Archive for the ‘Treatment’ Category
March 28, 2011 | By: Liz | Filed under: adoption,Age and Infertility,Deadly Silence,Egg Donation,Faith and Infertility,IVF,Peace to Parenthood,Personal Musings,Recurrent Pregnancy Loss,Sam Sex Parenting and Reproductive Law,The Journey to Parenthood,Thinking Out Loud,Third-Party Assisted Reproduction,Treatment,Uncategorized
I am getting over a pretty nasty bought of pneumonia. And as a result, I have had a lot of time to think.
To think about everything that I should be doing in the office but can’t. To think about everything that I need to be writing: my e-book on egg donation is pretty much finished but I haven’t had time to input the final edits or to speak with my design and production team about getting it ready for the marketplace; I have an article on egg donation and surrogacy contracts that is due to the American Bar Association in a matter of days; I have to talk to my publisher about revising The Infertility Survival Handbook; I want to write a blog about a RESOLVE event I co-hosted on March 24th at Bis.Co.Latte Cafe in NYC regarding the legal issues egg and embryo donation; and oh yeah I am supposed to be teaching a class on third-party assisted reproduction at a law school and I have to prepare the syllabus (that one may not happen).
To think about all the contracts that I need to draft and edit for clients.
To think about the new series of blogs I am working on (perhaps it too will become an e-book?) on the mind-body connection in dealing with and resolving infertility. Thanks to a Facebook friend, I discovered a wealth of information on something called “Conscious Conception.” I have a ton of research to do on Conscious Conception, it is a seed germinating in my mind and something I very much want to talk about. Just this morning I was staffing out work in the office and we got into a long conversation about how much I believe faith plays in people’s ability to deal with and overcome fertility.
And yet, all I am capable of on this gorgeous sunny day is to THINK about the overwhelming amount of things that are filling my proverbial plate. I am utterly and completely without the ability to deal with any of it today. For today my goal is to be able to breathe. One of the fundamental things in life which I must attend to if I am going to get back to these things, yes? Yet, instead of recognizing the very important need to take care of my own health, I have been beating myself up for my inability to do my work. I feel like I am drowning, literally and figuratively.
It was only upon stumbling across an issue of the Wellesley Alumnae Magazine and its cover article about “When Life Doesn’t Measure Up” and reading about how, when and why so many of my fellow Wellesley sisters feel like failures, that I realized that I feel like a failure for having pneumonia and not being able to do my work. And with that thought, I was off and running on a journey of self-analysis that of course brought me right back to the world of fertility and the feelings of failure that come with it.
Apparently, my college magazine conducted some kind of a poll asking graduates to discuss their feelings about their satisfaction with their life and feelings of inadequacy, failure, or success in a variety of different contexts. I don’t recall receiving a questionnaire in the mail or an email like this — must have missed out on contributing my own thoughts to this very profound poll. The reasons women gave for feeling like a failure were incredibly diverse. And yet, despite the very diverse reasons or situations my Wellesley sisters gave when describing their own issues with failure, including dealing with chronic illness, the article did not mention infertility or an inability to have children (or the choice not to have children) as raising issues of failure. Certainly, someone among the thousands of Wellesley graduates has experienced difficulties conceiving and must have felt like a failure. I did. I do. Why didn’t someone else talk about it? The Dixie Chicks talk about it in their song “So Hard” . . . a ballad that haunts me every time I hear it. It’s all about the feelings of failure and loss we have when we can’t conceive. One out of every 8 Americans is dealing with infertility. Why didn’t the Wellesley College Alumnae Magazine talk about it? Especially at an all women’s college, you would think that a topic like infertility and failure related to something so integral to being a woman would be recognized and not continue to be shrouded in secrecy. The article talked about the shame my sisters felt about their various failures, the secrecy that surrounded them but infertility was not among them. What gives?
The secrecy and shame surrounding infertility is pervasive. Just as for my sisters who are wrestling with their own failures of a different nature, the article pointed out that all of them felt better by talking openly in the article about failure and its impact on their self-perception.
Indeed, the magazine itself was often a cause for Wellesley alumnae to feel failure. By hearing about the success stories profiled in the magazine many women admitted that they felt that they had let down the school or that they failed to measure up to the “Wellesley standard” of being or becoming another Hillary Clinton. The article concluded with the following statement:
“But maybe what we don’t know is what failures happened to those women before they became household names that eventually brought them to the point of celebration. And until we hear those stories, too, we can’t begin to make new templates for success that acknowledge the inclusion of failure as part of a life well-lived.”
