Decisions, decisions

It seems that DH and I managed to make a couple decisions last night. We went out to dinner after I woke up and, with the help of a margarita, I found the courage to ask him where he stood on the whole "trying again" issue. I was sure he was going to say that he was done, so I was scared to even bring up the subject. I told him that, in my heart, I didn't feel like I was ready to give up just yet. I let him know that I was afraid that, in 5-10 years, I would regret giving up so quickly. I was shocked to learn that he had some of the same thoughts. So, we have decided to try one more time in March of 2011 after our annual tropical getaway for our anniversary.

We did make one stipulation though--we both need to be healthier, physically and mentally, before we start another cycle. I can't help but feel that some of my egg quality issues could be related to my piss-poor diet, my total lack of exercise, and my stress level and crazy emotional roller coaster. I know I've said I wanted to lose weight before, but this time I mean it (yeah, I know I've said that before too). It's a tough time of year to start this type of change, and I am not going to delude myself into thinking that I won't overindulge this week when we are back visiting our families. But, that doesn't have to be a gateway to 6 weeks of gluttony either.

So, I need to call the IVF nurse and let her know what we've decided. I'd like to get my next SSH done soon, so as not to delay our dates next year in case I do need surgery for another fibroid. I also need to make sure it's OK to be on the supplements even longer than we originally planned. In my head, that can only help, but I don't know.

One more decision that we have made recently is to tell our families about our IF struggle. It has been difficult for us to not have family support during all that we have been going through. There have been many times that our phone conversations with our families have not been honest because we haven't let them know what's really happening in our lives. We've both been honest with co-workers and other friends, but not with our families.

I think that the deception initially was borne out of self-preservation. There is a certain type of pressure that only families can exert and neither of us wanted the "are you pregnant yet?" questions every month. When we started TTC, we just knew we would have happy news for them soon, so we would wait until then to tell them. As the months dragged on, we were sure we had made the right choice--disappointing ourselves every month was bad enough, but imagine disappointing the hopeful grandparents and aunties-to-be! When we started with the RE last summer, we had that renewed hope that we would be pregnant soon. We figured we would tell them good news, followed by what it had taken us to get there. Wouldn't we all just chuckle about it then!

When my mom was here during our fifth IUI cycle, she found out about everything out of necessity. There was only so much lying I could do when I had daily appointments with the dildo-cam. She was sworn to secrecy and she stuck to it, thank goodness. We didn't exactly want to tell everyone over the phone, or have them find out from anyone else (facebook has presented a particular challenge), so we are telling DH's parents and my sisters when we are back visiting this week.

I have no idea what kind of reaction to expect. I'm pretty sure my little sis is convinced I'm dying or we're getting divorced or something--she picked up on my depressed FB status posts and caught my mom crying shortly after our failed cycle. Shoot, maybe IF news will be a relief for her! I know they will be supportive and it will be such a relief to be honest about such big events in our lives. I haven't decided yet whether I will point them toward this blog--I don't want to lose my safe space to vent about everything, but it would make it easier to keep them updated this way instead of repeated "how's it going" phone calls. So I guess I do have one more decision to make.

Anyone have any feedback on families reading their blogs? Did you feel like you couldn't be as open on your blog, knowing that you might need to vent about them but couldn't? Or did you find it helpful to keep them informed and less likely to bug you with questions?

The Long and Rambling Road--part 2

I'm not even sure how to approach the negative sides of this decision. Most of it is based on fear at this point, so there's nothing logical about it.

Of course, the biggest is the fear of failing again. I'm not sure how I would handle yet another BFN after working so hard.

I'm not too worried about cycling or the meds themselves. I handled them pretty well last time--no major physical or emotional side effects, knock on wood. The needles don't scare me, even though the IM shots did hurt a bit more than the SQ shots I had done in the past. The procedures went really well for me--the hardest part of the ER was the stinking doc who put the IV in a really sucky place. I didn't have much pain after the procedure either, which I am very thankful for. Transfer went pretty well too, so that isn't too much of a concern, either.

If we do try again, it would involve two cycles worth of meds--one for stims and one for the frozen cycle after genetic testing of all embryos. I'm actually more concerned about the second cycle and the hormones for that, probably because it's something I haven't done before.

What really has me worried right now is what we will find with the ER and genetic screening. What if I'm taking all of these pills and I still have crappy eggs in 3 months? What if the genetic tests show that we will never be able to have a baby that is ours? What if none of them are normal, so there's nothing to put back in? I'll have gone through all of that for nothing yet again. What if I use all the money we have left for one more shot with our eggs, when we really should have done DE?

