Still waiting for IVF funding in Ontario

This is the last in a series of posts sponsored by Conceivable Dreams.

When Kathleen Wynne became Ontario’s new premier earlier this month, I was full of hope that she would revisit and revive an issue that has been stagnating for four long years in Ontario. Back in 2009, an expert panel recommended that the province should cover the cost of up to three rounds of in vitro fertilization (IVF) treatments for women under the age of 42. Last week, I was deeply disappointed to hear that Ontario Health Minister Deb Matthews has said the province has no intention of implementing these recommendations.

I had the opportunity recently to participate in a set of media stories for web, radio and TV about IVF. At first I said yes, as you know that promoting funding for IVF has been dear to my heart for years. Before production got underway, though, I backed out. I changed my mind for two key reasons. The biggest reason is that my beautiful IVF baby will be 11 years old next month, and maybe this story is no longer mine to tell, at least not quite so publicly. Second, though, is that I had a sense that the story would be focusing more on the “women putting careers first, waiting too long to have babies” theme.

It’s frustrating to me that the issue of IVF funding gets tangled up with this image of type-A career women who put off marriage and children until their late 30s or 40s, and then turn to IVF when they realize they’re long past their fertility’s best-before date. I’m sure this happens, and of course I have sympathy for ANYONE who wants a child and finds that they are unable to conceive.
Continue reading “Still waiting for IVF funding in Ontario”

Thinking back, looking forward in support of Conceivable Dreams

It’s hard to believe that it’s been 10 years since we celebrated our first Christmas with Tristan – in the emergency room, as it turned out, as the poor guy had a wicked UTI and a spiking fever that saw us bundling him off to the University Hospital ER in London at about 5 am on Christmas morning. Oh the joys of parenting.

Just two years before that, we were celebrating a different kind of Christmas. I’d just endured our first intrauterine insemination and was giddy with hope over the holidays that it might work. I spent that Christmas dreaming up clever ways to tell our family I was pregnant. And I spent Boxing Day deathly sick and heartbroken with the estrogen crash that follows an unsuccessful cycle. (I’ve always been a little sensitive to the estrogen drop-off at the end of a normal monthly cycle, often enduring end-of-the-month migraines, but with my estrogen torqued to new heights by the reproductive treatments, the crash made me so sick I could barely get out of bed. And of course, I cried myself sick at the unsuccessful cycle on top of all that.)

The holidays are stressful for all of us, but when you’re enduring infertility they can be a special kind of hell. Here’s a few thoughts about how to get yourself through the holiday season with sanity intact. You can also adapt these if you’re caring for someone who is coping with infertility.

First, be kind to yourself. It’s okay to be sad, to be angry, to be stressed out. Your feelings are what they are, and they aren’t right or wrong. Give yourself permission to slow down, to take a break, maybe get yourself an extra treat. You deserve it.

Second, don’t feel overwhelmed by your obligations. If you can’t face the children’s Christmas party at work, then skip it. If you can’t handle seeing your sister-in-law celebrating Christmas with her newborn baby, excuse yourself. You’ll probably feel better if you do go, but if you truly can’t handle it, don’t force yourself.

Third, try not to let despair overwhelm you. Find little things that make you happy, whether it’s the warm Christmas lights on a snowy night, or wrapping presents for your loved ones. While it’s okay to be sad or angry, it’s not healthy to let it consume you.

We survived two Christmases of “trying” and one Christmas with officially diagnosed infertility before our lives changed thanks to in vitro fertilization and the arrival of our beautiful baby Tristan in March of 2002. We lost another baby in November of 2006, so I know a thing or two about infertility and loss around the holiday season. I also know that our government has in its hands the power to change the lives of families facing infertility. They’ve promised to fund IVF treatments, but we’ve seen no action in three long years.

One in six Ontario families suffer from some form of infertility. That’s why I’m happy to work with the advocacy group Conceivable Dreams, who sponsored this blog post. For more information, you can visit the Conceivable Dreams website, or follow them on Twitter and Facebook.

This holiday season, give your families an extra hug and remember that there is much to be grateful for in our lives. And think a kind thought for those still waiting, waiting, waiting for their dreams of an end to infertility to come true.

