A part of me

Have you seen this post on the long-term presence of fetal cells in the mother’s body? This, my friends, is wild and woolly stuff.

I read through some of the research linked from the article, and the more I read, the more incredible it seemed. There is real poetry here, as the author of the blog post points out. As an embryo adoption mom, it nearly brought me to tears.

This precious baby I carry is biologically unrelated to me, but as I write, her cells are crossing the placenta into my body, becoming a permanent part of my physiology, and perhaps even preparing to someday help me fight illness or injury. Already, we are linked in a bond utterly unique to mother and child.

I know the quiet joy I feel as her little fists pound and her feet jab, that connection that has nothing to do with genetics and everything to do with the role of nurturing a tiny life into existence. But I always suspected perhaps there was more happening in the neonatal processes. I wondered: How much do these nine months of intimate connection influence my baby? Beyond the emotional connection, does the physical bond of pregnancy make us a tangible part of each other? I love that at least in this one way, I can know the answer is a solid “Yes.”

Attitude adjustments

I’ve been (very!) slowly reading through the Bible over the last couple years, and right now I’m in the book of Acts. This morning’s chapter was the story of Peter’s vision of unclean animals and God’s call for him to take the Gospel to someone he never would have associated with on his own. It got me thinking about God’s power to change our attitudes.

It happens often for me, in different ways. I might be sitting in church when words from a sermon suddenly strike home. Sometimes a casual comment or well-timed advice from a friend will provide a shift in perspective. Maybe it’s just that still voice in a quiet moment, helping me see myself and the world more clearly.

My process in our embryo adoption experience has been a big lesson in God’s ability to change my perspective. I started out flatly rejecting the idea, mostly because it didn’t fit the plans I was busy making. It’s pretty amazing to look back on how God moved me from rejection to embracing embryo adoption. He was clearly at work.

But it’s been a longer process than that. It would be misleading to say we made our decision and never looked back. Our counselor told us several times that you can be excited about new opportunities while at the same time grieving a loss, and she warned us that grief is not a linear process. Sometimes little things can trigger feelings you thought were over. She was right, as she always seems to be. The thing about infertility is that every option involves a loss of some kind. We did grieve even as we moved forward with embryo adoption. More than once, I felt a stab as I saw myself or Jon (mostly Jon!) or maybe even a grandparent or uncle in my son and mourned the loss of that experience with our next child. We wondered how well other people would relate to what we were doing and whether our child would face extra challenges finding her place in the world. We grieved the loss of “normal,” whatever that is. In fact, there was a time somewhere in the middle of the process – I think around the time we were reviewing donors – when we both were questioning enough to need to walk through the entire decision again. We started at the beginning and talked about all our doubts and questions. What if finances weren’t a factor? Would things be different if we waited another year or two? After going over the whole process again, we came out in exactly the same place. This was the right choice. It was where God was leading. After that, things were easier.

I suppose, keeping in mind the counselor’s warning, there will probably still be some difficult moments ahead. But God has brought me to a place of peace and joy. Knowing He has led us here gives me such confidence in the future. In the way only He can, He changed my attitude to match His plan. Throughout this pregnancy, I have felt such a bond growing with Baby Girl, and the fears have faded away. I love the incredible way she came to us, and I love that someday, I will be able to tell her how she was chosen for us, before those tiny cells even began dividing.

File this under “temporarily stumped”

I started looking at baby books the other day, and it didn’t take long to realize there isn’t anything on the market that fits our situation.

There are several very nice baby books out there for adoption situations, but that language –  with sections on birth moms and adoption finalizations – doesn’t work for us. Traditional baby books provide for information about mom and dad and the family tree but obviously don’t include a section on donor families. I am so not up for assembling a book from scratch. I may be tackling an awful lot of DIY for Baby Girl’s nursery, but I know my limits.

Jon and I talked about it and decided to buy a traditional baby book similar to Corin’s – which is post-bound and allows some flexibility to remove or change pages – and customize it ourselves.

