you are not alone.

I spent most of my twenties fearing the end of my fertility, in part because I knew my mother entered menopause early. I also knew it took her mother, my grandmother, nearly a decade to conceive my mom, and that in the end she was only able to do so with the help of whatever fertility drugs were being prescribed in the early 1950s.

And yet, when my husband and I first received our infertility diagnosis, our RE declared me "fine." The problem, he said, was the testosterone supplement my husband's urologist had surgically implanted in his thigh: it had rendered him sterile.

The relief I felt in the time that we waited for my husband's sperm to come back is indescribable. I was fine! I could make a baby! According to the RE (the one I've not-so-affectionately dubbed Dr. God Complex), a year wouldn't make a difference in my fertility - in his mind, the line between 35 and 36 wasn't as dire as the charts seem to make it.

Ten months after being declared "fine," I was rushed to the ER for the recurring pain I had nearly every time I ovulated. I'd been complaining about these episodes for years, but my gyno had dismissed my complaints as mittelschmerz and basically called me a cry baby. I didn't think this sounded like typical female pain, though. I would simultaneously feel like I had to poop, pee, and vomit, and then I'd writhe in bed, clutching my lower abdomen and sweating, until some anti-anxiety medicine would kick in and put me to sleep. 

For two years this happened, nearly every single cycle, until it started to get worse. I started to have the episodes outside of ovulation. Two weeks apart, just before my period, on a random Tuesday. One of the worst times it happened was the day of a close friend's funeral. She'd died young, unexpectedly, from complications with an autoimmune disorder. I was delivering one of the eulogies. The attack came on after I'd already put on my makeup, and I just kept moaning no, not today, please, God, not today.

Miraculously, my body pulled it together long enough for me to deliver the eulogy, but the pain returned during the last third of the funeral. I handed my dish off to a friend and went straight home, where I sweated and writhed and cried for hours.

The trip to the ER happened not long after that - less than a week. The attacks were coming too close together. For the first time, someone decided to use a transvaginal ultrasound to see what was going on in there. That's when they discovered the 10 cm dermoid cyst taking up residence on my left ovary.

I lost the ovary in the surgery meant to remove only the cyst. My surgeon liked to cut things. He prided himself on how quickly he was in and out of my body. Speedy Gonzalez didn't think I needed that ovary anyway. I was still planning on doing IVF, due to my husband's low sperm count, and I had another ovary. One would be plenty.

In the years following, I've come to form a theory of my own: there was a reason I almost always ovulated from the left ovary. That's where all of the good eggs were. The ovary that was left behind was lazy. In the wake of surgery, it took a long time becoming active. In every attempt at ART, we could only coax one decent follicle from the right ovary. Every. Single. Time. When my AMH was finally tested, it was <.16 - undetectable.

The depression that followed my IF diagnosis was so deep and so intense that my therapist asked me if I would consider attending a Resolve support group. It would be good for me, she said, to connect with others in my situation. I had attended support groups before, for people with loved ones who had mental illness, and found them to be less-than-helpful. They were bleak, these meetings. I never left feeling hopeful. 

But my therapist was insistent, so to the Resolve support group we went. My husband and I sat in a room of other couples and some women flying solo. I told our story to a group of strangers and listened as they told me theirs. I cried along with the young woman who'd just gotten her diagnosis of cervical cancer. They would harvest her eggs, but she'd never be able to carry a child. The pain she was in was so palpable, I just wanted to hug her.

It was cathartic, attending that group, and we returned, month after month, for the first year after our diagnosis. I formed a couple of friendships with women I met in that group, one a fellow DOR gal like myself (Kindred). The meeting facilitator formed a secret Facebook group for us to keep in touch in between meetings. I felt like I'd found my people.

Later, I'd move on from those meetings to my secret Facebook group of women pursuing donor embryos. It's an active group, more than 530 members strong, comprised of women from all over the world. They have answered my questions, cheered me on through two cycles, consoled me after my first-ever pregnancy turned into a miscarriage. They have followed me through my current pregnancy, and a satellite group - one focused solely on anxiety/depression stemming from IF/ART - has held my hand through every fear I've had about losing another baby.

In short, these women are my lifeline. 