And this leads me to the following conclusions:
Until we hear stories about our feelings of failure and inadequacy arising from our infertility, and our subsequent success at overcoming them, we cannot begin to make those new templates for success that acknowledge how much stronger or sensitive we have become as a result of our infertility.
Until we hear stories about our feelings of failure and inadequacy arising from our infertility, we cannot begin to find faith that our own journey will end in success. We need to be inspired by the success of our sisters (and brothers) who have gone before us and achieved that which we long for — a baby — even if that success means embracing an alternate route to parenthood such as surrogacy, egg or embryo donation, or adoption.
It is, as my Wellesley sisters say, in embracing the loss in which we gain the faith to succeed. I wish there was no stigma to being infertile but I must confess that the lack of mention of infertility in this article really drove home for me the sense of the overwhelming stigma with which we live. I have a serious issue with the Wellesley Alumnae Magazine for not bringing to light a discussion of how failing at something as intrinsic as becoming a mother can be so devastating to our sense of self-esteem, to our marriages, and to our sense of failure as a woman. (I cannot fathom that not one woman responded to that poll and didn’t mention infertility and if that was the case, I am even more troubled by the statement that makes regarding how much we hide about our infertility).
Learning from others who share their own shame or other sense of failure about something with which we are all supposed to be able to do — conceive, carry and give birth to our children — is what will carry us through. For others it is not necessarily biological or medical failure but a sense of frustration at being unable to conceive because we lack the essential components — we are socially infertile. And learning from others who find ways beyond our social infertility will give us ideas and strength for achieving that which our sexual orientation precludes us from obtaining.
And as the wheels started turning and hit overdrive as I considered the article and my own sense of failure because I have pneumonia and am unable to work (and am thus letting down my clients to whom I truly want nothing more than to help have a child), and considered once again the stigma with which we live, I couldn’t stay silent. I pulled out my laptop and curled up in bed to “think through” this article and my situation and put together the pieces of this puzzle. My blog will now not only be devoted to discussing the concepts behind Conscious Conception, but it will be devoted to de-stigmatizing this disease. I know there is a Wellesley sister out there somewhere who is struggling to defeat the NOvary™ or endometriosis, to locate a birth mother, to navigate the increasingly complicated red tape of Ethiopian adoption, or to find a way to establish the fact that she and her partner are both the legal mothers of the child one of them delivered and which they intend to parent together.
So in my failure of having pneumonia, new ideas and inspiration have been born for my blog and thus my day has turned into one of celebration. And I ask you to please not be silent. I took the pledge with RESOLVE not to remain silent and today my failure in being human and having pneumonia has given me an idea of how I can fulfill my pledge to RESOLVE. My blog is a safe place where I hope to support people walking with me on this path, and to provide the occasional nugget of legal or medical information to move us another step forward on the path to parenthood. And thus I ask you to talk about your shame. Talk about your sense of failure. Talk about your frustration, your anger or confusion. (And if you are a Wellesley alumnae, help me convince them to let me write an article about infertility). Share your story here wherever you may be in your journey. And I will try and find people to share with you how they conquered the NOvary, endometriosis, found birth mothers, survived the red tape of Ethiopian adoptions, or proven their joint parentage.
Because I know that if we continue to be silent and give in to this crazy stigma, we will never know what failures happened to those women (and men) among us before they became mothers (and fathers), and that eventually brought them to the point of celebration. And until we hear those stories we can’t begin to make new templates for success that acknowledge the inclusion of infertility as part of a life with children.
And now for some random FAQ’s and reminders:
Yes, you can establish your parentage if you are a same-sex couple and one of you has a baby. Depending on where you live the mechanisms for doing this will vary. In some states you can file a legal action to have your parental rights established, in other states you may need or want to adopt (even if you are not married). In some States and in some circumstances you may need or want to do both.
If you have a functioning uterus, egg donation is perhaps the most successful route to pregnancy for women who have issues with the NOvary™. At many clinics, with a properly screened egg donor, live birth rates per egg donation are in the 60% range. Yes, you read that correctly, you could have a 60% chance of conceiving a baby using an egg donor. And among those that conceive using an egg donor, the rate of twin conceptions is in the 40% range (making a strong case for single embryo transfer).
If you are considering adoption but have financial concerns or are worried about wait times, relinquishment risks, or red tape, embryo donation is a rapidly growing path to parenthood. Using embryos donated from another family who has cryopreserved embryos which they no longer wish to use to build their own family, you may have a 40% chance of conceiving a child. In addition to the affordability of embryo donation and the high success rates, you have the opportunity to carry the child, control the uterine environment, and may have the ability to conceive more than one child (this will depend on the type of embryo donation you enter into, as well as the number and quality of the embryos donated to you).
