Rising and Yet Falling

So everything on paper is looking good. The number doubled and change from Wednesday to Friday. Then rose to 949 on Monday. If I were a normal person with a short OB/GYN history, I'd be on my merry way. I'd be picking out nursery colors.

But I'm not. This is my seventh pregnancy. I have one child. Granted, he's a pretty incredible one child, but those are some messed up numbers. So forgive me if I'm not dancing in the streets just yet. Or maybe, even if this thing goes the distance, maybe not ever, during the whole thing. Maybe it will be just like with my H, when his first cry in the operating room took me by surprise. When I said, There was really a baby in there, with a genuine sense of astonishment.

I'm terrified.

Yes, Virginia, there is a Santa Claus.

Today's beta: 116. Am told they look for 50 at this point.

The first step of many. But for tonight, let me just say, in a quiet voice in case fate is listening: yay.

Random Thoughts from the Wait

I thought I'd be somehow enlightened. I've been around the block on the two-week wait, the beta wait, the ultrasound wait. All the waiting. I thought I'd be above the drama. But no. I'm plugging all the search strings in: POAS after five-day transfer. Symptoms after five-day transfer. Success rates after FET. Engaging in the Dr. Google madness like some sort of newly initiated infertile.

Also, my in-laws arrive from the other coast tonight. Which means they will be here, in my house, the day of the test. Can someone please tell me how I am supposed to work this? I don't have a great history with them on these issues, what with their stone cold radio silence when we told them, on Mother's Day, that the reason we weren't doing much was that I was recovering from a D&C, from my fourth recent miscarriage. I told my husband that if it is negative, I shall be retiring to our bedroom and a tray of fettuccine alfredo, chocolate cake and a bottle of red wine shall be delivered to my bedside. But I'm not sure that really covers it. And what if it's positive?

Just to add to all the merriment, our cat was playing with a twist tie this morning, and when we turned away and looked back at her, she was licking her chops and the twist tie was MIA. We looked everywhere for it, and I called the vet. They strongly suggested we bring her in. While my husband was  waiting for her to be x-rayed -- and God knows how they got my Woody Allen of a cat to sit for an x-ray -- I came downstairs and saw the twist tie sitting right next to the couch. We paid $250 and they saw food and hairballs on the x-ray.

Meanwhile, I look about four months along. I'm going to assume this is from the massive amounts of progesterone I'm injecting into my body (based on reading of 19.5 on Wednesday -- this clinic checks two days after transfer -- they raised my dose to 1.5 cc), but if it turns out I'm not pregnant, I'm decidedly not amused.

Embryo in. Sanity out.

It happened. On Monday. They wheeled me in, they put my legs in the stirrups made for giants. They put the gorgeous looking embryo in me.

On the way out the door to the clinic, I checked to make sure I had everything with me. Wallet, check. Bottle of water to chug until I'm uncomfortable, check. I asked my husband if anything was missing. Got your vagina? he asked. Check.

I took the valium on the way, washed it down with the big bottle of water. I just figured, no one had told me it would hurt -- it might only help -- and I can't drink wine, so why not?

When I got into the OR and realized the embryologist was in the corner, I suddenly felt this presence in the room. It was sort of like the time I saw President Clinton speak -- when he arrived in the building, you weren't sure how but you just knew he was there, as if the electrons in the room had somehow started combining differently. He's here. That's how I felt about my embryo. It's here. Alive. In this room with me.

On the way out, they handed me a photocopied picture of the embryo along with a curious little slip of paper with my name at the top and the number of embryos thawed (1), transferred (1), and how many remaining in cryostorage (4). I showed my husband. Oh, he said. Our receipt.

Husbands are not allowed into the procedure room for the transfer at this clinic. I was really blindsided by this news upon our arrival, but luckily at that point I was already operating under the influence of Valium, so I was pretty much incapable of being ruffled by anything. Still, it's odd to think that he was not even in the room at the moment when I got pregnant. He said something about telling people we're really talented, with a wink. He's a funny guy.

I wish I could tell you it's been all fun and games since the transfer. I came home, enjoyed a Valium-induced sleep on the couch, and then, as the medication wore off, panic and despair set in. The familiar mental racquetball match of it-definitely-worked, it-definitely-did-not-work has commenced. And will continue until the test, next Wednesday. Have not decided if I will POAS before then.

The problem with the time after transfer is that it's no longer abstract. So much depends on an implanting blastocyst, on two pink lines, on doubling betas. So much.

Here We Go.

Am solidly full of estrogen. Up to 3 mg twice a day. If you see me in real life, and you are a good and decent person just minding your own business, you may want to run the other way. Consider yourself warned.

The transfer has been set and it is just days away. Am suddenly full of superstition and caution. Do not speak of the thing. We will transfer a single euploid embryo into a uterus primed for it, with the perfect cocktail of hormones my body is likely unable to produce when left to its own. I can find ready reason for optimism, data showing odds in line with egg donors, 25-year-olds. I can also find the stories of those who've come before me, did the work then rolled the dice and came up short.

I keep trying to figure out what to think. I keep looking for a mantra I can cling to. A framework for how to be ready for the disappointment, or how to balance realism and joy should it work. I've allowed myself some dreamy moments, daring to imagine that we might get to the other side of this with a real baby. A name popped in my head tonight and a chill of recognition ran through me. Do I allow myself these moments, or do they make more pain in the end? I've been in this game for six years and I still don't know the answer to that question.

Then there are the practical considerations, all the managing of this process, all the making sure nothing is missed. Calling the nurse to make sure TSH is added to my labs. Finding a prenatal vitamin with DHA already built in. Figuring out PIO shots (I used Crinone for my past cycles). Looking into the benefits of bedrest after transfer (apparently in the years since our cycle for H the tide has turned and they now do not recommend it). Trying to prevent regrets.

