Archive for the ‘Personal Musings’ Category
April 17, 2013 | By: Liz | Filed under: Age and Infertility,Egg Donation,In the News,infertility in the media,Infertility on Television,IVF,Personal Musings,Thinking Out Loud,Uncategorized
So Halle Berry is pregnant at age 46. She’s approximately my age. Jealous much? You betcha! You all know I want another baby. It’s hardly a secret; certainly not from my kids, my dear husband (DH), most of my friends, and Dr. C. I have become somewhat preoccupied with the notion of being pregnant at such an advanced age — my BFF from High School and my BFF from College both think I am absolutely, completely and utterly insane to want to bear a child at this age. [btw, I have a college reunion coming up, whadya wanna bet that many of my classmates have just started down the path toward parenthood and have little ones?! I am taking bets!]
But clearly, if judging from no other demographic than my client base, I am far from alone at wanting a baby in my mid-forties. I was somewhat surprised but quite happy when I heard that ASRM just increased the recommended age limit — cutoff — for women undergoing ART procedures to something like age 55. While I am not sure my own mojo is going to keep me going for another 10 years, I am delighted that ASRM is now recognizing and giving an opportunity to all those healthy women who are in a deadlock battle with the NOvary because they decided they wanted a seat on the New York Stock Exchange before they wanted a seat next to a breast pump. And these days those goals can and do become mutually exclusive. Sheryl Sandberg aside — who managed to pop out her babies in her mid-late 30’s, and no doubt did her research about declining fertility before making an educated decision to have her children while she still had a decent chance at doing so using her own eggs — most women who truly want and love their careers, or who truly want to find the right partner, wind up face to face with their biological clock, otherwise known as the NOvary.
The NOvary, to remind you, is the ovary that says NO! I am not going to give you a healthy egg. My days as a functional ovary have ended. Didn’t you read the memo I sent you (and Sheryl Sandberg) when you were 35 and I was starting to explore ads for condo’s in Miami? I am the NOvary, I am in control of your egg quality and egg quantity and good luck trying to have a baby without my cooperation!
But thanks to egg donation and now expanded age limits by ASRM, those of us with career aspirations or who haven’t quite found the perfect partner have been given a reprieve, a few more years in which to squeeze in our baby-making, and laugh at or otherwise stare the NOvary down.
The funny thing was, as I sat down to tackle today’s blog I wasn’t sure whether I was going to write about choosing an egg donor and some recent hullabaloo over ads for egg donors that were posted at MIT, or whether I was going to explore the whole notion of whether someone can or should be deemed too old to become pregnant. As I perused all my research on age and egg donation, and age and parenting, I stumbled across an article from TheBostonChannel.com which I had printed out in February of 2012. “How Old is Too Old To Have A Baby? Older Celebrity Moms Blurring the Biological Lines.” Half way through the first page of the article I read the following:
“Since 1980, the number of women giving birth after age 35 had tripled, and after 40, guadrupled, as more women climb the career ladder and take longer to find ‘Mr Right.’ In the media, we are bombarded by images of glamorous, 40-something celebrity moms like Halle Berry . . . who make it all look easy.”
BINGO, topic decided. Clearly Halle and I have something in common and something of which I wish to speak. But before I do, I want to be clear and say that I have no personal knowledge of whether Halle used any kind of assisted reproduction to conceive her baby (despite the myriad comments on facebook from my colleagues — all of whom stop just short of stating she used an egg donor to avoid risking a lawsuit), but I do find it interesting that an article and quote from a prominent fertility doctor written a little over a year ago would mention Halle Berry as an example of celebrities who are blurring the lines between what can be achieved the old fashioned way, without medical technology. You do the mental computations on this one. Coincidence, or did that doctor know something and Halle’s hiding something?
For what it’s worth, I do have more than one personal friend who conceived on their own in their mid-late 40’s such that I do believe it is possible that Halle could have conceived without assistance, coincidences raised by the aforementioned article aside. But Halle is my blog inspiration for today because she is blurring the lines and that pisses me off.
The reality is that for most of us mid-forty-aged women, we will need an egg donor to conceive a child. The NOvary has hit her stride by the time we have hit 40 — let alone 45 — and she ain’t gonna budge from her beautiful condo in Boca no matter how much we beg and plead. As I have been working on my egg donation book recently, it has taken on a new meaning as I often find I am writing not just to a group of women whom I typically represent in my legal practice, but I am writing to myself and for myself. I also am finding my new book enriched by my own efforts to justify my decision to bring another life into the world at this age, and gaining a better understanding of how and where to conceive this new life. For example, I recently was astonished to learn that by the time a woman reaches age 40, her chances of conceiving using her own egg in any given month declines another 2-5% per MONTH. The NOvary is powerful and while one day I am sure science will find a way to stop her, right now my age alone pretty much guarantees that I need an egg donor. And Halle and I are in the same age demographic whether or not she hit the genetic jackpot and managed to defeat the NOvary by some major miracle which did not involve donated eggs.
