A little bit of infertility
Things are not going quite to plan this cycle. According to nurse #3 at the clinic, I have “a little bit of infertility.” “We have only tried once!” I cried. “I have a 32 day cycle!” I said in defence of the fact I had not yet ovulated at CD15. “Spotting can be a perfectly normal experience!” I am becoming the uber-assertive-Stephanie-Brill-says-there’s-nothing-wrong-with-me client ( I refuse to use the word patient).
It’s now CD17 and there are no fertile signs as yet. We’ve had a slight change of direction. Following the call from the clinic’s regional manager, we’re now able to inseminate twice at a reasonable price and with DDX’s good-quality second-batch sperm. While I still really like the idea of an at-home insemination (and said-artichoke jar has been purchased) I suddenly started to freak out about not knowing who the bio-dad was. I’d got so used to this monthly alternation model between our two donors. I never imagined myself to be a girl who did not know who had gotten her pregnant. It’s different to having an anon donor as we’d still have some conceptialisation of the sperm-donater. I just didn’t like the idea of having to examine the features of the baby to work out paternity. And not having a choice about whether we divulged this information or not because we didn’t know. And we felt like we wanted to try with DDX having tried with DDY last month and that that was part of the agreement we had with them both. So, now that we’re back with our clinic plan, we’re going to do the clinic insems with DDX this month and then do at-home insems with DDY next month (possibly supplemented with an IUI with DDY). We realised that we should probably just choose one approach and stick with it, but intuition is important. And we’re in control of this process and want to keep refining it. And thankfully our donors are so great.
So, it’s a stressful week. I have another blood test and ultrasound tomorrow. As much as this is at the centre of our life, Lo and I are trying to work out where we’re going to fit the insems into our hectic schedule. It’s difficult finding the flexibility to be as absent from work as much as this process demands. I also don’t want to give it too much space, given how much I freaked out last time. My approach this time is to go to the clinic, go to acupuncture, and go back to the office. Although my wonderful acupuncturist is a hard man to catch. With our two inseminations, Dr Y&F wants to do two IUIs. I had asked for an ICI and IUI. But it will be my concession to her to go with two IUIs. Probably better chances, but I kinda liked the idea of the vaginally inserted sperm swimming their way up in a leisurely fashion. With the stress, the spotting, and the dramas I am feeling like September isn’t really our month. In October we’ll be on leave all month (a staycation! there was no way we were booking a holiday as we wanted the flexibility to be around for this whole process), we’ll be doing the KD DIY thang, and will be a lot less wound-up. So, in true ttc trooper style, my mind is already on next month.
Blogger’s digest
Why I love the acupuncturist
I had never seen an acupuncturist before. A few months ago, a friend of mine raved about this guy, and I was tempted. I loved the blissed out experience he described when he left there, the intuitive hands, someone who can tell all that ails you from your pulse.
The acupuncturist is even better than my friend described. He is gorgeous. In a quirky, slightly camp, can’t quite tell if he’s gay, preppy, hippy, premature graying, delightful way. He’s so gentle and so beautiful. He runs this well-to-do acupuncture clinic with beautiful silk screens and lovely light. He has the most amazing touch and this lovely serene face. It’s so nice to come across such a beautiful human being. And he is so interested in lesbian conception. In fact, he’s buying the New Essential Guide to Lesbian Conception, Planning and Birth just so he’s up with it. So, I am loving seeing the acupuncturist. Loving it.
Why we hate the clinic right now
We’ve had a really hard time with the clinic lately. Trying to do things our way, rather than their way, has not been easy. While they at first agreed that we could do two inseminations on consecutive days, one vaginal and one IUI, saying there would likely be no charge, they then went on to tell us that it was going to cost an inordinate sum. None of which could be refundable for various bureaucratic reasons. Even though now I am no longer taking the drugs and not requiring such regular monitoring we are still paying the same price per month as we did last month.
