You know you’re infertile when…

While most (…ok all) of my posts can be slightly depressing, I figured it’s important to mention that sometimes, you need to look at the lighter side of things!

Here’s my top 10 list of…

“You Know You’re Infertile When…”

10. When someone asks you what day it is, you respond by answering with your cycle day.

9. You buy home pregnancy tests in bulk from the dollar store… (because your husband threatens to leave you if you continue to buy the $20 ones!)

8. Every time you see fraternal twins your first thought is “I wonder if they were fresh or frosties?”

7. You take a home pregnancy test after taking an HCG trigger shot just so you can see the elusive 2 positive lines.

6. You learn how to read transvaginal ultrasounds while lying on your back.

5. You have a dedicated shelf in your fridge for injectable medications, needles, and vials.

4. You ever wondered if it’d be considered a threesome if the RE plus your husband were in the room when they finally got your pregnant.

3. You have shot up in bathroom stalls at work, restaurants, movies, theatres… and it was perfectly legal.

2. You actually know exactly how thick your uterus is, how many sperm your husband has, or how many follicles are currently growing in each of your ovaries at any given time.

1. You cringe at a phone bill if you have $1.25 in overages but smile and hand over your credit card at fertility bills in the thousands without a second thought.

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Impossible Decisions- What next?

You can call me a lot of things… but unorganized isn’t one of them.  Knowing that Dan and I had to make some serious decisions about what to do if this next Frozen Embryo Transfer doesn’t work, I started to do some serious research.

I’m the obsessive researcher, and Dan normally just nods his head in agreement.  However, these were kinda big decisions so, in the next two days, we both had to become as educated as possible about all of our options to try and make the best decision possible for us.  So off I went.

I actually created little binders of information that I was able to pull together about private adoption, public adoption, international adoption, and surrogacy.  I searched adoption council’s, public forums, medical research, information sessions, and peer reviewed data and just kept hitting print.  I collated all of the information and gave Dan his deadline.  By Sunday afternoon, we had to both read all of the information I found by ourselves and put together a list of questions, concerns, and what if’s.  Sunday afternoon we would sit down and figure out how to move forward.

Much to my delight, Dan delved eagerly into the information with a highlighter and was making notes about questions and concerns.  Sometimes I feel like I’m so invested into this process and he seems less so… he proved me wrong, again.  We both studied up to prepare ourselves for the big meeting on Sunday afternoon.

Sunday afternoon hit and my teacher’s college training was making me twitch as I didn’t have a flip chart to start taking notes in my living room.  I made due and Dan and I thought the easiest way to approach this was to make a Pro and Con list for each of our options.

Our options included to keep trying with fertility treatments, private adoption, public adoption, international adoption, and surrogacy. 

Option 1: Keep trying with fertility treatments was our first stop.  The Pro list was just as obvious as you would think… being pregnant, having our biological child.  However the CON‘s list was a lot fuller…

CONs- $+++++;  When do we stop?  When is enough enough; I’m dying emotionally and physically; it may NEVER work; we cannot plan anything, cannot go anywhere; always extremely sore

Looking at our list, I was suddenly overcome with emotion.  I knew, right at that moment, we were done.  The list wasn’t even close to done, but I could continue with the CON side of the list for ages.  I broke down completely sobbing on the couch.  We were done.  If this frozen transfer didn’t work, we were done.   I literally wrote on the piece of paper “This is the last time”.  It was devastating and relieving all at once.  I had so many mixed emotions.  I was devastated that this could mean that I would never get to know pregnancy, never get to have my own child, never get to fulfill the dreams that previously seemed so normal… to have a baby.  But on the other hand, I felt like making this decision was like taking a massive weight off my shoulders.  Getting pregnant was becoming my life mission, and finally admitting that I might just not be able to do it, by no fault of my own, was suddenly like a wave of relief.  The pressure was off, the guilt about my body failing was gone, and the fear about new treatments dissipated.  I could breathe again.Dan smiled at me and hugged me until I could settle down.  He fully felt this was the right decision for us right now too.

