Living life

This break cycle has been so nice for me. I am beginning to remember what my life was like before we started TTC, and it was (is!) good!

I haven't carried through with my plan to focus more on my health this cycle by eating better and exercising more. . . . primarily because things were crazy-busy at work for a couple of weeks and I am now getting over a nasty head cold. But I have been spending more time focusing on other things: a visit with my dad and stepmom, my job, my piano lessons, my golden retrievers, our vacation to DC in the fall.

Last week I got a call from the clinic where I did acupuncture for three months. They called because I haven't been in for a session in over a month. (I can only go on Saturdays, and I had plans for three of the four Saturdays that month; the fourth Saturday, both the practitioners were unavailable due to a conference.)

Although I know that acupuncture has helped some people--and my RE actually recommends it to his patients--I don't think that I am going to go back. It is expensive: $95 per session at my clinic (which specializes in the treatment of infertility), plus the price of my herbs. Depending upon where I am in my cycle, the herbs are usually between $20 and $30 per week. It's been nice having that $400-500 per month to spend on other things.

Aside from the expense, taking the herbs three times a day was inconvenient (and most of the formulations taste nasty!). In addition to the inconvenience, having to steep and drink the herbs three times a day was yet another reminder of our unsuccessful efforts to conceive.

Also, I believe that a three-month trial was enough for me to know that the treatment didn't really help me. For a while, I thought that the acupuncture was at least decreasing the frequency of my migraines, even if it wasn't making me more fertile. . . . but in the now five weeks since I've had a session, I haven't had a single migraine. So it seems that any "reduction" in the number of headaches I was having was a mere coincidence. (MM would say a placebo effect; he thinks the whole thing is hooey anyway.)

Being on a break has part of me wishing we could stop TTC altogether. I am not yet ready to give up all hope of our having a child of our own--and I know MM is not--but part of me wishes I was. It's so nice to just live life!

Some wonderful things have happened this month. I have volunteered for five-and-a-half years with M, a little girl in foster care. M has lived with three different relatives, in one group home, and in five different foster placements since she was removed from her father's care at the age of 3 (she is now 9). No fewer than four sets of adoptive parents (including one of her grandmothers) have walked away at various points in the (lengthy) process without adopting her. She has been in foster care limbo and "legally free" to be adopted since October 2004.

At long last, after over four-and-a-half years of waiting, M is now in a permanent home. These prospective adoptive parents seem to be wonderful people and very committed to her. I could hardly have picked a more ideal place for her to end up. I continue to pray that nothing will happen to disrupt this situation, but now am cautiously optimistic that M has found a "forever home" at last.

Thinking of M and her situation reminds me: I'm still working on that post about why MM and I don't feel that adoption is the path for us in the event that I don't get pregnant. I hope to post it later this weekend.

Although I haven't been writing on here, I have been reading blogs. I hope everyone who was reading this one has not given up on it after over a week with no entries!

Off to enjoy my weekend. . . . .

We were on a break!

We are on a "break" cycle. By "break," I don't mean that we aren't still TTC; rather, I am not taking medications and we are not having an IUI. I guess it would be more accurate to say that this is a break-from-treatment cycle.

MM really wanted us to continue to "try" this month, in spite of the break. I am fine with that, but I am not charting or using OPKs or anything else that might help me predict when ovulation might be, and he knows this. Still, my cycles are fairly regular, and I usually ovulate within a range of 4-5 days each cycle. Generally I ovulate no earlier than CD 13 and no later than CD 18, with CD 14 or 15 being the most common.

I have been exceptionally tired the past week or so. Our new doggy had to have surgery on his ear (he is fine); I am extremely busy at work; I haven't been sleeping as well as usual; and I've been getting up earlier than usual. MM is aware of this. I've gone to bed before 10:00 p.m. two of the past three nights.

Last night MM was annoyed when he "rushed" home at 10:30 (he'd been due home at 11:00) to find me asleep on the couch and uninterested in having sex when I was awakened. Seems he got the idea in his mind that we need to be "doing it every day this time of the month." We had had sex the night before, and as far as I'm concerned, that covered our "efforts" for this cycle. (Today is CD 15.)