I've made a lot of good friends thanks to my infertility. Some of the strongest, most resilient women I've ever met. My fellow infertiles, I call them. We share a bond that only another woman who's struggled to achieve (and sustain) a pregnancy can understand. 

That circle has expanded in the past seven months, after I started this blog and started spending time reading/commenting on other people's blogs. Women I've never met in "real" life, who I may never meet face to face, send me Facebook messages and leave me comments before every follow up appointment. "Thinking of you," they'll say. "Let me know how it goes." I do the same for them.

I am not alone. I am far from alone. And I am grateful to everyone in my support system, from the women I met in my Resolve group to the blogger whose story I just discovered last week. If you want to know how people survive infertility, this is it: through the camaraderie of fellow infertiles. People who've walked the path you're on. It doesn't matter if they're still in the thick of it or have reached the other side - these are your people. They will help you get through it.

I'm not fully "out" in terms of my infertility, but I will be. All along I've said that when I reach the other side - whether it be through a take-home baby or making the decision to live child-free - I will tell my story. I'll tell the story of my miscarriage, too, because that's another thing that needs to be talked about more openly. 

Why not now? you wonder. I'm just not ready. I'm still in the trenches, fighting my way toward the family my husband and I so desperately want. I'm not ashamed of what I've been through. I'm not embarrassed. Biology is what it is. A doctor put hormones in my  husband without counseling him that they would render him sterile. A surgeon stole my good ovary and patted himself on the back because of his speediness. I can't change any of these things.

For now, I tell my story anonymously, through this blog, because I want others to feel less alone. And it's working. Recently, a woman found my blog after researching the too-small gestational sac that led to her miscarriage. She told me that reading about my experience with the same thing helped her come to terms with her situation.

I cried when I read that. Because I can't tell you how many times I've done the same exact thing - found someone out there, through an online or in-person support group, or through the blogosphere, and said YOU, YES YOU, YOU ARE MY PEOPLE. THANK YOU FOR SHARING YOUR STORY.

This post was written in response to Resolve's National Infertility Awareness Week. Click here to learn more about the disease of infertility. To read more stories of hope, check out the NAIW 2015 Blogroll.

embryo adoption awareness day.

Today, November 25, marks Embryo Adoption Awareness Day. From the blog Wishing on a Snowflake:

"November is already known as National Adoption Month, so what better time to recognize EDA and spread awareness than during November? Also, with it falling near Thanksgiving, it gives us the ability to discuss the gratitude that EA brings to many families."

Liz is one of the most vocal advocates of Embryo adoption I've encountered. She's the founder of the super-secret Facebook support group I belong to for women pursuing the EA path - the one Kindred added me to before I knew I was definitely going to be pursuing that path myself. Interestingly enough, I actually found Liz's blog when I was researching whether or not you could get a colonoscopy when TTC. Then started following it. It took me a week or so to recognize the super-secret FB group connection.

The world works in mysterious ways.

Liz, who has severe DOR like I do, has been all over the news lately, sharing the story of how she and her husband came to adopt their daughter Sammy as an embryo. She recently wrote a post that includes links to the People.com coverage and a segment that appeared on Good Morning America.

The other person I feel compelled to mention on this day is Sara from Chronicles of An Adoption. She's a frequent commenter on this blog and has been just a lovely source of support. Sara's pursuit of parenthood is admirable and inspiring, and if you're not familiar with her blog, I encourage you to check it out immediately.

Here's Sara's post about Embryo Adoption Awareness Day.

This day of awareness is important to me personally, too. In the relatively short time I've been on this path I've educated at least two women about using donor/adopted embryos - one who's a confirmed infertile who thought traditional adoption was her only option, and one who's concerned that she may be infertile but doesn't have confirmation of this yet. I've educated others as well, but I think these two stick out the most because having this information could someday change their lives as it has mine.

And though she'll likely never read this, I want to say thanks to G, a woman from my in-person Resolve support group who became a mom through EA earlier this year. I'd never even heard about using donor embryos myself until I met her and listened to her story.

I wish I could contribute more to the cause, but I'm still a closeted infertile, for the most part. And, when it comes to using donor embryos, I'm not sure how much I'm willing to share beyond my innermost circle.

But I applaud these women, and am grateful for all that they've done and continue to do in our corner of the IF community.

the truth about 'the list.'

You know how sometimes you think things are a certain way and then they end up being something entirely different?

