Monthly Archives: April 2016

The Precipitate’s Not the Problem: An Infertility Primer for the Non-Infertile

“If you’re not part of the solution, you’re part of the problem.” – Your Mom

Or maybe not your mom. Maybe it was your dad or a great auntie. Maybe a principal or a well-meaning member of the safety patrol. Whoever it was — someone said it to you at some point. And you got the point. Unless you’re trying to fix the problem, you are the problem. We’ve all internalized it. And since no one ever ever wants to be the problem, our natural inclination is to offer solutions, to fix it.

And then we all grew up a bit. If you’re anything like me, you became even nerdier. Maybe you even got into the chem scene (which makes chemistry sound cool, don’t you think?). If that’s the case, you may have latched onto this alternative adage — my personal favorite:

“If you’re not part of the solution, you’re part of the precipitate.” – All the Nerds

{Source}
{Source}

It made you laugh and laugh (not as much as the ether bunny or the ferrous wheel, of course), but you knew deep down that it was only a chem joke. Not a real life lesson.

Or is it?

I posit that it’s a better saying, really. More accurate for particularly complex problems, like infertility. Because to extend the chemistry metaphor a bit further — in the case of infertility, there are only two solutes in solution. My partner and myself. Anyone else can really only be part of the precipitate. A precipitate can’t fix anything, it just hangs out in the tube, separate. But that doesn’t make it part of the problem.

{Image Source -- Thanks Dartmouth Chem Lab}
{Image Source — Thanks Dartmouth Chem Lab}

In the wake of our most recent crappy news, we’ve been offered a lot of love, a ton of support, and so very many ideas for next steps — ranging from “just relax” to offers of surrogacy and referrals to adoption case workers. These fixes come from a place of love, good intentions, and probably also a subconscious devotion to the first quote above. Unfortunately, it’s no one’s problem to solve. Instead, it’s Seth and my path to walk and because I know it’s hard to understand, hard not to want to fix, I thought it might be nice to share some aspects of infertility from my own perspective.

But you ain’t got no eggs!

Infertility happens for a million and one different reasons. Or even for no discernable reason at all. There’s male factor and female factor infertility. One or both partners can be affected. There can be no eggs, poor eggs, an inability to release eggs. Similarly, no sperm, poor sperm, immobile sperm. It can be mechanical — related to the shape or size or functional ability of the uterus, the shape or size of the vas deferens. It can be scar tissue, the result of surgeries, childhood radiation treatments. Genetic, chromosomal, hormonal issues. All of the above, none of the above, anything in between, or something else altogether.

We started out with “unexplained” infertility (i.e. everything seemed to be just fine). While it’s good to have nothing obviously wrong, lack of diagnosis makes treatment much more difficult — everything is just a guess at that point. However, after lots of tries (see below), we ultimately ended up with a diagnosis of diminished ovarian reserve. That means that despite being just 32 (and only 27 when we started trying to conceive), my eggs are just about out. The tank is approaching E and the few eggs I do have left are poor in quality — hence the miscarriage late last year. That’s our reason. And ultimately, it has the greatest impact on our potential solutions. So while I appreciate the offers of uteri for rent and the like, that’s not actually going to help me one bit. My body is technically quite capable of carrying a healthy pregnancy, we’re just missing half of the equation.

Grieving the loss of imaginary piggies.

Miscarrying last September was really hard. It was the most difficult experience of my life to date and the grief still comes so fiercely sometimes that all I can do is hold on and ride the wave for a while. I still had hope though, I thought that pregnancy would be followed by another. That we would have our own children. As it turns out, though, the lack of eggs means that the thing I’m really grieving is an imaginary future — one that was never going to exist, but always felt real to me in my mind. I’ve spent years wondering about the curly blonde babes Seth and I would someday bring into this world. I’ve always imagined us like Piggy and Kermit — all the girls would be pigs, all the boys would be frogs. Would they have my green eyes or Seth’s blue? My ready, beaming smile or Seth’s slower, more mischievous, lopsided grin?

Imaginary future... {Source}
Imaginary future… {Source}

And then just like that — I’ve been removed from the equation. No piggies at all. I can’t pass on the Vonck mouth. My genes won’t ever go anywhere, no matter what we decide to do next. That’s a hard pill to swallow. Something I have to wrap my mind around. Another loss to grieve, but how? There’s no memorial in the cemetery for this loss and it’s hard to know how to let it go.

All magic comes with a price, dearie.

After more than a year of trying to conceive on our own, we sought medical care for infertility and decided early on that we wanted to exhaust our possibilities to have biological children. And exhaust them we did. We’ve spent many, many, many thousands of dollars on diagnostic testing and assisted reproductive technology ranging from simple clomid and timed intercourse to intrauterine insemination (IUI) and finally two rounds of in vitro fertilization (IVF) over the course of 4+ years.  Side-effects, needles, injections, ultrasounds, surgeries, procedures, tears and snot and stress and rage and bloating and month after month after month of disappointment. We did it all for a chance — all at great cost.

None of it worked for us. Now we know why. And because we’re quite certain that we do indeed want to be parents, we’re left looking at the next set of alternatives.

Egg donation, adoption, fostering. And even those options have sub-options — fresh or frozen, international or domestic, public or private. And those sub-options have sub-sub-options — how do you pick a donor? Physical characteristics? Genetics? Occupation? Personality? Psych profile? And if you adopt — are you prepared to wait for an eternity? Are you willing to let a birth parent pick you? What if they change their minds? What if you fall in love with a foster child and then they get sent back to their biological parents (Wisconsin focuses on reunification whenever possible)? Can you bare that? Can you bare any of it?

It’s a lot to think about. So much to process. And all of it — every last option — comes at great cost. Physically, emotionally, financially. On top of everything we’ve already been through, every time we hear “at least” (e.g., at least you know you did everything you could, at least you can afford it) or “just” (e.g., why don’t you just adopt?) it’s like salt in the wound — minimization of everything we’ve done so far and the difficult road ahead to family. Yes, we are fortunate that we can consider options, but that doesn’t make the necessity of considering them any easier.

It’s not you, it’s me. 

The ugliest truth about infertility is that it colors everything. Over these last four years, infertility has become increasingly woven into my being and I have a hard time separating who I am from this thing I can’t do. I’m not proud to admit it, but in the face of cutesy pregnancy announcements, #blessed ultrasound pictures, and bow-decked baby bumps, happiness for those that I love and a sense of jealousy and bitterness are always there in equal measure. Of course, I wouldn’t wish infertility on my worst enemy, but that doesn’t mean I handle fertility with any kind of grace and I’m issuing a blanket apology for my poor reactions. It’s not you, honestly, it’s me. And presumably, someday it will get better, easier, to just be happy.

But here’s the most important thing: the announcements, photos, bumps, hashtags, motherhood memes — none of them have anything at all to do with me. So you shouldn’t stop doing them. It’s all worth celebrating and my scroogey attitude shouldn’t take away from that.

Conversely, radical self-care and self-preservation means that some Facebook friends are hidden and I won’t be RSVPing yes to a baby shower or making any more baby blankets for the foreseeable future. It’s too painful. I don’t ask for forgiveness or even understanding, just patience.

All roads lead to Rome.

Ultimately, there are a lot of different paths to parenthood. At present, I struggle because I don’t like any of the choices. Or, more accurately, I don’t want to have to make a choice. I will come around though. I always do, but as I said above, there’s no “just” about any of the paths. Once pregnancy via sex and waiting is off the table, nothing feels simple anymore.

In my present state of mind, egg donation proves that Seth really should have married someone else and fostering/adoption is unlikely to work out considering that even God wouldn’t choose me to raise a child — why would anyone else? Thankfully, Seth is much more capable of rational thought at the moment and I’m slowly starting to wrap my mind around some of the options. One foot in front of the other, all the way to Rome.

Not everybody wants to go to Rome.

But then again — Rome isn’t for everyone in the end. And there’s nothing wrong with making that decision for yourself. Families come in all shapes and sizes, Seth and I are a family all on our own and puppy makes three. Ultimately, though, the societal assumption is that if you’re infertile, you want to have children in any way possible and there’s the tendency to push couples struggling with infertility to pick a road and get to parenthood, one way or another.

