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Tuesday, November 14, 2006

Time, Time, Time Without the Hazy Shade of Winter

My friend, Mary-Katherine, has one of those stories that add to the completely annoying adoption myth. You know the one--if you "just" adopt, you'll get pregnant in the drop of a hat. I love it when people reduce adoption to a means toward fertility.

She did get pregnant while she was in the process of adopting. But that is because she was still having sex without birth control. Because who in their right mind wastes money on birth control when you have already determined that you can't get pregnant after multiple attempts at IVF? And the reality is that every once in a while, even women who produce eggs of poor-quality, let a perfect egg rip from their ovaries. And if you're literally having sex around ovulation every single month, your body will take advantage of this single perfect egg and you'll catch the brass ring. It's as simple as statistics. It's as simple as a blind pig finding an acorn, or however that saying goes. It can sometimes happen if you give yourself enough tries. You may be waiting 10 years, but it can happen.

The pregnancy was bittersweet because in gaining this new child, she was losing the child she was meant to adopt (the adoption was postponed and they will adopt in the future). It reminded me of a student I had whose mother gave birth to twins, losing one the day before what should have been a double bris. The girl wrote an essay about burying one baby and then coming back to the house for shiva and the bris of the other twin. It was the happiest and saddest day for that family.

This child came after a long road of infertility, one that Mary-Kath rode as if she were stuck on a Disney ride rather than taking a stroll with her own two legs. You know that Disney ride that I'm talking about--the one that you know rationally you could get off of if you had a panic attack (think Haunted Mansion rather than Space Mountain), but feel at the same time as if you're committed to seeing the ride to its end. Even though you know you can get off, you're not exactly sure how one goes about stopping the ride and walking off without feeling a plethora of emotions. So you just keep sitting in that black buggy, watching the ghosts shake the doors.

Mary-Kath calls it infertility with blinders--that mindset you can enter where you are just making decisions because it's easier to keep going than to take the reins and slow down the ride. Like me, she never took a break. Cycle after cycle, she would get to the end and start over with the only thought being, "maybe this time it will work." Every time the RE dangled a new possibility in front of her, she grabbed it. Because why not try everything--even if it doesn't point towards a solution to your problem? If you throw enough things at infertility, something is bound to work.

She was accepted into the shared-risk program for IVF because she seemed like a sure thing. She was only in her twenties and she looked fine, hormone-wise. But attempt after attempt ended in failure without explanation. She tried PGD (even though they hadn't had documented proof that PGD would help them with their problem)--and they called a PGD specialist who came out from the west coast twice a year to work with their "hard to impregnate" cases. Even though she was in the shared risk program, she spent a fortune.

It wasn't until they were looking at the literature and considering donor egg that she looked at her husband and said, "what are we doing?" While she wanted the experience of pregnancy, she wasn't tied to the idea that the child be biological. And since she had already determined that treatments were an uphill battle rather than a sure thing (it wasn't a problem, per se, with her eggs--it was an unidentified problem), it made more sense financially to go with adoption that had a real child at its end rather than donor egg, which may or may not work.

And of course, as the myth goes, she was deep in the adoption process and looking forward to her future child. And she discovered she was pregnant.

It's not that she regrets the fact that she tried treatments--she just wasn't happy with the way she did them. She made her decisions with blinders on--never seeing the bigger picture (would she be happier on a different path to parenthood? Would she rather try another straightforward IVF cycle rather than paying for PGD?). She contrasted that with her friend who paused between every cycle. Her friend would sit with the results and contemplate them. And she would go to her priest (she was Catholic) and discuss her feelings and discuss the decisions she had to make. Between every failed cycle, there was a pause. She used the time to reflect and gather her thoughts and move forward. She didn't come to parenthood any easier than Mary-Kath. But she came to it less stressed-out, frazzled, emotionally spent.

Treatments are hard. It's emotionally hard and it's physically hard. And it's financially as hard as hell. And when I say "emotionally hard" I mean that it's hard on so many different levels: the loss of your vision of conception, the failed cycles, the waiting, the talking yourself into injections. And it makes sense to take those pauses and recharge and discuss and make decisions with your head rather than your heart.

I just don't know how to do it.

I definitely felt the tick of time--even if I was in my twenties when I began. If I wasn't getting pregnant in my twenties, why should I believe that my fertility would get better in my thirties? I rationalized that my chances would be even lower the more I aged. Plus there was the fact that we wanted more than one child. So I started doing the math. If I had my first at 30, then we'd need to start treatments immediately so I could have my second around 32. And then we'd have to begin immediately again so I could have my third by 35. And I wasn't prepared to breathe or slow down until all three babies had popped out of my womb.

