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!

Tuesday, December 31, 2013

Another Year Comes and Goes

How on earth can it be New Year's Eve? How can I be staring down 2014, another year gone and another year scampering out of the gate? I feel like each year I write a tribute to the year, a tribute to the suckiness and a few things to be happy about. Usually it says something like, "2011, You Were a Stinker" or whatnot. Given that every year does not improve much in the family building department, I think I'll give that a rest this year. There's plenty of good stuff that happened in 2013, but, yet again, NO FREAKING BABY. No baby in my belly, no baby in my Little Room, nada. Two efforts to make said baby appear and...nothing.

It's strangely appropriate that I had my annual exam at the gynecologist today. End the year with the appointment I dread and hope that next year brings a different experience in that office. I still do not understand why you cannot just get your PAP smear in the RE's office. Why, when there is so much detailed exploration of my lady bits in that office, why can't they just swipe the cervy? Why must I go into the office that is filled with the experience I desperately want and cannot as of yet have to have that one little swipe? Argh. I did switch practices last year, because a) my old gynecologist was not exactly sensitive about the infertility and b) her office was a godawful cesspool of administrative hell (you had to come 20 minutes before your appointment or you would be "rescheduled" -- I came from school one day and was 5 minutes before my appointment and was made to wait AN ENTIRE HOUR to be "fit in," while hugely pregnant women and fresh babies surrounded me in the waiting room). The new practice is very Zen, with nary a harried office tech to be seen and, so far, very few hugely pregnant women. Plus there's a private waiting area, where I think you can hide if there are hugely pregnant women lurking about. Today the office staff were lovely but the nurse was perhaps cranky due to working on New Year's Eve. Or maybe she just didn't like me for some reason, as through the door I could hear her being perfectly pleasant to everyone else. She took my height and weight, and I could see the weight (ugh) but not the height. Until she input everything in and I saw it said 67.5 inches. WHAT THE WHAT? I am just shy of five foot six. I don't know how you gain an extra inch or two other than the speediest height stick maneuvering ever, but since it made my BMI a little more palatable I didn't say anything. Once I was at the doctor's a year or two ago and they put my weight in at 121 pounds. I just couldn't let them do it, because it was about 50 pounds off. I mean, for this year it's great (although I was a little concerned no one was like WHOAH NELLY, THIS LADY LOST A CRAPLOAD OF WEIGHT! and was concerned about, you know, cancer or something...), but the next time I go in I sure as hell am not going to weigh any 121 pounds. So I had them change it. This time vanity won out, because being 5 foot 7 1/2 sure helped my BMI, and no one will believe I have shrunk down next year. They will realize they just don't know how to wield the measuring stick thing and not suspect sudden onset osteoporosis. So anyway, I get ushered into my room and am told to put on the "gown," front open. Except the "gown" is more like a vest. How do you get off calling something a gown that doesn't come close to even grazing your ass? There was a paper blanket that was more like a doily, because that left my butt pretty open air as well. Oh well. The annual exam itself was perfunctory and not a big deal. It was what happened while I waited that was tough. I could hear the people in the room to my right. I could hear that they were being congratulated on being so pregnant, almost there (thank GOD according to the disembodied voice of the pregnant lady). AND THEN I HEARD A HEARTBEAT. That swishy sound I know from TV and movies and not my own experience, because I never get to hear one of those. Amplified and beautiful, and punctuated by laughter and the statement, "I never grow tired of hearing that!" Which made me feel a little better, because at least she appreciated the miracle that was happening. For her. While I sat mostly naked and barely covered in paper and struck by the thought that it's possible I may never hear that sound myself. Just through the walls of my gynecologists' office while I wait to get a PAP smear because fertility clinics don't do them. Sigh.

So here we are, one more New Year's Eve, one more year behind us and one more year ahead of us. I feel like I'm on a loop, saying, "I hope 201- is OUR YEAR!" 2010, 2011, 2012, 2013... and now 2014. So instead of feeling too terribly sorry for myself today, I mustered up excitement. Because while 2014 does not have a chance of being The Year of the Baby, it could be The Year of the Gestation or The Year We Do Our Homestudy. It's a year of possibility. (Just in case you're wondering why it's not the Year of the Baby, we can't do our last cycle until spring, because I need the chance to do Egg Boot Camp. More on that later.) I feel a bit at peace. If things work out medically with our new plan, then great! If things don't, hello and welcome world of adoption. I don't feel like I have a dead end in front of me. I feel like I have a world of possibility and our baby will be coming to us, I'm just not sure how.

In closing, I will share with you my rituals for New Year's Eve. Because I have rituals for everything, including fertility crap, you'd better believe I don't leave the crazy at the door on New Year's. Therefore, I spent the day deep cleaning. Mopping. Dusting. Vacuuming a second time. Taking out all the garbage after vacuuming. Get all the dirt of 2013 out of the house, chase out all that bad dirt. Welcome the new year with a fresh, clean house. Then, a bowl of oranges on the table. 14 oranges for 2014 (not sure if that means anything but I thought I'd respect the new year number). We will be opening the front door for 2014 and then running to let the old year out the back door. We will bang pots and pans with wooden spoons to scare away any evil spirits trying to get in on the goodness of the new year. And of course toast with champagne and cocktails, since I'm not in Egg Boot Camp yet. We are having neighbors over for cheese and deviled eggs (ha, lots of eggs) and butternut squash bisque and those cocktails. It will be a lovely way to end another fruitless year. A lovely way to usher in a new year and a new chance for family happiness.

Welcome, 2014. We welcome all good things that you may bring.

Happy New Year, folks! May 2014 be a fabulous year.

Sunday, December 15, 2013

(Mostly) Fertility-Free Holidays (or, my attempts at surviving yet another holiday while infertile...)

Ah, Christmas. The most wonderful time of the year. No really, I am not entirely sarcastic here--I love Christmastime. I love decorating for Christmas, I love Christmas music, I love shopping for fun surprises for my loved ones. But holy cannoli, Christmas is a rough time for people struggling with infertility.

I have written about this before, but it doesn't make it any less true. Christmas, while a wonderful time of cheer and love and togetherness, is also a time of feeling alone and left out and incredibly sad.

Why?

So much of Christmas is about children. The joy of children writing to Santa, the joy of children picking out their Christmas tree, the joy of children decorating wonky cookies. There are so many facebook posts about how amazing Christmas is when you see it through your child's eyes. There are songs about childlike wonder. There are songs about an amazing baby (yes, I realize the whole holiday is actually about celebrating an amazing miracle baby). Facebook is a veritable visual bombing of babies in their cute outfits, staring at the tree, decorating the tree, dressed up like a tree. Don't get me wrong--I don't have a problem with this. It just makes a body feel really left out when this is not what's happening in your house. And I know you don't have to have kids to enjoy Christmas, that's just silly. But imagine if all that joy and happiness and laughter and magic was something you desperately wanted and you could not at this point in time have it, and every Christmas reminded you that time keeps marching on and your house is exactly the same.

Well, not exactly the same.

Last year we shook things up a bit. We ditched everyone and took off to Vermont for Christmas. We felt naughty. We felt a tad selfish. And then we got there and experienced a Christmas where there's no tree with no toys for good little girls and boys beneath it, and no sense of old traditions that are empty. Just new traditions that are being forged. Christmas away is actually a lovely thing, once you get used to not having a Christmas tree of your own to come down the stairs to. It helps us to have a romantic couple vacation, to celebrate the season with our love for each other, and to not surround ourselves with our empty, silent house. (Bryce is probably snickering somewhere at the thought that our house is "empty" since he is continually on a decluttering mission, but it's devoid of the joyful chaos of babies and children. Totally full of stuff despite his best efforts to make it look like a sparse Scandinavian house.) We make memories together that don't make us sad, and save the traditions for when we can share them with little people of our own, however they end up coming to us.

And they won't be coming to us quite yet, because...

We do not do fertility treatments over the holidays. We have done that before, and it is a horrible disaster. I'm sure for some people it could mean a personal Christmas miracle, but for us it just compounded heartache and increased stress and made the holidays unenjoyable.  Even now, as our "last hurrah" is upon us, and time is ticking away, this holiday time is sacred. No treatments. No testing. It is worth waiting a month more. It is worth missing a few months of opportunity to keep that sanity and good cheer intact.

Good cheer is often spread through the annual Holiday Card. We have done a photo card every single year since we were married. I love those things. But the past few cards have been upsetting, because they are babyless. Bumpless, even. Every year chronicles a year of fun together, but still no wee one. Going along with the whole Bryce-loves-to-declutter thing, I would love to have shared pictures of each card with you in this post, but unfortunately they were misplaced. In an effort to declutter. A closet. Yup, the cards were in a little shutterfly box in a closet but they needed to be put away even further. Can you sense my frustration? So, you will just have to imagine the cards as I describe them:

Year One, 2009: Fun wedding photos. Celebratory card. All is good with the world.
Year Two, 2010: Pictures of Maine vacation. Fun photos, a little bitterness over no baby to be seen, but not unreasonable after one year, so we add the dog and cats to the card.
Year Three, 2011: Frustration mounting. No Maine vacation this year due to infertility, hearts broken by ectopic debacle, and so we stage a "glamour shot" attempt with the digital camera and the kindness of strangers. I realize there is quite a bit of boob on the card, but don't care because there's still no baby.
Year Four, 2012: Frustration is palpable. WHY IS THERE NO BABY ON THIS EFFING CARD??? Reeling from miscarriage this year and realization that genetic material is now up for grabs. Cheeky mistletoe shot in 1950s dress and Bryce in 50s-ish collared shirt and sweater. Cats in bowties, not just named but featured. Copy of card sent to fertility clinic with actual message, "I AM NOT RESPONSIBLE FOR WHAT HAPPENS IF THERE'S NO BABY ON THIS CARD NEXT YEAR. PLEASE PUT A BABY ON THIS CARD!!!"
Year Five, 2013: I did not want to send a Christmas card this year. I had decided last year was the LAST YEAR for a babyless card at Christmas. I had all kinds of insane ideas (including pictures of embryos around the card, Merry Christmas spelled out in needles, etc.) but none I'd actually do in earnest. So I decided we'd do a New Year's card. A card about hope for the next year, not the disappointment of what didn't happen this past year. Not that there's not a lot to be grateful for and happy about this past year, but it was another year where the summer Maine vacation did not happen (and was actually cancelled last minute thanks to the donor cycle timing that we could not control whatsoever), another year where despite our best efforts we did not expand our family, another year of heartache and stagnancy and watching the cards roll in with SCHOOL AGE children on them, not babies anymore. (NOTE: I do want your Christmas cards! Keep 'em coming! Time marches on for you, and not for me, which makes me sad, but shared photos of your families and pets do not make me sad.)

And so... New Year's Card. Like the Vermont trip, it is a departure from the normal tradition to preserve that for our futurefamily, and a creation of a new tradition to soothe our ravaged souls. I was originally going to send it out after Christmas, but guilt over all the cards coming in and obsessive-compulsiveness won out. I put the card together this weekend. A message of Cheer All Year! With 10 photos from this past year around it. I did not include the cats (mostly because they refuse to be photographed together and they typically are only photographed when doing weird things), but did sign their names. It is a card of remembering the good stuff that happened this past year. And on the back we wish for a fabulous 2014 to come. Where dreams come true. And the photo is my "Never Never Never Give Up" magnet. Because I cannot let this card go without in some way intimating the truth--it is highly upsetting that there are no babies on this card in any way shape or form. It is not by choice. We have traveled the path that was supposed to treat our medical disease of infertility, and it took us on a bit of a wonky side tour. This year we are pursuing one more medical treatment, one last hurrah, before we put the medical side of things to bed and pursue adoption. The NEVER GIVE UP means that we don't give up on being parents. We will make this happen, somehow. It may not be medical. We may need to let go of some dreams to achieve the ultimate dream. It is not easy. None of this has been easy. But you can only travel your own path, and go where your hearts take you. And so we nod to infertility on our New Year's card.

