Cycle Update

This is my first medicated cycle, and I've spent hours reading others' blogs to see what to expect from this experience, so I figured I'd update and share what's going on with me.

Today is CD 8.  My period ended on CD 6, with some slight brown spotting on CD 7.

My period started on Thursday February 13th at around 3pm, so we counted that was CD1.  I went in on Friday February 14th (Happy Valentines!  At least we don't celebrate that holiday, so it wasn't a big deal) for a baseline ultrasound. It showed 9 antral follicles on one side, 10 on the other.  No cysts.  Lining looked appropriate for CD 2 - I forget specific numbers. All looked good!

I took 2.5 mg of Letrozole (generic for Femara) every morning at 8am for 5 days - from CD3 (Saturday) until CD7 (Wednesday).  On Wednesday evening, I had 33.3 iu of Follistim injected into my left lower belly at 6pm, and another 33.3 iu of Follistim onThursday evening at the same time.

So, to put it more clearly, here was my schedule:

CD3 - 2.5 mg Letrozole (8am)
CD4 - 2.5 mg Letrozole (8am)
CD5 - 2.5 mg Letrozole (8am)
CD6 - 2.5 mg Letrozole (8am)
CD7 - 2.5 mg Letrozole (8am) & 33.3 iu Follistim (6pm)
CD8 - 33.3 iu Follistim (6pm)
CD9 - Ultrasound

My husband was a champ with the injections!  He really liked being a part of the process, so I highly recommend to other women going through this to have their husbands do the shot for them if they're comfortable.  I wasn't at all afraid of the injections, and probably would have preferred to do the shot myself, but after seeing how happy my husband was at being involved, I'm so glad I asked him to do it.

Today is CD9.  I drove up to my doctor's office today.  It's just under 2 hours door-to-door, so it was just about 4 hours in the car for a 10 minute appointment.  But it was worth it - it tells me whether or not we're using the right amount of medication to maximize our chances while minimizing our risks (like multiple pregnancies, ovarian hyperstimulation syndrome, cysts, etc.)

The nurse was so happy and cheerful, and she was nice and gentle with the ultrasound (compared to the nurse last week, it was much appreciated!).  I've got one 12 mm follicle on my right ovary, and one 15 mm follicle on my left ovary.  That means I'm definitely responding, and well!  My lining is 5 mm, which isn't ideal - it should be at least 8 mm before ovulation, but we've got time, and even at ovulation, we have a bit of time before implantation would occur.  I had a blood test to check my LH levels to confirm I'm not ovulating on my own already (not likely, but possible since the 15 mm follicle is considered mature).  They'll call me later today with the results and the plan from here.

Assuming I'm not ovulating on my own already, the nurse said to expect the doctor to tell me to do another night or two of Follistim and then come back in on Sunday for another ultrasound.  Meanwhile, I'll do ovulation tests 2-3 times per day to make sure my body doesn't start ovulating on its own.

Since we're doing timed intercourse this cycle, the nurse will tell me when she calls exactly when we're supposed to have sex over the next few days.

We already were told to have sex Tuesday or Wednesday this week.  Since I still had my period on Tuesday, we decided to wait until Wednesday.  And then on Wednesday, we took a bath together with some epsom salts that I mixed with peppermint extract and lavender extract.  I used a bit too much peppermint extract, and it felt like a Ben-Gay bath - all minty fresh and made our skin tingle!  It was a nice bath, but to risk being TMI, I didn't want that tingly sensation in other parts of my body!  So we skipped sex, with plans to do it on Thursday.

It's really hard to do it in the mornings during the week (and we are usually morning people, if you know what I mean) since my husband leaves so early for work, so on Thursday evening, we planned to do it right away when he got home.  He definitely was feeling the pressure, which is something we've tried hard to avoid in the 18 months that we've been actively trying to get pregnant.  I felt bad that he felt pressured, but there wasn't much I could do that wouldn't feel forced and fake to help him get in the mood.  As he described after, it's like going to play mini-golf as a work outing.  Sure, mini-golf is fun, but the fact that you HAVE to do it makes it infinitely less fun.

I'm not looking forward to telling him several more days/times that we have to have sex in the next week.  It's so specific, it's hard to keep it vague and low-pressure, with no mention of fun or sexy.