Disclosure: I am a valued member of the Conceivable Dreams blog team. As such, I received compensation, but my opinion, and my stories, are all my own.

A rambly repeat of our IVF story

It’s Thanksgiving weekend in Canada, and I have so many things in my life to be thankful for that I don’t even know where to start. My brother and his family are on the way for a visit, and the blessings in my life are truly too many to count.

As I mentioned last month, I’ve agreed to write some posts to support the work of Conceivable Dreams, a grass roots patient advocacy organization advocating for better funding for in-vitro fertilization (IVF) from government and private employers. They suggested a post around the theme of thanks, and while I can’t say that I’m exactly thankful for our dark drive through the badlands of infertility, gratitude is a theme that’s easy to weave into our IVF experience: I’m grateful that the technology existed to help us, I’m grateful that we only had to endure the experience once and that it was successful, and it goes without saying that I’m grateful for our success. Sometimes, when it’s dark and quiet, I wonder what our lives would have been like if this first IVF treatment had not worked… but, down that road lies heartache, and I try not to dwell on it too much.

With the theme of gratitude and thanksgiving in mind, I thought I’d re-post my original IVF story. This is actually the second of two posts. I wrote the backstory of our unexpected and devastating infertility journey here. Because I wanted this to be about giving thanks and happy endings, here’s the rest of the story as I wrote it back in 2005:
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A new bloggy sponsor and a cause worth supporting: Conceivable Dreams

Almost three years ago to the day, I wrote a blog post about the province of Ontario announcement that it would be funding in vitro fertilization (IVF) treatments. I wrote: “yippee!” Okay, so I wrote a lot more than that, and I’ll re-hash a lot of that in the next little while, because I’ve happily agreed to write a few posts about IVF funding for Conceivable Dreams, our newest bloggy sponsor. Conceivable Dreams is a grass roots patient advocacy organization advocating for better funding for IVF from government and private employers, a cause I support with all my heart.

The blog post I wrote back in 2009 about Ontario’s proposed funding for IVF treatments breaks my heart. Once every couple of months, someone posts a sad comment or sends me a heart-wrenching e-mail begging for information, for an update, for some glimmer of hope — and I have said so many times that I’m so sorry, but I don’t have any information. That announcement back in 2009 has been followed by three years of inaction and silence from the the government. Imagine waiting to start your family for three long years, with the family of your dreams tantalizingly close — but still not attainable.

With the cacophony of three little boys that fill our ears and hearts to bursting, it’s sometimes hard to remember the dark days of our infertility diagnosis and hard to believe that once upon a time, some doctor told us that we had practically no chance to conceive a child on our own. Infertility is so much more than a clinical diagnosis. It means giving up on a dream you felt entitled to your whole life. It is standing on a precipice with a yawing future devoid of the children you already felt were a part of you. It is losing what you never had but always expected.

Our only hope for pregnancy lay down the path of in vitro treatments, at a cost then that started around $7,000 — with no promise of success. Imagine spending that kind of money — on a maybe. I remember sitting in the armchair in the bedroom of the townhouse we rented, just me and Beloved and Katie, and crying my heart out to my mother on the phone. How could we ever afford something like that? We couldn’t even scrape together enough for a downpayment on a house. It may as well have been $70,000 as $7,000. And my wise, sweet mother asked me a question that I never forgot: “What else are you going to spend your money on?”

Indeed, that was the perspective I needed. For us, there was nothing else we wanted – not vacations, not cars, not a fancy house or toys or clothes. We wanted that family, and we had wanted it since we were each children ourselves. Beloved and I were born to be parents, and I believe that to my core to this day. It still seems so wrong to me that what stood between our younger selves and the family we dreamed of was money – the money to pay for a medical treatment.

Beyond the emotional, there are solid medical and financial reasons that the province should get moving on implementing coverage for IVF, and I wrote at length about them back in 2009. One of the driving factors behind funding IVF is controlling the number of multiple births, which are expensive on the health care system with higher incidences of premature births, c-sections, and intensive neo-natal care. Whereas (provincially funded) intrauterine insemination has no control over the number of embryos created, IVF allows for precise control of the number of embryos implanted.