We started a new tradition this year. Our neighborhood sponsors families in need each year, and each year in the hustle and bustle of things we forget and miss the deadline and feel like horrible people. I mean, I always donate books to the Ronald McDonald House at Barnes&Noble, and I put dollars in the red kettle, and I contribute to other things, but we have never actively shopped for a child in need. This year, we participated. We bought things for two little girls. You would think it would be sad to go shopping for children that aren't ours, and for a brief moment where I held adorable baby dresses in my hands it was, but it was an incredible joy to shop for these children. I mean, I shop for children every year because of friends who have kids. But in this case, we were shopping for children we didn't really know, and it was to give them a fabulous Christmas in tough times. We could take our good fortune and spread it about and give joy and imagine (as it would be creepy to track down the families and peer in their windows on Christmas morning) the sheer happiness that these girls will have when they open their presents straight from their wish lists. We got to play Santa, and it was immensely fun.

There you have it. Let old traditions go for a while so that we can forge new ones and save our sanity in these difficult times. Save magic for the future. Preserve as much as we can so that we can be the best parents to our FutureBaby(ies). Feed our love and keep the demons of doubt and despair at bay. Try not to throw things when commercials and/or facebook posts tout that you don't know what Christmas is until you've experienced it through the eyes of your child or you've had a baby or whatever. Enjoy celebrating with friends and family before and after the holiday, and over the phone or skype or facetime. Honor our families but stoke the fire of our little family of two. Get away from it all and try to have as fertility-free a holiday as we can when infertility has infiltrated the very essence of who we are. Somehow though, when you are away for the holiday and the stress of the house and responsibility and all that is gone...you can almost pretend that all is right with the world. Because in that moment, that beautiful, romantic, peaceful moment away from it all, it truly is.

Happy holidays to you and yours. May 2014 be the year that dreams come true and hearts are healed.

Saturday, November 30, 2013

So Much to be Thankful For (except that one incredibly important thing...)

Thanksgiving is over, and now I can officially begin the Christmas Music Onslaught that Bryce enjoys so much. I even gave him a present--I did not begin until today, a full day later than I am technically "legally" allowed to fa-la-la-la-la. Probably because yesterday was Family Thanksgiving, and it was very confusing to my Christmas circadian clock to eat turkey and ham and yams and pumpkin pie and listen to Christmas music at the same time.

We were supposed to go to Maine this year for Thanksgiving with Bryce's mom and stepfather, but that stupid storm-naming thing scared us off. Between the snow here (mostly Tuesday night) and the torrential rain there (two storms collide!), we all decided it would be better to visit in February, when we can stay longer than 2 full days and not have to wrassle with evil holiday traffic on a very, very long drive. I felt badly, but we used FaceTime to connect face to face and while it wasn't quite the same, it was nice.

Yesterday was Thanksgiving with my mom and stepfather and my sister, her husband, and her stepsons. It was lovely. We had crackers (normally a Christmas thing but my Mom found Thanksgiving ones and it was actually quite fun:
Here we are being all dramatic in our paper crowns...
Please excuse the upward camera angle and how unflattering it is! 
On Thanksgiving proper, Bryce and I had an incredibly low-key day. Just the two of us for most of the day, in sweatpants for the duration. We made the Thanksgiving Cow--a delicious red-wine-based French country beef stew that takes most of the day to cook. So yummy over mashed potatoes. We had wine. We had relaxation. We had the neighbors over for champagne and pie later in the evening. And then we ended the night sitting in our TV room, listening to music through Bryce's speakers that he built himself (and are incredibly impressive if I do say so myself--both in design with their beautiful walnut tops and sides and the acoustic science that went into the sound). We sat on the couch and listened to cd after cd, picking out individual instruments now audible thanks to Bryce's audio wizardry. And all of a sudden I started to cry.

All I could think was, "I have so, so much to be thankful for. We have this wonderful life--we have each other, we have good food and good wine pretty much all the time, we have good friends and good family, we have a cozy home with comforts galore, we can have a great time just sitting here and enjoying music on speakers that Bryce made himself and be content. IF NOT FOR THIS GINORMOUS BABY-SHAPED HOLE IN OUR LIVES, we could be truly content."

The tears rolled down my face and I couldn't put this sentiment into words, so all of a sudden Bryce was worried that he had said something or NOT said something that had put me in a bit of a funk. He told me I looked sad all day. In actuality, I was pretty happy all day, but it is really, really hard to try to shove that one missing thing to the background and enjoy a holiday that is supposed to be all about family (and food and wine). I did not realize that Thanksgiving is such a baby-centered holiday--that going on Facebook would result in an onslaught of babies in turkey outfits and "Baby's First Thanksgiving" captions and onesies and homemade memes. It also reminds me of the Christmas card situation, which I am working on but still puts little needles in my soul for not having a baby or even a babyling anywhere near it. AGAIN.

I am thankful for so much, but this gaping nothingness where OUR family ought to be is like a black hole that sucks light and joy right into it. I can hang on with my fingernails and try not to get sucked in, but man the holidays are hard. I am grateful for my extended family, I am grateful for my wonderful husband, I am grateful for our home, I am grateful for our jobs, I am grateful for our health...the list goes on and on. I am grateful that my father had a physical last Friday and he was able to catch the severe anemia that put him in the hospital for days with multiple blood transfusions and no answers for why this is happening to him. Anemia is what got his Celiac diagnosed, but now he's been gluten free for years and years, so why? Why was it so severe that he was told had it not been caught when it was he would have likely dropped of a cardiac arrest or a stroke? So scary. So frustrating that despite all of the wonders of medical technology there seems to be an awful lot that doctor's can't figure out. I am grateful that my dad is ok. I am scared that that may not always be the case. And, like a horrible, selfish person, anytime someone in my family falls ill I mourn the fact that there is a real possibility that they may not see me become a mom. Somewhat melodramatic when it comes to my dad, but then again, not really. There are no guarantees in life. It's so frustrating.

