Saturday, October 31, 2009

Taking Stock

My blood boils when I think about the pure white trash stock from whence I came, and how many babies have been born in my family out of wedlock and under the influence of alcohol and drugs. Those hooers are fucking fertile. Two cousins around my age had their first kid when they were each 16 (sibling rivalry much?). One of them appeared in an MTV documentary in the 1990's about polygamous lifestyles (allow me to join in your chorus of "what the shit?") and subsequently lost custody to the paternal grandparents. Because the baby daddy was in jail. The other cousin is a drug addict and thus had both of her kids (sired by different baby daddies, of course) removed from her custody by their paternal grandparents. Because their baby daddies are both drug dealers (guess that answers the "how did you meet?" question) and/or in jail. Ah, the beautiful South. Backwoods Mississippi. Where all the debutantes live. I didn't realize that most cotillions end in childbirth. My stepsister (also a veritable Southern Belle) had her kid out of wedlock when she was 18 and is primarily supported by my dad. He and my stepmother are basically raising her kid. She celebrated her kid's first birthday by throwing him a party at Hooters. Jesus.

As I contemplate how many cycles I have left in me with my own eggs, my genetic stock gives me pause. I am the zebra in this herd of retarded horses. Would I be doing my kid(s) a service by giving them a different gene pool? One that's a little cleaner? Can nurture conquer nature? I have so many options to sort through and my mind is racing as I wait for the RE second opinion/last chance consult. I am shuffling the deck with his-and-hers Clomid and IUI(s), IVF/ICSI with new protocol(s), minimal stimulation IVF/ICSI, donor egg IVF/ICSI, donor sperm IUI(s), and making an appointment with an adoption lawyer to discuss home studies. Head. Is. Spinning. Sometimes my analytic mind bites me in the ass.

Friday, October 30, 2009

Spooky

We all knew that this was bound to happen sooner or later. The seventh seal of the apocalypse has thus been broken:

I call it: "Plugs + TroutPout = ThrowUpInMyMouth."

Get in your bunkers. Hurry.

Bats Gone Wild

Since it's Halloween and all, I felt this apropos of the occasion. Here's an interesting tidbit on bats:

"Oral sex is widely used in human foreplay, but rarely documented in other animals. Fellatio has been recorded in bonobos Pan paniscus, but even then functions largely as play behaviour among juvenile males. The short-nosed fruit bat Cynopterus sphinx exhibits resource defence polygyny and one sexually active male often roosts with groups of females in tents made from leaves. Female bats often lick their mate's penis during dorsoventral copulation. The female lowers her head to lick the shaft or the base of the male's penis but does not lick the glans penis which has already penetrated the vagina. Males never withdrew their penis when it was licked by the mating partner. A positive relationship exists between the length of time that the female licked the male's penis during copulation and the duration of copulation. Furthermore, mating pairs spent significantly more time in copulation if the female licked her mate's penis than if fellatio was absent. Males also show postcopulatory genital grooming after intromission. At present, we do not know why genital licking occurs, and we present four non-mutually exclusive hypotheses that may explain the function of fellatio in C. sphinx."


Have I blinded you with science? Have another, uh, taste:

Figure 3. Copulation duration (seconds) in C. sphinx according to whether the female licks the male's penis (red) or not (blue).

Note the artist's tasteful rendition of a bat tapping that in the inset.

Would you like to watch this demonstrative video?:



Although this was on YouTube, it was included as actual supplemental "data" on the journal website. Music and all. Research funding to make hardcore bat porn. Who knew?

This just makes Batman THAT much more intriguing to me. And it helps explain the nipples on George Clooney's rubber batsuit.

Wednesday, October 28, 2009

All Work and No Play

It's been a while since my day-to-day revolved primarily around work, rather than today's RE appointment, scheduling tomorrow's, being out of office for some half-day procedure, etc. Now I have to fill my time exclusively with work. Takes the piss right out of me. I miss the cycle calender in some sick, co-dependent way.

It's open enrollment for benefits at work, and I decided to purchase an additional week of paid time off for next year. That's on top of 23 days and the week I can roll over from this year. For those keeping track at home: 6 weeks and 3 days PTO. Holla. One or two years ago, and up to as recently as the last failed IVF cycle, I daydreamed about how much time I would take for maternity leave: would I go back to work, take an extended leave of absence, or quit altogether and be a SAHM for a while? I thought about saving vacation days to tack on to the end of maternity leave. I felt I was being hopeful and practical. Now...I just want to hoard more vacation time. If we have any money next summer, I want to go to Italy (where my husband's people originate) and Ireland (my people's motherland -- irony intended). Or, if we are broke-ass from continued efforts to make a beh-beh (as I suspect we may well be), I will lay around the house and watch daytime talk shows. We'll see. I may need some weeks for trips to Colorado or China for all I know.

A friend called me yesterday to wax poetic about maternity leave and paid time off. She is due with her second beh-beh in May 2010. She had her first around the time I might have had mine, if my husband and I were capable. So I love my friend dearly, but I loathe hearing about her pregnancy. She means well and is actually very cautious about what she says to me regarding beh-beh news, but she relaxed her filter and launched into a rhetorical tangent yesterday about 6 weeks this, 8 weeks that, what about 12 weeks, blah, bah, blah. I actually physically tuned her out while she was talking. I just kept muttering "uh-huh" until there was silence and then changed the subject. I feel like a grade A jerk for being unable to carry on an adult conversation about my friend's pregnancy, but it is was it is. I am an infertile asshole. Love me or leave me.

One week until the highly-anticipated, second opinion RE appointment. Then my co-dependency can resume. Whew.

Thursday, October 22, 2009

Brought to You by the Letter "O"

According to my mittelschmertz and handy-dandy OPK, I am ovulating. As I type. Oh -- there it goes. All I can think is, "Who gives a singular shit?"

My husband insists we "try" anyway. Try to what? I think he's just on a (let's be honest, reasonable) campaign to get some semi-regular sex while my body is NOT a toxic dump of hormones. Get it while it's hot, sweetheart. This love machine is cranking out nookie for a limited time, after which it will be re-geared to make eggs and host embryos. Again.

In my head I am going down the commitment path toward one more IVF cycle with my eggs, provided the new RE can cook up a plan that gives me both renewed hope and sufficient confidence. The next step after that, if more steps are needed, will probably be to either move forward with a donor egg cycle or to consult with specialists in Washington, D.C. or Colorado. The expense of either scares the pants off me.

Speaking of which, I have wifely duties to attend to, so please excuse me as I now "try" to get pregnant. Hahahahahaha. Haha. Hahahahaha. Ha. That's rich.

Sunday, October 18, 2009

Mr. Brightside

What is so great about being positive in a bad situation? Why is it necessary to see the bright side of a terrible predicament?

It's not, if you ask me.

Or Barbara Ehrenreich. Her new book has been added to my still-languishing reading list and I lurve her blog. Among the many salient points she makes, her book simply questions whether it's A) helpful, B) necessary, and C) healthy at all to constantly try and see the silver lining during very dark days. I couldn't agree more in the midst of infertility. I have built enough character. I have learned enough life lessons. I do not wish to revel in the gifts this diagnosis has brought me -- I can count hypothyroidism, 20 pounds of unwanted weight, and mild situational depression among the many presents bestowed upon me by this undesirable and seemingly never-ending phase of my life. I am pissed. I am sad. I need to express that, not cover it with platitudes and sucker myself into a "chin up, sport" mode of thinking that does not settle my conflicting emotions or solve my babymaking problems. And I tire of people offering their oh-so-helpful suggestions (just adopt! adopt an older child! donor eggs! donor sperm! just relax!) to try and armchair quarterback my infertility struggle. I prefer to muck around in my stages of grief during the wallowing period and then counter it with brief, manic bursts of energy and fortitude. It works for me. Realism with a tinge of hope, tempered by a dollop of anger. I can be resilient without being positive. Empowerment means different things to different people.

Here is the infertility vs. happiness spectrum as I see it:


Right now I am a 9. I hope to be back to a 7-8 soon. I miss 0-1.

I will not try to look on the bright side of infertility, because it has none. I don't want to attend infertility support group meetings, as some friends and family have recently suggested I should. I would rather go to a therapist and gripe to her until I feel better or our 50 minutes is up, whichever comes first. Or cry on my husband's shoulder. Or cry alone. (I also can't bear the thought of watching the support group roster rotate in and out as everyone gets pregnant but me....it's bad enough already and I'm not really looking to up the ante in my voluntary face-to-face interactions.) I don't want to take a break and "see what happens." No magical thinking is driving this fate, and no amount of time will change our situation. I want to have a child. I have to do extraordinary things to make that happen. And I have failed thus far, over and over. It hurts. You can't put a cherry on top of this shit sundae and call it good eats. Not now, not ever. And so I refuse to act like I'm content when I am not.

Here's my ideal infertility support group. We don't have to act happy. We don't have to search for hidden spiritual treasures in infertility, because it's not necessary to pretend to be blessed by this in some bizarro way when we know we're running on empty. We can be angry. We can be scared. We can cry whenever we want or need to. We can IVF or IUI cycle until our ovaries weep, and we can take breaks when we need to. We can have high expectations, or none at all. And we can stay in this club until we have our Nth baby (for the lucky), because we all got here on similarly shitty paths. We are Barren Bitches. We hate being unpregnant against our will and don't have to accept that we're somehow better off for suffering.

Who's in?

Wednesday, October 14, 2009

Lapped

Lunch today with a friend was a semi-intervention for her to tell me in person that she's near the end of the first trimester. As would be I, had IVF worked in the first place. This is her second baby in the span of time I have failed to have one. I am so happy for her; but so very, very sad for me.

Monday, October 12, 2009

Off the Wagon

I figured, hey, I am not pregnant and taking a monthly cycle "off," so how's about I get my drink on? I had wine with dinner Thursday night. I woke up up with a headache Friday morning. But we had been at a loud concert* Thursday night so I assumed it was related to the ringing in my ears.

Saturday night we went to see my brother-in-law's band reunion gig (they were semi-famous in the 90's and haven't played together since) and packed into a crowded, smoky downtown Detroit bar. I could not resist the $3 vodka cranberries, so I helped myself to three. Oh shit. I felt fine until I woke up Sunday morning. Hell, I might still be hung over. I find the whole thing pitiful. Three drinks? My grad school self would laugh at my post-grad self. We used to make up pitchers of jungle juice with Gatorade titrated to the perfect balance of electrolytes, so you could simultaneously get wasted and remain hydrated. Beautiful. University of Michigan education dollars at work. (We're all science professionals walking undetected amongst you now, so be afraid. The same guy who tried to smuggle an entire 24-can case of beers into a football game on his person and consequently spent game day in the drunk tank is now a faculty member. At Stanford.) Where has my tolerance gone? Has my liver become so purified during this prolonged period of trying not to have a period that it chokes on a mere whiff of liquor? Sad. I can't even fall off the wagon properly anymore.

Side note on the stinky bar/brother-in-law band adventure: there were, of course, tons of old friends that my husband, sister-in-law, and brother-in-law knew once upon a time, who showed up to relive the glory days. Enter their long-lost high school classmate, Lisa. Lisa was drunk by the time we got there, and she decided that my husband and sister-in-law were her bestest buddies. When I was introduced to her, the first thing that flew out of her mouth was "Do you have any children?" -- to which I gave my usual, frowny-faced, "No, I do not." Without missing a beat, she blurted out, "Well, you don't look like the type who would." Uh, fuck you very much? She handed me her beer, turned her back to me, and took a bunch of pictures. Of my husband. Then she threw her arms around him, declared that she had always loved his face, and planted a prolonged kiss on his lips while my sister-in-law and I stared on in slack-jawed, creeped-out disgust. She said later that he was the brother she always wished she'd had. Riiiiiight. I've said it before, and I come to you with fresh proof: we are freak magnets.

* We went to see Them Crooked Vultures; check them out if you're a music geek like me. Queens of the Stone Age meets Foo Fighters meets Led Zeppelin -- no kidding -- literally a mash-up of these bands, and very good.

Saturday, October 10, 2009

What's Good for the Goose

This story has a beginning, middle, and beginning of an end. It's kind of a choose-your-own-adventure, really.

In the Beginning: There was a meltdown of epic proportions. I spent half the day in bed and the remainder watching HGTV through tears on Wednesday. I called KB and asked him to come home early so we could have A Talk. We worked our way through all options and how they all suck rocks, even making some decisions about donor parts if it comes to that. Going into The Talk, I was afraid he would hurl some clothes in a bag and run screaming, but he proved once again that he is my perfect match, effed up sperm and all. He wants a baby as much as I do. He wants me to experience pregnancy in all its bloated, painful glory. He will do what it takes for this to happen. Money and borrowed parts are no object.

In the Middle: Dr. Dick (not his real name) tells us that KB's morphology has improved over the past year. We now have 12% normal morphology. That's per WHO criteria, so nothing to write home from camp about, but it improved nonetheless and the motile dudes are holding steady at a just-suboptimal 40%. Not stellar, but not hopeless, either. We also have a likely reason now: all the ultrasound ass-raping proved there's no blockage or anatomical anomalies, so a slight dip in testosterone is the sole culprit. Clomid to the rescue! Dr. Johnson (not his real name) thinks it may, in conjunction with a bunch of supplements, help in the months ahead for either IUI or IVF. Poor KB is concerned about weight gain as a side effect. Suck it up, soldier! And welcome to my world.

Beginning of the End: We kind of have a plan. The New RE (with whom I hope to meet ASAP if he can move my consultation up) uses minimal stimulation IVF in his practice, which may be a good option for me. I don't make large quantities of eggs with supra-physiologic stimulation, so shifting focus to quality in a smaller number of follicles with less stimulation may be the way to go. You can use Clomid with few injectables, trigger, and retrieve; then ICSI proceeds as usual. The side effects and medication costs are both greatly reduced, so the possibility of needing additional cycles becomes within physical and financial reach this way. If he thinks that medicated IUIs are a reasonable bet at this point (converting to IVF mid-cycle if needed), I am willing to go there.* KB gets a taste of frequent office visits to check hormones and sperm in the next several months, so the results of those tests may dictate our weapon of choice in Operation Baby Bump. It's requiring a huge leap of faith I didn't know I had in me to accept that moving backward to mini-IVF or even IUI might be prudent, given the hardcore IVF-is-the-only-option brainwashing I've been subjected to for months, but I am mustering all my courage to face the odds.

If all of this is tried and fails, the donor egg talk can resume. KB and I debated the merits of donor egg versus donor sperm if we get that far down the road, and if I'm being honest with myself then I would prefer donor egg. Why, the sane people ask the crazy lady? To the tune of $15,000 and giving up my DNA? Well, first, KB and I decided we will not let money determine our parentage**; and second, my family is krazy-batshit-nutz, so I would be more inclined to relinquish my half of the genetic pool if one has to go. I also feel like I could live with that sacrifice, whereas with donor sperm I think I would drive myself insane worrying that it bothers KB (though he swears it wouldn't). On the other hand, donor sperm is cheaper and requires low-tech IUI....however, it can take 4+ IUIs to get pregnant, which is not much better on the whole than one IVF cycle with an egg donor who can make a baker's dozen follicles for me. We're hoping all of this proves to be moot, anyway, but the plan is in place. I love a plan. It soothes the Type A in me.

So: Clomid; fancy vitamins; and a kinder, gentler RE. This is our Hail Mary.

* We have done medicated cycles and IUI before, but my OB/GYN, being used to treating patients AFTER they have conceived, did not add any injectables or even a trigger, so who even knows if we timed it right.

** I have offered to turn tricks on 8 Mile, but KB (being the good husband he is) says we can borrow money or try to re-fi the house if needed. He's the sensible one in this relationship.

Tuesday, October 6, 2009

FU, RE BS

Let me be less veiled in my contempt: fuck you, reproductive endocrinology specialist, and your bullshit suggestion that we shell out $15,000 plus my own expenses for a donor egg cycle, or try donor IUI. Not gonna happen right now.

She would/will not make changes to a third IVF cycle; we would go right back to an antagonist protocol and likely only get 1 embryo to transfer, if any. Lather, rinse, repeat, until we run out of money or my ovaries and/or head implode. This is beyond disappointing. She will not entertain adding androgens to the protocol because that might shrivel my "beautiful uterine lining." What does it matter, if we don't produce enough embryos to shove into it? I'm not sure if I got a clear answer on clotting or autoimmune testing and/or prophylaxis, just some citations of studies showing women with known clotting mutations had higher pregnancy rates. Okay, that's academically fascinating, so what about my direct question regarding aspirin or low-dose corticosteroids? And I know my T4 numbers look good, but I still want to retest for free T3 to ensure my thyroid medication is appropriate and at the best dose for my recently diagnosed autoimmune hypothyroidism. Nope. Not needed, says the MD to the PhD in Immunology. Fuckity-fuckity-fuck. Fuck.

I requested copies of our records on my way out, and am trying to move the second opinion consult up to October. If he (New RE) is willing to explore protocol modifications, I am willing to go all in for a third IVF try. With MY eggs. In either event, we are also meeting with a urologist who has poked, prodded and clinically violated my poor husband in unspeakable ways and has yet to provide us with concrete information about what the ultrasounds, scans, and bloodwork suggest. Other than super shitty sperm syndrome (SSSS, since we are always in need of new acronyms). If Dr. Wiener (not his real name) thinks it even remotely possible that a 2- to 3-month course of meds could improve KB's sperm morphology enough to back it down to a low-tech medicated IUI, and try on our own in the interim (in case a few thousand sperm here or there decide to get off the short bus along the way), we would consider it. But I am not ready to throw in the towel and get knocked up with a stranger's spooge or to surrender my genetics to a woman I don't know (or one that I do, for that matter). Not ready for that right now.

Let me also add that I liked my current RE; really, really, like you-really-really-like-Sally-Field-liked her. But she started our little talk this morning by reminding me that if I were with another man, I would be pregnant; and if my husband were with another woman, she would be pregnant through IVF. Thanks -- should we send our divorce legal fees to you directly, or bill through your office? That was the harsh-light-of-reality speech that segued into the donor egg talk. Whatever.

Today feels like staring at a Dead End sign, pretending that I can't read. Willful ignorance is bliss.

Sunday, October 4, 2009

Therapeutic

It's a two-pronged approach: eating and shopping. We went out for dinner Friday night (eve of impending Fail) and Saturday night (Fail Day v2.0). Tonight I am getting a home-cooked short ribs-and-pasta comfort food number that I am already drooling over. Today I bought a bunch of clothes I don't particularly need but want (do I need a 7th coat? It's Michigan, so sure). And I shopped for a couple of new small-scale home improvement projects (hello, foyer chandelier I have coveted and same to you, spiffy new handtowel ring). It helps, a little. Money can't buy happiness, but it can buy shiny things to distract you.

Thanks for kind words and your own 4-letter contributions. Much appreciated. The Bad News Beta was a little easier to take this time, but doesn't leave me any less disappointed. I guess some people get knocked up with zero IVF cycles (lucky fuckers, literally), some people with only one cycle, and some with a second cycle or an FET. Then there are some who require many, many more. I think that's us. Fuckity-fuck.

And now, the engines turn toward IVF Attempt Number Three. Meh.

Saturday, October 3, 2009

Hope Is a 4-Letter Word

So is pupo.

As is poas.

And beta.

Then, finally, fail.

In the space of time between the negative HPT and spotting, all the way through the beta blood draw and until the phone call, I let myself wonder if I tested too early, if it was just spotting and not an impending period.

Fool.

I am not pregnant.  Again.

Shit.