G'night, Gracie.

It's over. On July 10 we went and signed the papers to destroy the three embryos at Big Shiny Fertility Factory, the last of the Nine.

It was just too much. In the end, my desire for another child was overwhelmed by the sense that the time for that had passed. I'm almost 42. Her Indoors is 50. Small Boy is 6. In the end, I'm unwilling to gamble the time, the money, the sorrow, for an unlikely payoff. I put ten embryos in my uterus. Presumably, if there were a tiny soul that were meant to be part of our family, it would have taken one of the ten fucking chances it had to hop aboard and stay for the ride.

But nope. It's over. It no longer matters how much scar tissue my uterus has. My super-light periods are now nothing but a convenience. Small Boy will never have a full sibling; I feel intensely lucky that we have met some wonderful donor siblings via the Donor Sibling Registry. I will never pee on a stick again, never hold on the end of a phone with blood roaring in my ears waiting to find out a beta number. I will never, ever have another goddamn miscarriage. Sometimes thinking that makes me want to weep with gratitude.

During the last one I held the infinitesimal thing in my hand and thought "welp, this is it, it's over." I then immediately thought "no, no it's not, I'm not at the end, there's still a lot of road left." But my first instinct was correct. Gravida 5 Para 1, that's me, and that's how I shall die. Gravida 6 Para 1 if you count the chemical. Despite a wee Google I can't figure out if you're supposed to count chemicals.

I did not carry these embryos home and burn incense over them. Big Shiny Fertility Factory definitely didn't seem set up for that kind of malarkey. Really, they had a hard time finding someone to witness the forms at all since there was some kind of staff meeting going on; I just wanted to get out of there. Maybe it's because the embryos from Al's were Small Boy's batch. If the embryologist had gone one to the right, one of them would be with us instead of Small Boy.

Or not. Maybe that somewhat crappy-looking embryo, which turned into a perfect little boy, was the only one in the bunch. Maybe it was the only one in both of my ovaries that was fit to make a baby, or whose peculiar chemical balance could overcome whatever clusterfuck is going on in my uterus. Maybe in all worlds it's him or no one.  I can't know.

I had to try, though, didn't I?

Dreaming

I've been feeling emotionally pretty steady, but my subconscious is working hard. I dream about children almost every night.

Last night's: I had two children. Small Boy was 6 and the other one was maybe 1 or 2 (in real life, Small Boy is almost 5 now.) Small Boy asked if he could take the baby for a walk and I said "Sure".

He returned later without the baby. I was panicked and started searching the town, running up and down streets calling out, crying, looking all around. In the pit of my stomach I knew the baby was gone and we'd never find (her? I think it was her.)

In my dream, I didn't blame Small Boy at all -- I blamed myself for letting him take the baby, for not thinking it through well enough when he asked.

Sometimes I comfort myself by thinking about this: there's a decent chance that my secondary infertility was caused by the c-section. I never had lining problems before. The two miscarriages due to SCH, that's an implantation problem, which is something I also didn't have before. It seems likely that my uterus just reacted really badly to being swabbed out after the surgery.

I have finally accepted that the c-section was about as necessary and inevitable as they come. See also: obstructed labor, impacted fetal head, obstetric injury, obstetic fistula, stillbirth, maternal mortality. I am goddamned lucky. I needed a c-section, and I got it, promptly. I spent the months after Small Boy's birth angsting about breastfeeding and PPD, not dealing with grievous injuries and the death of my baby.

If while I was in labor someone had said to me: hey, I'll cut you a deal. You give up your future fertility, and I'll guarantee you that Small Boy will be healthy and happy and everything awesome.

I would have taken that deal in a second. I cared about nothing at all more than getting him here safely.

Maybe I did take that deal; I just didn't know it at the time.

Everyone rewrites narratives until they find one they can live with. Maybe this is mine: that there is no world in which I got to have Small Boy and another baby. The price of Small Boy and his truly enormous 98th percentile noggin was my future fertility. It's a price I would have agreed to.

In Sandman, Death once tells someone who -- upon dying after a long span of time -- says "I did pretty well, didn't I?" and she says "You got what everybody gets: a lifetime."

Maybe I got what everybody gets: a family. This is mine. Railing about wanting a different one makes no sense, because if it were a different one, it wouldn't be mine.

I guess it's realizing that wanting more family for me really means wanting a different family. And I don't want that.

Disposition

I just mailed off a notarized form requesting to have our remaining vial of Small Boy's donor's sperm destroyed.

I asked our donor-parent group and nobody wanted it. I think the ones who wanted more kids have already all had them now. They're done.

Saving the vial didn't make any sense. I'm 40. My eggs are now problematic. If I want to try again, my best bet is my remaining frozen embryos.

I'm continuing to reconsider how good a bet that is at this point. I started trying for #2 at 37. It looked different, then. Her Indoors is older than I am. I've had four miscarriages at this point, three of them consecutive. There are lots of different ways to parse the statistics from here on in. None of them look good.

And there's another thing I have been resolutely ignoring. I loved being pregnant. Loved it. I had little to no morning sickness. Never threw up once. Slept beautifully, the sweetest, deepest, most satisfying sleeps I've ever had. Somehow I managed to carry Small Boy in a perpendicular fashion, poking straight out from my (extremely shortwaisted) body -- I was simply enormous, measuring five weeks ahead for the whole thing, everyone assumed I was having twins. But because I was carrying him in such an absurd way, it was darn comfortable. He wasn't pressing on my lungs, stomach, bladder. I could breathe fine, I could eat a full meal, and I didn't have to pee THAT often. Because I spent about two months looking like I was about to give birth at any second, I was vastly amused by the mingled fear and solicitousness my condition constantly inspired from bystanders. Totally fun. I could've kept going. And having Small Boy be part of me like that was pure magic. I would lie awake at night and thrum with joy.

But. But. But. All that aside.

I had insulin-dependent GD that was only barely controlled with large doses of insulin. I've since then developed high blood pressure, which is a strong risk factor for preeclampsia.  I had a totally un-fun flirtation with peripartum cardiomyopathy, which can, oh yeah, kill ya.  It took ages for my liver function to return to normal after the pregnancy. I felt fantastic. But I wasn't fantastic. My body was successfully juggling something that wasn't at all easy for it, and managed to keep all the balls in the air long enough to carry Small Boy full term and get him here safely. I will never stop being grateful for that.

But. Getting real old. High chance of miscarriage. High chance of complications.  A few years ago I was willing and able to plug my ears and forge on ahead. Who can pay attention to statistics when there's a chance of a wee tiny baby with soft soft skin and little fists? Who could be cold-hearted enough to consider the numbers when there's an entire life, an entire family member on the line?

Me, I guess, increasingly.

Small Boy is an funny little independent soul, an introvert who likes his quiet time. He's not begging for a sibling. Her Indoors thinks that one is the perfect number of kids. It's just me who's having trouble letting go.

Never is such a long time, though.

I Am Your Mother?

A while ago I stumbled across this retelling, helpfully tagged "children's stories made horrific":

Are You My Mother? by Mallory Ortberg, courtesy of the Toast.

I read it a few times, with a big ol' lump in my throat. Got me right in the gut. I felt it from both sides -- the horrible vulnerability of the little bird, the dog's desperation. Sometimes the membrane between this universe and the one where I didn't have Small Boy seems way too thin. I wonder if part of my drive to have more kids isn't wanting to put more distance between myself and that universe.

We were at the bookstore last week and I told Small Boy that he could pick out a book. He made a beeline for Are You My Mother? I visibly recoiled. "No, that one's creepy, don't get that."

He looked a bit disappointed and then, in his generally easy-going way, shrugged and said "You pick."

Well, didn't I feel like an awful mother then, inflicting my infertility-damage on Small Boy. I guiltily bought the book, and read it to him that night in the very brightest tones I could muster. And I'm going to keep reading him the goddamned thing until I can do it with a real smile.

Also, when we got home, I discovered we already had a copy. So now I have two copies. Okay, Universe, very funny. I get it.

A third of a way through the hiatus: some peace and gratitude.

I record the hard times here, but I rarely bother to record the good times.

Today I'm feeling very peaceful and very grateful. I am a human being and humans look for patterns, no matter how spurious. For a while I, mired in self-pity, imagined my theme as I don't get to have what most people have, what I always thought I'd have.

