T- 4 days

Baseline Ultrasound is tomorrow, and injections begin Sunday. I can hardly believe it.  I feel like I’ve been utterly consumed by a move and remodel, policy deadlines at work and oh yeah throw in an IVF cycle, too.

I mean, I am prepared, I’ve called the clinic several times “just to talk” aka answer my lists of questions. The drug order is standing by at the pharmacy at a whopping $4k waiting for me to make the call after tomorrow’s baseline appointment to have them overnight it. Consents all signed, time off work kind of confirmed (going to wait until the Baseline scan is a sure thing….) But still, how did we get here already?!

There are still so many uncertainties. Last time we moved into an IVF cycle, I tried to talk out all the details with Ryan beforehand.  I wanted to know we were on the same page for EVERYTHING, that we were fully educated, discussed all scenarios, and had a game plan.  This time around, I’ve accepted that’s just not realistic.  Ryan is emotional and a worrier (he would totally disagree, but I am married to the man after all, so I have a right to assess his personality).  Trying to present “worst case scenarios” and too much detail just gets him all revved up and the conversation gets nowhere.  So instead, I am playing it by ear.  If and when we have to confront embryo counts, miscarriage, FETs or embryo quality, we will.  Until then, it’s just not worth diving into the messy particulars.

I’ve been worried something is going to go devastatingly wrong. Maybe because that’s what happened last time?  Or maybe because my body never does well on birth control.  I skipped a day last week accidentally, so took 2 the next day, and ever since I’ve been spotting and bleeding daily.  Last night my left ovary was hurting – badly enough to wake me up several times.  I am nervous that I’ll go in for the scan tomorrow and something will be off.  As a male-factor couple, my body performing perfectly is something we are banking on.  I tell myself the doctors know what they are doing, I am nothing new or unusual, and I need to trust the process.  Still, I will feel better after tomorrow when we have a look at my system and I’m told we are a go.

And then, let IVF begin.

How to talk to your 40-something upwardly mobile divorced-with-no-children Director about infertility

In short, I don’t. I honestly don’t think he wants to know about my personal life and I don’t want to discuss my infertility with anyone, let alone my boss.  But my Director approves all my time off, and the erratic requests for blood draws, ultrasounds, egg retrieval surgery and embryo transfer will no doubt raise his curiosity.  My options, as I see it, are 3:

  1. Say nothing at all. Request the time off that I know in advance. When the unpredictable couple weeks come around and I’m driving 4 hours round trip multiple times a week to get my blood drawn and undergoing minor surgery and an embryo transfer, just call in sick as needed. It’s legitimate sick time, used at the doctors, and I can’t arrange it in advance. So call in sick when I need to, which will be a lot, and just let everyone deal with it.
  2. Be cryptic. Sit down with the boss and say “I’m having a minor surgery and will need some time off, but my doctor is waiting to see how my body reacts to certain medications before he schedules it. So I will be taking a lot of time off in the next few weeks for consultations and surgery, and just have to be kind of on call. Sorry.” I don’t think he’ll ask questions or pry, but I do realize this sounds fishy. Or like I’m getting cosmetic surgery or something embarrassing.
  3. Be honest. Tell him everything. It’s the workplace, so he can’t discriminate, and I’m sure in all his uber-professionalism he is tight lipped and does not gossip. But still – what if it doesn’t work? Will he feel obligated to be polite and ask how everything went? So, so awkward.

Another concern is the secretary I share with my boss. She’s really sweet and motherly, and no doubt if I call in sick or take sick time off she will be badgering me with questions about my well being, with the best of intentions of course.  If I tell her I’m having surgery and deny details is that weird?  Again, telling my work people I am doing IVF is a territory I’d rather not traverse.  If it’s unsuccessful it’s just another bad conversation I must have.  Not sure how to approach this.

IVF has begun

I got my preliminary “instructions” via email yesterday – I’d be lying if I said it wasn’t a little overwhelming.  And this is the easy part!  A physical calendar is in the mail.  I picked up my BCP this morning and popped the first one – now I can start tackling this list one day at a time.

