4th IUI Officially Failed

So now that we are indeed staring down the barrel of a loaded gun, I've been licking my wounds and mentally recovering from the fact that my body, for whatever reason, is broken. And after meeting with Dr. Fertility on Friday, now know that it's IVF or adoption unless miracles happen. And we've been short on miracles around here. So, I'm officially starting the IVF prep cycle on Day 5, which will be Wednesday of this week.

It seems odd to me that in order to prep one's body for IVF, you have to go back on The Pill. Funny how you need to ensure you can't get pregnant for a month to ensure the best odds to get pregnant the following month. I go in for blood work tomorrow, and if everything look A-OK, I'll start birth control on Wednesday to "rest my ovaries". Right now I'm sort of skating on masked emotion, trying not to think about it too hard, or I might back out. I'm just putting one foot in front of the other, and trying to hold onto my sanity.

Dr. Fertility wasn't as comforting this time around. He was 45 minutes late, and once he arrived at the consult, we had 15 minutes before I had to leave to pick up my son from school. So we got the abridged version of what IVF would entail, but I did not find it reassuring that he thinks with my "idiopathic infertility", that we have as great as 70% chance of conceiving per IVF cycle. With my odds, that 30% is an awfully big risk.

I wish someone would call and say they found a surprising inheritance that my grandmother hid when she passed away, and we would adopt in a heartbeat. I know to some people, adoption is the last option, the only hope. To me, adoption is the preferred option, just one we cannot afford. If $30,000 landed in our laps today, I'd be canceling the whole IVF thing tomorrow. It's crazy that it comes down to money. But I guess it always does, doesn't it? But if IVF works, and we get a wonderful little baby out of the deal, it will be worth it. I'm just worried about what happens if it doesn't work. I'm not prepared for that. I don't know if there is a way to prepare for that, really.

We will start the whole battery of hormones and drugs in October. Until then, I get a cycle off to rest my weary soul and my battered emotions. The storm ahead could be brutal. I will need all the strength I can muster.

Melancholy

Today I scheduled our IVF consult. I'm still bewildered and in disbelief that sperm + egg = baby has come to this. How on earth did we go from accidentally conceiving our beautiful son, to not being able to hold onto a single pregnancy? I think about this, obsess about this, probably more than is healthy. I lay out the facts and figures, and then try to think of all the possible answers, which of course, are none. I have a tipped uterus, and had to have a c-section with my son because he was breech- does that somehow factor into all of this? Though all tests conclude otherwise? Or maybe it's because I take too many bubbles baths, like coffee, don't exercise enough, or used too many chemicals somewhere in my lifetime? But I've tried not taking bubble baths, cutting out caffeine, exercising moderately, and living a greener life. Doesn't make a lick of difference.

So, here we are. Our son is 6 years old, perfect and beautiful in every way, and his requests for a sibling have pretty much subsided over the last year. My heart used to break when he would say "Mommy, why do all the other kids get to go home with other kids? Why do I always have to be by myself?" Oh, the tears shed over those words. My heart still breaks when he is playing with a family full of siblings, and he is immersed in the chaos that is sibling hood, and he is having the time of his life. I think about how different life would be for him if my body would just work the way it did with him. But it doesn't do any good to dwell, right?

Sometime soon we'll sit down with the Dr. Fertility, and he will lay out a plan for taking over my body hormonally, removing my eggs, fertilizing them with my husband's sperm in a laboratory, and then if all goes according to plan, sticking some embryos back inside me. It seems so incredibly foreign, so other-worldly to be even contemplating this. I know it's cliche, but life really isn't fair.

I wish we could afford to adopt.

I said the F--- word.

Today is 13dpo, or 14dpiui. I have taken a bazillion pregnancy tests, just waiting for that line to show up. And it hasn't. Tomorrow is D-Day, and at 9:30am I will be going in for an hcg test to end this last IUI cycle. And then it's onto IVF. 


I'm scared. 

