Tuesday, September 30, 2014

things we lose.

I've lost a lot of things as a result of my infertility, but one of the most painful was a friendship. And actually, I never thought I'd fully lost it, until I almost did.

Let me explain.

Until about a year and a half ago, I didn't have just one BFF, I had two. We all went to high school together and have known each other since we were teens. The BFFs have their own friendship with one another, but I've always been the Jerry that links them together. Meaning, it's not like we were ever a trio. More like linked duos.

My other BFF (I'm going to call her Gumbo) was one of my strongest sources of support during the early days of my diagnosis. We've been there for each other through most major life events...except when we weren't. Because as much as we love each other, we've ended up taking more than one extended break from our friendship. In some ways, we're too much alike. Too emotional, too sensitive. And we have a longstanding history of going through Big Things at the same time which ends up forcing us apart instead of closer together.

Around the time that I was gearing up for my first attempt at IVF, Gumbo was having serious conversations with her husband about future babies. As in, he wanted #3. As in, she did not. She was struggling to find a way to tell him this - that as much as she loved being pregnant, she wasn't ready to dive back into Diaperland again. In fact, she didn't think she'd ever be ready. She was happy with the two she already had.

I'm sure you can already see where this is going.

When my first attempted IVF got converted to and IUI, Mr. Hope couldn't be there for the first insemination (we did two back to back, to cover the spread). So Gumbo met me at the hospital. She made me laugh in the waiting room. She came back to the exam room and joked with Dr. God Complex who asked her if she wanted to get pregnant, too.

Afterward, we went to a diner where I ate turkey, as I think I'd read somewhere that turkey was good for fertility. I was calm, I was hopeful, I was certain that I'd just conceived my daughter.

As we left the diner, Gumbo mentioned something to me about having sore boobs, and how they kind of reminded her of how she felt when she was pregnant. Oh, and by the way, she told me, her period was late.

I winced. I don't know if she saw it, but I did.

I urged her to take a test. She didn't want to. I don't think she was ready to confirm what she already knew.

We took our first tests on the same day: 7DPO. Hers was positive.

Mine wasn't.

I had a feeling then that the IVF had failed. It wasn't rooted in anything other than my gut, and I was hoping beyond hope that I was wrong.

I started testing daily.

A day or two later, I got a superfaint positive. I even woke Mr. Hope up to show him. He didn't see it, but any woman who was trying to conceive totally would have.

Gumbo didn't see it when I sent her a picture. Even so, for one blissful day, I thought I was with child. That we both were. We'd be pregnant together. Our babies would play together. Wouldn't that make one hell of a story?

You already know how that story ends. The line didn't get darker. It faded almost immediately. Most likely, the superfaint positive was lingering traces of the trigger shot being picked up by a really sensitive test.

I fell the fuck apart.

It was so cosmically unfair that Gumbo, who didn't even WANT a baby, and who already had two of her own, could get pregnant without even trying, whereas I was throwing everything under the sun at my body and still couldn't conceive.

I told Gumbo I needed some time. That I couldn't help usher her through an unwanted pregnancy, when the only thing I wanted was one of my own.

She said she understood. Then she said she didn't. At one point, she told me she had another infertile friend who had been a tremendous source of support for her. That's great, I told her. I'm glad you have a more generous infertile in your life than I am capable of being right now.

There were some tense text messages exchanged over the next several weeks. Then, after about three months, I told her I wanted to make plans to see her. She was getting ready to take a trip, and plans kept shifting. By the time she was ready to talk dates, I was about to head into my next attempt at IVF. Also converted to IUI. Also a BFN.

I asked for an extension on the time out.

We talked around the time of her gender scan. I had convinced myself she was having a girl, because that was what I had wanted. When I found out she was going to have a boy, I felt relieved.

There were some text messages here and there, but we didn't talk again until there was a death in my family. She came to the funeral. She spoke at the funeral. I thought that maybe this could mark a new start for us. I was in a better place (sort of). And I missed her. I loved her. She is one of my oldest and dearest friends.

But nothing ever really happened. I'd text her and responses would come slowly. I'd message her through Facebook and hear nothing back. We had one phone call when a mutual friend was going through a major-league tragedy, but that was it.

