A "maybe" is worse than a "no."

Here is something I did not know: an unequivocal negative is easier than an ambiguous positive.

To women who've never had a positive pregnancy test, that will seem like the rankest heresy. In unison: "At least you know you can get pregnant."

Now let's try it in a round, to the tune of "Row, Row, Row Your Boat."

Great! Next let's break it down old skool-stylee.

Wait, that last was a really bad idea.

The truth is that I do have the knowledge that I can get pregnant, but it's not the comfort you might think it is, because I also have the knowledge that I can lose it. I can be happy, the happiest I've been in my life — and that happiness can be yanked away unceremoniously in the space of thirty seconds.

(Perhaps it's crass of me to mention money, but I must point out that it particularly stings when you spend $11,000 getting happy...and they still charge you a co-pay when that happiness is shattered. My most recent D&C cost me more than a live birth would have. But I'm not bitter.)

It's oddly soothing to know that's not at stake this time. This time, I can go on a valedictory vodka bender, cry until I look like Marty Feldman, and know it's over. Then, somehow, I'll just manage to scrape myself off the floor to pursue plan B.

08:14 AM in I've learned a lot...but I'm not sure it's worth it., Welcome to the bad place. Population: You | Permalink | Comments (6)


Exquisite understatement

The IVF process can be emotionally stressful, frustrating, confusing, and sometimes a great disappointment.

          — the handbook my clinic gives out to new IVF patients

12:32 AM in I've learned a lot...but I'm not sure it's worth it. | Permalink | Comments (0)


Great Wall

I've been thinking a lot about adoption in the last couple of days, thanks entirely to Dawn's extraordinary journal. It should be required reading for anyone who labors under the misconception that adoption is an easy avenue to becoming a parent. It should be required reading for anyone with a soul, in fact, but your soul is your own business so I can't really insist.

However. I have been thinking about adoption.

So much so, in fact, that last night I dreamed Paul and I went to China.

I have always wanted to go to China. My top two priorities:

  1. See the Great Wall in many different places so that I can marvel at the different construction methods and materials used in each region
  2. Stare at the mountains, which I am told actually do look the way they're portrayed in classical paintings
(I am a fascinating travel companion. Oh, yes.)

It's no surprise, then, that my dream prominently featured those cuttlebone mountains and the Great Wall. It also featured a visit to an orphanage and the acquisition of a tiny, solemn-faced daughter.

In my waking mind, adoption is a distant possibility, one to consider when I feel we've exhausted our other options (or exhausted my body, anyway). My dreaming mind clearly has other ideas.

The dream was worth it alone for the startling spectacle of Paul in proletariat blue, riding a rickety bicycle toward the Forbidden City.

10:54 AM in I've learned a lot...but I'm not sure it's worth it. | Permalink | Comments (5)


Pollyanna: Twisted bitch

If all my friends are giving birth now, neatly coinciding with my first due date...

...it means that at least they won't be giving birth during the second week in March, my second.

Who says I'm not a cock-eyed optimist?

03:24 PM in I've learned a lot...but I'm not sure it's worth it. | Permalink | Comments (4)


XXX libris

So I was thinking today about the naked lady magazines that are an inevitable feature of any clinic's "collection room." (I guess that's a nicer term than "wankatorium.")

I was wondering exactly whose job it is to select the visual aids. Are they chosen by someone with relatively cosmopolitan tastes, or by someone who picks them up gingerly by a corner, making a moue of displeasure? Is there some general medical consensus about which topics should be covered, or is it entirely an aesthetic decision on the part of the hapless curator?

Do they send the lowest-ranking staff member to that skeevy adult bookstore out by the airport? Do they keep petty cash on hand for just such occasions, or does the employee have to fill out an elaborate request for reimbursement? Description: January 2004 Manholes. Purpose: Client entertainment.

Or does the office simply maintain yearly subscriptions to an array of quality periodicals? Does the postman do a double-take when he sorts the daily mail and finds this month's Juggs nestled coyly beside this month's Breastfeeding Outlook? Who's in charge of sending in the card that says, "YES! Please send me 12 jam-packed issues of discreet, efficient masturbatory inspiration!"?

I know nothing of my own clinic's literature holdings. I keep meaning to send Paul in with a pad and pen so he can make me a list. The only helpful information he has volunteered so far is the intriguing fact that on the very top of the stack rests a pristine and current copy of The Journal of Light Construction.

04:03 PM in I've learned a lot...but I'm not sure it's worth it. | Permalink | Comments (12)


For the record

Among the photocopied pages from my file is the psychological evaluation the state requires before a couple undergoes IVF. I should note that said evaluation was performed by one of the cadre of skilled and caring mental health professionals getupgrrl captures brilliantly, velveteen and all.

I will treat you to some highlights from the report, with my comments:

[Julie and Paul] cite major ambivalence about having a child as their reason for wanting to significantly limit the number of embryos put back... A year later, I now invite my doctors to reinstall as many embryos as my body can manage to make. I don't really lose sleep these days over the possiblility of high-order multiples.

