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Sunday, July 25, 2010

Ignorance is Bliss, But Sometimes It's Not

Heather at "Can I Get Some Sugar With These Lemons" recently weighed in on this article in Elle written by a woman who became pregnant with twins after an IUI and then struggled over whether she should undergo selective reduction. Heather wrote a scathing but altogether reasonable reaction post here, mainly criticizing the author's ignorance of the multiples risk that was inherent in the procedure she chose to pursue, and also speculating as to the negative perception of infertiles this article would produce among the general public.

And I totally agree with Heather.

But, I can't say that I am at all shocked by this author's ignorance.

Because, here's the thing: I think that infertility bloggers tend towards the opposite end of the spectrum. We are the over-informed consumers of ART. We not only know that a doctor "transfers" embryos instead of "implanting" them, we also know what E2 is, we know how much of it you need per follicle for there to be viable eggs, we know how big those follicles generally need to be to hold viable eggs, we know how high our progesterone should be, we know what FSH is, what MTHFR is, what endometriosis is, what RPL stands for, we know about thyroid problems, we know about PCOS, MFI, morphology and motility. We know based on a beta number and the number of days past ovulation whether to cheer for a fellow blogger with reckless abandon, or whether to cheer for her with words of encouragement and hope. We know that cramps mean nothing. We know that boobs mean nothing. We know that google lies. We know that google tells the truth. We know too much. And I dare say, we may be the outliers, and the author of this article may represent the average IF patient.

Do most IF patients trust their doctors? Do most IF patients get all their information from their doctors? Do most IF patients base all their decision making on what their doctors tell them? Is this a reasonable way to go through IF treatments?

At this point I'd like to relate a story from my own journey through infertility. After 6 months of trying on our own, using OPKs and charting, and having nothing to show for it, I took the first step of making an appointment with my OB/GYN to ask about next steps. The appointment lasted, oh, 5 minutes. He said to me "I'm going to give you a prescription for something that helps a lot of women get pregnant. Take this for 3 months and if you're not successful I'll refer you to a fertility doctor." The prescription, of course, was for clomid. I had never heard of clomid, I didn't I know what it was or what it did. When I got home and told my husband that I had a prescription from the doctor that might help us get pregnant, my husband asked me if it would increase our chances of twins. I remember telling him that I didn't know, and I remember thinking to myself "Duh! It probably does!" At that point, I started doing my own research.

It's entirely possible that if my husband hadn't said anything that I would have continued being as ignorant as the author of the Elle article. But as soon as I started doing my own research, I started questioning everything. Clomid was supposed to be for women who didn't ovulate (or so I read), so why was I being prescribed this when I seemed to be ovulating fine? I also read something that said that clomid can cause cysts, and cautioned against taking the medication without being monitored by ultrasound throughout your cycle. I had previously had two cysts discovered during regular check ups (with a different OB/GYN), and so I began to worry about taking this drug for multiple cycles without being monitored. I actually called my doctor and expressed this worry, told him about my history of cysts, and he dismissed it immediately. But I didn't trust him any longer and after just one unmonitored clomid cycle, where I had a lot of pain and discomfort around ovulation, I decided to move on to an RE right away.

And I haven't trusted doctors since, because now I don't believe anything they tell me! (Kidding! I totally believe them, but only when they say things like "I don't know how much that costs, you'll have to talk to our financial department.")

Speaking of financial departments, I also wonder, if this was all being paid for by my insurance, as it was in the case of the author of the Elle article, would I have a more relaxed attitude? Because as it is, a big motivator for me to be my own advocate is the very real financial risk that my husband and I are agreeing to by undergoing an incredibly expensive treatment (IVF) that only has a 44% success rate (at our clinic, for my age group), and of course the multiple not-quite-as-expensive-but-still-more-expensive-than-an -iPad procedures that we underwent that only had 10-20% chances of success (IUI).

So did her insurance coverage have some influence on her relative ignorance?

I guess it's just hard for me to understand how someone could enter into IF treatments so carelessly. But, at the same time, it only took her one IUI to get pregnant, so it's not like she ever got to the point where she felt she needed to step up and take matters into her own hands.

But here's where I end up: whether the patient is informed and aware of the risks or not, IF treatments increase the rate of multiples. And as such, there are many many women who are finding themselves in the same situation as the author of this article, having to make a heartbreaking decision (though more likely they are pregnant with 3 or more, not just with twins). And until the precision of IF treatments is improved, or the underlying causes of IF are treated rather than just "worked around," women will continue to be faced with the decision to reduce, after working so hard to get pregnant in the first place.

Friday, July 23, 2010

My IVF Anthem

Since my issue with this company is ongoing, it seems that being put on hold and listening to the song "Eat For Two," with its "baby blankets" and its "baby shoes" and its "baby slippers, baby spoons" and "walls of baby blue," is now just a part of my everyday life.

But after listening to it today, for the... um... 5th time in 4 days, it seems that I am now, officially, immune to the song "Eat For Two."

Go ahead, make me listen to it again, it's okay. It's kind of catchy.

In fact, perhaps I'll make it my IVF anthem. I'll sing it loud, and I'll sing it proud. Just because I don't already have my "two," doesn't mean that I'm not already living for my "two." I quit coffee cold turkey (ow! my brain!), I quit drinking cold turkey (ow! my... okay, not as hard as the coffee, but still), I take my pre-natal, my folic acid, my extra B-6 and B12 every day, I am trying to do low impact exercise for at least 30 minutes every day, I am trying to de-stress and am thinking about trying some deep breathing and relaxation techniques (anyone have experience with Circle + Bloom?).

So, yes, I eat for two, walk for two, and breathe for two, now.

In your face, Natalie.

Thursday, July 22, 2010


I've been feeling pretty sorry for myself lately. I don't like this stage of life that I'm in. I just wish I could move on to something new - either a baby (please, please, please!), or other stuff (to be determined, but if we don't get a baby, it's kinda going to change my whole outlook on life, and I may have to: a) move somewhere else; b) go back to school; and/or c) become a drunk).

It's easy for me to get into that woe-is-me way of thinking, but it's not a healthy place. I'm trying to get it all out of my system now so that I can buck up when we actually start meds (August 4th!!). My goal, then, is to be in a zen place by August 1st. Okay, yeah, we'll see how that goes.

But, it certainly helps me lose the bad attitude when I'm confronted with the lives of others who are undergoing their own hardships.

There is a certain popular blog that I read (and if you read it too, which I bet some of you do, you're going to recognize which one I'm talking about). This blogger will, on occasion, and with much compassion, write about families that are dealing with challenges of their own:
  • Today she linked to the blog of a woman whose baby was born with a rare genetic disease. The woman found out when she was 17 weeks pregnant. Her daughter, now 3, has to have round the clock care and so lives permanently in an assisted care facility.
  • About a week ago she linked to the blog of a young mother of 6 who had been diagnosed with terminal cancer and had just died, only 2 1/2 months after finding out she was sick.
  • The blogger's own sister, a mother of 4, was horribly burned over 80% of her body in a plane crash. She survived, but is permanently disfigured.
I can't help but ask myself, even though I want so desperately to be a mother, would I trade my plight for the plight any of these women, all of whom have achieved motherhood?

***Oh, and BTW, I had to call that company again today. Guess what song I got to hear TWICE MORE while I was on hold? Eat for F-ing Two. I hung up the phone and asked my husband to shoot me and put me out of my misery.***

Wednesday, July 21, 2010

Shut It, Natalie!

Two days in a row I've been assaulted by the song "Eat For Two" while on hold (with the same company). Both times I had to listen to the part that goes "You know where this will lead, to hush and rock in the nursery, for the kicking one inside of me. I eat for two, walk for two, breathe for two now."

It ripped my heart out.

I couldn't help but imagine the (fictional?) woman who's perspective this is sung from: too young, not ready, but maybe in love; full of regret, but thinking of her unborn baby, kicking inside of her.

I have to admit that it made me long to be that woman. I guess I could have been that woman (maybe). One break of the condom and I could have been knocked up at 23, too young, not ready. It happened to a good friend of mine. She and the father, her partner, have a beautiful, smart 11 year old daughter now.

When I imagine the woman who is the subject of this song, I imagine my friend, alone in her pregnancy, with all of her friends still in school, or just embarking on their first jobs, maybe taking some time off after finishing college to see the world (I had just moved away from my college town after graduating when I found out about her pregnancy). And there she was, pregnant and unmarried (the father, also a good friend, did stick with her, although I know he was scared).

I wasn't envious for her then. But I am so envious of her now.

Maybe it's because that song, truly, is a beautiful song, and it kinda glorifies young unwed mothers a bit. Doesn't it?

Ugh. Gimme a baby, already, universe! Or please please stop torturing me!

Saturday, July 17, 2010

This Is Not a Post About My Boobs

On Thursday, after hitting "publish" on the "Boob Update" post, I rose from my chair, went to the bathroom, said a little prayer before looking in my undies (come on, you do it, too... right?), breathed a sigh of relief, peed, wiped... red. So, yeah, the boobs, they lie.

I called in to the my new REs office and they told me to come in the next day (yesterday) for bloodwork. I had to bring the hubs with me for his own bloodwork. We sat in the waiting room together, not speaking. I was on the verge of tears.

They called me back to take my blood, and the nurse barely spoke to me, just handed me forms. "Fill out the highlighted sections," she said. "Okay, sign here," she said. I continued to be on the verge of tears.

The nurse stuck me and it hurt, and the pain persisted the entire time as she took about 8 vials of blood. Still on the verge of tears.

We then met with our IVF coordinator and signed consent forms: ICSI, assisted hatching, cryopreservation, etc. I signed but forgot to date everything. Because I was on the verge of tears.

