Saturday, March 2, 2013

Our Invitro Experience.

Most people come to the crossroads of adoption because of infertility. We were no different.

The first time I walked into my doctor’s office to talk about my infertility, I was twenty-one.  I was thirty-nine when D’s adoption finalized.  Seventeen years.  Granted, there were breaks in there.  I was married at eighteen, moved out at twenty-five and was divorced at twenty-six, so there were a couple of years here and there that I wasn’t actively pursuing pregnancy.  But, only a couple.  I married John a year after the divorce, when I was twenty-seven.  Knowing that I had not been able to get pregnant before, made me start looking into infertility solutions pretty soon after we were married. 

Anyone who has been through the infertility rollercoaster knows it is an emotionally, physically and financially draining process.  One of these days, I should get all my medical records together and lay out the long list of tests and procedures I endured over a seventeen year span.  Biopsies, laparoscopy, medication, dye tests, x-rays, cat scans, ultrasounds, probing of all kinds—mostly of the uncomfortable kind, artificial insemination, lots of ovulation tests and timed “activity” of all kinds….and the list goes on.  I went through several doctors as each came to the same conclusion—“we don’t know what’s causing your infertility and we’ve done all we know how to do”.  Tears.  Next! 

In the Fall of 2004, I met a couple of women who were going through the Invitro process.  It was the first time I had really considered it.  Years of failed fertility had left me with little hope, but hearing that this had worked for them gave me a glimmer that I held on to tightly.  I scheduled my consultation, and off we went…quickly.  Our doctor had been on the forefront of the invitro technology here in Southern California, and at the recommendation of a patient of his, we moved forward.  The next eight months would prove to be more difficult than I had expected.

It started out normal.  I was checked out to make sure I was healthy and able to go through the process, and though I was heavier than I am now by about thirty pounds, I was still deemed strong and healthy enough proceed.  So, the medication began.  It starts with Follistem, which does just what it sounds like it does—it stimulates the follicle, or egg, development.  I was supposed to have been on it for about ten days.  On day three I could hardly stand up and was in a lot of pain.  I called the doctor’s office to tell them that I thought something was wrong.  They said that it wasn’t abnormal to feel some discomfort, but after explaining to them that I was way beyond “discomfort” they had me come in for a check-up.  I have a pretty high pain tolerance, but I couldn’t even stand up straight at this point.  After feeling my abdomen, they did an ultrasound.  I wish I could find the picture of that ultrasound (Google “hyperstimulated ovaries” and you can see what it looked like!).  I had an over-the-top reaction to the Follistem, which would set the tone for the rest of this whole experience.  Ovaries are normally the size of a walnut.  Mine were now “kissing ovaries”.  They had grown so large that they were touching each other.  Each one was bout five inches long by about two to three inches tall and wide.  They were full of eggs.  The ultrasound picture looked like a spider web.  Tons of eggs in there of various sizes pushed against each other, causing lots of pain.  We stopped the Follistem. 

Here is what is supposed to happen.  The Follistem stimulates egg development and your ovaries “recruit” a few eggs into the ovaries and then the medication helps them to grow to the right size for fertilization.  Usually this means a few eggs, which are then harvested (via minor surgery and a nice long needle through your cervix to suck them out), fertilized by hand, and then the fertilized ones are put back in with the hope that they will nestle in and begin to grow and you will be officially pregnant.  But this isn’t what happened.

You would think that producing lots of eggs would be a good thing, but it’s not.  What happened is that instead of taking a few eggs and nourishing them properly, my body kept recruiting.  So, my ovaries were filled with lots of eggs in various stages of development—some were the right size, but many were past their prime or too little, and they were all packed in so tightly, fighting for nourishment, that none of them were particularly healthy.  The other thing that happens, is that because you have so many eggs that are all affecting hormone production, different hormone levels skyrocketed.  We almost had to scrap the entire process and start over.  Hormone levels had to be within a certain range, and I was about seven times higher than I needed to be, so we just waited for them to drop, hoping they would slip into a normal range within the time frame needed for everything to still be viable.  This also meant I was getting my blood tested every day, which meant a fifty-mile round trip and needles every day, not to mention I felt awful and was in a lot of pain.  On the last day possible, my levels dropped into the right range, and we scheduled the surgery.  It is minor surgery, but it still requires being put under full anesthesia.  The doctor recovered forty-three eggs when all was said and done.  Forty-three.  About fourteen times what it should have been.