I asked the doctor this week if they recommend or use Valium during the transfer. My previous clinic did not, though it was an option. I do remember being overwhelmed by the intensity of the transfer -- being in the sterile OR, having a tiny life squirted into you as you try not to cough or pee your full bladder out. And there seems to be a suggestion that a relaxed uterus is optimal. My clinic gave me the option, and I guess my inclination is, sure, anything to escape my brain for a minute or two sounds lovely right now. But I can't seem to find any data showing an impact on outcomes, either way. So, did you or didn't you? Advice welcome.

Also welcome: funny stories. Hollywood gossip. Fashion tips. Your favorite banana bread recipe. A great playlist. Anything, dear readers, anything to keep me from thinking of the thing.

Wanna Be Startin' Something

Something was healthy. Five somethings, to be exact. On ice. Waiting.

So it took 18 eggs to make five healthy potential babies. If you buy into the whole concept here, we basically compacted a year and a half of reproductive effort into a single cycle and took the guaranteeed-fails out of the equation. Which means we may have saved ourselves a whole bunch of pain. Or maybe, with all the sudden possibility, maybe we're creating more pain in the end. Right now there's just no way to know. There's nothing to do but take the hormones and go in there and let them put them in, one at a time, until maybe one of them sticks and stays with us. Nothing to do but power through all the fear.

What am I afraid of?

I'm afraid it won't work. And I'm afraid it might.

I'm afraid I might not be good at letting all of it go, if I need to. And I'm afraid of being pregnant and of all the angst. Afraid I won't be able to stay above the fray, keep my head on straight through all the what ifs. You know.

But there's an available seat at our table and, as long as there's a legitimate shot in the offing, I need to try to fill it. So onward.

I'm on the Estrace. This is a new one for me -- did not take it for the fresh cycles for H. Not particularly enjoying the bloating or the crazy. Hold onto your hat if you're living under my roof right now.

All I have to say is, thank goodness for my girlfriends. Thank goodness for the lovely souls who ask where we're at and then listen to the long answers. Thank goodness for those with me in the trenches who know the shorthand. When I feel myself fast forwarding to worst-case scenarios and drifting to dark places I shouldn't go, I feel you huddling.

Something's Got to Be Good in There. Right?

Pinch me, for they biopsied nine of our embryos for chromosomal screening. Nine. Out of 12. This from doubts we could even make it to day five.

I know, I know. Deep breath. Reality check. We have miles -- miles -- before a real live baby. But tonight we shall celebrate this small victory on the way.

Day 5. Alive.

On Friday, the nurse called me and told me to be on stand-by on Sunday for a possible transfer. This was a little different from their prior assurances that we were almost sure to go forward with the chromosomal screening (PGS) with so many embryos growing. I asked to speak to the doctor, who called me at the end of the day. She said that nothing had changed -- we still had the 12 original embryos growing, and now we also had two additional, late fertilizers growing as well.

I was instantly intrigued. Who were these rogue embryos suddenly fighting to be part of the pack? Would they make it? Could they catch up? How cool would it be to know that your kid was a fighter from the moment of fertilization? Scrappy embryos.

Anyway, she said they wanted me to be ready for a call Sunday morning just in case, for all the reasons we'd discussed before. Which makes me wonder why I had to be the one to advocate for the progesterone, but no matter.

We woke yesterday not knowing if we'd be transferring or waiting. The time change made the wait seem even longer than it was. By the time the phone rang just after 9 a.m., I was pacing the house.

My husband and I had talked about it. We decided the thing we wanted the most was for their recommendation to be very clear. If they were on the fence at all or left it up to us we would probably opt to transfer the one or two best looking day-fivers and not risk the biopsy. But we hoped they'd make the choice easy for us.

And somehow, that's just how it went. The doctor was upbeat. Said we were in a great position with 5-6 embryos ready for immediate biopsy and more possible later yesterday or today. She said there was no question in her mind that we should go forward with the PGS. So that's what we did. We'll have results by later this week.

I'm trying not to get ahead of myself. Five or six embryos undergoing biopsy and now sitting in the freezer do not necessarily get you a baby in the end. But it's a start. It's the start we've been hoping for. I wasn't sure our embryos could ever get us to this position, and now we're here, and now no matter what happens we will know that we had a real shot. We have the numbers we need to be able to say that it was as good a try as we could have hoped for. And I hope that means we get a baby in the end. I hope it does.

Halloween Magic

Retrieval was Tuesday. Survived despite shaking like a small dog. My anesthesia phobia knows no end. Someday, if you give me enough wine, I may tell you about the bodily function horror that transpired.

But no matter. An impressive-for-age-37 18 eggs were retrieved, and of those 12 decided to try to become humans.

Now we wait. As they mature the team will make a clinical determination about whether they could handle the biopsy and freezer. All I can do is take Crinone (in case we need to pull the plug on screening and transfer instead) and hang out. For the record, with 12 embryos growing no one but me thinks it's even a possibility we won't have some good enough to test. I'm the one who pushed for the progesterone safety net.

Meanwhile, am relishing the victory of my beloved Sox. It doesn't have much to do with infertility, recurrent miscarriage or IVF, and that is one of the best things about it. But it does show that determination, belief in the face of bad odds and even switching up the management can sometimes make a little magic.

Luck Be a Disomy Embryo

I was organizing my closet just now when I rediscovered a beaded vintage clutch that was my grandmother's. I opened it, sort of hoping to find some sign of her former ownership of it, like a matchbook or a Nina Ricci lipstick. A penny, dated 1971, slid down the satin interior. She never carried or gave away a bag without one.

