Drum Roll...

Yep, we're having a girl!

Please Don't Turn Me Into a Story

There is one thing I hated so much while I was trying to get pregnant- stories. Every time I heard someone tell me about their cousin's best friend's sister who had three failed IVFs, but then when they decided to adopt, she got pregnant because she relaxed, I wanted to scream.

Please don't turn me into one of those stories. I know my situation is very happy and exciting, but it definitely will not happen to most women and is very rare. I just think of how those stories were very unhelpful and, sometimes, hurtful. I don't want my story to do that to someone. I don't want them to hear my story and then be told, "So, that'll work for you, too! You just need to take a break." When people think that's all infertiles need to do, they minimize the effort and pain that those ladies go through to try to have a baby.

So, please, don't share my story of getting pregnant on a break month before IVF as one that can and should happen to everyone. I wish it would, but in reality, it won't be this easy for most.

I'm Pregnant

If you haven't heard until now, I'm 13 weeks pregnant, first day of my second trimester! Just three and a half years after we started the trouble to get here.

This was a total shock and surprise to us. The last you probably know is that we were told at our meeting with the RE that we need IVF. We had decided to go on an indefinite break until we got all of our affairs in order, and just try to enjoy other things in life.

In the beginning of July, the doctor wanted to do one more test to make sure that he wasn't releasing me with any cysts or fibroids or fun things like that. He did another water/saline ultrasound test, where he pushed saline solution into the uterus and performed an ultrasound. Everything looked good and healthy. I asked then if we should bother using OPKs and timing things, and he said that was up to us. And, he left us with, (hint this part is important to remember:) "You may have a little better chance this month because the saline I just used could have pushed some of the blockage in your tube out of the way."

We decided to just have a fun time and take a true break. I put away all of the OPKs and calendars I have been using for three years, and tried to forget about them. We visited John's family for the Fourth of July, and did some other fun date nights together, just enjoying each other.

At the end of July, a symptom started bothering me. I had complained about it a couple of times to John, who finally said, "Are you pregnant?" I looked at him like, Seriously? 

But I was nice, I think, and just said, "No." Are you crazy?!

"Did you test?"

"No." Drop it, because I am not talking about this right now.

Pointed look.

Pointed look back.

I finally seceded and grabbed one of my 50 million pregnancy tests from my stash and took it so I could prove him wrong. I knew it was going to be negative. After setting it to process, I left the bathroom and came back a couple of minutes later when I remembered I had a chance to prove John wrong- a chance that I don't get very often.

But it was positive.

I yelled at John, showed him the test, and he agreed it was positive. I forgot how to breathe. I started to get light headed. I sat down. Then I looked again. And laid down because I forgot how to person. I'm pregnant?

Two seconds later I was on the phone with my RE's office and they told me to go in as soon as possible for a blood test. The next day, I took two more tests, one with two beautiful pink lines and another digital that had a plus sign on it. I got a call from the doctor, which confirmed that I was pregnant with hCG levels of 27.8.

I had a few more blood tests that showed really nice doubling times, and scheduled my first ultrasound. I was so nervous for that first ultrasound, since I had blockage in my tubes that could have easily prevented the egg from making it to the uterus, resulting in an ectopic pregnancy.

We got in, and saw that the baby was there, in the right place. Here is the crazy thing: It was barely 2mm out of the tube. Any fraction of a bit higher and that baby would have been life-threatening and we would have had to terminate. It was as close as it could get! Not only that, but the doctor saw that fluid surrounded the outside of the right fallopian tube, showing that ovulation occurred through it, but the left ovary had matured and ruptured a follicle.

Not only is my baby barely intrauterine, but the right fallopian tube reached around to the left ovary to pick up the egg. My RE said that happens in about 5% of cases. The doctor said, "I guess that saline ultrasound test did help clear whatever was blocking your tube! I'm really glad we did it!" I definitely agreed with him!

We had weekly ultrasounds after, to see the heartbeat, hear the heartbeat, and just check to make sure the baby was growing on schedule. And everything looked perfect.

I was released from my RE to a regular OBGYN, whom I love. John and I moved states just a couple of weeks ago, and I found a new doctor and office, and so far, I love them. We are so excited to be at this stage of the journey, finally!

Now, to reward you for reading this novel I wrote, (or if you just skipped it, which is fine with me), here are some pictures!

The test that was supposed to prove John wrong. I'm glad it didn't! Sorry for poor picture quality. It's the only one I have

Tests the next morning 

OPK that I took to show that they are positive when pregnant

I loved watching the lines get darker!

Ultrasound 5 weeks. We saw that little baby in the right place, even though we couldn't see it yet! Too tiny.

Ultrasound 6 weeks, the long thing is the baby/fetal pole. The round bubble is the yolk sac that fed the baby until placenta was developed.

7 weeks, we got to hear the heartbeat! It was 151 bpm and beautiful.

8 weeks, beautiful baby! We heard heartbeat again, 175 bpm.

9 weeks, and we saw baby move and squirm for the first time. At this ultrasound, my RE made a guess, and was very certain that the baby is a girl!

12 weeks, with my new doctor. More squirming and jumping. 

Apparently, right now baby is the size of a peach at 3 inches. I have an appointment on Wednesday to have a really good ultrasound where they will check for certain deformities, like spinal, and for Down Syndrome.

Oh, and here's my little 13 week bump.

Hiatus

I'm currently taking a hiatus from writing. I just need this time to process our latest news and give my mind and emotions a break for a while. If you want to contact me, please leave a comment. I will get an email letting me know that you've written.

Good luck to all, and hopefully I'll be back soon-

Allie

We Need IVF

We saw our RE today and had a long talk with him. I was right. We need IVF.

We still don't have an exact diagnosis to my infertility, but since we have corrected every other option, the only perpetrators left are my Fallopian tubes. Long story short, it's not a sperm issue, since John is not lacking there. It's not an egg issue, because I've had positives tests, showing that an egg was fertilized. It's not a cervix or lower reproductive organ issue, since we totally bypassed those with IUI. The only thing left are Fallopian tubes. And the only way to get around those is IVF.

