Infertility: 1, Career Development: 0

Today I found out about a really good opportunity at work to get involved in a project in an area that I'm really interested in.  I was my manager's first choice to work on it and was pretty stoked about it, as it will set me up as something of an expert in this area down the road.  Then I found out the details.

I would need to be out of town for about 4 or 5 weeks, starting at the beginning of September. 

Which is exactly when I expect to be stimming and doing an egg retrieval for IVF #3.  

I called around and tried to find out if there was a way I could join in for the second part of September.  No dice.  At the end of the day, my manager (who is relatively new to me, so I haven't even really had a chance to get to know him yet, and certainly not talk to him about my medical issues) came to ask my decision.  I had to tell him why I was turning down the opportunity.  He was great about it, and completely understood and supported me, but still.  Someone else is now going instead.

Fuck infertility.  Fuck it in its big fat stupid fucking face.

.....

Today is CD22.  Because of my DOR, my cycles have been getting steadily shorter over the past year or two.  I, who used to be a 32 or 33-day girl, dropped to a nice even 28.  Then 27.  Then 26, with the odd 25 thrown in.  I'm holding out hope that I make it to at least CD26 this time around, since I have to be back from our beach vacation in time to catch my LH surge (which usually happens around CD9...early ovulation is another of the joys of DOR) so I can start the estrogen priming properly.  So far so good.  There's no sign of my usual pre-AF spotting.  Of course by typing this the universe has figured out what I want and will now screw me out of it.

.....

Thanks to everyone for the book recommendations!  You've given me lots of great ideas for the beach, as well as to keep me going when I get home.  We're staying at a pretty small cottage that doesn't have WiFi, so I'll likely be out of contact (no blogging or commenting) for the week.  What am I going to do without my IF blog fix???  Stay classy, ladies.  See ya in a week!

Important conversations happen at the dog park

The past week has been kind of tough.  Not "crying at work" tough, although I've had that in the past.  More just like "totally bummed out and not sure it's worth it to keep going on this treatment train" tough.  Which scares me a bit, as it's the first time that I've turned my mind towards the idea of quitting this whole thing, taking my uterus and going home. 

I'd previously had quite a bit of optimism in our next cycle.  While I know DHEA isn't a magic pill, I'd really held out a lot of hope that this past three months of supplementation would be doing some good and our egg quality would be much better the next time around.  Now, it kind of feels like even if that happens (which is by no means guaranteed), I could just be throwing those embryos away by putting them into my faulty uterus.  Worse, the two-month Lupron treatment my RE is recommending feels suspiciously like a "what the fuck, why not?" kind of approach.  It's like when you're having a computer problem, and you call tech support.  They ask you a bunch of questions, shrug their shoulders, then tell you to turn off your computer and turn it back on again.  Weirdly, sometimes that solves the problem.  But other times it doesn't and you end up in the market for a new computer.  This treatment basically feels like a crap shoot, and if it doesn't work we're risking whatever precious few embryos we might manage to make.  

Throughout this infertility journey, M has usually been a few steps behind me.  I was the first to realize (based on symptoms and lab work) that I likely had DOR.  I was the first to face the facts that our first IVF cycle would likely be cancelled.  And throughout it all, he's steadfastly refused to get into any serious conversation about other options besides IVF, preferring instead to focus his attention on the situation at hand and worry about the rest as it comes.

This weekend, as we sat in the shade of a tree at the dog park watching Buddy run around, I finally got him to talk about the possibility that we might not come out of IVF with a baby.  And I asked him to start seriously thinking about whether he would be content to live child-free, or whether he felt so strongly about being a father that he would want to pursue adoption.  We're not even thinking about donor egg/embryo at this point, since if part of my problem is a lining issue then that's a non-starter.  

I admitted to M that, ever since our trip to see my niece, I'd been having a lot of thoughts about how hard parenting is and had started to doubt whether I was interested in pursuing adoption.  We talked about all the travel we could do if we stayed child-free, and the fact that we could probably retire early.  But there was no joy in this conversation.  No acceptance.  Neither one of us is there yet, and it honestly frightens me that we might get to this point sooner rather than later.  It feels especially hypocritical in light of my recent cheerleading post, but I know at some point it's possible that we'll be questioning whether we have it in us to go through this anymore.  I'm already kind of starting to do that, at least for myself.

That said, IVF #3 will quickly be upon us.  Since it's a well-established scientific fact that my uterus is an asshole, it looks like AF will arrive sometime this weekend or early next week while I'm sitting on a beach in Maine with M and his parents.  I've already done some legwork and found myself a clinic in Portland that will run my CD3 bloodwork, but my baseline ultrasound will have to wait until I get back.  

