15 weeks, C’s Birthday and SoCal IVF Clinics on the radio

Today marks 15 weeks along for this pregnancy. It feels good to be well out of the first trimester, but also a bit anticlimactic, since we know all too well that it doesn’t guarantee a healthy baby at the end.

This is one of those thoughts that I have frequently, but generally try to keep to myself so as not to bum everybody out. For example, last weekend, at a kid birthday party, I met another mom of a three-year-old. Shortly after establishing that we were both expecting babies this fall, she made a seemingly innocuous observation, “Isn’t pregnancy so much less stressful the second time around? The first time I was worried about everything, but this time, I just get to relax and enjoy it.”

I felt like I was in a sitcom where I can picture the outcome of either possible response:

“Well, actually, this is my fourth pregnancy; most recently, my daughter was stillborn at 41 weeks last July, so no, I don’t actually feel less stressed this time around.”

Um. Probably not the best way to make a new friend.

<<<SCREECH!!! Rewinding video footage…>>>

“Isn’t pregnancy so much less stressful the second time around?…”

“Mmm hmm. C. Samuel keeps us very busy this time around.”

It wasn’t technically a lie, but it also didn’t drop a giant shit on the day of someone who was just trying to make polite conversation at a kids’ party.

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In other news, C. Samuel turned 3 last week. Here are some obligatory cute pics from last weekend:

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Happy boy at his birthday party, wearing his “birthday hat”

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Riding his new bike on the boardwalk

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Sharing his toys with Jane on Memorial Day

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Lastly, while driving home today from Discount Tires, I got sucked into an episode of Reveal on my local public radio station, and ended up sitting in my carport for 40 minutes to hear the rest.

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I don’t understand why my tire blew out yesterday?! (C. took this pic of one of my ‘good’ tires, post blowout…)

The episode was about a highly suspicious IVF clinic in LA, and talked about the issue of inflating SART stats, in particular by putting in two or more embryos in young (under 35-years-old) moms without a prior history of failed IVF cycles.

The story certainly wasn’t perfect. (Most notably, I didn’t feel like they fully considered the financial pressures on couples that choose a multiple embryo transfer on their first try.) But it hit on several important ethical concerns that arise as a result of trying to sell services for something so emotionally-charged, expensive, and with such an uncertain outcome.

I also liked the fact that in the radio version (though not in the written article), they presented the head RE at our IVF clinic, Reproductive Partners, as a model of ethical practice (not that it applied to us, since we never made it transfer).

Here’s a written version of the story:

https://www.google.com/amp/s/www.revealnews.org/article/when-pregnancy-dreams-become-ivf-nightmares/amp/

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Spotting

Thanks to all of you who wrote reassuring comments. (Thanks to those of you who left empathetic “Oh, shit!” comments too! Validation of my feelings is always welcome!)

On Monday, I got a nice message from Dr. R (my obstetrician for Jane, and for this pregnancy):

Hi, K! Please pardon the delay, I have been out of the office. Usually, the very earliest we can definitively see a heartbeat is when the fetal pole measures at least 6 weeks (your fetal pole measured 5+4 weeks). So, things can be totally normal at this stage, the ultrasound was just a bit early. The good news is that there is a tiny fetal pole and a gestational sac which is exactly what we should see at this stage. Also, the gestational sac measured less than 2 cm. This is usually the cut off when we can visualize fetal cardiac motion. So, once again, probably too early. As far as I can tell, your hormones rose great when checked and you have a pregnancy in the right spot (the uterus and not an ectopic pregnancy). When I see you this week, if all is progressing well, we should see a heart beat then. This week will seem like forever for you, please keep the faith! See you soon! 🙂 Dr R.

Have I mentioned how much I love Dr. R? (Pretty sure I have, but it bears repeating!)

Unfortunately, as the title of this post suggests, I started spotting on Sunday. It’s not heavy, but it seems to be most noticeable in the evening – presumably when the progesterone from my suppositories starts wearing off – which I think can’t be a good sign. While I’ve spotted in my previous pregnancies (with C. Samuel, with Jane, and even with this pregnancy), it’s only been at 4.5-5 weeks.