The IUI Emotional Rollercoaster

For those who have never had an Intrauterine Insemination (IUI), it's not as big of a deal as one would think. Of course, that's if you leave the emotions out of it, which is easy to do until about 7 or 8 days past the IUI, when you begin to think "maybe if I took a home pregnancy test (hpt) now, it would be positive!" And so the insanity of the Two Week Wait takes full hold of you, and it becomes a pee-a-thon of stellar proportions. Oh, the money I have spent on pregnancy tests for the the past 3 1/2 years.... well, we could probably adopt! 


Since we've been told that this is our last IUI before we will have to move onto IVF, the stakes are that much higher. Because of this, I have made a note of every little thing that has been different from all the other cycles, and every little thing that has been different from the last three IUI's. Not that I think the differences will make one lick of difference. It's just that I need something to focus on, or I'm going to lose my mind. 


The funny thing about IUI cycles is that it's all one big dog and pony show, but your body is in control. You're given a variety of hormones, a chart to help you remember when to take which hormones on which day, and are subjected to a vaginal ultrasound not once, but twice (and sometimes more if you're body decides not to cooperate!). Oh, the joy of being an infertile woman. Thankfully, I'm now on a first name basis with my ultrasound tech, so I no longer care if I shave my legs for her or not. Weird, I know, but that's the crap you think of when you've got an ultrasonic wand shoved up your hooha. Your ultrasound on cycle day 3 shows if your egg follicles from the last cycle are all gone, and how many new ones are developing. You come back again after taking a bunch of follicle stimulating hormones, in my case Clomid, and then you get another ultrasound to see how big those egg follicles are. And how many. Usually I have two. One cycle I had three and had to decide if I still wanted to go forward, because 3 eggs could equal 3 babies. Eeek! But, with our luck (or lack of), we agreed to go forward with that one, and of course, that was a loser cycle. 

Anyway, back to the IUI. So, once it is decided your follicles are mature enough, you may or may not get an injection of HCG. Yes, the same hormone that pregnancy tests measure to see if you are pregnant. How cruel! This fun little event takes place with a needle to your stomach, but thankfully, only once. And surprisingly, if you do it yourself, it hurts less than if the nurse does it. Because you are much more kind to your body than the nurse is. Make a note of it. Once the hcg shot is given, you schedule your IUI. We did back to back IUI, meaning one IUI on one day, and another IUI on the following day. In our case, my lovely cooperative husband dropped the swimmers off in a cup at our fertility office, and then one hour later, I arrive for the party. The whole thing literally takes 15 minutes from start to finish. They stick in a speculum, which is the part that usually sucks, but usually not too bad, then they take a little catheter (after they've made you check a bazillion times that you & your partner's name are on the prepared swimmers' tube!), thread it through your cervix, inject the little buggers, and you're done. Lay down for 10-15 minutes, and then you can go about your day. Easy, right? It actually is. 


During this whole time you get to do bloodwork. Lots of bloodwork. Day 3, again on 7 days past ovulation, and again on 14 days past ovulation. That's the part I hate. That's a much bigger needle than the one to the stomach. But, the great thing about using an infertility center versus a general obgyn is that the blood work is usually back within 6 hours! Often I'll give blood at 7:30am and the nurse will call me by 2pm. That is fabulous. Gone are the days of waiting 2-3 days for results when you use an infertility center! 


Once your IUI is done, there's nothing to do but wait. And that is the hardest part. Because I get the HCG injection, also known as a trigger shot, I have to wait about 10 days past the injection to take an hpt, or the results could be a false positive. So what did I go and do this cycle? Took an hpt at 9 days past the IUI (9dpiui). And it was positive. Absolutely positive! Dark enough to see the line without squinting at all! So exciting, so hopeful!  That little voice inside my head knew it could be the trigger, but when I tested again this morning, fulling expecting a beautiful Big Fat Positive (BFP) on the test, it was barely a line. Still positive, but less so than yesterday. More than likely, my test yesterday picked up the last of the trigger shot. Stupid me. 

Can you see that faint little plus sign? Yeah, that's the culprit.

