Thursday, April 1, 2010

A tough week

After my initial enthusiasm about to the dr and getting going with a 'treatment plan', I soon discovered that the plan involved a lot of uncertainty, definitely a lot of pain and fear and not nearly as much hope as I had thought. So, I dealt with it in a really mature way- denial. As a psychology teacher, I must say it is fascinating to watch myself use the full array of Freudian defense mechanisms in coping with infertility (as this marked our 12th period since being off BCP, I am still new to using the dreaded I word)

You know there is rationalization like 'it's good it's taken us longer because we've had all this extra time together and had the chance to grow closer' (yeah right- it sucks). Regression or returning to child like behaviour like when I lie in bed and cry holding on to my teddy bear. Or reaction formation when i'm like 'i don't even want to be pregnant yet- I want to go the gym and lose weight and just enjoy being thin and young' (first of all, 27 isn't young and 2nd of all, I really hate the gym). Displacement is a favorite when I become filled with hatred towards my 14 year old student who is pregnant- or really anyone who ever has, is or will be pregnant...

But then there is the really dangerous one- denial. In it's more subtle forms, it's like 'oh I'm sure this will be the month!" But the really scary one is when you are riddled with PMS symptoms and so obviously about to start but still insist that you are pregnant. That was how I spent Tuesday and Wednesday. So after starting to have PMS symptoms on Thurs-Fri last week, I was expected my period Monday. Well, when dear old Aunt Flo didn't show Monday or Tuesday, I started to think 'maybe...' By Wednesday, I was convinved. I wasn't going to have to do fertility treatments, I was going to have a Christmas baby, I'd be through my first trimester by my birthday- oh I had it all planned out from when I'd take the test to how we'd tell every single person I know. In hindsight, I was of course pathetic, self damaging and perhaps delusional...

So when my period came this morning, I had to abandon old reliable denial and return to rationalization... December was probably not the best time, an April baby will be better, with the fertility drugs we have increased odds of twins which would be better given my fertility difficulties, I still need to lose a little more weight before I start gaining it, yadda yadda yadda.

So now that I am out of the land of crazy sad denial, I can finally write about Monday and about the plan. And in a way I am relieved. I mean, of course not that I'm not pregnant but that at least I KNOW I'm not and can stop freaking out and going to the bathroom every 30 minutes to check...

Anyway- Monday. Well, I had this great plan in my head that we'd go on Clomid and have IUI with the clomid (the dr had mentioned the IUI) and I'd do it three months in a row (May, June, July) and even though I've read some low success stats, I figured that wouldn't apply to me. I mean, I just have a tilted uterus and nothing else wrong. Surely Clomid and IUI would work a charm for me and by July, I'd be blissfully pregnant.

Well, I was wrong on many accounts. First of all, the dr doesn't think the tilted uterus alone can really account for our year of failed attempts so he could classify us as 'unexplained infertility' which seems to mean something is really wrong but we don't know what so we'll just randomly start doing things and hope something works. Awesome!

Secondly, given I ovulate regularly already, there is not a lot of potential benefit from Clomid and the dr said we'd have a 10% chance on any given month of it working. This was a huge blow to me- surely it would be like 20-30 if not higher! I mean, I said to Al but we had a 25% chance any normal month- how can it not be any higher with all that. He pointed out that healthy fertile couples have a 25% chance- we probably only ever had like a 2% chance so it is increasing our chances. If we do injectibles (shots), we'd have a 30% chance and if we do IVF, we'd have a 60% chance- all that based on our diagnosis, my age and the clinic's success rates.

Well, the best part of the whole thing is that Al and I left and had separately come to the same conclusion- that being that clomid kinda seemed like a waste of time and money for us. The dr recommended that if we did try clomid, we do so for only 2 or 3 months so we'd be looking at 2-3000 dollars and at best a 20-30% chance. And chances are we'd still end up needing to do the injectibles. Now the injectibles+IUI have a 30% chance each cycle so we figure if we do them 3 times in a row, odds are high we'll end up pregnant. So, in Al's business oriented mind- 3 rounds of IUI are the best odds for your buck. And in my mind, I can't handle three failed rounds of Clomid. So we agreed to skip Clomid and go straight to injectibles.

And we are very blessed because we are able to make this choice financially because my parents are actually paying for the treatment which is just massive. Like I feel so blessed every time I think about that. And so even though injectibles are 2500 dollars instead of 1000, my dad is happy for us to start there.

There's a couple of things about it that are particularly hard for me to come to terms with though. First of all, the shots. I am a baby about shots and the idea of Al having to give me daily shots is pretty terrifying for me. It's a lot less pleasant than my previous plan to swallow a Clomid down with a nice Coke Zero. Secondly, there is still only a 30% so no matter how you look at, there's a 70% chance it won't work. If I told you there was a 70% chance of rain tomorrow, you'd assume it would rain. Now this is the part where I am really trying to trust in God and not numbers and believe that God is not bound by odds so I am choosing to live in faith that it will work! Plus, it's 30% per attempt so it's much higher that it will work after 3 months.

Ok, and my third concern and probably the one I am having the hardest time with is- the way it all works, I cannot count on a timeline for our three IUIs. If they find I have too many mature follicles (more than 4), they won't follow through with the IUI. Which I know makes sense and we are not open to selective reduction so it really is essential because especially your first round, 5 follicles could lead to quintuplets and we can't handle that! But it just means that even though we're starting injectibles next month, there's no gaurantee we'll even get to try that month. Especially the first month, we don't know how I'll respond to the drugs and they'll be the most cautious. For your first one, they may not go forward even with 4 eggs. So that kinda does my head in because I can't know when we'll get our first real attempt. Then there's also a risk you develop cysts and have to have time off between injectible cycles. So I worry that if it took 3 IUIs, that could somehow manage to take like 9 months- argh!

But for now, I just have to take it one step at a time and embrace the potential and the positive. While all of these worst case scenarios could be true, I could also respond well the first time, have 3 eggs (that's what I am hoping for) and get pregnant on my first IUI- with twins, even better! So there's so much to worry about and so much risk in every direction but there's hope so I choose hope.

So that's my week. I will write again about Al's job interview (!!!) but I am happy to say that in the midst of the storm and despite no good news on our ttc front, I do feel God's peace and that is enough for today.

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