Sunday, December 31, 2006

Using donor eggs

Using donor eggs is often a last resort. I got this letter from one of the readers who wanted others to share their thoughts:

I am 40 and have been diagnosed with diminished ovarian reserve. I had a miscarriage a year ago after a year of trying and have been trying since. My OB told me after the miscarriage that if she didn't see me back in six months then she would assume we changed our mind. Well after six months of no luck I went back and was referred to a reproductive endocronologist. We have tried the ovarian stimulation route and I simply can't be "controlled" - no matter how many eggs I produce only one ovulates. We haven't even considered IVF with my eggs because our odds are so low - 3 cycles with a 10% bring home a baby rate. We don't have insurance coverage for any of this. Our budget is limited. So trying IVF and then looking at donor egg isn't financially possible.

We are considering donor egg as our best odds of having a child. I guess I feel a bit strange reading these other stories of women who are so worried about their genetic link to the child. Maybe I am just fooling myself but it just doesn't seem to bother me. I think (at least at this point) that if I carry the child and give birth and care for it then it is my child. I do however, feel strongly that I want to carry my husband's child. We have been together for 23 years. I can't quite explain why I am more comitted to his genetics than my own.

I hope I am just not lying to myself and that at some point this will all come crashing down. Some of it might have to do with the fact that my husband was diagnosed with MS five years ago - and his first two years were rough - I almost lost him. That is why we delayed having children - it turned our lives upside down. He has now been in remission for almost three years and his doctors are very confident he will remain so. I guess that brush with mortality made me want to keep a part of him come what may - even though he is incredibly stubborn and drives me crazy :) Has anyone else felt this way - a lack of concern that the child wouldn't be genetically hers?

We've upgraded!

We've upgraded to the new blogger & will now be able to add labels to the posts. I hope this will make things easier (and better).

Happy new year!

Tuesday, November 21, 2006

Soy cappucino

(That's what I'm drinking now. I made it myself with my fancy-shmancy coffee machine that my mom once got as a gift. It's not very good.

My youngest, Nomi, is 8 months old and she's been miserable for about 7 of them. She's had rashes, we thought she had colic, we thought she had reflux and allergy tests last week showed that she's allergic to eggs, milk, sesame and cats. (Hey, we only tested a total of 6 things.)

[I tried, I really did try to drink it, but I just got up to pour it down the sink. I hope the sink isn't in a vengeful mood...]

So, since she's exclusively breastfed & refuses any solids, we know the allergies have passed through my milk. The doctor told me to avoid dairy products, eggs and sesame. It might not sound so tricky, but the idea of soy milk disgusts me and my husband (who does most of the cooking around here) is a vegetarian (no fish either)... This leaves me with nuts, grains, fruits & vegetables (pretty much, though I'm also avoiding peanuts)... and here I was thinking that breastfeeding protected my baby...

Nomi is the miracle baby of my dreams. She was conceived so fast that she's only 12 months and 11 days younger than her sister. She's also the one who makes me realize that it makes no difference how long you wait. No matter what, you're ready to do anything you can so your baby will be healthy and happy.

Tuesday, November 07, 2006

Guilt...

I'm definitely guilty of not updating my blog frequently enough. I have plenty of reasons - all 4 of my girls have had some virus that makes them vomit. Nomi (7-1/2 months) had a wicked case of bronchitis. My husband test-runs his weekly lectures on human factors on me & has been under a lot of pressure to finish his dissertation proposal. I'm taking a course in decision-making this semester (for me, it's a correspondence course, since I can't make it to any of the lectures)... and the list goes on. Oh yeah, I try to work. Any of my clients reading this would tell you that try is the right word. I work in bursts, whenever I happen to find some time. That's why my emails are usually sent around 1 am...

FertilityStories has gotten a lot of updates lately & some candid new stories.

Scientists from the Reproductive Research Centre at the Cleveland Clinic Foundation in Ohio found a correlation between heavy cell phone use and low sperm count.

Peter Nagy, of Reproductive Biology Associates in Atlanta presented results of his study at the American Society for Reproductive Medicine conference in New Orleans showing that women born to older mothers were more likely to suffer from infertility. Scary... I would like to understand why this is and whether the older sisters of these women were, in fact, less likely to have trouble conceiving... I would also like to know what percentage of daughters born to older mothers suffered infertility as compared to those born to younger mothers - and whether there was any difference if the child was a first child or not...

How do you treat news like this and does it change your feelings about fertility treatments?

Thursday, September 28, 2006

An answered prayer

Almost two years ago, when I first started Fertility Stories I came across a letter that really touched me. It was written by a young woman "celebrating" 10 years of trying to conceive. I asked for & got her permission to publish it, under the name of Donna.

Some women have chosen to update their stories, others have not. I didn't even think I had kept Donna's address. When I came across it, I decided to drop a line & see how she was doing. Just a few hours later I got this letter from her:

"Just a few days ago I was discussing with my husband how special my birthday will be this year. For the first time I will be celebrating it with my husband and children. Yes, incredibly, after having lost a precious pregnancy along the way, we're now proud parents to twin boys who are 8-months-old..."

I wonder if she ever thought her prayers would be answered.

Wednesday, September 27, 2006

Quilt Raffle

Just a quick post to let you know that Julie's raffling off one of her amazing quilts for a family who is about to adopt. You can read the story - it's a great opportunity to help a family make their dream come true.

Friday, September 22, 2006

Sweet...

We're celebrating our New Year starting tonight. It's traditional to eat pomegranate - rimon in Hebrew, and when we do, we ask G-d to make our merits be as plentiful as the pomegranate's seeds.

Though long ago, I realized that resolutions don't need to wait for a holiday, it's still nice to be reminded that we should do good deeds without expecting anything in return. I do my best to keep this in mind all year round...

Just recently I ran into a woman who I've known for several years. In her line of work, people don't talk to her much, so I always take a few minutes to ask her about herself and to tell her a little about the work that I do. For the past few years, every time I ran into her I was following the story of her daughter who was TTC. She had a natural pregnancy, an early miscarriage & was then trying to conceive for another 3 years. They're ultra-orthodox & going to get help is a bit taboo. I talked to her (the mom), encouraged her to tell her daughter to get help. She finally did. It took another 18 months or so & she finally conceived. I was so happy for her.

A few months ago she had her baby and everything was looking good. Until she was staying with her mom for a few days & her mom noticed that she was depressed. She told me that she was surprised that after finally giving birth to a healthy baby her daughter could be so down... After a lot of coaxing, the daughter admitted that she was terrified of her husband. I didn't hear the details, but they're now in the process of divorce. I've been through divorce. After infertility. After waiting for too many years. Being in a really bad, abusive, unfixable marriage is "the end of the world". Divorce, in such a situation, is a chance for a new beginning... I felt good being able to tell her this from experience. It reassured me, once again, that G-d has a plan for me & that being able to give some encouragement to people in difficult situations is part of it.

So now for my good blog-deed of the day (week? month?) - a recipe for sweet challah (bread). You can make the dough in a breadmaker, which makes it really simple. It makes the house smell great :-)

Below is the breadmaker version. If you want the hard-work version, email me.

Recipe for 12 rolls or 4 small round loaves.




2/3 cup water or milk or milk substitute
2 eggs
1/4 cup margarine or butter
1/4 cup sugar
1 tsp salt
2 tsp yeast
3 cups flour

Once the dough is ready, take it out & knead it on a floured board.

Heat the oven to about 175C or 350F.

Optional: add raisins, roll out to a rectangle, spread with margarine & sprinkle cinnamon sugar. Roll from the long side of the rectangle and then curl the dough around to make a spiral shape.

After shaping it, it needs to rise 30-45 minutes the second time. Place on a baking tray lined with baking paper. Paint with melted margarine or egg; you can also add honey to the margarine :-)

Bakes fast, so check after 8-10 minutes.

Have a sweet new year :-)

Tuesday, September 05, 2006

A Roundup

First, a bit of support for "one of us"... Dr. Lillian Schapiro published her first novel, Tick Tock (the link takes you to an eBook version of the novel) . Lillian had a septate uterus (a layer of tissue going through the uterus) and endometriosis. She discovered she was infertile while working as an obstetrician and treating other women with similar problems. I have not yet had the opportunity to read her book, but it would be interesting to hear the story from the perspective of a woman who understands exactly what's going on from the very beginning (we all, pretty much, become experts as time goes by). Here's a link to the book on Amazon.

On Sunday, I read an interesting article in the New York Times about couples with a history of cancer that is known to be of genetic origin in their families, and their use of PGD - preimplantation genetic diagnosis - to avoid having babies who are carrying these genes. I found the article to be well-balanced - while stating the obvious advantage of knowing your child will not develop a specific type of cancer, it also discussed ethical issues, such as "playing God" and the fact that PGD is only available to people who can finance it.

