As Nature Intended?

When God told Adam and Eve to go forth and procreate, I’m pretty sure He didn’t mean for them to don white lab coats over their fig leaves, and huddle down in a lab to play with petri dishes and test tubes in order to create Cain and Abel. Conservative activists have probably use arguments such as this to express their belief that assisted reproduction is against God’s plan.

As someone who is not particularly religious, but does believe in God, I had not thought very much about that perspective. Truth is, I’ve always believed that God is love, and He wants people to live good lives and share their love, with whomever they see fit.  And if people need help having a child to share their love with, why shouldn’t they get it? But I had a bit of strange moment two days ago when I attended my first IVF class. As I was watching the video of the IVF process at RMA’s lab, the truly clinical nature of the process struck me more forcibly than ever before. All I could think was, is this how it was meant to be?

For a few minutes, I sat there, wondering about this. Was it OK to be trying to get pregnant this way? To entrust my fertility to my fellow man (or woman), instead of going about it the natural way? Of course, in my case, it’s never going to happen the natural way, so….

It was an odd few minutes, because I never thought that the moral implications of this process were an issue for me. The feeling didn’t last, though. All I needed to do was look around the room at the four couples in the room, waiting, and hoping for a child to love. And that brought me all the way back to what I’ve always believed. God is love, and He would not have given mankind the inspiration to create these processes to assist life if He did not want doctors to use the technology to help these couples have children to love. And, yes, that applies to me too. This is the only way for me to give birth to a child. I cannot believe that this is against what God, or nature, intended.

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One last note about Tuesday’s class from an emotional perspective (I’ll have an entry this weekend about the upcoming process. Preview – no abdominal surgery!). Going into this process, I knew it would be difficult, and lonely at times. I’ve talked about that in this blog. But, there are times when it really hits home, and Tuesday’s class was one of those times. As I sat in the two-hour class, and looked around, I saw the four couples, several female staffers, and one other female student who was on her own. It became evident, however, that she had a partner who just could not be there that day. So, I was the only single woman there, trying to have a baby on my own. I know that I’m not the only one that RMA works with, by any means. But, in that class, as I looked at the couples at the desks, and saw the husbands holding their wives’ hands reassuringly, I felt an overwhelming sense of loneliness. In that moment, I wanted more than anything for someone to be there to hold my hand.

The feeling did pass, of course, and was replaced with another new sensation. As I sat at the back table (of course!), contemplating these feelings of loneliness, a sudden thought entered my head – These people are taking this step together, and that’s wonderful; but I’m doing it alone, and that’s courageous. I never really thought about that before, but it suddenly seemed so obvious. There are so many women who want to have children, but are too afraid to do it on their own. I am the last person who would ever judge another woman for her choices – there are so many things behind every choice. And this choice is definitely not for everyone. But it never really occurred to me until Tuesday just how much courage this choice takes. It made me reflect on the last few years as well, and realize how much courage it has taken to reinvent myself after losing Mom and Dad. And I’m going to allow myself to be proud of having the courage to find a way to have a child to share my love with, and know that I will have the courage to face whatever comes to me.

“The Best Laid Schemes o’ Mice an’ [Moms]/Gang Aft Agley”

Everyone has a plan. Everyone thinks they can decide how things will turn out, and then it will happen. We’ve heard it before, “If you fail to plan, then you plan to fail.” And I’m as guilty of it as anyone. I always make plans, and think that, by stating that this is how I want things to go, then the universe will cooperate. Boy has the universe had a chuckle or two (or ten) at my expense over the years. But do I learn? No. Despite overwhelming evidence to the contrary, I keep thinking that a good plan is all I need for success.

And so it went with becoming a mom. I had a plan. I’d get pregnant by the end of the summer so that I could teach all year and then have the baby at the end of the school year. That way I would not have to miss unnecessary time at work, and I would not have to be pregnant during a hot and humid New York summer. I’d also be three months along at least by Christmas, which meant I could announce it in my Christmas cards. Hear the universe laughing? It’s an annoying, grating kind of laugh, like a Loon drifting along a lake at dusk, shattering the tranquility with its brash call.

