2 Years Ago...

I naively thought that within a few months I'd be pregnant. We should have a baby by now. We could have even celebrated a first birthday by now. Sometimes I really feel like a failure because I can't do the one thing that every other woman I know seems to be able to do so easily, most of them without even trying. Of course two years ago all I wanted was another child and it does seem like in a way I will be getting one. Jarrod has told us, his counselor, his foster parents and his social worker that he wants to come live with us. His counselor is going to be helping him write a letter to the judge for the next court date, July 22. So two years after agreeing that we wanted another child Danny and I may become the proud parents (well, dad and step-mom) of a troubled 14-year-old boy. Not exactly the family addition I had imagined two years ago but I told Danny yesterday that maybe this has been God's plan all along. If Jarrod comes to live with us all of our bedrooms will be full. Hopefully my mind and heart will get the message that our family is full and I'll stop wondering if we'll ever have another baby.

Happy Birthday!

Tomorrow my blog will be one-year-old. When I first started blogging I thought I'd blog about TTC for a few months, then I'd be blogging about pregnancy and soon about being a mom of two. Instead my blog has become about secondary infertility, endometriosis and being a mom of one.

With summer rapidly approaching almost two years have gone by since I convinced Danny we should just go for it and try for another baby. Lately I've been wondering if maybe it's time to just accept that Ashton will be an only child (besides Jarrod). Money has been tight and I'm not sure when I'll be scheduling my second surgery. I'd really like to have all of the doctor's bills caught up before I add to them but right now we don't have any extra money to throw at bills. I hate that our decision whether or not to have a second child is being affected so much by money. Other couples only have to worry about the normal "new baby in the house" money. We have to worry about whether we have enough money to even create a new baby. At this point I'm sad to say that TTC is taking a back burner to everything else going on right now. I still want another baby but as it becomes apparent that it's just not going to happen easily I have to accept that I can't control everything. I'm going to put away the thermometer and the OPK's. I'm going to try to stop obsessing about where I am in my cycle and try to go back to the way things were before we started TTC. At least for awhile.

The cost of not having a baby

How much does it cost to have a baby? Well, for "normal" people it doesn't actually get expensive until after the baby is born but for infertiles the costs start racking up long before that. Here's how much it has cost me to not be pregnant so far:

One failed Clomid cycle - $8.00
Initial visit to Dr. T and first u/s - $191.00
2 SA's - $70
CD 3 bloodwork and repeat u/s - $36.30
Bloodwork before lap - $26.80
Dr. T's charges for lap - $105.70
Bill for lap from the hospital - $2,863.82 (but one thing was coded wrong so that should end up being less)
Anesthesiology for lap - $70.52
Appendectomy (because it was covered in endo) - $99.90
Pathology for tissue removed during lap - $13.30

For a grand total of - $3485.34
Although, that should go down considerably after the hospital resubmits their claim. It's still a lot though. Infertility is one of the only businesses where the consumer forks over money not expecting a guaranteed return on their investment. And we just keep forking over the money as long as there is any glimmer of hope that one time it will work.

Secondary Infertility Article in The Telegraph

The Second Time Around posted an artile from The Telegraph on Secondary Infertility. The article does a great job of explaining the pain, anger and guilt that women suffering from Secondary Infertility go through, your child asking why he or she doesn't have a brother or sister, and how friends and even husbands don't always understand what we're going through. It's a good read, check it out.

Here are a few tidbits that really hit home with me:

I can never switch off my longing while the baby buggy clutters the hall and the cot is obscuring the entrance to the loft. I cannot throw a single item of my daughter’s clothes away or hand it on to another family in case, as I so desperately hope, I need it again. So I hoard weaning spoons, disposable swim nappies, bibs, alphabet blocks and teething rings. When I actually steel myself to throw away an old steriliser or set of well-used bottles, I do so through tears.

