IVF

Surrogacy

April 16th, 2010

I performed the wedding ceremony at my youngest sister’s wedding a few years ago. Another sister volunteered to to be a surrogate mother for my wife and I, modern science will let her carry our baby. I was tempted just so I could start a story with the line, “I married my sister, but my other sister had my baby.”

Despite multiple tries my wife and I have failed to have a baby with In Vitro Fertilization (IVF). Our doctor let us know we might have better success if a surrogate carried our embryos. Two of our sisters volunteered for the job. They offered before being asked, and without reservation, which says a lot about both of them. “If you don’t have reservations, you haven’t thought hard enough about it.” That was my reaction.

So, we all thought about it, a lot. And, if you haven’t thought about your sibling having your baby, which, why would you, I’ll tell you a few things you hadn’t thought about. Here are the Pros and Cons.

First, the Pros. There is one. Our sisters love us a lot. Enough to go through pregnancy and then give us a baby. We all think that would be an amazing result. That’s it though. Not much else in that column. It’s a big one, but still, there are a number of sizeable entries under Cons.

To begin, we have to choose one of our sisters to seriously ask. Two sisters volunteered. Who do we put at the top of the list? The youngest makes the most sense, which is a tough way to start; having to tell the older sister that her uterus is the B team.

People die in childbirth! What happens if something goes wrong? Okay, so dying during childbirth is highly unlikely. I can get my head around that. But, miscarriage is not. It’s just as likely as delivering a baby. The odds of miscarriage are about 50 percent in these circumstances. So, the odds are against my sister getting pregnant, but even if she does, it’s still a coin flip as to whether she will wake up in the middle of the night bleeding, and have to follow that with a doctor’s visit and a phone call to tell us she’s lost the baby. Huge Con.

That joke I told about my sister having my baby, I’d get a kick out of telling it three times, but that would be enough. Well, this isn’t the fifties, you don’t sneak off to have a baby if the circumstances make people uncomfortable. So, my wife and I are going to have to tell that story a lot, but not nearly as much as my sister and brother. This is an intimate personal decision you must get comfortable sharing with the world. If you know four adults that can do that without any awkwardness, you’re not normal. Seriously, good for you, but that’s unusual.

More than one person has advised, “You are not asking, she’s volunteering.” Which is a cop out. Asking someone to do something, and allowing them to volunteer, are the same moral ground. Our sisters have demanding lives of their own. Asking one of them to do all of that, and be pregnant with a baby she doesn’t get to keep, is huge. It’s bigger than that even. It’s a favor large enough to make me sea sick.

I like my brother-in-law. He is an excellent drinking buddy. And in my ranking system for beings, Drinking Buddy is up on the podium with Sister, Dog, and Wife. I know from our tries at IVF that the process is difficult on relationships, and there are a lot of them at stake here. Wives, husbands, brothers, sisters, not to mention a baby, all wrapped up in this decision. It’s a lot at risk.

We decided against surrogacy. It was too much. But, it could have gone the other way. There is a temptation, to both give and accept a gift of that magnitude. I could see how it’s something you might do.

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Biology

February 12th, 2010

I am not strikingly handsome or a member of Mensa. I will never set a world record or make a scientific breakthrough. I’m not special, and except to me, my wife isn’t either. A baby isn’t any more likely to be extraordinary because the two of us made it. So, is biology important at all?

In many ways, no, biology doesn’t matter. I’m confident I would love a child that’s mine, regardless of their DNA. That’s not the whole story though. Biology isn’t everything, but then again, it’s not nothing. There are definite advantages to creating a baby with your own genetics, both practical and emotional.

Having a child is scary. When you are considering jumping off that precipice, biology at least feels like something you can cling to in a sea of lurking unknown. I can’t know someone else’s medical and family history, proclivities, talents, weaknesses, and afflictions as well as my own. And, while I know my wife less well than myself, you know, we’re pretty tight. There is an element of becoming a parent that’s a gamble, but there is comfort in rolling your own dice.