So, what does all this mean? Well, when last I wrote, I was dealing with the issue of high estrogen levels, which was confirmed to be the result of ovarian cysts. We’ll call those the halcyon days, when that’s all I had to worry about. Because now that’s just number three on the list. Because why would I have only one complication? When you only have one complication, you’re clearly not trying hard enough. Enter a  blocked fallopian tube and a uterine fibroid. Yep, I’ve got the trifecta. I'm so proud.

Backing up slightly- After we discovered the cysts, I had to give myself a shot of Ovidrel, to stimulate ovulation and hopefully get rid of the cysts (Yay for an extra period this month!). In the meantime, I had the HSG test. The doctor I had, Dr. B. was amazing. It is a difficult procedure, especially for someone like me, and he was so gentle and talked me through everything. It was not nearly as bad as I feared. It was through this test that we found the fibroid and the blocked right fallopian tube.

I followed up with Dr. K., and he did another ultrasound (joy), to try and confirm the fibroid. It was hard for him to tell, so he wants to do a Saline Sonogram to confirm it. If it is in the uterine cavity, then I will have to get it removed. Otherwise, if the embryo attaches over the fibroid, it could cause a miscarriage. Thankfully, it’s a minimally invasive procedure, with no incisions, and a quick recovery (2-4 weeks before trying again to get pregnant). God bless Dr. K., too, who emailed me right back last week at Friends Lake and talked me off the edge of fear that I would not be able to get pregnant at all because of this. I told him flat out that his quick and reasonable response made it possible for me to enjoy one of the last weekends of the season up there, with Keith.

Of course, complicating the complications is my elderly age of 39. As Dr. K. and I discussed, the approach would be very different if I were ten years younger. But I’m not, and so conservative approaches are out the window – bye, bye! Dr. K. and I have come to the decision (one I was already close to making anyway), that IVF is going to be my best bet now. With a blocked tube, it’s a role of the dice each month to see if the egg would come out of the other side, and I have a greater chance of an ectopic pregnancy, even if I do get pregnant. And, we can’t stretch this out for months and months. There’s no telling when I’ll fall off the cliff of infertility – next year, or five years from now. Or even later, who knows? But I can’t take that chance. So, IVF it is.

I’m having the saline sonogram Friday. If there is no need to remove the fibroid, then the first IVF can be done in November. If it does need to be removed, I’m hoping the first IVF can be done in December. Otherwise, I’ll have to wait until January (the lab that needs to grow my baby is closed for the holidays).

So much for plans. No Christmas card announcement. Pregnant over the summer. Delivery at the beginning of next school year (all God-willing, of course!). But you know, what? Turns out I don’t care. I just want to be pregnant with a healthy baby. I like to think that these delays are just because Mom and Dad are looking for just the right baby for me up there, and it’s taking them a little longer. If I have a baby by this time next year, I will be very happy. If I don’t? Well, I’ll just adapt my plan again!

Tick, Tick . . . um, Boom?

So I haven’t written anything in a while, because there hasn’t really been anything to write about. At least, that was true for the first couple of weeks. I’ve learned that, once you have a failed cycle, and you need to wait for the next one, it’s kind of like sitting in a boring class (we’ll say Math, as a random example), and watching the clock tick the minutes by. Unlike the two-week period after doing an IUI, where you are anxiously wondering whether it worked, and worrying that it didn’t, the period after you know it fails consists largely of a dull routine of getting up every morning and peeing on a stick. So, every morning is one more Tick on the clock, until one morning, Boom! You have a positive result and it’s time to do the next procedure.

But, what happens when there’s no Boom? The Boom is what it’s all about. You rely on the Boom to make up for all the Ticks. And when there’s no Boom, what the hell do you then? Guess that’s what I found out this month. I kept doing the ovulation tests every morning and, by Day 16 of my cycle (very late for ovulation, especially for me), I still had not received a positive result. No Boom. I also had not had any symptoms of ovulation. Of course, that means, no IUI. But, I was leaving for Los Angeles the next day, to try my luck again pitching my screenplays, and I knew this was my only chance this month to do it. So, despite the fact that there was no Boom, I called and scheduled the procedure anyway  (I lied to them that I had gotten a positive result, but I did come clean to Dr. K later).