Mothers such as Lucy and me have to suppress more than just our sadness – we also have to rein in our frustration and irrational anger when those around us appear to become pregnant easily and repeatedly, revelling publicly in their fecundity. How awful it is, they say, to be pregnant again so quickly after the last one. Gosh, I just have to look at my husband and I’m expecting.

'Ever since I had my son, people have asked, “When are you going for number two?’’ and I would just smile,’ Lucy says. 'The truth was that we started trying almost straight away but it has just never happened. When people ask now I am honest and say, “We can’t seem to do it this time round’’, and they often look uneasy – but I would rather they ask. Sometimes I fear that people who don’t ask think that I don’t want another one, and that is really upsetting. The other day I volunteered to hold a friend’s eight-month-old baby (her second) and although she knew I had a child already, she said, surprised, “I didn’t think you liked babies.” I love babies but sometimes I avoid holding them because it triggers tears.’

What is the definition of insanity?

Albert Einstein once said “The definition of insanity is doing the same thing over and over again and expecting different results”. Well, if that's the case, sign me up! Yes, I am charting again. Danny actually asked me the other day why I was back to taking my temperature every morning. My answer: "because I'm retarded". Even though Dr. T has said that it will probably be almost impossible for me to get pregnant before I have another surgery I'm still holding on to that smallest of small chances that one of these cycles will work. Maybe I'm just in denial that my endo is as bad as Dr. T says. After all, I've been pregnant before so things must have worked once. The thing is though, I don't know how long I've had endo. My gut feeling is that I've had it for awhile and getting pregnant once before was just a miracle. But I'm not giving up so please, feel free to join me as I continue on my road to insanity!

For Friends and Family of the Infertile

This post is inspired by a post on one of the message boards I frequent. Someone posted asking what she should do to support a friend who was recently told her chances of becoming pregnant aren't good. Since I'm slowly letting family and friends know about this blog I thought it might be a good idea to post some links to articles and resources for friends and family of the infertile.

By far the best article I've seen is from the RESOLVE website:
Infertility Etiquette

There is also a list of resources on the Creating a Family site. A few different articles, a video and a couple of letters.

Feel free to check any or all of them out!

Today's RE Appointment

I had my post-op appointment with Dr. T this morning. I went in expecting to hear the worst and it was a good thing I had prepared myself. He said that I have pretty severe endometriosis. My uterus is actually pulled back and fused to my colon. There was endo on my appendix so that is why he removed my appendix. The opening of my left tube is blocked and my tube is very swollen with fluid. Dr T. suspects that I have hematosalpinx, which is blood collected in my tube. During my period some of the menstrual blood actually goes back into my tube and just collects there. The one bit of good news is that my left ovary is fine. There was no cyst on it, my tube is just so swollen that on the ultrasound it was too hard to distinguish between the tube and my ovary. What looked like an ovarian cyst on the ultrasound was actually the end of my tube. Dr T. said that with the severity of my endo it is very unlikely that I'll be able to have a spontaneous conception. My chances of getting pregnant the old fashioned way without more surgery aren't zero but they're pretty slim.

So what are my options now? Basically Dr T. I have two options. The endometriosis isn't a life threatening condition so I can choose to just let it be and if I want to get pregnant then I can try IVF. My other option is having another, more extensive surgery to remove all of the endo, try to unblock my left tube and remove the tube if it can't be unblocked. Dr. T said that my recovery time with the second surgery will be longer than with the first and in 95% of cases he is able to remove all of the endo with the scope so I wouldn't have any larger incisions.

I know that we can't afford IVF. One cycle of IVF costs about $15,000 and our insurance won't cover any of it. I'm not in a hurry to have another surgery with all that we have going on right now. The soccer season won't be over until mid-May and we also have who knows how many court dates and attorney appointments coming up for Jarrod. Dr. T said that I can basically have the surgery anytime so it's up to me to decide when is the best time. I'll take some time to let it all sink in and then discuss it with Danny before deciding but I'm pretty sure another surgery is in my near future.

