Saturday, October 20, 2012

teach me to braid

My mom had been encouraging me to start a blog for years. She knows that I love to write and that I have a lot to say. So during those weeks when the genetic family was considering us as a potential adoptive family for their embryos, I started to seriously consider the possibility. I didn't expect very many people would want to read it but I thought it would be cool to keep track of our future children's story so that they would know how they came to be Ericksons. I wanted them to be able to read about how much their parents wanted them and how hard we worked to bring them here.

After nursing Harriet and climbing back into bed one night, a title for the blog just sort of popped into my head...teach me to braid. The meaning is two-fold. I came up with the idea when I realized that if we have an African American child, I'm going to need to learn how to braid hair. I'm super intimidated by that prospect because I can hardly manage a ponytail some days. But it's part of the culture so I want to give it a shot. "Teach me to braid" has a deeper meaning too - the idea of braiding together cultures and skin colors to create a family. I put the "teach me" part in there rather than calling it "learning to braid"  because I want to acknowledge that I'm going to need lots of help in this process - from other adoptive parents, people who share our child(ren)'s ethnicity, etc. They will all be our teachers and I want to have an open, teachable heart. That's part of the reason I started the blog - to jump into this adoption/infertility community online.

When the embryo adoption fell through, we were bummed. Really bummed. It sounds so trivial but one of the first things I thought about was this blog. Wait a second, I thought, this was my plan. We were going to create a family that blends genes and cultures and skin colors. I was going to chronicle all of this, share it. Now what?

So I stopped writing for a while. What was the point?

When I started writing again, I decided not to change the name. We really hope to have a multiethnic family someday, but even if we don't, "teach me to braid" can mean a lot of things. Maybe all of our kids will be white. Maybe they'll all share our genes and maybe my braiding career will consist of twisting blonde hair into french braids. But that's still braiding, right? And as a mom, won't I need to learn to braid my career with my family life? Won't I need to teach my children to braid justice with mercy, humility with confidence, education with experience, gentleness with strength, joy with sorrow... Won't I need to keep myself accountable to enriching my own life with other cultures and perspectives? So even if my hands never weave a cornrow, a fishtail, or a french...I'll be braiding.

Harriet's godmother sent me this poem a couple weeks ago. The further I got into the poem, the more vividly I remembered reading it as a child. It's such a beautiful piece of writing. I had to share it with you. I think Corrie Ten Boom knew a thing or two about braiding.

The Weaving

My life is but a weaving
between my Lord and me,
I cannot choose the colors
He worketh steadily.
Oftimes he weaveth sorrow,
And I in foolish pride
Forget He sees the upper
And I, the underside.
Not till the loom is silent
And the shuttles cease to fly
Shall God unroll the canvas
And explain the reason why.
The dark threads are as needful
In the Weaver's skillful hand
As the threads of gold and silver
In the pattern he has planned.
—Corrie ten Boom





Thursday, October 18, 2012

the teeniest, tiniest babies


This past June, we met with Dr. C to discuss plans for adding another child to our family. I cried in the elevator on the way up to his office. I didn't want to be back there. In some ways, it felt like the happiest place in the world - where Harriet was conceived and spent her first few days in a petri dish. In other ways, it felt so sad. I hated the idea of opening the door to all of the emotions that come along with infertility treatments. I had been enjoying the respite, the celebration, the challenges of having a child rather than the challenges of trying to have a child.





We wanted to talk to Dr. C about doing a frozen embryo transfer (FET) with our one remaining embryo. But that conversation was over before it even started. Dr. C informed us that none of the embryos frozen at our clinic from April to August of last year were resulting in pregnancies. He wasn't sure what went wrong but he did know that our embryo and the rest of the embryos frozen around the same time were damaged beyond repair. Our embryo is still alive and may even survive the thaw but he assured us that it will not result in a pregnancy. They gave us two options. We could have our embryo destroyed and get a refund on our embryo storage fees (at least $1200 so far) or we could continue to pay storage fees and have the embryo transferred to my uterus at some point for free, knowing that barring a miracle, it won't survive. We didn't even consider option #1. Others might disagree, but to Andrew and I, destroying an embryo is destroying a child. So after about two seconds, we told Dr. C that we were going with option #2. 

