Nothing to update, it's been a slew of festivities, Christmas, my brother's wedding, Chinese New Year, so I've been distracted. I've been travelling for work, trying to squeeze work out so that I can feel less conflicted later in the year. I've had to tell my boss about the IVFs, if we plan to continue this year. You know, somewhere early in these last two years, I imagined telling my boss that I was expecting, crafting out what responsible things to say. Instead, I had the uncomfortable talk about what was wrong and that I might need flexibility from work and scheduling, to try to make medical progress. I even dreamed about telling my parents, or in-laws, or ex-boyfriend (does that sound Freudian, I swear it wasn't like that, they are all happily married with several children each). There was a time when, for a few weeks each month, I would start nesting and stop exercising, and would avoid buying clothes, just in case they might not fit again. I never thought it would be like this.
These last few days, somehow, have been emotional again. Partly because I'm just past ovulation in the current cycle but I know that it hasn't been successful. I hope, of course, but in my head, I know that even with a regular cycle, it isn't happening. And that makes me mad and sad.
I contacted our doctor about my concerns regarding a new cycle — what if they are all crappy quality eggs again, and what are we doing to improve the quality? He apparently went back over our file and suggested that the hubs do an advanced sperm analysis to test for fragmented sperm nucleus, to rule out that it is a reason for the high degree of fragmentation in the embryos. This is a more expensive test (of course it is).
That also made me mad and sad, but more importantly, having done some research, I found that 10% of infertile men have it (which is a low %) even though they would test fairly normally on a normal sperm test and, second, it tends to come hand in hand with fertilization issues (which we didn't have) and, third, it is merely diagnostic, meaning that nothing can really be done to change anything if you have this information and lastly, the treatment is like take more Vit C and Vit E, which I really don't think is an issue here. Also, the embryologist felt pretty confident the previous time that it was an egg quality issue and she had observed to me even at fertilization that the eggs seemed small and dense. Lastly, I felt this should have been cleared out of the way earlier, as opposed to two weeks from our next cycle on remnant DHEA, which I haven't taken, on medical advice, since December.
Although I understand the need to rule things out, sometimes it feels like these are just expensive hoops to get us to jump through, for no real purpose? In our case, this is also how the entire IVF process has felt. Sometimes winning is all there is. Otherwise, it's just an unpurposeful waste of time, pain and money.
I emailed a clinic in Thailand, which is meant to be one of the foremost in Asia for IVF. This is largely out of desperation, as many people had quoted to me about friends who'd failed here and succeeded there. But here's the rub. How did those friends of yours fail in IVF? Did they fail in implantation? Did they fail in producing embryos? Or did they, like us, fail in egg production and then in embryo quality, without actually transferring anything in three rounds? If they merely failed in implantation, then perhaps with a surrogate, or with a different protocol, they might succeed. If they are like us, well, then maybe it's so far behind the curve that the kind of reply you would get is similar to the unhelpful one that I received back (admittedly, in a prompt and kind fashion).
"Dear so-and-so, you are only 30 now (this doctor apparently can't do math) and on your last IVF round, you had around 15 eggs, even though the quality wasn't so good. I would still give you around a 50% success rate. If you have IVF done with us over two rounds and are unfortunately unsuccessful, we strongly suggest that you use donor eggs."
I wonder, for all those friends who recommended me to the next clinic, or miracle cure, whether they had ever stopped to consider whether their example of 'friend who succeeded' was quite as far gone as to be recommended donor eggs. My guess is no, since it is seldom infertile friends who dare suggest treatments. Or whether doctors who so glibly suggest donor eggs, accelerate it as just a method-that's-gonna-work. Especially in Singapore, where there is no monetary incentive or system for donor eggs, thus, we have a bank but it is empty. You have to find a live, parallel donor, in a very small, affluent country, and then a doctor who would be willing to supervise this tandem process, which obviously, doesn't or rarely happens.
