Random Rambles Regarding a Crazy Woman's Biological Clock

What's with this age and being able to forget all the difficulties of newborns?  Why is it that at precisely 15 months of age my brain begins to consider the possibility of another baby?  Is it because my brother and I are two years apart and I think that is a good amount of separation?  (I actually don't anymore, but I'll probably get to that later...no promises though.  This is a random ramble!) Or is it that I have returned to work and would rather be at home with my kids?  How do people know when they are done having kids?  Someone told me that it is when you stop looking at pregnant women with jealousy.  That's not it for me.  Pregnancy for me is just the route to having the child.  Don't get me wrong...I used to be so jealous of pregnant women that I actually hated them.  But I'm just not there anymore.  Knowing that I became a mother without being pregnant has taken the pressure off of the need to be pregnant.  I look enviously at the mothers of newborn babies.  And I'm not even a huge fan of newborns...I actually prefer 6 months and up.  But today I was looking through a parenting magazine and there were so many new neat ideas from Fisher Price.  My brain subconsciously said that I would get this really neat bassinet when I have my next baby.  Oh yeah...and that swing looks better than the one we have....and then WHAT AM I DOING?  I do know that when Lily was 15 months old I realized that another baby was not going to be provided via the stork and that we were going to have to try IVF again.  Once I convinced Scott to return to the fertility clinic we were on our way.
And speaking of convincing Scott....we have different personality types.  I think of a question and immediately require an answer.  Scott, on the other hand, likes to weigh our options and think things through.  His way is probably more sensible, but I have yet to lead him down the wrong path.  I do have to give him credit because he was the one that jumped at adopting Lily and he also was the one to decide to put down the registration fee for Jack's IVF cycle.  Maybe I should pay more attention to his ways...maybe he really does know what he is doing.  Wow....off topic once again.  The point of this paragraph was originally to say that Scott is done having kids.  We have a perfect family...a beautiful girl and a hilarious boy.  They play well together.  They love eachother.  They are healthy and happy.  Why would we want to ask for more? And by asking for more, there is a chance we would end up somewhere unplanned and that our wonderful family could be less wonderful because of it.  Scott is also terrified of another post-partum depression experience.  I shudder everytime I think of that part, but can't help but think that it was worth it everytime I look into Jack's big blue eyes.  (Oh yeah...and I think that the pressures of the biological clock and womanly hormones allow you to forget lots of things; depression, jaundice, vacuum, and stitches where the sun don't shine...just to name a few.) But one thing I do know is that I am no longer desperate to continue this journey to become a mother to more.  I have to respect Scott's opinion and I don't want to pressure him into anything he doesn't want.  And about the age thing....it looks to me that most parents of three of more have increased the age gap after the first two.  I think that's probably because they realize how hard it is to parent two really young kids at the same time.  If we do choose to have another I think I would want Jack to be at least three years old before we think about an addition.  Things became easier when Lily could put on her own boots and coat...and didn't want to be carried all the time.  That being said...we have tons of time to work it out.  Maybe in that time I will decide that this sense of peace isn't worth messing with.  Maybe Scott will decide that he wants a new baby to cuddle when our kids want to play more than snuggle.  We'll have to see.
In the meantime, I will continue to pay the fee to keep my popsicle babies on ice.  I can't imagine going through IVF again and really don't think that we will.  I also don't want to try naturally month after month.  But those two frozen embryos lead me to believe that eventually I would like to give them a chance.  The chances of those embryos becoming my babies are slim...the odds aren't great for frozen embryos...but I do know kids who started off that way.  I think eventually I would like to take a chance and let the powers that be decide what happens.  I worry that opening that door again would be a disaster...but that's just another part of this random ramble.
For now I think I will go peak in on my two sleeping babies and think about how lucky I am.  I will put the rest on the back burner for another day.

Speak up and speak out....Loudly!

