Choices

In the spring of 2007, I took my general exam. For those of you not familiar with the PhD process, most programs have a comprehensive assessment for their students to determine whether they have the knowledge base in order to proceed with their thesis and ultimately obtain their doctorate. Each institution and program is different in format and how/when this is administered, but the feeling of anxiety from the students is the same. I spent 2 months preparing for this exam, meeting with committee members and spending multiple hours in the library. On the day of the exam, though, I froze. My mind went completely blank and I found I had difficulty answering some of the most basic questions.

Somehow I passed. But the trauma from that experience, coupled with a poor sense of self, resulted in 1 1/2 yr slump where I was convinced that I would be asked to leave. Add in the fact that my project wasn't working, and I was one depressed and anxious graduate student.

In the middle of my fourth year, something changed. I decided to stop wallowing in a place of self-doubt and start taking what I wanted. I figured they now knew the impostor in their midst, might as well make the most of it. With the help of my advisor,  I switched projects and began working on a question that would ultimately lead to a publication and lay the groundwork for post-doctoral interests. I made choices to no longer isolate myself and began attending journal clubs, signed up for Toastmasters to improve on my public speaking skills and made a conscious choice to spend Saturdays with friends. What I realized was that though graduate school was a trying time, my outlook was making it worse. That I was the one holding myself back and, though there were still moments that were painful, I had to chose to move forward and demand what I wanted if I was to triumph.

The events of the past week have been the stuff of nightmares. Surrounded by beauty and signs of spring, Grey and I received the news that my body had failed our embies on Sunday. Grey and I have done our share of crying over this loss, wondering aloud why this is happening; what we did to deserve this type of pain. Honestly, we're no closer to those answers.

But something changed yesterday. Unlike January, where we were both defeated, the news of this loss has only deepen our resolve to be parents. We've decided that we both want this so much that no matter what, it's going to happen. We made the decision that, like it or not, the universe will give us our children.

In other words, we're done wallowing in the despair caused by infertility. Now we're fighting back.

Yesterday, after sleeping for a few hours, we talked about a plan. Adoption is still something we both want to pursue. But Grey wants to try one more time. He's not ready to give up on the 4 snowbabies we have left. And I'm willing to try given that our REs agree to investigating the cause for both of these miscarriages. I'm no longer willing to fly blind on the basis of "bad luck" and I've begun pulling literature from PubMed to discuss with Grey and hopefully with our REs.  In addition, we started pulling out the literature we have on adoption and made note of the different meetings from the agencies in our area.

We meet with Dr. Optimism on Friday in hopes of formulating a plan. IVF is diagnostic, and we now know where we are failing. Because of this, I want to know what we can do to investigate these causes, as now we have a pattern. Some of you have asked if I'm considering getting a second opinion. Honestly, I don't know at the moment. Both Grey and I have grown to trust this clinic, this team of care providers, and we want to speak with them about all of this prior to making any decisions. In addition, we've heard less-than-stellar stories about other clinics in this area, so seeking a second opinion may involve looking nationally. We'll know more following the meeting.

What would be helpful, though, is suggestions on testing to ask about. I'm unfamiliar with RPL panels or types of immune testing. We will be talking about karyotyping for both Grey and me.

I'm not going to lie, all of this is hard. And the temptation to curl up into a small ball is very high. But I know that's not going to change things, to help us bring home our children. I will grieve for my lost children, forever associating them with the cherry blossoms. But I'm no longer willing to be a victim to infertility. Instead, I chose to face this tragedy and fight. Fight for my family, fight for those I love who are also living this nightmare. I'm determined that this journey will not have been in vain, that something good will come out of it.

Thank you all for your comments and love yesterday. They have been and continue to be a source of strength during this time. There are no words to express our gratitude.

I'll end today with a scene from the musical "Across the Universe" that is now our battle anthem.

Rules of Engagment?

My fertility clinic is unusual. It's a relatively young practice embedded in a women's health care center. The waiting area is filled with women from all walks of life at various stages in their reproductive life. Because of this, the waiting area is split into 2 parts: the part I and my fellow IFers inhabit is also where older patients waiting for mammographies sit. Across the way is the OB/GYN area, filled with expecting mothers and young women. Over time, the receptionists have gotten better about putting up dividers and trying to keep the two separate. Still, it's impossible not to run into large bellies and infants. Thankfully, this is the only minus of the place, so I've learned over time to breathe, keep my eyes lowered and to bring an iPod.

There was one incident, though, that could not be blocked out.

Last September, following our third and final IUI, Grey and I were waiting to meet with Dr. Optimism to discuss IVF. Our wait was longer than usual, as things were running behind schedule. As I was settling into a distracted state, I heard a loud bang followed by loud and angry shhhing. Emerging from the other side was a woman with her 7 children. Her angrily scolding them for being "bad" and shhing to quiet them. The whole time, the kids ignored her, hitting one another, crying loudly and creating a scene. As she approached reception, an older woman sighed and said something along the lines of I-understand-how-hard-you-have-it-because-I-came-from-a-large-family-too. The mother made a huge gesture of rolling her eyes and complaining about how difficult is was to parent such a large family, talking about how her husband came from a family with 11 kids (BTW: husband is no where is sight). It was then that the eldest stopped hitting his younger brothers with a plastic water bottle, turned and looked at the woman. Smiling sweetly, he announced "my daddy wanted 11 children."

Yeah. I had the same reaction

The past couple of days, I've been thinking more and more about that incident. Especially in light of the discussion going on in many of the healing salons. About how I never want to be that selfish, both to my children but also by exposing others struggling to expand their family to any pain.

Infertility is an awful disease that is poorly understood by the general populous. Because of this, IFers feel like outsiders while battling to expand their families. Finding this community is a lifesaver for many, giving women the opportunity to share their journeys and connect with others.

So what happens when you get a BFP?

Sunday, as we made our way in the second beta, my mind became filled with imagines from the past 2 years. Memories of those dark moments, where it seemed everyone around me was announcing their pregnancies. Feelings of isolation and loneliness during the months of negative results. And jealousy of women who were able to conceive without a second thought. Following our miscarriage in January, Grey and I struggled with just being a part of life. No one, outside of those who had lived through IF and a few close friends and family members, understood.

The results from Friday and Sunday haven't changed my mind-set. Despite having two excellent betas, I not all giddy and announcing to the world that I was successful able to POAS; I'm still holding my breath and proceeding cautiously. Because I know all too well that it can end.

My other problem is that this news comes on the heels of learning about failed cycles and miscarriages for fellow bloggers. Too much heartbreak for women I care about and all of whom do not deserve this pain. And if I could, I would wave my magic wand and make it so that every woman on this journey was pregnant with the guarantee that it would go smoothly resulting in a baby to take home.

So where does this leave me? Well, I'm still trying to figure that out. I plan on continuing to blog, focusing on infertility. Because I am infertile and I know that infertility is now part of my identity. But as I progress through this journey, no matter the outcome, I know that I will need to write about it to some extent. Hence, I'm at a loss. How can I proceed without hurting those I care about?

This is where I open it up to all of you. In hopes of gleaning some knowledge and insight from this community. You've taught me so much in such a short period of time, I know that I won't be disappointed.

Brief update on this end: Our first ultrasound is a week from Thursday. As many have suggested in the comments, the "T" word has been dropped a lot by the REs and their team. What will be will be.

Quick update

Fatigue has set in and I'm finding it difficult to do the most basic of tasks. Don't get me wrong, I'm so happy to have symptoms. I'm just adjusting.

I had my second beta today. Dr. Optimism called with the results: Beta #2 = 808. One of the nurses from my clinic will contact me tomorrow for the next step. In the meantime, I'm filling my days with distraction.  I'll write as I know more.

I wanted to thank all of you for your comments yesterday. Everyone is treasured and greatly appreciated. This community is amazing. And I'm beyond lucky to have your support.

Hope?

Beta history (i.e. "the rollercoaster)

28 December 2011: Beta #1 = 66
30 December 2011: Beta #2 = 124
1 January 2012: Beta #3 = 91 (diagnosis: chemical pregnancy)
3 January 2012: Beta #4 = 119
5 January 2012: Beta #5 = 300
7 January 2012: Beta #6 = 887

I have an ultrasound and beta #7 scheduled for Monday morning.

Crawling back into my cave now.

Limbo

Short post today. My mind is racing and putting together coherent thoughts has been very difficult.  

Here's why: apparently I'm still "pregnant."

On Sunday, Grey and I received the news that my HCG levels were down from 124 to 91.  Dr. Practical suggested that it was a chemical pregnancy and that I should stop the meds. I pushed for one more beta to verify this (I'm a biologist and I like to see trends). Tuesday morning ultrasound showed some blood in my uterus.  Dr. Sage was pretty convinced that I would start bleeding that day and that we would be reassessing in two weeks.

Then I got the phone call that evening. It's never a good sign when your RE starts the conversation with "there are days when this job really isn't easy." Take home message: HCG levels were back up to 119.  Another beta scheduled for Thursday. I'm ordered to stay on medications. Mourning has been put on hold.

I'm pretty sure that everyone believed that I would be bleeding by now and that the next beta would level off or drop. Imagine all the new confusion when, today, we learned that my HCG levels are at 300.

Let me be clear: no one is celebrating at this point. There's a lot of doom and gloom, with my medical professionals preparing me for the worst. There's the very real possibility that me being "pregnant" means the only thing that is growing is placenta (blight ovum). So I may have to have a D&C (tentatively scheduled for Monday). Then there's the all so fun possibility of an ectopic. 

