Saturday, January 25, 2014

And The Award Goes To...

ME! And you and you and you and you and you and you! A very kind soul has nominated me for a Liebster Award, and I am happy and grateful to accept it. I have been gifted by Rice Cakes and Redemption, a thoughtful, fellow run-on-sentence blogger struggling with endometriosis, repeat IVF failure, and pursuing foster adoption to add to her family built through foster adoption. Whew! Please check her out.

With honor comes responsibility, so the rules are:

 1. Recognize the blogger who gave you the reward
 2. Nominate at least 5 (or however many you can come up with, less or more) bloggers with less than 200 followers (leave a comment letting them know they've been honored)
 3. Answer 10 questions given to you by the blogger who nominated you
 4. Give 10 questions to the bloggers you yourself nominate.

You don't have to play along, I won't be offended if you decide not to, but it can be fun and it's a great way to find new people to connect with! Viva la networking... And who doesn't like to be recognized for awesomeness?

My nominees are (and forgive me if I'm cheating, because followers aren't clearly visible on some, and pageviews aren't the same as followers so I'm not sure how to do this but whatever, enjoy your recognition...) in no particular order:

          1. A Boy, A Girl, & A Cat
          2. The Unexpected Trip
          3. Just A Little Off Kilter
          4. And The Vial Makes Three
          5. Teach Me To Braid
          6. Operation Baby Gage

These ladies are funny, they are inspiring, they touch me with their candor. Just in case you need a heads up, #5 and #6 are pregnant. So much love in this little group. So many chuckles in the middle of the crap soup that is infertility, no matter what part of the journey you're on or what methods you need to get to that family that, let's face it, should really be free.