I’ve started filling it out, but after copying down the same information I’d put in Corin’s book about mommy and daddy, how we met, and our family tree, I’m a bit stumped. Where exactly do I put information about Baby Girl’s biological family? What does that section even look like? Will it make her feel weird that her story didn’t fit any of the “normal” family templates and had to be cobbled together?

I’m going to be thinking about this for a little while. I’ll let you know how it comes out.

On bonding

I spent several hours yesterday sanding and priming Baby Girl’s crib, a stellar craigslist find, as is pretty much every piece of nursery furniture I’ve ever purchased. Well, more accurately, I started priming the crib and then let my dear husband take over. I also have a changing table to paint, so we’re going to be at this for a while. I will at some point post pictures, provided I don’t totally screw these projects up and find them to be a hideous embarrassment. I’m starting early, because Corin arrived at 37 1/2 weeks to an unfinished nursery. His nursery mural – an awesome functioning Narnia lamp post courtesy my talented husband – was complete when he was about 8 months old.

I’m excited about decorating a girl’s nursery. I’m excited about dressing a baby girl. I’m just excited. Years ago, when I pictured the family I hoped for, I wanted a boy first and then a girl. With all the baby plans that went awry, somehow this one was meant to be. I think I would have been thrilled with another boy, but given the uncertainty of any future family plans, I love that we are getting to experience both a son and a daughter. I love the way Corin says “baby sister.”

I am 22 weeks pregnant and already starting to get uncomfortable. Physically, this pregnancy has been harder than my first. I was more nauseous and threw up for longer, although I still had it a LOT easier than many. (God bless those of you who have had to hang over the toilet for the entire first trimester or beyond.) I have had heartburn on and off for a couple months now. (Great midwife tip: eat almonds to settle the acid!) I get very tired, which I assume is related to caring for one child while gestating another. (Jon read this and questioned whether gestating is a verb in that sense. I assured him if it isn’t, it should be.) At 5’2″, I don’t have much baby room. I grow immediately and increasingly OUT. My sweet girlfriends have been sending me pictures of celebrities who gained a lot of pregnancy weight. My skin is a mess. I have what I guess is a muscle strain from rapid belly growth.

It’s funny, though. Even with all the weirdness and discomforts of pregnancy, I am enjoying it so much this time. I didn’t hate pregnancy the first time, but I think I worried more and felt less at home in my own skin during those nine months. I did feel a connection with Corin before he was born, but I remember thinking the prenatal bonding wasn’t quite what I expected. This time, I am so aware of the bond I feel for our baby. Maybe it’s because this time I know what it really means to have a child to love. Or maybe I’m more aware of that bonding because of my early adoption-related fears on the subject.

In any case, I am soaking up as much as I can of this experience and am so looking forward to meeting this little one. I worry a little about HOW excited I am, because I’m 90 percent sure I’ve forgotten exactly how hard those newborn days are and am unprepared for the two-child balancing act. Hopefully our previous newborn experience will kick in. And please let this baby be a better nurser than Corin was… Also, thank goodness for family. I hope our parents are resting now. We’re going to need them.

Navigating the uncharted

I’d like to tell you about a couple of amazing people.

He’s a CPA. She’s a child/adolescent therapist. They live a few states away. She is a talented seamstress. He makes her laugh. Like us, they wanted a family but faced roadblocks. Their first IVF cycle resulted in their precious son and two cryopreserved blastocysts. A couple years later, they had a precious daughter. They knew they did not plan to pursue fertility treatments again, and so they had a decision to make.

They are our embryo donors. I don’t know exactly what went into their decision to donate. Jon and I had just a small taste of what they must have faced when we began our IVF process and considered the possibility of extra embryos. We know it wasn’t an easy choice, but our donors felt a sense of responsibility to those tiny blastocysts. And so they made an incredibly unselfish decision, and in so doing, gave us a gift of incalculable value. We have this opportunity to again become parents because of them, and I am still floored by that kind of generosity.

