At Last, 2010 in Re(ar)view

My first instinct is to say "... and good riddance!" but I have to admit that we learned a lot from this past year. There was a lot of SUCK in 2010, but there was a lot of love too.

• We are both gainfully employed, and even had a good year financially.
• I got to see BFF(H), which doesn't happen nearly as often as I'd like.
• I discovered the incredible IF community support, first on Twitter and then here in Blogland, without which I would certainly have run screaming mad months ago. Love y'all. Seriously.
• All of our parental units are safe and healthy, and we got to spend time with them.
• We are knocking out our debts one by one.
• Given all that we've been through, the Professor and I are in a good place in our relationship. We haven't suffered in that respect due to this IF journey.

I would like to think that starting 2010 with the news that the pregnancy wasn't viable was an omen for the year to come, and this year is getting a better start already. I guess that's the silver lining to not being pregnant right now... I can't possibly start this New Year with a miscarriage!

I don't do resolutions, never have and I won't start now. We haven't cycled since September (wow - that's hard to wrap my mind around), and at this point it looks like it will be late January before we get another shot. I have been strangely at peace with this whole situation for a while now. I am doing what I can on the most efficient time line I can manage, and that needs to be enough. I need to stop dwelling on obstacles and failures, and focus on Life.

I would like to think of 2011 as the Year of Letting Go. Whatever your hopes are for this New Year, my hope for you is a spirit of peace with whatever your future holds. I know that is my hope for myself.

My Wish for You

My Mom is in town for the holidays, and Prof's family will be arriving shortly, so I won't be around much for a while, my dear interwebs. I am so glad to get some time off work, and some time with at least a handful of my loved ones.

I hope you all find some peace for yourselves during what is undeniably a difficult time for us all, and may the New Year be better than the last.

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.

I Woke Up!

Obviously, or you wouldn't be reading this!

A big warm fuzzy hug to all of my Twitter girls who checked in on me throughout the day yesterday! That was so heartwarming - thank you all!

The hysteroscopy is done and dusted. The pre-op nurse thought I was so very funny because of the expression on my face when she went to insert the IV. I didn't see any humor there.

I admit, I don't cope well with the pre-op experience. I have some pretty deep seated fears of the anesthesia. I am terrified of not being in control of my body, and equally concerned about the possibility of not waking up (though that, at least, would be painless). So there I am struggling just to stay in the chair, and not pull out the IV and break for the door, and I have to be interviewed by every freaking member of the surgical team in turn without breaking into tears (because they really don't like that). It was exhausting.

I remember laying down on the table and getting hooked up to the monitors, then my RE poking his head in and asking me to confirm my identity. Then nothing until I woke up in recovery freezing cold and shaking and with a damn painful need to pee. Turns out I can't perform on a bedpan... it's a toilet or nothing for this girl. I was in a fair bit of pain in recovery, so they gave me a perc.ocet with my ginger ale and I haven't had any pain since. I did not puke this time! Small victories.

I slept on and off for the rest of the day. Every time I tried to sit up for more than a few minutes, or eat something, I got nauseated.  Professor very kindly went out in search of cookies during the evening, when that was the only thought my stomach didn't rebel at. I eventually managed some chicken noodle soup and crackers with my ginger ale, and this morning I felt back to normal. Yay!

I got to take home three large, glossy photos of my polyp. It turned out to be just one, but it was long and twisty. The RE said it was a little bit bigger than expected (though still very small) and he had to use a different tool than usual to remove it, but he was happy with the end result. I did get a really flattering and surprisingly comfortable pair of soft, stretchy boy shorts to wear home. When did hospital undies get so fashion conscious?

Questions I asked before they put me out, that I do remember the answers to:

How long should I expect to bleed? 
Light spotting for 2-14 days, everyone is different.

When can we have sex?
No penetration till after the post-op appointment on January 6.

When can we cycle again? 
As expected, this depends on when I get my next period. And what I didn't realize, is that when you go under general anesthesia, your cycle can reset itself. There's no way of knowing where you are in your cycle when you wake up. So this is a wait-&-see situation.

Does the cervical manipulation involved increase the likelihood that I could need a rescue cerclage in a subsequent pregnancy?
 My RE doesn't think so.

More Food for Thought (Updated)

We attended the IVF orientation session at our clinic last Tuesday.

Just in case.

There were maybe 10-12 couples there (including a sister who was there doing donor egg). I was surprised at first, but then I realized that they probably schedule the sessions so far apart deliberately to get a larger crowd. It could get REALLY awkward with a much smaller group. The crowd was basically a bunch of couples just like us, give or take a couple of years either direction. Most of them looked a lot more stressed than I felt. The presenter was my own RE, who I had not realized just happens to be the director of IVF services for our clinic.

Bonus.

We toured the facility - and frankly didn't see anything we haven't already seen with our IUIs, but it was clearly new to many of the other couples. I guess some people do go straight to IVF without the extensive IUI tour we endured.

Judging from the questions that came out during the Q&A portion, a lot of the presentation was new info for some of those folks. Not surprisingly, my exposure to this community has given me an excellent window into what IVF is really all about. Prof did pick up some new knowledge, and then there was the financial portion of the talk.

Our clinic has their own IVF Refund Program. Pay for two IVF cycles up front (at $7,500 each - not including meds and a few other ancillary fees) get up to three fresh and three frozen cycles. If no take-home baby, get a 75% refund or 85% credit toward a donor egg cycle. Seems awfully tempting, but we don't even know how we'll scrape together the cash for one cycle up front, much less two.

*UPDATED: Sorry if that last bit was a little confusing! Didn't occur to me that my readers outside the US might not be familiar with the shared risk pricing scheme. Basically, the patient agrees to pay for two full cycles in advance and the RE agrees to provide UP TO 3 fresh/3 frozen cycles for that payment. The only way the patient gets money back is if they don't take home a baby after all cycles are complete. The patient is basically betting on the prospect of needing at least two cycles, and the RE is betting on the prospect of only needing one. To my way of thinking, this gives the RE an incentive to get the job done. The factor that makes this such a good deal in my eyes is that the pricing structure at my RE is so much less than the national average, that two cycles cost about the same as one at many other clinics.

Hysteroscopy

Scheduled for Friday afternoon. I call in Thursday afternoon to get the exact time. No food after midnight Thursday, so I'm gonna be REALLY hungry.

Wondering what to expect afterward. How long will I bleed? How much will I hurt and for how long? When we can have Relations again? When can we cycle again?

What questions am I forgetting to ask?

One Small Step

Got the pre-op appointment out of the way today.

Quick recap:

Dr. Spa proved true to type, didn't include ANY measurements of the polyps on the saline sono-thing report that they forwarded to my real RE. Of course.

Dr. Real gave me a pre-op physical hisveryownself. Took a while, but he located one tiny tiny polyp on the ultrasound and maybe two even smaller ones, but they were so small that he couldn't be sure. The one he definitely saw was so small that no one would have seen it if they weren't really searching just for that.

All the paperwork is done. I call with CD1 and they start looking for an available OR slot. He is confident we can get this done in December. One step closer to the next step.

Mumble, Mumble, Moan

Fair warning - this is mostly moaning.

The family has vacated the premises, so it's safe to log back in. We had a lovely (if short) visit with the parents. We ate way too much and drank too much wine, and there is enough food (and wine) left over to feed another table of six. I didn't even bother to log my calories on myfit.nesspal. BFF(B) very kindly stashed my meds in her fridge so the parents wouldn't accidentally stumble on them and NOBODY mentioned grandkids or babies at all. Nice.

Started working on the Christmas lists (for giving and receiving). Actually ventured into the retail wilds on Saturday and scored a few gifties for Prof so I can start crossing things off! That was traumatic enough, I think I'll stick to the internet for the remainder. Funny, I used to love shopping, but now it's absolute torture.

Pre-op consultation with the RE is this Tuesday. No idea yet when the surgery will be, but this will get us on the waiting list so if someone else cancels in December we might get in sooner rather than later. Otherwise, looks like it might be January. More waiting.