Ok, question time! Here are mine that I got from Ms. Rice Cakes: 
1.     What is your #1 pet peeve?
Hmmmm. I have many, but #1 is probably not saying "thank you." When someone holds the door for you, take the nanosecond it takes to say "thank you." When someone lets you cut in when there's traffic, wave a little. When you drop something and someone picks it up for you, say "thank you." I don't think you can be too busy to show a little gratitude. And it so irks me when that seems to be the case. (I may possibly occasionally add in a little sarcastic "YOU'RE WELCOME!" when this does not happen.)
2.     Why did you start blogging?
I started blogging when I entered into the IVF phase of infertility, had just failed my first IVF, and felt strongly that I should speak out about it. I wanted to educate people on the realities of infertility, make the emotional crap more visible, be a resource on all things infertility for other people (I am an obsessive researcher), and just vent my feelings. I process through writing, and this blog has helped me in more ways than I can count. The fact that I've gotten proof that it's helped others makes me feel incredibly lucky to be a part of this community (which is kind of sick), but in the way that if I have to eat this shit sandwich, then at least I can make it as tasty as possible and share my tips with others. (Sorry for the analogy. Gross.)
3.     Biggest blogging related fear?
That I am misunderstood. I have been misunderstood before and it hurts. Also that sometimes nobody reads it, and while I do this primarily for me and if no one reads it I shouldn't be sad, who am I kidding? You put this out there to have people read it and have some kind of reinforcement for baring your soul so publicly. Sometimes you wonder if you wrote something weird, or if you're the only one who felt a certain way about a certain situation. 
4.     Best advice you ever got?
You cannot control the things that happen to you, or things that other people say or do. You can only control the way that you choose to deal with them. Attitude is everything. It's not easy, but you can let go of the choices that other people make. Your own choices are hard enough. (I have had a wonderful therapist for some time.)
5.     First job?
Ha! First illegal job was working as a "model" at Macy's spraying passersby with perfume at the tender age of 12 or 13. Made me feel bad for the perfume sprayers for the rest of my life. First actual job with a pay stub and taxes taken out was when I was 14. I was a crewmember of the YCC (Youth Conservation Corps), working for the county Parks department to blaze trails, build boardwalks, maintain county parks. Oh, and I was the only girl on my crew. That was AWESOME. (I did it a second summer, was NOT the only girl, and now knew how to draw male genitalia on fogged up windows from the gems in my previous experience.) I am a master of character-building experiences.
6.     Secret dream job?
Well, it wouldn't be a secret then, would it? :) Honestly, I love teaching and if all the bureaucracy stuff could magically go away and I could just focus on helping students learn and love learning, it would be even more swell. Also I would love to be a stay at home mom for a longer period of time than I fear I will actually be able to, and without the danger of losing my hard-won and impossible-to-regain teaching job in this climate. 
7.     Favorite household chore? Least favorite household chore? (that’s a two-fer)
I actually love vacuuming. No joke. I HATE scrubbing out the tub/shower. So awkward and unrewarding.
8.     Biggest risk you ever took & would you do it again?
Even though it led to the best things in my life ever, leaving my ex-husband was an incredibly big risk. I was kissing 30, finishing my master's in education and about to be student teaching (aka paying to work), and had spent nearly 10 years convinced I did NOT deserve better. I had no money, was scared I'd be alone forever, and uncertain of my job prospects. But I did it, even though everyone who was hoping I'd do it was unsure I'd actually do it, and I realized that I WAS worthy of so much more and I WOULD be ok and WOW could my life be a zillion times better. Hell yes I'd do it again. I would have put proposing to my husband, which I did via letter, but I was pretty sure he'd say yes so it wasn't a huge risk (although still scary). And if I hadn't taken that other risk I would never have met my wonderful husband to propose to him in the first place. So there it is! 
9.     Best vacation EVER (one you have already taken)?
Hmmmmm. I have to say going to a camp on a pond in Maine, near Bar Harbor. It is the most complete relaxation we have ever experienced. A week of hiking, kayaking, reading, coloring, cooking, eating out, drinking wine on the deck, climbing the pink granite coastline... it's just heaven. And lots of lobster in butter. Mmmmmm. (Sadly, infertility has interfered with this vacation the past few years, which makes us very depressed. Hopefully this year we get to go again.)
10. All-time favorite movie?
Ooooh, tough one. I love, love, love When Harry Met Sally. It's funny, it's heartwarming, it's real, it has THE BEST LINES EVER, and is timeless despite the horribly late-80s clothing and hair. I also love Bridget Jones' Diary, because it is also funny and real and has THE BEST LINES EVER (they tie). 
Ok, nominees, here are your questions to answer--have fun!: 
1. If you could go back in time to relive any memory, what would it be?
2. What is the food or beverage that you absolutely cannot live without?
3. When did you decide to start your blog?
4. What is your favorite room in your home and why?
5. What's your favorite quote (or one of your favorite quotes)?
6. All-time favorite book? 
7. What has been your favorite job over the years? 
8. If you could go back to school for anything other than what you went for, what would it be?
9. What is the weirdest advice that anyone has ever given you?
10. What song lifts you up when you're feeling down?
There it is, ladies. Congratulations and have at it! I can't wait to learn a bit more about you. And thanks again, Redemption and Rice Cakes!
PS -- I apologize for the weird formatting, cut-and-paste is apparently not very blog-to-blog friendly. :( Thanks to my much more tech-savvy husband for fixing the weird white blocks this appeared before it was 8 different fonts and sizes... 

Monday, January 13, 2014

Being a Teacher is Hard. Being An Infertile Teacher is Harder.

I love teaching, but there is no way that you can say that it isn't hard. It is, as my 95 year old grandmother (a retired middle school English teacher), would say, "a jealous mistress." You do it because you love it, certainly not for money or recognition or advancement opportunities. I love teaching Resource Room, self-contained Reading and English, and pushing into a general education English class, all at the 8th grade level. I love 8th graders, because they are in this funny middle place between childhood and adolescence (although lately it seems like it is entirely adolescence and I feel like 8th graders didn't look like THIS years ago...). They are testing out their personalities and testing out limits and discovering who they are. They are brutally honest. They have a goofy sense of humor. They need a lot of wrangling.

