Infertility and Assisted Reproduction
Personal Stories of Infertility and Pregnancy Loss
It's summer in the late 1990s, and Rob and I are coming up on our first anniversary. In addition, we are heading off on a adventure: after we sell or store all of our possessions, we're moving to the Middle East for two years. We’ll be teaching at an international school in Syria.
While we aren’t trying to get pregnant, we aren’t trying not to. It finally dawns on us that nature should have taken its course by now. A routine trip to my doctor leads to a hysterosalpingogram (as much fun to endure as it is to spell) and lots of questions by a Denver fertility doctor about family history, hormonal clues, etc.
Time is running out for any state-side diagnosis or treatment – we are to leave for Syria in mid-August. On top of this, my younger sister just found out that she is pregnant with her second baby. She is not pleased – her son is only 9 months old and a new baby doesn’t fit in with her plans yet. We cry in our soup together about the absurdity of her feast and my famine. (By the way, a few months later, her “feast” turns out to be twins).
We’ve committed to teaching here in Syria for two years. By sheer coincidence, we find that we’re living in the same apartment building as an “embryologist,” as he describes himself, a Lebanese fertility doctor who has trained in Germany. It takes me over a year to approach him about our situation.
He recommends the ICSI (intracytoplasmic sperm injection) approach. This will involve pumping me with hormones to stimulate egg production. With any luck we’ll get a bunch of eggs we can fertilize with individual sperm and freeze extras until we get pregnant. Even thought I am petrified of all the shots and the 2 (minor) surgeries, we proceed. Total cost turns out to be about 1/3 what we would spend in Denver.
The shots stink! Rob has to give them to me, except for the times when I can corral the school nurse. And we are trying to keep this a secret from the tight-knit and somewhat gossipy (but always well-meaning) school community. The hardest part of all is the near-daily blood tests – I’ve got teeny veins that run for their lives at the sight of a lab coat.
I’m knocked out for the egg retrieval – God bless drugs. But we harvest only one egg – bad omen. We proceed with the ICSI and watch on a video monitor as a needle injects one of Rob’s sperm into my egg. Are we watching the very first moments of our baby’s existence?
We call the clinic everyday to see if the cells are multiplying the way they’re supposed to.
They are! The embryo is of reasonable quality – not top tier but not doomed.
The next step is to implant the embryo into my hopefully hospitable uterus. More knock-out drugs. When I wake up I smell garlic (anesthesia-induced). And I wonder if I am pregnant.
We wait 10 days for a blood test to see if the embryo implants. I’m not supposed to ride in a car for awhile, so I take a week off teaching school. I’m left with a whole lot of time to be in my head. Is there a baby or isn’t there?
This blood test will tell us: pregnant or not.
We’re hoping for a 10 or higher on some hormone level. We get a 7 -– not a “no” but not a “yes.” We’re told to come for another blood test in 4 days.
I begin dreaming. I see my baby. My body feels tremendously nurturing, and I have a knowing that I am pregnant. All is well. I am told by an inner voice to dare to hope. In these four days, I allow myself to do so.
So I am incredibly pissed, after being fantastically shocked, that the second blood test shows there is no longer a pregnancy. There is anger at my body, at God, at my own intuition. It takes me years to work through.
I hang up on my sisters and mom when they call me in Syria to console. I am inconsolable. It feels the grief and anger will consume me. If not for teaching, I might have willed my broken heart to stop beating.
I never go back to the clinic or call the doctor.
I feel alone. I've tried to get over my dreams to have a family, and we've talked about some alternatives, but we don't seem to be able to pursue any. I've always been so past-oriented, because my future -- children being a huge part of it -- existed only in my vague imagination. Now, the future literally doesn't exist for me.
Several months later, we finish our contract with the school and pack up and leave Syria.
Back in the US, I can’t bear to go through fertility treatments again. I can’t bear to hope again.
We keep ourselves occupied by fixing up our old Victorian home and getting re-established in our jobs. Forgetting the sting of Hope, two years later we dip our toes into infertility waters again and see a Denver reproductive endocrinologist (RE). After all, there may have been medical advances since our first try, and we may not have received top-of-the-line treatment by our German-educated Lebanese embryologist in Syria.