So, procedure done, I headed off to LA. I continued testing, and I never did get a Boom. For perhaps the first time in my life, I didn’t ovulate. Sucky timing, that. Another month lost, and confidence shaken. If I didn’t ovulate this month, what about next month? How can I rely on ovulating in future months? Am I going to be able to get pregnant? I know it’s probably a bit of an overreaction, but if stress made me not ovulate, isn’t this just adding more stress? Does that mean it will cause me not to ovulate again? And what if the lack of ovulation is a sign of something else?

Well, I got a period on Friday, and did my Day Three Bloodwork today. And the result is that I have high estrogen levels. I’m really starting to wish that I had insisted on having the bloodwork last month, even though the nurse said it was unnecessary. Maybe we would have discovered this sooner. Anyway, there’s a lot of reasons my estrogen may be high, and I’m already starting to worry about what it might mean, especially with mom’s history. The doctor said it could be a sign of more cysts. Tomorrow I have to go in for an ultrasound and more bloodwork.  I also have to make an appointment for an HSG test, to see if there is any blockage in the fallopian tubes. So, two uncomfortable procedures in one week. What choice do I have, really?

To be honest, all I keep thinking is, did I wait too long? Did I somehow just slam head-on into the wall of infertility, right when I finally got everything together to do this? If I had done all this a year ago, would it have been OK? I know that’s borrowing trouble. I should just wait until I actually get the tests done. But I’m a first-class worrier, and I know it’s all I’m going to do until I know something for sure.

Is it really too much to ask for a Boom?

Back to School, and Back to the Drawing Board

I should have posted this a few days ago but the start of school (and its attendant chaos) got in the way. The important news? The first cycle didn’t work, so we have to start all over again. Gotta say – never been so disappointed to get my period! I tested Monday, at Friends Lake, because I thought it would be nice to get the news there, with Keith, if it were positive. But, it wasn’t in the cards. I actually kind of knew before I tested that it would be negative because I started the day with spotting, which suggested my period was imminent. But, because spotting is still possible, even when pregnant, I tested anyway.

I don’t know if it was because I had the spotting, and was thus expecting a negative result, or what, but I was not as upset as I thought I would be. To be honest (and I try to be!), I thought I’d be crushed, and that I would cry. But, really, I was disappointed, but not at all crushed. I mentioned that to Keith, and he said it was because I know this was only the first try, and not my only chance to have a kid. He’s probably right, but who knew I could be so reasonable about something like this?

It was probably also a bit of a reality-check for me. The odds of getting pregnant on the first try are small, and I was acting like all I had to do was set up a plan and a schedule, and nature would follow along. Especially at my age. My doctor and I have discussed it, and I have read enough articles (http://www.babycenter.com/0_age-and-fertility-getting-pregnant-in-your-30s_1494695.bc) to know that fertility decreases as you age. My doctor, bless him, keeps saying, “You’re not old, but reproductively you are.” And I know that’s the case. I need to get pregnant sooner rather than later, especially if I am entertaining any thoughts of having a second child down the road (which I am).

That, of course, brings us to the next step. In consultation with the doctor, we have decided to do one more natural cycle. If that still does not work, then he would like to start an oral fertility drug (probably Clomid). If I were younger, he would probably take it slower and see if the natural process found success over six months or so. But I’m aging every day, and can’t really afford to wait.

So, fertility drugs – the first thing everyone thinks about is twins (or more!). And that brings up an interesting discussion for me. First of all, according to Dr. K., the chance of twins occurring naturally is 3.5%. With fertility drugs, that doubles to 7%. That means I still have a 93% chance of a”singleton birth,” as they call it. But, with my Dad being a twin, and twins running in his family, I guess that gives me a higher chance of having twins myself. And I’m conflicted as to whether that’s a good or bad thing. Well, no, that’s not completely true. The only bad thing I can think of when it comes to twins is having to deal with raising them alone. But I’d figure it out – I’d have to. And I’ve actually always wanted twins (a boy and a girl – as if I can plan that!).

Twins would also resolve a number of issues for me. First, it would eliminate having to plan another pregnancy in my forties to have a second child. Second, it would make it easier for me to figure out my work issues (I could go back to teaching full time sooner if both kids were in school together). Third, it would answer the conflict I am currently experiencing as to if, and when, I should move out of the City. I talked about it earlier and it’s not my first choice, but I don’t see how I can stay in the City without a sudden influx of cash. And, up in Riverdale, I could get a larger 2-3 bedroom apartment for much less than my current place. With one baby, it would still be a debate. With two? I’d definitely have to move! Finally, twins would help me resolve one last issue. I have always known, since Mom passed away, that I want to get a pre-emptive hysterectomy to try and lower my cancer risk. If I have one child, I would wait until I was sure that I wasn’t going to have anymore. But, if I have two, then I would just go ahead and do it and get it over with.

Anyway, that’s a whole heck of a lot of speculation. Right now I just need to focus on the next cycle (in a little over a week), and hoping it works. Well, that and finishing a screenplay for my LA trip in two weeks. And teaching four classes at two schools. And grading papers (I hate grading papers!). Yeah, see, life doesn’t stop just ‘cause you’re trying to get pregnant!

Eep!

OK, so an unusual title for a post, I’ll grant you. But, it is appropriate – and accurate – because that’s more or less the sound I made on Thursday morning (8/22), when the Ovulation Kit came up positive for an LH surge. Because that meant – it’s time! 

As much as I was ready for this, the reality that it was time to have the procedure made me very nervous, and a little scared. There really was no turning back at that point. So I called and made arrangements for my first IUI. I went in a couple of hours after the test (at 9:15), because they needed two hours after the “thaw order” was placed for the sperm to be ready.

Given that this was the first time doing this, I didn’t know what to expect. I mean, I had researched it (http://www.webmd.com/infertility-and-reproduction/insemination-procedures-for-infertility), but had no idea if it would be painful. I figured it would be, though, since it requires opening things up down there, and that’s not a highly-trafficked area! And I was right, of course. The procedure is fast, just a couple of minutes, really, plus some time to lie down and let things, um, sink in. But getting in there is tough, at least for me. Yet another reason why I hope this works sooner rather than later. Of course the primary reason I hope for that is that I really want my baby. Also, it will be emotionally difficult to go through this several times. It will also be financially difficult, as each insemination costs me about $300, since it’s not covered (I did two, the second on Friday, to increase my chances). That doesn’t include the cost of the sperm. Then, there is the pain factor. I really don’t want to have to go through that twice a month for however many months.

After Thursday’s procedure, I had some cramping, which is considered normal. I took some Advil and was fine. I met my friend Trish at Starbucks and we talked all about it. It was nice to have someone to talk to after just having, pardon the expression, “taken the plunge.” Trish was really supportive, and getting together did help it all feel a bit more normal. After Friday’s treatment, I felt much better, and I actually went skating. I figured I should go while I can, and skating around on a public session is like walking on the street for me, so no big deal. I was a little worried about getting knocked down, although it was too soon for that to do any damage, as nothing had yet been formed.

Later Friday, though, I started to feel cramps – not like period cramps but, rather, diarrhea-type cramps. It didn’t really amount to anything, and I’m not entirely sure if it was physical or psychological. Because, of course, I’m now obsessing over whether it worked, and whether the slightest little thing can destroy my chances. I feel like I have to do everything all natural – which isn’t a bad thing, but I’m pretty sure I’m overdoing it ( I threw out a perfectly good package of goat cheese because I couldn’t tell if it was pasteurized or not). So today I allowed myself a caffeine-free Coke and a cup of Ramen noodles. I have to be realistic and accept that I’m not suddenly going to go Vegan or all Organic. That said, I do want to be as healthy as possible, because my age is already working against the health of my potential baby. I found some good fruit juices at Agata & Valentina (http://www.agatavalentina.com) that I’m diluting a bit with water (as they are both expensive and a bit rich). I think they may provide an acceptable alternative for Coke. Talk to me again next week, when school starts, though. 

My biggest problem right now is my state of mind. I’m a mess because I really want this to have worked, but I’m afraid to believe it did because I’m afraid of disappointment in a couple of weeks. But then I’m afraid that I will cause it not to work by not believing that it will. Now would be an awesome time to be able to talk to Mom. She’d know what to say to make me feel better, but she wouldn’t sugar-coat it for me. Argh! I really wish she were here.