all around you.

When you're infertile and want nothing more than to experience pregnancy and hold your baby in your arms, it seems as though everyone around you has the opportunity -- except for you.

I think any of us who have experienced infertility can relate to these experiences.  You're at the mall and every woman you pass seems to have a round tummy, is pushing a stroller, or is toting three kids through the crowds.  And you can't help but be jealous.  You can't help but envy what all of these women have because it's what you want and what, for some reason, you can't have.

Everyone around you announces their pregnancies.  And you have to react joyfully for them -- for each of them -- every time.  You say your  - Congratulations!  The - I'm so happy for you!  You ask the expected questions -- When are you due?  How are you feeling?  You compliment.  --You look beautiful!  You're truly glowing.

But inside you hurt.  Month after month you're faced with disappointment.  And month after month, they keep finding success despite your failure.  And each time, you're expected to be happy.  To be a good friend.

If you're like me, you want to be.  You want to feel joy for everyone who achieves what you cannot.  It is the most amazing thing one can experience in life, after all.  You want to be genuinely happy for these women who you consider to be your friends.  But it's harder than some might think.  After enough time passes, it's truly difficult to feel joy for others who achieve your biggest dream so easily.  While you're left further and further behind.  It's difficult to put on the expected show of happiness and excitement.  Because all you want is to feel that way for yourself.  Finally.  After so much waiting and heartache.  All you want is what all of these women are experiencing, and there seems to be no valid reason you can't.

Sometimes I'm afraid these building feelings of jealousy and envy and bitterness are harmful to me, too.  I fear that karma may get me (or is getting me) for my inability to always experience the kind of joy a good friend should.  I fear that the negativity finds a home inside me and burrows deep, and that's not the person I want to be.

I have yet to skip out on a baby shower due to my emotions.  I have yet to retreat from my friends because I'm not in the same place they are.  I have yet to hibernate and surround myself with my sorrow.  So I'm proud of these continued efforts.  But I just want to be normal again.  I want to be a kind, concerned, generous friend who feels true joy and excitement for the women who mean so much to her.  I want to join the club with them.  I want to feel included and back on the inside instead of the outside.  I want to experience everything that they are -- two years ago.  I want to be completely me again.

I hope my emptiness can be filled soon.  I hope my dark space can be brightened.  I hope my ability to truly be a good friend returns.  Because I don't like this.

waiting. and waiting.

I haven't written here in more than a month.  And I can't believe it.

I'm not even really sure why.  Part of me is just trying to get through these weeks leading up to IVF.  Part of me wants to avoid thinking about it and therefore avoid writing about it.  Part of me wants to pretend everything is normal.

But it's not.  My mind is constantly swirling with worry and hope and anticipation and anxious thoughts.  I often wish that at my most recent appointment my doctor, instead of telling me my IVF was being pushed back more than a month, would have said -- We're doing this tomorrow!  Get ready!

What could I do then?  I'd have no choice but to be excited and unprepared and just go for it.  There wouldn't have been these weeks of conflicting feelings and a cloudy head and all the ups and downs that come with waiting.  The waiting that I know all too well and despise so very much.  And today, I would know what the outcome was.

I want nothing more than for January 20th to be here -- the day of my planned embryo transfer.  I want to have completed the process and know that I've done all that I could.  I also don't want January 20th to arrive, because that will mean a new kind of waiting begins.  And when that wait is over, I will have an answer.  If it's the answer I want more than anything in this life, then I can only imagine my joy and excitement and relief and hope.  If it's not, I don't want to even think about the darkness I might feel.  I want to enter all of this as positively as possible, and I really do feel so hopeful and excited, but I am not blind to the other possible outcome.  And it's hard to completely dismiss and keep from clouding my perspective.

As I sit at the library with every intention of studying for my graduate statistics final (I do miss the days of no finals...), I instead turned to my blog.  Because my mind isn't full of formulas or probability or hypothesis testing.  It's full of hopes for our future and the child we so desperately long for.  It's full of questions and anticipation regarding my upcoming procedures.  It's full of fantasies of a plump belly and swollen ankles and movement within.

It is my hope that once this semester is over and I'm able to completely dedicate my energy and focus to the holidays and my family and friends, that my mind will be occupied by the joy and energy of the season.  And when all of it has passed and it's time to go home and return to a quieter life, we will begin IVF.

I can't wait.

delays.

I had my appointment about a week and a half ago now.  It was the big appointment I'd been waiting and waiting for -- where they'd do my mapping and give me the run-down on my schedule.  I had anticipated and anticipated it, and then suddenly it was here (after much frustration that you can read about in recent posts),

When I got to my doctor's office, I was welcomed with the same warmth that I always was.  I was instantly relieved to be there and so eager to learn everything that was to come during my appointment.  My wait was short, and when it was my turn to be seen, they took a full IVF work-up of blood work that will test for all kinds of STDs and other viruses ... They took quite a bit of blood, but I'm so used to it by now that I actually felt excited to be sitting in that chair with the nurse and a needle in my arm.  Progress!

I spent a few more minutes in the waiting room until the infertility nurse and RE could see me for my ultrasound, but it wasn't long at all.  They took me back and had me change and prepare for the ultrasound.  They performed a transvaginal ultrasound to take a look at my system and measure the depth of my uterus and of my cervix, as well as to note the shape and curve of my uterus (something I had never considered before).  They were pleased that there wasn't an extreme curve to my uterus, so I was pleased, as well -- not really knowing why that was such a great thing until I asked.  Apparently the less curve you have to your uterus, the easier it is for them to transfer the embryos via catheter on the big day.  Yay for not a lot of curvature!

They counted the number of follicles I had going on each ovary and seemed really shocked to see as many as they did.  Remember, I had 27 cysts when I was diagnosed with PCOS -- no dominant follicle(s).  So when they revealed their surprise, I was totally freaked.  The doctor even mentioned that he couldn't believe I had as many as I did after being on Lupron, the pill, and Metformin.  In my mind, I was thinking everything I had been through wasn't working.  I was afraid I couldn't move forward.  I was afraid we would have to try something else, or they were going to tell me this was the end of the road.

They continued on with the actual mock embryo transfer which involved them actually threading the catheter through my cervix and extending it all the way to the fundus of my uterus (back of the uterus).  The catheter literally poked me in the back of my uterus.  (This was just for measurement purposes and they will definitely not poke me on the actual day of transfer.)  My nurse kept her hand on my belly during the whole procedure letting me know it was normal to feel crampy or to feel painful twinges.  She said some girls have a harder time with it than others.  I did completely fine the entire time.  I didn't experience any cramping or pain, and the only discomfort I felt was when I was poked in the uterus.  Such a strange experience!  It kind of made me feel queasy just because it was so bizarre.

All of this was over in a matter of a couple of minutes.  It wasn't a big deal, they got the info they needed, and they assured me things looked good.  This is when I asked about all those follicles...  The nurse looked at me and said, "Oh, no, that's a good thing!"  Ah!  All my worry from before melted away.  Apparently I had 20 follicles, and she said that's exactly what they would want to see in someone my age.  I guess they just weren't expecting to considering everything my body had been to.  The follicle count changes every cycle, though. So here's to hoping that it remains good news and is beneficial to my outcome.

The doctor was willing to answer any questions I had about the upcoming procedure, but between my previous conversations with him, with people who have been through it, and all of my own independent research, I felt like I understood what would happen.  They assured me I'd see him again, so I didn't need to feel pressured to ask all of the questions I would ever come up with.  I let him move on to the next patient so that the infertility nurse could go over everything with me.

She explained that we would go over the schedule and an overview of all of the prep info, and she would send me home with all of my consent forms and legal documents to go over with my husband.  The first item she handed me was a schedule of the entire process -- every appointment was scheduled and written for me from Oct. 30th to Feb. 2nd.  This made me feel so relieved after all of the stress I was put through with the most recent scheduling hiccup.

However, we received some bad news.

As I looked at the schedule, the entire procedure was set for mid-January.  She began explaining as soon as she put the sheet in my hands.  If you recall, we were planning to do our first IVF cycle in early to mid-December.  In fact, we had to do it then if we didn't want to wait until spring.  Apparently all fertility institutes that provide IVF services are required to shut down for a certain amount of time (more than a month) to inventory, clean, and follow whatever other regulations are imposed on them.  Most institutes close at some point in the summer, but mine always closed beginning at the holidays and then through January.  Hence, the December dates.

Apparently one week before my appointment, my nurse got a call from the institute saying they've had to completely rearrange their schedule to close in December and then open back up shortly after the New Year.  This meant that three women like me who are undergoing IVF with my doctor had to be rescheduled.  I didn't have a choice in the matter, and my doctor didn't have a choice in the matter.

My initial reaction was disappointment.  I have been anticipating this for months and months.  In my mind, I have established a schedule for the end of my semester and the holidays all based around IVF.  The more I thought about it, though, the more it seemed like it might be even better for us to wait until January.  And so, I am now completely at peace with it.

You see, I began my first semester as a full-time doctoral student in August.  I was accepted and agreed to attend on a Fellowship back in April, around the time of my surgery when I thought we wouldn't be able to try again for about a year.  I was scheduled to recover from surgery, be on Lupron for at least 6 months, bring my hormones back up with a few months of birth control, etc.  Instead, though, we found out that my husband is also infertile, that I responded really well to my Lupron, and that we should pursue IVF while time is on our side -- we're 27.  Knowing that I was entering into a big time of change and challenge, we decided to move forward.  What other option is there?  I know I can handle it, and I want this baby more than I want a PhD.

