A (Small) Goal Accomplished

I mentioned in a post a couple months back that I decided to run in a 5K race on New Year's Day. That plan is still on track, and to prepare for the experience of participating in an organized run, I signed up for a 1 mile fun run that took place on Thanksgiving Day.

I was a bit nervous and kept looking at R and asking, "What on Earth was I thinking when I signed up for this??" But I accomplished my two goals for the day: 1) I ran the whole thing, and 2) I didn't finish last.

In fact, I finished in the top half overall for the 1 mile race. Not that that is truly impressive, mind you, when you consider that 1) the first 10 or 12 finishers were children and 2) my time was upwards of 12 and a half minutes. But still, it gives me motivation. And I finished just below the top 1/3 among all the women who did the 1 mile. Again, I'm sure many of them were walking it just for fun and not for a time, so it doesn't really count. But it gives me a benchmark to start.

My goal for the 5K remains the same - to finish, and hopefully not finish last. But I expect to be very close to last, because the Thanksgiving Day race also included a 10-mile run and a 5K. And for that 5K, most of the participants averaged a 10-minute mile or less. I didn't even come close to a 10-minute mile when I was only doing 1 mile, so I know I certainly won't be close to that this time around when I'm doing 3.1 miles. But that's okay. At least I'm in the race at all.

And I have to say, it feels really good to be accomplishing a goal, even if it's a small one.

The Numbers, Good and Bad

I've gone in for blood draws a couple of times this past week. The news has been a mixed bag, although I do think the good outweighs the bad.

First, the bad: I had a CD 21 progesterone test, and my progesterone level was only 0.5. I was pretty sure even before the test that I hadn't ovulated, but then as soon as I got home, it became clear that CD 1 was on its way. The test result only confirmed all of that.

If I continue to not ovulate, that clearly puts a crimp in our plans to try naturally.

However, the good news: Since it's been 2 1/2 years since my last FSH test and CD 1 showed up, I decided to get a CD 3 LH/FSH test done. FSH was 4.1, LH was 10.3. That's a pretty typical PCOS ratio, which isn't great, but I'm too thrilled by the FSH level to be very bummed about the PCOS right now. (Apparently, somewhere in the back of my mind I keep hoping that maybe the PCOS will go away...)

At least that FSH lets me feel like I have a little bit of breathing room in terms of time. If I do start to ovulate, we will try naturally. However, I don't think we'll spend a lot of time on that approach if my eggs don't seem to be making regularly scheduled appearances.

I've been thinking some more about my consultation with 2nd Opinion RE. As much as some of his comments were totally thoughtless, I do think his overall approach to our case has significant merit.

Every time I've pressed Doc, he refuses to acknowledge (to me, at least) that perhaps 32 eggs were a few too many. He is also adamant that we should go with the same stim protocol as last time. I, however, do not see the merit in continuing to bang my head against the wall with the same approach while hoping for a different result.

2nd Opinion thinks that 32 eggs were too many and probably compromised egg quality, therefore leading to embryos that might have looked good but were likely chromosomally abnormal. He thinks Doc used a valid protocol (4 vials for the first 2 days, then 3 vials per day after that) given the information he had to work with and the fact that it was my first IVF, but at this point he would recommend an even slightly lower dose of stims and would aim for significantly fewer eggs. I feel much better about that approach, because everything I've found in my research says 32 eggs are too many.

So now hope is sneaking its way back in, and we may be doing another IVF sooner than we planned, though it will still likely be late spring at the earliest.

Random Thoughts...

There seems to be a constant mish mash of thoughts running through my brain lately, and every once in a while one of them makes me think "I should blog about that." So here they are, in no particular order.

...on Stupid Things REs Say

I'm still processing last week's consult with 2nd Opinion RE. A couple of things I didn't mention in my last post:

At one point, he said, "As long as you're having miscarriages, I'm happy." I mean it - he actually uttered those exact words. "I'm happy." Are you nuts, too?? I wanted to ask. He must be, because a sane person can't possibly think that's a smart thing to say to a cynical, bitter RPLer. But then again, maybe he figured it was safe since he's 300 miles away and I couldn't exactly smack him through the phone's airwaves. I know what he was trying to say, but there's a better way to word it.

At another point in the conversation, he also compared my five miscarriages to foul balls. Technically, yes, they are strikes, he says. But even if you have 10 miscarriages strikes, you're still up to bat and you should keep trying. Yes, that was meant to be encouraging. Really.

...on Clothes Shopping with 50 Extra Pounds of Infertility Flab

For a very brief time in my life, when I was starving myself and consequently a lovely size 6, shopping was fun.

I ventured out today to try to find clothes for a couple of upcoming occasions. All I can say is What the heck are fashion designers thinking these days??

The item I have the most difficulty buying are pants. Now, please understand that I'm realistic about my size. I'd be lucky if that slinky little size 6 red dress that I had 10 years ago would fit around one of my legs with much room to spare at this point. So I don't go trying on size 10 pants when I'm, well, not a size 10.

I ventured into the dressing room with about 5 pairs of pants, and came up with the same results on all of them: Pant legs with enough extra yards of material at the bottom that a search party sent to find my feet would still be looking for them two days later, while around my waist, stomach and hips I look like a stuffed sausage about ready to explode from its casing.

My ankles don't need that much material - they aren't THAT big. So, fashion designers, please take note: Shear off some of those extra yards of fabric around my feet and move them about three feet north, where I could really use the coverage. And while you're redesigning them, could you also please figure out a style that makes me look about 30 pounds thinner? Thanks.

...on The 'Let's Try Naturally' Approach

Yes, well, about that. In order to try naturally, you need an egg. And an egg is something that my body does not seem to be in the mood to make these days.

I had an 18 day cycle last month. This month, I decided to do a CD21 progesterone blood draw to get a sense of what's going on, because I didn't see strong signs of ovulation. I got poked yesterday morning, then came home, went to the bathroom and saw blood when I wiped. It hasn't been enough to call it CD1, but still, this does not bode well.

Maybe it's just taking my ovaries a while to adjust to an infection-free environment after all the antibiotic treatment. Let's hope, anyway.

There's more, and I know you're all waiting with baited breath, but I'm going to try to get to sleep at a decent hour for once, so that's all for now...

Hope Hurts

Hope shouldn't hurt, but somehow it does.

Even though we're not planning to start trying again for a couple of months, and we plan to try naturally at that point, I went ahead and had a phone consult with another RE this week. I wanted to get a second opinion, and I figure it's best to be prepared in case I don't seem to be ovulating regularly or R's numbers come back low when he retests at the beginning of the year.

2nd Opinion RE said all the right things - he doesn't think my age (33) is a concern, he thinks I'll respond well (based on 32 eggs retrieved in July 2006), he thinks our issues have been chromosomal due to too many eggs being retrieved and that that's easily corrected with a slightly lower stim protocol, he thinks it's a good sign that I've been able to get pregnant so many times, he thinks I'll be able to carry to term with a healthy embryo, he thinks it will happen for us.

All of those are very encouraging things, and I'm grateful for them. But (and isn't there always a "but" with me?) as odd as it sounds, part of me was also sad after speaking with him.

To be totally honest, in some ways it would have been easier if he (and Doc, and Antibiotic Doc, and Ob/Gyn) had said "I'm sorry, but you're not creating good embryos, your chances of creating good embryos are nil, and you should just give up because this isn't ever gonna happen for you." At least then I could begin to accept that and move on. It's been 5 long, painful years. At this point, if he (and the rest of the bunch) had a general consensus of something like that, I think I could be ready to hear it.

But they don't. Instead, they're all sunny, optimistic cheerleaders about our case. They all say that we're so close, that we're way too close to give up, that we should definitely keep going.

When you've been doing this for a year, that's good news to hear. That's motivating and encouraging. When you've been doing this for half a decade, as strange as this may sound, it's painful and even a little bit scary to hear.

Because instead of the ignorant optimisim of a newbie who thinks "They say our chances are good, they say this is going to work, soon we'll be holding a baby - yea!", a beaten down, loss-ridden vet thinks "They said that FIVE. YEARS. AGO. Clearly they don't know what they're talking about. Do we have 5 MORE years of losses and heartbreak in front of us before this purgatory ends?"

And sadly, the only way to find out is to keep going.

I know I could opt to throw in the towel now, that no one is physically making me continue. But there is a part of me that still has hope. Granted, sometimes it feels like such a tiny part of me, so small that if hope was a visible thing it would require a high-powered microscope to see at this point. But still, it's there. And even if it wasn't, I still want this for R, so I would keep going for that reason alone.

I just never knew that hope could be so painful.

Is This Normal, Or Is It Just Me?

I've been struggling a bit lately with what it is that I want to do. Not in the "what direction do we take in dealing with infertility" sense, but in the job sense.

