Rigging the Lottery

Pregnancy is a miraculous thing.  So many things have to go the right way at the right time to make it possible, and even then you have only a 20-30% chance at best each cycle of getting pregnant.  Even less of having it stick and making it through the entire gestation and being born.  Yet people do it all the time, most without even thinking about how they won the biological lottery.

For those of us struggling with infertility, that lottery has become a numbers game.  We're the crazy caffeinated ladies with the bucket of coins at the slot machines at 4am when most normal people have already taken their winnings and gone to bed, while we are convinced just one more coin will get us the jackpot.  So we don't give up.  One coin after another.

At first it was fun and exciting, knowing the next coin might cause the machine to light up, bells to go off, and the jackpot to come pouring out in a stream of joyful coins.  You'd be so happy, and feel so glad that you won!  It was exciting each time you put a coin in, pulled the lever, waited to see if this would be the lucky turn.  And when you lost, it wasn't a big deal as you might win the next one.

After you've been putting coins in the machine for awhile, you might look up the statistics.  Okay, so at this particular Pregnancy Lottery machine, you've got about a 20% chance each time you pull the lever (or rather, each cycle).  So if you pull it a half dozen times or so, you're bound to win!

Except you don't.  And then you start realizing that 80% of people have already won the lottery after this many coins and you haven't.   And then you start calculating how likely it is that you'll ever win the lottery.  And how likely it is that you'll never win no matter how long you play.

You start to wonder if the machine is broken, so you have the staff come check it out.  You might have a defective machine and the mechanic comes to fix it before you can keep playing.  Or you need a special kind of coin that costs a lot of money to keep playing each turn. Or you might find out that the machine isn't the newest model with all the upgrades, and might just take a few extra turns to get your jackpot.

So once the machine is in more or less working condition, you start getting superstitious and strategic.  Maybe you start putting coins in all the machines, hoping one of them is a winner.  Or you commit to one machine, believing it eventually will have to pay out.  Or you start using only newer coins because maybe the machine can tell the difference.  Or you close your eyes and say a mantra every time before you pull the lever.  Perhaps if you pull the lever a little harder, or at exactly two seconds after you put in the coin, it will work this time.  And did last time not work because you forgot to say the mantra, or is the mantra keeping you from winning?

Eventually those losses start to hurt.  It feels like you have lost personally.  That something is wrong with you, that you're pulling the lever wrong, that maybe you just aren't lucky enough to win the lottery.  You've tried so hard, you've invested so much time and money, you deserve to win.  Damn it, you've earned that win.

Except you haven't.  And you might not ever win.  And that starts to weigh on you, like an anchor hanging around your neck, and it's all you can think about.  So you keep putting coins in, sitting there as dawn breaks, fanatically putting coins into the machine.

And of course, there's your friend who just arrived to the casino, who pulls up to the seat next to you at 6am as you're chugging another Red Bull to keep up the energy to continue.  She's fresh faced from a good night sleep, can't figure out how to put the coin in, doesn't realize you have to pull the lever, and yet still - her first tug on that lever - the bells are going off and the coins are spilling out and she's so happy.  How great for her - her first time!  She must just be naturally good at the Lottery.  Or really lucky.  Or both.  But she doesn't care, because she's convinced it was just "meant to be" for her.

And you just want to slug her right in her pretty exuberant face.

It's not that you aren't happy for her - okay, maybe not much.  But you want to be happy for her, so that counts for something, right?  It's not that you're a hateful selfish person, or at least you didn't used to be.  But after pulling an all nighter, plunking coins into the machines, strategizing about how to win, feeling like you've lost your sanity... why isn't it "meant to be" for you, too?!

So the pretty blonde walks off with her bundle of winnings, patting you on the shoulder and telling you that it will happen eventually, and you're still left sitting there, putting coins in the machine, hoping the next one will be your lucky coin.  Hoping the next pull on the lever will make all this obsession and pain and struggle worth it.

Friends vs. Phonies

I have a friend who went through cancer treatment recently.  She's thankfully in remission now, but she told me that she lost about 2/3 of her friends during the process because they simply weren't there for her when she needed them.

When she first told me that, I thought it sounded harsh - cancer treatment isn't fun, and some people aren't strong enough to be there for someone else through that process.  Taking a step back isn't the worst thing.  What I didn't realize is that when you are going through something truly challenging like cancer treatment, some people start to resent you for your struggles, and those friendships become toxic.