None of my 8th graders know that I have been trying, unsuccessfully and with much heartbreak, and over a long period of time, to have a baby. I have been told I look young for my age, and most of my students guess I'm between 28-30. (Thank you, completely blind students, possibly who have issues with math.) So maybe it's not weird to them that I don't have kids of my own yet. And it hasn't explicitly come up, so I don't really talk about it. Boundaries and all. Last year, in one of my 9th grade classes, I had a student flat out ask me how come I don't have any kids. Verbatim, "How come you don't have kids, Mrs. T? Do you not want kids?" I didn't know what to do other than to tell the (very general) truth. I said, "Well, I'd actually love to have kids. But sometimes you just don't get want you want. I hope to have kids, it just hasn't worked out yet." It was dead silent in the class, the student who asked said, "oh," and another student said, "That's SO SAD." And I said "yes, it is so sad" and then tried to steer the conversation back to Earth Science or ancient river civilizations or multiplying radicals or Great Expectations so that I didn't cry all over my lovely students.

That hasn't happened this year, which is just fine by me. However, sometimes class discussions end up in directions that just turn out to be heartwrenching and I have a hard time keeping Infertile Jess out of School Jess. I do a pretty good job compartmentalizing. I can be School Jess most of the time and tamp Infertile Jess down with very few (but spectacular) exceptions. Today was hard. Today I had to employ every strategy in my arsenal to not get sarcastic and/or burst into tears and/or have a complete meltdown and/or give 5th period English a detailed education in infertility.

You see, we are reading The Giver. Every year I read this book at least once, sometimes twice, because I teach it in Special Class English and I support it in Resource Room and this year I teach (or support) it in the gen ed English class. That's a lot of dystopia. The thing about The Giver, which I've actually written about before, is that it brings up all sorts of questions that are, uh, interesting for discussion in general but particularly if you have experience with infertility treatment. In this novel, a boy named Jonas lives in a Community that is carefully controlled so that everything is perfect, there is no conflict, hunger, unemployment, obesity, divorce, etc. -- because there is no choice. Families are made by successful adults applying for a child, and when that application is approved by the Elders they receive their new baby at the Ceremony of One, which takes place every year at the same time. New babies are cared for at the Nurturing Center, where all the pesky fresh baby stuff is handled -- learning to sleep at night, controlling crying, making babies as convenient as possible. Spouses (who had to apply for that privilege as well and are matched according to optimal compatibility) can have a maximum of two children, one boy and one girl. There is no sex and no romantic love because as soon as you become an adolescent, and you get the Stirrings, you must report it so that you can start taking a daily pill that will suppress those feelings and hormones and will make life so, so much simpler and free of strife.

So, where do these children come from, you might ask? (Unless you've read the book, which I really recommend, because it's a fabulous story despite the pain it causes me ALL THE TIME.) The new babies that enter the Nurturing Center are grown by Birthmothers. These are women carefully selected for the job, usually not the brightest bulbs in the pack but they have optimal fertility (at 12-13, which when the kids realize how this works they go EWWWWWW). They are perfect for the job. They are Birthmothers for a maximum of three years, where they live in relative luxury, eating delicious food, doing gentle exercises, and having minimal responsibility. Just brewing those fresh little babies. After their job is done they work mundane hard labor jobs for the rest of their lives until they enter The House of the Old. In this community, being a Birthmother has very little honor.

There are some benefits to this situation--if I lived in this Community, I would not qualify as a Birthmother, but my infertility would be a moot point since I'd apply for children and they'd be given to me. Sometimes students equate this with adoption, not realizing that with adoption you don't "apply" and then just get handed a baby at a yearly ceremony. But that's not what upset me. Neither is the usually somewhat awkward conversation about how Birthmothers get pregnant, since there's no talk of Birthfathers, and sex is not a part of this society. I usually explain in fairly deep detail how you can medically impregnate someone without any sex at all--just a woman, a catheter, and some sperm. I explain (appropriately) insemination and how even in our society, there are people who have difficulty getting pregnant the "regular" way and need medical technology to help. I say all this with a straight face, without at all revealing that I know all this from personal experience. I don't cry, I don't turn red, I don't start spurting all about my close relationship with that process. Sometimes students think it's weird. This year they were much more weirded out by the Stirrings conversation (awkward) and not by the insemination conversation.  So nope, that's not what put me over the edge this year.

