BFP Sinking In

Another week further  (c) Shutterbug

I had my IUI procedure done on August 17, and on August 19 my job was eliminated. So much for maintaining a stress-free environment full of positive energy.

I was luckier than most of the other people who received similar news that day, because at least the company wanted to find a place for me: back in a job I'd held fifteen years earlier. It was an incredibly traumatic and emotional day as I waited for hours to hear if I was among the coming layoffs, found out that I was, then heard there was an opportunity to stay, but it would be as simply a team member in a department where I had, a lifetime ago, once been the manager. A tough situation, but I knew I had to make the best of it with everything we were going through.

We got our "BFP" (big, fat positive pregnancy test) on August 28, and I started my new job the very next day. The news changed everything. I felt like I was floating, walking around with this wonderful new perspective and an entirely different future opening up in front of me. Work stresses suddenly seem so insignificant in the face of our life-altering news. In one instant I felt like a different person. It's been similar to the experience of getting engaged and married; suddenly knowing how that portion of my life story would play out. And now I get the chance at another role.

The road has been so long already that we've been afraid to get our hopes up: it's not like we don't know how many hurdles there are still to pass. I've taken a silly number of home pregnancy tests to convince myself this is happening, because there is so little tangible proof this is even real. My first beta blood test (to test the hCG level) was done two days early due to a clerical error, and came back at 90: a high enough number to make us think both eggs could be on the go. OMG. It is completely bizarre to walk around for weeks thinking first that there might be nothing, then knowing there is something, but still wondering if it is one baby in there or two. Beta two was 150, but it was beta three that was the most important. All we have to go on are these phantom numbers that hint at what's going on inside my body. It's surreal.

I had the blood test on Thursday, and my wife and I were hoping for the results yesterday. I sat at my desk waiting for the nurse to call, jumping at every ring, wondering how I would have a personal call with so many people around me. What if it were bad news? I was distracted the entire day, and finally left a message on the clinic voice mail asking for our results, but a call never came. Excruciating.

We were on pins and needles today, as each hour ticked past and we still didn't know if we were ok. One phone call. One number. The range of acceptable numbers is ridiculously broad, because it would not only indicate whether a pregnancy was on track, but could give an idea of how many embryos were growing. It was our understanding that anything over 500 was a "good" number. A high number of a few thousand would mean there was more than one baby. As the day wore on and still no call came we became convinced the delay was due to bad news. We kept ourselves busy and tried so hard to keep calm but the mind is a crazy place. 

The waiting ended in the mid-afternoon. Beta three is 774. It is perfect for one baby. We are on our way. There will be no more news now at all until our first ultrasound, scheduled at seven weeks.

My wife has spent time on several different online forums as we navigated this process; now that we've had success she moved to a baby bump group instead of an infertility support group. They create a time line for your pregnancy where each growth stage is represented by different seeds or fruits for the embryo's size. Last week our baby was a poppy seed; this week he/she is an apple seed. Next week a sweet pea. Sounds like a photo project waiting to happen. 

In the meantime we've started a journal to write notes to this baby we've so desperately wanted. I know we are not supposed to get our hopes up, but I want to remember everything. 

I've plugged all our dates into a couple of online calculators, and they say my due date will be May 10, 2012. Mother's Day is May 13 - whether the baby has actually arrived or not, we will be celebrating for the first time. I will be a first-time mother at 42. Not what I'd planned for myself, but sometimes the universe has other plans.

And I thought I was crazy before.

Four positive home pregnancy tests in the last 48 hours. Still doubting, and worrying that the Ovidrel shot is the culprit.

Have never wanted anything so much in my entire life.

Waiting for the doctor to call to confirm blood test.

Always waiting.

Stress and Perspective

This week I had my (our) 10th IUI procedure, coupled with a consultation with a nurse to discuss our next steps should this month be another disappointment.

I can't change the facts with positive thinking, or lifestyle adjustments: I have a roughly 15% chance of success if we go the IVF route. Spending around $12,000 on those odds seems not only irrational, but irresponsible. Yet how do I give up? This isn't working, and we don't have the luxury of more time at my age, nor the money, nor the mental fortitude to continue on this quest much longer. We came to the tentative decision that if this procedure fails as well, we will start the ball rolling to bring in my wife as the pinch hitter.