If you'll recall, back in February R and I decided that I should quit my job and embark on a new career as a Realtor. I'm working with another Realtor friend, and the plan was for me to have more time to do things like exercise and cook, to get healthy for another pregnancy.

Yeah, well, the best laid plans...So far, that free time hasn't materialized. Instead, I'm working more hours than ever before. And I'm not having a lot of fun, because our niche market is foreclosures. And when you deal with foreclosures, you deal with things like:

• transients living on the back patio of your property
  
• dead landscaping that ticks off the HOA (this week)
  
• phone calls from police saying "there's been a shooting and we think the perps might be holed up in the house you have listed..."
  
• dead rabbits in the yard (today)
  
• dead pidgeons in the driveway (today)
  
• phone calls from a utility worker saying "I'm in front of one of your properties...the door is wide open, the lock has been messed with so that it won't lock, and it looks like it's being used as a drop house..." (today)
  

That's not to say it's all bad, because I definitely enjoy not having to be at a desk from 8 a.m. to 5 p.m., and I don't have a boss that I answer to every day.

But I'm working harder and making less money doing so. And I don't have more time to do things around the house, which I told R I would do to take some of the stress off him.

So I'm debating what to do. I used to be a very focused person, at least, I was before infertility struck. It's been 5 years, and it seems like it has sucked the life and energy right out of me. And now I'm floundering.

Here are the different options I keep stewing over:

1) Find a full-time job. If I do this, I'd prefer to find one at a company that has infertility benefits (not easy to do, since I don't live in a mandated state) and one that pays about $10,000 more than I was making before. That part of the goal is probably more feasible. We need at least one or the other in case we have to go back to infertility treatments at some point. And if we get both, I'll use part of the extra money to pay for a house cleaning service, so that my ceiling fans get cleaned more often than, say, once a year...

2) Stick out the real estate career. This is the one that R and my therapist are voting for. Both keep saying, "But it has to get better..." And, yes, it probably will. But the issue isn't that there's not enough to do, because in the foreclosure market, that's not a problem right now. But my goal was never to be a traditional Realtor as a career, it was to get into the field so that R and I could start buying and flipping properties. And I still think that's a legitimate goal at some point, but not right now, not in this market.

3) Get a part-time job and adjust our spending habits to make it work. When I left, my former company split my job into two full-time positions. It appears that they've since switched one of those (the duties I'm more interested in) to a part-time position. I may be able to contact them about coming back, although I have mixed emotions about that for a variety of reasons. But even if I do that, do I then still do some of the real estate work, or just do the 3 days a week and use the extra time to really focus on my health? From a financial perspective, if we are disciplined, we could probably make it work without losing too much ground. However, even when I'm working full-time, I feel guilty about not making as much as R does, so I'm sure I'd feel even more guilt if I was only working 3 days a week.

4) Stay home altogether. Ok, this one isn't really an option. But it's nice to dream.

Honestly, I'm not a lazy person. In fact, I used to be an ambitious person. But in the past 25 months, there have been 4 miscarriages, 3 failed adoptions, 1 failed fresh IVF, 1 failed FET and three months of illness/major tests that resulted in an IBS-due-to-stress diagnosis. In the 2 years before that, there was 1 more miscarriage, 4 canceled IUIs and 4 failed IUIs. At this poitn, ambition is only a distant, faded memory. I know R has gone through his share of it too, but even so, I think it's at a different level when you're the one actually swallowing daily meds by the handfuls and having all those needles/ultrasound wands/IVs stuck into you.

I want a break. I need a break. I guess I need to think about why I made the change in the first place - to give myself the best shot at being healthy enough to have a successful pregnancy. And I don't think I'm doing that right now. And there will be many, many more years for me to work hard at earning more money, but not many more years when my eggs are still (hopefully, potentially) viable.

If only we were filthy rich and I could go with Option #4...I'd be the best darn potato a couch ever met! :-)

Woo Hoo!! (aka Goal #1 Achieved)

I am going to celebrate tiny little milestones in this weight loss process because, well, sometimes tiny little milestones are all that I've got. So...

Milestone #1 - I'm now back below 200 pounds. Yea!! I've never been so happy to see the scale say "199" in my entire life. (You've gotta keep in mind, this is a 5'7" gal who weighed 105 at one time in her life. Granted, that was not a healthy time, but that's beside the point at the moment.)

My next milestone is going to be getting below 195. I've decided to set 5-pound increments for my goals, and a secondary goal of getting to the next goal every 10 days or so. I know that sounds fast, but I'm doing it as much through exercise as I am through cutting back on what I'm eating.

Now, for some comments in response to the comments on my last post:

Grad3 - You crack me up! ;-)

Nico - I hope so! The feeling was still there this past weekend, unfortunately. I think I might be stuck with it for a while...

Anna - I'm glad I've got some running company, even if it's virtual company! :-) I've found that the more I run, the less I crave sweets. I'm not sure why that is, I'm just grateful that it's so. And thank you for the knee advice. I might have to give that a try. I had surgery when I was in my teens - something about the muscle that extends from my hip to my knee pulling my kneecap out of place. The surgeon said it's very common in dancers/gymnasts, and I did gymnastics for several years, so that was probably the cause of it. I also find that if I do my physical therapy exercises when it starts acting up, that usually helps.

And now for a completely unrelated comment...Do you know how to make a cat dance? Toss her into the middle of a room where the carpet has just been steam-cleaned and watch her try to figure out how to exit the room without getting her paws wet. Yes, this is what my evening's entertainment has been reduced to. Sad, isn't it? But also darn funny. I never knew a cat could walk on baseboards!

Weighing In

Um, about that whole weight loss thing...It isn't going quite as planned.

It started off well enough, with a 5-pound loss in about 2 weeks. I was pretty pleased. Then I spent 11 days out of town undergoing the antibiotic therapy. I thought I would have lost weight, because I did a lot more walking than usual. But apparently I also did a lot more eating than usual, because I gained the 5 pounds back, plus a couple of extra ounces to boot.

So I decided that I needed some extra motivation. There's an annual marathon/half-marathon race in our town each year in January, so I considered entering the half marathon. (Mind you, at this point I can't even run a half mile, much less a half marathon.)

But then I contemplated it more and realized that 1) I'm probably overreaching just a tad bit to think I could go from 0 to 13.1 in 3 months; and 2) even if I could run 13.1 miles, I have Absolutely. No. Desire. to do so.

I opted to set my sights at a more realistic level, so now my goal is to run in a 5K race on New Year's Day. And preferably to not finish in last place. Although honestly, to finish at all will be an accomplishment.

I found a 5K training program online. It's 8 weeks long. I finished the first week of it this week. Basically, it involves running incrementally longer distances on Tuesdays, Thursdays and Saturdays, walking on Sundays and resting on Mondays, Wednesdays and Fridays.

Because I have cranky knees, and because I'm not in shape at all, I've opted to spend Tuesdays and Thursdays doing the distances on an elliptical machine we have at home. On Saturdays, the plan is to go to the local high school, which has a soft, cushy track, and run there.

This Saturday was my first actual run. And I've discovered yet another joy of infertility: After all of those PIO shots, my ass now hurts when I run. More precisely, it stings. For about the first two laps, anyway. Then it turns into more of a dull, mostly numb ache. Or maybe it's just by that point I'm so focused on the feeling that my lungs are about to explode that I don't notice the pain in my ass as much.

I mentioned it to R. He said, "Well, what do you expect? We've poked you so many times, your mucles are now full of holes."

Great. Now my brain is stuck on the image of two pieces of Swiss cheese where my glutes are supposed to be...

The Things We Do For Kids . . .

This week it was R's turn to suffer for the cause.

Actually, the poor guy spent about 10 days suffering. It began with an itchy rash (an allergic reaction) and ended with getting his arm hair ripped off in an experience I imagine is rather akin to a woman having her leg waxed.

I imagine you're wondering how, exactly, does all of this relate to having kids?

As I mentioned in the Next Steps post, our next move was to undergo high-dose antibiotic therapy with a doctor we met in May. Part of that involved 10 days of IV antibiotics. I did fine and didn't have any issues with it, but R wasn't so lucky.

About 16 hours after he got his IV, he began having an allergic reaction to the medication. The poor guy was covered in a rash, and he began to swell a little bit too. (Fortunately, his reaction wasn't severe enough to make his throat swell and close or anything like that.) He had to go on prednisone and switch medications in the IV. It took a couple days, but the itching calmed down and the rash faded.

Then came the worst part of all - getting the IV out. Actually, it wasn't removing the IV itself that was the issue. Instead, it was removing all of the bandages that were holding the IV and the IV tube in place.

The thing is, R is blond and very fair skinned, so his arm hair isn't particularly visible. The morning he was having the IV put in, the medical assistant forgot to shave his arm. She didn't realize it until his arm was swabbed with generous amounts of iodine, at which point the arm hair became more obvious. But at that point, it was also too late.

