So, uh…

August 17, 2008

…I know I owe you all an apology. I see from checking my own site that my last post here was way, way back on May 30, 2008. Crazy. Why, that was before we even had a Democratic nominee for president!

What can I say, by way of excuses? It’s been an incredibly hectic summer; lots of family visits, lots of visits with friends, lots of leisurely reading, lots of writing (um, just not blog posts). G and I even took a fabulous beach vacation last month. Somewhere along the way, I just stopped fitting in blog time.

In fact, I hate to say it, but I am thinking of letting this blog go, officially (ha! I have the nerve to say this with regret, as if any actual readers are even left — deafening, the cry of disappointment that has risen up from the empty ranks of my blog audience). This is ironic, since G and I actually ARE about to start our first IVF cycle, this Tuesday (whoa). It may or may not work, though I hope it does. But I suppose I just don’t have a lot to say about it at this point. We’ll just see what happens, won’t we? I have been so, so lucky and smiled upon by the universe in my life so far–it certainly would be wonderful if that continued into the reproductive technology realm, but I haven’t started knitting the layette just yet.

We have three IVF tries that are covered by insurance, and that’s it. (Unless, I suppose, I switch insurance companies down the line, although Aetna really does seem like the best thing my job has to offer.) According to the RE, our prognosis is good; G’s numbers are low, but not dismal, so they can certainly glean a crop of decent swimmers to use in the ICSI process. I’m still reasonably young at 33, and my doctors assure me I’m in great health, reproductive and otherwise. So if there’s any time that IVF is likely to work for us, it’s now.

Still, it’s a crap shoot. I suspect that if we don’t have good luck with this we’ll table the kids thing and save some money for a few years, maybe consider moving on to adoption after we’ve rebuilt the savings. Or maybe we’ll give up on having kids entirely, I don’t know. I’m hoping we don’t have to make that decision. Right now, I would really love for us to hit pay dirt on the first IVF try so that we can save the other two chances for kid #2 (when I’ll be older and will need the extra help).

In the meanwhile, I may one day soon start a new blog, with a new title. Something that covers a few more of the things I’m interested in–academia, music, cooking, reading, running, writing, pop culture–things I’ve touched on here, but not in depth. I will keep you posted. Thank you, so much, for reading and commenting over the past year. You, and this blog, have been great to me, and I truly appreciate it.

Cheers (and stay classy, San Diego),

Cityprof

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Helloooooooo!

May 19, 2008

Yes, friends, I’m alive. I don’t know why I haven’t been blogging–just not in the mood? I’ve been busy, but not outrageously so. I’ve certainly been spending plenty of time elsewhere on the internet: Facebook, various message boards and keeping up with other people’s blogs has definitely occupied my time recently. But my own blog, totally neglected for some reason… I guess because nothing much exciting is happening.

I don’t know how long this post will be either (answer:  SO, SO LONG), as I’m starting to feel sleepy (and it’s already 1:00am) but I’m determined to post something before hitting the sack. So, what’s new? Ironically enough, even though I haven’t been writing, I certainly have been thinking quite a bit about infertility, parenting, and related issues.

So far we’re still planning to do our first IVF cycle in early August, but I have a lot of fears about it. Friday was CD1 for me (meaning my most recent cycle was 26 days), and meaning I’m expecting my next cycle to begin around June 11, and the one after that around July 7, and the one after THAT, which is the important one, around August 1. But I had some blood drawn at the doctor’s office last Wednesday, and I got a little nervous around the whole needle thing–I realized/remembered that I usually get through blood draws by looking away while the needle goes in. I guess if I’m doing the injecting, as with daily Lupron shots, that won’t really be an option, huh? G seems totally prepared to step up and do the injections for me, though, so maybe I can still keep up my “just don’t look, it’ll be over soon” approach.