After stepping into the not-so-fun world of infertility, I understand a bit better how she feels.  Also, to take it a step further, I'm so grateful for those friends who have been there for me through everything.  The ones who listen to me as I sob, the ones who hear and understand my fears but can give me hope, the ones who tell me kindly and firmly to step away from Dr. Google, who ask how I'm doing and really want to hear the truth.

I don't need tons of friends - just one friend is enough.  I'm lucky to have several friends, near and far, who have supported me through this.  Everyone deals with grief and fear and emotional struggles differently - for me, I lean on others.  I talk things through.  Things I keep in my own head are much scarier and drag me down much further than things I share with others.  Those who have taken some of the emotional weight off my shoulders have been invaluable to me, and I will forever be grateful.

However, as my friend who battled cancer pointed out, some people are not strong enough to be leaned on.  They like being your friend when you're happy, or when they need you for something, but when you're the one in need of support, you're just not any fun anymore and they don't want to be around.  I have experienced this recently, with two people who I have been close with pushing me away.

It's hard not to feel resentful, to be angry that two women who I have helped through numerous challenges in their lives have chosen to abandon me when I need friends the most.  And it's not simply distancing themselves - these friends have chosen to lash out, talk about me behind my back as if I'm being self-involved, to blow up at me about unrelated things because they can't handle dealing directly with why they are really upset. Anyone who knows me is aware that the one thing I cannot handle is passive aggressive behavior - I have always lived by the motto that if you don't tell me what your problem is, it isn't my job to figure it out.  I always try to be direct, honest, and fair with any issues that I have with someone, and expect the same of those closest to me.

With these two ladies, I answered sobbing phone calls, helped them through numerous issues, including an emotionally abusive relationship, a divorce, job hunts, losing a job, applying to schools, moving, buying a house, long distance relationships, a spouse's deployment, and family issues.  Over the time we've been friends, I've been largely happy - I've been the one supporting them, as I didn't need support.  When I finally need supporting, suddenly I'm an emotional drain and self-involved.

Part of me wants to lash out at them, tell them what I really think (which, I guess, is what this post is about - did I mention that I like to talk out issues rather than bottling them in?)  I am angry, I'm hurt, I'm disappointed by this abandonment and betrayal.  Two people I thought were my friends not only choose not to help me through this, but have chosen to think of my emotional neediness as selfish and draining.

I am choosing, instead of hating these two, to feel bad for them.  To feel sad that they can't know what it is to be a true friend, to be there for someone through the bad times as well as the good.  To feel sad that they won't get me as a friend anymore, because I'm a really good friend to have.  I stick with people through the good AND bad.

And I am choosing to focus on how lucky I am to have the true friends that I do have, the ones who answer my sobbing phone calls and who listen to my fears and help me deal with this challenge, day by day.

So this is what it has come to...

Most people who want to make a baby simply throw away their birth control.  Or for the more devious, poke holes in the condoms.  Seriously, every romance novel I've ever read (and that list ain't short) where the characters have sex just ONCE without a condom inevitably results in pregnancy.  Every.single.time.

So when we stopped using birth control last March because it was making me crazy with mood swings, we figured we had a decent chance of an "oopsie baby" before our September wedding, though we tried to avoid my most fertile time (as dictated by a downloaded period tracking app - which I've since learned is nonsense, but is oddly accurate for my clockwork cycles).  We even had a pregnancy scare in July when I thought my period was late, which turned out that I was simply completely unaware that my cycles could go from 28 days one month to 31 days the next and still be totally normal.

When we decided to actively start trying on our honeymoon, we were sure it would happen right away.  I research everything extensively by nature (a blessing and a curse) so I knew that we had about a 20% chance of getting pregnant each cycle, with 60% of people being pregnant by the end of 6 months.  So when 6 months came and went, I started getting a little nervous, but still... of those who hadn't gotten pregnant yet, about 50% of them would get pregnant in the following 6 months.  Surely we'd be one of those!  We're healthy and young - both under 30 years old, active, we eat healthy, my cycles are clockwork.  He's a Marine, for gosh sakes!  Aren't they incredibly fertile?

Well, those 6 months have come and gone.  We're staring down a week before our first anniversary and no pregnancy.  Several friends have gotten pregnant and given birth, or are just about to, since we started trying.  I've had 12 cycles of actively trying to get pregnant, with no luck.

I started getting nervous around cycle 9.  My husband was convinced it was just bad luck.  He did acquiesce to fertility testing during our 12th cycle, especially as we had had 5 unprotected cycles prior to actually starting to aim for good timing.

