the crazy time

After transfer I was feeling quite optimistic. I think of the embryos more as little seeds settling into some nice fertile soil. My husband is very, very optimistic which is wonderful. The microscopic nature of all this is very odd. I walk around thinking about the extra cells in my body, but hey, I've got tons of cells of all sorts, many of whom I'm probably completely unaware of. But now I'm thinking about some little bitty cells and their growth. It's pretty cool but remains entirely abstract.

This morning I woke up feeling much less optimistic, basically because it's so mysterious and there is nothing to feel physically. Also because I had bad dreams about my job and I don't want them to get at my psyche.

The lesson I think I have learned so far is that all of this is not a personal failing. In Buddhism and yoga we work so hard on non-attachment and infertility (or a life-threatening illness) are crazy times to try out these life lessons. So many of the patients at the IF clinic look incredibly miserable and stressed out, no sense of humor when I proposed that we just sit on eachother's laps when there's a line at the blood draw station. We could do a little Shiva reenactment with arms going out both sides and blood. But no, they pretty much don't talk and don't laugh and often look white as sheets or really, really unhappy.

I'm not trying to make light of the situation and I will be very upset if this doesn't work out but somehow the craziness of this process and my job combined have pushed me beyond taking the universe personally. It is just not feasible that all of this insanity can be linked to my personal failings - and in a weird way if all of it can't then maybe none of it can.

I'm a very impatient person, the kind of person who drives you nuts fidgeting and wriggling when told to wait, (this is why I HAVE to do yoga or I would be truly nuts) so this time of waiting is very, very challenging and scary and strange.

But I do love thinking of little seeds slowly growing in the dark AND there are no raccoons in my womb!

p.s. I'm a blogging nincompoop - I don't know how to post my email or how to organize my archives by subject. Any hints?

quick update

Three embryos transferred, everything seemed to go quite smoothly. Did yoga before and acupuncture afterwards WITH the anji cd recommended by mc downunder. Then went and ate falafel.

My husband is very optimistic, I'm baffled that this is even possible. It's an amazing process.

They gave us pictures of the embryos, 1 perfect 8-celled, 1 slightly less perfect 8-celled and 1 slightly less perfect 7-celled. We are worried about triplets but this is what the doctors thought would be best.

Interesting things about the process
- the entire quantity injected into me today was less than 1/250th of a teaspoon
- when they flush out the eggs they use a solution that is just like the fluid in the ovaries
- after transfer the embryologist takes the catheter back to the lab to make sure they all got out! (she has to look under a microscope).
- they did all get out and then I lay around with a full bladder for a while.

This is really fascinating stuff - I'm just amazed at the whole process and that it can work.

Thank you all so much for the good wishes, I'll post more later.

insta-Catholic?

Of the 17 eggs, 14 fertilized. 7 with ICSI, 7 the regular way. I am now the proud but virtual parent of 14 potential children. It boggles the mind. They are freezing 6 today and will do a transfer on Saturday morning of 2-3. I'm leaning towards 2 but I'll see what the Dr says.

I was very worried but I think this is excellent news.

Egg McMuffin

So what is the biological reason for nerve endings in the ovaries? My egg retrieval was excruciatingly painful and it still hurts. Needless to say I came home, fell asleep, woke up and ate lots of cookies and missed yoga. Very bloated and sore.

They retrieved 18 eggs, one broke, so they have 17. As the RE was poking my ovaries the lab people were yelling through a little hole in the wall, "we've got 8, we've got 10" and so forth. The lab person told me afterwards that she's always tempted to ask "do you want fries with that?" but I guess most people wouldn't find that funny.

So one scrambled, 17 whole, no fries and hold the cramps, please.

They'll call tomorrow with a fertilization report. Thanks again for all the nice comments! You guys are wonderful.

smooth dart-like motion

After some discussion of what this actually meant, I went to the bathroom and stuck the needle deep into my flesh. It hurt less than all those subcutaneous ones, and went in like butter. I guess for some reason I thought my flesh was more resilient. Anyhow, IM shot was no big deal. Only little mess-up was the poorly timed sex which was today not yesterday so now I'm worried the little spermies won't be so robust on Weds morning but such is life.

