Thursday, October 20, 2011

Cycle Day 4

This is always the easiest part of the cycle for me, when there's nothing to do, nothing to worry about, except to wait until my period ends and the ultrasounds start to see if any follicles are growing.  No possible pregnancy today, but no possible negative on a test, either, no need to check for spotting, no possible new bad news.

It's been so long, so many years and months and cycles of thinking about gearing up for a possible pregnancy or hoping for one or mourning the possibility of one yet again, that I can't even really remember what life was like when it was always like it is right now, at this easy part of the cycle, this tiny sliver of respite.

And I can't image what it will be like when I'm past this stage of life, either a parent or living child-free--I can't even imagine who I willl be then, since this has been the reality for so long, and since I feel like I've had to give up so much of my former life to focus so much of my energy on TTC in my 40s. 

I used to, simultaneously:
  • Live in 2 countries, Japan (where T is from), and the US, where I'm from--spending about 4 months a year at home, 8 months a year in Japan
  • Teach writing at the college level in the US
  • Run my own writing company
  • Run an award-winning global literary series
  • Publish articles and essays in major publications
Now I'm just infertile.

I live full-time in Japan because the traveling is too hard on the effort to conceive.  I no longer teach.  I no longer run my literary series.  I no longer publish.

I go to the fertility clinic and struggle to communicate with the nurses and doctors in Japanese.  I try to exercise gently every day and meditate and fight off despair. I try to eat well.  I try to remember every day how lucky I am to be with my husband who I adore, and I try to love him well. I try to ovulate.

But at base, it feels like all I am is just infertile.

What's Getting Me Through Today:
  • A new, pre-ovulation MP3 I downloaded from Anji online (http://www.anjionline.com/).  Don't love it but I like it.  It's calming and I like having something new to try and it's a nice variation to my standby favorite, the Bellaruth Naperstak MP3s.
  • The new batch of "healing" soup I made based on a recipe from a Chinese Medicine cookbook called A Spoonful of Ginger (http://www.amazon.com/Spoonful-Ginger-Irresistible-Health-Giving-Kitchens/dp/0375400362), which I love. Basically, I simmer chicken pices (about 2 1/2 pounds, with bone) with smashed ginger (6 slices), smashed scallion (6 stalks), water (9 cups) and sake (1 cup) for 1 1/2 hours.  Then I take  serving or two of that broth (and freeze the rest for later, for whenever I need chicken broth or want to make a new soup) and add whole spinach leaves, including the stems, and swiss chard, sliced into thin strips, and I simmer that together with salt and pepper for about 10 minutes.  And I felt really good after eating it!

Wednesday, October 19, 2011

Cycle Days 2 & 3

Just home from dinner, and from 2 and 1/2 glasses of wine I allowed myself to have since at least I know for sure that I'm not pregnant.  Suddenly, having my period doesn't seem so bad.

What's Getting Me Through Today

Wine

My Question for Today

How much restriction can we put ourselves through if the effort to conceive last years? I've read all the stuff that says no caffeine, no alchohol, no white sugar, etc., and I can see the importance of this after ovulation or when you're actually pregnant, but seriously, how do you last years and years without any of this?

One of my IF saviors, who I mentioned in my last post, Bellaruth Naperstek, talks  in one of her meditations about the importance of accepting that you can't force anything to happen, that you can only invite it to occur in its own time, and in the meantime, all you can do is "live your life, fully and completely, taking gentle good care of yourself."  So how do I live a normal, full, joyful life when I'm constantly trying to restrict myself?

My solution has been to allow whatever I want during my period, and then 3 cups of coffee and 3 glasses of wine a week before ovulation, and then only one cup of tea and no alchohol (or just a sip here and there of DH's wine) after ovulation.

It's still not perfect, but it's my mid-way solution.  And of course I still feel guilty a lot of the time that I'm not cutting out, 100% of the time, everything anyone has ever said could compromise fertility...

Monday, October 17, 2011

Cycle Day 1

My first cycle of my 44th year starts now.  2nd cylce after my last failed IVF (my 4th).  3rd cycle after my last miscarriage (my 2nd).  31st cycle of trying, not counting months without blood due to IVF meds and 2 brief pregnancies.

The 1st cyle of our last year of trying, since my husband, T, and I have decided to try until my 45th birthday.

Two days since I broke down and took a home pregnancy test, which somehow always feels like a failure of character or strength.

Part of my doesn't even want to write about this last year of trying.  It feels like infertility has taken so very much out of me and I have nothing leftover to spend on creativity or expression.  But the other part of me can't bear to spend another year, this last year of trying, barren in both baby and words.