Then, there’s been another issue with the blood test. Our donors made two donations, one on 25 January and one on 5 February. They were meant to be closer together, but the clinic ran out of liquid nitrogen. Yep, that’s right, ran out. So anyway, Dr Y&F told us that we needed to get a blood test done on, or after, the 25 July. We actually asked whether we needed a blood test six months after each donation and she said no, just after the first one. There is the three month window period in which HIV can be undetectable, with an extra three months to serve the legal cooling off requirement. So recently, she told us that the quality of DDX’s first deposit was not good and she would not be comfortable with us using it. So, this month, we were all expecting to inseminate with DDX (from the second batch) when we find out (as always, only by us asking plenty of questions) that the second batch can not be used until they get another blood test dated after 5 August i.e. six months after the deposit was made. With DDX overseas, each blood test costs us a couple of hundred dollars and them a lot of logistical stress. If we had known it was due on 5 August, we would have done it then, given we didn’t inseminate until mid August. (Although the clinic wouldn’t let us start at CD1 until they had the blood test results). This news came along with the massive price hike for the second insemination and left us feeling pretty angry with the clinic. They make the whole thing so difficult by not communicating with us about what is required, nor being flexible to our needs as fertile people wanting to access the services within a wellness model rather than just being on the medication rollercoaster. So we decided that we would draw a line at what we were prepared to pay, and that we would go ahead with an insemination this month (one IUI only) with DDX’s substandard sperm and meanwhile ask DDY (who is in town for work for a few months) if he was willing to do a couple of DIYs with us. We were committed to using DDX as we had agreed to alternate between them and we had used DDY last month. Combining the two means that who the bio dad is may be unknown until after the birth, but this was something we had all talked about as an option earlier on.
Why I am a crap fertility monitor
I have never been much good at fertility monitoring. I gave up on temperature charting. I tried, but it was just so tedious, and I found the results too hard to decipher, our digital thermometer too hard to use, and besides, because we knew we were going through a clinic, I didn’t feel a genuine need to keep close track. From the fertility clinic’s monitoring, I knew that I ovulated around CD18/19. I pay attention to cervical mucous. But given that we are now facing the prospect of DIY, I decided that we should be monitoring more closely. Once again, turning to Stephanie Brill’s advice, I decided we should begin cervical analysis with a speculum. A speculum is not an easy thing for a girl to lay her hands on in this town. After three calls to the local sexual health and family planning centre, and having to speak to three layers of management there, I finally convinced the senior nurse to give me one (I was happy to buy one but they wouldn’t sell it). She demanded explanations all about our family composition, the technique I was planning to use, then she left me a plastic speculum in a brown paper bag with my name on it behind the counter. And I raced over and picked it up in my lunch break. Not bad. We are yet to use it though. But I feel all the more virtuous for having it.
DDY goes DIY
The next step was to ask DDY whether he was interested in DIY. This was never in the plan. They were always going to be overseas and we had always been thinking in terms of the clinic. We all like the intermediary that the clinic played. We had plans to see DDY for dinner next weekend, but with the realization that, all going to plan, I will be ovulating early next week, we made this rushed approach, and I emailed him saying there was something that we needed to talk to him about and arranged for us to meet him for a drink after work yesterday. It was lovely to see him, as we hadn’t yet caught up with him since he’s been back. And we chatted so happily. I then explained to him about some of the troubles we were having with the clinic, and my decision to go off the drugs. This then led nicely into asking whether he was interested in helping us out, that if we continued with clinic inseminations with DDX and did DIYs with him. He paused, thought about it briefly, and then agreed. He said ‘sure, let’s discuss in more detail next weekend when we catch up for dinner.’ We then had to explain that it was a bit more pressing than that and that we were planning to inseminate early next week. He was happy about it, but a bit concerned it might be a little bit weird. But he’s got this wonderful ‘chalk it up to experience’ approach, so we all agreed that we’d try it and see how we felt about it and as always, an opt out option remained for us all if anyone felt uncomfortable. So, we are going to provide him with an appropriate jar (which Lo is going to give him at work on Monday as they work in the same district) and then we are going to collect it in the evenings after work and try and do inseminations over a few consecutive days, depending on my ovulation. So that’s exciting, but a whole new ball game and I’m having to re-read chapters of all my lesbian conception books that I never paid attention to before. And of course, Lo’s dad then contacts us saying that he’s going to be in town on the night we’re likely to do the first insem with DDY and can he stay at our place. There’s no way we can say no, so we resign ourselves to sneaking out to collect sperm and sneaking in to our bedroom to inseminate.
