Confession: I have a secret board on my Pinterest account called “Baby Wishes” that is not visible by the public but a private space where I accumulate all my fantasies about the family I know I will one day have, gathering the quaint wisdoms of other mothers and visions of what the empty second bedroom will one day look like. It is the cyber-manifestation of hope and unwavering determination; it is the onsie infertile women buy and tuck into the dark corner of a night-table drawer for the time when (not if) they finally hold a wriggly, clinging infant in their arms. It is filled with pictures of elephants.
At some point when all of this got so goddamn scientific–when the innocence of making love and making a baby gave way to combing through studies in Fertility and Sterility to advocate for myself across a stark desk from yet another doctor while planning yet another course of treatment–B and I decided that we do not want to know the sex of our someday-baby. Before all this, the pragmatic, neurotically future-focused, control freak in me always thought this was way too impractical to be worth it, and I never really understood “green-team” mothers who wanted to be surprised. But experiences change us, and I’m now so disgusted with how the exhaustive and meticulous analysis of every detail of human reproduction has robbed this process of its ancient, primal romance that I have resolved to take some of it back. If I have to go so far as to screen the chromosomes of our embryos after making them in a petri dish, watching them under a microscope, grading them on the minute details of their development to inevitably carefully select which one gets a chance at life, then when I finally get to be pregnant, I want to wonder, to feel the mystery, to anticipate that moment when the first cry wails through the delivery room and a nurse announces, “It’s a _______!” As such, my visions of our future nursery are all gender-neutral–an elephant theme, to be exact, of light gray and pristine white with bright splashes of turquoise, yellow, maybe an orange giraffe, some mixed and colorful patterns that remind me of India. It’s not just because I think elephants are cute; they feel somehow aligned with this journey we’re on–their demonstrative displays of grief at the passing of a member of the herd, the extraordinarily long period of gestation, the concentric circles of family and then pack structure in which they survive by virtue of a broad and intricate female support system, just as I have drawn strength from the many women in my life, and, maybe most of all, the way they never forget their pain because it drives them to make better decisions on the path ahead. Yes, our nursery will be filled with elephants, and when I look at the gentle beast I will eventually mount over my baby’s crib, I will remember all I have endured to arrive at this sleep-deprived 3am feeding and savor its joy.
Sometimes I just can’t look at this Pinterest board because the end game feels so distant, so uphill, so impossible to even conceive (pun intended) the pitter-pattering of little feet on the floors of my house, the tinkling voice of someone calling me “Mommy,” that the images trigger feelings of potently bitter desolation, barrenness. But the whole experience of seeing this cycle unfold has so buoyed my hope that I was able to flip through these pictures with a sense of peace I haven’t felt in years, mostly because my response to this protocol was so different, whereas my response to the other four with all their tweaks and new technologies and increased dosages were nearly indistinguishable from one another at all stages of the process. By looking at the ultrasound, there was very little observable difference: 10 follicles, some in the lead, all actively growing. We ended up with 7 embryos, which is both the mean and the median outcome of all 5 cycles. What’s been different is the estrogen levels in my blood and the continued erratic variability in B’s produced samples, which validated the decision to use aspirated sperm. Just some history: my highest estrogen level prior to this cycle was around 1800, the first IVF go-around, when the doctors pushed my leads to borderline overmaturity in order to trigger at a point when blood levels neared normal for the number of follicles measuring on ultrasound. A mature follicle should produce an estrogen level of at least 200, so the math just doesn’t add up with an E2 under 2,000 From there my blood estrogen was increasingly discouraging in subsequent cycles–around 600 at trigger with cycle #2, 15 eggs retrieved; around 900 with cycle #3, 12 eggs retrieved; around 1100 with cycle #4, 16 eggs retrieved. With this cycle I had the highest estrogen ever, over 2200, and 10 eggs retrieved. Healthy eggs produce estrogen, so sight unseen, I have reason to believe we have finally found means to improve quality, some data to set this cycle apart from the others and a fragment of a reason to believe it could thus work out differently this time. That combined with 2 renowned urologists who believe fragmented sperm could have played a role in our past failure, and research to support improved outcomes with testicular harvest, I have something to grab onto, to keep me warm at night while we wait and wait again.
I mean, the jury is still very much out, especially since my single eggs during natural cycles have produced a normal E2 of 200-something, and I have had period after period, loss after loss; especially since we won’t see these embryos develop to really know anything about their quality until after we cycle again in October/November, wake them up, and grow both batches out to biopsy. Then we have to pass the test of normal chromosomes; then we have to pass the test of implantation; then we have to pass the test of keeping a baby alive for nine months after six pregnancy losses, but somehow I feel up to the challenge, and my heart is brimming with optimism. It’s hard to say what’s different. All this is based on good blood estrogen levels and a nebulous fertilization report that says little about quality? NOW I’m suddenly encouraged by the prospect of growing my embryos in the CCRM super-lab? I have known that’s why we were coming here all along, and I knew my protocol was totally different and that it was possible (even if it wasn’t probable) that things could unfold differently, yet I still spent several months ahead of this trip panicking about donor eggs and fears of family disconnect and looking in the mirror at a face I felt I would never get to see in my children. Why wasn’t I able to latch onto these feelings of possibility before? Why grieve a loss that hasn’t happened yet, something B has been saying for months until I convinced him this was all the most expensive exercise in futility we would ever endeavor? And then I started thinking about operant conditioning and all we’ve been through, B and I–how experiences change behavior, how behavior is a product of cognition, how repeat trauma extinguishes hope and beats us into surrender such that we become blind to opportunity. And then, in total synchronicity, I opened up an email containing this post from my favorite fellow blogger:
I’ve been thinking a lot about this horrific psychology experiment performed on dogs during which they are shocked repeatedly when they try to escape from their enclosure. After a while, they give up. They whine and behave with helplessness. Or they become stoic and numb, doing the one thing they can do in the face of relentless pain—reacting as little as possible. When they are finally given an escape route from their enclosure, the dogs do not even get up and inspect it, do not even try to escape, because they have been conditioned by the shocks to expect the worst, to believe that there is no escape for them, ever.
It is hard to go from being that dog to being a different dog altogether. So I’m two dogs right now: I’m a repeatedly shocked dog who does not trust her escape route from the pen, and I’m a relieved, relaxed, excited dog who finally gets to go outside. And various dogs in between.
Is that the creak of a gate swinging open? I have to go inspect it, risk of shock or not. Otherwise, I’ll never get to leave this enclosure to explore the great wide world beyond the electric fence. I was kidding myself in the days of post-traumatic numbing when I considered a “child-free not by choice” lifestyle, even if it does mean donor-whatever. I won’t pretend that having to settle for that alternative wouldn’t hurt like hell with a lingering permanence of unhealed infertility and fear of rejection and stage-sharing and other shoes dropping, but this experience of mothering, parenting, family, watching the world through the eyes of someone for whom everything is new and fascinating, the love, the joys, the connection that grows out of the healing of broken bones and broken hearts: I will not leave this earth without seeing this from the inside. And that brings me back to the second half of the post from my favorite blogger, a new wisdom discovered on her own journey, which plucked a deep chord in me–with all this elephant reverie–again, at the perfect time with perfect poignancy:
One sign that I am moving on: this morning I was thinking about cancer, about how I have dearly loved and clung to one study which shows that, because the drive to reproduce is so primal, women struggling with infertility undergo stress equivalent to those who are struggling with cancer…I am now, more than ever, acutely aware of the importance of reproduction to our species, aware that by doing donor egg IVF, I am acting out of an ancient, instinctual space that cannot be squelched by any force, internal or external. DH and I have been watching nature documentaries almost every night for a couple of weeks now, and I am struck again and again by the great lengths to which animals and insects and plants will go to successfully reproduce, and to reproduce as much as they can. For the vast majority of life on this planet, the quest for reproduction is the main event, and pretty much nothing else matters—everything done is carried out in service to reproduction.
I have a vivid memory from one of the documentaries: a mama octopus finding the perfect lair in which to lay her eggs. She braids them together, and they look like strings and clusters of pearls, hanging all around her. She cleans them, waves air over them to stimulate circulation, and she does not eat anything herself. For six months, she stands guard over about sixty thousand fertilized eggs, while starving. When they are ready to be independent baby octopi, she blows them out of the lair and into the open water with her last, dying breaths. Of the 60,000, perhaps two will survive.
And this is where my awe in the face of the natural world makes the challenges of my life seem manageable, conquerable: to stand on the top of a mountain, 13,000 feet in the air, dwarfed by the enormity of the sky; to perch on a flower-dappled seaside bluff, as I did in July while another doomed pregnancy grew inside me, watching the ocean rage against the rock and feeling small juxtaposed against its raw power; to lay in the smell of the grass and wonder at a sky full of stars because it makes me remember that I am just a girl on this tiny planet floating in this incomprehensibly vast universe; to happen upon a herd of mountain goats and sit bemused as a mother eyed me suspiciously while her nervous calf scampered from behind to find the warm security of her flank. I stood at that summit with a smile playing across my lips, crisp air against my neck, encouraging news in my heart, and the perfect rhythm of nature invigorating my spirit. I am part of all this, swept up in the mighty current of animal instinct, a single thread in its infinite tapestry, and nature finds a way.
So here are some photos for you. The charming and brightly colored oven-mitts on the stirrups in all the ultrasound rooms and the hardwood floors throughout the facility that succeeded in making it feel homey (apparently the whole place was designed by Mrs. Schoolcraft herself), the post-it notes the nurses gave me after each monitoring appointment to keep me in the loop and alleviate the anxiety of having to ask pushy questions of aloof ultrasound techs, and the view from the waiting area in the surgery center upstairs while I waited for my retrieval:
And some pictures from all the great, albeit rainy, hiking we did at Mount Evans yesterday and Rocky Mountain National Park on Sunday: crystal clear lakes filled with trout, the intoxicating scent of pine mingled with brewing thunderstorm, big sky, orange sunsets behind the looming silhouette of mountains, evergreen trees and wildflowers:
Today, we table this. We’re off on a Denver microbrew tour…because I’m allowed to DRINK! And today when B and his nephew talk about the 15th century German roots of their family and their emigration to Tennessee and all they have in common in spite of meeting only recently, I will not let it hurt me. I’m going to curl up inside this hope and let it envelop me for awhile.