Monday, August 31, 2020

If At First You Don't Conceive, Try, Try Again

After an MRI and consultation with four different doctors who were unable to diagnose the mysterious bump on my forearm, it vanished as quickly and inexplicably as it had appeared.

My health restored, my husband and I refocused on the baby-making efforts. Since we’d canceled our IVF cycle out of fear that I had cancer, we started trying the old-fashioned way. It wasn’t going well. Sex had devolved into a mechanical exercise, the sole purpose of which was to unite sperm and egg. It was joyless, frustrating sex, and when my period came like clockwork in June and July, I wasn’t surprised.

The vasectomy reversal had been a waste. We were reproductively stuck.

At church every week, the lights went out toward the end of Mass for a minute of silent prayer. While the adults quieted down, I could still hear all the restless little kids in the sanctuary. It made me feel sad, sitting there with my empty lap. I felt like someone was missing and I didn’t know if they were going to come back.

“We’ll get there one way or another,” my husband said. I knew that was true – if only because I’m stubborn AF – but to quote Veruca Salt: “I want it now!”

I soon discovered another baby-making alternative: donor-donor (or double-donor) embryos. Author Elizabeth Katkin turned me on to them in her book Conceivability: What I Learned Exploring the Frontiers of Fertility. In a section on the future of infertility treatment, she mentioned a California clinic that matched intended parents (IPs) with embryos created with donor sperm and donor eggs.

Before we go further, a clarification: “embryo donation” and “embryo adoption” usually refer to a scenario where IPs receive an embryo from a couple that already went through IVF and have extra frozen embryos (or “snowflake babies”) that they don’t plan to transfer. Similar to domestic or international adoption, IPs may be required to have a home study with a social worker and a criminal background check. Legal contracts are executed and contact parameters are hammered out. Some families maintain lifelong connections so that the genetic siblings may know one another.

“Donor-donor embryos” are created in a lab and matched with multiple IPs. The process is anonymous all around and attorneys are not involved. A child born from a donor-donor embryo might have a genetic sibling (or siblings) born to other IPs, but they’d have to do some digging through the Donor Sibling Registry, a gene-mapping service like 23andMe, or private Facebook groups to find and connect with them.

I explored embryo donation/adoption by setting up a profile on the National Registry For Adoption (NRFA), a site that matches formerly infertile parents who have extra embryos with IPs. It’s like for the reproductively challenged. I contacted several couples who had embryos to spare and quickly discovered the problem with embryo donation/adoption was that most people wanted to believe they were capable of giving away their snowflake babies, but when push came to shove, no IPs were “good enough” to give them away to. (For the record, I wouldn’t be able to handle donating my embryos, either, but I also wouldn’t pretend that I was capable of doing so and giving people false hope in the process.)

Most couples I contacted ignored my messages completely; the few who responded said they were already considering other IPs to donate to (and yet, their profiles remained live on the site) or that they were only willing to donate to IPs who did not already have children, like myself (understood, but still discriminatory). One Minnesotan mom and I exchanged several emails after discovering we’d both gone to the same college at the same time and had probably crossed paths but didn’t remember one another. She suggested we get together for coffee, then ghosted.

So embryo donation/adoption was nice in theory, but in reality, it was like finding a needle in a haystack.

While Katkin seemed to dismiss donor-donor embryos as an eerie, questionable practice (which seems judgmental coming from someone who went through as much as she did to have her babies), it seemed practical to me. It was less expensive and had better success rates than IVF would be with our own gametes. It didn’t require a couple’s approval or a home study.

The clinic she cited (which I’ll call West Coast IVF) offered two donor-donor embryo packages rather than cycle-by-cycle pricing. The first package was $15K and included three transfers with either one or two embryos per transfer. The second package was $21K and included three transfers with one PGS-tested embryo per transfer, as well as gender selection. Medication and travel costs were all out-of-pocket, but the clinic offered a guarantee – if you completed a SIS (Saline-Infused Sonogram, which I had already done with Dr. Gerber) at its clinic before treatment began, and you did not sustain a pregnancy past 12 weeks after three transfers, all or most of the package’s cost would be refunded.

Financially, this sounded fantastic to me. There was barely any risk. My husband agreed that it was a great deal. But emotionally? It made me uncomfortable. Two people who never intended to have a baby donated their gametes, which were made into an embryo at clinic, which I was going to carry and birth? There was no love involved in the conception; would that have some kind of cosmic repercussion? Would God be OK with this? (Then again, hello! The Virgin Mary was a surrogate, and there are a lot of other reproductive workarounds in the Bible.)

The lack of genetic connection troubled me, too. Would we bond with the baby despite different genes? Would she be resentful that we didn’t know who her donors were? What would our family members say when they found out? (We’d kept everyone in the dark about our baby-making plans except my teens.) Would she look so wildly different from us that even strangers would know we didn’t conceive her?

On the other hand, both my husband and I kind of liked that both of us were being left out of the gene pool. We agreed that it would feel weird for me to get pregnant with an embryo that he had created with his sperm and an anonymous woman’s egg, just like it would be awkward for him to see me get pregnant with another man’s sperm. This way, the baby would be neither of ours, genetically speaking, but she would be "more ours" than a donated/adopted embryo with whose bio family we had to maintain contact.

The biggest advantage of donor-donor embryos was that they were as healthy as can be. This is opposed to embryo donation/adoption, where the couple donating the embryos likely struggled with infertility, and therefore might be older and/or have health issues.

Receiving a donor-donor embryo would also be less taxing on my body than traditional IVF. There was no ovarian stimulation medication or egg retrieval needed. I would still have to use a variety of fertility drugs to prepare my body for the transfer, but the transfer process was much less invasive than a full IVF cycle with my own eggs. A donor-donor embryo would allow me to stop obsessing about my fertility and just let the clinic do the work of making the baby so that I could focus on housing her (yes, we were already determined to have a girl).

Also, because I had a history of miscarriage, I felt reassured that if I got pregnant with the first or second transfer and miscarried early on, I’d have another chance to get pregnant. Having three tries took so much pressure off my body to perform.

I started to feel like maybe my mystery bump – and its ensuing drama – had happened for a reason. Only something as serious as the suggestion of cancer could have made me cancel the IVF cycle. And since we canceled, I was now open – and still had the money – to consider this new donor-donor embryo option.

We decided on the $21K package because of the PGS testing and gender selection. I knew if we chose the $15K package, I’d be tempted to transfer two embryos at a time just to increase the success rate, even though there was no way we could afford or be able to care for twins. I also decided to forgo the refund guarantee because I’d already had an SIS and didn’t want to cram in an extra trip to California.

I filled out a lengthy intake form, transferred all my medical records, and completed an hour-long informational interview with West Coast IVF’s treatment coordinator. The phone call left me with hope – hope that we could make this happen, hope that we were going to have a healthy baby, and hope that we were one step closer every day to meeting her.

There were just a few more hoops to jump through first…

Friday, August 28, 2020

The Wrong Kind Of Bumpdate

Before I knew it, I had a bump.

Unfortunately, it wasn’t of the baby variety. It was a hard mass on my forearm.

My acupuncturist first sounded the alarm. “You should get that looked at,” she said.

So I did, at a sliding-scale community clinic because I was trying to save money for IVF. A gangly, aloof doctor prodded the bump and asked me to flex my hand a couple of times.