We were close when I was young. I used to go sleep over at her house, and she'd teach me some Italian with scratchy old records. We'd watch TV and she'd let me go through her closet, a treasure chest of fur and silk and matching hats and shoes in Jordan-almond colors. I'd take all her costume jewelry out of the boxes and spray her trays of Shalimar and Dior, a new layer on the fragrant film already covering every fabric in the room.

And then I was an uncivil teenager -- thought I knew everything. Went to college. And then she died.

Our relationship wasn't perfect, but she loved me in that huge, unapologetic, forgiving way that grandparents do. And I like to think that she's looking out for me in some way. Like to think that that penny was a little sign of encouragement.

Forget my earlier post. I'm doing all I can do. A little luck is exactly what I need.

Trying Again

The meds have commenced.

The process of getting them in me the first night (Friday) would have been comical if it wasn't so stressful. Once again I ask, how is there not a better way than trusting regular people to mix medications and stab themselves with needles? It is ridiculous. Four years have passed and the whole thing was new again. And of course we got home late from an overnight trip and H refused to go to bed. Refused. I was sure he would come downstairs and see me injecting myself, and how would I explain my way out of that one? Even the cat went nuts, meowing her little cat head off just to add to the chaos and we'll-never-figure-this-out atmosphere of despair.

Anyway, we apparently figured it out, got the egg-making hormones in me, because I went this morning for labs and they told me to stay on the same doses. I also had a call with the PGD lab, during which they told me all the ways this could go horribly wrong and make it a hugely expensive and emotionally exhausting waste of time.

In spite of this, I think I'm doing okay -- managing. I think I'm mostly in denial, though it also feels like I have a low-level freakout simmering somewhere below the surface, threatening to jump out and terrify those around me at any moment. H's preschool teacher told me today that they went to Chapel for the first time and talked about the fact that God wants us to be kind to one another, and the thought of eight tiny people learning to be kind struck some sort of nerve and I welled up. I mean, should I just wear a t-shirt or sign like "Ask me about my IVF" so people know what they're dealing with right now?

Mostly this whole process is just reminding me of what it was like four years ago, when I was an entirely different person doing this. When I didn't have a beautiful, amazing, miracle of a boy already living under my roof. When I wasn't sure I'd ever win the battle and be a mama. I just think, What if it hadn't worked? Or what if the fact that it did was this incredible unlikelihood and we just lined everything up perfectly, every single thing, and that perfect combination of tiny things we didn't even know we were doing somehow made it possible? What if one of those things hadn't happened? Who would I be right now?

Right now I'm just a mama trying to see if I can do it all over again. I ask for nothing more than the same thing that parents all over the world get every single day, without trying very hard at all.

No Crystal Balls

Met with the new RE. Loved her. I've got my team. Now, assuming my post-surgery saline sonohystogram is clean tomorrow morning, it's time for the Hail Mary pass.

Started the Pill and already feel insane. Jittery, irrational, snappish as only artificial hormones can bring. My husband was trying to open a cellophane bag at one point when I was on the phone with the doctor's office today and I think my glare shot real laser beams through his core. I hope we both survive this.

A family member is pregnant, and there are all the complicated feelings -- you know. Another family member brought it up with me and I felt like she wanted me to be all unicorns and rainbows about it, and I tried to put on a good show. She acknowledged my struggle and told me I should be more positive about what's ahead. She said she had a good feeling. 

My ears are sort of dead to that at this point. There is no seeing, no knowing. Someone else's made-up optimism doesn't really do anything for me. I don't need optimism, pessimism, a fortune cookie, a rabbit's foot. What I need most of all is for you to tell me that no matter how the coin falls, you'll be there. To catch me, to whisper brave words. To distract me if it works, to bring a bottle of wine if it doesn't. To tell me it's going to be okay.

A Tale of All the REs

The balloon has landed, outside of my vagina. Gone is the plastic-tube penis. Alas, no Butterfinger or Jolly Ranchers fell out of it. It did, however, hurt like heck to have it taken out. FYI, if you ever find yourself going in to have a balloon taken out of your Queen Victoria, please do not overlook, as I did, the doctor's instructions to take some sort of painkilling or mind-numbing medication in advance. Because it's very difficult to try to relax, as they tell you to do, when they're yanking something from your uterus.

Anyway, the appointment went surprisingly well, other than the mind-blowing discomfort part. The RE who assisted on the surgery spoke very highly of my uterus. She feels it looks great, with really no signs of previous bouts of scarring. She didn't see any reason not to proceed as planned. The conversation, dare I say, made me feel something unfamiliar, something warm and fuzzy...something like hope.

Before we go any further, I feel like I need to bring you up to speed on where I am with REs. I've had some interesting recent consults that must be reported on. It feels like choosing the right RE could have lifelong implications, so I need you to help me make sure I'm not making a colossal mistake.

Let's start back in my old town, before my move this summer. I've spoken many times before about my devotion to the RE who helped us get to H. I first saw her back in the summer of 2008, when the first RE in the practice wanted to cancel a cycle. The nurses whispered to me that I might want to see this other doctor who would have more patience with the "low and slow" protocol required for PCOS patients. I'm sure it was against the rules for them to suggest another doctor to me, and I'll be forever grateful for their breaking them.

This doctor got me right away. She not only knows the medicine -- what was needed to get me to actually ovulate so I could get the IUIs done -- but she instinctively gets the hand-holding part too. I needed a coach, almost a mentor. I needed someone to say you can do this, someone to walk me through the tough parts, someone who saw me and believed in my quest for motherhood. Maybe it's not reasonable to need that from a doctor, but the good news was I never had to ask for it from her. She told me when I was being crazy, she gave it to me straight. But she never made me feel stupid or belittled my feelings about an intensely emotional process. She said the words I needed to hear, the right words at the right time, the words that helped me push myself harder and get through more than I thought I could handle.

