Follow me on the crazy, hopeful, discouraging, funny, and ultimately successful (one way or another) path to parenthood while facing infertility.

Thursday, May 26, 2011

Gearing Up Again

So here it is... the long wait since January is finally coming to a close. I am gearing up for our next, third, and hopefully final IVF attempt.

The wait was long, but it went by somewhat quickly. I had about 6 weeks of utter devastation and holing-up following the negative in January, then March was the for-kicks injectible IUI that lasted forever (20 days of stimming, that was NOT cool) and resulted, unsurprisingly, in nada, and then April. The long stretch of April where I waited for my negative test, and then had nothing to do until the first week of May.

May was significant because it marked roughly 3 months before retrieval, and my intent this time is to really prepare myself in those 3 months. They say that egg development happens 3 months before ovulation, so it's good to start getting ready early. I have made lifestyle changes up until this point, but with every negative test I have a period where I go balls-out nuts and eat crap and drink on a consistent basis and have coffee. And skip some of my supplements, since those are expensive little bottles and I don't see the point in taking them when I know there's nothing doing (how do I know for sure? I'm on the Pill between cycles). But now I am in that 3-month period and I am back to preparation mode.

It was probably ill-advised to start preparation mode the first week of May, which was 1) my 35th birthday, 2) my dreaded annual lady exam, and 3) Mother's Day. I did great until Wednesday and then pretty much threw my hands up and figured 1 week late won't matter. I ate well but drank my fair share of wine, margaritas, and Hendrick's martinis. And started Operation Dullard on Monday, May 9th. It's a little hard, because I really resent the concept that I am not pregnant because I'm not organic enough (my grocery bill argues I am), I didn't feed my body enough bizarre nutrients, I didn't eat enough of the right fertile foods. Those books and websites drive me crazy because it puts the blame squarely on me and flies in the face of reality--smack fiends get pregnant, people get pregnant while living their lives normally and don't know it for weeks, drinkers and smokers and midnight tokers get pregnant. The dorito-snarfing Strawberries & Creme Frappuccino-downing women get pregnant. So why should I suffer through the period before when I suffer enough once we get started with the injections?

Because even though I don't want to buy into the hype, I can't help but feel like I won't ever know if it would make a difference if I don't commit. A lot of these things that I'm doing to gear up are good for me anyway--eating organic and unprocessed (or minimally processed) whole foods is good for you. Engaging in stress-reducing activities like yoga, massage, and acupuncture is good for you. Taking supplements is good for you (although some question that), but until I try, I can't dismiss it.

So here is my Gearing-Up-For-Third-Time's-The-Charm IVF plan:
  • Eat organically and fill my plate with veggies and fruits as much as possible.
  • Drink a crapload of water. 
  • Limit coffee. Get down to decaf or no coffee at all by the end of June. 
  • Limit alcohol. I was going to completely eliminate it, but I figure one drink a week isn't going to hurt anything, up until I start Lupron. A glass of wine or an end-of-the-week margarita has stress-relieving properties that deserve notice! 
  • Take an obscene amount of vitamins. In addition to my current regimen of ultra pure fish oil (lemon flavored, which results in lemon burps instead of fish burps but there's still a whiff of the sea in there... gross, sorry), organic Pure Encapsulations Prenatal Vitamins (Sorry GNC, you've been replaced), OPC powder (grapeseed) and Vitamin D, I am also adding Calcium, L-Arginine (helps with implantation apparently),  CoQ10 (helps promote healthy cellular growth), and baby aspirin (helps with implantation as a mild blood thinner). I am going to need a bag just for my supplements when we go to Maine. 
  • Go to acupuncture regularly to increase blood flow to my uterus and prep my ovaries for their big performance. Relieve stress.
  • Go to Maya Massage regularly to increase blood flow to my uterus and rearrange my innards to their optimal positions, and relieve stress.
  • Continue my Yoga For Fertility Class for stress relief and body prep. 
  • Go to counseling to prepare my mindset for this next cycle. The last cycle was nothing short of devastating and I want to figure out strategies to go into this next one so that I am prepared to come out of it saner and more resilient, no matter what the outcome is.
  • Bring back the hilarious and beneficial Vag Steam Bath, to prep my uterus and get it ready to take on some new Tennants. Horrible pun but it made me giggle... 
Seem like a lot? It is. It's a lot to keep track of. I have to be totally ready for when I start Lupron at the end of next month. It is almost like a second job, all of this preparation for my body and mind. I hope that it's worth it. Bryce has his own list of preps to do (much shorter, as he is an important contributor but not the residence). It is a tremendous investment, and we are ready for our payout!

