aspiring baker

The other side

2008-08-25T14:50:00.000-07:00

Our culture is full of subgroups and clubs. You're gay, left-handed, Asian, Muslim, from another country, into pony play, a Mac user, whatever. When you meet a like-minded person, you might find a connection that others lack.

That's how it works among infertiles, too. We bond -- especially online -- over the months of disappointment, the dashed hopes, the miscarriages, the insensitive comments of family members, the fights with insurance companies, the misery at others' baby showers. We use cryptic acronyms, mourn the arrival of Aunt Flo, and send sticky vibes to one another.

But then some of us -- too few, it seems -- graduate or evolve or escape or something -- from our in-group. It's not quite like Susie Bright turning semi-straight, or a Jew going for Jesus, but it sometimes feels in the same ballpark. We are, now, one more poke in the eye of a person trying and failing to get knocked up.

That's how I felt this weekend, when I ran into a friend who's been trying to get pregnant for probably as long as I did. There we were in the supermarket, me with my Baby in a Bjorn, her with her husband and a slim waistline, looking at each other with much left unsaid. We talked of having lunch. Perhaps we will and she'll ask me for tips, or maybe she'll find the whole prospect too difficult and won't call. Who could blame her?

I've realized that I'm now on the other side. I'm done with my infertility supplies -- my speculum, my copy of Taking Charge of Your Fertility (great book) and Fertility Wisdom (skip it), any ovulation predictor kits that may be lurking in the depths of the bathroom cabinet. That's because if I decide to have another kid -- and though I always wanted two, lately I look back at the two years of struggle and am tempted to quit while I'm ahead -- I'll go straight to IVF and skip all the tracking/IUI crap. I used to consider friends who'd had miscarriages and went on to have healthy children as a beacon of hope. Now somehow, improbably, I'm that person who struggled mightily to get and stay pregnant and went on to have, keninah horah, a healthy child.

So I'm in a new club -- the club of new moms. We get together and go for walks, talking about sleep training, vaccinations, breastfeeding. We complain about our weight and exchange tips on the best Mommy and Me yoga classes. We do not, however, discuss our antral follicle counts or FSH levels. In fact, we don't talk about getting pregnant at all. Maybe some of these women had trouble conceiving; statistically, that has to be true. Maybe they look at their babies with the same amount of awe and disbelief and wonder and humility that I have when I gaze at mine. Maybe, like me, they tell their babies how very wanted they were, sometimes with tears in their eyes. Either way, they seem to have quit the infertility club, and for now, I have, too.

Rejected Facebook status updates of a new mom

2008-08-22T12:39:00.000-07:00

- 4 am AB's Baby slept 5 straight hours! Right on.
- 8 am AB is happy to have lost 3 pounds. Only 17 to go!
- 9 am AB, eying a sticky bun, wonders if how much her boobs weigh and if maybe she could get away with losing less than 17 pounds.
- 10 am AB is wondering if other parents find it odd to touch their children's genitals. Come on, has no one else felt this way?
- 11 am AB washed her hair two days in a row!
- Noon AB ate lunch standing up and walking around her house with Baby in a carrier, hoping the movement would keep him calm. Perhaps this is the secret to post-partum weight loss.
- 1 pm AB's Baby is on his third outfit of the day, owing to diaper malfunction compounded by user error.
- 2 pm AB tried and failed to run some errands, as Baby was more interested in screaming than in shopping.
- 3 pm: AB is trying to get Baby to nap.
- 4 pm: AB is in hour two of Project Sleeping Baby.
- 5 pm: AB is (sigh) still at it.
- 6 pm: AB has given up on the napping thing and wonders why motherhood doesn't come with its own personal bartender. Mojito, please.
- 8 pm AB remembers when she didn't wolf down every meal, hoping to finish eating before Baby cries.
- 9 pm AB, ever the partier, is heading to bed.

The swing of things

2008-08-06T11:37:00.000-07:00

That's what we're getting into around here, it seems. The good news:
- Baby is gaining weight appropriately.
- Breastfeeding is going quite well, except for a possible plugged duct situation. Overall, I seem to be the Bellagio fountains of lactation, which provides for some entertainment in our household. I can't complain.
- Baby sleeps often but not for long periods of time, though we have had a few glorious stretches of four hours and, once, a six-hour stretch. Am hoping for more.
- I'm healed from the birth and am starting to move my body around again.
- Baby is beautiful and sweet, and he seems to be on the verge of smiling.

The challenges:
- Staying at home alone with Baby can be difficult when, say, I want to take a shower, eat something, or do something other than feed, change, or hold him. Since I'm a Type A personality who excels at multi-tasking, sitting around nursing and watching the TLC network can be frustrating in its lack of productivity. (Yeah, yeah, I know, I'm solely responsible for the survival of another human being, and doing that is the very definition of productive. I get that.)
- Baby is frequently gassy, poor thing. Even when I don't eat foods from the cabbage family. (I don't buy the whole, it's related to what you eat business. At least not yet.)
- Brain is feeling the effects of non-consecutive sleep, causing me to write sentences like this one.
- Need to lose 20 pounds, but want to bake cookies instead. Only maternity clothes fit, and I have three weddings to attend next month.

So far our favorite baby products are the Miracle swaddling blanket (our ticket to longer sleep stretches), the Aquarium bouncy seat (which I scoffed at, not wanting something so, well, bright in my living room, but it's my ticket to a shower most days), and Calmoseptine diaper cream (this stuff rocks).

Since I'm fanatical about keeping this an anonymous blog, I'm not going to post any photos here. Sorry. Picture a cute Caucasian newborn, with a nicely shaped head and perfect features where they're supposed to be, and that's our Baby.

Seeing is believing

2008-07-02T10:29:00.000-07:00

It's a boy. He is fine, he is healthy, and we are perfect.

The big 4-0

2008-06-25T09:15:00.001-07:00

And here we are. 40 weeks today.

Funny how the number 40 has so many different significant meanings -- the Jews wandered in the desert for 40 years, Noah's flood lasted 40 days and 40 nights, Ali Baba had 40 thieves, freed slaves were given 40 acres and a mule. Of course, it's all well and good to consider a pregnancy 40 weeks long, because the average human gestation is actually 41 weeks and a day. Though not everyone knows the date of conception as precisely as some of us. I know that 38 weeks today, 23 eggs were retrieved. Of those, 11 fertilized and two were good enough to transfer. I'm hoping to meet one of them in the next week or so.

After two failed pregnancies and way too many hours spent watching Discovery Channel shows about preterm labor, I'm not sure I ever thought I'd actually make it to 40 weeks. Yet here I am at the end of what's been a largely unremarkable, uneventful pregnancy. No preterm labor, no bedrest, no preeclampsia, no gestational diabetes.

The hospital where I'm delivering recommends induction at 41 weeks, because they feel the outcome of induction at 41 weeks is better than at 42 (read: fewer stillborns). Over the weekend we thought I was going into labor -- I was having what I called cramps and what others called contractions about every 3-5 minutes. But then things calmed down. Still, I'm getting anxious to meet this little person and find out if he or she is okay. So today I'm seeing an acupuncturist in the hopes she can get labor started sooner rather than later. Stay tuned.

Adventures in antenatal testing

2008-06-15T09:27:00.000-07:00

Don't get me wrong: I have been, in many respects, fantastically lucky. At 38-plus weeks, I have managed to avoid all matters of preeclampsia, gestational diabetes, bedrest, preterm labor, and other unpleasantries common to pregnant ladies of my advanced age.

That said, the last week has been full of surprises. First, there are the amniotic fluid index adventures. Each week, I go for a non-stress test, thanks to my status as an elderly IVF patient. The test measures two things: the baby's heart beat (always fine) and the level of amniotic fluid. The latter was deemed to be declining over the past few weeks, and last Friday the nurse decided the lowish level warranted a physician's opinion. Said physician eventually determined that a) the baby seemed fine, if on the smaller side; and b) if the fluid continued to decline, which she felt was likely, we were looking at an induction sooner rather than later. "You will not be two weeks late," she decreed.

In preparation for my next non-stress test, I hydrated the hell out of myself, and with good results: the fluid level rose. Higher fluid level = no cause for concern = no imminent induction. Good stuff.

Less good, though, was the double-header news that: a) I am positive for group-B strep, requiring me to take antibiotics during labor. I'm disturbed by this because I have a few antibiotic allergies. And b) I seem to be positive for tuberculosis. This news is rather flummoxing, given that I haven't traveled to many exotic locales since I was last tested nine years ago, and I haven't had any symptoms of consumption. Which, like, I think I would have noticed. The doctor now wants me to have a chest x-ray, but I'm not particularly eager to do that at nearly 39 weeks. Seems possible they'll put me on some crazy drug regime to treat what might be latent TB, but I don't really know.

Again, don't get me wrong: I have been very lucky. The antibiotics thing will probably be fine, and the TB is most likely a fluke. Still, when did I become a magnet for infectious disease?

Suspension of disbelief

2008-06-01T09:53:00.000-07:00

I am sitting in the nursery. In a beautiful glider intended for breastfeeding, next to a crib filled with blankets and stuffed animals and adorable bedding, across from a changing table filled with baby clothes. There are also strollers (yes, multiple ones, I regret to say), a carseat, a swing, a bouncy seat, and assorted other items on the premises. There's a breastpump, a set of BPA-free bottles, diapers, wipes, kid books, and baby first aid stuff. There are baby carriers, a breastfeeding pillow, and books on every table advising how to get through labor and get a baby to sleep properly.

There's also a creature in my uterus that's stirring around right now. S/he is quite active and seems to have a definite schedule.

All of this seems to point to an actual live human being entering my family in the next month or so. In fact, at nearly 37 weeks, the kid could arrive tomorrow and probably be just fine (but, note to kid: please don't come yet. The world is harsh and cruel, and you could probably stand to cook a little longer.).

But I still find all of this pretty impossible to imagine. Yesterday, a friend asked about setting up some of the baby gear, and -- partly in an effort to keep my living room looking normal for another few weeks, and partly out of a self-protection mechanism I'll get to in a sec -- I said no, let's wait. She laughed and said, wait until what, you're in labor? And I thought, yes, perhaps labor will be an excellent time to fuss with poorly written instructions for items made in China. Or maybe when we're home from the hospital, sore, and overwhelmed and exhausted? That sounds perfect.

Maybe if I knew the gender this would seem more real. Or maybe if I hadn't spent two and a half years trying to get to this point, agonizing over infertility and watching two pregnancies go down the drain, I'd actually feel able to really connect with the being inside of me. I haven't sung to it as I imagined, haven't played the music for the fetus as I always planned. (In fact, I don't like calling it a fetus at this point. Isn't it a baby by now, asked the staunchly pro-choice feminist as she cringed a little inside?) I talk to the baby sometimes, occasionally encouraging it not to head-butt my cervix and asking it to consider going to sleep when it's 11 pm and I'm tired of the constant fluttering. But I don't know that I've connected with this baby in the way that I imagine others must do with their children. Can it really be the case that I'm going to be a mother?

Last October, just after my IVF procedures, a friend asked, when will you know if it worked? And I answered, in about nine months. It's coming upon that time. Even though all evidence points to success, I will still believe it when I see it.

PS Some stats:
Number of pounds gained: 29
Number of sympathy seats provided to me on BART: 4
Number of sympathy seats provided to me on Muni: 0
Number of people who've said I look small or even "tiny" for where I am in the pregnancy: 10+
Number of times I've run into people I know in the last two weeks and have had to tell them I'm pregnant: 2
Weeks of gestation it took for a woman I see once a week to realize I'm pregnant: 36
Percent of gender-specific dreams I've had where the baby turned out to be a boy: 0
Share of close friends surveyed who think this baby a girl: 4/5
Weeks since the amnio that I've managed to not call the perinatologist to find out the gender: 20
Number of non-stress tests performed thus far: 4
Number passed: 4
Times I've had heartburn during this pregnancy: 0
Number of contractions I've felt: 0
Weeks the baby has been head-down: 8
Pairs of work-appropriate pants that I can comfortably wear all day: 2
Pairs of work-appropriate shoes I can tolerate wearing all day: 4
Percent of rings that no longer fit me: 100
Number of days officially left in this gestation: 24

Phew

2008-05-01T05:52:00.001-07:00

For the first time in the last three years, I've made it through April without the baby(ies) dying. Two years ago last Sunday I had my first miscarriage; a year ago today I had my second. But today is May 1, and this kid still has a heartbeat and is still moving around. I'm starting to believe this might actually happen.

Last week I bought things for the baby for the first time -- I spent a big 40 bucks on a crib sheet and blanket. It's not that I don't have anything; it's just that I'm hugely fortunate to have many generous friends and family members. I partly haven't bought things because so far I haven't needed to, and I partly haven't bought things because -- even though there's ton of baby stuff in my house right now, provided by others -- I'm a bit superstitious.

There are still tons of things to do -- figure out legal stuff, decide about cloth v. disposable, decide about circumcision in the hospital vs. a mohel (don't bother flaming me; comments are moderated for a reason), get the baby's room ready, maybe pick out a few names, find a daycare center. But things are progressing: we've taken our childbirth, newborn care, and breastfeeding classes. I've got a dresser full of gifted baby clothes and a closet full of receiving blankets. I've got a stroller, a crib, a glider on the way, and two slings. And that's before the two showers that incredibly lovely and generous people are throwing for us.

Still: I'll believe it when I see it.

75 percent

2008-04-19T06:52:00.001-07:00

Many mazels to Nikole and John and Sara and Erin -- it's lovely to have read your blogs for so long and see the long-anticipated fruits of your labors. Congratulations!

I cannot believe that I may be next. I'm now 30 weeks pregnant. The baby moves often -- the other day I decided s/he will be a gymnast because of all the apparent somersaults -- which makes it pretty easy not to wonder if it's alive. Still I worry: just last night I dreamt I was bleeding and had to call the midwife at 4 am. But at some point in the last several months the anxiety changed: for a long time I worried I'd lose the pregnancy; now I worry about preterm labor.

But so far I've been incredibly fortunate. Placenta previa has been ruled out, thank God, and every doctor's appointment has been fine. Baby seems to be growing appropriately, my blood pressure hasn't gone through the roof (though, pessimist that I am, I still worry I'm doomed to preeclampsia), and I have felt either none or few contractions. I'm having a non-stress test in a couple of weeks -- a reward for being both old and an IVF patient. But beyond that, I'm free to do whatever activities I like, within reason. I've been incredibly lucky in terms of how I'm feeling: I'm tired, but I'm still exercising nearly every day (mostly walking and yoga, with the occasional half-mile swim), still moving around at mostly my normal pace. My goal is to continue that as long as possible.

I don't, however, always look pregnant -- even at 7 months someone yesterday said she wouldn't have known unless I'd told her. I haven't had a single stranger ask me when I'm due, something I always expected, and I think I've netted a total of two BART seats thanks to my 'condition.' It's definitely disappointing to have imagined looking big and pregnant, and instead to just look big and fat. I think it makes the weight gain (about 20 lbs so far, totally normal) a bit harder to stomach. My original goal was to gain no more than 25 lbs during this pregnancy, but now I'm trying to be comfortable with 30. Sure, you might say, that's totally fine and you're being all crazy paranoid obsessive-about-your-weight lady. Yup, you got it! But you may also recall that I lost 75 lbs about five years ago. I've medaled at gaining weight, and I want to make sure I can lose it again.