I mentioned in my earlier post that we felt a surprisingly strong connection with this family from the time we first began to learn a little more about them. In the early stages of our process and FET cycle, the counselor served as go-between and provided updates and photos to the families. Not long before our scheduled transfer, the counselor forwarded a note written directly to me by Lauren*. I was crying before I’d finished reading her words.

It was a simple note that said she was thinking of me every day. She said it was eerie how much we reminded her of her own family. She talked about what a good feeling she had about our transfer and how excited she was about the possibilities. If the note had been written on paper, I probably would have worn it out with rereading.

That same day, I sent the counselor a return note for Lauren*. We communicated by proxy several more times up to and after the transfer. Then, on the same day, without knowing the other had asked, we each suggested exchanging contact information. The counselor passed along our email addresses, and messages have flowed back and forth fairly regularly ever since.

I wasn’t sure when we first chose embryo donation what to expect in the way of a relationship with the donor family. Would it be weird or painful? Would we feel threatened or insecure about the donor family’s involvement? Would it somehow make our baby less ours? Jon and I both started out wanting our commitment to be fairly limited, although we were open to more if the conditions were right. Then we connected with OUR donor family, and it was no longer an abstract exercise. Now these were the generous, unselfish people who had given us our baby. We instinctively trusted them and trusted our collective ability to navigate this uncharted territory.

I don’t want to oversimplify. This is a relationship without an existing definition. We forge ahead without a map. It’s probably safe to say that for both the donors and for us, there are still joltingly emotional moments when we come face-to-face with the truly unique nature of what we’re doing. There will probably be more of those as this baby enters the world and becomes a part of our family. We don’t really know what this relationship looks like a year or five years from now. We play it very much by ear, and obviously, there are boundaries. Jon and I both already feel incredibly possessive and protective of this baby. If ANYONE dared to hint she is anything less than 100 percent ours, the parental lions would roar. But that has not happened. Both families understand this baby’s unquestioned place in our family, as our child. We also acknowledge the unique role her biological family has played, and we know they will continue to be a part of our lives as our daughter grows. I don’t know exactly what the future holds, but the sense of trust and openness has served us well through this process. I believe it will continue to be a great strength in the experiences ahead.

On Mother’s Day, Lauren* and I were thinking of each other, and we exchanged notes full of gratitude. It occurred to me that day that our baby is twice blessed, with two women who will have helped shape her life in very different ways. That thought might have made me uncomfortable a few months ago, but now, it makes me happy. The amazing thing about love in its best form is it multiples rather than divides.

In fact, with this baby, WE are twice blessed. We are richer for the incredible gift of our child and the presence in our lives of her remarkable genetic family.

*Name has been changed for privacy reasons. 

Transfer!

The medical protocol for a frozen embryo transfer – whether using your own embryos from a previous IVF cycle or donor embryos, as in our case – is much simpler than the process for a full IVF cycle. When you are starting from scratch with in vitro, the mother has to take injections to induce her body to develop as many eggs as possible. Once the eggs are mature – which happens with the aid of another injection – they are then surgically retrieved and fertilized in the lab. For a frozen embryo transfer, that part of the process has already occurred. In our case, the embryos had matured to blastocyst stage (which usually takes around 5 or 6 days) before they were frozen and stored.

There is still a fairly lengthy process to prepare the mother’s body for potential implantation of the embryos once they are transfered, however. First, the body’s natural ovulatory process is suppressed through birth control pills and subcutaneous injections of a medication called Lupron. Then oral estrogen is added to build up the uterine lining.

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The collection of meds and syringes, in all its glory

At least two monitoring appointments, which involve blood work and ultrasound, are necessary to make sure the body is responding to the medications and everything is ready for the transfer. Our actual transfer would happen at the clinic in Knoxville, but we had our monitoring done locally at the clinic in Nashville.