“What do you think it is?” he asked.

“A ganglion cyst?” I guessed. It was the closest (and least scary) diagnosis I had found on Google. The only thing was that ganglion cysts usually appear on the wrists or the hands, and mine was on neither of those areas. But I couldn’t even contemplate the alternative – cancer. A diagnosis that serious would warrant quitting the baby-making endeavor immediately.

“Yup. Ganglion cyst. You could have my job!” the doctor said cheerfully. “You know, in the old days, they used to just take a Bible and slam it down on the cyst so it would explode.”

That sounded painful but a lot less expensive than what he suggested, which was having it surgically removed. Unwilling to bankrupt my baby-making piggy bank for something as seemingly vain as having a bump removed, I made an appointment with a specialist to get a second opinion.

“This is not dangerous,” the specialist (who we'll call Dr. Trudeau, because he was Canadian) said after a quick exam. “You can ice it and wait for it to go away on its own, take anti-inflammatories for a month, or get it drained.”

Waiting wasn’t an option; every time I looked down at my arm, my heart raced and my mind whirred with worst-case scenarios.

“Can I take the anti-inflammatories if I’m trying to get pregnant?” I asked.

“I wouldn’t recommend it,” Dr. Trudeau said. “How long have you been trying?”

“We’re about to start IVF, actually.”

“Oh. My wife did IVF,” he said. “Nine times.”

My jaw dropped. Surely I heard him wrong.

“Yes, nine times. But we have a baby boy now.”

He pulled out his wallet and showed me a picture of his chubby-cheeked son. I said something complimentary.

“We used a surrogate on that last cycle,” he continued. Surrogacy was a whole other area of the infertility labyrinth that I had not yet explored. I would later learn that hiring a surrogate cost around $100K. “My wife is actually going to go in again soon so we can try for our second.”

I believe that sometimes God sends us the information we need in unconventional ways. This conversation felt like one of those divine messages. I’d been having doubts about doing IVF with my own eggs. I was scared of the aggressive medication protocol. Would it cause health problems down the road?

I'd also been digging into success rates through the Society For Assisted Reproductive Technology (SART), which compiles statistics on IVF patients. While the Minneapolis IVF clinic had the highest success rates in Minnesota, when I adjusted the search filter for patients my age with Diminished Ovarian Reserve (DOR), I found there were zero live births on a first cycle. None. As any infertility specialist will tell you, success rates tend to increase with subsequent cycles. But would it take nine times like Dr. Trudeau and his wife? We couldn't afford that. Hell, we could hardly afford to do it once.

Though I'd dropped $1,200 on the SIS, I had yet to make the down payment on IVF or start any drugs. There was still time to back out. But what would we do instead? It’s not like we had a better option.

But the IVF ambivalence wasn’t my main preoccupation at the moment. This damn cyst was.

“I’d like to have it drained,” I told Dr. Trudeau.

He seemed surprised but left the room to get a nurse to prepare everything he needed for the procedure. A few minutes later, he brought me to a room with an ultrasound machine and a tray neatly arranged with aspiration equipment.

“If it gives you any hope about IVF, my wife is 41 and our surrogate was 43 at the time,” Dr. Trudeau said as he spread a numbing agent on my arm. “We used to live in New York and no one there has babies young. Many women wait until their 40s to start trying.”

I nodded in recognition, though I also knew I did not want to be going through IVF in my 40s.

“I hope you don’t mind me sharing,” he said. “It’s just that no one talks about this stuff. My wife and I try to be open about our experience.”

“I appreciate that,” I said, though my attention had turned to the ultrasound screen, which Dr. Trudeau was using to guide the needle into my bump. He pulled back on the stopper of the syringe, but nothing came out except a little blood. He switched to a larger needle and tried again, but the same thing happened. He quietly cleaned up his equipment. Something had gone wrong; I just didn’t know what yet.

“You’re not going to like this,” he finally said, “but I think we need more imaging. I’m going to put in an order for an MRI.”

“What would that tell us?” I asked.

“What kind of soft tissue mass this is.”

“What kinds are there?”

The chatty doctor's sudden silence was terrifying.

“It could be a tumor,” he said.

My heart stopped. “This can’t be happening,” I thought.

“I don’t think it’s cancerous,” he continued, “but it could be a tumor. That’s why we need more imaging, so we can discuss options.”

I did not want more imaging. I did not want to “discuss options.” I wanted to wake up from this nightmare and go back to my incessant, silly worries about IVF.

Instead, I spent the rest of the day trying to find an affordable place to schedule an MRI, since my insurance was completely useless outside of a major catastrophe. The cheapest option was a chain of independent MRI clinics. Their estimate? $850.

My little bump was now a big ordeal. If this was (God forbid) cancer, there was no way I could move ahead with IVF. Even if the bump was benign, surgery to remove it was going to be costly. I was supposed to pay the deposit on IVF and start my medication protocol in a matter of days, but that seemed irresponsible now.

I knew what I had to do – cancel my cycle. My throat tightened as I called the Minneapolis IVF clinic to explain that we just didn’t have the money to move forward. (It seemed like an easier explanation than the mystery bump.)

“Are you sure you want to cancel?” the nurse asked. She sounded as upset as I felt. “Have you talked to our financial consultant?”

Yes, I’d talked to her, and she’d been completely useless. The irony of IVF financing is that they only offer it to people who already have perfect credit. Besides, it wasn’t (only) about the money. I had bigger problems now than old eggs.

I held my tears in until my husband came home. Then I doused him with huge, gulping sobs – not so much about the bump on my forearm as the baby bump that felt like it might never be

Tuesday, August 25, 2020

Patience Is A Virtue (I Don't Have)

My commitment to natural conception lasted a total of two weeks. During that time, just to feel like I was doing something, I started seeing an acupuncturist. I’d read that the ancient Chinese practice could improve egg quality.

My acupuncturist was the kind of woman I wished I could be: comfortable in her own skin, naturally beautiful, effortlessly fashionable, with a sweet and calm demeanor. She specialized in fertility, and had a slew of recommendations to help me get pregnant: nettle tea, keeping my feet and belly warm, eating hot foods. She also said I should enjoy my life, as is, right now. I nodded my head but had no idea what that meant. Little brought me joy anymore, other than exercising outdoors. What is this “fun” she wanted me to have?

While I soon disregarded acupuncture as an expensive nap, one good thing came out of it: the acupuncturist recommended I have my thyroid checked because mine seemed sluggish and that could make it harder to get – and stay – pregnant. Sure enough, when Dr. Baby-Maker tested my TSH (Thyroid Stimulating Hormone), the results showed I was inching towards hypothyroidism. She prescribed a small dose of Synthroid, and my TSH level soon normalized.

By late May, my husband and I weren’t yet able to try to conceive naturally because he was still healing from his vasectomy reversal. In the absence of hope, fear took over – fear that we would waste six months (or more) trying to get pregnant on our own, only to realize it would be too late to do IVF with my own eggs. Fear that we wasted money on the vasectomy reversal that could have gone to an egg donor cycle instead. Fear that even if I did get pregnant naturally that I would miscarry and we’d have to start the whole process all over again.

“I wish I could just start IVF tomorrow,” I said to my husband. “What are we waiting for?”

“We agreed to try naturally first,” he said. “We just need one sperm!"