As I've written before, in 2006 and 2007 I began April pregnant and ended it with a miscarriage. Even though I generally like the month of April, it began to seem like the cruelest month, indeed, a while back. Here's hoping 2008 improves April's reputation.

Seasons

2008-03-24T06:32:00.000-07:00

This pregnancy is nicely arranged around the seasons. It began around the autumn equinox, and it's scheduled to end (allegedly) around the first day of summer. As I near the end of the second trimester, I've spent all of fall and winter pregnant.

Which brings us to spring, one of my favorite seasons. Love the flowers, the strawberries, the fava beans and asparagus. For the last three years, I've spent the beginning of spring pregnant. Last year April began with the news of my second pregnancy, and it ended with a D&C.

This year things are looking -- keninah horah (or however you spell that) -- different. So far, this baby has been deemed by all to be in fine shape. We passed the amnio, passed the 20-week ultrasound, passed the gestational diabetes test (phew!). It moves around a lot, especially at certain times, and I haven't used my fetal heart monitor in weeks, because I know from its movement that it's okay in there.

Apparently my 20-week ultrasound revealed what might be a low-lying placenta, so on Friday we're having an extra ultrasound to see if placenta previa (where the placenta lies very close to or on top of the cervix -- bad) is on the menu. Of course I did the research and found out you're at a greater risk for PP if you're over the age of 35 (check) and have had previous uterine surgery -- like, say, a D&C or two (check). The nurse at my midwife's office has assured me the chances are slight, even with my history, so I'm trying to be optimistic. Especially because placenta previa would severely interfere with some upcoming travel plans. Cross your fingers.

Beyond that, though, I have few complaints. I'm able to exercise without a problem, I'm sleeping adequately, and while I feel giant, I'm still moving around at a good clip. Even though I've put on nearly 20 pounds, and even though I'm six months pregnant, few people seem to look at me and see that I'm expecting. I have one maternity dress that's gotten me a seat on BART a couple of times, but that's it. Even old friends, colleagues, etc., seem to think I'm just getting fatter. I certainly don't look the way I'd hoped at this stage, but given how the last two springs have begun, I'm beyond thrilled and exceedingly grateful to be beginning this part of 2008 with a well-established munchkin in my uterus. As long as I know it's in there, we're good.

Bumps

2008-02-18T07:35:00.000-08:00

If you ever want to see how differently human bodies carry extra weight, watch an episode of The Biggest Loser. The incredibly brave contestants bare almost all to get weighed each week, and what you'll see as they disrobe is how differently a few dozen or hundred extra pounds sits on different people.

The secret of weight loss, of course, is that if you have carried extra pounds for a long time, your skin doesn't just magically turn back into the smooth 22-year-old body you were hoping for. Skin remembers. Combine its extended stay in an extended format with whatever extra pounds you didn't lose, and your slimmer figure will be distinctly, well, lumpy.

There are two reasons I haven't put a baby bump photo on this site. First, I'm way too self-conscious to show that, because second, my baby bump is distinctly unsatisfying. Almost 22 weeks into this pregnancy, I don't really look visibly pregnant unless I'm wearing precisely the right outfit. Instead, I just look fat(ter).

You see, I naturally have two bellies -- a bit of belly above my waist (which, it seems, is where the majority of the 12 lbs I've gained so far have taken up residence) and a bit below. Now both areas are noticeably bigger than they were pre-pregnancy, but I'd be much happier if I only had the one below my waist -- the baby bump I'm supposed to have. Instead, I'm watching my usually defined waist gradually disappear, and eventually my two bellies (one fat, one baby) will meet. And then, I'm sure, I'll look quite pregnant.

Last week, a co-worker who was late to the big news figured it out and tried to touch my belly, I nearly bit her head off. I'm self-conscious about not having the right baby bump. And why wouldn't I be? Everyone else is -- just pick up a celebrity magazine and look for its "Bump Watch" section. Half the time the photos they print aren't even of people who are pregnant; they just had the nerve to breathe when the photo was taken. Earth to photo editors: that's not an embryo; it's a pelvis!

We're still here

2008-02-10T14:43:00.000-08:00

Apologies for not posting in a while; I've been traveling a bit and now have a nasty cold. (What's more fun that having a cold? Having a cold with round ligament pain and no drugs!)

The good news is that the munchkin is still around and now is kicking away -- I've been feeling it move for weeks, but yesterday my partner felt it for the first time. We had our 20-week fetal survey ultrasound on Friday, and everything looks good -- the doctor was happy with how the baby's heart, brain, spine, kidneys, bladder, stomach, and limbs looked. The kid is 9 inches long and weighs about 11 ounces.

I don't really look pregnant -- just fat(ter). (Even though I've gained 12 pounds and am wearing only maternity pants and mostly tops these days.) It's a little disappointing not to be showing at nearly 21 weeks, but I'll take what I can get. I'm excited about starting to show.

Next tasks:
- get room ready
- figure out what to register for (egads)
- hire a doula
- figure out daycare
- and a lot more than my virus-addled brain can't compute right now.

The sigh of relief heard 'round the world

2008-01-17T11:35:00.000-08:00

That was me this morning, falling to my dining room floor in relief at the news that the amnio were normal.

I've been telling people at work today. After two years of trying, and two false starts, this is a day I never thought I'd see. And yet, here it is.

PHEW.

The waiting game

2008-01-14T06:54:00.000-08:00

Is there any part of this process that doesn't involve long, expectant (ha) periods of time?

You wait to get your period to start birth control pills, you wait to start the injections, wait for daily phone calls announcing your estradiol numbers, wait for the call to do the trigger shot. Wait for the fertilization report, wait to pee on a stick, wait for your beta results.

But that's not all! Then there's the waiting for the seven-week viability check, waiting for the (cancelled) CVS, waiting for the end of the first trimester, waiting 45 minutes in a ridiculously small and windowless waiting room to see your OB, waiting to have the amniocentesis (at 16 weeks), and then, now, waiting for the results. And, provided all is well, of course then you wait to give birth and then, once the kid has finally arrived, wait for some kind of child-related disaster.

So far, everything with me is fine. Nausea is gone, headaches have subsided, lower back pain isn't as bad; I feel good. And our baby is still in there, it still has a heartbeat, it is measuring on-target. I may have felt it move. It has arms and legs, a bladder, a head, a spine, the whole megilla. The ultrasonographer at the amnio said all of the structures look good, and she listed several symptoms of Down Syndrome that she did not see in our baby. Then the perinatologist came along and, in what I presume was his standard, lawsuit-preventing answer to anxious gravids, said, well, 50 percent of Down Syndrome kids don't show any symptoms on an ultrasound.

Uh, fantastic.

So now we wait. Results take either 10 to 14 days or 7 to 10 days, depending on who you listen to. Today is day 5. As usual, I cannot wait. In some ways, this is the moment I've been waiting for the most, because while I've told several friends that I'm pregnant, almost no one in my close-knit office has any idea why I'm expanding. I've only told my immediate family. And I have waited for the moment when I actually get to tell people for so long. Here's hoping it actually happens.

Firsts

2007-12-29T08:29:00.001-08:00

"Is this your first?"

That's the question people ask -- in the deli, in yoga classes -- when they find out you're pregnant. It's a question I can't quite bring myself to answer.

My first would be about a year old now. Maybe he'd be walking. (For some reason I feel it was a boy.)

My second and third -- identical twin boys -- would have been born this month.

My fourth stopped developing about five weeks ago, and its sibling -- my fifth -- still seems to be around, kenina hora.

Yesterday after my prenatal yoga class, I went to a crowded taqueria for lunch. A woman from my class sat down to share my table. In talking about our pregnancies, we discussed our past ones. I realized that for the third time in a month, I shared very personal information about my miscarriages with someone I barely know.

I have fought so hard to become a mom. In my life, I've dealt with major work difficulties, breakups, and family health crises. I fought to lose and keep off 75 pounds, and I trained myself to run half marathons. But nothing has been harder than trying to conceive. And nothing has been harder than staying on track after disappointment upon disappointment. So when a woman sits down at a restaurant to share chips and salsa with me, I can't just blithely pretend that this pregnancy came easily. Infertility and miscarriage are part of this narrative, and I don't feel the need to whitewash it. Moreover, I feel that to get me, and to get what this pregnancy means to me, you need the back story.

No, this isn't my first baby. It'll hopefully be my first child, but it isn't the first time a living being has taken up residence in my womb and in my heart.

It's alive!

2007-12-19T06:29:00.001-08:00

It should come as no surprise to regular readers of this blog that I'm a little anxious about this pregnancy. Since passing all of the initial tests, I've graduated to a state of regular pregnant-ladyness. Which is great, except for the part about not seeing the doctor that often. How the hell am I supposed to go a whole month without knowing for sure if it's still kicking?

Well, I don't have to, thanks to the combined wonders of modern technology and the Internet. Yesterday the fetal doppler monitor I ordered came in the mail. For $46 a month, I can use this thing to find the baby's heartbeat and even see what it is on a digital readout.

I didn't really think it was dead; even though my nausea has mostly subsided and my fatigue has improved, I'm definitely getting bigger and hungrier. But with my second miscarriage, I had no miscarriage symptoms and the embryos were gone. So there's no guarantee that the absence of symptoms is good news.

But a display of munchkin's heartbeat -- it was in the 150s -- is a pretty good guarantee for now. Worth every penny.

Milestones

2007-12-12T06:42:00.000-08:00

I definitely feel like I'm in a foreign country without a map. This whole 12-weeks-pregnant-and-everything-looks-good thing is completely foreign territory.

Today I am 12 weeks. 12 weeks! Never would have thunk it. Can't decide if this is the start of the second trimester -- even the medical books don't seem to agree. I'm going to be literal (for a change -- NOT) and decide that I'll be in my second trimester at 13 weeks 3 days (divide 40 weeks by 3, etc.).

Last night I received my last intramuscular progesterone shot -- something I'd been getting daily for more than two months. Thank God. My ass is going to be confused when it doesn't get stabbed every night.

At this point, I'm like a regular pregnant lady, going to see the doctor every four weeks. Which means I don't go back to the doctor until 2008. After being wanded every two weeks at a minimum, it's bizarre to go four without seeing an ultrasound machine.

My newest worry: figuring out when to tell people, mostly at work. I would like to wait until the amnio results come back, but that won't be until around January 23, when I'll be 18 weeks (kenina hora). I can't imagine I won't be showing by then, and while I am generous of belly even when not knocked up, I think by then it will be obvious that I've gone beyond eating too many Christmas cookies.

So the question becomes, to tell before the amnio results? That terrifies me. I believe that everything will be fine, but at the same time, I am having a hard time balancing my desire to tell people before it's completely obvious and my desire to keep it quiet until I know the test results are okay.

Feedback welcome!

CVS converted to amnio

2007-12-06T16:27:00.001-08:00

We went to our appointment today. All looks good, but the doctor was concerned it might be difficult to get a sample of the cord for the surviving twin. He was having trouble telling what went where and felt it would be better if we wait to do an amnio, since at that point there will be no question of whether he's getting into the right sac.

So, no CVS today. However, we did get to see a bunch of really cool ultrasound pictures. We saw the head, the arms, and the legs! (It seems to have two of everything it should have, and just one head.) It seems to have my big nose, and it was really active -- moving around a lot, and it grew 4 mm just in the last two days! It had a heart rate of 170 bpm. We're 11 weeks 1 day today (cannot believe that!) but it measured 11 weeks 5 days. Maybe it'll take after its big momma.

The doctor was able to see that the nuchal translucency -- the fold at the back of the neck -- was nice and thin. That's good, because a thickened NT can indicate Down syndrome. He thought everything looked great, so we have to wait 5 more weeks for the amnio and 2 weeks after that for the results.

I was really nervous this morning about this test, and while I wish I didn't have to wait so long, I'd rather wait and know that the answers are pretty definitive instead of get ambiguous results and then end up having a CVS AND an amnio. So, provided nothing goes awry, we have no doctor's appointments until 2008.

My one and only

2007-12-04T14:05:00.000-08:00

What was two is now one. And really, that's okay.

The ultrasound we had two weeks ago showed two embryos. One looked fine, and one looked a little small and had a rapid heartbeat. Today's scan showed one great-looking embryo (measuring 3 days ahead of schedule) with a good heartbeat, and one embryo that was half the size and didn't have a heartbeat at all. This is now a singleton pregnancy.

We are both sad and relieved. The idea of twins terrified me, and the idea of a selective reduction pained me. At least if I'm not going to have twins, I can be glad the decision was made for me.

The next step is a CVS, which happens (egads) Thursday. I had been advised that a CVS wasn't recommended with twins, though our perinatal clinic apparently does them on twins all the time. Their miscarriage rate is the same (1 in 1,000) with both CVS and amnio, and a CVS happens several weeks earlier. I realized that if this pregnancy isn't going to happen, I'd rather know sooner than later. So Thursday it is.

I seem to have produced a lot of chromosomally problematic embryos. Here's hoping the one that's left is perfectly fine.

Public service announcements

2007-12-02T12:02:00.000-08:00

1. Pedestrians have the right of way in California.
2. On the BART escalator, you stand to the right and descend or ascend on the left.
3. Things not to put on a resume: "Typing speed: 48 wpm" or "GPA: 2.5." If it's not helping you sell yourself, skip it.
4. During IVF, embryos are transferred to the uterus. They are not implanted. If they could be implanted, a lot more IVF babies would be running around the planet right now.
5. I am sorry to say this, but implantation spotting is rare.
6. There's a Internet newsgroup called "alt.possessive.its.has.no.apostrophe." Consider this sentence: "It's cute that the dog is carrying its leash like that." "It's" is a contraction for "it is." It takes the place of a subject and a verb. "Its" is possessive. You use "its" just as you would use "his" or "her."
7. If you sell fish oil and dog food that contains meat, you are not a vegetarian co-op.
8. Everyone's height is proportionate to his or her weight, regardless of how tall they are or how much they weigh. If you are placing a personal ad and don't want to date fat people, just say "no fatties." It helps tell people more about you, and it does all of the rest of us the favor of not answering your ad.
9. Cappuccino doesn't have an H. Espresso doesn't have an X.
10. Panino means sandwich in Italian. Panini is plural. Therefore, a "panini sandwich" is both redundant and incorrectly plural.
11. Yes, your carry-on is probably too big for the overhead bin.
12. Al Gore won the popular vote in 2000.
13. Your golden doodle is cute, but it's still a mutt that cost $3,000.
14. No, I do not want a Jews for Jesus pamphlet, ever.

