I'm a Donor Too

I donated all of my leftover Meno.pur to a couple who had no prescription coverage. I was so excited to know that I was helping someone else towards a shot at their dream and so relieved that the meds wouldn't just be going to waste in my closet. Still... it was surprisingly hard to drop off the boxes,  smile and walk away casually.

I've been holding those meds for months now, knowing I would never use them. I told Prof later, that it felt a little like giving away my "blankie".

God please, I hope their cycle works.

Ongoing Debate

I have reached a point where I accept that no matter what our eventual decision, no matter what our eventual outcome... there is no possible future in which I do not always carry with me some sadness and some resentment regarding my experience of infertility and my perceptions of the fertile world at large. I'm not saying I will be mired in grief and depression for the rest of my life, but this sadness and resentment is part of me now, sort of a household item. I'm looking forward to the time when it's packed in a trunk in the basement, rather out on the coffee table in the living room though.

If someone could wave a magic wand and guarantee that if I had sex with my husband, there would be a baby... I would do it. So why am I debating whether or not I still want to pursue further assisted reproduction, when I know that the treatments aren't my hang-up? Good question.

Letters to a Young Poet

I wanted to share a handful of quotes from Rilke's Letters to a Young Poet that have stuck with me over the years, and some of which repeatedly come to mind when I am in a difficult place. Perhaps I should re-read the entire book...

“The point of marriage is not to create a quick commonality by tearing down all boundaries; on the contrary, a good marriage is one in which each partner appoints the other to be the guardian of his solitude, and thus they show each other the greatest possible trust. A merging of two people is an impossibility, and where it seems to exist, it is a hemming-in, a mutual consent that robs one party or both parties of their fullest freedom and development. But once the realization is accepted that even between the closest people infinite distances exist, a marvelous living side-by-side can grow up for them, if they succeed in loving the expanse between them, which gives them the possibility of always seeing each other as a whole and before an immense sky.”

“We need, in love, to practice only this: letting each other go. For holding on comes easily; we do not need to learn it.”

“Do not assume that he who seeks to comfort you now, lives untroubled among the simple and quiet words that sometimes do you good. His life may also have much sadness and difficulty, that remains far beyond yours. Were it otherwise, he would never have been able to find these words” 

“Be patient toward all that is unsolved in your heart and try to love the questions themselves, like locked rooms and like books that are now written in a very foreign tongue. Do not now seek the answers, which cannot be given you because you would not be able to live them. And the point is, to live everything. Live the questions now. Perhaps you will then gradually, without noticing it, live along some distant day into the answer.”

[The following is my favorite passage of the entire book. I have written it out by hand a number of times to reinforce my memory of it and I refer back to it whenever I am feeling suffocated by my fear of change.]

“Why do you want to shut out of your life any uneasiness, any misery, any depression, since after all you don't know what work these conditions are doing inside you? Why do you want to persecute yourself with the question of where all this is coming from and where it is going? Since you know, after all, that you are in the midst of transitions and you wished for nothing so much as to change. If there is anything unhealthy in your reactions, just bear in mind that sickness is the means by which an organism frees itself from what is alien; so one must simply help it to be sick, to have its whole sickness and to break out with it, since that is the way it gets better.”

― Rainer Maria Rilke, Letters to a Young Poet

Cancelled

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.

Oh FFS...

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.

Secret Fears

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.

Infertile Wonderland (or more WHY?)

I'm so weary.

I find myself wondering why I am continuing to push myself so hard (both physically and emotionally) to get knocked up. Why am I so single-minded in this pursuit?

Do I really want my husband's baby this much? Or am I just unwilling to admit there is something I can't do? I've spent so much of my life being told by people who love me that I shouldn't give up on some endeavor or other just because I was struggling, just because it was hard, just because I didn't see instant success. Always kinda made me feel like they thought I was being a quitter. Nobody likes a quitter, right?

Don't give up.

Keep trying.

You can do anything you set your mind to.

Have I reached the point that I'm just doing this to prove that I can? And to whom am I proving this... myself, the Professor, our families (who don't even know we're trying), the world at large? I don't know the answer to that, and I'm not sure I want to. But I do know that we haven't yet exhausted our options or our resources. We haven't tried everything we can. And I know that I don't want to look back in 10 to 20 years and regret not trying every possible option. So we continue... as soon as we get the all clear in January.

Tis the Season

I've already shared my feelings on this time of year, and none of that has changed, but this has been a particularly difficult Christmas season. I can't quite put my finger on why this is. I'm hoping that writing things out will help me clarify things and maybe that will help me get past it.

Oddly enough, my gloom doesn't SEEM to have anything to do with the absence of offspring in my home. That is a fairly persistent, dare I say, permanent gloom. A not-so-low-level hum of sadness that rests like a wet blanket on my everyday life. But I'm not really dwelling on that any MORE than I was last month, or the month before.