I never sat out a cycle unless my RE made me sit out a cycle or I was anovulatory for a month. And when we were sitting on the sidelines, I wasn't discussing decisions or regrouping. I was taking time for myself or recharging. I was half-standing, half-sitting, posed to race into the game at the first signal.

I'm not very good with sitting still in general.

It's such an interesting idea--the benefit of the pause. I'm not sure if this is a Catholic thing or just Mary-Kath's friend's thing. Is there anyone else out there who self-enforces a pause? And how do you use the time? How do you make yourself recharge and regroup? Or--if you don't pause like Mary-Kath and myself, what do you think of this idea and do you think you could ever put it into effect?

When Mary-Kath was telling me this story, the only thing I could think of was the beginning of that Simon and Garfunkel song, "Hazy Shade of Winter": Time, time, time / see what's become of me / while I looked around / for my possibilities. And later: Hang on to your hopes, my friend / That's an easy thing to say / but if your hopes should pass away / Simply pretend / That you can build them again.

It's a song cautioning about waiting. About not seizing the day, or the cycle. But what about when seizing the cycle leads you to make decisions wildly rather than sensibly? Especially when those decisions concern your health and your wallet? We have such a now, now, now mentality. It's drilled into us at an early age. Don't stand on the sidelines; get into the game. But is this the best way to approach treatments? I really don't know.


TeamWinks said...

The marketing phrases are endless, "Just do it" etc. I'm more like you. I don't pause, I run head on. I wish I knew how to pause. I moved to Alabama, without ever visiting. Spontaneous. I'm not sure if it is good or not when it comes to infertility, but neither is the inability to make a decision. I guess it is all about balance.

Anonymous said...

Damn, I was planning to do a post about that song.
: )

I have done self-enforced waits. Some of them were for practical reasons (D.'s work schedule), some were for emotional reasons or just a sense of needing a little more time to process a failed cycle. D.'s varicocelectomy added a long pause to our TTCing, although we were actively trying (just not in treatment) during that year-long wait.

But at the same time, these pauses/breaks occasionally make me feel that our infertility is "less authentic" because we have taken a longer route via the varicocelectomy. That maybe our 2.5 years of TTC don't entirely count because we knew that it could take a year to see results from D.'s surgery (although I never really believed that it would take that long).

I am Catholic, although nonpracticing... I'm not sure if that makes a difference, but certainly my very-much-practicing mother encourages me to be slow and reflective when it comes to TTC.

Anonymous said...

I've taken several breaks, two definitely on purpose. The first was after the terrible six weeks that included a chemical pregnancy, polypectomy (by hyeteroscopy), a prolonged recovery and the birth of our 3rd nephew in 14 months. Our docs suggested a three month break to digest what we'd been through but I refused and went back to it after a month.

When those cycles didn't work, we took another break after we had a disagreement with our doc about our next course of treatment. We decided to just sit it out and go on vacation and go back to it the next cycle.

When our first round of injects didn't work as well as expected, I was crushed and realized we needed to do IVF. I knew it might be on the horizon but suddenly it was do it or do not pass go. So we took a completely self imposed three month break from all meds and treatments and such to sort out the whole situation. We are self pay for IVF (but not IUI) so it was and is a huge decision for us. We did testing and a few exams for me but overall just took time to consider our options and what it meant for us, and talk to our families about it, etc.

During our break we decided to use up our coverage for IUI before the end of the year and then move on in spring. When it was time to go back, I was not excited. I wanted more time to feel like a normal person. But here I am, in the 2ww after another IUI.

I suppose I should add that both dh and I were raised Catholic but haven't practiced since childhood. I wonder though if it just ingrains something in you that forces you to be more wait and see -- as if somewhere in your subconcious you think God might be just waiting for quiet to show you what's next.

Anonymous said...

Intellectually, I LOVE the idea of approaching our options thoughtfully. Of taking breaks in between cycles, sitting back and really getting clarity before we try something.

BUT. I hate the uncertainty of not knowing what we're going to do next. I hate waiting to get the next thing. To me, it's a LOT more draining to enforce a break than just jumping back in with two feet.

I feel like there's no real "recharging" when it comes to infertility and particularly ART. Because that would assume that we know for sure that these treatments will net us a baby at the end of them. We don't have that knowledge. Just the uncertainty.

