Monday, January 14, 2008

a mother of an update, no pun intended

What a wild ride we've been on.

The Clomid made me ovulate late again, so I had the tank for nearly a week. Again. It's really annoying to continue to pee on opk sticks and continue to have negative results as the typical ovulation window passes you by. I started to worry that I'd missed my ovulation altogether, although the raging pain in my ovaries suggested it was still to come. The point of the Clomid is to cause you to create multiple follicles and it must be working on me because for the last couple of days before I ovulated, it practically hurt to take a step. I finally got a positive opk a full 4 days later than I expected. The positive test came in the evening, and by the time I woke up the next morning, the enormous pressure I had been feeling in my ovaries had subsided and my temperature had gone up a bit, so I figured the egg(s) had released. I called the NP, anxious to get in ASAP, and found that she was out for the day. Her secretary offered me an appointment the next day and (clearly warned by the NP) said that even though I would probably worry it was too late, the NP was certain it would be fine. Grrrr.

I took the appointment and called M right away - too soon, really. I ended up being less than cordial with her in my frustration. The decision before us was whether to throw away $250 and a soon-to-pass-quarantine vial in order to check off one of the two Clomid + IUI cycles our RE is requiring before moving forward. We decided to go for it. We also decided that I would come home at lunch and have a solo business meeting (My decision to take out 2 vials "just in case" paid off!) so that we'd have at least one somewhat viable shot this cycle. More important than completing the RE's checklist is the need not to take this horrible medication in vain - we had to do what we could to salvage any use of this Clomid cycle. So, I did an ICI at home - less effective, but hopefully closer to the right timing. This is SO not our month. The next afternoon, I went in for the IUI. M came along. As always, all lights were green, all signs were awesome, blah, blah, blah. She said she felt we caught the end of the "fertile window." We'll see. This cycle might be just F'ed up enough to work.

I ended up going for 2 acupuncture appointments last week and I also started an herbal treatment that is supposed to help with implantation. I was keeping in touch with my acupuncturist every day because she wanted to be sure to do a session right after my IUI, and on Friday when I hadn't surged yet, we went ahead and scheduled it for Monday because "surely" I'd surge over the weekend and go in then. Well, Monday came with no surge in sight but I was feeling pretty fragile emotionally so I kept the appointment. Then I went again on Wednesday after my IUI. That's about as much relaxation as my reproductive system can hope for!

All of the monitoring and calling providers and planning to rearrange my schedule was ridiculously draining. I have never been so fed up with this process as I was last week. I simply can't believe how hard we're having to work for this. I know it will all be worth it, but wow.

OK, the rest of this is me working through some stuff and documenting it for my own purposes. Feel free to skip it. It's not essential to the plot. ;-)

I wrote a LONG email to a good friend today and I hashed out a bunch of stuff about how I've been feeling and where we are headed. The gist is that I've (well, really we've, but I think I'm the one that's been doing more mental gymnastics over it because I'm the overanalyzer in our relationship!) been trying to work out whether being fed up with ttc is reason enough to proceed with IVF in a couple of months even though we're skipping a couple of steps that could come first, and I've come to rest on believing that it is. When we started this whole thing, I was determined to be patient and not rush to interventions we didn't need, and I still think there is value in that course of action for as long as it is working for you. But, it has ceased to work for us. I have been a basketcase over the past couple of weeks and the only thing I know for sure is that we are so ready to be done with this madness. My coworker, who got pregnant after we'd already been trying about 8 months, is less than two months away from giving birth and at this rate, it looks as though I won't even be pregnant by then. I never imagined this would be our road. Several of my friends are starting their own ttc journeys and while I truly and honestly want them to become pregnant quickly, I'm simultaneously terrified of the possibility that they too will be holding babies in their arms while we're still be treading water here in ttc land.

If we do go straight to IVF after our next Clomid cycle, there are really only two steps (one test and one treatment) that we'd be skipping that I might be a candidate for, and if the only benefit we get from that comes in the form of my mental and emotional well-being, then it is worth it for me. I'm ready to do whatever will give us the best chance because each cycle that we try feels so very long to me at this point. Waiting 3 more cycles just to make sure injectibles couldn't work for me before ending up at IVF anyway just does not feel do-able right now. Yes, I understand that the injectible cycles might work, but the chances of them working when Clomid didn't is so marginal - I just need more of a boost in the odds right now. Money is an important factor in this as well. We're really close to being able to afford an IVF cycle and if we have to pay for injectibles instead (several thousand dollars per month), it'll will deplete our IVF piggy bank entirely. I'm not willing to risk that right now.

Let's say the cost of injectibles is X and the cost of IVF is Y. X + X + X = Y, give or take. If we try 3 X cycles, we have to wait until we've saved up Y to try again. If we do things out of order and start with Y, we can try again as soon as we've saved up X, and the next after we've saved up another X, and so on, so there will be less of a break between tries.

Speaking of money, my parents gave us a significant amount of money to use toward IVF. We'll still have to come up with several thousand on our own, but it helps tremendously. They said that they've been meaning to take advantage of some of the "gifting" tax laws for a while, and the fact that they could start now at a time when we have such a large and specific need just made up their minds for them. I guess it goes without saying that we are very lucky women.

Our final argument for skipping to IVF is that we've finally accepted that breaking for a year or more to move just isn't going to be an option. I thought I could do it, but the last couple of weeks have shown me that I can't. So, we've basically decided that we will continue ttc until the house goes on the market with the understanding that if I do get pregnant, we'll be changing gears significantly and hanging out here for a while longer. This decision means we have more tries on our dance card than we thought. All other factors aside, we'd like to move this fall which would involve putting the house on the market in August or September, so the latest I could get pregnant would be then. Getting pregnant in August or September, however, would not be ideal as it would keep us in this part of the world for at least a year longer than we'd like, possibly more. So, looking at having 7+ more months to try and accepting that it may take some or all of half a dozen different treatments, it makes sense for us - strategically - to do whatever gives us the highest chance of working at the most relatively ideal time (in this case, sooner rather than later), then working backward from there.

Anyway, all of these factors and more are leading us to believe that proceeding with IVF after our next failed Clomid cycle will be the way to go. It wouldn't be the right answer for everyone, but it is for us. I know it may seem impulsive or short-sighted to an outside observer, but this process has changed us in ways I can't explain, and it's what we feel we need at this point. We're 16 months and 13 tries in and I am so, so tired. Maybe it won't work, and we won't be any better off than we are now, but we need to give it a shot. I need to give it a shot. I need to be able to move forward somehow.


Valancy said...

What an update, and what a lot to be going through. My heart goes out to you. I am hoping there is no such thing as a "next failed Clomid cycle" in your life, but if that is the case, I hope the IVF works and you have your baby on the way.

Mrs. Bluemont said...

oh, k i'm so glad to hear from you! i think that you have an excellent game plan and should do exactly what works for you. don't try to think too much in terms of "at this rate." each cycle is a new try. i have all the hope in the world for you. oxox