Not Choosing Peace

I should’ve known better. I’ve been married for over three years.  I should’ve known that if we decided to go out, we’d get into a fight.

It’s seasonably sunny and warm here in my area (Indian summer in October is typical).  Yesterday, Bob asked if we could go out today because of the sunny weather.  I gladly said yes.  Fast forward today.  We did chores in the morning and had lunch at home.  All afternoon, I had been waiting for him to get himself off the couch from watching football so that we could go out.  He didn’t really seem like he wanted to go.  I told him that we could just stay home.  But at one point, I also said, “Didn’t you say you wanted to go out today?”  He took that as me sending him mixed messages.  He still looked reluctant to go when he put his shoes on.  I told him (and I meant it), that I’d rather stay home than upsetting him because he didn’t want to go.  I prophetically said, “If we go out when you don’t want to, I think we’re going to get into a fight.”

Yes.  That was prophetic.  Because we did get into a fight.  We hadn’t even pulled out from the driveway and he already said something to upset me.  I remember a post by A Calm Persistence that struck a chord.  Her husband asked her a question that annoyed her.  She had two choices.  She could flip out and get mad, or she could choose peace.  And she chose peace.  I applaud her for that because it’s very difficult to choose peace at times.

Today was very difficult for me to choose peace.  At times, I get very angry because of what Bob says or the way he says it.  I already told him I would rather stay home than having this person next to me who didn’t want to go out.  However, he thought that I gave him mixed messages.  He didn’t think that I meant it when I said okay to not going out.  He felt guilty keeping me home and he wanted to please me.  But instead of pleasing me, he started to get upset and said things that were basically not true in my ears.

This seems like such a small matter.  Going out or not going out.  I didn’t care. I just wanted a peaceful afternoon.  My afternoon was anything but.

When I get angry, I say things that I shouldn’t say.  But I don’t get to that point of anger unless Bob continues to say something to push my button.  I don’t know about your spouse.  My spouse really knows which button to push.  He’s very lovely when he’s calm.  When he’s mad or upset, he becomes a little irrational and brings up a lot of different issues that we were even fighting about in the first place.  That gets me even more upset and angrier.  And then I start saying the F-word because I am so upset.  And that upsets him even more because of me yelling and screaming.  It’s such a vicious cycle and I just really want to stop.  I don’t know how to stop it.  I feel like sometimes there is this demon in me that I can’t control.  I knew that my foul mouth is so sinful and so provocative that Bob for sure would get upset.  However, when I am at that point, I just feel that I can’t stop myself from it.

A marriage needs a lot of grace and patience.  Grace and patience don’t come from ourselves.  They are granted by the Lord.  And we have to pray and to ask for it.  I sometimes feel like a failure as I fail at communicating with God about the constant need of grace in my marriage.  I fail to confess my sins of my foul mouth.  I fail to change how I interact with my husband.  And I also fail at communicating with my husband in a way that doesn’t further upset him.

We were fighting in the car.   He calmly told me which of my words upset him.  He told me not to talk if I couldn’t talk without screaming.  So I shut my mouth the rest of the way.  He parked the car and just sat there.  I opened the door and walked out.  It was a walkway by this crowded beach.  I walked very fast to the other side of the beach.  Tears started streaming down.  It was such a self-fulfilling prophecy.  I said we were going to fight if we went out.  We went out and we fought.  I was mad at myself for letting the fight escalate.  I was mad at him for being stubborn and saying things that upset me.  I walked faster and faster.  And tears kept on streaming.  This is not how I envisioned coming to the beach.  I stood there watching the people around me.  They were all playing, lying in the sun, throwing a football, having a picnic, riding the waves, running in the water, and having a lot of fun.  I stood there alone, staring at the ocean, hoping that my husband would at least come and meet me where I was.

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I felt so lonely.  Standing there felt so meaningless without him next to me enjoying the sunshine, the warmth, the sea breeze, and the view.  In this world, we have just each other to hold and to cherish.  We should be on the same front fighting the same cause.  We should be focusing our energy on enjoying each other and expanding our family.  Instead, we waste our time and energy on fighting because we don’t think for the other person first.  It all stems from selfishness.

Life is so messy sometimes.  Wouldn’t it be nice if we could get rid of all the fights and just focus on making a baby and each other?  I definitely need a lot of help in this department.  I just feel so vulnerable today… As if we were the only people who would get into fights.  That feels lonely too.  I hope to learn in the future to stop, breathe, and think about the two choices that I have.  I can choose peace or I can choose to win an argument.  I hope that I will learn to choose peace.

