Sunday, 29 September 2013
We remain true to who we are...
Whenever we inform anyone that both Husband and I are only children, we always receive the same response: "...interesting..." It is often held that only children are incompatible mates, but after sixteen years together, I've noticed that we were raised quite differently and we each exert our only-childness in individual ways. Perhaps it's a gender issue between raising a boy or a girl. Perhaps it's generational as Husband's parents are 12-15 years older than mine. Perhaps it's cultural between growing up in England or the States. It's just very different...
Husband's parents were in their very late 30s when he was born and he became the centre of their world. They were of modest means and he wasn't spoilt with material things, but they doted on him and practically waiting on him hand and foot his entire life. If he wanted a snack or a cup of tea, they'd fulfill the request at the snap of a finger. If a particular item of clothing needed to cleaned, his mum would run the machine right away. He could leave dirty plates next to the sink with the knowledge that his parents would do his washing. It has taken me years to break him out of this mold, and one of the reasons why it is so hard to visit with his parents, is that I am forced to watch him regress.
In contrast, I showed up in my parents' lives a day and a month after my father's 30th birthday and when my mum was only 27. They were the first of their friends to have a child and as they once explained to me; "We weren't going to be one of those couples whose lives revolved around their baby. We integrated you into our life." My parents continued to travel and visit with their friends and at a early age, I learned how to entertain myself. That was the first of my lessons on self-sufficiency. When I was 6 or 7, I started packing my own school lunches. At age 10, I was doing my own laundry and by age 12, it was my responsibility to mow the lawn and clean my bathroom. As a result, I've always appreciated the motto, 'if you want something done right, do it yourself!' To my own detriment, I don't like to delegate any tasks, even when I should.
Husband's parents arrived on a Monday afternoon. When I can, I'll go into work early in the morning, as I find I'm much more focused during this time. By the end of the day, I'm mentally exhausted and I struggle to complete my charting and other tasks. Not that night. I was in the zone; whipping through my notes and working through my results. I looked over at the clock. 7 PM. I needed to face reality: I was avoiding going home.
I texted Husband and offer to pick up some take-out on my way home. "No. Just come home." he replied. As soon as I got in, he announced that we would go pick up dinner. I clearly saw his motives; he wanted to stop for a beer while waiting for the food and he wanted to get even with me for arriving late. As soon as he closed the door, my house was filled with an awkward silence. I was listening to cars pass down my road, hoping each one was his.
My parents arrived two days later. They're a welcome buffer, but the contrast between his parents and mine emphasizes the awkwardness of the situation. Husband is very close with my Dad and the two can talk endlessly about baseball, DIY projects, beer, grilling...just about anything. My mother simply adores Husband. The four of us will engage in conversations while his parents quietly observe. You have to invite them to offer any dialogue, which is usually a single sentence containing a few words.
Nonetheless, we were anxious to have my parents serve as our 'wingmen' and we were disappointed to learn they had other plans. In the two days before we were to depart for Hawaii, my parents booked up their time with my aunt (my father's sister) and my cousin. Husband was especially upset as he was assigned to umpire a very competitive collegiate field hockey match (which was being televised on ESPN-7) and he really wanted his parents and mine to watch him. Despite explaining that we would be spending a week with my parents and that my Dad has limited time to visit with his sister and niece, Husband was still sulking. "This is my day" he whined "It's supposed to be all about me..." Thus confirming he's still the little boy who needs to be the centre of attention.
Meanwhile, I had the day off, although I went into to the office very early in the morning to wrap up some loose ends before going away for a week. On the rare occasion when I have a day off, I always try to swim with the noon group as a treat for myself. This day would be no exception. I arranged with Husband that I would drive his parents to the game when I came back from swimming, as he had to arrive at the field an hour before the start time. When we were both ready to leave, we realised we didn't have anything to offer his parents for lunch beyond leftovers.
Guilt consumed me as I drove to the pool. I'm selfish. I'm a bad daughter-in-law. I'm a bad hostess. I should have taken my in-laws out to lunch en route to the game. Despite acknowledging these feelings, I proceeded to my swim class (perhaps my coach sensed my guilt issues, as she delivered a rather punishing workout). I ducked out of practice early, but felt that the remaining sprinting sets would have been less painful than the upcoming car ride.
As I drove back home, I noted that although Husband and I are successful, confident reasonably well-adjusted people; we are flawed. He's an attention whore and I'm self-centred. As it is our strict intention to only have one child, what traits will we be passing on to him or her? Would I be too much my like my parents and raise a child who is distantly independent? Or after waiting so long for the opportunity, would be be more like his parents who place their child on a pedestal? How can we correlate the strongest aspects of our upbringing and mitigate the weaker ones?
My in-laws were literally waiting at the front door, ready to leave when I returned from swimming. I left the car unlocked and they packed the folding chairs into the boot while I changed out of my swimming gear. When I walked out to the driveway, they were both sitting in the back seat. That just says it all. I pointed out a few landmarks, but the drive was essentially in silence. Guilt ... eased.
Thursday, 26 September 2013
No Assumptions
I think each of us can share a story about a time we decided to open up about our infertility and found a kindred spirit experiencing similar issues. A few months ago, I was reminded once again that it is wise not to make any assumptions.
My mother is the oldest of three girls and my father is the much youngest of his siblings (there are nine years between him and his sister). So in addition to the isolation from being an only child, I'm six plus years younger than my paternal cousins, and 4 years old than the next grandchild on the maternal side. When we visited with my father's family, I was referred to as 'Baby Jane', while the youngest of my maternal cousins called me 'Aunt Jane' as I was taller than their mothers and other aunts.
When I was growing up, we probably only got together with my maternal cousins once or twice a year, and when we were younger my female cousin and I could easily play together. As we both grew older, we found that we had less in common. Oh, I'll just say it ... she was a band geek. We're talking Michelle from American Pie, "...this one time...at band camp..." although I don't want to think about what she may have been doing with her clarinet. She was a member of her high school's state championship winning marching band and played in her University's pep band for her undergraduate plus graduate years. If there is a hell, and I end up there ... playing in a marching band will be one of my punishments.
