When to try again

And now we arrive at the last of our unpleasant decisions following Jane’s passing:

Decision 10: When to try again.

By way of background for those of you who are new to my blog: three years ago, after an early miscarriage followed by 6 months of unsuccessful trying on our own, I was diagnosed with diminished ovarian reserve. I’m a non-responder to stims, having produced only a single egg during medicated IUI, and IVF cycles. Miraculously, we conceived our first rainbow baby C. Samuel spontaneously in between IVF cycles. After C. Samuel was born, we decided to try for #2 via natural cycle IUI. On the sixth month of this, we conceived Jane Margaret.

Some conclusions from our adventures in infertility:

  • I have precious few good eggs left. (One of my doctors predicted that I would go through menopause before age 40…I’ll be 38 next month.)
  • I consistently ovulate one (and only one) egg per month, with or without stims.
  • When we’ve been lucky enough to have one of C’s supersperm catch a good egg, the babies that result are beautiful and perfect (though I can’t say the same for the resulting placentas).  😦

Contrast that with the following advice re: trying again after stillbirth:

  • The American Pregnancy Association recommends waiting several months up to a year to try again after a stillbirth.
  • Dr. R recommended waiting 3-6 months before trying again.
  • Dr. R mentioned a study suggesting that shorter time between pregnancies may be correlated with shorter umbilical cords (part of Jane’s perfect storm), though she acknowledged that the study wasn’t especially compelling.

Having discussed all of these considerations and more, C and I quickly agreed on a decision:

We want to try again as soon as possible! 

We both find the egg scarcity argument more compelling than the emotional self-care concerns. What if I ovulate my last good egg on one of the months that we’re “waiting to try”?!

As it happens, my own body forced a bit of a compromise, since it took 11 weeks for my period to come back after Jane’s passing. My bitchy Aunt Flo showed up on Friday, and on Saturday I got my blood drawn to repeat my CD3 (in this case CD2) bloodwork. Unlike last time, my FSH went in the wrong direction (up to 17.7 mIU/mL). :/

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At least C. Samuel is optimistic. He busted this song out during a recent visit to Ong Ba’s (Grandma & Grandpa’s) house. Neither C nor I had ever heard it before.

 

The Rainbow Song lyrics:

Red orange yellow green blue purple,

red orange yellow green blue purple,

red orange yellow green blue purple,

makes the rainbow bright bright bright!

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[Deep breath] Here we go again.

Can we possibly have enough luck left over for another miracle?

Why my husband rocks!

As we go through this infertility business, it’s easy to focus on myself – after all, I’m the one who has to take my temperature every morning, pee on countless sticks, miss work, strip from the waist down to get violated on a regular basis, check my panties every time I pee, overcome my needle phobia to give myself nightly injections, and on and on. But over the last few months, I’ve come to appreciate C more than ever before. Here are a few reasons why:

C has to put up with constant reminders of our infertility. I’m a college science professor, which means that the vast majority of people I interact with each day are either (a) 18-to-21-year-olds who haven’t started trying to make babies yet (not great for my body image, but an advantage nonetheless when it comes to IF), or (b) 40+ year-old men. Of the colleagues I come in contact with on a regular basis, only one is pregnant (to my knowledge), and two have a very cute children whom I welcome on the rare occasions when they bring them to work. C, on the other hand, is a pediatric dentist. When he’s not recovering at home from senseless injury accidents, he sees kids all day, every day. He gets asked every day whether he has kids and (when he says no) whether and when he plans to. The fact that he doesn’t have any kids yet is somewhat of a professional liability. (What kind of weirdo trains for a job that puts him in constant contact with kids but doesn’t have any of his own?!)

On top of that, C has to put up with his aunts who have no qualms asking about our babymaking plans and sharing their wisdom. (Incidentally, C’s parents have been awesome. C is Vietnamese, and wasn’t surprised when his dad sat him down after our wedding to impress upon him the importance of focusing on having a baby…preferably one born in the Year of the Dragon. Sadly, I miscarried that Dragon Baby while staying at their house; and C’s parents brought me heating pads and ibuprofen and said all the right things. Since then, they haven’t asked once about grandbabies, or given any family-building advice, or commented on my work hours or nightly glass of wine, or…)

C has been present and supportive through all this. He was with me at my first OB appointment last June, where we learned of the missed miscarriage. C held my hand through the appointment, walked me down to the lab for my hCG blood draw where I started crying (to the bewilderment of the phlebotomist), and later told me that he had never loved me more than in that awful moment.

C was with me at the first couple of RE appointments…including the one when Dr. Y informed us that I have diminished ovarian reserve. And since his accident in March, C has accompanied me to every single RE appointment, no matter how minor.

C is bankrolling our IF treatment. Yeah, yeah. I know. It’s ‘our’ money, not ‘his’ money, and infertility is ‘our’ problem, not ‘my’ problem. But that doesn’t change the fact that his choice of career and his success at that career make ART a viable option for us. Consistent with his Vietnamese heritage, C is very price-conscious. He’s willing to spend money when he’s confident of what he’s getting for it, but he hates to waste money. So, it came as somewhat of a surprise when Dr. Y was going over our protocol options and mentioned cost as one advantage of the particular protocol he was recommending. Without hesitating, C said,

“Price is not a factor in our decision.”

It turned out that Dr. Y thought this particular protocol was the best for our situation regardless of cost, but it was awesome to know that we were going with the option that Dr. Y thought had the greatest probability of success, not merely the one that would be easiest on our pocketbook.

