Wednesday, May 30, 2012

Death by Google

Diminished Ovarian Reserve
DOR success stories
DOR natural pregnancy
DOR symptoms
improve ovarian reserve
improve FSH
improve amh
adenomyoma infertility
adenomyosis pregnancy
adenomyosis infertility treatment
adenomyosis infertility surgery
adenomyoma surgery pregnancy

To cope with anxiety, some people drink. Others eat. Having been deprived of both, I google.  I google and google and google. I google the same search terms over and over again.

This has helped me to a certain extent. I know more, have found a few blog buddies, and have all kinds of theories about my conditions which I will share with you in future posts.

However, for my anxiety, it does nothing.  Nothing.

Somebody stop me.

Friday, May 18, 2012

Returning to the scene of the crime

I'm not doing so well.  I arrived at my parents' house for a visit Tuesday, and my period started Tuesday evening, which was no surprise, since we missed the egg this month.  Wednesday was my monthly day of hell, which I initially thought was not going to be so bad. Hadn't I been keeping up with my supplements, my fertility yoga, the centering prayer? Wasn't I feeling less stagnant than usual?

But then I called my RE's office to schedule my hysteroscopy, and the nurse told me to avoid all blood-thinning medications: aspirin, NSAIDs, etc. I was already doped up on Aleve, so she told me not to take any more. I thought I was over the risk of vomiting, so I had a light dinner with my parents.

Then the Aleve wore off. I took Tylenol, but, to put it indelicately, it didn't do shit. Stabbing abdominal pain, severe aching in my hips and knees, and vomiting followed, plus very heavy bleeding. I took one of my specially-compounded Valium suppositories, and continued to vomit. I took another. No effect. I finally gave up and took an Indocin suppository, which is an NSAID, but I just couldn't take any more. Ten minutes later, I was asleep.

The pain was excruciating, but worse was the accompanying despair. The deep sense of failure of not being pregnant. The hatred and disgust that my body was doing this to me again.

I missed DH, who couldn't come home with me because of work. My mother was on hand, emptying the vomit bucket at regular intervals and directing me to rinse my mouth with water, but her presence was a mixed blessing. She never knew how to comfort me when I was a child. When I was a teenager, suffering with the same damn cramps (which were longer in duration but less intense) she told me that I would feel better if I moved around.

She now understands how very abnormal this is, and I know it's hard for her when she has to see me like this, but she's no better at comforting me. I learned long ago how to comfort myself, but when I'm in that much pain, I just can't. My despair at failing to conceive finally spilled out, but her response was to remind me that we're "going to adopt anyway" and maybe I should just tell DH that I want a hysterectomy now, and that I should just "think positive."

I told her that that was Gospel of Prosperity bullshit and that I didn't want to hear anymore of it. She got the message.

That was two nights ago, but the effects of the physical and emotional trauma still remain. I thought it would be better to come home for my day of hell than to stay alone at home. But now I wonder if it's the best thing for me to be back at home in the house where I felt so alone growing up experience the same medical condition.

I wonder how long I can keep doing this, going through this monthly hell.

I can't have surgery to remove the adenomyoma, because it might scar my uterus closed. I can't conceive, possibly because of the adenomyoma.

How long before I call it quits forever?

Monday, May 14, 2012

The Master Plan

DH was home this weekend, so we had time to discuss big life things. We made a Master Plan:

Western medicine: When my period starts, I will schedule my hysteroscopy to remove the endometrial polyp. Afterwards, I will try to find a holistic gyn or (even better) holistic fertility specialist with whom I feel comfortable.  My RE sucks.

TTC/Alternative Treatments:  After my hysteroscopy, I will continue all of my mainstream and alternative treatments. We will continue to track ovulation and "actively" TTC until January. If I'm not pregnant by January, I will probably go back to eating and living the way I did before. I'll keep up the Centering Prayer, because it keeps me sane.

        -Finances: We will put $xxxx/month towards paying off debt (DH was unemployed for a long time). As soon as our debt is paid off, we will put that amount into savings for adoption. At this rate, we should have enough saved by January.

       -For now, we have pretty much decided to forego trying to adopt from [country of origin]. The program is closed, the procedure is uncertain. There are too many risks involved.