This year, today, in fact, the discussion turned to how come there's no bullying in this Community. The role of parents. How parents are very responsible and there are a lot of rules and everyone does a good job instilling politeness and relying on each other and responsibility. How one reason why you know these parents will do a good job is that they must apply for children, that they must prove they are responsible, that they aren't just GIVEN children. And then started the comparison to our society. The English teacher I work with is in his forties and has three children which I assume were conceived without much effort and carried no issue. Because what followed was this:

English Teacher: What does it take to have children in our society?
ET: Do you have to pass a test?
Student: Yeah, a pregnancy test!
MH: Yeah, plus a clomid challenge test, an HSG, a hysteroscopy, a saline sonohistogram, an FSH and AmH draw, a laparoscopy, an autoimmune panel, a karyotype...etc etc etc. And I keep failing my pregnancy test.
ET: You're RIGHT! There's no TEST. There's no REQUIREMENTS. All you have to do is GET BUSY. ANYONE can have a baby! ANYONE! You don't have to do much at all.
MH: OH HOLY JEEZUM ARE YOU FUCKING KIDDING ME RIGHT NOW. NOT ANYONE, actually. (my cheeks start getting hot)
ET: Think about it--what test to people have to do to have a baby? Do you need a license? Think of all the people who have babies without thinking about it. Who don't think about the responsibility. Who can't take care of them, but did they have to APPLY? NO. In our world, all you need to do to have a baby is, what did we call it the other day? SETTLE DOWN. (Settle down is a euphemism for have sex, as in "You get married and then you settle down" -- a reference to the fabulous conversation about the Stirrings.)
MH: I think I might cry. All I can think about now is all the idiots out there who should have a license to conceive, but they don't and they can and I CAN'T. Why can't he say MOST people? I wonder how many students in here will find out they are infertile later. 1 in 8, people, 1 in 8. Oh, and I needed a psychological evaluation to do a donor egg cycle that we may not have even needed to do and we will need to fill out a short novel in paperwork if we decide on infant adoption and basically get a license through a homestudy and the more you WANT a baby and can't have one, the more HOOPS you have to go through and STILL there are no guarantees. Think about something else. Think about something else. DO NOT CRY IN FIFTH PERIOD ENGLISH. YOU ARE NOT TO CRY!

Awesome, no? That discussion went on for TEN WHOLE MINUTES and I consider myself ACCOMPLISHED because I did not walk out or cry and I tried my best to not look visibly upset. I'm pretty sure I looked visibly upset, but not enough for anyone to really notice unless they were looking hard. And they weren't, which is a good thing. Except this teacher KNOWS I am infertile. And either he didn't think about it or he forgot or this is a good spiel he's used before and he didn't want to change it for my benefit, because it was full of absolutes and I don't think it even occurred to him that it might be HIGHLY UPSETTING to me. I don't really feel like I can say anything, because I don't expect conversations to change because I'm in the room and it's upsetting to me given my situation. However, it would really be swell if the words MOST PEOPLE were in there, because there are a lot of infertile people who do not just have sex and get a baby, POOF. I am not alone. I'm sure there are students whose parents struggled or who have siblings many years apart or are adopted or have adopted siblings. I can't be the only one who would feel upset about the assumption that SEX=BABY, easy. And it's not like I want to tell a bunch of adolescents that some of them could have sex and it wouldn't result in a baby, I feel very much cheated by my own middle-and-high-school health classes that told me that sex and even heavy petting could result in a pregnancy and there was NO MENTION that I could carefully avoid sex and then protect the sex for years and years and it wouldn't have mattered, because there would not have been a pregnancy without massive medical intervention. I'm not sure it's worth it to mention that it upset me, except that other conversations like this are sure to happen again and maybe I need to be able to have the out to leave the room. I'M NOT EVEN ON MEDS YET. Thank goodness we'll be onto something else by the time my hormones are a mess and it's not just the PTSD of my experiences so far that send me into tears in English.

Being a teacher is hard, but rewarding. Being a teacher with infertility is a mine field. You just never know when one is going to blow, destroying your carefully constructed facade of normalcy from 7:15-4:30.

Saturday, January 11, 2014

We Are Hard To Classify

Life is strange. This journey is stranger. We keep thinking that we've figured out our bugaboo, that we finally have the answer to our issue with conceiving, and then things get turned around. Let's start with the IVF part of our journey, which is the last 3 years or so.

