Are your friends IVF Friendly?

The last couple of weeks have catapulted us deeper into the world of IF, and specifically IVF, faster than we had anticipated. This sudden change has much of our spare energy and brain time thinking and talking about this new detour in our journey to TTC.

As such, we are sharing varying degrees of this chapter of the journey with friends and family. As it was before with trying to get pregnant in the early days, repeat miscarriages, and infertility, we share more with some people and less with others.

There is my friend that knows every detail of my miscarriages and has been a great support. There is the dear friend who has shared a very similar path and knows all the IF lingo, goes to my same clinic, and is a great resource. There are family members that know bits and pieces- we share what we have the energy to share at any given conversation. And there are the friends that know nothing or almost nothing of our journey.

I have found it interesting as we now enter our IVF chapter that the unspoken rules and reactions from friends and family are changing a bit with some people. Some of our family and friends that I felt comfortable baring all to in the past, I don't feel as comfortable any more. One friend in particular, who has been a non-judgmental, well informed, eager learner throughout our TTC so far, seems to have changed the playing field now that IVF is our new reality. I'm don't know why she is pulling away, nor will I probably ever fully understand- but it has me taking a mental note that as we dive into IVF, not everyone is going to be IVF friendly friends. And predicting which friends will be is proving to be even harder.

On the flip side, I have two friends in my life that have been the most unexpected friends to rise to the occasion to be there for us right now. Both friends are as fertile as can be. (No, I am serious- we are talking fertile!) Both friends have very limited knowledge about IVF. They know about "test tube" babies, "petrie dishes", Oct.omom, and Jo.hn & K.ate plus8 (who by the way used IUIs not IVF). But I have to say, that these two friends have brought me to tears and to laughter in the last few weeks as they have sincerely offered support in their own ways. When it comes down to it, hands down I know their love for me as a friend. And that goes a long way to overlooking some of the comments that from others may sound ignorant or judgmental. But there has not been an ounce of judgment in anything they have said or done so far. They are eager to learn the ins and outs, and yet respectful of our boundaries. And I just wasn't expecting to have so much support from them. Because on the surface, they just don't seem like they would be very IVF friendly friends. They really don't "get" IF or IVF, and yet they are surprising me in so many ways.

No matter how careful I am to choose who we share with and how much we share, I know that it is still possible we will be unexpectedly hurt by some friends and possibly unintentionally hurt others. IVF, and all of its onion peel layers yet to be removed, is a hot button in our society. It is misunderstood, debated, disputed, condemned, and oversimplified. There is just no getting around it. It stirs up value debates around ethics, financial responsibility, ethics of clinical business practices, adoption, faith, God's will, and plain ol' personal choice. Add to that that we are stepping into the midst of that onion, with our own layers of complexities. ..namely three years of loss, three years of hoping beyond hope, and now- IVF.

My hope during this chapter is for me to find the strength and compassion to speak about our choice to conceive through IVF. I hope that through our openness others it might give others space to reflect on this complicated decision. Not everyone has to agree with us, nor do I expect IVF to be the right decision for all people. But I hope to find the words to speak honestly about why this is the right decision for us. And maybe, just maybe, we might help to nurture a few more people into more "IVF friendly" friends for others some day.

The Pain- take three

The Pain hit again this morning- third cycle in a row. I am so so grateful that it was much more tolerable this time- it still was a 9 or 10 on the pain scale, but it wasn't off the charts like the last two months. I am guessing (and hoping) that the ibuprofen is what helped. Hoping that that means I can manage the pain proactively again in the future, if need be.....

But hoping there won't be a "next month"- hoping a two dark lines on a stick is all I see next cycle, or at least sometime this year.


If history repeats itself, AF will arrive about 48 hours after the pain episode, so still looking like Thursday will be Day 1. Blooddraw on Saturday (day 3) and if all goes well with that- we'll be approved for the shared risk program and we'll have our IVF #1 calendar mapped out for us shortly thereafter!

So so ready.

Mind dump

Excuse me as I just dump the contents of my brain in my blog: (Don't expect anything logical or intelligible)

- Patiently waiting for AF to finally come; Been spotting for four days. Ready to get this show on the road and nervous as heck all at the same time.