Surely I am not the only one who doesn't wish to have sex just because "it's time." Surely other women out there have desired sleep more than sex on occasion, even if TTC. Right?!

It's so sad that (a) my husband feels the need to fit in daily sex during this time of the month, no matter what else is going on, and (b) after less than six months of actually being married, I am annoyed that my husband wants to have sex daily (but to be fair, I probably wouldn't mind were it not "goal-oriented sex").

[sigh]

Ho hum

Barring something unforeseen coming up, the next few weeks on this blog will probably be quiet ones. Because I don't believe for a moment that we will actually conceive on a break cycle--I have my doubts about whether we'll ever manage it with assistance, much less without--I don't plan on paying much attention to where I am in my cycle this month or making any attempt to predict my "fertile window."

There is a possibility that I may have an emotional experience that I want to vent about, and I am working on a post about why MM and I aren't particularly keen on pursuing the option of adopting in the event we are unable to conceive our own biological child. . . but otherwise I probably won't have much to say. (I can only post so many times about how EVERYONE ELSE IN THE WORLD seems to be getting pregnant except me. Two more announcements on Facebook this week, by the way.)

If I had a "Hope Meter" on this blog, it would be at zero most of the time. (One good reason I don't have one!) Occasionally something happens that gives me a glimmer of hope, though. Not so much hope that we will eventually be successfully in our quest to have a baby, but hope that I will be OK, whatever happens.

I have alluded before to friends I have who conceived their "miracle" baby on a break cycle after two failed IVFs and then conceived again when she was only four months old. These are my friend R and his wife E. I have known R for many years. He was my boyfriend from 1994 to 1996, when I was 23 to 25 years old. We actually lived together for over a year, and many people (including R and my parents) thought that we would eventually get married. We broke up (relatively) amicably in the fall of 1996.

Anyway, R and I have remained friends over the years. I attended his wedding to E in November 2000. We don't talk often but do exchange Christmas and birthday cards and talk on the phone on an average of once or twice a year. Since he has been married, I have seen R only once. . . . but this is due more to the fact that we live in different parts of the country than due to any awkwardness on his or E's part about our friendship.

I had a card in the mail yesterday out of the blue from R. (I smiled on seeing the envelope because it was addressed to my married name. Except I kept my own name. I guess R doesn't realize that.) My birthday was in March, and he sent me a (belated) card for it, so I was surprised to hear from him. The card was a "Thinking of You" card signed by him and his two girls with photos of them (now almost-5 and almost-4) inside.

Seeing photos of the children of a man who I could have married gave me a moment's pause. But then I was just happy for my friend and happy to see how they are growing up.

I am happy with my life and wouldn't change it. It's good to remember that.

Thoughts on IVF

I'd like to start this post by acknowledging the fact that it's likely that the majority of people who use IVF would not CHOOSE this route to parenthood. I would venture to say that nearly everyone who uses IVF to conceive would much prefer to simply conceive a healthy baby without medical assistance. I say "the majority" or "nearly everyone" because there are many reasons for using IVF, and I can't know the reasons why every couple chooses this route. (Perhaps, as in My Sister's Keeper, they have chosen IVF to ensure that the child who is a result has certain, specific genes rather than due to infertility.)

I would also like to make clear at the outset that our thoughts and feelings on this matter are just that: OUR thoughts and feelings. In no way do I wish to imply that we are right and those who chose otherwise are wrong. To me, decisions about ART are extremely personal--as personal as the decision to have a child--and what is right for others may not be right for me and vice versa.

I have alluded before to the fact that both MM and I are against IVF for us, but for different reasons. MM's primary objection to IVF is the expense relative to the success rate. I should first of all mention that our insurance covers nothing for IVF. If we end up going that route, we will be paying 100% out of pocket. We do not have $10-30K in savings that we can use for IVF, so we--like many other couples--will be in the position of either borrowing the money or asking MM's parents for the money. (My parents don't have lump sums of money they could give us; my in-laws have the money, though whether they would give it to us for this purpose is a separate, thus far unasked--and unanswered--question.)