Money has also come up a few times in our discussion of how long to try IVF with my (scarce, presumably crap) eggs before considering other options…namely donor eggs. Not surprisingly, C was a fan of the donor egg option; it has a much higher probability of success, allows C to have a biological tie to our child, allows me to carry and give birth to our child, and (perhaps most significantly) leaves open the possibility for siblings, since a donor ought to yield a greater number of viable (or, more precisely, vitrifiable) embies.

But C surprised me in a conversation a few days ago. He started out with his thoughts about donor eggs, then pointed out that he hadn’t been thinking about how I might be feeling. He said something to the effect of:

“I thought about how I would feel if it was my sperm that was the problem and we were considering donor sperm…

If we try IVF enough times, it should eventually work. At about $10K per cycle, if it takes us 10 cycles, that’s $100K. So what?! It’s the cost of a basement. I mean, if we can’t have kids, we don’t need a basement anyway!”

Now I’m not so cavalier about spending $100,000 on IVF – or with the emotional toil of ten cycles…yikes! (In truth, I’m sure he doesn’t feel quite that way either.)  But I knew what an amazing turnaround that was for him. I knew that he was working hard to empathize and understand what this must feel like for me. And I loved him SO MUCH in that moment, and told him so.

I could go on and on with reasons why my husband is awesome – like how he jumped through all the hoops to get married in the Catholic Church (he’s agnostic), and went with me to mass the Sunday after the ill-fated OB appointment; or how he listens to me talk NONSTOP about infertility (I try to come up with other stuff to talk about, but it’s like IF is all I think about right now!); or how he never asks me whether I think my job is the reason for my DOR. (I’ve wondered whether breathing low levels of solvent vapors throughout most of my adult life is a factor, and I’m sure he has too, but he’s kind enough not to say it out loud!)

I have no idea how, after four weeks on Match.com, I met this gorgeous, brilliant, rich, generous, stylish and fun guy, who, inexplicably, has a thing for uber-geeky, clutzy, introverted girls. (On our first date, I used the expression ‘rate-limiting step’ in a conversation.) It’s sort of like when Dermot Mulroney’s character on the New Girl fell for Zooey Deschanel…except that I’m no Zooey Deschanel! In terms of cuteness-to-dorkiness ratio, I’m closer to Alyson Hannigan in the first American Pie movie (not in How I Met Your Mother; she’s adorable on that show), just substitute her sexual worldiness and flute skills for some old-fashioned Catholic guilt and chemistry knowledge…

I was already amazed to have met and married C, and I am even more amazed to see how this man – who up until last summer led a charmed life – reacts with grace and humor in the face of shitty circumstances. C has missed the past 9 weeks of work due to excruciatingly painful injuries caused by a cop’s reckless behavior, and he calls this time his “sabbatical”, and spends it taking online classes to improve the efficiency of his business, practicing on the guitar, and designing our future home (hence the basement comment above)!

As much as IF sucks, I’m grateful to be going through it with an amazing man at my side. And the past year – including a miscarriage, infertility, and a car accident that almost took him from me – has only made me appreciate that fact even more.

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The two of us on our wedding day, bowing to request our ancestors’ blessing during the traditional Vietnamese wedding ceremony.

How we got here.

Hmm. How far back should I go?

I could start at the beginning… Once upon a time, there was a 21-year-old girl who loved school in general – and organic chemistry in particular – so much that she left her college boyfriend to move out to the east coast to go to graduate school. She didn’t worry about having kids yet. After all, she was only 21 years old, and would have plenty of time once her career was on track…

Hmm. Maybe that’s too early to start. How about when we started trying to get pregnant… After getting married last January, and recognizing that we wanted more than one kid and that we weren’t getting any younger, we started trying to get pregnant in early March. In month 1, this just meant ‘pulling the goalie’ and going for it. The next month we tried to time it starting around day 10 and continuing for about a week straight. The third month, a friend gave me her copy of ‘Taking Charge of Your Fertility’ by Toni Weschler. I read it in a couple days and figured out what we were actually supposed to be doing… We got pregnant that month, in my first attempt at charting.

Everything was great. We went on our perfect little honeymoon to Ireland (which we had put off due to my work schedule), where I restricted myself to the hard Irish cheeses, and only the tiniest sips of Guinness and Irish whisky. We came back and went to our 8 week appointment the next week, only to see that there was no heartbeat. The baby had stopped growing at 5 1/2 weeks…

But we were okay. We had gotten pregnant once. We knew that I was ovulating, that nothing was blocked, that his swimmers could swim,… Fast forward to December. By that point, we had had several cycles in which we timed things perfectly and no pregnancy. By this point, I’d read enough books about infertility to know not to put off seeing a specialist. So we made an appointment in January with the Kaiser Reproductive Endocrinologist.

And what now? After the standard tests, we know that C. is superman. (The nurse literally said his sperm test results were the ‘best she had ever seen’.) And at the ripe old age of 34, I apparently have the ovaries of a 45-year-old woman…

So we’re moving ahead with medicated intrauterine insemination (IUI, aka ‘the turkey baster’) next month, and probably in-vitro fertilization (IVF) after that. This month we have ‘homework’ to get ready for IUI, including a hysterosalpingogram (HSG, more about that later), and a 2-hour class on how to give myself hormone shots. Add another notch to the tally of stuff-I-never-wanted-to-know.

Tomorrow I take a blood pregnancy test (spoiler alert: I’m not pregnant) and pick up a prescription for antibiotics. Both are required before they’ll do the HSG on Thursday. Will let you know how it goes!