So why does the pile of yet-to-be-wrapped gifts on the dining room table cause me to break into tears? (Actually, this one I know. Those gifts don't seem nice enough, creative enough, just plain good enough for the lovely people I bought them for. And that breaks my heart) Why can't I seem to get off the couch to put ornaments on the tree that Prof so sweetly set up and strung with lights? Why does the thought of the cookies and other treats I still need to bake cause my stomach to turn? Why haven't I been able to sign our names to the Christmas cards and put stamps on them?

I don't know what (if any) relationship there is, but I do know I have been feeling much less confident and competent for the last few months. I've spent two years now doing everything I know to do in an attempt to bring our child into the world, with no success and no explanation of why nothing has worked. I have failed at the most basic, biological level. I know this won't be a surprise to any of you IF'ers, but this fundamental failure is coloring my perception of every other aspect of my life. Clue #1.

Ah.

If you back up a few lines, there's Clue #2. Two years. In 10 days, we will hit the anniversary of our one and only BFP, our one and only glimmer of hope that we might ever see success. In just over two weeks, we will mark the two year anniversary of throwing away the BCPs. And the one year anniversary of learning that our BFP wouldn't last. In just over a month, we will be at the one year anniversary of the miscarriage that ended that lone BFP.

That's a lot of weight for a festive season to bear.

Oh Doc, Just One More Thing...

After our last WTF consult with the RE, we were a little bit in shock. The change in diagnosis and the possibility of uninsured IVF in our future were a kick in the ovaries to be sure. It actually took a few days for all of the information we'd been given to sink in, and of course once it had, we just had more questions. I called the insurance company and my HR department (several times each) and eventually managed to get confirmation of what the RE had told us:

No IVF coverage under any of the health care plans offered by my employer. Period.

Then I set about booking the second opinion with the fertility center recommended by my acupuncturist (and approved by my midwife), only to be told by my insurance company that they weren't a contracted provider so none of their services would be covered. Which after 3 days, many phone calls and much gnashing of teeth was proved untrue. So after a little more Google-mining, I put in a call to our RE with our follow up questions (answers are my paraphrase):

• If the theory is that the recent 9 day luteal phases were really early miscarriages, then do we have a concern about egg quality or chromosomal issues? Not really
• My acupuncturist and I were discussing my periods and it sounds like mine are clot-heavy, is this a concern? Not really (my last acupuncture treatment seems to have helped with this)
• Can you prescribe the PIO during my next injectible IUI cycle so I can hoard it for a possible future uninsured IVF? Yes, though the cost is minimal anyways
• Can I go ahead and get the AMH tested even though you aren't worried about it? Yes, but it may not be covered by insurance. (I am checking this out today)
• What can you tell me about state funded grants for uninsured IVFs? Funding has run out and is not currently expected to be renewed (damn).
• Is it OK to take melatonin to help me sleep (any contraindications)? Go ahead - it's fine.

There are a few other questions that I will pose if/when we reach the point of IVF. The melatonin question was actually a little sneaky. I read an article recently about a new study that reported improved egg/embryo quality in IVF patients who were given 3 mg melatonin. There was no information on timing/frequency of dosages, but I figured if it helps me sleep through the night AND has the potential to improve our chances it would be worth a shot.  After a week on it, I have slept through the night twice in a row, so that's good at least!

Ultimately, I chickened out of mentioning the second opinion. The Professor feels strongly that we should be upfront about it to minimize awkwardness. I will do it when I request the records, but I just caved in the moment and couldn't broach the subject.

Room to Breathe

Well, CD1 is just around the corner. I've got the cramps and headache, and light spotting started this morning. With my work schedule for the next four days (including the weekend) being packed solid with meetings and events from 6:30AM - 10PM daily, there is simply no time for a baseline appointment.

AND, the Professor and I have been wanting to hit the KOA the next weekend before they close for the season. That's not a deal breaker, but it would complicate things what with trying to manage injections and monitoring appointments.

AND, I haven't had a chance to call the RE to discuss the questions and concerns* that have come to mind since our consult last week.

PLUS, I'm still trying to find/schedule a second opinion and sort out insurance options.

Which is all to say that I'm feeling more than a bit rushed and this cycle hasn't even gotten started. So I'm calling it off. One more benched cycle won't be the end of the world, and the extra time will undoubtedly mean that I will be in a better place (both mentally and physically) to gear up for a Last-Chance-IUI when the next CD1 rolls around.


*Questions & Concerns that still need addressing:

• If the theory is that the 9 day LPs are really early miscarriages, then do we have any concern about egg quality? Chromosomal issues?

• Is there anything I can do to optimize egg quality?

• Should we be concerned about clotting issues? My periods are very clot heavy, though I didn’t realize this until discussing it with my acu last week.

• Can we check if my insurance will cover PIO for a 4th IUI?

• I want my AMH tested before dropping $10K cash on IVF. Period.

THIS Is the Thing That Breaks Me Down?

You've met BFF(H). There hasn't been a single moment of her recent pregnancy/delivery that bothered me. Not her pregnancy announcement, not the ultrasound pictures, not seeing her seven months pregnant belly or sleeping in the nursery when I went to visit her over the summer.

