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.]
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.]
(Hugs) I am very sorry you're having to wrestle with all of these thoughts and questions. I've been dealing with it too. Per my current RE, IVF with ICSI is the best way for us. I am like your husband. As much as I want a biological child, I am not ready to go into (further) debt. It would not be fair to any of us, child included if it worked. If the IVF didn't work, there's no way I could pay the payment on the loan for something that I don't even have. That's just too jarring to think about.
ReplyDeleteI do hope you can come up with an agreement with your dh. It's hard to go through this with support, but without it, that's just too much.
I can understand your frustration so far with your IUI cycles. When you only get one mature egg from a medicated cycle, I can see how that might feel futile. Having said that, I wouldn't be ready to say that IUIs aren't going to work for you. And I do kind of think the more eggs the better: the more eggs you produce in a given cycle, the more chances one of them will be a winner. But it seems to me like you might want to try something other than clomid/follistim to see if you can get a better response.
ReplyDeleteAs for IVF, you're right that in any one IVF cycle your chances are 40-50%, but my RE told me (although I haven't heard this elsewhere) that over 3 IVF cycles your chances go up to 97%. So, as long as you look at it not as a 1 shot deal, but as a 3 shot deal, you can get a lot better odds.
Of course, you're also talking about a lot more money that way, money that you said you don't have. I, too, am debt averse. But, for some things, you have to go into debt. Like buying a house. And buying a house is risky, too - there aren't any guarantees there, either.
And, as far as your work issues, as you said, once you're pregnant and have children, your work schedule will have to accomodate them, and most places would be understanding about this. But, maybe they would be understnading about your TTC difficulties, too? If you decide to do IVF, and are up front about what that will mean to your job during that time, maybe they would be accomodating to that?
Just my 2 cents. You can tell that I think you shouldn't discount IVF. I think your and DH's concerns are very reasonable. But at the same time, the desire to have children, in a lot of ways, is not all that reasonable. And I think that's okay. Sometimes you just have to weigh your options, and then go with your gut.
Good luck to you guys!
you are correct in thinking a donor egg IVF cycle would be less taxing on your body. for me, the egg stimulation and retrieval were somewhat uncomfortable, so not having to go through those would make the process easier. If it gets to the point that my RE tells me my eggs are no good, I will certainly pursue using donor eggs. It would be nice to have a child biologically connected to my husband, and it is more important to me that i experience pregnancy and carrying a child than being biologically related to it. i think carrying the baby gives you a chance to truly bond with the child, so it won't matter that you aren't biologically related. Good Luck with whatever you choose.
ReplyDeleteI'm so sorry that you're feeling stuck. For what it's worth, someone shared with me recently that it takes, on average, 4.8 IUIs for a BFP...not that that makes it any easier.
ReplyDeleteI should start this next paragraph with the caveat that we've pretty much accepted that we're about to head down the IVF path. Debt-averse, unfortunately, is not a term I'd use to describe us. I wish it was sometimes, but it's not. And, while there are many things that, looking back, weren't worth adding any debt for...IVF isn't one of those. For us, the chance at a baby is 100% worth whatever debt comes with it.
Now, do I think it sucks that we're paying that kind of money for only the chance? Without a doubt! But, Jane's thoughts seem right on to me. Some things are worth going into debt for. But, that's just us.
I guess, to be honest (and only from my perspective) I struggle with jumping from IUI to child-free. There are so many other options that we're discussing from IVF to donor to adoption. That said, many of those require foregoing a biological link and I completely understand that it's a no-go option for many. But, I know that I wouldn't be able to move away from having children without exploring all the options. I would always wonder.
I wish you some peace this cycle. And, I truly hope that this is it for you and you don't have to consider these options any further! (((HUGS)))