Wednesday, November 16, 2011

Flunking the Fertility IQ Test

I was on the phone with a woman who's writing a new book about infertility - she's a nurse who's been involved in treating couples for many, many years - and one of the things she mentioned as a goal of her book is that she wants people to get it into their heads that although technology is moving along, biology is still biology - and waiting to try to conceive until your late 30's and early 40's isn't always the best idea...

And then I came across this article by JoNel Aleccia about the fact that women didn't consistently answer correctly even some of the most basic fertility questions.

A few years back, I did research about women's estimates of their chances of conceiving each month. Interestingly, I found that the overestimated their chance of conceiving quickly, whereas they underestimated their chance of conceiving if they had already been trying for more than a few months. I never got around to doing the statistical analysis, but when I do, I think it will be an interesting read.

Tuesday, September 20, 2011

Woman with double uterus delivers twins

Wow. I just read this article about Andreea Barbosa, a 24-year-old woman who just became mom to twins, each born from one of her two uteruses. 


Again. Wow.

Almost as exciting as finding out I was pregnant

Seriously. I know it doesn't make any sense, but I pressed the "Send" button to send the first draft of my seminar paper off to my advisor and I got tears in my eyes. I've got that sensation of something big and exciting that's happening... Finding out I was pregnant (all 6 times) is the only thing I can compare it to (OK, perhaps with the exception of Nomi's pregnancy that included the shock element). There's also the uncertainty - will he like it? Will I have to make a lot of changes? But no matter how many changes he asks for, I know that I'm going to finally finish the degree I started back in 1985.

1985. I was 16 years old, after graduating high school a year early (I'd skipped kindergarten too). I moved to Israel on my own and went to the preparatory program for overseas students. After that, I studied nursing for a little over a year before I dropped out. I studied graphics briefly (completed a course) and then got an associates degree in printing (finished in 1990). But I had to go back to school after that... I took my first course at the Open University in the fall of 1995, just when I found out I was pregnant with Matan and Lilach. Since then it's been on and off for (wow!) 16 years.

My seminar paper (the topic of which is ethical aspects of commercial cord blood banking) was my last requirement. I still haven't submitted the final version to the university, but I'm most of the way there - and now I have no excuse not to move ahead with so many other things that I've put on hold. YAY!


and BTW - if you're considering banking your newborn's cord blood and you don't have a specific reason to do so, send an email or leave a comment. I can direct you to the information you need to make an informed decision.

Tuesday, September 13, 2011

A baby after cervical cancer

Dina Sela-Bracha and her husband became parents to little baby Keren last week (see article in Hebrew).

A few years a go, Dina had heavier than normal bleeding and discovered she had cervical cancer. The first medical center she went to, recommended a complete hysterectomy, including both ovaries. She decided to get a second opinion.

She ended up with her uterus and ovaries intact, but with a 1cm long cervix - not long enough to hold a pregnancy. When she found out she was pregnant, it became clear that she would need a special type of cerclage, which required her to fly from Israel to the US for the surgery.

According to the article, she was on bed rest from 36 weeks and then had a planned c-section. This is only the third case in Israel in which a woman carries a pregnancy successfully following recovery from cervical cancer.

Congratulations to the Sela-Bracha family!!!


Thursday, August 25, 2011

Starting school

In less than a week, 5 of my kids will be going to school.

5, because Hadas graduated last year.

Matan and Lilach are starting high school (10th grade). Abigail is starting 1st grade, Nomi - kindergarten and Yirmi is going into pre-pre-school.

The summer has been chaotic, messy, loud, HOT, expensive and full of cool art projects. We're ending it with a going-back-to-school ice cream party (any excuse for a get-together).

I can't help thinking how ready I am for the kids to go back to school and for my life to go back to normal (normal?) - a few hours without screaming, screeching, whining and fighting each day... and, as thankful as I am to have each and every one of my precious children, I really can't wait.

Tuesday, June 14, 2011

Rare news - frozen embryo transfer after death and donating a uterus

I've read two very interesting articles in the past two days.

In one, Keren Ayish, was battling infertility when it was discovered that she had a brain tumor. She successfully beat the cancer and then continued fertility treatments. Four years later, the cancer returned and spread. Keren had a miscarriage at 13 weeks and eventually died of cancer.

Before she died, she begged her husband to have their two frozen embryos transferred to a surrogate mother so that she could have a child after she died (article in Hebrew). After a 6-month battle with Israeli bureaucracy, finally her husband was able to get permission to take their remaining frozen embryos to be transferred to a surrogate mother in the United States. She became pregnant and gave birth to a boy last week. The baby will be named with the name chosen by the parents before the mother died.