We will transfer this embryo because when we signed up for IVF, we decided that we were going to give every single one of our embryos the best chance at life. Obviously, transferring the embryo gives it a better chance than destroying it. We only have one embryo frozen but I feel especially heartbroken for the families that had 10, 12, or more embryos. You can make a whole family out of that many embryos. They are having to say goodbye to all of those children. I can't imagine it.


I also feel bummed that I will have to go through all of the shots, all of the monitoring, all of the side effects with very little to no potential for success. I keep reminding myself that it's the least we can do for this tiny baby, and secondly, God CAN do miracles of all sorts. I want to start praying that he will save this embryo but I haven't been able to yet. My faith feels really small and science feels really big in this situation.


Long before we knew that our remaining embryo had been damaged beyond repair, Andrew and I started talking about adopting embryos. When I bring up the idea in conversation, most people say, "I didn't know you could do that!" Yep. You can! I'll give you more information about the process at the end of this post. Back to our conversation with Dr. C...


Andrew and I were both thinking the same thing but he was the one to bring it up. He asked Dr. C if he would be willing to transfer an adopted embryo or two alongside our embryo free of charge. That way, since we had been considering embryo adoption anyways, the frozen transfer wouldn't be wasted. In some ways, it even felt like God was directing our path toward embryo adoption by turning something painful (a damaged embryo) into something wonderful (a free transfer for adopted embryos). Dr. C agreed to it right away and a little bit of hope poked its head into a bleak situation.


Soon after that conversation, I started doing my research. I talked to the agencies, read family profiles, and had a long discussion with Dr. C about the specifics of the process. Then we found the family. They had everything we wanted - a sufficient number of good quality embryos, the desire to stay involved in the lives of the children they were hoping to place in an adoptive home. They had been waiting ten years to find a family for these embryos. Can you imagine? For ten years, these babies have been frozen in time - not living here on earth, not enjoying heaven...just stuck. The sad truth is that part of the reason this family has been waiting so long is their ethnicity. They are African American and non-white embryos can be difficult to place. Ugh. I don't like truths like that.


We wrote our introduction letter and our profile. We agonized over the exact wording and debated which 15 pictures would be best to send. I'll admit that I was overconfident. They've been waiting ten years, I thought, They've got to pick us. Plus, we had everything they wanted.

College degrees? We both have master's degrees.
One child? Yep, Harriet's going to be a great big sister.
Christian home? Absolutely.
Married for five years? Check.
We don't put our kids in daycare.
Our extended families live nearby. 
Andrew's a nurse. 
I'm a family therapist.
Pregnancy, birth, and breastfeeding all went smoothly with Harriet.


On paper, we looked really good. But after three weeks of waiting, the agency called to tell us that the family didn't want us. She said that they loved everything about us and had seriously considered moving forward with the adoption, but the thing that held them back was the fact that we still have an embryo left. They wanted their embryos to be the focus.


I wanted so badly to tell them that their embryos will be our focus, that we had already grieved our damaged embryo and were hoping to move forward wholeheartedly. But we had already said that stuff in our letter. The family had made their decision and it's their right to base that decision on what's important to them. I think I had talked myself into believing that these babies were our babies and that they had been waiting ten years for us. I was wrong. It was tough at the time and because no other family seemed like a good match, we stopped looking for a while.


A couple weeks ago, I checked the website again. There were a couple new families, looking to place their embryos in adoptive homes. We're toying with the idea of contacting the agency again to see whether one of these families would be interested in us. We just really love the idea of embryo adoption and don't want to lose sight of that goal.