The universe, however, was not done taunting me this week. As I was being told to reduce the stress in my life (the doctor laughing a little at her own advice, commiserating at how impossible that is for anyone undergoing fertility treatments) and think positively, my job was "eliminated" at my company after sixteen years. Unlike many of my less fortunate coworkers, I was offered a lateral move within the company to a completely different position, which means I can still choose to have a paycheque. The choice was obvious given our hopes of continuing with treatments for either myself or my wife, so I'm grateful on a few levels. I escaped four previous rounds of layoffs unscathed, and have come out of the fifth better than most. To say that yesterday was stressful does not begin to describe the emotion of thinking I might be out of a job, then adjusting to the mindset of starting a totally different job, and then guiltily watching long-time friends exit the building for the last time.

I just can't wrap my head around the fact that I don't have any control over so many major aspects of my life. I can't control my infertility, and therefore can't control what the future definition of our family will be. I can't appear to control my body, which has betrayed me by steadily gaining weight over the last year of fertility drugs, depression and stress. And now I don't have control over what my job will be next week. I suppose you could argue these points, since I guess I have the option of choosing not to have children and to turn down the job offer, but I feel trapped.

This is not where I thought I would be at the age of 41. I'm trying to focus on what is important and good in my life, and maintain perspective on what is not, but that is harder than you might think.

My wife remains my saving grace, my support system, my family, my best friend, and the love of my life. I know that having this relationship makes me one of the luckiest people on the planet, since many will never know the joy of finding their "person". I just wish love could pay the clinic bills.

TTC - Tomorrow, Tomorrow

Another ungodly early day on Sunday showed two perfect follicles (whew), but one dangerously thin uterine lining. It was 0.55mm where in the past it had always been 0.83mm or more. 0.6mm is apparently the cutoff for continuing with an IUI cycle - another measurement to learn and obsess about. Another side effect of the drug that was supposed to be helping me to conceive.

That afternoon my wife and I drank champagne and ate far too many delicious, sugary carbs at a friend's bridal shower. Enjoy it while I can, I figured. The next morning, for the first time ever, I forgot to set the alarm. I was slow to wake, but when I poked my wife in the arm she bolted awake and asked what time it was. Seven o'clock, I said, at which point she gasped that we had to be at Mt. Sinai in fifteen minutes. I don't think either of us have ever moved so fast.

We were just ten minutes late, and the blood tech hit my vein on the first try. Dr. Arthur laughed when she took my measurements during the u/s. "What did you do in the last 24 hours?" she asked. "This is an incredible difference for one day, your lining is now 0.78mm. I'm not just saying this, it looks beautiful." We beamed, and the details of this cycle began to sink in. I had two perfect follicles of equal size and maturity, one on each side. This meant there would be no losing half the sperm as they swam up the "wrong" tube, because we had a ticket for both routes. The lining would support implantation, my levels were all where they should be, and this will surely be our best chance yet.

Make that our last best chance. I don't feel that I can continue to put my body, my brain, and my relationship through this process any longer. I also can't keep flying in a holding pattern at my job at a floundering company, feeling as though I can't search for something new when my hope is to be pregnant any day.

I can hardly focus on anything else aside from this process, and my emotions are all over the place. My wife called me over to the sofa where she sat last night, and cautiously expressed her excitement and intense desire for this cycle to work out. We held onto each other and talked about our dreams.

I was the last of my friends to marry, and I will (hopefully) be the last to become a parent. I have seen friends, coworkers, and some strangers in the news who should honestly have never been allowed to procreate, pop out babies like it was the most natural thing in the world. I have had to be supportive and excited while hiding my own jealousy as woman after woman I know announced her pregnancy. I am filled with fears, and doubts, and longing.

Tomorrow is the big day. I am setting myself up for the biggest heartbreak imaginable, but I must believe this is my time. Our turn. The beginning of the next chapter in our life together. I want my child to come into being in an environment filled with love, and happiness, and hope. And so I will treat this once again as a done deal, and believe that tomorrow we are making our baby.

Come on, little one, just get here. We're waiting for you.