CBC News - Montreal - Fertility under provincial jurisdiction: top court

You may or may not be aware that the government is trying to decide whether infertility and the associated treatments should fall under provincial or federal law. There is also discussions in some provinces as to whether or not treatments such as IVF should be publicly funded. This blog is not about my opinion of either. I want to talk a little bit about the misconceptions associated with the decisions to have these treatments and the alternatives. If you are or have ever been infertile, feel free to read the article but beware of the comment section. My husband was upset that I was even reading it. It is filled with assumptions regarding IVF, infertility, and adoption with a few people with experience trying to desperately stick up for the rest of us. I did not comment because those with experience were grossly outnumbered and most of the replies were not based on fact and therefore anything goes. If you choose to read that section, perhaps you should get out the ice cream, cookies, or wine. You might need it.
In the next few months we are going to hear more and more about these topics. What I am asking is that you educate yourself before commenting and once you know actual facts, speak up and speak out...loudly. Some people choose to live childless lives. That is their choice and if they are happy, I am happy for them. Either way, imagine wanting to be a parent and not having the opportunity. People who experience infertility imagine their lives as useless. They think about all that they have to give and how it could be wasted. They imagine Christmases alone and dying alone. Psychologists equate the pain of infertility to the pain of losing a loved one and to a similar stress as being diagnosed with a terminal illness. If you haven't been there, you cannot imagine.
I noticed that in the awkwardly uneducated comments section that there was a lot of talk about it being God's will that the infertile are not parents. Infertility is an illness not unlike cancer or diabetes. If it's God's will, then that is like saying that we should get rid of insulin and chemotherapy. There is talk that we should ban fertility treatments until all the parentless children in the world find families. That might work in theory, but Canadians do not have access to "family-less" children all over the world. And international adoption often costs way more than IVF so if you can't afford IVF, you can't afford to adopt. And let's face it, adoption just isn't for everyone. Don't those children deserve the right family? And if the intention is to find parents for everyone, why not ban pregnancies in general? Would that not make the whole process a lot faster? Why should the responsibility of orphans fall on the shoulders of the infertile?  Another misconception is that children created by infertile parents are also infertile and that we are creating a larger problem in the future.  Some fertility disorders are genetic but IVF children are not doomed to be infertile.  I do believe that something we are doing is increasing the number of infertile people, but that is a whole different topic. 
What I am asking is that you make sure you know the truth before creating an opinion.  I am not asking you to approve of or reject the decisions relating to government responsibility or payment of treatments.  But please do not make assumptions regarding infertility, IVF, adoption.  The whole picture is just so much bigger than anticipated.

Jack Spratt

Jack was created on my husband's 30th birthday.  This was no rendezvous in the park. 

The previous fall we had decided that we wanted Lily to have a sibling.  We had put our names down on the adoption list for Saskatchewan and had spoken to our contacts in Nunavut and it didn't look like adoption was going to happen again for us any time soon.  We returned to the fertility clinic looking for suggestions and answers.  We needed to know what they thought after our previous failure.  We thought that they would tell us that our chances were lower because of a previous failed attempt, but the opposite was true.  They thought they could take our issues from the first cycle and use them to make a better cycle this time.  We paid our registration fee and were told that they would contact us in April.  They called in January to see if we would be ready to start our birth control so we could cycle in March.  I knew this would make for a December baby and I never wanted a December baby....it wasn't nice to get all their presents in one month and I was worried about them being the youngest in the class.  But, if I had learned anything, it was not to be picky...so I got really excited instead. 
A second IVF cycle is so different from the first.  The first time you are positive it will work.  You are terrified of the needles and interested in every part of the protocol. The second time you are not fooled by the first timers' excitement, the needles are boring, and you try not to think about what is happening at all.  We used a different drug to stimulate the egg production and this time we got more and they were ready in half the time.  (As an aside, we had a 30th birthday party early because we knew that we would be busy at Scott's actual birthday.  I had been drinking...totally different from cycle #1...and the alcohol thinned my blood so much that when I had to do my shots that night, it wouldn't stop bleeding.  We hadn't told anyone about this cycle so I was searching our bathroom for band aids for my belly....Yup...I went upstairs to shoot up at my husband's 30th birthday.)  On retrieval day we got eight eggs, six were fertilized, two implanted, and two frozen.  The first cycle we moved our bed into the living room so I could be entertained while on complete bed rest.  The second cycle I tried to be on bed rest but I had a toddler and so my bed rest was a bit less restful.  The first cycle I stayed on bed rest for three days.  During the second cycle we went for a walk because it was the first spring day and Lily wanted to splash in puddles.  I tried not to get too excited but when the day passed where I knew our cycle had failed the first time, I couldn't help it.  I ran to the bathroom every hour to check if I had my period.  I tested to watch the drugs leave my system.  I promised Scott I wouldn't test for a positive test and that we would wait to hear the results from the clinic....but I broke my promise.  When I got that first positive I could not believe it.  I had dreamed of that moment for so long and I had no idea what to do.  I tested throughout the whole pregnancy and was sad to see the positive tests go away after Jack was born.  The day of the ultrasound we found out that both the embryos had implanted but one of them no longer had a heartbeat....but there was a beautiful fantastic strong heartbeat on the screen.  I just wanted to stare at if forever.  I rented a doppler monitor so I could hear that beautiful sound whenever I wanted.
We had done it!!  And I now have two incredible kids!!