Connections between drugs and infertility are a frequent question that I find in my inbox. This article discusses marijuana use by women (OK, female mice) and the findings that it can cause early pregnancy failure. Another thing to definitely stay away from.

I'm currently working my way through an article on IMSI - intracytoplasmic morphologically selected sperm injection - published in Fertility Weekly. The method uses sperm that are selected in real time and dramatically improves the take-home baby rate. I hope to have a review of the article up in the next few days... stay tuned.

This post brought to you by:
eBooks
(Fertility Stories does not get commissions from purchases at eBookMall & was not asked to review or present this or any other book.)

Monday, August 21, 2006

Crazy Days

These past few weeks have been really crazy. My husband and I watched more TV this past month than we have in the past 4 years put together (when we each, individually, decided we'd had enough of TV). But with Israel being at war, we felt a need to be more in tune with what's going on than you can be just by clicking 'refresh' on the news sites every 10 minutes (or less).

We didn't take in any refugees from the north. It was beyond what we felt was possible with our house (no extra space) and our colicky daughter, who spent 3 to 4 hours screaming each night, until she finally fell asleep around midnight. (Last week, we finally took her to the doctor, who believes she has reflux and has put her on an antacid that seems to be working.) We did have friends from the north come to visit - they had a baby born just before the war & every time the air raid siren went off, they grabbed her & ran down 3 flights of stairs to the bomb shelter. After days of multiple alerts, the mom decided it was more dangerous for her to be running down the stairs with a baby than to just stay put. Her husband decided it was time to get out of there, so they grabbed the baby's diaper bag, a change of clothes and ran down to the car between sirens.

And then one night, a few days before the cease fire, I thought I heard the doorbell ring. It was about 1:40 a.m. and we'd finally turned off the TV after another episode of "The Inside". It couldn't be any of the kids... I went back to sleep. And then I was sure it was the doorbell. In my pajamas, I went downstairs to ask who it was. "Police." Police? Fortunately I was too tired to have any of those split-second crazy thoughts like the ones I had when my parents left me with my 2 little brothers saying they'd be back soon. I remember wondering, about 8 hours later, how I was going to tell my brothers that our parents were dead. (Of course it turned out that there was just something wrong with the car they'd gone to pick up & since it was in the days before phones were invented (OK, not really, but my parents didn't call) I discovered at the age of 10-1/2 what worrying was all about... anyway, back to the point... my first thought was that they must have the wrong house. "Do you have a daughter Hadas?" Um. Yes... "and do you know where she is?" Yes again. She's upstairs in her bed. She was downstairs on the computer until close to midnight. What happened? I tried to understand. The only thing I could think was that they could arrest her for speeding... that is... speed-reading... she swallows books.

The police told me to wake her up and bring her downstairs. I did. They then told me that someone had called to say that she had called them to say something terrible had happened... and then hung up. They were just about ready to break down our door... It wasn't Hadas who had called and we have no idea why someone would have pretended to be her. The phone records didn't reveal who the caller was, so I guess it will remain a mystery.

The bit of time that I have found, I've spent reading some blogs. Poor Elizabeth has HG, a terrible condition I had never even heard of. While her pregnancy is going well, in a better world, it seems that women who suffered from infertility could at least be exempt from things like that. Electric Lady (who has a unicornate uterus) sounds like she's doing better (spotting is another one of those things infertiles shouldn't have to deal with once they finally conceive). DI-Dad's kids finally met their half-sibling - I can't wait to hear more. It takes a special kind of person to do what Eric's doing! And last, but not least, Nilla's FET results are sounding good :-) Being a mom to FET kids myself, I find hearing successful frozen embryo transfer stories brings me a special smile.

Anyway, this post is about as crazy as these past few weeks have been... I hope things will be back to normal soon.

Saturday, July 29, 2006

New drug for recurrent miscarriage

GroPep, an Australian company, was just granted the European patent for their drug PV903. From the press release: "GroPep is currently conducting a phase I clinical trial on PV903 to evaluate the safety and tolerability of vaginally administered PV903 gel and to determine whether PV903 has effects on vaginal immune cells in a manner consistent with its proposed role in treating immune-based infertility. Results from the trial are expected during the second half of 2006 and if successful, GroPep will seek to partner PV903 with an international pharmaceutical or biotechnology company with an established franchise in reproductive medicine. "

Recurrent miscarriage is defined as the loss of three or more consecutive pregnancies before reaching 20 weeks of gestation. GroPep states that "It is estimated that some 50% of all cases of recurrent miscarriage are the result of an inappropriate maternal immune response that treats the fetus as “foreign” and ultimately results in pregnancy loss. " Their site also elaborates on the scientific background of PV903. Personally, I would have liked to have seen references to medical articles, but they do mention the university at which the research was done.

In brief, research showed that an immune response can occur prior to conception, this response later causes diminished placental growth, immune rejection of the fetus and miscarriage.

If the clinical studies work out the way they would like them to, PV903 will be administered vaginally after intercourse. The drug will alter the female immune system and allow a strong and healthy pregnancy to occur.

Sounds promising.

Sunday, July 23, 2006

OMG What do you say?

Way back, when I fantasized about making ovulation kits affordable in Israel (it worked, the price has gone way down), I started importing and selling ovulation kits on a website that I made. There was very little money in it but I kept up with it almost as a public service. So, in addition to selling tests (which means packaging them on my own and sending one slave or another over to the post office) I also give tips on how to use them over the phone.

About 18 months ago, Diana started calling me. At first she thought she was missing her ovulation because her cycle was short and she waited twelve days before going to the Ritual Bath (links to a book I really enjoyed by Faye Kellerman). I gave her tips about who she could call for help, like Puah - an organization that combines infertility with halacha (Jewish law). Finally, she convinced me to sell her fertility tests (that I insisted she didn't really need) and then she called me for support practically daily for the next two months. Later, her husband was tested and it turned out that they were definitely going to have difficulty conceiving naturally... The last time I talked to her was shortly after she'd gotten that news. That is, until today.

Today Diana called and told me she had good news. She'd gone through her 2nd IVF cycle and it was successful. Well, kind of successful. Before she let me congratulate her she told me what was troubling her. Her first beta was 32. Her second beta, 4 days later, was 35.

Having gone through a pregnancy that started with a beta of 29, I remembered from my research at the time, that starting with such a low beta usually isn't that great. A beta not doubling isn't necessarily a problem very early on, but barely going up after 4 days & staying that low is definitely bad. I hated to be in the position of telling her that it was pretty likely that it wasn't going to work out.

She called me back later, looking for a shred of hope. Maybe something she could eat would make it better? Maybe because the estrogen & progesterone levels were good that it would be OK? Maybe more than one had implanted and then only one remained? And then came the guilt - maybe it was something that she did? Maybe she didn't pray hard enough? I did everything I could to reassure her that it wasn't something that she did and also that there was nothing that she could do.

I wish I could have given her hope. I told her my story. With a first beta of 29 & then 35... weeks of not knowing what was happening (my fetus was hiding behind the huge hematoma (blood clot) that ended up washing it out - the first time I saw a sac was at 8 weeks & then, suddenly there it was, a fetus with a heartbeat, exactly the right size for 8 weeks). I waited to miscarry, knowing that it would happen, but my baby kept growing normally and as the time went by, I thought I might beat the odds... After weeks of bleeding on and off and two weeks of complete bedrest, I lost the pregnancy at 13 weeks. Warning: Stupid ultrasound technician comment ahead. My mom drove me to the hospital and the technician who finally saw me said, "Are you sure you were pregnant?" Huh?!? I'd had an ultrasound at 6 that same evening & I saw the fetus with its arms and legs moving around. I'd miscarried at home & I didn't even know... (Obviously, the bleeding and cramps had been really bad, I did know I was miscarrying, I just didn't know it was already over.) No, I didn't go into all that detail with Diana, it just went through my head. I was thinking that I hope for her sake that if it's going to end it ends quickly.

Although I wanted my pregnancy to continue, knowing that it probably wouldn't definitely made the miscarriage less tragic for me. Maybe knowing the truth early on is the best?

Diana told me she's too drained to go through another cycle. I told her that she'll do it when the time is right for her and that I'll be waiting for her to call me with the good news. I know she will.

Sunday, July 16, 2006

IVF in a war zone

Picture this. You're supposed to go in for IVF early Sunday morning and the city in which you live is bombarded with Katyusha rockets on Friday night and Saturday... You get your trigger shot as you're anxiously watching the news and hoping and praying that things aren't going to be so bad by Sunday that your retrieval won't be able to go on as planned. (From what I understand you *have* to have the retrieval if you've had the trigger shot, so it seems that the retrievals will go on as planned.)