We are in this strange limbo, where we know we are going to do ONE LAST TRY. We know that we are giving medical treatment a last go of it, and I am going to try to not be nauseous about giving myself injections again, as we are likely going back to my eggs. Which I hope is not a mistake. I am going to try not to dread turning my kitchen counter into a nurse's station, with sharps containers and many different size needles and medications. I am going to be grateful that I am pretty much never doing PIO again. My hips and thighs are STILL numb, and at times downright painful with stabby-ness that comes and goes. Maybe that's a good sign? Maybe that means feeling is returning? All I can say is it makes exercising mighty challenging. Any jolt to my legs ranges from very uncomfortable to painful. My husband can playfully smack my ass in the kitchen and have it result in tears from the pain jolting down my leg. Fun times. We have one more second opinion to go, and are waiting on a report from our second second opinion. We have hope, which seems more and more to be less of a friend and more of a friendly neighborhood crack dealer, but whatever.

We are not trying anything until after January. Which means that this is a fertility-free holiday--as much as I can keep that swirling black hole of babylessness at bay. We are free to eat and drink whatever, because we will not be doing a cycle any earlier than March. Because I need three months to get my ovaries in shape, since they've been out of the equation for so long. After the holidays, that means a whole lot of deprivation for me. A whole lot of acupuncture appointments. Three months of this monklike existence to hopefully end in the joy we seek. I am grateful that we have this opportunity. I am grateful that we can give this one last try. I will try not to read too much into it. I will just do everything possible to stack our deck, and try so hard not to lose my marbles in the process. I will try next year to be the recipient of a group post on FaceBook for ladies from yoga past, one mentioning "Don't Stop Believing," and NOT be the only one on that list who is not finally a mommy. It was meant well, but realizing that everyone on that list had been successful EXCEPT me was incredibly painful. Again, I feel like the Little Match Girl, with my frozen nose pressed against the frosted glass, peering in on a warm family life while slowly freezing to death. Conversely, I felt very lucky twice in the past week and a half to have my friends who, unfortunately, are pressing up on that cold glass with me. One who sent me a beautiful flower arrangement for "being in her brain" through my blog posts (something that made me feel good that I could accurately depict this hideous space of being, and also sad that my heartbreak and hope and souring relationship with fertility treatments echoed so closely for her). One who I had a 3+ hour coffee date with to talk and sufficiently horrify any other patrons at the coffee shop who weren't prepared to eavesdrop on a conversation regarding uteruses and sex after infertility and fear of failure and how identity is so mixed up in this process and blood clotting disorders and sperm. Sorry, patrons of Starry Nights Cafe. It was worth it to share that space with my friend, despite what a sad and hopeful and furious space it is. In a weird way it is very comforting to have people who still share this space with me. (God I feel guilty putting that out there!) We are a tattered band of Match Girls. Instead of dying with a spent match in hand, we will ninja kick our way through that glass one day. Much better end to the fairy tale.

There it is, all my Thanksgiving thoughts for this year. I am thankful for so much, and yet still yearning for so much that shouldn't be so hard to grasp onto. I am grateful for my marriage and my home and my family. I yearn for the family that we create, in whatever way that ends up being.  I honestly have no idea but am exceedingly grateful for the options and opportunities out there. I am thankful for the capacity to still find space in my heart for thankfulness and gratitude, when at times it feels like, at this point in loss and pain and disappointment, my heart should be withered and atrophied. But nope, still have space for love and gratitude in there. Still have space for hope. Still have space for that special, tardy little soul who is meant to be placed in our keeping. We're ready, we're waiting, we've left a whole lot of love set aside just for you, FutureBaby.

Our Thanksgiving picture, hazed out from searing beef cubes and
Bryce looking puffy-eyed from the sliced shallots.
Come on, FutureBaby. You know you want in on this wonderful life! 

Saturday, November 23, 2013

Thankful November--Choice

In years past, I did not so much participate in Thankful November. For those who don't already know, this is a thing where you post (on FaceBook) something you are thankful for every day in November. I am still in my love/hate relationship with FaceBook, and I thought this year would be a good one to consciously try to publicly acknowledge the things I am thankful for each and every day. You don't need FaceBook for this, really--you could just meditate a bit on what you are thankful for every day, but it's kind of nice to add something meaningful to the countless memes, selfies, blow-by-blows of household chores, and baby photos. Oh, so many baby photos. Sometimes my thankfulness posts have been on the facetious side (I am thankful for Uncle Woody's caramel popcorn... mmmm that is good stuff), frequently food-related. Sometimes mine have been love letters to my husband, because he deserves them. And sometimes they have been infertility related. I am thankful for hope. I am thankful for support. I am thankful for nonjudgmentalness. (Not a word, but whatever.) I am thankful for friends. I am thankful for family.

Several days ago, I started to type in, "I am thankful for choices." I was going to say, "I am thankful for choices. They may not always be easy, but I am thankful that they exist." And then...I could not do it.

Am I thankful for choices?

In one way, HELL YES. I am forever grateful for the medical technology that exists that makes it possible for me to still be batting around the idea of motherhood via pregnancy. Decades ago, I would have had to decide between living child-free and adoption long ago. I would not have had a way to treat my medical condition. I would not have reason for the hope I have that maybe I could be pregnant and birth our child.

On the other hand, having these choices has turned into a bit of a double-edged sword. Because there is so much medical technology out there, the carrot continues to dangle. The promise of one more cycle leading to "our miracle" is out there, gleaming on the horizon. Or glinting. Perhaps with a bit of a taunt in that eyeshine. I find it incredibly difficult to move on when this possibility exists. I am not stupid, but I am stubborn. To have the consult with CCRM and the first of our two semi-local consults result in the feeling that another cycle with different components (be they medications or gametes) could be our ticket to success was both encouraging and...not. Because in a weird way, I think we were almost hoping that we would be told "forget it, this will not happen for you." But we weren't. We were told, "perhaps you have been barking up the wrong tree. Perhaps a bit more tweaking will end this godawful losing streak." With percentages that still aren't 100%, but are high enough to give me pause. How can I let that go? How can I not give that a shot? A "last hurrah" if you will?

