Tuesday, April 29, 2014

Minding the Nickles and Dimes

My hubby always is annoyed when I am worried about money for these attempts.  Yesterday he was looking through the medical explanations of benefits (for a reason unrelated to fertility treatments) and saw my blood test for genetic diseases, specifically that his insurance covered a very small portion of the $1,200 cost.  You can imagine the screaming in my head when I heard about a $1,200 bill that I didn't know was coming.  I don't panic that much, in the scheme of things $1,200 is small change, but I still don't like to drop a grand without knowing about it.  (Also what has my life come to that this is small change?!)  I called the clinic and gratefully discovered that that my bill, regardless of insurance coverage, will be $99.  I don't know how this works, it probably involves tax write-offs on the part of the company, but all I know is I don't owe (much) money!!

Today I met with the doctor and found out all kinds of good news.  Amazingly my genetics test came back clean, as in I am not a carrier for anything tested.  I'm surprisingly pissed at this, shouldn't there be something fucking wrong with me?  I mean, honestly.

My AMH, which is what tells them how my ovarian reserve is, was 1.1, which was exciting because the doctor told me it was 'higher than my FSH would have predicted'.  Then he quickly killed my excitement by telling me it showed moderate to severe ovarian failure.  I guess it's better than undetectable and a severe failure?  Which is what he originally predicted.  Sure, it's 'better'.

However, after looking at my tiny ovaries (yeah, did you know they get smaller the less eggs you have, thanks nature) he saw that I only have 4 antral follicles this month.  If I had 7-10 then I could do a heavy all-out IVF and hold out hold for 4-5 solid mature eggs.  Since it's such a small amount of antral follicles I will actual proceed with a mini-IVF for a hope of 2-3 mature eggs.  This only saves me money on drugs, but the procedures all cost the same (great!).  My clinic does have a pre-purchase plan for two cycles and when I asked if I should do it he was firmly negative.  Door closed.  Also I can't pursue the donated egg option until my IVF is completed.

So, I am awaiting the calendar of events from the nurse, along with my drug order.  I asked to be tested for MTH factor (it's a problem absorbing folic acid) and for anti-thyroid antibodies since my thyroid came back high for someone trying (TSH of 2.6).  He wasn't concerned about either of these things, but he okayed the tests, and that's all you can really ask for in a doctor.  He would not do the endometrial biopsy on me because apparently it's a consensus that it shows/proves nothing.  It's fine, I suppose I don't want an incredibly painful (from what I've heard) test run for no reason.  Also, he is sure I'll won't have a problem if I end up pregnant, that my problem is all eggs and not uterine.  I have to say, I do like his confidence.  There is something reassuring about being told solid nos and yeses.  It's a highly under-rated skill.

I ended my day by going to one of my step-children's orchestra performances.  It's so fun to go hang around families with multiple children, not at all like salt being rubbed in a open wound.  Then I got to drive home and think about how my husband's ex-wife "provided his mother with grandchildren", a quote almost directly from my sister-in-law during the planning for his mother's funeral.  That's should go on someone's all-time worst somewhere.  I do recognize that I am a super-bitch and emotional rollercoaster right now and if I can recognize it, it's got to be bad.  Weee - birth control!!

Monday, April 28, 2014

Tendancies Towards Hippie-hood

Ok, to be completely honest I've always been more of a hippie than a non-hippie.  Partly because I grew up in the country, partly because my mom got rid of our TV when I was 8, and partly because my mom doesn't believe in western medicine for the most part.  Can you see the theme?  It's clearly my mother's fault, someone get me on Oprah!  What, she's off the air?  Unacceptable! I didn't suffer what is clearly years of child abuse to not get on Oprah!

I digress, raised with a slightly skeptical attitude towards western medicine and a mother who probably wouldn't take chemotherapy if it would cure her from cancer (and she's not sure it will, and technically chemo has a 30% cure rate of Hepatitis C which she's had for 32 years and is treating with a naturopath) and the fact that I live in the Pacific Northwest where we are all non-aggressive (or is that passive aggressive), vegan, vegetarian, gluten free, lactose free, non-GMO hippies, has lead me to embrace non-traditional treatments.  Also, it doesn't hurt that I would do anything to have a baby.

It wasn't much of a stretch for me to jump into all of the following:

Acupuncture: one of the first things I did after my first failed IVF attempt.  I couldn't fathom not throwing everything I could at the problem.  I'd had a few earlier brushes with acupuncture but just hadn't forced myself to go in, plus I was a tiny bit scared of the needles.  My acupuncturist is great, amazing, wonderful and I have convinced at least two other people to see her. 

Vitamins/Herbs: acupuncturists will prescribe mixes of Chinese herbs (not delicious), which if they are specialists in the fertility are totally safe* to take before you start stimming, plus your medical professionals may give you ideas about additional vitamins to take.  I take Maca Root, Vitamin D3, Omega-3, CoQ10, a prenatal, and a baby aspirin.  I do not take DHEA, but I've heard it can be very good.  I try and avoid blog articles about what I should be taking and relay solely on the advice of medical professionals.  Everyone seems to have an opinion about what will/should get you knocked up.