Right now, Seth and I are pretty certain that we want to find a path to parenthood, but I think it’s really important that people accept any choices we do decide to make from the perspective of the precipitate. These things are incredibly personal and based only a little on biology, medicine, and rational thought. More than anything, we have to trust our emotions, our hearts, and each other to make the right choices for us moving forward. We both have to be on board with something 100%, no judgement if not.

The same goes for any other couple, any other family, and if you find yourself interested in learning more, I highly recommend perusing CNN’s recent infertility awareness week series. I shared this article on Facebook this morning and got a great response to it:

When you ‘come out’ about infertility

And there are several related articles written by or about couples who’ve made a variety of different choices that make great points about why people don’t talk about infertility (and why they should), how a “happy ending” to infertility can mean different things to different people, and how varied infertility experiences can be.

 

I’ve been spending a lot of time lately with the writing of Brene Brown and Anne Lamott and Jenny Lawson. Brave women who share their stories in an honest and beautiful way — they’ve opened me up to a whole new level of comfort in the idea of vulnerability and struggle and story telling and I think that for me, infertility is another avenue for that. The ranks of the infertile… not a tribe I’d have chosen to join, had it been a choice at all, but it’s a fierce one and I’m in good company. Someday, I’ll have a very intentional family and Seth by my side and I’ll be in good company then too. Thanks so much for being here through it all <3

 

Negative.

Our pregnancy test was negative and it’s all over now. I’m not ready to talk about it, definitely not ready to be any kind of positive about it. I need some time and space to grieve the future I had envisioned because it is most certainly gone, and that’s a hard thing to let go. It’ll take some time. I’ll be back when I’m done.
Thanks so much for hanging in there with me. 

A thought exercise (for me) and job offer (for Mindy Kaling).

Guys, I am struggling. All the hormones, all the waiting. The exhaustion — mental and physical. The guilt and negative thoughts. I’m really struggling.

But after an hour of tears in my therapist’s office and the ugly sobbing of so many incredibly unkind words toward myself, Dr. C suggested a thought exercise.

While I can’t quite wrap my mind around self-kindness, to treat myself as though I were a good friend, I can invent a friend and do pretty much the same. (I’m excellent at make believe, which is the nice way of saying lying.) I can invent a friend with a new diagnosis of, say, MS. (She was infertile at first, but Dr. C though maybe that would be a bit too much. So MS it is.) A debilitating and life-altering disease. A diagnosis that affects an individual and his or her partner. Sort of like infertility…

What would I say to that friend?

To my fictional friend, recently diagnosed with MS.

Your life is different now and will always be different. But your life is most definitely not over.

In fact, nothing has actually changed. Instead, you have an answer. It’s a terrible, horrible, no good and unwanted answer. But it’s an answer. And the answer doesn’t actually change a single thing about you.

The MS was always there. It’s a cruel trick of genetics, fate, chance. A cruel trick of whatever it is you believe controls the uncertainty in life.

(Personally, I believe in biology and probability, even when I don’t like it. (And sub-parenthetical, I apologize for being the kind of friend who cites their own blog in a letter to a friend.) But I have to let you chalk it up to whatever it is that you believe in.)

It’s not a punishment or a judgement on your moral fiber, the being that is you. It’s a circumstance. And you are not a victim of circumstance.

You are brave. You are resilient. You are head strong and heart sure. You love and are loved. None of those things will change. They are, like you, unshakable at their core. Because they make up your core.

Yes, there will be bad days. Days when MS feels like the only thing. When it feels suffocating and dark and all encompassing. Those days will pass. And there will be good days, days when you forget MS exists at all. Those days will pass too. Each is only a day. A day inhabited by the same brave and beautiful you, capable of anything and everything. Even surviving, living, thriving.

No one who loved you before loved you because you didn’t have MS. And there’s no reason to expect that anyone will love you less because of it. You are loved for something much deeper than your external circumstances, including what your body can or can’t do — by your spouse, your family, your friends, your dog. Like you, those loves will not change.

