Tag Archives: questions

Another reason infertility kicks rocks

This doesn't even begin to show what nine kinds of ticked off looks like. I was here -- and for good doggone reason.

I mentioned that part of my stress during the last several weeks involved work. Aside from the initial problem that had me sitting in human resources, I got wind of the fact that my “medical condition” had come up in discussions toward the need for some type of resolution. Actually, the comment — which I received through a super-reliable source — essentially alluded to my “oversensitivity, likely a result of (my) medical condition.”

I’m a lot of things, but sensitive probably isn’t at the top of the list. Incorrect characteristic aside, I was nine kinds of ticked off. Yes, nine.

I was outraged at the lack of understanding, at the blanket application of what “undergoing infertility treatments” means. I was livid at the seeming sexism that drove the conversation. The belittling of a legitimate work concern because of my “medical condition” had me seeing red.

Post-rage — even though I’m still on the same drugs progesterone and estradiol, mind you (told you it wasn’t the drugs) — I remember that anger tends to be a secondary emotion. I’m ready to admit now that more than anything, my feelings were hurt.

Understanding the value of personal authenticity to myself and others, I try to live a fairly transparent life. Despite what my writings suggest, I’m not an open book. I’m more like a library offering. Through conversation and revelation of the type of person you are, in a way you can’t explain with words, you’re filling out an application for a library card. The way you fill out the paperwork gives me insight into what version of the book you can check out. Regardless of whether you get “Goodnight, Moon,” “Charlotte’s Web,” “Are You There, God? It’s Me Margaret,” “Fight Club” or “The Sun Also Rises,” you’re still getting the real me with all my quirks.

I was a small child for my age and would get questioning looks when I’d attempt to check out library books that looked well beyond my literary capacity. Eventually, though, some librarian would decide it was OK for a 12-year-old to read John Jakes’ “North and South” and let me have the book.

That’s how I felt when I said in a meeting that the work situation needed to be in the hands of someone with the authority to deal with it. Not only was that kind of power above my pay grade, I have other things I’m focused on, I said. “For example, my husband and I are undergoing fertility treatments.” At that point, injections and ultrasounds were normal to me. I said “undergoing fertility treatments” like people say, “We’re moving” or “Our car broke down.” It is a condition of life, a normal condition of life like anything else that sucks and requires a coming to terms. After you reach the terms, it is what it is: life. And I decided the person I’d spoken to was in a position to handle that. I was wrong.

Having my life used against me felt like a sucker punch to the gut. The irony was that such a twist of words never would’ve been used to describe a woman battling her way through cancer. What is it about infertility that makes that kind of marginalization OK?

I still haven’t figured that out; I did however address what I’d heard. Despite broad deliverance from tearing people down with my words, I had not forgotten how to border on intimidating. I’m a little person; it takes a little of that sometimes. But really, it was the use of the words “illegal, if not, then unethical,” a reference to the employee handbook and prayers that began with “God, go before me …” that seemed to have an impact.

The abundance of ignorance regarding infertility perpetuates the embarrassment that many of us feel in the need to utilize advanced reproductive technology. It keeps us silent and hidden and unnecessarily distant from the support we need. To break that cycle, we’ve got one option (and I stole this from Jeff Bridges in “The Contender”). It’s simple: Don’t be embarrassed.

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Pee-er Pressure (in the Mr.’s own words)

I'm comfortable with this scenario, but the Mr. needs something more.

I’m giving up my normal rant space to the Mr., who really wants — nay, needs — me to take a home pregnancy test. His offering is largely unedited — aside from those dreaded double spaces after each sentence. (Who still does that?) Nevertheless, despite promising ultrasounds and no evidence suggesting that there isn’t p-word outside of our cautious uncertainty, he wants to see a positive home test. Here’s why:  

About three and a half years ago, I had a question I really, really wanted to ask the woman I loved. Just a few simple words, but it was a monumental question. The big question. You know the one. It was the biggest question I’d ever asked her. Eventually, after a princely sum on a ring and tickets to a dinner whose taste I still can’t remember, I got my answer.

