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

Monday, November 16, 2015

#Microblog Mondays: Mourning What Will Never Be



Friday night I had a dream. I dreamed that against all odds, we got pregnant naturally, on our own. Except for some reason I got a call with beta numbers, not a double-lined pee stick.

And the number was 3.

Which is really odd, because a HCG level of 3 wouldn't even be considered positive at most clinics.

And it wasn't good in the dreamworld either, because I realized that again I was being presented with a short time to be excited, and given the experience we had with the ectopic where we started at 12 and then rose but wonkily until it resulted in tragedy and surgery, I was filled with doom and sadness and realization that pregnancy was just not going to ever be something attainable or positive for me. Ever.

I woke up and felt...resigned. Bryce and I had hashed out discussion after discussion this week that ended in the one decision regarding our embryos that sticks -- we won't be transferring them to me. That is not an option for a slew of reasons:

1) We've never been successful before
2) We don't know if my uterus will be okay by then
3) We really don't want to go down that road again, the literal driving part but also the injections, the appointments, the calls, the disappointments
4) It was discovered in my blood workup YEARS ago that I am heterozygous for the prothrombin gene mutation, which puts me at significant risk for stroke and blood clot. With that combined with my tendency to have migraine with aura, my current OB/GYN refuses to put me on anything with estrogen in it. Which means progesterone-only birth control pill, or Depo Provera (which I start next week, because the progesterone-only pill was a nightmare of constant and unpredictable bleeding that left me feeling like a 14 year old again and also hampered my quality of life at home, ahem, a LOT). Which also means he doesn't recommend any additional estrogen, which would be utterly necessary for another transfer. (It also means menopause is probably going to be craptastic, because estrogen therapy falls under that umbrella, too, I bet.)

That last one is huge. That last one had my doctor saying, somewhat dramatically, "So, let me get this straight. You are planning to adopt a child, become a mother, and then purposely put yourself at risk for a life-threatening clot by doing a frozen transfer afterwards?" Yeah. I sound like the douchiest of douches when put that way. I have always been willing to put my own health second to a chance at becoming a mother, which drives Bryce crazy, but when you think about the fact that I would finally be a mother, finally have that caregiving responsibility, finally be parenting, and risk my health to do it again in a way that has pretty much proven to us how slim the chances of success are... it sounds awful. I can't do it.

I am left in a place that's strange, because there is a calming sense of closure that comes with realizing that I will never be pregnant, EVER. I have been able to hang on to this fantasy of having it all thanks to those frozens, and that's all it is, a fantasy. Which means in opposition to this closure is the death of a dream.

And I am sad, so, so desperately sad. Which is appropriate, I guess. I mourned it when we walked away from our embryos and opened the beautiful door to adoption. But I could hold on to that tiny sliver of hope that I wasn't REALLY walking away, because there was still this CHANCE that pregnancy could still be mine one day. Except it won't be.

That's okay, because that part of our journey was filled with pain and loss and a constant feeling of failure. Failure that made me question myself, question my body's usefulness, question how much I could put myself through. How much I could put OURSELVES through, really. It's incredibly hard to realize that my stubbornness pushed us away from our current pathway to parenthood initially, that we could have opened that door years ago if I wasn't so stuck on the fantasy of pregnancy.

I will move through this, I will heal and not be split, no matter how infinitesimally, between the hope for a pregnancy and the reality and beauty of adoption as our best choice for parenthood. I will let go of the fantasy, finally, and put it in the ground so that I can focus on the unfurling hopes and dreams that are waiting for us through adoption, on the other side of this wait, that have a definitiveness that pregnancy never did. It's kind of freeing, actually.

I love this quote from Helen Keller, one that used to irk me when I was being obstinate (or tenacious, depending on how you look at it) but that now expresses pretty perfectly how I feel about our journey up until this point:

When one door of happiness closes, another one opens; but often we look so long at the closed door that we do not see the one which has been opened for us...  -- Helen Keller

I'm ready to consider that door and see it for what it is -- closed and locked and perhaps even blocked on the other side with a bureau or a chair wedged up under the doorknob. I'm ready to walk through that open door unfettered by backwards glances at what will never be, to accept that that particular dream is gone, but that the new door offers a dream that is SO MUCH BETTER for so many reasons.

