Limbo

When I first started reading infertility blogs, I remember looking at bloggers' TTC timelines and wondering what the hell was going on with all the down time.  There seemed to be such huge gaps between various tests and treatment cycles, on top of the unfathomable intentional breaks that people seemed to be taking.  WTF? I wondered.  If you wanna get pregnant, just get on with it already!

Oh, how naive I was!  I didn't realize just how much waiting is involved in this whole process.  Doing the math, I've calculated that we've only been actively trying to get pregnant for three months out of this whole year.  An IVF cycle in January, an FET in March, and another IVF in September.  That's it.  That's all we've been able to do.  The rest of the time has been waiting for cycles to start (February), having an endometrial function test done (April), giving DHEA supplements time to work (May to August), and now doing Lupron treatment to fix my lining (October - present).  That's a whole helluva lot of waiting.

 

You look like I feel, baby.

This week marked 5 weeks since my last Lupron shot.  My RE said my period should return within 6 to 8 weeks.  Soooo...AF could be here next week.  Or it might be three more weeks.  Or my body could be totally whacked and need a boost to re-start.  I have no idea.  All I can do is sit here and be impatient, because I really really just want to get this over with.  I want to know if I'm going to have my own baby, or if I'm going to be trying to have someone else's.  

Then there's the dread.  I've come to learn that it's typical when you've had a few IVF failures.  Lately it's taken the form of me being unable to sleep while I worry about having a disabled child.  My thought process goes like this: I have crappy eggs.  Older women have a higher percentage of chromosomally abnormal eggs.  If you're over 40, close to 90% of your eggs could be abnormal.  I'm closing in on 38, but my ovarian reserve was assessed to be that of a 43-year old.  So where do I fall on the abnormal egg scale?  We've only ever had one embryo, so we haven't ever bothered to do pre-implantation genetic screening (PGS) since it's not like we have options of which one to transfer.  I suppose if we were made of money we'd do the testing anyway and wouldn't transfer anything if our one embryo came back abnormal.  Since we're not, we're going to put it in and take the chance.  But I really don't want to bulk up my infertility resume by adding a miscarriage.  And the prospect of a disabled child is daunting.

Both M and I have one cousin each with rare chromosomal disabilities.  Neither one of them is hereditary (that we know of) so our RE wasn't worried about it being an issue for us.  I bring it up only because both of us have watched our extended families dealing with the many challenges that come with having a child who will essentially never grow up, and who will need some form of care for the rest of their lives.  While our cousins have enriched our families' lives in wonderful ways, I can't help but wonder whether they would ever have existed if they had been IVF embryos with abnormal PGS results.  Or if the technologies had been available at the time, would our aunts have chosen to terminate their pregnancies knowing the many health problems their children would have to endure?  It's a fraught question and I quite honestly don't know how I would answer it myself.  What I do know is that I would have a very difficult time even thinking about terminating such a hard-won pregnancy, but depending on the severity of the disability it might be a very sad necessity.  In the case of a milder disability, what would we do?  How would we manage?  We don't have family living close by, so we'd largely be dealing with things ourselves.  And since this would likely be our only child, there'd be no sibling left to take over for us when we're gone.  Is it fair to place this burden on my extended family?  Or worse yet, have our child end up in the care of the state?

This is what goes through my head while I'm tossing and turning at 3am.  And yeah, I know I'm getting way ahead of myself.  Our embryo might not even survive the thaw.  Which would be equally shitty in a different way.  Or, if we wanna go waaaaaay out there, it could implant and be perfectly healthy and I could go on to have a totally uneventful pregnancy and delivery.  I guess it's just that, after so much disappointment, it's really hard to imagine that we'd be lucky enough to finally have such a positive outcome.

Does not compute

You guys are not gonna freaking believe this.

Remember when I blogged about my high school friend Calla, whom I'd suspected had been struggling to conceive and yet announced her pregnancy via posting an ultrasound pic on Facebook just a few weeks ago?  

