infertile again

I haven't been feeling infertile lately. It was sort of strange going to the clinic, having the ultrasounds, taking the medications. I had a child a little over a year ago. The birth went well. Nursing went well. Motherhood entered into every single moment of every single day. So how could I be infertile? Also, lots of my blogging friends have been getting pregnant with their second child, many without treatments. I've often wondered if I'd be one of the lucky ones whose reproductive shortcomings are miraculously healed by their firstborn.

Despite a sluggish response to clomid, I was pretty confident the first treatment cycle would work. But it only took one negative pregnancy test to cure my denial and make me feel completely infertile again. The nurse called, and I could tell by her hello that the news wasn't good. So with one little word from a woman I've never met, infertility came crashing back into my life. 

My ignorance is gone, but my hope remains. In fact, I feel just fine about that negative pregnancy test. I told the nurse that I wanted to take a month off, so I’ll start my next treatment cycle after a round of birth control. I have this hunch that my body needs a reset after two years of infertility treatments, IVF, pregnancy, birth, a year of nursing, weaning, and then less than two weeks off before starting fertility drugs again. I’ve also heard that cycles following a month of birth control tend to be more successful. I mentioned that to one of the nurses a while ago, and her response was patronizing – “If that was true, we’d have everybody on birth control every other month.” Does anyone have evidence for or against this claim – anecdotal or otherwise?

Another benefit to taking a break from treatments is that it will give me a chance to really focus on getting healthy again. Two months ago, I weighed less than I did on my wedding day. I felt so good, super healthy and fit. I had been eating well, exercising regularly…and nursing was a big help too. Since weaning Harriet, I have gained 14 pounds. Actually, it’s probably more like 16 or 17 pounds because I had been carrying a couple extra pounds in my chest back then…which is long gone at this point. There was a part of me that was even a little worried I’d get pregnant my first cycle because I didn’t want to start a pregnancy in a place where my clothes are already way too tight.

I am going to work really, really hard this month to get my cardio fitness, flexibility, and strength back. I’m also going to eat well – lots of protein, very little sugar. Losing weight while doing fertility treatments is not only a bad idea, it’s impossible. So having this month of birth control will help facilitate a time-limited period of focusing on my physical health.

I also told my care team that I want to try a different stimulation med next time around. We’re going to do femara instead of clomid. I also requested to be put back on metformin, which is a diabetes drug that can help regulate blood sugar (women with PCOS often have blood sugar issues). I’m curious to see if it will make a difference. I’m feeling positive overall. But those fears still creep in every once in a while – What if this doesn’t work? What if another child isn’t going to be part of our story?

The biggest questions and anxieties center around my care. What if I’m on the wrong meds? What if my doctor doesn’t really know me? What if there’s a better clinic out there?

I have a friend who survived three failed cycles with my doctor (Dr. C) before starting treatments at the Colorado Center for Reproductive Medicine (CCRM). She got pregnant there and she raves about them. Apparently her doctor said that Dr. C had her on the wrong meds at the wrong doses. What if she’s not the only one?

The Colorado Center for Reproductive Medicine has been coming up again and again and again as I read infertility blogs and do research. It seems everybody is either going to CCRM or getting a consult there. I even have a friend who is considering moving to Colorado in order to pursue treatments at this clinic.

CCRM has high success rates and their embryology lab is supposed to be exceptional. I’m not so sure about the lab at my clinic. During our IVF cycle, the doctor retrieved about 19 eggs. Once the eggs were fertilized and given a chance to grow for a few days, we only had three left. Three out of 19. They put two in my body, one of which didn’t make it. So then there were two – Harriet and the embryo they froze in the lab. But then Dr. C told us that our embryo was damaged beyond repair by some person or process or malfunctioning machinery. So now we have Harriet. From 19 to one. I just don’t trust our lab. My eggs are young! They should have been able to save more than just one embryo for us. One of my blogging friends spoke with a CCRM doc who said that their lab has success with embryos that would die in other labs…labs like the one at my clinic.

I like the fact that my clinic is allowing me to take ownership and make decisions about which meds I take. But on the other hand, I sort of want them to say, “Here’s the med and dose we want you on because we have studied you, your body, and your condition, and we are very confident that this is the best option for you.” Instead, they’re just like, “Sure, do whatever you want.” But I’m not a doctor! I have no idea what I’m doing!

So we’re considering switching clinics if we end up having to do IVF. But CCRM seems to be significantly more expensive. And then there are the travel expenses – plane tickets, long hotel stays. And the time off from work. And being away from home for long chunks of time. And figuring out how Harriet fits into all of this.

Part of me thinks, we got pregnant at our clinic! Their version of IVF brought us this priceless gift:

(I'm talking about the one on the left.)

But I just have this unsettled feeling in my gut about the care I’m receiving. Mostly, I just hope it doesn’t come to IVF. I don’t want to have to do that again. I don’t want to have to make those decisions.

Sometimes I even wonder if I should be doing my intrauterine inseminations somewhere else, not in another state, but maybe at another clinic in our area. Our clinic is considered to be one of the very best in our state, but who knows? Maybe it’s not the best clinic for us. I would love to hear people’s opinions on clinics, especially CCRM. If you have received treatments there, what did you think of them? Do you feel like you paid more than you would have paid elsewhere? I’m also considering sending my records to CCRM for a second opinion. Has anyone done that?

Nothing like a negative pregnancy test and all of these impossible questions to make a girl feel utterly infertile.