When the IV was inserted, she covered his arms with clear, very sticky bandages from about 5 inches above his elbow (which is where the IV went in) to about 7 inches below his elbow, then wrapped the whole thing in an Ace bandage.

My IV was in the top of my hand, because I have no good arm veins left after 5 years of blood draws. So I was fortunate in that 1) there isn't a lot of hair on the top of my hand and 2) there wasn't nearly so much bandaging involved. But still, when my IV was taken out, ripping the bandages off of the few hairs there were definitely was the most painful part.

Being the kind, supportive, smart wife that I am, I opted to stay far, far away when R had his IV taken out. (Meaning, I stayed home.) The nurses used alcohol and a couple of other sprays and liquids in an attempt to loosen the adhesive, but no such luck. Then they decided to cut the IV tube so they could get the IV out and then concentrate on the rest of the bandages.

Unfortunately, they didn't think that plan all the way through. When you cut an IV tube and it is no longer hooked up to a pump and IV bag, it starts to backflow. And R does not do well with the sight of anyone's blood, much less his own. So at that point, they had to lay him down on the exam table and then just rip the bandages off so that they could get the IV tube out and stop the bleeding.

He's usually pretty staid and goes right back to work after medical procedures, but he decided he'd had enough trauma for the day and headed home from there. His skin is still peeling.

All I can say is, when we finally get them - regardless of how we get them - these better be some darn perfect kids!

An answer

We got the results of the D&C testing this evening. It showed a gender chromosomal abnormality - the baby was XO instead of XX or XY.

My ob said that about 98 percent of first trimester losses have that particular abnormality. He also said that is encouraging news for us to try again, because it appears it was just bad luck with the embryo and wasn't a problem with the uterine environment or something else.

It still doesn't necessarily explain the other four, but at least we know that no matter what we did, the outcome of this one was beyond our control.

I'm still processing this news. I think I feel mostly relief, because now it's easier to think that maybe it really wasn't my fault after all. It was hard not to think "Did I lay around too much? Maybe I should have been more active?" or "Did we stop the progesterone too soon?" or "Was my blood pressure the cause of it?" or even "Did the fact that I was soooo emotionally reserved about this make the baby feel unwanted and fail to thrive?"

But a little part of me also feels heartbroken over the fact that there was no way this could have ended the way we wanted it to. It's hard to think that beautiful flickering heartbeat and that normally shaped (from what we could see at the early stages, anyway) baby wasn't this perfect little being we thought it to be.

The fact that the chromosomal abnormality was gender-related is a bit ironic. I told my ob up front that I didn't want to know the baby's gender, because for me it would be easier just to always think in terms of "the baby" rather than know if it was a boy or girl. And now I can go on thinking that way without having to know that the answer is sitting in my chart somewhere.

Next Steps

Some of you already know from previous posts that I am a planner. I have to have my next steps in place, a Plan B, and even a Plan C and Plan D sometimes, so that I can keep moving forward.

Never mind the fact that so far none of the plans have actually gone according to plan; I still have to have them, for the comfort factor alone. So it should be of no surprise that R and I were already talking about what to do next on our way home from the ultrasound that showed the lack of heartbeat.

Some aspects of the plan are easier to write about than others, so I’ll start with the easy stuff.

The Plan, Part 1

This part of the plan is simple to explain: LOSE WEIGHT. Lots and lots of weight.

Now if only it was as simple to execute. Like most of us, weight loss has never been one of my fortes. But I am determined to make it happen.

I’ve gained 40 pounds since beginning the fresh IVF cycle last summer. I didn’t need to gain any weight to begin with, but I now top the scales above 200, and even at 5’7”, that’s not good. Since I’m prone to pregnancy complications anyway because of the PCOS and blood clotting issues, I was pretty stressed about what additional complications the extra weight would cause. One was pretty apparent up front – my blood pressure at all of my ob appointments was high, up to 150/100 during one appointment.

So I’ve created a progress chart that is posted on a wall in our bedroom, and R and I are dieting. I’m not doing any particular diet, just trying to 1) eat less, 2) eat healthier and 3) actually attempt to cook at home from time to time. I also started exercising again two days after the D&C.

In two weeks, I’ve gone from 206 pounds to 202.4. My goal is to lose 2.5 pounds per week, which I know is pretty aggressive, but even if I can be in the 1.5-2 pounds per week range I’ll be pleased. R started out strong, and I was afraid that soon he was going to weigh less than me, which would be wrong on sooo many levels. But the scale was less kind to him during our last weigh in, so I still weigh less than him, at least for now.

My first goal is to get below 200. Then I’m going to concentrate on 170, then 160, and then we’ll see after that. It’s hard to imagine that I used to look at myself in the mirror when I weighed 105 pounds and thought that I was fat, but I did! (Many years ago in college, while I was struggling with eating disorders.)

Ok, so that’s it for The Plan, Part 1. I may post my progress (or lack thereof) from time to time as extra motivation for me to be good.

The Plan, Part 2

I’ve found this to be more difficult to blog about, which is probably part of why I’ve put off blogging about next steps.

On IF blogs, we seem to strike an unusual combination of the public, the private, and the vague. Meaning that our blogs are open for the world to read, we put out there details about cycles, thoughts, feelings etc. that many of us may never share with people IRL, and yet most of us choose to maintain a degree of anonymity by not putting forth identifying information about what clinic we go to, which doctor we see or even (in some cases, like me) specifics about where we live.

But on the treatment front, our next steps are pretty specific. Those of you who are familiar with the theory and approach I’m about to explain are going to know exactly who I’m talking about and exactly where I’m going.

I’m okay with that, because if I wasn’t I wouldn’t blog about it, but on the other hand it feels kind of weird. I think part of it is that I don’t want to come across as an advertisement. Although really, how can I be an advertisement when we haven’t gone through treatment yet, much less had success with it? The other part is some of you may think I’m crazy. But then again, at this point that’s probably not too far off from the truth!

So here goes. There’s a doctor I read about from an online IF forum who believes bacterial infections can cause infertility and miscarriages. I had heard about him a year ago and filed the idea away in the back of my brain. After we lost the twins in January, I thought of it again but was too emotionally tired to pursue it. I finally got around to calling and setting up a consult in the end of April, and then that following week we found out our clinic was requiring us to do our last FET.

We went ahead and did the testing with this new doctor before beginning the FET cycle, just because I wanted to be ready to move forward if we got a BFN. This doctor handles testing in a different way, growing specimens in the lab for about three weeks rather than just a few days, so many patients who test negative through the labs they usually use wind up testing positive through his lab.

The day before our transfer, we found out I tested positive for three infections, and R was positive for four. (None were STDs.) We were a bit surprised that we had that many infections, because we are asymptomatic, but apparently they can be low-grade and still cause problems.

The infections were in my cervix and uterine lining, and it’s likely that they’re also in my ovaries. The doctor believes that introducing an embryo to the uterus can cause the infections to flare, thus raising NK cell levels and resulting in the embryo being attacked by those cells. He says our embryos were likely infected within themselves as well, because R’s infections were found in his seminal fluid, which means that his sperm is marinating in infections as they’re growing and developing. Just like it’s impossible to detect sperm with high DNA fragmentation by looking at them through a microscope, it’s also impossible to detect infected sperm that way.

His belief is that infections damage the DNA, which causes chromosomal issues. And my ob thinks it was likely a chromosomal problem that caused this loss. That could also explain the other losses we’ve had.

So, our next step is to go through high-dose antibiotic therapy to get rid of the infections. Some STD infections tend to be stubborn and can’t be completely eliminated but only tamed down. But since we didn’t have any STDs, the doctor thinks ours can be completely eliminated.

We have to go through a few months of therapy and then wait one more month after that, so we can start trying again around the end of the year. The timing actually works out well, because that will give me a few months to lose some of the weight and develop healthier habits. Also, I need some time to focus on other things in my life, so I’ll have the opportunity to do that.

Once we reach the end of the year, assuming R still has normal sperm counts and I’m ovulating, we’re going to try naturally. I realize that sounds like we’re going backwards, which is a bit insane. (Okay, maybe more than a bit…) But the whole point of IVF was to create better quality embryos that would then last. Clearly, that approach hasn’t worked. And I’m tired of putting my body through all the stress it has to go through when we cycle.

We’ve gotten pregnant naturally twice before, so we know it’s possible. My ob is on board with prescribing the Lovenox, and I’m sure I can get progesterone suppositories from him, too. He doesn’t think they’re necessary, but he knows that given our history, there’s no point in saying no to me because they won’t hurt.

So we’re going to see what happens in 2008. I won’t completely rule out going back to IVF at some point, but definitely not in the immediate future. And if I don’t get (and stay) pregnant naturally in 2008, as much as we dread hate absolutely abhor the idea of adoption hell, we will reluctantly reconsider that option again.

