And the best news of all........

I'm officially on "the list" at CCRM.

All of my tests are back and good and they have all of my paperwork from the last pap and mammogram and physicals - I'm done with all of it.

After 2 laprascopic surgeries, 3 hysteroscopies, removal of both fallopian tubes, 2 saline sonograms, dozens of transvaginal ultrasounds, too-many-self-injections-to-count, dozens of blood tests for every infectious disease known to man, 1 cancelled IVF, 1 failed insemination, 1 donor embryo transfer, the heartbreaking chemical pregnancy that resulted and a whirlwind trip to Denver and back in 24 hours, I'm IN!


CMV Negative

Oh good grief! I never thought being negative for a virus could be a bad thing.

Yesterday I got an email from my nurse at CCRM asking me to make sure I selected a CMV negative donor. Well, I didn't. I pushed back and asked why, since my RE in NJ indicated it wasn't necessary - that the risk of that donor having had "active" infection while donating sperm, given all of the testing that's done for active infection vs. antibody response suffices but that if I felt more comfortable, sure, choose CMV negative.

But this time it wasn't an option for me. Never mind the $1,500 I've spent on the current batch sitting at the cryobank waiting for me to have it shipped out. I LOVE this donor. I couldn't have picked a more perfect genetic specimen if I'd met him and fallen in love. On paper, intellectually speaking, this guy's "it." The rest is nurture and that's up to me.

So I said, "no, my donor is CMV positive" and then went on in the email about how I couldn't even imagine this being an issue. After all, I'm sure there are hundreds of CMV negative women undergoing IVF with their CMV positive husbands. So what does CCRM do, insist they use sperm donors so as to eliminate the negligible risk in the pregnant woman developing CMV infection during pregnancy? I mean, the risk in married couples is actually greater - as they're having intercourse and are living in close quarters throughout the woman's pregnancy. So if the husband were to develop active infection during that time, yes, the fetus would be at very high risk of VERY serious disabilities.

But when you're using a sperm donor from a cryobank, that sperm is pretty locked up in terms of risk factor. For example, my donor was tested for every infectious disease we know of, THEN he donated for 6 months and THEN he was tested for all of the same infectious diseases again. ONLY after the second set of tests returned negative did they release his sperm, guaranteeing that the batch taken from when he donated was outside any viral conversion window. You can't have the same guarantee in a spouse. He could be tested and 4 months later develop CMV or HIV or whatever a week before the fresh donation he'd give on IVF (retrieval) day and he could theoretically pass on that virus at that point - or over the subsequent weeks/months.

Considering those testing differences, using donor sperm is infinitely more "safe" than using the sperm of a spouse.

I was sweating it though. I thought, great, they're going to say that it's unavoidable to eliminate the potential risk of a spouse transmitting active CMV (which is far greater a risk than an anonymous sperm donor) because wives will always want to use their husband's sperm but that in my situation ( a single woman), I can avoid the risk to zero at transfer by using CMV negative sperm. My answer would be, "So what, I still can't eliminate it to zero in pregnancy and I am as committed to using this donor as any wife is to using her spouse's sperm - besides which, this is MY decision."

I was so upset and was just winding myself up, more and more. And what was happening to me is EXACTLY what I wrote about here. Rather than remaining calm and knowing it would work out, I was wound so tightly that when the call came at almost 5 PM ET (CCRM is on Mountain time - two hours earlier), I had to force myself to wait for her response before I jumped down the throat of my very kind, responsive and understanding nurse who has been nothing but good to me.

I had a bunch of ammo in my belt and I'd already mentally drafted the note I would send to the doctor and copy the rest of them. This was a deal-breaker for me and I would detach myself from CCRM and ask them to reimburse me what I'd spent with them so far for not disclosing this before my visit out there.

"Sky, I just wanted to get back to you and tell you it's fine to use CMV positive sperm if you'll just sign a waiver for us." I smiled, my chest loosened and everything was right with the world. I was suddenly cheerful.

Another catastrophe averted!

Back from Mexico!

Ohhhhhh, it was so lovely to be away from the office and to read my book "Something Borrowed." I was stopped 3 times on the beach by women telling me they'd read it and what a wonderful book it is and that I would be even more glued to the second in the series "Something Blue." Well, I finished the first book and bought the second last night at Barnes and Noble - full price, I don't care - it's that good. No, that GREAT!