Our original IVF schedule was going to interfere with my finals, and I was going to be on all my meds starting right before Thanksgiving (a stressful time to be studying for finals and writing papers).  My husband and I had purchased plane tickets this summer so that we could be in San Francisco for my aunt's wedding over Thanksgiving weekend, so I had just come to the conclusion that I'd have to cancel.  We were going to have to stay home, away from our families for Thanksgiving since I wouldn't be able to travel on the meds.  I was going to have to take a pregnancy test on Christmas day.  I am in a dear friend's wedding on December 28th.  I absolutely dreaded the thought of the significance Christmas day would hold.  It would be magical if I received the best news of my life on Christmas day 2013, but I feel like it would add insult to injury to get a negative.  And if I did get bad news, I couldn't imagine being functional or a good friend in the wedding.

SO.  IVF in January means that my husband and I will not only be busy and occupied by the holidays and time with family leading up to the procedure, but we will also be coming off a long break from grad school for Christmas.  I hope that this means I am relaxed, at peace, and ready by the time January rolls around.  It will mean I can ask for massage gift certificates for Christmas, I can see my aunt marry the man she loves, my husband and I can have one last glorious California vacation, we can spend the holidays with our families, I can be a supportive bridesmaid to my friend, and I can look forward to the start of a New Year -- 2014 (I like even numbers way better, anyway).  Sounds like a good plan, right?

I'm feeling optimistic today, and I like it.  This could really happen.  In January.

I hope and wish and pray.

sex drive.

This post might be a little personal, but it's another glorious aspect of this infertility struggle.

Infertility and the treatments that go along with it rob you of so many of the joys of life.  Sanity?  Gone.  Emotional stability?  Non-existent.  Sense of humor?  Only sometimes there.  Confidence?  Shot.  Happiness and joy for others?  You have to try really, really hard.  Energy levels?  Particularly low.  Sex drive?  Apparently not so great either.

Throughout my Lupron injections and pseudo-menopause experience, after surgery and various medications, even through hot flashes and headaches -- I never really lost my sex drive.  I kept waiting for it, because I was told it might be a problem.  But it never went away, and I was thankful because that was one thing that went easy on my marriage.

But now I'm off the Lupron, my hormones are elevated again, I get my period, I've exited menopause... and I have no sex drive.  I'm on birth control pills to regulate my hormones and my cycle, and all I can tell myself to explain it is that my body has finally been put through hell -- why would I want to have sex?  My hormones went from not existing to being way up there in a matter of a month.  My body has been poked and prodded.  I take medications meant for people with different problems and diseases, and so I feel sluggish and exhausted.  Very low-energy.

I've gained a little weight in hopes that it will help with IVF, and even though it's not much, it doesn't quite feel like me.  I'm not as motivated.  I'm tired.

My husband continues to be supportive and understands that my body has been through a lot.  But something like this is bound to affect a relationship.  Just like everything else -- every other aspect of this crazy experience -- it's something we have to get through together.

If nothing else, these dry spells will help prepare him for the wait time before his IVF specimen is taken.  :)  The silver lining?

my appointment was made.

I called my RE's office literally the moment they opened yesterday morning, as I had planned.  I even ducked out of a meeting to stand in the hall and hit redial until it actually started ringing rather than going to their answering machine.

I spoke with the saint of a receptionist who continually tolerates me and supports me and comforts me.  And she had good news.  The RE and his fertility nurse had finally stayed late last night to play catch up from their absence and go through all of the waiting charts -- including mine.  They went through all of my info and my cycle timing and decided I could be mapped on Oct. 30th at 3:30 p.m.

I have a fucking appointment, thank god.  Finally.

I immediately felt relieved just to have an answer, to know that I can go in there and talk to someone face-to-face and get a read on how all of this will go.  I was truly, truly contemplating ditching the whole plan.  Not because my intense desire to have a baby is waning, but because I was losing confidence in the whole situation.  I was considering finding another doctor, starting over.

But that thought sent me into wild sobs, too.  I couldn't come up with a good plan that would make me feel better.  To find another doctor would mean starting over -- with everything.  I would abandon a whole year worth of work.  It would mean investing even more money in this whole process to retest what we've already tested.  It would mean a delay, and time is something I want to keep on my side.

If I can go back to my RE and achieve that feeling of We're going to get this figured out, then I will feel better again.  If I can leave there feeling cared about, then my questioning and doubt might go away.

Until then, though, I know I'll be nervous for this appointment.  I just want to be positive and feel good about every step I take moving forward.  I want to feel like everyone is in my corner, like everyone is rooting for my positive results.  I want to feel like I'm not just a patient to my doctor but someone he cares about and wants to succeed beyond how it reflects on his practice.  I want to feel like I did all the other times I had appointments there.  I want to forget that I was completely neglected for a month.

Really, more than anything, at the end I want this to work.  That's all I want.  That's all I want.

pain of going home.

I'm not even sure that I should write a post about this because I don't know that it's fair.  (And it will once again reveal how crazy I am.)

My husband and I went home to my in-laws' for a long weekend a few days ago.  I was really looking forward to it because we hadn't seen them in a few months, and I was eager to have a few days away from the daily routines that dominate my life lately.  I have really wonderful in-laws whom I love very much and actually enjoy spending time with.

But when it comes to my in-laws, our infertility is kind of a strange topic.  My husband is much more private about our issues than I am, so my family knows all about it, and he has kept his largely in the dark.  It wasn't until late this summer that they even knew about his fertility issues, and they didn't find out about mine until the night before I was going in for surgery back in April -- you know, just in case something happened.  I don't completely agree with this approach because I don't want our infertility to feel like a secret, like something we need to hide and be ashamed of.  I don't know that that's how my husband really feels (he says it's not) -- he is a private person, after all -- but I can't help but wonder.

At this point in time, partially thanks to my inability to keep all of this under wraps, his parents pretty much know exactly what's going on.  They know that we've been told IVF is our only option.  They know we will consider adoption if our IVF attempt doesn't work.  They know we both have issues that aren't easily solved.  They know about my emotional struggles with all of it, and they know about my husband's very rational approach to everything.

As time has gone on, it has become a topic that is more and more comfortable for my in-laws, I think.  At first, they never ever brought it up -- which kind of made me frustrated and angry at times.  Or if I brought it up, the only response I ever got was something positive -- a la "It will all work out!  Keep your chin up!"  This kind of response made me want to scream.  Now, though, I am able to talk more freely about it, they ask questions, they seem more engaged and interested, and they also seem to have a bit more compassion.  And I am so thankful that they've come around a bit.

As far as we know, my husband's siblings, a young sister and a younger brother, are mostly in the dark.  Or maybe that's me being naive.  I suppose it would be reasonable (and would definitely happen in my family) to assume that my husband's parents have filled his siblings in.  If they do know, though, they don't let on.  For some reason it doesn't bother me one bit to think that his siblings don't know anything about our struggles.  For some reason I'd almost rather it remain that way.

Confession:  I'm a fairly competitive person.  To be competitive when it comes to fertility seems ridiculous, but I think what I feel is this dread of all of those around me, those I love, realizing this dream of having children before I do.  Even though I started on the path first, even though I've put in the time, energy, emotional wackiness, money, physically draining procedures and medications and exams, etc. -- I'm afraid that everyone around me will get to the finish line first.  And I have already experienced this awful phenomenon several times with close friends.  But it would be so much more difficult if my sister-in-law were to have a baby first, or if my brother-in-law were to.  It would mean that they could give make my in-laws' dreams of being grandparents come true.  It would mean that all kinds of excitement and pride and love would revolve around them.  It would mean that I would have to watch from the shadowy corners in pain, knowing that I can't have what they can.

Granted -- none of this is happening.  Hopefully none of this happens any time soon.  Neither of them are even married (both are in serious relationships).  But every time I go home to my in-laws', I can't help but think about it.

And so this brings us to something I'm embarrassed to admit.  My sister-in-law has fairly recently entered into a serious relationship with a guy she met at work.  Recently we all found out that he has a daughter who doesn't live with him.  My SIL had never met her until this weekend -- when we all did.  This whole situation is a source of anxiety and jealousy for my sister-in-law.  She's looking at this guy as a potential life partner and considering the fact that he's already had a child ... with someone else.  I know that is difficult, and I'm not sure how I would react, especially when she's so young and wants to do all of that with her husband for the first time.  I found myself, though, feeling jealous.  Jealous that if she marries him, she will immediately have a child in her life.  She will get to be in some kind of a mother role without even trying.  This little girl will help my in-laws to feel like (and I suppose eventually be) grandparents to her.

I am sure being a step-parent when you're not prepared to be doesn't sound ideal, and I feel for her.  If I weren't in my situation, I would completely understand.  But here I am wanting a child more than anything, and it is kind of difficult for me to think about.

I'm kind of jealous.  And I feel ridiculous for it.

i'm freaking out.

A few posts ago I wrote about my futile attempts to get my RE's office to return my calls so that I could schedule my mapping (or mock embryo transfer) that was supposed to happen last week.

I called for the first time back on September 30th and have called 2-3 times a week since then.  Never have I received a return phone call to ease my mind or schedule the appointment.

Nothing.

I've spoken to the receptionist every single time I've called.  And I know it's not her fault.  She's the one who takes the messages and leaves them for my nurse.  She's the one who talks me through my frustrations on a weekly basis.  She's the one who apologizes profusely for my worry and stress and the fact that I'm not receiving the care that I should.  But it's not her fault that I haven't been called.