They report they currently have a nice lifestyle and are not 100 percent convinced that they desire to be parents... I felt it would be dishonest not to acknowledge some reservations about the ways our life would change. We do have a comfortable life (I would never have said "lifestyle"), and children will change that drastically, in some ways for the worse. Funny, though — I never saw this as a sign of ambivalence, as the psychologist clearly did. I saw and see it more as a gesture toward pragmatism, and possibly a sign of our true commitment to having children, even though we know we'll be losing some of the things we love about our life together.

[Julie and Paul]...report a history of anxiety and depression which they seem to be managing quite well together as a team...They both deny low self-esteem...Both deny thoughts of death and suicidal ideation. No evidence of delusions or hallucinations. Oh. Good. Not delusional. Whew. And if you were looking for problems with my self-esteem, it's not low you'd need to worry about.

[Julie and Paul] are a couple coming to seek fertility treatment but with expressed ambivalence about the procedure... I think you'd have to be a nutjob fruitbat wingnut not to feel ambivalence about the procedure. They stick needles into your ovaries, for crying out loud.

They do have concerns about the new responsibilities of having a child. I think their ambivalence will enable them to accept the results of any negative outcome of this treatment. This bit near the end sent me into a rage last night, and I find myself getting sputtery about it again. Can you see why? Wait, I'll rephrase it to make the infuriating part obvious: Because they're not sure they want a child, they will breathe a sigh of relief if this voodoo shit doesn't work. First of all, we are sure we want a child, and recognizing that it won't all be moonlight, roses, and unsoiled fuzzy sleepers doesn't dull that desire. Second, I defy anyone to "accept" the "negative outcome of this treatment" — the many Gothic ways in which things have gone haywire for us this year — with anything but rage, anguish, and a feeling of powerlessness so profound that I can barely make myself pick up the phone to order the next round of drugs. If my "ambivalence" makes this easier, I'd hate to see how people with "delusions or hallucinations" about the romance of parenthood handle it.

07:40 AM in I've learned a lot...but I'm not sure it's worth it., The doctor is IN | Permalink | Comments (6)


A brief reproductive history of Christmas

Last year at Christmas we gave my family the news that we'd gotten married. We were on the schedule to do our first round of IVF in January. With a curious mix of optimism and pragmatism, we decided our families would handle the news of a pregnancy with greater enthusiasm if we were no longer, you know, living in sin.

On Christmas day my period arrived. In the pre-holiday shuffle I'd packed neither tampons nor ibuprofen, so I spent the bulk of the day in festive contortion with a giant wad of toilet tissue making the crotch of my trousers bulge most attractively. When we'd finally finished unwrapping the presents, I crept out to the nearest open gas station and bought a box of Tampax Slender Regular (the only flavor available) and about a dozen two-tablet pouches of Advil (the only denomination available).

This Christmas day was cycle day 14, and I ovulated right on schedule. But Paul and I spent the night in separate bedrooms, so unless some immaculate nookie took place that I don't know about it, I am not, at the moment, even remotely pregnant.

If you've ever had difficulty conceiving, you may be aware that there's a certain perverse comfort in knowing you're not pregnant. I don't even have to wonder. There's no urge to weigh my breasts judiciously in my hands on an hourly basis. I don't have to sneak into the second bathroom to plunder the Aladdin's cave of HPTs under the vanity. And I can worry that the twinges in my lower abdomen are the result of a grapefruit-sized fibroid instead of hoping that they're implantation cramping.

05:24 PM in I've learned a lot...but I'm not sure it's worth it. | Permalink | Comments (6)


"I'm sorry." And leave it at that.

Yesterday someone found this site by searching for the term:

appropriate response when a friend's IVF is unsuccessful

Thank you, anonymous searcher, for having the sense and kindness to know that there are appropriate things to say. (Contrast this with the preponderance of jackasses whose outpourings of wisdom resemble nothing so much as a broken sewer main.)

As a rule of thumb, I will say that funny hats and noisemakers are probably not in order.

But you may need more detail than that. Always eager to please, I will make a short list of some comments that might be appropriate:

  • "I'm so sorry."
  • "Oh, God, you must feel rotten. How are you holding up?"
  • "Do you want to talk about it?"
  • "FUCK. I was really hoping this would be the one!"
  • "What can I do to help? Cook you dinner? Take care of your pets for a few days while you're feeling low? Bring over a fifth and get you really, really shitfaced?"

And, ever the completist, I will list some comments that will not be helpful in the slightest:

  • "I know how you feel." No, you don't. You couldn't possibly, no matter how eager you are to share my burden. (Note: Even if you've been through several failed IVFs of your own, this is not the time to shift the conversation to yourself.)
  • "It just wasn't meant to be." Thanks for the help, Nostradamus. Now shut your couplet-spouting trap.
  • "You can always try again." You know what? At $15,000 a pop, maybe I can't.
  • "Maybe you should just accept the situation and move on." Hey, great idea! *smacking forehead* I'll just accept the situation. Why, as soon as I set my mind to it I'll be over my grief in a jiffy! I'll move on. Now why didn't I think of that? Who needs the worthless baggage of lifelong dreams, anyway? Thanks! I feel much better now.