Yesterday, I felt mad and sad, and this morning, I woke up feeling much the same way, because my mother rang me up and part of the call was her constant refrain to me to "relax". Do less. It's so irritating. I told her that is a fairly simplistic reason for a 24 month wait and empirically crappy embryo quality. But she was like, oh one day you'll be very surprised, just relax!
I really felt like cursing. My mother, I often suspect, had endometriosis (she more than I, had all the classic symptoms) and she struggled for four consecutive years after conceiving me, at a younger age than I am now, to try for my brother. She was menopausal at 39, maybe four years after her second birth. She is the last person who should be naive about my experience of poor hormone levels, or my need to pass time, or make the most of my pre-menopausal thirties.
She then proceeded to tell me, excitedly, to check for gluten intolerance because she just watched a TV show which suggested this could be a cause for unexplained infertility and this woman who owned a bakery stopped eating cakes, and got pregnant. As we know, there are also chain-smoking drunks who get pregnant, so it's not exactly correlated. I also don't think I have gluten intolerance since Asian diets aren't particularly high in gluten, I don't eat much cake, despite baking a lot of it, and perhaps more scientifically, I don't have any symptoms of gluten intolerance. You know, symptoms, those things that usually indicate what the causes might be?
There are two parts to this experience, the first is not having conceived after two years. Now, this part feels lousy, particularly when you feel stuck in time while everyone is progressing on. It can also feel empty, because whatever you fill your time with doesn't feel as right, and it can feel sad when you consider that maybe, you won't be able to have a biological child. I would also lump having to deal with other people's reactions and suggestions in the negative category. However, there are also upsides to this part, primarily the freedom and choice of your time, the lack of liability and the variety of your experiences. Not having to deal with sick, infectious, whiny children. Sleeping late and not having to pretend to care about music lessons or saliva rash. That kind of thing.
Then there is the physical IVF, or seeking medical help part, which involves many hours of waiting, pain, needles and hope, coupled with disappointment. There is Nothing Good about this part, not a single part of it is good and for us, with nothing to transfer after three tries, it is particularly pessimistic, if not devastating. This is where people who say things like, but you have financial freedom and time if you don't have children, should get a clue, that if you don't have children and are trying to have children — the process will quickly strip away just as much of my finances and time as your live children do to you. This is also where people who say everything happens for a reason and to teach you something, should get real that there is no real reason for jealousy, loss, or self-pity. Only people who are relatively fortunate and who already have children have the luxury of saying BS like that.
Why would you tell someone who has to go through all this trouble and pain that they are doing something simple wrong, like relaxing? Even if that is true, which it is probably not, it is totally unhelpful. For someone at their wit's end, it must be one of the most frustrating things to hear and such advice is easier said than done. First, we have certainly had more than our fair share of relaxation, because two years is more than enough time for you to be relaxed and not relaxed. And second, like anything in life, maybe it would happen. And maybe, it would not. I would think you can't purposefully determine your fertility, any more than we can control our heartbeat, and yet we take medication for heart irregularities, we don't just Relax them away.
So, I told her, as calmly as I could muster, that compared to many young people, I consider that I am already very sedentary, have more free time and don't go out much, all of which are true. I asked her what her practical solution would be for filling up empty lives, or to feel better, if we were just to stay at home, would she suggest that we can still go running, for example, or did that fall under not relaxing, and told her that generally, young people are more active compared to old people. And do you know what she said? She compared us to my brother and sister-in-law! (Who, it's true, lead far more dissocial lives). And to my cousins, both of whom have two young daughters and hence, are as limited as most young parents should be.
Most days, I can be cheerful and positive. I can believe in affirmations like we deserve this and we are putting in the right energy to be at the right place at the right time and I am determined that our luck will change, because people who are successful with other aspects of life like business, home and relationships will speak of how they had to really believe in it, and visualise it carefully every day. But then there are some other days, sometimes when, it is enough to be hurting, without having to deal with nitwits. Except when the nitwit is your own mother, then I guess there's not much to be said.
