The phone call

Earlier this year I received a phone call.  It was from DH, who was out of town attending a family reunion.  (I couldn't go because of work.)  We chatted briefly about the relatives he saw, and then his voice became very serious.

DH: Um, are you sitting down?  I need to tell you something.

I immediately thought the worst—like someone died or his mom's cancer returned.  I actually did sit down.

DH: You are going to be an aunt.

I was confused at first—none of our siblings are married.

Me: What do you mean?
DH: My older brother is having a baby.  Well, his girlfriend is.
Me:  Oh. Wow.

[Silence]  I sat there in complete shock with my mouth literally hanging open.

Me: I didn't know he was dating anyone.
DH:  I didn't either.  He met her a few months ago, I think.  They haven't been together very long.
Me:  Are they going to have the baby?
DH:  Oh, yes.  For sure.
Me:  Are they going to keep the baby?  Are they thinking about adoption at all?

I was thinking, "Oooh, we could adopt their baby!  Wait...what a weird situation that would be—raising your brother's biological child.  And we haven't even discerned adoption yet.  Okay, scratch that thought."

DH:  They will keep it.  You know how much my brother wants kids.
Me:  Are they taking about marriage at all?
DH:  Actually, yes, but there isn't a date.  They had to tell some of her relatives that they were engaged to keep peace in the family.  In the meantime, she's going to move into his house.

At some point during the conversation I started to cry.  I had a million thoughts racing in my head.  Why do they get to have a baby?  Why can't we?  It's not fair.  They knew each other for a few months at most before they got pregnant.  And now we're infertile, and they're having a baby.  We're supposed to be having the first grandchild, not them.  (It's scary how much I sound like the older brother in the prodigal son parable...being infertile brings out some pretty ugly thoughts.)

Then I realized:  their having a baby has nothing to do with my inability to have one.  This jealousy has no purpose except to make me bitter and anxious inside.  Fertility doesn't depend on whether you're married either...crazy thought.  No one can "earn" a baby...God doesn't work like that.  We should be thanking God they are letting this baby live.  And we should praise them for making the choice to let this baby live..that cannot have been an easy decision.

I've had a while to ponder this.  When I think about it now, it still hurts a little but I think it's mostly because it shines a spotlight on our infertility—reminding me that we can't have a baby so easily (or at all, at the moment), which makes me sad.  I'm trying to see the upside of the situation.  Here's what I came up with:

1.  They live far away, and we rarely see them (less than once a year), so I won't have to face them often.
2.  This might satisfy my mother-in-law's desire for grandchildren for a while, so hopefully she will stop asking DH when we're going to have kids.  DH told her there are some medical "issues" but hasn't been more specific.  You would think that would be enough for someone to back off the subject, right?  (especially given the fact that two of DH's married cousins—on my MIL's side—are infertile, so this is not new in their family...)  We shall see.
3.  I now have an excuse to peruse the baby aisles at stores.  I will still secretly wish it were for our own child, but this will do for now.  (Eh, who I am kidding?  I never needed an "excuse" to browse the baby aisles before.)  ;)
4.  I also have an excuse for a sewing project.  Or an inspiration for one.  More to come when it's finished.

The verdict on HCG

I found out the results of my lab tests from last cycle.  Dr. A wanted to see how my hormones were responding to the HCG injections, so he ordered some post-peak labs on three different days.  I was optimistic that the HCG was helping even before having the labs done.  Since starting HCG, my post-peak phase is about three days longer than before (not that it needed to be longer), my mood-related PMS symptoms are gone (oh, how DH loves that), and my post-peak mucus has nearly disappeared.  DH likes all this evidence that his injection-giving technique has been working; the HCG is getting where it needs to go—very reassuring for him.  Anyway, the labs say my progesterone is much improved since HCG, and estrogen looks good, too.  It's nice to have one problem solved!

Speaking of injections, DH is such a trooper in giving them to me.  I remember telling him after the first few failed TTC cycles, "You know the first treatment I'm going to get is HCG.  You know who gives the HCG injections, right?  The husband.  You know I wouldn't be able to do it."  His eyes got very wide, he shook his head, and he said he would never give me any injection.  Over time he softened a bit so by the time Dr. A actually ordered HCG, DH was willing to administer them.  (thank goodness!)  He was so nervous for the first one, bless his heart.  He had been trained by a nurse, we had general step-by-step written instructions from the clinic, and we had a random website I had discovered that went into great detail for each step.  (DH declined watching the how-to video on YouTu.be that I found...I think that would have made him more nervous.)  I had been told (and read) that the injection shouldn't really be painful at all—just a quick stick.  I suppose that is true if the injection giver is experienced, but for a newbie like DH, perhaps not.  There was some definite offering up of some burning pain that first cycle...  ;)  I swear one time DH rested the needle on my skin and slowly pushed it downward.  I don't recommend that technique.  DH did get the hang of the dart-like motion eventually, and the rest have been pretty much pain-free.  If at some point we get pregnant, I will likely need progesterone injections, which make the HCG ones look like a walk in the park.  For now, I am very thankful for HCG.  :)

The fertile world around me

Lately I have been reminded how fertile my friends are.  A couple weeks ago I received a birth announcement and a pregnancy announcement on the same day.  Two other friends are further along in their pregnancies.  There were two more births this week.  I am assuming there will be another pregnancy announcement shortly since I know a couple who has been TTC for a little while now.

