Question of the day

This needs to be a quick post so I am asking for you to help me write it. A friend talked to me today about the fact that she is turning 40 a may want one more kid. She shared with me a conversation she had with an older friend. She asked, "When do you know when you have had enough kids?" He replied, "Well, is your house full? Not, have you filled all the rooms, but do you feel like your house / family feels complete?"

Ahhh . . . is that how you know? It just doesn't ring true to me so I came up with some reasons of my own. Help me out and offer up some of your own answers.

How do you know when you have had enough kids? (By "enough" I include zero too - it isn't enough obviously, but I think the questions still applies)

• When you don't have the money for a(nother) fertility treatment
• When you can't bare the possibility of another BFN
• When you can't bring yourself to start on all that adoption paperwork
• When you don't think your body can handle any more fertility drugs
• When your husband / partner can't stand you on any more fertility drugs.
• When it is more important to your mental health to walk away than keep trying.

What else?

The follow up post

I wanted to post a follow up post to my terribly depressing post from yesterday. I had actually gone to bed thinking I would sleep on it. There were moments when I wondered if it was an accurate portrayal of how I felt as the evening went on. When I couldn't sleep at 4 am this morning because I kept thinking about it, I went ahead and hit the publish button. Perhaps not the best frame of mind to make the decision, but now that it is posted I don't think I will pull it. It was accurate for how I felt at the time, even if I am a bit embarrassed about it now.

Today I wonder why I cared so much yesterday. As I have stated in this post, I think about LB being the product of DE almost every day, but I would say that 98% of the time there is no emotion associated with it. It is of no more consequence than if the sun is out or not. Actually, it is of less consequence because a sunny day has a bigger impact on my mood than the origin of LB's genes, at least most of the time.

Here is where I am putting part of the blame on my emotional meltdown: Sunday I danced my Psalm of the Infertile Woman piece again - I pulled out all my emotional baggage for the performance (performance isn't the right word because it is supposed to be more of a prayer, but you know what I mean); that night we didn't sleep well - LB waking me up 7 times in 9 hours; bright and early Monday morning I had my first blood draw for my upcoming FET - walking into that clinic brought up some suppressed grief, I suspect.

I am not going to say it is all ok, however. Better to look into the wound and see if it is worse than I thought or if it just bled a lot for a moment and is actually healing nicely. To that end, I have made an appointment with my grief counselor and set up a get together with a wonderful lady I know who raised one adopted and one genetic child. I hope the latter person can answer some questions about how it is the same and how it is different. Since I don't have anything to compare it to, I am probably over selling the genetic connection.

And the thing is my genetics suck - heart disease (mother, grandfather), mental illness (father and several of his siblings), cancer (11 of 13 female cousins had breast cancer), arthritis; you name it we've got it - in spades. We definitely traded up in terms of better prospects for LB.

I come back to wondering if a portion, perhaps even a greater portion, is that need for success. That need to say, "I can do it too, so there!" But we all know the harder part is being a good parent for decades than getting the sperm and egg to make a healthy baby (not that the latter isn't hard for some of us).

I also think it will benefit me not to think about it too much. I don't want to bury my grief, but I don't need to poke it with a stick either. And sleep . . . more sleep would be good. I am currently reading the No Cry Sleep Solution and hoping to change our sleeping habit for the better. I haven't had more than four hours sleep in a row in nearly 9 months. I'm not complaining. Better to be tired from waking up with a baby than to have no baby at all. Still, the shortest road to insanity is sleep deprivation.

What might have been

Note: I was hesitant to post this as it is possible someone from my clinic reads my blog. My apologies in advance if I offend anyone. I have no doubt that the people at my clinic have the best interest of their patients at heart.

When I did my first IVF cycle, the most recent stats available for my clinic were from 2004. At that time, my clinic had a 56.7 live birth rate for people under 35 and CCRM had a live birth rate of 58.5. I was one week passed my 38th birthday. My clinic's stats in my age group didn't quite measure up, but since my clinic only did about 25 cycles while CCRM had over 130; it was safe to assume that it was just a statistical difference (the reliability range overlapped with CCRM). Additionally, their rates were much more comparable in the pregnancy rate per transfer category.

I signed up for 3 cycles with my clinic - two being early miscarriages and one being a BFN. By the time we went for our fourth and last-chance-with-my-eggs cycle, I was comparing DE cycles only and still felt pretty good.

Today I was thinking about our up coming cycle and on a whim decided to check out the most recent stats. I shouldn't have looked. While CCRM has continually (from 2004 - 2007) had a live birth rate in the low 40's for women in my age group (38-40); my clinic has hovered around the mid to upper 20's - even taking a hit across all groups in 2007. I am now led to believe that our chances of success would have been about 1.8 times greater had we gone to CCRM. It feels awful to think things might had been different if we had tried a different clinic.