I'm pretty excited, to be honest!  Two follicles!  I know it's not quite double our chances from a normal cycle, but it feels like it.  Especially since we'll likely have two large & beefed up eggs, great timing, supplemented lining with progesterone suppositories (Endometrium) that I will start after ovulation - I'm hopeful!

Even if this cycle doesn't work, I'm hopeful for the next couple of months.  Once we add IUI next cycle, we'll have a really good chance each month if this cycle is indicative of future responses.  Also, I normally ovulate on CD 15-18, but today is CD 9 with nearly mature follicles, so I'm likely to trigger on CD 11 with a CD 13 ovulation.  Which means cycles will go a bit quicker (assuming progesterone supplementation doesn't make my normal 14 day luteal phase into something significantly longer) which means I get better chances quicker.  At this rate, I could start my luteal phase almost a whole week sooner, which means finding out sooner, which means starting my next cycle sooner (since, despite the hope I have for this cycle, I'm still very prepared - at least intellectually if not emotionally - for another failed cycle as chance still aren't great for success).

I'm happy! I'm excited!  I'm so relieved I didn't end up over responding.  I'm so excited that I seem to be responding just as we would hope at this dose.  I'm grateful that my insurance has covered so much of our treatment expenses so far.

I'm in a good place emotionally today, so that's good.  I'll take the sunshine in the middle of this rain storm where I can find it.

Edit:  Well, it's been less than a hour since I wrote this post, but I just got the phone call from the fertility clinic. They said if my LH level from my bloodwork this morning was over 15, they would have assumed I was about to ovulate on my own.  Thankfully (though no surprisingly) my LH is 3.8.  So the doctor wants me to do two more doses of Follistim tonight and tomorrow and come back on Sunday for another ultrasound and bloodwork.  In the meantime, I'll do ovulation tests to make sure my body doesn't change its mind and start ovulation before hand.  Since there's no such thing as privacy in this process, I told the nurse that we had sex last night (Thursday, CD8) and she suggested we have sex again tomorrow (Saturday, CD10) and then wait for the results on Sunday to hear from the doctor when we should proceed after that.

Letter to My Future Child

My precious child,

I want you to know how hard I am working so that we can have you in our arms rather than our dreams.  We love you, even before you exist.

Today, your father nervously asked for instructions on how exactly he should jab me with a needle. That needle contained medication that will hopefully help my eggs grow.  We both hope every day that you're in one of those eggs, and that we'll time everything right so that the egg that will someday become you has the best possible chance to become the baby we've hoped for and dreamed of for so long.

Your father was so brave!  He did not want to hurt me, so he asked several times how to do it correctly.  He first practiced with a normal pen the motion of jabbing me in the belly as I pinched the spot where he was aiming, to the lower left of my belly button.  

I had already set the vial of medication into the pen that is used for injections, attached a needle, and removed the cover and handed it to your father.  Then I swiped the area with alcohol and pinched the spot where he'd be aiming.  He didn't hesitate, though he was clearly nervous.  He jabbed the spot and held, like I had told him.  Then he depressed the button so the magic medicine slid into the right spot as he held the needle still.

"Okay, now we count to 5," I told him.

"One... two... three... four... five.........six!" and he pulled it out.  It came out at a bit of an angle, so it scratched my skin slightly. 

He felt so bad that he had scratched me!  I tried to wipe it away with the alcohol wipe, but it bled just a little bit more.  Not a big deal, but I didn't want to stain my clothes, so he ran to get a bandage.

"Did that hurt?" he asked nervously as he kissed my forehead.  "I'm so sorry I scratched you!  I'll do better tomorrow."

He was so proud that he had done it, and I must tell you that it made him happy to feel like he's part of this process.  We're both working so hard so that we can have you.  He loves me so much that he didn't want to hurt me - but he also loves you, even though we haven't met you yet, and that is why he gives me the shots.

We're both so hopeful!  We have hoped and wished for you for 18 long months now, but now we have doctors and medicine to help us get a little bit more likely to meet you sooner rather than later.

"I feel a warm sensation down near my ovaries," I told him as we sat down for dinner after taking the shot an hour earlier.

"Really?" he asked enthusiastically.  "It's doing magic!"

We're hoping for magic. We're hoping for you every day.  You are so very much wanted and wished for and loved.

We've loved you since before you existed.  We just need a little magic to create you!