Open and Transparent

In the beginning of my fertility journey, I would share about our struggles with a selected handful of friends.  I was not blogging back then.  I had made a few friends with a few ladies I met on an online forum who were over 35 and trying to conceive.  Other than a couple of friends and a couple of coworkers, nobody at church or at work knew that we were trying.  I was feeling quite lonely and scared.  It was a dark period of time.  I wanted to beat the odds and prove my OB/GYN wrong (because he recommended IVF following a review of the labwork that showed my extra high FSH and extra low AMH).  I was struggling emotionally, mentally, and spiritually.

Fast forward to today.  After two years nine months of this journey, I have come to a totally different place.  Every time I start a cycle, I email all the people I know will pray for us.  This group is expanding to about 15 people.  They include people in my bible study group, people who used to be in my bible study group, people at church, people in my family, and people I met online.  I truly feel that being surrounded by prayers and prayer warriors made a difference in our previous cycle.  Except for work, many people in our friend circle, church circle, and my bible study circle know about our journey.

I am a discussion group leader for an international bible study program.  I am part of about 30 leaders that meet every Saturday morning for training.  Every time we meet, we are given a piece of paper to write down our prayer requests.  We pass the paper to the lady next to us and the prayer will be prayed aloud during our 25-minute prayer time.  During the first training session a few weeks ago, I sat there and contemplated what to write down.  The most important thing back then in my life was for the mini-IVF cycle to go well and for the retrieval not to be interfering with the bible study schedule.  I looked around me and saw that three-quarters of the people in the leaders circle already know about my struggles.  I didn’t think I minded other new leaders knowing about me going through fertility treatment.  So I decided to be bold and wrote down my prayers request as “Pray for the upcoming cycle of fertility treatment to go smoothly”.  My friend next to me who got the slip turned to me and asked, “Do you want me to pray this aloud?”  I said, “Go ahead since most of the people already know about it”.  So she prayed aloud for me.

Fast forward this past Saturday at the leaders meeting, a brand new lady came and sat next to me.  Before the meeting started, she said she wanted to chat with me about my fertility treatment.  After the meeting, we stood outside of the church and talked for about 35 minutes.  She and her husband’s story is similar to my story with Bob.  She got married late.  At 38, she has been trying for the last 14 months but nothing is happening.  On that Saturday, she found out that her first IUI attempt had failed since AF just arrived on that day.  It seems like her AMH is fine though.  She poured her heart out and I tried my best to share my experience and my knowledge and to answer all the questions that she had.  At one point, she made a remark about the amount of knowledge that I have on this issue.  She said that she deliberately came to sit next to me because she heard the prayer request for me the other time and really wanted to connect with me.  She explained that this is still something that she and her husband have not shared with many people so she was very glad that I could talk with her.  I am so happy and grateful that opening up about my struggles appears to have helped someone else feel less alone in this very lonely journey.

As a group leader, I lead about 15 ladies in a weekly discussion group.  We also share our prayer requests with one another so that we can all pray for one another daily.  During our first round of prayer requests last week, I again had the choice of waiting to share or sharing immediately.  Last year, I did not share about our struggles and the cycles until after mid-semester.  After much prayers, I decided to be open about my experiences this year because I would really appreciate prayers from these group members.  So I put down “Pray for wisdom, strength, and peace from God during our fertility treatment”.  I sent out all the prayer requests to the ladies.  Two days later, I received an email from one of the ladies.  It said:

“I saw in your prayer request that you are going through fertility treatment and was wondering if you would feel comfortable if I asked you a few questions about it down the line. My husband and I met with a doctor at a fertility clinic to discuss the various options a few months ago. We are still praying and deciding when we should start the process.  Although I don’t feel comfortable sharing it with our group yet so I won’t request for prayers for it. We haven’t spoken with anyone about it since it has been quite stressful and discouraging. We are also trying to surrender it to God.”

I was surprised to have received this email and at the same time so glad that I was being open.   If I had not been open, this sister in Christ would not have anyone to talk about this with.  I am also glad that she opened up because it must have been hard for her to write to a stranger about her struggles.  I wrote her back right away and said:

“You can ask me any questions any time.  I am pretty open about my journey and my struggles.  I didn’t start out that way but after going through it for a a while, I have become very open about it (except for at work).  I am sorry that you are going through the uncertainty at this point.  My husband and I have been trying for almost 3 years.  We have done a few cycles of IVF and had an early miscarriage back in February after our first ever transfer.  It took us six months to feel ready emotionally and mentally to start all over again.  I know what you mean by it being stressful and discouraging.  I found that my first year of trying was the hardest.  It has actually gotten a little easier mentally, emotionally, and spiritually after I have accepted that this is our path and I have to trust God on it.  I would love to share with you my journey and answer any questions you may have if you feel comfortable with it.  We can talk over coffee or on the phone if you would like.  Just let me know. :)”

