The Mommy Club

Treatment update: I called the RE’s office the other day and was disappointed to find out that he wants me to take metformin for the next cycle, and then I can start on Letrozole. This bummed me out because it basically means that my next baby-making chance probably won’t be until the summer. Then again, I know that starting met is important, and that it takes a while for it to be effective. I feel like I’ve done everything bassackwards by first doing three cycles of Clomid, then starting the met. Oh well. I know by my OPKs that I have high LH levels (although blood tests came back normal), and I’ve read that might be related to insulin. So who knows—maybe met will be the magic pill for me!

Last night, I attended a scrapbook party at my SIL’s office. Everybody there was a mother—except me. As I sat working on my page, I listened to my SIL and her friends discuss doctor’s appointments, temper tantrums, baby groups and the like. I stayed silent, because, well, I had nothing to say. I frequently feel this way when I talk to my SIL or other members of the Mommy Club. It’s like they’re all part of a sorority that has so far excluded me. There are countless opportunities for moms to meet other moms and subsequently schedule play dates and other social opportunities. They welcome each other, because they have a common bond. If I, however, showed up for Stroller Fitness (my SIL’s weekly exercise group), everyone would look at me a bit strangely, and whisper to each other, “What’s she doing here? She’s not a mom!”

I’m not saying that I only want a baby for the social opportunities—far from it. I just feel completely ready to be a cliché, to be a “soccer mom,” or a tee-ball mom, or a kiddie ballet mom. Yet that opportunity has not yet come to me. Instead, I’m forced to grit my teeth and smile as people say to me things like, “When you have kids you’ll understand.”

Please, someone teach me the secret handshake so I can join the club!

Wishy-washy me

OK, I admit it—I’m wavering. I wrote a long post explaining why I’m staying with my OB instead of the RE, and now I’m wondering if that’s the right decision. I have a week to decide.

I spoke to my OB today on unrelated issues, and she told me she doesn’t usually prescribe Letrozole; she refers patients to an infertility specialist. So I basically know that when I go to see her for my CD3 u/s, she’ll prescribe me 150mg Clomid and probably metformin. I may be able to talk her into monitoring my follies, but no trigger shot (again, I’d have to get that from the RE). Since we’ve been having challenges trying to time intercourse (see previous entries), I wonder if it would make the most sense to go to the RE and get trigger shots.

So, should I stay with my OB for another cycle or two, or return to the RE who mistakenly counted me out at CD13, five days before ovulation (and no, he’s not a bad RE—I just have weird ovaries, and he was trying to save me some money)? I would appreciate as many opinions as I can get. OB visits are covered under insurance; RE visits are not.

Another marshmallow man

My waking temp was 98. It appears clear to me that I ovulated on CD28. No chance of pregnancy, so we'll start over again next cycle.

I really appreciate all of your advice and comments on how/if Clomid worked for you and what your cycle lengths were. Some of you have suggested I see an RE, and with good reason. Here's why I'm not currently seeing an RE:

Clomid cycle 2, 100 mg: I went to an RE for a second opinion. He suggested monitoring, and I came back on CD13. Biggest follie was 11 mm, and he said that while he could monitor me again in a few days, he suspected this cycle was a bust. I believed him, cried a little that night (it was Valentine's Day), then went forward, determined to start Letrozole next time around under his care. But I ovulated on CD18, and by sheer coincidence (mostly), M and I had well-timed sex the night before ovulation.

Clomid cycle 3, 100 mg: If I had continued with the RE, he probably would have checked me again, and again, and again, until finally, after at least four or five ultrasounds, he would have given me the hCG shot shortly before CD28. Out of pocket, that would have cost me more than $1,200.

I made the decision that since I didn't appear to be getting any better care from my RE than from my OB (who seems like a well-informed, supportive doctor), I would stick with my OB for the time being--especially since Clomid appeared to be working.

This next cycle, whether the OB puts me on 150 mg Clomid or on Letrozole (because she's going to want my cycles to be shorter), I'm going to request monitoring. If she refuses, or if I find that she is opposed to prescribing Letrozole now or in the future, I will seriously consider switching permanently to the RE. For now, I feel I have enough information about the options available (thanks to you guys and my other Web searches) to be able to know when my OB isn't giving me the care I need.

I'm 29, and we've been trying to conceive for a year now. Although I'm getting pretty darned impatient, I know that I still have the luxury of time. If I wanted the best possible chance of getting pregnant RIGHT NOW, and money were no object, I would go straight to IVF. As it is, I was even talking last night about requesting an IUI. But M (wise man that he is) brought up a good point--if we jump ahead a few steps now, chances are we won't ever be able to go back.