If you don’t have a functioning uterus, gestational surrogacy is another option for becoming a parent. Using either your own gametes (genetic material), or an embryo created from egg or sperm donation (or sometimes both), another woman can carry a child for you and you will have all legal and parental rights upon that child’s birth. Surrogacy laws vary by State, and it’s far from inexpensive, but when done correctly, surrogacy is a wonderful means of building a family.
And let’s not forget what is now almost considered boring: IVF. If you have a viable uterus, eggs and/or sperm but for other reasons have difficulty conceiving on your own, with the assistance of In Vitro Fertilization, your chances of conceiving get better every day. With the improvement of the culture medium used to nourish embryos, together with advances in reproductive medicine, some families will have as high as a 70% chance of conceiving. Although the vast majority of families using IVF will need more than one attempt before conceiving, this is a technology that should not be ignored.
Other things to consider are:
PGD, (Preimplantation Genetic Diagnosis). This enables you to select only those embryos that appear chromosomally normal for embryo transfer in an IVF cycle. For older infertility patients, those with a family history of hereditary illness, or those with recurrent pregnancy loss, PGD can increase your chances of conceiving a healthy baby.
ICSI, (Intracytoplasmic sperm injection). This is where doctors inject the sperm into the egg to help facilitate fertilization. For families with male factor infertility this can help side-step problems with sperm that might prevent it from fertilizing an egg.
DNA Fragmentation Assay. This is a test performed on sperm to determine whether the sperm are chromosomally normal. Although there is a large range of “grey area” where it is unclear whether the sperm are going to cause problems with conception or pregnancy loss, this is proving to be a very important aspect in solving cases of recurrent pregnancy loss, IVF failure, or otherwise diagnosing “hidden” infertility issues.
Blood Clotting Disorders and other immune issues. Do you have unexplained pregnancy loss or IVF failure (with an egg donor)? Go get a work-up from a hematologist or other doctor specializing in diagnosing harder to find infertility issues. Sadly many physicians routinely overlook or discredit the influence or impact of blood clotting and/or immune issues on the ability of an embryo to implant in the uterus, or to the ongoing development of a baby.
Are you going to stay silent, or are you going to talk with me here about what you are feeling, what you are trying to do to overcome your infertility, or what you did that helped you overcome it? Speak. If not here, then find somewhere. Please.
January 18, 2011 | By: Liz | Filed under: Check This Out,Current Affairs,Faith and Infertility,In the News,Infertility In The Movies etc.,Infertility on Television,IVF,Personal Musings,Recurrent Pregnancy Loss,Thinking Out Loud,Treatment
I’ve said it before and I cannot believe I am saying it again. Why is having a miscarriage something people pretend never happened? Or worse, why are people judged so harshly after having had a miscarriage for not embracing any subsequent pregnancy and being a little bit cautious and tentative about the whole thing?
Yesterday I read an article on some random website announcing that a celebrity had just announced she was pregnant. The article was extremely critical of the fact that she had waited until the 6th month to announce her pregnancy, and commented that it may have been due to the fact that she had suffered a prior miscarriage. It then went on to discuss all sorts of celebrity pregnancy issues. But it was about the third article I have seen recently commenting on a celebrity’s miscarriage. None of the articles were supportive, not even for the one celebrity that was openly going through fertility treatment and then lost a baby. Any miscarriage at any time in pregnancy is awful. As many of you know my final infertility diagnosis was unexplained pregnancy loss (which has since been explained). I had 5 IVF miscarriages (including a pregnancy that started as twins), and I don’t want to tell you how many more I have had on top of that because at some point you just have to stop counting and cope. I have blogged about at least one of them.
I have always been open about my miscarriages and my pregnancies. I am one of those “put it out there” kind of people. But a lot of people choose not to share early pregnancies. They instead choose to wait to make an announcement when they are sure that the pregnancy is viable or the fetus is otherwise healthy. Everyone does it their own way. And as this is a very personal subject, I was offended that this article “accused” this celebrity of failing to disclose her pregnancy earlier. MYOB!
Miscarriage is poorly understood on so many levels. I will blog about the medical aspects later, but for today let’s address the emotional component. I may have blogged about this before but someone recently commented to me that 20 years ago no one even talked about this. My grandmother’s generation suffered in complete silence, often not even sharing the loss of a pregnancy with their spouse!! The fact that we are beginning to talk openly about miscarriage is a huge leap forward.
Did you know that among the fertile population only 20% of all conceptions result in a live birth? That number decreases with age. With so many women choosing to build their families later in life, whether they conceive on their own or with some form of medical assistance, their chances of experiencing a pregnancy loss are much higher. Doctor’s often warn patients who are over 35 not to get excited about a pregnancy until they see a heartbeat on ultrasound because the risk of miscarriage is so high. NOvary™ or not, miscarriage is devastating.
If you ask me, all these women need support, information, and the ability to discuss their grief in whatever manner is most appropriate for them and to do so without criticism! But the fact remains that most people still won’t even admit they had a miscarriage. The entire first trimester of pregnancy is shrouded in secrecy and thus any resulting miscarriage is as well. It is not a personal failure to lose a baby. It is an overwhelming emotional experience whether you are six weeks or six months pregnant. I think people should be able to talk about miscarriage — I think people need to be better educated about pregnancy loss but as noted that is a subject for a different blog post — and not have it be considered something shameful or even worse, “no skin off your nose dear, you were only 7 weeks pregnant, get over it”.
Is it the fear of being shamed that causes us to hide our miscarriages as was true for my grandmother and her generation? Is it the need for privacy and the accompanying silence during the first trimester that causes the secrecy? Or is it the fear of the “just get over it” response that people don’t discuss this topic?
Well, I am going to discuss this topic. I think I have enough experience to have some insight into the emotional aspects of pregnancy loss and I’ve done a ton of research on the topic, both for The Infertility Survival Handbook, my own personal curiosity and now for the revised and updated version of my book.
My final comment of the day is this. Whether we choose to grieve in silence or in public, please don’t attack us for our choice in so doing; you need to understand that it is a tremendous blow to every woman (not to mention her partner) who experiences a pregnancy loss. If you know someone who has shared this information with you, BE SUPPORTIVE.
I was dropping my son off at school recently and there is church nearby where I had parked my car. Alongside the church is a beautiful garden and in that garden there was a headstone that caught my attention. It was a headstone with the picture of a baby in-utero and it was dedicated to all the unborn children in the world. The headstone had the name of a baby who died in utero at about 5 month’s gestation. It wasn’t some pro-life stunt; this was a real headstone for a real fetus who died leaving a family devastated.
If I can do it, I will try and post a picture of the headstone (without the family’s name). I would like to thank that family for putting that headstone there and for the church for allowing it, because I now have a place to go and lay flowers on my “bad” days. Because frankly, my girlfriends don’t get it. This headstone gives me an outlet, a place that recognizes what I and so many others have been through.
And for those of you who have experienced a pregnancy loss you have my empathy and a giant cyber hug. To that celebrity who just announced her pregnancy at 6 months, you have my congratulations. To that cyber author, I can’t post what I think about you, but I do hope that you never have to endure what so many of us have been through.
September 23, 2010 | By: Liz | Filed under: Age and Infertility,Egg Donation,IVF,The Journey to Parenthood,Thinking Out Loud,Third-Party Assisted Reproduction,Treatment
Most people who know me, know that I am in my mid-early 40’s. Turning 40 wasn’t a big deal for me. I have such a baby face that sometimes I have a hard time getting people to take me seriously. Turning 40 for me was a milestone of maturity I had long waited for. You have to take a woman in her 40’s seriously. If for no other reason than you’ve got the mileage to deserve it. And yes, thanks to amazing strides in modern medicine (not to mention Botox® and Viagra®), people are living longer and are taking the time to enjoy their life; people are doing things later in life and enjoying them with the vigor and spirit of someone fifteen to twenties years younger. No longer are we rushing ala “Mad Men” into marriage and childbearing in our 20’s. Women are taking the time to establish themselves and find the right mate. Forty has thus become to the former Twenty-Somethings, what 30 was to our parents’ generation.
There is a lot more fun to be had and work to be accomplished, praise to be garnished and shopping for hot “Jeggings” (well maybe not for me) to be done in one’s 40’s. The “not your mom’s kind of jeans” have given way to a new look for those of us who are fabulous and 40: long hair and tight jeans are acceptable on a 40 year old woman’s body. No longer are these considered unacceptable for a woman of a “certain age”! No longer does turning 40 qualify you as a “woman of a certain age” and for that matter, neither does turning 50!! As a dear friend of mine recently turned 40 and all her friends gave her a shout-out on Facebook (and yes, someone not yet 40 begged my friend to confirm that 40 is the new 30), it was generally considered among her already 40 friends that turning 40 was a cause for celebration. So yes, my friends, your 40’s are a decade to be embraced and not dreaded.
Except for one small, “eensy weensy” factor of which no woman should ignore and most women to my surprise are unaware of . . . have you met
Who or What is the NOvary? Well, let me fill you in! The NOvary is the any-woman’s ovary who has decided not to cooperate with her plans to become a mother. The NOvary does not care if you’re 30, 35 or 40. She can and does reside in all women of all ages. However, she tends to emerge with more Attitude at or around the time you turn 35. And by the time you turn 40, the NOvary has almost universally decided to take over your reproductive system and your Plan. The NOvary defies what medical science and a good cosmetic dermatologist have allowed us to enjoy — another decade of productivity and passion for all things, most especially those career, clothing or relationship related. Because let’s face it, not every woman is ready to, or wants to have a child, in her 30’s. Indeed, we have been taught to wait and enjoy, and to relish life! And we should!! But then as we turn 40 and we’ve lined all our nice little ducks in a row, or decided we don’t need our ducks to be in a row, and we consider parenting, we come face to face with the not-so-new but seemingly unknown nemesis to pregnancy and motherhood:
The NOvary is the Ovary that says NO to all your carefully defined and created plans. In the world of fertility, or rather infertility, 40 is from the reproductive endocrinologist’s standpoint, the death of your childbearing years. The NOvary has not run a slick social media champagne – in fact it’s quite the opposite – she has been enjoying our ride along with us all the while knowing her little secret, and enjoying her secret power. The NOvary is the Ovary that no longer makes healthy eggs and she is so stealthy and sophisticated that you can actually conceive on your own for a few years as she gains her power and comes into her prime. But even though she hasn’t hit her full capabilities to destroy your dreams (or so you think) her influence over the eggs she releases on your behalf will cause you to miscarry, and miscarry again. Lulled into a false sense of security that your eggs are working because you are getting pregnant, she continues to work her evil spell, pushing you farther and farther into her control.
So powerful is the NOvary that she can continue to elude you into believing that you are still fertile even though you’re 40. So powerful is the NOvary that she can fool even the smartest of reproductive endocrinologists who will look at all your Day-3 data, manage to retrieve some very “healthy” looking eggs from your ovaries, only to find that those fertilized eggs and “beautiful” preembryos don’t turn into the baby you are longing for. The NOvary can place the cleverest of masks on eggs that are on the verge of retiring, and making them look as fabulous as you do in your 40 something glory. But the NOvary knows: your eggs have long since passed their expiration date.
How do I know this? How did I meet the dreaded and feared NOvary? Over hundreds (and I unfortunately mean hundreds) of my clients have battled her, failed to defeat her, and then faced the reality that (whether they are Thirty-Somethings or Forty-Somethings, married, career in place, or otherwise just determined to become a mom), if they want to realize their dreams of becoming pregnant and having a baby that they would need to bypass the NOvary altogether.
Yes, we can defeat the NOvary. You still have options and a powerful weapon to defeat the NOvary; one of those options is donor eggs and your success rate using donor eggs is about 50 to 60 times higher (perhaps more than that) than your chances are of defeating the NOvary. Yes, you read that correctly, success rates for using donor eggs are (at some fertility clinics) close to a 60% live birth rate!
Just as medical science has preserved your beauty and created a body that does not look, act or feel anywhere near 40, it has created a technology that can put the NOvary out of business! But be warned, while 40 is truly the new 30 . . . the NOvary has no intention of catching up with the rest of us, and if you want to have a baby and you haven’t yet decided to TTC or the TTCing isn’t going anywhere, consider the fact that she may be up to her devilish deeds.
Celebrate your age and enjoy your life . . . but please don’t forget she’s out there . . . looming in the shadows and finding new ways to avoid detection by physicians and scientists alike . . . and her name is the NOvary!
p.s. up next, another option for defeating the NOvary . . . stay tuned!
June 23, 2010 | By: Liz | Filed under: Check This Out,Treatment,Uncategorized
Today’s topic is one that I have been meaning to address for some time, but my colleague Mike Berkley did so very well in the following article on sperm DNA fragmentation and miscarriage that I thought I would just post the link to his article. I can tell you that this stuff is really controversial, but also documented at higher rates of fragmentation to play a significant role in pregnancy loss.
January 30, 2010 | By: Liz | Filed under: Check This Out,Current Affairs,Egg Donation,Thinking Out Loud,Treatment
So I have only read part of this article. It brought tears to my eyes and as I am mid-struggle with my own quest to have another baby I was too moved to continue reading it. But I immediately recognized that this is an article to share and discuss. What I want to discuss is how the news was imparted to the author . . . and what I felt was wrong with it. Why don’t doctors, even OB/GYN’s and RE’s know how to tell someone they are infertile and why didn’t THIS woman’s doctors know she has many options for having a baby . . . why did she get immediately (and incorrectly) told:
“I’m sorry you can’t have a baby.”
WTF? Read on: