Friday, July 31, 2009

Switching RE's

I've been reflecting on our experience with our RE, and have wavered back and forth about switching...although I am always leaning towards leaving. When we made our first appointment back in March, I chose this clinic because it is the only local one. They also have great SART scores and an excellent reputation, so I figured we should start at the "easy" place to go. We said at that time that if we were unhappy there, we would definitely switch even if that meant driving.

I guess we're at that point, and I'm thankful we can leave after having only one cycle invested there.

One thing I do not understand at all is that after having such a TERRIBLE experience there, I discovered that not only to they have "great" scores, they are pretty much the #1 clinic (based on scores) and see LOTS of patients. Their main office is in the Big City 2 hours away from me, and they have multiple satellite offices...including one in my town. How can they be "the best" when we have found them to be disorganized, vague, and difficult to communicate with?

After discovering this, I started to wonder if the problem was me, not the clinic. Maybe I had too high of expectations for them? Maybe I'm just a really stressed out and difficult patient? My FIL started helping me research clinics in the Big City yesterday, and he even pointed out that our current RE appears to be "the best," and if we get pregnant by going to him who cares about bedside manner? And part of me agrees. I want a competent doctor, not necessarily someone who holds my hand. But the issue was not JUST bedside manner, it was lack of attention to me or my cycle, poor communication all around, and not feeling like they proved themselves to be competent. Even if they do have "the best" scores.

Also, I do know that DH and I are not typically the kind of people to complain. I don't like to rock the boat. We tend to stay with the same doctors, insurance agents, etc. We're really not that picky. So I think the fact that DH and I felt so strongly about leaving says a lot and I think we just need to leave.

I started looking at SART scores, and it was fairly discouraging to see that my current RE really does surpass almost all of the MANY clinics in the Big City by far. And IVF is not totally off the table (I think?), so I want to factor SART scores into my decision. How could I leave a clinic with 50+% live births to go to one with 30%? I began to feel stuck.

But then I found one I had overlooked! It has great scores almost equal to the current clinic, and rave reviews on a webboard I looked at (unlike my current RE, which made me feel a little vindicated). Everything on their website sounds like exactly what I am looking for, and I went to bed last night that I had at least found an option.

But, hopefully, I won't need that option! :)

If you have switched RE's, do you have any tips for making the transition as smooth as possible?

Also, if anyone is in the southern part of CA, I would love to hear where you go! Email me at makingmemom@gmail.com :) Also, if you're anywhere near me it would be so fun to meet a blogging friend someday!

Wednesday, July 29, 2009

We made it: IUI was this afternoon!

I have felt so incredibly stressed, tense, and unhappy these last 24 hours -- I just wanted to make it to the IUI and GET IT DONE! It was crazy trying to schedule it today. They only had ONE appointment available at 3:30pm, and my DH was LEADING a meeting from 2:30-3:30, and then in a meeting from 3:30-5:00. I called DH crying and asked if there was anything he could do to come home and provide the sample. He ended up telling his work that something came up and he had to run home briefly. When he got home I tried to tell him to go fast without pressuring him (is that possible?). He made me laugh by responding, "Sure, Mrs. I-can't-pee-under-pressure. This should be a piece of cake!" I love how he makes me laugh.

Good news: DH's sperm were moving fast after the wash!!

Bad news: There weren't that many. She likes to see at least 50 on a slide, but she only saw 20 (but they were moving fast!). She also saw white blood cells, which I've never seen on any of DH's SA reports. Huh.

I was also disappointed that she didn't have the equipment to do an actual SA and tell me the pre-wash and post-wash numbers. So I have no idea what "20 on a slide" correlates to...was that 10 mil post wash? 500,000 post wash? No idea. Maybe it's just as well I don't know that information so I can't google it to death...although in the future it seems kind of important to know, don't you think?

The NP had me lay down for 15 minutes after the IUI. I sent DH a text and told him that I loved him and was praying that we were making a baby right now. I also told him his sperm were moving fast after the wash -- that should make his day!

As I texted him and prayed I laid there with silent, relieved, and somewhat happy tears sliding down my cheeks and landing with loud plops on the paper sheet. I am happy and thankful the sperm were moving. I am happy and thankful we were able to do an IUI. I am praying this is our miracle.

Thanks for all of your support, ladies!! I feel like I couldn't do this without you.

xxoo

Tuesday, July 28, 2009

Horrible day

There were so many new developments today that I don't even know where to begin. I'm sorry if this post is all over the place....

So remember how yesterday I said I had EWCM but got a negative OPK (line was too light)? Well, this morning I woke up to a pretty big temp jump (from 97.23 to 97.58). Of course, I started to wonder if I had already ovulated and posted on the nest. People said temps can be weird on clomid so I let myself forget about it. Plus, if I already had, nothing would be done about it anyway.