I know that this is just PMS-driven unhappiness and that my mum meant well and was just trying to comfort me, to be helpful and was perhaps unthinkingly carried away. She would hardly be the first to rush at miracle cures and clinics, and I have done it myself. It is often the closest to us that bear the brunt of having to deal with the bad days. And to be honest, I guess it grated because I want to believe her. I want to think that maybe one day, when we are relaxed, or unrelaxed, or old, or young, or believing or disbelieving, it will just happen. Hell, I want to believe that it will be possible for us, even if the whole world crashes and burns, or ices over.
My mother does have a weird way of dealing with it though, one that I see mirrored in many people around me. It's almost a denial that it would not be possible, an inability or unwillingness to contemplate doing anything tangible, rather than waiting on the intangible. She is always reading the media advice about infertility, but she doesn't, for example, offer to make red date tea or boil the TCM herbs, which to my mind, would be far more helpful. She quotes examples of people who have succeeded, but till today, has no concept of how IVF works as a medical process or how much intervention it entails. And she's not the only one. It makes me question whether I've been too good at down-playing my own life experience and hidden behind too many smiles. Perhaps she simply doesn't realize that if I didn't push myself to do things, to go out and socialize, I would fall into a deep depression that just involved curling up in bed and sobbing at what keeps happening.
And sometimes I wonder if I'm the same. Am I just grasping on to this hope, without tangibly taking steps forward, whether that involves donor eggs or adoption? Is it because of some sappy sentimental reason like I'm not ready in my heart, or because I hope that time will just work this out too and slip through a diamond egg in a vault of low-quality ones? Is it because to take action seems so final, whereas to hope doesn't involve making decisions about the right time, or the end of time?
We filled out the papers for a home-study today. These are the questions used to evaluate you for suitability for adoption, after which, if you check out okay, they come to visit your home and then give you the green light to adopt. Of course, with stoppages of time along each stage of this process, the whole thing could take awhile. But it is a start, one that I realize not everyone would have to, or be willing to contemplate. I don't know where I'm going with it, any more than I knew, at the start of this awful journey, how far I'd have to, or be willing to go. And I'm not saying that for sympathy, but rather, because it's the truth.
I don't want to be, like the NYT Motherlode page so eloquently put it "like an addict, doubling down on a bet when I knew the odds were against us. So when the first round went bad, we did a second round just to be sure". And similarly with adoption, I don't know that I know what I'm doing, or when. If I feel relieved, or humiliated, or excited. I don't know what to tell this child and I'm terrified that us being their parents won't ever make up for knowing your parents gave you away. But since the process will take awhile, I want to be prepared.
Luckily, the hubs and I had a lot of laughter filling out the forms, he of course, didn't take much of it seriously. On his strengths, he wrote, 'very strong'. On weaknesses, he wrote, 'Sloth', on mine, he wrote "poor spelling". In safety hazards at home, he wrote, 'swimming pool, stairs and a toddler-height coffee table'. On activities you intend to do with your child, I wrote 'homework, arts and crafts, baking, tennis, travelling, skiing', which he crossed out for 'swimming, discipline, imaginary stories'. As he filled in the gender preference as none, he looked up at me and said, you know, if we never have any children, I still love you so, very much. Oh, that broke my heart in ten different places.
I was prepared for tough, or personal invasive questions, but the question that shocked me the most was the last one "what books have you read about adoption, please give the title and author of two books". You have to read books about adoption? I haven't read any books. Nobody makes you read books before you conceive (although they really should, many people should never have been allowed to be natural parents). But then I thought, well, why hadn't I thought to read any books? It makes sense that you should, after all, you wouldn't expect anyone to just hand you a child.
And that made me mad and sad too. Because nature does, doesn't it? For some people, IVF or medicine does, too.
