Saturday, May 26, 2007

The irresistable force and the immovable object

Many years ago, pre-infertility, pre-Mystery, heck, pre-everything, I spent a summer backpacking in Southeast Asia. A few weeks after I arrived, all bowel functions ceased. This was a huge shock, as, well, I don't mean to brag, but I've always been rather productive in that department. A day passed, then two, then four, then a week, and nothing. I kept eating, figuring that eventually I could push the obstruction through, but to no avail. I just blew up like a balloon. A great big balloon full of, well, you know.

At the time, I was in a small remote village, and from the waist up was having a glorious time. There was no pharmacy, and no doctor, so seeking medical attention would have required a several-hour bus trip. I kept putting it off, assuming that the problem would eventually sort itself out.

Ten days into the ordeal, I felt forced to take desperate measures. Now if you have ever been in that situation, you can probably imagine the sort of unspeakable act that I'm talking about. If not, then there is no way that I am going to be the one to pollute your mind with such thoughts. Let's just say that it wasn't pretty.

And it didn't help. I was the world's worst consumer of toilet paper for a shockingly long time. Then, all of a sudden, I started feeling a gurgling in my bowels. Being rather inclined toward digestive distress, I was familiar with this feeling as a precursor of explosive diarrhea. And I started to wonder which would win, the diarrhea or the constipation. I pictured an epic battle going on in my belly, resulting the victory of the one and the annihilation of the other, or alternatively, in a massive explosion. In the end, the diarrhea won, as it always does. Thanks to a convenient giardia infection, that was my last experience with constipation. Until now that is.

While we all wish for an uneventful pregnancy, last week was a little TOO uneventful. Uncomfortably uneventful. There were no "events" whatsoever. So, once again, I find myself full of, well, you know.

Monday, May 21, 2007


Yesterday, a far-away friend asked if I was showing yet. I carefully examined my belly, and decided that while I've gained a few pounds, and have had to retire several pairs of trousers, I didn't think that a stranger, even one seeing me naked, would realize that I was pregnant. Fat, yes, but not pregnant.

As if to mock my hubris, today a big belly suddenly popped out. I am now showing. Just like that. Pregnancy is very strange.

Saturday, May 19, 2007

The road not taken

As the exhaustion and morning sickness subside, I've found myself obsessing about my body a bit less (there's not really that much going on, other than absolutely absurd intestinal issues that are too embarrassing to discuss in public), and thinking about how I got here, and all of the choices that I made along the way.

I'm sometimes amazed at the diversity of decisions that people make when dealing with infertility. For some people, the natural first choice is to adopt. For others, the obvious thing to do is to run to the doctor after just a few months of frustration. Others wait for literally years before seeking medical attention. Others seek medical diagnoses quickly, but refuse treatment. Obviously your own family background (and that of your partner, if you have a partner), your level of knowledge about fertility/infertility, and your economic resources will affect your decisions. Still, people in really similar situations seem to seek very different solutions.

My Mystery Man grew up in a very poor country, and had a neighbor that struggled with infertility. Seeing a doctor was impossible, as they couldn't afford it, and even if they could have, there wasn't an RE for hundreds of miles. They just continued to try for over ten years, and finally got lucky. Other couples in his country simply have to make do with childlessness, having no alternative. Mystery also has a friend whose father divorced his first wife because they didn't have a child after two years. This man just naturally assumed that it was his wife's "fault", and that the natural solution was to trade her in for a different model. Can you imagine how this poor woman must have felt, especially after she then had to watch the new wife have nine children? Knowing this, I never forget that we're the lucky ones. Still, having adoption and a dizzying array of treatments at least nominally available can make moving forward very hard.

If you decide to adopt, there are a million choices to make. Foster-to-adopt? Private adoption? Open or closed? Domestic or international? If international, what country? Do you care about the sex? The age? What about special needs?

For me, adoption has always been (and remains) a good option, from an emotional perspective. However, as every infertile couple (but astonishingly few fertile couples) realizes, it's really not that simple for many or most of us. If you decide to foster-to-adopt, you have to qualify (living in Korea would certainly put the kibosh on that for us), and in most cases will end up with a special needs kid. It can also be difficult to be matched with an infant. For us, the latter issue was also a serious issue. We speak two languages at home, and plan to continue to do so. Adopting an older verbal child who did not share my husband's language would force us to either try to force an already traumatized child to learn a new language, even though we COULD communicate with the child in English, or to entirely give up on my husband's language, which is like giving up on a part of our souls. It's tempting to think that the child would just "pick up" on a new language, but the fact is that would never happen if we spoke English to the child. While kids can be language sponges, they do tend to take the easy route when given the option. We're also not particularly well set up for a special needs kid, given our rather mobile lifestyle. Obviously we may end up with a special needs kid regardless, and will do our best to provide a loving supportive home for whatever child we end up with, but deliberately choosing a special needs child didn't seem wise.