In the comments, most of you advised me to drop her from Facebook.  I didn't, only because I knew that if I did, my two best remaining friends from high school (one of whom is pregnant herself) would have to deal with the fallout drama.  I didn't want to do that to them.  So I just resolved to ignore the whole issue and go on my merry way.

Then today, I received a message from her.  Just a "hi, how are things?", but it was so out of the blue I couldn't ignore it.  I guess I'm just a glutton for punishment.  I replied.  We exchanged pleasantries.  She asked for my mailing address.  A Christmas card I'll never receive, I thought.  Then, since I couldn't avoid the obvious, I wished her congratulations on her pregnancy.  Her reply (verbatim):

It's still hard to comprehend.  I honestly didn't think it could and would never happen.  I was beginning to accept that it wouldn't.

Obviously there was no closing this can of worms.  What ensued was an hour-long texting session during which she told me that it had taken them four years to conceive.  She and her husband had never done any treatments, I suspect for financial reasons.  But her cycles were totally wonky when she came off the pill, and she said she could never figure out when she was ovulating.  She said the depression got so bad at one point that she could barely stand to be around her nieces and nephews.  But she hardly told anyone.

Of course I told her about our troubles as well.  She knew (through our remaining mutual friends) that M and I were having difficulties, but didn't know the specifics.   I gave her the Cliff's notes version, and she gave me something I totally did not expect: a sympathetic ear.  No platitudes, no "it'll happen when you least expect it", no "just relax".  Just an offer to listen whenever I needed to talk, and a heartfelt expression of hope that things would work out for us.

I still don't think I've picked my jaw up off the floor.  So much of this just does not compute with me.  Why now, after so much silence?  Why bother at all?  And having been through something similar herself, why make a pregnancy announcement like that?  One that she must have experienced herself when she was still on the other side, and known how hurtful it could be?

 

I still haven't quite decided how I feel about it all.  It's a totally weird mish-mash of emotions.  It's nice that she reached out.  I doubt I'll end up talking to her much further about it, but the gesture is appreciated.  And then there's the inevitable pity party.  Of course she can reach out now.  She's all but past this.  She got lucky.  I haven't.  And I don't know if I ever will.  As much as it felt good to talk to someone I know about this stuff, I ended up crying as I texted her and relived all the disappointment.  The loneliness and isolation.  The fear that I'll never see the end of it.  

I guess more than anything, I'm just confused by it all.  Seems par for the course for our relationship, really.

Canadian ART law: Saving us from pig-babies since 2004

A few months ago I alluded to the fact that M and I had settled on a plan for moving forward if our upcoming FET fails.  It's probably obvious to most of you that this plan involves donor eggs.  What may not be so obvious is that for a long time, we didn't think that donor eggs were an option for us at all.  That's because Canada has what are probably the most absurd laws ever to be crafted regarding assisted reproductive technology (ART), apparently written after someone watched Gattaca or Species one too many times and decided they absolutely had to protect the Canadian people from the horrible future that awaited them if ART practitioners were allowed to run amok.  Since I'm a former lawyer with too much time on my hands, I decided to do a little dissecting and illustrate the sheer bullshittery that us poor northern infertiles are dealing with up here.

I'll start by saying that the principles behind the Assisted Human Reproduction Act are actually pretty reasonable.  They're mentioned right up front, and include wonderful goals like ensuring the health of children born through ART, preventing discrimination in the provision of ART services, and protecting the health and well-being of women whom the law acknowledges are "more directly and significantly affected" by ART than men.  Sounds good so far, right?  We can all get on board with that!  Let's set up a framework to make sure that all those great things happen!

