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.

funny how fast things move.

I've been reading and rereading what's below about a dozen times, afraid to hit "publish" because I know I've written some things that may offend one or more people who read it. But I don't want to edit anything out, because it's honestly what I'm thinking/feeling/doing. And I'm quite certain I'm not the only one thinking/feeling/doing these things. But just know that I know that you may think I'm complete and utter fucktwit, and that I'm okay with that. Or at least, I will be.

Yesterday I went to talk to Dr. Smiles about next steps. I'd spent the morning feeling fluttery and anxious, and the solo drive to the clinic was tense. It didn't help that I kept getting stuck behind old people, people on their phones (illegally), and people just generally not paying attention.

After a stay in the waiting room (this clinic has for serious four different waiting rooms, and I spent time in three of them yesterday), I met with his PA and gave her a quick overview of why I was there. Since my cycles have been so screwy, she had me go in for a scan. The ultrasound tech noted that I had a couple of small, fluid-filled cysts (as opposed to the hairy dermoid variety of days past) - they looked exactly like follies to me, so I asked her how she could tell the difference and she gave me a semi-snarky answer about her years of training. Thanks for the education, lady.

Next was Dr. Smiles, who made a joke about me wanting to turn more of his hair gray. (I didn't really get it.) We talked about doing one more cycle with my egg and Mr. Hope's sperm. (And in typing this I realized I kept saying my "egg," as in singular, because we've never gotten more than one egg out of me, no matter how hard we try.) But I also told him I was worried that my insurance gravy train would run out before I'd built my family. He asked me about a donor egg backup and I said no, but would he be open to transferring my embryo and a donor embryo at the same time?

He said yes.

Total game-changer right there. It was something Mr. Hope and I had discussed but didn't think was possible. 

Dr. Smiles said, "The thing is, if you get pregnant, you won't know which embryo took." To which I replied, "Am I really going to care?" He said, "I don't think so. I think you'll be happy you're pregnant." Which is exactly what I was thinking. Well, that and that if I did get pregnant, I'd likely assume it was the donor embryo anyway just because I haven't had such luck with my own genetic material thus far.

He asked me about getting started before Thanksgiving. I asked about the average wait for embryos. None, he tells me, despite the scary paperwork that indicated otherwise. "We have a huge operation here," he explained. 

It's a tony clinic, too, situated in the heart of richville. Like, there was some construction, and the GPS ended up taking me through a residential section on the way home. It was OH MY GOD, RICH PEOPLE land. I drove by mansions. Literally, mansions. The kind that look like they need their own staff just for bare-bones upkeep.

I managed to get out a few more questions before Smiles ushered me off to talk to the third-party reproduction coordinator (TPRC) about how this all works. I like Dr. Smiles, but meetings in his office tend to end rather quickly and without you even realizing it. One minute we're talking Lovenox and prednisone; the next I'm in yet another waiting room, checking work email before the TPRC shows up.

She took me to an exam room. I gave her my completed application and wrote out the $100 check while she explained how the process worked. Basically, she'd record any preferences or criteria that Mr. Hope and I had, and then she'd look to see what they had in stock. In about 48 hours, she said, she'd be forwarding me profiles to review. If we liked one, we had our match. If we didn't, she'd either look for more or we'd have to wait for new embies to come in.

This, to me, is the scariest part of using donor embryos. The fact that someone else is doing the pre-selection for us. In embryo adoptions, you can look at pictures of kids born as a result of those embryos from the same set, or kids born from a previous one. With the completely anonymous donor thing, you don't get any pictures. Not a single one. You basically go in on blind faith, hoping that the clinic will match you with embryos that will produce a child that looks at least a little like you.

I'd asked Dr. Smiles about this, and about whether or not the staff remembers what the embryos' bio parents looked like. He said, "These are our patients. We know them well." I felt a little better after that, but not as much as I would've liked.

And yes, I know that some people don't give two figs about the baby looking anything like them. I am not one of those people. (Clearly.)

The TPRC and I went over our criteria, which really, were more like preferences. Since Mr. Hope and I do want a kid that looks like it could conceivably be ours (see what I did there?), I ran down things like hair color and eye color. Then we went over some stickier stuff.

Interests. 

Occupation. 

Education.

The interests part isn't so difficult, because in a lot of ways Mr. Hope and I are complementary opposites. Pretty much the only thing we'd feel clueless about is if we had a baby of the sporty spice variety. As in: we are not jocks. We wouldn't know what to do with a jock. We'd have to learn a whole new language. But as I told TPRC, "That's not, like, a deal breaker or anything." She wrote: "Athletic not required."