       -We have decided to pursue domestic adoption of an infant of color. We will investigate agencies and make a choice by January.

       -After the holidays, DH's job will end. In January, we will start getting together paperwork, etc. for domestic adoption.

As for me, I'm swinging between enthusiasm for adopting and despair that I'll never bear a child. All part of the roller-coaster, I suppose.

Sunday, May 13, 2012

By Any Means Necessary?

How far would I go to have a child?  The desire to have a child entails the willingness to go through the misery of morning sickness, first trimester fatigue, the excruciating pain of actually giving birth, the risks to my health.  I would be open to having a c-section if necessary for the health and safety of my child.

I've restricted my diet, given up alcohol and caffeine. I spend time every morning organizing supplements. I choke down concoctions of wheat grass and Chinese herbs.

I've endured a saline hysterosonogram. I am having a hysteroscopy in two weeks. If I could have a laproscopy, I would have one.

These are minimal interventions. If pregnancy doesn't result, the recommendation is for a round of injectables, followed by IVF.  The side effects of the "minimally invasive" fertility drugs that my RE has recommended include headaches, mood swings, abdominal tenderness, ovarian cysts. Many women report that the IVF drugs permanently change their bodies. They also carry the risks of hot flashes, cysts, and Ovarian Hyper-Stimulation Syndrome.

The risks of many interventions are also financial. Many women with diminished ovarian reserve cannot get pregnant with their own eggs. They must use the eggs of a donor, often with a price tag of $35,000.  A cheaper alternative is to ask a friend of family member to donate for you. Would I be willing to watch my sister inject stimulants in the hopes that she has eggs to give me?

Some women with adenomyosis cannot carry a pregnancy to term. To bear their own, biological child, they must use a surrogate, another womb on loan. A popular option is to go to India, where a woman will bear your child for far less than the going rate in the US.

Is it all worth it, once we have that child in our arms? Is any intervention, procedure, or transaction okay, as long as we can parent? When do we decide to call it quits?

How far would you go to have a child?

Tuesday, May 8, 2012

A Big Step

This morning, I called an adoption agency to inquire about adopting from [country of origin].

We are committed to trying to conceive. For now, I am keeping up with all of my Western and alternative therapies. I will have a hysteroscopy at the end of this month. I will continue to track my ovulation. Nevertheless, we realize that without IVF, it may be years before I get pregnant. It may never happen.

So, we are beginning to look into adoption. Our preference is to adopt from [country of origin], but this is fraught with difficulties. First among them is that their international adoption program is currently closed! The second is that I'm not aware of any adoption agencies in the US that work in [country of origin]. Like pregnancy, adopting from [country of origin] may or may not work out for us. We are open to adoption alternatives: domestic or international, but for now, we're trying to follow this path where it may lead us.

Monday, May 7, 2012

Update: Post-testing follow-up with RE

It looks like I do have diminished ovarian reserve. Although my FSH did drop a bit (I couldn't bring myself to ask the specific number), my AMH was low (.29).

In addition, I have an small endometrial polyp (7x5mm). According to my RE, polyps can secrete a substance that interferes with implantation. There are women who've carried pregnancies to term with polyps; there are also women who conceived only after having polyps removed. Removal involves a hysteroscopy, a 20-minute procedure conducted under general anesthesia. I'm inclined to do this.

Regarding my ovarian reserve, RE wants to shoot me full of fertility drugs in the hopes that ovulating two eggs at a time will increase the chances that I'll get pregnant.  I have my doubts about this, which I will explicate in another post.

If injectibles don't work, she wants to proceed straight to IVF.

She didn't seem to be pushing aggressive intervention.  She acknowledged that she has seen people with DOR get pregnant with no intervention at all. She has also seen people get pregnant with injectibles and timed intercourse.  And she has seen couples who needed IVF.

I will be scheduling the hysteroscopy as soon as I get my next period.

I do not plan to take the injectibles. I am not interested in IVF.

I am trying to come to grips with the fact that I might never get pregnant.

Sunday, May 6, 2012

Why I don't take a prenatal vitamin

At the top of every communication from my RE, there is a reminder to "begin or continue taking a prenatal vitamin." I won't be doing this. There is nothing magic about pre-natal vitamins. They contain they same vitamins and minerals found in many other supplements.

