How do you know?

How do you know your family is complete? How did you decide? Did you always know? Did you just stop? Were you forced to stop by circumstance, or forced to accept more than you expected?

What’s it like for families who don’t have the spectres of infertility and loss lurking in the shadows of their hearts? How different would all this be if we hadn’t struggled so hard to earn the two precious boys we have?

In one minute, I’m perfectly content to stop. Two beautiful boys is a lifetime of blessings. And then the pendulum swings, and with entirely the same amount of conviction, I know that we’ll have another child. Know it in my bones. It’s a truth, a certainty. That lasts about an hour, and then I don’t know again.

When I look at Tristan and Simon and how truly wonderful they are, I can’t help but think that having another child – boy or girl – would be more of the same, therefore wonderful. How can I say no to the idea of more of the most amazing thing that ever happened to me?

And then the fear kicks in. The fear of pain, the fear of loss, but mostly the fear of really fucking things up. It’s not the idea of the third child that scares me. It’s the risk. The what-ifs.

What if we decide to try, we commit to the idea of that third child, and then we can’t conceive? How long do we try? How do we decide to stop trying? Can I face month after month of not conceiving – again? Can Beloved?

And if we can get past the fear of trying (and let me tell you, even after Tristan and Simon, the struggle with infertility has left deep and painful scars on my heart. Mine, and Beloved’s too)… even if we get past the fear of trying, there are so very many things that can go wrong.

If we are lucky enough to conceive again, I’m now 37 years old and officially of advanced maternal age – and with a history of infertility and miscarriage. Can I deal with nine months of paranoia? What if I have another miscarriage? What if I don’t have another miscarriage, but something is wrong with the baby and we have to face a horrible decision? What if the baby is born, but that baby has needs beyond our ability to cope? Do I even have the right to risk my family’s collective future simply because I selfishly want that which was denied to me?

And these are beyond the more pedestrian worries of whether the boys will be content with another sibling, whether Simon be okay as a middle child, whether I’ll have enough time and energy for a whole other person in the family, how we’ll cope with the logistics of five in a world that favours families of four. All these things seem trivial now, but just six weeks ago seemed like epic problems.

I need closure, trite as that expression may be. I need to know that I can give away my maternity clothes, get rid of the crib, and pack up the baby gear for good. I need to be able to pick out a few favourite things that I’ll keep for sentimental sake, and get rid of the rest of it. I have boxes on boxes of baby and toddler clothes, toys, bottles and spoons and bowls, a baby tub and a cradle and a playpen. I have baby gates and booster seats, stacks of bibs and blankets and towels, and shoes in every size. I have three strollers and three car seats and a beautiful pine crib – and I just to know whether I’ll ever need them again.

That’s a lot of clutter in my house, but mostly it’s a lot of clutter in my heart. I need to know. I can’t just let the idea of my next child drift away like the sunlight fades out of a summer day, dragging on for months or years. I don’t want to feel this sad yearning uncertainty forever. I need to know.

Saying goodbye to frostie

I’ve always believed in a greater order to the universe, if not in an actual higher power. Not exactly fate, because I believe we do control our own destinies. But I strongly believe that everything happens for a reason.

That makes it only marginally easier to say goodbye to frostie. No need to pee on a stick this morning, because nature informed me in her own bloody way last night that the cycle didn’t work, that toastie never did become stickie, and that I’m not pregnant.

I think the strangest, saddest part of the whole thing is saying goodbye to the idea of frostie. For five years, as long as we’ve had Tristan in my life, we’ve also had frostie. Frostie was like an empty chair at the table, a place-holder for the child that might someday be. It was our back-up plan, our big ‘what-if”. It was also the twin of Tristan. For five years, we paid a couple hundred dollars to keep it in frozen slumber, and it seems incredibly sad to me to go through all the effort of re-energizing it, only to have the cycle fail.

But everything happens for a reason, right?

You only had to read a post or two in the past couple of months to know I was occasionally ambivalent about the idea of having three kids. And yet, typically, now that I’ve been told I can’t have something I want it more than ever. I’m such a Leo.