For now, I want to continue gathering data about myself and my response to medications. I have to remember that I really have only had a chance of getting pregnant on Clomid once. So, the fact that I'm not pregnant yet does not frustrate me. What I do want is to be able to better predict my ovulation day (especially given M's problems). That can be solved through monitoring.

Thanks for sticking with me through this long, rambling post! I'll leave you with one final thought: Barren Mare brings up an interesting point with her Stay Puft Marshmallow Man theory. Both times I ovulated on Clomid, I had already given up the cycle for lost. Hence I wasn't QUITE as focused on trying to conceive as I had been previously. Hmmm. I sincerely, sincerely hope that was just a coincidence. Because I don't even want to think about what it means for all of us if the assvice that we should "just relax" proves to be even a little bit true. Just like Ray in "Ghostbusters," there is no way that I can just "not think about it."

What the #*&%!

I was all prepared to beg my OB for a Provera prescription so I could get going on my next cycle, and perhaps start a round of Femara. But then…

I got a temp rise. Not a big one, not nearly as big as last time, but it’s been sustained for a couple of days. The thing is, if this really is what I think it might be, I ovulated ON CD28! On Clomid! I realize this isn’t unheard of, but I certainly wasn’t expecting it. I so wasn’t expecting it, I know for a fact that I didn’t get pregnant this cycle. So now I have the 2ww just so I can start my next cycle.

If I really did ovulate, I’m not sure how to take this. Sure, it’s great that the Clomid apparently did work, but M and I really cannot handle going at it nonstop for 2-3 weeks straight every cycle (see previous post). OPKs don’t work for me. My CM is unreliable (you just gotta love PCOS). So do I switch medications to Femara? Do I up my Clomid dosage to 150 mg, and hope that doesn’t lead to more CM problems? Do I go directly to IUI? Do I request an HCG injection (and I don’t think my OB does them, so I would have to go to the RE, which is not covered under my insurance)? I am so torn. I would really appreciate some advice. Have many of you ovulated really, really late under the influence of Clomid?

The problem no one likes to talk about

Sex.

Do I have your attention yet? Except, for those of us who are infertile, sex doesn’t have the same blush-and-giggle effect it might have had when we were 16. It often becomes clinical; a necessity, not a means of intimacy. And that is a tragedy.

I debated even writing this post, and I most certainly had to get M’s permission before I would even consider it. You see, M and I have a little bit more of a problem than just my PCOS. I guess you could call it “male factor,” but actually, his swimmers are doing just fine and dandy. It’s more an issue with, um, transportation.

M takes Eff*exor for anxiety (unrelated to trying to conceive). He switched from another medication because of the sexual side effects, but it turns out Eff*exor isn’t too great in that department either. To use an incredibly lame analogy, it’s not that he can’t get the fire hose to the fire; it’s more that it’s hit-or-miss as to whether he can actually get water from the hydrant to come out of the hose. Get my drift? Not surprisingly, this leads to quite a lot of frustration for both of us. Often, we have to wait three days before we can have sex again, which is not very conducive to baby-making—especially when OPKs don’t work for me because I have high LH levels.

We saw a urologist today who specializes in such issues, and she confirmed—there’s nothing wrong with M physically; it’s those pesky anxiety medications. The bad part is, switching to other medications might lower the effectiveness, or cause even more nasty side effects. So he’s going to have to see a psychiatrist to weigh his options.

Imagine this scenario, played out over and over again: “Honey, we have to have sex tonight, because it’s CD15, and there’s a chance I might be ovulating. I don’t have any EWCM, but then again, I never do. So, let’s try really hard to relax, grit our teeth and pray to God it’s going to work.” Next morning: “Oh. My temperature didn’t rise, so I guess I wasn’t ovulating after all. It doesn’t matter that it didn’t work for us. Um, I know last night was really stressful, but could we try again tonight? We don’t want to miss our one chance this cycle.” And on and on.

At this point, I view pregnancy as a needle in a haystack. All the stars must align, and by sheer luck, everything needs to happen at EXACTLY THE RIGHT TIME for us to have a chance in hell. I have to put my faith in God, because what other choice do I have?

Does it suck to be you?

