Trying to conceive
When I first heard about this year’s National Infertility Awareness Week theme, I admit I was a bit confused. Who exactly is supposed to “Start Asking”? Is it the fertile people who already don’t have a clue how to talk about infertility, and often ask the wrong questions anyway?
Turns out, it’s us, the infertile community, that should be asking the questions, according to RESOLVE, the organization behind NIAW 2016, April 24-30. We should be asking for better insurance coverage of fertility treatments. We should be asking the media to cover infertility in a real way, instead of a sensationalized one. We should be asking our family and friends to support us.
This is all so important, and I applaud RESOLVE for putting forth these questions. But going back to my original presumption—what about the fertile people? I would argue that instead of putting the onus on the infertility community to promote awareness, we extend that to fertile people as well. What about that annoying aunt who asks when you’re going to have children? What about those clueless friends who wonder why you won’t come to their baby shower? These people don’t understand what to ask, or how.
I wrote on this blog about the most ignorant question, and later posted it on The Huffington Post as well. The piece, “It’s None of Your Business How Many Children I’m Having,” got over 300 comments on the site. People argued about whether or not this guy, a stranger who asked across a table full of people whether and when I would be trying for a baseball team, was in the right or the wrong. “Can’t people ask about anything anymore without offending someone?” people lamented.
The thing is, there are times and places for everything. In fact, in that very same piece I discuss how a similar question had been asked by the colorist at my hair salon. But because she asked gently—”Do you think you’ll have more children?”—in the relative privacy of the hairdresser’s chair, my hackles didn’t get raised, and I felt comfortable revealing that I’d love another, but we’d had trouble getting pregnant.
So it’s really not about whether you should ask but rather about how you should ask. And when you do ask, don’t ever assume. Don’t assume a woman isn’t currently pregnant and just not ready to reveal it. Don’t assume a woman isn’t currently going through a miscarriage. Don’t assume that people can have babies and want to try the reproductive feat of achieving a sports team. Don’t assume a couple even wants children in the first place.
I would argue that the criticism against my HuffPo piece—that we live in a culture where no one is allowed to talk about anything—is the exact opposite of how I feel. In fact, I feel like maybe a better theme for NIAW might have been “Start Talking.” Because that’s the real problem: No one talks about infertility. People don’t even really realize it exists. It’s something that happens to others, so people assume those they know and talk to can actually have children. True, people generally can have kids. But that’s the point of “awareness:” People become “aware” that infertility exists for one in eight couples. Maybe it exists for your sister or your coworker or your friend or your neighbor. Or the person you just met sitting across from you at a crowded table.
Infertility awareness can be about inspiring infertiles to make a difference. But it can, and should, be about getting others to understand and to promote it as well. Wouldn’t it be great if fertile people joined in the cause too? Wouldn’t it be wonderful if they also posted on Facebook and Twitter to spread the word and hashtag #NIAW and #StartAsking? That’s where we should be headed. After all, not everyone who wears a red ribbon has AIDS or who does a run/walk for breast cancer has it themselves. The people who do those things maybe know someone affected (a mom, sister or friend who had breast cancer), or maybe they are just recognizing the importance of a cause and are jumping on board.
That’s what we should want. That’s what I’m going to #StartAsking for.
How aware are you of infertility among your family and friends? If you are infertile yourself, do you wish you had more support from fertiles?
**Warning: possible TMI ahead**
I am using “bloody” here as both the literal meaning and the English curse word.
As part of my testing to see if I can get pregnant again, I had a saline sonogram, which is like a regular ultrasound except they squirt fluid up into your uterus, which somehow gives them a better picture of what’s going on in there. It’s kind of uncomfortable because they have to stick a catheter up through your cervix, and then you have some cramping afterwards because your uterus is thinking, “Get this stuff out of me now, please.”
I didn’t really expect for my doctor to find anything. That seems oddly naive and optimistic of me, especially in hindsight. But I had passed my second shot at a prep cycle (I failed the first), so I felt like things were looking up. Maybe I could even cycle in the next few weeks.
But the doctor did find something. A four-centimeter fibroid that is pushing into the cavity. She said she would consult with the surgeon and let me know, but it would probably require a hysteroscopy. This is a procedure in which they go in through the vagina and clean you out. It involves anesthesia, but you go home right afterwards and recovery time is minimal. There is no actual cutting involved.
The next day I got a call from the doctor. She tells me that the surgeon thinks I need to actually have real surgery to remove this thing. “Like a laparoscopy?” I asked her. I had a lap six years ago to remove endometriosis. It was an outpatient procedure that involved four small incisions, through which a camera was inserted and the surgery was performed. “No, a laparotomy,” the doctor replied. “Like a C-section.”
So, as I understand it, this would mean actually cutting me open and going at the fibroid from the outside of the uterus. It would involve a couple of nights in the hospital, two weeks until I can drive and at least two or three months until I can try to get pregnant. It’s that last bit that is killing me. I don’t want to wait anymore. Now our timeline just got pushed back almost half a year, by the time we will actually be able to get this thing scheduled (apparently the surgeon is very busy).
