Oxford Journal Study

Since I'm still at a point where I can't put into words how I'm feeling, here's a nice upbeat little study for you:

http://humrep.oxfordjournals.org/cgi/content/full/20/7/1944


Difficulty with acceptance of infertility
For many women, the point of acceptance of childlessness had not been reached, which hindered the decision-making process. ‘I am always going to have regrets that we can't have a child, but you have to accept what you have got rather than what you haven't. You have to make alternative plans and they don't include children’. However, for some, ‘many questions remain unanswered’, and ‘many issues unresolved’. Similar sentiments were voiced by others: ‘Facing up to the fact that you will never have your own child is very traumatic and in a sense we feel forced into the situation of being childless’, or: ‘I think it's still happening [acceptance], it's such a long process, I mean we stopped treatment in May of last year, and I still can't accept it’. Although the decision to end treatment had been made, these women were generally less positive, not only with their inability to accept biological childlessness, but of their decision. Those who went on to adopt or have less invasive treatment such as donor insemination were more likely to feel more positive about their future, and no longer viewed themselves as ‘childless’: ‘I must admit the adoption changed things for us dramatically. We had another focus and we were probably ready to move on earlier than those couples for whom adoption is not an option’. One woman was more cautious about adoption and viewed the process as socially less acceptable; ‘We were too old for adoption, and anyway, we were not prepared to take on a child who may well be psychologically damaged’.

Stress associated with IVF
A common response from women was related to the stress caused by IVF treatment, and the process of decision-making often exacerbated this. However, relief of the cyclical process of ‘treatment and stress’ was evident once the final decision to end treatment was made. One interviewee indicated that: ‘the IVF for me was an extremely traumatic experience and I just wanted it all to end’, and went on to clarify that it was her life that she wanted to end. Others reported similar feelings of depression: ‘The GP started me on antidepressants. I just wasn't coping with it all’, or: ‘In a way, I felt quite depressed, not in the clinical sense, but I felt so low, so down, in a way I had never felt before. That lasted for about two months and I decided then that I never wanted to feel like that again’.

Unrealistic expectations of treatment
Making the final decision to end treatment was influenced by unrealistic expectations of success and the inability to cope with treatment failure: ‘I suppose we were naïve in thinking that IVF would work first time’. Many women were initially hopeful, but eventually succumbed to despair after repeated unsuccessful cycles of IVF: ‘In the beginning there was so much hope, I mean it was something positive we could do, and now ... there's no purpose in life anymore, no relationship left. What's the point?’. Many felt that continuing treatment was their only means of suppressing feelings of negativity and pessimism. Respondents appeared to go through a period of critical self-reflection in arriving at the decision to end treatment: ‘We never thought we would still be here [having IVF] three years on, but in time your attitudes change and you are faced with dilemmas you never thought possible’.

Pressure from media and society
Prior to making the final decision to end treatment, many women had searched the Internet for information about the possibility of new treatment options: ‘I searched every web-site you could imagine. If anything, it made me feel better about my decision in that thousands of people were going through the same experience’. However, some felt that medical staff appeared uncomfortable when faced with the results of their own literature search: ‘You never seemed to approve of the information we downloaded from the Internet, but we had to explore all options before making the final decision, leaving nothing undone I suppose’. In essence, the media proved to be another source of pressure on couples who experienced a social obligation to try new technology in order to reproduce: ‘It's the whole extended family thing. It's almost like a fashion accessory—sorry to be so flippant, but you're not accepted in the same circles or the same way if you don't have kids’. One couple commented on the apparent effect of ‘monthly media headlines’ that created indecision with regards ending treatment by suggesting that significant breakthroughs were imminent: ‘You read about it [in the media] all the time, third time lucky for IVF couple or someone who gets pregnant after adopting a baby’.

Social and professional opportunity costs
Most women had spent the majority of their thirties going through investigations and treatment resulting in a sense of ‘missed opportunities’, which eventually influenced their decision to end treatment: ‘I was so drained throughout treatment and never felt sociable. We had a great social life before IVF and a part of me wanted that back so badly’. Many were unable or unwilling to share their concerns and anxieties with close family and friends, distancing themselves from potential support networks. One woman captured her own experience: ‘One of my closest friends said that I had changed since starting IVF when I called off lunch yet again. ... I didn't feel sociable, but deep down I missed the social interaction. I suppose I was afraid that someone would appear with a baby or to say that they were pregnant, and I just couldn't cope with that. I had to stop [treatment]’ Some women actually described feelings of relief at the end of treatment, with one woman explaining in detail how she could now move on with her life: ‘I wanted my life back, and I remember feeling great sadness at the thought of never being pregnant, more than that, never having a child, but also a huge relief that I wouldn't have to go through another IVF cycle and the disappointment and grief that it brings’ Being released from the incredible stressful cycle of events that surround IVF treatment was expressed by another respondent: ‘I'm still grieving for the child I never had, for my fertility, but I feel a sense of relief that I don't have to go through the emotional upheaval of another cycle and that we can now move on’. For many, infertility and assisted conception-related issues created a sense of ‘life on hold’.

