready for something. Sure, you can step up and deal with it if it happens unexpectedly, and you can even grow to be happy about it. But when you have to make a conscious decision to start down the path, it just seems ill advised to do "just in case" the future might not work out the way you think it will. You do the best you can in the moment and try to look at mistakes as educational opportunities.

Just like parenting, I expect.

We can't plan for everything. We can't see the future. And every past decision we have made, every path we have chosen, has contributed to who we are today. Baby-making situation aside, we have a great life.

Do I regret not starting to try sooner? Occasionally, in darker moments... of course. I'm only human after all. But on the whole, no regrets.

Award Season (UPDATED)

2011-02-05T13:09:00.001-05:00

Apparently tis the season for blog awards as well. Quick shout out to missohkay (currently on the path to adoption after RPL) and A (who recently got an au naturel BFP after three years of treatments), both of whom have recently honored me with awards - thanks so much ladies! If you haven't met them yet - go introduce yourself.

I'm going to cheat a bit with the rules of the awards and direct you to this post for some random facts about me, and in the spirit of randomness, I nominate everyone on my Recommended Reading list in the sidebar (25 most recent posts from blogs I follow).

Now get out there and give each other some love!

UPDATE: Shortly after I posted this I got another award, this time from Moon, so I'm rolling it in here as well. Thank you Moon!

Welcome to My Soapbox

2011-01-30T11:58:00.001-05:00

"We decided it was time to start a family..."

I've seen this phrase crop up several times recently and it always raises my hackles. I'm quite sure it is said unconsciously and not meant the way it sounds. The person writing it is inevitably referring to the decision that they were ready to procreate or adopt, but by extension, this would mean that they are not yet a family (so logically neither are the rest of us who are living child-free, either by choice or circumstance).

I believe in the power of words. While they can only have whatever power we give them, it takes real effort to dis-empower a word. I try to choose my words carefully to express my true meaning. Professor and I are already a family. We will continue to be a family whether or not we ever produce offspring. Your spouse is the ONLY family you ever get to choose. Even those of you who are in the process of procreating or adopting without a life partner are still part of a family.

Don't denigrate what you already have in the face of what you want.

(Stepping down from my soapbox now)

ABCs: In Which I Expose My Inner Bitch

2011-01-28T11:10:00.003-05:00

DISCLAIMER: I wrote this post awhile back before I managed to LET GO. We've all heard the saying, "It's always darkest before the dawn", and this was definitely written in a very dark place. A place I am so grateful to have escaped since. Perhaps I needed to go there before I could come to the place I am now. I debated over whether or not to hit publish, and have decided that as negative as it is, perhaps it will also help someone else to not feel so alone in the dark.

In alphabetical order:

Angry
Bitter
Callous
Fearful
Hurting
Mean-spirited
Petty
Selfish
Stubborn
Ungrateful

I've read this same basic post on so many other blogs, and I never once thought that the writer was being bitchy or at all unreasonable. And yet. As I sit here letting my thoughts take form on the screen, I FEEL like a royal bitch of the worst persuasion. I feel any number of horrible character traits surfacing and crowding out the better aspects of my personality. And I feel awful about it. But I have to let the thoughts out, or I'm afraid they won't ever go away. And I guess I want other IFers in my same shoes to know they aren't the only ones who have these thoughts. God I hope I'm not the only one having these thoughts. Maybe I won't ever hit "Publish". We'll see.

I am in a rather bleak place at the moment. I'm trying to focus on hopeful thoughts, but I'm really struggling. I won't lie. Those ABCs up there are the main things I'm feeling right now. Not pretty is it?

I've recently stumbled on a whole raft of new blog and twitter friends. And each time, as my cursor hovered over the "Follow" button, I hesitated. They were, every single one of them, in or at the edge of a 2WW. And I actually had the thought, "If I follow them now and they get a BFP in the next week or so, how will I continue to watch? What kind of pregnant infertile will they be?" And I clicked "Follow" anyways, because I want to be bigger than that. I want to lend support where I can, even though I feel more like a weight belt than a life vest these days.

