PTSD

This post is kinda a continuation of last post.  "I should be more happy", I keep telling myself.  Don't get me wrong, I AM happy that we are finally able to have a baby.....REALLY REALLY happy.  But a piece of me thinks I should be more happy. Elated.  Shouldn't I be even more happy than the average person who finds out they are going to be a mom for the first time?   Sometimes I got to wonder what was wrong with me.  It prompted me to bring it up with a trusted therapist and even do my own research to see if I'm "normal".  Everyone likes to feel as if what they are feeling is normal and I'm no different in this situation.  Everyone needs to feel as if their feelings are validated and important...and that you're not crazy. Upon my research I found a few interesting medical research articles.  PTSD is what I found. PTSD, I thought?  To me it was weird and impossible.  Isn't PTSD only what soldiers get after horrifying and life alerting experiences?  Surely someone with infertiltiy couldn't be compared to them?  I'm not saying I have PTSD because I'm not self diagnosing myself....I'll leave that to the professionals.  BUT I just want it out there that it can happen and IS real.  I would never dare to compare infertility with being on the battlefield, as the soldiers that have been see more in their lifetime than I luckily ever will.  God Bless them for doing what they do, because I couldn't.  But in a much different way couples that struggle with infertility have lived through their own different and VERY real kind of battle.  I just wanted to share some excerpts of the articles I found and make everyone aware there are other articles of "proof" if you need it.  

Examining PTSD as a Complication of Infertility

, New York Hospital-Cornell Medical Center, New York City, , Manhattan Psychiatric Center, New York City, , New York Hospital-Cornell Medical Center, , Cornell University Medical College, , Advanced Fertility Services, New York City

Disclosures

Medscape General Medicine. 1997;1(2) 

"Posttraumatic stress disorder (PTSD) is a psychiatric disorder that may develop following exposure to threatened or actual injury or death. While commonly associated with war or natural disaster, symptoms of PTSD have been described in patients who are undergoing or who have completed infertility treatment or high-risk pregnancies....."

"Posttraumatic stress disorder (PTSD) is diagnosed in patients with persistent psychiatric distress resulting from events involving actual or threatened death or injury.^[1] Subsequent to the trauma, victims experience feelings of intense fear, helplessness, or horror. The precipitating trauma sets in motion a series of physical and emotional reactions that can have major and long-lasting effects. The characteristic triad of PTSD symptoms include (1) persistent re-experiencing of the event, (2) avoidance of reminders and numbing of responsiveness, and (3) increased arousal. Significant distress and functional impairment may result. Psychologically, PTSD is characterized by a classic triad of intrusive, avoidant, and hyperarousal symptoms."

"Although PTSD commonly occurs in situations such as war or natural disaster, other life-threatening situations like sexual or physical assault, being kidnapped or taken hostage, or being diagnosed with a life-threatening illness^[2] have been cited as precipitants...."

"The inability to conceive can catapult some patients into a state of shock, disbelief, and helplessness.^[3]Infertile couples must grieve 2 losses simultaneously: the loss of their ability to procreate as well as the loss of the hope for children. Women who have difficulty conceiving may react to these dual realizations as simply loss, or alternatively as psychological trauma. Those who experience a loss may subsequently develop major affective or adjustment disorders, but those who experience this loss as a trauma may instead develop PTSD. We have observed the development of PTSD in women who have experienced a variety of reproductive problems, including infertility, miscarriage, complicated pregnancy or delivery, and multiple births."

"When PTSD develops in response to infertility or other adverse reproductive events, patients exhibit the classic triad of symptoms described above. They may re-experience the trauma as nightmares, flashbacks, and intrusive thoughts about distressing procedures or pregnancy loss.^[1] Symptoms may manifest as extreme distress under seemingly innocuous circumstances, such as seeing a pregnant woman, menstruating, or visiting the doctor's office; these types of occurrences may trigger a recollection of the infertility battle or mark an anniversary of events in the struggle to conceive and/or to complete a difficult pregnancy."

"Avoidant symptoms include hesitance to discuss the trauma or to engage in any activities, thoughts, and feelings connected with infertility, pregnancy, or childbirth. The woman may be reluctant to discuss the experience with even her most intimate contacts. Avoidance may result in failure to bond, or a delay in bonding, with a newborn. Some PTSD-afflicted women even experience an aversion to the baby and become anxious just holding the infant. Other symptoms include amnesia regarding certain aspects of the trauma, apathy toward previously cherished pleasures or toward other children at home, hopelessness, feelings of isolation, and a general dulling of emotional responsivity."

"Comment. This case demonstrates the feelings of shock and helplessness associated with infertility itself. Some patients become overly involved in their infertility treatment as a defense against feelings of inadequacy.^[3] Further, the infertility work-up and treatment may be perceived as trauma in that it can be painful, humiliating, and intrusive. The nature of the treatment may lead to estrangement from one's own body and sexuality and a distorted perception of the self as merely a vessel for conception. This case also demonstrates some of the marital and sexual problems typical of patients with infertility.^[9,10]"..... Social withdrawal is common with PTSD and has the effect of depriving the woman of much-needed support of friends and relatives. The stigma of infertility is another barrier to seeking support."

"... It is painfully ironic that many of the patients who win their battle with infertility subsequently develop PTSD or another psychiatric illness during or after the pregnancy. Since the full implications of the relationship between infertility and PTSD have yet to be fully explored, this area remains very worthwhile for future research"

Here is few excerpts from another article:

Allyson Bradow, director of psychological services at Home of the Innocents, a nonprofit organization in Kentucky

"The definition of trauma should be expanded to include expectations of life," said Bradow, who went through fertility treatments herself, and conducted the study as a doctoral student at Spalding University in Louisville. "Having children, expanding your family, carrying on your genetic code — that's an instinctual drive that we have as human beings. And when that is being threatened, it's not necessarily your life being threatened, but your expectation of what your life can be or should be like," she said.

The general diagnosis of infertility, or not being able to have a baby, is kind of this giant earthquake that rocks your world. And then, there's all the aftershocks," of fertility testing and treatment, Bradow said.

Bradow said the symptoms she experienced during fertility treatment went beyond those of depression and grief, conditions previously linked to fertility treatment. Others she spoke with felt the same.
To find out how widespread these feelings were, Bradow and colleagues surveyed 142 people who had undergone fertility treatments, and who visited online support groups for infertility. Survey participants — 97 percent of whom were women — completed an online survey to assess their symptoms of PTSD. They were asked to consider their infertility diagnosis and fertility treatment as their traumatic event...Overall, 46 percent met the criteria for PTSD. Among this group, 75 to 80 percent said they felt upset at reminders of their infertility, such as seeing commercials for baby diapers. Other common symptoms included feeling distant or cut off from people, or feeling irritable. Many also said they felt hopeless, and had changes in their personality."

I'm still not "over it"


As I've posted before, just because our miracle finally happened, doesn't mean I'm cured of infertility and that "I'm over it".  Anyone with something so devastating and life changing would agree that the wounds are always somewhat fresh, especially when a trigger appears.  Why do you think so many cancer survivors are passionate about joining walks and celebrating life?  The hard part is that the infertility folks don't have the support like most other groups.  There's no "infertility survivor" support group.  You'd be hard pressed to find any type of support group readily available, although this is slowly changing.

