Pep Rally for Follicles

D took the prescribed medication as instructed, but her ovary check on cycle day 10 did not show enough "action" for the nurses to get excited about. Are her ovaries supposed to be discoing, I wondered. "Action," we've since learned, refers to follicle growth. D had some follicles but they were all really small. We were asked to return for another check in a few days to see if the follicles had grown.

I chanted "GROW, GROW, GROW!" to D's ovaries over the next couple days, thinking that maybe those little follicles were just confused or unmotivated and needed a pep rally. Well, no such luck. The second check revealed six follicles on one ovary, but none of the six were more than 9 mm. Apparently 18 mm. is the optimal size for insemination.

The good news is that Dr. Jaffe was utterly unfazed by this information and told D that there is absolutely nothing to worry about. D craftily asked the same question several times just to make sure:

"So there's nothing to be concerned about?"

"No, there's nothing to worry about."

"So, we shouldn't be worrying about anything then?"

"No, we'll just monitor things this month."

"So, we're just monitoring this month?"

I wonder if all patients do this weird parroting thing.

Since I didn't attend the second appointment, I came home from work armed with a gazillion questions even though D had given me a play by play on the phone while she was at the doctor's.

"So, she said that we shouldn't worry? Did you ask her specifically if there was anything wrong?"

Can you believe that this is what we've been reduced to? We used to have intelligent conversations in which we rarely repeated ourselves and now look at us!

Anyway, it seems that D's body just didn't have the response to the medication that they would have liked, but there are other medications to try. So, no insemination this week, but we'll start the whole cycle again soon. Grow, follicles! Grow!

Doc Martin

Tuesday of this week, we had a consultation with Dr. Jaffe. Both D and I agree that Dr. Jaffe has a similar bedside manner to Doc Martin, which if you're unfamiliar with the show, means that she essentially doesn't have one. I find the fact that she doesn't sugarcoat anything oddly comforting though. I feel confident that since she hasn't driven us to tears(yet), that our prospects for pregnancy are good. Anyway, she did say that because D has a low ovarian reserve (this is based on AMA level; she has a .6 and .7 is preferred), she'd like to take an aggressive approach with us -- meaning that D will take ovulation inducing drugs and the doctor will monitor follicular growth through ultrasounds to determine the optimal time to inseminate. This was the first we heard of this low reserve, so we were pretty concerned, but Dr. Jaffe seemed unfazed. In fact, when D asked if that meant that this would be our only chance to have a child, she answered with an emphatic "No" but added that if we want a second, we shouldn't wait too long after the first. Our plan for the end of May / beginning of June will look like this:
1. D will call to schedule an ovary check on day one of her cycle.
2. The ultrasound ovary check will occur on days two or three.
3. If everything looks good, then D will be started on a five day regimen of
Letrozole (we chose this drug because it has less side effects and is less likely to produce multiples than the more popular and less expensive alternative Clomid).
4. On day eleven of her cycle, D will have another appointment for a follicle scan to see how her follicles have responded to the drug.
5. D will then be sent home with an injectable drug called Ovidrel to induce ovulation and be instructed to administer it on a particular day (based on the size of her follicles in the scan.)
6. Two days after the Ovidrel shot is administered, D will then be inseminated through an IUI procedure (this is where the concentrated or "washed" sperm is injected directly into the uterus.)
7. A week after the IUI, D will go in for a Progesterone check.
8. One week later, we'll either be excitedly buying pregnancy tests or waiting around for the next time we can try again.

It actually felt really good to finally order some of our donor specimens to be shipped from California Cryo to CRM -- it felt like the beginning of something. What's weird is I have almost begun to feel like my contact over there at California Cryo, Shawn, is an old friend since I've spoken with him so often about paperwork, medical authorization, etc. So when Shawn wished us "Good luck being Mommies!" before he hung up with me this last time, I couldn't help but smile.

D and I have been tossing around baby names for weeks now -- actually we've made about a zillion solid name decisions that we thought (at the time) were definites and (as would be expected) consequently reversed those decisions -- we already went through Sophie, Sophia, Isabel, Isabella, Jaden, Sebastien, and Skylar. Right now, we like Gracie and Hannah for a girl and Dylan and Jaxson for a boy. I'm partial to Gracie because my grandmother's first name began with a G, but I have a feeling we'll go through a few million more than this before delivery day.

I'm about halfway through She Looks Just Like You: A Memoir of (Nonbiological Lesbian) Motherhood by Amie Klempnauer Miller. It's not the greatest writing I've every seen, but it's certainly heartfelt (I teared up a few times and was thankful that I had my sunglasses on.) There are so few books about our experience! Perhaps if this all goes as planned, I'll write one. : )

All Clear for Take-Off

Last Monday we had our psychological evaluation with Dr. Ott at the Center for Reproductive Medicine (CRM). Each of us filled out about ten pages of paperwork prior to our consultation, answering questions about everything from our perceived self confidence levels to sleep habits. And when I say "everything," I actually do mean "everything." We had to rank our satisfaction levels with our sex lives and our relationship, so of course I demanded D tell me exactly what she wrote for everything (I doubt that was part of Dr. Ott's plan).

Dr. Ott was a warm and very friendly thirty something woman who had actually given birth to her daughter after going through IVF at CRM. Following her treatment, she decided to dedicate her practice to couples facing infertility issues so she opened the Mind and Body Program at CRM. I'm privy to this information because I of course researched her history before our appointment.

We waited only about ten minutes before Dr. Ott's blond head appeared through the opened door in the waiting room. "Which of you want to go first?" I immediately jumped up and D grumbled. I knew though that I'd likely have a coronary if I had to wait in the waiting room wondering what D was saying in there during her interview. I had tried to anticipate questions like I do for job interviews -- "Why do you want to have baby?" "Have you prepared a financial plan for a baby?" etc. But she didn't really ask anything like that. Instead, she read through my paperwork and asked some very specific questions about what I had written. For example, one of the questions in the paperwork was "What three things would you like to change about yourself?" And part of my answer involved developing better public speaking skills since my lymph nodes swell at even the thought of presenting in front of colleagues. She found this amusing with me being a teacher and we discussed that for a while. After about ten minutes, I felt myself relaxing. Then it was D's turn and I uncomfortably waited in the waiting room and entertained myself as best I could with my iphone -- feeding virtual fish in a virtual fish tank. About twenty minutes later, I was called back in so the two of us could speak with Dr. Ott together. She smiled warmly and announced, "I think you two make a great couple!" And with that my shell of nervousness finally melted into a puddle at my feet. She excitedly went on about how we'll make great mothers and how we balance each other's personalities really well. While D is calm and peaceful (and apparently has "a great aura" -- which of course made me wonder if my aura was the color of poo or something), I worry enough for the two of us (or three of us when the baby comes). We then went on to discuss places in the area that offer prenatal partner yoga and types of foods that cut down on morning sickness. For that, she recommended mint ice cream. So D and I walked out of there feeling great about ourselves, our relationship, and our motherhood prospects. In fact, in the car D mentioned that it felt like our relationship had finally been validated -- it was sort of like the first time that we'd been approved of by a third party (probably because we're gay and thus never get the public support that straight couples get.) Regardless, we both felt great and went to our favorite Thai restaurant afterward to celebrate.

We scheduled the HSG test (a test during which a dye is injected into the fallopian tubes to determine if they're open)for last week as well. For that, I have very little to say since I spent the majority of the time in the waiting room watching the television screen read "no satellite signal" and listening to the FL rainstorm raging outside. I also brought with me a Chilean coin a colleague and friend had brought back for me after one of his many adventures -- he had said that it'll bring me good luck. I've had it with me for every important appointment we've had so far and will likely be clutching it in my palm when D's inseminated and when she gives birth.

After D emerged from the closed door, she said "Everything is fine" and then ushered me toward the exit. I assumed (as is my nature) that something was wrong; otherwise she wouldn't want to wait to talk until we were in the car, but of course I worried for nothing. When we were finally in the car, she said both fallopian tubes were open and Dr. Jaffe had even remarked that her reproductive system made a "beautiful picture" -- not one we'd likely frame and put up in the living room, but that still sounded really great. D prodded Dr. Jaffe with as many questions as she could get in during the short minutes it took for the doctor to reach the door (it was really crowded at CRM that day and Dr. Jaffe had appointments back to back) -- Can we buy the sperm? Can we get pregnant? To which, Dr. Jaffe gave her the all clear. "Order the sperm. You can get pregnant!"

So, we've ordered the sperm from California Cryobank -- six vials of a "very handsome" musically-talented tall blond and blue eyed high-STA-scorer who sounds in his audio interview to be extremely intelligent and kind. And we have a consultation with Dr. Jaffe on Tuesday, D's Birthday, to discuss drugs to promote ovulation and to schedule our first insemination in June!

Everyone think happy pregnancy thoughts for us in June.

Our First Appointment

We had our first appointment at the Center for Reproductive Medicine in Lake Mary yesterday. We were referred there by a lesbian couple who, by the way, are now happily pregnant after only three inseminations (IUI's).

Both D and I were incredibly nervous, having no idea what to expect. As a result, we growled at each other the night before, the morning of, and even on the car ride there. I felt a little like I was waiting for a job interview as I turned magazine pages (not because I was actually reading anything but rather because it kept my hands busily occupied) in the waiting room. And I couldn't help but eye the couples, looking equally uncomfortable, sitting in the seats surrounding us. All the men seemed to have their eyes glued to the Nancy Grace sound-a-like prattling on about Tiger Woods and his many sexual faux pas. The women were busily reading leaflets and articles about financing IVF procedures. D and I, as is normal for us, stood out like a stain on white linoleum, but nobody seemed to notice -- a pleasant surprise. We were unusually early (that's because of me for those of you that don't know us) so we had plenty of time to read through magazines and grow more nervous.

When D and I were finally waiting in Dr. Jaffe's office, D said that she felt a like we were waiting to sign mortgage papers rather than waiting to discuss baby-making. Staring at the fake wood desk in front of me and the Rothko knock off paintings to my right and left, I had to agree.

We both really liked Dr. Jaffe. She was warm (as was the staff), extremely knowledgeable, and patient. And she apparently is a chocolate addict (we watched her steal ample chocolates from what appeared to be a nurse's box of candies in between appointments). I made a mental note to buy her chocolates if we ever get pregnant.

Our appointment began with first a nurse and then Dr. Jaffe firing a series of questions at D about her medical and sexual history, etc., while I tried to look like I was supposed to be there -- in other words, I very consciously nodded and smiled at what I thought were the appropriate times. D is so thoughtful that she turned to me several times to ask if I had any questions. I could tell she was making the gesture to try to include me, which made me love her all the more.

After the third degree, D was ushered into another room where Dr. Jaffe conducted an ultrasound examination of her reproductive organs. Although I was invited, I wasn't there at the time because D and I decided that it would be inappropriate for me to stay during the procedure. So I waited outside by the nurses' station where I ironically watched daughters accompany their mothers and male partners accompany their spouses or girlfriends into the various exam rooms. D told me after that Dr. Jaffe had mentioned something about a cyst and what might be a small fibroid, but "there was nothing to worry about." Of course we're worrying.

Then blood was drawn -- five or six vials. I asked if they left any for D, to which the vampire nurse smiled. The blood tests will determine hormone levels, etc., from which they can extrapolate information about D's ovulation and the quality of her eggs. We were handed a zillion pieces of literature on everything from the pros and cons of hormone treatment to the ins and outs of shopping at sperm banks (definitely not bedside reading). We were informed of the FDA requirement that we schedule a consult with a counselor -- some sort of psychiatric evaluation. We were also told to call the facility when D next gets her menstrual cycle (this should be in a few days), at which time they will schedule an HSG test (a dye test to see if her fallopian tubes are open). I never thought I'd be counting down the days to a fallopian tube test, but I am...

Hopefully, we'll have test results at our next appointment and know more definitively our chances for getting pregnant. Sorry about the unusually clinical nature of this posting, but I think I'm still recovering from handing boxes of Kleenex to teary-eyed apologetic eighteen-year-old plagiarists while still trying to retain my strict superintendent glare(ah, the last week of the semester -- what joy!).

Making Sense of the Charley Brown Adult Talk

Robert, the lawyer, gave me some clarification:

1. If the Florida Appellate Court upholds the adoptions which were previously granted in Dade County, we can prosecute a co-parent adoption here (in FL).
2. We can see if Dade County will hear our co-parent adoption even pending the appellate opinion (this option will likely be costly).
3. We can go to a state which accepts non-resident adoptions and prosecute the co-parent adoption there (this sounds like the best option for us).
4. We could get married in a state that allows gay marriage, give birth in that state, and have both of us listed on the birth certificate (not likely).