- Sinus headache has me feeling like I've been run over by a truck. Been hanging out with my laptop in bed all day doing nothin'.

- I'm cranky, just plain unexplainably cranky. Well, it is most likely PMS brand crankiness. So, I am just letting it be what it is today- and trying to ride out this crankiness, knowing this too will pass.

-Been mindlessly searching the internet, here is a sampling of some googling I have done: "IVF without lupron","maternity clothes","jelly belly new flavors," "IVF with large endometrioma", "living room end table".

- Been preoccupied with worrying about whether or not my "painful attack" will come again this cycle. If it follows the past two cycle's pattern, it will come anytime now. Been taking ibuprofen regularly this week trying to help prevent it or at least take the edge off if it does happen again. Oh I hope I can avoid that pain again....

- The end of 2010 is fast approaching. A reflection on 2010 deserves a post in an of it self, but January 1st will mark the three year anniversary of our TTC. I am so glad we are in active forward motion right now, working with an RE, otherwise I think that anniversary would bring pretty deep despair. Actively "doing" something helps to stimulate hope. I've have also found myself thinking about the fact that in our three years of TTC, this is the first year in which we did not experience a miscarriage. Granted, that means we also were not successful in getting pregnant, but I am (in a small way) grateful to have had a break this year from everything miscarriage. It has been much needed for healing.

- The Christmas holiday was nice, busy and quiet all at the same time. I think every other sentence started with "Next year maybe bambino will be with us doing this,", "This might be the last christmas just the two of us", and so on and so on. While I enjoyed it immensely at first, I started to get a little freaked out that we were jinxing ourselves. I know it is not logical fear.

Lab results

Fasting Glucose: normal
Fasting Insulin: normal
AMH: normal

Sigh of relief. Next step is to wait for AF (about 7-9 more days) to arrive and then day three bloodwork.

This is getting real.

(There is a small hang up with part of our funding source, good news is that I learned we don't have to pay until late January, but still stressing a bit. Hoping it resolves itself).

Christmases Past

Last year I did a recap of our Christmases past, and I thought I would do it once again. Here is a recap of our Christmases as a married couple:

First Christmas
We had been married for all of 6 months. We had learned of DH's diagnosis of stage 4 cancer just two weeks before Christmas. Having just recovered from the 1st surgery to diagnose and biopsy, a week before Christmas we had our first day (of what would be many) hanging out at the chemo center as DH received his IV meds. We felt raw and stripped bare and yet full of life and purpose all at the same time. The shock was tremendous not knowing what was ahead. The hope and despair equally as jolting. The comfort and support that surrounded us from our community- family and strangers- was life changing. That year, DH decided he wanted to sing xmas carols together- it is a tradition that we have continued every year. So I printed out a ton of songs from the internet, and we sat by the fire xmas day and sang carols, and held each other.

Second Christmas
The second Christmas I was home on break from grad school after living on campus far away from DH for nearly 3 months (we racked up lots of frequent flier miles during that time!!). It was wonderful to be home. DH was done with treatments (final surgery had been in June) and 6 months later, he finally had his umpf back. We traveled out of the country (the trip we had had planned for the previous xmas, but canceled when he was diagnosed) and had the most wonderful xmas.

Third Christmas
Our third year of marriage, we rejoiced as we decorated the house for the first time. Year 1 we hadn't really decorated because we thought we would be out of the county for all of winter break, but instead ended up with doctors and chemo labs. Year 2 we were out of the country and so we didn't decorate, and so year three was a time to celebrate just being home. The simple things like hanging lights, telling stories about each xmas ornament we hung and how it came in to our lives. It also was the first year that my FIL was living in the same town as us and so it was the first year we celebrated xmas with more then just the two of us.

Fourth Christmas
Snow. Snowed in for days. Barely made it to the Christmas eve worship service. A quiet Christmas. We celebrated a 2nd year of having DH's father living near by. The grief was present as we had had our first miscarriage earlier that spring. The grief was magnified in that my baby sister had had her first child just before Thanksgiving, and the family was all together (across country in a different state than we live) oohing and aahing over the new grandchild over the phone. While the grief was there, and I was struggling with the fact that my estimated due date and the birth of my niece had come and gone and I was still not pregnant again. But I still mustered up some hope- assuming naively that the next time we got pregnant we would be home free.