You don’t have to qualify to have a child of your own. No interviews, social workers, reference letters, lawyers, counsellors, mandatory classes, support groups, criminal record checks, or doctor’s reports. You can argue that the process of qualifying to be a parent is both a good, and in the case of adoption, a necessary thing. I would agree, but the fact of the matter is, it is stressful to be examined with such intensity, and then to put yourself up for scrutiny by mothers, boyfriends, families, and government agencies.

When the woman you love tells you she doesn’t just want to have a baby, she wants to have your baby, that’s visceral. The desire to see your lover’s face reflected in your child is primal. Biology has gravity, there is a pull to it.

DNA, of course, does have concrete influences. Our kid has about a 75% chance of having brown hair and eyes. Who cares? Not us, but that’s not my point. My child would inherit some of my traits, and it is nice to think that they might benefit from some of my better ones. Maybe procreation is the ultimate act of narcissism, I don’t know, but I get the attraction. Biology isn’t everything, but it’s not nothing.

Next week something other than baby stuff I think. I’m trying to write a speech about Empathy for a Toastmasters competition. I’m struggling to find some way to lighten it up a little, the premise is that I could have easily been a killer. Oh, I know right, the laughs keep on coming.

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Choices

February 5th, 2010

There is an interesting talk on TED dealing with how too many options have a negative impact on happiness. It’s more difficult to select a salad dressing when you have a vast array available at your local supermarket. With all those options your expectations are extremely high, and when your choice fails to be perfect, there’s the nagging suspicion that you could have done better, so you are less likely to be happy with your choice. We had a meeting with our fertility doctor yesterday, and I’m feeling like I understand that better.

We could try IVF again. The doctor is surprised / concerned we have not yet been successful, but there is no outstanding reason to wave us off another attempt.

We could try a donor egg. The age of M’s eggs is a factor, and none have successfully implanted. The doc thinks this is our best chance to get M pregnant.

We could try donor sperm. The advantage here is this is a less complicated / expensive procedure, and we could take a few tries at it.

We could do IVF with a surrogate (with or without implanting M at the same time). This increases our chances, but clearly adds complexity, and affects other people’s lives.

We could give up fertility treatments and carry through with the adoption process we have started. This opens up a whole new series of choices: age, race, nationality.

Each choice has different benefits, risks, costs, success rates, and schedules. On top of all that are some serious and hard to answer personal questions about what having a child is all about, what is important, how badly does M want to be pregnant, and how do we feel about biology. We will have to make a choice from all those options, and it’s a decision with a lot of variables. It’s overwhelming. It really is. I have less of an idea about what we should do than I did before the meeting.

If you got pregnant by sharing a bottle of wine and an orgasm. Nice work. I’m envious.

The paradox of choice – TED

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The Plan

January 18th, 2010

When does The Plan stop being The Plan? We anticipate, create visions, project into the future, it’s a uniquely human curse. When The Plan fails to mesh with real life do you revise it, abandon it, or create a new one?

When we first started In Vitro Fertilization we secretly entertained notions of an easy home run. IVF overcame the vasectomy, which was the only hurdle we foresaw, and we’ve had excellent news at every step, except, of course, the final result. We have not decided if we will continue with the process.

Science provides other options. The doctor has suggested a surrogate, and to my great shock, we’ve had several volunteers. I’m still trying to get my head around the idea. It seems, extreme, and it involves other people in a process we’ve found to be stressful and highly emotional. No decisions here either.

The initial stage of the adoption process is a report that takes up to half a year to complete. We are going to get started on that in case it is what we decide to do. It’s always been our back-up plan.

The Plan still is. Same destination, different route.

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An Infertility Love Letter

January 7th, 2010

ivf_heartI’ve been surprised to learn that everyone has fertility issues, or has a connection to someone who does. For my wife and I, last year was dominated by a pursuit of pregnancy. I thought I would start this new year by sharing some observations about that.

