Friday, April 29, 2011

Myth: Only "Older" Women Have Egg Quality Issues

It's National Infertility Awareness Week! And to celebrate, RESOLVE: The National Infertility Association has created a Bust a Myth Blog Challenge to raise awareness about some of the most common infertility myths. Accordingly, I'm dedicating this post to busting one of my favorite all time myths: Only "Older" Women Have Egg Quality Issues

In the land of TTC, once you hit 35 you might as well start planning your day around the Price is Right and making dinner reservations for 5:30-- because it’s how the reproductive medical community is going to view you: OLD. Of course it is fair to say that we’ve been warned of the tragedy that befalls those who are endearingly referred to as “women of advanced maternal age.” More and more clinics are now urging women to make use of egg banking services and at least one company has now come out with an over the counter FSH test-- (really awesome for us infertiles who already pee obsessively on sticks “just to be absolutely sure” that we are not pregnant--now we can follow up the initial $15.95 test with a second $15.95 test that will confirm that we’ll likely never get pregnant). 

But I digress. What nobody ever tells you is that not only do egg quality issues affect those +35, but they also affect the -35 crowd as well. And even…ready for this…the -30 crowd too! Though it is not nearly as common, it does happen, and I can tell you from personal experience that nobody (including the medical community) is prepared for it when it does. So what should your doctor’s response be when an FSH test reveals that you've tested at an above normal level at a below normal age?

A.       Nothing. Medical providers should assume it is just a flawed test, not say anything, and not suggest a retest until the patient has spent several thousand dollars on failed treatments that were completely inappropriate for someone with high FSH.

B.        Repeatedly ask if you are absolutely sure you never had chemo or were exposed to radiation when you were younger. (Because clearly these are the kind of things that one forgets.) 

C.        Repeatedly refer to you as “a 45 year old just for the sake of discussion.” (WHY? Why can’t I be the twenty-something year old who happens to have very high FSH levels? Regardless of egg age there are a lot of other differences between a woman in her twenties who is trying to conceive and a woman in her forties who is trying to conceive.)

D.        Prohibit you from cycling in the regular IVF program because you don’t meet their FSH cut-off (i.e. you will royally screw up their clinics statistics) but eagerly suggest that you enroll in their donor egg program (i.e. you will totally boost their statistics). Oops…bad call on their part. Even with a 95% chance of success I still royally screwed up their statistics.

E.         Acknowledge the uniqueness of your position. Recognize that support options that may be helpful to a woman in her forties may make a woman in her twenties feel like even more of an outsider (i.e. donor egg support groups). And suggest alternative family building options that have a high chance of success but are not completely cost-prohibitive (i.e. using a surrogate and egg donor in India!!!)

While Options A-D are all a part of what makes my journey mine, I hope that by bringing awareness to this myth, others will have the courage to seek out an Option E approach... even at an age, when 5:30 still means happy hour.

Monday, April 25, 2011

A Most Wonderful Easter Sunday...

A Most Spoiled Dog

Cutest Niece Ever Acting Cute
Brother-In-Law #1, Mom and Duane

Sister #1 a/k/a Best Friend Ever and Me

Sister #2 a/k/a Best Friend Ever (Sadly Losing to Brother-In-Law #2 at the Egg Game)


Because Sometimes One Basket's Just Not Enough

Look! No Hands!

Thursday, April 21, 2011

Choosing a Coach for the Baby-Making Team

Amanda and Dustin, this one's for you...

I envision my children’s birth much like a celebrity awards show. Someone announces that I’ve finally won (after years of unrealized nominations), I am handed my “prize,” and finally, I whip out a mile-long list of the names of people I’d like to thank, without whom it would never have been possible. 

Over the past three years the list has gotten long. Very long. While we knew early on that this baby-making stuff wouldn’t exactly be the two-person one-bedroom affair that we were told it would be in middle school, we never could have imagined just how large our “team” would become. And while choosing the right players is obviously important, choosing a coach is equally so. While it’s clearly a very personal decision, I think it is helpful to hear how others went about the process. The following are the three main factors we considered when choosing our doctor in India (in order of importance to us).

Communication: In the U.S. I’ve experienced both the tiny local clinic where it seems even the janitor knows your daily estrogen levels to the giant baby factory where receiving a call from your doctor would have been like receiving a call from the big man Himself. Both have plusses and minuses. However, for this journey, being so far away, I wanted to go with a clinic with a more personal feel. So that eliminated some of the biggest clinics (despite the fact that for the most part they are more established). Additionally, I spent the past year reading others’ blogs. I noted what people thought of their clinic’s communication and whether they always felt in the loop. I love the blog opinions because while it is easy for a clinic to hand you a reference of someone who had a great experience, the blogs tend to tell the real story. Finally, I started contacting the clinics. At this point, SCI came out a clear winner. SCI has international case managers who responded to my emails like, yesterday. Plus they have been through the experience themselves. I love this. With regards to using an agency, I am not a fan of intermediaries. I like to get my information from the source and I often feel that the more people involved, the more likely information is to get misconstrued- sort of like that childhood game of “telephone.” So, for me, using an agency was never an option. 

Care: While the US requires that clinics report their statistics through a national database, there is no such requirement in India (as far as I am aware). Regardless, when I cycled in the US using donor eggs, my clinic gave me a 75% chance of success on the first try and a 95% chance of success by the second cycle. Guess who was still beating the odds the fourth time around? Needless to say, I’m not too hung up on statistics. However, since we’ll be using a surrogate for the first time, I was concerned about the surrogate care. I liked that at SCI, surrogates are housed nearby in apartments with their families as opposed to in a dormitory without their families. My family makes me happy. My bet is that having their families around makes them happy too. In my opinion, happy surrogates equal happy babies. 