Sure we will have our child we wanted so badly but I still am traumatized by my experiences the last few years.  I have more anxiety than the average pregnant woman that something will happen to my baby.  It took years to get where we are and unlike them I don't have the luxury of trying again should something horrible happen.  With every new symptom or lack thereof....I'm nervous something is wrong.  
Unlike everyone else I know we had to pay to get pregnant.  We have accrued debt most other couples will never know.  Sure we had a little help, but most of it we did on our own by saving money and working extra jobs.  Hallelujah for friends and family that helped us out.  Like most couples, soon we'll have daycare to pay for.  We both need to work and aren't lucky enough to have family watch our child.  But UNLIKE most couples, we are still "paying the baby off".  Babies are expensive and if we are going to make ends meet, it is essential the debt is paid off before the arrival of our child.  While other couples are enjoying shopping for baby items, I'm frantically figuring out how I'm going to pay for these items AND our debt at the same time.  While I'm lucky to be where I am, it does take alot of the joy away that I was SO looking forward to experiencing.  
As I mentioned in my previous post...most of my friends get to "family plan".  They get to decide how many kids they are having and when.  They get to choose if their child has a sibling and when.  We don't.  We know our child will be an only child and I so desperately want them to have a sibling.  That will never happen.  Before people asked me if and when I had children....now they ask how many I'm going to have and how far apart.  Some even comment I NEED more than one child to avoid "only child syndrome" or a "spoiled" child.  Seriously?  Some people are so naive.  Some people have even commented that we will not be real parents until we have two....for all the fighting and sibling rivalry.  Considering we have fought for this and have been through hell and back, I can say we already are REAL parents because we have been through more than most will ever know or experience.  THAT is what makes a real parent....sacrificing for your child.....not listening to fighting.  We can't afford a baby AND expensive fertility treatments so it WILL be an only child.  But hey.....I am lucky to have at least one.  Many others don't even have that choice.  I wish people would realize that. 
I'm extra sensitive about gender questioning.  My least favorite question is, "what do you hope your having" or "what would you prefer, a boy or girl?"  For most, this is a simple and innocent question.  For me, it sets off a trigger.  After ALL we've been through we are just lucky to have ONE child....we were told we'd likely have none.  Why, after knowing we could have ended up without any, would I be picky enough to want a certain gender?   I'll take anything since we are lucky to have anything at all.  For me it's the equivalent of a starving person turning up their noses at baked chicken....you should be blessed you have what you do.  It makes my blood boil when people who have all boys and are griping that they wanted a girl with this pregnancy.....do they realize some people can't have any.  Any child is a blessing.
I've been warned by a therapist that guilt and subsequent depression are a side effect of those who have children after struggling with infertility.  Seems weird but when she explained it, it made complete sense.  Most would think that after we finally achieved our goal, we'd be happier than most.  The truth is that we have placed high pressure on ourselves for wanting children.  We know firsthand how lucky we are to be blessed with a successful fertility treatment and a child.  Let's face it, most parents have moments when they want to strangle their child and most pregnant women have moments when they wish they weren't pregnant anymore.  It's human nature.  However, we often feel guilty for having these thoughts since we know how lucky we are.  We feel horrible and guilty for having such awful thoughts when we could have ended up with nothing at all.  Sure it's human nature, but often we are harder on ourselves than "normal people" without fertility issues for such negativity.  I've already had moments when I could barely get out of bed from morning sickness and could barely make it through the day.  I was SO hard on myself because all I could keep thinking was "you should be so lucky, you could have nothing" and "this is what you asked for".  It's also funny how at the first moment you let your guard down and complain, people are 10 times quicker to let you know it.  We seem to be held to higher standards when it comes to venting...like you're not allowed.  Sure I'm hard on those that complain about what they have.....but that's usually because they don't follow it with the acknowledgement that they are still blessed and lucky to have what they do.  I don't need to be made to feel guilty when I complain.....I make myself feel that way enough.  And I know how lucky I am, even when I do complain.  Not everyone does.  

What the doctors don't tell you....

The goal of infertility treatments are this:  Step one = to get pregnant. Step two = to stay pregnant.  Some couples that struggle with infertility can easily get pregnant but are plagued with frequent miscarriages.  I think most are like us....we couldn't make it to step one and couldn't get pregnant.  Either way, both are devastating because you never get to bring a baby home and have the family you long for.  

So when we FINALLY made it to step one after several years and procedures later, we didn't realize the uncertainties that could happen after that.  I think the hard part for me is that we've never been pregnant, so how do we know if there's a problem with miscarrying?   It is a big unknown the doctors never really speak of.  It took us years just to make it to the first step and I couldn't imagine trying so hard to get pregnant and then find out we have yet another problem with carrying and keeping the baby.  It was a big blow.  I'll never forget the phone call from Dr. Sobel when he said our beta was positive.  I suspected it was, but hearing it was by far the best words ever spoken to me.  "Honey, I'll clean the house" was the second.  Just kidding.  However, it was followed by news I didn't ever suspect.  "Come in every 3 days to get your blood tested to make sure it's a viable pregnancy." What?!  How could this not be viable after all we've been through?  We were SO focused on getting to step one.....we never even thought about step two.  While I was elated I was also more scared than I've ever been in my life.  For about 2 weeks I went to the office about every third day to  make sure my hormone levels were steadily rising.  Numbers that don't rise means you are losing the baby.  Waiting for those results every three days was painstakingly slow and horrible.  I must have checked my phone a million times.  For fertility doctors, this procedural...for me it felt like life or death.  

The next step is waiting for your first ultrasound....usually done at "5 weeks pregnant".  They kept saying how important it was to hear a heartbeat, but "don't worry, sometimes it's too early".  I've ready blogs and internet articles about women who finally got pregnant, only to never hear a heartbeat.  It made me sick to think that could be me too and the worry got the best of me, even though I was still happy to just have this chance.  I lost a few nights of sleep during this process needless to say.  Having never been pregnant, I didn't realize how important and fragile early pregnancy is.  It's something that wasn't spoken to me...maybe because it would have just fueled my worry.  At week 5, we had our first glimpse of our baby-to-be and we were SO lucky to hear a heartbeat.  THAT was the best sound I've ever heard.  For the next few weeks, I had weekly ultrasound appointments to make sure the baby was developing according to plan.  Although it's pretty obvious, no one ever told me how important this was....mostly because most women don't get 50 million ultrasounds because they are "normal".   I can remember long nights of waiting for the next ultrasound, hoping and praying all would be well.  There's so many things they are looking for in these ultrasounds....which means there are so many things that could be wrong.  Once I knew what they were looking for, I had a check off list in my head each time I went.  With each good ultrasound I grew slightly less anxious, but the feeling never completely goes away.  Most women get one to two ultrasounds their entire pregnancy because they are "normal" and not "high risk", that it's foreign to them when I speak of so many ultrasounds.  While I was dreading the ultrasounds in a way because I might have gotten bad news, they were a needed relief to see that everything was ok.  With each ultrasound the doctor's gave me my "chances of miscarriage"....something I never knew or thought of before....but it was real scary.

