Archive | January, 2010

what constitutes “fair”

30 Jan

i had pretty much put it out of my mind. my bloodwork that is. about two weeks ago i went for an Ovarian Assessment Report (OAR). essentially a test that “establishes the Egg Retrieval Score™, an index value which combines age with blood levels of AMH, inhibin B, FSH, and estradiol, as a useful predictor of egg supply”. all very state of the art and apparently more reliable than the standard estradiol and FSH draw because the results are standardized and not left to some lab technician holding up the vial and making his/her best guesstimate. anyhow i went for the blood draw and figured the result would be back in a few days. when i didn’t get a call i just guessed that we would discuss the results during my nurse visit in a few weeks. no harm no foul. i had other things to think about (like running this marathon in 8 days). before i went to see the RE in november i had no idea there was possibly an issue with my FSH. it had been tested and the RE immediately noticed it in my file and circled it and said do you know what this means? but i had never seen it and it meant nothing to me. it was 11.6. she then drew a line on a graph and said this is where you should be and then pointed to the other side and said but you are somewhere over here but we don’t really know where and then proceeded to ask about how many follicles i usually had for my IUI’s. so this test was ordered to get a more comprehensive picture. fast forward to wednesday night. i was reading a blog and a woman mentioned getting her blood results back. she was a bit disconcerted about her FSH. and it made me wonder. thursday at work i was overwhelmed with last minute tasks and requests and trying to get everything set before i head to the east coast for a business trip and then straight to the west coast to run. so i called and asked for the results. the nurse said it might not be back yet but she would check and call me back. when she didn’t call back i figured the Dr. would be calling me back. and she did. friday afternoon while i was in a meeting and left a message. FSH of 13.7. AMH of 1.14. overall result of “fair”. apparently the OAR comes with some fancy charts and graphs so a copy is in the mail. not that i will be here for a week to see it but it will be awaiting me on my return. and if M is so moved she can try to decipher it all before then.

all of this leads to the question of what constitutes “fair”? the report says nothing about my chances of getting pregnant just my chances of producing a lot of eggs. and that’s not looking so hot. so what is the problem with that if it only takes one to get pregnant right? hmm. the eggs have to be retrieved. and they have to be mature. and then they have to be fertilized. and then they have to divide. and continue to divide. and become little embryos ready for transfer. the more eggs the better the possibilities. we have one shot at this. i am not really a gambler. nor is M. i am the type of person who plans my spontaneity. the RE seemed unphased. of course this is her job. it is what she does. she said this doesn’t really change anything. of course i didn’t actually speak to her either. i need to see the report. though i don’t know if it really alters any of my thinking all that much. i can’t say i am thrilled. i was holding on to a little bit of hope that this first test was high and was inflated a bit by all the stress of the failed IUI’s and the rounds and rounds of injectables. but this one was after 9 months of nothing so it is what it is. and as for what is fair i don’t think much about IF is fair for anyone but hopefully for us this is just a minor stumbling block.

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contingency planning

28 Jan

there is so much superstition involved with fertility and infertility. at least for me there is. i can probably tell you what i was reading every single time i went to the doctors office for appointments. and what clothes i wore. and if i ran. and how much. possibly even what i ate if i think about it enough. and this isn’t last week we are talking about – this is going on over a year ago. but it seems like you always want something to blame for why it didn’t work. some reason to point to. because it at least offers a tangible thing that can be changed. manipulated to possibly yield better results this time. the past few months have been filled with a lot of thinking about how things should go and what is the best thing to do. and how things will go when quite honestly i don’t have a lot of control. sure it is my body. but in so many ways i am essentially turning it over and saying “do with it what you must – i’ll be over here waiting – let me know if you need anything”. and i am okay with that but it involves a level of detachment that i am not used to. the last iui was chocked full of injectables. some to stimulate. some to halt ovulation. i didn’t know whether i was coming or going. and it was stressful because it seemed that no matter how much medication was pumping through my veins it wasn’t doing what it was supposed to. now it has been a while and i am aware that could possibly happen again though i must admit i am a bit more confident in the group of doctors and nurses i am now working with. from the get go they just seem to own the process better. i am confident that i will be getting excellent care. and i feel the healthiest i have possibly ever in my life. when everything finally begins i will be coming off of two marathons in 6 months. i eat healthy. my perspective has shifted and everything just seems possible right now. with all of that said though i still understand that science is still science. it is not infallible. and i can lay all the groundwork. all of the hormones call be perfectly selected and working their magic. my reading selection can be spectacular. i can stop running. or cut back. or keep running. or do whatever they tell me to. i can eat anti-oxidants until i am blue in the face and do everything and anything that is asked of me and still something. anything can just not work. i have to recognize this as a possibility while still trying not to dwell on it. it is not an easy fence to straddle. and i keep wondering what i will do if it doesn’t work. but i worry that a contingency plan is somehow saying that i don’t believe it’s possible. and i believe it is possible. i don’t want a contingency plan. i want a baby.

preparations

23 Jan

i am seemingly always in a state of preparation for something. be it work or sleep. a meal. or something bigger like a wedding or a party. a race. i have spent years preparing for things. big things. small things. and a lot of the in between. often i’m not even sure of how big it is until i am somewhere in the middle of it. and there is occasionally even that feeling of utter confusion when i realize that what i thought was minor and insignificant was really much bigger than i ever thought. and vice versa. and by my nature i am a planner. i come by it naturally. my mother thrives on planning. and being busy. she loves it. so it really should not come as a surprise that i have also “inherited” this quality. but things that i plan are a bit different. some are entirely ordinary like visiting and ultimately choosing a kindergarten for our son. my weekly runs. showing up for work reasonably on time. having dinner with an old friend from law school. and some are well quite honestly, nothing i ever thought i would be doing.  among these could include gearing up for another marathon in about two weeks. if you asked me several years ago if i would be running marathons i would have laughed but now it just seems to be part of what i do. this is only my third marathon but it is my second in about 5 months so the training all just flowed together. and it keeps me sane and happy. work is a constant moving set of preparations but it is a general ebb and flow and nothing out of the ordinary. i am also preparing to head to nyc for work for a few days before i head to ca for the marathon. this will be the first significant amount of time away from my boy. and while it will be a great adventure for me allowing me to catch up with dear friends i haven’t seen in years. and even enjoy visits with family on both coasts it is always a bit discombobulating to me at the same time. the most significant preparations though have been a long time in coming. both mentally and physically. after too many failed attempts and surgery and medications that make you lose parts of yourself and expertly timed planning and ordering bodily fluids from across the country in hushed conversations in the work cafeteria, all the conventions of modern science have been unsuccessful in getting me pregnant. over three years ago when we decided we wanted to try to have a second child i never would have imagined this is where we would now be. with the boy it was so easy for m. one iui and magically there he was. but now here we are. in a place where i have made more preparations that actually mattered than ever before. the failures of last year were heart wrenching. and expensive. and after several months off a referral was made and a new plan has been suggested. a path of last resort. so that is the one we are now preparing to walk down upon my return from ca. it promises nothing more than to be interesting. and i don’t need to prepare for that.