Monday, March 25, 2013

Obsessive Forum Newbie

For as many years as I've been a blogger, I am brand-spanking new to forums. I'm treating them like my parents would have treated Facebook had I had the extreme misfortune of them finding their way there. You know what I mean: the old folks who have no idea that they're posting a really private conversation on someones public wall? That would've been my folks, but alas, they never did own a computer, so I was saved in that respect. I've already committed a forum faux pas by posting on the wrong board because (like my parents would have been on Facebook), I had no idea I was even in there. Geez. I feel like a fogey.

Anyway, while I've found egg donation forums to be fascinating and informative, there comes a time when a girl just needs to step back and take a deep breath and say, "whoa, buddy, that's a lot of information."  Quite honestly, I'm glad I never made my way into forums in my pre-DOR days. I would've driven myself insane with the countless hours of google research after being given 'food for thought' from fellow posters.  That's about what I'm doing right now and my head is swimming.

With infertility, is it possible that *some* ignorance can be bliss? I miss the days when my RE would suggest a route to take and, given that it was within reason and that I trusted their opinion, I would take it. I mean, don't get me wrong, I did my homework. I pushed for RPL and genetic testing after only one miscarriage. But did I agonize over every clinic's success rates across the country as I'm doing now? Or ask for additional tests that were beyond a traditional panel? No. When first approaching IVF, I found a clinic with decent success rates within driving distance who accepted my insurance for some diagnostics, met with them, liked them and went for it. Of course, that was back in the days when we were plain old 'straight up' MFI (demonstrating how relative things can be when I can refer to an IVF as 'plain'). Now, I'm questioning everything and combing through SART with a fine-toothed comb, feeling like if I go with 'average' then I'll be short changing myself. I'm suddenly becoming willing to fly across the country for a chance at the 'golden egg'. My husband is labeling it obsessive and I think he might be right.

I haven't gone into these almost-9 years of infertility with blinders. I'm well aware of what's out there, but there has been a level of detail in the infertility community that I have very deliberately avoided so as to not become consumed by it. I understand why others would go that route. You must be your own advocate and I know of a friend who is generally fascinated by it. It's interesting, but fascinated I am not. Searching for clinics and additional tests makes me anxious. I realize that to a certain extent it is a necessary evil, but I want to make my time doing this as short as possible. There's the possibility of there being no end. One discovery can lead to another and another and before you know it, a season has passed and you realize you've spent it with your head in google having heart palpitations. Not my cup of tea.

We'll be meeting with our ridicuously over-priced infertility therapist this Friday and maybe then I'll be cured of this obsession. :)

Wednesday, March 20, 2013

F-ing FB

Shit. Pregnancy announcements, bump and ultrasound pics--seriously, when the F am I going to learn to stay off Facebook?**

*I guess I could just block everyone, but why bother when having an inkling of self restraint and just staying off altogether will do the job a lot better?

My Bastard Friend, Grief

Ah, yes, there you are. I was waiting for you and wondering where you were. You see, I got swept up in thinking that I could just move on and start formulating plans. Foolishly, once again, I believed that I would heal through doing this alone. I acknowledged the sadness, briefly, but it almost seemed momentary when I began to hit the ground running, combing through donor profiles, getting labs in order, almost planning a nursery for our sure-to-be new addition. I was surprised by how easily I was taking it. However, all along, I kept wondering where you were in the back of my mind, knowing that a fall-out was likely imminent. And now here you are, my old friend, grief, clutching to me and I'm pretty sure you won't let go until your job is done.

You're such a drama queen. You never enter a room quietly. When you come, you arrive in a ball of anger, without warning. You are an irritant, making every noise or word in the room prickle on my skin like needles. You make me snap, you drape me in envy. You make me believe that every woman in the world is living a charmed life and it is I alone who must make the decision between never experiencing motherhood again or going through methods I quite frankly resent. You force me into isolation because whether through social media or real contact, I can't swallow other people's happiness right now and it makes me feel like a monster.

There are some who might profess that looking on the 'bright side' is the only way to deal with this, but I know that there is a danger in denying your existence. I tried hiding you from my son, but in his three-year-old eagerness to try out his vocabulary, he asked me why I was 'furious' yesterday. I hadn't done anything-hadn't raised my voice, but it must hang on my sleeve like an announcement because I am furious. I am so angry. I ask you, "Why is everything so hard? Why must everything be taken away, seemingly all at once?" I won't question any further because I don't want to know and I don't want to tempt the universe.

But do know this: I am pissed. It is ugly, but it is real. I'll try to hide it because for most it is too messy to look at, but it's where I am. Mr. S put it clearly: it's not fair. This isn't f*cking fair. Maybe a preschool playground is the only place those words belong (sans the F word), but they so accurately describe exactly what I think about being stripped of any ability to have further biological children.

