Day one!

Because I know my reproductive workings have you on the edge of your seat, I felt it necessary to broadcast to the entire interweb that it is, in fact, day one of my cycle. The cycle. The cycle that will lead, in approximately two weeks, to my wee Frostie finally coming out of its deep freeze, at which point I think I will begin to refer to it as my little Toastie instead.

Next stop, an ultrasound on July 13. Stay tuned!

Miscellany

You, my bloggy friends, have been wonderful thing week. Thank you for your jokes, all of which I will file away to later torture friends, colleagues and strangers on the street. Thank you for your support, and your kind words, and your suggestions on how to brush my kids’ teeth. Y’all are rockstars in my book – for this week, at least!

But hey, it’s Friday, and the Friday before I have ten whole days of vacation, nonetheless. So forgive me if we ramble just a bit, because I have the attention span of a firefly today.

For those of you keeping score on the frostie thing, I had my ultrasound yesterday and everything looks great. I have a blood test on Monday, and if the progesterone levels are within range, we’re good to go next month. After this week’s leaky ambivalence, I’m feeling excited and enthused again. I was gobsmacked by how nice the new Ottawa Fertility Centre is, especially compared to the facilities before. The ladies’ room had granite counters and flowers – I can only imagine how nice the sperm-gathering room must be! The whole place has an air of cool calmness, just what you want when you are at your most vulnerable.

It’s been such a busy week, and there have been tonnes of stuff I meant to talk to you about. For example, did you see that new show “America’s Got Talent“? We were instantly hooked; it’s perfect summer brain candy. It’s like the Gong Show, which I’ve always loved, but with David Hasselhoff, for whom I have developed a latent affection after seeing this video. Go ahead, click on it – I dare you, and then I double dog dare you to not be humming that song all day (right, Andrea?) What with this, and that new Gameshow Marathon, it’s all my favourite childhood TV shows all over again. Nothing reminds me of the endless summers of my childhood like The Match Game, the Price is Right and Card Sharks.

And speaking of childhood TV, did you hear that CBC is finally retiring the old Mr Dressup episodes? Even though I didn’t realize they were still on any more (Ernie Coombs died in 2001, after all) it does make me feel a little sad, and a little old, that they won’t be running those old episodes in perpetuity.

One more note on seminal children’s programming – I don’t think I ever told you that I finally got my Electric Company DVD set as a Mother’s Day gift. It so rocks! Now I just have to get a couple of Muppet Show DVDs and The Littlest Hobo and I’ll be set! Simon’s current favourite movie is Beloved’s copy of the old Batman and Robin movie from the 1960s, so with a little luck and a good stock of 1970s TV DVDs, we many never have to watch an episode of Dragon Tales or Arthur again.

And now, finally, my contribution to the joke-fest yesterday – to which you should feel free to continue to contribute, by the way. If you know me IRL, chances are you’ve heard this one; it’s one of my favourites!

When Beethoven passed away, he was buried in a churchyard. A few days later, the town drunk was walking through the cemetery and heard some strange noise coming from the area where Beethoven was buried.

Terrified, the drunk ran and got the priest to come and listen to it. The priest bent close to the grave and heard some faint, unrecognizable music coming from the grave. Frightened, the priest ran and got the town magistrate.

When the magistrate arrived, he bent his ear to the grave, listened for a moment, and said, “Hmm, interesting, that seems to be Beethoven’s Ninth Symphony being played – backwards.”
He listened a while longer and then said, “There’s the Eighth Symphony, and it’s backwards, too. Most puzzling.” So the magistrate kept listening. “There’s the Seventh… the Sixth… the Fifth…”

Suddenly the realization of what was happening dawned on the magistrate; he stood up and announced to the crowd that had gathered in the cemetery, “My fellow citizens, there’s nothing to worry about. That’s just Beethoven decomposing.”

Emotional wreckage

Ah, there’s nothing like a good meltdown to clear your head. Maybe the toddlers are on to something?

Apparently, I’m not taking this whole frostie thing with the zen detachment I thought I was. I was talking to a friend today, my knickers in a twist supposedly about all the *other* things I’m trying to balance right now (new job, new French lessons, pending holidays – I’ve got a list as long as my arm right now) and when I lost it and choked up and eventually started leaking around the eyes (isn’t it absolutely mortifying to cry at work?), I really thought it was about my new French teacher. She’s new, painfully new, I’m her first-student-ever kind of new.