I went through my first IVF cycle at Haifa's Rambam Hospital. Picturing the women going in today was scary. I checked in at one of the forums I read - some messages were like this message from 'honey', "If you need a place to stay, I live in {name of city} and you're welcome to stay with me. My fridge is equipped with Decapeptyl, Progynova, Endometrin, and Pregnyl - so we're in good shape." or this from 'Lilach81' - "We live up north and are currently staying in the center of the country. I have an appointment today which I (obviously) can't make - I need advice from women in this area about a doctor who can perform an ultrasound and blood tests for me..." (At least there's socialized medicine in Israel, so cost won't be a factor in most cases.)

I can only imagine what these women are going through. Going through IVF is stressful enough without it being performed in a war zone... I want to send my best wishes to those women on both sides of the border who are going through IVF at this difficult time.

Wednesday, July 12, 2006

DI Dads speak up

Eric Schwartzman who runs a Yahoo group called DI Dads dropped me a line a while back to let me know about an article in USA Today about dads to kids born by donor insemination who are speaking up. It's about dads (and families) who've chosen to tell their children about the way in which they were conceived. Eric himself was interviewed for the article.

I found it interesting that Eric says that the term 'father' is used for the donor and dad for the social parent (the male parent raising the child). I like the separation between formal and functional... I really understand why it's important for these dads to speak up - they're making it legitimate to have children with the help of a donor. This will make it easier for future couples contemplating using a sperm donor and will make it easier for children who were conceived in this way.

When I was a kid, most adopted children didn't know they were adopted. Today, I think it's rare for a child not to know. I doubt that this change will happen as quickly with children born using donor insemination, but the work Eric and others like him are doing seems like a step in the right direction.

Monday, July 10, 2006

Stem to Sperm - A future solution for male infertility?

A team of scientists led by Professor Karim Nayernia in Newcastle University successfully grew sperm cells from embryonic stem cells. This article (from The Age) describes the research in further detail. A picture of the mice who were born as a result of the sperm grown in the lab can be seen here. The second article (from Daily Mail) says that the technique could allow men suffering from certain types of infertility to 'grow' their own sperm. One way in which this could be done is by surgical removal of immature sperm cells from a man's testicles and then growing them in the lab and replacing them. The article discusses additonal possible applications of the research.

Interestingly, the first article fails to mention that the resulting mice were far from healthy and suffered from a variety of medical conditions.

As with any new technique, this one too is at least five years from being available to men suffering from infertility, but it may offer hope for the future.

--- Unrelated Note ---

For all those who are interested, I've added the option to get an RSS feed for this blog. See the link on the right - clicking it allows you to choose where you'd like your feed to go.

Tuesday, July 04, 2006

Endometrial polyps and pregnancy

One of the questions that reached my inbox recently was, "Have you heard of anyone successfully conceiving with an endometrial polyp?" Truth? I haven't actually come across those terms together before... I decided to look it up and found a study done by Perez-Medina et al from the Santa Cristina University Hospital in Madrid, Spain.

The goal of the study was to determine whether polypectomy (removal of the endometrial polyp/s) prior to IUI (intrauterine insemination) affects pregnancy rates. The women were divided into two groups - one group who had a polypectomy prior to beginning IUI and one who did not. The overall pregnancy rate was 51.4% in the study group and 25.4% in the control group, with the conclusion being that polypectomy is indeed helpful. Surprisingly, 65% of the pregnancies in the study group occurred before the first IUI.

The researchers also noted that they found no significant correlation between the size of the EP (endometrial polyp) and pregnancy rates.

Wednesday, June 28, 2006

One in a million

3 million IVF babies have been born. Wow. Pretty amazing if you think of it. If you multiply that by the average number of cycles it took before viable pregnancies and then multiply that by the average number of shots each woman got... well... I don't even want to think of those numbers.

As I read the article I thought - one out of each million IVF babies born so far in the world is mine :-)

Today my oldest daughter (IVF, conceived after 3 years of infertility) had the Bat Mitzvah party for her friends. We rented a screening room at the new movie theater in town and the kids got popcorn & drinks & watched a movie. The mess stayed there - good thing too - I would have run out of bags for my vacuum cleaner...

Anyway, earlier in the day I had taken her to a mall about 30 minutes from here (to buy something to wear), in a place where I had lived for a few months in 1997. The only thing that made my time living there bearable was my friend P. who had IVF-ICSI twins (they're 11 now). When I drove there today, I remembered how funny P. was when people used to ask her if they were 'natural' - she pretended not to understand and said things like, "they have candy once in a while"... I thought about her again today when I came across an article about a study done on children born by ICSI. It says that they've studied kids who are 8-years-old and that they're doing well. 8? I think ICSI's been around for about 15 years, so why are the oldest kids who are being studied only 8?

As opposed to IVF where the sperm fertilizes the egg naturally (albeit in a lab), with ICSI, a single sperm is injected into the ova. It's pretty easy to understand why this might be a riskier process... From the data presented, it looks like children born as a result of ICSI are pretty much the same as children conceived naturally - they mention that the higher incidence of malformations found among ICSI children is probably a result of the genetics of the parents who end up going for ICSI & not the process itself.

Monday, June 26, 2006

Pre-ICSI treatment for men

In last week's European Society of Human Reproduction and Embryology meeting, A. Farrag from the Grimaldi Medical Group, IVF/ICSI Unit, Rome, Italy presented a study done in the Grimaldi Medical Center. The study wanted to show the effect of treating patients going through ICSI due to idiopathic male infertility (male infertility, the cause of which is not known) and oligospermia (very low sperm count) with recombinant human FSH (gonal-F) before the IVF-ICSI cycle.

The men who were treated received Gonal-F shots 3 times a week for 3 months.
The results were good. Compared to the control group, the clinical pregnancy and implantation rates were higher and the early pregnancy loss rate was lower.

I wasn't able to find where the research was published, but if you're going through ICSI for one of the above reasons, it seems worth looking into.

Sunday, June 25, 2006

Sparing men from infertility after chemotherapy

At the European Society of Human Reproduction and Embryology meeting in Prague, last week, Alon Carmely from Bar-Ilan University (Israel) said that his work (select Tuesday from the top and then click the 2nd to last link. Finally, look for A. Carmely - there's a summary of his presentation) showed for the first time that the injection of AS101, a drug that enhances the immune system, could protect the testis from the effects of paclitaxel (Taxol), a widely used chemotherapy drug.

Alon Carmely and his team knew that AS101 had been shown to have chemoprotective effects in both animal and human studies, and they decided to investigate whether it could help avoid testicular damage in mice treated with Taxol. The results showed only minimal testicular damage in the group that had been injected with AS101. Mature sperm was also found, as opposed to the control group, in which the testicles showed severe atrophy and empty seminiferous tubules (where the sperm-producing cells are) .

This provides hope even for those men who did not freeze sperm prior to beginning chemotherapy - some for lack of time, some because they were simply unable to think that far ahead while dealing with the uncertainty of cancer.

Friday, June 23, 2006

Transplanting a uterus?

A story I just couldn't miss... Successful uterus transplant in ewe - Scientists have successfully transplanted a uterus in a sheep. The hope is that such a transplant will be available for women in about 5 years. There are some major problems - the transplant would have to be from a relative (mother, sister) and could only be in place for a maximum of one birth or two years (whichever comes first).

Wednesday, June 21, 2006

Infertility News

I try to keep posting, but sometimes life and trying to make a living get in the way. I've had so many ideas run through my head about what this post should be about, but very little time to actually blog it.

My mom, who reads several (or more) infertility blogs religiously, keeps me posted when I get behind and has also sent me a few interesting articles recently. So, I'd like to thank my mom for sending me material for this post!

First. Robber Barren over at Ovaries on Strike saw two heartbeats on her ultrasound this week! I wish her an easy pregnancy and healthy babies! (My daughter saw me reading the post and insisted on knowing why I was crying...)

Next. My war against stress has met a glitch... It seems that stress-induced-infertility does exist. Some of the headlines read "Cutting stress may boost fertility", "Stress could make women infertile" and "Learning how to beat stress could be the best infertility treatment". All of these headlines are somewhat misleading - it sounds like they are referring to all kinds of infertility. The headline that was most accurate was Behavioral Therapy May Help In Stress-Related Infertility. The study discusses women who stopped menstruating and ovulating - due to stress - and the effect of cognitive behavior therapy on their fertility. There's also a brief mention of the effect of stress on male fertility, but no specific data. The study performed by scientists at Emory University in Atlanta, Georgia only studied women whose infertility was caused by stress-induced amenorrhea.

