I'll take one miracle please...

I honestly don't know why I am writing anything today. I have nothing to say that is different from what I've said before or is in any way constructive. I am just soooo depressed. Things seem completely insurmountable and horrible. I cannot snap out of it. IM is feeling the same.

We are moving on to the next step...obviously since we've failed at every single thing we've tried. Adoption. "Hey, you can always adopt!" "Hey, have you thought of adoption?" Yes and yes...I have heard of adoption before, like all other sentient human beings!!! and yes, in a way, one can always adopt. HOWEVER, it is entirely more non-trivial then just about anybody realizes. It is no surprise to me that some couples opt for yet another IVF cycle. At least that is a known...you know what it costs...how long it takes...what it entails....the emotions that will come with it. By now, we are pros at IVF cycles. Not that they are easy but we know what we are doing. But, what is the point of another? The writing is on the wall--it's been on the wall for a year. It's just never gonna work for us. I have just as much confidence in IM becoming pregnant naturally through a miracle or immaculate conception as I do in an IVF (natural or donor) cycle working. That as, I have almost zero confidence in both. I feel like I'm locked in a room and there is no way out. There are a few doors but they are locked and I don't seem to have any keys and, in fact, I'm not even sure if keys are what I would need to open them at all or even if they are actually real doors and not just mirages of doors. There are no windows and no way to communicate with anybody outside. The only way out of this room is via some sort of miracle. Where is our miracle?!?!
Without a miracle I don't see any way out of this place.

So...adoption? How's that sound? Well, our situation is slightly unique (only slightly) in that we are not a "typical" white couple or a typical black couple or a typical hispanic couple...ok...we're an interracial couple and finding a child that "matches" us is seems pretty much impossible without a miracle. (Of course, what does "match" me and is that a ridiculous concept to even think about? Probably.) International adoption has become completely absurd in that it takes nearly 2 years from the beginning to finally having a baby, and it is almost not even a baby since, at the youngest, it will be nearly 2 years old. Anyway, all of our concerns are surmountable I know. It is just a matter of thinking them through and tackling each of the so-called issues one at a time and most likely determining that they are not really issues at all.

After all, we've gone through this process before. First it was dealing with the prospect of seeing a Dr about fertility. Then it was actually getting tested--sperm test, ultrasound, blood test, etc. Then it was actual treatment--actually seeking out help to do something that is supposed to be done naturally...something that is supposed to be magical and wonderful. We didn't know it at the time but it was THEN, 5 years ago, that the dream died. It just wasn't obvious at that point. It seemed the dream was salvageable. (I don't mean to sound horrible and cynical and negative, I'm just begin realistic and pragmatic....my life, fertility-wise, is all too real.) Then it was the whole process of going from simple, relatively inexpensive treatments to the big daddy; IVF. Then it was donor eggs. Now it is adoption.

I'm just fucking exhausted. I need a miracle....oh I'm too realistic...I "want" a miracle but I "know" they don't exist. Please, can I have a miracle anyway?

Trying to keep my head up

I am feeling so sorry for myself today. I've been on the verge of tears all day and my boss even asked me if I was OK. Which somehow made me feel worse and I almost broke down right there on the spot. I'd like to blame it on hormones but it's not. It's just this. This whole experience.

I found out two of my colleagues from my last place of employment (whom I still work with from time to time) are both pregnant. For one, it's her second. For the other, it's her first and she's only been married for about 6 months. And of course I am thanking my lucky stars that I don't work with them anymore. Because I know I could not have handled it one bit. I am a wreck at just the thought of them. The idea that this comes so easily to everybody else but me.

I spend some time on Friday night with an old friend who had a kid about 3 months ago. He knows our situation except for the donor component. He feels for us, I know he does. And yet he spent several hours talking to me about how his wife is depressed and feeling lonely, burdened with the new responsibility of being a mother, and how much work the baby is. Well boo hoo. It was a fine line because he obviously has this disconnect between talking about my situation and talking about his. I mean, he doesn't realize he's complaining. And realistically speaking, he's NOT. But of course, to me, he is complaining and it's almost unbearable at times. I finally told him I don't feel sorry for them. That was about it.

And I have had indications that another childhood friend is pregnant. If she's not, she will be soon. I know they are trying.

I think it's all just too much for me right now. I'm just so depressed. I wish I could go home and have a good cry. I need it.

Testing a new mantra

Well, the cycle failed. The inevitable question is "now what?" Adoption? That's most likely since we've just about run out of reasonable medical options when you factor in that IM is totally exhausted and demoralized by treatment. Unfortunately, adoption is not a particularly easy road to travel either. Such is life. Anyway, something occurred to me while thinking about all this stuff and I wrote the following email to IM:

"You know...for some reason today I'm feeling like wishing and hoping for us to have a baby through IVF or some miracle is equivalent to wishing you were taller. You know what I mean? What's the point? We are what we are."

Perhaps that will be new mantra. We are what we are. Is that any good?

Of course it was...

IM took a home-pregnancy test last night when we got home from our trip. Of course, it was negative. Of course it was. It seemed completely inevitable. After all, I actually went on the trip with her so I could administer her shots and all that jazz. $380 and 3 days off work so that I could give her a painful shot every morning while the embryo inside her most likely was already dead. The official pregnancy (beta) test is Tuesday but, really, what's the point? I know, really without any doubt, that miracles simply do not exist--I have never experienced one, so, what's the point of a pregnancy test on Tuesday.

Even having been through this many times before it is always devastating. I laid on the couch for about an hour and then went to the store to get beer and wine so that I could get drunk. Honestly. That lame, drink your sorrows away, type of drunk. The kind where the sorrows don't really go away at all.

IM keeps saying this is like some sort of cruel joke. We have sacrificed so much and compromised so much and given up so much and been through so much. Enough already.

This has been an impossibly hard year and I'm completely exhausted and beaten.

Right now I'm sitting in a hotel room trying to work while IM is going to a conference at the hotel. You see, I came with her on this business trip so that I could give her shots in the mornings since we are still in the 2WW and she has to have delestrogen (every third day) and progesterone-in-oil (every day). So...about $300 to make her life a lot easier. She's not the type that can give herself shots. These are hard-core intermuscular shots with big needles, so I don't blame her. At first she thought maybe there would be a clinic close by she could go to and have them give the shot. Ugh. Considering the amount of $$$ already spent in this process, $300 is not too big a deal so I came with her. Luckily, my job allows this kind of thing. But it really does provide a good example of how much work it is and how inconvenient going through fertility treatment is.

We have a pregnancy test for Tues and IM will most likely take a home-test on Sunday when we get home.

I'm feeling really down about this cycle and really negative. I don't know why. It just feels pretty hopeless right now and it seems like it cannot possibly work. But...I don't know anything and there is obviously still a chance. The transfer went pretty close to perfect...no...it was perfect. The embryo thawed out almost perfectly with 95% cells intact and growing. That's all good news.

Anyway, the hotel is actually really nice, I've been running every morning, and I have been able to see some family that we have that lives here...so all in all it's not so bad.

Let's just hope IM is pregnant. Then all of this, and all the BS we have been through, will have been worth it.

Breathing...

Waiting, waiting, waiting. To quote my mother-in-law "breathe innnnnn, breath oooouuuuttt". I wonder how our little Mr. Bubbles is doing? I suppose we will find out soon enough.

Embryo transferred

Well the little guy thawed out just fine as it turns out. The doctor said we had 95% of the original cells which is great great great. So we made it thru the first hurdle. We were both fearful that it wouldn't thaw and this would all be in vain.

The transfer today was smooth, partly because of the dilation of my cervix last month before the cycle started. My RE was the one who did the transfer which was wonderful because she knows my crazy roller coaster of a cervix anyway. But it went smoothly.

So now we have the 2ww ahead of us. The clinic gave us a picture of our little embryo-- this is the first time they provided this. Our previous clinic used to give us a chance to see our embies under the microscope which was super cool. But today we got a picture which was exciting. We are calling the embie mr. bubbles for now. It may evolve. I wanted to call him mr. blob but that was just too ugly.

So now we wait. Intended D has already been doting on me and i love him for everything.

Wish us luck...

Today's the day. We have the FET today--frozen embryo transfer. A lot of things have to go right today. The embryo has to survive the thawing process just like Austin Powers. I've been worried about this and full of anxiety for a few days now. We only have one embryo so really nothing bad can happen. So, wish us luck or say a prayer or whatever!

IM is got a bag of frozen peas on her butt right now and I have to go give her a shot. Lot's of fun around here!

Cycles, emotional that is....

IM mentioned to me the other day that a couple we know (they are loooonnnngggg time friends of ours and nearly the same age among other similarities) are TTC. Trying To Conceive.

Riding my train to work this morning a thought popped into my head, for no good reason: If this cycle we are doing right now fails--and it certainly has a good chance of failing considering our previous record--and our friend gets pregnant, I don't know how I'm going to deal with it.

The thought literally made my heart sink in that anxious way. You know that feeling? That emotion that makes you want to simultaneously curl into the fetus position and run as fast as you can for the hills? That emotion that makes you want to "check out" of your life and start anew? That feeling that made Forest Gump start running? That's what I felt when this thought came creeping into my brain. To make matters worse and more complicated I am very unhappy, guilty, and frustrated that I feel this way regarding somebody we love having success. Not only success, but the realization of a dream most couples share. It is certainly our dream. Ah, but there's the rub, right?