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Ok, on we went with our pro and con list.  Next up was Option 2: International Adoption.  This was also a fairly easy one for us, in fact, we didn’t even have to make the list.  Because I have mental health concerns and a history of depression, 90% of countries with an adoption agreement with Canada would automatically exclude us from their list.  We didn’t meet the criteria.  It felt almost ridiculous that we could be discriminated against so blatantly based on medical concerns, however, it technically wasn’t Canada that was discriminating… it was other countries.  So what were we to do?  Cue another breakdown.

As if it wasn’t bad enough that we were going through the hell of fertility treatments due to MY medical issues, now, because of other health issues, we wouldn’t even be looked at for international adoption.  Dan really picked a winner… :S

Okay, so we’re down to three other options… Surrogacy, Public Adoption, or Private Adoption.

Option 3: Public Adoption… After looking into the general timelines and the ages of children that were available (infants were often not available), we decided that Private Adoption would be the route that we would take if we chose adoption. 

Option 4: Private Adoption

PROs- Cost-medium; not based on science/miracles; move past ivf/infertility; socially acceptable; help a child who needs a home/altruism; lots of education and assistance available to get started; child presented to you is as a choice; ability to research into the health of the baby and familial history to some extent; can start the process asap; adoption practitioner/agency to assist with process

CONs- If come into agreement while birth mother is pregnant, she can revoke it at any time; only able to work with one Mother at one time so all eggs in one basket; based on luck; no guarantee of lifestyle during pregnancy; not biological child; are we just giving up (fertility); 21 days (+8) that the mother, after the baby is placed in our home, that the mother can revoke the placement; based on luck; no guarantee of medical disclosure of birth parents; timing- average timeline for ‘adopt ready’ status is about 1 year; many adoptions are open adoption- a sliding scale agreement to allow birth parent(s) involvement in the child’s life

While there was heavy pros and cons on each side, this was a real viable option.

Option 5: Surrogacy

Even though this was not the route we expected to even think about, it was an option that we potentially had.  I felt it was important to look into each and every option so we made our PRO and CONs for this also.

PROs- it would be our own biological child; having the option like treating it as if it was our own baby while in utero (baby showers! ultrasounds! getting called when in labour!); legally our own child from the start with no chance of revocation; timing is shorter than other options; high success rate; feeling like part of the pregnancy; we trust Jen 100%; Jen has two other healthy children with uncomplicated pregnancies; Jen’s in a good place in her life and would psychologically be able to do this; there would be no complications during the pregnancy/birth due to me being on anti-depressants or having a bleeding disorder

CONs- $+++++ (actual estimates in Canada range from $70,000 to $90,000); stress on our friendship; definitely not socially acceptable- how do we explain this one to our friends, never mind our own child later on in life; would need to do another IVF cycle as we have no embryos left; not guaranteed to work; how would this be for Jen’s kids- this confusing enough for adults, never mind her own kids; confusing for her daycare kids (she runs a daycare)… plus try explaining this to her clients; 

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… We decided to take a break.  We made the lists, now we had to figure out where we were going next.  It was down to private adoption, or to have my best friend carry our baby…  Time to get a snack.  Food cures all.

We sat back down with two viable options.  We talked about the pros and cons of each and talked about the ones that weighed heavier than others.  Both potential options were potentially emotionally fueled.  We made the decision that money was not going to play a factor- we couldn’t force ourselves into an option simply looking at dollars and cents.  The heaviest issue for us with adoption was the idea that we could work with a birth mother for months for her to simply change her mind and either not give us the baby, or worse, take the baby back after s/he had been placed with us.  How could this be something we could get through?  Dan had always been a big proponent for adoption and we loved the idea of helping a child who needed a loving home. 

Having Jen act as a gestational carrier (surrogate) was, let’s face it, frickin’ weird!  But once we got over that ‘minor’ point, the option was actually interesting.  Dan, who previously laughed off the idea, was now coming around to having some real discussions on how it would work and what it would mean.  What would people say?  … wait, why do we care what people would say?

We spent an hour discussing the pros and cons… and finally came to a decision.  If this round of frozen embryo transfer was not successful, we wanted to seriously look into surrogacy.