In the meantime, I'm looking for recommendations for beach reading that will totally take my mind off infertility.  Nothing too light and chic-lit-y, but nothing too deep either.  Help a sister out and leave your suggestions in the comments!

Unexpected answers, unwelcome delays

The results of my Yale Endometrial Function Test (EFT) are in.  I knew the second that my RE launched into the "so this is what we're testing for..." speech that something was up.  Otherwise she would have just said everything was fine.  So what's the verdict?

First, some background.  The EFT is an experimental test that is pretty much still research at this point.  It tests various secretions made by your lining which are essential for embryo implantation (if you're really science-y, read all about it here).  For the rest of us dummies, Yale's Dr. Kliman compares it to a surfer riding a wave.  Your lining is made up of two parts: the glands that produce the secretions necessary for implantation, and the stroma which is the connective tissue that holds the lining together.  The glands (the surfer) need to develop in sync with the stroma (the ocean) to catch the wave and create the proper conditions for implantation, or else your cycle is just a big fat wipeout (OK, I added that last part). 

Back to me.  While my progesterone levels were right on target for CD24 (test day), it turns out my glands were mildly out of phase with the stroma.  As in, according to my stroma it was CD24, but my glands were acting like it was CD18.  Lazy bastards.  The final diagnosis: moderate glandular/stromal asynchrony.  Translation:  fucked up lining to go along with my fucked up eggs.  Treatment: two months of Lupron-induced menopause to reset my system and hopefully have things sync up.

 

Me either, Liz.  Me either.

So here are the fun facts.  My RE is recommending proceeding with a new IVF cycle ASAP, given my ever-diminishing ovarian reserve.  We would tweak my protocol to use estrogen priming instead of birth control and Suprefact instead of Orgalutron as an ovulation suppressor, as apparently some women produce better eggs on Suprefact.  Which is important, as my RE helpfully informed me that I was wrong in thinking that I had only 30% normal eggs last time.  I apparently misheard.  I had 13% normal eggs.  Which, out of the 8 mature eggs I had, is exactly ONE.  I assume it's the one that made it to blast.  Wow, this appointment just keeps getting better!

Anyway, following the egg retrieval we would do another "freeze all" on Day 5.  This sucks, as I was planning on asking for a Day 3 transfer this time around based on the fact that the idea of having nothing to transfer is really, really horrible.  And as much as my clinic is convinced that they're perfectly mimicking the inside of a uterus and that if an embryo doesn't make it to Day 5 in the lab, it wouldn't make it inside me, I'm starting to think differently.  In my time blogging I've seen too many stories of women with dodgy-looking embryos on Day 3 that no one thought would make it to Day 5, who went ahead with a Day 3 transfer and got pregnant.  But it looks like I won't get the chance to try out that theory.

Following the IVF cycle I would do two months of Lupron depot shots to send me into joyous menopause and reset my uterus.  The problem here is that the Yale EFT is not conclusive, and in fact some REs online seem to consider it complete bunk and have said they would never do the Lupron treatment after an abnormal result.  Also, the EFT isn't able to pinpoint any specific reason behind the lining abnormalities.  It could be anything from an endometrial infection (my biopsies are always clear) to a hydrosalpinx (my tubes are fine) to endometriosis (no sign of this as I've never had any pain with periods) to a too high/too low BMI (I'm normal) to perimenopause (well, DOR, so duh...) to stress (boy howdy!).  Also, my Google-fu appears to be failing me right now as I've been completely unable to find any anecdotes out there where people had success after Lupron treatment for an abnormal EFT.  There are no failures, either.  There's just...nothing.

I know I should be happy that I've found a possible answer as to why our decent-looking blastocyst failed to implant last cycle.  But honestly, it just feels like yet another kick in the ass.  My fried eggs won't stick to my teflon uterus.  Really, is there ANY part of my reproductive system working properly?  No?  Then why are we even bothering with all of this?  And now we're looking at an IVF cycle (August/September) followed by Lupron (October/November) which means we're into Christmas and 2014 before another FET, if we even have any embryos at all.

FAAAAAAAAAAACK.

Better

For the past couple of weeks, it's felt like almost every time I opened up my blog reader there was more bad news.  Another disappointing retrieval, another failed cycle.  Another miscarriage.