And then I started this blog. And I sent her and a few other close friends, family members, and fellow infertiles the link.

Yesterday she wrote back and told me that she was happy that I seemed to be in a better place, but that she wouldn't be following my blog. That it was too hard to read because we were no longer friends. She had closure, she said, and wished me the best.

I'd gotten fired from our friendship without even knowing it.

And okay, yes. A year and a half is a long time to be on sabbatical from a friendship. But it wasn't like there had been no contact. Only, every attempt I'd made to reconnect - the Facebook messages, the random texts - she'd viewed them as me acting like nothing had happened, instead of me putting my toe back into the friendship water, so to speak.

I felt a little blindsided, to be honest. And I told her that. And I told her how I didn't want to sweep back into her life just because I was ready and expect her to be ready to. I was trying not to be an asshole, because I already felt like one for needing such an extended break to begin with.

We exchanged several emails yesterday and have plans to talk this week. I'm glad for that, because I do love Gumbo and I never once thought our friendship was over for good. I just thought she needed more time to get over the hurt she felt when I abandoned her in her time of need. She was right to feel hurt. If I'd been a better person I could've sucked it up. But I wasn't that person. I was me, and I was devastated, and I just couldn't do it. Not then.

Funny postscript to this story: Just after my first IVF with Dr. Smiles (my first actual IVF, as opposed to one that got converted to IUI), while I was still in my two-week wait (2ww), one of my closest work friends (aka Glam Colleague) found out she was pregnant. This, just weeks before her wedding.

The day she told me, I had a pretty good feeling my IVF had failed. I hadn't even started testing yet, but it was Gumbo all over again. (She and Gumbo are actually similar in a lot of ways, to be honest. She's like my work version of Gumbo.)

So now Gumbo's little boy is on the cusp of turning one, and Glam Colleague is about to pop out her little girl any day now. And my arms are empty.

Still.

But today I go see Dr. Smiles, and I get on "the list" for a donor embryo.

Maybe, just maybe, my arms won't be empty much longer.

Monday, September 29, 2014

preparation.

Today I start my pre-colonoscopy diet (or, as people who suffer from Crohn's disease call it, a "low-residue diet"). Here's what I can eat between now and Thursday breakfast:

  • White bread
  • White pasta
  • Cream of Wheat
  • Yogurt without fruit in it
  • Saltines
  • Pretzels
  • Low-fat protein (boiled chicken recommended)
  • Some cheese
  • Mashed potatoes
  • Canned green beans and peas

Here's what I can't eat:

  • Fresh fruits and vegetables
  • Whole grain breads/cereals/pasta
  • Nuts and seeds
  • Pretty much anything with fiber

Mr. Hope is in heaven, as he prefers to eat like a picky toddler. I, on the other hand, am totally lost. This is completely foreign to the way I eat on a daily basis. And yes, I love to indulge in processed garbage once in a while, but NO fresh vegetables? I mean, really.

I'm also filling out the paperwork for tomorrow's appointment with the third-party reproduction coordinator at my clinic. As of tomorrow, we will officially be on "the list" for donor embryos. Is it too soon to squee?

Sunday, September 28, 2014

changing the conversation.

I started this blog because I needed a place to write about what Mr. Hope and I were going through, infertility-wise. I decided to do it anonymously so that I could keep my business just that: my business. This allows me to be more open/honest in how I'm writing about things. I always figured I'd share the link with my family and close friends so I could keep them up informed about where we are in the process (even though I haven't sent it out yet - I wanted to get a bunch of posts down first). 

But I'm realizing the more I write, the less anonymous certain parts will be. I think I'm going to have to be okay with that. Starting now.

Last night, my BFF came over and we went out to dinner with Mr. Hope. Her sister in law (SIL) just had a baby and she was telling us about a recent visit and then started reading Mr. Hope the riot act about how he better behave when we have our baby. Suddenly it hit me that if I get pregnant any time in the next 12 months, BFF and I can't take the trip to Europe we have planned for our 40th birthday.