I'm really worried, too, that DH won't even want to try again. I know that he isn't as intent on this as I am and he has said that he's ready to be done before. He let me know how hard this is for him--not because of anything that is happening to him, but watching me go through everything. Even though he didn't say it at the time, it was really hard for him to watch me mourn our last cycle. He said he doesn't want to see me hurt like that again. He's more convinced than I am that there is something inherently wrong with our gametes, and that it will never work. Yet he won't even consider DE--for him, it's ours or nothing. I'm not OK with nothing right now, so DE is looking more appealing to me.

Of course, money worries are also a factor. We have a very nice home in a great area, we have two nice cars (OK, one nice car and one truck that used to be nice but at least still runs), we enjoy traveling, but we also have a lot of debt. How on earth can we pay for this without driving ourselves even deeper into the hole? Our insurance will likely cover only about $2k toward the procedures, and ??? for meds (I can't seem to get an answer from anyone on that). This means that I need to come up with at least $15k for procedures (IVF with ICSI and genetic testing) and whatever insurance doesn't cover for meds. We've got $5k in a HSA from last year that will roll over and we can put another $5k in it this year, depending on which benefits we choose. DH gets quarterly bonuses that we usually put toward debt, but that could be put toward cycle costs. We should learn how to live within our means and tighten our financial belts a bit, but past experience shows we are both pretty bad at this. If we can't cut spending, then we need to increase our income. I can usually pick up extra shifts at work, but then I'm increasing my stress level at the exact time I need to be reducing it. I'll do what I have to do but, ugh, why does it have to be so hard?

The Long and Rambling Road

We're back from vacation and much less stressed. We spent 3.5 glorious days doing a whole bunch of nothing. We camped in our lounge chairs, alternately poolside or on the beach, and soaked up the sun. I read one book and got a good start on another--DH is still finishing the 900-page monstrosity that he started in Cancun. I turned off facebook, ate lots of food, released baby sea turtles, and got a couple heavenly massages. We played in the ocean, floated in the pool, drank too many mojitos and did our darndest not to think about our IF. We were very fortunate in that the resort wasn't crawling with couples on their baby-moons, which was a big fear that I had going in.

But now we're back, and I feel like I need to make a decision about pursuing further treatment. We need to select our benefits for next year, and our IF decisions will play a large role in deciding which plan to choose. If we're not going to do anything further, we might as well go for the lowest deductible with higher co-pays since we are not going to be visiting doctors nearly as often. If we are going forward with another cycle, the plan with the high deductible then 100% coverage makes more sense because of the sheer number of visits involved. Both plans have the same IF coverage, which we are about to max out anyway.

So, I hope you will indulge me and allow me this space to work out some of my thoughts on the decision at hand. Since I haven't found a therapist that I want to work with yet (OK, I admit, I haven't tried again), I'm going to use this blog as a poor-man's therapist and bounce ideas off myself--and anyone else who cares to read them--in here. Please, please, please provide any feedback that strikes you--things I haven't thought of, things I'm thinking too much about, etc. Fresh perspective is enlightening and will help me along in my decision-making.

To be honest, my side of this is pretty easy--I want to try again. I really want to be pregnant and grow a baby within me. I want to know what it's like to have someone kick me from inside. I want to fall in love with my expanding belly, knowing how hard we worked to get to that point. I guess this is part of why I don't really want to adopt--I want to experience the whole gamut of pregnancy. I want to bond with someone before they are even born. I know it's not always sunshine and rainbows, but I'd happily take the bad and the good right now.

I'm not sure why, but I feel like we came close with our last IVF and that our next one would work. I mean, we really didn't come close at all--nothing implanted, but 8 of the 9 mature eggs fertilized normally. Yes, my egg quality isn't great, but it can't be that horrible either if so many were able to fertilize and grow. My DHEA levels were still low at my repeat test after 2 weeks on 75mg supplements, so my dosage has been increased. Heck, if that's the reason for the poor egg quality, then fixing it with supplements could make a huge difference. Plus, I'm taking other supplements that are supposed to help with egg quality (L-Arginine, Royal Jelly, CoQ-10, Maca, Inositol, Fish Oil, Wheatgrass, Melatonin) so something in there's got to help, right?

When it comes down to it, I guess I figured that I will know when I'm ready to stop and I don't feel that way yet. I know there are many negatives to consider, and DH's feelings play a huge role in this decision too.