I've been wracking my brain trying to figure out how we'll pay for the IVF if we end up on that road. My maxed out FSA will cover most of it, but they don't cut me a check until a procedure has been performed and a claim sent in. The IVF has to be paid in full two weeks before retrieval. Which leaves a gap that my credit card can't handle. So there's that.

I have our last major work event of the year coming up this Thursday. I had to leave this event early last year with the onset of what I have since decided was an early miscarriage. After three days of sore boobs and brief flashes of nausea (the likes of which I had never experienced before and have not seen since), I got what was one of the worst periods of my life right in the middle of this event.  My period is due over the weekend (can't pinpoint since I didn't track ovulation this cycle), so if my luteal phase is shortened, I may get to have my period for the event this year as well! Good times, can't wait.

We should get our new appliances this week (if all goes according to plan - ha! ha!) and I need new tires on my car before we get actual snowfall (or godforbid ICE). I'm more thankful than I can express that we have the cash to do these things right now and don't need the credit card for Christmas gifts this year. Not all bad. 

Every inch of my body hurts and if I breathe deeply, I get an unpleasant hot feeling in my lungs. With everything I need to accomplish this week, I DO NOT need the flu. I just want this week to be over already.

Just to Hear Myself Talk

Still trying to manage direct contact with my original RE (really need a name for him) to discuss next steps in regards to the saline sono-thing and the polyps. I left a message, but have not received a call-back. I'll try again Monday. Not critical yet as the whole records transfer thing is still in process, but I just want to feel like I have a plan of action. I'm really in limbo at the moment. Not quite Hell, but it sucks all the same.

Tick-tock, people. Tick. Tock.

Professor is home safe and sound, no further airplane malfunctions. He did opt-out of the nudie scanners and got thoroughly groped for it. He also caught a bug and has been a little under the weather, but all in all, just glad to have him back.

We ordered a new fridge and stove on Saturday. The ones we have now came with the house when we bought it and have seen better days. Neither were much to speak of when they were new, and that was clearly a long time ago. We had hoped to have the new ones in place for Thanksgiving, but alas, that was not to be. I am inordinately excited by the prospect of new appliances. I keep catching myself giggling at the prospect of loading up my fancy new fridge shelves. And an ice-maker! At last! With these appliances installed, our kitchen will be done! We have been working on it little by little since we bought the house over four years ago. I think the master bedroom may be next...

This will be a busy week. I have a haircut and we are double-dating with BFF(B) and her DH on Tuesday - to see HP7! We also have rather a lot of housekeeping to get done as we are hosting my Dad and both of Prof's parents for Thanksgiving this year (thus the hope for the early appliance delivery).

May not be posting again before the holiday, so just in case:

Happy Thanksgiving! Try not throttle anyone!

Second Opinion (Think Again)

I went today for the saline hysterosonograph at the second opinion clinic. First thing I asked was if they had my blood work back from last week. They did (so why didn't they call me with the results?) and the verdict is:

FSH = 10.7
AMH = .33

The FSH is up from 9.1 in September. I have yet to consult Dr. Google about these results, but only because the doctor was pretty clear in her analysis. Basically it could be much worse, but this isn't very good news. They will have to push me a little harder to get a good response for IVF. Not a big surprise at any rate.

That conversation out of the way, we moved on to the saline thingy. My overall impression of the whole procedure was "wet". The doctor kept asking me how much pain I was in, but honestly, I never felt a thing other than wet. I kept waiting for her to get started, and it wasn't until I saw what was happening on screen that I realized what she was doing. The upshot is there are a few very small polyps at the top of my uterus. She didn't think they would necessarily prevent me getting pregnant, but they might. She did say it would not be a great thing to get pregnant with them in there because they could get larger and bleed and cause problems, and it would be better to have them out before going any further.

The only thing that makes me think this really does need to be done is that this office can't do it. They suggested I have my regular OB perform the hysteroscopy. I had them send the records to both my midwife and my original RE. I'll discuss it with them both before moving forward on anything, but it looks like this puts us out of the running for a December IUI. Which also puts IVF further in the future.

I wonder how fast my FSH is rising...

Saturday Night Fever

In true Slackie fashion, I am spending Saturday night curled up on the couch with the cats. Professor is on his way to Paris for the week on business, so I'm feeling a bit sorry for myself. Sure I've been to Paris before and yeah it's only a week and he'll be in meetings for ten hours a day, but I'm spoiled. I would have preferred either to go with him or for him not to go at all.

So here I sit, fretting about the airplane he is on (which had a malfunction necessitating de-planing for a while) and focusing perhaps to an unhealthy degree on the likely next steps in our IF journey. God it's awesome being thirty-eight!

I'm doing a lot of thinking about IVF even though we still have one last IUI to do.  I've done a little more digging to see if there is anywhere in reasonable driving distance that we should consider for a proper second opinion, and all signs continue to point to our original clinic being the top IF group in our area. I can't help wishing that we had gotten a real second opinion. I feel like last week's appointment was mostly just a look at what not to do. I've revisited the IVF success rates for our Chosen Clinic versus our "Second Opinion" and the Chosen Clinic has much better numbers. In reviewing their standard protocols, it looks as though for patients my age (38) with my diagnosis (unexplained), they recommend both assisted hatching and ICSI.

I'm still waiting on the blood work results from the second opinion appointment. The AMH takes about ten days to get results because it has to be sent away for the test, so I'll be waiting a while yet. This Tuesday I have a saline sonohysterograph as I've never had one. I'm slightly nervous, but don't really expect to find anything problematic there. After that I will just wait for CD1,which will be around December 5th. Then it will be full steam ahead on injectible IUI#3! I bet I have my baseline the same day as the IVF info session at our clinic. Any takers? The timing will actually be pretty good, with stimming, monitoring and IUI all wrapped up just days before the family descend on us for Christmas. I'll know the outcome by New Year's.

I'm trying not to think about what the new year might hold.

Second Opinion (Second Thoughts)

I have to preface this by saying that when we started fertility treatments, we did our research and asked around before we settled on our original choice of RE. We didn't take cost into consideration at all. The clinic we just visited for our second opinion was presented to us a few times as being a really excellent and less expensive option (and my acupuncturist went so far as to say it was better than our original choice), so we were confident that we chose the best for the first go around, but had this highly recommended back-up for our second opinion.

The best word to describe the second opinion is BIZARRE. If nothing else, the experience highlighted the fact that for the last twelve months, we have been in treatment at the premiere fertility clinic in our area.

Y'all. The place is a spa. That's the only way to describe it. It looks from the outside like a boutique hotel with beautifully landscaped grounds. When we walked in the door, we were standing in front of a hostess desk boasting ads for specials on Ave.da make-up and could see a huge glossy display of OPI nail polish in the room down the hall.

All I could think was "WTF?"

Things just got weirder from there. The receptionist offered us coffee from the new coffee shop they had just opened downstairs and seated us in what looked like a living room with a roaring fireplace and a huge display of self-help books and even oracle cards for sale.

My records still hadn't been entered in the system, even though they'd had them for over a week. The doctor wasn't on the premises yet and it was already nine o'clock. When they finally got my info in the system and the doctor came in for the consult, things seemed to start looking up a bit. Until it became clear that he hadn't really looked at my records. The first thing he said after a quick glance over our treatment history was "You've really been through the ringer!" He asked the right questions and gave good answers to the questions we asked, but still. He briefly reviewed our treatment history and jumped straight to the IVF talk. He was enthusiastic about getting me the AMH test and a couple of other basics that haven't been done. He also was quite clear that for someone my age, he would transfer 3-4 embryos in IVF. Y'all, I'm not comfortable with that!