Unbelievable. Another set of double-twins! I read and re-read this story trying to figure out why Tasha Riddle would opt for surrogacy after having 11 miscarriages. I guess they couldn't find anything wrong with the embryos and concluded that for some reason she could not carry a pregnancy. Anyway - Tasha's best friend, Raquel Mitola, offered to act as her surrogate. Both were implanted with embryos from Tasha's IVF cycle and both got pregnant - with twins! The two sets were born 8 days apart.

Twins are indeed a double blessing. Quads? I bet Tasha's going to stop deleting that Valium spam from her inbox any day now...

Sunday, June 11, 2006

A Few Donated Dollars

Believe me, my PayPal balance was nothing to write home about. I make a few bucks here and there by selling fertility tests on my Israeli (Hebrew) site (www.poriut.com). I go through a complicated monthly process of changing the money into Shekels so that I can report it to my business and pay taxes... I always transfer an even amount, so that I sometimes end up with a few leftover bucks in the account.

While reading an infertility blog, I came across a site with a donation link that I found irresistible, so I clicked the button and set my PayPal account back to an even zero.

It would be great if there were funding for everyone who needs fertility treatments, but since there isn't, I hope I that those who can help will. I hope I find more opportunities like this in the future and that sometime I'll be able to make a donation that will actually make a difference. Until then, this felt good :-)

If you can, try it!

Saturday, June 10, 2006

Keep Fighting the Stress Myth

I've said it before, but it's worth saying again. No woman going through infertility wants to hear the words, "just relax".

There are a lot of myths about infertility - this page of fertility myths on Ovusoft is one I love - it discusses the most common ones. As part of my quest for the truth, I've searched high & low for research on the effect of stress on infertility and have yet to find an article that claims to have found a direct connection between the two.

An article recently published here (ic Wales) discusses stress and infertility. The first few paragraphs seem to imply that stress is linked to infertility. It's only once you grit your teeth and get past that, that the article mentions that "it may not be the stress directly...". Another researcher who didn't actually find a link...

I've got one question (OK, two) - If stress were really an important factor in fertility, like something that changed your body's chemistry so that an embryo couldn't implant, how would so many IVF babies be born? What could be more stressful than that?

Sunday, June 04, 2006

Infertility Bloggers - Persephone Did It!

Wow! Persephone's long-awaited babies (nicknamed Aleph & Bet) have arrived:-)

It's amazing how happy you can be for someone you don't even know...

Here are a few other blogs I've come across. I'm putting up a list of soon - if you've got one, send it to me or add it in your comment.

A Little Pregnant
Project Genesis
In A Holding Pattern

Wishing Persephone & Lance a big Mazal Tov & hoping for a lot of happy stories :-)

Wednesday, May 31, 2006

Happy Birthday to my IVF-FET Babies! Babies?

I can't believe it. It was almost exactly 11 years ago that I had my eggs aspirated for the fourth time. My oldest daughter, now 12-1/2 wasn't 2 yet and I was worried she would remain an only child forever. She was born after nearly 4-1/2 years of marriage, a result of my second IVF cycle.

When she was 6 months old, I was ready to try again. I had traveled to visit my parents in the US and I came back sick. It wasn't clear what it was I was sick with. Tens of tests and nearly a year later, a professor who headed the Internal Medicine ward was convinced it was Hodgkin's Disease. He sent me for bone marrow aspiration. As I expected, the results were fine. With no more ideas or tests left to run, the doctor finally diagnosed me with CFS – chronic fatigue syndrome.

I read up on CFS & understood that the fever might take years to go away. More surprisingly, I came across research that showed that pregnancy often cures CFS. (I looked for information about this now & found a question & answer session with Dr.Charles Lapp - where he was asked about his experience with pregnancy in CFIDS. He answered that about two-thirds of patients get better during the course of pregnancy.) With this information, I decided to go ahead with the IVF treatment despite the fact that the IVF department advised against it.

The first cycle failed (4 embryos, no pregnancy). The second cycle, on June 6, 1995, resulted in 8 embryos - four were transferred and four were frozen. The transfer failed. Next was the frozen transfer cycle. The frozen embryos had been graded B,C,C & D, but all survived the thaw and we transferred all four. On the 11th day after the transfer, I started bleeding. A pregnancy test showed a faint pink line... but when I went for the pregnancy test at the hospital a few days later, I was convinced it was over. Later that day, I was shocked to hear that my beta was 600.

In the first ultrasound, I saw three sacs. About two weeks later, on my daughter's second birthday, after a bout of heavy bleeding and cramping, I was amazed to see a heartbeat... and another heartbeat... twins!

My CFS did go away sometime during the pregnancy. Those little hearts kept on beating until they were born at the end of 39 weeks of pregnancy - on June 6, 1996 - exactly a year after they were formed.


I want to wish a very happy birthday to Harry and Judy, my miracle babies who are turning 10 on 06/06/06 :-)

Sunday, May 14, 2006

Ouch! It's Mother's Day

Did this really have to happen, you wonder... Did they really make a day just to make me feel even worse? Do I really have to call my mom and tell her how happy I am for her that it's Mother's Day... and my mother-in-law too? It seems more like a reason to wake up in the morning crying... or better yet... just hide out the whole day so that you don't have to face the world and feel like such a failure.

Is being a mom really so important or special? Why are we brought up with the idea that we'll grow up and become mommies, when not all of us can? It seems so unfair...

For those women who do want to have children, the pain of not being successful can seem unbearable. As the years go by, which is what frequently happens, the dream seems to slip farther and farther away. When I was going through infertility, I remembered what my father had told me about AA meetings (he ran them at some point, as an Army chaplain) - one day at a time. I felt my life was going one month at a time. If I could get through this month, I would get to the next month when there was another opportunity to succeed. Getting my period was a fresh start... one that would bring me closer to being a mom.

I guess that during all those years of infertility, in a way, I already was a mom. The love I was going to give my child was already there, along with the things I wanted to teach him or her. I kept my playfulness so that I could be playful with my child and I remained optimistic so that I could bring my child into a house with optimism. I was already able to feel my ability to nurture a child... and if I was willing to go through so much to have a child, clearly I would do everything I could once I was finally blessed with it.

To all those who have been lucky enough to become moms, happy mother's day! And to those who are still waiting, in my book, you're honorary moms & you deserve to celebrate.

Wednesday, April 26, 2006

How many embryos should I transfer?

I got the following question in my mail today:

"Hi, I'm in the process of going through donor egg after many failed IVF cycles. My doctor has advised that we have 2 embryos transferred but I am concerned of the risks - mainly of health issues that can occur from delivering premature babies which is usually the case with twins."

Tough question. I looked up the research that's been done on the topic and found the following review of research from The Cochrane Library, Issue 1, 2006(http://www.cochrane.org/reviews/en/ab003416.html):

In simple terms, when transferring two embryos you raise both the likelihood of achieving pregnancy and the likelihood of twins. Following is a quote with the statistical data removed:

"The clinical pregnancy rate per woman/couple associated with two embryo transfer was significantly higher compared to single embryo transfer. The live birth rate per woman/couple associated with two embryo transfer was also significantly higher than that associated with single embryo transfer. The multiple pregnancy rate was significantly lower in women who had single embryo transfer. "

In the research led by Dr. Ann Thurin, from Sahlgrenska University Hospital (http://www.brightsurf.com/news/june_04/ESHRE_news_063004_b.php) the transfer of single embryos (SET) was compared to double embryo transfer (DET) and the rate of pregnancies after the transfer of two embryos was not very different (39.7% vs. 43%). However, many of those opting for SET had to go through an additional frozen transfer cycle to transfer the second embryo.

With regard to twin prematurity, in a French study (Rufat et al., 1994) of 1263 IVF pregnancies, the prematurity rate (less than 37 weeks of amenorrhoea) in twins was 43.8% compared with 12.2% in singletons, the corresponding figures were 13.9 and 2.9% for extreme prematurity (less than 33 weeks of amenorrhoea). Indeed, at least according to this study, having a twin pregnancy more than triples the risk of prematurity. In this article - (the abstract is in English, the article in French), there's some good news - early diagnosis of twin pregnancy by ultrasound and subsequent treatment (resting at home and regular clinical examination of the cervix) was successful in reducing the rate of prematurity.

When I was going through IVF (Rachel's story), it was common to transfer 4 embryos, which I did 4 times. Two of those cycles failed, one resulted in the birth of a singleton and one in the development of three sacs - 2 of which became embryos and resulted in the birth of twins. In my last IVF cycle, I transferred two embryos and became pregnant with a singleton (I later miscarried due to a large uterine hematoma).