Andrew and I both felt called to adoption before we even met. We view God’s command to take care of widows and orphans not as a suggestion but as a personal call to action. Why embryo adoption? We firmly believe that embryos are children with souls, just as valuable and worthy of life as a child who has already been born. But most people who are interested in adoption don’t realize that there are so many pre-born children out there, frozen in time and waiting for parents. Because we’ve lost children early in pregnancy, we understand how priceless those tiny lives are, and we want to use our experience to give embryos a chance. 


Want to learn more about embryo adoption? Here's my own quick list of FAQs. I got most of this info from conversations with doctors and people at the adoption agency. I am doing my very best to present this info accurately, but this isn't a research paper so if you want exact numbers and that sort of thing, google away.


Q: What is the difference between embryo adoption and embryo donation?
A: The terms are often used interchangeably but there are important differences. I've read articles saying that embryo adoption is a ploy to make more money off of the adoptive parents and push the pro-life agenda. I completely disagree. We like the embryo adoption model better than embryo donation because it allows the genetic family to choose the adoptive family. If we had embryos that we weren't able to transfer to my uterus for whatever reason, I certainly would want to handpick the family who got to parent them. With embryo donation, the doctor is usually the one to decide which embryos go to which family. Embryo adoption also allows for an open relationship between the genetic family and the adoptive family. Ideally, if we end up adopting embryos someday, we want our child's genetic parents and siblings to be very present in his or her life. We'd like to exchange updates, pictures, and even visit one another periodically. Studies have shown that open adoption is healthiest for the child because it gives him or her the opportunity to know people who share their genes and eventually ask important questions of his or her genetic parents.  I've heard it's possible to have an open embryo donation but this seems to be much less common. When you adopt embryos, you have to complete a home study, a matching period...basically all of the stuff a family goes through for a traditional adoption.

Q: How many embryos are out there, frozen, waiting for families?
A: hundreds of thousands

Q: Why would a family want to place their embryos in an adoptive home?
A: The IVF process can result in the creation of lots of embryos, but in most states, doctors prefer to transfer only one to three embryos at a time. The rest of the embryos can then be used by the couple, donated to science, destroyed, donated to another couple, or adopted by another couple. Some couples aren't able to use the embryos for whatever reason (their family already felt complete, financial issues, mom's health problems prevented her from being pregnant again, etc.) but they don't feel comfortable destroying the embryos or having them used in experiments and then destroyed. So they decide to terminate their rights to the embryos and give another couple the chance to birth and raise them. Genetic families do not receive any payment from agencies or adoptive families. 

Q: How does it work? 
A: After you're matched and all the legal stuff goes through, the embryos are shipped to the adoptive family's clinic (or the adoptive family travels to the embryos) and the embryos are transferred to the mom's uterus. It's called a frozen embryo transfer and is less invasive and complex than IVF. The mom is simply given drugs to prepare her uterus for a pregnancy. The FET is a painless procedure that doesn't require anesthesia. 

Q: What if the adoptive couple doesn't get pregnant?
A: It's a huge bummer because you've already spent the money on the legal fees (about $9000) and the transfer (about $4000). There are a lot of risks that come with infertility treatment. Embryo adoption is no different. 



Tuesday, October 9, 2012

ivf

Here's how IVF works. They give the "almost mom" medication (both pills and shots) to make her ovaries go into overdrive and make lots of eggs. During a normal cycle, a woman makes one or two eggs. During an IVF cycle, a woman can make several dozen. The shots aren't very fun. Some of the needles are very long and thick. I remember the progesterone shots being the worst. My husband was working full-time overnight shifts and going to school full-time during the day, so he was really, really tired during our IVF process. I would have to wake him up to give me the shots. The progesterone is thick like olive oil so it takes a long time for the medication to work its way through the needle and into the muscle. He would never want me to turn the lights on because he didn't want to fully awaken. It took a lot for me to trust this half-asleep man to give me a shot in the butt with a huge needle in the dark, but when you want a baby, almost nothing stands in your way. Once he was so tired that he only gave me half the medication and we had to start over. After that, I insisted on a little bit of light.