Ok, Kami, but what about the live births per transfer? Those rates actually stayed pretty comparable and you always made it to transfer so isn't it fair to only look at those rates and let yourself off the hook? Maybe. I just don't know. Perhaps my clinic isn't as good at stimulating older women and so cancels more cycles. Perhaps CCRM preselects their patients. I just don't know. My suspician is that CCRM is just better at stimulating older women since when you select for diminished ovarian reserve they still have around a 40% live birth rate and about a third of their patience are diagnosed with diminished ovarian reserve (something I was not diagnosed with until the DE cycle)

I have often had the shadow of regret hanging over me for not going to an RE sooner - for believing our miracle pregnancy in 2004 wasn't just a fluke. Now I am left feeling that I made the wrong decision for at least not trying CCRM for our last-chance-with-my-eggs cycle in early 2007. Would that have translated into a live, mutually genetic baby for us? We will never know. I'm not a statistic. I'm not 100 cycles or a hundred women. I do know that right now I feel like I have been kicked in the stomach. Although not intentional, I feel like I have been the victim of fraud. I feel cheated.

One of the things that has always bothered me about moving to DE is that I never had proof that my eggs had abnormal chromosomes which I understand to be the best indicator of poor quality eggs (please correct me if I am wrong!). PGD was too expensive and wouldn't have increased our chances of a viable pregnancy and in at least 2 of the pregnancies (Ernest and my first miscarriage) the karyotype came back normal (the miscarriage was normal female so it could have been my cells tested but the tech stated "probable placental villi" in the report so she thinks she got the right cells). The second miscarriage did not have a reliable karyotype.

Of course, normal chromosomes didn't do us any good with Ernest. He was non-viable outside of the womb because of a birth defect that caused the preterm labor. We were told it was just bad luck at the time.

So the questions continue to swirl around in my head: Wrong choices? Wrong clinic? Bad eggs? Bad luck? Yes, for those long term readers, I have been down this road before.

Just to rub salt in the wound, I feel guilty having these regrets because I have LB. Even now she is holding a chunk of crusty bread in one hand and a chunk of apple in the other - taking turns shaving off little bits with her bottom teeth (every once in a while, I have to go pull a too-big bite of bread out of her mouth to wails of unhappiness until I put a small bite back in) and it is terribly endearing. There is no doubt that I love her with all my heart. And there is also this.

I don't think this (this weight, this sadness, this cloud of regret) will ever go away completely. Like the loss of a child, the grief is always there it just punctures your life less and less often with less and less force. Unlike the loss of a child, it could have a too-big impact on LB if I am not careful. (I say "too big" because everything I am could have an impact on LB since everything I am impacts the way I parent.) I don't know what to do about it either. Perhaps I am hiding it from her well enough at this age and by the time she knows any differently, it just won't matter that much to me anymore.

As long as I am having a poor me moment, I will also say that it sucks that it was male factor infertility that brought us to the table in the first place. I am convinced we would have had children easily at 34 had we not had male factor issues.

Where is the road map to tell me how to get on with my life after failed infertility treatments, a dead baby, and mistakes in judgement and be happy that we were successful with the next best alternative? When and how is it ok to grieve what you didn't get while you are parenting the miracle that you did get? When can I be selfish and let the tears flow and when do I need to pretend it doesn't matter to me at all? What about those of us who still feel like failures sitting in the waiting room of our fertility clinic even though we have successfully found a path to parenthood?

I don't know, but I am done with self pity for today. Brad will be home from work soon and poor LB has been too neglected. I promise my next post will be much more positive. I'm off to see if nibbling on baby toes and blowing on a baby tummy will lighten my mood a bit.

Update: Please see the follow up post.

Perfect Moment Monday

Waking up to the sound of birds singing.


For other perfect moments this Monday, visit Lori's blog

Understanding

If you want to know what it is like to lose your only child and not be able to get pregnant again, please read this post from the Shifty Shadow.

B lost her much loved daughter, Maya, a few days after birth in May of 2006. She learned that Maya died from an unbalanced translocation and has since been trying to have a child via IVF and PGD.

Trivia

How do you get a sleeping baby to wake up? Think to yourself, "Hey! I have some time to blog!"

So in lieu of a comprehensive post about EC'ing I was hoping to write, I am just going to throw out some random thoughts / observations as the day permits.

• LB isn't quite crawling yet, but she is close. She scoots backwards pretty well and rolls around.
• One of my favorite nurses at my clinic just gave her notice. It can't be a good thing when a nurse leaves after years with nothing else lined up. Selfishly, I hope I don't notice a difference beyond missing my nurse.
  
