A Light in the Dark

A year ago this month we lost our first pregnancy.

This is a strange time of year for me, because of it. I was thinking the other day about how I really need to rake the leaves in the backyard and then I remembered, Oh! I was raking leaves the day before I started to bleed.

I had known it was coming – my hCG had dropped to 7 at my Thursday morning blood draw and the nurse told me it was a matter of days, if not hours. I took that Friday off from work and did chores all day, desperate for something to do, desperate for something to break through the heavy numbness that had washed over my body, and then sickly horrified when the next day something did.

That Friday when I got back from the grocery store, I headed out back and slowly, carefully raked the rotting yellow leaves into piles. As I raked, my thoughts skittered around in sharp jerks. I thought about those monks that created meticulous sand gardens only to destroy them. This thought was both strangely comforting and vaguely irritating. I thought about ladies in Victorian novels that were always dying of a broken heart. Previously this had seemed like a slightly pathetic yet amusing literary technique, and my know-it-all 10 year old self was smugly sure this wasn’t an actual, medical possibility. Now I questioned that former certainty. I thought about death. Would it hurt to die? Probably, I thought with detachment, it depended on how you died, but I wondered if your body reached a certain point and no longer felt anything? I hoped my baby wasn’t feeling anything. I hoped my baby was already dead, and my body was able to comfort it before it left, in the only home it ever knew. I wondered if a miscarriage would hurt, even one this early. I wondered if there would be anything to see. Would “it” come out resembling anything? Or would it just look like a period? It was awfully small, I thought, doubtfully.

Interspersed between these thoughts I was chanting over and over to myself. With each stroke of the rake I thought, “I’m sorry, baby. Mommy loves you. Mama loves you. I hope you’re not in pain. We’re so sorry. We couldn’t keep you. We couldn’t save you. I’m so sorry. I hope you’re not in pain. I love you. I’m sorry.”

I didn’t cry at all that day. I’d cried so much in the days preceding it that my body felt like a dried up and brittle husk. Each gust of the November wind threatened to shatter me into a thousand pieces.

I woke up early Saturday morning and thought for a brief moment that I was dying. The pain in my abdomen was strange and intense, but the pain in my chest gripped me so hard I could barely breathe. There was a howling in my head that seemed to echo around and around in my body.

I woke Tammy up at 5 and asked her to draw me a bath. My brain was only working in short bursts, and I could only seem to think one step at a time. All my brain could do was signal to my body to get somewhere warm, and float. So I did. The pain was coming in waves and I thought, how curious! I’m in the water, and the pain is like waves! My thoughts were stopped short by the realization of what those waves were. I lay there in the rapidly cooling water and thought, dully, “this is it.” I wasn’t bleeding yet, but I knew.

The howling and the waves of pain intensified as I stood up out of the now cold bath, and the first trickle of bright red blood ran down my leg. I watched it hit the tiled bathroom floor and said softly, “goodbye, sweet baby.”

Then I went back to bed.

Insurance Can Kiss My Ass

I have no insurance coverage for infertility, other than an initial diagnostic appointment (that doesn’t include any, you know, diagnostic tests like blood work, HSG, ultrasound, etc., because that would be too fucking logical). Everything else was 100% out-of-pocket. I am so envious of those of you who a) live in states where there is mandatory coverage and b) can utilize those benefits. We used to live in a state where there was coverage, but HAHA SUCKERS it didn’t apply to us. It only applied to those individuals who used their husbands sperm. i.e. no lesbians or single women or hetero couples with severe MFI who decided to use a donor. Because obviously, those of us in the previously mentioned categories do not deserve to have children. Obviously.

ANYWAY, moving on swiftly. I had an experience today that reinforced my need for an insurance vendetta.

As I stated above, I have no insurance coverage for infertility; no monitoring, blood work, ultrasounds, procedures themselves (IUI or IVF) and definitely no prescription drug coverage. HOWEVER, once I got pregnant (ultrasound tomorrow to confirm that I am, in fact, actually still pregnant and not newly awakened from a month-long delusion/psychotic break) certain medications that I took for infertility (estrogen, progesterone) are now covered due to my pregnancy “status”. When I called to order more drugs after my BFP, I told the pharmacists my new “status” and asked joyfully what the co-pay was. The pharmacist responded that they needed to have my doctor’s office call my insurance company to confirm that I was, in fact, pregnant. This was a month and 3 refills ago. Each time the pharmacist tells me they’re going to call over to my doctor’s office and ask THEM to call my insurance company. Of course, they don’t fucking do that. Today I got a little royally pissed off vexed in a MOST ladylike way, and told them what was up.

30 minutes later, I got a call from someone at the pharmacy asking if I was pregnant. OMFG. I only told you all that a fucking MONTH ago. She promised that she would call over to my doctor’s office to have them confirm the dates of my pregnancy, so they could retroactively reimburse me for money paid out-of-pocket for the last 3 refills. An hour later I found out that my doctor’s office would only confirm my pregnancy as of May 29th, and I had called for a refill on May 28th. So that $400 haul of drugs won’t be covered.

Reading over what I wrote, maybe I should be more irritated at the pharmacy and my doctor’s office, instead of the insurance company. And yes, the pharmacy definitely dropped the ball on this one. And I’m going to have a little chat with my doctor’s office tomorrow to see WHY they claim me pregnant on May 29th when I had my positive beta on the 24th. But you know what? All of this mess would have been avoided if I had coverage in the first damn place. God.

**UPDATE: I just got my meds delivered to my office building (damn right they deliver) and the workers in the mail room made many HILARIOUS jokes about my “drugs”. HA.HA. Hilarious. Lets talk a little louder about my DRUGS when the CEO is just down the hall! Fabulous idea.

Coming Out

In honor of National Infertility Awareness Week, I wanted to chat a little bit about coming out. I know this is a big topic of discussion among the infertility community: Do you talk about it openly? Completely in the closet? Only tell a few specific friends? What about telling your family? What about work, does your boss know? What do you tell work when you have to take off? If you’re reading this, you probably have a blog, but most of them are anonymous or semi-anonymous.

I have a lot of experience with the coming out process. You see, when you’re gay, coming out is not one big “here I am, world!” moment (although that’s often part of it). It’s a decision you have to make every day, sometimes multiple times a day. It can be as small as when the woman ringing up my groceries asking “how do I like that vegan cheese?” and I have to make the instant decision: do I say “oh, I have no idea. My wife is the vegan” or do I say “I haven’t tried it yet”, and move on?

It can be a bigger deal, of course. In a job interview, do you mention your wife? Will that have an impact on getting hired? What about colleagues you don’t work with very often. When they ask you about your plans for the weekend, do you mention her? Or do you say something non-committal about chores and weekends never being long enough? I’ve been at my job for over three years now, and I hate that I still have to have these thoughts (it’s a fairly large office). And do you correct people when they say something about my “husband”?

Being openly gay and being openly infertile is not a perfect comparison, of course. But there are similarities.

1) Judgment. If you tell, are they going to judge you? Say it was your choice (i.e. the gay “lifestyle” or promiscuity or putting your career first or waiting too long, blah blah blah)? I’ve gotten judgment about being gay, mostly from Tammy’s family, but also from former “friends” from high school (there’s a damn good reason I left that hick town) and strangers. I haven’t had the joy of experiencing much infertility judgment directly. The “best” example I can think of is Tammy’s brother, a year before we started trying, telling us that he didn’t support infertility treatment, because if you cannot have kids “naturally”, then “nature” is trying to tell you something and you shouldn’t reproduce. Sanctimonious ass. I think he might change his tune if he and his wife had any trouble getting pregnant (they didn’t. Tammy’s family is disgustingly fertile. Fertile and sanctimonious).