In the infertility blogosphere, sometimes it feels like everyone in the world is getting pregnant except for you.  And as much as you're happy to see your blog friends achieve success, you feel unbearably sad that you're being left behind.  It's not a good feeling.  While I've certainly never cheered someone's failure, I will admit to some horrible uncharitable feelings of "well, at least it's not only me who still isn't pregnant" in some of my darker moments. 

But I've come to realize that it's equally bad when it seems like no one is making their way out of here.  Even though those feelings of jealously inevitably arise when another infertile gets pregnant, with it comes a sliver of hope.  A "that could be me" moment.  A boost of morale in this unending war against infertility.  After all, if no one ever manages to make it to safety after crawling out of the trenches, how long before we all give up fighting?

I'm not usually one for pithy sayings or inspirational quotes.  I'm far too snarky and sarcastic for that.  But a while ago I came across a song whose lyrics resonated with me.  Right now, this excerpt feels pretty damn appropriate:

You got disaster to the left
And devastation to the right
A catastrophe in front of you
And a fiasco in behind

But if you wanna keep the peace
Sometimes you have to go to war
So hup! Two! Three!
It ain't worth nothing if it ain't worth fighting for

I have to believe that this song is right, and that it will get better.  For all of us.  "Better" may not necessarily mean what we first think it will mean.  Some of us will suffer quite a few wounds before finally hauling ourselves out of these trenches.  Some of us will retreat, nursing scars and regrets, or will go on to fight in other ways.  But the war will end for all of us eventually, and I can only hope that we will all find our own forms of peace.

If you're one of the people who are wounded right now, know that we're all standing here with you.  You are not alone.  If your tour of duty is up and it's time for you to go, we understand.  It takes a special kind of strength and courage to do so, and we salute you for it.  Otherwise, get up.  Take a breather if you need it, but then you get your ass back in this fight.  Like the song says, it ain't worth nothing if it ain't worth fighting for.

Do I want it bad enough?

Today is the second last day of our visit with my family.  It's been a wonderful vacation, minus M coming down with a sinus infection that's knocked him for a loop for the past day or two.  We've had beautiful sunny weather (quite the rarity for a province that's normally the rain, drizzle and fog capital of Canada) and I've spent a ton of quality time with my niece.  Leaving her tomorrow will be hard, but there's also a part of me that will be happy to get back to our house, our quiet routine and our bird/dog menagerie.

In spending so much time with my niece, one of the things that I've actually ended up reflecting on a lot since I've been here has been my desire to be a mother.  I'll start by saying right off the bat that nothing's changed, not really, and M and I will still be doing our next IVF in a month or so.  But I've started to wonder a little bit if I really want it as bad as I should, or at least as much as everyone else seems to.  

The thing is, I didn't always want to have a child.  Admitting this seems a little bit blasphemous in an online community committed to pursuing parenthood.  It feels like for a lot of infertility bloggers, becoming a mom is a dream they've had since childhood and fulfilling this goal is something they have a deep, visceral need to do.  It's never really been that way for me.   In fact, into my late twenties I was pretty adamant that I didn't want to have kids at all, and my online dating profile when I was 28 reflected that.  Looking back on it, I can't really decide if it was a factor of not having met the right guy yet, or not wanting to give up my time, my freedom, my money and my figure (yeah, I'm shallow, but it's hard work for me to stay on the slim side). What I do know is that I would never have been someone who felt strongly enough about motherhood to go through IVF with donor sperm to have a baby on her own.  I fully respect those who do, as it's got to be the farthest thing from easy, but it wasn't for me. 

Two things changed for me in pretty short order when I was 33 years old.  I started dating the man who would become my husband, and my niece was born.  For the first time in my life, I was in a position to be around a newborn and feel the incredible power that such a little being possesses.  A power that makes you want to do everything you can to protect it and keep it happy and watch it grow to experience life.  And, at the same time, I was finally with someone who I could envision as a full partner in creating and caring for that little being.  M and I started talking about marriage, and then kids.  It was something he wanted, and I realized that it had somehow become something that I kinda, sorta wanted too.  I mean, I was still incredibly terrified of the demands that a baby places on your life, your relationship, your body and your finances.  I was under absolutely no illusions that having a child would be easy or even enjoyable for large parts of it.  But I was part of a team now, and as a team I felt like we could do it.