My testing all came back normal - they took blood work on Day 3 of my cycle (Day 1 - also called Cycle Day 1, abbreviated as CD 1 - is the first day of a period).  They use that blood work to test several hormones which indicate if my body is responding normally to ovulation.  All normal.  They also do a transvaginal ultrasound at that time - yep, a dildo-cam.  I had 15 antral follicles - a fancy term for the eggs that have started to form.  Every cycle, a bunch of follicles start to form, and then a few become dominant and grow bigger while the rest die off.  Then one (or sometimes two) reach full maturity, and your body lets off a surge of LH (a hormone responsible for triggering ovulation) and your body releases the egg.  That's called ovulation.  They would like to see 8-16 antral follicles, so my number was good.  I don't know exact numbers, but all my blood work was in the normal range.

In addition, they do a test between CD 7-12 (I did it on CD 7) called an HSG.  This is when they insert a catheter into the uterus, fill it with dye, and see via ultrasound if it drips out the ends of the fallopian tubes.  They can see the shape of the uterus, if there's any blockages in the tubes, and often clear the tube of a slight blockage.  Everything appeared normal for me.  I was petrified of this test, as I had heard it was very painful, but it was no worse than a normal pap smear - not something I'd volunteer for, but certainly not worth all the nerves I had leading up to it!

My husband had an easier test compared to the multiple visits, blood tests, dildo-cam, and pumping dye into my uterus - he just had to jerk off into a cup.  They test to see the semen volume per milliliter (count), the movement of the sperm (motility), and the number of sperm that are shaped normally (morphology).  They're also supposed to test to see the pH level and if there are antibodies present that could indicate an infection or an immune response that kills off his own sperm.  His test came back not great - they like to see >20 million for count, and his was 56.4 million.  Not bad, but not rock star quality.  For motility, they like to see 50% forward moving, and his were at 25%.  Not good, but since he's got a normal count, it's not terrible.  Then he's got only 4% normal shaped sperm - under strict guidelines, they like to see 4% at a minimum, so technically he's normal.  And experts debate the importance of morphology in fertility at all.  But it's not good, especially when combined with the sub-par motility.  I don't know the pH or the antibodies, but at this point, there's enough reason to focus on improving what we're working with, especially before we invest more money and time and heartache into fertility treatments.

So this is what it has come to...

While my husband finishes up 6 months of intense military training, we will be putting further medical treatment on hold.  It's too hard to schedule (read: impossible) and now that we know the issue is likely my husband's swimmers, we'd like a chance to improve them naturally.  We weren't exactly surprised by the results - he's working out in extreme heat at least 5 days a week, he's under extreme stress, he isn't eating well, he's been sick, he's drinking frequently, he's exercising excessively.  All things that can result in lower count.  And I likewise have been stressed (4 moves in 12 months isn't exactly easy, as well as getting married, finding a job each place we move, and keeping a positive outlook during the frustrations of trying - and failing - to get pregnant month after month).

So we'll be self-medicating until February.  Did I mention that I research things to death?  Well, I do!  I unleashed my powers on clinical research trials related to vitamins to improve fertility.  I cross-referenced my information with my sister-in-law, who is a pharmacist, to make sure we weren't risking bodily harm from any of these supplements taken together, and my brother's girlfriend, who has extensive experience with homeopathic treatments and works as a medical assistant at an osteopathic center that likes homeopathic remedies. 

Our recipe for the next 6 months:

Me:

• Every day:  
• NatureMade Prenatal Multi +DHA
• Baby aspirin
• CoQ10 (ubiquinol - 200 mg)
• Royal jelly (500 mg)

• Pre-ovulation:  
• Evening Primrose Oil

My Husband:

• Every day:  
• Equate Complete Multivitamin
• Daily Wellness Fertility Blend for Men (2 capsules)
• CoQ10 (ubiquinol - 200 mg)
• Centrum ProNutrients Omega 3 (EPA/DHA Supplement)
• L-Arginine (1000 mg)

So the plan is to do that, try to cut back on alcohol, I'm focusing on exercising a minimum of 4x per week, and if we're not pregnant by February, go back and see the Reproductive Endocrinologist about having my husband's sperm analysis repeated to see if the numbers are better, and testing for hostile cervical mucus.

Fingers crossed this handful of pills every day is all that we need!  I feel like an old lady with her pill box, but I'm excited to see if it works!