Pricks

Fertility medications  (c) Shutterbug

This is just a small assortment of the paraphernalia we require for one month of attempted baby making. How I wish that a glass of wine and romantic music could do the trick. 

It was very difficult to make the decision to go in this direction after spending close to $20,000 already on other procedures, especially knowing the weak chances of success due to my age (41). It was also difficult to imagine suffering through more side effects and opening myself up to unknown repercussions of injecting all these hormones. Most of all, it was difficult to wrap my head around this truly being the last-ditch hope, bringing out the big guns and wondering how my body would respond.

An early ultrasound showing six potential follicles was encouraging, but then we were crushed to hear after a whole week of injections that only two were growing. Not enough to proceed with the IVF procedure according to Mt. Sinai's protocol; this cycle would be converted to yet another IUI. A very expensive IUI. It had cost $70 for the Clomid that produced two eggs in the past; this time it had cost us $4,000 for the same result.

My wife and I recently read the Stephen King novel "11/22/63". A favourite line that the author repeated for emphasis was: "The past is obdurate - it does not want to be changed." We feel in our case it is the future that is obdurate. How can we not be meant to be parents, when we have so much to give?

The hardest part of all this is the lack of answers; everything is gray. My body could produce a completely different response to the same medication in a different cycle. We could try a different combination of drugs. We may have chosen to gamble on what was simply the wrong month. We could second-guess ourselves to infinity, and into bankruptcy.

This cycle was a mess: a call on Day 11 to say that my LH was beginning to surge, which isn't supposed to happen with Puregon injections, and also could have been avoided if I'd done Cetrotide injections - medication we'd had to purchase but then were told not to use unless instructed. Now I had to take an Ovidrel shot immediately to trigger ovulation in 36 hours, but they were going to perform the IUI in 24 hours. That was fine with me, as I consistently felt the procedures were being scheduled late.

This IUI experience was the worst one yet. Half an hour past our appointment time we questioned the receptionist, who just asked us to wait some more. A large, imposing nurse named Patricia, who is apparently also a midwife, led us to a cavernous procedure room we'd never seen on the other side of the clinic. She informed us our sample was still not thawed and it would be yet another half an hour. We sat and went through my chart together to kill time, and reviewed some of the previous test results. My FSH level was 16 this month, basically in total ovarian failure, yet my estrogen level was 2500 - a very good indication I had produced two mature eggs.

Finally ready to proceed, we gave Patricia the usual information about needing a Cook catheter bent a certain way to do the IUI. She proceeded to injure me badly enough to require packing my body with gauze to stop the bleeding, and then said she'd better try the Cook catheter. We were stunned and I was speechless from the pain, wanting to throttle her but needing this time-sensitive process completed. Patricia fumbled with the sample and said aloud that she might not have "got it on right" and she hoped it wouldn't "leak out" of the vial. Absolutely unfathomable that this woman had a job.

It was hard not to cry openly from pain and frustration when it was over. The helplessness we feel at every stage of this process is ruling our lives, and it is a struggle to function at work and in social situations.

We are now three days into our two-week wait, and I am taking progesterone daily to preserve the pregnancy that may or may not be underway.

I have done everything I can do. It is impossible not to get ahead of ourselves, imagining every outcome. One baby? Twins? Another miscarriage? A negative test? The trouble is that if the procedure doesn't work, we have to decide immediately whether to try again or not, and by what method. 

Do I give up on seeing any trace of my family genes in our child? Do we start trying to have my wife carry instead? Do we give up entirely and focus on building a life without children?

How do we continue to have hope after so many disappointments?

Patience Is A Virtue

(c) Shutterbug

I am not sorry to say goodbye to 2011.

The year ended with two more BFN results, and the overwhelming feeling that we are trying to force something that wasn't meant to be.

I've viewed many different forums and read many different stories from people who've had it easy, and many who've had it a lot worse than we have. That being said, I'm starting to feel pretty dejected about our journey.

October 2009 - April 2010: monitor cycles, choose sperm donor, undergo mandatory clinic testing and counselling

April 21, 2010: IUI #1, BFN

May 18, 2010: cycle cancelled when ovulation not detected

August 29, 2010: IUI #2, BFN

September 25, 2010: cycle cancelled due to poor estrogen response

October 22, 2010: cycle cancelled due to required surgery

November 28, 2010: IUI #3, BFN

December 23 & 24, 2010: IUI #4 & 5, BFN

January 20 & 21, 2011: IUI #6 & 7, BFN

April 30, 2011: IVF cycle #1 cancelled due to cyst, decide to try medicated IUI

June 25, 2011: IUI #8 with 100mg Clomid, BFN

July 21, 2011: IUI #9 with 100mg Clomid, BFN

August 17, 2011: IUI #10 with 150mg Clomid, BFP

September 28, 2011: miscarriage at 7wk6d

November 16, 2011: IUI #11 with 150mg Clomid, BFN

December 17, 2011: IUI #12 with 150mg Clomid, BFN

It's hard to believe we've been at this for two years. This list of procedures can't begin to convey the emotional and physical pain we've endured, and the way our lives have adjusted to make this process the centre of our universe.

