Despite the fact that I might not actually need an OB after tomorrow, I decided that I’d go on the hunt for one. It’s a blood sport in this town. They are all so overbooked. One that I called (came highly recommended by a friend and has a 4.7 rating on RateMD) is taking patients with a delivery date starting in August. I can just barely slip into her schedule. So I booked her. I mean, I don’t get to see her until 3 months anyway and if I have to postpone, then at least I’m sort of in the door.

One of my friends thinks I am making a mistake. Well, not a mistake per se, but she thinks I should book with a different doctor (he got a 5.0 rating and my sister went to him but his receptionist is a b****!) because his hospital has a tunnel to a kids’ hospital next door so if anything should happen, it could be a lifesaver. This does make sense to me but I feel badly about the first doctor, who seems like she’d be really nice. No final decision yet but clearly I don’t have time to languish.

The advice I received from every single female friend I have who has kids is, call several doctors even before you get a positive result. Literally on day of ovulation or retrieval or transfer and give them the approximate date (lie if you have to, they said!) because otherwise you may be really truly stuck.Talk about more stress.

I learned another neat trick: make sure your referring doctor indicates you’re high risk. That way you’ll get priority treatment and the OB’s staff will actually return your calls. They’ll also fit you in whenever necessary, unlike a regular low-risk pregnancy. What surprised me is that my donor clinic does not consider me — or most “regular” patients — as high risk.

While I was on the RateMD site, I looked up my fertility doctor from the second clinic I went to — and wasted three years with. She and her partner are some of the lowest rated fertility docs in this town. Comments consistently say that patients are made to feel like numbers, lack of confidentiality, and not listening to the patient or explaining consequences of treatment or drugs. More seriously, someone else had a similar experience as I did where the doctor prescribed meds “just in case” even though tests showed no underlying condition existed.

So there you go, ladies! One more thing to think about and sort out while you’re in the very busy throes of IVF.

Advertisements

Ugh. Every time you have a glimmer of hope in the IF world, something comes back to bite you. Found out that my hCG levels from Monday were 40. The clinic says this is good but they usually want to see around 50. If my hCG doesn’t double by tomorrow morning I’m SOL. Tomorrow cannot come fast enough. Maybe if I sleep through the whole day it’ll be here before I know it. On the other hand, I’ll probably have nightmares.

I looked up hCG counts:

PREGNANCY STATUS SERUM hCG LEVELS

from conception from LMP (mIU/ML or IU/L)
7 days 3 weeks 0 to 5
14 days 28 days 3 to 426
21 days 35 days 18 to 7,340
28 days 42 days 1080 to 56,500
35 – 42 days 49 – 56 days 7,650 to 229,000
43 – 64 days 57 – 78 days 25,700 to 288,000
57 – 78 days 79 – 100 days 13,300 to 253,000
17 – 24 weeks 2nd trimester 4060 to 65,400
25 wks to term 3rd trimester 3640 to 117,000

According to this researcher:

Levels double on the average, every 30.9 hours until values reach 6500 mIU/ml (6,500 IU/L) at approximately the eighth week after the last menstrual period (LMP). After that the rate of rise becomes individualized, peaking between the 60th and 70th day (9 to 10 weeks) LMP. HCG decreases slightly between the 12th and 16th week post LMP, and then remains constant until birth.

Levels for normal pregnancy fall within the following wide ranges. You will note a discrepancy between the ranges of normal in the two tables below. The actual level can vary widely, and is not as significant as the amount and rate of rise, particularly before 10 weeks.

I suppose I’m within range… but what a range. I remember a friend telling me she was in the 100’s with her first two tests.

I want to tear my hair out but then I’d just look like a crazy woman and not be pregnant. I feel so disappointed, so sad and so worried. My uterus has been feeling kind of heavy, if you know what I mean. Like the feeling you have before you get your period… it’s waiting to disgorge. I mentioned it to the husband and he got scared but then he thought that, well, early pregnancy often feels like you’re getting your period. So I don’t know.

Last night we saw a great little house in a fabulous school district. We had decided to put an offer on it late last night but this morning, with this news… maybe it’s tempting fate? You should’ve seen the frenzy around this house. First day on the market and couples (with babies) were circling like vultures. And it’s not even that large… we’d outgrow it soon enough. But the renovation was very well executed and nothing needed to be done to it. Which is unusual in our city. The normal thing is a do-it-yourself reno (i.e. cheap and ugly) and a price raised beyond affordability.

What to do?