Counseling, with a fair amount of positive thinking, fertile thoughts and a large dose of daily hypnotherapy.  I never thought I'd be into that, but it turns out I totally am.  Of course negative thoughts are always going to pop up, it's important to acknowledge them and finish with 'but I'm open to the possibilities', or other mantras as appropriate.

Marrow soup: a broth you make from organic beef marrow bones.  Organic is actually important because you don't want to expose yourself to high doses of antibiotics or any heavy metal contamination.  It is as amazing as you think it would be, hopefully you can gag down a cup a day.  I get use to it fairly quickly and begin drinking it about one week into my mock cycle.

Mayan massage: this type of massage centers around ensure that your uterus is in a proper position for pregnancy. It can increase blood flow to your ovaries and uterus, which we know is ideal when you are stimming or trying to conceive.  You are supposed to go before you are stimming and then continue nightly with a quick self massage.  It's fairly easy, although I've never been particularly skilled at remembering to do another nightly thing.

*My advice/opinion should not be mistaken for that of a doctor, I am just a person writing a blog and you should speak to your own fertility endocrinologist because they may have a totally different opinion.

Friday, April 25, 2014

Rambling Thoughts, Upcoming Adventures

I am not qualified to discuss miscarriages, because I've never been pregnant.  Not a whisper, not a hint, not a day late... well maybe a day but it wasn't due to pregnancy.  This is going to sound horrible, because I know miscarriages are terrible events and are awful and sad, but sometimes I wish that I had had one.  Just a little one, to know it was possible, to trust my body knew what to do or to have gotten it 'over with'.  Often the success stories I hear include multiple miscarriages (and I'm including chemical pregnancies in that), so I worry that because it's never happened... what if I finally get pregnant and it doesn't keep?

It's hard to have faith during this process.  Even the good things come with a niggling sense of doubt.  A sense of doubt that grows with each failure and mocks even your smallest achievements.  I've made great eggs before, I'm only 34, but I don't have a measurable ovarian reserve and I don't have an unending well of money to throw at my problem.  At some point I have to stop, I have to decide if what I want (a family) is worth giving up something that others get to take for granted (being biologically related). 

I've seriously considered where it ends, I've developed my exit plan, rubbing the sandpaper of failure on my heart so that the edges of the pain are blunted, polished.  I'm not sure it will hurt any less when I get there, if I get there, but it's at least been partially worked through.  I can focus on other things now, hopeful things, blue and pink things.  I can hopefully harness the power of positive thoughts.

Speaking of positive thoughts, next week at counseling we are doing soul retrieval.  She said I could google it, but that it's pretty new-agey which is something that makes me nervous, but I'm kind of excited about it.  It's supposed to repair your soul from trauma, the idea being that if you have suffered trauma that part of your soul has split off and needs to be retrieved.  Last week my acupuncturist even needled me a "release", which I had never had done in 2 years of going, it was amazing.  I can barely describe it, but I definitely feel more hopeful and lighter.  All good things during my mock cycle (a mock cycle is the birth control cycle before you begin the injections for IVF).

Wednesday, April 23, 2014

Resolve to know more...

It is RESOLVE's Infertility Awareness Week.  I hate that word - infertility.  It sounds so final, like barren or childless or 'why did you choose not to have children?' (a question I was asked when I was 31 and trying).  My New Year's resolution of 2014 was to strike infertility from how I describe myself, for the most part it has worked.  I use 'fertility challenges or challenged', because hopefully someday I won't be struggling, even if having children looks different from how I think it will look now.  I will always have the baby I was meant to have.  Though I should admit this mostly positive outlook comes after a year and a half of therapy.

This is RESOLVE's awareness week and even though I am posting here I do wonder who they expect to spread the awareness.  I am very open and have a 'close' group of friend with whom almost everything is shared, but even I am not going to go around my office and chat about infertility awareness.  I even have a hard time impressing "infertility awareness" on friends, most of whom have easily conceived even in their early 30s judging on the amount of babies in my facebook feed.  Only 1% of women have premature ovarian failure in their 30s, even less in their 20s, and while I don't know precisely when it developed I do know that I am in a tiny group.  There is only a tiny group of us that would start trying to have a baby at 30 and not ultimately be successful. 

I do wish celebrity culture would be more honest about it.  Today in a People there was a birth announcement for (one of) the Helmsworth wife (age, 37) who had twin babies.  This, of course, could have been natural, but there are so many twins in Hollywood, almost like there is assisted reproductive technology being used (haha).  I don't begrudge them the use - I welcome it!  But I do wish there was more honesty about how difficult it can be to have children in your 30s or early 40s.  There isn't a lot of time to fix problems if you start that late, which doesn't seem 'late' to you until you have an issue.  Your fertility naturally begins to decline at 27.