DH & I showed up for our appointment with Dr. RE at 4:30pm, and we were the last appointment of the day. I was expecting it to be a "talk only" appointment to go over is plan for treatments, and brought a list of all my questions that have been swimming around in my mind all these months. However, as I signed in the receptionist told me the Dr. wanted to do a post-surgery SHG and gave me the pee cup so they could do a pregnancy test before the procedure. Ok...I wished they had told me that before coming in, since I had JUST gone to the bathroom 5 minutes before going in. She gave me a bottle of water to drink.

So I went to the bathroom and TRIED with all my might to go pee. I got super stressed out and almost started crying in the bathroom. I know it doesn't sound like that big of a deal, but seriously -- I think telling someone they HAVE to pee on an empty bladder is almost a form of torture. And I was so hopeful and anxious for this long awaited appointment/ cycle that I wanted it to go right. I ended up giving up and was starting to feel very stressed...

We went into Dr. RE's office to talk (and figured I would try again to pee after the meeting). I was told by the receptionist that the doctor wanted to go over my post-surgery report, but he had nothing to really say about that. Or about anything. I felt more stressed. I started asking all my questions, and his answers were vague, noncommittal, and...well, I could have learned more from google. I tried to tell him about my weird cycles -- ovulating early, spotting, short cycles -- and I didn't think he really listened. Shouldn't these things I'm telling him inform his decisions about my treatment?? My stress grew.

And then I tried to pee again, but I was so stressed I don't think I could relax the right muscles. I could feel the pressure in my bladder but I just.couldn't.go. and I was so stressed about not going. I have no idea what time it is at this point (I would guess 5:15pm), but I could sense that everyone just wanted to go home for the day, and that me and my silly first IUI cycle and lack of peeing was keeping them from going home.

Since I couldn't pee they said they wouldn't do an SHG -- just a regular ultrasound. I was happy that they could at least tell if I was approaching ovulation, since I was worried about ovulating too early. Sure enough, I had a 22mm follicle that Dr. RE said was "about to ovulate." Yes, this is on cd 8. I feel like a freak. But ok...Dr. RE said it doesn't matter that it's early, and said to go home and use OPK's.

And I was confused. If I'm about to ovulate wouldn't I just do an IUI soon, I asked? Then he offered to just do the OPK at the office right then....if I thought I could pee. I did manage to pee but my urine was sooooo diluted (almost clear) that I didn't trust that the OPK would be accurate. The nurse did the OPK and said the line was too light so it's negative. I asked her if the clomid could effect the OPK's and give a false reading, and she said you should start using OPK's on cd 10. I reminded her that I am on cycle day EIGHT and that I just had a huge follicle, and told her I tend to ovulate early. She acted confused and went to find the doctor (who I later discovered was changing out of his work clothes so he could head home).

Dr. RE, I guess, told her to give me an HCG shot. This is where it all gets fuzzy and I don't know who told who what and when. The nurse got the nurse practitioner involved (since I think the RE had passed the baton to them now), and they talked for 5 minutes while I just stood in the hallway mostly unable to hear what they said but could tell they weren't exactly sure what was going on. The NP called me into her office and said, "So Hillary, what's going on?" Seriously, she asked me! Shouldn't the RE and/or the nurse have been able to communicate everything to her!? So I rehashed all the information I knew, and she said they wanted to give me an HCG shot and do an IUI the next day. She asked me who was doing my IUI? Um...what?!? YOU ARE! I wanted to scream....but I said it calmly. She said a NP who works in our town does them for their office (the same one I've gotten my u/s from). Which could very well be fine, but how is this any better than going to an ob/gyn for an IUI? They don't seem to be doing much for me, here.

Somewhere in this meeting the RE came in and she confirmed with him about the HCG shot and he gave me some weird kind of high-five. I saw him a couple minutes later in the hallway and he patted my shoulder and told me I needed to relax. Awesome, thanks doc. He passed by my poor DH who was waiting in the lobby all that time, and told him to try to help me relax.

By this time it was about 6:00pm and the NP gave me the HCG injection. I had to ask her all these questions to get the details about what I was supposed to do the next day, and I honestly feel like if I hadn't asked I would have come home clueless.

By 6:30 DH & I were leaving. Finally. I was so tense and stressed. We grabbed something to eat and I vented the whole time about all the things that felt strange and wrong about our appointment and cycle. I felt like if I didn't ask the questions or know all that I know from reading blogs and Dr. Google, I would be SO LOST. I still feel lost. And I don't think I should feel like that when under the care of an RE. I don't feel like he or his staff read my charts -- that I have to explain everything to them. I don't feel like anything is done specific to me, that this is just a one set course for all and I'm just along for the ride. Granted, I know this is my first cycle so he had to just start somewhere, but I don't feel like his patient. I don't even know how to put it all into words. Nothing specific was horrible, but the whole experience was horrible. I left feeling like I don't trust them. DH left so mad. He called his parents and told them how awful he thought the Dr. and staff treated me and he is refusing to go back there. We figured we'd do our IUI tomorrow and that's it. We'll find a new RE.

Then we got home and I was very emotional and sad. I suddenly remembered my temp jump from this morning, and had a new freakout that I could have already ovulated and they didn't even pick up on it. I know this is kind of ridiculous, but like I said I don't feel like I trust them. I told this to DH and he got even more angry and said we weren't doing the IUI tomorrow. He doesn't trust them, feels like they screwed up their chance at being our doctor, everything felt too off, and why waste the money to do the IUI if I might have already ovulated anyway? Of course, this set me off even more and we had a little fight -- I want to finish the cycle. I figured I'd already put clomid & HCG in my body, paid for the meds and ultrasound, dealt with that appointment...I wanted to complete the cycle. We ended up calling my ILs to get a third-party, less emotional perspective and they helped us come to an agreement about doing the IUI tomorrow.

So I guess we're doing it. I'm not excited. Something about this whole experience just makes me want it all to be over.

One HUGE, HUGE blessing is that I actually DID have this appointment today. I had scheduled it 2 weeks ago before we ever knew were were doing an IUI cycle. I had wanted the appointment to be sooner and had been upset about waiting for it....but if it had not been today I think I would have definitely missed my ovulation. I would have been devastated to miss our first treatment cycle, and I would have had to start a whole new cycle with this RE. Now we can just make a break. And, despite my negative emotions, I am thankful for this.

I don't feel very hopeful about this cycle tonight -- it just feels all wrong. But I can't help but hope and pray that we get a miracle out of it. Mostly for the baby part, of course, but it would also be wonderful to not have to find a new RE and do all this all over.

Monday, July 27, 2009

HSG & last day of clomid

I *think* things are all clear with my fallopian tubes! The radiologist said that from a preliminary look, everything was fine...although he will have to examine the slides more closely to confirm that. I'm so thankful that a test came back ok!

I must say I was really, really nervous about the pain I might experience during the procedure. After my horrible SHG and knowing that most people think the HSG is worse, I was quite anxious. I took two extra strength tylenol an hour before, went for a walk outside the clinic just before my appointment, prayed, and tried to remain calm. However, I almost cried when the nurse asked me if I knew what to expect! I told her I did in a teary-I'm-trying-not-to-cry voice, and thankfully she was very sympathetic. I think she talked to me a lot beforehand to try and keep my mind off of what was to come. :)

Thankfully, it really was a piece of cake for me. Only mildly uncomfortable, not painful, and it hardly compared to the SHG pain. I was so relieved and thankful! Really, the worst part of the HSG was taking the antibiotics! I started them yesterday and have a 4 day course. These antibiotics are more intense than most I've seen and have all these guidelines -- empty stomach, no eating for an hour, a full glass of water, and no lying down for a half hour. So yesterday morning I took my first one on an empty stomach...and became very nauseous. It was awful. The feeling even made me question if I could handle being pregnant, because I was so miserable. I ended up laying on the floor next to DH sobbing because I felt so bad (maybe this was the clomid, too?). As soon as the hour was up he had fixed me a delicious lunch that made everything better. Needless to say I was terrified to take the next dose, but the next two have been fine. I think the first one must have just been a problem because I was super hungry.

In other news, I have also just finished my clomid and am on cycle day 7. I am thankful to report no side effects yet! I am very curious about when I will ovulate -- for the last three cycles I think I ovulated on cycle day 10. Today I had some beige tinged EWCM....so maybe I will still ovulate soon!? I used an OPK today but got a negative result. I am really hoping the clomid pushed my ovulation back just a little...and that I don't accidentally ovulate before my IUI. I go in for an ultrasound on Thursday (cd 10). Please, body, just hold off on ovulating until after Thursday so I don't have to stress out and call the RE!

Whew, what a big week! Tomorrow we are meeting with Dr. RE to discuss "the plan." It feels wonderful to be doing things, and have the HSG out of the way. :)

Sunday, July 26, 2009

A little sobering

On Friday Dr. Uro called my husband to discuss his most recent SA results. Actually, the funny thing is she called him on Thursday and left a message. He called her back and left a message telling her to just call me, since I'm more available during the day and "know more about all the information anyway." I think she just didn't want to talk to me and get grilled with questions, nor relay her less-than-optimistic news to an emotional, infertile woman....so she ignored his message and called him directly.

DH said that she and Dr. RE had talked and decided to, "Go ahead and try an IUI." She repeated that they really can't predict how the sperm will look post-wash, so this will be a way to find out. She also said that DH's SA results were not quite what she had hoped to see after the surgery and they aren't great, although they do fluctuate.

Then DH said he didn't want to "burst my bubble," but that her tone was really not hopeful about the success of an IUI. It didn't shatter me -- I knew this. I knew we were barely qualified for this procedure.

However, I must say on cycle day 6 of our first IUI cycle, it is a little sobering to know that the doctors don't have much hope for success. I know God CAN give us a miracle, and I am praying that he does. I am not discouraged, but I think my hope is a little more in check -- at the moment, at least. Hope is a tricky thing and can creep in all too quickly. :)

Friday, July 24, 2009

Menopause

**Disclaimer: I know I am a neurotic infertile. I know it is crazy to go down this path....but this blog is filled with my thoughts as I go through infertility. All of them. Even the crazy ones. :) **

I have been thinking that I will go through menopause prematurely.

There, I said it. :)

And when I say prematurely, I don't mean next week or next year or anything. I really have no idea how early. But based on all my tests that indicate ovarian reserve, I feel like I am barely hanging on in the "normal" fertility range.

FSH: 8.7 & 9
Antral follicle count: 11 (8 on one ovary, 3 on the other)

I am 28 years and three months old. I see women on the internet in their late 30's with numbers like mine.

So...yesterday I googled. And came across a helpful website that had charts galore. And according to their chart, I am not in the "excellent category." My antral follicle count of 11 falls in the 11-14 range and is, "Normal (but intermediate) count, the response to drug stimulation is sometimes low, but usually adequate. Slight increased risk for IVF cycle cancellation. Pregnancy rates as a group slightly reduced compared to the "best" group." And, mind you, I'm at the very bottom of that range...if I had one less resting follicle, I would be in the "reduced count" category.

And then I went to their FSH chart page. Again, I'm not in the "best category." With my FSH of 9, it says, "
9 - 11 Fair. Response is between normal and somewhat reduced (response varies widely). Overall, a slightly reduced live birth rate."

Now, before you say anything, I know that my results are NORMAL. They are FINE. I can still potentially get pregnant. I have eggs. I do not have diminished ovarian reserve. I know. :) That's why this post is kind of crazy. And I am sorry if anyone reading this post DOES have DOR and is envious of my 11 follicles and 9 FSH. I am so sorry, and please know that I am thankful I am where I am right now. I'm sorry if it sounds like complaining.

This post is much more about that nebulous future out there....in which I hope I will have at least one baby. And of course I say, "I would be happy to get one baby!" But the truth is, my infertility struggle is not just about that one baby. It's about all of my hopes and dreams...dreams of a house full of children...and with test results like mine I can't help but feel like I might not get that....even if I do get one. Which I would be so very thankful for. But I would also have to let go and mourn those other dreams, you know?

I called DH during lunch yesterday sobbing. I said when we meet with the RE I think he will tell us we need to go straight to IVF with sperm like yours and eggs like mine that might be getting bad sooner than later. I said maybe we should consider IVF more, because maybe I won't have my fertility for very long. I explained all the numbers to him. I don't know if he understood them all, but I think he was kind of sad, too.

But then...Dr. RE called me. He said let's do an IUI this cycle. No mention about IVF. I took it and ran.

DH came home from work and I opened the door for him smiling. "We get to do an IUI this cycle!" I said. He gave me a hug and said, "This is pretty different than the tears at lunch." I was happy and hopeful. I am still happy and hopeful...not necessarily that THIS IUI will work (how lovely would that be!), but that we're working on getting our baby. Our one baby. That's all I can do right now.

I feel like it was such a blessing from God that he has given us the opportunity to do an IUI this cycle, right when I was feeling the weight of our current infertility as well as our future infertility. I realized I cannot and should not worry about the future. God has given me this suffering to endure, to grow from, and, most importantly, to seek him in. He has given me this suffering today, but who am I to say what blessings or sufferings he will give me tomorrow? I have been humbled.

From Matthew 6:28-34 (I added the emphasis):
28"And why do you worry about clothes? See how the lilies of the field grow. They do not labor or spin. 29Yet I tell you that not even Solomon in all his splendor was dressed like one of these. 30If that is how God clothes the grass of the field, which is here today and tomorrow is thrown into the fire, will he not much more clothe you, O you of little faith? 31So do not worry, saying, 'What shall we eat?' or 'What shall we drink?' or 'What shall we wear?' 32For the pagans run after all these things, and your heavenly Father knows that you need them. 33But seek first his kingdom and his righteousness, and all these things will be given to you as well. 34Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.

Thursday, July 23, 2009

Um...we're on!?!

Dr. RE called and said he wants to put me on a medication to boost ovulation this cycle and then do an IUI. Oh.My.Gosh!!! I know it's only a month earlier than expected, but this is so surreal that I am actually going to do a treatment cycle. After knowing you're infertile for almost 9 months without any real action....just testing, surgeries, and waiting...it's strange to finally move forward. Exciting but scarier than expected!!

