More procedures

I met with the RE again today to go over the month of testing that turned into three months of testing, and it did not go quite as I’d expected.

From what the nurse practitioner told me after my SHG, I thought there were a few irregularities with lining thickness that showed up, and that was all.  From what the radiologist told me at my HSG last week, I thought there were some hints of synechiae, but that it didn’t look like a big deal.  Apparently, taken together, my RE thinks that these results are a big enough deal that now I need an MRI and a hysteroscopy, and that my husband and I should hold off on trying again until both of those procedures have been completed.

The MRI is to determine whether or not I have fibroids.  Apparently the shape of my uterus on the SHG was irregular enough that she thinks there’s a possibility of fibroids — but she also said that the irregular shape could be caused only by adhesions, which it’s pretty clear that I do have at some level.  I don’t need to do the MRI, strictly speaking, since they could probably figure everything out during the hysteroscopy — but it will determine whether or not the irregularities are due to fibroids before I have the hysteroscopy, which is important mostly so that I know what to expect going into the procedure (since fibroid removal is a bigger deal that adhesion removal).  Then, the hysteroscopy is supposed to go in and fix whatever adhesions are kicking around in there, plus the fibroids if they exist.  Since I have a history of adhesions, and since adhesions can cause RPL, and since I now have two tests results pointing to adhesions in my uterine cavity, she says she thinks we should definitely do the hysteroscopy to remove them before trying again.

In theory, this course of action makes practical sense.  In practice, I am bummed that this testing/treatment process is just dragging out indefinitely.  What I initially thought would be one month of testing (in December) will now be a minimum of four months of testing/treatment, and it sucks.  And I don’t even know when we’ll be able to start TTC after that — it depends on whether it’s fibroids or just adhesions.

One step forward, two steps back.

So, that’s where I am now.  I don’t know a whole lot about timing at this point — I have to call to find out about MRI scheduling tomorrow.  She said she could probably do the hysteroscopy on my next cycle, but only if they can do the MRI *and* schedule a pre-op appointment before then, which means during the next 2-3 weeks.  So, things are a little bit up in the air right now — I have a treatment plan, but I don’t know how long it’s going to take or what to expect in terms of recovery time afterwards.  Ugh.

Anyway, I’m mostly managing to be zen about it — I’m really just discouraged by the long, slow timeline, but it’s nothing I’m not used to at this point.  Mainly I’m sad that we aren’t supposed to TTC until this is over.  It just feels like so much wasted time that I don’t have. But, all of my other tests looked good, including ovarian reserve, so I’m trying to remind myself that a few months here or there are unlikely to make a difference in the long run and that this currently looks like the best route to a new healthy pregnancy.

I’ll keep y’all updated.

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HSG #3

Well, folks, do I get a prize for surviving my third HSG today?  They are always super-fun, of course, but actually today’s was basically a non-event — catheter/balloon placement was not even a little bit painful.  Not sure whether the difference is due to having had a full-term delivery since my last one or whether I just had a magical doctor doing the placement, but hey, I’ll take it!

As for the results, they were very good — better than I thought I could expect, really.  Both sides spilled dye almost right away, and the radiologist told me there was really only a little bit of scarring noticeable and only slight dilation on the left.  I don’t know if it’s even possible, but this HSG seemed much better than the one three years ago, when the dye only partly spilled and they told me I had a partial hydrosalpinx on the left.  So, good news, I suppose!  Although also no magical interventions to help this process go faster, presumably.

There was one thing that came up on the HSG that I am interested in asking my doctor about when I see her next week to debrief about this 3-month testing ordeal.  The radiologist pointed out to me some synechiae on the fundus of my uterus.  They were pretty obvious — it looked like a little notch taken out of the top of my uterus with little fingers poking out on either side.  He said, “With a history like yours, I’d be surprised if there wasn’t a little scarring,” and seemed to mostly downplay it.  But scarring and uterine irregularities are some of the main known and treatable causes of RPL, so I’m wondering whether it’s significant enough that the RE might want to do something about it.  I’m also wondering why it didn’t show up on the SHG I had in December.  So, that’s something to bring up at my appointment on Tuesday.

And with that, I’m done with testing.  Hooray!  No obvious major problems, which is good in a way, but which also means no obvious solutions.  I’m sure I’ll update more after my follow-up appointment with the RE this coming Tuesday.  I’m expecting she’ll just tell me to go away and try on our own for six months or something, but who knows?  I am turning 35 this weekend, so maybe she’ll be more likely to want to intervene to step up the pace?

