3 Years

Today is our fourth wedding anniversary.  It marks the 3-year point of our TTC journey.

Something that I find even more shocking, is that I just realized that this day also marks over 5 1/2 years of suffering from infertility... even if we didn't realize it until we were a couple years into it. But it's the number our doctors really care about.

You see, we went off of birth control due to other health-related issues for me in September 2008.  That was nine months before our June 2009 wedding.  We tried to be careful *most* months, using condoms or abstaining when we thought I might be ovulating, but back then I didn't keep a calendar or chart temps or anything.  And some months we honestly didn't care and went for it anyway.  Back then we thought we were lucky that we didn't have any oopsies before our wedding.

Beginning on our honeymoon, we decided we wouldn't start "trying" yet, but we also wouldn't try to prevent.  So we just did whatever we wanted and let whatever happened happen.  A year went by as I finished up grad school and again, we figured we must have just been lucky, since we still had not gotten pregnant before we were completely ready.

Where the three-year-mark begins:

By our first wedding anniversary, in June 2010, I had graduated from grad school, was interviewing for my first real professional job, and we knew the time was finally right.  We'd been together for seven years, been through a lot of milestones together, and everything had finally fallen into place for us.  We were officially ready for the next step, we were going to start our family!  Although even then, I distinctly remember B voicing a faint concern that was beginning to creep into his mind.... why hadn't we gotten pregnant by "accident" yet?  We hoped nothing was actually wrong and we really were "just lucky."

I remember being so excited, I started buying all kinds of books about what to expect before you're expecting, I downloaded an app for my smartphone to track my cycle, I even bought ovulation kits and pregnancy test kits.  I think I also bought my first basal body temperature thermometer at this time, having heard you were supposed to chart your temp but at the time not fully understanding why.

Nearly six months passed, and we were still not pregnant.  I needed to have my yearly exam anyway, so I figured I'd ask what steps should be taken to get us checked out just in case, since several of my friends and acquaintances had been suffering from various forms of infertility.

My OBGYN recommended we start with B getting tested first.    In January of 2011 he did and we got our first analysis with low numbers.  We tested again in April, same.  I started getting all my tests done, everything checked out until the HSG... those results came back with a blockage.

We got a second opinion with a urologist specializing in male infertility.  He did a special test on B's sample to check for sperm defragmentation.  Like all his other counts, they came back on the low-end of the normal range.  That cost us $400 out of pocket.

The new doc wanted me to get a second HSG, I did in July and they were able to break through the block this time.  He suggested we give it a couple months.  Nothing.  In October we did our first IUI.  It didn't work.  We wasted $1300 this time.

Our doctor recommended another IUI, I read on my health insurance website that we could get IVF for $5000 down in Illinois, and a friend's sister was able to gather free meds for me.  We thought we'd go for it, rather than doing a few rounds of IUI which would add up to the same amount quickly anyway.  You can read about what happened with that here.

When we decided not to do IVF in January 2012, we decided to do one more IUI in case B's counts improved at all post-wash this time.  In February we did an IUI cycle, but B's post-wash count came back so low this time, they couldn't even in good faith recommend we proceed with the procedure.  $900 wasted.

The urologist suggested varicocele repair surgery to see if it improved B's counts.  He agreed to the procedure and went under the knife in April 2012.  His counts did not significantly improve by the three or nine month marks post-surgery.  At least our health insurance covered this one.

Here we are, over a year past his surgery, and exactly three years past our official TTC date, and well over five & a half years of unprotected sex and still no baby.  Still no hope for improving our situation naturally.  Just waiting.  Planning for IVF next year.  Sitting alone together in the empty house we bought last year with plenty of room to grow our family.

But at least we are together.  And this is our four-year wedding anniversary.  We do have a lot to celebrate today, and we will.  But I just wanted to take these few minutes first to pay respect to everything we have been through together the last 3-5 years.  The strength it has taken for us to face these difficulties is something to be honored and celebrated too.  So today, we really do have a lot to celebrate.  And hopefully next year at this time, we will have even more to celebrate and plan for, especially if the IVF early in 2014 works and we have the baby of our dreams on the way :)

New Beginnings?

Coming across this article about turning Mother's Day into an empowering day for the infertile, which I blogged about here, and which was written by someone not too far away and kind of close to home (at least the home where part of my heart still is) reminds me that B & I have been thinking more about getting a second opinion before pulling the trigger on IVF next year.  