Love,

Your Mom

Feeling the Pain

"Ouch!"

That's my ovaries talking.  They're sore.  It feels like someone is beating up on the poor little guys.

"I'll take your mind off your ovary pain."

That's my head responding to my ovaries.  This headache is pretty distracting.

Drugs are something that teenagers and Hollywood stars do for fun.  They pay big money and risk big consequences by intentionally buying and consuming (through whatever form - pill, needle, smoke, or in a certain tweenybopper star's adorably juvenile drug habit, styrofoam cup mixed with soda).  Supposedly it's fun?  Otherwise, why do they do it?

I don't like drugs.  I don't like taking anything.  I'd rather suffer through a headache than take pain killers.  After having my wisdom teeth removed, I refused the narcotics in favor of Tylenol.  When I had shingles, I declined Vicodin in favor of Tylenol 3 (acetaminophen with a little codine) to just take the edge off my discomfort.  I went off birth control 6 full months before our wedding because I simply didn't like taking drugs - we chose to take the risk of a pregnancy before it was desired rather than take the medicine (it was a calculated risk - we were emotionally and financially ready if it happened, it just wasn't the best time for us).

I don't like drugs.  I tried to fix our problem with vitamins, which I still preferred not to use.  Neither my husband nor I took vitamins before we found out we were having trouble (well, I have taken a prenatal since when I went off birth control).

This month, I'm taking 2.5 mg of Letrozole (often sold under the brand name Femara, but I'm on the generic) from the 3rd day of my cycle every day at 8am for 5 days.  I took my 4th dose this morning, and tomorrow will be my last Letrozole pill this month.  Tomorrow night, I will take out my fancy Follistim pen and pull out one of the beautiful and expensive Follistim vials.  I will dial that pen to 33.3 ml, pinch the fat in my belly below my belly button and wipe it with an alcohol wipe (because clearly what every woman wants is to grab a big old hunk of her belly fat) and jab a needle in it, press the button down so that all the liquid gold (at $1 per ml, that stuff is VERY expensive!) gets into my subcutaneous area.  I'll likely put a warm compress against the spot for a bit, as I've heard it can help the spot keep from stinging too badly, and help the medication spread out and be absorbed (cold is apparently NOT suggested as it can prevent the medication from being absorbed properly).

So here I am, pumped full of drugs. Every day that I've taken the pill, my head has started to ache a few hours after I swallow the drug.  Each day it has gotten a little bit worse, and today is pretty bad.  It's still not awful, but it definitely hurts.  Supposedly the injects don't have side effects, besides injection site soreness, so I'm sort of looking forward to those.

But I'm also afraid to take the injections, because my other side effect has been soreness in the general area of my ovaries.  They ache, and sometimes they pinch like a bad period cramp but just on one side.  I know something is happening down there, and so I'm hopeful for 2-3 mature follicles when I go in for my monitoring appointment.  But of course, my imagination goes to over responding - I'm afraid of 4+ follicles.  This cycle, that wouldn't be a huge deal as we are doing timed intercourse which lowers our chances.  Future cycles, I'd be worried about anything over 2 follicles because I really don't want twins and am absolutely petrified of anything greater than that.

I don't like drugs.  I don't like what drugs do to my body. But I'm so hopeful the drugs will bring me what we've sought after for so long, and then it will all be worth every penny, every ache, every pain.

Living in an Infertile Body

Every twinge, every cramp, every mood swing, every headache, every bout of diarrhea or constipation.  Every time a smell makes me gag, every time my sinuses are blocked, every time I wake up to pee, every time I can't sleep, every time I feel like going to sleep early or taking a nap.

Every moment, I am wondering what my body is doing.  Whether it's related to my fertility.  Whether it's a symptom of pregnancy, or a symptom of infertility.  Whether it's a sign my body doing things normally, or whether it's a sign something is going wrong.

Every twinge.  Every day.

I live in this body, and this body has failed me.  It has not been able to do an essential bodily function - reproduction. And so every sensation, I am hyper-vigilant of what it could mean.

I will myself to let it go and not pay attention, but the very next twinge, my imagination starts running again.

I remember when it was fun and exciting.  Back when we first started trying, I remember excitedly reciting every potential symptom to my husband.  I remember we walked into a spice store a few days before my period was due, and I gagged and had to leave.  We were both so excited at the idea that it could have been an early symptom.