I fucking hate this!

...our next step if this cycle doesn't work is relatively obvious. We are running out of options after all. Adoption...another donor cycle...another fresh cycle? Childfree is not in our future...we are not a childfree kind of couple (not that there's anything wrong with that...we're just not). Even though the next step is pretty well established it fills me with unhappiness and anxiety which is 99% due to just sheer fatigue. A normal human being simply cannot fail repeatedly at something they long for with such passion without long-lasting detrimental effects. Post-traumatic-stress-disorder? Seems about right.

How's that for melodramatic? What was my "mantra" again?

Officially started

Last night I game IM a shot of delestrogen and the cycle is officially under way! It sucks that the tears she was crying had nothing to do with the shot physically hurting, although I'm sure it did. She has had hundreds of shots by now. It is beyond old at this point and starting shots again for another cycle just reminds us that we've been down this road before and it ended in failure. Anyway....there's no need to be depressed just yet...there's always plenty of time for that later...so here's hoping for a successful implantation in a few weeks!

Well...it has begun

Today we went to the IF office to sign our waivers or whatever you wanna call it. I would prefer to just put my signature on file and mark my preferences once and for all. We've filled out these stupid forms about a dozen times and I'm just getting sick of it. Initial here..initial there...sign here. Fine. Do whatever you need to do to impregnate me wife! I'm okay with it!

Anyhoo, IM had blood work and an ultrasound. I'm sure everything is ok and depending on blood levels she'll get a shot, administered by yours truly, tonight to officially kick of the festivities. For a FET cycle IM has to take progesterone-in-oil and delestrogen (I think). They are both intramuscular shots and, hence, painful...and not very fun to give either. The progesterone-in-oil is the worst b/c it's a large dosage, hurts like hell, and the oil doesn't really break down well so IM will get knots and bruises....her bruises don't really show which is nice I guess but they still hurt. Let's just hope I don't hit a nerve (LITERALLY!) on accident. The whole point of the meds is to prepare her body to be pregnant since it's not a natural cycle and she won't ovulate so her body won't be ready. I'm sure we've blogged about the details before and I'm losing interest in these types of things anyway. I know way too much about a woman's cycle considering the fact that I'm not a medical doctor. Plus, I didn't become a Dr b/c I'm just not that interested in this stuff...so there! And, yet, I now know it anyway. Great. Still, though, the science behind ART is pretty amazing and fascinating.

Many things have to go "right" this cycle. IM's preparation via drugs hopefully goes well and she remains relatively healthy for the cycle. The embryo needs to survive the thawing process. Both embryos survived perfectly last time so hopefully this one will too...but you never know and it is a painful thought to consider that it might not make it. Pretty devastating. Plus, a bunch of unneeded drugs would've been taken. Then, the transfer has to go well. We've had potentially important issues with that since IM's pathway to the uterus is like a twisty path of death evidently...we've blogged about it before. So I'm hoping for the best and repeating the mantra of "Why not us?". It could work. Nothing says it can't and IM actually got pregnant last cycle...so it did work in a way. So this can work too. IM, of course, is taking the usual tactic of assuming it will not work since it hasn't after all this effort b/c she doesn't want to be disappointed when (if?...let's stay positive) it doesn't work. Whatever. At the end of the day our success or lack thereof for this cycle doesn't change depending on our fucking attitudes. The world is too cold and cruel for attitudes to matter. I know that as an incontrovertible fact through my personal experience. The "universe" doesn't fucking care about anybody one way or the other. Shit happens for random (but well established scientifically) reasons. It's not as if we don't have a baby yet b/c IM and I are not sufficiently positive and hopeful. I mean honestly. This isn't the fucking Secret. Oh wait...what was my mantra. "Why not us?" Ahh, there it is. "Why not us?" "Why not us?" "Why not us?" "Why not us?" ...

Stories seldom told....

I meant to write about this quite a while ago but never got around to it. Since today I'm feeling quite lazy regarding this blog I figured I may as well say something in an attempt to jump start things a bit.

Emotionally I'm in that lame limbo...or purgatory is probably a better word...state where we are going to start all the meds here in a little bit for the next cycle. We have one frozen embryo left and are hoping to hell it works. Anyway...I don't want to write about how shitty I feel about everything infertility and how infertility feelings infect nearly everything else and start eating away at my ability to feel confident in other life areas and take pride and feel happy about my job and blah blah blah it goes on and on.

So...I thought I would give a Cliff's Notes version of a story. This kind of story is very seldom told because it's just too fucking terrible to repeat more than once or twice.

We have an infertile friend who is in somewhat the same situation as us. (By friend I suppose acquaintance is better but IF brings people together on a different level.) Her situation is easier than ours (in that they have not been at this as long as us) and harder than ours (her family situation is much more pressured and frustrating). Anyway, she and her husband decided to do a donor cycle. Of course, as documented on this blog, this decision is agonizing and long and hard in itself but they did it and chose a donor they were happy with. The did a cycle and everything worked splendidly. She got pregnant with twins! Of course, twins is not what you want because there is a higher chance of complications but...whatever...people have healthy twins all the time. Well, as shitty luck would have it they lost one of the twins quite early on....but late enough that they were able to hear two heartbeats...so this I'm sure was a devastating loss. Then...as luck again would have it...she lost the other. This time, however, was much further along. IM knows how far along (I can't remember) but it was far enough that she had to go under the knife, as it were, to take out the fetus. I suppose in a warped sense it could've been worse and she could've been asked to deliver a dead baby. I literally cannot imagine how they are dealing with this loss. So many compromises of dreams and compromises of entitlements--simple things 90% of people get automatically--are made before a person even gets to donors. Then a whole new set of compromises and grieving the loss of a whole other set of dreams kicks in. Then, if the cycle works, a sort of miracle occurs (honestly, the more I think about a successful donor cycle the more astonished I am with the....miracle of it all). To have that brutally taken away is something I wouldn't wish on Satan himself. There are no words to comfort them and there is nothing I or IM can possibly say. Not to mention the very real fear that something like that could happen to us.

Women that get pregnant through IVF or donor cycle IVF do not have normal pregnancies. Not that they are full of complications necessarily but the naive joy that 90% of women experience during a pregnancy is always rudely taken away from infertiles by fate and life. That's one of those hard things to learn personally and harder to explain to somebody else. It is also at the root of how a successful IVF cycle DOES NOT CURE INFERTILITY. It does make you a parent though and that's ultimately what we are all hoping for!

...update...

One of the main points of this blog (to us at least) was to document this so-called journey of ours. So, in that spirit, here's an update.

The last cycle failed in a miscarriage. IM almost had to take some sort of miscarriage inducing drug to...well...what's the word...force a period and hope everything came out on it's own. Otherwise, a surgery (D&C I guess) would have been necessary. Everything, however, went fine and we didn't have to do anything besides let it happen on its own... and we are thankful for small blessings. After the period she went back on b.c.p.'s b/c the Doc wanted to take a look inside her uterus to make sure everything was on the up-and-up. This last Friday, IM had the procedure which is non-trivial to some extent since it requires anesthesia (a lot like an egg retrieval) and they put a scope up through the cervix into the uterus and look for polyps, fibroids, scarring, and anything else. She passed with flying colors! So, that's good....and bad in a way since we have no idea why she miscarried. I guess sometimes shit just happens and there's no explanation. Besides, had something been wrong she would've been looking at another surgery. The one bit of news is she evidently has some sort of polyp in her cervix which can't really be removed without risking real problems and it doesn't really affect anything anyway. What it does do though is it makes it hard to put a catheter up the cervix into the uterus for embryo transfers...which IM has always struggled with. The last couple times it has been a painful and frustrating exercise as the Dr is trying to insert this catheter up there again and again. Then the Dr has had to switch to a harder catheter which, as our luck would have it, has lower success rates...I guess it is more likely to damage the embryo on transfer. Then there is also the issue of IM's pain and cramping as the Dr tries to shove this catheter up her cervix....there is the potential that this cramping hurts the chances of the embryo implanting. Sooooo...because of this surgery, IM's cervix is dilated (from the surgery and will stay that way for a while up to the transfer hopefully) and the Dr mapped out the route through the cervix to the uterus in great detail. Apparently you go straight in and take a sharp 20 degree right turn! Whatever.

Well, with all of that done we have the green light to go ahead with our last embryo which is literally chilling out waiting to be hatched. The transfer is set for Nov 11. I'm trying to be positive and imagine it working but it's very hard since we've had so many repeat failures. The upshot with this whole endeavor is that if this doesn't work we get a boat load of money back since we are on a shared-risk plan (that will soften the disappointment a little bit I suppose). Also, that means the Dr is highly motivated for this to work too :)

...alright...I'm not in the mood for anything more.

Out of the archives...

It's been a couple months since I posted or even looked at the blog. It seems like the hit counter is a lot higher than last I looked. So if anybody is reading this, I hope it's helping. Or means something to you. It's been really a couple rough months. The miscarriage happened in June. It's now September and my body is just barely recovering. Mentally I'm not sure I'd say I'm as well. Intended D and I have been fighting more than we probably have in the last 8 years of our marriage total. We are at a point where we both feel really helpless. "I feel impotent and out of control. Which I really, really hate."--- to quote Clueless. (would it be funnier if impotence were our problem? I dunno.)

I am not worried about our marriage per say. I'm more just worried about our mental health. We have finally reached that point where it feels like there are no answers. Having a donor cycle fail. Man. We just didn't see that possibility as a strong one. Donors are supposed to be the solution aren't they? That solution that we finally take the plunge and accept. The option we finally embrace as that one gift that comes with a huge compromise --- but a compromise that gives us so much that it's worth it.
And then when that fails, then what?...
Then we move on of course. But it's so painful. How many times do we have to compromise?

We have one more frozen embryo using donor eggs. One more. So now the questions start surfacing... Should we get a second opinion? (or more like a third, because this is our second serious IF clinic and we have had the same outcomes from both of them...)
So a third opinion would have to be from one of the miracle clinics... Cornell or Sher or one of the voodoo doctors who don't follow the protocols established by the mainstream docs but who seem to make occasional miracles happen. But are they really miracles?
And the more important question is: do we have the emotional stamina to actually track down the miracle solution? *sigh*

From the archives of my email I found an email that I consider a third, fourth and fifth opinion. We were the case study that was presented at our clinic's monthly case study. They all discuss the case, figure out as a group what's going wrong. This was from February 2008. Yes, a year and a half ago, when we started up with IVFs at our current clinic and had a failed cycle. It was already our 3rd IVF total. So the following is an email I sent to Intended D. Because we are using this blog as a record of sorts, I thought it would be a good idea to post it here so remember these details which I am prone to forget in the abyss of treatment cycles and protocols, conversations and phone calls that have occurred over the years...
---- Original message ----
Date: Mon, 11 Feb 2008
From: Intended Mommy
Subject: conversation with the doctor
To: intended D


So I spoke with the doctor for about 15 minutes.

The information from the cycle indicates to her that it goes back to my egg quality again. We had 27 mature eggs, and only 14 fertilized normally. There were another 7 that fertilized abnormally. She said that is an indication of egg quality, like what we talked about with (our first previous favorite RE).

Normally this is correlated with diminished eggreserve, but of course in this circumstance, I havelots of eggs, they are just abnormal. She had no explanation for this, the science hasn't come that far (although she didn't say it that way...)

She is going to present our case at their weekly case meeting, to get other feedback from other doctors. So that'll help, and she'll get back to me next Tuesday. The suggestion she made re: protocol is changing it to another protocol where you don't use lupron, but use another drug to maintain suppression of the ovulation. It's called an antagonist protocol if you want to look it up.

There is no data to suggest it is going to work. It's just another thing to try, to see if the embryos look any better.

She suggested if this next cycle doesn't work, she would be ready to recommend donor eggs, although she would be willing to work with us up to maybe 6 cycles if we wanted to. The arbitrary chances she gives us are 25% chance of IVF working. She has seen women in my situation, but it's not common. (The more common situation being diminished egg production...)

She doesn't recommend genetic testing because it requires removing a cell from the eggs at day 3 and then putting in blastocysts. It takes 2 days to assess the chromosomes. She doesn't think the embryos would be worth compromising because our embryos don't survive to day 5 anyway. NONE of the embryos grew AT ALL after day 3 this time around.

One thing she would have us try is a blood test checking OUR chromosomes -- checking the karyotype. If we come back with any mutations in our chromosomes, it might explain the poor quality of the embryos. It's UNLIKELY because we don't have any strange qualities that manifest. But it might indicate something that would at least tell us that we are not likely to create a health embryo at all..., so she is going to send us a lab slip to get it tested. It takes a month she said.

She doesn't think it's immunologic because that is typical for recurrent pregnancy failure more than just poor quality embryos. And she doesn't think it's the endo because again, all signs lead to poor embryo quality. Bottom line is there isn't much that can be done about poor embryo quality. (Unless we see a miracle doctor, of course) So for now we are going to wait until next week to see what comes out of the conference with the other REs.

(aren't you glad I took notes?)

---------------------------------------------

if anybody is wondering, the karyotyping came back normal, the immunologic testing I had after the miscarriage in June indicated an abnormality in the MTHFR but not an abnormality that explains anything. And of course here we are with donor embryos and we've still failed. What do we do now? Plan F was and still is adoption. We will love our child regardless of where the child comes from. I'm just tired.

At the movies...

IM and I went to see Julie & Julia yesterday afternoon...matinee price, baby! It's certainly a good movie and that "phony-balony" Meryl Streep is amazing in everything she touches. So when you add Amy Adams and Stanley Tucci...and, hell, I'll even include Nora Ephrom...then you are guaranteed at least an enjoyable movie.

(one might consider the rest a "spoiler" so if you haven't seen the movie and can not accept any surprises being ruined, however slight, then stop reading)

There really interesting thing to IM and I is that there were a couple scenes pointing out Julia Child's apparent infertility (or to be fair her and her husband Paul's infertility...not like finding who to blame is even a worthwhile enterprise except for diagnosis and treatment). The first scene is really subtle and I wondered who else noticed (other than infertiles) where Julia and Paul are at the park and a woman pushing a stroller strolls by :) and there is just a pause...and Paul squeezes her hand a little bit more and she glances his way. The 2nd is when she reads a telegram announcing that her sister is pregnant. She reads it in Paul's presence and proceeds to break down in tears while assuring him that she is very happy for her. It kind of chokes me up just writing it. It was a very well done scene.

Anyway, another interesting thing is a few movie critics (notably salon.com) and film bloggers noticed the infertility part and mentioned it in their reviews. Of course, any asshole with an opinion can opinionate and the review at salon.com got some interesting ones...such as this one, this one, and this one. The first two are completely asinine and rolling infertility in with feminism...come on! There is a rule: don't talk about shit that you don't understand. It's very simple and yet so many people don't follow it. The third one though is a little more interesting. How do we know Julia Child was infertile...was she? According to her biographies she never had kids and thought it would have been nice to have had them. But, I think it's a stretch to say it was no big deal to her. How do we know what a super positive, private, woman of her generation thinks. We barely talk openly about infertility now and it's 2009 for god's sake.

I guess I'm just curious about Child. There is always that sense of the infertility "club" so to speak and learning of a member you were unaware of is always kind of fun. Is fun the right word? I suppose it's nice to have evidence that you are not alone and that someone as accomplished and famous as Julia Child dealt with the goddamn bitch of an unsatisfactory situation too.

Oh...and evidently Julie Powell has PCOS....so she's in the club too. Too bad for her...but I'm happy she's open about it.

immunology testing

I have not posted in a long time because I just feel totally overwhelmed, frustrated, and confused about the whole situation right now. Well I'm totally overwhelmed, frustrated and confused about a lot of things in my life right now but that's another story.

But because Intended D wants to use the blog to keep track of our path, I should post the latest events. The RE decided since we had the 2nd miscarriage that we should finally do immunological testing. Thank god she didn't have to use any deductive logic, because the little computer gave her a red flag when she typed in m/c #2... So much for independent thinking.

So the results are back. I've not mentioned this before, but our nurse is one of those people who cannot complete a full sentence and uses "you know..." to fill in blanks far more than a person should. She talks to me as if I've been through this shit before. Well I haven't...So she leaves a lot to be desired in the communication department. But my RE is out of town until the end of the week so the nurse had to give us the report.

The MTHFR tests show 2 mutations. From what the nurse says, they show that I don't absorb folic acid normally. So I am supposed to now start on Fogard to help with absorption.

Despite the mutations, my "fasting homocysteine" was normal (I didn't do this fasting, btw... does this matter?????) so this indicates that the miscarriage wasn't the result of a clotting issue.

Secondly, my RE wants me to get an anti-thrombin 3 panel done, so I just had the bloodwork for that done a couple days ago. So now we will await the results of that.

Finally, I haven't had a period in almost 8 weeks. So they tested my estradiol, progesterone, and a beta. Beta was obviously negative. The nurse told me that my system is "quiet" so now they want to put me on provera to get things started again. It'll cause a lining to build up, followed by shedding. When I asked her if this would result in normal cycles again, the nurse advised me to start on BCPs again when I'm done with the provera and resultant period.

But she DIDN'T answer my question...

Of course it makes sense to start on the BCPs because we're planning on a hysteroscopy next. But it is disturbing to me that this is treated so lackadaisically. Isn't this kind of a big deal to just NOT have a period for so long?

So I might start on the provera tonight. I'm a little reluctant about this whole fucking mess. I'm anxious to talk to the doctor about it all. My nurse is useless.

This feels like a bad joke....

...so IM goes back into work after our 2 week vacation to find out that she will not be getting the job that she was promised months ago after all. Wow. Now she has 6 weeks to find something else....after turning down and not pursuing many other promising options of the last few months. I hope something better is around the corner but this year is really really really turning out to be quite lame. What's that phrase? "Fuck my life!"? Oh yeah, that's it.

Fuck our life.

Life goes on?...or does it?

...two steps forward and one step back....


Well, yesterday was a big day. Two couples, one family and the other basically family, welcomed new healthy babies into the world. Congratulations to them (and us too I suppose since we will be interacting with these little ones eventually and sharing in the joy).

Why do I feel so sad?

Life goes on?

I suppose life does actually go on and in that spirit...and in the spirit of keeping this blog moving along as well....I'm gonna blog about something pretty non-personal but interesting.

CNN.com has an article I stumbled across today with the title "Who's your daddy? A celebrity look-alike". Essentially, all it is about is a sperm bank in LA that tries to describe what the sperm donor looks like by comparing them to a celebrity that they resemble the closest. I think this is actually a great idea!

From the article:

"The goal was not to say you can have a baby that looks like Bob Saget," Brown said. "The goal was to say this donor happens to resemble this celebrity."

This is something I have thought a lot about actually...you tend to think a lot about a lot of stuff like this when you are going through this :( The same type of thing is also true of egg donation places where you are sometimes shown a few select pictures of the egg donor, sometimes only a baby picture of the egg donor, and sometimes nothing at all. The entrepreneur side of my personality was thinking of a egg donor agency (or whatever the preferred word would be) where the couple or woman meets with some of the staff and given some family photos. THEN, using most likely a combination of computer modeling and human intuition, a donor is chosen out of the egg donor database that will most likely provide the DNA that will produce a child that most resembles the family doing the choosing. Make sense? As we have blogged about before it is extremely difficult emotionally and technically to make a decision of an egg donor. Also there is the "issue" of knowing what the donor looked like...looking back years later at your child (hopefully...if it worked) and thinking "my child looks just like the donor and nothing like me!" My idea could take that away b/c you wouldn't really know what the donor looks like at all and yet hopefully the child would "fit" in looks-wise into the broader family, i.e., brothers, sisters, parents, cousins, etc. Anyhoo....I'm getting sidetracked and giving away one of my many great ideas :)

So, at any rate, I think the celebrity sperm donor look-alike thing is a great idea. But....this is also a quote from the article:

Bonnie Steinbock, professor of philosophy who specializes in bioethics at the University at Albany in New York, said it magnifies the superficiality in society. "There's something strange about a culture that has stratified rigid types of beauty where everyone looks alike. Now they're trying to create children through who the [actor] of the moment is."

Oh, come on! Get a real profession you hack! Bioethics? Do some real work! :)

Ultimately though this sums it up nicely:

Bioethicists are divided over the program. Sperm banks routinely allow clients to search based on ethnic background, hair color, eye color and skin tone. They offer extensive details such as donors' height, weight and educational background.

"There are legitimate reasons for this, so the child fits in with the already existing children in the family or so the child looks more like the social father," said Mark Rothstein, director of the Institute for Bioethics, Health Policy and Law at the University of Louisville School of Medicine in Kentucky. "Most people would consider that to be acceptable. ... If you're creating a little Keanu Reeves, then I have problems with that."

Firstly, "social father'? That's a new one! How about father! Why is it so fucking hard to call a father a father and a sperm donor a sperm donor???
Secondly, "bioethicists are divided"? Oh good, I thought there were "real" problems with the program :)
Thirdly, I have a bit of a problem with "then I have problems with that" quote. Oh, you do? Well, luckily, it's none of your fucking business what motivates a person.

Whatever, I say it's a great idea. It's just too bad that cnn.com and people with little to no experience in these sorts of matters insist on having opinions. What is it they call these types of opportunities? Teachable moments? Perhaps this could have been used to discuss the complications, emotions, and heartaches of being faced with choosing a sperm or egg donor? Oh, nevermind, why start now with responsible reasonable journalism.

Today's bloodwork appointment. Another egregious offense?

So again another interesting exchange with staff at my RE’s office left me thinking that not enough training goes on for the support staff. If you read my post about the phlebotomist from hell, you know what I’m talking about. But she’s not support staff. She’s direct patient contact. So was today’s faux pas. She was the person who checks the patients out at the end of the visit, the person who you pay and who schedules the next appointment if necessary.

We were talking about MJ’s funeral, which is of course all over the news and my RE’s office has CNN streaming into the waiting area at all times, so it’s ALL MJ all the time. There was talk of the dermatologist who was his doctor, and apparently (according to the check-out woman) the sperm donor for his children. Don’t know if that’s true, but if it is, you heard it here first!!!

So the check out lady continues by saying that she doesn’t know if people are talking about it yet, but you know when they do, “it’ll be all about how this guy’s the kids’ dad, not MJ”...

As I am sitting here writing this, I believe it sounds like perhaps she was saying “other people” will be saying it’s the doctor’s kids... As if she knows proper donor lingo and that it’s NOT the doctor’s kids, it’s MJ’s kids. BUT believe me. That’s not what she was saying. She was referring to MJ’s kids as the dermatologist’s children.
Oy.
I was a little stunned and wondered how far to take it. I didn’t have it in me to pursue. I just left the office with my head spinning. I suspect they already see me as—well who knows how they see me. The waiting room was empty, no other patients in there but me. But was it really up to me to have this conversation with them? I believe my complaints are now going to come in the form of complaining to the doctor, or perhaps writing a letter to the clinic. Listing their egregious offenses. Can’t decided if I’m hypersensitive. But ultimately I believe if there is one place that hypersensitivity needs to be acknowledged and allowed, it’s in an infertile woman’s safe place. Don’t you think?
So now we wait for the final (hopefully) blood draw results. Never hoped for a zero before. strange... isn't it?

Recovering ... or trying to.

Ugh where to begin? Well first of all, my last beta was at 11. So I’m almost there. I am scheduled again in a couple days, and they are hoping to have it be 0 again. So it’s been almost 3 weeks and here we are. Amazing how long it takes for the beta to drop.
Also, we got the results from the blob back. So the doctor called me to talk about the “next step”. She called me several days ago to tell me that the blob didn’t show any “product of conception” in it so there was nothing to assess for karyotyping. But the testing may not have shown any ‘product’ simply because it was still so early.

So now, since I’m up to 2 miscarriages, I officially qualify for testing for clotting issues. It’s funny. Before we embarked on the donor cycles, I asked her what else could be done, what else could be tested, etc... at that time we were told “nothing else”. But add one more miscarriage to the list, and suddenly it has a red-flag next to it saying “test for x,y,z...” do these REs not know how to think on their own? Are they down to such an algorithm that they are not allowed to think outside of the box and say “well, this patient has only had 1 miscarriage but 5 failed cycles and she’s only 33.. blah blah blah... so perhaps we should consider a, b, or c. But no, only when a donor cycle fails TWICE that she decides something more should be done. Suddenly it's a "trend"...It’s so fucked up.

So now once my beta hits 0, I get to have some bloodwork done to test for thrombophilia (I think?)... She says everything else has been done but that. Also, she mentioned perhaps doing another sonohystogram to check my uterus and do another mock embryo transfer...I asked about whether it’s worthwhile to check my uterus for other problems, and then the discussion of a hysteroscopy came up. The benefits of a hysteroscopy is that it’s more sensitive (obviously since there is actually a scope looking at the inside of the uterus!) than a sonohystogram. So we discussed this, and at first I was more than a little wary of having another procedure. The last time I had a hysteroscopy it turned into a laparoscopy because he couldn’t get through my cervix or had some trouble... so he had to cut into my belly. They fill you full of gas, and it’s pretty painful. It’s a tough recovery for the first couple days, I thought I was going to die from the stabbing pain!!!

But apparently they would do it right in the office, under twilight anesthesia, and there is no risk of doing a lap because they don’t have the facilities for it. She felt pretty confident she could navigate my cervix again, and not puncture anything (yikes!)... And the best part is that through the course of the procedure, she would dilate my cervix. So the next embryo transfer might not be so heinous. I also asked her why the last 2 transfers have been so difficult.. what could have changed in my cervix to cause it to be so closed up? Of course we have no answers for that.

So as soon as I get my bloodwork back with a 0 beta, I can get the clotting testing started. That will take a couple weeks. In the mean time, with my next period, I can start on BCPs (what’s the fucking point of that? As if my body is actually going to get pregnant.. I mean – to quote Gob Bluth- “C’mon!”)... While on BCPs they can do the procedure, and then do the FET the month after that since I’ll be on the pill already...

Anyway, that’s a possible next step before we move on to the final embryo. I am not really in any hurry to do this. I am not in any hurry to do anything. My body is still in a state of flux, and although I’m not spotting or anything, I can tell things aren’t normal. I need a few months to just recover. My butt is still painful and numb from the IM shots, my brain is still jelly and my heart is still broken.

It’s so painful to think about, I think I am just trying to move one day at a time. I am in a mode of feeling and believing that there is nothing to be gained from allowing myself to hurt too much. This was such a terrible experience, I just want to get past it and move forward. Intended D subconsciously (and sometimes not so subconsciously) blames me for being so negative. As if I am the reason it didn’t work. We are definitely a yin and yang – you have to remember this is the same man who, for the first 2 years of ttc, kept deciding our problem wasn’t infertility, but that it must be random that EVERYBODY else out there gets pregnant in the first few months, the first YEAR at the most...and that we should just wait it out...
and of course his reply would be that I was ready to adopt after the first 6 months of failure. Yes, we are opposites.

At this point, I’m being practical. I am the type who doesn’t go back for more pain. It’s not like I was negative during the cycle. It’s that at the end of the day, my eyes are on the goal of having a little one in our home.

I believe that when we get to that point, we’ll be OK. It’s like when we had our brief encounter with a pregnancy and neither Intended D nor I were feeling remorse, regret, or disappointment over having used donor eggs. Instead it was elation and excitement and relief. My having agreed to use donors was a leap of faith that when it’s all said and done, we’d be happy. That’s what everybody always told us. So what choice did I have but to believe those who came before me? Well isn’t this the same thing? Adoption was not our first choice, nor was donors. But at the end of the day, what is our goal?
Anyway, I’m worried that I am not dealing with things that well but I don’t know how else to handle it. Thinking about my friends who are having children, either naturally or through their own miracles, has just been a reminder of our failure. Even my IF friends are mostly having children now. I am the last woman standing. I think it’s tough because nobody we know has done the adoption route yet. So it just feels so strange. I can’t bear to think about it all or I just want to break down and cry.

I'm losing it...

I'm having a really hard time. I just finished reading Harry Potter (book 6) in preparation for the movie :) and was struck by a passage towards the end (no spoilers so don't worry) between Dumbledore and Harry. Harry was worried about the similarities between himself and he-who-must-not-be-named considering their biographies, among other things, are similar. Dumbledore remarked that a main difference is that Harry had not allowed himself to be consumed and taken over by hate and that, considering the life he had lived and all he had been through, was quite remarkable. This passage from a children's book struck me because I feel that I am falling victim to hate similar to Voldemort!

I can't get over this miscarriage and the unfairness and unjustness of it all. I have no hope left, no love. It is all just too unfair. We deserve more than this and I can't seem to snap out of it. I understand that, in the grand scheme, infertility is something that can be "dealt" with--so to speak, i.e., it's not HIV, it's not cancer, it's not life threatening. I get all of that and more, it's just I can't stop feeling sorry for myself. It's terrible. As I've blogged about before we have friends that are expecting babies or have had them very recently and I absolutely cannot be happy for them. I just can't right now and it makes me feel completely horrible! I had a flash of panic thinking about the "what if" of my brother and his wife getting pregnant and having another baby (the third). I panicked because I don't know how I would react. The mere thought of it happening makes me sick. This is what infertility can do to a person. The inconveniences, the intrusions, the procedures, the money, the shattered hopes and dreams are all things I've been dealing with, in my opinion, rather well. But this new one...this loss of love and ability to be happy for others and this self-centered pathetic feeling of sorrow for myself, I cannot shake and I feel terrible. I am continually challenging the powers that be (but probably aren't) to make things right. This is too unfair and unjust to stand. IM and I have sacrificed soooo much...tooo much...to have a little success. IVF with donor eggs is not a miracle (although it is if you think hard about it). I'm not asking for a miracle here....I'm just asking for a chance to be able to fulfill a shadow of our dream when we got married: to have kids and a family.

Another thing I've had the wonderful opportunity to learn through this infertility journey is how couples that have experienced a tragedy break up. Whenever I heard of these couples that lost a child to a murder or accident and then eventually got divorced I was always amazed at how something that should have brought them together actually pushed them apart. I get that now. It has nothing to do with a lack of love between each other or of blaming the other for the tragedy (that's what I used to think) or whatever. Instead, I think it is a matter of having no other way to move on. It's just very difficult to move on WITH that person. I'm not suggesting that IM and I are having troubles...we're not. But I can understand the feeling. When IM and I got married we always always always imagined having a family. It was a given and something both of us were looking forward to when the time was right. To have the dream severely altered or taken away entirely is a pretty tough thing to confront and "moving on" is difficult. To start a family was "our" dream...together...it makes no sense without the other.

Distractions and unintentional insensitivity

This may not deserve a post in itself but I figured "why not?"

Last year, a few coworkers and I had what we would call a good year. This year hasn't been nearly as successful for the both of us. While discussing this in a matter of fact sort of way and trying to think of excuses for ourselves my friend said very jokingly "Jimbo (not his real name) and I have brand new little babies at home, what's your excuse?" Hahaha :( I had no response to give him but what I was thinking was "Well, I suppose my excuse would be continued frustration of infertility, failed treatments, loss of financial stability directly caused by infertility, and a miscarriage--which happens to be happening right now! Not only babies are a distraction you know, a lack of baby is a pretty big distraction too."

He was joking and doesn't really know our situation (especially the miscarriage) so...whatever. In truth, if there was a time to let this particular friend know about the pain we are going through right now that probably would've been a good time but, oh well, the moment passed. The last thing I'm in the mood for lately is reliving it all and trying to explain the situation.

But...it got me thinking a lot about how much of a distraction infertility can be. It's so funny because I catch myself thinking very often that if only we could be successful and IM was either pregnant or we had a little baby I could settle down and really dedicate myself to and, mostly, CONCENTRATE on work. Of course, that sounds crazy to a person with a baby because kids are a huge distraction and a LOT of work. Be that as it may, the effects of infertility on the rest of your life is very easy to underestimate because it sits there hidden and isn't obvious to outsiders or even yourself sometimes. It's similar to a chronic debilitating illness in that way. It's just so frustrating because so many other things take a back seat to this desire to have a baby and start a family--so many other things just seem trivial and it's hard to motivate myself to do things whose outcomes are so far down my list of desires. Make sense? A baby is by far the most important thing to me right now and second place is so far down the list it's like everything else is just tied for second since I have almost no interest in them. A success at work? A dream job (promotion)? Yeah, that'd be nice and I definitely want those things and am striving for them. But I'd trade them all for a baby. No question.

Today's experience: insensitive phlebotomist and "products of conception"

I had to get my beta checked today to make sure that it is dropping the way it should. It trips me out to think that I am still rockin' a positive beta. Technically I am still pregnant. I should be taking lots of HPTs! They'd all be positive, as I've always dreamed. It's just not fair. Beta was 274 so it is definitely dropping.

Today I experienced an insensitive staff person talking about things she shouldn't be talking about. It's interesting how sensitive these people must be.... and how well trained they have to be in order to be good at what they do.

There is a very well calculated reason why pregnant women and children are not allowed at RE offices. We infertiles are very sensitive to seeing any sign of pregnancy and children. Particularly in our "safe" zone: the RE office. Doctors don't even advertise signs of their own kids in these offices if they know what's good for them.

Anyway, I digress...The girl drawing my blood today was a new one. She was talking to the other phlebotomists while drawing my blood, as if I wasn't there which is the first no-no of patient care...

She asked her co-workers if they had seen some show on TV last night.

She said "so and so is pregnant! Can you believe that?... blah blah blah... and she had a couple miscarriages I think..." blah blah blah. The other girls were just kind of quiet and not really talking too much. I was getting more and more emotional -- first with the conversation of somebody being pregnant can be enough on a bad day. When the conversation turned to miscarriages it was just too much for me. I started welling up with tears and my heart was pounding. I was livid because you DO NOT talk about this kind of thing in a IF clinic.

So I said very harshly : "You need to think about what you are talking about around patients."

She really quickly looked up at me and apologized and was silent for the remainder. The other girls turned around, and looked totally embarrassed. It's like they had forgotten I was there or something!!!

I was furious, I was almost crying. That's just not OK to talk about. Too much sensitivity around the subject. I almost said "You want to talk about miscarriages? I'm having one right now. What should we talk about?"

Part deux: product of conception

I ended up asking my nurse about bringing in the blob I gave birth to yesterday. I want to do whatever testing can be done on it to ascertain some answers. As i mentioned yesterday, i stored it in a tupperware container. They said for me to bring it in today rather than waiting until tomorrow. It needs to get into the right solution ASAP or something technical like that. ( i wasn't sure if it should have been refrigerated or something... how does this stuff work!?)

Anyway, the nurse said they will do a karyotyping if they can, and a pathology report to identify if there is indeed a "product of conception" in the blob. PRODUCT OF CONCEPTION? Does that mean fetus? Does that mean ... placenta? What does that mean exactly? It's such a protective term to keep us from having to say yucky words and have yucky thoughts. I found it absolutely fascinating that that's the lingo they use.

I don't resent it necessarily. Mostly I just found it interesting.

So I had to go home and pick up the blob and take it to the clinic. It was a strange experience handing over this tupperware container of the blob for somebody to analyze. What a strange job that must be! It crossed my mind after I left the clinic that I should have asked for the tupperware container back. I would have loved to see the look on their faces! It makes me giggle to think about. I don't think I could have said it with a straight face though.

the ultimate in self-loathing...

Well ladies and gents, wonderful intended D gives me a wee bit of grief from time to time for not being a dedicated blogger. So since he's otherwise indisposed traveling overseas, here I am to share my tale of woe.

The absolute worst offense to a woman who has to give up on her attempt at a pregnancy is the pain that comes with a miscarriage. It is excruciating. It is beyond words. It is an offense to the psyche that transcends all emotional pain because it is a concurrent pain in the abdomen.

I have had 2 miscarriages in my life now. I don't know if I should be proud of that. One seemed like a fluke. It was so long ago. Here I am able to officially claim two now. My pain today was so bad, despite more Advil than was probably safe, that I felt that I was going to pass out. That kind of pain that gives one nausea. I have rarely experienced it but today was a day to remember. And here I was crying on the phone to intended D as he is boarding a plane and will be out of reach for who knows how long until he makes it to his destination. What a loser I am for worrying him like this.

The grossest part is some of what came out is now in a tupperware container. Should I take it to the doctor tomorrow? I'm not sure what the point of that would be. It's not like we need to test is whether we have chromosomal issues. This is a donor. We have one more embryo left. And I don't see us using this donor again because what's the point? (what's the point of anything, really...) Does anything need to be tested? I plan to keep it in the tupperware for a while longer. Maybe I'll do surgery on it myself and look for the critter that might be somewhere in there the size of a pin head. Congratulations to me!

If you read Intended D's last post, you'll see that he expresses himself in more optimistic hues than I do. Although the beauty in his post didn't go unnoticed even in my current state of mind. Parenting is an act that is more than giving birth or having a genetic tie. What he saw on the train was priceless and I'm so glad it meant something to him. I have married an amazing man whom I would not trade for all the chocolate in the world!

Mothers and fathers...

With infertility a person has to really evaluate what it means to be a mother or a father. Is it having a genetic connection to offspring? Is it parenting? Is it the constant worrying that comes with these little people that you are responsible for? I suppose it's all of those things but the first one I listed--genetic connection--is way down the list usually. Not just for infertile people but for most people I think. It's like the old saying "any asshole can be a father but it takes a real man to be a dad" or a parent or whatever. You get the idea.

Anyhoo, I'm riding the Metro today and I see a lady in her mid-forties, white, grayish hair...with two little girls about 8 or 9 years old. The girls are black--as in african american--with corn-rows. As they get off they both took their mother's hand and walked away (at least I assume she was their mother) and I thought that there's the true definition of a mother...that's what it is all about. Being a parent.

Whatever. The point is quite obvious, but being pregnant and giving birth does not make you a mother. Maybe a "by definition" mother but certainly not a parent. Parenthood is something that you work for and earn. Luckily, for IM and I--as if we had a choice in the matter, we want to be parents and someday we will be parents. I wonder who the lucky kids will be! :)

Reconnecting?

One of the worst things about dealing with infertility is lost or paused or strained relationships. There have been friends in our past that have started families or even infertile friends that have been successful and moved on. Losing those friendships..due to their success...brings on a lot of guilt (at least for me). I wonder why I am not strong enough to maintain certain friendships but it can be very hard. Obviously, friendships can be strained when one side starts a family and the other doesn't. These "trivial" differences can be simply not wanting/caring about preschool or dance recitals or blah blah blah. It's hard to relate to those things when you are not dealing with them and so, for that reason, relationships can--sort of--naturally move on.

Mostly, what I am speaking can be exemplified by a few friends we have. One just had a baby and another is currently pregnant. (we've "lost" many friends like this) It's just very hard to maintain strong, or rather close, friendships with people who are achieving what we so desperately want. I'm not excusing us. We could be stronger. But...we're not. And, also, it's not as if these people are less of friends. The friendships, especially the ones that make us feel the worst, are such that we will always maintain deep friendships...family-like friendships..at least I hope these friendships will remain (hopefully the bridges are still there and not completely burned). But, maintaining day-to-day contact is very trying. Of course, the other side of the equation is they can often not understand our position. I don't blame them.

The interesting thing is that while IM was officially pregnant for that happy, fun, and exciting week we started having conversations regarding reconnecting with lost and neglected friendships. Hoping that this was our chance to get back in touch and hope that all was not lost. Then...then the beta hcg started to grow slowly, eventually stopped, and now is decreasing indicating a miscarriage. So, we're not having a baby after all. All of that talk of reconnecting neglected friendships vanished in a flash. I actually feel like cutting myself off even further...even from family. My brother's family, has been exempt from my feelings in this regard, for a long time but my resentment over infertility is starting to creep into that relationship too. I am not being a very good Uncle...that's for sure. Or a good brother. It's as if with every failure I (or we) sink deeper and deeper and it is harder and harder to see the outside world. Old friends seem farther away and our motivation to reach out becomes less and less.

The miscarriage is still very fresh and so is the wound so...hopefully...I will start feeling better and normalizing all of this eventually.

Miracles don't exist

IM had another hcg beta today and an ultrasound. The ultrasound didn't show much (the Dr thought there might have been something in the uterus but it was only a tiny blip). Then we got our hcg beta number back and it was 647. That's a very slight drop from the last number of 649. Here's the table and plot:



Here are the numbers:
date beta days-post-ovulation
6/5/2009 - 70 - 15
6/8/2009 - 159 - 18
6/10/2009 - 246 - 20
6/12/2009 - 398 - 22
6/15/2009 - 649 - 25
6/17/2009 - 647 - 27

The embryo (or whatever you call it at this stage) has apparently stopped growing and I guess that's the end of that. No miracles for us. This was not an entirely unexpected result considering how things have been going but IM is feeling really terrible. I'm still in the analytical stage and feeling emotionally numb about.

The good news, if there is any, at this stage is that the Dr does NOT think it was(is) an ectopic pregnancy since IM has not had any pain in one side or the other and nothing could be seen on the ultrasound. So IM stops taking meds today and the pregnancy will hopefully resolve itself over the next 4-5 days. ...which is not a pleasant experience to say the least but it is certainly better than having to induce it happening by taking methotrexate--that drug has a few nasty side effects one of which is you're not supposed to drink alcohol just at the time you need it most.

...I've got nothing left to write at this point....

It looks like its over...

We got the hcg beta number back. 649. That's well below what we had hoped. As you can see from the new plot that point is well below the 66% threshold point. In fact, the two-day growth rate over the three days (from 398 to 649) was 47%. That's the slowest yet. So, that coupled with the fact that there was nothing on the ultrasound pretty much sums it all up and it's pretty much all over now.


Here are the numbers:
date beta days-post-ovulation
6/5/2009 - 70 - 15
6/8/2009 - 159 - 18
6/10/2009 - 246 - 20
6/12/2009 - 398 - 22
6/15/2009 - 649 - 25

Now the question is: what's going on? Is (was) the pregnancy ectopic? What's up? The ultrasound didn't show anything at all...including no irregularities. So what they do next--assuming the beta continues to drop, grow this slowly, or stay the same--is IM will get a shot of methotrexate which is (to quote wiki) "commonly used (generally in combination with misoprostol) to terminate early pregnancies (i.e. as an abortifacient). It is also used to treat ectopic pregnancies. In the case of early missed miscarriage (particularly a blighted ovum), in which fetal demise has occurred but the body has not expelled the fetus, methotrexate may be used to help the body begin the miscarriage process." Lovely. I don't know what happens after that, i.e., does the embryo expel itself from the uterus. If not, a D&C will probably have to be done. The other crappy thing is IM goes back Wednesday for blood work and possibly a methotrexate injection, then again on Sunday for blood work and maybe ultrasound, then again on Wednesday for blood work and ultrasound, etc.

To make this just terrible, I go out of town on Thursday through Sunday and then I leave again on Tuesday and don't return until the following Monday. So I will be gone throughout almost all of this. That's such a painful thought. IM should not have to do this alone but I can't get out of these trips I don't think.

I suppose also that my Mom will also want to know how things are going. That conversation will not be fun at all. She likes to pray for things...and to be fair there really isn't much else she can do...but so far, along this infertility journey of ours, prayer has absolutely done NOTHING. But, neither has anything else. If I could just sink into a puddle of mush right here on my office floor I would.

When, if ever, is it going to be our time? When? We've had enough pain, enough disappointment. Enough of it all. Enough experience. Enough growth. Enough. We've learned all that we're going to learn. We've learned about our relationship. We've learned about ourselves and how we see parenting and genetics and the whole nine-yards. Enough. We've learned enough. Considering we've already learned how to have a miscarriage I'm not quite sure why we're being forced to learn this one again! I guess this time we're learning how to have an abortion--in a way at least. This is just a goddamn bitch of an unsatisfactory situation! It's our turn. When will it be our turn? I'm just so tired of being disappointed. I'm right back to where I was a few months ago: I can't imagine actually being successful in this. I just can't imagine it.

Memories

Today IM had a blood draw (we should get back the beta hcg number later today) and an ultrasound. According to my math the beta is most certainly below 1000 and you're not expected to see anything on an ultrasound if the beta is below 1000. Of course, considering that we are 5.5 weeks along (or so) it would be better if the number was higher and thus it would be nice to see a nice old gestational sac right smack in the uterus doing it's thing. Well, needless to say, the ultrasound showed nothing. Once again we have not experienced a miracle. A miraculous occurance where suddenly the embryo starts growing like a champ and we end up being in that 15% of normal pregnancies with initially low beta numbers. The ultrasound didn't show anything else abnormal either...for whatever that's worth. So, we'll see what the number is today and go from there. Most likely we'll have another ultrasound on Wednesday where the beta will be either well above 1000 or we're screwed...in which case answers will be a little easier to come by.

I'm sooooo down right now. I just don't care about anything right now. I have lots of work to do and an upcoming work trip to Italy (Tuscany even) which one would think I would be looking forward to. Right now, I'd rather not go. This has got me thinking about memories and the whole "it's better to have loved and lost than not to have loved" mantras. The weird thing to me is that present experiences severely shape your memories of the past. IM and I spent this last weekend (the one before this one) in NYC with family having just moved past a bunch of positive hpt's and a positive beta hcg blood test. We were kicking around the idea of calling IM pregnant, getting used it a bit, we told our parents the good news (all while remaining cautiously optimistic...we've been burned before). What's weird is I can't recall that good feeling anymore. It's gone. The only feeling I can remember is how I feel right now. You know, that feeling that comes along with "who are we kidding, good things don't happen to us". It has truly been a terrible year. It is hardly believable to be honest...all the things that have or have not happened this year. I was starting to think that odds alone would garantee a pregnancy out of this donor-egg IVF cycle we are doing. How could it not? How is it possible to have continual bad luck and no success. I don't want to complain too badly. Things suck all around to all people and it's not like everything has been terrible---baring one important exception. However, we have just had no success. Everything we've tried to do or wanted to happen or hoped would happen hasn't.

I don't know...I'm off track. Mostly I just was contemplating how interesting it is to be unable to recall the happiness that I was feeling only a week ago.

Weird Dream

Last night I had a weird dream. I was on a resort like island (think Bahamas) with people I know but I can't say who. The island was filled with other youngish people vacationing. Now, everybody had either a lizard or a snake and these little reptiles served a purpose for what I can't remember. Anyhoo, as it progressed, I'm driving my car back from somewhere and I had been keeping my lizard in my pocket. I was worried that he was going to die so I decided to hold him in my hand and he kept biting me. Not painfully but still. Then I was also carrying a snake in my other hand (for somebody else...it was somebody else's snake and I was returning it or something) and it had wrapped around my hand and was biting me too. Eventually, the snake became too much and I stopped the car at a little creek and thought "screw this, I'm throwing this snake back in the water...it's just not worth the pain". Now I'm back in the car on my way and my lizard jumped out of my hand and started running around the roof of my car and I thought "oh well, no big deal, I'll get him later." Then it was morning.

So? Wtf was that all about?

New numbers

IM had her hcg beta tested again on Friday and we were expecting the worst. It came back...well...sort of in the middle. 398. So, we're calling the little critter, the 5-day blast that's hopefully still there trying his best to grow "398". We're trying not to get too attached so...well...isn't it obvious why?

So, here's are numbers now:
date beta days-post-ovulation?
6/5/2009 - 70 - 15
6/8/2009 - 159 - 18
6/10/2009 - 246 - 20
6/12/2009 - 398 - 22

In case you're keeping score that is a growth rate of about 62%. That's slightly lower than the "magical" 66% that you commonly hear and read. But....it's higher than our last growth (from 159 to 246) which was 55%. Our first growth rate (between 70 and 159) was 73%. I'm not sure what to make of it all. I made a plot where I added our new point above. So, our little "398" is still hanging in there...but only barely. We have another beta test on Monday and we will hopefully see a number of over 700 or 750--something above 800 would be great.

If you're interested in a couple of hcg calculators out on the internet here's a couple here and here and here.

Ok...gotta go. We have some friends coming over for an Arrested Devolopment marathon!

(sigh)

I just argued with IM about our cycle. What did we argue about? Well...we argued about whether this cycle was doomed. I took the position that we'll have to wait and see but it doesn't look good. She took the position of doom until I finally admitted that yes, the cycle was certainly going to fail and would be a miscarriage. The numbers bear this out. Fuck this! This is what infertility does to you. It reduces you to arguing about whether the cycle is going to fail after all...after all of this positive feeling and happiness.

Oh yeah, and I still have to give IM her shots. Two tonight! Delestrogen and PIO! What fun.


.....I am just fucking miserable right now.

Numbers: or "Never tell me the odds!"

IM had her 3rd hcg beta test today and....(drumroll!!!!!)...246. Hmmm. Lame. Here's where we are:
date beta days-post-ovulation?
6/5/2009 - 70 - 15
6/8/2009 - 159 - 18
6/10/2009 - 246 - 20

Ok, days-post-ovulation is a bit tricky b/c IM didn't actually ovulate. But, we transferred a 5 day blastocyst on the 26th of May which works out to making today 15 days post 5 day transfer, which I believe, the IVFers around the internet call 15dp5dt. They love acronyms! Now essentially you add these numbers to get 20 days-post-ovulation. At least I think that's how it works :) Anyway, where was I?

Evidently, it is best for a viable pregnancy if the beta doubles every 2 days, or doubles every 48 hours, or sometimes you read doubles every 48 to 72 hours. Another number you read/hear is 66%, in that you want the beta to grow by 66% every 48 hours. Considering 48/72 = 66% that must be where the number comes from. What it really means is that if your beta is on the slow end of the spectrum and doubling every 72 hours it will be growing by 66% every 48 hours. Make sense? Well, if you crunch our numbers a bit you see that between our test on the 8th and the one today (the 10th) the beta grew by 57%. Of course, like everything in IVF there is some controversy about how solid a number 66% is and whether a person should start feeling discouraged yet (why do I feel discouraged then?). In that vain, you read numbers like 50% and 60%. Well, fine, whatever. It still doesn't change the price of oil in Egypt...as they say. (Do they even say that?) Being the nerd that I am I made a plot.


So here where are back again, 360 degrees in a full circle. A betting man would be betting against us....again. I want to cry, scream, and just sink away into nothing and disappear. And to think....I was feeling really confident this morning until we got our results. It's just amazing how emotionally labile I am these days. (Labile...that's IM's favorite word.) I'm high and low and all over the place. I'm feeling soooo discouraged right now and this morning I was feeling confident that if I wasn't quite a father yet I would be one soon. How's that for pathetic? Why will this not happen for us? We've compromised so many of our dreams so far that it is just nearly unacceptable for this not to work. I would say I'm ready to give up...but I'm not. I don't know what I am. Plus, this cycle we are in right now and the fact that IM is in fact pregnant right now...as I write...well...let me just say it's still a possibility that this will work and we will finally get our dream. Our next number is very crucial in my mind. The beta needs to hang on to the lower end of these growth curves or I think we're fucked and all I can contemplate right now is: what then?

...I'm trying really hard to channel Han Solo right now when he admonishes C3PO to "never tell me the odds!"

Expectations...

I've always been a big believer in the idea that much unhappiness can be traced to having expectations that are not warranted or unrealistic. Unrealistic expectations are obviously dangerous but even unwarranted or ignorant ones are equally dangerous. For example.....

...quick recap....IM took some home-pregnancy-tests and all were positive....then on Friday she had a blood test and a positive beta with a number of 70....the nurse says "well, we usually like to see over 100" but then she realizes that our original beta was supposed to be yesterday, i.e., 3 days after the one IM took...so the nurse renormalizes and says it's actually looking good....so on Sunday night IM takes another h.p.t. and gets a positive (that was a pretty obvious result considering she had a positive beta two days earlier but she likes to see a positive h.p.t result!)...so that brings us to yesterday....

Yesterday was supposed to be the original blood test and they like to see a number above 100. Well, IM's number yesterday was 159! Good news! Things are growing and everything is moving in a positive direction. However, two weirdish things happened:
(1) we got playing the expectation game this weekend. We were feeling really positive and happy about our situation. We told both of our parents the news (we know...it's early...but why not share happy news) and were allowing ourselves to feel good. Then we start talking about the nuts and bolts of betas. How the beta is supposed to double every 2 days (it turns out there is quite a window of acceptable range for the doubling though) and we start making "bets" on what the beta will be. IM figures it'll be 250. I figure it'll be around 200 b/c the beta grows exponentially and blah blah blah who cares :) So, right before our eyes...unbeknowest to us...and against my usual philosophy we set up an unwarranted expectation--an ignorant one. So, even before we had the beta results I found myself feeling really down yesterday. I was stressed out and dreading the result. There was all this pressure that the beta be high...at least around 250 or hopefully better...I wanted the number to be even higher than we thought and then that quietly and stealthfully became what I expected the beta to be. But, there's the rub. What did we base this expectation on? Almost nothing.
(2) Meanwhile the nurse tells IM the result and then tries to temper any excitement by saying that it's right on a "border" of growing too slow...something about 66% and 154. Huh? This could very well have been IM's first beta and it would've been over 100! The nurse also lets out that the Doc wrote something like "beta increasing as expected". That sounds like a good thing, right?

So, yesterday, we're both at work and IM calls me with the results and she's really negative sounding which totally affected my reaction. Then we both spend a hour or so messing about on the web looking at beta calculators and other mishmash. Ultimately, it seems there is quite a huge range of beta numbers that constitute normal growth...so we're doing fine! This whole thing just makes me furious b/c now I'm trying to build back up to a positive mood regarding this whole thing. It's just amazing how fragile your mood and emotions are when you are undergoing IVF treatment like this.

All in all, the beta is increasing and has, in fact, more than doubled in 3 days from the first beta. This is normal growth indicating that everything is going as it should! IM is pregnant! It finally happened!

Stay tuned for the next beta.... :)

Cautiously optimistic

Here's some visual evidence. Perhaps not the boldest of lines but a line nonetheless--this pic is (I think) the second of three tests in as many days which were all positive and the newer one being slightly "darker" than the last. Plus, IM had a blood test at the clinic today and...sure enough...it's positive and her number (70?...what are the units?) is about right. We're expecting it to increase with some regularity over the next few days and IM will have another blood draw on Monday...then again...then again....then again....for a while to establish that everything is a-ok. Meanwhile she gets to get injections from me for quite a while longer too!

The feelings are quite strange. We're both totally distracted and scared, happy, terrified, relieved.... Name the emotion and I'm pretty sure I'm feeling it a little bit.

Another interesting thing is how different this one feels compared to our last one about 4 years ago. I remember feeling kind of scared about the prospect of being a Daddy. I knew that I could and would do it but I was nervous about the prospect. Now I'm not nervous at all. I'm absolutely ready for it. We've been waiting and waiting and waiting to be parents for a long time now...so we're pretty much ready. I know people like to say "no one is every fully ready". Hogwash, we're ready! I think that I had decided in my mind that eventually...somehow...someway....we would be parents. It was just a matter of time and effort (and money) to get there (or here I guess). And I think I've pretty much considered us both a Mommy and Daddy in waiting. I'm so excited for everything that lies ahead.

"Cautiously optimistic", however, is our mantra and we chant it often. We're as early on in a pregnancy as it's possible to be--most would only call this a chemical pregnancy at this point. But a chemical pregnancy turns into a regular one almost all of the time. So we are optimistic and right now...at this moment...we're going to have a baby!

testing...testing...

I don't know if Intended D is going to post anything today or if I am beating him to the punch. Last night after my pity party about being told by the nurse that I might not be able to go to Italy, I decided to buy some HPTs. I decided that if I test this morning and it's negative, I am going no matter what because duh... I'm not pregnant. So why would I rob myself of not being pregnant and also not getting to go on vacation. What a load of bullshit to not get to go...

Today is 8dp5dt. First thing this morning I tested. It started with just the standard single line which I was expecting so it was just confirmation of the deprivation that is my life...Then slowly this second line started to appear out of nowhere... really slowly and really faint but definitely visible. (I want to put in exclamation points here but it's just too soon. I'm scared to.) Upon seeing this second line start to appear, I was basically numb. My heartbeat didn't even accelerate as far as I could tell.
Here's what strange although probably not uncommon: I would almost say seeing that faint second line (that started turning slightly darker but was not solid yet...) caused ambivalence to surface more than anything else. Fear of being taken for a ride, of having a false positive, fear of having a happy moment taken away by a bad test or a decreasing beta. Or another miscarriage. Better to not have a happy moment at all? I didn't know what to feel.
Intended D was still half sleeping, aware I was testing and probably wishing I wasn't...
I was trying to think of how to tell him this unexpected, completely random, unbelievable and still unconfirmed outcome of the test. Back when we thought I was still fertile and we thought we were ordinary, when we started ttc, I had thought about how I would give him the news. Women get to be one step ahead of the man in this arena and I wanted to make it something special the way I'm sure most other women do... To annound our pregnancy to Intended D, I had prepared to surprise him with a copy of She's Having a Baby (a favorite movie of ours) and a baby rattle or spoon with a bow tied around it. (oh how cliche...) But infertility has robbed us of any spontaneity we could have ever hoped for. Even in our current situation I had daydreams that I've gotten good at suppressing.... I had imagined seeing a double line, calling out his name, to see him come running, I'd run to him and meet him halfway holding the sacred HPT between us, tears and laughter and he picks me up and whirls me around. Elation, excitment....
....nope.... I couldn't do it. I couldn't get excited about it and I couldn't get him excited about it.
One of the many natural emotions most adults who have children get to experience that we have been robbed of is the naivety of a positive pregnancy test. I know too much.

I walked around the corner to him still in bed and announced "Well, rather than saying it's negative, I'd say the results are inconclusive..."
judging from his response, his immediate upright posture and request to see the test, this was probably the best thing to prepare him that I could have said. Intended D is a scientist and I know how he thinks. His response was the best ever... He concurred that he, too, saw a faint line, and processed the implications of it. He said that this second line is definitely some thing different, because typically there is an abnormally white area next to the single colored line, just to rub in how so very negative the test result is.

We spent the morning in shock and disbelief, and for me, a pinch of denial. We took pictures of the positive because I don't know when I'll ever see that again and I want to savor it forever. The only other times I've ever seen a second line was my ill-fated pregnancy (with subsequent miscarriage) 4 years ago, and ovulation tests which I LOVED taking back during our IUI phase because I got to finally pass a test with a second line and see what success feels like!!! How pathetic is that? So I have two more sticks, which I will use over the next couple days, and if things are going well I'm sure I'll give some HPT company a boost in their share value by buying more HPTs so I can see more double lines... just to try purge years of dissapointing BFNs.

I am afraid of reacting just yet. I know it's still way too soon. But this is something. I'll definitely say that much. This is something.

absolutely no control whatever... sigh

I am so furious and frustrated and ... ugh.  I can't think of enough proper adjectives.  I feel so helpless.  Intended D has the opportunity to travel to Europe this summer, two different stints just a couple weeks apart for work.  So we decided -- hey, let's have the wife (me) come along since I haven't had a vacation in a long time.  Would be fun right?  Expensive, and hard to fit into our schedules right now but it's hard to pass it up when his expenses are already paid. Time to live spontaneously.  I've been trying to break out of the mold and this is a good time to go.  IF by some one in a million shot I'm pregnant, wouldn't this be a nice way to have a vacation before life changes forever?  And if it's negative, well obviously this gives me something to look forward to on the horizon to get me through this...

Well travel needs to be booked ASAP because Intended D is supposed to leave incredibly soon. We finally looked seriously at tickets, hotels, etc.  And he said "should we ask the doctor if it's OK for you to travel ...just in case?"... to which I replied "Why would we have to ask... pregnant women travel all the time... but OK I'll send the nurse an email."

Well the nurse replied telling me that she forwarded my email to our RE and to not make any travel plans until we've heard from the doctor... she's guessing it's going to be a problem.  WTF???

So let's assess the situation.  I have been powerless to becoming pregnant for, oh, like 6 years now.  So we all agree that I've already got a pretty low level of control to start with.  And here I am trying to plan a vacation so if this cycle fails (which has a 70% likelihood) then I can have at least something to look forward to.  WELL, the small chance in hell that I am going to be determined to be pregnant next week is going to hold me back from being able to plan a trip to Italy, because timing is becoming an issue and we need to book our tickets ASAP so we don't get raped with the costs of the travel.  If we wait until the results of the cycle next week, we'll have to likely pay a lot more if I go along.  This is a trip we can't really afford as it is, so obviously if the costs increase a lot, it's prohibitive.  I feel like I have no options and I am tired of it.  Today i was just thinking that once we've exhausted our donor embryos (we have one frozen left...) if we don't act on any subsequent treatment, nothing would happen.  We would most likely never have a child.  We have to actively actively actively seek out help or this is it.  This is our life.  

I am feeling so confined right now, so powerless, so fucked.  

Feelings of inadequacy

We spent yesterday and today among too many children.  Intended D is a cyclist and loves going to bike races...(he tried his hand once at racing and had a crash that gave him a minor concussion.  The beginning and end of his racing career thank goodness!)... We had back to back road bike races in the area yesterday and today, and went to watch them both.  Our good friend was racing in both of them.  We also got to spend time with his wife and baby, and other friends and their baby, and we were surrounded by another million or so other kids.  The cycling community seems to like to bring their kids to bike races.  I'm sure it's a nice way to keep kids somewhat occupied outside in the fresh air, get family time, and at the same time get to take in a bike race. It was a tough time although it was also good visiting with friends.  

My primary response to the two days with such a plenitude of parents and kids was anger and inadequacy.  I see these women and men carting around these kids and I just feel like after all these years of marriage, there must be a whisper campaign spreading through the crowd of young, blissful, proud, arrogant parents regarding why we don't have children.  My insecurity and inadequacy transforms the situation to the following scene: I picture a spotlight on me.   Parents go about their business but out of the corner of their eyes, they are watching me attempting to engage with their children and suddenly my standard comfort with children turns awkward and uneasy.  My arms are uncoordinated and ungraceful, and I try to carry a child in my arms or tickle them but it just causes me to appear like a clumsy ogre.  They are watching me thinking to themselves "boy, she doesn't really know how to act with kids, no wonder they don't have any.  But her husband is so good with them... poor guy..." 

Or the other situation is these perfect parents watching me playing with a kid and thinking "she's so good with kids, a natural... I wonder why she doesn't have any... maybe she is infertile... oh poor girl, how pitiful.  She must feel so pathetic.  I feel sorry for her...."  

Which one is a better scenario?  I don't know.  

Intended D doesn't seem to have this issue.    He is able to not direct any anger toward kids.   He loves them all... He is able to pick and choose which parents he is resentful of.   This is a phenomenon that is a cause of some consternation for me because he is angry at random friends whom he deems undeserving.  He (in my opinion, irrationally) decides who is deserving of parenthood based on some algorithm which I am not privy to.  But that means he harbors random resentment toward some friends strictly because they have a kid.  But another friend with similar circumstances seems to get off scott-free.  At least I am angry with all parents and all kids.  I don't discriminate.   Aaaaaaanyway....i digress...

Intended D wasn't bothered by spending this time with the kids.   I wish I could figure out how to do this-- harness some peace without such feelings of inadequacy.  When I feel well and unaffected, I am able to separate out myself from others.  I am me, I have my struggles and issues, and so does everybody else.  I totally get that.  But the 2ww isn't a great time to feel well.... The concept of pregnancy is so unthinkable to me.  For me it's as unimaginable and unlikely a human function as having a penis.  Parenthood in general feels this way, not just pregnancy.  And yet this is something that everybody else takes for granted.    What do I feel inadequate about?  Inadequate as a woman.