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When the unexpected happens (i.e. nothing at all)

What happens when “social infertility” becomes just plain “infertility”? When what seemed to be a simple process, supported by the statistics, fails?

And fails, over, and over, again.

I guess when that happens you have three choices. There are variations on those choices, but there are only three main ones. You can either stop, keep doing the same thing, or try something different. You have to make a call. And that’s where we are now. B has had half a dozen unsuccessful cycles, statistically way more than it should have taken for us to get pregnant. She has had all the fertility tests and investigations both her Fertility Specialist (FS) and I could think of. We’ve done Pre-implantation Genetic Diagnosis (PGD) on our embryos.  And there is no real explanation as to why my lovely partner is not pregnant.

So we have to decide – do we stop, do we keep doing the same thing, or do we try something new?

At this stage, stopping is not something we want to do. We would love to have a baby together, and we feel like we need to exhaust our options before we call it quits.

Doing the same thing is not really an option either. The swinging hormones are playing havoc with B’s mental health. She already suffers from a mild form of Premenstrual Dysphoric Disorder (PMDD), so the constant hormonal highs and lows are hell for her. not to mention the dangers posed to her as a survivor of a high-grade hormone-responsive breast cancer. She should be taking Tamoxifen to block those very hormones we are injecting into her, but can’t while we’re TTC! And while she is accepting of the risks, they terrify me.

So then, it seems our only option is to try something new – but what? I’m forty-four, nearly ten years older than B, and my ovarian reserve is two. For those of you who don’t know what that number means, let me put it like this: our fertility specialist used the word “futile” when we asked if my eggs were an option. So donor eggs are a possibility, but we already have PGD-normal, healthy embryos from B’s eggs. It may instead be implantation into B’s uterus which is the problem. Which leads us to the next option: we take our PGD-healthy embryos and transfer them into, as our FS described it, “a proven vessel”. A used uterus, one that has successfully carried pregnancies and delivered live, healthy children. We could find a surrogate, but it seems superfluous to do so when we have a uterus that fits the bill right here in our home. I guess I just need to decide if this forty-four year old body is ready for another go round…

health · ivf · relationships

Challenges…

So, I’ve been absent for a while. Did you miss me? Awww, thanks! Sorry about that, but there’s been a bit going on that’s kept me away from the keyboard. Short update: four excellent quality embryos, one double-embryo fresh transfer and one double-FET (frozen embryo transfer) down, and we’re not pregnant. B’s only 37, and statistically, we should have had a successful implantation and pregnancy from four embryos, so it was time to do some further investigations. She’s had hysteroscopy and flush, biopsies, and today is day one of our next full cycle—although our plan is to have PGS (preimplantation genetic screening) done on our embryos this time, to rule out any genetic problems preventing pregnancy. This means we’ll be freezing after PGS and implanting next cycle, if any of our embryos pass the screening.

Unfortunately, our journey to parenthood hasn’t been our main focus in the last month. Instead, drama queen that I am, I demanded that everyone’s attention be focussed on me, and I tried to die from a combination of two super-rare conditions. Yay me! If you want to know more, google xanthogranulomatous pyelonephritis (XGP), then google secondary psoas abscess. Yep, my body tried to kill me. So I had an emergency nephrectomy, and lost my XGP right kidney. Surgery had some complications: I had a diaphragmatic laceration and plueral (lung) trauma, which resulted in a haemo-pneumothorax; once that was repaired, my surgeon removed the rest of my kidney, inadvertently tearing away the anterior wall of my psoas muscle and filling my abdomen with pus. At least the abscess was drained, right?

So I woke up with a chest drain as well as an abdominal drain, oxygen dependent, on three different sorts of intravenous antibiotics, and on more pain relief than any of my patients have ever needed. Fentanyl, ketamine, epidural anaesthesia, regional anaesthesia, oxycodone, pregabalin, and—my favourite—intravenous paracetamol. Recovery has been tough, and is on-going, but I’m grateful to still be alive—considering that either the kidney condition or the abscess could have killed me, and the complications certainly should have!

Next steps: getting me back to work, and getting B pregnant. I’m not sure which is going to take more effort, but I’m up for the challenge on both!

ivf · relationships

Because biology refuses to behave as a science…

I’m a veterinarian. That means I’m a scientist—a medical scientist.  I understand not just the anatomy and physiology, but also the pathophysiology, pharmacology and specific interventions associated with medical treatments in a range of species, including primates. And IVF and ET technologies were developed by vets and used in cattle reproduction, well before they were introduced as human reproductive technologies. So this IVF journey holds little medical mystery for me.

I’ve also been the gestational parent, multiple times, and I have experience as a volunteer supporting women through the perinatal mental health minefield—I understand the huge gamut of feelings and emotions and side-effects that might accompany both naturally conceived pregnancies as well as those achieved using assisted reproductive interventions. I know. And I sort of wish I didn’t. Because it means that I understand that things may never be the same again.

I know B’s cycle like a familiar pathway. I know how her mood fluctuates, how her body changes, how her sex-drive changes, and I know when her period is due, almost to the hour. That should have been tomorrow, mid-morning. Only it wasn’t. Good old “Aunt Flo”, to borrow a phrase from the online baby-making community, arrived this afternoon. That means our IVF journey has started—our day one blood test happens tomorrow morning. And I’m grieving, just a little bit.

I haven’t seen B much these last couple of days because she’s been out with her SES unit, activated in response to the flood crisis in south east Queensland after ex-tropical cyclone Debbie travelled down the coast dumping huge volumes of water into already full catchments, sending rivers crashing over their banks. As a result, we missed our last few days of just us—where her body was just mine, in the same way my body belongs to her. Because now the treatments start, and whether this cycle is successful or not, our normal has changed. So while I’m truly excited about expanding our family, and having a child with B, I am grieving the end of this stage of our relationship, and the loss of that last night as just Jodie and B.

I hate writing this—I sound like a petulant, self-centred bitch, but I promised myself I’d be honest in my documentation of this journey. My point is this: if I’d known this was how I would feel, I might have done things differently. Maybe someone else reading this will use my grief as a heads-up to prevent their own. They might take steps to make those last few days before treatment starts more special. Or not. Maybe I am just petulant and self-centred. Either way, they are my feelings and I will own them—I am grieving at the same time as I am starting an exciting, brand-new adventure with my soul mate. Life is messy and complicated, isn’t it?

ivf · relationships

The Other Mother Syndrome

I’m sitting here alone, watching South-East Queensland scramble to prepare for the flooding that’s coming as ex-tropical cyclone Debbie works her way down the coast. The state government has taken the unprecedented step of closing ALL schools across the SE today, so my seventeen-year-old and eleven-year-old daughters aren’t at school, but I’m still home alone. They got a call from my ex-husband and have gone to see him for the day—so my plan of bunkering down at home with the girls and a pile of DVDs and some home-made buttered popcorn got nixed before I’d even had a chance to voice it.

It’s hard being the parent who has to tell them to clean their room, or do the dishes, or do their homework, when their other bio-parent chooses to only have one weekend a fortnight with them, when he always has something fun planned, and with him there are never any responsibilities or boundaries. It’s hard not to point that out when he rings them and offers to come get them and do something fun with them on an unexpected day off school, without running it past me first. It’s hard not to tell them that it hurts me that they come to me all excited and ask can they go with him. It hurts me to say, “Of course, if you want to.” But I do anyway, because I don’t want them to resent me anymore than they already do. Mother guilt is a bitch.

So, I’m home alone—my partner, B, is a State Emergency Service volunteer, and she’s gone out to be an orange superhero, and help deal with the many emergencies already happening as the deluge continues. Feeling like I do about the kids being out with their father, it’s hard to not feel abandoned by B too. My insecurities are racing madly around my head, screaming that no-one ever chooses ME. I know it’s selfish, I know it’s irrational—the jealousy on both fronts is completely unwarranted, but I still feel this way. I wonder if it’s worse because, as I’ve recently discovered, I’m suffering from a disorder I’ve nicknamed “The Other Mother” Syndrome (TOMS), and these new feelings are just piling on top of the ones already there.

TOMS is a disorder characterised by feelings of jealousy, inadequacy and loss, suffered by a partner who is not a bio-parent to a child (or a potential child who is still to be conceived and/or born). In my case, it’s been exacerbated by the fact that I have experience as the bio-parent—I consider that my role, and without that role, I don’t know where I fit. B will start an IVF cycle in the next few days, and I feel like I have no place in her journey. She doesn’t really understand—she sees my support and participation as essential to the journey. But I see mothering as my role. Don’t get me wrong, I have no desire to be pregnant again. I didn’t love being pregnant any of the three times I did it previously. But I know how to do that. I don’t know how to assume any other parenting role. And I’m desperately worried that any mothering role I assume has to take something away from B, and I absolutely don’t want to do that.

I’ve looked around for information on parents in my situation, and it’s sparse. I’ve read a couple of books that address the issue, but offer no real solutions. The general consensus seems to be that it will be okay once the baby arrives and is past that initial “only wants mum” stage. But holy shit, that could be a really long way away. I’m not sure I can deal with feeling like this for that long. So I need strategies—I need to define my role during the trying to conceive and pregnancy journey. Help me, please.