We had been putting it off because I've been so busy with work and travel, and honestly, for a long time we still had hoped that B's varicocele repair surgery would have worked, but now things are slowing down and we are fairly confident that one year post-surgery, the lack of improvement in his semen analysis is pretty indicative of the surgery's affect on our fertility.  Which is literally nothing.  Zero improvement.

But come mid-June, we'll return from our last scheduled trip in the foreseeable future.  I have asked B to get one more semen analysis done over the summer sometime just to confirm that 1.25 - 1.5 years out from surgery, nothing has changed.  I was thinking about visiting an entirely new clinic and going through all the rigors of female infertility testing again just to double check and see if in 3 years my hormones or blood levels have changed, or if my fallopian tubes are still open, or if my ovaries, cervix, or uterus are all still okay.  I was thinking we could try to find referrals for places that are very "holistically" focused, so that they would consider my cycle more instead of just doing the bare minimum and pushing us toward IUI & IVF like our current clinic.  Our RE just moved back to Canada, so we need to see someone new anyway.  Maybe this is the time to try someplace new just to make sure we've explored absolutely everything before we go into so much debt for IVF.

If we start hunting around in July and spend the summer getting things checked out.... again.... that would still give us six months before IVF to sort it all out definitively.  I think it would also be nice to start some therapy or find a support group at that time too.

Yes, I think upon our return from this last trip in June, much of our focus and energy will need to shift toward building our family and our future.  I'll be sure to blog about those experiences here, as this is my best place to sort through my feelings and record all that I learn along this crazy journey!

What happened two months ago

Ok, I've alluded to this a few times now, so I'm finally taking the time to open up and share what happened in September.

My first cycle after my trip to Finland & Russia in August was totally normal.  Before that, in Finland, I was about 12 hours or so late, but that's actually about right because it was a 9 hour time difference.  My period also lasted a day or two longer, but that's pretty normal too since I'd been travelling.

Anyway, the next cycle all seemed normal through the rest of August and into September... except my period didn't come when it was supposed to in September.  When I was just a day or two late, I didn't think much of it since I had been travelling during the previous month and that might have messed up my internal clock a little.

When I was 3 days late I took an early pregnancy test, just to see if I should be going to the beer garden that night after work or not.  It was negative, but was started raining later that afternoon so I didn't go out anyway.  Probably for the best I figured, just in case.

Two days later I was five days late and was really starting to wonder.  I tested again and was still negative, so I started googling about when those tests were supposed to be most accurate.  Everything said that while they can detect on the first day of your missed period, they are more accurate about a week later.

So I decided to make an appointment with my gyno for a blood test.  The next morning, day 6 of being late, I went in for a blood draw.  B & I were both so convinced at this point that this must finally be "our time" that I didn't even bother calling the RE doctors.  I didn't want to go in to work that day after the appointment, as I wanted to be home where I had cell reception when I got the call with the news.

When they called late that afternoon, I was shocked to hear the test was negative.  They had done a quantitative test, not qualitative like I'd asked for though, so I was frustrated and asked for some answers.  The nurse who'd called me said that sometimes women can just have an "off" cycle.  That's when I thought I should schedule a check up with the gyno since it had been a couple years.  Time to make sure nothing has changed on my end of things while we've been working on B this whole time.  She couldn't fit me in for weeks though, which is why I didn't go until the morning I flew out for India.

I was still pretty frustrated though, and called Robbie to get a blood draw from them too.  He agreed that we should do a qualitative one to see if we could get any answers.  The next day, day 7 of being late, I went in.  Later that day, those results came back as 0, completely negative.  I was not pregnant.

I wanted to make an appointment to have another consultation with Robbie and start completely over on all my testing, in case something had happened in the last two years since I'd first had all my stuff done.  Maybe I've developed PCOS, maybe I have endo now, maybe I'm not ovulating anymore & need clomid, maybe my tube is blocked again and they needed to open it up again.  SOMETHING!

He couldn't get me in for a week, but I was going to be out of town presenting at a conference, so I had to schedule the appointment for two weeks out.  This was so ridiculous, how could they learn anything about what was going on with my body that would cause me to be a week late if they didn't look at me for two weeks?!?!? I was beyond frustrated.  I was devastated and crushed and angry.  I wanted some answers about what was going on.

I didn't believe it could be true that I was not pregnant and nothing abnormal was going on with me.  I did a ton of googling.  There are women who don't produce the HSG hormone & never get a positive pregnancy test result.  Also, if it was a chemical pregnancy, that might not produce the hormone either but would cause me to be late.  Also, if I was pregnant but about to miscarry, it's possible that I hadn't been far enough along to detect the hormone and then lost it before I could get the positive result.  Clearly, I was in denial and couldn't believe that I wasn't pregnant.  I was grasping for anything to hold on to that could help me make sense of everything going on around me.

But honestly, I've never been anything but like clockwork.  I always get my period right on target, maybe a day or two off, but never a week!  I always ovulated between days 14-16, like clockwork!  I'm so regular it's almost laughable in the face of our infertility, and here I was A WEEK LATE and the doctors were all just trying to tell me that sometimes women have an "off month" and I shouldn't be concerned unless this becomes a pattern?!?!?!?  I was so mad!  I want to be on the fast track to fertility, so if something major like this occurs, I want my team of doctors to start running tests and getting to the bottom of what caused this change!  Grrrrrr.....

The next day I started spotting and then got my period.  I fell into such dispair.  I finally started believing that it was true that I was either never pregnant at all, or had been and was miscarrying, or had had a chemical pregnancy.  Either way, it felt like a huge loss.  

Do you see the hidden baby in this image?
This was totally B & I making plans for our future with our baby when we thought we were pregnant.

Even B seemed to be affected by it.  We'd started making plans, even discussing whether I should cancel this trip to India that was coming up, and debating whether we'd be trying to do his big 4-0 birthday trip next summer, since I'd probably be on maternity leave.  We were making plans about decorating the spare bedrooms in our new house and buying a bigger car when we could afford it.  We were blissfully happy hoping that our time had finally come, and we'd gotten there naturally, without having to spend $20k + to get there.

Then on Day 8 I got my period and it all came crashing down around us.  B was sensitive the first day and then seemed to move on.  Not me.  I was sad and angry.  I tried to focus on figuring out what had happened.  I wanted answers.  Oh, and get this, my period only lasted 2 days!  WTF?!?

When I finally got to go in to see Robbie, he seemed to think that trying on our own is futile now and we should move on to IUI's. I told him that we want to skip that or maybe just do one, before moving on to IVF in early 2014.  He seemed to kind of write me off then.  If I wasn't going to do ART now, he didn't seem interested in exploring other less invasive ways to help us in the meantime.  He told me work on losing weight, and if my next few cycles were like this, then maybe we could talk about clomid, but if I get right back on track again, then he said no way to the clomid.

Then we argued about math which really pissed me off.  I came home and told B about how Robbie was trying to tell me that each IUI has a cumulative effect, which is such bullsh*t.  Dr. J had previously explained it to us the exact opposite way.  Yeah sure, each IUI has a 20% chance of working, but that doesn't add up to getting 100% odds after five IUI's.  No, the fifth one still just has a 20% chance of working, just like the first one!  

God Robbie pissed me off!  He tried to make the analogy that if I flipped a coin twenty times, my odds of getting heads at least once would be much higher than if I just flipped it once.  Yes, fine.  But I'm not doing 20 IUI's!  And besides, every individual time you flip that coin, it's always going to have a 50/50 chance of being heads.  

Gawwwwwwd he pissed me off!  And flipping a coing doesn't cost you $1300 out of pocket each time like an IUI does.  We'd rather put that toward the $13-20K + that we'll need for IVF soon anyway.  Which by the way, only has a 50% percent chance of working.  Geesh, with Robbie's reasoning, we should just spend all our money playing the lottery, and then then when we win after playing for a while (which according to him we'd have good chances of doing after playing more often), we could just pay for IVF right away!

Seriously, what kind of a doctor argues this way?  This is why I talked afterward with my gyno about how I don't "click" with Robbie.  I'm so glad she encouraged me to feel comfortable switching to Dr. Strawn.  I really feel like that guy respects me as an individual, not just another patient with the same old textbook problems & routine solutions.  Strawn's the one who said B & I have been infertile for over 4 years, since we went off contraception, not just the 2.5 years that we think we've been "actively trying."  I really respect this guy & feel validated by him, not belittled.

So that's the story.  For the first time in my life I actually felt the thrill that I always imagined I would once I finally got pregnant.  And then it was ripped away.  I'm kind of in the place where I was after we decided not to do the IVF in January 2012 again.  It's not a good place and I'm just trying to process everything.

Blogging is helping of couse.  Sometimes blogging too much kind of keeps me stuck in this world where it's all I think about so I stop for a while for my mental well being & balance.  Then something happens and it helps me to process it by writing it down again, and if I get positive feedback from those who love me or have been there too then it helps me a little more.  And if I can help someone else going through this too, then that helps even more still.