IVF is determined to be the best option for us as we have significant male factor in terms of counts, motility, morphology, etc. and I have proven to be less than stellar at IUI-appropriate follicle production. Our first two IVF cycles focus on my PCOS since we are doing ICSI and we have apparently compensated for the sperm issues thusly. Our first two IVF cycles are horrible failures, with low mature egg retrieval rates, low fertilization rates, and poor embryo development. No frozens.

We switch things up and move to a different doctor in the clinic. He takes the approach that maybe PCOS isn't so much the issue as egg quality. Changes the protocol to reflect this, and our mature egg retrieval rates improve significantly, fertilization rates are still low but we have more to work with, and we have frozens for the first time. ICSI continues to be the fix for the sperm, and we have our first pregnancy (ectopic freakshow, surgery, lost tube) and then a frozen, fresh, and frozen later our first uterine pregnancy (results in miscarriage). At this point 16 embryos have come and gone and we need to take a long hard look at where we are.

We switch back to our first doctor when our doctor leaves the practice for another one in a different area of the state. We decide we will do donor eggs, because obviously we have an embryo issue with 14 embryos not implanting at all and an early miscarriage, and not the best embryo development. Must be chromosomal abnormalities. We prepare for a year for a donor cycle and are devastated when it does not work. 30 eggs retrieved, 21 fertilized, 6 frozen at the 2PN stage (Day One), the remaining 15 left to culture, only 4 make it to blastocysts and 2 are frozen. Disappointing and disconcerting, but no one seems to think this is a big fat red flag. (By the way, the donor was a massively proven one, with a large number of first-cycle successes with EVERYONE ELSE. Which makes me feel just STELLAR.)

Try a new protocol for the DE FET, add Medrol and extra PIO, decide to do single embryo transfer. Find out days before thaw that this is not possible as the two blasts were frozen together. Blasts thaw, one is great quality and the other is deemed, "You can choose not to transfer that one." We transfer both because who knows, but get a negative anyway. Twice a day PIO shots after 7 previous cycles of PIO shots results in a weird nerve damage issue that plagues me still today (that was September). We are beyond frustrated.

Seek second opinions. All second opinions so far point to the failed Donor Egg cycles as evidence that the chromosomal abnormality is likely not having anything to do with the eggs. Which leaves us with the sperm. Which leaves us contemplating Donor Sperm as an option.

So now, four years into our journey with three years of IVF under our belt, different protocols and different genetic materials, we find ourselves pursuing an IVF cycle with MY EGGS again and DONOR SPERM. WHAAA? Beyond strange. We have spent time mourning my genetic contribution, soothing ourselves with the research in epigenetics. I have done a LOT of rationalizing about why it's not a terrible thing to not use my eggs. And now... we are back to my eggs. It is a lot to process. But, not nearly as much as it is to process the loss of B's sperm. There IS NO epigenetics with sperm. Biologically, that cupful is the only contribution. I should say genetically, as biologically I think can encompass the nurture aspect. The father-sticking-around aspect. The reason we're not like other mammals where the male takes off after the perfunctory penetration and the lady mammals are left to do all the raising themselves, if they even stick around too long after the cubs/pups/kittens/whatever are born. But it is a huge loss, and not one that we take lightly. We are sad. It is a lot to take in. And to add to it the weirdness of thinking I would never stim again to facing the daily shot monster and the sore ovaries and the egg retrieval (yay anesthesia I guess) and the hard toll on my body, and we are dealing with a lot right now. I am not complaining, because I know that I am getting my eggs back and that is something not a lot of people experience. Plus it seems somehow rude to talk about my difficulty wrapping my brain around the return of my genetic material when my husband is losing his outright.