So here I am, still waiting for Friday’s ultrasound, hoping that I’m wrong to think that this pregnancy is all but over…

 

Inconclusive ultrasound

Today, at 5 weeks 6 days, I went in for my ultrasound. More precisely, I raced from work to my ultrasound, where I arrived 3 minutes late. C was out of town for a meeting in NorCal, and was texting me to see when he should step out of his meeting to Facetime me…

They got me back into the room quickly, and when the nurse practitioner came in, she said it was fine to Facetime with C, and I called him up. She said that my blood tests had looked really good, and she wished for good news for us, since we “have had enough heartbreak.”

The good news:

  • We saw the gestational sac.
  • It is located in the uterus.
  • It measured at 5 weeks 4 days (within the error range of the measurement, according to our nurse practitioner).
  • We saw something resembling an embryo, which had something resembling a yolk sac, and something resembling a fetal pole, which measured at about 5 weeks 5 days.

The less-than-good news:

  • We did not see a heartbeat. Our NP prepared us for this even before she went in, so we know it doesn’t mean anything…but with C. Samuel we saw the heartbeat at 5 weeks 5 days, and we would really have liked to see it today.
  • More alarming was the nurse’s demeanor. She clearly didn’t like the appearance of the embryo, saying “I would like to see it more defined at this stage.” She reassured us that “I have seen pregnancies that looked like this at this stage, and then developed into healthy pregnancies,” which, frankly, wasn’t very reassuring at all.
  • Ultimately, she gave us 50:50 odds that this pregnancy would progress.

So now we wait until next Friday, praying that this coin flip goes our way…

There Is No Good Card for This

This morning on my drive to work, I heard an interview with Emily McDowell on NPR. If you haven’t heard of her amazing Empathy Cards, stop reading right now and go check them out!

Seriously, I’ll wait.

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After I lost Jane, a coworker sent me this card:

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I went straight to emilymcdowell.com and ordered 20 cards the same day.

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I didn’t even realize until this morning that she has an infertility card too! (Although many of her other designs would also be perfect for infertility, pregnancy loss, or a whole bunch of other shitty things…)

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Anyway, the reason for the interview was that she just coauthored a book, titled – wait for it – “There Is No Good Card for This: What to Do When Life is Scary, Awful, and Unfair to the People You Love.”

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I live with my foot permanently wedged in my mouth, and have lamented the fact that I have been/would be pretty worthless at comforting a friend in the way my amazing friends (including several who read this blog) did for me.

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I just added this book to my Amazon cart. Can’t wait!

Well, fuck!

That’s what I said when I read my most recent email from Dr. Y’s nurse:

“YOU DAY 3 LAB WORK CAME BACK AND THE RESULTS SHOW AND ELEVATED FSH AND THE AMH IS LESS THATN 0.03. IT WOULD BE BEST IF YOU CAME IN AND HAD AN APPOINTMENT WITH DR Y. I WILL NOT HAVE ANY APPOINTMENTS UNTIL AFTER YOU RETURN FROM EUROPE. PLEASE CALL ME AT xxx-xxx–xxxx SO THAT WE CAN SCHEDULE AN APPOINTMENT”

Yes, she writes her emails all in caps like that, as if I needed any more reason to feel alarmed.

My AMH is less than 0.03. I didn’t know the test measured amounts that low.

In what feels like another lifetime, I once wrote a long post about what AMH (and FSH and estradiol) mean for fertility.

Here’s a summary of my results the four times I’ve taken these tests. Prior to yesterday, 0.17 ng/mL was the lowest AMH of anyone I know in real life (including my Resolve support group).

  1/26/13 5/4/13 4/24/15 10/8/16
estradiol (E2) 24.6 pg/mL 27.2 pg/mL 23 pg/mL 20 pg/mL
follicle stimulating hormone (FSH) 13.7 mIU/mL 13.5 mIU/mL 9.7 mIU/mL 17.7 mIU/mL
anti-Mullerian hormone (AMH) 0.17 ng/mL 0.22 ng/mL 0.31 ng/mL <0.03 ng/mL

 

I’m feeling pretty hopeless at the moment.

At least I get to go to Rome on Sunday.