I was perfectly fine and happy when the baby was born and the photos of her and her husband with the baby started arriving in my inbox. So, when I saw that I had a new email with a new photo album from her, I was nothing but excited to see how the baby was changing.

Right up until the photo of her mother holding the baby. At which point I burst into tears. Not just a few tears trickling down the cheek, but full body gasping sobs. My damned eyes are filling up again just remembering. Somehow, I hadn't realized just how much it meant to me to have a chance to see my Mom holding my child. I don't understand why this should be so much harder than seeing BFF(H) or her husband holding their child?

Is it because this disappointment feels so fresh and new, whereas I have already had so many months to adjust to the disappointment of perhaps never seeing my husband holding our child? Is it because of the recent change of our diagnosis to "unexplained" and the appearance of IVF on our horizon (and thus my new-found fears for my egg quality)?

I'm serious... if you have any ideas, I'd love to hear them.

Making My List (Checking It Twice)

We have our fourth (fifth?) consult with our RE on Thursday. I have been compiling a list of questions I would like answered. I fear that a great many of them will be answered with, "We're just not sure".

• What's with the regression to the 9 day luteal phase?
• Why did Clomid fix the LPD, but injectibles + progesterone supplements NOT (even with multiple follies)?
• Is it a coincidence that the only two cycles using Ovidrel were the only two medicated cycles with a shortened LP?
• Is it possible that my body simply isn't making use of the available progesterone for some reason? 
• Has the diagnosis shifted from LPD to "Unexplained"?
• What is the plan to get better response from Rightie this time?
• Should we just wait for Leftie's month instead?
• Why do you expect this new progesterone plan is going to help?
• Has my AMH been tested? If so: what was it, and if not: why?
• If this doesn't work, what is the next step?

Can you think of any other questions I should be taking along?

Happy Birthday to Me! (UPDATED)

For those of you who don't follow me on Twitter:

• Today is my 38th birthday
• Today is 9 days past IUI
• Today is CD1

I didn't even get within spitting distance of my beta. My RE has some serious explaining to do.

UPDATED: Thank you all for your comments and commiserations, they have been heartwarming indeed. I have a CD4 baseline scheduled on Monday morning. It's later than they like to see me, but that's the soonest I could get there. It may be too late and the cycle may get canceled. We'll see.

And It Just Keeps Sucking (Updated)

I have spent almost the entire day in tears. After this morning's monitoring visit, I just don't see how this cycle can work.

The whole point of these treatments is to get more than one mature follie to trigger so that there will be more than one corpus luteum dumping out progesterone so that Confuterus won't just up and flush out its contents at 9dpo.

I have one dominant follie. One.

The blood work indicates that my hormones are taking off. I go back for more monitoring tomorrow.


UPDATED (9.5.10): I still have a single dominant follie, which is now mature. I still don't have much hope for this cycle, but I am less emotional about it today.

When we questioned the doctor (not my usual one) about what exactly this "unexpected rise" in estrogen meant for the cycle and what the chances were for success with just the one follicle, she got incredibly uppity and defensive. She kept repeating that it wasn't a BAD thing and she didn't understand why we were so upset about it. She kept saying "People get pregnant with just one follicle all the time!" and all I could think was that if I can't get pregnant with 2-3 follicles, why on earth did she think just one would do the trick?! It wasn't a rhetorical question - I really wanted to know WHY she felt so confident. She was very clearly put out and annoyed by our lack of understanding. It was like being yelled at in a very hushed tone, and neither the Professor nor I appreciated it. She also described me as "aging", and I've been having enough trouble with my impending 38th birthday as it is.

I did FINALLY get her to understand that we had been so upset yesterday because no one bothered to EXPLAIN the results, or even just to say it wasn't bad. All we knew was that it was "unexpected" and "surprising" and not something they have seen my body do in past cycles. Of course we were worried - especially with the less than enthusiastic ovarian response this time!

Henceforth, I will request to see anyone BUT her for every appointment, and I will also tell my usual RE about this experience the next time we see him. I think I'll call her Dr. Hate, though the Professor had a much more accurate descriptive than I am willing to use here. I bet you can figure it out.

UPDATED x2: Estrogen is still high (for me), LH is beginning to surge. Plan:

Ganirelix + Gonal F tonight
Ovidrel tomorrow
IUI Wednesday
Fingers crossed for the next 2 weeks

So-Called Clean Slate, or WHY? (without answers)

Why was I so much more optimistic about this process last week when I first started spotting and realized that the last cycle failed, than I am today?

Why am I feeling so defeated NOW, when just yesterday my baseline appointment gave me the all clear to start a new cycle?

Why am I riding an emotional roller coaster, moody as hell, when I haven't even taken the first Clomid yet for this cycle?

Why am I having trouble focusing long enough to string two sentences together, when I'm nowhere near the two week wait onset of Hampster Brain?

Why do my damn eyes keep leaking (not crying, nuh-uh I AM NOT) for no reason?

Why can't I feel the sunshine anymore?