#2?

We started the conversation about considering trying again. In a nutshell, there is a lot to consider and I'll try to unpack it here. 

Financial

Having a baby is expensive. Doing treatment to have a baby is very expensive before the baby even arrives. I estimated that between the hospital bills, celebration, setting up the nursery, and getting all the gear we spent nearly ten grand. That doesn't even include all the money spent trying. Obviously a lot of items will not need to be bought again (stroller, furniture, etc) and any celebration will be a much smaller affair, if not entirely on zoom. Even so, we still need to factor in potential hospital bills and fertility medication costs. This is before we factor in the monstrosity that is daycare costs for infants under two or the debt we're paying down for replacing the roof last year. 

Medical

My weight is back to where it was before we transferred. I gained 27 lbs during the pregnancy, lost 20 by 6 weeks pp. During the early months of the pandemic I gained an additional 15 lbs - I can blame it on nursing or stress or lack of sleep but it was probably a combination of all of them . I'd like to continue losing weight and focus on healthy eating and exercising. Over the summer I got some labwork done with my pcp for my annual physical that was nearly a year overdue and got some results we're monitoring. One of the liver numbers was high. She said fatty liver can be caused by pregnancy and breastfeeding so she wanted me to retest several months after stopping to breastfeed. I was originally planning to stop breastfeeding around the one year mark but weening has been going slow. I just don't think we were both ready. We're down to twice a day for a few minutes and slowly decreasing. Either way, I messaged my pcp asking about following up and the recommendation was to get blood work and see where the numbers are at. 

Nearly a year ago I stopped taking thyroid medication per my endocrinologist's recommendation. I was about 8 weeks post partum when I realized my refill was out and I hadn't been on the medication for nearly a month. My levels were tested and since they came back within the normal range she recommended staying off of the meds until we can reevaluate at my March appointment. Then covid happened and that appointment never did. The fertility clinic used to recommend seeing a TSH under 2 for pregnancy but now that level has been updated to under 4.5. 

Emotional/mental

Fertility treatment is a roller coaster. It's an exhausting and draining process. Even assuming best case scenario of successfully getting pregnant, the first weeks are rough and we have no support in terms of childcare or cleaning or whatever. It would be all on the two of us so we really have to be prepared for it mentally. 

Covid

There's so much unknown about this. We don't know if covid causes or increases risk of miscarriage or birth defects if someone gets it while pregnant. We don't know if someone who had covid or is vaccinated prior to pregnancy is immune or has increased risk of defects. We're still not really clear on how safe it is to be indoors with masks, even though we know it reduces the risk significantly. So what does this mean for doctors appointments? Potential hospital stays? 

We do know that pregnant people are in a higher risk category. We know that pregnancy can potentially exacerbate covid symptoms. There is no safe daycare option before everyone is vaccinated. Hospital stays are very different than before - you may be allowed one visitor and they may or may not be able to leave. Even if everything goes smoothly with labor and delivery and we all get home safely, there are still so many appointments within the first few months, for baby and mom, and each one can increase risk of exposure - we just don't know where this pandemic is headed or where we'll be a year from now.

Each of these considerations is very serious individually. All together they seem insurmountable. A rational person may say that it's definitely the time to wait. Some may argue that a "vaccine is on the way" and if we hang tight for a bit then the whole covid situation will resolve and a lot of these considerations will become moot. 

All that may be true, but I've been burned before for waiting and I don't want to repeat that mistake. Before trying for our first we waited several years while trying to get our finances in order. We wanted to finish school and buy a house and pay down debt before taking on the challenge of parenting. How did that turn out? Not only did we never fully get to where I'd like financially (thanks, 2008 recession) but we ended up needing multiple years of fertility treatment before being successful. Trying doesn't guarantee success. If we end up needing another IVF to keep trying then we're up against the clock.

I spoke to our RE to catch up. I love her, she's the best. Her recommendation was that it's a personal choice but that she wouldn't put her life on hold due to covid. With regard to our treatment, she would want to do a saline ultrasound and biopsy to see where things are. If all comes back normal then the transfer would be the following cycle. If anything needs to be addressed, then we would treat and take it from there. Before even doing that, I need to address the liver and thyroid issues first. 

So that's the timeline. I'll use December to follow up with my pcp and endocrinologist. In January I'll verify our new benefits and see what, if anything, insurance will cover for a FET and the medication associated with it. Maybe by February we'll know more about a vaccine and we'll be ready to do the u/s+biopsy in the spring. In the meantime we'll continue to try to save money, pay down debt, continue to lose weight, and get in the mindset of gearing up mentally.