Just a Little Bit Sad

I love fall. I love the changing leaves, the pumpkins, the cooler weather, the apple picking, the flushed cheeks and almost visible breath. We got married on a favorite holiday, Halloween, because the fall is such a wonderful time of year.

But I'm just a little sad this fall. A small part of it is Facebook and all the pictures of kids running around, picking out their pumpkins and playing in the leaves. But most of it is things I see or feel in real time. We went to Powers Farm Market to get pumpkin doughnuts for Bryce, and saw the teepees getting set up for the spooky display of jack 'o lanterns they do every year for kids. We saw the first pumpkins set out for choosing. We saw the giant tubs of mums. And I sat in the car with our wonderful greyhound while Bryce got his yummy doughnuts and cried quietly to myself. I cried because I want to go to Powers and pick out pumpkins and apples and doughnuts and mums with my own little children. I cried because most of the families I saw with young children had parents obviously younger than us (and I always wanted to be a "young parent"). I cried because this year we'll be walking through the teepees while shrieking children run past us and once again won't be even expecting a little one of our own (yes, I realize we weren't even married last year at this time, but it's more a life-in-general thought than an actual relationship-timeline thought). I think we might be the creepy childless people in the teepee at this point.

Sometimes it just hits me--the feeling of impossibility that, despite our being told that we have excellent chances at succeeding eventually, just haunts me. The feeling that this might not happen for us the way we envision it (or further away from how we envisioned it, since I don't think many young people dream "Someday I'll meet the man of my dreams and we'll make a baby in a lab!"). I cried myself to sleep the other night, because I was lying in bed and just trying to imagine a little person coming into the room saying "Mommy, I can't sleep!" or "Mommy, Daddy, I'm scared!" and I had a really hard time with it. Normally I can see a child in this house no problem, but for some reason that night I couldn't picture it and it made me unbelievably sad.

I know that I will get past the sadness and feel more hopeful soon, but it is a constant yo-yo. One day I'm hopeful and can think about names and picture what the little room upstairs will look like, and the next I'm crying over other people's kids screaming over pumpkins. I guess I just have to stay on this rollercoaster and enjoy the ride.

Food for Thought

Over the past year I have changed my diet pretty dramatically. First it was because I went gluten-free after years of unexplained abdominal pain and general intestinal distress. My father had been diagnosed with celiac disease and he thought I should be tested since I was having a lot of trouble with similar issues. Amazingly, my GI did not want to test me and told me it was likely just IBS and to eat more fiber, which made me sicker. I self-diagnosed and took myself off gluten to see what would happen. It was utterly transformative and for the first time in forever I have a normal digestive system (of course unless I get into gluten by accident). This was in July of 2009, before we met with our RE (reproductive endocrinologist) regarding trying to conceive. It turns out that celiac disease and gluten intolerance can contribute to infertility as well. Seriously, can't I catch a break here?

GF cupcakes I made for my wedding

As a person who can't eat gluten, I suddenly had no choice but to eat very healthy. I have been eating pretty healthfully for the past 5 years or so--more salads and veggies, less red meat, virtually no fast food, cooking more and eating out less (save for Maria's Mexican Restaurant, which we go to just about weekly and is our incredibly delicious but high-fat cheesefest meal of the week). I can't eat the cookies, cupcakes, danishes, breakfast pizzas, etc. that show up at school. I can't go out for pizza unless they carry gluten-free pizza, which is just not the same. Many processed foods have "hidden gluten" -- malt flavorings and colorings, additives to make them bind well that are made from gluten. So, I ended up eating more organic foods by default because they aren't as processed. I can eat cheese, ice cream (yum, Coldstone Creamery has a lot of GF options), some candies, and any number of homemade treats that I make gluten free thanks to yummy cookbooks, blogs my aunt (also celiac) sends me, and new products offered every day. In general, I have to work pretty hard to eat unhealthfully.