I really hate when that happens.

Hitting bumps on the donor embryo road and we haven't even been on it all that long. Well, actually, it's just one enormous bump in the form of the third-party reproduction coordinator, a.k.a. TPRC, who will henceforth be known as the UnproRepro (as in: unprofessional reproduction coordinator). Because she totally is. Horribly, horribly so.

Remember when I said that I was told I was getting around seven profiles of potential embryo donors? Well, I didn't. In fact, I didn't get ANY within the 48 hours I was originally supposed to, because the UnproRepro was trying to find profiles with certain features my husband and I don't even have (because she doesn't listen. Or take good notes. Or whatever). I ended up sending her a picture yesterday morning, to make sure she had a visual reference for what we actually looked like/were looking for.

Almost immediately after that, she sent us two profiles. Mr. Hope, who hadn't gone to work yet, and I were ecstatic. We opened up the first one to discover that the mom of said embryos was 39-years-old (as in: older than me) and that there was history of debilitating diseases on both sides (mom's and dad's, including dad's brother). So that was a nonstarter.

The second profile looked really promising. Mom was significantly younger (30 vs. 39, though still slightly older than I had expected, Dad shared some of our interests, both had great education). But then we got to a line about the dad having a couple of physical characteristics reminiscent of Mr. Hope's Babymama, and my heart sank a little. My brain played it out: Babymama already had a kid that looked exactly like Mr. Hope, and we'd end up with a kid that looked like it belonged to her, and I still wouldn't look like any part of this family.

Keep in mind that I'm reading/reacting to these with zero solid food in my stomach for nearly 24 hours (prepping for the colonoscopy) and a wicked sinus headache. And also, that I'd been expecting seven profiles, not two, as well as mothers in their 20s (based on Dr. Smiles telling me that I should have no problems provided I used much younger genetic material). Also that I did not, as you will soon discover, have a clear concept of how this program worked, seeing as I got one version from Dr. Smiles and something different from the UnproRepro. In hindsight, I probably should've pushed for more info when I met with her on Tuesday, instead of letting her sweep me out of the exam room where I was getting my breakneck-speed overview. But per usual, hindsight is mos def 20/20.

So I emailed her a couple of questions, such as:

Q. Can you please tell me what 2PN means?
A. 2PN means that the embryos were frozen the day after they were retrieved, once fertilization occurred.

Q. Also we were hoping for blastocysts - are they all blastocysts? [asked before I got the answer about what 2PN meant]
A. No, blastocysts are very rare because most embryos die off before they become blastocysts. If we had any blasts, we'd likely only have one. [Italics added here by me.]

Q. Is there a reason why there are so few matches? We were really hoping to find some embryos from younger women considering my advanced maternal age.
A. One thing that you will need to understand is that donor embryos come from a couple trying to have their own child, not an egg donor. The average age is 30-39.

Q. Do we know what births resulted from the same embryo batch?
A. We only accept embryos from cycles that have produced a child.

[Uh, that's great, but this is the first time I've heard this information.]

Please note that nearly all of the above was taken directly from our email exchanges, though I did copyedit her responses because I am like that.

At some point during this exchange I told the UnproRepro that I was confused about how things worked and was available by phone if she'd prefer to talk, so she called me.

The conversation was emotionally charged from the start, so I may be messing up the order of how this all went down. But these are the highlights:

I mentioned our concern over the 39-year-old mother and how that's older than I am. "Not everyone has your problems," she snapped. I told her I understood, but that statistics showed the older the egg, the more likely the genetic abnormalities. She told me the other set of embryos not only had a birth initially but already provided another couple seeking donor embryo with one. Good information to have, lady. Feel free to share these things at any time.

I asked her again about the Day 2 embryo thing, because this is what I had with both of my failed transfers.

"No, you didn't," she told me.

"Yes, I did," I assured her.

And then we literally exchanged several more no, you didn'ts and yes, I dids, before she says, "No doctor in the country does Day 2 transfers!"

"That's funny," I said. "Because mind did. Twice."

"But they're not even ready to be transferred then!"

This went on for a few more minutes before she shouted at someone to get my file.

I moved on.

I asked about seeing more profiles, and she said, "That's all we've got. Most people only get to see one profile. You got two - you should feel lucky!"