Ok, so here are the details. First of all, Dr. RE is difficult to get information out of and he seems rather vague. I learned I need to have a list of very specific questions in front of me when I talk to him. However, it was hard to ask all the questions I had swimming around in my head because I was caught off guard with his phone call. Hmph. I did ask about the HSG, and he said I'll do that next week to make sure my tubes are clear before the IUI (if they are not we would cancel the cycle). I asked what he thinks our chances are with an IUI, and he said it will depend how the sperm look after being washed.

So....I think we're looking at this cycle almost like another test. DH's sperm pre-washed don't really move forward....how will they do post wash? And how many will he have? I think those are the big questions, and it's worth it to move forward to get those answers. I am also excited to test MY body on clomid. Will it boost my ovulation, lengthen my LP, and stop my spotting?!

I thought I would be bouncing off the walls excited, but I'm feeling rather stunned. I'm starting clomid today!

Wednesday, July 22, 2009

Unexpected action!

Today I very casually called the RE's office to set up an appointment for my HSG. As far as I knew, that and our appointment with Dr. RE would be the only infertility related items happening this cycle, and I have been very content with waiting to start treatments until next cycle. That is, until today.

The nurse called me back and left a message saying they want me to get my cycle day 3 blood work and an ultrasound tomorrow. She also said Dr. RE is calling Dr. Uro to go over my DH's SA's!!

Honestly, my heart skipped a happy beat when I heard this message. I get to do something! We're that much closer to an IUI! Dr. RE is being proactive about figuring out our MFI with Dr. Uro!

I became giddy. Oh, it doesn't take much to sprinkle some extra hope into my infertile heart -- just a blood test or two, really. :) I then started to wonder if we could even do an IUI THIS cycle....

But I had to quickly banish that thought. It wouldn't be wise to start taking clomid, get an HSG, and then find out my tubes are blocked, right? I mean, why pay the money for the drugs and endure potential side effects if I don't even know for sure that an egg can get through my fallopian tubes? Right??

(Secretly I'm hoping you'll tell me it's no problem and I should just go for it, but I can't shake the thought that the more logical thing to do is to still wait until next cycle.)

Either way, I'm excited. And that darn FSH better not get any higher. (For ICLWer's or new readers, my FSH was 8.7)

Tuesday, July 21, 2009

Where I am

DH & I just got home from our two night get-away trip. It was the absolute perfect mix of rest, togetherness, romance, relaxation, and marriage building! I am so thankful. The last point may sound a little strange, but we went into our trip hoping it would be a bit of a "marriage retreat"....and it was! So intermixed with lounging at the beach with our fiction (I am re-reading Pride & Prejudice for the 100th time....), eating yummy food, soaking in the bath (not DH, of course -- poor guy!), watching a movie, and going for a bike ride, we each read a marriage book that was given to us. DH read This Momentary Marriage by John Piper, and I read Sacred Marriage by Gary Thomas. Both gave us great food for thought and much to talk about over meals.

************

I have been feeling weepy but spiritually satisfied lately in the midst of infertility. It is difficult for me to put words to it, but I am thankful! I just tried to describe it a friend who sent me a thoughtful and sweet email, so I thought I would share my response to her today to give you all a glimpse of where I am at:

Thank you so, so much for you your prayers and sweet email. I was quite weepy myself on Sunday morning...I often am at church. I think being in worship and hearing God's word always brings that deep, painful, but soul satisfying truth into my heart of God's goodness, faithfulness, and hope in salvation in the midst of my aching heart. I feel like I am offering it up as a sacrifice, and it is GOOD but emotional. This Sunday even more so with a sermon like that! I actually did cry in the car ride home trying to explain to DH how powerful and almost strange it is to FEEL so much emotion and sadness side-by-side with believing 100% that God is the only one who satisfies. It penetrates me to the deepest parts of my soul somehow.

I don't know if that makes sense, but hopefully you can see that God is answering your prayers in the work that he is doing in my heart. Of course, I still wish it didn't have to hurt so much. :)

I am praying for all of you....and now I'm off to catch up on how YOU have been these last few days!

Saturday, July 18, 2009

Memories

My college roommate is moving back to town next month with her husband. As I was thinking about her....

I remembered that she is an only child, and that it took her parents 8 years to conceive her. Eight years.

I remembered my aunt and uncle. They have no children. I asked her once why they didn't, and she said it just didn't happen.

I remembered my babysitter and her family. She watched my brother and I for 6 years, so we knew them well. One hot summer day we went over to swim at her sister's house as we often did. As we drove over, she explained to us that the baby we had seen in her sister's belly had died. As I swam and played without a care in the world, I saw my babysitter sitting with her sad sister.

