Tuesday, March 31, 2009

Warning: May be offensive to some readers

Disclaimer: I don't wish to offend anyone who reads this blog--and I appreciate any and all who do and who comment--but at the same time, this is my place to vent my feelings related to TTC. Some of you who are devoted believers in God or in the power of prayer may find this post offensive. You have been warned.

I was raised strictly Roman Catholic by my father and my devout Irish grandmother. (My mother, raised Protestant--Presbyterian, I think?--promised when she married in the Catholic church that her children would be raised Catholic and thus supported this path as well.) Until I went to college at age 17, the only Sunday of mass I had ever missed was when I had the chicken pox at age 6. . . and then only because I was still contagious. We even attended mass on holy days of obligation, made sacrifices during Lent, didn't eat meat on Fridays, prayed the rosary, the whole deal.

So I guess it's no surprise that I often think about religion and sometimes consider going back to attending church regularly. I'm not certain that my beliefs are any longer aligned enough with Catholicism to allow me to attend the church of my youth every Sunday (though I do still go on rare occasions), and I've not found another church where I feel more comfortable.

Church is also an activity in which MM has no desire to participate. He was raised Lutheran and went to church regularly with his mother until he was confirmed at age 13. . . . after which he was told that whether to go to church was his decision and he promptly stopped. Pressed to describe my husband's religious beliefs, I would likely say he is agnostic. He believes in a supreme being but doesn't particularly believe in organized religion. He thinks that most of the questions which religion seeks to answer ask the unknowable. (He thinks that "religion is a crutch for the weak-minded," too, but that's another post.)

I've been thinking about God and religion these past few days for a few reasons. One is that a dear friend of mine has asked me to be one of her infant son's godmothers at his Episcopal baptism on Easter Vigil. I am very honored to have been asked! Although my sister long ago asked me to be Rowan's godmother, Rowan has not actually been baptized as yet, so this will be my first time serving as godmother. So I will be going to church again--a church much like my own--in the near future.

Also, happily, the case on which I serve as a CASA volunteer may soon be coming to a close because it looks as though a successful adoptive placement has been found for little M. I don't want to raise my hopes too much, lest things fall through (as they have before), but M had a positive first meeting with the prospective parents last weekend, and things are proceeding. I really hope this is "it" for her; every child deserves to have a permanent, loving home. Thinking of M's circumstances thus far in her young life (a mere nine years) often makes me question the existence of a benevolent God.

Then I heard about two other things today that give me additional food for thought. A coworker related a story about a two-year-old girl who she encountered at an urgent care last night whose mother (younger infant also in tow) exhibited an apparent disregard for her child's needs and developmental level. And an online friend of mine who recently had IVF found out that she is not pregnant.

Working as a volunteer with abused and neglected children in foster care and just living life and observing what goes on around me, I have long found it hard to see a benevolent God at work in deciding who becomes a parent. I've known parents who are abusive, more who are neglectful, and parents who put their addictions before their children's best interests. I've known plenty of people who never wanted children and didn't really want them once they arrived. I've known an even greater number of parents whose behavior would not qualify for the intervention of Child Protective Services or the like, but is damaging to the child all the same.

In addition to my 7+ plus years as a CASA volunteer, MM supervises felons on probation, so there isn't a week that goes by when he doesn't hear about someone's unplanned (and usually unwanted) pregnancy. Most of his male felons have little or nothing to do with the children they father, either in terms of financial support or actual involvement in the child's daily life. I suppose it is possible for someone to be a convicted criminal and still be a good parent, but that's not usually what MM sees.

At the same time, I know a number of decent, caring, successful people who are unable to have children of their own. As one example, one of the partners in my firm--a devoted, Christian family man who has been married for nearly 40 years--has two grown children, both of whom have struggled with infertility. (His daughter ended up having two children through IVF, and his son and his wife are still waiting to adopt, after having had one adoption fall through--heartbreakingly--just before Christmas last year.)

As we have continued along our own longer-than-expected journey to parenthood, I've met (via the internet) even more people who fall into this latter category. It sometimes almost seems that one's fertility is inversely proportional to one's ability to be a decent parent. (Well, not really, because I do know a few good people who have four or more children and are good, loving parents.)