Except, I swear to god she told me she'd be sending around seven. I remember this because I thought, "Okay, good, that gives us lots to think about." Since then I've been trying to figure out if I could've misheard her, but even if she said, "I'll be sending you some," some is one syllable vs. seven's two.

Then she told me that the selection was extremely limited - that she'd sent me the only two donors with brown hair. I questioned this, because isn't brown hair fairly common? She told me she had some African-American embryos, some East Indian embryos, and about seven blond-haired, blue-eyed embryos, but no more brunettes. Period.

I think the UnproRepro uttered the phrase, "You're gonna have to understand" about half a dozen times during our short phone call. She also pushed the donor egg thing hard, when I've told her repeatedly that we aren't interested in that.

At one point, I told her I felt like she was being kind of hostile toward me. She said, "No, I'm not, and I'm sorry you feel that way..." and then proceeded to come at me with, "I really think you'd be much happier with donor eggs." Again.

There's some other stuff that was said, but this was the gist of it.

After the phone call, I sent this email:

I'm sorry that I apparently misunderstood how your program worked. When I met with Dr. Smiles, he said, "These are our patients. We know them well," and that you try to match couples with embryos that look like they could conceivably come from the recipients. He said, "We have a huge operation here," and made it sound like there were an abundance of embryos waiting to be implanted. He also stressed to me the importance of using young eggs (in relation to donor embryo, not donor egg) to ensure success. 

This is a huge decision for a couple to make. When I spoke with you on Tuesday I thought I'd be getting more information than I actually did. I can't be the first person to have a ton of questions about how your donor embryo program works, can I?

Also, I have told Dr. Smiles from the start that I do not want to pursue the donor egg route. I would really appreciate it if you would not present that to me as my only option. Or, if it is, please let me know and I can look outside Posh Clinic.

Lastly, I have to say that I feel very disconcerted that you would tell me that no doctor in the country would transfer Day 2 embryos - that they're not even ready at Day 2 - when *both* of my transfers were done on Day 2. I will follow up with Dr. Smiles on that.

Thank you.

Her response was almost total CYA and did not make me feel the least bit better:

As far as donor embryo programs go, we do have a “huge operation.” That does not mean, however that the amount of embryos available are not limited.  We do, however, do our best to meet the criteria a patient has in mind.

We do know our patients well, and that is why we feel very comfortable accepting the embryos.  And as I’ve said, we only accept embryos from cohorts that have produced pregnancy. You are certainly not the first patient to have questions about how a donor embryo program works. I was under the impression that I answered all your questions satisfactorily when we met on Tuesday. I made the time to see you, and would have been happy to continue the conversation had I known that you were not comfortable with the information presented to you.

We are by no means saying that donor egg/donor sperm is your only option. It was simply a suggestion since it would be easier to meet your criteria that way since what we have to offer you at this time is not satisfactory.

Lastly, I never said that no doctor in the country would transfer on day 2. What I said that there are only 2 days that doctors plan a transfer and that is day 3 or day 5. On some occasions, a day 6 transfer is indicated. That is a nationwide protocol.

I do apologize that in your case, I was incorrect and you were transferred on day 2. There was an exception made in your case as the feeling was that the embryo would not survive until the normal transfer day. I am sorry that I was unaware that such an exception was made in your case. [Again, emphasis here is mine.]

We will, of course, continue to to do our best to match you. The next set that comes along that meets your criteria will be e-mailed to you. 

To which I immediately responded:

I didn't turn down both sets. Just the second one with the 39-year-old mother. You said I had until Monday to let you know about the other set. 

No response.

This last exchange took place while I was in the waiting room before getting my colonoscopy (which was clean, by the way - yay!). And even though I'd put a call into Dr. Smiles before leaving to get said colonoscopy, I wasn't home by the time he returned it. So, no talking to him before Monday.

What I did do is put some queries out to my secret Facebook support group. I found out that other clinic-based programs follow the one-profile-at-a-time rule. One woman said that with hers, if you passed on a profile, you got dropped to the bottom of the list.

Other women working with other clinics, like NEDC or FIRM, have had different experiences (one woman got to review 40 profiles before making her selection!). I haven't looked too closely at either NEDC or FIRM, honestly, because until yesterday I felt good about working with Posh Clinic. I do know that NEDC requires a home study, which we were trying to avoid (due to cost, time it takes to complete one, etc.).