My point is that people who don't struggle with infertility will never know how this feels....getting the best news of your life but that black ominous cloud still looms overhead.  Miscarriage sucks no matter who has one or what the circumstances, but unlike my fertile friends I can't "just try again" next month.  This is a once in a lifetime chance the way I see it....a miracle (if I believed in them).  When I first started this journey, I didn't realize that I'd accumulate emotional scars that would never go away.  This is just one example.  While I'm lucky that we are going to have one child, it still kills me that I can't give our baby a sibling, especially when I hear friends say "well we'll likely have more than one".  I want that too...but I can't have that.  I want my baby to grow up with a brother or sister.  I want them to have someone when we are gone...someone to spend holidays with and someone to reminisce about memories.  It kills me to hear people "plan" their future.  How they talk about how they are going to "try" to get pregnant so their kids are only 2 years apart.  Don't talk to me about trying, because you don't know the true meaning.  It must be nice to be able to plan your life the way you want it because your body works the way it was intended....so many people take this for granted.  

Bittersweet

This post is bittersweet and surprisingly alot harder to write than I ever imagined it to be.  The past 37 months have hands down been the hardest journey physically, mentally and emotionally that Chris and I have ever had to traverse.  I wouldn't wish this upon my worst enemy.  Sure infertility isn't life threatening but then again, ALOT of things people have to deal with in this world aren't and are still freaking difficult to navigate:  many illnesses, death of a loved one, divorce, loss of a job...   Somehow no one "gets" how tough infertility is to live through...until you've lived through it.  It often gets brushed to the side.  There's no ranking in life of difficult circumstances so I'm not preaching that infertility "takes the cake" on anything, but I DO know it's hard...damn hard.  I'm living proof how significant it can be in someone's life.   Who can possibly judge "who has it worse" and who has enough gall to say one person's struggles with any problems are harder than anothers'?  Interestingly enough, research has found that women experiencing infertility have emotional stress levels similar to cancer patients.  Most people that experience infertility live through some amount of depression.  Depression stemming from any cause is no joke.    
One thing infertility has taught me is to never judge someone's problems or way of handling them unless you've been there.  It's easy to say how you'd handle the situation until you've lived through it.  

So that leads me to our announcement.  WE ARE EXPECTING. I can finally say "I'm pregnant!!!!!"  Because we are a bit high risk, for obvious reasons we didn't want to announce too early.  I can't imagine anything worse than telling everyone we FINALLY did it, only to announce we miscarried. There is still a chance, but the farther along I am, my chances become less.  There are no words to describe how we felt and how happy we were when we first found out.  Shocked...elated...overjoyed....  I was convinced it was yet another failure in the so many we have on our belts.  But this time we got lucky and I thank God and anyone else who'll listen that our dream finally came true.  Even though we are so very happy, I will admit a huge part of me can't yet be happy yet.  I'm so conditioned to believing that everything ends is failure.  I can't help but to think that why is this any different and that this pregnancy will end.  The scars infertility leaves are always there and this is a big reminder how deep they are.  I don't think I will truly be happy until I see and hold our baby for the first time....until I know it can't be taken away.  Unless you've lived through so much disappointment it's quite difficult to explain how it's so hard to be happy....but actually for those who've experienced infertility it's quite a normal feeling. Sure most women at some point in their pregnancy worry something will go wrong, but couples who've lived through infertility have it worse due to past experiences.  ANY miscarriage I'm sure is difficult, but we don't have the luxury of trying again next month.  Hell, even it's taken 3 years, 3 IUIs and 2 IVFs to get pregnant....not to mention most couples don't have to shell out upwards of 15 grand for one single shot.  There's alot more at stake is all I'm trying to point out.  

The other problem I struggle with is all the people who read or follow this blog that are still trudging through the trenches of infertility.  Our journey has been a long one....but SO many others have been even longer and my heart aches for them.  Even though we've been through hell and back, I'm still one of the lucky ones.  Some will never get so lucky and may never get their chance.  It's just so incredibly unfair.  I can be honest and speak the truth that while I was happy for those who got pregnant before me, I was also incredibly heartbroken for myself.  I was angry and sad beyond belief to watch someone else live my dream....something that comes so easily for most people.  I cried silently for days at some pregnancy and birth announcements that is wasn't me too.  While I'm ecstatic for myself, it kills me to think that I am causing pain for some of my readers.  I know....I've been there.  No one wants to hear.... "just be patient, or it'll happen, or have faith, or you never know, or when it's meant to be".  For someone living through infertility, that advice is crappy because it's not always true and even if it is it doesn't kill the pain in the meantime while we wait.   And all we have to do is wait.  So I'm not going to offer any advice but just know that my thoughts are with those who are still battling their battle.  

I'm not sure what'll happen to my blog.  As of now my wounds are still fresh and I don't think I'll ever really get over the past few years.  It stole a big part of my life but you know what?  It taught me alot about myself...how strong I am and it taught me alot about life and other people.  That's a lesson that's is priceless and can't be earned without living it.  Even though we are pregnant, it's still not over and my scars are still there.  It's something I still am and likely will always be passionate about and likely it'll always be close to my heart.  There's still so much to be said and likely I'll keep saying it for anyone who wants to learn more about infertility or what we have to go through.  I don't think I'll be turning this blog into a pregnancy update because for most that would be too difficult to read as I know it was for me.  I guess time will tell but don't stop following as I still have alot to say for those who care enough to listen and not judge.  

We will know any day now if our IVF worked and we are or aren't pregnant.  This two week wait (2ww) as they call it has been nerve wracking and harder than going through all the actual tests and procedures.  Your mind has a way of playing tricks on you and it's pretty hard to control when you want something so badly.  I've tried to keep myself busy and distracted and this has helped alot.  I'm also not getting my hopes up because I've had them crushed so many times before.  That's why I guess it's so hard to hear things like "you just never know".  That may be true, but I also know from experience many times it's not.  I'd rather be pleasantly surprised than devastated.  I guess either way I'd be devastated, but it's much harder when you think it worked and then everything comes crashing down.  The doctor's had me believing that our IUIs would work, so each time I believed them....and here we are two IVFs later.  

When I go for bloodwork, a few hours later they will call with the results.  From experience, those few hours in between having your blood drawn and getting the call are the worst. Last time I already knew it failed because mother nature told me so....but for some reason I still held onto hope that it wasn't true.  This time, mother nature hasn't yet graced me with her presence yet and I hope she takes a LONG vacation for 9 months.  

The bloodwork tests my beta hcg levels....a chemical released by the baby-to-be.  That means implantation was successful and technically you are pregnant.  That is a HUGE hurtle to cross, HOWEVER since a huge amount of pregnancies and IVFs end in chemical pregnancies or very early miscarriages, it's only the beginning.  This is why most women don't want to announce their pregnancy until after the first trimester....I won't have that luxury.  It's critical and very touch and go the next few days if I test positive.  IF I am pregnant, two days later I take another blood test to see if the levels are rising.  This is really the ONLY way to know if the baby will likely survive early on...and many don't.  I can't imagine how horrible those two days would be.  This is why when people ask me what the results are on our first test....I wouldn't feel comfortable sharing it because it's not yet official and alot can go wrong.  There would be nothing worse than telling everyone you are pregnant FINALLY only to tell them a few days later that you lost it.  I've been placed in an awkward situation because so many people are pulling for me and just want to know.  I DO TOO and I'd be ecstatic if we passed the first test (you have no idea) but it would be far from official!!!  So please understand my own sanity I don't think I can share the news (if I even get good news) too early on.  If it fails....I have another bridge to cross.  