"Um…actually you need like 20 million to conceive naturally," I informed him. We might be able to make do with 5 million sperm for IUI, but a sperm analysis showed my husband only had 2 million sperm with 11 percent motility (meaning, this is the percentage of sperm that actually moved). In sum, he had a meager amount of lazy swimmers. If we were to do IVF, Dr. Gerber said ICSI would be mandatory, not an optional add-on. My husband’s sperm couldn’t even be trusted to find and fertilize an egg in a petri dish! The situation looked dire. The numbers game of conception was not on our side.

To make matters worse, it was spring. The world was green and budding. The sun was shining and people were out with smiles and sunglasses on their faces.

I wanted to not exist.

It seemed like every living thing was reproducing, from dragonflies to ducks to rabbits. A robin made a nest in a tree on the side of our house and laid four blue eggs there. Four! Even the birds had more eggs than me. 

One night during dinner, I was talking my husband’s ear off about baby-making options. IUI, I had decided, was a waste of time and money because the success rates, even with healthy, motile sperm, topped out around 16 percent, while IVF had up to a 34 percent success rate.

Once again, I don’t know what changed his mind, other than his desire for me to shut up.

“If you can guarantee we won’t go bankrupt, I’m OK with starting IVF now,” he said.

If I’d learned anything about fertility treatments, it’s that guarantees were few and far between. But, worst-case scenario, we would do one cycle of IVF, and if it didn’t work, natural conception would be our only option left. There would be no more deliberation because we’d be out of money.

I called the Minneapolis IVF clinic and soon our IVF cycle was “dated,” meaning we were scheduled on Dr. Gerber’s calendar. It was a huge milestone in the assisted reproductive technology (ART) world. July 8 was our estimated egg retrieval. Over the phone, a nurse rattled off everything we had to do before that date, starting with a boatload of paperwork, which the clinic mailed to me.

There were surreal decisions to sign off on, like if we wanted to be tested for a slew of rare genetic conditions, the hitch being that if my husband or I had any of them, you would need to do PGD to make sure your embryos didn’t carry them, lengthening the time from retrieval to transfer and making yourself crazy with worry in the process. We looked at the price tag and decided against it. We already knew the major diseases our potential offspring was at risk for; why go looking for more?

There was also the question of what to do if we had extra embryos. I thought it was sweet of them to assume there would be leftovers when Dr. Gerber hoped for two embryos, tops. But let’s say we won the fertility lottery; would we freeze the extra embabies? (For an annual storage fee, of course.) Donate them to another infertile couple? (Probably not. I couldn’t handle knowing "our" children were out there somewhere.) Give them to science for experimentation? (NFW.) Let the clinic dispose of them? (Don’t kill my babies!) We opted for frozen storage.

Next was STD testing, accomplished with a simple blood draw. (All clean.) Then it was time for an SIS (Saline-Infused Sonogram), which was similar to an HSG but involved a saline injection in my uterus during an ultrasound to see if my baby house was the right shape.

I was nervous about the SIS given my excruciating experience with the HSG. On the appointed day, I lay on the treatment table and studiously stared at the fluorescent lights above me. The panels were splattered with green paint, like the clinic had entrusted a toddler with interior design. It cast a sickly hue over the room.

I turned my head when Dr. Gerber came in. He looked older than I remembered but was handsome in a boyish way with his pink bowtie. He stood by as a nurse did a vaginal ultrasound and together they counted my resting follicles on the screen – seven. The average for my age group was nine, though some women have as many as 25.

“That’s about what I expected, given your low AMH,” Dr. Gerber said. His tone wasn’t enthusiastic or discouraging; just factual. (I felt stupidly reassured because I’d seen an episode of Keeping Up With the Kardashians where Kourtney visited a clinic about freezing her eggs and she only had five resting follicles -- and she was one of the most fertile women in her family. So there.)

Dr. Gerber inserted the speculum, disinfected my cervix with a long, Q-tip-like device, then inserted a catheter. He removed the speculum and injected a tablespoon of saline into my womb. He was gentle; I didn’t feel anything. A 3-D image of my uterus appeared on the screen and Dr. Gerber traced the triangle-shaped outline with his finger.

“That is a textbook perfect uterus,” he said.

My womb was ready. At least we had that one thing going for us.

SIS complete, the next item on the IVF to-do list was LH testing, which I could do at home with an ovulation predictor kit. Once I had an LH surge (which indicates ovulation is about to occur), I’d come in for a progesterone test. Then I’d start a medication protocol; there are several used in IVF and explaining them all would be above my pay grade. Mine was called “Long Agonist,” which sounded foreboding. My husband’s frozen sperm also had to be shipped to the IVF clinic in case he didn’t have enough swimmers come retrieval day.

We were on the IVF treadmill now. It was dizzying trying to keep all of these steps straight but I also felt comforted by having a plan. We didn’t have to decide anything anymore; we just had to follow directions. Or so we thought

Saturday, August 22, 2020

Snip, Snap! Snip, Snap!

The morning after my reassuring HSG, my husband and I woke up early and set off for the hospital in Rochester, Minnesota, where he would have his sperm set free once and for all.

My lead foot got us to the medical mecca of the Midwest in an hour, just as the sun was coming up. After checking in, my husband changed into a lilac gown and was whisked away to anesthesia. It would be hours until he’d return to the recovery room, so I ate a greasy breakfast in the cafeteria, then drove the few blocks to the local YMCA to work out.

Text updates pinged on my phone at random intervals: “The patient is in the operating room.” “The patient’s procedure has begun.” “The patient is doing well.” It felt weird to receive updates in this robotic way, but I used them as reminders to pray.

After lunch, I went to the surgical waiting room, where a board on the wall showed all the patient ID numbers alongside status updates like “Surgery Prep,” “In Surgery,” “All Done!” I felt like I was waiting for my flight to land. My husband’s number finally appeared. It said, “Waking Up.”

I headed to the recovery room. My husband wasn’t there but a new roommate was – an older gentleman who’d just had heart surgery. He and his wife were watching Fox News, which seemed like the wrong kind of programming if you were trying to keep your stress level low. There had been another school shooting, in Denver. This was the world we wanted to bring a child into?

After an hour or so of gloom-and-doom reportage, I started to get worried. I asked a nurse where my husband was.

“Oh, is he the one with the notoriously low heart rate?” she asked.

“Um…not to my knowledge,” I said.

She looked over her notes and read off pulse rates in the 30s and 40s. Those did sound low.

“That’s probably what’s behind the delay,” she said.

I took a walk to pass the time, the gravity of the situation creeping up on me. This surgery was much more intense than what we'd been sold. My husband could die. And for what? A few (million) sperm? What the hell we were thinking?

When I returned to the recovery room, my husband had finally arrived. As soon as he saw me, he opened his arms and started crying. The urologist, the baby-faced Dr. Howser, graciously passed it off as a side-effect of the anesthesia. (I didn’t have the heart to tell him my husband was a crier.)

Dr. Howser launched into after-care instructions.

“No ejaculation for two weeks,” he said. “Then oral and manual ejaculation only until one month post-op. Penetrative sex after one month, but only with him on top. No woman-on-top until two months post-op.”