I remembered that my mom and my aunt are 5 years apart in age, and that my grandmother told me once she had had a series of miscarriages in between them.

I remembered sitting in church in college and hearing that a couple had just adopted a baby. A year later I heard they adopted that baby girl's brother.

I have seen adoption, loss, and infertility....I just never knew. I didn't know.

Wednesday, July 15, 2009

2nd Post-Surgery SA results

My stomach is in knots. There is some improvement, but there are also a couple things that are worse. The total motile is half of what it was on the last SA. I know these things fluctuate. I just don't really know what to think about these results right now. We are so borderline about whether an IUI is even a realistic option. What will the RE say on the 28th??

Current SA (7.14.09)
Count: 59.6
Volume: 3.2
Motility: 15%
Total motile = 28.61 mil


******
For comparison....

Pre-surgery SA (10.31.08)
Count: 72.6
Volume: 6.1
Motility: 3%
Total motile = 13.29 mil

1st post-surgery SA (4.30.09)
Count: 145
Volume: 4
Motility: 10%
Total motile = 58 mil

*****

Soooo....the total motile is half of what the previous SA showed. Was that really high count a fluke? Also, the morph came back abnormal on this one. DH's morph has always been in the normal range (although it's only the WHO scale), but this SA showed a normal morph of only 17% (down from 58% on his first SA).

Lastly, the motility grade has consistently remained at 1, which means the sperm move their tales but do not move forward (4 is the best score which means they have fast, progressive movement). I have chosen before to kind of ignore this since I only figured it out through all my googling (and haven't talked about it with a doctor). But I think that's pretty bad. Maybe the sperm washing will help?

*****

I am feeling pretty down tonight. I didn't even want to write this post....I came home, got some rice cooking, and just wanted to lay on the couch. But, in an effort to keep perspective, I am thankful for: the fact it only took 1 day to get the SA results, an easy day at work, time with friends and in Bible study at our small group tonight, and that DH will be home in a minute.

Tuesday, July 14, 2009

Thankfulness

This past week our church studied "thanksgiving," and the Bible study and sermon really spoke to my heart. Both were those "aha!" moments where I saw the goodness of the Lord in front of me and my infertility seemed so small in comparison. After the sermon, we had a time of sharing as a congregation and I was so touched by what others had to say. One woman shared about turning to God in the midst of day to day struggles, including ones with her husband, and how utterly thankful she is that He there. Another young woman (who has downs syndrome) stood and thanked God for all the love she sees around her, and that God created her, "in her mommy's belly." Wow.

I want to share a few passages that ministered to my heart -- the first is from the Psalms, and the second two are from our church "study guide" written by our pastors and members of the church. I won't be citing it directly (shame on me, I know!), because in order to remain anonymous, I don't want to name my church. I figure they would understand. :)

"Enter his gates with thanksgiving, and his courts with praise! Give thanks to him; bless his name! For the Lord is good; his steadfast love endures forever, and his faithfulness to all generations." Psalm 100:4-5

"To choose an attitude of thanksgiving is to live a life characterized by hope. We know that our current circumstances aren't the sum total of what our future holds. Again and again, the Psalms express every range of emotions -- grief, fear, envy, anger, joy, confidence. What is notable throughout is the chosen attitude of thanksgiving." -- My church's Bible study guide

"[God] knows we need to say thank you in order to develop heartfelt gratitude. That gratitude, in turn, makes us hopelessly susceptible to joy, and with joy we can't help but live lives of hope. And our hope is in the risen Christ." -- My church's Bible study guide

My little list of thanks for today:
*my salvation and my hope
*my DH
*pina colada icees in summer
*begonias
*my house
*vacation next week!
*bbq-ing...especially vegetables!

What are you thankful for today?

Sunday, July 12, 2009

To have both...

When I found out about our male factor infertility, it was like a huge punch in the gut from out of nowhere. There was no way for us to suspect low-functioning sperm -- there are no signs or symptoms most of the time. So when we found out, we initially felt shock and a deep, heart wrenching sadness. Male factor felt so black and white, so final, and without much option for "treating" the issue. We thought we would just have to either work around it through IVF or give up on biological children altogether. Both options felt scary and overwhelming, especially since this was only our very first infertility test. Go directly to jail without passing go....

We were fortunate that DH could have the varicocele repair surgery and that it did improve our male factor situation. The fact that there was a potential surgery and that it did result in improvement seems rare in the world of male factor from what I gather. We are thankful.

And, I think to some extent we have grieved our male factor diagnosis. The initial shock and pain wore off after many prayers and tears, and I think we came to a place of acceptance. Of course, there have been and will continue to be moments of intense sadness over our MFI, and I'm sure if there are failed treatment cycles those feelings will wash over us anew. And, of course, we feel the sadness over our infertility -- it just isn't as intense as when we found out.