In the other news story, Eva Ottosson, a 56-year-old mother from Nottingham is donating her uterus to her daughter, Sarah, who due to a condition called Mayer Rokitanksy Kuster Hauser (MRKH), was born with no womb (watch the clip here). I wish them a lot of luck and a successful pregnancy and birth!!!

Thursday, June 02, 2011

My favorite children's books

A while ago, I sent my internet friend, Bea, a list of books I enjoy reading to my kids. I've decided to share them here as well, since I am really picky and I would have loved to find recommendations like this all in one place.

The books I like have to be enjoyable both the the parent AND the child (otherwise, I kind of fall asleep)... most are funny or clever or touching or interesting - or a combination of a few of these. I left out books like "Cat in the Hat" that kind of troubles me; "The Three Little Pigs" that I just find boring; "Don't Let the Pigeon Drive the Bus" that I really like, but you can't just sit and read it, you have to talk about the pictures and explain what's happening, which isn't always what I feel like doing (requires too much unavailable brain power, at times). Let me know if you like my list, think I've left out other great ones, think ones on the list aren't worth reading, etc...

Most of the books have links to the Book Depository, where you can buy them with free shipping worldwide (and good prices to begin with - almost all of the books are under $10). Until Sunday, the 5th of June, they're having a 10% off everything sale, using the coupon code MAY11.

Here goes:

My Dr. Seuss favorites
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One Fish, Two Fish, Red Fish, Blue Fish - this one is silly and makes me laugh no matter how many times I read it.
Hop on Pop - same & good for early readers who can pick up a word or two here and there
Green Eggs and Ham - both a classic and a fun read

Eric Carle books - these are the ones I know and like best
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The Grouchy Ladybug - lots of repetition and a good story
The Very Lonely Firefly - slightly happier than the previous. We have the version with built-in sound at the end, which is a nice touch.

Good books to read to little kids (even under 3)
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I'm Not Feeling Well Today by Shirley Neitzel - a very simple story, but it builds up piece by piece so that the kids learn it by heart. (May be hard to find.)
The Little Engine That Could - also a classic - and my son, Yirmi, is crazy about trains (particularly Thomas the Tank Engine)
Leo and the Wallpaper Jungle - just sweet. (May be hard to find.)
My Friend is Sad - great for even really little kids - and short, clever and funny.

For slightly older kids (probably around 4-5 and up to 7 or so)
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Stone Soup - we have the John Muth version. Excellent pictures and a very enjoyable story
Caps for Sale - another classic, something charming about it. Circus Caps for Sale is excellent too.
Sylvester and the Magic Pebble - nice. A bit long for really little ones, but I enjoy reading it.
The Empty Pot - I found this touching - and also teaches a good lesson.
Madeline - might be more a girl book, but we enjoy reading it (and our best listeners are girls)
Mike Mulligan and His Steam Shovel Beautiful story.
My Lucky Day by Keiko Kasza - clever. (May be hard to find.)
The Princess and the Pizza - part of the 'fractured fairy tales' series. This book is both clever and hilarious and will give both you and your kids a good laugh.

Tuesday, May 31, 2011

So you think your life is hectic?

It probably is. When I was going through infertility, it was hard for me to think of other things. I focused my entire being on becoming pregnant. It took up most of my thinking-time, even when it wasn’t taking up my actual clock time. I was proud of myself for being able to do my work without screwing up, because I was so overwhelmed… When I finally got pregnant, I was focused on getting through the pregnancy OK and having a live baby. And then she was born and I was really over the moon, but hey, I had a new baby to take care of – which was just so much to think about and so much to do (but still less overwhelming than the infertility)…

Since then, I’ve had numerous ups and downs. Times when I have been so preoccupied with something that I forget everything except the absolute most important things (like picking up my kids on time or making sure there’s enough food in the house) and times when I feel like I have to find something new to fill my time. I’ve taken anywhere from no courses to 3 at a time, depending on how I felt. Sometimes I crammed as many work hours as possible into my schedule & other times I worked just a few hours here and there… Life has been so dynamic that I’ve had to adapt over and over again to new situations. I think we all do.