Or...not.  Instead we could just write a list of all the things that you're not allowed to do.   Let's look at a selection of prohibitions from Section 5, which states that no one shall: 

• create a human clone by using any technique - That's cool.  People aren't sheep.  And heaven knows the last thing we need is another Kim Kardashian. 
• create an in vitro embryo for any purpose other than creating a human being or improving or providing instruction in assisted reproduction procedures - Also fair.  No making embryos for shits and giggles.  But embryologists gotta learn somewhere, so they get a pass.
• maintain an embryo outside the body of a female person after the fourteenth day of its development following fertilization or creation, excluding any time during which its development has been suspended - Wait, what??  Embryos can make it to Day 14 in the lab???  Well then how come none of mine can make it to bloody Day 5??? 
• perform any procedure or provide, prescribe or administer any thing that would ensure or increase the probability that an embryo will be of a particular sex, or that would identify the sex of an in vitro embryo - So gender selection is out?  I don't personally care as I think most infertiles will take what we can get, but there are some cultures out there that have an unfortunate tendency to abort/kill female fetuses/children.  This raises an interesting debate about whether allowing gender selection caters to that discriminatory mindset, or prevents a bigger tragedy down the road.  I don't have the answer to this one.
• alter the genome of a cell of a human being or in vitro embryo such that the alteration is capable of being transmitted to descendants - Ah yes, the Gattaca scenario.  Humans aren't to be bred like dogs.  Pathetic that this has to be legislated, but it's a slippery slope.  It starts with someone wanting a blond kid, and doesn't end until there's a race of super-intelligent white supremacists ruling the natural-borns with an iron fist.  Because movies. 
• transplant a sperm, ovum, embryo or foetus of a non-human life form into a human being - OK wait, this just got weird.  Who would do this?  What female is volunteering to give birth to a gorilla baby?  Good God, there are people who would actually do that for money.  I hate people.
• for the purpose of creating a human being, make use of any human reproductive material or an in vitro embryo that is or was transplanted into a non-human life form - So gorillas aren't allowed to birth human babies either.  At least that's fair.  It's a two-way street, gorillas. 
• create a hybrid for the purpose of reproduction, or transplant a hybrid into either a human being or a non-human life form - A hybrid?  Like a pig-baby?  So you're telling me that pig-babies are out, then?

 

Poor pig-baby.  You'll never exist.  At least not in Canada.

All joking aside, once you get past the prohibitions on pig-babies and birthing gorilla babies (or having a gorilla birth your baby, I don't care, you can't do it so stop asking), you get to the really stupid stuff.  As in, this:

7. (1) No person shall purchase, offer to purchase or advertise for the purchase of sperm or ova from a donor or a person acting on behalf of a donor.

Soooo....yeah.  There's that.  Basically, what the Canadian government is trying to do here is create legislation in support of another one of their main principles, which states that "trade in the reproductive capabilities of women and men and the exploitation of children, women and men for commercial ends raise health and ethical concerns that justify their prohibition".  Which, yeah, OK.  No one wants anyone to be exploited.  But I think we can all agree that there's a huge difference between having a warehouse full of illegal immigrants undergoing egg retrieval after egg retrieval for the financial gain of their underground egg-lord, and being able to pay a willing donor a couple thousand dollars for the pain and suffering of undergoing an egg donation cycle.  As it currently stands, an infertile couple can only compensate a donor for her out-of-pocket expenses.

Sure, yeah, I'll spend several weeks injecting myself with mood-altering hormones, waking up early to have my vag probed, and undergoing a surgical procedure involving a giant needle poking into my lady-bits.  That'll be $62.00 for subway fare.  Thanks!  Clearly, no one involved in drafting the legislation has ever undergone an IVF treatment.  Lucky them.

What probably bugs me the most about this is that, when writing the Assisted Human Reproduction Act in 2004, the Canadian government had the chance to do things right.  They could have instituted a set of controls on egg donation designed to ensure that no one is exploited while still making egg donation a viable option for couples struggling with infertility.  They could have placed a monetary limit on donor compensation, making it less likely that desperate donors would put themselves in harm's way out of financial need or that recipient couples would offer ridiculous sums of money to encourage donors in financial straits.  They could have put a system in place to ensure egg donor health, so that donors can't donate more than a specified number of times per year, or clinics can't put donor health at risk by attempting to retrieve more than a certain number of eggs per cycle.

But no.  Instead, we have the current system which basically outlaws donor egg completely, unless you're able to find a completely altruistic donor.  In my case that would have been my sister, up until she started having her own fertility problems about a year ago.  The other alternative is to go online to the underground marketplace of donors offering their services on fertility message boards or Craigslist.  And yes, both things exist.  I wasn't even searching for them and I found them while researching donor egg options.  Which means that the Canadian government has essentially created the very problem that the legislation was attempting to prevent in the first place.  Way to go, guys.  Stellar job.

As a result, if we want to do donor egg we won't be doing it in this country.  I don't have anyone who can give me eggs for free, and I'm not willing to wade into the black market to buy some.  We had initially ruled out donor egg entirely, based on the exorbitant prices that I was finding for clinics in the US.  But then a co-worker told me about another colleague who did donor egg in Europe, and I started researching.  And donor egg became an option again.  We haven't settled on a clinic yet and we're still in the very preliminary stages of figuring it all out, but at least we have the comfort of knowing that our journey won't necessarily end if this FET fails.  Which is enough to keep me going for now.

The Flaming Infertile

My metamorphosis as an infertile superhero continues.  First, I discovered that my vagina had super-strength.  (Incidentally, "super vagina" is one of the most commonly searched terms that brings people to my page.  That, and some variation of a pet eating DHEA.  I had no idea it was that common a problem!)

Anyway, about three weeks ago I received my second Lupron Depot shot.  Up until then I'd been lucky and hadn't really had any of the side effects that everyone warns you about, like headaches and moodiness and joint pain.  But that changed after the second shot.  Like Dr. Bruce Banner getting dosed by gamma rays and turning into The Incredible Hulk, my Lupron shot has turned me into...

The Flaming Infertile!

This is what my super alter-ego looks like in my imagination.  What a nice rack I've got!

That's right, I've been gifted with the superpower of bursting into flame.  That is, hot flashes.  Although, like The Hulk, I can't really control my powers so well at the moment.  I know because I tried.  I was a bit chilly while I was waiting for my morning train last week, so I actually willed myself to have a hot flash.  It didn't work.  But when they do come, boy howdy!  Roasty toasty bizness up in here!

In all honesty, I actually think I've been pretty lucky in that my hot flashes are fairly mild and they go away fast.  I feel an initial flush in my face, kind of like I just got embarrassed and am blushing (although I've had M watch me when I feel one coming on and he tells me I don't actually get red, I just feel like I do).  Then the heat drops from my face into my upper torso, and I feel like there's a little furnace burning inside my chest and back area.  If I'm home I can pop a few buttons and fan myself, but at work I can't do much but lean forward, since sitting against the cushioned back of my office chair feels like I'm leaning against a black car on a summer day.  Leaning forward at least gets the air to circulate a little.  Within a minute or so, a fine sheen of sweat pops out (again, I'm lucky in that it's not really noticeable) and then...it's all over.  The air cools me, I give my damp nose and upper lip a little wipe and it's done. 

What my hot flashes lack in intensity, they make up for in frequency.  It's nothing for me to have a few of these episodes per hour.  Which is particularly annoying at night, as I tend to wake when it's coming on, throw off the blankets, then cover up again as the sweat dries and I get cold.  I asked my mom what her hot flashes were like during menopause, since I really didn't feel like mine are that bad and I wondered if maybe it had something to do with the fact that mine are medically induced rather than natural.  But Mom said that hers were much the same as mine, so maybe I've actually won the genetic lottery for a change and won't have a crazy menopause to deal with.  

So now it's just a waiting game until my cycle starts back up.  My RE estimated 6 to 8 weeks after the second shot, which gives me a period just before Christmas, but given my past history (my period didn't come back on its own for a year after I stopped the pill) I'm a little worried I might need medical intervention to bring my cycles back again.  Just have to wait and see, I guess.  

In the meantime, I'm continuing to work on developing my superhero costume and figuring out how to explain to my boss why I'm wearing a cape and a mask in the office...

The definition of lucky

A couple of weeks ago I played in a charity Texas Hold 'Em poker tournament hosted by a guy in my office.  I like poker and play every once in a while, but I'm certainly no pro and don't know the odds in my head like most of the guys I play against seem to.  I've played in similar tournaments before and usually hold my own for a while, but generally end up getting taken out by one of the more experienced players well before the final table.  I just look at it as spending the $30 buy-in to support a good cause and have a couple of hours of fun.

Except this time, I had CARDS.  I mean, I had really reaaaaally good cards.  It seemed like every hand was begging to be played and before I knew it, I had knocked out a bunch of people and had a huge stack of chips in front of me.  I made it to the final table (the only woman against 8 or 9 guys, I might add) and in a final two showdown against the second most senior guy at work...I won!  I got lots of congrats on my playing, and yet I knew that a big part of the reason I won was due to the fact that I had been getting such awesome cards the whole time.  It was partially skill, but also a whole lotta luck.

And then it occurred to me that I didn't really consider myself lucky.  I mean sure, I now had $400 that I didn't have a few hours prior and that was a good thing.  But I would much rather have had a positive pee stick in my hand.  Even though they lost, pretty much every guy at that final table was going home to a fertile wife and a couple of kids.  I guess my definition of luck has changed.

Tequila and a Bullet: Our Love Story

No, I'm not talking about some weird Quentin Tarantino rom-com.  As promised last time, it's the story of how M and I met and eventually got married.  Obligatory censor's warning included for sexual content and graphic violence.  Everyone under 18 gone now?  Ok, good.  Let's get started.

Picture it.  Ottawa, 2005.

 

I learned everything I know about storytelling from Sophia Petrillo. 

A beautiful young girl leaves her family and moves halfway across the country to take a new job.  She meets the man who will be her future husband at a mutual friend's housewarming party.

OK, so the story of how we actually met is pretty lame.  Bear with me, it gets better.

M and I hit it off and spent all night chatting, and I had a feeling he might ask me out.  But as I would later learn, my husband is nothing if not a procrastinator, so he took his sweet goddamn time doing it.  So long, in fact, that I had started dating someone else and had to regretfully turn him down.  By the time I was single again about a month later, M was himself taken and would remain so for two whole years.  I moved on, but always kind of thought of him as the one that got away.  When he and his long-term girlfriend finally broke up, I circled the carcass of their relationship like a vulture hoping to pick up the spoils.  But strangely (to me, anyway), M didn't seem interested and ended up in yet another relationship with someone else.  I took my bruised ego and sulked off, vowing never to give him another thought.  Which would be easy, because I had just found out that I would be transferring my organization's office in Toronto in a few months.

In January 2009 I was going on vacation to Mexico with a group of friends, and found out at the last minute that M had split from his most recent girlfriend and had been encouraged to tag along to lift his spirits.  Instead of being excited, I was actually kind of aggravated.  I'd given up on this guy, but I knew that with alcohol comes sluttiness (for me, anyway!) and I really, really didn't want to waste my week trying to get his attention.  Well, that lasted until about the third shot of tequila, and we ended up (finally!) hooking up on the beach on the first night of the trip.  We stumbled back to his hotel room...where I promptly passed out on the bed and he spent the night praying to the porcelain god.

When I awoke the next morning, I felt a) terribly hungover and b) mortified.  I had no idea how M was going to act about all this, or if we would spend the whole next week being completely awkward around each other and ruin the vacation for everyone.  We ended up being cool about it, and then the unexpected happened: after dinner on the second night (a totally sober one since most of us couldn't handle the thought of more booze yet) M asked me if I wanted to come back to his room again.  We fooled around some more, and with consensual faculties intact we ended up having sex.  We had a brief conversation where we agreed that, since I was headed to Toronto in six months, this would be a no-strings-attached situation and we'd just have fun for the next little while without worrying about the future.

Now ladies.  We ALL know how well most women are able to compartmentalize our feelings, and remain completely emotionally detached from a guy that we've been pining over for the better part of four years.  I was pretty sure I couldn't do it, and yet threw myself into the situation anyway knowing that heartbreak was coming in six short months.  M and I went on some dates, watched a lot of Battlestar Galactica, and did the naked tango on the regular for a few months, but never discussed the inevitable.  It was destined to be a bad situation.

And then M got shot.

 

I'm totally resisting my urge to leave you with a cliffhanger right now.

One day in March, after we'd been "dating" for about three months, M went to a shooting range with a couple of buddies who are in the army.  He's a bit of a military enthusiast and though he doesn't own a gun, he'd gone shooting before and is apparently a pretty good shot, so I had no reason to worry.  No reason, that is, until two of his friends showed up at my office to tell me that M had had a small accident at the range and was in the hospital.  One of those fuckers actually said to me, "He's fine, he just needs a few stitches.  You should call him now."  So I, a bit freaked out but reassured that he was OK, called his phone.

A clearly drug-enhanced M answered and when I asked what happened, he slurred: "Don't worry, baby.  The bullet went right through."

I halted, then glanced at "it's just stitches" guy (who looked sheepish).  "The bullet went right through what, M?"

"My leg."

I resisted the urge to punch "it's just stitches" guy and told M I was on my way to meet him at the hospital.  The full story, as I would later learn, was this: after firing a bunch of rounds, M had gone to put the gun back in the holster he was wearing on his hip.  As it was a chilly day, he was also wearing a big fleecy sweatshirt, the kind that has elastic loops at the bottom to cinch it tighter.  One of the loops caught around the trigger as he was pushing the gun down into the holster, and BAM!  The gun fired.  The bullet entered the top outside of his calf, travelled between his tibia and fibula (I'll just give you a second to absorb how absolutely miniscule the chance of that happening was, as opposed to shattering one of his leg bones) and exited on the inside of his leg, just above his ankle.  (Note: for those of you shouting "why wasn't the safety on??" I'll explain as best I can, since I know nothing about firearms, that this type of gun doesn't have a safety as such.  Rather, the pull load on the trigger is so heavy that it by itself is deemed impossible to fire accidentally.  To which I say a big fat HAH!)

The result of having your casual sex partner who you secretly have genuine feelings for get shot is going to be one of two things: either you're going to cut and run because hospitals and surgeries = scary, or it's going to bring you closer together, and damn fast.  In our case, it was obviously the latter.  I quickly leaped into "serious girlfriend" mode, spending days at the hospital while M went through numerous surgeries to release the pressure that was building inside his calf and then do a skin graft to sew it all back up again.  (Warning: graphic content but if you are curious this is the surgery he had and yes, his leg looked almost exactly like those pictures.  It's still a pretty heinous scar.)  It was only after meeting his mom and dad for the first time in a hospital room (fun times!) that it occurred to me that maybe I should ask M for his thoughts on having me around so much and whether or not it was something he actually wanted.  Lucky for both of us, he did.  (Although I did have a laugh later when he told me that, immediately after the gunshot while he was still on the ground being attended to by the range safety officer, he had been asked if he had a wife or girlfriend or anyone who should be notified.  He says that he was verging on answering "it's complicated..." but then just went with "yeah, call my girlfriend".)

M and I were pretty much inseparable during his recuperation, which took several months.  Although his mom had come to town to stay with him and help him out, I headed over to his place after work pretty much every day.  My move to Toronto was looming, but with everything that was going on we still hadn't talked about what was going to happen.  We'd been through so much together that I couldn't imagine splitting up.  I wondered if our planned breakup still stood.  Finally one day I got the courage to ask him what he wanted to do about it, and we agreed to give long distance a try.  Shortly thereafter he proposed, and found himself a position in Toronto and moved to join me.

And that, my friends, is the story of our relationship.  The way I figure it, the moral of the story kind of depends on your frame of mind.  If you're a hopeless romantic, it's this: that true love will eventually win out, no matter how bad your timing and how many obstacles you face.  And if you're a cynic, it's this: don't play with guns.  You might end up shot.  Or worse...married.