Travelling has been helping as well.  It keeps me busy so I don't have time to think about our struggle so much.  And it puts things in perspective by reminding me of all the wonderful opportunities that I'm able to take advantage of right now, which I probably couldn't do if I was pregnant or had kids.  India in particular has also reminded me that things could be a lot worse for us.  Many other people in the world don't have clean drinking water, a sanitary place to go to the bathroom, or have access to proper food or shelter.

On the other hand, travelling also gives me something positive to focus on like having new experiences and making new memories, especially as a couple with B this time!  Of course, like I've said in the last several posts, it's always in the back of my mind and I have guilty-little-pleasure thoughts about making a baby with B in India and naming it Asha or Indie or something.  But seriously, without some kind of hope, where would we all be?

I was watching a movie on the way to India and one quote really stood out to me. In the movie, the character was explaining that they have a quote here in India that goes something like this, 

"Everything works out in the end, and if it's not working out, then it must not be the end."

I love this.  Whenever I start to get sad about our baby woes, I need to remember this quote.  It really gives me renewed hope for our future and this crazy journey we are on.  It also stands as a testament to my stubborn personality and perseverance.   I will never give up on the dream of my child.  I just can't do it.  Motherhood is something I was born for.  It's all I've ever envisioned for myself.  It's all I've every truly wanted.  

And B is going to make such a good daddy.  His capacity for love, nurturing, and protection has always been one of my favorite traits of his.  He's going to be an amazing father and I just want to finally give him the opportunity to realize that potential.  I just want to have that man's babies.

Well anyway, he's joining me here in India for some touring after I finished my work here, so either way we'll have some amazing experiences and take with us some amazing memories to share for a lifetime together!

Maybe things haven't changed so much afterall

OK, so back in March, I wrote a post claiming that a "change" had occurred.  You can read the original post here: http://inconceivablestory.blogspot.com/2012/03/change-has-taken-place.html, but the point of it was that I was trying to say that I wasn't so sad all the time about my & B's struggle with infertility anymore.  I was even trying to come up with justifications for the idea that it might be better to live "child-free."

So, the truth is, I don't think anything was changing inside of me, and I don't think I'm ready to accept the idea of a child-free future at all.  You see, five days after I wrote that post, one of my best friends emailed me to tell me that she is pregnant again - with her second child.  So she'll have two kids, ages two and under, before B and I are able to conceive our first.

I wept. 

I couldn't help it.  I wasn't upset with her of course, I was just sad for myself.  You see, when this friend announced she was pregnant with her first child, B and I had not been preventing pregnancy for a while, but we had not yet decided to "try" for a baby yet either.  

A couple months after she announced her first pregnancy, B's and my one-year wedding anniversary rolled around and I graduated from grad school with my second master's degree.  It was finally time for my life long dream to come true.  We started trying for a baby.

By the time my friend's first child was born that Fall, she asked if I had "the itch" yet.  I told her I've had the itch since I was about twelve, and that B and I had been trying and were just waiting for that special month to arrive when we'd have the good news we'd been waiting for!  

Of course, in the back of our minds, B and I were already wondering if something was not quite right.  We'd only been "trying" for three or four months at that point, but before that we'd not been preventing for a year, ever since the wedding.  And I'd been off of birth control for medical reasons for about eight months prior to that... with many months of not being careful.  So really, we wondered, why hadn't we gotten pregnant yet?  Just lucky we hoped...

For months after my friend's baby was born I'd spend several days a week visiting her and her baby.  It was great timing because I was finally done with grad school, in my first real job, and finally had free time like a normal person!  Plus, I was able to get the baby fix I needed on a regular basis.  Her child was the most beautiful being.  She was such a good baby, and to this day lights up my world every time I see her.  The best way to describe her is as a perfect little blessing.  And now, as she is getting older, it is such a delight to see her growing and learning.  

So anyway, I spent a great deal of time with this friend right before and ever since the birth of her first baby.  She was such a considerate and thoughtful friend and always asked me how things were going with our own baby making efforts every single month.  Somehow she'd always ironically call on the the day I'd gotten my period.  Oh well, I'd joke, another month of drinking and banking sick time at work for my eventual maternity leave!

By midwinter that year, B & I still were not pregnant and we really started to wonder if there was something bigger going on that we should know about.  For young healthy couples they usually say to wait for a year of unprotected sex before testing for infertility.  But since we'd already been having unprotected sex for over two years (though we'd only been actively trying to time things out for about 6 months), B started getting tested... just in case.

It's best to get the male tested first because it's much less invasive than the female infertility workup.  It's best to rule out male factor infertility first, before you begin poking and prodding the female partner.  In January of 2011, we got our first analysis results back showing that B could potentially have low counts.  But it was January, and we are in the upper-midwest, and he'd done it at home, taken it outside to drive to the clinic, and delivered it to them about half an hour later.  We decided that there were too many variables and we'd get a second opinion.

In April that year we went to the only urologist in the area that specializes in male factor infertility - Dr. J.  B's sample came back slightly better this time, but still just on the cusp of the border between the range of what's "normal" and what's a problem.  We had another sample sent away to a lab out west somewhere... the only one in the country that tests for DNA fragmentation to see if that was our problem.  Again, he was right on the border between normal and the problem zone.

All this meant that B's swimmers could be the reason we hadn't conceived yet, but the evidence wasn't conclusive.  Dr. J did notice that B had varicoceles which could be causing his lower counts, but even that wasn't conclusive as many men get them who don't suffer from infertility.  He suggested we keep trying for 4-6 months and if we had no luck, try an IUI, which should give this counts the little extra boost they needed.  So we started up all the female infertility tests on me in the meantime (just to be sure there wasn't anything additional on my end to worry about while we were trying naturally), which continued throughout the summer.

We were still hopeful that there was nothing wrong, but as each month went by with one negative pregnancy test result after another, eventually my friend stopped asking if this was finally the month.  Instead she started asking how the testing was going and if we knew anything new that could help us.

That summer we did learn that I had a blocked fallopian tube, which sent me into a panic at first, until my OBGYN reminded me that I should still have a 50% chance of getting pregnant because most women ovulate from each side every other month.  Anyway, they were able to go back in and open it up and it's been open now for 10 months and guess what? Still no pregnancies.

Anyway, I've blogged before about all the testing and IUI's and it all ended with B having varicocele repair surgery last month.  Since it takes a man 90 days to produce new sperm, we are now in a waiting period.  We can't test to find out if the surgery improved B's counts until July, so no thoughts of trying for a baby until then.

Apparently, a good percentage of men who undergo this surgery see improvement after those 3 months!  Of those that don't, many of them will see improvement within about 6 months.  Of those that are left, some will have improvement within a year, and a few within two years after the surgery.  

So, we're hopeful about July, but shouldn't get our hopes up too high.  Or, maybe a better way to think about it is that we shouldn't lose all hope if the counts don't improve because there may still be a chance for things to get better down the road with a little more time.

So that's where we are at with the whole TTC thing, and that's the update (for now) on what we know about how B's surgery went.

But what does any of this have to do with my friend telling me she's pregnant and/or me saying things haven't changed so much after all?

Well, my point is that this friend telling me she was pregnant again kind of burst my bubble.  It brought back all the happy hopeful memories of when B and I first started out on our journey toward parenthood.  It reminded me of times when friends having babies was just exciting, not bittersweet.  But it also reminded me how long we've been TTC.  It reminded me of where we started out and all that has happened along the way to bring us to where we are today.

It made me think about the fact that she'll be done having kids before I even start.  Any of our hopes to be pregnant together were thrown out the window.  It made me wonder what it will be like to be going through the baby phase once all my friends are done with it and reclaiming their bodies, sleep, and free-time.  It made me think that once again I was behind all my peers in "life" (committing to a serious boyfriend, getting engaged, finishing school, buying a house), but this time not by my own choosing, and it made me feel sorry for myself.

I know I had written that wonderfully optimistic post about how something had "changed" inside of me and that somehow now other people's pregnancies weren't bothering me as much.  I do think that is still true, but not because something inside me changed.  And to be honest, my friend's being pregnant didn't "bother" me.  The reason it made me cry is not because she is pregnant again (because of course I'm very happy for her, and told her that immediately...and honestly truly meant it), but because it triggered emotions about myself that I hadn't been feeling for a couple months.  But again, not because anything had profoundly changed inside me to make me feel differently.  Rather, I think I was just distracted.

Distracted by B's impending surgery.  Distracted by work.  Distracted by the warmer weather and exercising the dogs.  Distracted by the biggest financial decision that B and I have ever made together....

Distracted by the process of buying our first house!

Stay tuned for more to come on that soon :)