Misdirected Anger

I'll never forget the first time someone pointed out to me how angry my blogs seemed.  "Are you kidding me?" I thought.  Clearly this must have been coming from someone who's fertile and hasn't understood or lived through the struggles of infertility.  It's more than a disease...it ruins your chances of fulfilling what's important to the majority of human beings....having a family.  How could this NOT be important and how could I NOT be angry we weren't blessed with something nearly every other human being doesn't have to give a second though to?  Didn't I earn the right as a woman to have the chance to be a mother? But my motherhood has been taken away from me.  As I've learned from counseling, I have every right to be angry as anyone with this disease or ANY disease does.  One of my goals with this blog was to help others understand why I'm so angry about not being able to have children.....I guess I must not have gotten through to everyone and as life goes, I probably never will.  I'm ok with that, but what I'm NOT ok with is being judged for having normal feelings....especially from someone who's never lived a day in the life of someone infertile.  My job as a therapist is to help people overcome their physical disabilities.....but I know that RIGHTFULLY attached to those physical disabilities is mental and emotional baggage that comes along with them.  I understand and accept that many are angry about what's been dealt to them so it blows my mind that other people can't be more understanding of the anger I or anyone else can  have from being the unlucky one who has to deal with something so life changing.  No, it's not fair....LIFE isn't fair but I've said this before and I'll say it again....it's easy to say that when you aren't on the receiving end of the unfairness.  That cliche hits really close to home when it's YOU...only then can you truly understand the reality of this cliche.    

So yes...of course I'm angry I can't fulfill my lifelong dream of having a family.  Isn't that what most people in this world strive for (a fulfilling career, a family and to be happy)?  Isn't that why most people get married to someone they love so they can make children?  Yet we are shafted and don't get to fulfill the dream that everyone else seems to take for granted....the ease of getting pregnant and having kids. When does anyone ever say...."Gee I'm really glad I could get pregnant and that I'm not infertile"?  Most people don't give it a thought.  It's just expected we can procreate.  When have you seen commercials or walks for infertility like there seems to be for every other disease or problem under the sun?  We often get left out and swept under the rug...like it's no big deal.     Even though enough people live with infertility, it's just not something people talk about or really appreciate the impact of.  I know I never did until the past few years.  It's so easy to blow it off and think or say "just relax, it'll happen" or  "I'm sure it'll all work out" or to come up with a billion million reasons and solutions for not being able to get pregnant and have a baby.  I still have people who are insensitive enough to say: "I'll give you my kids for a day".  What I should say is "I'd love them actually, but only if you learn to live a day in the life of someone who can't have them."  Most people that embark on IVF will get pregnant....however many do not for true medical or unknown reasons.  What about those people?  What about those who will never know because they simply can't afford another treatment to find out?  From talking with friends and  family I know at least 6 other couples (some directly and some indirectly) who've tried IVF.  ALL have gotten pregnant.  My point is that not everyone does....odds are someone won't.  Will that be us?  In my head I'm thinking "well it worked for all of them, so I must be the 1 in 6 who doesn't....it's gotta be someone."  I feel really happy for each and everyone of them because I know how it feels to want this so badly.  But that doesn't mean I can't be angry and upset that it hasn't yet been me too.  I've learned that underneath anger is a whole lot of pain and hurt....the anger is just what we see on the surface.  How does anyone ever get over those scars, baby or not?  

I can't tell you how sad I am when I hear another pregnancy or birth announcement....this is one of the very reasons I quit facebook.  Life is so centered around families and children and I'm reminded and bombarded constantly.  The entire world seems to revolve around families, children and babies: back to school, mother' day, father's day, Christmas, commercials on TV...you name it, it's year round.  How can people without children feel like they fit in?  I know I can't always run away and avoid these things, but my wounds are still pretty fresh and from what I've learned will always somewhat be exposed.  It's something you hold onto forever, even if it's only a little bit.  It never completely heals but hopefully lessens somewhat with time.  Because these things are triggers for me, I learn to avoid them and deal with them on my own time when I'm ready.  No one gives people a time frame to heal from the death of a loved one, but it seems that some people give me a ticking clock for when I should be over not being able to have children....easy to say unless you've lived it.  When will it EVER be ok that I can't be a mom?  

How can I get over my dream to have a family when you hear daily news of reports of child abuse, neglect, or people just killing their children....children I can't have?  It's so difficult to hear anyone complain about their children, family or pregnancies.  Hell, it's difficult to hear them talk about the joys of it all because I  may never know them.  It's an exclusive club I've never got the invite to.  I'm always on the sidelines.  I feel so left out and defeated during these conversations that I'd often rather not participate or place myself in a situation where I'll just end up sobbing in the bathroom later.  What I WOULDN'T do to be in their shoes... if they only realized how lucky they really are.  As an analogy:  would any normal person complain about what's on their dinnerplate in front of a starving person?  Most people unknowingly do this but I just have to deal.  People SHOULD be able to talk about their kids (good or bad)....it's just hard to hear.  I can't help to get so angry at people who have lots of money to afford treatments or people who have lots of money that are blessed enough to not even need treatments in the first place.  I work hard for my money too.  I'm so jealous and frustrated that some people's biggest problem right now is what color to paint the bathroom or what type of kitchen cabinets to get.  I remember those days but they are long gone.  I miss them.  It's hard not to feel a bit angry at people who can afford expensive things when the only thing I want to buy is a chance to have a baby.  I don't want a car, or a nice house, or a boat, or diamond earrings, or a great vacation, I just want a family.  Whoever said money can't buy happiness never  knew of infertility.  

In the three years we've been struggling to have a family, I can count over 2 dozen friends and family that have had children...some even on their second in the time it's taken us to try for one.  It's been over THREE years for us.  That's a long time to feel this way...to try for something so hard.  It's incredibly frustrating watching everyone else.  We feel like we are hitting our heads against a brick wall or are running on a hamster wheel.  Right now, a very good friend of mine is pregnant and she won't be the last.  Of course I'm happy for her, but it doesn't mean I'm not sad as hell inside for myself.  I will admit it takes ALOT of practice to feel happy for someone else when you are dying inside....when all you want in the world is what she has.  It's so hard to brush your feelings to the side just to have a normal conversation.  It's heartbreaking to watching her belly grow while I get to stick mine with needles for the chance to join her on the other side...knowing I may never.  It kills me that soon her house will be decorated with baby pictures while the only one I may ever have is just a Polaroid of two 8 celled embryos.  In a few months she'll get to hold her baby and take it home from the hospital while I have nothing to hold but a photograph of what could've been.  She'll get to have a baby shower, will get to pick out a crib, will be one day sending her baby off to kindergarten and I can't.  It's infuriating we have to try SO damn hard, while they didn't.  I hate it.  I'm angry about it and I'm so sad inside it can't be me too.  It's not her fault she got pregnant and I can't....so how is it fair that I can't bear to hear her share stories about her pregnancy?  It's not.  My point and question to everyone is HOW do you get over not being able to be a mom, HOW do you move on from something you want so badly when you are reminded so frequently?  HOW do you watch someone else live your dream and still remain close?  I don't want to be a bitter person, but really underneath it all I'm whole heartedly devastated and more sad than I could have ever imagined being.  How do you control how you feel when you can't so it doesn't ruin relationships and my chances of happiness as well?  How can I get people to understand the hurt behind the anger?  How can I have meaningful and fulfilling relationships with people who have what I don't?  How can I put my own feelings aside to join the the joy of others?    How can I get people to understand why on "bad" days I can't attend baby-showers, family functions or just hanging out?  How can I stop pretending to plaster a happy face on myself when all I want to do is cry?  How can I ever be happy?

