Feb 26, 2011

Million Dollar Children

Yesterday, I was searching for one of my favorite recipes "Million Dollar Chicken", dubbed as such because it won the million dollar prize in the Pillsbury bake-off several years ago (by the way, here's the recipe, it's really easy and totally awesome). Well, at least I thought I was searching for million dollar chicken, that is, until I realized I had just performed a search for "Million Dollar Children." Umm, what?! Somehow this is strikingly similar to a month or two ago when I posted on this very blog that I had "fried the motherhood" (of my laptop).

And Y thinks I am a bit unhealthily obsessed - really?! Do you have any of your own cringe-worthy IF Freudian slips to share?

Feb 21, 2011

In a fertile world of self-appointed fertility experts...

First off, happy February ICLW and welcome to anyone stopping by for the first time! Before I get to the real topic of this post, just a quick update to say that I had IUI #5 yesterday and I can't really put my finger on why, but I just have a good feeling about this cycle, so here's hoping for some good news in 2 weeks!

I've noticed a lot of posts springing up in the IF blogosphere lately about the decision to be open or private about IF treatments. Of course, completely open to completely private spans a wide gamut of in-between where I believe most of us probably fall. I don't see it as an all-or-nothing decision to keep your IF struggles private or to be open about it - while I am on the private side in 'real life', for me the decision of who to share with and how much to share with them is definitely very context- and situation-dependent.

All of this talk about the choice to be open about your IF journey got me thinking about what holds me back from sharing more. I realized the number one thing that drives me bonkers about being open about my issues is that in my personal experience, every woman who has successfully reproduced regards herself as a fertility specialist and therefore, more capable and clearly informed in the issues of reproduction, than me, their pitiful and woefully reproductively unsaavy pet project/friend/co-worker/daughter etc. This is especially true among women who had to, at one point, engage in the trying aspect of trying to conceive for more than 3 minutes (and by 3 minutes I mean one cycle) and therefore, believe they 'get it'. If they are especially saavy, they might tell me about this miracle pill called Clomid that their ob/gyn prescribed.

I find it particularly striking that when IF comes up in conversation (and again, I am not such a big sharer, so I am drawing upon a fairly narrow set of experiences), no fertile woman has ever just said to me "I am sorry" or "that really sucks." Instead it by default becomes a teaching/learning opportunity for them in which I am expected to assume the role of the helpless childless chick while they enlighten me on how I must relax or try this great pill called Clomid or this great pee stick called an OPK and comiserate with me about what it was like for them to be in my shoes. (I am not trying to minimize the tribulations of the normal TTC experience - I know that BFNs suck no matter what the cycle number, but at the same time I resent the assumption that by virtue of not having been successful, I must be less informed, when I spend such an exorbinant amount of time learning about and obsessing over every detail of human reproduction.)

I think it is interesting how us IFers are encouraged to be more open to spread awareness, yet whenever the topic comes up, it is I who is being made aware and supposed to learn from my fertile counterparts. I guess it makes me angry at myself that I allow that to be the dynamic - that I smile and nod and graciously accept their advice. Obviously, if another infertile who had been successful was trying to give me advice or comiserate, I would be grateful and inspired, but I haven't had the privilege of such an exchange yet off of the internet. The irony is not lost on me that if I were more open about my infertility, I would likely find kindred spirits among my circle of friends and acquaintances!

Feb 13, 2011

great expectations

The summer I was 17, I got my first lab job. I owe a lot to the principal investigator who was open-minded and altruistic enough to hire a high school student for the summer, and I can definitely say that the two summers I spent in his lab heavily influenced my choice to become a researcher and not go to medical school (gasp!).

One thing M. said to me before hiring me was that I needed to realize what doing molecular biology on a daily basis was all about - basically mixing miniscule amounts of things that look like water with other things that also look like water. He just wanted to make sure I had realistic expectations of what I just signed up for. He said, from his point of view, my happiness in lab that summer and perhaps with science in general, would be dictated in large part by the distance (or lack thereof) between my expectations and reality.

Many years later I still hold this little nugget of wisdom as a universal truth - the closer your expectations align with reality, the more content you are likely to be with your current situation. You can probably see where I am headed with this, but in no other experience in my life, has the distance between my expectations and reality been any further than in our quest to start a family.

A lot of my frustration (and even sadness) seems to stem from repeatedly, again and again, failing to meet my expectations, Y's expectations, the expectations of our families, and yes, even the expectations of our doctors when it comes to getting (and staying) pregnant. I am sure my story of chronic failure to meet these expectations is relatively common, especially among those of us who arrived here with no suspicious histories and no other warnings.

When we started TTC at 25 and 33 with no history of previous problems, young and healthy as they say (currently 27 and 35 and still young and healthy), we were both quite confident that within 6 months of well-timed intercourse, we'd be expecting. After one cycle, even two, it was still easy to believe that we were just swimmingly fertile but so far unlucky. After 6 months, the nagging, suffocating feeling that maybe we weren't like everyone else and this wasn't going to be so easy, set in. Still, I took great solace in all the women I met on TTC message boards who got pregnant after 8, 9, even 10 months of earnestly trying - if they got pregnant, so could I.