Now I know that early pregnancy symptoms are usually nothing more than progesterone symptoms.  If you can't turn a pregnancy test positive, then there isn't enough hCG in your system to cause any symptoms.  You can have progesterone symptoms whether you're pregnant or not, but it doesn't stop a woman from hoping.

It's amazing how much I've learned about how my body works.  It's like a mini-biology crash course.  I know more now about how my cycle works, what my body's likely doing on any given day of the cycle, what is necessary to occur for fertilization and implantation to happen.  I've used that information to pay close attention to every detail to try to figure out what's going on, to see if there's some lesson that will indicate the problem or a solution.

Is that cramp endometriosis?  My uterus tipping towards the bladder can be seen on the ultrasounds - is that a sign of endometriosis?  Would my experience with HPV several years ago affect my cervix?  Scarring or pH level preventing sperm from getting through my cervix? Or is my cervical mucus the right consistency, or is it somehow hostile to my husband's sperm?

I've spent over a year now more aware of which cycle day I'm on than what day of the week it is.  It doesn't help that I haven't been working much because we've moved 4 times in the 18 months we've been trying thus far.  I am so in tuned with which day of my cycle it is, it's hard to turn off.

Sometimes I wonder what's going to happen when (I can't bear to say "if" but that's often how I think of it) I get pregnant.  How will my life change?  Will I still over-analyze every twinge in my body?  I'm sure I likely will, as it will then be motherly protective instinct over the baby I will have inside me.  Will I think of my life in terms of weeks of gestation, rather than cycles and cycle days?  Probably.

And once I have a baby, will I count life in terms of weeks and months of the child's growth?  Until I try to conceive a second child (assuming we're lucky enough to have a singleton pregnancy with our first conception... otherwise, we might be done after one pregnancy) I have feeling that my life will revolve around that long-sought after child's growth.

When I have two children, do I simultaneously count time passing with both their ages (assuming they aren't twins)?

I'm starting to wonder if I've gotten lost in this process.  Where am I inside this body of an infertile?  When do I get to have control of my life again?

I'm trying to refocus on other goals that have nothing to do with reproduction.  I'm trying to focus on writing a book I've been wanting to write for a very long time.  I had taken a job to try to help bring in some extra money, but that job did not work out (and I am not remotely disappointed as I was pretty dismal at the idea of going every day).  So now that the job is gone, I need to focus on my own health and well being.  That involves exercising and writing.  However, it seems easier to write about infertility than the novel that I've been tooling with for about a year now.  But I need to focus on tangible dreams and goals that don't involve living inside my own head, living inside my body.

Raw and Ready

I'm feeling like someone scraped my soul with sandpaper.  I'm just sore and worn out emotionally.  Every time someone asks, "How are you?" I wonder if they can handle the truth, and how much of it I should be honest about and what I should hold back for fear of oversharing.  People don't want to know the truth.  Even those who care don't want to know that I'm feeling empty and hollow and raw and tired and hopeless, because their next question is how to help, and they just can't make it better right now.

I had my baseline appointment today for my first medicated cycle.  My period came with a vengence last night, as expected, and though we had hoped to drive up to our clinic together on Saturday for this appointment, they told me that they only do monitoring appointments on weekdays typically.  Which is news to me, but whatever.  My new job had told me that I didn't have to work today, so I could drive up by myself, which I did.

I wasn't nervous, and I wasn't expecting it to be emotional.  I had the transvaginal ultrasound (as we infertiles occasionally affectionately call it, the dildo cam) first.  A nurse practitioner came in and introduced herself and said she was learning the equipment.  Man, she thought that thing was a stick shift!  DO NOT PUT ME IN THIRD GEAR, PLEASE!  It freaking HURT!  I involuntarily said "Ouch!" three or four times and stiffled it another few.  I don't mean to exaggerate, but it honestly felt violating.  It was worse than my HSG, which I was very scared of at the time (unnecessarily, it turned out).

I thankfully have 10 antral follicles on one side and 9 on the other, which was deemed to be "excellent" and then I was sent to pee in a cup to confirm what I already knew (especially - TMI warning - since the "pee" was red instead of yellow) that I was not actually pregnant (but go ahead and rub salt in that wound).