I was shocked, not because of the dirty talk but because this was new information. Somehow, I’d thought that after a couple of weeks of recovery, we could try to conceive right away. Now it sounded like this was going to take longer than I thought – a recurring theme on this baby-making journey.

“Sorry for being blunt, but I don’t want you two to damage what we did today,” Dr. Howser said. “We’ll see you in three months for a sperm analysis.”

“Three months?!” I thought. I tried to imagine trying to conceive naturally for that long without knowing if my husband was shooting blanks. I knew I didn’t have the patience for that. I started to wonder why we’d thought this was such a good idea in the first place.

“We were able to freeze some sperm,” Dr. Howser continued. That had been a $1,200 add-on we’d opted for at the last minute, just in case the procedure didn’t work. “You could do IVF right away with it if you wanted. Just let us know where to send it.”

Dr. Howser handed my husband a form saying that in the event of his death, I would be given custody of the sperm. I barely had a moment to register how ridiculous this situation was. Then the doctor gave me his cell phone number and shook my hand. “Let us know how it goes for you! We love to hear success stories!”

As soon as we were left alone, my husband said, “I want to punch everybody.”

I was trying to be a calm and patient caretaker, but the truth is I kind of wanted to punch everyone, too. Or cry. It was a toss-up.

“You’re just loopy from the surgery,” I told him. “Eat something.”

He grazed his way through pudding cups and cookies and granola bars and string cheese, all washed down with ginger ale and Pepsi. I was peeved that none of these foods or beverages were on the “healthy sperm diet” list. It was like the hospital was actively working against us. My husband’s gown was soon covered with crumbs and stains. He looked so vulnerable and weak, instead of the strong, virile man capable of impregnating me.

I wondered if this had all been a waste and if we should have done IVF instead. Why did every decision feel right in the moment but wrong later on?

“Is our dream dumb?” I asked my husband.

“No,” he said.

I had my doubts.

In order to be released from the hospital, my husband had to complete a couple of tasks, like walking down the hall and peeing into a measuring cup. The former was no problem but he couldn’t make the latter happen, not even with the so-called soothing sounds of the tap running or me (instead of a nurse) holding his cup. A bladder scan was ordered (Can you believe that’s someone’s job?!) and when it showed his bladder was overfull, a male nurse had to “cath” him. Then my husband had to start the fill-the-bladder-and-try-to-pee routine all over again.

After 12 hours at the hospital, my husband was finally discharged.

“Next time we see you, you're going to be helping her with the pain!” a nurse said as we departed.

I wanted to believe her, but at that moment, giving birth seemed so, so far away.

Would I be able to wait for nature to take its course? Or was it time to fast-track the baby-making process?

Wednesday, August 19, 2020

Testing, Testing

“Avoid the internet.” That’s what the instruction sheet for the HSG (Hysterosalpingography) said. Whoops. Too late. I’d already over-Googled and everything I read predicted this would be painful. On the plus side, there were message board murmurings that it was easier to get pregnant post-HSG because it cleaned the reproductive organs out.

A lot was riding on this procedure, which tests whether the fallopian tubes (where sperm travel en route to fertilize an egg) are open. If the tubes were blocked, we’d have to cancel my husband’s vasectomy reversal and drop thousands of dollars on IVF. If the tubes were open, we could, um, plow ahead with our plan to try to conceive naturally for six months.

At a radiology office, I changed into a scratchy gown and placed my belongings in a locker. Dr. Baby-Maker led me to a treatment room, which was brightly lit and packed with high-tech equipment. In other words: terrifying. 

I climbed onto the exam table and was about to assume “the position” when Dr. Baby-Maker realized one of the stirrups was broken. 

“We’ll just have to make do,” she said.

Make do indeed. She instructed me to press my heels into the table pad (easier said than done) and then inserted the speculum. She was unusually silent as she dug around deep inside me.

“Your uterus is really tucked back in there!” she said.

“Yeah,” I thought, “It’s hiding!”

She inserted a catheter with a tiny balloon on the end through my cervix.

“You might feel cramping, “ she said. “Or you might feel nothing.”

I felt nothing, and mentally congratulated myself on being such a trooper. Then the balloon inflated. Holy shit.

“All set!” Dr. Baby-Maker said. She called in the radiologist. I couldn’t see him enter the room from my position but his baritone voice announced his arrival.

Dr. Baby-Maker injected dye into the catheter. I felt more pressure in my womb. We all watched on a black-and-white screen as my uterus filled up. Then we waited. And waited. There was no movement in the tubes, which were thin and delicate, like tiny ribbons.

“There’s a lot of fluid just spilling out here,” Dr. Baby-Maker remarked from between my legs.

“Try adjusting your balloon,” the radiologist instructed.

She did, and all of a sudden, I felt like I got kicked in the uterus by a horse. My vision went black. A guttural groan escaped my mouth. My legs trembled. I felt like I was in labor.

“Are you going to faint?” Dr. Baby-Maker asked. That would be a first for me, but no, I was not going to faint. 

She encouraged me to breathe. I gulped down some air. I hadn’t realized I’d been holding my breath. Then again, who can relax in a situation like that?

“There goes the right!” the radiologist cheered. “That’s the left!” 
With confirmation that both of my tubes were open, the radiologist departed and Dr. Baby-Maker removed the speculum. A huge gush of dark fluid flowed from between my legs and onto an absorbent pad on the table.

“The cramps should be going away now,” Dr. Baby-Maker said. “Cramps” felt like the wrong term for the excruciating throbbing in my sacral chakra.

Dr. Baby-Maker chattered away excitedly about my open tubes and my husband’s vasectomy reversal. She offered to do IUI if we wanted to speed things up.

She held out her hand and helped me down from the table. I was still stunned silent.

A thought which I’d had many times ran again through my head: I wish we could just adopt. (Though as I’d learned, there was no such thing as “just” adopting. That process was simply a different kind of grueling.) Getting pregnant and giving birth was the “easiest” way to grow our family, but it was also a pain in the...uterus.

“Good luck with everything! I look forward to seeing you for your pregnancy!” Dr. Baby-Maker trilled. I wished I could be as excited as she was about our prospects.

I stepped out into the sunny spring afternoon and texted my husband to tell him my baby canals were still open for swimmers. Now all he had to do was set them free

Sunday, August 16, 2020

There's More Than One Way To Make A Baby

"Is this a sign or a test?" I asked my husband as I brushed five inches of snow off the top of his car with a broom. Overnight, an April blizzard had battered its way across Minnesota. A cement-like layer of snow covered our driveway. "Is God saying, 'Stop!' or is He saying, 'How bad do you want it?'"

“I don’t think it necessarily has to be either. And I don’t think it’s worth trying to figure out,” my husband said before firing up the snowblower.

I was constantly trying to discern God’s will – a fruitless and frustrating endeavor – as it concerned our baby-making options. “Would it be that hard for You to be a little bit clearer?” I often thought. “I mean, come on! You’re God. You can do anything!”

Ah, but He’d left us silly humans to decide for ourselves. And this morning, we had an appointment with a Minneapolis IVF clinic – and we weren’t going to cancel.

We somehow managed to slog into the clinic’s parking ramp on time. Despite the weather, the clinic was bustling – phone lines trilled, couples filled out paperwork, and delivery drivers dropped off packages. John Mayer’s voice singing “Fathers, take care of your daughters” echoed through the waiting room. It seemed like an insensitive song to play at an infertility clinic.