Miraculous Science

Assisted Reproductive Technology is always a controversial topic.  There are the people who believe that it should (or should not) be paid for by the government.  There is the religious aspect.  The Catholic church is certainly not a big fan.  Much to my mother's dismay, we joked that Jack might burst into flames during baptism.  This was not the case.  I once participated in a chat room where two women were arguing about whether their pregnancies were miracles or acts of science.  I just kept thinking to myself, "Does it matter?  Won't your baby be just as fantastic either way?" There is also the concern about multiples, premature infants, and birth defects.  Trust me.  I've heard it all.

I wish everyone had the opportunity to check out the walls of photos in my fertility specialist's office.  The walls are covered.  I think they might have to use the ceilings next.  These are families who weren't able to be families without it.  It's tough to argue all those other points when you see Jack smile or wave for the first time.  It's tough to think it could possibly be wrong when you stare at his peaceful face when he is sleeping.  I was lucky to have the support of family and friends but I know lots of people who had to keep it a secret because their family thinks it is wrong. 
I know so many people affected by infertility and I have been fortunate to be able to share in so much joy at the birth of their babies.   I also have friends who are currently trying and I can't wait to hear about their successes.  I have a friend who has twins, a boy and a girl, and is currently awaiting her ultrasound to see how many babies there are from her current  IVF success.  I have another friend with a two year old girl and newborn baby boys from superovulation.  I have a friend with a two year old girl from IVF and a surprise one year old boy.  There is the three year old boy awaiting his brother or sister all from IVF.  There are the three year old twins from IUI and the four year old twins from IVF.  These are all close friends who wouldn't have their families without assistance.  I know of so many other acquaintances who have been helped as well.  The issues just don't compare to the love I have seen. 
I'm not going to argue why the issues are right or wrong.  I'm just too busy being a mother to my answers anyway.

What does progesterone do to the birds anyway?

This post isn't really about birds.  But just for interest sake, birds who are given more progesterone hatch more females.  I would have thought it to be the other way around being that progesterone is more of a male hormone.  But that really is beside the point.  This post is really about IVF cycle #1....better known as my costly failure.
Back when I knew that getting pregnant wasn't going to be easy, but before I really knew how difficult it was actually going to be, I used to say that I wasn't interested in trying in vitro fertilization.  To me it was like putting a $10000 deposit down on a car with only a 50% chance of actually getting the car.  As time past and I became more desperate to become a mother, my thoughts on IVF changed completely.  I now suggest that anyone who is struggling at all to get pregnant should get a referral to a fertility clinic early in the ball game.  It often takes a long time to get in and once you realize you need it, that wait is painfully long. So what if they call you and you are already pregnant?  What harm is there in that?

