Thanks

First, thanks for the comments ladies.  I know that I should probably talk to them about how much it hurts.  My excuse is that I think I could cry, and I really don't want to do that.  I am the boss. We are friends, but but employer/employee friends.  You know?
IVF # 5 has officially commenced.  Yesterday all was quiet in my ovaries, so stimulations started.  I feel hopeful, but not convinced it's possible.  I keep thinking about our back up plans and hoping that will be enough to help us through if it's another negative cycle.

Kicked when I'm down

Negative post...
I work at a small clinic.  There are 6 of us.  2 are pregnant.  I was told about the first pregnancy just after my failed IVF#3.  I was told about the second pregnancy during IVF#4.  Each one hit me, but I am friends with these girls and do feel happy for them.  Their growing bellies do send me some "pangs" of sadness for me, but I ask them questions and purposely try to show interest still.  People just do NOT understand infertility and the depression it causes.  My co-workers know about my infertility and my failed IVFs.  But these girls seem very unaware that comments they make can hurt.  And that I don't want to hear endless chatter about pregnancy when I'm already having a bad day.  But I suck it up, because it's an amazing time for them.   I wait until I get home and then talk it out with my husband, to try to stay sane.  Last weekend, with my thoughts shifting toward the possibility of adoption, I felt renewed hope.  I self-talked that all our clients knew about both pregnancies now and therefore the conversations, at least with the clients, would return to normal.  I can move forward.  I had 2 pretty good days at work this week, feeling positive and renewed.
And then pregnant co-worker number 2 found out she is having twins.  Wow.  I thought client conversations were  pregnancy focused with her being pregnant!  The conversation about twins was overwhelming and painful.  Just yesterday I was told/asked "you better be careful or you might get pregnant!", "are you going to announce a pregnancy now too?" and "how fun is that to be surrounded in all this baby talk?" all in one day.  Wow.  And the twin mom herself saying "I wish I could drink wine", "it's so stressful, it's just something everyday", "where will I put 2 high-chairs?".
Sometimes I wonder how I manage to keep this all secret from the clients.  I really want to snap somedays.  I want to yell "fuck you all.  I'm infertile and depressed about it and you are all insensitive fuckers!".  But I don't.  I suck it up.  And I wait for CD1 to start IVF #5.  And I try to think positively about moving toward adoption.  And I want to cry, all the time.

An Epiphany?

Since our CCRM consult, I've been mulling over what to do with this information.  Do I want to go to Denver?  I know that I want to have a baby, so is this the next step?
I work with clients with spinal cord injuries.  A complete spinal cord injury means that they will not be able to feel or move anything below the level of the injury.  An incomplete spinal cord injury means that they will be able to feel some things and move some muscles below the level of the injury.  Although some incomplete injuries have very small disability, most are nearly as disabled as the person with a complete injury.  Only they see they can move some muscles and they think that means that they should be able to walk.   No one can tell them that they WON'T ever walk again, but most of the time that's the case.  Years ago I realized that often having an incomplete injury was worse than a complete injury, because it meant that the person couldn't move on with their lives.  They couldn't except that this was their life now, and try to move on with a new quality of life.
I'm not comparing infertility to spinal cord injury, but a couple of days ago this information helped me have an epiphany.  I am unable to move on with my life.  I am unable to accept my problem because I keep thinking that something can fix it.  Having "unexplained infertility" means that no one is ever going to tell us that we can never have a baby, but no one really knows if we ever can.  But with 4 failed IVFs, the picture is getting clearer.
I don't want to go through another year of this.  I don't want to go to CCRM and spend another year investigating and trying and hoping and failing.  I'm sad that we've spent so many years "stuck" and unable to do anything but plan around TTC.   
I started Lupron Friday.  IVF #5 starts this next weekend.  But that's it.  After this, I think I can say that I'll be done.  I think it's time to move toward adoption.  Making a decision to adopt means that we can move on, just with a different life plan.

