It's good to have options.

Well, part one is over. Even though it feels like we are still standing at the bottom of the mountain looking straight up, the good news is we can now start climbing. I had my hysteroscopy and polyp removal about 2 weeks ago, and now that my uterus has received its clean bill of health, we can now start moving forward with why we went to a fertility doctor in the first place: to try to make a baby!

Since we have the great fortune (/s) of having been diagnosed with infertility - RPL (repeat pregnancy loss) and DOR (diminished ovarian reserve) - the bright side (?) (really grasping at straws here) is that we have more than just the traditional option of how to proceed with the baby-making attempts. This week we had a consult with our doctor to discuss our various options, which didn't really yield any new information but did at least verify what we thought our options would be, and gave us some insight into which path we should choose.

The first option, naturally, is...to keep trying naturally. Although we now have some data and numbers about the number and quality of my eggs, there's no way to really quantify it. Even if there were, as long as I have some remaining good eggs (which I ostensibly do), there's always a chance we could end up successfully getting (and staying) pregnant the good old fashioned way. As they preach in high school sex ed class, it only takes once!

However, given the information we now have about my DOR diagnosis and our two miscarriages, neither we nor our doctor are feeling particularly confident about our chances going au naturel. To be clear, we (the three of us) are fairly confident we can get pregnant (see: two previous pregnancies - again, go us, I guess?); we are not particularly confident about having a successful pregnancy to term. Of course we can't put an exact percentage on how likely (or not) we are to be successful naturally, but at this point it seems more unlikely than likely without medical help. Which leads us to...

The next option, which is to try a medication called Femara that will help stimulate my ovaries to release multiple eggs, with the idea being that more eggs = better chance of at least one of them being a good egg (compared to the not good eggs I've apparently gotten pregnant with previously, hence the miscarriages). To be quite honest, this is the option I'm the least excited about, as the emotional cost doesn't feel like it's worth the potential benefit. 

For background, and while I'm laying out my entire medical history, I have been clinically depressed since high school (officially since my sophomore year of college), and that is still very much a pervasive issue, especially as I navigate infertility. I was never super keen on being on hormones for that reason, which is why I spent the majority of my birth control years with a non-hormonal IUD. After my miscarriage in December I descended into the worst depression I've experienced in over a decade and, while I'm mostly better, I still don't feel like I've fully recovered. My mental health over the last year has been super up and down, and the hormonal roller coasted I've been on has really done a doozy on me. 

So, all of those things considered, and with the fact that Femara only doubles our chances from about 10% naturally to 20% with medication, Option 2 is my least favorite so far. I just don't know that the hormonal implications are worth it for the relatively small increased benefit. Our doctor seems to agree - while he certainly advised us that it wouldn't be a bad idea to go this route, it wasn't the one he recommended as being our best bet.  Which leads us to...

The final and (in my opinion, most likely) option: IVF (intrauterine fertilization). I could and probably should write an entire post on how I really feel about this. Maybe I will. But for now I'll say that, as much I saw the (IVF) writing on the wall from the beginning, at the same time, I also...didn't? Getting a diagnosis of something rather than unexplained infertility was both a blessing and a curse. While I think Ben was happy to get any answer, as opposed to no answer, and I was too to some extent, it's been a tough pill to swallow (mostly for me) that we will likely need some degree of medical intervention to have a baby together. And that medical intervention might mean our kid being made in a petri dish, which is about the least romantic way one can imagine. But, I digress - like I said, I have thoughts on this subject that could make up their own post.

Although I still feel like I don't have a good grasp on it, I'm learning so much about the science of making a baby, and from what I have gathered so far, IVF is really the best path in our particular situation. If we do go that route, the doctor will retrieve a bunch of eggs from my ovaries and be able to genetically test them for viability. Although nothing is a guarantee, we'll essentially be able to figure out which fertilized eggs are viable and likely to implant and grow into a healthy baby, and only those 1-2 eggs that meet that criteria will be inserted back into me. I made the analogy the other day that it's essentially the difference between throwing darts in the dark vs. turning the lights on - it's totally possible to hit the bullseye in either scenario, but much more likely in the latter scenario. It costs a pretty penny to turn the lights on, but at least we won't be throwing blindly like we have been. Even if we go this route, there's an almost non-zero possibility that we'll have try at least more than once; such is infertility, I'm learning. But even with that taken into account, it seems like IVF is our best shot. 

One thing I do want to say is that the care we have received so far in the last 2.5 months we've been going to this clinic has been incredible, and while I was sort of hoping for more guidance from our doctor, I'm also glad that he really didn't push us in any particular direction. He assured us that the choice is totally ours, and that no matter what we choose, there is various support the clinic can provide to help us to be as successful as possible.

So now that we're all caught up, this post is really a whole lot of nothing. We haven't made a decision yet about what we want to do. We're sort of in limbo, which is my least favorite place to be in life in general. But I just wanted to give a snapshot of where we are right now and what we're thinking and hoping. After much discussion we're heavily leaning toward IVF, which feels like a whole new world in and of itself, but we're pressing on and exploring this uncharted territory the best we can. We're not quite ready to jump into IVF at this very moment though, so we think we're going to take a month or so to just...be and breathe and process everything we've been through so far, and then hopefully start the next phase, our IVF journey, in the next couple of months (?!). 

Until next time,

T