Then I spoke with the nurse, who is not my typical contact as my nurse is out of the office this week.  She explained how to use the medications I'm about to have to take, when to take them, and went over my calendar.  We practiced the injectible medications to make sure I get it right.  She was very nice, and very helpful.  She asked about my experience with the pharmacy, which I confirmed was less than quality customer service, and she apologized and explained that others had complained and they were switching pharmacies going forward.  So I'm glad I wasn't just being a difficult customer!

I explained that I was worried about twins, and asked about how many mature follicles is too many.  She confirmed that it's a real possibility, that they have lots of twins from their procedures, but not so many triplets and not any more than that.  But really, I don't care how many triplets they have or don't have - I don't want twins.  I started getting choked up at the idea of having a 20-30% chance of twins, if I can even get pregnant at all.

As I checked out, the receptionist tried to charge me the full amount before I suggested that my insurance is supposed to cover 80% of timed intercourse cycles, which she then confirmed and I only had to pay around $25, so I'm VERY appreciative of my insurance right now!

I cried in my car for awhile.  Ugly sobs.  And I went on Facebook to try to distract myself so I could collect my thoughts enough to be okay driving home, and sure enough, there's a friend's pregnancy announcement on top of my news feed.  I lost it.  I ended up calling my Mom to try to talk me off my hysterical fit, and she did, but not before a good long hysterical temper tantrum fit.

Really, I don't get why simply because I'm infertile, I should embrace without reservations the idea of a) twins, b) sperm donors, c) ovaries the size of grapefruits, d) IUIs, e) IVF, f) adopting.

As if it's just like buying one brand of milk instead of another.  If I want milk, and everyone's getting milk, and I can't get milk - I can only get almond milk or goats milk, or I can try to find and milk a cow for my own milk, why can't I be pissed about it?

Why am I expected to go, "Oh well, if I can't have milk like everyone else, I've got no problems with drinking almond milk!"

Almond milk is perfectly nice, but why can't I say, "You know what, damnit, I want milk!  Everyone else gets it whenever they want it.  I don't really want almond milk or goats milk right now, I want cow's milk!  If I can't have cow's milk, I'll learn to accept almond milk or goats milk and it will be just fine in the long run, but right now I want cow's milk, damnit.  And I don't want to risk getting kicked by the damned cow to get that milk.  I want it to come in a carton at the grocery store like everyone else, and it is NOT FAIR that I can't do that!"

I just want a baby.  ONE baby at time!  A biological baby that shares genes with both my husband and me, preferably.  I don't feel like I'm being selfish for feeling the urge to want to see if our child has my husband's or my features, grows tall like my husband or stays short like me.  Everyone else takes it for granted, but why am I made to feel like I'm being unreasonable for really wanting that?

So... there's that.  I'm raw about that.  I'm hopeful, and scared, and resigned, and sad, and angry.  It's a whole bundle of emotions to carry around every day, and it weighs me down sometimes.  I'm so exhausted from it all, I just don't have the strength to feel anything right now.  I poured it all out of my face in tears this morning in the parking lot of my doctor's office.

I took a picture of my tear stained face as "The Face of Infertility" but it was too depressing so I deleted it.  That level of misery does not need to be documented - it needs to be survived and put behind me.

And to add to it, I started a new job on Monday.  I didn't love the job, I had a pretty nasty co-worker.  I was going to give it another week to see if it got any better.  Today my new boss called me and told me nasty co-worker had filled her in on why I wasn't "a good fit" and that she thought it best we go our separate ways.  Which is fine, I was going to quit anyway. But as my husband so aptly summarized, it's like a bad date - you don't want to keep dating, but you get pretty pissed if they're the one to break up with you first.  What's wrong with you?  They're the one with issues!  Of course you were cold and disinterested - they were so terrible!  They don't get to break up with you first!  It's their fault!  But really, in the end, it doesn't matter.  It's over, and it didn't work.

I'm feeling pretty raw about that, too.  Not disappointed, as I disliked the job and was upset that I would have to struggle to fit in monitoring appointments, and not be able to meet with my new psychologist who I really need.  I just feel embarrassed that I got let go.  What's wrong with me?!  Why didn't they like me?  I could overanalyze it all, and feel like a pretty terrible person, but I am going to try my darndest not to add this to my overwhelming heap of stress.  I'm going to try to just move past it.