Except, I was riding the bus home after work, and I couldn’t stop crying. Not hysterical, hitching sobbing… I was just sitting there, looking at the river and the passing scenery, except I couldn’t stop the steady stream of tears running down my face, and I realized that the point at which I actually started to cry, we weren’t discussing my French lessons at all – we were discussing my pending mock-cycle ultrasound to check my lining. And everytime I would settle down and get myself under control again, I’d idly think about frostie or the ultrasound or the goddam OPKs, and I’d start crying again.

Hey, I only took one year of psychology, but I don’t think you need to be Dr Freud to figure this one out. Besides, really, who cries about French class?

Okay, I admit it, I’m not zen. I’m officially freaked out about the frostie cycle.

I’m freaked out because I peed on three OPK sticks yesterday and none were obviously positive and then I peed on another one this morning and the line was practically non-existant so I called the clinic in a panic saying, “I must have surged yesterday, is it too late?”

I’m freaked out because I feel terrible that I haven’t been actively doing everything I can to make this cycle a success. I could have been taking vitamins, or eating protein to boost my lining, or taking viagara (apparently that helps the lining thicken, too) or doing accupuncture or about 100 other things I’ve seen the girls on the IVF boards doing to improve their chances of success. We could pay for assisted hatching, or ask about embryo glue. But we’re not. We’re just doing this, letting nature take its course.

It suddenly doesn’t seem natural, it seems apathetic. And that’s no way to prepare yourself for a pregnancy, for a future life.

Crap, crying again. Fucking hormones – and not even artificially boosted hormones. 100 per cent me. Good gods, the mother guilt has crept beyond the mothering era, beyond the pregnancy, into the pre-conception period.

I’m freaked out because I want this baby with my whole heart, and my whole heart is terrified of having another child. How can I feel both ends of the spectrum with complete intensity? I’m completely invested and absolutely ambivalent. I want both outcomes, and neither.

I do feel better, having cleansed my emotional plumbing with a good cry. And I’m going to try really hard to go back to my zen “the universe will make the right choice for us” attitude.

In fact, forget the viagara, the vitamins, the accupuncture. It seems what I really need is a clown – the type with a red nose, floppy shoes and rainbow hair. According to this article, “after introducing clown therapy to patients having in-vitro fertilization, doctors at Assaf Harofeh Medical Center in Zerifin, Israel, said the conception rate rose from 20 to 35 percent. (…) The scientists, who submitted their research to the European Society of Human Reproduction and Embryology meeting, had set out to see if humor could reduce the stress and anxiety of the IVF treatment, particularly after the embryo had been transferred to the woman’s womb. A smile, a few jokes and magic tricks was enough to get them to laugh, and in some cases, conceive.”

So, bloggy friends, have at it. What’s your best joke today?

The Great OPK Adventure

I call the clinic, because I have one stick left in my box of five, and I’m guessing that since my life is never straightforward and uncomplicated, I’m going to have to buy another box of ovulation predictor kits. The nurse confirms that yes, I’ll have to buy another kit if my surge isn’t detected on the last stick.

So I’m feeling a lot of pressure as I pee on the last of the sticks, and lo and behold, there is a line – a really faint, turn it just so, let’s try looking at it under the window type of line. I haul out the package insert with the directions on it yet again, and look from my used test to the sample diagrams and back, and while I am happy there is in fact a line, there is no denying the “this is not a positive” nature of this particular spent stick. I’m about to resign myself to forking out another $50 on a box of OPKs when Belvoed says, “But what about that box of tests that’s been under the sink since we moved?”

I rifle through the cupboard, and sure enough, I do have four fifths of a box of OPKs from our IUIs, back in, um, 2001. I check the expiration date on the box – November 2002. (Insert Homer-Simpsonesque “it’s still good!” here.) I actually call the toll free number, and to the credit of the person with the lovely Louisiana drawl who patiently answers my enquiry, she doesn’t laugh out loud when I ask whether three and a half years past its expiration date is too late to get a decent reading from a test. Unsurprisingly, the answer is yes. Way too late.

I’m almost resigned to going back to Shoppers Drug Mart when I remember what you said about buying online. Hmm, I need a stick in the next 24 hours… what do you think the odds are of me ordering one, and receiving it, in time to pee on by 5 pm tomorrow. Yah. But then I remember what Anna said, about a place here in town with cheap OPKs, and I tell Beloved to take over making dinner while I do a little Googling. Because all of this has transpired in the 20 minutes since I’ve gotten home from work, when I should maybe be making dinner for my family.

