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You have to have a plan.  Everybody knows that.  You have to know what happens next, and, if you're smart, what happens when that doesn't work, either.  Staying a few steps ahead of what's actually happening now is an excellent way to manage disappointment, and an even better way to pretend you have some control.  Not knowing is not an option, because nothing makes an infertile woman crazier than standing still.  (But, hey, if you know of something that does, please tell me about it so I can obsess about that, too.)

This is my problem: I don't know what happens next.  For the first time since we started trying to have a child, I can't see around the corner.

From the time when I first started charting, dutifully clamping my thermometer between my teeth before I'd even turned over in bed, playing with my own personal Silly Putty and crooning, "Spinnnnbarkeiiiiiit," I had a plan in mind.  Because I'd been diagnosed with endometriosis, infertility was not a surprise to me; I had time to get comfortable with the idea of IVF before it actually came to that, and to imagine I knew how far I'd go.

Of course you don't really know how far you'll go when conditions are always changing: Your cycle fails again, but your doctor cheerfully reminds you it's a numbers game.  Or you get pregnant only to miscarry, and you think, well, now we know it can work...  Or your husband changes jobs and all of a sudden your treatments are covered by insurance, and wouldn't it be foolish not to go for it?  Or you hear about a new protocol, a new clinic, a new technology, and start making phone calls — just gathering information, of course, but isn't it interesting that...?

This last cancellation has shaken me.  Before, when my body was responding poorly but well enough, when I made decent embryos and got pregnant on a fairly regular basis, the next step seemed so clear.  Try again.  You'll get there.

Now it's not so obvious.  Conditions don't seem to be changing.  The last two protocols we've tried have failed so utterly that it's hard to have faith it won't happen again.  Other protocols?  Maybe, but why should they work any better?  Donor eggs?  Is it worth a risky pregnancy for a half genetic sibling?  Adoption?  Can I work through my significant resistance to meet it with a glad heart?

Tomorrow I'll talk to my doctor at Cornell.  I don't plan to cycle there again, but I need some perspective on how to proceed.  It's likely we'll try again locally, once, trying simply to get to retrieval, but at the moment I'm not hopeful.  After that I have no idea.

I don't know what's next and it scares me.