Great News!

Not only did I screw up the dates of when my vacation were but my period came 9 days early. And by the skin of my teeth, I will be home from Mexico the day before I need blood work at the local RE. Whew! THANKS TO MY LUCKY STARS!

I bitch when it's bad but I want to be grateful when it's good!

So yesterday was CD1 and tomorrow I start the Vivelle patches - Woo Hoo! Yeap, I'm anxious to get this mock cycle out of the way and get on that list - then I'll relax (for now!). :)


Unfortunate Coincidences in Timing

You know, things ultimately work out for me - they really do. And I don't want to minimize that truth, but don't think for a second that they work out easily for me. Heck no, that is NOT the case.

I've work very very very hard for every single thing I have in life and none of it fell into my lap, yet I'm still so grateful. Many people work incredibly hard and never realize the fruits of their labor.

But timing in life has always been uncanny for me in many ways. For example, I travel for work - but not often and that's by design. I wouldn't take a job that requires a road warrier because not only do I hate to travel, I have animals that need care and it costs me a good chunk of money every single day to board my dog if I must travel.

I probably hadn't traveled in a year and low and behold, wouldn't you know it - I had to move my very first IVF cycle one month forward because of extensive travel one month. So I did it in March vs. February and when you're 41 every single month matters with your own eggs, truly.

Then I learned I had to have my fallopian tubes removed and when my gynecologist gave me the first available O.R. date of September 2nd, I couldn't do it because I was going to spend the weekend in Quebec with my cousin and her husband. Argh!

And now, the only thing standing in the way of me getting onto the CCRM waiting list is the start of a mock cycle and GUESS F-EN WHAT?! Yeap, I have my once-annual tiny vacation coming up - this year it's Mexico for 4 days.

Well, if my period arrives any sooner than October 29th, I'm screwed royally because I can't have a transvaginal ultrasound on the day I would need to. !#^$%^&@! I'm furious over my total and complete awful luck with timing. And if it doesn't happen then I could even miss next months timing too - because I have to travel to a conference in Miami on November 20th.

More than anything, I just want to get on the waiting list for CCRM and then I can relax. Until then, I'm not moving forward - I'm in total limbo!

So much of IVF is waiting, waiting, waiting, waiting. For Pete's sake, we only have 12 periods a year and anything and everything is ignited by cycle day 1 of a period so, do the math people, it's not much opportunity - which is why women spend YEARS in this endeavor.



Infertility after 40

This is one of my pet peeves. I've been on dozens of boards and read of women in their 40's defining themselves as having "infertility."

Is that technically true? Yes, but it's intellectually dishonest. Because after the age of 40, fertility naturally takes a plummet south. Women do get pregnant after 40 naturally all the time, and yet it's so very rare, statistically speaking.

Maybe it's my aversion to the label generation we live in. When I was growing up, classmates were allowed to be "not smart." Now, a label must be placed on the child - so he has Dyslexia or ADHD. God forbid he's just lazy or not as genetically blessed with a strong IQ as is another child.

And this nonsense has reached us "infertiles." Now, I'm guilty of using the word infertility to describe myself, but I do it for the sake of ease and because I don't know of one word that defines it all more closely.

But the truth is that I am not "infertile" - I'm just old.

There is a line and I'm very comfortable making the start of that line a girl's first period and the end of that line her 40th birthday. If she can't conceive in between those lines, then yes, she's infertile. But after 40?! Nah, her eggs are just old! Get a grip. Yeah, I know it makes us feel better to wear the "infertility" label, but it's not really accurate, is it?

Think of Michelle Duggar, who is pregnant with her 18th natural child (turned 42 last month). They're born-again Christians and accept as many children "as the Lord will bless us with," yada, yada, yada. Well, what if next year she doesn't conceive child number 19 - what if she never conceives again. Imagine Michelle telling Oprah that she's infertile? HA! I bet even Oprah couldn't keep a straight face!

Before you feel offended, think it through. Otherwise, every single woman on the planet suffers infertility in her life time - either because she's an 8 year old girl or because she's a 48 year old woman. And that's ridiculous!

I suppose one could argue that if you have your period, you're still technically in reproductive years but we all KNOW that's not the case. We all KNOW that after 40, pregnancy is unusual, even with expensive fertility intervention.

So all this spewing for nothing really, 'cause I still say I'm infertile - until someone gives me a better description (which I would be only-too-happy to use).



You heard it here first folks!

During several conversations with my doctor, nurse and psychologist at CCRM, I felt pressured to WANT an egg donor who looks like me. I told them, over and over and over again that I DO NOT CARE! I said, as long as she's a proven donor, is caucasian and has anything but brown eyes, she could look NOTHING LIKE ME. How much more clear could I be?!

And yet......I was still asked for a picture of myself. Huh? Then the psychologist (the nicest and prettiest woman with the kindest voice and personality - she's pregnant and will, no doubt, make a great mom!) gently says "but if she did look like you, you would prefer that, right?" and I caught myself saying "well, yeah" but then I quickly added, "but I DON'T CARE!" AHHHHH! I felt like once again, like my emotional comfort level was being questioned because I don't feel as 99% of other women feel. But I can't help that and I'm not going to apologize for it. I am who I am.

But here's the kicker - NO ONE asked me if the sperm donor looks like me. I'm 5' 5" with medium complexion (think Italian looking), dark brown hair and light brown eyes. And no one gave a flying rat's ass if my sperm donor was an 8' tall African American or a Japanese guy or an inhabitant from another planet. Whomever I chose in that department was totally fine.

I mean, WTF?! Fertility clinics can't seem to get their heads around you wanting an egg donor who may not look like you but have no trouble whatsoever with a sperm donor who is the opposite of you. Again, WTF?! Hasn't anyone told these guys that children are genetically as much a part of the sperm as they are the egg?

For all they know, I could have been using the sperm of my brother (who would look like me) and that would raise another set of eyebrows. But if you're using a donor egg and donor sperm, what EXACTLY is the difference between a woman using her sister as her egg donor vs. using her brother as her sperm donor? NOT ONE SINGLE THING. Yet it brings the look of horror on people's faces and tests the gag response. Again, I don't get why!

So all of this leads me to believe that sperm must be shit - worthless trash - and fertility clinics must honestly believe that embryos are genetically 99% egg and 1% sperm.


Mourning my Genetic Child

During my psychological evaluation at CCRM, the psychologist raised the subject, as I expected she would.

I kick myself for being a straight shooter so often, but I'm led right back down that path soon thereafter. Fabricating politically correct bullshit is easy to do, but anathema to me, truly. I said, "I didn't really feel any deep loss over not having genetic offspring - I would accept someone's kidney if I needed it and I accepted this." Now, I'm not an idiot - I realize there is a difference - ovaries produce the blueprint to make replicas of ourselves and that's pretty powerful stuff. But, still, my eggs don't work and I can transplant someone else's eggs into me to replace a process my body doesn't do anymore. Yeah, too rational and not enough emotion behind it - but it's honestly how I view it.

She's skeptical and proceeds to tell me there are many cycles of grief and that they don't always come in sequence but can bounce around from later stages of grief to an early stage to a middle stage. And I got the point - I could have just bounced right into "acceptance" as my first phase but may be broadsided with anger and sadness later on. And instead of telling her exactly what she wants to hear ("yeah, you're probably right and I'll have to consider that"), I say something like, "maybe, but I've never felt differently than I feel right now." She's stumped. It probably says to her that I'm some awful, unfeeling person who is incapable of bonding to others and should never have a child. Ugh! I wish I could just lie and say what's expected for the sake of having a baby who's going to have an awesome life, by the way! Alas, I'm not that girl, I'm the girl who tells you the truth if you ask for it.

I think about my good friend N. Nine years ago she underwent IVF at the age of 41 (same age when I began). I thought it was so avant-garde and noted it wasn't ever going to be something I'd do. (See why you should shut the fuck up until you're in someone else's shoes?!) Well, after 25K, she learned her eggs weren't working and whether donor eggs weren't popular at the time or the RE just didn't offer it up, N pursued adoption a couple of years later. And from Nepal came an awesome little lady A, who is now almost 6. Last year N was staring at A with that love-struck face mothers have towards their children and said to me "Sky, I'm so grateful that the IVF didn't work or I wouldn't have A - I couldn't love another child more than this." I smiled.

Things work out for the best sometimes.

Fetal "Reduction"

After my visit to CCRM, I have much more thinking to do on this subject.