It was strange to be there knowing that everyone had the same goal as us and couldn't achieve it on their own. I sized each couple up, trying to figure out how old they were, how long they’d been trying, and how the hell they could afford this. The consultation alone was over $400; they didn’t even let you sit down until it was paid.

Our doctor appeared and called our names. He looked like the Gerber baby all grown up – pale, blonde, probably genetically perfect. His corner office was dominated by a huge oak desk, his walls lined with bookshelves that were too empty for my taste.

I’d sent the clinic every imaginable medical record I could find regarding our fertility, which Dr. Gerber said he’d reviewed. He agreed with Dr. Baby-Maker that my (appallingly low) AMH was not predictive of my ability to get pregnant.

“But I am concerned about your FSH levels,” he said.

FSH (Follicle Stimulating Hormone) is what tells oocytes (premature eggs), to start growing. As the eggs mature, FSH levels decrease – as in, “My job is done here!” Low FSH levels were good.

A normal FSH level in a woman my age was under 7.9.

My FSH level was 17.7.

“The FSH is yelling at your ovaries and they’re responding in a whisper,” Dr. Gerber said.

I momentarily imagined my reproductive organs arguing. It was not funny.

Dr. Gerber laid out several laminated diagrams of the IVF process. First, there were medications to shut down my natural cycle. Then there were medications to artificially induce ovulation. Rather than one egg per cycle, I would (ideally) produce eggs in the double digits. When the eggs were mature, I would be put under general anesthesia and the doctor would insert a needle through my vaginal wall and into my ovaries to aspirate the eggs out. The eggs would be fertilized with my husband’s sperm, either traditionally (one egg in a petri dish with a bunch of sperm, may the best sperm win) or by injecting a single sperm into each egg (if my husband’s sperm weren’t up to the task). The embryos would be cultured for several days; if any survived and were healthy, they would either be transferred back into my uterus or we would freeze them for a future transfer.

It was all very complicated.

 Dr. Gerber laid out our options:
- A vasectomy reversal, followed by six months of attempting to conceive naturally
- A vasectomy reversal, followed by IUI (Intrauterine Insemination) if my husband’s sperm count was low
- A vasectomy reversal, followed by traditional IVF
- Skip the vasectomy reversal and do IVF with TESE (Testicular Sperm Extraction, basically sucking the sperm out of my husband’s testicles with a needle) and ICSI (Intracytoplasmic Sperm Injection, aka injecting the healthiest sperm into one of my eggs) right away instead

The success rates of all of these options differed, of course, as did the costs. Like buying a car, there were endless add-ons to the IVF process. Given our ages, Dr. Gerber recommended PGS (Pre-implantation Genetic Screening, which identifies chromosomal abnormalities) and PGD (Pre-implantation Genetic Diagnosis, which identifies genetic defects that would prevent implantation, cause a miscarriage, or pass various diseases onto the baby).

The down payment for IVF was $12K. A cycle with ICSI would be around $18K. Add TESE and we were up to $20K or more. PGS and PGD? Close to $30K. Our health insurance covered nothing. Some states have mandates that insurers must cover infertility treatment, but Minnesota is not one of them. (This pisses me off to no end, as infertility is very much a medical problem, but that’s a rant for another post.)

“I don’t have any problem with you two trying to conceive naturally,” Dr. Gerber said, as if he were some sort of reproductive warden. “But we could just go straight to IVF with your eggs. Don’t wait more than a year to do that, though. I’d start you on high doses of hormones and would be pleased if we got two embryos per cycle.”

I didn’t know much about IVF, but I knew that two embryos per cycle wasn’t much – and not all embryos are created equal. Even if we could get two, if they were abnormal, or subpar, we wouldn’t be able to transfer them. Then we’d have to start a whole other cycle from scratch. Even if the embryos were OK, what if we transferred them and they didn’t implant? What if they did and I miscarried? It seemed like a lot of trauma to my body and a lot of unknowns for so much money.

“What about donor eggs?” I asked, even though I knew we couldn’t afford them. The egg donor cycles started at $30K and went as high as $47K. “Aren’t we at the point where that would make more sense?”

“Egg donor treatment is one of the most successful assisted reproductive techniques available,” Dr. Gerber conceded. “But I don’t think you’re there yet. I’d want to try a couple cycles of IVF with your own eggs first.”

(Of course he would. He wasn’t paying for it.)

“If you decide you want donor eggs, know that there is a waiting list,” Dr. Gerber added. “And it’s a more involved process.”

First, we’d have to do a consult with a reproductive counselor. Then we’d have to meet with the egg donor program coordinator and a financial coordinator. That would be followed by a medical workup. Then we’d presented with one egg donor at a time. Once we chose an egg donor, the IVF process would start.

Realistically, I knew an egg donor wasn’t an option for us, mainly because of the cost. My husband and I had already argued about how much was too much to spend on chasing the baby dream. His limit was any figure that would force us to go into debt. Thirty grand was definitely in that range.

“If cost is your main concern, you could just go ahead with the vasectomy reversal and try to conceive on your own,” Dr. Gerber said. “Because if we tried IVF first and didn’t retrieve enough eggs or have any quality embryos to transfer, I’d probably recommend a vasectomy reversal and natural conception anyway.”

We sat in silence for a moment and tried to absorb the massive amount of information he’d lobbed at us in under an hour.

“Clear as mud?” he finally said.

I did feel clear, at the time. IVF seemed too extreme. Infertility for our age group was defined as six months of timed intercourse that failed to result in pregnancy. By that measurement, we weren't infertile; I was just impatient. So my husband and I decided we’d go ahead with the vasectomy reversal, try to conceive for six months, and if nothing happened, we’d go back for IVF.

On the car ride home, I breathed a sigh a relief. The matter was settled. Later that day, however, Dr. Gerber called.

“Have you had an HSG?” he asked.

Yet another acronym I was unfamiliar with. He explained it was a procedure where dye was injected into the fallopian tubes and an X-ray was taken to see if the dye (a dummy substitute for sperm) flowed freely through the tubes.

“If your tubes were closed for some reason, the vasectomy reversal would be a waste,” he said. “Seriously consider having it done.”

Ugh. It felt like every time we cleared a fertility hurdle, 10 more appeared in its place. God was definitely asking, “How bad do you want it?” My answer: A baby was the only thing I wanted anymore. Giving up was not an option. We were all in.

So I scheduled the HSG for the day prior to my husband’s vasectomy reversal. His and hers fertility procedures. How (un)romantic...

Thursday, August 13, 2020

One Good Egg

“Based on your health history, there’s no reason why you and your husband shouldn’t be able to conceive naturally,” my new, unnaturally perky OBGYN said. With her megawatt smile and lightly freckled face, she was too pretty to be smart and too optimistic to be experienced, given the horrific things that can happen during pregnancy and birth.

But my insurance only had one OBGYN practice in-network that specialized in infertility, and the clinic only had one doctor taking new patients, so this is who I got. Not that I'm complaining. My new doctor, who we’ll call Dr. Baby-Maker, was the friendliest practitioner I had ever met; it was hard to believe anything could go wrong in her presence.

So when she told me that I should have no trouble conceiving after my husband’s vasectomy reversal, I believed her. She recommended six months of trying naturally before investing in any tests or procedures.