This time it would have to be on our terms, though, meaning the adoption attorney we want to work with would have to agree to take our profile and not call us until there is a baby to be picked up at the hospital. She knows what we’re open to (either gender, any race, no major drug or alcohol use), so she shouldn’t need to call us to see if we want our profile to be shown for a particular situation. And we definitely refuse to go through months of being matched again – twice was waaayyyy more than enough, thankyouverymuch.

So, there it is – The Plan. Now we’ll see how long it takes before it goes drastically and unexpectedly off course…

Why?

I know I promised to blog about our next steps, and I will, soon. I promise. But right now I'm still sorting through some other thoughts in my head.

I have to admit, I'm struggling with the "Why?"s of the losses we've endured.

Of course, there's "Why me?" and "Why us?" But honestly, to me, those are the less significant of they "Why?"s. The reality is, it happens to some people, some couples. I understand that. I can even accept that the best answer to those questions may be "Why not me?" or "Why not us?" Because really, saying "Why me?" implies at least in some way that perhaps I am less deserving of this than others.

To me, the biggest question is also the smallest: Plain and simple, "Why?"

Forget that this is happening to R and me, or to other RPL bloggers, or others IRL who have suffered RPL. Why does it have to happen to any of us? And like most situations that cause people to ask, "Why do bad things happen to good people?", there is no good answer. And certainly no obvious answer.

I'm beginning to think that, at least in some ways, we already have the answer within ourselves. The answer to "Why?" is the answer we choose to create by how we respond in the face of our pain and suffering.

I don't feel like I'm explaining this very well, so if you're scratching your head and thinking "What on earth is she trying to say?", my guess is you're probably not alone. I'll try to explain by giving a couple of examples that have stuck with me recently.

While browsing CNN last week, I came across a guest blog by Miles Levin. He was an 18-year-old diagnosed with a rare form of cancer that is diagnosed in only 350 children in the entire U.S. each year. Sadly, at the time I came across his post, he had just passed away. His entire post was inspirational and thought-provoking, but one paragraph in particular stood out:

"Unlike many cancer patients, I don't have much anger. The way I see it, we're not entitled to one breath of air. We did nothing to earn it, so whatever we get is bonus. I might be more than a little disappointed with the hand I've been dealt, but this is what it is. Thinking about what it could be is pointless. It ought to be different, that's for sure, but it ain't. A moment spent moping is a moment wasted."

I often feel "entitled" to have children. I feel like it's unfair when I see a mom with her kids, and I don't have any to hug or take to school or bake cookies for. But when I read that paragraph, I realized that Miles is right. My whole life is a bonus, and I've been blessed to experience 15 more years (and hopefully many more to come) of this bonus than he ever got to. It helped shift my perspective back to more on what I do have and less on what I don't have.

The sentence "It ought to be different, that's for sure, but it ain't" also struck a chord. Life should have been different for him. It should be different for me, and for you, and probably for 99.9 percent of us in this world. But it isn't. I need to acknowledge that and keep moving forward, rather than allowing myself to get stuck dwelling on it.

Because, really, who knows how many moments any of us has left? I'd rather spend those moments cherishing what I do have than moping about what I don't have.

Another person I've been thinking a lot about is a woman with whom R and I went to high school. She was in R's class, and I was a year ahead of them. Neither of us knew her per se, but I knew of her. She was homecoming queen, and voted "most likely to make you die laughing" in the high school yearbook.

From what I read in her obituary last year, she kept that sunny, graceful outlook on life to the very end. She was 30 when she was diagnosed with ovarian cancer, and she died less than a year later. She had been married for a few years but didn't have any children. I don't know if that was by choice, or if she and her husband just hadn't started trying yet, or if they also had problems with IF. But talk about life being unfair. I still get the opportunity to try for kids. She doesn't.

My life may be unfair, it may not be exactly what I want it to be. But at least I still have it. I'm living and breathing and in every single moment, I have the opportunity to make it the best life I can.

Losing these babies that have lived inside me (however briefly they may have stayed) is tragic, no doubt about it. But I'm also slowly beginning to understand how incredibly fortunate I am that my struggle comes in trying to create a new life, rather than fighting desperately to keep my own life from ending decades too early. And if that realization helps me to live life more fully, to take it less for granted and see more clearly all the good things I have to celebrate, then, at least in this moment, I can accept that as the answer to "Why?"

Thank You

I'm still here, and for the most part I'm doing surprisingly well.

The outpouring of support from all of you has helped tremendously, and for that I am very grateful. THANK YOU.

R and I were talking the other night about our reactions to this loss. He hasn't shed a tear or really shown much emotion about it at all. It's not that he doesn't care, because I know he does. But he was so much more emotional when we lost our first baby more than three years ago, so I was getting concerned about him.

He said this whole process has become unreal to him - that seeing all the babies (or lack thereof) on the ultrasound machine's video screen has become like watching a movie someone has made about something unrelated to you. And the injections that he helps me with don't make it any more real, because when you're first thinking about getting pregnant, you think of a romantic night in bed with your spouse, not jamming them with needles day after day.

I can understand his point of view. Obviously it's a little different for me, because I was feeling the nausea and uterine stretching pains and all that stuff. That made it a little more real to me.

But I think I'm getting so much practice at dealing with losses that I'm learning to cope better. For the most part, anyway.

Friday was a bad day. I was in a professional development class all day, and it was a monitored class - in order to get credit, we couldn't leave the room while class was in session. That shouldn't have been a problem, because we were given two breaks in the morning and afternoon, along with an hour for lunch. But as we came back from the second break, I glanced at my phone and saw that it was 10:15 a.m.

Without warning, a thought struck me: "A week ago at this time, I was in my final hour of pregnancy. We were on our way to the surgery center." My eyes filled, my throat closed up, and right there in a class of 100 people, I began to cry. I tried to be as quiet as possible, and I think only a few people around me noticed, but it was still awful. I wanted to jump up , run out of there and hide in the bathroom, but somehow I managed to will myself to stay in my seat. I didn't even have any tissues with me, so I had to just keep wiping at the tears with the back of my hands and try to sniffle quietly.

When I got home, I crawled into bed. R stopped and picked up dinner for us, which I ate while laying in bed, and then I fell asleep. An early night was definitely what I needed. And it's been better since then. I know I'll have more bad days - and more good days - in the future. That's just how grief goes. It's a messy process.

But all of you make it easier. So, again, thank you.

The D&C is Done

This morning I was almost 11 weeks pregnant. Now I’m not.

I didn’t want to go to sleep last night, because I knew it meant that morning would come and then I’d have to go to the surgery center. And let them take my baby.

I hadn’t cried much up until today, but I knew today would be different.

I managed to blink back the tears at the registration desk. Then the intake nurse came to get me, and the tears began to fall. The whole time she was taking my vital signs and going over my medical history, she also kept talking about her own attempts to have children. I don’t know how many she lost, but I know she lost one at 7 months. An autopsy couldn’t find any reason why her baby was stillborn.

I continued to cry. She continued to talk, telling me that she and her husband wound up adopting two children. “My son was a great kid, but there’s something off with him. He doesn’t do well as an adult,” she confided. He’s a couple years younger than me. Apparently he got into a knife fight last week.

That was when she suggested we look into adopting. Thanks, we’ve been there. Then she asked how many pregnancies I’ve lost. The tears were still falling. Four pregnancies, five babies. She asked if my doctor had suggested we do any testing to find out what caused them. Gee, there’s an idea we hadn’t thought of. Then she said, “You guys should look into doing IVF or something like that.” Ok, thanks, we’ll consider that.

Finally, she escorted me to the bathroom so I could change into the hospital gown and robe. After that, it was off to the pre-op area. I was composed until Ob walked over to R and me.

“Are you sure?” I tried to choke it out, but it took a few attempts before Ob could understand me. He squatted down in front of me, took my hand and gently pointed out that even if he had somehow overlooked the heartbeat, the baby’s shrinking size was conclusive. I didn’t realize I was squeezing his hand with a death grip until he tried to stand up.

The nurse came to get me, and I had to say goodbye to R. The last time we would get to hug while I was still carrying our baby.

I cried the whole way as she walked me to the operating room. People we passed in the hallway were probably staring, but I didn’t care. I just concentrated on the floor, on forcing myself to put one foot in front of the other. She was very kind, telling me that if I wasn’t ready, I didn’t have to go in. That they would wait as long as they needed to. Do you think they would have minded waiting 20 years? There was no point in putting off the inevitable, so I just kept going.

The anesthesiologist was kind, too. He tried to lighten the mood by making a joke about being at my service as he took my robe. Then I climbed onto the operating table, and he began putting in the IV while the nurse put on a blood pressure cuff.