I find the site for the Extraordinary Baby Shoppe online with relative ease, and I’m astonished to see they carry a five pack of OPKs for EIGHT DOLLARS! That’s more than an 80 per cent discount off the drug store price. And they have an actual store, right here in town. I find the hours of operation, and they are open today and tomorrow from 1 to 5 pm (it’s a mom-based business, and they work when they can around their kids’ schedules. How cool is that?) so I look at the clock and it is – no joke – 5:01 pm. But I pick up the phone anyway, and call, hoping someone is still stacking diapers or counting cash tapes and waiting for the last customer to leave. Alas, there is no answer, so I leave a babbled message about needing an OPK and hoping to drop by the store tomorrow and could you please confirm if you have any in stock before I take the bus over there on my lunch break.

And I promptly forget about it, until about half an hour later during dinner, when the shop owner actually calls me back. She is on her way home right now, and the store won’t be open tomorrow because it’s her daughter’s graduation from senior kindergarden and she can’t find anybody to cover for her. I’m thinking, ‘It figures.”, but she keeps talking, and asks me where I live and when I tell her, she says if I don’t mind the drive, I can come out to her place tonight and pick some up.

Let’s pause for a moment and think about this interaction. I am brokering some sort of deal for discount ovulation predictor kits on the phone with a stranger I met through the Internet while my kids eat crackers and peanut butter for dinner and my husband watches me with growing alarm over what he hears from my end of the conversation. This doesn’t happen to normal people, does it?

So I get her address, and pack the boys into the car after dinner, and we set off on a quest for cheap OPKs. It’s a 42 km round trip through pastoral farmland from my suburb to hers and back again, and the whole way we flirt with black, vicious storm clouds that threaten a mother of a storm. In my head, I’m writing this post with poetic terms like pathetic fallacy, and snickering because the last thing Beloved said to me as we left the house was an accusation that I get myself into these things simply because they make good blog fodder, and he is probably right.

I arrive in her driveway at the exact moment she does, and I pull enough money to cover the kits and the tax out of my skirt pocket. We stand between our collective preschooler-filled Ford Foci station wagons (two cars and four preschoolers between us) and I feel like some sort of suburban addict, handing over my cash for five loose OPKs.

We race the storm home, and arrive ahead of a torrent of biblical proportions that spends itself in the fifteen minutes it takes to get the boys ready for bed. I am absurdly pleased with my newly acquired, cheap OPKs, and decide to celebrate my frugality (five tests for less than the price of one!) by splurging and taking a random test. With a surfeit of tests, I can afford to indulge myself. Oh, the excitement of my suburban life!

I tear open a package, remove the strip inside, and stand holding the alien thing for a panicked moment – there are no directions!! Please join me one more time in a rousing chorus of, “On Internet, how I love thee.” A bit of googling later, and I figure it out. I test, and the surge line is stronger. Recklessly, I decide to test not only earlier in the day, but many times tomorow. I have four tests left – I could test at breakfast, lunch and dinner and still have one to spare. I am positively giddy with my own spendthriftedness. (Sorry, Kerry – just try not to think about what may or may not be in my cube today.)

And the most exciting part of the whole evening? While doing my illicit suburban driveway purchase of bulk OPKs, the amazing woman from the Extraordinary Baby Shoppe, where you should all go for any future baby-related purchases, reached into her car and said, “Here’s a complimentary pregnancy test, too.”

That thing is going to haunt me in about four weeks’ time.

The one with too much information

I’m standing in the ‘family planning’ aisle of the drug store, ostensibly to buy my ovulation predictor kit, except I’m distracted by – did you know they make condoms with little disposable vibrating rings on them? God bless technology.

I shake myself from a bit of a daydream, the details of which I decline at this moment to share with the Interweb, and go back to scanning the shelves for my OPK. Nope, don’t need a vibrating condom (or do we?), don’t need a pregnancy test (yet), don’t need any gel or foam or sponges. Oh, here they are. HOLY CRAP! $55.99 for a box of five pieces of plastic that I’m going to urinate on and throw in the garbage? That’s $11 a piss!

I see that there is a generic brand, and for a minute my inherently cheap nature (Dutch-Scottish roots) battles with my diva complex (even when choosing things to urinate on, I deserve only the best). What if I buy the generic one but it’s not as good, and somehow I screw up the date of my ovulation? There is a $13 price difference, and since this is only a mock cycle and I still haven’t entirely overcome my ambivalence about this whole ‘getting pregnant and bearing a third child’ thing anyway, I suck it up and pick up the generic box.