My experience was that carrying twins was a bigger strain on the body. During my twin pregnancy I was much more susceptible to illness and even spent a few miserable days in the hospital hooked up to an IV after I came down with a mysterious (non-pregnancy related) virus in my mouth. I was lucky to have an uncomplicated pregnancy that continued through the 39th week, when my doctor decided to strip my membranes to induce labor.

Carrying twins, of course, is not the only issue. Once they're born, you have two babies to take care of... quite a challenge. I read this very insightful blog entry on Infertility Is Funny. I think she captured well what being a new mom is like. Multiply that (at least) times two if you're thinking of twins...

The decision of how many embryos to transfer is not an easy one. I think today I'm actually glad I didn't have all the information in front of me when I made my decision.

Sunday, April 02, 2006

Nomi's here...

We're still not sure how we're going to spell it, but our new daughter got her name yesterday - Naomi (Nomi) Hallel.

Two weeks ago, an ultrasound showed that the abdomen circumference (AC) was larger than the other dimensions. As I wrote in the previous post, there was also too much amniotic fluid & testing showed that I had gestational diabetes.

On Thursday morning, I went to the hospital to be induced. The delivery room was packed with people. So packed that they were delivering babies in the room generally used to assess the condition of women who reach the delivery room... We were told that we'd have to wait. At first it seemed I'd be able to go home, but then the doctor advised that I stay there - that my health insurance wouldn't cover me were anything to happen to me when I was outside of the hospital. I stayed, hoping they'd call me sometime during the night. They didn't. Friday morning, my husband came back & we waited all day. Finally, around 11pm, he went home, knowing he'd sleep best in his own bed (we live about 35 minutes from the hospital). The woman beside me was snoring loudly & I couldn't get to sleep. One of the nurses gave me a bed in another room and I finally was able to sleep. At 2am, they came to call me.

I was immediately wide awake. I collected all my stuff and went to the delivery room. I took a nice shower & started to get ready for the induction. My husband arrived at around 3. Finally, we were able to talk to a doctor - all along, we'd been trying to understand the risks of delivering a baby in our situation, but it was hard to get anyone to really listen. With the weight estimated at 8lbs6oz & being told that the error was up to 10%, we feared that the baby could be as big as 9lbs4oz - not too big under normal circumstances, but with gestational diabetes, the shoulders can be wider than normal & then have trouble getting through. If that happens, there's nothing that can be done... So we debated whether we should opt for an elective c-section. We collected all the information that we had from all the different sources (2 ultrasounds, 4 or 5 doctors and my personal experience with 2 previous births of babies over 8lbs) and decided to go for a regular delivery.

They started me on the pitocin drip at 5:30am. I was dilated 1.5cm & 50% effaced. It didn't take long for the contractions to start & they were manageable. I had decided early on that when it started to get really painful I'd ask for an epidural. I kept my husband busy putting ice in my mouth every few minutes & kept the midwife busy putting the monitor on & taking it off every time I decided to go to the restroom. I felt the contractions mostly in my back & had my husband put an ice pack on. It was amazing how much it helped. It seemed like the time was flying by. For a while I sat on a chair, with the monitor & the ice. My husband fell asleep on the bed :-) I dozed off a few times myself... At around 4cm, the contractions were getting harder to manage (though I was doing OK with the breathing) & I wanted to make sure they'd have someone to give me the epidural (usually it takes about an hour). The anesthesiologist just happened to be there at the time and decided to do it right away.

He was an annoying guy & I didn't enjoy having the epidural put in, but the pain went away & that was pretty nice. Every hour they gave me another dose. After the 2nd dose, the head had moved down low enough for the midwife to decide to break the waters. I was somewhere around 5cm. Two of the doses didn't spread evenly & there was one place where I had a lot of pain, but it was still tolerable. Amazingly, throughout the entire labor, the baby's heartbeat was good & the baby was active. I could feel kicking practically to the end.

The midwife asked me if I had the urge to push & I said I didn't. She checked me and said I was almost fully dilated. During the next contraction, she asked me to push lightly. 10cm! She told me we were ready to push & I was really excited. I pushed during the next contraction and the head was out! The midwife had me sit up and told me we were going to deliver the baby together. I thought she meant that I'd push and she would catch the baby... Actually, she meant that we would catch the baby. She put both my hands on the baby's head and I pushed and held the baby as she slipped into the world.

With the midwife's hands still on her, I placed the baby on my chest. We did it! It was 4:10pm Saturday afternoon. My husband and I were overjoyed!

It turned out that the baby was just 8lbs1oz. Her blood sugar level was tested every 3 hours for her first 24 hours. All of the tests were normal. My tests were normal too :-)

On Monday night, I got a few hours off from the hospital & I went to my little sister's wedding. I left after the 6 o'clock feeding and was back in time for the 9 o'clock feeding... Amazingly, my sister had chosen a wedding hall right next to the hospital. I left the hospital all dressed up... proud to have my hospital bracelet around my wrist.

My parents hosted a weekend in honor of my sister & her husband this past weekend. My 3 brothers came with their families, so all 21 cousins got to spend the weekend together :-) We piggy-backed on it & my husband's family joined us on Saturday morning, when we named our baby.

Nomi just seemed like the right name for the baby. Hallel means praise. Praise for G-d is exactly what I felt when our baby daughter was born safely and healthy.

Wednesday, March 22, 2006

A blogging break... with good reason

If you could see me now, you'd probably understand. I look like I'm about to burst. I am.
I'm 39 weeks pregnant.

On Sunday, we went for an ultrasound, where I immediately noticed that the stomach was large (relative to the rest of the baby). I asked the technician to check the amniotic fluid and she saw that there was indeed excess fluid. My doctor sent me for the extended glucose challenge (you fast for about 8 hours & then have a blood test, drink 100 grams of glucose and have a blood test each hour for three hours). I went first thing Monday morning. We anxiously awaited the results as our carpenter turned our storage-free house into a storage paradise... The results finally arrived Tuesday afternoon and the results were positive. I have gestational diabetes.

I called my doctor who said that he has to transfer my care to another doctor whose expertise is gestational diabetes. I was able to get an appointment for today. I didn't know what to expect, but I thought that he would recommend that I control my diet, take multiple blood tests, etc. I was ready for that. I was shocked when he said that he'd see me tomorrow morning in the hospital. Huh? Hospital? What? He explained that I'm too far into the pregnancy to start trying to control the diabetes with diet and that letting the pregnancy continue is riskier than inducing now. So tomorrow I'm going in to be induced.

I was induced with my first baby. I was put on the pitocin drip for an endless amount of hours and I had strong contractions that I was really proud of myself for being able to control with breathing. Unfortunately, after all those hours I still wasn't dilated. At all. I finally asked to be allowed to get up and walk around. I took a break for about an hour & when I came back, they broke my water and then things started to move. It still took another 11 hours and the pushing was endless... Not the best experience.

I'm counting on the fact that subsequent deliveries are not as difficult, especially after Abigail's birth. Anyway, I'm sure it will be a little while before I'll be blogging again.

In the meantime, I'll be keeping my fingers crossed for all those who are currently trying to conceive.

Saturday, March 11, 2006

Infertility and the Dead Sea

I spent this past weekend at the Dead Sea. As far as I could tell, no one actually lives there, there's just a long row of hotels (actually 2 groups of hotels), a few (extremely) tacky shopping centers and some spas...

The Dead Sea water has a unique chemical composition that is known to be therapeutically effective for various health conditions - skin conditions like psoriasis, rheumatic diseases (e.g., osteoarthritis), respiratory diseases like asthma and many others. People come to the Dead Sea from all over the world for the one-of-a-kind treatments.

As I sat with my feet in the water (that has a kind of greasy feel to it), I wondered if there are any treatments for infertility that are associated with the Dead Sea... As soon as I got home (after sifting through my email) I searched for reliable information about such treatments. Unfortunately, I didn't find any. I guess that for people who believe that stress is a factor in infertility, the Dead Sea is a place where it's easy to relax...

On Friday, we went to Kibbutz Ein Gedi, and walked around the botanical garden. It's incredible to see the amazing variety of plants that grow there. Some like I've never seen anywhere else. It's hard to imagine, but there's desert all around and Ein Gedi is an oasis of greens, oranges, reds and yellows...

Thanks for hanging in there, I'll be back on track with the next entry. I just felt I had to share part of my experience.







Monday, February 27, 2006

Infertility Tourism & The Baby Business

At breakfast this morning, an article about infertility caught my eye in our local paper. It was about a new book by Debora Spar - The Baby Business: How Money, Science, and Politics Drive the Commerce of Conception. The book (from what I read in the article) discusses the people who gain from the "infertility business" and mentions that there is a price for everything (sperm, eggs, womb rental, etc). I tried to find the article online. Instead, I found this review of the book, which was no less interesting.

