~ ONE JOURNEY ~
~ There is only one journey: going inside yourself. ~
- Rainer Maria Rilke
La Vida in Vitro, Part 4 ~ Tuesday, September 16, 2008
The Crying Game
Well, there you have it. Close, but no cigar(s) to be handed out in approximately nine months or so.
Thanks so much, everyone who's been sending along good wishes and thoughts.
We're both pretty upset--though that's possibly an understatement. For me, I'm actually closer to being devastated. The part that we thought wouldn't work, worked. The part that I really did believe would work--no problem with implantation last time--didn't.
We had a pretty good clue last week, when the spotting I was experiencing (Implantation bleeding? Implantation cramps?) turned into a veritable tsunami, so to speak (i.e. not so implantation-ish). But, we wanted to get the official word, from the official pregnancy test, before we announced it.
So we're still dealing with the grief, the questions (is there anything that could have been done differently in the course of the entire procedure/protocol? Anything that could be tweaked, that would yield a statistically significant better chance of success?), and the next step. Going into this IVF, I had figured this was my last shot at the fertility stuff. My body, it seemed, just didn't want to get pregnant or be pregnant--as had been demonstrated and reinforced again and again over the past several years. But now that insidious grain of hope has been planted. If the thing that we didn't think would work, worked, then is there a chance that doing it again might, just from the perspective of probability, yield better results?
Hard to say.
So, I'm poised--torn between saying "got the message, thanks" to my body (this was one of the most physically painful periods I can recall having experienced, like that endometriosis was giving me the finger for having the temerity to try and sidestep all the damage it had wrought to my reproductive apparatus over the years and actually get pregnant)--and saying "nope, I think there's still a chance, and I"m going to take it"--and spending the $10,000 for another cycle, while keeping my fingers crossed.
Or, we could put that $10K towards the cost of adopting a baby. I believe a domestic adoption (if it's not through Children's Services) is around $10K. International adoption is even more.
But for now, it's time to grieve that possible path that hovered tantalizingly before me, before it suddenly reached a dead end. The one nice thing is that the other path remains open--I have almost a full-time roster of classes, and so at least, I have something to occupy my thoughts, rather than brooding, when I'm supposed to be trying to do some writing. Busy is often very, very good.
Thanks again, everyone! It's over and out, for now.
Labels: fertility, IVF
::Posted by Anduril Elessar @ 5:52 PM::
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La Vida in Vitro, Part 3 ~ Tuesday, September 09, 2008
The Waiting Game
At this point, the roads haven't yet diverged. They're still running in parallel--a full-time course load on the one hand, and a pregnancy, on the other. Though now, I've gotten into two upper level courses, so I've got a half course-load, which I hope to keep, even if I get pregnant.
For whatever reason, I found it difficult to write about the treatments as they were going on. I suppose part of it may be that as a fiction writer, I like to know what's going to happen next in the story--that's the only way that you can craft in foreshadowing, and proper setups with characters and situations.
But, given that I actually still don't know the outcome--whether or not the treatments worked--there may be more to it than that.
It might well be that the process was taking its emotional toll. See, the funny thing is that I'd reached a certain stage of resignation with IVF, back when we were entering into the cycle. I figured there was a good chance that it wouldn't work. So, I felt pretty equable and unruffled about the whole thing. But
sangfroid only took me so far, and after a few days of doing my injections, the hope began to seep in.
I managed my hope in the same way I've managed my physical and sometimes emotional pains in the past: via meditation, though such a notion may sound odd. Manage hope in the same way one manages pain?! It's true. That's because hope, if it's subsequently disappointed, can be just as devastating--or much more so--as expected pain and loss. It is, after all, a kind of loss, when you dream of a certain future and then learn that it will not come about. And, you're starting from a higher emotional point than you would be, if you had no hope, so there's a far steeper, more precipitous, fall.
And so, while I was both happy and surprised to find that tendril of hope creeping in--it felt good--I also knew that I couldn't lose myself to it. Not with the stakes this high, because if things didn't work out, I'd be all the more bereft by the end. I'll still be bereft if it doesn't work, but there are degrees of bereavement, degrees of desolation.
