Monday, September 22, 2014


I've never been good at keeping secrets. This is partly due to the fact that I prefer to live my life as an open book. Or, at least, I used to. I even had a fairly raw, letting-it-all-hang-out-there blog for several years, in which I exposed even the ugliest parts of myself and my life.

And then I grew up.

And then I got an office job.

And then I had coworkers who read my blog.

I discontinued the blog. It was too weird with all of the daily F2F interaction. Later, I ended up deleting it altogether.

But I miss it. That whole community aspect. The spilling your guts to strangers who eventually become friends, but not the kind you see in your everyday life. Especially now, as I find myself myself navigating so many Big, Scary Things.

Such as: infertility.

Oh gawd, I can hear you thinking. Do we really need yet another blog about IF? Probably not. But right now I'm going to be completely selfish and say I don't care, because I need a place to talk about this shit, openly and honestly (albeit anonymously), before my fucking head explodes.

Like I said, I've never been good at keeping secrets.

This is what I'd put in my "siggy," if I was posting on one of the many IF-related message boards:

TTC since 2/2011
Me: 38 - DOR - one ovary, AMH <0.16, MTHFR
DH: 34 - low(ish) count & morphology (1%)

3 IUI cycles = BFN
:: changed REs ::
IVF #1 with ICSI = BFN
IVF #2 with ICSI = BFN
:: currently on a break from treatment ::

For those of you who may be new to the world of IF (which, FYI, is short for infertility), let me break this down for you in terms you may better understand:

Mr. Hope, as I will be referring to my dear husband (DH) from now on, and I decided to start trying to conceive (TTC) in January 2011. I think our first actual birth control-free cycle was in March, but I can't remember because I was still under the delusion that we could make a baby just by having unprotected intercourse.

In May of that year I had a wicked late period that turned out to be just that: a period that arrived two weeks late. I was worried, not only about the wonky cycle but also about some pain I had almost every time I ovulated. (I still had both of my ovaries then.) My gyno dismissed this pain as mittelschmerz. I also asked about whether or not I should be worried that I wasn't pregnant yet (oh, to be that naive again!). She gave me a nice pat on the head, recited some statistics about women in their 30s, and advised me to wait a minimum of six months before seeing a reproductive endocrinologist (RE).

Mr. Hope had a medical issue that accelerated that appointment slightly; the elevator version is that he had next to no sperm because of testosterone supplementation. The RE did a monitoring cycle with me and declared me "fine." He pushed for us to use donor sperm but I said I'd rather wait for Mr. Hope's swimmers to return. We wouldn't have been able to do anything right then anyway, as my insurance had zero coverage for IF. Mr. Hope's had 100% unlimited coverage (this, I think, has been one of the biggest blessings of all), so we decided to add me back to his insurance during open enrollment and revisit the conversation after the new year.

In February of 2012 we went back to see the RE and discuss treatment. Mr. Hope had enough sperm for the RE to do intra-cytoplasmic sperm injection (ICSI), which is where they pick the best sperm from the sample and inject it into the retrieved eggs. (Here's a cool video about how ICSI works, in case you're wondering.) We were whisked from the doctor's office straight over to the IVF coordinator's office, where we were given a lot of paperwork and calendars and the like. Then she deposited us in the insurance coordinator's closet-sized office, where we were asked for a $500 enrollment fee not covered by insurance and a backup credit card in case insurance didn't come through.

It was about this time that I started to have a full-on panic attack because hey, I thought we were just going in for the results of Mr. Hope's latest sperm analysis. I wasn't ready for the actual babymaking part yet. My house was a mess. There were issues with Mr. Hope's job and a complication with mine. Etc. We decided that we'd wait until summer, using the time in between to eat healthier, exercise more, do some work on the house, and generally get our shiz together.

