Why Am I So Calm?

Honestly, I have no freakin' idea...

I was having trouble sleeping all weekend worrying about cycling in July. That may sound ridiculous to some, but I have felt for months that in order to maintain my sanity, I needed to allot time for at least two cycles this summer. I would be comfortable trying a FET once the school year begins, but I wanted at least two tries (either two fresh or one fresh, one frozen) before returning to work. After all, the crazy IFer always has to brace herself for failure and have a Plan B.

Anyway, I was stressing out majorly that we wouldn't be able to cycle in July, I and I was basically powerless to do anything over the weekend. Now that it was Monday, I took charge and decided to do whatever I can to ensure a July cycle.

I started calling both Penn and Cooper at opening this morning. After leaving yet another message on the medical records office voicemail at Penn this morning, I decided to just go in person and push my way to my HSG and IF records. As soon as I got out of the shower, the IVF nurse at Cooper called me back with some good news.

First of all, I have a CD3 baseline ultrasound and bloodwork scheduled for early tomorrow morning. She seemed to have a protocol in her hands because she said that she would submit the order for my prescriptions today. She did say again that we were really down to the wire, but I told her that I was on my way to Penn for some records and she seemed pleased with that. She mentioned that we would be stimming with Menopur and Follistim, but upon hearing that we are self-pay patients, she said we may swap to Bravelle instead of Follistim so that we could take advantage of their H.E.A.R.T. pricing program. So, that sounds like we have a protocol, right?

Anyway, she said to wait by the phone for a call from Freedom Pharmacy in the event that they need billing and shipping information. After I got the release forms filled in for Penn, I went off to my part-time summer job of babysitting a precious seven year-old with Down syndrome, keeping my phone close by all day.

When I got home from babysitting and C came home from work, I recapped my discussion with the nurse and we decided to go ahead and call Freedom as I had not heard from them all day. Of course, just to throw another wrench in the gears, they have no record of us or any prescriptions. Luckily, they overnight all of their meds, so as long as I can get the nurses to put through the order tomorrow, I will have the meds by Wednesday. If I have to start stims tomorrow, I can either ask for sample meds or beg for a separate script for the fertility pharmacy in the same complex as the RE.

So, here's the same question again... Why am I so calm? Maybe I am just too tired from freaking out all weekend, or maybe I know it's just too late to worry. At this point, whatever is going to happen will happen. I am just hoping that everything is sorted out by the time I leave Cooper tomorrow and I can get my meds and get this show on the road.

Things I Learned This Weekend

1. The diagnostic cycle was a BFN. Duh. I went in on the 5th for our pregnancy test, but my body has been wanting to start spotting for almost a week and the progesterone has been the only thing holding that off. It was pretty obvious to me that it was a bust anyway, but procedures are procedures.

2. It's news to everyone at Cooper that I wanted to do IVF this month. Umm, why else would I be here?! I made it pretty clear on several occasions, but it doesn't help that I see someone different pretty much every time I am there. When I went in for the beta draw, I asked if I should make an appointment with Dr. C to discuss the next steps, but they said to wait for my results and they would provide instructions. When the call finally came, I was told to stop the progesterone, but that there were no appointments with Dr. C until August (?!) and that I didn't have a protocol or any scripts written up (?!?!). Apparently, I still need more tests that I wasn't told about and my HSG and medical records from Penn still aren't there.

3. I may not be able to cycle in July after all. Even though DH and I rushed in this morning for the infectious disease blood work, there is still no protocol or scripts. Today, I began bleeding, so tomorrow really should be CD1. That means ALL OF THIS needs to be sorted out in the next 72 hours or July is out of the picture. I only get two personal days per year and I am starting a new position in September, so I was really counting on two chances this summer. I will be crushed if this logistical nightmare forces us to wait until August. IVF was supposed to bring me hope and right now, all I feel like doing is crying...

The diagnostic cycle rolls on...

We are back from the beach and this diagnostic cycle continues, even though my body is giving signals that June is over and it's ready for July.