I remember thinking, “When I wake up, my baby’s going to be gone, and I’m not going to be pregnant any more.” And I remember trying to keep quiet and still as I cried.

Then I woke up. The oxygen mask was still over my nose and mouth, and I couldn’t open my eyes yet, but I realized I was sobbing. The hysterical, heaving, uncontrollable sobs you cry when a brief moment in time has just permanently, gut-wrenchingly altered your life forever. A moment as brief as the flicker of a tiny little heartbeat.

One of the nurses grabbed a Kleenex and pressed it against my eyes until I was conscious enough to move my arms and hold it myself. A couple of times, I heard someone say something about getting R, and then I heard myself begging, “No, please, don’t. Not yet. I don’t want him to see me cry.”

I don’t know how much time passed, but I kept refusing to let them bring him back to the recovery area. He’s seen me cry so many times during the past four and a half years. I know this is painful for him too, and I just can’t bear to add anything more to his pain. But then I heard the phone ring, and my nurse saying, “She’s fine. No, she really is fine. But I don’t know. She keeps saying she doesn’t want him back here. She hasn’t stopped crying since she came out of the operating room. I’ll have to ask her for permission.”

R is a very shy person, so I knew he had to be very worried to have approached someone. I realized that even though I wasn’t letting him see me cry, I was still causing him pain. So he came back to recovery, and I was able to leave about 15 minutes later.

Physically, it hasn’t been bad at all. I suspect this may be a lot less painful than the other four miscarriages were, particularly the first and third ones, for which I refused to take any pain relievers. (The first one because I didn’t know if I’d ever have another pregnancy and was determined to experience every last moment of it; the third one because I was still carrying Twin B at the time and refused to take anything on the very slim chance that the pregnancy would progress.)

I’m home now, and the tears come and go, as I imagine they will for a very long time. But I function best when I know what steps I’m going to take next, so R and I have made some decisions. We’re taking a different approach, and I’m going to focus on some other things, but we’re not giving up altogether. I’ll post more on the plan in a few days.

The Flicker of Hope is Gone

We had our 4th ob appointment today. I'm 10w2d. No heartbeat, and the baby measured at 8w4d - 0.3mm smaller than our last appointment two weeks ago.

There's no explanation as to why at this point. Everything looked perfectly normal - for an 8 1/2 week pregnancy with no heartbeat, anyway.

I'm waiting to hear when the D&C will be. It will be my first, even though this is our fifth miscarriage. The others never got far enough to need it. My ob is going to send the tissue for testing to see if it will give us any answers.

This cycle used the last of the embryos we had. We started with 17 during our fresh cycle in July/August 2006. 17. We worried at the time that we had created enough embroys for 5 or 6 families. And now there's none. Not one family, not one baby.

I feel dead inside. I've dealt with the pain of loss before, but this is on a whole new level. I don't know what to do, how to begin to process this. I don't want to eat dinner, I don't want to watch TV, I don't want to work, I don't want to do projects around the house. I guess what I really want is to not be inside my own skin anymore, to not be me. Because if I'm not me, then I don't have to deal with this.

I'm not sure where we're going to go from here. Before this pregnancy, I was getting to a place where I felt like I might just learn to live with being childless. It's not something I would choose as an option (though please know I'm not criticizing those who do). But since at this point that is the reality of our life, and despite trying our very best it still is the reality, I'm not sure we have another alternative but to accept it. After our devastating failed adoption attempts, I don't know that I have the strength to go back to that. And IVF hasn't given us any answers or any successes - it's simply added to the losses and compounded the pain. I don't see us going back to that route, particularly since R's counts are now normal and the RE doesn't have any answer to "why?" and just recommends trying the same thing again. Maybe we'll just try on our own and see what happens.

Progesterone Scare

Why does this process have to be so damned hard?

Every time I start to let myself get comfortable and relax a little, I get smacked upside the head with something that is cause for concern.

This time, it's my progesterone level. My clinic usually stops the PIO and suppositories at 9 weeks, so I went in last Monday to have my estradiol and progesterone levels tested. They were 958 and 45, respectively. The clinic told me to stop the shots.

Because I lean toward the paranoid side, I insisted on continuing the suppositories (with the clinic's blessing) and retesting again (which is something they don't usually do).

The results of yesterday's testing: estradiol is 543 and progesterone is 15.4. I'm not quite as concerned about the estradiol at the moment, but I'm on the verge of hysterical about the progesterone. From what I've been able to find online, it should be around 30 at 10 weeks. I'm 10w2d.

So far, I haven't had any spotting. I did have some minor pains last night and this morning that weren't totally familiar and made me a little concerned, but I was managing to stay calm.

I have a previously scheduled ob appointment in about 4 hours. I'm really scared. I can't imagine that such a huge drop in progesterone is 1) a good thing for the baby; 2) a good thing for the pregnancy in general; 3) a good sign about my body's ability to maintain a pregnancy.

Please excuse me while I go find a paper bag to breathe into for the next 4 hours... I'll post again tonight.

We're Both Still Here (As Far As I Know, Anyway)

I really have to get this Google Account thing figured out. Right now it takes me about 10 minutes just to log in, which is why I haven't posted nearly as often as I otherwise would...

I only have a few minutes, but I wanted to post quickly to say that so far, things still seem to be going ok. At our last appointment, Kiddo had grown to measure three days ahead, and the heartbeat was 173 - right on track.

Ob is on vacation this week - (the nerve!) - so my next appointment isn't until Tuesday. It's been the longest 9 days of my life, and there are still 6 more to go.

So far, I've been pretty calm and okay with things. I appreciate all of your comments on my last post. What Thalia said about Liana regretting that she didn't allow herself to enjoy her pregnancy before she lost Zappy really struck a chord. Regardless of whether this ends in 30+ weeks with us holding a healthy, bouncing baby or at some earlier point with a heartbreaking outcome, this is still the only pregnancy I'm going to get to experience with this baby, and I do want to enjoy it.

To that end, I've allowed myself to take a couple of little steps into the world of pregnancy. This week, I asked R to bring home a couple of pregnancy books from his parents' house. (When we moved last fall, I asked him to take all baby related things to his parents; I didn't want them in our new house.) And this weekend, I'm considering going maternity bra shopping with a friend. I'm only 9w3d - I can't believe how quickly I'm outgrowing some of my clothes.

I'll be back soon with more posts...

Hope and Stress

Hope is still alive. Today's appointment went well. But this pregnancy in particular, because it is the one that has provided us with the most hope, is also one of the very most stressful experiences of my entire life.

And that's saying something, because I'm not exactly a stranger to long-term, high-level stress: I served as a full-time caregiver for my diabetic, bedridden grandmother when I was 12 and 13 (while still going to school); when my dad left and my mom fell apart right before my senior year of high school, I got a job and spent two years making the mortgage payments before my mom was able to pull herself together enough to function; R and I lived through about two years of continuous uncertainty during which his company conducted 8 rounds of layoffs.

All of those were painful, difficult experiences. But this is different. The stakes are even higher.

Everything went fine all last week. I was calm. I reached yesterday and I thought, "If tomorrow's appointment goes well, I'm going to try very hard to be a normal pregnant person. I'm going to try to relax and enjoy this and let myself blithely, naively think that of course there's going to be a baby - a happy, healthy, perfect little baby - that pops out of me in a few months."

HA.

I went to the bathroom last night. And wiped. And saw a chunk of mucous that immediately made my mind think "cervical plug." Followed by, "Oh, God, my cervix is dilating." And, "This can't be good." And, a little later, "Why are those uterine pains not as strong? Does that mean my uterus is shrinking back to its normal size? Oh, God, my uterus is shrinking! This is SOO not good."

You can imagine the night I had. And of course, I went online and found a web page written by a woman who lost something at 10 weeks that sounded a lot like the mucous I saw. Everything seemed fine for her for several more days, and then she started bleeding and miscarried.

I didn't tell R about any of this, because he wasn't feeling well yesterday, and I didn't want to add stress to the headache and nausea he was already experiencing. And I couldn't come post on here because I can't figure out how to get Blogger to let me switch over to the new Blogger, so I have to go through a convoluted process to reset my password every single time I want to log on even though I haven't forgotten my password. And I just didn't have the strength or energy last night.

Fortunately, my appointment was already scheduled for this morning. Once again, I was in tears by the time the ob walked into the room. But he did a cervical exam, and he said my cervix was very tightly closed. He thinks what I saw may have just been the byproduct of all the progesterone suppositories I've been taking.

Then we did the ultrasound, and he was quiet as he studied the screen. I didn't see a flicker anywhere, but then again I didn't have the best angle for viewing. I kept waiting for him to say something, and then finally I couldn't take the silence any more and asked, "Do you see something? Is there still a heartbeat?" There was. Apparently, I need to tell him to speak up sooner next time.

