Intuition

Maybe it was some kind of deep womanly knowledge, or whatever - but somehow I knew. The cycle is canceled - I have a giant cyst wringing my left ovary like a dishrag.

And now? My RE wants me to try again right away, as soon as my ovary goes back to normal. I am desperate for a month off - I have that bloated crappy feeling that makes the idea of doing this again incredibly unappealing. But - and, remember, being told that things will probably "be fine" is basically what has screwed me in this all along - he is saying that I really shouldn't waste any time. That ovarian reserve can plummet one month and then that's it. That at my age I can have possibilities one month that can never be matched again.

But I am so tired. Possibly the fact that I have been up all night has something to do with that, but I am also just tired in general. I'm tired of having my life revolve around infertility. I could actually be a fairly happy person if I could just put all this behind me. And yet, it's just hanging over me in this looming, unending way. Two more paid cycles. Between now and September.

Here's the thing: my husband will be working mainly out of town until the end of August. Our plan had been one cycle now, while he's in prep, and - if needed - one in September after he wraps. The thought was that if this cycle didn't work, at least I could have the summer to get my groove back. And my RE is saying of course it's my decision, etc. etc. - but I asked him what he would recommend and he said frozen sperm and go, go, go.

Really?

Stimulation Depression

When I picked up the stims the pharmacist eyed the order rather dubiously and even said "Wow, that's a lot of follistim..." I tried not to let it shake me, but the truth is this freaks me out.

I remember when I first used injectables. My dose was something like 37.5 units per day. I didn't even do an IUI - it was just a medicated intercourse cycle. Since I actually got pregnant, I somehow ended up thinking that I wasn't even really infertile after all - that I just needed a jump-start because my husband traveled so much that we weren't getting the consecutive attempts that most couples have. When I look back at that cycle, I realize that if it hadn't worked I probably would have moved on to IVF years sooner than I did. Sometimes you think things make sense when they're really just signs of nothing.

I am telling you now, you will be able to knock me over with a feather - even through the internet - if this cycle actually works. I am going through the motions, but somehow my body already knows this is a bust. I can feel it in my bones, in my cells. I am practically pouring follistim into my ovaries, but somehow I can't muster up even a little enthusiasm for hope. I suppose it's better this way - better than the other way around, at least - but it just doesn't seem right. Shouldn't this at least spark that tiny bit of hope that stays hidden in your heart even when you know you shouldn't let yourself dare to allow it at all?

Wonder Woman

I wonder about everything. All the time. I wonder if this is at all worth it. I wonder if I will have to deal with some kind of repercussions for taking all of these hormones. I wonder if I can keep myself from getting too hopeful this time. I wonder if it matters that I forgot to take the dexamethasone yesterday.

I wonder if it's too soon, if my body isn't ready. I wonder if I've really recovered at all from the loss, if I'll secretly be happier if it doesn't work. The one thing I don't have to wonder about is whether I'm only doing this now because my husband will be working out of town soon and I have a deadline with my clinic.

I wonder if I'll know when I'm ready to be done with this. I'm stuck in this weird place between being unable to look at babies because I ache for the ones I didn't have, but also not actually being all that crazy about babies, lately. I mean, I loved my own baby, and I know I would love another one. But babies in general, eh. Maybe it's just the effect of long-term ganerelix, the forced-menopausal chemical stop sign for reproduction. I sometimes look at stained sticky mothers tethered to strollers matted with wet crumbs and I just wonder why I'm doing this at all.

Secondary infertility is a weird set of contradictions. I don't have that original driving need to have a baby, to be a mother. I'm in it for other reasons now, and maybe those reasons aren't as compelling. I would so love for my daughter to have a sibling, someone to connect her to family in her own generation and the next. I would love to have the experience of raising a kid the second time around, when I kind of know what I'm doing and am not just figuring it out as I go the whole time. I would love to have another child with my husband, because he's turned out to be such a great dad. But I wonder if I wouldn't be better off just enjoying what life has given me.

I wonder if any of this will seem to make more sense tomorrow, after the stims start working their chemical magic?