Sunday, May 15, 2011

Infertility + Career = ?

Infertility touches every aspect of your life, and your career is no exception. It is incredibly difficult to balance your career and your increasingly more complicated and challenging efforts to become a parent. Ironically, once parenthood is yours, it doesn't exactly simplify your relationship with your career, either. But if you are infertile, those issues come up early and are particularly sticky.

Infertility and Your Schedule
Infertility demands a lot of time, and doesn't give a flying leap about your schedule. Your appointments are often in the early morning, and as frequently as every day or every other day depending on where you are in your cycle and what treatment you're pursuing. Imagine having to come up with a reason to miss work for an hour every other day for week or two, as often as every month. Imagine the added stress of needing to finagle your schedule and keep on top of everything while you are going to get poked with an internal ultrasound wand and stabbed with the blood draw and getting good/bad news about your follicles. Like you can go back to work and be totally present after an appointment like that. But, unfortunately, if you are going through infertility treatment, constant appointments are a necessary evil. You pretty much live at the clinic. For me, the earliest appointments are at 7:00. Unfortunately, since I teach at a high school, I will be late even if I am lucky enough to get a 7:00 appointment.  And I travel, so I start at a different location that has a slightly later start time (if I started at the actual high school I would be REALLY late with a 7 am appointment!). Plus, my clinic is 25 minutes away from my school. It makes it pretty impossible to not have it affect my work. I don't know if it is easier or harder if you work in an office--you need to be away from your desk on a regular basis, so even if your times for doctor's appointments are more flexible, you are still gone an awful lot. And I'm sure it's noticed. 

You Got Some 'Splaining to Do...
It is near impossible to keep the fact that you are doing infertility treatments completely hush-hush at work. At least, if you don't want to look like a major slacker and/or crazy person. All of these doctor's appointments are pretty suspect, especially when they snowball from once a week to twice a week to every other day and then every day as your cycle progresses. And if you do IVF, you'll probably take time off sick for retrieval and rest after transfer. When the procedures for my second IVF took place the week after winter break, I ended up being out for 2 weeks--I stimmed aggressively and was incredibly uncomfortable and unable to really book it down the halls (or even waddle down the halls) by the end, and then I hyperstimulated and needed to rest so the fluid wouldn't keep building up in my abdominal cavity. I was not expecting to be out for so long, but luckily had the sick time available and had planned 2 weeks' worth of lessons just in case. (Psycho planning worked in my favor for once!) I also snagged an excellent sub. But had I not let key supervisory people know what I was going through, they may not have been as understanding about my lengthy absence. And that was on top of my absences for inseminations and tests and multiple doctor's appointments that have me coming in late on a regular basis. People who haven't gone through this or known someone close who has gone through infertility really can't see a scenario where it would be necessary to miss so much work. At first I tried to explain with the vague, "I have a chronic non-life-threatening medical condition that requires frequent doctor's appointments for treatment and procedures." The non-life-threatening part is very important--otherwise people immediately think that you're dying. Because CANCER is what usually goes through people's minds when you say you have to go in for treatment and you'll be out a lot. I forgot to say that part once and the woman I was talking to went white, grabbed my hand, and whispered, "Oh god, are you ok?" It was very awkward. But back to the 'splaining... vague works for a while, but eventually I think it does help to 'fess up to what, exactly, you are doing. Because if you're doing it for a while, it becomes a little suspect. People who are paying attention might start to figure it out. Telling what you're doing helps when your hormones are wacked out and you may lose it a little at work. I had to explain myself to an administrator last year when I got a bit unreasonably emotional and worked up in a parent meeting. I was on a ton of meds and emotionally undone, and it just caught up to me at an inopportune moment. I don't regret telling her why I was a basketcase--I'd much rather she know it was because I'm doing infertility treatments than think it's because I'm unbalanced and perhaps not meant for education.

