The appointment went like this.

First, we went through our file with the nurse, who did a quick audit of our embryos. Six two-day-olds and two blastocysts - all frozen in pairs. The FS asked if we'd like to do a single or double transfer, and we said we'd lean towards a single, but since they're all frozen in pairs, if we ended up with two on the day we'd transfer them both rather than discard the "leftover". And then he said, really? they usually do freeze them singly, because we like to promote SETs. They only freeze pairs if they're not good enough to fly solo. Let me look at your file... oh... well... don't worry, we get a lot of pregnancies from all types of embryos. But what we'll probably do is thaw out some day twos and grow them on a bit and then see, just in case. But we'll also note down that if we have one decent embryo, that'll do, and we won't go crazy thawing lots more to ensure that we have a double transfer.

Then he said how is my cycle because isn't it a bit screwy, and I said well, not really, only when it sees you coming. For example, it has been like clockwork for over twelve months, set your calendar by it, except for this month, when it has decided to get, yes, screwy. I am on day I've-lost-count-maybe-fifty-something. (I've actually accrued enough years' worth of data now to suspect that I'm only seasonally polyoestrus, because I really don't cycle much from mid-Autumn through to the winter solstice, but then otherwise I am pretty much ok, unless I'm living near the equator, in which case I'm fine all year around, but I didn't mention this because it sounds whacko which, as an interesting aside, is how I get by February if I'm living in the UK over winter.) Anyway, to his credit he didn't make me do a pregnancy test, he just asked me what sort of protocol I'd like to start out on when I begin my next cycle.

Not much has changed. He still recommends a natural cycle for those that naturally have textbook cycles. He said I might like to choose a medicated cycle, though, which involves a protocol of the usual - basically oestrogen, followed by progesterone. Then I said, what about the OI cycles we were doing last time? and he said, we did what? oh right, flick flick flick, yes, so we did, I wonder why...? but everything did work very nicely didn't it, except that one time when we bumped the dose up and started a bit early and got too many eggs... so yes, if we did the same thing as we did those two times and look, you actually did get a bit pregnant, which is encouraging, isn't it? And I said that, all other things being equal I would stick with what I know, and he confirmed that all things were indeed equal - that the real reason they usually don't use OI with puregon is because (given that ovulation is not required for an FET and that women respond to such a wildly different range of doses) it's easier to take over the whole cycle than to tweak the FSH so you ovulate only a single follicle, and that as long as the oestrogen is right and the lining is good and the progesterone is afterwards what they'd like to see it is all the same, which I can understand, and so since, in our case, we seem to have figured out how to manage an OI/FSH cycle with approximately as much accuracy as a fully-medicated cycle and more than a natural one, that was that, except for the bit where we all laughed and said how my ovaries will probably respond completely differently to the FSH nowadays and therefore throw it all out the window.

And then I asked about clexane, and he said why the hell not.

And he wrote down FET, 1-2 embryos (from day twos), OI with FSH, clexane.

And then he said call me on day nine of your next cycle, and I said we were going to wait til after our July ski holiday because I don't want to be pregnant on the ski fields, and we laughed, and then I said no seriously though, we're going to start after the holiday, and he said fine, whenever, he's away for a week in July but after that he's all mine and I said good.

And then we left.

No wait - first we signed some new paperwork and paid more for our consultation than I remember paying several years ago.

Then that was that, til August.

I have a new referral letter. It says that my GP is sending me back into the capable hands of my FS, because I am "ready to have another baby". I keep getting stuck on that line. It's not exactly what's going on.

Not that I haven't spent a great deal of energy thinking about timing, but I haven't spent much of that energy pondering over pregnancy, birth, or newborns. Instead, I've been thinking about being ready to try. I've wondered whether I'm ready to face treatments again, whether I'm ready to drag myself into the clinic at fuck-o'clock in the morning, endure repeated blood draws and self-injections, and make nice with the dildocam. Whether I'm ready to live, once again, the hurry-up-and-wait, plans-on-hold lifestyle that ART treatments demand. Whether I can handle the emotional tension of a cycle whilst staying adequately and appropriately engaged with the child I have now. I've thought about whether I can bear to open the can of worms that using up one's embryos might bring - once we start again, will we be able to stop at a sensible point, or will we get sucked, by degrees, down the vortex of I've-come-this-far-and-I'm-not-leaving-without-a-baby? I've wondered how our finances will go, with the burden of treatments, which cost - by the by - more in a month than our last little addition, and that's with excellent insurance coverage. And of course, somewhere in this, I've considered the possibility that the treatments might actually work, but to be honest, I've quickly dismissed it as being the least of my worries.

Am I ready for another baby? Truthfully, I haven't bothered answering that question. If it works out that way, I'm confident we'll cope. If it doesn't? Well, that's what concerns me.

Then again, this time I have something I didn't have before - and I'm not talking about the Prata Baby, although he is also here, it's true. What I have this time is experience. I am not bewildered, or fearful. I am not lost or anxious. I am stronger, and less brittle. I have learnt so much about coping, and recovering. I don't know yet if this will be enough to see us through, but perhaps it is enough to begin with.