I feel like I'm toting billiard balls in my pelvis and I'm really tired but so far so good.

Retrieval tomorrow morning. I'm hoping I can function by the afternoon. They said no driving for 24 hours. Can any of you pros tell me if I can teach a yoga class about 8 hours after retrieval, I don't need to move around a lot, just be coherent.

thanks for all the nice comments!

hooked on narrative

Since last November or so I've been reading IF blogs. In this time I've read a lot fewer novels and become completely hooked on the narratives out there. Plot twists at every turn. I get very sad when people go through utter nonsense and seem stuck in some kind of crazy drug hell and I get all weepy when the one little embryo transferred makes it. Some other bloggers have commented that they get a little worn-out by reading all the drama. I love it. Sorry. I'm just a sucker for narrative. So when I started writing I assumed there would be others like me reading and who are thinking, just give us the gory details, we want the plot!

So the little IVF plot is intramuscular HCG tonight, but only half the dosage. My first IM shot. I now have two cute circles drawn by the nurse on my upper butt. My husband said no way for the shots which is fine. Why make it unpleasant for both of us? Retrieval on Wednesday morning and if all goes well, this is where I start to get nervous, transfer on Saturday or Monday. I can't tell you how many follicles there are, I didn't ask but there seem to be plenty and plenty of large ones. All doctors keep saying "very good." Which I guess is an A- so that's good.

Cue the plot-thickening soundtrack....

signs?

There's been some discussion about signs and signals and chances of fertility and everything working - good omens and so forth. Last summer, while I was in Switzerland, two storks flew over my head but I didn't get pregnant. I've rubbed pregnant bellies, held babies, had IUIs on special days, gotten sperm prayers, have a baby milagro, burnt candles, saw baby-shaped clouds and so forth. I've also faced more unluckiness in other aspects of my life than most people have to deal with so the law of averages should make me...fertile! Har. So as I go on with IVF, still on stims, here are my most recent signs that this will work:

1. The on-screen presence of Sandra Bullock in Crash gave my husband terrible gas, or so he claims. (His Qi is flowing and his sperm count will go up after all the digestive excitement).
2. On my way to my ultrasound today, all of which is indirectly linked to my husband's lowish sperm count, I got to hear the governor of Illinois talk about "testicular virility." (why can't we say balls any more?)
3. For the third night in a row the raccoons have neatly dug up my pea plants. I have now surrounded the plants with a concoction of chipotle peppers. (tender young life will grow despite the evil forces of the masked bandits)
4. I now have a mysterious bruise on my abdomen that sort of looks like a green heart. (it's a love vibe from my uterus)
5. I cannot imagine how my job situation could be any worse. (this is good, now I can obsess about something that's not IF)
6. The new Star Wars movie seems to be about the revenge of the cysts. (but I think it's fiction so in real life they won't win)

This sign business is for the birds. Seriously, why have I believed in it all my life? Now that I am older and wiser I just don't see how good things come in three or bad things do or rainbows come after rain, etc. It seems completely random out there in the universe. Or maybe I just don't have the right equations to figure it all out BUT I thought all this meant I would get pregnant. Otherwise how can I bear to go to the movies with an audibly farting person, I just can't sacrifice any more unless it's going to get me some good karma!

leave my peas in peace you scavengers!

IF, it's everywhere

I do love the woman who draws my blood - some months we spend more time together than I do with my closest friends. We see eachother early in the morning, on weekends, through good times and bad. I've been going to this clinic for a good year and a half so we've had some nice conversations over the vials.

Today she finally told me her child (now a teenager) was born after 8 years of trying and IVF. Wow. And now she draws our blood. During those many years she was trying to get pregnant she worked the same job in OBgyn - in delivery. Unbelievable. I would have cracked I think.

There are some pretty amazing women out there.

where's the karma?