Foggy Daddy said that maybe this is a sign we should go with adoption. Except that I don’t believe in signs (and, I thought, neither did he). Maybe he just meant that this is evidence that pregnancy is not the best route for us to have more children.
OK, so say we sign up with the adoption agency whenever it is that they start letting in new families (they told me “spring,” whenever that means). Then we have to get all our paperwork in order, have our home study, etc. Then we wait. Who knows how long it could be? What if we are waiting for a year or more? Then I’ll be thinking, Damn, I should have just had the surgery.
But on the other hand, what if it takes a while to get pregnant? Or what if it doesn’t happen at all? Then I’m going to be thinking that we should have gone with adoption, which at least has a definite end point. There will be, at some point in the future, a baby for us through adoption.
Once again, I have to make a decision without all the information.
So then I descend back into anger. I hate my stupid body. I hate my uterus more than any other part, because that stupid organ killed a bunch of my babies and now it’s preventing me from having more.
I suppose I should be grateful for it, because it gave me Sam. But it grew him sideways in such a way that he had to come out with a planned C-section. He was wedged in there so well they had to call in another doctor. They called him a “difficult extraction.”
I saw a blog post once about a woman who was having a hysterectomy. The title was “Die, bloody bitch” (I googled but I couldn’t find it again). For some reason that line has always stuck with me. I have had endometriosis, adenomyosis, fibroids, you name it. I don’t know how I ended up with such a messed up reproductive system, but I have a feeling somewhere in my future, after I am done with all this trying to get pregnant business, a hysterectomy awaits.
And I will be glad to see it go.
Have you ever felt you “hated” a part of your body?
When I first started breastfeeding, I was faced with many challenges, from a NICU stay due to failure to latch, to a milk protein allergy that had my doctor telling me to quit. But I persevered, and by around five months had established breastfeeding as a comforting (for both of us) routine and ritual. I loved it.
The thing about breastfeeding for me was that it helped prove to myself that my body was capable of doing something right, after years of infertility and miscarriages. It helped heal me, in a way. I was able to feed my baby, to make him grow. All that weight he gained? That was from me! It was an amazing feeling.
After I got laid off and decided to stay home, I ditched the pump and the bottle, and continued to let LM nurse on demand. Breastfeeding was a big part of our first year or so together, a way of bonding us together. This was something special only we shared.
As he passed a year, the age at which most babies are weaned, many of my mom friends stopped breastfeeding. But I didn’t see any reason to stop, so we kept going. Luckily, I faced no pressure from my husband or family to wean. They were supportive of my decision to keep nursing.
Eventually, though, in the back of my mind I started to think it might not be a bad thing if he weaned. Nursing a toddler is not as calming as nursing an infant. There is a lot of twisting, kicking, pulling, twiddling and general gymnastics going on. I wanted to tell him, “Just stay still!”
Plus, I wanted to think about having another baby, which would entail fertility treatments yet again. Now, doctors will generally tell you to wean before attempting an IVF for two reasons. One is concern about the medications, and another is that a raised prolactin level may impede your lining’s growth and make implantation less likely. But, both of these concerns are greater when you’re talking about an infant who gets all of his nutrition from nursing — less so when talking about a toddler who nurses once a day. Plus, although there haven’t been any studies on fertility meds one way or another, the little research I could find said that the drugs, which are naturally occurring in a woman’s body anyway, are safe.
There seems to be a bit of a “don’t ask don’t tell” attitude when it comes to fertility doctors and nursing. I was worried when we saw our RE (reproductive endocrinologist) that she would ask me if I was nursing, but she didn’t. I talked to a few other moms who cycled while nursing toddlers. I felt confident that I was producing so little milk that LM would not be at risk from nursing, nor would my prolactin level be too high (and bloodwork showed it wasn’t).
Then in a serendipitous turn of events, LM started weaning as I geared up for my fertility testing. The first to go was the nursing around naps. Our routine became such that he would fall asleep in the car on the way back from our morning activity, and then I would transfer him inside. When he woke he would sometimes ask for it, but after telling him no a few times, he stopped asking. He still threw a big tantrum after waking up from naps cranky, but he didn’t seem to connect that with needing to nurse anymore. Then, because he started staying up super late when he napped, we started encouraging him to go without napping anyway.
Then it was the morning. Because I’m lazy, I would generally take LM back to bed with me to nurse. But on the days Foggy Daddy got up with him, he just took LM straight downstairs. And LM didn’t seem to miss it. One Saturday morning LM burst back into our room after Foggy Daddy changed his diaper. I was still in bed, and he hopped up, asking to nurse. FD asked if he wanted to go downstairs with him. LM thought about it for a minute, said, “downstairs,” and got off the bed. He actually chose his breakfast (or his father) over me.
That left nursing before bed. It just so happened that last week my sister was visiting my parents, so we spent several evenings there. We’d change LM into his pjs before leaving, and he’d fall asleep in the car on the way home, and we’d transfer him to the bed. One night as I went to lay him down he woke up. “Mama, lay down,” he instructed. Here we go, I thought, believing he wanted to nurse. But he just cuddled next to me and went to sleep.
The last night at my parents’ house I decided to stay over. LM stayed on an airbed on the floor, and he made me sleep next to him. But, he woke up throughout the night, frequently asking to nurse. Because I had put my foot down on night nursing a long time ago, I felt comfortable refusing. In the morning, though, he asked again, and the desperate look in his eyes made me give in. A few sucks, a few minutes, and he was done. I was so tired I had my eyes closed the whole time, but now I wonder if I missed the last time he would ever nurse.
The real test would be putting him to bed at home. So far, two nights have passed in which I’ve put him down without nursing. The first day he asked, settling into position in the cradle of my arm, but I asked him if he wanted to read a book instead and he popped back up.
Last night he didn’t even ask.
So this might be it. This morning he did briefly ask, but I gently redirected him and he was OK with it. I don’t quite know how I feel about it. Part of me is glad — now I can pursue fertility treatments without worrying about it. But what if I can’t cycle after all, or if I don’t get pregnant? I feel like I would have encouraged him to wean for nothing. I could have maybe had a few more months of nursing my baby.
I will miss that special relationship. I tell myself that if I’m determined to have another child, I will nurse again. Even if our second child ends up being adopted, I will try to induce lactation, or at least feed him or her with a supplemental nursing system (in which a tube is taped to the nipple through which breastmilk or formula flows) in order to experience some of the same bonding I had with LM. There is no reason a baby can’t be nursed for comfort, even if he or she gets her nutrients elsewhere. I recently read about a tribe in Africa where the fathers actually nurse the babies when the mothers aren’t available.
So maybe it’s just time. There were no (or few) tears. True, there was gentle encouragement from me, but LM seemed to be going down that path anyway.
So, breastfeeding, thank you for allowing me to feel like a woman again. Thank you for giving me the opportunity to bond with my baby in that way. Thank you for this special gift that not everyone is able to experience.
I will miss you.
(Of course, there is a chance that LM could ask for nursing again. In fact, by writing this, I’ve probably jinxed it. So stay tuned.)
Extended breastfeeders, how did you feel when your child finally weaned? Did you have to encourage your child, or did he or she do it on their own?
LM’s tantrums lately have been EPIC. He just can’t calm himself down.
I know the feeling.
I feel like I’ve been on the verge of a meltdown myself lately. I always hold it all together, even as more and more is piled on top. I’m just not really sure how I’m doing it. It almost feels like muscle memory, the way I go through my day and take care of my toddler and make phone calls to doctors and therapists and write my stories and answer emails and talk to other moms. It all still feels, well, actually, foggy.
I remember when I felt more sure of my place in the world. When I knew what was going on in news and entertainment, when I didn’t constantly feel like I was behind the times. When I was out in front of things, instead of running to catch up. When I was gliding through my life effortlessly, instead of struggling to just keep my head above water.
I felt safe and secure. I had mental spaces I could go to that were places of comfort. I had activities I found therapeutic. I felt content.
It’s weird, this parent thing. In some ways I’m completely happy. But in other ways, I’m more stressed than I’ve ever been in my entire life. Can those two feelings coincide?
In some ways I think, Oh just get over yourself. And in other ways I think, F that, I do have it harder than other parents. I’m dealing with a kid who can’t hear. It’s hard. These two different voices are constantly battling in my head as I struggle to understand and accept my reality.
On top of that, I’ve decided to embark on an Extreme Fertility Challenge. Ready? First challenge: Grow an 8mm triple stripe uterine lining for your prep cycle! Uh oh, you failed, because your lining failed to convert to the proper striped pattern (betcha didn’t know that uterine linings can have patterns, did you?). Try again!
Next up: An OT evaluation for LM. OT stands for occupational therapy, but it has nothing to do with work. Well, not work in terms of employment. It’s more like how you work in your environment, or something. I’m not really sure. Anyway, LM failed (or passed, depending on how you want to look at it) that one too. Apparently all of his jumping and climbing, plus the picky eating and clothes sensitivity, plus his out-of-control tantrums mean he has some sensory issues going on. Again, not exactly sure what “sensory issues” are, but something having to do with the way you process input from your environment. Maybe at least now I have an explanation for all those shocked looks I get from other moms at the play gym when LM performs his usual crazy antics.
“You’re working way too hard,” the occupational therapist told me. “You’re trying so hard, doing everything you can. We need to help you out.” Finally, a validation! I’m not crazy. LM is f’ing hard! There is a reason I’m constantly on the verge!
I know I struggle with how much I put on my own plate and how much gets heap on there by life. But I don’t believe in doing things half-assed. There are things I want to accomplish in life. Every time I try to chill and relax and slack off, I feel guilty that I’m just being lazy because there are so many other things I should be doing. I have a hard time carving out “me” time. The time I do have never seems long enough, and then I’m back to regular life. I feel like I’m on a hamster wheel, going around and around again. Day after day, going through the motions.
I want to be able to just turn the wheel off and stop for a moment. Ironically, LM’s issues are forcing me to pay more attention to him when he’s playing, to try to engage him, to stay in the moment. When his therapists come over, sometimes they seem to just be playing with him, and I’ll think, “What the hell am I paying you for?” But then they will explain what they are doing, how they are using play to teach him. I try to replicate that, but it isn’t easy. Or maybe I’m just not a natural at it. But it’s hard.
Sometimes I wonder what would occupy my mind and my time if LM didn’t have any of his issues. And if I didn’t have “issues” getting pregnant. If LM was just a regular kid and I was just a regular mom who could get pregnant again whenever she felt like it in the privacy of her own bedroom. I fantasize about that. I know no life is perfect. I struggle on a daily basis with realizing that, with not trying to aspire to some nonexistent existence, with trying to find a way to make it through this fog to a place where I feel comfortable again. I want to get to a state of mind where I don’t find it necessary to remind myself whenever I start to feel light and happy of all the dark things in my life that should curb my enthusiasm. I know I should be happy in spite of all those things going on. But it just feels like too much.
I’m working way too hard.
Do you feel overwhelmed with the responsibilities in your life? How do you deal?
Sometimes I think I’m a glutton for punishment. Like Bill Murray in Groundhog Day, I sometimes feel like I am living the same day over and over again, just trying to get it right. I often fail. And I often bring it on myself.
Case in point: After five years or so of relentless testing, poking, prodding and disappointment, I finally freed myself from the dreaded RE (reproductive endocrinologist, or fertility doctor)—but tomorrow, by choice, I’m going back.
I have a sense of deja vu about the whole thing: the making of appointments, the gathering of medical records, the filling out of senseless forms when they have all the information anyway. I’m sure I will feel that way when I walk through those doors tomorrow, hold out my arm to give blood, open my legs for my date with the vag cam (sorry if that’s TMI, but you fertility patients know what I’m talking about).
I don’t know if it’s a good idea to try to get pregnant again. Part of me wants the doctor to say, “You know what? Your messed-up body just can’t handle it. So don’t.” But will she say this? True, clinics want to hedge their bets to increase their success rates, but they also want to make money. Would they turn away a willing and eager participant? I do know my doctor, and I should give her more credit that that, I suppose.
I know that’s passive aggressive anyway. I should make my own decision. And I can’t afford to wait any longer. I want to know what the deal is, what our plan is. I’m not going to spend another five years on this. It’s now or never.
Adoption is on the table. I actually contacted our preferred adoption agency, but they are not accepting new families until the spring. Well, spring is fast approaching (didn’t Punxsutawney Phil predict an early one?) and I want to make a plan.
That is really what’s behind my whole drive to figure this thing out. Why on top of everything I’ve got going on with LM’s hearing loss do I want to open myself up for more responsibility? Not just the responsibility of going through treatments, but of having another baby? Because I need a plan. I can’t stand to have this hanging over my shoulders, the will-we-or-won’t-we have another baby. There is never a good time to have a second child, just like there is never a good time to have a first child.
So we’re going to just do it.
Well, hopefully. After all, that’s not totally up to us. I wish I could just get pregnant on my own terms, like so many of my mom friends are doing. I wish I didn’t have to think about it. I wish I didn’t have to go all through everything. Again. Like Groundhog Day.
But that is my choice, isn’t it?
I posed the question to my FB group of infertility survivors: How did you make the decision when and how to have a second child? Many of the moms responded that simply, they didn’t. They decided to be one and done. They couldn’t go through that again. And they couldn’t start a new process (adoption) that could very well involve years of waiting as well. They just didn’t have it in them.
Do I have it in me? I don’t consider myself stronger than anyone else. I don’t know if this is an utterly stupid thing to do, to decide to go back down the rabbit hole of my own personal Groundhog Day (how’s that for mixing rodent metaphors?).
But I really want another child. I know I could be happy with just LM, but it’s there, nagging at me, this thing that I really want that I feel I at least have to take a shot at.
So here we go.
Let Groundhog Day begin again.
Fellow fertility patients, how did you decide what to do about having more children? One-and-done moms, how did you make that decision as well?
This week I got a Fit Pregnancy assignment on ways to improve your egg quality. I started with a Google search, which led me to some message boards for those TTC (trying to conceive). Reading about women whose list of supplements sounded like a code of numbers and letters – CoQ10, DHEA, etc – or who were doing shots of wheatgrass daily (yes, it tastes like grass), or eating royal jelly (queen bee poop, basically) brought back memories. And not good ones.
Those supplements are the fuel of desperation. When you can’t get pregnant, it seems that there is both nothing you can do, that everything is out of your control, and that there are so many things to try, it’s overwhelming. These “alternative” treatments fall into the latter category. Western medicine is great, but when it doesn’t work, you start looking for answers elsewhere.
That led me to a wonderful, if slightly crazy, Korean acupuncturist and TCM (Traditional Chinese Medicine) practitioner. I can’t say if anything she ever did for me worked. I know I spent a lot of money there. I was willing to try anything and everything.
But, I knew that she really believed in what she was doing – she wasn’t trying to scam me. She owned her business, and worked long hours. When she wasn’t practicing acupuncture, she was in the back of her shop mixing strange concoctions of herbs to give to her patients. She wouldn’t have been so dedicated if she didn’t believe in it.
