TTC is a hard habit to break

Over the past two+ years, I've worried about the following things:

-Endometriosis
-High FSH
-Periods too long and heavy (pre-surgery)
-Periods too short and light (post-surgery)
-Late ovulation (Spring 2011)
-Early ovulation (2012)
-LUFS
-Blocked tubes pre-surgery
-Blocked tubes post-surgery
-Adhesions
-Pre-menstrual spotting (pre-surgery)
-Tail end brown bleeding (post-surgery)
-Asherman's Syndrome (post-surgery)
-Premature Menopause
-Poor quality eggs
-CM too watery
-CM too acidic
-CM too thick
-CM insufficient
-Insufficient endometrial lining
-DH's sperm count
-DH's sperm quality

The vast, vast majority of these conditions never affected me (endo, blocked tubes-pre-surgery) or came and went on the odd cycle (anything related to ovulation timing and CM). In other words, I spent hours--days even--Googling many conditions that I didn't have that I didn't need to worry about.

Now that we're fully committed to adoption, i.e. the big fat check has been mailed off, it no longer matters. It does not matter when or whether I ovulate. It does not matter if my uterus and pelvic cavity are scarred into oblivion.

But I can't seem to stop. I keep Googling, though it must just be out of habit. It's harder to let go of TTC, when it has consumed me for more than two years. I try to turn the page, but my mind keeps me on the TTC train. It's time to let go, but I don't know how.

P.S. My TEBB (tail-end brown bleeding) has mysteriously vanished, just when I had planned to ask my pelvic pain specialist about it. Perhaps it was just that my uterus hadn't fully healed from the surgery until now.

Afraid of the Dark

Thanks to all who replied to my questions about TEBB. I think I'm going to schedule a visit with my pelvic pain specialist when I'm having the weird clotting black spotting and make him do some cultures. If nothing odd turns up, perhaps I'll revisit after we adopt. To be perfectly honest, I'm not entirely sure that it's a good idea to throw antibiotics at every case of TEBB, especially in the absence of positive cultures. Antibiotics wipe out good bacteria, not only in the digestive tract, but in the sinus cavities, ear canal, vagina, etc., and it can take a long time to rebuild.

But for now I need to be done with TTC for my own mental health.

We went to our adoption orientation, and it was fantastic. The agency seems to be a good fit with our values and ethos, the other couples were lovely, and best of all, they were very reassuring that they only accept as many couples as they anticipate placing within a year, and they only accept couples whom they feel are a good match for their birthmothers!

Despite all this reassurance, I'm struggling a bit.

The first issue is that we need to send in our big fat check. Once we do this, it's irrevocable. The money is gone, and it's a lot of money. DH and I have been discerning adoption for years now, and we had agreed that this is our best bet for becoming parents. We asked ourselves whether we could really pursue open adoption, and decided that not only could we do it, we didn't want any other kind of adoption. But now that we are on the verge of mailing the big fat check, I'm hesitating.

I want the safety and security of what is known: our current childless life. I'm like a child afraid of the dark. I'm afraid of where this path will lead. I'm afraid of the heartache that adoption, and parenthood, will inevitably bring. I'm afraid of the unknown and the unseen.

I Need the 411 on TEBB

Since my surgery, my cycles end with 2 days of brown bleeding, followed by another two days of black, spotted discharge. I would describe it almost like a scab that's flaking off inside off me. (It's great that there's no such thing as TMI in the infertile world.)

I've read enough bloggers who are using NaPro physicians to know that this could signal something VERY bad that could require 10+ days of intravenous antibiotics. But I also know that such regimens often don't work. 

At this point, I'm pretty much done with TTC. In a few weeks, we leave for our orientation weekend with our adoption agency. My mind is occupied by the homestudy and adoption profile. Once we make the payment to the agency, it really is best if I do not get pregnant. (Not that I can be bothered to avoid pregnancy.) We didn't even try this month because during my fertile time, we were out of town for my sister's wedding, sleeping in my old bedroom with ten other people in the house.

Still, I'm curious about this TEBB:

-Is there any problem with doing nothing? If I do have an infection, is it fine to just let my uterus be infected?

-Why would this have suddenly popped up after my surgery?