I was absolutely sure that I'd get a call today.  My RE and his fertility nurse were out of state at a conference all last week (when I probably should have been mapped) and then I found out that their two other nurses are no longer there -- so they're short-staffed.  I understand all of that.  I get that things are busy.  But I thought they'd finally get to my messages today.

At 4:36, I still hadn't heard anything, so I called.  I was fairly sure their answering service would pick up by then, but I thought I might as well try.  No answer.

The thing is that my mapping was supposed to be done last week -- during the third week of my third pack of birth control pills.  The timing is important.  And now my fear is that my IVF cycle will be pushed back.  Or maybe even worse that they'll go ahead half-assed just trying to get me "done."

The way all of this is being handled is really concerning me, and I have to say that I am not feeling more and more confident in what's to come as time goes by.  All of this has me wondering if I'm making the right choices -- about my doctor, about IVF, about everything.

I want a baby more than anything, and at this moment, I'm feeling like my desire and need are being taken advantage of.  I want a baby so badly that I will pay what I cannot afford, and I will put myself through hell -- for a shot at one.  And what do they stand to lose?  A dip in their success rates?

Tonight I lost it.  I talked to my husband for about an hour after I called this afternoon to no answer.  We discussed our options.  I shared my feelings about it all.  I got teary.  He suggested we drive the hour and a half to the RE's office and wait in the waiting room until someone will see us, that is if we don't get a call in the next day.  I resolved to call again first thing in the morning and be very, very clear about my frustrations and my doubts.  But I know it's not the receptionist's fault.  And I know she already knows what I'm feeling.

My mom called as my husband and I were wrapping up our conversation.  I answered, and she sensed irritation in my voice.  I had already told her about my frustrations two weeks ago, but she was surprised to hear it hadn't been resolved.  And then I lost control.  I sobbed and sobbed and sobbed to silence on the other end.  All she could say was how sorry she was.  I couldn't stop crying.  It was ugly and pathetic, but all of my nerves and anger and concern and frustration had to go somewhere.  And they did.

I remember the last thing my nurse said to me as I left my most recent appointment back in August was, "Remember just try to remain calm and stay positive!"  How can I be calm when no one is caring for me?  How can I remain positive about all of this if IVF hasn't even started and I'm already more than exhausted?  How can I stay trusting if my RE's office won't even communicate with me?

I need to feel like I'm a priority for this to work, and it's wearing on me.  Should it be this hard?

conflicting information.

I am a researching freak.  I read just about everything ... Books, articles online, message boards, etc.  Especially when it comes to infertility, I want to be as knowledgable as possible.

I'm also susceptible to trying anything and everything to make sure this upcoming IVF cycle works.  Obviously there are no guarantees, but I'm one who will fall into the trap of any recommendation or suggestion that something specific will help my chances.  You say eating a pomegranate a day will have me ovulating in no time?  I'll do it.

Part of this approach is that I'm afraid if IVF doesn't work that I will find a way to blame myself.  If I didn't exercise properly in preparation for IVF and it fails, it will be my fault.  If I drank too many glasses of wine during this waiting period and IVF fails, it will be my fault.  If I didn't do acupuncture in the 12 weeks leading up to IVF and it fails, it will be my fault.

Totally irrational, but I know myself.  And that's exactly what I'll do.

So like I've said before, I'm exercising and eating "right" and getting the acupuncture.  I'm not drinking alcohol.  I don't use tobacco or any other drugs.  I've gained a couple of pounds of cushion because a former doctor told me that fat helps with estrogen production.

Maybe it's all ridiculous, maybe it's all for nothing.  But I don't know either way.

So in my quest for all of the information so that I can make informed decisions about my health and well-being during this wait period, I have stumbled across a TON of info.  Maybe even all of the information ... as I intended to find.

The problem is that so much of it is conflicting.  One study suggests women consume full-fat dairy products.  Another says women should stay away from dairy products.  One article says higher IVF pregnancy rates were found in women who took a gluten-free approach.  Other nutritional suggestions say to eat lots of whole grains.  One site will tell you to exercise daily, another will tell you to take it easy.  What the hell?!

My acupuncturist has made diet suggestions based on my specific issues.  She says that because I suffer from blood stagnation (Chinese medicine's diagnosis of an imbalance that causes endometriosis), I should eat warm foods.  They should all be cooked -- no raw vegetables.  I should drink warm drinks.  I should avoid wheat, dairy, and sugar.  I should eat a lot of leafy greens, high-protein foods, and fruits.  Makes sense...

I will gladly do all of that.  But is it true?  What about the studies that claim the opposite?  What if one way is detrimental, but I don't know which way that is?  What if I take the wrong approach?

By now you've all come to the conclusion that I'm a crazy person.  And I am.  But what do I do?  I'm the biggest worrier on the planet, and I have the best intentions.  This is my one shot, and I don't want to blow it.

Do I eat what I want within reason?  Do I allow myself the ice cream?  Do I keep eating pastas and whole grain breads?  Do I ditch the dairy?

(Don't even get me started on all of the meth-heads and processed-food junkies out there who are popping out babies like crazy.)

Ugh.

worries.

I was on three months of Lupron shots over the summer to shut down my reproductive system and clear out any remaining endometriosis that wasn't caught during my April '13 laparoscopy.  My case of endometriosis was classified as advanced -- Stage III, so my uterus and bladder were affected, and my doctor wanted to be sure that everything was taken care of.

I think I've written before about my laparoscopy and my particular experience with endometriosis.  I never really experienced much pain with it -- or not pain that I acknowledged -- and I was very fortunate in terms of symptoms.  My laparoscopy revealed that I was riddled with endometriosis, and my doctor was especially shocked by how much he removed from my bladder.  Apparently he has rarely, if ever, seen such a thing in a 26-year-old.

Prior to my surgery, I had had pain that I didn't recognize as pain.  I'm not really sure why.  My pain was related to my bladder, and I often felt it after emptying my very full bladder -- kind of a stretched-out discomfort -- and when holding my urine mid-stream (like when you have to pee in a cup at the doctors office).  I really didn't think anything of it and only recognize that it was pain in hindsight.  In fact, during my medical history interview with my RE, I answered that I never experienced pain, and I was being honest.

Once my surgery was complete and I was on the Lupron injections, my bladder pain was completely gone.  And that's when I realized that I had indeed been uncomfortable.  At my August 7th appointment where I was completely checked out by my RE and where I confirmed I was no longer feeling any bladder pain, I was telling the truth.

I'm worried now, though, because I'm experiencing some of that same discomfort again.  And I don't know why, and I don't know how that's possible.

It's not all the time.  In fact, it's not even every time I have a full bladder.  And it's not as uncomfortable as it was.  I can't predict when it's going to hurt and when it's not.  I'm not even sure if I should call it pain.  But it doesn't feel like it did when I was on the Lupron, and I'm afraid it's either going to affect our ability to move forward with IVF or the outcome of IVF.

I will of course bring this up at my mapping appointment next week, but each time I experience that discomfort, I can't help but wonder if somehow my endometriosis is back.  But how could it be?  I've been on Lupron injections and then gone straight into birth control -- both of which remove and then prevent endometriosis.  Maybe it's all in my head?  Maybe I'm just worried in general?

Has anyone else out there had bladder pain related to endometriosis?  I've done my fair share of googling, but really I need to stay away from all that.  I don't need to start wondering if I have cancer (and believe me, I will wonder that!).

liebster. whaaa?!

My new friend Anne over at The Second Bedroom is on her own infertility journey.  We follow one another's blogs, and we are both rooting for each other as we make our way down this windy, bumpy path.

She surprised me a couple (okay, maybe a few?!) weeks ago by nominating me for a Liebster Award.  Honestly, I had no idea what it was, so I checked it out.  A Liebster Award is a blogging award given by other bloggers to those who have fewer than 200 followers but who write promising blogs.  Naturally, I was excited and honored that Anne felt I fit the criteria.

Then I was the worst blogger for about 20 days.  I guess I've been busy and haven't had a lot of soul-bearing to send out into the world.  But here I am with a break in my day -- hopefully enough time to do a semi-Liebster post -- and I'm ready to put it out there.

For this post, I think I will give the 11 facts about me and answer Anne's questions.  I may write a separate post nominating blogs and listing out my questions a bit later.

11 Facts About Me:

1.)  I am more of a pessimist than an optimist.  It might be my least favorite quality in myself, and I wish I could change it more easily -- especially with all of this infertility stuff.  Help!

2.)  I am from California.  I haven't lived there for 18 years, but I still often claim it as home because it is the one place I lived as a child where I felt life was mostly stable and good.  I still feel home when I go back, and there is no other place I'd rather be than standing beside the Pacific Ocean at Avila Beach.

3.)  My dad died of ALS when I was 16 years old.  He had been terminally ill since I was 12 and my little sister was 8.  I have a lot of very difficult memories and a lot of guilt about how my teenage self dealt with grief.  But I'm able to forgive myself when I realize that if my dad could do it over again, he would do some things differently too.  (He was a wonderful man and father.)

4.)  I get some sort of weird enjoyment from denying myself certain things.  If I get new clothes as a gift or even buy them myself, I resist trying them on at the store and/or when I get home.  I bought myself a new MacBook Air when I started my PhD program this fall and didn't take it out of its box for a week, not until my husband made me.  If I haven't managed my time well or have procrastinated accomplishing something, I won't allow myself something I want.  I'm not sure what any of this means.

5.)  I have the best girlfriends in the entire world.  I don't have tons of them, but I have 6 or 7 friends who are my people.  That's the only way I can describe it.  Most of them I've known since middle school or high school or college, and I have trouble finding others who are like them.  We are weird together and have the very best time.  They are made just for me, and I am made for them.  Plain and simple.  It's a strange, wonderful feeling to belong in that way.

6.)  Ever since I was a tiny child, like four years old, I've experienced this intensely irrational empathy for fictional, often illustrated characters that is really hard for me to explain and is mostly hilarious and strange to other people.  For instance, you know Snuggles from the fabric softener commercials?  That adorably sweet little bear?  Well, I always had this irrational fear that something awful would happen to Snuggles because he was so kind and innocent.  Literally, I was four years old and hated those commercials because I wanted to cry for Snuggles.  The same thing with the Peanuts characters.  And now my sister has introduced me to this character Catbug, and I can hardly stand it.  I want to rescue them!  I know this makes no sense to anyone else...  

7.)  Another of my least appealing qualities is that I'm a fairly envious person.  I feel jealous when people have things I want but don't have -- they could be very superficial, materialistic things or more important things -- like babies.  I am envious of ease of process and lack of struggle.  I suppose this is fairly normal, but I think my envy might be a little more intense than others', and I don't like it.  My husband urges me to be happy and satisfied with my own life, which I would love to do (and am in many ways), but I can't help but look at what other people have and wonder why I don't have the same.  Sometimes it makes me into a bitter bitch.  :)  

And let me put it out there that every time I feel that way, I need to be reminded that really, I have an incredible life and am so very lucky.  So many worse things could be a part of my every day, but they're not.  

8.)  If I want something, I will work really, really hard to get it.  I mean, I'll go to great lengths to make it happen.  Whether it has been academically or relationship/friendship-wise or infertility... If there's something I want, or something I want changed, I'm going to try my best to make sure it happens.  Maybe that's what makes me so envious -- that sometimes even though I've worked really, really hard and tried my best, I still am not a recipient.

9.)  I am a performance-oriented, over-achieving kind of gal.  I want to be the best or among the best, and sometimes I put a lot of pressure on myself because of it.  I wish I could be more into the experience or what I might learn, but often my focus goes to the achievement side of things.  I've gotten better as I've gotten older and made my way a little bit through life, but it's still my tendency.  I'm still working on it.

10.)  I love clean, sparkly sinks.  (And a clean house, in general).  It's a clean sink that can really get me, though.  I feel like if my sink sparkles, my entire kitchen does.  If I don't have time to shine anything else up, I go straight for the sink, both kitchen and bath.

11.)  I literally (and I do know the meaning of the word literally and am using it correctly here) have the single best husband in the entire world.  Yes, I get frustrated with him.  Yes, he gets frustrated with me.  Sometimes we don't see eye to eye.  Sometimes we don't completely understand one another.  But no one in this world could live with me each day and know me so well and still love me the way he does.  When I hear other people talk about their marriages and relationships or failed marriages and failed relationships -- when I hear my divorced and married friends talk about their ex-husbands and husbands -- I truly feel a major sense of guilt.  I can't chime in and join those conversations.  I can't complain about the same things they complain about.  I've never been treated badly.  I've never been disrespected.  I've never been taken for granted.  My husband is the kind of guy who makes decisions about his own life based on what's best for his family (me, as of right now).  He's the kind of guy who rubs my feet while we're watching TV -- just because.  He's the kind of guy that will leave notes of beautiful prose he's written for me on my dresser.  He cooks me dinner every night.  He tells me he's proud of me every day.  He never makes me wonder if he thinks I'm beautiful.  He praises my work ethic, my intellect, and my compassion daily.  He makes me feel like I'm really doing okay in life.  And never, ever does he ask for anything.  I know that I don't necessarily deserve him, but I'm never giving him back.  (And fuck you, universe, for keeping fatherhood from him -- because he'd literally be the best at that, too.)

_______

Now, on to Anne's questions.  (She asked 10 questions instead of 11 because she despises odd numbers -- and I can respect that.)

1. What do you turn to for comfort?

Without fail, I turn to my husband, my mother, and my sister (and often my closest girlfriends, too).  Usually all three.  They let me complain and cry and wail and scream and cuss and be furious.  And when I just need someone to listen and let me let go, they are there.  I know I'm reading this question with a little bit of the infertility perspective, but lately that's what comfort means to me.

2. Do you have any habits/mannerisms other people consider odd but you couldn't do without?

I'm trying to think.  I probably have lots of them, but I don't know what they are because people don't tell me when I'm weird.  Okay, I've got one.  When I'm bored/nervous/anxious/etc., I pick at my cuticles and peel off the dead cuticle skin.  I don't peel my skin back or get all bloody or gross or anything; it's really just what happens when you get a manicure.  But it's probably kind of gross to watch.  I can't live without it because it kind of soothes those uncomfortable feelings for me and helps me to pass time.

3. What is your favorite thing to cook? Or, for non-cooks, to order in?

I'm not much of a cook, but my husband is.  He's very inventive and adventurous with his cooking, and he makes so many delicious meals.  One of my favorites that we need to do again (and I did help with this one) is Phad Thai from scratch.  It was so, so good.

4. It's your day off. No commitments yet. Shockingly, ALL your laundry is clean. What do you wear?

I would probably put on something comfortable but not sloppy.  Dark skinny jeans, a loose, flowy tank, a long necklace, and gold sandals.  I also love dresses more than any other article of clothing, so if it's summer, I will often choose a sundress and sandals.

5. You can have one word or phrase stricken from the minds of humanity--they just forget it existed and you NEVER have to hear it again. What is it?

I'm not really someone who despises certain words.  I feel like they're all necessary for some reason, and even if they aren't aesthetically pleasing, they serve a purpose.  I really can't think of one that I'd just like to get rid of.  If the reason for the word disappeared along with the word, then I would choose mosquitoes.  Because those bitches ruin my summer every year.

6. You're a billionaire, hooray! What charity do you make your pet cause?

I would put a lot of money into ALS-TDI (Amyotrophic Lateral Sclerosis Therapy Development Institute) and other organizations that support research for ALS (commonly known as Lou Gehrig's disease).  I used to be a lot more active in raising money than I have been lately, and whether or not I become a billionaire, I'd like to pick that back up.  My dad died of ALS when I was in high school, and I am devastated over and over again each time I learn of a new family who is forced to make the disease an intimate part of its life.  

7. Do you wear socks to bed?

In the winter, yes.  In fact, I freeze all winter long and often times just can't warm up.  I'm a huge fan of wearing all kinds of layers when I go to bed in the winter. In the summer, no socks.

8. I've got a gift card for you! You can't spend it on bills. Only frivolous things. Where do you go?

For an all-around fun place that would allow me to spend the money on a variety of items, I would choose Target.  They always have cute stuff, and I could find clothes, accessories, home goods, outdoor stuff, etc.  If I'm just considering my wardrobe, my go-to is always Gap.  Can't help it.

9. What one thing that you do on a regular basis do you wish you never had to do again?

I would love to never wash my hair again.  If I really sit around and think about it, there are way bigger tasks than washing my hair that I should probably eliminate first.  Okay -- if I could never clean my house again and it would still always be clean, I would choose that.  A clean house feels amazing, but I don't always have the time, energy, or motivation to get it done as frequently as I would like.

10. If you were an expert in one area, and people came from miles away just to ask your thoughts, what area would that be?

At this point probably infertility!  I don't feel like an expert on anything, and I don't even feel like I know a little about a lot of things, so I'm not confident that I can really answer that question.  I do know that I've learned a lot about infertility because I've read so much about it and investigated so much on my own.  I also feel like I am very familiar with the grieving process and dealing with difficulty and loss.  Expert?  No.  Definitely not an expert on anything.

fucking call me back.

I'm going to warn you... I'm a little angry.

And this isn't my usual what-did-I-do-to-deserve-infertility anger.  Which is worse, I think.  But still.  I'm pissed off.

You see, I'm due for my first IVF attempt at the beginning of December.  My last appointment with my RE was on August 7th where they decided I didn't need my remaining three Lupron shots because I had responded so well and there seemed to be no evidence of my advanced endometriosis.  At this appointment, they talked to us about IVF, and my husband and I decided to go for it.  All of our questions were answered, we discussed the financial side, and we put a tentative schedule together with my doctor and nurse.  I left feeling completely overwhelmed and anticipating the next four months as we made our way to the weeks of IVF process.

I was referred to my RE last spring after 14 months of trying (and it was a battle to get that referral -- something else that still pisses me off!).  At the time, I had no idea who he was or why he was so great.  Come to find he's one of the most successful in the nation and was actually on the team who achieved the first IVF pregnancy back in the 80s.  This boosted my confidence in his knowledge, ability, professionalism, etc. and so I've always felt that I'm in good hands.

During my first visit, I came to know the receptionist/office manager and all of the nursing staff, as well as my doctor.  I will say that my doctor is not the most personable.  He has never once offered consolation, and it's clear he doesn't have a whole lot of empathy.  He's smart, he knows what he's doing, and that's why he's successful -- but he's just not a warm person.  He would be even more successful, in my opinion, if he could express some compassion for his patients and could make it a more personal experience...  Not happening as of now, so I'm moving on.  His nursing staff, though, and his office manager -- amazingly wonderful women!  They are kind, they give me hugs, they make me feel good.  They express their understanding of how difficult this must be.  They tell my husband and I that they've been thinking of us and hoping we're doing okay.  They make me feel like a human being, and I am forever grateful for that.  In fact, I've been going through complete withdrawals since I haven't been in for an appointment since August.  I had been in every 2-3 weeks since March, and this absence makes me feel uneasy.  And really, I kind of miss them.