I have a new referral letter, and an appointment on Thursday. I think - and I hope - we are ready.

Alex wanted donations made to Rainbows for Kate, instead of flowers, at his funeral. If you would like to do something for Max/Alex and Vee, you can make a donation here. If you have a cancer charity in your home country that you prefer, I'm sure it would be similarly appreciated.

If you like the look of this dish, you can find out the story behind it and how to cook it here. Please take a picture when you're finished and help spread awareness of and raise funds to battle sarcoma.

Cook's notes:

I used 4 chicken thighs (deboned); about 2-3 tbl butter; maybe 5tbl of lime juice; 1 tsp crushed chilli (would have used more, but PB was eating it), about 2tbl cheat's chopped coriander leaves (from a jar - should have used more); maybe 1/2 tbl sesame oil; four pineapple rings (from a tin), and about 4-5 tbl of sultanas just covered with rum.

I also used a bit of the pineapple juice from the tin, added at the simmer stage, and reduced after simmering, covered.

The green stuff is julienned cucumber and some spinach leaves, which needed using up. They went in the leftover juices at the end, for maybe a minute (just until the spinach was wilted).

All juices left in the saucepan were drizzled over everything at the end.

I was initially sold after hearing "chicken" and "butter" in the same recipe, but even so I was surprised at how tasty it was. I didn't find it too sweet at all, and I'm sensitive to that sort of thing, but I did use a fair bit of cous cous and maybe I went light on the pineapple and rum.

It's funny. It's not really funny.

All week I've been opening my reader to look at the blogs, and then more or less just closing it again, a couple of minutes later. My eyes are kind of sliding off the posts. I haven't heard a word anybody's said.

Away from the computer, it's different - busy, bustling, self-involved. I have the luxury of being able to put the lid down on my laptop and thus gain a little precious distance, unlike Vee [invite only], who has to live wholly entangled in the day to day of having Alex gone. Me - for me it's moments like these, when I try (once again, again) to figure out what I'd like to say. I'm not sure what I'd like to say.

I've never been good at this. Others have written touching blogs, and Vee has the most heartbreaking post of all [invite only]. I keep searching, not so much for something to say, but for something to do, and it's eluding me somewhat, but here's a shot.

Alex wanted donations made to Rainbows for Kate, instead of flowers, at his funeral. If you would like to do something for Max/Alex and Vee, you can make a donation here. If you have a cancer charity in your home country that you prefer, I'm sure it would be similarly appreciated.

And if there's something more you want to do, how about joining me in this? Just over a month ago (on March 20th, to be exact), Vee sent me instructions for a dish Max concocted during a moment of respite [password protected] from the burdens of his illness. I'm going to the shop in a moment, to buy the ingredients. I probably can't recreate the exact dish, as it was sort of ad libbed in Vee and Max's kitchen as they went along, and I certainly can't recreate that day itself, complete with all its cast and crew. But I'd like to honour that moment, by putting this dish on my table over the weekend, and I'm hoping you do, too.

Here's how to join in:

1. Read the instructions below, and shop for your ingredients.
   
2. Cook the dish, or something close to.
   
3. Take a snap of your dish and post it on your blog.
   
4. Please leave this message at the top of your post:
   

   Alex wanted donations made to Rainbows for Kate, instead of flowers, at his funeral. If you would like to do something for Max/Alex and Vee, you can make a donation here. If you have a cancer charity in your home country that you prefer, I'm sure it would be similarly appreciated.
   
   If you like the look of this dish, you can find out the story behind it and how to cook it here*. Please take a picture when you're finished and help spread awareness of and raise funds to battle sarcoma.

   
   
   *Alternatively, write your own tribute, including the recipe and instructions for joining in.
   
   Links:
   Rainbows for Kate - http://www.rainbowsforkate.com.au/
   RFK Donations page - http://www.rainbowsforkate.com.au/donations.html
   This post for recipe and instructions - http://infertilefantasies.blogspot.com/2010/05/chicken-la-moondance-max.html
   
   

Recipe

Ingredients:
- lime juice
- sesame oil
- fresh, chopped chilli
- fresh, chopped coriander (cilantro)
- sultanas
- rum
- chicken
- butter
- pineapple
- cous cous

"I can tell you that we marinated the chicken the night before in lime juice, a dash of sesame oil and fresh chilli & coriander. Also soaked the sultana's in rum the night before.

Then cooked the chicken in butter just so it gets a nice golden brown...( yes not very health conscious we never used butter but gosh it tastes so good!)

Take chicken out of the pan and cook pineapple in chicken juices.

Add a bit more butter and then throw in sultanas with rum (you can add extra rum if you like at this stage) and sit chicken on top of pineapple and sultanas and put a lid on the pan and let it simmer for a while so chicken cooks through.

Serve with couscous.

It can be quite sweet but if you eat it all together then it tones down the sweetness down a bit.