I am not a fan of euphemisms. I'm a call-it-what-it-is-girl. If it's too distasteful to say, then maybe you shouldn't do it. Euphemisms are so often used by hypocrites - a personality trait I abhor!

So let's call it what it is - a selective abortion. There ya go, I said it.

I've posted about this subject already but yesterday at CCRM I was asked by no less than 3 people to ponder the subject. My doctor, the nurse and the psychologist. Their policy on donor embryo transfers is pretty strict at two, at most. And what I really felt was mild influence from them to transfer only one embryo (given I have several high quality embryos) and that's okay, because I felt they had my interests in mind.

But here's the rub. The chance of one embryo becoming a viable pregnancy is around 60%. Two embryos is in the 85% range. That's a 25% spread - too much for me to ignore.

Now for the brutal news - the chance of two high quality embryos becoming a twin pregnancy is around 45%. And I don't remember the chance of one of those embryos splitting (giving me a triplet) but it was not some statistically low number like .001%.

I honestly do not know how to play this out. And at the end of the day, while I met with their psychologist, I was honest with her.

I said, "you know, I've thought about that many times this year and I'm no further today knowing what I'd do than I was the first day." I went on to tell her what I told my doctor - a single embryo transfer is not something I can consider without the facts in front of me on transfer day.

For example, consider this wonderful scenario that I hope befalls me. My doctor calls me on day 5 transfer morning and says "Sky, I have amazing news - you have 9 stellar embryos, it's hard to know which is better than the other, they're all top grade and I have two that are hatching. Right now we're going to freeze whatever you don't want to transfer. So, will it be one or two?" I would say, "one." Perfect. (and may that be EXACTLY what happens and turns into a beautiful little person for me!)

But here's an alternate scenario that I hope and pray does not happen. My doctor calls me on day 3 transfer morning and says "Sky, you have 3 good embryos - the rest don't look like they'll make it. One is excellent and the others are good." Frankly, my answer would be - TRANSFER THEM ALL. I wouldn't want to return for one final embryo transfer if two failed, aside from not feeling great about freezing/thawing - it is never as good as fresh.

But what if those 3 less-than-stellar embryos all implanted?! Well, I think a triplet pregnancy is out of the question for me - I would have to selectively abort one. But what about a twin pregnancy to a singleton? I mean, if I'm not ethically barred from selectively aborting a triplet to a twin, why not a twin to a singleton? What's the difference? It's still terminating one fetus, isn't it?

And what happens here is that I realize doctors and nurses form an enormous bias and impart their personal religious and moral ethics on patients - and that concerns me. I mean, if you're willing to support the selective abortion of 5 fetuses to 2, why not support the selective abortion of 2 fetuses to 1? After all, isn't it is lawful to abort 1 fetus to zero.

DISCLAIMER: I'm not saying I could selectively abort twins to a singleton because I just don't know. I don't even know for sure if I could selectively abort triplets to twins. How could I know? I'm not in that place! But I guess I have trouble with anyone in the IVF world making moral judgments around this. Aren't we are all guilty of having our hands in the life/death pool whereby we have a hand in creating multiple embryos and then actively discarding some?

I personally know two women who are as Catholic as the day is long - staunch pro-life ladies who've also had IVF and had remaining embryos. Neither could bring themselves to donate those embryos to another couple and both of them chose to discard the embryos. I mean, huh? If life starts at conception then how is tossing them down a sink or by way of an abortion any different? Doesn't it provide the same outcome - they're still dead.

Just some thoughts as I embark on a donor egg cycle in future. I know I'll be faced with some very difficult decisions for which no choice will be without risk and, ultimately, I may have to choose the lesser of two evils - whatever that is for me personally.

I can only trust that I'll make future decisions with the same level of honesty and integrity in which I strive to live my life.

Tonight, more than ever, all of my sisters in this IF journey are on my mind - I wish you all peace, happiness and the fulfillment dirty diapers brings.

Back from Denver (CCRM)

Whew! Whirlwind trip. I flew out Thursday at 6 PM and arrived back in NJ Friday night, just after midnight.

Denver was beautiful and I expected nothing less. I love Colorado - the mountains, the clean, crisp air, the lack of smog and pollution that covers NJ, a state I've grown to hate living in (alas, a very well paying job in a major national corporation and a small, but valuable, network of friends, it'll be years before I can leave).