Then, when I first started on the infertility journey, I read all kinds of books that told me which foods were "fertile foods" that would boost my chances of ovulating regularly and prepare my body for a healthy pregnancy. They also told me all the things in my house that could add chemicals unwittingly to my food--plastic containers, microwaving takeout containers not meant for the microwave, etc. At this point I still believed that there was a chance I could control my fertility and we wouldn't have to move to IVF, which seemed like a scary, expensive, "last chance" option (since after IVF, there's stuff they can do to tweak the process of IVF but there's no more higher level of treatment than that--just donor egg, donor sperm, or surrogate). I bought pamphlets on fertile foods at the natural grocery store. I faithfully ate sardines several times per week, upped my dark leafy greens and fruit intake, replaced all of my plastic tupperware with glass containers (the lids are still plastic but you microwave food with a paper towel on top so the plastic can't leach) and honestly tried to use the natural kitchen cleaners (they just didn't clean as well, so I just don't breathe while I spray the harsher stuff). I try to avoid microwaving vegetables to cook them because apparently it saps them of their vitamins. I bought stainless steel pots and pans and environmentally-friendly nonstick pans that swore they wouldn't flake the nonstick stuff into your food. I bought everything organic -- fruits and vegetables, milk and eggs, meats (although chicken I have a hard time with because it's just SO expensive-- spending $10 on one package of chicken is a bit
much). I drink whole milk because even though my milk is organic, cows who produce milk are either pregnant or nursing and so there are high levels of natural hormones in the milk. Supposedly when they skim the milk to make it reduced fat (or no fat) it concentrates those hormones in the milk, adding them to your system in a way that can affect your own hormone levels.

All of this is good for me--but now that I am at the IVF stage it is frustrating. None of it made one bit of difference to my ability to conceive a child. Part of this is because with male factor infertility, I could do everything possible for my body to get it to ovulate but if the sperm can't make it to and then in the egg, it didn't matter. Bryce made these changes too--he even had to drink a nasty herbal cocktail, Proxeed, that has been proven to improve numbers for men. It did, to the point where motility (the sperm's ability to swim well) had increased quite a bit, but the numbers were still not high enough to make success with IUI (intrauterine insemination) likely. We were in a "gray area of poor prognosis" for IUI due to low sperm counts alone. With IVF, everything is incredibly controlled--my system is totally shut down and restarted with medications that doctors can adjust to control both egg production and timing; they can actually inject the sperm into the egg so instead of needing 10 million or more for IUI, you really only need 100,000 so that they can hand-pick the absolute best-looking ones for fertilization. Nothing we do to our bodies to improve reproductive function truly matters at this point. Bryce actually got the go-ahead to quit downing the gross herbal cocktail, because we're all set for sperm for IVF. My egg production and ovulation is completely artificial--my own body has nothing to do with the process. We are in the midst of mad scientist conception and it is as far from organic as you can get.

Cod in a lemon butter sauce with
fingerling potatoes and
organic green beans

I still do many of the things I did in the beginning when I thought that it was possible for us to beat the odds and conceive naturally (or semi-naturally). I love my glass food storage containers, even though they are wicked heavy in my lunchbag. I continue to eat everything organic because I think eliminating those chemicals can't hurt and I still need a healthy body for pregnancy, even if it makes no difference to my chances of conceiving. I'm still chugging the whole milk (although occasionally I go 2%) in my cereal and tea and occasional latte. I only eat organic red meat if I'm cooking it myself, and we eat it maybe once a week or once every two weeks. I eat uncured bacon so that I'm not eating preservatives. I have not been on a sardine kick lately, but I have been eating more low-mercury fish and organic low-mercury albacore tuna since I hate chunk light, but regular albacore is high in toxins that stay in your body for long periods of time. I don't eat things labeled low-fat that replace real food ingredients with chemicals and things I can't pronounce.

I'm still mad--all of this work and effort and it didn't make a difference in the conception department. Meanwhile there are women who don't have to stress about their diets and conceive by accident or easily on purpose without even thinking about organic or inorganic or if they get enough vitamin A or E. I know that life isn't fair, but it seems particularly unfair when going through infertility. However, I have to think that at least due to all these changes I have a healthier body, even though I have to put that healthier body through the ringer before I even go through pregnancy. In the interest of positive thinking, I just have to shift my focus--instead of eating to try to coax my body to get pregnant, now I'm eating to prepare my body for a healthy pregnancy.

Letting Go of "The Plan"

I am a planner. I like to know everything in advance so that I can be prepared for whatever it is I'm doing. I can research it, have my talking points in line, have a schedule put together, and everything will work out great. Or at least it's supposed to, right?