But that’s the point! Halle is blurring the lines especially for anyone who isn’t ready to face the reality of our rapidly declining fertility in our forties. I have reconciled myself to the fact that my peak fertility has long since passed and I acknowledge that I share the same spot in the waiting room at the fertility clinic — or should I say egg donation agency — as all the Sheryl Sandberg wanna-be’s and all the women who hold seats on the NYSE, or who have finally found their mate. I doubt that most of my contemporaries, however, even those who know and understand what I do for a living, truly understand just how high the odds are stacked against us. Indeed, at a recent dinner with a fertility doctor I sought to learn more about the advantages of egg banking — or more precisely the decision to freeze one’s eggs to be used later in life when a woman is ready, willing, and able to have a baby on her terms. The doctor explained to me that far too many women are coming to him to freeze their eggs in their late thirties or even early forties — an age at which he often won’t even discuss permitting them to freeze their eggs. What he was trying to tell me, and he is by far not the first fertility professional to tell me is this: women are thinking of using egg freezing to buy themselves more time but are coming to the fertility clinic when their eggs already have passed their expiration dates and when the NOvary has taken up residence in Boca. The women who wish to take time before becoming a parent and who should be freezing their eggs are at a minimum ten years younger than the ones seeking out this new “stop-the-NOvary” technology. And Halle’s miracle conception isn’t helping doctors explain to all the women asking to freeze their eggs at age 35, 39, and most especially at age 41 that it’s probably too late; its certainly too late to spend thousands of dollars freezing crappy quality eggs! Just because ASRM says we can continue to try getting pregnant using medical technology when we are 46, 49 or 51, does NOT mean that medical technology will involve the use of our own eggs. Just because Halle got pregnant at 46 (presuming she has used her own ova) does NOT mean that women can wait until whenever we damn well choose to have a baby.
I love Halle, I think she is beautiful and talented, and a great mother. And it’s none of my business how she conceived this child. Except that if she did use an egg donor, or any kind of medical assistance to conceive her baby, she has truly done every woman who looks to her as a roll model a huge disservice.
My other love, Jennifer Anniston, who I hope will be the next celebrity to announce her impending motherhood, has made remarks which lead me to believe that she recognizes biology is not on her side (and to be fair Halle did say she thought this phase of her life was over — but what phase of her life did she refer to? Getting pregnant the old fashioned way or changing diapers and breast feeding?).
I also get, as a reproductive lawyer, why Halle might not be able to say she used an egg donor. If she used an egg donor and entered into an anonymous egg donation agreement, she might be legally precluded from making any reference to egg donation when relating details of her conception story, lest she inadvertently reveal the identity of her egg donor. This is a discussion I have had with celebrities whom I have represented and who have used egg donors: Whether and to what extent they are willing to go public, as there are ways to go public while still protecting the anonymity of their egg donor. It can be done and I am hopeful that one of them will one day — when she and her family feel the time is right for their family — make some kind of public remark about how their family was conceived. I also understand, however, that to make that statement is to forever disclose very personal details involving their children. These are details that their children should have a right to agree to share with the public or request remain a private, family matter. But many of my colleagues feel that the minute Halle Berry accepted her status as a premiere celebrity that she lost that right to be private and even more, voluntarily gave up her right to privacy in the interest of promoting that status as a female celebrity roll model which she has so openly embraced. I think it’s worth exploring this aspect of egg donation in the celebrity community in a blog devoted more to legal and ethical issues that are discussed when drafting an anonymous egg donation agreement. But putting these dynamics and very delicate issues aside, there is no getting around the fact that Halle’s pregnancy is going to perpetuate the overwhelming misconception that women in their mid-forties can get pregnant with a healthy infant, carry to term, and live happily ever after. The percentage of women who actually achieve this, however, are less than 2% of the female population.
More and more young women are getting the message. But far too many women age 35 and older simply do not understand the ticking time bomb that is the NOvary and will look at Halle and think “see she did it! so can I!”
Sadly, the reality is that Halle is (again assuming this is an old-fashioned conception) one of an extremely small number of women who get pregnant in their mid-forties. She is incredibly lucky. The kind of lucky that wins the $110,000,000.00 lottery. Congratulations to Halle (and my thoughts and prayers are with you Jennifer and Justin), but to anyone who looks at these women and think they are representative of the general population, or that they indicate a realistic chance for conceiving a baby using your own eggs at the same age as has (presumably) Halle, please do your research. By the time we turn 30, 90% of our good, genetically normal eggs have joined forces with the NOvary, by the time we are 40, 95% of those eggs have moved into that plush condo in Boca. The older you are, the more risk you face of serious infertility issues related to egg quality and quantity, and high rates of miscarriage due to chromosomally abnormal eggs. Halle may have won the lottery. That she is healthy enough to carry a pregnancy I have no doubt, but that she had healthy enough eggs to easily conceive this baby, that was a real long shot and if she did get pregnant using her own eggs, she is one helluva a lucky lady. Because 99% of the rest of us aren’t going to be so lucky. Please don’t look at Halle as your inspiration or roll model, whatever it was that led to the conception of this child defies the laws of fertility. I want all of us to have babies regardless of whether we are 35, 45, or perhaps even 55. But using our own eggs at those ages is something we must face as increasing unlikely as we increase in age.
Donor egg, and even egg freezing, give us the chance to wait until we are 46 to have a baby. Whether or not Halle is one of the many, many women who chose donor egg to help them conceive is something we may never know. But a word to the wise: don’t assume she conceived that baby without the help of medical science and/or another woman’s healthy egg. As I said in the beginning of this blog, a little over a year ago Halle Berry was cited as an example of the women in Hollywood who are blurring the lines and confusing women into believing our fertility exists far longer than it realistically does. What an interesting coincidence that a year later, she is announcing that she is pregnant and that a wonderful miracle has taken place.