I am doing the best I can to not misdirect my anger towards others.  It's not their fault they have what I don't....but it's also hard to see it.  It's also not my fault that I have to be the one to deal with this.  The problem with infertility is that I have no one to be angry at.  Do I get angry at God, my husband, my friends, myself?  Of course I can't...no one did this to us....so it's hard not to be angry at the universe.  I have no one to direct my anger and hurt at...just a shitty disease that I can't do anything about.  I'm doing my best to keep my emotions at bay and to not misdirect my anger towards others because it's not fair to anyone...but it's so hard not having someone or something to be angry at.  

From my previous update, we had 10 eggs retrieved last Thursday.  Of the 10, only 4 were mature which is horrible.  I wonder if they triggered and retrieved too early, not allowing the rest to mature.  Of the 4, only 2 fertilized which also isn't good.  Luckily both made it to transfer.  We were sweating bullets for three days hoping and praying we'd have something to transfer.  Our transfer was Sunday and both embryos were doing well at that time.  We were able to transfer two grade A embryos (one 8 cell and one 5 cell).  Embryos are given a grade based on how they look and how they divide, with grade A being the best. For day three transfer, they like to see between 6 to 8 cells.....one of ours was a little behind but at least was surviving.  The difficult part is that the grade of the embryo doesn't necessarily relate to pregnancy rates. Like everyone knows last time, both of our embryos were perfect, yet we didn't get pregnant.  Some people have horrible looking embryos, yet are able to have a baby.  As of now, it's strictly a waiting game.  By the mid to end of next week I'll have my blood test to see if this IVF worked and we can fulfill our dream of parenthood.  Until then, there is no way of knowing.  

Once the embryo is transferred, it must go through alot of critical changes.  Sometimes many arrest (stop growing) for no reason....from what I've read it usually it's because they have genetic abnormalities.  The embryos have to continue to divide until day 5 of life (two days after our 3 day transfer) to reach the blastocyst stage which is a critical point in development.  Once it reaches this phase (that would have been Tuesday for us), it hatches out of it's hard shell.  Sometimes embryos don't have enough energy to do so, so it dies.  We payed extra for assisted hatching.  Prior to transfer, the embryologist places a microscopic hole in the embryo to allow it to hatch with increased ease.  After it hatches, it starts to embed itself in the uterus and hopefully implants.  This process takes a few days and is where many IVFs fail.  Technology isn't advanced enough to assist with implantation or to understand reason for failure.  In an average healthy women, each month there is only a 20% chance of implantation....therefore we have about a 20% chance of this IVF working.  Not the best chances, but much better than our next to zero percent chances of getting pregnant without IVF.  To do what I can, I'm taking a progesterone hormone twice a day and am continuing with acupuncture twice a week.  We are leaking money faster than we are bringing it in at this point.  I can't face having to pay a debt off every month and be reminded of a failed procedure and an unfulfilled dream.  After this IVF, we need to throw in the towel....at least for a long long time (months to years), possibly forever as our finances don't allow for any more tries.  This year alone we paid more than $28,000 for treatments....it still makes me so angry that most women get pregnant for free and just don't understand how lucky they are.  

Living with infertility is such an emotional rollercoaster ride, although there are many more downs than ups.  Again, never in my wildest dreams did I think we'd be the lucky ones who get to understand firsthand what this disease means.  As a therapist I can appreciate that there are so many horrible and debilitating diseases out there that I'm grateful I don't have.  I think the hardest thing, besides not being able to hold your dream in your arms, is that it's a silent disease.  If I had a limp, a cane or a walker (and trust me I'm grateful I don't), people would see my struggles in some way and could possibly begin to process my pain.  The pain of any disease goes far past the physical.  It's hard living with something that no one knows you are suffering with, and few who understand and can relate.  

When someone close to you dies, it's acknowledged by society as a loss.  There are rituals around this kind of loss:  cards or flowers are sent, people verbalize their condolences, we have funerals to try to finalize our loss and say goodbye, and usually there is never an "expected" timeframe to recover from this loss.  It's hard for people to understand how significant the loss is with infertility, likely because there was never anything tangible that you could touch or hold in your hands.  But that's exactly the point....we wanted this baby for so long, dreamed so much,  and prayed so hard for it and it never came true.  We envisioned ourselves as parents our entire lives, got married with that exact intention, and now must say goodbye to our dreams and future.  Again, I doubt that anyone with children can argue the impact they have on our lives.  Lives are forever changed with children and I will never get to experience the joy of that.  No one sends cards each failed month, no one sends flowers, there are no rituals to help me grieve my loss (albeit several people say they are sorry), I'm expected to report to work and function as if nothing ever happened, like my loss is insignificant .... and some are too scared to say anything at all.  With each loss I have, life around me goes on as normal when mine has skidded to a complete standstill.  I don't get to pull out the "loss card" when I'm having a bad day like someone who has lost someone does.  Try explaining why you're sobbing because you've just gotten your period for the umteenth time, why you breakdown at Walmart when you have to buy tampons, why a simple trip out in public when you see a pregnant woman can cause you to spiral out of control.  I rarely get to use this excuse because most people expect me to move on quickly, don't know or don't understand what's going on.  With each loss I'm still expected to "have hope".  This really irks me, makes me realize few really understand the impact this has on our lives, isolates me and frankly hurts my feelings.  How many times have I heard "don't lose hope", "you just never know", or "keep the faith"?  SOOOO many.  While I don't want to seem overly pessimistic, it can be true but likely not the case for every infertile couple.  But these comments, while I know aren't meant to hurt my feelings, don't bring me our baby.  Please understand that I've heard them the time before that, and the time before that, and the time before that, and the time before that, and the time before that, and the time before that, and the time before that, and the time before that, and the time before that, and the time before that, and the time before that,and the time before that, and the time before that, and the time before that, and the time before that, and the time before that, and the time before that, and......are you getting the idea?  Again while a small part of that could be true, the reality is that it's likely not and sometimes these seem like broken promises no one can deliver to us.  We are expected to wait and pine over something that may never happen, while remaining happy and living our lives to the fullest.  That seems like an oxymoron.  While I'm not giving up quite yet I still can't live in the land where everything is guaranteed to work out....because I know all too well it may never.  While I don't want to give up on us and want people to help us understand there could be a small glimmer of hope, I also need people to be real with me and to sit with my discomfort instead of trying to wipe it away and "fix" it.  It seems like a tall order.  I wouldn't be doing this if I wasn't hopeful, but nothing is guaranteed.  

To put it into perspective how I feel sometimes, it's like someone who just gets told that they have no other options.  There is no more chemo that will work, no more surgeries that can correct their problem or save them.  We've been told that there are no other options for us.  IVF IS our last chance to have a biological child and we sure as heck can't afford adoption (like that will also fix my innate desire to give birth to my own).  We have hit the end of the road.  Would you say to someone who was just told that there will be no other treatments for their cancer or disease to "just have hope",  "maybe they'll be a cure next month", "it could happen", etc?  I sure hope not.  That seems pretty insensitive and trivializes things a great deal. Life threatening or not, most would say they are sorry, let the person sit with their emotions and just try to be there for them.  Yet I hear these things all the time, I hear advice, people always want to fix us.  In my eyes, as the person who has to deal with the heartbreaks each treatment, it IS the same.  I may not be physically dying but emotionally I am a great deal.  I guess that doesn't warrant the same treatment.

