Tuesday, June 30, 2009

Twittering infertility

Not only have I recently created a twitter account for Fertility Stories (come follow me here: http://twitter.com/fertilitystorie) but I realize there are quite a few infertility tweets going around.

If you tweet about infertility, leave a comment so that I can both follow you and create a directory of infertility (or fertility) twitterers.

My tweets are about site and story updates, interesting articles and news.

Monday, June 29, 2009

Book Excerpt - Riding the Infertility Roller Coaster

Iris Waichler, who wrote Riding the Infertility Roller Coaster was willing for me to share an excerpt with you. It seems (from what I've read on her site and in reviews) that she's chosen to approach the big picture a little more practically than some others - talking about, for example, how to find a doctor or lawyer and the possibility of deciding to stop pursuing treatment and to remain childless.

Here's the last chapter of the book. Enjoy!


This summer I took my daughter to an amusement park. We went with a friend who also has a daughter as a result of infertility treatment. We ended up taking a ride on one of those chute roller coasters that ends up splashing in water. Kids my daughter’s age and size were allowed to ride it. I hate roller coasters and haven’t ridden one in over twenty years. We slowly inched our way up and I thought this isn’t so bad. Suddenly we were at the top of a forty foot drop. Our car began falling down the tracks. My heart raced, my anxiety level shot up, and my head throbbed. I had my daughter in a death grip. We made it to the bottom of the ride and hit with a big splash, before gently floating into the stopping point.

My friend and I staggered out of the chute car. We were shaken. Our girls jumped up and screamed, “Let’s do it again and again.” I thought: let’s try another ride (not a roller coaster). There was a giant pirate ship that moved back and forth like a pendulum. We climbed on that, and as it began to rock back and forth, I lost my stomach on the second swing. I closed my eyes praying it would end soon, and hoping that keeping my eyes shut would ease my suffering. It didn’t! My friend and I got off that ride and I looked at her and said, “The things we do for our kids. I’m sure that’s not the last time we’ll do something for them we would never do otherwise.” She nodded and smiled knowingly. It was also somehow comforting to have my friend there with me going through it. She totally understood what I was thinking and feeling without me saying much of anything.

I thought about that day as I began to write this last chapter. There is the obvious parallel of the roller coaster, which I use as a metaphor throughout this book. I thought those rides that day really did mirror infertility treatment for me and many others. I would do something that terrified me, that wreaked havoc on my body and my mind for my child. I would take what I perceived as a personal risk for her. When I knew I couldn’t handle the roller coaster anymore I chose another ride, hoping that different ride would work, and it would please her and end successfully for both of us.

Those of you reading this book will be in many stages along your infertility journey. There will be days when things will go well, when test results are promising, or when you actually learn that you are pregnant. The day may finally come when it is time to leave and go bring home your newly adopted child and start your family. You may get word from your clinic that they have found a donor match for you or that a surrogate has been identified who will help make your dream of becoming a parent come true.

There will also be days where your test results will show that you are not pregnant. And days when you learn the medication you have been taking is not working, and you will have to try something new. Perhaps, you will continue to be unsuccessful at getting pregnant, and your physician won’t be able to identify the reason for your infertility. Maybe you will get to the point where you feel that if you have to undergo one more needle prick you will scream. You may ask yourself what is wrong with you or your partner—or what “bad thing” you did—that you are unable to create a child, no matter how many treatment options you use.

There may also come a day when you and your partner decide to stop infertility treatment and begin your post-treatment life, choosing to live childfree. It may be hard to imagine this day coming, depending on who you are, and where you are in your infertility journey. Not everyone succeeds, but life can have many fruitful outcomes.

All of these scenarios are emotionally charged. Whatever happens to you and your partner as you continue along the path of your infertility treatment, you can be certain you will be forever changed by your infertility experiences. Your relationships with your partner, your family, and your friends will also be impacted by your infertility experience. Your infertility will challenge and perhaps change these boundaries. You will be forced to make difficult decisions along that way that will test you in new ways. Your infertility journey may cause you to question your own instinct and your judgment. It will force you and your partner to look deeply inside yourselves to understand and define your values, religious beliefs, and life choices. By definition, the need to undergo infertility treatment creates a life crisis.

My hope for you is that you also recognize that you do not need to be a passive passenger on this difficult infertility journey. After reading this book, I hope you can and will be able to assume an active role. If you have a doctor that does not seem to be meeting your needs, you can find another one. You can hire an attorney to offer you information and provide you with the legal protection you need as you negotiate surrogate, adoption, or donor arrangements. Remember, you do not need to go through infertility treatment alone. If you are having difficulty coping with the challenges that arise, you can seek counseling on an individual or support group level. There are lots of places to go to get the specific information that you need to make informed decisions along the way. Friends and family can be educated by you and your partner, and if you enable them, they can help you meet your needs as you proceed through your infertility journey.

The surprising part about the challenges of infertility is that facing them can become an empowering experience for you. You will need to arm yourself with the proper tools, knowledge, and support systems. Don’t be afraid to rely on existing support systems or, if necessary, you can help build new support systems to aid you and others to get to where you are going. Allow yourself the flexibility you need to alter your course along the way, as your circumstances change. Your infertility journey may help you achieve a new and greater level of intimacy with your partner, your family, and certain friends. Your ability to overcome the crisis that may occur can strengthen you. You may make new and lifelong friends along the way. You can actively determine if and when your journey comes to an end. Give yourself permission to look at and consider all of the options that are available to you. Take comfort in knowing that the number of treatment options available to you is growing. The technology, science, and research are ongoing, and ever changing. As doctors gain a greater understanding of the realm of infertility, the success rates for infertility treatment are improving. There is no reason to think that this trend won’t continue.

There is no doubt that, wherever and whenever you emerge from your infertility journey, you will be forever changed. There is no way to know the outcome or what it will make of you. You will certainly be changed in ways that you had not considered when you began. The person you become as a result of this experience will be better equipped to deal with other life challenges that will undoubtedly arise in the future. The resiliency of the human spirit, and the potential capacity that we all have to cope with uncertainty and crisis, is something that has never ceased to amaze me in my many years of work as a social worker.

My hope and wish for you is that, wherever your own personal infertility journey ultimately takes you, it is a place you can accept and look forward from. Whatever our outcomes, we all need to find a future direction where we want and choose to go. My wish is that, wherever this leads for you, it ultimately offers you some sense of peace, belonging and fulfillment.

Find out more about Iris Waichler's book at her site - Riding the Infertility Roller Coaster

Rainbows for Kate

...for more info.

Post stolen from Bea. (I hope you don't mind.)

Friday, June 26, 2009

Making pita

Ever since we took Abigail to Kibbutz Gezer, where they had an activity that included making pita, I’ve been thinking that I’d like to make pita at home. I’ve done it once in the past and it came out great, but then I lost the recipe and couldn’t find another one that looked worth trying.

 Abigail rolling out the pita Abigail handing the pita to the taboon guy Pita Ruining the pita with chocolate spread. Yuck.

So today, when Ohad said that he preferred I use the outdoor barbeque to make chicken, I figured I’d finally use the cheapo wok we bought and make more pita. (You flip the wok upside down on the barbeque. Works like a charm.) Instead, I ended up finding a recipe that actually recommended you make the pita in the oven and I didn’t feel like standing in front of the barbeque anyway, so I made them in the oven.


The recipe makes 8. We were able to take 2 to freeze – the others all got eaten straight out of the oven.

The kids kept asking me how you make the pockets. You don’t. They just magically appear :-)

Thursday, June 25, 2009

I did hate those IUIs

Forbes published a story a few days ago about a study that tested results of couples who went through either three or six IUI cycles before moving on to IVF. I looked for the original article, which they said was published by Fertility and Sterility, but I wasn't able to find it in their list of articles.

According to the Forbes article, the couples were divided into two groups of 256 (3-cycle program) and 247 (6-cycle program). Couples from both groups who had not yet achieved pregnancy went on to up to six cycles of IVF.

The results were surprising - the average time to pregnancy in the 3-cycle group was eight months whereas it was eleven months in the 6-cycle group. In addition, the couples in the 3-cycle group saved on average over $2600. They explained part of this savings by the fact that more women from the 3-cycle group had singleton births (and births of multiples are more expensive). Overall, 67% of the couples in the 3-cycle group and 61% of the couples in the 6-cycle group ended the study with a baby.

I would be interested to hear why the researchers think that the success rate in the 3-cycle group was higher (if it is statistically significant) - does it have to do with being run down? Do the IUI cycles have a long-term negative effect on the uterine lining?

Monday, June 22, 2009

How much of us is our genes?

In 7th grade in Israel, the kids spend the entire year researching their families. They interview them one-by-one, create family trees, and discuss traditions and recipes handed down from generation to generation. The grand finale is an evening in which everyone prepares a family recipe and brings it to the school and then listen to a whole lot of speeches about what our roots mean to us.

Some of the speeches annoyed me. I know that there's a girl in the 7th grade who was adopted shortly after birth and there could be others, so statements like, "If we don't know our past we will never know our future" just sounded wrong to me. Do adoptees feel that the parents who raised them had no impact on their lives? And how about kids born from sperm or egg donation? How do they feel when they hear things like this? And then we can go to an even simpler example - what about a child who grew up in a single parent home because one parent just walked out one day? (I can think of several readers of this blog who were in that situation.) Does the fact that a parent was far from perfect mean that they don't have a chance to be amazing people?

I realize that schools can't ignore the fact that most children have two pretty-much-OK biological parents, both of whom they have contact with on a regular basis, but is there some way to make everyone feel like they're OK even if they don't know exactly what their genetic heritage is? Thoughts?

Friday, June 19, 2009

Something to do during the 2ww...

Comments are constantly coming in to an old post about the two week wait, reminding me just how awful it really is and how welcome distractions are. Here are two I recommend...

I love gadgets... and even more than I like buying them, I like window shopping, which, these days, means browsing the web.