All babies are miracles, the question is whether and to what extent Halle’s pregnancy and her little miracle will continue to confuse, confound, and frustrate all of the women who look to her as a symbol of fertility, of a fertility that frankly does not exist for the vast, vast majority of 46 year-old women. The odds of someone like me conceiving using my own eggs? Let’s just say I don’t play the lottery. If I choose to have a baby at any point in the coming months or years, it will be from the miracle gift of egg donation. I’d rather bet on the odds of having a 75% chance of conceiving and carrying to term than the 95% odds against me being another Halle Berry.
Tags: age and infertility, Egg Donation, Halle Berry
April 2, 2013 | By: Liz | Filed under: Check This Out,Deadly Silence,Egg Donation,In the News,infertility in the media,Infertility on Television,IVF,Personal Musings,Recurrent Pregnancy Loss,The Infertility Survival Handbook,Thinking Out Loud
We are rapidly approaching National Infertility Awareness Week (April 21-27); a week that is devoted to raising awareness of infertility and its impact on our lives. This is an important week, not just because we are discussing infertility on a national level, but because many of us may are faced with thoughts and memories that have long since been buried. Or have they? Many an infertile woman will understand very clearly what I mean when I refer to that which I call Post Traumatic Infertility Stress Disorder (PTIFSD). This is the part of our lives where we are periodically haunted by our infertility (IF) treatment, sometimes years after it has ended. Regardless of the outcome of our treatment, PTIFSD is signaled by a random flashback to one of any number of emotionally devastating moments during infertility treatment, a flashback that comes out of nowhere and is so vivid and acute that it catches our breath and momentarily disables us.
The first time I encountered PTIFSD was about two years after I had stopped IF treatment. One day I was holding my baby while on line in Starbucks and a woman came in bursting with news for the friends who were waiting for her: she was finally pregnant with twins and her beta was high! Upon overhearing this news (along with everyone else in Starbucks, most of whom probably had no clue what a beta is or why it was relevant) I had an immediate flashback to a time I too had learned I was pregnant, had a high beta and was probably carrying twins. My flashback delved further, rapidly scrolling through memories of the messages on my answering machine, including those from three nurses at my clinic to congratulate me and share their excitement about my pregnancy. Two of them gave me information that initially had not been shared with me, information which confirmed that I “must be” carrying twins, although that would later be confirmed by ultrasound. My brain spun with these memories and I became disoriented. It was only when the child in my arms, my child, grabbed my hair to get my attention that I snapped out of my seemingly trance-like state. I forgot where I was in time. I forgot I had a child. All I could remember were those happy moments of learning that I finally had a healthy pregnancy under way and the devastation that followed approximately 9 weeks later when I learned that I had to undergo yet another D&C and that my dreams were once again, dead.
While some of us do emerge emotionally unscathed from infertility treatment, many of us carry battle scars that last a lifetime. There is a cruel side of infertility treatment that people don’t often talk about and it involves the emotional scars we are left with, sometimes years after our treatment has ended and we are supposed to have “made peace” with our family building. Not many people will acknowledge that they still have bad days, get jealous or angry (sometimes very angry) over something small and seemingly benign but nevertheless powerful enough to cause a shock wave of traumatic and painful memories from our days undergoing infertility treatment to overtake us and send us into a tailspin, the likes of which we haven’t felt since. . . well since our days of infertility treatment. It has been a long time since I had a PTIFSD encounter but sadly, I had one recently and it was no easier to tolerate than was the Starbucks encounter I described above. And what struck me most was that while I understood that my infertility might still be fresh in my mind less than two years after my husband and I walked away from our IVF Clinic, I didn’t expect those same memories to carry with them the same ferocity so many years later. I mean, it has been over ten (10) years since I underwent an IVF cycle. Certainly time must have tempered my feelings, yes?
Apparently the answer was a resounding “no”. I was checking my email one morning when I received a surprise baby-on-the-way announcement from one of my childhood friends. She and I not only went to kindergarten together but we went through infertility treatment together. Despite having similar diagnoses, she went on to achieving several successful pregnancies via egg donation. I was so happy for her that I knitted a little sweater for her first born. What I experienced upon opening her email a few weeks ago, however, was hideously painful and I was left depressed, lethargic, moody and frightened. My friend had gotten pregnant by accident, in other words, without medical assistance. Indeed, much to everyone’s stupefaction, despite her age and many infertility diagnoses, she is experiencing a very healthy twin pregnancy. As I sat there reading her email I was happy for her, but at the same time I was overcome by memories of us holding hands while waiting to have our blood drawn in the morning, and the time she called in tears because she finally had to face the fact that she needed to use donor egg if she wanted to achieve a pregnancy (or so everyone thought at the time). And as I relived those memories (emphasis on the word relive) and read her email again I suddenly was overcome by anger and jealousy that I was not the one sending out the email. Out of nowhere I was overcome with a jealous rage that bordered on hate. Hatred for someone I have loved since I was so small a person? Yes, if I am truly honest I have to admit that I felt inklings of hatred for her. For the next day or so I had mood swings and bit people’s heads-off for no reason. It was only when I finally told my husband what I had received in that email that the feelings became less intense. Somehow by acknowledging my feelings I was finally able to begin to move away from this non-stop video memory spinning inside my head. Somehow this email had me caught in a perpetual mental loop of painful and devastating memories from my IF. As the memories subsided, I remembered a conversation with a therapist I had seen during and after my IVF days. During one of my sessions, she commented that what I was experiencing seemed a lot like post traumatic stress disorder; and so she and I created a new diagnosis, Post Traumatic Infertility Stress Disorder or PTIFSD.