What's Getting Me Through Today
  • A cup of coffee and a glass of wine, since during my period I allow myself a break from all the lifestyle restrictions that come with TTC at an "advanced maternal age."  I once read a book from a Chinese-medicine Dr who wrote that women should not pursue any fertility treatments during their periods, since it's a time to rest.  I doubt by that he meant for me to drink wine and coffee, but if I can't create a baby, at least I'll be creative with semantics.
  • Circle & Bloom's CD1 recording (MP3) in their natural cycle fertility program.  Feel mixed about this program sometimes, but I love having a recording for every day, like a tiny slice of solace meant for each point in my cycle. (http://www.circlebloom.com/get-started/natural-cycle-fertility-program/)
  • Bellaruth Napersak's MP3s.  I usually listen to the fertility ones, but sometimes during my period, I listen to the tracks of grief, actually.  Helps me feel like I'm moving on.  I really love her stuff: http://www.healthjourneys.com/Product_Detail.aspx?id=11
  • Yoga!  It's the one thing I've gotten out of this whole infertility experience that I know is a plus, no matter what the outcome.
What I'm Wondering about Today

How do we find positive things in this infertility experience, especially if it hasn't resulted in a baby?  Is there anything I can take from this will have actually made my life better?  So much of it is just sheer heartbreak, and sometimes I'm terrified I'll look back, at 45 when/if I give up then, and think, I spent 4 years of my life devoted to this effort, and what do I have to show for it?

Friday, February 25, 2011

Fertility & Positive Thinking: Tool or Trap?

Two recent pieces of news/writing have prompted this post:
  1. A new article in Reuters about a study showing that stress may not have any impact at all on IVF outcome: http://www.reuters.com/article/2011/02/25/us-fertility-stress-idUSTRE71O0B520110225
  2. A post by the wonderful Deborah Lynn of The Resource Guid for Pregnancy at 40: http://www.over35newmoms.com/testimonials.html?entry=on-becoming-our-infertility
So here's my take on positive thinking, negative thinking, and the stress of feeling overwhlemed by infertlity:
In the world of women over 40 who are trying to conceive, the latest mandate is not to take your prenatals or avoid coffee: it’s to think positively.
In the more than two years I’ve spent in my “40+-and-TCC” online group, positive thinking has come up more frequently, and passionately, than any other topic.  When to start thinking positively (Envision your follicles growing with every shot!), what daily actions you can incorporate into your visualization-regime (Keep imagining a baby seat in the back every single time you drive your car!), and, most importantly, what to do when spirits flag (Never, never let the negative get inside your head.)
The advanced-maternal-age sector, along with the infertility community at large, has embraced the pop-culture trend of “if you build it, they will come,”  spawned from such best-sellers as The Secret and Creative Visualization: Use the Power of Your Imagination to Create What You Want in Your Life. But nowhere today does the admonishment to visualize success seem to ring more loudly—or, I’ve begin to think, more problematically—than in the Over-40-and-Trying-To-Conceive sector.
The support and caring and love that accompany the admonishments I mention above from my TTC online group: these are real and admirable and invaluable, and in no way to I mean to diminish that.  But their insistence on forcing us to deny or push away the stress and even the feelings of hopelessness that are an inevitable part of having our hopes dashed month after month: this is what I fear is harmful, actually.
As one oft-cited expert has written, “You can think yourself (in) fertile! It’s your choice.” And herein lies what makes the positive-thinking mandate so tricky: the corollary that the failure to conceive stems not from biology but personal shortcoming.  Similar criticisms have been made of applying positive thinking to the effort to overcome cancer, depression, etc.
But there’s another problem with compulsory optimism: the stress it can cause through denial of the natural lows accompanying infertility.  A handful of experts are starting to explore this paradox and the link between the suppression of negative feelings and an increase in cortisol, a chemical that may inhibit conception.  As Dr. Lisa Rouff has written, “It can be common for some infertility patients to [try to] maintain a very optimistic outlook… [But there are] pitfalls of this type of thinking as it relates to infertility treatment.” (http://www.lisarouff.com/blog1/index.php)
I’d like to propose an alternative to enforced optimism—and the only mind-set that has worked for me after four IVF cycles, one miscarriage, diminished ovarian reserve, and eight pregnant friends: allowing ourselves to experience our full range of emotions, and limitations, with compassion and acceptance, and then embracing our fierce potential to create our strongest possible bodies, ones that will eventually support either a healthy pregnancy, a deep appreciation of all we’ve already built, or a vibrant child-free life.  I’m not advocating giving into the despair infertility can cause, or allowing it to overtake us forever.  But I am advocating allowing ourselves to acknowledge it―and not blame ourselves for it―and even to feel it fully, before we expect ourselves to move on to what I believe is the true opposite of negative thinking: not willful positive thinking, but realistic thinking, supplemented with pride in ourselves for all that we achieve and create when we make it through one more day of infertility.