Am I willing to put myself through this punishing promise for the hope that I will finally have my miracle? I have enough choices that it is possible for me to believe this is the case. We have options. We have tests that haven't been done yet, and treatment options we haven't tried yet. It's not out of the realm of possibility. We could end on a high note and go home with our precious baby that I baked myself. How many times do we hear the miracle stories of women who tried and tried and tried and right when they were ready to move on (usually phrased as "give up"), they got pregnant. I've heard this story. I've seen it firsthand from actual people, not internet myths or friends-of-friends-of-friends. But does that mean it will be me? How many times have I thought this is my time? I'll tell you. 8 times. The last 4 were among the "We have suffered enough. This is our time, it has to be." Nope, it does not have to be anything. It is possible to suffer. And suffer. And suffer.

I have another choice. I can choose to end this right now, to leave the stone unturned, and to pick another path. A path that has its own uncertainties, but a new path to learn about and research and journey down, one that WILL result in a baby. So why can't I pick it right now?

Because I have too many choices.

Because I need to throw myself into this last hurrah. After realizing that there is a stone, a big fat, hulking stone, left hideously unturned, I must push it over. I must know if hope lies beneath it, and the reality of parenthood somewhat how we dreamed it years ago when we first decided to have a family together. I must do this last thing, and I do mean LAST, to know that I did everything. Writing it now it sounds so silly. I have done so, so, so much  leading up to this point. I have taken shots in the thigh and sustained nerve damage in my hips and legs. I have researched so much that when I look into a new therapy and there is a choice between "Women and Families" and "Physicians," I pick the "Physicians" side, hands down. Don't dumb it down for me. I want to know the language of power so that I can converse with doctors in their language. I have done so many things, sane and not so sane, to try to make this work. And it hasn't. But...I feel we have enough information that is new that I think we've missed something.

However--if we do all the tests and they all come back showing normal everything... that will put a chink in my well-armored reserve to hit me baby one more time. We need to have enough different that we truly feel that we are not beating a nearly-dead horse. Otherwise, that door can creak shut so that I can fling myself into the new door. Right now I feel that I have two feet, one in each door. I have these two choices and they both have their merits.

Monday we went to the adoption agency orientation. It was amazing. It was very hopeful, very positive--everything pointing to a resolution and a family within our reach. I teared up many times. I felt moved. I felt... I could DO THIS.

So why am I not? Not right now, anyway?

Because on Wednesday we had another second opinion at a clinic about an hour away. It was also very hopeful, very positive. This clinic can do many of the insanely cool things CCRM can do, and was open to many different options. And the pricing was phenomenal. We could do our last shot here without too much damage to our financial ability to afford adoption. It was another good choice.

But.

I am really struggling. This is kind of a stream of consciousness post, because I don't really know where I'm going. Sooner or later, I need to close the door on treatment and I understand that I will likely have to be the one to do it.  I just have the hardest time thinking that I can leave treatment behind when I have done all 8 of our transfers with the same clinic. We need a bit of innovation. I need to know that we didn't just go with what was cozy. Given a cancer diagnosis, you would never just go with one clinic if you weren't seeing results. You would fight for your life (given the ability). You would seek a second opinion. In hindsight, I feel like we should have committed to a second opinion earlier. But you live and learn. We are super loyal people and it is at times to our detriment. It's not too late. We can do a Hail Mary cycle elsewhere, give it our best go with different protocols and tests and technology, and see where we land. And then move on.

The question is, will it be worth it? I could decide to shut the door and get started on a homestudy process this month and be well on my way to bringing an infant home from the hospital. I could start a new journey with a new sense of hope and purpose. If only I could let go of the overwhelming desire to have us experience pregnancy and birth and maternity clothes and baby showers before the baby is here and setting up a nursery for a baby that is likely arriving on a known timetable (no guarantees though, given possibility of preterm labor and premature birth). I feel selfish saying this, like I want all the accoutrements when the important thing is the BABY, the FAMILY that we will have, and not the ruched tops and shooting merchandise with a laser gun. It's not just those material things. It's the feeling of being robbed of an experience we were supposed to have. That experience that exists all around us but may never come to fruition in the way we dreamed.

But is that so bad? To have your dream altered in its mode of arrival and gestation? To paraphrase a comment I received on my last blog, am I willing to sacrifice a year with my child in the effort to have that child in the way I dreamed it, even though that has already changed and been sacrificed in so many ways?

The choice of adoption is a very appealing one. I am very open to this option and grateful that we have such an amazing adoption agency in our area. But I know myself well enough to know that I cannot, CANNOT pursue both medical treatment and adoption at the same time. As much as it would "save time," I cannot do homestudy classes and an IVF cycle at the same time. I'm an all or nothing kind of gal, and I immerse myself utterly in what I'm pursuing. And what I'm pursuing, while flagging behind a bit, remains medical treatment for infertility. One last shot with a new team. I would not honestly be able to answer honestly that I have resolved my infertility and have committed to adoption without this "last hurrah." I think that is a good thing. I want to give the process my all. I want to be as devoted to adoption as I have been to medical treatment. I cannot split myself between the two choices equally. I just don't have it in me. It wouldn't be fair to anyone. I would always wonder. I may still wonder if we try something new and it doesn't work, but at least I will know I did all I was capable of doing. I think my FutureBaby could appreciate that--I want to honor his/her mode of arrival with all my being. And I can't do that with a foot in both worlds.

Bryce has been very supportive of my convoluted decision-making process. And I reserve the right to change my mind. I could get started on injections again and feel an overwhelming sense of WHY ARE YOU DOING THIS TO YOURSELF? A sense of WRONG. And then the choice will be clear. Or I could get into this new cycle and feel a new sense of hope with every stick and every painful, swollen follicle. I don't know. See what I mean about the choices?