I told her I was more interested in education level. There's no way to say this without sounding like a complete asshole, so I won't even try: I'm way more afraid of having an unintelligent child than having an ugly and/or unfit one.

Hear me out: Mr. Hope and I are really flipping smart. And not just book smart, even though we have Mensa-level IQs and multiple degrees. More like we have an excessive amount of intellectual curiosity. We ask a lot of questions. We formulate a lot of opinions. We never stop learning. That's partially what drew us to one another to begin with. I fell in love with his mind before I fell in love with his face. (Granted, it's a really lovely face. Especially the eyes. And the lips. And all of it, really. But to me, a pretty boy without a brain is utterly useless.)

While I am confident that we'll be the kind of parents who nurture intellectual curiosity, I can't imagine that nature doesn't play a hefty role in what you've got to work with in the first place. And really, does wanting a smart kid make me that horrible a person? 

So then the TPRC gave me this whole speech about how smart people can make a less-smart baby, and less-smart people can birth a genius. I told her I knew that, but if we could stack the deck in our favor, why wouldn't we try?

I didn't think to ask to see a sample profile, but the TPRC said she had way more info on each of the donating couples than I'd just given her. She seemed confident that we'd have enough to make an informed decision. 

In another 36-48 hours, I should have the first round of possible matches. And, depending on the results of my blood work, Mr. Hope and I could potentially be pregnant before Christmas. 

I mean.

Come on.

By CHRISTMAS?

Surely you must be joking.

The one thing standing in our way of hurtling toward this mixed cycle (I don't know if that's an actual term or what, but this is what I'm calling it) is my body (shocker!). According to Dr. Smiles, I did not get my period when I bled late last week. My lining, he says, is too thick for that.

Say what now?

I won't get my blood work back until later today, because they drew it too late yesterday. But I'm hoping that will give us some answers as to where I am and what happens next.

things we lose.

I've lost a lot of things as a result of my infertility, but one of the most painful was a friendship. And actually, I never thought I'd fully lost it, until I almost did.

Let me explain.

Until about a year and a half ago, I didn't have just one BFF, I had two. We all went to high school together and have known each other since we were teens. The BFFs have their own friendship with one another, but I've always been the Jerry that links them together. Meaning, it's not like we were ever a trio. More like linked duos.

My other BFF (I'm going to call her Gumbo) was one of my strongest sources of support during the early days of my diagnosis. We've been there for each other through most major life events...except when we weren't. Because as much as we love each other, we've ended up taking more than one extended break from our friendship. In some ways, we're too much alike. Too emotional, too sensitive. And we have a longstanding history of going through Big Things at the same time which ends up forcing us apart instead of closer together.

Around the time that I was gearing up for my first attempt at IVF, Gumbo was having serious conversations with her husband about future babies. As in, he wanted #3. As in, she did not. She was struggling to find a way to tell him this - that as much as she loved being pregnant, she wasn't ready to dive back into Diaperland again. In fact, she didn't think she'd ever be ready. She was happy with the two she already had.

I'm sure you can already see where this is going.

When my first attempted IVF got converted to and IUI, Mr. Hope couldn't be there for the first insemination (we did two back to back, to cover the spread). So Gumbo met me at the hospital. She made me laugh in the waiting room. She came back to the exam room and joked with Dr. God Complex who asked her if she wanted to get pregnant, too.

Afterward, we went to a diner where I ate turkey, as I think I'd read somewhere that turkey was good for fertility. I was calm, I was hopeful, I was certain that I'd just conceived my daughter.

As we left the diner, Gumbo mentioned something to me about having sore boobs, and how they kind of reminded her of how she felt when she was pregnant. Oh, and by the way, she told me, her period was late.

I winced. I don't know if she saw it, but I did.

I urged her to take a test. She didn't want to. I don't think she was ready to confirm what she already knew.

We took our first tests on the same day: 7DPO. Hers was positive.

Mine wasn't.

I had a feeling then that the IVF had failed. It wasn't rooted in anything other than my gut, and I was hoping beyond hope that I was wrong.

I started testing daily.

A day or two later, I got a superfaint positive. I even woke Mr. Hope up to show him. He didn't see it, but any woman who was trying to conceive totally would have.

Gumbo didn't see it when I sent her a picture. Even so, for one blissful day, I thought I was with child. That we both were. We'd be pregnant together. Our babies would play together. Wouldn't that make one hell of a story?

You already know how that story ends. The line didn't get darker. It faded almost immediately. Most likely, the superfaint positive was lingering traces of the trigger shot being picked up by a really sensitive test.

I fell the fuck apart.

It was so cosmically unfair that Gumbo, who didn't even WANT a baby, and who already had two of her own, could get pregnant without even trying, whereas I was throwing everything under the sun at my body and still couldn't conceive.

I told Gumbo I needed some time. That I couldn't help usher her through an unwanted pregnancy, when the only thing I wanted was one of my own.

She said she understood. Then she said she didn't. At one point, she told me she had another infertile friend who had been a tremendous source of support for her. That's great, I told her. I'm glad you have a more generous infertile in your life than I am capable of being right now.

There were some tense text messages exchanged over the next several weeks. Then, after about three months, I told her I wanted to make plans to see her. She was getting ready to take a trip, and plans kept shifting. By the time she was ready to talk dates, I was about to head into my next attempt at IVF. Also converted to IUI. Also a BFN.

I asked for an extension on the time out.

We talked around the time of her gender scan. I had convinced myself she was having a girl, because that was what I had wanted. When I found out she was going to have a boy, I felt relieved.

There were some text messages here and there, but we didn't talk again until there was a death in my family. She came to the funeral. She spoke at the funeral. I thought that maybe this could mark a new start for us. I was in a better place (sort of). And I missed her. I loved her. She is one of my oldest and dearest friends.

But nothing ever really happened. I'd text her and responses would come slowly. I'd message her through Facebook and hear nothing back. We had one phone call when a mutual friend was going through a major-league tragedy, but that was it.

And then I started this blog. And I sent her and a few other close friends, family members, and fellow infertiles the link.

Yesterday she wrote back and told me that she was happy that I seemed to be in a better place, but that she wouldn't be following my blog. That it was too hard to read because we were no longer friends. She had closure, she said, and wished me the best.

I'd gotten fired from our friendship without even knowing it.

And okay, yes. A year and a half is a long time to be on sabbatical from a friendship. But it wasn't like there had been no contact. Only, every attempt I'd made to reconnect - the Facebook messages, the random texts - she'd viewed them as me acting like nothing had happened, instead of me putting my toe back into the friendship water, so to speak.

I felt a little blindsided, to be honest. And I told her that. And I told her how I didn't want to sweep back into her life just because I was ready and expect her to be ready to. I was trying not to be an asshole, because I already felt like one for needing such an extended break to begin with.

We exchanged several emails yesterday and have plans to talk this week. I'm glad for that, because I do love Gumbo and I never once thought our friendship was over for good. I just thought she needed more time to get over the hurt she felt when I abandoned her in her time of need. She was right to feel hurt. If I'd been a better person I could've sucked it up. But I wasn't that person. I was me, and I was devastated, and I just couldn't do it. Not then.

Funny postscript to this story: Just after my first IVF with Dr. Smiles (my first actual IVF, as opposed to one that got converted to IUI), while I was still in my two-week wait (2ww), one of my closest work friends (aka Glam Colleague) found out she was pregnant. This, just weeks before her wedding.

The day she told me, I had a pretty good feeling my IVF had failed. I hadn't even started testing yet, but it was Gumbo all over again. (She and Gumbo are actually similar in a lot of ways, to be honest. She's like my work version of Gumbo.)

So now Gumbo's little boy is on the cusp of turning one, and Glam Colleague is about to pop out her little girl any day now. And my arms are empty.

Still.

But today I go see Dr. Smiles, and I get on "the list" for a donor embryo.

Maybe, just maybe, my arms won't be empty much longer.

preparation.

Today I start my pre-colonoscopy diet (or, as people who suffer from Crohn's disease call it, a "low-residue diet"). Here's what I can eat between now and Thursday breakfast:

• White bread
• White pasta
• Cream of Wheat
• Yogurt without fruit in it
• Saltines
• Pretzels
• Low-fat protein (boiled chicken recommended)
• Some cheese
• Mashed potatoes
• Canned green beans and peas

Here's what I can't eat:

• Fresh fruits and vegetables
• Whole grain breads/cereals/pasta
• Nuts and seeds
• Pretty much anything with fiber

Mr. Hope is in heaven, as he prefers to eat like a picky toddler. I, on the other hand, am totally lost. This is completely foreign to the way I eat on a daily basis. And yes, I love to indulge in processed garbage once in a while, but NO fresh vegetables? I mean, really.

I'm also filling out the paperwork for tomorrow's appointment with the third-party reproduction coordinator at my clinic. As of tomorrow, we will officially be on "the list" for donor embryos. Is it too soon to squee?