When my Dad and I were driving my car cross country in 2007, we stayed with my aunt and uncle (my cousin and her brother were in their mid-twenties and were still living at home) for a few days. During our last night, my cousin started to open up to me a little. She mentioned she had been on a few dates with some who was pretty interesting, but her biggest hang up about him was that he had the same name as her brother. Two years later she married him. Late in 2010, I received a text from her, "Hi. I know this is awkward since we don't really talk, but I don't know who else to contact." Her period was two weeks late and she had a very faint positive pregnancy test. Unfortunately, she had just started a new job and didn't have insurance benefits yet. As she works as an ER nurse, she was able to get some beta quants drawn, which revealed she had a chemical pregnancy. It meant a lot that she felt comfortable reaching out of me, and I stressed that my door would always be open.
A year later, when I removed my IUD and was getting ready to start the procreation process, I took note that I hadn't heard a pregnancy announcement from her. She contacted me in May of 2012, as they were vacationing in the Bay Area and wanted to try to get together. It was the first time we assembled on our own, apart from a family gathering with our mothers or grandparents. Oddly, her younger brother was accompanying her and her husband on their vacation, which made it hard to get her alone to talk privately. Shortly after that holiday, I noticed that my cousin and her brother each had the same picture of the siblings as their Facebook profiles. I though it was unusual, but as Husband and I are only children, it could have been something I just didn't understand.
Earlier this year, I happened to be in the city where my cousin lives and I called her up to see if she was available to get together for a drink. It was the first time the two of us ever convened on our own. I thought about addressing fertility issues by saying something like, "hey, are you two having any difficulty conceiving? Us too!" Yet, it never really felt right to introduce that topic, so I didn't broach it.
A few months ago, I received an email from my mother:
Rachel and Ross have separated, will be getting divorced.
Sent from my iPad
I wasn't completely surprised, I thought there was something telling within her Facebook profile. Yet, I must also admit that I didn't quite see it coming. Looking back at our last conversation, she didn't say anything that indicated she was having marital problems; but actually, I don't think she mentioned her husband much at all. My Dad later informed me that they went through couples counseling, but once they agreed to divorce, she felt as if a weight were lifted and she could breathe again. I'm glad I didn't bring up the topic of having children. One of the other reasons for non-procreation other than infertility and deciding to be child-free, is relationship troubles. A good reminder to respect privacy surrounding sensitive issues, even if you suspect you're in familiar territory .
My mother is the oldest of three girls and my father is the much youngest of his siblings (there are nine years between him and his sister). So in addition to the isolation from being an only child, I'm six plus years younger than my paternal cousins, and 4 years old than the next grandchild on the maternal side. When we visited with my father's family, I was referred to as 'Baby Jane', while the youngest of my maternal cousins called me 'Aunt Jane' as I was taller than their mothers and other aunts.
When I was growing up, we probably only got together with my maternal cousins once or twice a year, and when we were younger my female cousin and I could easily play together. As we both grew older, we found that we had less in common. Oh, I'll just say it ... she was a band geek. We're talking Michelle from American Pie, "...this one time...at band camp..." although I don't want to think about what she may have been doing with her clarinet. She was a member of her high school's state championship winning marching band and played in her University's pep band for her undergraduate plus graduate years. If there is a hell, and I end up there ... playing in a marching band will be one of my punishments.
When my Dad and I were driving my car cross country in 2007, we stayed with my aunt and uncle (my cousin and her brother were in their mid-twenties and were still living at home) for a few days. During our last night, my cousin started to open up to me a little. She mentioned she had been on a few dates with some who was pretty interesting, but her biggest hang up about him was that he had the same name as her brother. Two years later she married him. Late in 2010, I received a text from her, "Hi. I know this is awkward since we don't really talk, but I don't know who else to contact." Her period was two weeks late and she had a very faint positive pregnancy test. Unfortunately, she had just started a new job and didn't have insurance benefits yet. As she works as an ER nurse, she was able to get some beta quants drawn, which revealed she had a chemical pregnancy. It meant a lot that she felt comfortable reaching out of me, and I stressed that my door would always be open.
A year later, when I removed my IUD and was getting ready to start the procreation process, I took note that I hadn't heard a pregnancy announcement from her. She contacted me in May of 2012, as they were vacationing in the Bay Area and wanted to try to get together. It was the first time we assembled on our own, apart from a family gathering with our mothers or grandparents. Oddly, her younger brother was accompanying her and her husband on their vacation, which made it hard to get her alone to talk privately. Shortly after that holiday, I noticed that my cousin and her brother each had the same picture of the siblings as their Facebook profiles. I though it was unusual, but as Husband and I are only children, it could have been something I just didn't understand.
Earlier this year, I happened to be in the city where my cousin lives and I called her up to see if she was available to get together for a drink. It was the first time the two of us ever convened on our own. I thought about addressing fertility issues by saying something like, "hey, are you two having any difficulty conceiving? Us too!" Yet, it never really felt right to introduce that topic, so I didn't broach it.
A few months ago, I received an email from my mother:
Rachel and Ross have separated, will be getting divorced.
Sent from my iPad
I wasn't completely surprised, I thought there was something telling within her Facebook profile. Yet, I must also admit that I didn't quite see it coming. Looking back at our last conversation, she didn't say anything that indicated she was having marital problems; but actually, I don't think she mentioned her husband much at all. My Dad later informed me that they went through couples counseling, but once they agreed to divorce, she felt as if a weight were lifted and she could breathe again. I'm glad I didn't bring up the topic of having children. One of the other reasons for non-procreation other than infertility and deciding to be child-free, is relationship troubles. A good reminder to respect privacy surrounding sensitive issues, even if you suspect you're in familiar territory .
Monday, 23 September 2013
Out and Proud
I know it's an odd headline; as I haven't disclosed anything even to my own parents, I'm probably the most closeted infertile. I don't have the super vagina to be as out and proud as Aramis. (Brilliant observation from the great Betty White: "Why do people suggest that you need to grow balls when they want you to act tough? Testicles are soft and delicate. You want to be tough? Grow a vagina -those things can take a pounding!") While I'm not there yet, I'm made some strides in being a little more open about our infertility.
In the beginning, it was only Husband, Co-worker, my colleague who removed my IUD and I who knew our intentions. As I tend to be a rather quiet and private person, it was fitting with my nature. Only out of necessity, I brought my colleague's medical assistant into the loop. I needed her as an ally in order to maintain my discretion. Husband and I met with a genetic counsellor and did carrier screening before we started trying (oh, we had all the gear and no idea...) and I had her scan and then shred my results. However, she became a little too involved. She would often ask when my cycle was due and would try to figure out "when we should test" and then suggested a date that was way too early. I had to politely inform her that I appreciated her interest, but not her participation.