So happy we could cry

December 1, 2009

I don’t even know how to begin this post because I am having a hard time being happy when I feel the pain of so many of you. So it’s with a bittersweet sentiment that I post that we got a positive result yesterday. (Although how positive, we don’t know because the darn lab hadn’t done the beta hCG! What is up with these people!??) I am cautiously optimistic as we have yet to check that the hCG is doubling at the rate it should. We’ll know more at the end of the week when I do more bloodwork.

The odd thing was that due to the fact that I chose not to use a local fertility clinic (bad mistake; if I do this again, I’ll sign up with one instead of relying on my family doctor whose office is definitely not set up to handle the demands of an IVF cycle), I had to use independent labs. I used the husband’s hospital lab so the results went to his office first. I was “robbed” of getting to tell him the news; instead, he called me. It was quite strange as I’d always imagined I’d be the one telling him.

Frankly, I was stunned. I sat down in my comfy leather chair and literally just stared ahead not seeing anything. I was excited but felt keenly that I did not know how to handle the  news as I’d only ever heard bad news in the past. It was surreal.

I was moved beyond tears when the husband came home, hugged me tightly and rocked me with his sobs. It was the culmination of six and a half years of trying unsuccessfully — IUI, IVF, surrogate and now DE — to have what he most wants. It was relief and disbelief and happiness and fear that it might yet all go wrong. The feeling of, can we really be happy?

I will keep you all posted and am sending out positive vibes to each and every one of you. On the flip side, if anyone is considering DE, do think about it some more. It really could be your path to mommyhood.

The Waiting Game

November 30, 2009

In an IVF cycle it’s hard to know which day is the worst day. Is it the first time you stick yourself with a needle? Is it towards the end of the drug regimen when you can’t find a virgin spot for the daily shot? Is it retrieval day when the nurse can’t find a vein because you’re so damn cold and the drugs don’t help you stop feeling the piercing of that huge needle on your ovaries? Or post-retrieval when the drugs finally wear off and you’re dealing with the aftermath? Perhaps it’s the day you go for your pregnancy test and the countdown ’til 3pm when you’ll get The Call?

Today is the dreaded pregnancy test day. I went in this morning and am trying — rather unsuccessfully — to ignore the fact that I’ll be getting a phone call later this afternoon. I think if I had an office job, I’d be more successful in “busy work” but as I’m a creative type, I’m finding myself somewhat blocked. Looking around my desk, I’m trying to see what else I can do. Well, it’s month-end, so I can do some accounting-type stuff, but that doesn’t take all day. Maybe I’ll shop for Christmas decorations; get the place feeling like a holiday is coming. Maybe I should just pick up a book that I’ll get swallowed up in. Argh! I hate the waiting game. I’ll let you all know whether I’ll be opening a bottle of wine tonight or not. In the meantime, I’d love to get feedback on the question of what is the worst day in the cycle?

The debate on IVF and the commodification of reproduction continues up here. There were a few articles in Toronto Star recently about donation of sperm and eggs that basically showed how ridiculous Canadians are when it comes to staying within the grey area of the law. It reminds me of our laws on marijuana: for many years the laws were so convoluted and mish-mashed it was both legal and illegal.

Typically Canadian, we have had an actual Royal Commission on assisted reproduction and we now have some sort of Office that is supposed to deal with the issue. There are, in fact, laws on the books although I don’t recall them being passed by Parliament but they must have been as the Commission insists it is trying to enforce them. What they say is this:

  • anyone wishing to assist in reproduction, i.e. be a surrogate, offer their sperm or eggs, is to be an altruistic participant
  • anyone caught paying for these services or ‘goods’ is subject to a fine of $250,000 and five years in jail

I have no idea how the Commission came up with these rules and who they polled about infertility. But the sum result of these rules is driving the search for surrogates and donors underground. The Star article cited a number of couples looking for egg donors — wait for it — online! They don’t even know what to ask; they certainly don’t have any kind of system in place to screen donors; it’s completely ridiculous. This is not a system that protects the infertile couple or that helps them in any way, shape or form.

I understand that some Canadians, being the milquetoast nation that we are (unable to call a spade a spade), want to “avoid” the commodification of anything related to human genetics. But the truth is, we are all commodities, even and perhaps especially, as adults. Those folks working to build your car, or serve your coffee, or take your money at the bank, and you — whatever it is you do — we are all just numbers in the big corporate game. Cogs in the wheels of our commercial society.