Some people have kept in touch with me through this crazy thing I simply call “life” and some have chosen to be bitter about the times when I didn’t call often enough or forgot to answer their email. I think those who understand that everyone’s life is hectic realize that sometimes they have to be the one who calls, even if it’s ten times in a row (or more). If the other person is happy to chat – keep calling. I find myself on both sides of this – there are people who ‘always’ call me and people who I ‘always’ call (there are, admittedly, more of the former). The people I’m most disappointed with are the people who’ve chosen both not to call and to be bitter about the fact that I haven’t called. Want to talk to me? Pick up the phone. Send an email. An SMS. Leave a comment on my blog. Write me a message on Facebook. Drop by my house… I’m not that hard to get in touch with.

If you’re going through infertility and you’re feeling overwhelmed, I think this is a good message to give your friends and family. If you’re a friend, keep this in mind. That’s what friends do. They don’t keep score.

Thursday, April 28, 2011

The reluctant egg donor - part 3

Quick recap: While still partly under anesthesia, I signed away what turned out to be 2 eggs which were then fertilized and transferred to another woman

After many nights of wondering, imagining what she/he/they would look like and be like, I decided that I was ready to know either way.

I made the call to the clinic, explaining the story, telling the nurse all the details she needed and asking whether I could leave my agreement to be reached in the file. She wasn't sure, but she said she'd get back to me in an hour or so.

I picked my kids up from school & my cellphone rang just as they were getting out of the car. I gave them money to get pizza (we'd just pulled up at the pizza place) and sat in the car to talk. She'd been able to look up the information and she told me that there was no pregnancy.

No pregnancy. No kid (or kids). No unknown siblings for my kids... No people to meet who might want to get to know me just because they share some of my genes... No fancy 'breaking it to the kids' talk either.

People I've told since have said that it must have been a relief to hear that. It wasn't really. I actually felt very slightly disappointed, but mostly ambivalent. What the knowledge has done is freed me from wondering what ever happened. I do wonder how I would have felt had there been a child (or children) and either we never made contact or it took a very long time...

Is it what I hoped for for many years? Definitely. Is it easier this way? Also definitely. Is this the best way things could have turned out? I'm not sure...


Monday, April 11, 2011

The reluctant egg donor - part 2

Had it been a terrible mistake to donate eggs? Was I putting my own cycle in jeopardy? When I called the next morning, 4 of my eggs had been fertilized and I remember the nurse telling me that of the 3 eggs I had donated, only 2 had been usable.

I had 4 embryos transferred on the third day post-retrieval. I've told the story before (see here), but I'll tell it here in brief again. At around 17 days post transfer, I started to feel bad, like I was getting the flu. I was supposed to wait to test until 20 days post transfer (that's how they did it then in Hadassah), but I'd been going in for tests every 4 days and I'm sure that they'd secretly tested my beta-HCG and not told me. So, at day 19, the nurse told me to go in for a test and that evening I found out that I was pregnant. (I actually had to go downtown to pick up the results by hand - and then take the vial of blood to another lab a few buildings away so that they could do a quantitative test - totally insane, if you think about it). After what the doctors suspected to be an early miscarriage of one embryo that implanted but never developed, I went on to give birth to Hadas (now 17-1/2) at 42 weeks.

Early on, I must have asked what ever happened with the eggs, but no one could or would tell me. And then, as time passed, I was both convinced that I would never know what happened and not sure that I really wanted to know.

There were nights that I would wonder if it would be better for me to know or not to know. At the different ages, I would imagine other Hadas-like people who had a part of me in them and didn't even know I existed. Mostly I came to the conclusion that the knowledge that it had succeeded would be unbearable - that it would be so hard for me to know that there were other kids around who looked like me, who were my kids' half-siblings (biologically), so I decided I would probably be better off not knowing.

Later on, as Hadas grew, I could imagine her running into half-siblings who she didn't know existed (especially when she started going to IASA - the top rated school in the country)... and even later, I imagined myself meeting the kid(s). I tried to figure out whether they would be interested in knowing about me, how my family would accept the whole story... it was clear to me that they wouldn't be mine in any way, just perhaps have some sort of interest in me and maybe feel some sort of connection to my other kids.

I found that imagining little kids as people you can't meet is much more difficult than imagining big kids in the same way. Kind of like once they're their own people it would be OK. I tried to get information on the laws concerning egg donors in Israel, but couldn't find any information. Would it be possible for me to leave information saying it was OK for them to get in touch with me once they turned 18 (only 1/2 a year from now)? Would there be any chance that they actually would? In a way, I felt obligated to leave that type of message, if at all possible, because I thought of myself in a similar position - not knowing who my biological parent is - and thought that if I decided that I wanted to know, it would be awfully nice if I knew that my bio parent wanted to get to meet me too.