Ever since my brother introduced me to Deal Extreme, I go there every few days to see what's new (they actually have an RSS feed specifically for this purpose). Today I saw this Sound and Music Activated Spectrum VU Meter EL Visualizer T-shirt:

It's a shirt that has an "EL panel with a Spectrum VU Meter" - meaning the LEDs in the middle of the shirt respond to sound like a graphic equalizer. I read reviews on another site and it seems like people really like it. A really nice thing about DX is that they offer free shipping anywhere in the world. Yup. Free worldwide shipping! I've ordered from them twice now and aside from one order being split in two (one sent immediately, the other a few weeks later), I've been really happy with them. Any item that you buy more than 3 of, check for the bulk discount (it's significant).

Another site with free international shipping (or what they call "free delivery worldwide") that I've heard is really worthwhile (especially if you're out of the US) is Book Depository. They have a feature on their homepage that lets you "watch people shop" - as people buy books, the name of the book and the country are displayed on the map. Cute gimmick :-) I love watching this.

How do you/did you distract yourself during the two week wait? What are your favorite shopping sites?

Tuesday, June 16, 2009

Testing fertility in the comfort of your home

About three years ago, a British company, Fertell released a home fertility test kit for couples - it includes tests for both the man and the woman ($89.99). The men's test was the first home test that shows whether the sperm motility is within the "normally expected levels needed to reach and fertilise the egg". Until then, the most popular home sperm test you could buy was the FertilMarq Male Fertility Sperm Test (also known as PreConceive) ($36.95 & free shipping), but what FertilMarq can tell you is just whether the sperm concentration is above or below 20 million sperm cells per ml. It doesn't tell you anything about the motility. Another test on the market is Micra Sperm Test - At Home Test for Sperm Count and Motility ($79.95) which got mixed reviews on Amazon.

The women's test is an FSH test, which is a good indication of ovarian reserve (i.e., whether the eggs produced are likely to be of good, fertile quality or not). This type of test isn't new - Estroven Menopause Monitor Kit - 2 tests ($18.10 + shipping, currently out of stock) and obviously it's important to pay attention to the sensitivity of the test. ETA - see comment below

I find Fertell's test for men fascinating. I wonder if it will bring around the revolution that they expect - more men will test at home to know if there's a problem. Is the reason that men aren't going to the lab because they're embarassed to carry the sample in (from my experience they usually just palm this off to the woman anyway) or because they're afraid of the results? Maybe it's a combination of the two and the Fertell sperm test will make it just a little bit easier for reluctant men to test themselves.

I do wonder what you do with the results? I guess you go to your fertility specialist (assuming the results are bad) and say, "My Fertell came out lousy." or something like that and then he sends you for a lab test. If the Fertell test comes out good & you end up pursuing fertility treatments anyway, you'll end up having to give a sample somewhere down the line.

I'm glad to see that there's continued work to make the life of those struggling with the first steps of trying to conceive easier. I hope that it will save a lot of couples a lot of time and heartache. They say it can save you up to a year. That's exactly right. If the test is poor, you can go ahead and make an appointment without ever trying to conceive. That does sound cool, at least in retrospect.

Too bad it's such an intimate item, otherwise it might quickly become a popular wedding present.

Monday, June 15, 2009

Endometrial Biopsy & Implantation

A while ago, I read a fascinating article about endometrial
biopsy as a method for improving embryo implantation
with IVF.

While researching connexin43 protein in women going through fertility treatments, Prof. Nava Dekel of the Weizmann Institute, an expert on women's fertility, discovered that after having had an endometrial biopsy (using an instrument called a pipelle), a remarkable number of women (11 out of 12) had become pregnant and given birth to healthy babies! The article goes on to detail several personal experiences (with lots of happy endings :-))

Rehovot's Kaplan hospital has been offering the treatment since 2002 . In their experience of about 1300 cycles, it significantly increased IVF pregnancy rates - 48% pregnancies in the group treated with pipelle & IVF vs. 31% pregnancies in the group who did just IVF.

A clinical trial being perfomed by Dr. Togas Tulandi at the McGill University Health Center in Canada is currently testing this and according to the dates listed, it should be nearing completion. The clinical trial took women without tubal disease, uterine pathology, severe male factor infertility or positive cervical cultures, but did include couples with mild male factor infertility or only a single fallopian tube. In this study, they are comparing the results of IUI with and without endometrial sampling. I'm curious to hear the results.

Thursday, June 11, 2009

My twins turned 13!

And 13 means that Matan became a Bar Mitzvah today. We still haven't decided when we'll celebrate his Bar Mitzvah (long story, not for a blog) but his father took him to the Kotel today, where Matan read from the Torah (thanks to my father, who taught him) and then they went on a tour and out for breakfast (brunch?).

Apparently we were sort of, kind of invited, but for many reasons decided not to go. My ex actually called my parents to invite them and they did go - and took pictures.

My 3 older kids (left to right - Matan, Lilach, Hadas)

Matan putting on tefillin.

Matan carrying the Sefer Torah, with my dad behind him.

Matan reading from the Torah.

Congratulations, Matan!!!