A Day in the Life

We are all set for IUI #5! I take my last Menopur and buserelin this morning, inject the Pregnyl at midnight, and then the insemination is booked for 2pm on Monday.

This month, I feel more relieved than excited. I’ve found superovulation to be a gruelling process. I don’t mind the injections per se – sticking a needle in myself no longer seems like a big deal – but the drugs are faffy to prepare and have to be taken at the same time every day. A typical day looks something like this:

No scan appointment (every other day)

06:00 – Wake up whether I like it or not, and wonder why on earth I opted for 9am injections “so I could have a lie-in”.

08:00 – Start worrying that I will inadvertently miss my injection slot, will have run out of needles, or the drugs will have frozen in the refrigerator.

09:00 – Evict cat from kitchen and close door. Realise other cat is still sat on windowsill. Lather, rinse, repeat. Eventually wipe down kitchen table, wash hands and set everything out. Worry that I will somehow cock up the injection process. Draw up buserelin and inject. Uh-oh, now it’s time for the Menopur. I’ve managed to cut myself snapping the top off the glass vial several times, and my fear is that it will completely shatter and I won’t have any solution for injection. OK, breathe. Make up Menopur with the scarily large pink needle, change needle and inject.

09:20 And relax! Or in other words, switch on the computer (also on the kitchen table, since we’re decorating my office) and start work.

Scan appointment

06:00 – Woken up by my alarm. Clearly, today is the day I would have had a lie-in.

08:00 – Arrive at clinic. Worry about where to do injections in an hour’s time, and again, wonder why on earth I decided on 9am. Scan shows my follicles are growing nicely (though I get scared when the sonographer starts with the smallest one, which wasn’t worthy of mention last time. For a moment, OH and I both think my follicles have shrunk). Nurse takes my blood – it’s been quite some time since I’ve had to lie down for a blood test, and I start to wonder whether I might be brave enough to watch.

09:00 – Do injections, either at the clinic (they let me use one of their rooms) or in OH’s office. Go for (placebo) coffee and breakfast.

10:00 – Fill prescription at hospital pharmacy, which is on the other side of town. I walk, so at least I’m getting plenty of exercise.

11:00 – Arrive home, realise I forgot to put my out-of-office on (oops), and attempt to cram a day’s work into a few hours.

16:00 – Ring clinic for blood test results. I really must ask what they’re testing for one of these days, because the ‘result’ they give me is usually something like, “Come back on Wednesday.” I’m working on the assumption that they’re checking my oestrogen and the levels are OK.

18:00 – I’m shattered, but my back is also killing me from working at the kitchen table, so I’d better get on with that third coat of paint.

A word to the wise: Don’t embark on a major decorating project at the same time as any fertility treatment that involves injections and close monitoring. I thought I was “getting on with my life outside TTC”, but I was wrong. What I’ve actually done is ensured there’s chaos in several areas of my life rather than just one.

Now, I must go – it’s almost time to wipe down the kitchen table and evict the cat.

Spain and Beyond

Here are a few photos from our holiday in Spain:

I’m glad we went. It was hard getting it together enough to buy holiday clothes and pack, and I sometimes found it difficult being around so many people (OH’s family) while I was grieving, but it was also healing, being in such a beautiful place and with children. It was on the day of the second photo, meandering along the shore with my niece and feeling the waves lapping at my ankles, that I realised I was going to be all right. This is a broken world where I have lost two babies but it is also a beautiful world of sunsets and oceans and other children to love.

I sat and meditated on a sun lounger one night and I acknowledged that I don’t know what lies ahead of me. Maybe I will have a successful treatment and give birth to a healthy baby – I hope so, and at this point the odds are still in my favour. On the other hand, maybe I am medically infertile. Maybe I will have recurrent miscarriages, and maybe the next few years will be filled with grieving and loss. I realised that if that is my path, I will accept it, and I will do my best with what I’m given. For me, nothing other than a child of my own (conceived by me or OH or adopted) can fill my need to be a parent, but I can still use my infertility and bereavement to support others in the same boat, and my mothering instincts to be a fantastic auntie and godmother.

It feels as though I’ve come to a new place of acceptance. In May, when I realised my spotting might be implantation bleeding, I promised God everything I had if this was a viable pregnancy. I vowed I would give all the remaining money we have saved for fertility treatment to charity, even though we might need it for other expenses. And it turned out I was pregnant – but that still wasn’t enough for the tiny life inside me to survive. It will never be enough because I’m not being punished, and if I have the child I so desperately want, it won’t be a reward. It will just be what happens, happening.

Over the past nine months, I’ve read several books aimed at Christians who are infertile or bereaved, and I’ve seen two explanations for why bad things happen. One is the idea that this is all part of God’s plan and although we might not be able to understand why, it’s for the greater good. At first, I found this comforting, but it’s a double-edged sword: it implies that God is choosing to do this to me. Why would God single me out for so much pain, and shut his ears to my increasingly desperate prayers, yet look at the woman next door and immediately give her everything she wants? I can’t help feeling that a God who does that is cruel, and a God who is cruel isn’t God. And yes, you could argue that good things can come from adversity – I don’t think I would be getting on so well with my sister now if I hadn’t had the first miscarriage – but I’ll be honest: I would never, never, never, never have sacrificed my child to repair another relationship. No mother would.

The other explanation is that this world has been broken by sin, and therefore is a cruel and unfair place where tragedies happen to people who don’t deserve them. Miscarriages, therefore, are not necessarily God’s plan, but he can work with them. I came across this idea in What Was Lost by Elise Erikson Barrett, and at first it puzzled me, but I find myself increasingly drawn to it. I don’t know which theory is correct, if either, but I know this is the one that will allow me to maintain a relationship with God. I need God and I need to believe that God can work with adversity and bring good things out of shit circumstances, but I also need not to believe that he wanted me to lose my babies.

This is turning into a very heavy post, so I’ll finish with some good news. We’re starting superovulation on Thursday! Despite what I’ve written above, I have a good feeling about the treatment and I’m hopeful that the extra follicles (if we manage 2-3) will boost my chances of conceiving a baby with the right number of chromosomes.

Nine

I’ve had a really good feeling about this cycle for the past two weeks. I’m not really sure why – maybe because in the end, the timing of ovulation seemed so perfect. Or perhaps I felt that after two BFNs it was about time for another pregnancy, or that the ordeal with the six catheters practically guaranteed a good outcome. Who knows? I could visualise our embryo inside me, I secretly thought of myself as pregnant and I kept having to remind myself how depressing the statistics for IUI are.

On Sunday, though, I started to worry. It was 10 dpiui (days post IUI) and in my last cycle, I got my period on day 11. I was scared of the same thing happening again, of all our hopes and dreams literally going down the toilet before I’d even had a chance to test. So I was devastated when, late that night, I had some red spotting. It’s happening again, I thought. My luteal phase is getting shorter and shorter. There’s barely time for an embryo to implant. I should never have asked for another natural cycle. I went to bed and cried and prayed and fell asleep in OH’s arms. The next day, I made sure we left my in-laws’ house early because I wanted to be safely home before I began to bleed.

It wasn’t until late that afternoon that I started to understand the situation differently. Not only had my period not come (normally, it would be within a few hours of any spotting), but I was starting to feel nauseous. On Tuesday the nausea remained and my breasts were killing me. I know most women don’t get these symptoms until later on in pregnancy, but I had them from 9 dpiui last time and they were so strong, I knew it was for real. There was no doubt whatsoever in my mind that I had had an implantation bleed and was pregnant. The only question was, would it stick?

Today I went to the clinic for a blood test and it showed I have an hCG (pregnancy hormone) level of 9. The nurse basically told me the pregnancy isn’t viable and that they’ll follow it up in a week. I haven’t had a bleed, but apart from that, it seems to be a similar situation to my last miscarriage.

And yet…

Everything I’ve read about hCG levels says that you can’t tell whether a pregnancy is viable or not from one number. That they vary enormously and what’s important is how much they rise between one test and the next. That anything between 5 and 25 is an “equivocal” result and should be followed up with another test a couple of days later. I’ve read forum posts by women whose first level was 9 and who went on to have healthy pregnancies (as well as by women who miscarried) and I’ve learned that according to the American Pregnancy Association, hCG levels in women who are four weeks pregnant can range anywhere between 5 and 426. Maybe there’s less room for variation in mine since we know roughly when I ovulated, but what if the embryo just implanted late?

I know 9 isn’t a great result, and there’s probably a reason why the clinic’s outlook is so pessimistic, but it seems to me that there’s still hope. And I don’t want to wait a week to find out whether that hope is misplaced or not. I can’t repeat the test in 48 hours because the lab is closed at weekends, but I’m going to ring the clinic tomorrow and ask whether I can go back in on Monday. I’m not ready to write this baby off just yet.