And she did what it took, she came up with the formula needed to get us to our H. For that, my gratitude is and always will be beyond the bounds of words.

However.

After I found out the third post-H pregnancy (in November of last year) was another fail, I started to get itchy. My RE was standing by her sense that IVF wasn't the answer. I didn't know if she was right or wrong, but I wanted to try something else. If the definition of insanity is doing the same thing and expecting a different result...I just needed to mix things up. I got two opinions.

One was perhaps the most bizarre meeting with a physician I'll ever experience, so that one is worthy of a separate post. But the other meeting was with an RE at a well-known center that's made many of my friends mothers. He said the right things. He thought he could help. He felt IVF might be the answer. We decided to try it, and we wanted to fit it in before our move. But I wanted closure with my longtime RE so I had her do the post-D&C look at the uterus. She pronounced it clear and was incredibly gracious about our moving on.

I started the Pill. It made me sick. I was stressed about the move, and the whole thing just didn't feel right. I stopped the Pill and decided to wait until after we moved.

Then we moved, I found out I was pregnant again (who knew I am now one of those women we hate, except for the minor point that all my easy-to-conceive fetuses have died), and things got a little more complicated. I had to find an OB in a completely new town and state to track the pregnancy. I had to trust her to do the in-office D&C and not scar me. I met with an RE, liked him well enough to have him to do the post-loss sonogram, and then decided when he found something awry -- the new fibroid in the cavity -- that I didn't feel comfortable enough with him (or, more specifically, his fertility center) to have him cut my uterus.

What I've realized is that I'm just more comfortable treating this process like it's a medical condition -- i.e. going to a doctor directly affiliated with a medical center, or more specifically, an academic medical center -- than a standalone clinic. There's something more "retail" about the latter, something that feels a little less grounded in science, even though I know the facts don't really back that feeling up. It's just my gut, and after everything I've been through I just think my gut deserves to be heard.

So I ended up at a center that has that hospital/university connection, and a team of doctors that I'm coming to trust. One just finished her fellowship at another well-known university-affiliated program, and while she's new to the specialty, I love her energy. She is the one who talked me down from the ledge before surgery the other day, and when she removed the balloon on Monday she inspired confidence by knowing exactly what she was talking about. It does give me pause to work with someone less experienced, so I'm meeting with a more experienced colleague of hers in the practice next week to come up with a plan. Together, they're beginning to feel like a team that truly might lead me to another baby.

I don't know when this fibroid came up. I don't know if it was there when my long-trusted RE scoped me in March, though I do know that my new doctor told me they didn't see it in the OR when they initially went in with the hysteroscope -- only when they used ultrasound did they find it. It sort of tells me that maybe it was there, and maybe her policy of using hysteroscopy versus saline sonogram may be flawed. But that fact, all the steps I took to get to this point, painful as many of them were, is starting to feel less important to me than the steps -- the possibility -- in front of me. I'm taking that as a good sign -- something I haven't seen in a while.

New Methods of Vaginal Humiliation

I'm sick of feeling vulnerable.

I'm sick of laying down and putting my legs in stirrups and bracing myself for whatever they're going to find.

I'm so tired of being wheeled into yet another procedure, brought down the long, sterile hall, alone with the doctors and nurses, because it's my body that's broken and needs fixing, and no one else can go through the surgery for me.

I'm long over laying on the couch, losing another sunny day to feeling like shit, or bleeding too much, or crying the hormones out.

I don't want to worry anymore about heartbeats or complications. Can no longer handle being the 1% standard deviation patient.

I had the surgery, on Wednesday. They successfully removed my submucosal fibroid.

And now, having thought I'd suffered every humiliation possible in this quest for children, I learned but wait! There's more. There's something called a balloon catheter that they sometimes put in your uterus after something like a fibroid surgery. They blow it up with saline and shove it in there so the walls of the uterus won't touch and form scars. My witty friend S. suggested that perhaps they could put candy in it instead, so you could be a human piñata! That would only be mildly less humiliating.

Last night, the tube of this catheter fell out of my vagina, which they warned me may happen. So now? I have a long, plastic tube hanging from me. This feels nothing like the tampon string the doctors suggested it would feel like. They should really test these things out before they go making such declarations. What it feels like is a big, heavy piece of plastic hitting the inside of my thigh and shifting around every time I walk. I now know roughly what it would feel like to have a really skinny penis and it makes me sort of understand why guys are always adjusting themselves.

But back to the surgery. So I finally settled on a surgeon and center, though I still had reservations. It took me years to build enough trust with my old doctor to the point where I never questioned her, and surgery became if not comfortable, at least less panic-inducing for me. I'm still trying to process exactly what happened, but it seems like she missed the fibroid in the cavity when she scoped me in March, before the last pregnancy. That pregnancy was chromosomally normal. Did it land on the fibroid? Would I still be pregnant with a healthy boy if it had been caught? Was it indeed there, or did it surface during or after the pregnancy? I am asking questions about a doctor I adored and trusted wholeheartedly, and constructs of reality are being torn down. So I don't know exactly how to trust a doctor I really don't know at all.

I got my period last Friday, of course, the day we headed off with H for a much-needed mini vacation after a summer of moving and settling in. I called the office, scrambled in for blood work and the surgery was scheduled for Wednesday. And even after all I'd been through, every prior surgery that told me this one would be okay, I was terrified. We dropped H with a generous friend willing to watch him and then I was in my pre-op room, waiting.

I wanted my husband to do it for me. I wanted to run away. I wanted to pick up H and enjoy the sunshine at a park. They wheeled me in. I said I wasn't sure I could do it. They called in an anesthesiologist who "specializes in anxious patients." I asked the other guy if I scared him away. The row of doctors and nurses lined up at my bedside laughed. They gave me Versed, the edge was gone, and the last thing I remember is being told a random story about the anesthesiologist's first job.

