Thursday, December 31, 2009

An excerpt from the holiday letter I wish I'd written

As usual, 2009 has been an eventful year.

In January, to kick off the new year, we embarked on a series of invasive testing at a well-respected local fertility clinic. After multiple canceled and rescheduled appointments with our very popular doctor, having been told that he could find nothing wrong with either of us except that my eggs are "old," I started using traditional Chinese medicine and acupuncture in an attempt to achieve pregnancy without medical intervention. Three months later, after spending thousands of dollars and enduring weekly sessions with acupuncture needles and three-times-a-day teas with the foulest tastes and smells imaginable, we resigned ourselves to having to use the fertility clinic's services.

As you can see only MM, the dogs, and I here in our family photo, you have probably already guessed that, despite the months of fertility drugs and frustration and thousands of dollars spent, we are still childless. (And no, I am not pregnant in the photo, just fat.) In early August, just a couple of weeks after the dogs' drug overdose (more on that later), I got my first-ever positive pregnancy test, only to find out within the same day that I was having an early miscarriage. We hope it is not the only positive pregnancy test we will ever see, but who knows?

On a related note, I'd like to extend my congratulations to the twelve people who announced their pregnancies this year--one the day after my miscarriage was diagnosed--and the fifteen people we know who welcomed their first child into the world in 2009. And especial kudos to the two friends who managed to accomplish both the birth of a child AND another pregnancy this year! You know who you are. . . .

I am a little late to the party with this topic, but wanted to share my thoughts nonetheless.

I know my fellow ladies struggling with infertility can relate to the mixed emotions associated with receiving friends' and family members' holiday greetings. On the one hand, I genuinely love hearing from everyone, finding out what they have been up to, and seeing how their kids have grown. I actually like getting photos with my holiday cards. On the other hand, the newsletters and especially the photos can be a painful reminder of what we don't have and may never have.

Oh, and by the way: I hate it when my friends, the parents, only send out photos of their kids. Yes, I get that you are probably unhappy with your figure after having given birth and that you'd prefer to hide from the camera. . . and yes, I want to see your kids looking cute and Christmas-y and see how they have grown since last year's card. BUT I'd also like to see a picture of YOU, my friend, even more than I'd like to see a picture of your offspring, especially if we don't often see one another during the year. Ahem.

Our "family" photo this year was a picture of MM, the goldens, and me. It was a very nice photo (thanks, BFF), but I'll admit that I wondered whether it would seem a little pathetic to my friends and relatives with children. "Oh, look: S has been married for over a year, and she and her husband still just have those big, hairy dogs, two of them now. Guess they aren't having any kids; she is getting kind-of old."

I've decided that for Christmas 2010, I am going to make a concerted effort to make sure that I get a good photo of MM and me on each trip we take. (We already have our first, to Las Vegas, planned for the third weekend in March.) Next year's photo greeting will be a collage of us in all the fun places we visited. That way my friends with small children can envy ME the way I currently envy THEM. . . . I doubt most people who are parenting small children get to take 3-4 trips a year just for fun.

Yes, I am being a little snarky, and my intention is somewhat inappropriate for a time of year that is supposed to be filled with joy and good cheer. Oh well. I guess I'm just a horrible person. (Hey, maybe that is why I've been cursed with infertility!)

Happy New Year! I hope 2010 is a better year for us all.

Wednesday, December 16, 2009

Done

Our latest cycle was a bust: AF arrived four days ahead of schedule last Saturday. It was no surprise that it didn't work--the definition of insanity is to keep doing the same thing and expect a different result--but I was surprised and annoyed to get my period four days earlier than I'd expected it. Seems that the drug regimen for this past cycle screwed up my body in more ways than one.

Because I started having cramps and spotting on Friday afternoon and knew that AF was on her way, MM and I had a long talk Friday night about this "journey" we have been on these past 20 months of TTC. To summarize our discussion, we have agreed to stop doing intervention. We both feel that the toll it is taking on us, physically (on me), emotionally and financially, is too much. And given our "unexplained" diagnosis, we don't even know for sure that the treatments are necessary or helpful.

We re-visited the IVF option and once again agreed that it isn't for us. We agreed that we still feel that adoption isn't for us. MM does not believe in prayer, and I have been having my doubts on the subject myself.

If no "miracle" occurs in the next two years, we may consider pursuing donor egg IVF at CCRM at that time. It would be a compromise in a lot of ways, but we think it is a compromise that would be worth our consideration. Unfortunately, the price tag is high: around $30K per cycle.

I know there are a lot of people who are willing to go a lot farther, spend more money, and do more to try to achieve a pregnancy. MM and I agree that we have done about as much as we can reasonably do at this point. (He sagely pointed out that what we have already done is far more than most of our friends who have children ever had to do.) We don't intend to go into debt, or push me to the brink of my sanity, or allow our entire lives to revolve around TTC any more than we already have.

Since our discussion, I have felt relieved that I will no longer be closely tracking my cycles, taking injections, doing OPKs, and the like. I'm relieved that I won't have to think about TTC and that I can focus on other things again.

I have not found, however, that our decision has made my inability to have a child of my own any more easy to bear. In fact, though my primary emotion about my childless state is currently grim resignation, I am still angry and sad, too.

I think the holidays and the focus on families that is even more prominent than usual this time of year is enhancing my feelings of loss and grief. (I'm sure those of who reading this who are in a similar situation can relate.)

So that's where we are. I may still post on here from time to time about my emotions about our infertility, which I'm sure are not going to go away any time soon, but I will no longer be writing about my experiences with treatments because I won't be having any.

I see that a few people have already stopped "following" this blog since my last post, and I anticipate more will stop reading once I post this entry. I understand; we are looking for others who are sharing our experiences, and insofar as the pursuit of treatment goes, I will no longer be sharing the experiences of most of those who read this blog.

I have been trying to focus on the fact that the majority of my life is very good. I am relatively healthy; I still have both my parents and a sister and a nephew; I am married to a terrific guy; I have lots of friends; I am gainfully employed in a job that I enjoy (most days).

Somehow, though, knowing that I have all these things and more does not take away the pain in my heart because of what I don't have, what I probably will never have.

I hope this gets easier to accept as time passes. We'll see.

Thursday, December 3, 2009

Hiatus

I don't think I'll be posting much for a while. Of course I will let you all know if--by some miracle--this cycle results in a BFP, and I will continue to read all the blogs that I follow regularly and comment where appropriate.

Although I first started this blog to have a place to vent my feelings and to connect with other women going through similar experiences, I am beginning to view it as one more way in which I have allowed myself to become fixated and obsessive about our inability to have a baby. Though I enjoy writing here and reading and responding to comments (which, by the way: I cannot email a response to a commenter if her blogger profile is private), I think these activities are just giving me more opportunity to dwell on things.

(Arguably, reading others' blogs is also adding fuel to this fire, but I have become oddly attached to the writers whose blogs I read and don't want to lose track of their stories.)

I just don't think that I currently have much to say that I haven't already said before. I still find myself constantly assaulted by others' happiness about their pregnancies and children; I still find I can't be happy for any "fertiles" who conceive. I still have envy, anger, grief, guilt, frustration and all the rest. I just feel like I've said it all before and don't have much new to share in terms of feelings.

So. That's where I am. I didn't want anyone who has been reading even semi-regularly to think that anything bad had happened to cause me to stop posting, and I don't plan to abandon this blog entirely. I just probably won't post again for a while.

Tuesday, December 1, 2009

Transition

Though nothing has really changed since I had my mid-cycle u/s on Sunday, I have had a shift in my thinking which makes it feel like I am going through some sort of transition. The thoughts that popped into my head about the futility of our continuing to do IUIs have not gone away; in fact, they have multiplied and intensified. I think it is time for a change.

MM and I have not discussed any next steps in depth for some time--the most he's said on the subject is that I can "stop whenever [I] want" and that he is still opposed to IVF--and this decision is obviously one I won't make on my own. Having said that, any thoughts I express here are mine alone, not his or ours.

The more I think about it, the more I am becoming convinced that it doesn't make sense for us to continue using drugs to stimulate my ovaries and doing IUIs. Because I already ovulate regularly on my own, I don't truly need ovarian stimulating drugs. IUIs are an empiric treatment for us anyway, since we are "unexplained." There is no documented problem with my cervical mucus or MM's sperm count that would make the procedure a must for us.

I am in the midst of completing my fourth cycle with Clomid, and two of those cycles have also included Follistim. None of these drugs have produced the desired effect, a pregnancy. One might argue that, aside from this cycle, they have produced the desired effect of stimulating my ovaries, since I have had at least two mature follicles every medicated cycle but this one. But my ovaries don't truly need stimulation, and merely producing eggs that don't result in pregnancy isn't exactly the goal.

Given that IUIs and ovarian stimulation have not worked for us, the logical next step would be IVF. But we are not going down that road, for all the reasons I've already discussed here.

Putting aside all my objections and hesitation about IVF, MM's main one is the money. (Not surprising, given his debt aversion and the fact that he will not be the one experiencing the physical and emotional side effects of the procedure.) MM once made a passing remark that he would be willing to do IVF if the odds were better, say greater than a 50% success rate. Even CCRM can't guarantee a success rate of over 50% for someone in my age range, let alone our RE's clinic. (I stand corrected: a quick search of CCRM's website shows that their success rate for women 38-40 using their own eggs was 50.7% in 2007, though that was for pregnancies and not for live births. I'm pretty sure MM means a success rate for live births.)