There is a musical currently playing on Broadway called “Avenue Q.” It’s sort of the antithesis of “Sesame Street” and stars 20- and 30-something puppets and humans with foul mouths. The opening song, “It Sucks to Be Me,” features the main characters singing about how much their lives suck. One character just lost his job, one wishes she had a boyfriend, two others are stuck in an intolerable roommate situation. Most of the musical is about how difficult life is for everyone. The closing song begins, “Everyone’s a little bit unsatisfied/Everyone goes ‘round a little empty inside.” It sounds depressing, but the musical is actually hilarious.

When I start to feel sorry for myself because of my infertility, I just think about that song, and about the people in my life. We’re all stranded in lifeboats in the middle of the ocean; our boats just look a little different from each other. Here’s a sampling:

--Our good friend S, a 29-year-old guy, just sent out a mass e-mail telling his friends that his girlfriend just broke up with him on the phone. Just a few weeks ago, when M talked to him about the relationship, he said it was going “really, really well.” I wouldn’t be surprised if he had been looking at rings. This is a guy who was formerly a “playboy,” but it seemed to all of us that he had finally found the right person with whom to settle down. Now it’s back to square one. In the meantime, he’s still substitute teaching because he lost his job a couple of years ago.

--My co-worker J was so happy she and her husband had finished their last payment on their minivan (they have two kids). Then, less than a month after that last payment, it broke down. Engine failure. Warranty expired at 100,000 miles, and they had 102,000 miles on it. It would cost $3,500 to repair it, so instead, they’re going to do a Band-Aid repair (about $800) and go shopping for another car. So much for saving money. They even considered canceling their upcoming vacation.

--My BIL (the husband of the SIL who talks about “when we have kids”) is a CPA with his own business. For three months every year, he lives in the office, working 12-14 hours, seven days a week. My SIL basically has to raise their toddler alone during tax season. This will be their life until he retires. It gets harder on her every year.

--My friend K has a degree in film from Northwestern University, but she hasn’t been able (or motivated) to find a job in her field. So instead, she works at a store in the mall and lives at home with her mom (she’s 29). Although recently, she found a new guy, so temporarily it doesn’t suck to be her.

--A year ago, a man at our church had a stroke/brain aneurysm. He was left severely disabled, and his wife and five young children nursed him until he died about six months later. Now, the wife is left to cope with raising her family alone.

When I start to feel sorry for myself, I try instead to think about all the good things in my life and all the reasons why it doesn’t “suck to be me.”

My dirty little secret

At our church, we have a special time at the beginning of the service for celebrations and prayer concerns. The church also keeps track of prayer requests in its monthly newsletter. M and I have only offered up a prayer concern a couple of times for relatives with health issues.

I have sometimes wondered, if we eventually go ahead with IVF, would we put our names on the prayer list? On one hand, it is an invasive procedure whose outcome is uncertain. Prayers certainly can’t hurt. On the other, I don’t know if I’ve ever seen someone’s infertility woes and procedures become the topic of church prayers. Why is this?

I can easily answer my own question: Because nobody ever talks about infertility until it’s over. That is, until the couple either decides to go on without children or adopts. I don’t add “or until the couple conceives” because many couples never tell anyone how difficult it was for them to have a child. And so the “veil of silence” continues. My co-worker (due to give birth any day now) and her husband conceived twins after three or four IUIs. Yet when people ask if they underwent ART, they say no. She only admitted it to me after I shared my own story. She says they’re very private and don’t feel that other people need to know. That’s their choice. But when they were going through three years of hell, how many misunderstandings or badly timed inquiries could have been prevented if anyone besides close friends and family had a clue what they were going through? Could they have been strengthened by other people’s thoughts and prayers?

We vent on these blogs about the annoying questions other people ask about possible children in our future. But if the other people don’t know anything about what we’re going through, how can we blame them for saying the wrong thing? It’s not a sin for a friendly acquaintance to ask when/if a couple plans to have children. It’s all part of the process of getting to know someone. If they continue to badger the couple, that’s a different story, but we infertiles are so sensitive, we bristle if someone even mentions babies.

Not that I’m any different. My SIL, who knows all about our problems, will occasionally talk about some sort of baby item she will give to us “when we have a child.” She’s not wrong in saying that. M and I plan on adopting if my ovaries turn out to be duds in the end. We WILL be parents, someday, one way or the other. Yet I don’t even like her talking about us as parents! It’s hard for me to even envision it, when it seems so far away right now. We are fortunate; M and I have only been married two years, so we haven’t yet reached the point where everybody who doesn’t know about our problems will be wondering what’s going on.

Still. I hope that if IVF is in our future, we have the courage to share our worries with our church family, who I know will try their best to help us carry our load. Infertility is not our dirty little secret.