I learned something else today. Most pregnancy losses due to factors such as genetics or problems with the embryo usually occur 8 weeks or later. Since mine were so early, and I've had so many (7 weeks, 5 weeks, 4 weeks, possibly a fourth at 4 weeks), they are indicative of tubal pregnancies. Those are embryos that don't make it out of the Fallopian tubes. It's very possible to have multiple ectopics in a row if the Fallopian tubes are compromised. Many tubal pregnancies end on their own very early, so I have been lucky that I haven't needed surgery to remove them. If they don't end on their own, it is a very dangerous and life-threatening situation for the mother if not treated quickly.

We visited with the financial counselor to talk about costs. And with a financial aid program through the office and another program to help with costs of medication, the estimated cost is between $8,000 and $10,000. We just don't have that money, and we won't have it for a long time.

I never thought that after three and a half years that I'd be here. Having put so much effort, sweat, blood, and way too many tears toward this goal, and still sitting here at the beginning. And now, we'll have to just sit here and wait. The hardest part will be sitting here not being able to do anything about it.

Also, today marks the one year anniversary of this blog. What a way to celebrate.

Infertility on TV and Movies

Infertility is hardly ever treated delicately and with necessary understanding by the media. Instead, it usually perpetuates the stereotypes that the infertility advocates try so hard to bust.
**Possible TV and movie spoilers ahead**

I originally began this post as a rant in response to an episode of Modern Family I had watched last season. Yes, it was a long time ago. Yes, I'm still miffed about it. This episode started with Phil and Claire talking about some friends of theirs. They said that these friends couldn't have children, and that they were so lucky because they could travel, have nice things, have more money, and go out whenever they wanted. Phil and Claire then wished that they were in their friends' situation. The rest of the episode showed how awful kids are, and how much it sucks to be parents. The writers then attempted to make it somewhat "happy" in the last 30 seconds when the parents said, "Even though everything about this sucks, it's worth it."

I was so angry by the end of this episode that I resolved to never watch the show again (which, admittedly, wasn't a hard decision, seeing how it was a pretty dumb show to begin with). It wasn't just that the parents were complaining about having kids. All parents do that and can relate, so I understand when shows do that sometimes, even if I grumble through the whole episode. I was angry because they wished they had the "glamorous and luxurious" life of an infertile couple. Being infertile is in no way glamorous or luxurious, and it definitely should not be envied. This stereotype is one of the most damaging and hurtful.

Another example of poor representation of infertility is in the show How I Met Your Mother. Robin, one of the characters, went in to see her doctor one day, had one test done, and left with the news that she will never be able to ever have children ever. Diagnosing infertility is never that easy, and certainly can't be decided on one test alone. I admit that there is usually only one test for a male to see how things look on his end. But for females, there are endless amounts of tests to determine everything about her fertility. Unless Robin was completely lacking in ovaries or a uterus, she would not know she was completely, truly infertile after one test in one day. It's a grueling, expensive process that is emotionally taxing.

Further is an example from Grey's Anatomy. The main character, Meredith, finds out after trying for a baby that she's infertile. I do give it partial cookie points for showing the difficulty with taking fertility medication and possible side effects. However, after adopting and not trying to get pregnant, one day *poof!* she's pregnant. And has no complications, carries to full term, and delivers a baby. While this situation does happen in a very small portion of infertile couples, it's not a common one by any means. One of the biggest misunderstandings that people believe all the time is, "Just adopt, and then you'll get pregnant!"

A similar one happens in multiple shows and movies. A character can't get pregnant. She stops trying. Magically, she immediately gets pregnant without help despite all of her problems. The best example I can think of with this is the movie Baby Mama. Tina Fey's character wants to have a baby, but is infertile. She hires a surrogate, and hilarity ensues. By the end of the film, Tina Fey magically overcame all of her problems without treatment or even trying at all, and got pregnant by having sex one time.

While I appreciate that the topic of infertility is brought up for audiences little by little, there are a lot of problems with how it's portrayed. So in the end, you have to ask, "Is it better for media to bring up the topic, flaws and all, or is it more damaging to the overall cause of the advocacy efforts?"

IUI Failed

My third IUI has failed. That's it, folks. The doc wants to meet up on Tuesday to talk about the next steps. I'm sure that will include some testing, which will most likely those expensive tests that we didn't do five months ago.

Since IUI didn't work in three shots, it's highly likely that IUI will not work for me, since we do not have a male factor problem. So all that's left is IVF...

I'm trying not to worry myself, but trying to be prepared for what the doctor may say on Tuesday. If we need IVF, I don't even know what we'll do. We'll have to put everything on hold indefinitely because we can't afford it.

Number Three

I realize that I haven't updated about my own treatment in a while. To be honest, last month was pretty devastating, and I have taken a step back from all infertility related things lately.

But, we went ahead and completed the third IUI last week. I'm now 5 days past the IUI, 6 days past my trigger shot.

My drugs this time were a bit different. I stuck with the 100 mg of Clomid, but we started my FSH earlier. I did Clomid cycle days 4-8, an FSH shot day 9 and another one day 11. And, on our ultrasound on cycle day 14, we saw not one, but TWO follicles!!! One on the right and one on the left. Since the HSG showed that my left tube is blocked we don't know if we could have success from it, but it's also an outdated test result. I did have it about a year ago, and my blockage could be better now, especially since I have had two miscarriages since the test. We are just excited at the prospect of possible twins.

If this one doesn't work, our doctor wants to meet with us again to discuss where to go from here. He said he was confident, since we don't have sperm issues, that three times should have done it. Especially since I had two medicated cycles before the three IUIs, too.

Un-due Date

Waiting is painful. Forgetting is painful. 

But not knowing which to do is the worse kind of suffering.

-Paulo Coelho

I saw the word "un-due date" on another infertility blog to describe the date that she was due with her baby before her miscarriage. I had always struggled to find a simple word to call it, which is why I thought un-due date was perfect.

June 4th is my un-due date. This one has been really hard because I have three friends who all are due within a week or two of this date. So every time I would see them, or hear an update or milestone about them, I'd think, That was supposed to be me, too. I know it's not good to play the jealousy game, but sometimes it's just going to happen. And there isn't much you can do to stop it. It's just hard to sit here and remember, I would have been a mom today.

I was hoping to offset this bad news with some good news, but I have no good news to share. My recent cycle was a bust. I thought I had succeeded this time for a few reasons, but the blood test came back negative. Perhaps it was another really early loss, or perhaps there were a bunch of really weird coincidences. We'll never know. The only thing we do know for sure is that a viable pregnancy did not result from last cycle.