The only procedure I am aware of that can consistently offer a >50% success rate for someone my age is donor egg IVF. Believe it or not, based on my current limited knowledge, I might be more willing to do a donor egg cycle than a standard IVF cycle simply because I would not have to go through ovarian stimulation. I am aware that I would have to take other drugs, including injections, and that they would have their own side effects. But at least to my uninformed mind, it seems like being a recipient of a donor egg would be a little easier on the body than a standard IVF cycle with one's own eggs. (I welcome anyone who knows different to educate me on this point.)

One huge problem with donor egg IVF: the price tag. A little preliminary poking around reveals that it is in the neighborhood of $25-30K. I know MM would balk at that. . . . though perhaps a little less once he learned that the anticipated success rate can be as much as 70-80%, depending on the clinic.

Using a donor egg would involve giving up my own genetic link to our child, but at least s/he would be genetically related to MM. And because the vast majority of people assume that when a woman gives birth to a child, that child is her own, the only people who would know otherwise would be those whom we chose to tell. . . a distinct difference from adoption.

I know that the cost of adoption is similar, and I know that MM sees adoption as a true last resort option. . . last resort in the sense that I believe he might opt to live child-free rather than pursue it. He, even more than I, has a real sense that he wants a biological link with the child he raises as his own.

Honestly, probably the best thing for me to do at this point is to take a little break and get clear in my own mind about what I want to do next. I have been talking for some time about seeing a counselor to talk about my feelings related to our infertility, and I should. It's just hard to make that a priority with so many other things going on at work and in my personal life, not to mention the expense. (Our insurance is VERY limited in which counselors it will pay for, and I haven't found anyone who is anywhere near my office who is "in network" and has experience in counseling people with infertility, so I will likely end up paying out of pocket for someone qualified.)

I'd be interested to hear what those of you who are still TTC have to say about my thoughts. I find that the perspective of people who are pregnant or parenting is just different enough that I have a difficult time relying on their advice. For obvious reasons, no one can imagine choosing a child-free life once they have already had the experience of parenthood. Unfortunately, I don't have anyone in real life to whom I can turn for advice: at this stage in my life, only three women in my circle of friends are childless--one of those by choice--and none of those have experienced infertility.

[On a quick physical note, given when I took my trigger shot, I should have ovulated sometime yesterday or early this morning. The resolution of the near-constant pressure and discomfort over my right ovary which I'd had since around Saturday would lead me to believe that I did, in fact, ovulate. MM and I dutifully had sex both Sunday and Monday nights. So I should start feeling back to normal physically in a day or so.]

Sunday, November 29, 2009

Cycle #20 mid-cycle u/s

This morning's mid-cycle u/s showed a lead follicle of 30.5 mm and several other, smaller follicles, but no other follicles which are large enough to produce and release a mature egg. So in exchange for five days of Clomid and five injections of Follistim, at a cost of around $300, I got basically the same result I'd get in an unmedicated cycle: one egg.

Needless to say, I am not happy about the result. The doctor who did my u/s this morning (yes, I actually had one of the clinic's doctors and not a NP) agreed that this is not the desired response and that, assuming I am not pregnant after this cycle, I will likely be looking at a change in medication dosage for the next cycle.

I'm doubly irked when I think about the fact that last cycle I produced between two and four mature follicles. Why my RE felt that my dosing schedule should be changed is still a mystery to me, and it's now obvious that I did better on last cycle's protocol. I know that dosing is not an exact science, but I don't appreciate the guesswork involved when it translates to wasted money and time for us.

On the plus side, my endometrium was good: 13 mm. After completing the u/s, the doctor observed that some couples opt to do only timed intercourse rather than IUI when only one follicle is produced. After talking it over with MM, we have elected to do that this cycle. Why throw good money after bad? Our insurance will only cover a portion of six IUIs, lifetime. So I triggered when I got home and will have to do nothing more onerous the rest of the cycle than have sex with my husband the next three nights.

Another negative about my ovaries' response this cycle: because my lead follicle is so large, I will have to go in for a baseline u/s to rule out a cyst before starting the next cycle. Assuming that we need to do a next cycle, of course.

Today is one of those days when I am questioning how much more of this I want to do. I don't love taking days of injections even when they produce the desired effect--who does?--but I find it even less appealing when the time, money and effort spent don't result in an increased chance of conception.

I think back once again to the fact that the one-and-only BFP we have ever seen was during a break cycle. . . . and a cycle where my stress levels were through the roof, I was eating like crap and avoiding the gym, and on top of all that, I was taking high-dose ibuprofen! Just makes me wonder whether all this intervention is pointless for us. And why I am bothering to eat better, reduce my stress, avoid certain drugs, and all the rest when it doesn't seem to make any difference.

All these thoughts lead me to think about something even deeper: why am I not more committed to trying everything and anything in order to conceive? Do I just not want to be a parent as much as other people? I read and hear all the time about couples doing multiple IVF cycles, and borrowing tens of thousands of dollars, for a chance to have a baby, women going through much, much worse than I and for much, much longer and still being willing to keep trying. Yet here am I, annoyed at cycle #20, having done a few cycles of IUI and timed intercourse without the desired result.

It seems that many couples who are at our point in this process begin thinking seriously about moving to IVF. It's logical, especially when the woman is my age. That course of action has been suggested to me/us by more than one person. But I am no more interested in starting down that road than I was in May when I wrote this post about our feelings on IVF. MM's feelings on the subject have not changed either. We do not see IVF as an option that we wish to pursue, for all the reasons I talked about in my May post.

Today is CD 12, and I have had a headache on five days so far this cycle, including today. I don't know that I can definitely attribute any or all of those headaches to medication side effects, but I do know that, though I am prone to headaches, that is a much higher frequency than normal for me. And I know for sure that I have suffered with a lot of side effects from the progesterone gel each cycle I've had to use it: cramping, constipation, fatigue, vaginal dryness, breast tenderness.

I'm tired of (figuratively) beating my head against the wall. I find myself thinking, once again, that perhaps it would be better to just focus on other things and stop taking these drugs that don't seem to be helping and may well be causing my headaches. And don't even get me started on the emotional side effects of the drugs. I've gone from someone who has long been noted by family and friends for her calm stoicism--my sister has joked often that I'm "dead inside"--to someone who can barely make it through a day without crying.

If you've made it this far, thanks for reading. I'm not looking for advice. I realize that only I (and my husband) can decide when it's time to stop and whether we want to do more. There are no "right" answers to the questions in my mind.

I'm just venting my frustrations and thinking out loud.

Wednesday, November 25, 2009

Gratitude

Be thankful for what you have; you'll end up having more. If you concentrate on what you don't have, you will never, ever have enough.
~Oprah Winfrey


When I was in my late 20s and going through a transitional period in my personal life, I ran across the quote above--in Reader's Digest, of all places--and it inspired me to begin keeping a gratitude journal. The idea of the gratitude journal is that each day you write down five things for which you are grateful. The entries don't have to be detailed, and you should try to pick different things each day.

Having done this fairly consistently for the better part of a year, I can tell you that it is not always easy to find five things in a day for which you are grateful. You quickly exhaust the obvious things, like good health, family, friends, pets. Some days I could not think of anything beyond the very basic and mundane: air conditioning, Advil for a headache, making one more green light than usual on my way to work.

I do believe that keeping this journal helped me to shift my thinking and to view my life--which, at the time, was far from what I had hoped it would be--in a more positive light. I don't do it consistently anymore, but I do pick it up again from time to time. I also maintain a "gratitude list" on my work computer and look at it when I'm having an off day.

With Thanksgiving Day coming up on Thursday of this week (at least for us here in the U.S.), I have been reading many emails and status updates on Fac.ebo.ok this week about things for which the writers are thankful, and they got me thinking about gratitude. It seems to be typical of most people that we tend to focus more on what we don't have or what is bad or negative in our lives than on what we have that is good and positive. I think this is especially true in a goal-oriented society like ours, where we are always striving for the next thing, the better thing.

This tendency to focus on the negative, or the lack, in life has become more pronounced than ever for me since I realized that TTC was going to be harder, and take longer, than I'd thought and that we might never be successful and have a child of our own. Despite the many good things in my life, I have spent most of the past year or more focusing on what I don't have: my own child.

So allow me, for a moment, to briefly mention all the things for which I am grateful. I'm grateful for having been born in a country where many freedoms are my birthright. I'm grateful to have been raised by two parents and a grandmother who loved me, nurtured me, and never abused or neglected me. I'm grateful to have had a close relationship with my grandmother, who had such a different world view from anyone else in my childhood because she had been born and lived in what was practically another time, having been born in 1903 and seeing the invention of the car, the airplane, television, and more.

I'm grateful for having a sister close to my age with whom I grew up and to whom I am still close. I'm grateful for my little nephew, who may be the closest thing I ever have to my own child. I'm grateful to have good adult relationships with each of my parents and to still have them around as I approach middle age.