(A little history here: BFF and I are practically birthday twins. We also have husbands who tend to screw up birthday celebrations. So now we take a trip together each year, just the two of us, to celebrate our birthday. These are honestly the best vacations I have ever taken in my entire life. I spend half the year re-living them and the second half anticipating the next one.)

Mr. Hope said, "What, you wouldn't trust me with a newborn?" And I said, "Uh, that's not it at all. I'm thinking about breastfeeding." And then BFF and I had to school him about what that means and how I can't just pump and dump all over a foreign country, nor can I tote around a gimongous cooler of breast milk and take it home on the plane. BFF said, "We could always bring the baby with us," to which I replied, "On a seven-hour flight?" And then she was like, "Yeah, as soon as I started to think that through I realized it wouldn't be possible." 

Then we started talking about maybe postponing our 40th trip until the 41st birthday, which would give us time to save up more money and for me to finish breastfeeding, blah blah blah, and brainstorming contingency plans, like maybe doing a spa weekend nearby so we wouldn't skip the birthday thing altogether. 

It struck me that we were having the kinds of conversations that we used to have before my infertility diagnosis. The ones when I still believed that I could procreate. The ones we stopped having when my first two attempts at IVF had to be converted to IUI due to poor response/development of a lead follicle. When I started saying things like, "If we're lucky enough to get pregnant" instead of "When we have a baby."

I feel like making the decision to pursue the donor embryo path has given me, Mrs. Agony, a little bit of hope again. And I'm really liking how that feels.

Saturday, September 27, 2014

menses watch, day 3.

Yep, still bleeding inconclusively. Over the past three days I've used a sum total of three tampons, only one of which had any sort of significant absorption, and even that one was only half used. I typically burn through a super every 2 hours on Day 2 of my period, so this is saying something. Most of the time I'm still seeing watery pink/scarlet, and only when I wipe.

(Can I just apologize now to anyone who's actually reading this? I promise not to talk about my bodily fluids this much in the future. It's just that I am still reeling over getting my period a full week early, on what will be the shortest cycle I have ever had in my whole entire life, if it is in fact my period and not some mid-cycle bleeding due to rapidly approaching menopause.)

Something else is going on with me, and that is: after spending the past three-plus years mostly in the infertility closet, I've started to drop conversation bombs like no big whoop. Yesterday I met an old friend for coffee - the last time I saw her was something like ten months ago - and I was like, "Oh, and we've been battling infertility for years and are starting to move toward using donor embryos, so that's really where my head is at most of the time." And then proceeded to babble on about how I don't usually talk about our infertility because people tend to say the wrong thing or give me the "poor you" look that makes everything so much worse.

"They probably mean well," my friend said, and I instantly felt guilty for babbling in the first place, because I know she's right.

But also: I am part of the problem, because I have never once spoken up and told someone that what they said was completely inappropriate and hurtful.

Like: when the LabCorps tech said, "You can't have a baby? You can have some of my eggs!" and then spent the next 28 vials talking to me about her C-section scar.

Like: when one of my direct reports said, "It's a shame you aren't a mom; you'd buy your kid the best friends" after I made cupcakes to welcome her and two other new employees to the organization.

Like: when my boss, who knows I'm in treatment, said, "You'll see. Your life doesn't really begin until you have children."

(Is it any wonder I want to stay hidden in the infertility closet?)

Tuesday can't come soon enough.

Friday, September 26, 2014

menses watch, day 2.

Went sanitary-protection free last night just to see what would happen. When I woke up this morning: nothing. Not even when I wiped. Then, a little later, the watery pink stuff came back. It got a little heavier at one point, enough to use a tampon. But when I took the tampon out several hours later, there was barely anything on it.

I have had some cramping today, though, and a distinct lack of any symptoms that would lead me to believe this is anything other than a super-early, super-light period. Joy!

I called the IVF monitoring team at my clinic, because I'm supposed to do that on Day 1 of my next period. Which I'm thinking was yesterday, but am still not 100% sure. They were trying to schedule an appointment to confirm ovulation, because that's when I'll start the estrogen priming for our next IVF, but the last two cycles have been so wonky that they decided to have me do blood work when I'm in the office next Tuesday to discuss the rest of my protocol with Dr. Smiles and get started on the donor embryo process.

