Now what

Today we got some news that has left me without direction for the first time since we started down the crazy rabbit hole of trying to conceive. Wisehubby visited Dr. B(alls) and found out that despite his surgical repair three months ago, his count, density, and morphology all stayed the same--bad. His motility rose slightly, but it is still well below normal, as well.

Originally, Dr. B(alls) told us that we could think about IVF six months after the surgery. Today, he recommended nine. NINE! That means that the soonest he recommends trying again based on Wisehubby's recovery is September. That will be almost full year after our first IVF try, two and a half since we started actively trying to conceive, and three and a half years since I went off of birth control pills.

On top of everything else, I don't even know if we could do September. I am a school teacher, and my work schedule is very inflexible. It was incredibly hard and painful to work through my last cycle, both physically and emotionally. I do not know if I want to do it again. Part of psyching myself up for a second, more aggressive, round of treatment was the knowledge that I would be doing it from the comfort of my living room on vacation; I could wallow with my swollen ovaries all day long.

That means that, if we follow the advice of the man who knows best, we may not get a chance to conceive until summer 2013. The thought of that GUTS me.

All of this to say, now what? Where do you go from here?

To bed.

Taxing

Throughout the last year, I knew that we were throwing a lot of money at our fertility issues. Because I was so desperate to make our dreams come true, I didn't stop to see exactly how much it was costing us until it was time to itemize our medical bills for our taxes.

As it turns out, IVF is a very taxing process, in more way than one. Since we did IVF last fall, we spent more than 14.5% of our income on medical bills, after insurance paid out: prescriptions, doctor visits, dentist visits, and lab work. That is over double the amount you need to claim an itemized deduction on your federal taxes. We did just that, plus we itemized our charitable giving and educational expenses (graduate school). We ended up getting a return big enough to pay back the loan we had received from my in-laws last fall to help soften the blow of paying for IVF in cash. I can't wait until it is processed.

The point of this is to say, please, please, if you are reading this, living in the United States, and seeking fertility treatment, be sure to keep bills for all prescriptions and lab work. As for doctor and dentist visits, I found that the easiest course of action was to call each office and ask for them to mail a year end statement to us. That way, we didn't have to sort out the dozens of visits to the male Dr. B, on top of several visits for Wisehubby and I to Dr. P and our dentist, Dr. H, each.

IVF is taxing, but you may get a little bit of relief at tax time if you remember to itemize!

Factor V

I've been joking about having a mutant baby for so long that I had begun to forget the horrible truth behind it all. I dismissed Wisehubby's morphology issues as mutant sperm because I was using humor to hide from the pain. Now, I have only to look at myself to find a *real* mutant.

That's right, I have a Factor V mutation. I didn't know a lot about this today when the male Dr. B delivered the news unceremoniously over the phone, so I once again was left reeling by his news. After reading a bit about it, I have a ton of questions, many of which I will get answered by my primary care physician, Dr. P--thank goodness, she's not a B!

Depending on the severity of it all, I might even have to find myself a hematologist, which is a ripe kind of fun because a dear friend of mine is applying for fellowships in hematology/oncology--his wife calls him Dr. B, but that's his first name.

From what I can tell from Dr. Google, I'll have to take injections of blood thinners throughout any future cycles, as well as throughout any pregnancies. This means that you have to be very closely monitored at all stages of the pregnancy, and many women have induced labor or scheduled c-sections to avoid placenta problems.

I'm just starting to soak all of this in, so this was a pretty dirty post. If you know anything about this stuff, please HELP! I'm a mutant, but I feel so powerless.

An email and a response

A colleague sent an email to our small group of teachers who specialize in the same subject recently that ruined my day:

"Just wanted to let everyone in on my week…

[We] found out that we are pregnant with #3 this week. :)

We had a blood test done on Wednesday because we have NO clue how far along I am, and turns out I am anywhere from 8 to 14 weeks. 

So…we have a sonogram on Monday to find out for sure.  I will keep you all posted.

TGIF.

Best regards,

[Fertile Be-otch]"

Then this today:

"Well, turns out I am 15 weeks along as of today, [our daughter]’s 1st birthday.
The baby has little man parts and we couldn’t/can’t pick our jaws up off the ground.  There is a whole kid in my stomach that I didn’t even know about for the past 15 weeks.  I’m amazed and shocked and really excited. ☺
Just thought you guys would want to know the update!