-Is there any chance it could be anything other than an infection? What?

-Did you have any other evidence of infection besides the TEBB? (e.g. foul-smelling discharge, etc, abdominal tenderness?)

-Did antibiotics clear up your TEBB? Have you conceived in the time since?

-Are there any non-NaPro physicians (besides Dr. Toth) who buy that TEBB is the result of infection?

-Should I go to my pelvic pain specialist about this? Or would he just laugh at me?

Any and all opinions, experience, anecdotes, and data are most welcome!

Wishful Thinking Freakout, or WTF

You might NOT be pregnant if you experience:

-Sore breasts
-Abdominal cramping
-Spotting
-Nipple twinges
-Frequent urination
-Slight, sudden onset incontinence
-bleeding gums
-queasiness in the mornings
-increased hunger
-a post-ovulation rise in BBT
-heartburn
-Moodiness
-Fatigue
-A late period

These are all symptoms of a condition known as Wishful Thinking Freakout (WTF). Although WTF is rare among the fertile, it occurs all too frequently among the infertile. WTF symptoms flare as the menstrual period approaches and become acute if a menstrual period is late.

 If you are experiencing WTF, do NOT take a home pregnancy test. Do NOT call your doctor.

WTF has no cure, though certain life-style techniques can help manage the symptoms, including copious amounts of chocolate and wine.

Treatment for Infertility: When are the costs too high?

Jen at This is More Personal recently stopped blogging for the best of reasons: in December, she and her husband adopted a baby girl.

Jen's struggles have helped me so much in my own journey. After one round of IVF, which resulted in a chemical pregnancy, and a few canceled cycles, Jen and her husband decided they couldn't take any more. Jen's experience put words to something I had been thinking for a while: IVF has emotional, financial and physical costs that are rarely, or perhaps never, acknowledged by the medical profession. Reading through Jen's narratives of her IVF journey made me clearly see that IVF would break me. The stress of spending $15K on a twenty percent chance of getting pregnant, the mood swings that come with high doses of hormones (for whatever reason, I'm extremely sensitive to all medications), the anxiety of being constantly poked and prodded.....I knew I could not do that. The emotional, financial and physical costs of IVF would be too high for me.

(This actually had very little to do with most religious arguments against IVF. I'm not convinced that the unitive and procreative purposes of marriage should never be separated. As for the destruction of precious embryos....what was my body was doing with my embryos every month for a solid year? I was unlikely to produce dozens of eggs, and a couple embryos would probably have been safer in the hands of a competent embryologist than in my inflamed womb.) 

So instead, I turned to alternative therapies. I had always had a healthy diet, but for a solid year, I eliminated alcohol, sugar, refined grains, fried foods, and caffeine. I ditched exercise that I loved, like swimming and intense yoga and instead stuck to the brutally boring Fertility Yoga. I took my temperatures every single morning, stressing out when I ovulated a few days early, because of course, women with DOR "always" ovulate early (except when we are completely asymptomatic). I meditated, I prayed. I structured my days around what supplements I needed to take and when. My entire life became about trying to get pregnant.

It didn't work. Eventually, I realized that these alternative therapies also have high costs. When you give up activities and things that used to give you pleasure in order to get pregnant, and you don't get pregnant, month after devastating month, you begin to lose your soul. Eventually, I realized that I could not continue to live that way; even if I did eventually get pregnant, didn't my child deserve better than the person I had become: jealous, bitter, joyless?

So, I've stopped. I need to update my supplements page, because beyond a few vitamins for basic health, I've stopped taking them. I still do Fertility Yoga, but I also swim and go to Ashtanga Yoga once a week (even in the luteal phase). I'm still staying away from fried foods, because they really do make me feel sick, but if I feel no immediate benefit to eliminating a certain food, I just go ahead and eat it (in moderation).

More joy in my life makes it easier to face infertility, and the fact that I might never get pregnant. Because really, nothing--not even motherhood is worth my soul.

CD 1: Procedures and Policies

This is the last time I will announce CD 1.

Why? This is an infertility blog. The odds that I am not pregnant on any given month are far higher than the odds of a pregnancy. In my continuing quest to manage expectations, I'm going to expect my period fourteen days after ovulation.