What I'm really pissed about, though, is how my case has been handled in the past 3-4 weeks.  You see, when I left my August 7th appointment, I left with several prescriptions -- Metformin to address my PCOS, Dostinex to address my elevated Prolactin levels, and three packs of birth control to get my hormone levels back up, to keep endometriosis away, and to regulate my cycles.  My instructions were to call and schedule an appointment for mapping when I started my third pack of birth control pills.  So of course I figured up the day of my first pill of the third pack and put a reminder into my phone to call and schedule the appointment (as if I would forget).  Right on schedule, I called.  I talked to the receptionist/office manager, and she took a message.  She wanted to talk to the fertility nurse to make sure she scheduled it correctly.  This was a Monday.  She assured me I would be called back within a couple of days.

One week passed, and I hadn't heard anything.  So I called again.  I reminded her of my issue and that I needed to schedule an appointment for during my third week of pills.  Come to find out, my doctor and the fertility nurse will be out of town that entire week.  So the receptionist was going to talk to the nurse and figure out what they should do.  I never got a call back.

The following week, 8 days later, I called again.  I reminded her once again what was going on and that I hadn't heard anything.  She assured me that the nurse would get back to me within two days.

I was beginning to panic.  Everything with IVF is on a schedule.  When my husband and I decided to go forward, we decided to go forward as soon as possible.  Our fertility clinic is closed during the months of January and February, so if for some reason we didn't or couldn't move forward right away, we were going to have to wait to start this entire process until the spring.  We didn't want to wait.  Not getting answers in regards to my mapping appointment was making me worry about the entire schedule of this process.  If they couldn't map when they planned to, could they even do the IVF procedures when they planned to?  Was this going to push everything back?

Wouldn't you know it, I never heard back from the nurse.  I called again four days later, and this time I assertively expressed my panic and frustration.  I was kind, but I was irritated.  I still didn't get to talk to the nurse.  Once again I was told my call would be returned.

It wasn't.  So I called for a fifth time yesterday.  And on my fifth attempt to talk to someone, the receptionist told me that she had been left with instructions to schedule my appointment early next week and that she would call me to do so once their schedule was finalized.  She assured me that everything would be okay, nothing would be pushed back.

I have to say this gave me a sense of relief.  But I'm still pissed.  Why did I have call so many times?  Why did I have to fight so hard for such a simple answer?  Why am I not a priority?  Why don't they have a fucking nurse's line???

I just want all of this to work out.  I want December to be here, and I want to strip away all of the mystery of this IVF process.  I want it to work.  I want to be happy.  And I don't want my RE's office -- the only place that can possibly help me -- to be a major source of stress and anxiety.  How can I relax and feel positively about this process and this experience when I can't get the answers I need?

I love these people, and they are so good to me when I'm receiving care in their office.  It's hard for me to even reconcile that I have such trouble with them when I'm not there.  We'll see if I'm contacted to get this appointment made for next week.  We'll see if I have to advocate for myself as usual.

Fucking call me back.

getting ahead of myself.

My mom, who through all of our trying to conceive, was just sure I needed to relax, to quit worrying about it, has finally come around to realizing it wasn't my stress level, and I wasn't crazy for being so sure something was wrong.  She gets the truth of it all now -- that we're infertile.

Now she's very sensitive to hearing about other couples' struggles with infertility or journeys toward adoption or IVF, or whatever the case may be.  A couple of weekends ago, she called me with news about a couple she met who had adopted a baby.  She had gotten their contact information for me and assured me that the mother was more than happy to talk to me about the process.

Maybe this should make me more uncomfortable than it does, but I'm all for reaching out to others who have struggled with infertility, who have chosen one path over the other, who have taken the adoption route or the IVF route, or whatever.  I'm all about making connections and learning from other people who have been there.  As I've said many times, this is a very lonely road, so if talking with others who have been there makes it a little bit more bearable, then I'm goin' for it.

So I called this gal.  Remember, though, that I've got IVF scheduled.  It's happening in December.  All of my focus should be on staying positive and getting ready for this life-changing procedure, right?

Why can I not just keep my focus on IVF??

Should I really be calling complete strangers that my mom talked to about adoption?  Should I really even be thinking about that right now?  Am I dooming my chances at IVF by not putting all of my figurative eggs in one basket?  Does this mean I'm not totally committed to IVF?  Does this mean I don't believe it will work?

I don't know the answers to any of these questions, and I am likely to drive myself nuts considering the possibilities if I dwell on them too long.  But it all does make me wonder.  Should I be less realistic and instead, more optimistic?  Probably.  And I'm working on it, but I haven't mastered it yet.

I'm incredibly aware that I essentially have a 50/50 shot at this.  I think maybe my way of coping with this incredibly unsettling probability and my awareness of the fact that this very well may not work, is to keep my mind open to all of the other possibilities...  Maybe my thinking is that if I keep investing myself into other options, if IVF doesn't work, I won't crash so hard knowing that there is a next step.

Really, though, I want to be excited.  I want to truly anticipate our upcoming IVF and hope-hope-hope that it works.  And I want to believe that it can work and that it will work.  How do I convince myself of these things?  How do I live in the moment?

I called that woman.  And she talked with more for over an hour and was so kind and so supportive.  And she, like all other women dealing with infertility, made me feel as though I'm in good company.  She taught me a lot about the process and what to expect if we do go down that road.  And she made me feel hopeful -- that one way or another, I will be a mother.

But right now my path is to see if I can achieve motherhood through IVF.  I want to focus on that and only that.  Does anyone have any tips?  How do I put my blinders on and quit constantly considering the possibility that it won't work?

blogs.

Sometimes I get online to work on something that has a pressing deadline or to check my e-mail or to look something up, and I quickly find myself on infertility blogs.   I seek them out because these blogs are written by people I can actually relate to.  They're infertile too!  They remind me that I'm not the only one, that my break-downs and my moodiness and my jealousy are all really normal for someone in my shoes.  And I need that.  Frequently.

Last night I should have been working on some statistics homework for a graduate class I'm in.  I should have been.  Instead I found myself on one of my favorite infertility blogs which then linked me to about seven new infertility blogs ... and I had to catch myself up on each of their stories.  I found blogs specifically by women who were undergoing IVF or who had been.  I found blogs by women in almost my exact same situation.  And I did feel that I'm not alone, and it was comforting.

But then I got sad.

I'm in this three-month waiting period to begin my first IVF cycle.  I'm taking a myriad of drugs to get my body ready before I start the actual IVF stim drugs.  But mostly it just feels like waiting.  It feels like prolonging the inevitable, and in many ways, I just want it to be here.  Because I'm excited and nervous and terrified.

I read these stories by women who had been there, who had been through the entire IVF process.  Some of them had been through it more than once.  And many of them weren't successful.

I've been working so hard to stay positive about what lies ahead.  I've been trying to stay out of my head and only think happy thoughts about this end result.  I've started acupuncture and meditations to relax.  I go running every morning to kind of physically rid myself of nerves.

But it's all still there.  This might not work.

I read the blog of a woman who was starting her second IVF cycle.  I went back and read through her first IVF journey, and it broke my heart.  She wrote about how hard she was working at staying positive, she wrote about feeling like it was really working after her transfer, and then she came crashing down.  And I could relate to every word in those entries, and I could see myself in her and my situation in hers.  It reminded me there are two sides to what's coming up -- a life-changing happiness and joy and an earth-shattering despair and depression.  Sounds dramatic, maybe, but I don't think it is. And I will only experience one or the other.

I'm sinking everything I've got -- emotionally, physically, spiritually, financially -- into this hopeful attempt.  I just don't want to be let down.

And so, while I know that reading these blogs has helped me tremendously in feeling less alone, and they've really educated me about my options and the different processes people pursue, sometimes they just make me sad.  I decided, in last night's funk, to go to bed early and hope that I would wake up this morning feeling a little more optimistic.

A night's sleep is magical.  But I wake up every morning acutely aware of all of the possibilities.  I suppose no blog will change that fact, so I will keep reading.  It's better to avoid the loneliness.

someone else's baby.

We went to some friends' for dinner tonight.  The husband is in my husband's class in the Optometry program, and the wife is a friend from a former job (and because our husbands are friends).

The wife and I have known each other for about two and a half years now.  When we first met, we were both in the midst of strong baby desires.  We were fighting them off because our husbands were just beginning their four-year programs, but we both admitted we couldn't help but hope we'd have babies in the near future.  We talked fantasies constantly at work (our offices were joined by a doorway) -- baby names, pregnancy, birth plans, doulas, baby showers, announcements, etc.  Everything.

Her older sister had endured struggles with infertility for three years or so and had basically been told there was nothing more they could try if they weren't interested in attempting IVF.  She wasn't.  The wife and I used to talk about our sympathy for her sister and brother-in-law.  How awful it would be to know you couldn't have your own children.  How hard on a marriage.  How difficult to have to abandon your biggest dream.

Funny looking back.

My husband and I began trying during this time, and although I was acutely aware of the possibility of infertility, I told myself I'd be pregnant very soon.  I didn't tell a single soul we were trying.  No one.  I wanted it to be our secret, and I wanted our joy to be private when it worked.

Instead, though, our friends got pregnant.  First try. 

We had only been trying five or six months, so even though I was jealous, I thought our turn was just around the corner.  But it wasn't.  I watched her pregnancy.  I went to her baby shower.  I met her sweet daughter at the hospital the day after delivery.