One by one, every single one of them got their BFP. It's like I'm some twisted kind of infertile good luck charm.

Waiting for your BFP? Step right up! Just raise your hand and I'll follow you online - your BFP is right around the corner! Guaranteed!

Yeah, I know. Not realistic. But you'll notice that Realistic isn't on that list up there. Stubborn is though. I'm not gonna let the bitch win. I'm not going to UN-follow. Not if I can help it. Every time in the past that I've stopped following someone, I've felt horrible about it. But sometimes, it hurts more to keep watching. And sooner or later, they stopped following me too. And I have to wonder if they had any idea at all why I stepped away and how hard it was to do it? I don't know.

I know this is kinda ugly, but there it is. I just ask that my internet friends please be understanding if sometimes I'm a little quiet or don't seem particularly enthusiastic. I'm focusing a lot of energy on keeping my head above water and keeping the Bitchy at bay. Sometimes, that's all the energy I have.

Nobody?

2011-01-26T09:36:00.000-05:00

Well, it looks like I get to keep my 50,000 internetz because NOBODY guessed where the quote came from! For the two of you who actually care:

In Terry Pratchett's Hatful of Sky, shortly after Tiffany casts out the hiver, she and Granny Weatherwax have a blazing argument in the middle of the road. At the climax of the argument, just as Granny makes her point, she stops and says, "Peace be on this place".

If you haven't read the Tiffany Aching series, I highly recommend it!

The POAS Test

2011-01-24T15:21:00.006-05:00

I seem to be running up against my first series of tests in the Year of Letting Go. Yesterday was the one-year anniversary of my miscarriage. I was pleasantly surprised to be totally OK with the anniversary. And admittedly a little surprised not to be more hopeful about my late period.

Yep. According to my iPhone app, my period is three days late. I didn't bother to track this cycle, so I have no idea when I ovulated, but my iPhone has yet to be wrong about CD1. I hesitated to POAS because I don't have any symptoms (of pregnancy or impending period) and I really didn't want to do anything to disturb the peace.

But.

There was ONE stick in the house, and there's always a chance... always a little hope, right? So yesterday, on CD28 (MysteryDPO), I peed on a stick. And the stick said No. Actually, the stick said "Not Pregnant" because the only one in the house was one of those fancy digital ones, but you get my drift.

Amazingly, I passed the POAS test as well.

BFN but the Peace reigns undisturbed.

Last Anniversary For a While

2011-01-23T10:37:00.003-05:00

One year ago today, after weeks of waiting and knowing it was coming, I had a miscarriage. My one and only pregnancy. And today?

Today, I am OK.

Today, I'm just wondering if I'll ever get a second chance.

Peace Be On This Place

2011-01-21T09:24:00.008-05:00

50,000 internetz to the first reader to peg that reference...
(HINT: teen fiction)

I don't know how it happened, or why, or to be honest, even when. All I know is that I am suddenly so completely at peace with all of this IF business. I declared 2011 to be the Year of Letting Go. There was Runny Yolk's post that inspired me to confess my Secret Fears and all of your lovely responses to that confession. Thank you so much for those comments! Y'all make this road so much less lonely and you are the reason I keep coming here. Then Jess said this in a post on her blog:

... a child should be icing on the cake, not the cake itself.

What a fabulous reminder of the whole reason the Professor and I waited so long to toss the birth control in the first place. We've had a few really good, clear-the-air type talks lately and I've just been feeling so at peace. It's been coming on for a while now. I'm reaching a point where I'm getting a feeling of closure. Maybe it's that we've been ticking options off our treatment list so steadily. Maybe it's that I'm feeling my age. Maybe it's getting to know ourselves so very well through this process. I wish I could share a map to help anyone who needs to find this peaceful place, but I just sort of woke up here.

We've given this baby making thing our all, and we aren't finished yet. Yes, we still have one IUI left, and then a round of IVF (and depending on the results of that, any FETs we might be so lucky to squeeze out). Really, quite a long way to go yet! But I sense that the time is coming when I will be ready to call it quits. I won't be one of those women who appear to have bottomless reserves of both strength and funding to continue IVF time and again. We will only have the money to do one fresh cycle. IF we get anything to freeze (BIG IF), we might be able to scrape together enough for FET.

