Tears of joy

So I thought it had all sunk in nicely overnight, and decided bravely to call my folks long distance with a "Hey, guess what!" to have them share in our excitement.

My dad, who is - aside from my dh - the sweetest man in the whole world, answers the phone. "Hi dad, is mom there too? Could you get her on speaker phone, because I have some news." My mom comes to the phone and instead of telling them about the surprise IVF cycle start, I get so verklempt that I can't get a word out. I hand the phone to hubby, who promptly tells them the basics about the IVF and sperm aspiration without missing a beat. It sounds like he's talking about the weather, only more excited. (I told you, I have a great husband.)

All of this, while I sob and smile and nod and wave with my hands in front of my eyes - the way Oscar winners do - in an effort to compose myself. Hubby comes and sits next to me on the sofa and puts his arm around me while I cry with joy - and he talks to my parents. I managed to get a few incoherent sentences out, but by the time they were saying goodbye and "We love you, we miss you, we wish we could be there with you," the next crying fit started.

After years and years of waiting and anticipation, the moment of telling my parents that we've started IVF was simply too big. They have known from the very beginning that we may never give them grandkids, they have never pressured us, or asked us whether we were making "progress" on the baby front. They love my husband like they do my siblings and I. He is their son.

I have the most amazing and selfless parents, who have always been supportive of me, whatever the path was I chose. Through all of the infertility struggles, my parents have just listened, asked questions, encouraged me, and said, "We love you." I wish I can be the same kind of supportive parent to my soon-to-be kid(s).

All in a Day - IVF/ICSI cycle #1 starts

The thing about relinquishing control is that life sometimes just magically works itself out, without my intervention. Sometimes, it's best to take my sense of reason out of the equation and just go with the flow. Today was such a day.

My plan was to go for a consult in March. Then the fertility clinic called and said, "We had a cancellation. Can you come on Monday?" I have always been impatient, and even more so where IVF is concerned. So, of course, I jumped at the earlier consult.

AF, usually as regular as clockwork, started two days late, and there I was, going in for a consult on day 2, and beyond all expectation, coming home with a protocol, prescriptions, and instructions to start a fl.are protocol TONIGHT. It's a beautiful thing, really, when you're in your thirties and have Endo, not to have to wait one nanosecond longer.

The doctors were contemplating the best approach and protocol, and the one said to the other, "She's ready, man. Look at her. She's ready." And so I was. In that moment when it became evident that I could start today, the weight lifted from my shoulders. The waiting is over, and I'm entering the next phase. I am suddenly feeling at peace with it all.

Hubby is beaming. I'm beaming. We're really doing this and it's not as daunting as it seemed a week ago. Now there's no turning back, and I'm okay with that.

On my way to buy the meds, I turn the radio on, and hear the ending of a song, "today... today... today." No kidding. Today. It's been an unpredictable day already, and it's only the beginning. It takes an hour to get the prescriptions filled, and they don't have it all, but I don't even stress about it. As long as I have the meds for tonight, I'm fine.

I switch the radio on as I drive to work, and hear, "Make a wish, take a chance, Make a change, and break away." No time to ponder the song, or bond with my box o' meds, as I'm late for a meeting. I grab an opaque bag and shove the meds in the work fr.idge. After the meeting, I retrieve the stash, and rendezvous with dh in a parking lot to do a covert meds handover as I head into another meeting. He couriers the meds home, while I focus all the attention I can muster on the meeting.

It's 8 p.m. when I'm finally home and can start to process the day, and figure out tonight's injections. Let the fun and games begin! The 2 shots (lupr.on and gon.al-f) were easy and painless. Now that I've spent months reading everything and educating myself, I can let go and just do this thing.

It's a crazy horse. But somebody's gotta ride it.

Obsessing about IVFing

Now that I’m forced to wait, I realize I’m getting utterly and joyously obsessive. It’s as if I have IVF OCD. I have read every IVF/ICSI blog I can lay my hands on, subscribed to IF forums, and have Go.ogled the heck out of every protocol on the planet. I have sobbed when reading about cancelled cycles, BFNs, and m/c as if they were my own, and have basically spent every waking moment thinking about IVF.

