crap

As I was sitting on a plane today, waiting to take off to Charleston for the weekend, my phone rang. I had a feeling when the number popped up as "blocked" that is was the new Dr.'s office.

In fact it was the new Dr. herself.

She didn't sound as enthusiastic with my numbers as I had been. That's because that missing AMH number came in.

0.22

I have no eggs left. The low FSH may indicate that they can get me to respond to meds, but the AMH means they will only get at most, 1 or 2. The chances of those 1 or 2 being healthy eggs? Really, really low.

I knew this was hanging out there. But after several hours, it is finally starting to sink in. adjectives like "barren" keep popping into my head out of nowhere.

From the get go, this was never about a biological child for me. But somehow getting diverted onto the TTC path has made me think more and more about the possibility of a biological child and how amazing that would be. We are a cute family with some really strong genes (my siblings and I and all my nieces and nephews look *exactly* alike). Picturing that has started to play in my mind.

I think it has also been playing in my mind to think of that with the added "as if" I had managed to get married. That happy little family unit, the great combination of our genes. My way of tormenting myself.

Now I'm thinking what that would all be in the context of the truth of my physicality. Barren. Infertile. How that can have additional impact when you are part of a couple. I think of what a failure I would be. Gosh, maybe it was better things worked out the way they did and The One That Got Away got someone who was fertile (even in her 40s). One more dig to that gaping hole in my heart.

Instead I have to fight this and start thinking donor embryos. Start doing research. Start finding a donor. Focus on the positive and what can be, and not what is not and never will be, right?

Right.

Still, I think copious amounts of wine and some tears are on the to do list this weekend.

now for the rest of the story

[originally saved as a draft under the title "my gut says ... this feels right"]

Wow, didn't realize it had been so long since I posted. The new schedule of juggling work and school has me busier and more sleep deprived than I've been in that last two years of the From Hell work project, but I am so much happier. At least when I'm in lab/class or studying. Work I have a hard time giving a fig about. Except when I remind myself that a lack of income is looming fast on the horizon.

Friday (okay, now last Friday) I had my appointment with the new RE, Dr. W. I like her. The office was quiet, low key. but very friendly, and not at all the rushed, you are just a mouse in the lab feeling that I had from the other REs office. I was an actual human being here. It could be because this is a satellite office for a big city clinic with lots of smaller offices, and only one doctor on staff here.

Or it could just be because they are awesome and have a different approach to it all.

First thing was it was the doctor who came to the waiting area (right on time) and called me back with a huge smile on her face. She is cheerful, bright and enthusiastic. And realistic. She also gave me the usual, "You are here on your own? Where are the men? Look at you, you are beautiful, professional, why no partner?" If you could figure that one out as well as my fertility....

We sat in her office and reviewed my history and medical file, and finally got to those pesky numbers. Mind, they only have the CD3 testing that had been run last March (09) as part of my clomid challenge. I was not about to offer up, "Oh, hey, my midwife ran CD3 tests last month too, and just to let you know, my FSH was up to nearly 40 now!"

And this is where the doctor was realistic: my numbers suck. They are basically saying that someone who should not be facing diminished ovarian reserve yet is. It's a fact. But where she differed from my prior RE is she mentioned donor eggs or donor embryos with enthusiasm, and asked very gently, "How important to you is it that this be genetic child of yours?" I know my answer, but the power of the emotion still caught me off guard, so I was more than a bit choked up as I answered. I've been on this road a long time. Sometime in college I decided "I'm adopting a baby" and having a husband never entered my mind as part of that picture. I've fought the adoption fight for close to four years, and came out feeling beat up and worthless, and basically like there was no hope as a single woman. I know, it does happen, but it is few and far between. Being turned away from agencies, nearly scammed by others, all the rest I won't even get into right now. I'll go back if I have to, but I want to give the chance to carry and birth a child one hell of a fight first.

When my prior RE had given me the "It's hopeless with your own eggs" speech, she rambled right into, "You'd have to consider donor eggs, and that's just so expensive, you really don't want to go down that road when in the end it wouldn't end up being your child."

Yeah, she said that. SHE. A woman. In the reproductive field. I think that is pretty much when my heart said "Bitch! I'm done with you!"

Is donor egg/donor embryo easy or inexpensive? Hell, no. But I'm sorry, when you take a cell or a small handful of cells and nestle it into your womb and feed and nourish and grow those cells through the miracle of it all with every bit of life force from you, how can you dare say it's not your child? How can you say to a child that you adopt, and look at the first time and know instantly that this is the child that has been waiting for you and meant to be and give that first hug that forms the start of that bond and say it's not your child? Anyway, I don't want to get sidetracked with this, but it really struck me the difference in how the two female doctors approached this.