Holy crap… (seriously, sometimes words don’t do justice to what you’re actually feeling).

Okay, to do:  1) Call Jen and let her know we are actually seriously thinking about her offer to carry our child if this round doesn’t work and pray she doesn’t run at the thought that this might actually happen. 2) Say a prayer that this crazy emotional day was all for naught and hope that the transfer on Tuesday is successful. 

All we want is a family… who knew it would be this hard.

 

Here we go again… FET #2

September 3, 2013.  My Dad’s birthday.  Also the first day of our next frozen embryo transfer cycle.

Although we continue to bounce the ‘what’s next?’ conversation around, I have decided to try and focus on growing my uterine lining! Yes, that’s what I want to focus on.

Today is the ‘random’ start date for my next cycle as I don’t have any natural cycles.  Mentally, I’m in a pretty good place.  I’m excited to start again, hopeful the drugs are going to work this time in a (sort of?!!) timely way, and that this is going to end with a positive beta test.  I am literally dreaming at night of how we will find out that it is positive- peeing on a stick, the phone call from the clinic, how to tell my family, who are we going to tell, and if I’ll just burst out crying because of the great news!  But I also find myself struggling… How much optimistism is good?  If I focus on the great news, the baby bump, the baby shower, the newborn pictures… will it just hurt even more if it doesn’t work?  On the flip side, moping around assuming it won’t work isn’t going to be doing myself any good either.  Is there such thing as a happy medium? (Literally.)  Dan says to focus on small steps, so step one is to start the estrogen pills again and pray that my lining starts to thicken up.

The goal is over 18mm.  I’m sitting at about 10mm when I start.  The good news is that the docs have learned that nothing is easy with me, so they start me, right off the bat, with a good dosage of estrogen.  They start me off on 6 pills daily (12mg), 3 in the morning and 3 at night, all vaginally.  Wonderful.  I’m back to being a smurf with blue pills.

The other thing we are giving a shot this round is acupuncture.  I have done a lot of reading and several fertility and medical studies have proven that fertility acupuncture has been shown to have positive effects during IVF and FET cycles.  At this point, I’m willing to try anything.

There is a clinic that specializes in infertility not far from the fertility clinic so I called and made an appointment.  The practitioner is an MD from China and was the deputy Dean of the Chinese School of Traditional Medicine in Beijing.   He came very highly recommended so I walked into the clinic on the first day of my new cycle.  Not really knowing what to expect, I was pleasantly surprised that he was very well versed in fertility.  He asked all the right questions about my cycles, the meds, the dosages, and checked me out from head to toe.  He instructed me to lie down on the bed and turned on ‘relaxing’ Oriental music in the background.  Honestly, I was half laughing in my head as this really isn’t my thing, but if there is even a chance it would work, then I’m at least giving it a chance.

The guy took my pulse and said I was too agitated to start so he would come back once I had calmed down.  Uhhh… ok Adele, calm down.  Ten minutes later, he walks back in and re-takes my pulse.  Apparently, I had settled enough for him and he asked me to close my eyes and focus on the music.  He proceeded to put little needles in the tops of my ears, my ankles, my feet, and all around my abdomen.  In all, there were more than 25 needles now sticking out from various parts of my body.  He put a basket covering my needle ridden belly and then covered me in a heavy blanket and told me he’d be back.  He gave me a mini doorbell to ring if I needed anything and then he left the room.

Generally, each time you had to lie there for about 30 minutes.  It was weird.  I was lying in this dark room with random ‘calming’ music in the background and supposed to be relaxing.  All I could think about was if this was all BS or if it actually worked… Cause if this was BS, he was sure putting on a really good show.

