The Great Uterine Wall

Never has my uterus needed more of a break than now. In the three years of trying to conceive, this is probably the only moment in which timing has been on our side. What better way to escape from this infertility quagmire than to go far far away to China. My husband has a project in Beijing and I'm coming along for the ride! We depart this thursday and it's the perfect way for me to leave all my losses behind and fly fly away. The last time I was in Asia was in 1997 when I was working in Tokyo for the summer during grad school and I travelled through China and Thailand. So I feel a nostalgia for my more adventurous travel days when going to "unknown territory" meant jetting off to thrilling escapades instead of unsatisfying follow-up meetings with your RE.

According to my RE, my tubes are clearly not causing the ectopics. On the flip side, he thinks perhaps it's my uterus that is not cooperating. My Great Uterine Wall may be keeping the embryos out thinking they are hostile enemy. He proposes doing a uterine biopsy to see if it is abnormal. If it is, then he would proceed with a estrogen priming protocol and using an estring to thicken my lining, As I sat there listening to him, taking it all in, I said to myself, "Wait a minute, that all sounds nice and dandy but this would mean I have to do IVF#4?" As I said before, I have all but given up on my uterus so why would this give me any hope that she will cooperate? There is nothing to say that some more estrogen it just going to magically transform my Great Uterine Wall and whallah - baby. I just don't trust it anymore.

As much as this gives a miniscule glimmer of a chance that my uterus might still work, the prospects of a nice young and hospitable uterus is still incredibly appealing to me. In a nutshell, the surrogacy agency was extremely helpful and informative. The process is long but not too ridiculous in terms of steps. Basically after you actually find a surrogate there are some legals issues and medical testing and then the rest is just like if I was doing IVF on myself, just transfer happens with someone else. 

So it will help me to list the pros and cons here so I can get my head straight and then run off to China and pretend none of this exists in my life. 

Pros of Surrogacy

• A safe non-hostile environment for my embryos.
• No more testing and procedures for me to keeping chartering unknown territories that leave me lost and frustrated.
• No more ectopics
• A physical separation from potential loss. Maybe it will hurt a tiny bit less if I am not the one physically miscarrying?

Cons of Surrogacy

• Expensive!
• It would take 18 - 24 months if it worked the first time. If you have to cycle again it's even longer. I will be close to 40 if and when this ever works.
• I have to get use to the idea of letting a total stranger carry my child. 

Pros of doing IVF#4 on myself

• Not much, besides if it worked I would be pregnant way earlier than doing surrogacy. That's been the case for 3 IVFs already. But why would I believe something that's cried wolf too many times?

Cons of doing IVF#4 on myself

• Risk of new protocol not making any difference, which then creates all the following risks:
• Risk of Ectopic and all evil havoc that it causes
• Risk of Miscarriage because of my horrible luck, plus my blood clotting factor
• Risk of BFN
• Risk of total and complete annihilation of my heart.

So all in all, surrogacy is still winning the race. But for this very moment in my life, I'm going to leave behind this country, with all these questions in it, and go to a new country where life means new tastes, new sites, new sounds, new people, and not a needle in sight.

UPDATE: I've heard that apparently you can't access blogger.com in Beijing. So probably won't be able to post while I am away. But will certainly report back when I set foot on U.S. soil. 

The Fertilization Report!

Portrait of Eggs

"When you start with a portrait and search for a pure form, a clear volume, through successive eliminations, you arrive inevitably at the egg. Likewise, starting with the egg and following the same process in reverse, one finishes with the portrait."

-Pablo Picasso

In the midst of all this IVF technology and petri dish babies, I forget that I am still part of nature. I'm not just a piece of meat to be probed and experimented with. I'm actually in the middle of one of the most amazing parts of nature - the making of the egg. 

On a short hiatus in Boston, I stumbled upon the Harvard Museum of Natural History. Needing a short respite from the blistering cold, I welcomed the warm quiet of a museum. As I walked through the halls, it's no wonder that two exhibits stood out to me. First I went to the Glass Flower collection by artisans Leopold and Rudolph Blaschka who created nearly 4,400 life-like representatives of the plant kingdom. I was not only struck my the amazing craftsmanship of the glass flowers, but also the endless variety of flower ovaries. Some ovaries were simple, others like intricate jewels, and all were distinctly beautiful. 