We decided to be open about what we were doing and how it was going. That’s been a positive thing for us. This process is difficult enough without having to maintain a double life, but even if you choose not to talk to family or friends, try a professional. We both went to counseling, and I’d recommend the process. Infertility generates anger and heartache in significant quantities. Talk to someone, it helps.

You can do everything right, and still not win. That’s a tough pill to swallow but that doesn’t make it any less true. Do what you can, and let go of what you can’t control, which is almost everything.

A positive attitude all of the time is not required. If wishing was what it took, we’d all be pregnant. It’s okay to feel angry, frustrated and hopeless. Stop beating yourself up over it.

Stop feeling sorry for yourself. Your situation is worse than some, but better than most. Self pity is a comfortable place to wallow, for awhile, but don’t settle in.

You are not what people have in mind when they plan (or don’t plan) to get pregnant. No one is getting pregnant to spite you. I’m sure that’s what if feels like, but it’s not true. And they are not trying to tell you in a way that upsets you. I’m sure it feels like that too, but people don’t like to keep secrets from their loved ones, and it’s tough to know what the right words are.

We had a “State of the Union” meeting with our fertility doctor. My perception of our conversation varies significantly from my wife’s.

I heard the doctor say:

“It could be, that despite having plenty of good news along the way, that we have simply been unlucky, but we must also reconsider other possibilities. I’ve never been thrilled with the thickness of your endometrium (uterine lining) and my gut feel is that may be a contributing factor.”

Michelle heard:

“This is your fault. You have substandard equipment. You have let us all down. In summary, you suck.”

Faulting yourself because the lining in one of your organs is a few millimeters too thin, or a funny shape, or missing all together, makes no sense. You have freckles, or straight hair, or your second toe is longer than your big toe. These are not things you can attribute blame to. They simply are. You can fit that into whichever philosophies you hold. It may be random chance, fate, karma, predetermination, or the will of God. No matter which is true, there’s not much you can do about it. This is not your fault.

I’ve read many accounts of people that are upset that someone else got pregnant “easily”. This someone just got married, or has only been trying for a year, or hasn’t spent as much money on treatments, or has had fewer procedures. Measuring the relative worthiness of other people’s pregnancies implies that happiness has a price and that your pain, determination, or hope will eventually foot the bill, but you know life doesn’t work that way.

Life’s not fair. Good people die, the rich and famous are rarely deserving, and teenagers get pregnant just by looking at each other. It’s great to rage against the unfairness of it all, but it’s like screaming at a tornado, it feels good, but it doesn’t change anything. Of course it’s not fair, get over it. I don’t say that to trivialize your hurt, but simply because I see no alternative.

Your problems with infertility may end with what you desire, a baby, or this may become one of the major tragedies of your life, but not everyone who experiences a tragedy is made a victim by it. Seek counsel, tell it, write it, paint it, howl it at the moon if that helps. This need not be a fatal blow.

bruises
We men are the supporting cast in this drama. Women take the lead, along with the burdens of that role. I am sure there are other men writing about this somewhere, although we must be a rare breed because I haven’t stumbled upon any of them. So, I find myself in a position I’ve grown accustomed to from my family life, the lone male in a room full of women. I know to resist giving suggestions and advise, but I’m terrible at heeding my own counsel. My intent was not to upset anyone, of either sex, but if I did, I’m sorry, remember, I’m just a dumb boy.

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Just Breathe

December 14th, 2009

Forever on the edge, waiting. Always the promise, never the realization. It feels like I’ve been holding my breath for a year.

Anticipation, excitement, heart break, disappointment, anxiety, worry, frustration. It’s draining. I want off this ride. I want a vacation, a respite from decisions, a postponement on planning, an interlude to breathe deeply.

What the future brings, I will discover tomorrow. What I have today is more than enough.

Love to you and yours as the year draws it’s conclusion. Be good to one another.

I’m a lucky man to count on both hands
The ones I love,..
Some folks just have one,
Others they got none, aw huh,..

Just Breathe – Pearl Jam

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Twat Pills

December 4th, 2009
Beautiful brunette in a black dress and high heels

“I’m trying to think of a way to write this story so you will let me tell it.”