But the other possibility is that I only lost one embryo. That the other one implanted late and is now growing. This is something that is talked about after the fact, because it's rare. Add to the fact that Grey and I have learned that HCG isn't really a great indicator for how the pregnancy is progressing (think PSA tests for prostate cancer), but it's the only early marker we currently have, and that adds a whole new level to the anxiety mix.

I want an answer. "No" hurts, but at least I get to grieve and have some closure. Limbo is it's own special hell and Grey and I are beginning to wonder what we did in out past lives to deserve this.

Beta #6 is on Saturday. 

Picking up the pieces

The last couple of days have been hard ones. Harder than I every imagined. I've cried a lot, both in private, with friends and with Grey. I've watched him cry too, which broke my heart all over again. I've bargained with the universe, had moments of sadness and anger. But mainly I've been kicking myself for allowing myself to finally feel some peace follow the first couple of betas. Though short, those few days where everything was progressing allowed me to feel that we might actually be able to move forward for the next few months. How foolish of me.

Today I went in for my final blood draw. When I called the clinic to find out where I could pick up my lab slip, I learned that Dr. Sage wanted to see me after my blood draw. I barely held it together in the waiting room, dreading seeing all of them again. But I'm glad we saw him. Dr. Sage examined me and confirmed that, though the pregnancy didn't last, there were good signs that this cycle had been successful. He told me that he thought it was simply a bad roll of the dice and encouraged us to take a month off and then to proceed with a FET. I have an appointment in 2 weeks with Dr. Optimism to check on my progress of recovering and to talk about the future. In the meantime, I've been ordered to rest, allow menstruation to start and to take care of myself. Both Grey and I received many hugs and condolences as we were leaving, reaffirming how lucky we are to have found this clinic.

The question, now, is how long do we stay on this path. The answer is different for everyone; some stop at IUI and immediately move on, others will continue with treatment for many years. There's no "correct" choice and I would never be naive enough to suggest someone take a particular path. Yet it's something, if you've been on this road long enough, that you'll start thinking about.

Last night, something shifted. A good friend took me out for some tea and we spent 2 1/2 hours of me talking/crying and her listening, followed by 30 minutes of her offering words of support and comfort. During our "conversation" it became clear that I needed to begin the process of resolving my infertility. I've been on this journey for too long and I only have a short amount of patience left for treatment. That's when our conversation turned to adoption.

A bit of background on Grey and I regarding this issue: we come from families with two very different view points on this issue. Grey's family is rich from adoption; his maternal grandmother was adopted, one of his cousins and even his eldest nephew. He's always viewed this process as a beautiful thing, as without it he would not have the family he has today. My family views adoption as a great option . . . for everyone else. Like many others in this country, adoption is very misunderstood and is seen as something only "broken" people pursue. And adopted parents are seen as substitutes for the child's "real" mother and father. Granted, this is never spoken outright. Hell, they'll even deny it! But this summer, this view-point became glaringly clear after my mother and aunt conspired to have me adopt my cousin's son after the state threatened to remove him from my cousin's custody. My mother's response to my reasoning why this wasn't a good option of "no child you adopt will ever truly be yours" still echoes in my head.

My view on adoption began to change when I first meet Grey's nephew. Though physically different from the rest of the family, this child was clear one of them. And it was infectious, as they demonstrated to me that love was not a conditional thing. When Grey and I were starting off our marriage, adoption was something we talked about, something to consider after we started our family. It wasn't until last year that I was faced with really analyzing this option that it became apparent it was something I really wanted to do. As I talked with members of my support group about resolving, I realized that no matter if pregnancy was or wasn't an option, adoption would be the path we would take.

Now I know that the road to adoption is a hard one. The process is filled with many different options (domestic vs. international, closed vs. open, infants vs. small children) and I'm more than aware of all the stories of heartache from adoptions that have fallen through, delays and even stress from the process.  In addition, there are many things that need to be considered within the next few months, if this is going to happen, and none of it can be decided overnight. But I also see the stories of those who have come out on the other side and see how much they love their children. The joy that is there in those families. And I want that.

So, here's our plan for 2012: We're giving ourselves 6 months.  We'll proceed with the FET and hold onto hope for pregnancy. But in 6 months, if our situation hasn't changed, we begin the adoption process. I've already looked into local agencies such as AMARA and Holt, but plan on spending time that I normally would worrying about a cycle on researching our options.

Tonight, we are saying goodbye to our two embabies. We will tell them, though they were with us for such a short period of time, how much we love them and miss them. Tomorrow, we'll begin picking up the pieces and moving forward.

It's over

Beta #3 = 91.

Dr. Practical has agreed to do one more beta on Tuesday, but she's fairly confident that based on this trend, we had a chemical. I'll stay on meds till Tuesday and if the results indicate trending downward, will stop all medication.

Both Grey and I are in shock and denial. Heartbreak will follow soon.