I am grateful for our public educational system and student loans, for without them I would be uneducated. I am grateful for having been given the intelligence to pursue my interests and the opportunity to change careers when I came to believe that doing so would be for the best. My education and the jobs I have had have brought the majority of my friends into my life, as well as giving me the ability to be self-supporting and giving me a purpose.

I'm grateful for the many friends I have. After having been something of a social misfit through high school, having a lot of friends was something that for years I could only dream about. To this day, I know a make a greater-than-average effort to keep in touch with my far-flung friends, and it is worth it for me.

I am grateful for my golden retrievers, who bring a smile to my face every single day. I'm grateful that I have the time, the money and the ability to help people who need it.

Last, but not least, I am grateful for my husband MM. We will be celebrating our first wedding anniversary this Saturday, and he commemorated the occasion today by sending a beautiful bouquet of flowers to my office a few days early so that I could enjoy them before the holiday. It's strange when I think of how close I came to marrying someone else, only to meet MM mere months after breaking my engagement. Had I married my ex-fiance, I would never have known MM at all. I can't say that that would have been a tragedy, because I would never have known what I'd missed, but I will say that this may well be one of those instances in life where things happened for a reason. I couldn't imagine anyone more suited to me than MM, and I know he feels the same about me. We fit.

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We will leave early Thursday morning to spend a few days at my father's house in New Mexico for the holiday. I hope anyone reading this has a good Thanksgiving Day, surrounded by loved ones.

Friday, November 20, 2009

Starting cycle for IUI #3 today

I heard back from my "favorite" NP at our clinic yesterday around 1:30, and I am doing a slightly different protocol this cycle than last:

Clomid 50 mg CD 3 through CD 7 (11/20 through 11/24)
Follistim 100 units on CD 3 and CD 4, 75 units on CD 6, 8 and 10
OPKs before 11:00 each morning starting CD 8 (11/25)
Follicle check u/s on the morning of CD 12 (11/29). (She had asked for CD 11, as I'd suspected, but agreed to schedule it for CD 12 instead.)
Trigger with Ovidrel when instructed to do so prior to IUI

The NP said that the doctor decided to "tweak" the Follistim dosage a little this cycle, for reasons he did not share with her (and that are not clear to me). My initial dose on CD 3 is a little less (I did 125 units last cycle), but my second dose on CD is a little more (100 units vs. 75 units before).

I remarked "I guess the dosing is not an exact science," and her response was "It sure isn't!" How reassuring. LOL

My only mild concern was that my lining was just over 7 mm last cycle at my mid-cycle u/s. She told that my RE just wants it to be in the 7-12 mm range, and as long as it is, he doesn't worry about it, so he did not perceive it as a problem last cycle.

It should be interesting doing OPKs and injecting myself while I am at my dad's. I'm not usually very good at stealth. ;-)

Thursday, November 19, 2009

CD 1 and other stuff

I have been neglecting my blog this week, in part because I have been busy and out of the office, and in part because I haven't really had much to write. This post will be a quick update, bullet style.
  • I started spotting Tuesday night, and AF arrived early Wednesday morning.
  • I placed my cycle day one call to the clinic's nurse line at 8:30 yesterday morning and have yet to hear back. I will call a second time if I don't get a call by noon today.
  • Because I haven't heard from the clinic, I don't know yet whether they will agree to do my mid-cycle monitoring u/s on CD 12 instead of CD 11. Which means that I don't know yet whether we will be doing treatment this cycle because I am out of town and absolutely unavailable for an u/s on CD 11 (and cannot, at this late date, change my plans).
  • If we end up doing treatment, it will be a repeat of last cycle.
  • I woke up with a migraine on Tuesday morning at 5:30. Nevertheless, I had to drive nearly 200 miles through the open desert to attend two depositions that day.
  • The date for these depositions had been set for months, and as they involved multiple parties, some from out of state, could not be changed. No one else could attend because the partner who is the only other lawyer in the firm who knows anything about the case was unavailable. So I had to suck it up and do the best I could. I survived, thanks to regular doses of ibuprofen and Excedrin.
  • My RE doesn't like for me to take ibuprofen, but he is even less OK with my taking prescription Imitrex, so I had to "pick my poison," as I needed one or other to function.
  • By Wednesday morning, my migraine had finally faded to a dull ache. . . . but returned full force yesterday afternoon as I attended yet another deposition.
  • I am still headache-y this morning, though slightly improved from yesterday.
  • I do not want to be at the office today. Such is life.
  • I have hardly seen my husband all week between our respective job responsibilities and my going to bed early due to my migraine(s).
  • I get to make a 250-mile round trip tomorrow for my fourth deposition of the week. It's good, though, because I will get to visit M, my CASA case child, briefly while I am in her city.
  • I am very much looking forward to next week, when I will only have to work THREE DAYS. Wish every week were like that! ;-)
  • I'm also looking forward to seeing my dad. It's been six months since I've seen him, which is probably one of the longest periods ever that we haven't seen one another.

Sunday, November 15, 2009

Waiting for cycle #20 to start

I spent a good portion of yesterday wallowing in self-pity. On the one hand, I feel a little silly for being disappointed at yesterday's BFN: I've seen so many already, and I know that the odds of success for an IUI with injectables are only about 20% or so at the most. On the other hand, I felt that I wanted to acknowledge my sadness at yet another failure, so I did.

Yesterday's BFN means that MM and I will celebrate our first wedding anniversary on November 28th still childless. This probably doesn't sound like a very big deal to many of you, who perhaps didn't even start TTC-ing until you had been married for some time. But when a couple marries in their late 30s and still wants to have children, it is not at all uncommon, in my experience, for them to start TTC right away. Many even give birth to a first child before their first wedding anniversary. (I can think of several couples of my acquaintance who fall into this category.) Everyone is aware that "time is of the essence" once the woman is over 35.

Our upcoming anniversary also just makes me more aware of the passage of time. In my introductory post, I mentioned the fact that we started TTC just over seven months before our wedding date. (We knew pregnancy could take longer to achieve when the woman is over 35. Little did we know how much longer, in our case.) There was actually a period of months when I was mildly concerned about being visibly pregnant for our wedding. How naive that seems now.

It makes me sad to think that we are nowhere closer to our goal of becoming parents together now, after 19 cycles TTC and nearly a full year as a married couple, than we were a year ago. The only things the past year has brought us in regard to TTC are disappointments, inconvenience, stress and less money in our bank account.

Anyway. It is what it is. I am feeling better today, and I am very grateful for all your supportive comments yesterday. (And by the way, a glass of wine is a great suggestion after a BFN; unfortunately, I gave up alcohol entirely about a year ago due to migraines. Drats! I did throw healthy eating a bit to the wayside, though, and eat foods that weren't "clean.")

Now I am just playing the waiting game. Looking back on the previous two cycles when I used progesterone gel, my period did not arrive for about 5 days after my last dose. Assuming that my body reacts the same way this cycle, I can expect that AF will not arrive for another few days.

I am actually hoping that AF arrives no earlier than Wednesday. . . otherwise my monitoring appointment will fall on a day during our trip to my father's in New Mexico over Thanksgiving weekend. I'm not sure if my RE can/will give me more than a day's leeway for performing my mid-cycle u/s, which is supposed to take place on CD 11. And there is no way I could get the u/s done in the city where my dad lives: even if I could find a place there to have it done, our clinic does not permit that. They will only do my IUI if they do the mid-cycle u/s. (And I wouldn't want to do that anyway, because my dad and stepmom don't know that we are doing intervention, and I intend to keep it that way.)

So we shall see. It's not impossible that AF will arrive earlier and we will have to skip this next cycle. If that happens, so be it. As I've mentioned here before, I have never been 100% sold on the idea that the drugs and IUIs are truly improving our chances, given that the one-and-only BFP I have ever seen was during a break cycle. And I'm not thrilled at the idea of taking Clomid & Follistim while staying at my father's very small house with my nosy stepmother, but I will do it if I have to.

MM and I were talking today about a trip we plan to take in March. MM always takes a week off in March--he has for years--and coincidentally, it is usually the week in which my birthday falls. We had first talked about going to Disneyland and California Adventure, but after a trip to Costco today and looking at their travel brochures, we are also now considering a return trip to Hawaii (though not to Maui, to one of the other islands). It's fun to plan trips and talk about things in the future, but I couldn't help thinking that if I am pregnant by March, the odds of our being able to actually take this trip will likely be close to zero. I didn't mention this to MM, though, because nothing is definite yet--with the trip plans or TTC--and I didn't want to burst his bubble.

Once again during yesterday's wallowing, I thought about how much easier it would be to just give up. We are friends with a couple about the same age as us who married just a couple of months before us. In contrast to us, though, they agreed before they were married that they did not intend to have children. (They have nieces and nephews whom they adore, so it's not that they don't like children, more that they are both very career-focused--both on the police force, one a canine officer and one a detective--and like their freedom.)

I couldn't help thinking how much less stressful their first year of marriage has probably been than ours. Sure, I love MM, and I have no doubt that he loves me. We are happy, in the main. Our relationship is good, solid, and fun. Dealing with disappointment every single month can't help but take a toll on any relationship, though. We are both often angry, sad, frustrated, uncertain, and all the other things that go along with infertility.