The next exhibit I was drawn to was called, surprise surprise, "Nest and Eggs." There were breathtaking displays of bird eggs, showcasing their diversity and the way birds nurture their young. Each one, from the basketball-sized egg of the elephant bird to the tiny hummingbird egg, was stunning. I couldn't believe that this same kind of beauty was happening in me. Where's the exhibit with the big uterus and my stimulated assortment of follicles? But in fact, this is what I have to remind myself that what's happening in me is indeed of museum quality distinction.

So this is my ode to the eggs growing in me right now. From the glitzy fabergé egg to the frail Humpty Dumpty to good old green eggs and ham, my eggs, your eggs, are part of the distinguished array of eggs in this world. Beyond how many they will retrieve this Saturday, or how many will fertilize, or how many will implant, I make these incredible things called eggs that are the beginning and the end and everything in between.

As the great author Zora Neale Hurston writes, “The present was an egg laid by the past that had the future inside its shell.”

Lemon Dates

Oh yes, I am bitter. I know it's not healthy, but when you've gone through multiple pregnancy losses these calendar dates that I call "Lemon Dates" still creep up. By definition, these are the dates that "could have been." Everyone has these markers and once there is any chance of being pregnant the dates all pop up. When is my first ultrasound? When will first trimester be over? And of course, the most significant, when will this baby be due? So today is a lemon date. If my first IVF had not been ectopic, I would be due to give birth around now. You might say, "Why think of such pointless 'what ifs' when all it does is torture you?" So why does this phantom due date irk me more than the one coming in July for IVF#2 miscarriage? The explanation requires a back story.

How many of us have had the unfortunate experience of a friend getting pregnant so effortlessly while you wait at your fertility clinic for your next god damn blood test? I bet many of you out there, if not all of you, have a story to tell about this most unfortunate thorn in a friendship.

My story begins with IVF#1. There is a very distinctive kind of hope during your first time because it's all unknown territory. You have no IVF failures yet to jade you. There is the freedom to believe this will finally be the answer. So nothing can explain the joy and utter relief I felt when my first IVF resulted in a BFP. Nothing. However, it didn't last long. If you can imagine how high I got, you know how far I had to fall. The rest of the story unfolds in a disastrous mess of betas not rising, taking a chemotherapy drug called Methotrexate to basically kill off the growing embryo, and living like I was a time bomb, fearing my fallopian tube would rupture at any moment and I would bleed to death. It took 15 gut-wrenching, devil-spawning weeks to get to zero. Needless to say, I felt seriously fucked over. 

During those 15 weeks, a very close friend who lives far away, but knew of my loss, called to check up on me. After spewing out my agony to her, she proceeded to say back to me, "Well, I have good news." My stomach turned and all the muscles in my body tensed as I said, "You're pregnant." So yes, my friend got pregnant with her THIRD child exactly when I had my ectopic pregnancy. However, she chose not to preface her news with a "I know this is a crazy time for you, but I have to tell you..." Nada. It was as if I had not even mentioned to her anything about an IVF and a now obliterated embryo once lodged in my fallopian tube. She went on to talk about how "stressed" she was about the nanny situation...blah blah blah. What could I do? I was shocked and played along. She didn't want to look at the 500 pound gorilla in the room so I let her believe I didn't see it either. 

Maybe you are thinking to yourself, "Your friend is an asshole." Yes, in the heat of that moment, I thought that too, and for several weeks following. I went into the deepest depression and internal anger I've had during this infertility experience. When I managed to climb my way out of it, I emailed her to explain how pissed I was about how she handle it. As much as I would like to portray her as the villain, I knew she simply didn't know how to deal with this ugly situation. She's never experience any major death or loss or tragedy to know what's it's like. She might have wanted to spare my feelings by not saying anything but whose feelings are really being spared? If you can pretend you aren't hurting someone you can almost get away with believing it. I wasn't about to let her get away with it. So it was good to let her express how horrible she felt about the situation and for me to hear that. In the end, I had no choice but to lay out my conditions to her - I can't hear about her pregnancy. 