• LB's favorite food is avocado. She will lunge for it. She hates banana and while she doesn't usually spit it out, she will sometimes shudder as she eats it.
  
• I'm getting cold feet about our FET in April. We only have one embryo and there is only about a 10% chance it will make a live baby, but it is worth trying since it is more than $20,000 less than a fresh cycle and we only want one more kid. If we had a surprise pregnancy, I would be thrilled so I think the hesitancy is due more to not wanting to go back to the clinic. I was always treated well, but there is just so much stress and bad memories associated with it (with some good memories too).
• I don't want LB to grow up comparing herself to others. It is a habit that has certainly not served me ("Why does she get a baby and I don't?"). How do you do that in a society as competitive as ours? How do I learn to stop modelling that behavior?
• LB loves to play peek-a-boo. Actually we call it "Where's LB?!". We cover her with her blanket and shout "Where's LB?!" Sometimes she pulls the blanket down herself. Sometimes she goes perfectly still so I ask around . . . Ender, have you seen LB? Chaucer, have you seen LB? Then I find her and all her limbs start flapping! One of our favorite games.
• 20 years ago when my mom made me my latest baby blanket (adult sized) she got enough material to make 3 more for my sisters. She never made them. One of my sisters had decided she doesn't need a duplicate of her baby blanket anymore (how crazy is that?!). I now have that material. With some slight modification I hope to make a new one for me and two for LB (or one for a sib if we should be so lucky)
• I'm getting used to the idea of only having one child. Even though we are going to try, I just don't believe it will work. Yes, part of this is me trying to protect myself. Better to be surprised with it working then disappointed when it doesn't.
  
• If I believed in a god, I would be praying for Spring or at least a good thaw. I want to ride my bicycle!
  
• I love the way LB pushes herself from her tummy to a sitting position. So cute!
• On our first plane trip with LB, I was doing my best to keep her quiet and comfortable to be kind to any fellow infertiles who may have been aboard. Shortly after a beverage service, she started to get pretty unhappy so I opted to walk her up and down the aisle to calm her. I put her in front of me facing out and walked up the aisle and it was working. I turned around to walk back towards our seat at the back of the plane and she started squealing with delight. She sounded like an airhorn from the good ship Look At Me. That is not what I was hoping for. We managed to entertain her the rest of the flight from our seats.
• Just over two weeks to daylight savings time!
• LB is 8 months old today.
  

That's all for now. Hopefully soon I will be posting about our EC experiences. For the time being a teaser . . . we almost never change a poopie diaper and haven't changed one in over 3 weeks. The diarea she had while diaper free a couple of days ago doesn't count. Oh, did I mention she was teathing?

Stillness

A few days ago, I got off work at 4:00 to a fussy, sleepy and hungry baby. I quickly shut down my laptop, scooped her up from the babysitter and sat down on the couch to feed her. She nursed and then drifted off to a sound sleep. And by "sound" sleep, I mean a nap that I know could last more than an hour as long as I didn't disturb Her Nibs. Our little LB is a light sleeper and if she sleeps for only 5 to 10 minutes and then wakes up she will think she had a great nap until she gets cranky again - about 20 minutes later.

Knowing that I would be sitting there for at least an hour - maybe two, I started looking around for one of the books I have been reading. I could see two of them, but both were out of reach. Fine. Can I reach my laptop and get caught up on some of the blogs I follow? Nope - further than the books. Hmmm . . . what to do, what to do? This was going to be a long, boring couple of hours.

I let my eyes roam around the room looking for some kind of distraction and noticed the sun setting out the window. Beautiful. We haven't seen the sun much lately. Then I realized - I don't need a distraction, I need this - stillness. This time to myself that I have been longing for. Usually, when I have some time lately I am always trying to get caught up on things, feeling always behind and in a rush.

I had nothing I could do. Just sit. Not wait, just sit. I sat letting my thoughts come and go as they may, not focusing on anything for very long. I noticed the shadows changing as the room around me darkened with the setting sun, the weight and warmth of LB in my arms, the trees soon to be covered in leaves again. I admit I even spent a few minutes fantasizing about getting pregnant easily. What I didn't do is think about things I needed to get done or judge myself for dreaming about something I won't get.

It was a nice hour and a half. I was almost sad when Brad came home, the dog went crazy and LB woke up. But then it is always nice to get to say, "Daddy's home!"

For other Perfect Moments for this Monday, click on over to Lori's blog.

A few more answers about having a donor egg baby

I am finally getting back to answer the questions asked in my delurking post. Please see the rules at the beginning of this post before continuing.


JenniferK asked:

How important was it that the donor look like you? Were there certain characteristics you would have insisted on? Why? Now that you're on the other side do you think a resemblance is more or less important than you thought it was then?