Today seems to be a day of threes. We've been trying for three years, three months, and three weeks, this is my third un-due date (and hopefully last), and it will be my third IUI. Yes, we are doing one more! I had a very, very generous donation from a family member to pay for the whole cost of this cycle! We're excited and nervous to do this once more. My nurse told me yesterday that most success from IUI happens between the third and the sixth one. So I'm right in that window! We're hoping it works because I don't think there will be a fourth one. At least, not anytime soon.

Ways to Cope

It's unavoidable. Infertility causes plenty of negative feelings, including depression, anxiety, and worthlessness. It's so easy to let yourself get caught up in those feelings, and let yourself spiral down into dark places.

It takes a lot of courage, and a lot of work, but your life doesn't have to be ruled by these emotions. There are many healthy coping techniques to use that will make life better.

Resolve.org posted a list of different techniques to use in their Coping Techniques article, and I heartily second all of them.

"1. Learn about the normal responses to infertility. 

The first step in reducing the stress of infertility is to stop feeling panicky about feeling rotten! Read about the emotional aspects of infertility.

2. Another step in overcoming isolation is to build a bridge back to your family.
All but the least sensitive can be educated about infertility, and can be taught by you how to be helpful and supportive. Ask them to do some reading on infertility. Also, be sure to let them know how you want to be treated.

3. Give yourself permission to cry and be angry.
Don't try to shut off your feelings. If you need to cry about the unfairness of one more pregnancy announcement, go ahead. If you need to pound a pillow or pummel a punching bag, do it. When you try to "snap out of it," you waste all your energy.

4. Give your spouse/partner permission to feel and cope differently than you.
If you're a wife, don't waste energy trying to get your husband to feel as devastated as you do. If you're a husband, don't try to get your wife to be "more like a man," forgetting about infertility except when she's at the doctor's office or in the bedroom.

5. Improve your communication about infertility.
You might try what I call "The Twenty Minute Rule," which forces you to limit the amount of time you talk about infertility in a given evening.

6. Tell your spouse/partner how you want to be helped.
But partners are mere humans, incapable of mind reading. If you need to pass up the family gathering that features five nieces and nephews under two, then say so. If you want to be hugged, or massaged, or left alone for a few minutes, or just listened to without any response, you'll be more likely to get what you want if you ask.

7. Get more information.
One of the worst facets of stress is uncertainty about the future. You can't get a crystal ball, but you can reduce some of your uncertainty by collecting information."

Welcome Record Courier Readers

I hopefully anticipate some new readers referred here by the Record Courier article published on Friday, May 17. And I would like to say welcome, and thank you for stopping by!

I was very honored when Sheila Gardner asked if she could interview us and write about our story. And, after reading it, I feel like she captured a lot of our journey very well! I'd like to thank her for taking the time to write it and help the community understand a lot of what we, and many millions of couples with infertility, experience.

I hope that if you have any questions about infertility, or want to learn more, that my blog can help you find anything you wish to know. In the article, I recommended Resolve.org as a resource. I think I reference or link to their site in every post that I write. Any bit of information you need can be found through them.

One thing I wish the article had covered, and I understand there was a length restriction, so not everything could be covered, were a few basic facts about infertility.

Infertility is defined as "a disease or condition of the reproductive system often diagnosed after a couple had had one year of unprotected, well-timed intercourse, or if the woman has suffered from multiple miscarriages and the woman is under 35 years of age. If the woman is over 35 years old, it is diagnosed after 6 months of unprotected, well-timed intercourse."

It's estimated that 7.3 million people in the United States alone suffer from infertility.

That works out to be about 1 in 8 couples.

This disease is very widespread, and affects more people than many realize. And with the tremendous emotional, spiritual, physical, and financial strains, it's a major issue.

For those who think they may be experiencing infertility, please don't hesitate to find help now. My one regret is that I did not seek the help of a specialist as soon as I suspected a problem. I was worried about the cost of treatment, and thought that my family doctor would be able to help me at a more affordable cost. However, I ended up wasting a lot of time and money on things that did not help. A specialist, or Reproductive Endocrinologist, is the best and most highly trained person to help. For those who are local to my hometown, call the Nevada Center for Reproductive Medicine and set up a consultation. Both of their doctors are amazing, and their whole staff are incredible and friendly. They can help! Visit nevadafertility.com to get more information. For more about when to see a specialist, read a recent post, When Should I See a Specialist?

For those who are here to learn and know how to best support their family and friends, please take a look through my posts. If I may, here are a few that may interest you the most:

Join the Movement and Speak Out! My post written for Resolve.org's National Infertility Awareness Week as part of the Blogger's Unite Challenge.

Comfort IN, Dump OUT talks about an article written for the LA Times, which discusses the best ways to help someone going through any sort of trauma.

Infographic, a quick visual representation of some interesting and helpful data.

Thanks again for stopping by! If you have any questions, or wish to contact me, please take advantage of the Q&A tab at the top of the page. I'm truly humbled by friends' and community's interest in infertility, and hope that I am able to help everyone to understand a little bit more.

EDIT: The article was just published online. However, the newspaper requires a subscription fee in order to read it online. If you care to look anyway, it's here: http://www.recordcourier.com/news/6534385-113/allison-infertility-jeppsons-john

Infographic

I saw this posted on Pinterest today, and thought it summarized a lot of information really well. Enjoy!

IUI 2 Done, and Interview

As of this afternoon, we have done everything we can for this cycle. We had IUI #2 done with a final sperm count of 25 million (which is great!). We had one follicle mature on the right again, which is good and bad. My RE was a bit concerned that my follicles have been maturing on the right three months in a row. He said that my body may be compensating for a problem that is happening on the left, which is possibly causing the blockage, and that it may also be compromising the right side. He said statistically for me, since we have good sperm count, IUI should work in the first three tries, and that if it doesn't there may be another problem altogether. We're just hoping that it works this time so we don't have to worry about it!

Also, last week, John and I were interviewed by a reporter with the local newspaper about our journey for a story that will be published either tomorrow or Friday. I am very nervous about it! I felt like the interview went well, but after I kept thinking to myself, "I can't believe I said that!" and "I wish I had clarified/explained that more." The reporter was very kind, so I think she'll write a good article. I'm just very anxious to read it! I hope to see some good feedback and support from the community. 

After it's published I will put a link to it on here so you can read it. I don't know if I will be able to sleep tonight!

Me and Ann

I am a big fan of the show Parks and Recreation. Currently, one of the characters, Ann Perkins, is trying to have a baby. Since she is a single woman, she was beginning ART treatment, which I could partially relate to. It's been interesting to see how they portray a woman who is TTC, especially in the non-traditional way.

Last week's episode started with Andy finding a positive pregnancy test. He then went around to all of the women in the show to figure out which one it is. When he approached Ann, her reaction was just absolutely perfect! I asked my friend to turn it into a clip for me so I could put it on here for you to see.

Another New Experience

The other day I had the experience of giving an injection to myself. It was quite odd. I don't think I have ever purposefully inflicted pain on myself before.

I was running late to work that morning, so I had to just grab all of my materials (including my sharps container), and go. When I got to my classroom, I sat down and had to remember how to mix it all and prepare the injection. The instant it was all ready, the bell rang and students started coming in! I was so embarrassed. But, it had to be done, so I turned my back to them, and started to put the needle in.

It was odd how I hesitated. I thought, "This is a tiny needle. It's not going to hurt at all." But the second it pricked my skin, I had an involuntary reaction and pulled it away. So I went in for a second try, and bared my teeth, and sunk it all the way in. And holy cow, the serum burned! I probably did it too slowly, but I finally got it done and I'm not sure anyone even saw. At least, no one asked about it or my sharps container. I guess it's not that abnormal to see someone give themselves shots in the stomach. Many people have to do insulin shots all the time.

That was my first time ever giving a shot to anyone. And, I'm proud to say that it didn't hurt afterward, and there is no bruising. All of the shots that the nurses did at my RE's office the last few months left a bruise, and a couple hurt for a while after. One of them that was in the stomach was even bruised for a week! I guess I did something right. I hope this is the first and last time I have to give myself a shot!

Just Adopting

One thing I hear from people pretty often is, "Have you started to think about adoption?" and "Why don't you just adopt?" And while it is an option to consider when trying to build a family, it's not as simple as "just adopting."

The first step in the process of adopting is making sure you're ready for it. I was told a story once that really opened my eyes to this step in the process. A woman and her husband were at their initial interview with their case worker to open their case and start the process. And the first thing that the case worked asked was, "Have you finished mourning your infertility and your chance of having a biological child?"

That question is the first thing you have to answer, and one of the most important. For most people, we are not ready for adoption until we can truthfully answer "yes" to that question. Adoption should not be thought of as a last resort or a final ditch effort to have a family. If you think about it in that way, you are not ready for adoption. It should be a decision you come to because you are ready and wanting to raise a child, even if they are not biologically yours. Resolve has a lot of material about this issue, and on the subject of the emotional aspects of adoption, they said, " The turning  point for many couples is when they realize that they would rather be parents than be pregnant. Often, around this same time, is when the idea of adoption begins to no longer seem like the next step in a series of failures, but rather the first step in an exciting journey that will end in success. When you can embrace it in those terms is when you are emotionally ready to begin."

On Resolve's Facebook page, they asked the question, "What are some of the things you shouldn't say to someone who is having trouble conceiving?" And while there were many good answers, there were a lot about adoption. One member said, "Although we did eventually adopt, there is no 'just' about it. The adoption ride is not for everyone and is every bit as emotional, difficult, nerve-wracking, and expensive as our battle with infertility. And adoption is not a cure for infertility. Having a child in your home is a wonderful blessing but the pain of infertility is not erased by adoption. You must deal with the trauma of infertility before adopting and you must know what while you will be overjoyed, your infertility will still be a part of you." I feel like her word summed up everything perfectly. It is not a cure for infertility. Parents who adopt don't feel like their infertility magically vanishes. It's still a part of who they are.

Once someone is ready, the process isn't as easy as "just adopting." The first, and one of the biggest hurdles, are finances. Private adoption can cost up to $40,000 or more, which is the cost of two or three IVF cycles (Resolve.org, "When Should You Consider Adoption?"). There are cheaper options, but they come with a higher risk of not getting the child, like fostering to adopt, and my Church's adoption service, which usually has a waiting list of about 5 years. Many people don't know how difficult, expensive, and long it takes to adopt a child.

It is not easy to decide on adoption. And it's not easy to adopt. It's a decision that many couples struggle with, and some never decide to adopt. For me, we are not ready. At all. We have not yet given up hope of having our biological child, and will fight for that for a long time to come. And, we may never decide to adopt. Many couples decide to live child-free, and can still feel fulfilled and at peace with their lives.

IUI #2

I got the official news today that my first IUI did not work. What made it really hard hearing that this month is because there was a bit of confusion with my tests.

I had blogged earlier that I was testing out my trigger shot, and I got negative tests on 7 DPO this month. The test was also negative the next day on 8 DPO. But on 9 DPO, after two days of negative tests, I had four positives. Four beautiful even-John-could-see-the-lines positives. I knew for sure I was pregnant. But the next day at 10 DPO, they were negative. And every test after that was negative, too. We don't understand what happened. Our guess is that there was some tiny bit of the hormone that was sitting in a bit of tissue, and finally released into my body later, turning the tests positive. I don't think it was another early loss. It seems a bit early for that to have happened.

Here are the tests from this month. The two on the bottom are two of the positive ones from 9 DPO right under negatives from 7 and 8 DPO. 

It was such a rollercoaster and I'm so exhausted and emotionally worn out. The worst news is that this upcoming month, IUI #2, is the last treatment that we can afford. If it doesn't work, I don't have any idea what we'll do next. I don't feel comfortable trying on my own because of my history of miscarriages. I want to be watched very closely and be on progesterone at the earliest possible moment. I do have some refills of Clomid and progesterone left, so I guess it would make sense to use those up. But I feel like I've been put through the ringer. I am so tired and don't know how much longer I can take it. Maybe taking a break would be good for me.

I'm just waiting for my new cycle to start, and we'll do this all over again. However, we are raising my dose of Clomid from 100 mg to 150 mg to try to get more follicles. Especially if it's the left ovary's turn. We want to try to get one or two on the right.

EDIT: After my appointment, we decided to stay on the 100 mg Clomid, and add a shot of Bravelle to increase number of follicles. Increasing the dose of Clomid doesn't always mean a higher number of follicles.

Join the Movement and Speak Out!