Our transfer date was Tuesday, January 17. We left Corin with my parents, traveled to Knoxville the night before and stayed with friends in the area overnight. The transfer was scheduled for mid-morning. I’ll admit: even having been through the process twice before, I was nervous. It’s a strange thing, the mix of hope and fearful reservation that becomes so familiar during fertility treatments. About half an hour before our transfer, we were taken back to the preparation area, where I got into my lovely hospital gown and cap and the nurse took my vitals. I was disappointed to find out Jon would not be coming into the room with me for the actual transfer.

We were both anxiously waiting to talk with the embryologist. She came into the curtained area after what seemed like a longer wait than it was. This would be the moment we found out how our embryos had fared in the thawing process and which ones would be transfered. As soon as she started with, “Both the embryos from your primary donors thawed beautifully,” we broke into smiles, and the anxiety faded. We would not need to thaw any of the embryos from the secondary donors. She showed us a picture of our two beautiful little blastocysts.
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Every fertility clinic has its own internal system for grading the quality of embryos at the time of transfer. It’s subjective, and they always tell you the quality grade doesn’t necessarily predict the outcome. It does give a sense of the odds, though, so when the embryologist told us we had an AA and an AB, we were ecstatic. They were the highest-quality embryos we’d ever had.

From that moment, both Jon and I had an underlying sense of confidence. We felt God at work. Of course the doubts would creep in over the excruciating 10-day wait for that first pregnancy blood test, but the nervousness faded and we came away feeling more excited and hopeful than we ever had after a fertility cycle.

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Just before the procedure

It wasn’t long before I was wheeled into the small procedure room, which was kept dark and cool. It had a sliding window directly into the lab, through which the embryologist passed our precious cargo. The transfer itself went beautifully and was over in about 10 or 15 minutes. I watched the ultrasound image on a big-screen TV as the tiny embryos were placed in exactly the right spot in the uterus via a cervical catheter.

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The white spots just below the cursor are the embryos after being transfered. 

I rested back in the waiting area, with my feet slightly elevated, for about 30 minutes after the procedure, and from then on, it was mostly business as usual.

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Immediately post-transfer

We headed to IHOP for some lunch and tried not feel frightened at how high our hopes were. I was instructed to stay in town and rest the remainder of the day. We stayed again that night with our friends and headed home in the morning. Jon bravely administered twice-daily intramuscular shots of progesterone, and we waited.

Ten days later, I headed to our local clinic for the quantitative hCG blood test that would tell us whether we were pregnant. Make no mistake: Regardless of our sense of confidence, those 10 days CRAWLED. They always do. But by that evening, we knew: I was pregnant. The number told me it was probably one baby, although we wouldn’t know for sure until our first ultrasound at 6 weeks. I had a second blood test three days later to make sure the numbers were climbing as they should be. They were. We were thrilled. My official due date is October 4, 2012.

We had two ultrasounds, at 6 and 8 weeks, at the local fertility clinic and were then released as “normal” obstetric patients. The intramuscular progesterone shots continued, with repeated blood tests to make sure my hormone levels were where they needed to be. All went smoothly, and my poor, sore bum could finally begin to heal after the 12-week mark. (Truthfully, it’s still a little sore.)

This was our beautiful baby (our sweet girl, we know now!) at 8 weeks:

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Really, what can I add to that?

Eenie, meenie, miney…

It’s probably safe to assume that most couples, before choosing to procreate, do not sit down at the kitchen table and write out a full family medical history and personality profile for each partner. For most of us, the decision to have children is not so much an evaluation process as an instinct to pass along our genetics, with all that entails, to the next generation. It’s a natural desire, and for most families, what you have is what you get.

Choosing embryo donors was an entirely different world. Before we even began looking at donor profiles, we had decisions to make. Did we want a closed or open arrangement with the donors? If open, how much contact did we want to have? Did we want our children to have contact?

We chose an open arrangement. In the end, we both felt it would be important for our child to have access to complete information about his or her biological family and even to have the option of eventually meeting them. Traditional adoption has moved to more open arrangements in recent years, and research shows the adopted children have benefited. It just seemed we would want to be able to answer any questions our child might have about the family whose genetics he or she shared. As it has turned out (and as our counselor predicted), the openness has already benefited us, as well.