I’m still muttering to myself about the price, none of which can be claimed or deducted or in any way reimbursed, when I get to the cash register. I make a comment to the cashier about it being friggin’ expensive, and too bad it’s not a 20x points day (I am a junkie for loyalty programs. Canadian Tire money, Air Miles, HBC points, Esso points… I love ‘em all.) The cashier brightly informs me that Saturday is a 20x points day, if I would like to hold off. I pause, considering various schemes that would allow me to pay for something on Saturday that I must start peeing on by Thursday, but can’t come up with anything. The cashier notes my expression, and says, “You could come back and get a refund and then re-buy it on Saturday.” I try to imagine a conversation that would convince a clerk to refund a half-used ovulation kit, and decide that the points, which would probably only be worth a grand total of $1.17 or so anyway, are probably not worth the stress.

Stress is what you feel when you try to figure out exactly when you are going to pee on the sticks, because the directions tell you that you must pee on the sticks at roughly the same time every day, preferably between 10 am and 8 pm, but not with first morning urine. (Their bold, not mine.) And yes, I did read the entire package insert. Twice. Because even though I’ve used these infernal things before, I’m just like that. I read the entire sheet of directions and cautions in the tampon box every couple of years, too.

So back to my scheduling dilemma. I have to start peeing on the stick on Thursday, and probably for the five days subsequent. That’s two work days, two weekend days, and another work day. There is no reliable routine anywhere that I can follow. I’m strongly drawn to peeing on the sticks in the morning, simply because I can then call the clinic early in the day when my LH surges. Except that means peeing on the stick at work.

The directions (yep, not only did I read them, but I’ve pretty much committed them to memory) say that I have to leave the peed-on stick horizontal, little windows facing up, for three to ten minutes before reading the results. So do I sit there in the public stall, test balanced on my knee, waiting for the results? Ten minutes is an awfully. long. time. to be sitting in a stall at work. They may send in a search party. Or should I wrap it in paper and carefully bring it back to my cube, leaving it on my desk until I am ready to read the results? Will my colleagues, who read this blog, ever come into my cube again? Would you borrow a pen from, or drop by for a consult with, or have coffee with a co-worker if you knew she had at any time brought urinated-on objects into her cubicle?

Fun though it is to speculate, my colleagues will be relieved to know this is all a moot point, because I have in fact forgotten to bring with me a test on which to pee. (Oh, how I cringe at the google traffic this post is going to attract.) So at home it is. By default, I now have to remember to find some time during the arsenic hours between 5 and 8 pm to remember to take the damn test for the next five days.

You think this dithering is painful? Wait until we get to the whole “Is this a line?” frenzy of indecision. I remember the first time I used an OPK, during our (ultimately unsuccessful) intrauterine inseminations. After dozens (that felt like hundreds) of negative pregnancy tests, at least seeing a little line appear felt like a victory. “Hooray, my pee too can make a line appear!” (Aha, maybe this is why guys pee in the snow?)

Excuse me, all this talk of bodily functions has triggered a need to make some water. I’d best pee now, while the peeing is good, because starting at noon I’m going to be holding it to make sure I have a good reservoir built up to pee on that stick by 5 pm. It’s going to be a long day…

Wheeeeeeee!

It’s day one. Here we go!

(breathe, breathe…)

It’s ‘day one’ of my pre-transfer mock cycle. Aren’t you excited? I’m positively giddy!

For those of you who haven’t been committing this stuff to memory, here’s the plan:

Next Thursday, June 15, I start using a pee-on-the-stick ovulation predictor kit. The OPK detects the surge of luteinizing hormone that occurs just before the ovaries release the follicle into the fallopian tube. When I get a positive indicator for the LH surge, I call the clinic back and go for an ultrasound, probably the next day. They measure my uterine lining, because you need a thick and juicy lining to make a cosy home for an itinerant embryo. Then, six to eight days later, I go back to the clinic for some blood work to check my estrogen and progesterone levels. That’s it for the mock cycle month.

Then I call again next month with my day one, and it’s the real deal. About ten days after my day one, I go in for another ultrasound and they look to see if a good sized follicle is maturing and ready to ovulate. If so, I go in to the clinic every day for a blood test to monitor for the LH surge – no messing with OPKs for the real deal, I guess.