In honor of 2013's National Infertility Awareness Week, I decided to make my voice heard by participating in Resolve.org's Bloggers Unite Challenge. Infertility is defined as "a disease or condition of the reproductive system often diagnosed after a couple has had one year of unprotected, well-timed intercourse, or if the woman has suffered from multiple miscarriages and the woman is under 35 years of age. If the woman is over 35 years old, it is diagnosed after 6 months of unprotected, well-timed intercourse" (Resolve.org, "Frequently Asked Questions About Infertility"). 

I decided to become a strong supporter and advocate for the infertility community sometime after my first miscarriage. It put me into a deep depression that made everyone, not just myself, miserable. I had feelings of hopelessness, abandonment, loneliness... Things I felt because I was completely alone in my battle. I was uneducated about infertility and pregnancy loss, and had no idea that help was out there.

I had to work on my own to pull out of it and find my happiness and joy again. Once I did, I was a new person. I was stronger and knew I could overcome anything thrown into my path. It was then that I knew I had to make my voice heard. I had to let everyone out there experiencing infertility know that they are not alone. During that time, I resolved that I would never let anyone I know go through what I went through.  I had to let all of my friends, family, and members of my community know what infertility is, and how to help those in their lives who are afflicted with it. I had to let everyone know that infertility is hard, but it sure doesn't have to be lonely. It can be overcome solo, but why not make it easier and do it with support?

I utilize Facebook quite often to discuss infertility with my friends and acquaintances, joining in on Resolve.org's discussions and posting updates about my own struggles. I love writing in this blog, Progressing in Circles, where I discuss my own treatments and pick topics to discuss and teach. I was a writer for a website belonging to my alma mater where spoke up about my journey. Many of the readers were very receptive to that, and a few have contacted me to find more support. And lastly, I am very excited to announce my latest project that I have been working on for the last few months, The Infertility Survival Guide. It's a book that is aimed toward infertile couples in my church, and gives advice, validation, and just a hint of humor about how to survive as an infertile couple in a very fertile and family driven world.

Looking back, I am very proud of my efforts to expand understanding and support for the infertility community. Even though I feel like I should be doing more, I am doing all I can at the moment. It's always a very touching moment to receive emails and messages from friends, and sometimes even strangers, complimenting me on my advocacy and asking for help. I wish I had had someone in my own life to talk to when I was in the dark about infertility, so I'm glad that I can be there for other people.

Now, I encourage you to also speak out. Whether or not you have infertility, you do have a voice. Infertility awareness is more important than a lot of people know. It is a real disease that affects an estimated 7.3 million people in the United States alone. Because it's such a private issue, it's taboo in many societies. But, it can cause a lot of depression and anxiety due to feelings of loss, struggles with self-esteem and worth, unfulfilled ambition, and other hidden emotions. It's very real, and shouldn't be ignored!

So, the solution? Educate, educate, educate! Resolve has so many amazing articles available to aid in answering any question. First, please read all of the following pages to learn as much as you can about the disease and the best ways to help.

What is Infertility?

• Frequently Asked Questions about Infertility 
• Infertility Diagnosis
• The Hidden Emotions of Infertility
• Fast Facts

For Family and Friends

• When Infertility Strikes
• Myths and Facts
• Infertility Etiquette 

Second, post on your own blog, Facebook, Twitter, etc. Please help us to expand Infertility Awareness Week to reach the ears of more people than ever before. Chances are, there are many people you know who are silent in their struggles. Be open about infertility, and you'll be amazed how many people may approach you about it and share their story.

And lastly, be a listener and a support for those people. There is no reason for infertility to be lonely. Nearly 1 in 8 couples of reproductive age suffer. We are far from alone! We are out there. Be open and be an encouragement. I know many friends who were scared and ashamed of their disease until they found someone willing to give them support. Be that support. To read more from me about that, read "Comfort IN, Dump OUT" posted earlier this week.

If you are suffering from infertility yourself, there is hope! I strongly urge you to find a support group, either local in your area, or online. I never could have been this strong and hopeful without my support groups. They are invaluable resources.

And remember, there are many ways to build a family. Even though going a different route may not be the one you expected, it will still get you to your end destination. It's just like taking a long car trip. One time, my family was making a six hour drive from my grandma's house back to our home. We were in the last hour of our journey, and couldn't wait to get out and stretch our legs and take a shower. However, we were stopped and sent on a three hour detour due to the river flooding. It was utter mayhem in the car with complaining and whining. But, there was nothing we could do about it. The only thing we could do is take the detour if we wanted to get home. We ended up getting home late, but we still arrived. The extra three hours hadn't changed anything. Our house was the same, our toys were still in our rooms, and our cats were still waiting for us. The only thing that had changed was us. We ended up on the most beautiful drive we had ever seen. Some parts were slower and very winding, causing us to slow down and drive more carefully, but others displayed the most gorgeous countryside, farms, animals, and color-changing trees we had ever seen. We saw such beauty, and were able to actually enjoy the journey it took to get to our destination.

The infertility journey is much the same. Many times you may be sent on a detour that is not of your choosing, and sometimes it will be slow and winding, but you can still learn and grow so much stronger than you ever were before. And, after that journey, you can still arrive at your same destination of having your family. Your detour may take you through many different ART treatments, adoption, and perhaps even lead you to the decision to live childless. But all are good, and all can give you peace and fulfillment, and be that destination you have been working toward.

Speak up about that journey. If you are in the process, share it to inspire others! Speak about those gorgeous trees out the car window. Share the beauty you have found in yourself during this journey. Talk to your support system about that flooded road. I know it's scary to open up sometimes, and it's not encouraging when people say the wrong things. But how will they ever know the right things to say if we don't teach them?

Read more about National Infertility Awareness Week here
http://www.resolve.org/national-infertility-awareness-week/about.html

"Comfort IN, Dump OUT"

John showed me a wonderful article that was written for the LA Times recently called, "How not to say the wrong thing" by Susan Silk and Barry Goldman. The tag line states, "It works in all kinds of crises – medical, legal, even existential. It's the 'Ring Theory' of kvetching. The first rule is comfort in, dump out." All quotations in my post come directly from the article linked above. 

One of the authors of the article was diagnosed with breast cancer, and it surprised her how many inappropriate and and just simply wrong things were said to her. One story she told was when a work colleague came to visit, but she was too tired to have visitors. The work colleague was very offended and told her, "This isn't just about you." Confused, she replied, "It isn't? My breast cancer isn't about me?" 