I now have learned how to recognize and embrace the PTIFSD memories and use them to remind me of the joy that surrounds me. I hope my PTIFSD is now truly at rest in my past. But it’s okay if it is not. Because I know where these feelings come from, and that they will go away. These feelings do not control me, nor does my infertility continue to define me, instead it is the genesis of my growth as a human being, a woman, and a mother.
I recently had dinner with an infertility doctor. He asked me why I wrote The Infertility Survival Handbook and whether it had been cathartic. I told him why I wrote it – to let other women know they were not alone – but I also acknowledged that writing it wasn’t the least bit cathartic. My healing process is one that continues. Perhaps writing The Infertility Survival Handbook was my way of starting the healing process but I would be lying if I said I was finished with it.
The Infertility Survival Handbook was released during National Infertility Awareness Week (NIAW) in 2004. Today as we approach NIAW, I am thinking of all of the women (and men) who are currently struggling to have a baby. Now on its’ ninth (yes 9th!! Woot! Woot!) printing and as I contemplate writing an updated version, I think of all those women who have read my book and have emailed me, messaged me on facebook, or even called me (on a private number at home at 6am); women, who like me, struggle with the emotions that linger even after they have become mothers. PTIFSD is not yet in any diagnostic manuals, but I wish it were. I had two wonderful therapists who helped validate the emotions I was experiencing both during my treatment and well after it ended; therapists who believe in PTIFSD and its power. Not everyone has people in their lives like my therapist who invented PTIFSD, or someone that understands and “gets it”. And it is for those women I write this blog.
No you are not alone. Being unable to conceive a child when you so desperately want one, is painful. You are entitled to express that pain. You should not be shushed or told to “just relax” so you can get pregnant. And yes, that pain can stay in your heart and mind and hide there waiting to jump out and catch you off guard. That too is normal and you are entitled to express that pain as well. You should not be shushed or told “it’s over now just forget about it”.
You are not crazy. Infertility is a part of your life regardless of the ultimate outcome. It is an experience that shapes you and has the power to disfigure you – to change who you are – if you let it. If you think you might have “Post Traumatic Infertility Stress Disorder”, talk to someone. Get those feelings out. Give your feelings a name. Sometimes just by having a name, a reason, or a diagnosis gives you closure and helps you move past the feelings and you experience a sense of relief that allows you to let go. I may not be like my childhood/IF buddy who is on the verge of delivering twins. But I also am no longer be at the mercy of my memories. By being reminded that my reactions and feelings when confronted with things that trigger painful memories has a name, PTIFSD, I have been able to regain my balance. Or perhaps it is simply the understanding that, like anyone who goes through a very traumatic experience, I am bound to (at some point) relive that trauma, which has enabled me to begin to heal on a new, even deeper level.
Infertility awareness requires not only an understanding and recognition of the disease itself but of what that disease can do to us. So if all the media coverage regarding infertility in the coming days (of which I hope there is a lot), finds you feeling a little more blue (or red) than normal, a little bit more withdrawn or melancholy, remind yourself that this media coverage is triggering some old buried memories, just as that woman in Starbucks and my friend’s email caused me to become momentarily blinded by sadness, grief, and anger. It is okay that our infertility causes some of us to experience things and feel emotions long after we thought they were over. That can be a part of infertility too, PTIFSD; and it too deserves some recognition during NIAW.
The point of NIAW is to help us recognize that we should not suffer in silence, that we should band together and make people aware that infertility is a disease. What I wanted to share with you, and make people aware of is not just the medical diagnoses, but the sometimes unbearable emotional pain we feel. We also should not be forced to suffer the emotional pain in silence.
Tags: emotional impact, infertility, IVF, miscarriage, NIAW, Peace to Parenthood, success, The Infertility Survival Handbook
April 1, 2013 | By: Liz | Filed under: Deadly Silence,Faith and Infertility,I'm Just Another Angry Infertile Woman,Personal Musings,The Journey to Parenthood,Thinking Out Loud,Uncategorized,visualization
Infertility brings with it many kinds of pain. The pain of an empty uterus could be used as the catch-all category for the pain we infertile folk feel, but really it can and should be broken down into more palatable and discussable categories. I don’t know about you, but I find that whole empty uterus thing to be a bit patronizing (although true). So let’s explore the burning pains of infertility, those that are momentary and those that haunt us sometimes years after we ended treatment, those that come and go along with our menstrual cycle, and those that blindside us when we have failed to read The Infertility Survival Handbook and obtain a first hand account of whatever procedure you are undergoing. I mean let’s face, I have been THERE, and I have done THAT. All of THAT. And I get the pain. Even now.
There is the pain of daily injections (momentary) and from transvaginal ultrasound wands (slightly longer than momentary but nonetheless uncomfortable when one’s ovaries are the size of large oranges and someone is poking at them). There is the unbearable pain of a hysterosalpinogram when you have blocked fallopian tubes (or a sadistic doctor who tries to open your fallopian tubes without advance warning — and for what it’s worth the advance warning just would have made it worse). And the devastating pain which follows a miscarriage.