Repeat U/S

I've been sick for the past 3 days so I haven't felt like sitting at the computer. I did see my RE yesterday for another u/s though and wanted to post an update. The cyst is still there and the RE said that it looks like my ovary might have even attached to my uterus because of the pressure from the cyst. So in the words of my RE "that buys me a ticket to the OR". I'll be having a lap next cycle. He said that we could try to squeeze it in this week but I need time to put in for time off work plus I feel crappy this week already, no need to add to it. He canceled my HSG since I'm having a lap done anyway. He said that if he thinks I really need the HSG he can just do it while I'm out for the lap. So I get to call on CD 1 and schedule surgery. I'm pretty nervous because I've never had any kind of surgery before and never had to be put under. I'm just glad it's an outpatient surgery.

More tests

I went in today for my CD 3 labs. Not sure when I should have the results. My RE's office has a voicemail box for each patient to call in to check labs. They never put Danny's SA information on mine though, I had to ask today. The nurse and the lab tech both said his numbers look fine. I didn't get copies and I don't remember the exact count but motility was 57% and morphology was 11%. The lab tech said that she hardly ever sees morphology much higher than that because their standards for "normal" are so high. I also finally got to see the numbers from his first SA. Count was normal, motility 43% and morph. 8%. So both motility and morph. went up! I'm going back in on Tuesday morning for another ultrasound and then my HSG is Friday morning.

RE Apointment

The appointment went well. I really like our doctor. He seems to really know what he's talking about and didn't try to sugar coat anything. He told us not to worry about the Lyrica, that he really doesn't think it will cause us any problems. He wants me to have all of my CD 3 blood work done again and have an HSG done next cycle before he gives us a treatment plan. Danny had another SA done today so we'll see how his numbers are compared to the last one.

The doctor did an ultrasound today which kind of surprised me. It showed that I have a retroverted uterus, which I already knew from when I was pregnant with Ashton. My right ovary is "beautiful" but I have an endometriosis cyst (endometrioma) on my left ovary. He said that in most cases they are usually benign but if it doesn't go away on it's own then I'll have to have surgery to remove it. He did say that there is a chance that it is a corpus luteum cyst but probably not. I'll go back next month for another ultrasound to see if it has gone away or gotten smaller. If it hasn't then I'll have laproscopic surgery to remove it. He did mention that there is a chance that I could lose my left ovary but if it comes to surgery he would try to save it.

Not really what I was expecting to hear but if this is what has been causing all of our problems and it can be fixed then that's good. He also said no more Clomid for now. He'd like to see what my body does without any medication first, then see if I need to move on to Clomid or other drugs.

Some info I found:
What is an endometrioma?

An endometrioma is a mass of tissue (noncancerous cyst or tumor) that contains shreds of endometrial tissue. Endometriomas most frequently occur in the ovary, in a part of the peritoneum (sac around the internal organs) between the rectum and uterus, the wall (septum) between the rectum and vagina, and the outside of the uterus.

How are endometriomas treated?

Several surgical treatments are available for endometriomas:

Simple puncture - This procedure is completed by draining the fluid from the cyst. Endometriomas have been shown to recur in about 50 percent of the patients treated with simple puncture. However, a more aggressive surgical approach, such as cutting away the mass, can cause extensive adhesions (scar tissue) that may prevent the ovary from releasing an egg.
Ablation - Another approach is to drain the cyst and remove its base with laser or electrosurgery. However, heat can also damage the ovary.
Cutting away of the cyst wall - This is the procedure of choice to decrease recurrence of disease. This procedure can also damage the outer layer of the ovary that contains the eggs.
Draining, drug therapy, and surgery - Endometriomas can also be drained, treated with medication, and later removed by surgery. Endometriomas recur in 8 percent of the patients treated with this procedure. Results from several different prospective studies have reported pregnancy rates of 50 percent over 3 years. There are no randomized clinical trials comparing these different treatment methods.