They realized then that a lot of people don't know how to react or treat people in the middle of a crisis. So they came up with this great theory to help.

"Draw a circle. This is the center ring. In it, put the name of the person at the center of the current trauma." This first direction is simple. Who is involved? For the author who had breast cancer, it would be herself. 

"Now draw a larger circle around the first one. In that ring put the name of the person next closest to the trauma." This could be a spot for a spouse, or others directly affected by the trauma.

"In each larger ring put the next closest people. Parents and children before more distant relatives. Intimate friends in smaller rings, less intimate friends in larger ones. When you are done you have a Kvetching Order." 

So what do you do with this order? The directions are simple: Comfort in, and dump out. It goes on to explain that those in the center ring can dump any feelings out to anyone. They are in the very middle of the crisis, and can complain to anyone. And, others can do the same, but only to the people in the larger rings. 

A diagram from the article demonstrating the theory.

My favorite paragraph in the article talks about this more. "When you are talking to a person in a ring smaller than yours, someone closer to the center of the crisis, the goal is to help. Listening is often more helpful than talking. But if you're going to open your mouth, ask yourself if what you are about to say is likely to provide comfort and support. If it isn't, don't say it. Don't, for example, give advice. People who are suffering from trauma don't need advice. They need comfort and support. So say, 'I'm sorry' or 'This must really be hard for you' or 'Can I bring you a pot roast?' Don't say, 'You should hear what happened to me' or 'Here's what I would do if I were you.' And don't say, 'This is really bringing me down.'" 

People need to send the comfort in, and dump out. Don't dump your feelings further into the circle. It's never helpful. Dump your feelings to people further out in the circle, to those who are further from the problem. Give nothing but comfort and support to those further in by saying things like the author listed above. It's a simple rule, and is just brilliant.

So why am I posting about this on my infertility blog? Because this is just the sort of thing that is absolutely applicable to infertility. Comfort in, and dump out. The best way to be supportive is to simply follow the order. I know I have posted this before, but this Infertility Etiquette article from Resolve is the exact kind of things that people in the larger circles can do for their infertile friends in the center circle.

And, finally, I made my own diagram following the directions above.

The gossipmongers always dump in.

For many people I know experiencing infertility, this is a really stressful problem. For me, there hasn't been much of a problem recently. The only thing I can think of is when I spoke in church to the entire congregation and told our story. I opened up about how long we had been trying, about our three miscarriages, and feelings about it. I'm glad I did, but at the same time, wish that people knew what to say to me afterward. I had all kinds of reactions from "Oh, I know exactly how you feel. It took me five months to conceive my last child, and it was so hard, and complain complain," and "I know this great energy/voodoo/spiritual/shaman/prayer ritual that will make you fertile," to "Don't you know that the Church has an adoption service? Why don't you just use that?" and "Have you tried going on vacation?" Luckily, you, my wonderful friends, have been nothing but supportive. I truly admire everyone for their kindness and support these last few years. You're all the very best kind of friends I could have. Thank you for reading my blog these past months, and for listening to everything I have been teaching you.

NIAW

Today is the first day of National Infertility Awareness Week. It will go through Saturday, April 27.

Our purpose in celebrating NIAW is to let those with infertility know that they are not alone, help them find resources that can help them, and educate the public about infertility. It is a very scary, heartbreaking, lonely, and frustrating time. Since it's so private, many people are not open about it. It's a very misunderstood disease, which leads to a lot of problems.

I am going to do my best this week to help accomplish those goals! I have spent the last few weeks working on posts, and already have a few ready to go. I encourage you to also do the same! Please participate and help us spread the word! Here are a few options for you to consider:

Resolve's Bloggers Unite Challenge: Share your thoughts with your readers by writing under the topic of "Join the Movement..."

The Infertility Voice NIAW Facebook Timeline Covers: Change your Facebook cover for the week to show your support.

Wear an Infertility and Pregnancy Loss ribbon this week

Donate to Resolve to help fund educational events, support groups, public awareness initiatives and advocacy efforts.

And lastly, show your love for your infertile friends and let them know that you are thinking of them!

I'm excited about this week, and hope that you enjoy the posts that are to come!

Cost Round Up

We are really starting to feel the financial strain on us due to our treatments. Previously, I discussed that our medicated and monitored cycles had cost us between $500-600. With the IUI, the cost went up. 

Again, this is what I pay without help from insurance.

Appointments:

• Baseline- $200
• Follicle check- $200 
• Second follicle check- $200. This is not always necessary every cycle, but definitely a possibility. I did need it this time.
• IUI procedure- $400

Medications:

• Clomid- $20 for 100mg dose.
• hCG injection- $60
• FSH injection- Usually $120, but I got mine as a gift from the office.
• Progesterone- $45
• Baby aspirin- Didn't cost enough to factor in.
• Prenatal vitamins- About $5.

Tools:

• Ovulation predictor kit- $12.

Labs:

• Blood pregnancy test- $45. 

Optional:

• Pregnancy tests- I did decide to test out my trigger (I was bored and couldn't resist) so I bought a new 50 pack from Amazon again for $16. 

The total from this cycle ended up being just about exactly $1200 (and would have been $1300 if I had paid for the shot the office gave me). We paid a portion of that with the very generous donation from my parents toward treatments, but ended up paying well over half with our own savings. It's really starting to come down to the wire. If it doesn't work this time, can we afford another IUI cycle? If we can't afford it, do we just go natural and try on our own? Do we go on birth control and take a break for a little while? 

It's sad how much money affects treatments. It's very frustrating that money is getting in the way of me completing my journey. This is a huge hurdle for many couples who go through infertility, and is never an easy one, especially with a vast majority of insurances not covering any part of infertility treatment. 

Trigger is Gone

So, I did decide to test out the trigger. I just relaxed about it a lot more, and didn't stress this time.

So I am at 7 days past my IUI today, which means that I am 8 days from having the trigger shot. Last month, I didn't see it turn negative until 11 days after my shot. And this month, surprisingly, I had it turn negative today. So it is negative 3 days earlier than before. I'm a little disappointed because I have heard that the hCG can aid with implantation a lot, but I guess there isn't much I can do about it.

Trigger tests this month, last one from today at 7 DPO.