And tonight I held the six-month-old baby girl.  I've held her dozens of time in the months since she was born.  But tonight I touched the bottoms of her feet.  I squeezed her little thighs.  We nuzzled our heads together.  And I imagined, for just half a second, what it might feel like to experience all of that -- to make those observations -- with my own baby, whether it be biological or adopted.  My baby.

It was one of those moments that stops your heart for just a moment.  I frequently get those glimpses, and when I do, I can't even distinguish whether they make me happy or sad.

Probably both.

do what you gotta do.

As we enter this less-than-three-months wait period before we begin IVF, my husband and I are really committing to being as healthy as possible.  It takes about three months for an egg to mature and for sperm to develop, so it's important that in the three months leading up to an in vitro treatment the couple do what they can to make healthy, nutritious choices.

There's really no explanation for why one IVF cycle works and another doesn't.  Just like there's no explanation for why a girl who uses recreational drugs, eats only processed foods, and hasn't exercised in years gets pregnant ASAP while a fit and healthy girl struggles with infertility.  Sometimes I feel ridiculous for going to extremes in trying to be as healthy as possible -- devotion to daily exercise, lots of fruits and vegetables, not a drop of alcohol, not a drop of caffeine, etc. -- for a perceived better shot at pregnancy.  I mean, can that really make a difference?  We've all been to WalMart, and everyone seems pretty fertile there...  In fact, most of my friends, family, and acquaintances haven't even had to consider their fitness level or diet habits and have gotten pregnant no problem.

I don't know why any of this works the way it does.  What I do know is that there is so much working against me that is completely out of my control.  If I can focus on the things I can control and make healthy choices for my body and my mental/emotional/spiritual wellbeing, then I should.  Because what's it going to hurt?

At the end of this process, I will either have a baby or a negative result.  If I am so fortunate as to be pregnant, I want to know that I made really smart choices for my baby and me and that I've created an environment that will hopefully be as healthy as possible for my child.  If I don't come out of this pregnant, I need to know that I did everything I could.  I don't want to end up obsessing over the choices I made and what they might have meant for the outcome.

So that's what I have in mind when I make choices each day.  That doesn't mean I don't eat anything I actually like, because I do.  But I try to eat a lot of fresh fruits and veggies, organic eggs, whole grains, and good proteins.  I allow myself to indulge in ice cream (because this isn't a time to lose weight), but I choose ice creams that use only natural ingredients.  I don't drink alcohol.  Not at all.  I refuse caffeine and instead drink a lot of water.  I go for runs and walks daily.  And I feel really good for all of these reasons.

My next step in doing all that I can to help this IVF stuff work is to see an acupuncturist.  I've read a lot of articles and studies that link IVF successes and acupuncture.  Do people get pregnant after IVF if they haven't used acupuncture?  Sure.  Do some people go the acupuncture route and not get pregnant? Definitely.  But I'm going to try it.  And if nothing else, I hope I get some quality relaxation and mind-clearing quiet out of the deal.

I'm going to do what I can to put myself in the best possible situation for in vitro to work.  It's all I want, so I'm not going to waste my shot at this.

Here's to hoping it works.

too much.

I've really been doing well lately.  Trying to stay positive; trying not to stress too much about our situation.

But then something happens that just sends you over the edge, and suddenly you're not doing so well anymore.

My husband and I are both infertile.  (More on his situation in a post to-come.)  Back in May, my RE wanted to do a semen analysis, you know, just to make sure we didn't also have to worry about my husband's fertility.  So they did one.  It came back that he has a severely low sperm count, poor motility, and poor morphology.  We were devastated.  The doctor's next step was to have my husband come in immediately for blood work and a karyotype (map of chromosomes) to help rule out any easy --- or difficult, I suppose, considering the chromosomes... -- fixes.  All of this was submitted to insurance.

On Saturday we got home from picking up my vehicle from the service department at the dealership.  We had just written a check for $1,100 for its repairs when I checked our mail.  There was a bill from the hospital my RE works with.  Four months later.

$1,400.

That's what we owe for my husband's blood work.  Did I mention his blood work didn't reveal any easy fixes?  It didn't reveal anything abnormal at all.  It gave no new information.

$1,400.  A giant fucking reminder of our infertility.  A reminder of how much this is financially costing us in addition to the physical, mental, and emotional tolls.

$1,400.  A bill we can't afford.  And we haven't even started IVF yet.

We have already spent thousands.  We still don't have our baby.  So I broke down...  Because I was reminded of how much we have already been through and how little we have to show for it.  Because I'm tired, and we're broke, and this isn't easy.  Because I need to stay strong and positive as we enter this next phase -- this phase where we have our best and only chance at this, but I'm not sure if I can.

And then I got over it.  It's $1,400, but it's only money, right? It might be money I don't have, but someday I will, and when I have my baby, I won't think for a second about this stupid bill.

I just need my baby.

fyi: pcos.

My other major fertility issue is polycystic ovary syndrome, commonly referred to as PCOS.  To me, PCOS is more difficult to understand than endometriosis.  Bare with me as I do my best to explain it... And keep in mind that I'm doing my best to understand all of it.

I was diagnosed with PCOS at my first consultation appointment with my reproductive endocrinologist.  He performed an ultrasound that revealed I had 12 cysts on one ovary and 17 on the other.  Multiple cysts on the ovaries doesn't automatically reveal PCOS, though, just as an absence of cysts doesn't mean you don't have PCOS.  Confusing already, huh?

See, before all of this, I had read plenty about PCOS.  In fact, I had even consulted my doctors about it because I had the irregular cycles that sometimes characterize PCOS.  All of my doctors dismissed this possibility because I don't fit the typical profile of a PCOS patient.  Women with PCOS tend to be over weight, have excess hair growth in areas that don't normally grow hair -- upper lip, tummy, feet, etc.  I don't carry extra weight, I'm not necessarily "hairy", or not by my doctors' standards.  I don't have a lot of acne.  It just wasn't a concern to any of them.

Ultimately, I was surprised to be diagnosed because I had been so sure that it wasn't a possibility for me.  Come to find out, I did have some irregular hair patterns.  Hair that grew down from my belly button shouldn't be there -- this was something that had bothered me since I was in high school, but I had several girlfriends with the same thing, so I felt fairly normal.  I'm not talking a man's happy trail here... just blonde hair, but hair that was more noticeable to me than the very, very fine fuzz that covers my body.  In addition, my RE gently pointed out hair growing on my feet that was also an indicator.  Does this mean that if you have a little tummy hair and hair growing from your big toes that you have PCOS?  Probably not.  But apparently my combination of signs led to my diagnosis ... Plus all those cysts on my ovaries.

I really felt terrified that this diagnosis was going to be the end of the road for me.  The only people I had ever known or heard of that had PCOS couldn't have their own children.  In my mind, this meant I wasn't going to be treated.  I wanted to cry right then and there, but I didn't know these people.  I was alone.  I just wanted to get through the appointment.

My doctor and nurse were wonderful about making sure I could see what they saw and that I understood what was going on.  It continues to be a lot for me to process, but they eased my mind about the treatability of my situation.  This was not the end of the road -- and it wasn't even the end of the road when we found that we needed to treat not only PCOS but endometriosis, too.

What exactly is PCOS?

Polycystic ovarian syndrom is a hormonal disorder that's characterized by the presence of actual cysts on the ovaries.  There are certain indicators of PCOS -- some of which I've listed above -- that include weight gain, unusual hair growth patterns, irregular or absent menstrual cycles, acne, and inability to achieve pregnancy.

Apparently the exact cause of PCOS is unknown, but I've asked them to explain to me what they do know.  There is a connection between PCOS and Type 2 Diabetes because of an insulin resistance.  Many women with PCOS who are overweight may be diabetic or pre-diabetic because of this insulin resistance.  Metformin, a drug prescribed to diabetic patients, has been used to treat PCOS with great results.  Women who aren't classic PCOS patients may not be at risk of developing diabetes as many with PCOS are.  Instead, their insulin resistance may only affect their ovaries.  Weird, huh?  It doesn't make sense to me either.  So I'm one of those gals -- with the weird insulin resisting ovaries.

Unfortunately, there are risks that come with PCOS.  There is an increased risk of heart disease, Type 2 diabetes, endometrial cancer, high blood pressure, etc.

How does PCOS affect fertility?

In my individual case, I had a total of 27 cysts on my ovaries during my ultrasound back in March.  These cysts were fluid-filled follicles.  My doctor explained that my body was producing plenty of hormone -- such as LH -- but that my body was putting energy into producing several follicles.  None of them were going to mature into anything, and instead they were preventing ovulation.  Obviously without ovulation, I couldn't become pregnant.  Even if I were to ovulate every once in awhile, it would be difficult to predict timing because of the irregularity of my cycles.

My treatment:

In the couple of months leading up to our first IVF attempt, my doctor has me on a low dose of Metformin, the drug often prescribed to diabetics.  My blood sugar levels were tested, and they are low to begin with.  Metformin lowers blood sugar, though, so although the drug will do its magic on my cysts, it's also going to lower my blood sugar further.  I was instructed to take one tablet every night with a heavy meal -- hopefully the heavy meal would help keep my blood sugar up.  I felt the effects in the first couple weeks of taking Metformin because I easily got light-headed, was really tired, needed to eat frequently, etc.  At my next appointment, which will be in October, I should have more information on how the Metformin is working and my PCOS status.

it's so strange.

In previous posts I've mentioned the grieving process in regards to infertility.  For me, the ups and downs are uncontrollable.

