Wednesday, September 10, 2008

Sharing the News

A few days ago, T and I broke the news to my mother. Over breakfast, we said we had some news. Her eyes shone, and she started to smile. It was clear she thought she knew what we were going to say.

"No, don't get excited," I said. "This isn't good news."

At that, her thoughts went to the worst case scenario. "Should I get out some Kleenex?" she asked.

"No, it's not bad news, either. It's just - we are starting IVF."

Naturally, she wasn't that familiar with IVF and had tons of questions, which I think we answered. It was a long discussion. In the end, trying to be reassuring, she said she was "happy for us."

"Really? You're happy I get to inject myself with all sorts of drugs?" I joked, even as I understood her intent.

"No, no. I just mean, I know everything will work out."

It might. But there's an equal chance it might not.

In any event, I'm taking birth control and counting down the days until the Lupron injections start.

Tuesday, August 26, 2008

10 DPO

I'm ten days past ovulation, and nary a sign of pregnancy in sight. I'm not tired, hungry, or experiencing breast tenderness.

But of course my hopes are sky high. My doctor decided to check my progesterone, and it's at 30.5. Which is high, and also good. Anything over 15 is good.

I'm telling myself not to get my hopes too high, and, logically, this progesterone level means nothing. But it is hard to silence those hopes.

Wednesday, August 20, 2008

Cautious First Steps

T and I met today with our fertility doctor to get information about IVF. We're still not certain about taking that next step -- or, rather, I am not certain; T seems to have few qualms.

Even though I consider myself somewhat knowledgeable about the IVF procedure, the hour was a deluge of information, too much to digest.

This is the process, as described to me, and assuming my recollection & notes are accurate:

-Take birth control pills for 3 weeks
-Subcutaneous injections of Lupron for 10 days
-Subcutaneous injections of follicle stimulating hormone, multiple times per day, not sure how long, with monitoring ultrasounds every 2-4 days
-Subcutaneous injection of "trigger shot," timed exactly 36 hours before egg retrieval
-Surgical egg retrieval, requiring anesthesia
-Beginning on the retrieval day, intramuscular shots of progesterone, continuing for up to 12 weeks if pregnancy results
-Fertilization at the lab after retrieval
-Wait 3-5 days after retrieval for embryo development
-Transfer of embryos into uterus
-Wait, hope

After this, a 40-50% chance of a viable birth.

There are also ethical issues to be addressed: How many embryos will we transfer? What should be done with unused frozen embryos -- discarded, donated to science, donated to another couple, preserved? What should be done with those frozen embryos if one of us dies, or we divorce?

It is a lot to take in. My head is spinning. But we won't make the decision just yet.

Tuesday, August 12, 2008

Adoption Education

T and I attended the first of the many education classes required to be able to adopt in our state. It was a long day, and an emotional one.

About 30, maybe more, people attended. Some couples with biological children, but most not. Some couples who chose adoption as the first and only step, but most not. It was reassuring, in a way, to be in a room filled with people who have some idea what we have been going through. A better idea than do we, even - many of them have progressed much further in fertility treatments.

Between lecture, small group discussions, videos, and presentations from adoptive parents, the day was emotionally exhausting. We heard from a married couple and a birthmother about their open adoption experience -- how and why she chose the couple, how they negotiated the openness. Of course, the agency put on the most ideal example. They have such a warm and open and caring relationship; the seven year old daughter even attended her birthmother's wedding last year. I think if everyone could be assured of having this kind of experience, adoption wouldn't be nearly so scary.

I also got a chance to speak with them further over lunch. The adoptive mother answered a question someone had by mentioning, in the course of her answer, "I know I am her mother." I asked the birthmother whether that was hard to hear. Not at all, she replied. "I knew this was their baby. It was like I was carrying her for them."

Of course, it was not all sunshine and roses. Part of the education was to talk about risk factors - the possibility of fetal alcohol exposure, drug exposure, unknown health problems, mental issues. It was an honest and tough look - and only the first of many classes.

What was most interesting to me was T's reaction at the end of the day. He is still on the fence, more so than I, about adoption. But something about the day's discussions flipped a switch in him. I have traditionally been fairly open about our fertility struggles, whereas T has told no one. But that evening, in a group of friends, while I had stepped away no less, T opened up and shared his story. I was stunned.

We have a lot to think about.

Wednesday, August 6, 2008

Yet Again

Yet again, I'd gotten my hopes up high, even as I told myself not to. That internal monologue is hard to silence, that glimmer of hope impossible to extinguish. 'Am I feeling nauseated? More so than I normally do at this stage of my cycle? No, this is typical. But what if it's not?'

Yet again, this time over a lovely outdoor breakfast with my family, on a weekend trip away, just before a hike, the cramps started. Another failed cycle.

My doctor now doubled my Clomid dosage from 50 mg to 100 mg, and I don't know why. I'm nervous about increasing the Clomid after it caused a cyst on an ovary not too long ago. I'm also nervous that it will, as usual, make me ovulate crazy-early, and specifically while T is out of town. But here I go, another try, yet again.

Saturday, July 26, 2008

Baby Shower

As luck would have it, the day of my most painful IUI ever was also the day of a friend’s baby shower. On the best of days, a baby shower is potentially traumatic to a woman dealing with infertility. Getting that glaring reminder – that there’s something wrong with you, that normal people don’t need drugs and catheters and blood draws and ultrasounds just to get knocked up – two hours after yet another technician has penetrated your cervix was not something I was looking forward to. At least the baby shower didn’t happen to land on the first day of my cycle. That would have been trying.