In other news, the semester is in full swing, I’ve got two big gen-ed classes and a seminar this semester with >100 students altogether, we just got back from a lovely weekend visiting dear friends in Boston, and next weekend we’re off to Texas for a conference, with kiddo in tow as we visit friends.  S is experimenting with two-word phrases, continuing his “hide and seek” obsession phase, and just generally getting ready to turn two in a couple of weeks.  I’m finally feeling like I’ve come out of the funk of last fall, when the weight of my dad’s death on top of two miscarriages in a row just put me over the edge.

As I’ve gone through all the heartbreak and waiting of the past 9 months, I often just take a step back and reflect on how fortunate I am to have S with me this time around.  He is the light of my life and the apple of my eye and all the cliches in one tiny little toddler-shaped body.  Whenever I am with him, I soak up the snuggles, knowing he’ll be too big too soon. There is never a moment that I take his existence for granted.  I continuously marvel at what a miracle he is.  And he gives me hope that someday this process just might work again and we might add a whole new layer of love to our beautiful family.  I have a lot to be thankful for, and a lot to hope for.

I win!

Guys, I just won a pretty prestigious award for junior faculty in the physical sciences!  I got a phone call about it this morning, but I can’t tell anyone about it yet because they don’t officially announce the winners until February, so I’m telling you because this blog is anonymous enough that it’s still basically keeping the secret!  I was allowed to tell my department chair, and I also told my husband, who took S and me out for cupcakes at the local bakery after dinner tonight to celebrate.  Yay!

It’s really nice to get major recognition for your research and teaching, of course.  It also makes me a little bit wistful… would I be doing this well professionally if my childbearing had gone as planned and I already had the 2-3 kids we were hoping for by now?  But I also feel fortunate to have this amazing career that I love that can go well even when fertility isn’t going well, in addition to an amazing husband and son who fill my life with love even when the professional side is tough.

I also want to give an anonymous shout-out to the people who manage this award.  Applicants have exactly one year of eligibility, based on when they started their faculty job, and mine fell right at the end of my parental leave with my son.  During my year of eligibility, I tried to get a proposal together, but I was struggling with a non-sleeping little infant who had only just started childcare for a few hours a day.  When he came down with an ear infection and then had an allergic reaction to amoxycillin the week before the deadline, I knew it was basically hopeless to get a decent proposal together.  Fortunately, I have a friend who won the award a couple of years ago, and she clued me in that I could ask for a deferral of my eligibility to the following year because of my parental leave.  I asked for the deferral, they immediately said yes, I applied the next year, and I was selected!  Hooray for family-friendly policies!

So, I’m on a bit of a high right now.  It turns out that I’m the first person to ever win this award from my institution.  It’s making me feel pretty good about the whole tenure thing, which is also nice.  Persistence clearly pays off in science, so it’s got to pay off in fertility too… right?

One Month of Testing Becomes Three…

Well, so much for “One month of testing and you’ll be done!”  I haven’t yet seen the RE for a follow-up appointment, but apparently after reviewing my SHG and endometrial biopsy results, she wants to also do an HSG.  But since she didn’t realize it until a week into my current cycle, I have to wait another cycle to get it done.  I guess technically we can try to get pregnant this cycle, and if it works, great… but I’m not optimistic.  At least the HSG doesn’t prevent us from trying next month, so it’s not as though we really lose time, but I was just hoping to be done with testing and ready to move on to planning.

Here’s the recap on the testing results that are in so far: apparently everything is pretty much normal.  The endometrial biopsy was negative, all my blood tests were normal, the SHG showed nothing weird except for a slight thickening of the lining on the anterior wall, which I already wrote about — and if it were anything serious, the endometrial biopsy should have picked it up.  So no answers, but also no identified problems.

So then, what triggered the HSG, you might ask?  I’m not actually sure, since I didn’t get a chance to talk directly to my RE (I was supposed to have an appointment this coming Tuesday, which she suggested over electronic messaging that I cancel and reschedule for after my HSG).  But here’s the story as I see it:

Before the HSG, the APRN doing the test did a baseline ultrasound.  Everything looked just as expected, but she did point out an odd cyst-like thing near but not on my right ovary.  She said it might be a paratubal cyst, and that it looked like it was in the location of my right fallopian tube, but didn’t seem too concerned.  After the test, I mulled it over and remembered that during the 6w ultrasound where we found out I was miscarrying my last pregnancy, the ultrasound tech had seen the same thing, although she didn’t mention that it might be tubal — she just told me that it was a cyst-like thing that wasn’t on my ovary.  Just to back up a step, these two ultrasounds were actually pretty close together in time — we found out I was miscarrying the first week of November, and then the testing cycle and SHG took place right after I had my first post-miscarriage period in December.  So it’s clearly the same cyst-like thing, which was not there in June when I was going through my second miscarriage, but was there immediately after my third (most recent) miscarriage.