Cost: While cost was obviously one of the main reasons we decided to pursue surrogacy in India in the first place, it didn’t really factor into my decision when choosing a clinic. For the most part, I didn’t see that much of a cost variance between clinics if working with them directly. So for me, a few thousand dollars more was worth it if the clinic came out on top with regards to communication and care. 

Finally, while it is imperative that you do the research and assess your options, I don’t think ANYONE ever feels confident going into this process. Eventually, you just have to make the leap. Frankly, we were leaning towards SCI when we found out that one of our top two donors there had already been reserved for the fall. Let’s just say it lit a fire under us to reserve our other favorite. We found this out around 6:00 am and spent the rest of the day racing around (ok my amazing husband spent the day racing around) to wire money to India to secure the other donor. After an exhausting day, I came home and assessed what we had done that day. Had we really just wired 150,000 rupees (it sounds like so much more when you say it in rupees) to a clinic we’ve never seen, in a country we’ve never been to, to reserve a donor we’ve never met, for a procedure that we don’t even have a contract for yet??? And then up popped an email from SCI, letting me know that everything had been received, and that the donor was reserved, and that for now, all was well in surrogacy-land. And as the anxiety slowly dissipated I realized that regardless of how apprehensive I was feeling about the process, I was completely confident we had chosen the right clinic.

Sunday, April 17, 2011

This is Not a Blog About Marijuana and No, We are Not Pregnant Yet

Choosing a name for the blog was a little more difficult than I anticipated. As I was mulling over ideas that could even begin to capture the spirit of this journey, Robert Frost’s poem “The Road Not Taken” came to mind. I mentioned a variation of this title to Duane and the following debate ensued:

Duane: That’s not the title of the poem. It’s “The Road Less Traveled.”

Me a/k/a the Former English Teacher: No, you’re wrong. It’s a common misconception. While the words “less traveled” are used at the end of the poem, the title is “The Road Not Taken.” Go ahead-- google it. I know I am right. 

And of course we all know how the debate ended because I am the wife and we all know that no matter what-- the wife is always right. Nevertheless, to compare this journey to a road not taken would be completely inaccurate. In fact, had it not been for others who were willing to travel it before us (to whom we would like to publicly extend a GIANT thank you), we would never have even found the road, let alone had the guts to venture onto it. So in the end I decided that “less traveled” was far more appropriate. I then emailed our dear friend Asha for the Hindi translation of the word “road.” The following conversation ensued:

Me: Duane, Asha told me the Hindi word for “road” is “rasta.” I’m going to call the blog “Rasta Less Traveled.”

Duane: Bern, do you realize what most people in America are going to think your blog is about when they see the title?

Me: Duane, I get it. I don’t care. The blog is to educate EVERYONE about the unique path that we have chosen. And if it happens to attract a few people in search of some less-oft smoked marijuana, well then I guess, all the better.

Additionally, I would like to state that we are not pregnant (yet). I have received several emails, primarily from local friends asking if “she, I mean you, I mean, uh, you know, you guys are pregnant right now?” Big sigh….We wish! Because frankly it would be SO easy to start this blog when all the fun, good stuff starts happening. However, I am not a cheater and as a result, I have started the blog from the very beginning with the purpose being threefold: 1) to raise awareness of this unique family building option, 2) to serve as our children’s story so that they can understand just how desperately we wanted  them (despite possible confusion at times regarding their unique birth stories), and 3) to keep our friends and family updated on our situation and occasionally relieve me of having to explain why I am just not up for attending their [insert baby shower, child-centered event here]. Accordingly, because it is just as important for intended parents to hear about the good, the great, and the truly magnificent, as it for them to hear about the bad, the ugly, and the down-right miserable, and because I don’t think that reasons two or three could be accomplished without sharing the WHOLE story, I have decided to start the blog now…at the very beginning of the road.   

Friday, April 15, 2011

Learning to Not Think Like a Lawyer

For the past three years, I have heard time and again that the ultimate goal of law school is not to acquire substantive knowledge, but rather to learn to “think like a lawyer.” As my graduation date now looms a mere three weeks away, I am confident that if this was truly the goal, then alas, I should consider myself a success. My husband would probably tell you that I had a head start, given my type-A personality and the fact that I can spend a week in Vegas without having the slightest urge to gamble, but rest assured that whatever existed before has increased exponentially. Yes, as a result of three grueling years of law school, it’s nothing but clear, calculated, full risk/cost assessed decisions for this almost-attorney. With the exception of one…

WE’RE PURSUING SURROGACY IN INDIA!!! Now granted, I have researched and blog-followed and forum-stalked the adventures of many, many others who have gone before us, but the fact is that try as I may, the components of this particular decision are simply incompatible with my newly-programmed lawyer-thinking brain. It is extremely risky and impossible to cost- calculate, and if it does when it does work, the entire pregnancy will take place roughly 12015 kilometers or 7466 miles or 6488 nautical miles away! Are we really going to do this?!?! The answer is yes. And the reason is simple…we have truly exhausted all of our options here in the US. At the ripe old age of 29, I have lost four pregnancies, engaged in various “novice” fertility treatments, and finally endured the ultimate insult- three and a half failed donor egg IVF cycles. After taking a break we began looking at other options that neither involved my “mature for their age” eggs or my inadequate egg carton. After considering adoption (long waiting lists, lots of money up front and a thirty-day return period) and US surrogacy (costs totaling $130K+) we decided to pursue surrogacy in India. So without further ado, I present to you OUR story…