And, for me at least, it's easier to deal with uncertainty with action. Otherwise I just get caught up in my head while I'm being thoughtful and reflective...

But that might just be me. And I'm certainly not saying that my method is correct. At the end of the day, it's really all about how well you can cope with the infertility. IMO, for some people, it might mean taking breaks. For others, not so much.

Erika Jurney said...

I've lived the cliche myself. I found out I was pregnant 2 days before we went to adopt our first child. I'd had many miscarriages, as well as a previous trip to adopt a baby where that didn't work out either.

We figured we could end up with zero, one, or two children. Two would be the jackpot, but there was nothing we could be sure about.

We hit the jackpot and count ourselves incredibly fortunate. But still... we get people all the time saying "See, all you had to do was relax!" And I want to punch them. I know, I'm so mature!

When we were doing treatment stuff, it was completely impossible for me to take a month off. I was obsessive about it. Every time I was forced to (like clinics closing for Xmas) it shattered me.

I usually came back refreshed from the break, but there was no way I would have ever taken a break on my own. The constant battle was tiring, but I just couldn't give it up.

s day @ said...

I haven't really thought about it until now but in hindsight I am realizing that I seem to take a break every 3 months. I am a "plan" kind of girl and I have to have a plan. Most of my plans are around a three month or three cyle plan. At the end of each plan I end up sitting around and trying to figure out my next move. Each time I come up with a new plan it takes about 1 cycle to get the new plan up and running.
I am LDS (mormon) (and no we don't believe in having multiple wives :) side note) Anyway I don't really think that my religion affects my decision to press foreward in TTC or to slow down and take a break, but I don't know how that affects the catholic religion.

Somewhat Ordinary said...

I am nearing the end of something that you could call a forced self enforced break. Well, technically we haven't even started yet, so really I'm probably not making a bit of sense right now. Plus, this answer will probably sound very indecisive!

Around the time that we went to our first RE appointment at the 1 year mark I had a husband who wasn't on the same page as me, I had a job change and I had 2 different trips that were interfering with 2 different diagnostic tests I was planning on having. I could have said I was moving forward, but I felt like circumstances weren't in my favor at the time. My husband said he would do whatever I wanted and I thought long and hard about it and felt like it was best for me to put things on hold. If it were up to me none of that stuff would have happened and I would have moved onto IVF and be pregnant by now (ha, if it were up to me?!).

I have reached the point now though where the break needs to be over. We were still "trying" these last 9 months, just not seeking treatment. I would say it was a good thing for us because I'm stable in my new job but, most importantly my husband has stopped saying unenthusiastically he'll do what I want to saying he WANTS this more than anything.

So, for me a pause in my plans was a good thing. It made him realize that just waiting and seeing isn't cutting it anymore. my recharging was more my husband getting charged then me getting recharged.

BUT, I don't think it works for everyone. I had circumstances that made it the right thing for me. If you had told me during that first cycle of trying that this was the way things would have worked out I would have said "No way! I'm too impatient and I want this too bad to make myself wait." If anything IF has taught me, Ms. Type-A, to have patience!

Anonymous said...

I am on a break now, only for a couple of months it has been a busy AC year. So we thought summer is good time to "relax" and make the most of it before doing another cycle in the new year. We need to use this time also to "find" ourselves again, be a couple. Do fun active things together and not have to worry about the embryo popping out place. :)
I do hate breaks more than anything but I think this one we really need.

What is so difficult is that because we have a zero sperm count we can't just hope that it may just happen that month without any assistance. If we are not doing AC then we are doing nothing towards our goal. Another thing about having break is that we don't have time on our side.
I know once January is here I will be itching to get back into it !

Anonymous said...

I'm on a much needed break. I needed to re-group after the m/c and also to get some things in order before I start stressing out again. On my break I can reflect on my choice, see if there's anything I want to do differently and work on making me a better person, and hopefully some day a better mother. Oh and there's the pesky issue of saving money, because as we all know, this ain't cheap.

Anonymous said...

just to add another example to the myth: last year i had a friend who the adoption/pregnancy thing happened to. And now she has a 1-yr old adopted son and a 3 or 4 month old biological one!

i'm more like you. i want to charge ahead and get this done. in our case, it's my husband who puts the breaks on, for months, between treatment cycles. it kills me. i feel resentful. i want this done. i want this part of my life resolved. and i have to wait... for him.

~r said...

I never sat out a cycle voluntarily, but we but we did have a lot of breaks because of B's schedule. Even though I wouldn't have chosen to skip those months, I was often grateful for the chance to relax... at the same time, because B was gone so often, we felt like we had to continue on any cycle he was home.

