NTNP

Cycle 18 has failed. This means that we’ve now progressed to what is called Not Trying Not Preventing (NTNP) until we are able to pursue IVF. NTNP is kind of a weird concept because we aren’t using any sort of birth control to prevent pregnancy, so we are still technically trying to get pregnant, but we also aren’t obsessing about when I am fertile and making sure that we have sex during my fertile time. So, we basically just do what we want when we want and if we aren’t in the mood when I’m fertile, then we won’t worry about doing it. I’ll still be tracking my basel body temperature to confirm ovulation so I know when to expect my period. I have a drawer full of ovulation prediction tests so I’ll use them until I run out.

I’m not hopeful that this more “relaxed” approach is going to be successful because there is no scientific evidence that “just relaxing” will help you get pregnant. Unless you have chronic stress (a diagnosed medical condition) or have undergone major trauma recently, stress does not impact your fertility.

It’s incredibly frustrating to be on cycle 19 and to not be able to move forward with treatments. With 13 failed natural cycles, 2 failed medicated cycles and 3 failed medicated IUIs it’s likely that IVF is the only option. I know “life’s unfair” but that doesn’t make it any easier. It’s unfair that I’m dealing with infertility. It’s unfair that people get pregnant by accident or that people who are terrible parents get kids. It’s unfair that I have to choose between putting my career on hold or putting having a baby on hold.  

Cycle 18

With only 5 days left in cycle 18 it seems weird to be writing this post now. But, honestly, I just haven’t felt up to it. Cycle 18 has hit me hard. We’ve now been trying to get pregnant for the length of TWO pregnancies. That is how I’ve been thinking about it, even though it isn’t exactly true because I have short cycles (25-26 days) so in months it’s “only” 16, but by the time I hit the 18 month mark I’ll be at cycle 21.

At this stage I have no hope for getting pregnant naturally, especially given that 3 medicated intrauterine inseminations failed and one medicated cycle has failed. I felt so much hope on IUI cycle #1. That was lost when IUI cycle #2 failed – 2 eggs and 50 million sperm placed directly into my uterus and still no pregnancy. While statistics differ on the chances of getting pregnant after a certain length of time, they all agree that after the first 6-12 months your chances of conceiving are very low. From babycenter.com:

·      30 percent get pregnant within the first cycle (about one month)

-   59 percent get pregnant within three cycles (about three months)

·      80 percent get pregnant within six cycles (about six months)

·      85 percent get pregnant within 12 cycles (about one year)

·      91 percent get pregnant within 36 cycles (about three years)

·      93 to 95 percent get pregnant within 48 cycles (about four years)

The difference between 1 year and 3 years is so small that it is hard to hold on to hope that this will happen for us without IVF.

When I first started checking out pregnancy communities, I would see women that have been trying for 18 months, 2, 3, 4 years to get pregnant and still have no living children. I would wonder how they kept going after all those failed cycles, all those failed infertility treatments. Now that I’m in that same position, I don’t really have an answer besides “you just do”. You just kept going forward because that is the only thing to do if you want a baby. You go forward until you’ve exhausted all your options, or are out of money, or just can’t take it anymore, and you decide that you’ll live child free not by choice. As much as I’ve given up hope, I’m still moving forward. I’m doing my last medicated cycle (progesterone only) before we switch to what is commonly referred to as not-trying-not-preventing while we wait for life to settle down so that we can pursue IVF. If IVF works I anticipate we will be at the 2-3 years trying before we (finally) can hold our baby in our arms.

Triggers

It surprised me how many infertility triggers are out there. I expected the “obvious” ones – pregnancy announcements on Facebook, baby pictures, holidays, anniversaries – to be triggers, and despite being prepared for them they are still a source of sadness, a reminder of what is missing from my life. I didn’t anticipate the less obvious triggers. The things that seem completely innocuous but cause me to bite my lip and fight back tears. Things that you wouldn’t think are triggering. Things that are only triggering to me.

Last night I started watching Captain America: The Winter Solider since I’m going to see the new Captain America movie today. I wasn’t sure if I had seen it before, but as I watched it I realized that I had. It took me awhile but I realized my husband and I went to see if the night before our wedding. We went with my brother-in-law, a cousin of my husband, and my sister and her fiancé. My sister and I didn’t have a great relationship at that time. I wasn’t sure if we’d ever have a great relationship, but we were fine then. We are essentially estranged now. I had to stop watching the movie because I didn’t need the reminder of the horrible, hurtful and selfish things she said to me when I tried to open up to her about my infertility testing.

People don’t always know what to say to someone struggling with infertility. Many times they say the wrong things - you’ll have a baby on God’s time (why doesn’t God want me to have a baby now?), you can always adopt (because everyone has an extra $20,000-$60,000 lying around), you can take my kids (thanks, glad to know you’d give up your kids), have you tried x, y,z thing (my doctor has me on strong fertility drugs, but sure, just trying the position you suggested will definitely fix my infertility), just relax and it will happen (yup, I am definitely preventing myself from getting pregnant because I’m too stressed out) - and inadvertently hurt you. When your friend tells you that they are struggling with infertility, just listen. Say you are sorry for what they are going through and that your are there for them if they need to talk, or need a hug, or need to drink all the wine and rage at the universe, or just need to smash things. Even if you’ve never struggled to conceive, show empathy and be there for them.