I was soaring yesterday, so sure it had worked, so sure that I could go shopping for baby clothes and a new crib and all the fun stuff that comes with knowing it worked. But now, doubt has creeped back in. What if the test was a chemical pregnancy? What if it was the trigger? What if this does work and I lose another baby? What if it never works at all? After this fourth and final IUI, the nurse handed me a patient satisfaction survey to fill out. I love the Fertility Centers of Illinois, so they got high marks for everything. But when they ask for any suggestions on how to make the experience better, I simply put "Guarantee Pregnancy. Just Kidding. Sort of." Yep, that would make the whole experience better. Knowing that there was light at the end of the tunnel.


And so, I keep waiting. 

On the Other Hand, Adoption

I've been drawn to adoption for over a year now. I am far more willing to adopt a child than to go through IVF. The reasons are many, but I don't really need to make a pro & con list for Adoption. The pros list is huge. The con list is the cost. 


I began researching adoption about 2 years ago, but thought we'd never have to really think about it, so I didn't delve in to deep. Early this year, after researching both domestic and international adoption, I asked Russ if he would be willing to go to an international adoption seminar nearby. Surprisingly, he agreed. We sat in a freezing cold room, sifting through brochures on adoption from several countries, both of us agreeing that China would be our preference due to the travel time and the fact that my husband travels to China every year for business, so he feels some ties to the country, and also some familiarity with it. We listened to the requirements, the travel, the options, all of it a lot to take in. When all was said and done, we decided that IF we could ever adopt, a China Special Needs child would be first on our list. 

We then were blessed with a visit from an adopting family, a lovely young couple who adopted two boys from Russia. The boys, not biological brothers, but brothers in every other sense of the word, stole the show (and the hearts of everyone in the room). They were adorable, real live breathing adopted children- they could be like ours! And they were adopted at ages 1 and 3, which is the age range we would love to adopt in. My heart is set on adopting an older child, and international adoption can provide that. But then, someone asked the question- how much did you end up spending? Their answer? $80,000. Granted, they adopted two boys, which pretty much doubles the cost, but still. We don't have that kind of money. And we never will. So, back to the cons on adopting. 

Disappointed, I began researching domestic adoption, both through an agency and through our state's foster system. After speaking with a friend who was brutally  honest about adopting 4 kids through the foster system, I knew that route was out. For many reasons, the top one being that my son has to be my first priority, and fostering could be devastating to him. Then I spoke to a friend who has adopted a domestic infant through open adoption. Maybe we could handle that, but the risk of laying out all that money and having the birth mom change her mind- well, we can't afford that. So, back to infertility treatments we went. 


This week, I read this wonderful book:

It was an honest look at adopting both domestically and internationally. It was a bit churchy for my taste, but otherwise it was chalk full of good info. The author shares her story of open adoption, and my mindset on the idea shifted a little. Enough so that I filled out an application for an open adoption agency nearby, but have no submitted it. But it's a step.

If I could have my way, we'd adopt internationally, and we would've started the process a year ago. But the reality is that, to adopt anywhere, we would have to save/raise $30,000. I've researched adoption fundraisers and grants, but I don't see how we could do it. It doesn't mean I won't try. I'm starting to save a little here and there, I'm listing things on craigslist.org and Ebay to put a little money in the bank, but until we pull the trigger and decide to buckle down and do everything in our power to adopt, I have to give IVF a try. 

So, the decision is made, I guess. We'll see what my husband has to say, but I think it's IVF or bust for now.

On the One Hand, IVF

IVF is one of those things that happens to other people. Not me. Not us. But yet, here we are, contemplating IVF. It's hard to wrap my mind around. Knowing that our only option to have a baby may be one fraught with hormones, needles, petri dishes, and a multitude of doctor's visits is somewhat unsettling. After three losses, I find it hard to believe it will work. I find it hard to believe anything will work. But Dr. Fertility laid it out- after this IUI, it's IVF or bust. 


I've been wrestling with the different emotions pertaining to IVF, and I finally decided to sit down and write a list of pros & cons, the good old-fashioned way. 