She wrote me back the next day with this response:

“Thank you for being so open and transparent with your fertility. This process can feel so lonely, especially since we are at the beginning stages. Our doctor presented us with several options to start and it completely went over my head because there’s so much information. I do know he suggested starting with Clomid. He also talked about IVF being one of the options after we tried everything else. However, what made me uneasy was that he said the clinic will make me sign an agreement to abort the third fetus if the treatment resulted in triplets. He said IVF sometimes but rarely result in triplets and he said it wasn’t safe or something so you have to sign an agreement to not keep the third. This is something we don’t feel comfortable with so we have been holding back on starting any treatment. We know the chances are very slim in it resulting in triplets but we are not comfortable with it.  Do you know if that’s a policy for all fertility clinics? We might wait until end of this year before we start treatment. I would love to hear more about your journey on phone or in person sometime. I am sorry to hear about your miscarriage. I will be praying for you as well. God is good and faithful. He always has better plans than we can imagine even if it doesn’t feel that way when we are going through trials and hardships. I will be praying for you! I’m also very grateful He placed me in your group this year.”

I saw her during our discussion group on Monday and made sure that I reached out to her.  We were making plans for getting together either this coming Saturday or some time next week so we can talk in person without interruption.

In this group there is one pregnant lady this year.  I am actually not bothered by her presence at all.  But I can only imagine what the sight of a pregnancy lady may affect this other lady with infertility issues.  The interesting thing is that these two ladies actually share the same first name.  I wonder if this infertile lady would have the “why me” mentality.  I am even more glad that she’s in my group so she really doesn’t feel that she’s all alone in this.

God works in very mysterious ways.  I am not sure why Bob and I have to go through this very difficult journey.  This is something that I probably will never understand until I see God face-to-face.  One thing I am sure is that God is with me every single step of the way.  He guides my path and allows me to be increasingly at peace with this path.  He gives me strength to live everyday.  He also gives me the courage to be open and transparent and share with others.  I did not know that my openness would touch another person’s life.  It appears that being able to be open not only touched one person but two people this week.  I am so thankful for the opportunity to serve these ladies and for them to feel less lonely.  God is amazing and He orchestrates every little and big thing in our life.  There is no accident that I encountered these two ladies this year.  God does not make mistakes.  I am excited to see how God can use me this year to help encourage them.

More Consultations

Cell phone reception was nonexistent in certain parts of the mountains when we were in Denver.  It said “no service” the whole duration driving out of Estes Park.  You can imagine how shocked I was when my phone suddenly rang.  It was a San Francisco number that I didn’t recognize.  I looked at Bob and asked if I should pick it up.  He said of course.  I am so glad that I did.  It was UCSF calling me to let me know that there was an opening on Monday (6/30) for the consultation that was originally scheduled for July 17th.  My first reaction was that I didn’t have access to my work calendar so I couldn’t say for sure if I could take that spot.  I hung up and Bob looked at me funny.  He said, Can’t you just call work and ask?  Duh.  Sometimes my brain doesn’t function.  So I called work and was pleasantly surprised that my schedule was clear for the available time slot at UCSF.  I tried to call the number from the previous caller ID but was being passed around in the automated phone system.  I finally hung up, looked up the reproductive health clinic’s phone number (thank goodness for cell phone reception), and happily connected with the clinic and snatched up the opening.  I was very relieved to have the appointment move up to Monday as Bob didn’t start his new job until Tuesday.  It was nice to have him around when we met the doctor.

So the whole reason why I scheduled a consultation was because I chatted with a lady who also frequents the High FSH forum that I visit.  We talked about six months ago and she shared all of her experiences with me cycling at UCSF.  She has been banking her day 2 embryos for many cycles and recently started transferring.  The cost of each minimal stimulation cycle is about $6500, a lot more affordable than going back to my own RE.  Since UCSF is so close to my work, I figured I should really speak with Dr. No Nonsense before I make a decision.

Yup I am naming this doctor Dr. No Nonsense.  He was gentle and kind, but was also direct and non nonsense.  His intern went over the history with us first and I felt that I was being quizzed.  Good thing I remembered most of the details of our cycles.  Then Dr. No Nonsense went through the history with us again.  He did an ultrasound and found that there was one antral follicle on the right ovary and possibly two antral follicles on the left.  When we finished, we had a talk about the next steps.

He drew a diagram for us.