Follow your nose

2007-11-26T06:54:00.000-08:00

I seem to be developing a supersonic sense of smell. I've always had a strong aversion to most dairy products, but lately cheese is showing up in unusual places. First, the squash soup at Thanksgiving tasted cheesy. It wasn't, because the chef had described to me, in detail, the vegan recipe. Then, at dessert, I took a slice of pecan pie, and as I raised it to my mouth, I thought, this smells like cheese. Now, I've never made pecan pie before, but I read enough cooking magazines to know that cheese isn't typically found in pecan pie. (Apple pie, maybe.)

I asked the baker if there was cheese in the pie. She thought I was insane, of course, and said no. But I was later vindicated when my partner smelled the pie and agreed about the cheese scent. The baker later recalled that she had used some kind of raw butter that's particularly cow-y. Hence the cheese smell. Later on, I found myself holding my breath every time someone opened the leftover-laden refrigerator. Bleah.

This is either going to launch my career as a private investigator, or become unpleasant really fast.

Pretty, pretty, pretty good

2007-11-19T18:57:00.000-08:00

I am still pregnant, and I am still pregnant with twins.

One embryo measures 20mm or 8 weeks 3 days, with a heartbeat of 183. That was deemed completely fine.

The second embryo either measures 18mm (8 weeks 2 days), as determined by the first doctor, or 15mm, as determined by the second, with a heartbeat of 197. The combination of the smaller size and rapid heartbeat suggests that this embryo may not make it. But it's hard to know.

If the second twin doesn't make it, I think I'll feel a combination of sadness and relief. If I'm not going to have twins, I vastly prefer that the decision be made for me.

I go back either next week or the following week for another ultrasound, and I'm going to schedule my genetic testing. Apparently CVS isn't recommended for twins (hive mind: input is welcome), so we'll probably do an amnio. I am concerned that I'll start to show before the amnio, and that I'll have to tell people before I'm ready, but perhaps I can cross that bridge, etc.

Thank you, as always, for your well wishes. And happy Thanksgiving -- I hope all of you have as much to be thankful for as I do.

8 weeks, 3 days

2007-11-14T06:42:00.000-08:00

That's how pregnant I am. I've never been this far along before, so this is uncharted territory. I have had some cramps in the last few days, which I do not appreciate, but the nurse said not to worry (yeah, right) unless I see blood -- not spotting, but actual red blood. (No spotting whatsoever, and you can bet your grandmother's Venetian glass collection that I check every single time I'm on the toilet.)

Our next appointment is at the clinic on Monday. If all goes well, I graduate to an actual OB -- just like a regular pregnant lady! -- and have an appointment with one later that afternoon.

Meanwhile, the Twin Freakout Level has been reduced to Schoolbus Orange from Blood Transfusion Red. I find denial is a wonderful thing. But it's hard to deny completely -- last week my pants began to be tight, and this week I had to raid the supply of clothes I saved when I lost a lot of weight four years ago, in the event someday I'd need them again. (I'm attributing my larger size to a twins thing because probably most women who are eight weeks pregnant with singletons aren't out shopping at Pea in a Pod.)

Even some of the clothes I saved are too small in the waist. I thought I'd just buy a few things in larger sizes at the Gap, but when I couldn't find what I wanted in the store, I ordered a few things from Gap Maternity. Of course I am conflicted about this: I fear I'm jinxing myself, but at the same time, since I work in an office rather than a gym, I need to attend my job wearing something other than sweatpants.

Viability is still a huge concern. I've had a few dreams where I started spotting, and at least one with a too-small embryo on an ultrasound. (I think there was just one in that dream. See? Denial.) Sometimes my breasts aren't as tender, or I feel more energetic, and I think, shit, this is already going downhill. But then a wave of nausea hits, or I feel assaulted by fatigue, and I think, this still seems to be happening.

Hopefully the doctors on Monday will agree.

In which I reveal myself to be a horrible person

2007-11-07T06:34:00.000-08:00

I'll just say it: I don't want twins. My partner, a reluctant participant in the Bun Project to begin with, definitely doesn't want twins.

Now, I recognize there are all kinds of horrible things about saying this. I have friends who have twins. I actually was a little obsessed with twins in high school (blame the Sweet Valley High books). I would like to have two children, if the first one doesn't kill me. I smile at women with twins in strollers just like you. I think there is something wonderful and special and unique about having two children at the same time.

But I don't want to do that myself. First, I worry about the complications of a twin pregnancy -- I've heard too many horror stories, even though I've personally observed some big successes. (Luckily for me, I have no medical problems other than the whole infertility thing.) I like to think I'm quite competent -- okay, I am quite competent -- but I'm not sure I can handle two babies. I have no close family in the Bay Area, and though my close family isn't that far away, they're not here. I have wonderful friends, but most of them have their own families to take care of. I have some financial resources, but I'm not sure that would be enough. I have a demanding job that I have every intention of keeping. (Hell, we can't afford for me not to work.) I have a partner whom I love dearly, but who generally would prefer not to have children and has described her ideal involvement with a child as being like a "50's dad." How, precisely, is this supposed to work?

This may be an awful thing to write, karmically, given the two embryos that seem to have taken up residence in my uterus. I know. And I know some people will say, "God/the universe doesn't give you anything you can't handle." At the risk of sounding ridiculously callous and practical (bingo!), I don't think so. People don't choose to get cancer, but I think my brilliant friend who recently died of cancer in her early 50s didn't get sick because she could handle it. She got sick because sometimes life sucks. People aren't given sextuplets because they can handle them; they, and their doctor, make a choice to risk and then have sextuplets. It's a choice.

And this twin pregnancy was, I regret to say, something of a choice. We had two embryos, and we could have chosen to transfer one. Given the embryo quality, we could have put in one, but given my history of miscarriage, the doctor (who described her approach as conservative after we said, adamantly, "We don't want twins!) recommended two. One would be a fail-safe measure.

We have discussed selective reduction, but I don't know that we could do it. We'll have to see how the next ultrasound looks, and later, what the genetic testing shows. (If you're really offended by talk of selective reduction, I'm sorry, but please don't flame me in the comments. The management has a strict no-abuse policy. Especially because the management, at the moment, is an emotionally fragile, bloated, and nauseous pregnant lady.)

In the meantime, I'm trying to balance my joy at getting asked back for a second interview here, and my absolute, utter terror at what it might show.

Three words

2007-11-05T11:50:00.000-08:00

Viable twin pregnancy.

Or, to use a few more: there are two embryos in there, two heartbeats, both good. Two sacs, one smaller than the other but still probably fine. The doctor gave it a 20 percent chance of becoming a "vanishing twin." In other words, he gave it an 80 percent chance of sticking around.

Excuse me while my partner and I completely freak out.

Tonight's fortune cookie

2007-11-04T21:29:00.001-08:00

It read:
"You will pass a difficult test that will make you happier."

Sure hope so. My first ultrasound/viability check is tomorrow morning.

Taking care of the girls

2007-10-31T06:38:00.000-07:00

I don't remember my breasts ever getting so big in a pregnancy. I'm six weeks today, and they feel like they're taking over the planet.

After losing a lot of weight years ago, I went to the Town Shop while in New York and had the bra queen measure me. After telling me that my current brassiere was a disaster, she got quite friendly and then declared me a 34D. For perspective: A few years earlier I'd worn a 42C -- perhaps misguidedly -- and arrived in the store wearing a 36C. And while I may normally be a 34D, I don't look particularly stacked.

With my bras feeling a little tight -- last week, a sports bra that closes with a zipper literally burst open while I was taking a walk, which was delightful -- last night I hauled out the measuring tape and pulled up a few Web sites to find out what I should be wearing. At Victoria's Secret, I'm a 38A; at Barenecessities.com, I'm a 34DDD.

WTF? Do I have to go back to the Upper West Side to get the real story?

PS If you've carried a pregnancy to term -- or even if you've had a pregnancy last longer than 8 weeks -- did your breasts ever stop being so sore?

Disclosures

2007-10-29T10:39:00.000-07:00

Last night I dreamt a (nonexistent) co-worker found out I had done IVF and was gossiping about it with other colleagues. In the dream I ripped into her, asking her why it was her business to disclose my medical condition to others. I was really pissed off.

I have a complicated relationship with information. As I've mentioned in the past, I'm an information junkie. At the same time, I'm quite private about this whole TTC thing -- there are two people in my large, close-knit office who know about the bun project and IVF, and one knows I'm pregnant. I like to assume that the many, many others have no idea.

As IVF began to take over my life (and, more importantly, my brain) recently, I told a few friends about it. At a bris for a friend's newborns the night of my egg retrieval, I told a few friends not normally in the loop what I'd been doing earlier that day. (I partly felt I needed to explain why I didn't want to spend a lot of time standing up.)

Two weeks later, to the day, one of them emailed to "see how I was doing." Of course she wanted to know if IVF had worked. Since this friend and her partner tried for years to get pregnant, eventually succeeding with IVF, I was surprised she even went there, but she did. I ignored the email.

Another close male friend has called several times lately to check in, and asked how IVF was going. Since we've exchanged voicemail and email for the past week or two, it's been easy to ignore this as well. But finally, this morning, freshly awake from my screaming-at-the-co-worker dream, I wrote him an email and said, among other things, "Thanks for asking about IVF. I don't have any news to report, but if I do, I'll let you know."

I know: I can't have it both ways. If I opt to open up to people, I'm allowing for the possibility that two weeks later, they'll ask a question and expect an honest answer. But for me, two miscarriages and three embryos down and no children in tow, "no news to report" is an honest answer. It may be months before I have any news. I'm the publicity director of this project, and I'll schedule my press conference when I'm good and ready.

Small steps

2007-10-25T06:02:00.001-07:00

It's a cliche that you can't be a little pregnant. But, as Julie has written eloquently, actually being "a little pregnant" is totally realistic. I'm in my third pregnancy and have no children. At least five embryos have seen the inside of my uterus; at least four have implanted. If I'd stayed pregnant the first time, my kid would be 10 months old; if I'd stayed pregnant the second time, I'd be something like 34 weeks along with identical twin boys.

Some women, upon seeing two pink lines on a stick, immediately head to the babies emporium and stock up on maternity wear. They send out mass emails announcing that their baby is due eight months later. They tell their bosses. At the risk of sounding like a complete asshole, when I hear about those people, I sigh and think, good God, they have no idea. I've never bought myself anything baby-related. I refused to go to a prenatal yoga class last time, wanting to wait until I saw a good heartbeat. (I never did.) I go to the dentist while pregnant and hope it doesn't come up.

I am treating this pregnancy as if I were unemployed and saw an ad for my dream job. I've submitted my resume, and secured a first interview, but I'm miles away from getting an offer and signing up for benefits and putting my feet up on my new desk.

The big interview is Monday, November 5. My third seven-week viability check. Sure would be nice if they invite me back this time around.

Second beta is back

2007-10-22T11:40:00.000-07:00

The first was 828, at 16 days past retrieval.

Today, at 19 days past retrieval, it was 3,079.

The nurse said that's in the range for twins.

Say it with me: "holy crap!"

First beta is back

2007-10-19T11:27:00.000-07:00

It's 828.

That seems high and great and everything, but last time I was pregnant, it was 520 at 16 days past ovulation, and it tripled in two days, and I still miscarried.

Next test is on Monday.

On the plus side, I definitely feel pregnant.

Evidence

2007-10-16T06:43:00.001-07:00

So I succumbed to temptation

2007-10-16T02:31:00.000-07:00

and took the test. (It's 2:30 am. I said the Serenity Prayer first.)

Two pink lines.

Please, please, PLEASE let whatever's in there last for the next 9 months.

Oy, the temptation, part 2

2007-10-15T17:59:00.000-07:00

Six and a half months ago, another two week wait was ending. On the Monday morning my period was due to arrive, I woke up at 2 am needing to pee. I had been on edge all weekend, cranky as hell. In the middle of the night, as I looked at the clock, I thought: am I ready to take a test? Because, I said to myself, if it is negative, that means you are going to do IVF. Are you ready for that information?

I was ready to end the suspense, so did my duty. And saw two pink lines.

Today I'm in the same situation. My blood test isn't until Friday, which, I learned today, is quite a bit later than it would be at some other clinics (one popular one in town has patients get their blood tests two weeks after the retrieval; mine does it two weeks after the transfer, which adds three entire days).

At this point, a test should be pretty accurate. Last week I took one to ensure the trigger shot was out of my system. A positive last week wouldn't have meant a positive; it might have meant the trigger was still hanging around. A negative meant that a future positive would be meaningful. It was negative, so a test now would be the real deal.

Not knowing is driving me nuts. Last night I woke up, needing to pee, and considered taking a test. But I didn't have the nerve. And now I'm pondering taking one tomorrow. The question is, what's weighing on me more? My desire to know, regardless of the answer, or my desire to not have my hopes for my first IVF cycle be quashed?

I am an information junkie. I am overly cerebral and logical and analytical. I am so Type A. So it's pretty uncharacteristic that I would fear information, but that's kind of what it is: I'm nervous about it, but I want to do it. If someone could do the test for me, without me knowing, and only tell me if it was positive, I'd be in heaven.

Wednesday is my birthday, and I don't want to get a negative test then. So either I take a test tomorrow morning, or I wait until Thursday. What would you do?

Oy, the temptation: a dialogue

2007-10-14T19:52:00.000-07:00

Aspiring Baker: "I can't figure out when to test, but I don't think I'm going to last that long."
AB's smart partner: "What about Wednesday?"
AB: "I don't want to get a negative on my birthday."
ABSP: "What about Thursday?"
AB: "I'm not sure I can wait that long."
ABSP: "Well, if you test sooner, isn't it possible you'll get a false negative?"
AB: "Yes, but then I'll know."
ABSP: "Well, if you get a negative, you'll just be on an emotional rollercoaster that you don't need."
AB, contritely: "True."
ABSP: "What about testing Thursday?"
AB: "Yeah, that might be a good idea."

[Background: Blood test is Friday, which will be 13 days past transfer and 16 days past retrieval. Tomorrow I'll be 9 days past the 3 day transfer. Symptoms: impossible to distinguish among the effects of the progesterone, estrogen, and usual two-week wait paranoia.]

Open letter to Pope Benedict

2007-10-11T09:31:00.000-07:00

Dear Pope Benedict,

Thanks for your recent comments that embryos should not be used for stem cell research, because doing so "violates the sanctity of human life."

Now, I realize you don't speak for me -- I'm a Jew, and we believe human life begins at birth. Still: On Saturday I made the decision of what to do with 11 embryos created in a lab with my eggs and a stranger's sperm. Those embryos were of varying qualities. Two went into my uterus, and remaining nine stayed in the petri dish. Why? Because despite your beliefs to the contrary, these embryos were not, really, human life. They wouldn't have survived in my uterus, and they never would have become children.

But they're not without potential. You see, Pope Benedict, I am participating in a stem cell research study, and my remaining embryos have been donated to science. I could not be more convinced that this is the right thing to do -- particularly because someone I love dearly has Parkinson's Disease, an illness that could someday be cured with therapies developed from embryonic stem cells.

If I'd transferred those embryos to my uterus, they would have died. I could have had the lab toss them in the trash. But instead I think they're doing more for human life in their current capacity than they could have in any other circumstance.

