Hard Choices

For the sake of simplicity in this post, I'm dividing our next steps into two groups: group 1- we both (Sam and I) have a genetic relationship, and group 2- one and/or both of us do not have a genetic relationship with our child.

I'm currently struggling with our next steps. Unfortunately, I don't even really know what I want, which makes it particularly hard to agree (or disagree) with Sam about any of it. Every time I try to talk about any of the options, I start to cry. I'm feeling particularly vulnerable at the moment and all possible plans make me feel even more so. But I like to have plans, so I continue to think through them even if it's uncomfortable.

There are things that I like and don't like about each of the possible plans. I like that domestic infant adoption feels quick(ish)… it's certainly not a guarantee, but the possibility is there. I like that IVF gives me the potential to overcome infertility. I like that donor embryos is a cheap less expensive option. But with all the plans that fall into group 2 (donor egg, donor embryo, domestic and international adoption) I have a couple of things that I really don't like, a couple of things that I'm afraid of and can't seem to work through.

I've said several times before that adoption has always been a part of my family building plan. In my teens and early twenties, my dream was for 4-5 biological children first and then 1-2 adopted children, specifically via international adoption. To say I had a rose colored glasses view of adoption would be an understatement. I had never heard of adoption scams, or stealing infants from hospitals. I would never have dreamed that there was an underground rehoming network taking place in my own country. Adoption just seemed beautiful: it was all about rescue and redemption. I never thought I might need adoption in order to have a family, so it seemed almost ministerial rather than simply family building. 

My view of adoption has slowly changed. I'm honestly a little afraid of adoption. I'm afraid of getting in over my head, of unknowingly contributing to crime, of separating a child from his/her first family unnecessarily. In no way do I mean to say that adoption is bad. I have many, many friends who have or are currently adopting. I've seen adoption work. I've seen adoption be beautiful just like I imagined. But I've also heard things that make me nervous, things that seem to freeze my feet in place. 

My greatest fear with adoption seems to be spreading into all forms of family building that don't have a genetic connection, essentially all plans in group 2. My greatest fears center around the third party... the biological mother and/or father. Whether you want to admit it or not, adoption, donor embryo, and donor egg/sperm all have a third party involved. The fact that I would not have a genetic reflection in the face of my child isn't what I'm afraid of... looking at my child and not seeing high cheekbones or thick brown hair doesn't frighten me. What scares me is how the third party (or lack there of) might affect my child. How not knowing anything about his biological mom might forever leave a giant hole in his life. It seems to be a nonissue for some kids and a giant deal for others… I'm not sure if the difference is in the children or how they are raised.

In donor egg/sperm situations there is almost always no information available. In some instances, the couple receiving the eggs only knows height, weight, hair and eye color, and education level. Other than that, they simply know the donor passed whatever sort of preliminary tests required of donors. Unlike is most adoptions, even once the child turns 18, there is simply no additional information to provide the child… she will never know more about the woman who helped create her. The lack of information is typically to protect the donor from a child/children hunting for her years later. I don't think this eliminates donor eggs for us, but it's certainly something to think about, something to prepare for, something to process.

If the fear of raising a child who feels like a giant piece is missing from her life due to the lack of information frightens us, it seems that our next steps should be some form of open adoption or open embryo donation. But the moment I hear "open" an entire new set of fears arise.  I'm not sure if it makes me insecure or shallow but the idea of my child knowing and/or seeing his biological parents scares the dickens out of me. My dream of parenting never included a third party... the "adoption triad" as it's called. I understand why it's often the best situation for the child, but oh my heart. I'm not sure if I'm mature enough to handle that dynamic... I imagine I would forever be jealous of any connection my child might have with his/her biological parents. Meeting up at a park or inviting them to birthday parties scares me... and not simply because our parenting styles might be different or they might not be people I'd naturally choose for my child to hang out with. My biggest fear is that my child would prefer them over me. (insecure much?)

I can literally hear it ring in my ears, "you're not my mom." She might scream it as she turns, flouncing her hair, and slamming her bedroom door. The words probably came following a fight about boys or make-up. I'm pretty sure I said equally mean and hurtful things to my parents growing up, but that phrase might just rip my heart out if I ever hear it. It might be my biggest fear about losing the genetic connection with my kid(s). I certainly don't want to raise kids who feel incomplete, but I'm also afraid of allowing the biological parents into our lives. I'm afraid of how the third party would change my relationship with my child. It all just feels scary and foreign in ways I wasn't prepared to feel until group 2 was really right in front of me.

All of these thoughts have been swirling around ever since I wrote "Plans G-K". I had asked Sam several weeks ago to start thinking through our options so that we could discuss it soon. We finally talked about how we each feel about the different plans this past weekend. Essentially, I feel like we have six options (not including another FET or living child-free).

1. Expensive IVF: Somewhere with GOOD statistics like CCRM or maybe Advanced Fertility Centers of Chicago
2. Cheap(er) IVF: It would be $1000 less to go back to FIRM (which was already a fraction of the cost) for another round
3. Domestic Adoption
4. International Adoption
5. Donor Eggs
6. Donor Embryos

It should be shocking to no one that Sam and I didn't list our options in the same order. That would make things way too easy.

Sam's list: 3, 5, 6, 1, 4, 2
Amanda's list: 1, 5, 6, 3, 2, 4

Sam likes adoption for two things: he thinks it will be faster and that it's more of a sure thing.
I like IVF with CCRM (or other really good clinics) because it eliminates all of my above fears and allows me another shot at beating infertility (I'm not normally so competitive). International adoption is at the bottom of my list because, if this happens to be the only child we ever have, I don't want to miss having a baby. And I think repeating IVF at FIRM is at the bottom of both of our lists because of my poor response. It just seems dumb to repeat the same thing and hope for different results.

