It Shouldn't Be

I decided to spend the $350 and go to my local clinic. As I lounged in bed until 7:45, I decided this was a *VERY* wise decision and well worth every cent.

But, it was upsetting this morning when I realized that I knew all the nurses and the doctors called out my name and asked me how I was doing. And, all the people in the waiting room were new, anxious.

I was the veteran.

With no badges evidencing my success.

P.S. And, to only make matters worse, my antral follie count was only 7. AWESOME.

I didn't want to be there. Doing this again. In the exact same place I was a year ago.

Bye Bye Cranky

If you haven't been able to tell by my last month's worth of posts, I've been mucking around in some dark and dreary emotional bogs. Questioning the foundation I laid for my life's structure (selection of mate, selection of career pursuit, etc.), my end goal vision for my life's efforts, and the ideals upon which I made all these decisions. I am finding it easier to fall into the mass-produced, commercialized, non-introspective version of accomplishment: big house, happy marriage, several kids, money-making career, car with appropriate logo, bling, bling, bling. Sign me up to be one of the mindless masses. I vowed to become some version of a Stepford wife: fully botoxed, brow-lifted, and boob implanted. Quit my job, spend copious amounts of time working out, and learn how to properly apply make-up, do hair, and select "cute" outfits. For, if I could become someone's version of a "perfect life" … maybe it wouldn't bother me so much that my life wasn't so.

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CAVEAT: Please do not take this to mean that I am disparaging of stay-at-home moms, rich people, people that own big houses, people that have had cosmetic surgery, etc. I am more poking fun at the caricatures of success promulgated by mass media, People Magazine, and The Real Housewives of XXXX, among others. Let's just say I've spent too much time watching T.V. this past weekend and there is a lot of junk out there! In fact, I do dream of staying home with my little guy, being able to work out whenever (once a running addict, always a running addict), etc. And, what's not to love about a big house? See how conflicted I am???
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Thankfully, the clouds appear to be lifting, as my husband mentioned the other day that I no longer grunt in response when he says hello in the morning. In fact, he said that I even gave him a smooch without him even having to remind me to use my "human skills" and express affection to those we love. (Admittedly, I am by nature the less affectionate partner…and become even more troll-like when in a funk.) I've also begun again to recognize the beauty in the life I have created: a husband who knows and loves me and can make me laugh hysterically; friends I can lean on; a comfortable house with happy colors; a career where I get to use my brain (well, almost 50% of the time). However, in going through all of this, there are some gleaming cracks to which I need to attend. I am not sure of the wisdom putting off this self-maintenance until we reach closure on our attempt for another child. I'm not sure I can pursue both at once. But, they are niggling at the back of my mind and I wish someone would straighten them out for me.

Enough about that.

Today is supposedly CD3. I got my withdrawal bleed on Sunday after quitting the pill on Friday. Interestingly enough, my improvement in mood coincided with quitting the pill…

I don't get the antagonist cycle. It doesn't feel real that I have started the cycle because I haven't DONE anything yet. No drugs. No doctor's visits. I guess all of this will change tomorrow…

The big debate this week was whether I would get up at 4 am tomorrow morning to drive up for my first monitoring appointment with the clinic in NJ. My sucky insurance company will only cover me for treatment at one clinic, so any visits to the local clinic will be entirely out of pocket ($350).

What do you think? Is it worth $350 to skip 8-10 hours in the car and an early AM wake-up call? I was thinking not…but then woke up to icy weather conditions this morning and groaned at the thought of having to drive a significant numbers of hours ALONE in this crap.

Root Cause Analysis

In my family, the solution to a problem is to find the person/event/thing to blame. Once the duely accused has been accurately identified, the issue at hand is considered to be laid to rest, no further analysis required. My husband believes this is an intellectually inferior analysis as it assumes that in placing blame the problem is solved. He also holds that this sort of logic fails to cover the "sh*t happens" category of life challenges and results in a lack of ability to gain "perspective" and move forward.

Over the past few months, I have been trying to conduct my own personal root cause analysis of our infertility.

The simple answer would be to blame my husband for his poor sperm quality. And, some days I certainly do that. But, that doesn't explain my "diminished ovarian reserve." I try to convince myself that I can still hang Fault on him because if his sperm didn't SUCK so much, we would have gotten pregnant when I was 28 and first "pulled the goalie." Thus, I would have gotten pregnant respectively at 28 with my first and 29 or 30 with my second. No problems. Life would be Easy Street.

