And now it's time for... What's With Those Ovaries?!

(You know, I can't help but feel a bit ridiculous typing a post all about my ovaries. I think to myself, "Does anyone out there in the world really give a f#$% about my ovaries? Why am I publishing this?" But then I remind myself that I read tons of IF blogs about other women's ovaries, and I never once think to myself, "I don't give a f#$% about this woman's ovaries." I guess it's just the nature of the beast. So I proceed.)

My ovaries are acting suspicious. Not like sneaking out of the house in the middle of the night wearing dark clothes and coming home with used stereo equipment... more like having long, whispered phone conservations and then answering "wrong number" when asked who it was on the other end.

I'm all like, What's the deal, ladies?

And they are all like, Who... us?

After the soy isoflavones debacle of last month, I never did really figure out whether I had/have a cyst or not. Needless to say, those pills are at the very back of my vitamin shelf this month. Actually, I have a lazy susan in there, so sometimes they are in the back, but every now and then they are spun around to the front when I am looking for something else. But you know what I mean. I am still taking the vitex supplement, though. Illusions of control, anyone?

To familiarize you with my ovaries (here we go!), when I am doing a cycle au naturale, they are generally very quiet, except the day that I ovulate, when it feels like I am being stabbed. On cycles when I am on drugs, they start the chatter early, and I can hear them doin' their thang more days than not.

So this cycle, I should not be hearing them whatsoever. (The vitex doesn't really affect the follicular phase, it does more for the luteal phase that comes after O.) But I am on CD15 now, and they have been squawking away for several days. And the worst part is that it's lefty again -- second cycle in a row! Righty seems to be my lucky side, I was hoping for her this month. I'm really confused now.

Possibilities:

I will O very soon, like a NORMAL PERSON!! (Not likely. Normal? Ha.)

There is some residual effect from the soy isoflavones from last month, and it is stimulating the ovaries again. (I've heard of this happening with Clomid.)

I do have a cyst on old lefty, and it's craving attention more than Miley Cyrus or Paris Hilton. (My cyst is famous! That is so hot.)

Or is it something else entirely???!!!!

So, my lovely Internet contestants, anyone care to play my hypothetical game show: What's With Those Ovaries?! Grand prize is a slightly opened bottle of soy isoflavones.

The universe strikes again

I recently volunteered to be on the board at Bean's preschool. Next year I will be the co-chair of fundraising, sharing the role with another mom whom I have not yet met. I'm really looking forward to working with her, as I've heard such great things about her and our back-and-forth emailing has been pleasant.

But today she mentioned that she's pregnant.

Due the same week that I would have been, if my chemical pregnancy hadn't just been chemical.

Really, universe? Was that necessary?

All's quiet on the reproductive front

Due to my unusually long follicular phase (probably because of breastfeeding), the time between AF and O is an extended snoozefest. Which I suppose is a good thing this month, because my parents are staying with us for 8 days on a visit from Michigan. Let's just say... awkwardness averted and leave it at that.

Anyway, stay tuned for next week, I have a couple of topics rolling around in my head that I'd like to get out when I have more time to focus on the blog. Oh, and if you have any questions, or if there is something you'd like to hear about, please do post in the comments or send me an email. I'd love to address them!

Ambivalence

When AF shows her face, it's disappointing. But there is a part of me that breathes a sigh of relief.

One more month to enjoy Bean's babyhood without focusing on a second child.

One more month of our nursing relationship.

One more month of feeling physically good to hold Bean and play with him.

One more month that DH and I outnumber our offspring.

One more month filled with the hope of a pregnancy one day in the future (as in: it's not all over yet, this isn't the last time, God willing).

It was a big transition when Bean was born -- it almost felt like he was an intruder, interrupting the well-oiled machine that was me, DH, and pooch. But now we are doing so well. We have a happy rhythm. We are three first borns (and, well, whatever the pooch is). Would another person fit in? As an eldest child, would I be able to understand the mystery that are youngest children?

I know these are common fears of second time mothers. And I'm sure as Bean gets older and we still don't have a bun in the oven, this will change. But for now...

... it's actually okay.

Tools of infertility

AF came today. Ugh. But damn if breakfast wasn't delicious!

You might be an Infertile if...

... you have been to the dollar store buying home pregnancy tests so often that you have to bite back the urge to say something to the clearly disinterested clerk like, "I work with at-risk teens" or "If only you sold the tests so I could figure out who the fathers are!"

... you choose which check-out line in the grocery store not for the shortest length but for the lack of pregnant bellies and babies.

... you have hidden in the bathroom when a coworker brings in her newborn during her maternity leave.

... you know the difference between "transferring" embryos and "implanting" embryos, and it annoys you to no end when the media gets it wrong. (And they always do.)

... your friends have had multiple children in the time you have been trying to conceive one.

... sex no longer figures into your TTC plan.

... the baby clothes you naively purchased in eager anticipation when you went off birth control have since gone out of style.

... you have considered quitting your job, going on welfare, and getting addicted to crack, because those women never seem to have trouble getting pregnant.

... if asked, you could provide your basal body temperature for any of the past 365 days. (With corresponding chart, of course.)

... if you do get pregnant using your own gametes and deliver a real live baby, you and DH quickly scan your newborn to find physical traits of both of you. You know, just to make sure the doc grabbed the right tube.

A thank you

In the blogosphere, it's not hard to identify a woman who has struggled to conceive a child. It may be mentioned in the "about me" section, or evident from the links to infertility-related support in the sidebar, or in the title itself. (Which was what I was going for on this blog, I'm guessing you picked up on that.) I'm sure many women who have been touched by infertility choose not to mention it in their writing, but there are enough who do -- and are loud enough about it, thank goodness -- that the online IF community is strong.

In the real world, however, it is much more difficult to play Spot the Infertile. Which is part of the reason why many of us withdraw and don't offer up our stories as readily as we can on the Internet. You are more likely to get a "You know, my friend had problems so she adopted a baby and then she finally got pregnant!" or "Have you tried propping your hips?" than a "I've been there too, I'm so sorry."

I'm not sure how many other infertiles are guilty of this, but when I am in a room full of other moms, I automatically assume that they all got pregnant quickly and easily. Not accurate, obviously, but my self doubt feeds this notion. Back when I first had Bean, I would not only imagine myself to always be surrounded by the fertility gifted, but I would subsequently feel like I was a lesser woman, a lesser mother, because of that.

I couldn't do it on my own.

They could.

Line drawn.

As Bean has gotten older, this thinking error has lost a lot of strength. Perhaps it's because having a smiling, healthy son has empowered me to some degree, or perhaps I've reflected more on what I've been through (I overcame a fear of needles to give myself shots, I'm pretty sure that makes me awesome on SOME level), or perhaps it's because time wounds all heels. Or something like that.

But now that we are TTC again, some of that old insecurity has slithered back into my heart. Not as bad as it was before, hopefully it won't be. But I look at the other moms with two kids close in age and wonder what they did right -- and what I am doing wrong -- to achieve pregnancy so readily. (And do not say propping her hips. I'll glare at you menacingly.)

Which brings me to today: the MOMS Club Easter potluck lunch.

Let me set the scene first. About 46 of us (moms and kiddos) RSVPed. It was held at a local church, the food set out in one area while the kids burned off energy in the playroom. It was absolute mass chaos. I have been a member of this group since January, but because of Bean's two-a-day nap schedule, it's been very difficult to make it to events. This was by far the biggest gathering I had been to, and I knew only a couple of the other moms. It was very overwhelming for both of us, so upon arriving, I took Bean to the corner to play with some blocks where we could interact more quietly with whomever was nearby.

I chatted with one mom whose 3-year-old son took interest in the blocks as well. After a brief discussion on the difficulty in finding a reliable auto body repair shop, she looked at her son wistfully and said out of the blue, "He's going to be our only child."

Never having met this woman before, I was so surprised at her candor that all I could reply was, "Oh really?"

After a pause, she continued. "Yes. We went through a lot to get pregnant the first time."

"We struggled quite a bit with him, too," I replied, nodding at Bean. "We are hoping for a miracle again."

She ruffled her son's hair. "We often call him our miracle."

With that, her son went bolting out the door into another room, and she excused herself with a smile to follow him.

Wow, did that really just happen?

After the Easter egg hunt, it was time for lunch. I sat down with two other moms. One of them, who I do know from previous events, has two young kids who are Asian (she's Caucasian). It's possible her husband is Asian, but as neither kid seems to have any of her physical traits, I'm guessing they are adopted. The second mom sat with her 6-year-old son, I had not met them before. They were very nice and I enjoyed the conversation. In sharing stories of our kids, the second mom said, "The other day, my son asked if he could have a sibling." She laughed easily and naturally before continuing, "I told him that we had tried but it didn't work out."

"I want a sibling because I'm bored," her son piped up to inform us. "My friends are always sick."

His mom went on, "He said he wants a sibling by the time he's eight. I told him even if he has one now, it will be a baby and won't be able to play with him for a long time."

The topic flowed naturally to other subjects, but of course my mind was stuck there. If the situation had been different, I would have loved to have talked her to more about secondary infertility, however it was obviously not the time.

Maybe I don't get out much (okay, I definitely don't get out much), but I was surprised that two women I had known for no more than five minutes each had chosen to share even a small piece of their struggle with infertility with me. It was a great reminder that I cannot assume to know what another woman went through to conceive. And I don't have a monopoly on IF heartbreak, no matter where I am. When I open my ears, I can hear in real life what I hear from so many others online.

So to those two women today, I want to give a shout-out, props, thanks, etc.

By being open about your IF, you are doing more of a service than you realize.

I took soy isoflavones to boost ovulation, and all I got was this lousy cyst

Well, I'm not entirely sure I have a cyst. Unfortunately, having a personal ultrasound machine in your home is rather cost-prohibitive, limiting it to the rich and insane. So this is just a guess.

To rewind, last month I ovulated on CD 25. Which sucks. A general rule is that if you ovulate after CD 22, your follicle did not produce a good egg. (Kinda like overcooking a cake in the oven.) So this cycle, I decided to try using soy isoflavones, which is a supplement you can take that is supposed to work like Clomid does to produce a stronger ovulation. Of course, Clomid didn't work for me in the past, but I don't have a lot of options.

I took the soy iso for five days early in my cycle. I could definitely feel "something" happening, and on CD 22, I finally ovulated. Not fabulous, but an improvement over the previous month.

Ovulation was strong and hurt like a bitch, similar to what it was like when I was taking fertility meds. However, even now that I am several days past, I can still feel something in my ovary. It's not pain. Just... something. Like a pebble or a poke, usually when I bend or turn to the side.

Possibly a cyst.

Developing cysts while on fertility treatments is a dreaded, but common, side effect. It can derail treatments faster than a lapse in insurance coverage. I never had a single cyst during the 13 months I was taking the drugs before, but there's a first time for everything. If my hunch is right about this, I am definitely out this month. Five weeks and a bottle of riesling wasted. (Okay, maybe not entirely wasted...)

*sigh*

So, what's wrong with me

(I strictly mean in the TTC sense, of course.)

(We don't have the time to get into everything that's wrong with me.)

Let's talk diagnosis, shall we?

When we first started TTC, I charted my daily basal body temperature and fertility signs. After several months passed and we weren't pregnant, I noticed a troubling pattern in my charts that seemed to indicate that I wasn't ovulating every month. Most OB/GYNs won't discuss infertility testing or treatment until 12 months of unsuccessful TTC (being that we were 25 and otherwise healthy), and my own doc subscribed to those guidelines. A friend and coworker of mine suggested that I talk to her OB/GYN, who had delivered both her sons, as she found him to be more proactive in general than others she had seen.

I went to see him, charts in hand, and was immediately glad I did. He looked them over and declared that some of them suggested annovulation. "We'll put you on Clomid, and in a couple of months, I'll see you back here pregnant," he smiled warmly and confidently. I was thrilled and relieved! In the meantime, he ran bloodwork on me to detect hormone levels, sent me to flush out the tubes via an HSG, and tested DH as well (perfect results each time). But still, BFN after BFN. He raised my dose of Clomid... another BFN. I met with him in the office again, this time he was somber, and almost seemed apologetic. "Well, I can either keep you on Clomid and start monitoring you with ultrasounds and bloodwork during the cycle, or I can refer you to an RE." He seemed to lean that way, so I gratefully (but fearfully) accepted the referral.

By the time we sat across from the RE, we had been TTC for one year. Like my OB/GYN, the RE was optimistic that we could conceive. "I give you a ninety percent chance," he stated. Step right up, place your bets on baby! Odds are 9 to 1! The RE was friendly, took the time to talk to us, and had a wonderful staff. We were in good hands as we began another round of tests. This time, more invasive: the Clomid Challenge Test and the post-coital test. Lots of needle pokes and ultrasounds and embarrassing procedures we don't need to go into (no pun intended, ha ha ha). As before, all the results came back perfect. A relief on one level, it was also frustrating not to get any answers. As the BFNs kept rolling in, the RE looked me in the eye and said the words I dreaded hearing: "I am going to send you back to your OB/GYN for a surgical procedure. We need to do a laparoscopy to check for endometriosis."