Family reunion

Sorry for being a bad bloggy friend this last week. I just got back from my family reunion in Colorado. My dad’s side of the family has a reunion in the mountains of Colorado every 3 years. This year, 65 of us – all direct descendants of my 90-year-old grandmother – made it to the YMCA of the Rockies in Estes Park.

This was my first post-infertility reunion. And it was hard. Our crew of 65 included 22 kids. And not just any kids, but freakin’ adorable, sweet, funny kids. The kind of kids that I want to have. The weekend also included a large amount of marveling at genetic parenthood – how virtually everybody there owed their life (or their spouse’s life) to this one woman – my grandma. Now don’t get me wrong, my grandma is awesome! But it still stings to think that I likely won’t have any genetic children…or grandchildren…or great grandchildren…

But enough of this pity party. There was a lot to be thankful for. For one thing, not one single person asked when we would have kids, or why we didn’t have any yet.

(I suspect this has something to do with a little incident last summer… After getting my positive pregnancy test, I texted my parents a photo…which my dad immediately posted on Facebook! I called him and made him take it down right away, but several relatives had already seen – and ‘liked’ or commented on – it. Seeing as there is now no baby, I can only assume they figured out what happened and had the decency not to comment on it. Either that, or everybody thinks I’m still in my twenties and have plenty of time – neither of which is true, but who can keep track when there are so damn many of us?!)

Another plus of the weekend: my adorable husband. A few weeks ago, I casually mentioned that wheatgrass juice is allegedly supposed to help with egg quality. The next week, I got home from church to find this in my kitchen:

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A couple weeks later, C decided that blending and straining the wheatgrass wasn’t good enough, and ordered a mechanical wheatgrass juicer.

This sweet man couldn’t imagine me going for almost a week without any wheatgrass, so he packed the juicer and a bag of wheatgrass in a little cooler, brought it along, and made me wheatgrass juice each day that we were there, cleaning the juicer in our room sink after each serving. 😉

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He also offered to “live like a monk” with me, giving up alcohol and unhealthy food for the next three months. (Okay, so part of the reason is that he wants to lose weight, but I still found it adorable.)

And on our last night there, after an abrupt and heavy downpour, the sun came out to reveal the most amazing double rainbow I’ve seen in years! (I would say ever, but I grew up in Hawaii, so I’ve seen some pretty amazing rainbows…)

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I’m not sure when or how, but in moments like this, I know that everything really is going to be alright!

Super sweet

How sweet! Aislinn at Ms Baby Makin, Ana at In My Garden Grow, My Eggtimer at The Egg Timer is About to Ring, and Lauren at On Fecund Thought (cutest IF blog name ever!) nominated me for a Super Sweet Blogging award. I’m so flattered!

I apologize that it took me so long to accept and pass along the love. (Don’t worry, this chain letter isn’t accompanied by a threat of 7 years of bad luck!)  In any case, I decided to accept this excuse to lavish praise on some great bloggers.

Conditions for accepting the award:

Thank the person who nominated you. Thanks so much Aislinn, Ana, Eggtimer and Lauren!

 •Answer 5 super sweet questions:

  1. Cookies or cake? Is cheese not an option? If not, then cake. Preferably made from a box (with pudding in the mix, yum). My favorite flavors are “yellow” and “cherry chip”…with – you guessed it – cream cheese frosting.
  2. Chocolate or vanilla? Vanilla. I know I’m weird, but I am not a huge chocolate fan. I’ll eat white chocolate or very dark chocolate (70% cacao or higher). In particular, Lindt truffles with the white or black wrappers are great! Milk chocolate is totally gross. Especially Hershey’s milk chocolate. Yuck!
  3. Favorite sweet treat? I’m not a big sweets person. I’d choose potato chips over candy hands down. But if I must choose, my favorite sweet treat is probably the aforementioned Lindt truffles…
  4. When do you crave sweet things the most? Sometimes after church I crave a glazed doughnut.
  5. Sweet nickname?  My mom used to call me Suga Buga. I think she meant it affectionately, but it sounds kind of weird now that I think about it – like I pick my nose and eat it so much, my boogers must have sugar in them? Maybe this is why I’m not such a sweet tooth…

 •Include the Super Sweet Blogging award image in the blog post:

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•Nominate 12 other bloggers. Here goes:

I’ll sort them based on what I like about them. I’ve also marked the blogs that talk about pregnancy or parenting with an asterisk, to avoid any surprises!

Fellow scientist (or pro-science medical professional) bloggers:

1. Ana at In My Garden Grow is an immunologist who illustrates her blog with these awesome colored pencil drawings. Okay, so she nominated me, but the rules didn’t technically say ‘no pingbacks’, and she’s a scientist. I couldn’t help myself. (Tag, you’re it again!)

2. Jenny at A Natural Scientist* is a PhD natural scientist of some sort (the few hints I can find point to biotechnology – which narrows it down NOT. AT. ALL.) Jenny ultimately made the brave choice to step out of the lab to be a full-time mom…and to blog about it.

3. Catwoman73 at Two Adults One Child* is a respiratory therapist who struggled with secondary infertility. Catwoman loves chemistry, ergo I love Catwoman.

4. Jane at Mine to Command is a medical professional (with a chemist husband) who has awesome taste in TV shows and movies, which she cleverly peppers into her blog (pay attention to the fictional names she uses for the characters in her stories!)

Inspirational bloggers:

5. TracySue at Journey to Somewhere*. Okay, so she’s actually not blogging anymore (at least not at this site), but she is an endocrinologist friend of a friend (though we’ve never met) who chronicled her experience with IVF. I read her blog from beginning to end as I was starting this journey. With her cute POAS “experiments” and scientific explanations, TracySue inspired me to start this little blog.

6. Jen at Overworked Ovaries* is a fellow DOR-sufferer, who writes one hilarious blog…and is pregnant with twins! Yay!

7. luvnmysailor at The Road to Minimart* is my first Protocol Buddy. I met her through the online forum for my local Resolve support group. She used my weird protocol to the letter. And got pregnant. Yay!

Sweet bloggers:

8. MrsDJRass at Baby Baby Please! is super sweet and a generous commenter. She had a BFN today and could use some words of encouragement!

9. Fertility Doll is sweet, funny, interesting, open, and – most of all – authentic.

10. elaaisa at Childless in Paris writes a poignant and sweet blog, interspersed with charming anecdotes about life amongst the Frenchies. (She’s Italian.)

Generally hilarious bloggers:

11. Aramis at It Only Takes One is in the DOR club. She also writes a brilliantly funny blog which I read from beginning to end in a day. (I couldn’t stop reading!)

12. Jenny at Stupid Stork! is an alchemist who takes the giant pile of shit that infertility gives her, and transforms it to shining gems of side-splitting humor, week after week.

*****

I was going to add a blurb about dexamethasone at the end here, but the story is turning out to be more complicated than I originally thought, and I barely have enough time to shoot up some nun pee before The Bachelorette starts … So, I’ll save the chemistry lesson for next time. Later!

Inspiration…and testosterone

Since starting this little blog, I’ve enjoyed finding other bloggers to commiserate with. But in finding bloggy friends, I’ve done my best to avoid blogs of people who were already pregnant. (Exceptions include Vanessa at Yeah Science! – the name of her blog was just too tempting,  and JoJo at An Infertile Road, my very first follower, who got pregnant – on her first IUI! – while I was following her.) I avoided pregnant bloggers because I wanted to shield myself from having to think about pregnant women, a sentiment that Jenny at Dogs Aren’t Kids expressed so well in a recent post.

The problem with this strategy – at least for me – is that it didn’t leave much room for optimism. I loved that there was/is no shortage of support and excellent company in my misery…but I also found myself doubtful that treatment could work for me. I mean, it didn’t seem to have worked for any of my other bloggy friends, so who was I to expect that it would work for me?! (Another problem with this strategy is that it makes me a little bit afraid of actually getting pregnant – like this amazing support system will suddenly vaporize as all my new friends go running for the hills!)

Since my last post, I took advice from Kimberly at No Good Eggs and joined my local Resolve support group. I haven’t been to a meeting yet (the next one is November 19th), but I joined their online forum. On this forum I found inspiration in the form of a Protocol Buddy – someone who followed my weird IVF protocoland had the same baseline AFCand got pregnant! And she writes a blog! I am so encouraged!

Furthermore, this experience gave me the courage to face my fear of pregnant infertility bloggers, and I started reading Jen’s blog, Overworked Ovaries. (Jen’s name and cute avatar kept popping up in the comments section on all my favorite blogs, with hints that her infertility issues might be similar to mine.) I’m about halfway through reading her posts (oldest first), and I find it so exciting to read a story that I know has a happy ending! It’s also great to see that so many of her awesome bloggy friends haven’t abandoned her, but are following along and cheering her on through her pregnancy. And I can’t help but think this is what it’s about! This is what I want!

And I feel hopeful.

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Now, let’s talk about testosterone. But first, the disclaimer:

I am NOT an endocrinologist, or any kind of medical professional! This blog does NOT purport to offer medical advice, medical opinions, or recommendations. Please take this for what it is – the ramblings of an infertile woman trying to make sense of her complicated treatment protocol!

*****

Last night I applied my final Androderm patch. The night I applied my first patch, I noted first that it is weird looking. C calls it my third nipple.

ImageI wasn’t exactly sure how to apply it, so I checked the website. Clearly they are not marketing to women trying to get pregnant:

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I couldn’t help myself, and decided to check out the website for Estrace cream for comparison:

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I’ll leave it to cleverer folks than me to comment…

Anyway, I waited to write about the testosterone-priming until now, partly because I was hoping dreading expecting to observe some side effects. I observed none. This fact makes me a bit skeptical that this low-dose patch would actually do anything for a 200+ lb man with low sex drive. Then again, that’s not why I am taking it.

And why am I taking it?

From what I can tell, the use of androgens (broad term for male sex hormones including testosterone and DHEA) to treat infertility patients is pretty new, and pretty controversial. Most of the papers I read were written by physicians at the same few clinics. But I think the gist goes like this:

  • Recent studies suggest that Diminished Ovarian Reserve is a condition characterized by the reduced ability to make androgens (including testosterone). This correlation seems to be especially strong in younger DOR patients. (Interestingly, several of the papers contrast DOR with PCOS, a condition characterized by overproduction of androgens…)
  • Testosterone is produced in the ovaries, in ‘theca cells’. Testosterone from the theca cells enters the ‘granulosa cells’, where it is converted to estradiol. (You can read more about estradiol in this post.)Image
  • Granulosa cells are the cells that surround the developing follicles and help prep and develop the eggs for ovulation.

The thought is that in theory [insert head tilt and two-handed gesture] since DOR patients can’t make as much testosterone, supplementation (through a gel or patch, or indirectly by taking DHEA – a testosterone precursor), will stimulate the granulosa cells to do their thing and prep those eggs. This is supposed to “enhance follicle recruitment” (more eggs) and “promote follicle growth and development” (better eggs).

At least a few studies seem to support this theory, showing a greater number of large follicles and better overall pregnancy outcomes for DOR patients treated with androgens (versus untreated DOR patients).

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I start stims (Clomid 100 mg + Menopur 150 IU) tonight, so I guess we’ll see!

Why my husband rocks!

As we go through this infertility business, it’s easy to focus on myself – after all, I’m the one who has to take my temperature every morning, pee on countless sticks, miss work, strip from the waist down to get violated on a regular basis, check my panties every time I pee, overcome my needle phobia to give myself nightly injections, and on and on. But over the last few months, I’ve come to appreciate C more than ever before. Here are a few reasons why:

C has to put up with constant reminders of our infertility. I’m a college science professor, which means that the vast majority of people I interact with each day are either (a) 18-to-21-year-olds who haven’t started trying to make babies yet (not great for my body image, but an advantage nonetheless when it comes to IF), or (b) 40+ year-old men. Of the colleagues I come in contact with on a regular basis, only one is pregnant (to my knowledge), and two have a very cute children whom I welcome on the rare occasions when they bring them to work. C, on the other hand, is a pediatric dentist. When he’s not recovering at home from senseless injury accidents, he sees kids all day, every day. He gets asked every day whether he has kids and (when he says no) whether and when he plans to. The fact that he doesn’t have any kids yet is somewhat of a professional liability. (What kind of weirdo trains for a job that puts him in constant contact with kids but doesn’t have any of his own?!)

On top of that, C has to put up with his aunts who have no qualms asking about our babymaking plans and sharing their wisdom. (Incidentally, C’s parents have been awesome. C is Vietnamese, and wasn’t surprised when his dad sat him down after our wedding to impress upon him the importance of focusing on having a baby…preferably one born in the Year of the Dragon. Sadly, I miscarried that Dragon Baby while staying at their house; and C’s parents brought me heating pads and ibuprofen and said all the right things. Since then, they haven’t asked once about grandbabies, or given any family-building advice, or commented on my work hours or nightly glass of wine, or…)

C has been present and supportive through all this. He was with me at my first OB appointment last June, where we learned of the missed miscarriage. C held my hand through the appointment, walked me down to the lab for my hCG blood draw where I started crying (to the bewilderment of the phlebotomist), and later told me that he had never loved me more than in that awful moment.

C was with me at the first couple of RE appointments…including the one when Dr. Y informed us that I have diminished ovarian reserve. And since his accident in March, C has accompanied me to every single RE appointment, no matter how minor.

C is bankrolling our IF treatment. Yeah, yeah. I know. It’s ‘our’ money, not ‘his’ money, and infertility is ‘our’ problem, not ‘my’ problem. But that doesn’t change the fact that his choice of career and his success at that career make ART a viable option for us. Consistent with his Vietnamese heritage, C is very price-conscious. He’s willing to spend money when he’s confident of what he’s getting for it, but he hates to waste money. So, it came as somewhat of a surprise when Dr. Y was going over our protocol options and mentioned cost as one advantage of the particular protocol he was recommending. Without hesitating, C said,

“Price is not a factor in our decision.”

It turned out that Dr. Y thought this particular protocol was the best for our situation regardless of cost, but it was awesome to know that we were going with the option that Dr. Y thought had the greatest probability of success, not merely the one that would be easiest on our pocketbook.

Money has also come up a few times in our discussion of how long to try IVF with my (scarce, presumably crap) eggs before considering other options…namely donor eggs. Not surprisingly, C was a fan of the donor egg option; it has a much higher probability of success, allows C to have a biological tie to our child, allows me to carry and give birth to our child, and (perhaps most significantly) leaves open the possibility for siblings, since a donor ought to yield a greater number of viable (or, more precisely, vitrifiable) embies.

But C surprised me in a conversation a few days ago. He started out with his thoughts about donor eggs, then pointed out that he hadn’t been thinking about how I might be feeling. He said something to the effect of:

“I thought about how I would feel if it was my sperm that was the problem and we were considering donor sperm…

If we try IVF enough times, it should eventually work. At about $10K per cycle, if it takes us 10 cycles, that’s $100K. So what?! It’s the cost of a basement. I mean, if we can’t have kids, we don’t need a basement anyway!”

Now I’m not so cavalier about spending $100,000 on IVF – or with the emotional toil of ten cycles…yikes! (In truth, I’m sure he doesn’t feel quite that way either.)  But I knew what an amazing turnaround that was for him. I knew that he was working hard to empathize and understand what this must feel like for me. And I loved him SO MUCH in that moment, and told him so.

I could go on and on with reasons why my husband is awesome – like how he jumped through all the hoops to get married in the Catholic Church (he’s agnostic), and went with me to mass the Sunday after the ill-fated OB appointment; or how he listens to me talk NONSTOP about infertility (I try to come up with other stuff to talk about, but it’s like IF is all I think about right now!); or how he never asks me whether I think my job is the reason for my DOR. (I’ve wondered whether breathing low levels of solvent vapors throughout most of my adult life is a factor, and I’m sure he has too, but he’s kind enough not to say it out loud!)

I have no idea how, after four weeks on Match.com, I met this gorgeous, brilliant, rich, generous, stylish and fun guy, who, inexplicably, has a thing for uber-geeky, clutzy, introverted girls. (On our first date, I used the expression ‘rate-limiting step’ in a conversation.) It’s sort of like when Dermot Mulroney’s character on the New Girl fell for Zooey Deschanel…except that I’m no Zooey Deschanel! In terms of cuteness-to-dorkiness ratio, I’m closer to Alyson Hannigan in the first American Pie movie (not in How I Met Your Mother; she’s adorable on that show), just substitute her sexual worldiness and flute skills for some old-fashioned Catholic guilt and chemistry knowledge…

I was already amazed to have met and married C, and I am even more amazed to see how this man – who up until last summer led a charmed life – reacts with grace and humor in the face of shitty circumstances. C has missed the past 9 weeks of work due to excruciatingly painful injuries caused by a cop’s reckless behavior, and he calls this time his “sabbatical”, and spends it taking online classes to improve the efficiency of his business, practicing on the guitar, and designing our future home (hence the basement comment above)!