The baby measured right on track. We were hoping Kiddo would be 1 cm today, and it was 9.9 mm - close enough! It measured exactly 7w1d, which is what I am today. And the heart rate had increased to 148 bpm, up from 111 bpm last week.

My ob knows what we've been through, and he's good about not just blowing off my concerns and saying "Everything looks fine, don't worry." Instead, he's taking a much more realistic approach. Last week, after the ultrasound, he said, "This is a step in the right direction, but you're not out of the woods yet, not by a long shot. You've still got a ways to go."

This week, he said, "These are a few more steps in the right direction." I like that he's not just taking a cheerleader attitude, but at the same time, I wish I was the kind of patient that would allow him the luxury of that attitude.

I'm trying to be grateful for this. I want to be hopeful. After almost 4 1/2 years of hell, I want to be happy that we're here, that we're seeing a heartbeat and making progress. But instead, I'm in tears. Partially tears of relief, I'm sure, but if I'm being honest, a lot of those tears stem from fear, too. I don't want to be like this - for Kiddo's sake, for my sake and even for R's sake. But I don't know how not to be.

Larisa of "The Waiting Womb" wrote a post at the beginning of this month about the "ifs" of IF. It struck a chord with me, because I, too, wonder "When will the 'ifs' stop?"

The ob said we could come back in two weeks, but he left it up to me. Our next appointment is for next Monday morning. As we were leaving the doctor's office, R asked me if we are going to have weekly appointments for the whole duration. Yes, I told him, yes, we probably are.

A Tiny Little Flicker of Hope...Literally

After I had blood drawn yesterday morning, I decided to call my ob/gyn and have them fit me in for an ultrasound. I wanted visual documentation of how far the pregnancy progressed so that we'd have that information for the future in case we needed it.

The blood test was inconclusive - the number (14,523) was higher than Thursday's (6,849), but the doubling time was 83 hours, which was also a lot slower than it has been (29 hours, 32 hours, 45 hours) to this point. So I didn't know if that meant the number had been higher on Sunday and was on its way down or what.

So at 4 p.m., R and I went for the ultrasound. By then, some of my symptoms had started to return. But I was still completely freaked out. And then, the moment of shock came - my ob said, "There's a sac." And, a few moments later..."And there's a heartbeat!"

I'm still trying to process it. A heartbeat. A tiny, gorgeous little flicker of light. And hope. We even got to hear the heartbeat. It was 111bpm. Ob said anything above 100 bpm is normal at this point. I thought it was supposed to be faster, but he said it should get faster during the next couple of weeks. I haven't googled it yet to see if that's really true or if he's just trying to keep me calm.

I allowed myself to be happy about this last night. And hope has certainly snuck in, in a big way. But at the same time, this makes it even more scary. I know how to deal with an early loss. I know how to deal with "I'm sorry, but the sac is abnormally shaped and it's measuring a week behind. I'm afraid there's no hope for this." I've had lots of practice. But with this, I've had no practice.

The next ultrasound is scheduled for next Monday. Ob understands that I'm going to be extremely high maintenance, so he didn't even try to suggest scheduling something further out. In the meantime, I'm going to try not to freak out quite as much about any fluctuations in my level of symptoms. We'll see how that goes...

Disappearing Symptoms

I may have come out of my cave too soon.

Last night, after I posted, I noticed that I wasn't as tired or as nauseous as I have been in the past, and I wasn't as bloated, either. I also had some lower back pain and pelvic pain that made me a bit nervous, although it did stop after a little while and it was mild.

Then when I woke up this morning, I realized that my chest isn't nearly as sore as it had been, even when I go poking at it. And I'm still less bloated.

So far, there's been no spotting. And last time, I still had all my symptoms when the cramping and bleeding suddenly started.

I'm not quite sure what to think. I'll probably ask R when he wakes up if he's sure he gave me the PIO instead of the E2V last night, but I'm sure he did.

I'm leaving for the lab now. I have an appointment in 5 hours, so I e-mailed the clinic and asked them not to call me with the results; I want to get through that appointment and then I'll call them.

Will the 4th Time be the Charm?

Obviously, I haven’t been blogging during these past few months. To be honest, it simply became too painful. Our friends in normal life have kids, many of them two or three at this point. We’ve been long since left behind. Friends we made through Resolve, who started out in the same place as us, also now have at least one or two children. We’ve been left behind by the infertile community.

And then the veteran bloggers who were around when I started blogging all moved on to success, along with many bloggers who started after me. And once again, I’ve felt left behind. Everyone else is moving on to the new phase of their blogs – life with pregnancy, life with kids – and here I am basically retyping the same old variation on a theme: I’m pregnant, oops now I’m not; we’re adopting, oops now we’re not.

I needed my life to focus on something else for a while. And that plan was working, until our fertility clinic decided to brighten up the week leading up to Mother’s Day for us. It’s a long story, but for the sake of brevity, let’s just say the clinic’s financial coordinator was telling us we had to do an FET, the RE was insisting that our next cycle had to be a fresh cycle, and we got stuck in a very awkward tug of war between the both of them, who apparently are either unwilling or unable to communicate with each other.

It was handled, in my opinion anyway, very badly. But regardless, the upshot was that we wound up having to do an FET in June. It was a total no confidence cycle – the RE made it very clear that he didn’t see the point of it, and it was obvious that the feeling rubbed off on everyone, R and myself included.

I forgot to go get blood drawn, the clinic forgot to put me on the schedule and so didn’t realize that they should have been seeing lab results for me, I had to self-dose a couple of times, the clinic forgot to schedule a procedure I needed, they added a medication to my calendar that I wasn’t supposed to be taking, I left $350 worth of meds in a hotel room when I was traveling out of town, a bottle of suppositories I brought when I was traveling out of state to the clinic melted and congealed into one big glob of goo, etc. And then, to top it all off, the morning after bed rest ended, I backed R’s truck into a pole. It was pretty much the perfect cap to an absolutely laughable cycle.

And then, of course, the betas came back positive. I’ve had four so far, and they’ve all risen appropriately. I have the next one tomorrow morning.

My enthusiasm for this pregnancy is totally and completely underwhelming, to the degree that it’s causing concern among those who know me well. But it’s the best I can do at this point – it’s all I’ve got in me to give.

I’m 6 weeks today. That makes tomorrow 6 weeks 1 day. And 6 weeks 1 day has historically not been a good day for me. In Pregnancy #1, I began spotting on 5 weeks 1 day, and it ended in a miscarriage on 6 weeks 1 day. Pregnancy #3 seemed to be going fine. No spotting, nothing. 6 weeks 1 day came, and I thought we’d make it past that point. I was starving for lunch by 10 a.m., my sense of smell was very strong, I was running to the bathroom every couple of hours, I made R come bring me a huge dinner at 4:30 p.m., there was not even a speck of spotting. Then, at 7:15 p.m., I felt some cramping. I was in Target. I went into the bathroom, and there was a lot of blood. We lost twin A a few hours later, and then twin B 9 days after that.

I’m nervous and scared, about the blood test and about the whole day. Not that getting through tomorrow means that we’re in the clear by any means. Every day is limbo, and each morning I get up and go through it all over again. It’s like I’m living the pregnancy version of Groundhog Day. If this isn’t going to result in us holding a live, healthy baby in our arms in 7 ½ months, I just want it to be over with now.

Like I said, my enthusiasm for this is less than underwhelming.

How I Spent My Saturday Night

I knew something was up when I came home late in the afternoon and my mom said, “Sooo, I have a question for you: How would you like to go shopping for a new dryer?”

Considering that when I had left the house earlier in the day, our dryer was fine as far as I knew, it struck me as a bit of an odd question.

It turns out my mom had unwittingly left a black wax pencil in one of her pants’ pockets and then proceeded to wash and dry the thing. It also turns out that while a black wax pencil can make it through a gently spinning cold wash cycle relatively in place, intact and totally undetected, that’s not the case once it reaches the inside of a warm dryer where it bounces up, down and all around.

My poor, unsuspecting mom opened the dryer to find that her load of laundry was covered in black spots and streaks. So was the inner bin of the dryer, as well as the inside of the dryer door. At first she thought the dryer had somehow sprung a major oil leak. Then when she stopped to consider that the dryer doesn’t function via oil-lubed engine, she went searching for other possibilities. And found the stub of the wax pencil.

After some frantic, but unsuccessful, attempts to wipe the interior clean she decided it would just be easier to buy a new dryer.

But it turns out that I’m cheap. Or, more accurately, that I don’t see the need to spend $500 on a new dryer when I could put that money toward an oh-so-much-more-fun IVIg infusion instead. (More on that in a later post.) So after a few unsuccessful attempts of my own to rid the dryer’s insides of its new paint job, including blasting the waxy film with steam from my hand-held clothes steamer, I came up with a question of my own: “What would Heloise do?”

