I hate the term “bump” and wish we, as an English-speaking people would strike it from our lexicon. While I’m at it I also hate the term “hubby”, “preggo” and “fur baby” and many others. I have dogs. I love them. They are not my babies. I also have a husband who I also love, and if I ever call him hubby please feel free to punch me in the face. I am not now nor will I ever be “preggo”. Because it’s a freaking canned spaghetti sauce for the love of all that is holy.

I’m probably a little raw to be writing this today but I’m in a fuck it mood.

There are things about the online IF community that really bother me.

1. That some of you call yourselves infertile because you started trying 6 months ago and weren’t pregnant in the first month you wanted to be. The definition of infertility does not include you. I’m sorry.

2. That people have such a fit over pregnancy announcements. Yes it hurts. Quit bitching about it. Everyone else’s lives should be put on hold because you are having trouble conceiving? Get over yourselves.

On a kinder note, how can you possibly expect to have a grace bestowed upon you when you resent or have envy at someone else? I do not understand this thinking. Yes, it stings. Sometimes I have flashes of jealousy but actually letting it ruin my day? No. Its past time we put on our big girl panties take it on the chin and actually open our hearts to the new life they are beginning, weather or not we perceive them or judge them as deserving. If it’s really that awful for you, terminate your Facebook account and don’t look back. Become a hermit, let it define you, lay down and get comfortable in your misery. Actually don’t do any of those things, take your power back. Don’t let some unknowing person take your strength or your compassion for others.

3. That people avoid the mall because they don’t want to see other pregnant women. See bullet two.

I know that this post does not show the compassion or empathy that some of you deserve. I know it does not change how long some of you have been trying. But here’s the real truth. Most of you are barely in your 30’s or are in your early 30’s. You have at least another 10 years to keep trying. Trust me when I tell you as a 44-year-old woman, my time is fucking short. This isn’t what I wanted for myself, it isn’t ever where I thought Id wind up. But it’s where I’m at. Every month I face some new ugly surprise that makes continuing down this path scarier and scarier. Every month that’s failed costs me roughly 3k plus, and that doesn’t include meds. I have 2 blasts, that it’s taken me 7 months to make. The truth is I need 5-6 so that I can PGD testing them to make sure there are no chromosomal abnormalities. Statistically, the chances are of the 5 or 6 that are tested, maybe 1 will be normal or maybe none. If there is 1 that is normal and transferred, there is no guarantee that will become a live birth. Stare that in the face for a while. Because those are the cold hard facts of my situation.

My other choice is to carry on. To keep trying, to try to make light where I can, because no matter how this ends, it will not define my life or who I am as a person.

I didn’t want to be an old mom, but if I am given the opportunity to be one, I will be. People say… “well just adopt then”.. only no one wants to give a child to a family where there is someone who is over 50. My husband will be 50 in October. So that’s out. Fostering? Same thing.

This is my only option, aside from Donor Eggs which will mean having to find someone, and it costing another 30k. It’s still on the table but its a last resort for me.

I do not have the ebb and flow of even normal IVF cycles. I do not have the comfort of the same thing happening month after month.

I read so much misery and despair in your blogs. I see so many women sad and getting used to that misery. I want you to want better for yourselves. I want you to open yourselves to the grace of being happy for others who are receiving the gift you want so much.

In my 20’s I miscarried at 5 months. I know about loss. In hindsight though I was married at the time to an abusive alcoholic so it was probably the best thing for all of us. But it took me 2 years to get past it. And every year on the date of my miscarriage I count its age and wonder what that child would have been like and how different my life would have been.

I can’t change any of this. I can’t wish for things to be different, for me to be younger, for my life to have turned out differently, because it won’t. This is my reality. Its hard. In fact its the hardest thing I’ve ever done. Some of you have called me brave. I’m not. I’m terrified, I am scared out of my wits. To be completely honest after yesterday appointment, I did some writing on a project I hope will turn into a new job, talked to a friend for a few minutes and went to bed. At 7pm. When my husband got home around 9:30, I was still awake, but I didn’t talk to him about it, I just lay there with the covers over my head and tried not to think. Tried to numb the overwhelming feelings of fear. I eventually went to sleep, but “brave?” no.

When I got up this morning, I hoped Id feel better. I don’t. I’m still scared, still afraid. Still don’t know what is going to happen this cycle or next or the one after that. What I do know is I will face it, keep trying to move forward, fight my tendencies to isolate and keep trying. With or without children I am determined to try to find a way to make my life meaningful.