I'll think about the negatives tomorrow--today it's a rare sunny warm fall day, so I want to get out and enjoy it!

Incommunicado

Sorry I've been slacking lately--I guess I let the depression get the best of me. But, I'm starting to emerge from under that rock now, so I should get back to posting soon (not that I have a lot to say from over here in limbo-land).

I will continue to be away for a bit longer though. DH and I arrived in Cancun tonight and I plan on staying away from the internet and especially all things IF-related for this vacation. I've been up for over 24 hours at this point (worked overnight then to the airport for our flight), so I'm pretty sure I'm just going to hit the hay soon.

That is, after I make my selections from the pillow and aromatherapy menus--man, I love vacation!!!

RE follow-up appt

Even though my talk with DH went well on Sunday night, the meeting with the RE on Monday didn't go so well. He started off my saying how sorry he was that the IVF didn't work and how, as an office, they really go through the cycle with you. Yeah, right, you pompous ass--you're just pissed cuz I'm bringing your numbers down! (Clarification--I like my RE, he's good and has numbers on par with CCRM, but he's an arrogant jerk)

So, we ask him what we learned from this cycle and he points out the embryology report that said poor quality eggs despite the beautiful-looking stim. Of course, none of this was relayed to us during the cycle, which I told him was just one example of the poor communication that they have set up during the post-ER part of the cycle. Anyway, I asked him about the fibroid that the u/s tech had seen on my last few scans and he rudely dismissed the tech's findings, despite the fact that he removed several fibroids last year. Then he essentially told us he was too busy with IVF's to bother with another myomectomy, so he would refer us to someone else to get it done if needed.

Then he jumped back into the poor egg quality and was pushing us toward donor eggs. DH is definitely against that (I'm not as opposed as I was before) but the RE kept pushing it, even though we already told him we wouldn't go that route. So back to my piss-poor eggs. I asked him about ways to improve egg quality, and he went on and on about DHEA and how he was the first in the area to use it and how CCRM didn't start using it until after he did. Ugh!

He did say that he would want to do genetic testing on all of our embryos if we went ahead with another cycle with my eggs. He didn't really want to hear that we wanted to do it this time but that his staff talked us out of it because we seemingly didn't have any risk factors. He finally admitted that he should do another SSH prior to cycling again, just to make sure that the fibroid wasn't causing a problem. He said that he would put me on DHEA for 8-12 weeks before another cycle if we wanted to go ahead with using my eggs.

Then he told us that we needed to take a break and get away from it for a while. We couldn't cycle again this year, partly because of the DHEA and partly because they shut down at the end of the year for routine embryology lab maintenance. He encouraged us to just relax and enjoy the holidays without this hanging over our heads. Then, he was done--he didn't really want to talk anymore or answer any more questions. He apparently had told us all that he wanted to tell us, and our time was up. I had gotten through most of my list of questions, so off we went. He made a copy of the embryology report and our cycle monitoring sheet for us, and we were on our way.

Needless to say, I cried most of the way home. I called my mom and cried about how unfair it was that I went about things the right way (job, marriage, house, then baby) and that I felt like I was being punished for it. She brought up using my sisters as egg donors, this time suggesting not just the older fertile myrtle, but my crazy younger sister too. I couldn't seem to get through to her that I wanted my baby, not just a baby. I met DH for dinner (we had taken 2 cars to the appt since he had been at work) and managed not to cry at the restaurant. It was a very quiet dinner, though--not much talking since just about anything would have set me off on another crying fit.

I've gotten past most of the crying now. I spent a good part of the day yesterday looking up ways to improve egg quality. I went to the store and bought some supplements (maca, royal jelly, l-arginine, wheat grass, CoQ-10) though I can't find anywhere how much of this stuff I'm supposed to take. I'm going to get my baseline labs drawn for the DHEA and get started on that. I'm still not sure if I want to cycle again, but if we do decide to try again, I don't want to have to wait even longer. At this point, it will be the end of January before I've done my 12 weeks of DHEA--hopefully we will have made a decision by then.

If anyone knows of other ways to improve egg quality (heck, I'll stand on my head 3 hours a day if I need to), please pass the info along. Or, if you can tell me how much of these stinking supplements I'm supposed to take, let me know.

The talk

DH and I are meeting with the RE this afternoon for our "what went wrong?" meeting, so we thought it would be best to discuss things first and kind of get a feeling for where we stood. It went pretty much as I expected it would, except that I didn't cry at all.

DH told me he's pretty much ready to be done with TTC altogether. His feeling is that if our embryos didn't make it past day 6 to freeze, then there must be something incompatible with life going on and it was never going to work. He didn't want to go through the stress of doing this all over again for the same depressing result. He doesn't want to see me go through the heartbreak of a BFN yet again, especially after investing so much time, stress, and money into an IVF cycle. He also said that he doesn't want to do this over and over again, that we need to draw the line somewhere. He did admit that he still sees families and wants to have that, but that he's not so sure he is willing to do all that it is taking to get there. We both agreed that we don't want to adopt.

Of course, I had to admit to him (and to myself) that I'm not ready to give up yet. I feel that since we got so close this time (decent mature eggs, good initial fert report) that we just ended up on the wrong side of the numbers. He hasn't done the research that I have and he doesn't read the IF blogs at all, so he doesn't see the possibility of succeeding on subsequent tries after a failed first attempt. I am, of course, deathly afraid of putting so much into another cycle just to get yet another BFN, but I guess I'm getting past the initial heartbreak enough to think about the possibility of it working. I'm really afraid of getting caught back up in the emotions of it and not being able to stop at some point. I'm glad he's more grounded than I am in that regard because otherwise this could end up taking all of our money and many more years of heartache.

I guess we will see what the RE has to say this afternoon. I have a list of questions to ask based on some reading that I've done. I'm sure there are some that I'm not thinking of, so if you have any suggestions, I'd love to hear it.

I hate Fridays!

Well, at least I hate them on the weeks when I have to work Fridays. Sometimes I actually like Fridays because it means DH comes home after a business trip.

So, I head back to work tonight, which brings up a whole new set of issues. Last weekend at work, I was so raw and emotional from the BFN that I didn't really answer people's questions. I know that they were trying to be supportive, but I ended up getting lots of questions and assvice that I really couldn't deal with, so I walked away. I struggled with the fact that, while I was too raw to really talk about it, I was even more hurt when people didn't say anything or ask about it. This weekend I feel a little stronger and kind of need to talk about it more, but I'm sure people will have forgotten about it by now. So how can I handle it if I get the questions and assvice again? I'm not as easily weepy as I was last weekend, so getting all teary-eyed and walking away might not work.

Some people asked me about adoption. DH and I have discussed this and I don't really think either one of us wants to adopt. I know this sounds silly, but I've had some trouble with bonding with my adopted dogs and I'm afraid the same thing would happen. It would be totally unfair to whatever child we adopted if I felt like I couldn't bond with them because they aren't "mine". I would like to think that I would overcome that and love them just as much as if I gave birth to them, but I'm not willing to take that chance. There is also the money aspect of it--in many cases it can cost much more than trying IVF again. Plus, I often feel like I am not desperate for a child, so a prospective adoptive child would be better served by going to a family that will undoubtedly love them as their own.

Then I got questions about what went wrong. Now, I know that most people don't understand the whole process so they are just trying to ask questions and show support. But what it felt like was an accusation that I did something to cause the last one to fail, since the last time I saw most of them was right after retrieval and fert report and thought we had 8 great embryos. I would briefly explain that the embryos weren't as great as we thought originally and we put back the only 2 that survived. Of course, talking about that would bring me to tears and I would have to excuse myself. But how do I address this now? Sometimes it just doesn't work and there is no good answer. It's not like it's every time a fertile couple has sex that they get pregnant. I wish I had an answer as to why it didn't work so I would know where to go from here.

Oh, and here's the best one. My mom called this week with a great suggestion--why don't I talk to my older sister about using her eggs since she's obviously fertile (4 kids under 12)? "Honey, you've got the same DNA, and then you could use DH's sperm"? Really mom?!? OK, first of all, my biology background really wants to explain to you that we don't have the same exact DNA, despite having the same parents. Second, we don't know that it's my eggs that are the problem! It could be DH's sperm, it could be my uterus, it could be any number of other factors that are causing us to fail at conceiving--that's why they call it unexplained infertility! And finally, there is no way on earth that I am having that conversation with my sister. This is the same sister who used her entire matron of honor speech at our wedding to give us grief over not wanting kids at the time. She is a big part of the reason that we haven't been open about this struggle to the rest of the family.

So, how do I deal with it this weekend? People don't want to hear the raw, honest, crappy truth that I'm sad and scared and struggling with what direction my life will take now. They just want to hear the happy, unicorns-farting-glitter, everything is okay lies because it's easier for them.