TTC - The Final Countdown

"Aunt Flo" arrived right on time this month, just as she has every other month for as long as I can remember. Trying to keep one's expectations low means less opportunity for crushing disappointment at this news, but results in more of a constant, low-grade depression.

Last month was not the first time I told myself it would be the last time I would suffer the pain, inconvenience, and indignity of all the requisite fertility procedures. I said I needed a break and I meant it, but when my seemingly inevitable day 1 arrived, I had to make the choice of whether to call it into the clinic or not. Suddenly I began to feel anxiety at the thought of taking a break instead of relief, envisioning one of my poor little eggs making its journey with nothing there to meet it. This is the reality of being in a same-sex relationship: there will be no happy accidents. It would be another lost opportunity; the slimmest of chances that this will be the month. And so I called it into Mt. Sinai, as I have so many times over the last year and a half.

My day 3 ultrasound fell on a Saturday, as so many of my procedures do, and the Mt. Sinai clinic was packed. My appointment was strangely late, at 9:00, and we could barely find seats in the waiting room. We were uncomfortably close to those around us; two couples who had each shown up with needy toddlers. A woman across from us recognized an older gentleman sitting nearby and proceeded to have totally inappropriate, top-volumme conversation with him about what he and his partner were going through. He took pains to be polite, giving ever-shorter answers to her barrage of questions ("So, are you in the middle of IVF?"), but soon appeared to be completely absorbed in his child's video game as a means of avoiding the interrogation. Some people have zero ability to read others, and zero filters.

A very tall, large, and intimidating black woman appeared in the doorway, swinging her long braids and demanding to know who was still waiting for blood work. She then began pointing at people, stabbing the air and grunting, occasionally demanding to know their names. "YOU!" she would yell. "BLOOD?" she demanded, scowling. When she came to me and heard I needed bloodworm, she grunted and pointed at the hallway, which I had to assume meant I should follow her. She didn't smile, and didn't talk other than to point at the computer screen and say, "That you?". Bracing for the test, I was unsurprised when her painful jab missed my vein. While pulling the needle in and out of my arm, changing the angle of entry to spear the uncooperative vein, she finally asked, "Does that hurt?". I was practically in tears, but had to laugh as I responded with What do you think? Once I was done, my wife and I proceeded to watch as she repeated this exchange with other people. How did this woman ever get her job? Surely you still have to interview and be chosen in the medical field, just like with any corporate job? Or as a nurse are you simply given assignments? Does no one care whether you have the shittiest job performance imaginable? There doesn't appear to be any accountability at Mt. Sinai. How could there possibly be so many incompetent people, month after month, doing a bad job with an even worse attitude? It crossed my mind that it was a teaching hospital, but these people were far too old to be students, and there was certainly no instruction going on that I could see.

This ultrasound was our first introduction to Dr. Rebecca Arthur, who we'd been told would be taking over our case during Dr. Liu's mat leave. She seemed nice enough, and spoke with confidence. When I asked about the follicle count, she told me not to worry about it from month to month, as it would probably not vary much given my age and test results (FSH/AMH levels). I think she said there were four this time. I asked about alternative drugs, since I was feeling like the Clomid wasn't having much effect, and she said injectables were an option for about $1,500 - but would likely not have that different a result. What?! I couldn't really process that news. Wasn't that the next step for an actual IVF procedure? Wouldn't those be the "big guns"? She offered to up my Clomid dose to the maximum 150mg to see if that helped, and we agreed to go with that.

This time the side effects included the usual fatigue, increasing mood swings and bloating, but also threw in some new insomnia, daily headaches, and daily nosebleeds. All this, and yet know that it's important to maintain a positive, stress-free environment for yourself to maximize the chances of conception. 

As I go about my daily life, I can't help but wonder whether anyone has used fertility treatments as a reason for actions of temporary insanity in court.

TTC - One

I have never had to wait so often, for so long, for so many things, in all my 41 years.

There was an interminable wait for our day 3 ultrasound to find out how many "potential" follicles" I had for my second attempt at a medicated IUI cycle, we were thrilled to hear the number six. In fact, that might turn out to be too many for an IUI procedure - but we had come to terms with the very real potential of a multiple pregnancy by this time. I obsessed each night as I swallowed my 100mg Clomid pill, wondering what was going on inside my body. If last month had begun with 4 follicles and resulted in 2 eggs, then surely I could count on that as a minimum this time around. But what if there were three? Four? The madness of the roller coaster continued. And we waited. And the side effects grew in intensity, as we learned was to be expected with successive cycles on this medication.

