Are We There Yet? (Part 2)

Towards the end of September 2006 I got back to VA and started to work. I contacted my insurance, found out that they would cover 50% of the costs and got all the authorization numbers etc. One of my friends had mentioned that she had used In Vitro Fertilization to get pregnant with her little boy. I called her and asked her who she used. I was so happy to know that she had used the same practice that had been recommended by my ob/gyn. If you are thinking about going to a fertility specialist (also known as a Reproductive Endocrinologist) make sure you ask around and find one that comes well recommended. It makes a huge difference. I didn't know at the time how well I was going to get to know the people in the office, and how often I would be going there over the next year.

After speaking with my friend I called and made an appointment with the specialist. The first appointment is just with the doctor. Sort of a "get to know you" and figure out what to do. They had sent us a ton of paperwork that we were supposed to fill out about us and our histories, and then bring in with us. When we went in to speak with him I took all of my charts too. They were wrinkly and not always the neatest. (Some I had even recopied they were so messy. But they were done very early in the morning.) At first he was a little amused by my charts. He didn't say so, but I could just tell. I talked to him about my concerns about my luteal phase and clarified a little about M's history. He did eventually really look at my charts, and I think he was able to eliminate some tests because of them. He ordered the tests that he wanted done, and then sent us to another room to meet with our nurse. At Shady Grove Fertility (the group we went to) every couple is assigned a nurse. She is the one that you call with questions, concerns, etc. She calls you with test results, and explains all of the protocols and things that you need to be doing. Ours was a tiny and spunky forty something woman named Shirley. I REALLY grew to love her. At first you don't realize how much you will rely on your nurse. You think "how many questions can I possibly have?" and then you start the process and realize how naive you were. I called her a lot, and she never ever made me feel like I was a nuisance. Not once! I even talked to her in Costa Rica when I had questions that needed to be answered. She explained a few things, told us about the tests, when to make appointments, etc. Only one test is for the males. They take a sample of sperm and look at it for the shape, the number of sperm, and how well they move. All the rest of the tests are for the woman. Most of the tests are also very day specific. You have to have the tests on a certain day of your cycle. After receiving all the instructions we then were ready to leave the office. Our last task of the initial consultation was to schedule the test for M's "sample". Being from such a strongly religious background it was a little intimidating for us, but we were happily surprised to find out that there are special condoms for those that want to use them. When we asked the receptionist for one, she was so flustered and started searching and looking for the "doo-hickey" (her exact words). We left the office laughing. We would have thought the receptionist would have been a little smoother, but overall it was a good experience.

The next month was filled with tests. Lots of tests. They took tons of blood work, they tested M, and they did a bunch of tests on me with ultrasound and other things. I started to get a hint that there might be a bigger problem than I thought as I would get a few of the numbers back on my blood work tests. But we still didn't really know anything. After all the tests were done we then scheduled our follow-up with the doctor. I was very proactive at scheduling everything because I was so anxious to get going. All of this took a little over a month. The next time we saw the doctor he had our results. I was still pretty sure he was just going to suggest I take clomid, or some progesterone and we would be good to go. As we sat down he went through the all of the tests results one by one and really broke everything down for us. Turns out that I had not one but two problems! I was a little floored, then to complicate things further it turns out that M also had an issue. He talked to us about our options. We could try doing an Intra Uterine Insemination (IUI). Which is a long way of saying artificial insemination. They would stimulate my ovaries to make more than one egg, then take a sample from M and using a catheter inject it past the cervix, making it easier for the sperm to connect hopefully with an egg. The doctor told us that we had a 5-10% chance of that working for us. He then told us about IVF. He said that in that procedure they would again stimulate my ovaries to make A LOT of eggs (many more than in an IUI) and then they would extract the eggs from my body, and then they would inject one sperm into each egg to help them fertilize. The embryos would be allowed to grow and then they would transfer no more than two into my body after a certain amount of days and hope that they would implant and start growing. The doctor told us that we would have about a 40% chance of that working in our case. M and I just kept looking at each other still in shock. We didn't expect for there to be so many problems, and to be told that even with a lot of medical help we only had about a five percent chance of it working. Somehow we mumbled and stumbled our way through the next process, we decided to start with the IUI. Even though the chances of success were much lower, it would be much less invasive and cheaper. (I found out later our insurance required us to start with the IUI anyway.) We talked to our nurse about what to do next, and then we walked to our car. In the elevator we both started laughing. It was that nervous kind of laugh that happens when you don't know what else to do and just are shocked! We were shocked. We joked that fair is fair and at least we both had a problem. I was really surprised to learn that one of my problems was endometriosis. Endometriosis can be a really hard thing to diagnose. I was an easy case because of a very specific type of cyst that they found called an endometrioma. I have none of the symptoms that normally come with the condition. (That's a good thing in my book.) I was also surprised because my doctor told me that it is normal for women to be diagnosed with endometriosis even older than I was at the time. Who knew?