Based on data reported to the CDC for dates from 1/1/2000 to 12/31/2007, our clinic cites an Estimated Live Birth Rate for women in my age range (38 to 40) of 40.5% with normal testing. As with most clinics I've researched, the success rate is slightly higher for fresh cycles than for frozen cycles. Some clinics in other states cite higher success rates.

Before we were even sure that we would need to use ART to conceive, when we were discussing the topic of someone else's IVF, MM once opined that he "wouldn't pay that much for anything without at least a guaranteed 50% or greater chance of success." In conversations that we've had on the matter since then, he has stuck with this opinion.

MM has a huge aversion to going into debt for any reasons, but especially when the money being spent may not even allow us to achieve our desired result. Anyone who knows anything about IVF knows that it is entirely possible to go through three, four, or even more cycles and still not have a living baby to show for your efforts.

While I don't have MM's same aversion to debt (witness the $60,000+ I borrowed for law school), I agree that IVF is, in essence, a very expensive gamble. Sure, the odds are much better than the lottery, and the "prize" is priceless and irreplacable. . . . but it is a gamble nonetheless.

My primary objections to IVF are the effects that it would have on me. Even a smooth, relatively uneventful IVF cycle means a lot of stress on my body. It will also likely mean a lot of time away from work. I am the primary breadwinner in our household, and I only get two weeks each of sick leave and vacation per year. My job also involves occasional travel, which could be extremely hard to coordinate with the regular monitoring that IVF requires.

I am fully aware that being pregnant and having a child will also mean stress on my body and time away from work. However, this just goes with the territory of pregnancy and parenthood, and the majority of people will understand that, having gone through the same experiences themselves or with their spouses. I can't see myself going to my firm's partners and telling them that I am already going to need lots of time off, even before ever getting pregnant. I do not think that that would fly.

I am also fearful of the effects that the medications used would have on my body, both in the short term and the long term. I'm not sure I can handle the medication side effects, especially as they impact mood and mentation. The increased risk of multiples concerns me. And I am a little concerned about whether certain medications might increase my risk of some cancers in the future. (I've already had to sign a release to this effect just to take Clomid.)

[As an interesting aside, MM has told me that if we "knew for sure" that IVF would work, he would want us to do it, despite the reservations I have stated above.]

If I had to try to sum up my biggest objection to IVF for me, though, I think it would be most simply stated as "Where does it end?" If I'd be willing to do one IVF cycle, why not two? Three? Four? More? A friend of a friend recently gave birth to a baby conceived on their 6th IVF cycle. Tertia, writer of the blog"So Close," did nine cycles of IVF before she was able to bring a living baby home from the hospital.

To me, the easiest way to avoid this "slippery slope" is to simply not start. There are things in this life that each of us want desperately which we are denied for one reason or another. If the only way that MM and I can conceive a child of our own is through IVF, perhaps it would be wiser for us to simply accept that this is something which, for reasons unknown to us, we are being denied.

Until we started seeing the RE, like most healthy young men, MM wasn't even aware of most of the options available to us. If we don't succeed in these next five cycles of IUI, we may be discussing them further. Who knows?

As it stands currently, at the start of cycle #15 TTC with no explanations for our infertility and one failed IUI under our belts, that's where we are. I cannot say with absolute certainty that our feelings on the matter won't change if/when we realize that IVF is our only remaining option. (It's not as though either MM or I has a moral or religious objection to the procedure.)

Back to daily life

Thanks for your comments on my last post. I do realize that Clomid is a commonly prescribed and widely available drug; however, trying to reach someone at my RE's office over a weekend to phone in a prescription in another state would've been challenging at best. I would've had to wait (perhaps hours) for a call back and find a pharmacy near our hotel. Doing all this would have definitely forced thoughts of TTC upon me during what was intended to be a relaxing getaway weekend. I wanted to be able to enjoy myself without having to keep my mobile phone at the ready to deal with something I was trying hard not to think about while I was away.