On some level, I wish I just didn't have the desire to be a parent. I wish MM didn't have that desire. It would make our lives so much simpler.

Saturday, November 14, 2009

Friday, November 13, 2009

Eventually

eventually, -adverb: finally; ultimately; at some later time.

I saw this necklace in someone's etsy boutique a few weeks ago and bought it for myself. (Though the woman who made it is a survivor of IF, I found her blog and etsy boutique in a circuitous way totally unrelated to this blog: she is now an adoptive mother, and a law school classmate of mine who gave up her baby through open adoption had a link to this lady on her blog. Serendipitous.) I've worn it nearly every day since it arrived.

I don't know that it means to me that, in fact, "eventually" we will be parents. I think it's more a reminder that, eventually, our current ordeal will be over, one way or another, and life will still be good, whatever the outcome.

Today is 14dpIUI #2.1 and is technically my test date. I will POAS tomorrow morning and post an update then. (Those reading this who are early testers probably think I'm crazy, but trust me: I would be significantly less productive at work today if I tested, regardless of the result. Better to do my mourning--or celebrating--on Saturday, when I will still be just as pregnant, or not.)

Thursday, November 12, 2009

Today's horoscope

"You may be temporarily denied the thing you want. What's important is to trust you're on the path you were meant for. Your day is coming, with celebration and awards, too!"

OK, so I don't really believe in my horoscope, though I read it for fun most weekdays. Today's struck me as perhaps significant, though. (I have no doubt some other Aries read this and thought the same thing about her own situation.)

13dpIUI #2.1, only two more sleeps until I POAS.

Unbelievable

I think I've mentioned here before that I have a bad temper which I have worked hard to learn to control over the years. So though I don't get *as* mad or get mad as often as I used to, I can still become enraged if I feel it is warranted.

Today was one of those days. I will try to be brief. In February of this year, my husband wanted to use the same accountant to prepare our tax return that he had used for the previous few years. I had been doing my own taxes my entire life up until this point, but I agreed. The accountant charges a flat fee (can't recall how much) for the filing of a joint return.

I could not attend the appointment with the accountant in person, so I typed up a detailed list of my deductions, along with dates and receipts, and MM provided this, in total, to the accountant along with all the other necessary documentation he requested. Despite this, when we got the copies of our returns--after they had been filed, never having been given an opportunity to review them prior to filing--I found two mistakes. While they were not likely the type of thing for which the IRS will have you put in federal prison, I felt that they needed to be corrected because my (electronic) signature is on that return.

Finally, a few weeks ago, the accountant filed an amended return on our behalf, correcting his errors. And charged my husband $100 for doing so.

Because MM dealt with the receptionist and not the accountant himself, he did not feel that he was in a position to argue about the additional charge. I insisted that he contact the accountant personally and have him refund the $100. Today he finally did so.

The accountant grudgingly refunded the money but made a sarcastic remark to MM to the effect "your wife is a lawyer, so she should understand about billable hours."

Yeah, I am a lawyer, and I do understand billable hours. I also understand that it is unethical to charge your client extra to fix YOUR OWN mistake. He should be paying US, not the other way around. I could NEVER ethically charge a client for work done to fix my own error, and I would never do so. And all of this could have been avoided had he simply done what he should have done and allowed us to review our returns before he filed them on our behalf.

Needless to say, we will be changing accountants for 2010. I am still debating whether to make an ethics complaint to his licensing entity as well.

Don't f$%& with me, especially during the 2WW!!!!

Wednesday, November 11, 2009

12dpIUI #2.1

I woke up around 4:00 this morning with a headache. Ugh. This is something that happens to me occasionally even prior to ever taking fertility drugs, so I can't say that there is a correlation.

I continue to have more discharge than usual (TMI, sorry), and this morning in the shower I noticed a very small amount of pink-red spotting at my cervix (which is low, firm, and closed). Man, that progesterone gel is nasty! Ugh.

Because of my headache, I slept in later than planned and arrived at work later than usual, so I don't have much time to write more. Not that there is really much more to write. Just waiting. . . .

Only three more sleeps until I test now.

Tuesday, November 10, 2009

11dpIUI #2.1

WARNING: THIS POST CONTAINS TMI.

As per usual for my treatment cycles, I have been using intravaginal progesterone gel. The first cycle that this was prescribed for me, back in April, I had to use the progesterone gel at bedtime, and I followed the same dosing schedule in June/July when we did only timed intercourse after Clomid. After this most recent IUI, I was instructed to use it twice a day. ("Based on my age," the NP told me.)

I hate the progesterone gel for reasons I have previously written about. Still, it is preferable to daily (or more frequent) intramuscular injections of progesterone, so I can't complain much. The inconvenience and "ick" factor are small prices to pay if it actually helps me maintain a viable pregnancy.

This cycle, I've noticed something new, and I am wondering if it is related to the increased frequency of use of the progesterone gel. In addition to the usual yellowish-white clumps I notice on every trip to the ladies' room, I have also noticed over the past couple of days that things are just a little. . . . wetter down there. Usually I have the reverse problem with the progesterone, vaginal dryness, so I was a little surprised at this development.

Thoughts? I'd be interested to hear from anyone else who has experienced this.

Monday, November 9, 2009

10dpIUI #2.1

I attended my 5-year law school reunion this weekend. It was good to see some old friends and to check out the new law school campus. MM was a very good husband to give up the majority of his weekend for the reunion.

I learned of yet another law school classmate who is expecting a baby this week. (Third child for him, but first with his current, second wife.) In the five years since we graduated in May 2004, at least 24 people have had a child (some of those two or three). Five people from my law school class have given birth within the past six months. Seven are currently pregnant (or their wives are). The majority of people in my class didn't have children when we were in school, though some did.

Mind you, I don't even keep in touch with everyone from my class. I am probably only aware of what about half of our class of 160+ students is doing nowadays, either through direct contact or shared acquaintance. The numbers could be even higher if I knew about everyone in the class.

Which got me thinking: if I took everyone I know from law school out of the picture, I would be hearing about FAR fewer babies and pregnancies. Just sayin'. I'm not planning on actually doing this. I only have four non-law school friends/acquaintances who are currently pregnant, and two of those I know from my charting website.

On the 2WW symptom watch: I continue to be quite tired, needing 9+ hours of sleep a night to feel rested, instead of my usual 8. I have had some breast tenderness and some mild cramping. So basically all the expected progesterone gel side effects. ;-P

The wait until my Saturday morning HPT continues. . . .

Saturday, November 7, 2009

Doggy update

Although I posted an entry for Sebastian's birthday, I haven't written about how our dogs are getting along for a while. Given the fact that my Bad Karma Dog post garnered more comments than any other post I've written on this blog, I must believe that people are interested in an update.

In short, they are doing well! We had to make certain changes in our interactions with them--like removing all toys/chewbones from ready access and teaching them to sit and wait for food or to go outside--but it has paid off in spades. We have had only one fight in the past three months, and that was nearly two months ago, when I foolishly bought them the rawhide chews with "real meat" inside. (Hunter finished his first and decided he wanted Sebastian's, too, and was willing to take it by force.) There is no more tension, and no more "mad dogging" from either of them.

We were away for a week in late September, and the boys stayed home with twice-daily visits from their dogsitter. (They also have a dog door so that they can go in and out as they please throughout the day.) When we returned home, they seemed to have bonded in our absence: suddenly they were wrestling together like (overgrown) puppies, lying with their paws touching, and licking each others' faces.

An old high school friend of mine was staying with us when the "dog troubles" began in early July. She returned for another visit last week and was amazed at how well they are getting along. Here is a photo of her and "the boys."

And thank goodness, Hunter's "black cloud"/"bad karma" seems to have dissipated. (Knock wood.) He has had no health issues since their medication overdose in July. His tail fracture healed without complications, and he is now pain-free and has full use of his tail. He has leaned out and lost about 4 lbs since we brought him home. His coat and skin look healthier, and even his teeth are whiter. (I did take him to my church's St. Francis Festival last month for a blessing, just in case, though.)

Sebastian is his usual self. It's sad sometimes to see how much he has slowed down over the past few years due to his mitral valve insufficiency, but he is still pretty spry most days for an 8-year-old golden and contented with life.

So there's my update on the goldens. No longer causing drama, and continuing to bring joy and entertainment into our lives. ;-)

Friday, November 6, 2009

7dpIUI #2.1

One good thing about having to use progesterone gel? It has helped to eliminate A LOT of my unhealthy obsessing during the 2WW.

I used to analyze every little twinge in my lower abdomen or my breasts. If I were tired, I'd think "Aha!" If I were crabby, it must be because of my soaring hormone levels! If I felt nauseous, it was never the slightly iffy breakfast I'd had or too much coffee; it was surely a very early pregnancy sign!

If I weren't on the progesterone gel, I might think that the mild off-and-on cramping I've had or the sensitive breasts mean something. I would be thinking "Hey! Maybe I'm pregnant!"

But I know from past experience that these are just medication side effects. I know that I have experienced these same symptoms before during treatment cycles when I definitely was NOT pregnant.

Another thing that helps to cut down on unhealthy obsessing during the 2WW is being hella busy. And yeah, I've got that one covered, too.