Another thing I found during my search was an article about "Infertility Tourism" in the New York Times. Felicia Lee mentions people flying to various places around the world to find cheaper egg donations, to have IVF less expensively, etc. Travelling to go through in vitro fertilization makes a lot of sense - get to visit a foreign country and hopefully come home with a really special souvenir... There are additional advantages like the fact that the experience is much more likely to be a positive one, even if the fertility treatment is unsuccessful.

As mentioned in the New York Times, in Israel, IVF is covered by the national health service. It took me time to realize how lucky I was not to have had to pay for the treatment. I was already an Israeli citizen when I started battling infertility, so once they approved my file, all I had to do was pay about 10% of the cost of the medications that I took. It was about $100 - $150 per cycle. I have tried to imagine what it would be like for money to be the obstacle between having and not having a baby. The decision for those going for expensive infertility treatments is like buying a high risk stock (sometimes repeatedly), but with the desire to have a baby being such an obsession (for most), I don't know how couples can decide to stop.

Saturday, February 18, 2006

Pregnancy and Parenting After Infertility

Fortunately, this subject comes up a lot. Women who've been ttc (trying to conceive) for a long time finally find themselves pregnant and they're shocked it's even possible. It takes a while for it to sink in and then, once it does, come the fears that something will go wrong. I think those of us who have gone through infertility are much less likely to take a healthy pregnancy for granted.

Apparently, at least from my experience, you're more likely to bleed when you're pregnant from IVF. This could be because sometimes more than one embryo begins to implant and the other(s) "miscarry" early on or just because the hormones aren't natural (because the corpus luteum or "yellow body" doesn't always produce hormones to support the pregnancy as it would in a natural cycle). So with me, I was finally pregnant, then I had horrible, scary bleeding (cramping and all) and only after that I saw the heartbeat for the first time. It made the first months very stressful. This happened to me in both my first and second IVF pregnancies (see my story). In both, it was suspected that I had a "miscarriage" though the pregnancies continued to full term, resulting in healthy babies.

So you're pregnant. And then you get nauseous. And you're supposed to be so thrilled that you're pregnant that you don't even feel the nausea. In fact, it's a pleasure. You love every minute of it. You're proud when you rush to vomit. You're over the moon when you can't sleep because you've got morning sickness so badly... except... um... it isn't really all that much fun, even when you really waited for the pregnancy. Even when you made a thousand pacts with G-d about what you would do if you were ever lucky enough to finally be on your way to becoming a mom. You still feel sick as a dog and you'd really like to feel better. Soon. Now. You get the same stretch marks from pregnancy whether it's IUI, IVF or natural. You feel tired and swollen and heavy toward the end of the pregnancy whether you've waited 5 years or 5 minutes... Is it legitimate to complain? Of course it is. Just like it's going to be legitimate when your contractions are killing you or when you're going to be tired if your baby keeps you up all
night.

It seems like (and is) such good fortune to finally have a baby after you've wanted one for so long, but I wonder if it makes the experience of being a parent a different experience? Maybe you're more likely to take a long period of maternity leave to be with your baby or you feel more protective than other parents do. Maybe while you waited to have the baby you had a lot of time to dream about the things you want for him, her or them... and then those dreams lead you to do more things with your child than you would have otherwise. Maybe you had time to save money and you have better financial resources so that you can provide additional enrichment to your child. Maybe you're more patient. Maybe there's no difference at all...

I'm starting my 35th week tomorrow. My ankles are so swollen that I was surprised I was able to put on my shoes this morning.

Tuesday, February 14, 2006

IVM - In Vitro Egg Maturation. A Way to Avoid Ovarian Hyperstimulation Syndrome

I just read an interesting article about IVM - in vitro egg maturation. The method, according to the article, isn't new, but so far only about 300 babies have been born using it. Its main advantage is that it allows a short treatment cycle (3 days of medications) after which the immature ova are obtained. This significantly reduces (or perhaps completely eliminates) the risk of ovarian hyperstimulation syndrome (OHSS). For women who have suffered OHSS and are afraid to go through another IVF cycle or have been told by their doctor that it is too risky, IVM can be a last-resort by which they could still have a baby of their own.

The article specifically mentions women with polycystic ovarian syndrome as good candidates for IVM. I actually never knew that having PCOS put women at higher risk for ovarian hyperstimulation, but apparently, as mentioned in this article (by a center offering IVM), it does.

One disadvantage of in vitro egg maturation is that frequently the outer part of the egg becomes practically impenetrable - the sperm just can't get in, requiring intracytoplasmic sperm injection (ICSI) to be performed. Another disadvantage is that the ova are extremely sensitive and therefore need to be tracked very carefully as they are being matured in the lab. Both of these issues raise the costs associated with the procedure (compared to regular IVF), though the cost is likely to be offset by the much lower cost of medications used to stimulate egg production and the savings due to having less blood tests and ultrasounds (because of the shorter stimulation protocol).

IVM can also be used with regular IVF cycles, when despite a regular stimulation protocol many immature oocytes are obtained, so it can also give couples going through IVF more eggs, meaning that they will have more embryos to freeze for future cycles.

I'm always encouraged to hear that there are more and more solutions for infertility. If IVM can be perfected, perhaps someday in the not-too-distant future, it can replace today's method (usually 1-2 weeks of daily injections) that puts a great strain on women's bodies and consumes so much of their time and energy.

Tubal Reversals & Vasectomy Reversals

I recently got hooked on Yahoo! Answers (I have some great tips for anyone else who's into it). I hang around to answer questions about trying to conceive and about a variety of other things (my most recent answer was to a ridiculous question that asked whether you'd prefer to drown in mayonnaise or be stoned to death by pickles - yes, I'm serious) and I've come across quite
a few questions dealing with tubal reversal.

This morning I had another letter in my inbox - "I was married with 2 children (and) decided that I didn't want anymore children so I got sterilized (had a tubal ligation). 6 months later the marriage broke up. A year later I met my future husband who I would love to have more kids with, so my option is IVF.

We looked into a sterilization (tubal ligation) reversal but it has a high cost and lower success rate compared to IVF. We are now just beginning an eggshare IVF where I'm donating half my eggs to another lady. I am excited, frightened and nervous but I know this is the road I need to go down to get my end result."

I spent some time researching tubal reversals - different clinics claim different success rates, but overall - they're not highly successful. It seems that there are too many women who have had tubal ligations that they regret... and too many men who have had vasectomies that they regret. I find it ironic that people who felt they were "overly blessed" are now facing exactly the same issues as those who are going through (secondary) infertility.

After the original posting of this entry, I received the following question:

Q- I have had a tubal ligation, is IUI an option for me?

Unfortunately, the best I could offer was the following:

A - If you've had a tubal ligation, IUI will unfortunately not help you. With IUI, the fertilization still occurs in the fallopian tube, which, in your case wouldn't work.

IVF (in vitro fertilization), on the other hand, is an option. See more about
IVF.

Thursday, February 09, 2006

Stilettos & Infertility - Where Did This Come From?

I do my best to keep up-to-date on what's happening in the news in terms of infertility... It interests me and it helps me give better answers to people who ask me questions.

Not long ago a friend of my sister-in-law called me to talk to me about her daughter who was going through IVF. They live in a very tight community and the daughter didn't want anyone to know what she was going through - especially because the cause was male factor. At the time I first talked to her, the daughter had just found out that her first IVF was successful, but she was bleeding. I told the mom that I've had it go either way - twice the pregnancy went on, once I ended up losing the baby. (See my infertility success story.) I chatted with her a few more times & the last time she called (earlier this week), it was to thank me for having been willing to provide her with honest answers to her questions - and not just to say, "it'll work out OK." The daughter is now well into her 4th month of pregnancy and the bleeding stopped long ago.

Today I did a Google search for infertility in the news and one of the first things that came up was how Stiletto shoes can effect female fertility. It makes me wonder - who researched that? Having read the (very short) article, there's no mention of any statistics or any reasonable explanation to the claim... The article refers to the shoes as "killer heels" and discusses the way in which they shift the woman's balance. Where did this article come from and why would a generally reliable news source publish an article with no facts backing it up? As if women going through infertility don't have enough to worry about, now they have to think that maybe their fashion choices are to blame???

I don't believe what's written in the article, but, to tell you the truth, heels have never been for me anyway.

Sunday, February 05, 2006

Husbands & Sperm Donation

I got the following letter recently and I must say I found it infuriating. Fertility Stories has received many tens of stories from women (and even one from a man, Jim - which he updated recently, after the birth of his daughter) who either contemplated or went through with sperm donation and this is the first that expressed this opinion. Our page on donor thoughts also paints the picture entirely differently and I was very surprised to receive this:

"I have been prompted to share my experience following Joan's story (posted January 20, 2006). They have been married for almost 4 years and just discovered that the husband has no sperm.