So I said I was certainly open to donor eggs/donor embryo provided we are not talking about a $40K egg. But I wanted to give my body one last shot. One good kick in the pants to see if there was a good egg that could be shaken out. The RE smiled and said, "Good. We're going to get you your baby." And that was a phrase she said a couple of times. In her words, it takes three things for a pregnancy: a womb, sperm, and an egg; but people often mistake that a womb is just 1/3 of the equation -- it is much more.

In reading through the land of IF in the last year plus, you find there are two types of REs -- those who look at FSH, see one high number and say, "Nope, that is what your body is saying, and it's over" and those who read FSH month to month, and look for a low FSH month to try an IUI or IVF. Happily, new RE is in the latter camp, believing fully that FSH varies from month to month, and that doctors and acupuncturists can lower it and get a good egg. She agreed that my scarred and stunted right ovary may very well be affecting the FSH number since all others numbers looked good. But she also cautioned that endometriosis is very strongly connected to DOR. Research suggests that inflammation in the abdomen and the stimulation of the body's immune defense to that probably has a lot to do with destroying the primordial ovarian reserve.

So the protocol we decided on was to see if my body would respond to FSH suppression with estrogen (Estrace). This would help my pituitary relax since it was thinking the ovaries were busy doing their job, help to down-regulate my FSH receptors (which are most likely shot and exhausted after be yelled at so loudly month to month), and it would also give my follies a nice vacation to sit around in a pool of happy estrogen, and fat and strong. Sound like a win to me! So two weeks of Estrace, stop, I'd get my period and then we would do CD3 testing and go from there. If it could be lowered to 15 or under, IUI was possible. If it got to 12 or below, oh, we're talking IVF.

I left feeling good, but also realistic. I really don't think estrogen is necessarily going to do anything. After all, haven't I had a history of estrogen dominance? I tried to not let my logical brain take over, and started the Estrace on Saturday. It was about then, too, that I just seemed to let out one last held breath and said "whatever". It is what it is, I can't control it and change it. But I can move on to contingency plans and just not be so wound up in it all.

Which means I felt really good this week. Well, at least until class on Wednesday and the surprise period explosion after only 4 days of Estrace. (is it really a surprise if your cycle was 30 days long? Yeah, I didn't think so...)

~.~.~.~

And so we come to today and CD3 testing. I had/have a migraine to beat the band today, but stumbled out to the REs office for blood work and a scan. Nurse H who was driving the dildo cam today was excessively cheerful for 7:45am, but I'll take it. I didn't get to see the screen, so was a wreck over what my terrible antral count would be. Until she reminded me that I was on a suppression cycle, and they weren't expecting to see much. As expect, old Righty is a dud, still tiny, and absolutely void of follies. But Leftie apparently had 4 nice ones sitting out on pool floats, soaking up the rays. Nurse H chirped that this was an excellent reading for a FSH suppression cycle and sent me off with a huge smile.

I managed to keep from barfing at work (migraine) until noon and then packed it in. As I got home, my cell rang, and Nurse P was calling with my blood work. The AMH wasn't back yet, but she had the rest. My jaw hit the floor:

TSH - 2.87

Prolactin - 11.9

LH - 5.6

E2 - 36.7

FSH - ....... 14.2

Say what?!? I made her repeat the FSH a couple of times. She said she was quite pleased with the response and though the doctor is on vacation and I have to schedule a follow up with her to confirm anything as far as how we are proceeding, she said hopping back on the Estrace for a couple weeks would not be a bad idea.

So I should really go and call the office to schedule that follow up, and take a nap to chase of this migraine, but good golly, it looks like we may be on to something here!

road signs?

part of my pushing for natural cycles right now has been my treatment at the RE clinic, and feeling like nothing but a cog in their wheel. my infertility should be simply situational, but they see things in numbers, so that "40" stamped across my forehead means i'm in the hopeless range.

of course i'd searched for other fertility clinics, but being a smaller state, nothing came up but the one clinic i was going to, linked to notorious hospital, part of huge massive soul-eating medical group. there wouldn't be other options, unless i opted to travel out of state, which i was kind of toying with. i know the RE i've seen is excellent, and very much a realist, but she feels very much to be lacking a soul. the whole place does. this is a painful and frustrating journey -- you'd expect those in it day to day to have compassion and humanity. it must just get dragged out of them with all they see...

giving my musings this week about how i want a road sign telling me which way to go, tonight's experience has me going hmmm.... there was a huge new billboard up on the highway, saying something along the lines of "need help having a baby? bear left" with a big arrow. it was pointing towards huge massive soul-eating medical groups shiny hospitals and my clinic, so i figured it was their ad. but it wasn't their signature colors, so i searched for a name.

oh, hello huge fertility specialist from neighboring state. i had no idea you now had a office around the corner from my REs group. i'm up on their website now and fining it a wealth of information, unlike my clinic which is simply, read our name! we are linked with hospital! this is all you need to know!

looking for some metaphorical road sign and i find a literal one. i may have a back-up plan for my back-up plan.