Being a total wuss in the face of pain, I was devastated. But when the surgery finally rolled around, it wasn't nearly as bad as I expected. I even got souvenir photos of my internal girlie parts! (My friend and TTC buddy Mary told me that I have beautiful ovaries, I will never forget that. Am I lucky to have awesome support or what?) When he was poking around in there, the OB/GYN found mild endo, and he lasered off the areas that he could. However, both he and the RE agreed that the location and degree of my endo was NOT a factor in why I could not conceive. Considering that the occasional annovulation was corrected by the Clomid and everything else looked perfect, I received the label of unexplained infertility. "Nature is inefficient," my RE explained. I resisted the urge to kick him. He is a nice man, after all.

Then in February it was time to step up the treatments. We agreed at the start to do five IUIs (three with Clomid and two with injectibles) before having "the talk" about what to do next. It feels wrong to gloss over this part, as it was the most trying time of my life to date, but maybe it will be a subject for another day. Suffice it to say, on that fifth and final IUI, we got our coveted BFP. And at exactly 40 weeks pregnant, I delivered our healthy, gorgeous, wonderful, perfect, fantastic, beautiful son.

Thinking about what is causing this -- because it's too hard not to know -- my feeling is that the main culprit is the endo. I've read a lot about it, and its effect on fertility just isn't well understood by doctors. I personally think it is making things "hostile" and screwing with implantation. Only God knows... maybe the doc is right, and Nature is being inefficient.

Maybe she needs a new organizer.

Anyone want to chip in to get her a Blackberry?

The boob for a baby?

To recap my experience with breastfeeding the Bean, it started off rocky. And by rocky, I mean I was supplementing the baby with formula and trying to get him on the breast constantly and pumping like mad to increase my supply, meanwhile getting hardly any sleep and crying my eyes out daily.

It took weeks of 24-hour dedication, but I was *determined* to exclusively breastfeed this little guy. I felt like I had failed conception (IUI), failed delivery (C-section), and now I was failing at motherhood by not nourishing my child on my own.

Yes, I realize this is unfair and unrealistic. And if anyone who dealt with IF and/or a C-section and/or BF trouble tried to pull that "I'm failing" crap, I would go and kick them in the shin. Because come on, that's ridiculous.

Double standards aside, when my efforts paid off and I could stop supplementing Bean, I was overcome with an enormous sense of relief and accomplishment. While I carried a lot of self doubt from IF, I was so proud of myself for persevering in this area. Because it was damn hard. And I did it. Maybe I could be a mother after all.

I hated BFing at first, I was resentful even as I was determined. Then around six months, it wasn't so bad... I enjoyed it, kinda. And then we hit one year, my personal goal for us. Finally the ambivalence is gone, I love the bonding between us and the nutrition I give him -- makes me feel better about the fries he had for lunch the other day. I am also blessed with a super supportive DH, who never once has asked me when I plan to wean the Bean. (I'm guessing the main reason is that he enjoys having a free pass out of soothing Bean at his night wakings. The guy's not stupid!)

Now that we are hoping to add to our family again, the main challenge (beyond my questionable fertility) is that we are breastfeeding. Although AF returned early at 4 months post partum, she has been anything but reasonable since then. Cycle lengths and ovulation days are all over the board. I have the feeling that I would regulate again if I weaned the baby, but the thought of stopping before at least one of us is ready makes me want to cry. We worked so hard to get here, and it's finally so lovely!

I am surprised myself at my reluctance to wean. But I suppose it comes down to this reality: I might not have another biological child. This might be the only baby I nurse. If I knew for certain that if I weaned him, I would get pregnant in the next few months, I would start tomorrow. But if I wean now and I don't get pregnant again, I will be crushed to know that I ended before either one of us was ready.

It's the lesser of the evils, I suppose. I've given up enough for infertility, I'm not going to add breastfeeding to the list.

**Disclaimer: I pass no judgement on moms who chose not to breastfeed, it's just another decision that we all have to make on our own based on circumstances and resources. I do take issue, however, with the misinformation and lack of support out there for new moms, especially among doctors and L&D nurses. It makes me really sad when a mom isn't able to reach her BFing goals because of bad advice. But that's a soap box for another time.