Cycle Day Whatever

I did finally get a period, of course. But now I am in pre-cycle limbo, in a sort of antagonist-suspended animation. Instead of BCPs, I am on a quarter-dose (62.5) of ganerelix. I do have CD6 and CD9 wanding appointments, and a CD-2 lab slip for baseline blood work.

My protocol is only a little bit different this time. In about a week I'll go on the half-dose of ganerelix plus the always lovely dexamethasone. When I start the stims I'll be on three days of follistim 600, then step it down to 375 for (hopefully) fewer days than last time. There is a correlation between stim time and quality, so we're hoping for a faster response this cycle. As far as quantity goes, more is always nice, but quality is the focus now. I am a science experiment, at this point. I keep telling myself that it will be so nice to be done with this, to know one way or the other, to be free from always wondering. If this cycle is a bust, I have one more in September and then it's all over. Done.

It's so odd to be back at the clinic. I don't have the visceral loathing that I came to have for my last clinic, the money-sucking-time-waster that I have to drive by on my way to work. In general, I'm happy with my RE and the staff is efficient and helpful. But it's sad to be back there, to know that whatever happens I won't have that same hopeful feeling again. If it works, great. If not, fine. I know I've written this same kind of sentence over and over again - it's my mantra now. Whatever happens, fine. Fine, fine, fine.

But who am I kidding? I know that hope creeps in, that once things look good at all, at any step along the way, hope flings itself into the picture and then that's that. I keep wondering if it will be different this time, if I won't let myself expect too much, if I can keep the process at a distance. And maybe I can. Maybe. But I doubt it.

Points For Presentation

At the beginning of an IVF cycle, anything is possible. It's like a figure-skating competition - everyone starts with six points and then deductions are taken for flaws in each element. Each segment is judged for it's technical merit. But even though my US was executed perfectly - good symmetry of antral follicles, no cysts or scar tissue - I will automatically have points deducted for advanced maternal age. And, unfortunately, there are no points for artistic merit in this phase - a recent waxing and good fuzzy socks don't count. (Artistry doesn't come into play until the lab portion of the program.)

I tend to be flawless in Lining and Bloodwork, but I have always been uneven in Stimulation and Embryo Quality, so I've added some extra elements to my regime and am hoping that, with a little tweaking of my long program, I can manage to work through my weak spots. I have a really good support team - my acupuncturist and endocrinologist from my last competition as well as a new hematologist and a maternal-fetal medicine specialist who seems to work with all the winners in town. And of course, the RE, who is coaching me to what will hopefully be my best performance yet.

It's early in the program, and as we know, anything can happen. The protocol has been tweaked for optimum results, and we are still aiming for a flawless execution of stimulation. I can say honestly that I'm really doing this for love, not because I desperately want to win. I don't need a gold medal, but it sure would be nice to place in this event and go onto the finals.

I started the ganerelix today - let the games begin!

Girls and Boys

No, this isn't a gender-selection post. At least, not in the ART sense.

I went to a girls' school for one year in the seventh grade. I honestly didn't even think about not having boys around. Sure, I had a crush on a boy in the sixth grade, but I would have been mortified if he'd actually talked to me. But in the eighth grade (we only left for seventh while my father was on a sabbatical year) the same boy picked me as his square-dancing partner, and I was thrilled to the core. When he do-si-doed me I felt like I was floating on the gym floor.

What - you didn't have square-dancing at your school? In P.E.? We had it right after roping tricks. It was a tie-in to Texas history. Then we all went to the LBJ ranch and watched sausage-making demonstrations, which at least made the square-dancing seem not so bad.

In any case, I just don't know what to think about all-girls education. On the one hand, it would be lovely not to worry about anything romantic while at school. But on the other, is lack of exposure to half of the species a good idea? Is familiarity with boys more of a distraction, or a benefit? And for a skinny, quirky smart girl, is the fact that other girls use the attention of boys as currency reason enough to go to a girls' school?

Have any of you gone to a girls' school? Wish you did? Wouldn't even think of it?