I forgot to ask the exact details, but I think it’s about two days after the surge they start thawing our little frostie in the morning, and they transfer it to my uterus with the same sort of turkey-baster device that they used to place the sperm during the IUIs.

And that’s it, except for the torturous two-week wait between the transfer and the pregnancy test. Gulp.

You know that I’ve already analyzed the hell out of the timing on this, so let’s share the math. Day one of mock cycle = June 6, therefore day one of ‘for keeps’ cycle will likely be approximately July 4 (our wedding anniversary is July 3, which is also five years to the day after I found out I was pregnant for the first time, the pregnancy that ultimately miscarried.) So I’ll start going to the clinic for blood work approximately July 14, and the transfer will likely take place within a week, probably around July 20.

And here’s where it gets dicey: we have tickets to see Thomas the Frickin’ Tank Engine on July 22 in St Thomas, an eight-hour drive away. Oy vey. So do we ditch our tickets ($80 for the four of us) and go ahead with a July cycle? Do we roll the dice, keep the tickets and hope transfer happens before the morning of July 21, so we can hustle on down to Southern Ontario? Do we delay the cycle until August? Can I live with the what-ifs if we delay a month and it doesn’t work out?

Speak, Interweb. What should we do?

Fertility watch

Warning: too much information alert! You are about to read about my bodily functions, the monthly girly ones. Consider yourself warned. This is the last chance to avert your eyes before gratuituous descriptions of “female troubles”.

So you probably haven’t been nearly as obsessed with my “moon tide” as I have been. That’s perfectly okay. In fact, I think I prefer it that way. But, I’m about to bust with excitement, and rather than just discuss it with someone, why the hell not post it on the Interweb and discuss it with everyone. Right?

And no, let’s be clear that I am NOT PREGNANT, as it occurs to me that it might seem that I’m heading in that direction. Nope, in fact, I have been more fastidious about birth control in the past two years than any other time in my life. Ironic, isn’t it, since the first child cost me a bundle.

And that bundle, she said by way of weak segue, is more or less what I’m going on about now. As you may remember (I’m sure you’ve marked it on your calendar and committed it to memory, too) in order to start the whole ‘turn frostie into a real, live bouncing baby’ process, step one is to call the clinic and tell them it’s day one of “rebooting my ovarian operating system”- any time after June 1.

You’re so clever, you’ve already caught on that it is not yet June 1. But way back when the doc said my earliest start date would be June 1, I did the math, and it seemed like my day one would fall right about May 28, meaning day one of my first “old faithful” after June 1 would fall some time around June 26, and what with the need to do a mock cycle first, we wouldn’t actually be thawing the frostie until the beginning of August, which seems like an awfully long way away.

BUT!!!

Here it is, the fourth of May, and the “crimson tide” has not yet arrived. (It will. I know it will, any minute now. If nothing else, I know my body well enough to be 100% sure of that.) But, if we do the math and day one comes today, maybe tomorrow, that means that even if I have a regular 28 day cycle, instead of the 30 day cycle I just finished, day one will arrive ON June 1, maybe even June 2, which means I can start the mock treatment month in June and bring home frostie a whole month earlier, in July.

Isn’t that great? Aren’t you glad you mucked through this entire convuluted post just for that? Yeah, me too!

Let’s review, shall we?

Fact: to begin mock treatment month, day one of “wearing the red shoes” must fall after June 1.
Fact: my cycles usually run 29 to 30 days.
Fact: this month’s cycle will start on or after May 4.
Fact: May 4 + 29 days = June 2
Fact: June 2 is commonly AFTER June 1
Ergo: I will be able to begin my mock treatment in June.
Ergo: I will be able to begin my ‘for real’ treatment in July.

(Aren’t you glad I didn’t have a blog when I was going through IVF? Can you imagine the posts you’d be getting?)

Footnote: special thanks to this page for all the bloody euphemisms.

Three is the New Two

We’ve just come back from our consultation with our reproductive endocrinologist (RE), aka our fertility doctor, to discuss what we’re going to do with our frostie.

(For those of you new to the conversation, we have a single frozen embryo, our ‘frostie’, left over from the IVF that resulted in Tristan.)