All of the decor was a posh mixture of Mediterranean/Asian/ShabbyChic (even in the ultrasound rooms). It was like going for a facial and getting wanded instead. They left Professor and I alone a few times throughout the appointment, and we both just kept looking at each other with wide eyes. It was really kinda hard to believe it was for real. And TWICE before we left, the nurse mentioned all of the workshops, yoga classes, massage and acupuncture services, etc. that they also offer onsite. I'm sure that for some people, this would be a very warm, relaxing, comforting environment, and I hope those people can find this place and can make all their dreams come true. I, however, am definitely not one of those people.

BIZARRE.

At the very least, we will get the tests this new guy suggested and since today just happened to be CD1, they were even able to do a blood draw for those. We'll then be comfortable going back to our original RE and placing ourselves and our finances unreservedly in his care. I think I'm ready now for a final IUI in December.

*Bonus update: We have achieved yet another unmedicated 14 day luteal phase! Yippee!

All Eyes On the Scoreboard

I'm staring down yet another CD1 and contemplating my third benched cycle in a row. We go in for our second opinion tomorrow morning and may or may not be getting some new ideas. With only two covered injectible cycles left on my insurance, it seems wise to hold them in reserve pending new information and a potential change of plan.

In ten days, on November 18, we will hit our one year anniversary in fertility treatments. Like the rest of you, I never expected it to take this long or require this much effort. It's been a busy year to say the least. As we approach the twelve month mark, our IF scoreboard reads as follows:

CD1s: 12
IUIs: 6
Clomid Cycles: 5
Injectible Cycles: 2
Benched Cycles: 5
Pregnancies: 1
Miscarriages: 1

Those last two are a real kicker, huh? Looking at those numbers, I know we've done a lot this year treatment-wise. I think if we had done any more, we would literally be done at this point, yet I've been feeling guilty for not jumping immediately back into treatment as soon as the last cyst resolved. I even felt guilty the one cycle I took off this summer to preserve my sanity from the Clomid Crazies. The first CD1 after the most recent cyst fell at an incredibly inconvenient time, but if I had been more motivated, I probably could have found a way to squeeze in a baseline appointment. And this month, it is only the voice of fiscal responsibility cautioning me to conserve my insurance coverage that is keeping me from pursuing treatment. Both months perfectly good reasons to skip a cycle, and yet I feel this guilt.

Help Where It Is Needed (Updated*)

Since being told we were looking at IVF in the next year, and then being told that our insurance won't cover any of it, I've been keeping my eyes and my mind open to ways that we can scrape together the funds for it. We have no real savings. What little money we do have put aside is earmarked for the tax bill (self-employment has its down sides and the tax bill is a big one). All spare cash that comes in is going straight to paying off debts like student loans, credit cards and back taxes (see previous comment on self-employment down sides). We have some equity in the house, but adding more debt really doesn't seem like a sound plan of action.

So what can we do, short of begging our parents for help (which would only be a last resort)?

First and foremost, I will max out my FSA contribution this coming year. Providing I have leftover meds from the next and final IUI, then the FSA will cover most of the remaining cost of one round of IVF. One. Round. And my paychecks will be reduced by a terrifying amount for the entire year. I am so scared of the possibility of the Professor having a month or two when the contract work isn't paying out and having to figure out how to pay our regular bills on my greatly reduced income. My income alone isn't enough to cover our expenses as it stands, but with that level of decrease... well, it's just frightening. It's still not a brilliant plan, but it's a start.

*Updated: I just realized that by January, our back taxes and my student loans will be all paid off! Those payments total about half of the monthly salary reduction I'll see from maxing out the FSA. Things just got a little less scary!

In an effort to find some other solution, I started looking around and found the following non-profits that offer grants for IVF or adoption assistance. They are all for US citizens only as far I can tell, but other parts of the world must have similar resources where the health care systems don't fill the need. I'm going to create a Resource page and add these there, but if you know of others, let me know so I can add them as well!

INCIID IVF Scholarships
Tinina Q. Cade Foundation
Fertile Dreams
Parenthood for Me
NYS Infertility Demo Program (varies by clinic)
*B.U.M.P.S. Inc.

More options and suggestions from Resolve.

Happy Holidays (harumph)

I love the Holiday Season, as long as it stays a few months in the future! There's something magical about the promise the holidays hold as long as they aren't right upon us. Of course, once we hit November 1, all bets are off and the stress just builds until the grand yet soporific anti-climax of New Year's Day.

This time of year always brings back memories of idyllic childhood Christmases, and those memories get all rolled up with the stories in the multitude of holiday children's picture books I've collected over the years. My Mom is a regular June Cleaver and really did an amazing job of building these memories for me to carry forward. She would be in the kitchen baking holiday treats while my Dad fought with the Christmas lights in the living room, and I would bounce between the two "helping". Somehow these ghosts of Christmas past are so seductive in their air of fantasy, that there can be no chance of present-day reality living up to their standard. I know I'm not alone in this, that this is part of being a grown-up. But I can't help but think that, in the usual way of things, grown-ups get to move through this transition into recreating those fantasies for their children, sharing the stories with new little ears, seeing the lights with new eyes. And we all know how that's panning out in this house.

So all of that leads to a host of conflicting emotions. I feel like I should be jolly and hopeful, but I can't help reminding myself of Reality. I want to be generous and giving, but some days have trouble just dragging myself along.

• I hate traveling.
• I hate family drama.
• I hate feeling like I have to go broke to make things "Merry".
• I hate wondering if this will be my last Christmas with my grandma.
• I hate the fear of the inevitable questions about the absence of offspring in our marriage.

That's a lot of hate. Hmmmm... what about things I love about this time of year?

• I love evergreen scented candles.
• I love Christmas trees and decorations.
• I love making cookies and other tasty treats to share.
• I love the early season snowfalls, as long as I'm not driving.
• I love sitting down for a big family meal and seeing my loved ones faces around the table.

Sorry if this post was a bit of a bummer for you guys, but it's where I'm at today. I know this is no great revelation. This is just Life. It is what it is and it's down to me to make the most of it.

Here's to a Change in the Weather

I think Fall is gearing up to give way to Winter here. I love Fall - it's my absolute favorite time of year. The colors, the cooler temperatures, the wardrobe options, the distant promise of the Holiday Season.

It's a time of transition. Our second opinion is scheduled for 11.9.10, so I put on my Big Girl Pants and called my RE to request my records be transferred. I talked to my favorite desk girl, and told her what I needed and why. I told her I didn't want my RE to take it the wrong way, but we feel that it's only wise to hear it from two separate clinics before we go further into debt to move on to uninsured IVF treatments. You just don't drop that kind of cash without being certain that it is the best plan. She was very understanding and very helpful. She even called to let me know when the records had been sent. 

That's about all the news I've got from this week. I've been feeling like I don't have much to say and feeling bad for not being more supportive of you all. I go through these stretches sometimes when the words just aren't there. I'm still reading my Twitter feed and I'm caught up on my blog reader. My heart hurts for you all, but I don't really know what to say. So many of you have had bad news and mishaps this last week. It's like there's a black cloud hovering over my IF crew, and we're all waiting for a change in the wind.

More waiting.

Happy 101 Blog Award

Big thanks to Holly over at Life As a Navy Wife & Everything Else for passing this along to me! This one is super easy! Here are the rules:

1 - Post who gave you this award (done)
2 - List 10 things that make you happy:

• My husband
• My cats
• The beautiful Fall colors in the park today
• Roasting marshmallows over a campfire
• Rediscovering the brand new sweaters I bought at the end of last winter
• Pumpkin Spice lattes
• Long weekends
• Having enough money to pay the bills
• A good BBC mystery
• A new book released from a favorite series

3 - Pass the award on to 10 Bloggie Friends:

• The 2 Week Wait
• This Is Personal
• My So-called (TTC) Life
• Park Slope Purgatory
• Stolen Eggs
• His & Her Infertility
• Liberal Granola Girl
• Baby Making Diaries
• Fertilely Challenged Black Sheep
• Infertility Musings

Happy Reading!

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.