I suspect the ultimate consequence of this all was that while I remained pretty calm for the most part (aside from the occasional meltdowns that I attributed to the hormones I was pumping into my body each day), I think there may have been a hidden toll exacted, and that manifested as a deep reluctance to write about the treatments while they were happening.
So, a few updates.
Within a few days of starting, as one of the eggs started getting really large, they had me start injecting a second hormone to prevent that one big one from ovulating. It brought my grand total of daily injections up to $475 per day (none of it covered by our--or any other--drug plan we could find).
There were two other, smaller, ones they were hoping to grow large enough to use as well. It took about two weeks. But, for much of that two weeks, there was doubt about whether to go ahead with the retrieval or not. Usually, they like a minimum of five--four at the very least, in special circumstances. Otherwise, they call it off and start again. We were able to sway them to proceed by pointing out that we didn't have that option. We had gone forward at maximum, so calling this off and initiating a second cycle with the same protocol--maximum dosage--wasn't likely to yield different results.
I suspect they could have insisted, but they were kind enough to let us see it through.
Thirty-six hours before the retrieval--which I sometimes refer to as "the harvest", where they go in with a big ol' needle and drain the eggs out of the sacs in which they were growing--I had to inject another hormone that would trigger the final maturation of the egg and stimulate ovulation. The idea is that they go in just before ovulation and take the eggs out themselves. Then, the party in the petrie dish begins.
At the retrieval, after the three sacs were drained, they found a fourth! This was greatly exciting for us, increasing our chances by a significant amount.
Three of the four fertilized. Given my age and precedent, they agreed to put all three back in. They also took a lovely picture of our three little zygotes and printed it off for us. It's pretty cute.
It's one of those things that will be really adorable and funny if this all works out, and unbearably poignant if it doesn't--rather like the fuzzy, early ultrasound we have of the little fetus I miscarried before. Somehow, it feels so much more real with the images in hand. That tiny, curled little creature would have been a baby, then a toddler, then a child, and so on, if things had worked out differently.
But, I'm really glad to have those pictures. They're an affirmation--a testament to the fact that we hoped, and we tried, and to the fact that those little zygotes, like our little fetus, existed, even if they never reach a stage of development in which they'd be viable and able to survive in the world. After all--it's a struggle for all of us, sometimes, isn't it?
Lastly, they are a record. These attempts may be the closest I ever come to being a biological mother. And that alone is worth cherishing.
Labels: fertility, IVF
::Posted by Anduril Elessar @ 8:21 AM::::
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La Vida in Vitro, Part 2 ~ Friday, August 22, 2008
Two Roads Diverged in a Yellow Wood...
It's rare that the metaphorical crossroads in life loom so clearly and in such close conjunction as they seem to be right now. We came into London on Thursday night, all set for our first day of tests, ultrasounds and injections, all of which would determine whether or not I will be able to conceive and bear a biological child.
But, I will be getting up at 6 a.m., because that is also the morning that my registration for classes at U of T opens. So, from six to six-thirty, I will be trying to sign up for classes for the coming nine months, after which, I'll out for my first day of tests, which will determine whether I will have a child in the coming nine months.
I've been at crossroads before, and have had to make choices, but there is a peculiar resonance to this close a juxtaposition. Two roads before me, not necessarily mutually exclusive, but very likely to be (because of different other physical complications, it's very possible that if I get pregnant, I'll be ordered to bed rest pretty early on and will have to give up on the idea of classes). This particular morning, I'll be taking the steps I need to advance along two widely divergent paths.
It will be several weeks of following this particular road, before the fork comes--but for now, it's a matter of, on the one hand, trying to work out what classes I'll be able to register for, which ones I'll be wait listed on, and how I can get off waiting lists and into the classes I need to qualify for a Master's, and on the other, doing the injections and blood tests and trips to London.
In a few weeks, this uncertainty will be resolved, and I'll be advancing along one or the other route. But for now, there's this odd sense of irresolution and doubled lives, like two possible transparency overlays, where there's a map, and if you put one transparency over it, it shows one route, but then if you put a different transparency over it, a totally different route--with maybe just a few roads in common--gets highlighted.