- to be continued

Monday, April 04, 2011

The reluctant egg donor - part 1

It was an interesting coincidence when my mom asked me a few days ago (rhetorically) if I could imagine what it might be like to have a child out there, somewhere, and not know anything about him or her. And although she didn't literally fall off her chair when I said that I actually did know what it was like, I think she was kind of surprised at my answer.

It all started back in January of 1993. I was going through my second IVF cycle (the first produced a lot of eggs, but only one embryo) and the ultrasound showed a large number of follicles, meaning they expected a large number of eggs. Egg donation was in high demand and the laws either didn't exist or were unclear, so the best way was to get them from women already going through IVF cycles. The only problem being that women going through IVF cycles want the largest chance of pregnancy & therefore don't want to give up any chance at it...

I was 23 and I knew I might never be a mom. Never. I mean, not ever. Never being pregnant and never having the chance to hold my very own newborn baby. Never being able to breastfeed or cuddle my warm baby late at night... Never being able to walk down the street with a stroller or play airplane and make the baby crash straight into my hug...

Now, if you knew me as a kid, you probably know that being a mom was the one thing I most wanted in my whole life. I think there's pretty much nothing I wouldn't have given up to become a mom.

So, when the doctor who was treating me asked me if I'd be willing to donate some of my eggs, being careful to promise me that it wouldn't hurt my chances of getting pregnant, I thought about another woman in my position and this possibly being her only chance of becoming a mom... and I told the doctor I'd think about it. [He also tried to get me to pay him a large amount of money so that he would be the one to do my egg retrieval, but I said no. He ended up doing the retrieval anyway. I bet he had his motives for that...]

IVF is an emotional roller coaster. One day the follicles look great and they tell you that your retrieval will be in just 2 or 3 days. The next day, they (the follicles) didn't grow as quickly as expected and it's put off. You're constantly calling the clinic to find out what you've got to inject - and when the nurse doesn't answer the phone, you forget you'll miss the clinic before the staff goes home and then have no idea... [I bet it works differently now, maybe you get an SMS with your daily dose or something] and the meds make you crazy and bloated. And the anticipation of the anesthesia for the egg retrieval makes you nervous. And you're so invested in the cycle that sometimes you think that if it fails you'll never have the emotional strength to go through it again. And then you realize that even if it succeeds and you become pregnant that it doesn't mean you're going to end up with a baby... [There's more, but I think you get the point.]

So, my egg retrieval day arrived. I was put under general anesthesia and I don't know what I had thought about before then in terms of the donation, but I know that I hadn't made a final "yes" decision.

I have a vague recollection of waking up with a clipboard shoved in my face. "Sign here." And in those few seconds that it took me to sign, I signed away 3 ova. 3 possible babies.

Thursday, March 17, 2011

Home!

Dee's baby finally came home this week, healthy and doing great! He's still tiny, under 6 pounds, but gaining well.

I read a sweet article (Hebrew) yesterday about a woman whose son was killed when he was 22. At 47, she decided she was going to have another baby. She had 6 or 7 failed IVF attempts and finally gave birth to a son on her 49th birthday(!). The couple has 2 more children aged 24 and 20 (the baby is now 2) and she said that she took into account that if something ever happens to her the baby won't be alone in the world. The older kids, according to the article, have a close bond with the baby and the whole family feels like having the baby in their family has made life more worthwhile. Interestingly, the mother also mentions the things she's missing out on (comparing herself to her friends who are traveling, for example) and that it's more difficult to run after a toddler at 51... I felt the article represented well what motherhood at a later age is like.

Tonight on Israel TV (Channel 2, one of the two we get), they're showing one couple's story of infertility - from the promo, I understood that, as a last resort, they hired a surrogate mother in India. She became pregnant with their twins and just weeks later, the mother discovered that she was pregnant too. Two months ago, the surrogate mother gave birth to two boys and last week, the mom gave birth to another boy. Although the story fills me with joy, I can't imagine having to mother 3 small babies all at once :-) - I found an article about it here (Hebrew). If you wait after the 1st commercial, you can see the parents talking about the situation and their fears (Hebrew).
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In other, infertility unrelated, news, I sat on or too near a cat (a stray who adopted our home as hers) on Saturday and she both bit and scratched me. Apparently I'm having a bad side effects from the tetanus shot, since I've been sick ALL week (fever, chills, runny nose, muscle pain, sore throat, etc.) - either from that or from the antibiotics I'm taking...

I finished the last course of my degree and am now just 2 seminar papers away from getting it. Not easy to find the time to work on it.