After posting on the boards and getting a bunch of advice from other Cooper patients, I decided that I would just go ahead to the beach on Saturday and commit to the appointment on Monday instead. On Monday, I went in for an ultrasound and blood work, but no post-coital. Only later did I find out that I was supposed to have a post-coital, but I didn't see the point since C and I didn't get very "coital" in our tiny, thin-walled condo that we were sharing with two lesbian friends and my aunt. Nope.

Anyway, the ultrasound revealed that one of my two follicles had "fizzled out" and that I would have to come back on Thursday. Tell me something I already knew - they concluded that I was a super-late ovulater. On Wednesday, C and I had to very awkwardly and quietly have sex, then go back for yet another post-coital/blood work/ultrasound. They found more bad CM that was "way too thick" and inhibited sperm movement and that the dang follicle was still there. They said that it may be that the egg itself had ovulated, but that the follicle was still working itself out, so I was told to start progesterone suppositories on Friday.

Fast forward to yesterday, I started spotting so I called the RE to see if I still should be using the suppositories since it seems like my ute is over this and ready to move on. She said to keep using them and that spotting was not uncommon.

If this diagnostic cycle has taught me anything, I now know that CM is an issue, but that it was significantly improved with Mucinex. I was also being really dried out by allergy meds, so I'm off those. (Achooooo...) Finally, it is abundantly clear to me that even though my ovulation is very regular, it is really off, so it needs to be regulated with meds and monitoring.

I guess it has been really helpful in the decision-making process, however. Initially, Dr. C really wanted to try more things with either TI or IUI before moving on to IVF, but was also open to moving on if we preferred. I think this cycle (and my nine failed IUIs) have convinced me that moving on with IVF is our best option. It looks like everything that needs to be healthy is ready to go for IVF and the things that need improvement are pretty much bypassed by it. We've decided to move forward with a July IVF when this cycle is over.

I am supposed to go in for a beta draw on July 5, so to me that will be the "all systems go" date. Even though my body would like to be "perioding" right now, at least the progesterone is holding that off until next week so we can start this thing off right. Oh, and conveniently it is holding off until I get to do more fun stuff we have planned for this weekend and the 4th of July! (Hey, I have to find the positives in IF sometime, right?)

IVF Consultation

It's been a while and I guess it is time for an update!

Our first appointment for our IVF consultation at Cooper was yesterday.  It was very strange, to say the least.  Dr. C's office is unlike any other doctor office I have ever seen.  He sits behind his desk in in an ornately-carved wooden throne with giant medieval looking furniture all around the room and - I kid you not - Enya playing on a loop from big speakers on the bookcase. 

While we waited for the doctor, a young Zac Efron-looking guy kept poking his head in the door.  When we originally were seated in the office, there was a wallet and keys on the table that had been left by a previous patient.  I figured that this guy was awkwardly looking to grab his wife's wallet without disturbing us.

Much to my surprise, when Dr. C came into the room, the same young guy followed in and had a seat right next to us.  Dr. C said that he was a medical student here to observe, in all his t-shirt, shorts and flip flop-wearing glory.  Under normal circumstances, that would be fine, but this guy sat slumped in his chair almost as if this was the principal's office and he just started a food fight in the cafeteria.  Seriously, dude.  If you are going to sit in on a conversation about my vag, sit up in your chair and put on some pants and a damn labcoat. 

As soon as the conversation started, Dr. C put it right out there - he would love for us to do an IVF at Cooper and he would totally understand if we wanted to start right away during the summer due to my schedule as a teacher, but he thinks there are more options.  He was stunned and dismayed to hear that C's sperm was never checked for antibodies, that I had never had cultures taken of my cervix, that my cervical mucus (CM) had never been tested, and that we never had progesterone therapy.  We have been TTC for over three years and for just about two of them, we have been taking Clomid, Femara and ovulation triggers, then suddenly just whoosh - an RE is telling us that this protocol was almost pointless for us. 

I should say that I thought when I made this appointment that we would be discussing protocol options, maybe taking a few more tests, then getting our prescriptions in order and drawing up our calendar for a July IVF.  After getting all this taken care of, C and I are supposed to leave tomorrow for the Jersey shore and just relax.  We have not been on vacation for years, and I mean we literally have not even taken a day off.

