Five Stages of Negative Beta Grief

As I'm sure you can infer from the title, I received word on Thursday afternoon that I am not pregnant. It is now Saturday and I'm just starting to feel that I can type this out without coming completely undone.

As I lay on the floor crying before Husband came home, I thought about how I would be able to get over the grief and move on in time to see anyone outside of the two of us. Being "in the closet" has plenty of advantages for us, but when grieving over the loss of something that wasn't actually yours or even real yet, it's hard to explain to anyone why or what you're grieving over. No one sends flowers or cards, there is no obituary, nothing to eulogize, and nothing to mourn for except for the loss of what you thought was meant to be.

The stages of grieving over a failed cycle have been different for me than the well known Kubler- Ross model*; it's really hard to "Deny" when a doctor tells you that you're not pregnant based on bloodwork done that morning. For me, the initial reaction was, "try to be strong until I get off the phone. Then I can cry," yet I hardly heard a word the nurse said because all I could feel was Devastation.

Does anger come next? I cannot speak for others but it's hard to be angry at anyone but myself, and yet anger did not come after Devastation.. For me, I was more angry as I was waiting and waiting for hours longer than they should have made me wait to take the call. I took my blood test at 6:10am and did not hear back from them until nearly 3pm, but once the phone rang there was no possible way anger could beat the anxiety that was then replaced by devastation. It's difficult for me to be angry when you're grieving something that never was. Anguish describes this time best.

It's impossible to bargain a negative beta. I suppose the argument can be made that it is also not reasonable to do so after a death, but I felt that I had done all of my infertility bargaining previous to the test results, "if I do this, I will be pregnant", "God, please please let me be pregnant, I'll never swear again." What can I offer up now? The test is done and nothing that I gave over in my bargains was accepted. No, anguish does not turn into bargaining, it turns into something much worse and uglier: Blame. On myself, on my RE, on my dogs for touching my stomach, on the random lady who bumped into me at the store, I'm extremely ashamed to concede that I felt tiny flashes of blame towards Husband but mostly I blame myself. I blame myself for the stress I put myself under, for taking the two weeks off of work, for going too fast up the stairs one day, for what I ate and didn't eat and for what I've done or haven't done in my life to cause karma to take her vicious vendetta against me now. 

Depression is a reoccurring theme throughout infertility. I'm not clinically depressed by any standard, but I do get down about all things babies and infertility. Disappointment is what I have been dealing with. Disappointment sounds like such a tame word compared with "devastation" or "anguish" but when you're thinking in terms of not being able to share happy news with loved ones, or with spending another holiday season without a baby in your belly, disappointment is a powerful stab that leaves it's mark. 

If we were mourning the death of a loved one, we would undoubtedly come to Accept our loss. Usually after the services and the body has been buried or ashes spread into the ocean, many people describe feeling a release or a calming acceptance that they've said goodbye and that their family or friend is laid to rest. Yet, to task me to accept that I am not pregnant? No. There is no acceptance that I can't have a baby after all my husband and I have put ourselves through for years and for this cycle alone. Crackheads and murderers have children; I cannot and will not accept that I cannot have a baby. Yes, this cycle failed, but I won't accept that, either. I want answers and I want a solution. There is also no "final " stage of mourning a failed cycle until the next cycle comes along and brings some hope. Until then, all things infertility and fertility related will make me Apathetic. Many women in the infertility world have said that it is extremely difficult to get excited when they are about to start a new cycle. The feeling of apathy comes from the grief that we've become so familiar with and have learned to brace ourselves for. Yes, hope will reappear and push me into another cycle, however, - call it self-preservation - with each negative test, a little piece of me breaks off and a fraction of the amount of hope I had last cycle is now taken over by apathy. 

* Otherwise known as the 5 stages of grief

Here We Go Stimming, Here We Go (Clap Clap)

                     

After what felt like a painfully long 30 days, my period came on Friday morning, right on time. I tried to high five myself in the bathroom, called the clinic on my way to work, and by lunchtime I'd been instructed to show up for my baseline bloodwork and ultrasound the following day. At the clinic, I ran into an old friend of my husband's and mine, who was waiting for his wife who is in the middle of her first round. After getting over the initial schock - what I've known to be quite inevitable - we got caught up a bit and I think he and his wife were releived to know that they aren't alone and we parted promising to get together in the upcoming weeks. 

The rest of my time there was textbook and, on my drive home, I even got to watch an absolutely breathtaking sunrise over the autumn New England leaves. Then the waiting and checking my phone every twenty* minutes for notification and instructions from my RE (a very big part of me was concerned that my OHSS was still a problem, because well, my luck). Husband and I went to the gym to keep me distracted - hey did I tell you all I'm doing the couch to 5k program? - but still no email by the time we got out. The longer the email took, the more I was convinced that I'd be getting one of those "concerned nurse/RE" calls and I tried to busy myself but man, the anxiety was not cool. 