Day 11 finally arrived after another night of broken sleep. My wife and I laid bets on how many eggs there would be this month. We both felt there would be three. Off we went to the clinic for the scan to hear...one. One. The same number I would have had with no medication. One may be all it takes, but after this many failed cycles it feels like a losing ticket. I acknowledged the change in my outlook, the mind games of going from desperately not wanting multiples, to feeling as though it was hardly worth the effort with only one egg.

Day 12 blood work came (after the usual black comedy of attempts to find my vein), and o surge.

Day 13 blood work came (after a morning spent plotting the murder of the blood techs), and there it was. Day 14 would be our big day, and of course it would be the only day that my beloved wife had unbreakable, long-standing plans. Time to call in reinforcements.

On day 14 I woke and soon found myself doubled over with abdominal cramps, and thinking I would have to cancel the procedure. I was panicked about whether there was time to stop the thawing of our $700 sample, and then decided I just don't have a month to waste. Suck it up. My close friend accompanied me as the IUI was performed by a nurse practitioner named Eileen, who happened to be 7 months pregnant. I joked that I really needed to start drinking the water at Mt. Sinai, at which point she looked at my sympathetically and apologized for her condition and said, "I can only imagine how hard this must be." I just hoped she would bring me some good luck.

As I suffered through the experience that I now realized would be the norm for me, Eileen tried to keep me distracted by asking a variety of questions, and my friend tried to support me with solid squeezing of my hand. Eileen was surprised by the difficulties as she admitted what was usually a 2-minute procedure for most women was 15 minutes of sheer torture for me. 

I made it through. And now we wait.

TTC - BFN

BFN  © Shutterbug

If I were smart (and if I actually had any available cash left after my myriad of treatments), I would be investing in one of the companies that makes these magical little sticks.

Judging from the number of comments on various forums and blogs, I am not the only woman who begins obsessing about these tests on the day of her IUI, and proceeds to make and break bargains with herself every day thereafter on when she will begin taking them. I've come full circle in the last year of madness: I began the process full of excitement and enthusiasm, testing far too early, then as pessimism loomed I tested later and later (because as long as you don't see a negative result, a positive one is still possible), and finally I am back to testing the moment a reliable result seems plausible. This time around I took 4 tests, which brings my running total up to…a zillion. Probably the financial equivalent of a really successful trip to the LCBO for some really excellent wine.

We tried to think positively and truly believe that this was the month, how could it not be with two lovely little eggs on their way? Each time we try we do our best to remain calm, be optimistic, create a soothing environment for nature to take its course, and balance all that with not getting our hopes up too high. I failed miserably at that part this time around.

I fear I am becoming one of "those women", the ones who see pregnant women at every turn and feel a combined rush of jealousy and irritation. The ones whose eyes pick out every news headline about abused children and shitty parents who think, "Really? THEY were able to pop out kids, but I can't?" I vacillate between wanting to talk about this process all the time, because it is on our minds all the time, and wanting to scream if someone asks me about it when I don't feel like sharing. 

My lovely wife and I can't help but examine our feelings every now and then, and both of us have to admit that our life together is already pretty full. Our time is our own, our money is our own (aside from this process), we can be spontaneous, we are madly in love, and we aren't anxious for any of those things to change. I worry that there is a reason this isn't working for me, that perhaps this isn't the path I'm supposed to take. I worry that I am too old, too tired, too impatient, too set in my ways to be the kind of parent I would want to be, and that the stress of parenting could damage our marriage. But when our neighbour's little boy threw his arms around my legs and called out my name, tears sprung to my eyes…and I have to believe that is also an indication of what is missing in my life. Children's clothing and book stores are like a magnet for my wife, where she can get lost for hours shopping for our future child.

So I guess we press on until the decision is much clearer. Clomid, round two.

My day 3 u/s this time showed a minimum of six follicles, in which I took irrational pride.

There are still so many hurdles to clear, even if we finally get a BFP. I can't believe we can't even seem to get to that stage of the game.

Please let this be the month.