And heck, Simon taught us that we don’t need a lab and a dozen specialists and a couple thousand dollars to make a baby. There’s an easier, much more fun and FREE way to go about it, and you know how I feel about free. I love free.

So yes, today we are sad to say goodbye to frostie. To have a dream end this way is always sad, but we are so very blessed in so many ways. I never, ever want to be that person who reaches past what she has trying to grasp what she wants. Never.

So long, frostie. I’m sorry it didn’t work out for us.

I have no idea what to call this post

I’ve spent a lot of this past week and a half pretty much obsessed with my breasts. They’ve always been the canary in the coal mine, my first indicator of pregnancy. As such, I must have groped myself several thousand times since frostie became toastie. There are entire freshman classes at large universities who have experienced less groping that I have groped my own breasts this week.

Despite the fact that they should have been bruised from all the groping, my breasts were sending some pretty strong ‘not pregnant’ unsignals up until Sunday afternoon.

Here’s a nickle’s worth of free advice for you. In the middle of the two week wait, during a fertility treatment cycle, do NOT randomly choose to wear a bra that you haven’t worn in three months. You will be driven to the brink of insanity trying to figure out if the change in the consistency of your breasts is due to the hormone fluctuations of early pregnancy, or a too-small cup size of an ill-fitting bra.

So I broke down Monday morning and peed on a stick. And despite my best efforts to conjure a second line out of the urine-soaked ether, it was quite obviously negative. I peered at it until I was cross-eyed, looking at it flat on, at an angle, and under four kinds of light – the only thing I lacked was a black light – before finally accepting the fact that the second line was simply not going to appear.

I threw it in the garbage, crawled back into bed (did I mention this was all at 4:30 in the morning?) then stumbled back to the bathroom and checked it yet again. Still negative. I laid it carefully on the bathroom counter, remembering tales of seemingly-negative tests left to ferment on the counter for hours that magically materialized as positive later in the day. But it didn’t.

But I was still feeling pretty hopeful, because Day 11 of a cycle is still on the early side. And when you’re an infernal optimist, you don’t give up that easily. Besides, my breasts remained convinced I was pregnant, and who can argue with a breast?

So I peed on a stick in the wee hours of this morning, too. No big finish here – it was negative, too. And while it’s only 24 hours later, this one has the weight of finality for me. This is the one that made a few tears of regret slide down my cheeks, because now I believe it. I think it’s done.

I’ll still pee on my remaining sticks, at least until tomorrow, but no matter how hard I try, I can’t will even the faintest hint of a positive out of those evil pee sticks, and it seems to have been enough to convince my breasts that they’re not pregnant, either.

Don’t console me now, because I’m still holding out until the blood test on Friday. Hey, you never know. But if you want to post a comment, wish me a happy birthday instead. Thirty seven years ago today, I started out on this crazy trip, despite my best efforts to the contrary. (I was late, and breech, and they had to come in and get me. Stubborn from the day I was born.) I love birthdays, and don’t know why people don’t like to celebrate them. Today of all days is my day, and that’s worth celebrating.

The emotional gamut that is the two-week wait

It’s been a week since frostie became toastie – or, as Beloved has christened it, “Stickie”. We’re half way to resolution and I’m finding the wait much harder than I expected.

I know, I’m not exactly famous for my patience in the first place, but I kind of figured that I would have less emotional investment this time around. I mean, either outcome is wonderful – on one hand, we have a gorgeous family with just the four of us. On the other hand, we have a gorgeous family that is 25 per cent more – therefore 25 per cent more gorgeous – than before. I can’t lose.

And yet, I have spent a lot of time fretting. And flying. And fretting. And flying. Lather, rinse, repeat.

I’m developing a theory on the two-week wait, because I’ve had a little bit too much time in my head to think about it. The two-week wait allows you to experience every single possible emotion on the spectrum, from elation to desolation, just to prepare you for any possible eventuality when you take that pregnancy test.