I am grateful. I am grateful that these choices are there for me to make. Selfishly I wish that they weren't so that the path could be clear. But, really, when in life is the path EVER completely clear? There is so much room for regret, but that is a wasted emotion. I could already regret giving one clinic 8 cycles. But we did, and we don't regret it. It would have probably been a good idea to seek a second opinion before going DE IVF. We basically did a very expensive experiment. But there are never any guarantees. And it seemed the right decision at the time. And, actually, we learned something from it. Too bad we're not eccentric millionaires. One last shot. With another clinic. With new components (sorry frosty 2PNs, we may be putting you on the back burner first... I can't lose my endurance for needle sticks and ultrasounds with frozens that may or may not be any good based on everything so far). With the knowledge that our hearts are open to adoption once we can give it our all. It's all out of hope. And love. And respect. Respect for the tiny life that we long to be responsible for and love. Respect for not only our journey, but his or hers. I so wish it could be easier.

Saturday, November 16, 2013

Pretty Sure My Relationship With IVF Is An Abusive One

I am not really doing so well these days. My head is spinning with all the information we are sifting through, and my attempts at reining all this in with a multipoint "plan" have not really served to make me feel better. Today, while attempting to have breakfast over "The Daily Show" and instead having a nearly two-hour powwow over dippy eggs and bacon, I came to a realization. I am in an abusive relationship with infertility treatments.

Unfortunately, I know what it's like to be in an abusive relationship. Mostly emotional and verbal abuse, but with the occasional dash of physical thrown in. My first marriage was a disaster of epic proportions where there were pockets of really good stuff (I married the man after all, it couldn't have been all bad...) mixed in with a lot of "you stupid fat bitch," shoes kept by the door so I could run out at any given moment, a hollow core door that had a gaping hole in it from where I ran into my office to hide from my ranting other half and he was so pissed I locked it that he tried to kick it in, Nicole Kidman's smudged face on my living room wall from where a Glamour magazine was thrown at my head so hard that it left a transfer print on the wall behind me (lucky me he had shitty aim), and various threats to snap my neck whilst fighting. It was a pretty awful existence, not one that had me running for the abused women's shelter (I had very few bruises and no out-and-out "beatings," so I had a hard time considering it "abuse," but I think you will agree with me that it absolutely was), but one that had me occasionally debating with my damaged subconscious about the merits of divorce. I always tamped it away. I'd made my bed, yada yada yada. It could get better. To leave was scary, unknown. To stay was pretty close to scarier, but not quite. I could survive it. I didn't think it was bad enough to leave even when I left our apartment in Yonkers at 10:00 pm, hysterical and frantic, walked to the Mount Vernon West train station in a completely unobservant state and then, after taking the train up to White Plains, walked the 2 miles or so through not the best neighborhood, crying all the way, to my best friend's house. The sad thing was, after spending time sorting through the fight that I had fled from, I was upset mostly because I was afraid I was the one who would be left. Abusive relationships are horrible because of the fear and the physical and emotional pain, but also because they completely strip you of your dignity and sense of self. But they make you into one hell of an actress, capable of convincing (if not entirely) family and friends that you are ok when you are DEFINITELY NOT OK, and most of all, convincing yourself that you are ok and maybe you deserved the things that were said or hurled and everyone has their burdens to bear and some people are just fiery and any number of lame excuses that you hear coming out of your mouth as a tiny shred of your former self screams from the back of your subconscious, YOU HAVE BECOME A FREAKING LIFETIME MOVIE. THIS IS RIDICULOUS. YOU DESERVE MORE. But I didn't think I did. I needed something concrete to hold on to, that couldn't possibly be construed as me deserving what I got in any way, and that gift came as a realization of years of cheating on top of the screaming and insults and indignities and shakes and punches and hurling of objects in my general direction. Finally, something I could hold on to that definitively said, YOU MUST LEAVE THIS HORRID SITUATION. And I did, but years after I really should have. 

Why am I sharing this with you? I don't really like talking about it so much, because it seems like a completely different life. Thank god, everything is so different now in most arenas that this seems like a bad dream that happened to someone else. But occasionally it hits me just how much I went through, and how much you can convince yourself that things aren't really that bad when they absolutely are. And this morning I made the realization that my relationship with IVF is really not that different from my relationship with a person who stripped me of self-respect, insulted me daily, and made me feel like I could do nothing right or well; yet somehow I was compelled to make a nice dinner and try my hardest to make the best of a less than ideal situation. 

Friday I had my third ultrasound and blood draw as part of a ridiculous experiment with a natural cycle (monitoring only) for the purpose of seeing what my hormone levels and lining look like without meds. The answer: not much. I went in before school and knew that I would get in late but in time to teach 2nd period, but I had started bleeding again like a full period even though a normal person would be ovulating now and my estrogen really wasn't moving, which wasn't surprising since I had been spotting since my period started in late October and so this heavier bleeding was throwing me for a loop and pissing me off. I went in having decided that I was going to pull the plug on the whole thing and that no information on my levels was worth this torture since obviously I am dysfunctional (oh, I'm sorry, my REPRODUCTIVE ORGANS are dysfunctional) and obviously I need meds and we weren't going to do an IUI if I did miraculously make a follicle because we still aren't sure if my eggs are kosher or if Bryce's sperm is kosher and maybe my uterine lining is missing that protein and not implantation-friendly anyway. I was already on thin emotional ice. But then the blood draw was a bit of a disaster. My veins suck. They are tiny and reluctant and, probably, tired. My good vein was still bruised from Monday. So another vein was tried, but it was not producing anything and then I felt a stabby pain that was sharp and breathtaking, and the tears started rolling silently down my face. Another vein was tried in my forearm, one I was terrified of because I just KNEW it was going to be painful. It was. More tears. I was having a hard time keeping them back full force, and after my other arm was stabbed and it produced enough blood...I lost it. I kept thinking WHAT ARE YOU DOING? WHAT ARE YOU DOING? WHAT ARE YOU DOING? I can't take this anymore. At this moment in time, I felt such a complete and total sense of THIS IS WAY, WAY TOO MUCH FOR ME. And the tears kept coming. And then the sobs. And then I couldn't breathe and I was wracked with silent, squeaky, convulsive sobs. I was escorted to an exam room so that I could fall spectacularly apart in semi-privacy (I am pretty sure more than one patient witnessed this breakdown). A very supportive nurse practitioner stayed with me while I tried to pull my shit together. It took at least 20 minutes.