Of course, needles are the least of my worries; actually I’ve been having a lot of anxiety, lately, about how much children might change our lives. Can I still stay invested in my career once we have children? Will I still be “me,” or will I lose myself to motherhood? Will G still be attracted to me once my boobs get (more) saggy post-breastfeeding? That last one is less about G and more about me–sure, it’s shallow and silly, but I’m very apprehensive about the bodily changes, as I’ve mentioned here before. Probably because I’ve lost so much weight recently, I’m overly conscious of my hard-won new body and what pregnancy, childbirth and breastfeeding are likely to do to it. And don’t get me started on my “gaining all the weight back” fears. If I do manage to get pregnant, I’m just going to have to be mindful about my eating and try to keep up a moderate exercise routine. Maybe I’ll subscribe to Fit Pregnancy.

The career thing is no small question, either. I’m finishing up my grading over the next couple of days, and so I’ve been sneaking in some work on my new book, and I’m getting really excited about it. If I get pregnant right away and give birth before the next part of my sabbatical (Fall 2009), will I actually write this big exciting book, or will it fade into “what might have been” as my sabbatical becomes a de facto maternity leave? I’m sure it sounds silly that I am worried I’ll “never” write my book–kids don’t stay infants forever, after all, and I should be able to devote time to writing during the summer months, even if I am teaching full time during the school year–but sabbaticals, uninterrupted research and writing time away from teaching, only come around once every seven years of service. If I squander this one, I’m looking at Fall 2016 as my next possible leave time. 2016! I guess I had better learn to be productive in smaller bits of time.

But all of that pales in comparison to the financial concerns. Here is where I get really terrified if I think about things too hard. For one, lately G and I have been wondering whether we’ll EVER be able to afford to buy a home. Things are so expensive here that a 20% down payment on a 2-bedroom condo or co-op is about as much as my annual salary. (!!!) How do you save that amount of money up? Neither of us has an inheritance to draw upon for the down payment, unlike so many of our friends and colleagues who’ve purchased homes in the city with their parents’ financial help. Plus, unfortunately, we owed so much in taxes this year that all of our expendable income is now going towards paying off the tax bill and none toward building up our savings.

In fact, once that tax bill is paid off, we’ll (hopefully!) be at the point of starting to pay through the nose for daycare. There is literally no room in the budget for daycare at this moment, like, zero. So the only way we can afford a kid at all is if I really do use the second half of my sabbatical as mat leave (*sigh*) and we don’t pay for daycare until February 2010, when the tax bill will be paid off and a decent chunk of money will re-enter the monthly budget.

Ultimately, I honestly cannot see how we will manage to get ahead once a child is in the picture. Or even stay where we are. Kids need so many things! Clothes, food, toys, not to mention tuition–etc, etc, etc. In this moment I very much feel that in choosing to pursue parenthood we are, in fact, choosing perpetual poverty. I know that the joy children bring can be well worth the sacrifice, but I feel like our budget is on a razor’s edge right now and I am SO AFRAID that having a child, no matter how much joy s/he will bring, is also going to mean taking on enormous credit card debt just to make ends meet (and UGH, how I fought to get out of credit card debt after graduate school! We have absolutely no CC debt right now, though we do have G’s student loans, which are more than enough debt for a lifetime).

I almost cannot fathom going down this unpredictable road when we are so financially unstable. Sure, we make decent money, but we live in one of the most expensive areas of the country, pay through the nose in taxes, and right now in addition to rent we’re paying a car note, those student loans, and the aforementioned tax bill.

The thing is, I am more sure than I have ever been that having children would be a wonderful thing, that G and I would make great parents, and that our marriage would, if anything, become stronger as a result of sharing the experience of parenting a child. I’m not convinced it would survive the financial hit, though, especially if we start bickering about money. In order to afford to pay the tax bill (on our new, smaller net income, as we are having much more withheld to avoid being in this situation again next year) we had to lower, drastically, the individual “mad money” we are each allowed every week–we cut it by about two thirds. Immediately, we started to squabble about little things like who owed whom three dollars in change from the Dunkin’ Donuts breakfast we shouldn’t have bought in the first place because we now need to eat every meal at home in order to be properly frugal. Once we adjusted to our new circumstances we got over that kind of pettiness, but I just cannot fathom having even less budget leeway (and more of a sense of fiscal urgency, because our child’s present and future well-being would be at stake) and the possible conflicts over money that might ensue.