If we fail this next IVF, we likely have to give up our quest for parenthood.  Yeah we're emotionally exhausted, but I know we could push more.....sadly it's our paychecks and pocketbooks that are holding us back. It just doesn't seem fair.  I'm NOT ready to give up fighting, yet money dictates that I do.  With biological clocks being VERY real, it's a big deal.  I SO wish we made alot of money....but we don't.  I SO wish that people who suffocate their babies and hide them in toilet tanks (headline news last week) couldn't have them and I could.  Some people have said for us to look on the bright-side of things:  kidding or not, we'll never have to wake up in the middle of the night to feed a crying baby and be tired the next day, we'll never have to deal with screaming temper tantrums in the middle of the store, we'll never have to change diaper blowouts, have to deal with moody teenagers, or paying for college.  We'll have more of our money for ourselves.  We won't be tied down, will have freedom, we can travel.  YAY....didn't we just win the lottery on that one?  Seriously?  I'd trade all that in a millisecond.  If I win that lottery, I also don't have to deal with hearing my child say "mommy, I love you", or getting homemade cards for mother's day, I won't have to wonder how someone that looks a bit like me and a bit like Chris will look like, or being a proud parent at a soccer game, or watching my child graduate and blossom into and adult, or having someone visit me in the nursing home.  Yeah, I really won that lottery on that one.  
  

I wish just once I could share good news.  Thursday was the big day for egg retrieval surgery.  I took my last injection (hopefully ever) Tuesday night.  The "trigger" shot is the final step in preparing the eggs to be retrieved; it's supposed to mature and ripen them.  Immature eggs are incapable of being fertilized and are essentially useless.  Retrieval must be exactly between 35 and 36 hours after the trigger shot.  Too soon and the eggs will not be ready and are useless.  Too late and I will naturally ovulate and lose them all.  We arrived at 7:15 am and I was prepped for surgery starting at 7:30.  This time I was placed in a private room and had an absolutely wonderful nurse, Paula.  From the start she made me feel welcome and comfortable.  She went above and beyond to review my medical record with me just to give me the piece of mind that she knew who I was.  It really did help....I didn't feel like another number to her.  Even though I had gianormous veins, she had some difficulty starting the IV, mainly because I'm a needle phob and a complete baby.  I  moved and we had to start over....15 long minutes later I was starting my IV antibiotics and fluids.  My surgery was set for 9:00 and was taken into the room a little after 9:00.  I guess the doctor wasn't quite ready so I was lying on the OR table for like 15 minutes just staring at all the equipment and trying not be be a bundle of nerves.  Even though it was my second time, I was still nervous...not about the physical stuff but that I wouldn't have good results.  I just wanted to get it over with so I knew.  Within a matter of time I was put to sleep, woken up and learned I had 10 eggs retrieved.  Not too shabby, although I was still hoping for more than last time since I was on a higher dosage of hormones this round.  Upon waking I had more abdominal pain than last time and it caught me off guard.  The nurse explained that the needle (what they use to extract the eggs) tore some tissue in no man's land and I needed a stitch or two since I didn't stop bleeding.  Due to the anesthesia I was quite loopy and my emotions of the whole thing finally got to me.  She and I talked a bit about how hard IVF is and how it wears you down...how hard it is to desire something you simply cannot have.  She told me someone close to her was going through the same thing and that made me feel like she somewhat gets it.  She asked if she could say a prayer for me that we will have our baby.  I was completely touched and wished more nurses were this great.  

The following day (yesterday) I called out of work.  To be honest, if I didn't lift anything too heavy I probably could've worked but mentally I couldn't take it.  I knew at 8am I'd be getting a call from the lab to go over our results....how many of my 10 eggs were actually mature and how many fertilized.  It's a BIG deal.   Last time our numbers were SO great and I knew that there was a chance they wouldn't be this time....I just didn't expect them to be as bad as they really were.  Of 10 eggs, only FOUR were mature and could be used....only 40%!  That's awful.  I am wondering what happened...should the doctors waited one more day for the eggs to get bigger or is this just a fluke?  I just don't know.  Of the four only two fertilized.  Only two!  That's even more awful.  I knew that we have trouble getting the embryos to grow and the likelihood of them making it to transfer, dividing correctly and staying alive is bleak.  At least last time we had more than 3 times that amount to play with.  I am so upset but if we make it to transfer tomorrow I need to try to remain as stress free as possible.  This morning we received a phone call that the lonely two are doing ok.  They check only once a day to see how and if they are dividing and are alive.  Too much poking at them isn't good.  One embryo is 2 cells and the other is 4.  Those are normal numbers, but looking back at  last time it was the third day (tomorrow) that all went to hell.  Most just stayed at 2 cells.  I am hoping and praying with all my heart that they make it over the next hurdle.  I want at least two to transfer, to increase my chances.  If one or both dies, I can't bear the thought of not even having a chance.  

I Would Die For That

http://www.youtube.com/watch?v=AnqJCLMIc2k

This is just what a small glimpse of how we feel.

DAY 9:

  Today is my 9th and final day of stims.  I will definitely not miss my nightly cocktail of injections.  After tonight I have two more shots to give myself.  My morning injection is a drug that makes sure I don't accidentally ovulate and lose the eggs I have worked so hard to make.  I've been doing these morning injections for the past 4 days and tomorrow is my last.  My belly is sick of being a pin cushion.  Then tomorrow night I will inject my "trigger" shot which ripens the eggs for my retrieval on Thursday.  Thursday is the big surgery day for egg retrieval.  In the grand scheme of things, being on injectables for 9 days seems relatively short to do such a big job.  I've been following up with the the doctor every other day and now that I'm closer to retrieval I go daily for monitoring (more bloodwork and ultrasounds).  They found 8 follicles which contain hopefully mature and beautiful eggs.  For my age and problem, 8 to 10 is average.  I'd like more, but as long as they are all good quality I'm going to be happy with what I've done.  I can honestly say I couldn't have done more: avoiding caffeine for 7 months, alcohol, eating organic when I can, exercising, multiple vitamins and supplements, and even acupuncture. I am nervous for retrieval...not so much for the physical pain of surgery, but for the outcome.  In infertility treatments, passing each step is a milestone.  I've made it past the biopsy for co-culture, I've nearly made it past the medication phase, then comes the egg retrieval, then the ICSI for fertilization (where they inject the sperm into the egg in the lab), waiting for the embryos to grow, then embryo transfer, and then hoping and waiting to see if I'm pregnant.   I seem to pass each hurdle so well, until the time when the embryos are supposed to actually grow. I think what will make me the most nervous the next few days will be seeing if our embryos grow this time. It was SO disappointing last time when they said everything with my cycle was picture perfect....until the embryos just didn't grow. Waiting for my daily phone call from the embryologist at the lab was so nerve wracking and I'm dreading it again.