So here goes: 


PROS

• Could result in a biological child
• Mostly covered by our insurance plan

CONS

• May not result in a child
• May result in multiples
• May result in another loss
• Will subject my body to hormones, medication, injections, and surgical procedures
• Will cost a good amount of money out of pocket, even with insurance

No matter what, my con list is always longer than my pro list. But the two things on the pro list are pretty heavily weighted. I know if we don't try IVF, I may regret it later. Especially since most of our treatment will be covered by insurance. How much, I don't really know- finding out is on my "to do" list. 


I know how tired I am of the infertility treatments right now, and we're only treading on "light weight" status with the IUIs. I'm not sure I can handle what is to come with IVF. Not sure about anything. I know for some women, being pregnant and giving birth to a child is all that matters. To me, and maybe it's because we do have one biological son and because we've suffered through three losses, I'm more about the child. I don't really care how we add to our family, I just know we're not complete yet. 

I basically now have three weeks to decide what we do if this IUI cycle fails. I have to schedule a pre-emptive IVF consult next week because the whole pre-IVF stuff has to be laid out in advance, I guess. I don't know if I can make this decision that fast, but I do know that I want to be done with infertility treatments the second we ring in 2011. I want to be done with this part of the journey, one way or another. 


So maybe that's my answer. Give IVF a try until December is over? Sigh.

First Comes Love, Then Comes Marriage...

Like everyone else, we thought the next part would be simple. And surprisingly, for the first child, it was. I conceived while on birth control pills, a simple and uneventful pregnancy that brought us so much joy. We hadn't been trying, hadn't even been thinking about a baby, but yet, there he was. 9 months later, Evan was born via c-section, his little self meeting the world butt first. I was 27 when he was born. Six years later, I cannot imagine life without him, nor could I have imagined the journey for our second child to be so fraught with difficulties. Our official diagnosis is Unexplained Secondary Infertility. 

It all began about 4 years ago, when our son turned two and we decided to stop all birth control and just see what happened. I wasn't all that disappointed when we didn't get pregnant right away, with my son in full throes of toddler tantrums and in the middle of a move to a new house. But once we were settled into the new house, my biological clock kicked in, and we were in full "trying" mode. For a while, nothing happened. After 8 months, I had my annual gynecology exam, and at the time asked the doctor for some help/advice/insight. This older doctor asked my age (29), laughed it off, and said "you're still young. Be patient. It can take up to a year to conceive." But it had been a year. Well over a year without being on the pill. I was upset with his indifference to my concerns, but how ironic that a week later, I had a positive pregnancy test! I was in shock, and we were so excited! It was just before Valentine's Day, so we bought our son a shirt that said "I'm the Big Brother", took an adorable picture, and doctored the photo up to look like a Valentine's Card. We then sent it to our family without even a thought as to how early it was in the pregnancy. I felt great and we were on cloud nine! 

A week and a half after we sent out our Valentine's, I felt a giant cramp tear through my lower midsection, and immediately knew it was bad. I went to the bathroom, looking for blood, but it wasn't there. I tried to breathe, tried to reason, but I knew in my heart it was bad news. That night, I began to miscarry, and my doctor's office had me go to the ER. By that point, I had bled so much, I knew that there was no way they were going to find any hint of a pregnancy on ultrasound, but still they tried. There was nothing. I spent several weeks beating myself up about shoveling the snow, drinking caffeine, and thinking of every little thing I might have done wrong. My family was supportive, and we had only told a couple of friends who were so great during that time, but I have never felt so alone. The grief of what might have been was heart-wrenching. Meanwhile, everyone and their sister were getting pregnant or having babies. We had to endure "so, when are you having another??" about a million times. 

After we were given the all-clear from our doctor, we began trying again, assured that it was a fluke and that the odds of it happening again were slim. I began my research flurry, learned how to chart my cycles, invested in Ovulation Predictor Kits, read every book I could get my hands on, and changed my diet. I even found a wonderful support group of women who were going through very similar situations on a site called Two Week Wait. I even submitted to having myself poked with needles 1-2 times a week via acupuncture to try and heal my body. I tried Yoga and breathing exercises. I was determined. 

Acupuncture has proven to increase odds of conception in some studies!

Four months later, we conceived again. This time we told no one, save for the girls I had become good friends with in my support group. A week and a half later, another miscarriage. More devastation. I was then referred to my gynecologist's "Fertility Coordinator" within my Obgyn's practice. I was run through the gamut of basic infertility testing- hormones, white cells, antigens, and more. All normal. I suffered through a sonohystogram to make sure my tubes weren't blocked or I didn't have other abnormalities- all normal. And low and behold, when we went to our first official consult when all the results were in, I brought with yet another positive pregnancy test. Ecstatic, the Fertility Coordinator drew my blood to test for HCG, only to deliver the news two days later that the level of the HCG hormone was not very good. I already knew that, however, because I had been testing and testing and testing- the lines on the test growing fainter instead of darker. Chalk up miscarriage #3. 

Because we had conceived 4 times on our own, the Fertility Coordinator didn't feel the need to have my husband, Russ, tested and we began our experiment with fertility drugs. I found the entire process daunting, which was not helped by the fact that the "Fertility Coordinator" was not very coordinated at all. Nor was she ever available. When we first met, she told me I could email her "anytime! My phone (shakes phone at me to prove point) is always on and I can always access email!". But emails would go unanswered for days, or sometimes more. The ultrasound tech went off on a rant on the Fertility Coordinator to me, the patient, during one appointment, while I was on her table. I think that was the final straw. That, and the hormones made me a complete lunatic. I mean, completely Coo-coo for CocoPuffs crazy. I had a sobbing fit over my son spilling water in the basement. As I bawled on the floor, I just told him over and over again that it wasn't his fault, and that mommy just didn't feel good. That was it. I was done. I wasn't doing this anymore. I told her we were done with treatment, and we went back to trying on our own. Over a year later, we had not gotten pregnant, not even a little. 

Early in 2010, I was talking to a fellow mom at my son's TaeKwonDo class, who happens to have twins that are my son's age. We got to talking, I asked about the age difference from her oldest son and the twins, and she offered up the information that her twins were conceived through IVF. And so the conversation started about our journey, and she gave me the number of her reproductive endocrinologist- a doctor at the Fertility Center of Illinois. It took several months for me to finally get up the nerve to schedule a consult, especially with the terrible experience at my own obgyn's office, but I did. The day of the consult with Fertility Center of Illinois, I was shaking with anxiety, sick to my stomach with the nervous adrenaline rushing through my veins. Within 2 minutes of meeting our Doctor- I like to call him Dr. Fertility- I felt my entire mind melt into his hands with trust and relief. He was now in control. And it was a very good and reassuring experience, not to mention, it was night and day from working with our obgyn's office. I breathed a sigh of relief, and fertility treatment part two began.

Infertility testing means giving lots and lots of blood. Lots.

One of the huge differences between the Fertility Center of Illinois and my obgyn's office was the staff. Holy geez, the staff is worth their weight in gold. You're never bothering them, never asking the wrong question, never calling too often. They are kind and patient, and since infertility is all they battle, they are ALL on your side. It's an amazing feeling, and I wish we had started here first. We went through $4000 in testing, thankfully all covered by insurance and a state mandate to cover infertility diagnosis, all of which was normal. We found out that I have one copy of the MTFHR gene, which is a disorder that makes it difficult for your body to absorb folic acid, but it only causes problems when you have two copies of the gene. To be safe, I take extra folic acid, but the doc assures me it has nothing to do with three failed pregnancies. Once the testing was complete, we were onto Intrauterine Insemination (IUI).

There is nothing that brings you closer as a couple then asking your husband to put his swimmers in a plastic cup and drop them off at a doctor's office for you. The one thing we've learned as a couple is the need to laugh. If you don't have a sense of humor, don't bother with infertility treatments. With infertility treatment, you will soon have no qualms about having strange people see you naked on a regular basis, talk about reproduction as if it were a baked potato with dinner, and having yourself poked and prodded and drugged with hormones several times a month. There is nothing romantic about any of it, and nothing like literally putting the fate of your family in someone else's hands. We have had three IUI's now, none with success.

We are now on our 4th and final IUI cycle. Dr. Fertility will not allow anymore, and for good reason- it's a waste of money.

We now have a difficult choice to make... onto InvitroFertilization (IVF) or onto Adoption?