A river in Egypt

In the springtime, there are always a few bugs that manage to crawl their way into our home. Today I found an ant in the bedroom. Did I gently pick it up and take it outside? No. I crushed it. Or I tried. I stepped on it and heard it crunch underfoot. When I looked, it was still alive and trying to crawl away. I stepped on it again and again and it was still alive and squirmy. Tough little guy. I finally had to pick it up and flush it away.

I remember clearly during my first IVF cycle coming across an article about Br00ke Shields. It said she had tried IVF seven times before becoming pregnant. Madness, I thought. What kind of crazy person persists when the odds are clearly against them? If it doesn’t work the first or second time then just accept that it’s not gonna happen. Okay maybe, I conceded, three tries would be needed. We discussed this, my husband and I. Three tries is what we were prepared to do.

So anywho….

I started a cycle just a few days ago. I am not thinking about the details. I have no interest in my estradiol level, or follicle sizes, or lining thickness. I don’t want to know. Today was my 300th injection since all this began. I’ve been keeping track. That doesn’t count all the pokes I’ve endured for various blood tests. I’ve made a reservation at a NY hotel (freakin’ $300 a night. And no it’s not a fancy hotel. And yes, that’s like 8 gazillion Canadian dollars). I haven’t booked a flight. I’m not really convinced that things will progress well enough to actually require a trip to the clinic.

I’m not being pessimistic, really I’m not.
This is a realistic assessment of the situation based on lots and lots of past experience.
A Bayesian analysis of sorts.
The potential success of this IVF cycle (low) is not independent of the (lack of) success seen in past cycles. The cumulative evidence shows that i) I suck at making eggs ii) I suck at making embryos iii) any embryos that are transferred are promptly killed by my uterus.

But there is a chance. It is a tiny chance and we are taking it.
It is madness, but it’s a step I must take before coming to next one. Each time I do this I emerge a little crushed, a little broken. But I'm still here.

I won’t be providing updates on my progress, but here's a little preview what may or may not happen.
Scenario 1: Follicles will grow and estrogen will rise BUT subsequent bloodwork & ultrasounds will show follices have shrunk/disappeared and estrogen has fallen/reached a plateau. We will cancel our trip.
Scenario 2: There will actually be 3-4 follicles and we will book flights to NY. The clinic's bloodwork & ultrasound will show there is no point in proceeding. They will send us home.
Scenario 3: There will be 3-4 follicles which continue to grow. We will make it to retrieval and 1-2 eggs will be retrieved. They will not fertilize or if they do they will not divide. The clinic will send us home.
Scenario 4: Same as #3, but the eggs will fertilize. We will have 1-2 embryos. We will come home. I will rest. I will refrain from lifting heavy things. Two weeks and 14 PIO injections later I will find a single blue line.

Looking at the calendar, if all goes according to schedule the Beta will take place on my birthday or Mother's day. So that'll be swell.

Wrinkles in time

Last week my former thesis advisor James was in town to give a talk. I hadn’t seen him in over eight years. After the talk they had arranged to take him out for lunch and somehow I got included in this group as did Don, a colleague of mine (also my former boss, and current friend). We chatted about work and who was doing what. Any children? Dr. J asked.
Noooo I replied, staring at my plate, suddenly very interested in my salad, ‘but Don has a lovely baby girl!’ Don gave me a quick smile, ‘she’s 17 months now’, he said. And the talk turned to his baby.

Seventeen months.
We had gone to the same clinic only weeks apart, Don’s wife and I. It was my first IVF cycle and her fourth. I was wildly optimistic. Like many newbies I assumed that IVF was a golden ticket. If it didn’t lead a baby on the first try, surely all we needed to do was try once more. Don’s wife was much more realistic. He first cycle had been cancelled, the second resulted in one embryo, the third was cancelled too. She only had a few follicles and was hoping for two or three embryos. That’s exactly what they got. I was in my two week wait when they got their positive Beta. By the time her little girl was born I had gone through two more negative cycles. By the time they were celebrating their baby’s first birthday I had gone through six. Now she is 17 months. I saw her just before Christmas. She has inherited her father’s curly hair and cherubic face.

Sometimes it feels like the last three years have flown by. What have I been doing the past few weeks, months? I don’t seem to have accomplished much at work, or at home. My long list of unfinished projects keeps getting longer. Suddenly it’s the middle of April and it’s 2006. How did that happen? Other days it feels like I have been here FOREVER. It has been an eternity since we got married and started ‘trying’. Everyone, it seems, has two or three babies in the time I’ve been trying for one. Even my former students send me photos of their newborns.

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I’ve been planting seeds in trays of soil in our dining room. You open a packet of seeds and there are hundreds inside. Some of them will sprout and some won’t. You give them equal attention, good soil, lots of water but only some of the sprouts will thrive. Out of the entire packet I’m usually left with two dozen strong seedlings. The parallels are obvious. My husband found me hunched over a tray, nearly in tears. Any entire flat of nasturtium sprouts had died. You see, I said. ‘I give them love, a cozy home, and they’re fucking ungrateful. Why won’t they grow?’
‘Aren’t you taking this gardening thing too seriously?’ He answered.

Later we were lying in bed, both of us trying to talk the other into a back massage. Mine was sore from the hunching over, his is always sore. We are old I thought. When my mother was my age I was a teenager. ‘Even if we do ever have children’, I said to him, ‘we will be geriatric parents who complain about their sore backs. We will be too tired and too decrepit to play with them. We will be grey haired and wrinkled* with bad knees and arthritic hands.’ He disagrees. He thinks we are still young. We have years and years ahead of us. This is not comforting when there is a good possibility that those ‘years and years’ will be spent without children.
‘Were you really ready to be a parent in your 20s?’ he asks.

Yes I think I was.

When I was 20 something my body worked. It was dependable. Nothing hurt. I exercised, I did yoga. I drank coffee in the mornings and wine at night. I had two ovaries and two tubes. I never thought about them. Except the occasional cold, I never got sick. I’d never been to the hospital. I had never heard of endometriosis, or vaginal ultrasounds, or donor eggs, or ICSI or assisted hatching. I had a job, an apartment, a new car. I was ready to have a baby. He was not. He wanted to wait until we had a house, until his career and our finances were more stable. Well, we’ve got the careers now and the house. But the house it empty.

It would have turned out differently, I used to think, if we started earlier. If only I had insisted. If only he had been ready. I drove myself crazy thinking about this after the first few failed cycles; wishing I/we had made different decisions. But now I realize it doesn’t matter. I’ll never know what could have been. Perhaps I would have just been a younger infertile. Would that be any better? No. Plus we wouldn’t necessarily have had the resources to pursue IVF, and I don’t think we would have had the strength (in ourselves and in our relationship) to go through everything we’ve endured for the past four years.

So, it is what it is.

*The wrinkles have already started. I’m starting to develop something called ‘laugh lines’. Funny thing is, I don’t remember doing much laughing in past few years.
Laugh lines my ass. Who came up with that?

Neighbours

We live in a neighbourhood that’s not very neighbourhoody. The area has a mix of rental homes (taken up by students and youngish professionals…I put myself in this category) as well as older people who have lived here for many many years. The houses are very close together which is wonderful in promoting an ‘urban’ feel, but not so wonderful if you value privacy. On one side we have a grumpy neighbour- a seventy something woman who has no family and lives alone. She filed a complaint with the city when we were building a fence to enclose our courtyard because she feared that the fence post might touch her house. On the other side there is a townhouse with three units, each occupied by lovely couples whose children are grown up and have left home. And then there’s Mr. P. He lives around the corner, but our courtyards border one other. He's a retired widower- used to be a youth counselor with a local church. He has sons (two, maybe three) who live in town and drop by often to see him. He is friendly, sometimes too friendly, holding us up with useless chatter about the history of his house, or the growth of his vines while we stand on our front porch, keys in hand, trying to balance heavy groceries or awkward packages. He is a harmless if slightly annoying presence. I haven’t seen Mr. P in a few weeks; not unusual given the miserable weather.

On Saturday I picked up the local newspaper. There on the front page is a picture of a 20 something man recently convicted of first degree murder. He had tortured and killed a co-worker three years ago. The story is gruesome, and the motive doesn’t seem very clear. It was part robbery, part drinking/pot smoking session gone wrong. Turns out this guy was living just 3 blocks away from us AND has the same last name as Mr. P. I looked in the phone book. There are only two Ps in town. Crap. I think this murdering torturer is my neighbour’s son.
But I can't be sure.
It’s not like I can knock on his door and say ‘oh, by the way is so-and-so enjoying his stay at the Big-house?’ Anyhow, I am freaked out. Completely freaked out.
What kind of neighbourhood do I live in?? This is supposed to be the nice part of town. Mr. P is the guy we trust to keep an eye on things while we’re away (because he’s always there and he’s nosey).
So, how do I play this? Keep being friendly to Mr. P or be more guarded? Show sympathy? Pretend I never read that newspaper article?
What exactly is the proper etiquette when you think your neighbour has raised a killer?
What an odd town I live in.

On a more positive note, I was absolutely giddy on the weekend when I found that the local grocery store was mistakenly scanning my favourite tomato sauce as $0.99 per jar instead of the usual $2.99. Amazing that after having spent (wasted?) tens of thousands of dollars on IVF treatments that have gotten me nothing, I can still get excited about having saved $2 (!) on a jar of tomatoes. Actually, I went back and bought 12 more. Think I'll spend the evening fondling the jars and cooking up a big pot of pasta.