When I was a very young girl, I had the notion somehow, that I would adopt one day. I don't know why I thought that, except that I was a fairly tomboyish kid, tall and strong and decently good at sports. I didn't have any notion of being liked by boys, definitely no certainty that I would necessarily get married. I had an equal perception that males and females were beautiful and attractive. The all-girls school I went to did nothing to dispel those notions as I had hardly any access to boys and before I reached college, I genuinely felt that I would be fine on my own and nothing that defined me depended on being with someone, or having a family. I was, in fact, proud of that, especially as the girls I knew melted away into far more feminine entities as we reached co-ed junior college.
Being at the adoption talk made me realize how jarring my own perception of myself was, in the context of a largely conservative Asian society. I may have thought I would adopt, I realize, but my parents certainly must not have; the young mother giving the talk certainly didn't and all the older people sizing us up did not. If you ever want to test your ability to stand apart from the crowd and to walk steadfastly in your own sight, I suggest you go to one of these talks.
There are several state agencies that are involved with the adoption process in Singapore, but as I had already realized, they are merely agencies, they are not regulators. They are like the Ministry of Manpower; if you want to employ a foreign worker, you go and take a test, or some sort of certification regarding how they should be paid, or how you should treat them. Then, you are on your own, or have to liaise with a private agency to actually find this worker. Adoption is exactly the same. I had thought that I would be getting procedural advice, but instead, what we got was a 20-something-year-old counsellor (with two biological children of her own, no less), telling us things about how parenting was an emotional process. The talk did nothing to pacify anyone's fears about birth defects or genetic issues, or just plain being swindled by an agent or the legal process of international, cross-border adoption. It still seemed like a process rife with lemons and car agents.
If I had one takeaway, it was that this process would be longer, harder and more expensive than I thought. And yet it was there, the certainty of being a parent was stronger in that session than any gynae clinic I'd ever been in. It was stronger even than sitting in Planned Parenthood, back in those blustery Boston days.
Was it because I was changed? Older and more ready? (Indeed, there are many days, weeks when I don't feel ready, nor do I want to sacrifice my lifestyle, income and flexibility). There are also many times when I feel far too old and that I would have been more energetic and suited for this when I was still an invincible, if irresponsible twenty-something year old.
But sitting in that shabby little community center room with the temporary folded tables, so supremely out of place with thinking about your future children or family, I felt like she was out there somewhere and she was not wanted. I had never felt how much I wanted her. Maybe it's true that you never feel how much you want this child until you know she is already there, already exists. Maybe clinics are just too sterile, too medical, too clinical, for this imaginary, unborn child to seem real. Anyone who thinks approaching adoption should be purely a happy experience and won't make you cry just from the sadness, the emotionality and the reality of what you and these kids are going through, is just not thinking.
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Well, here goes nothing, I reminded myself, as I checked in for the Day 8 scan. Dr N had mentioned before that a good result on this, a normal-person result, would be in the high teens. I might see two or four follicles; I hope for the follicles at least, that I had seen before on the antral follicle scan. I also knew all too well that they might not contain eggs. Those eggs might not fertilize.
As soon as it swiped across, I knew we had follies. I caught my breath, not with hope, but at how many there were, more than I had ever seen before. "I am impressed," smiled Dr N. "16 follies!" When I saw my AMH and FSH bloodwork, I understood. The AMH had shot up to 12.1 from 5.9 and FSH (which measures how hard your body has to work to summon follicles and ovulate) came down from 11 and 15 at its height, to 7. No wonder I had responded, like a normal person, to the meds. I felt amazed and not for the first time, I wondered at the predictability and the strength of these treatments, considering that other than the fierce acne breakouts, I felt little different, both physically and mentally.
Day 10: While waiting in the clinic, I struck up a conversation with a girl going through the same process and we commiserated about how painful the Orgalutron injections were, given the more blunt needle and more viscous medicine. How many follicles do you have, she wanted to know. About 15, I said. Wow, she replied, that's really good!
Bad news. They are scattering. Which is to say, the follicles are growing at vastly different speeds, some are approaching maturity, while others are still small. This isn't good because the lead follicle will be ready way before the others are and that means that despite the initial number, we won't get many after all and the cycle may not be usable. My heart sank when Dr N. said this and at his furrowed frown. I'm trying to make it through the second week. I am so tired, and so restless.
I emerge from the clinic, holding back tears. I pass an older Eastern European lady who is sitting regally in a chair, in a deep cobalt blue dress and she smiles beautifully. It will be ok, she says to me. I only had two eggs and I'm pregnant with twins. IVF really works, she says, you just have to keep trying. I hope that's a good omen.
Day 13: Good news, sort of, they are all on track and growing. The smallest ones will probably not be usable, but Dr N's plan is to forego the largest, lead follicle (which will be too mature for use) and concentrate on the cluster of 5-6 follicles that are behind the largest one. I don't really know what to think and I'm overwhelmingly just relieved that he says they will be ready for retrieval at least a day before we leave for our holiday, or else not at all. He has managed to forget, despite being reminded at each visit, that we are going away, but he reminds us again that my uterus lining is too thick for a fresh transfer and it will have to be a frozen embryo transfer (FET). I'm ok with this, as I know they have a higher statistical chance of working, particularly if they wait to do a Day 5 transfer as opposed to a Day 3 transfer.
The time is startlingly close and I have to go through the scary process of dressing in the gown, going into the operating theatre and blacking out. You would think I would think this a breeze now, but I am surprisingly nervous. The staff are really great, well-mannered and not intrusive; the older anaesthetist so calm, well-spoken and good-looking that Z. whispers maybe if we have a boy, we should give him the same name. I remember waking up, as if out of a deep dream and Dr N's beaming face appears in front of me. "We did really well!" he says. "We got 12 eggs!"
We rested in the same room as another couple, a lady that I had been seeing in Dr N's waiting room these past two weeks, whom I surmised was an older Indonesian woman. Her tall husband was loud, had short shaved hair and a penchant for red-checked shirts. She had a short, sensible haircut and a quiet, sad look about her. She had one child, whom they kept bringing into and out of the room, and presumably, was trying for a second. She had a very small number of follicles and when Dr N came to check on us, I heard him say quietly that she had one egg.
This is where people always say, it only takes one. But I want to say that at her age, with possibly a similar and the highest possible dosage, unless you have absolutely no issues, there is no way, almost no way you can make it through the process on one egg. Sure, that one egg might be destined to fertilize and become a sticky bean, but this idea that IVF is a great leveller is completely not true. One is also what you would have produced without any meds at all.
Behind the curtain, I heard her husband ask Z. how many eggs I'd had and his awkward pause, before he said, 12 eggs. Oh, said her husband, that's a lot. But, Z. added quickly, we'd tried before and had much fewer. One could also add we don't know how many will work — but there was no point. There are no statistics, no sympathy, no empathy and no consolation for how incredibly horrible, lonely and desolate it feels, whether it is just to go through and be subject to this process, or to have others doing better than you, to have that very little hope and the expectation borne out of all you have tried and risked, be quashed by a bleak reality. To know that it is possible, just not for you. I know how it feels and I felt for them, behind that quiet curtain.
The recovery over the next couple days was tough and not helped by the mere two days in between the surgery and a long overnight flight. I had thought, from my previous experience, that recovery was a breeze, with a little bit of menstrual-like cramping; I now realize that it differs with the number of eggs they actually retrieve. In this case, there were a lot more eggs retrieved and the pain and discomfort was a lot more. It was really not comfortable, but we were elated, especially by Dr. N saying to us that he hoped we could do a January transfer. January! It hardly seemed possible, and yet it seemed to be happening. We hoped so much that this time might be different, it might have worked, we might get something. We seemed to have, at least, a reason for hope.
The embriologist called and told me that out of the 12, 11 eggs were mature enough to be utilized, which really does attest to the importance of a proper stimulation process, and 8 eggs have fertilized, which is a good result. I know that we might be down to just much fewer in the next days, but I can't believe our luck is holding and Z. is happy, maybe just really relieved that his part hasn't let down the side. He runs around the house singing 'reproduction, reproduction' while holding his hands in a conical shape above his head and it makes me laugh out loud (and wonder about these genes that we are perpetuating). We are getting on a plane to Budapest, Vienna and Paris in 12 hours and I can't wait. I'm just praying; I don't want our dream run to end.