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Given our history of not getting pregnant naturally, IVF is of course the best way to achieve fertilization.  However, given the low egg reserve, we may not encounter a normal egg for quite a few cycles.  The first thing he wrote on the paper was the words “Egg Donation”.  His point was, if we only had a limited amount of money enough just for one thing, he would recommend egg donations.  He looked up and looked me in my eyes.  He said, “I don’t feel that you’re quite done with your own eggs, right?”  He knew that I only had one transfer.  He could sense that I couldn’t really say that I have done everything that I could until I finish doing a few more transfers with my own eggs.  So, if we had some money to spare, then he would support us trying to use my own eggs first.  He drew the graph of number of eggs and age.  We are fighting the battle of trying to find that elusive good egg.

This is the route he’s suggestion:

  • Do minimal stimulation cycles
  • Use Letrozole (Femara) from CD2 to CD6
  • He may add Cetrotide/Ganirelix depending on the cycle
  • ICSI all the eggs that we have
  • We may get no embryos, one embryo, or two embryo each cycle
  • We can decide to transfer each cycle
  • We can also decide to bank the embryo(s) at day two or day three
  • Banking embryos will allow us not to have the emotional effect of the two-week wait every single cycle
  • He doesn’t suggest growing the embryo(s) out to day five or six due to the low number of eggs.  He thinks when we don’t have many to play with, each one counts
  • He believes that a good egg can be stressed out too much and not grow to day five in the culture, but can survive in the womb
  • Day 2 or day 3 embryos’ thaw rate is over 90%
  • He thinks that my uterus should be fine with transfer because the fibroids that I currently have are in the posterior position of my uterus and not in the cavity

Did I tell you that this clinic is three blocks away from work?  So convenience is a huge plus for me.  I received the fee schedule in the last couple of days and found that each cycle of mini-IVF with UCSF IS about $6500, which is a fraction of the cost going to my current RE.  Medication will not be much because of the low dose stimulation.  The only downside is that this is a big clinic so I will not be seeing the same doctor for any of the monitoring ultrasound or egg retrieval.  This clinic has over eight REs.  Dr. No Nonsense will be managing my cycles though as he will be the one making the decisions for me and with me.

I feel very comfortable with this doctor as I felt the compassion and warmth from him.  It’s very different from some of the online reviews I have read about his bedside manner.  I like him and I think I can work with him.

Fast forward to this past Wednesday.  I rushed home to be available for the scheduled 5:30pm phone consultation with Dr. Y down in Southern California.  Phone did not ring once for another 25 minutes.  I called the Li.fe IVF phone number. Fortunately someone picked up.  I was told that Dr. Y was still talking to another patient.  My phone didn’t ring until 6:30, a whole hour after the scheduled appointment.  I don’t know if I should be worried if that is an indication of their future performance, stressing me out with a doctor that does not respect other people’s time.

We were on the phone for half an hour.  I felt that I was driving most of the conversation, as I asked him many questions.  The following are the highlights:

  • Given my history of having one embryo or no embryos each cycle as well as a history of endometriosis, he suggested doing natural IVF (no stimulation) or minimally using just half of a pill of Clomid (25mg).
  • (A little patch of endometriosis was discovered during my surgery to remove uterine fibroids.  I don’t know if that is enough to say that my endometriosis is messing up my system)
  • I asked him why he uses Clomid and not Femara, he said that Clomid has the function of blocking the estrogen receptors.  Somehow that helps with preventing premature ovulation.  He said that Femara doesn’t help with that.
  • Since we’ll be banking embryos rather than doing fresh transfers, we don’t have to worry about the effect of Clomid on thinning the lining
  • He also doesn’t think using Clomid will make my FSH go higher in subsequent cycles
  • He believes in growing embryos to blastocysts.  He doesn’t believe that an embryo that doesn’t grow to day five can survive in the uterus if transferred on day three (an opposite view of Dr. No Nonsense)
  • He thinks that at my age, I would need at least 4 blastocysts if not more to have a chance at having a life birth
  • He recommends doing PGS on the embryos (which we have decided not to do a long time ago)
  • The blastocyst rate at his clinic for patients my age is 50%
  • He suggests that I do six cycles
  • He said that we can start planning the travel when the follicle(s) reaches 14 to 18 mm
  • He doesn’t suggest using Cetrotide/Ganirelix but he does suggest using trigger shot

Those are the points.

So now I have a decision to make.

Egg donation vs. own eggs?

Most likely we’ll try my own eggs first since Bob started his new job and we can start saving up money again for donor egg cycles if my own eggs don’t work in a few months to a year.  My uterus is not going to grow old as fast as my ovaries.  So if my own eggs don’t work, my uterus hopefully is still in good shape.