And I still stand behind what I wrote, back in 2009 (really, just go read the blog post, it will be easier, and it’s a good one!):

You know what I would even consider as a reasonable compromise, for those of you who feel that taxpayer dollars should not be funding fertility treatments? Fund unsuccessful treatment cycles. Including two IUIs, a cycle of IVF with ICSI, four years of frozen embryo storage, and the costs to thaw and transfer Frostie, we easily spent $10,000 or $12,000 to overcome our infertility. I think you’ll agree that my darling Tristan is worth every penny times a thousand. We’re lucky that we never had to face the unimaginable agony of an unsuccessful round of IVF treatments compounded by the idea of spending all that money for naught — just try to imagine spending everything you have, financially and emotionally, and coming away empty-handed.

It’s for all these reasons and more that I am proud to support the work of Conceivable Dreams. If you have any doubt in your heart, read the comments at the end of the post I wrote back in 2009 for just a sample of the struggle facing thousands of Ontario families-in-waiting. For more information, you can visit the Conceivable Dreams website, or follow them on Twitter and Facebook.

Disclosure: I am a valued member of the Conceivable Dreams blog team, and I have been compensated for this blog post. However, the opinions expressed on this blog are always my own.

Ontario proposes IVF funding

My jaw dropped open in surprised delight when I heard yesterday that the province of Ontario is considering funding up to three attempts of in vitro fertilization (IVF) through OHIP. Hello (Ontario Premier) Dalton McGuinty? Between this and the all-day kindergarten thing, I think I love you.

I haven’t had time to read through the entire report yet, but I will and I’ll write an informed summary and analysis when I do. (Um, I still owe you that second post on the Senate Child Care report too, don’t I? It’s on my list, I swear!)

Anyway, here’s what I think of the recommendation at first glance: yippee!!!, with a healthy side of “It’s about farking time!” As most of you know, my first son Tristan was conceived through IVF in 2001, so I admit to a strong bias on this. But you know what? Given the horrible amount of misinformation and misconceptions (snicker) that swirl around the issues of reproductive technologies, people who have been there and done that truly are in a better position to evaluate the proposals.

I find it rather ironic, in fact, that (assuming the recommendations are implemented) our reproductive years will have fallen smack dab in the middle of the decade and a half during which IVF was not funded through medicare. Up until 1994, IVF was funded in Ontario, and continued to be funded for women with two blocked fallopian tubes. I’m quite happy with how things turned out for us, though, and wouldn’t change a thing — but I sure would love to know that other families don’t have to abandon their dreams of having a family simply because they can’t afford to spend tens of thousands of dollars on fertility treatments.

Here’s why I think IVF should be funded not just in Ontario, but in all provinces and territories.

As the media has noted, one of the driving forces behind the recommendation to fund IVF is the idea of reducing multiple births. Multiple births are expensive on the health care system — there are higher incidences of premature births, c-sections, and intensive neo-natal care. One of the conditions of public funding would be that Ontario’s 14 fertility clinics would have to agree to stricter controls on the number of multiple births, which they would do by making more stringent the rules about the number of embryos that are transfered during an IVF cycle.

(I’m a bit removed from the latest clinic culture these days, but in 2001 when I was 32 years old, they would not allow me to transfer all three of our surviving embryos. We were allowed to transfer two and elected to have the third one frozen. So the clinics haven’t exactly been irresponsible to this point in time anyway. I’ve always been a little bit shocked to hear stories of clinics – largely in the US – that would allow the transfer of up to five or more embryos for a woman undergoing her first cycle, who is young and otherwise healthy.)

The idea, then, is that the amount that would be spent to fund up to three attempts of IVF would be offset by the reducing the costs to the system that result from currently high percentages of multiple births. What’s not mentioned, IMHO, is the value to the system of us creating all these little future taxpayers. Aren’t we all wringing our hands about declining fertility rates?