Outing Your (Hopefully) Imminent Maternity Leave
The problem with telling people in power is that now they know that, if things work out, you're going to be going out on maternity leave. It could be this year, it could be next year. But you're going out, for at least 6 weeks and possibly more. I can take up to 2 years (unpaid) leave per birth (I don't think you get 4 years for twins), and come back to a job. Not my job, but a job. And while it is illegal to make hiring or assignment decisions based on someone's family planning situation, you can't help but be a little paranoid. I had a situation this year where it was suggested that for my own benefit I tell HR that I'm going through IVF, and that I tell upper level administration as well. I did, but now that I am waiting to hear on a transfer to another position, and my current position doesn't exist next year, I am wondering if that was a mistake. I doubt it, as it's totally illegal to make decisions based on pregnancy or possible pregnancy, but it does make me nervous. In an office job, you might wonder if you are being passed over for projects because of your tardiness/frequent absences/knowledge that you may not be there the whole year to see something through. It's very stressful.

Making Decisions Based on Infertility
If you have options or you are facing a change, a challenge, an opportunity in your career, you automatically have to consider your infertility into whatever you are moving toward. Or at least I do--I am not quite able to live my life as if I might not be pregnant later this year and take on the "I could be hit by a bus tomorrow! I'm taking the high-power promotion anyway!" attitude.  I have been interviewing and was accepted onto the hiring list for a very desirable district (sadly, they do this when they don't have openings, or not enough openings for everyone in the hiring pool). But I had to think... is this the right time for a change? If I start in a brand new classroom, will I be able to have the flexibility I currently have for my appointments? Of course, I am in a bad position because no matter what, I am starting over with something new next year. I will have to figure out a way to get things finagled so that I can make it to all my appointments and stay sane and continue being the hardworking teacher I pride myself in being. It scares the crap out of me. I am hoping that our summer IVF will be successful, and I will start the year pregnant and just have to finagle prenatal appointments, which are much more exciting and people enjoy hearing about SO much more than follicle growth. But I've done this before, where I filled out my plan book dates just until when I thought I would be going out on maternity leave. It was incredibly depressing to have to go back and fill in those dates when it didn't work. What if it isn't successful this summer, again? I know people who have taken leaves, who have lost their jobs, who have elected to not work during treatment because it is just too much to juggle. If my transfer doesn't work out for whatever reason, should I get a part-time job instead so I can fully focus on treatment? Should I not worry about pursuing another job until things work out? It seems kind of crazy, but is it? I don't see myself taking that route, but it really does make me nervous to start something new with all of this on my plate.

Balancing your job and your infertility is incredibly hard. It means sacrifices. It means telling a lot of people you don't know well what you are going through so they don't think that you are in rehab (I might think someone who comes in late like I do as frequently as I do was hung over all the time!). It means making your private business everyone's business. Because on top of dealing with your supervisor, everyone else is noticing your absences and erratic behavior. Sooner or later you won't be able to dodge their inquisitiveness anymore. And then you will have coworkers asking when "we" find out you're pregnant or not (answer, "I find out soon. You find out when I tell you."). This process makes you have to make choices--what can I handle with all of this on my plate? Which is more important, getting pregnant or being awesome in my job? Because it really feels like it's almost impossible to do both, at least long-term. So many people deal with difficult questions once they are pregnant and readying for a maternity leave--how long do I go out for? Do I find awesome and affordable daycare, or stay home for a while? Which is more costly? How long can I stay out on maternity leave and keep my career on track? I feel like I have a whole other set of questions before I even get to those issues. I'm sure it is possible to balance your job and your complex, scientific babymaking mission. It just feels incredibly difficult.

Friday, May 6, 2011

Mother's Day

 
Mother's Day is a very nice holiday--you honor the woman who gave birth to you, or who raised you, or who did both. I love my mom very much and think that Mother's Day is a great way to show special appreciation for everything she did and does to help make me the adult I am today. I am so grateful. I also love my mother-in-law, and she deserves special recognition as well for everything she did and does to help make Bryce who he is today, and the way she made me family so quickly.

But, for the infertile people out there, Mother's Day isn't just a celebration of your wonderful mom.

It's a celebration of being a mom. It's a celebration of new moms. It's a celebration that smacks you in the face -- on the radio, on TV commercials, in the grocery store, by the side of the road, in the card aisle... and you are horribly, overwhelmingly left out of the whole business. Sort of.

See, as a person who is desperately trying everything possible to get to that blissful (if exhausting and overwhelming) state of motherhood but failing at every attempt, Mother's Day is like being excluded from a club that you have done everything everyone else has (and more) to get into. You are feeling pretty damn hazed at this point. Everyone's got flowers and cards and brunches (or so it seems)--everyone but you. You want to be a part of it--you want to be the one who is receiving a card for a new or expectant mom. But you're just not. And you have so little control over it.