The embryos that had the potential for human life (note: potential) are dear to me; I am crossing my fingers that I get to meet one or both of them some day. I wish more of the others had more baby-making potential. But they didn't, and I am thrilled to be participating in the stem cell study.

The practice of doing research on stem cells was severely curtailed in the US by President Bush in 2001, when he banned the use of Federal funds for embryonic stem cell research. This, despite widespread public support for the practice. Pope, I can only hope that my incompetent, lame-duck government doesn't try to implement your religious viewpoints any more than it already has.

I pray for the embryos in my uterus and for the ones in petri dishes everywhere, in the hopes that all of them can make dreams of all varieties come true.

Yours,
Aspiring Baker

Now with 200 percent more embryos!

2007-10-06T15:40:00.000-07:00

Had the transfer today. Of the 23 eggs that retrieved, 11 fertilized, and only 2 produced embryos worth transferring. That's quite disappointing, given that everyone seemed certain we'd have something to freeze. The remaining 9 embryos were pretty poor quality, and the clinic didn't think it was worth it to try to grow them some more and freeze them. (She seemed to think that while my ovaries are producing large quantities of eggs, apparently the quality is not so good.)

That left us with two embryos. The clinic grades them on a scale from 1 to 6, 1 being the best and 6 being the worst. It's rare to have a grade-1 embryo, but we had one, and the other one was rated a 2. The doctor felt these were very good and recommended transferring both. She thought the pregnancy rate might be 50 percent with two, and that we'd have a 25 percent chance of getting pregnant with twins (or: 50 percent chance if I got pregnant). The rate for transferring one, of course, was lower. We agonized, given our fear of twins, but in the end decided that two was the best choice. It wouldn't have been worth it to freeze the grade-2 embryo, and I couldn't see going through that whole process to end up with just one embryo.

So, cross your fingers that this whole adventure ends in a healthy pregnancy -- preferably a singleton pregnancy. We'll know if it worked in about two weeks.

48 percent

2007-10-04T21:19:00.001-07:00

That's the portion of my 23 eggs that fertilized. That's 11 embryos, for the kids in the back of the class. Of the 23 eggs retrieved, 10 were not mature, and 2 fertilized abnormally, leaving just less than half of those puppies left to divide in the comfort of a warm petri dish across town.

The transfer is scheduled for Saturday. If you're reading this, please cross your fingers that some of those 11 embryos are still in good shape then.

The eggs have left the building

2007-10-03T21:18:00.000-07:00

Had my egg retrieval today. All seemed fine -- they got 23 eggs. I'll find out tomorrow how many fertilized and what they're looking like. The transfer should be this weekend.

Side effects

2007-09-27T06:57:00.000-07:00

Steve Martin once published a piece in the New Yorker called Side Effects. It began,

"DOSAGE: take two tablets every six hours for joint pain.
SIDE EFFECTS: This drug may cause joint pain, nausea, head-ache, or shortness of breath. You may also experience muscle aches, rapid heartbeat, and ringing in the ears. If you feel faint, call your doctor. Do not consume alcohol while taking this pill; likewise, avoid red meat, shellfish, and vegetables. O.K. foods: flounder..."

Reading the folded-into-tiny-pieces papers in my fertility medicine, one wonders why side effects can't be a little more desirable. Why does everything cause weight gain (check), headaches (yes, thank you), nausea (thankfully, no), fatigue (not too much) and bloating (why, I'd be delighted)? Where's my weight loss, high energy, unusual wit, surprise talent for the clarinet, and super intelligence? With Lupron, my main side effects were weight gain, crankiness, and, according to one friend, shinier hair. I will admit that my skin hasn't been this clear since the fourth grade, thanks, no doubt, to the ridiculously high levels of estradiol present in my bloodstream (1,200 today).

Seven days into Gonal-f and Repronex, my latest side effect (in addition to the above) is ovaries that are starting to feel rather large. That's because they are: today's ultrasound showed 19 follicles of various apparently appropriate sizes. I go for another check tomorrow, and if all goes well, I expect the embryo retrieval to happen early next week.

The nice thing about all of this bodily funkiness is that I won't be able to attribute every physical symptom in the two week wait to early pregnancy symptoms. Instead, they'll likely just be side effects.

Playing the numbers

2007-09-24T13:28:00.000-07:00

OK, readers -- all four of you -- here's the math question of the day. The subject: whether to transfer one or two embryos. Here's what you need to know:

1. I have a 25 to 30 percent chance of getting pregnant if I transfer one.
2. I have a 40 percent chance of getting pregnant if I transfer two.
3. If I transfer two and get pregnant, I have a 20 percent chance of having twins.
4. If I get pregnant, I have a 15 to 20 percent chance of miscarriage PER EMBRYO that takes.

Twins scare the hell of out of me. But I could do without another miscarriage and another failed cycle. Seems to me that if I transfer two, I'm just as likely to miscarry as I am to get pregnant with twins. Yet my overall success rate is higher.

Anyone got an opinion here?

Chances

2007-09-21T06:52:00.000-07:00

I am obsessed with the numbers. My doctor gave me a 25 to 30 percent chance of getting pregnant if I transfer one embryo, and a 40 percent chance of getting pregnant if I transfer two. In my dream last night, I asked her what she thought my chance of another miscarriage was. She said, since you've had two, I'd give it a 40 percent chance. 40 percent. In the dream, I sat down in the middle of the street and curled up into a ball.

After 10 days on Lupron, I start the "stims" -- the FSH drugs that should make my ovaries feel like baseballs -- tonight.

Book club, part 4: Everything Conceivable

2007-09-10T19:29:00.000-07:00

Here is a tip: If you are electing a risky, complex, and invasive medical procedure, do not read a lengthy nonfiction book about said procedure. Whatever does not scare the shit out of you will invariably make you bitter, sad, or frustrated.

If you are worrying yourself silly about how many embryos to transfer in aforementioned risky, complex, and invasive medical procedure, perhaps you should skip the section about the couples who transferred several embryos and ended up with dead 20-week-old triplets, or ridiculously preemie quads, or whatever. If you're scared of twins, you should skip the section where the author mentions that IVF embryos are more likely to split into identical twins, particularly if you have already lost an identical twin pregnancy. If you're feeling sensitive about your move to IVF, you'll want to avoid the temptation to find places where the author seems judgmental or unkind about the subject. (But: said places are rare.)

That said, Liza Mundy's Everything Conceivable: How Assisted Reproduction Is Changing Men, Women, and the World is interesting and informative. I read it somewhat obsessively, though skipping over the parts that did not feel immediately relevant, and I learned a lot. It has chapters about egg donors and sperm donors, on surrogacy, on selective reduction. I think the author is sympathetic to her subject and well-informed. But I still kind of wish I hadn't read it. Sometimes knowing more isn't a good thing.

The perfect man

2007-08-31T06:03:00.001-07:00

At first, you think: there is no other man for me. He's perfect! Tall/short, brown-eyed/blue-eyed, musical/athletic, smart (they all have to be smart, don't they?), the ethnic background I want, etc. He kind of reminds me of my high-school boyfriend. He is the one!

And then time passes. You get pregnant, and you imagine what your children will look like, and then you miscarry, and you think, was he the one, or was it me? And so you try another guy, and the more you pore over his profile, you think: this one's even better! He's shorter/taller, has better hair, better family health history, whatever. He's gotten other women pregnant, too. Yes!

But then he seems not to be the one, or more specifically: the two of you fail to produce anything of note, other than several costly cycles of disappointment. And so you move on. And you find another guy, and you think: he sounds like such a nice guy! But he doesn't have any pregnancies. That's okay -- I'll try him! Maybe I'll get lucky! And you're excited about
him, until the doctor doing the IUI gives you the sperm count from the lab, and it sucks, and two weeks later think, this guy is not the one!

So you go back to the first guy, miscarriage man. Maybe that was a one-time thing! You never combined that guy with fertility drugs! And the cycle when you have lost all patience and hope, and you decide, this is it, after this I'm taking a few months off from this crap and then I'm going to IVF, you wake up one morning, wonder where your period is, pee on a stick and get two pink lines.

And you think: I am so lucky, this guy is the one for me! It works! And you imagine what your children will look like, and your beta numbers are great, and all is well until you have an ultrasound and your partner looks at the screen and says, it looks like there are two in there, and the doctor says, yes, well, it was identical twins, and now it looks like what was two will soon be zero.

And you miscarry, and you somehow, incredibly, do not fall apart, and you take time off, and eventually you get ready to try again. And you find out that miscarriage man does have a higher spontaneous abortion rate than other donors you've tried, even though it's still within normal range. Forget him, you say, trying to pin the trisomy 12 diagnosis on him. And you try a new guy--seems funny! smart! whatever!--for an IUI that you fear will be unsuccessful as soon as the nurse practitioner holding a syringe full of sperm gives you the disappointing sperm count.

Weeks later, your not-pregnant self prepares to deliver an unknown man's seed to the IVF clinic. Which guy to use? Crappy sperm count? Miscarriage man? Guy who might have some kind of birth defect in his genes somewhere? Another guy altogether? And you panic, thinking, what if I can't find all of my vital qualities in one of these donors? What if the person I pick lacks these things I've held so dear? You worry: what if, after spending so long not getting what I want, I still can't get what I want?

And you pore over profiles, and look at other sperm banks at this late date, thinking, maybe if I shop around I'll find the right guy, and you think, maybe X quality or Y quality isn't that important, or maybe I should reconsider. And you think of your friends, whose beautiful 3-year-old was the result of changing donors at the last minute, and of the woman at the sperm bank who said, "no matter who you pick, you're going to get the right kid." And you close your eyes, and pick someone, and drive a nitrogen tank full of frozen sperm through San Francisco, and you hope and pray mightily that she'll be right.

What the UPS fairy brought

2007-08-25T12:35:00.001-07:00

I got a present in the mail today: 5 pounds worth of drugs. Check it out.

The drug dealer calleth

2007-08-22T12:45:00.000-07:00

The scene: A San Francisco apartment, August 2007, 8:30 am. A woman (mid-30s) is trying to leave for work when the phone rings.

Woman: Hello?
Caller: Hello, may I please speak with Aspiring Baker?
Woman: This is she.
Caller: This is Your Insurance Company's Pharmacy Department. May I verify your date of birth?
Woman: Well, no, actually, because you have called me.
Caller: Yes, and we need to verify your date of birth.
Woman: Uh huh. But how do I know you're who you say you are?
Caller [testily]: Because I am.
Woman: In this age of identify theft, I'm sure you can appreciate my hesitation to reveal my date of birth to a random caller. I wouldn't give you my social security number, either.
Caller: [more testily] I didn't ask for that.
Woman: [conciliatorily] Right. But surely you can understand why I wouldn't want to give out personal information over the phone when you have called me.
Caller: [resigned] May I verify your zip code, then?
Woman: Yes.

Now, I recognize that I'm a little cranky these days, but really -- what corporation in this day and age -- particularly one that's subject to HIPAA -- thinks that someone who answers the phone is just going to verify their date of birth?

Said phone call subsequently revealed that the insurance company will send via UPS seven -- count 'em, seven -- drugs to my home. They are:

- Lupron
- Gonal-f
- Repronex
- Novarel (HCG shot)
- Estradiol
- Medrol
- Progesterone

They even include all of the syringes and alcohol pads. This is going to be fun!

Now we're both on the Pill!

2007-08-20T22:30:00.000-07:00

Well, okay, only one of us is on the pill. But who can resist a Sixteen Candles reference? (Bonus points to anyone who can name the line following this one...*)

Got my period yesterday, started birth control pills today. I expect to start shots in about three weeks and do a retrieval/transfer in about six.

The next big question: provided eggs are stimulated, retrieved, fertilized, etc. -- how many embryos to transfer? The minimum is one, and the maximum is two. The issue: if I hope to avoid twins, and if each embryo has a 20 percent chance of implanting and at least a 20 percent chance of miscarrying, and if IVF has a 30 percent chance of twins, how much do I need to pay a statistician to figure this out for me?

* It's: "You gave me birth control pills? Do you know what that can do to a guy my age?" Such a good movie.

Signs point to no

2007-08-17T06:02:00.000-07:00

Looks like I'll be starting the birth-control pill this weekend (just what I always dreamed of!).

7 Reasons Why/Not

2007-08-15T06:38:00.000-07:00

(Scroll down because Blogger is being silly)

Reasons why	/Not
Breasts are tender	but not necessarily any more tender than any other day 25 of my cycle.
Temperature was really high today	as it has been many other times when I was not pregnant.
I was pretty tired over the weekend.	So?
I've felt sick to my stomach the past couple of days	and also have a little sore throat, which isn't typically a pregnancy symptom. Plus, if morning sickness is kicking in already, I'm going to be the first woman on record to naturally conceive septuplets.
Lots of weird dreams	which means I've been getting lots of good REM sleep.
Cranky!	Again, so?
Cramps	In a theoretical universe where you're trying to keep things in your uterus, motions to expel are not so good.

Back in the saddle again

2007-08-05T07:49:00.001-07:00

If you knew me, you'd probably be surprised to learn that I am superstitious. I am extraordinarily logical and practical; I've been accused more than once of being unemotional at times when emotions should have been front and center. What can I say? I'm a Myers-Briggs ESTJ, all the way.

But it was superstition that guided me to the sperm bank yesterday morning, to commence my 18th two-week wait. After all, yesterday was my father's birthday, which was a good sign, and if I got pregnant, my due date would be the second anniversary of my first miscarriage. That has to be two good omens -- a coming full circle, if you will. Plus, even though I'm not religious and only learned about this tradition a few years ago, the number 18 is lucky in Judaism.

And so yesterday, after journeying to my favorite farmers' market and watching sea lions frolic under the San Francisco Bay Bridge, I wandered into some stirrups and got shot up with some guy's spooge.

To be frank, I am ambivalent now about this decision. On the one hand, my timing was good (felt ovulation sensation all day), and I am anxious to get on with this baby-making process. On the other hand, I'm a little on the fence: I traditionally abstain from a lot of TWW exercise (at the advice of multiple acupuncturists), and I'd sure love to go running right now. I'm not at the weight I thought I'd be when I tried again, and part of me wanted more time for a break.

What's more, I had planned to do a little ceremony for embryos 2 and 3. I planned to bring the ultrasound photos to the beach, write a letter, and say Kaddish for them before I tried again. I feel like I'm supposed to do that. But instead the photos are sitting in an envelope on my desk along with some positive HPKs (gross, I know, but don't pretend you wouldn't do the same thing! Please?).

Part of me feels it's bad luck to say I'm not 100 percent excited about this cycle, that I'd still like to hop on the treadmill and find a way to fit into my skinny jeans. But the logical part of me believes there's nothing I can think that will change the outcome of this cycle. After all, being totally gung-ho hasn't had an effect in the past, so why should the reverse be true? At the moment, I think I need to stop my quest for self-improvement and tendency toward self-doubt and just try to be.

From PostSecret

2007-07-30T11:32:00.000-07:00

This image from PostSecret resonated with me even before I saw this comment that went with it:

" Sent: Sunday, July 29, 2007 9:09 PM
Subject: "You aren't being punished..."

