Thursday, August 28, 2008

It's starting already

My IVF cycle won't officially start for another 8 weeks, give or take, and I'm sitting here at my desk right now with a big knot in my stomach.

I start a new acupuncture treatment plan in about an hour, so I guess I'm feeling like all the madness starts NOW. Or in the next in 1 HOUR AND 11 MINUTES, anyway. Plus, the appointment is at the clinic, so I've got the walking-through-the-door thing to make myself do.

DH is funny. He emailed a little bit ago to ask if I was "all buttery" for the acupuncture (when the practitioner checks one of the inserted needles, she wants it to feel like it's moving in butter). I replied that I felt anxious. About a minute later he called to invite me out for dinner. But I had no idea what he was talking about:

DH: Do you want to go home right after or stay out?

Me: Stay out where?

DH: I could stay at work and get a few more things done.

Me: I have no place to go. But you can work late if you want.

DH: I just thought you might like to eat on the way home.

Me: By myself? Why? Do you need to work really late?

DH: No! I thought I could meet you somewhere since we'll both be on the same side of the bridge. We could eat an early dinner out and wait out rush-hour traffic. Both of us. At the same place.

Me: Oh, wow, I didn't catch your drift there at all. Sure!

Hope we both understand where we're meeting.

Monday, August 25, 2008

Baby pools and baby fools

It's cool and rainy today; in my neck of the woods, the hot, hot weather is probably gone for the season. The pic shows our doggie enjoying a refreshing dip in her baby pool as summer temps soared.

The pup is just 7 — still a baby to us! — but she is aging. For her breed and size she's on the cusp of senior status.

I can relate to that. My family tends to thrive into their 90s, and by that measure I am still a young woman. I feel young. But reproductively speaking, I am old. Who knows, maybe I never did fit into the "young" category, reproductively speaking.

DH and I have taken a little time to determine our next steps on the TTC front. Not too much time, though. We've stayed aware that my fertility is declining at the speed of dog years. (Don't get me wrong. DH's fertility ain't exactly on the upswing either, but mine is the more crucial factor at present.) As Dr. K told me, I'm on a hill going down; I'm not yet on a cliff about to get shoved off. So we're still in the game . . . for the NOW that keeps slipping away all too quickly.

One of our recent talks was sparked by a mutual noting of all the subtle age-related changes to the dog's features, gait, and demeanor. It's soooo painfully sweet to watch those changes evolve in contrast to her eternally youthful attitude. She's older, but she will never "grow up" all the way. She still trusts us to address all her basic needs, acts greedy for treats, takes joy from snatching bees from the air and finding squeakers in her toys, and — remarkably — keeps walking or running (best fun EVER!) through any pain from stray thorns, bloody scrapes, or arthritic joints. This creature lives in the moment. She seizes her chances. She enjoys current opportunity — and expects it in the future — regardless of past disappointments (read: never enough treats).

In that spirit, we've decided to do one more round of IVF with my eggs. It's what we want, and I'm done feeling guilty about it.

Hey, it has worked before. As DH says, "We were on our way." And Dr. K assures us it's NOT unreasonable to assume there's a golden egg for the hatching. We probably even had a good embryo last time, but chance and the many mysteries of life caused an abnormal one to implant.

We can't and won't try indefinitely. We do, however, feel strong enough for one more whirl.

I read this quote from Erica Jong the other day:

"No one ever found wisdom without also being a fool. Writers, alas, have to be fools in public, while the rest of the human race can cover its tracks."

I thought about just sharing the first sentence for this post. (I am a writer and relate to the second from that POV, but this blog's not about that.) But then I realized, no, the whole dang thing applies beautifully . . . all you have to do is switch out "writers" in favor of "couples seeking to conceive using ART." And/or, of course "bloggers."

Wednesday, August 20, 2008

The big to-do

I clearly remember the days WebMD (sort of) reported on today, when motherhood was not on my to-do list.

If you look at my sidebar's reproductively focused history, you might glean that the pursuit of motherhood failed to make my list until I was 38.

As a child I always assumed I'd be a mom. Frankly, I didn't think anyone could get out of it. Once I hit teenagerhood and heartily embraced my future as an Enjoli woman, I told myself "I will do this, but on MY modern-woman terms. I will wear Charlie instead!"

Let's pause for a word from our sponsor . . .