My first Mother's Day as a definitive infertile individual was a little rough but not too bad--I had moments of sadness, I by turns avoided Facebook and tortured myself by the parade of cute mother-child portraits and kindergarten breakfasts, but I participated in the whole business. My sister and I cooked up a Mother's Day brunch at my mom's house (I just couldn't face a restaurant brunch filled with young families and babies) and I had potted flowering plants for both my mom and my sister, who is a wonderful stepson to two young men. I was so proud of myself for that touch--"Look how OK I am! I can even put out flowers for everyone and be the only woman at the table without any! I am so well-adjusted." That was before we did IVF. Unsuccessfully. Twice.

This year, I am really, really struggling. I thought for sure we'd be pregnant by now. I thought it was remotely possible we might even have managed to have a baby by now. I have had two incredibly high-tech procedures that put a total of 5 embryos, 5 pre-babies into my uterus. They just didn't step up and stay. So, with those painful experiences, and the increasing sense of feeling left behind, this year I am not well-adjusted. But I have a plan. And maybe my plan can help other people who are struggling with Mother's Day, too:

  • I celebrated Mother's Day with my mom a week early, last Sunday, at a brunch I hosted at my house. If you can't celebrate early, try celebrating at someone's home. I am lucky that I could get away with a one-on-one celebration--I don't know how I would handle an extended-family babyfest. Not well, probably.
  • I had help with cards--I just can't handle the Mother's Day card aisle. There are always wonderful new or expectant mom "Your FIRST Mother's Day!" cards that just take me down when I see them. I am a horrible card-cryer--ask my friend Lynn, who takes me shopping for sympathy cards all the time because a) I can pick out some pretty good ones and b) it is highly entertaining to watch me start sobbing in Hallmark over a greeting card. For someone I don't even know 99% of the time. This year, I had Bryce pick out a handful of cards that he thought I would like and find appropriate, and then I read that small selection (completely missing the new mom genre) and chose the one I thought was the best. I should have Bryce help me more often, because the best of his bunch was an out-of-the-park hit with my mom. So I got the card I needed with minimal damage to my fragile state. 
  • I am going to avoid trolling Facebook this weekend. Starting Saturday, and going through Monday. I will have a strict "no backrolling" policy for those days, because nothing makes you see just how far behind you are in the baby department as going onto Facebook and realizing that there are 8 gazillion babies born to your friends and acquaintances, most of them this past year. This year has been a record for "Congratulations!" messages. I love my friends and think that they are wonderful mothers. But I won't be telling them so on Facebook. It is just too hard. That's probably ok, because if you scroll through Facebook on Mother's Day pretty much all you see is "Happy Mother's Day!," so I'm pretty sure no one will miss my contribution. Also, by not backrolling I can avoid seeing all those horrible inspirational forward-type posts that talk about what a blessing it is to be a mom. Great unless you've been withheld that blessing.
  • I have a plan for Sunday--it is a designated PJ day! I am not leaving the house. We are not going out to breakfast or any other meal where I can be barraged by what we don't have despite trying so, so, so hard. (This is not a sacrifice--I make way better home fries than most diners we've gone to and my friend gave me three gourmet bacons for my birthday so we are doing it up! UN-Mother's Day Brunch, woot!) We aren't going outside (past the back yard at least), because I don't want to see the stroller and picnic brigade. We are camping out inside and having a fun, relaxing day that is completely Mother's Day free. No radio, no live TV, no recorded shows that have Mother's Day commercials on them--just reading, games, and ridiculous movies that have nothing to do with celebrating being in the Mom Club. I may finally force Bryce to watch Anchorman with me. Actually, I am really looking forward to Sunday. 
There it is, my Mother's Day plan for self-preservation! I'm sure that little things are out there that will set me off--I've been a little weepy lately. Small things like the cashier at Wegmans wishing the person in front of me a Happy Mother's Day (and she had no child with her!) but not me (like somehow she had mom radar and something about me didn't compute), and having the only newborn in the area right behind me in line. Like going to Starbucks to meet another infertile friend the other day and being smacked with the "All Mothers Are Special" CD by the cashier. I have nothing against this stuff, but it's just insult to injury.  I'm special too, even though I'm not a mother.  I've come pretty close. I just haven't sealed the deal.

Happy Mother's Day to everyone--but especially to Mothers In Spirit. Those of us who have the mom's heart, and the mom's love to give, just no baby to give it to. Those of us who struggle all year and hope that this will be our first Mother's Day, only to have it come again and be left out of the celebration, pressing our faces up against the glass instead (or in my case, hiding in a closet in my
PJs with Will Ferrell). We are all moms, too--we just haven't found our babies yet. We just aren't recognized for our awesome mom-ness. There is no card for the mom-in-waiting. I hope that this Mother's Day is a peaceful, painless, short-lived day for all of you who are like me. And I hope that everyone who is among the lucky, who is a recognizable recipient of the celebration, is aware of just what an incredible honor it is to be celebrated for such an amazing miracle.

Tuesday, May 3, 2011

A Schmear Wish

This week is kind of a doozy--I have my 35th birthday on Thursday, Mother's Day on Sunday, and my annual lady-doctor visit tomorrow. You wouldn't think that a routine, non-treatment related visit to the doctor would be anxiety-inducing, but this one definitely is.

This is the third time I am going to the gynecologist with fertility on the brain--three years ago I came with sperm numbers in hand to see if we would need to try naturally for 6 months to a year or, given what we already knew about the male factor, if we could get an express pass to the fertility clinic. My doc perused the paperwork and said, "Yup, you'll need a referral. You'll just frustrate yourself trying on your own. This isn't terrible though--you'll get pregnant. You just need some basting." Ah, "basting," the incredibly clinical term for IUI (intrauterine insemination). I left with hope that next time I came I would be pregnant.

Fast forward to last year's annual exam--where I had to both say I wasn't pregnant (obviously, since I would have seen my doc for the OB portion of her expertise) AND that I had been diagnosed with PCOS (Polycystic Ovarian Syndrome). Something that I was a little irritated hadn't been diagnosed earlier, but since I had been on the Pill for pretty much all my reproductive adult years it wasn't really anyone's fault per se. The basting wasn't working out so well, as we'd done 5 at that point with no results. It was a pretty perfunctory visit, with a "good luck to you" in there but not much else--I was firmly in the hands of the fertility experts, so what else was there to say?

And now, tomorrow. I get to go, the day before my less-than-exciting birthday, and STILL be empty-wombed. This is going to be somewhat awkward. "Basting" did NOT do the trick, and IVF so far hasn't quite put a baby in me, so I really don't know what will be said. And then there's the fact that when you go to a regular lady-doctor, there is no sign in the waiting room that says "Out of consideration for our patients, please avoid bringing children with you if at all possible." It is a baby mecca. A toddler mecca. A giant-pregnant-belly mecca. A place where excited couples are waiting to hear heartbeats and see hiccuping fetuses and have their pee sticks confirmed. A place where C-sections are scheduled and birthing plans reviewed. Admittedly, there is also the odd unhappy pregnant lady in there (the one with faulty birth control, the teen with her pissed-off mom), but that doesn't exactly make me feel better. I sit in the waiting room, read my book and try to drown out the cacophony of motherhood around me.

So my wish is this--why can't fertility clinics offer pap smears? That is really the only reason why I am going to this appointment. My lady parts are incredibly well-visited lately and I have portraits of my ovaries. My female hormone blood levels are known to me pretty much at all times. I KNOW I am not pregnant. All I need is a simple cancer screening. I don't know if other people have this issue too, but I am seriously wondering--why not? Reproductive Endocrinologists are highly specialized OB/GYNs. It would be awesome to add Pap Smear to the repertoire of procedures and checks done at the ridiculous number of appointments we go to as fertility patients. Please--save us from the fertility-patient-unfriendly waiting rooms of our regular OB/GYNs until we, too, have a nugget to view!

Sunday, May 1, 2011

I Just Know It Will Happen

Even though it is not technically still Infertility Awareness Week, I had one more myth to bust that has been weighing on me. It's the "But you're such a good person/You would make a great Mom!/I just KNOW this will happen for you!" frame of mind.

Before I get into it I want to be clear--anyone who says anything to me with good intentions has my sincere appreciation. Infertility is a difficult subject and for some reason it can make people very, very uncomfortable. Probably because there is no perfect thing to say. It is emotional, and visceral, and nothing someone can say will truly make it all better. But for the people who let their good wishes known, I am always appreciative. People want to offer hope and positive energy, and you hate to counter it with an ugly truth. But, to quote the X-Files, "The truth is out there." And it's not always pretty. Or easy to hear.

