What might have been

Note: I was hesitant to post this as it is possible someone from my clinic reads my blog. My apologies in advance if I offend anyone. I have no doubt that the people at my clinic have the best interest of their patients at heart.

When I did my first IVF cycle, the most recent stats available for my clinic were from 2004. At that time, my clinic had a 56.7 live birth rate for people under 35 and CCRM had a live birth rate of 58.5. I was one week passed my 38th birthday. My clinic's stats in my age group didn't quite measure up, but since my clinic only did about 25 cycles while CCRM had over 130; it was safe to assume that it was just a statistical difference (the reliability range overlapped with CCRM). Additionally, their rates were much more comparable in the pregnancy rate per transfer category.

I signed up for 3 cycles with my clinic - two being early miscarriages and one being a BFN. By the time we went for our fourth and last-chance-with-my-eggs cycle, I was comparing DE cycles only and still felt pretty good.

Today I was thinking about our up coming cycle and on a whim decided to check out the most recent stats. I shouldn't have looked. While CCRM has continually (from 2004 - 2007) had a live birth rate in the low 40's for women in my age group (38-40); my clinic has hovered around the mid to upper 20's - even taking a hit across all groups in 2007. I am now led to believe that our chances of success would have been about 1.8 times greater had we gone to CCRM. It feels awful to think things might had been different if we had tried a different clinic.

Ok, Kami, but what about the live births per transfer? Those rates actually stayed pretty comparable and you always made it to transfer so isn't it fair to only look at those rates and let yourself off the hook? Maybe. I just don't know. Perhaps my clinic isn't as good at stimulating older women and so cancels more cycles. Perhaps CCRM preselects their patients. I just don't know. My suspician is that CCRM is just better at stimulating older women since when you select for diminished ovarian reserve they still have around a 40% live birth rate and about a third of their patience are diagnosed with diminished ovarian reserve (something I was not diagnosed with until the DE cycle)

I have often had the shadow of regret hanging over me for not going to an RE sooner - for believing our miracle pregnancy in 2004 wasn't just a fluke. Now I am left feeling that I made the wrong decision for at least not trying CCRM for our last-chance-with-my-eggs cycle in early 2007. Would that have translated into a live, mutually genetic baby for us? We will never know. I'm not a statistic. I'm not 100 cycles or a hundred women. I do know that right now I feel like I have been kicked in the stomach. Although not intentional, I feel like I have been the victim of fraud. I feel cheated.

One of the things that has always bothered me about moving to DE is that I never had proof that my eggs had abnormal chromosomes which I understand to be the best indicator of poor quality eggs (please correct me if I am wrong!). PGD was too expensive and wouldn't have increased our chances of a viable pregnancy and in at least 2 of the pregnancies (Ernest and my first miscarriage) the karyotype came back normal (the miscarriage was normal female so it could have been my cells tested but the tech stated "probable placental villi" in the report so she thinks she got the right cells). The second miscarriage did not have a reliable karyotype.

Of course, normal chromosomes didn't do us any good with Ernest. He was non-viable outside of the womb because of a birth defect that caused the preterm labor. We were told it was just bad luck at the time.

So the questions continue to swirl around in my head: Wrong choices? Wrong clinic? Bad eggs? Bad luck? Yes, for those long term readers, I have been down this road before.

Just to rub salt in the wound, I feel guilty having these regrets because I have LB. Even now she is holding a chunk of crusty bread in one hand and a chunk of apple in the other - taking turns shaving off little bits with her bottom teeth (every once in a while, I have to go pull a too-big bite of bread out of her mouth to wails of unhappiness until I put a small bite back in) and it is terribly endearing. There is no doubt that I love her with all my heart. And there is also this.

I don't think this (this weight, this sadness, this cloud of regret) will ever go away completely. Like the loss of a child, the grief is always there it just punctures your life less and less often with less and less force. Unlike the loss of a child, it could have a too-big impact on LB if I am not careful. (I say "too big" because everything I am could have an impact on LB since everything I am impacts the way I parent.) I don't know what to do about it either. Perhaps I am hiding it from her well enough at this age and by the time she knows any differently, it just won't matter that much to me anymore.

As long as I am having a poor me moment, I will also say that it sucks that it was male factor infertility that brought us to the table in the first place. I am convinced we would have had children easily at 34 had we not had male factor issues.

Where is the road map to tell me how to get on with my life after failed infertility treatments, a dead baby, and mistakes in judgement and be happy that we were successful with the next best alternative? When and how is it ok to grieve what you didn't get while you are parenting the miracle that you did get? When can I be selfish and let the tears flow and when do I need to pretend it doesn't matter to me at all? What about those of us who still feel like failures sitting in the waiting room of our fertility clinic even though we have successfully found a path to parenthood?

I don't know, but I am done with self pity for today. Brad will be home from work soon and poor LB has been too neglected. I promise my next post will be much more positive. I'm off to see if nibbling on baby toes and blowing on a baby tummy will lighten my mood a bit.

Update: Please see the follow up post.