Not sure if this is the correct email to comment on a post card or not but....

All I can say is thank you. I just recently suffered a miscarriage and have felt for weeks like God was punishing me for something I had done. You have been the only person who knew just what to say."

Still trying to decide about an IUI later this week.

Decisions, decisions

2007-07-29T09:30:00.000-07:00

The problem with lists of pros and cons is that such lists don't usually assign weights to the options. Everything is equal. Which makes this list of pros and cons a bit flawed.

On doing an IUI this cycle (it's day 8):
Pros:
1. I'd like to have a baby.
2. I might avoid IVF.
3. I could get this show on the road earlier.
4. Physically, there is no reason not to try -- I'm in good health, don't have any contraindications that I can think of.

Cons:
1. The chances of success are low.
2. Particularly since I haven't taken any fertility drugs this month, and it's too late to do so now.
3. Absurdly, doing an IUI this month will probably cost me more than doing IVF in two months.
4. Supplies of my new donor are very low, so it would make sense to try to maximize his seed.
5. I haven't done very much acupuncture lately.

Of course, if I try this month and don't succeed, it has no effect on my IVF plans. But I'm getting impatient.

Any thoughts?

Small blows

2007-07-25T17:04:00.000-07:00

It is not getting easier.

At times I think I'm fine, I'm handling this so well, I am a trooper. I rock. Then new information knocks on my door and punches me in the face.

Sunday my period arrived in full force just before I attended a friend's baby shower. In addition to the in-utero fetuses in attendance, a new mom brought her newborn to the shower. I remember when the mom, the pregnant friend, and I were all knocked up at the same time. We were going to go out for pregnant ladies tea, only I nixed it, wanting to wait to see a good heartbeat. I made it through the shower pretty well, but I look miserable in the photos.

Yesterday it was the news that another co-worker is pregnant. I suspected this woman might want to have another baby, and just yesterday I saw her walk by and thought she looked pregnant, so I'm not entirely surprised. Then today the news that another co-worker's wife is expecting -- more news I anticipated. This is now past the time that I would have shared my news. I would have been part of the pregnant people club. Instead I'm part of the one-person club that has to leave the office to walk around the block and keep myself together after someone whispers to me that his wife is pregnant.

When I was a kid, the street next to ours always had block parties for the Fourth of July. I knew kids on that block but always felt left out, wishing we had parties on our street. Thirty years later I feel the same way. As my co-worker mentioned something about how much your hormones rage during pregnancy, I wanted to say, I know -- I've been there. Of course I haven't been there, really; I've spent about 12 weeks being pregnant in my life, less than a trimester. But when someone tells me their news, I feel this urge to share mine, to be recognized. After reacting probably not as enthusiastically as I should have with co-worker number 2 today, I pondered opening up to him. Instead I'm writing a blog post from my desk, wishing my block would just throw its own party already.

Numbers

2007-07-15T11:28:00.000-07:00

Women don't often discuss their weight. I was once at lunch with a group of male co-workers when, to my amazement, one of them began asking the others what they weighed. Nearly all of them chimed in, and none seemed to really think anything of it. I sat silently, in awe. Can you imagine being a table of women tossing out their weights like it was their batting averages? Not so much.

For most of my twenties I weighed more than 200 pounds. I am five-foot four and a half, and I wasn't that big because I was big-boned; I was that big because I was fat. I weighed around 225 in the mid-90s, and by my early 30s I had dropped to about 210. When I was 32, I began losing weight. I didn't diet, count calories, or have surgery. I started watching my carbs a little bit, ate more protein, stopped snacking so much, and started a running program. When I turned 33 I weighed 161. I dropped to about 150 six months later, and I've hovered around that weight ever since. I ran a half-marathon on my 34th birthday; I ran a second one a week later.

When I was heavy, I thought there were ways I could hide it. In college I always left for classes early, so I could hike to the third floor and pant without being noticed. At my first job after college I developed a habit of not turning my head to the side to talk to people; I thought they'd notice my double chin if I did so. (Um, they probably noticed it anyway.) I avoided an office river rafting trip because of the whole bathing-suit issue. I hated summer business trips because I'd get sweaty. I hated having to scoot by someone on public transit because of how big I was.

When I was heavy I always felt there was a smaller person inside. My self-esteem was horrible, and though I always felt awful about my body, the idea of losing weight -- I probably thought I should weigh around 130 -- was insurmountable. That's why I am probably more amazed than anyone that I've managed to keep the weight off. I still don't know exactly how I did it and what prompted me, but it's among my proudest accomplishments. Not just the weight loss but the keeping it off, because it's said that 95 percent of people who lose that much weight gain it back in two years. (The National Weight Control Registry tracks people who've kept off weight for longer periods of time; I reached a milestone when I'd kept my weight off long enough to become eligible to join it.)

It was absolutely incredible to me the first time I tried on something in the Banana Republic women's department and it fit. I'd bought men's XL sweaters for years, but I wasn't able to dress as I wanted because the apparel industry is so incredibly backward when it comes to meeting the needs of its potential customers. (Do you know how much more money I would have spent on clothing in those years if I'd found something that fit me, was age-appropriate, and that I actually liked?) When I first started shopping at regular-size stores, I felt a bit disloyal to my former self, who had written angry letters to the CEO of J. Crew, asking why they didn't carry anything beyond a size 14. (Now they've expanded to size 16 -- whoopee. I meant two-digit sizes starting with the number 2, people.)

I've kept my weight off over the years not by dieting like a mad woman -- I've previously mentioned my penchant for baking -- but by exercising and weighing myself religiously. I believe the body has certain weights it can naturally maintain, and 150 seemed to be that for me. (220 was, too.) Even though at 150 pounds I still have a belly and would never be described as skinny, I decided that I could handle 150, plus or minus 3 lbs. So when I got up to 156 recently, after the second miscarriage, I decided I had to deal with it. I spent two weeks doing the first phase of the South Beach diet, eating only vegetables, protein, and nuts. My energy sucked, but I got enough to eat, and I lost 6 lbs. I originally thought I'd stay on the diet for a while and try to keep dropping weight; I have this fantasy of getting down to 145 and fitting into a pair of jeans I could wear back when I was running half marathons.

Instead I spent yesterday eating candy and pizza. I'm going to start eating better soon, like maybe tomorrow. But things are hard enough right now without feeling perpetually in denial. I am working on convincing myself that weighing 150 pounds is good enough. Sure, it would be great to weigh 145 before getting pregnant again. It would be great to weigh 130. But 150 has been good enough for more than three years. What's different now?

Blessed events

2007-07-15T11:08:00.000-07:00

There are three invitations on our fridge right now. One for the wedding of my 26-year-old cousin, who's having a very large, presumably extravagant (and heterosexual, if that's not obvious) wedding; ten bucks says she's pregnant before she's 30. The second is to the lesbian wedding of a friend with a toddler; she conceived on the first try, and for their wedding gift, they're asking friends to contribute to an IVF fund. Not because they need to do IVF for kid #2, but so they can use one partner's egg and the other's uterus. The last invitation is to a baby shower of a close friend who's expecting twins after struggling with infertility for a while. When I was pregnant, I imagined attending these events with a nice little second-trimester belly. Instead I have my usual grandmotherly figure.

Is it any wonder I'm a little cranky these days? This summer was supposed to be a break, and in some ways it has been: I haven't touched my basal body thermometer, haven't gone to acupuncture, and even spent two less-miserable-than-expected weeks on the South Beach diet (more on that later, maybe). In other ways this hasn't been a break at all, because the very nature of a break makes me anxious. The longer I wait, the longer I wait. I probably won't be pregnant again until I'm at least 37. Given that I got pregnant at 35 and 36, and given that I've always wanted two kids, this freaks me out. I worry that if I do get pregnant, it may be my only pregnancy -- if I'm able to maintain it.

It's also not entirely a break because of the hoops I need to jump through to prepare for IVF -- blood tests, copious forms, choosing the next sperm donor, etc. My doctor's office wanted me to see a psychologist to discuss my feelings about "third-party reproduction." This nearly made my head explode: for some reason no one has required me to see a therapist for the 17 cycles of third-party reproduction and two miscarriages I've already experienced. Why is it different now? (Since I already have my own therapist, I'm finding a way around this, but the very idea of this enrages me.)

To get started with IVF, I need to call my doctor's office when my period arrives. From there, I take birth control pills for a month (that'll be fun!), then start the other no-doubt-delightful drugs in anticipation of an egg retrieval about 6 weeks after my period arrives. At the earliest, an egg retrieval could happen in late August. Until recently I thought I'd wait until the end of the summer to get things going. But this week I realized that this break isn't a break; it's a stagnant pause I never wanted. Maybe the best way to stop feeling pissed off and sorry for myself is to accept that I'll never be ready for another miscarriage. I'll never want to do IVF. Maybe going to Paris before I get pregnant again isn't as important as just getting this goddamn show on the road.

Why?

2007-06-28T06:42:00.000-07:00

Listening to Jeff Gammage discuss his book China Ghosts: My Daughter's Journey to America , My Passage to Fatherhood on Fresh Air yesterday nearly made me cry. Gammage wasn't particularly excited about becoming a parent when he and his wife traveled to China to adopt their daughter. (This after being unable to have biological children.)

I adopted a dog from the SPCA and would never buy a purebred. How could I, when so many great dogs need homes? Yet I view adoption as a last resort, even though when I think of the efforts I have gone and will go to in order to become a parent of my biological child, I'm frankly a little embarrassed. It brings tears to my eyes to think of all of the children in orphanages around the world, yet I'm still hoping to have my own child.

Part of the reason is I want the experience of pregnancy. And I undeniably want a child that's genetically related to me. But why? Are my short, chubby, musical, cheese-hating, Type A Jewish genes so precious that they must be preserved for posterity in creation of another human being? Of course wanting biological children is rooted to some degree in narcissism. I think it also reflects a passion for one's family and roots -- particularly important to Jews who saw our ranks decimated last century.

My child will be only 50 percent related to my partner and I. Most of the time I cling to that 50 percent, minimizing the donor's biological importance. But occasionally I wonder, if I'm only getting that 50 percent to start with, why not just dump it and go for adoption? If I have my own biological child, does that leave one more child in an orphanage somewhere who will never have the kind of loving home I could provide?

Yes, I still exist

2007-06-26T19:48:00.000-07:00

It's been a while. One of the things about not trying to conceive for the first time in a year and a half is that you suddenly have all of these other things to think about. It's remarkable to start my day with a Web site other than Fertilityfriend.com. It's amazing to spend the month not constantly monitoring my cervical mucus and breasts for possible signs of ovulation or pregnancy.

I am spending my break trying to drop some weight -- currently on day six of the South Beach diet. It's been nearly 20 years since I actively went on a capital-D diet. This one has its benefits, like the fact that it's not low-fat, but it also has many drawbacks. (Cannot believe I haven't eaten a piece of fruit in six days.) I'm planning to cheat on the Fourth of July, but beyond that I don't know exactly how much weight I'm trying to lose or how long I'll tolerate this. Probably not much and not very.

It feels both good and bizarre to be doing something with my body other than trying to get pregnant. Last week I ate a nicoise salad for the first time in eons. Yes, I know the mercury takes a long time to leave your system, but it sure was a nice change.

At the moment I'm waiting for my RE's IVF coordinator to call me so we can think about getting things moving. I had some blood tests earlier this month, both for my primary care physician (cholesterol and fasting glucose) and fertility doctor (HCG, TSH, and some antiphospholipid thing that could have contributed to miscarriage). Everything was normal. At this point, the only explanation for miscarriage #2 is trisomy 12. Number 1 will always remain a mystery, I guess.

Which leads me to this existential issue. I've always been fascinated by twins. I loved the Sweet Valley High books as a teenager. At the same time, knowing people with twins has only increased my fear of having them myself. (As a result, I'm pretty sure that conceiving identical twins last time around was nature's way of giving me the finger.) One of my main reservations about IVF has been the risk of twins, though of course that can be minimized with a single embryo transfer.

And hence the dilemma. Back in the single-miscarriage days, it seemed perfectly reasonable to transfer a single embryo. Hey, no reason to think that this one embryo will be flawed even if the first one was, right? But miscarriage #2 has changed the game. I've had two conceptions that I know of and two that failed. If I'm going to go to the bother of IVF, and I have a history of making problematic embryos, does it make sense to transfer two in IVF to maximize my chances? (Personal policy is not to transfer more than I am prepared to raise or carry, at the moment.) Or, again, would doing so only ensure that Mother Nature would again give me the double-fingered salute?

Results are in

2007-06-05T20:46:00.000-07:00

It is odd, to say this, but the miscarriage pathology results are good. The embryos were male and had trisomy 12, a genetic abnormality that causes miscarriage; embryos with this genetic profile aren't viable. This is good, because a) the fact that they were male ensures they were able to isolate the embryo's genetic material from my own, and b) this kind of trisomy is a one-time occurrence, more common among women of my advanced maternal age (36), but not a sign of any long-term problem.

My doctor is a dream -- smart, competent, warm, and nice -- and she remains quite optimistic about my chances. She still considers me a "great" candidate for IVF, and she also suspects that if I tried several more times with Femara and IUIs, I'd probably get pregnant again. I'm not exactly sure what I'll do next -- probably IVF. But I'm going to take at least the summer off. Still, I'll have a saline sonogram (to investigate the topography of my uterus) and a blood test in a few days. I'm hoping to get as much of the IVF prep out of the way now, so I can relax and not worry about it.

It's incredible to have a doctor who actually inquires after my well-being. And a relief to hear she's very supportive of me taking a break. Walking into that office today, I really didn't know what to expect; I felt there was a possibility I'd learn I would never have a baby. So to leave the office hearing the echoes of optimism in my head was quite a treat.

Book club, part 3: Baby Love

2007-06-04T22:08:00.000-07:00

What I disliked about Rebecca Walker's Baby Love: Choosing Motherhood After a Lifetime of Ambivalence

Where to start?

1. Her meandering. I don't need to know about the trials of her hot water heater and the moths that ate half her wardrobe. That's great if she enjoyed steak and spinach and salad and mint chocolate ice cream. But why am I reading about it?

2. Her astonishing self-involvement. Walker treats her pregnancy as if it were an international event. (Predictably, this bit raised my blood pressure: upon being told a friend had a miscarriage, she declares, "Well, I'm not going to be having one of those, thank you very much!" Lucky you.) Lucky for her, she's able to take time off from her work when she needs to. She has the money to buy anti-stretch mark potion number 59. She has the luxury to interview multiple doulas.

3. Her assumptions. Yes, I know her mother is Alice Walker. But does every reader? It's not mentioned anywhere in the book. Might have been nice to go beyond describing her mother as simply a writer and mention, say, that she won a Pulitzer Prize, or something.

4. Her subtitle, "choosing motherhood after a lifetime of ambivalence." This so-called ambivalence is a central tenet of Baby Love, but I have some news for Walker: I don't think she was nearly as ambivalent about having a child as she thinks she was. She tried getting pregnant in a previous relationship, she considered having a child with a male lover. That doesn't sound like ambivalence: it sounds like a combination of luck and good, old-fashioned family planning.