I’m at the point where I get annoyed if my husband dares ask me about anything else.
Him: “What would you like to do tonight?

Uhm, let’s think about this for a second.

Me: “Read about gonadotropins.” (I say this deadpan.)
Me (distracted, after a minute or so): “Why? What would you like to do?”

Then he sighs softly and walks away towards his laptop, kind of sulking, kind of relieved that I’m not engaging him in a discussion about Go.nal-F. He knows I'm hyperfocused, and he knows I need space. This is why I love him. He gets me.

I’m not really dreaming about a child(ren) as much as I’m thinking about IVF and its impact on our lives. Contemplating what I’m about to do, and how I feel about this point of no return that we’ve been approaching for ten years. IVF has been a vague possibility for all these years, something we’d get to when the time was right. But the time never seemed right, and now, suddenly it’s here, and in focus. And coming at me fast.

If we don't try IVF, we'll never know. And there's some comfort in not knowing. It keeps the hope alive.

I’m overwhelmed by the thought that I’ll finally know whether it’s possible for me to have my husband’s child(ren). I’ve always believed that if we had “intervention” in the form of IVF, we might just be able to realize this dream. I now know that if it doesn't work, I’ll be devestated, not only for the BFN, but for the whole belief being proven wrong. For being so stupid as to have believed that it might work for us.

Soon I’ll relinquish the last 1% of control (or the illusion of control), and just do. Just be. Just breathe. I’m at that tipping point where my destiny is to be revealed.

Murphy's Law of Infertility

Trying to be discreet about IF at work is an exercise in futility. The RE hardly ever calls me back, and my boss is hardly ever in my office. However, these two universes are *guaranteed* to collide the moment the boss pays me a visit about something urgent.

I had to excuse myself today, grab the cell phone, and head outside, because where else can you say things like, "sp.erm aspiration," "transvagi.nal ultrasound" and read a list of VDs you tested negative for aloud, and still act natural?

Then there's technology. Try staying calm while you order *all* of your medical records to be faxed to you, stat. First, the nurse has me on the cell because of the obvious privacy concern. Instead of dialing the fax, she attempts to fax it to my cell. I should have just quit right there.

Me: "Uhm, I hear a call coming in, and the ID is blocked. Is that you calling me?"
Nurse: "No, I'm dialing your *fax*. Oh, wait. I can hear your voicemail.... That's strange."

Duh!

She tries again and one page comes through on the fax.

Me: "Good, you got it. That's the right fax number."
Nurse: "Okay, I'm sending the rest now. Stay close to the fax. Let me dial again."

Then my cell rings AGAIN. "Wait. Hang on. Are you dialing my cell again?"

Nurse: "No, I dialed your fax number! This is really strange." (She's starting to sound perplexed.)

She tries again, and the fax machine begins spewing out 30+ pages of my not-so-sacred medical history. Of course, there's a hiccup. It runs out of ink in the middle of it all. I mean, why on earth would I have anticipated this to be quick and easy?

I quietly replace the ink so as not to draw attention to the lengthy illegitimate fax, only to have the fax machine's alignment function go belly-up. One co-worker lurks, trying to see what I'm up to, while another leans over and catches a glimpse of my sad ovaries as she tries to help fix the issue.

Throughout this ordeal, I'm still on the cell trying to get the doctor's office to resend the fax. Another colleague has now entered the office and is looking at me pitifully and puppy-faced, non-verbally asking my help with the copier that is busy eating multiple pages of her project. I lean over and unjam the thing, while talking to the nurse, and then proceed with my stealth faxing maneuver.

Next time I'm trying to do anything personal during my lunch break, I'll be sure to send out a memo. It may contain words like, "scro.tum" and "test.icle." In fact, you can bet on it.

Uro-logically Speaking

Dr. Hopeful said hubby is a young and healthy almost-half-century, and that in his esteemed medical opinion, he'd be "very surprised" if dh's "good sized" right testicle didn't yield a gazillion sperm. Dh is in excellent health after all, so why am I doubting this will all work out in the end?