So how do we move forward from here? Obviously, we arm wrestle for it. I think the best move from here is to research each of our top options first. We might have a phone consult at CCRM and go to a few informational meetings at a couple adoption agencies. I've just finished reading Called to Adoption: A Christian's Guide to Answering the Call. I'm on the hunt for other good reads. I don't think we're in a desperate hurry to make up our minds… I'm in a desperate hurry to have a baby, but as all options cost a good chunk of change, it won't be any time soon. We've got time to research and talk and pray… hopefully our next steps will seem clearer to both of us with time. I do think I'll schedule a consult with Dr. Duffy at FIRM in the coming weeks to at least discuss the possibility of transferring all four remaining embryos. If he likes that idea, that may be our next step as it's certainly the cheapest and we'll have fully exhausted our options before moving forward.

Essentially, all of these are good options… there's no bad option here is it brings us a child of our own. But that doesn't mean choosing is easy… these are hard choices to make. These are decisions that I never in my wildest dreams thought we'd be making, not even when infertility was dumped on us. I'm still trying to wrap my mind around the reality of our life. There are moments when I just want to cry, tell God he's completely unfair, and refuse to give up any more than I already have. In those moments I just want a baby without stress or fear, without worry or heartache… I just want it to be simple. But simple it is not. I certainly don't believe the old saying that the Lord won't give us more than we can handle… I think the story of Job pretty clearly disputes that. But I do think wherever He leads me or allows my life to go, He'll see me through. He's allowed infertility to be a part of my life for one reason or another… I have to believe He'll see me to the other side, hard choices and all.

Stuck on Repeat

Well friends, it's another negative. I'd be lying if I said I wasn't sad... super sad. Two more of my embryos died. Two thousand more dollars were spent for another negative. I really don't know what else to say... we tried, we failed (again).

I have absolutely no idea where we need to go from here. I know I'm not ready to kiss the dream goodbye, but I also know that I am so, so tired. I'm so over this season, this journey. Can I have a different story? Even if the grass isn't as green as I imagine it is on the other side, I'm ready to cross over. But how much more do I want to go through? How much of the dream am I willing to give up? Genetics? The pregnancy? The birth? Infancy? Do we move on to the next logical step and simply try IVF again, maybe at a better clinic like CCRM? But what if that fails too? Then what? We'll have spent $30,000 on CCRM... we'll need another $10,000-35,000 to move on to the next, next step. Or should I simply admit that my eggs aren't up to par and skip a second round of IVF? Should we go straight to adoption or donor embryos? I feel overwhelmed by the possibilities, but even more so by all the zeroes following the dollar signs.

We do technically have four (maybe three) frozen embryos. One 8 cell, one 6 cell, one 4 cell, and one 3 cell.... the 3 cell is the questionable one. I don't really understand  enough about meiosis and mitosis and all that stuff to get what my doctor was saying, but essentially, he's not sure that the 3 cell actually has male DNA in it. I know, weird. Essentially he said on Saturday (day two) the egg looked to be unfertilized, so he reported that we had seven embryos. But when we showed up on Sunday, what had looked like an unfertilized egg the day before suddenly had three cells. He's unsure if it successfully fertilized or not... at least, I think that's what he said. The 8 and 4 cell are frozen together and the 6 and the 3 cell make our fourth straw. At this moment, if we did another FET next, I'd want to transfer all four. I can't believe I'm saying that... three months ago transferring three seemed like a terrifying and dumb choice... but that was transfer one and this would be transfer three, with the four worst embryos. The odds have to be incredibly small of a 3 cell, day 3, grade 3 embryo becoming our take home baby. I don't want to toss it, but I just don't feel good about transferring either group alone.

I really don't know which way is forward... all paths thus far just seem to circle us around and around and around. Our story just seems to be stuck on repeat. But ultimately, we have time to figure it out. As we don't have $30,000 in our bank account, we're not ready to move forward with plan G, H, I, J or K. In the mean time, I'm going to let myself cry, take a long, hot bath, and drink a Diet Coke... and there's probably a pint of Ben and Jerry's Salted Caramel Core in my very near future. Other than that, I'm going to look forward to the good things we have ahead: house hunting continues tomorrow and anniversary next Thursday. Life's not all bad... I've got to remember that.

The Trifecta

I'm in search of The Trifecta. What is that, you ask? Oh well it's essentially my pursuit of happiness: a good job, a home, and a kid. I'm knocking on the door of 28.5 years and I'm still in search of The Trifecta. I know it's become the sad, sad, sad story of my generation that we're reaching milestones later, and later than we (or our parents) ever imagined. Sam and I appear to be particularly stunted... thanks infertility.

Suddenly it feels as if there is potential, potential to achieve The Trifecta. Unbelievable. Simply unbelievable. I won't get in to the employment thing because that just seems dumb to talk about on a public blog, but I'm EXCEPTIONALLY pleased to announce that the Greavus are house hunting! Eeekkkkk! I know, I know. Probably not that exciting, but to us, we're beyond pumped. The reason we're finally pulling the trigger on a house is probably a little premature and maybe the strangest reason ever to start the search. Essentially, if we decide adoption is our next step, we will have to move. No one, and I really mean that, absolutely no social worker would approve us for a home study in our current setup... we don't even have smoke detectors. When we started thinking about moving, we realized (once again) that rent is not cheap. We started crunching numbers and well, to get into a nice(r) place that will accept our 80 lb Weimeraner, our cat, and would pass a home inspection.... well it's not pretty. I exclaimed, "we could own a house for less than that!" And do you know what? We actually can!