It was the answer I’d expected, hoped for, prayed for and was relieved to get. I’d seen the signs after all: She told me she loved me, moved halfway across the country for me, she laughed at my lame jokes and allowed me to experiment on her with my cooking. And rare was the day we hadn’t spent thinking of and talking about a future together. So, yeah, the signs were there. But it was the most real when she had that ring on her finger, that word of affirmation ringing in my ear. She later teased me about my nervousness, even while admitting that she wasn’t always sure that moment would ever come. Bottom line, we didn’t know till we knew.

So here we are again, where there’s a question to be answered. This time it’s not about matrimony. It’s about maternity. It isn’t about whether she’ll take my hand. It’s about whether we’ll form a band. There’re no musicians singing in the background, and instead of a diamond ring in my hand, I’ve got a cheap piece of plastic. Ain’t nothing sexy about where this stick goes and she probably won’t walk around with it on her finger (although that would make one heck of a mood ring).

(Now that I’ve conflated my proposal and a pregnancy test, my head is filled with images of how so many other questions would be more simply resolved if it could be settled with a little pee. Does she love me? Is she laughing at me or with me? Is she really mad I ate all of the cookies? Two lines for yes, one line for no.)

So, call it peer pressure. or pee-er pressure. Or just one more time where a guy’s gotta know. Sure it might be beside the point. Even a little bit anti-climactic. But, remember that Kay’s Jewelers jingle: “Every kiss begins with Kay”? Well, every pregnancy begins with pee.

Babe, all I’m saying is give pee a chance.

It’s the %@*$# drugs

We're done with the injectables, but these two seem to pack a more emotional punch. The Mr. finds it funny; he's allowed. Everyone else, look out.

It’s the drugs. It’s the drugs. It’s the drugs.

At least, that’s what I’ve been telling myself as a result of reaching the highest levels of pissivity. (That’s an original derivative of a word I hate to use and wouldn’t, well, if not for the drugs.) I was warned of the side effects of estradiol and progesterone, but I wasn’t expecting the same work-related poop storm from a few weeks ago to keep spinning. I don’t have the time, the patience nor the willingness to address it, but here it is, and here I am, nine kinds of ticked off.

Soooo, maybe it’s not the drugs.

However, the fear and resulting paranoia that pressure from this clusterfox will hurt my chances of housing the Wonder Twins long term might be drug manufactured. It would make sense to think that every significant upset would have a negative effect, but honestly, it doesn’t. Medically anyway, no one thinks so.

In addition to preparing me for mood swings, fatigue, and general haziness, the RE-mandated psychologist addressed stress and how I’d deal with it. Her focus was specifically now, the time between the transfer and the first blood test determing whether the in-vitro cycle was successful. Even though she encouraged a coping strategy — because, obviously alcohol is out of the question — she insisted that everyday wanna-throw-a-shoe, to-Hades-with-everybody, dare-you-to-walk-in-front-of my-car varieties wouldn’t be enough to derail pregnancy. What would have an effect is stress related to fear for my life, of being evicted and otherwise homeless or of not having food. Anything less than that would be implantation gravy.

I was relieved to leave aside the pressure of always trying to relax. In trying for so long to conceive, I’ve heard “Just relax” enough times to consider the phrase profane. And telling me that never works anyway. So rather than “Keep Calm and Carry On” like the book says, I’m doing just fine aligning myself with its companion piece, “Screw Calm and Get Angry.”

And if you don’t like me when I’m angry, well, let’s go with that idea that it’s the blankety-blank drugs.

Countdown …

One innocent victim of my hormone-induced emotional outburst hours before the egg retrieval

So, just like a magwai, I can’t eat after midnight up until after the procedure Monday. It’s amazing how much you want something when someone says you can’t have it. I think the frustration is really just masked anxiety about whether everything will go as planned. I signed the waiver, but I’m still not worried about the more severe risks like excessive fluid buildup, stroke or death. I’m not sure about many things, but I’m most certain that God wouldn’t allow my last “meal” before meeting Him to be pineapple jelly crescent rolls, doxycycline and candied gummy pre-natal vitamins.