The tests last trigger, bottom test at 7 DPO. Still positive.

I guess there really is just no telling what my body is going to do month to month.

Visible Embryo

One of my guilty pleasures is tracking the progress of my could-be-baby after ovulation until I can test to see if I'm pregnant. There is a really neat website called Visible Embryo that has pictures, explanations, and all kinds of neat things. It starts with 1 day past ovulation, and continues on stage by stage to show the growth all the way until birth. I always just follow along at the beginning, watching how my baby would be growing, just in case I'm pregnant.

From Infertility to Pregnancy Conference. Also, Contest.

I encourage everyone to access and watch this conference being broadcast via internet. It's starting on April 21 and going through May 4. The conference will feature lots of expert speakers who will discuss many different areas of infertility. Just register on the site (it's free!) and check out the schedule to make sure you don't miss the talks you are interested in.

From Infertility to Pregnancy Virtual Conference

I also came across this amazing opportunity to win a free IVF cycle from the Northern California Fertility Medical Center. Entering is simple, and must be done by April 28. Even if you don't live close, wouldn't it be worth travel costs to win a free IVF cycle?! I entered and hope I have a chance!

When Should I See a Specialist?

This is a question that everyone starts to ask themselves when it starts taking longer to get pregnant than expected. I remember starting to have this question pop up in my mind once I hit the three/four month mark. And while this is actually a very normal amount of time to conceive, I think a lot of couples can be impatient and start feeling like it's taking too long. It doesn't help that stories fly around about how often accidents happen, or how teenage girls get pregnant all the time. There is a myth that floats around that it's easy to get pregnant.

So what is a normal time to expect to get pregnant? The American Society for Reproductive Medicine says that if a woman is under the age of 35 to start seeking help after unprotected intercourse for one year, and for women over 35, six months. So if it's taking longer than you expected, so say, more than two or three months, you are still doing okay. Sometimes it takes a little longer for some to conceive, and there isn't a problem. It's just up to luck. But once the six month/year mark comes up, it's time to start seeking some help.

However, sometimes one can suspect something is wrong without needing to try for that long. RESOLVE.org posted that if you answer yes to any of the following to visit with your doctor.

• I have painful periods.
• I have irregular periods.
• I can not pinpoint when I ovulate.
• My partner/I have a history of STDs.
• I have an unhealthy Body Mass Index (BMI). (underweight or overweight)
• I have had more than one miscarriage. 

As for who to go see, that's a personal decision. I initally started treatment with an OB/GYN because my insurance covered it. They are able to run the simple, initial tests like a semen analysis and do ultrasounds, prescribe medications like Clomid/Femara and progesterone, and order imaging tests like a hysterosalpingogram. Some OB/GYNs are comfortable starting infertility treatment, and some aren't.

The best bet is to go directly to a specialist, a reproductive endocrinologist. They are the most skilled in this area, can help diagnose problems quicker, and get you set on the course of treatment that you need. It's worth it to go directly to a specialist. My only regret is that I wasted time "doctor hopping" instead of going immediately to the person who could have helped me best. 

The IUI

At my ultrasound yesterday we saw one beautiful follicle ready to go. A second did not mature in time, but we are really okay with that. It only takes one, right? So I was given my hCG trigger there at the office, meaning that ovulation will occur 24-48 hours after the shot. So it will be sometime this afternoon or evening. I haven't decided if I will test out my trigger this time. It seemed to add a lot of stress before. I may just do a test or two here and there just to see what it's doing.

We went back today for the collection and insemination. John described the collection as the "most awkward moment of my life." And I will stop there. We handed it over to the lab there, and they prepared the sample. What happens is they wash it to get rid of any dead or imperfect sperm, take the healthy ones, and place them in a liquid that helps them to "swim" better.

While we waited, we walked around the mall that is just down the street. And not that it matters, but I got some really cute new sandals! Anyway, when we went back, they put us in a normal exam room, and when the APN came in to do the procedure, she announced very excitedly that we had an amazing sample! Sperm count, post wash, is considered normal at 15-18 million (Average is between 18 and 40 million). In the 20s is excellent. And we had 36 million! We were really excited to hear that. Once again, the prayers helped!

The procedure itself went really fast. It started out similarly to a pap smear, with all of that funness. Then she inserted a catheter in the cervix, injected the sperm sample, and that was it. Really simple. After, she left and had me lay down for about 15 minutes. She turned off the lights for some reason, which we thought was funny. Nap time!

I will have a blood pregnancy test done on April 26th. I am not sure if I will post about the results, positive or negative, because we don't know when we would tell people once we know I'm pregnant. We still have to come to an agreement about that. I don't often do this because I have always been so open, but I would really appreciate no questions about my results. Just so we're able to keep things private if we want. Thank you!

Secondary Infertility

While I don't personally suffer from secondary infertility, I have a lot of friends who do. Secondary infertility is "the inability to become pregnant, or to carry a pregnancy to term, following the birth of one or more biological children. The birth of the first child does not involve any assisted reproductive technologies or fertility medications" (Resolve.org, "Secondary Infertility"). This is an extremely sensitive issue, and not just from comments and misunderstanding from the "Fertile Myrtles."

I decided to write a little about this for a few reasons. The first is to encourage me to try to understand secondary infertility better. The second reason is because I saw the following question posted on RESOLVE: The National Infertility Association's Facebook page:

"One of our Facebook Community members wrote: 'I am upset with people sometimes. I just started IVF for secondary infertility. We are lucky to have one child. My last baby was a still birth. I can't stand it when people repeatedly tell me to be thankful for my only living child. My dream was to have two children. I don't know how to tell them off without hurting their feelings. Any advice? Really, I am getting close to blowing up at people.' Please leave your comment for her below:"

The comments that followed were all over the place, from telling the woman that "You really should be thankful for your child. Stop being so angry and enjoy the one you have," to some really good words of support. The surprising thing is that all of the comments, insensitive ones included, came from members of the infertility community. 

I can understand both sides of the issue. For those going through primary infertility (like me) who haven't been able to have even one child, it's so easy to feel like the women going through secondary are being ungrateful for the child that they do have. When we would do anything to have even just one child, it's hard to see someone complain, "I can't get pregnant!" when they already have one. It's easy to think, "I would do anything for just one! Appreciate and love the one you have! At least you have one." 