I wouldn't go so far as to say I feel hopeful, because what I really am is realistic. One of our last attempts might work. Or none of them might work. We will do everything we can, and that will have to be enough. And whatever the outcome of these next cycles, we will be OK.

I haven't lost hope. I've just let it go.

Please let this feeling stick around.

Secret Fears

2011-01-18T11:45:00.012-05:00

Inspired by a recent confession by Runny Yolk, I've decided it's time to open up about one of my big IF fears. I took so much comfort from reading her post, and being smacked upside the head once again with the YOU-ARE-NOT-ALONE stick. So this is in hopes that one of you (who maybe don't follow Runny Yolk) will get that same message: You are not the only one. I know that, because I am not the only one. See how that works?

A little bit of history here: until I was, oh... say... about 34? I couldn't stand children. Didn't really know any people who had them, wouldn't accept a table near them in a restaurant, generally cringed when confronted with them. I didn't even babysit as a teenager. Kids were my Kryptonite. I certainly didn't want any of my own, and I wasn't quiet about it. To this day, I still hesitate when presented with the opportunity to hold infants.

So why am I doing this?

I couldn't give you the date, but the moment is fixed in my mind like a photograph I've seen a thousand times. As I said, I was about 34. I was driving to work one afternoon (I used to work nights) and I saw a woman pushing her 1-2 year old daughter down the sidewalk in a stroller. There was nothing special about them, they were just an ordinary Mom and baby doing an ordinary thing. It was like time stopped and someone flipped a switch. I was open to a child of my own. Of course, I'm now racing towards 39 and no closer closing the deal.

I'm sure I've mentioned this here in passing, lumped in with a range of other fears, but I've been afraid to give it too much sunlight lest it grow roots and flourish. After more than a year jam-packed with failed fertility treatments, I finally came clean to the Professor last week about one of my deep dark What IFs. Damn that was hard, but luckily for me, he responded in true Professorial fashion and made me feel better on the spot. When will I learn to open up sooner?

Lately, I've been worrying more and more that the reason we haven't seen any success in our efforts against infertility is that I'm in it for the wrong reason. Obviously, the RIGHT reason is wanting a baby. But wait! I DO want a baby! Well, maybe I don't want it enough? Maybe that girl who didn't like kids is still hiding in there and sabotaging my efforts? Because, if I'm honest... when I think about reaching the point where we've exhausted our resources and our options and still not having a baby... it no longer scares me. It doesn't sound like the end of my world. I can think of plenty of good aspects to that situation.

When I shared all of this with the Professor last week, the first thing he said was "Good."

Also obvious, is the fact that this is totally irrational. I've been having trouble pinpointing my motivations for everything I'm putting myself through. I'll tell you right now that I still don't know. I'm just less worried about not knowing since I talked to the Professor about it last week. Maybe I'm deluding myself into a better frame of mind to deal with an ultimate failure at this task? Whatever. I'll take it.

So if the "right" reason is wanting a baby and wanting to be a parent, then as they scroll across my mind's eye, my possible "wrong reasons" are as follows:

I want make the Professor a father, to give him the gift of offspring. This is a fact. No argument, and while not ideal, still a laudable reason.

I'm afraid to disappoint our families, who I know want grandkids. This is also a fact. Though I was never one to do something just because my parents wanted me to, this is an area where I'd rather not disappoint.

I'm just stubborn and can't handle the idea of failing at something I set out to do. This is... close. But not quite right somehow. When I truly fail at something, I usually just blow it off. I am sometimes perfectly OK with not being good at things.

Perhaps a better way to put it would be:

I'm just stubborn and can't handle the idea of failing at something I care about. That feels right. And there's something very important there.

I care.

That's a good enough reason for me.

Need to Vent?

2011-01-16T15:25:00.000-05:00

A few of my bloggie pals have mentioned recently needing to get something off their chest, but being concerned about someone or other reading it if they put it out on their blog. This reminded me of a blog I recently subscribed to by IF Good Samaritan, Lois Lane: Off the IF Record.