Regardless of the decision to adopt, we would never feel comfortable bringing our child home to our current place, so moving is a must at some time. And now that we've started looking, we're both full three quarters steam ahead. We are trying to be EXTRA cautious with our choices. While we fully realize that the third part of our trifecta could come in the form of the two little embryos we transferred, we also realize that it might not. We could be years and thousands upon THOUSANDS of dollars away from a bring home baby. In order to save thousands, we need enough margin in our monthly budget. Which means the house of our dreams is not in the works, nor is the house we thought we'd buy when we got married... no this is the house of reality. The reality that says any child may cost $30,000+... literally. Dream homes are for later... much, much later. This will be a true "starter home"... and not like the starter homes my generation and those proceeding us thought were starters homes, no this will be a true starter home. But the cool thing is, we're still so excited about it. It probably won't even have five of our top ten wants, but it's still INCREDIBLE that we're even doing this.

As to the whole baby thing... I'd be lying if I said I hadn't thought of the potential we have right now. The potential for a positive pregnancy test on Friday and a bring home baby in 36 weeks. I've certainly thought of how ASTONISHINGLY different out lives would look if we weren't expecting to spend the next few years saving for a chance at a baby. I mean obviously, our lives would look waayyy different just because we have a baby... that in and of itself would be ridiculously different. But in terms of finances, things would radically change if we weren't up against IVF or adoption.

The potential for big things, for life altering change is definitely there... as to how significant the potential is, I have no idea. What are the odds we actually achieve ALL THREE?!?!? Probably slim... our lives simply do not seem to work that way. But two out of three? Still amazing. One out of three? I'd still be thrilled with ANY positive thing right now. Particularly if that one is a BABY... literally, I'll live in a hovel and work for minimum wage for a baby.

Speaking of baby... test day is Friday. I'm giving myself about a 5% chance of a positive beta which is low even for me. My doubts are at an all time high because I had period-ish cramps on and off all day Sunday, all day Monday and most of Tuesday. They are gone now, but I still don't think this bodes well. But one way or another, we'll find out on Friday.

And even if all three fall through, our anniversary is next week... I'm reminded that we are abundantly blessed to have four years of marriage behind us. We have a small trip planned to get away and relax together over a long weekend and I'm ridiculously excited! Other than Florida for IVF (which was too stressful and sad to even consider a vacation) this will be the first getaway since our last anniversary. We're ready.

What Will Be

I apologize for the delay in updating after the transfer. I realized yesterday after quite a number of "hey, you okay?" texts and emails that I should probably update, but I didn't. I'm struggling to find much more to say on it other than it happened.

The transfer was pretty boring (which is good) and pretty much exactly like last time. It was interesting to note the similarities between IUI #1 and IVF #1 and then IUI #2 (3 & 4) and FET #1... for both IUI #1 and IVF #1 there was so much suspense, so much drama surrounding the transfer. Ooooo, this could be it. And eekk, what's going to happen? Anxiety level 12 out of 10 for both. And then its over, the sperm are deposited or the embryo is in place and it's like, ughhhh, what a let down. Glad that's over, but I don't feel any different. And I still have to wait, and wait, and wait. The drama should really be reserved for beta day.

I guess that's why we were both pretty chill about the whole thing. Sam and I both kept checking in, "are you nervous?" we asked about twenty times. That morning I woke up, rolled over and asked Sam if he was ready to pick up the kiddos from the daycare (aka, the freezer). I wasn't nervous. At least not until we got there and they called us back to meet with the doctor. When we were there last time, everyone in for a transfer went straight back, no chit chat. So when they called us back to chat, I immediately thought that one or both failed to thaw. And then I felt dumb for not being nervous about the thaw. Luckily, they both survived the thaw. The doctor explained that a successfully thawed cell does two things: it plumps back up nice and full, and it's translucent when light is shined through it. For an embryo (day 3) to successfully pass the thaw, at least half the cells need to do both of those things. Our 9 cell did perfect, 9 for 9. Our 8 cell dropped back to a 7 cell, but the doctor said that was still excellent. So in the end, we transferred two day 3 grade 3 embryos, one 9 cell and one 7 cell.

The transfer itself was fine. I'm still bummed that I don't get photos of the embryos. I'm thinking about writing a letter to Dr. Duffy with my two biggest "complaints". They aren't really complaints, but just things that I was really frustrated about when I found that FIRM does things differently than 90% of the other clinics out there. Number one: I think it's dumb that they don't allow the partners back in the room. The reason feels like it has zero to do with keeping a sterile room, and everything to do with processing the transfers quickly. It's like a mill back there. One person gets a transfer while one or two others change and sign releases. One comes out, another goes in. Despite the fact that the transfer feels very anticlimactic after it's over, I still wish Sam could be part. The second wish would be for photos of the embryos. For some of us, those are the only photos we will every have of our babies. Once they're gone, they're gone, and it's too late.

But all in all, it was a success. We traveled down to Jacksonville on Saturday, watched Georgia lose to Kentucky, walked around the mall, and had a delicious dinner Maggiano's. Sunday morning we completed the transfer and then hit the road. It was an incredibly short trip and super exhausting. Therefore, I took yesterday off to recuperate and rest. I'm not sure that it was incredibly necessary for the embryos as implantation will most likely take place on Thursday or Friday if all goes well. It was nice to catch up on laundry and chill though. I've got one episode left of Revenge, and we caught up on The Walking Dead last night (whoa!). Speaking of laundry, I don't know if the nurse made a mistake but she said not to lift more than three pounds… three pounds?!?! Umm lets see here, Everest (my cat) weighs seven pounds and she's like lifting air. I kept analyzing the laundry… "let's see, four socks, three t-shirts, and a pair of Sam's shorts… that's about three pounds… trip one to the washing machine. One of Sam's hoodies…eek, that's about three pounds too… ehh, just leave it, I don't have time for 1,000 trips to the laundry!" Seriously, three pounds? Who comes up with this stuff? I'm pretty sure my laptop and my purse individually weigh three pounds, and I don't even have 25 lip products like other people (not naming names). I guarantee I've lifted more than three pounds since the transfer and I'm not sure that there's anything to be done about that unless I'm spending the next two weeks in bed with a servant to tend to my every need… which I'm not.