Doctor vent

Yesterday I was setting up our mail order prescriptions. Danny has quite a few because he's Type 1 diabetic. I got to wondering if any of the prescriptions he takes could have an affect on his sperm quality since I've heard that some can affect motility and morph and both were a little low on his SA. One medicine he's been taking for over 2 years now is Lyrica. He uses it to help with his nerve pain (it has to do with his diabetes). So I'm reading the drug facts about it when I notice this:
Men who are planning for fatherhood should also talk with their doctor before taking Lyrica. Studies showed that the drug made male animals less fertile. Also, birth defects occurred in the offspring of male animals who were treated with pregabalin.

I was with Danny when the doctor prescribed this so he knows that DH is married and would then possibly want to father another child. He never mentioned this to us at all. I know that really we should have read about it before he started taking it but if a drug has serious side effects aren't doctors supposed to at least mention them? I am so angry and frustrated that this could be what's keeping us from conceiving and even if we do conceive that baby could have birth defects. We have an RE appt. tomorrow so I plan to ask him about this. This is my first Clomid cycle and now I'm terrified to even TTC :(

ETA:
I found more information on Lyrica. A study was done with male rats:
In fertility studies in which male rats were orally administered pregabalin (50 to 2500 mg/kg) prior to and during mating with untreated females, a number of adverse reproductive and developmental effects were observed. These included decreased sperm counts and sperm motility, increased sperm abnormalities, reduced fertility, increased preimplantation embryo loss, decreased litter size, decreased fetal body weights, and an increased incidence of fetal abnormalities. Effects on sperm and fertility parameters were reversible in studies of this duration (3-4 months).

I'm really hoping that the RE has some information on this. I'm really interested in the "increased preimplantation embryo loss". I could have actually been pregnant several times in the last year and a half and the embryo just didn't implant. I'm guessing we'll probably have to avoid getting pregnant for awhile. It takes about 90 days for new sperm to form so we may have to wait until April to start trying again.

Clomid: Day 1

Yes, I am officially taking fertility medication. And of course this morning I woke up to find news of my niece's new baby in my email. Surprisingly I didn't feel sad or really even upset at all. I've really been in a better state of mind about this whole TTC business and I think I can give the credit to my doctor. She really took the time to listen to my frustration and asked a lot of questions. I think it also helps that we finally have an appointment with an RE. It really feels like, after a year and a half of going nowhere, we are finally headed down a road that will lead to a baby.

Happy New Year! On to Cycle 20 :(

What a way to start the new year. After having a chart that looked amazing last week, AF showed up this morning right on schedule. So I guess I'll be starting Clomid on Tuesday. I dropped off my Clomid prescription yesterday so I'll probably go tomorrow or Tuesday morning to pick it up. I got the results of the blood work I had done at my doctor's appointment and I apparently have a vitamin D deficency so I also get to start taking a vitamin D supplement. Yay for more pills!

Belated Merry Christmas!

This past week just flew by. I spent so much time getting ready for Christmas I almost feel like I didn't have time to really enjoy it. Christmas Eve I drove Ashton to my parent's house because I had to work that night. Our family always gets together Christmas Eve and I wanted Ashton to be there even if Danny and I wouldn't be. I ended up having to work until 10:15 but Danny and I drove down to my parent's after that. Ashton refused to go to bed until he finally was so tired he went to lay down with my mom and ended up falling asleep. Then,of course, he slept until almost 10:30 Christmas morning. He got almost everything he asked for and was really happy with the aircraft carrier we found at Toys R Us. We had a big family dinner, even all of my brothers showed up, and finally got home around 7:30 that night. I had to work the day after Christmas but had the whole weekend off. Then, today I got to leave early!

Here are a few Christmas pics:
Our Tree

Ashton, Christmas morning

Ashton and my mom


In TTC news, we have an RE appointment! I got a call today from the RE's office and scheduled the appointment for 9 am on January 13. I was surprised that it's only 2 weeks away but then I remembered that I actually called them at the beginning of this month and it's taken this long for them to get all of the paperwork and medical records they needed back before they would even schedule the appointment. I'm not sure what I expect to accomplish by seeing the RE but I'm hoping we at least get some sense of where were at as far as IF goes.

I heart my doctor :)

I went to a new doctor yesterday for a general checkup. I'd done some searching and found a family practicioner that several ladies on some TTC boards go to and decided that I was long overdue for a physical so I made an appointment. She was so nice, I wish I'd found her before I went to the OBGYN for testing. Even though I didn't go in expecting to talk about TTC I mentioned how long we've been trying. She started asking me detailed questoins about TTC, what tests we've had done and what the results were, if I'd tried Clomid, etc. I told her we're waiting to get in to see the RE so she didn't want to do the pelvic ultrasound or HSG that she would normally recommend since the RE will probably do those again anyway. I didn't take my charts in with me but from what I described with my cycles she said she was surprised my temps were showing ovulation. I have pretty short periods with lots of spotting and she said it almost sounds like annovulatory bleeding. So she give me a prescription for Clomid! She said that would probably be what the RE will do first anyway so I might as well get the ball rolling. So if no BFP this cycle I'll be starting Clomid after the first of the year!

Could this day get any worse?

Yesterday sucked. I really, really wish I'd just stayed in bed. It didn't start out bad. Ashton was being a pain but he's 5 so I expect that. We went shopping for a little bit with my mom and went out for lunch. I made the mistake of going to Wal-Mart and things just went downhill from there.

When I got to work I went to check and see if I got the job I had bid on. I was looking through my bid history and the job isn't even on there. I know I bid on it and I got the confimation but now my history shows I never bid on it. I was really hoping to get the new shift (days) because I would start it the week of Christmas and not have to work on Christmas Eve. So I guess that won't be happening.

Then I found a seat, started keying, and realized I was right under an air conditioner vent. Yes, the air conditioner was on even though it was no more than 40 degrees outside. So I froze until lunch time. I did have soup for lunch so I got warmed up. Then after I ate I called Danny to check in. For some reason he decided to share the news that our old babysitter (his friend's wife) is pregnant. This is after she said she was absolutely not having anymore babies. This is also the friend that when Danny told him we were TTC last year said "you aren't supposed to try, it just happens". Oh, and did I forget to mention that AF showed up yesterday? Yes, it was a great day all around. I so hope that I get to relive it several more times. I just kept thinking that my Chuck Palahniuk quote to the left was so fitting.

Give me a break

No, I haven't fallen off the face of the earth. I've just been taking a much needed break from all things IF related online. Even though this isn't just an IF blog I felt the need to also take a break from it. So many things have happened since the last time I posted, we've been a busy family!

Ashton started soccer in September. He really seemed to enjoy it but isn't great about keeping focused on the game so he has yet to score his first goal. The games will start back up in March so hopefully he'll be better about staying in the game then.

Halloween is always exciting in our house. It's my favorite holiday and Ashton seemed to be just as excited about it this year. He went as "the unknown vampire" this year. Actually the costume was a grim reaper but I let him call it whatever he wanted. We went to a neighborhood in town that actually closes the streets for trick or treating. All of the houses go all out with decorations and Ashton had a blast. We ended up walking about 12 blocks that night!

My 28th birthday came and went without a lot of fanfare. I just figure it's one year closer to being 30. Yippee.

For Thanksgiving we went to my parent's house. A few of my cousins and their kids were there. Ashton had a blast playing with the kids. It was good to see some of our family that we don't see often but our family gatherings have gotten smaller in recent years. My mom's twin sisters both died within the last 4 years and it's made the holidays hard on everyone. We used to have a house full at Thanksgiving and Christmas and even though we still have quite a bit of family it seems somewhat empty now.

As far as TTC goes, I haven't charted since September. The break has been nice but I think I'm going to start charting again when my next cycle starts. My doctor never called back after she left Danny's SA results on my voicemail and we decided that it would be better for us to go ahead and make an appointment with a Reproductive Endocronologist. The RE in town has new patients fill out the paperwork and request their medical records before they will set up an appointment. I got the packet yesterday and have it almost filled out so hopefully we'll be able to get in soon.

Other than that no news to report. I'm hoping to post more frequently now but with overtime looming I might still go MIA occaisionally.

Results

My doctor called Tuesday with the results of Danny's SA. I don't have the details since my doctor always seems to call when I'm at work so I'm just going by what she said in the message she left on my voicemail.

She said that his count was fine but the motility and morphology were both a little low. Danny is diabetic and she said that could have something to do with it but that also the paperwork said that it was 70 minutes between the time the sample was collected and the analysis was done. We live close to the lab so he produced the sample at home and we drove it to the lab. The lab requires appointments and his was for 10:30. He did his thing at 9:50ish and we drove it straight to the lab. Now my doctor wants him to do another SA in a few weeks. I really feel like it was the lab's fault it wasn't done right in the first place and I'm ready to say just forget it and we'll work with the first results. Of course AF also decided to show up yesterday. So I'll wait until I can call my doctor to see if I can actually talk to her about it. I know it takes at least 2 SAs to really determine if there is a problem but I just don't feel like dealing with it right now. I'm thinking about seeing if I can talk Danny into starting some vitamins to help things out just in case it wasn't just because the lab took so long.

Labs and Tests and Blood work, Oh My!

Since my last IF related post I've gone back two more times for blood work and Danny has done his SA. My P4 (progesterone) came back "fine" and my CD 3 blood work was all normal. The CD 3 consisted of FSH, insulin, glucose, and testosterone. Since the lab didn't throw the thyroid panel in with that I got to go back in yesterday to have yet more blood drawn for it. Danny got to produce his sample for the SA at home and we drove it to the lab. Why can't IF testing for women be more fun than a poke in the arm?

I also got the first IF related EOB (explainatin of benefits)in the mail. It was for the claim for the progesterone bloodwork. The claim was denied and the EOB said that I'll owe $54. Now I know that infertility diagnosis and testing is in fact covered by my insurance. I checked our plan booklet before I called to make the first appointment with the doctor. According to the booklet all I should have to pay is "10% of the Plan allowance and any amount over $2,500". So I got online to see if any other claims had been processed and I just hadn't received the paper EOB. For my CD 3 blood work the claim amount was $385 and insurance only paid $24.30 so I owe $239.70.

First thing this morning I called the claims department at the insurance company. I wanted to find out why they weren't paying the 90% that the booklet says is covered. Turns out on the P4 claim the doctors office used a procedure code that isn't current so I need to have them resubmit that claim with a different code. The CD 3 blood work claim was fine but I had to meet our deductible before they would start paying the 90%. According to the customer service rep I talked to the deductible has now been met so all claims filed from now on will just be subject to the coinsurance. Why do inurance companies have to make everything so confusing?

My brain is broken

I haven't posted for awhile because I forgot my password. And rather than have a reminder sent I stubbornly thought I could remember it on my own. Nope!

The past week has been pretty boring. I went in for my blood draw for the progesterone check on Wednesday. My doctor called Friday and left a message saying the results were "fine". Good news I guess but I'm actually hoping to find something simple wrong so we can fix it and move on.

AF arrived today so I have to call tomorrow to set up an appointment for the CD 3 bloodwork. I'll have to go in Tuesday for that. I lucked out last week because Ashton was at my parent's house on Wednesday and he didn't have to go with me. He'll be home this week though so I have to take him. Hopefully we won't have to wait too long so he won't get restless.

This weekend has been a bust too. It's rained all weekend so the only thing we got accomplished was registering Ashton for AYSO soccer. Yes, I am officially a soccer mom. I really hope he likes playing because after shelling out $85 to register him he is going to play in every game, whether he ends up liking soccer or not!