I then take this sort of thinking one step further: my selection of a mate and wondering about prior ex-boyfriends and their progeny-making potential. Would I have a brood of Bengali-American mini-me's with my college boyfriend/best friend/love? Or, would I have outdoorsy, simple kids with my high school boyfriend after spending a few years abroad. This alternate life "sliding doors" fantasy leaves me feeling distant and guilty about questioning the life path I have chosen in marrying my husband. My feminist self chastizes for falling into the pre-industrialized world-view that my life's aspirations should be pinned up the potential achievement of my husband. The greater sin seeping into my mind is that my life would have been better without my husband. That if I could tell the young me in the bar the night that I met my husband that I should STAY AWAY from that charming young boy with the wry wit and golden tongue because I would be chosing a life with pain and strife. I am sure that my idealistic young self would say that "pain and strife" is found in every life path and that the more important selection would be of a partner with which to bear the burden. Older, callus me would tell younger, idealistic self someday I would find the love of a child more important than romantic love. That if I was asked between saving my husband or saving my child before my house burned to bits, I would emphathically choose my child.

Since placing the blame on my husband results in a less than appealing self portrait, I try to blame the socio-cultural values which provided me with the logic of denying the human body's biological preference for procreation in the late teens and 20's. Of finding value in establishing one's sense of self, adventure, and career prior to pursuing the nuturing of a young child's heart and mind. Even more, I find myself resenting that the stronger convention for me wasn't to get married young and have babies while I was still a baby myself. Why didn't I see how much "cooler" it would have been to be younger than all the old, ancient moms? Why did I think that my kids would like me more if I had an interesting life before they were born? Why did I think my kids would respect me and my time more if I had an established, interesting career and vocation? Why did I think that I would feel more satisfied with my life if I had these experiences prior to having children?

I find myself questioning the value of having a career at all. What exactly did I think that I was going to ACCOMPLISH with my career? Why didn't I know that the only thing that would matter to me in my life would be to have children?

At the base of my root cause analysis is the scariest thought of all: that somehow I am to blame. For not knowing myself enough. For not knowing how important it was for me to have a family and make decisions accordingly. For not having the foresight to see the culmination of my life's decisions resulting in pain and anguish.

I find it a heavier weight than I'd like to bear, failing life's game of chess.

Less Room in my Heart

Lately, I've been feeling like there is less room in my heart. Like I am some version of the Grinch with a heart two sizes too small. I am convinced that I am the only forsaken one and everyone else lives these smiling, happy, perfect lives. The constant inner dialogue--or rather bickering--in my brain between the "good" me and the "bitter" me is endless. And, more often, I am finding that the "bitter" me is winning.

I took this lovely on-line infertility stress test the other day (and we know how accurate and reliable on-line tests are). Turns out I should probably be institutionalized. Or at least have intraveneous happy drugs. Or live on my therapist's couch. I swear I'm not exaggerating. They should have just labeled me as "certifiably kah-razy person" who is not handling the stress of infertility well. Um, are you really serious? Is it NOT normal to feel sad most of the time when going through multiple failed IVF treatments? Should I be estactically happy when people tell me they are pregnant? IS there anything to research on the internet BESIDES infertility treatments? (DO you know how many times I've googled the phrase "success stories after multiple failed IVF treatments?" Enough times to know that if I refreshed my computer every 15 minutes for the next three weeks nothing new is going to pop up.) Did the person that created this test EVER go through infertility?

Back to the original point of my post: not everyone is living gloriously perfect lives. As much as I would like to believe this because it would validate my "woe is me" depression and bitter-mean thoughts sprinkled upon undeserving prey.

CASE STUDY A THAT LIFE IS NOT PERFECT FOR ALL THOSE WITH BFPs:
My friend who got pregnant on her first round of IVF...and who I couldn't bring myself to call the first week after her BFP? Turns out she has a really slowly rising beta, had her doctor tell her at 5 weeks there was no fetal pole, only to reverse this diagnosis at 6 weeks, and has been continuously bleeding due to a blood clot. Not perfect. Not easy.

CASE STUDY B THAT I AM NOT THE ONLY ONE THAT EVER HAS BAD THINGS HAPPEN:
My other deliriously fertile friend who gets pregnant the first month she tries and even managed to get pregnant with twins (NATURALLY) the first month they started trying for #2. She's in pre-term labor at 29 weeks.

Life is not perfect for everyone else. If we ever do manage to get pregnant, life will not be perfect for me.

This is a horse-pill for me to swallow at the moment because I'd rather be this adolescent whining about how NOBODY understands my PAIN and NOTHING anyone else is going through can POSSIBLY be as hard as what I am going through. (Note Sarah McLachlan music in background.)