For the past few days, I have truly felt good.  Maybe I've had proper distractions, maybe I've just been too busy to wallow, maybe I've hit a period of rationality (which is guaranteed to be brief)... I don't know.  But right now I'm feeling hopeful and positive and eager for December to get here.

Now, when I let myself think about what December getting here means, I get a little panicky.  For lots of reasons, I suppose.  For the most part, I feel panicky that I will have an answer and that it could be the answer I don't want to hear.  On the flip side of that panic, though, is such intense excitement and hope.  And if I get the answer I've wanted for so long, I can only begin to imagine how I might process it.

I make a conscious effort not to use the word 'exciting' when describing my anticipation of the coming months because excitement doesn't begin to cover it.  I would definitely use that word if I knew IVF was going to work.  I would definitely use it if I knew I would get good news.  I am not guaranteed any of that, though.  In fact, there's an equally good chance that I will be disappointed beyond belief.  That I will enter a new level of mourning in this journey.  That I won't know what to do next.  And for the reasons that I will experience one of two very different results, I am overwhelmed by the approach of December.  That's the only word that currently works for me.  Overwhelmed.

For now... For now I'm going to work on concentrating on today and what I might be able to accomplish in the moment.  I'm going to enjoy my day-to-day.  Stay positive and hopeful.  And in the background, I will anticipate December.

fyi: endometriosis

All of us coping with infertility have in common similar struggles.  But we've arrived where we are for different reasons.  I want to explain one of my reasons.  (And I'll explain the others later).

I have endometriosis.  Stage III (Advanced) endometriosis to be exact.

Endometriosis is:

A condition where the lining of the uterus, which is usually shed during the monthly period, begins to grow internally outside of the uterus.  There are different theories as to why and how this happens, but a common one is that the lining, at some points in time for certain people, flows back and out the fallopian tubs.  Then, rather than my immune system taking care of these foreign cells immediately, they attach themselves to other organs and grow and shed there, often causing scar tissue.

My endometriosis was found on my abdominal walls, uterine walls, bladder, and ureters.  Microscopic endometriosis was growing within my uterine walls causing it to be spongy to the touch.  I had an endometrioma growing on my right ovary that was likely causing the pain I experienced prior to surgery, and my doctor was shocked at the advanced stage of my condition.

Because my endometriosis was extensive enough and because some of it was not removed during surgery (those cells in my uterine walls that were making it spongy), my doctor decided my best course of treatment would be to take six injections of depo Lupron over the course of six months.  One shot would be given every four weeks.  Depo Lupron is a GnRH agonist, and while I don't want to get into the specifics of how it works and what it does (not because it would be dull, but because I'm sure I don't totally understand), I will give you my explanation... Apparently GnRH agonists shut down your reproductive system and eliminate hormones from your system.  They allow your system to rest while eliminating those microscopic cells.  Depo Lupron essentially sends you into a temporary menopause for however long you continue the injections.  I was prepared to be in a state of menopause for six months -- complete with all of the symptoms of menopause that women experience.

How does endometriosis cause infertility?

Many women diagnosed with endometriosis will find that cells have caused damage to their ovaries and/or to their fallopian tubes.  Damaged ovaries could result in poor egg quality and/or prevent proper ovulation.  Blocked fallopian tubes would prevent fertilization by keeping the egg and sperm from meeting.  In addition, it is thought that certain toxins are released in the body because of endometriosis around the time of ovulation.  These toxins can affect the uterine lining and the overall environment for fertilization and later implantation.  Any interference on the part of endometriosis in this delicate process can be detrimental -- obviously.

It is widely recognized that IVF is the most successful option for women with advanced and severe stages of endometriosis.  Many doctors will begin by offering IUI treatments when endometriosis is less severe, but research shows that success rates are low.  Always do your own research but also consult your doctor when making these important decisions -- infertility is not predictable, so one case doesn't determine the outcome of another.

Some literature out there suggests that women with endometriosis have a slimmer chance of success with IVF than the average woman undergoing the same procedure but for different reasons.  I've found some articles that argue this point and others that refute it.  Those that suggest this lower success rate do seem to note at least a subtle correlation between those toxins I mentioned earlier and difficulty with implantation.  IVF removes the whole process from the body, so obstructions in the fallopian tubes and influence of these toxins on sperm would not be factors.  Either way, though, women with advanced to severe endometriosis have highest chances of conception through IVF.

My concerns lie in the fact that I do have advanced endometriosis and I did have an endometrioma (or chocolate cyst as they are sometimes adoringly called -- isn't that just the cutest name?).  The literature that suggests my chances are lower than others undergoing IVF freaks me out.  I should probably stop reading it, but I'm out of control.  I wanted to go into this procedure with a realistic but positive outlook, and it's really hard to marry the whole realistic thing and the positive thing when we're dealing with infertility here.  They just don't work well together.

Without really getting in there and beginning stimulation, we don't know how my ovaries will respond, how many follicles I'll produce, or whether or not those follicles will contain healthy, mature eggs.  It's such a gamble.  I know for a fact that my tubes aren't blocked (structural stuff was checked out during my lap surgery), so that's not my issue.  We don't know my endometriosis's impact on my egg quality, and I'm afraid that these "NKa" toxins will inhibit implantation once we've done all the hard work.

In the meantime, in an attempt to ease my worries, I've been ignoring other pressing tasks in order to stalk message boards for evidence that there are women out there (and hopefully lots of them!) who have advanced or severe endometriosis and have gotten pregnant through IVF.  And they do exist.

I just hope I can join them.

cruel joke.

My husband is in school to be a medical professional.  He came home today with the assignment of contacting hospitals in a particular urban area for quotes on facility fees for non-complicated vaginal deliveries.  It's for a healthcare course where they're examining the current system in the U.S.

Because none of these hospitals have taken him seriously or given him the time of day to answer his questions when he presented himself as a student, he decided to call as a potential patient.

Here's the dialog I'm listening to in the other room:

"Hi, my name is Jason, and my wife is pregnant.  We are uninsured but would like to start preparing and are shopping around for the hospital we plan to use.  Can you tell me the cost of the facility fee for a typical vaginal delivery?"

...and my wife is pregnant.

HA!

Yet another reminder that I'm not pregnant.  And we don't have to make these calls.  And none of this is really happening.

Thanks universe -- you're so funny.

funny.

how we got here.

Let's go way back.

Since the time of my first period, they've been really painful.  Like, I hadn't felt pain like that when I got my first period.  One time when I was 16, I woke up in the middle of the night with the worst cramps.  I didn't even think I could walk.  I eventually made it up the stairs from my room in the basement to the bathroom and threw up.  Because it hurt that bad.

After years of painful but very regular periods, I got on birth control when I got to college.  They assured me that it would help with cramps and other PMS symptoms.  And it did.  Birth control helped the pain, and although it caused other issues I wasn't too pleased with, it was nice to have a break.

Fast forward six years to age 24, and I was married and thinking about starting a family.  I knew from earlier experience that I wasn't one to return right to my regular cycle after stopping the pill, so I planned to go off of birth control earlier than I might want to so that I could be sure my cycles were back to normal by the time we wanted to start trying to conceive.

As expected, my cycles weren't normal right away.  I think I got my first period off of birth control like eight weeks after finishing my last pack.  From there the gaps got narrower, but they still weren't regular -- not even a bit.  I had six-week cycles, 40-day cycles, 28-day cycles, etc.  I kept track of my cycles on a calendar, knowing it might come in handy.  This lasted more than a year.  At my yearly appointment, I brought up my concerns.  My doctor said some people just really responded differently to hormonal changes, but he thought checking my thyroid and doing other bloodwork might be informative.  So we did.  And everything came back normal.

My husband and I moved to a different state, and it was time for my next yearly exam -- and this time I wanted things figured out because we were ready to start a family.  She echoed what my former doctor said.  Birth control probably wasn't to blame, and maybe I just thought I had had regular cycles pre-birth control but really didn't.  Just to check things out, she wanted to do some bloodwork also and check my various hormone levels at specific times in my cycle.  So we did.  And it came back normal.

I bought ovulation strips on Amazon so that I could try to figure out if I was indeed ovulating.  You know, it would be awful if I wasn't.  I didn't want to waste any more time, so I started peeing on those things right away.  And obsessive me became obsessed.  I downloaded an app on my iPhone that would help me to keep track of my cycle.  Guess what?  I got a positive ovulation test strip two days in a row.  I was ovulating, and I was so excited.  In my mind, my doctors were proven correct.  Everything was working fine, and we should start trying.

So that month -- the month I got my first positive OPK strip -- we had unprotected sex and thought wishfully about having a baby together.  But I got my period a couple weeks later.

No fear, though.  That was our first shot.  Being the researcher and reader that I am, I got online to really figure this whole process out.  I read everything.  I learned about taking my basal body temperature, checking my cervical mucous, looking for signs of ovulation like mittelschmerz and egg white mucous, and charting all of the info on my phone and paper and pencil charts.  I had one on my fridge.  Every morning I woke up to the sound of my 6:30 alarm -- weekdays and weekends, on vacation or at home -- and took my basal body temperature.  I recorded my findings on my phone immediately.  I woke up and checked my cervical mucous.  I even checked my cervix.  I noted all of this.  Then I would transfer it to the paper copy.  It was such an involved process.  We timed sex; we did everything perfectly.