And as I told the UnproRepro, Mr. Hope and I hadn't ruled out the other profile. The one that looked really great except for the "might possibly turn out looking like Babymama" thing. (I even wrote to her, "We're not ruling out that one but I really do not want to have a child that looks like his ex. I'm sure you can understand why." This, I was trying to explain, is why I'd asked about reviewing other profiles. So that I could make the most informed decision possible.)

Look, it usually takes me a long time to make big decisions. A long time. Typically, I like to research all of the options. I discuss these options with multiple people. I ponder things. I write about the things I ponder in order to process them. Hell, it took me over a year and a half to purchase our TV. And no, I am NOT comparing a child to a television set. But, like, do you know how many models I had to look at  and how many reviews I had to read before I finally pulled out the wallet? How can I possibly make a decision on our future baby after looking at just two profiles?

I guess the larger question is: How do you know which one is the right one?

The answer is this: You can't, actually. You have to go on gut. Or faith. Or both.

And when I realized that - that my anxiety was being fueled by the unknown factors and not having enough information (or not having the right kinds of information) - I started to get really pissed off at the UnproRepro. This is your job, lady. To work with distraught couples who come to you because they don't have any other choice. They don't have what they need to make a baby, so they come to you. They come to you to get an egg or sperm or both in the form of an embryo. You, lady, are the end of the line - the last chance they have to produce a pregnancy. Have some fucking compassion, will you? Get some fucking bedside manner here.

One of the women on the Facebook group told me she'd worked with Posh Clinic on her fresh donor egg cycle and had a horrific experience with the UnproRepro (who, by the way, I hadn't even named in my posting). She told me they almost backed out before the cycle because the UnproRepro was so unprofessional and because she had been treated so poorly. The whole experience, she said, was so terrible she'd never go back there again.

So I know I'm not alone here, and that's validating. I am going to write Dr. Smiles a letter about the whole situation, because I feel like he needs to know how the UnproRepro is representing his practice.

Now Mr. Hope and I have to decide whether we want to take the other set of embryos or not. The fact that they've produced babies for two couples makes me lean toward yes, as really, that's what I want here: a baby. To be a mom. Sooner, rather than later.

But I do still have concerns over the Day 2 vs. blastocyst thing. Will Posh Clinic grow the embryos out after the thaw? And, if so, do they wait until they reach blast to transfer or do they do it on Day 3?

These are things I feel like I should've known already but I don't. I didn't prepare enough for my meeting with the UnproRepro because I thought she was going to give me a comprehensive overview. That's on me. My bad.

Clock's a ticking, Mr. Hope's still sleeping, and I'm so deep inside my brain right now I don't know if I'll ever find a way out.

from contemplation to preparation.

Last night I had dinner with Kindred Spirit, a woman I met through my local Resolve support group back when my diagnosis was still new. We bonded pretty quickly due to the fact that we were both DOR gals, close in age, had married later in life, and had similar mother issues, among other things. We'd only attended a few of the same meetings, but kept in touch through a secret Facebook group.

I'd had a bit of a breakdown a couple of months ago that led to me posting in said FB group about my anger and frustration. Also this:

I wish I could let go of this need to have a biological child of my own but it's literally been YEARS and I can't get past it. And even when I think that *maybe* I could get to a place of peace with going the donor embryo route I am convinced that it, too, would end in failure and that would gut me.

Kindred commented on the post that night to let me know that she and her husband had decided to pursue embryo adoption after their yearlong break. I knew they'd started down that road previously but had run into some setbacks, and hearing this news made me so incredibly happy. Kindred and I started messaging back and forth about how she came to this decision and how soon she'd be starting this new leg of her journey.

In the Transtheoretical Model of Change, behavior that leads to change must pass through several stages: precontemplation (no intent to change, sometimes not even aware that change is necessary); contemplation (aware a problem exists, thinking about overcoming it, no commitment to action); preparation (intending to take action); action (what it sounds like); and maintenance (also what it sounds like).

I was still stuck in the contemplation phase. (Kindred, on the other hand, had moved into preparation/action.)