On the other side, I can understand that it's still extremely heartbreaking to experience infertility, no matter how many children one has. I think of the pain month after month, the disappointment when seeing failed cycle after failed cycle. That could not possibly be easy for anyone. John and I had always imagined having three or four children. True, we will be happy if we are blessed with just one, but there will still be a sense of loss for the other children we feel should be in our family. I'm sure those couples going through secondary infertility must feel something similar. It must be truly saddening and frustrating to begin your family, and then not be able to feel completed. I have also heard a lot of sorrow coming from, "not being able to give my child a sibling." 

Those men and women with secondary infertility need and deserve just as much support and love as those with primary. It's harder to know who they are, and sometimes you may not even know the people in your life afflicted with it. It's easy to look at someone with children and think that they are not struggling. I guess the main point here is that you can never judge someone. Never just assume that they don't have problems, and don't assume they aren't grateful for their children. All of the friends I have talked to love and adore their children completely, but simply yearn for more. Not one has ever taken their child for granted. They understand what it really means to appreciate the gift that they were given. 

Three Cheers for the Right!

I had my ultrasound today to check on my follicles and see if I was ready for the IUI. And while everything wasn't quite ready yet, we are so so so happy to report that all of my activity is happening on my right ovary! I had one dominant follicle measure 12 mm, with a few smaller ones. A mature follicle needs to measure at least 18 mm. I will be going back for another ultrasound on Thursday to see if everything is ready, and plan to do the IUI on Friday. The APN was nice and gave me a shot of follicle stimulating hormone, which will encourage the follicles to mature. And the best part is a drug rep just stopped by their office and left a sample of the FSH shot, which she just gave to me at no charge! It is usually about $120, so that was a very generous gift! She gave me a double dose of it to try to increase the number of follicles that will mature. We're hoping that a second will mature in addition to the dominant one.

Thank you everyone, because I feel that your prayers worked! We had great news, and hope that the trend continues. If everything works out, I'd be due on January 1st, 2014. We're hoping for New Years twins!

Moving to the Next Step- IUI

At my appointment yesterday, since we have done five rounds of Clomid with intercourse to no success, we decided it was time for us to move on to the next step. So treatment this cycle will be a little bit different. We've decided to try intrauterine insemination, or as some people call it, artificial insemination.

This cycle will be very similar in that I am still taking 100 mg of Clomid to stimulate follicle growth. I've had success with a good number of follicles on that dose, so we are keeping it the same for now. I'll still track the days after Clomid with an OPK to see if I get an LH surge and ovulate on my own. If I don't get a surge, I'll still have to use the hCG trigger.

The only difference is that when I do ovulate, instead of relying on just intercourse, the doctor will inject the sperm directly into the uterus, bypassing the cervix altogether, and placing the sperm as close as we can to the egg. The nurse practitioner told us that this practice will double our odds of conception. This is a good 2 minute video about how this is done.

We are going to be traveling, and really hope that, if I do have a surge and ovulate on my own again, that we will be back home so we can do the procedure. If my body decides to be a superhero and ovulate really early this time while we're traveling, we'll have to cancel the IUI and try with just intercourse again. 

Please, send us lots and lots of prayers! This month, so far, will be the best chance we've ever had. We may just get our January 1st baby!

Nothing... again.

Everything I was feeling was just the progesterone, I suppose. Here we go again. Can't it just be my turn already??

Progesterone, Pregnancy, or PMS?

The three P's in my life currently. I have been experiencing tons of freaky things in the last week and a half. The cause could be any of the three P's. Unfortunately, the side effects or symptoms of all are almost identical. It's enough to drive anyone crazy!

Luckily, I know that anything I felt prior to around 7 days after ovulation had to be the progesterone. Anything earlier than that would be much too early for pregnancy symptoms or PMS.

So far, this is what I've been experiencing-

1-3 DPO: Ovary pain, and sharp stabbing pain (which ended up being a bladder infection, so throw that in there and it makes it even more confusing). Conclusion: Ovulation pain and an infection.

1 DPO - Current: Sensitive nipples. Conclusion: Progesterone.

5 and 9 DPO: Big wave of depression. Seriously, like weeping all day, not being able to get out of bed, and no appetite. I was diagnosed with clinical depression in college, and that's exactly what it felt like. I even told John that I needed to go to the doctor and get my Zoloft back. I read online that women who have a history of depression can experience a new episode once they start progesterone. I have a long history of off and on depression, so that doesn't surprise me. Conclusion: Progesterone.

5-9 DPO: Backache. Conclusion: ???

6 DPO: A quick, sharp pain, and then tiny little cramps that I hardly noticed. Conclusion: Progesterone.

6-9 DPO: Nausea. One day I couldn't eat anything at all besides ginger ale and Ritz crackers. Conclusion: Progesterone.

7 DPO - current: Cramps and bloating. They started small and left me wondering if they were even cramps at all, but today they are definitely noticeable. Are they a good sign? A bad sign? Do they mean anything at all? Conclusion: Progesterone, PMS, or pregnancy. Who knows!


There is a reason why it's silly to track symptoms or think that a certain symptom means something. It's easy to talk yourself into thinking you are pregnant when you're not, and it's easy to let yourself lose hope when you feel PMS-like symptoms. Currently, I am trying really hard not to think too much about them. I'm telling myself they are all because of progesterone. The only thing that has been worrying me are the cramps. They feel so much like PMS cramps that I can't help but just know that Aunt Flo is right around the corner.

I ovulated on March 11, either in the evening or at night. When I had my ultrasound at lunch time that day, my egg was still there, and we could see that I had not ovulated yet. So, technically, when I tested this morning, I was only 9 DPO. That's still really early to test. So I need to pick up my chin and not count myself out yet! I just can't get over this nagging feeling that it's just not my turn this month.

Laughter is the Best Medicine

I follow RESOLVE.org on Pinterest, and occasionally they post hilarious pictures, comics, jokes, etc. about infertility. This is by far my favorite so far!

Click to enlarge

I admit that I have all but three of these things in my house right now. The only ones I'm missing are a wine glass (I don't drink), a sharps container (only because the pharmacy completely forgot to send it to me with my hCG and needles), and stirrup socks (??).

Also, here's a cheeky thing they've posted that I thought was funny, too.

Here's my stork:

Fun with Clomid, hCG, progesterone, etc...

And finally,

At least I'll get to the end, right?