This planning streak has gotten me into trouble before. As a young 20-something I had it in my mind that I should be working right after college, live with my boyfriend no more than 2 years before getting married, get married at 24, and have my kids by 30. I was right on track with my plan. I got my job at Scholastic within weeks of graduating. I moved in with my boyfriend that fall and was married 4 months after turning 24. I was totally planning on having those kids by 30, but I hit a snag in my planning when my husband at the time decided that we should wait and so I got my master's in education instead. My plan was going great, but my life was awful. I had married someone who was, to say the least, not a good partner for me. I had friends coming to me in tears begging me not to marry this person because of the way I was treated, but I did it anyway because I was in love and of course things would change for the better. And, shamefully, because breaking up and starting over on my own was not in my plan. I was living an unhealthy life of tiptoeing and avoiding the truth of my situation because going outside my plan was unthinkable. Well, then multiple, long-standing infidelities were revealed and a lightbulb went off--I deserved better than The Plan! I would jump into uncertainty and get divorced in the midst of student teaching and leaving the safety net of my job at Paychex! I would abandon The Plan! It was terrifying. I turned 30 as my life was upside down -- this marker for having children was already here and I didn't even have a good, loving partner to consider conceiving with. I was starting over as many of my friends were having their first or second babies.

So I let go of The Plan temporarily. I decided to "take things organically," a phrase I repeated over and over in hopes that I would feel more comfortable operating planless. I met my husband, Bryce, during this uncertain time--horrible timing that a plan wouldn't have supported, but because I was sans plan I went with it. I tried very hard to get rid of preconceived notions of timelines and waypoints in our relationship (although I was the instigator for just about every milestone we hit, including getting engaged since I was the one who proposed).  I am very lucky for my husband. He treats me with love, care, and respect. He is incredibly supportive. He is patient with me when I don't necessarily deserve it. He makes me laugh. We have a wonderful time together, with or without a plan.

Now, though, I want a plan in the worst way. Infertility has robbed me of the ability to even attempt to plan. Here is a situation where I can research the topic to death and be as well-informed as possible, set up timelines and schedules for treatment, and it won't matter. Not one plan I have made for when treatment would happen or how this would go in general has actually been viable. You simply can't plan anything when in infertility treatments. You can't plan vacations (a time that seems good now could mean packing needles in your bag, needing to be in the office for a procedure, or not being able to relax because you're in the stressful 2-week-wait later). You can't plan for when these procedures will be, because they are entirely dependent on how your body responds to drugs--and that is completely unpredictable. One month you could be on medication for 17 days, another it could be 12. There is no way to know. You can't even really plan for future cycles--I wanted to get a date on the calendar for our next IVF cycle but can't until I hit day 1 of my next cycle and have a test done (I advocated for a saline sonohistogram to check out the interior of my uterus--I'm not paying a gazillion dollars to try again if they haven't checked out my uterus fully). I have pages and pages in a notebook of plans I tried to make for when we would do different cycles of different treatments and they just didn't happen when I wanted them to. I have to fill in the rest of my plan book with dates for school because I was thinking if I planned for being successful with our first attempt in August, I would go out on leave in mid-May. So I didn't fill in anything past the first week of May because I wanted to plan for getting pregnant with my first IVF. That plan didn't work either. It is so frustrating!

I am trying my best to let go of this need to constantly plan. My body has a plan of its own. The little tiny human that will call me Mommy has a plan of its own. Somehow I have to give up wanting to control this process and just let it happen. I have made one step towards that--I have decided to plan cycles for when I can next do them, not around school calendars or other obligations. They will happen when it's the right time for the procedure, not when I decide it's the right time for my schedule.  I will not plan my life based on a "what if?" situation, I will take it as it comes. Maybe if I stop trying to control every part of this process it will actually happen for me. Oh no, did I just make a plan for not planning? I think I'm going to need some help with this...