Wednesday, November 4, 2009

Facebook strikes again. . . .

"Baby, baby oh baby on the way!!"

I saw the above on a friend's status update today. This time the friend is someone to whom I was an informal mentor of sorts when I was in high school; she is 8 years younger than I and already has a daughter who is 3 or 4 years old.

The friend is 16 weeks along, so at least she had the decency to wait until the 2nd trimester to announce her pregnancy. And of course, she and I do not keep in close enough contact for me to reasonably expect a personal notification, nor does she know anything about my own TTC failure.

Add another name to the "pregnant" list. . . . I actually created a "pregnant" friends list for myself on Fac.ebo.ok: there are currently 9 (three others--no longer on the list--have given birth in the past month or so).

Monday, November 2, 2009

Potpourri

I started my progesterone gel last night,and this morning I am already having some mild menstrual-type cramps in my lower abdomen. I really hate the stuff, but I have to confess that I am glad that I am using it rather than taking progesterone-in-oil injections.

I had one of those weekends that was fun but exhausting. Friday night MM and I had dinner and went bowling with three other couples. The wives are all friends of his from his early days at his current job; they have all moved on to other things but have remained friends with each other and with him. Two live in the Phoenix metro area, and we see them 3-4 times a year; the third was in town from Rhode Island for a visit, and I had not met her or her husband before. It was fun hanging out with them, and I hadn't bowled in a few years, so that was fun, too.

Saturday morning I got up before dawn (a RARE occurrence for me!) to drive to Tucson for an all-day training, followed by taking M, my CASA case child, out for Halloween. After I'd taken M home, I went to a Halloween party hosted by a mutual friend of the friend with whom I was spending the night and didn't get to bed until midnight. And I still had to drive 2+ hours home on Saturday morning after having breakfast with my friend and her husband.

I got home a little after noon yesterday and was tired all day. I did almost nothing productive. MM and I went to a movie, I read and edited/uploaded my photos from Halloween, and I went to bed early, a little after 9:00.

Despite the fact that I had little down-time this weekend (and even less productive, getting-stuff-done time), Monday morning arrived, just as it does every week. Imagine that. Back to the usual grind today.

The friend I stayed with on Saturday night is the friend I wrote about here who is pregnant with the same due date I had for my one-and-only pregnancy that became my early August miscarriage. Needless to say, there was a lot of talk of pregnancy and babies while I was with her and her husband. I actually felt OK about it; I am very happy for them, and it's obvious that they are happy and excited, too.

These past two weeks have made me wish at times that I only worked part-time: when I have so much going on outside work, it can almost feel like my job is taking time away from what I'd rather be doing. (I'm sure the partners in my firm would LOVE hearing that!) Ah well, it pays the bills, I mostly like my job, and I know I'd be bored out of my mind eventually if I didn't work. Not to mention that I would likely spend WAY too much time on unhealthy obsessing about our infertility.

Reminders of our TTC struggles are everywhere. If it isn't my (many) pregnant and parenting friends and acquaintances, it's a commercial or a stranger in a restaurant with a toddler and a big belly. Even the movie we saw yesterday (Couples Retreat) featured infertility as part of the plot line. (Not a true spoiler: the main couple were considering divorce because of the effects of being unable to conceive on their marriage.)

C'est la vie. Not much way to avoid it. Even locking myself in the house wouldn't work. ;-)

These next two weeks are likely to be busy as well. Busy-ness at work is pretty much a constant, and my five-year law school reunion is Friday night/Saturday morning. We have tickets to see Dave Attell the following Saturday. I have been invited to attend a bridal shower/bachelorette party for a friend's wedding next Wednesday evening, and I feel obliged to attend because the friend is a fairly close one and I have already had to decline attending her wedding.

Being busy during the 2WW is a good thing. I will test the morning of 11/14.

Friday, October 30, 2009

IUI #2.1*

*I refer to it as "2.1" because we should have really had IUI #2 in June.

Today MM's appointment was scheduled for 8:30 a.m. and mine was scheduled for 10:00 a.m. I triggered late Wednesday night, and everything looked good to go. Even before the trigger, I could tell ovulation was close by my CM, and it became even more abundant after the hCG injection.

MM left for the clinic with time to spare. There was no road construction to hold him up. All was on track.

At 8:40 a.m., I got a call from MM telling me that he couldn't "do it." He had been in the masturbatorium (my word for it, not the clinic's) for a while and just didn't think he'd be able to, er, perform.

At first, I thought he might be finished and joking with me. . . but as I listened, I realized that this is not something that he would ever joke about. So I remained calm and matter-of-fact-ly told him that if he couldn't do it, he couldn't do it. He should just tell the staff so that they could cancel my IUI appointment and refund the co-pay for processing his sample. He expressed concern about all the injections I'd taken and the money we've spent, and I pointed out to him that *some* sperm would get to those eggs through intercourse. Our odds of success would be slightly lowered by going that route only, but not to zero.

After we talked a few minutes, he said he would go back in and try "one more time." He called me back about 15 minutes later to say that he'd been successful, though he'd had to "resort to" watching porn. (Hey, I'm pretty sure that's what it's there for. . . ) He also told me later that he thought calling me helped: part of the pressure he'd been feeling had apparently been a result of his thinking that I would "freak out" if he couldn't "get the job done."

I'd place bets that had MM walked out to the front and told the staff he couldn't do it, he would not have been the first-ever man to find himself in that predicament. Yes, our part is much worse. . . even MM acknowledges that. . . but it's still hard for most men to perform under pressure, I'm sure.

I was surprised that I was able to remain so zen about the whole thing. When we did our first IUI in April, I would've definitely freaked out if MM had called me with the same situation. Now? It is what it is. He could either do it, or he couldn't, and no amount of upset on my part was going to change that. Slightly out of character for me. Hmm.

The IUI itself was uneventful. I was brought in shortly after my appointment time and had the NP whom I like/know for the appointment (and who also did my first IUI). Physically, I felt pretty much the same as I did with my first IUI in April: some cramping and pressure, but nothing unbearable. I continue to be bloated and feel pressure--and occasional twinges of mild pain--in my lower abdomen, but the scale was down 2 lbs this morning, so maybe my water retention is beginning to subside.

So now the wait begins. I am supposed to POAS two weeks from today, but I will actually wait two weeks and a day so that I can POAS on a Saturday morning rather than a Friday morning. (I've learned through painful experience that I don't generally have a productive work day after waking up to a BFN. And I can only imagine how distracted I will be if a get a BFP!)

I've never been one to POAS early, and with the hCG trigger shot, I am even less likely to do so. (The only way that would work in my mind would be to "test out" my trigger and start POAS-ing tomorrow or the next day. I believe that this only fuels unhealthy obsessing, and so I don't/won't do it.)

I hope that the next two weeks are as busy as the past two. If they are, I won't have much time to obsess.

Any prayers, positive vibes, good thoughts, white light, energy or the like that anyone cares to send my way will be greatly appreciated.

P.S. Did anyone else find that the Clomid/Follistim combination made you really tired? I was EXHAUSTED all day yesterday: went home a little over 4:00 and napped for over an hour, and then went to bed at 8:30 p.m. and slept straight through--except for one bathroom trip--until nearly 7:00 a.m. VERY unusual for me, as nearly always sleep soundly for 7-8 hours a night and thus am hardly ever tired unless I'm ill.

Thursday, October 29, 2009

Random stuff

  • I am majorly bloated. The scale is up 3 lbs from two days ago. I am hoping that once I ovulate tomorrow sometime that this will resolve. Ugh.
  • Found out last night that another acquaintance of mine is expecting. The best part? She is a struggling single mother who has a 10-year-old and a 7-month-old already. This pregnancy is her second unplanned pregnancy in a little over a year. She is not excited about her pregnancy, for obvious reasons. Awesome. (And as a side note, her lesbian sister and her partner have been doing donor IUIs for months without success. I'm sure THAT will make for fun holidays in her family. . . . )
  • Life has been extremely busy. I have had something going on every evening this week, and that will continue through the weekend. I'm exhausted!
  • Glad it's Thursday!

Wednesday, October 28, 2009

IUI #2.1, CD 13

Today is CD 13 for me, and so far, still no + OPKs. (I have been checking twice a day--once mid-morning and once mid-afternoon--since Monday morning's u/s.) That's a good thing. The NP told me at my u/s on Monday that my best chance of all my four potential follicles developing and releasing mature eggs would be if my body does not start its own LH surge prior to my trigger shot (scheduled for tonight at midnight). If I'd surged on my own and had to trigger earlier, odds are good that I'd only have had 1-2 follicles large enough to contain mature eggs.

Ovulation must be getting close for me, though--notwithstanding the fact that I will be trigger tonight--because my cervix is very high and soft, and I have a lot egg-white cervical mucus. . . so much that I noticed it without doing an internal check. I hope that's good.

So I have my fingers crossed that all four of the follicles we saw on Monday's u/s will have developed enough prior to the trigger to produce mature eggs. The more eggs I have, the more "targets" there will be for the sperm, and thus more chances of pregnancy. (Right? It seems logical.) At my age, and with our history, I feel that there is a much greater chance of yet another BFN than my conceiving high-order multiples. I know it's a possibility, but it seems to me to be a slim one.