One other argument that I don’t see in the current media coverage is this: currently, Ontario does provide funding for other fertility treatments like Clomid and intrauterine insemination (IUI). I’ve never used Clomid (a drug that essentially causes you to ovulate more than one egg, thus increasing both your chances of conception and your chances of multiple births) but we did try two cycles of IUIs with superovulation, meaning they used drugs to torque my reproductive system into producing multiple eggs, took a sample of Beloved’s junk and ran it through a gyroscope-thingee (really!) to filter out all the poor swimmers, and had the surviving sperm squirted into my uterus.

The difference between IUI and IVF, then, is a much higher rate of control of the number of conceptions that occur. With (currently funded) IUI, multiple rates are much higher and completely out of the clinic’s control — millions of frisky sperm seek out up to half a dozen fertile eggs. With IVF, the conception occurs in the labratory instead of the uterus, and the doctors place one or two embryos into the uterus, hoping they will implant and grow. It’s the difference between using a calligraphy pen or a bucket of paint to dot your i, if I can make up an analogy.

As an aside, as many of you know, though Tristan was conceived through IVF, Simon and Lucas (and the babies we lost in 2000 and 2006) were conceived naturally. Beloved had an OHIP-funded surgery on his bits in 2001, while I was pregnant with Tristan, because he was in considerable discomfort. (You have to be in a lot of discomfort, I think, to have elective surgery down there — spoken as someone who will never know!) As a consequence, his fertility improved dramatically and obviously. So we might have been able to avoid the whole cost of the infertility treatments had the fertility doctors recommended this OHIP-funded surgery before the IVF.

You know what I would even consider as a reasonable compromise, for those of you who feel that taxpayer dollars should not be funding fertility treatments? Fund unsuccessful treatment cycles. Including two IUIs, a cycle of IVF with ICSI, four years of frozen embryo storage, and the costs to thaw and transfer Frostie, we easily spent $10,000 or $12,000 to overcome our infertility. I think you’ll agree that my darling Tristan is worth every penny times a thousand. We’re lucky that we never had to face the unimaginable agony of an unsuccessful round of IVF treatments compounded by the idea of spending all that money for naught — just try to imagine spending everything you have, financially and emotionally, and coming away empty-handed.

At the very least, this proposal levels the playing field just a little bit for people facing infertility. This editorial, written by a couple who have filed a discrimination complaint at the Human Rights Tribunal of Ontario, outlines some of the ways in which the current system of funding for reproductive technologies in Ontario are discriminatory. Two blocked fallopian tubes? You get three funded IVF attempts. Testicles fried from the radiation to treat Hodgkins disease? You’re out of luck. PCOS? So sorry. Low ovarian reserve? Too bad. Poor sperm motility or mobility or count? Yer on yer own, buddy.

Anyway, I’m all over the place here. As you can see, even after all this time I still react passionately to stories about infertility and reproductive technologies. (Hal, if you’re reading, now you know why infertility is one of the metatags on my blog!) I am beyond delighted to see that Ontario is considering funding up to three cycles of IVF for eligible families, and applaud the province of Quebec for its forward-thinking policies in this area. Once I read the report, I’ll come back with another post and try for a more detached tone. (Anybody want to take bets on how long I’m able to maintain that illusion of detachment?)

What do you think? (And yes, I’m open to dissenting opinions, so long as they are expressed with respect. And you realize that there’s nothing you can say that might change my opinion on this one!)

Beloved visits Dr Zap

Poor Beloved. Not bad enough I have no shame in blogging about my life, but now I’m blogging about his most personal bits. Good thing we’ve got a lot of family freebies out of blog over the years to compensate for my appalling lack of respect for his private parts.

He’s going today for his first consult with the vasectomy doctor. Could it be any more ironic? Seven years ago when I was pregnant with Tristan, the poor man went under the knife to have his bits repaired (he had a varicocele, which is basically a varicose vein in the scrotum, and it can cause pain and infertility) and three boys later he’s going back under the knife (well, laser) to turn off the faucet. From infertile to abundantly fertile and back to infertile in one decade.

I’m extremely grateful that he’s willing to undergo this procedure so I don’t have to undergo the much more invasive and risky tubal ligation, and birth control pills are not an option for me as they make me horribly sick.

There’s no doubt (well, very little doubt) (no, really, no doubt) (almost 99.9% doubt-free) that we’re done with this baby-making thing, and yet I still can’t help but feel sad and a little bit anxious about taking such irrevocable action. We just couldn’t afford the daycare or the education of four kids, and our house is already bursting at the seams with love and stinky running shoes. And if we won the lottery tomorrow? Tough call. My first thought is that I’d consider it again, but then I’m 39 now and the last pregnancy was hard on me. Not sure how well I’d handle another, let alone the possibility of losing another one. And the idea of going back to “trying” again? Ugh. That’s one chapter of my life I’m quite happy to leave behind, thank you.

It’s been such a huge relief knowing that Lucas is the last baby. I’ve been savouring each stage, each moment, each milestone, knowing that we won’t go down this road again. And I’ve been ditching my baby and maternity stuff like a madwoman. So really, we’re done. It’s taken me two paragraphs to reconvince myself after the finality of seeing it all in print in front of me, but really, we’re done.

You know what really gobsmacked me, though? When Beloved went to our GP and asked for the referral to Dr Zap (they cauterize the vas deferens. Eep.) she asked him if he had discussed the idea of the vasectomy with me and if I was in agreement.

Can you believe it? Can you imagine the hue and cry if a woman needed a man’s approval or agreement (tacit or otherwise) to get her tubes tied or an abortion? Now, I absolutely agree that a husband and wife should be in complete agreement when such drastic action is taken, but this just seems wrong to me. They’re his bits, and much as I claim ownership over the rest of him, in the end it’s his choice to end his fertile years — short and blissful though they have been.

And on a not-quite-completely unrelated topic, I must tip my bloggy hat to Kate, who has come up with what I think is by far the most pithy and succinct commentary on Sarah Palin, a saga I have been watching with amazed disbelief: “Why is it that women should be trusted with the Vice Presidency, but not with their own reproductive decisions?”

The one where I’m not pregnant

I peed on a stick yesterday morning. One line. Sigh.

I’m not terribly surprised. I knew I had ovulated fairly late in my cycle, if at all. (Funny, I spent all of our infertile years being mystified by my body, using a microscope to read its inscrutable signs. Now it sends me fertility signals in 72-point font, and yet I still can’t force it to succumb to my will. I am truly my own worst enemy.) I would have been expecting day one last Friday given an ordinary cycle, but I might have ovulated up to five days or a week late, so I really shouldn’t have been expecting my period any time before this weekend.

I got sucked in by hope, though. Damn optimism. There was nothing I could put my finger on, but I simply felt like I might be pregnant. Part of that might have been the absence of the injustices my body usually offers in the week before my period arrives either. I’ll save you the gory details, but we’re mostly talking about minor mood swings, bloat, and an inability to stop eating – especially eating junk food.

By Monday, pregnancy watch had officially commenced with the scrutinizing of the toilet paper. You know how it is, where you begin wondering if you are peeing all the time because you are pregnant, or because you just want the chance to check the toilet paper again to stave off doubt and denial. And there’s that brief suspended moment just before you examine the tissue where you are braced for the tell-tale smudge of blood, but holding out hope for a pristine smudge-free wipe.

While making dinner Tuesday, I had begun thinking about home pregnancy tests and when I might be able to test without feeling foolishly premature. I’d been idly thinking about a possible leftover (unused!) test from last summer, and when I rooted through the bathroom cupboard and found one, it seemed like a postcard from fate. It was a freebie; I could test and be sure of the answer and stop what had become a near-constant cacophony of “what-ifs” in my mind with one quick trip to the bathroom.

To test or not to test. This is the question of women the world over. So much hope, so much fear, so much possibility, so much dread, all imbued into one little chemical strip. There is widespread agreement in the infertility community that “pee sticks” are evil. Assuming you are trying to conceive, the positive test is the best possible outcome. However, the negative test doesn’t allow much closure. We’ve all heard the stories of people who have negative hpts and go on to have lovely babies nine months later.

I’ve had a rocky relationship with the pee sticks myself. Three positives, one of which was Simon (I never got that far in to the two week wait with Tristan; I had a positive blood test when I started showing signs of OHSS nine days after the embryo transfer.) I can’t even count how many negative ones. Dozens, probably.