Test day is next Friday, March 28th. If all goes well, super! If it goes like things typically go, I have one week to get over it before our Anniversary… perfect timing. My attitude is kind of "what will be, will be"... I'm not particularly optimistic, but I am feeling slightly more hopeful as is usual post transfer. Ten more days to go.

Still in the Trenches

It's Spring Break for 99% of the city of Athens and the town I call home is dead... it's glorious! I know, I know... don't call a college town home if you don't like college students. I actually love college students, but there's something rather spectacular about the quiet. About a city's streets carrying the amount of traffic they were actually intended to rather than an additional 30,000 motorists. Downtown is lovely, and peaceful, and not filled with students handing out flyers, blasting loud music, or smoking. (Geez, I sound old) Campus is a ghost town. It's similar to summer, except even better... only the zealous over achieving graduate and professional students remain.

The quiet is really nice... something this introvert really relishes. But it also opens up the ability to reflect and ruminate. Today I find myself realizing something. It is both amazing and disheartening; both exciting and frustrating; both exhilarating and draining. That thing is this: I'm getting left behind. Day by day, my friends climb out of the trenches of infertility and start the next chapter. And that is INCREDIBLE and about ten other positive adjectives in all caps. It's what we're all hoping for, praying for, fighting for. I know anyone who has ever been in the trenches knows what I'm talking about. You're fighting side by side with some of the most beautiful, inspiring, lovely women you've ever met. For a while it's all, "we've got this," but then suddenly you look to your right and where there were ten fellow fighters, there are two. You quickly look to your left and find that they too have all, every last one, climbed out of the pit. No, actually, there is one left, but she's on the final rung of the ladder, and not for one moment do you want to call her back, or tell her to wait. You give her the thumbs up and smile as tears stream down.

Slowly but surely, it happens to us all. In the course of anyone's journey, if you find yourself stuck in the trenches long enough, you will find yourself looking left and right and wondering, "where did everyone go?" I suddenly find myself there. It's not an actual baby boom, but more of a revelation... the longer I stay, the more I'll have to say goodbye. I really hate goodbyes. The goodbyes are sweet for sure. I'm so incredibly happy for all of my friends. The point of the journey is to get out, to cross over, to move on... it's beautiful when it happens. But no matter what, even if they stick around to blog, something changes. To no fault of anyone, the relationship changes. The commiserating comments and words of shared frustration change to positive, happy, blissful words of encouragement. It becomes, "don't give up; your day's coming" as if once out of the trenches the memory and fear of never crawling out somehow begins to fade. The relationship, while valid, and beautiful, and worth continuing, changes.

I personally don't dislike reading about bumps and bibs and bottles and birthdays. Seriously nothing puts a smile on my face faster than a bump update from Aubrey. That girl fought so hard... she deserves every single moment of this and then some. But there are inevitably the moments where I am left without words to share. When we're all in the trenches there is a sisterhood of shared experiences. We've all got something to share whether that's "my first time on climid..." or "my follicles grew 4mm in one day..." or "I had a weird reaction to that medication too!" or "my husband's counts really improved after...". Months and years go by where I feel a connection solely based on experience... we live in different cites, come from different faiths, exist in different socioeconomic levels... but we're all here fighting (in different ways) for the same thing. There is always something to say. And then suddenly she has outpaced me and I have no clue why a Dr. Brown's glass baby bottle matters or whether a Moby wrap is better than a K'tan. Do I say, "I have no idea about any of that, but I'm excited you're making these fun decisions" or does that feel like a subtle reminder that she is there and I am not?

This post was never intended to be a discussion on our relationships during and "after" infertility. Really it's just my musings as I realize that my friends are climbing out and crossing over. And like I said it's AMAZING... but it's also kind of lonely. And yes, there are always more women learning of their diagnosis. There will always be women turning to blogging and starting the journey with this beautiful community. But hunting new blogs feels daunting and overwhelming. I love the serendipitous ways I've encountered my friends over the years. To sit down and actually search out new blogs feels forced and tiring... kind of a "will you sit beside me at lunch?" kind of thing.

So where to from here? I don't know. It's always hard to know, because you never know how long you'll actually be in the trenches. But one thing I certainly think I should do is take a moment to celebrate the BEAUTIFUL women I love who have crawled or are crawling out of the trenches. I'm so, so  happy for you ladies. You have fought the good fight... you deserve every blissful moment and then some.

Second trimester and beyond:
Amanda @ beloved burnt toast: 26 weeks
Emily @ Eat Love Procreate: 17 weeks
Hopeful and Hungry: 18 weeks
Kimberly @ No Good Eggs: twin boy and girl 27 weeks
Annie @ Sweetest in the Gale: 16 weeks
Em @ Teach Me to Braid: twins 32 weeks
Team Hop: 23 weeks
Rebecca @ The Road Less Traveled: 27 weeks
Aubrey @ Two Hearts and One Dream: twins 21 weeks
Mrs. Lost @ Where is That Bird?: twins 20 weeks


Out of the trenches (Fall 13-Spring 14):
dspence @ Donating Hope: baby boy born March 5, 2014
Ali @ Here I Go Again: baby girl born March 1, 2014
Genny @ His Plan, Our Journey: baby girl born October 8, 2013
Sara-Lynn @ Home Grown Love: twin boys born October 16, 2013
Lentil @ Lamenting the Lentil: twin boy and girl born February 19, 2014
Lindsey @ Operation Baby Gage: baby boy born February 11, 2014
Rain Before Rainbow: baby girl born February 27, 2014
Ready for My Turn: twin girls born November 18, 2013
Laura @ The Adventures of an Infertile Myrtle: baby girl born February 16, 2014
Allison@ The Blogivers: baby girl born November 1, 2013
Emily @ The Empty Uterus: baby girl born February 6, 2014
Jennie @ You've Been Sass'd: baby boy born September 29, 2013

And to the ladies who are a few steps up the ladder: we are all rooting for you. Keep climbing girls!