Fifth Christmas
Last year was our fifth christmas as a married couple. We had had our second miscarriage the prior spring and had moved on to IUIs. We had just had two back to back BFN from IUI #1 & #2 and were leading up to IUI #3. My spirit was very heavy last year. I wrote on my blog that "the darkness has settled into my spirit even deeper this year. DH had to drag me kicking and screaming into the holiday spirit this year. I am glad that he did- he pulled out all the decorations and I watched, as the fire roared and the xmas music played, I felt my spirit lift a bit." Even as I wrote that, and even though the grief was very very thick at this time last year. I was still hopeful that we'd get pregnant in 2010 and that the third time would be the charm.

This year
So as Christmas 2010 was approaching and we were not closer to answers or a child, I felt the anxiety creeping in. In a strange way, the diagnosis of Endo, and the doctor advising us that IVF is our only option, was an early Christmas gift. Christmas is a hard time of year for infertiles, at least it is for me. Three Christmases have come and gone and we do not yet have a family of our own to celebrate it with. DH and I don't have any relatives in the area, so it is just him and I during the holidays. I've become a Scrooge at the holidays and I am convinced that IF is to blame. But finding out that mystery behind why we haven't been able to get pregnant and why I have been in so much pain- gives us some clarity, and makes the decision for us that IVF if the next step if we really want to try to get pregnant. And we know IVF has really good odds. Better than anything we have tried so far. As the Christmas approaches, I feel like instead of grief, I am feeling a flicker of hope. A hope that lets me believe that maybe, just maybe by next Christmas we make truly have a family or be well on our way.

Dare I say..

This is the most hope I have felt in a long time. I think there has only been one other time in the past three years that I have felt so hopeful, truly hopeful that indeed we will come out of this IF journey with a baby in our arms.

Knock on wood, but it feels so good for a change.

I daydream at work. I find myself smiling as I am driving, thinking about what it would be like to see a flicker of a heartbeat on an u/s screen, for a change.

Co-workers talk about plans, 3, 4, 9 months from now- and I grin as I calculate how far a long I might be.

I know this is a very presumptuous. And I would be lying if I didn't admit that there is a voice in the inner most part of me that is screaming "you silly, silly lady, why subject yourself to more disappointment, you know the rug will be pulled out from under you - FAST AND HARD!"

And yet I am giddy and hopeful and looking forward to AF arriving so I can call and starting scheduling blood work.

Approximately 17 days and counting until Operation IVF Cycle #1 commences.

And the one thing that is most certainly true. I have no doubt that this is what I want more than anything.

40 Years ago

It is eerie how history is repeating itself. My mom dealt with infertility caused by endometriosis. I always knew this, and I always knew that the fact she got pregnant with me was pretty miraculous. But now as I am facing the same diagnosis, the magnitude of this is hitting much closer to home.

40 years ago, almost to the month, my mom ended up in the hospital with severe pain. She was diagnosed with endometriosis and told to get pregnant sooner versus later. She was 21 and newly married.

Years went by and they were never able to get pregnant. They decided to adopt and 5 years after her diagnosis they adopted my older sister as an infant. 4 more years passed and they looked forward to adopting again soon as they were nearing the top of the wait list.

My dad ended up in the ER after breaking his ankle at a party. As the story goes, my mom had been throwing up, assumed she had the flu. My dad's nurse convinced her to take a pregnancy test. They got the call the next day that it was positive, and my mom had even forgotten about the test. She had been living with endo for almost 10 years at this point. And never in all that time did she get pregnant. I had always found meaning in this story, I grew up not taking being able to get pregnant for granted because I knew from an early age the grief and joy my parents experienced as they grew their family. But the reality of just how long they waited is hitting close to home. I know all about waiting. The nearly a decade that they were unsuccessful in getting pregnant, and then out of now where she gets pregnant with me, has a healthy uneventful pregnancy and birth. This boggles my mind.

I snuck into this world. There is no rhyme or reason why I am here. I defy all research and statistics.

