Tuesday, September 16, 2014

– 16 and Pregnant

So, most people know the MTV show “16 and Pregnant”, where girls end up pregnant, usually because their boyfriends didn’t want to wear a condom (?!?!) and/or they were afraid that birth control would make them fat (yeah, how’d that work out for you?). Well, obviously, that does not reflect my situation because A) There was no chance of my accidentally getting pregnant and B) The age of 16 is so far in my rear-view mirror that it’s barely a blip anymore. But if you look closely at the title of this post, you’ll see that it doesn’t say “16 and Pregnant,” but, rather, “–16 and Pregnant.” And that, of course, has to with my choice of egg donation.

Rewinding a bit, I’m reminded of a conversation that I had with Dr. K during my last visit before he discharged me to Dr. W. He told me that, of all his patients, I was probably the one who went to egg donation the quickest. In fact, over the almost a year that I was his patient, he remarked more than once that I was moving through the process more quickly than most.

Of course, there are a variety of reasons for why it takes some people longer, and for why I made certain decisions in a rather expeditious manner. The first is a very basic reason, and that’s money. Fertility treatment is not cheap, and few insurance companies provide coverage for it. As a result, many women and couples must space out their procedures until they have the money to pay for it. As I have detailed in the past, my treatments have come out well into the low six figures (especially when factoring in the +/- 30% tax penalty I paid on the money I withdrew from the beneficiary IRA). But, Mom and Dad left me in a position to be able to pay for these treatments, so I was not forced to put anything off. Yes, I went through an obscene amount of money in a year, but it will end up being the same amount as if I had spread it out over a longer period, so there didn’t seem any point in waiting.

That, naturally, leads me to another factor – time. I’m 40 now. I started this process just shy of my 39th birthday. From a reproductive standpoint, I was already way too old to take my time in getting pregnant. Unlike a woman, or couple, who started treatments in their early thirties (or younger), I could not afford, biologically, to take several years to get pregnant. The risks just keep going up with age, and the odds become less favorable. So, it was sort of a “now or never” kind of situation.

You can start to get a picture of the progression here. I had the money and I didn’t have the time. I also tend to have an imminently practical streak, and I don’t believe in repeatedly doing something that hasn’t worked, hoping for a different outcome. So, after two failed IUIs, we did the testing to see what might be at issue, and found the blocked tube. That, along with a lower egg reserve, suggested IUI was not a practical approach. So I chose to move on to IVF. Obviously that was more expensive and invasive but, again, there didn’t seem much sense in trying another IUI and just hoping we got an egg out of the side that wasn’t blocked (waste of money and sperm in my mind!).

After the first failed IVF, when it was clear that I couldn’t produce a lot of eggs, I brought up the concept of egg donation to Dr. K. He seemed relieved because he had wanted to bring it up with me, but it can be a sensitive issue (more on that shortly). I knew that I still wanted to try IVF once or twice more with my own eggs, but figured I should lay the groundwork for the donation process.

So I tried IVF two more times. The second time resulted in the chemical pregnancy that has previously been detailed, and the third time resulted in once again not getting a viable embryo. At that point, it did not seem to make sense to continue down that path. My eggs were not cutting it, so it was time for a new approach.

This is where the final hurdle to egg donation can arise for many women and couples. Using a donor means that the mother will not have a genetic connection to their child. For many people, that is a difficult reality to come to terms with (as is using a sperm donor if the father’s sperm cannot be used). For some, it is a hurdle that they can never overcome, and that is perfectly understandable.

For me, it wasn’t really a huge deal. The genetic connection was never as important to me as simply being a mother. I won’t say it didn’t matter at all – there was a part of me that wanted to carry on a part of Mom and Dad. But (and again, I’ve written about this before), I never had any concerns about my ability to love a child or feel connected to a child that did not share my genetic make-up. I have previously discussed my attachment to my dogs, and we know that they have no genetic connection to me! So, when it came to the emotional aspect of “letting go” of the dream of my own genetic children, that was not such a huge step. My real dream has always been to be a Mom, however that might come about (adoption was always an option for me as well).