When it was over, I couldn't wait to leave. I bounced up, relief overshadowing the need to move gingerly. I was standing in my friend's driveway talking about H's time with her when I felt the first gush.

I got home and assessed the damage. Lots of blood. Pad the heaviest I've ever seen, densely red. I called. They told me it's normal, it's probably less than I think, when you've been laying down a while it gushes out sometimes. You know what? I've been to this performance before. I know a pas de bourree from a pirouette. I know the difference between blood coming out and coming out in a way that almost hurts. They urged me to lay on the couch a while and see if it slowed. When I moved at one point and saw that my couch cushion looked like a b-grade horror film scene, we were back in the car on the way to the ER.

I sat on the toilet in the ER, giant clots coming out of me, and just thought I'm done. Worst-case scenarios whirled through my head. They tell you there's a risk of their piercing your uterus during surgery. Don't they say that because it happens sometimes?

That wasn't what happened to me. I was in a 1% complication bracket with the complication it was, but luckily it wasn't the kind of 1% that required more surgery or worse. It was a bleed at the site on my cervix where they put the tenaculum. Apparently bleeding at that site is common, but usually resolved at the end of surgery. Mine reopened and needed cauterization. Then I could finally go home to the couch, still dizzy from the meds. I slept on and off for two days straight. I felt like I'd had a run-in with a large truck. I'm still exhausted.

On Monday, the balloon catheter comes out. Then I meet with a doctor to determine an IVF plan.

I've known for approximately forever that I wanted kids. It's deeply part of the fabric of me, like feeling the first chill of autumn somewhere in my soul and loving Nora Ephron movies. I can't change that. I had a beautiful baby boy 3.5 years ago and it didn't cure me of wanting kids any more than winning the World Series makes a ball player pine for retirement. For some reason, the one thing I've wanted, more instinctively than anything else, is hard. Damn hard. Harder than anything I've ever done. And unexpectedly, despite all the time I've spent in this zone of fighting for it, I feel like I have fewer answers than ever about what it all means or where I'm supposed to go or how long I'm supposed to fight.

What's in a Name

So somehow I ended up moving to the fertility capital of the universe. No one told me this was the case when I was looking around. This was not a point included in my realtor's tour of my new town. But shortly after arriving, I looked around and realized that everyone -- my husband thinks this is an exaggeration but it is not, it is literally everyone -- has at least two kids with one on the way. Having four children here is not unusual. And no, I did not move to Utah. As you likely surmised from my last post, I have moved to the suburb of a -- perhaps the -- major metropolitan area of the country.

If this quest for number two is ultimately a failure and I remain a parent to one, I will rock it, don't worry. I'll take the money I would have spent on diapers, buy a Birkin bag and send around a birth announcement about my new baby that doesn't cry, poop or keep me up at night. But for now, now that I'm still trying to take down secondary infertility with everything I've got, it makes me feel like a bit of an outlier. I'm new to town, and I've got this baggage, this thing that may ultimately make me different from most everyone else here. It makes me feel, for the moment, just a little bit more alone.

The other day I met some very nice moms on the playground. As we were chatting, a nanny came over with her charge and as soon as she said her name, this mom chimed in and started asking her about it. The mom said that her sister has been telling her to use it if she ever has another girl. It's a relatively unusual name that you don't hear often, and it happens to be my girl's name. So much so that my husband and I use it in casual conversation to refer to a future child that may live in our house. As in, that would be __________'s room. In this conversation about the name, the woman went so far as to use the actual nickname we were planning to use, saying her sister wanted her to use that too. It was sort of like watching a horror movie that you somehow can't put on pause. I wanted to jump in and say that's my girl's name too! But for obvious reasons I did not. Because it would have made me look weird, because I may never have another child, girl or otherwise, because it was too painful to even hope that someday I may actually have the problem of having a girl, selecting this name, bumping into this woman and looking like a shameless copycat. So I stayed silent.

My husband doesn't get why this bothers me so much. He thinks it's ridiculous that I would even worry about using the name, even if I end up running in the same circle as this mom, which is unlikely since our existing children are different ages and what is the likelihood that I will have another child that happens to be the same age as the children this woman will obviously be having, most likely without difficulty or complication?

I'll tell you why it bothers me. Because I have a funny feeling that in a couple of years, when I'm running around town with my Etoupe Birkin bag anchored on my arm, I'll hear this woman calling after her newest charge, calling out the name I so wanted to use too, and it will sear my chest like an arrow. I'm bracing myself right now.

Good RE Hunting

I decided over the weekend to get a second opinion here. I like the new doctor we've seen, but I just wonder if I'm more of an academic medical center kind of girl.

If anyone out there knows anything about NYU's program and its physicians, please email me at goodegghatched@gmail.com.

Keeping the Dream Alive

I want this space to be about more than my continued battle with infertility and loss. I want it to be about playing in the sand with my H, and how sweet three is, how good it is to wake up every day and know I'm his mom. Because that's what my life is like, too.

But when you struggle to conceive and deliver, and you dare to wish for more than one child, there's this background noise of that struggle that won't be ignored.

I thought I was going for a routine saline sonogram today with my new RE, to make sure there was no scarring from the May D&C. I thought it would be straightforward, even if there was a small amount of scarring. But the truth is, and I never, ever say this, you know I'm a worst-case-scenario girl, I thought it would be totally clean and we'd be ordering IVF meds today. Instead, you know what was there? A new fibroid. In the cavity. That he wants to remove in the OR.