Where Have I Been?

• Avoiding the fact that we've spent a year doing fertility treatments with no positive results.
• Avoiding pregnant people.
• Avoiding people with small babies.
• Avoiding the email in my in-box inviting me to participate in the elite field of racers for the DC Marathon (ha, double-ha...can I even run 1 mile at my old pace right now???)
• Avoiding failed New Year's Resolutions.
• Avoiding the fact that I have to return to work full-time to help pay for more fertility treatments or adoption.

But, I've also been trying to enjoy the two weeks off with Nugget. I feel so thankful to have him and have loved my time with him. If we ever do get to have another child, I hope that I can take a few years off of work and just enjoy the children.

Baking Christmas Cookies:












Practicing Taking Pictures with my Pretty New Lens:











Watching Nugget Enjoy Spending Time with His Grandparents:











Watching Nugget Enjoy His Bounty of Christmas Presents:











I will write more later. There has been quite a lot of drama going on with our insurance company. One day we're covered for a cycle in NJ. The next day we're not. It's so draining. Oh, and we didn't strike gold with our natural cycle this past month. Sigh.

Tired of Being Left Behind

The hardest aspect of infertility is the loneliness. It is isolating to be so far on the other edge of fertile. 3 failed IVF cycles this year. I know no-one that has come this far or spent this much with nothing to show (other than those of you in the blogosphere). I know that others have talked about the hierarchy of pain and how we tend to diminish others pain if they have not suffered as much or as long as we have. I want to be a bigger person and not be bitter, but it is difficult to be surrounded in a world of people that know nothing of the pain and struggle we have been through this past year. To listen to my friends talk about the timing of their second or third child, while we are dying to have another is agony. If only we could worry about timing.

I have two friends that have gone through fertility treatments (IUIs and IVF) this year and both got pregnant. One friend got pregnant on her second cycle with twins and delivered her healthy baby girls last week. I found out yesterday that the other got pregnant on her first IVF cycle. I am so weary of never getting to the other side. To see them get pregnant and move on with life. While I am still here, still stuck. Still not pregnant.

I want to rid myself of this pain, but I don't know how. I can't run until exhaustion. I can't cry enough tears. It lives in me, this warped bitter chain of thorns around my heart. Pinching every time I breathe.

Cornell Meeting: Hope Glorious Hope

The RE was great: the right balance of concern, empathy, and scientific reasoning. She said that given my husband's numbers, while the morphology was low, there was no reason to believe that we couldn't get pregnant naturally. That being said, she said that she understood how we must find this inconceivable given all that we've been through this past year. She suggested the following:

Protocol change: My AMH and low response did indicate that I had an ovarian reserve issue and she thought that we needed a different protocol that did not include lupron, as it was likely oversupressing me. In addition, she would pretreat the ovaries with a "different agent" to coordinate the growth of the follicle (estrogen priming protocol?). She said that she would also start us at a higher dosage of FSH stimulating (for example, follistim) and limit the FSH/LH stimulating (menopur).

Day 3 versus Day 5 Transfer: She suggested that we do an "aggressive" Day 3 transfer, i.e., transfer 3-4 embryos. She said that there has been a shift in protocol to using Day 3 transfers again and that the body is the best incubator for the embryos, which is why Cornell does co-culture of embryos with endometrial cells from their patient.

No PGD, Immune Issues, Endometrial Implantation Issues: She also said that she didn't believe that we had any genetic issues that impact the quality of the embryos and wouldn't suggest PGD. She said they don't know the long term impacts of PGD and that PGD might identify one cell with an issue, but that other cells may be chromosomally normal. She said embyros have an ability to "heal" themselves and that if the embryos were given a chance to survive on their own, they may overcome any of the issues in one or more cells. She also doesn't believe that we have any indicators of immune or endometrial implantation issues.

So, now what?

We don't have any insurance coverage with Cornell and would have to pay out of pocket. IVF costs $15,000 (co-culture, ICSI, assisted hatching), which I believe doesn't include the cost of the drugs, so tack on another $5-7,000.

We would have insurance coverage for RMA and would likely only have to pay for the PGD ($4,500) if my husband's insurance doesn't cover it.

Do we try one more cycle at RMA since we would basically have to pay nothing and then if that doesn't work go up to Cornell? Or do we just go to Cornell now and suck it up?

Do we do PGD? Is it just a waste of money? If we don't do PGD does it make sense to go to RMA?

Decisions. Decisions.

HELP!