Of course that doesn’t mean that it helped. But as I said, I was willing to try anything.
When I first saw her, she was running behind. I waited on the couch in front of the three rooms used for acupuncture treatments, filled with women trying to get pregnant (her specialty). Then she took me to her office. A huge wall of little drawers of herbs, like an apothecary’s cabinet, took up half the small space. She asked me questions about my history and looked at my tongue. Then she pronounced that she knew what was wrong with me. “Good,” I said. “Because no one else does.” She then proceeded to tell me that my uterus was cold.
Hmph, I thought.
I didn’t want to start on herbs, so we agreed instead to twice-weekly acupuncture treatments. During our sessions she did something I’ve never heard of another acupuncturist doing – placing rocks on my stomach, with a heat lamp over my belly. Apparently this was to warm up my uterus. I was instructed not to eat anything cold, like ice cream, and even to drink liquids at room temperature. I was also to use a heating pad daily – it belted around my waist and contained inside it flat rocks that, when the pad was heated in the microwave, apparently had the same warming effect as our treatment. Using a regular electric heating pad was, she said, not sufficient.
But after more failed cycles, I decided to try the herbs. They were crazy expensive because they were all imported, and weren’t regulated by the FDA. I didn’t tell my regular fertility doctors I was taking them. I knew what they would say – they didn’t know what was really in them or how they would interact with the medications. But I had tried their Western medicine way, and it wasn’t working. I didn’t care if the herbs weren’t studied – they had been practiced in Asia for centuries.
The stuff tasted like crap. I had to take two bags a day of the brown substance, filled with some strange assortment of deer antler and turtle shell and unicorn horn – oh wait, not that last one – but some very random stuff.
I still didn’t have success.
Her next suggestion was moxibustion, which consisted of burning herbs over my belly in a little pot. Well, that’s how it was supposed to work, anyway. The first time she tried it, she set off the fire alarm and the fire department actually showed up at her door. I sat in the treatment room, half naked with burning herbs on my stomach, listening to this little Korean woman try to explain moxibustion to a burly, surly fireman. Even in my desperate state, I couldn’t help but laugh.
Plus, the stuff smelled like pot. I would go for treatments on my lunch hour, returning to work smelling like I had just lit up in the parking lot.
When I still didn’t get pregnant, she looked up what else she could try. I was already taking the aforementioned wheatgrass shots and spoonfuls of special, expensive royal jelly. I was taking that long list of supplements. I had even bought some for Foggy Daddy. But she had something else for me to try: Placenta powder.
You heard right. Placenta powder.
This was obviously not my placenta since I had not yet been pregnant. This was the ground-up, dried placentas of some other random women. Is it safe? She assured me it was. OK, what the hell? I thought. I’d already taken every other weird substance known to man.
It actually didn’t taste that bad. Just a spoonful a day mixed with water. Yum! Just don’t think about what’s in it…
OK, so none of this stuff actually worked. I still could not maintain a pregnancy. My acupuncturist actually encouraged me to stop trying to get pregnant, saying that I should focus on my career, that she in some ways regretted having children because she couldn’t focus on her career as much as she wanted. That there were other things in life. She was so distraught by her inability to help me that she started doing acupuncture on me for free. I was her pro bono case. She said she’d never seen anything like it.
I eventually took a little break from all of it, including acupuncture.
When it was time for my last cycle, I had already gone another route that mainstream doctors think is bunk: reproductive immunology. This guy had me taking an intravenous blood product called IVIG; and when that didn’t work, we tried an off-label injectable called Neupogen, commonly used to boost cancer patients’ white blood cells during chemo. The doctor also had me taking a fairly high dose of prednisone, which puffed me up and gave me the dreaded “moon face.”
I decided to go back to my TCM lady solely for acupuncture in my last cycle. She took one look at me and in her English-is-not-my-first-language-so-things-come-out-with-no-filter way said, “What happened to your face?” Thanks, I thought. Like I don’t feel self-conscious enough.
That cycle gave me LM. We continued to do acupuncture until around 16 weeks, and then she hugged me and wished me luck. I sent her a birth announcement and she called me when she received it, happy almost to tears.
I have no idea if any of it made a difference. It appears that my other witch doctor, the reproductive immunologist, might have had the right medicine for me. Or maybe it was all just sheer luck. But when I think about going through all of that again to have another child – the list of supplements, the crazy treatments, the acupuncture, and not knowing if any of it is even doing anything – it seems overwhelming. Reading the stories online recently of women who are doing all of it brought me back mentally to that place, that lonely, desperate place. I’d be happy if I never went back there again.
Did you do anything crazy to try to conceive?
The front-page New York Times article on “leftover embryos” from infertility treatments earned an eye roll from me. The story explores what happens to extra embryos that are frozen after an IVF cycle – usually they are used if the fresh IVF doesn’t work or ends in miscarriage, or for a sibling or two down the road. For some couples, though, they have more embryos than they know what to do with. Hence the ethical dilemma.