After 30 minutes, a small bell would ding outside my room and he would come in and pull all the little needles out.  I have a bleeding disorder so then I would have little pinprick fountains of blood trickling from various points in my body that I would try to stop with random pieces of kleenex.  I looked like a 14 year old guy learning to shave.  You honestly have to chuckle at the stuff I’m now willing to do if there is even a slight chance of success.  At $87.00 a pop, acupuncture was my new way to get another 30 minutes of sleep after fertility.  For the rest of my cycle, I proceeded to go about three times a week. Another $261.00 a week was peanuts compared to the amount I was paying for the meds and the actual procedure.  To be clear, none of which we really had at this point, but if I was in for an inch, I’d be in for a mile.  Oh, poverty induced by my fertility…

As my cycle progressed, the Chinese Doctor would calculate whatever special formula he had and moved the the little needles around my stomach like little soldiers preparing for battle.  It was a relaxing time for me to decompress and try not to think of strategy for my next meeting I’d be prepping for.

In typical fashion, my f*ing lining didn’t thicken up as quickly as it was supposed to.  You’d think by now, I’d expect that.  But each cycle I’d have a renewed sense of hope that the doc would have figured out my random medically puzzling body.  Alas, not yet.  After CD 5, I started daily monitoring appointments again.  I was driving 40 minutes for blood work and transvaginal ultrasounds each morning as a mini wake-up call.  Trust me.  This gets old.  Very fast.

CD 18 I was finally at 18mm.  My lining had never got thicker than this, but the clinic assured me that there was no benefit to being any thicker than this.  Once you hit 18mm, the chances of success were equal to that if I was at 19mm or 23mm.  Okay, it’s almost time.

We added in Progesterone suppositories again on CD 18.  The clinic decided to do things a tad different this time and they gave me the rectal ones.  Wonderful I thought, but the benefit was that I didn’t have time out all the various pills to shove up there at different times.  These ones I could put in the same time as the estrogen.  These turned out to be a life saver.  These didn’t make any mess at all and once they were in, you didn’t have to worry about anything until it was time to do it again.  If you told me I’d be bragging about how awesome the rectal suppositories were compared to the vaginal ones just a short year ago, I would have been asking what institution I was committed to.  Oh, how things change.

I am now on 4 estrogen pills vaginally in the morning and 4 at night, plus the progesterone suppositories morning, noon, and night.  Oh yes, this is the ‘easy’ cycle compared to IVF, but they sure keep you busy.  My hormones are raging and I’m hvaing every early pregnancy symptom out these plus menopausal ones to boot.  I spent my days dressing in layers so I could strip down at any time when I was hit by a hot flash.

September 26th was to be the big transfer day.  I booked special acupuncture appointments for before and after my transfer as the Chinese doc told me to, and I was getting ready.

The closer I got to the transfer date, the more worried I became about our back-up plan.  I needed to have some sense of control over this, and the back-up plan was my control.  I made Dan promise that before the transfer, we would sit down and hash out all the pro’s and con’s of all our options if this round didn’t work- then pick an option.  We shook on it and planned a date.  The Sunday for the transfer he promised me would be dedicated solely to fertility/life planning.

I was happy.  Two more days until our planning date and four until the transfer.  I started saying extra prayers that the back-up plan was going to be nothing but wasted time when we got our positive beta, but felt good knowing that we would have it ‘all figured out’… whatever that meant.

Breathe in.  Breathe out.  My new motto.

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Difficult Decisions… What Next?