Later as a young adult, despite adoring children, motherhood got bumped to my eh-I'm-just-not-sure-I'll-do list. It stayed there for YEARS. My feeling was why think about it when I don't have that fire? Never mind that I didn't marry till age 30 (I was in nooooo rush on that front either). Surely I'd know when/if the time was right and just act on it then. No biggie.

I'll admit that throughout that ambivalent period some part of me still assumed I'd reproduce. But it was the same part that still thought conception basically just happened to everyone.

In those days I never heard one peep about anyone trying to conceive. (Maybe that was considered crass? Or, quite probably, maybe I didn't pay all that much attention to the details!) Every pregnancy was announced as having come as a BIG surprise to everyone involved. You know, birth control failed, glances were exchanged, towels were shared, coats were hung up next to each other. Of course, everyone I ever knew would, eventually, make their BIG announcement(s). That was fine for them. I wasn't there yet. And oh boy did I balk at anyone telling me I needed to get on the baby-making stick. (Three's Company–style double entendre intended.)

At just shy of 35 (and right before a second round of major abdominal surgery), starting a family made the pretty big jump to my to-probably-do list. Concerns for my future fertility were effectively scared into me, and I followed every last recommendation about ensuring proper uterine healing. I took it very seriously. Yet I still felt a surprisingly deep (er, stupid?) sense of "time on my side." And I deferred all serious family-planning talk — in favor of chasing a "better" career and a big stretch of settled alone time with DH — to age 38, at which point getting pregnant shot straight to the top of my to-do-and-do-NOW list.

The desire hits different people at different times and in different ways. When it finally hit me in the face, its impact got right to knocking me down at every turn. Luckily, I was blessed with stamina, so I keep getting up.

At 43, I know putting "create a healthy take-home baby with DH" on my to-do list (see how I've learned the art of specificity!) doesn't mean it's going to happen.

But man, oh man, that item IS on there. Crazy I might be. But ready to crawl away from the fight I am not.

Tuesday, August 19, 2008

How can I get this baby to my house?

You've probably seen this sweet whale baby on the news. It's separated from its mama and trying to suckle a yacht.

My heart positively aches to see the video (it hurts just to think about the poor scared sweetie).

I want to send for it. We have a couple extra rooms. I'm thinking we could knock down a wall or two and build a perfectly lovely tank.

Think DH would notice?

Sunday, August 17, 2008

LIVE from the corner

Like my little corner? I took the photo to show faraway loved ones a close-up of how the new paint and carpeting on our main floor look with our furniture.

Looking at the pic right now makes me want to crawl into that space and live there. Just for a little while.

As a child, whenever I disappeared from view at home, you could bet I was actively escaping family frenzy by quietly hanging out in a tight spot that nobody else really thought about: the low crook of the massive oak out back; a sliver of plush green carpeting between the picture window and couch (we called it a "davenport" then); the small slab of countertop between the refrigerator and kitchen wall; the cave underneath the basement pool table; or — my favorite — the lighted corner of my tiny-but-packed bedroom closet (door tightly closed, please).

I craved the confinement. It helped me focus my thoughts.

I notice my house full of grown-ups fails to feature any cozy little retreats — with the notable (and terribly noticeable) exception of my piled-high-with-stuff office. That's where I'm sitting right now, taking one of my frequent stabs at thinking things through on the reproductive front. I'm refreshing my memory on treatment plans, giving my favorite search engine a workout, scanning a book with essays about choosing to live child-free, and looking at work calendars, finances, travel schedules, old journal entries . . .

I've had an absolute bear of a time keeping my office clutter-free ever since we began pursuing ART treatments. For a long time, I told myself the mess kept on top of ME (instead of the other way around) because I was so distracted, often harried, as we traversed the bumpy, medically assisted path to potential parenthood. But while moving piles around and definitely NOT making things appear any tidier this afternoon, I realized that I've created just the kind of hemmed-in retreat I used to need as a kid. I feel safe in my office. Wedged into the corner with my stuff. Comfortable, calm, protected, and in touch with my thoughts.

Eureka! An insight! I'd say that's progress, even if it's about the method to my madness.

I'm hoping to make the leap from insights to decisions very, very soon. Although I've obviously been taking strength from my little corner full of stacks 'n' stuff, I'm itching to raze the place.

Thursday, August 7, 2008

Odds are . . .

I had my best-ever RE appointment exactly 2 weeks ago.