I called the RE's office this morning to confirm that today (CD 6) would be too late to start the Clomid, and the nurse confirmed that our RE doesn't ever start it after CD 5. So this will end up being an unmedicated cycle for us. As upset as I was on Friday night about "wasting" a month, I have now come to terms with it. It's not the end of the world.

I did mention to MM on Friday night (after I was less upset) that it would be very ironic if I ended up getting pregnant this cycle. Such is our mutual attitude about TTC at this point that his response was "yeah, right." Neither of us believes for a moment that that will happen.

Anyway. . . . I did have a very fun and relaxing weekend. Kudos to MM for planning it all!

I am going to focus more on my general health this cycle rather than on TTC: going to the gym at least 3-4 days each week and eating more healthy whole foods and less processed crap. I could really stand to lose some weight, too. Though I have no reason to believe that my weight is hindering our TTC efforts, it would be a good thing to start a pregnancy at a healthier weight than I am currently.

I know that I won't be able to totally forget about TTC this cycle--even MM knows roughly when I ovulate each month--but I am going to take advantage of this unplanned break to put the focus on other things.

P.S. MM went back to the pharmacy this morning and picked up the Clomid. No explanation (or apology) was offered for why it wasn't given to him on Friday. At least I am now set for next cycle when it arrives.

Unplanned break

As I mentioned, MM and I are flying to San Antonio tonight to spend the weekend. MM's office is five minutes from our RE's clinic and the adjacent pharmacy to which our RE calls in my medications. (My office is about a 15-20-minute drive from there.)

Last night I asked MM to pick up my medications for this cycle on his way to work. He later called me, annoyed, because the Ovidrel had to be refrigerated and I hadn't told him that. (I didn't know.) At work, refrigeration was not a problem, but he'd planned to hit the gym on the way and couldn't leave the Ovidrel in his car with a daytime high of 102 degrees today.

No problem. I told him to bring the Ovidrel to my office on his way to the gym, though it took him about five minutes out of his way.

I brought the Ovidrel home and popped it in the fridge, knowing I wouldn't need it for at least ten days.

As we were packing up and leaving for the airport, I suddenly realized that MM had never given me my Clomid pills. . . the main reason I'd asked him to pick up my meds today. Today is CD 3, the day I start my Clomid.

To make a long story short, MM paid for Clomid but did not pick up Clomid. He *assumed* it was in the bag with the Ovidrel, but never opened the bag to check.

So it looks like we're taking an unplanned break this cycle. The RE's office and pharmacy are both closed until Monday morning.

I was extremely upset about wasting a month (and about my husband's carelessness and seeming lack of concern/interest), but I'm over it now. He has apologized profusely and feels awful.

Just going to move on and enjoy our weekend.

Round 2

I got a call from my RE's nurse late yesterday afternoon and am set up for my medications and my mid-cycle follicle check u/s. My meds will be the same as last cycle except that the RE has changed my hCG injection from Pregnyl to Ovidrel due to the nasty welt I developed after the Pregnyl shot. I will be taking Clomid 100 mg CD 3 through CD 7 (starting tonight!), checking OPKs every morning between 10 and 11 starting on CD 11, and triggering when instructed to do so. Once our IUI is complete--and, once again, there is a potential issue about the date for that--I will be using the progesterone gel again (yuck!).

About possible IUI dates. . . . based on last cycle, I ovulated on CD 16. My normal ovulation day without meds would usually be between CD 13 and CD 15. So I'm thinking that my IUI could potentially be any day during the week of May 18. Any one of those days would work fine for me EXCEPT May 22 (CD 17). On that day, I have to drive six hours round trip to attend a deposition in a small town. Because we are going to trial in the case in mid-June, the deposition cannot be rescheduled. And there's not a snowball's chance in hell of getting the partner to cover it, given that it involves sacrificing an entire day; he just has too many other things going on.

I will be positive and keep my fingers crossed that my IUI falls on any other day except CD 17. But you will recall how that worked out for me last cycle. Well, my luck is bound to change for the better eventually, right?

I have my follicle check u/s on May 18 (CD 13), so I will know more then about when the IUI might be.

Here we go. Hope this works.