Wednesday, February 16, 2011

Missed Birthday

Today would have been our baby's first birthday, if it had ever been born, if it had ever lived past 8 weeks and 5 days, if its heart had kept beating.

I'm not sure what one is supposed to do on a missed birthday after a missed miscarriage after the only pregnancy one was ever able to concieve, after 27 straight cycles of trying (minus the 3 during the actual pregnancy-of-the-baby-that-never-was, the one after that baby-that-never-was's "missed" miscarriage, and one additional one when one and one's husband were on different continents and thus unable to try procreating), after 3 IVF cycles, 4 embryo transfers, and over two years straight of monthly minor heartbreaks or major depressions, depending on one's state of mind when one's period shows up yet again.

Does one cry inconsolably?  Hold some sort of missed-birthday ceremony?  Increase one's dosage of Zoloft?

I've done none of the above.  But I did stay in bed until past noon.  And then watch reruns on TV.  And then had a muffin and a coffee, neither of which is allowed on my fertility diet.  And then decided that I just couldn't take this feeling of being in limbo one second longer, with nothing to show for it.

So now, against all my better judgment perhaps, I'm writing out loud. About being infertile, in limbo, and in total confusion about how one goes ahead with one's life in any kind of productive way when one cannot seem to reproduce.

My questions:

  1. How does one make anything meaningful, achieve anything worthwile, while being chewed whole and spat out daily by the soul-sucking experience of infertility?

    --and, perhaps more easy to answer:--

  2. How does one mark the birthday of a baby-that-never-was?

Monday, October 18, 2010

I Was a Mother Once, For 9 Weeks and Five Days

I was a mother once, for nine weeks and five days anyway.
Or  seven weeks and five days if you count from the date the doctors plucked my eggs from my uterus and fertilized them in a Petri dish with my husband’s sperm, and then re-deposited “the most promising looking one” back inside me two days later.  (Pregnancy, I learned then, is medically dated from the date of your last period, the “start of your last cycle,” not the date of conception.  In this case, since the doctors themselves presided over the moment of conception, I know that my first and only offspring sprung into existence exactly 14 days after my last cycle commenced.)
Or maybe I was technically a mother for only six weeks and five days, if you don’t count the last week, the seven days during which my body became a maternal mausoleum, a secret graveyard holding fast to the little embryo whose heart had stopped beating, the doctors guessed, two days before the ultrasound that confirmed it had gone quiet.  One hundred and sixty eight hours, approximately, from the time my “missed miscarriage” (when the fetus dies in utero but the mother’s body does not spontaneously miscarry) began to the time the same doctor who had, almost two months earlier, removed my egg for fertilization, now began to administer anaesthesia through an IV in my arm, so I’d be unconscious during the egg’s second, and final, removal.
I can’t say I acquired a great wealth of wisdom during my almost-ten weeks of motherhood.  But I did learn a few unexpected things (beyond the meanings of all the acronyms on the “over 40 IVF online listserv” I had joined, being 41 and new to the processes both of trying to get pregnant and facing infertility.  Acronyms like TTC, ET, 2WW, and PUPO, or “pregnant until proven otherwise,” really just a kinder interpretation of the two week wait during IVF, when you know you have an embyo inside you but you don't know it it has implanted or gone still).
I learnedthe night after the ultrasound that confirmed the fetus’s heart had stopped, as my husband lay his cheek against my stomach and cried silently and the banal love-song coming from the television made my chest burst with grief like when I was a teenager mourning a crush-gone-bad, only it now felt a thousand times worsethat motherhood means a whole new way to have a broken heart.

Sunday, January 3, 2010

Pigeon Envy

The last time we tried to make a baby in a petri dish, a pigeon laid its eggs behind the air-conditioning unit on our balcony, right in the middle of downtown Osaka.  I had gotten my period that morning, meaning that one more attempt at natural conception had failed, and it was time to start IVF.  It was mother’s day.   I took the eggs as a personal affront.

I can’t believe the audacity of that bird,” I thought. “Procreating on my property. When I’m reproductively challenged.

Two days later, I started my shots.