Hope

Getting a negative result on my first IVF was devastating. Negatives are devastating in their own right all through the process, but when IVF is presented as by far your best chance of getting pregnant by the team at your clinic, a negative truly stinks. The first day I got my negative (first from peeing on a stick, and then the more conclusive call after my HCG beta blood test) I was a mess. I cried for hours. I had no choice but to go to work the next day with my swollen frogfaced eyes, as it was the first week of school. I even had a training on Saturday followed by a faculty party later in the night (I was so NOT in a party mood, but amazingly it briefly took my mind off things. Probably helped that I had a lot of wine that evening). It wasn't until Sunday when I had nothing to take my mind off of things and I had downtime that I could truly process what that meant. No baby for me this time around. I had thought so positively throughout the entire cycle and felt betrayed.

Hope is a funny thing. It buoys you up. It fills you with possibility. It allows you to dream and plan things like nursery bedding. It fuels late night conversations with your husband about what you think your child will be like, what kind of parents we'll be. But then, if things don't work out, hope can make your fall into despair and discouragement so much harder. I kept a daily journal throughout my first IVF cycle of what I was feeling both physically and emotionally each day. In part I did this so that it could serve as a reference for future cycles (either if this one didn't work or if we did it again for a sibling), but I also did it thinking it would be the world's earliest baby book. A preconception journal since when you go through this process you know way more about conception than those not going through infertility. I could have pinpointed the exact day that my potential child was conceived. I have pictures of the embryos that were placed back into my uterus (that are getting pasted into my journal -- I can't bear to throw them out even though the embryos are long gone). I read that journal today as I waited for my doctor to come into my post-cycle follow-up consultation. It was amazing how much hope was in every entry, how much positivity I put into my emotional state during the cycle.

Even though that hope didn't work out this time, after the consultation I feel hope again! I was very nervous going into this meeting. I was convinced that they were going to come back with something else that was wrong that wasn't allowing us to get pregnant. Instead, they reiterated how we are still excellent candidates for IVF even though it didn't work this time. How everyone at the clinic wouldn't have been surprised if we had gotten pregnant from that cycle, even with twins. Interesting, because I had been under the impression that the cycle was a dismal flop. (I started out with 18+ follicles, which were whittled down to 10 at egg retrieval, then further down to 7 actually mature enough to attempt fertilization, then 5 that actually fertilized, and 2 that were actually viable.) That put things into perspective. So, we got the go ahead to do another cycle (I won't be specific here about when I am actually in a cycle because then it can get sticky with trying not to share news until 2nd trimester) at some point in the near future. We also qualify for a package deal (pay for 2 cycles and get 3 fresh + 3 frozen if you've got surplus embryos, if you're not pregnant after all that get 75% of your money back), which means we have really great chances at success since they only approve people who have a low risk of failed cycles. And a successful pregnancy is defined as healthy at 20 weeks, which is reassuring since we are terrified of early miscarriage.  So, if we are unfortunate and miscarry, it doesn't disqualify us from continuing with the cycles we paid for (plus the bonus cycles).

So, I'm allowing myself to hope again. Maybe this next cycle will be our time. And if not, at least we have the backup of more cycles paid for through the package program. And if that doesn't work (which we've been assured it will, but can you really promise that?) we get money back to put towards adoption. It's a win-win, really. Welcome back, hope!

Gratitude

When engulfed in the world of infertility, it can be difficult to find things to be grateful for. It's much easier to find things to be royally pissed off about. Why won't my body do what it's supposed to? Why won't his body do what it's supposed to? Why once we get everything to meet and join and divide won't it take? Why do I have to have an experience where I could feasibly get pregnant without my husband in the same state, much less in the same room? Why do I get to have ultrasound after ultrasound of my follicles but never an ultrasound of a tiny growing being? Why do I have PCOS, which in addition to making it difficult to get pregnant also makes it difficult to stay pregnant? I could keep going here, but I won't.

In the interest of positive thinking, I would like to instead dedicate some time to things I am very grateful for. I don't necessarily think that positive thinking can get you pregnant faster (which would imply the inverse, that thinking less positively can keep you from getting pregnant--I have a lot of things keeping me from getting pregnant but I refuse to believe that my thought process or worries are one of them!). But I do value positive thinking as a way to rise above everything I'm going through, to anchor myself in in hope instead of despair, and to acknowledge that while there are a lot of very unfair things to my situation, I am also very lucky.