So, in the end, it became more of a question of what was the most practical and expeditious way to make my real dream of motherhood come true. Like I said, I didn’t have the time, or the inclination, to keep throwing money away on things that weren’t working. So the answer to the question of how I could become a mom became clear: egg donation. That, naturally, is where the title of this entry comes in. Through egg donation, Dr. K and I found ourselves working with 23-year-old eggs, rather than 39-year-old eggs, and that was the last ingredient we needed for success – eggs that were 16 years younger than me.

That was the trick. Younger eggs gave me an exponentially higher chance of getting pregnant (and it did work on the first try). As Dr. K put it, it put me in another stratosphere (from a less than 20% chance to a 60-70% chance). Even though we only got 2 embryos, they were far healthier than the ones we got from my own eggs (you can see it if you go back and look at the embryo pictures). And, the more I thought about it, the more I found comfort in the idea that this would give me a much higher chance of healthy babies too. My early screens showed a 1 in 7000 chance of Down Syndrome, while using my own eggs would have resulted in something more like 1 in 200. The risk of Trisonomy is far lower too. Overall, with 23-year-old eggs and 20 year-old sperm, my risks are the same as if I were 23 and had a 20 year-old partner.

So, for all practical purposes, this was definitely the right decision for me. It was a journey that seemed long, even though it was less than a year – but it fit a potential several years of emotional ups and downs into that time. And I am kind of grateful that I am able to put at least some of the risk factors largely out of my mind. And then there’s the comment from the in-house psychologist at RMA, who told me that a lot of her clients come back to her and tell her how freeing it is to know that any little issues their kids have (allergies, bad hair, etc) aren’t their fault! That’s a whole load of Mommy Guilt off the shoulders. So, yep, all in all, a good decision!

Tuesday, September 9, 2014

Not the Weekend I Had Planned...

La, la, la… This is me, blithely making my way through pregnancy, marveling at my lack of symptoms (never puked once!) and commenting to all and sundry how uneventful things have been. My only worry (which has been well-documented) was that all this ease was misleading, and that something was wrong. Now, I’m not going say that something is wrong, exactly, but something went very wrong on Friday.

My biggest concern during the day on Friday was having to drive back into the City from the Bronx to get the dogs in order to then drive up to Friends Lake. It was such an inconvenience, putting me more than two hours behind in the drive, but the dogs could not stay in a hot car while I was in class. So, when I finally left the City, in all its Friday afternoon traffic, at 4:30, I kept griping that I’d already be in Albany by then if I could have left straight from school. I could not have known that I would never see Albany that night, but I would spend some time in picturesque Rhinebeck,NY.

Rhinebeck is a lovely little town in the mid-Hudson Valley, filled with galleries, shops and restaurants. Or so I’m told. The downtown certainly looked nice, with all the people gathered at the sidewalk cafes, enjoying the late summer evening, as I drove through it at 8:30 at night, looking for Northern Dutchess County Hospital.

But, I’m getting ahead of myself. After picking up the dogs, it was a struggle to get out of the City in all the traffic. About two hours after leaving the City, I stopped at my traditional gas station stop in Hopewell Junction, about 65 miles North of the City.  A quick fuel up and bathroom break, and I’d be ready to go. It was the bathroom break that began the real odyssey. I noticed a small amount of bleeding, which concerned me a bit, and I considered turning back for home, but I didn’t want to overreact. I put in a liner and figured I’d monitor it and see how things went. Back in the car, and off we went.

About 20 minutes or so later, I started feeling cramping, and I knew that was not a good sign. But I kept driving. After all, what was I supposed to do in the middle of the Taconic? Then Brooke started whining in the back seat.  At first I tried to hush her, but she kept it up. I knew she hadn’t really gone to the bathroom before we left, so I reluctantly pulled off in Pine Plains (Now about 90 miles or so out of the City). Before I could find a spot to pull over (and by now both annoyed and growing more concerned about the cramping), Brooke puked all over the backseat. I finally found an area near a park, got her out, cleaned it as best I could, and took both dogs for quick walks. But by now, I could literally feel blood flowing out (sorry for the graphic detail), and knew I was in trouble.

My next choice was to try to find a place to buy sanitary napkins on a Friday evening in roughly the middle of nowhere. The GPS directed me to a Stewart’s, and that’s when I realized how bad things were. Not to be too graphic again, but some garments did not survive the night. Once I took care of that, I called my doctor’s office. The on call doctor, Dr. E., called me back and when I described what was happening, she asked, “Why didn’t you just come to the ER?” I said that I didn’t know what to do, and oh, yeah, I’m about 100 miles away! She told me to get to the nearest hospital, and when I said that the GPS said that was Northern Dutchess, she said, “Yeah, that’s a good one. Go there.”