By June, we'd revamped our diet and I lost thirty pounds. I felt like I was in a good place to start a family. And then my "mittelschmerz" got worse. After a trip to the ER, we discovered that my left ovary had a ginormous dermoid cyst hanging onto it, and I lost it in the resulting surgery. The ovary that was left behind turned out to be very lazy. Plus the trauma of surgery sent my follicle-stimulating hormone (FSH, the stuff that tells you how hard your ovaries are working to recruit your eggs) up over 10, which is considered not great for attempting IVF. It rose cycle after increasingly shorter cycle, which prompted the RE to order an anti-mullerian hormone (AMH) test, which is a newer but fairly stable way of measuring ovarian reserve (how many eggs a woman has left). Mine came back at .16: undetectable.

Keep in mind that I'd spent the past year thinking that the only fertility issue we had was with Mr. Hope's sperm, which had since returned in decent numbers, albeit with poor morphology (i.e. the percentage of sperm shaped the right way for conception). But ICSI made the morphology thing a minor inconvenience, whereas my hormone levels indicated that whatever eggs I had left were likely rotten.

If you don't have eggs, you can't make a baby. Period.

My RE told me he could get me pregnant anyway, diminished ovarian reserve (DOR) be damned. Having a God complex makes a man promise many things he can't deliver. Mr. Hope and I wanted to believe him, so we marched forth into our first attempt at in-vitro fertilization (IVF).

The cycle started to go downhill almost immediately (issues with a lead follicle developing, instead of all of the follicles growing at the same rate) and I was converted to an intrauterine insemination (IUI). I went into the procedure convinced it would work.

It didn't.

I was devastated.

My next IUI was almost accidental. I wasn't on any stimulation medications (stims) but I had a good-looking follicle the RE didn't want to go to waste. So we did another IUI, which resulted in a second big fat negative (BFN).

Our next attempt at IVF happened in the summer. My medication protocol had been changed slightly but my response rate was basically the same.

As in: not good.

As in: another conversion to IUI.

As in: another BFN.

My RE turned into kind of a dick around this time, possibly because my body wasn't complying with his Almighty's treatment plan. Instead of altering said plan, he started to lay the foundation for breaking up with me. Suddenly we went from I CAN GET YOU PREGNANT to YOUR EGGS ARE CRAP AND I WON'T WASTE MY TIME ON YOU FOREVER.

So I left. I went to another RE. We prepared for a new protocol. During my pre-cycle, which is what I always call the cycle before I start stims, there was a death in the family. We postponed again.

Finally, in February 2014, a full year after my first failed IVF-cum-IUI, we went up to bat again. Things looked good for a while. And then they didn't. Only this new RE (we're going to call him Dr. Smiles, since he's got a thousand-watt one) didn't mind going to forward with just one follicle (follie). So we went to retrieval, and the egg fertilized, and we transferred back a meh quality 3-cell embryo (embie) on Day 2, which resulted in yet another BFN.

I went immediately into another cycle, as I'd read that sometimes this was a good thing for women with DOR. Not so in my case. The cycle looked like a bust early on. Somehow we made it to retrieval. This time the egg was immature. But wouldn't you know it, the Little Egg That Could pulled through in the co-culture (the stuff they grew it in), and it fertilized, and we transferred back a really lovely 4-cell embie on Day 2. When that one resulted in a BFN, Dr. Smiles called personally to say the whole thing had been textbook (you know, except for the only popping out one egg part) and there was nothing that we could've done differently.

Sometimes, he said, these things just happen.

After that, Mr. Hope and I went to meet with Dr. Smiles to discuss next steps. This is often referred to as the WTF appointment (which means exactly what you think it means). That's when he told us that we should start to seriously consider going the donor egg or donor embryo route. It wasn't the first time Mr. Hope and I had been given that speech, but it was the first time we talked about those options in any kind of depth.

Then we took a long break due to work travel and vacations and, if I'm being totally honest, some road construction that would've made the hour-long drives to the clinic even more of a bitch than they already are.

And that brings us mostly up to date. I say "mostly" because how we got to this precise place - which is us deciding to give IVF with our own embryos one more go but simultaneously starting the donor embryo process should this last-chance cycle fail to produce a viable pregnancy and ultimate baby - well, that's another story for another day.

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