I am grateful that:
- I live in a time where access to fertility treatments are fairly accessible and eventually getting pregnant with the help of reproductive technology is a reasonable possibility for me. (Even when it feels like it's never going to happen, I can reasonably hope that it will.)
- I have a wonderful, supportive, loving husband who is going through all of this with me and instead of stressing our new marriage, this process is bringing us closer together.
- My husband truly believes and shares often that while our dream is to have children, if that doesn't happen in any way due to whatever factors, we will still have a very fulfilling life together full of love (and probably some really good wine).
- I have amazing friends who support me in a variety of ways--from phone calls to visits to cards in the mail and unexpected surprises to bring me good luck.
- My family is very supportive and not obtrusive--they let me share what I need to and don't push for more information. I was particularly grateful for my family when I had to share the news of my failed cycle--they handled it beautifully when it was disappointing news for them, too.
- I have an amazing support network of other women who are going through this process through Strong Fertility's support group and CNY's fertility yoga and support group.
- My fertility clinic offers free 1:1 counseling that can be very helpful when things get stressful or hard to handle. And it's free. Did I mention it's free?
- We have the financial resources to pay for treatment (to a point) -- our decision to keep trying to have a baby isn't dependent on the cost of the treatment.
- We are both employed in this tricky economy with very good jobs. One less stress to add to the mix.
- While we have both male and female factor infertility standing in our way, we have diagnoses that make us good candidates for IVF. Our doctors are confident that it will work eventually. It could be much harder for us than it is.

That is an awful lot to be grateful for!

Sensitivity: A Sticky Wicket

When you are going through infertility, you require extra sensitivity. This can be confusing to your friends and family and even your husband (or partner) because different days bring different needs. I have days when I can be around babies without sadness and go to Target and walk through the baby aisles to see what we might want someday and it doesn't make me tear up. I love babies--obviously I am doing everything possible to have one. But other days I just can't handle it. I feel like the world is shoving one newborn or hugely pregnant person in my path after another--I go to Starbucks and an employee on maternity leave is showing off her new baby to everyone. I go to Wegmans and everywhere I turn there's a tiny baby crying and it just tugs on my heart and makes me want to run out of the store crying. I get on Facebook and it's the day everyone is either posting pictures of their new babies, announcing pregnancies, or posting "If being a mom is the best thing that has ever happened to you and your life is completely fulfilling because you have a child, press LIKE!" It is not that I am not happy for everyone else. It is not that I can't stand to be around babies right now. It is not any one thing--it's the combination of everything all at once. We live in a very baby-centric society. Magazines and television shows and websites are constantly scoping out new celebrity baby bumps, baby products celebrities use, whose baby (or babies) are the cutest. There is no where you can go where this focus on motherhood, pregnancy, and babies isn't slapping you in the face. Maybe a strip club, but that's not really my scene.

This can be a tricky minefield--both for me and for those around me. All that I can say is that showing interest and expressing support is always appreciated. Just about everyone I know has at one time or another said something that could be hurtful, completely unintentionally. There's no way around that--and honestly I know that people are not meaning to hurt my feelings. Sometimes people say things but they don't know what I'm going through. I may vent about this to very close friends, but even as I am venting I am not actually mad at the people who unwittingly said something insensitive. How can I be if they are in the dark? A question that I am fine with today could make me cry (but still answer) tomorrow. Asking me how I am doing and what is going on in the process is always ok. If there is a question that I'm not comfortable with, I will tell you (although there's not much I'm not comfortable with). If you are curious about the ins and outs of infertility I am more than happy to share -- it shows me that you care and want to be more informed about this highly invasive and involved process. If you have success stories of people you know who've gone through this process that's wonderful--but it won't always make me feel better. (Ditto for "my sister had her babies in her 40s, it's not too late for you!" -- A well-meaning story, but age is not really our problem so it just tends to make me feel worse that someone with 40-year old eggs can get pregnant and I can't.) There are some days when all I need is for someone to be there while I cry and nothing you say will make me feel better, but the fact that you can be there to listen and hand me a tissue means a lot. There are other days when I just want to be alone with my discouragement and sadness and need quiet time to myself. And even other days I can sit surrounded by pregnancy books and dream about the day when that will be my reference, and not the overflowing shelf of fertility-related books. (At the moment, the pregnancy books are all stuffed back in a drawer safely out of sight.) It truly is a rollercoaster.