By the way, or as my students would say "BTW," I just started reading Harlyn Aizley's Confessions of the Other Mother (about nonbiological lesbian moms) and it has prompted this new swirl of concerns. For example, what am I going to be called? Will I be Mommy S? Momma? Maybe I should just wait and see what our child comes up with. : )

Choosing Pizza Toppings, I mean, Sperm Donor Traits

Surprisingly, Robert, the lawyer I met with on Friday, was not bald, nor was he poorly outfitted. He also seemed very knowledgeable. I inquired about developing a co-parenting agreement, and he explained that the document has absolutely no legal value. In other words, it wouldn't really do us any good except to decrease what little money we're saving for the baby. He did present a number of other options though. First, D and I could get married in a state in which gay marriage is legal (assuming we get up on the right day of the week and pick a state where the law doesn't change every half hour); this would somehow affect the child's status. Second, we could complete an out-of-state adoption after the child is born. He explained that he can refer us to an adoption attorney in Washington for this. I'm still a little unsure of how both of these options work so I sent an email to Robert yesterday asking for clarification. I think I might have been so excited by the thought that it's possible for me to legally adopt our child that the rest became little more than adult talk on Charley Brown:  "Wa-wa-wa..." 

In terms of the donor agreement, it seems that unfortunately we won't be needing one of those. Our known donor has decided that he can't commit to our plan for fear that he'll become more attached to the child than he would intend to be. While this may sound like a serious setback, it actually feels sort of freeing. Our friend will still be known as an "uncle" to our child and will still be in his or her life, but we won't fear that he'll want more than we're willing to give. Honestly, too, I think I worried that I would feel a bit like an outsider because of having the biological father in our lives. D and I went on the California Cryobank website and did some preliminary searches.

Choosing a donor is surprisingly a little like choosing pizza toppings. Let's see, we want a donor with at least a Master's degree -- check -- but not in something geeky like molecular biology or engineering... We can choose each item -- hair color, hair type, skin tone, ethnicity, level of education, Keirsey personality type, facial features, etc. And we can even read an essay written by the donor (D has already warned me that a misused apostrophe is not necessarily cause for elimination). And each donor's description is something corny like "easy-going adventurer" or "cool chemist." I imagine our future child asking about his or her father and my answer being "Your father was a cool chemist, honey." Ha! What's really interesting is since each donor is anonymous, there are no actual pictures (only baby pictures and drawings of the adult man's face) but the donor's appearance is described in terms of what celebrity or celebrities he most resembles.  "Look, Sweetie, there's your donor daddy, Brad Pitt!"


Our first appointment at the fertility clinic is in two weeks -- April 28th. It seems like time couldn't move any slower! D is busy calculating when we have to inseminate to produce a baby in her preferred zodiac signs, and I'm already figuring out what teaching load I should request for spring and summer of 2011, hopeful that we'll have a newborn around then. We'll update the blog when we definitively choose our toppings -- I mean donors. : )

The Dangers of Obsessing about Babies while Jogging

9S3736AD5NKZ
 
I realized last night that my partner and I can barely watch a full thirty minute episode of a favorite TV show -- in this case, Nurse Jackie, without one of us expressing a concern containing the phrase "What if?" about some aspect of the process. When did we transform into these weirdly obsessive people? And really, if we're unable to have children, we'll be exactly who we are now -- and that's not cause for alarm or a nervous breakdown, right?

 I was jogging this morning, which I should mention is usually a zen-like activity for me, and found that my mind was as un-zen-like as it could possibly be. All at once I was calculating the cost of fertility drugs, worrying about the temperature of our water tank (I just read that to baby-proof one's house, the water tank has to be set to 120 degrees or less), and wondering if the YMCA has a prenatal yoga program.  It's a wonder I didn't run into a car or the side of a house!

I always knew that parents, by definition, are in a constant state of worry, for some even panic, but I hadn't realized that the worrying starts with just an idea of a child of one's own.

A famous Zen proverb is “When walking, walk. When eating, eat.” I could do well to follow this advice. It'll save me from having to wear a helmet while jogging.