Unexpected Words of Wisdom

I may not like her family and their politics and this makes me wish she had done something to further the cause while she was in spotlight, but credit where credit is due, she nailed this one:

The English language lacks the words to mourn an absence. For the loss of a parent, grandparent, spouse, child or friend, we have all manner of words and phrases, some helpful some not. Still we are conditioned to say something, even if it is only “I’m sorry for your loss.”

But for an absence, for someone who was never there at all, we are wordless to capture that particular emptiness. For those who deeply want children and are denied them, those missing babies hover like silent ephemeral shadows over their lives.

-from Spoken from the Heart by Laura Bush

Cycle #22 Report Card

This report card details progress made by Miss Leftie in the 22nd cycle TTC.

7dpo Progesterone: 14
(A+) Excellent number and much improved over past results. Congratulations Leftie!

Luteal Phase: 14 days
(A+) Exemplary behavior, again much improved over past cycles.

Pregnancy Achieved: Negative
(F) This is an area that needs significantly more work on Leftie's part in order to achieve a satisfactory grade. Must try harder.

CUMULATIVE AVERAGE: 2.7

Recommendations for improvement:

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.

Answers, In a Way

FYI: This is gonna be a long post and possibly interesting only to me.

I got my 7dpo progesterone levels (unmedicated cycle): 14 (YAY!)

So by way of an update on our re-visit with the RE... all in all we left the appointment feeling fairly upbeat, which is quite a feat as you will soon see. We reviewed the last 11 months of treatments and discussed positives, negatives and possibilities. He even apologized profusely (unprompted) for our experience with Dr. Hate. It was pretty clear that we weren't the first patients to have such an encounter with her, and that she is on her way OUT.

To review the questions we took in with us:

What's with the regression to the 9 day luteal phase?

The big surprise for me was that he feels like the last two cycles with the 9 day luteal phase were actually early miscarriages rather than failed LPs. Non-viable embryos that implanted for a day or so and then fell apart. This is based on the statistics for success for my protocol, my response to it, the bloodwork, the ultrasounds and the fact that a similar ovarian response with the Clomid DID result in a full 14 day luteal phase.

Why did Clomid fix the LPD, but injectibles + progesterone supplements NOT (even with multiple follies)?

This is related to the above. He explained that Clomid would result in the desired amount of progesterone and length of luteal phase, but can negatively impact the quality of the uterine lining, whereas the injectibles would improve both, making it more likely that with injectibles we got implantation (with subsequent failure).

Is it possible that my body simply isn't making use of the available progesterone for some reason?

He doesn't think this is realistic in my case, as I did carry that blighted ovum to more than eight weeks even without progesterone supplementation.

Has the diagnosis shifted from LPD to "Unexplained"?

Yep.

What is the plan to get better response from Rightie this time? Should we just wait for Leftie's month instead?

He doesn't feel like there is good evidence to support waiting for a Leftie month. In reviewing my previous cycles, there were months that Rightie was noticeably more responsive and there is no guarantee that my ovaries are on a strict rotation. The plan is for increased GonalF dosage and progesterone (both oral AND suppositories).


Has my AMH been tested? If so: what was it, and if not: why?

No. All evidence from my other blood levels, tests and ultrasounds show that I respond well and can produce plenty of eggs. He says he does order the AMH test for some of his patients, but doesn't see indicators that it would be valuable in my case.

If this doesn't work, what is the next step?

This brings the total to three suspected early miscarriages and one blighted ovum miscarriage. Which now that I've had some time to consider it,  makes me wonder about my egg quality. Question for the next visit.

We discussed the statistics for success with the injectibles/IUI protocol, and our RE feels like after three failed cycles on this plan, there isn't much point to continuing it. So we're doing one more injectibles/IUI cycle with adjusted dosages and tweaked progesterone delivery. After that, he suggests switching to IVF.

Deep breaths.

He also informed us that our insurance won't cover it (not even meds).

Deeper breaths.

The "good" news is he estimates the total cost, including meds, will be about $10K per cycle (including the cost of meds). From what I've seen on Twitter and in BlogWorld, this is downright cheap for an out-of-pocket IVF. Not that we have $10K laying around. It will probably mean coming out of the IF closet to our families and begging for funds.

More deep breaths.

It will be worth it if we get a baby out of it.

Happy-Hopeful Blog Award

Yet another TAG - You're IT out of BlogWorld! Big thanks to SoCalled(TTC)Life and thisispersonal who both tagged me for the Happy-Hopeful Blog. I suspect this award is intended to be bestowed upon someone who is perhaps in need of a reason to focus on Happy and Hopeful thoughts. That would certainly be me.

HAPPY

I'm going to refrain from using the most obvious (if accurate) answers: my darling Professor, my adorable furbabies, my recently paid off car. Instead it's something much more momentary and fleeting. I get the most amazing sense of lightness and peace on crisp Fall days with weather like today. There is something awe inspiring about the quality of the light as the sun strikes the changing colors of the leaves on the trees against the backdrop of dark storm clouds on the horizon. The sight never fails to stop me in my tracks and make me think "I am alive and THIS is beautiful".

HOPEFUL

I have to admit, moments of happiness are somewhat easier to come by than moments of hopefulness. Oddly enough, that is exactly what is giving me hope right now. Hope, and dare I say confidence, that however our IF journey plays out, the Professor and I will still have an abundance of reasons to be happy. I don't really have much hope at the moment that we will be able to successfully bring our own offspring into our lives. But I have every hope that we will be able to live happily either way.

I'm tagging the following players for Team #Hope:


The Fertilely-Challenged Black Sheep
NoBabyRuth
Gurlee at Infertility Musings
LowFatLady
GaijinHousewife

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?

I've Been Tagged!

There's this "getting-to-know-you" game that's been making the rounds through BlogWorld in recent weeks, and I just got tagged - I'm IT! NoBabyRuth tagged me since we were Cycle of Fail Buddies last month. If you haven't checked out her story yet, you should. Her life as an expat totally fascinates me, as does her European IF Journey. The game goes like this: answer the series of questions and tag three bloggers who you'd like to see answer them as well. Pretty simple!

1) What is your dream occupation?

Archeologist. I think this is an outgrowth of my career as a potter. Ceramics is a field in which you can't help but be aware of the immense and intriguing history of the craft, of all of the people who went before you and the objects they left behind. I think it would be terribly exciting to be the one who actually gets to find, excavate and identify those artifacts, to extrapolate their histories and the stories of the people who made and used them.

2) What is the best dish that you can cook?

White Chili - check it out.

3) Have you ever been mentioned in the newspaper? What for?

Yes. A few years ago, I was featured in a short article about the non-profit art center where I was working. Nothing particularly special, they wanted a photo and I was the only one doing anything "artsy" when the photographer arrived. I was probably mentioned in high school as well, but can't remember specifics.

4) What’s the worst and/or most memorable job you’ve ever had?

Toss-up...

WORST: dishwasher or buffet waitress in Florida. The dishwasher job was just plain gross. Other people's partially eaten meals and garbage, and everything all steamy, wet and mushy. YUCK. And I'm sure you can just imagine how rewarding it would be to wait tables at an all-you-can-eat buffet in a retirement community in Florida.

MOST MEMORABLE: teaching pottery. That would be the thing I am best at, the thing I enjoy most, the thing I promise myself that I will get to do again. It is so rewarding to show/tell another person how to do something they've never done before and don't really believe they CAN do, and then see their excitement when they get it right for the first time! Nothing like it.

5) When you were a teenager, at what age did you envision yourself getting married? How old were you in reality when you got married?

When I was a teenager, I was certain without a doubt that I would be dead by age 24. I couldn't tell you why. It was just something I believed. I never dreamed I would live long enough to get married. Needless to say this strange belief evaporated after my 24th birthday. Professor and I got married when I was 36 years old (though I still feel like I'm in my early 20's).

6) What’s your most hated household chore? What’s your favorite?

I can't honestly say that I have a favorite household chore. I don't like ANY of them. I am a terrible housewife. The relative squalor in which I exist would probably appall you (it appalls me, just not enough to motivate me very often), although I suppose things aren't really dirty so much as dusty and cluttered. My most hated chore would probably be cleaning/changing the catbox. My least hated would probably be loading/unloading the dishwasher.