“But…if you want to test your AMH, we can,” she conceded.

AMH stands for Anti-Mullerian Hormone, which is produced by ovarian follicles. Women are born with all the eggs they’ll ever have, so their egg stashes (or ovarian reserve) decrease as they age. AMH level is indicative of ovarian reserve. A robust ovarian reserve means a woman may be able to get pregnant faster; diminished ovarian reserve (DOR) means it may take longer to get pregnant naturally, that IVF may be less effective, or that pregnancy with one’s own eggs may not be possible.

An AMH measurement is an inexpensive and non-invasive way to measure fertility. All it requires is a blood draw. So I surrendered my best vein to the lab tech, who told me the results would take up to two weeks to come back.

I wasn't worried. I’d had no problem getting pregnant in the past. Granted, my last pregnancy was 15 years prior. But I’d been studying up on all things baby-making with the massive tome Take Charge of Your Fertility. I was already familiar with charting my cycle, but this took basal body temperature monitoring to a whole ‘nother level. (For the uninitiated, a BBT is taken immediately upon waking with an extra-sensitive thermometer. Over the course of a month, temperature patterns can indicate various infertility issues.)

So far, I’d had several cycles that, on paper, looked perfectly normal. I also had the tell-tale egg-white cervical mucus for a day or two mid-cycle. All these things indicated I was ovulating. Now I just needed to confirm that I had enough eggs with the AMH test.

Ten days after the blood draw, I had a hunch that maybe the results were in but my clinic hadn’t gotten around to calling me yet. I logged into my online patient chart. I was right. There they were.

The median AMH for my age group was 2.03.

My AMH was 0.24.

In other words: abysmal. I had the ovarian reserve of a woman on the brink of menopause.

I called my husband – and started bawling.

“My dream is dead and we haven’t even started trying yet!” I wailed.

Ever the rock, he said I should hold off on freaking out until I’d spoken with Dr. Baby-Maker. I decided to go for a walk to calm down, and just as I set out, a nurse called.

“Dr. Baby-Maker says your AMH is lower than expected but it’s not predictive of whether or not you can get pregnant,” she said in a flat, affectless tone that indicated that this was one of many times she’d delivered disappointing news that day. “It’s a relatively new test and is more often used to measure whether IVF will be effective or not.”

Among fertility experts, there is some disagreement as to whether testing AMH is helpful. On the one hand, it can estimate your ovarian reserve; on the other hand, it cannot predict your chance of getting pregnant. As any infertility homeopath will tell you, ovarian reserve is not about quantity, it’s about quality. All you need is one good egg.

How do you improve egg quality? A whole lotta lifestyle changes. Eliminate alcohol, caffeine, sugar, and processed foods from your diet. Remove as many plastics as possible from your environment. Do acupuncture. Reduce stress. Supplement with royal jelly, CoQ10, and DHEA (but only under a doctor’s supervision because you could do serious damage to your body). Drink red raspberry leaf, nettle, or chaste berry tea.

In anticipation of baby-making, I had already given up caffeine. I had stopped taking my allergy and acne medications. I ate clean, drank the teas, and limited my sugar intake to a small serving of dark chocolate daily. I never drank alcohol. I was doing everything right, so why was my egg supply so low?

I did what I always do when distressed – I went on a Googling spree. The best thing about the internet is that if you click long enough, you can find success stories for anything. Sure enough, I found a message board where women with AMH levels even lower than mine had gotten pregnant – naturally and/or with IVF, some with twins. So there was a sliver of hope.

“Isn’t it possible that the doctors know nothing and we can just try?” my husband asked later.

I tended to glom onto whatever doctors said and treat it like irrefutable fact. But facts are not always the same thing as the truth. And only God knew what the truth about our baby-making potential was. In this matter, my husband had more faith than me, which was unusual.

“We have to be courageous,” he said.

“I’m trying,” I replied. “But you might have to keep the hope alive for both of us.”

“I don’t know any other way to be.”

Dr. Baby-Maker’s recommendation was to test my AMH again at the start of my next cycle in case the low level was a fluke. But I didn’t need to get bad news twice. No, it was time for the big guns (or huge needles, as it were).

We scheduled a second opinion at an IVF clinic...

Monday, August 10, 2020

One Baby Bummer Begets Another

“We can’t have a baby right now. It’s not an option,” my husband said.

We were having our morning coffee in the low-lit kitchen, a sweet routine if we were getting along; a bitter one if we weren’t. This was one of the bitter days.

“I think having a baby is something you think you want but I don’t think it would turn out the way you expect,” he said. (He might have been onto something there.) “Can’t you just be grateful for the children you have, our marriage, this house?”

“I am grateful for all those things,” I said.

And yet. When I tried to envision the near future of just us two, even if we made good on our mutual fantasy of a tiny home out West, I couldn’t help feeling like we’d just be sitting on the porch together, waiting to die.

I wasn’t ready to be an empty-nester yet. I didn’t want to just be gainfully employed, married, and comfortable – I mean, I did want those things, but not only those things. I wanted to enjoy life, but I also wanted challenges (the good kind, not the unexpected and devastating kind). I wanted growth and connection with a new human being.

“Aren’t I allowed to have a dream?” I asked.

“It would help if it were an attainable one,” he said.

“I think it is attainable. We just can’t afford it.”

But then a fortuitous thing happened. I got promoted at one of my freelance gigs. I was making more money, and saved enough to pay for a vasectomy reversal. I floated the idea of meeting with a urologist to discuss the procedure. At first, my husband refused. But within weeks, he’d changed his mind. Why? He saw a cute toddler at church. That was it. I still don’t understand how that flipped the switch. (She was cute, but not that cute.) I could give God the credit – I’d been praying, asking Him to intervene. Maybe my prayers were heard. Maybe He opened my husband’s heart.

Whatever the reason, on a frosty February day, we trekked to a clinic where a silver-haired urologist (who we'll call Dr. Dick, for reasons that will soon become obvious) examined my husband, asked a few questions about our health histories, and sketched a diagram of what a vasectomy reversal involved. While the reversal was much more complicated than the original vasectomy, requiring hours under the knife and weeks of recovery, it looked so simple and painless on paper.

Dr. Dick consulted a chart that factored in my husband’s age (47), my age (37), and the length of time since the original vasectomy (six years). The fortune-telling formula said we had around 40 percent chance of pregnancy within six months.

It was a gamble, but the odds were good. (They were also wildly unrealistic, but we didn’t know that yet.)

“You’re both young and healthy. I don’t see why this wouldn’t work,” Dr. Dick said. That first statement should have given me pause. Yes, we were healthy. But young? Come on.

Still, I wanted to believe him. I heard what I wanted to hear. (What I didn’t hear was the “six months” part. That would soon seem like an insufferably long time to wait.)

The procedure was pricey – between $6K and $9K – but at that point, we were unaware of any other alternatives, except buying sperm from strangers on the internet and shooting it inside my womb with a turkey baster. (Seriously. We had no idea that there were other options.)

In our minds, the choice was: vasectomy reversal or empty nest.

Idling in the car in the parking lot, I wondered aloud if we could get the vasectomy reversal and let nature and God decide? Not force it? My husband answered with excited kisses. The idea of making a baby was definitely an aphrodisiac for him.