Each cycle involves sleep deprivation, daily trips to the clinic in terrible traffic, insane amounts of money in parking fees, physically painful procedures ranging from blood tests to ultrasounds to inseminations, discomfort and side effects from medications, stress from having to take time off work, stress from waiting for test results, and stress on my marriage as my wife and I both ride the roller coaster of emotions. As strong as our marriage is and as much as we love one another, no one could go through days and weeks of the hope/disappointment cycle without friction. It never lasts for long, but it is always a bit of a struggle to balance our moods when I am frustrated and dealing with hormonal side effects, and she is naturally an optimistic and positive person.

I shake my head at the arrogance of not wanting to shop for a wedding dress when we first started trying, so sure was I that I would be pregnant at my wedding a few months later. I am no longer even a newlywed, and there is no baby in sight.

I also shake my head at my ignorance of thinking I should do everything possible to avoid a multiple pregnancy. The fear of having to cope with twins is what kept us from using medication at all in the beginning, and kept us (in addition to the expense) from trying IVF earlier.

But now here we are, in the place I've tried for two years to avoid: drugged up and in danger of having multiples. Funny how quickly that goes from being a fear to something you would gratefully accept as an alternative to a childless life. 

Fertility medications for one month of IVF treatment  (c) Shutterbug

My wife has patiently and carefully administered the three daily injections into my stomach, where the site burns and then aches, and the drugs cause increasingly debilitating headaches and bloating. The drugs cost around $4,000, depending on the number of days required to reach the right levels, the donor sample cost $700, the procedures come in at around $9,000 depending on whether sci-fi treatments like ICSI and assisted hatching are required, and there are other incidental costs as well. This is not for the faint of heart or wallet.

My scans have shown that the most follicles I could develop this month would be six. Mt. Sinai believes in only doing an IVF cycle when there is the potential to retrieve five or more eggs. Four or less and they would want to convert to an IUI: a horrible prospect. You are to assume that not every follicle will contain an egg, that not every egg retrieved will fertilize, and that not every fertilized embryo will survive to transfer. There are so many hurdles, so many decisions, and So. Much. Waiting.

Blackjack

"OJ" aka Blackjack at THS  (c) Shutterbug

On November 17, I was sitting at my computer and procrastinating about work by checking evil Facebook. I have a variety of friends who are as certifiably crazy as I am about animals, and there were several postings that caught my attention and led to additional clicking. Moments later I found myself perusing the animals available for adoption at the Toronto Humane Society.

I found him in the "Special Needs" section. I don't know what it was that made me click there of all places, and I don't know what it was about him that reached out and grabbed me and wouldn't let go.

His story was short and sad. Seventeen years old, stuck in a cage at the shelter for two months since his owner died, and suffering from indeterminate health issues. He was so handsome, and we were so bereft of a male cat in the house since losing Taz.

My wife and I managed to sleep on it for one night, but the next day both admitted to our inability to get him out of our minds. Another impulsive decision was made. My wife and my house both came into my life this way, which gives a dangerous boost to my confidence in my impulses.

Friday, November 18 we raced to the THS after work, knowing the adoption centre is only open until 7:00 p.m. We arrived at 5:50, hoping that was plenty of time, but were warned at the front desk it may not be. We raced to the new "cat house" on the second floor, took a number outside the office, and waited. We met other people who were there to browse and to adopt, and everyone appeared quite shocked by our interest in this elderly guy. His age didn't phase us; he was exactly what our house has been missing.

Eventually we were seen, the paperwork was completed, a discussion was had, and a tour was given. They led us through the maze of cages to our chosen creature, embarrassingly named "OJ". Let's see, at 17 years old he would have been born in 1995, when a certain black male was in the news...ick. I don't care how old he is and how long he's had that name, he's getting a new one.

He had undergone some serious dental surgery upon arrival at the shelter, and was missing nearly all of his teeth. This caused his tongue to loll out of his mouth, and created a spectacular stream of constant drool, but his eyes were bright and clear, his coat was thick and shiny, and he was ready to get the hell out of that cage. The vet came over to caution us about his health conditions, which turned out to be nothing more than a thyroid condition and mild kidney trouble. A pill twice a day and some expensive food was all it would take to manage his care; a joke, really, after our veterinary issues up to that point. Our last cat had a thyroid condition, and I myself have a thyroid condition. Thyroid schmyroid.

The girls on staff were incredibly sweet, and stayed late to complete the paperwork that would send "OJ" to a good home. As of 7:20 p.m., he was ours.

On the way home, we threw around a few names related to the word "black" for his colouring, and the name Blackjack came to my mind. It's a casino game we love, and the name stuck. It was only much later when looking at the date that I realized it was my beloved late Uncle Jack's birthday, which made it all the more appropriate.

It took him just two days to settle into our home and start coming out of his hiding places. It took less than a week to introduce him to the dogs and have them all make peace with one another.

It took only a minute for us to love him, and know we made the right decision.

Blackjack at home  (c) Shutterbug