As much as IF sucks, I’m grateful to be going through it with an amazing man at my side. And the past year – including a miscarriage, infertility, and a car accident that almost took him from me – has only made me appreciate that fact even more.

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The two of us on our wedding day, bowing to request our ancestors’ blessing during the traditional Vietnamese wedding ceremony.

On being Catholic and infertile

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I’m a practicing Roman Catholic. And so, when first faced with our infertility troubles, I made an effort to better understand the church’s stance. (I knew that the church does not approve of IVF, but why exactly? What about IUI? Hormone injections?) Fortunately, while exiting church one day, I spotted the above pamphlet for $0.50. I bought it, and here’s what I learned:

Catholic church-approved infertility treatments:

  • charting (also the only approved form of birth control; we Catholics call it Natural Family Planning or NFP)
  • ovulation test strips/monitors (POAS = not a sin)
  • most testing/evaluation procedures (see exception below)
  • drugs, hormones, suppositories (whether taken for the purpose of encouraging ovulation or supporting implantation or pregnancy)
  • corrective surgery

Unapproved infertility treatments:

  • Testing sperm obtained by masturbation (Yep, jerking off = still a no-no. As an intriguing side note, there are apparently Catholic church-approved ‘perforated condoms’ that can be used to collect semen samples during sex – the perforations are necessary to avoid violating church teaching about contraception. And, suddenly my mind jumps to a wildly inappropriate prank idea…Then, that thought is replaced by a mental image of showing up at Dr. Y’s office and handing him a dripping condom…)
  • IUI or any other form of artificial insemination
  • IVF (or ZIFT or GIFT…do people still do these?)

So, what are the underlying moral objections to these forms of treatment? What I learned in this little booklet didn’t come as much of a surprise. I’ll paraphrase:

  1. The purpose of sex is procreation, so any act that divorces the two is a sin.
  2. Life begins at conception, and any act that destroys life [even an embryo] is a sin.

Now I have to acknowledge that Catholic Church teaching is consistent. That first statement is the single reason why the church forbids masturbation, anal/oral/etc. sex, contraception, and gay sex – all of which represent sex without the possibility of procreation. Assisted reproductive technologies (including IUI, IVF, etc.) on the other hand represent procreation without sex.

It wasn’t hard for me to reject the first argument. In fact, I rejected that argument a long time ago. (Judging by the size of the average Catholic family these days, I think it’s safe to say most American and European Catholics reject that argument, whether consciously or not.) Specifically, I don’t believe that God would make gay people only to present them the unappealing choice between being celibate or a sinner. I also don’t believe that God would limit heterosexual couples to a contraceptive choice that forces one partner to choose between ignoring her hormonal urges each month or getting pregnant with her 12th child… (Incidentally, I was especially surprised a few years back to learn that my favorite Dominican priest, Fr. D. shares this concern!)

The second argument is more difficult for me, and I’ve managed to avoid it during the IUI process, but not if we move forward with IVF. This is the same argument for why the Catholic Church opposes abortion, an issue which I also struggle with – perhaps more so now that we are experiencing infertility. I’ll set aside abortion for now, but what do I think about the destruction of embryos as a result of IVF? If you had asked me a year ago, I would have given a totally lame answer:

“I think it’s great that many suffering from infertility will get to achieve their dream of pregnancy by IVF, but I wouldn’t go to those lengths.”

If pressed, I might have continued that it would seem like “such an extravagant use of resources just for the luxury of my own biological child.” That “there are so many unwanted children in need of homes,” and that “maybe it was God’s way of saying he had another plan for me.” Yup, I was one of those people. I can’t believe my good friend N. (who went through 3 or 4 fresh IVF cycles – I lost count – ultimately resulting in a gorgeous little boy) didn’t slap me across the face when I told her I’d never do IVF. I’ve since apologized for being such a hypocritical idiot!