Within a few minutes of talking to Dr. C, though, C was providing a "sample" in one room while I was getting bloodwork, ultrasounds and a post-coital test in another.  After seeing two follicles in the right ovary, no observable CM and excellent test results from C, Dr. C wants to do a diagnostic cycle right now and actually try to get us pregnant this cycle with just progesterone therapy and Mucinex.  He gave a very convincing explanation as to why my previous IUIs didn't work and I was actually thinking that with my new assessment of inadequate CM, this might just be all that we needed.  He ordered us to pick up some progesterone suppositories and Mucinex from the pharmacy, have TI at 7am, then come back at 9:30 today for a repeat post-coital. 

I drove all the way back to the office today for another post-coital, ultrasound and bloodwork.  (Did I mention that the office is in NJ and I live in the Philly western burbs?!)  Now I am starting to get freaked out.  They were able to get CM during the post-coital, but it was only rated "fair."  I was fine with TI, progesterone and an appointment or two, but today they started talking about IUIs and more appointments.  They are saying that they want me to come back tomorrow and Monday, but this is a bit of a problem...

C and I are scheduled to leave bright and early tomorrow morning for the beach.  We are traveling with two friends who do not know about our IF or treatment.  Our only option if they make us come in would be to detour through Marlton on the way to the beach and just awkwardly explain to our friends on the way.  If I have any appointments after tomorrow, however, I will have to drive three hours roundtrip from the shore house to the office.  We have a few daytrips planned with my coworkers and other friends and I may have to cancel these if we proceed with another IUI.  This would be really frustrating, especially considering that I am not optimistic about IUIs. 

Right now I am waiting for the call about my bloodwork, but I am seriously considering not going tomorrow.  If I have to make the drive for an appointment or two next week from the beach, I can get over it, but I don't think I have another IUI in me, especially if it means my friends sitting in the car waiting for me tomorrow.  I guess we will just have to wait and see...

Took the first step...

It's been ages since I have posted here, but it's about time I did. I called today and made our first consultation appointment for IVF for June.

It's really beginning to sink in that we are moving on after so many failures and such a long break. I am cautiously hopeful that this might really work for us. I had been thinking or a long time that summer would be the perfect time to cycle and since we last spoke, my mom has really been pushing me to take the first step. My last official day at work is Wednesday, June 13 and I really meant business this time - I made our appointment or my very first day of summer break.

I don't really have much else to write about. I will just be spending the next few weeks focusing on weight loss, vitamins and gearing up for treatment again!

NIAW 2012

So, once again I missed National Infertility Awareness Week. It just ended on Saturday and, ironically, the theme of this year's NIAW is "Don't Ignore Infertility," which is exactly what I have been doing lately.

It's been incredibly hard to ignore, and yet incredibly easy at the same time. It is hard to watch everyone around me celebrate their children and their new arrivals and pregnancies. I have another team member who is counting down the minutes until her maternity leave, two others still on maternity leave, not to mention that I am one of just a handful of non-parents and I just got invited to a baby shower for a woman I have never met.

On the other hand, when there aren't periods of elevated hope each month, there aren't periods of massive despair, either. Without treatment, there's just a constant level of wishing and dreaming without the roller coaster ride of hopefulness and hopelessness. It feels like it has been forever since we have been in any treatment at all and yet it is almost time to get the ball rolling for our summer IVF.

I haven't been on the boards at all lately, not on purpose really, but because I have been extremely busy and I feel like I have nothing to say. While others are moving forward, I am just standing still.

On a mostly unrelated note, I have been moved at work to a new position and I'm not very happy about it. I have worked tirelessly over the last four years building a science curriculum from the ground up and now I am expected to pass that work onto someone else. I have been moved to 7th and 8th grade social studies and I will be starting from scratch all over again. I'm not upset about it and in the long run I think it will work out fine, but it was a bit of an unwelcome surprise.