Now, 9 months later, in the back of my mind I've been preparing for the email. The one I know is coming like all the other announcements of the newest additions with various photos attached, sometimes even a link to a whole fucking website. So an email arrived today. My strongest desire was to just hit delete and I could vaporize the whole situation. I didn't want to remember my ectopic. I didn't want to think about the baby she is having at exactly the same time I would have had my baby. I didn't want to remember how easily she gets pregnant. I didn't want to have to fake happiness. I finally decided to get it over with. "Just read it like you are ripping off a band aid - quick and painless," I thought. Within all her small talk, she basically was informing me of her induction date next week. Is it a preemptive strike email to warn me that the bigger email announcement is coming? I'm not sure. I am hoping this is her way of letting me know the birth date and I will be spared the mass email announcement. But most likely these things don't cross fertile people's minds. 

The hard part is that my bitterness is always mixed with guilt. It's not her fault that she's a constant reminder of my loss. She mentioned in the email feeling stressed about whether the baby will be healthy or not and I just don't know how to sympathize. I know anything can happen, but I place all my bets that her delivery will be just fine. Am I a bad friend for not writing back a nice email reassuring her that it's all so exciting that your baby is coming? Am I a bad friend to not want to hear about this kind of stress that I can't relate to? Am I a bad friend for not putting aside my own pain. Yes I already know I am, but I am also human. I'll come around I am sure, but bear with me today, I'm angry that she gets sweet fruit and I get a lemon. 

Be My IVF Valentine

I was never a huge fan of Valentine's Day as a holiday. It goes way back to kindergarten. I remember the smell of glue and scatterings of doilies, colorful papers, and scissors. Back then in the utopian world of elementary school everyone got a Valentine because love was to be for everyone. We all picked out packages of Valentine cards to give to the entire class. Everyone expected one in their cubby and that was that. On the other hand, the construction of our own Valentine's cards during class was slotted for the special people in your life - Mom, Dad, Grandma, Grandpa, and maybe if in a good mood, a sibling. There wasn't suppose to be anyone romantically "special" to receive these hand-crafted cards. 

So when a little boy at my table gave me a huge crayon colored heart with my name + his name on it, I got really mad. Madness came from the fact that he was NOT the boy that I liked, but regardless of even that, it is nearly impossible at that age to enjoy such blatant publicly spelled out love attention from a boy. One might expect a pull on a pig tail or a sticking out of the tongue, but the worst thing he could have done was give it to me in front of my entire table of fellow kindergarteners. They all proceeded to roar with laughter doing the sing songy "My name and His Name sitting in a tree. K-I-S-S-I-N-G!" In my utter embarrassment, I tore up the Valentine right in front of the little boy's face awaiting the audience's reaction. I did it painfully slow so he could feel every rip. The table paused and then burst out with a new rigorous laughter, but this time it was for him. I guess even at that young age the drama of rejection is thrilling entertainment.

I will always feel bad for what I did to that poor sweet boy who innocently tried to show me his love. What can I say, I just snapped. I became heartless to protect my own skin. No doubt kids are cruel in that particularly doggy dog world of kindergarten. So the memory stayed with me and I never felt very gushy about Valentine's Day after that. The funny thing is that in the end, I married that boy who gave me the Valentine. Not literally that same boy, who I hope is not today also blogging about the girl in kindergarten who scarred him forever, but a man who very much would have been a boy like that in kindergarden. A person who wears his heart on his sleeve and would have probably gone up to many girls in his elementary school with earnest and heartfelt Valentines. It was confirmed when my husband confessed that he was indeed that type of little boy and even fell in love with his kindergarten teacher who he would call on the phone just to talk. 

So years later I think the gushiest feeling I can admit to having on this Valentine's day is the fact that IVF has revealed the sweetest kind of valentine, the most supreme form of love, which goes well beyond any puppy love crush, or a lustful encounter, or even "husband" in the traditional meaning of the word. Through IVF our partners are the people who keep us standing through unbearable, unthinkable moments.  You know it's really love when your partner will masturbate into a cup on command, tolerate your hormonal insanity, keep optimistic about your prospects, and hasn't tossed you aside for wife number two or three like some emperor in need of an heir. They are quite happy to spend their lives with us, with children or without. What better kind of valentine could you have?

Tell me your most memorable Valentine moment. Good, bad, sappy, romantic?