But no such luck. With single-digit odds of success, all donor material, lots of meds, hassle and moolah, we might be able to achieve pregnancy -- if you factor in a miracle. We have only one wad to shoot (financially speaking), and it looks like deciding on another IVF treatment would be like betting your 401K on a ground sloth that somehow wandered onto the track at Belmont.
I am still so sad that I won’t get to see what a mixture of Rob and me will look like. From the day I met him, I envisioned passing on his beautiful blue eyes to our baby. My talent for music, his sense of adventure, our love of books. I have melded our features together in my mind and come up with dozens of dazzling permutations.
This dream will never be realized. This dream will never be realized. This dream will never be realized.
I have to keep telling myself in order to let go. Such a firmly rooted dream is not easy to pull up and discard.
My pillow is wet for months on end.
I buy a book about living childfree. It helps me reframe our available decisions. Instead of being at the mercy of a stupid god who allows stupid fertility situations to occur (don’t tell me everything has a reason because most of the reasons are also stupid), I can see that I do have choices.
One of the hardest things about infertility is that I've spent four years being choice-less, passive, a victim. I need to feel I'm in the driver's seat of my life again, and this book helps me gain that perception.
1. We can continue to be childfree. Benefits: we’ll have $$ and time to have fun, travel, see movies, be spontaneous.
2. We can try fertility treatments again. Costs: lots of $$ with low odds of success.
3. We can look into adoption.
So we do.
For whatever reason, we are drawn to a particular agency, LFS, which is conveniently holding an orientation session in a few weeks.
In this orientation session, we learn what open adoption is, what the process will be, and the biggest revelation: you don’t just get put on a list and wait until your number comes up –- you get CHOSEN to be parents by expectant mothers who have decided to make an adoption plan.
But the best part of the meeting is the end, when an adoptive couple arrives with their 10-week-old baby boy. They tell their story. We know we could have a similarly happy story. The beaming mom and dad are in their late 30s and we are inspired. It is September, and I declare that we’ll have the mountains of forms filled out by the end of the year.
We get fingerprinted to make sure we aren’t on a List of Very Bad People. We take a marriage test and score pretty well. We separately answer nearly 40 essay questions, and we each write a 5-page autobiography. We get three friends to say (hopefully) nice things about us on a confidential form. We dig up and copy recent tax returns. We request credit histories and have physicals. We ask our fertility clinic to write a letter on our behalf. We go to the DMV and get our driving records.
And you can’t help but think that if all people had to go through all this before becoming parents, there would be a baby bust just for the hassle-factor.
The day after New Years, I submit a fat packet of all requested material. We are on our way.
The home study is an arduous and months-long series of tasks adoptive parents-to-be undertake to prove we're not felons, bad drivers, tax-evaders, financial incompetents, bad spouses, or hopelessly stuck in the grief of infertility.
We hit the adoption counselor jackpot with Sheryl. Without words she somehow conveys that there are no sides and paradoxically, that she is on our side. We feel she is our advocate, yet we know that the system is designed with babies –- born and unborn -– as focal points. She puts us at ease and there is not one instance in the entire process where we feel judged.
The home study requires her to meet with us separately and together. Sometimes we meet in her office, and she also comes to our home. So we clean more than usual. But when she arrives, she says that what she is actually doing is completing an odd checklist used for foster-parenting. Do we have a refrigerator? Are there fire extinguishers and smoke alarms? Dust bunnies are thankfully not on the list.
We submit our profile on March 14.
I call Sheryl on the one-week anniversary of submitting our profile. She says it looks great, as do all the other ones from the couples in our adoption class. There' a lot of competition in The Book of profiles.
“And by the way," Sheryl says casually, "there’s an expectant mother due in three weeks who is interested in your profile.” My heart starts to leap out of my chest.
“It’s a bit of a sketchy situation,” she continues. The heart leap turns into a heart drop.