When I say this to my wife, she is standing over a mirror, with a foot on either side. I’d add, “in a compromising position,” but that’s redundant. You can’t straddle a mirror in a prudish way. It certainly doesn’t help matters that she is applying vaseline.

Normally, laughing would not be my response. I’d be too busy congratulating myself on marrying this girl, however, this is not what it looks like. It’s rare you can use that expression and mean it.

There are a lot of drugs involved in In Vitro Fertilization; vitamin and mineral supplements, hormones, and drugs designed to enhance, suppress, or encourage things in her body. An alarm rings six times a day. Everytime it does, she has to inject a liquid into her stomach, or take a pill. Some of these pills she can swallow, and some she has to take inter-vaginally, she has to insert them. Why the hell the vagina needs to consume this medicine in such a direct fashion I don’t know. I’ve already established I’m no gynecologist.

Every eight hours she puts two pills up her, and that’s the only thing that goes up there for two months, if you get my drift, which you must, I’m not being subtle. An orgasm contracts all sorts of muscles, as some of you may have noticed, and that risks a pregnancy. All that equipment is dedicated to other projects at the moment. For more than three months it’s off limits. You can bet that isn’t on the brochure for In Vitro Fertilization.

So, we have some time on our hands, which leads to some restless nights. One evening my wife looks over at me laying in bed and says, “We should shave you from head to toe. Everything except eyebrows and hair.”

“Yah?”

“Sure. What do you think?”

“I think we’d have to be pretty bored on a Saturday night.”

Thankfully, it hasn’t come to that, but we had a good laugh, and it’s important to remember to do that. This process is hard. There is a lot of anxiety, heartache, and stress. If you can’t find some humor in it, you have to fill the space with other emotions, and that’s rarely better. This is why, when her alarm goes off, she announces, “Time for Twat Pills.”

There is so much going on that we had to make up a calender with the dosages and procedures, which change every couple of days. As each of the six alarms goes off and she injects, inserts, or ingests a medicine, we cross it off the calender.

I saw her swallowing her vitamin so from the kitchen I yell upstairs, “I’M CROSSING OFF VITAMINS.”

“OK. AND TWO O’CLOCK TWAT.”

“OH. YOU DID THOSE?”

“WHAT? TWAT?”

“YAH.”

“YAH, I DID THOSE.”

Maybe that sounds strange to you. In truth, it’s lost all meaning for us now. It’s just another noun. Seriously, have about a dozen of those conversations and see if the words “Twat Pills” doesn’t start to settle into the decor.

Which brings us back to the mirror and the vaseline. As I said, it’s not what it looks like. These pills she inserts, the Twat Pills, they slowly melt, and well, the vagina is not Tupperware, it leaks. So she’s having trouble staying dry, and in what could only be considered a tragic irony, she has diaper rash.

The most valuable aspect of a sense of humor is the ability to laugh at yourself. You end up taking a lot of unexpected roads in life, at least if you are doing it right, and it’s often scary and unpleasant, but if you squint your eyes right, it’s a little funny too. So my wife and I have a good laugh, and I tell her that I love her, and that it is a shame that she will never let me tell this story.

Good response to my request for more “favorite clicking”. We’ve got some movement on the Reader Favorite board. Nice job folks. Thanks.

We find out the results of this IVF round next week. We both feel a bit reserved about it. We are trying to avoid disappointment by attempting to not get excited in the first place, which works about as effectively as you might expect.

Michelle beats herself up for not being the personification of positivity. So she’s feeling bad, about feeling bad. This whole process is a real mind fuck. Fingers crossed.

I’m still working on the story about what an awesome soldier I was. I’m having trouble though, it keeps getting longer, and I don’t have an ending (that’s good), so that might be next week, or not.

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Hopeful

November 27th, 2009

embryos
How do you feel?

Hopeful.

Me too.

More mellow this time though.

Me too.

Because we are more prepared for it not to work?

Maybe.

Ya.