I'm going to rant and rave for a bit.  Today we just went grocery shopping.   I swear every time I go to Wegman's they have a pregnant women's convention.  Then I get home and put my groceries away.  Most people have a vegetable drawer.  I have that too, but I also have a fertility drawer where my medication that cost thousands of dollars sits.  It's just not fair.  Most people this weekend will be enjoying their holiday.  I'll get to be recovering from surgery and pining away about the outcome of my potential babies.  Most people will be spending Labor Day with their families while I'll only be dreaming of the family I can't have. I work in a medical office building and get to see pregnant women waddle down the hallway to the antenatal suite all the time....some with children in tow.  I just want ONE....they have two, three, sometimes more.  I've only seen the inside of that room in my dreams.  Even if this IVF does work out, it's unlikely I'll ever be able to give my child a sibling.   Since we started this journey, by no exaggeration I have counted over TWO dozen of my friends and family that have gotten pregnant in the time it's taken us to try for just one...some are already on their second.  While I'm happy for everyone else, I am so heartbroken for myself and wonder when it will be my turn.  I'm sick of watching everyone else get so easily what we can't.  I'm sick of hearing pregnancy and birth announcements while I sit here and inject myself with medication for a small chance of getting pregnant.  It's so difficult to watch yet another pregnant belly grow as I watch needles being stuck in mine.  This past weekend, we went out with friends and what was part of the topic of conversation....?  My husband happened to start a conversation about his job regarding unwanted children.  He works for the court system and sees SO many parents neglecting their children or giving them away because they can't care for them.  While he was telling stories, I was trying not fume inside that my fate is this. I was trying not to cry at the fact that people who don't even want children or can't care for them can have them while we can't.    

I started the injections Sunday night.  By now I'm a pro and can do it without cringing.  Every night at 9pm I religiously give myself two to three injections in my stomach.  I'm on a hormone cocktail of Gonal F and low dose HCG...both help to stimulate follicle growth (where the egg grows).  In a typical cycle without hormones, females have many follicles that develop each month but only one wins out to beat the others and grows an egg.  The rest are immature eggs incapable of being fertilized or never grow an egg and are discarded naturally by the body. The hormones I'm taking will help all those normally discarded follicles to grow a nice mature egg inside.  In an IVF cycle by the time all is said and done, each ovary will swell to the size of a grapefruit.  I can tell you from experience that this is quite uncomfortable and sadly the closest thing I've ever felt towards pregnancy.  I can somewhat vouch why pregnant women complain about their bodies but I would gladly trade places with them.  Most women who get pregnant easily and naturally will never appreciate how lucky they really are. 

I started out with a glitch in this cycle.  I received expired medications from the pharmacy! It's a good thing I happened to check the expiration date.  This is likely very atypical so those going through IVF shouldn't freak out....just remember to check your boxes and vials.  On my first day of injections I noticed it expired that day.  If the medication is expired or not kept refrigerated, it could severely compromise the results. It was a mix up at the pharmacy and likely the medicine was still actually good.  They still sent me a new vial, free of charge but I did have to take the expired medication for one day until the new one arrived.  Since it wasn't the most important medication to stimulate egg growth and it was only one day, it was likely no big deal.  So many things can go wrong in a cycle and so many things can cause anxiety that I'm trying not to let this freak me out or cause my stress to elevate more than it initially did.  

Tonight will be my 4th night of injections....typically most women "stim" for 9 days, so I'm about half way there.  In a few days I will start a third injectable medication to make sure my body doesn't accidentally release the eggs (ovulate), causing the procedure to fail.  This morning was my first appointment with the clinic after starting medications.  Again, I had a few glitches.  I normally have gianormous veins.  But today for some reason....not so much.  She stuck me a few times and dug around for a bit until she finally got some blood.  Now both my forearms look like I have track marks on them and are bruised...and I have roughly 3 to 4 more times I have to give blood within the next week. Ugh.  With it being summer, it's hard to hide and I don't like people (patients) asking questions at work.  Work is my ONLY time NOT to think about our problems with not being able to have children.  My ultrasound wasn't that great either.  I only have 7 developing follicles...that's HALF of what I had last time.  I know NO IVF cycle is the same and to never compare, but it's hard not to be disappointed in my numbers.  The less eggs = less potential babies.  Only about 2/3 of retrieved eggs are actually mature.  If I do the math, that's about 4 to 5 eggs we have to work with.  From those, typically only a third will become fertilized which leaves me with only 1 to 2 potential embryos.  Considering our problem with the embryos not developing, that doesn't leave us alot to work with....last time we had EIGHT and look what happened?  I understand this can change for the better or worse, but it's still difficult to not think about the outcome.  With this being our last chance to have a family, I am SO incredibly nervous.  One key thing I've learned is that it's the quality of the eggs, not quantity.  For now, that is all that's keeping my chin up. 

So for now I'm busy with appointments and trying to juggle work.  I had acupuncture yesterday, I had an appointment today with the clinic, tomorrow I have acupuncture again, Friday I have another appointment at the clinic and that's only this week....  Even though I'm nervous as heck, I'm doing rather well overall.  I'm thankful for the support I receive from my friends and family and only hope that support will continue and  multiply should this fail.  I can't imagine what a wreck I'll be....it's hard when no one understands completely or has been in my shoes.  It's easy to imagine how one should deal with this....until it's you.   

It's hard to believe we are at it again.  Trial number 2...and hopefully our last.  We are hoping and praying for success this time around since financially we are unable to pursue our journey past this round.  This IVF is a bit different this time around.  Our doctor recommended trying something called co-culture.  It's where they take my uterine cells, grow them and later allow the embryos to grow on top of them.  Last Monday I donated 10 vials of blood to this cause and this past Wednesday I had a uterine biopsy to collect cells.  I'd imagine they are growing in the lab right now.  The biospy was quite unpleasant and downright painful to say the least.  But I've had practice since I had a few others before.  At least it was quick.  In case you're wondering, to collect the cells they insert a long catheter through the cervix and into the uterus.  Even though I've had biopsies before, this was the first time I could stomach looking at the instrument used to collect the sample.  

Tomorrow I go for initial bloodwork and internal ultrasounds to get a baseline of my hormone levels and egg development.  Sunday is the big day I start injections (between 2 to 4 a day for about 10 to 14 days).  Last time I didn't have too many awful reactions to the hormones except a few hotflashes, bruises,  and abdominal pain and swelling.  I am hoping for the same or better this time around and am praying my body will respond to the medication to produce lots of good quality eggs.  Initially, I'll follow up with the clinic every other day, but closer to the end I'll be headed there daily.  It's ALOT of appointments and not always easy to juggle my work schedule.  I would suspect in about 10 to 14 days I'll be headed for surgery to retrieve the eggs.  

In addition, this time around I am trying acupuncture.  I've had three consults at great clinics and ALL doctors recommended I try it.  Acupuncture helps to stimulate blood flow to the ovaries to provide them with nutrients needed to grow healthy eggs.  I've been going weekly for the past 5 weeks but will start going twice next week and the week after.  Unfortunately this is running us a few extra hundred dollars but it's a chance I need to take.  If we fail, I want to be able to have the piece of mind that I did everything within my control to improve our chances.  

I wish I could say I was optimistic.  I've had too many letdowns and heartbreaks to be.  I am hopeful though, but am realistic.  I knew last time I'd be upset if we failed, but I didn't realize HOW upset.  It's worse than anything I could have ever imagined.  This time more is at stake since it's very likely it's our last.  If this fails, we will never be parents and that's a BIG deal for us. I'm hoping with every ounce of my being that it'll finally be OUR turn.  

