Tuesday, November 06, 2012

FAQs

Q: How have you been? (Read: Are you secretly pregnant?!?)

A: I am not that great, but I try not to live my life like a giant sad sack all the time. I go to work, I run, I plan trips, I watch my favorite TV shows. Infertility is always there in the back of my mind, often the front. Pregnant bellies, cute babies and happy families are literally everywhere I go, constantly reminding me of my unfulfilled desires. Seeing them fills me with despair, which is twisted and makes me feel like and alien, like the sinister kind from Prometheus, not the cute kind from Toy Story. It seems like the easiest, most natural thing in the world for most people to conceive, but it’s something we can’t manage to do no matter what we try, which is heartbreaking and helpless-feeling and frustrating and very scary. But like I said, I just keep getting up and going about my day, and I try to make the best of my life.

And I assure you, I am not secretly pregnant. If Philip and I do manage to become pregnant by means of some expensive treatment, there is no way I will be able to keep it private for three months. I promise you, you will find out very soon after we find out — and you’ll get to follow me as I fret and agonize over the very real chance that the pregnancy won’t last.

Q: Have you been to a fertility specialist?

A: Yes, we are seeing Dr. DeVane at the Center forReproductive Medicine in Orlando. We liked him very much at our initial two-hour consultation. And we haven’t laid eyes on him since. That’s not entirely true — I did see him from a distance a couple times at the clinic, and I felt like I was seeing a mirage or an angel in a dream. Hopefully we’ll get to interact with him more once we start more aggressive treatments.

Q: Did they find anything wrong with you?

A: Not really. My ovarian reserve was too high, which suggests an ovulatory problem and made the doctor suspect PCOS. However, further testing showed I most likely do not have PCOS, as my insulin levels were normal. I have all the signs of ovulation every month — cervical fluid, elevated temperatures, normal progesterone levels and a regular period. The doctor suggested that although I may be ovulating, the eggs may not actually be rupturing out of the follicles. We don’t know for sure though, and the only way to find out would be to perform a series of ultrasounds. Ultrasounds run about $150 to $275 a pop (and our insurance doesn’t cover any fertility treatment), so I’m not really interested in doing that — especially since, whether my follicles are rupturing or not, the treatments are the same. P.S. My fallopian tubes are not blocked. Yay.

Q: Did they find anything wrong with Philip?

A: Not really. His morphology was a little out of normal range, but not enough to warrant him seeing a urologist or to start any medication.

Q: Are you doing any treatments?

A: We have done two cycles of medication plus “timed relations.” Both months, I took 2.5mg of Letrozole for five days. Letrozole is a breast-cancer drug that lowers estrogen levels, similar to Clomid. Philip also gave me an injection of Ovidrel in my stomach both months. Ovidrel stimulates ovulation. Fun fact: Its production process involves the expansion of genetically modified Chinese Hamster Ovary cells. Don’t be jealous. Then we had sex. This approach did not work for us.

Q: What’s the latest with fertility stuff?

A: We are taking a month off from treatment this month because of personal travel that conflicted with ovulation. Taking a month off has been a nice break, and I don’t miss going to get poked and prodded at the clinic every few days. It is also making me feel hella impatient and completely crazed, but I keep trying to remind myself that this was the decision we made, and we prioritized other things this month. The plan right now is to try our first IUI next month.

Q: Oh, I think my friend did that! Is that where they make the baby in like a … test tube or something?

A: No. IUI stands for Intrauterine Insemination. What you are thinking of is IVF (more on that in a moment). It used to be called “artificial insemination”; thank God they abandoned that moniker. Philip will create a semen sample, and then lab technicians will “wash” it, essentially weeding out the champs from the losers. Then they’ll put the little guys in a centrifuge and get them all wound up, then inject them directly into my uterus. This way, they won’t be subjected to the hostile, acidic environment of my big, bad vag, and they’ll be a lot closer to the end goal, so they don’t wimp out too soon. From what I’ve read, about 10 percent of IUI cycles result in a pregnancy. Those are not great odds. However, I ended up in the 10 percent of people who are infertile, so anything is possible.

Usually a fertility doctor recommends three cycles of IUI before moving on to IVF. That stands for In Vitro Fertilization, and that is when they’ll retrieve my eggs and mix them with Philip’s sperm in a Petri dish. After the eggs are fertilized, the doctor will take the one or two most promising-looking blastocysts and transfer them directly into my uterus, hoping they’ll implant. About half of all IVF cycles in my age group result in a pregnancy. These are much better odds, but as you can see, still not a guarantee by any means. Also, an IUI cycle costs about $1,000. An IFV cycle costs about $12-20K. So there’s that.

Q: Well, at least you know you WILL be a mother someday, even if it’s through adoption, right?

A: Actually, I don’t know that, which is largely what makes this so difficult. Statistically, 5 percent of women won’t be able to conceive, even with treatment. And to conceive with my own body is what I want. To be frank, I want to carry a baby in my own uterus that is made up of my egg and Philip’s sperm. I want to go through everything that pregnancy entails — the getting fatter, the throwing up, the feeling of the baby moving around inside, and the giving birth, no matter how painful it is. The thought of going through multiple cycles of IVF without success overwhelms me and brings me to tears, and we’re nowhere near IVF yet. When it comes to treatment, I don’t know how far is too far for us. I don’t know when we finally surrender and start looking at other options — and other options are just as emotionally grueling, uncertain, expensive and drawn out. If I KNEW we would be parents someday, and it was just a matter of waiting, it would be difficult, but it would be much more bearable. It’s the fear that after all of this — and so much more — we still may have to face the fact that we’ll forever be a family of two. People tell me all the time, “It’ll happen,” and I appreciate that they’re just trying to be reassuring. But I don’t know that it will happen. And that’s what’s so terrifying.

Q: What if you did IVF and ended up having twins?

A: I would be THRILLED!!!!!!!!

3 comments:

Jen K. said...

Can I submit my own FAQ?
Have you asked your doctor about how running might effect fertility? I have two friends whose drs have told them running effects it, wondered if you had heard anything of the sorts.

erika said...

Jen, that's a good question. I shared with my RE that I'm a runner, and he didn't tell me to stop. I've done a fair amount of research on this question, and I can't find a definitive answer. I can't imagine giving it up, as it's one of the few things that bring me relief and release in the midst of my struggles with IF, but I do worry it may be part of the problem. Then again, I know other women who ran marathons and then promptly got pregnant the next day, so who knows. :/

Jen said...

That's why I wondered too cause I also have friends that run like crazy and get pregnant easy so I was surprised when my other friends mentioned it. Guess it's just another one of those frustrating "depends on the person".