She also gave us papers to sign if we wanted to be involved in a research study that would use leftover unviable eggs and sperm and could potentially help other couples undergoing IVF in the future. I wanted to help, but when I read over the paperwork, the sentence that caught my attention was the one that said something about if any of our leftovers were ever used commercially our privacy would be protected. Used commercially? Privacy protection? Uh-uh, no way. We didn't sign, I felt bad that I wouldn't be helping other infertile couples in the future, and I remained on the verge of tears.

Finally, we left.

I was not myself. Hubs said "Are you feeling okay?" and I shrugged. He said, "I think all that blood they took from you must have tired you out."

Yeah, okay, NO.

I don't feel bad because they took a few vials of blood from me. I feel bad because I'M BROKEN, I'M INFERTILE, I DON'T WANT TO DO IVF, I DON'T WANT ANY OF THIS TO BE HAPPENING TO US, AND EVEN DOING THIS STUPID IVF WE MAY STILL NEVER END UP WITH A BABY.

The tears welled, but I did not cry.

I'm going to try and put on a brave face for myself, for my husband, and for the world. But I'm scared.

Friday, July 16, 2010

Dear Boobs...

Dear Boobs:



Thursday, July 15, 2010

Boob Update!

Okay, everybody: exhale. I don't think it's my turn this month.

I started spotting a little yesterday, and today I feel like I'll be getting my period any second now. Boobs are still larger than normal and a little sore, but not as firm as they were a few days ago. I think this just may have been the universe's way of f-ing with me. Maybe the universe saw how relaxed I've been over the last few months and instead of rewarding me with a pregnancy, decided that there just wasn't enough crying going on over at the TTC Hopeful house, so why not try to get my hopes up a little a lot so that they can just be CRUSHED MERCILESSLY.

Anyway, it's not over until the lady in red makes her debut (seriously... any second). But I'm looking forward again, instead of being trapped in that horrible endless cycle of "Are my boobs still sore?" Ten seconds later: "How about now?" Ten seconds later: "Now?" Ten seconds later: "What about now?" ("aaaaaggggggghhhhhh!!!!!")

So, as soon as the red lady shows, I will call my new and improved RE's office (Dr. Big Time) to let them know that I'm on CD1. On CD3 I'll go in for day 3 bloodwork. If that checks out fine (***please!***) then I'll start Lupron at the end of the cycle, wait for my period, and then start stims.

IVF!!! Hee-yah!!

Tuesday, July 13, 2010

Breaking News About My Boobs

Today I am 12dpo. Starting at 9dpo my boobs started to A) feel firmer; and B) feel bigger. Yesterday, they started to feel a little bit sore.

On all of my clomid and injectable cycles I had sore boobs starting at ovulation. They would remain that way until a few days before my period was due, at which point they would go back to normal, and all my hope would be extinguished.

In every other non-medicated cycle, they have stayed "normal" throughout the 2ww, despite all my poking and prodding.

So, on Saturday, when I did my regular cop-a-feel test, I was pleasantly surprised when I realized that, in fact, they felt different.

So, now I'm poking and prodding like a maniac all day long, thinking that as long as they stay like this, I have hope, but worried that the next time I grope myself they'll be back to normal and, again, my hope will die.

Ugh. My period is due on Friday. So. Far. Away.

And I hate that most likely this is some stupid fluke that actually means nothing and will get my hopes up and then CRUSH THEM.

Friday, July 2, 2010

Hello (Again) World!

It looks like I took June off from blogging. Hmm. Not sure how that happened. And I'm not sure if this is going to be an "I'm back" post or just a quick update before I disappear again. So, we'll see.

I am currently in my last cycle before embarking on IVF. As soon as I get my period I'll go in for day 3 bloodwork, then start Lupron at the end of that cycle, then get my period again and start stims.

This month is our fourth month of "trying naturally" since we failed our last IUI. Am I crazy to still be hopeful that "natural" could actually work for us?

Last month I miscalculated when my period was due and thought I was late. But I knew there was a possibility that I'd miscalculated so for 2 days I didn't look at my chart because I wanted to live in that other world, just for a little while. And it was a wonderful wonderful world. It's like lollipops and unicorns over there, ladies. Then, those 2 days went by, and I thought maybe it was safe to check my chart, that maybe I really wasn't going to have to leave that wonderful world. And when I checked my chart I saw that my period was due the next day. Well, it was nice while it lasted.

Oh, and I came back positive for the MTHFR mutation. Dr.'s email said "your blood clotting workup was essentially negative except for one very minor thing called an MTHFR mutation. This is very very common and is associated with a very low clotting risk...i merely recommend for this that you take additional folic acid daily." He makes it sound so... benign. Is it? Dr.'s email went on to say: "You had one of the a type mutation and one of the c type mutations = double heterozygote." He says I should take "minimally 2mg total" of folic acid daily. If anyone has any experience with this and what it really means to me please let me know.

Finally, our one year anniversary is coming up next week. Married life is awesome. We were together 7 years before we got married. They were often tumultuous years, too, which is maybe why we waited so long. But this past year, besides the IF crap, has been blissful. Just blissful. Wish we'd tied the knot earlier.