Seems the expectant father is not sold on the adoption idea. But for various reasons, he’s not in a position to argue. So there may be a problem and there may be none at all.
Do we want to meet Crystal? YES! We set up an appointment for the upcoming Sunday.
Rob and I arrive at our meeting a few minutes early to get situated. I sit down and imagine how it will be to first lay eyes on Crystal -- and my nervous bladder cries for attention.
As I head toward the bathroom, I am in my head about exactly how I want our first impression to be. I walk through the small doorway from the counseling room to the hallway, and... squeezing past me is a young woman with a big belly and a big smile. Crystal. How can it be that she is putting me at ease?
I come back to the room and we do formal introductions. Crystal’s mom is with her. Her role seems to be part guardian angel, part Rottweiler.
Amy, Crystal's counselor, starts the meeting.
Crystal tells us that staying with the birthfather would not be good for her 4 year-old son, the new baby, or for her. The birthfather has stopped contesting the planned placement and is willing to sign papers. She seems to go from being supremely angry with him to hopelessly in love with him… and back. We don’t press.
She says she picked us because of the love and respect we have for each other, and because we seemed a bit goofy. And because Rob is very handsome. I don’t argue.
Although Amy is supposed to facilitate the meeting, we bypass her. Crystal, Rob and I talk as if we’ve known each other for lifetimes. Only Crystal’s mother seems the voice of caution. She asks pointed questions, “Now, you plan on having open contact, right? You’ll tell the child about us, right?”
We respond: “We’ve never done this before, and we’re not sure how to do it ‘right.’ But we do want to lead with our hearts, and we think it will be best for the baby to know where he or she comes from and how much Crystal loves him or her. We know that our relationship is like a see-saw… first Crystal has all the power and we just have to trust. Later, we’ll have all the power and we will want to prove trustworthy to you.”
The counselor brings up the birth. Crystal surprises us with this: “I want you guys to be there with me. You are the parents, and you’ll hold the baby first.”
All our prayers – even the ones we didn’t dare to pray – have been answered. We give Crystal our cell phone number (we’ve been advised not to share last names yet) and the counselor dismisses us, continuing her session with Crystal.
The ball is in Crystal’s court. She’s given us no reason to think she may back out. She says she’ll call in a day or two to get together again – after all, the baby is due in three weeks!
Crystal allows us to be in the delivery room with her. I get to “help” by holding a leg, and Rob does double-duty by videotaping and one other important thing.
I had never been present at a birth before, and I am so grateful to Crystal for allowing us witness this miracle. As the baby crowns, the first thing I see is a ridge on top of a head – which brings to mind a Klingon. Come to think of it, we don’t know much about the biological father. Could we love a baby with a ridge on its head?
It turns out that the ridge is just the umbilical cord, and within seconds we see that the baby is very teeny and well-formed and gooey and ohmygoodness – IT’S A GIRL!
The plan is to bring our(!) baby home the next day.
Crystal spends much of our daughter Tessa's birthday with her, bonding. Why? Our agency advises that it’s important for a firstmother to have the chance to say goodbye, which also requires an unhurried hello. This time alone with her baby helps her heal, and that will be better for all of us in the long run.
But we are on edge. This baby is Beauty and Love incarnate – how could anyone survive separation from her? And if Crystal decides to parent, we might have to face such separation.
We’ve been advised to make a clean break. The plan is to say goodbye to Crystal at the door of the hospital and not to have contact with her until after she relinquishes – about three weeks from now.
We do the exact opposite of a clean break.
Our plan is to make a quick getaway, to say a guilty goodbye to Crystal and bring our daughter home. This plan was carefully crafted to make this day as bearable for Crystal as possible.
Crystal had called me from the hospital that morning. “You know,” she said calmly, “I’m going to cry today. I’m going to cry a lot. This is going to be an unbelievably tough day, having to leave the hospital without Tessa.”
“Of course,” I mumbled, my throat tightening.
“But I just want you to know, “ Crystal continued, “that I’m not changing my mind. My tears do NOT mean I’m changing my mind. I still know this is the right thing, but I need to know I can cry in front of you.”