To help me cope with CD 1, each month, I am going to do one small adoption-related task. This is jumping the gun a little bit. We want to see whether I'm still really infertile post-surgery, plus DH needs a job before we can actually apply to an agency. But adoption-related tasks and decisions will help me feel less desperate when my period arrives again. So for those of you playing along at home: until June, adoption-related updates will signify that another cycle has come and gone.

DH was turned down for a job last week, which was a bitter disappointment, right when my PMS was at its worst. But I started feeling better on Monday, when my period started in full force. Tuesday, I called Adoption Agency #1 with a list of prepared questions, mostly cribbed from Stirrup Queens. Actually, before I called, I had a full-on panic attack. I was convinced that the Agency would be quick to tell me that there was no way in hell any birthmother would choose us to be parents. I expected a long list of questions about our ages (too old, especially DH), our home (rented apartment), finances (lots of medical debt) and mental health (touch and go, most days).

But instead, there was lots of good news. Agency #1 adopts mostly Latino and African-American infants. They place about 25 children a year and have 15-20 families on the waiting list at any given time. The average wait is 6-12 months for 95% of their couples. The five percent of couples who wait longer usually have strict criteria for the birthmothers and potential children. (The agency led me to believe that these are the couples who only want white children who've been protected from any potential harmful substance their entire stay in utero. That's definitely not us.) So....6-12 month wait! That's crazy fast.

The money aspect looks like it will work out for us as well. For our recent wedding, we put the word out that we are saving money to grow our family through adoption and our friends and family were most generous. Plus, I get a generous adoption benefit through work. And the Adoption Tax Credit means that as long as we have the money saved up in advance, we probably will not bankrupt ourselves adopting.

[I would like to take a moment now to reflect on the fact that my (former) RE said that it was a "shame" that I wasn't willing to try IVF because my chances of success were a good 20% per cycle. At a cost of $11-15K per cycle. In what society is it reasonable to pay more than $30K for a chance to parent your genetic offspring?]

So for now, I'm not focused on CD 1, but the fact one day in the not-too-distant-future, DH and I will be parents.

Infertility Vacation

I have had a lovely three months. No TTC, no charting, no obsessing during the 2WW.  After a year of thinking of myself as "the infertile one," I once again learned to see myself as a human being. Part of this was a tiny bit of self-delusion. I could almost tell myself that instead of being the couple without children, that we were the couple without children--yet.

But still, it was really good for me to have this time away from TTC. For one thing, after about a year of struggling with very low libido, my sex drive came back in full force after the surgery. I don't know whether this was because my body changed after the surgery, or because there was no pressure to have sex at a certain time on a certain day. Or maybe it was because we hadn't had sex in months by the time DH came home after working away, so I was just starving.

It was so wonderful to have sex just because we wanted to have sex and to reconnect with the idea that sex is pleasurable! and fun! Who would have thought? 

Another positive change was that now that for the first time in about a year, I'm enjoying my work again. Despite the constant drama at work, I really do enjoy what I do and I feel like I make a contribution to my field. 

The most positive thing is that overall, I have learned to love my life as it is. I enjoy good food, a loving husband, making music, my career, working out (I have so much more energy now that I'm not fighting iron deficiency all the time!), pets, church and prayer. I almost don't have time to enjoy everything. While I would like to be a mother and to grow our family, I no longer feel so desperate to have a child. I'm sure the dark times will come again, but for now, I am at peace.

A while ago, I read on a blog that "Infertility should be thought of as a terminal illness. Instead of destroying your body, infertility destroys your spirit." The blog has long vanished from the interwebs, so I don't know what became of the 29-year old whose ovaries had suddenly, inexplicably, and inexorably shut down. 

My advice is as follows: Don't let it. Don't let infertility destroy your spirit, steal your identity, and define your life. I was perilously close to spiritual death by infertility when stepping away from TTC saved me. 

Do what you have to do: adopt, commit to living child-free, focus on your career, hobbies, exercise. Whatever it is you have to do, do it. Just don't let infertility steal your soul. 

Recovery Update

Turns out that I did have diaper rash--but when you're an adult, they call it a yeast infection. I've just begun a course of Diflucan and should be feeling better soon.

I'm still tired and high on painkillers most of the time, but every day, I walk a little farther, I take fewer painkillers, and I'm conscious for a greater part of the day. This is progress, frustratingly slow though it may be.

DH left my parents' house this morning and I have been feeling emotionally vulnerable and weepy ever since he left. Though he had a bad cold, we have a lovely Thanksgiving, just the four of us. I also love seeing how my parents love my husband. I know that they loved him before, but after my sojourn in the hospital, something has changed with his relationship to my family and to my parents. He is one of us in a new way.

My mom and I are flying back to my city on Tuesday. I'm not ready to go back to work a week from Monday, so I will call Dr. S's office tomorrow to see about getting another week off work. I'm trying not to feel like I'm malingering, but every time I think about going back to work in a week, I burst into tears.

Oh, I'm not sure I mentioned this before, but DH and I are benched from TTC for the next three months. My uterus needs time to heal before it could sustain a pregnancy. In a way I'm relieved to have the time for DH and I to focus on our relationship and sex lives without the stress for TTC.

And suddenly all is new

I wrote my last post from the depths of despair. Of all the deadly sins, despair, the enemy of hope seems to be the one that gets me every time. But there have been some big changes that give me reason to hope.

Number one is that DH got a job! It is a temporary job, to be sure, and one that takes him far from me, but one that will hopefully set him up for a permanent job closer to home in the future. And it will provide us with the money we need for....

Number two. I spent the summer coming to the realization that the amount of pain and anxiety I experience with every menstrual cycle is untenable. The despair of CD1 is one thing. The despair of CD1 combined with excruciating pain and vomiting is seriously enough to drive me to self-harm every single month. This situation cannot continue. My pelvic pain specialist in my city is, unfortunately best friends with my RE. After consulting with her (with my consent), he is under the impression that I cannot get pregnant without IVF, and that if I don't want to do that, I might as well have the adenomyoma excised. He has only removed such masses for women who were done with childbearing.

Not inclined to put my fertility in the hands of someone who thinks that I will never get pregnant, I sought a second opinion with a very famous surgeon who specializes in endometriosis. Dr. S has done this surgery hundreds of times, for women who have gone on to have children. The surgery is expensive, but now that DH has a job, we can afford it. I am scheduled for November, which means I will only have one! more! period! before surgery.

Dr. S will remove the adenomyoma, reconstruct my uterus, and remove any additional endo that he finds in my pelvic cavity. I am terrified, but others have been through worse and survived, right?

Dark Night of the Soul

The day the nurse called to tell me that my FSH was high was among the darkest days of my life. I cried for weeks. But through that time, I had the most remarkable feeling of being loved through my grief. I felt the love of God, and the love of my dear husband, who unequivocally stated over and over again that even if we could never have biological children, he wouldn't want to be married to any other woman. I remember sitting in my favorite place at work, grading papers on a Saturday afternoon and just feeling flooded with love.

Masters of spirituality such as John of the Cross and Theresa of Avila call that experience of God's closeness and love consolation. The feeling of God's absence or silence is called desolation, or the dark night of the soul. Consolation and desolation happen independently of your emotional state, or of what is happening in your life. My period of consolation coincided with one of the saddest periods of my life. 

At the moment, I am in a period of desolation. Unfortunately, this desolation is coinciding with DH losing his job, my waning faith that I will ever get pregnant and, at the moment, horrible PMS and the knowledge that I am not pregnant.

I am finally ready to try Natural Cycle IVF but we do not have the money. We are not paying down debts; we are not saving money for adoption. DH has been looking for jobs, but every lead has come up empty. 

In truth, he lost his job months ago, but I was sick of thinking and writing about infertility. I just couldn't write about having to come up with a new plan all over again. And every plan requires thousands of dollars that we don't have. 

Above all, I am tired. I am tired of being positive, of swimming against the temptation to despair and depression. I am tired of the never-ending roller coaster of hope and disappointment. 

Every month, I think, "Perhaps things will change this month. Maybe we'll finally conceive. Maybe DH will get a job this month." And each month, nothing changes. We do not conceive. DH does not find a job. 

Nothing ever changes.

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?

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.

Adoption:
        -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.

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.

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.

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.