Fast forward five weeks. Kindred adds me to another secret Facebook group, this one centered on embryo adoption. At first I was taken aback. I mean, I wasn't there yet. I still hadn't answered a very kind email from a woman I hadn't met, referred to me by my in-person support group, who was using donor embryos and offered to meet up for dinner to discuss. (Which reminds me: I need to answer that email, STAT, with a big fat apology included.)

At first, I didn't check into the group that often. When I did, I didn't like or comment on anything. I just lurked. But then Kindred posted something, so I liked it. And then some ladies shared their good news (like first-ever positive pregnancy tests, something which still eludes me) and I liked that, too. And then one day there was a post about something only tangentially related to fertility that I felt compelled to comment on.

I was becoming part of the community without even realizing it.

And then one night, after coming home from Glam Colleague's workplace baby shower, I kind of lost my shit.

The minute Mr. Hope walked through the door I started crying...and didn't stop for hours. It was the kind of crying where water just pours out of your eyes and snot drips from your nose and you are practically convulsing from all of the sobbing. Ugly crying, painful crying, crying that leaves you feeling hungover the next day.

Two days later, I crafted an introductory post to the Facebook group. Almost immediately, responses started rolling in. Instead of making me feel like a noob, these women welcomed me with open arms.

This is when everything changed.

Not because the women were so warm and welcoming (although I'm infinitely grateful for that) but because in responding to their comments, I started to get clear on what I was thinking/feeling about going the donor embryo route. Or, more accurately, what I was fearing.

That the kid wouldn't see me as her real mom.

That she would never stop wanting her biological parents.

That she'd regret not being one of the lucky ones "placed" (so to speak) with her bio family.

In realizing this - that the majority of my fears were based on a hypothetical child hypothetically rejecting me, and that I'd likely manifest a similar anxiety and insecurity with a biological child (not loving me, or wishing she'd been given a different mother)-

Well, let's just say I had kind of a moment.

The next day, Mr. Hope and I sat down to have a looooong talk about next steps. We were supposed to be starting our next pre-cycle (an estrogen priming cycle), but I hadn't done the things needed to do to get us there. I told him about my epiphany and that I felt like I was finally ready to head down this path I'd been avoiding.

He said, "I just want to raise a baby with you. I don't care how we get one."

This has pretty much been his attitude all along, but remember: Mr. Hope already has a biological child of his own. I don't. So I am not only mourning the loss of a tiny human that is half Agony, half Hope, I'm also having to come to terms that I am at the end of my particular evolutionary line.

This, I think, has been one of the hardest parts for me to accept.

One of the women in the secret Facebook group left me this comment:

There is a grieving process in adoption. Adoption is ONLY formed through loss. With EA, loss of birthing a bio child and loss of the embryo from being raised in their bio family. Loss of the dream of how our family would be formed. Often loss of numerous other children along the journey to build our family. It's a tough road, but I truly believe that going down this road not only makes us stronger, but also makes the depth of our relationships stronger. Life is just more precious in general when we've had to fight to bring life into the world the way we have.

I cried when I read that.

I cried, too, when Mr. Hope and I decided on our plan.

We'd always said we'd try three IVFs before calling it. We had one left to go. Mr. Hope said, "I think we should still try one more time. That way, we have no regrets. We'll know we gave it everything we had."

(It helps that our out-of-pocket expenses are extremely limited when it comes to IVF; our largest expense is the $500 fee for the anesthesiologist, and we get that refunded by the insurance company after the fact. If we had to shell out $12k of our own money for every attempt, I'd probably have reached a different conclusion.)

As we head into this third and final IVF attempt, we're going to simultaneously start the process for donor embryos. I think I know in my heart of hearts that this is how Mr. Hope and I will get our baby. But I want to be able to go into the process with a clear head - and without a bunch of niggling question marks hanging over the decision.

Back to Kindred Spirit: She is in her down reg period, just four weeks shy of her first fetal embryo transfer (FET), which falls on my Precious Pup's birthday ("It's a sign!" she said. "It's going to be a great day!") Kindred is positively glowing, all giggles and dimpled smiles. She showed me pictures of her embryos' already-born siblings. They look like they could be hers.

As for me: Making the decision to talk to our RE about donor embryos feels like an elephant just got off my chest. It feels like relief. Like I could stop fighting the inevitable. Like I was surrendering, but in the best possible way.

I can't wait to see what happens next.