Speaking of: Finally got a hold of the third-party reproduction coordinator today and she sent us all of the paperwork to get on "the list." There is, apparently, a waiting list to receive donor embryos at my clinic, though I have no idea how long it is. When matches come up, the recipient who's been on "the list" the longest gets preference. To get on "the list" officially, you have to turn in a fuck ton of paperwork and a $100 nonrefundable application fee. 

So even though we're heading into another IVF with our own genetic material, I'm turning in the paperwork and check on Tuesday because I want need to get on "the list."

Lots has been written about the difference between donor embyros and embryo adoption, but if you're unfamiliar, read this. Mr. Hope and I are undecided which route we'll take, but we're leaning toward donor embryos because it's just so much more economical. Also, you don't have to go through any kind of home study, or wait for a couple to pick you to receive their embryos, or go through lawyers. (Downside: it's completely anonymous, so there's no chance of having an open situation where resulting kiddos can get to know their bio siblings/genetic helpers).  

You do get an awful lot of information about the donors, though: height, weight, hair/eye color, education, occupation, and interests in addition to a medical history (although some is self-reported and therefore could be incomplete and/or inaccurate). What I forgot to ask today (but will on Tuesday) is if there are any photographs of the donating couple or siblings. I'm guessing no, because of the anonymity. But I have read at some clinics the nurses try to match you with couples where there is a physical resemblance. 

Oh, and I haven't mentioned this yet but I totally have to get a colonoscopy on Friday. Which you can't do when you're pregnant (there's anesthesia involved), so I think I'm going to ask them to check my hCG level on Tuesday just to be certain I'm in the clear.

Why am I getting a colonoscopy, you wonder? Because I've been having some digestive issues and there's a family history of polyps. Since Mr. Hope and I are trying to get preggers, the gastroenterologist thinks I should go ahead and get checked out now instead of waiting 10 months or longer to find out there's a problem.

I never ever thought I'd feel so old while still being relatively young.

Thursday, September 25, 2014

you've got to be kidding me.

Last night I started to feel a little crampy, like I do when I ovulate. Only, I'm fairly certain I ovulated a week ago Wednesday (I tend to feel my ovulation). Foolishly, and like most women who want a baby really, really badly, I had a fleeting thought about implantation cramps. But then I put it out of my mind.

Today was one of those days that was just good, plain and simple. Ever since Mr. Hope and I made the decision to pursue embryo adoption at the same time we are going through our third and final IVF with our own genetic material, I've felt happier and more at peace than I have in ages. And even though my job is totally cray cray right now, and tensions are super-high in the office, today just felt light.

So there I was, laughing with some coworkers and marveling at this more-than-bearable lightness when WHAM.

I discover I am bleeding.

On cycle day (CD) 18.

A full seven days before my period is due.

What. the. fuck.

Before my fellow infertiles/baby-hungry mamas-to-be even think  the words "implantation bleeding," you should know that A) it was bright scarlet and B) there was more there than could comfortably be considered spotting.

Thus began frequent bathroom trips to monitor said bleeding. Thin, watery scarlet turned to even thinner pink. Then it turned a darker cherry and got slightly thicker before retreating back to watery scarlet or pink. I only see it when I wipe or check my cervix. It's not even enough to warrant a pad.

My boobs aren't sore, and when I took my temp tonight it was 97.6 (my luteal temps average between 98.0 and 99.8, though I'm not an official temper because it just seems like too much of a hassle). So, really, all signs are pointing to this:

I got my mofo period ON CYCLE DAY 18.

I have never in my whole life and 26 years of menses had a cycle this short. Ever. And, coming on the heels of my last cycle - in which my period arrived a full 9 days late and was so super-light that I actually took a couple of pregnancy tests afterward (cheapie Wondfo strips so as not to break the bank) - I can't help but think: Is this it?

Am I hurtling toward menopause a full year and some change before I turn 40?

Seriously, WHAT THE FUCK?

Wednesday, September 24, 2014

from contemplation to preparation.

Last night I had dinner with Kindred Spirit, a woman I met through my local Resolve support group back when my diagnosis was still new. We bonded pretty quickly due to the fact that we were both DOR gals, close in age, had married later in life, and had similar mother issues, among other things. We'd only attended a few of the same meetings, but kept in touch through a secret Facebook group.