Even though I was pretty sure early on that we were going to have issues, my family doctor made me wait eight months before referring me to the gynecologist.  Gynecologists are female experts, but they are not fertility experts.  They are a good start to help you track your cycle to see where things are at.  I did 13 cycles of Clomid (a drug which causes and improves ovulation.  This is often how high number multiples are created.)  The recommended number of Clomid cycles is never to be more than 12 cycles in your lifetime.  My last two cycles of Clomid were IUI cycles (where they monitor your cycle and then introduce your partner's sperm into the uterus via a catheter at just the right time. Very romantic.)  Usually people do three cycles of IUI but after the two failures, I was starting to literally fall apart and decided to take a break until we could get into the fertility clinic.
We met with the fertility specialist and she recommended that we try IVF.  At this point we had tried everything else and so my opinion on this costly venture had changed.  We first needed genetic testing, which was the first thing we passed in a long time, but it added more time to our wait.  Our first appointment at the clinic was in November and by April things were finally a go.
This is the story of my first IVF cycle.  Everyone is different and every cycle is different, so don't think they all go exactly like this. The ironic thing about starting an IVF cycle is that you are put on birth control.  This is to make sure you are in the right part of your cycle when they want to begin.  It felt really weird after all that time to actually need birth control again.  And then start the vaginal ultrasounds....large object in large condom placed in the vagina to get a good look at the uterine lining and ovaries.  The first time this happened, the room had two doctors and three residents.  My husband, always the joker (but sometimes inappropriately so), made a joke that this reminded him of that time in Mexico.  No one laughed and he became even more quiet and uncomfortable.  Oops.  You are then started on a medication that suppresses the body's ability to make its own hormones.  It is like going rapidly into menopause.  And then start the stimulation hormones which produce a high number of eggs in each ovary.  Every few days you return for blood work and another ultrasound to make sure everything is going well and to adjust your dose.  Unfortunately, the drug that I was injecting wasn't working for me and by the tenth day of injecting and testing, I was switched to another.  This drug worked better but the first drug caused me to produce very few eggs and the ones that we had were of poorer quality.  It was too late in the cycle to do anything about it and so we pushed on.  When the follicles containing the eggs are large enough and your estrogen level is at an appropriate level, you inject another drug which ripens the eggs.  Exactly 36 hours later, those eggs are retrieved.  You start inserting progesterone capsules vaginally three times a day to get the lining ready for implantation.  This continues until a negative pregnancy test or 12 weeks pregnancy.  It is not fun, but you get used to it after a while.  The day of retrieval you are given Ativan to relax you and narcotics by IV.  I'm not going to lie.  Having a needle stuck through your vaginal wall and into your ovaries over and over is extremely painful even on those drugs.  We retrieved six eggs.  I was really disappointed.  We rested for a bit and then headed for home.  I passed out in the elevator and my dear husband had to carry me to a bench and get me a wheelchair.  I can't remember any of it.  And then we went out for lunch.  It had become a routine for us to go for lunch following any procedures and so we went again.  I can't remember that either.  The next day they called to tell us that four eggs were immature and could not be fertilized but the other two had fertilized.  This caused panic because we were putting two embryos back in and what if they didn't make it to transfer?  Not all fertilized eggs become embryos and if they do, not all embryos are good quality.  But we weren't going to have a selection.  I prayed for the next three days.  I don't often pray.  I think that if there is a God that is actually listening, there are so many other things that he or she should be looking after.  But this time I decided I wanted it to be me.  The day of transfer we had two beautiful embryos.  We were hopeful and happy.  They were transferred back into me the day before Mother's Day and so I spent that Mother's Day on bed rest but knowing that I had babies swimming in my belly.  The vaginal progesterone is supposed to keep you from getting your period but exactly one week after transfer, I got my period anyway.  No one knows why, but these things happen.  Unfortunately I was at work and I was devastated.  I called the office and they said that sometimes people have bleeding and still end up pregnant.  I wanted to believe them but I didn't.  Because there was a chance I continued my progesterone up until my pregnancy test a week later.  Because we knew things did not look good, we planned a trip to Edmonton for that weekend.  We needed some time away together to mourn the loss of those babies.  We had seen pictures of those embryos and had become attached to the idea of the family we were to become.  I went to get my blood taken and then we jumped in the car and drove to Edmonton.  I brought the progesterone just in case we had a miracle and I still needed it.  Halfway there, the nurse called my cell phone.  The result was negative.  We were not going to be that family that we had dreamed of.  Without thinking, I opened the car window and let my progesterone fly through the air.  They are perfectly round little balls and they looked really neat bouncing on the highway behind us.  I don't know why, but something about that made me feel a bit better.  In hindsight, there were probably a lot of female birds hatched in that area from my progesterone.