He must have keyed into my hopelessness and overwhelmedness with the entire process, because he ended with, "This is exciting," as if to say, "I'm giving you permission to be excited, because the odds are good." Of course, he couldn't - and didn't - say that.

Besides, any amount of time spent on blogs and IF forums informs me the chances of conceiving on cycle #1 and carrying a baby or babies full term are remote - and I'd be foolish to hope for that when the babymaking battle scars are to be seen everywhere I turn.

I've always been a pretty realistic person (as opposed to a fatalistic or overly optimistic one), so throwing that realism away won't be happening anytime soon. I will, however, try my best to conjure up a bit of hope and a smidgen of excitement.

More Funny Business

Infertiles know there's nothing sacred about conceiving with ART. I've had to expose myself to so many u/s techs, doctors, REs and nurses over the past few months that I don't even worry about what I wear to the doctor's office anymore. I mean, I'm going to be naked half the time anyway, so who cares. There is no room for privacy, let alone bashfulness.

I thought I had been doing a stellar job of relaxing while exposing myself in more ways than one, and talking about the most intimate details of my life. But the universe had a surprise in store: I discovered this process can also be... funny. Now I know "humor" is not generally a concept associated with visiting any medical professional, but trust me. When you're infertile, you take humor wherever you can find it.

I haven't found much to laugh about lately, and the last place I anticipated cracking up was accompanying hubby to an urology consult. I mean, can you say, "a-w-k-w-a-r-d."

In search of a second opinion, hubby and I visited a remarkable, intelligent, wonderful board-certified, Harvard-trained, specialist who - with all the compassion and warmth in the world - also found ways to sneak the funniest punch lines into the conversation. But this doc, as amazing as he is medically, surely missed his calling as a standup comedian.

So, while hubby is in the other room still fastening his belt, the doc comes back into his office where I was waiting and says to me gently and compassionately, "The men have it so easy when it comes to IVF." He paused, and with impeccable comedic timing, says, "So, you should really bug him about going for a prostate exam soon." I about died laughing, and all I could get out was, "There is justice in the universe after all."

This doc may be a man, but he sure as hell gets it, all of it: the stress, the injections, the violation of the female body. And he may be focused on guys all day long, but he has the ability to see the world from a woman's perspective. The world sure needs more specialists like him.

Farming Out

It's quite the concept to farm out the most significant and life-changing experience to a group of REs, embryologists, nurses, pharmacists, and goodness knows who else.

I've known for more than a decade that IVF would be in my future, but the closer I get to it, the more I'm mourning the loss of conceiving "normally" (whatever THAT means!) I'd like to think I'm totally over the lack of romance this process entails, but maybe I'm not. I'm really resentful that it will take an army of specialists to make an embryo in a petri dish, and that it might not work despite everyone's best efforts. Dh's sperm won't even get to "swim" to fertilize the egg, for heaven's sake. It'll be shot straight into the egg, if we're lucky enough to have eggs retrieved for ICSI, that is.

Some days, I just want to shout from the rooftops, "Why does this have to be so $%&* complex and expensive?" And then the internal whining, "It's not FAIR!" Ugh. I know, I know life's not fair. But honestly, IF just sucks in so many ways. Sometimes I want to give up before I've even tried, because of all the "what ifs." It's beyond daunting, and running away seems like a perfectly reasonable response.

Healthy - With a Vengeance

In anticipation of the upcoming IVF cycle, I've forced myself to start exercising again. Getting into my gym clothes and onto the treadmill seems to be the toughest part of the exercising routine. Especially since all I really want to do is cry and sleep, in that order. Or, on a good day, sit on the sofa and read every blog post and forum about IVF experiences and protocols (which often leads to more crying).

Once I'm on the treadmill, however, the anger and frustration with, and injustice of, IF could keep me walking, forever. Spinning infinitely and seemingly getting nowhere but exhausting myself... it closely resembles how I feel about this infertility path, actually.

I've recently been on a total health rampage. Exercising with a vengeance, drinking daily vitamins, eating better, fresher, healthier meals. I suspect it has little to do with the honorable goal of preparing my body for IVF and a possible pregnancy and more to do with exerting control over the 1% of my life I still have a semblance of control over while the rest is slipping away into this infinite pit of IF despair.

