Please…

May 30, 2008

…keep Jennifer over at Contrary to Popular Belief in your thoughts and prayers. She recently lost her pregnancy at 17 weeks. I don’t know whether she is hoping for comments on her most recent post, but I know it helps me to know that people are reading along in support, especially when things have taken a painful turn. So in case you’re not a regular reader of her blog I thought I would call it to your attention.

I’m just speechless, and so devastated to hear this sad news.

Take care of yourselves; I will post a longer update on me-land soon.

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But first, more updates: it turns out the class that we were scheduled to attend on March 4 was an IUI class–obviously not quite so useful for us now. The IVF classes are on Thursdays, not Tuesdays. So I cancelled for the 4th and scheduled us for the next available IVF class, which is Thursday, March 27th. Seems like an age from now, but again, I know time will fly by. G’s repeat SA is also scheduled, for Thursday, March 20th. On that day, we’re also going to sit down together with Dr. No-Nonsense to talk about our options.

That’s pretty much why the “thoughts and feelings about IVF” in this post are only part I. I’m quite sure that after we talk to Dr. N-N, I’ll have more to say. But, I figure, I might as well start musing now.

So. Thoughts and feelings (so far)? Well, I am a little freaked out by the idea of entering infertility treatment at the top level, so to speak. No easing into it with Clomid for us! Instead, it looks like we’re going straight for the big guns. Which does mean that we’re going straight for the method most likely to work for us, but also means that if IVF somehow doesn’t work, well, there’s nowhere else to go medically. And since we only get three covered-by-insurance attempts, I am feeling a lot of fear about how much seems to be riding on each cycle. I’m trying to feel the fear and let it go rather than obsess about it, but it is hard not to get stuck in negative thought loops of this sort: What if the first cycle doesn’t work? Or what if it works, but then (God forbid) I miscarry? Talk about “wasting a turn.” (I apologize if this sounds flippant, as I don’t mean it that way) Or, if it takes us all three covered tries to get pregnant, will my head explode during gestation from anxiety about everything we have riding on this last chance for a successful pregnancy? Or, if it takes us all three covered tries to get pregnant, what will we do when it comes to child number two, if it comes to that?

And, the one that I can hardly even bear to write out, but lurks behind all of these: What if all three cycles don’t work?

Logically, I know that the odds are probably reasonably in our favor. I’m young, and (thankfully) in overall good health. Surely that means we have as good a chance as anyone does for IVF success, right? In 2006, my clinic had a 67.2% pregnancy rate for women under 35 years old, though I don’t know the live birth rate. But the point is, the “under 35” group is the group with the best chances, that’s clear from the numbers. So I know there’s really no reason to be all doom and gloom about it ahead of time. I also know that focusing on failure before we even get to the beginning of the process is a good way to create that reality for myself, so I want to start shifting my thinking in a more positive direction. But it’s hard to do, I admit. Maybe because I’m afraid to get my hopes up? Or because after sixteen or so months of trying, unsuccessfully, to get pregnant, I’m finding it impossible to believe that pregnancy really is in the cards for us?

I don’t know. All I know is that the idea of IVF is scarier, on an emotional level, than I thought it would be.

…And yet I’m also impatient to get started! Part of me wants to throw caution to the wind and do our first cycle in April rather than May. I will see what G thinks, and what Dr. No-Nonsense says when we talk to her. I can cross the due date bridge when I come to it, deal with the maternity leave issues and the timing issues and all the logistics later. Right now I’m feeling like, well, let’s just go ahead and give this scary shit a try. Why not?

Some good news, thankfully.

February 27, 2008

THANK YOU ladies for all of your kind words of support responding to my post earlier today–I was SO upset when I wrote all of that, just beyond frustrated with the whole situation. And it means so much to know that there are folks out there reading along and commiserating.

I am feeling much better now, in no small part because I talked to Dr. No-Nonsense, finally. She’s so great, very very calm and reassuring. Talking to her reminds me of why I chose this clinic in the first place. And she came bearing good news: sickle-cell is not going to be an issue for us, because only one of us is a carrier. It turns out, though, that G is the carrier, not me. I can’t believe the on-call RE I talked to yesterday misread the results! Dr. N-N said that she wants me to get tested for a few other types of anemia, to make sure there aren’t any other potential genetic issues that might crop up because of G’s sickle-cell trait, but actual sickle-cell disease isn’t a concern. Whew.

While we were on the phone, Dr. No-Nonsense confirmed that IVF would be what she recommends for us next, which didn’t surprise me. With G’s numbers, she thinks it’s the best option. She asked us to make an appointment to sit down with her and talk about the process. She also suggested that G see a urologist, I guess to get a specialist’s advice about the possible medical reasons for his sperm’s lackluster performance.

So, that’s where we are as of tonight. Sickle-cell is off the table, and I am VERY happy about that. We’re going to take the rest one thing at a time. Next up: injections/IVF class on Tuesday the 4th. Will keep you posted!

All-around bummed.

February 27, 2008

I just got off the phone with the RE’s office; my chart is in Dr. No-Nonsense’s office, so the nurses can’t get to it, apparently, to give me more info on G’s sickle-cell results (clearly that means that Dr. No-Nonsense is not in yet–I don’t know whether she’ll be in today). The best they could do was promise me a call back when they are able to get their hands on the chart.

So, naturally I am frustrated. Hence, I am blogging instead of working; I have meetings back to back starting at 11:00am, one of which I need to make some photocopies for, so I don’t have much time to write a real post. Still, I’m really annoyed and upset, and not just at the clinic for being so (seemingly) incompetent.