After six months of doing everything right and timing everything right, we still weren't pregnant.  That's okay, though, right?  A majority of people are pregnant by then, but we will definitely be pregnant by the year mark.  I didn't really believe my self-talk or the shit everyone else said to me, either, though.  I scheduled an appointment with my OB/GYN because I thought maybe six months of trying might warrant some investigation.  Nope.  I'm fairly certain she thought I was crazy.  She told me to come back at nine months if it was really worrying me.  So I did, because I still wasn't pregnant then either.  But I don't think she remembered telling me to come back at nine months, so it was just kind of frustrating. Then she told me to come back at the one-year mark.  That's when I would be officially infertile and could be referred to someone who actually knew what the hell they were doing.  But stay positive! she said as I left.  Don't let this stress you out.  Just enjoy the trying!  It'll happen, she told me.

Then it was February -- the one-year mark -- and I still wasn't pregnant.  I knew it.  Something was wrong, and everyone just wasted a year of frustration and hope and disappointment.  No one listened to me, and now they were going to?  Because I had hit a magic number of months of being childless?

I met with another doctor in her practice, and she didn't seem to know much either.  She looked at my charts and asked me some questions and said that it sounded like I was ovulating and that everything was probably fine.  Had my husband been checked? she wondered.  Nope.  No one ever offered to check him, and oh yeah, semen analysis isn't even possible in the town we live in.  So she was going to refer me to a specialist in a larger city.  Did I want Dr. So-and-So or Dr. What's-His-Name?  I don't know -- what the hell is the difference?

I was referred and was able to make my own consultation appointment within a couple of weeks. Luckily they had a cancelation, and I could get in two weeks later.  The anticipation was killing me.

At my very first appointment with my brand new reproductive endocrinologist, I was first interviewed.  They wanted medical history, they wanted family history, and they wanted to hear about what I knew about my cycle.  They made copies of the 12 charts I had so meticulously kept, they took several viles of blood, and then I was able to meet the doctor in his office.  He read through my information and asked me what I thought was wrong.  I don't know... maybe I have low progesterone?

(Did I mention that by this time I had read every article and blog and message board on the internet that even mentioned infertility?  Also, I had read three books about infertility and several on conception and pregnancy.  I was definitely hypothesizing myself...)

He agreed that it could be a possibility, but he didn't think that was my only issue.  We discussed my slight pain during intercourse.  (I didn't get it all the time, just when circumstances were right).  We discussed my mom's experience with endometriosis before conceiving me.  We discussed my dad's sister's experience with endometriosis before conceiving her kids.  We discussed my aunt's inability to have children because of premature ovarian failure.  (And it was beginning to look like heredity wasn't working in my favor...)  We discussed my irregular cycles.  And then he sent me down the hall to change into a gown for a pelvic exam and transvaginal ultrasound.

I couldn't believe they were being so thorough so quickly.  He started with the exam -- with nurses and resident in tow.  Immediately he found the spot that caused me to wince with pain.  He wasn't surprised.  And look at this, and look at that.  All signs of what he thought might be endometriosis.  Next, he did the ultrasound and immediately found a total of 27 cysts on my ovaries.  I wanted to cry right then and there.  The term poly-cystic ovaries was thrown around, and then I really wanted to cry.  I knew people who didn't have children because of PCOS, and here I was.

They sat me up, and I asked questions.  They got out pictures of endometriosis.  They explained the cysts.  I would be scheduled for surgery in two weeks to investigate the presumed endometriosis and to check on the cysts.  If endometriosis was found, they would remove it with a laser.  If the cysts were too big, they could be drained.  After surgery, a treatment plan would be developed and pursued.

I still felt very emotional, and so I asked if this was going to be the end of the road for me.  They smiled and said no -- this was all very mild compared to what they see on a daily basis, and things were very hopeful for me.  This could all be treated.

YES.  I was on a high like I hadn't experienced in a long time.  Not only did I have answers, but they were treatable answers, and I would have my baby.  I would have to be patient and endure a little bit, but it would be worth it.

My surgery was exactly two weeks later.  My husband went with me and was there to speak with my doctor when it was over.  My husband recorded my doctor's comments on his phone so that I could hear exactly what they found.

I did indeed have endometriosis.  I also had an endometrioma (bad news).  There was endometriosis on my abdominal walls, my uterine walls, my bladder, and my ureters.  It was bad.  It was Stage III Advanced, and my doctor couldn't recall ever seeing such an advanced case on someone my age.  26 years old.  After he reviewed all of the photos and information, he would determine a treatment plan and would be able to discuss it with me at my post-op appointment.  That's all the information I had for two weeks.

At my post-op appointment, he reiterated the extent of my endometriosis.  He was shocked I wasn't in more severe pain for the past several years.  He couldn't believe it was so out of control because I was so young.  (None of this shock and awe was helping my psyche at the moment...)  My cysts were small and nothing had to be done with them during the surgery.  They decided to start me on six rounds of depo Lupron the following month to further address the endometriosis.  I would receive one injection of the drug in the rear every four weeks, and as a GnRH agonist, it would shut my reproductive system down and allow it all to rest.  Microscopic cells of endometriosis that remained in my uterine walls (causing my uterus to be "spongy") that could not be removed with the laser during surgery needed to be taken care of, and the Lupron would eliminate them.  I was nervous about these shots because they would send me into a temporary menopause -- and at a very accelerated rate.  For six months I would be without estrogen, which could in turn reduce my bone density.  Side effects such as hot flashes, headaches, mood swings, depression, and insomnia were to be expected.

I got my first shot in May 2013 and experienced very few side effects.  I got my second shot in June 2013, and the hot flashes began.  They were miserable, and the midwest heat and humidity didn't help a thing.  In the meantime, my husband went in for a semen analysis, you know, just to make sure everything with him was okay and to confirm that we only needed to focus on my issues.  Well, he ended up with a severely low sperm count, poor morphology (3%), and low motility.  We were both devastated because we felt our chances of conceiving were slashed again.  He went in for further bloodwork and a karyotype to see if we could get some answers.  Everything came back normal, and  I was reminded of how frustrating "normal" can be when you know it's not.  "Normal" just meant that we wouldn't get any real answers, and there was nothing to treat.  No way to make it better.

My doctor offered to refer my husband to a urologist who specializes in male fertility and partners with him on IVF.  It was our only shot at figuring this thing out.  We received a copy of the referral letter in the mail, and it was the first time I had seen or heard my doctor say anything about IVF.  And he was indeed saying that IVF was his recommendation for us if we wanted to conceive.  That was our answer.  This was worst-case scenario material only two months before, and here we were.  Reality.  IVF.

At my appointment to get my third Lupron shot, I was met with information I hadn't expected.  At next month's appointment -- the appointment that would normally be reserved for my fourth shot -- we would have a consultation with the doctor.  My husband should plan to be there, and I could expect to have another pelvic exam.  If my husband and I decided that we were interested in moving forward with IVF, the doctor would check me out and consider forgoing the final three shots in pursuit of IVF.  From there I would be sent home with drugs to treat my cysts, birth control to keep my system dormant and to reintroduce estrogen levels, and all of my vitamins.  We would even discuss a schedule of when to do IVF.

This was big news, and it was a lot to wrap my mind around.  I thought I had three more months on these shots and several months even after that before we'd have to make a decision.

After talking with my husband, we decided IVF was a path we wanted to take.  At least once.  Because it's our only option, we feel we owe it to ourselves and our efforts to give it a shot.

We arrived at my fourth appointment armed with dozens of questions we needed answered.  We knew that we could be leaving there officially beginning the IVF process, or we could end up just continuing the shots based on what my doctor found.  My RE began the consultation by answering all of our questions and explaining the process and the timeline.  He explained that a pelvic exam would give him a good idea of how my body has responded to the Lupron, the condition of my uterus, and my current pain level.  The exam revealed that I was no longer experiencing any pain, he felt my uterus was firm and healthy, and he was impressed with how well I had responded to the injections.  Three months of grueling hot flashes (this shit was no joke) paid off, and really, I had been so lucky to not experience some of the more severe side effects.

SO.  We could move forward with IVF if that's what we wanted to do.  He explained that the success rate is 50/50; it's the national average.  He explained that there's no way of knowing what issues may come up until we're in the middle of it.  He explained the travel schedule, the time commitment, the time management involved, and the procedures.  I had read about all of this before.  I knew all of these answers.

But I was completely overwhelmed.

He stepped out of the room so that I could get dressed and we could meet with his fertility nurse to go over details.  As the door shut behind him, I buried my face in my husband's shirt and cried.

This was wonderful news.  We could move forward.  Maybe we would be pregnant in four months time.  This was awful news.  We can't have our own children naturally.  The future of our family will ride on this one procedure that is just as likely not to work as it is to work.

Fuck.

I composed myself and we gathered our things and made our way to her office.  She was very good with us and explained the financial side, the scheduling, the time frame, etc.  I felt informed, and I felt good about the decision we were making.

I was given three prescriptions to take for the next three months:  birth control, Metformin to help treat my cysts, and Dostanex to treat elevated Prolactin levels.  I would continue taking vitamin B6, fish oil, prenatals, and calcium supplements twice daily.  And I would continue taking my prescription vitamin D weekly.  I was to continue drinking lots of water and asked to consider gaining five pounds or so because "it couldn't hurt."  I committed myself to abstaining from alcohol, exercising daily, and trying to eat right while adding some calories to my diet.  I was told to come back in October 2013 to be checked over and to do a "trial run" of the egg retrieval/implantation process so that they could measure the dimensions of my uterus (more on why later).  From there, they would schedule my tentative egg retrieval day -- sometime in early December -- and determine when to start me on my IVF drugs.  The fertility nurse gave me a hug, asked me to try to stay positive, and sent us on our way.

And we walked out the door...

The process now begins.