Other adoption options were also out for two reasons: first, the money. We would really struggle to afford to spend $20,000 on a private adoption right now, and we don't pay US taxes, so the tax credit wouldn't help. Second, we seriously doubt that a birth family would choose us, given our lack of white picket fence, our highly mobile lifestyle, our stay-at-home dad plans, and our insistance on speaking a language largely perceived to be useless 90% of the time.

The other issue, which might sound absurd, but is very real to me, is that I don't think I could bear the paperwork, home study, and general invasiveness of the process right now. When my dear Mystery Man applied for his US visa to come to my country to marry me, we had to fill out a mountain of paperwork, provide letters and explanations of our relationship, proof of our sincerity, photos, phone records, and affadavits from friends, as well as detailed financial records and every identity document that you can imagine to the INS. It was supposed to take 3 months. Then the INS was absorbed into the US Department of Homeland Security, and became the BCIS (that was before it was the USCIS, for those of you who are up on your immigration trivia). In the process of becoming more "secure", they developed an enormous backlog, and his visa application ended up taking almost 10 months, during which time we were stuck in different countries. Those were the longest 10 months of our lives. We got no feedback whatsoever during that time, other than that the application was "being processed". There was no guarantee of success, and in fact, we know several people whose applications were rejected during that time. The best part is that if they reject your application, they don't even say why.

Luckily for us, Mystery Man's application was approved, and suddenly we were given three months to get married and prove it, or he'd have to leave the country again. Luckily, I'd never wanted a big wedding, but still, three months struck me as a bit unreasonable. We managed, though, and I thought our troubles were over. Then we had to apply for his green card so he could stay in the US. The process was at least as onerous as the visa application, and just as unsettling. While his application was pending (1 year), he couldn't leave the country, and we were not told when to expect that situation to change. So, we lived in fear that something would happen in his family, and we'd be faced with the awful choice of not being there for them, or going back to square one with all of the paperwork. Luckily, all was well, and in a year he was given a "conditional" green card, good for two years. After two years, we then had to apply for his "permanent" green card. This is when it got really invasive. Not only did they want to see our financials again but they also required that we provide letters from family and friends about the nature of our relationship, and other "proof" of the relationship. (The reason for the "conditional" status is to make sure that it's a "real" marriage.) I don't know about you, but I found asking friends to write letters to the US government stating that my husband and I actually love each other really mortifying. They were understanding, and wrote really touching letters, but still... When I went to file the paperwork, the agent in charge told me that they only actually interview some of the couples that apply for marriage-based green cards. I asked how they choose, and she said "well, I'm sure they'll interview you, because you don't have kids." (I'll bet you were wondering what this all had to do with infertility, weren't you.) So, I actually considered getting a letter from my RE stating that we were in fertility treatment, and that he had repeatedly (albeit unsuccessfully) inseminated me with my husband's sperm for the purpose of getting me pregnant and sending it to the fucking US Department of Homeland Security for the amusement of a bunch of bored paper-pushers. Now can you tell me how that incredible invasion of my privacy would make the homeland any more secure?

Well, long story short (you thought that was long? I've barely begun with my tales of immigration woes--I spared you the entire story of how they sent the green card to the wrong STATE a few weeks before we were leaving for Korea), Mystery Man now has his green card. I, however, will never be the same. The very thought of preparing an adoption dossier makes me sweat and shake. I have no doubts whatsoever about how much I would love and cherish an adopted child. However, I'm just not ready to put my happiness in the hands of faceless bureacrats again quite yet.