Now, combine this with the fact that I had high hCG levels in my most recent pregnancy — the last measurement at 5w was 2700 with a doubling time of less than two days.  At those levels, you’re supposed to be able to see a gestational sac on ultrasound.  But at my 6w ultrasound, there was no gestational sac… just two small irregular lumps in my uterus that the tech said might be bleeds.  And I know that the right side is the side I ovulated on for the pregnancy, and it’s also the side that this possible tubal cyst is on.  So, after remembering all of this, I wondered… is there any possibility that my most recent pregnancy could have been an undiagnosed ectopic, and the thing on my right tube is not a cyst but rather the missing gestational sac?  Obviously I wasn’t in any danger, since the RE did follow my hCG levels back down to zero, so if it was ectopic it resolved on its own (like 80% of ectopics, apparently).  But it seems like it would be an important thing to know to figure out how to proceed — and I already knew I had elevated risk for an ectopic since my second HSG showed scarring of both tubes.  Since I’d been seeing my local OB for the miscarriage, and then went back to the RE for RPL testing, nobody had all of the information, so it makes sense that the RE wouldn’t have considered it.

Anyway, I wrote a message to the RE’s office containing this question, and asking whether I should have the records from my most recent two pregnancies sent to the office.  The RE replied that an ectopic pregnancy was plausible, though difficult to know for sure, and that I should have the records sent over… and that’s when she suggested an HSG to assess tubal patency.  If you’ve been reading my blog for a while, you already know that my tubes were somewhat damaged during my first pregnancy, which we found out during my second HSG.  But since I then proceeded to get pregnant three times on the right side, it’s pretty clear that at least my right tube was still functional.  However, apparently now this cyst thing (or possible gestational sac?) is weird enough that she wants to make sure it’s not blocking my right-side tube.

I’m not actually sure what to hope for in this case.  Part of me is just sick of endless trying to get pregnant and miscarrying, and as I’m turning 35 I’m sort of thinking… I kind of hope it’s blocked, because then we can just do IVF already, and then they’ll do PGD and make sure they’re implanting chromosomally normal embryos and maybe it’ll finally work.  Of course, I’m not exactly excited about doing IVF, so in that sense I hope my right tube looks no worse than the last time they did and HSG and I can just get pregnant the old-fashioned way again.  I’m also just generally feeling grumpy about doing a THIRD freaking HSG, right after I’ve just done an SHG and an endometrial biopsy.  Enough messing around in my uterus, already!

Anyway, much as I’m not wild about the idea of another HSG, I am a sucker for information, and I do want to know whether my tubes have gotten worse or not.  So, I’ll go along with it, and wait for my next period, and do the HSG, and see what happens.  But that means I probably won’t have the results of the HSG and meet with my RE until, like, late February or even March.  UGH.  I hate the slowness with which this sort of testing and treatment moves.

And in other news, I’m currently away for three days at a conference (in Washington, DC), and I miss my little guy something fierce.  I felt so guilty leaving him, especially since he had a fever the day before I left and was super clingy and only wanted his mommy.  I hope he doesn’t think I abandoned him!  I cannot wait to snuggle that little munchkin tomorrow afternoon.

So, that’s where we are now.  I hope all y’all’s new years are off to a better start!

So Long, 2017!

I’ve rarely been happier to say goodbye to a year, but the flip side is that I’m looking forward to a fresh start in 2018.  Here’s the Cliff’s Notes version of 2017, and what I’m looking forward to in 2018:

The Good

  • My son.  He continues to delight and amaze me every single day of his life.  This week at home with him has been truly lovely.  He’s starting to have the patience for longer books (Dr. Seuss’s ABC, Angus and the Ducks, and Do You Speak Fish? are three current favorites), and his sense of humor is just wicked (this week it’s all about the yes/no questions and giggles: Is this hairbrush your dada?  NO!!!!  Is this pillow your dada?  NO!!!!  Is that doggie your dada?  NO!!!!  Totally cracks him up every time).  We have a Solar System rug in his playroom, and he loves running from the Sun to Jupiter to Neptune upon request, and playing Solar System Twister by trying to stand on as many planets as possible at the same time.  He likes to play hide and seek, mostly by hiding in plain sight and dissolving into giggles as we pretend to search for him (Is S under the table?  Is he in the bathroom?)  I could go on and on, but I’ll stop. 🙂
  • Work stuff.  My first postdoc got a job offer!  This was a huge deal, since I have been worried that he would not get an academic job and would be forced out of academia after which I would have been convinced that I ruined his career by bringing him to my rinkydink little college for a non-traditional postdoc opportunity.  Instead, he was offered a potentially permanent job that he would most certainly not have been qualified for before working in my group for four years.  I am so happy for him.  And I shouldn’t jinx it, but my year of supervising three thesis students isn’t going as badly as I feared, and I think they’ll all have high-quality theses come May.  There’s also a light at the end of the tunnel for a really big invited review paper that I’ve been working on for about a year now — it should be done by the end of next week.  It’s a ton of work, but will have high impact, and I’m pretty proud of it.  And as I wrote a few days ago, I totally rocked my 5th-year pre-tenure review and am optimistic about the tenure process that will start next fall.
  • My support network.  Having difficult years really makes you notice all the wonderful people in your life who are around to help you through the crumminess.  First prize goes to my amazing husband, of course, but I’ve also got prizes to hand out to other relatives and friends as well — the list is long enough that it makes me feel good about where I am in life right now.  Having a kid hasn’t totally squelched my important relationships as I feared it might.  I’ve been leaning on them a little more than usual of late, though, so I’ll have to make sure I’m giving back in the new year.

The Bad

  • Two miscarriages.  Recurrent Pregnancy Loss diagnosis.  Ongoing testing with no answers yet.  Coming up on a year of TTC living baby #2.  Oh, and the due date for my first post-S pregnancy is coming up this week.  Blargh.
  • My father died.  I had a complicated relationship with him, which has made it tough to sort through my feelings about his death, but the short version is: it sucks.  I think my grieving process has been largely focused on morbid thoughts about the mortality of my son and husband (also myself), which is not fun.
  • My mother had major surgery two weeks ago (a hip replacement).  Recall that I am ruminating on mortality, so it freaked me out emotionally right from the start.  My mom also lives a two-hour drive away, which is better than a plane flight away, but since she lives by herself she really needed help.  I made three round-trip drives in a week (one overnight stay the day she came back from the hospital, plus two day trips).  Thankfully, she’s on the mend now and I can relax a bit.  But I’ve really been feeling the whole “sandwich generation” thing this year.
  • Work-wise, this fall was a survival semester, in the sense that I phoned it in on a lot of teaching stuff and was kind of a crappy collaborator on a couple of projects.  Mostly I managed not to be too crappy at any one thing, which I feel like I can be at least a little bit proud of when you consider how my semester went.  Another part of my grieving process seems to be occasional irritability, which is out of character for me, and there are a couple of emails I wish I hadn’t hit “send” on — although I have to say that the people on the receiving end did basically deserve them, even if I am usually more diplomatic.  Oh, well…. I don’t think I burned any bridges too badly.  And I did an OK job of circling my wagons and prioritizing critical stuff like my research group and paper drafts, so hopefully I managed to mostly insulate my professional list from my personal problems.

The New Year

  • Getting back on the TTC wagon.  In a way, it feels good to have a fresh start after this most recent miscarriage, and to know that I’m back with the RE who will keep a really close eye on everything and do whatever she can to help us conceive the living child that we’re dreaming of.  I had visions of being a normal pregnant lady at my local OB’s office, but the silver lining of being abnormal is that I get more support and reassurance and can work on developing a plan.  I’m optimistic about our chances of success, since S is proof positive that my body is capable of carrying a baby to term.  I wish I could see the future and know how long it will take and what we’ll have to go through to get there, but I’ve been through enough at this point that I’m also feeling relatively calm and confident that I can just go with the flow for a while.  I am definitely in a much better place than I was three years ago after the loss of our daughter.  It seems like I shouldn’t be, since I’ve had three times as many losses by now, but for one thing I have S, and for another thing I’ve developed a certain amount of resilience.  I have hope for 2018.
  • The push to tenure.  There’s a certain narrowing of focus that happens when you’re less than a year from putting in your tenure packet. I’m in a good place right now: I already have a really solid portfolio of work, and I have a bunch of things in the pipeline, and I know what I need to do before next fall.  I’ve already done most of what I need to do, and the rest is in process.  Some of it is dependent on other people (like my students), but not too much.  I’ll be working hard this year, and I’ll have to prioritize like crazy, but the tenure process is another thing that I’m optimistic about for 2018.  I am so looking forward to submitting my tenure packet next fall and knowing there’s nothing more that I can do.  I think I’ll feel good about the body of work that I’ve accomplished on the tenure track.
  • The adventure of parenting.  I know people say the twos are terrible, and plenty of people will tell you that threenagers are worse, but you know what?  I’ve loved every age and stage of S’s life so far, and while there are certainly challenging moments/days, the thrill of seeing this little person growing up into himself more than outweighs the difficulties.  I am more crazy in love with this kid than I ever knew I could be, and I am looking forward to seeing what new skills and interests and ideas he develops in the new year.  I’m looking forward to getting more insight into his odd little mind as his communication skills improve.  And I’m looking forward to more snuggles and giggles as the toddler years wear on — I know that all too soon he’ll be too grown up for mama snuggles, so I’m soaking up every moment of it while it lasts.  I also love watching my husband surprise me with his parenting ninja skills, and I fall in love with him again every day as I see him growing into an amazing father.  He is so creative and funny with S that it just melts my heart.  Our family is so beautiful right now, and I hope that it will always stay that way — or perhaps even grow in love with a new member on the horizon.