I have a 2-inch-thick Hints From Heloise book that could be useful if I took it upon myself to actually, ahem, clean every once in a while. My mom cracked it open. It recommended something like WD-40, which we weren’t sure was such a terrific idea, but it did spark another thought: Avon’s Skin So Soft product, which apparently not only softens skin but also manages to remove waxy residue from enamel-coated surfaces.

So I spent Saturday evening laying on the laundry room floor, giving the dryer a more thorough cleaning than any of our other appliances are likely to see in their lifetimes. And as an extra bonus, our clothes smell oh-so-soft.

Oh, How I Hurt

This weight thing has gotten out of control. My face is fat, my feet are fat, and I’m even outgrowing some of my by-now-all-elastic-waistband wardrobe.

So I woke up Monday morning bound and determined to do something about it. My chubby little self was in the pool at the local gym by 6:15 a.m.

I love to swim. I was practically half fish when I was growing up. And besides being great fun, it’s a wonderful form of exercise – I can raise my heart rate without sweating. Instead, I sluice through the cool, refreshing water. If I’m not sweating, it doesn’t feel like exercise, which is apparently key for me.

But I digress.

I swam the first lap. It was fine. Since I hadn’t exercised in a very long time, I was taking it easy and not pushing myself. Then, about a quarter of the way through my second lap (still taking it easy and not pushing myself, mind you), my arms began to tingle and burn. Then they began to shriek at me, “What the heck are you doing?”

I kept going. I was bound and determined to keep swimming. For a whole hour, no less. And I did. Eventually, the burning sensation went away. I’m not sure if it was just that my arms went numb and I could no longer feel their protests, or that they finally just gave up and adjusted. Either way, I kept going.

When the hour was finished, I was so proud of myself. I had spent a whole hour exercising, and I felt great.

That lasted less than eight hours.

That afternoon, as I was changing out of a t-shirt, I discovered a problem. I hurt. More accurately, my upper arms, shoulders and neck were sore to the point that I almost couldn’t get the t-shirt over my head. And I had a major headache, most likely triggered by my throbbing neck muscles.

I spent most of Tuesday in bed, popping pills to try to make the headache go away.

But on the bright side, my feet look thinner.

That Was Then, This Is Now

Exactly six months ago today, I was at home, spending Labor Day with R. We were doing actual labor on Labor Day, using a rented steam cleaner to blast dirt out of the grout in our tile floor. It was a long-overdue task – we’d lived in the home for four and a half years and hadn’t bothered to clean the grout once in that time.

We’d just finished our first (failed) fresh IVF cycle and preparing for our first FET. I was working at a job I’d had for five and a half years. Other than that FET cycle, we had no major plans coming up.

That was then.

Fast-forward six months, and here we are: We’ve unexpectedly bought a new house that is 50 percent larger, my mom has moved in with us, we’ve had one failed FET, a second FET that started out well but ended in the miscarriage of twins (one at a time, nine days apart), I’ve quit my job, I’ve embarked on a new career, and we’ve found out that R’s sperm counts are suddenly normal, which means that we could conceivably (sorry, I couldn’t resist) get pregnant on our own.

Welcome to now.

Oh, and did I mention that we’re also gearing up for another fresh IVF cycle in a couple months, assuming that we don’t conceive naturally?

I’m hoping that the insanity will settle down soon. I’ve had the best intentions of spending more time blogging and catching up with all of you. Unfortunately, as it turns out, I stink at quitting, so I haven’t yet had as much free time as I hoped to.

How is it possible to stink at quitting, you ask? Well, let’s see. I, um, keep showing up to work even though my two weeks’ notice has come and gone. My last full-time day was in mid-February, but I told my boss I would continue to work part-time for a while. We didn’t set a firm end-date for the part-time schedule, and when I’ve attempted to bring that subject up, my former boss and current boss kind of start to panic. And I am the quintessential people-pleaser who hates to disappoint people, so I haven’t pushed the issue.

I can’t complain, though, because I couldn’t be more flattered – they’ve made it very clear that they would love for me to stay. But I did finally tell my boss on Friday that I need to stop altogether, so my last day will either be this coming Friday or the Friday after that.

My intention has been to spend more time exercising and eating healthy, and to begin a new career as a Realtor. I’ve always loved homes, I’m a native to my city so I know the nuances of the area well, and I met a Realtor a couple years ago who quickly became one of my best friends. She is an incredible person. She is a fertile, but she totally gets infertility even better than some former infertiles that R and I are friends with. She has been in the business for about four years, and we are working together now. She is totally holding my hand every step of the way; otherwise, there’s no way I would have been brave enough to step out and do this!

But I love the idea of having more flexibility and freedom in my schedule and of being able to be my own boss. So R and I have given me a year to see how this goes. So far I’m having fun, but combined with the part-time job, I’m still not having a lot of free time. Hopefully that will change once I quit for good and actually stop showing up…

Bad Infertility Humor

How do you know you've been dealing with infertility for waaaaayy too long? When a joke like this is funny to you:

R and I were talking a few mornings ago about the idea that since he has sperm again, and since we've gotten pregnant the natural way twice, maybe it will happen for us next month. He actually kind of gets upset at the idea, because he feels like I don't produce great eggs/lining on my own and we might be likely to repeat the miscarriage pattern. (Never mind the fact that our pregnancy conceived through treatment led to the exact same outcome!)

I assured him that I'd do my best to exercise a lot and eat low-carb, because that helps reduce the PCOS symptoms and improve egg quality.

"So, you never know - maybe one of my ovaries will cough up a relatively good egg next time around," I said.

He replied, "Ok, but can you tell it to please make sure it coughs up one with a yoke this time?"

Get it? Yoke - yoke sac? Which is what is consistently missing from the picture during our ob ultrasounds.

I told you it was bad...

The Results Are In

Not a big surprise - today's beta was negative. I had begun to suspect as much, because my symptoms abated during the weekend.

We're fine with it. Chances are, egg quality wasn't high and my lining wasn't great coming off the miscarriage, so we wouldn't have had high hopes even with a positive beta. That, and I need to lose some major pounds before we give this another serious go, because after the last two cycles I am now overweight to the point that my blood pressure is a bit high.

On a happier note, this is my last full-time week at work, so hopefully I will actually drag my overly plump, sorry little (well, actually not-so-little) bottom to the gym very soon. I bought a new swimsuit last week for just that purpose. You know it's bad when you've outgrown even the stretchy things in your wardrobe. Like your old swimsuit...

Sometimes, You've Just Gotta Laugh

Because really, what else can you do? Especially when you find out three weeks after you've miscarried twins that there's a chance you might be pregnant again.

Yep, welcome to my life, which at this point makes a three-ring circus seem dull and ordinary.

I showed signs of ovulating last week. I thought, "Okay, good, maybe my body is working like it's supposed to. I'll see if CD 1 shows up in a couple of weeks." I usually bloat during ovulation, then it goes away for about 10 days, then it comes back a few days before CD 1. This time, the bloating hasn't gone away. So I thought, "Okay, this is a bit unusual, but my body's been through a lot, so it's probably just confused."

This morning, as I was driving to work, I felt a little bit of unusual pelvic cramping. It wasn't menstrual cramping, and it wasn't the typical pinch I get around ovulation - that already happened last week. So I thought, "Hmm, this is kind of weird. It's almost like implantation cramping. And the timing would be right for that, because today is CD 22, and I typically ovulate around CD 16. But nah, it can't be...because R hasn't been on Arimidex for seven months, and he doesn't produce sperm unless he's on it."

I didn't give it any more thought as the morning progressed. Until Dr. Crass's nurse called to give me the report of the semen analysis R did on Monday: "Normal, normal, normal, normal, normal!" She was in shock. So much so that she double-checked the cup to make sure it had his name on it, even though he was the only patient she did an analysis for on Monday. She said she almost fell to the floor in disbelief.

So R has sperm. 78 million/ml's worth, with 53 percent motility, and the vast majority of them swimming in the right direction. And one of my ovaries may have coughed up an egg. I've been instructed to resume the baby aspirin, Lovenox, mega doses of folic acid and progesterone supps.

We'll see what next week's betas bring.

A Leap of Faith

Big changes are afoot over here.

I gave my two weeks' notice today at work. It's something I've been thinking about and R and I have been talking about for a while, but still, the timing was a surprise even to me. R had been hesitant for us to take this step right now, but yesterday he did an about face and said, "Why don't you quit?"

So today I did. I won't be staying home full time, but I'll go into more detail in another post. For now, let's just say that at least I'll have more time to blog and to catch up with all of you.

Between this and the sudden house-buying of last fall, I seem to be living my life on the impulsive lately, don't I? Let's hope this works out as well as the house has!