Once we made that decision and outlined the type of communication we envisioned, the NEDC coordinator emailed us the first set of anonymous profiles to review.

I don’t know if there is really an effective way to describe the experience of shopping for your child’s biological make-up. How do you prioritize health factors, personality traits, talents and interests? Did it matter if we related to the donors’ taste in music or movies? How concerned were we about a history of clinical depression? What about diabetes or heart disease? We knew the single biggest predictor of IVF success is the age of the mother, so that was another factor.

As silly and shallow as it sounds, I had a terrible fear of ending up with an ugly child. I worried about the same thing before Corin was born. The counselor we have had access to throughout the process suggested it was related to fears about bonding. In any case, I was disappointed that most of the donor profiles didn’t include photos. But perhaps it was for the best. The one profile that did have photos sounded good on paper, but – there’s no kind way to say it – the children were homely. I couldn’t get past it. I felt like an awful person, but I just…couldn’t.

We passed on the first set of profiles, and the coordinator sent us a couple more. We passed on those. And so the winnowing continued. It was harder than either of us expected. There was really nothing wrong with any of these donor families. (Well, there was this one, but I won’t go there.) It was just incredibly hard to look at a few pages of anonymous information and decide definitively whether this was the biology we wanted for our child.

The NEDC coordinator actually had quite a task before she even selected profiles to send us. First, she had to choose from donors whose openness preferences matched ours. Then, she had to consider the number of embryos the donors had available, and at what stage the embryos had been frozen. In order to proceed to transfer, we would need 5-6 embryos. Because few donors have that many embryos, we would likely need to be matched with TWO donor families. To further complicate matters, not all embryos are frozen at the same stage of development. Some are frozen as blastocysts, some as 3-day embryos, and some even earlier. Our embryos needed to be at a similar stage of development in order to all be ready for transfer at the same time. The coordinator also tried to factor in physical similarities, although we eventually told her that mattered less to us than other factors.

There were a couple donors earlier in the process that had potential, but it was maybe on the fourth batch that we found two profiles we really liked. One had two embryos available, the other four, giving us our total of six. Predictably, I was ready to commit and Jon wanted to keep looking, just in case. I emailed the coordinator about more profiles, and that’s when we realized exactly how demanding we were. Her reply essentially said, “Yeah, that’s pretty much it. We’ve exhausted all the donors that meet your parameters.” So, here we were. These were the donors.

I don’t know that I could tell you exactly how we chose these donors. There were factors that weighed heavily, like levels of education, career choices and skills and hobbies. The medical histories were pretty clean. Both couples were relatively young. Aside from the concrete factors (or perhaps because of them), we felt a connection, as if these were people we could relate to. All of this came with a lot of prayer.

Once we made our choice, the NEDC contacted both donor families for their approval of the match. It was a nerve-wracking couple of weeks before both approvals were in, although the coordinator assured us donors approved the match 90% of the time. After they received the approvals, the NEDC provided all our contact information to the counselor, who was responsible for helping us finalize the legal contracts. After speaking to each of the donor families, the counselor was able to tell us more about them: their first names, their children’s names, a bit about their story and a little about how they felt about the match.

I’ll never forget the counselor’s call after her interview with the first family. As she told us about them, I felt an overwhelming connection. I remember thinking, “I love these people!” I don’t know what it was, exactly. Perhaps God was giving us the confidence that these were the people, this was the child He had chosen for us. We named this family as our primary donors. The second family would be our secondary donors; their embryos would be used if needed. We exchanged photos with both families, and I was amazed at how much our primary donors reminded me of us. Their two children – a boy and a girl – were adorable.

We had decided on a January 2012 transfer. All parties settled on the terms of the legal donor agreements pretty easily, and I mailed in the last signed, notarized contract on December 9. That was also the day I began the first step in my medical protocol. The train was leaving the station.