I only ever did one facebook posting to my friends about trying to have babies later in life.  I said something about not waiting to try until you were 40 and not to expect it to be easy if you do wait.  The most insensitive comment I got back (granted, from "friends" who don't know what I am going through) was 'I'd just adopt'.  Like it's simple, easy and without pain and enormous expense, when honestly it is a similar cost and more successful (more likely to end up with baby) to do donated eggs.  Huh, maybe I'll do a facebook posting again, so I can relieve my aggression by yelling at my "insensitive" friends.  That's sounds like a solid plan and a good way to trim my friend's list...!

And just in case you are interested:
  • http://www.resolve.org/infertility101  (Basic understanding of the disease of infertility.)
  • http://www.resolve.org/national-infertility-awareness-week/about.html (About NIAW)
  • Friday, April 18, 2014

    OMG The Weight

    Oh, the weight!  I've always been a skinny girl, my friends called me a skinny bitch, but the hormones have raged within me for too long... or at least that's what I blame.

    When I first went into a clinic I was an avid Bikram yoga practioner, and oh I loved it!  I had severe panic disorder in my mid-twenties and randomly a coworker invited me one night.  I went and loved it, while the coworker never went with me again.  Bikram melted all the anxiety out of me, it was impossible to have a panic attack after you'd been to a class.  Then, slowly but surely, it changed the way I thought and how I internally treated myself.  But as soon as I went in to a Fertility clinic I found out that such high temperatures are (apparently) bad for your eggs.  You shouldn't take hot baths/hot tubs or do hot yoga when you are 'trying'.  So I stopped...

    And slowly put on weight.  For the first six months I didn't actually put on weight, I just slowly expanded as my muscle turned to (I assume) fat. I moved up a couple sizes in pants, my ass being the first thing to expand.  It's been two years of various treatments now and my last IVF attempt I didn't gain a pound, I was watching closely.  I didn't lose any either, but considering the massive dose, I was super happy I didn't gain.  Then I went off of it and OMG gained another 4 pounds. 

    My normal dieting procedure would be to (essentially) eat a lot less while working out.  Apparently hunger and dieting shuts down your fertility even more, so I've resisted even in my 'off' months.  I don't need any help shutting down what remains of any natural fertility. 

    So I eat as healthy as I can (my eating habits are a whole other post) and try to not get hungry.  Every time I get hungry I get a little paranoid that I am 'turning off' what little I have.  I am getting my thyroid checked yet again this year and am hoping it is ok.  Last year it was fine, the thyroid stimulating hormone needs to be between 1 and 2 for conception. 

    And yes, I still occasionally go to a 'regular' yoga class, but it's only been recently.  I also starting doing an hour a day on a walking treadmill!  Hopefully it will be enough to keep me from going into the 'overweight' category on the BMI table... I'm almost there, I made the mistake of looking yesterday.  I need to process some non-attachment and if I didn't have a giant mirror in my bathroom it would be a lot easier!

    Monday, April 14, 2014

    By Way of Introduction

    33 was not a good age for me, after all it was the age my father was when my uncle put a bullet in his left ventricle.  I wasn’t expecting much from 33 other than the anxiety of knowing you’d outlived a parent, but since I had been trying to have a baby for three years I did rather expect to already have had children. I actually turned 33 in 2012, if I had died the same exact age, to the day, as my father I should’ve died on December 21, 2012.  This struck me as ironic, since it was the Mayan doomsday and, clearly, since the world doesn’t actually revolve around me I knew it wasn’t going to end.

    In March I attempted my first IVF, not because I was told it was my best option, I was actually told to do an injectable IUI cycle.  However, the cost of drugs being what it is my husband and I skipped to IVF.  I was surprised when my body only produced 3-4 follies, having expected at least 10.  We changed the cycle to an IUI, but it failed and I went in to review with my doctor.  He said I had diminished ovarian reserve and it was “like trying to get a 44 year old pregnant”.  Doom leered in my face, the specter of not having children raised its head more clearly than ever before.  Why did I have to be here at 33?

    In a second IVF attempt later that year I managed to produce 10 follies which ended in 7 mature eggs.  I was so excited on retrieval day; I had never expected it to be so good.  I would have been happy with the 4 from the first attempt.  My excitement was dashed when my doctor was only able to retrieve one side (I know, he clearly wasn’t a good doctor), 3 eggs were all fertilized, two developed, they did assisted hatching (further research may tell you it’s not a great idea) and transferred them back into me.  Certainly these would work!  It didn’t.

    In a third IVF attempt they pumped me full of the maximum drugs; my body had 4 follies which devolved quickly into 1.  Oof, again we switched to IUI, but mostly to feel the money spent on the obscene amount of drugs wasn’t wasted than to attempt an actual pregnancy.  My doctor patted my leg and said we couldn’t really expect much with my poor ovarian reserve.  I was now 34 and crushed.  I went to my acupuncturist who had patiently and quietly allowed me to choose my own path, who strongly and firmly told me to get a second opinion. 

    Which brings me to today: today I started birth control for one more attempt at my own IVF (as opposed to a donated egg IVF, which is plan B).  I have a new doctor, of which my acupuncturist (the only medical professional I now trust) has a firm faith, even if she doesn’t like other doctors at the same clinic.  I still have the same diagnosis: premature ovarian failure.