First, the facts: the frostie has an approximately 75% chance of surviving the thaw. (This is much higher than I thought.) Then, given my age at the time of conception, there is a 13 to 15 % chance of the embryo transfer leading to a successful pregnancy. (This is much lower than I thought.) And I don’t know if this is reflected in the percentages or not, but the doctor said that embryos that were created in the same cycle that also led to a successful pregnancy have a better chance than those that were created during a cycle that did not lead to a pregnancy.

The minute I saw those numbers on paper, because the RE has this habit of writing down what she says, I wanted this embryo – this baby – fiercely, without ambivalence, and with my whole heart.

So many thoughts, so many feelings, so much to say… bear with me, this may be my least coherent, least linear post ever.

More details. Facts are my friends.

I will do this as a non-medicated cycle. Because there is no waiting list for frozen embryo transfers (FET) right now, I can call the clinic any time after June 1 to inform them it’s the first day of my cycle. From there, we do a month-long ‘test cycle’. I go in for blood work to check my estrogen level some time just before I ovulate, and go in for an ultrasound around the same time to make sure my uterine lining is nice and thick. Four days after ovulation, I go back in for more blood work to check my progesterone levels. Assuming the hormone and lining measurements are within the right range, the next cycle will be the one that counts.

For that cycle, I think I also do an estrogen check, and I’ll use an at-home ovulation predictor kit to detect the surge in luteinizing hormone (LH) that indicates ovulation is about to occur. Three days later, they thaw the frostie early in the morning, and the embryo will (assuming the odds are with us) be transferred into my uterus later that morning.

No drugs, no waiting – just a cheque for $1500, and more hope and vulnerability and anxiety than I can stand…

And now we roam from the factual to the esoteric. Here’s a few more details that are flavouring my emotional soup.

The clinic is moving in two weeks, to be a private stand-alone clinic instead of being part of the Ottawa Hospital. A sidebar note for those of you who have cycled at the Parkdale clinic: when we went through our IUIs and IVF, I remember being upset that patients waiting for an ultrasound as part of their fertility treatments had to share the waiting room and ultrasound facilities with the high-risk obstetrical unit. It was horribly painful to see those beautiful, fat bellies in the depth of my own doubt and sorrow and fear.

Did you know that the hospital administration recently dismantled the 5th floor ultrasound clinic entirely, making it necessary for patients to go all the way into the hospital proper and to the LABOUR AND DELIVERY ward to have any ultrasounds done? Can you imagine? Even for someone like me, who rarely grudged someone their successful pregnancies or beautiful children, who never faced the pain of an unsuccessful IVF or worse, a treatment that went to hell right in the middle, couldn’t have faced going to the L&D ward and hearing and seeing all those brand new babies every second day at the most crucial part of a cycle. Unbelievable. The RE said that was one of the main factors that led to the decision to be a standalone clinic.

Anyway, back to me. Because it’s all about me, isn’t it? The clinic moving shouldn’t have much of an impact on me and our cycle, except that the new location is a little bit closer to home, and a lot more convenient to get to, and to park at. This, to my view, is a tick in the “the universe wants this to happen” column. (I’m all about what the universe wants right now. It’s how I’m dealing with the whole thing, on an emotional level. If the universe, or God, or Fate, or whatever else you want to call it, wants this abstract concept of a frostie to become an actual living person, via me and my comfortable uterus, then so be it. And if the universe, in its ultimate wisdom, doesn’t think that a third child is in our best interests… well, I’m a little bit too emotionally invested in the concept right at this moment to consider that alternative. But you get the drift.)

And then the RE was telling us how a big collective of obstetricians, including mine, are moving from the building next door to the clinic to a medical centre about 10 kms in a direct line closer to my house, which would be extremely convenient – if I happened to get pregnant. Which really must be the universe trying to tell me something, right?

(Do you get the feeling it’s going to be a long couple of months? Yah, me too.)

So that’s where we are. In the “more than you really needed to know” file, (and yes, that file will fill to overflowing over the process of this cycle) my last two cycles have been 30 and 29 days, and my most recent day one was April 3. If I have two 30-day cycles, I will have a day 1 on June 1. If I have one 30-day cycle and one 29-day cycle, day 1 will fall on the last day of May and I’ll have to wait until late June to call in my day 1 for the mock cycle. Transfer will either occur in early July or early August.

All my pregnancies to date (three of them) have been conceived between May 9 and June 15. I’m not sure what the universe is telling me here.

Let the obsessing begin.