First trimester:
Julia @ Finding a Way Out of IF
Infertile 625 @  Hidden Infertility
Conceptionally Challenged
Kasey@ Stupid Broken Eggs
Beth@ Beth & Harrison Slatery

I'll be honest, I shed a few tears putting that list together. We're going to blame it on my estrogen levels. It is incredible to look over a list like this… someone, somewhere beats infertility every day. And honestly, I'm so glad it's you girls. You are beautiful, beautiful women and I know you'll be fantastic mothers. Congratulations to you all!

Frozen Dreams

So today is CD 13, or more importantly the one and only monitoring appointment for my frozen embryo cycle. A frozen embryo cycle is so chill, practically boring compared to IVF. I'm guessing this is what clomid was like, but honestly I can't remember. No actually, clomid was more stressful because I was still worried about timed intercourse and those stupid sticks and "did I hold my bladder long enough?" and "oh my gosh, I have to pee, but I don't have an OPK!!!" Yeah, clomid was more stressful.

I have been so chill throughout this entire cycle... no worries, no stress. I forgot to take my three little blue pills the other morning and couldn't work up enough energy to care. "It'll be what it'll be" is kind of my motto. It's pretty much the complete opposite from "let me eliminate all bad things and eat only good things and rub my tummy and talk to my follicles and, and, and" that was IVF. Instead, I've somehow, unintentionally decided that there's not really much I can do to change the outcome of this. I'm pretty removed from the whole deal.

There was a moment yesterday when I started to stress and worry about today's appointment. I've never done an FET, so I had no idea what my lining would do. Would this pathetic protocol they've got me on of six little blue Estradiol pills a day really be enough to pump up my lining? As I've never been monitored off meds, I have no idea what my lining does all on its own. My worst lining ever was 6.2 and my best was 11.4. I started to worry that my FET might be cancelled and I began to realize that despite being chill and feeling uninvolved, I really do want to have the transfer. I just need to complete this transfer. Yes, I'll still have four more embryos, but the chance of success with either of the other straws is significantly less than with this straw. I need to complete this transfer so I can officially start thinking next steps. It feels like our future is frozen right now. The answers sit frozen in tiny straws in Jacksonville. They will either be our bring home babies, or we have more road ahead of us. Either way, I'm just ready to know. And ultimately, I just need to be doing something. Doing nothing feels miserable and makes me into an anxious, whiny, irritable person.

The monitoring today went well. I drove into Gainesville as neither of the hospitals in Athens could process Estradiol labs same day (lame). The ultrasound technician at the OB's office was a sweetheart... I'm sure she's used to monitoring baby bumps and all that kind of fun stuff, but she showed a genuine interest in my cycle and wished me luck. She reported that my lining was over 9mm... that's all I really cared about. I hit the car and let the tears fall... God, I want this. There's such a lovely, fluffy, squishy little home just waiting for those embryos. And I know they're subpar in terms of grading, but they're mine, and I LOVE them. I just want them to come home.

We're what feels like 2,000 milestones away from either of those sweet embryos coming home. They have to thaw well, the transfer has to succeed, they have to grow to blastocysts, they have to implant, they have to continue to grow... all of that before we even get to the pregnancy test, at which point we'll still have 1,995 milestones left to go. We're soooo far away, but for some reason hearing that my lining was lovely just made it feel like we're a teensy bit closer. Endometrial lining has really never been the issue for me (only on clomid), so I know we still have the REALLY BIG hurdles left to go, but man, I really, really want to succeed. I'm tired. I've run this race. I've fought the good fight. I'm so ready for this to be over. We're rapidly approaching three years of actively trying, most of which have been in the care of a Reproductive Endocrinologist. These have not been idol years... we've saved, we've prayed, we've tested everything (well almost), we've moved step by step through each of the procedures... I'm so tired and I know Sam is too. I just want to move on with our lives. God, I really, really want this to work.

I've already heard back from my nurse at the RE's office and she reported that my blood work is "great" and she's confident we're moving forward. I'm waiting to hear when I'll start the antibiotic and the Crinone (yuck). We're set to head to Jacksonville Saturday morning. I'm not sure exactly what time the transfer will be on Sunday, but I'm sure I'll hear some time today. Unfortunately we have to drive back after the transfer on Sunday. With Sam's job, we really can't take the extra days, but I'm planning to relax and rest the whole way back. And then the long two week wait will commence once again.

That's about it for now. I'll be sure to update after the transfer. In the mean time, head over to Julia's blog. Today is beta number two following donor eggs at CCRM. And check-in with Suzanne. Tomorrow is a BIG DAY and we're hoping Suzanne has a lovely, fluffy, squishy lining of her own. And please don't forget Holly. Let her know you're thinking about her as the due date of Brinly and Jude is Saturday.

Unsolicited Advice

I really don't know exactly what it is about the human race that causes us to need to give advice, but we all do it. We all want to be problem solvers specifically. I'm guilty of it too. Growing up, my nickname was "Mother Merritt"... I think it was in large part because I was a fixer. Tell me your problem and I'd find a solution, patch up the friendship, find you a date to the middle school dance, etc. Our advice and problem solving is usually well intentioned, but often times life would be better if we could all learn to zip our mouths. The more friends I have who gain the title of "Mom", the more stories I hear of rampant unsolicited advice. Neighbors, in-laws, mailmen, friends, cashiers, etc. give advice in the grocery store, at work, over Sunday dinner... it's really unavoidable.