Best regards,

[Fertile Be-otch]"

I couldn't send the response I wanted, so I settled for nothing. If I was a brave, bridge-burning bitch, here's what I would have said:

NO! I do NOT want to know the update. I do NOT want to hear about how you are so fertile that you could conceive clearly without trying less than a year after giving birth to your second child. In the time that you have been knocked up not once, but twice, my husband and I have suffered through one miscarriage, one failed cycle of IVF, and one testicular surgery. I don't think it is cute or funny or kind for you to share. I want to punch you in the uterus, if you must know. Yup, that's about it.

Best regards,

Wiselady

"Elegy"

"Elegy"
from Want by Rick Barot

In this rain we are moved to anecdotes.
That people float candles out to the river.
That in a field there is the crickets' grief.
It could be colder just now but it isn't.
Though there are the posters' missing faces.
Though a car is upside down, wheel turning.
The day will only want to keep arriving.
We will startle for the clothes by the bed.
For the vein glowing green on the thigh.
The coffee will come black in its cup.
The bread will be made of something clean.
This will not seem enough and it isn't:
The white nouns of the moon, the paper.
The handkerchief pulled from an empty fist.

Wiselady's IVF Tips

Looking back on my IVF cycle, I learned so much about myself and IVF in general were I to do things again, here are some tips that I would follow.

1. Have band aids ready during injections. You never know when you'll get a little blood droplet, and Wisehubby had a better time not staining my waistband or cringing when he could quickly apply a band aid. It didn't really help physically, but it was easier on both of us.
2. Take off at least one day after the retrieval. I only took off the minimum amount of days by doctor's orders, and it was a little bit of a mistake. Retrieval was, to me, the most painful part of the process. Your ovaries still feel so swollen, even after being relieved of your eggs, plus you have cramping because the retrevial involved puncturing of your lady parts with a needle. I was totally distracted by the two week wait, anyway, so I wasn't any good to my students at work.
3. The needle goes straight in with a firm push. Seriously, push a little. Nothing sucked worse than the morning that I accidentally let my Lupron sharp bounce out of my tummy. Who wants to stick themselves twice?
4. Put on your glasses and double check the dosage. Wisehubby administered only half of the dose of progesterone in oil, which is delivered in big, nasty needles into the butt. Ok, so something did suck worse than letting my sharp bounce out. That was a rough morning, because we had to switch needles for drawing down, draw down again, and then stick the other cheek. It was the hardest day to keep from crying.
5. Get a good audio book to listen to while you're waiting. Wisehubby and I listened to Catching Fire, the second book in Suzanne Collin's Hunger Games trilogy, in the car and using headphone splitters. It got our mind off of all of the what-ifs that nag you while you wait, which you do a lot when you're going through an IVF cycle. Day time TV stinks anyway, so it was nice to avoid pretending to be interested in it while we waited after the transfer.
6. Make an IVF box. I had a plastic box dedicated for storing all of my non-refrigerated IVF supplies. I appreciated it after the male Dr. B confirmed our failure; I just put the lid on it and shoved it to the back of my closet. It'll be there for when we try again.
7. Make an IVF bag. I used a pretty insulated lunch sack for storing all of my refrigerated IVF supplies. I could easily grab it, throw in an ice pack, and go if I needed to administer drugs on-the-go. It also looks just like a lunch sack, so it reduced questions. If people saw it while we were out on the town, it just looked like a lunch sack or purse. If house guests looked in our fridge, it didn't stand out. I did tell a lot of people about our IVF, but it didn't mean I wanted them staring at our meds.
8. Wait until you are "all done" to get a log of all procedures and charges. I started off trying to provide substantiation to our FSA for every charge, but it got to be too much. Plus, the male Dr. B's office staff would file everything with insurance and then carry charges over into your next visit. This made individual visit receipts worthless to the FSA. You have a long time to provide substantiation, so I just asked for a complete itemized receipt of all services when I went in for our WTF follow-up appointment. Faxed to the FSA, it seemed to take care of business.

Nothing Left Beneath

It’s been a decade since I first slipped

this mask on,

the day my mother said

goodbye to her child.

You left me,

a broken girl, masked for protection.

I unmasked myself

only in that split second before I fell

asleep, drifting into a void

of feeling.

My mask became a part of me,

the way my friends don’t recognize me

without my eye glasses.

When I said goodbye last year

to my child

whom I’d never met,

I tried to take off the mask.

That’s when I found that there was

nothing left

beneath.