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Tuesday, June 17, 2008

Barren Advice: Nine

This is the ninth installment of Barren Advice. You can ask questions that are fertility or non-fertility related.

Barren Advice is posted each Tuesday. If you have your own question for Barren Advice, click here to learn how to submit. Please weigh in with your own thoughts in the comment section and indicate which question you're addressing if there are multiple questions in the post.

Dear Mel:

Today I had my embryo transfer for my first IVF cycle, after 6 years of TTC, several years of alternative treatments like acupuncture and herbs, 8 prior assisted cycles including 6 IUI's, 1 miscarriage. Normally I am very good about refraining from urine pregnancy tests and waiting for the blood test results. This cycle, though, my husband and I will be travelling during the week when I was scheduled to have my blood test. Because of the difficulty of finding a lab to do the blood test in our destinations, the RE decided to postpone the blood test until I get back, almost a week after I was originally scheduled for the test.

My question: Should I do a urine test on my own, or wait for the blood test?

Pros of testing myself:
-During my one pregnancy which led to miscarriage, each day that I was pregnant was among the happiest of my life. I wouldn't want to miss out on any joy that may be coming to me, especially after the hundreds of days of non-joy over the past 6 years.
-If the urine test is positive but then I miscarriage by the time of the blood test, it might be good to know about the miscarriage for diagnostic purposes and the next IVF cycle.
-2WW becomes 3WW! I am patient, but there are limits.

The big con:
-Our week and a half of travel involves visits to multiple family members including staying in their houses. No family members know anything at all about TTC, IF, etc. We do not plan to announce a pregnancy, if there is one, for at least a couple of months, due to a combination of miscarriage concern and weird family dynamics. If the test is negative, I would have a hard time concealing my disappointment and/or making up an excuse about why I am so upset. If the test is positive, neither my husband nor I have a good enough poker face to hide our excitement. We don't want anyone to know anything at this point, but I'm not sure if I would be able to keep positive or negative test results a secret.

I know that you and most of the rest of the IF world are far less secretive than I am, but we definitely want to stay in the IF closet. That said, if you were in my situation would you test or wait?


There are going to be people who write in the comment section to wait and they will also have good reasons. And therefore, I'll start this off by saying that you should read through everyone's thoughts and then weigh each one, choosing the one where you have no argument to make inside your head to the contrary. My advice is going to be to test.

Unless you are the type who can truly compartmentalize, you will still be experiencing emotions over infertility and the cycle regardless of the outcome. Sometimes, the waiting is the worst part. No one wants to go into a cycle thinking that it won't work, but it sounds like you have looked ahead and know what happens next, therefore, though a negative will sting like the dickens, you do have a goal of picking yourself back up and giving yourself emotional Benadryl even if you don't necessarily know how you will reach that goal from this vantage point. I think having that in your pocket, knowing you will get there even if it is simply a matter of putting foot over foot for the next few weeks, is a huge source of strength. By which I mean that you should notice your own internal strength that you can plan for the future, accept multiple possibilities, and have the sense to think ahead. Those facts alone point to a person who has internal fortitude.

Why test--for the very reason you state as a pro in your question. I believe wholeheartedly that we should grab happiness where we can. Some would rather not know about a chemical pregnancy, and in some cases I agree that ignorance is bliss. But in most, I believe when you are going to be unhappy anyway, to grab the five minutes of happiness passed your way. To turn it down gains nothing--it doesn't lessen the unhappiness on the other end. If the cycle doesn't work, you are going to be sad. If the cycle does work and it turns out to be a chemical pregnancy, you are going to be sad. If the pregnancy continues for a bit, whether or not you tested will have no impact on how you feel later on with whether you reach term or not because new information will be added to that emotional path. So, in terms of immediate reaction, I would take 5 minutes of happiness and 71 hours and 55 minutes of unhappiness over 72 hours of unhappiness. But that is just me. Some feel that the sadness on the other end is even worse when you swing down from great heights. But, in my world, sadness is sadness and the shade of it doesn't really matter.

There are plenty of non-conception reasons you might be sad or anxious or in a bad mood and needing space. Problems at work, a fight with a friend, debating a career change. You may not be able to hide the feelings, but you may be able to explain them away.

And if it is positive and you're giddy, there are excuses galore you can use. You can pretend you received a call from a friend who is pregnant which allows you to gush about "her" pregnancy (and later gives you the opening: "remember how I told you about my friend that day..."). It could be something good happening at work or just that you're in a sunny mood in general.

I hope that is what happens on your trip--that you're too happy and people get suspicious that something good is happening.

In Eat, Pray, Love, Elizabeth Gilbert closes off the first section--Eat--with an explanation for why she took four months out of her life to only seek happiness. She explains: "But I felt a glimmer of happiness when I started studying Italian, and when you see the faint potentiality for happiness after such dark times you must grab onto the ankles of that happiness and not let go until it drags you face-first out of the dirt--this is not selfishness, but obligation. You were given life; it is your duty (and also your entitlement as a human being) to find something beautiful within life, no matter how slight."