Since then I've been chewing and mulling. Ignoring and denying. Processing and calculating. Daydreaming and nightmaring. I sit here tonight wondering what the odds are that my best RE appointment was also my last.

My first RE appointment, ever, happened in 2005 — a year and a half after DH and I, at 38, had thrown caution (read: BCPs and condoms) to the wind. I was 40 at that appointment.

I am 3 years older than 40 now and, interestingly, my quoted odds for pregnancy from any method are higher than they were back then. Not because I'm such a graceful ager, mind you. It's just that my RE-calculated odds have improved with more data. We know more about my response to different drug protocols, how my uterus performs, what kind of ICSI-assisted fertilization rate we might expect, and lots of other junk.

At 43 I have an estimated 25% chance for a successful IVF with my eggs. At 40 my chances were quoted at 4%–8% for the same procedure. You'd think I'd be ecstatic to have "achieved" such a stunning gain. But I'm not. The numbers make me ill. No achievement here.

Those early odds came from an RE who wasted the second 18-month stretch of my tick-tocking clock of child-bearing viability. With him we did tests, tests, and more tests. Never any procedures, because he wanted all possible results before giving us the same odds he quoted from the start.

As that process unfolded, the constant activity of ultrasounds, blood draws, tube testing, and sperm studies made the whole approach seem thorough. But in hindsight, especially after switching to a clinic that actually wants to help us get a take-home baby, I believe that our association with the first RE was absolutely fruitless and downright damaging to our cause. I'd love to have that money back, but I'd pay five times what we shelled out to him to recover the time. And I harbor a secret feeling that stress from that time directly caused the shockingly rapid, out-of-nowhere recurrence of problematic fibroids that resulted in my need for yet another major uterine surgery. More lost time.

I just wonder, how can I come to terms with the realization that I must have had AT LEAST a 25% shot at success 3 years ago? (That RE intentionally stalled us, and it was no surprise to read the clinic's detailed SART statistics from 2005–2006: they cycled exactly 0 patients of my age.) Three years ago everything about me (DH too) was younger and any embryos DH and I might have created would potentially have been better suited for survival.

I guess I can come to terms with the realization. That's just a fact. The problem with looking back is that I'm gutted from knowing that we stuck with that RE so long, despite having a bad feeling about him at first handshake. Funny thing is, I know many women who've had wonderful experiences at his clinic. I'd still recommend it for non-AMA patients because their facilities are top-notch and their success rates are terrific.

Back to the questions I'm asking myself. How can I feel good about a 25% chance for success when that means odds are 3 in 4 that success won't come? (Odds for miscarriage after a "success"/confirmed pregnancy = a different set of odds altogether.) Granted, for this last IVF the odds going in were only 1 in 10 that we'd succeed. We accepted those, and a pregnancy occurred. But we lost it, and odds are excellent that not only were most of the perfect-looking embryos we made chromosomally abnormal, but that any success we might have with another try would end the same way. No baby.

I don't know. I left the hopeful, encouraging RE consult buoyed by the 1 in 4 chance that IVF could work. That's the best number I've ever heard about any option using my eggs, ever-ever-ever. Yet odds seem high that I can't keep traveling this road.

No idea what we'll do, that's for sure. Dr. K says it's fine to take a couple more months to decide. That I'm on a hill (going down) but not quite falling off a cliff. Her recommendations, knowing what she knows about our fertility profile and personal wishes as a couple, were to pursue the following options in order:
  1. One more IVF with my eggs (25% odds for success; should do this soon)
  2. DE-IVF (70% odds for success; can do this anytime in the next few years, so I don't feel as time pressured)
  3. 3 or 4 IUIs (5% odds for success but a way to feel like we're doing "something")
  4. TTC on our own for a while longer (lowest odds for success — couldn't really assign a figure, but, hey, nobody can tell me now that pregnancy is totally impossible)
  5. Move on (she stressed that we could do that now with total confidence that we'd given this whole thing a proper whirl)
A year ago I didn't even want to attempt IVF with my eggs. I wanted DE-IVF, and I wanted it 2 years ago. Two years ago I wanted adoption or DE-IVF, and I wanted that 3 years ago.

Today? Tonight? I seem to want all my own eggs in the basket or nothing. Number 1 or number 5. And I want one or the other right this minute, whatever minute it happens to be.

What to do, what to do.