There is pain, before, during and after fertility treatment and there is no getting around it. There is no getting around the pain of a miscarriage, but the lessons we learn from it can make the pain more bearable. (And for what its worth I think “the lessons we learn from it” also is a bit patronizing. My apologies but I couldn’t find another way of describing what I want to talk about).
Even in the early days of trying to conceive — the pre-IVF days — there is pain. The pain in the arse of taking your temperature every dang morning (thankfully the pain isn’t actually in your arse now that they have these wonderful digital thermometers which can help chart your basal body temperature). And of course there is the pain of toilet paper.
What say you? The pain of toilet paper? Indeed my friend. The pain from toilet paper burn, or TPB for short. TPB is brought on by the obsessive compulsive mentality that we sometimes wander into when our period is due and we are trying to make a baby. Any color on that toilet paper might be a telltale sign of our impending motherhood so you don’t want to miss it. There might even be diagnostic value to the color which would help your doctor determine if there is something going on, or going wrong with your menstrual cycle. So, for those of us who tend to wander into OCD territory (who me??), TPB can become a real hazard. And as I recently discovered, it can become a hazard even when you aren’t trying to make a baby.
Now, the average woman going to the bathroom does not wipe obsessively, nor does she pay much attention to the process, technique or results involved in use of TP. Such is not the case for a woman going through infertility treatment. There is a significant amount of attention paid to the process, there are several different techniques for wiping (all of which are designed to reassure the crazed woman in the loo that she is not getting her period), and the results are quite obviously, critical. Many a woman has called a friend or perhaps even a nurse to discuss the details of a particular swipe of TP and the medical analysis or conclusion that should be drawn therefrom. Stop laughing or rolling your eyes. This is serious. When you have lost all control over your reproductive capabilities and you are going through emotionally and physically challenging medical procedures, the littlest sign that something has gone wrong (or perhaps gone right if it’s implantation spotting) has tremendous potential impact on your life. In the absence of HPT’s, TP becomes a valid and useful substitute for self-monitoring during the post ovulatory or post embryo transfer phase of a cycle.
Why are we discussing TPB as one of the many representations of the pain of infertility? Well recently I had the displeasure of being reminded about it, but not under the circumstances you might think. Rather, I experienced TPB out of fear that I was going into menopause. Now let’s be clear. I am not in menopause, nor am I perimenopausal (well I suppose Dr. C might argue otherwise simply by virtue of my advanced maternal age). But as the window begins to close on my access to fertility treatments, and as I continue to wrestle with thoughts of going back for one last try, the thought of menopause is, well, frightening. It’s one thing to have lost the ability to independently reproduce and/or carry to term due to infertility (i.e. without Dr. C). It’s another thing to have my entire reproductive system close up shop and move to Miami.
Now the rational part of my brain understands that the last several months of my personal life have been subject to profound and extreme stress. I have always prided myself on the fact that my menstrual cycle is regular to a fault. The only time I have ever been late, I was pregnant. But there is always a first time for everything, and so a couple of months ago I missed a month. Then another month. I didn’t need to take an HPT because I knew I hadn’t ovulated (let’s just say that after TTC for 7 years some habits die hard, especially if you are a fan of Toni Weschler). My sane brain was telling me that the reason I hadn’t ovulated was from stress. My OCD, however, kicked-in into high gear and I was rapidly becoming obsessed by the fear that my days being of “reproductive age” were dwindling. And the longer I went without a visit from Aunt Flow, the more the OCD took over. How ironic. TPB brought on not by the fear that I wasn’t pregnant (and the hope that I was) but rather that I was in menopause. Despite repeated attempts at convincing myself I was overreacting, I kept making trips to the loo and quite quickly (haven forgotten good TP technique) I had a significant case of TPB.
I finally decided I needed to decompress and meditate. So I did. I meditated, I did yoga, I slept, and I paid more attention to eating things other than Snicker’s bars. And I ovulated. Or so I thought. Going by the fertility bible written by Toni Weschler the signs were clear. But I wasn’t 100% sure. And so, 11 days after my suspected ovulation I was back rolling through TP, making extra trips to CVS to buy an emergency six pack of TP, and this time relearning my TP technique. And yet I still felt the burn. And finally, when I could stand the TPB no more, she arrived. Precisely 14 days after the day that I thought I had ovulated (and let me extend my never ending thanks to Toni Weschler for teaching me so much about my ovulatory cycle).
I write this neither because this experience with TPB has led me to once again revisit the status of my own family building and a continued longing for another child, nor because I am working through my fears of the inevitability of menopause and that one day my reproductive years will come to a close (although technically the fact that the NOvary has put a “closed-gone fishin’ sign” on the front door does not mean I wouldn’t be able to get pregnant with some medical assistance), but because I was so struck by the way infertility and the quirky little habits and tricks we use to cope with it — TPB — endure. TPB also is symbolic of the loss of control and fear that we live with when we are infertile.
In the end, I am grateful for that recent opportunity to experience TPB. It is helping me work through those last remaining “what-if” thoughts which linger after you move on, after you stop treatment without a baby in your belly. But it also reminded me of how many women are out there running the race to the loo and counting the days until they can take an HPT or get their blood drawn for their beta. I am glad I had my little TPB encounter because it has once again helped me connect with my clients and understand what they are going through.