Prior to me losing my job, we had discussed the need to take a vacation in April/May.  It might mean a treatment break, which is just fine, but we really, really need some relaxation.  My favorite trips are adventure trips - 3 cities in 10 days, long flights to far flung places, budget hotels and overnight trains.  I love it!  But it's not relaxing - it's hard work.  Exciting and fun and thrilling, but not relaxing.  And really... I need to relax.

I'm sick of everyone else telling me to relax, especially as they make it seem like relaxing will solve my infertility.  But really, I'd be the first one to admit I'm high strung at the moment.  I'm struggling with depression and anxiety.  It's amazing how two words summarize a vast canyon of pain and suffering - depression and anxiety.  There's so much I'm wearing around my neck at the moment, pulling me down, but it's all wrapped up in those two simple words.

So I'm just... raw.  Too tired to be sad, scared, angry, embarrassed, frustrated, frightened, overwhelmed, mad, envious, irritated, tired.

I'm too tired to be tired.  Let's just do this already.  Whatever may come, or not come, let's just freaking get this party started already.  I'm ready.  Well, no, I'm not.  But I'm raw, and that's nearly as good as ready.

That would have been TOO easy!

As I'm staring at a negative pregnancy test 12 days since my IUI, I'm ready to call it.  Not surprisingly, it didn't work.

We had a 10-15% chance.  Why did that make me feel so hopeful?  I believed we'd beat the odds.  I gambled wrong.  Bye bye, $650 we spent on that IUI.  We bet and lost this round.

So... we're upping the stakes.  Medications.  This is such a double edged sword, because it gives us more hope at success, but the idea of twins petrifies me.  I don't like the increased risk of multiples that comes from taking fertility medications.  At all.

But at this point, it feels like our only option besides "wait and see" and seriously, after 18 months, waiting is killing me.  I feel like my entire life is wrapped around the idea of waiting for the possibility of being pregnant one day.  Maybe.  Hopefully.  Without medical help, unlikely.

I'm in the process of ordering our meds.  I'm not a fan of my customer representative I've been assigned at our pharmacy - she does NOT return phone calls, and often has to be hunted down via page after I've already left two voicemails over the course of three days.  I've given up on being patient - I call her directly and leave a message.  If I don't hear back within 1 hour, I call and have her paged.  I'm a customer, damnit, and they'll be making a lot of money off of me (hopefully more from my insurance company than out of my pocket, but either way).

I already have my progesterone (Prometrium) and my trigger (Ovidrel) and my Femara (generic brand Letrozole, 5 pills, 2.5 mg).  I'm waiting on my Follistim, which we are in the process of going back and forth between my doctor's office and the pharmacy and my insurance company to get the override approvals for the dosage prescribed.  Because it's such an expensive drug (think thousands of $$$) the insurance automatically caps it at 1 vial.  We needed the pharmacy to call the insurance company to request override, which they did (only after I called the insurance company, who told me that, so I called the pharmacy and asked them to, of course.  Twice.)  They overrode the prescription from 1 vial to 3, but the doctor prescribed 4, so I have to call the doctor to ask them to call the pharmacy to override that last quantity limitation.  I'm not sure if they will or not, or if we can ask the pharmacy to give me smaller vials so it fits in the quantity now allotted by insurance.  I'll fight that battle this afternoon.

Either way, my period will likely be coming tomorrow or Thursday.  I got my positive OPK on a Wednesday and went in for the IUI on Thursday, but I felt ovulation cramping late Wednesday night around midnight, so I wouldn't be surprised if my period comes tomorrow evening, even though I usually have a 14 day luteal phase and I'm counting the day of IUI as ovulation day even though it happened a few hours before, likely.  I didn't get an ultrasound with my IUI (it was out of pocket) so I'm not sure, and never will be.

I'll be going in for my baseline appointment on Day 3.  Which I'm grateful looks like it will be Saturday, since I just started a new job and don't relish the idea of asking for time off already.  And it means my husband will probably be able to go with me, and I always enjoy having him with me rather than make the trip alone.  Maybe we can check out an awesome barbecue joint nearby after the appointment?  That would be fun!