Putting aside the obvious effect on those who want children and cannot have them--because one could argue that it's somehow part of "God's plan" for some of us to wait longer/work harder to become parents--when I think about this state of affairs, what makes me doubt God's involvement in the process is the children themselves. What child deserves to be born to a parent who will abuse or neglect her? Or to be unwanted? Or even to be born to a parent who will fail to nurture her and allow her to live up to her full potential?

The only explanation that has allowed me reconcile what I see in the world with God's existence is this: whether and when children are born, and to what parents, is something with which God does not involve himself. Like war, or famine, or disease, it's simply a part of the human condition, and no amount of prayer or devotion will affect it one iota.

The other logical explanation--that God allows innocent, defenseless children to suffer needlessly--is just unacceptable to me.

I know there are those who "pray to become pregnant," and I certainly don't judge them. I have prayed about numerous things in my life myself. But I for one don't believe that prayer works for this. To the extent that I pray about TTC at all, I pray that God will grant me the grace and serenity to accept whatever happens and to cope in the event that I never have a child of my own.

And yet if I *DO* ever have a baby of my own. . . . I am sure I will say that I am blessed.

Waiting

wait (v): 1. to remain inactive or in a state of repose, as until something expected happens.

Today is CD 27 for me, which means that if this cycle follows my usual pattern, tomorrow will be CD 1 of a new cycle. That means that I could be starting Clomid in just a few days! I have mixed feelings about that but am feeling good about actually taking some affirmative steps (beyond just the standard "have lots of sex" approach) to get pregnant.

For me, waiting has been one of the worst parts of TTC. I am fortunate in that I ovulate pretty regularly and don't have anovulatory cycles, so my "wait" to ovulate has usually been about the same as anyone else's and of a predictable length. Of course, there is the dreaded two-week wait every month. And once we started testing, we have had to wait on the results of our tests, too.

Now that we are starting treatment, the stakes will be even higher. Now each failed cycle will not only represent another month of time lost. . . it'll also mean money spent that we will never get back.

Like many other Americans, I'm not great at waiting. It's not even so much that I'm impatient, though I am. It's more that I prefer to take action rather than sit around and hope for the best. I'm a "take charge" kind of person.

And yet I wait.

Monday, March 30, 2009

Oh, no, he didn't

I think I've mentioned here before that my father is not really "in the loop" about our conception efforts. As best I can recall, he asked me when MM and moved in together last summer whether we'd considered having children (pointing out my advanced age, thanks Dad), and I told him then that I'd been off the pill for a few months. I kinda led him to believe that we were not preventing but not exactly trying.

I love my father dearly, and we have a pretty good relationship. I'd have no problem confiding in him if it were just him I'd be telling. I confided in him throughout my childhood, so I know him to be discreet and capable of keeping things to himself. (As one example of his discretion, he never told us that my mother--his ex-wife--had had a child out-of-wedlock before they were married. He waited for her to tell us when she was ready.)

The reason he is on "limited information" status is because of his wife. My stepmom--whom my father married when I was 18--and I have a pretty decent relationship as stepmom/stepdaughter relationships go. We are far from pals but are not exactly a Cinderella situation either. I do not view her as a second mother--being already a sophomore in college when she married my dad--and she's not someone I'd ever choose as a friend. Regardless, she is a good human being who I do believe generally has my best interests at heart.

However, though she is a very nice person. . . . my stepmom cannot keep a secret for sh1t. I've learned this through painful experience: there have been two separate and distinct occasions where I have shared something with my father in confidence that has been disclosed to people who are decidedly NOT "in the know" about my life by my stepmom. The last occasion was as recent as about three years ago.

Because it's pointless to try to stop my father from telling his wife things--not even sure he'd agree to try--I decided long ago that the easiest course was just to not tell him things either. He was the last of our four parents to know about my plans to marry MM, among other things: MM's parents, my mom, and my sister all knew months before I told Dad.

In a way, I hate not letting my dad know as much about my life as he otherwise would. But he has seemed blissfully unaware thus far, so no harm done.

On the phone this morning he hinted to me about whether I might be pregnant. I told him that I am not. He then asked whether MM and I have "been tested" at all; I guess he is beginning to think (as are we!) that I should've been pregnant by now. I told him that MM and I have both had a full, general work-up done by a doctor who specializes in these things and that all our tests are normal. At which point he said, "Well, I guess you guys just need to relax and it'll happen."

