It's official...

I got a long-awaited call from my RE herself yesterday. 7-10 business days is sure a long time to wait, especially on Day 9.

Drumroll please ..................... come April-May, we will be starting our first IVF treatment.

Much to our surprise, my husband's test results were not as good as the first ones back when we first got started with our RE. She found it would be most successful if we did IVF, as the quantity, quality and mobility of the sperm was lower from last time.

It was hard to hear. I felt awful for my husband, as he said he would have a hard time dealing with an inability to give me children naturally. We held each other, and I said to him, over and over, that it didn't matter if we had assistance getting pregnant. It didn't matter if we adopted children to grow our family. It didn't matter if it ended up being just him and I (and our fuzzy labradoodle baby). I loved him, he was no less a man for this, he was no less of a wonderful, beautiful spouse to me.

We're both nervous about treatment. About how it will affect our marriage, our day-to-day. There was so much to talk about. How to work our schedule around frequent visits to the doctor's office (he works nights, and sleeps during the day, so this might be tricky), who would keep an eye on me for the 24 hours after egg retrieval surgery, how much it would cost and what to do about the expenses (what would insurance cover? what were our options with treatment? how many times were we willing to do this before calling it quits?) And for sure the biggest question of all, how many eggs would we decide to have implanted?

My RE had told me that my husband and I should discuss reduction, should the procedure result in more children than planned. I knew what my thoughts were. I was relieved to hear my husband thought the same thing.

Reduction wasn't an option.

The idea of traveling to the nearest big city, to have a needle inserted into my pregnant belly, and randomly pierce the heart of one (or more) of our children with medication that would stop the beating, how could we do that? We realized and understood why some people had to, but to just pick which of our children would die was unfathomable to us.

So we had to REALLY think hard about how many eggs we wanted implanted.

It's a difficult, almost impossible gamble with fate and money. Paying so much for a procedure, and knowing that eggs implanted didn't always successfully grow, we wanted a least a few to increase our chances that we would have even one child. If we chose to pick the quantity of 3 or 4 eggs, maybe only one would make it. Twins would be completely fine. Triplets, even quadruplets, we would handle, if my small uterus (which still had an invading septum taking up some space) would allow it. But any of those eggs, maybe even all of them (rare, but who knows?) could split in two or even (VERY rare) into thirds. Then the well being of all involved would be at a serious risk. Then there would be no choice but to reduce, or experience the heartache of children within me struggling, and maybe losing, their chance to live.

I trusted and fully believed that my very skilled doctor was not going to allow this to happen. Through her expertise, she knew how to balance everything, from amount of sperm to fertility medication to eggs implanted, to prevent too many babies from developing.

I only say too many babies because I know that there would be a high risk that some of them would not make it. Lord, if my body could safely accommodate 10, I would still be the happiest (and largest) pregnant woman, and the most thrilled (even if sleep deprived) mother around (and round for that matter.) They would be my children, blessed little boys and girls created with God's grace and between myself and the man I loved, our greatest accomplishments. We would find a way.

So now, more waiting. When you undergo fertility treatment, there is a lot of this thing called waiting. For the menstrual cycle to start, to begin the one month of birth control to prime the body, to start injections, to harvest the eggs, to let them mature, to implant, and to take that test to see if there is another round of waiting in store, or if you'll simply be waiting those 9 months to have that baby placed into your arms for the first time, at long last.

Waiting was fine with us. Though no amount of it fully prepares you for the rigorous obstacles of fertility treatment, we needed time to absorb all that was going to happen. To focus on loving each other and enjoying each others company while it was still just the two of us. You never know what you're getting into with this. We did know that it was worthwhile. It was worth the wait.

Oh goody

*Note: REALLY long post, sorry for the novel!*

Last week, I took my injections class.

Entering the building that housed my RE's office, I felt the lingering unpleasant memories of the uncomfortable procedures I had had done there. 

Not once, but twice, I had had my uterus filled with dyed water to check for abnormalities, turning it into a reproductive water balloon. I had felt what must be like a child growing inside of me, if it had done so at warp speed. Cramps? YES. It was very unpleasant. The first one had determined I had a uterine septum, a growth hanging from the top of the uterus, that had to go via surgery to make room for munchkins. Simply explained (and a bit of a tongue twister) there was not enough "room in my womb".

Thankfully, the 2nd water test (I call it this because I don't recall the name, I only recall that when I did, I didn't like the sound of it, so it's for the best) after an equally difficult-for-me-emotionally but entirely successful surgery, showed I wouldn't have to do either surgery nor water test again. Whew! Relief, right? But I sensed that that was not the end of my wonderful experiences at the RE. Oh no, the real fun was just starting.