With my own eggs, SoCal or local?

That’s the biggest question.  I have no gut feeling.  I just feel that there is a huge dilemma in my heart.

In terms of cost, both places are about similar.

In terms of expertise in minimal stimulation, Dr. Y is no doubt the one to go to.  He does this day in and day out with many many many patients.  He’s been doing this for a few years and this is all he does.  Dr. No Nonsense started doing this a couple of years ago and also does IUI as well as conventional IVF.  Dr. Y may know more about how to tweak the protocol for each individual in terms of FSH level, estradiol level, and the state of the ovaries.  Dr. No Nonsense may do a one size fits all model.

In terms of day 2 embryos vs. blastocyst, it appears that there is a higher chance for transfer if we bank day two embryos.  But does having a chance to transfer mean a chance for a baby?  Or is the chance for a baby higher if we can make blastocysts?  For this point, I don’t know which doctor I should believe.

In terms of convenience, UCSF wins.  I cringe every time I think about having to schedule and go to outside monitoring appointments, coordinating with L.ife for their instructions after each scan/blood draw, keeping a watchful eye on my follicles so that I don’t ovulate before the retrieval, timing the travel and booking plane tickets for the right date, booking hotel and car rental, letting clients know last minute that I will be traveling, and traveling/making it to the appointment.  Those are the things we have to do.  And I cringe.

I am at a crossroad.  Can you feel that I have lost my sense of direction?  It’s compounded by cycle day one today, AF showing up, and the feeling of inadequacy as a woman who cannot bring a life into this world in the most natural way.

This is a lonely road.  I know Bob is traveling it with me.  I know that God is there for me.  I know that many of you are out there rooting for me.  But it’s still a lonely and scary road.  I know that once I make a decision, I will be much better.  But at this moment, I am overwhelmed.

Maybe I’ll go hide under a blanket for a little while.

That Lonely Feeling

Today, I feel lonely.  Lonely in this world of pregnancy announcements, pregnancy news and updates, sight of pregnant women, newborn babies, and successful adoptions.  Lonely even in the world of my fellow real life friends, online friends, and blogger friends who finally, after waiting for a very long time themselves for those two lines, or that phone call/email about a potential adoption, or the delivery of their newborn rainbow babies.  I am happy for them, but I still feel lonely.  Today.

Especially when my body is not cooperating and my basal body temperature continues to stay below the cover line.  There is no ovulation in sight on Cycle Day 29.

Especially when my friends start to talk about trying for number two or three.

Especially when one by one, my secret Face.book friends have a “baby boom” and have gotten a BFP one after another.

I cheer them on.  But I hurt deep down inside.

Not so much that I want them to suffer any longer.  Not that I envy them that it came so easy, because it didn’t come easy.

For one, she lost two babies and finally could try to get pregnant once she started to have health insurance coverage.  I can’t imagine what goes through her mind right now.  Probably terrified to see what her beta number will turn out and has a mix of elation and anxiety of whether or not this baby will survive.  You’re robbed of the joy and innocence when the false hope fools you repeatedly.  But I am feeling lonely in that world of congratulations and those two lines that get darker and darker each day.

It took another friend 4.5 years to have her first child.  It has taken another three years to get this fresh BFP, out of the blue, when she is taking a break from fertility treatment.

I am happy for her.  I really am.  But at the same time, I feel lonely.  That yet another friend gets her BFP.  One after another, I am becoming one of the only few people who don’t have children or who aren’t currently pregnant in this group.

That is such a lonely feeling.

Today, the unknown is killing me.

Right before Christmas, a coworker of mine finally got engaged after dating her long time boyfriend of seven to eight years.  You know what my first thought was?  Oh no, I don’t want her to get pregnant before I do!  It’s such a shameful thing that my mind went straight to making a baby and was not thinking about the joy that she has of finally becoming engaged and planning a wedding.  I thought of myself and how I would react if she got pregnant right away.  I didn’t have enough faith that my time would come even before she walks down the aisle.  

That made me feel lonely and silly to think that someone who hasn’t even gotten married would get pregnant before I do.

A week ago, one of the girls in the Bible study group that I lead emailed me to notify me that she is no longer going to attend because she recently discovered that she is expecting and she has been very tired.  This is the second lady in my group who has gotten pregnant in the last year.  It was such a happy news but again, I felt lonely.  

Of course I don’t expect myself to feel good every single day.  It’s in my constant prayers that I have peace and strength to go through everyday.  I am confident that I will feel fine again.  Maybe tomorrow.  But today, I am lonely in this world of fertility and struggles.