And that’s the year!  Happy 2018 to everyone.  My hope for you all is for a brighter year full of love, laughter, new memories with your loved ones, and wishes coming true.

Brief Tenure Update

As I wait for the endometrial biopsy Friday and the follow-up visit with the RE, I thought I’d give a (sorta) brief follow-up update on my tenure saga.

After all my angst, my 5th-year pre-tenure review happened promptly and smoothly.  At my university it involves an official letter summarizing the department’s evaluation and a one-on-one conversation with my department chair.  Both were glowingly positive.  The conversation with the chair may have made me blush a little bit.  It was basically my chair talking for maybe ten minutes about how great I am at my job.  Then, when he asked if I had questions, I was like, “Um, thank you, this is all wonderful.  But if I had to concentrate on one thing this year to make my tenure case stronger, what would it be?” and he said, “Really, there’s nothing.  Just don’t let your teaching evaluations slide, because the university-level committee gets hung up on trajectories, and yours started out so high that it’s hard to show an upward trajectory.”

So, yay!  But also, ack!  My department has never yet officially told me anything I can do to improve, and it constantly freaks me out — because everyone can improve in some way, of course, and having no direction is disconcerting.  And also because I watched a close friend go through a horrific tenure debacle last year in a closely related physical science department, during which she worked really hard on fixing the things they told her to fix (mostly related to teaching) and then after a whole long saga her department ultimately denied her tenure on the basis of something they hadn’t told her to fix (purely research).  There were many major WTF moments during her case, and it really soured me on my institution (particularly the offending department), and has made me far less trusting of the tenure process and some of the people at my institution.  I’m pretty sure that my department is a heck of a lot more functional than my friend’s former department, and that my case is a heck of a lot less borderline than hers was, but still, I worry (she and her husband are now happily employed at a small college back in the Midwest, closer to their families, so her story thankfully has a happy ending).

And, what about all my angst about thinking that my chair was going to recommend that I use my extra year before going up for tenure?  It didn’t amount to anything, or at least nothing that I could decode.  We talked about the timeline a little, and he said that the main thing was to make sure that everyone is on the same page about my timeline, but that he wanted to make sure I understood that I only get one chance to go up for tenure, which I assured him was very clear to me (for the non-academics: the tenure decision is up-or-out, in the sense that if you are awarded tenure then you are more or less guaranteed a job for life at your university, but if you are denied tenure then you are fired and you have one year to find a job before you are unemployed).  My impression was that he was basically covering his / the department’s butt, to make sure that I couldn’t come back later if my tenure case was denied and say that I didn’t understand that going up early meant I couldn’t also go up on time.  Which I get.  Everything else about the review pointed to the conclusion that my department thinks I’m doing great and doesn’t foresee an issue with letting me go up “early,” but they can’t officially say that because it would look like a promise that I will get tenure next year, which they can’t officially make.

One bizarre thing about this whole interaction is that we have a new chair this year, who also happens to be the second-youngest member of the department (after me) and also the person with whom I am most friendly.  So it’s been awfully weird interacting in this very official way with a friend, and we have both had to carefully monitor our verbal filters in a way that we do not normally do.  He’s usually the first person I go to for advice on sticky situations or to kvetch about some problem in the department, and I am usually really appreciative of his honest and thoughtful advice and perspective.  But as chair, there are things that he’s not allowed to say, and also things that he is obligated to say that he wouldn’t normally say.  And there are things that I would normally want to ask him that I am no longer allowed to ask him (for example, I am no longer allowed to discuss with him which scientists at other universities to solicit for external reviews of the research portion of my tenure case, which stinks because he is the person who works closest to my field and also the person in my department who has been through the tenure process most recently and I would really love his advice).  It even came up towards the end of the review when he gave me some official-sounding line about how we don’t have an official junior faculty mentoring arrangement in the department but that I should feel free to go to any of the faculty for advice (I think this is an awful way to “mentor” junior faculty, by the way, but that’s a subject for another post), and I said that I always appreciated his advice and then there was this moment where we both acknowledged that it stinks that he is now chair and can’t give me unfiltered advice when I really need it.  Ah, well… this is one of the down-sides to being in a tiny department.  The flip side, of course, is that my department chair is a friend who I am confident has my best interests at heart and genuinely wants to keep me as a long-term colleague.  He’s inexperienced, but capable and ethical.  It could definitely be worse.

