We saw the Raffles Hospital specialist Sheila Loh today; she said we were lovely but she doesn't know if she can help. She said the pattern I was exhibiting is that of declining ovarian reserve and the system is failing, from the second-round results. It is highly likely that my mum did have this defect, which is present in 1% of the female population and that I have it too, as I exhibit the characteristics of the last 10 years of imminent menopause, i.e. 40–50-year-old women. We can try to take DHEA for 3 months and then try IVF again, but it is a very long shot. Also, if we don't want to consider donor eggs, then it would not be wrong of us to approach adoption at this time, while trying naturally, because we have tried very hard already.
It was the most rational and perhaps the kindest advice a doctor has ever given me, but it was still much more emotional than I was prepared for and I teared up in her office, with the elderly nurse silently pushing me a box of tissue (which just made me cry more). It was also, as a friend pointed out, honest, in that she wasn't pushing us on what were ever more expensive and invasive options.
She pointed out that it wasn't so much cost or ability to redo IVF, as the percentage chance of success against the odds that we had. She also told me something interesting about DHEA and what it does. Basically, it pushes primordial follicles to become antral follicles (these then become follicles which may yield eggs) and in so doing, raises your AMH (which is secreted by antral and actual follicles). In so doing, it may actually bring forward menopause, which is fine, if you, like me, would have been early menopausal anyway and if it brings about results and pregnancy, which is, after all, the only real need for them eggs. There is no way to increase the number of follicles or eggs that you are naturally born with.
She also said that hubby's statistics, although not good, were not impossible. His morphology (shape) of 2% was indeed poor, but motility (speed) was average and it was compensated by a fairly high count, since both of these are percentages of the total. Basically, with such statistics, she has definitely seen natural pregnancies, meaning that if either of us didn't have the conditions we do, it wouldn't be this way.
We haven't yet seen Dr W, in NUH, or Dr Nair, at Mt E, and we will see them both, primarily to decide if going private is something that we eventually want or need to do, should we proceed to a 3rd IVF later on. I doubt that they will say much different. Nothing that she said was anything that I hadn't heard or contemplated before. But time and time again, I am baffled, left in wonderment sometimes, at how long it has taken to really wrap my head around this, to really accept and understand (and till this day, I'm not sure I completely comprehend) what we are going through and what it means or doesn't mean. I think the constant feeling of limbo comes from alternately being told to fight on (in IVF) and relax, just let it go or take it easy. Which are you really supposed to do? Is it even possible to be mentally aggressive and easy-going at the same time? I suspect, as we've gone through this process, we've alternately been one or the other at different times and it has only added to the weariness and frustration.
I guess when the facts are put to you gently and kindly, it is easier to accept them. And saying that you may never have a biological child, even though I have more than processed this thought before, is an out-of-body experience and it is tough. We love the idea of adoption, I guess we are lucky that we both always have, but it doesn't help to take away the edge of mourning a loss of something you always wanted also, or always thought you had. It may help, afterward, to take the loss of a dream, but for a while, it's so raw and fresh each time that it takes time to move forward, let alone for it to be ok.
I guess now that it seems we are getting to the tail-stages of what we can or should do, I feel some relief at drawing up loose ends. I don't know that it has left us any different to when we first started trying to conceive naturally, almost two years ago now and in some part, I do wish that the doctors had reached this prognosis much, much earlier. That it, in some ways, may have affected our results. The relief stems from the fact that even chasing it has become decidedly un-fun. At first, even with medical treatments, you might feel that there is something to be proven, if only to yourself, that it is possible or impossible. By now, I understand that it is what it is. I'm prepared to take the DHEA for three months and maybe even roll the IVF dice again. But in the meantime, I'm also happy to stop cutting myself so much slack, get back in shape and move on with what we want to do in life, or the family we want to get to. There should, after all, be a limit on how much getting pregnant should be about resolve. Resolve, surely, is also needed when you already have those kids, resolve to raise them and to do right by them.
In some senses, I am getting 'better' mentally and I don't know if that means stronger, more resilient, or just more indifferent. That means that where I used to feel a real kick of resentment, every time I saw a baby photo pop up on Facebook, I now feel almost nothing, except oh, good for her — of course it would be fast, she's really young — or even slight sympathy that parenting is hard and involves a lot of crying. I accept, for the most part, that if we adopted, there would be little intrinsic difference between our 7-year-old and any 7-year-old. If we are lucky, ours would be a little more worldly, a little more compassionate and a little more aware, which is not a bad thing in this self-centred world.
As I sat in the Raffles Medical waiting room, I saw some toddlers with their parents and I wondered why do children assume their parents love them? It occurred to me, as I was waiting, that if we adopted a little girl, for example, she would never expect us to give her back. Because to her, we would be the only parents that she ever knew. Her only concept is of one set of parents. Does that mean adopted kids are more aware that love is a choice? And does that make them more emotionally insecure, or can they find their strength and choices within that emotion?
(I am being very one-sided, it is also fair to say that every divorce-remarried-kid out there knows that love is an effective choice, but doesn't perhaps reflect upon that in a parent-child relationship).
There is an article circulating around on the web by Colin Goh (of the Colin Goh and Woo Yen Yen cartoonist-film makers-satirical writers about modern-Singaporean-drudgery-of-practicality fame), about having children and against the Time magazine article about how not having children was the way to financial and self-releasing freedom. I have mixed feelings about his article. While I am genuinely a fan of his humour and his thinking and I really did enjoy his update (who could not, when he compared his daughter's birth to Alien, with his wife barely in labour when a bloody foot emerged out of her clitoris), his piece was so tawdry and sentimental. It was so rehashed — I'm-so-tired-but-having-a-kid-is-magical-wonderful — that it felt like any other social piece of crap that waxing sentimental parents forward. It didn't glorify parenthood, it just said it was so worth it, which — isn't that what all time-immemorial articles have said?
Yesterday, after the conversation with the doctor, I sniffled to my dad, something that I very rarely do because I think he feels sorry enough that we have to go through this and I don't want to be told that it Can happen (seriously, people, I know that, how many times do you want to say it while I keep having negatives every month — sure, I can live till 35 before I give up hope that it's going to happen, while in the meantime it's the recurrent disappointments that are making me impatient and angry — what's going to change that, huh?), and I said, but what if it never does happen? To my surprise, he laughed, gave me a hug and told me to read the Time article. And that, people, coming from an incredibly conservative Asian father, who has only ever known the Asian way in his own life, is real progress. That is real freedom and real choice, and giving it to someone despite all your prejudices and experiences. Colin's piece, where he belatedly discovers that pragmatic drudgery isn't just Singaporean (oh boo hoo), actually wasn't socially progressive at all.
Not that any of us are socially progressive by choice. Who would choose to go this way?