Not much to report on the fertility front. Unfortunately, there wasn't enough tissue from Baby B to do any chromosomal testing. We had hoped there would be, and that that would provide us with some answers.

Basically, our next steps are:

1) I have to have blood drawn for a genetic karotype to see if I have some sort of chromosomal issue that might be causing genetic abnormalities in the embryos. (R had his done a few years ago when he was first diagnosed with male factor, and it was normal.)

2.) We have to get an answer from our clinic about whether we can do PGD since we are in their shared-risk plan. They generally don't allow patients to do the shared risk plan if they need PGD, but usually they know before patients enter the plan if PGD is necessary or not. It sounds like Doc is willing to consider it, but he has to get the other partners in his practice to sign off on it. Doc wants to do PGD if my karotype comes back abnormal. I want to do it even if the karotype comes back normal, in the hopes that it might provide some more clues to why I keep miscarrying.

3.) R had to have another date with a cup. Since his surgery, for the past 18 months his counts have ranged from barely within normal to practically non-existent when he's not on Arimidex, even though his testosterone level now seems to be holding steady in the normal range. (It was very abnormally low before the surgery.) Because of the fluctuations, Dr. Crass (the urologist) wants to recheck his hormone levels and counts before agreeing to restart the Arimidex.

4.) Unless something unforeseen happens, we're planning fresh IVF #2 for late spring. Retrieval should be sometime the first week of May, and I will probably be spending Mother's Day on bedrest. At least that would be a nice change from the recent years' routine of spending it miscarrying.

Since I'm going to have much more flexibliity in my schedule soon, I have big plans to exercise like crazy and acquaint myself with our kitchen in an attempt to lose the weight these past two cycles have piled on. Forget outgrowing jeans or shirts - I've outgrown my SHOES! Eeeeekkkk!

Well, That Was Fun While It Lasted

As I’m sure you can guess, Friday morning’s ultrasound did not go well. It was done at an office that includes a perinatologist, a genetic counselor and a radiologist who specializes strictly in obstetrical radiology. If you’re there, it’s because something is going (or appears to be going) very, very wrong – it’s not the kind of place where you go if you’re having a happy, run-of-the-mill pregnancy.

After what was by far the most thorough wanding of my life (the tech recorded 53 different images!), the radiologist came in and gave the verdict: “abnormal pregnancy tissue,” “an abnormally shaped gestational sac” and “there’s no hope for this to progress.”

I held it together pretty well up until the words “there’s no hope,” and then my throat closed, my eyes started to fill up and I scanned the room in hopes of spotting a Kleenex box. The tech noticed, and she grabbed a very long, thin box and brought it over to me.

For a moment, I didn’t understand, because this was not like any Kleenex box I’d ever seen. Then, as she pulled out this big, thick paper that had to be at least 20 inches by 20 inches, the image of a clown pulling a giant handkerchief out of his sleeve flashed through my mind. The sound that came from my throat began as a laugh but ended up more like a choked cry.

The radiologist and the tech took that as their cue to high-tail it out of the room, which they promptly did. As soon as the door shut behind them, I buried my whole face in the clown Kleenex and wailed.

I have to hand it to that place – at least they know their audience. No normal-size tissues designed for a dainty little sneeze. No siree, these were definitely industrial strength Kleenex, designed for industrial strength tears.

I’ve been told to stop all meds and to expect the miscarriage of baby B to begin sometime this week.

Two miscarriages less than three weeks into the new year. Not exactly the way I had pictured to start 2007…

Complications

On Monday, I was composing a post in my head about how well this pregnancy seems to be going. My symptoms were good over the weekend – fatigue, increasing nausea, etc. I was ready for lunch by 10:30 a.m. on Monday (the women in the office were laughing at me), and I made R stop and get me a ridiculously large dinner when he stopped by my office at 4:30 p.m. because I was already starving again. Just before he arrived, I went to the bathroom. Everything was fine – not even a speck of spotting.

Less than three hours later, there was blood. Not just a little bit of spotting, but a small clot in the toilet and enough to bleed through to my pants. I paged the doctor on call at my ob/gyn’s office, and he advised us to go to the emergency room.

So we did. And we sat and waited, and sat and waited, with me getting up every hour or so to go pass more clots. When you’re barely 6 weeks pregnant and bleeding, the ER docs and nurses know there’s really nothing they can do for you, so you are at the bottom of the waiting room food chain.

We sat there for five hours, until 1 a.m. I finally went back to the triage nurse, told her I was thinking I’d probably be better off just going home and promptly burst into tears. She promised to try to get me a bed as quickly as she could, which turned out to be another hour later.

They put me in the ER’s ob/gyn room, which at least afforded us a little more privacy than being in a bed separated only by curtains. I remember R and I joking and laughing about things, although at this point I don’t remember what the subject of our jesting was. I just remember commenting on how perverse it seemed that we are able to laugh while I’m sitting there possibly bleeding out our baby. But I guess we’ve been through this so much that it doesn’t phase us like it used to.

An ultrasound was done, and the tech couldn’t see a gestational sac. We thought that was the beginning of the end, but then my hcg level came back at almost 7,400. The first miscarriage I experienced was at pretty much the exact same point in the pregnancy, and that time my hcg on that day was only 424. So we grasped onto the little bit of hope that number presented.

We finally got home at 6:30 a.m. on Tuesday, and then slept for several hours. The bleeding had turned to light spotting, and by early afternoon, it stopped altogether for a few hours. It returned Tuesday night, but by this morning was brown instead of pinkish red and then stopped by late morning.

We went to my ob/gyn for another ultrasound today. He was able to see a gestational sac, although he said it only looked like it was about 5 weeks, and I’m 6w3d today. He wasn’t happy with the quality of images he gets from his machine for this early stage, so he’s sending me for a level 2 ultrasound someplace else on Friday morning.

The spotting resumed again after the ultrasound, but it’s still very light and mostly brown, so I’m trying to take those as good signs. Our RE thinks we still have a good chance of this working out, and that I probably lost a baby on Monday night. The ob/gyn says we “have a fighting chance” and he’s not willing to say it’s a non-viable pregnancy at this point, but of course he’d prefer the sac be bigger. (Wouldn’t we all?!)

So for now I’m sitting at home, trying to rest and not drive myself too crazy worrying about what is ultimately beyond my control at this point. I’m going to try to catch up with all of you during the next few days.

Poking My Head Back Out

I suppose it’s time for me to come back out of my cave.

I’m fine – I haven’t been sad or depressed or anything. It’s just that we’ve had a lot of non-infertility stuff going on what with moving, trying to sell two houses and getting adjusted to a new boss, so the infertility stuff (and blogging and pretty much anything else not house-related) has kind of been pushed to the background for a couple months. Actually, it’s been kind of nice not to focus so much on infertility – I was even beginning to remember what it is like to have a “normal” life!

But, of course, “normal” only lasts for so long, and in my case it tends not to be long at all.

We did our second FET in December. Doc gave us two choices after FET #1 failed: Do another FET, this time transferring back three embryos rather than two; or leave our eight frozens alone for now and do another fresh cycle with less stims (not that I was on much to begin with) to see if that could improve egg quality.

I didn’t see myself being up for another fresh cycle until March or April, so we opted for the FET. To be honest, I wasn’t really in the mood to do that, either. I looked at it mainly as one more thing we had to do so we could cross it off our list, and at one point I almost opted not to go forward with the cycle and wait until after the beginning of the year.

But finally I found a little better place, and we continued forward. Then the betas came back:

Dec. 22, 7dp5dt: 48
Dec. 26, 11dp5dt: 181

So, I’m officially – well, you know. I still have a difficult time saying the word. There are some people who know we were cycling. I’ve told them I’m “incubating.” It’s more scientific, less emotion-laden. It helps me be detached.

I’m 5w1d today. I had some mild pain/cramping/aching from about 3w6d to 4w4d. That made me nervous. Then it went away. That, too, made me nervous. It came back a little bit yesterday. That made me happy, then nervous.

I’ve also had nausea and a heightened sense of smell on and off, but that doesn’t seem to be happening consistently either. I’m happy when I feel it, but nervous when I don’t. On the plus side, so far there hasn’t been a speck of spotting and I’ve been going to the bathroom pretty much every two hours very consistently.

Our first ultrasound isn’t scheduled until Jan. 11, which would be 6w4d. It will be with my ob/gyn, since we cycled out of state. I’m debating whether to call and see if I can get it moved up to this week. What do you think?

People keep saying, "Oh, aren't you so excited?!" Honestly, no, I'm not. Blissful ignorance is not an option anymore in our world. I'm scared. I'm trying to have faith. I'm taking it one day at a time, because there are no guarantees and things could change at any moment. I don't know that I will truly be able to be excited until I am holding a baby in my arms.

Here's hoping that 2007 is a year that brings all of us great joy...