5. Her obfuscation. One section talks about her several-year romance with the mother of Solomon, a boy she helped raise. Another section talks about her several-year romance with an unfaithful rock star -- a woman who's a mother, but doesn't necessarily seem to be the mother of Solomon. Only she must be, given that Walker and I are the same age, and there's no way she had two eight-year relationships since graduating college by the time she wrote this book. What's more, many of us know this mysterious mother-of-Solomon/rock star to be Me'shell Ndegeocello. Why does she bandy about her hematocrit numbers and mother drama but refuse to name her ex?

6. If the answer to the last question is because of Solomon, I have to ask, if Walker is so concerned about Solomon knowing his mother was unfaithful, how will he feel when he reads this much-discussed section?

"It's not the same. I don't care how close you are to your adopted son or beloved stepdaughter, the love you have for your nonbiological child isn't the same as the love you have for your own flesh and blood. It's different."

This feels like a giant fuck-you not only to Solomon but to millions of parents -- including many lesbian and gay parents -- around the world. Walker may feel this way, but who the hell is she to make that pronouncement for all adoptive and non-biological parents everywhere?

I read this statement to a friend who has two children; she gave birth to one, and her partner birthed the other. She responded, "I don't know what you're talking about. Both my children are my biological children." I imagine many other parents would agree.

Two small blows

2007-06-02T08:37:00.000-07:00

So May pretty much sucked completely. Miscarriage, family stuff, everything. I was so happy when June arrived, a clean slate.

But it didn't start off so easily. Yesterday two small pieces of news felt like punches in the stomach: first, a former co-worker -- someone who could easily be described as the least maternal person on the planet -- had a baby. Second, I overheard another co-worker telling people his wife is pregnant. Her due date? Same as mine would have been. I had to go into the bathroom and breathe deeply to ensure I would remain composed.

Frankly, things have gone so awfully lately that it wouldn't surprise me in the least if the news Tuesday at my pathology appointment was the worst kind.

I sure am making a lot of solo dinner reservations lately under the name "bitter."

28 days later

2007-05-29T13:54:00.000-07:00

It's been four weeks. Incredibly, my period showed up today, almost right on time (usually I have 26-day cycles). I'm surprised only because I thought my body would take longer to kick back into gear. But no, we're back in business, earlier than I'd expected.

Here are a few random thoughts:

1. Overall, I recovered from the D&C very easily. However, my breasts were still really tender for five days afterward, and I didn't feel like myself (read: not pregnant) for about a week.
2. I read and intend to post a review of Rebecca Walker's new book Baby Love: Choosing Motherhood After a Lifetime of Ambivalence. The summary: this book annoyed me. More, hopefully, on that later.
3. I have a few new phrases in my vocabulary. They include, "my first miscarriage," "the second time I was pregnant," "my second D&C," and, my favorite, "I am down two pregnancies and three embryos."
4. Today in Whole Foods I really enjoyed pushing past an extremely fertile woman (two babies under the age of 2) in order to grab three boxes of tampons. Fun!
5. On the bright side, I have lately enjoyed tuna, tequila, and running. I have stopped taking all vitamins. I have painted my toenails with abandon, done a shoulder stand in yoga without caring, and bought clothes without worrying that soon, they may not fit.
6. On the less bright side, I have still not returned to my pre-pregnancy (#2) weight. As I was miscarrying I gained a few pounds, and I have not dropped them. (Lest you think I sound like Bridget Jones: years ago I lost nearly a third of my body weight, and it's important to me to maintain that loss. I do that by trying to vigorously police my weight and dieting when I exceed the maximum weight I can tolerate. I am still not skinny in the least, and as I've said in the past, I'm a girl who enjoys my chocolate cake.)

This has been a difficult and hectic month for me -- aside from the obvious, I've also been dealing with a now-somewhat-abated family health crisis. As a result, I haven't yet adequately mourned my embryos -- I'm sorry, I can't call them babies. Next week I should get the pathology results back from my doctor's office, and that should provide some closure. It seems the results could show a few things:

a) Down Syndrome. This is actually the best scenario, as it explains the cause of the miscarriage and doesn't indicate anything about the prognosis of future pregnancies, theoretically.
b) Genetic translocation. This would indicate something about either my or the donor's genes, in a more permanent way. Since the donor has a number of births, it would probably be me. So not good.
c) Nothing. If the pathology can't explain the miscarriage, that's bad. Either it could mean I have some kind of clotting disorder that prevents blood from getting to the embryo (diagnosed by blood tests, treated by injections that may not be proven to work). Or it could suggest I have a uterine malformation that could explain both the miscarriages and the infertility. (Treatment: surgery.)

Never have I hoped for Down Syndrome more.

No longer pregnant

2007-05-02T06:38:00.000-07:00

It's over. The D&C yesterday was a bit painful, but the pain was brief, and overall it was a piece of cake. (I was in and out of there in less than 45 minutes.) Unlike last time, every person in the office I saw offered their condolences. It's funny how much of a difference that makes.

I spent the remainder of the day on the couch, sleeping, watching quality TV like "Celebrity Fit Club," and eating won ton soup. I was pretty knocked out by the drug cocktail they gave me, but haven't had any pain. Today I'm back to normal.

This time was much less physically draining, but I don't know where I am emotionally. I'm still stunned that this happened again. When this first started happening last week, I thought, I have never been inclined to read a book like When Bad Things Happen to Good People until now. When I mentioned this to someone else, she said, "I just keep thinking of Job." The night before the D&C, I was up for a couple hours in the middle of the night, thinking, reading, and crying. I tried to re-read Job, though my attention span was a little lacking. He has everything -- kids, servants, land, etc. Then he loses it all, and asks God why. Eventually he gets everything back -- twice as much as he had before.

That first pregnancy felt like everything to me. I was so excited; I distinctly remember driving on the freeway being so thrilled with my secret. I was devastated when it ended. And the second pregnancy was really a savior: it came at a very dark moment as my hope was eroding. I was so confident it was going to work this time, especially given my HCG levels. I was superstitious about numbers, about the fact that it was my last IUI attempt before moving to IVF. It felt like everything had finally fallen into position.

So you'll forgive me for not sequestering myself in a corner this time, sobbing constantly. I've done that before. And I really don't know what to do with this experience. I don't think it was my fault; I don't feel there are any lessons to learn; I wouldn't have done anything differently. I am still in shock.

The doctor will analyze the pathology of the tissue she removed yesterday, and we'll get the results in about five weeks. If it's a common chromosomal abnormality, they don't worry too much, but if the tissue has a more unusual genetic variance or is genetically normal, then they'll want to test me for a bunch of other things.

In the meantime, I am taking a big fat break. Last time I miscarried I tried again as soon as I could, and I didn't stop for 12 consecutive cycles. I was a woman on a mission. Now I am really excited about having some serious time off -- time to sit in a hot tub and not worry that it's frying my eggs, time to drink whenever I want and not worry what half of my cycle I'm in, time to eat raw fish, go running, get back into shape, and travel. But most importantly, I am excited about getting back to my pre-TTC self. This process has been so hard on me. It's warped my priorities and made me a crazy person, and it's hurt my relationship. I'm ready to put the bun project aside for a while so I can get my life back.

Coming soon: miscarriage number 2

2007-04-30T16:19:00.000-07:00

No heartbeat on today's ultrasound, so I'm having a D&C tomorrow morning.

The universe is awfully rude. Not only do I have two embryos with no heartbeat, but I also have a bad cold coupled with zero miscarriage symptoms and still-present pregnancy symptoms. Good times.

Anniversaries, part 2

2007-04-26T06:39:00.000-07:00

Today is the anniversary of what may now have the distinction of being my first miscarriage. And since I seem to be the subject of the world's biggest practical joke, it is also Take Your Children to Work Day at my office. Whoo hoo! Plus, there's this whole, 'is my pregnancy going to fail and when' question. Good times, really.

It's hard to know what's going on with my body: my breasts are still quite tender (I keep feeling myself up in the night to double-check), my mild nausea is still around (though is it ebbing? Is my stomach unhappy because I'm upset? Hard to tell), and my temperature is still really high (98.8 this morning, about as high as it ever gets.). I've had no spotting since Sunday, when I had a minuscule amount, and pretty much no cramping. WTF?

Emotionally I don't even know where to begin. Last time I was a mess from the moment I had the bad ultrasound. This time I'm numb and in shock. I feel like, I'm not sure I can afford to go there again. It just seems so obvious. This last two week wait made me crazy. I was tired of being depressed and despairing even when I was depressed and despairing. I identified with what Max's Mommy wrote about being sick of her infertility:

I'm tired of me. I'm tired of thinking about This all the time, writing about This all the time, talking about This all the time. I'm tired of hanging out at my very own personal Pity Party. The chips are stale and the music never changes. (For some reason it's Come On Eileen by Dexy's Midnight Runners. Makes me want to jam an ice pick into my eye socket. Repeatedly.) And don't get me started on the guest list, a boring navel-gazing crew which consists solely of Feeling, Sorry, For, Myself.

I'm kind of there, too. (But I love "Come On Eileen," and the cookies at my party are always fantastic.) Maybe -- probably -- my somewhat stoic black humor will evolve to massive fits of sobbing. But when you pile upon the logistical challenge of getting pregnant as a lesbian, a miscarriage, a year of unexplained infertility, the reluctant decision to have one more IUI and then move to IVF, and then a second probable failed pregnancy that -- just to pour some kosher salt into the wound and stir it around real good -- would have yielded not one but two children: I mean, if that isn't the universe flipping you the bird, what is?

I'm Jewish but not very good at it. In Jewish tradition, you light a Yarzheit candle in memory of someone's death. Judaism doesn't have a ritual for miscarriage, nor does it even recognize a person's existence until something like 40 days after birth. But I always thought I'd light a candle today for last year's miscarried embryo. But given where I am now, I'm not sure I can do it. Last year, after I miscarried, I went to the beach, wrote a letter to what would have been my first baby, said the Mourner's Kaddish, and cried. The letter, the ultrasound picture, and the positive pregnancy tests are in an envelope labeled #1.

I cannot believe I may have to label a second envelope #2 and #3.

Unkind universe

2007-04-23T11:36:00.000-07:00

I wish I had good news to post, but I do not. Today's ultrasound showed almost exactly the same thing that my 7-week ultrasound did last time.

The main difference: this pregnancy started off as identical twins (thus explaining the high HCG numbers), but one twin is very small and has no heartbeat. Unfortunately, the surviving twin is one week too small (measuring 6w1d, as opposed to 7w1d) and has a slow heartbeat (115 -- they'd like to see it at 140). My doctor gave me a 95 percent chance of miscarrying. I am scheduled to go back in a week to see if anything's improved, but this embryo basically grew 2 days worth in 8 days based on the last ultrasound.

If I end up having a D&C, they'll run some tests on the tissue to see if they can figure out what went wrong. (I wasn't able to do that last time, since I passed the bulk of the pregnancy before the D&C.)

I am in complete shock. I was so sure this one was going to work -- I feel more pregnant than last time, and I just felt the universe couldn't do this to me twice. Apparently, I was wrong. I simply cannot believe this is happening again.

Countdown

2007-04-17T06:16:00.000-07:00

Last week I came home from a super-relaxing yoga class and noticed some spotting. Of course I totally freaked out, even though the amount was small. I've been having menstrual-like cramps throughout this pregnancy, which didn't worry me until I saw the spotting.

I called the doctor's office and was told to monitor the spotting and call if my cramps or spotting worsened. The spotting went away for a bit, but when it came back I called my doctor's office and was able to go in for an ultrasound. (On a Sunday morning -- I am very lucky.)

I was six weeks exactly, and there was some good news: first, I am indeed pregnant; second, the pregnancy is in the uterus, and third, the embryo measured 5 weeks 6 days (the machine has an error rate of plus/minus 4 days), which is perfect. We didn't see a heartbeat, which the doctor said was okay because it was a little early (he said seeing a heartbeat would have been "a bonus"). But seeing that ultrasound was a huge relief. At least now I know what not to expect next Monday, when I have my next appointment.

I have faith this is going to work. I definitely have pregnancy symptoms -- crazy tender breasts, a bit of nausea, fatigue, low energy, crankiness. The spotting is gone, and here's hoping I can remain calm for the next six days and two hours.

What happened last time

2007-04-10T19:07:00.000-07:00

I was cautious. I barely told anyone, even my family, and when I rubbed my belly, I said, "I hope I get to meet you."

Thus it was not entirely a surprise when, seven weeks pregnant and on a one-day trip to Los Angeles, I looked at the toilet paper after peeing and saw a tiny, miniscule amount of spotting.

The following day was my "viability check." This is the ultrasound they do at around 7 weeks to check the pregnancy -- is there a heartbeat, is it ectopic, etc. Even before the spotting, I was counting the hours before the appointment, as I knew that if you see a good heartbeat at that first visit, your risk of miscarriage drops from 25 percent to 5 percent. And when that day finally came, the office people gave me a big book about giving birth at the local hospital -- stopping once to swap out the first book they provided after realizing I was an elderly gravid -- before the ultrasound. Or in other words: before they knew if I was going to need it. Which, it seemed, I would not.

I will never forget how Dr. Unsympathetic squinched her face looking at the screen. The ultrasound revealed a week-smaller-than-expected embryo and a slow heartbeat. This, coupled with the spotting, was not good, but she was optimistic and sent me off for urine and blood tests and instructed me to return in a week. Only later would I learn, from reading my own medical records, that on this day she had recorded the phrase "possible embryo demise." Information that might have been useful if she had actually uttered it to me. (The good news, I suppose, was that I was pregnant and it was not ectopic.)

The following day, as I continued to spot, I called her and asked, how likely am I to miscarry? Her answer: 70 percent chance of a miscarriage. Hey, now that's information. Over the agonizing following week I barely held it together, shying away from children, painfully aware of my fading pregnancy symptoms, and petrified the increasing blood would begin flowing uncontrollably while at work. One week later, the follow-up ultrasound revealed what I already knew: the embryo was dead. We scheduled a D&C for the following day.

That night, I woke up with very strong cramps and knew the miscarriage was beginning. Over the next two hours I sat on the toilet, watching the products of my conception fall into the bowl. The bleeding was so heavy that I could barely leave the bathroom without making a complete mess. And though this experience was unpleasant, the fact that I was emotionally prepared for it made a tremendous difference. And since I knew I was going to the doctor the following morning, and since a close friend who had two miscarriages had told me what to watch for, I didn't worry too much as I sat there, cramping and reading magazines. All I can say is: thank god this did not happen at work, as it would have been absolutely horrifying.

The following day I brought my iPod to my appointment. When the D&C started, I pressed play on Coldplay's "Speed of Sound." Forty-five seconds later, it was over.