It makes trying to classify this blog a little awkward, too. I used to be an IVF blog. Then I was a donor egg IVF blog. Now I'm a donor sperm blog with a history of donor egg, still IVF. It is more than a little strange (although the least of our worries). I have found it a little difficult to find other donor sperm blogs out there, particularly people who are not yet successful to commiserate with. Or to assuage B with, as he is feeling pretty low on this whole subject (but not low enough not to look under this rock and see if this is our root cause of no babies). I used to post this blog on Facebook, which had its pluses and minuses, but that ship has sailed. If I want to write about my infertility, OUR infertility (as I too often forget to include), I have to keep it semi-anonymous because of this sperm donor piece. I completely respect this wish, as I know how hard it is to grapple with the loss of genetic material. But I don't know what it's like to do that WITHOUT the epigenetics piece. And while I know what it's like to go through the emotions of loss and feelings of failure and questions of worth and worries of bonding, I now have turned around and received all that back. So while I can say "I know how this feels" to some extent, really, I don't. It's different for guys. I think it's harder both because of the contribution thing and because of how, typically, guys process things (or don't). It's tricky business.

Consider this my foray into now chronicling our Donor Sperm IVF journey... a completely new leg of what I never ever thought would be this complicated. EVER. I will share the feelings, I will share the realities, I will share the worries. I will share the process, because it is a little daunting. And not a little bit different from our Donor Egg process. Selecting a male donor versus a female donor is worlds apart, at least for us. I will share my new approach to using my eggs and what it's like to stim after you thought all that was behind you. I will do my best to be sensitive to B's needs for privacy while processing this the best way I know how, by writing. If you are a Facebook person who found this, I ask you to be just as sensitive. We are in new and tenuous waters that we haven't figured out how to tread yet. We have added another layer of complexity and strangeness to our already pretty strange and complex path so far.

Thank you for your continued support, thank you for your information, thank you for your patience as we figure this new thing out.

Thursday, January 2, 2014

How Do You Say Goodbye? Looking for Advice

I am facing a bit of an awkward situation, and I need your help figuring out the best way to go forward. You see, my husband and I have been with the same clinic for four years and change, and we have done 7 IUI attempts and 8 transfers (4 fresh and 2 frozen my eggs, 1 fresh and 1 frozen donor eggs) with the same clinic. I cringe a little bit when I say that, because it goes against so much good sense with managing your medical care, but we did change things up a lot and we did actually have two different doctors with the same clinic.

However, it is time to move on, and I'm not sure how to do this. In the time we've been with our clinic, they have grown to feel like our friends--everyone has been super invested in helping us to create our family. We have received personal calls from nurses offering condolences when things didn't work out. We have exchanged bottles of wine in appreciation. We send crazy Christmas cards with cats on them and beg to have a baby on the next card (oh well). When we walk into the clinic, we are met with "Heyyyyy! It's Jess and Bryce!" and it feels so warm and caring. However. I cannot continue to make medical decisions based on how nice people are. I cannot continue to go a path where there are more "No we don't do that"s and when the answer is "yes we will try your crazy idea" then I am the one who brings it all to the table and I am the one who catches protocol errors and I am the one who feels like I am managing my care and I am decidedly NOT an RE. I need a little innovation. Scratch that. I need A LOT of innovation. The way it always works for everyone else is definitely NOT the way it works for us. 

We almost went for a second opinion before the donor egg cycle. It was scheduled and on the books, but then I had to fill out all new paperwork and that was very overwhelming and then we made the decision to pursue donor egg definitively and I liked my clinic's program a lot more than the other clinic's program. I really wish we had consulted with somewhere like CCRM at that point, because we could have afforded it at that space in time. Now, having finally taken the leap and done a few consults elsewhere and having been a little more than a little stunned at some of the revelations thrown out there, that hindsight is kicking me in the butt. WHY didn't we move on earlier? Now, although I have heard such wonderful things about CCRM and I do believe that they are miracle workers, we just can't afford it and have adoption still on the table. And adoption needs to be on our table, because while maybe it will just take someone else with a different approach to solve our medical pieces, it feels like we are just made to be on the other side of the statistics. I would agree with the "You have to think positive!" people and say that isn't constructive to think that way, but it's just true. It doesn't mean it has to continue to be true, but for self-preservation, I have to go with the assumption that while the miracle COULD happen, it just as easily COULD NOT. If we thought it truly was not possible we would not be going into this final round of medical treatment. But we would be fools not to realize that it's a very good thing we have been opening our hearts to domestic infant adoption, as scary as that has seemed to us. And, since according to our last calculations domestic infant adoption will cost in the ballpark of $33,000 for us, and even if we take into account the supposedly $13,000 Adoption Tax Credit (that, while it was made permanent as part of the Fiscal Cliff legislation, was not made permanent in the way it was originally conceived when we go to pursue this option of creating our family -- please go to RESOLVE to learn more and continue supporting this bill!!!), it will mean a bill of at least $20,000. Which in itself is a lot to swallow but especially when you've spent so much on medical treatment that seemed promising but left you empty-handed. So, unfortunately, we cannot justify spending that much money and more on going to CCRM and traveling to Colorado multiple times in the hopes that we do not have to spend the money on adoption because our family will come to us from medical treatment. Even CCRM isn't 100%. 