6/22/17 – first day of last menstrual period
6/23/17 – start birth control pills; Take 1 pill daily, active pills only same time everyday
7/5/17 – last birth control pills. Spotting and light bleeding is normal after stopping last pill
7/8/17 – RESTART birth control pills; Take 1 pill daily, active pills only same time everyday
7/13/17 – Injection class and consent signing for you and your partner in a group with a nurse at 9:00am
7/20/17 – blood test before 8:30am in Lab THEN ultrasound at IVF Clinic
7/20/17 – last birth control pills. Spotting and light bleeding is normal after stopping last pill
7/23/17 – Start Follistim and Menopur injections to be taken everyday AND couple to take Azithromycin 1000mg after dinner
7/26/17 – Last day of Exercise and/or Intercourse/Sex.
7/27/17 – blood test before 8:30am in Lab THEN ultrasound in IVF Clinic (present your venture card to the receptionist). Bring your Ganirelix on this appointment.

Pity Party for one, please

I have mentioned my sister is pregnant. Leah is 2 years older than me and we’ve always been close.  This is her first child, the first grandchild in our family in 12 years, and everyone is very excited.  Everyone except me.

I was at a family gathering this last weekend, Leah and her husband were there, and all anyone wanted to talk about was her baby. Her pregnancy has been harder for me to face than I expected, and I’m ashamed and annoyed that it bothers me as much as it does. I’ve had one frank, tearful conversation with Leah; the moral being Infertility Sucks.  It sucks for Leah, since this joyous occasion for her is tainted by my pain.  It sucks I can’t genuinely be happy for her; I try to, and I make an effort to inquire about her health, the baby, and I say “that’s so exciting!” even though it’s all out of obligation.  I want to do what I can to make this as un-awkward as possible for all parties involved, and that means sticking a smile on my face and faking it.  It sucks that this lifelong bond with my sister is suffering at a time when she least deserves it.  It sucks that my mom and my other sister, Alexis, are also roped into this dual role of celebration with Leah and sympathy for me.  It sucks that Leah knows they are showing restrained enthusiasm because of me, and that Leah doesn’t get to be the recipient of unbridled family excitement.

And it sucks for me. It’s been easier for me to dig deep and find sincere happiness and joy for friends’ and coworkers’ pregnancies.  It’s different with Leah, I suppose because I feel some possession over the family’s reaction and everyone’s interest in her growing stomach.  Those well wishes and inquiring questions were supposed to be for me.  It sucks that I had hurt feelings from the beginning, when Leah announced her pregnancy to me in front of other people, and I had to bite back the emotion for hours until everyone left. That week no one reached out to see if I was ok with the news; even when I called my mom and we talked about “Leah’s pregnant! So exciting!” she didn’t even mention ANYTHING about how this might be hard for me. I don’t need my aunts or uncles or friends or coworkers to walk on eggshells around me, but I do need my mom and my sisters to proactively support me in my grief the same way they support Leah in her joy.  And it sucks that they didn’t offer this freely, and in my bewilderment I thought maybe I was being selfish, and it took my husband calling my mom and admonishing her that she finally picked up the phone and asked “how are you doing with this?”

Even though we talked it out, it sucks those wounds still hurt, and that I’m jealous and I’m sad; I know it’s not a good look. It just sucks.

We are doing IVF at the beginning of August and the timing is precarious. We aren’t even sure if Ryan’s sperm will make viable embryos or if they will implant.  We are hopeful, but the month of August will be one hurdle after the next through an egg retrieval, embryo transfer, 2WW and beta counts.  My mom has declared August to also be the month of Leah’s baby shower, and is already group texting us about plans and details.  She went as far as to offer my house for the location, which will happen on a cold day in hell.  I think it comes from a good place; my new house and lovely reno being the one bright spot in our lives, and my mom maybe thinks I’d feel pride at showing it off? But a house hardly makes up for the inability to have a baby.

When Leah’s baby is born, late September, I will either be newly pregnant or perhaps grieving a loss or failed cycle.

There is no way around any of this but through it. My emotions and well-being are at stake, and so are my sister Leah’s.  Our mental health and need for family’s support is not mutually exclusive, and we will be competing needs.  I truly hope I have reason to celebrate in the next few months, but I know I have to go in with eyes wide open.  Hoping for the best, but preparing for the worst, and knowing that August and September might be the best month’s of Leah’s entire life, and some of the worst for me.

Last Natural Cycle

“Was thinking it would be awesome if somehow by the grace of God you got pregnant.”

I went away for the weekend with some of my girlfriends. While I was crushing grapefruits and limes into my tequila and peering out at the expanse of blue lake waters off the patio, my phone buzzed on the countertop and this was the message that appeared.

According to my app, last week I was ovulating.  This was my last natural ovulation before starting BCP, hella hormone injections, and ultimately completing an IVF cycle.  So like any good couple who is trying to conceive, we tried.

You see after almost 5 years of negative pregnancy tests, next-to-nothing sperm counts, and doctors telling us “you are not a candidate,” we still hold out hope.  A part of both Ryan and I still think maybe this month will be different.  Maybe we will be that lucky couple who tried and failed and tried and failed and waited years and finally signed up for IVF and just weeks before starting we got pregnant naturally!

That’s the worst part of infertility, in my opinion.  No matter how slim your chances, how long, how broke, how much the hope and optimism has been beat out you, you still naively wait for your period every damn month and think “maybe this could be it.”

But if not, at least I know we didn’t go down without a fight.

Maxing out the credit cards

Today I purchased one fresh cycle of IVF + ICSI.  It cost $13,200.  (This does not include medication, which they say will be $3,000 – $6,000.)  I split it between 3 credit cards.  We have about half saved already, so we will pay that off, transfer the remaining balance to a credit card with a no-interest promotional period, and pay it off slowly over the next year.

Ryan asked “Does this mean there is no turning back?”  Well, not really.  If we happen to get pregnant naturally, the whole thing is refundable.  If we change our minds, we lose a $500 deposit, but that’s all.  Both of us have a healthy dose of cold feet and feeling slightly nervous, but not like last time.  As big a commitment, decision, and purchase as this is, we know what it’s like to not have the option.  In this life you get one lap and you’re done, and I know taking the IVF plunge is part of my journey.

We are on the Kaiser calendar for the week of July 30th.  My next step is to call on the office on the first day of my next period, which should be May 20th.

Onward!

Good News + Good News

I had a doctor’s appointment yesterday for a saline sonogram and trial transfer – essentially giving the doctor a chance to go up the hatch and make sure everything was as expected.  I had 9 follicles on one side, 12 on the other, and my lining was 6.8.  I have no idea what any of this means, but I am including it since I hear so many infertility blogs reference these things. The doctor tells me I passed this part of the process with “flying colors” and everything looks great.  We did expect my reproductive health to be a non-issue, but good news is good news so I will take it.

However, as a couple facing male-factor infertility, the big unknown was Ryan’s appointment today.  He drove the 3+ hours in rush hour traffic to visit the clinic’s man room full of nudie mags and produced a sample to put on ice.  The plan is for him to do this a couple times prior to IVF so there is something to fall back on should his fresh sample not be sufficient the day of.  One of the possible diagnoses the andrologist mentioned is that Ryan may have a system that fluctuates wildly in sperm production.  Some times it’s not good, but sometimes it’s really, really bad.  It’s been all over the place – though always low – and there’s no telling what you get.  I asked the doctor to please examine this sample before freezing.  After all, we’ve been this far before only to hear the shocking news that Ryan is incapable of producing viable swimmers.  So… can we please be sure that won’t happen again? I have been worried this will happen again.

We just got the results, bless this Dr. for sending them just an hour after the appointment, and we have count at 1.5M and motility at 17%.  This is HUGE, people.  Last time I want to say count was under 100 (not 100K or 100M, but 100) and motility 0%.  The puritanical diet is paying off!! Dr. says this will be fine for IVF with ICSI, and it will be frozen and waiting for us.

So much peace of mind! Having a decent, usable sample on ice means we at least won’t face the devastation of a cancelled cycle last minute.

I have to praise God for this one.  It has dawned on me recently that God may be using my infertility struggles for his glory.  After all, if there were no infertility in the world, God wouldn’t be able to really show his power and his strength and prove true all that positive scripture about how he cares for us and will make the childless woman a mother of children.  Life can’t be perfect if Jesus wants to step in and do some great work.  So if that’s what this battle is all about, this public display of grief and disappointment, then so be it.  Because I know God will deliver us, and he wants to be sure others know, it, too.

He gives the barren woman a home, making her the joyous mother of children. Praise the Lord! Psalm 113:9

He heals the brokenhearted and binds up their wounds. Psalm 147:3