Overworking It

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

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

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

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

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

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

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

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

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

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

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

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

Are you now as confused as I am?

Issues, I Haz Them

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

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

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

WTF (do we do now)?

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

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

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

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

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

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

IVF The Remix (Conversion)

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

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

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

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

IVF The Remix (Update #3)

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

Saturday AM monitoring revealed:

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

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

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

IVF The Remix (Progress Report)

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

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

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

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

I'll check back in on Sunday.

IVF The Remix (First Peek Inside)

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

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

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

Beats the crap out getting cancelled!

IVF The Remix - May I Vomit Now Please?

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

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

Seriously. I may vomit.

Once More, With Feeling! (UPDATED)

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

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

Deep breaths.

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

Is It Time to Panic Yet? (UPDATED)

I have a sneaky feeling I'm fucked.

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

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

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

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

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

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

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

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

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

Dream Vacation

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

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

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

Sabotage

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

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

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

In My Dreams

As promised on Twitter...

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

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

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

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

IVF Remix

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

I call with CD1 for another baseline.

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

Any takers?

Limbo

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

lim·bo

noun \ˈlim-(ˌ)bō\

2 a : a place or state of restraint or confinement

   b : a place or state of neglect or oblivion

   c : an intermediate or transitional place or state

   d : a state of uncertainty 

 

 

I'd say that about covers it.

Cancelled

Again.

Before I even got started.

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

IVF The Do-Over, Please Hold

Yesterday was CD1 as expected.

Yesterday I was home sick from work with a cold.

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

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

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

Today I am still home sick from work.

Today I missed the call with my blood results.

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

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

On Your Mark... (UPDATED)

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

No BCP. No Lupron. No suppression at all.

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

This should be interesting.

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

Batter Up

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

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

Hold me.

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

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

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

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

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

First world problems.

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

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