Speaking of God, I imagined laying out on the altar Hannah-style in church today after all because I just didn’t have the words to pray for what I want. We sang a song, “God is sovereign, holy and just and on His word we’ve got to trust. For the at the sound of His voice, the Earth became. When God speaks in your life, you won’t be the same.” Between the singing, ministering and worshiping, I felt my heart praying and the tears fell. It wasn’t a shining moment because I haven’t figured out how to cry and sing at the same time. Nevertheless, it was a moment that I felt like God and I were on the same page on this babies thing. It made worship at the next service that much easier. Even then, the tears kept flowing though. I’m sure it’s the estrogen.

According to the Mr., I’ve also been a little more aggressive in a way more characteristic of me PMS’ing. I never take it out on people — or at least not at people who can hear me — but it definitely comes out at the television, traffic, talking heads on TV. The victim on the way home from church was a squirrel pausing in the middle of the street. A squirrel! Yep, it’s got to be the drugs. And it’s expected to get way worse.

After the retrieval … (I should describe that. Using a transvaginal ultrasound to find the follicles, a doctor will guide a needle to where it’s supposed to go and extract fluid that should include an egg. If it does, the egg goes into an incubator. He or she will repeat that process until all the follicles are aspirated. The eggs will then pair with a fresh sample from the Mr., and then we wait.), I’ll start oral estrogen and, uh, non-oral progesterone. That’s supposed to not only make me sleepy but also edgy. Doesn’t that sound like fun for everybody?

I’ll keep taking the antibiotic to ward off any cooties from the procedure and wait again to hear about the number of eggs and the likely transfer date. In the meantime, at least immediately after the procedure, I’ll do nothing but feel the lovely haziness of good hospital drugs. As always, we’ll see what happens.

“Write this down and repeat it back to me.”

Monday is egg retrieval day, but hold the sparkling cider. I've had too many BFNs to get excited just yet.

“What? Huh? Wait. OK. Um, hold on. OK, I’m ready now. Go.”

That was the beginning of my conversation with the nurse today confirming that Monday will be my retrieval day, also known as the great Christmas Egg Hunt. I worried about the shots, and now I’m the subcutaneous injection queen. I worried about the drugs having no effect, and now I have 12 measurable follicles (right — 19, 17, 16, 14, 12, 12; left — 17, 15, 14, 13, 13 and 11). FYI, follicles grow 2 mm per day and are mature, meaning more likely to have mature eggs, around 18. The number of follicles does not necessarily correlate to viable eggs, and not all eggs retrieved will necessarily be fertilized. My awareness of the fact that there’s no guarantee that they’ll find enough quality eggs for fertilization basically gives me another reason to keep the sparkling cider on ice for now.

It’s not that I’m trying to be Debbie Downer; it’s just that at this point of trying to have children, I know all too well how it feels to get my hopes up and then let down with a BFN (big fat negative). After peeing on stick or two every month, you learn to take everything as it comes. I used to search for pregnancy T-shirts with funny sayings in anticipation of a positive test amid imaginary symptoms. I’d always feel dumb afterward for thinking too far ahead. Although by God, I’ve managed to accomplish many things and overcome situations that haunt people for life, my inability to get pregnant up to this point has always made me feel like something of a failure and occasionally like God wasn’t listening on this one. I kept praying but then encouraged other people to pray; though, I didn’t tell them about the struggle.

As for being a childless failure, cognitively, I know otherwise. Emotionally, though, it takes some convincing. Being happily married and struggling to have children feels like being the smart girl who isn’t considered pretty. You do a good job pretending it doesn’t matter, but then something happens as a reminder that you do. Some of my Facebook friends are fertile Myrtles; they’ve had two kids in the time I’ve been trying to have one. Stuff like that can get to you if you let it. I’ve tried not to let it, but I’m human. And maybe that was behind my annoyance with having to endure the entire in-vitro fertilization process to have the children I’ve been psychologically preparing for since 2005.

Now, here I am at the critical point — less than 36 hours from the egg retrieval but beyond the hard part — and I’m only thinking as far ahead as drug No. 6, a pre-emptive antibiotic that I’ll take orally starting in the morning.