So, grief, I know your intentions are good, that it is only through you that I will come to know any sense of peace or healing, but I don't enjoy your company and when you're done this time, try to take a long hiatus because quite frankly, I'm tired of you.

Tuesday, March 19, 2013

Why Do You Want a Second?

S blogged recently about an article that asked the question: Is having a child a rational decision?  Well, most anyone who has gone through the hellfires of infertility and especially treatment can attest that no, it most certainly is not. There is just no way that you can logically explain why a human being would rake their heart, body and bank account over the coals, sink needles into their abdomen, play with crazy-making hormones and endure the inhumanity of everyone and their grandma looking up their lady bits just for a chance at more body-breaking, bank account draining 'bliss' (better known as parenting). No, that's not logical. So, when my doctor asked (as she has a few times over), "why do you want a second?", it took me a moment to verbalize anything that didn't sound like a YA-inspired fairytale. I wanted to sound...logical. But the truth is, I can't. 

So, how do I explain to myself why I would put us through this again without logic?  This post is my attempt to do that.

My doctor assumed that having a second was to give G a sibling as that's what most of her patients say.  Quite honestly, that is a nice, neat and simple thing and is probably the most 'logical' reasoning I could dream up. And it's true. I want him to have that, especially given my difficulty as an only child. But the other truth is, I want a second child because I I'm not sure there's a language that depicts it. It feels like a force, like instinct, like the desperation to breathe when you're holding your breath, except that even that can be logically explained. Having a child cannot. It is not for my own survival. I will live on without another. But the best way I can explain it is that someone is missing here. This picture is not yet complete. It seems that there should be another mouth to feed, another set of arms wrapped around my leg.  I am overwhelmed by life's demands and I want more.

I tried to state it clearly to her that I wanted to be someone else's mother. Perhaps that didn't come across as convincing, but if not that, then what would?  Isn't it interesting that this question, or rather, this requirement to logically explain the decision to have kids is usually only directed at infertiles? Have you ever heard anyone corner a fertile at a party requesting why they want another kid? (not that I've had this happen, but it's frequently suggested that perhaps I should just be happy with what I have...) It is as if because we must go an extra mile (or 20), we must justify our efforts to others. (to which I would say, in my most poetic prose, "suck it.")

 Motherhood has and will always be the hardest, most frustrating and confusing (and that's not just the TTC part!) and absolutely best thing I've ever done. I always knew it would be, so when it came time to drain my bank account and sink those needles into myself, it felt almost...logical. Today, it feels even more logical because I know exactly what can become of it.

Monday, March 18, 2013

What's In a Gene?

Long before we stepped foot back into our RE's office this last week, I had explored several other methods of building our family beyond IVF with my eggs, including adoption, embryo adoption and egg donation. In fact, I had been turning each over in my head slowly throughout the months that passed by, despite the fact that we had all but signed on the dotted line for a fresh IVF with my eggs (obviously this was before we found out I am nearly peri-menipausal). So, when we began discussing options in our RE's office, it might have seemed premature for me to announce that I wanted to go with donor egg, but at that point it had seemed like I had processed it from every angle possible. Except now I know that hypothetical considerations are far different than when you're facing it as your reality. 

Because nothing is more sobering (and bizarre) than staring into the face of your potential child's genetic mother and realizing that you're not looking into a mirror but instead at what looks like a glorified dating profile. And at some point you also realize that the face you are looking at is not one you may recognize now, but may grow to know well later on in the face of your child.  In fact, if we do go this route (and my money is on it that we will), I will never look into her face in person and this alone is one of my biggest hesitations in going forward. Why? Because I want my child to know where they come from (genetically speaking). In a perfect world, I would hope that each and every strand and fiber of their genetic link would be at their fingertips. It is part of who we are and to deny that reality would be negligent.

So, why is it, in 2013, that egg donation is usually ANONYMOUS? (caps used very explicitly by my clinic in their paperwork to really drive the point home) It begs me to ask, what year is this exactly? 1970? Have we learned nothing about the psychological health and well being of our children at this point?  And should I participate knowing that this may actually be creating future grief? Should I embark on this endeavor knowing full well that my child may never have access to half of their genetics? (btw, these are hypothetical questions for DH and I, no one else)

As a parent, I feel that it is my responsibility to minimize any foreseeable and preventable suffering or in the very least, provide my child with the tools to learn themselves and to navigate their world. A key part of this feels linked to genetics.  For folks like me, those thoughts (predictions about how my movements now will effect them later) must happen long before conception. I don't take this on lightly. I realize that the grief resulting from egg donation is very different than that in adoption, but there must be some common elements, especially at the heart of each being the process of identity. It's hard enough knowing who we are and where we belong without removing a significant part of that equation.