And that’s the update!  I now have written evidence that my department thinks I am doing a great job, and verbal assurance that there are no obvious weak spots in my tenure portfolio that I should try to fix in the next year.  I definitely have an agenda of things I would like to get done before I submit my portfolio, which I briefly outlined with my chair.  I think it’s achievable and will represent a body of work that I feel proud of.  I’m feeling good about going up on my desired timeline.  And, honestly, I’m feeling much more positive about my job than I have for a while.  It’s amazing what a little bit of acknowledgement and appreciation can do for your motivation.  I’ve felt more creative and committed to my department.  During our meeting, my chair included a little pep talk about how the department loves the work I’ve been doing and how it seems like my interests and skills are really well aligned with the department mission so I should just keep doing what I want to do and try not to worry too much about external pressures (like tenure criteria, I guess).  And I do feel like I’ve grown into the position — I’ve gotten my sea legs with teaching, and I’ve reached some sort of equilibrium with finding a research advising style that is effective without being too draining.  I can almost feel the breath of fresh air that I felt when I got my first faculty job offer — suddenly, I felt freedom to define my own research program rather than worrying about working on projects that would get me letters from specific superstars in my field.  Tenure is also supposed to grant that sort of freedom, and I can almost feel the burst of creativity and self-direction that is supposed to come with tenure.  I have ideas for ways to experiment with teaching that I’ve been afraid to try because they’d introduce unpredictability into my student evaluations.  I have ideas for research directions that are a little wackier than I was comfortable with when I needed to show that I could get proposals funded consistently.  Now, if I can just keep my teaching evaluations from sliding this year, maybe I’ll be able to take advantage of that freedom and space for trying new things!

Testing Cycle and Tenure Ruminations

OK, quick update for the people who care about pregnancy/RPL, and then longer rumination for people who care about tenure.

I’m now about halfway through the testing cycle that my RE had recommended.  I had my second SHG last week, and have gotten the results of most but not all of the blood work she ordered.  The short news is: everything looks pretty much normal.  Of course, I have mixed feelings about this.  On the one hand: yay, no obvious problems!  On the other hand: if I have no obvious problems, then there are no obvious solutions to help me stop having miscarriages.  The SHG did show that the lining on the posterior wall of my uterus was noticeably thicker than the anterior wall, and they said that it was slightly unusual but might not be clinically significant.  So my RE recommended an endometrial biopsy, apparently forgetting that she had already recommended an endometrial biopsy, which I already had scheduled for December 29.  So, endometrial biopsy it is!  Now I’m just waiting for that test date to roll around, and after that, we can presumably start trying again.  My follow-up appointment with the RE isn’t until later in my next cycle, so perhaps technically we should hold off for another cycle in case there’s more testing or treatment she recommends, but we probably won’t.  Since there’s been no significant abnormality so far, there seems no reason to wait.  Plus, it probably won’t matter anyway, since I ovulated on my “good” right side this month (two follicles, apparently!  Blargh, I was bummed to miss the opportunity…) and next month I’ll probably be ovulating on my “bad” left side, which means all attempts at conception are likely to be futile.  Oh, well… but one cycle of missed opportunity still seems worth it, just in case they can find a treatable cause of our recurrent miscarriages.

Now, on to the tenure rumination.  If you don’t care about tenure, feel free to skip the rest of this post.

First, some context: Friday was the deadline for my department to submit its letter for my 5th-year review to the administration.  At our university, the 5th-year review is the last check-in before the big tenure review one year later.  It’s a department-level review, but the administration wants to see the letter before they give it to me, basically to cover their a$$ses legally and make sure there’s nothing controversial in there that could come back to bite them if I get denied tenure in the future.  My chair tells me that usually this administrative rubber stamp doesn’t take too long, and he hopes that we will be able to have our one-on-one meeting about the review before the end of the calendar year (though obviously at this point the timing is out of his hands).  Which of course means that I’m freaking out a little, so keep that in mind for the rest of this discussion.