Ganirelix is the Devil

This Ganirelix acetate shot might as well be a small taste of hell in injection form.

Not that anyone’s grading me, but in my on mind at least, I passed an inital hurdle in the in-vitro fertilization race. Based on results from Tuesday’s ultrasound, I have seven measurable follicles at decent sizes (three at 12 mm, two at 11, two at 10 and a lot of small ones) to keep the cycle going. It’s been my biggest fear that the $350 in prescription drugs and the past five days of shots to the gut would suddenly end in a canceled cycle. But today is cycle day seven, and we’re still on.

About those follicles: Everyone who ovulates does so because of an egg that matures inside a follicle before popping out in anticipation of a sperm hookup. My injectable medications have given me super-powered ovaries that have produced more than the typical one or two follicles that would ordinarily lead to one or two eggs. Mature follicles tend to measure about 18 mm. When I did the intrauterine inseminations, 18 mm meant it was time for a “trigger shot” of Ovidrel, an injection that encourages ovulation. I’ll still get the Ovidrel with in-vitro fertilization; it’ll just be exactly 36 hours before the retrieval.

That would be shot No. 4. But that one, I can handle. It’s that doggone Ganirelix that is most certainly from the devil. It burned after the Mr. injected me and left a bruise that is painful to the touch. I walked around work with my pants down, covered by my jacket. So far, it’s the worst thing that has happened in the process, and it’ll happen again — every morning until … Crap, I don’t know when it’ll stop.

All I can do is follow the advice of a diabetic friend with 15 years of needle experience and consider the pain an offering commemorating Christ’s ultimate sacrifice. It sounded trite when she first said it, but given the hell of this Ganirelix shot, it’s gon’ take Jesus, the 12 disciples and Rufus to take this devil down.

Next ultrasound and blood draw: Thursday.

What if … ? (Ode to @IVFandme)

The ominous BFN, or big fat negative. What if after all of the insemination and in-vitro fertilization attempts, this is all I see? God forbid.

Visiting friends in New York allowed my mind to veer away from that hovering in-vitro fertilization cloud — with the exception of the nightly shots. (Speaking of, it’s almost that time again.)

When we all lived in the same city, we often played the “What if …” game just as we did this weekend. What if I came home and the Mr. had a pet monkey? What if Mrs. Friend told her husband that her name was Ursula when they first met? What if one of us caught another of us cheating on the other of us? It gets deep and sometimes wild and crazy as driven by a double dose of vivid imagination. The possibilities stray so far out of anyone’s mind that it takes a while to decide on the most honest and likely answer. For example, I never thought about what food I’d eat if I could only eat that one thing the rest of my life with no consequences until I had to answer the question.

The same day we hung out, I aimlessly scrolled Twitter to find the following tweet: “No more treatments for me. Moving to childfree, kicking & screaming with a side of crying. #MovingOn” and then “For the twithearts that don’t know my story: 3IUIs, 3IVFs, 1DEIVF, 2FET: all BFN. I truly gave it my all. #MovingOn #Infertility.”

For those who don’t know the lingo, the woman I follow with the Twitter handle @IVFandme has endured:

  • three intrauterine inseminations,
  • three in-vitro fertilization attempts,
  • one in-vitro fertilization attempt using donated eggs and
  • two frozen embryo transfers

… all leading to a BFN, infamously known in infertility circles as a big fat negative pregnancy test result. That’s a whole pharmacy of drugs, a lot of little tubes going you know where and God knows how many, ahem, “private viewings” to go through without a baby to show for it. I wanted to kick something on her behalf, and I couldn’t help thinking: What if that were me?

I don’t think people understand that when you get to the point of fertility treatments, you’ve already tried everything you know to do and that everything else really is a crapshoot. It’s not a sure thing. So, although I look fine with the frequent transvaginal ultrasounds, multiple drugs, blood draws and injections that not only expose my belly fat to the Mr. but turn it red so he can see it better, know that I’m anxious, I’m nervous, I’m occasionally pessimistic and sometimes downright depressed. Fortunately, the worst of it never lingers. But like the darkside, it’s always there. When I explain that I’m “undergoing fertility treatments,” congratulations are not in order. This (group of attempts that may go on for years until I’m tired or bankrupt) feels like my last ditch effort, and I don’t want to jinx it by celebrating what could be a lost cause and maybe a waste of money. “We’ll see what happens” is about all I can politely muster with that weight behind every fertility-related move.