For everything unwanted (a negative pregnancy test), there is something wanted (a positive pregnancy test). For every swipe of TP that remains spotless we need to remember to focus on the spotlessness in front of us and even glory in it, be excited by it, by the expectation of it; and not give in to the fear of the appearance of a spot on another swipe of TP and/or the end of a dream whether for that month or longer. In the face of a spotted or soaked piece of TP we need to try and remind ourselves to stay focused on the day when we find out we will go months without worrying about TPB or better yet, no longer care. My somewhat random fear of menopause has served to remind me that all of this, including menopause, is meaningless. Instead of looking at the burning pains of infertility as a negative, at TPB as a negative, I am instead looking for all the positives they reveal. Without all those trips to the loo, I wouldn’t be here today, with the career I have, the family I have, and without the intense sense of inner peace that my recent bought of TPB has brought to my my life. Yes the pain of infertility burns. But through the ashes left behind after the burning subsides, there is birth, or in my case, a rebirth.
Tags: Beta, HPT, pregnancy test, toilet paper burn, TPB, trying to conceive, TTC
February 15, 2013 | By: Liz | Filed under: Current Affairs,Deadly Silence,Faith and Infertility,infertility in the media,Infertility In The Movies etc.,Infertility on Television,IVF,Miscarriage,Peace to Parenthood,Personal Musings,Recurrent Pregnancy Loss,Stillbirth,The Journey to Parenthood,Thinking Out Loud,Third-Party Assisted Reproduction
The shrowd of silence around stillbirth and pregnancy loss finally is being lifted. Someone is making a documentary about miscarriage, recurrent pregnancy loss, and stillbirth. This morning I watched the trailer of “Still” a documentary devoted to raising awareness of the pain of the loss of a pregnancy, a child born too soon, or a stillbirth. I think “Still” may focus more on stillbirth or pre-term delivery, but some of the articles I read as I researched its production indicated that the documentary intends to address recurrent pregnancy loss and/or miscarriage more than is touched upon in this trailer.
As I watched the trailer I was reminded of a long call I had with a new client this week. It is rare that I have a client who has a similar background to my own experience with infertility. Like me she has experienced 12 unexplained pregnancy losses (although I sort of stopped counting about a year ago when I went through it again . . . something about hitting the number 13 and I really decided it didn’t matter how many I had, I have had enough, one is enough). Only in addition to experiencing a number of first term (non-chemical) pregnancy losses, my new client also lost pregnancies in the second trimester and near the beginning of the third trimester. We had a lengthy conversation about how isolating it is, how lonely it is, how there is no person other than your partner or spouse who “gets it” (and even then sometimes perhaps they don’t totally get it because it isn’t their body), and how the silence that surrounds pregnancy loss can engulf one’s life, one’s existence. Our call also reminded me of a blog I posted about a gravestone I once saw that marked the death of fetus. As I commented in that blog, it wasn’t a pro-life stunt. It was a family who had been given permission not only to mark the death of their baby while in utero (or loss of their pregnancy) but to recognize all those other families that have suffered the same pain. In silence.
Reproductive medicine has provided so many advances to assist infertile couples in achieving their dreamed of family but recurrent pregnancy loss remains largely unexplained. While theories abound, there are far too many of us who don’t know why this happens to us, repeatedly. Reproductive medicine and reproductive law now give us the option of having our biological child carried by someone who is likely to deliver that child when we can’t. Indeed, the option to use a surrogate after experiencing pregnancy loss is perhaps the driving force behind at least half of my clients who come to me to assist them with legal agreements as they begin their journey using a surrogate. As is the case with the call and the client I just mentioned.
As many of you know, in the absence of an explanation of why my babies die, I was too frightened that a surrogate might lose my child. I couldn’t ask another woman to risk experiencing the pain I have dealt with so many times. Adoption was always something my husband and I had wanted to pursue so when we were faced with the [dreaded] conversation where our doctor told us we were out of options other than surrogacy or adoption, it was a no-brainer for us. It was going to be adoption. And as one of the women in the trailer for “Still” points out, I wouldn’t turn back the clock or make different decisions; because without those pregnancy losses I wouldn’t be parenting the two beautiful children I have now. I cannot imagine a life without these particular little souls in it. It seems like a heartbreaking price to pay but as I told my new client, one day when this is all over and you are holding your baby in your arms, it will make sense and you will know that but for all that came before (all 12 of those horrendously difficult pregnancy losses) this little baby wouldn’t be yours.
But as she journeys toward that day where she hopefully does feel that sense of peace and gratitude for the child in her arms, she is left with a huge void. She has no one to talk to. I had no one to talk to. Even my best IVF friends didn’t understand how I felt. Excuse me: how I FEEL. I still feel pain on a day that one of my longtime friend’s celebrates, the day she heard the heartbeat of each of the babies she was carrying. I don’t begrudge her that joy. I celebrate with her. But for me, inside, it always is a reminder of the miscarriage that I experienced just a few days earlier. My client and I share a special bond, one of knowing what each carries inside her and the thoughts that creep into our mind throughout the day. Thoughts that largely go un-shared with anyone.
Will “Still” do justice to this topic, to this diagnosis, to the countless women and men who have endured the loss of a life growing inside them or one that came into the world far too early to survive? I think so. I hope so. Because I would like nothing more than for women like me who are going through what I went through, women like my new client, to have a voice in the reproductive community. To have doctors pay attention to our kind of infertility. To have better resources and support groups. To just plain have a voice to express their pain. Amazing options for family building notwithstanding, the pain associated with recurrent pregnancy loss, miscarriage, and stillbirth shouldn’t continue to be shrouded in silence.