Hoping our child some day knows the depth of the miracle that he/she too will be.

Where my thoughts are

When we first received the diagnosis, I grieved pretty hard. I wasn't expecting that, and it caught me off guard. I can feel that shifting now and I am certain that the day we did our bloodwork and banking helped. For the first time in a long time, we were making forward motion towards our goal- of having a family. And, now I feel like I am patiently awaiting diving head first into our first IVF next month.

But where I get stuck in my head with thoughts that are less then helpful and sap my positive hopeful mood is when it comes to my body and old history-

My body- I have wanted to lose weight. I don't feel good about my body at all right now. And I have been trying, and it just hasn't been coming off. I always imagined losing this weight before getting pregnant. And now, we are talking about diving into IVF immediately. And I am fearful of how this will be. I know the injections and such are tough on overall health to start with, and I know how pudgy I felt in the two previous pregnancies, even early on. And I just dread the thought of adding all of that on top of my current weight, in which I just don't feel very comfortable in my own skin. And yet, I don't have the energy to postpone this IVF cycle either- I am ready to do this now. I just hope that even with the extra weight I am carrying, I can embrace my body and all of its changes if (when?) I get pregnant. I fear that instead i won't enjoy the pregnancy because of how uncomfortable I already feel in my own skin.

Old history- I've written about it before, but the grief of our two miscarriages has always been amplified because of how identical they were in the calendar. So, our miscarriages both were in the same month, one year apart. And our unfulfilled due dates then were also were both to be in October, one year apart. If we proceed with this first IVF as planned, we would be following that exact same timeline. And we'd have the same approximate due date as both of our previous losses. this has been tugging at my heart- scared that we are being set up for yet another loss in the same time frame and only compounding and reopening the hurt. Then the other side of me secretly wishes for this very first IVF to work- for it to all go smoothly, and in the end finally fulfill those October due dates that when unfilled previously. I long for the story to be written that way, but fear that we will just be walking the road of deep despair instead.

Like I said, I know this isn't very helpful thinking, and I hope to stop dwelling on it and just move on, but maybe by writing it out, I can start to let go of the fears and trust I'll be able to do this one day at a time.

Bloodwork and Banking

Yesterday I had a quick blood draw. My RE wanted to check my AMH to look at ovarian reserve. I was going to object, because it isn't covered by insurance and I just had this done a year ago and it was fine then.

But a year ago, I didn't have a grapefruit size endometrioma encasing my ovarian. And after consulting Dr. google, I am learning that ovarian reserve can be hindered by this cyst. Ugh! Just what I need. Saying some prayers that my eggs are still plentiful.

The doctor also ordered a glucose/insulin test. Which I am so glad. I have been concerned that I have developed insulin resistant and I mentioned this to me. And he took me seriously! (Novel concept- can you tell that my experience with doctors in the past has me a bit jaded). I'll have both tests back in a week. That is about the only thing we are waiting on before knowing for sure if we'll start IVF next cycle.

Then the bank. We had some unexpected extra time after visiting the lab and before I had to get to work, so we stopped at the bank to explore one of the options we are considering in figuring out how to make the finances work for IVF. DH admitted to me later that he was fully expecting the trip to be a waste of time. And instead it was the easiest, most straightforward process and we gained a ton of information from a very sweet banker. Basically, if we choose to go this route, we are now all set to be able to make the IVF for our next cycle. And all it took was 20 minute conversation and setting up a few things. As we left the bank, arm in arm I teared up a bit- grateful to have something go so smoothly for a change, and I said to DH "She (the banker) has no idea the significant role she just played in the final steps to bringing us home a baby." DH giggled and squeezed me and we walked to the car in amazement. He has mentioned that moment several times since as he says he loves hearing me talk with hope again for a change.

And he is right, it does feel good to let hope seep back in just a bit-

YES! No, Maybe, wait, I mean...

Where am I?

Tired. Spinning. Interspersed with itsy bitsy tiny glimpses of hope and excitement. (Emphasizing tiny).

I think I am grieving, which is surprising me a bit. I am glad there is a clear answer why we haven't gotten pregnant, I'm glad there is a definite reason for the pain, that it wasn't all in my head.