7) What’s your earliest memory?

My earliest memory is not really of a specific event, but more a collection images in my mind. They are from the house my grandma lived in when I was a toddler, the pallet she made up on the floor for my bed, the kitchen with an old metal highchair that I sat in to eat, the prickly holly bushes with bright red berries by the front door. I've asked my mom about these rememberings, and she says I would have been a little more than 2 years old. I know they are actual memories because we don't have any photos taken in that house.

@thisispersonal
@the2weekwait
@LiberalGranola

TAG - you're IT!

Life After IF

Or life with IF. What if there is no "after"? What if there is just IF?

I've been doing a lot of thinking the last week about the future. Being benched really takes the focus away from "this cycle" and redirects it towards "what next". Obviously, the immediate future holds another injectibles cycle. But after that?

I'm considering getting a second opinion. My yearly midwife visit is coming up. The visit that got me a referral to the RE last year. I'm going to discuss a second opinion with my midwife and see what she thinks about the fertility center my acupuncturist has been suggesting I check out. Then I'll need to check with my insurance to see if they'll pay for it.

Realistically, I'm 38 years old, my FSH is OK but not great, treatment has not been successful and I don't really know how long I can continue to push forward. Don't get me wrong - I'm not giving up, but I do feel like time is running out and I don't really know yet how far I am willing to go. I don't know where my breaking point is. If the RE suggests IVF, I will likely be fine moving to that step. But what additional issues might IVF uncover? Will we be encouraged to consider donor eggs/sperm or even surrogacy? We haven't discussed these possibilities, but somehow I don't see us going down any of those roads.

What I am considering is what comes next when I eventually do reach the point where I just can't continue with treatments. Professor and I have discussed adoption and we are in agreement that it is not the right path for us. This actually makes me feel a little sad and a little ashamed, but I have to be honest. It just isn't right for us.

And that leaves just us. Child free. I don't think there will ever come a time, as long as I live, when that thought doesn't hurt at least a little bit, but I am beginning to accept that as a possible outcome. I do worry about what (if anything) we will tell friends and family. I feel like we would need to tell them at least the basics. I don't think I could live that big a lie for the rest of my life. I still worry about becoming an object of pity, you know "that poor woman who couldn't have children". I dread year after year having to witness the disappointment and longing on Professor's face as he watches other people living life with their children and eventually grandchildren.

I am facing these fears, and I am beginning to approach a sort of peace with the idea.

Comfort Food

In honor of Fall and due to the fact that I have no cycle news to report, I thought I'd share one of our favorite cool weather recipes -

White Chili.

This is a recipe that I made up based on some chili that I had at a restaurant and fell in love with. Growing up in Texas, I was raised on traditional red chili. Needless to say, I make a pretty mean chili if I do say so. I even won first place in a chili cook-off once!

I know there is supposedly a big divide over whether or not "true" chili contains beans (actually, it doesn't), but ever since my days as a poor starving college student when I had to stretch every ingredient to its fullest potential, I've been adding beans to my recipes.

To chili snobs everywhere, I say: WHATEVER! My chili tastes good! The Professor goes back for seconds and that is a rare occurrence indeed. Anyhoo, on to the instructions:

2 chicken breasts
1 medium white onion, chopped
2 cloves garlic, minced
6C chicken or vegetable broth
1 16oz can white beans, drained & rinsed (I use cannellini)
1 small can chopped green chiles
1 7oz can Herdez salsa verde (or 3/4C green salsa)
1t cumin
1t dried oregano
1/2t chili powder
1T masa (or regular flour, but masa is better)
salt to taste

You will want to use a large soup pot. I don't use any oil, because I am cooking in cast iron, but you can if you like.

1.  Sear the chicken breasts over high heat until they begin to brown, then reduce heat to medium and chop or shred the chicken as it finishes cooking.

2.  When the chicken is almost cooked through, add the chopped onion & garlic and cook until soft.

3.  Stir in the cumin, oregano & chili powder. I like to deglaze the pan at this point with a splash of bourbon or white wine.

4.  Add the broth, beans, green chiles & salsa verde and stir. Reduce heat to low and simmer for about 30 minutes.

5.  Place the 1T masa or flour in a small bowl and stir in small amounts of hot water until it reaches the consistency of heavy cream. Add this mixture to the simmering chili, stirring constantly. Simmer for another 10-15 minutes. If the chili is not thick enough, repeat with another tablespoon of masa/flour.

This makes four servings. We serve with cornbread. If you are making cornbread from scratch, you can also substitute masa for the regular flour in the cornbread recipe - it makes it that much better!

As far as where to buy masa if you don't live somewhere they sell it in the grocery store, you can get it on Amazon (this is even the brand I use, though I got mine at the store).

Loss for Words

I don't know what to say.

I'm benched, so no cycle news to obsess over or report. I'll probably start the OPKs this weekend, since I've already got a box of them. Why not...

I'm caught up on all of your blogs. I'm celebrating with you, crying with you, infuriated on your behalf and waiting right along with you. But I seem to have no words.

So I will leave you with the minor details that are pinging around in my skull for the moment:

Work is getting busier. Today was the first day in weeks that it took me until the very end of the day to get through my inbox. No time for wool gathering. This is a relief, as I have really been starting to worry that I'm missing/forgetting some big chunks of my job. I shouldn't be as caught up as I am. Not at this time of year. With our big board meeting coming up, this makes me VERY nervous.

The house plant is not doing well. I bought it some organic plant food, and have been feeding it and watering it (but not too much/often) and keeping it in the sunshine. And now it has only two leaves, one of which is dying. Oh, and the organic food seems to have given it flies. *sigh*

Last night after work, I went to a yoga class for the first time in more than ten years. It was not easy, but it felt incredible after the fact and I'm only a little sore today. My darling Professor even bought me some new yoga gear as an add-on birthday gift! I'm determined to ditch those 18 pounds that have hitched on since we pulled the goalie and I'm worried about my future health. My BMI is solidly in the "overweight" category and both of my parents have been diagnosed with Type 2 diabetes after lifelong overindulgence and insufficient exercise. I DO NOT want to go there.

We made our last car payment this week. It feels awesome! We're going to redirect that payment to my student loans next and might get them paid off by the end of the year. That will also be awesome!

Happy Thoughts:

I got a pretty new necklace in the mail today.
My boss gave me a nice fat S*bux card for my B-day.
Professor has no immediate plans for travel.

Benched & Back at the Drawing Board

Well, I went in for a baseline appointment this morning (CD4). I started crying before I even got out of the waiting room. I held together so well over this past weekend. If you had asked me on Friday or Saturday, I would have told you that I was disappointed but not surprised that the cycle failed. Yes, I was concerned about the repeated 9 day luteal phase, but I didn't shed a single tear. Until I walked into the RE office this morning.

This appointment was with one of my favorite nurses, and her first question "How are you doing?" set me crying again. After verifying that Confuterus was still in there, she checked the ovaries and WHY HELLO THERE giant cyst on Rightie! Leftie had a bunch of little follies prepping to go, but Rightie had one huge cyst left over from that one huge Follie of Fail.

I had a chance to discuss things with her after I retrieved my pants and my dignity. Benched without question, and depending on estrogen levels, I might need to suppress with BCPs before the next round could begin. She told me that my official RE was in today and would be reviewing my results, but she felt like it was time for me to go ahead and schedule another consult with him. Even she agreed that the plan as it stands would need changing. When my eyes started leaking again, she suggested I avail myself of the free counselor they keep on staff.

Free counselor on staff? Uh... OK. Done.

Another cool thing about my clinic is that whichever nurse sees you for monitoring is the nurse that calls you later in the day to discuss your results and next steps. This means she already knows where you're "at" and it makes the follow up more comfortable. So when she called, she knew what my questions and concerns had been and had the answers ready.