If you need a REALLY anonymous place to vent, this is a good option. Check it out!

Score One for Me in 2010 (I guess...)

2011-01-14T11:28:00.000-05:00

I've just been reviewing my recent health insurance claims from the last few months of 2010 and I noticed something unusual.

Perhaps I should back up a bit. I am mildly ashamed to admit that I very rarely bother to review my processed claims. It's so rare that I have an issue, and the bills I receive from providers are almost always minimal. So I usually just go with whatever they send.

Now that my brain is emerging from the fog that was the end of 2010, I realize that I never received ANY kind of bill for the second opinion back at the beginning of November. Nada. Zilch. Not even lab work, which would have come from the lab directly. And that includes the much debated AMH test which my insurance informed me in advance would definitely not be a covered expense.

And I vaguely remember a phone call from the specialty pharmacy at the beginning of December during which the billing rep told me they would be refunding my copayment for the last batch of Gon.alF I ordered in August because my insurance paid it in full.

That's weird, why would they have done that?

With these nagging little items gaining ground in my consciousness, I decided to investigate. So I went online to review my recent claims. Those charges were all in there, claims processed and completed. Under the column heading "You Pay Out of Pocket", each one said $0.00. This goes all the way back to mid-August.

There's a thought pinging around in the recesses of my mind, but I don't know where it came from exactly. I think I met my out-of-pocket limit for the year. For the first time in my life. After which point, my insurance paid for everything.

Does that actually happen?

Just Be There

2011-01-12T09:01:00.000-05:00

I recently witnessed an extended conversation on Twitter that I found incredibly disturbing and I eventually decided to unfollow someone because I was so uncomfortable with the self-righteousness and judgement that I perceived in their remarks. Note, I said "I perceived". Perhaps I misunderstood, but I doubt it. More than anything, I needed to not see it in my Twitter feed anymore.

A few hours later, I saw this post in my blog reader. And it spoke to me.

I know it isn't precisely to the point, but it brought home the realization that when we are hurting, when our hearts are heavy, there are some responses to our pain that hurt more than they help. That people who are maybe just trying to show us what they think is a better way of looking at things, can actually cause us incredible suffering.

We can't make each other better and we shouldn't try to shame each other into prettier feelings.

Post-Op Update (In a Nutshell)

2011-01-10T12:02:00.001-05:00

In a nutshell, it would be a little cramped!

Done groaning and rolling your eyes? Good, moving on.

WE ARE (moving on that is)!

Thank you all so much for your thoughts and wishes last week. The post-operative appointment was super simple. We sat and chatted with our RE for about 30 minutes. That's it. The first thing he asked was if I remembered talking to him afterward, and I must admit at this point, I do not remember that. He didn't seem surprised.

He reviewed the surgery (actually pretty cool). He had a transcript of sorts which he read back to us, with all kinds of details, and photos too. There were actually multiple polyps that he removed, then followed the removal with a "light" D&C. Professor was really getting into all of the minute detail in the transcript, right down to the measurement of fluids found to have leaked back out and onto the floor of the operating room after the surgery.

The tissue he removed was sent to pathology and all came back clear. We are on the books for our final IUI as soon as my next CD1 turns up, and in the meantime, we were instructed to go home and get busy! Next week, I will call up the specialty pharmacy and refill my IUI meds.

We are still in the middle of the road, but the engine is running and we are in gear.

A Little Help FOR My Friend

2011-01-08T12:00:00.000-05:00

I never cease to be amazed at how many people have stumbled into my little corner of Blogland, and how generous you all are.

I want to ask a favor of my readers who are IVF veterans, and I promise it won't cost you more than a few minutes of time! Please pop over to see my dear Twitter friend Jen (@thisispersonal) at This Is More Personal and give her the benefit of your experience. She is embarking on her very first IVF and is looking for some tips on managing the emotional/mental/psychological side of the trip.

Knowing you are out there has made this last six months so much easier to bear. Thank you all for the love you have shown me, for your comments and concern, just for being YOU!