Reader mail – funding for reproductive technologies

Last week after I posted about demanding public funding for IVF, I exchanged a series of e-mails with Janet, a regular blog reader from elsewhere in Ontario. I’m posting chunks of our conversation here, with Janet’s permission, because while I disagree with her, I think she raises some interesting points worth debating and I’d be interested in your opinion, too. A lot of you are familiar with the state of reproductive technology in Canada, and a lot of you are not. I’d love to hear from anyone who has a thought to contribute.

Janet’s original e-mail (which, rest assured, was very polite, respectful and full of compliments about my writing style) and reply to my response have been edited together here:

I simply don’t think taxpayers should be paying for these treatments at this point in time, and here’s why:

I am the parent of a child with a developmental disorder, and along with that comes many issues, not the least of which are long waiting lists (1-3 years, no joke) for services like speech therapy. There are wonderful services out there, but they are expensive and right now, unfortunately, are”only for the rich” (to quote the link on your post today).

I do think more potential parents need to become aware of the risks that go along with multiple birth pregnancies that are often a result of IVF. And I know that this education is not happening. And if it is, not effectively so.

Also, in our province (I also live in Ontario), autism funding is cut off at the age of six (as if these children will somehow have no need of services after six). One of my friends has to pay $7,000 PER MONTH out of her own pocket for her daughter’s treatment, simply to ensure her child will be able to communicate with others, never mind function in society. None of this is covered.

As a parent, I really do realize that the emotional side to this issue cannot be ignored. But by asking for government and taxpayer involvement (and suggesting that a potential under-population propblem could be resolved through IVF), the issue is now open for practical debate, and there are some very practical issues involved.

The other issue, which I think is a real hot button, is one of personal responsibility. As a 37-year old woman (and not in my ideal age range for reproduction without inherent risk) I’m not sure that taxpayers should pay for my fertility treatments because I’ve decided to wait until my natural fertility has declined significantly to address my reproductive desires (N.B. I’m talking ONLY about age-related infertility here).

I have been thinking about this a lot lately, and I really believe that in this kind of a situation, I should be paying for fertility treatment out of my own pocket if I really choose to have another child, at an “advanced” age, reproductively speaking. For God’s sake…I’m finding new, wiry grey hairs on a daily basis!! Is this the best time for me to be having another child? As much as I may want to? I don’t know. It’s such a personal decision, and that’s one reason why I think it should have a personal solution.

There does seem (among women our age) to be a belief out there that just because the technology exists, we can and should use it. I’m just not so sure that is always the case.

Until our society can afford to take proper care of its existing citizens, I’m not sure we should be asking society to fund potential pregnancies. I certainly don’t want to fund overseas adoptions for couples/individuals who decide to go that route, and I’m not sure what the difference is here. Maybe I’m missing something? I would love to hear your point of view on this.

And here’s the bulk of my replies:

I think comparing funding for autism and special needs to funding for reproductive techologies is like, to use a tired old metaphor, comparing apples to oranges. They have more differences than things in common. While I don’t argue that maybe we should be funding special needs more – I’ll readily admit my ignorance on this subject – I do believe that IVF should be funded and here’s a few reasons why.

First, and I know people hate this argument, but unless you’ve been through the hell that is infertility, you really have no idea what a basic human right it is to want to parent a child. When you have spent your entire existence simply assuming that the largest part of your life, and perhaps, if you are like me, your singular goal, will be mothering and then to find out for medical reasons beyond your control you are about to be denied that…. as I said, it’s impossible to put into words if you haven’t been there.

ARTs are funded unevenly in our country. In Ontario you get full funding for three attempts at IVF if you have two blocked tubes, but you don’t get that same coverage if you live in other provinces. And if your IVF is due to male factor, or other factors beyond bilateral blocked tubes, you don’t get coverage. The government has seen fit to bless some forms of ARTs, the older ones, with funding but still calls IVF – a procedure that is 25 years old! – experimental. You mention (and I have to admit, I bristled at the suggestion) that maybe there are dangers to the children that are conceived under ARTs. One thing about IVF, which is not funded, versus IUI, which is funded, is that with IVF you have much greater control over the number of embryos, therefore significantly reduced numbers of triplets or other high-order multiples. Almost all of the risks inherent to IVF (and believe me, this is something I’ve researched very very carefully) are from the risks associated with conceiving multiples and most of the fertility clinics I know of, certainly the Ottawa Fertility Centre, do not take the risk of multiples lightly. I had only three embryos and my clinic refused to transfer more than two due to the risk of triplet pregnancy. To say that there isn’t enough education of patients going through the process is insulting to both the doctors and the people they are treating.

