Friday, December 29, 2006

Pick a Tarot Card

Ok- I need to stop playing but I couldn't resist. Note, I am the "womb where ideas gestate"

You are The Empress

Beauty, happiness, pleasure, success, luxury, dissipation.

The Empress is associated with Venus, the feminine planet, so it represents,
beauty, charm, pleasure, luxury, and delight. You may be good at home
decorating, art or anything to do with making things beautiful.

The Empress is a creator, be it creation of life, of romance, of art or business. While the Magician is the primal spark, the idea made real, and the High Priestess is the one who gives the idea a form, the Empress is the womb where it gestates and grows till it is ready to be born. This is why her symbol is Venus, goddess of beautiful things as well as love. Even so, the Empress is more Demeter, goddess of abundance, then sensual Venus. She is the giver of Earthly gifts, yet at the same time, she can, in anger withhold, as Demeter did when her daughter, Persephone, was kidnapped. In fury and grief, she kept the Earth barren till her child was returned to her.

What Tarot Card are You?
Take the Test to Find Out.

Thursday, December 28, 2006

Women's Mood DisOrders

There is some new research on SSRI's and pregnancy
SSRIs and Persistent Pulmonary Hypertension of the Newborn which suggests that it might not be such a good idea to take anti-depressents through out pregnancy.

I was always one of these people who thought the health of the mother was an important factor in pregnancy and weighing that against the unknown side effects to the unborn child seemed to balance out. Now with this new research I am not so sure.

I have been on meds for 13 years and have no idea what I might be like if I went off - it's been too long to remember life before my dopes. My recent bought with depression courtesy of the HRT meds is not a good foreshadowing for how I might fare au natural.

My dope doctor is retiring and he suggested that I go to see a psychopharmacologist who specializes in medication and pregnancy. I've located someone whose expertise is in the "women's lifecycle" which means I can talk to her about pregnancy and menopause all in the same breadth. I'm sure she will find me an interesting case.

I hope we can come up with a reasonable plan. Appointment Jan. 10th.

Stay tuned...
PS - she like everyone else is very expensive and doesn't take insurance.

Wednesday, December 27, 2006

New Years resolution a Few Days Early

okay - I am going to make the same new year's resolution that probably 50% of all Americans make every year. To get in shape and lose weight. But this is serious stuff. It will be the last time pre-baby (cross fingers) that I have a chance to do this in earnest.
B* leaves for Australia on January 2nd - my first official day of Operation Fitness.

The Plan -
excercise 5-6 times/week incorporating some high end cardio (spinning) into my training atleast 2 times a week, 2 days of yoga, 1 pilate class per week

food - calorie cutback. I do my biggest damage right now at dinner and with B* out of the country I should be able to save significant calories at dinner time - no dessert, and focus on keeping it under 500 calories (he is the cook in our family and it is a big no-no not to express enthusiasm and clean the plate at meal time).

Breakfast is a smoothie or an egg and lunch is a lean cuisine or other type item. Swap carbs for protein when possible and no buffet dining on the weekends (my biggest undoing - we go to buffets every weekend - korean, idian, indonesian, brazilian - we are maniacs!). Fruits and vegetables are sanctioned snacks.

Goal: lose 8-10 pounds in 2 months. or 1 lb a week. If I can achieve this goal I will be back into my size 6 clothes which always puts a smile on my face.

Thursday, December 21, 2006

DE Quality Concern

After reading Sparkle's latest blog entry at IF and the City I totally freaked out about working with a Utah donor through a Utah RE's office - even though they will be working directly with my RE's office. If you click through and read the entry you will see that the donor cycle was a failure, only one good egg to put back and none made it to freezing. As Sparkle points out, her cycles were better than the donor's cycle.

Now granted the situation is quite different. In Australia you have to basically find your own donor and they cannot be legally compensated. I will be investing $24,000 plus to ensure that everything goes off like clock work.

In any case, I emailed my donor coordinator today because it has been a week and still no confirm on #124 and she is leaving the country shortly to go to Africa for a month and will not be reachable. I am concerned that we are already off to a bad start with the Utah clinic and if they are not operating at the same level of care as my RE's office I am not sure that going with #124 is such a great idea.