We do have other options locally and have been working with a doctor that we knew previously who is with another clinic that has an amazing embryology lab. And who is open to a lot of newer things without needing convincing. And who has brought a lot of ideas and research to the table already and we haven't officially even started on as patients. Pretty impressive. We have another second opinion, our last, at a clinic nearby in about a week and a half. And while our clinic offered that if we worked with CCRM or another clinic we'd have to travel to that they would be happy to implement whatever they recommended, or do our monitoring locally, I just don't think I can do it. 

I just don't think that I want to continue on at a place that I've been to so frequently for so long with nothing to show for it but a drawer full of pictures of embryos long gone, surgical pictures of a tube swollen with a freak ectopic pregnancy from an IVF cycle, and my one and only ultrasound picture of a sac in my uterus. I can't do it. I feel almost like I have PTSD going to that clinic. I hyperventilate. And, as I wrote earlier in November, I had a massive meltdown in their office the last time I was there for something remotely treatment-related. I want this "last hurrah" to be free from all of the past losses and frustrations that are enclosed in those walls. I want this last try to be truly new in as many ways as possible. And I feel horribly guilty about it. 

But that guilt and sense of loyalty has, in a sense, held us back. Maybe. I mean, we would have had NO ISSUE seeking a second opinion earlier if we didn't just so badly want our current clinic to seal the deal. And we knew they wanted to. There have been many tears and touching moments in the transfer room. But all that aside, it's just not the best idea to stay with the same clinic for 8 cycles. Other places have fresh eyes on things. Other places have different lab procedures and different drug procedures and different tests they are more willing to do and do with more frequency. And it's time to move on. 

So, how to do that? I don't want to just slink off into the ether. I don't want to disappear after 4 years and 3 months. If I was loyal enough to stay despite limited success, it would be pretty crappy to just POOF disappear. But, at the same time, do I want to do a consult in person to say goodbye? That might prove to be pretty freaking awkward. And I don't want to feel like I have to defend my stance. I don't want to feel pressured to give it ONE MORE SHOT. Especially since in all of our second opinions so far the consensus has NOT been that we need to continue with donor eggs and that we have "age related egg quality issues." How can that be when my FSH and AMH are stellar? No, everyone else has said, "it looks like the sperm could be your issue." I felt a little like my clinic was doing a lot of lady-finger-pointing without looking at HALF the genetic material. So I do feel some frustration, but at the same time I want to be able to say goodbye and have some closure and, in some way, let them know that when (if) we are successful medically, that they will have definitely played a role in that. We wouldn't have the data to say that we are dealing with a sperm issue if we hadn't done the egg donor cycle to see that our blast development was pretty darn poor, and that occurred before the embryos even had anything to do with me. It's not a blame thing, my body/his body, but it is interesting how many times it's just assumed to be a female issue and that ICSI can overcome anything. Grrr.

So what would you do? Write a letter? Steel yourself and set up a last consult? Send an email? Make a phone call? Or fade away into the ether? 

It's awkward no matter what, but I just can't let it go completely when there's such a history. I so wish we were leaving because we were being released to our OB/GYN. That's how I dreamed it. That's what I'd hoped for. But it didn't happen, and I truly feel that it won't happen unless we let this chapter end and start up elsewhere. It seems like everything in this process is a letting go. 

Thanks for your help--I appreciate it!