I begin to cry, too, anticipating her feelings. “Just don’t take it personally,” Crystal concludes, “when I cry because you walk in the door.”
Prior to this moment, I loved Crystal as my daughter’s firstmother. But now, I have such deep respect for her as a person, for being able to be so clear and compassionate with me. For knowing herself so well, for facing her day with such clarity. I am so thankful to her for having this conversation with me.
We gather all the stuff and say our goodbyes. I whisper in Crystal’s ear during a hug, “You call whenever you’re ready. I love you and I’m thinking of you every single day.”
She looks at me with pure love and trust in her sad eyes and whispers, “I know. I will.”
We finally make our quick getaway and head home. With our daughter.
Fast-forward to Tessa’s first birthday.
Crystal, son Tyler, mom Cheryl and friend Tara join our family and friends celebration. Tessa smooshes chocolate cake all over herself and it’s a delightful day.
I tell my mother-in-law that we’re going to start the ball rolling for a second adoption.
“Ohhhh,” she says with a bit of dread. “Are you sure you want to so soon? I mean, if the second adoption goes as quickly, you will REALLY have your hands full.”
I reconsider our pending action. With adoption, family planning is so uncontrollable. We could end up with children 13 months apart, or 5+ years apart. Did we just get lucky with a short wait the first time? Should we wait to begin waiting again?
The busy-ness of life with a toddler takes some of the indecision out of our hands. We aren’t able to get to the second application for several months. I watch Tessa playing in the sprinkler.
Could I ever love another being as much as I love her?
Sheryl from LFS conducts our second home study much like the first. It’s still nerve-wracking. The first time around I didn’t worry about her noticing the Cheerios ground into the carpet.
You’d think that for being repeat customers, adoption fees would be reduced significantly. After all, the agency knows us well and should be able to spend fewer resources being able to vouch for us. But as it happens, the fee is reduced only by $1000.
I realize that much of what we pay goes to counseling people in unintended pregnancies. Some of them make adoption plans and some don’t – but all who come are helped. I don’t begrudge Lutheran this, although I’m not happy about watching our small savings account evaporate.
Again we have to provide references, tax returns, credit histories, and driving records. We both have physicals, and we both get fingerprinted. Have our prints changed in the last 18 months? Why can’t they just run the same prints through again and save us the hassle?
We also have to re-take the marriage test. We scored quite well the first time, but not so well this time. We didn’t fail, but we do some areas of stress.
It’s March, and because of a snow day, Rob is home with Tessa and me. We plan to bundle up and go sledding down our street.
When the phone rings.
“Hi, Lori. This is Sheryl from Lutheran Family Services. I’m actually calling to talk with Tessa.” Sheryl giggles, obviously loving this part of her job.
I put the handset on speakerphone and hand it to my daughter. “Hi, Tessa. I’m calling to see if you’d like a baby brother…”
My heart stops. A baby? A boy? Rob overhears from the next room and rushes in. I reach for something to takes notes on and with, and try to get my 1001 thoughts to line up single file.
Sheryl fills us in. "David" was a complete surprise to his mother, Michele. While preparing for midterms about three weeks ago, Michele’s college roommates rushed her to the hospital with suspected kidney stones. But she ended up in Labor and Delivery instead.
Doctors determine the baby was about 5 ½ weeks early, and he has some respiratory challenges that kept him in the hospital for nearly a week. This gives Michele a chance to figure out what to do. She decides to parent this adorable and tiny blond boy, and lines up help from her mom and Andy, David’s father. Friends also promise to support her until school is out in a few months.
Within a week, though, things fall apart. Michele’s mom lives 70 miles away from her school and just can’t help as much as is needed. And while details on Michele and Andy’s relationship are sketchy, he also proves not too present or helpful. Friends have their own lives and problems. And the baby is colicky. Michele simply can’t make this huge and immediate adjustment. Wanting some guidance and perspective, she calls Lutheran Family Services for counseling.
To give Michele the space to make such a monumental decision, Lutheran places David in Cradle Care. This is like a foster situation where loving people (in this case, a couple who built their family through Lutheran) care for a baby while a mother decides what is the best course for her and for her baby. She takes about two weeks to come to a decision, visiting David nearly every day, and showering her love on him.
I can't even imagine being faced with this situation. Most people who have experienced the "famine" of infertility can't fathom the "feast" of an unplanned pregnancy. I am eternally grateful that Michele made this decision carefully and with a loving heart and a clear head.
Looking at all the factors that only she can know, Michele decides adoption is the best path for David and for her. When she's ready, LFS offers her the book of waiting couples.
The weekend is a whirlwind of getting ready. We get the bassinet out of storage. We rearrange Tessa’s room to make space for a baby. We get out all the bottle and bath paraphernalia that had been put away several months back. We buy itty-bitty newborn diapers. We tell our families. We think of names.
"David,” while a perfectly fine name, is not on our list of boy names. We are not sure how attached Michele feels to it, and we brainstorm our own list anyway. Rob comes up with a name from his family tree, Reed.
We plan to propose it to Michele when we meet her.
At the agency, Michele’s counselor, Cheryl, invites us into her office where Michele is already waiting for us.
Is this the woman who will make us parents to a son?
We tell her that we have enjoyed a fully open relationship with Tessa’s firstmom, and that it has been positive in every way. We tell her the door is as open as she wants it to be. "I chose you two because you’ve already done an open adoption. I’m not sure exactly what I want, but I’m glad to know that you have been true to your word with another birthmother.”
She asks about our parenting style, our extended families, and she wants to know a little about our home. We provide answers.
The meeting is soon over. Cheryl and Michele will continue a counseling session without us. Our counselor, Sheryl, has told us that if Michele makes up her mind today, we’ll have our Entrustment Ceremony tomorrow.
Sheryl calls later that afternoon to tell us Michele has decided that we are to be this boy’s parents. We are to come back to the agency’s offices the next afternoon to meet him and bring him home.
We go into a mild state of shock. In adoption, your whole world can change in a heartbeat. We are finally going to complete our family. We think. You just never know.
This time we bring Tessa. My parents also come to share in our special day. David’s cradle care parents are there, too – they’ve been taking care of David for the past two weeks while Michele made her decisions: first she had to be clear that adoption was her best choice, and second she had to decide who would be her son’s forever parents.
My parents and Tessa head for the conference room. Rob and I again greet Michele in her counselor’s office. This time, in her arms is a tiny bundle of blue. The baby boy was barely 5 pounds at birth, about a month ago. He is ravenously hungry, slurping down the contents of the bottle Michele is holding.
I see her mixed emotions on her face as we enter the room. She silently braces herself. She is relieved to be done with this painful decision, but she knows she is experiencing her last few moments of parenting this baby. She greets us, but no smile is forthcoming. I cannot imagine what she is going through.
She allows me to hold her baby. Her baby. The baby. The baby. Our baby? Our baby.
I gaze into the deep blue abyss of his eyes. His body responds as if he, too, is bracing himself -- for yet another caregiver. His arms become rigid, palms balled up into fists, and he tries to focus on my face. I hold him closely and begin to coo and sing soothingly. Rob is looking over my shoulder, seeing all that is and will be for our family.
Cheryl herds us into the conference room, where Tessa is holding court over Michele’s three college roommates and the baby’s cradle care parents. Cheryl guides us through introductions, and says we’ll now begin our Entrustment Ceremony.
In a moment of group reverence, we all bow our heads.
There are tears of all kinds – of infinite bounty and of immeasurable loss. I am at once full of gratitude and love and joy, and also of the unbearable grief that is just now hitting Michele.
I long to reach out to Michele. But I have absolutely no power to help her. I am the anti-help. I am both allowing her have the life she envisions for herself and taking away the new love of her life. She and her roommates leave the conference room. I hug her on her way out, but I can tell she just wants to have the decision executed and behind her.
We gather our things to go home. I am surrounded by my parents, my husband, my daughter and my son. My heart feels like it might burst.
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