So the decision was between treatment and no treatment, and what treatments to pursue. Now I'm a proactive kind of girl, and never seriously considered postponing (or declining) treatment. My sweetie, however, took some convincing. It wasn't that he didn't want a baby, he just was a) hung up on the idea of doing it the "natural" way, and b) reluctant to spend money on treatments when he still believed that we could get pregnant the old-fashioned way. So, we started with testing, and found nothing. No explanation, no hope for improvement, nothing. However, I think that meeting with the RE helped him to understand that no diagnosis did not mean that everything was OK, and that given my age (did I mention that we had planned to start trying as soon as he arrived in the US, so the Department of Homeland Security's administrative delays actually cost me 10 months of my reproductive lifespan? Do I sound bitter?) we'd really better not dither around too much. So, we started with clomid, then clomid/iui (times 3). Nothing worked. I was in despair. I had a lap, they found and removed endo, but still nothing. My insurance only paid for 50% of infertility-related tests, treatments, and meds (so we were already out several thousands of dollars), and specifically excluded IVF. Meanwhile, our RE said that IVF was by far our best option. For me, the decision to pursue IVF was never difficult from a medical or emotional perspective. I was always more afraid of childlessness than needles, and was not particularly hung up on getting my "natural pregnancy" merit badge. However, the financial angle was huge. My doctor said that he'd give us about a 40% chance of succeeding with IVF per round, and the out-of-pocket cost for each round would be around $12,000-$15,000. Now I'm sometimes painfully logical, and couldn't help but notice that this meant that there was about a 60% chance that we'd be out $15,000 and still have no baby. The fact that it took my sister 3 rounds of IVF to get her BFP really didn't reassure me on this point either. Now we probably could have scraped up $15,000, but would have really felt the loss. I don't mean felt it like "no new car this year", but more like "well, I'd really like to buy that can of beans, but we really can't afford it, so I guess we'll just be eating ramen this week". (I guess I've never mentioned this but we're paying for Mystery Man's little brother and sister's private schools, so even though I make a decent salary, and Mystery had a decent salary while we were in the US, our money doesn't go far.) So, moving to Korea was an absolute godsend for us. With IVF at $3000/shot, I knew that we could go ahead and plan for 3 rounds of IVF. My number-crunching told me that we'd have a really good chance of succeeding at least once in three rounds.

After the first failed round, I never for a moment reconsidered that plan, and I never had a moment of regret about the decision to try. I can't say how I would have felt if all three rounds had failed. However, it's hard for me to imagine that I could regret trying more than I would have regretted not trying. So, it's sometimes a bit hard for me to understand how other couples who have insurance coverage for IVF can be so reluctant to move forward. I know that everybody is different, but for me, giving up on my own "natural" fertility and putting it into my doctor's hands was such an enormous relief.

The other day, Mystery Man said that now that we've succeeded with IVF, he feels a lot more optimistic that we'll get pregnant naturally with #2. I nearly fell out of bed laughing. The very thought of deciding to try for #2 and not starting by calling the RE is absurd to me. Not only do I think that we'd have basically no chance of success, but the thought of getting back onto that natural ttc roller-coaster is horrifying. I guess I'm an IVF addict, but I'd far rather just pay $3000, take my shot, and get my answer in a few weeks than spend another 3 years facing negative after negative.

Saturday, May 12, 2007

Is it just me?

Lately, I've been finding myself rather at a loss about what I should and shouldn't post. Do I really think that it's necessary to mention being tired again? Will anybody really want to read about the fact that I can now (just barely) feel my uterus in my lower belly? Is it beyond unnecessary to celebrate the fact that I am now officially entering the second trimester? Well, the answer to the last one at least is a resounding NO, I think. For some reason, the end of the first trimester was a big deal to me. With every passing day, I start to become more optimistic that maybe, just maybe, there will actually be a baby at the end of this all.

In general, though, I actually feel more comfortable blogging about my neuroses, psychoses, and dilemmas than about the happy moments that have resulted from my first-ever (apparent) victory in my long-running war with infertility. It's not that I'm not grateful. I'm beyond grateful. Almost 14 weeks into this pregnancy, I still feel like kissing my RE every day to express my gratitude for my incredible luck in making it so far. Infertility is still far to fresh in my mind to take a second of this for granted. Rather, I am (like every other former infertile, probably) coping with the survivor's guilt in part by trying to shut up when I don't have something to say that I'm not embarrassed to say in front of people who are still in the battle.

What I'm about to say, though, is not only embarrassing to say to people who are still in the battle. It's embarrassing to admit to anyone at all. Nonetheless, I thought I'd throw it out there, just to see if I'm the only freak in the world, or if other people actually think about these things. Are you ready? Here goes... Sometimes I worry that they put the wrong embryos back in my IVF cycle, and that this is actually somebody else's baby. Am I completely deranged? Should I run, not walk to the nearest psychiatric emergency clinic?