So let's review the deck stacked against our heroine at this point:
-PCOS/unexplained infertility
-Asherman's
-Recurrent/unexplained loss
-MTHFR
-Slightly hypothyroid
-And today, a bonus fibroid

I have a history of a few fibroids that until now, did not excite anyone. They were out of the way, and even as recently as in March when my longtime RE did a hysteroscopy, there was nothing inside the cavity. So of course I'm totally weirded out by this whole thing (where did it come from? did it move? how did it just spring up out of nowhere?) and since I hardly know this new RE and had years of trust built up with the one that got us H, I reached out to her. She was so lovely to call me and talk about it and look at today's images, which I emailed her. And then I asked her if she could do the procedure, and she basically told me it's time to cut the cord.

I know she's right. But sometimes I don't like the sound of the truth. I heard a lot of that kind today.

So where are we? Hell if I know. I'll tell you what it feels like: It feels like someone is trying to tell me something.

All I know is it's hard to keep on dreaming when the facts keep whispering to you that the dream is over.

It's Not Easy Being...Well, You Know

I believe in global warming, just as I believe in gravity, osmosis and medicine. It's science, it's real, and I know we ignore it at the serious expense of future generations. Politics aside, I think it's up to all of us to find small ways in our busy lives to try and do what we can to preserve resources and reduce our footprint. But I'm also a realist, and I know that the really big changes are up to the powers that be -- the scientists behind the products and infrastructure that really operate the country and the world. Without real fundamental change, I suppose I feel a bit fatalistic about the whole thing -- like what can I really do as an individual to make a difference? Other than vote. Which I do.

Global warming aside, I must admit that the real reasons I look for eco-friendly, nontoxic products for health & beauty and home cleaning are selfish ones. When I was pregnant with H, I started to think a lot about what I was putting in my body. I know I went over the top at times and grossly overestimated the potentially harmful effects of given products and foods. But I did a lot of reading about the variety of chemicals in everything, from food to moisturizer, and it disturbed me. As an oncologist recently told a friend, at this rate we're so chemical-ed out that for too many women it's not a matter of if they'll get breast cancer, it's when. It's a sobering thought.

So I try to maintain a healthy balance for me and for the kiddo (the husband too, though I can't get him fully on the bandwagon). I do use chemicals in products, and there are certain things, like foundation, that I just can't let go au naturale. But I read labels and try to avoid parabens, phthalates, etc. I just don't buy the argument that "we're all going to die anyway" or that "there are harmful things everywhere." I just think, why not try to limit some of that junk and avoid carcinogens? Again, it's science. I mean with those arguments, why not avoid the doctor and try blood letting next time you're sick, too?

Anyway I started thinking about it all again this week as I am setting up cleaning service in my new house (the old-school, hardscrabble New Englander in me still feels very tentative and slightly embarrassed when talking about my cleaning ladies, but yes, I have them, I love them, and I just think people have different gifts, that mine is not cleaning, and my time is more wisely spent on other things). I'm trying to get cleaning products down and it's hard to get the right balance between "green," nontoxic choices and things that will really work. I think I've got it down to vinegar and water for floors, Bon Ami for scrubbing sinks, etc., Whole Foods Green Mission all-purpose spray (or similar) for general purpose cleaning, and a harsher Tilex or Soft Scrub in showers around once a month for build-up. Oh and this great product called "Spit and Polish" for stainless steel from a company called Murchison-Hume.

That's my lineup, at least for now. What green products are you loving these days?

Royal Joy

The royal baby was born today, and instead of bitterness over the blatant fertility on display (or envy over the Duchess' embarrassment of fashion riches at her disposal), what I thought today was that an adorable couple was expecting a baby, and it was everything that event is supposed to be: fun, exciting and bringing joy to a family, a nation and a fleet of admirers across the globe. It reminded me that although bringing a baby into this world, for me, will never be without a dark, murky underbelly, at its core it's about new beginnings and promise and hope, not only for the baby but for those who love him (or even fans from across the globe who are a little enraptured with the glamour and tradition of the royal family).

Thank you, Kate, for putting the fun back into it for me, vicariously, if only for a day. My wish for you is that in spite of the press corps, the hoopla, the restrictions of protocol, you get what every mama deserves, to relish all those magical first moments with your sweet little boy.

In the Moment

My sister-in-law is pregnant with twin boys, and as of last week when contractions intensified to under 10 minutes apart, on bedrest. This is an IVF pregnancy, and I need to state upfront for the record that I don't begrudge her a minute of much-deserved joy (and I personally could not be more excited to meet my nephews). But I can't help but feel envious of her.

I've sat right where she's sitting, and I know how nerve wracking bedrest can be when you don't yet know the outcome of a complex pregnancy. But oh, the sweet anticipation. To spend the day searching online for nursery gear, all the highs and lows of parenting a baby still in front of you -- I just want five more minutes in that fleeting space. I want to wait for, and then meet, my sweet H all over again.

It's so hard to fully appreciate where you are, without looking back, to grasp that today is the yesterday you'll look back on soon enough. I really do get that these days, with my three-year-old boy, are just as precious, just as fleeting. I want to marinade in them, to be better at taking mental pictures, to just appreciate. So often I find myself zoning out, thinking about the next thing, the work I have to do, the things I want to buy for my new house. These moments are rushing by, every stage giving way to a new one, and sometimes I'm just not present.

I may not have another baby. But right now I have a three-year-old boy and I want to make every moment of that count. Every single day I am grateful and amazed that he's even here, but I want to somehow apply that better to the day-to-day with him.

How do you make the moments count?

On another note, for some reason Google decided to do away with Reader, and I now find myself without a blog reader or my list of much-loved blogs. I did download my data from Reader before they turned that off, though Google doesn't really provide much guidance on how to use it, so I may have to start from scratch. If you a) know how to access the data and/or apply it to a new reader once you download it from Google, b) have found a new blog reader that you can recommend, or c) write a blog you think I read or would like to read, please, please leave me a comment so I can piece my blog life back together.

An Interesting Case

Here is what happens when you spend your 30s trying to have babies. You create in the process the War and Peace of medical records. Mine was getting out of control -- a menagerie of random test results, dictated notes from physicians, ultrasound reports. It was time to clean it up.

So before I met with the new RE, I sat here sorting through the mammoth stack of paper, letting my nerd flag fly as I categorized the records by stage: "Recent recurrent losses," "Full-term pregnancy," "IVF," "IUI/Clomid." Of course I had to stop every once in a while to read something monumental and remember some milestone from the past six years, like road signs on some highway of doom. I'd see something like the surgeon's note on H's c-section and erupt in tears, realizing that I could be doing this without an actual child already living in my house, that my story could have kept being sad without the joyful vacation of a bona fide pregnancy that resulted in that Holy Grail of assisted reproduction: a live birth. Then I'd realize my walk down memory lane was keeping me from a very important show like Housewives or Keeping up with the Kardashians, and I'd refocus on the task at hand.

Anyway, the result was a highly organized, epic medical record, complete with an at-a-glance timeline I created for the top of the stack. The doctor was duly impressed. He brought us into his small office and was sort of hopping around like a cat on a hot tin roof as he started talking. I don't know if it was that he was excited by my case or the fact that we were veterans that knew what was going on, but he was pretty jazzed about my faulty uterus. Which was helpful, because as I said I'm exhausted by this process and went to the appointment with a certain degree of weariness about the whole thing. He basically said we should do IVF with the genetic screening, and gave us a rather convincing sales pitch about that, even though he was careful to say that the ultimate choice was up to us. I did ask what it meant that the last fetus tested as chromosomally normal, and wouldn't that mean the screening wouldn't really do any good, to which I received one of those circuitous answers that you can't really remember or repeat verbatim. It was essentially that those tests are ultimately not totally conclusive as there can be an unhealthy fetus that tests as healthy. Which makes no sense, but whatevs. I guess it's one of those things where you can't let the facts get in the way of hope.

So here I am. Waiting for my period so I can have a saline sonogram and then possibly shell out a good $8,000 for IVF with chromosomal screening (with insurance) so I can live the rest of my life knowing I went to the ends of the earth to give H a sibling. I'm a little torn because I was told at a second-opinion consult with an RE in my old city (who I almost cycled with before moving to my new city; more on those visits in a future post) that the screening probably wasn't necessary and I think I'm sort of in his camp. I actually think what's happening is that the PCOS is still at work, exposing my eggs to the wrong concoction of hormones as they develop, and that IVF rights that by letting the docs take control of your body, which when left to its own devices just cannot be trusted to produce a living human being. That's my Google MD assessment.

So anyway I'm torn and not sure how we'll proceed, and I guess just hoping my period takes another three months to arrive so I can have a break and think about it.

And oh, by the way, another medical professional let it slip and inadvertently blurted out the gender of my loss in May and this one was a boy. A brother in the making that my H will never know.

Forty-Six Healthy Chromosomes. Zero Explanations.

In general, I don't think of the fetuses I've lost as lost children. That is an evolution from my first loss, pre-H, which, because it was my first-ever pregnancy, felt most like the loss of someone. In general, I find it easier to go along with the doctors and assume these pregnancies were the beginnings of life forms that were ultimately incompatible with human life, and my body had the good sense, for better or worse, to recognize that and let them go.

But every once in a while there is a wild card that throws off that construct I've tried to build neatly around these losses. There was the second of these past four losses, last year, that looked perfect on-screen right up until the moment it left my body, suddenly, without explanation. That one still haunts me. What was wrong with it? Did my body reject a healthy baby? Could that have been another sweet little H who might have walked and talked and said funny things?

And now I have another one to ponder, another pregnancy that suddenly seems more like it could have been a loss of an actual person than some ersatz collection of cells. The OB called yesterday and told me that the karyotype on this pregnancy came back showing no chromosomal abnormalities. Which is now sitting out there like some ominous clue in a bad suspense movie, leaving us to ponder why, then, the heart of this little creature started beating but couldn't become anything more. Why it then died too, joining four other siblings, or mizukos, or promises of lives that were, for whatever reason, defined or never to be known, not meant to be.

It's hard to know sometimes how to read the highway signs of life. What am I to take away from this fourth loss? Do I listen to this nagging voice saying maybe it's time to toss that proverbial towel? Or do I listen to this other voice that says this is your dream, and you don't walk away from your dream just because the going gets tough? What if I'd walked away before H? Some people do, and no one would have blamed me if I had.

My meeting with the new RE is tomorrow. For the first time since I started this slog six years ago, I have no plan, no direction, no clue what I want to do. All I know is that I've spent my entire 30s to this point trying to have babies, and I'm exhausted.

Day Three

I was doing fine, but I forgot about day three. That dreaded day three. It doesn't matter how you feel in your head, because when the hormones take a nosedive, they're taking you with them. My OB told me about the curse of day three when I lay in my hospital bed weeping, inexplicably, after delivering a perfect little baby three years ago. The day three business of dropping hormones also happens when you get a sick fetus sucked out of you, and this is just one of life's unfair, dirty little secrets. You can't be okay about it even when you really feel okay about it, because the physical process is going to force you to cry.

And cry.

And cry and cry and cry until you're limp and the only thing you know how to do is binge eat ice cream.

I also drove myself to get sushi for dinner, blasting Florence Welch on the way. Next up: a reckless caravan of additional verboten pregnancy foods including unpasteurized cheese, meat sandwiches from food trucks, etc. And, as soon as I'm done with this doxycycline, a bottle of wine.