I read into your question that you want to feel okay with testing. That you want someone to tell you that it will be okay if you test--that you will get through the day regardless of whether you are circling the bottom of despair or bubbling over with happiness. You will get through the day. It may not be perfect. It may be messy and emotional and full of excuses--but I don't think that a day where you don't test will look that much different. Infertility doesn't simply hang out, sipping a cappuccino while you navigate a visit and wait to test. Those emotions--those fears and hope and excitement and anxiety--are there anyway. At least test and see what you are facing.

No really, the beauty of a blog advice column is that you get to weigh in with your two cents too. Let the questioner know if you support the advice, add to the response, or dispute it completely. I would love people to add to my argument, but I'd also love to hear the opposite side: why she shouldn't test.

Leave a comment in the reaction box below--only keep in mind that conflicting advice is embraced and rudeness is not. Want to ask your own question? Click here to see what you need to send in order to be included in a future Tuesday's installment of Barren Advice


Jen said...

I think you should test too. The only reason I eventually stopped testing was because I got sick of wasting the money for all the negatives. Besides, I don't think I could wait an extra week for the blood test, particularly if I were expecting a period that (hopefully) wasn't coming.

Kathy V said...

I have never gone through ivf but I think I would test. I think I would want to be prepared either way. If it tests negative then you can prepare yourself for the eventual arrival of AF and you don't necessarily have to go for the bloodwork. If it tests positive that is reason to go for for the blood work so you know the numbers. Plus like Mel said there are plenty of reasons to be happy or sad that you can use for an excuse of anybody asks. (Although if you are trying to keep this a secret from family just becareful what you do with the peestick. Can't just leave it lying around and can't just throw it away either.)

KLTTX said...

I'd test too. If I did not test, I'd be obsessing about every symptom or non-symptom the entire time.

MamaSoon said...

If you are on progesterone supplements (PIO or suppositories), I would definately test the day beta would have been or the day after. But take one of the super sensitive pee sticks, like first response E.R. Good luck!

Lauren said...

I think you should test. I have zero patience, so the 2ww is long enough as it is without adding another week onto it.

If it's negative, sure you'll be disappointed on your trip, but would you rather be anxious and unsure the whole time, or at least have an answer? Personally, I like knowing, not guessing.

I think it comes down to what you feel the most comfortable with.

Best of luck!

Patricia said...

Add me to those who would test.

I think your RE will still have you do the labwork, regardless of the outcome. But testing gives emotions somewhere to go. Instead of bouncing all over the place and being distracted by them, you can focus in on the test and then deal with whatever is real afterwards.

And if you're anal like me (my beta is Friday) you'll test more than once anyway.

I hope you get exactly what you want.

Overwhelmed! said...

I think you should go ahead and test.

I'm keeping my fingers crossed for you!

Wishing 4 One said...

Let me start off by saying I respect all the opinions here.

Me personally, in all my 5 IVF cycles, as bad as i wanted to, I didn't test at home. Why? Not sure, but I always waited for the blood test.

If you really want to test do it. Nothing any of us say here can "make" you test or not. You have to do what your heart tells you. Just try to prepare yourself mentally either way and don't draw any conclusions until after blood work and seeing doctor.

I am wishing u the best news, test at home or not. Really sending best wishes your way for a BIG FAT POSITIVE SOON!!!

Io said...

Hm. I think Mel said it exactly.
Good luck anon.

**susy** said...

I say test. I know it'll be hard to deal if its neg, but if you can a wk to enjoy a BFP all yourselves, I'd risk it. Here hoping and keeping everything crossed for you!!

RM said...

I'm impressed that you have the self control not to test. I pee on 12 of the stupid things days before I even should!

Good luck! Sending good energy your way.

InfertileMadWoman said...

I have to say that I agree 100% with Mel. I say test, and then you will have your answer one way or the other. Either way if you test or don't test, the answer will be the same come Beta day. I hope that your trip goes well, and I really hope that you get your BFP!!


Robert said...

Simple. Ignorance is never bliss. You may not like the information and you may wish it was otherwise, but having the information is empowering and at least lets you know what you're dealing with.

Having said that, I am a man and have never been pregnant so I can't speak by standing in your shoes, but I would never want to not know.

Samantha said...

That's tough with the family situation. If it were only a couple of days longer, I would say wait, but for a week, test. I have avoided pee sticks with later cycles because I didn't trust the negatives, but if I had to wait an extra week for my beta, it would be a different story. Your levels should be high enough for the test to be definitive, and I think that whether you test or not, you will be going through a lot of emotional turmoil.

Veronica said...

Since I haven't been in your situation, I can't offer any "good" advice, but I'll say that i think I'd be peeing on that stick faster than you can imagine. Hope that whatever you decide that you are well.

Piccinigirl said...

I will caveat this with saying that in almost 4 yrs of TTC, I only POAS a total of 3 times and that I did not do it with our IVF, I just waited for the blood test.

However, I am not you. Reading your questions and the pros and cons that you laid out told me one thing, that you should test. You are strong enough to do it. I agree with Mel about grabbing happiness where you can and having that 5 minutes of it is better than having none at all. After 4 yrs I expected nothing, If someone asked me the morning(and come to think of it our nurse did)of my beta what I expected the outcome to be, I can HONESTLY tell you I didn't know. I didn't a yes or no, I had lost expectations. So I never tested because I figured someone or body would tell me the news.

I say test, test for all of us who couldn't/didn't and in small places wished we had.

GOOD LUCK, hoping for that BFP for you.