And so today I thank the people behind this documentary entitled “Still”. THANK YOU for initiating a dialogue that is long overdue.
And one final note, to all those physicians who have dedicated their careers to exploring the mystery of recurrent pregnancy loss . . . THANK YOU.
If you would like to watch the trailer click here
Tags: adoption, gestational carrier, hope, infertility, miscarriage, movies, Peace to Parenthood, premature birth, recurrent pregnancy loss, stillbirth, The Infertility Survival Handbook, youtube
January 8, 2013 | By: Liz | Filed under: anonymous sperm donation,Current Affairs,Financing Fertility Treament or Adoption,In the News,infertility in the media,Infertility on Television,Insurance for Infertility,known sperm donation,Personal Musings,Same Sex Parenting and Reproductive Law,Thinking Out Loud,Third-Party Assisted Reproduction
The perils of known sperm donation are reasonably well known. For those who read this blog you know all about my concerns about the Starbucks’ Sperm Donors. Alas now sperm donors are hitting Craigslist and probably other help wanted sections in newspapers and magazines. The same issues I discussed with those gentlemen engaging in a little afternoon delight in the bathroom at Starbucks and delivering their sperm donation to the recipient waiting outside the door also apply to those gentlemen responding to any other help wanted ad. As recent publicity surrounding a gentleman in Kansas reveal, even those with the best of intentions who attempt to protect themselves legally may still be deemed a daddy when all they wanted was to do a good deed. Indeed, William Marotta, our Craigslist donor du jour, has acknowledged that “no good deed goes unpunished”.
For those of you unfamiliar with the case (and I cannot imagine there are many of you who don’t know about it, because news of this case managed to reach me under the rock inside the cave in which I dwell), a little over three years ago Mr. Marotta responded to a posting online in Craigslist by which Angela Bauer and her then-partner, Jennifer Schreiner, were looking for a sperm donor to help them conceive a child. I have yet to learn all the gory details (that cave is pretty deep and news is slow to filter under the rock) but I gather that William, Angela and Jennifer entered into a written contract pursuant to which William, with the permission of his wife, agreed to donate sperm to Angela and Jennifer. William declined to accept any money in exchange for his donation. As purportedly stated in the contract — and let me be clear that I have not read the contract — William specifically stated that he had no intent to be a parent of the child, or have any involvement in its life whatsoever. Angela and Jennifer were to be deemed the legal and natural parents of any child conceived from William’s sperm donation. Angela and Jennifer also specifically agreed to assume all financial responsibility for the child and to hold William “harmless” from any claims against him for child support or other financial assistance for the child. In short, the contract stated that William was never to have any financial responsibility for any child born as a result of his sperm donation. (Just to make my life easier as I type, lets call Angela and Jennifer the “Moms”).
My devoted blog followers all know by now that the laws surrounding third-party assisted reproduction largely revolve around people’s intent at the time they conceive a child. Even with the existence of a statute governing third-party assisted reproduction, it is prudent to explicitly state that intent in a legal contract between the parties to any third-party assisted reproductive arrangement such as that entered into between William and the Moms. Cudos to William and the Moms for having the foresight to sign a contract stating that none of them had any intent for William to be “dad” and that the Moms would hold William harmless from any claims for financial support for the child. That “hold harmless” provision is further evidence of their desire and intent to have complete and sole responsibility for financial matters pertaining the the child. One major problem, however, is that (according to an NBC report), it appears that the contract they used to ensure that William wouldn’t have parental rights, was found on the internet. I am not sure that William and the Moms had legal counsel as part of this process.
My devoted blog followers and/or anyone who has called my office with a contract they found on the internet and wish to have me review in connection with their plans to build their family, know that I feel that contracts found on the internet are nasty little buggers that get everyone into more trouble than they avoid, and I won’t touch one. Putting aside copyright violations (btw, when we reproductive lawyers draft these contracts we retain a copyright in them so any time someone uses one of them they are — in addition to risking their family status — violating federal copyright laws), template contracts found on the internet simply are not specific enough to address the nuances of reproductive law. Case in point, William and the Moms.
My devoted blog followers and/or clients also know how anal I am and that I make sure that when drafting a contract of this nature — typically called a Known Sperm Donation Agreement — any applicable state statutes are mentioned in the contract. I also like to mention the terms of the statute and make sure that everyone is following the proverbial letter of the law. This is where we run into some problems as Kansas has a statute governing sperm donation, and William and the Moms didn’t follow the letter of the law. Regardless of where and how William and the Moms found this contract, they didn’t address a provision in Kansas’s statute on artificial insemination which provides that the parties to the sperm donation must have a licensed physician perform the insemination in order for the sperm donor to avoid having parental rights.
I have never fully understood why these statutes (and New York has one) require a physician to do the insemination. I suppose it could be because when these statutes initially were drafted, home insemination kits weren’t available and legislators wanted to dissuade people from having the sperm donor personally inseminate the intended mother, especially if the intended mother is married to a man other than the sperm donor. Anyone remember the scene in The Big Chill where Kevin Kline’s character gets down and dirty and does the deed with one of his and his wife’s best friends, played by Mary Kay Place, in order to help Mary Kay Place’s character conceive a child?? I suppose the whole infidelity thing combined with the desire to drive revenue to physicians led legislators to the notion that only a doctor should perform an artificial insemination. But times have changed and now you can find a home insemination kit on the internet. The primary demographic to which the home insemination kits are marketed are lesbian couples, just like the Mom’s at issue in the Kansas case which we are discussing.
Why are home insemination kits so popular you might be asking? Well, for those of you fortunate enough to have all the working parts necessary to conceive a child without assistance from fertility doctors, being gay does not meet the definition of infertility and the insurance requirements necessary to obtain coverage for artificial insemination. LGBT families have something called “social infertility.” Whether or not you like or agree with the term “social infertility”, due to their sexual orientation, the Moms were/are infertile insofar as they lack the healthy sperm necessary to fertilize their eggs. The Moms needed a sperm donor and it happens to be that cryopreserved or frozen sperm isn’t that cheap, and the processes involved in an “artificial insemination” (or to correct and update the terminology an “Intra Uterine Insemination” or “IUI”) ain’t cheap either. Without insurance coverage, the average IUI cycle can cost a coupla thousand to even a few thousand dollars. Enter the home insemination kit which costs under $50 including shipping and an otherwise healthy socially infertile woman has access to technology that will enable her to conceive albeit without the missing sperm. As we’ve discussed, Craigslist, Starbucks, and online forums have become common ways for women like the Moms to locate sperm without the cost of using frozen semen. Added in is the benefit of being able to meet your sperm donor and be able to provide your child with some background regarding one of his or her progenitors. Times certainly have changed and the law, certainly in Kansas, has not kept pace.
Speaking of times-a-changing, the “child” to whom William contributed his genetic material is now a three year old little girl and the Mom’s have since separated. Due to an illness, one of the Mom’s had to apply for state financial aid and Kansas got a little nosy and demanded that the Moms reveal William’s identity before it would provide any financial aid. Upon learning of the situation and William’s identity, the Kansas Department for Children and Families decided to go after William for $6,000 in child support together with imposing an ongoing obligation to provide support. William can’t afford any of this and justifiably is fighting Kansas’s claim.
The whole thing is wrong and is a glaring example of good intentions gone awry, lack of education and awareness of reproductive laws as they pertain to things like sperm donation, the failure of state legislatures to keep pace with societal changes, and the frickin’ frackin’ fiscal cliff. I understand that Kansas is broke but I would much prefer that it spend state resident’s tax money going after all the “dead-beat dads” who are intentionally leaving their children to starve. Dads who intended to father a child — and who may well have conceived that child or children through a physician-assisted artificial insemination or other third-party assisted reproductive technologies — and then post-divorce abandoned their financial obligations to that child or children. Why are we going after a man who never intended to be a father and did his best to help women who did want to be mothers? Especially when the mothers want to be financially responsible for their child but due to medical circumstances beyond their control cannot cover all of the costs associated with child-rearing and are forced to seek financial assistance from the state. Financial assistance, I might add, to which a single mother who knows nothing about her child’s biological father would be entitled.
So here we are with a legal battle being fought by good people with good intentions but who made a mistake. I understand Kansas has a right to seek child support from a genetic parent, but in this instance, that genetic parent should be standing in the shoes of an anonymous sperm donor. But for the fact that the Moms didn’t use a doctor when they conceived this child, William wouldn’t be in this mess. To many people it seems like an awfully unjust and harsh response by Kansas. Sadly for the Moms they don’t live in a state which might have permitted one of them to adopt the child in order to assure both parents full parental rights, or which otherwise recognizes same sex relationships such that both of the Moms could be listed on the child’s birth certificate and further be considered the legal and natural child of the Moms’ relationship. Steps which would not only have protected their parental rights in a same sex relationship but would have protected William from this mess. If both of the Moms were recognized here there wouldn’t be a need to find William. Sadly Kansas is not an LGBT friendly state. Combine that with the facts of this case and many people wonder if the Moms aren’t being singled out as a result of their sexual orientation.
Would the single mom to whom I just referred, who doesn’t know details about her child’s father, be similarly pushed into identifying him in order to be entitled to financial assistance from the state? Somehow I don’t think so. Somehow I think that a single mom would have gotten the financial aid more easily than this now single Mom who conceived her child while in a same-sex relationship. Is that which is taking place in the State of Kansas a violation of the Moms’ rights under the Equal Protection Clause of the United States Constitution or otherwise discriminating against them? One could certainly make the case (and hopefully someone is making the case) that but for the fact that they were involved in a same sex relationship at the time this child was conceived, and but for the fact that they didn’t have the financial resources to be able to access affordable infertility services that they might not be in this predicament.
As for William, he is the poster man for someone doing a good thing but not crossing all of his “t’s” and dotting all of his “i’s”. Had he known about the requirement that the Moms must use a physician to perform the insemination and/or insisted that they use a physician before he would consent to the donation, he might not be where he is today.
But that doesn’t make what Kansas is doing okay or even justified. I’d really much prefer they go after some of the dead-beat dads out there who owe the mother of their children a heck of a lot more money than is at issue in this case. Seriously folks, let’s get our priority’s straight.
Let’s go after legitimate law breakers before we go after good people who made a technical error. So what if the doctor didn’t pull the plunger on the syringe? Give me a break.
Tags: Artificial Insemination, discrimination, home insemination kit, Intra Uterine Insemination, IUI, Kansas, known sperm donation, known sperm donor, LGBT, reproduction, same sex parentage, sperm donation, sperm donation statute, sperm donor