Also, have any of these Commission members gone through IVF? Do they understand the medical long-term consequences of it? Do they feel the pain of it, literally and emotionally? I cannot possibly imagine harvesting eggs out of the goodness of my heart. I cannot imagine that there are huge numbers of women lining up to carry babies for women that cannot. In fact, a very good way of maintaining privacy and anonymity is to commodify this. When there is a perceived fair exchange, everyone goes merrily on their way. Just as an example of the effects of these rules, my own fertility doctor recommended that we search out a donor in the US through a clinic that provides the service and then coordinate the donors cycle and our cycle in two different cities, then fly the donor to Canada for the retrieval. Well in fact, it’s easier and cheaper to just sign up with a US clinic and go there for one week during retrieval and transfer. On top of that, the donor can rest and recuperate in her own home.

While I’m on the topic, let’s also be honest about surrogacy: if we agree that abortion is a woman’s choice — and it is legal in Canada, thank goodness — then why is using your body to carry a child for someone not a woman’s choice and a service for which she can be paid?

It does not make any practical sense to limit reproductive efforts. By doing that you will always discriminate against someone, somewhere. Either your society supports assisted reproduction or it is against it. Grey areas only serve to create desperate situations that end up punishing the innocent.

For example, the same Commission recommended funding IVF for a prescribed set of infertile couples (age limits and the like) for three tries but limiting the transfer of embryos to one per try. I’m sorry, but who are we to judge and impose an age cut-off? On the one hand, you’ve got governments and society telling women to get multiple degrees and join the workforce and put off child bearing. Then you turn around and tell them, Oh, by the way, we won’t fund your IVF because we made a mistake. We now believe women should have children earlier in their career and worry about climbing the corporate ladder later in life. It also dismisses the 14 percent of Canadians that have unexplained fertility. It’s amazing that science can do so much to help couples conceive but we still can’t figure out why a great many folks can’t conceive with any type of intervention. All of these couples, who need help the most and go through the most pain and spend the most money, are being relegated to the margins of society with this potential new law. We are getting into Orwellian territory with such proscribed criteria; talk about the nanny state.

These recommendations were not developed to help infertile couples but to eliminate the apparently staggering number of multiple births that are supposedly draining the health care system. The debate also gets couched in terms of “being fair” and “providing service to the poorest to level out the opportunities” but that is not really true. If it were true, then we’d see opportunity at every level of fertility treatment (including donors) for every infertile couple no matter what their income or diagnosis.

I consider these laws and the thinking on this issue by the Commission as wholly lacking compassion and far-sightedness on the issue of commodification. Let’s just be honest: sperm and eggs are commodities. We should regulate their sale and sure, the price might go up, but if the government truly puts their money to back up their so-called beliefs, then perhaps they should cover part of the costs. If your population needs  help reproducing for economic reasons, then step up and use this as a tool to build your country. Otherwise, suck up to the fact that Canada cannot be a one hundred percent welfare state and accept that there is such a thing as private health care choices, and hey, maybe offer a better tax deduction.

 

 

Happy Turkey

November 27, 2009

Happy Thanksgiving to all my American IVF friends … eat for two and think positive! All the best to everyone.

Dealing with Privacy

November 25, 2009

Today I started to catch up with all the people in our support network whom we had told about the DE. My intention is to ask them to respect our privacy and the privacy of any child we may have. Of course, I don’t just come out and say it like that! They’ve been there for me through the harrowing decision-making and have assuaged all my doubts and fears. So they deserve a full update of the situation and besides, I’m genuinely interested in keeping them up-to-date. But what a tangled web we weave, to use an old cliche! Somehow when you start thinking about it, then considering it, then trying it on for size, you realize how many people you want to discuss it with. Then there is their spouse… and are we dinner table conversation too? And all this before telling our families. It is very important to lock the gates and make sure that everyone knows you appreciate them immensely but also that they remain discreet.

We did not tell our parents because even though they mean well, they are very concerned. When we informed them about a regular IVF cycle, I remember having to eventually explain to them to stop calling every other day with a plaintive, expectant,  What’s new? It drove me nuts and the pressure was too great. First, to deal with your own disappointment is bad enough but to have theirs on your shoulders is just too much. If this process doesn’t work, I’m sure my friends-only support network will offer the usual platitudes and I’m used to those, but it’s not as disappointing for them as it is to potential grandparents, aunts, and uncles. As it stands, the family will know if this works and even then, not everyone will know about the DE. I know we’ll have to be strong to deal with pressure from parents that think we should tell this relative or that, but I’ll take my chances and guard my child’s privacy. Sometimes you think that all this is in the future so why think about it now, but I’ve found that it’s better to have a plan and be prepared. I wonder how other people handle this kind of additional pressure on top of having to go through all this?