Physical and emotional pressure exerted on the couples' relationship
Financial pressure and the need to balance the conflicting demands of IVF, with those of an everyday social and professional life, caused frequent conflict within the marital relationship. ‘We had spent over $22,080 on IVF; not that we grudged the money; I mean you can't put a price on a child, but it added to the stress of it all’. In addition, whether to have another cycle of treatment or not created further conflict: ‘We just couldn't agree on whether we should have another cycle of IVF. Neither of us would admit we had really had enough, as you don't want to be the one who admits defeat’ Many commented on physical and emotional pressure that IVF exerted on their marriage/relationship, often resulting in periods of depression: ‘He [her husband] would have carried on, but I couldn't have coped with another disappointment, the anger and especially the depression—I just couldn't do it anymore’. As time went by, repeated failure lead to despair and isolation: ‘The constant stress and disappointment was incredible. Looking back, I would have risked my marriage for it all [a child/children]’

Can I take a message?

We got home from DC Saturday night. And just for future reference, spending 5+ hours in the car extremely hungover? Not recommended.

Walked in the house to messages blinking on voicemail:

1. My aunt. Calling to see how we were doing. Sending us good thoughts.
2. My grandmother. Just thinking about us, wants to know if we got home ok. She loves us.
3. My mother-in-law. Hopes we’re doing alright, give her a call when we feel like talking.
4. My mother. Since you guys are home early, we should go to this arts and crafts show.

Really. Either you get it or you don’t.

Pardon me while I go see a movie.

Thursday was a weird fucked up day. In the hours after my doctor's appointment, I was trying to kill time between checking into our hotel and waiting on my lab work to come back. So I took myself to a movie. I was entirely too distracted for much of anything, but I can usually zone out in front of a movie. I was at the theatre an hour before they even opened, and once they did I simply asked for a ticket to their earliest showing, provided it wasn't scary. Eagle Eye. Pretty good by the way. Or at least in an action-junky-no-need-to-think-things-through kind of way.

I picked a seat right beside the door and sat there with my cell phone in both my hands - turned on vibrate, and with the little flashy light thingy on the outside turned on. A visual, a tactile. It rang just as the opening credits started.

I jumped up and was out of the theatre standing in the hallway when I heard my doctor’s voice: “16. Dammit.” It took me a split second to decipher.

16. My LH levels. They can’t go above 12 before you trigger. 4 points. Four fucking points stood between a possible successful cycle and a cancelled cycle. He asked me if I wanted to come back in for more bloodwork “We could test again – you never know…maybe the lab made a mistake…maybe the levels went back down.” Great. This is my doctor grasping at straws.

“I’m not coming back in. I’m going to see a movie.” This was my response to my doctor telling me our 5th awful attempt at having a baby was over. “I’m going to see a movie.” This was my response to hearing I will never carry a child, we will never have biological children. “I’m going to see a movie.” It’s hilariously fucked up. There has got to be some really telling statement in there about…well…I don’t even know – reality TV watchers? People voting McCain? Women defeated by infertility treatments? All of which – very fucked up.

After our diagnosis, I knew it was going to be a rough journey, but I also knew it would work. You think if you try hard enough, if you do it enough times – eventually it has to. But unfortunately, that’s not the case. We could do round after round and still end up here. We’re not willing to live our lives like this forever. But I’m having a hard time admitting The IB has won. If she were an actual person I’d kick the crap out of her.

There’s a part of me that isn’t sure I’m ending this without regret. In fact, I can’t say 100% that this is the end (and for that reason). If we had just made it through the retrieval this time and it didn’t work, I’d be able to live with that a little easier. But you know…canceling a cycle because I can’t count. Well, that’s fucking stupid.

I don’t know. We’ve decided to give it a few months, see how we feel. See how the idea of calling this the end still sits.