I called Dr. Dick's scheduler. She wasn’t in, so I left a message. As the hours ticked by without a return phone call, my mind felt flighty; my stomach was squirrely. I was as anxious as a high schooler waiting for her crush to call. I’d never been a patient person, but if I couldn’t even stand a day of suspense, how would I make it through nine months of pregnancy? How did I wait so long to meet my babies twice before?

Finally, a call back, and a surgery date set: March 12. If all went well, we might be able to conceive by Easter. It felt preordained.

In my journal, I wrote: “Thinking about a baby is the only thing that makes me truly joyful right now. In that area of my life, there are no questions. Only, ‘How soon can this happen?’”

Not soon enough, as it turned out. After my husband completed all the paperwork and underwent a physical, Dr. Dick called to inform us he’d canceled the surgery. He cited cost as the reason. Because one of my husband’s vas deferens (the sperm-carrying tubes) was cut very low, Dr. Dick determined he would have to do the procedure under general anesthesia, in a hospital with a specialized piece of equipment. Robotics were involved. That would bump the price up to $20K. He wanted to transfer us to a colleague at a different clinic, one who would do the procedure for $7K. Unfortunately, the new urologist couldn’t see us for at least eight weeks.

So this is how this baby-making thing was going to be: slow and disappointing.

We were back to square one – no, we were even further behind than where we started. This should have registered as a bump on the road to baby, but it felt like a hole opened up and swallowed us. I was infuriated at how Dr. Dick led us on. I went full Karen (before Karen was even a thing) on the clinic. They refunded the consultation fee, but obviously couldn't force Dr. Dick to do the procedure.

My husband said anything over $10K was “crazy money” (how quickly that assessment would change…) and that if the reversal was really going to cost $20K, canceling was the right thing to do. I, however, was desperate enough that I would have paid it. (But in hindsight, I’m glad I didn’t.) 

To add insult to injury, that night, a couple we knew – just a few years younger than us – called to announce they were pregnant. I seethed with jealousy. Imagine being able to make a baby whenever you wanted, for free and in a fit of passion! (Granted, I’d done this in my 20s, but somehow that was of little comfort now.) Instead, our ability to procreate was determined by doctors – their procedures, their schedules, their price points. It was all so unfair.

I cried my way through a box of Kleenex, then took to the internet. It wasn’t long before I found a new urologist at a hospital a short road trip away. I'll call him Dr. Howser because he looked way too young to cut anyone open. Still, we set a date for surgery. But before the big day, Dr. Howser recommended I get a fertility workup done. After all, if my eggs were old or MIA, a vasectomy reversal wouldn't bring us any closer to a baby.

It was time to put my body to the test...

Friday, August 7, 2020

Meet The Fosters

Kids in cages. That was the tipping point.

It was the summer of 2018 and families were being ripped apart and detained (such a sanitized word for such an inhumane act) at the U.S.-Mexico border.

“This space seats 1,000 people,” said the priest of the progressive Catholic church my husband and I attended at the end of a Mass. His eyes welled up with tears and his voice warbled. “Imagine twice that many children separated from their parents.”

The lights in the sanctuary went out as we prayed. I wept for the bereft mothers with empty arms and the terrified children with no one to cling to.

As we exited the church, my husband happily chewing his "I went to church" reward cookie, I said, “I wish we could do something to help those kids.”

But what? I started researching and found an article about a Christian foster care agency that was placing children separated from their parents at the border in homes across the Southwest. The agency had a branch in Minnesota. While we wouldn't be able to help those kids through this agency, we could open our home to someone.

The agency purported to help people create families in non-traditional ways, through domestic infant adoption, international adoption, and foster care. I suspected adoption was out of our reach financially, but foster care might be feasible. The baby lust that flared up in 2016 hadn't faded; I'd just gotten busy with freelance work. But now, assignments had plateaued and I had time on my hands, enough time to care for another child. Foster care was like temporary parenting, so it might be easier to get my husband to agree to it, too.

My husband and I watched a few videos about foster care on the agency's slick website. We were surprised to learn that foster parents were a diverse group, not the homogenous white, wealthy, suburban couple demographic I had assumed would have the resources to foster children. If a 60-something single woman could foster several children, surely we could, too. We signed up for an informational meeting.

On the appointed night, we arrived at a nondescript office building and filed into a charmless room arranged with tables for two. There were eight couples there, all seemingly in their 20s or 30s. Two agency employees, wearing crisp business casual clothing and carefully applied makeup, commenced their well-practiced presentation on all the agency’s services. We followed along in our informational packets.

Infant adoption sounded appealing, but the price tag was prohibitive – over $20K to adopt domestically. Just to put a profile together and complete the agency's screening process was at least $11K, with no guarantee of a child. A birth mother had to choose you, and there were far more couples waiting to adopt than there were birth mothers willing to surrender their offspring, so you were essentially competing with other wannabe adoptive parents. Even if we could've afforded domestic infant adoption, I knew there wasn't a birth mother in the world that would choose a lower-middle-class, blended family like ours over a well-to-do childless couple for their baby (and I couldn't blame them; I'd choose the latter couple, too). 

That's why so many couples opted for international adoption – more babies to adopt, in part because of overfull orphanages. But there were restrictions abroad on everything from the adoptive parents' ages to income to heath, and they varied from country to country. The cost? A whopping $40K. 

The wait was long, too, no matter which adoption route you chose. Years. Plural.

Foster care was the agency’s area of greatest need. A stat that stuck with me: in the U.S., there are three churches for every waiting child in the foster care system. If each congregation stepped up to support one family to do foster care, there would be no more waiting children. 

My Catholic guilt was already overwhelming me. Then the reps showed a video of an adorable 9-year-old boy in the foster care system. He was obviously a handful (he didn’t stop moving the entire video) but he was sweet and articulate and said he longed for a mom and dad. My eyes welled up. "I could love that kid," I thought.

Foster care it was. We scheduled an intake interview and soon found ourselves seated on a stiff, floral-patterned couch in a tiny office as the intake coordinator laid bare the realities of foster care. The kids needing placement had suffered unthinkable neglect, physical abuse, and sexual assault. And if we were hoping for an infant (which I was), we were out of luck. The agency hadn’t placed any babies in the last year. Their greatest need was homes for teens, sibling groups, or children with special needs. We didn't have the space or the emotional bandwidth to provide that level of care. 

The intake coordinator understood. But even if they could find, say, a 4-year-old child with no siblings to place with us, were we prepared for the bedwetting? The sleep disturbances? The violent outbursts? The destruction of property? The multitude of doctor appointments, court dates, supervised visitations? I could feel my husband’s eyes grow wide even though I wasn’t looking directly at him.

I’d majored in psychology as an undergrad and had interned at a treatment center for children with mental and emotional disturbances. While the kids I’d interacted with (mostly boys) were certainly challenging, I’d also found them charming.

But this was not that. There was no going home to decompress at the end of the day. Placements were 24/7 and lasted from 12 to 20 months, after which, the children went back to their family members. Foster parents were encouraged to get attached to the children but had to be prepared to be heartbroken when they left.

The coordinator was definitely not trying to sell us on the foster care idea. In fact, it seemed like she was dutifully trying to scare us away.

“If we decide to go forward, what’s the next step?” I asked.

Paperwork. Lots of it. A deep dive into our family history, mental and physical health, financial records, and more. The agency wanted to know not just what type of parents we were but how we were parented, too. There would be four to five home visits from social workers, and likely home repairs to make our fixer-upper safe and accommodating for foster children. There would be criminal background checks and we’d have to provide multiple references, professional and personal. 

“But we’d have a placement for you by Christmas,” the coordinator said.

So there was that – foster care moved fast. There was also financial compensation, but considering that kids often come to foster homes with little more than the shirts on their backs (and sometimes, not even that), the weekly stipend was barely enough to cover the children's expenses.

Many wrought conversations followed. My husband wasn’t sure he could handle a kid who'd experienced serious trauma. Though I tried to argue that there was no guarantee how any child – biological, adopted, foster, or otherwise – would behave, I didn't want to drop us into a powder-keg situation, either.

“I’ll do it for a year,” he finally acquiesced.

“A year?” I gaped. Just to get to a placement seemed like a lot of work to only to do it for a year.

There was one other option: foster care adoption. Basically, you agree to provide foster care for a child who probably isn’t going back to their family. Once parental rights are terminated, you can adopt them. The advantage of foster care adoption is that it’s free, and the state subsidizes Medical Assistance for the child until they turn 18.

It sounded too good to be true. And as it turned out, it was. In our county, the wait from foster care placement to the finalization of adoption was 18 to 24 months. The representative wouldn’t disclose how many babies they had placed in the last year, but she did say that most people getting licensed for foster care adoption were doing so in order to take custody of family members. Also, foster families were expected to foster at least one child first – and return them to their families – before they could foster-to-adopt another. That would mean up to four years in limbo before we could legally adopt a child.

“Foster care is not the fast-track to adoption,” she said.

Understatement of the century.

I felt defeated. The system made people jump through so many hoops. On the one hand, I understood why; I’d heard the horror stories of children who were removed from abusive homes only to be retraumatized by unfit foster parents. But I’d also heard stories of foster parents who depleted themselves financially, physically, and emotionally caring for kids – especially teens – who didn’t want their help.

I didn't want to believe that giving back and growing our family were mutually exclusive, but it seemed like they were. We quickly found an alternative way to do the former, by volunteering as a family for an organization that packed and shipped food to children in need. As for the latter, if we wanted a baby, we apparently had to make our own. The only problem was I couldn’t do it alone, and to get my husband on board would require some serious convincing – and an invasive medical procedure...

Tuesday, August 4, 2020

Baby Lust

Nabokov once wrote, “My heart was a hysterical unreliable organ.”

Same. See also: ovaries!

Both organs conspired to turn my life upside-down when, in my 35th year, all of a sudden, I wanted a baby.

Big deal, you’re thinking. Typical biological clock going tick-tock, tick-tock, right?

Not exactly. I already had two teens from my first marriage. When I remarried, my husband got a vasectomy. I held his hand through the procedure, got sick on the smell of cauterization, brought him bags of frozen peas as he recovered. We figured it would save us unnecessary worry. We couldn’t afford another child even if we’d wanted one. And we didn’t want one.
Until I did.

The urge to reproduce resurfaced a few days before Christmas of 2016, when (I’m embarrassed to admit) I saw Jenna Bush Hager on the Today show. She was fresh from a visit with host Savannah Guthrie, who had recently given birth to a son. “It sort of makes me want another baby, which I haven’t said out loud yet,” Bush Hager gushed.

Something clicked. I knew that feeling. That longing for a new being, a fresh start, especially at that moment, as many were mentally preparing for the end of the world as we knew it. It was the worst time in history to have a baby, but maybe that was point.

An apocalypse baby. I liked the sound of that.

I hadn’t Googled anything baby-related in years, and when I did, I immediately landed on the documentary The Business of Being Born. My heart swelled as I witnessed woman after woman brave the harrowing experience of giving birth. I cried when the midwives caught the squirmy, squinty-eyed infants and placed them on their mothers’ chests. Birth is an experience you never forget, and that moment where mother and child meet for the first time is by far the most mind-blowing a human can have.

So maybe that’s what was behind my baby lust: meaning. In a world that seemed to be going to shit faster than a baby can fill a diaper, I wanted something pure and good to cling to.

Most women I knew in their mid-30s were just starting their families or had decided not to have children at all. Rare was the 35-year-old who’d raised a couple of kids and, just when they were about to launch, decided to bring a new baby aboard.

Would I regret having another baby? No way. Would I regret not having another one? That was more difficult to answer.

When in doubt, Google. “Age 35 want another baby am I crazy?” I typed into the search bar. The online threads that popped up unanimously veered towards “Do it!” whenever a woman—regardless of age—asked internet strangers if she should have a(nother) baby. But I was not the kind of mother who hung out on parenting websites or message boards (or so I thought). This advice was not for me. No one would list “maternal” among my top 10 traits. I was a Mommy & Me drop-out. My frequent refrain was: “I love my kids, but I hate parenting.” In many ways, I was the anti-mom.

So how to explain this overwhelming desire to sign on for another 18 years of child-rearing?

I took to Instagram to remind myself what infants looked like and to see if they triggered further baby lust. (My teens were born before social media existed. Back then, if you wanted to bombard people with baby pictures, you had to mass-email them.) Spoiler alert: babies were still cute! Only now, they had more clever clothes, like onesies that said, “Needy AF.”

“OMG I have to have one!” I thought. (The onesie? The baby? Both.)

My husband found my baby lust amusing but didn’t endorse taking any action on it. He enumerated the reasons why having a baby was a Very Bad Idea. For starters: the sleeplessness, the spit-up, the crying, the diaper blowouts. Later there would be the parent-teacher conferences, the carpool lane (aka my hell on Earth), the dental and pediatric appointments. Parenthood was 10 percent fun and 90 percent toil.

There was also the question of how old was too old to start parenthood all over again. My eggs were likely bargain-basement material now, and my husband’s sperm might not be much better. Pregnant women over 35 are often considered “geriatric” and high-risk by the medical community. A woman my age had a 1 in 350 chance of conceiving a child with Down Syndrome; by age 40, that chance rocketed to 1 in 100. I’d also read there was a higher likelihood of congenital defects and autism if the father was of “advanced age,” which my husband apparently was. And how’s this for scary? My baby daddy would be almost 70 by the time our imaginary child graduated high school! Given all this, was it fair for us to bring a baby into the world?

“Maybe having a baby is a ridiculous idea,” I said as we headed up to bed one night.

“Yeah,” my husband sighed, sinking into bed next to me. “I felt old just going up those stairs.”

My brain said my baby days were over. Ah, but my heart (and my ovaries, if they were indeed still operational) had other ideas. I recalled the blissful sensation an infant sleeping on my chest, the knee-weakening smiles, the squeals of delight. I missed a lot of the awe of parenting when my children were little because I was too consumed with just trying to survive as a single mom.

Would I be a better mother now because I was more mature, more settled? Maybe. But then I thought about the nausea and the weight gain and the full-body pain and the hormonal rollercoaster involved in gestating and giving birth. I realized I wasn’t attached to the experience of being pregnant. In fact, I could do without all that, thank you very much. I just wanted to grow our family. Was there another way to do that?

I contemplated this question and eagerly awaited the answer. I kept my heart open to whatever form it might take...and sure enough, an opportunity to parent again eventually presented itself...