Nevertheless, I already told my boss that I was planning to have a "procedure" this summer and that I wouldn't be able to come in and plan as often as I normally would have. I hope at this time next year, work will be the least of my concerns...

Another "closet?"

This post was written in late March, but I am only getting to post it right now...

Well, I'm in full swing of Spring Break and, while it's not as eventful as I had hoped, we're having a good enough time of relaxing and getting some housework done.

My email inbox has been flooded lately with messages from Resolve gearing up for National Infertility Awarenesss Week in April. Just like last year, this brings up a mixed bag of emotions for me, particularly involving my privacy about my IF.

Right now, only my closest relatives know about our struggle. My mom, my two closest aunts, my "couslings" (my cousins that are so close, they are like siblings), and my dad are the only ones who know, and a handful of friends. I sometimes think that it must be "out" by now considering how long it's been since we were married and the fact that so many people do know, but many of C's relatives continue to ask questions and aassume we're waiting, so I guess not...

Anyway, I was reminded of something very insightful that a grad school professor once said about prejudice. During a conversation about prejudice and racism, several students made some grandiose claims about what the "worst" kind of prejudice is. My professor, who was one if the most brilliant and inspiring that I have ever had, happened to be gay. She said that she would never quantify what was worse or harder than something else, but there is one definitive way that being gay is different than a given race or ethnicity. She said that while your appearance may not announce your affiliation, like race obviously does, there is an enormous and undeniable fear that even those closest to you might reject you or judge you when they find out. Throughout your life, your race is known to those around you and your family is generally of the same background. But when you're gay, you can try to hide it, or you can face that fear head-on. As a friend and family member to many gay people and an outspoken supporter, I found this incredibly wise and thought-provoking.

Just like my professor, I will never attempt to quantify a particular experience, but there are certain parallels with infertility that are worth discussing. First of all, there is always a choice to hide your infertility, or to come out and discuss it. I have decided that I will only share my diagnosis and my struggle with those who are closest to me for now because, admittedly, I fear judgement from others about my choices. I also find the questions painful, even if they are well-intentioned. Once we have success, however, I will share the long journey with more people and I will have no fear of their judgment because I will have a little person in my life who proves that I made the right choices.

Similar to my professor's comment is the fear that even those closest to you may reject your choices or foist their opinions on to you. Those friends and relatives who I have told are the ones I knew would be 100% supportive and had no agenda. I also knew that they loved me and C enough to let us make the choices and not to pry. Those who do not know, however, are the ones for whom I had some doubts. C's family is not only Catholic, but supremely fertile, while C and I seem to be both supremely un-Catholic and supremely un-fertile. His parents also are completely broke, by their own choices, I must add, and I'm sure would have a thing or two to say about our spending $1000s on what came to them for free... seven times over. I really don't need their opinions and prying any more than I am already getting it.

My family, on my dad's side at least, also has it's religious wing. I have never bothered to consider what their views are on IVF, IUI or ART in general, and I really don't care right now, so they can wait, too.

As many people as there are who push us to "just adopt" out of either opposition to reproductive medicine or some compassion for kids who "need homes," there are just as many people who would impose philosophical objections on that adoption. There is a significant movement of people out there who would judge, even hate us for raising a child of a different race. I even fear that C in particular would face some serious rejection from his own family and co-workers. Even if the child were white, there are many in our lives who I fear ould not consider the child he same way. Again, the judgement of infertility can be sneaky, hidden and embedded into your own family and friends.

During National Infertility Awareness Week, I would like to embrace the notion that there is no shame in infertility, a notion that I whole-heartedly believe. On the other hand, I also believe that my infertility is also my own and I can choose to deal with it in any way that I choose. That's the double-edged sword of so-called "awareness" movements. There is no shame in it and I would love to own it and march on Washington, but I also need to do what is best for me to deal with it in the now.

So, for the time being, it's going to remain private. I will post here about NIAW, but there will be no Facebook campaigns for me. When we do finally have success, I feel like it will be such a blessing and release, not only that we finally get to have our child, but also that we can unburden ourselves of this semi-secret that we've held onto for so long.