So in the gloaming of an early morning, before anybody else in the house is awake, I pee on a stick. Every single time I’ve taken a pregnancy test, I am swept up by the swell of possiblity and the suspension of disbelief in that breathless moment where the urine surges up the little stick. I’m almost afraid to look, afraid to give up the hope of speculation to the harsh reality of fact. The moment seems endless, my optimism champing at the bit, my mind already formulating announcements and due dates and nursery colour schemes.

One line. With an exhalation of breath, I take an embarrassed moment to reign in my rampant optimism. Of course it wasn’t positive. How silly of me to think so. I never really thought I was pregnant. I was just, you know, making sure.

Later that afternoon, I can’t help myself. I pull the test back out of its nest of tissues in the bathroom garbage bin. I peer carefully at the used test, trying by sheer force of will to conjure a ghostly pink line in the hopelessly blank space beside ruby-red test line. I step to the window and turn the test back and forth, squinting at the test from various angles until I am nearly cross-eyed. Despite my best efforts, the test remains stubbornly negative. I move to toss it back into the waste bin, but stop and lay it carefully on the counter. I’ll check one more time, later.

You never know. Hope springs eternal.

My 15 minutes in Chatelaine

Thanks to my colleague Rebecca, who was the first to realize that the Chatelaine article I mentioned is already posted online! No more skulking around the magazine racks at every grocery store and news stand in town, waiting for the paper copy to arrive. Er, not that I was doing that, of course.

Anyway, it’s with great pleasure and excitement (and a certain lack of subtlety) that I happily point you toward the article in the online May edition of Chatelaine magazine, In vitro we trust – coming soon to a paper edition near you! In my humble opinion, even past the bits that feature me, it’s a well balanced and informative article about the state of reproductive technologies in Canada. It’s quite long, though – nine screens’ worth – so grab a cup of your beverage of choice before you settle in if you want to read the whole thing.

There’s nothing about our story that you haven’t already read here, and here, and here, and here, and here, and here, and here (shameless, aren’t I?) but it still tickles me to see it all laid out like that in somebody else’s words. I was pleased to see that the article manages to shout out both boys and blog by name (sadly, without a direct link. Oh well.)

Even though we knew it was coming and discussed it in advance, I still cringed just a bit when I saw the bit outing Beloved’s low sperm count. We’ve come a long way from the days immediately after our diagnosis, when we could barely discuss it between ourselves. By now, of course, he has become rather acclimatized to me discussing our most intimate moments with the widest possible audience – in blog, on national TV (not once, but twice!) and now in a national magazine as well. He took it in stride, and in fact insists I correct the record by clarifying that it’s not so much that his sperm are not copious, but that (in his words, not mine) they are “stupid”. The fertility doctors used the slightly more clinical term, “of impaired morphology”, but you get the point.

All this to say, in my usual belaboured and roundabout way, that I’m terribly proud to be featured in the article. In case you hadn’t gleaned that from my oh-so-understated neon billboard of a post about it.

A box of raisins

The forecast called for a mild day with drizzle, a nice change from the month-long deep freeze we had been enduring. I happily dug my long spring coat from the back of the closet where it had been languishing behind our heavy winter gear. I shrugged into it and ran out the door, late as usual for the bus that was just pulling up to the curb. It was only when I got off the bus downtown and was walking with my face turned up to the newly softened spring breeze that I shoved my hands into my pockets and encountered the cardboard box. I pulled out my hand and opened my fingers. A small green box of organic raisins. In a heartbeat, my upbeat mood turned melancholy.

Of course, I thought to myself. I haven’t worn this coat since last fall. Last fall, when I was pregnant, I never went anywhere without a stash of granola bars and raisins to stave off that sudden lurch of nausea brought on by an empty stomach. I would have been switching to my winter gear just about the time we lost the baby. The last time I wore this coat, I was pregnant.