Note to medical staff everywhere: when a lesbian couple comes into the office with one partner pregnant, you can pretty much guess it's a wanted pregnancy. Therefore, when said pregnancy is miscarrying, it would be polite and decent to offer your condolences and express sympathy. A, "I'm sorry this is happening to you," would suffice. Instead, not a single person in that office ever offered emotional support to me; the closest was the one man in the office, a nurse midwife, who guided my partner over to me during the D&C and held my shoulder. He won the decency award that day, but unfortunately the competition was pretty pathetic.

After returning home, I spent the rest of the day lying on the couch. Friends brought me food. I was back at work the following day, ("what was wrong with you?" one boss asked. "A stomach bug," I lied -- I had decided a email reading, "I'll be out of the office Thursday having the remnants of my brief pregnancy sucked out of my uterus" might be uncalled for) and I was able to resume my normal activities immediately.

When I got pregnant last time, I asked Dr. Unsympathetic if I needed a blood test. She said it wasn't necessary, given that I was having pregnancy symptoms, had a positive pregnancy test, and missed my period. Yet those blood tests might have yielded information about how successful the pregnancy was destined to be. Certainly they would have been useful this time around, when I could have used them as a basis for comparison. (Pregnancies destined to miscarry seem to have lower HCG levels at first, and the rise seems to be slower. The general consensus is that last week's numbers are both high and rising nicely, so that's a comfort.)

This time, I've bid farewell to Dr. Unsympathetic (so long! don't let the door hit you on the way out!) and am hoping both for more empathy and, more importantly, better results when I go for my viability check (at my fertility doctor's office) on April 23. You can bet I'll be counting the hours again.

Second blood test is back

2007-04-06T10:38:00.000-07:00

They want your numbers to double in 48 hours. Mine TRIPLED!

My HCG level was 520 on Tuesday and was 1,564 yesterday.

I'll have an ultrasound (the viability check -- the appointment that showed the problem last time) on April 23.

Thank you for your kind wishes. They mean a lot to me.

First blood test

2007-04-03T20:01:00.000-07:00

It's back, and my HCG level at 16 days past conception/ovulation is 520. I'm going back on Thursday for a second round. Cross your fingers that it rises nicely!

A picture's worth, etc.

2007-04-02T06:09:00.000-07:00

Bitter, party of one? Bitter?

2007-03-27T06:28:00.000-07:00

This is my 17th cycle trying to get pregnant. This time, I took Femara (a breast cancer drug also thought to help with infertility) and had an IUI. Everything on the pre-IUI ultrasound looked fine, and my timing was good. If this try doesn't work, I'm going to IVF.

I always thought I'd do everything "perfectly" on my last try; I'd avoid sugar, I'd get lots of acupuncture, I'd stay relaxed, I'd eat my sweet potatoes and papaya and seaweed. Instead I'm baking like a maniac and my anxiety level is high. On Friday, in a tense meeting, I wrote the date in my notebook and thought, 'a year ago today I found out I was pregnant.' Later that day I attended yet another baby shower for someone who both conceived and will give birth after my pregnancy failed. My office just announced that Take Your Children to Work Day will take place in late April -- on the anniversary of my miscarriage. A close friend who also had trouble conceiving is now in her second trimester. I'm thrilled for her, and we've talked about it a lot, but it isn't easy (see Akeeyu's smart post about this).

There is so much riding on this try. If I don't conceive this time, I won't have a baby in 2007. I always thought that by starting at age 35, I wouldn't be an older mom. So much for that. And of course I'll be moving to a procedure that's incredibly invasive, time-consuming, and costly (even if I'm not paying for it -- thank you, magical insurance). Now, as I wait to find out if this the 17th try is the charm, it's hard to not scrutinize how I'm feeling each day -- what is my temperature doing, are my breasts more or less sore than last time, is my fragile emotional state meaningful or just the universe's way of offering me a gentle fuck-you?

Kinds of gratitude

2007-03-11T16:56:00.000-07:00

I appreciated this post from Barren Mare, who's pregnant after years of struggling with infertility. (Her post about finding out she was pregnant during an IVF consultation is pretty priceless.)

Anyway, here's a bit of what Barren Mare had to say about being pregnant after all of her efforts:

Somebody said to me several weeks ago that one of the nicest things about being pregnant must be the great relief to know I'm not infertile after all. I've been thinking about this a lot since then. I suppose that, strictly speaking, it appears to be true, at least for the moment. But it's odd. It's odd to think that somehow getting pregnant can cancel out all the aggro and grief I felt during the years when we tried and tried and tried without success. During which we endured invasive testing and fertility treatment, without success or even answers as to what the problem might be. And even now, I have no idea why it suddenly happened. [...]

When something finally, miraculously occurs, it's undeniably lovely- but it's also kind of scary. Because if you don't know why or how it happened- luck? timing? an unusual planetary alignment?- then it's hard not to believe that this is your one and only chance. That lightning can't strike twice, so if something goes awry, you're cast out of the kingdom forever, with no way back. And having finally seen your way clear to safety on the horizon, it's impossible to fathom how you might ever recover from that.
So no, "relieved" is not really the word I would choose. I feel greatly, vastly fortunate, but also hugely wary. Much of the time I feel like this happiness is on loan to me, rather than a permanent keepsake. But that's one of the life-changing aspects of infertility- there is less inclination to take anything for granted.

I appreciate Barren Mare's realism and ability to recognize the universe's randomness. I wish her all the best. The same goes for Infertile Pediatrician, whose smart blog chronicles her experience trying to conceive "all the while working with those who are quite fertile and their offspring." IP is newly pregnant, and I'm crossing my fingers for her that this one sticks.

Anniversaries

2007-03-09T06:28:00.000-08:00

Today is the one-year anniversary of when I got pregnant. I am "celebrating" by getting my first mammogram. Ironic, as I could not get a mammogram if I was pregnant or breastfeeding (as I would be now if I'd stayed pregnant), and as I am considered high-risk for breast cancer because a) my grandmother had it late in life, and b) I am 36 and have not given birth.

I got pregnant on the fifth try, and as I miscarried, I comforted myself with the thought, hey, I got pregnant pretty quickly, so I shouldn't have trouble getting pregnant again. Eleven tries later, I'm getting a mammogram. This cycle is my last IUI before moving to IVF. (I have incredible insurance coverage for IVF, so the decision to take that path is much easier.)

I have a lot of hope for my 17th try -- despite being a very rational person I have a strange superstitious streak when it comes to this stuff. Seventeen is a lucky number for me, and I really don't want to do IVF. First, I know I can get pregnant without it, and second, I'm worried about scheduling all of the shots, appointments, egg retrieval around my very busy job, as my bosses and most colleages doesn't know about the bun project. Furthermore, many of my friends who've done IVF have ended up with twins; that's not my first choice. So here goes number 17: this time with Femara, acupuncture, and now, yoga.

As the months have passed my brief pregnancy has felt like a dream, a fluke. I'd give so much to know and harness whatever magic was in the air on March 9, 2006, when two different ovulation predictor kits couldn't agree on whether I was ovulating, when an ultrasound showed imminent ovulation, and when a single IUI, performed apparently at the exact right time, knocked me up.

What I've tried

2007-03-04T07:26:00.001-08:00

Here's a partial list of the things I've done to get pregnant:

- 12 non-medicated cycles of IUIs
- 1 cycle taking 100 mg of Clomid
- 1 cycle taking 100 mg of Clomid with an estrogen patch
- 1 cycle taking 50 mg of Clomid
- 1 cycle taking Femara
- 1 hysterosalpingogram. That's the delightful x-ray where you lie half-naked on a table in the hospital's radiology department, with your legs spread so far apart you have a whole new understanding of your hip flexors. Then it gets better: a radiologist squirts dye into your uterus, and everyone in the room watches the monitors to see if the dye behaves as it should and moves through the uterus and into the fallopian tubes. (It does.) The idea is that it both identifies any blockages in your tubes and also clears them out. I have (what turns out to be futile) faith in this procedure, as I was conceived after my mother had one.
- Several cycles with Acupuncturist #1 and three with Acupuncturist #2
- Used a mail-ordered speculum to monitor my cervical opening
- Tried three different sperm donors
- Rolled my body onto one side after an IUI when I knew which ovary had the golden egg
- Taken my temperature nearly every day for almost two years
- Tried to radically reduce the amount of sugar I eat, with limited success
- Taken Chinese herbs
- Taken up yoga
- Had tests to measure my FSH, LH, progesterone, and antral follicle levels (all fine).
- Avoided: hot tubs, wine, massage, running, abdominal work-outs, lifting heavy things.

It's funny how much more relaxed -- in a limited way -- I've gotten over time. It's 12 days after ovulation, and in the past I would have chastely turned down a margarita in the two-week wait. Lately, though, my attitude has been, I'll have the pinot noir. My alcohol tolerance is pathetic, so it's not as if I'm pounding shots. But I like wine, and I'm no longer interested in denying myself something that I don't believe will really make a difference. If I find out I'm pregnant, I'll stop drinking, and only then.

This cycle I didn't take any drugs and have been seeing Acupuncturist #1. I've decided I've got one more IUI cycle in me (next time with Femara again) before moving to IVF. Here's hoping I don't have to.

Things I love about the Bay Area in February

2007-02-24T07:13:00.000-08:00

The only thing to fear...

2007-02-18T07:54:00.000-08:00

The American tradition of instilling fear in people is thriving in the study of pregnancy. Eating fish may cause developmental delays -- but if you don't, your kid may have poor verbal and social skills. If you conceive in the spring, your baby may be premature. If you're black, you're three times as likely to have a preemie. If you do IVF, your risk of birth defects is higher. Heightened sensitivity to hormones may cause miscarriage, and remember that whole vaginal birth thing that's been working for millions of years? It may cause brain hemorrhages.

It's a wonder anyone gives birth to healthy babies at all -- except, wait, that's what happens the majority of the time.

All of this fearmongering (and I'm not exaggerating -- pretty much all of the stories linked above were published in the last 30 days) brings us to our latest subject of our book club, Angela Wu's Fertility Wisdom. I bought Wu's book when I started seeing Acupuncturist #2, and
at first found Wu's explanations comforting. She prescribes a strict diet, a lot of rest, Qi Gong exercises, and even wearing red underwear (if your constitution is cool, warm it up, etc.).

All interesting stuff, and Wu is highly regarded in the Bay Area for her ability to help women get pregnant. But it's easy to be scared reading her book -- she argues that you can't follow her plan just 75 percent of the way, as you can't be 75 percent pregnant. She tells the story of Marcia and Bill, who tried for 13 years to get pregnant. Wu told Marcia to cut out sweets, wheat, and dairy:

"Everything went well until the third month. It was Marcia's birthday and, frustrated after months of the 'deprivation diet,' she wanted cake. Bill gently reminded her of their priorities: Wasn't all the progress they'd made -- and the hope of the baby they'd wanted for 13 years -- worth more than cake? With Bill's help, Marcia overcame her craving, and by the end of the 3rd month, she was pregnant."

If you try everything Wu advises and don't succeed, she suggests that you look deep within yourself

"to your true feelings about having a baby. Are your Three Treasures -- head, heart, and gut -- powering your efforts, or might old feeling be blocking your access to the one resource every infertile couple needs: hope?"

That's right, I forgot -- it's always our fault. I feel so much better now.

Reading list, part 1

2007-02-13T21:25:00.000-08:00

I’m really enjoying Peggy Orenstein’s new book, Waiting for Daisy: A Tale of Two Continents, Three Religions, Five Infertility Doctors, an Oscar, an Atomic Bomb, a Romantic Night, and One Woman’s Quest to Become a Mother. I first came upon Orenstein’s writing in this New York Times piece (Times Select required) about how she mourned her miscarriage in Japan. The story had nothing to do with me when it was published in 2002, but it stayed with me – so much that when I learned I was going to miscarry last year, I sought out the article and found new meaning in it. (The Buddhist divinity she writes about is the same one I mentioned here.)

It’s hard to feel sorry for myself when I read Orenstein’s story – diagnosed with breast cancer at 35, three miscarriages (one of which, a partial molar pregnancy, meant she couldn’t try again for a year), and several failed IVF attempts, including one with donor eggs. On the other hand, I don’t have what amounts to a own private sperm bank, as Orenstein did. I started trying when I was 35; she didn't have a child until her 40s. There's lots that's familiar in the book, too -- she begins seeing an acupuncturist who prescribes herbs that smell "like feet;" the book mostly takes place in the Bay Area; one of my doctors even makes an appearance.

I haven’t finished Waiting for Daisy – it arrived yesterday, and though I’ve already read 200 pages, I like to pace myself. Reading it is like eating chocolate: it's a tonic, and I can't get enough. At the same time, I already know the ending (the title tells it all) and I have to ask: would you buy an infertility memoir whose book jacket didn’t describe the author as living with her husband and child? If Orenstein had chucked it all and decided to try to live happily with her saintly husband in placid Berkeley, perhaps with a SPCA-special mutt for company, would she have gotten a book deal?

Frankly, I don't care. Because I identified with this section:

"I needed a baby to restore my faith in my defective body, heal my wounded sexuality, assuage my grief, relieve my feelings of failure--to make me whole again. At one time I would have told a woman like me that childlessness was not her problem; it was her inability to recognize the value in all that she had, in all that she'd built for herself."

Now, if you'll excuse me, I need to go pace myself some more.

Control

2007-01-29T06:05:00.000-08:00

I started acupuncture right around the time I started trying to get pregnant. I'd never tried it before, but a friend swears that acupuncture made her second IVF attempt succeed. So I figured, why not? I found an American acupuncturist who'd worked in a fertility clinic and had special protocols for women trying to conceive. She prescribed herbs to take twice a day (two formulas -- one for before the insemination, and one after).

When I got pregnant, I had been taking the herbs she gave me. But I ran out just as the test turned positive, and by the time my new supply arrived, I felt intuitively that I shouldn't take them. So I didn't.

The acupuncturist also advised against going running after ovulation. I've heard this elsewhere, but my OB at the time (Dr. Unsympathetic) thought running was fine. After I found out I was pregnant, I went running a few times, because I really wanted to.

After the miscarriage, I tried a few more times and wasn't getting pregnant, so I decided to see a different acupuncturist -- a older Chinese woman whose ability to get infertile women pregnant was legendary. She had, apparently, a more traditional approach: you were instructed to bring a jar of urine to each appointment. She'd take the jar, shake it up, and assess you based on the bubbles. That's right.

Here are some of her suggestions:
Don't exercise: during your period, around ovulation, after ovulation.
Don’t eat: sugar, dairy, anything cooked in the microwave, beef and poultry if it wasn't organic.
Eat: yams, seaweed, papaya, shrimp, seafood, fruit.

She didn't prescribe herbs (they took too long to work, she said, but if you really wanted them, you could go see her sister), and she advised against taking a prenatal vitamin (I acquiesced and switched to simple folic acid). She also suggested I lose 10 pounds. (Whatever. Losing weight while trying to conceive is generally frowned upon.)

Acupuncturist #1's treatments were relaxing. Number 2's were downright unpleasant. They were painful, and there was a lot of yelling. "GET A COLOR. Cervix is LIGHT LIGHT BLUE. Uterus dark blue. Fallopian tubes light blue. Ovaries dark dark blue." Then she'd wiggle the needles -- nicely positioned around my uterus and ovaries -- in such a way that I'd feel a shock. "TURN TO GOLD!", she'd yell. I'd arrive home exhausted.