I'm doing my first IVF cycle. I'm supposed to take care of myself and avoid stress. Why isn't the universe cooperating? I'm facing crazy personal stress at work. This would not be the week to sneak into my office and leave weirdly accusatory letters now would it? And if I had known there was going to be covert character assault would I have left the notepad by my phone with those oh-so-revealing words??? "Gonal-F" followed by dollar signs. (I have an office with a door that locks and people in charge never enter it, usually).

Maybe they have no idea what that means - does the general public know a fertility drug when they see it? Why couldn't they wait for some other month to really pick on me?

Why isn't the universe helping me to RELAX? What kind of craziness is this?

Although I have to say, I love my clinic even more, when I burst into tears after all this the blood technician started ranting in my favor and giving me legal advice. Yay! someone is on my side but I sure have to pay a lot for the sympathy.

Good news is that the RE said everything looked "very good" my estrogen is at 128 (I don't know what that means) there are plenty of follicles and the lining is where it's supposed to be. I go back for an ultrasound - and professional sympathy on Thursday.

how'd they find me?

So I've heard the tales of infertiles getting Similac coupons in the mail and so forth. Today I received a letter, "Your name has been carefully selected to take part in this critical national referendum on......", now there are a lot of national referenda about which I have something to say, but overpopulation? I'm sorry, I'm sorry. I want to have a baby and I'm guilty as charged.

Should I put the free overpopulation magnet on my fridge? The part that baffles me is that we are getting overpopulated because of "births, teenage and unplanned pregnancies, internal and external immigration..." Are teenage and unplanned pregnancies somehow not births? And what about the overly planned pregnancy? I guess I just can't tell where these people lie on the political spectrum. I'll keep giving my $ to Planned Parenthood for the time being.

day 3 of stims

I'm up to 3 shots a day - tired of all the poking. Tomorrow I go in for the first real ultrasound - this seems to all be going at a snail's pace. I've done IUI with injectables but somehow this is different. It's like I'm already preparing myself for the end what with thinking about adoption and looking at horses. Want to hang out with childfree people? Many of them are at the stables. They have horses and sporty cars and they are couples who do things TOGETHER like owning a horse and going on trips. But I'm thinking a couple who can be with their horse 4x a week just doesn't have kids at home. Or they have kids with NO after-school activities whatsoever which frankly is non-existent in the my overachieving neck of the woods.

If I psych myself out for failure and then the IVF works will it be more like a real oops pregnancy? Or should I sit and do lots and lots of positive visualization with those moxa sticks and my belly? It's all so abstract and future-oriented. Where is the "be here now" of IVF? The Ram Dass of the hypodermic syringe? The present-mindedness of the subcutaneous shot?

Do you wake up in the morning and embrace your shot-mindedness? Or does it just make you crabby?

Someone should write a book on this. The spirituality of IVF (see Internal Spring's recent Buddha post for more on this).

Whether you go to church or meditate at home, how does spirituality enter into your dealings with ART? not the morality or culture per se but rather your own feelings about being in the process and being a spiritual being.

OR............

which one?

IVFperiod

my first period on Lupron - I forgot about those periods that are traumatic events. After many years of nonchalance I have now suffered a bout of public bleeding (not spotting) other people SAW that I was on my period and I'm a grown woman - this is insane. It's like being a teenager again except without all the heavy petting. I don't know if this is typical but it's pretty wacky for me.

the red sea.

another book review

When I first tried to find out why I wasn't getting pregnant, we were told it was unexplained. I had all the right plumbing and hormones. Time went by. Then they decided our diagnosis was male factor, sometimes my husband's sperm count is very low, sometimes it's just lowish. He went to the man-doctor who said no varicocele one time, yes varicocele the other time. Whatever. Not a solution for us. My man has contributed much in his ongoing hot affair with the plastic cup but that was it. I won't bore you with the list of everything, but I have taken oral drugs, injectibles, have had my cervix poked through at least 11 times, have probably had a gazillion ultrasounds, etc. This despite there being nothing wrong with me. They eventually found a polyp but that can't explain 3 ½ years of infertility.

I am a feminist – this whole business struck me as extremely sexist. Why attack me and my poor cervix? Why is ALL of the high-tech stuff focused on MY body? and why do I continue to go along with it?

So here's another book review. Don't be scared by the title, it's a very intellectual book and the depressing parts are not about failure but have to do with feminism and identity (and perhaps the author's use of words that make me feel tired, "liminal" "material-discursive" "normative" "discourses of gender," etc.). Anyhow…

When IVF Fails: Feminism, infertility and the negotiation of normality by Karen Throsby

This is a British book by a sociologist which caught my eye. Her basic premise is that IVF represents the meeting of nature and technology. When it works, nature is helped. However, when it doesn't work is basically not discussed, seen as the woman's fault, framed as baby consumerism, and that is when the meeting of nature and technology gets very problematic. The first IVF baby was by no means the first IVF attempt, I didn't know that. It took a lot of tries. Even the term IVF is a misnomer in her analysis since it is only about "fertilization." Which as we all know is a key component but fertilization ≠ baby in hand. She writes: "the term IVF, in centering on the moment of fertilisation, fails to even hint at the full process of engaging with the technology" (11).

Throsby writes: "The image is one of the natural order restored and rests heavily on the assumption of the naturalness of reproduction, particularly for women, and the understanding of science as progressive and capable of comprehending and controlling human reproduction." (2). But what happens to that natural order when there is no baby? That's why she chose to interview couples for whom IVF had "failed" in one way or another.

I liked the author's own definition of infertility "the active but frustrated desire for a biologically related child" (14). When couples choose to stop IVF they are not removing the desire, they are just changing their actions. Infertility as desire never goes away. However, by having gone through IVF, couples can prove to society that they are normal, that they do indeed have the desire for children and have done everything they can. She presents it as a damned if you do, damned if you don't scenario. I feel that is still very much how people react – I want children (socially acceptable female behavior), I am over 35 and desperately want children or am a lesbian who wants children (socially questioned female behavior). Our desires as women are thus always secondary to gender or social norms.

It's a long and wordy book but the key arguments are very interesting to me. Her discussions of finances and adoption are coming out of a British context where the NHS exists and where, according to her, domestic adoptions are rare and difficult (I didn't know that).

Throsby's conclusion is that IVF is a form of women's work and should be seen as such. It is not just about fertilization or the embryo. It is about women's bodies yet the woman's body disappears from the entire discourse. She analyzes fertility clinic brochures which always juxtapose cute baby – nature - with white lab coats - technology.

Basically, her conclusion is that this whole process will continue to be very, very hard on women as long as we are entrenched in the gender stereotypes that govern the entire discourse surrounding reproduction. I, for one, don't see this changing AT ALL in the US in our current political climate where embryo rights are far more important than women's rights but one can dream of the day when society will change.

I think she's on the right track – I would like to see a version of this in layman's terms or in the popular press. Her points are excellent.

P.S. I just looked up the author and see she has written a lot on the topic - I've got to read this one!..."'Vials, ampoules and a bucketful of syringes': the experience of the self-administration of hormonal drugs in IVF" Karen Throsby (2002) Feminist Review 72: 62-77

ooh baby horses!

I get to see foals frolicking when I drive in to work - they are so adorable that I blurted out to my friend, "I don't want a baby, I want a foal!" They are so graceful and they can walk! human babies look kind of lumpy in comparison.

So imagine my delight when I learned today that my clinic's embryologist raises Arabians. Maybe I will get a foal-baby. It just warms my heart to know the scientist in charge loves horses.

All systems go. Drugs are on their way, big shots start on Saturday.

time for book reviews!

In the spirit of taking charge I got several books on infertility – a few quite academic and then some more popular press – I'll try to post reviews as I get through them in the hopes that this might be useful for someone.