Alas, finally, finally, at the eleventh hour, the email to start Gonal F came! Woohoo. Never been so psyched to get a shot in my life. So last night it began and it was like riding a bicycle; husband had fallen asleep on the couch and I didn't even need to wake him; just set up the pen and went. Tuesday will be my first monitoring appointment, so here we go!

*Who am I kidding? It was definitely more like every five to ten minutes.

My Intro

I've never written an intro for this blog because I've had some sort of brain block but below I want you all to see my work in progress and hopefully chime in with some tips.

I met my husband in 2005; he was about to be 30 and I was 22 and trying to finish school. It was instant attraction although not an instant romance, I believe what really glued us together was our shared love of family and children and our desire to build a family of our own. 

We were married in the spring of 2009 and although we decided to give it a year of marriage before "trying" to conceive, I still pulled the goalie immediately and never refilled the birth control script after the honeymoon. 

Even though we were not aggressively trying until about 2012, I always had the thought that something wasn't quite right. We also had to contend with my family history of the genetic condition SCA1 which is autosomal dominant (meaning you cannot simply be a carrier; if you have it you have and will have a 50% chance of passing it on to your children). My mom has SCA1, as well as 2 out of her 4 siblings and various cousins of hers. She came to us with the idea of possibly using IVF to negate the possibility of passing it on, if I were positive. I spent a long, long time debating whether I even wanted to know - onset is usually not until at least middle age - and if I was positive, I struggled with the idea of "playing God" and whether I would've been ok knowing that someone could have made the same choice about me. 

By mid 2012, I had yet to become pregnant and my periods had never seemed to even out after stopping birth control; with cycles ranging from 14 to 60+ days, it was impossible to track anything. I finally went to my OBGYN with all of this information: the "not trying but not trying not to", the weird cycles, plus the family history. His immediate reaction was that we were dealing with infertility and that I should meet with a reproductive endocrinologist(RE) specializing in genetics immediately. 

My OBGYN and RE both convinced me that I had to get genetic testing immediately; the biggest impact was when my OBGYN said "you may think it's fine to deal with SCA1, but what if you have a child who can't?" Done. I met with one of the oldest geneticists in the country and four weeks later he called me with the best news I could have heard - negative. With the fright of passing SCA1 thankfully behind us, it was time to move along and get to the bottom of not being pregnant after almost 4 years. It was decided fairly quickly that we'd do IVF with ICSI since our main concern ended up being Male Factor Infertility(MFI)  This blog is my Infertility journey from that point on. 

Infertility is painful; it is in no way glamorous - as some reality shows may lead you to believe -, it is lonely, and there are many, many obstacles and disappointments. The emptiness infertility leaves upon a couple is impossible to describe to anyone who has not dealt with it first hand. I hope to convey the journey to those who are lucky enough to avoid it and to offer a place for those who are dealing with infertility to feel less alone and to hopefully laugh at as much as we can along the way. 

The Long and Winding Road

Husband had his semen analysis yesterday and I was able to have a good long chat with our RE. The sperm numbers are up but the motility is non existent; as in not even one sperm doing a little jiggle trying to move. So, it's not looking like the quality is ever going to really improve - and now I know not to waste my freaking time after sex and I can just get up and pee already!- so we can finally move forward with the next protocol.

Timing, Mother Nature, and whatever powers their may be out there being the motherfuckers that they are, yesterday s also the day my period decided to show up. I told my RE that I was going to sweet talk him into letting me start the cycle today and he laughed and said that it's unfortunately up to the insurance company; we still need approval for round two which of course has been on hold. Soooo, if it were up to my RE we would've started with monitoring today and gone straight to five days progesterone in a week or so and then straight forward to the transfer. Lovely, easy, all the work up to my husband this time around, right? Big fucking negative, Ghost Writer. 

We are one of TWO of his patients ever to have insurance say that egg thawing is still an "experimental science" and won't cover it (ahhh, a loophole. I know, I should not complain because we do get so much covered). Therefore, I get to do an entire round of IVF drugs again starting next cycle. Tell the folks what she's won: this will be a smaller round since my awesome RE is going to give the finger to the insurance company and thaw my eggs anyway on my retrieval day, so I'll get to skip Lupron all together, thank you baby Jesus. 

There's a lot to worry about, per usual and I'm completely jaded from my last retrieval experience but I've got about a month to get it out of my system and then I'll be riding the hormone crazy train again. Woowoooo.