• Estrogen only slightly high, no suppression needed (relief).
• Another round of GonalF (dosage tweaked again)
• AM/PM progesterone supps + oral progesterone (we'll see)

I'm kinda bummed that I'm benched for Leftie's month and will be trying this adjusted plan with Rightie AGAIN. I need to be sure to ask my RE what he plans to do to get a better response out of Rightie next time.

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.

LOST:

I've lost so much since we started down the path to expand our family. Innocence, naivete, dreams, one pregnancy, untold amounts of sleep, the ability to plan anything more than two weeks in the future... Occasionally my mind but never any weight. My sense of being valuable as a wife and employee, of being adequate to the task at hand (otherwise known as daily life), my motivation to care for and improve myself...

IF FOUND, please notify me ASAP!

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

Oh.

I just this moment realized that today was the due date for the BFP that didn't end up being a baby.

I don't know what to think about that.

I'm So Vain (Maybe That Song Was About Me)

I don't look my age. I never have.

As an early teen, I was always assumed to be older. In my twenties, I was frequently assumed to be a teenager. Now, at the age of (nearly) thirty-eight, I am usually taken for being in my twenties. I almost never wear make-up and my beauty regime is super basic.

I am generally grateful for the genetic hand I was dealt. The women in my family tend to live active lives into their nineties. My Mom didn't hit menopause until she was fifty. All of which is to say, the women in my family all seem quite young for their age.

In retrospect, I think maybe I let this go to my head.

In my mid-thirties when I started thinking about my fertility and getting started on a baby, I comforted myself with this apparent youthfulness. My body still looks so young! My Mom was fifty before she had The Change! My insides must surely be as youthful (and thus fertile) as my outsides!

What vanity! What arrogance! What a CROCK!

Until I accepted my infertility and started to make my way into this online community, I had never really thought about even authentically young women having fertility issues. How arrogant... this has definitely been a humbling experience, to say the least.

New Blog Friday with Infertility Overachievers (UPDATED)

If you are here visiting from New Blog Friday at Infertility Overachievers - Welcome!

Obviously, my name isn’t really Slackie, but my beloved husband is an extremely private man and he has requested that I keep my online presence anonymous. Since this is his story too, and since I love and respect him, I concede that point. I call myself Slackie because my diagnosis was Luteal Phase Deficiency. In my own words, I have lazy ovaries – a couple of slackers if ever there were… If you want to start at the very beginning, you can find all the basics here. Check the sidebar to see my cycle history (Not That Anyone's Counting).

You find me in a bit of a blue spot at the moment. I wish I had some humor to offer you, something clever and entertaining. A song, a dance, even a knock-knock-joke. Truth is, I'm just trying to keep hold of that sunshine, but there's a pretty dark cloud overhead today.

Yesterday was CD1. Four days early. Even the nurse who scheduled my baseline for this morning was puzzled by that one. 20 cycles y'all. TWENTY failures. Good follicles, good lining, good timing, good blood work. And yet, here we are again. Last cycle was my first on injectibles. I didn't really expect to get a positive this time. I was treating it as a practice run, you know, getting to know how my body would respond to the new protocol. With three follicles triggered and progesterone supplements aplenty, this early end was decidedly unexpected. I've already determined to hit the acupuncture a little harder and get back to my yoga. What else?

I hope today's appointment will provide, if not answers, at least some ideas for new directions to try. I'll update when I get home this evening.

UPDATE (as promised): Thanks for the comments and well wishes, both here and on Twitter! No clear ideas as to why things went sideways just at the end of last cycle, and some small possible cysts were hanging out on Leftie. The doctor was uncertain if we should proceed with treatment this cycle due to those maybe-cysts, but my blood work came back great so it's full steam ahead! GonalF dosages got tweaked and my progesterone will be doubled up in the luteal phase this time. I'm also gonna hit the acupuncture weekly instead of every other week. Cross your fingers that the insurance will cover the GonalF refill - there was some question over that when I called it in this afternoon.

Yeah - What She Said!

If you don't already follow NoBabyRuth, you gotta read this post.

That is all.

CSA

A couple of years ago, I stumbled upon this blog and discovered the concept of the CSA. For anyone who doesn't already know, CSA stands for Community Supported Agriculture. It's basically local farmers (frequently organic) who pre-sell shares of their harvest to the public for the growing season and then deliver boxes of freshly picked vegetables to a central drop-off weekly.

Early last March, I received an email that an organic CSA would be dropping off at my workplace this season for anyone who wanted to buy in. I read the list of planned crops and convinced BFF(B) to split a share with me as an experiment. The boxes started arriving at the beginning of June and boy am I glad we split a share. That's a ton of veg! Good stuff all, but such large quantities.

We've made several different kinds of salads, soups, stir-fry, and tried some new veggie side dishes. Last week I made homemade salsa and I got my fresh basil to root in a cup of water, so I'm hoarding it till I can make pesto. I've even tried some new vegetables that I've never eaten before, including: kale (not bad), garlic scapes (YUM), turnips (blech), radishes (hmmm...). I have yet to figure out how to use up quite that much zucchini.

This week's box includes:

lettuce
arugula
tomatoes
sweet onions
garlic
sweet peppers
hot peppers
beets
turnips
swiss chard
eggplant
basil
kohlrabi

Since the Professor is out of town, I gave the majority of the box to BFF(B) this week, but I'll be making more salsa, some from-scratch marinara sauce, some pesto and a stir fry to start. Anybody got a good recipe for beets or zucchini (previous box)?

Thou Shalt Not Covet (Except I Did)

Maybe five years ago, I saw a woman in the bookstore carrying her baby in the coolest, most beautiful sling. At that point, I had never seen anyone use a sling before. Not only did the concept seem so logical, the fabric was unbelievably lovely. I actually stopped a stranger in a store to ask where she'd bought something.

She told me it was a Hotsling, so I went online and drooled. I wanted one so badly (and we weren't even trying yet) that I went ahead and ordered one for a friend who was expecting. And of course, since I was already ordering, it only made sense that I should be fiscally responsible and order one for myself as well. To save on shipping. Right? And of course, the one I liked was in the "Discontinued - Sale" section, so it was deeply discounted and I might never see it again...

So I have this beautiful sling hidden in the back of my bottom dresser drawer. I used to run across it every now and then and look at it and dream. After a time, I pushed it further back in the drawer and piled stuff on top so I don't do that anymore, but it's still there waiting. I know I'm not alone here. I know some of you have done it too. What baby item did you see before you got your positive (or before you were even TTC), and decide you just had to have? Include a link if you can!

Extra-Versatile Blogger Award

One of my beloved tweeps, the fabulous Andrea over at Waiting for Baby, was gracious enough to bestow a second Versatile Blogger Award upon me (thank you Andrea - I feel so unworthy)! Andrea writes about her IF journey, gluten free living and natural/complimentary therapies. Go visit her and say hi!

The first time I received this award, I followed the rules, but according to Andrea I don't have to follow them this time around. Let the rule breaking commence! If you missed the first one, you can read the original post here. I wanted to take this opportunity to introduce you all to some IF blogs I've recently begun following by a few of my lovely commenters. Head over and give them some love!

Shufuinjapan over at Gaijin Housewife in Japan (NZ expat in Japan)
NoBabyRuth: Playing Baseball Without a Bat (US expat in Spain)
missohkay at the misadventures of missohkay (new Chi-town blogger)

Chemistry Lesson (Learning Mine)

As I said to one of my tweeps after the first couple of injections were done, I'm feeling like the change of protocol has given me a renewed sense of energy and hope. 

I was feeling really worn down by the repetition of the same protocol. After month upon month of Crazy Pills and IUIs followed promptly (or rather, after every interminable 2WW) by BFNs, I had reached a point where I ceased to believe that what we were doing was ever going to work. Perhaps somewhat extreme and melodramatic, but I felt it in my soul. In spite of the dubious success of our first medicated cycle, and my RE's insistence that this would work for us again, I had no hope, even though the Professor and my RE did. Thus the "resting" cycle last month, and the consultation resulting in the change of protocol.