So, now’s a good time to ask what people think is the biggest concern on my mind at this point (you know, beyond worrying about miscarriage). Yeah, big surprise, I was worried about the dogs. What was I supposed to do with them if I had to stay in the hospital? How long would I even be in the ER? They couldn’t stay in the car indefinitely. I had been in touch with Keith, who was prepping to leave for his Divisional tournament on the St. Lawrence River at 5AM the next day. He said to keep him posted, and I knew he would come if I needed him to, but everything was so up in the air.

Now is a good time to point out a fairly obvious thing – Northern Dutchess Hospital is nothing like a City hospital. And, yes, that’s a good thing. I pulled into the lot, got the dogs settled with water and open windows in a secluded spot in the back, and went into the completely empty ER waiting room. In less than five minutes, the triage nurse had processed me through and led me to an exam room (she also promised to let security know my dogs were outside just in case). I was in luck in one respect – the only good timing I had was that I had come in when the ultrasound tech was on-site (another patient had needed an ultrasound). Otherwise, they would have had to call her in from home – definitely a difference from, say, NY Presbyterian or Montefiore.

Also unlike the City hospitals, within three hours, I had been examined, had blood and urine taken (and the results obtained), had a thorough ultrasound, the ER doctor had consulted with Dr. E., and I was discharged. They discharged me because they could not find any cause for the bleeding. The babies both looked fine on the ultrasound, blood and urine came back normal and the cervix was closed. So, they had no idea why I was bleeding (by that time the bleeding had slowed somewhat, but I was still cramping). So, it was bed rest for the weekend and follow up Monday with my doctor’s office – and no, I could not go to Friends Lake.

Here are the ultrasound pics of the little troublemakers:

Twin A "Bedazzler" - likes the photo shoots

Twin B "Sparkle" - likes to moon the camera

So, once I was discharged, out I went to the parking lot. Cali and Brooke were sound asleep in the car. I woke them, walked them, grabbed some snacks from the cooler, and started the two-hour drive back to the City, getting in at almost 1:30AM. The poor dogs spent 9 hours in the car and ended up right back where they started! And I spent the rest of the weekend obsessing – I mean, resting.

The verdict? So far, all I’m getting is “Sometimes this happens.” I have to go for an ultrasound tomorrow to double-check that everything is OK with the babies, but nothing else for now. But, the nurse basically told me that, if anything else happens, I have to stop working and it’s automatic bed rest. And that, of course, raises any number of life complications, even as it might solve the pregnancy complications. Because, of course, I have dogs to walk and a move to make in a couple of months. Groceries to do. An apartment to clean. And despite what the baby books seem to believe, I have no husband, partner, mom, grandma or sister who can swoop in and do all that for me.

I did have that once. I had two parents who would (and did) drop everything to be there for me. Right now, Mom would be here, looking after me. In fact, when everything kicked off on Friday, all I would have needed to do was call them and before the words, “I’m at the ER” had left my mouth, they’d have been in the car, motor revving, pulling out of the driveway. Aside from the obvious concerns about the health of the babies (and the dogs!), that was the most difficult part of this whole experience, and the only part that ended up making me cry. For most of my life I was blessed with the kind of unconditional love and support that everyone dreams of having. And I won’t say that I took it for granted, because I always knew how lucky I was. What I took for granted was the assumption that it (they) would always be there.

I know some people never have that, and I should be grateful for having it for as long as I did. But it’s hard to have people like that in your life and then not to have them. And I know that Keith would have come if I’d asked him to – like I said, he was on call in case I needed him to come get the dogs. But he has his own issues and obligations, and I wasn’t going to ask him to drive an hour and a half just to hold my hand.

I don’t need someone to hold my hand. I really don’t. But, on occasion, it would be nice to have someone to do that. Or to put their arms around me and say, “It’ll be all right.” I’m very comfortable with who I am, and with being on my own. But that doesn’t mean that I don’t sometimes wish for that someone who would hop in the car and speed out of the driveway before the words, “I’m at the ER” have left my mouth.