I think I made about 21 eggs but I can't remember exactly. During the egg growing stage, the "almost mom" goes in for several ultrasounds so the doc can count and measure the eggs. They schedule the egg retrieval for the optimal time, waiting long enough for the eggs to mature but not long enough for the ovaries to release the eggs on their own. The ovaries get HUGE. I looked like I was about five months pregnant and my waistline grew a full two inches in less than 24 hours. It's pretty uncomfortable but you live with it because the doctors tell you it's a good sign.

The egg retrieval is done under anesthesia. They use a big needle to extract the eggs one by one.

Not a cute picture. IVF isn't always cute...especially when you're waking up from surgery.


While this is going on, the "almost dad" makes his "deposit." During the IVF process, women have to cope with the lion's share of the responsibility, time commitment and physical discomfort. Men cope with most of the awkwardness. I guess I'm fine with that.

Now the doctors and lab people put the sperm and the egg together in one of two ways. Sometimes they just dump a pile of sperm on the egg and let the fastest swimmer win. Other times they do their best to handpick the Michael Phelps of the bunch and inject that one sperm into the egg. This all depends on sperm count and quality. We did option #1 because Andrew doesn't have any fertility issues, just me.

Transfer day. So excited!


Then you wait. A few days later, someone from the lab calls with an update on the embryos. (Sidenote: Pre-sperm, it's an egg. Post-sperm, it's an embryo.) They told us how many successfully fertilized (I think nine) and how many were growing (I think seven). A couple days later, they called again to tell us that we had three five-day blastocysts. Around day five, embryos change shape. They go from looking like a pile of bubbles to looking like a planet. The planet-looking embryo is a more stable form and they call it a blastocyst or "blast" if you're hip with the lingo. Your chances of success are higher with a five-day blast than with a three-day embryo. They also grade the quality of the embryos. I don't remember our exact grade but I think it was one level below the best.

One of these embryos in Harriet. The other is her twin who implanted in the lining of my uterus but died very soon after that.

We chose to transfer two embryos to my uterus and freeze one. (Embryos can be frozen indefinitely without affecting their quality.) The transfer is super easy. They give the 'almost mom" valium to relax her uterus, put her in the stirrups and squirt those teensy babies into the perfect spot where you hope and pray with all your might that they'll implant in the uterine lining and hang out there for the next nine months or so. Another sidenote: Doctors can't implant embryos into the uterine lining. They can only transfer them to the uterus. I'm sure some doctors somewhere are trying to figure out how to make embryos implant. But as of right now, embryos implant (or don't) on their own.

Then they send you home for two days of bed rest. During this time, you do all sorts of things to "increase your chances." You make this stuff up as you go and read into every little detail. You eat nachos because they are delicious and the baby or babies might decide to hang around to see what other delicacies you serve up. You watch happy movies so the babies don't get scared or anxious and bail. You avoid sitting up, walking and especially peeing to keep them from falling out (even though the doctors and nurses have assured you again and again that no one has ever peed out an embryo). You practice positive visualization. You pray. You try to keep your hope at the perfect level - too low and you might have a self-fulfilling prophecy on your hands, but too high and you might come crashing down if the pregnancy test is negative. I wish they could prescribe hope in the ideal dosage for infertility patients. That would be nice.




Then the real waiting starts. We had to wait about ten days for our pregnancy test. That was tough. Lots of people do pee tests before the official blood draw but we didn't. We just waited ten...long...days. Both Andrew and I took the day of the pregnancy test off. We tried to distract ourselves all morning. Dr. C called around 1:30. We were standing in our garage when he told us he had good news. That was a big moment. We hung up the phone and immediately thanked God, took our first belly pictures and planned how we were going to tell our families that night.

For us, IVF was an answer, a cure, a finish line, a beginning...a miracle. Will we do it again? I sure hope not. We just don't have the funds (our first IVF was about $16,000). So we're hoping something else will work. Something less expensive. But when it comes to infertility, less expensive is often still super expensive. So we'll just have to wait and see. We're just so grateful that we got to do IVF once...and that it worked.


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