I'm sure this has been helpful.

05:29 PM in I've learned a lot...but I'm not sure it's worth it. | Permalink | Comments (6)


Can't work. Too easy.

As I lie fretting in bed at night, every bit as insomniac as I am during an IVF cycle, I think of every one of the very good reasons this IUI can't work.

Low motililty.  Abysmal fertilization in the lab.  Iffy Fallopian tubes.  Theoretically bad eggs.  No suppression, so possible early ovulation.  And the crappiest attitude north, south, east, and west of the Pecos.

But those, I tell myself, can be overcome.  They have been overcome, at least for a very short time, once.  Those reasons are mere technicalities, easily dispensed with by telling myself firmly, "It happened before.  It can happen again."

However, there's one reason I can't wave away: This can't work because it's too easy.

A quick comparison reveals all.

IVF: At least 31 days of preparation before starting stims.
IUI: "Oh, hey, my period's here.  Now where'd I put that syringe?"

IVF: $10K and up, without meds.
IUI: $210.  Sometimes I spend more than that on my hair.

IVF: Three injections a day.
IUI: Just one little prick.  Uh.

IVF: Progesterone suppositories, laying waste to any unfortunate defenseless underpants in their path.
IUI: A well-regulated vagina, prim and oozeless.

It must feel different when you're going from Clomid to injectables, going one more step up the ladder toward expense and invasiveness, but when you're moving backward from IVF to IUI, an IUI seems like a goddamn cakewalk. 

How could something so easy possibly work?  How could I get pregnant without the most extreme intervention, the most esoteric manipulation, the most ruinous expense?  Although it worked last summer, it worked only after the suppression and the daily barrage of injections of a planned IVF — to say nothing of the grinding anxiety and panic as cancellation loomed large.

This can't work.  It's too easy.  No pain, no gain...right?

This kept me awake last night for at least an hour after I went to bed.  And then it occurred to me: Why worry that I'm not putting myself through enough when the hard stuff hasn't worked, either?

And then I slept like a Benadrylled baby.

10:30 AM in I've learned a lot...but I'm not sure it's worth it. | Permalink | Comments (18)


Take that, Fred Phelps

God loves gay people and I have proof.

My cousin J. is a middle-aged single man living in New York. The only people in the family to be surprised when he came out were his parents and my grandfather. (The other member of the oldest generation, my grandmother, took it with characteristic aplomb, but then I can't be sure she really understood what he meant. My grandmother is a shining exemplar of the power of peaceful denial.)

The rest of us sort of rolled our eyes and said, "Well, yeah, and...?"

J. is going to have a baby. He found a surrogate who lives in the Midwest, provided her with the necessary biological product — sorry, I can't really think about a family member's semen without cloaking it in several layers of protective euphemisms — and, voilà! 40 weeks later, he's going to be a father.

See how easy that was?

Now it's true that individual gay people are just as prone to infertility as breeders. (Get it? Infertility? Breeders? Hah? Hah?!) In fact, PCOS seems to be twice as common in lesbians. But in any given gay couple, what are the odds that both partners will be infertile?

If you're a lesbian with blocked tubes, your partner could still conceive a child. If you're a gay man with a low sperm count, it's probable that your partner has no such handicap. Let's face it, with two sets of ovaries at your disposal, you can afford to cherry-pick. With four testicles in play, your specimen cup runneth over.

In either case, you're still going to need to involve a third party, so the necessity for ART is a foregone conclusion. That third party is likely to be healthy and fertile — he or she wouldn't be in the running otherwise. And needing medical intervention of some kind doesn't exactly come as a shock when, you know, we're talking two men or two women.

Straight people in monogamous relationships don't have these advantages. First, you just have one set of each flavor of gonads. If my ovaries are tapped out, I can't really turn to my husband and ask him if I can borrow his. Second, the notion of turning to a person outside your partnership for help is an awkward one for many couples. Third, we're brought up to believe that any man and any woman can reproduce, and we grow up expecting we'll be no different.

Imagine our surprise and delight.

Now, according to the people who make my holiness their business, aren't straight married couples supposed to be favored by God? Aren't we supposed to receive all sorts of divine fringe benefits because of our unimpeachable piety? If God's so crazy about us hetero marrieds, shouldn't he be giving us the cosmic high-five every time we do it on cycle day 14 — or at least every time we turn, defeated, to infertility treatment?

But noooo. It's gay people who have the reproductive advantage!

The only conclusion I can draw from this is that God actually prefers gay couples. He loves them so much, He wants them to be fruitful and multiply. I just knew the homophobes were wrong.

Update: J.'s baby was born on January 27. Beautiful, beautiful family.

10:16 AM in I've learned a lot...but I'm not sure it's worth it. | Permalink | Comments (12)