In the meantime…I’m out of here. Maybe I’ll go see a movie.

And.....it's over. Again.

Follicle at this morning's ultrasound was 17x13. Too small to trigger you say?

Well my bloodwork came back - LH at 16.

Cycle fucking cancelled....surged before the goddamn trigger. Again. And again. And again.

We had already arranged for a hotel so I could be close to the clinic. We decided to keep the room, do some sightseeing, catch up with old friends and do some major drinking.

Third Appointment (Cycle Day 11)

Today follicle jumped up to 15x12 (although one measurement had it at 16x12). Huge amount of growth in 24 hours.

LH came back at 6.6, so the ligering question is - is that the level prior to the LH jump, or the drop before the big surge. Bloodwork in the morning will tell.

Doctor wants to retrieve on Saturday morning - they're getting me in for the earliest appointment.

Tomorrow morning I do bloodwork/ultrasound at 10am. Then I'm checking into a hotel and waiting for the clinic to call me in for a second round of bloodwork in the afternoon. Trigger will be tomorrow night.

I'm nervous that tomorrow morning's bloodwork will show I surged today. I've had a good deal of uncomfortableness in my abdomen today....usually I don't feel that until after the trigger.

So...Shit!...or Yay! I don't know which yet.

J gets in tomorrow - I'll be so relieved when he's here.

Second Appointment (Cycle Day 10)

Today: Follicle at 11.9 x 9.9.

Just talked to the clinic, I'll be going in everyday for bloodwork/ultrasounds from here on out. Since I've surged so quickly in the past, they want to keep an close eye on me.

J arrives on Thursday...thank god.

First Appointment (Cycle Day 8)

This morning was my first dr. appointment. Follicle looking good for Day 8. It's on the left side (for the 3rd time), size is 11x8mm. Not going back until Tuesday.

My grandfather drove me up for the appointment. He was big-and-bad on the ride up saying he wanted to talk to the doctor and see if there was anything more we (we?) can do to make this work. Was kind of terrified on the trip there - the last thing I need is my grandfather screwing up my relationship with my doctor (he's a 6 foot 2, bear of a 70+ year old man who doesn't understand a thing about IVF, but wants to see it work for us). When we pulled into the parking lot, he decided to wait in the car instead - wouldn't even come sit in the waiting room.

On the drive back, we got behind the only goddamn vehicle in the state of VA with the license plate: "MLFHNTR." After a few minutes of trying to figure out what it said, my grandfather turns to me: "What kind of hunter?" Christ alive...what is up with the fucking universerse? "No idea, Pop."

Coming through town, he turned off at the cemetery. A visit to my uncle's grave. I hadn't been since he died 6 years ago. We only stayed for a few minutes and as we left, he leaned down and patted the ground. My grandmother says he goes at least twice a week and she's never seen him leave without patting his grave. Absolutely breaks my heart.

Home sweet home

Well, my fabulous husband got the internet running again. I am back at home...although still chained to the desktop...still beats the pants off Panera.

And tonight's the VP debate...I can't wait to hear what nutty thing comes out of Palin's mouth next.

The perfect storm

Amazing how three major things at work can all fuck up at the exact moment...

1. My morning started with my internet going down. I called my provider, those bastards tell me they can have me back online...in 48 hours. Yeah, I work from home. I'm then informed that if I run a business from my house, that I'm supposed to have BUSINESS internet...not personal internet. I don't own a business, I don't run a business from my home....I telecommute. Hell, I didn't even know I could GET business internet until today. Apparently biz internet has a 4-hour service turnaround....it's also more than double what I currently pay. Annoying.

2. The internet going down wouldn't normally be a big deal. But oh wait...I dropped my laptop off at the repair shop 2 days ago. For the first time in 2.5 years I am not mobile, and my internet goes on the fritz...seriously.

3. This is the first time in 2 months that I've had a crisis client going on at work. I had a 150 page report due out at 8am. Yeah...didn't make my deadline.

And of course all this is the perfect time to go wrong considering the economy is in the shitter and I'm absolutely convinced that my company's going to start layoffs at any moment. Sweet...look at me being late with deadlines....

All that leads me up to Sunday. That's my first IVF appointment for this round (did I mention LAST round?). I need to be mobile for my trip...and I haven't even heard back from the computer repair jackasses.

I'm typing all this from borrowed internet (Panera) on a borrowed laptop. This is seriously sad stuff. Even sadder? I'll be here at Panera at 6:30am when they open to start tomorrow's report. woohoo.