Now I (obviously) don't deal with advice about Pampers vs cloth diapers, or sleep training, or temper tantrums, but unfortunately I often deal with unsolicited advice in terms of infertility. And the strange thing is that 99% of the time, I know it's from people who mean well and actually love us. Unfortunately, that's not always how it comes across. I wish people could hear their comments through my ears; hear what I hear.

There are always my favorite pieces of  advice, the old standbys such as "just relax," "take a vacation," or "just adopt; you'll be pregnant in no time." I'd like to take this moment and share a little public service announcement if I may. If your advice begins with "just," keep it to yourself. There is nothing simple about infertility, and the fact that some people think they can simplify it and solve it with "just ______" is not only frustrating, it's insulting. Think about it from this perspective: Imagine you own your own business, and you're in the red for the third quarter in a row. If a friend says "just relax," does that feel helpful? And as to a vacation... have mercy. I'm certainly willing to take anyone's advice if they are paying, but unfortunately we spent almost 40% of our income last year on medical expenses. That doesn't leave a lot of room for Cancun or Vail. Sad trombones. And as for the weird wives' tale that adoption leads to a pregnancy... goodness, don't get me started.  If that was really my intention, if the only reason I pursued adoption was so that I'd get pregnant, wow, let's just sum that up in one word: TERRIBLE. That is horrible advice, and I'd be a horrible person if I took it. Agreed?

Sometimes people have more "medically" related advice. These helpful people know of an herb or a tea or a pill that will fix me up in no time. Or I often hear from people encouraging me to overhaul my diet, eliminate all the food groups I actually like and eat brussel sprouts for the rest of my days because brussel sprouts (ick) have healing infertility properties or whatever the case may be. I'm never going to deny that eating healthier would benefit me... I'm pretty sure it would benefit anyone. However, I really don't think tea and kale are the cure to our infertility issues. Maybe I'm wrong, but I just don't. It's not that I don't want to hear about the magical pouch of joo joo or the wonders of lima beans... really, I'm not hating on being healthy. I simply don't want to be bombarded with "try this" or "have you thought about this?" constantly. No one wants to be judged: the fact that I ate three quarters of a container of Ben & Jerry's Salter Caramel Core ice cream doesn't mean I don't want  a baby bad enough... it means I just heard about a whole heck of a lot of babied made the old fashioned way.

The last category of people are, sadly, the ones for which I have the least patience. These are the well intentioned people who say things because they need to sound spiritual, or hate silence, want to be encouraging, etc. Phrases such as "give it to God," "pray about it," and "let God take control" just about push me over the edge these days. For the most part when someone shares advice like this in person, I try to steer the conversation elsewhere, and thus far, I have withheld my initial reaction which is to punch them in the face. If the comments come via Facebook, I contemplate deleting the person, but I typically just go eat a cookie. Here's the thing I wish I could get across; it's actually kind of Biblical: examine your own life with an equally fine toothed comb, before you make assumptions about someone else. I guarantee that we all have areas of our lives that we should pray about more or relinquish control of... that's the nature of being broken people with messy lives. But I would never point out another person's area... it's kind of the whole "plank in the eye" idea here. And again, the fact that someone assumes that Sam and I are not praying about our infertility or that we don't relinquish our hopes and dreams to the Lord, well, it's insulting. We should all just make this deal with one another: "I promise I won't point out your marriage problems, money issues, child rearing problems, medical issues, etc. and offer platitudes for solving all of YOUR problems, so I'd appreciate the same. Okay?" It's really that simple.

As I said, I'm 100% sure I used to be as guilty as the next person of offering "advice" in the name of helping. But once you have an area of your life where you regularly receive this type of aid, I guess you just grow more sensitive to it. It just gets old. There is one thing I've learned over the years and it's this: the thing about unsolicited advice, in all situations, is that it's all about the delivery of the advice. Believe me, I've had some friends and mentors sit me down over a yummy lunch or a nice cup of coffee and say some really hard things to me over the years. Things about not wasting my present season, things about loving my husband better, things about putting infertility treatments on hold until we got our finances in order... those things were HARD to hear. But it is so much easier to accept advice when it comes from someone willing to take the time to actually share why they feel that way.

If you REALLY think that your friend needs to try an herbal concoction, well take her to lunch, give her the tea, and tell her why you think it's awesome. Even if she thinks you're crazy, she can't fault you for caring enough to do all of that. That speaks love way more effectively than a comment on Facebook. In the same way, if you earnestly care about a friend, instead of offering a quick "let God take control," try a coffee date, and give her the opportunity to talk. You will have created much more fertile ground for your advice, and you can offer to pray for her rather than offer wisdom at her. I'm telling you, delivery makes all the difference.

In terms of infertility specifically, the internet is filled with blogs and websites that offer help if you're wondering what you should and should not say to your infertile friend or family. I myself did one way back when... check it out if you need some helpful hints on what to say when there are no words. There are a lot of things that should just not be said because they are really never, ever helpful. But there are a lot of things that exist in a more gray area, and it's all about the way you deliver it. I imagine that this principle can be extrapolated into pretty much any area. Mothers everywhere are nodding their heads as they remember the "advice" from the well-meaning neighbor who just had to share about the dangers of some toy she saw in the yard the other day. Delivery is everything people... if it's a burning need down deep in your soul to help, find an appropriate way to deliver your advice.Your relationships will be better for it.

On the Calendar

Well, it appears that IVF somehow brought my body as close to "normal" in terms of cycle length as I've ever been… strange. January's post-failed IVF cycle was 28 days. That never happens. I was expecting to start some time this week, but instead I started last Thursday night. My nurse said to call Friday CD 1 though as I needed to start Estradiol on the first day. So it's official, I'm less than two weeks away from a Frozen Embryo Transfer. Odd. After all the fuss with IVF, an FET feels pretty boring.

