You are currently browsing the monthly archive for June 2012.

There isn’t really much to report here. AF is almost over (yay!), so I have approximately 22 days to go until I am calling the RE’s office again to get things going. I am hoping I have better luck this time!

I’m trying to get into really good shape with the hope that I’ll be able to exercise a little during IVF. I know there may be days where I can’t, but I’m thinking I’ll be better off if I’m in better shape to begin with. I’m especially concerned about running…I don’t mind taking a week off, but I would hate to lose a whole month. I’m still doing yoga, and I just started swimming, too. I hope I can keep up with at least some of it throughout my IVF cycle.

We’re supposed to go to an IVF orientation soon, too.

I don’t really know how I feel about any of it. I’m excited, but I’m freaked out, too. I don’t know how it will go or how I’ll feel. It may work, or it may not. My eggs may not respond well at all, and that could be the end of the road, or they may be fine, and I could be pregnant by September. Or, we could end up somewhere in between – not pregnant but not the end of the road, either. I’m trying to just go with it – the unknown – and hope for the best. So far so good, but I have a long way to go!

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I hate having my period. Even though it’s better than it was before surgery, cramps woke me up at 4 am last night and made it impossible for me to go back to sleep with any kind of consistency until, of course, 7 am when it was time to get up. They’ve been fine ever since, but I’m tired and fatigued. I don’t know why that happens in the middle of the night. I had a few drinks with dinner, and sometimes I wonder if drinking makes my cramps worse. It’s hard to say. I’m definitely not up for going for a run today.

When I was visiting my very pregnant friend recently (the one who got pregnant easily), we talked about labor. She and her husband had attended some kind of a birth class, and I got the impression it was a fairly natural/alternative-leaning class. They were saying that they would rather give birth at home, but that it’s too expensive. She said something like, ‘thousands of women do this [give birth] every day, and always have.’ She was saying that basically all the medical intervention that’s available isn’t necessary, because giving birth is so common. Thousands of women – giving birth – every day!

That’s so not my reality. In my reality, getting pregnant isn’t easy. It takes time, and money, and determination, and coordination, and science…and even then, it may not result in a pregnancy, much less a baby. If I ever do get lucky enough to get pregnant and actually deliver a baby, it won’t be a commonplace, everyday event. I’ll have been waiting for that baby for almost five years. In her world, I’d have a child in kindergarten, but in mine, I’m still waiting. It doesn’t matter if thousands of women give birth every day, because in my world, no one gets pregnant easily. It’s as foreign to me as living in another part of the world.

I have good news, and I have not-so-great news.

The good:

– Today is CD 1, and for the first time in many months, I did not have days of spotting before my period.

– I also – for the first time in over two years – was able to run the day before my period without being in so much pain that I thought I might pass out or vomit from pain.

– Also a plus – no mid-cycle spotting.

– I have only taken tylenol TWICE since 4:00 am (I usually take at least two, but sometimes 3, every four hours for the first 2-3 days of my period).

– I think I am benefiting from the surgery, even though I’m obviously not pregnant yet.

– I think I may even be losing a little bit of weight sans-ovary-covering-endometrioma. My tummy is flatter and less bloated. Maybe it was throwing off my hormones?

The bad:

– The IVF lab that my RE’s office uses is closed for the month of July.

It’s sort of crazy, right? I swear, I am moving toward treatment at a snail’s pace. I went to see the RE in February. It’s a good thing I’m patient!

I feel good overall, though. I’m hoping to use the extra time to keep achieving the balance of getting into even better shape while engaging in some poolside drinking – not simultaneously, of course. AF should arrive next time in mid- to late-July, and I’ll start bcp’s on CD 5. The amount of time I’ll be on those is tbd.