We never had to make that decision. My cycles yielded a grand total of two frozen embryos, and that was after I begged and pleaded for our clinic to freeze something (they have “high standards” for freezing, which I fear may have meant that some viable embryos were thrown out instead of frozen, but that’s another story). These frozen embryos were created after my last IVF, from which I miscarried. I then used both frosties in my last-ditch FET (frozen embryo transfer). One of them became my son.
Now, faced with questions about whether to do a fresh cycle or to adopt, I wish I had the problem of too many embryos. It seems a much better problem to have than not enough. I can hear you now, though, telling me that’s a selfish way to look at it, that I’m only considering my own feelings and not those of the (potential) children frozen in time and space, just waiting to be born.
The thing is, even if you have lots of embryos that you think you won’t need, you may. FETs don’t always work. Miscarriages happen. Six frozen embryos could turn into only one live baby. So it’s really a moot point until you are done having kids. And even then, knowing my morbid nature and my tendency to hoard things, I would probably keep them for a long while just in case something happened to my living children.
Eventually, though, a choice would have to be made. And while I agree that it is difficult morally and ethically, I just don’t think it’s the sort of crisis that warrants a front-page New York Times story. Yes, there are some aspects of assisted reproductive technology (ART) that hold certain dilemmas. But it bothers me when the media choses to focus on those parts of ART when the general public still doesn’t even have an understanding of the basics. It just reinforces the weird and scary of this misunderstood process, and neglects the fact that ART has helped create thousands (millions?) of happy families over the years. One lawyer quoted in the piece even mentions an “‘ick’ factor.” Really?
I would like to see a greater effort to promote understanding and acceptance of ART, but that doesn’t sell newspapers. You know what does? Fear. Controversy. For every celebrity battling in court over frozen embryos (like Sofia Vergara), there are thousands of families living quietly and happily as a result of their own frozen embryos. Why do we have to pick out the rare occurrence and use that as a moral directive? And the issue of frozen embryos is not even new, so why is it being covered now?
But you’re still skirting the question, you might say. What about the frozen embryos no one wants? I think embryo donation is a wonderful thing. The whole “Oh, but what if they grow up and marry their sister?” thing is, again, an uninformed way of looking at it. As with children of adoption, psychologists now advise that children born as a result of donated eggs, sperm or embryos be talked to early and often about their origins, obviously in age-appropriate language. As more children born from donors grow up, hopefully society will catch up with the times and it won’t be a big deal. So if two donor children meet maybe they would be open with each other about that. True, many donations are anonymous, but there are usually enough clues to piece it together. Besides, the likelihood of this happening are rare to begin with.
If a couple just can’t wrap their head around embryo donation, though, I believe that donating to science is a wonderful thing that could improve infertility treatments in the future and maybe even save lives. I would feel OK about this option.
The NY Times article also mentions a clinic in California that is creating embryos which are then made available to couples. Patients like this program because it is quick and has a money-back guarantee. But one fertility lawyer quoted said it was commodification and one step removed from a “mail order catalogue.” To me, this is insulting to the couples themselves. Couples looking for embryos are at the end of the line. They just want a baby. They are not looking to pre-select a baby from a catalogue, choosing a child they think will be tall and blond and blue-eyed and smart. They are not sitting there thinking about creating the “perfect” child in some kind of Brave New World. When they imagine their child, they are probably imagining a baby who looks like them, imperfections and all. It’s not about selecting traits. It’s about finding a child to love who just somehow belongs in their family. Who is theirs. What is so wrong about that?
OK, but what of this child – shouldn’t he or she have a say how he was created? How will he come to view his origins? Well, first of all, none of us had a say in how we were created. And I would venture that far more babies are born “unwanted” the natural way than through ART. Couples going through ART really, really want a baby. You can bet that they will love whatever child comes into their family. And as for how these kids will view their origins as they grow, well, that depends more on us than on them. Children have to be taught that something is wrong or unnatural or weird. If we all accepted ART as a wonderful way to make a family, so would the children born of ART. They would only think it was weird if we tell them, consciously or subconsciously, that it is.
Do you agree that, once again, the media is perpetuating the belief that ART is controversial and weird?
A recent news piece about a couple who almost made a tragic decision – terminating a baby who turned out to be perfectly healthy – both angered me because of it’s inflammatory reporting and earned some sympathy for the couple. I, too, had some worrisome testing results in two of my pregnancies that caused me weeks of anguish. Here’s what I learned.
OK, so first of all, these blood tests only assess your risk. It bugs me when people say they had a “positive” test result. There is no such thing. Your result is either 1 in 1 million, 1 in 1000, 1 in 8, etc. Yes, there is a point at which you get red-flagged, but it’s still not “positive.” Likewise, there’s no such thing as a “false positive.” If your risk is 1 in 5 and you turn out to be one of the other four, it wasn’t false. It just means you were lucky. Only diagnostic testing can tell you for sure one way or the other.
When I was pregnant with my first baby to make it out of the first trimester, every test and ultrasound filled me with dread. I went to my MFM (maternal-fetal medicine, a.k.a. high risk doctor) for my NT scan with a ball of knots in my stomach, but my ultrasound turned out to be perfectly fine. My blood test results, however, were not. My baby had a significant risk of Down Syndrome.