I started out pretty confident that Frostie>Toastie>Stickie had implanted, and I was pregnant. I had nothing to base it on but my own instincts, which have been pretty good about predicting actual pregnancies, but not so good at predicting gender. (I was gobsmacked to find out my babies were boys both times – I had been sure they were each a girl when I was pregnant.) I spent most of the weekend blissfully imagining how the next nine months might pass with me pregnant, and passed idle time considering how we’d arrange Tristan’s room into a shared room for the boys, and checked out other people’s mini-vans every time we drove somewhere.

I’ve slowly slid down the confidence scale to the point where I’m now fairly sure that it didn’t work. Why? Because I’ve spent WAY too much time in my head, that’s why. I don’t feel any pregnancy symptoms yet, although the deeply repressed logical part of my brain keeps insisting that at a full week before my period is due, there simply aren’t any symptoms to be felt.

Every couple of hours, I’ll have a random surge of confidence, and the gyroscope in my brain will announce it worked and I am pregnant. The alignment of dust motes in Namibia will cause a ripple in the Force a few hours later, and my emotional barometer will plummet, convincing me that the cycle has failed and menstruation is imminent.

It’s all becoming rather tiresome, to be honest.

At least it’s not as bad as the two-week wait with the IVF that resulted in Tristan. I had a toxic reaction to the estradiol level in my blood from the follicle stimulating hormones, and developed Ovarian Hyperstimulation Syndrome, a potentially serious condition that causes fluid to gather in your ovaries. Pregnancy excerbates the condition, and when my OHSS symptoms started to abate about five days after we transferred two embryos, I was so sure that the cycle failed I cried for days – including a rather embarrassing breakdown at the clinic when they told me my OHSS had cleared up enough that I didn’t need to come in for daily monitoring any more. In my hormone-addled brain, no OHSS = no pregnancy.

That was around six days after transfer, pretty close to where I am now. And then, three days after that at nine days post transfer, I started to feel sick and bloated, and when late in the day I started having trouble drawing a breath, I called the doctor on call to check in. He ordered me to the ER and to make a long story short, we found out that night that I was pregnant. (We found out two weeks later it was twins, and lost one of the twins two weeks after that. The whole story is here, if you haven’t read it yet.)

And all that means pretty much nothing. I just have to wait. And wait. And wait. Did I mention I’m not so good with the waiting?

I’m thinking of buying some bulk home pregnancy tests from the Extraordinary Baby Shoppe – they’re only four for five dollars, plus the freebie from my great OPK adventure. I could start testing on Monday, but I’m just not sure if I could handle a full week of negative HPTs. I saw enough negatives in our years of infertility, thank you.

But hey, was that a twinge in my left breast? Maybe it’s a little tender? Or, maybe not. Maybe it’s tender because I keep groping it, trying to see if it’s tender.

Argh. I really hate waiting.

Baby pictures!

So I didn’t get the artistic blog photo I wanted, but I can at least share this picture of the transfer. You’re looking at an ultrasound of my interior plumbing – isn’t it exciting? The big dark ‘sea’ at the top of the picture is my very, very full bladder, and the bottom half shows my uterus, with the cervix on the far right. You can see the catheter in the centre, and three or four bright white spots that are the fertility goo that surrounded the embryo in the catheter. (Ya, I know, what it really looks like a big grey smudge. But humour me… )

I had asked Beloved to scan the ultrasound picture for me the night of the transfer, but the editorial comments were an unexpected addition.

"Your mucous is lovely!"

It’s not every day you get a compliment like, “Your mucous is lovely” but being the affirmation-junkie that I am, I’ll take it!

That’s what one of the two (two!) reproductive endocrinologists (RE) who helped turn frostie into a toastie yesterday told me. He also said I have an ideal uterus, and I’m filing that one away for a day when my self-image is feeling particularly low. “Yah, I may be pudgy and dull today, but at least I have an ideal uterus and lovely mucous.”