Habitual Aborter

Serious shizz has gone down, people. We moved again -- a major, out-of-state move this time. Because I love my husband and he hated his job, because, let's face it, I was bored in the little town where we last moved, and apparently, because I'm a glutton for punishment, which upending your entire life when you have a preschooler so clearly is.

But let's start with what's germane to this forum, namely: girlfriend realizes, a mere two weeks after arriving in her new town, that her period probably should have arrived by now. This cycle was all thrown off because I'd stupidly thought I could handle squeezing in an IVF cycle before moving. I thought, hey, I am the queen of multitasking! I can handle this! But no. I could not handle it. So after four days on the Pill I stopped the Pill and pulled the plug. And I had a withdrawal bleed (right after my regular one) so my RE said that could throw off timing and don't be surprised if it takes a good six weeks to get my period. 

So I wasn't worried when I bought the test. I had been talking to my friend that day (one Who Knows) and told her I was going to test but there was No Way, Repeat, No Way it would be positive. Which in retrospect makes no sense, because why would I be testing if I thought there was no way. But anyway when I got home from the playground I sat H in front of the boob tube and went to pee on another stick, and I'm telling you, the "Pregnant" line lit up before the control line, literally as soon as a drop of pee landed on it. I definitely shrieked from shock, and I'm pretty sure the words were, "You have GOT to be kidding me," and I later thought I would definitely have to rewrite history on that if this pregnancy stuck around. And then I thought, I will probably be punished for not being instantly filled with joy. But I'm sorry, once you've had a miscarriage or two -- or three, or four, if you're me -- if you are alive and a feeling human being and not a robot, your first feeling at seeing the two lines is dread-laced fear. 

Anyway, I will get right to the point: the D&C was yesterday. I don't know what was wrong with this one. I only know that when I went for my second OB visit (after scrambling to locate one in my new area who might be able to handle me), I was talking to the receptionist when I felt the gush of blood. I bled profusely as they did a scan and saw a sac and a yolk sac and sent me on my merry way with a 50/50 prognosis. I returned last week and the OB, who scanned me herself, told us there was a heartbeat but it was incredibly slow. We scheduled the D&C for yesterday and scanned again just to be sure. Another day, another still screen, another IV of sedatives, another vacuum ripping out what could have been my bonus baby. 

I didn't cry this time. Well, I did, just a little, when I heard "Isn't She Lovely" in the car last weekend, because it moves me and I was hormonal and the tears were sort of involuntary. But that was it. I never connected with this pregnancy, never allowed myself for a second to believe that it could come true. So there was nothing to mourn, really. I realize this could sound harsh and unfeeling to someone who's never been in these shoes. But trust me, after one miscarriage, or two, or three, or four (this was my fifth, all told, with one before H) bring you to your knees, you sort of reach a point where you don't have to do that again in order to let it go. It's sort of like shorthand, or muscle memory, or something. You sort of say to yourself, yup, this sucks so bad, but you don't have to actually go through the histrionics to reach the same conclusion. You decide you could spend some time falling apart but quite frankly you'd rather search on Pinterest for some decorating ideas for your new house.

So. I can read the writing on the wall (I'm smart like that). If I want another baby, I have to put on my big girl pants and do the damn IVF. There are moments, though, when I'm not sure. You know sometimes when you try really hard for something, like a new job? You buy a new suit, you arrive early to the interviews, you make sure you're totally on point. And then they keep having you back to meet with different people and you don't hear from them exactly when they tell you that you will, and you start to get the sense that you bought a new suit for nothing, that they may never actually hire you? And then the whole thing starts to jump the shark, and you feel like, damn it, if they don't want you then you don't want them either? 

That's how I'm starting to feel about this. Like, if being a mom of two doesn't want me in its fancy little club, then I have better things to do than to keep trying to sneak under the velvet rope.

I'm meeting with an RE in my new area in two weeks. We'll see if he can say anything that makes me feel hopeful again.

Stuck.

So, picking up again, here's where we are.

The miscarriage isn't over, ladies and ladies. My last beta was on Saturday, and the level was...drumroll...1.6. This is down from 3.5 the week before. I've been bleeding again, for the past week and a half. I found out I was pregnant in October. The calendar says it's January. Will this one ever end?

Meanwhile, there was one final, craptastic piece of bad news I needed to hear about this loss: the result of the genetic testing. I suppose I'm grateful we had a result at all, as I realize this is not always the case. But it's not easy, no matter how mature and rational you think you can be, to hear about what was wrong with the fetus you thought might be your baby. I shook while the nurse told me this one had Trisomy 8. And although I knew it may not be totally advisable, I let her also share that it was XX.

We all build our own framework of how we think the world works: who God is, how we're all here, when we believe life begins. We listen to politicians debate the same, and sometimes we vote based on those beliefs. But those views are all theoretical, aren't they, until the lines are all blurred when we find out we're pregnant with a much-wanted baby and then it's gone as quickly as it came. Our frameworks break down. We're left with questions, curiosities. This fetus had a beating heart inside of me. Yet Trisomy 8 is a condition incompatible with life. So was it ever alive? Can you have a beating heart and not be alive? Was it ever really a girl if it could never actually be a person? It makes my head hurt. To say nothing of my heart.

When my beta finally reaches zero I will go in for a recurrent miscarriage panel to ensure nothing else is going on other than wonky, old eggs with genetic defects. Then I will try one IVF cycle and see if it works. I have no idea if it will, or if this is a good plan or where I will be if it doesn't work. Or if it does. At this point, I have questions and no answers.

Friends and family members are getting good pregnancy news. I have authentic, deep, boundless joy for them. Truly. But may I also admit this thought: why not me too? It wouldn't take anything away from anyone else, would it, for the universe to grant just one more? Why not a wait that ends with good news, just one more time, for this girl too?