My god, this must be the most boring post EVER to read. Right about now, if you’ve read this far at all, I’m sure you’re wishing I’d stayed away! Apologies.

The bottom line is, I’m anxious about doing IVF, and not all of it is baseless cold feet. Rationally, the smartest thing to do could be waiting another year to start treatment–I’ll still be young enough to have good IVF prospects, at 34–and maybe my book will be almost done, and we’ll be closer to having paid off the tax bill, and maybe found a way to build up a little more in savings… But emotionally, waiting just seems wrong. I think we’ve waited long enough. Maybe I’m foolish (probably) but I’d like to take the plunge and see what happens, in spite of all the practical terrors I’ve just laid out. I guess some part of me still believes it will work out okay for us if we just take a chance, and step out on faith.

Feel free to tell me I’m crazy, though.

RE update

March 21, 2008

Hi again!

So, the meeting yesterday with Dr. No-Nonsense went very well, as did G’s repeat SA–his numbers, while still low, were better this time. Last time his concentration was 1.5 million per ml, and this time it was 6 million per ml. I’m not sure, yet, what his total volume was (“normal” volume is at least 2 ml, and last time G’s volume was twice that, at 4 ml), but assuming it was at least 2 ml, that makes his total count at least 12 million, more than double last time’s total count. Yay! Dr. No-Nonsense attributes this to the longer abstinence time–five days instead of three–before the second test. She suggested that when we do the actual IVF cycle we should shoot for that, so his count will be as high as possible going in.

Dr. N-N also said ICSI, in which the best and brightest sperm are hand-selected and injected into the eggs, will be a definite for us. She explained the whole IVF process: two weeks of Lupron to suppress the normal cycle, eight to ten days of Gonadotropins to stimulate egg production, and then egg retrieval, fertilization via ICSI, and then transfer back into my uterus after either three days or five days, in hopes that one or two of the fertilized eggs will implant. She said in someone my age they are likely only to transfer two fertilized eggs, which would put twins risk at 25%. I thought, but didn’t say, that I see that number as a “chance,” not a “risk,” as I still sort of would like to have twins. I know I’m probably being naive about that, though.

I did ask about day-3 versus day-5 transfer, and she said they have good results with both; pregnancy rates for day-5 are somewhat higher, but that I shouldn’t stress out if we ended up doing day-3. We also talked, briefly, about cryopreservation of embryos–she said the clinic only freezes embryos if they are of extremely good quality, but that if we ended up with even a couple of extra that met these quality standards, she highly recommended that we grant permission to the clinic to freeze them. FET cycles cost less, are less invasive, and because quality is so important to the clinic, their pregnancy rates on FETs are almost as high as those on new IVF cycles. So that could be good news if we want a second child a couple of years down the road.

As far as downsides, we talked a bit about OHSS, which she said she doubted would be an issue for me because I don’t have PCOS and I do ovulate regularly, so I have average rather than unusually large egg reserves. But she said this was still a slim possibility, and to be aware of it as a reason for cycle cancellation. We also talked about the reverse, under-responding, and why we might have to cancel a cycle as a result of that–she also said she suspected this would not be an issue, because of my young age, but we should be aware sometimes happens. Basically, she first let us know some of the things that could go wrong, before saying that she actually thought our prognosis very good. Why? Well, I’m young, my eggs are young, and G has at least some good sperm to work with. She actually said that she is “optimistic,” which has me pretty excited!

Now G has to make an appointment with a urologist, because she said that while there are a lot of potentially unworkable genetic reasons for low sperm count, there are also short-term fixable things, like hypothyroidism, and it might make sense to hold off on IVF if his issue is something like that. Honestly, I don’t know what that means in terms of our timetable; the urologist that Dr. N-N recommended happens to be on vacation this week, so I’m not sure when we’ll hear from his office on getting an appointment, and I’m not sure what G’s diagnosis, ultimately, will be. Still, the impression I got was that we could start a cycle as soon as we wanted after taking the IVF class next week. My only concern with going ahead before having the urologist weigh in is that if G’s sperm count issue is caused by something treatable, and Aetna got wind of it, there might be some question as to whether IVF should be covered for us or not. I definitely don’t want to start down this expensive road, only to find out that my insurance isn’t covering us after all!