The hardest thing about #2's advice was following her dietary restrictions. I'm a girl who enjoys her chocolate cake, so avoiding sugar entirely was really challenging. And it was hard to reconcile the advice -- she wants me to eat sweet potatoes, but she doesn't want me to cook food in the microwave. If that's the only way I'm going to eat them, does the benefit of the sweet potatoes outweigh the cost of the microwave?

I actually did a pretty good job, for a while, of cutting way down on the sweets (though not cutting them out entirely) and eliminating some dairy. I found a seaweed snack I liked and a form of papaya I could tolerate, and ate seafood that's low in mercury. I definitely wasn’t perfect, but I tried. But with all of that effort, I didn't get pregnant.

During this journey, having new things to try, like acupuncture and Clomid, has been a real comfort. It’s nice to feel as if you can control the outcome, in truth, you can’t. When I miscarried, Dr. Unsympathetic was adamant that there was nothing I could have done during my pregnancy to change the outcome. I believe her. So at some point, as I spent weeks munching on seaweed and passing up brownies, I realized that the problem with Acupuncturist #2’s approach was that it gave me the illusion of too much control. When I miscarried, it wasn't because I went running, and if I didn't get pregnant, it wasn't because I ate a KitKat bar. While cutting down on the sugar is, for me, a good idea (I have a little bit of a problem with the chocolate-chip cookie dough), blaming my sweet tooth for my infertility isn’t. I mostly eat a healthy diet, but women across the country get knocked up eating junk.

A friend told a story of another friend, S., who was having trouble conceiving. S. had cut out running but eventually started up again, reasoning, ‘I’m not getting pregnant by not running, so I might as well run.’ (She eventually did IVF and has twins.) I didn’t get pregnant following Acupuncturist #2’s recommendations, and when I started on the fertility drugs, I stopped seeing her, knowing that she would disapprove.

I haven’t gone back to see Acupuncturist #1 in a while. (I never thought I was the kind of person who'd have not one but two acupuncturists.) It’s hard to schedule, especially given all the schlepping I have to do for the rest of the project. I still occasionally eat sweet potatoes and dried papaya, and the seaweed snack is a keeper. But I’ve given up the illusion that my diet will be the determining factor in whether a healthy egg meets a healthy sperm, fertilizes, continues to divide, and seven to 10 days later, finds a nice comfy uterine lining in which to implant. Sometimes it’s a relief to accept the things I cannot change.

Choices

2007-01-22T06:34:00.000-08:00

At 19 I had a pregnancy scare. I had a boyfriend, the condom broke, and I spent $20 -- a huge sum to me at the time -- on a pregnancy test that didn't provide an intelligible result. Fortunately, I got my period a few days later. But I wouldn't have hesitated for a moment to get an abortion, even though my Catholic boyfriend told me later he would have been upset about it. My body, my responsibility, my choice.

Yesterday's New York Times magazine has an interesting and maddening article about an anti-choice movement that claims abortion harms women psychologically. The movement relies on debunkable, quasi-scientific studies that say women who've had abortions have more psychological problems than those who didn't. One of the main characters in the story is a woman who's had four abortions and mourns them; she now organizes memorials for aborted embryos. She has three daughters and didn't teach them about contraception, because, she says, "“Abstinence works better than birth control, really. It’s just that people don’t do it.” So, big surprise, her 17-year-old daughter got pregnant. It makes me crazy to think there's a woman out there who claims to be advocating for women's health, yet failed to teach her own children about contraception.

I deeply mourned my miscarriage -- a spontaneous abortion in medical parlance -- at eight weeks. It is possible I would have mourned an abortion when I was 19, but I can guarantee you that whatever psychological harm might have been induced by that procedure would have been far eclipsed by the harm -- both to me and to a child -- of regretfully becoming a parent as a college sophomore.

I don't disagree with Bill Clinton's position that abortion should be "safe, legal, and rare." Abortions will be rare when women are educated about birth-control options, when more men start being willing to wear condoms, and when both sexes have access to affordable, effective contraception.

Until that time -- and even after -- let's celebrate. Today is the 34th anniversary of Roe v. Wade. Here's to many more.

Datebook

2007-01-07T20:55:00.000-08:00

If you're trying to get pregnant my way, you get a whole set of special tasks to handle each month. Let's take a tour, shall we?

Day one of my period: Call the doctor's office to tell them the news. Schedule ultrasound appointment. Call the sperm bank to buy some more sperm (sorry, I just can't call them swimmers). Refill prescriptions.
Day two: Pick up first prescription (Clomid), but learn that the insurance company won't refill the second prescription (for the ovulation-trigger shot) for another nine days.
Day three: Begin taking Clomid, at twice last month's dosage.
Day six: Call the insurance company to request coverage for the upcoming IUI. Convince partner to scribble authorization code as we drive through pouring rain the day after Christmas.
Day seven: Call sperm bank to arrange pick-up of giant nitrogen tank containing expensive sperm. Call doctor's office to arrange drop-off.
Day nine: Go back to the pharmacy to retrieve the second prescription.
Day ten: Go to doctor's office for ultrasound, which indicates a good number of good-sized follicles (which contain eggs). It also indicates a thin uterine lining, a side-effect of Clomid, which the doctor declines to do anything about (I used an estrogen patch to treat this at my last doctor's office, but this guy tells me "we only do that with IVF." WTF?) Doctor repeatedly warns of the risk of twins (from the multiple follicles whose presence is thanks to Clomid) and says, with absurd optimism, "it's very likely you'll get pregnant this time."
Get told to take shot, which I've brought with me in case a qualified nurse can be convinced to administer it. Get turned down, but learn that the pharmacy has sold me the wrong needles for the shot. Get the right needle from a nurse, drop the needle on the floor, get another one, do the shot. Schedule IUI for the following day. Then, leave the office, drive across town to the sperm bank. Pick up the nitrogen tank, which is supposed to remain upright yet tips over in the car, spewing white smoke. Panicking, find parking space. Carry (now very cold) giant tank two blocks to the doctor's office. After the lab removes the sperm, carry tank to car, and drive it across town back to the sperm bank. This little errand takes three hours to complete (minus the 10-minute detour for a croissant).
Day eleven: Go in for IUI.
Days twelve - twenty-five: Await news of success or failure, indicated either by continuing high temperatures or the arrival of blood. Try to avoid the temptation to take a pregnancy test before it's reasonable, as doing it too early is both expensive and nearly guaranteed to disappoint.

Cold snap

2006-12-20T06:40:00.000-08:00

Did I really think try #13 would work?

When I got pregnant, I thought, I'll have a baby by Christmas. When I miscarried, I thought, surely it'll happen again quickly. I never imagined I wouldn't be pregnant by my due date, yet here I am, buying tampons and making plans for my next series of inconveniences.

Here's hoping for better luck in 2007.

Heat

2006-12-17T11:16:00.000-08:00

Heat is good.

Heat means your body is making stuff. It's whirring.

If you're trying to conceive, your basal body thermometer is your first interaction of the day. It's a little fussy: you need to take your temperature before you get up, drink water, etc., and if you wake up early or late, the temperature is unreliable.

If you're a woman who ovulates, your body has two basic temperatures: in the first half of your cycle, before you ovulate, it's a little lower; say between 97.5 and 97.9. After you ovulate, the follicle that released an egg turns into a corpus luteum and releases progesterone. That raises your temperature, say to between 98.1 and 98.5. (You know how in the movies, the wife walks into the kitchen with a thermometer in her hand and says to her hubby, "I'm ovulating"? Total crap. Once your temperature has risen, it's over.) If you get pregnant and all is well, progesterone production will continue and your temperature will remain high. Some books say you're almost definitely pregnant if your temperature remains high for 18 days.

If you don't get pregnant, your progesterone will fall around the time your period arrives. Which means that if you're waiting to find out if you're pregnant, you can get a preview by watching your temperature. A single dip isn't bad -- sometimes this is caused by a fertilized egg implanting into the uterus -- but multiple dips are an unhappy trend. My period isn't due for two days (though I took Clomid this cycle, which can make things screwy), but my temperature was down this morning and yesterday. Toss that in with some cramps and a bit of low back pain, and you've nearly got yourself a negative pregnancy test with no signs of blood and without peeing on a stick.

The price of pregnancy

2006-12-17T10:39:00.000-08:00

$10,278.90.

That's how much I've spent this year trying to have a baby. I have a strong stomach, but writing that makes me want to throw up.

That includes:
- $8,680 to my sperm bank for sperm, intrauterine inseminations (including about $1,800 for inseminations that my insurer should have paid for but wouldn't -- long story), ultrasounds I wasn't able to get otherwise, sperm storage fees for vials I bought before I got pregnant and then didn't need, and tank rental fees when I had the pleasure of schlepping a large nitrogen tank around town.
- $67.80 to the Web site that lets me do charting easily (I have my own Excel spreadsheet, but I like this site)
- $964.36 to Acupuncturist #1, for both treatments and Chinese herbs that I didn't always take
- $504 to Acupuncturist #2 (more on her another time)

That doesn't include:
- a number of $15 co-pays to the three doctors I've seen this year
- however much I've paid Walgreens for overpriced ovulation predictor kits
- the time I've spent dealing with insurance companies

When I started this process in November 2005, I envisioned myself spending a year and about $10,000 to get pregnant. That, I thought, was about what I was willing to handle. I'd hear about friends doing IVF, feel horrified at the cost ($12K-15K a try), and vow that I'd never do that. Now, a year later and $10,000 in the hole, with no intentions of stopping, I'm surprised that I didn't realize back then what a slippery slope this would be.

Teetotaler

2006-12-14T06:19:00.000-08:00

When you're trying to conceive -- or TTC, as the message boards call it -- you live your life in two-week increments. At the beginning of your cycle, when you've just received the disappointing news that is your period, you can do what you want -- eat raw fish, unpasteurized cheeses, drink what you like, etc. But once you've ovulated, you're told to behave like a pregnant lady: no sushi, alcohol, brie, etc.

It's hard enough to wait two weeks to find out if you're pregnant without omitting wine from your diet. Plus, it's just that much more time that you aren't drinking and aren't truthfully explaining why. (I'm not much of a drinker anyway, but for some reason, my co-workers always seem to question why I don't drink at every opportunity.)

The truth is, a glass of wine probably won't affect whatever might have been conceived at this point (I'll know whether I'm pregnant in about a week). The UK's health guidelines recommend: "Excess alcohol can harm your unborn baby. If you do drink while you are pregnant, it is better to limit yourself to one standard unit of alcohol a day (roughly the equivalent of a small glass of wine, a half pint of beer, cider or lager, or a single measure of spirits)." The US, by contrast, essentially tells expectant ladies that no amount of alcohol has been shown to be safe during pregnancy.

Let's recap: many women in the US who are of child-bearing age probably drink. A lot of them get pregnant accidentally (perhaps -- here's a novel concept -- as a result of drinking), which means they don't spend the two weeks after they ovulate in fear of yellowtail maki and cosmos. When they find out they're pregnant and decide to keep the baby, most of them probably stop drinking. Yet we don't have an epidemic of newborns with fetal alcohol syndrome because women who didn't know they were pregnant didn't stop having a glass of wine with dinner.

It's holiday party season now, a time when lots of folks look forward to getting ripped on the company dime. Time for me to decide whether I'll throw caution to the wind and have a cocktail, whether I'll order a decoy drink (decoy drink (noun): a beverage designed to look alcoholic but isn't, so as to avoid the questioning glances from insecure colleagues who hate it when others don't drink with them), or whether to stick with water. This may sound bizarre, but you would be amazed at the number of very smart people who look at a person at a party with a glass of water and say, with genuine concern, "you're not drinking?"

If it's a woman in her mid-30s (in my particular demographic/place of employ), not drinking might a sign to the clueful that a reproductive project is underway. When you're a lesbian among a bunch of straight people -- even relatively evolved straight people -- this doesn't come up. I'll take that, and perhaps a pinot noir, for now.

The red cloth

2006-12-11T06:46:00.000-08:00

Yesterday I attended a ceremony for children who have died from abortion, miscarriage, stillbirth, etc. I’m not religious, but when I miscarried I found it frustrating that there weren’t any ceremonies to help me cope. But it turns out that Buddhism has one, and a friend who lost one of her twins during her pregnancy last year heard about the event and asked me to join her.

It was held in a beautiful Buddhist monastery in Berkeley. We were instructed to bring red cloth, a needle and thread, and scissors. We spent the first hour making something, an offering, and then had a brief ceremony where we each placed our items on a figure in the temple. I sacrificed a too-big Old Navy tank top and made a little hat out of it, with red grosgrain ribbon around the rim. (Turns out I don’t have a future as a seamstress.) It was odd to sit on a mat on the floor of a freezing cold temple on a Sunday afternoon, sewing in intense silence with 17 other people, some quietly weeping.

The priest said the act of making the offering was designed to help us release the being we were doing the ceremony for, and that was hard for me. I’ve held on to my pregnancy as a life raft in the trying-to-conceive process; it tells me my body is capable, that there's a possibility. Since our society doesn’t have a way of recognizing miscarriage, it’s been important for me to hold onto it, to tell people, to be visible. But I realized yesterday that perhaps the act of releasing my failed pregnancy could help make room for a new one. Here’s hoping.

Aspirations

2006-12-07T20:22:00.000-08:00

Let’s get caught up:

Last November I began the Bun Project: an attempt to get myself pregnant at age 35. The ingredients: a basal body thermometer, donor sperm, copies of The Essential Guide to Lesbian Conception, Pregnancy, and Birth and Taking Charge of Your Fertility, an overpriced and underperforming ClearBlue Easy fertility monitor, and a body that was in reasonably decent shape and showed no signs of reproductive inability.

If you think lesbians conceive their kids by either picking up a guy in a bar or sterilizing a kitchen implement most commonly used on Thanksgiving, your horizons could use some broadening. Yes, you could do either of the above. But the professionals would advise something called an intrauterine insemination, or IUI: first the sperm is treated in a lab to remove all that nasty semen, which your uterus doesn’t like (under other circumstances, this job is done by your cervix and something called cervical mucus – having fun yet?). Then the sperm is injected into the uterus with a very thin catheter. Some women find this procedure to be uncomfortable, but aside from the whole speculum/stirrups/lamp shining onto your private parts thing, I don't mind.

From there, you wait two weeks, constantly monitoring your body for signs of success – tender breasts, nausea, crankiness, the absence of blood. Pregnancy tests typically don’t go positive until shortly before your period is due, but if you are pregnant, they can still register a false negative if you take them too early.

A year later, my list of ingredients has expanded to include approximately 12 packs of ovulation predictor kits, two OB-GYNs, one reproductive endocrinologist, two acupuncturists, 21 IUIs, seven blood tests, one hysterosalpingogram, ten doses of Clomid, two estrogen patches, two HCG trigger shots, 12 unwelcome period arrivals, and one miscarriage. This is my story.