But I guess I am sort of not ready to leave naive land where I could dream that maybe, just maybe we could just give it time and eventually we'd get pregnant on our own. So, as I come in to our new reality I feel some grief.

The endo is stage 4. It has entirely encased one of my ovaries in a grapefruit size endometrioma (spelling?). Most likely it is spread lots of places.

Doc said that we could do surgery to remove it- but it will come back, and in the meantime removing it won't improve our chances of TTC that greatly and given we also have not so great numbers in the sperm area of things, and we aren't getting any younger- he recommends IVF as the next step.

And by next step I mean as in the very next step- starting our first IVF on my next cycle which starts in just a couple of weeks.

Commence freak out.

Part of me is ready- i like the idea of not thinking about it or planning for it, but just doing it. we've been on this journey for THREE YEARS. part of me feels like ripping the band aid off and just diving in. Waiting accomplishes nothing anymore.

But my responsible side if stressing about the money. As of a few weeks ago, I had finally declared to DH that I felt like we were on track and that we'd be able to make this work to do IVF down the road. But in three weeks? We would have to make some financial decisions now that I wasn't yet ready to make. So, my anal excel sheet side of me is freaking out a bit.

But - we know now that our only option is IVF. and by all accounts we are good candidates for coming out on the other end with a baby. And that makes me so joy ful and so scared to death at the same time. I'm not sure if I am ready to handle the emotionally fraught 1st trimester. Waiting for the chance at seeing a heartbeat. I'm not sure if I can handle any more bad luck.

IVF, I am ready to take you on (i think), and I will do so with courage (i hope), but please or please spare us a little bit (or a lot), will you? Let us not fall on the wrong side of statistics yet again. (if this is even the step we decide to take).
I beg of you.

Diagnosis

Extensive Endometriosis

Diagnosed today by my RE

My right ovary is the size of a grape fruit

The rules of the game just changed and my head is spinning.

Step 1& 2 done- 3, 4, & 5 to come

My Plan I've added one more plan of action, so my 4 step plan is now 5 steps. The goal in all of this is a) having movement so I feel like I am pro-active in our TTC and overall health, and b) making sure at the end of this journey, however it goes, that I can feel like I advocated for myself in making no stone is unturned. Step 1 was my current gynecologist- I was skeptical. She hasn't been the greatest doctor for me and I have been on the verge of walking away from my 12 year relationship with her. This appointment sealed the deal. I talked about my extreme pain I had experience last cycle and she was patronizing, tapped me on the knee, and said- "pain is just a part of getting older, make sure to have some advil handy." She also repeatedly reminded me I was soon to be advanced maternal age and I needed to "get a move on" and get pregnant. My jaw hit the ground- she KNOWS my history- two miscarriages and now infertility- WHAT DOES SHE THINK I HAVE BEEN TRYING TO DO. Anyways. Done with her. Needless to say, the appointment didn't accomplish much, other than confirming for me she is not a good doctor for me.

Step 2- I had an appointment with a nutritionist I have been working with a bit. Nothing earth shattering came from it, but good for overall health. I told her I believe I have insulin resistance, and she was helpful in saying that it is a credible disorder and that any (good) doctor should pursue exploring this.

Step 3 is this week. And I am surprised that i am the most nervous about this one. I'm seeing my RE. I haven't seen him in a long while (9months maybe?). I'll be talking to him about this severe pain and insulin resistance. But also, I want to map out as plan b (well, C? D? down the road a bit more) the pre-testing needed for IVF. I'm still giving us another year or so, give or take a few months, but once we reach the point of feeling ready to move on to IVF, i don't want to dawdle getting to the start line.

Step 4 and 5 are for good measure- seeing an naturopath/acupuncturist the following week and a gynecologist that came highly recommended by a friend. If my RE takes me seriously and is aggressive in trying to understand this pain, and my insulin concerns- I may cancel the appointment with the gynecologist. But if not- I wanted a back-up option already on the calendar.

It is a lot of appointments, it feels like overkill. But then again, it feels good to have a plan. Most of all, it just feels good to finally have the energy (again) to plow forward- I feel like we've refocused on what we want in all of this (family) and what we have to do to move us in that direction (push the rock up the hill of TTC).