I am feeling slightly bloated, and the scale went up a pound and a half overnight, despite my eating healthfully all day yesterday and drinking about 3 liters of water. I'm thinking that the bloat and water retention is due to all that (excellent) activity going on in my ovaries and expect both to subside once I take the trigger shot tonight and ovulate.

I'm oddly optimistic about this cycle. I've obsessed the least that I've done during any cycle in quite some time, and I am perversely encouraged by the fact that my body has not yet produced its own LH surge. In both prior cycles when I've used meds and planned to do IUI (one that I did, one which had to be converted to timed intercourse), I got a + OPK prior to the day when I was scheduled to take my trigger shot. There is probably no significance at all to this last fact, but it gives me hope simply because it is one way in which this cycle is not like the previous (failed) medicated cycles I've had.

We shall see what happens. I shall report on Friday how the IUI went.

Does it never end?

The above arrived in my email inbox yesterday as part of an online invitation. The sender was someone whose name I had never heard, but the guest of honor is a friend of mine who I'll call "A". A and I first met when we worked together as prosecutors and continued our friendship after she left the office. We shared many of the same interests in movies and books, and she was going through a divorce when I broke up with my ex-fiance in March 2007, so we spent a lot of time together during the last several months I lived in Tucson before moving back to Phoenix in July 2007.

Needless to say, given the fact that I had no idea she was pregnant, since I moved to Phoenix, we haven't kept in close touch. To be fair, I think A would acknowledge that our lack of contact is more her fault than mine: there have been many occasions over the past 18 months or so that my emails or phone calls to her have gone unanswered. I'm not bitter about the fact that we haven't had regular contact; these things happen. People get busy with their own lives.

A met her current (second) husband around the same time I met MM. The last time I saw her in person, they had reached the point in their relationship where they were talking about The Future, but things were complicated by the fact that they lived in different cities. I knew from phone calls and emails that they married (also a "planned elopement") about two months after we did, but I haven't really talked to her since then.

So A is 30 weeks pregnant with a boy, due January 4. I am happy for her, but I have to admit, seeing this in my inbox stung.

(To be fair to A, she knows nothing of our struggles with TTC. She doesn't even know we are TTC, let alone with medical intervention.)

Oh well. Finding out that A is pregnant didn't bother me as much as finding out that two more of my law school classmates are also expecting

Tuesday, October 27, 2009

When?

Though we have only been TTC for 18 months or so, it sometimes seems that I have been waiting an interminable amount of time to be a mother. Isn't that the theme of TTC, especially for those of us with infertility? "Hurry up and wait"?

Unlike some women who wait to TTC until their late 30s to TTC because they came late to the idea of wanting to have a child, I've wanted to be a mom for years. Even as a young teenager babysitting, I used to think about having my own child someday. I've often joked with friends and family that, had I lived in Victorian times, when higher education and employment would have been pretty much unavailable to me as a woman, I would probably have at least 10 children by now. But for the fact that I've spent most of my adulthood pursuing higher education and two professional careers (and married for the first time at age 37), I have no doubt I would have started TTC long ago.

Starting in my late 20s, I'd even talked to my mom about moving near me to help me with my child if I was unmarried by age 35 and chose to be a single mom. But I didn't truly want to take that path, so I kept waiting for the "right" time and the "right" situation. Once I met MM, I finally felt that the time for TTC was right. Not only had I had found a man who could be a partner in every sense of the word and who I thought (think) would make a wonderful father, I had had years of freedom to pursue my own self-centered interests and goals. I was finally relatively established in a career I enjoy, with no imminent plans for any significant changes on that front.

It has seemed to me a great irony that now that the time is finally right for me to TTC, I have been unsuccessful. The fact that we don't know exactly why--except that I am "old"--makes it all the more frustrating.

I've written here before about the disproportionate number of people of my acquaintance who are currently pregnant or have become first-time parents in the past three years or so. I learned in the past week about two more law school classmates of mine who are pregnant with their first children. My 5-year law school class reunion is coming up on November 6, and I feel confident that I will be confronted with news of at least 1 or 2 more pregnancies while I'm there, in addition to possibly seeing pregnant women face-to-face. I know that several of my classmates will be bringing their small children to the reunion as well.

To me, one of the worst things about infertility is the uncertainty. Not knowing if we will ever be able to conceive and deliver our own child. Not knowing whether the treatments we are pursuing will work (or really, given our "unexplained" diagnosis, whether they are even indicated for us). Not being able to plan very far into the future because we don't know if we will be pregnant or parenting then. (Right now, I can't even plan a trip for my 40th birthday or think about the next car I'd like to buy without the concern that it plans will have to be changed.)

If I knew FOR SURE that we would eventually have a child of our own, I think I could bear the seemingly interminable waiting. I would gladly pay the price of treatment and endure the injections and all the rest if only I knew that our time would come. Despite both our reservations about it, I think we would even go as far as IVF if we knew that it would work.

But I don't know that. I can't know that.

Even though we have only been TTC 19 cycles, I feel that I have been waiting for YEARS to welcome my child into the world. And I'm still waiting. . . . for something that may never come.

Monday, October 26, 2009

Mid-cycle follical check u/s for IUI #2

I had my u/s this morning, and it was uneventful. I had the NP I know and trust, and I was in and out in less than 30 minutes.

I have four follicles that are big enough that they might release mature eggs this cycle, two on the left and two on the right. The two on the left are smaller--about 13 mm each--and the two on the right were 18.5 mm and 16 mm. The NP said that this was a good response to the drugs I have taken.

Based on this morning's u/s, I am scheduled to trigger late Wednesday night and have my IUI on Friday morning. BUT I have to keep checking my OPKs daily because there is a chance my body will produce its own LH surge due to the one 18.5-mm follicle I have. If that happens, I will likely have fewer eggs and will have to move up my IUI.

Depending upon how things shake out, I should have two to four eggs to work with this cycle. I know that this means that twins (or more) are not entirely out of the question. . . . but honestly, after 18 months of TTC with perfect timing every cycle, normal testing for both of us, with one other failed IUI and only one BFP ever (resulting in a very early miscarriage), I am inclined to think that the odds are greater that I won't get pregnant at all than that I will end up pregnant with multiples.

I have been very fortunate. My drug side effects have been minimal: some moodiness, occasional hot flashes, and some lower abdominal bloating as ovulation gets closer. And I keep reading on others' blogs how the writers gained weight from fertility drugs. I started "eating clean" about two weeks ago and have actually lost about 5 lbs this cycle. Aside from the symptoms I mentioned above and being a little more tired than normal, I've felt pretty much normal.

Still, my abdomen is bruised from the five Fol.lis.tim injections I've taken this cycle, and I still have my hCG trigger shot to go. I hope this cycle is "it" and will produce that elusive sticky BFP we have been waiting for.

Friday, October 23, 2009

Is everyone a parent or pregnant?

This post got me thinking about my own Fac.ebo.ok friends. As I've mentioned in earlier posts, it seems like an awful lot of them are pregnant or have young children.

I counted today, and of my 322 friends, approximately 25 of them are past child-bearing age (I used age 42 for women and no cut-off for men), and I didn't count them. Also, there are about 25 of the remaining almost-300 who I don't know well enough--or don't talk to often enough--to know whether or not they have children and what their ages may be.

Of those friends remaining, about 270-some, the breakdown is as follows:
  • 145 have children age 18 or under
  • 48 of those have at least one child under age 2 (and in some cases, more than one)
  • 11 are pregnant or have pregnant wives
In fairness, I will also disclose that 5 of the women with children under 2 and two of the pregnant women are women I met through my fertility charting website. (That may slightly skew the results.) Even taking that into account, that leaves 43 people with kids under 2 and 9 pregnant people.

I guess this shows that not EVERYONE I know is pregnant or parenting. It only seems that way. ;-)

Still, over half of my friends on FB who are of child-bearing age are currently parenting, and that's a lot.

Happy birthday, Sebastian

Today is my dog's 8th birthday! Though I've noticed him slowly becoming less active over the past couple of years (which we now know is due to mitral valve insufficiency), it's hard to believe he is 8.

Since I adopted him when I was 31, still single and childless, Sebastian has been the recipient of all my maternal love and affection. Like many women, I wanted to be a mom before I was in a position to even TTC. Some people may consider it strange or sad, but in some ways, Sebastian has helped to fill the void in my life caused by not having a child of my own to love. I don't know what I'd do without him; he has brought me happiness every single day that he's been in my home.

Here are a few of my favorite shots of "my boy" from over the 7+ years I have had him:

The day I brought him home from his rescue foster home, August 25, 2002

Taken during a professional shoot we did in December 2003

Another shot from the December 2003 shoot

On the beach in Rocky Point, July 2008

A random day with a stuffed toy, fall 2007 (pre-Hunter: they don't get stuffed toys now to avoid fights)

Welcoming Hunter and sharing his "comfort couch," May 2009 (Sebastian is the one in the back)

Thursday, October 22, 2009

Thank you

I so appreciate all your comments and input! (Though no one in my area has emailed me; maybe no one in the Phoenix metro area reads this blog?)

While talking with MM about this last night, I thought of something that I hadn't really considered in regard to changing practices. Doing so will likely mean at least a 1-2 cycle delay for us, just in order to get an appointment with someone else. A nurse friend of mine pointed out today that a new doctor might also make me/us repeat some of the testing that has already been done (bloodwork, HSG, semen analysis). We have already had too many delays already--this cycle's will only be my second IUI since we decided to start intervention in APRIL--so that is another consideration. I am 38 and will be 39 in March, so I don't have a lot of time to waste.

My other concern in changing practices is that it will be more of the same elsewhere. None of what I have experienced at my current clinic could have been anticipated or learned prior to becoming a patient there. I was assured at our initial consultation and later sit-down appointments with the doctor that they get you quickly in and out for monitoring appointments, something I later learned through (painful and expensive) experience is not the case. The only person I know who had been a patient there had nothing but good things to say. . . . but then again, she did IVF there, so perhaps her experiences were different.

In reality, most clinics are more focused on IVF because that is how they make the most money. We are paying about 1/10 of the cost of an IVF cycle for each IUI cycle we do.

At this point, I think I am going to discuss the situation and my concerns with the one NP in the office with whom I have had regular contact and established some rapport. Perhaps she can guide me and help alleviate some of my concerns.

In any event, I cannot do anything until this cycle is complete. Perhaps I will get pregnant this cycle, the pregnancy will stick, and I will be referred back to my OB/GYN and won't have to worry any more about this. A girl can hope. . . .

Wednesday, October 21, 2009

When to change REs?

I have blogged here before about various frustrations with our RE's clinic. Our physician himself is wonderful--he helped T's daughter conceive each of her two children through IVF and has consistently been voted one of the top physicians in our city--and he is the only RE I know who has actually treated someone I know. BUT we have only seen *him* a sum total of three times . . . all for sit-down consultations. At our current clinic, both the ultrasounds and the IUIs are done by the nurse practitioners. From what I have been told by the office staff, the doctors are busy in the mornings--when these things occur--with IVF retrievals and transfers and other procedures. The doctors do perform the HSGs, but as it happened, I had my HSG on a day when my doctor was out of the office, so one of his partners performed my HSG (way back in mid-January 2009).

Our clinic seems to be quite busy; there are always a lot of people in the waiting area every time I'm there. We have had long waits in the waiting room(s) at all three of our appointments with our actual doctor--including having to reschedule entirely one day when an emergency arose during a procedure--and I have had long waits for many routine monitoring appointments as well.

Long waits alone were not enough to make me change clinics, but after my latest interaction with one of the NPs there, I am giving it some serious consideration. Allow me to explain.

I had to have blood drawn for a beta hCG last Friday afternoon before I could start the current treatment cycle. Nevertheless, the NP who saw me that day (and actually drew my blood) provided my prescriptions for Clo.mid and Fol.list.im and gave me the go-ahead to start this treatment cycle. Her reasoning was that because I have now had two periods since my (very early) miscarriage, the odds of the blood test showing I'm pregnant were practically zero. I agreed with her logic and started my meds accordingly on CD 3, this past Sunday.

Monday I received a voicemail message from a different NP simply saying that she had the results of my labs from Friday. After two failed attempts to reach her when I called back, I left her a voicemail asking that she call me again and just leave the test results on my voicemail. (My message identifies me by my full name, so she'd have no doubt that she'd reached the right person.)

She didn't call me back until early this afternoon, at which time she left me a message that my beta hCG was "less than 1"--good, and what was expected--and that this was "good news" because it meant we could "start another treatment cycle." OK up to this point. She then instructed me to call on CD 1 to start the next cycle.

Umm. . . I guess she didn't read my chart. I've already started the next cycle. I've taken three days of medications and am scheduled for my monitoring u/s on Monday.

I found this troubling. Because the NPs are the ones directly managing the care I receive at our clinic, their failure to be informed and up-to-date on what is going with me is concerning. This message is kind-of a little thing, but my concern is that it is an indication of poor communication and a lack of continuity of care.

And in the interest of full disclosure, let me share that I worked as a RN from 1994 to 2001, prior to going to law school. I never worked in a fertility clinic, but I think the concepts of communication and continuity of care are pretty universal in any area of health care.

So what say you, fellow patients? Would this concern you? And if so, would your concern be great enough to change clinics?

And on that note, could anyone in the Phoenix area who is reading this and is currently seeing a RE shoot me an email at sangela71 at yahoo dot com? If we do decide to change clinics, I'd like to get your take on wait times, continuity of care and physicians where you go. (For obvious reasons, I'd prefer not to disclose the name of my RE or clinic on this blog.)

Any feedback would be appreciated. Thanks.

ICLW

If you have found your way here via ICLW, welcome!

I am S. My husband ("MM") and I have been married for almost a year! Because of my "advanced" age (I'd just turned 37 at the time), we actually started TTC in April 2008, several months before our November 28 wedding in Maui. We both knew we wanted to be parents, and we had heard that this process can take some time when you're older. Little did we know how long. . . . We live in our suburban home with our two golden retrievers, surrounded by families with toddlers, new babies and pregnant moms, and wait for it to be "our turn."

We are "unexplained." All our testing has been normal. Our RE has told us that the most likely explanation for our failure to conceive is poor egg quality related to my age. (I am now 38 and will be 39 in March.)

We have just started our 19th cycle TTC. I had a very early miscarriage in August, the result of a break cycle. That was my one and only BFP, and I have never been more than about 5 weeks pregnant. (Our complete TTC history is in the left sidebar, if you're interested.)

If all goes as planned this cycle, I will be doing my second IUI in a little over a week. I am currently on CD 6 of my first cycle adding Foll.sti.m to Cl.omid. I hope this works! Even though I would hate to be due in late July--I live in Phoenix, where it gets to 110+ daily that time of year--I will take a healthy pregnancy any time I can get it by this point!

Tuesday, October 20, 2009

Pregnant people

None of the partners in my firm know about our TTC efforts or our infertility--though there have been a few veiled comments since our wedding about whether I am pregnant or plan to have children--and I intend to keep it that way, for a variety of reasons. I am not a particularly private person in general, but I don't like to be an object of pity, for one thing.

If I were going to tell any of the other lawyers here about our efforts and lack of success, it would be "T," one of the partners for whom I work about half the time. T is a deeply religious man in his 60s who has been married to his wife--a 3rd grade teacher--for 40 years and has a grown daughter and a grown son, both of whom are married themselves. T is a very nice person. He is almost never in a bad mood--very unlawyerly in many ways--and is the type of person who makes a point of asking after his employees' health and families.

T has two grandchildren, aged 6 and 3: his daughter's two children who were both conceived through IVF. T's son and daughter-in-law have been struggling with infertility as long as I've known him (just over two years). They are the couple I was talking about here when I wrote about a failed adoption just before Christmas last year.

Today at lunch, T told me that his daughter-in-law is "finally" pregnant and due in June. He told me that "the prayers of many people have been answered" by this event.

You might think that this news would upset me, but actually this pregnancy announcement is the first I've heard in a while that made me feel nothing but happiness. Though we haven't been TTC as long as T's son and daughter-in-law and have endured nothing like what they did related to their failed adoption, I can well understand how they might have been feeling these past 2+ years and how ecstatic they must be to finally be expecting.

Funny how I've reached a point where only the pregnancies of the infertile (excepting close friends/family members) seem to make me whole-heartedly happy.

P.S. On a related note, I have seen three pregnant women at various stages in the past 24 hours, and the woman who did my pedicure yesterday shared that her daughter is pregnant with #2. When I asked the pedicurist how far along her daughter is, she said "about 5 minutes." She is due in late June and already telling people. She has an 18-month-old already and had no problems conceiving or during pregnancy, so I guess she figures a + HPT = healthy baby in 9 months. Ah, ignorance is bliss.

Meme about Us

What are your middle names? Mine is Angela; his is John (my dad's name)

How long have you been together? Together 2 years, 1 month; married almost 11 months

How long did you know each other before you started dating? We met online, so our first meeting was our first date

Who asked who out? He asked me

Who made the first move? He did (though he says I did, lol)

How old are each of you today? I'm 38; he's 36

Did you go to the same school? No.

Are you from the same home town? No.

Who is the smarter? He says I am. He is by no means dumb, though.

Who majored in what? I majored in a few things in college but have my BA in psychology, an AD in nursing, and a JD. MM has a bachelors in criminal justice and a masters in educational leadership.

Who is the most sensitive? MM is FAR more sensitive than I

Where do you eat out most as a couple? Red Lobster (his favorite), BJ's Brewhouse, and a couple of Italian places

Where is the furthest you two have traveled together as a couple? To Maui, Hawaii for our wedding/honeymoon

Who has the worst temper? I do

How many children do you want? I would've liked two; he wants one. At this point, we will be lucky if we have one.

Who does the cooking? Usually we each do our own meal preparation. I've cooked for him about five times ever (he is a VERY picky eater).

Who is more social? I am. If it were up to him, we would never get together with anyone else

Who is the neat-freak? He is. He ABHORS clutter and picks up after me. Sounds good, but it's actually created some problems when he has thrown my stuff away or put it where we couldn't find it.

Who is the most stubborn? We are both pretty stubborn. ;-)

Who wakes up earlier? Me

Where was your first date? We met for drinks at a Mexican restaurant near my office. Drinks turned into dinner, and later we went dancing at a local jazz club.

Who has the bigger family? Me, by far. MM is an only child whose parents are both only children also.

Do you get flowers often? No. MM only buys me flowers on Valentine's Day

How do you spend the holidays? We have agreed to alternate his family and my family.

Who is more jealous? He is

How long did it take you to get serious? A few months

Who eats more? I eat more food, but he eats more crap

What do you do for a living? I am an attorney; he is a probation officer

Who does the laundry? We each do our own laundry

Who is better with the computer? I am

Who drives when you're together? We take turns

What's your song? We don't have one

Monday, October 19, 2009

Protocol for IUI cycle #2.1

We are following the same protocol as we did for the August cycle which was aborted when we learned I was pregnant but having an early miscarriage.

Clomid 50 mg CD 3 through CD 7 (10/18 - 10/22)
Follistim 125 mg on CD 3, 75 mg on CDs 4, 6, 8 and 10
OPKs before 11:00 each morning starting CD 8 (10/23)
Follicle check u/s on the morning of CD 11 (10/26)
Trigger with Ovidrel when instructed to do so prior to IUI

Though we agreed to start treatment six months ago and did our first IUI cycle in April, this will only be our second IUI. Besides my chemical pregnancy in August and the delay that resulted from that, I've had to take breaks for a few cycles for reasons ranging from my recent vacation to conflicts with my work schedule to MM forgetting to pick up my medication. (And ironically, the one-and-only BFP I've ever seen was a result of our break cycle in July.)

In the six months since we committed to treatment, we have had fewer cycles without medical intervention than with. Weird.

I had really hoped to be pregnant by now. Ah well. Onward and upward.

Friday, October 16, 2009

Here we go

For the past couple of hours, I have been having some mild cramps of the sort that I get just before my period. When I visited the ladies' room just now, I had the little bit of rust-colored spotting which is also typical for me pre-AF. Looks like AF is on her way.

I then started thinking about the fact that today is Friday. The pharmacy through which I get my fertility drugs is closed on weekends, so if today ends up being CD 1 for me and we are going to do treatment with Cl.omid and injectables this cycle, as planned, I need to get the medications today in order to start them on CD 3 (Sunday). (I don't know if Walgreens et al. even carry the Fol.lis.tim I need.) If AF doesn't fully arrive until tomorrow, I could wait and get the meds on Monday. . . but I'd rather not take a chance. I also was told after my chemical pregnancy in August that I would have to have blood drawn for a beta hCG before I could proceed with the next treatment cycle, and I'm not sure if that will still apply, given that this is now my second period since the early miscarriage. (The RE doesn't routinely check a beta each cycle.)

I called and left a message on the "nurse line" at my RE's office. I hope someone calls me back before the end of the day!

Just thinking about coordinating everything that goes into another treatment cycle has my chest feeling tight and my heart racing. And this is just for IUI + injectables! I can't imagine how women do it for IVF. I really don't think I could handle it.

EDITED TO ADD: It kinda goes without saying, but I'm bummed that, once again, I am not pregnant this cycle. Keep hoping I'm going to be that "urban legend woman" who conceives on a break. Alas.

Wednesday, October 14, 2009

Show & Tell

**WARNING: CHILD MENTIONED AND PICTURED**

(Originally this post had photos. In the interest of not having photos of my family, including my nephew, on display indefinitely, I have removed them as of 5/29/2012.)





























Nearly three years ago--it will be three years exactly on November 8th--my sister did something for my parents that I will never get to do: she made them grandparents for the first time by giving birth to my nephew Rowan. (Even if we are eventually successful with TTC, my mom and dad are now already grandparents.)

I got to spend lots of time with Rowan during our recent vacation. We spent half of the eight days of our trip with him and my sister and brother-in-law. We even took the little guy to the National Zoo on our own one day while Mama and Daddy were at work. (That was an adventure I'm sure my husband will never forget!)

Here are a few of my favorite photos of Rowan from our recent visit.



Playing in the wood chips at the playground

Flexing for Uncle M


At the zoo play area (which he preferred to the animal exhibits)


Finished an ice cream cone with only a little help from Auntie S

Effects of weight loss on fertility?

Before infertility, my one constant struggle in life has been with my weight. I have been overweight to some degree or another since I was a teenager. (Heck, maybe even before that: I weighed 8 lbs, 8 oz. at birth!) Currently my BMI is around 36. Bad, I know.

I've read a lot about how obesity can adversely affect fertility, but everything I read seems to be in the context of women who have PCOS and/or anovulatory cycles. Although I have only conceived once in 18 months (and then had a VERY early miscarriage), I have regular cycles, and my RE believes, based on cycle length and testing, that I do ovulate every cycle. Because of this, I've been thinking that my fertility is not affected by my weight.

I know that I should lose weight for my own health and for the sake of having a healthier pregnancy (should I ever be lucky enough to get/stay pregnant). But I've been wondering lately whether losing weight might make me more likely to conceive? (Side note: I accidentally typed "lucky" for "likely" the first time. Freudian slip?)

(One of the pitfalls of being "unexplained" is that you spend your time thinking about everything and anything that might possibly affect your fertility for good or ill. Not that it's worse than having a specific, diagnosed problem; it's just different. It's the reason I've tried acupuncture, meditation, cutting out simple carbs, and a variety of herbal supplements, too.)

If anyone has any thoughts on this issue, I'd love to hear them! Email me or leave a comment on this post. Thanks.

Friday, October 9, 2009

Random anger

I don't know if I am unique in this, but I tend to think much less about my inability to have a baby when I'm not actively trying to get pregnant. In the early days of TTC, when I was checking my temperature and cervical mucus/position daily, or later on when going through a cycle taking fertility medications, thoughts of our infertility have at times been darn-near all-consuming. Now that I no longer bother with daily temperature-taking, in a cycle like this one, when I've taken no medications designed to "help" us conceive, I can mostly put our TTC struggles out of my mind. I think that is quite an accomplishment after 18 months of TTC without success.

And yet. I notice that random things which would have occurred without my notice two years ago can now make me almost irrationally angry. Sometimes when I start thinking about things that MM and I would like to do in the near future. . . . say, a trip we'd like to take in spring 2010. . . . I think about the fact that we really don't know if any plans we make that far in advance can come to fruition. If I'm not pregnant by then, we will likely be doing some type of treatment that would preclude going out of town. If (hallelujah!) I was pregnant then, it might be a safe time for me to travel. I will admit: this makes me mad. I feel in some ways that I have lost control over my life.

(When we were on our recent vacation to DC and northern Virginia, I thought fleetingly about the fact that when we scheduled that trip in early April, I had high hopes that I would be pregnant by the time we went. Clearly that didn't happen.)

I can hardly stand to hear about child abuse anymore, even on the news. Sure, this is a topic that no one really ENJOYS hearing about, but I've been working with abused and neglected kids in foster care as a volunteer for over seven years. Before I was TTC myself, sadly, I had grown somewhat accustomed to hearing about all but the worst cases. Now? I get really, really upset.

One of the hardest situations, simply because it is so frequently occurring: now, even when a friend or acquaintance who I know will be a good and loving parent announces her (or his wife's) pregnancy, my initial reaction is seldom happiness: it's anger. Double that anger if it's not their first child. For friends and acquaintances' pregnancy announcements, the anger is usually quickly overshadowed by my happiness for the couple--how quickly being somewhat related to how close I am to the parents-to-be and whether the child is their first--but the anger is never NOT there, even if it's only for a split-second. "Why her and not me?" now pops into my head EVERY.SINGLE.TIME.

And don't even get me started on how I feel when I hear of people's "accidental" or unwanted pregnancies. Thankfully, being in my late 30s and working in a law firm, I don't hear about these as much as the average person, I'd suspect. (Although my husband, as a probation officer, hears about them quite a bit.) Talk about "Why her and not me?"

In our extended family, my unemployed, uneducated, poor, country relatives reproduce with ease while I continue to wait, month after month, for it to be "my turn." Just in the past month, my mom has informed me of one (unplanned, out-of-wedlock) birth to a second cousin. A great situation, as the "baby-daddy" apparently skedaddled long before the blessed event. She also told me that my 23-year-old second cousin who has a toddler is due again in December. Oddly, my mom also decided to wait to tell me about cousin #2's pregnancy. (I don't see this cousin often, so I likely wouldn't know unless Mom told me.) I don't know how she thought THAT would spare my feelings; maybe she misguidedly thought I'd be pregnant myself before I found out about her second baby.

Even well-meaning advice from people can really chap my hide. My father shared with me last week that he knows a woman in his church who is having her first baby at age 42, saying "so there's still hope for you." Ugh. I love my parents, but they are both absolutely clueless when it comes to talking to them about infertility (and Dad is on limited information status anyway).

I've long struggled with my temper, and I am by no means a patient, calm person. With time and effort, I have learned to control my anger in most situations and circumstances. But I have never before experienced these random flashes of anger. . . . anger that flares suddenly, seemingly out of nowhere. Anger that I must swallow and control.

Yet another awful thing about infertility.