We now return to our regularly scheduled programming.

I seem to have left you with a very depressing blog entry in January. My apologies. Every week since then, I kept thinking I would write, and then something would happen, and I wouldn't write, and then the prospect of catching you up on everything that has happened proved daunting, and nothing would get written. So now, I'm going to do my best to tell you what has happened in the last few months. It may take a few posts.

After my Christmas miscarriage, I tried to regroup. I went to the San Francisco Yoga Journal conference, where I tried to make friends with my body again. I saw my wonderful Bay Area friends and checked in with my Palo Alto doctor. I had a whole bunch of blood (15 vials) drawn for a recurrent miscarriage analysis. I went back home and prepared for a transfer of two of my frozen embryos by eating well, doing yoga, and playing with my puppy. The recurrent miscarriage testing showed that I am heterozygous for a clotting thing called MTHR, and so I add folgard twice a day to my baby aspiring and prenatal vitamin regimin.

I got pregnant from that transfer, but the pregnancy only lasted a few days. They call this a chemical pregnancy, the kind of pregnancy you wouldn’t even know about unless you were in fertility treatment and were getting blood work done early and often.

Immediately after the news of this third pregnancy loss, I went into full research mode. I remembered that a friend of mine had mentioned that a clinic in Colorado had the best IVF numbers in the country. I started reading all the fertility boards I had been avoiding for so long. I figured out which clinic was the famous one. I called to make an appointment, but since it was already 5 pm in Colorado by the time I found out I was losing the pregnancy, I had to leave a message. During that weekend, I did not feel depressed. I did not feel sad. I just felt compelled to find more options. I did a lot more reading about adoption, both domestic and international. I ordered two books on surrogacy and two books on adoption. (Apparently Amazon is one of the primary beneficiaries of my fertility woes.)

I found a local acupuncturist. I ordered the book the Colorado clinic had just put out, and read the chapter on genetic testing of embryos. That book mentioned a book on Traditional Chinese Medicine treatment of infertility, and so I bought that book as well.

On Monday, I was ready to make some calls. The first call was to the Colorado clinic. The receptionist gave me the first available phone consultation—6 weeks later. I learned that I would need to send all of my records for review before that consultation, and that then, I would need to go to Colorado for a full day of tests about a week after the beginning of the next cycle after the phone consult. And then I wouldn’t be able to start an actual IVF cycle until two or three months after that.

I felt the beginnings of that state of angry and sad and overwhelmed that my lack of fertility has periodically brought up. I tried to line up other options for the interim. I asked my local RE when I could do another frozen transfer. This clinic does their IVF in batches every other month, so I knew that the next retrieval month would be in May. The nurse said I would probably miss that one because my HCG levels would probably not go down to zero in time, so I would have to wait until the next cycle in July. JULY! So then I went to my next best option, exploring the idea of shipping my frozen embryos to another clinic, this one in Portland, to do a frozen transfer earlier than July. The nurse there gave me the first available appointment-three weeks away. This nurse and I had a very amusing conversation in which she suggested it would be best to pick up the “cooler” from my current doctor’s office, and drive my embryos to Portland myself. Ah, the comedic possibilities.

So then I called an adoption agency, and they told me that they ask prospective adoptive parents to stop all fertility treatments when they start the adoption process, because they say one needs to mourn the loss of her fertility before one can bond with an adoptive child. I get this, I really do, but when the wait for a child is over a year, and the wait for an IVF cycle is 5 or 6 months, it seems cruel to not allow me to start the paperwork while I am waiting for something, anything, to happen. Anyway, all of these frustrating phone calls released a great tidal wave of emotion in me. I got back into bed with my puppy at my feet, and I cried and cried and cried for a few days. Then I got back out of bed, and went to my first acupuncture appointment with a new acupuncturist, to the gym, and a few weeks later to the doctor in Portland.

The doctor in Portland was super-nice, but he had not reviewed my records before I arrived, so we spent a good deal of time going through my medical fertility history. He made notes on a stack of blank, unlined paper with blue pen, and when we were done with our dialogue, he said, “Well, I see the problem.”

“Oh, good, I thought.” This dude has noticed something that no other doctor has noticed. Now he will tell me to make some minor lifestyle change, like sleeping on my right side instead of my left, and then I will get pregnant and carry to term.” Okay, I didn’t really think this. It was more like, “If I were naïve, I might think that this man is going to be able to help me in some non-invasive way, but really what he’s saying is that if I haven’t gotten pregnant by now, with all the interventions I’ve had, it’s because things are really messed up.” And in fact, he started listing things on his paper: the endometriosis, the miscarriages, the trisomy 7, the chemical pregnancy, and at the bottom of the list, he wrote the number 37, my age, and next to it Advanced Maternal Age.

“As you get older, the number of aneuploid, or irregular, embryos increases,” he said, circling the number several times.

“So I would recommend doing genetic testing to see if you can generate any normal embryos at all. Because if we do another round of IVF and we test the embryos, and because of your Advanced Maternal Age, none of them are normal, maybe you want to move to donor egg.
Now, in fact, I did not even know that this clinic did the kind of genetic testing I was interested in, and I had intended to go to Colorado for my day of tests, and use the Portland clinic to do a frozen transfer of my existing embryos. And the last thing I intended to do was to use a donor egg. So I said so.
“Yeah, I don’t actually want to do donor egg,” I said. And I was about to say, “I will move to adoption if IVF with my own eggs does not work out,” but the doctor gently interrupted me.
“No one wants to go to donor egg,” he said. “But it can be a really great option, particularly if you have a younger sister or cousin.”

“But I don’t have a younger sister or cousin,” I said.

As many of you know, I am an only child, and my primary goal in building my family is to acquire more than one child, especially since not having any siblings has been particularly difficult for me in the wake of my father’s death. And you will notice that I am putting the words Advanced Maternal Age and Donor Egg in bold. This is because that is what it sounds like to me when people use those words, like they are shouting, even when an impartial observer might say that they are speaking in a normal tone of voice.
And the doctor said, “Are you sure? Because all women are worried about using a donor egg but if you have a younger sister or cousin, you’d be surprised by how much DNA you share. My brother and I, for instance, are very similar, because we share so much DNA. It’s just a great way to preserve your genetics when you are of Advanced Maternal Age.

It was at this point that I decided I could not work with this doctor. He was very nice, and very competent, but I cannot deal with something who does not listen to me, and who insists on praising the glory of genetic connection, while at the same time making me feel like a shriveled old crone and reminding me about my lack of siblings.

We continued our conversation. I asked polite questions about the genetic testing, and we decided that the next step was to have my day 3 FSH (follicle-stimulating hormone) tested.

“I suspect it will be high,” the doctor said. For those of you who don’t know, high FSH is bad.

“The last time I had it tested it was 4.7,” I said.

“Well that’s too low,” the doctor said. “That’s almost anovulatory.”
My heart started to sink, but then my brain started working. “But I just did a round of IVF in November, and I produced 32 eggs,” I said.

“Oh, yeah,” the doctor said, standing up and walking toward the door. “That’s pretty good. But I expect that it’s gone up since then.
I drove back the 2 hours from Portland to Eugene and fell into one of my now-patented angry, crying funks. That one lasted a few days, and by the end of it, I was certain that I needed to move on to the Colorado clinic.

Nayla