On the other hand, the female factor diagnosis has unfolded slowly over time, with the no one "real" diagnosis, but rather with lots of symptoms and questions. Low progesterone? A fibroid? Spotting, spotting, and more spotting? Short cycles? Female factor has been gradual, subtle, and less intense. I almost think it has felt more hopeful -- once I get the right medication, diet, doctor, surgery, etc. it will "go away." But with more hope comes more potential for lows. And I feel the female factor monthly. With each cycle I am reminded that my body is failing me in its ability to conceive, and my body seems to be reminding me more and more often that it is unable to cooperate in this "getting pregnant" endeavor. I am heartbroken that my body won't act like it was designed to do...over and over.

Neither male or female factor feel easier or worse to me. I'm sure for other infertile couples their experiences with each or both could be very different than ours. But as I have faced the female issues more lately, I was suddenly struck by how my emotions and expectations have changed and varied with each side of our infertility.

But the underlying emotions are the same with both, and with all of you -- our wombs are empty. Our arms are empty. And how wonderful it is that we can all support one another with our different diagnoses and situations!

Friday, July 10, 2009

Cycle day 12

Well, after taking my temp for a couple days I am guessing that the bright red "spotting" that I had on cycle day 21 was actually my period...which makes me on cycle day 12 today. And, get this: Based on my temperatures, I believe I have already ovulated. The two temps I have taken have always been in the range above my coverline from when I was charting regularly. And, yes, high temps could mean pregnancy...but four negative HPTs later, memory of some red "spotting" from too long ago to actually be "implantation bleeding" and still be testing negative, and a history of annoyingly short cycles leads me to this conclusion.

Can I just say how incredibly weird it is to go from thinking your period was late and having a teeny-tiny ounce of hope that you're pregnant to suddenly realizing you have already had your period and ovulated in your next cycle? I feel like I am in the Twilight Zone and that some vortex of time sucked away half a cycle without even knowing it. My mind got lapped by my cycle and I can't turn back to get it. We lost a chance at a baby by the sheer fact that my body does strange things and forgot to tell me it's time to try. It tricked me into waiting for my period!

Now, I haven't completely ruled out anovulation, but I think an early period and early ovulation fits the pattern of my body since I seem to have that going on these days.

The track record:

End of May cycle: 19 days long
Early June cycle: 20 days long
End of June cycle (current): On cd 12, I'm just guessing that ovulation occurred around cd 10.

Honestly, this information was more disturbing than upsetting. I gave up on the idea of being pregnant on Wednesday, and for the last two days I just wanted to figure out what in the world was going on with my body.

I am disappointed to have to give up on my chance to try this cycle. DH and I were honestly excited to go at with all we have and hold our hopes high. And I was going to use my progesterone suppositories. We're going out of town for a belated-anniversary trip in two weeks, and we even thought we might get to *try* on vacation. Or, at least, I would be early enough post ovulation that I wouldn't have any spotting. Now...well, now I just might be having my period on our trip instead. Or heavy spotting that is oh-so-s.exy. **sigh** Sometimes that happens (I can't always plan trips around my period!) and I know it's not a huge deal, but it's just a big shift in what I was thinking and hoping...

I think this post sounds more discouraged than I am. I'm more annoyed than anything else. I am looking forward to our RE appointment and I am definitely starting to chart again. No more of this confusion.

**ETA: I just made our SA appointment (next Tuesday) and RE appointment (July 28). The RE had an appointment available on next Tuesday, but since we won't have the SA results I wanted to wait and get the next available...and it was two weeks later!! In my crazy IF emotional state, I almost burst into tears on the phone at the thought of waiting the extra time. I made it through the conversation but started sobbing immediately upon hanging up. The receptionist was so nice about it, and I think that made it harder not to cry. She said she would put us on a list to call if there are any cancellations. Maybe I am more upset about how last cycle and this current cycle have unfolded than I realized. My wacky cycles have reminded me that I am not in control nor can I even plan anything (who knows when my next period will be, and maybe we will miss the chance to do an IUI then....). God is in control....God is in control...God is in control...I am praying this and am seeking to rest in that truth.

Wednesday, July 8, 2009

Stark white

I think my period is "officially late" today....well, as official as it can be without even knowing when I ovulated. But today is cycle day 30, and I have never had a cycle day 30 before. Hope sprung up, and I caught myself fantasizing about the moment I would see 2 lines and imagining myself pregnant.

However, I have had two days in a row of single-lined, stark white pregnancy tests. I began to wonder...which is worse, waiting, waiting, and waiting for that expected period, or a negative pee stick?

As I stared at the first single-lined stick yesterday, I wished I had just waited for the red flow to come. A BFN is such a blow and insult. The starkness of the white side taunted me, "Seeeee....you're NOT pregnant! Why would you even think that?!"