But You're Such a Good Person!
Unfortunately, nice has very little to do with it. I could constantly have bluebirds singing on my shoulders and be able to calm crying babies with only a wink and sit down among carnivorous creatures to read them picture books unharmed--and it wouldn't make me more fertile. I am a pretty freaking good person--I have volunteered, I give to charity, I love my career as a special educator, I am sensitive, caring, and giving to those around me. If karma exists, I should have lots of good fortune. And, to be honest, I do have more than my share--a wonderful husband, a challenging job in a crappy economy, a (very nice) roof over my head, supportive family and friends. I just want to add a baby (or two) to that good fortune. Unfortunately, PCOS and male factor infertility really don't give a hoot if you are nice or mean. They affect the sweet people and the miserable people equally. Mean people have babies every day without a hitch, so sadly me being a good person has nothing to do with it. It's an added bonus to my quality of life, but not a prerequisite for pregnancy.

But You Would Make A Great Mom! 
This goes along with when people tell you you are great with children and should have a ton of them. In this infertility journey, I have met a lot of women who have awesome "Mom" factor. They are caring, creative, soothing, loving, and just can't wait to direct that energy towards a child. Their child. But somehow, we are all childless (or can't seem to add to our families). There is no correlation between great Mom potential and the ability to get and stay pregnant. Just like plenty of seriously crappy moms (the ones you see in the news scarring and killing their children in cruel and unusual ways) have no problem getting pregnant. I know women who built their families in different ways and will likely never be pregnant, but they are awesome, awesome moms. So being a great mom doesn't guarantee that you will achieve successful pregnancy. I wish that a burning desire to carry a biological child and become a terrific, model mother would make it so, but it's just not how that works. (Just like I would like to think that going through this process will make me a better, more appreciative mother--but that argument doesn't necessarily hold water either. Maybe more appreciative, but not immune to frustration and impatience.)

I Just KNOW This Will Happen For You!
This one is super hard. Because I would LOVE to believe it. I would LOVE to say, YES! I can totally see this working out for me! That is my hope and my dream. That is why we put ourselves through this demanding process time and time again, because we truly believe it will. We can even see it. I have seen in my mind what my daughter would look like (don't ask me why I think I'm having a girl someday, no clue but that's what I see). But that doesn't mean it HAS to happen. It doesn't. There are so, so many people for whom it hasn't happened yet. Or for whom it never happened. For every miracle success story there are so many stories of people who chose another path (or for whom another path was chosen). When you hear "I just know this will happen!" it is really hard not to ask, "HOW?" Because if there is a crystal ball that shows that, I want to see. I wish I had that certainty but after 7 failed IUIs and 2 failed IVFs my capacity to be completely behind the "It WILL happen!" train is pretty limited. I wouldn't do all this if I didn't think it was possible. But to protect myself, I have to have a realistic view. I have to smack myself with the reality of my previous attempts and the reasons known and unknown for failures. When you go into a cycle dead certain it will work, it doesn't mean it will. IVF cycle #2 was like an experiment in this mindset--if I try to "think it true" am I more likely to get pregnant? Nope. Just more likely to be completely emotionally devastated. So I am going with a middle ground now, as we plan for IVF #3. I am feeling positive but I know it doesn't HAVE to happen. Just by probability alone we have a sickeningly high chance of failure. But we will concentrate on the possibility. You can't go into a cycle all doom and gloom and keep your sanity (or be sane in the first place--you would never spend this kind of money and torture your body in this manner if you thought you had a snowball's chance in hell--you have to think you'll be on the lucky end for once). But at the same time, you also have to (at least briefly) entertain the possibility that it might not work. Ever.

So that's my two cents. It may seem a little depressing, but it is actually really helpful to be rooted in reality and know what's possible and what's not. Infertility is a medical condition. Medical conditions don't care if you are an awesome person, you would make a great mom, or that you refuse to accept that this might not happen to you. People, on the other hand, do care--and for that I am so grateful. That people who aren't in the infertility microcosm feel so strongly that we will be successful for all the reasons above warms my heart. But it doesn't change the cold hard truth--infertility is a numbers game and it is largely about timing and luck. It is one big heartrending gamble. Going into it with a positive attitude is important--but you can't ignore reality and keep the wherewithal to stay strong on your journey, wherever it takes you.