Totally Normal

At last, some hopeful news on the IF front. My RE called today and left a voicemail saying my FSH of 3.4 and estrogen levels look "totally normal." I don't recall when the last time was that I heard any good news on the reproductive front. I've been expecting the worst - it's a coping mechanism learned through many disappointing interactions with physicians and surgeons these last few months.

But today I could actually hear my RE smiling as she left the voicemail, and it made me relax instantly. Finally, things are looking up despite the Endo, the surgery, and my age.

Caffeine Highs and Lows

Cranky doesn't begin to describe it. I've been slowly cutting back on my favorite cup o' Joe in the morning in anticipation of IVF cycling, and today, I bravely kicked the habit completely.

Frankly, if not for coffee and chocolates, what else is there to look forward to in a life consumed by doctor's appointments and work? But my Starbucks and Illy addiction is sadly no more. I tried replacing it with a cup of tea this morning, but blegh! Suffice it to say that it's NOT the mama.

I used to favor tea over coffee every time. In fact, I never used to touch the caffeinated stuff. But after I met dh, the coffee ritual became a sacred part of our mornings.

Giving up coffee is a small enough price to pay in the pursuit of a baby, I guess. After all, if we're going to spend tens of thousands of dollars on a petri dish miracle, the least I could do is give up coffee. Dh drank coffee this morning and beer tonight... It's not even worth giving him the evil eye, but hey, *somebody* has to look after those precious, expensively retrievable sperm.

The Waiting Game

We’re just waiting. Waiting for FSH results, waiting for hubby’s appointment, waiting to make an appointment at the local clinic, waiting to cycle. I almost lost it when hubby told me he might have to reschedule his appointment because of his work schedule. With everything hinging on this one appointment, I wish he’d just get it over with so we can move on to IVF, and fast.

Are My Eggs Cooked?

I drove to the nearest Quest lab this morning to have my FSH, LH and Estradiol tested. Let’s hope my ovarian reserve looks as good as my RE said it did after looking at the “many follicles” during my u/s. I can’t handle more bad news right now.

If my FSH is over 9, then the news is not only bad in terms of ttc, obviously, but it’s a double whammy because we won’t qualify for the shared risk insurance option down the line. My mom was 39 when she gave birth to my brother, and I’ve read that one’s mother’s fertility clock can be an indicator of one’s own ovarian reserve. I’m cautiously hopeful.

A poster on one of the forums mentioned a clinical trial in NYC. I completed their pre-screening evaluation, so we will see if anything comes of it. They are comparing different IVF protocols. My RE reckons I’m at risk of OHSS, so mini-IVF wouldn’t be objectionable. I wonder if MF is reason for disqualification. We shall see. I wouldn’t mind a free IVF cycle.

A Visit From the Finance Fairy

I spent the entire day obsessing over our finances, but think I’ve started to figure it out. I applied for my free credit report from https://www.annualcreditreport.com/cra/index.jsp
and applied for a free trial from http://www.myfico.com/ in order to get my credit score. Then looked into a gazillion credit cards, and finally settled on Capital One’s because it had a 0% interest for 12 months, plus a low APR thereafter.

With our savings ($4,000), my pretax flexible spending account for healthcare ($1,800), our employee retirement contributions ($1,000/month), and the extra money we usually put into our mortgage, we may just be able to afford MESA and have enough for the downpayment round of IVF #1, interest-free. Not having to apply for financing for round 1 would be wonderful. We’ll put the meds on our credit card, and pay it off within 3 months. Then, early next year, we’ll claim anything above 7.5% of our adjusted gross income from the IRS, including mileage, hotel, and other medical expenses, like dental, vision and co-pays. (Minus the $1,800 for the flex spending account, of course.)

Ladies and gentleman, we have the beginnings of a plan. Thank you to everyone who posted financial info on all the various IF forums, this “plan” could not have materialized without input from those in the trenches, and my friend, Google.