If I have alienated you I am sorry. it’s not my intention. There are times though with the points of view in this community are very one-sided, and I think for the sake of an open honest discussion you have to hear both sides.

If you take issue with anything I’ve said here please feel free to comment. I welcome opposing opinions and challenging questions.

And thank you for taking the time to read my ranty post.

Circus School, Traditional IVF & AMH

There has been a lot of talk in my world lately about AMH and what it does and doesn’t mean.  Assume when I say “my world” what I mean is in my head. It’s involved reading a lot of white papers, and understanding who the players are and what they are trying to determine with this piece of information that can be so devastating to so many women. You may or may not recall that 5 days ago I was told that my AMH was .16, which puts me in the bottom 1% in my age bracket.

Prior to 2008, the “gold standard” for treating infertility was FSH and E2. As IVF became more popular and sought out by infertile couples, IVF clinics began to try to protect themselves by only taking on the cases most likely to have a positive outcome. The reason for this? Largely couples chose clinics on their success rates. If a clinic had 1000 patients, and only 20% of them were getting and staying pregnant, then you can see that those odds are really quite poor. Consequently you can expect that the profit margins can and will suffer. But if a clinic was able to “cherry pick” their patients by only taking on the ones who had the best chance of a successful outcome, then the clinic can control their percentages, stack the proverbial deck in their favor, and potentially make larger profit margins. Thus enticing new patients to cycle there.

For those of you who have been to more than one clinic, you know that some are hard sell used car sales man types, some downright refuse to treat you depending on your age, or your issues, and some promise the moon, knowing full well that they are taking your money without giving you the chance at a positive outcome. Trust me when I tell you, that the profit margin in these clinics is huge, primarily because most people pay at least partly, out-of-pocket. Overwhelmingly IVF is not covered by insurance. Yes there are exceptions but most people have to pay at least some amount out-of-pocket.

Is it ruthless of me to boil it all down to money? Maybe, but these clinics are business’ and every business is in business to make a profit. Some just go about it with more integrity than others. I’m not saying all traditional IVF clincs are bad either. What I am saying is “your mileage may vary.”

The best I can research is that the AMH test was conceived of,  and propagated by Dr. Schoolcraft at CCRM for evaluating the reserve for his patients who are mostly undergoing traditional IVF. If you had a low AMH, you would be shown the door right away so that he could keep his 40+ success rate in the 30-40% range, which didn’t last when he ceased cherry picking, because economic conditions are making it hard for him to be so choosy. AMH, just like FSH, is only indicative of quantity, it provides no indication of quality. It also provides no information about whether or not you can sustain a pregnancy assuming you should become pregnant.

Traditional IVF clinics now treat AMH as their “gold standard” but its only one piece in a larger puzzle. And to see the larger puzzle you need to understand the motivation behind this test, and at least grasp how the other pieces fit.

I am not doing traditional IVF. Because of my age, there are very few IVF clinics that will treat me without trying to shove the idea of donor eggs down my throat as an immediate cure-all. Not that there is anything wrong with donor eggs or people who use them. I’m just not there yet, and my RE doesn’t think so either. Donor eggs are seen as the single “condition” under which traditional IVF clinics would in fact be willing to treat older patients, or patients with secondary issues.

The treatment I am pursuing is based in the idea that fewer eggs produced =’s higher quality. So far I have found it to be so, but it’s still basically the same process as regular IVF, it’s just less drugs, and it’s significantly less expensive. Depending on where you do it, the outcomes are still very high considering nearly everyone getting treated there is of AMA, and lots of times, have secondary fertility issues. What I’m talking about here is still somewhere between 30 and 40% success rates even though this particular Dr, takes on the hardest cases. Women that are post hysterectomy, have cancer, polyps, PCOS and varying degrees of additional secondary issues.

AMH is rarely tested for at the kind of clinic I go to, because it’s just not that important to the goal or the outcomes, and my RE sees it as 1 factor out of a myriad of other factors.

Its harder to find information about the larger picture, because well, it just doesn’t serve most IVF clinics, so fewer are willing to write about it. But the information is there, from reliable sources if you look.

Its taken me nearly a week of researching, and mulling it all over to be able to articulate this, and I hope its helpful to someone. I think what it says about me is that I am an enormous nerd who has the ability to completely geek out with numbers, percentages and algorithms. Who also has the desire to truly understand this new language I am learning.

School is dismissed.