I've been trying to limit my disclosures to those who are on a need to know basis, as well as a few close friends and fellow infertility sisters. I had my first opportunity to try coming out when I attended an annual meeting for a professional association earlier this year. One of my former clinical instructors also attends and each year I get asked the same question:
"So Jane, ... any kids yet?"
This year I had an answer he wasn't expecting.
"No. We're infertile and I miscarried about six months ago."
"Aww Jane ... Jeeez!" Just in case I had missed the irony, he added, "and you're in OB aren't you?
...and I don't think he'll ask that question again next year! Being out and proud has some rewards.
Husband has also taken steps to create his support next work. He informed his parents, his best (local) mate, and a few hockey umpire friends. I had almost forgotten that he had disclosed to his best English mate, until Raj approached me at a quiet moment during the Arkansas weekend to ask how things were going. I don't remember too much of the conversation, as I was a bit tipsy; but I recall he was really supportive and wished us well without issuing any empty promises. Actually, as we later ended up doing cartwheels in the bar; 'a bit tipsy' is probably an understatement.
We had nearly made it through that weekend without anyone asking about our procreation intentions, until Robin approached the subject on the morning when we were all departing. I thought about giving the short and simple answers, "maybe" or "not just yet". I'm not that close with Robin as we've only met a few times and we don't have that much in common. So I'm not sure quite why, but I decided to share our entire story. I finished by informing her that we would be starting IVF next month. "Well, sometimes it can take up to a year. Sometimes you just have to stop thinking about it so much..." she offered.
Hand-slap to forehead. Ah yes, this is the reason why you don't discuss your infertility with others. The unsolicited opinions and advice. Had I not learned my lesson from dealing with Myrtle? It was astonishing to me that after informing her of the issues encountered during our two year plight, she thinks more time is all we need. Why are some in denial of infertility? It seems akin to describing that a gay relative "just hasn't met the right girl yet". There isn't anything wrong; conception just hasn't happened for you yet. Depending on the time frame, that is the definition of infertility. Even when you have an identifiable factor, others are still convinced there is a magic formula yet to be employed that will lead to a spontaneous pregnancy. I can only imagine how difficult it is for couples with unexplained infertility to describe their situation.
Sigh. This is the disadvantage of being out and proud. The burden of educating others. I dispelled the notions about needing to 'relax' and 'stop trying so hard', which she may actually accept because of my professional credentials. I decided to take things one step further, and I pulled up my post that was inspired by the father-daughter dance at her wedding. I'm not sure if I violated any rule by sharing the IF blogging world with a non-TTCer, but when she handed my phone back to me with tears in her eyes, I felt that I had succeeded in enlightening her about infertility.
A week and a half later, it was Husband's birthday. In addition to the calls, texts and facebook posts, he received this email from his friend Leonard: 'Happy birthday. You're nearing 40 mate, time to think about decorating the nursery'. Oh, a double Bozinga! Referencing his advancing age and worth less child-free status! Such is the argument for being out and proud. It may avoid insensitive comments from unsuspecting friends. His message was especially annoying as it took Leonard and his wife Penny over a year to conceive their first son. I used to send her copies of the quarterly publication Conceive, as almost none of the patients in the waiting room in my clinic seemed to be having any difficulties. Leonard later noted that Penny was irritated each time she received a copy in the post, not that she didn't appreciate them or find some helpful information. It just always reminded her why I was sending them to her. I can really appreciate that now. Unlike Leonard, who can no longer appreciate being in that situation. I guess, like my cousin, they figure that having a surprise spontaneous conception revokes their infertile status and induces an amnesia for their experience.
I've not thought about how I would reveal our infertility struggles if I were to become pregnant; as I'm not allowing myself to entertain such thoughts. If we come up empty, I've considered creating an infertility announcement card. Perhaps the front would have a picture of the two of us and the inscription would read:
Recently, Co-worker came in to the office for her 6 week postpartum check, twins in tow. After fawning over the babies, Michael Scott asked her, "So, did you get cleared so you and [her husband] can start doing it again?" I should mention here that Michael Scott has a very inappropriate crush on Co-worker's husband and she was disgustingly flirtatious with him when he accompanied Co-worker for her visits. Co-worker just pointed to her double pram and replied "Um, that's how we got into this mess in the first place!"
I turned back to my computer screen and carried on typing. I don't want to judge any fellow infertile and I would never begrudge her for hiding something so private from such a nosy busybody like Michael Scott. Yet, my mind flashed back to one of the final scenes from the movie Flight where Denzel Washington was telling his story to fellow inmates at a prison Alcoholics Anonymous meeting.
"That was it. I was finished. I was done. It was as if I had reached my lifelong limit of lies. I could not tell one more lie. And maybe I'm a sucker. Because if I had told just one more lie, I could've walked away from all that mess and kept my wings, kept my false sense of pride. "
Someday I will be out, and I will always be proud.
In the beginning, it was only Husband, Co-worker, my colleague who removed my IUD and I who knew our intentions. As I tend to be a rather quiet and private person, it was fitting with my nature. Only out of necessity, I brought my colleague's medical assistant into the loop. I needed her as an ally in order to maintain my discretion. Husband and I met with a genetic counsellor and did carrier screening before we started trying (oh, we had all the gear and no idea...) and I had her scan and then shred my results. However, she became a little too involved. She would often ask when my cycle was due and would try to figure out "when we should test" and then suggested a date that was way too early. I had to politely inform her that I appreciated her interest, but not her participation.
I've been trying to limit my disclosures to those who are on a need to know basis, as well as a few close friends and fellow infertility sisters. I had my first opportunity to try coming out when I attended an annual meeting for a professional association earlier this year. One of my former clinical instructors also attends and each year I get asked the same question:
"So Jane, ... any kids yet?"
This year I had an answer he wasn't expecting.
"No. We're infertile and I miscarried about six months ago."
"Aww Jane ... Jeeez!" Just in case I had missed the irony, he added, "and you're in OB aren't you?
...and I don't think he'll ask that question again next year! Being out and proud has some rewards.
Husband has also taken steps to create his support next work. He informed his parents, his best (local) mate, and a few hockey umpire friends. I had almost forgotten that he had disclosed to his best English mate, until Raj approached me at a quiet moment during the Arkansas weekend to ask how things were going. I don't remember too much of the conversation, as I was a bit tipsy; but I recall he was really supportive and wished us well without issuing any empty promises. Actually, as we later ended up doing cartwheels in the bar; 'a bit tipsy' is probably an understatement.