So, while I appreciate you taking the time to write, I wholeheartedly disagree with you. For what it’s worth, by the way, we do have tax credits to trim the costs of adoption, both domestic and overseas, and I’m in support of those, too!

One last point from me, and only because it’s one that drives me crazy. Of all the families I know who have gone through IVF, and I know at least 20 in real life and know of hundreds of others through contact on IVF message boards (and blogs!), ‘advanced maternal age” is almost never the issue. I’d say never, but maybe there are a few of them out there – but at least of the 20 or so in my tight little circle, all have had things like burst tubes or severe endo or male factor infertility – there was no real factor of personal responsibility, just of medical necessity. I think the image of the career girl who finally gets the urge to procreate in her mid-thirties and turns to IVF when it takes too long the old fashioned way is a creation of the media. Even factoring out the cost, the uncertainty and the needles and the hormones and the intrusiveness of an IVF cycle makes it far from a casual undertaking.

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What do you think? Consider the debate officially opened, but please be respectful. It’s a sensitive issue on all parts, and I’m extremely proud of the high level of respect commenters have always shown here.

Speak up about reproductive technologies

My friend, fellow blogger and survivor of the IVF trenches Northern Mom posted this form letter from the Infertility Awareness Association of Canada earlier this week, and I think it’s an excellent initiative. I’m embarrassed to say that my activism in the area of reproductive technologies has diminished considerably lately, but it’s still a cause I am passionate about.

We have a new federal government now, and your Member of Parliament needs to hear that you care about these issues. Here’s the information from IAAC:

PLEASE WRITE A LETTER TO YOUR MEMBER OF PARLIAMENT TODAY!

Our elected officials prefer to hear from us personally – not in a form letter we might all agree to sign. To help you carry the message to Ottawa, select one or more of the recommended key messages listed below. Please feel free to put them in your own words – or share your own experiences.

To find your Member of Parliament using your postal code on line, go to: http://canada.gc.ca/directories/direct_e.html

1. Children are Canada’s most valuable future resource. Previous governments have claimed to be concerned about our country’s declining birth rate. Yet they have refused to provide crucial assistance for many Canadians who are committed to becoming parents.

2. Nearly one Canadian couple in six experiences infertility problems. Infertility is not a choice. It is a medical condition. These couples need professional assistance in order to conceive. Yet today’s most advanced assisted reproduction technologies (ART) remain beyond their financial means.

3. The new government says that it will stand up for Canada by meeting the needs and interests of Canada’s families. Mr. Harper’s election platform declared that the family is the building block of society. What about standing up for Canadian couples who want to create their families, but can’t – because they need medical assistance to do so – assistance that is often beyond their private means.

4. The new government is committed to relieving financial pressures on low-income and middle-income families bringing up children. It has promised to provide childcare money directly to parents. Will it also provide assistance to couples who want to create families but cannot, without financial access to assisted reproductive technologies?

5. Restricting access to IVF compromises the fertility of women, causes immense financial hardship to couples requiring assisted conception treatments and makes IVF affordable for rich families only.

6. Infertility problems also carry social and economic costs: lost working hours, poor productivity, psychological and psychiatric support to treat stress and depression, and marital breakdowns.

7. The total cost of a refundable tax credit for IVF treatment would be $170 million for the entire country. This represents a little over one tenth of one percent of Canada’s $130 billion estimated total health care spending in 2004.

8. Since 1983, over 15,000 children have been born in Canada through assisted reproduction technologies. Today these children – many of whom are now of voting age – and their parents and extended families expect our political leaders to courageously and fairly address this important issue, so that all Canadians may share not only the costs but also the public benefits of IVF treatment.

9. It’s time for Canada to take a major step forward in health and family policy by guaranteeing funded IVF treatment. I sincerely hope our country’s infertile couples may rely on your support.

Write to your province’s lawmakers too! Canada’s provinces exercise primary control over health care. So please make sure that you also write to the Premier and members of your province’s legislative assembly.

To find your MLA you can search the Web at the following links:
Newfoundland and Labrador – House of Assembly
Prince Edward Island – Legislative Assembly
New Brunswick – Legislative Assembly
Nova Scotia – Legislative Assembly
Quebec –Assemblée nationale (National Assembly)
Manitoba– Legislative Assembly
Saskatchewan– Legislative Assembly
Alberta – Legislative Assembly