I'm trying to be positive--there are exciting prospects along either path. After all, it's up to me to try to get the most out of my life, regardless of the path it takes. I might not have much control over how many eggs my ovaries are going to produce, nor whether any of them will fertilize as a result of some candle-lit dinners and one-night stands in the petrie dish/test tube. Then, there's the question of whether one of those that does fertilize, once back inside, will implant and start growing into a baby.
None of that is much in my control. The one thing that I can control is how I look at the situation. This is the end of the line for us, from the fertility perspective. My body has been damaged and sliced up by the surgeries. I'm working with essentially half an ovary, in total (my other ovary, which has also been reduced to half its size, is apparently inaccessible). I'll be injecting the maximum dosage of drugs, in the hopes of getting *something* cooking in there. But it simply may not happen.
Given that, I have to be very careful about the kind of hope that I'll allow myself to experience. Throwing all my eggs (so to speak) into one basket (ovary?)--the biological child route--is dangerous, because it's entirely possible this won't work. And if it doesn't, and I'm totally invested in it emotionally, it will be devastating. I have to focus instead on the ultimate outcome--a child, someday, somehow. In Vitro is one possibility--a route that for now is still worth exploring. But there are other ways, and I'm open to them.
Still, fingers crossed, for now.
Labels: fertility, In Vitro Fertilization, IVF
::Posted by Anduril Elessar @ 7:00 PM::::
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La Vida in Vitro, Part 1 ~ Thursday, August 21, 2008
A couple of years ago, I learned, as a result of some pretty conclusive exploratory surgery, that I am infertile. More than that, without the recent innovations in fertility treatments, I would have been deemed sterile. Salt-sown-in-the-ground barren. It's only thanks to the In-Vitro Fertilization technologies--resulting in the famed and so-called "test-tube babies"--that there's even the remotest chance I might be able to have biological children.
I actually wrestled somewhat with the idea of "coming out" on this topic. It's one that's still cloaked somewhat in mystery and shame, though I don't really understand why. As friends whom I see somewhat regularly know, I'm actually very open about it and if asked, I'm happy to answer any questions people have.
My hesitation in posting about our adventures actually came from the knowledge that others aren't as comfortable with the topic as am I, and so, some people might feel squeamish or like I'm just giving way too much information--though I have no plans to go all gory and graphic about it. If you happen to feel that way, feel free to read no further. I'll title all future posts on the topic "La Vida in Vitro, Part #", which should serve as an easy marker for steering clear of them--and I respect that choice.
So, as I say, I wrestled with the idea of posting on this topic, but finally decided in favour of it for three reasons:
1. There are family members and friends who are curious about our progress and our adventures as we try to grow our family, and this is a good way to keep people who want to know up to date.
2. There may be people out there who are curious about the details, but shy to ask. Don't be. But, this will provide some background on the day-to-days of it.
3. As I mentioned above, this is a topic that still seems shrouded in mystery and, worse, in shame. The temptation is strong, when the diagnosis come through, to blame oneself or to hate oneself, though most people who aren't infertile or sterile might be puzzled as to why. Others might well be able to understand such reactions, but are also quick to point out that such feelings are irrational and make little sense (which reminders I actually do appreciate, since it keeps things in perspective on the darker days). It's true. They are irrational--they don't make sense. It's an emotional thing and has little to do with logic.
And so, such difficulties are often kept as dark secrets. There are tons of anonymous blogs about it out there. Fair enough, I respect that. Not everyone is able or willing to go public with their difficulties and heartbreak. Sometimes, the honesty is so dark and raw and wounded that I can understand why they don't want their names associated with it.
But, I also think that the best chance that people have of coming to terms with that shame and self-loathing is if those who have such experiences and feel ready to share them, come out and talk about them openly, without the mask of anonymity. It's hard enough, coming to terms with the thought that you may never be able to bear biological children, without also feeling ashamed, like you have some horrible secret, and second-guessing whether there was anything you could have done differently, that might have prevented such an outcome.