The idea is to do as many cycles in one year as our credit, time and health will allow, because then at least, we can recoup some of the cost. Since we’re self-pay, we have to do this smart. Not only that, my Endo will grow back, and we therefore have a window of one year of “optimal fertility” to work with. And then there’s my age egging us on, so to speak.

If IVF #1 doesn’t work, our round 2 plan is to buy a $20k shared risk plan (if I qualify), or to go to Cornell. It’s too early to know, but I guess our decision will be informed by how MESA goes, and how I respond during our first cycle. It kills me that the economy is limping along just as we embark on this journey. Our timing just sucks. I wish we had started when I was younger.

PM$

My fighting spirit is back this morning. I have PMS and I’m pi$$ed off, so give a wide berth. No gold digging surgeon, no matter how amazing he is, will keep us from realizing our dream. I scour the infertility forums for more information on MESA costs and find nothing useful. Come on Dr. Google, throw me a bone.

Someone posts saying their urologist charges $4k for MESA and he’s outside NYC. Glimmer of hope. Dh makes an appointment while I look into a fertility clinic an hour’s drive away. I like the local clinic's shared risk and no-interest packages, but I hate their stats. I guess you get what you pay for. We have to at least try before we give up. It makes sense to exhaust the cheaper options before me move on to the big guns.

The Clock Stops Here - And So Does the Buck

On our way home from work, hubby tells me his doctors fee will be $10,000 for MESA. That doesn’t include the anesthesia or hospital fee, or any other incidentals. I walk through the door to our house, my beautiful watch that hubby bought me for my birthday two years ago breaks and falls from my arm as I’m unloading the groceries.

Dh meant to replace the watch for my birthday, but never got around to it. It hits me that I can’t even afford to spend the $100 to replace the watch because we’re saving every damn dime for this ridiculous roulette that is IVF/ICSI. So, no birthday present or Christmas celebration, just the surgery, and the painful realization that I’m a year older, still have no child(ren), and awaiting my next period.

I throw the stupid broken watch against the wall, slam my bedroom door out of sheer frustration and disappointment, and weep for hours until there’s nothing left. It’s not the watch, or disappointment around the holidays, or PMS, or hubby.

I'm so angry all the time now. Each setback, health, financial, or emotional, hits me harder than the previous. I have no reserve. I’m hovering between despair and disappointment. My dream of a family is slipping away. We take a few steps forward only to slip farther back. And I feel he just doesn’t get the urgency. I’m constantly “on” him to make a doctor’s appointment, find out information, request medical records, get the questions together, etc.

There’s just no proactiveness in him and it drives me crazy. He’s totally laid back and I’m all type A control freak. Usually, that works for us. He mellows me out. But clearly not when it comes to IF. I’ve sat back for a decade thinking he’ll step up to help me figure all of this out, because he’s the one who had the failed VR. But I’ve finally realized it’s going to be up to me.

So step away slowly. I’m driving this trainwreck now.

To Cycle or Not to Cycle – IVF Is the Question

We have not arranged financing, called the nurse coordinator to make an IVF orientation appointment, or had my FSH levels tested to check my ovarian reserve. We’re in a holding pattern. All of this will need to happen in January, but for now I’m enjoying the “lull” after a year of intense pain, three months of blood tests, transvaginal ultrasounds, surgery, and post-op appointments. I’m reading to prepare for what lies ahead (can one ever really be prepared?) , healing from the Endo laparoscopy, and generally just trying to take a break to enjoy the holidays. We will need to wait until February to cycle. In the meantime, we are faced with the “Do we really want to put ourselves through this?”question and “Can we really afford it?” The answer to the first question is, “No, but we have an irrational, biological need to procreate and IVF/ICSI is the only way.” The answer to question 2 is, “No, but see answer to Q1.”

My clock is ticking louder every day. Birthdays and periods certainly don’t help to take one’s mind off the topic. I’m increasingly facing a deadline and realizing it’s “Now or Never.”