One of the things that threw me for a loop was a stupid Facebook meme. Someone had posted it the day before and it resonated with me and made me feel horribly lost and sad. It was "When one door closes another opens, but sometimes we spend so much time staring at the closed door that we do not notice the open one in front of us." I feel like IVF is not a closed door, but it's slowly creaking shut. My capacity to keep doing this is pretty freaking impaired. I am feeling like it is slowly killing me. But I don't yet have that AHA! revelation that lets me shut the door. I have to be the one to shut it. I have a partially open door in front of me, but I can't deal with two doors that are ajar. I need, NEED one to close. I need the in-person confession from the cheater and the pile of printed out emails that detail the affair. I'm too scared to make the leap myself.

It's not quite the same thing. I never sat in my old house and wondered, "What if all of a sudden my asshole husband becomes Prince Charming someday?" But I do sit here and wonder, "What if there is an answer for us, medically, and it is possible after all for me to become pregnant and birth our baby?" It's not impossible, supposedly. The question is, how many times do I need to keep my shoes by the door before I come to the conclusion that perhaps the medical route is not the best way for us to build our family?

I have invested so much into the medical path. I have overturned a lot of stones, only to come up empty, in every sense of the word. I have to be ok with the fact that I may never get the answer and the fix I so desperately seek. It's possible that next time could be THE time that gets us pregnant. There is always hope that things will get better, that we will have an answer. And then that hope is dashed, over and OVER and OVER again. For seemingly no reason.

In a way, I feel like infertility gives us just enough hope to be the flowers and nice treatment after a whopper of a fight that has left us bruised and shattered inside. I'm not quite ready to get a divorce, to shut that door myself. I am pretty freaking close, though. It is so hard to admit this, not because I think it is a failing, but because I feel failed. Robbed, really. Why should this be so hard when it is supposed to be just the way things work out? We want a family, and we want it sooner than later. It is so, so, so hard to realize that this medical business may not be the way to do that when we've been so gung-ho about it and had so much reasonable hope that this would not be the way things turned out. I don't want to prolong my childless home out of a sliver of hope that we might find the answer. If the answer means a lot more poking and prodding and blood draws like Friday's, I'm not sure I have anything left. As Bryce said this morning over our eggs that had grown a bit cold from all the heavy discussion, infertility has sucked so much away. It's all we talk about. It's all we know how to do anymore. It has become imbalanced, and we are so much more than blood draws and treatment options and possible silver bullets that turn out to be just more disappointment.

Where does this leave us? I honestly don't know. I know I don't know how much more I can take, physically or emotionally. I did manage to get back to school and go to the last 15 minutes of 2nd period and the teach the whole rest of the day. People are very understanding and it wasn't a problem, and if I had needed to go home and spend the rest of the day in bed I think I could have made that work. But I didn't want to. 8th graders are a strange balm for a shattered soul. I wasn't myself on Friday, that's for sure. But I did it. I made it through the day. I was kind of a good actress. As I told the teacher I share a room with, totally stealing from Clueless, I am a Monet today. From far away I look just fine, but get too close and I'm just a blurry mess. I had someone tell me I was incredibly strong. I agree, I am a strong person. I have to be. But at this point, is that more a blessing or a curse? Is my determination to make this work keeping me stuck in one door and when the other door may bring us the joy and love we long to give and share? It's entirely possible.

The plan continues, in the meantime. Another second opinion consult on Wednesday. The orientation with the adoption agency on Monday. Bloodwork is in progress to see if we are dealing with a translocation on Bryce's end. I'm not sure what to hope for here. I'm not sure what to do next. I do know that there is a definite limit on what I can do moving forward in terms of IVF. I am getting awfully close to being able to let go, to fling the other door wide open and leave this dysfunctional but ever appealing hope of success, no matter how slivery it may be at this point, behind. 

Wednesday, November 6, 2013

Consult #1: Questions, Possible Answers, Possibly More Questions Than Answers

Well, hello strangers!

It has been a rough couple of weeks and I am tired. I have been starting and saving and ultimately not posting incomplete posts for a little while here, because sometimes I just can't bring myself to write about where we are right now. There have been periods in my life where I didn't write in my journal, because it was too painful to see what was happening in writing (see about 3-4 years of my 5 year first marriage). I kind of dropped down into that mindset again because I just CANNOT keep writing that things aren't working. I have a new journal and I wrote in it with hope during our last FET cycle, and according to my journal it's still September and I'm still waiting. I am so tired of writing the words "It was negative" over and over and over again.

And here, in this internet world, I haven't really delved too much into where we are. It's too hard. It's a little personal feeling. And the truth is, I don't really have a clear cut answer.

Our plan consists of this:
1) Complete three 2nd opinion consults with other clinics, preferably before the end of November. Complete orientation with a local adoption agency. Gather information on all possible options.
2) Make a plan for what to do with our 6 2PN embryos sitting in the freezer.
3) Don't do anything with said 2PNs until February at the earliest, because we desperately need a Fertility-Free Holiday and we want December and January to belong to US. Not uncertainty and heartbreak and drugs.
4) After 2PNs are thawed and grown and transferred, either dance a hestitantly joyous dance and call it good, or realize that we are at a big fat fork in the road and make a difficult decision. Continue down this path that has been largely unsuccessful? Or blaze a new trail into the world of domestic infant adoption and learn a whole new language and way of being hopeful and expectant with a new kind of uncertainty.

Pretty good plan, eh?

Today we had our first consult, with CCRM in Denver. Over the phone, as I don't have a transporter handy. It was very, very interesting. I really wasn't sure what to expect. Or what to hope for. Or how I would feel with pretty much anything that would be said. Did I want them to come back and say "pregnancy is a long shot for you?" so that I can put this all to bed? Maybe. As hard as that would be, for the love of all that is holy, I would love for SOMEONE ELSE to make the decision that we've had enough and that hope is fleeting and this is just not going to happen for us. Because if there is a good chance that there is something missing that could be a gamechanger, I just don't think I can put it to bed without peering under that rock and clearing away what lies beneath. Did I want them to say "we've had a bunch of patients JUST LIKE YOU and they are all bouncing their bundles of joy on their laps RIGHT NOW?" Maybe. Of course that probably means more treatments and more punishing my already punished body and, yet again, no 100% guarantee of success, so possibly more flushing money out to the depths of Lake Ontario.