The look of the donor wasn't really that important to me. I wanted someone close enough that it wasn't obvious that our child was conceived in a less than traditional way. I was much more concerned in finding someone who matched in personality. In terms of personality, I thought if I could find someone I could be friends with than it was probably a good match. The only thing I insisted on was that she liked to dance. Quite by accident our donor does look quite a bit like me. You can see a picture of us on this early post. I'm the one on the right.

I don't think I have changed my mind in this. I have lots of friends who don't look anything like me, yet we have much in common. Off the top of my head, I can't think of a single friend where we don't have similar interests, views, intelligence, etc. I wanted to make my relationship with our child(ren) as easy as possible. One of my early childhood experiences with adoption, my very conservative aunt adopted a very wild redhead. I thought their relationship was strained because of the difference. I don't know if that was really this issue for them or how their relationship is now, but it gave me someplace from which to start. Now, I look and act a lot like my mother, but we agree on almost nothing, so you never know.


Squarepeg asked:

How often do people comment that LB looks or doesn't look like you? Your DH? How to you answer or handle the comment/question?

When/how to you plan to share LB's story with her?

I don't get that comment very often. Everyone knows she is not my genetic child so they probably didn't feel comfortable saying it even if they thought it. There were times, early on, when I longed to have people say that LB looked like me. I have, on occasion, had strangers make that comment and it wasn't really satisfying. In my head I always thought, "Well, she doesn't. Not really." I did have one humorous occasion where a very lively waiter kept looking between Brad and I trying to peg where LB got her eyes. First it was me, then "no, it is your husband" and back again. We were dining with friends so it was fun to share this inside joke. It left the waiter completely baffled.

As time has gone on, I have changed the way I have answered the question. I'm still not quite comfortable with my response. With strangers, I just say, "Thanks." or "Do you think so?" or something equally non-committal and polite. With family members, I have said, "But she doesn't." or when that didn't feel right, "Really? You think so?" but that doesn't quite work either. I'm touched that they keep looking for similarities between me and LB (both in terms of appearance and personality) and forcing the issue when I deny responsibility.

As for telling - early and often. Well, not overly often. I don't want to make LB's conception a big deal, but I want it to be part of her story. I understand if you tell a child before she is 4 she will never remember being told so it will definitely be before then. I imagine telling her about her conception the way other parents tell children about their birth - lots of happy images and making her sound like the most special kid on the planet (which, of course, she is!). As she gets older, I will throw in more details because at first I'm sure she won't understand what it really means to be the product of a donated cell even if she knows about it. That's the plan anyway. We shall see how it turns out.


Julia asks:

I find that while I adore my baby girl to pieces, I still do wish that she were genetically mine. And not because I wish she were different in any way, just because there's all this stuff that goes along with it that I am sometimes not sure I am strong enough to deal with. This is all such new territory. Does that make sense? Do you ever feel like that?

I absolutely feel like that sometimes. When she was new and still pretty generic, I found I still wished I could go back in time and redo everything. Maybe if we went right to an RE, we would have never conceived a soon-to-be-dead baby. Maybe we would have had a successful IVF right out of the gate. I would love to have erased the heartache, pain and regrets in my life. Now that she is more of a little person, it isn't so easy. If someone came to me right now and said that I could go back in time and be guarateed a (relatively) easy conception and birth of healthy babies (2 please, 1 at a time) I might be tempted. It would probably all sound very good until the moment when I would hold LB for the last time. I would have to say good-bye and know that I would be un-making her and un-knowing her. I wouldn't do it. I love her too much. She is the child I want to see grow up.

One other revelation I had recently on this subject. Originally I had asked my younger sister to donate her eggs (she wasn't comfortable with the idea). I felt that her genes would be my genes, just a circuitous route. I have three sisters and we are all very much alike although we are also quite different in important ways. I don't recall what brought it up, but I was reminded that I might have used my sister's eggs. "Oh!, " I said as I held LB tighter, "I'm glad she doesn't have my sister's genes!" It sounded odd even to my ears because I was sure I wanted LB to have my genes and I was sure my genes were the same as my sisters.

It is complicated sometimes and I don't know how I will handle every situation. Sometimes I worry about being strong enough too. Recently there was an anonymous comment pointing to a set of blogs against adoption, ART and donor gametes. It made me uncomfortable to think that LB wouldn't be happy with her conception in the long run. I know some adult children aren't, but there are also many adult children who are happy even though they were adopted or the product of donor gametes. My goal is to love unconditionally and help LB be a happy and well adjusted adult. I don't think her conception is as important as how we raise her. I do think it is important to be honest with her about that conception and I am glad we have a known donor in case she ever wants to meet her genetic contributor.