I left the decision until almost the last minute as it was, informing the hostess that I wouldn’t know until a few days in advance whether I could make it. Five days before the shower, I made my decision, and let the hostess know. One day before the shower, I tested positive on my ovulation prediction kit (OPK) – and had to tell the hostess I would be a bit late to the shower because I had a doctor’s appointment. I am sure she was puzzled. I did, though, let my friend, Hope, know exactly why I’d be late.

T almost didn’t let me go. I was still curled up in pain after the recommended 10-15 minutes of lying on the table had elapsed. When T saw how white I was, and how I was walking somewhat hunched over, he said he was scared I wouldn’t be able to drive out to the shower. I convinced him I would make it, and the pain subsided – not completely, but a lot – by the time I arrived.

As far as baby showers go, and judged from the perspective of a rational observer, Hope’s shower offered up nothing about which to complain. No over-the-top cutesiness, baby talk evenly balanced with non-baby talk, and only two party games – participation voluntary.

I am not a rational observer.

One woman, a friend of Hope’s whom I’d met once or twice before, mentioned that she wished she could have a third child. Since she had two girls already, she wanted a boy. She joked that, if she carried another girl, her husband probably wouldn’t even show up to the delivery room. Someone suggested she do sex selection via IVF. I said nothing. But, I admit, I was bitter. How nice to have two healthy children, so easily. How fortunate to joke that having a female child would be of so little consequence that your husband would ignore her birth. How flippant, to suggest offhandedly fertility treatments solely to choose the sex of your child, probably blissfully ignorant about the pain and the side effects and the costs involved.

This probably sounds as if I were more bitter than I really was. These thoughts were fleeting, and I extracted myself from the conversation quietly.

Surprisingly, what affected me the most was not the cute baby clothing, or the tiny toys, or the baby talk, or someone asking whether I planned to have children. What caught me off-guard and threw me for a loop was that another of Hope’s friends, Cindy, was also pregnant, about 7 months along. I’ve been acquainted with Cindy through Hope on and off throughout the years, and I like her, but we’ve never been friends. So I’m not sure why it felt like such a punch in the gut to see a second pregnant woman at the shower. Maybe I just needed the time to mentally prepare, to put up a wall.

In the end, I went to the baby shower. And I’m glad I did. I am happy for Hope – truly I am – even as I am occasionally sad for myself. So I am glad I made the decision to try to put aside my negative thoughts and celebrate this new life that is coming soon

Sunday, July 20, 2008

Back in the Stirrups Again

There's that old saying about doing the same thing, over and over, and expecting different results this time as a sign of insanity.... I found myself with my feet up in the stirrups over the past two days for yet another IUI, hoping again that I'll defy the 3% success rate odds.

In June, my entire treatment cycle was canceled because the Clomid caused me to develop ovarian cysts. I couldn't start Clomid in July, though, because I was traveling when I needed to visit the clinic for a diagnostic ultrasound. Clomid would have doubled my success rate odds to a whopping 6%. Alas.

I like to describe an IUI (intrauterine insemination) as the "medical equivalent of using a turkey baster." The clinic processes a semen sample, washing it to select only the best and brightest sperm, and somehow "waking up" the sluggish ones. Then, my feet up in the stirrups, my ass all but hanging off the end of the table, naked from the waist down, the technician inserts a catheter into my cervix. Through the catheter, the sperm are deposited directly into the uterus, apparently so that they have less of a chance to get lost and don't have as far to swim. Wait. I thought these were the best and brightest. Apparently, lazy, too.

In my experience, the pain can fall anywhere in the range from, "Wait, you're done? I didn't know you started," to, "F@s#$, I'm going to kick you in the face!" Yesterday's IUI fell squarely on the painful end of that spectrum. Normally, when there's pain, it's more like menstrual cramping, but only when the catheter is inserted. Yesterday, the pain got increasingly worse as the technician worked - and it did not end when she took everything out. I lay on the table, with one hand over my eyes and the other gripping my husband's hand, white with pain. Even after 20 minutes, I was scared to get up because I thought I might pass out or vomit. When I did get off the table and went into the bathroom, I saw that my face was pale as a sheet.

The next morning, of course, I was fearful, knowing I'd have the same technician. The wait seemed eternal; as compared to 1 1/2 hours from start to finish yesterday, the whole process today took 3 1/2 hours. There was no apparent reason for the delay. Luckily, today's procedure went a million times more smoothly. Only some slight cramping when the catheter was inserted, and it stopped within a minute.

So here I am, in another two week wait. Hoping that this time, the outcome will be different.

Tuesday, June 24, 2008

Beginning the Process

We completed our preliminary paperwork to begin the adoption process today. Filled out the basics, wrote the check, mailed it to the agency we'd researched.

T, my husband, perhaps is not entirely on board with adopting. I perhaps am not entirely on board with the next step in fertility treatment. The only thing about which we seem to be on board is creating, somehow, a family.

I am at a point where I am genuinely excited about the possibility of adoption. Scared, too, but filled with giddy anticipation. At the same time, I have not given up on conceiving a child. The steps it might -- probably will -- take to get there, though, now seem overly daunting. And I cannot say whether I can take them.

Where this road will take us remains to be seen, as do the twists and turns the road will take. Adoption? IVF? A life without children? But the journey has started.