Or is it significant? Yes. Of course it is, but it is not the most significant. A child born to us by way of egg donation will be loved beyond measure.  We will surround them with family and opportunities and (if I hadn't mentioned this before) will disclose as early as possible how they came to be and will celebrate this. We will celebrate that every roadblock was perfect because we were led to them in exactly the way was meant to be and that their biological mother was obviously a pretty outstanding lady to help make it happen. I do hope we know more about her than just that, but until we can utter those words, we must find a way to make peace with this. Or go a different direction...

PS. We will be going to our first infertility therapist soon to hash this all out. I can't believe it's taken me 8 years of this ridiculous carnival ride called infertility to get my head adjusted...
PPS. I'm aware of donor/sibling registry and hoping that even if our donor does not register, that our kid's siblings might.
PPPS. Donor egg has a 75% success rate. Each. Cycle.

Friday, March 15, 2013

Answered Questions

At 32 years old, my AMH was 1.8, typical per this graph and standard estimates. At 33, it was 1.4- lower but not incredibly out of range or out of the realm of IVF possibility.

Today, at 34-years-old, my AMH is a whopping .22. (Just in case you didn't notice, there was a decimal point in front of those 2s.) Do you know who would be expected to have an AMH of .22? A 45-year-old woman. And no, this is not the typical trajectory of most people.

So, why did my hormone levels drop so dramatically in such a short amount of time? With perfect timing, we just so happened to have an appointment scheduled with RE#3 the day after we got the results and apparently, this drop could have been hapenning for years. Hormone markers can have a lag time, so when we were working with embryos from my 30-year-old eggs in the face of 'normal' hormone values at the time, I kept wondering why A.) I needed more stims than other 30-year-olds and B.) why my implantation rate VS. chemical/miscarriage rate was a little wonky. Now we might have the answer.  The doctor made clear what I already knew. These were possible signs all along that something was awry. It just took my body awhile to reveal it.

It sounds crazy, but it's nice to have an explanation to match the inuition that has been screaming at me all this time. Male factor--yeah, we had some of that. But reading all the way back to my blog entries over the past almost-5 years, I asked the question over-and over: is it also female factor? Doctor after doctor told me no. In fact, they always wondered why I would even ask this. I mean, who could blame them? They had nothing, no black-and-white numbers at least, to suggest it. The only thing that clued me in was my intuition and last time I checked, that wasn't exactly a scientifically valid marker (personally, I think I've had it confirmed often enough to say that it is. In fact, my DH calls the level at which my intuition is correct 'creepy'.)

And yet, we got one healthy child from one IVF, which is far above average. "Consider yourselves tremendously lucky" is the message we've received. You don't need to say that again to me. I know this very, very well. And then I can't help but think that perhaps I should also consider myself lucky that I never did another IVF with my eggs. It's quite likely that the chances would have been so much lower than any of us actually knew. That was my hesitation to begin with. 20K on what? A 10% chance? That's what it probably would have been, while my age suggests that it would have been closer to 30%. Do you know that RE#4 was satisfied with going on my AMH/FSH numbers from last May? That had we not been messing around with RE#3 on the side who requires them every 6 months, we might have actually gone through with a full fresh IVF with my almost-permimenopausal eggs that would have probably ended up cancelled/unsuccessful? (that's not totally true-I would have requested them, but still...)

So, yes, I am grateful that our discovery saved us money, heartache and also answered years-long questions I had been harboring. It's not everyday that someone from the unexplained camp (which is what I have always considered myself) actually gets an explanation. It certainly helps with closure. I won't deny that it also calls up more 'what-ifs' than I can count, but generally speaking I have a strong sense of 'everything happens exactly as it's supposed to' which buffers me from that.

It is likely that I will reach perimenopause before I hit 40. I will be in the pre stages of menopause at the same time many women my age will still be having kids. Wow. That is really a piece of information that is hard to swallow. I mean, I know intellectually that there will be no more biological children for me, but beyond reproduction, there's an entirely new level of blending this idea into the overall schema of myself that I need to grapple with. It's redefining. That's what this whole thing really is about: redefinition: redefining self, redefining family, redfining life. It's not what I pictured, but it's mine and I need to find a way to embrace it or in the very least, accept it.

In that very meeting, we were presented with other options and for now I will say that we're exploring them. I think we have made our decision, but perhaps we have not made our peace with it yet. I'm sure I'll be back on here soon over-analyzing every emotion and idea connected to it, but until then, thank you so much for your support. What a crazy ride this continues to be and I'm not sure what I would have done without this space...once again.

Tuesday, March 12, 2013


I am surrounded by good news and other people's hope. It should wash over me like a contagion and I should revel in the fact that new life is being celebrated everywhere I turn. Except that I am not in the mood to celebrate. Not anymore.

It turns out that it wasn't a lab error. Today effectively marks the culmination of all BFNs I could possibly gather in my hypothetical future for there will be no other attempts, at least not in the biological sense. I officially have diminished ovarian reserve. Today, I mourn.

I am no longer at a borderline stage. It took my body less than a year, from May 2012 to March 2013 to more than double my FSH and my AMH is being measured at less than a quarter of what it was last year.  My values look like those of a woman ten years my senior. Obviously the change was so dramatic that my doctor assumed a lab error.  I knew better. I think I always did.

I could wax poetical about the intricacies of what I feel, talking about grief and loss in stages and details, but I think I'll take a cue from my son who states it plainly enough. I am sad. I am just sad.

It feels like I'm lugging around a 50 pound heart, one that is so tender to the touch that any movement I make hurts. But I must move, as I have this past year, but damn, it's hard. I'm just tired of feeling so battered all the time. Loss after loss, every time I try to get up and brush myself off, I'm knocked down again.  

In just a little over two months time, a second unfulfilled due date will pass and no one will notice but me.  And knowing that that child was my last chance, truly my last chance, it will not pass easily. And yes, I have the ultimate trump card-a living child. I am beyond blessed to have him, but still I hurt. I am sad. I am just sad.

Tuesday, March 5, 2013

Jumping to Conclusions

It's likely that our decision (to IVF or not to IVF?) just got a little easier. Not easier emotionally, but easier from an actual decision-making standpoint. Because when something is completely swept off the table, well, you can't decide on it any longer, can you? The decision is out of your hands. 

I went in for routine labs last week. I emailed the nurse for the results and she simply replied, "they are all normal!" (with the requisite exclamation mark, of course). Hmmm...what exactly does 'normal' mean? As you may or may not recall, I like my numbers, so a subjective description of my ovarian functioning just doesn't cut it, not when so much in on the line. So, I followed up: "what was my FSH?" In the flurry of emails conerning other matters, she managed to not answer this particular question. This is a HUGE pet peeve of mine. I hate it when people don't read the whole email and you must come back and ask the same question again, but while this could have been the case, it also seemed almost deliberate, like she was actually avoiding the question and had in fact not missed it. So, I asked again. And there was radio silence for a good long while (despite the fact that she's usually fast on the draw). And then she replied, "your FSH is 'under review' with the doctor and I cannot release the number yet. We'll call you Monday."

Wha-wha-what? What does that mean?

That was Friday and I tried my best over this already lousy weeekend not to read into it too much. A nurse called me Monday and prefaced the numbers by saying that it was probably a 'lab error' because there is no way it could possibly be that high. How high, you ask?


Yeah. Just in case you're not versed on FSH numbers, let me give you my subjective descriptions:

Piss poor.
Practically pre-menopausal.

At first I believed her. Maybe it was a lab error. But then my inuition (or that's maybe my pessimism) set in and I felt, deep in my gut, that the number is totally accurate. My doctor can't imagine how it would be, but stranger things have happened. It's not impossible. My Mom went into peri-menopause at 39, full menopause at 45 (of course, she was a smoker and RE#4 said that accelerates menopause but hey-there's obviously some genetic component).

If my ovaries are this dusty, logistically, what does this mean? This means that our decision has been made for us. There will be no free will in the matter of our assisted reproduction (what little free will we had to begin with). There will be no IVF. That'll be off the table. My biological connection (whatever that's worth) will end with my only child. Although I was hesitant to go forward with IVF for a number of reasons to begin with, there's something about possibly being stripped of that option altogether that's more devastating than I ever anticipated. There's a helplessness that exists with infertility and everytime I'm dealt a blow, it only compunds.

They're having me repeat with an AMH test today, which will be a more reliable predictor. Quite honestly I assumed that they were also testing AMH when they originally drew my labs as that's now more the gold standard, but they didn't. Because of the snail's pace our lab takes, it'll be 4-5 days until we get results back. In those 4-5 days, I have made the conscious decision to plan for the worst.  Maybe that's the not healthiest response, but I'd rather be pleasantly surprised than float along happily assuming a lab error only to lose the wind out of my sails once more.  No, 'wind out of my sails' is too pretty of a description. Plummetting to the earth and smacking head first into a cliff is more like it. 

Yes, I realize I may actually be freaking out over lab results that are wrong, but this is how I do it, folks. I expect the worst, so even when I meet 'bad', it doesn't seem all that awful because, alas, it's not 'the worst'. What can I say? It works for me. It probably produces a series of unnecessary mini-panic attacks, but still, it works. For the past month, I had been mentally preparing myself to hold onto hope, even going so far as to convince myself there was a chance our IVF might work. So, my expectations were beginning to climb. The distance from before that call to after was a long way to fall and I didn't have a moment to gather myself in preparation. I don't want that again. I don't do surprise well, so when they call next week, you better be believe I'll be prepared in full SWAT gear.