As a year began to close in on us, we knew that we wanted to do some initial testing. We left our first appointment with the RE feeling about as optimistic as we had the first month we started trying. While other people left their first RE appointments downtrodden and depressed, being told they were "officially infertile" and had a difficult road ahead, we left happy as clams and confident that our problems were something a few Clomid and a bottle of wine could easily fix. With our own expectations long quashed, our RE had great new expectations for us. He mapped out on a sheet of paper the number of couples with no previously diagnosed problem unable to conceive within a year. He told us that among women my age like myself, in his experience, 80% would get pregnant within a few Clomid+IUI and FSH+IUI cycles. It was only the straggling 20% who would ultimately need IVF to conceive.

And for a brief time, we did meet both our and someone else's expectations, when I got pregnant following my 2nd IUI. Again, after our first ultrasound, we were reassured that the chances of a miscarriage were quite low - we had expectations that we would keep this pregnancy. Of course those expectations went out the window, too, once we learned our baby didn't have a heartbeat a few weeks later. After that, the RE was quite confident we would be pregnant again in no time.

Needless to say we are on our 5th IUI and still nothing (and my implication certainly isn't that 5 IUIs are a lot in IF World, but rather that it again falls short of the expectations that were perhaps unfairly set for us personally). Oh, and that pesky myoma I was initially told not to worry about? Apparently I should be concerned enough now that it is not in fact subserosal and needs to likely come out in the next year.

Y gets exasperated by my perpetual "what-ifs", my constant need to always have some worst-case scenario tucked in the back of my head. I get exasperated by his unwavering optimism, his genuine belief that next cycle is always the one that is going to make our dreams come true. I believe that such unwavering optimism can be dangerous eventually, that it can blind you from the truth and keep you steadfastly devoted to a path that no longer logically makes sense (I do not believe that this is happening to us yet, but if we are still without baby or viable pregnancy in a year, I would be ready to consider adoption, whereas Y seems unable to even contemplate giving up our dream of a biological child, even if it means endlessly cycling like a hamster on a wheel).

I get so tired of constantly failing everyone's expectations. If at any point, someone could have looked me in the eye, whether it be my husband, my parents, my doctor...whomever and could have said to me that this is going to be very hard and we have no idea when it will end or what the resolution will be, maybe I would feel much better about the state of things. Then if I succeeded, I could think that I beat the odds, I could believe that this is my miracle baby, instead of every single time being reminded that once again I have failed miserably to meet the basic expectations set out by someone else.

Feb 9, 2011

my surprise hysteroscopy (there are better types of surprises)

As predicted, AF came right on time yesterday. I went in this morning, expecting to just find out my dosages and instructions for IUI #5 and then be on my merry way, but IF World (it reminds me of this giant toy store "Child World" that we had near us growing up) had other plans for me today. Back when we started doing monitored cycles, the ultrasound technician told me I had a myoma. Since the ultrasound technicians regularly measure it, I knew that it had been growing slowly. However, a few months ago when I asked RE 1 about it, he said not to worry about it.

Today RE 2 decided we should do a hysteroscopy to see whether the myoma had penetrated through the uterine wall. The hysteroscopy itself wasn't so bad (and I was shocked they squeezed me in right away, as well as grateful since it gave me less time to be anxious), but it was just slightly awkward given 1) I am bleeding because I am, you know, in the middle of my period and 2) the crowd of 4 that convened around the circus attraction that is my uterus. RE #2 felt the compulsion to make casual conversation with the resident and med student who had assembled around him about my famous PhD advisor (also in the same medical school as the teaching hospital where the fertility clinic is located) lest I retain any anonymity.

The grand conclusion was that they could in fact see the myoma on the inside of the uterine cavity meaning that it had invaded through the wall, but only minimally. RE 2 said that it probably needs to come out eventually, but that I can wait until a failed IVF or successful pregnancy (whichever comes first) before surgery.

I expressed my disappointment about only having one lousy follicle last cycle, but he recommended that we stay with same (low) dose of FSH for this cycle, since from my experience with Clomid he knows I am very easy to over-stimulate. I am feeling pretty sad and despondent in general lately. I guess by IUI #5 I feel like I am hanging around in IUI purgatory biding my time this cycle and next until our health fund will fully cover IVF, if that makes any sense. Obviously it would be amazing if I got pregnant in the meantime, but I don't know how realistic it is, especially since they aren't willing to get any more aggressive with the FSH until we move on to IVF.

I have a lot more to say, but I think I have already gone on at too great length, so I will continue these thoughts soon...In the meantime, lots of congratulations and good vibes for a sticky baby and a happy & healthy 9 months to those who recently got good news, and many thoughts and prayers to everyone who is struggling and waiting.