I have gotten back in touch with my best friend from my childhood (from about age 8 to 14). She and I have led radically (and believe me, if anything, this is an understatement) different lives and she is now writing a book about her life. I get the new material every day in my email and I can't wait for it to be published. It is truly incredible that she's still alive (she says so herself).

Lastly, Hadas (my oldest daughter) got her driver's license, donated blood and even got herself an organ donor card. She's constantly having interviews for next year, when she starts her army service. I am definitely enjoying this age (17). Maybe the fact that she lives away from home (she goes to a boarding school) & we have almost no conflict helps...


Wednesday, March 09, 2011

Early...

In the past I've written about Dee and what I called "the arrangement"... here's a long-awaited update.

At the 24-week ultrasound, the baby seemed a bit small. They started to go for all sorts of tests to see if the doctors could discover a reason. They couldn't. As time went on, the baby's growth continued to be slow. Several doctors suggested that Dee and the baby's father terminate the pregnancy. Since the chromosomal tests were good and the ultrasound showed a well-formed baby, they decided to continue looking for a doctor who would recommend that they continue the pregnancy. The IUGR (intrauterine growth retardation) continued and the doctors began to prepare the baby's lungs for an early birth. Finally, at 34 weeks they decided he couldn't wait anymore and the baby was delivered by c-section. He weighed under 2 pounds.

It has been nearly 3 months and the baby's doing great. His weight gain has been good and his prognosis is excellent. They've been practically living at the hospital since the birth, but the baby will be released home soon. Dee, who was worried about being able to breastfeed since she had breast reduction several years back, has been able to successfully breastfeed and the parents are getting along extremely well - they just can't wait to take their little baby home.

Sunday, January 30, 2011

Although no one asked, I'll tell you why

My (not exactly) last post was about domestic abuse which includes, as I mentioned, not only physical abuse, but emotional abuse too. And although no one asked if there's any connection to infertility here's why I think it can be.

For any couple, there are stress points, but infertility presents additional and particularly challenging ones.

When a couple decides they want a child, sometimes both partners want the baby equally, sometimes not. When they fail to conceive, perhaps both partners are disappointed equally or perhaps one takes it much worse than the other. This is one point at which bad things can creep into a relationship. Imagine this scenario (and, sorry for assuming that the woman usually wants the baby more than the man, I've just never had the experience of being a man...) a husband and wife decide that they want to have a baby. They try the first month and nothing happens. Neither's particularly disappointed. In fact, trying was fun & they look forward to trying again. But nothing happens that month either, or the next month. Or the next. The husband is nonchalant and is sure that they'll succeed sometime. The wife is beginning to be stressed, because she always worried something would go wrong / heard about her cousin who went through inferitlity / always wanted to have a baby by the time she turned 30 / or a hundred other reasons. She comes out of the bathroom crying that her period arrived and her husband just doesn't get what the big deal is. A husband who expresses empathy despite not feeling what his wife is feeling is helpful. A husband who lets his wife know how ridiculous he thinks she's being about it is not.

Another point is the decision to go for testing. If the couple has decided to have a baby and it's time to go for testing (general rule is after 12 months for a woman under 35 & 6 months if she's over 35) and the husband makes this difficult or doesn't agree to go for testing. This lack of support makes the woman feel helpless - sure, she can go for testing herself, but isn't having a baby a "couple" thing? And what if he's got low sperm count or no motility? If the couple agrees that the wife will be tested first, cool. But if the husband objects to being tested once the wife is finished with her testing, or to proceed with necessary treatment, it can be a huge stress point.

A biggie - once you've gotten the results of your tests, whether or not they're conclusive, there can be blame from one partner, whereas the other partner may feel guilt. Guilt can make one more vulnerable and make any blame aimed at him or her that much more hurtful. (And, of course, let's remember that in the vast majority of cases, the infertility is not self-inflicted, so blame is completely out of place anyway.)

Another point is financial priorities. If treatment (the success of which is unknown) is expensive, one partner may not feel willing to give up other things instead (e.g., a bigger house, a better car, vacations) or to go into debt. If his or her partner feels differently, it's another major stress point.

As time goes by without a successful pregnancy, achieving a pregnancy can become an obsession that leaves everything else - even the marital relationship - behind. What happens to a husband whose wife is so obsessed with getting pregnant that he can no longer have a conversation with her about anything else? Where's the support that he expects to get from his partner when he has a lousy day at work?

These are just a some of the points at which I see relationships falling apart because of infertility - I'm sure there are many others. Have you felt any of these happen in your relationship? Any clever ways to avoid them?