While we were waiting for all the appropriate timing to start the first IUI we did several things. We took an injection class that taught us how to give me subcutaneous and intramuscular injections. We both can now give shots to anyone if you need it. We also gathered all the meds and made sure that our insurance stuff was in order. And then we were ready to start. We did our first IUI in December of 2007. The first time that M gave me a shot it was so hilarious. First of all you are dealing with VERY expensive medications. We had to be so careful on dosing and sometimes when you are trying to get an air bubble out you would inadvertently squirt out some of the medication, and think "there went $40 onto the table." M was very nice to give me the shot. We were both so nervous about the first shot that we both had an incurable case of the giggles. Laughing doesn't really help your hand be steady, so it took us a long time to calm down enough for M to actually inject me with the medicine. Doing fertility treatments changes your life. All of a sudden we had a fridge full of medicine, extra needles, and sharps containers. We traveled with the medicine and had to make sure that we were giving the medicine within a certain time frame. We went home for Christmas to San Diego. Normally I would have a blood test to determine if I was pregnant, but since I was gone they told me just to take a home pregnancy test. I took one. It was negative, but since I had gotten it at the dollar store I didn't trust it, so I bought another one. I took it the next day and it was negative too. Even though I didn't really expect it to work on the first time, it was still a blow. It always was.

That is thing that surprised me. Every month we tried, with or without medical help I have thought I was pregnant. I realized I wasn't, I didn't feel pregnant, and yet at the first sign of being a little bit late I would take a pregnancy test. I took a lot of pregnancy tests during those years. I started buying them at the dollar store because they are expensive. And yes, they are just as accurate. Over the next seven or eight months we would try two more rounds of IUI. Each time the nurse would call me and say "I'm sorry you're not pregnant." During this time we had to get rid of all our shame. Everyone who has done this process has stories that would make others blush. I have stories that I can't tell anyone because they make me blush! We got used to most of the embarrassing things. We thought it would be such a fast process once we had medical help. We learned to be patient. The drugs would make me produce cysts, and so some months we would be ready to go, but my body would need a break. Then M might have a long business trip during crucial times, etc. It was a humbling time for us. Not many people knew when things were happening for us. Not even my siblings. Our parents knew, and as the process started going along I would tell more people about the exact timing. It just helped to have people know. Then when I was sad, I could be sad. I didn't have to pretend. And there were days that I was sad. I was sad for a lot of things. I have decided that mostly I was sad because I was realizing that I would not have as many children as we had hoped for. Some women deal with that realization easily. I had a bit of a hard time with it. All our friends were on their third babies, and we were still waiting for the second. There were a few things that helped me. One was B-man. He has such a personality and presence that I couldn't mope around the house. I had a child, I had experienced pregnancy. I had already been lucky in ways that some women can only dream of. We realized also during this process how lucky we were to have B-man. I think God sent him to us so fast because he knew what was coming. I was surprised at how I was more sad about the miscarriage during this process than when it actually happened. At the time I didn't realize how lucky I was to have gotten pregnant on my own. Being knowledgeable about our fertility issues made me feel like a little miracle had been stolen from us. I eventually came to peace with it. Sometimes bad things happen. No one is immune to them, and sometimes there is no explanation. It was just one of those things. After the third try I was pretty sad. I knew that most likely we would have to move on to IVF. We knew the success rate was much higher, and our doctor was very hopeful for us. As he put it, I was young, and despite all my problems (and there were a lot) I still had age in my factor, and that was the BIGGEST factor there was. But it was in no way a guarantee. It cost about ten times more than the IUI and was a much more intense and painful process. I was very realistic by this point in the process.

During the short time of preparing for IVF we decided that we would also start pursuing adoption. We wanted to add to our family, and we didn't care how that happened. There were a lot of questions about my fertility that would be answered when doing IVF. They get a much better idea of egg quality when they harvest them. I had such fantastic results during the IUI procedure that the doctor didn't think it was worth trying more IUIs. If it was going to work, it should have worked already. We announced to everyone that we were looking to adopt, another very humbling experience. But I was amazed and excited at the information that we got from people. We had already decided to try IVF. We decided that we would try it once. If it didn't work we would hurry and get our papers together as fast as we could. This was happening in August of 2008, and we thought if we really hurried we might be able to get our adoption papers ready by the end of the year. Then we would re-evaluate and decide what we wanted to do. We filled out all the necessary paperwork for IVF, (it is a mountain of papers and releases and full of ethical dilemmas for people who don't believe in abortion) and brushed up on our injection skills, paid a lot of money, and waited to start.