It’s only been four months. Amazing to think that if I hadn’t lost the baby, I’d still be pregnant right now, not even all that close to my May 8 due date. I’d be huge and uncomfortable and obviously pregnant, able to feel even the smallest of the baby’s movements. I’d be having trouble finding a comfortable way to sit, let alone sleep, and would be deep into preparing the boys for the impending arrival of chaos. I’d be pulling out the old cartons of baby clothes again, picking through to find sentimental favourites and reminiscing about how my giant boys used to practically swim in the tiny sleepers. I’d be hating my maternity clothes and missing my old favourites that no longer came close to stretching across the vast expanse of my stomach. I’d have forgotten what my feet look like. I’d be uncomfortable and crabby and glowing, all at the same time.

But, that’s not how it turned out. Instead, on the weekend that would have been baby’s first weekend at home, by a coincidence of timing we’ll be enjoying the company of my extended family on the free camping weekend. It’s taken a very long time for me to be able to consider the month of May without a sharp constriction of my throat. May finally no longer means the birthday that won’t happen. It means the month with the fun getaway, the month before our big vacation, the month when the boys switch to their new (sshhhhh!) caregiver.

Even though the shock and pain and immediate grief of the miscarriage have faded to a gentle melancholy, it only takes a little box of stale raisins to bring it to the fore again. And every month, the red tide of disappointment spills forth, dashing once again my hopes for another chance to be pregnant.

My feelings on getting pregnant again are complex, not clear even to me. I would like to be pregnant, love the mechanics by which one gets pregnant, but am so very afraid to become embroiled in the emotional maelstrom that is Trying. And every month since January, when we officially started Trying again, I’ve been heartbroken to find myself not pregnant again, even as I wonder in the bright light of day whether I am ready or able to risk going through it all again.

How ironic it all is. When I was speaking to the writer for the upcoming Chatelaine article, she seemed intrigued by my statement that I still consider myself in the camp of the infertile, even having conceived three babies naturally and Tristan and his twin through IVF. (I was still pregnant at the time.) For someone who considered herself infertile, we had really only spent that one year trying to conceive – and then a bunch of other stuff happened.

Sure, it took us more than a year and more than $10,000 of medical intervention (including the IVF and two IUIs) to conceive Tristan, but both Simon and the baby lost in November were conceived without concerted effort on our part. We weren’t really even Trying with Simon – in fact, we were celebrating the sign-off of waivers on our new house. Oops! We didn’t Try before Frostie either, because we had high hopes for that to work out, and when it didn’t I became pregnant the very next month anyway.

And now, so ironically, for the first time since before Tristan was born, seven long years after we tumbled into the land of the infertile, here we are again. We are Trying and it’s Not Working.

It’s different, of course. Back in those dark, lonely, scary days when we were first struggling with infertility, I was wracked with fear that we would never have the family we so dearly wanted. Now, the cruel and abrupt arrival of the monthly red messenger is disappointing, but not crushing.

With each month, as we drift further and further away from the last pregnancy, the urgency to replace and restore my pregnant condition subsides. All things being equal, I think I’d like to have that third child some day, and so we’ll keep trying for a while. Keep trying, without Trying, maybe.

That’s a whole lot of emotional detritus to stuff into one little box of raisins.

Children of Men book club

A couple of weeks ago, I posted my 10-pages-in book review of PD James’ Children of Men. At the time, I mentioned I’d read the book to be a part of today’s Barren Bitches Book Club tour. The idea is that each person who participates in the book club submits a question to the group, and then everyone answers five of the questions on his or her own blog.

With the birthday festivities of the weekend, I didn’t get the chance to devote much time to this, so I’m going to cop out and answer only three questions. It was hard to choose only three!

1. Some of the most memorable passages were those that described how dolls and even kittens came to take the place of babies for people after Omega. In all of these scenes, it is women who are pushing dolls in their strollers or taking kittens to be christened. Why do you think P.D. James chose to only portray women in these scenes? How does this fit with your own experiences of how men and women cope with infertility in similar or different ways?

One of the things I found striking about this book is the detachment of the protagonist, Theo, through the first half of the book. (Especially in contrast to the second half.) He seems detached not only from the global tragedy of the crisis of infertility, but from his own life. It’s especially obvious when he talks of the accidental death of his daughter Natalie, beginning with the horribly abrupt way he introduces the subject: “Today is my daughter’s birthday, would have been my daughter’s birthday if I hadn’t run her over and killed her.”