And an after thought we should have garnished the plate with a coriander leaf and some chilli...but hey Alex has been watching too many cooking shows!"

What if, because of the years lost to infertility, we miss important parts of our son's life?

---------->>>>

"Just gone?" I was standing on a footpath by the side of a road with Mr Bea, holding the handle of The Prata Baby's stroller, watching a red car disappear around a corner. The driver's last words - said with an eyeroll - had been, "You know how it is when you have a kid. Two years of your life - just gone!"

"It's not like twenty-four months are just sucked out of you for nothing," I complained.

"Yes, but, I'm sure you've noticed," Mr Bea replied patiently, "the first couple of years can be pretty all-consuming. You don't get much achieved apart from raising your child."

"I don't deny it, but at the end of those two years you have a two-year-old to show for your efforts," I persisted. "You haven't wasted those two years, you've chosen to spend them raising a child." Mr Bea patted me (rather condescendingly, I thought) on the shoulder, and sighed, and agreed that I was right, of course. We didn't have to delve further into it. We both knew I was comparing the act of raising a child to the years of failing to conceive one in the first place. There was no need to explain, to either of us, how infertility can eat up your time and energy and put your life on hold. How it can stop you from advancing a career, or experiencing that must-see travel destination, or renovating that house, or even just getting that dog, on the basis that the next cycle (or the one after that, or surely, at the outside, the one after the one after) will be the cycle that changes your lives forever - til one day, maybe two years later, maybe more, you look back and realise you've progressed more or less nowhere at all.

I say "more or less" nowhere. Of course, there is always one type of progress we can't avoid - the progress of time. We started trying at twenty-six years of age, not old by any means, but the end of my life only got closer during those years of failing to conceive, and that knowledge leaves me with a thought I can't quite shake, even now: infertility has robbed us of several years as a family. What if that means we miss an important milestone in our son's life? What if, because of those years lost to infertility, we miss the publication of his first book, his appointment to public office, or his graduation from Oxford? What if we miss his wedding, or never get to meet our first grandchild?

What if, because of those years lost to infertility, we're not there when he needs us most - during his mid-life crisis, personal bankruptcy, or marital breakdown? What if we're no longer there to see him through a life-changing medical condition - perhaps even infertility itself? We've no good reason to believe he's more likely than the next person to be the one-in-eight who suffers as we have - the fertility specialist guesses Mr Bea's ultra-low sperm count may be the result of a virus he caught as a teen, and The Prata Baby has already been vaccinated against that one - but infertility can strike randomly and without warning, so there's no reason it couldn't be our child, either. What if, because of those years lost, there's nobody to help him through, as only a parent can? There are some things you just can't get back.

But time is not only a thief. Whilst our lives were on hold, others were making remarkable progress in theirs, and I'm not referring to all those friends who managed to have two, if not three, consecutive children as we chalked up fruitless treatment cycles, one right after another. I'm talking about reproductive scientists the world over, who were working hard to try and fill our every question with an answer, even that pitiful one we cried during the dark hours after yet another loss: why me? I saw significant changes over the two years we spent with our clinic - new drug protocols to reduce the risk of hyperstimulation syndrome, improved embryo culture techniques, better pregnancy rates per cycle, new information on the causes and treatment of miscarriage. Because of this, as I gear up to transfer our remaining embryos sometime later this year, a new question dares to play in the back of my mind: What if, someday (soon?), assisted reproductive technologies just... work?

This week Resolve (U.S. infertility association) organizes National
Infertility Awareness Week. Get basic information about infertility here.

Mel enlisted the blogging community to give an insight into the various
ways infertility impacts people's lives, expressed so aptly by the two
words "what if?".
Part One of Project IF
Part Two of Project IF
---------->>>>

I want to tell you one last story before I go.

When we started IVF, there was a woman I knew of through a message board. Like us, she and her husband had started trying to conceive in their mid-twenties, and like us, they unexpectedly ran into male factor infertility. Unlike us, they ran the gamut of infertility treatments without result, and turned to inter-country adoption, which was no better. Ten years, they spent, pouring tens of thousands of dollars into a state-run system which invaded their privacy, tied up their lives, and then pulled the mat from under them just as they thought they were getting close, by suspending programs or simply shutting them down. With their fortieth birthdays looming on the horizon, they returned to their fertility clinic, half-hoping for a miracle, half-hoping for closure. They were battered and worn, and felt no closer to parenthood than when they'd started treatment over a decade earlier.

But after reviewing their history and running some tests, their doctor gave them this rundown: age had turned against them, so he couldn't guarantee anything, but a lot had changed since they'd last tried IVF, and he thought they still had a fair chance if they were willing to give it another go. As a bonus, IVF had also become more affordable since they'd last tried it - thanks again, to advances in technology - so they decided they had little to lose. Only a few years later they were a complete family of four - mum, dad, and two, consecutive IVF children, born two years apart, without complications. What a difference a decade makes. If I wasn't so busy trying to soak up what I have here and now, I would say I can't wait to see what the next one will bring.