I received the following reassurance from the donor coordinator:

I understand your concern and who knows, maybe by march we will have found some donors in the area that would work for you. If not, and we go ahead with 124, the beginning of her cycle would be in Utah, however once she starts stimulating, she will come out here for the critical monitoring. Also, keep in mind Dr.*** will be monitoring her from the very beginning, only instead of doing bloodwork here, it will be called over from there. He will work out the protocol, dosage, etc, so you do have that assurance of control.

While we monitor, if we see the donor isn't doing well, we will cancel the cycle and do another, without penalizing you the entire cost of another cycle. Depending on where in the cycle it is cancelled, you would have a credit towards the next cycle, and that is something Dr. *** would work out with the billing department. The donor would still be paid a small stipend for taking the injectibles, but since she didn't make it to retrieval, she forfeits the majority of her stipend.

I am not entirely without worry either about this partnership. So far it has been difficult getting answers and information from them, and I think mostly it is due to the fact that they were not adequately prepared for this collaboration, and have gotten a little over their head. Once the holiday passes and the staff prepares for the new year, I really do believe communication will improve between our facilities.

I felt better after receiving this email. I guess I better adjust to the idea that I may have to select another donor. :(

Wednesday, December 20, 2006

Depression and HRT

A month ago I was put on hormone replacement therapy for my menopausal symptoms - I figured that since the DE was going to be a few months I might as well get some relief from the hotflashes etc.

About 2 weeks ago I started feeling kinda depressed, which makes sense, accepting infertility, dealing with Donor Egg issues, lack of genetic connection, a frustrating job - yes I have a list of issues. But the depression just kept getting worse. At first like small waves washing ashore and then bigger waves and then suddenly I felt like I was pinned under a wet blanket. Everything started sending me into a free fall of despair, an article in the paper, a conversation with a colleague.

I am trained to catch myself in these depressive moments - 13 years of therapy will do that for you. But usually you turn a corner and start to bounce back but this started to feel like infinite blackness. And the most curious part of the whole thing is that I am on a therapeutic dose of Effexor which has worked for me for over 8 years.

And then last Friday is hit me, it was the HRT I was taking. I had similar issues on certain virtuousness pills a millennium ago and it made sense that I might have a similar reaction on these pills which are not unlike virtuousness.

So on Saturday I stopped taking the HRT - there was not instant relief. As of yesterday I was still experiencing some of the vertigo of a bad depression but I am also starting to see it lift.

I called my psychopharmcologist who confirmed that effexor and HRT can be a potent combination and it sounded like I needed to stay off all HRT for a while and wait for my mind and body to recalibrate. He said if I still felt bad after the holidays to call him.

I called my RE and they said that given my bad reaction they are hesistant to prescribe an alternative and that I might want to investigate bioidentical hormones instead.

So I sit here and wait for the veil of depression to fully lift and for the hot flashes to return. As Roseanne Rosanna-Danna's Grandmother use to say, "It's always something. If it's not one thing," it's another."

Sunday, December 17, 2006

It's All in the Genes, Except When It Isn't

It's All in the Genes, Except When It Isn't by Liz Mundy, in today's Washington Post Outlook section gave me pause. She is working on her forth coming book: "Everything Conceivable: How Assisted Reproduction is Changing Men, Women and the World" (Knopf).

She takes the position that we are speeding past the issue of genetic connections too quickly in understanding what defines a family. I don't disagree that there is an industry out there that encourages couples to move to quickly move to DE as the logical progression after failed IVF but how or why does that necessarily lead to the conclusion that as a society we are failing to understand the genetic connection in defining family? Since when is that the definition? Sometimes the genetic connection is a curse not a gift. I've often wondered how I ended up with my parents, we seem such an ill fit - the answer is genetics. And all the personality traits I've spent 10's of thousands of dollars to unlearn, are, at least in part, due to genetics.

Genetics does play a role in identity but so does environment and childhood. DE is not really adoption even though some would call it that but it is a means to a wanted ends. And yes, I would like to have a child that has my physical traits (call me a narcissist) but what I can give it beyond DNA to me is far more important. IF anything my DNA is not the best thing I have to offer - predisposition to depression and anxiety - how are these gifts?

This article seems to suggest that those who choose to embark on the journey of using Donor Egg or donor sperm do not fully comprehend the implications of what we are doing. These are not decisions that anyone takes lightly - they are painful and gut wrenching and I find this article insensitive to those of us who have been brave enough to seek parenthood when it has not been easily handed to us.

If you want to respond directly to Liz Mundy here is her email:

Here is a reprint of the full article:

It's All in the Genes, Except When It Isn't

By Liza Mundy
Sunday, December 17, 2006; B01

There's a lot we don't know about the pregnancy of Mary Cheney -- but a few things we do. We know that the vice president's openly gay 37-year-old daughter is expecting a baby whom her parents are happily preparing to welcome as their sixth grandchild. We know that she plans to raise the child with her longtime partner, Heather Poe. And we know that there must be a man involved somewhere -- either a friend or acquaintance (a "known donor") or a donor from a sperm bank.

In short, we know that this pregnancy involves what's called, in the fertility business, "collaborative reproduction."

That's the trade term for a situation in which a couple (or a single person) conceives with help from a third party who probably won't be involved in raising the child, but who agrees, as one egg broker put it, to "genetically contribute to the conception process." It's a situation unprecedented in human history, but now common to the point of being commonplace. Yet these technologies are setting in motion a social experiment that will unfold over decades, creating hundreds of thousands of families in which the role of genetic ties will be newly tested -- and the meaning of family reevaluated.

In the United States, donated sperm is used in 80,000 to 100,000 inseminations each year. In 2003, at least 15,000 in vitro fertilization procedures -- in which the gametes, a woman's eggs and a man's sperm, are united in a petri dish and the resulting embryos are transferred into a uterus -- were performed with donated eggs; that number grows by 20 percent annually. More than 1,000 babies are born each year through surrogacy, in which a woman carries a child for another woman or, increasingly, for two gay men.

These explosively popular science-enabled multi-parent arrangements are altering our understanding of what parents are and how families can be formed. And they're confusing our thinking about genetic relationship and its importance to the parent-child bond. Collaborative reproduction is becoming widespread at precisely the moment when we've become ultra aware of how genes run the show in the unfolding of a human being: controlling everything from physical attributes such as height and hair color to a predisposition for certain illnesses to a tendency toward shyness or a taste for fine wine.

Interviewing hundreds of families for a book on assisted reproduction, I've been struck by how conscious people are of the power of genetic inheritance -- and yet how bewildered they are about how a missing genetic connection might affect their family.

Reproductive medicine and the profit-making industry that has grown up around it send a powerfully mixed message, encouraging parents to accept that genes are crucial to the formation of their children, yet irrelevant to the formation of a relationship with those children. Genes matter, the message is, except when they don't.

"Let's face it: Donor gametes is an experiment," one fertility doctor aptly put it. "Who the hell knows how it's going to turn out?"

An irony of assisted reproductive technology is that it was invented to help infertile couples have biological children, yet quickly became a way for people to knowingly conceive children who would be biologically related to just one parent.

Only six years after IVF first succeeded in 1978, with the birth of Louise Brown to a British couple, doctors discovered that it was startlingly easy to achieve a pregnancy in a woman by using eggs from another. By the 1990s, egg donation had caught on as a way to help women in their late 30s and 40s whose eggs were no longer viable. So popular is egg donation in Washington that one clinic scours rural Pennsylvania for donors. The area's more than 15 clinics compete with ads hyping the quantity and quality of available donors.

Meanwhile, sperm donation has been around for more than a century. The first known procedure was performed in 1884 by a doctor who inseminated an anesthetized patient with sperm from a medical student, without asking her permission or telling her afterward. By World War II, donor sperm was a routine "treatment" offered to married couples. In 1992, a variant of IVF in which a single sperm cell can be injected into an egg made it possible for many infertile men to have biological children. Since then, single women and lesbians have become the majority of the clientele seeking sperm donation.

People selecting a donor are bombarded with information about the donor's likely genes. Web sites for sperm banks and egg brokerages invite prospective parents to sort anonymous donors based on ethnicity, College Board scores, personality tests, shade of skin and curl of hair. For a fee, they can order childhood photographs or scrutinize a handwriting sample. "One of them couldn't spell; she spelled 'Catholic' wrong," one mother told me wryly. She rejected that donor.

The message is that genetics are everything -- everything -- in the formation of your child. And parents of course believe they owe the child the best genes. As one gay couple put it: "What are you going to do -- get someone with a 1550 [SAT score], or are you going to cheat your child and get them a mom with a 1210?" In choosing their egg donor, they made a decision tree assigning values to attributes they were looking for.

Yet even as these genetic profiles are being posted and peddled, the importance of genetics when it comes to parenting, or to the child's own psychological and emotional growth, is downplayed, if not ignored. The message here is: Your child won't be related to you, but she will still love you, no problem. Every day, families are being formed by parents trying to hold in their heads the competing notions that genes, while important, aren't. Genetics matter -- except when they don't.

Is gamete donation like adoption? "I've always looked at this as adoption that is run by the medical profession," says Bill Cordray, now in his 60s, who is part of a group of donor offspring agitating for the right to know their donors' identities, arguing that people denied that knowledge are unable to understand themselves. Accepting this argument, some countries, such as Britain, have banned anonymous donation.

But in the United States, many egg and sperm brokers disagree. They point out that adoption involves the grief of relinquishing an actual baby. In donation, nobody's relinquishing. Everybody's happy. What a child needs, they say, is not a relationship with the genetic parent, but a coherent narrative about the way he or she was born.

Yet the industry tacitly recognizes that genetic connection can matter. In the late 1980s, a surrogate in New Jersey contracted to be inseminated and to surrender her own biological offspring to the father and his wife. But after giving birth, she didn't want to give up the child. A court forced her to do so -- in the famous "Baby M" case. As a result, most surrogates now are "gestational carriers," bearing babies created with eggs that are not their own. Everyone assumes that having no genetic relationship will make it easier for a surrogate to hand over the baby. Genetics don't matter -- except when they do.

In two-parent families, many parents still don't tell children they are donor-conceived. "Parents are afraid that if they tell the child they are not the genetic parent, the child will love them less," Fay Johnson, a longtime surrogacy broker, told me. Though the donor has no legal claim, parents worry that he or she possesses some kind of unarticulated blood claim, and they fear that person's power. "I'm the dad, damn it," I was told by one man, who thought that if his sons grew up and wanted to track down their donor, it would be a sign that he had failed as a father. One mother told me about dreams in which her anonymous egg donor knocked on her door, asked to see her son, and left taking both the son and the woman's husband with her.

And of course, children don't always see things the way their parents do. The Sperm Bank of California, a small nonprofit established in 1982 to serve mostly lesbians and single women, has pioneered an "identity release" program that entitles offspring, at 18, to learn the identity of their donors. In a study conducted as the first deadline for tracking down donors approached, the bank found that though most children were comfortable with their origins and regarded the people who had raised them as their parents, most still wanted to meet their donors. And many more than anticipated wanted a relationship with the donor.

Collaborative reproduction has brought happiness to many, and children to millions. There aren't enough adoptable children in the United States to meet people's desire for kids and family life. And there are men and women who are comfortable giving away an egg or sperm. The result is children who, by and large, will be glad to have been born.

But it's wrong when an industry stokes the genetic anxieties of would-be parents yet fails to provide the support to help us all figure out how to deal with the ways in which genetics do affect family ties. It's also wrong when would-be parents get shuttled along too quickly. Some women now go through IVF one or two times and, if it fails, are encouraged to move on to egg donation as if it's merely another step in a medical process.

Like adoption agencies, clinics need to acknowledge that you can't just slip a new set of genes into the conception process and go on as though nothing had happened. They need to connect parents with counselors who know the research. Egg-donation recipients typically receive an hour's worth of counseling; sperm bank patrons often get none. Yet these families are going to unfold in unexpected directions.

Not long ago, I interviewed a mother who had conceived twin daughters with the help of an egg donor. At a wedding, she ran into the donor, who was a casual acquaintance. The woman did not want children and was glad to help someone who did. But the donor's parents were also at the wedding, and the girls' mother noticed them looking at her twins. They were the girls' genetic grandparents, looking, a little wistfully, at the granddaughters they would never have.

What is a donor? What are a donor's parents? The reproductive field needs to acknowledge that these questions exist, and that the answers matter. After all, the Cheneys won't be the only genetic grandparents of Mary's baby. Presumably, there will be another set out there -- somewhere.

Liza Mundy, a Post reporter on leave,

is author of the forthcoming "Everything Conceivable: How Assisted Reproduction is Changing Men, Women and the World" (Knopf).

Saturday, December 16, 2006

Been there Done that....

If you are approaching advanced maternal age and have high FSH you might find this information to be of interest.

Ofcourse you still only have about a 5% chance of getting pregant.

I spent almost a year (9 months) trying to beat the odds but frankly it was exhausting and seemingly futile. In the end I had to ask myself the question, "What is it that I really want?" (in addition to my doctor encouraging to discontinue my unlikely attempts to get pregant through vigilant monitoring and estrogen suppression)

I'm rolling the dice with DE but the odds have just gone up from 5% to 80% and it will still have a genetic connection to B* and I get to carry it around and feed it for 9 months prior to birth.

Friday, December 15, 2006

Donor #124 Is Available

I don't have the lock down in writing confirmation but it appears that Donor #124 will be traveling to Africa in January (reminder - I was hoping this would be the case because B* is out of the country until mid-March) and will therefore be available to start syncing cycles in February but not before. It's all good. I wanted her as the donor and now it appears that it will work out.

I've been feeling draggy today, work is slow and there is a gross lack of direction and ambiguity that drives me insane. I also have to get my finances into rehab pronto. No shopping therapy or spending quick fixes for my moods these days.

In other sidebar type news we took Mr. the Dog to check out a local dog Agility course to see if it would make for a good hobby. He needs better hobby than his current one of destroying the house. He was quickly jumping over the poll and reveling in his accomplishments so I am planning to start his Agility lessons in early January. He clearly felt important on the ride home sitting up on the arm rest peering out at the oncoming traffic.

Wednesday, December 13, 2006

More Blood and More Humiliation

I went to my ob-gyn today to get all the tests done that are required for the Donor Egg program. I was informed that my insurance might not want to cover it because my annual was last February. I said to the nurse - "code it as something else" and she said well you can talk to the doctor first.

Fine, so I talked to the doctor - the one who referred me to my RE - and updated him on my whole tale of whoa.

Doctor said, "Are you getting the support you need?" but before I could really answer the question he was on to the next item, it was a pro-forma question - my mistake for taking it as care and concern.

When I told him we were waiting until March when B* gets back from Australia to inseminate he said that's too bad. Not a helpful remark given my own anxiety about waiting.

I asked if he thought it was normal to be more depressed than usual with all the hormone changes and everything else and he said "yes it's normal, are you having thoughts of suicide?" No I said.

Don't forget to take your calcium and be sure not to eat any raw fish while pregnant - I'm sitting there thinking don't you think I am a little past the safe pregnancy lecture with all I have been through?

These questions and statements just kept popping out of him the whole time -

Then they took 4 viles of blood and it hurt. I picked up the safe pregnancy information booklet and drove home, I was done.

Tuesday, December 12, 2006

DONOR #124 - Answer the Questions Correctly and Win an All Expenses Paid Trip to Our Nation's Capitol

I've settled on #124.
Why #124?
**She's tall
**1350 on her SAT's
**Planning to attend med-school
**Two generations of scientists in her family
**She's 21
**She's attractive (she doesn't really look like me but her coloring and face shape are similar)
I had a good gut feeling from her profile and picture

Being a good donor is about egg quality when you get right down to it. Intelligence was a factor that also loomed large as I reviewed the candidate profiles.

I left a message for the Donor Coordinator who will be back in the office tomorrow. She has already let the office in Utah know that there is someone actively interested in donor 124.

My NEW big anxiety - Timing

B* is leaving Mid-Jan and not back until late March. Which means if I want fresh and not frozen sperm I am going to have to wait until late March for the insemination. I am concerned that the donor will not want to wait that long - technically it is a delay of about 6-7 weeks. The pros of the delay for her will be time off during the holidays etc so I am hoping that she is amenable. There was also something in her profile about hoping to travel to Africa in January -- I told the coordinator that I hoped she still wanted to go :)

It is going to be hard to wait until March - yes the drugs will start several weeks earlier but it still feels so far away. There is sooooo0 much waiting with all of this stuff it often feels interminable. The upside of the wait is that it gives B* and I a little more time to get our fiscal house in order.

Every time a see a pregnant woman (especially at the gym) I get a twinge of jealousy.

Wednesday, December 06, 2006

Lot's of Q's and A's - My visit with the Donor Egg Coordinator

Today I got to ask all my questions of the Donor Egg Coordinator - she is probably 28 and very serious. Here is what I found out:

Q: What is the current rate of success with DE at this office?
A: Since I started in August we have worked with 10 couples all of whom have become pregnant, 8 with Twins.

Q: Did any choose selective reduction?
A: No, although one pregnancy became a singleton at 8 weeks.

Q: Why are you using Utah donors (we are in DC)?
A: One of our doctors knows someone out there who used to work in Virginia and they have more donors than recipients in Utah (no suprise).

Q: Are these donors mormons?
A: About 50%

Q: Does it cost more to use a Utah donor?
A: No because their fee is lower, so the funds are used to pay for their travel and per diem while they are in town.

Q: What is/is not covered for the $24,000?
A: Donor meds, IVF but not ICSI. Not covered are the required blood work ups on donor recipients, donor recipient meds ($1,000), freezing ($2,000) or FET cycle if necessary.

Q: How long will it take once we select a donor?
A: Approximately 6 weeks - sync cylces (I have none so that is easy), supress, stims, retrieval and transfer.

Q: Can we select the donor now but wait to start the cycle?
A: That is usually not a problem if it is a month or so.

And that was it - I have my files of 3 candidates and will provide my reviews shortly.

Tuesday, December 05, 2006

Donor selection - The girl with the best eggs wins

It turns out my email from the Donor Coordinator was delayed and she resent me the list after my little pesky email yesterday.

She sent 7 profiles (very short like - height, weight, age, coloring, hobbies, ethnic origin). I am instructed to pick the most interesting 3 and she will give me their full medical files and essays, etc. to review. I can also look at child and adult pics in the RE's office.

I consulted this morning with someone who just went through a similar process with getting Sperm and she said something very profound,

" In the end, we picked the donor with the highest sperm count and disregarded most of the stuff we went in thinking was important."

I think she is right, pick the person with the best fertility - who cares if they are interested in greek literature or play multiple instruments. You want this to work. (She also agreed that tall was on her list of important features. )

Monday, December 04, 2006

Battling the Blues

I'm not sure if it's reality sinking in about my own infertility and mourning the loss of the genetic connection to a child or the crashing of estrogen in my body, but this weekend was rough.

I just wanted to sit on the couch and watch QVC.

I'm also coming to terms with all my debt and trying to figure out a way to try and pay some of it off --

No word on potential donors but I did send the coordinator a little end of the day note (I have to be careful not to turn into a pest before we even get started or I will be in big trouble).

Friday, December 01, 2006

E Pluribus Unum - Utah

I just got off the phone with the Egg Donor Coordinator -

She will email me possible donors on Monday afternoon for prelminary review. Once I have selected those that look the most promising I will get to review their detailed profiles and can make an appointment to come to the office and see their photos (photos don't leave the office).

I asked if the donor pool has grown since last month when I was handed a list of about 10 - she said that they have started working with a number of donors in Utah and as a result have expanded the pool significantly.

Now don't get me wrong but I hope all the donors aren't Mormons. Not that there is anything wrong with the Mormons but a jew from the Northeast is quite a different breed of person - both genetically and environmentally. The truth is that I am not going to find my genetic clone out there, nor do I need to. I am sure that my donor will have great genetic material, whatever their religious beliefs (which are not genetic as far as I can tell).