Then, we waited three days while they fertilized our eggs, and prepared to put them back in.  I felt so sick, but figured it was just all the hormone manipulation and stress.  It wasn’t.  I went back in, excited to be putting the eggs in, and the doctor came in with more bad news.  I had Ovarian Hyperstimulation Syndrome.  The condensed explanation is that the drugs had caused “leaky” blood vessels, and essentially, my body was taking the water from my blood and depositing it into my chest and abdomen.  So, my blood was getting thicker and my abdomen was filling with fluid.  The problem with elective procedures is that your insurance doesn’t cover complications that arise because of it.  My doctor wanted to admit me, but knew it would be a huge expense.  He gave me the option, but we chose to monitor it for a few days and then if it got to what he considered to be a dangerous level, he would have no choice but to admit me.  The solution?  Drink lots and lots of fluids.  Seven to Eight liters a day of anything I could stomach.  My stomach was distended.  I had to pee every forty-five minutes or so.  I looked like complete hell.  And I felt worse.  It was one of the worst weeks of my life.  On top of that, I had to go in to have my blood drawn every day.  Sunday morning, my doctor called and said he had been awake through the night worried about me and wondering if he’d made the right call.  The problem with “leaky” blood vessels, is that thick blood leads to clots, which are life-threatening.  He gave me one more night and said if my blood hadn’t shown improvement the next morning, I would have to be admitted.  I was so spent physically.  I just could not drink the amount I needed to.  My poor husband was trying to keep me on target, but I was done.  The next morning, the tests looked better, and I began to improve.  I was still anxious to put the eggs back in, but they said we would have to wait a few months to let my ovaries and everything shrink back to normal size, and allow my body time to recover. 

For three weeks, I made the drive every day to have blood drawn.  It’s a good thing I have hoses for veins, because by the time it was over, I looked like a drug addict, and the thought of the needle going into my bruised arms again just made me cringe.  Eight fertilized eggs were frozen, but they weren’t the healthiest of eggs.  He called them B+ eggs.  I was used to being a A+ student!  Putting them back in was another saga.  Ideally, you put eggs back in right after you harvest, because your body is naturally at the right stage for them to be received and implanted.  But, when you use frozen eggs, you have to get your body back to that stage in an even more unnatural way.  More drugs.  And these were worse.  I had daily shots in my stomach and shots in my hips.  The stomach ones were actually not too bad.  The needle was small, and John was able to do them.  The hip ones were so painful and cause huge knots almost immediately.  My friend was a physician’s assistant, and he did those for me.  The needle was bigger, and after everyone knotted it, but became more difficult and much, much more painful.  I used to dread those, they hurt so badly.  I don’t remember exactly how long I had to do those—close to two weeks or so.  These affected me emotionally more than any of the other drugs had.  It was the first time in my marriage that I felt angry and could have driven off into the sunset and never returned.  I knew it was the drugs talking, but it took a toll on me.  I don’t ever want to feel that way again.

Despite the physical and emotional toll on my body, we were able to go back in as planned and have the embryos put back in.  By the time my eight B+ eggs thawed out, only three of them had survived.  My doctor said normally he would only put two back in because of the high risks associated with triplet pregnancies.  But, because of the low quality of the eggs, he left it up to me, and we chose to put all three in.  He wanted me to promise that if all three took, we would consider selective reduction to ensure a healthier pregnancy.  What a shock that was!  I am not a fan of abortion in any form, although I do believe that in the case where the mother’s life is in danger, then she should be able to make that choice.  I spoke to a few people with my same religious beliefs to see how they felt about that choice should that occur.  They all assured me that in a case where my life or the life of these other babies was in danger, that we rely on the expertise of these doctors to help us with that decision, and that it would be okay no matter what I decided.  I felt fine with that, except that I just didn’t want to have to make that choice.  Not because I felt any guilt at aborting, but because I didn’t want to give up even one child.

I wouldn’t have to face that decision, though.  None of the embryos took.  I wasn’t pregnant.  Again.  I was very sad and disheartened.  The three women I knew who had recently gone through Invitro had all had healthy babies.  I was the only one who failed.  I know it wasn’t my fault, but I was very sad.  By this time, six months had passed since we had begun the process, and I was worn out.  Physically and emotionally drained.  We met with our doctor and he said that if we wanted to try again, he felt like he had a better handle on how my body would respond now, and that we could make some adjustments and hopefully be more successful.  He said I was certainly the exception and that he only had maybe one patient a year that reacted to all the drugs as badly as I did.  I didn’t know if I wanted to do it again, but John really wanted to try, so we did.

We dropped the rest of our money on a second round.  This time, I only produced a paltry twenty-three eggs!  Still seven to eight times more than I should, but a much healthier round.  Still only about eight were viable.  I didn’t go into Hyperstimulation and we were able to put three embryos back in within a few days of harvesting, which was another round of day surgery and anesthesia.  John was so excited and hopeful.  I was not so hopeful.  Disappointment after disappointment had left me too cautious and a little hopeless.  We waited a few days and I was sick to my stomach.  He had considered these “A+” eggs and as good a round as we could hope for with the way my body reacts to everything.  I was working in the garage with a friend of mine the day I went in for the pregnancy test.  It was a blood test, since it was so early in the process.  I couldn’t focus on anything.  I was painting and had my big overalls and work boots on.  I finally told her that I was tired, and wanted to go lie down, so she went home.  I went inside and saw the light flashing on the answering machine.  My heart sank.  I was afraid of what the message would be.  My fears would be confirmed.  I wasn’t pregnant.  I crawled into bed, boots and all and just cried.  I couldn’t even speak.  It would be about four days before I said much of anything.  John and I holed up in our house.  I just couldn’t face anyone or anything.  I have dealt with a lot of emotionally difficult situations in my life and had never just shut down.  But, everything came to a head that day, and I shut down.  I knew I would recover.  I always did.  I just needed that time to mourn, and I took it.  I had great friends who understood and didn’t push.  They knew when to leave me alone and they knew when to step in.  They would be that same great strength for me when we faced an even more devastating moment in having to give our first almost-adopted son back to his birth father.  That experience was even more tragic for us because we had gone through this one.  But, maybe in some ways, this prepared us for dealing with that one. 

Loss is a difficult thing.  I’ve learned a lot about myself and what I am capable of.  Those who went through all of this with us, were part of a small handful of people who could comprehend what an incredible day it was when we finalized our adoption.  The greatest joys can only be as great as your greatest sorrow.  Opposition in all things.  And these difficult moments made having D that much more of an incredible miracle.

Our little miracle.  D came to us through adoption, and what
a dream he has been.  Born May 2009.  Took him home July 2009.
About two months later, we attended an adoption seminar and prepared to start the process.  We decided we were done with fertility issues.  What good would it be to have a child if my body was so damaged by the process, or the emotional battle took too great a toll on our marriage?  What would be the joy in that?  So, I came to terms with the fact that I would never experience pregnancy or have a child that was part of me biologically, and I was fine with that.  I just wanted a child, and it didn’t matter what he or she looked like.  It would be four more years before that dream would be realized, but what a dream it would be.

The Surfboard. My second favorite Gotcha Day memento.

I was reading a thread on a Facebook post recently about the terms that adoptees/adoptive parents/birth parents don’t like.  Things like “real mom” were pretty universally disliked.  But there were others that I was surprised to find were so controversial.  The term “biological mom” was disliked by lots of birth mothers, because they felt that was such a cold, scientific term and they felt like much more.  I even saw that “birth mom” was disliked by many because birth mothers (for lack of a better term….I don’t know what to use any more!) felt that was a description of one event and not what they really meant in their children’s lives, even if they had placed them for adoption.  But the one I’ve been thinking about the most is how many families didn’t like the term “gotcha day”, which refers to either the day the adoptive families took their new child home, or the day the adoption was finalized.  I was surprised this was so controversial.  Both those days are certainly monumental days in our lives, and though we don’t do a full on celebration for either day, we certainly recognize it and maybe get a special dessert or commemorate it in some small way.  We do need to be sensitive about how the child feels about that day because it may be a very bittersweet day for them.  For us, a dream came true.  For them, a dream fell apart.  It marks the point of no return for their biological family.  It marks a day of finalization when it became sure reality that they would no longer be an official part of their biological family.  And no amount of showering of love and gifts can replace that loss.  So, of course, we need to be sensitive.  I’ve heard of some families that ask their adopted child every year how they feel about it and if it is something they want to celebrate.  Some years, they are sad and don’t want to celebrate, and some years, they do.

That said, one of my favorite things in our house—one of the few things I would try to save in a  house fire, is the thing that commemorates the finalization of our adoption.  This surfboard.  We threw a big party when everything was done, and I wanted something that everyone could sign.  I didn’t want to do a mat for a picture frame.  I wanted something more personal.  As we thought about it, we came up with the idea of a surfboard.  John loves to surf and we love the ocean and we live fifteen blocks from the beautiful blue Pacific.  And on top of that, when we chose D’s name, the one thing that sealed it for us was that D meant “son of the sea”.  Our house is an old beach cottage style and it just seemed like the perfect fit on all levels.  A friend of ours went through his boards and gave one to use that his kids used to use.  It was signed and dated by the surfboard maker and had been built in the 70’s.  It was perfect.  Well, not yet.  It was perfect later after everyone had written a special note to D on the night of this perfect party.  This board hangs in his room, and I often stop and read the signatures and the messages and remember what an incredible time that was.  After so many heartbreaks, this dream had finally come true.  The adoption finalized when he was sixteen months old, and each birthday since, we have stood it up, and marked his height in red up the center of the board, so it’s meaning is growing each new year.  There are expressions of love and sweet messages from kids on there, and there are things like "Scharpf Forever" and "remember your mother is always right" and clever bits of advice, often about surfing or being happy.  But I think my favorite one is a simple phrase...."And then there were 3."  It makes me tear up every time I read it.  I think that summed up that day best of all.  One of these pictures shows a photo behind the board and a teddy bear.  The photo was taken the day we finalized as we celebrated....where else?  On the beach, and on a surfboard.  The bear is wearing the onesie I made for our little Isaac who was returned back to his birth father after five months.  Many thought that onesie belonged to D, but he never wore it.  It's been on that bear since the day Isaac left.  I thought it fitting he be there to help us celebrate.  It makes that statement even more meaningful and powerful to me.  And then there were 3.

To read more about some of the memories mentioned in this post, see these links:
Our failed adoption:
What kind of adoption language to use or not use: