You are currently browsing the monthly archive for July 2012.

There are some days that infertility doesn’t really phase me. I’m sure that’s unimaginable for some people, but I’ve struggled to have children for so long that a lot of times, it’s just part of me, and isn’t something I really dwell on. I remember when I was married to my ex, and first struggled with infertility – it was so different. Infertility was inescapable. It was on my mind all the time. That was over ten years ago, though, and I guess if I hadn’t figured out a way to deal with all this by now, I’d have lost my mind.

I remember when my ex and I had been ttc for 6 months. I was terrified and sad – I just couldn’t believe this was happening to me. In all honesty, I freaked out. I would read about people who had been trying for a year or more, and I didn’t think I could stand it if I still wasn’t pregnant in six months, or even worse, a year. I took vitamins, I charted, I used opk’s…and we crossed into the territory of trying for over a year. I had some initial bloodwork and a HSG. My ex had a SA. I stopped drinking alcohol. I gave up caffeine. I bought a fertility monitor. Nothing worked. One year turned into two, and while I thought it would get harder, it didn’t. I think in some ways, I gave up. I finished my master’s degree, and ‘when we have children’ turned into ‘if we have children.’ I think I started to doubt it would ever happen. The more I was able to accept the fact that we may never have children, the more determined my (now ex) husband became. As we approached the three-year mark, we finally made an appointment to see an RE*. I felt like I defied the odds when I saw a long awaited positive on a pregnancy test a month before seeing the RE. I had 24 hours of shock and happiness before I miscarried the next day. We started treatment a month or so later. Six months after that, we stopped treatment and got a divorce. I was 31.

Deciding to try to have a family after getting remarried was hard. We were so happy, and I didn’t want to risk that. I was afraid what infertility might do to my marriage with M. That was the hardest part…well, that and the fact that I really didn’t want to deal with the disappointment of infertility again. When we passed the six-month mark, I knew that once again, it wasn’t going to be an easy road. I think I realized, then more than any time before, that there really was something wrong with me*. I was the common denominator in the struggle to have a baby. There were times I was sad, but it was nothing compared to the devastation I felt the first time around. We didn’t waste time and saw an ob/gyn at the six-month mark…had more testing…and no answers. I charted and used opk’s, but no luck. We tried Clomid. I don’t know if I really expected any of it to work out, so it was more frustrating than disappointing. I guess when your expectations are incredibly low, it’s hard to be let down.

We moved on, and took a break. At some point, we agreed that we would just accept that we couldn’t have children. In all honestly, after coming to terms with the decision, it wasn’t that hard. There were times that it was sad, but it wasn’t really part of my day-to-day life. I was infertile, and while I wished I wasn’t, I accepted it.

The problem, though, is that the option is always there to change your mind. A year after we supposedly came to terms with living childfree, I decided to try acupuncture. I thought that maybe since traditional medicine had been unable to find a solution (or even the problem), an alternative approach might work. I was hopeful, and almost optimistic. After four months, it became obvious that this, too, wasn’t working, and we decided – again – to stop ttc and commit – again – to living childfree. We’d been ttc for almost three years. I was 37.

I think, if things had gone differently, we might have continued along that path. But a series of events happened: I was diagnosed and treated for severe cervical dysplasia; my father was diagnosed and treated for a rare form of lymphoma (cancer); my friend, who dealt with infertility for seven years, got pregnant via IVF; and everyone we know who hadn’t had children yet decided to have a baby. We decided we don’t want to have any regrets, and we’re running out of time.

It’s hard to feel optimistic after all this time. Our first IVF cycle is approaching, and I obviously want it to work, but it’s so hard to believe that it could. It’s so hard to imagine it all working out. It feels like winning the lottery…I haven’t spent much time imagining it because it probably isn’t going to happen. That doesn’t mean I wouldn’t be ecstatic, though.

I find myself thinking about our current situation all the time – wondering how the IVF cycle will go and whether it will work. We can’t plan anything that would take place after September because we don’t know if I’ll be pregnant or if we’ll be trying more cycles of IVF. I don’t know if my eggs will even respond, and I don’t know what we’ll do if they don’t. It feels like the end of the road…we’ve put this off and procrastinated and tried to accept other options, but here we are. We’ll either come out of all this with a baby, or we won’t, but we’ll know we tried.

*Although we were initially diagnosed with ‘unexplained infertility,’ our second or third IUI showed that my ex had almost no sperm. The suspicion was that he had an infection. Years later, he remarried and had a baby. I don’t know if his issues were resolved or not.

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I’ve been getting back into my exercise routine after a lapse from a work trip. Swimming, running, and yoga – it feels like a good balance.

I’ve been thinking about my RE and am thankful that she’s such an advocate of exercise and fitness. At the IVF orientation, she mentioned that she recommends exercise before and during IVF (unlike some RE’s), because she thinks it’s advantageous to be as healthy as strong as possible during an IVF cycle. She said the stress-relieving aspect of exercise doesn’t hurt, either.

I’ve become obsessed with making my own bread. It’s delicious and better for you than store-bought!

I’ve also been figuring out ways to eat all the vegetables we’re getting from our garden.

I’ve wondered if all this garden-tending and bread making (I made my own pasta a few weeks ago, too!) are somehow a temporary subconscious effort to feel like I’m creating something – since I’ve failed so far at making a baby.

I’ve tried to be thankful for a summer free of infertility treatments, even though that was not the plan.

I’ve realized that early September (when I should start IVF) isn’t all that far away!

I’ve wondered what we’ll do if IVF doesn’t work…and how many tries it will take to come to that realization.

I’ve been thinking about DE and wondering if it’s a good fit for us. I haven’t come to a conclusion. I’m hoping we don’t have to address it, but I know we might. We were really interested in adoption and only abandoned that idea because of the cost (my health insurance covers IVF) and some concerns I have overall that I’ll have to address another time. But, the idea of adoption is appealing to me, and I look at DE in some ways as an extension of that. One of the advantages of DE over adoption – for me – is having more control over the in utero environment, less concern about bonding/attachment (I know most people who adopt have no problem with attachment/bonding, but it would be less of a concern for me with DE), and the ability to use younger and healthier eggs. I love that there would be a genetic link to my husband, too. My main concerns are related to the issue of whether or not to tell family, the child, when to tell…but I guess I have some time to think about all that. M was totally opposed to DE but is now less opposed.

I’ve tried to be more optimistic about my upcoming IVF cycle. It’s just so hard to imagine anything working after all this time.

I’m over my frustration from last week. I don’t feel like I have a choice, really, but to just deal with it an move on. When I think about the time that’s passing – or has passed – since my lap in April, I can’t help but be aggravated, but it’s not really anyone’s fault. Here’s a quick recap of my delays:

  • May: I realized I didn’t have insurance approval (pre-authorization) to move ahead with any kind of treatment. This was partially my fault, because I should have realized and mentioned it sooner. They really couldn’t have submitted anything, though, until after the lap, because that documented stage 3 endo as a cause fro treatment. The billing person at my RE’s office could have also asked about it earlier, but since the insurance company didn’t mention this requirement when she called to confirm my coverage initially, she didn’t know about it. The insurance company also gave her the wrong information for requesting pre-authorization, which delayed things further.
  • June:  great news – insurance approval received in time for my cycle. Bad news – IVF lab is closed in July, which is when we would need to do the retrieval. Another delay.
  • July: AF arrives a week early. IVF is delayed again because of a trip we have scheduled in August.

We’re going to try to see if IVF will work in August, but I have a work trip in September that I can’t cancel. It keeps lining up where these trips occur exactly when I’d need to be monitored, which is massively frustrating. The worse case scenario is that I’ll start bcp’s for my IVF cycle in September. I only have to take them for a week or two, and while I do have a work trip scheduled for September, I should be on bcp’s then. I have no travel scheduled until November after that, so I am hoping it will work out. I’m counting on it, really. 

It’s massively frustrating to have to wait this long to do anything. I wish I were thinking more clearly when they told me the IVF lab was closed, because I would have asked about doing a medicated IUI instead. I thought of it this time, but with AF’s early arrival and my work trip, it just didn’t work out. I’m annoyed that the nurse didn’t get back to me to confirm that a medicated IUI cycle was out of the question, but I feel like I’m sort of in a strange place at the RE’s office. I was switched over from the all-things-but-IVF (ATBI) nurse to the only-IVF-nurse, and it seems hard to switch back. The IVF nurse is awesome and really responsive, but when I tried to find out about a medicated IUI cycle, I assumed (maybe incorrectly) that the ATBI nurse would be the one to talk to. She never got back to me, which is disappointing. I’m trying to give them the benefit of the doubt…maybe they just don’t want people switching back and forth between treatment plans out of desperation to do anything at all? 

I thought about asking about a medicated IUI cycle again, but if IVF is delayed again in August (which I am expecting, really), a medicated IUI will also not work because of that trip we have planned. So, IVF it is – and it’s really only a month away, anyway. It just feels like it’s taken forever to get to this point. I just need to make the best of it in the meantime.

As if it wasn’t complicated enough trying to figure out if we should do IUI or IVF this cycle, and trying to see what would fit within my travel schedule, I realized today that my period is coming early. I’m spotting – kind of a lot – and woke up in the middle of the night with cramps, which I’ve had on and off ever since…and today is CD 23. I could scream or cry or kick something…because I’m pretty sure that means we’ll be doing NOTHING again this month. I thought a medicated IUI would be a good option, but I have to go out of town for work on Tuesday, and I won’t get back until very late Thursday night. Since it’s now Friday afternoon, I don’t see how I would have time to get medication before leaving at 8 am Tuesday morning. On top of that, there’s the whole monitoring aspect of it, and the problem of traveling with medication and dealing with all that on a work trip. I can’t see how IVF would work at all, because it’s no longer a question of extending bcp’s by a week or so – my August trip would fall right in the middle of an IVF cycle no matter how you figure it. It’s just so incredibly frustrating – I went to the RE in February, had surgery in April, and have basically been wasting time ever since.

And my early period? It’s such a reminder of the fact that I am running out of time – that things are getting out of whack, and my eggs are getting old. Did I mention my mom was in her mid-40’s when she went through menopause?

I’ve looked at calendars and plotted things out, and had some discussions with M about the possibility of doing IVF when my cycle starts – which should be next week. My RE always starts with bcp’s, and I already know she wants to use the lupron flare protocol. She plotted an example of an IVF cycle out of me a few months ago, and I looked at some online, too. My RE starts with 2-3 weeks of bcp’s, followed by lupron, then stims, etc.

The only way I’d be able to start IVF (or preparing for IVF, I suppose) next week is if I take bcp’s for three weeks, instead of two. We have a trip planned and a wedding to go to, and I’ll be out of town for five days. Those days are four weeks after my cycle should start, and if I took bcp’s for two weeks, I’d need way too much monitoring by then to be out of town. I could even be getting close to retrieval. If I took them for three weeks, my guess is that I would be on lupron and stims during the trip. It would be early in the process, and I don’t know if they’d let me go five days without being monitored, but I guess I’m wondering now if I even want to deal with IVF while traveling. The IVF nurse thought we could swing it, but after going to the orientation and hearing how important it is to stay in town during the cycle, I’m just wondering if we shouldn’t wait until there’s an easier month. Another issue is that I have to travel in September for work, and it looks like the timing issue is almost identical in September as it is in August.

What do you (the small handful of people who are reading this) think?

Here are our options:

1. Stop worrying and just do it. As long as the IVF nurse thinks we can swing it, start IVF with my next cycle and bring the medication on the trip. Cross our fingers that the timing works out ok, and try not to stress about it.

2. Do a medicated IUI cycle in July and August (which M and I have not tried), and start IVF in September.

3. Stop trying to figure it out and just ask the IVF nurse and the RE what we should do.

We had our IVF orientation yesterday. It wasn’t mandatory, but the nurse encouraged us to go if we could. It was pretty informative – most of it I already knew, but they had someone from the lab present, too, and that was interesting. I think M and I learned a few things.

The downsides were that they kept emphasizing the decreased success rates with advanced maternal age, and they mentioned a few times how difficult it is to coordinate an IVF cycle while traveling. I’m sure that other people felt like the stressed different aspects of IVF, and it might be that those jumped out at me because those are pretty much my two concerns, but it left me feeling kind of apprehensive.

I’m sure they mention the decreased success rates because they want people to have realistic expectations. I mean, not everyone does research and reads blogs, right? I’m sure there are a lot of people who think IVF is a sure thing, and it’s not. And it’s less of a sure thing when you’re nearing 40. Still, though, it’s hard not to be bothered by it. Why didn’t all my friends who are the same age as I am who got pregnant easily not have to worry about advanced maternal age?!? I couldn’t help but feeling like my ovaries are like a ticking time bomb, and that we’re running out of time. I’m 38, but my FSH was high, so not only do I have advanced maternal age, but I’m running out of eggs (by the day, it feels like).

Then, there’s the IVF scheduling. If they let me be on bcp’s for three weeks (instead of 1-2) at the beginning of the cycle, I think it can work out. If not though, August AND September will be out. I have trips planned at the same point in the month two months in a row, and I can’t get out of either of them. I feel like I keep getting myself emotionally and mentally prepared for an IVF cycle, and sometimes it feels like it’s never going to happen! Between these scheduling issues and my ticking-time-bomb ovaries, I just feel so frustrated and honestly…kind of bummed.

It’s hard to feel optimistic about something when it seems like it’s never going to happen.

Today is CD 19, which means that AF will arrive sometime next week.That also means that sometime next week, I’ll be calling the IVF nurse to start bcp’s. I’m nervous and excited. We’re going to an IVF orientation tomorrow, and I don’t know if that’s going to make me feel better or worse. I have leftover IVF medication from a friend of mine (who is literally having a baby any day/minute), and I feel like it’s a ticking time bomb in my fridge. At first, I was able to just ignore it, but now that my IVF cycle is looming in the not-so-distant future, it’s like it taunts me every time I open the door.

I’ve got a pretty good exercise regimen going, and I’ll definitely plan to continue that until I can’t. I hoped to lose a few more lbs, but I’m already a healthy weight – I just wanted some buffer for any potential weight gain from IVF or lack of exercise.

I’m trying to be optimistic and excited without counting on it working the first time. I mean, there’s a 50-60% chance that it won’t, so I don’t want to get my hopes up. If it did, though, that would be freaking incredible. After 4.5 years, I can’t imagine knowing I am going to have a baby.

I’m still a bit freaked out about some travel I have to do in August, and how that will affect the cycle, but I’m putting my faith in the hands of the IVF coordinator and am assuming that she knows what she’s doing. Since I travel for work, and we both have friends and family on opposite coasts, there’s rarely a month where I don’t have to travel. Hopefully, this August trip won’t pose too much of a problem.

In the meantime, I feel like everything is in limbo. I don’t know if we’re going on the vacation we planned for the spring, because it’s dependent a little bit on whether this cycle works (I don’t really want to be 8 months pregnant on vacation!). My office is in shambles, but I don’t know if it’s worth dealing with because we’ll need to move a lot of things around to accommodate a nursery. I don’t know if we should be throwing ourselves into projects around the house now, so that M doesn’t have to do them on his own if I’m pregnant, or if we can do them at a leisurely pace. And then there’s my job, which is getting stranger by the day, but I have to keep it in order to have IVF covered by my insurance. What I want to do about my current job situation also hinges on whether or not we have a baby.

I know it’s common to feel like it’s impossible to plan when dealing with infertility, but because we’ve been at this for a while, that aspect hasn’t affected me in years. I mean, the chances of us actually having a baby were so slim that we’ve pretty much lived like it wasn’t going to happen. Now, though, we’re caught in the middle – unable to live like it isn’t going to happen, but not like it definitely will, either.

When AF arrives next week, I feel like a whole bunch of uncertainty is going to arrive with it.

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