March/April Shout-Out

I don't really know what to say right now...

We are all still here, Inhabitant is still kicking away in the inside to my eternal relief. March basically sucked as usual (with occasional rays of sunshine). April is sucking much less, but has not exactly been blissful either. I'm back on pelvic rest due to random episodes of unexplained spotting and mild contractions. Work is completely insane and I'm exhausted.

This week was NIAW and I couldn't even tune in. I spent the week owning that fact that I'm still carrying a lot of sadness, resentment and jealousy and that is not likely to change any time soon. So I have the happy thoughts of Inhabitant and the accompanying fears on his behalf, plus the grief for years wasted and embryos that didn't make it and siblings that will never be... and I am not feeling eloquent or even articulate, much less able to rally to any battle cry for awareness. I'm just trying to get through one day at a time and that is going to have to be enough for now.

PSA: Stopping vs Quitting

PLEASE NOTE: This is NOT an announcement of the outcome of our cycle (beta results in a few days). It is simply a subject that has been weighing on my mind in recent weeks.

Apparently, it has to be said. Stopping is not the same as Quitting.

It is a subtle difference, but an important one. Quitting implies action ceased due to frustration or fear of failure. Stopping implies action ceased due to desire, an educated decision or strength of conviction.

I knew going into this DEIVF cycle that it would be our last, no matter the outcome. Our hearts and our wallets are exhausted. This was part of our decision making process going into the cycle... do we have the reserves to get through even this one more? We decided that we did, but that it had to be the final attempt. Half way through the cycle, I had the realization that indeed, I do not have the heart to do this ever again. In the card we wrote to include with our gift for our egg donor, I thanked her for giving us the opportunity to find peace no matter the outcome. And that is just the thing. This cycle represents our limit. We can move into our future knowing that we did everything we could. We will not look back and regret stopping here. Of course, a negative result or another loss will be heartbreaking without question. But we can find peace.

In this community, those few of us who resolve our infertility journey by choosing to move on child free are often rather frightening to those still in the trenches. They see only "giving up" without the release of a future that was chosen. They offer support in the form they themselves still need: encouragement to keep trying, keep looking for answers, get another opinion. It is well intentioned, but misplaced support.

What we really need, when we reach this point, is for the community to wish us peace with our choice. We need respect for the strength it has taken to make that choice. We need to not be ignored, just because our situation makes people uncomfortable. We also need to remember that resolving this journey without a child does not invalidate the years of struggle and the experiences we have had. We can be a resource to those still struggling. We can be an inspiration to those who are questioning their reserves.

Don't Ignore...

.. the fact that you were the result of your mother's one successful pregnancy

.. your weird menstrual cycles and crippling abdominal pain

.. the total and complete lack of any oops/uh-oh moments in all those years of haphazard BCP use

Don't ignore the signs. Learn more.

National Infertility Awareness Week
Resolve.org

The Other "Other Side"

Mali has a great post on transitions and the concept of success/failure within the ALI community. Specifically, as these apply to those living without children after infertility. As someone recently weighing this option against my current path to DEIVF (and fully aware that this may yet be my ultimate outcome), I appreciate her continued presence in this community.

Go read her post.

My Trench is Taking on Water

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

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

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

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

Not-Penny's Baby Shower

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

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

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

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

The Knowing

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

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

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

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

Gratitude

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

Thank you.

IVF Monitoring #1

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

Sigh.

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

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

Letter to Human Resources

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

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

Dear AVP of Human Resources,

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

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

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

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

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

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

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

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

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

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

Sincerely,

Moi


Baby steps people, baby steps.


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

All the Cool Kids Have One

Happy NIAW!

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

Holla Georgia!

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

Thanks y'all!

Much Ado & Motivations

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

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

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

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

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

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

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

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

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


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

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

When the CIA clears our files. (BumpyJourney) 

When you stop watching my uterus. (naturalmelnow)

The voices told me not to.

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

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

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

Why? Are you selling?

When do you need to know?

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

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

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

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

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

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

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

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

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


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

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

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

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

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

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

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

Beating a Hopeless Horse

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

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

Crinone

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

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

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

Regret

Should be a four letter word.

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

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

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

Just like parenting, I expect.

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

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

Award Season (UPDATED)

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

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

Now get out there and give each other some love!

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

Welcome to My Soapbox

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

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

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

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

(Stepping down from my soapbox now)

ABCs: In Which I Expose My Inner Bitch

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


In alphabetical order:

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

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

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

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

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

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

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

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