I should clarify that when I say "worry", I don't mean "lying awake at nights fretting", I mean more like wondering, but in a slightly apprehensive way. And when I say "somebody else's baby", I don't mean a baby that I won't (or don't already) love with every fiber of my being. I mean a baby that someone else might also have a legitimate claim on. That's the part that takes me from wondering into apprehensive wondering. Given that every other customer at my clinic was Korean at the time that I was going there, if they DID put the wrong embryos back in, then it will be obvious to everyone involved on the child's birthday. What would this mean for us? Would we be in danger of having the child taken away? In the US it wouldn't, but in Korea, who knows?

I think that some of this anxiety results from the differences between the procedures at my clinic here in Korea versus my clinic in the USA. In the USA, with every IUI, we had to sign a document when we dropped the semen off to be washed stating that the semen came from my husband's body, and that it had been in our custody since it had been produced. Then when we picked up the washed sperm to take it in for the IUI (it was in an office across the street from the RE), the technician signed a document basically stating that the sperm hadn't been out of her sight, and I signed a document stating that I had verified that the name on the label was my husband's name. Then at the RE's office, Mystery Man had to sign something saying that he agreed that I could be inseminated with his sperm, and I had to sign something stating that I had verified the identity of the sperm with the technician. They were serious about chain of custody issues. Here in Korea, though, we just brought in a vial in a paper bag (carefully kept at boob temperature on the subway ride), wrote his name on the vial, and handed it over to the receptionist, not to hear from it again until the day of embryo transfer.

When I think about this realistically, I realize that they probably relaxed a lot of that legalese here partly because Koreans are less litigious by nature than Americans, and partly because having me sign legal documents in Korean is not only an exercise in futility, as far as communication of risks and responsibilities is concerned, but also requires that they provide a translator, which would be an enormous hassle. I can't believe that they really fling embryos about randomly in the back room. Furthermore, even if they do normally fling embryos about, I would think they'd be a bit more careful with mine, given that it would be really obvious in my case if they made a mistake. So, rationally, I realize that I just need to turn off the TV and my imagination and stop thinking about things like this. Still, I keep finding myself wondering.

Honestly, if they did make a mistake, I'll still be grateful for this amazing gift. However, I've got to say that I really really hope that they didn't.

Saturday, May 5, 2007

Pink or blue

Being pregnant is amazing, in a very good way. Being infertile was also amazing, but in a way better categorized as "soul-destroying" than "good". I was constantly amazed at how miserable the absence of something that I'd never had could make me. How jealous and petty I could be. How stressed I could be for months and years on end. Mostly, though, I was amazed at how different everything was than I thought it would be. Prior to infertility, I'd always thought that if there was the slightest hint of a problem, I'd run screaming to adoption. Of course this was before I had actually researched adoption, and knew about the expense, the paperwork, the waiting, the parenting issues with attachment, loss, etc. It was also before I met my Mystery Man, who is rather more concerned about the issue of genetic relatedness than I am. I had also thought that whatever happened, I'd face it with grace. (I couldn't even write that without laughing at myself. I have been many things over the last three years, but graceful has not been one of them.) I had thought that I wouldn't take the risk of multiples. I had thought that I wouldn't do IVF, and never even considered the possibility that one day I might be excited, thrilled even, to be starting a cycle. I had never thought that any step of the way would feel the way that it did. If there is one enduring lesson that has come out of all of this it's that you really never can know how you'll feel in a situation until you've actually experienced that situation.

It's the same way with being pregnant. I was right about how happy it would make me. I really am happy every day about this pregnancy. That's one thing that is exactly as I expected. However, I'm a lot less controlling about it than I thought I'd be. I assumed that I'd have amnio. I had never even given it any thought before a few weeks ago. I KNEW I'd do amnio. Now I don't think I'm doing amnio, and I don't even really remember when I changed my mind. Similarly, I have always, always, known that I would find out the sex of my child as soon as possible. I thought it would help me to visualize and bond with the child inside of me. I thought that it would prevent any whiff of disappointment on the day of my child's birth. I thought I'd want to know. So, I'm shocked to find that here I am, and I really don't want to know.