Because, you know, the doctor's appointment won't be fun.  We'll get instructions on how and when to take the medications, how to inject the shots (which, of course, I already looked up videos online so I'm prepared - I am not afraid of the needles, I'm afraid of the twins).  This cycle will be timed intercourse, so I still only have about a 10% chance of success, same as last cycle, but now with the meds, we add in the fun bonus (NOT) of 20-25% chance of twins and (gulp) 2-3% chance of triplets.

It's not that they're not cute and adorable, because they are.  And it's not that I don't think we can do it, because I know we could.  The twins would lack for nothing that a single baby would have - love, affection, good food, clothing, attention.  But it's selfish - I don't want the risks of carrying twins, the elevated risk of losing one or both in utero. Infertility has handed me enough of a burden to carry, I don't want to add miscarriage and loss to that list.  I also don't want the risks of premature labor, the challenges that face premie babies, the developmental delays.  I don't want the physical risks for me - the higher risk of gestational diabetes, pre-eclampsia, cervical failure.  I don't want to have to go through a c-section, which the vast majority of twin pregnancies are.  I don't want to have an induction because there's simply no room for twins to continue to grow.  I don't want an induction, period.

Assuming the pregnancy and delivery go okay and we end up with both babies healthy at home (which is lucky, with twins, and often involves a NICU visit first), it doesn't get easier.  I also don't want to have two crying babies and have to choose which one to comfort first.  And at what point do you put down a still sobbing baby to pick up his or her sibling, who has been crying the whole time you've been carrying the first?  I babysat for my friend's twins, and this was the most eye-opening part of it.  When you're playing with two babies on the floor and the doorbell rings, what do you do?  You can't carry them both with you.  So you have to choose - pick one up and put him in the crib and take the other one with you?  If there's no crib, you have to take the time to put the baby in a secure spot, like fastening the buckles on the rocker.

How do you put them to bed at night?  My friends would put their twins on the floor and lay between them, and then pick one up and put them in the crib as they fell asleep.  My dreams of walking around and soothing a crying baby would be difficult, as there would be another crying baby on the floor.  Or in their crib.  And how do you get two babies to go to sleep when one cry wakes up the other and causes a chain reaction?  Getting twins to sleep on the same schedule is very difficult (i.e. impossible) for the first few months, so sleep for the parents is impossible.  At least with one baby, you can catnap when they sleep during the day (which I'm quite good at!).  With twins, there's no downtime their whole infancy.  Breastfeeding is exponentially more difficult as you have twice the soreness and twice the milk demand and twice as time consuming.  How do you make sure you're making enough milk for two babies? It's survival time for parents, you don't really get to enjoy it (if there's any parent of twins out there reading this who disagrees, I'd love to hear it! This is just what I've seen/heard).

And if one parent has to go away for a few days for work (as my husband often does) -  that's pure panic.  Sure, every new parent is apprehensive about the first time they have no back-up.  But seriously, one person with two infant twins is pure panic-mode.  What if there's a house fire and you can't physically pick both wiggly babies up at the same time and you drop one?  What if you have to put them in the car?  You can't carry the babies with you to put them in the car seats at the same time - you have to bring one out while leaving the other inside.  My friends would bring the car seats inside, put both babies in car seats, and then bring both car seats outside at the same time and snap one in at a time.  Have you ever tried to carry two car seats?  It's HEAVY!

Selfishly, I feel like I would be sacrificing all my dreams of being a new Mom by having twins.  I wouldn't get the sweet moments of napping on the couch with a baby, or "baby wearing" and going about my day.  Every moment would be survival mode, full of poopy diapers, constant breastfeeding (as I'd still try to do that with twins as I believe in its biological advantage), baby-wrangling, crying.  So much for cloth diapers - that would be next to impossible to keep up with everything else.

I don't want twins.  I don't want twins.  I don't want twins.  That is not how I picture being a mother.

I REALLY don't want triplets.  We won't even go there.

And I feel like I'm jinxing myself.  At this crossroads, I either risk twins or I risk never being a mother.  It's a horribly unfair decision that I have to make, and I'm very angry at the universe that this is a choice I'm forced to seriously consider.

This month I will be choosing to take the meds.  And crossing all fingers and toes that I do NOT end up pregnant with twins.