Sacrifices

I always knew that being a mom I would have to make some sacrifices.  I knew I'd have to give up the freedom to be able to meet with friends at the last minute, staying out late on a weekend (then again I don't do that now!), having the amount of "me" time I have now, sleep, among many many other things.  I knew it wouldn't be easy but am still convinced that the rewards of parenting far outweigh all the negatives.  I didn't bargain that trying to get pregnant for the past three years would require just as many sacrifices.  While I don't think any new parent can truly grasp the difficulties of parenting, the past three years have really prepared me for my soon hope-to-be job as a mom.  

Awhile ago someone said that they didn't see Chris and I sacrificing alot to be parents.  Those that are close to us and know our struggles will likely tell you differently.  This statement really shocked and bothered me because I know the hell we've been through for the past 35 months.  Each couple that struggles with infertility has their own different struggles, but I bet and can guess by following others' blogs and chat rooms that our sacrifices are similar. I'd like to provide some insight on some of the things we have sacrificed.

Privacy:  Letting a team of complete strangers (doctors, nurses, etc) into on our private life isn't exactly easy.  They know everything about us....what we eat, how many partners we've had, how many times we have sex in a month, when I get my period, our entire medical history, not to mention "baring" all at appointments. Any woman will tell you gynecology appointments aren't a day at the amusement park.  The best way to describe my appointments are like gynecology appointments on crack.  They are much more invasive, more painful and much much more frequent.  

Time:  For us, trying to get pregnant is a BIG time commitment.  Like most of you, we didn't just get to have sex a few times and end up pregnant.  I've used ovulation kits for months, timed sex around ovulation, failed 3 IUIs and one IVF.  During treatment cycles I have to go to the doctor around 3 to 5 times a week.  Many are last minute and unpredictable since it depends on my body. Juggling my work schedule is stressful.  To date, I've had at least 50 appointments.  It's also a big time commitment in terms of being informed.  I've spent countless hours reading books (about 8 total), researching the internet for information and researching clinics and doctors.  

Sex life:  As taboo as it is to talk about, I'm gonna do it.  Yeah our sex life has suffered.  Sex is no longer an intimate experience as a couple... it is strictly about baby making.  When you have doctors telling you "when" and countless tests and instruments up that part of your body, you don't exactly feel sexy.  I hate when people tell me that "practicing to have a baby is the best part" so we are lucky.  Any good thing done long enough gets tedious.  Chocolate ice cream is delicious, but when you eat it every day it gets old.  What's worse is that for us it a futile effort, putting more pressure and stress on us when the doctors give us the green light.  I can guess for most infertile couples, sex causes some stress and arguments.  

Body:  I feel like a piece of meat...like a science experiment.  I can't count the number of times I've had blood taken, injections filled with hormones, and painful procedures.  My body no longer feels like my own.  

Indulgences:  I've given up alcohol, all caffeine, have been trying to eat mostly organic, and am taking about a dozen supplements daily just to try to increase our chances.  I LOVE coffee but haven't had any since January 26th.  I don't cheat...even a little.  When your desperate for something, you'll do anything. I've also been pretty diligent with taking care of myself by getting the right amount of sleep and exercising regularly.  All these things take time to do well.

Sanity and state of mind:  I will admit I'm depressed alot of times.  I'm doing my part by acknowledging it and getting the proper help.  I withdraw and isolate myself from people sometimes.  I cry alot.  I get angry alot.  I am sad alot.  I cried four days straight at a pregnancy announcement.  It took everything I had to pull it together.  I felt like a monster being so angry that it's not me too.  Anyone that's been depressed will tell you it's something you can't help.  While I have a good life and am blessed with may great things, it still doesn't fill the void I have.  It makes me feel ungrateful for what I do have.

Self esteem:  My body isn't doing what it's naturally been made to do.  We fail month after month.  I can tell you I feel less of a woman and strangely an adult as a result.  I'm sure my husband will tell  you the same thing about his masculinity. I see others getting pregnant and having families so easily.  Why is it SO difficult for us?

Money:  Assisted reproductive technology is expensive.  The average IVF is about $15,000.  We make a decent living, but we have school loans, car loans, and a mortgage like everyone else.  Recently I tallied our bills since starting this journey.  I stopped adding at $26,000.  For us, that is ALOT of money.  Because we were blessed with some donations we ended up paying about $21,000 of our own money thus far.  That could have been saved for daycare, for our child's college fund, for needed baby gear.  If I'm lucky enough to have our next IVF work I will be struggling to pay our IVF debt and buy baby gear at the same time.  It won't be easy.  I worked hard to have a good education so I could make a decent living and I feel it's been a waste of time.  Most people are lucky enough to not have to deal with this.  A year ago, before the doctors broke the news that IVF was a must, we went on vacation to Utah.  We didn't plan on needing IVF...who does? Earlier that year we had just failed 3 IUIs and we needed a much needed get away.   I am not ashamed we spent our money on that.  Anyone in our shoes probably would have done the same for sanity sake.  Vacations, clothes, and home repairs are a thing of the past.  

IVF #2 officially kicked off today.  It's a bit sooner than we anticipated but I'm at the mercy of mother nature.  I went for baseline ultrasounds and everything is normal and looking good.  In 2 weeks I have to donate 14 vials of blood so they can make a serum to be used for our co culture.  Being a certified needle-phob, I'm not exactly looking forward to it....then again I'm not looking forward to any of this.  Unlike most of you, I can't get pregnant for free or painfree.  It was painful writing out that five digit check...it's even harder the second time around.  It's still incredibly difficult for me to not become angry at those who make having a baby seem so easy.

This round of IVF we are trying co-culture.  Instead of growing our embryos on the medium in the petri dish they normally use, they are going to harvest and grow my endometrial (uterine) cells.  The theory is that this will provide a more natural environment for the embryos to grow on top of....the better the embryo, the more of a chance I have of becoming pregnant.  Long gone are the simple days of having sex to get pregnant.  It's the norm for us now to associate petri dishes and uncomfortable procedures with making a family...talk about a total mood killer.   Instead of one man to make a baby, I have a whole team of them (and a few women).  Science is amazing....it'll even be more amazing if this actually works this time. In about 3 weeks, I will have a biopsy to collect some uterine cells.  Biopsies are never pleasant, especially when you're awake, but it's minor compared to the rest of it.  Somehow they use my collected blood and uterine cells and grow them until time of egg retrieval.  The whole IVF process this time will take several weeks, but at least the hormone injections won't be for another month.

As of now, I'm as ready as I'll ever be.  We didn't exactly hit our financial goal and had to put some of our IVF on charge....nothing like charging a baby on a credit card.  This isn't exactly how I envisioned being in debt.  Hopefully it will work this time as I can't imagine paying monthly installments for something we don't have.  Each bill, I'd be reminded what happened....or didn't happen.  I'd much rather be saving my money for future baby-gear, day care, etc.....but this is my reality right now.  For those of you who had kids the easy way....be thankful.  Chris and I are doing our best at holding up emotionally.  The past 6 months have by far been the hardest few months or our lives...we have good and bad days but are learning to navigate through this.  I anticipate the next few months could even be harder depending on our outcome.  Due to alot of reasons, mostly financial, we doubt there is another IVF in our future.  So much of our lives and happiness is riding on this.  I'd be lying if I didn't say I am a nervous wreck inside!