So yeah. I got the "just relax" comment from my 67-year-old dad. Wonder what he'd say if he actually knew that we've been actively trying for 14 cycles now and will be starting intervention soon. He'd probably REALLY think we need to "relax" then. ;-)

Friday, March 27, 2009

We have a plan

Our rescheduled appointment with the RE was this afternoon. I really like our doctor and have heard nothing but good things about his clinic. . . but again today, we had to over 30 minutes past our appointment time to see him. This on an afternoon when the scheduler told me on Tuesday he had nothing else set! Clearly that was not the case--or things were set after our appointment--because I saw him coming out of a treatment room prior to seeing us and he got buzzed that his next appointment had arrived shortly after sitting down with us.

I supposed it's a good thing to have a RE who is in demand, but neither MM nor I are patient people by nature. And being a lawyer in private practice who must account for her time by the billable hour has not made me more patient or tolerant of waits! Couldn't help but that I wasted 0.6 hours of billable time. Dumb, I know. Anyway.

We finally got in for our consultation, and we were both pleased with the way things went. MM's repeat S/A was much better: way fewer "round cells," a concentration of 95 million sperm/ml (can't remember his total count, though), and morphology of 10%, which the RE said was fine. We discussed our options. Well, to be more accurate: I told the RE that I had researched our options and asked him to tell us what he would recommend as a first step for treatment. (MM hardly said anything, and most of what the RE said confirmed what I'd already read. Nothing like having done your research!)

The end result is that I am going to start Clomid this coming cycle if I am not already pregnant. (And I have no reason to believe that I'm pregnant; I have zero symptoms, and in fact, we had less sex this cycle than usual, especially during my fertile window.) We will do a HCG trigger shot and IUI. Although I don't want to waste any more time than necessary, we're not ready to jump right into IVF. . . and it doesn't make sense for us to do so, given that we are "unexplained" and probably "sub-fertile" rather than "infertile," according to the RE. Plus insurance will pay for a portion of IUI and nothing for IVF.

He wanted to wait on giving me injectibles until he sees how I respond to Clomid and said that he would be concerned about the risk of multiples with MM's high sperm count if I responded too well. So he would like to start with a Clomid cycle to see how my ovaries react.

MM was very pleasantly surprised to hear about his good S/A ("super," as the RE put it) and was encouraged because he felt that the doctor sounded confident about the chances of getting me pregnant. He is optimistic that the IUI and Clomid will work on the first try and we won't have to pursue any other treatment.

Of course it'd be great if this works on the first try, but I'm realistic and like to look ahead and consider the "worst case scenario." We've agreed that if I am not pregnant after two cycles of just Clomid and a trigger shot, the RE will add injectibles to the mix.

The nice thing about using only Clomid and a HCG shot is that the entire cost of the IUI, including drugs and monitoring, won't be costing nearly as much as we thought: the full, cash price would be just under $1000, and we'll be paying less than that because MM's health insurance will pay for 50%. . . and 50% of a lower rate at that because it's insurance.

We're too late to have a 2009 baby, but I'm hopeful that I can still be pregnant before I'm 39 and a mom before I'm 40.

Wednesday, March 25, 2009

Postponed

We got a call from the RE's office yesterday asking if we would be willing to reschedule our appointment to Friday afternoon due to a "personal matter" of our doctor's. So we should have been at our appointment as I write this but instead will be seeing the RE at 3:00 on Friday afternoon.

Another RE in our clinic performed my vaginal u/s and HSG, so we have only seen our doctor for our two "sit down and discuss" appointments. I will note for future reference that this is the second time (out of three appointments) that we have had to reschedule due to unforseen circumstances with our doctor. And at our first appointment, he was running behind and made us wait 45 minutes past our appointment time before we saw him.

We like our doctor, and he is one of the best in our state, but I'm not sure how comfortable I feel will all the scheduling difficulties. I 'm not at the point where I'd consider switching clinics or even doctors yet, but I hope that this won't turn out to be an issue once we start treatment.

Monday, March 23, 2009

Time away

MM and I returned last night from a long weekend in the NYC area with my sister and her family. I didn't think about TTC much while we were gone, and it was terrific. I'd brought along my Chinese herbs, but didn't take them as it turned out to be way too inconvenient when we were out and about all day.

We got to spend time with my much-beloved (& only) nephew, 2-year-old Rowan. MM was so terrific with him. In fact, I think Rowan now likes him more than he likes me. LOL Anytime MM was not in the room with us, Rowan was asking "where's Unca M?"