We had nearly made it through that weekend without anyone asking about our procreation intentions, until Robin approached the subject on the morning when we were all departing. I thought about giving the short and simple answers, "maybe" or "not just yet". I'm not that close with Robin as we've only met a few times and we don't have that much in common. So I'm not sure quite why, but I decided to share our entire story. I finished by informing her that we would be starting IVF next month. "Well, sometimes it can take up to a year. Sometimes you just have to stop thinking about it so much..." she offered.
Hand-slap to forehead. Ah yes, this is the reason why you don't discuss your infertility with others. The unsolicited opinions and advice. Had I not learned my lesson from dealing with Myrtle? It was astonishing to me that after informing her of the issues encountered during our two year plight, she thinks more time is all we need. Why are some in denial of infertility? It seems akin to describing that a gay relative "just hasn't met the right girl yet". There isn't anything wrong; conception just hasn't happened for you yet. Depending on the time frame, that is the definition of infertility. Even when you have an identifiable factor, others are still convinced there is a magic formula yet to be employed that will lead to a spontaneous pregnancy. I can only imagine how difficult it is for couples with unexplained infertility to describe their situation.
Sigh. This is the disadvantage of being out and proud. The burden of educating others. I dispelled the notions about needing to 'relax' and 'stop trying so hard', which she may actually accept because of my professional credentials. I decided to take things one step further, and I pulled up my post that was inspired by the father-daughter dance at her wedding. I'm not sure if I violated any rule by sharing the IF blogging world with a non-TTCer, but when she handed my phone back to me with tears in her eyes, I felt that I had succeeded in enlightening her about infertility.
A week and a half later, it was Husband's birthday. In addition to the calls, texts and facebook posts, he received this email from his friend Leonard: 'Happy birthday. You're nearing 40 mate, time to think about decorating the nursery'. Oh, a double Bozinga! Referencing his advancing age and worth less child-free status! Such is the argument for being out and proud. It may avoid insensitive comments from unsuspecting friends. His message was especially annoying as it took Leonard and his wife Penny over a year to conceive their first son. I used to send her copies of the quarterly publication Conceive, as almost none of the patients in the waiting room in my clinic seemed to be having any difficulties. Leonard later noted that Penny was irritated each time she received a copy in the post, not that she didn't appreciate them or find some helpful information. It just always reminded her why I was sending them to her. I can really appreciate that now. Unlike Leonard, who can no longer appreciate being in that situation. I guess, like my cousin, they figure that having a surprise spontaneous conception revokes their infertile status and induces an amnesia for their experience.
I've not thought about how I would reveal our infertility struggles if I were to become pregnant; as I'm not allowing myself to entertain such thoughts. If we come up empty, I've considered creating an infertility announcement card. Perhaps the front would have a picture of the two of us and the inscription would read:
We've been through all the procedures and tests,
and can truly say we've tried our best
Alas, a family of three,
Was not meant to be...
Recently, Co-worker came in to the office for her 6 week postpartum check, twins in tow. After fawning over the babies, Michael Scott asked her, "So, did you get cleared so you and [her husband] can start doing it again?" I should mention here that Michael Scott has a very inappropriate crush on Co-worker's husband and she was disgustingly flirtatious with him when he accompanied Co-worker for her visits. Co-worker just pointed to her double pram and replied "Um, that's how we got into this mess in the first place!"
I turned back to my computer screen and carried on typing. I don't want to judge any fellow infertile and I would never begrudge her for hiding something so private from such a nosy busybody like Michael Scott. Yet, my mind flashed back to one of the final scenes from the movie Flight where Denzel Washington was telling his story to fellow inmates at a prison Alcoholics Anonymous meeting.
"That was it. I was finished. I was done. It was as if I had reached my lifelong limit of lies. I could not tell one more lie. And maybe I'm a sucker. Because if I had told just one more lie, I could've walked away from all that mess and kept my wings, kept my false sense of pride. "
Someday I will be out, and I will always be proud.
Friday, 20 September 2013
Cringing in Silence
As I walked into the break room to refill my water bottle one morning, two medical assistants were chatting about where they take their dogs to be groomed. One I have already introduced. Betty confided to Co-worker that she failed to conceive on her own, and by the time she went to an RE, she had a depleted ovarian reserve. It took her a long time even to acknowledge Co-worker's pregnancy and she revealed that even years after embracing her child-free status, she still found baby showers and other children-related events difficult to attend. When I joined the practice nearly five years ago, a few staffers revealed that Veronica was trying to conceive. Two years later, she disclosed to me that she failed to ovulate with 100 mg of Clomid and she decided not to pursue any further treatments. Her husband had a teenaged daughter from a previous relationship, and she had accepted her role as a step-mother. A year ago, she approached me and asked for an IUD, noting that she'd be pissed if she became pregnant at this time. I could appreciate her desires and understood that it was a painful process to arrive at that place.
Michael Scott, the office busybody, walked in the room and started listening to their conversation. "You spend how much on your dogs?" she gasped (as if she didn't engage in any frivolous purchases ahem, purses!) "That's ridiculous" she criticised. Betty was quick to react, "My dogs are my children!" she exclaimed as Veronica nodded in agreement. Michael Scott just rolled her eyes, "No they're not. You should have had real babies."
I nearly dropped my water bottle. While I would never actually resort to violence; on any given day, I could fantasize about hitting Michael Scott. Now I was imagining myself putting my weight behind my punch. I'm pretty sure Co-worker is the only one who knows about Betty's infertility history, but Michael Scott certainly knew about Veronica's story.
Her words stung like a slap in the face. They may not have been directed toward me, but I felt their effects. Such is the solidarity of infertility. Make an insensitive comment to one of my sisters and you hurt us all. I wanted to speak up. I wanted to say something to put Michael Scott in her place. Alas, I cannot. To do so would expose their skeletons as well as mine. Members of this sorority vow to honour each other's secrets. Such is the solitude of infertility. Alas, I'm cringing in silence.
Michael Scott, the office busybody, walked in the room and started listening to their conversation. "You spend how much on your dogs?" she gasped (as if she didn't engage in any frivolous purchases ahem, purses!) "That's ridiculous" she criticised. Betty was quick to react, "My dogs are my children!" she exclaimed as Veronica nodded in agreement. Michael Scott just rolled her eyes, "No they're not. You should have had real babies."