There are a lot of reasons that I don't want to know. I think probably the most profound on an emotional level is the yearning for some sense of "normalcy", a whiff of old-fashioned romance, in this pregnancy. This baby was the result of my Mystery Man wanking in a cup, and me being given enough drugs to make Margaret Thatcher ovulate, and then being impaled on a giant needle and having my eggs sucked out. Neither of us when in the room when our baby was actually conceived. He/she spent three days in a lab before we even met. I've had an ultrasound every two weeks or so from that date on. I don't think that this makes my baby any less of a miracle than any child (rather I think it makes her/him even more of a miracle), but it has made the whole process feel rather, well, medical. Since I'm not going to have a nice home birth with a midwife (at the age of 38, and after years of infertility, that strikes me as a very very bad plan, if it's even possible in Korea), and there's no guarantee that I'll even be able to have a vag birth (you never know!) I'm finding myself really fixating on the moment when the baby first arrives, and I get to hear those magic words "it's a _____!!!!!!"

I also just don't care about the sex. I care if the baby is healthy. I want desperately for the baby to be healthy. At this point, that's the only thing I care about. Before infertility, I used to fantasize about having a baby girl, and then a baby boy. I thought I had it all figured out, and if I had gotten pregnant right away, I probably would have been slightly disappointed if my little life plan hadn't worked out that way. However, having had years to think about it, I've realized that ANY child is such a precious gift that I would be insane to think that it makes any difference what flavor I get. Every child is a unique and precious individual, and is welcome in my uterus, in my home, and in my heart.

Finally, (on a political/social note) I think that people put WAY too much of an emphasis on an infant's sex. Since my friends have started having babies, and I've had to deal with showers and baby gifts, I've realized that almost all baby clothing is categorized as "girl" or "boy". People, an infant does not care what color it's wearing! And even if they did, who's to say that boys like blue better? Some girls hate pink! Baby clothes are a trivial example, though. I really worry more about the tendency to assume that a boy will be one way, just by virtue of being a boy, and that a girl will be a different way, just by virtue of being a girl. Having been a nanny for a baby boy, I WAS amazed at how early and strong his attraction to cars and trucks started. However, he also liked his doll, and LOVED dancing (his grandmother once walked in while we were doing my own uncoordinated version of salsa together, and watched us for about five minutes before I noticed she was there. I was mortified!) Most girls love their barbies, but some don't. Some boys hate sports. Some girls love fishing. These things happen, and sometimes it's very hard on a child when everyone tries to force them to be something that they're not. So, for now at least, while I can keep the world from imposing its expectations (reasonable or unreasonable) on my child, I'd like to do so.

Mystery Man isn't quite as sold on the idea of waiting as I am, but he is warming up to it. Our one real problem is that this means that we have to prepare TWO names. I had a dream last night that our child was already a month old and we still couldn't decide on a name. Given how undecisive we can be, I wouldn't be too surprised if that actually happens. Oh well, if we wait long enough, the baby can pick their own name!

A footnote--this post is NOT intended as a criticism of people who do choose to find out. Like I said, I'm shocked that I'm not begging the ultrasound tech to try to figure it out now, and certainly don't feel that finding out is wrong. I think that if I still had any preference whatsoever, I would find out, because the last thing I'd want to feel on my baby's birthday is anything but thrilled.

Wednesday, May 2, 2007

Anatomical details

Nuchal fold width--fine.
Nasal bone--present.


Having an abdominal ultrasound was a surreal experience. I never thought I'd make it to the days of doctor's appointments with pants on! No worries, though. I did still have to have a pap smear and a transvag ultrasound to check the length of my cervix (which was good-yay!), so I got plenty of pants-free time too.

What a huge relief. The only disappointing thing was that the tech had the monitor facing away from me the entire time, so I couldn't see what was going on. My lucky husband saw it all, but failed to give me the running commentary that I wanted. Oh well. The important thing is that all is well.

Sarah asked what it was like. Really, it was just like having an absurd quantity of gel put on your abdomen and then a ball rubbed around on it. The one thing that surprised me was how long it took. The tech was working on me for a good 15 minutes. Of course this made me really nervous, since he didn't say anything while he was doing it. I guess he was just being thorough, though.

I was also surprised that they didn't do any bloodwork. I wanted to ask the doctor about that, but then she suddenly disappeared before I had the chance. I have heard that it's not that accurate with women over 35, so maybe that's it. Or maybe it's just a Korea thing. Who knows?

Tuesday, May 1, 2007

Footnote to the last post

I was just looking at my last post, and realized that it might have sounded like I thought A&M were odd because of their religion. That wasn't what I meant at all. I meant that they were odd in terms of their social skills, doing things like paddling out to the sea just to abruptly accost me about deep philosophical matters while I was treading water. I hope that nobody was offended.

My nuchal scan is tomorrow. I'm a bit nervous, but am also looking forward to getting it over with. It's always nice to get a look at what's going on.