I try to share in their joy.  I really do.  I love that God is blessing so many of my friends with such a beautiful gift.  I express my congratulations in the most heartfelt way I can muster.  Some days I impress myself.  For some reason it is easier for me to be happy and sincere on the phone than by e-mail...perhaps it's because I let myself cry while writing e-mails because no one sees or hears the tears.

After one of the recent births I was looking at the baby pictures posted online, and I just started to sob.  DH simply held me.  He understood and didn't have to say a word.  It felt just like the scene from Ju.lie and Jul.ia.  I was so happy for my friends but at the same time I hurt so much.  I wondered if they knew, if truly knew the magnitude of the blessing they had been given.  Somehow the blessing seems infinitely greater when you're looking at it from across the chasm of infertility.

What's my diagnosis?

Want to pretend you're a hematologist for a day?  Want to show off your Dr. Google skills? 

Let's play* "diagnose polkadot's clotting problem."  I've already tried to do it, and I've come up with a range of possibilities from benign to scary, so I doubt you'll find something worse than I did.

Here's the data you have to work with:

INR - normal
CBC - normal
PT - normal
PTT - very slightly short
Factor VIII - elevated
vWF antigen - elevated
vWF activity - elevated
platelet function (two different assays) - both short closure times

What diagnosis explains these lab results?  Anyone brave enough to try besides TCIE?  ;)

*Sadly I have no fun prizes like holey soap if anyone comes up with the same answer as my hematologist.  I will just be super impressed at your googling skills...and I have high standards when it comes to that.

Doctor #2

In an interesting turn of events, I recently had a consult with Dr. C, who is trained in surgical NaPro.  (random opening in his schedule...fortunately he's within driving distance)  After going over my history and test results, he gave me the plan:  laparoscopy, hysteroscopy, endometrial biopsy, and HSG (to flush out the fallopian tubes) all in one day.  I will be blissfully unconscious the whole time.  (That is really best for all those involved.)  He said he will be prepared to deal with whatever he finds—if there is a polyp, it will removed; if there is endometriosis, it will be lasered out.  He was rather cheerful and almost enthusiastic about it—kind of like a coach motivating his team with the game plan.

Just when I thought it was time to go, he decided he should do a pelvic exam.  I was so close to getting away without it.  As he was leaving the room so I could change into the gown, he asked very nonchalantly if he could do the endometrial biopsy today. 

What I was thinking: "How on earth are you going to get that sample?  That requires going through the cervix...  Can't you do it during the surgery while I'm unconscious?  You're going to be in there anyway.  That was the plan you mentioned five minutes ago."

What I said: "Okay."

Apparently I am easy to convince.  I had no idea what I had just agreed to.  He returned with a nurse and a large tray full of metal objects.  I am glad I didn't know ahead of time what was going to happen.  (I googled it when I got home, and the description sounded worse than what it was.)  It was uncomfortable, and there were lots of cramps.  He needed two samples, so he had to do it twice.  Fun.  Ah, the things we go through to figure out why we can't get pregnant...

Afterward he was silent for a minute and looked like he was pondering something.  Then he asked if I bruise easily (yes) and if my gums bleed easily (sometimes, yes).  Great, now I have a clotting problem.  Why has no one asked me about this before, I wonder?  (especially that dental hygienist who turned white as a ghost at how much my gums bled during a cleaning a year ago...poor girl was traumatized)  Dr. C decided to order a clotting panel and said if the biopsy and labs are normal, then we'll schedule the surgery.  It must have been quite the panel he ordered since it required eight tubes of blood.  He said if the results are abnormal, he will call me.  Otherwise, he won't.  No news is good news, got it.

Less than 24 hours later he called.  The biopsy results weren't back yet, but the labs were.  I do indeed have a clotting problem, one that is out of his area of expertise, so I am meeting with hematologist in a couple months (that was the earliest available).  I wrote down which of the assays were abnormal and consulted Dr. Google.  Not a good idea.  Based on what I found, I came up with a couple possible diagnoses.  Also not a good idea.  (I am not a doctor...what do I know?)  I hope I am wrong, and it's just due to stress, which is actually on the list of possibilities.  Now I have to wait for the appointment with the hematologist for the real diagnosis.

I sent the lab results to Dr. A hoping he would have some insight.  He could not comment specifically on my labs, but it was reassuring to hear him say that many infertile women have clotting abnormalities which are usually treatable, and they go on to have normal pregnancies.  I really could have used that reassurance yesterday when I was convinced I have a horrible disease and will never have children—biological or adopted.  DH likes to call me his drama queen from time to time...  :)

So now we are taking a break from TTC until meeting with the hematologist.  As much as I want to find and fix the cause of our infertility ASAP, I am looking forward to this break.  Infertility is going to teach me patience whether I like it or not.

P+17? Nope, CD1

The third cycle with HCG was a bust.  I did set a new personal record for post-peak phase length:  16.54 days.  Technically I could have gone to the lab to have my HCG level checked (pregnancy test) that morning before AF started, but Dr. A thought peak+17 might be a bit too early to test--HCG from the injection might still be hanging around.  Making it past lunchtime on peak+17 without AF starting was pretty exciting, though.

This cycle we're adding an antibiotic to see if it will eliminate some of the extra bleeding. Can I just say I would be ecstatic if I had fewer days of bleeding?  Obviously, if it helped me get pregnant, that would be great, but less bleeding would definitely be a welcome step.