I nearly dropped my water bottle. While I would never actually resort to violence; on any given day, I could fantasize about hitting Michael Scott. Now I was imagining myself putting my weight behind my punch. I'm pretty sure Co-worker is the only one who knows about Betty's infertility history, but Michael Scott certainly knew about Veronica's story.
Her words stung like a slap in the face. They may not have been directed toward me, but I felt their effects. Such is the solidarity of infertility. Make an insensitive comment to one of my sisters and you hurt us all. I wanted to speak up. I wanted to say something to put Michael Scott in her place. Alas, I cannot. To do so would expose their skeletons as well as mine. Members of this sorority vow to honour each other's secrets. Such is the solitude of infertility. Alas, I'm cringing in silence.
Wednesday, 18 September 2013
Numbers and Figures
As we were wrapping our initial REI consult last July, my RE commented, "I think you have a good chance with IVF." "Forty percent" he estimated off the top of his head. I wasn't quite prepared to hear that we would need to consider IVF at that moment, let alone to comprehend that a forty percent success rate would be accepted as 'good'. I couldn't think of any other situation in medicine, or in life for that matter, where a higher failure rate is satisfying. It truly reflects the unique and precarious nature of infertility. "So, that means there is a sixty percent chance that IVF will not work..." I immediately countered. "Well Jane, that depends if you see the glass as being half full or half empty..." He replied, sounding a bit like my mother. "No. That all depends if you are drinking or pouring." I retorted with a saucy tone.
I hadn't intended to be a smart-alec, although it was an added bonus. I did have a point. I've always hated that simplistic test used to determine if one is an optimist or pessimistic, as it entirely depends on the situation. One cannot make an evaluation without any context. A mother who is trying to feed her baby is happy when the bottle is half empty. A pregnant woman taking her glucose challenge test is annoyed when the bottle is half full. A bartender is optimistic when he sees a half empty glass, as it means that the patron may order another. I become irritable if the night is getting late and Husband's pint glass is still half full as I want him to finish up so we can go the fuck home. As it is with so many things in life, it's not black and white.
The 40%-60% split stood out in my mind for another reason. Years ago, when I was talking a colposcopy training course, the instructor referenced a retrospective study from New Zealand. The researchers collected data on women who had high grade lesions on a Pap smear, but failed to comply with the recommended evaluations and treatments. Twenty years later, 40% were eventually diagnosed with cervical cancer. "Isn't it more impressive that 60% did not progress to cervical cancer?" I asked earnestly. The instructor chided that I could not view the results with "Pollyanna thinking." Thus, implying that 40% was still a significant cancer rate, and was irrespective to the fact that 60% did not develop cervical cancer. Maybe it reflects the fact that it's a difficult comparison between infertility and cervical cancer, but on the surface it still seemed odd. In one situation fewer patients gets cancer, but it's still considered bad; in the other, fewer patients get pregnant, but that's considered good? I suppose it helps to frame with ideals and realistic expectations. Ideally, one wants to have a zero percent cancer rate, and I think my instructor was trying to emphasize the role of intervention and treatment in this situation. Ideally, one would like all infertility patients to become pregnant, but unfortunately it's not realistic at this time. Forty percent becomes a significant number when you compare it to the fact that very few patients would be able to conceive without intervention. I also appreciate that 40% is a higher rate compared to couples with more challenging diagnoses.
If we were to take the laize-faire approach to conception, I would estimate our chances for success to be 0.1%. I am somewhat making these numbers up as I go along, with a preference for whole numbers to make my maths easier. I am basing that figure on the fact that even with my Clearblue Monitor, it is still difficult to determine when I will ovulate, and being able to schedule coitus during that time is another obstacle. Perhaps with proactive efforts, our chance of spontaneous conception would be around 1%. Thus IVF increases our chances by 40-400%. It is projected that an IUI only has a 15% opportunity for success in ideal conditions. My RE noted that the sperm count should be between 5-10 million (in the absence of male factor issues, there doesn't seem to be an increase in pregnancy rates when the count is higher than ten million). As we had less than half of the desired sperm count and if you round down a bit to adjust for my old age, we probably had a 4% chance for pregnancy. IVF increases those odds ten-fold.
The diagnosis of infertility really starts to hit home when you approach the data that way. Modest success rates are still preferred to the alternative of doing nothing. It's also helpful to frame your expectations. There is a greater probability that this won't work. It is statistically anticipated that I won't get pregnant with these treatments. Two out of three couples leave their REI clinic heartbroken. I haven't asked my RE to re-estimate our chances for success, and I don't plan to do so. I already know they're probably lower that what he conjectured last year. Just as I dismiss the platitudes proclaiming it will happen! as merely being meaningless words; statistics are only numbers, and they don't necessarily mean anything.
I hadn't intended to be a smart-alec, although it was an added bonus. I did have a point. I've always hated that simplistic test used to determine if one is an optimist or pessimistic, as it entirely depends on the situation. One cannot make an evaluation without any context. A mother who is trying to feed her baby is happy when the bottle is half empty. A pregnant woman taking her glucose challenge test is annoyed when the bottle is half full. A bartender is optimistic when he sees a half empty glass, as it means that the patron may order another. I become irritable if the night is getting late and Husband's pint glass is still half full as I want him to finish up so we can go the fuck home. As it is with so many things in life, it's not black and white.
The 40%-60% split stood out in my mind for another reason. Years ago, when I was talking a colposcopy training course, the instructor referenced a retrospective study from New Zealand. The researchers collected data on women who had high grade lesions on a Pap smear, but failed to comply with the recommended evaluations and treatments. Twenty years later, 40% were eventually diagnosed with cervical cancer. "Isn't it more impressive that 60% did not progress to cervical cancer?" I asked earnestly. The instructor chided that I could not view the results with "Pollyanna thinking." Thus, implying that 40% was still a significant cancer rate, and was irrespective to the fact that 60% did not develop cervical cancer. Maybe it reflects the fact that it's a difficult comparison between infertility and cervical cancer, but on the surface it still seemed odd. In one situation fewer patients gets cancer, but it's still considered bad; in the other, fewer patients get pregnant, but that's considered good? I suppose it helps to frame with ideals and realistic expectations. Ideally, one wants to have a zero percent cancer rate, and I think my instructor was trying to emphasize the role of intervention and treatment in this situation. Ideally, one would like all infertility patients to become pregnant, but unfortunately it's not realistic at this time. Forty percent becomes a significant number when you compare it to the fact that very few patients would be able to conceive without intervention. I also appreciate that 40% is a higher rate compared to couples with more challenging diagnoses.