So we’ll see. Either way, though, I’m pretty psyched about our ultimate prognosis being good. There *may* just be a pregnancy and a baby at the end of this for us after all. Woot!

Sorry it’s been so long since I updated! There’s really nothing new to report, which is why I haven’t been posting. Well, that, and the fact that I’ve been crazy busy at work. I had an article revision due by March 15, two overlapping batches of papers to grade (poor planning on my part with that one!), and a couple of long novels to reread for my classes. It’s been a little overwhelming, but still better than last month.

Now, thankfully, I just submitted the revised article to my editors today (whew), so that’s a huge load off. Plus, next week will be light on teaching duties, because it’s midterm time for my undergraduates. And the book I need to read for my graduate students? It’s the same book that my recently-submitted article was about! So I feel fairly caught up on that, even though I do plan to reread it quickly this weekend.

Anyway, blah blah blah. There IS one other thing that has changed; I found out that I will be going on sabbatical this fall. Yay! This is good for many reasons–the main one being that no matter what, I will now have uninterrupted time to work on my second book before bringing a new baby into our family. No teaching for basically eight months, all time that I hope to devote to the new manuscript. Which is good, because I have a lot to get done on that project–mostly reading and researching, at this point. Although I hope to get at least one chapter/article written while I am on leave, I probably won’t be ready to produce anything truly substantial, like an introduction, until early 2009. Luckily, the fall of 2009 is when I’m supposed to take the second half of my sabbatical. Ideally, that will be the time to finish up the writing.

Of course, by then we just may have a baby in the house (at least I hope so!). I’m going to try and stay flexible and not freak myself out too much about what that ultimately will mean, career- and bookwise. I know it will all work out. One thing I do NOT want to do is rush this new book, just because I have other things going on in my life, including our IVF plans. This book has the potential to be a major step for me, professionally, if I give it the time it needs to develop, and give myself the time I need really to think through the ideas I’m trying to parse. So I don’t want to rush myself too much–I know I’m not going to be anywhere near finished with the book by December 2008, even if I have a much better sense of where it is going. And that is okay, because I want to give myself the time I need to produce a second book that I can be proud of.

Similarly, I don’t want to constrain or otherwise try to “time” or control our IVF efforts, with any professional obligations in mind. I have realized, since my last post (and thank you all, as always, for your wonderful, reassuring comments) that this process is not in my control. And, further, even if I try to control it, there are many things I simply cannot foresee. I could get pregnant right away and have an easy, uneventful pregnancy that allows me to work happily through my ninth month. I hope that happens. But I know that I also could have bad morning sickness, or just be too exhausted to get much work done, or end up on bed rest, or any number of things that would still mean a healthy baby at the end, but might make the actual pregnancy not so easy and work-friendly. There’s no way to know. Worrying about it now is only going to stress me out and make an emotional process even more difficult.

So instead, I am trying to have faith. Faith in the idea that G and I ARE going to be parents, sometime soon, and that when we do cross that bridge, we ARE going to figure out a healthy and manageable way to handle the details–financial, professional, and personal. I know that the universe wants that for us, and the universe is going to help us make it happen.

I really do think that everything happens for a reason, and that our path to parenthood is ultimately going to work out, as is my path to a second book and, eventually, full professor (not to mention G’s path to a better, less stressful administrative position and/or a better, more lucrative clinical practice). Maybe this odd line I feel myself to be walking, between growing my career via the “birth” of this book and growing our household via IVF and a very much hoped-for future pregnancy, is an early introduction to the tricky process of balancing work and family, something I haven’t really had to deal with much before now. (G is definitely “family” to me, but so far it has not been too much of a challenge prioritizing our marriage and still getting the work done that I needed to get done, since we are both professionals. Adding a baby will definitely take things up a notch).

Right now, I really do believe that even though I can’t see around this particular corner, things are lining up just as they should, and what I must do is be patient, continue in the process of both working on the book and pursuing i/f treatment, and just see how things unfold.

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?