Being infertile on Mother’s Day

Back when we started trying 16 cycles ago, I thought I’d get pregnant right away. My family is full of women that got pregnant easily so I had no reason to believe that I would be any different. Mother’s Day would have had me 12 weeks and I had already planned how to tell my parents. The baby would have been my parents first grandchild so I was going to send them a combined Mother’s Day and Father’s Day gift of mugs saying “World’s Best Grandma” and “World’s Best Grandpa” with an ultrasound picture. I didn’t get pregnant cycle 1, but there was always Father’s Day because I would for sure get pregnant cycle 2. I stopped planning announcements on cycle 8 when my OBGYN diagnosed me with infertility. Even then it never crossed my mind that I still wouldn’t even be pregnant the next time Mother’s Day rolled around.

I think the mothers in my life are amazing. They deserve a day to recognize how amazing they are. But getting through the past few weeks has been incredibly difficult. Everywhere I turn there are advertisements for Mother’s Day. “Show Mom some love by shopping our 30% off sale”, “Last minute Mother’s Day gifts”, “Buy a special gift for your Mom”, “Put Mom at the top of your list”. Social media is full of Mother’s Day things, including this new post going around my friends list: “Motherhood dare! (I accepted) I was nominated to post a picture that makes me happy/proud to be a mom... (only one picture) I'm going to tag some ladies whom I think are fabulous mothers (I know way too many to tag you all - sorry), and can rise up to the challenge of posting a pic of their own. If I've tagged you as one of the awesome moms, copy the text and paste it to your wall with a picture, and tag more moms! HAPPY MOTHER'S DAY (soon) to each of you xoxoxo "I LOVE BEING A MOM and I love all of YOU”

Every single one is a small stab to my heart reminding me that I’m not a mother. Despite doing everything I possibly can to become a mom, I am not. 15 failed cycles, including 2 failed intrauterine inseminations, 3 different doctors, 8 doctor visits, countless blood tests, an HSG, a transvaginal ultrasound, an abdominal ultrasound, 3 monitoring ultrasounds, $1200 on fertility treatments, $600 on medications, a semen analysis, ovulation prediction tests, pregnancy tests, fertility charting app, basel body temperature thermometer, 3 books on charting your cycles and increasing the chances on conception, many research articles on fertility and infertility treatments,  almost 2 years of prenatal vitamins with DHA, extra B vitamins, extra vitamin C, extra vitamin D, baby aspirin, Coenzyme Q, vitamins for my husband, Preseed lubricant – all I see is a stark white pregnancy test. I don’t get to see my husband kiss and talk to my belly. I don’t get to hold his hand and look at wonder at an ultrasound showing us our baby. I don’t get to feel my baby grow inside me, feel my baby kick. I don’t get to hold my baby with my husband, look into their eyes and think “we made you”.

While you are celebrating tomorrow, while you are posting things like the above on Facebook, and even while you are struggling with a difficult pregnancy, a challenging toddler or a mouthy teenager, take a minute – just one – to think about your friends and family that want so desperately to be mothers too. The ones with no living children. The ones struggling, doing everything they can to conceive. They may not have shared their story with you, but with 1 in 6 Canadian couples struggling with infertility and 1 in 4 that have miscarried, they are the woman in front of you at the grocery check out, and the one sitting next to you on the bus, the coworker in the office down the hall, your neighbour, your cousin, your friend. They are struggling to get through tomorrow and they are wishing and hoping and praying with every they have that next year, next year will be the year that they are a mother too.

Back to square one

I successfully defended my PhD recently. I have been working on the revisions from hell for over a week now. Although all of my examiners signed off on my thesis with minor revisions, one of the examiners appears to hate one of my chapters and I have no revised it 4 times. I now not only have the record for fastest PhD completion in my lab, longest PhD thesis in my lab, I now hold the record for most revisions to a thesis. I have literally rewritten the chapter once a day every day for the past 4 days.

A few days after my thesis defence I had an exciting day. I was offered an amazing post-doc position – my dream position – and had IUI #2 in the afternoon. I had 2 eggs for the IUI, 50 million sperm, and my doctor finally found a combination of meds that prevented my luteal phase bleeding. I was filled with so much hope that maybe the treatment would finally work. I’d finally get my baby. But I was also filled with worry – what if it did work and being pregnant screwed up my new job. I couldn’t celebrate my new job because I was so worried about what would happen if I got pregnant. Another thing that infertility has taken from me.

There is only one infertility clinic in the place we will be moving for my new job. As much as I’m worried about being pregnant impacting my job, I’m even more worried about moving and having to wait months – I have friends that have 15 MONTH waits - to see a new doctor. I’ve been waiting over a year for a baby. I’ve already waited 3 months to see an RE after my referral, 1.5 months for an appointment with an OBGYN to get an RE referral. I’m done waiting.

IUI #2 didn’t work. We decided to go forward with IUI #3 and will work out something so that it doesn’t impact my job. I’ll use the same meds protocol this cycle. We have an IVF consult with our RE just over a week. Luckily, I was able to get a quick appointment because she had a cancellation – she was booking into June. I’m hoping we will have the time to do an IVF cycle before we leave. I’m not sure if we’ll go all the way to embryo transfer at this time or if we will do a frozen transfer in a few months. IVF is our last step. It was a step I was hoping I’d never reach. It shouldn’t be this hard.