And the doubt creeps in

Yeah, so I know I'm supposed to be gently incubating during this time between IUI and beta, but the reality is that the closer I get to Monday the more I Google to try to figure out the odds of getting a positive based on our particular circumstances. Not that it's even possible to figure out my exact chances, but I've been looking at studies of sperm quality and IUI pregnancy rate, stimulated ovulation IUI at my age and pregnancy rates etc. And the numbers, they are not good whichever way I look at them. First there's our male factor issue which was deemed "minor" by my husband's urologist, "suitable for IUI" by my RE and "pretty frickin hopeless" (my definition) by the literature. Most studies talk about requiring at least 10 million motile sperm after processing for pregnancy to occur, our sample was only 2.5 million. Other studies mention needing pre-processing motility to be >50%, ours was 26%. Rate of progression needs to be at least 3, our sample was rated a 2. Pregnancy rates overall for IUI were only about 7% per cycle for couples in circumstances similar to ours. No need to start thinking about painting the baby's room, that part seems clear.

I know they are just numbers, and a 7% chance is not insignificant enough for me to indulge in a pitcher of margaritas with a clear conscience, but chances, they are slim. I guess all I can do is wait for Monday and try to prevent myself from wasting $10 on an HPT.

Cautiously optimistic

Things appear to be progressing nicely, the follicle on the left is now 19 mm and there are now 3-13 mm follicles on the right, with my estradiol level up to 753. I am to take another 150 units of Gonal-F tonight and then go back in tomorrow morning for monitoring. When I pressed the nurse for more details (I'm getting much better at this) she said we are aiming for 3-4 follicles that are at least 16 mm in size and that she "wouldn't be surprised" if I used the trigger shot tomorrow night. I asked if the larger follicle on the left was problem and she said that it is likely to be re-absorbed and that we are really only working on the 3 on the right. I can't remember the exact details of our first IUI cycle, but I think we were in a similar boat with 4 follicles but one much larger than the others, except that time around using twice as much FSH. So far, so good.

In other news, I found the results of this study to be sobering. They were looking at the rate of live births in a cohort of women undergoing up to 6 cycles of IVF at a clinic in Massachusetts. In the paper they claim that they picked 6 cycles because Massachusetts has a mandate that fertility treatments must be covered by insurance, and that typical coverage in this state allows for 6 cycles. I live in this state and I definitely don't have enough coverage for six cycles of IVF: my insurance caps my coverage for fertility related treatment at a dollar amount that might pay for 2-3 IVF cycles, which is one of the reasons I insisted that we start with IUI (the main reason being that our doctor said we were good candidates). Anyway, the main findings were that the chance of having a pregnancy resulting in a live birth after six full cycles of IVF were between 65 and 86% for women under 35, but only 23-42% for women over 40. That's less than a 50% chance that I will take home a bio baby after a lot of treatment, much of it that will not be covered by insurance. I never really believed the statistics about the rapid decrease in fertility after the age of 35 because it just wasn't part of my life experience. My mom had a surprise pregnancy at age 37, one of my best friends just had her first baby at 40 after barely trying. I know their experiences don't mean anything for my odds, but hey, when you're not trying to get pregnant you really don't pay attention to these things.

I don't know how far I want to take this. Personally, when it comes down to whether or not I would pay out of pocket to continue trying to get pregnant after my insurance runs out, right now I don't feel inclined. Given my odds (I'll definitely be on the other side of 40 by then), I think I would rather spend the cash on adoption fees, assuming my husband is on board. Hopefully I won't have to make that choice, but hey, I like to be prepared.

One

I understand that many women in the throes of infertility are deeply irritated by the phrase "it only takes one." For me, "it only takes one" is a mantra that allows me to consider the possibility that I will win the baby lottery. The reality is that while one egg and one sperm do a baby make, it may never do so for me, and I have no control over whether it does. At 39 1/2 I am fully aware that my window for conception narrows every day. Honestly, I never thought I'd be in this position (who does, right?) but I happen to have good insurance and a top-notch clinic right down the street and when I realized how important it was to my husband to do everything possible to try to have a child that shared our genes, I shrugged and said I would try. Somehow in just six months we seem to have become deeply entrenched in a process that I know is more likely to fail than to succeed. And while I won't say that I'm ok with it, I do understand that the outcome is as out of my control as it is for any woman. Money and medical treatment can only increase my odds of getting pregnant by a small percentage, and in the end it will come down to a random collision of two cells that triggers a cascade of biological events that has the potential of resulting in a baby. Right now, it's enough hope to get me by.

Baby-friendly cars and other leaps of faith

We spent the weekend test-driving cars because I either need to spend a small fortune repairing my current one so that I don't die from carbon monoxide poisoning, or I need to replace it. Given that my car is 9 years old and has been having more and more frequent and expensive issues, I have opted to ditch it and buy a new (to me) one. I have a thing for station wagons, what can I say, I like to haul stuff. I'd like to upgrade to all wheel drive and the options for wagons in my price range are limited (I know there are a bazillion of them on the road, but I didn't love the Out6@ck I tried). Oh, Toyota, why can't you bring back the Corolla wagon, circa 1982?

Anyhow, we decided to expand our options and looked at small crossover SUVs since they are really just station wagons with a few more inches of head room. As the sales people went through the features, they inevitably asked if we were planning to expand our family, and then went on to talk about car seat tethers etc. Now, while we want to expand our family, given our ages and medical issues, the odds are pretty even that we won't. So, do I buy a car with good child seating options or not? If I choose the car with the most child-friendly features and we don't end up with a baby in a year will the damn car be a constant reminder of our fertility journey?

It's a decision that is requiring a certain leap of faith, at least on my part. Since we're unlikely to have our parental status decided by a spontaneous pregnancy, we've already had to put our desire to be parents out there by pursuing ART and, in doing so, putting metamorphic neon signs above our heads that scream "We're Trying to Have a Baby" to innumerable doctors, nurses, receptionists and insurance companies. It's just a little bit scary, declaring my intentions and being unsure of my body's ability to deliver on them. So, while I'm much more comfortable standing securely on the edge, peering over to observe danger from afar, leap I will.

Besides, I have to think of the resale value.