If we were to take the laize-faire approach to conception, I would estimate our chances for success to be 0.1%. I am somewhat making these numbers up as I go along, with a preference for whole numbers to make my maths easier. I am basing that figure on the fact that even with my Clearblue Monitor, it is still difficult to determine when I will ovulate, and being able to schedule coitus during that time is another obstacle. Perhaps with proactive efforts, our chance of spontaneous conception would be around 1%. Thus IVF increases our chances by 40-400%. It is projected that an IUI only has a 15% opportunity for success in ideal conditions. My RE noted that the sperm count should be between 5-10 million (in the absence of male factor issues, there doesn't seem to be an increase in pregnancy rates when the count is higher than ten million). As we had less than half of the desired sperm count and if you round down a bit to adjust for my old age, we probably had a 4% chance for pregnancy. IVF increases those odds ten-fold.
The diagnosis of infertility really starts to hit home when you approach the data that way. Modest success rates are still preferred to the alternative of doing nothing. It's also helpful to frame your expectations. There is a greater probability that this won't work. It is statistically anticipated that I won't get pregnant with these treatments. Two out of three couples leave their REI clinic heartbroken. I haven't asked my RE to re-estimate our chances for success, and I don't plan to do so. I already know they're probably lower that what he conjectured last year. Just as I dismiss the platitudes proclaiming it will happen! as merely being meaningless words; statistics are only numbers, and they don't necessarily mean anything.
Monday, 16 September 2013
Initial Instincts
"Trust your initial instincts -they are usually correct." I recall many teachers offering those words of wisdom, but mind you those same teachers also advised you to "read every question carefully" and to "review your work." Often many exams were not necessarily testing your knowledge, but were evaluating your ability to find the best answer that fits a particular question. In which case, your initial instincts could be misleading.
When I first moved to California, I was planning to keep my Connecticut plates and my CT driver's license in order to maintain my New England identity. I had always done so when I lived in other states for schooling and training. However, my Dudley-do-right husband pointed out that California highway patrol is strict about making new residents register their vehicles, and I would need apply for a California driver's license in order to facilitate voter registration. Still not able to let go of my Connecticut roots, I kept my old mobile phone number. My RE is one of the few who recognises the area code, as a reflection of the fact that ten years ago we lived in the same town on the other side of the country.
I had to take the written exam in order to obtain a California driver's license, and I was rather surprised at their primitive testing process. When I took the test as a teen in Connecticut, it was computerized. Each question actually showed you a little video and you judged your answers based on what you thought was appropriate in that situation. There were only 16 questions and you needed 12 correct responses to pass. I got my first question wrong, but then aced the next twelve and the computer stopped the test after I submitted my 12th correct answer. Fifteen years later, the much larger state of California simply issued a double sided sheet of paper with multiple guess questions and I think we had to supply our own pen. There was a designated testing area, which was merely a large counter and no one proctored the exams. One could easily cheat off a neighbour.
I thought that 15 years of diving experience and reading the California driving handbook the night before would be enough preparation, but I was wrong. I was truly struggling with the questions. The temptation to cheat was overwhelming, but I felt I had to maintain some integrity. I re-read one question and changed my answer by placing an 'X' though the box I had filled in and coloured in the one for my new answer. Later, I reviewed it once more and thought about what they say about your initial instincts. I placed another 'X' though that box and circled my original answer. Just to make my intentions clear, I added the words 'Yes' and 'No' next to my responses.
I handed in my test and watched as my paper was hacked with a red marking pen. "Five incorrect. FAIL!" pronounced the DMV employee as she signaled to the next person in the queue and handed my exam back to me. Humiliated, I walked out of the DMV as quickly as possible. I was devastated. While I can't say that I never failed a test in my academic career, it was a rare event. Now I had just failed one of the most fundamental exams in one's life. I got back in my car to drive home after failing my driving test and I looked over my paper. She had marked the question where I changed my answer twice as being wrong, but indicated that my original response was correct. I stormed back into the DMV, drew another number and waited to confront the disgruntled DMV grader. "How do I know you didn't just mark this now?" she demanded. I was tempted to mention that if I wanted to cheat I could have done so while I was taking the test... Instead, I pulled the "May I speak with your supervisor?" card. I plead my case and he believed that my initial intention selected the correct answer. "Always trust your initial instincts" He advised me. "They are usually right."
When I went into hypertensive crisis after consuming birth control pills for ten days, I expressed concerns to my RE about what this would mean for potential IVF protocols. He noted that he preferred to use microdose Lupron, and more recently when we started IVF discussion, he commented that a Lupron agonist protocol is standard. However, when he proposed my tentative schedule, he described that after giving it some thought, we could stimulate with a natural cycle. This makes me question which suggested protocol truly reflects his initial instincts?
I know my initial instincts were correct when we decided to pass on the original proposed time table. In addition to coinciding with the in-law invasion, it would have been really difficult to be out of the office while I've been trying to tie up loose ends before my vacation. There was one more disconcerting aspect about that possible retrieval date. It would fall on little Myrtle's first birthday. I know that I need to move past the fact that Myrtle conceived naturally on her second attempt while I am infertile... However, to be going through a procedure for assisted reproduction at the same time when everyone is celebrating the day her relatively easy pregnancy led to a textbook spontaneous vaginal delivery on her fucking due date and produced her gorgeous daughter; would be filed under the heading: Not Helping.
The easy solution would be to wait for my next natural cycle in October, but my RE will be attending the ASRM annual meeting during the approximate retrieval time. If we look toward November or December, we could be conflicting with the holidays. I don't want to wait until 2014, as when we met with my RE for a postmortem after my miscarriage, he recommended starting before that date. I'll be 38 that year, and success rates start to drop. Sooner is better than later. After trying to avoid IVF for over a year, I don't want to delay any longer. So we're back to the (original?) plan of a lupron agonist protocol. He's targeting a retrieval date of 30 October, so I'd start stimming around the 20th (Interesting that he picks the retrieval date and works backward). Husband has no travel plans during this time, I may run a half marathon on the 20th, but then my competition schedule is clear until my 80s run mid-November. Not that it would be critical, but just an added bonus that my calendar happens to be free, and it seems nice to have some aspect working in my favour.
Husband couldn't resist pointing out the irony. Just before we started trying to conceive, we signed up for this holiday time share so that we could take family vacations with our little one. Not only is a trip with both our parents, my aunt and uncle, cousins and their estranged significant others not what we had in mind, it created a barrier for us to achieve the dream of having a little one. Alas, a reminder not to count your chickens before they hatch, but it also reflects how one decision can affect circumstances in the future. Yet, which ones are pivotal? Would the difference between the two protocols be akin to picking six of one or half dozen of another? Calling 'heads -I win; tails -you lose' on a coin toss? Or could this be a game changer? Whose initial instincts will be validated? Only time will tell...
When I first moved to California, I was planning to keep my Connecticut plates and my CT driver's license in order to maintain my New England identity. I had always done so when I lived in other states for schooling and training. However, my Dudley-do-right husband pointed out that California highway patrol is strict about making new residents register their vehicles, and I would need apply for a California driver's license in order to facilitate voter registration. Still not able to let go of my Connecticut roots, I kept my old mobile phone number. My RE is one of the few who recognises the area code, as a reflection of the fact that ten years ago we lived in the same town on the other side of the country.
I had to take the written exam in order to obtain a California driver's license, and I was rather surprised at their primitive testing process. When I took the test as a teen in Connecticut, it was computerized. Each question actually showed you a little video and you judged your answers based on what you thought was appropriate in that situation. There were only 16 questions and you needed 12 correct responses to pass. I got my first question wrong, but then aced the next twelve and the computer stopped the test after I submitted my 12th correct answer. Fifteen years later, the much larger state of California simply issued a double sided sheet of paper with multiple guess questions and I think we had to supply our own pen. There was a designated testing area, which was merely a large counter and no one proctored the exams. One could easily cheat off a neighbour.
I thought that 15 years of diving experience and reading the California driving handbook the night before would be enough preparation, but I was wrong. I was truly struggling with the questions. The temptation to cheat was overwhelming, but I felt I had to maintain some integrity. I re-read one question and changed my answer by placing an 'X' though the box I had filled in and coloured in the one for my new answer. Later, I reviewed it once more and thought about what they say about your initial instincts. I placed another 'X' though that box and circled my original answer. Just to make my intentions clear, I added the words 'Yes' and 'No' next to my responses.
I handed in my test and watched as my paper was hacked with a red marking pen. "Five incorrect. FAIL!" pronounced the DMV employee as she signaled to the next person in the queue and handed my exam back to me. Humiliated, I walked out of the DMV as quickly as possible. I was devastated. While I can't say that I never failed a test in my academic career, it was a rare event. Now I had just failed one of the most fundamental exams in one's life. I got back in my car to drive home after failing my driving test and I looked over my paper. She had marked the question where I changed my answer twice as being wrong, but indicated that my original response was correct. I stormed back into the DMV, drew another number and waited to confront the disgruntled DMV grader. "How do I know you didn't just mark this now?" she demanded. I was tempted to mention that if I wanted to cheat I could have done so while I was taking the test... Instead, I pulled the "May I speak with your supervisor?" card. I plead my case and he believed that my initial intention selected the correct answer. "Always trust your initial instincts" He advised me. "They are usually right."
When I went into hypertensive crisis after consuming birth control pills for ten days, I expressed concerns to my RE about what this would mean for potential IVF protocols. He noted that he preferred to use microdose Lupron, and more recently when we started IVF discussion, he commented that a Lupron agonist protocol is standard. However, when he proposed my tentative schedule, he described that after giving it some thought, we could stimulate with a natural cycle. This makes me question which suggested protocol truly reflects his initial instincts?
I know my initial instincts were correct when we decided to pass on the original proposed time table. In addition to coinciding with the in-law invasion, it would have been really difficult to be out of the office while I've been trying to tie up loose ends before my vacation. There was one more disconcerting aspect about that possible retrieval date. It would fall on little Myrtle's first birthday. I know that I need to move past the fact that Myrtle conceived naturally on her second attempt while I am infertile... However, to be going through a procedure for assisted reproduction at the same time when everyone is celebrating the day her relatively easy pregnancy led to a textbook spontaneous vaginal delivery on her fucking due date and produced her gorgeous daughter; would be filed under the heading: Not Helping.
The easy solution would be to wait for my next natural cycle in October, but my RE will be attending the ASRM annual meeting during the approximate retrieval time. If we look toward November or December, we could be conflicting with the holidays. I don't want to wait until 2014, as when we met with my RE for a postmortem after my miscarriage, he recommended starting before that date. I'll be 38 that year, and success rates start to drop. Sooner is better than later. After trying to avoid IVF for over a year, I don't want to delay any longer. So we're back to the (original?) plan of a lupron agonist protocol. He's targeting a retrieval date of 30 October, so I'd start stimming around the 20th (Interesting that he picks the retrieval date and works backward). Husband has no travel plans during this time, I may run a half marathon on the 20th, but then my competition schedule is clear until my 80s run mid-November. Not that it would be critical, but just an added bonus that my calendar happens to be free, and it seems nice to have some aspect working in my favour.
Husband couldn't resist pointing out the irony. Just before we started trying to conceive, we signed up for this holiday time share so that we could take family vacations with our little one. Not only is a trip with both our parents, my aunt and uncle, cousins and their estranged significant others not what we had in mind, it created a barrier for us to achieve the dream of having a little one. Alas, a reminder not to count your chickens before they hatch, but it also reflects how one decision can affect circumstances in the future. Yet, which ones are pivotal? Would the difference between the two protocols be akin to picking six of one or half dozen of another? Calling 'heads -I win; tails -you lose' on a coin toss? Or could this be a game changer? Whose initial instincts will be validated? Only time will tell...
Friday, 13 September 2013
Oh, Yes...I did.
Shortly after AF's arrival announced the failure of our final IUI, I sent a text to Myrtle.
20 bucks. In-laws set to arrive in ten days and I'm still not pregnant. It's contributions to my Mai Tai fund.
Her response: Ughh ok I will begrudgingly pay!
I wanted her to know that I didn't forget about her bet. A year ago, just before little Myrtle was born, we were texting about whether my in-laws would actually make the trip. "I'll bet you $10 they don't come" she offered. Then she added, "Actually, I'll be collecting $20 from you. $10 for your in-laws staying home and $10 for you getting pregnant." I was less than a year into my TTC and infertility journey, but it just seemed inappropriate to be wagering on my uterus.
I truly know that she means well and doesn't quite know what to say in this situation, but it just resonated that she's been wrong with so many predictions. When I first disclosed that we were getting off to a slow start, she confidently assured me "it will happen!". As I was still naive at that time, I didn't feel I had much cause to doubt her. After I informed her of Husband's diagnosis of moderate male factor infertility; she proclaimed, "I still think you'll conceive on your own." Her blind faith astounded me, but I couldn't help read into her emphasis on a spontaneous conception. Was she some how implying that there would be something inferior about a pregnancy achieved with assisted reproduction?
After I flew out to Connecticut to host her baby shower, she sent me a thank you card and included a note, "I know in my heart that I'll be throwing a similar event for you soon." Yeah, more than a year later is not exactly soon... although it's a moot point as I wouldn't want her (or anyone) to arrange a shower for me. Finally, on her Christmas card she wrote "...and now we ring in 2013 which will be your year!" To be fair, I think she sent it after I received my BFP and before my miscarriage. Her experience found that positive pregnancy test equals baby. She didn't know that you have to hold your breath for a few serial ultrasounds. Although 2013 has been my year to achieve some personal best swim times, complete two more half marathons, start cross fit classes and return to the tennis court; not that Myrtle ever asks about those events.
I wanted to prove a point. That predictions based only on hopeful thinking are not only irritating at the time the words are spoken, but they add to our ever present disappointment when they don't come true. Additionally, there is some concern that I could also be forced to hear her say 'See, I told you so!' if I were to become pregnant; you know as if she truly had psychic powers to back up her insight. Although I'd be willing to take one on the chin in that situation. It's simple; don't make empty promises -especially ones with a time frame.
Thankfully, Myrtle didn't point out that I did in fact spontaneously conceive, so technically she was correct with two of her assertions. I didn't want to counter that a pregnancy that didn't even make it to the first ultrasound appointment is not what either of us had in mind. A few minutes later, she sent another text asking if I had received an email from the Commish. A few years ago, a friend of Myrtle's husband invited us all to join an NFL elimination pool. Participants must pick a winning team each week (can only select a team once) to remain in the draw and the last person standing wins the pot. I don't have much interest in American Football, but I enjoy the strategic aspect of the challenge. Myrtle is actually much better at guessing NFL winners than she is at forecasting my fertility and usually stays in the pool the longest out of me and our die-hard football fan husbands.
I confirmed that I did receive his email and intended to participate this season. In his message, the Commish announced that this year's contest is brought to you by the letter 'O' and the number '3'. "As in, Oops! We now have 3 kids!" Sheesh, not even an NFL elimination pool is safe from someone flaunting his fertility. Myrtle offered that she could pay my $20 entry fee. "Thanks, that would be great." I accepted, mentally thinking that I would be applying that earning on to a chance to win $4,000. That's the cost of my stims, GPD testing or a FET! Infertility treatments themselves are a gamble, is it so far fetched to be gambling for them?
20 bucks. In-laws set to arrive in ten days and I'm still not pregnant. It's contributions to my Mai Tai fund.
Her response: Ughh ok I will begrudgingly pay!
I wanted her to know that I didn't forget about her bet. A year ago, just before little Myrtle was born, we were texting about whether my in-laws would actually make the trip. "I'll bet you $10 they don't come" she offered. Then she added, "Actually, I'll be collecting $20 from you. $10 for your in-laws staying home and $10 for you getting pregnant." I was less than a year into my TTC and infertility journey, but it just seemed inappropriate to be wagering on my uterus.
I truly know that she means well and doesn't quite know what to say in this situation, but it just resonated that she's been wrong with so many predictions. When I first disclosed that we were getting off to a slow start, she confidently assured me "it will happen!". As I was still naive at that time, I didn't feel I had much cause to doubt her. After I informed her of Husband's diagnosis of moderate male factor infertility; she proclaimed, "I still think you'll conceive on your own." Her blind faith astounded me, but I couldn't help read into her emphasis on a spontaneous conception. Was she some how implying that there would be something inferior about a pregnancy achieved with assisted reproduction?
After I flew out to Connecticut to host her baby shower, she sent me a thank you card and included a note, "I know in my heart that I'll be throwing a similar event for you soon." Yeah, more than a year later is not exactly soon... although it's a moot point as I wouldn't want her (or anyone) to arrange a shower for me. Finally, on her Christmas card she wrote "...and now we ring in 2013 which will be your year!" To be fair, I think she sent it after I received my BFP and before my miscarriage. Her experience found that positive pregnancy test equals baby. She didn't know that you have to hold your breath for a few serial ultrasounds. Although 2013 has been my year to achieve some personal best swim times, complete two more half marathons, start cross fit classes and return to the tennis court; not that Myrtle ever asks about those events.
I wanted to prove a point. That predictions based only on hopeful thinking are not only irritating at the time the words are spoken, but they add to our ever present disappointment when they don't come true. Additionally, there is some concern that I could also be forced to hear her say 'See, I told you so!' if I were to become pregnant; you know as if she truly had psychic powers to back up her insight. Although I'd be willing to take one on the chin in that situation. It's simple; don't make empty promises -especially ones with a time frame.
Thankfully, Myrtle didn't point out that I did in fact spontaneously conceive, so technically she was correct with two of her assertions. I didn't want to counter that a pregnancy that didn't even make it to the first ultrasound appointment is not what either of us had in mind. A few minutes later, she sent another text asking if I had received an email from the Commish. A few years ago, a friend of Myrtle's husband invited us all to join an NFL elimination pool. Participants must pick a winning team each week (can only select a team once) to remain in the draw and the last person standing wins the pot. I don't have much interest in American Football, but I enjoy the strategic aspect of the challenge. Myrtle is actually much better at guessing NFL winners than she is at forecasting my fertility and usually stays in the pool the longest out of me and our die-hard football fan husbands.
I confirmed that I did receive his email and intended to participate this season. In his message, the Commish announced that this year's contest is brought to you by the letter 'O' and the number '3'. "As in, Oops! We now have 3 kids!" Sheesh, not even an NFL elimination pool is safe from someone flaunting his fertility. Myrtle offered that she could pay my $20 entry fee. "Thanks, that would be great." I accepted, mentally thinking that I would be applying that earning on to a chance to win $4,000. That's the cost of my stims, GPD testing or a FET! Infertility treatments themselves are a gamble, is it so far fetched to be gambling for them?
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