I think we are kidding ourselves. It will still be terrible to hear “No”.

Ya. Happy sticky thoughts.

I love you.

I am disappointed, in you, quite frankly, dear reader. Many people told me they had a good laugh at me being terrified, but no one is voting for favorites. Clicking that little heart lets me know what worked and what didn’t, and it helps new people find things I wrote that don’t suck. If you read something here that you think qualifies to be put into that category, I would appreciate it if you would click the favorite button . I feel better now that we’ve had this talk.

I’m writing a story entitiled “Twat Pills“, about our fertility experience. I suppose I’m letting you know for two reasons. One is that some people may find that word offensive to some degree. The other is that I think it’s a funny story, so if the word doesn’t bother you, then you might get a giggle out of it. In either event, you can avoid/anticipate it as you see fit.

Happy Thanksgiving southern neighbours.

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Vasectomy

November 13th, 2009

I have been asked to share my perspective on vasectomies, and not simply because I have had two of them. I also got an infection following the second one, which made for a funny story, but I narrowly averted loosing one of my testicles. Then my wife and I changed our minds, and decided to have kids, so to secure my sperm a doctor extracted it with a needle. I have lengthy and unique experience in the area, is my point.

My road to a vasectomy started just like everyone else’s, with sex. “The Pill” reduced my wife’s libido to a point where birth control became superfluous, so we eliminated those, and our haphazard use of condoms felt like gambling. The list of solutions to avoid pregnancy is not long. Abstinence is not on our list, and the rhythm method works really well as long as you are comfortable having up to eight children. That left surgical options, and quite simply, those are less complicated for men, with fewer risks. So, I decided to get a vasectomy.

It’s a simple procedure. I don’t want to be flippant about this, but if you are able to be clinical, there’s not much to it. A local anesthetic and about twenty minutes in a doctor’s office. It takes longer to change the oil in my car.

Here’s the rub; low risk, is not no risk. In a minority of cases problems develop. Infection, inflammation, and chronic pain are all potential consequences. Not to mention that men with vasectomies have been known to father unexpected babies. However, in the majority of the cases, once you’ve calmed down from having someone cut open your scrotum, the only result is tenderness for a few days, and of course, sterility.

It seemed to work just like that for me, at first. More than a year after the operation I developed a complication. I’ll avoid medical terminology, what am I a doctor? The only detail that is relevant to my story is that sex became uncomfortable, or rather, I was unable to perform my “big finish” without some accompanying pain. Unless you are into some pretty specific fetishes, testicular pain during ejaculation is not desirable, so I was intent on getting that fixed.

The remedy was to cut out the old vasectomy and do another one. This was a more involved operation requiring general anesthetic, still low risk, but once again I won the “kicked in the nuts” lottery. I developed a serious infection following the surgery that put me in the hospital with a fever and very specific swelling. I made it to the other side of that sterile, without pain, and thankfully, with everything still in place.

forrestThen I decided I wanted to have children. Which I can’t adequately account for, but that’s what happened. A friend recently asked me about my inexplicable change of heart. “Well,” I said, “no one has ever accused me of being indecisive.” In whichever direction I’m going, I’m running, like Forrest Gump.

My road to sterility was definitely more harrowing than most, but I’m not unique in wanting to change paths. Vasectomies are reversible, with a good success rate, but it is not something I looked into. As you might imagine my internal debate about further surgery anywhere near my entertainment equipment went something like this, “Not a fucking chance.”

Instead, I elected to have a needle inserted into my scrotum to extract sperm from the source, which I know doesn’t sound any better. My wife and I agreed to try In Vitro Fertilization (IVF), for which the doctors need sperm, and more than a plastic cup and happy thoughts were required for me to participate. I’ve written about this elsewhere, I almost passed out, but other than that, it went fine.

To the poor guys who have been cringing since paragraph one; I’m done talking about terrible things that can happen to your balls. I have a bunch of sperm frozen, awaiting the chance to unleash my progeny on the world, and my reproductive equipment can go back to being entirely recreational, which was the point when I started this whole debacle. All’s well that ends well.