Joan, and others struggling out there, I got married in 1994 and 4 years later the doctors said that I have no sperm and will not be able to father a child. We have been living in tears for more than 11 years in this condition. It is important to understand what your partner goes through, especially if it is only one of you with a problem. Let us not be selfish and try to get a solution that satisfies only one partner. Children are meant to be for 2 people - husband and wife.
Friends and family have offered many options, all of which will never replace biological children. While we could have gone for donor sperm, I feel that the child will be for my wife (and another man!!) and not ours. Adoption may seem neutral but such children usually find their biological parents when they grow up. And this can be so frustrating.

Many times, people around us do not understand what we go through. On several occassions we have been blamed for delaying childbearing (we are now 37). We have failed to forget the whole matter. Sometimes we feel desperate and other times we are so hopeful through prayer. But the desire for biological children is unquenchable.

As a way forward, we have decided to sink ourselves in prayer. There is nothing impossible with God. We believe that soon we shall have children and our tears of sorrow will be replaced with tears of joy. Let us continue the struggle prayerfully. Miracles still happen, and ours will happen soon. Keep your hopes high, irrespective of your age."

Though I can understand the desire to have the same biological connection to your child (as your spouse does), I find it difficult to comprehend how someone with such a strong desire for children could also be so against adoption.

Please feel free to share your comments.

Thursday, February 02, 2006

Donating Sperm for a Sibling? A Brother's Thoughts.

I got an interesting letter a while ago from a young man who I'll call Joseph.

"Hi. My sister & her (lesbian) partner have asked me to be a sperm donor. They joked about it five years ago. We kind of left it in the air for a bit then, as I was living abroad at the time. They turned to other possible donors, somewhat to my relief. Three possible donors later, each backing out after talks and meetings etc, they decided to try a fertility clinic.

We live in Ireland where no such service exists or (I think) is legal - for lesbians. In the last year they have gone 7 times. Each time was unsuccessful, each time with less and less trust in the system - there is no personal touch, no feeling of getting good service from the clinic...the prices are going up, and they feel - being 'foreigners' they are being ripped off. That's all tied up with the anguish and emotions, the fertility drugs etc., etc.

About five weeks ago they came back to me - their original first preference. I've grown up, am 34 and have very different views to 7 years ago, but I am very worried. Being a donor is one thing, being the child's uncle and father is another. They gave me a book which is very much from a woman's point of view. I'm not finding much sensitivity for the man, the donor. Even the donor's experiences seem to be coming from men who are very unattached to their sperm.

I don't think I sound crazy. But I am afraid that if I donate I will be part of something very real, a reality I will want to be part of. But what happens then? I want to help my sister, I want to help her partner. But what about my parents? What about me? I've never been given the opportunity to be a dad before. I thought that was taken from me once I came out to myself 17 years ago. I need to talk to someone who has had similar experiences, those who did it and those who didn't. I'd appreciate your comments.

Joseph - Ireland."


This was my response:

"Dear Joseph,

Thank you for contacting us. I read your story and I think that it's very good that you're taking the matter so seriously.

I would be happy to post your question on Fertility Stories along with any answers we receive. Let me know if you are interested.

Personally, I think that there are a lot of issues involved: You would be placed in an un-natural relationship with your sister, being a co-parent to her child (which, actually, biologically would be your child). What would your legal obligations be? What would your sister and her partner's expectations be from you? What would happen if your sister and her partner decide to dissolve their relationship? Would you have visitation with the child? Have to pay child support? What if you disagree with the education they choose for the child?

It seems the matter is very complicated and would have very long-term effects on your life.

I also think you are correct in that most donors have no desire to have any sort of connection with the children born of their sperm - this has its advantages, such as keeping just the 'parents' in the picture (particularly in heterosexual couples).

I look forward to hearing from you.

Rachel"


Joseph's response:

"Hi Rachel,

Thank you for your reply. I think posting my query may be a good thing, as I need some real life experience feedback. My friends are differing very much in their opinions. Some flat out no's. Others are envious.

I'm not sure if I was clear - I am gay as well as my sister. My sister is 2 years older than I and we are very alike in looks, mannerisms and personality - strong family line hey! No wonder I am their number one choice. Since I have taken on this consideration seriously my mind has wavered and weaved from positive to negative, from fear to excitement. Each step has ramifications in each and every direction. Yep, I'm feeling a little overloaded. I'm not under pressure, although a 'no' is not going to go down well.

The need, want, to have a child I think has heightened this year with the treatments and drugs, I think my sister's girlfriend is more than ready and 'wants a baby'. I was worried about my sister. I was leaning towards a negative gut feeling up until we actually sat and talked about it. I was concerned my sister was being pushed into this, her partner is persuasive and I wondered if, like me, my sister had never really thought about having kids before. It's so hard to know...maybe if I was lucky enough to be in a long term relationship and my partner was the family kind, and I loved him dearly, then yes I think I would want to have a family.

There is so much uncertainty… And that's before the legalities. I already know that there are no legalities. I mean, there is nothing in place to protect me, as a donor - to remain just a donor. No law exists in Ireland to prevent my sister &/or her girlfriend from claiming child welfare. Would I argue it? If things were to change? How could I? The child would be biologically mine. But trust is the bind. I trust my sister, her girlfriend. I trust their ability to bring a child up well. I trust them that should circumstances change, they would not turn on me.

I know to anyone reading this I may sound very selfish, but I am trying to get to the heart of why I want to do it, why I don't. Part of me thinks - stop thinking, just do it, you can't know the outcome - who knows the outcome of a child, the conception, the birth, the life. The changing of all relationships as time passes. None of it can be controlled. Is that a positive or negative?

Thanks for listening,
Joseph"

We look forward to your comments.

Thursday, January 26, 2006

Stories & Decision Making

My husband recently started his doctorate. He's spent the past year or more reading articles on decision-making and visualization. Not visualization like imagery, but rather the visual display of information. A few days ago, he emailed me about an article that he was reading, that reminded him of Fertility Stories. (We do actually see each other too, it's just that he was at the university which is about 60 miles south of here.)

The article - "SUPPORTING INFORMED CONSUMER HEALTH CARE DECISIONS: Data Presentation Approaches that Facilitate the Use of Information in Choice" by Judith H. Hibbard and Ellen Peters (Annu. Rev. Public Health 2003. 24:413–33) discusses the information patients need when dealing with health care systems, in order to allow them to make informed decisions.

Interestingly, they found that, people who were provided with information in the form of a story were both able to better understand the situation and make better decisions as a result of this understanding.

So... if you're dealing with infertility - on to the stories :-) Enjoy.

Wednesday, January 25, 2006

That Rotten Two Week Wait... Rambling

Like it's not bad enough that you didn't conceive last month, you have to wait two long, long, everlasting weeks until you find out if this month you succeeded... Two weeks, if you're one of the lucky ones who has a fairly regular period or if you're going through fertility treatments and already know how many ultrasounds, blood tests & clinic visits it usually takes before you ovulate.

As soon as the 2ww begins, you're soooooooo in tune with your body. It's like everything's under a magnifying glass. Are my breasts sore? You put your hands on them to make sure. Is the smell of (fill in the blank) making me sick? COOL! Didn't I just go to the restroom a few minutes ago... quick lookup... frequent urination? YES! Another sure sign... And then you remember that it's only been about half-a-day since your IUI, IVF or natural attempt... Hey, only 13-1/2 more days to go.

A good thing to do at this time is to take care of yourself as if you are pregnant. Get enough rest, eat healthy foods, take your folic acid. Fantasize about things that make you happy - enjoy it now, who knows what will be at the end of the two weeks?

So you've gotten through the first few days? The next step is the bargaining step. You think to yourself, "I won't test at least until the (fill in the blank-th) day" or "I am waiting for the blood test." And the days eventually go by, they have to. Slowly, but they do... You read up on how long it takes until the sperm meets the egg, how long it takes for the fertilized egg to travel from the fallopian tube to the uterus, how long it takes for implantation. You wonder if implantation bleeding is real or a myth. Is it a good sign or a bad sign (whether you have it or not)? Once 7 or 8 days have passed, you realize implantation really could have occurred.

The magnifying glass now acquires a high-powered-lamp and a super-sonic microphone system to go along with it. I crave pickles. And chocolate ice cream. And I am so tired. All the time. My breasts are sore. They must be sore. And my jeans don't fit the way they did yesterday. Or... maybe this is all in my head...

By day 10, the bargaining usually begins again, along with the thoughts, "If I test now, it's still probably too early... that means I can test now & it's still not final... So, if it's negative, I still have a chance..." Some women break down about here. Some last another few days and some make it through the whole two weeks.