PS -- I will write about something happier next time, promise. Just muddling through at the moment.

Want to read more #Microblog Mondays? Go here and enjoy!

25 comments:

  1. Mali, feel free to tell me about ectopic pregnancy through IVF in a comment here, thanks!

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    1. Okay, here goes. (It will be long!) When an embryo is transferred into our uterus, it doesn't implant immediately (if, of course, it is going to implant at all), which is why I am always doubly annoyed when the media uses "implants" instead of "transfers." It can float around for a day or two before implantation, and this means it can move from the transfer site. It can therefore travel up into the fallopian tube, and implant there, causing an ectopic pregnancy. Or it can implant at the entrance of the fallopian tube, causing a cornual or interstitial ectopic pregnancy.

      The figures you were given (less than 1%) surprise me, because they are not the figures we used at the Ectopic Pregnancy Trust, based on sound research by some of the world's leading experts. In fact, ectopic pregnancy rates through IVF are higher (4-6%) than in the general population (1-2%). This is often because women who need to seek IVF treatment have an underlying, undiagnosed condition (that has contributed to infertility) that may heighten their risk of ectopic pregnancy.

      So any IVF clinic that is telling you the risks are below 1% do seem to be ignoring the research we were provided with. After one ectopic naturally, the risk of a repeat is about 10%, and after two (my situation), that increases to 25%, so IVF then becomes the lower risk option.

      Still, 90% of women who have ectopics go on to conceive again successfully (ie, in the right place). And 50% of women who have ectopics have none of the risk factors, and will never know what caused their ectopics.

      Conditions that can lead to tubal or interstitial (at the connection of the tube to the uterus) ectopic pregnancies can include tubes that are blocked or semi-blocked (so if an egg floated up, it might not get back to the uterus), balding of the cilia (these little hairs that waft the egg down to uterus can gradually disappear, and so can't do their job), and - I was also told by my own specialist, so can't 100% back this information, when he was trying to figure out why I had two (one, tubal, one, interstitial, neither IVF) - the fallopian tube contractions that help push the egg downwards can, on occasion, reverse. Many of these conditions are almost impossible to diagnose.

      I was interested to see that you were told your cilia were pointing or directing the wrong way. I've never heard of this (and wonder how they knew, as the cilia are so tiny infertility tests can't see them - perhaps they conducted investigations on the tube that was removed?). But it could explain how you had an ectopic with IVF, along with any of the other explanations.

      This inspired me to copy and paste as a post on my blog. I've added a little more information, and done this here - http://nokiddinginnz.blogspot.co.nz/2015/11/ectopic-pregnancies-including-with-ivf.html

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    2. Oh wow, that is interesting information for sure! It all makes sense. So much floating, so much miracle to all the right conditions happening all at once to result in a sustaining pregnancy. They did remove and do a pathology report on my tube, and it may be that I'm misremembering and it was something about the cilia but not necessarily that the hairs were reversed, just probabilities that the cilia were likely at fault. We were definitely told less than 1%, though, because that statistic really stuck with me over the years and my husband remembers it that way, too. So interesting to find that it's a higher probability. It does drive me crazy, too, when the media uses "implant" synonymously with "transfer." If that were true I'd have been way more successful! I appreciate the time you took to put all this together and I'm going to head on over and read the full post. I knew it was possible, I just can't wrap my head around how something placed just so, without all the pesky traveling from the tube down into the uterus, would choose to make such a disastrous wrong turn. (Yup, personalizing again, can't seem to help that. Ha.)

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  2. I think you have to let yourself muddle through all of this and feel all the feels for as long as you need to feel them. So that you can truly move on to the next thing and have closure. I don't know if you read Alphabet Salad, but her microblog post this week has a positive spin on moving on.
    A million hugs and prayers for you. My heart breaks for you, but is so hopefull that your mystery baby isn't far away.