Yesterday morning I got to my appointment at CCRM. Okay, the place is beautiful, state-of-the-art with a luxurious atmosphere. It's high-end, which goes with the price tag, I guess. I was shuttled from one appointment to the next. The first was with my doctor - extremely nice, thoughtful and intelligent man. Then came the ultrasound to measure blood flow to the uterus and to determine if I'd need some acupuncture in advance of the donor egg cycle to improve things. Nope, don't need it - blood flow to my uterus is fine. Good.

Then I had the nursing consult with my nurse who is just lovely - wish I could have her eggs! Then came the fiber optic hysteroscopy. I was dreading this and I'll tell you why. Any time I'm "advised" to take 800 mg. of ibuprofin before a procedure, that's bad fucking news in my book! So I was scared. The nurse insisted it wasn't bad at all. Yeah, okay, whatever - what's she going to say at that moment, "don't worry, this is a sound-proof room and we'll hand you a leather strap to bite on?"

When I was prescribed an HSG, I did some online homework and read a couple of reports on fertility boards of women who claimed their HSG wasn't bad and didn't know what all the fuss was about. Though I'm sure they weren't lying about their personal experiences, I opted to believe the other 98% of women who said it was unbearably painful. One comment on an infertility board carved itself into my brain last year and it went something like this: "That was the most painful thing I've ever experienced in my life. I can't believe they're allowed by law to do that without anesthesia."

I have never recovered from that report of an HSG and I will likely remember it for the rest of my life. And thanks to the removal of my fallopian tubes, I will never have to have one!

Okay, so back to the fiber optic hysteroscopy. First there was a mock transfer after which my doctor said "oh, this is going to be a very easy transfer." I guess I'm "easy." Then came the hysteroscope and the gas that's pumped into your uterus to expand it and the doctor looks through a lens to see what's going on in the uterus. What I felt was the tiniest bit of discomfort - and I mean TINY! It was a walk in the park - a hair more uncomfortable than a pap smear. THANK GOD! It was such a breeze that I felt silly for fearing it for the past month.

And don't think it escapes me that I'm actively pursuing pregnancy. I can imagine my water breaking and me asking the nurses, Hey, is this delivery going to hurt? Ridiculous! I have to get over this!

Well, then I was off to the lab for the whole enchilada of sexually transmitted disease testing, consent form review, finance (yeah, the money baby!) where I plunked down my Visa for the $2,500 deposit to get on "the waiting list" for a donor egg, and I was done at 3 PM. I hopped into my SUV rental and high-tailed it back to Denver International for my flight back to NJ. I'm beat!

Next and final steps: Mock cycle.

My next CD1 (ETA of 10/28), I start on Vivelle (estrogen patches) and go to the local RE for an ultrasound at the indicated date to check my lining.

And that's it baby, from then on I am officially on WAIT STATUS.

I was told to expect 6-9 months but then she said "now that I told you that, I will tell you that the less criteria you have in terms of a match, the sooner the match will happen.

Now, I'd already begun this process saying that my criteria is SLIM.

Must be:
  • A proven donor
  • Caucasian
  • Anything except brown eyes
  • And DOES NOT need to look like me whatsoever.
Yeap, that's it. If that doesn't get me matched before 6 months, heck, I don't know what will. My hope is for a February or March cycle - gives me some more time to lose weight (Ugh!).

I love this quick matching story at CCRM. I dream about it! And she's got two of the most BEAUTIFUL, yummiest little munchkins I've ever seen. How absolutely wonderful!

Well, hang on, twins for her is a spectacular blessing - for me (a single parent), it wouldn't be wonderful at all. Rather, terrifying, thought-provoking, devastating - yes. If I had a wonderful prince charming for a husband, I would welcome two (two for the price of one - woo hoo!) but I know my limitations and one is all I can handle right now.

Which brings me to another subject that I'll post about separately.


This Friday......

I have a date at CCRM for my work-up. It's been a long-time-coming to get to this point where I do what I wanted to do nearly a year ago - go for a donor egg cycle! At last, I'm on my way.

Will definitely post about my day in detail when I return. I'm nervous about the fiber optic hysterscopy after I read about the 800 mg of Advil I should take in advance (yeah, sounds lovely!).

Hoping for good news this week - all the way around!