2) Which leads me to my next point, unhelpful comments. I think everyone in the infertility community has experienced this. We have a “once burned, twice shy” mentality about telling, because so many people we’ve told have been complete idiots with their response. They’re trying, bless their hearts*, but so often fail miserably. I’ve experienced way too many of these:
“why don’t you just adopt?”
“I’d NEVER do IVF. I don’t believe in playing God”
“Maybe God doesn’t want you to be parents”
“It was a blessing the miscarriage happened when it did”
“Want to borrow mine?”
“Be glad you don’t have kids – you can sleep in, enjoy “you” time, and you have money to spend on yourself!”
Etc. etc., ad nauseum.

Gay people also experience their fair share of unhelpful comments. I’ve also experienced way too many of these:
“Are you sure it’s not just a phase?”
“Maybe you just haven’t met the right guy yet”
“Can I watch?”
“So who’s the man?”
“Hate the sin, love the sinner”
“God has a plan for your life, and it doesn’t include being gay”
Etc. etc., ad nauseum.

So, have I come out? (Gosh, don’t I make it sound GREAT to be out?) I’m pretty much as far out as a person can be with my sexual orientation. I’m very hopeful that at some point in my life I’ll stop caring about the judgment from random people at the grocery store, and I’m also hopeful that as our society advances, judgment that matters (in terms of employment, housing, etc.) will lessen. As will the shit comments.

Am I out with my infertility? Not really. My immediate family knows, and I talk about it a lot with my parents. Many of my aunts and uncles know as well. Most of Tammy’s family does NOT know, due to their shaky status on their sister/daughter/etc. being married to a woman (THE HORROR). The poor dears might lose their damn minds if I threw GAY BABIES into the mix. I did tell two of my sisters in law after my miscarriage, and regretted it immediately. SIL #1 kept saying things like “well, you’re getting closer. It’ll happen when it’s supposed to happen”, and SIL #2 asks me about it every. damn. time. we see each other, while eyeing my stomach suspiciously. Damn, I wish I hadn’t told them. Seeing them this weekend for a family wedding (remind me to bitch at/tell you about this damn wedding).

I DID, however, tell my boss on Friday. I had to let him know I needed 2+ days off in early May, but I didn’t know the exact dates. I have taken a lot of time off over the past year, and he’s been very/mostly good about it. I had a monthly meeting with him, and he asked me, very concerned like, if everything was OK. And it just tumbled out of my mouth. He looked VERY surprised (now I’m curious as to what he thinks was going on) but quickly pulled himself together. He really knew almost nothing about infertility and treatement, but he asked decent, semi-intelligent questions, and wished me luck. When I told him about my miscarriage, he said his wife had had one. She was 11 weeks. Now of course, they have one and another on the way. He said I could take off all the time I need for appointments, treatment, etc. Yay! One non-shit response from the big bad world.

I know the value in coming out. The gay community has benefitted immensely from people coming out. Studies show that people change their mind about gay rights when they find out they know someone who is gay. If you trust the statistics, there are roughly the same number of gay people as there are infertile people (and then you have fabulous crossovers, like yours truly!). What would happen if we all came out? All posted our blogs on our Facebook page, or just started casually dropping appointments and bloodwork and all that jazz into conversation?

I’m not brave enough. I wish I was, but I’m not. I feel too raw to open myself up to the judgment and critisism that I’m sure will follow. I’ve told myself that once I have a baby, I’ll start being open about how hard it was to get him/her. But what if I never get there? Will I be in the closet forever?

*Where I come from, “bless your heart” is the perfect insult. It blends sugary southern sweetness with absolute biting criticism. You can almost always follow “bless your heart” with, “you fucking idiot”.

Ahoy, you Dumb Ovaries!

It was definitely negative. The Hope Monster had crept back into my brain, telling me I was a late implanter! That was going to have a healthy pregnancy! With TWINS! but of course, I wasn’t, and I’m not.

Tammy and I spoke with the doctor this afternoon, and we have decided to move forward with IVF. As the doctor said, I should be pregnant by now and they aren’t sure why I’m not. She also told me I shouldn’t waste my money on another IUI cycle. Can’t get clearer than that.

As for the timing, she’s having to check to see if we can move ahead with this month, due to our committment April 25-26th. She does want to put me on birth control for 2-3 weeks, and 3 weeks might be pushing it, especially if my period decides to stay away for a few days. But IF my period starts by Wednesday, and IF she thinks less time on BC might be OK, we’re moving full steam ahead with IVF. Or, as my fertility nurse put it, “we’re going to really blast your eggs”. Blast away, matey!

(Artistic rendering of my reproductive organs in a few weeks. Not to scale.)

Family Business

My parents are visiting this week. They’re staying through Thursday (or maybe longer, depending on the snow storm that’s coming tomorrow night).

I’m very close with my parents, and they have known about our attempts to conceive (and give them their first grandchild!) from the beginning. When I was a kid, I talked with my parents a lot about wanting to having kids when I grew up. Now, especially with my dad being a biologist, I value their input and advice in something that has turned out to be a lot more complicated than I had originally planned on.

We had a good discussion yesterday about IUI and IVF, and my (lack of) fertility. Keep in mind that my parents had their own weirdness with fertility. They tried for a few years to have my older sister, but they were only trying for a few months each year. You see, my mom is a college professor and wanted to have the summers off to bond/take care of a baby. She was having kids before FMLA* or any kind of guaranteed time off, and the dean at her college had only promised her a weekend. A WEEKEND. Can you even. So she figured she would time her pregnancies to coincide with the end of the spring semester. But with my sister they didn’t have any luck for a few years. Now with me, I was conceived on the first try, apparently.

Anyway, my parents are convinced that I wasn’t receiving proper care at our old clinic. They think the doctor was too young and inexperienced (true) and that I shouldn’t have been on Clomid in the first place as my lining started out on the thinner side (true) and they think I should “re-set” my counter and ignore those 8 tries at the old clinic (no can do).

I understand why they want me to do that: they think I need to stop thinking of myself as broken or having some problem that needs to be fixed. And my Dad thinks I shouldn’t be so quick to jump to IVF. While I understand and appreciate their suggestion, I’ve done this 10 times now, and yes, all 10 times count. At some point I have to re-evaluate my options and decide where our remaining money is best spent. I know I have some readers in the UK, and I have no idea how the cost of IVF/IUI with the NHS works, but here in the US unless you have insurance coverage (which almost no one does for infertility treatment) it’s all out-of-pocket. The cost breaks down this way (it varies a little bit by clinic and location):

Natural cycle IUI: $400 for doctor fees, $700 for 1 vial of sperm
Clomid cycle IUI: $1,500 for doctor fees, about $150 worth of medication (clomid + trigger shot) $700 for 1 vial of sperm
Injectable IUI cycle: $1,800 for doctor fees, about $750 worth of medication (injectable stims + trigger shot) $700 for 1 vial of sperm
Fresh VF cycle: $9,500 for doctor fees, about $3,000 worth of medication, $400 for 1 vial of IVF sperm (less expensive, woo!)
FET transfer: $3,000 for doctor fees.

As you can see it’s farking expensive and adds up quickly. So we need to choose wisely. And I think it’s time to move on to IVF.

Finally, my last comment in this meandering post, the Hope Monster has reared her ugly head. Remember how I was pretending this whole thing wasn’t happening? That all went out the window when my dad casually dropped into conversation that he think’s I’m pregnant. And then Tammy chimed in to say she ALSO thinks I’m pregnant. WHAT?! Guys, I had JUST gotten to a good place where I had moved on from this cycle and was pretty much only thinking about IVF. Now I’m right back in the trenches, praying to the pee stick gods at dark o’clock every morning, holding my breath and waiting for a miracle.

*Can I just interject that our FMLA is complete and utter bullshit. 6 weeks unpaid? Are you fucking kidding me? Every single other developed and/or wealthy country in the WORLD does better than that. It’s pathetic.

Trying to Look Busy in the Two Week Wait

So remember in my last post how I said progesterone made me crazy dizzy? Well, just to make liar out of me, my body decided to NOT be dizzy on progesterone this month. Last month at this time, I was having to hold onto my desk multiple times a day due to my extreme vertigo. Now I’m just coasting along without any side effects (other than the disgusting ooze).

I’ve been working really hard to minimize my expectations for this cycle. Yes, I’m doing the progesterone and yes I’m taking my prenatal vitamins, but other than that I’m doing my best to ignore the whole thing. I did buy some pineapple to snack on at work, but when it got kind of funky I tossed it without buying more. Previous cycles I would have dropped everything and run straight out to the store to buy more. MUST EAT PINEAPPLE. I COULD BE IMPLANTING RIGHT THIS VERY MINUTE ZOMG.

I don’t have high hopes because a) I only have one mature egg and b) why would this cycle work when nine others haven’t? And the one that did work only worked for a little while?

So I’m gearing up for IVF. I’ve been trying to figure out what protocol I might be on: birth control for two or three weeks prior to stims?  Or Lupron/other drug to keep my ovaries quiet? One thing I’m worried about is the timing. Tammy’s brother is getting married at the end of April and we’re both in the wedding. If my calculations are correct I might be starting stims around the beginning of April (that leaves two weeks to be on BC). Would that be enough time to stim, go to ER and transfer?

Ugh. I hate uncertainty, and I hate not having control. Which is why infertility/sub-fertility shit is such a perfect match for me!

Extreme Sexiness

The IUIs went well this weekend. Copious egg white cervical mucus was confirmed by the doctor performing the second IUI; enough for a host of hungry brunch goers. He also patted my foot upon completion. I felt a bit like a dog. Hopefully I’ll be a pregnant dog! Woof.

I started the progesterone this morning, which I absolutely hate. Besides the fact that I walk around feeling like you have a yeast infection for two weeks, I get dizzy and crampy. As much as I try to relax (haha! Yeah right) during the TWW, I can’t ever forget about it because of the nastiness that is being shoved up my lady business twice a day. It could be worse though; I could be dealing with the PIO, which I have heard horror stories about including one woman who heated the oil too much and it ended up burning her from the inside out. Holy crap balls. Maybe my yeasty suppositories aren’t so bad after all.

 

That Was Fast

Today was a lesson in things going wrong, fast. And then quickly correcting themselves.

The ultrasound this morning showed I’m ready to trigger my sad and lonely follicle. It grew from 14.2 to 20.2 in two days.

I had a panicky moment this morning upon the realization that I hadn’t ordered the sperm yet. What can I say, I wasn’t expecting my follicle to grow that fast. They never have in the past! My follicles generally grow about 1mm every two days, so I was expecting something around 15, maybe 16.

But I, cool customer that I am, quickly rang up the cryobank to rush order the sperm…only to find out that the sperm we wanted to order (new donor) was out. Dammit! Someone took my vials! Then, while I was all in a tizzy trying to figure out what other donor to order, the lady at the cryobank told me my clinic doesn’t accept same day delivery of donor sperm. I may or may not have let a few “fuck”s slip out, which the cryobank representative was too professional to acknowledge. (Thanks lady answering the phones at 7AM for the cryobank!)

I called the fertility clinic on the other line, and immediately launched into a sob story of how quickly my follicles grew, and I didn’t KNOW and could they PLEASE accept same day delivery JUST THIS ONE TIME, etc. etc. The andrology assistant let me run through my whole melodramatic spiel, only to tell me that the cryobank was confused, they do accept same day delivery. Well. All right then.

All’s well that ends well, as the sperm got ordered, and we’re all set for IUI Saturday and Sunday (waiting on confirmation from my bloodwork but I’m sure that’s what’s happening).

Cross all your bits for me!

The Next Person to Say “It Only Takes One…”

Morning monitoring showed I have ONE lazy dopey follicle growing. All of the other follicles are too small to measure. Fuck a whole lot of that. Seriously. Fuck it.

Bloody Valentine

The cycle wasn’t a success. Obviously.