I pressed the elevator button, and despite having, in only a few minutes, mentally relived those painful experiences, I felt a surge of determination upon me, synchronized with the buzzing of an approaching elevator. I was, after so much hesitation, fear, and discomfort, actually prepping for my race to motherhood (corny? yes, but I'll make my point!) 

The diagnosis of my PCOS, the altering and addition of medications to stabilize my body, my surgery, testing both hubby and myself, these were the equivalent acts of a runner loading up on carbs, (ironically, my diet was the opposite, darn pre-diabetic PCOS) the conditioning practice runs, the good night sleep before the big race, the stretching of the body prior to taking off. Just like a runner who had checked off all her pre-race essentials, I was ready to run through the extremes of testing, IUI/IVF procedures, scans, but first and intermittently throughout my race, there would be injections. 

Yeah! Remember when I said the real fun was just starting? Injections is that wonderful, fun, can-you-tell-I'm-desperately-sarcastic? part of this race. 

I arrive at the appropriate floor, and state to the secretary my name and purpose of standing before her. I immediately see beyond her on the counter, a cluster of white paper bags. Was one of those for me? 

Sure enough, she searches through the little sea of white to locate one, which she hands to me. I felt like  a little kid again, given a goody bag of treats at a party. Interesting party, as I knew none of the guests, there were no decorations or cake, and I'm pretty sure the nurse wasn't going to dress up like a clown for our amusement. 

Looking into the bag, I thought "if this were seen as an actual party, it would sure be a questionable one". Inside, there was a bright red sharps container, a syringe, a tiny bottle of fluid with a silver cap, a disposable cup, and a stapled-shut brown paper bag, which I later learned was full of extra syringes. If handed such a assortment arriving at any other gathering, I would have dropped it and made a mad dash for the car. But no, the reality of my situation came flooding back, washing over my silly amusing party analogy, with the discovery of a pamphlet on self-administering fertility injections, explaining IUI/IVF, and the lovely menu of drugs to choose from, with accompanying costs. Oh yeah. THAT'S why I was here. 

Further digging into the bag after settling down in the waiting room, I found one last thing, a slip of paper with my "plan"on it. I felt a chill of anxiety reading it "One vial a day, could change after semen analysis." Was I starting this right away? At the moment, I didn't know what that brown paper bag contained, and in horror, my mind raced agonizing whether or not it contained my prescription shots. My doctor, while the best in town, and a person I trusted with my life more than anyone else for coping with infertility, wasn't exactly the one to take things slow. Quite the perfectionist and competitor, it had felt like she had grabbed my hand and pulled me into taking the fertility treatment plunge, down the dark, scary, syringe-filled abyss we go. It was only because of my cowardliness and God's timing that she hadn't had the opportunity to knock me up. Starting me on meds as soon (and sooner than I was comfortable with) as possible was not unlike her. 

Was I really ready for this? What did it entail? As other women, some with spouses, some with friends, some alone, trickled into the waiting room, with white bags matching mine, I wished my husband was with me. He was at home, awaiting our first pieces of furniture we had not bought used, nor been given for free, but had purchased brand new. Our house was going to look so grown up, and much less like a bachelor pad (most of our furnishings were from his pre-marriage days). We were becoming adults more than ever, and as I sat here, I realized more and more that I was taking a giant leap into the next phase of our adult lives; becoming parents.

A short woman with glasses and sleek brown hair came into the waiting room "If you're here for the injections class, follow me, please."

We followed into a small conference room, a projection screen displaying a large picture of what I assumed was the VERY beginning of a baby, a microscopic cluster of multiplying cells. Ever the eager student, I took a seat in the front row. Another young woman who had also come by herself sat beside me. I wondered what her story was? Or for that matter, what was the story of any of the women here? It was none of my business, of course, but I had to ponder if any of them were in the same position my husband and I were in. It would be wonderful to not feel so alone in our particular situation (more likely than not though, infertility situations can be like snowflakes, each one unique from the others).

 I contemplated starting off a conversation with the woman beside me, beginning with a compliment on her cute, oversized green purse, but the short woman who had ushered us here took her place and began to talk about what was to be covered in class. The embryologist would begin with a brief explanation of what went on in the lab, "behind the scenes". Heavy, and bespectacled like the short lady, she seemed nervous and always out of breath, speaking of each little step in the quest we were about to embark on; down to when we'd visit the office for test and screenings, the processes made to either insert washed sperm into the uterus after controlled ovulation (IUI) or of harvesting, fertilizing, and administering eggs back into the uterus (IVF), and even the fact that we'd repeat our information to insure the sperm being injected into us or our eggs was, in fact, that of our significant other's or the correct donor (can't stress the importance of that!) She showed us a series of slides depicting healthy versus unhealthy eggs after fertilization for IVF, assuring us that only the best quality eggs would be used for implantation. Seeing how at any time, an egg could be dismissed as being unfit for implantation made me realize what a miracle pregnancy was; an error could happen at any time in these early stages, a pregnancy discontinued, often without the woman knowing it, and yet there were babies everywhere; especially and painfully true in my perspective, having ached for a baby of my own for so long.