I thought I’d be more upset, but I’m not. To be honest, I’m conflicted about the upcoming IVF cycle. It’s exciting, in a way – the possibility of it working, and the idea that we would actually be having a child. It feels good to know we’re doing all we can, even if the end result isn’t what we would have wanted. I guess that’s where the conflict comes in, though…I have no idea if it will work. Of course, I hope it does, but I know it could go either way. I’m not looking forward to being on all that medication, and just dealing with the stress of an IVF cycle. So, while I’m excited to move forward, I also don’t mind hanging onto my life as I know it for another month. And I’m determined to make it a good one!

We finally have insurance approval for IVF! The insurance company isn’t requiring us to try IUIs or anything else first – which I suppose is an advantage of having the (now removed) endometrioma. I’ve been feeling crampy on and off, so I’m sure AF is going to arrive today or tomorrow. Once that happens, I’ll contact the nurse and tell her we are good to go! I’m hoping the fact that I have to travel every month until October won’t be an issue, but we’ll see. Most of the trips are short, but they all involve flying, and I can’t cancel any of them. I keep trying to figure out the possibilities on my own, but it’s too confusing, and I don’t completely understand all the variables. My RE said I’ll need to take bcp’s for 2-3 weeks, but I don’t know what determines whether it’s 2 or 3. If taking them for 3 weeks would work out better in terms of my travel schedule, would that be an option? Could we go for 4 if we wanted to? Instead of trying to figure it out myself, I think I’ll just email them when AF is here and see what they say.

The only other thing we have to figure out is payment. My RE’s office doesn’t use in-house embryologists. They have a partnership with a fertility lab, and that lab doesn’t contract with insurance companies, which means that we have to pay them upfront and will be reimbursed at a lower rate. I know we are SO lucky to even have insurance for IVF and to get reimbursed at all, but the amount we’ll have to pay them is around $4,000. While my insurance company is saying that we’ll be reimbursed within 2 weeks, the my employer is the one who actually pays the claims, and they tend to pay about a year late. So, it’s entirely possible that we won’t see that $4,000 until next year. If the cycle fails, and if we don’t have any extra embryos and want to try again, we’re looking at another $4,000. I’m trying not to mentally go down that road until we’re there, but it’s definitely an issue that we may have to address at some point. I don’t even know where we stand with medication costs.

So, we’re excited but scared – both about the process and the cost. We’re ready to move forward, though, and once AF arrives, we’ll be on our way!

We’re going out of town at the end of the week for a long weekend, and AF should arrive at the end of that trip or somewhere around there. I hope to have an AF-free vacation, but we’ll see. It’s obviously not within my control.

We’re also still waiting for insurance approval to start treatment. While there’s a chance we might get approval in time to do an IUI or IVF cycle this month, chances seem kind of slim. I keep trying to figure out what might be possible, but it gives me a headache. I run through different scenarios (what if AF arrives on Monday…CD3 is Wednesday…or how about if it’s on Tuesday…could we squeeze in an IUI cycle, maybe? Since IVF would start with bcp’s, maybe IVF isn’t out of the question right now…oh but then there’s that work trip in July…and why am I even thinking about this at all – I’m still waiting for that insurance approval…) It’s like a circus in my head, and after a while, I decide to just stop thinking about it.

This is exactly what happened last time we tried to pursue treatment. We were all ready to move forward, and then everything stopped while we waited for insurance approval. It’s hard to stay motivated when nothing is happening. I know there are a lot of people who can hang on to hope and can stay motivated cycle after cycle, but that’s not me. I get mentally and physically prepared to move forward – to just give up my normal life and replace it with fertility drugs, tests, and procedures – I make the appointment, we have discussions, and we make decisions. I get ready. And then, nothing happens…and I start to think about how much I like my normal life, and how none of this is probably going to work anyway, so maybe I should just let it go. We were ready in February when we made the appointment to see the RE – we were ready when we scheduled my surgery – and we had hoped to just keep that momentum. But since April, we’ve just been waiting. We were supposed to start an IVF cycle in May, but between insurance delays, AF, and travel, I’m starting to wonder if it’s ever going to happen. I know it’s not THAT long – especially in the scheme of things – but it’s frustrating, and it’s hard to hang on to that momentum to keep going.