Back to the point, I do think this detachment is reasonably representative of men coping with infertility. While there’s no doubt infertility is equally painful and difficult for men and for women, I think men are much more stoic. I think that women internalize the infertility and make it a part of their identity, of who they are, to a much greater extent than do men. Maybe this has to do with the fact that women tend (sorry, painting with very broad strokes here) to identify themselves as a mother first, when men tend to identify themselves based on their accomplishments or employment. Finally, I think it has to do with the fact that infertility is such an emotional issue, and women are simply more open (again, generally speaking) to expressing their emotions than are men.

2. In describing the world’s “universal bereavement” over it’s lack of children, the narrator tells us, “Only on tape and records do we now hear the voices of children, only on film or on television programmes do we see the bright, moving images of the young. Some find them unbearable to watch but most feed on them as they might a drug.” How is this like your life dealing with infertility? How do you cope when you are confronted with images or reminders that are painful to you?

I pulled that quote out in my book review, too, because it resonated with me. I’d say I’ve passed through both points on that spectrum, both needy for the companionship of the children of my friends and acquaintances, and unable to tolerate them. In the darkest times, I remember being unable to visit our friends in their child-filled house in a child-friendly neighbourhood simply because I was too full of fear that it would never happen for me. There were times when strangers holding babies and pushing strollers in the mall made me cry just by virtue of being there.

For me, though, the hardest part was not the children but the pregnant bellies. Actually having a child was a mythical thing that I may or may not have been able to achieve and that I yearned for in a vaguely abstract way, but I ached to be that woman with the beautiful round belly. It was especially hard because a very good friend was pregnant at the same time we lost our first baby and went through the unsuccessful IUIs and made the decision to finally pursue IVF.

Even now, two beautiful boys later, I still find myself on a bad day with an unsettled sense of resentment when I see strangers with new babies. I think of the baby we lost in November, the baby I expected to arrive in May, and I feel a tug of regret.

3. The Omegas are portrayed as cruel, self-obsesssed and cold. Do you suppose that’s a function of the way they were raised (as the last generation of children) or something inherent in them? Do you think that infertility has an effect on parenting?

To answer the second question first, I used to think about the effect infertility had on me as a parent a lot more than I do now. I don’t think it has affected things like discipline or how I treat the kids, but I do think it had, especially back in the earliest days, a huge impact on the guilt factor. On the very worst days, deep in the dark of night when my nipples were bleeding from a poor latch and Tristan wasn’t gaining weight and I was exhausted and terrified and my life was suddenly inside out, I keenly remember being wracked with guilt about not being beautific with joy after finally having the baby I wanted so badly.

And to the first question, I do think the author intended to insinuate that the Omegas were a product of an indulgent upbringing. Theo observes,

Perhaps we have made our Omegas what they are by our own folly; a regime which combines perpetual surveillance with total indulgence is hardly conduicive to healthy development. If from infancy you treat children as gods they are liable in adulthood to act as devils.

I think this is an interesting reflection on how central to our lives our children have become, and how parenting in the 21st century seems to be largely about overscheduling children with activities to make sure they are challenged and engaged for the maximum number of hours possible each week. While I’m quite guilty of making the boys the centre of our family, rather than equal partners, I hope that as they get older we’ll be able to restore a bit of equillibrium so that everything is not entirely about them. (Some day I’ll get around to writing a whole post about this, instead of flying past it in one quick paragraph, as I’ve been thinking a lot about it.)

And now, a message from the Barren Bitches Book Club organizers: Intrigued by this book tour and want to read more about Children of Men? Hop along to more stops on the Barren Bitches Book Tour by visiting the master list at Stirrup Queens . Want to come along for the next tour? Sign up begins today for tour #3 ( The Time Traveler’s Wife by Audrey Niffenegger) and all are welcome to join along. All you need is a book and blog.

Coincidentally, The Time Traveler’s Wife was the book that was the genesis of my 10-pages-in book reviews, and one of my favourite books of 2005 – perhaps even of all time. Highly recommended reading, and if you’re reading it, why not join the book club tour?