“Mean Doctor,” as I like to refer to one doctor in the practice, did not make it any easier for me as she harshly explained the results. My pregnancy was already difficult enough, with bouts of heavy bleeding that had put me on bed rest. I was trying to run my magazine from my couch, and was stressed to the max. Now I had this to worry about. If I had further testing to be certain, it would be invasive – a CVS or an amnio. And with my pregnancy already so unstable, I didn’t want to risk miscarrying.
After the appointment I thought about what I would do if the baby had Down Syndrome. As much as I had gone through to have a baby, I couldn’t fathom the challenge that would be in front of us; and it was in fact our past struggles that were leading me to consider terminating. I didn’t think I could handle any more struggle in my life.
Unlike the couple in the news piece, though, I was not going to make any decisions until I had confirmation. I showed up for the amnio at 16 weeks completely stressed out and on the brink of tears. Mean Doctor (ugh, how had I ended up with her again?) came in before the procedure to make sure I understood that especially for this pregnancy, the procedure could induce a miscarriage. Wait a minute, I thought. Wasn’t this the woman who told me to have the amnio in the first place? Then the water works started. I told her my husband and I needed time to talk. She and the technician left the room. I couldn’t stop sobbing. It was just all too much to take.
“Please,” I said to Foggy Daddy. “Tell me what to do. I can’t make this decision.”
Normally one to let me make the decisions about the pregnancy, because, after all, it was my body, FD sighed. “I don’t think we should do it,” he said. I felt like a burden had been lifted off my shoulders.
The doctor came back in and we told her our decision. Later in the medical notes I read that she wrote we had decided not to have the amnio “after considerable deliberation.” FU, lady. FU.
We went home with no further answers than we had before. It turned out not to matter because a little over a week later I lost the pregnancy. Genetic testing was done and the baby, our daughter Samantha, did not have Down Syndrome. Part of me wondered if losing her was payback for considering terminating. But since then I’ve learned not to see the universe that way.
A year and a half later, when I got pregnant with LM and had the same results with the NT blood work, I wasn’t phased. There were no markers on our ultrasound for Down Syndrome, so I had a feeling that these “off” results were just something my body does. I would not risk miscarrying from a CVS or amnio, however small the chance, but now there was another option: more bloodwork that can more accurately test for genetic abnormalities. Brand names include MaterniT21 and Harmony, the latter of which my doctor ordered. Apparently there are some fetal cells in the mother’s blood that the lab can look at – but the first sample they took from me did not have enough cells to test. The second sample was the same. I was starting to lose hope, and resigned myself to the unknown. But the third and final sample finally yielded results. The genetic counselor left a message with the good news that the baby had a very low chance of Down Syndrome, and I replayed it over and over. “You’re hearing the same thing I’m hearing, right?” I asked FD. “Yes,” he reassured me. “We’re good.” After my past experience, I wouldn’t have considered terminating the pregnancy, but I was happy to have my mind put at ease.
Then at 16 weeks I had more bloodwork, something known as the “quad screen.” And more wonky results followed: I had high alpha-fetoprotein. Apparently this put the baby at risk for spina bifida and some other problems. When the doctor (not Mean Doctor, thank God) called me in, I saw the grave look on her face. I was, oddly, calm. I just didn’t believe there was anything wrong, that my body just doesn’t adhere to “norms.”And I was right – LM did not have spina bifida, or anything else.
This isn’t to say that I don’t believe in prenatal genetic testing. It’s a good way to cheaply, non-invasively assess risks, and can make you better prepared for the birth and care of a child with special needs. It is about much more than just termination. But the flip side of this testing is that it makes many more women worried than, in fact, need to be. I think it’s a necessary evil.
Did you do prenatal genetic testing? Why or why not?
Last week the Duchess of Cambridge, a.k.a. Kate Middleton, gave birth to her second child, Princess Charlotte, the “spare to the heir,” as the royals call it. As her first, Prince George, is only a month older than LM, the timing of it all renewed my longing for a second. If it was time for a second for Kate, isn’t it time for me, too?
In a strange way, it was fun to be pregnant at the same time as Kate – we had some sort of connection, which is cool for me because I’m obsessed with all things English. But when the prince turned one, it seemed that the clock was ticking for the royal couple to announce number two. This is the same thing that, I fear, will be happening soon among my mom friends. And I will be left behind, again.
I know I should be grateful to have just one. There was a time when I would have wished for that and nothing more. And as I have said, the longing for a second is not nearly as painful or debilitating as the wish for a first. If LM does end up an only, I think I’ll be able to become OK with it, in time. Side note: I hate the term “only child,” as if “only” is not enough. Why not “one and only?” That sounds special and unique.
But, you see, like the royals, I need a spare, although I’m trying to understand my own reasoning for why. This saying, “an heir and a spare,” confounds me. In some ways it’s insulting, to think that one child can replace another. Or to think that royal women exist simply to pop out children to continue the line, which may have been how it was in the past, but haven’t we moved beyond that? Maybe the monarchy is just hopelessly (I almost wrote “hopefully” – Freudian mistype?) stuck in the past.