We're still not 100% sure exactly what we're doing with the embryos, growing all six to day 5, or transferring the best two on day 3. If I had to say today, we're transferring an 8 cell and a 9 cell embryo on day 3. My doctor really hasn't given much direction on this, but based on the comments from the IVF Nurse Coordinator, this seems like the wisest route. Basically she said if we really want to transfer something, it's our best bet as the doctor isn't sure that we'd even get a blast if we grew all six to day 5. Talk about a confidence booster.

Which pretty much sums up my feelings on the subject… I'm in need of a major confident boost. I know that there's a chance of success, and I know that once they transfer the embryos, I will have glimmers of hope no matter what, but going into this, I just can't really scrounge up a lot of "this is it" and "it's our time" type feelings. This feels more like the next step we have to take before we can move on to whatever the next, next step is. It essentially feels like a waste of money, time, and energy, but I simply can't discard or even leave those embryos behind. I said I'd give them all a chance and I feel required to do just that. So that's what we're going to do: we're going to give our next best two embryos, both graded 3 due to fragmentation of cells, a chance.

In the mean time, I don't know if I should feel pleased that I'm cool, calm, and unconcerned because this big weight of hope is missing or if I should feel terrible for a lack of faith, both in my God and my babies. I mean I fully believe that He can show up and do mighty things to bring one or both of these embryos home to me, I'm just not so sure that He will. If that's a lack of faith, well then call it what it is, but that's where I sit. I fully believe that Jesus can do ANYTHING, I'm just not sure if He'll choose to do the ONE THING I'm asking.

In the mean time though, I've racked my brain for hours trying to think of some success stories from day 3 grade 3 embryos… this is the time when you can tell me all those "my brother's fiancé's sister's best friend" stories. Really, lay them on me. I can't seem to really even find all that many ladies in my community with day 3 embryos… there are a few, but the grades are better. And that's kind of where my head is these days. I hear a success story, but then immediately think, "but she had day 5 embryos, and the doctor doesn't think mine will even make it to day 5, let alone the nursery". Or I'll read a story of a positive beta from day 3 embryos, but then my mind goes to, "but she had grade 1 or 2 embryos… they were pretty much perfect". When I call the clinic, even the nurses are always shocked to read the file that says day 3 embryos. "Oh, I just assumed you'd have blasts, honey; you're so young," they say, "I'm sorry." Yeah, me too lady, me too.

So that's where we are. I'm doing a lining and estrogen level check locally next Wednesday. If everything looks good, Sam and I will head to Jacksonville Saturday for a Sunday morning transfer. My protocol seems really wimpy and pathetic next to everyone else's extensive list of medications for an FET, so I'm just hoping that these teeny little blue pills are, in fact, doing something fabulous with my lining.

Send me your success stories friends! The FET is on the calendar for March 16th. I've got 12 days to get my head on straight regarding this transfer.

Fertility: A Downhill Slide

So hopefully, the last post on fertility vs infertility helped to explain why it appears some people can't seem to stop procreating, while others can't start… it's all a long continuum from fertile to infertile. One thing that's kind of HUGE that I didn't touch on (the post was already lengthy) is the relationship age has on the spectrum. It's kind of a sensitive topic for me… I think you'll see why.

By the definition of infertility, all women are headed that direction. If the definition is simply the inability to become pregnant with unprotected sex within a year, I bet you can guess which part of the population is 100% infertile. Yep, menopausal women. And unless you've found a way to ward off the dreaded change in your body, you're headed towards "infertility" too. Let's look at a chart for all the visual learners out there:

Find your age: The black line is the likelihood you'll conceive in a year,
the green line is the rate of infertility. I was SUPER lucky to fall into that 5%.

Here's the thing I really hate about charts like this and the label "infertile": There is a really distinct difference between me, 28 and unable to conceive after 32 cycles and countless medical procedures and my mom, 57 (sorry mom) who is well past menopause. We're both unable to conceive, but I have no real explanation, while she, she's simply too old. I personally feel like there should be a difference in the diagnosis or terminology or something. Many of my friends and I, who were diagnosed with infertility at the height of our fertile years, we are different from other women who are diagnosed with infertility because they are a few years if not mere months away from menopause. It may suck for both parties, but we are different. One group has an abnormal and unnatural occurrence within the body, the other has a body behaving exactly as it should. To call me and a 50 year old woman the same thing in terms of ability to procreate is just kind of dumb.

But how does age relate to the fertility spectrum? Well, unfortunately, no matter who you are, it's pretty much just like the title says: a downhill slide. Most girls start their period in their teenage years, 12 is currently the average in America, but somewhere between 10 and 15 is normal. For a few short years, a girl's body is regulating, meaning most girls don't start off with regular, monthly cycles. And even when they do have a cycle, they don't always ovulate… the system is kind of working out some kinks. The problem of course in terms of teen pregnancy is that when teenagers do ovulate, most of them, will have excellent eggs. Egg quality really doesn't get much better, to the detriment of many an American teenager. But that's a different topic all together. A woman reaches peak fertility about 20… the eggs are stellar (normally) and the body is in rhythm (most of the time). That peak fertility window only lasts a few years. In fact by 24, the downhill slide has already begun. I know, believe me, I feel your pain. The good news is that initially it's a slow decent; unfortunately it picks up speed later.

Now many of you are probably thinking, "but I know someone who got pregnant at 42, 45, 47" or whatever and she never did IVF. Well first of all, don't be so sure. A lot of women may choose not to share their personal journey towards a child quite so outspokenly as I have. Hollywood is RAMPANT with women utilizing Assisted Reproductive Technology in secret in their later years. But you're also right. You probably do know someone who had a child in her forties without ART. That's because even at 45 our handy chart says there's a 5% chance of conception. Basically, out of 100 45 year old women, 5 will become pregnant within a year. So yes, it does happen. It's just a lot less likely to happen than at 25 or 35.