But as the day progressed and there was still no period in sight, I became thankful that I had taken that test in the morning. Otherwise, I knew I would be driving myself crazy hoping, hoping, and more hoping that I was indeed pregnant. But because of that negative test, I made it through most of the day without more than a , "Huh, no period yet...." thought.

The downside of the negative pee stick is that hope can return far too easily. It ain't over 'til it's over, as they say. And with no period to end the wait...I began to hope that, perhaps, the stick hadn't shown my truly pregnant status yet. It was too early. The pee sticks are cruel in how they allow hope to creep in and out.

This morning I peed once again on a home pregnancy test, and was met with the same stark whiteness on the side where I was hoping for a faint hint of color. I'm not pregnant.

After getting ready for work, I did go back and look at that pee stick again with an ounce of hope left in me. Still white, still nothing. And into the trash it went, along with my hope for this cycle.

*****
I have three theories:
1. I did have some bright red "spotting" last week (Monday?). Maybe that was actually my period, although I have never confused the spotting with a period. It just wasn't heavy enough and there were no cramps. But, I am leaning towards this theory now and will take my temperature tomorrow to see if it is pre- or post-ovulation. I could be on cd 10 today!?!
2. Maybe I just ovulated later than normal this cycle. I was traveling and with a cabin full of girls, so that could have delayed things.
3. Did I have an anovulatory cycle? I've never had one of those, but there's always a first time and my cycles are weird. I wouldn't put it past them.

Monday, July 6, 2009

A time of rest

Ever since my sudden sense of hope, I have felt grateful for what feels like an emotional time of rest. Some days and weeks of this infertility journey have been wrought with so much pain & anxiety that are very taxing on my heart, mind, and soul. God has been so good to provide me with moments like these along the way that give me a chance to sit back and enjoy life while infertility is pushed a little further back in my mind.

I am still excitedly waiting for my new cycle to start to we can get the REAL trying-to-conceive show on the road. I had a nineteen day cycle last month, and now I'm on cd 28 waiting for AF to arrive any minute now -- it's crazy.

(And, yes, if you just had the fleeting thought of what if you're pregnant this month, I had that thought, too. I'm ignoring it since we only had s.ex once before I think I ovulated because we were at summer camp. And we weren't supposed to TTC this cycle, anyway. And I have have 28 day cycles before. So, yes, I've thought of that and those are all the reasons I'm pushing that thought aside.)

To answer a few questions I've gotten, we are not doing an IUI this next cycle. My appointment last week was with my Ob/Gyn who performed the fibroid removal surgery, but we have yet to meet with our RE to set up our treatment plan. We just couldn't squeeze in the SA, HSG, & appointment to discuss everything into our last couple weeks. So we're trying the old-fashioned way this cycle and I'm going to use progesterone suppositories post-ovulation to hopefully stop the spotting madness.

Thursday, July 2, 2009

Appointment with Dr. Ob/Gyn

I had my post-surgery follow up with Dr. Ob/Gyn yesterday. Everything has healed well and I'm good to go and get pregnant! She has a spunky personality and I really liked talking to her.
Overall, she was very reassuring about my fertility woes, although she also had a sound of surprise in her voice at a few things I told her. In a weird way this was also reassuring in letting me know that I am not just going crazy and things are not quite normal...

#1 - I showed her DH's SA most recent numbers to get her opinion about an IUI. First, she said in that surprised, not-quite normal voice when I pointed out the 10% motility, "Is that pre-surgery or post-surgery?" However, she then took my own pen from my hand, leaned over my notepad, and wrote "IUI" in big bold letters. She said she thinks we definitely have a great shot with IUI's. She must have been able to tell I'm a stress case, and it made me laugh that she wrote that in my notebook.

#2 - I told her about my spotting (again). She asked if it was 1-2 days before my period, and I said, "No, more like 10." Surprised voice, "Oh, really?" But then said it's probably hormonal and not a big deal (I wonder how many times I'm going to hear that??). Take the progesterone, she said. She also said it could still be residual healing from the fibroid removal, but this cycle my spotting was exactly like it's always been, so I doubt it. I just don't think doctors know what to do about it, really.

#3 - I told her about my FSH & estrogen levels on cd 3 (8.7 & 68 respectively). Again got the surprised voice, "How old are you?" (28) that quickly turned into, "That is still very normal." I think she said things are normal and fine about 10 times, and I liked that. She said to just keep monitoring my FSH and if it starts creeping up to get more aggressive, but that it is a normal number.

She sent me off and told me to go have an IUI and get pregnant! At this point I feel like she might have been down-playing things a little too much, but I think I needed that, you know? It's not like I'm going to run out and really think we're normal...but it helped keep me calm. It was nice to have an encouraging doctors appointment. :)