In terms of succession, though, in years gone by it made sense. Many children didn’t make it to adulthood. Even a king who took the throne could die an untimely death and need to be replaced. Wars have been fought over this stuff. In our current world, though, why wouldn’t it have been OK for Prince George to be an only? Why did they need a spare? Well, for starters, maybe Kate and Will just wanted to have more kids.
As do I. But my reasoning for needing a spare, although morbid, also falls along the old rules of succession. What if something should happen to LM? If he was all I had, I don’t think I could handle it if I lost him. If he had siblings, it would be horrible, but I would still have something to live for and someone to be strong for. I would still have graduations and weddings and grandchildren to look forward to. If my one and only perished, I would have nothing but empty years stretching before me until I died alone with no one to take care of me. See, I told you it was morbid!
I suppose I should be worried about the effects of being an only on LM himself. Will he miss not having a sibling? Will my care in old age be a burden to him with no one to share it with? Somehow, though, I think he could handle it. He has lots of cousins and baby friends. Every only child that I’ve known as an adult has been perfectly well-adjusted. And I’d do everything I could to prepare for my elder care ahead of time.
No, it’s me I’m more worried about.
On one of my FB groups, one for women who have families post-infertility, a mom of an only lamented that she was feeling left out because of all the other moms she knows who are pregnant with their second and thirds. Other women who also have just one, agreed, saying that they frequently wondered, “Where are all the other moms of onlys?” It seems that we, and our children, are the odd ones out. Maybe I should start a club.
I’m happy for Kate and Will. But I’m also jealous. I want my heir and my spare (and maybe another spare after that). And damn, I want to look that good after giving birth, too.
Are you a parent of an only child? Did you ever feel the need for a “spare”?
I refused to read all the comments on my Washington Post article. This is because the first few seemed so mean and troll-ish that I figured it wasn’t worth getting upset over. Maybe as an internet blogger I need to grow a thinker skin. But regardless, a couple comments that I did read, hurtful though they were, got me thinking: Am I self-centered as a parent? Am I self-centered about my infertility?
The first charge against me: In the opening anecdote, in which three moms including myself did not move our strollers to get out of the way of an approaching jogger, I admitted that I “felt bad for our lack of consideration.” Some commenters apparently thought that this was not enough and decided to berate us and lament that parents think the whole world revolves around them and their children.
OK, I get this. To people who don’t have kids, it seems like everywhere you go kids are ruining your peace and quiet. Their strollers block the way. They bring general chaos in their wake. It can be quiet annoying. But the thing is, kids are like that. They are chaos personified. You never know when they’re going to freak out or have a poop explosion. They’re going to cry on airplanes. Sorry. There is just not much you can do about it, although I agree that some parents are more aware than others of their surroundings and how their kids are affecting people around them. In our instance, though, we were very, very new moms. It was literally the first time I’d been out for a walk with him in the stroller. I was late and couldn’t figure out how to catch up with the other moms. I parked in the wrong place. I was sweating my ass off. I was stressed and hormonal. And I didn’t know what the stroller etiquette was. So to that jogger, wherever she may be, I offer an apology. As a somewhat seasoned mom, now I know better.
The second charge against me: That I complain too much about my infertility. I have read so many comments like this over the years directed at people with infertility, and I fail to see what about this condition causes such a visceral, callous response. Would you say, “Just get over it,” to someone who dealt with mental illness? Losing a limb? The death of a loved one? Cancer? If you think my analogies are extreme, I can assure you they’re not. A study was done that revealed that people going through infertility treatments had the same level of depression as those going through cancer treatments. In most cases (but not all) infertility will not kill you, but it will greatly affect your quality of life. I don’t understand how people can go on and on about how their kids are their world, but then ask people who are having trouble having a child to just forget about it.
I did beat infertility. I now have a child. But just like any trauma, the scars stay with you. And for some reason, the scars of infertility, like infertility itself, are just not talked about. So that’s why I wrote the essay. Am I “over it”? As I said in the piece, I am struggling not to let it define me. And now as I try to figure out how to have a second child, the wounds are opening up again. There is post-traumatic stress – the feeling of being out of control of your own life, the anxiety of fearing you’ll lose everything you love – that may never fully go away. Dealing with the aftershocks of infertility happen every day. It is a valid point of view and one not generally heard by the general public.
I know infertility may not be the worst thing in the world, but unless you’re living in a war zone or extreme poverty, nothing else is either. (But knowing that there are so many other bad things than can happen is something that plagues me. What’s next? I’m constantly waiting for the other shoe to drop.) I know that many people have gone through other, different traumatic experiences. Their points of view are valid, too, and I’d love to read essays about their personal struggles. But why does that preclude me writing one about mine?
Sometimes I do feel like I’m a broken record, harping on infertility over and over again. But this is my experience. This is my reality. This is what one in eight couples deal with. This is what’s not been talked about. I am going to be an advocate for myself and my silent sorority. So to those who want to criticize my writing about it, I say: Get over it.
Why do you think infertility is so misunderstood by the general public?