One of the few memories I have of my high school chemistry teacher (I wasn't the BEST science student) is of him explaining that the definition of insanity was doing the same thing, repeating the exact same procedure over and over again and yet expecting to get different results.

TMI alert:

The resting cycle was actually restful. Yes, I used an OPK and we did our best to follow up on the positive reading. Yes, I broke down and used the progesterone through my luteal phase, just in case. But I didn't believe it would work. And my poor Confuterus displayed some of the most bizarre behavior I've seen since stopping the birth control pills over a year and a half ago. For the first time in my life, I had ovulation spotting. Mildly alarming, but proclaimed to be "nothing to be concerned about" by the nurse when I called in about it. Then I started spotting again only 9dpo, and saw bright red blood at 10dpo. Assuming a resounding luteal phase failure, I called into the RE to report CD1 and scheduled my baseline. And immediately stopped bleeding. Too late to cancel the baseline, so I went in anyways. The ultrasound showed a still active corpus luteum* and bloodwork indicated declining progesterone. The nurse predicted my period would be only a few days out. Spotting resumed later that day and continued until 15dpo, which ended by becoming CD1. Repeat baseline on CD3 cleared us to start injections that very evening.

Chemistry lesson: my reproductive bits don't function properly without benefit of modern science.

Lesson learned.

The odd thing is, this undeniable feeling of hope doesn't seem to apply to this particular cycle. I've grown so accustomed to lack of results, that I don't feel like this is quite "my turn". It feels more like a practice run. So I'm just focusing on getting comfortable with the protocol, working up the nerve to do the injections myself and gathering information about how my body responds to these drugs. I'm just glad to feel like there are still options, and that eventually something WILL work.

*Side Note: As a result of our recent Potter-thon, I kept referring to it as "Corpius Luteum" like it was some kind of magical incantation to increase progesterone levels. Unfortunately, now I can't STOP calling it that!

Voodoo (or No Pain, No Gain)

I have this strange way of thinking about pain and illness. This has only really occurred to me as my periods have gotten heavier and crampier over the past few months. I feel like when my body gets sick, it has a natural process for ridding itself of the offending intruder or healing the injury and I have this almost superstitious belief that if I take medicine to dull pain or dry up mucous or whatever, it will slow down or somehow derail my body's natural healing process.

I suspect that if I take a pain pill, it will make it take longer for my period to be over. That by dulling the pain and mellowing the cramps, I'm actually stretching out the process. That somehow the more it hurts, the better my uterus will be cleaned out of the blood. When I had my miscarriage, I wouldn't take the vic.odin until it was all over and I wanted to sleep hard. I think of myself as a total wuss, but I seem to have a higher tolerance for pain than I once thought.

My reluctance to take pain pills is increased by the fact that acetaminophen does absolutely nothing for me and never has. I have an unfortunate reaction to ibuprofen, and you can only take so much naproxen per day. Since I do sometimes get debilitating migraines and episodes of sciatica, I have a prescription for ketoprofen which I hoard like magic beans.

This last time around, the cramps were so bad I had to take a pain pill.

I'm hoping there's someone out there that can tell me I'm not crazy.

Much Ado About Nothing

Y'all that totally did not hurt.

We've started the GonalF shots. I say "we" because the Professor is currently performing the injections for me. I say "currently" because now that I know exactly how little they hurt, I am determined to do this myself (under his expert supervision) before we are finished. I think I'll still let him do most of them for a number of reasons. I know I have an hourglass figure, but I somehow never realized until this evening how tricky it is to look directly at my belly because my boobs stick out so far. It's a curse. More than that though, I want the Professor to be as heavily involved in this process as possible. And I like when he does stuff to take care of me. Sticking me with a tiny needle and injecting me with hormones totally counts as taking care of me, especially since I was so scared to begin with.

I was so anxious about this first shot that I couldn't even think about food when I got home from work, in spite of my hunger. I basically sat on the couch and waited for eight o'clock to roll around. I re-read the instructions that came with the injector pen. I made the Professor re-read the instructions as well. I had him recite the procedure in full detail from memory as we set up shop in the bathroom.

I pinched. He poked. We counted to five and it was over. I barely felt it.

Professor admitted after the fact that in spite of his experience at this particular task, it had been hard to do that to me, because it was ME. I assured him it really was painless and we had a good giggle about how anxious I'd made both of us.

God I'm starving! Time to order a pizza to celebrate!

Quote, Un-Quote

My favorite quote since the age of about 12 is really a very short poem, by the amazing Shel Silverstein:

Listen to the mustn'ts, child. Listen to the don'ts. 
Listen to the shouldn'ts, the impossibles, the won'ts. 
Listen to the never haves, then listen close to me... 
Anything can happen, child. Anything can be.

Keeping Hope (and House Plant) Alive

So I have this plant, this very sad plant. I have no idea what kind of plant this is, aside from House Plant. It is the only plant we have inside our home. It was given to us as a housewarming gift by someone who had no idea what a danger I am to green and growing things.*

For the last year, this poor plant has been hanging on by a thread (kind of like me). It looks so pathetic that I actually quit watering it, hoping it would just go ahead and die so I could empty the pot and move on to killing other plants outside. I sometimes wonder if the Professor has been watering it behind my back (though to be fair, I have not expressly forbidden this), because the damn thing simply will not die. It now consists of two stalks bearing a total of three leaves. But it is still green, still alive.

I found myself contemplating this poor little thing the other night, and my thoughts kept jumping from the plant to my infertility and our repeated failed cycles and back to the plant again. I kind of feel like my motivation and hopes in our struggle to conceive are reflected in this indomitable little mess of a plant. Every time a leaf turns brown and dries up, I pick it off only to see a new leaf break out of the top of the stalk. There are always just enough leaves for the little plant to look alive. And cycle after failed cycle, we pick ourselves up, revise our strategy with just enough hope to make another attempt at beating infertility. I've certainly received more love and better care than Plant, and while neither the plant nor I have actually seen much improvement, we both keep pushing forward.

I'm thinking of giving it a name and some water. Maybe some fresh soil. But if I start taking care of it and it dies, what will that mean for me?

*Note to self: Don't forget to go out and be dangerous to the green and growing weeds in the front yard ASAP!

Where Does the Time Go?

I had one of THOSE moments today at work. One of those "anniversary" moments.

Last year, the end of the two week wait in our first cycle with the RE fell just after Thanksgiving. By the end of the holiday weekend I was actually having some mild symptoms, super-sore boobs and sudden, random flashes of severe nausea. I also had some light spotting. The Tuesday after, I was working an annual special event our office puts on and I got my period. It was bad, the worst in my recent memory. As soon as the event got under way, I told my boss I needed to go home. I'm fairly certain now that I was actually having an early miscarriage. I can still remember those symptoms vividly, and while the next cycle brought us our first ever positive and more super-sore boobs, that particular variety of nausea has yet to reappear. Neither has a positive.

Today at work, I overheard a conference call regarding the initial planning for that same annual event. It was like someone drew the needle across a vinyl record (you know the noise they use in a sitcom when everything comes to a screeching halt). Heads up! Here comes an anniversary! When the annual event rolls around this year, we will have been working with our RE for one year and TTC for one month shy of two years.

Please God let me be knocked up by then...

For My Next Trick

I'm back! I had a great visit with my BFF, and I'm home. I REALLY don't want to go back to work.

*sigh*

Anyhow... we had our follow-up consult with the RE last week. We're changing things up! Once this "resting" cycle is over, we'll be starting injectibles.

Whoa. For realz y'all.

The RE was still confident that Clom.id would eventually do the trick, but also agreed that we would be smart to step up the game. So we're switching to Go.nal-F plus Ovid.rel. He mentioned the increased chances at pregnancy (10% increased to 20%) and the increased chances of multiples (again 10% increased to 20%). It also means a lot more monitoring, so more time out of the office.