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    1. Thanks, Charlotte -- I went over to Alphabet Salad and just loved it. I know better things are coming, but you're right, those feels just demand to be felt. (Whoa, transparent "Fault in Our Stars" reference...)

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  3. I agree with Charlotte - muddle until it feels right to move that new door. Excellent Helen Keller quote for the situation. Sending lots of positive thoughts your way. *hugs*

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    1. Thanks so much... ironically I have the Helen Keller quote on a magnet, next to my original "Never, never, never give up" Churchill one. That one speaks to my resolve and tenacity, but the Keller one speaks to letting go. Something I'm notoriously awful at. Thanks for the positive thoughts and the hugs!

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  4. You will still have some of these feelings about pregnancy even after adoption. But the amazing goodness of caring for a child will eventually heal your heart.

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    1. Thank you... I am hopeful that I can keep healing my heart before that child comes into our keeping. It will be so nice to eventually have the perspective of looking back on all this pain through the fuzziness of my joy in having a much different reality in days to come.

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  5. Sending healing thoughts your way. It is natural to grieve the shutting of such a significant door. Our thoughts are with you.

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  6. Love the quote. So apropos. my thoughts arw with you.

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    1. Thank you. I really do love that quote and it's applicable to so many situations where moving on to other opportunities would be necessary.

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  7. As hard as I'm sure it's been for you, I so appreciate you sharing about the struggles you've felt about your embryos. I think about ours often and while we aren't at a decision making spot yet, it's been comforting (?) to read about another person's process of determining what to do. I really appreciate the honesty and transparency of all of your posts!

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    1. I'm glad it's helpful! Honestly, it's helpful for me to process all this crazy grief-filled ethics study through writing about it, so I am thrilled that putting my process out there is helpful if not for now then for decisions that lurk on the horizon. Thanks for your thoughts!

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  8. You have to feel what you're going to feel. And I think acknowledging it IS the way to move forward. Sending a hug.

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    1. Thank you for the hug... it definitely helps to name it and work through it rather than pushing these feelings of grief down and plastering a smile on my face because I'm supposed to be happier now that we've set everything in motion to bring our baby home in a very different way.

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  9. Isn't it interesting how sometimes dreams can help us understand our own hearts and minds. Every day is a step forward,keep going.

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    1. Absolutely. I have to just keep picking those feet up and moving them forward... I'm pretty good at picking myself back up, but this has been a hard concept to wrap my head around and process fully. I think once I do, though, it will be so much better.

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  10. Sending lots of hugs. This is all so tough, but you are going to get through it.

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    1. Thank you so much for the hugs and the encouragement, much appreciated!

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  11. Your door analogy reminds me a lot of my Infertility Waiting Room post. I also know that finality, that absolute finality, when there is no chance of pregnancy every. It is hard to deal with, and I am not surprised you find it different. I often hear people say "I knew how I would feel before our last IVF because it would have been our last," but they don't, not really. Because that tiny sliver of hope is still alive inside us, and means we don't have to confront that absolute end of hope. Nor does it allow us (as maybe you are finding with that sense of calm) to open our hearts and minds to a different hope, to hope for other things. So I want to send a hug, because before that new hope, or even in conjunction with it, there is a desperate sadness that you have to feel, and I want you to know you're not alone. It sucks. But it is the beginning of healing, too.

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    1. Thank you so much for your understanding and thoughts. You put it so perfectly! Kind of sitting in the sadness today. It will get better. I look forward to healing and having scar tissue instead of scabs that crack from time to time.

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  12. Oh Jess. I'm so sorry. I absolutely agree about the door opening, but closing this other door is heartbreakingly hard. Thinking of you during this time. The crossroads is extremely hard.

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    1. Thank you so much for your thoughts... it's a funny time of failure and freedom, of closure and feeling that loss intensely. I thought I could pry that door open in the future, but I guess better to realize now that it is shut, shut, shut so I can revel in the joys of the wide open door we're already mostly through.

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