The other context has to do with parental leave and the tenure clock extension policy at my university.  Since these policies vary from place to place, it’s worth a bit of explanation about how it works here: these days, the parental leave policy is that you get a full semester of leave at full pay if you are the “primary parent” (usually birth mother) of a child.  (If you’re not the primary parent, the leave policy is less generous.)  Then our clock extension policy is that all parents have the option of taking zero, one, or two semesters of tenure clock extension for each child born/adopted while on the tenure track.  I agonized over whether to take the clock extension and how much clock extension to take, but in the end my (previous) chair made the point that at least in theory there’s no down side to taking the full two-semester clock extension, since there’s no penalty for going up early for tenure at my university, which means that even if I take the full year of clock extension, I can still go up for tenure at the normal time if I am ready.  So, that’s what I did, and I have been discussing with my department all along that my plan is to go up “on time” according to my original clock (which would be one year “early” with the extension that I got because of the birth of my son).  So according to my current plan, I would submit my tenure materials next fall, around October or November.  This review is therefore an important final check-in about my progress towards tenure — if there are any red flags, I can delay the submission date of my tenure materials by up to a year, but I’m hoping to just get it over with and submit on time.

Yesterday when I checked in with my chair about the progress of my 5th-year review, he said a few things that made me think that he was going to encourage me to take the extra year, which freaked me out a bit, and I’ve been ruminating on it ever since.  The caveat here, of course, is that he didn’t actually say “I think you should take the extra year,” and I’m probably reading way too deeply into offhand remarks, but I actually think it’s probably not a bad thing for me to do some thinking through the issues so that I will be prepared for our official 5th-year review conversation.

If he asks me, “Why do you want to go up early for tenure?” … what will I say?

I think my answer breaks down into two major professional and personal answers, and two minor but still valid supporting answers.

Professionally: First of all, I want to remind my chair that I’m not going up early.  I’m going up ON TIME according to my original clock.  Basically, I don’t want to spend an extra year on the tenure clock unnecessarily even though I am grateful to my university for giving me the option.  Because I think I’ve earned it, darn it.  And because I don’t think there’s any substantial deficit in my tenure packet that an extra year would fix.  My reviews so far have been glowing.  Advisors inside my department, outside my department at the same university, and outside my department at other universities have told me that my department would be nuts not to give me tenure, and a few of the people outside my department at my university have told me I should *actually* go up early… like submit my materials now.  And when I look at the evidence, I think they’re right.  My university requires “excellence” in three categories: teaching, research, and colleagueship (this last category is also known as “service,” and even though we are technically supposed to be excellent, nobody ever gets denied tenure because of colleagueship, and my colleagueship is just fine).  As a liberal arts college, the emphasis is a bit more on teaching, and the research expectation is a smidge lower than at a research university.  My teaching evaluations are consistently the highest in my department, and comfortably above average for the university and my division within the university.  I’ve taught every level of course that we offer, multiple times.  I will have supervised six theses, an average of one per year, by the time I go up for tenure, which is consistent with my department’s number of majors per faculty member (and I’ve never turned a student away from my research group who wanted to work with me).  My thesis students have gone on to be very successful, both in and out of academia, even when it wasn’t a priori obvious that they would be (and my first postdoc just got an offer for a permanent job this week, woohoo!).  As for research, here I also think I’ve clearly exceeded my department’s expectations.  My department expects that we should publish 1-2 papers per year.  In my five years on the tenure track, I have been an author on 33 papers, with 8 originating directly from my research group (where I or one of my students or postdocs is the first author).  There will be at least three more from my group in the next year (one already in revisions, one to be submitted this week, one drafted and to be submitted next semester; in my field it’s rare for a submitted paper to not be published within six months, as in, it has never happened to me).  Anyone in academia knows that h-indices are fraught with all kinds of issues, but as a blunt instrument they’re commonly used to indicate research impact.  My h-index is essentially identical (+/-1) to the next two most senior members of my department.  Let me be clear: it’s not identical to what theirs were when they went up for tenure.  It’s identical to their current h-indices, even though one is 8 years ahead of me post-PhD and the other is a full professor who is a couple of decades ahead of me post-PhD.  For them to deny me tenure on the basis of research quality or quantity would be absurd.  External letters matter too, but I am well known in my field and have received several high-priority invitations in the past year that will get me significant visibility in my final pre-tenure year — and I’ve been networking and inviting senior people in my field to my university for talks to make sure I have enough exposure.  There’s no official guideline about external funding (just that we should seek it as needed), but I’ve brought in almost $1 million in grants during my time on the tenure track, which is a typical milestone for tenure at a research university (which ours is not).  Professionally, when I look at my case objectively, I just don’t think there’s a reason to wait.

Personally: I think I probably shouldn’t bring this up with my chair, but there’s one huge personal reason that I want to go up for tenure this year: I do not want to be worrying about tenure when (assuming we’re lucky enough to get there) our second child is born.  I really hate that I put pressure on myself to be productive during my first parental leave, and to come back to work and start traveling again before I would have if I hadn’t been worrying about tenure.  I don’t blame my university, but it is an unassailable fact of my personality that if I have tenure hanging over my head, I will be worrying about my productivity while I am on leave.  I know that no matter when our second child is born, I will need to worry about some professional things: I will still have a responsibility to my research students and collaborators to help move projects along.  But I want to remove the tenure pressure from the equation.  I’ve worked so hard to earn tenure, and so hard to have kids, that I think I’ve earned a parental leave that is on my terms.  I also have the feeling that if I take this one tenure clock extension, and have a second kid during the clock extension, that I’ll have no choice but to take the additional clock extension, and that means I’ll spend nine years in pre-tenure purgatory, which just sounds miserable.  We’ve been trying to have a second kid for almost a year now, and if it had worked out, I most definitely would have used this clock extension — but in my mind, the silver lining of two miscarriages in a row is that now my second baby definitely won’t be born before next fall so I can get tenure out of the way before baby #2 comes along.  While I think a year is a reasonable long-term approximation of the impact of a child on one’s career, the impact is extremely front-loaded, and in the short term, a year is not enough.  I can’t shake the feeling that the more clock extensions I take while my kid(s) is (are) young, the farther behind I’ll fall as tenure approaches, though I am quite confident that in the long term I will be an asset to my department (and in the short term as well, as I discussed above).

In addition, the two minor issues that I mentioned are:

(1) The feminist in me wants to get tenure on time because I see how parental leave and clock extensions put women behind men and I think it sucks.  The last successful tenure case for a woman in the sciences at my university took nine years (two parental leaves) and a bunch of controversy before it went through.  Meanwhile, the guy in her department with three kids and a stay-at-home spouse sailed through early — and in fact, her department encouraged the woman to delay her tenure case so that she wouldn’t go up for tenure the same year as the man.  So now she’s less senior than him (and paid less!) even though he started after her, and even though they both had kids on the tenure track.  I think it sucks.  I don’t want to delay my seniority, and I want to show other women in my university that they don’t have to be scared to go up when they’re ready.  I think the clock extensions are a good option to have, but I don’t think anyone should be putting pressure on pre-tenure women to use them for any reason other than their intended purpose.  Not to avoid going up in the same semester as the hotshot young guy, and not (in my case) for no clear reason other than that it’s expected.  One question I would like to ask my chair (but probably won’t) is: if you pretend that I don’t have a baby, but that my record is otherwise identical, would you still be sitting here now at the end of my 5th-year review telling me that if I only had an extra year on my tenure clock it might make or break my ability to meet tenure expectations?  I am really quite confident that the answer is no.

(2) Money.  With tenure comes an 11% pay raise.  One of the main reasons that women’s salaries lag behind men’s salaries is that they advance more slowly in the childbearing years.  I don’t have any interest in being part of that statistic, thank you very much.  I did a sketchy calculation yesterday about the difference in lifetime earnings between getting that boost one or two years from now.  It’s definitely in the tens of thousands and approaches the hundreds of thousands of dollars (depending on what you assume you do with the extra money).  My husband and I are not strapped for cash, thankfully, but I want fair compensation for the work that I do, including timely raises when I have earned them (like now, I think).

Of all of these reasons, I think I’ll have to focus on the professional reasons when I talk to my chair.  But I think the other reasons are important, and I wish I could talk about them.  Particularly the personal one about wanting my next baby to be post-tenure.  I get a little weepy when I think about how I might have spent more time with little baby S if I hadn’t been pushing myself to get back to work and not fall off the tenure track.  I still get weepy every time I think about being away from him while he’s so little.  After all I’ve been through for S and the future sibling we are hoping for, I want to take the professional pressure off a little and just be there for them while they are small.  Possibly this is exactly the kind of thing my university dreads when it considers the institution of tenure — that it provides a license to take a step back from professional responsibilities.  But I’m not that kind of faculty member.  Believe me — I don’t have a dead wood bone in my body.  I have every confidence that over the course of my career I will be an enormous asset to my department.  I’m just a human who wants to shift priorities a bit for a few years and not jeapordize my entire career as a result, which is the nature of the up-or-out tenure system.