Hubby seems distant, sulking, disinterested. I suspect he’s in denial about it all and I’m getting angry because he is unwilling or unable to express his feelings. I know he’s having a hard time with the details, but he’s such a pragmatist that I can understand that he comes across as disinterested. To his mind, it’s “Let’s just do it. No point in procrastinating, or reading all there is to know. It is what it is.” I interpret his laissez faire approach to mean that he doesn’t care. Which I know isn’t true. It just bugs me that he’s not reading, asking questions, or being as “present” as I’d like him to be. Somewhere deep inside, I fear that this is a precursor to him being distant and disinterested in any future child(ren) we may have.

IF Makes Me Trilingual, and Counting

There’s much more to worry about than I ever knew. This journey, with its gutwrenching highs and lows, is well-documented by brave women across the globe. Contrary to what I thought, it’s not that hard to find someone cycling, dealing with insurmountable odds. (In our case, MFI and FFI – Endo Stage IV attempting IVF/ICSI.)

Despite all the emotional turmoil, learning to decipher infertility acronyms is just one more overwhelming obstacle in a road riddled with bumps, pitfalls, milestones and footsteps of those who have gone before. With every new term you discover, you realize you’re slowly entering a collective consciousness that you never chose to be part of. How to make the PIO shots easier, deal with the 2WW, to POAS or not. I still don’t know what 6dp3dt means, but I’m sure I’ll be enlightened soon…

It’s both comforting and disturbing to read everyone’s stories, heartaches, journeys and outcomes. I find myself anxiously awaiting the news from people I do not know, but care about. Every beta day, every BFN, could be my own and it helps to answer the “What if this were me?” question.

I catch myself playing “What if?” more frequently, as I try to come to terms with the infinite number of outcomes. “What if the cycle is canceled?” “What if no embies make it?” “What if I get a BFN?” “What if I m/c?” I resent fertile women who bypass “Go” and start their journey at the “What if I m/c?” phase. Of course, I realize that once you’re pregnant, and have a child or children, the “What ifs?” are infinite too.

From Sea to Shining Sea

Infertility makes you question your being, your sense of self. Suddenly equilibrium is beyond reach, a constantly downward shifting goal. If I could only get pregnant, if I could only resolve the pain, if I could only test negative for ovarian cancer, if only it wasn’t stage IV endo, if I could only get through the day without sobbing at the sight of a parent hugging his child. Holding onto the dream when despair cloaks every cell, hormones rage, and I’m an ocean away from support, seems infinitely impossible. The firmer the grasp on the floating dingy, the more I bob about uncontrollably, at the mercy of an endless sea of disappointment.

Twilight

Night falls and the words emerge, pushing sleep to the boundaries of irrelevance. When the fireflies dart across the sky, the katydids start to sing, and the dog enters her impenetrable dreamworld, that is when my words come out to play. They exist mostly beyond my grasp, outside of consciousness. Molded by dreams, warped by memory, they exist in a parallel universe where time is suspended and reality has no meaning.

Words crossfade in an endless stream of surreal concepts, hoping for sense to promptly follow suit. Yet sense hardly ever responds to command. Words demand unlocked inspiration, freedom and the perfect alignment of the planets.

All Over the Map

It's not just my heritage that's all over the map. My feelings are scattered about who I am, who I come from (you read that right), and where the country of my soul is. The reality is no less confusing. I'm a South African with German, Dutch, and French Hugenot heritage, living in the US.

The duality of dual citizenship, leaves me torn between two continents, two hemispheres, and the stark contrasts of third vs. first world existances.

While I love being immersed in America, and have my future here, my past lies in Mother Africa's womb. The cradle of existance, the country of my birth. I'm forever tethered to her by my childhood, my family, my language and my culture. The umbilical cord of twelve generations ties me to her. She is in the memories of smells and the faces of fellow Africans I meet.

Even as I witness myself becoming more American each day, I long for the sting of the African sun on my skin, the sounds of huge family get-togethers, and the ease of not having to explain myself, my name, my being or my birth country's horrid past.

The country of my soul has no border, no government, no allegiance. It is a passport-free, bureaucracy-free zone straddling generations of migration fueled by persecution, a longing for freedom, and a Babel of languages.

I am neither here nor there, neither African nor American, and yet I am the sum of these disparate parts.