WebMD recommends a prenatal vitamin with around

400 mcg of folic acid
400 IU of vitamin D
200 to 300 mg of calcium
70 mg of vitamin C
3 mg of thiamine
2 mg of riboflavin
20 mg of niacine
6 mcg of vitamin B12
10 mg of vitamin E
15 mg of zinc
17 mg of iron

With the combination of vitamins and supplements I already take, I have all of those bases covered. In addition, calcium blocks iron absorption; if you want to actually absorb the iron you're paying for, you shouldn't take it with any calcium at all.

Finally, like everything having to do with conception and birth, pre-natals are much more expensive than your average multi-vitamin. No one desperate to conceive would balk at the price of a vitamin, so they charge more.

I'm hardly against spending a lot of money on supplements, but have given and will continue to give pre-natals a pass.

Thursday, May 3, 2012

Infertility before infertility

"How long did it take you to conceive N?" Asking my dad about my little sister's conception was pretty awkward. But I had a reason for asking.  Diminished ovarian reserve tends to run in families.  I was always sure that my ovaries were fine; I was conceived five months into my parents' marriage, when my mother was 36. She had my one and only younger sister when she was 41. I thought this boded well for me, until I thought about the four years between me and my sister.  What 38 year old postpones a second child?

Awkward pause. "You and your sister are four years apart," answered my dad.

"I know, but did you try for all that time or...." Did I really want to pursue this line of questioning?

"You and your sister are four years apart," my dad repeated.

"So, um, you tried that whole time?"

Yes, they did. They tried for two years before they were successful. "Your mother went to the Marian shrine in [country of origin] and prayed for a baby. And then she got pregnant again shortly after that."

When my parents were struggling with infertility, or as my dad would say, taking a long time to have a baby, there were no FSH tests and ultrasounds. Because they knew they had been pregnant before, they just kept trying until they were successful, when my mom was 40.

"So sometimes, it just takes a long time," my dad continued. "Remember Auntie R and Uncle N? They took five years to have a baby. They spent thousands of dollars traveling to Marian shrines all over the world. They even went to Lourdes. And after five years, it worked!"

There you go. In the age before IUIs and IVFs, the only thing to do about infertility was to pray. Rather than spending thousands of dollars on medical interventions, you could spend thousands of dollars on a pilgrimage.

Sometimes, I think about the couples who spend their savings on a chance at having child, only to walk away with their arms empty. I think about the couples who have had multiple rounds of IVF, all failures, only to conceive naturally months or years after they've given up. Sometimes I wonder if after all this medical intervention we are any better at controlling the vagaries of conception than we were when the only treatment for infertility was prayer.

Wednesday, May 2, 2012

I don't deal well with disappointment

DH is working out of town. He had been unemployed for a year, which was hard financially, and harder psychologically for him. We decided that living apart for the next several months was worth it for three reasons: 1) it's temporary 2) it will allow us to save money for adoption if we need to adopt 3) unemployment was wearing him down. But the trade off is that it makes timing intercourse with ovulation tricky.

This was my fertile week, but on Saturday DH came down with a terrible cold, followed by a sinus infection and dry cough. I was hoping he could come and visit last night, but he was still feeling too sick. He had planned to come tonight, but when I woke up this morning, my temperature was up and my cervical fluid had dried up.

We missed the egg.

Let the recriminations and catastrophizing begin:

-What if this was my only good egg?  The only one that I will ever have?

-Why couldn't he take better care of himself? Of course working 60+ hours a week plus eating out all the time will predispose you to whatever virus is floating around.

-We had to miss last month too because of my saline sonogram and DH's work schedule. We will never have a month that works for us, and even if we do, there's no guarantee that I'll produce the golden egg that month. If we take two of every three months off, the chances that we will ever conceive are that much lower.

-Women with DOR tend to ovulate early. I usually ovulate on day 15-17, but this month, my temp went up on day 14. This means that my ovulation will get earlier and earlier and I'll be in menopause by the time I'm 36.

I know rationally that disappointments come much bigger than this. I know that most of the above points are  cognitive distortions, as my therapist would say. I know that my DH deserves better than this.

I know that I deserve better than this.