But the MS may, and likely will, change your mind and work some magic on your heart. It may increase your capacity for empathy and understanding. Maybe it has done these things already. Yes, it may also sometimes make you feel jealous and ragey and bitter about the able-bodied, unaffected folks around you. But a small price to pay for the beauty and appreciation and opening of heart you get to experience, don’t you think?

It’s not so much that MS itself is a blessing. More so that it’s not a curse or a punishment. It’s not out to get you. It’s not your fault. And because you are who you are, you can take what MS gave you, the cliched lemons, and make some cliched lemonade. Maybe some lemon bars too. Because you’re talented in that way and always go beyond the cliche to find something a little deeper and a little more dusted in powdered sugar.

Yes, MS is forever and it is yours to live with for all that time. But you will. Live. And love. And be happy and sad. Joyful and sorrowful. Grateful and jealous. Brave and scared. Just like everyone else, but also a little bit different than most.

I can’t necessarily understand, but I’m here for you, as your friend, as someone who loves you. And I’ll always be here for you, as someone who tries to understand and never stops loving you. No matter what.

Always.

R

Meant to be a mom or not, I can be a pretty stellar friend. Certainly a better friend than internal monologue-ist (which is not a real thing, I just invented it to make the point that I’m a total jerk to myself). And now, when my own verdict arrives in the near future, I can read the letter above. I can sub out the MS and sub in a state of infertility no longer changeable. And most importantly, I won’t have to go to my crappy internal monologue-ist for her thoughts on the matter. In fact, I may even have to let her go and re-post for the position.

We’ve decided to go in another direction…

Help Wanted — Qualifications: eloquent, Harry Potter fan with good sense of humor. No jerks need apply.

And with that, I suspect I may be trying to hire Mindy Kaling as my internal monologue-ist. She’s even had appropriate experience. This could be excellent.

{Source}
Couldn’t have found a better picture — results on Thursday. Two days is like forever from now. {Source}

Second Verse, Same as the First…

[I sit down at the kitchen table to do some work.]

Seth: Do you care if we watch a Homeland?

Me: I don’t care… but you better check with the pup.

Seth: She loves Homeland. She’s snuggled up with me, giving me a belly rub.

Me: She’s giving you a belly rub?

Seth: There’s a lot you don’t know about us.

My house is a weird place.
My house is a weird place.

IVF isn’t really going well this time. Worse than last time, actually. And last time wasn’t stellar. (For more information, please see the start, the middle, the middle again, and the end of IVF.)

I was really bummed on Saturday. I cried a little on the way home. I was sad and tired and mad at mother nature for the surprise April snow and I couldn’t keep all that in. So I cried a little. I even let myself wallow for a while after I got home.

And then my wallowing turned into a nap. It was a magic nap. I was legit tired.
And then my wallowing turned into a nap. It was a magic nap. I was legit tired.

But somehow, miraculously, I’m ok today. Despite the cold and massive Eustachian tube clog that’s causing me some pretty intense ear pain. Even with a big grant deadline looming. And even though IVF is still not going well and there are very real thoughts of the pointlessness of the injections and the potential waste of money swirling around and around in my mind, I am ok. Because I’ve done everything I could possibly do — to treat the cold, to finish the grant, to have a baby.

Since we miscarried in September, I’ve supplemented with vitamin D (mine was pretty low) and melatonin. I’ve upped my soy intake and been eating really very healthy (healthy plus chocolate, because… chocolate). I lost 30 lbs and ran a marathon (even though chocolate). I’ve read the literature and prepared my body and worked on my mind and myself and religiously taken my pills, injected my drugs, gone to all my appointments, and still… it’s not really working.

There is nothing else I can do.

There is still a chance of success, albeit a low one. In fact, we may not even get to go through with the procedure at all, pending further test results. And somehow I’m ok.

Because my family is in the other room, watching Homeland and giving each other belly rubs. Maybe it’ll grow a bit and maybe it won’t. We’ll be ok either way.

What my brother-in-law calls a "dog circle" is pretty much my favorite thing.
What my brother-in-law calls a “dog circle” is pretty much my favorite thing.

 

So I guess the second verse really isn’t exactly the same as the first except that the first verse was IVF and so is the second. I just have that line stuck in my head because Seth insisted on playing I’m Henry the 8th I Am this weekend. So weird. Love him.