I always thought I'd have a big wedding, with an enormous white dress and dancing till dawn. But when real life hit, we didn't have the money for a huge wedding, and getting married quickly seemed more important than getting married in the way I'd fondly thought we would. So this is what we had: a tiny, beautiful wedding, with our very dearest close to us.

So I'm trying this on as my new theme: Small things, done with great love (HT Mother Theresa).

Small things, done with great love, are not a bad way to make a life.


My beatific mood is helped by the fact that we've gotten some very good news. Small Boy was offered a place at a private school that we love but could never afford, with enough financial aid that we will be able to pay for it and eat food.

So yeah, feelin' lucky. Feeling peaceable with my uterus. I'll see where I am in a few months, but right now, the where-is-my-infant pain seems to be fading, not increasing.

Taking a break, or, Shore Leave for the Pequod

When Small Boy was born, I went into labor at 6:30 in the morning. I wasn't fully dilated until 2:30 a.m. or so, and that's when I started pushing.

I pushed hard. I pushed really hard. I wanted Small Boy to be born. I wanted to stop laboring. I pushed really hard for more than 2.5 hours. I'm in mediocre shape at best, and by the end I was so tired I could barely breathe, but I knew I couldn't stop. After 2.5 hours Small Boy had progressed downwards not at all. My cervix was good and swollen, but the situation was otherwise unchanged.

Then Small Boy (who had been a trooper the whole time) started having some decels, and the OB called a c-section for fetal distress and failure to descend. He had been monitoring me remotely; when he burst into the room and was like "lady, you are done here" I burst into tears.

I had rather wanted an unmedicated birth. I had badly wanted a vaginal birth. But when I burst into tears, I wasn't upset because I wasn't going to get the birth I wanted. I cried because I was so relieved and grateful. I knew that I could not keep going much longer. I was just too tired.

We later found out that Small Boy's head was severely impacted in my pelvis, and that there was no way he was exiting in any direction other than out of my abdomen. I could have pushed for hours more, I could have been twice as strong and determined, and nothing would have changed.

I'm too tired. I'm putting this down for six months. My plan for spacing my kids is scuppered. My plan for giving birth to both kids before 40 is scuppered. I'm never doing a fresh cycle again. The embryos aren't getting any older. I need to stop for a while. My family needs me to stop for a while. I need to let this white whale go, for a time, at least. Maybe I'll return to it and maybe I won't.

Maybe I'll learn that I can live with this, and that the pain of the missing person grows less over time. Maybe it'll get worse.

In any case: right now, I am putting this down. In six months I'll see where I am.

Two years later.

A lot of women who miscarry have problems with anniversaries. Sure, I remember some dates -- the very first time I was pregnant, the due date was supposed to be December 21; for my second miscarriage,  August 1; July 31 for the third and June 3 for the fourth.

I remember these dates but they really don't have any heat in them. I thought I was pretty impervious to date-ghosts. But the other day Her Indoors mentioned this year's Christmas Tree Festival. Now, I'm Jewish, but I love a good Christmas tree festival as much as the next girl, and of course Small Boy adores it.

And it was like a sock to the gut. 'Cause the last time time we were at the festival, I had a backache and was walking slowly because I was easily winded in that weird early-pregnancy way. That was what turned out to be the Sea Monkeys, miscarriage #3.

Why hasn't the date of my miscarriages bothered me before? Because duh, I've always managed to be pregnant again. First miscarriage, 5/08; in 5/09 I was pregnant with Small Boy. Second miscarriage, 12/11; by 12/12, pregnant again, although to no avail.

But I timed it wrong this round. By all rights I should have put off the transfer for another six weeks, so I could have been pregnant on the miscarriage-aversaries and then had that miscarriage at the traditional time of year.  But nooooooo. I had to do it early, so this year's miscarriage was in October, and so for the Christmas Tree Festival I'll be walking around not only not pregnant, but not even in the middle of a cycle.

I can't believe I'm here a year later, not only not having made any progress but having made negative progress. I have fewer embryos stored and I'm at higher risk for miscarriage, having had three in a row.

But I guess in a way I have made progress. I'm further along the road I'm going down, and I know that road is not endless. I'm closer to the point where I give up and start to Deal. If I'm going to subject myself to years of this pain for nothing, at least those years are drawing to a close.

Right now I feel like I'm grieving in slow motion. Not really, just kidding, maybe a little, if I mourn properly does it mean I'll then get what I want? I don't know whether to hang onto hope or just let it go. I wish I knew which the operative cliche was.

 I find myself reassuring people, friends, medical professionals. "It's okay!" I chirp. "I got my little guy!" And it's true but it's also not true. It's what good infertiles say, grateful ones, ones who don't think I should get to have what so many other people have. I am grateful, every day, grateful beyond breath for Small Boy and how he's spun my life and heart right around like a record, baby, I am, I truly am. But at the same time I'm angry that I'm supposed to be grateful and content with what it seems like practically the whole fucking world takes for granted.

The other day I walked past a box of First Response Early Result Pregnancy Test with FREE Keepsake Due Date Calculator! And I audibly scoffed. A keepsake due date calculator, after the first pee stick? Getting a bit ahead of yourself, aintcha?  And that's assuming it's positive. How many of those suckers get bitterly tossed into the trash?

But then I realized it's not that ridiculous. Most pregnancy tests are probably purchased by women who already suspect they're pregnant. Most positive pregnancy tests result in actual children. A keepsake due-date calculator on a two-pack of FRERs is utterly laughable from my point of view, but my point of view isn't representative. It's just my reality.

Small Boy is four, and we're going on lots of kindergarten tours, meeting lots of other families. This is the age interval when most families are mid-spawn, or have recently spawned. Lots of babies, lots of newborns, lots of big bellies, lots of brothers and sisters. I suppose in another five years or so it'll all simmer down other than the occasional "oops". That will be easier.

Okay, breaktime's over.

I'm ready to start again.

It's been a good extra month. I am hypertensive, and there is a rather short list of pregnancy-safe medications (which of course I've been on temporarily for, oh, two years now while TTC). I was on a high dose of labetalol, which worked okay but made me super tired all the time and also dizzy whenever I bent down.

At the start of last month I thought "fuck it, I have to start living my real life, baby or no baby." So as part of the reclaiming-my-life project, I marched down to my GP and told her I wasn't happy on labetalol.  I've found an alternative (nifedipine) that appears to be working, and omg how much do I love not dreading buying something from the bottom shelf at the supermarket. I hadn't realized what a drag constantly trying to not squat or bend down was. I feel freeeeeeee!

My energy has come back, too. I'm in a positive feedback loop right now where because I'm not so tired, I'm getting a lot more exercise, which in turn energizes me. I've also put some major effort into upgrading my diet. Her Indoors was away for a whole week and I was rather afraid I'd starve, and so bought some meal-replacement spirulina-peatmoss-whatever protein shake mix.  That got me started on a smoothie kick,and I discovered that having breakfast and lunch smoothies seems infinitely easier to me than preparing and packing breakfast and lunch. I got a one-serve portable blender and have been going wild. For breakfast this morning I had coconut milk, soy butter, kale, and strawberries.  Lunch was avocado, kefir, spinach, cilantro, lime.  Nommm! I don't really do the protein powder shakes any more, but it's comforting to have them as a backup in case I just can't be arsed to cook (in the past, when I couldn't be arsed I'd just eat whatever random crapola came strolling by my desk). I haven't eaten this well in years, and I am actually approaching a so-called-"normal" BMI for the first time in about a decade.

And yeah, did I mention more energy? I've been taking Small Boy to the playground every day, which is awful good for both of us. Small Boy is an awesome small boy, and does something side-splittingly funny at least four times a day.

I dunno, things have just been good.  The last miscarriage is far enough in the past that it all seems like a dream now. Come on, what was I thinking? Pregnancy seems mysterious, remote, something that happens to other people.  Remote feels much better than just-outside-my-reach.

So of course, now that I'm feeling calm and happy and healthy, what I need to do is fuck it all up. Get back on that crazytrain of tests, hormones, appointments, waiting uncertainty, peeing on strips of cardboard, squinting at lines.

I'm expecting my period to start in the next few days. Between days 5-15 I'll have an HSG. If that looks okay (please) I'll start another FET cycle.

Really, with that much fun? How could I stay away?

Selective attention

• Everywhere I go I see pregnant women and tiny babies and brothers and sisters clinging to each other. It's okay, it'll fade, it's just such an odd phenomenon.
  
  
• Her Indoors keeps dreaming that we lose Small Boy (literally, in  a crowd or something). Last night I dreamed that he was kidnapped, but I beat up a building full of thugs and got him back. He ran outside to my getaway car (and old Jeep. I'm not sure what that means) and I worried about the lack of an approved carseat, but threw up my hands and drove away anyway. So in the end, I guess it was an empowering dream.
  
  
• The bills from the D&C are rolling in and... I owe nothing! Turns out I hit my out-of-pocket maximum right before all that. It's surprising how soothing that discovery is.
  
  
• All quiet on the uterine front. Trying to get my medical records (fruitless so far), waiting for my appointment with Big Shiny Fertility Factory.
  
  
• Working up to a post on the subject of Ooops Pregnancies and the Infertile Blogger.
  
  
• My health insurance was actually real sweet when I called them. I was armed to the teeth in Sarcastic Mode and they instantly disarmed me. The person at the other end of the phone apologized twice, and said "I'm sorry for your loss." It is amazing just how good it is to hear those words from an outside party. I remember when going over my history with the nurse who was doing our non-stress tests, I had to mention the first miscarriage, and the nurse said "oh, I'm sorry". And I was so grateful to her for just stopping for two seconds to acknowledge that. It really does mean something.
  
  
• The last Saturday passed without notice. This is a good thing because it means I've stopped counting. I had to look at a calendar just now to confirm that yes, it would have been 9 weeks. But you know, it wouldn't have. That blast just didn't have what it needed to survive; there's no world where that particular embryo turned into our child. The aberration was that it implanted at all.
  
  I'm on one of those birth-month boards and at least 80% of the posters have a second child by now, or are in the process of building one.  Now I'm starting to see the posts from women who got pregnant at the same time I did, but with a happier ending. At first it was acutely painful, but as time goes on and our fates diverge, it starts to feel less personal. I was never on that road. I only thought I was.

Waiting for the flood

I stopped the progesterone on Monday. My RE called later that day, with a kind "sorry" -- I didn't need to hear it, but I appreciated it.

For next round, which will be in bloody October (well, the transfer will be), we're going to switch to IM progesterone. I don't believe that there's a strong reason to do so, but I don't mind. The shots hurt, but Crinone isn't exactly pleasant, and maybe it was the lack of a sharps container that interfered with the last cycle.

I've been thinking, too, about fresh cycles. Two weeks ago I was fat and sassy, sitting on my 14 frozen embryos. Now I'm down to 7, 5 of which are slow-frozen. I have a fantasy that maybe I'll be the one person whose embryos like slow-freezing better than vitrification (or the lab fucked up the vitrifying on my embryos) and that the five I socked away from my very first cycle will thaw beautifully. But chances are that they won't. That means that if the next FET doesn't work I'll likely be starting fresh again, at age 38 this time.

That's okay. It'd be less scary this time, since I know the process inside and out by now. But this time, unlike last time, I have limits. First time 'round I pretty much would have kept going until I fell over. This time I've got... more exit conditions.

Mainly it's about how well I can hold my shit together. I have Small Boy now, and he deserves to have both of his mothers firing on all cylinders. I'm willing to allow for a substantial performance hit, given that I believe that a sibling would be of long-term use to him, but there's a limit.

Right now it's in his best interest for me to try for quite a long time and not succeed, because apparently my BFN-coping mechanism is to buy Small Boy a buttload of stuff. His first train set -- clothes -- some DVDs of vintage Sesame Street -- if I don't catch promptly, this kid is going to be spoiled rotten. I did not budget for this when figuring fertility expenses.

6dt5dt: the right way to get a BFN

5:30 a.m. Wake up when 2-year old decides to join you in bed.

5:35 a.m. Lie awake trying to convince yourself that you don't have to pee.

5:36 a.m. Consider that this pee will be FMU (that's First Morning Urine, for any of you not on the crazytrain).

5:38 a.m. Pee. Test.

5:38-6:00 a.m. Stare at pristine white test, willing a shadow of a line to appear.

6:01 a.m. Give up, crawl back into bed.

6:02 a.m. Have toddler jam chubby arm around your neck, nestling fragrant head under your chin. Breathe. Think about how lucky you are to have this small, strange, snuggly person unfolding before your eyes every single day. Twine ankles with your best beloved, in your comfortable bed, with your healthy child between the two of you. Cry a bit from the happy, and also the hormones.

6:15 a.m. Drift off for a second sleep, smiling.


So... yeah. Still BFN. Still wish it weren't. But you know, I think I'm on to something here. I'm going to start scheduling my HPTs for right before a designated snuggletime. There's a depth I just can't plunge to when the Small Boy shoves his arm around me and sighs.

I have also been thinking a bit about the Slow Path. A year or two ago, I was sure that my struggles to conceive had done nothing but damage me as a person. I was more guarded, anxious, cynical, angry, bitter. Damaged. I thought that I was a worse mother than I would have been if I had traveled a smoother path.

But I've started to think that it's not true. I think that I genuinely have, to a great extent, healed. I can tell, because some of the patterns I feel myself bending into now are simultaneously familiar and unfamiliar: my brain bends that way, but it hasn't for a long time. And that's very, very good.

I don't know if I'm a better mother because of infertility, but I'm starting to cautiously think that I might not be a worse one.

4dp5dt, 6am

Woke up at 4, couldn't get back to sleep. At 6, got up and peed on stick. Result: a negative so white it could cause snow blindness. Took my glasses off, tilted it hither and yon. Not even a decent evap to entertain myself with.

So it begins...


ETA Lest it all sound too desolate: spending a splendid cuddly day with Small Boy. I set up a pop-up tent-tunnel combination that I scored at Value Village last year and have just now realized that he's old enough for. Later on we'll go to the library, maybe to Whole Foods. It will be a nice Sunday, regardless.

Schrödinger's Fetus

My uterus
contains two embryos. Quantum theory says, I guess, that they are neither alive nor dead. In general, this explains why quantum theory is something that I never intend to trouble my pretty little mind with in any sort of systematic way.

But right now, specifically, at this moment, I am a fan of quantum theory. I much prefer to spend the next few days thinking of the embryos as neither alive nor dead. It's painful to think that it could be all over already, and I just don't know it yet. Better to think that they are neither until the instant that first drop of pee hits the peestick.

Where we are
1 day past 5 day transfer of 2 embryos (both 3BB).

How we got here
For a while I'd been making noises about trying for another "starting around Small Boy's second birthday." He turned two on Tuesday. Wednesday we transferred two defrosted embryos.

Things that are true #1: this is nothing, nothing, nothing like the past three attempts.
I am in no way discounting the acute pain that secondary infertility causes some people when I say oh my fucking god so much better. Last time, failure was "dangling over the abyss." This time, failure is "not getting what I want". I mean, I know I would have survived, I would have had to, people do. But every time I thought of it, my brain just blurred into pain. Now? I'm not as flippant as I hoped I might be; I care. I care a lot. But... my worst-case scenario is not the abyss. It is (kinnehorah-inshallah-god willin-and-the-creek-don't-rise) only raising my funny, fascinating son.

I can never feel hard-done-by. I have him, and while I may not be grateful every day, I am at least grateful every second or third day.

Things that are true #2: this is nothing compared to the physical devastation of my fresh cycles.
Frozen embryo transfers are so low-key that they barely register. It don't mean a thing if it don't involve a sharps container, you know? Take some pills. Stuff some gel up your vagina. After a couple of weeks, stick a couple of embryos in there and see what happens.

C'mon. At no time during this cycle have I been able to say "breathing hurts". Calling that a win.

Things that are true #3: this is still amazingly nerve-wracking. Maybe it's the hormones; although there are no injections (my protocol was strictly Estrace - Crinone) there are still tons of hormones floating around my brain. Or maybe it's that it's impossible to ignore the magnitude of what we're trying to do and the difference it could make in all of our lives.

So the request I am making to the universe: please. I am so grateful for what I have. Can I have some more?



Procedural notes for record-keeping:
D3 E2 = 52 FSH = 7.9