And shots. I'm such a wuss. *shudder*

We sat with a nurse and got the run-down on the injections, plus a little practice kit so we could familiarize ourselves with the injector. We played around with the demo pen for while. Seems pretty simple. She also gave us samples of a new alcohol swab from Walgr.eens that has a mild anesthetic in it. Apparently, other patients have been reporting good things about these new swabs. I'm game!

The nurse will sort out the pre-authorizations and order the meds for me. I just have to call the pharmacy this week to arrange for the delivery (and find out how much it will cost).

Anyone else who has used this same protocol out there... what side effects (if any) did you notice?

Trying... Not Trying (My Wandering Mind)

I'm sure I won't be the first (or the last) to fail to truly rest during a TTC break. You're with me on this, right?

I told myself early in the last cycle that my heart and mind needed some time away from the hormonal roller coaster that Clomid brings with it. To say nothing of the concern that I've done five rounds of it now, and recently read that more than six is not recommended.*

I also had a fair bit of travel scheduled for this cycle and didn't want to be stressing about timing a trigger and IUI (and potentially being on the road at the critical moment, thus having to cancel), and then traveling with those lovely progesterone suppositories.

And then with the onset of CD1, everything fell into place such that the Professor and I would be in town together at just the right time. Of course, I still wanted a break from the prescriptions and certainly didn't want to travel with them. So it became an official break.

Except... I went out and restocked the OPKs because... oh, please. We ALL know why. And of course, I bought the combo pack that comes with a digital HPT. Because, OF COURSE!

Because I will be in town from CD8-CD14. And I always ovulate between CD9-CD14 and the Professor and I will be following our instincts as per usual. And we've all heard the stories of people who took a break and suddenly their bodies just did what they were supposed to, even without the prescriptions.

So here we are trying, when we aren't really trying. And my mind is all over the map, even without the fertility drugs. And as scattered as I feel, I also feel frighteningly blank. I've been reading my Twitter feed and keeping up with my blog reader, but most days I just can't think of a thing to say. I'm sorry I haven't been commenting much on your posts. I have been riding the waves with you, I just haven't known what to say lately.

I feel like I'm not really here.

*Remind me to ask my RE about that. Did I mention that we have a consult scheduled with our RE on Monday?  I'm so worried that there is something more wrong with me that they missed because the luteal phase defect was so obvious. I don't even know what blood tests were done at the beginning. Maybe our one BFP was actually a total fluke? I'm hoping he brings his crystal ball to the appointment.

Mood Swings and Dreams

Since my most recent BFN, and the start of this resting cycle, I've been dealing with some pretty intense mood swings (for lack of a better term). Maybe priority shifts would be slightly more accurate... but they seem to be tightly tied to my moods.

I knew before I got the official results last week what the outcome would be, and I was back in the Pit of Despair with a bad case of the "Why ME's". By the time the nurse called with the beta results, I was fairly numb and just wondering idly what the hell to do next (but without any real drive to do anything at all). 24 hours later, I was so at peace with my lot in life, that I almost wanted to walk away from the whole process and focus the rest of my life on enjoying the Professor and myself. And then realizing that no, I can't just give up. But I do need to focus a little more on the Now and a little less on the What If. Keep striving for our goal, but stop living just for that moment. And if that moment never comes? Well... that will be a loss to be grieved, but it will not be the end of my world.

But when I'm lying in bed at night, waiting for sleep to steal in,  I replay all the little moments that have stuck in my head thus far and all the little moments that I would be missing if I stopped now. The first time we thought we'd actually gotten me pregnant... sitting at lunch with the Professor and pondering the reality and he actually teared up. The only tears I've seen him shed over this whole mess. The moment when we finally got that first positive, but were too shocked and scared to be really excited. And then there's the future moment when we finally get to tell our parents they will be grandparents, a thousand little moments watching my baby sleep in the dark, listening to a little voice chattering in the back seat of the car, little hands reaching out to grab stuff off the grocery store shelves as we roll by.

Tiny little dreams, mundane even. But they're my dreams.

So Happy It's Scaring Me (I May Need Help)

I am so lucky. I have so much more than so many other women. I have so much to be thankful for.

There are times when I am confronted with how easy my life is and how good I have it, and I can't help but feel utterly content with my life just as it is. And for some reason, these moments are inevitably followed by a flare of panic. My instinct is to be wary of feeling too happy because, suddenly, there is the certain knowledge that everything I have can be taken from me in the blink of an eye, and what devastation that would be.

Knowing how much I have means knowing how much I have to lose. I am genuinely afraid that if I let my guard down and revel in my contentment, then bad things will happen. There are days when it is all I can do to force myself to walk out the front door and get in the car because I am absolutely certain that if I do, I will never make it home again. There are days when I sit on the couch with ears straining and heart pounding, waiting to hear the Professor's step on the porch because I am so terrified that he might not come home. What the hell is wrong with my head?

This weekend I was sitting in a sandwich shop, eating dinner with the Professor and thinking about my friends inside the computer. Some of y'all are going through some truly horrific shit right now. I make no bones about it. Some of what you are dealing with in addition to your infertility and/or adoption struggles... I am time and again amazed that you just keep going. And that is what tells me that you will be a great parent when you do get your chance. You do what needs to be done, you find the strength, whatever comes your way. You keep pushing forward because stopping is not an option. You are awe inspiring. I would like to think that if I were faced with the same situations, I would weather them as well. But I honestly don't know. I do know that I need to stop my whining and be a little more mindful of what I have been given. I will try.

I have my own home, a nice car, a good job and (relatively) good health. I have enough income to pay my bills and I do not worry where my next meal will come from. I still have both of my parents. Most importantly in my mind, I have a husband who is my best friend in the whole world, who loves me to distraction whether or not I ever produce his child and without whom life would lose its sparkle.

Yes, I want a baby. No, I may not ever get one. But in this moment, I am focusing on what I do have, because I HAVE SO MUCH. And I want to enjoy it.

Gurlee Made Me Cry

So after being away from blogworld for a while when my Mom was in town, I opened my email to discover that Gurlee over at Infertility Musings had bestowed on me the Versatile Blogger Award. And I cried. Like most of you, I started this blog just to have somewhere to vent, to get everything out of my own head with a hope that someone out there would say, "Me too. Doesn't this shit just suck?" 

Thank you Gurlee *sniff*sniff*

So as I understand it, this is how the award works:

1. Thank the person who gave you the award. (Thx again Gurlee!)
2. Tell 7 things about yourself that readers may not know.
3. Pay it forward by nominating 8 bloggers you’ve recently discovered.

So without further ado:

1. I have an English Garden and I hate gardening. I have to pay someone to come take care of the flower beds because otherwise things start dying and weeds take over and the next thing you know... there goes the neighborhood!

2. I was in the past (and will be in the future) an artist. I packed up my studio to take my first ever 9-5 job in order to do the baby-making thing with decent insurance and maternity pay. It's been two years and I'm only just now starting to miss it. I'll get back to it when I can have a home studio.

3. I actually like my job. I've only been there for 18 months, but I go home at the end of the day knowing that I contributed to making the world a better place.

4. Salsa is my number one comfort food. No joke. I was raised in Texas and good salsa is probably the thing I miss most.

5. I am a book addict. I collect first editions, particularly young readers and teen books. Yes I like Harry Potter, Percy Jackson and Twilight (all for different reasons). I also love Diana Wynne Jones (Chrestomanci) and Catherine Webb (Horatio Lyle).

6. I am allergic to cats. I have two.

7. I have a soft spot for aquariums (the kind you visit, not the kind you keep in the living room), but find zoos depressing. I am particularly fond of sea urchins. But not for dinner.

I would like to bestow the Versatile Blogger Award upon the following:

1. APlusB at a+b, waiting for c
2. Becca at Liberal Granola Girl's Blog
3. Hope Springs at Moving On to the Next Plan
4. Jay at The Two Week Wait

5. Jenny at Among the Blossoms
6. My So-Called (TTC) Life
7. Secret Sloper at Park Slope Purgatory 
8. This is More Personal