This morning I am up at 8 DPO (eight days post ovulation in my two-week-wait, for the uninitiated), and a new lab popped into my account through the hospital lab report system. Actually, it is an old lab, my AMH result - anti-mullerian hormone - another indicator of ovarian reserve. While my FSH was a respectable number for a late-39 year old, my AMH is just "okay" - literally, the word used by Dr. Cuddles in the lab report. I am not someone approaching 40 with the egg reserve of a 32 year old. I am approaching 40 with the normal diminishing egg reserve of a near 40 year old. Could I get pregnant? Sure, though with a high likelihood of using eggs with diminishing quality and a high potential for miscarriage. Could a stroke of good fortune after some of the fertility nightmares I've experienced render this whole conversation moot? Sure, though I am wise enough now not to bet on miracles anymore, not when I am already so blessed with what I have.
In the middle of the night last night, I awoke with a startling headache and sensation of dizziness, following some pretty wretched -and gory - dreams. The old me would be all "oooh, maybe it's a pregnancy symptom." The new me believes this is my body's new normal for PMS symptoms.
And with that, I told Husband this morning I would agree to my RE's suggestion to try to beat this clock a little. I will agree to a cycle or two of Clomid, and assuming that doesn't work (and also assuming we can find the money for it) will consider moving to injectables, perhaps with IUI. These drugs will stimulate my ovaries to produce more eggs a cycle, increasing the likelihood of getting a good one. Is there a risk of multiples? Gah, yes. But it is a risk I think I am willing to take.
IVF remains a path I just can't consider. Never say never they say, and god knows, when I thought we were carriers of a balanced translocation I was all, "sign me up!" However, our insurance (actually husband's insurance) will only pay for IVF after two years of infertility - I hope to learn in my follow-up appointment with Dr. Cuddles whether she could code two chromosomally related miscarriages as infertility. If those miscarriages are viewed by the insurance company as "you're not infertile" - then IVF will easily be ruled out for us, because we don't have $30K to pop for it (we barely have savings for IUI).
There's also this: I know too many women who have suffered the depression of failed IVFs. I can only imagine it to be a hypermagified sense of loss. All of the struggle, the timing, the hormones, the literal physical pain you endure - and it comes with a very low statistical success rate for women in my age bracket. No, I don't think I can do it. I admire the women with the resolve to push there, but I am not one of them. My beautiful - albeit small - family of 3 will be enough (I think).
Another thing struck me this weekend: I think I do need to put a time limit on this endeavor. I have been trying to have another baby since 2012. We are on the cusp of 2014. Two years of miscarriages, surgeries, complications have been exhausting, now that I am emerging from it. I can't put an age - say, 42, - or a year - say, 2016 - on this, but I have to come to terms with the reality that I don't have an infinite amount of energy. I can't make baby-making a mission. I can make it the subject of a blog, and spend many hours talking to virtual friends about it, and I may end up in therapy over it, but I have to find a way to balance this pure longing with the ability to function in my daily life. And I suspect the only way to do that is to let it go.
I see now that this is a pretty eastern way of viewing the world. Hell, maybe all of this acupuncture is working.