Toward the very end, it gets a little easier. By then you've pretty much decided if you are or aren't pregnant and taking the test means you're actually ready to know for sure. My guess is that every woman, even if she's "sure" she's pregnant, is at least a little worried that the test will be negative... and that will end the fantasy.

In this, the age of impatience, many of the searches for Fertility Stories have to do with pregnancy symptoms. Cramping after IUI; not nauseous pregnant; if my breasts are sore am I pregnant; faint pink line pregnancy; no symptoms pregnancy; IVF implantation bleeding... if you think about it, it makes sense. A letter that used to take a week is now an email that takes 10 seconds. News that you waited until 5:00pm to hear is on the Internet instantly. You can check your bank account to make sure your check was deposited even if you only think about it at 2:15am and if you need your addressed changed on something, you send a fax so they can change it right away... so why does it have to take 2 whole weeks to find out if you're pregnant???

This is where this blog entry actually ends... If you want to read on, feel free. Before that, just a quick ad - this is my favorite online bookstore & I highly recommend it!


The BookDepository

My experience

I (see my story here) went through this (the rotten two week wait) oh... about 50 times, I'd say (maybe more). Each time I'd think it couldn't be so bad to wait two weeks & each time discovered anew that two weeks can be an eternity. With the first pregnancy (from IVF), my breasts were so tender by the 9th day that I couldn't sleep on my stomach. It was back in the olden days when they made you wait 20 days - by day 19, I felt so awful that I called the nurse and told her I thought I was coming down with the flu. She asked me what I was feeling and sent me for a blood test. It came back late that night. My beta was 2500.

With the second pregnancy (IVF - frozen embryo transfer), I had bleeding before the 14 days were up, so I had my sister run and get me a home pregnancy test on day 12. It was positive. I assumed the bleeding was a sign that it wasn't going to succeed & I was shocked on day 14 to find that my beta was 599 (I was to later discover that I was expecting twins). In both cases, I have to admit that I felt "something" that was getting stronger and stronger.

My 3rd IVF pregnancy didn't start well (and didn't end well). My beta was 29 & there was a huge hematoma (blood clot) in the uterus. I miscarried sometime around the 13th week (after several weeks of bleeding heavily on & off).

Ironically, my 2ww was much shorter than expected with my last pregnancy - I was in my first cycle after delivering my daughter, exclusively breastfeeding, and I thought the chance of pregnancy was fairly low. I had what I thought were either pre-menstrual cramps or ovulation, so I took an ovulation test (I sell discount kits out of my home) and it was positive, so I guessed I was finally ovulating... A week later, I was feeling tired and just generally different. Without thinking, I took a pregnancy test upstairs, put my baby in her crib (she was all of 4-1/2 months) and took the test, which was immediately positive (no waiting a minute, no faint pink line). I was in shock. So was my husband, when I was finally able to tell him about half-an-hour later. I decided to kill my business selling ovulation kits & pregnancy tests if the test was wrong. The next day, I took a test made by a different company (I get free samples too...) and it was positive even before I put it down on the counter... It turned out that I was 6 weeks pregnant. (I didn't kill the business :-))

Nomi was born March 25, 2006. Yirmi joined our family on March 8, 2008.

---
March 13, 2010 - I recently launched a new tool for bloggers at sleeQo.com. It allows you to fill in memes (like the one below) and post them on your site. If you're a two-week-waiter, feel free to drop by sleeQo (see the link at the bottom of the post) to fill it in and post it on your blog.

Two week wait

Rules: Answer the questions about how you get through the two week wait (the time between ovulation & your pregnancy test). Tag 5 women to do the same.
  • How long have you been trying to conceive?

    I'm not currently trying to conceive, my youngest is now 2 - and he is our last.
  • What number child are you trying for?

    See above.
  • What's the worst thing about the two week wait?

    The worst thing for me was not being able to think about anything else.
  • When do you find the two week wait starts getting difficult?

    As I went through it more and more times, I felt that only at around 8 days post ovulation I started to feel it. It was like the first week was a break, since I knew there was no chance I'd feel anything.
  • Do you feel like you're "super aware" of every little twinge during the two week wait?

    I was. Definitely. But the times I was convinced I was pregnant I was always right.
  • Have you found any things that help you get through the two week wait?

    I think the best was convincing myself that it wasn't up to me, that if it was going to work then it was & if not then not. It took a lot of the pressure off of me.
  • What's the worst thing to say to you during the two week wait?

    I'm sure it'll work.
  • ... and what's the best?

    Probably saying nothing at all :-)
Everyone tagged fill in this meme
Sleeqo

Monday, January 23, 2006

Stolen Stories

For a long time I've been wondering why Fertility Stories barely comes up in Google searches. Today I finally found the answer. Someone stole 8 stories from Fertility Stories (including my personal story - hullo?!?) and put them up on a competing site.

The way Google works is that it doesn't like duplicate content, so it only lists one. Seeing as this plagiarizer put the stories on a large, well-known site (as a subsite - it's not one of the biggies who did this), Fertility Stories got knocked off of Google's list. Lovely, huh? So I wrote an abuse report to the site and sent a message to Google about it & hopefully I won't have to call my lawyer in because they'll take down the site within 24 hours. Hopefully.

I can't say that I never looked for stories. I did. I looked for ones that had the names of the authors, I contacted them and I asked for their permission to use the stories. There's not one story on the site that was published without it... In my fantasy, women who wrote last year or even a few months ago will write to update their stories and tell us their good news. It happens here and there (some of the stories have little updates at the end), but not as often as I'd like...

Anyway, fighting this thing drained a lot of my energy & the battle isn't over until the site goes down. So that's my story for today. I really put a lot of work into this site and into answering tens of questions a day. Copyright infringement is really ugly.

Sunday, January 22, 2006

Babies in the Waiting Room

Forums. They're all over the place and they're a great way to be able to share intimate details of one's life without actually revealing anything about who you are. Once in a while, I like to read messages and offer some hope for those who need it.

I read a message from a woman who had poor quality embryos and I told her about my FET (frozen embryo transfer) cycle that I did just to be able to move on to a "real" (fresh) cycle... and about my twins who are now 9-1/2 years old from that cycle. A woman with a small hematoma (blood clot) wrote to ask if there's any hope for her pregnancy and I wrote back that I had both cases - a large hematoma that eventually caused a miscarriage & a small hematoma that disappeared sometime around my 9th week of pregnancy. Usually, I only answer when no one else has...

Different forums have different rules. The ones in the US tend to be the strictest, where you have to write "pg ment" or "m/c ment" (pregnancy or miscarriage mentioned) in your title. Of course there's also "kids ment" and others. You can't put your successes in your signature line because you'll be hurting other, less fortunate, people's feelings. And there's the inevitable - "I can't believe that someone brought her 2-year-old to the fertility clinic" and all the women who jump up to say how horrible it is. Over the years (and I've been reading infertility forums on the internet for 10 years now) this has come up in almost every forum I've read.

It took me over 3 years to conceive my first child. Not a very short time, especially since I was under 21 when I started trying. My friends were all older, all having babies, and believe me, I was soooo sick of being invited to their baby parties that after a while I only went to those of really close friends. But when I was in the waiting room and a woman came in with her baby, it made me happy. It gave me hope. Hey, I could be like her someday. I could have a baby too... and even try for another! I would attempt to start a conversation to get some encouraging information. "Was your baby born through IVF?", "How many cycles before you succeeded?"

My second cycle was successful and I delivered a healthy baby girl at the end of 42 weeks (I had to be induced). I was 24-1/2 and I refused to let anyone call her an only child. She was my first child. After she was born, I went back for treatment as soon as I could, to try to get pregnant again. I didn't take her with me, but only because it wasn't convenient (I dropped her off at her nursery school and then drove to the fertility clinic).

Seeing some of the less tolerant messages makes me wonder what an ideal situation would look like. Would they (the writers) really like to see the world on hold until they're successful? Would their life be happier if their friends didn't flaunt their pregnancies, if their little sister didn't have her 3rd child (usually it's an unplanned child or the sister's not married). And in general, would a childfree world really be more convenient? Um... oops... that is... until they have their child...

For those of you who are going through infertility - enjoy seeing other people with children. When your child is born s/he will be the most special and precious person in the world to you. You'll want everyone to see how wonderful, unique and beautiful your baby is. You'll take him or her (or them :-)) for a walk in the park, to the pet store, and to the playground just for fun, not to make anyone feel jealous... People who walk around with their children are not being insensitive. They're living.

Enjoy life now. Smile at little children the same way you'll want people to smile at yours someday. Hopefully someday soon.