Sorry, Mr. and Mrs. Friend, I’m breaking the rules and sticking by my non-answer: I don’t know what I’d do if it were me.

As for @IVFandme, my thoughts are with you. With a remote understanding of your individual suckage, I know at least part of the road you traveled to this point and send virtual hugs your way. It ain’t much, but tonight’s shots are dedicated to you. Ouch and sugar honey iced tea.

Let’s play 20 questions (Part 1)

They arrived. That’s a month of in-vitro fertilization drugs.

It occurred to me once I decided to go public with my infertility struggles that people would have a lot of questions. I’ve found that when I open up in a quest for comfort, I instead do more educating than emoting. To remedy that and to avoid repeating myself, I present the most common questions I encounter and answers as they stand right now. That’s my disclaimer for if or when my answers change.

1) Why can’t you have kids?

I don’t actually know that I can’t. I just know that I haven’t. I have a diagnosis of diminished ovarian reserve, meaning I don’t have as many eggs as expected for my age. (I’m in my early to mid-thirties.) Therein lies the challenge and why we – the Mr. and I – are trying everything available to make it happen.

2) What’s that like?

Well, in short, it sucks. It’s annoying. It feels unfair. And I wish it wasn’t so. I get down about it sometimes, and maybe I wanna complain. It just doesn’t make me feel any better. So, I refocus. I write. I pray. I take my prenatal vitamins as an act of faith.

3) Did you pray about it?

Yes, for Christ’s sake, AND in His name with fasting. Intercessors welcome.

I get very tempted on Sundays to throw myself on the altar at church Hannah-style, but I’m pretty sure security would take me down and carry me out before I can say, “Amen.”

4) Are you having enough sex to get pregnant?

(People do ask.) Yep.

5) How long have you been trying?

I’d say not long enough for infertility street cred. Things have moved really quickly, but when I count back, the path to this point feels like a long road. I ditched the Nuvaring the last week of January 2010. I can’t believe it’s almost 2012.

6) What’s the effect on your marriage?

There’s been no negative effect. It was already the two of us against the world. Now, it’s the two of us against infertility. Beyond that, my husband amazes me every day just by being his funny, supportive and thoughtful self.

7) How many kids do you want?

For most of my life, I wanted five. Before we got married, we decided on three. There’s a song from my hometown that’s now my song: “Any way you bless me, Lord, I’ll be satisfied.”

8 ) Why not just adopt?

Oh, why not get a bike instead buying a car? It’s transportation, right? Sorry, that darn humanity. Um, adoption could be considered a “fix” for childlessness perhaps, but not infertility.

9) So you’ll be doing that artificial insemination stuff?

Kinda. Nobody calls it that anymore. For one, there’s not much artificial about it – sperm and eggs are still required. What used to be called “artificial insemination” is modernly known as intrauterine insemination, or IUI. Sperm cells, which usually “walk” to meet a single egg, instead get a bath before taking an express train via a thin catheter guided in most cases by a nurse. The actual procedure takes about a half hour, including time just laying there. I’ve done that three times. No dice. That’s why I’m at the in-vitro fertilization stage. The fur is similar, but it’s an entirely different animal. We’ll be experiencing it together.

10) What do they have to do?

Essentially, with drugs, they’ll suppress my reproductive system, jump-start it with more drugs to make my body produce multiple follicles, which house eggs. Doctors will then go get the eggs, pair them with sperm from the Mr. in a lab, offer them wine and hope they hit it off. Once matches are made in heaven, the doctor will let me hold one or two of them for safe keeping, and I’ll eventually look like I ate a watermelon seed. I’m oversimplifying to explain the procedure without the gory details that – again – I’ll experience when it all happens with you along for the ride.