Rowan is an adorable child and basically very good. He is 2, though, so he can be uncooperative at times and is understandably into everything. It's so fun to hear him talking in complete sentences, singing, and seeing how his mind works. He's obviously very bright.

On the flight home yesterday, I read Tertia Albertyn's book about her struggles to have a child, So Close: Infertile and Addicted to Hope. Overall, the book was a good and quick read. Some parts made me cry (and I am NOT generally a crier), and her style of writing made me laugh in places, too. I started out thinking "how could anyone go through nine IVF cycles?" Once I'd read the whole book, it made a bit more sense to me.

When I was tearful midway through the book, MM noticed my tears and asked what the book was about. When I explained, he shook his head and said that he couldn't understand why anyone "in our situation" would want to read about something like that.

I guess that is a key difference between MM and me. As our quest to conceive a child of our own has continued, I've become more and more interested in reading about other women's struggles. He still doesn't like to think or talk about the whole thing much.

Our appointment with the RE is in two days. I have mixed feelings about it, but do feel that we need to start doing something.

Tuesday, March 17, 2009

Disclosure

MM successfully provided his semen sample for his follow-up semen analysis today. He produced it at the RE's office and said it wasn't quite as bad as last time because he knew what to expect. He still felt that the amount he produced was less than his usual but said it was "more than last time."

Aside from his having a brief minor freak-out that the lab might have run the wrong test--another basic S/A rather than a S/A including strict Kruger morphology--which I cleared up with a phone call to the office, it was minimally traumatic for him.

Given the way things went with our last round of testing, I don't expect to hear anything about MM's latest S/A until our follow-up appointment with the RE next Wednesday. It's probably better: we are leaving town tomorrow for a long weekend in NYC with my sister and her family. If the results are less than encouraging, it will be better for MM not to find out just before spending four days with my two-year-old nephew.

MM had dinner with his parents without me last night. He was already out in their neck of the woods (about a 45-minute drive from our house) for a spring training game, and I had a meeting with a doctor at my office at the same time that could not be rescheduled. It was the first time that MM has been alone with his parents for quite some time; generally speaking, we see them about every other weekend for dinner, and we both go together. (The one time he went alone, after we were engaged but before we were married, his parents were really weird about my not being there, so we decided that we wouldn't repeat the experience.)

When I have asked him whether his parents know about our TTC struggles, MM has said that they don't "need to know" and that it is our "private business." I personally have no problem with their knowing. My mom and my sister both know about our efforts and testing thus far and have a rough idea of what our future plans for intervention are. (My dad doesn't know anything but that I'm off birth control. . . . but that's because his wife can't keep a secret and I know from hard experience that he can't NOT tell her stuff.) I have also told a few friends who are discreet and also sympathetic because they have either struggled with infertility themselves or have a close family member who has struggled with it.

In some ways, I feel MM's parents should know because they have a vested interest in the outcome. MM is an only child, so MM is their only available path to grandparenthood. They never pressure him or me in any way--that's not their style--but I know they'd love a grandchild or two because it's been mentioned. I've also had a feeling on a few occasions when I've declined wine at Sunday dinners that I've inadvertently raised some hopes.

So I was interested to hear last night that he had decided to tell his mom and dad everything at dinner (at Red Lobster, no less). He told them that we've been TTC for nearly a year, that we've had a full basic work-up done which showed no problems with either of us, and that we are seeing the RE again next week to talk about our planned next step.

He said they seemed mildly curious but didn't ask a lot of questions. His father did express concern that we might do IVF and end up with "quadruplets or more," and his mother volunteered that they know a woman personally who did IVF and had triplets. But once MM told them that we are not to the point of doing IVF (yet), they were reassured and only had a few questions about how IUIs work. (Not that MM is well able to field these questions. . . . )

I actually feel good that he told them. Not because I necessarily want more people "in my business," but because I think it's good for them to know that we are struggling with this. I'll be 38 on Saturday, and I certainly don't want them to think that we are purposely putting off having children. I also want them to have the opportunity to mentally prepare themselves, as MM and I have done, for the possibility that we may never have our own biological child. I think that will be as sad a realization for them in some ways as it has been for us.

I'm interested to hear how others have handled this situation. Who have you told that you are TTC and how much detail have you given them? And looking optimistically ahead. . . . who will you tell when you get pregnant, and when will you tell them?