I'd had a bit of a breakdown a couple of months ago that led to me posting in said FB group about my anger and frustration. Also this:

I wish I could let go of this need to have a biological child of my own but it's literally been YEARS and I can't get past it. And even when I think that *maybe* I could get to a place of peace with going the donor embryo route I am convinced that it, too, would end in failure and that would gut me.

Kindred commented on the post that night to let me know that she and her husband had decided to pursue embryo adoption after their yearlong break. I knew they'd started down that road previously but had run into some setbacks, and hearing this news made me so incredibly happy. Kindred and I started messaging back and forth about how she came to this decision and how soon she'd be starting this new leg of her journey.

In the Transtheoretical Model of Change, behavior that leads to change must pass through several stages: precontemplation (no intent to change, sometimes not even aware that change is necessary); contemplation (aware a problem exists, thinking about overcoming it, no commitment to action); preparation (intending to take action); action (what it sounds like); and maintenance (also what it sounds like).

I was still stuck in the contemplation phase. (Kindred, on the other hand, had moved into preparation/action.)

Fast forward five weeks. Kindred adds me to another secret Facebook group, this one centered on embryo adoption. At first I was taken aback. I mean, I wasn't there yet. I still hadn't answered a very kind email from a woman I hadn't met, referred to me by my in-person support group, who was using donor embryos and offered to meet up for dinner to discuss. (Which reminds me: I need to answer that email, STAT, with a big fat apology included.)

At first, I didn't check into the group that often. When I did, I didn't like or comment on anything. I just lurked. But then Kindred posted something, so I liked it. And then some ladies shared their good news (like first-ever positive pregnancy tests, something which still eludes me) and I liked that, too. And then one day there was a post about something only tangentially related to fertility that I felt compelled to comment on.

I was becoming part of the community without even realizing it.

And then one night, after coming home from Glam Colleague's workplace baby shower, I kind of lost my shit.

The minute Mr. Hope walked through the door I started crying...and didn't stop for hours. It was the kind of crying where water just pours out of your eyes and snot drips from your nose and you are practically convulsing from all of the sobbing. Ugly crying, painful crying, crying that leaves you feeling hungover the next day.

Two days later, I crafted an introductory post to the Facebook group. Almost immediately, responses started rolling in. Instead of making me feel like a noob, these women welcomed me with open arms.

This is when everything changed.

Not because the women were so warm and welcoming (although I'm infinitely grateful for that) but because in responding to their comments, I started to get clear on what I was thinking/feeling about going the donor embryo route. Or, more accurately, what I was fearing.

That the kid wouldn't see me as her real mom.

That she would never stop wanting her biological parents.

That she'd regret not being one of the lucky ones "placed" (so to speak) with her bio family.

In realizing this - that the majority of my fears were based on a hypothetical child hypothetically rejecting me, and that I'd likely manifest a similar anxiety and insecurity with a biological child (not loving me, or wishing she'd been given a different mother)-

Well, let's just say I had kind of a moment.

The next day, Mr. Hope and I sat down to have a looooong talk about next steps. We were supposed to be starting our next pre-cycle (an estrogen priming cycle), but I hadn't done the things needed to do to get us there. I told him about my epiphany and that I felt like I was finally ready to head down this path I'd been avoiding.

He said, "I just want to raise a baby with you. I don't care how we get one."

This has pretty much been his attitude all along, but remember: Mr. Hope already has a biological child of his own. I don't. So I am not only mourning the loss of a tiny human that is half Agony, half Hope, I'm also having to come to terms that I am at the end of my particular evolutionary line.

This, I think, has been one of the hardest parts for me to accept.

One of the women in the secret Facebook group left me this comment:

There is a grieving process in adoption. Adoption is ONLY formed through loss. With EA, loss of birthing a bio child and loss of the embryo from being raised in their bio family. Loss of the dream of how our family would be formed. Often loss of numerous other children along the journey to build our family. It's a tough road, but I truly believe that going down this road not only makes us stronger, but also makes the depth of our relationships stronger. Life is just more precious in general when we've had to fight to bring life into the world the way we have.

I cried when I read that.

I cried, too, when Mr. Hope and I decided on our plan.

We'd always said we'd try three IVFs before calling it. We had one left to go. Mr. Hope said, "I think we should still try one more time. That way, we have no regrets. We'll know we gave it everything we had."

(It helps that our out-of-pocket expenses are extremely limited when it comes to IVF; our largest expense is the $500 fee for the anesthesiologist, and we get that refunded by the insurance company after the fact. If we had to shell out $12k of our own money for every attempt, I'd probably have reached a different conclusion.)

As we head into this third and final IVF attempt, we're going to simultaneously start the process for donor embryos. I think I know in my heart of hearts that this is how Mr. Hope and I will get our baby. But I want to be able to go into the process with a clear head - and without a bunch of niggling question marks hanging over the decision.

Back to Kindred Spirit: She is in her down reg period, just four weeks shy of her first fetal embryo transfer (FET), which falls on my Precious Pup's birthday ("It's a sign!" she said. "It's going to be a great day!") Kindred is positively glowing, all giggles and dimpled smiles. She showed me pictures of her embryos' already-born siblings. They look like they could be hers.

As for me: Making the decision to talk to our RE about donor embryos feels like an elephant just got off my chest. It feels like relief. Like I could stop fighting the inevitable. Like I was surrendering, but in the best possible way.

I can't wait to see what happens next.

Tuesday, September 23, 2014

alternatives.

Although my husband and I had been trying (unsuccessfully) to make a tiny human since early 2011, I didn't know I was infertile had infertility until two years ago, when Dr. God Complex ordered an AMH test and it came back at <.16 (undetectable). Even then, I still didn't know for certain, because Dr. GC told me he thought my hormone levels were affected by my recent oophorectomy, and we'd have to wait three to six months to see if they would normalize.

Around this time, some women in my local Resolve support group were talking about SART data. SART stands for Society for Assisted Reproductive Technology, and the data refers to self-reported success rates with IVF. Where I come from, there are two main clinics that handle all of the Infertiles. The one I was going to was a one-man show run by someone who, back in the Louise Brown days, had been a pioneer in the field. In fact, most of the doctors over at the other clinic - a Keurig-and-fancy-snacks-in-the-waiting-room type place - had learned from him in some form or another.

But when I looked up Dr. God Complex's stats in SART, the numbers were dismal. Whereas the numbers from the Keurig clinic were pretty strong.

We opted for a second opinion.

The workup at the Keurig clinic was extensive and required us talking to a lot of different people, including several students who I guess were interning or doing residencies or whatever. Three hours after our arrival, we still hadn't seen the doctor, which would've been okay if there had been a warning about spending half our day there. (There hadn't been.)

When we finally got in to see the actual RE, he was a cold, clinical man with absolutely zero bedside manor. Even though my husband had taken the time (and dropped something like $30) on getting copies of our records from Dr. GC's office, delivering them himself to the Keurig clinic the week prior to our appointment, Dr. Coldheart hadn't even bothered to glance through them.  

Instead, he took one look at me and my plus-sized body and guessed that I had PCOS (I didn't). When I explained that I'd lost my ovary and, as a result, had been getting elevated FSH readings and the disappointing AMH results, but that Dr. God Complex had assured me that they were because of the surgery and not because, you know, I'm completely infertile, he looked at me like I was speaking Mandarin.

He then informed me that Dr. God Complex was totally wrong, and that he (Dr. Coldheart) had no idea why Dr. GC had told me such "falsehoods" to begin with. AMH, he informed me, didn't fluctuate due to surgery. It didn't tend to fluctuate, period. 

With cold, clinical precision, he delivered the ol' "less than 1 percent" speech (as in, "I give you less than a 1 percent chance of IVF success"). I then was given the donor egg speech (as in, "Your eggs are crap, so we think you should purchase some young, fresh ones and increase your chances to 30 percent or higher"). If I insisted on doing IVF with my own eggs, they'd comply, but I was informed the likelihood of failure was "high" and then I'd end up having to use a donor down the road anyway.

I started crying in Coldheart's office. Like, tears-streaming-down-my-face-in-rapid-succession crying. He stared at me, blank-faced, and said, "I know this isn't what you want to hear." Really? You think? 

And in the midst of this raw, emotional outpouring, Coldheart had the nerve - the absolute gall - to tell me that I was too fat for his fucking clinic to work with in the first place. He advised me to drop 40 lbs. yesterday, and told me that until I did, the clinic wouldn't work with me, period. (Later I would discover that this, in fact, is one of the reasons the clinic's SART data was so much stronger than that of Dr. God Complex's - because they had a longstanding history of cherry-picking clients of the right weight, the right age, etc. The most favorable conditions for providing them with more successes.)

So then I got angry. Like, really angry. I don't like being told I can't do something, including reproduce, and I especially did not appreciate getting this diagnosis from an unfeeling heartless bastard of a doctor who saw me as a set of statistics and not, you know, a fucking human.

I vowed that I would prove him wrong. That I would get pregnant with my own everything, and then walk back into his office with my healthy bouncing baby whatever, and show him how wrong he was.

What happened next was kind of epic. Like, if my life had been a movie, this would've been when the empowering pop song started playing over a montage of me taking Action (capital A intended). 

There were thrice-weekly fertility yoga sessions. There were daily green cocktails of wheatgrass powder mixed into organic, unfiltered apple juice. There were boatloads of supplements. Seriously, if I actually calculated how much I've spent on fruitless vitamins and minerals the past couple of years... Probably enough for a nice beach vacation. No joke.

Some day I'll write a post about all of the crazy shit I've done in the name of increased fertility. Pretty much the only things I didn't try were giving up wheat and/or dairy and/or meat entirely, though at times I limited all of the above. 

None of it worked.

Clearly.

With each fresh failure, I'd revisit that day in Dr. Coldheart's office. He had been right; he told me things I didn't want to hear. Things I wasn't ready to hear. I would scour the interwebs for stories of women who were like me - my age, my weight, with my FSH/AMH/WTFever. Women who ultimately found success by using DHEA or doing acupuncture or praying to a pagan god of fertility. 

But for every success story I found, I'd read five more about women who found success another way, either through donor eggs, donor embryos, traditional adoption, or making peace with going child-free. These were all options discussed in my monthly Resolve support group - in fact, I had never even heard the term "donor embryo" before my first meeting with that group. I went home and Googled it that night.

From the beginning, any conversation Mr. Hope and I had about alternative paths to parenthood included conversation (albeit limited) about donor embryos. It appealed to me more than donor egg, because my husband has a kiddo from a previous relationship (and one who is his spitting image, no less). So I already had on child in my life who was half Hope and none me; I didn't want or need another.

But a child who was biologically neither of ours? That could work. That was adoption, only I would cook someone else's bun in my own oven. I would still get to experience pregnancy. Birth. Breastfeeding. 

Yet even as I started to see the benefits, I still couldn't get my head around the idea entirely. I felt like the fertility community wanted to have it both ways; surrogates were "gestational carriers" but recipients of donor embryos were something more? And while I completely understood that true parenthood is the part where you, you know, actually raised the kid, I had so many concerns and fears about getting to that point.

I recently came across a quote by William Arthur Ward:

"The pessimist complains about the wind; the optimist expects it to change; the realist adjusts the sails."

I've spent the past couple of years thinking I was the realist - cutting out caffeine! eating more kale! bending my body into poses designed to increase blood flow to my lady business! - but really, those were all acts of an optimist. Someone who hoped that switching to unscented body lotion would make her rotten reproductive parts start working again.

But I am so tired of wishing and hoping and waiting. Every fresh failure takes more and more out of me.

It's time to be a realist.

So now Mr. Hope and I are adjusting the sails, and heading into the uncharted waters (for us) of embryo donation. 

On Tuesday, I am driving to see Dr. Smiles to discuss the protocol for my third and final attempt at IVF, as well as his "third party reproduction" coordinator to discuss the embryo donation program at the clinic. The decision to pursue both simultaneously has given me more peace than I've had in the last 12 months - possibly longer.  

I think being a realist kind of suits me.

Monday, September 22, 2014

backstory.

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.