I still feel that way.  I know that if we can ever manage to have a baby, we'll be good parents and we'll rise to meet the challenges that come with building a family.  But I have to be brutally honest here, and say that I wonder if we're really prepared for the changes we would have to make if we're successful in having a child.  Being around my niece has been a bit of an eye-opener for me.  While I've loved spending time with her, quite frankly, she's tiring.  I'm a novelty to her, so she's been pretty focused on spending time with me since we got home.  That's meant endless running and story-telling and colouring and bubble-blowing.  I've helped her get dressed.  I've helped her go potty.  I've held her when she's had a toddler meltdown.  And at the end of five or six hours with her, I'm done.  It's honestly a bit of a relief when 7pm hits and my sister tells her it's time to go home or go to bed, and I get to hug and kiss her and sit back and relax.  But for my sister, there's still work to be done.  Because she's the mom. 

What all of this has driven home for me is that there's a huge difference between understanding on a conceptual level that having a child changes your life, and actually living it.  Right now, M and I know conceptually that if we succeed in having a baby, our down time will be severely limited if not eliminated completely.  But what happens when our leisurely weekend mornings of coffee and internet-surfing actually disappear?  Our ability to just plop down on the couch and turn off our brains for a few hours in front of the TV will give way to listening to baby monitors, washing dirty bottles and folding onesies.  We'll be tired and irritable.  We're not even close enough to either set of grandparents to have someone pop over to relieve us if we need a break.  We'll be out on that tightrope without a net, and nowhere to sit if we get tired halfway across.  We'll just have to keep going, no matter how much we might want to stop.

Sometimes it feels like I'm the only one terrified of this prospect.  When I mention it, M casually shrugs his shoulders and says that we'll deal with it when/if it happens, and that it's part of parenthood.  But seriously.  We've only been here for a week, and this is how I feel.  Is it possible that I'm simply too selfish and lazy to be a mom?  That I don't want it bad enough?  What if I'm only supposed to be an aunt?  If we lived here permanently (not an option), would I get enough of a taste of kids by being around my niece that I wouldn't want one of my own anymore?  What if we do end up managing to have one of our own, and I end up resenting the loss of my previous life, or worse yet, resenting our child?  Everyone else always seems so sure!  Are these the kinds of things other people worry about when they talk about having doubts about having kids?  Do the people who have always wanted kids think about this stuff?  Or does having these doubts mean that my instincts as a twenty-something were right, and that I shouldn't be trying to have children at all?

Happiest Canada Day ever

No, I'm not pregnant.  

Yesterday marked the start of a two-week vacation for M and I, and we flew east to spend it with my family.  I haven't been home in two years.  While my folks have come up to Toronto for the scattered visit, my sister and her family haven't, and although we Skype almost every weekend, it's just not the same.  Yesterday I got to play with my niece in person for the first time since she was two years old, and it was awesome!

It's one of those weird things that I can't explain about infertility.  Being around other people's kids isn't generally fun for me.  I manage as best I can, but I find it hard not to let it bother me that everyone else is making these happy perfect families and M and I are getting left behind.  I see the joy that my friends take in their kids, and it hurts me that I can't do the same with my own children.  But for some reason, none of that is present when I'm with my niece.

Maybe it's because when I'm with her, I'm not just "friend of parent who is obliged to find said child cute and wonderful".  I have a job for a change, a role to play.  I'm an aunt.  And my niece IS cute and wonderful, dammit.  I don't have to put in any work to see that.  Obviously, I'm totally biased, but I'm allowed to be.  She's my blood.  At this rate she may be the closest I ever get to being a mom.  So I'm damn well gonna make sure that when I'm with her that it's the best time of her life.

When she arrived yesterday at my folks' house, there was a short moment of shyness.  Even though she sees M and I every week on the computer, I'm sure it was a bit weird to see us in person for a change.  But that only lasted a second, and pretty soon I was chasing her around the backyard and jumping in her kiddie pool with her.  I can't even explain how happy I was when this little four-year-old girl asked if I would sit next to her at dinner, or if I would hold her hand as we played hide and seek with "Uncle M".  I also think she has a bit of a crush on M, since at one point she leaned over and conspiratorially whispered to me that she wanted to go over and give him a hug and a kiss.  Watching M play with her also shows me (not that I ever had any doubt) what a great dad he would make, but not in a melancholy way.

We have ten days here, and I'm planning to make the most of them.  We're going to do some touristy/sightseeing things for M's benefit, and we'll have dinner with some of my high school friends and visit with cousins.  We'll also be spending the weekend at my parents' cottage and drinking more beer than is probably good for us, 'cause that's just how we roll.

And now if you'll excuse me, I have a very important date.  Apparently my niece declared to my sister this morning that she didn't want to go to day care, but that she would go until lunchtime but them her mom and Auntie Aramis had to come pick her up.  It's nice to be in such high demand!