I realized today that this summer marks four years of M and I trying to start a family. I spent three years trying to have a baby with my previous husband, and I realized today that I have spent, in total, 7 out of the last 10 years of my life trying to get pregnant.

Sometimes I wonder why I’m not more upset…about being infertile, not knowing whether I’ll ever have a family…but then I remember – that’s a long time…to accept it, and to thrive despite of it. 

And the thing is, it’s a lot easier this time around. When I was married to my ex, I was devastated when we had difficulty conceiving. I really think that infertility was one of the things that eventually led to our divorce. It wasn’t the only thing, of course, but it was a contributor. During the first year, he always told me I was overreacting, and he complained to his mother about how poorly I was handling things. And then she told me that he told her (which is an example of how infertility may have contributed to our divorce, but certainly wasn’t the sole cause). I was devastated and felt unsupported. I was angry, and later became resentful. Years later, he wanted to aggressively pursue treatment and said he couldn’t imagine his life without children. He said I was ruining his life when I was hesitant to move forward. So, I did, and went to almost every single appointment alone…including the one when I was getting an IUI and had to tell my ex that we had almost no chance of conceiving because his sperm were deformed, heading in the wrong direction, or missing all together (they suspected he had an infection that they somehow missed in the SA and previous IUIs). He was supposed to follow up with them, and didn’t. I was finished – with all of it. 

And even though it was assumed that my ex was the one with “the problem,” as so many people like to say, I knew that wasn’t the whole story. I honestly hoped that it was true, but I didn’t believe it. And 3 years later, when he went on to have a baby with his new wife, I knew.

When I got remarried, M and I didn’t plan to have children. I wouldn’t have married him if he was desperate to have a child, because I didn’t want the pressure. I didn’t want anyone to ever tell me again that I was ruining their life because we couldn’t have children. 

I was a different person when I got married the second time. I was 33 instead of 26. I was well aware of how fragile a marriage can be, and that life is what you make it – there are no guarantees. I married M because I could envision my life with him – just the two of us – and be happy with that. 

Our decision later to try to have children has hard – for both of us, but for different reasons. I was afraid I wouldn’t get pregnant (and with good reason), and that our marriage would suffer. M was afraid to have children, period. But we set our fears aside and forged ahead. I was heartbroken when I realized I would be dealing with infertility again, but as time passed, I realized that I confronted what was, at the time, the scariest thing. I was afraid dealing with infertility would damage us, but it didn’t.

It’s so different to be blind-sighted by infertility than to confront it a second time. It’s still upsetting, and I wish I would just (after four years!) get pregnant already, but the grief and despair just aren’t there for me anymore. It just is. I am infertile. I have been for the past ten years.

There’s a different pressure now – because I’m 38. I’m running out of time. I have a lot of friends who are 38 and are getting pregnant without even trying, but that’s not me. My ovaries think I’m in my early 40’s, and even sans-endometrioma, odds aren’t on my side. We were really torn about IVF vs adoption, but since I have insurance coverage, we’re going with the IVF. I don’t think there’s time for both. And I’m still waiting for insurance approval for my IVF cycle.

I have no idea if it will work or how many cycles I’ll be able to tolerate. I’d love to say that we’ll have a family one way or another, but that simply isn’t true. What I will be able to say is that we tried, and if it doesn’t work, that has to be enough. And if that’s how it ends, then it will be ok. I guess that’s the gift of time. Over the past four years or seven or ten, I’ve accepted that I may have a family, but I may not, and life will go on – and we’ll thrive despite of it.

I attended a dinner with some colleagues this week, and in the course of a conversation about one of our past college presidents, this person said, "Never want something too much." He was talking about this particular president’s inability to deal with some of the issues he faced, because he was paralyzed by his desire to be a college president. I thought about it that night – not in terms of my employment – but related to infertility. It’s hard to remain rational, to make good decisions, and to appreciate the good things we already have when we want something so much. When is it too much?

Sometimes it feels like everything is on hold and in limbo. I’m waiting for insurance approval so that I can start treatment which may or may not work. I feel like it’s time to move on to a new job, but I can’t, because I need my insurance benefits for infertility coverage. I don’t know, though, how long treatment will last, or what I’ll do if/when I get pregnant. I can’t look for a new job early in my pregnancy, because what if I have a miscarriage and need to start all over? On the other hand, maybe my job would be ideal if I had a baby, and I’d be glad I stayed. What if I don’t ever have a baby…what do I want to do then? I think I need a more rewarding and fulfilling job, but I feel like a lot of my skills are fading away the longer I stay in my current position. But I have to stay, until I know what’s going to happen. What if I never feel like I know?

I’m reading "Wild: From Lost to Found on the Pacific Crest Trail." I love it, and it’s giving me a lot to think about. She is absolutely not writing about infertility, but she’s writing about survival, after enduring tragedy, making bad decisions, and losing herself all together. It’s somehow inspiring, but I can’t really articulate why yet. There’s a quote at the start of one of the chapters:

"What is it you plan to do with your one wild and precious life?" — Mary Oliver

I keep thinking about that quote – that this IS it…that this is my one shot at my life. It’s what’s making me move forward with fertility treatment, and it’s what makes me want to leave it behind. I want to live life to the fullest, but I also don’t want to have any regrets. I think about what my colleague said. It’s such a balance.

I feel like I’m at a crossroads, and even though I’m surrounded by uncertainty, I’m calm. But I’m ready to see which path will be mine.

History

2014
May: BFP for baby #2, due January 2015

2013
July: Our daughter is born!

2012
November: Still pregnant. Fingers crossed! EDD 7/5/13
October: retrieval 10/12; 5dt 10/17; BFP!!! 10/25-hcg=70; 10/29-hcg=391
September-October: IVF, microdose lupron flare protocol
June-July-August: approved! dealing with scheduling issues and most likely starting IVF in September
May: waiting for insurance approval to start treatment
April: laparoscopic surgery to remove endometrioma on left ovary; diagnosed with stage 3 endo
March: RE finds cyst - suspects endometrioma; also high FSH, low AMH
February: consult with RE; bloodwork, hsg

2011
January-February: Acupuncture once per week, vitex and natural progesterone after ovulation; back to charting bbt
March-April: end of ttc
May:diagnosed with severe cervical dysplasia (CIN III)
July-August: L.E.E.P. procedure and recovery

2010
December: Start acupuncture
May-November: Not actively trying/on a break/enjoying life
April: Not actively trying, still waiting for insurance coverage for injectables
January-March: still waiting to start injectables

2009
December 09-March 10: On a break while waiting to start injectables
November 2009: 50 mg Clomid CD 5-9; BFN
October 2009: All tests normal; Take 50 mg Clomid CD 5-9; BFN
July 2009: Ob/gyn asks for bbt chart, S/A, CD3 b/w; plan tbd.
April/May 2009: Switch from OPKs to the Clearblue Fertility Monitor
March/April 2009: Start using OPKs and bbt

2007-2008
Sept/Oct 2008: Stop preventing; 'if it happens, it happens'
Summer 2008: Stop BCPs; using bbt chart to prevent pregnancy
May 2007: Married again! husband #2; no plans for children

Previous Life
Fall 2005: Divorced
Summer 2005: See RE; more b/w, clomid challenge test, sonohysterogram; 2 Clomid IUI cycles - BFN; male factor discovered (he now has a child with wife #2)
Spring 2003: See ob/gyn for IF, get b/w and HSG; All results normal; Husband #1 gets S/A, which he says is normal; results never sent to ob/gyn
Spring 2002: Stop BCPs, begin ttc and charting bbt
Oct 2000: Married to husband #1