So what do you do to be supportive and navigate my minefield of conflicting emotions while still having a give-and-take friendship? A friend of mine from a support group had a great strategy--her best friend was going through a pregnancy at the same time that she was going through multiple (unsuccessful) IVF attempts. They had a system--she would say "I need you to be my best friend, not my best friend who's pregnant" if she was having a difficult time and couldn't handle pregnancy-related topics. Her friend would say "I need you to be my best friend, not my best friend in infertility treatment" if she needed support talking about her pregnancy or adjusting to her newborn at home. The upshot is, honest and clear communication without fear of saying the wrong thing is the best way to go. I am trying very hard to temper my infertility talk with the other things going on in my life, and to be sure to ask you what's going on in yours. It's a struggle because treatment is so consuming and affects you physically and emotionally in so many ways. I require a sliding scale of sensitivity, patience, and a sense of humor these days, and have truly appreciated the support I have received so far.

To share or not to share?

Trying to have a family is a funny thing. No one talks about it when it's going well and it's a fun, romantic process--who wants to know about your intimate babymaking in the low lights (or no lights) of your bedroom? For those who are lucky to experience babymaking this way, the fun is in the telling once you are pregnant and feel confident telling the masses--for some the conservative 12-week mark, for others posting the pee stick on Facebook. You get free reign to discuss pretty much anything pregnancy or baby related and receive support publicly for all the ups and downs you encounter along the way. People are excited to see your sonograms and hear about tests that confirm the sex, the health, the size, etc. People are also excited to hear all the (sometimes gory) details of the birth and newborn foibles (breastfeeding! circumcision! poop! constipation! thrush! rashes!).

But there is another side to the story--what happens when babymaking is as far from the bedroom as it can get? When making a baby involves a team of medical professionals, mixing injectable medications on your kitchen counter, having blood drawn so many times you look like a heroin addict? Silence. No one talks about it publicly. You feel like crap because you have ovaries the size of navel oranges but feel compelled to post about what you ate for dinner on Facebook because the true subject that dominates your life is considered not "socially appropriate." So what do you do? Do you keep it all bottled in and mystify people when you cry at commercials featuring perfect families (or that awful Virgin Mobile commercial where the woman is giving birth but only cares about reading gossip on her smart phone)? Do you tell people and risk having some people support you and others distance themselves? In the beginning, my husband and I decided to not tell anyone but a short list of very close friends. We didn't want people asking questions all the time. We then expanded the list to parents only and maybe a few more friends, using a letter to explain the ins and outs of the process and what it would likely mean for us. As treatments got more involved, we got a little more open (such as with key people at work) because we'd need to take time off for work--or in my case explain why a routine meeting had me overly emotional.  But still, we didn't go full disclosure. We felt isolated. I felt like I was on a coverup mission or had to pussyfoot around the subject, and it made me feel awful--like somehow I should be ashamed of what I have to go through to have a chance at a baby. It's resulted in some sticky situations and misunderstandings with friends and family alike.

So, I am writing this blog for several reasons. I want an outlet to share my experiences while I am on the infertility journey. I want to share what I have learned along the way because it may help you or someone you know. I want a way to inform people of this process and how you can support a friend or family member who is going through infertility treatment. I want to encourage others to be more open so that there is no feeling that infertility is something to be hidden, to be talked about sparingly (mostly to save others from awkwardness). This process is incredibly isolating, but it shouldn't have to be. Infertility affects 11.8% of women ages 15-44 per the CDC, which doesn't even take into account male factor infertility. That's a lot of women!

What I am NOT looking for in this blog: I am not looking for a pity party. I am not looking for advice on how I can get pregnant (relaxing, adopting, being more positive, sleeping more, eating vegan, quitting my job, eliminating stress, etc.) -- friendly suggestions on books, services, resources etc. are welcome. I am not giving any kind of medical advice--only sharing my experiences and what has been helpful to me. Hopefully it will help you too--whether you are also struggling with infertility, know someone who is struggling with infertility, or want to know what's going on in my life right now (since infertility pretty much dominates).

I hope that this will be a good experience for the writer and readers alike. Thank you for reading as I start to share my journey publicly!