"What about Sarah from the Bible?" some of you may wonder. She was 90! If she had a baby at 90, it must be possible at 40, 50, 60 and so on. You're right, Sarah was old. In fact, Sarah was so old that when she heard she would have a child, she laughed. (I have quite a few ideas about that laughter, but that's for a different post). Sarah's story is in the Bible in detail because it was a MIRACLE. If pregnancy late in life was the norm, Sarah would most likely have received one simple line: "And Sarah, Abraham's wife, gave birth to a son."… the end. Could it happen again? I think so, absolutely… and it would still be a miracle because it's not only unlikely, it's impossible without divine intervention.

Okay, so back to the average, regular, mostly fertile woman. At 24 the downhill slide begins, but it's not something she's going to notice. She'll simply slowly start to have fewer eggs available while at the same time the eggs that are available become lesser quality. This degenerative process by which eggs are lost regardless of ovulation, pregnancy, or even birth control is called atresia. What does this mean for the average woman's chances at conception? Well on a macro scale, the above chart tells us that a woman my age should have around a 78% chance of conception within a year. But on a micro scale, the average, normal, fertile woman has about a 22% chance of conception.

Find your age: The percentage is your chance of conception per month
(if you're normal).You'll note the decline picks up dramatically later.

Now you understand why, despite fearing that you'll be just like me, it's unwise and unnecessary to run for the doctor if you aren't pregnant in three months. Out of one hundred 28 year old women, 22 will be pregnant at the end of the first month… they are either Wonder Fertile Woman, or they shacked up with Super Sperm Man, or everything was just darn perfect. But the other side of that statistic tells us that at the end of the first month, 72 of the 100 women will not be pregnant… so if you're not, you're in good company, and not necessarily (or even likely) in company with me. Breathe easy. One thing to note is the chart is again the AVERAGE, but most importantly it's the average for a normal, functioning woman meaning that women like me are not skewing the numbers. You may certainly find that your chances are higher than this... you might be 28 and have a 27% chance of conception each month. Likewise, you might be 28 and have a 20% chance each month... both are normal functioning women.

So what does all of this tell us? Well, for the average fertile person, unless you are ready to have children at 22, you're likely going to miss your most fertile window. And unless you are akin to Michelle Duggar, you are unlikely to have multiple babies in your forties. But the good news is that there are quite a number of relatively fertile years in there. I certainly wish I could wave a magic wand and increase fertility and extend it a few years, but as I cannot, either for myself or for you, it's wise to know what you're up against and what the future most likely holds. As you age, no matter who you are, you will move further down the fertility spectrum. Someone may be at the far, far left end of out spectrum in her twenties, but in her late thirties she will most certainly be less fertile. She will require more time and/or more resources to become pregnant. She might find herself somewhere in the middle of our spectrum... requiring LOTS of sex and maybe even a few pills. Someone who was more average in her twenties, maybe requiring 6-9 months to achieve pregnancy, will most likely require even more time and/or resources in her late thirties.... both can still get pregnant, but both have been affected by age as well.

Unfortunately, age is not the only factor in infertility, but it is certainly a factor. Every woman is headed towards the inability to procreate, some of us just arrive there ahead of time. Some women have diagnoses for things such as Diminished Ovarian Reserve or Premature Ovarian Failure. DOR is a natural occurrence… we're all headed there. But it becomes a major problem when you receive that diagnosis at 25 or 30 rather than 45. POF is the loss of ovarian function before 40, and unfortunately it can occur as early as fertility begins as some conditions are present at birth. In both of these instances, when the diagnosis comes during your fertile years, it means that the "normal" no longer applies. Your body may be 25, but your ovaries are behaving like they're 45. Therefore, you essentially have the same chance at conception as a 45 year old.

For myself, my infertility appears to be unrelated to my age, either my actual age or the age my ovaries think they are. There's no way to know, but I may have been equally infertile at 16 and 20 as I am now. My doctor says that if egg quality is my issue, there were really no indicators. For most women with egg quality issues, there are red flags such as hormone levels. Typically egg quality is in direct correlation with egg quantity. If you google egg quality, you will find that just about every article discusses the direct link between egg quality, quantity,  and age. Anytime you find an article addressing poor egg quality and young women, you'll read about indicators like high FSH or low AMH leading to a diagnosis of one of the above conditions, DOR or POF. I have neither of these. I am a one of the rare women who appears to have ample eggs, but a higher than normal proportion of poor quality eggs. Remember the chart with the red and green dots, well it appears I have a lot more red than green. So even when we do IVF, the odds of us scooping up 5 green eggs are low. We do not, at this point, know why. As to whether my infertility will worsen at a faster rate than a normal 28 year old, we don't really know. But as I've been given worse odds than the average "normal" 45 year old for conception on my own, I don't really think it matters.

So what's the point of all of this? As I stated before, I'd like to assure my friends who are just starting out and afraid of what it means when one cycle fails, that things are most likely incredibly normal and your baby is on the way. I hate to think that my own story will become a terrifying drama played out in the bedroom of my friends… sort of. I say sort of because, while I don't want to scare anyone, honestly, if my story causes you to kick the birth control to the curb 6 months or a year before you're both "ready," I won't feel bad. Yes, the odds are that you'll get pregnant 3-6 months before the opportune time, but really is there ever a perfect time? And if by chance you're one of the ones who finds yourself not pregnant within the first six months, and you're starting to wonder and worry, well when that pregnancy test shows positive at the the eleventh month, you'll thank me for getting you started sooner. You're welcome.