So my feelings about IVF have changed. Did they change because now it’s me? Because now IVF is my best chance at a genetic child? Certainly that has something to do with it. But something else has changed too.

After a miscarriage at 9 weeks followed 10 months of infertility (not to mention another six failed pregnancies among close friends in that same time period), I just don’t think of embryos the same way. Before this whole experience, I think I easily could have viewed each sperm cell and each egg as a ‘potential baby’. Under the right conditions, they could fulfill their destiny and grow into a living breathing human being. [insert slight sarcasm here]

What is now apparent is that, even under the best conditions I can muster (cushy uterus, healthy & “relaxed” host, optimum timing, perfect super-sperm), I’ll be lucky to get one of my eggs to reach its so-called ‘potential’. And the best chance of doing so is through IVF.

So how can I view the demise of 3- or 5-day-old embryos (assuming I’m lucky enough to get any) as ‘destroying a life’, when they almost certainly would never have existed without IVF, and when we are actively doing everything in our power to help them develop into a baby?

Frankly, I can’t (or won’t) see IVF that way. At least not now. And as a Roman Catholic, I’m okay with that!

Postscript: To those who would call me a ‘Cafeteria Catholic’

I know you’re out there; people who will accuse me of being a ‘Cafeteria Catholic’ or ‘CINO’ (Catholic-In-Name-Only), or what have you. Aside from trotting out my Catholic credentials (baptized, confirmed, and married in the church; attend mass weekly and on all holy days of obligation – including while traveling; fast and abstain during lent; confirmation sponsor to my sister; selected by the priest to serve on my church’s Pastoral Council; etc.), and getting angry (man that term irritates me!), I like to point out two observations:

  1. Everyone I’ve ever heard accuse someone of being a ‘Cafeteria Catholic’ is, by their own definition, a Cafeteria Catholic. It’s hard not to be. The Catholic Church – more than any other church – has an official opinion on just about everything. To not be a Cafeteria Catholic, someone would first have to take the time to learn everything that the Catholic Church teaches, and then take on the Herculean task of adhering to that teaching. Actually, to spot the hypocrisy involved in this accusation, you typically don’t even have to work that hard. Pick an issue outside of Catholic moral teaching (better yet, just pick something outside of the small subtopic of sexual morality) and ask the accuser how they live that teaching in their own life. Almost invariably, users of the term Cafeteria Catholic totally ignore some or all tenets of Catholic teaching on social justice, stewardship of the environment, capital punishment, just war, and so on. (For some reason, these folks seem to be obsessed with sex. Maybe they are angry that they’re not having enough …and are envious of everyone that is.)
  2. The use of the term ‘Cafeteria Catholic’ betrays an utter misunderstanding of where Church teaching comes from. Catholic Church teaching is not static. In fact, one of the things about it that so many fundamentalist Christians find objectionable is that we don’t believe the bible to be the final and supreme word of God. Instead, we believe that God continues to speak through an ever-growing Church tradition. New issues (moral and otherwise) arise, and the Church responds, typically by enlisting a panel of experts and church leaders, who engage in extensive discussions, and prayer, and ultimately arrive at some kind of consensus that is adopted as the official Church teaching. Thoughtful and prayerful consideration of issues is part of the process. Consistent with that tradition, priests are NOT mindless drones that regurgitate official Church teaching. The majority are highly educated critical thinkers, taught to ask challenging questions and grow in their faith through independent thought and prayer. Why should laypeople behave any differently?

If I disagree with American policy (or even a small subset of American policy), am I a ‘Cafeteria American’? Can I be a ‘Cafeteria Chemist’? The Catholic Church is losing enough believers as it is. Do we really want to be in the business of telling people they don’t belong?

I don’t mean to imply that the Church is ‘wrong’ about infertility treatment, and that my beliefs are ‘right’. I fully recognize that my knowledge and experience is inherently limited, that God’s plan is beyond my comprehension in this life. But I also feel confident that I am thoughtfully and prayerfully considering the consequences of my infertility treatment, and as of today, I am comfortable proceeding with IVF if this IUI cycle fails…