CCRM phone consult

The Dr. was great.  He was friendly but professional.  He came off caring and organized.  After reading through out notes, a little questioning period, and then specifically asking what we wanted from the consult, he came up with 3 things we would do if we follow through with them.
Keep in mind, what we really wanted from this consult is to see if it is true that we are simply "unexplained" and it's like "rolling the dice".  We may or may not be successful just depending on stats.
This Dr. actually said "you've had 11 embryos transferred back with no implantation.  We should be questioning more than the stats".  Our first and second RE have both said "it is what it is".  Good to know at least some of these Dr's care about finding an answer.
So his suggestions are:
1. Genetic analysis (I've already asked for this in June at 1st RE follow up.  The results should be in for our Nov. appt)
2.Sperm chromatin assay.  His reason's for this is consistent with second RE stating that it's mainly the egg quality that matter from day 1-3 but the sperm and egg for 4 onward.  So maybe there is a sperm problem that hasn't been diagnosed.
3. Beta 3 integrin, intrauterine biopsy.   Apparently if this protein isn't present, implantation rates can decrease.
Basically, these suggestions are what is suggested to people who have had multiple miscarriages.
So, I feel good we have some suggestions.  We're very unsure what we will do with these suggestions.  I find it odd that the suggestions for someone who has never had any form of implantation can be put in the same basket as people who have several miscarriages.  But at least it's a theory.

Embarrassed

Today I ordered my medications for IVF #5.  I am not talking about it with anyone but my husband.  I know at least my receptionist must know, as I've scheduled all my mornings off again starting 2.5 weeks from now.  And I know the girls at work will see that I'm not there every morning for 3 weeks.  They will know, and yet I don't want to tell them.  I think I feel embarrassed.  Isn't that odd?
I am sad.
I feel like something is missing in my life.
I feel stuck.
I feel like I'm "on the outside".
I feel longing.
I feel stress and anxiety.
Those feelings all make sense to me.  But now I have this new feeling of embarrassment that I'm doing it AGAIN.  I can't explain it and I hate that it's just another uncomfortable feeling I get to have, but there it is.

Our plan

We're going to do it one more time.  The Dr. at our clinic says that 5 tries is "the old college try" and after 5 it's just not a great investment.  So, that will take place around the end of October.  I'm going to start the bcp whenever my CD1 arrives.

As for our mental health, we've talked with a councillor who confirmed our thoughts that maybe we should  have a back up plan.  So we talked with our Dr. today about other options to make sure we will have a family someday.  

As of today we have a few back up plans in the works.  

1. We've contacted CCRM for a phone consult.  Basically, we're having a difficult time with the whole "unexplained" diagnosis.  We've done 4 IVFs and are no closer to a diagnosis.  Both of our RE's have used lovely catch phases like "it is what it is" and "welcome to human nature".  Today we were told that IVF is just like rolling the dice and we have most likely just been on the other side of the stats for our cycles.  Yet, these doctors don't seem frustrated that their profession has a black hole of knowledge.  We just want to hear the Dr. at CCRM say the same thing as our newer RE.  Then, I guess we'll have to believe that there is just no more information to be gained or explanations to be had.

2. We have learned the process of donor eggs and have a somewhat local contact.  The problem with this plan is that we don't actually know if it's my eggs or his sperm that is causing embryo failure.  But still, this is a plan to think about and see if we're comfortable with it.

3. Adoption - the word is out there now and we've been mulling it over.  I have a contact through my mom who I'm hoping to get some preliminary questions answered through.  We'd like to know how long it can take, how much it costs and what the first steps are.  I would like to have contact information for an adoption agency before going into this IVF, so if we fail again we can start this process ASAP.

So now that we have some plans, I instantly feel more sane.  I continue to have my emotional issues from spending the work days with pregnant co-workers and client's who want to know why I'm not a mother.  But we have a plan so someday, hopefully, we'll be able to look back on these dark days and be proud of ourselves for getting through them.

Where I'm "at"

First, thanks guys.
Emotionally, I'm better than I was after the 3rd failed IVF.  I think I'm just more tired then I am sad.  I work with 5 people in my little clinic, and 2 of them are pregnant.  Their bellies are growing and they look so cute and happy and I want it so much.  But, I'm coming to realize that it may not ever happen.  We are meeting with the RE in a week or so and will make the next plan.  It may include another IVF or maybe it will be the start of adoption or egg donation plans.  I really don't know right now.
I'm not sure how often I'll be blogging for the next while.  I had really (naively) started this blog to document our first IVF and then my pregnancy and such.  I just don't know if I want to blog now.