Would I have the vasectomy again? Probably. It was the right decision at the time. If I had all the above information in advance, or had an inkling I was going to change my mind, clearly I would have made better decisions, but you can say that about anything.

Bad luck magnified an error in judgement, twice, but hell, it’s a risk every time you get out of bed, and sometimes you get the short straw. Thankfully, I’m not a typical example. My only advise is to consider your options, perhaps more carefully than I, then pick a direction, and start running.

This article was written after prodding by Angie, one of the ladies at ivfdiaries.com, who asked me to write about my experiences, and opinion, on vasectomies.

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Of Mice And Men

September 21st, 2009

girl_skinned_kneeYour plans may bear no resemblance to real life. When faced with a discrepancy, it is you that must adjust. That’s an important life lesson, the good news is, we get many chances to learn it.

We received disappointing news. Our third round of In-Vitro Fertilization failed. The pregnancy test was negative. Fuck. Right? Right.

A positive result would be exciting and fill us with anticipation. It would be awesome. This is the opposite of that. This sucks. Life is often shades of grey; this is not one of those times, that’s my point.

Some take solace in labeling misfortune as fate, or God. Cosmic forces willfully conspiring against us having a child strikes me as the opposite of comforting. I take a simpler view; sometimes you get lucky, and sometimes you don’t. We are involved in an elaborate coin toss, and we are zero for three.

If we ever manage to have a kid I already know a little about what sort of father I will be. The first available opportunity will find me saying, “That’s right, life’s not fair. No point in crying about it. Get up and keep going.”

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Do These Look Bigger?

September 18th, 2009

“Good news, I think I’m going to puke.” My wife says this with a smile as she turns to face me in the car.

She is constantly searching her body for clues. She feels tired, her breasts are sensitive, but not as sensitive as yesterday, when she was a little nauseous, but today she has cramps, and a persistent headache. Everything means something, or maybe nothing, but it all ratchets up the anxiety.

“I feel like I should know something by now,” she tells me. The belief in good signs today, translates to worry about bad signs tomorrow. It’s a ride I’d like to get her off, so in as supportive a tone as I can muster I say, “Baby, you don’t know shit.”

The twelve day wait is tougher on her. She assumes responsibility for things out of her control, and if the pregnancy test is negative, she will see it as a personal failure. Nothing I say will change that.

breasts bra and tape measure

The absolute truth is, we won’t know until the doctor tells us the results, but my Sherlock is still on the case. Hormonally fueled body obsession does have fringe benefits. She sent me a text message consisting of a photo taken with her camera phone, and a question, “Do these look bigger to you?”

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Universal Health Care

September 14th, 2009

People come here from the U.S. to our fertility clinic. The clinic and the staff are excellent, but primarily it is the cost that brings people here. In many cases it is cheaper for couples to spend money on meals, hotels, and travel to come to Victoria for IVF treatments than it is to pay for it in the United States. That is unfortunate.

universal_health_care

Dear neighbours1 to the South:

Universal Health Care is an idea that most developed nations have adopted, and we love it, honestly. It’s not perfect, but if you get sick here, you will be taken care of, which we consider our collective right. You may come to see it that way too.

Don’t let insurance lobbyist scare you by shouting “Socialism.” Your government gave billions to bail out auto companies. It is too late to label government involvement in the economy as evil. That ship sailed a long time ago. You should at least get something for your money.

Most of you want to see changes in your health care. It seems like you have a big battle ahead of you. I hope you win. You deserve it. Until then, come up to visit Canada for your fertility treatments. We’d love to have you.

Good Luck,
Dirk

P.S.

I almost hate to mention it, but the Metric system, seriously, it’s here to stay. Every nation except Burma, Liberia, and the United States use it. That’s embarrassing.

In summary, Universal Health Care, it’s a good thing, and the Metric System, not a passing fad.

Resources

Footnotes

  1. Yes, that’s how we spell it. We like to throw useless u’s into the middle or words. I don’t get it either. []
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