This is the most compelling reason for me--the hope of adding another individual voice to those of other women who have chosen to be open about their infertility, in the hopes of reducing the stigma associated with it. That's the reason that I decided to go for it. After all, I can always give updates to friends and family in person or in private, and those who are curious but shy could probably do a quick web search and learn more than they ever wanted to about it all.
For this first post, I figured I'd just fill in a bit of the background.
I learned that I was infertile, conclusively and without any chance of conceiving naturally, at the beginning of 2005. The biology of it all is irreversible and irremediable. Short of a deity descending to lay healing hands upon my uterus, it's just not going to happen.
I went through a couple of IVF cycles at the time. The first one didn't complete, because I'm a "poor responder" (i.e. I didn't produce enough eggs, despite my daily hormone injections). The second one, with far higher dosage, resulted in a pregnancy that featured a week-long hospital stay, and ended in miscarriage, a few months in. A few weeks after that, I had a cancer scare and went under the knife. The years since 2005, I've been under the knife ~3 or so additional times. It seems as if each time that my body was deemed ready to go through another IVF cycle, the doctors would have a last look and discover some further impediment. So then, the wait for a surgery date would begin again and the timer would be reset for my next treatment.
Now, after a long wait, I'm back to the IVF days--the days of injections, of blood tests and of condom-covered ultrasound wands. Of dizzy spells, nausea and bloating.
But these are minor, as is the fact that I'm administering my own injections.
I'm not afraid of any needles--nor ultrasound wands, for that matter! Bring it, I say--and Lay on, Macduff!
So yes, the joy of it is that it's a go! A go! After all these years, all this waiting, this fact alone feels miraculous.
Now... to find out if my sliced up, "poor responder" ovaries (each surgery pared away at one or the other of them--half here, a third there, and so on) are up for the challenge!
And so, we begin!
Labels: IVF
::Posted by Anduril Elessar @ 7:28 PM::::
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La Vida in Vitro, Epilogue to Part 1
An Urban Myth for the Infertile
I have many friends who, over the years, have told me innumerable stories about how "a friend of a friend was struggling, just like you. But then, she and her husband gave up and started taking steps to adopt a child/had just adopted a baby/had given up on having children. And then, guess what? She got pregnant!"
I know this is true. I know people who have lived this very phenomenon themselves. Actual friends, who share this with me as their experience. It's a beautiful thing--and what a wonderful event, to be blessed with such a bounty of love and children. This is their experience and their reality.
But, it seems that if someone hears you're infertile, or sterile, this is the often the standard panacea, told by someone with no direct experience of infertility, concerning the friend of a friend. (I'm inferring the lack of direct experience in many cases, just because if they'd struggled with it themselves, they'd likely have learned how complex and varied the different causes of infertility can be.)
Everyone, without exception, who has told me this story has done so with the best of intentions, no doubt because they don't realise (and haven't asked, or given me the chance to explain) that in some cases, infertility can be conclusive and irreversible. They're doing it to cheer me up, to give me hope and help me feel better. At first, when this used to happen, I'd smile and thank them. Sometimes I'd try to explain that for me, this is a biological impossibility, while touching on the whole deities and healing hands bit.
But this is one of those memes that's as robust and tenacious as those albino crocodiles in the sewers. And, because I don't like being coy, and saying,
"Oh yes, well, I have some ahem, medical stuff coming up"
or lying outright and saying,
"We're uh, just not ready to um, start a family right now",
it's entirely possible that a question like,
"where have you been all this time?" or
"what will you be doing next week?" or
"so, when are you and Tom going to start working on a family?"
will result in some mention of my infertility. And then, often as not, The Story will, once again, rear its grim and gossamer head, and I'll smile wanly and mumble something like, "well, that's lucky. Good for them."
See, it's not that I call it an Urban Myth because it's not true. I call it an Urban Myth because it's Out There, and because for many people who are infertile, depending on the nature of our condition, it could never, ever, apply to us. And so, for us, it truly is a myth--one that we hear depressingly often, and which serves as a reminder of the kind of pleasant surprise we're never going to experience for ourselves.
Labels: IVF
::Posted by Anduril Elessar @ 6:00 PM::::
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