I'm scared.  I'm really scared.  My dreams of getting pregnant without medical intervention have already been ruined.  I don't want my dreams of enjoying motherhood to be destroyed, too.  I'm feeling selfish and angry, and damnit, I just want ONE baby at a time, please!  And yes, I know I could "just adopt" (as horribly inaccurate as "just" is as an adjective) but I strangely want a biological child - I want to see my husband's eyes and my nose in a child we created.  Why is it that infertile people are made to feel selfish for wanting a biological child and not easily rolling into adoption as a quick "solution"?   And I don't want to endure months upon months of needles and pills and suppositories that turn my ovaries into grapefruits and my body into a science experiment. I don't want to put my feet in stirrups several times a month - I thought the annual pap smear was bad enough.  And I really, really, really don't want twins.

Why is this so difficult?!

I will have my first baseline appointment probably on Saturday.  And then a few days later I'll start Femara pills, once a day.  And then Follistim for a few days.  And then back for more monitoring appointments, until we're ready to trigger.  And then trigger, and then doctor-ordered sex.  And then we wait, again, two long painful weeks of hope and anxiety and denial and anger and fear.  Two weeks where every cringe or cramp makes my mind whirl.  And then likely, we do it all over again.  Or, if we do get that long awaited positive pregnancy test, my excitement is combined with waiting anxiously for our first ultrasound to see if we're expecting twins.  I'm not sure how I'll feel if that day comes, where we see two embryonic sacs.  I'm sure I'll be thrilled to see my children finally after so long, but the fear and sadness that they both came at once will be something I will have to face.  If that day comes.

The Industry of Infertility

For those of us who have been in this game for over a year, we've all spent some money on this process.  From ovulation tests to pregnancy tests to vitamins to doctors' appointments, eventually it starts to feel like you're bleeding money.

And everyone has an answer - and usually it costs money.  Acupuncture, massages, Chinese herbal medicine, yoga, meditation, SoftCups/DivaCup, baby aspirin, Vitamin D, CoQ10 (or its more expensive derivative - Ubiquinol), L-Arginine, L-Carnitine, acetyl-L-Carnitine, Omega 3, DHEA, folic acid, zinc, selenium, combo vitamins like Fertility Blend for Men (or for Women), green tea, red raspberry tea, Vitex, maca root, horny goat weed (yes, that's what it's called), and so many more!

I've tried (and thus paid for) probably 80% of the above.  Let's see... out of the 25 things I listed, I count 3 I haven't tried (the last 3).  So for anyone looking for a miracle cure, none of those are it!

That's not to say none of them have helped.  My husband's sperm count went through the roof, and his motility jumped from 25% to over 80%!  Yoga and meditation have helped me feel less anxious.  Also add in therapy, which I didn't list as no one has ever told me it's a miracle cure (well, except my first therapist, who told me that she had a client who dealt with some childhood trauma that she had suppressed and then voila! Pregnant.  Add it to my list of reasons I wanted to punch that therapist in the face).

However, the more I look into infertility and my constant search for a solution, the more I find opportunists who are looking to make money off poor men & women who can't seem to get pregnant as soon as they would like.  I'm not talking about doctors - at least not most.  I think doctors - or at least hope - believe in their Hippocratic oath, to do no harm.  They're there to help us.  That's not to say IUIs and IVF and consultations and medications don't come cheap - they certainly can be the most expensive part of the process for someone battling infertility!  But I'm hoping they're not in it primarily for the money.

And I'm not saying acupuncturists and massage therapists or really, that any one person is in it for the money.  I'm sure there are plenty of people whose intentions are to help those of us who are dealing with this monster.  But man, there just seems to be tons of way to throw away a TON of money on this process!

So far, we've had 17 failed cycles.  I estimate I've peed on 3 pregnancy sticks on average per cycle (don't judge me!), 4 ovulation tests, bought $30 of vitamins on average per cycle, and several hundred dollars on myriad other potential solutions.  Altogether, I hate to estimate how much, but it's likely over $2000 already, even buying internet cheapies for the pregnancy and ovulation tests.

This month, we spent $650 on the IUI.  It's the first BIG CHUNK I have seen go out the door in one payment. In addition, I spent probably $30 more on a yoga/meditation DVD and other meditation tapes.  This month stings financially.  A failed pregnancy test in a week (because you REALLY think I'm going to make it much further than 9 DPO before I test?) will make it sting a lot more.

I can't help but wonder how much money some people make off poor people like me who just want a baby.  I can only hope that they have good intentions rather than seeing us as a cash cow.