My husband T―a Japanese salary-man who couldn’t be more different from the Jewish-doctor-son-in-law my parents had envisioned, but who’s the best thing that ever happened to me―grumbled when he saw the offending orbs sitting mock-innocently on the balcony floor. But eventually he bowed to the inevitable. “We have to at least try to save them,” I argued when he suggested removing them.

“Even if that evil bird did steal my eggs.”

So T builds a cardboard nest, pulling out old Sanyo boxes from our futon closet .  He dons rubber gloves and a mask. (“Don’t get bird flu!” I yell stupidly as he steps onto the balcony) and puts the eggs and some twigs in the box.

Every morning after that, I shuttle to the clinic to get my shots―because although in the US, women are allowed to give themselves their own hormone injections, apparently in Japan, infertile women can't be trusted with sharp objects. Then I sit at home trying to work. The pigeon and I pass the time side-by-side, she perched in her little box just outside the glass, warming her eggs, me on the couch inside, tapping the computer keys.  Every so often, I put my laptop down, slide open the door, and try to see what’s happening beneath her.  She stares sideways at me, blinks her beady eyes.

"We're both creatures out of nature,” I announce to her one afternoon as she fidgets.   “You’re just a silly bird trying to hatch your babies behind the air-conditioning unit of an apartment eight stories high, in a huge, polluted urban maze, tucked inside a Japanese salaryman’s discarded cardboard box.

“And I’m a 41-year-old woman with ‘poor ovarian response, trying to get knocked up by a Petri-dish and an army of doctors who don’t speak my language.”

She cocks her head away from me, stares into the bowels of the air-conditioner, rocks lightly on her genetic loot.

At the clinic, the doctors tell me that some follicles are developing, although more slowly than average.  “Well, my eggs are growing, slowly,” I tell the pigeon.

“But better than they expected,” I add quickly.

She blinks blankly at me. Later, when she flies away on one of her pigeon-errands, I peek into the box. The eggs lie there, silent, white, obscenely oval.


The morning before my egg retrieval, when they will puncture the four follicles that have finally grown and suck out the oocytes inside them for “remote fertilization,” I slide open the glass to check the pigeon.  There’s a broken shell in the box, but the other egg is hidden beneath the bird. 
When I meet T  on the subway platform later, he asks excitedly, “Did you see the pigeon? The egg?”  He has taken the afternoon off from work so he can go to the clinic with me.
I grab his hand.  A housewife and some dark-suited salarymen shift slightly away, noting the public affection without doing anything as gauche, in the lexicon of Japanese manners, as staring.
“Yes! What did she do?  Did she smash the egg herself?” I sound disapproving, but secretly I’m a little relieved that perhaps, after all, she’s not going to turn out to be the better mother.
“No,” T laughs.  “It hatched. She’s sitting on it.”
“Oh,” I say, relieved but twistedly, a little disappointed.   “Well, that doesn’t seem like very good mothering, to sit on your babies.”
“It’s what pigeons do to keep them warm, like with their eggs” he says, rubbing my palm with his thumb as the signal for the oncoming train sounds. It’s followed by a voice over the loudspeaker, crisply offering information, or maybe warning, in a blur of words I cannot decipher. 


The chicks learned to fly a few weeks later. They were practicing taking off when I took the HPT on the 14th day and saw a faint blue line.
They were long gone by the time our embryo’s heart stopped, which the doctors estimate was at 8 weeks, 5 days.  They told me at my 9-week scan.  Or they tried to make me know, with their broken English, their Japanese insistence on politeness-at-all-times:  the examining doctor didn’t ever actually say, “I’m sorry, your baby has died.”  He just kept shaking his head and sighing, sucking in his breath, moving the ultrasound wand around inside me, shifting the screen so I could see the stillness splayed across it, waiting for me to say something.

But I wouldn’t.  I wasn’t going to be the one to birth those words.

This weekend, T and I are celebrating our anniversary.  And today, after months of recovering from the miscarriage and trying everything possible to make another pregnancy occur, my period has once again announced itself.  With its impeccable timing.

So soon I’ll start going back to the clinic, the same place where they knocked me out with anesthesia and scraped the little embryo out of me last time.

I'll have shots every morning for around two weeks. A few days later, I'll most likely have another embryo inside me, another little being who’s half-me, half-my-beloved.  I'll stay around the apartment resting, hoping that if I don't knock about too much, the embryo might implant.  Maybe I'll go to the balcony door then, look out to where the pigeon and her babies used to be, and touch my belly, wondering whether life stirs or has gone still inside.