Anonymous Infertile said...

I have taken a couple of semi-voluntary breaks and ton of involuntary breaks. Each new dr. I see puts me on some different medication to try to control my insulin. Most dr's want to wait at least three months to see if it starts to work within that time. Usually it doesn't but we still trudge on.
Both types of breaks are hard but I usually do come out of them somewhat refreshed and ready to move on.
I wish I could say that the time of the break made all the difference but it never takes all the pain away. I may seem like I talk about ttc less during these breaks - which makes everyone 'think' that I am 'doing better' but it doesn't mean that I am thinking of it any less. I am just not analyzing ever little twinge in my ovaries or obsessing over opks.

Anonymous said...

So far, I've only taken forced breaks- the RE requires one "free" cycle between treatments. And I'm always ready to race on- complete with blinders (and I'm a practicing Catholic). And I had the time frames all mapped out- if I get pregnant this time, I'll start my next treatments at this time--- I had babies planned out for the next several years with each cycle.

Now I'm contemplating a self-induced break. I am a little fearful, which is why I've not yet committed to it. I started trying at 25 and am now 32. My fertility clearly isn't improving like fine wine. But neither is my life with the constant stress.

If our FET in January doesn't work, we'll be approaching the 7 year mark. The seven year itch. I'm itching for a break. A chance to live MY life. Not my Infertile Life. But that is subject to change. Frequently.

Anonymous said...

damn - tried to post a comment but blogger went out on me. I guess it took a 'break'. :-)

aaaanyway - I am so much like you in this respect. I have never taken break since we started this. Only if the dr forced me. and then I cried and pleaded with her to not make we wait. I don't know how to pause. I think it might kill me. I would be giving up.

Anonymous said...

I was never a break girl, until recently. But here's the thing - I don't feel so much like I'm "taking a self-enforced break". I feel like what we're doing is necessary to achieve our goal. I even think it's the fastest way to achieve our goal.

Physically, my cycles were going haywire. They weren't haywire before IVF, and I have chosen to believe in my body's homeostatic tendancy - its ability to heal itself over time. I'll get back to you on the success of that theory.

I'm certain of the break's value on the emotional front, however. I was on a downward spiral. I felt charging on with treatments was more likely to lead to failure due to not being able to take it any more than the end-point we're after.

So are we on a break? Yes, I guess, but I don't feel like we're waiting, passively. I feel like we're healing, actively.


Anonymous said...

I am another living example of that myth -- after 2 years of infertility, we conceived our first son within a month of finishing our home study and filing our I-171. We continued with the adoption and had two children inside 11 months: our bio child was 11 months old when our adopted 2 1/2 year old came home. I saw no problems in doing both ... we wanted more than one child and were thrilled to have both options work. And for us, adoption wasn't any kind of a second choice -- it was something we had been planning to do all along, regardless of whether we could have bio kids.

On the pause issue: I don't think that anything specific about Catholicism leads to more breaks or pauses -- except for one element. For those who follow the church's teachings closely, several forms of ART, including IVF, are forbidden. I am a Catholic and I do not agree with the Church's position on ART. But for someone who has deep faith or has not worked through these issues, I could see the pause as necessary to think through the decision to go against the church's teachings.

BTW -- I just found an article about a teacher in Wisconsin who was fired from a Catholic elementary school for doing IVF this past spring. She signed a contract to follow the church's teachings and her principal used that as grounds to fire her. That really disturbs me.

Anonymous said...

I can see the value of such a pause, but when desperate for a child the idea of waiting any longer for another attempt was unbearable for me. When I was delayed due to polyp surgery six weeks seemed forever. I'd already waited how many years? I didn't want to wait another minute? Logical? Not really. But it's just the way my mind worked then.

Anonymous said...

How funny, I am thinking about that exact thing and wondering if I would feel better if I took a pause or if I would feel worse.

It's such a tough call. I am trying to listen to my inner voice but I hear, "Do it, do it, just go for it. The more you do, the more chance you have that one time will be successful," and I hear, "Maybe time to breathe is a good idea?" I really do not know whether I will approach the next cycle more relaxed or whether I will simply spend the next 6 weeks thinking, "What if ...?" and so it is this what if that drives me. What do they say, "You don't regret the things you do, only the things you don't,"? We are definitely taught to go, go, go. Then again, we are also taught that if we try hard enough, we will achieve our dreams, and we are also taught that life is beautiful. We all know that sometimes that is not the case.