The great embryo debate

This is a very personal and controversial topic.  This is me sharing my thoughts with you.  I am not looking for any suggestions or advice.  I am sure the answers will come to us in time...
The whole time you are in the process of an IVF cycle all you do is count your eggs.  Every fertility clinic has a different recommendation on how many you want to retrieve.  Every woman wants a million.  More eggs = more chances.  Unfortunately, like everything fertility related, this is not an exact science.  You could have 20 follicles containing eggs and retrieve six.  You could have ten follicles containing eggs and retrieve 15.  Using ultrasound and blood work, the doctors have an estimated idea of what's going on in there, but there is no definite answer until they are out.  Once they are taken from the woman's body (under the influence of narcotics to reduce the pain) they are placed in a dish and either covered in washed sperm or injected with one particular sperm.  This depends on your "issues". And then, like everything fertility related, you wait.  By the next day any eggs that have been fertilized contain a bubble that let's you know that things are a go.  From there, the fertilized eggs become embryos by cell-division.  The ones that don't fertilize are discarded.  Around day 3 of the waiting, the embryos contain approximately 8 cells and are ready to go back in.  A woman my age usually can transfer two embryos back into the uterus.  Any remaining embryos are graded.  If they are doing really well, they can be frozen that day.  If they are struggling a bit, they are grown for another two or three days and will be frozen at that point only if they do well.  So, as you can see, the number of eggs can be whittled away in the process of becoming an embryo of choice.  Frozen embryos remain frozen until which time you determine you want to try again.  When you are in the process of a cycle, you want lots of embryos in case it doesn't work.  You want as many chances of success as possible.  In our second cycle, we retrieved 8 eggs.  Only six of those fertilized.  The two best were transferred back in, two were frozen on day three, and two did not make it to be frozen later.  One of the two transferred back became my blond haired, blue eyed beautiful baby boy.  The other tried really hard to make it, but stopped growing when I was five weeks pregnant and was absorbed by my uterus. 
We are now a wonderfully happy family of four.  We have been trying for so long to have a family and I really just want to be happy.  I fear that I have already achieved more than was possible and that I should thank my lucky stars and stop pushing my luck.  I always thought I would donate my remaining embryos to someone who needed them.  My daughter only became my daughter because of the selflessness of others.  I should try to be as kind with someone else in need.  Right now, in Canada, they are working on an anonymous embryo donor program.  I thought this would be a fantastic option for us.  But now I have Jack.  I see how wonderful he is and wonder what those embryos could become.  There is a very low success rate with frozen embryos so it could all be for nothing, but what it if wasn't?  What if I am meant to be the mother of those children? 
But, what if I'm not?

The creation of family

I was happy...for a while.  At first the idea of having an only child was okay.  I had this wonderful little girl, I could get KFC with all the other mothers on Mother's Day, I was able to do all the kid stuff.  But then I thought about my own childhood.  Everything was better about my childhood because I had a brother.  I thought about our many camping trips and how we had entertained eachother.  It's not that I think that children are better because they have a sibling.  I don't think they need a sibling to be well-rounded or happy.  I just wanted Lily to have the kind of family memories that I had.  My quest for my first child was completely for me.  The quest for a second was for her.  I always knew that if we were offered another Inuit child, we would jump at the chance.  That would be the best scenario for Lily.  She would have someone to discuss her feelings of adoption with.  But I had realized that Lily was a once in a lifetime chance and that we couldn't count on another delivery from the stork.   Our decision to have a biological child had nothing to do with a desire to be pregnant or have a child that looked like us.  We already knew that those were small concerns in a lifetime with your child.  This time our quest for a biological child was a default after waiting for another adoption.  It's strange to think that when we wanted a biological child, we adopted.  When we wanted an adopted child, we got pregnant.  Maybe it was a lesson in unanswered prayers. 
After our first IVF cycle we had returned for a consultation.  Their suggestions were not at all what we wanted to do.  Because of this, I had a hard time talking Scott into going back.  Because our first cycle was a complete failure, we thought our chances of it working were small.  They explained that each cycle is individual and that our chances were the same as the first time.  I wasn't sure what Scott was thinking when we left the office, but he headed straight to the receptionist's office to pay our registration fee.  It was decided.  This was our next path in our journey to create our family.

How bad do you want it?

The story goes like this.  I wished upon a star (probably a million times) and begged and pleaded with the powers that be to please give me a child.  While making those wishes, the child I had in mind was blond and blue-eyed.  Of course, after years of trying, I had thought about adopting internationally.  Probably from Kazakhstan.  That's where blond-haired blue-eyed children come from.  I met two fantastic people during our first IVF cycle.  Even though that cycle was a very expensive failure, I still can say that their friendships are entirely worth it.  The statistics of IVF gave us a 2/3 chance of success.  There were three of us.  I was the 1/3 that was not successful.  Just as one dream of a family ended, another began.  One of those new friends had been offered a baby from Nunavut.  She was now pregnant and called me to tell me about that baby.  I was still totally devastated over the failure of our cycle and was not ready to set myself up again quite yet.  But my husband jumped at the chance.  If you know us at all, you know that this is totally opposite of both of our personalities.  I am the one running towards our new endeavor as the last one is completed.  He is the voice of reason.  But he wanted this.  I, on the other hand, was concerned that my family photos would look somehow wrong with this dark-haired dark-eyed child in them.  That is a statement that I never wanted to say out loud and here I am writing it for the world to see.  His response, "How bad do you want it?"  He was talking about motherhood...and wow, did I ever want it.  Of course, moving forward, there were many concerns about adopting.  Honestly, it's a super scary process...totally worth it, but really scary!!  I am thankful every day that he pushed the issue because I have the most beautiful, caring, affectionate, sweet daughter in the whole world.  And when I look at my family photos, I don't think about the fact that she is adopted.  It think about how lucky we are to be a family.  Now, when I meet people who are trying so hard to create a family but who are not interested at all in adopting, I think to myself, "How bad do you want it?"  I guess adoption is not right for everyone, but thankfully it was right for me!!

To test or not to test...to test of course

In hindsight, it's kind of like a bad joke.  How many pregnancy tests does it take to prove infertility?  Many of us spend months if not years trying to prevent pregnancy using birth control of some sort. At some point in our lives someone told us to be very careful.  It is easy to get pregnant if you mess up your birth control.  Miss one pill or have one condom break and you will have a baby on your hands.  Unless it's not. Unless you won't.  As a pharmacist I realize that you can actually get pregnant if you miss one pill.  I'm just not sure I truly believe it.  My first month off of birth control, I was very excited about the prospect of being a mother.  And when it got close to the end of that first month, my testing addiction began.  Before that first period, I am sure I tested at least ten times.  I bet most women don't even test that many times in a lifetime.  And so it continued month after month, year after year.  I even found a website that sells inexpensive tests.  My addiction was getting expensive!  And once the fertility treatments began, I would then use pregnancy tests to make sure that the medication that they gave me was leaving my body.  Now I had more reasons to pee on those annoying little sticks.  Our first round of IVF was followed by plenty of testing.  How could it not have worked?  They must all be wrong.  But they weren't and so my childless life continued.  When it came to our second round of IVF I promised my husband that we would wait patiently for the doctor to tell us whether or not it worked.  That had to be a less stressful way?!?  The medication that they give you to get your eggs ready during an IVF cycle makes a pregnancy test positive.  I wanted to watch the medication leave my body so I tested during that period...for absolutely no reason but to satisfy my testing addiction.  When the medication was gone, the tests began to show negative again, which was to be expected this early in the cycle.  I wanted to do one last test to make sure that the medication was out of my system (even though it had been for the last two days) and this test came up POSITIVE!  Now what do I do?  Do I pass out from excitement?  Do I lay on the bathroom floor and cry with relief?  DO I TELL MY HUSBAND?  (Remember I promised and I swore I would not let my addiction get the best of me!!)  I know what to do....I'll take another test!!