We had our quick WTF (‘follow-up’) appointment with our RE.  He, again, gave us no answers.  He said they didn’t have answers.  My body was just not accepting the embryos.  It could just be bad luck, but could also be something wrong with me.  We knew the PCOS was what was screwing up the egg production, but my body seemed to not want to get pregnant either.  Great.  Onwards we go.
In my rollercoaster phase leading up to Sept 3rd, our new start date for another FET round, Dan and I were struggling with the biggest questions of all… when was enough, enough?  How many more rounds do we do?  How much money do we spend?  When is the emotional and physical turmoil too much to continue with.
At this point, we had spent 1.5 years dedicated to fertility.  To be fair, the first several months were simply appointments.  However, my life had consistent of nothing but fertility hell since January 2013.  It was like putting our lives on hold.  We were unable to do most things due to my daily appointments requiring us to be in proximity to the clinic, the shortage of money (which was all spent on fertility) or me being too sick or too sore to do anything.  Our quality of life had been decimated.  Yes, having a family was important to us, but at what cost?
Perhaps it was time to start looking at other options.  Other options… wait, did this mean I wasn’t going to be able to get pregnant?  I will never be able to feel a baby grow inside me?  I will never be able to feel the those first flutters that all pregnant woman talk about?  Did this mean that we would never be able to have our own children?  Would we ever get to have a newborn baby at home?  What were these ‘other options’ anyways?
And so I started to research to see what was out there.  To be fair, we still had two frozen embryos, and they were obviously going to work… but a back up plan was my way of staying in control.  At least we had a Plan B.  Or one could say that we’ve probably already used up the Plan B, C, D, E, F, and G.  So perhaps I was drafting a Plan H.  Nonetheless, a worst case scenario back up plan.  It was so incredibly important to me to have a plan because if our next round failed, we were back to square one.  No more embryos.  No next steps.
My best friend Jen* and I were talking through this all one day while I was driving to a meeting (on speaker phone!!).  She was great at the balancing act between staying optimistic, being realistic, and listening to my concerns.  She was honest and told me exactly how it was.  She was also amazing because, somehow, after all this, she was still willing to listen to be go on and on about fertility.  There was a reason she has been my best friend since High School (welll… except for a minor bump in the road where I hated who she was dating and refused to talk to her… Forgive me?) After analyzing every piece of our crappy fertility puzzle, she suddenly became serious.  “Adele, I know we’ve talked about this before and you keep blowing me off like I’m joking… but you and Dan can make great quality embryos.  It seems as if the only part not working now is that your body won’t carry them for you.  I know there is a lot to think about and understand, but Adele, I will carry your baby”.
Ummm… Cue me laughing nervously.  I start to stammer and say how Dan would probably faint before that happened plus that it is actually kind of crazy…. And she stopped me.  “Don’t answer me now.  You need to do another round, and we would need to seriously look into it and understand everything before making a decision, but just know that I’m serious”.
We then continued talking about life, our jobs just normal stuff but I couldn’t quite get this out of my head.  Jen, carry our baby?  WTF!!?… Would it actually work?  And is she on crack- this was actually crazy!
We hung up the phone and I immediately called Dan and told him we had to talk and rehashed the entire conversation that was just had.  Dan listened quietly then said how amazing it was for her to offer, but then asked if I was seriously considering the offer.  I told him I didn’t know, but I had never actually really thought about surrogacy as an option.  Dan said to focus on our next round.  Then said he didn’t think that was something he’d ever consider… it was too, well… weird.  This incredible offer that came out of left field that I didn’t know if we’d even need, just got shut down so fast I didn’t really have any more time to think about it.  Yah, I guess it is weird.  Fine.
If surrogacy was out, then what else did we have left?
1. To keep trying.  Do another round of IVF… but when do we stop?
2. International Adoption
3. Private Adoption
4. Public Adoption
5. Accept that we couldn’t have kids and enjoy our child-less lives together.
Dan and I had a long talk that night.  Tomorrow was September 3rd and I was starting another round of FET.  I made him promise me that we would set aside an evening with no distractions- just us- and work through the different options and figure out where we would go next if this round didn’t work out.  These were not going to be easy choices… but they needed to be made.  The deadline I gave him was that we needed to have our Plan B (or H or whatever we were at now) decided before they transferred our two last embryos.  He agreed.
Holy crap this sucked.  FET you better work!
*Names changed for the potentially not so innocent 😉

The Dreaded Psych Appointment…

After 9 months of fertility and medical testing, then 8 months of active fertility treatments, and an empty wallet & uterus, I was at my breaking point.  It was clearly demonstrated by my constant sobbing for over a week without even knowing if the latest transfer worked.  Our RE essentially told us that we (me!) had to go see the in-house psych doc before starting us on another cycle.

After finding out the bad news yesterday that our FET didn’t work, I was actually feeling a lot better.  Not knowing if it was going to be bad news yet again was the worst part.  Dan and I got ready to head into see the doc.  I really just wanted to wear pjs and not shower… but assuming he would be reading into every aspect of the visit, I dragged by butt up and into the shower.  Trust me… this was an accomplishment.

At the age of 19, I was diagnosed with depression, which was later diagnosed as chronic depression.  This meant that I stay on anti-depressants all the time, forever.  Up until now, I had never had any issues- my mood was great, my appetite better than good, I loved taking part in activities and keeping up with friends.

In the last couple months, I had slowly been transformed back into the me that I didn’t want to remember.  The me where I would much rather curl up in bed and never leave.  The me where some small miniscule thing not going perfect was enough to derail me completely.  Let me paint a picture of how my thought process worked.  I use the simplest of simple of examples: Stubbing my toe.  Now stubbing my toe on a normal, non-fertility time in my life would simply hurt.  Now, there might be a chance of a foot hop with a not so proper swear word, but that would be it.

Stubbing my toe while depressed: Stubbing my toe would turn into me being pissed because I ruined my pedicure… which would make me so upset because the money we were spending on fertility meant that I couldn’t actually get a pedicure… which would make me devastated because I would start counting the money we have spent and focus on the absolutely nothing we had to show for it but bad memories and wasted time… which would devastate me because I would think about all of the physical and mental pain going through fertility cycles… which would push me over the edge because I’m not pregnant and would need to do another cycle to try again…. which was hopeless because with these cycles even the simplest things didn’t go as planned…. oh not going to plan, that pretty much sums up everything that is going on with my life.  Cue me sobbing uncontrollably and staying in bed inconsolable for hours on end…. especially when Dan wasn’t as upset as me.  Doesn’t he get that our lives are ruined and never going to get any better?

You get the point… not pretty.

Well off we go to the psych appointment at the fertility clinic.  I had heard good things about the doctor, however, I wasn’t exactly sure how this was going to work.  I had been to my share of doctors re: depression, however, what did it mean to go to a doctor re: depression when I was already on anti-depressants?

We got called into the back room with this little old man.  He introduced himself and said he’d had an opportunity to talk to our RE regarding our unusually difficult cycles.  He sat us down and started to ask questions.  Me, being me, basically got right down to it.  I told him I know exactly what was wrong.  He stopped and asked me to explain.

I told him I’m a Type-A personality.  I love plans.  In fact, I take extreme pleasure in making to-do lists and short and long term plans.  Oh, and I generally get what I want.  I work my ass off and make sure that my plan works out.  I’m dedicated, passionate, hard working, and love having control.  That would be the issue.  I have zero control of fertility.  Nothing is working how it is supposed to.  The nice little 28-day cycle diagrams on the walls in the clinic didn’t mean anything to me as by day 28, I’d just be getting into the swing of things- not finding out if the cycle was successful or not.  Worse yet, the doctors didn’t even have control!  They had no ideas about what was going on and why I didn’t react to the drugs.

So take a control freak and put them in an incredibly stressful situation where they have no control, at all.  That equaled me.  An emotionally devastated 26 year old woman who could think of nothing else but the feel of an empty uterus.

The doc smiled and we chatted about life- how and where I grew up, school, work, our marriage.  You name it, it was on the list.  At the end of the session he basically said what we already knew- we had a great and supportive marriage, great relationships with family and friends plus lots of support.  However, I wasn’t dealing well with not having control.  He suggested that I already seemed to have recovered well from what our RE had described my emotional state yesterday, and he gave us the go-ahead to move on with a new cycle when we felt we were ready.  This time, however, we’d have to go back and continue to chat with him.

Sounded easy enough to me.  We walked out of the room and through the fertility halls.  I turned to Dan and said, let’s do this.  He wasn’t sure what I meant… I walked up to the IVF nurse and asked her what day I could start another FET cycle.  We had two embryos left.  My plan consisted of us getting pregnant ASAP and get this part of our lives over with.  I wasn’t going to wait.  I didn’t have control about much in this process, however I could have control over my start times.

The good news here was that because my body is so messed, I don’t have cycles.  Because I don’t have cycles, I do random starts.  So against Dan questioning me if I was ready, I booked my first monitoring appointment to get this show on the road.

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Failed cycles behind me, and a new Frozen Embryo Transfer to come.  I’m getting pregnant damn it. :S