A month has passed since my original post and just like life, our journey to become parents has evolved during these four weeks. More decisions, more reality checks, more lessons learned, and more…hope! Even with some things that might have included some negative tinges, my husband and I have kept the channels open discussing what feels right, what feels off, and where to head next.
That Damn Thyroid
Well, we upped my meds again and my TSH (which can affect ovulation and overall egg quality) hasn’t gone down to normal levels yet, so we upped it once again and I’ll know in another week if we are yet to get it down to that happy 2.5. My fingers are crossed because, even if fertility was not our priority, I still want to be healthy!
Any woman who’s had low AMH (quantity) and high FSH (quality) can empathize with the question that’s been on my mind…are my eggs just rotten? It’s an “ugh” question and lots of folks like to say hush now, they’re not rotten, when the fact of the matter is, my choice of adjective may not be ideal but I am 41.
But Others Have Done It!
The great irony for me is that my perception of being able to get pregnant at 41 was actually quite optimistic, because over the years there have been a sizable number of women who’ve come in and out of my life who have gotten pregnant in their late 30’s, early 40’s, with seemingly little struggle. That matched with the stories of celebrity mums at my age just made it more stunning when my ND checked my levels. So the great reality check definitely happened, and while we could have embraced an “ignorance is bliss” when we first decided to start trying, I’m eternally grateful that my ND was all about getting me prepped and checked and treated in advance.
Looking at Past Providers
Going back into my annual exams with ob/gyns, not one ever even suggested testing my ovulation or taking blood samples to see where my levels were at. Only one, literally 6 months after my divorce at 31 when I’d first moved back to Portland, solo, even broached fertility. She said as we were in the hallway walking out, “at your age you might want to think about freezing your eggs” and that was it. Considering the cost of an uninsured process like that, coming from the mouth of a wealthy doctor as if there were no financial considerations, it was a really callous thing to say, and one of the reasons why I don’t like going to most ob/gyns who give you 15-20 minutes of their time and pull in a quarter of a million a year or more providing this miniscule amount of care and thinking random comments like this in the hallway where others are around is an appropriate way to counsel. Then hearing from so many women that the majority of RE‘s out there are known to be some of the most insensitive, cold, god-complex-ridden folks out there in the medical field (and experiencing it with 2 clinics firsthand)? It really leaves you with a bad taste in your mouth. Anyone who knows me knows I’m a stickler for accountability, and the lack of it in this profession along with the “first do no harm” philosophy that is lost among a lot of providers, it’s so sad to me.
The New and Improved Fertility Doctor!
Shockingly, we found out about the new doctor on Yelp. Yep, for kicks I decided to see if any of the bad providers’ clinics were reviewed and all I can say is I wish we’d checked sooner rather than relying on advice to go to the first one we were referred to. There seemed to be a resignation of many that RE’s are assholes and you go to them for the expertise but not the love. I’m so glad I called bullshit on that. With the majority of infertility treatment not covered by insurance, I sure as hell was not going to put up with and PAY cold insensitive jerks. Because here’s the deal: my belief is that parenting is challenging enough without the process of becoming a parent being so brutal, and if they can’t treat you like a human being instead of a transaction, fuck ’em.
Anyhow, we saw the good doctor for a free consultation (what a concept – the others didn’t offer this and it’s something I rarely hear about in traditional medicine), and from the wonderfully kind lady on the phone to the warm, genuine smile from the doc himself, my husband and I both – finally – exhaled. And along with this? He talked about money upfront, the discounts for the uninsured, and was both realistic AND kind to me about my options. [While the last RE told me she didn’t think I had much of a chance yet had no hesitation to suggest 4 rounds of Femara + IUI (while not mentioning it only would increase my odds by a couple of percentage points), then IVF &/or a donor egg, with all of these adding up to several tens of thousands of dollars by the end.]
Doctors like our original one prey upon women’s desires and sometimes desperation to get pregnant with a careless “I’ve seen it happen” comment, rather than being gentle but realistic, with actual success rates for their age group and situation. SART success rates are published, but many manipulate their numbers or market deceptively to prospective patients. And when you’re in a vulnerable, emotionally charged situation that many times is one of if not the biggest challenges of your life? Well, many allow REs to walk all over them and don’t think about questioning their recommendations or their lack of bedside manner.