So yes, everything went extremely well yesterday, and frostie is now officially a toastie, snug in my womb. He/she came out of the five-year deep-freeze extremely well. They look for an embryo to be six to eight cells, and this one was seven cells – bang on average. And they grade them in quality on a scale of one to five, five being the best quality – but, the nurse assured me, they almost never see a grade four or five quality- and frostie was a grade three plus. I am absurdly proud of this, as if I had anything to do with it. I’m as proud as when Tristan passed his first year of swimming lessons, which again, had basically nothing to do with me.

Jojo, I did ask about the placement of the embryo in the uterus (that, and about a hundred other questions – it was like Curious George goes to the Fertility Clinic) and one of the REs said that yes, there is in fact an ideal place, high up in the uterus. A few minutes later, the nurses, REs and lab technicians clustered around the ultrasound monitor gasped appreciatively, in much the same way you ooh and aah over a particularly vivid fireworks display, when the RE skillfully launched the embryo and a small amount of fertility goo into exactly the place the RE had just indicated on the monitor. One of the nurses later said that the fertility goo drifted placidly out of the catheter in the most ideal way, and again I was absurdly proud.

The whole procedure only took 15 or 20 minutes, and then I was free to empty my way, way, WAY overfull bladder. Oh yes, and the RE also complimented me on my bladder capacity. He said, “You must be great on a road trip.” Why is it that I attract comedians wherever I go? (Cool aside – you know why they want you to have a full bladder? Because it presses on the normally curved uterus, making it straighten out and providing a much more direct path for the catheter. The RE said they have a statistically improved success rate with a full bladder during transfer. I am endlessly fascinated by this stuff.) I had already gone three times in the half hour leading up to the procedure to let off a bit of pressure, and by the time they had launched toastie out of the catheter and then sent the catheter back to the embryologist to verify that it was empty, I was just about cross-eyed with the need to relieve myself. And let me tell you, no amount of kegels will prepare you for the exercise of trying to empty your bursting-to-capacity bladder as quickly and efficiently as possible while simultaneously contracting your cervix snuggly and tightly closed around a microscopic embryo.

Like a good blogger, I had wanted to bring my camera into the clinic with me. I had visions of a particularly amusing photo taken from my perspective on the table, looking down past my stirruped legs to the accumulated medical personnel at the business end of my anatomy, but the nurse and Beloved disabused me of the idea.

The good news is – I have pictures! The bad news is, Blogger won’t let me post them. I’ll try to put them up later. Evil, wicked Blogger – how you vex me!

The rest of the day was entirely uneventful, in a mildly hedonistic sort of way. We went to the movie (just average, but I’d happily fork over $10 to watch Johnny Depp read from the telephone directory, so it was a pleasant afternoon) and by coincidence of timing, I had a previously scheduled appointment to get my hair cut yesterday, too. The only thing I lacked was a massage, or maybe a pedicure, to make it the perfect “all about me” day.

But of course, it isn’t entirely all about me. For those of you wondering how Beloved is faring through all of this, I have to tell you I’ve been a little concerned about that myself. He has a few more reservations than me about the whole ‘third child’ thing, and he didn’t seem nearly as invested in the whole idea of frostie as I was – but then, that seems par for the course in many male-female relationships in these types of circumstances. I think it takes a little longer for guys to be able to give themselves over to hope, and a little bit longer for them to internalize a pregnancy, or even a potential pregnancy, as a reality.

Any concerns I might have had about his reaction evaporated last night when he performed what I can only describe as an impromptu interpretive dance of the embryo gaining cells and implanting in the uterine wall. Oh, how I wished I had a camera nearby, because it was a thing of beauty!

It’s all good. It’s all very, very good! And now, I think I’ll consider myself pregnant until I find out otherwise. (You should see the grin on my face!) My blood test is two weeks today, on August 4.

*glances at watch*
*taps watch face*
*glances away*
*looks at watch again*

It’s gonna be a long two weeks!

3.. 2.. 1.. GO!

Oh look, it’s yet another post in the ongoing saga of “oh for the love of god, will you either get pregnant or shut up about it already”.

Well, we’re almost there. And when I say”we” I mean “we” as in all of us, because I’m really enjoying having a couple hundred of you along for the ride. I like knowing that a lot of you have been there (and been there, and been there) but I also hope that this has been an informative little peek into the world of infertility for some of you.

And now, on with the show, because tomorrow’s the big day! After an epic amount of waffling and no small amount of coaxing from my colleagues, I finally decided to take the whole day off. We have to show up at the clinic for 10:30, and I have to have a ‘very full’ bladder. The nurse suggested I drink a litre or more of water starting around 10:00. (Do you think a litre of Tim’s coffee would be an acceptable subsitute?)

Around the time we show up at the clinic, we’ll know whether frostie has survived the thaw, about an 80 per cent probability. The actual procedure will be at 11:30. (Are you squirming at thinking of sitting on a ‘very full’ bladder in a waiting room for an hour? Because I sure am.) I think they encourage me to have a little rest for another 20 minutes or so after the transfer – and who am I to say no to the rare opportunity for a daytime nap? – and then we should be out of there by 12:30 at the latest. We arranged for the caregiver to take the boys on Thursday instead of Wednesday this week, so Beloved will be there for the whole thing, and then we’re going out to an afternoon matinee after that.

The only decision that remains is whether to see Pirates of the Carribean, Superman, or You, Me and Dupree. I’m leaning toward a little Johnny Depp action, if only I can claim later in life that he had some impact on my fertility and reproductive capability.

Don’t you love it when a plan comes together despite a complete absence of planning on your part? Yet another sign from the universe that we’re on the right track!

I wish I had something more coherent for you today. I don’t even have a cute anecdote from the boys to apologize for this week’s relentlessly self-obsessed drivel. Bear with me, we’re almost done, and soon I will get my head out of my reproductive tract and turn my gaze back to the rest of the world. But, although it’s a tight call, my reproductive tract is still marginally less scary than the rest of the world just now.

I’m floundering for a way to end this that doesn’t seem like I’m fishing for a sea of “good luck!” comments (hey, lookit that – flounder, fishing, sea – and I didn’t even do that on purpose!!) but other than my newly discovered marine theme, I got nothing.

Um, so – how’s life with you these days? Oh wait, here’s another idea – we could play “Infertility Questions”. As in, if you have any questions about infertility treatments or the emotional rollercoaster or any of that stuff, me and my panel of experts will answer them for you. Or, you could tell me about your dog, or your goldfish, or just about anything to distract me from tomorrow.

(And if you think this is bad, you ain’t seen nothing until you’ve seen the new low in neurotic obsession that is the ‘two week wait’. Stay tuned, it’s likely to get ugly.)

Frostie update

I’ve been promising an update for a couple of days, but I’ve been holding off for two reasons. One, I don’t really have anything of substance to report, and two, I wanted to be able to capture some of my thoughts and impressions on being back in the world of the infertile again. Whatever thoughts might have been floating around won’t float close enough for me to capture them in writing, so you’ll have to make due with a bare-bones update.

The ultrasound on Thursday showed that my lining is around 6.5 mm, which I think is right about bang-on average. The nurse to whom I spoke certainly seemed satisfied with it, anyway. (I’d appreciate any comparisons from those of you who have been through FETs before and are as neurotically obsessive about remembering and noting these things as I am!)

As of yesterday morning, I’m paying daily visits to the clinic to have them draw a vial of blood, which they analyze for the surge in luteinizing hormone (LH) that will precede ovulation by about 48 hours. There’s no way of knowing exactly when that will happen, but based on my fairly regular cycles, I expect the surge to occur Monday or Tuesday, with transfer two days after that.

Each morning, I get to the clinic between 7:30 and 8:00, and wait only 10 or 15 minutes for my turn with the phlebotomist. I have small, rolling veins, and getting a blood draw is always a pain in the arm. They’ve resorted to taking it from the back of my hand, which is slightly more uncomfortable but better than having them dig around the inside of my elbow with the needle, which is what they did the first two times. Youch! After four or five hours, the nurse calls me with an update, telling me (so far) simply that I have to show up to do it all over again the next day.

I’m still on the fence about how to go about the transfer itself. Actually, it’s how to accomodate the transfer that I’m waffling about. The wisdom on the subject of the amount of bedrest required after the embryo transfer runs the gamut from “you can leave the clinic on a pogo stick after transfer and not pose any risk to the embryos or implantation” (a favourite saying of the head of my clinic) to a week of absolute bedrest, as advoated by a lot of American clinics.

When we went through the IVF that resulted in Tristan, I took nearly three weeks off work to encompass the last few days of stims, the unexpected coasting, the retrieval and transfer (three days apart) and a few days after. The actual day of the transfer, we left the clinic and went out for lunch on the patio of our favourite restaurant, then went to the video store where I rented three movies and spent the rest of the day lying on the couch. It seemed like enough. Oh, and I ate about three pounds of fresh pineapple, shredding the inside of my mouth in the process.

This time around, I am considering working the morning of the transfer, or going back to work afterward, depending on the time of day of the transfer. I have a hell of a lot of work to get through and two weeks of vacation starting on Friday, and I’d like to get some stuff off my desk. Quite frankly, it would probably be more restfull to sit in my quiet, air-conditioned cube and work at my computer for an afternoon than be at home with the whirling dervishes that are the sunshine of my life. I dunno… I keep waffling about this. I’ll play it by ear, I guess.

I’m not even sure if Beloved will be able to accompany me to the clinic the day of the transfer. There’s no official reason for him to be there – he made his, ahem, contribution to the process five years ago, when the embryos were created. The transfer doesn’t involve any medication for me, so there’s no reason I might need assistance after the transfer. That leaves only the more intangible fact that it would be nice to have him there, but we’d have to arrange for someone to mind the boys, no easy feat on a weekday. Only a few days remain, so I guess we’ll play this one by ear, too.

If I seem a little detached about this whole process, it feels the same from here. If I really stop to think about what we’re doing, my stomach fills with butterflies – but I try my best not to think about it too much. Whatever happens happens, right? If I don’t invest too much up front, there is less to lose – and everything to gain.

Now I have to go do some laundry so I can wash my new skort and take a picture to post so Marla will quit pestering me about it, and I can settle once and for all the debate raging about how far above my knees the hem actually falls…

Ultrasound day

I’ve got nothing to say today, folks. I’ve got an ultrasound appointment at 7:30 this morning, followed by four hours of French class. (Ugh.) And yesterday, which is actually right now because I’m frantically typing this Wednesday night – see how I put myself out for you? – isn’t going to work because I have two boys who have decided sleep is optional and a husband who is out teaching and there’s just no muse to be found anywhere, let alone a few minutes to string some thoughts together. So it’s not so much as I’ve got nothing to say as I’ve got no time to say it.

And it’s a crying shame, because we’ve been having some great conversations this week!

So forgive me for not having something more interesting tposted today. If anything exciting comes out of the ultrasound, I’ll post later, but I think all they will do is check to see if there is a decent-sized follicle that will give then an indication that I’m getting ready to ovulate, and then we’ll start the daily blood tests to check for the LH surge that I used to OPKs to detect last month.

But if you’re desperate for a diversion, have you seen “ask metafilter“? I’ve been flipping through it on and off for a couple of months now, and every time I open the page, I find something that sucks me in. Then again, I have the same problem when I open a dictionary. And sometimes the phone book.

It’s late, my brain stopped working about an hour ago (hell, more like about four hours ago) and for some reason my fingers are still typing… it’s really time to shut this down…

Day one!

Because I know my reproductive workings have you on the edge of your seat, I felt it necessary to broadcast to the entire interweb that it is, in fact, day one of my cycle. The cycle. The cycle that will lead, in approximately two weeks, to my wee Frostie finally coming out of its deep freeze, at which point I think I will begin to refer to it as my little Toastie instead.

Next stop, an ultrasound on July 13. Stay tuned!