Some reasons why I am bummed:

1. I’m wondering if I made a bad decision on going with Columbia over NYU in terms of choosing an RE. I am not liking how they’ve handled this situation at all; if you are going to make me worry about sickle-cell by informing me that I have the trait, the least you could do is have my husband’s blood test results ready at the same time, so I will know for sure whether it’s a concern or not. And to be unable to locate my chart when I call back for information? AARGH.

(Clearly, overnight I’ve become one of those “hysterical” infertile women that I didn’t quite understand before I got to the treatment stage, railing against insensitive nurses and disorganized clinics. I was always sympathetic, but I never really “got it” until now. Stop jerking me around, Columbia! Just give me the information I need so I can know what is what and stop feeling quite so helpless.)

2. My doubts about parenthood are back. Maybe this just isn’t for me. Or maybe I don’t deserve to be a mom. It’s not my lifelong dream, becoming a mom, as it is for some women. (Hello, Jennifer Garner in Juno). I don’t feel I was “born to be a mother.” So why should we even go down this road, which seems to be such a difficult and complicated one so far, if I’m not even 100% sure that parenting is right for me?

I know a lot of people who are ambivalent end up happy parents anyway, but in those cases often their bodies or their partners’ bodies decide for them–an accidental or unexpected pregnancy means they’re on the road to parenthood, like it or not. Maybe our bodies are deciding for us too, just in the opposite direction. Which seems so unfair, since while I don’t feel born to be a mom, I do feel like I’d like to give it a try anyway, especially with G. But it’s hard not to feel like the universe is telling me bio-parenthood is not for us. (I need to write a separate post with my thoughts about adoption, but I’m not ready to go there yet)

3. I am also hating the hurry-up-and-wait aspects of this process. Not just the clinic snafus, but also, as I alluded to at the end of last post, the other bureaucratic stuff that means we really need to wait until May or June to do a cycle. Why? Because my institution has no maternity leave policy.

This means that if I give birth in January, when school is not in session (which is when I’d be due if we did a cycle in April or even late March) I would be expected to use January break as my “leave.” If I give birth in the summer, I would be expected to use summer break as my “leave.” If I give birth in the fall semester, I could take 6 weeks paid using my sick leave (or up to 12 weeks with a special doctor’s note that I needed extra time to heal), but this would not cover the entire semester. So I’d need to be back to work when the 6-12 weeks were up. And then I’d have to work spring semester, when said kid was 2-4 months old.

The only good time to give birth (especially now that we can’t afford for me to take unpaid time off) is early spring. Then I could use sick leave for 6-12 weeks paid, and have the summer paid, and go back to work in the fall when my kid was closer to 6 months old. Which is still too young for daycare in my opinion, but what can we do?

See what I mean about the universe conspiring against us?

I have to go to my meeting, so I’m going to post this. I may edit later.

Um… IVF here we come?

February 26, 2008

In other words, folks, the SA results are not good. We’re going to have to repeat the sample to make sure, but it looks like we’ve got inadequate sperm count (only 6 million when they like to see at least 40 million), not-so-great motility, and questionable morphology too. Crap! I worried that we’d be dealing with male factor, but still can’t believe BOTH of us have turned out to be “broken.” This plus my blocked tube means we are not a couple who are statistically likely to start a family on our own!

So, unless the second test shows that these results were a crazy fluke, it’s looking like IVF may be the next step for us, rather than Clomid/IUI. With male factor, I think IVF + ICSI are fairly standard procedure, and both are covered by Aetna (well, up to a limit of three cycles per lifetime–generous, but not that generous).

In the when-it-rains-it-pours file, I ALSO found out today that I’m a carrier for sickle-cell anemia. I have to call tomorrow to see if I can track down G’s blood test results (I’m utterly confused as to why those weren’t ready to be given to us along with the SA info). If it turns out that he’s a carrier as well, we’d have a 1 in 4 chance of having a kid with sickle-cell disease. That would mean that our IVF cycles would also have to include preimplantation genetic diagnosis. I doubt that our insurance covers this, as the certificate of benefits (which I have SCOURED, believe me) makes no mention of it either way. At our clinic, PGD costs an extra $2500 per cycle. I am REALLY hoping that G is not also a carrier.

So that’s my news. Also, apropos of crappy news, thanks, all, for the commiseration about our tax bill last post! Ugh, right? We’ve managed to reconcile ourselves to it, and have even figured out a decent way to budget for the payments (even with lower net salaries, since we’ve also had to ask the IRS to withhold a bunch extra from both of our paychecks so that we won’t have this problem again next year). But still, damn. The tax news does sort of pale in comparison to the infertility news, although after a good cry behind closed doors at work today, I’m even feeling a bit better about the infertility stuff. It sucks, yes, but it’s not the end of the world, or the end of our plans for parenthood.

G, of course, is his usual upbeat self in spite of the news. I am hoping he’s not just putting on a brave face for my benefit–he definitely plays the role of being my “rock” in hard times, but he doesn’t always take care of his own emotional needs, or let me play that same role for him. So I’m trying to keep the channels of communication open in case he does have unhappy feelings he wants to share, but he claims he’s okay, and that he’s “saving his emotional breakdown energy” for something really insurmountable. Which is a pretty healthy attitude. I hope I can maintain a similar level of mental health this summer*, which may be WAY more eventful than I expected it to be.

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*If we do have to go straight to IVF, it won’t be until May, for a whole host of reasons that I’ll explain in another post.