The embryologist finished her speech, then handed it off to the short woman, a nurse as it turned out, who explained in detail the variety of shots. The syringe in our white goody bags was for practice, the little vial of fluid was saline, and we would be practicing the delicate art of preparing the syringe with medication. The syringe given to us was a terrifying 2 inches in length, and my heart felt like it sank to the building's basement when she said this was the needle we'd be sticking into our own tushes.

I stared at the sharp silver instrument, glistening menacingly in the dim light of the classroom. NO! Surely there was another option? I was a classic case of butterfingers, frequently stabbing myself with a smaller, less menacing needle when I sewed together crochet projects, or with head and eye pins when making jewelry, my fingers and hands dotted with red pock marks. Hell no was I going to shove a needle into my ass.

Still, I followed along, helplessly a few steps behind, as the nurse swiftly instructed us to sanitize our instruments, now uncap the little vial, and in a smooth motion and with syringe at an angle in vial, suction up the liquid. Turn the syringe upside-down, and tap gently to remove bubbles, pushing on plunger slightly to remove air. Now move it over to hover above the little disposable cup, and again, with a smooth-but-quick push of the plunger, inject the medication.

I was still trying to get a large, stubborn bubble, lazily sitting on the bottom of my upturned syringe, to float to the top, discretely tapping it with an anxious index finger. People were starting to stare, in amusement or pity, I didn't know which. The nurse smiled at me sympathetically, and I felt my face flush. "Come on you stupid bubble", I coaxed, and as if persuaded by insult, it begrudgingly rose to the top. I pushed on the plunger just a little to attempt to release it from it's tiny prison, surely serving it a favor to return to its fellow air brethren, but a fountain of fluid spluttered out, the bubble remaining in the syringe. This was NOT working out.

In an attempt to keep up, I deposited the fluid into the little cup then DAMNIT! In the movement of inspecting it for leftover fluid, I nicked myself square in the palm of the hand, a tiny blossom of blood quickly surfacing. No, this was DEFINITELY not working out.

Then the nurse interrupted our practice to show us our other option of injectable medication. I watched with increasing interest as she modeled the highly preferable injection pen; pre-mixed, just turn the dial for the currect dose, SMALL needle, and into the thigh, easy as pie. Wow! I prayed for this option, otherwise, I was going to be 10x more in a world of hurt and awkward discomfort. Was it pricier? Of course, easier things were often more expensive, but would it be worth it. TOTALLY.

The nurse passed out all the medication options that we might by fate use to conceive our children, and I examined the boxes, with their long list of directions and risks in tiny print. Cautions stating that my ovaries may become overstimulated from this medication, a rare but dangerous condition, that that medication would burn upon application, the importance of application at the exact same time every day, maybe more than once a day, based on the severity of our infertility issues, the percentage of success of conception in my hands.

The class closed so pupils could inquire about private questions. If there had been a contest on who could ask the most questions, I definitely won. With much disapointment, I learned that since I had had two long, but consistent menstrual cycles, we might not get started until late next month (if I continued to have cycles on my own), as treatment had to begin at the start of a cycle.

Yes, I understand that is a very short time to wait, and even a total of just over a year that I've waited seems like a blink to some women who have waited 3, 5 or 7 plus years for a child. I felt guilty for complaining that it's only taken this long, knowing these women have been suffering in child-less silence for much longer. Thanks to my awesome, persistent doctors, I have covered so much ground over a year, progress that can take years and years for others to achieve.  I am chomping at the bit to be a mother, despite the little, faithful voice in my head that says that God's plan and timing are the very best for me, keeping in store something more wonderful than my wildest dreams.

As I write this, I am (im)patiently waiting for a call from the doctor's office, which will reveal the results of my husband's test results, which will in turn determine my fertility treatment fate. Will I be using those syringe in my goodie bag, or the much less scary injectable pen? Would I undergo IUI or IVF? And a LONG way down the road: would it be successful? Would I be posting the good news with an accompanying ultrasound or positive pregnancy test on FB, announcing our pregnancy to thrilled family members, ring in 2014 with our own baby New Year? Who knows. I pray for the patience to have faith, keep calm, and wait.