From PostSecret

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

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

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

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

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?

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

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

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

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

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."