Next Step to Homemade
So we talked about what treatment was available versus what was realistic. We talked about what was worth the time and the money, and what options could cover the “if I look back will I regret not trying ______” type of thoughts. And the fact is, there is really only one possibility left to try with these eggs I’ve got left, which is a series of natural gonadotropin injections to try to produce more eggs when I ovulate. It also has way fewer side effects compared to Femara, and has a bit better results. To be honest, we’re not banking on this, but it’s the one last try we want to take with my ovaries. Emotionally and physically, I don’t want to be 42 or 43 and still obsessing on this. We will be parents, and know that it may just look a little different than we once visualized. And that’s cool. So, tonight we kick this off, and my husband, to keep him involved, will be giving me the tummy shots 🙂 We’ll give this a try and see what happens, but if it’s a no-go, then the donor egg catalog gets opened…
Our DHS Verdict
While the above was all happening, we also watched how DHS was – and was not – handling our application to foster/adopt. Poor follow through, refusal to provide copies of information, and more, leading up to our first appointment with – wait for it – a social worker who was brand new to her job, available only part time, and just couldn’t seem to find half the references that were sent to her weeks ago. In the first appointment, which she said would be an hour, she was at my house for almost 3 hours, as she wanted to start my 1:1 interview which she’d not told me about in advance. She seemed frustrated that we didn’t know if we wanted to foster or adopt (we’d applied for both) and then when we were open about our plans to adopt from an agency, she said that this was a “red flag” to them because they think we should only be focused on going through them. Going through them means we either get a temporary child OR waiting up to FIVE years to be able to adopt, and at the court hearing to adopt a child, you would be against up to 50 other families, with a possibility of rejection even if the child has been living with you and even if the social worker has recommended you. And along with that, not to mention the social worker telling me is that they as an agency assume that you as an applicant will parent like your own parents did (wow that’s mass generalization and so untrue for so many of us…), it really turned me off. Oh…and did I mention they explicitly said that we’d have to “keep a good eye on the checks that come in to make sure that accounting is right as they get it wrong a lot and you have to keep on them to get things fixed.” Scary to see this is a state agency we’re supporting with taxpayer dollars.
Happiness is Crossing an Ocean
On the international adoption front, Friday we sent off our packet of paperwork to the adoption agency. We have decided that we’re going to adopt a little girl, with our preference being a baby but open to a child up to age four, as we’d like to have some time before school and such begins for us as newbie parents, and to give her time to acclimate to living with us with a new country, climate, language, community, everything. It takes 12-24 months from the time we apply, so we thought we’d get crackin’ on this while we work on the homemade plans as well.
There was a LOT of paperwork – a ton of references to get (huge thanks to our American and Australian friends who wrote so many beautiful things about our relationship and potential as parents!), medical clearances (my naturopath’s letter was not accepted so I had to meet a GP and get a physical this week at the last minute so I could get a clean bill of health from him), employment and income statements for each of us, complete our autobiographies for the home study, three different criminal and background checks (gotta love that we got fingerprinted with DHS the same day but they won’t share results with the agency, and found out that the Oregon State Police and DHS require separate background checks, kind of worrisome that those two agencies aren’t sharing info, yikes!), 10 hours of online training, and much, much more. The agency has been great (a little rough around the edges when it comes to communication style, but having talked to an adoptive family who worked with them on 3 separate occasions, we took their advice and rolled with it), and we can’t wait to get the home study started !!
While the online forums and support of our friends and family has been lovely, talking to other women whose bodies have also challenged them in this process was something I finally got to do after learning about RESOLVE, a national network of support groups for families experiencing infertility issues. Last week I met six women at a local meeting who all had different issues they were contending with reproductively, running the gamut from PCOS to premature ovarian failure to unexplained infertility to diminished ovarian reserve (moi). It was such a sigh of relief to get in there and just vent all that was on my mind, my experiences, and listen and learn from others. I was grateful, and will look forward to the next meeting as well.
Our journey to build a family continues. It has streamlined in a few ways, educated us in many, and inspires us every single day. It has brought us closer together and really kept us focused on what’s most important, and while some days I curse at the challenge, I know that I would never want to have started any earlier. I am the parent I want to be now, and would never have been nearly as prepared or confident ten or twenty years ago. So I’m 41, and I’m facing it head on, and with my most amazing and wonderful partner, we are creating a family in our own way.