What did we get?

Interesting, interesting stuff. We have been questioning whether or not sperm could be an issue. We have been told it is likely not an issue, that chromosomal abnormalities in sperm are likely not our issue, and so we have concentrated on MY eggs and MY uterus. When really, in addition to my uterus (which has been photographed and poked and prodded and tested within an inch of it's little 8cm life), sperm is the only other constant. We did donor eggs and had similar results. In fact, we had a lot more fertilized eggs, but our ending number of blastocysts was not stellar. 4/15 that were allowed to culture and grow out, and only 3 of those resulted in good quality blasts. The rest either arrested or did what embryos do when they don't make it to Day 5. And then there's those 6 that were frozen on Day 1, those enigmas that may or may not amount to anything, really. So, uh, remind me again, why isn't sperm a factor? Oh, yeah, according to CCRM, that was TWO out of the THREE possibilities they threw out there. 1) Chromosomally abnormal sperm due to translocation, identified through karyotyping (which we haven't had done). And/or 2) Fragmented DNA in the packaging of the sperm, testable through a screening they do in office in Denver. INTERESTING. Both of these result in a) poor implantation rates and b) early miscarriage. Both things we struggle with, despite having stellar SuperDonor eggs at our disposal. Hmmm. And, if I may add, feeling very frustrated, things I have asked about and been pooh-poohed by our current medical team. Harrumph. Now, I realize that we are talking one out of 3 consults. But this clinic is apparently the best in the nation. So I am pretty sure that I can take what they say seriously. We will be testing for these issues. It doesn't mean that's what's going on, but OH MY GOD it would be so exciting if we had an actual answer. Of course, at a price. Losing Bryce's genetic component would be a big loss, but he has so much more to offer than sperm. Nurture over nature. I would pee myself if this was our silver bullet. What's this #3 possibility? That perhaps I don't produce enough of a protein in my lining that is the essential ingredient in an embryo implanting in the uterus. An issue identified through an endometrial biopsy (ow ow ow) and then treated with the super Lupron time release shot over two months. I have never heard of this, have you? The protein is called "integrin?" Apparently a relatively easy fix. If that's something going on.

Oh, and the recommendation for our little 6PNs was... thaw them all. Grow them out to 5 days. Do not transfer anything earlier than 5 days. Risk losing them all because chances are they won't do anything if they aren't blastocysts anyway. (This is not the opinion of our current team...they say grow to Day Three, Day Five is too much of a risk.) Oh, and karyotype first, because if we do have the translocation in the sperm, then chances are those embryos are no good. Even if we did get pregnant with them we would likely miscarry and if we didn't miscarry then we'd pass the translocation on. Do I want to do that? Do we want to give the gift of infertility to our future children? NO NO NO. So, now we have to figure out a) when to get the karyotyping done and b) how to say, "yes I'd like to grow my 2PNs out to Day Five fully realizing that they may all arrest and we have nothing to transfer." Gargh.

So there you have it. They would like us to fly out to CO for a day-long workup for both Donor Egg and my eggs. Because, oh, my eggs aren't totally off the table necessarily. If it's a sperm issue. So then we get to switch around our genetic mourning. I've done pretty well mourning my eggs. How to deal with the possibility of reintroducing them into the pot and mourning Bryce's sperm? WHY DO WE HAVE TO DEAL WITH THESE HARD QUESTIONS AT ALL? I am so frustrated. We are so frustrated.

And, if you haven't noticed, we are also looking into domestic infant adoption. For information. To see what this agency has to offer and if we have a better feeling from them than we did from a different agency, whose seminar we went to two years ago and left us feeling hopeless. However, just so you know, WE WILL NOT DO THESE THINGS SIMULTANEOUSLY. We are hunting and gathering right now. We are searching for information so that we can make an informed decision. Adoption is NOT a fertility treatment. We will not be filling out paperwork and putting ourselves into adoption so that, while we're "not thinking about it," we will get pregnant. It is unbelievable how many times I have heard that. I need to put medical treatment behind me before I can commit to adoption. I am very open to adoption, more so than I've ever been. We're tired of all this. We realize, WE WANT A BABY. We want a child in this house. We are tired of being just the two of us and two tiny furry beings. We want noise. We want chaos. We want another outlet for the incredible love we have to give. And we are so, so tired of the emptiness. But, we want to enter into adoption with a clear mind and heart.  Actually, I should revise that. Bryce could go now. I am the one who needs to feel more resolved. I am the one who is finding it difficult to let go of this hope that has not exactly served us well. I want one more try. It's like crack. Expensive, body-punishing crack. (Oh wait, that sounds like actual crack, although I think that's cheaper than gonadotropins...) The possibility that there is a fix and we could have the experience of pregnancy and that whole piece of the human condition that has been so elusive to us is just so...addicting. How can I close the door when there's still hope and the possibility of an answer and a treatment that will make this dream come true? But, at the same time, how can I keep torturing us with this uncertainty while there is another way to become the parents we dream of being? Tough times. Tough questions. No good, solid answers.

So, once the 2PNs are gone, and we are either happily pregnant and hoping we stay that way or yet again in this lonely drifting boat, we have to decide. Further treatment, or move onward to adoption? If we choose further treatment, we have to put a number on it. We can't invest a lot of money into another try. That's the thing with the possibility of a sperm issue--donor sperm is WAY WAY cheaper than donor egg. Maybe we give that a shot. We have two more consults to go and the adoption orientation to absorb. We have more information to gather. We don't have to make a decision until later. We are off until February (well, one consult is in January because we didn't want to do anything in December and November was booked). Why, why, why must this all be so exhausting? I hope that we can survive this exploration process. I hope that we get more answers than further questions. I am so grateful for our togetherness and open hearts...I don't know how I'd survive all this if we didn't have such a strong relationship. Here's hoping there's a resolution of some kind looming on the horizon...