So this week I got through two.
First – The Infertility Survival Handbook
by Elizabeth Swire-Falker
This is a very informative and friendly book but a little too "lite" for my liking. She covers all the basics, especially about IVF. She eventually adopted and wished that she had done it much, much earlier and also addresses choosing a child-free life. This would be a great book for someone who had no idea what they were going to go through with ART. Since I've been at this for a while, however, I don't know if it would be my first choice. I found out most of what she talks about on blogs and her conversational, chatty tone made me a little impatient. This would be a great gift for someone who was facing infertility and maybe who didn't have anyone to talk to and/or was uncomfortable talking about the nitty-gritty details. It's more like chick lit than like science but her heart is definitely in the right place and her information is very good.

Second – Infertility and Identity by Devaraux and Hammerman
This book is written for therapists who have to deal with infertile clients. The tone is thus much more academic. I really liked this book even though I am not a therapist and don't wish to replace my therapist. Their investigation and understanding of the scope of infertility and its consequences is thorough, kind and far-reaching. The first idea they raise is to get clients to think beyond infertility as identity, to remember they are much more than that. "…the primary objective of our model is to help clients stop labelling themselves as infertile and integrate the experience of infertility into their whole being, along with all other aspects of their identity"(12). This is scary stuff for some of us but also wisdom with which many veteran bloggers would probably agree. I found myself quite moved by the proposition, even though it seems rather simple. The book emphasizes that therapists need to know about any specific concerns like a history of abuse, addiction, cultural or religious issues, etc. The authors constantly remind therapists that every single situation is different. On this point they also insist that infertile therapists may not make the best therapists for infertile patients because, although sympathetic, they can be blinded by their experience and think it's the ONLY experience of infertility. I say amen to that as well. There really is a wealth of information in this book but it is in clinical-speak so you have to pay attention. At the end of the book they address concerns I had never really thought about, concerns about how infertility never really goes away (another theme we've seen on many blogs). The authors raise issues of how an adoptive couple will deal with their adopted daughter's pregnancy (bet you hadn't thought of that one but it's going to be weird), how people who have accepted and embraced childfree life can be completely thrown off by an unexpected pregnancy, and how deaths and tragedies throughout life will resurrect the grief of infertility and infertility will thus color many life experiences. These authors have thought through so many of the issues – get your therapists to read this book or pick it up yourself if you want a serious read.

tomorrow - baseline ultrasound and writing the big IVF check... here we go!

how to feel?

Darling Hashai (hashai.com/blog) just wrote about not knowing how to feel and she's just finished IVF and it didn't work.

I dread being in that final "not knowing how to feel" situation but I think that it is only one of many in our strange adventures.

I've been trying to educate myself on what I'm going through. Many books talk about the grieving of infertility. I for one am pretty bad at grieving and also am not so sure about the emotional effects of grieving on a regular 28 day cycle. I am just now starting my first IVF cycle after 3 1/2 years of trying to get pregnant.

How do I feel? How should I feel? are the questions that haunt me on a daily basis.

In the early years of infertility (with a little help from that bad drug, Clomid) - I felt rage, jealousy, anger and bitterness at the unfairness of it all. There were often times I felt complete despair and sadness but I must say that these were always brought on by infertility + something else that's awful. So bad day at work + period = massive sobbing. Or family drama + rude people + bad weather + negative stick = sad, sad, sad.

I must say that just infertility alone does not make me sad per se. It's a weirder, less definite feeling. Sometimes there's relief mixed in, or anticipation, or obsession, or a sense of being resigned. The infertility feelings can fluctuate within seconds, like a little stream.

Now that we're starting IVF I'm very afraid of more situations where I don't know how or what to feel. The drugs make me crabby and a little depressed, the possibility of actually getting pregnant makes me VERY excited, the anticipation that we will have to give this all up makes me actually feel peaceful, the poking and prodding of my body makes me feeled used and violated, the love of my husband makes me feel like my life is really much better than I ever thought it would be.

When I tell people about this cycle, I realize over and over again that no one knows how to feel. A very dear friend (who loves children) reacts in a "I could never do that" sort of way. My mother thinks this is great and will all work. My IF friends are cautious. Some members of my family really don't want to know, others have told me they pray special sperm prayers for us.

IVF brings out odd reactions in the general public - and IVF brings out odd reactions for those of us going through it who really get lost in the process.

How to feel? it's very odd - I don't know what to compare it to. It's both like gambling and mourning and jumping off a cliff and quietly measuring meds day after day - what is all of this?

My quandary is that I have two distinct tendencies both of which are reinforced by others. My acupuncturist says take this time to relax, be happy, enjoy life, be in a really good space. So I feel like protecting myself, like ignoring work, planting more flowers, planning to read lots of novels, doing restorative yoga - basically checking out.

My therapist actually suggested that this could be a very cathartic time because my emotions will be on the surface so I could go through powerful grieving over other family stuff, face my past, delve into the depths of my own personal sadness and complexity. And I think this is the time to do more creative writing, to think about what's really important in life, to reconnect with people who were important to me, to make myself entirely vulnerable to the world - since I will be that anyhow.

I'm afraid that I'll wake up and do #2 and by lunch do #1 and by the end of the month still not know how I feel about all of this.

how to survive an IVF cycle

According to the Infertility Guide or some such title it is good to start a little care package for yourself while going through this month of shots and emotional stress.

they suggest:
some fun movies - I got all of the 10 Commandments (The Decalogue) by Kieslowski
light reading, magazines - I've got the Nation and New York Review of Books
fun bath oil, pampering goods - I've got needles and alcohol swabs
special treats - I've got some good olives
spa appointments - I'm taking my cat for her shots

something tells me I'm just not girly enough for this crap
can one get pregnant without chick flicks, chick lit, face masks and sparkly toenail polish?

real real parents

I am a step-parent and I have been for 5 years. The kids are basically with us half the time so that's a lot of kid time. When I met them they were just hitting adolescence so it was kind of like go straight to teenage life without collecting $200 or getting to squeeze a toddler. I grew up with a step-parent so I have very clear ideas about what matters in this kind of situation.

They need as much love, attention and respect as possible from as many adults as possible. My step-parent was pretty aloof, I try to be very engaged.

And they need to eat lots of fruits and vegetables and learn how to travel and learn about music and be exposed to different ways of living and play in nature and learn to be courageous in our world.

One thing that is very strange is that their mother is completely threatened by me - I say strange because I don't make them call me anything mom-like and I relish being step and not regular mom. I have a completely different role, and frankly, it's a good one. I do not wish to replace, I couldn't replace her but then again she couldn't bring to their lives all that I do. It's cumulative in all ways, more love, more listening, more perspectives on life, more attention.

So I was reading some of Karen's thoughts (at the Naked Ovary) and reflecting on the most recent fiascos with "real mom." I'm a parent and the kids know it. They never refer to any other parent as being more "real." But their insecure mother does all the time. And frankly I worry about the kids getting the message that she is afraid they don't love her enough.

Perhaps the great thing about being an adoptive or step-parent is that we know we love our kids and they know we love them because the reason we are here with them has nothing to do with biology and everything to do with choosing to love. I don't know if this is coming out right. But there is something to be said for kids seeing adults making a real effort to be with them and to be engaged when they're with them.

Any thoughts?

lupron

excerpts from an infertile's notebook

1. first day of Lupron, IVF looming on the horizon
2. my brother now knows his wife is having a boy in August...wonder when he's actually going to tell me about the pregnancy?
3. who should I tell about the IVF cycle?
3a. pro - provides many more opportunities for bingo (see Akeeyu's site)
3b. con - provides many more opportunities for bingo

any advice? I would love the sympathy about the shots, the extraterrestial probes, the stress, HOWEVER, I don't really want long-distance monitoring by my often oblivious family.

For the time being I've been vague - and even in the vague conversations I've been getting lots of bingos.

coming soon.... book review of Infertility and Identity