How artichokes come into all this
Lo and I both love Lesbiandad’s story of the donation being made in an artichoke jar and then when they were pregnant them taking an artichoke plant to the donor as a gift. (I think this is in Confessions of the Other Mother). I love this. So we decided that an artichoke jar would be best for us. I then discover Stephanie Brill also recommends this – I think something about its wide opening –so, now Lo and I are in search of artichoke jars. Not being big artichoke fans, it’s a whole foray into a new aisle of the supermarket and a bit like the pregnancy test, we need to find the perfect special jar of artichokes.
Meanwhile, drama returns
Just when everything starts lining up so well something strange happens. I gained a bit of weight last cycle, I think the combinations of the drugs (I am going to blame them for everything) and being afraid to exercise during the 2WW. So lately, I have been trying to pick up the pace on the exercise. I did a very high impact aerobics class on Tuesday, and again on Wednesday. On Wednesday (before the class) I noticed a very small amount of spotting. I thought it might have been the hard-core exercise dislodged something or caused a small tear. It is now Friday and it’s still coming. It’s less like spotting and more like a very very light period. I called Buffy about it this morning and she seemed to think it was fine. I am due in tomorrow for a blood test and ultrasound so we will see what that says. But it worries me. With Lo on the computer for her assignment all the time (I am typing this on our very old lap top that I will then transfer and upload to the other computer) I have not had much opportunity to ask Dr Google. (I did for a moment at work, but typing mid-cycle bleeding into your work computer is not always the best look). But it’s making me a bit worried about whether we can even go ahead this cycle, what this means, and whether it’s to do with the drugs from last month having stuffed up my cycle? I will probably have a better indication when the blood tests and ultrasound results come back.
But at least the clinic isn’t quite so bad anymore
Then this afternoon the regional manager of the infertility clinic company called me about our blood test issue and the cost of the second insemination. He said that Dr Y&F was happy for us not to need a second blood test to be done. He also said that she would waive her fee for the second insemination, thus reducing the inordinate cost by about half. Both of these are very good items of news. I took the opportunity to give him some feedback about our frustrations, reiterating that we were happy to comply with whatever their procedures were, but needed to have these communicated to us with enough time for us to implement them. I told him how hard it was to make decisions with no information. I told him that from a business perspective, there was a captive market of people like us, but that they did not make it easy for us. He was so receptive to my feedback and is actually attending a workshop with all the staff from the clinics this weekend about how to enhance the patient experience, where he said he would use this call as a case study. I took the opportunity to sing Buffy’s praises. He wished Lo and I all the very best for our cycle and was really very good with dealing with the issues which is just so refreshing.
And so
And so we are now with decent insemination prospects, excellent known donor arrangements, a free speculum in a bag with my name on it, a newfound appreciation for artichoke and then this weird spotting, period, mid-cycle bleeding episode to mess things around. Please think of me tomorrow with the blood test and ultrasound. It would be good to have some answers, and for this bleeding to stop.
Nearly at the start line
The sperm has passed its quarantine period with the all clear. The consent forms have been received. My period has arrived – the last period for a long time that won’t mean anything. Our donors are modelling a perfect combination of being whole-heartedly detached and supportive at the same time. Despite some silent panic from our side about them getting blood tests done and consent forms organised, they provided everything on time, as requested and so happily. Dr Young and Funky called me to check in and said ’see you at the insemination!’ (that was a weird conversation to be having at my desk at work). We have spoken to Buffy the Sperm Nurse who wants us to come in for ‘Nurse Chat’ on Friday morning (this involves ticking a box called ‘Nurse Chat’ on a clipboard when we arrive in the waiting room, parting with a large sum of cash, being given a truckload of drugs and some advice on injecting.) I start the injectibles on Saturday morning and she expects we’ll start the blood tests and monitoring next Wednesday.
It sounds very perfect and it generally is. It was a tough few weeks in the lead-up, and Lo & I got really worried that things might fall through, for no apparent reason, except our donors don’t provide us with regular update emails – they just do what we ask of them. Lo thinks that the fact that they are complicit, but slightly non-communicant on the email, is exactly what we want from a donor. She would be worried about what it indicated about their emotional stake in the process if they were donors that were writing updates about each stage of the process with utter excitement. I think she’s right. They both wrote perfect things on the consent forms about their reason for donating being wanting to help us become parents because they thought that we’d be wonderful.
I’m pretty impressed that we have pulled this off. That we asked them and they said yes, that we’ve managed it in crazy timeframes and over a long and difficult distance. I was so pleased to see Lo’s face when all the forms and tests rolled into our inbox. She looked like the cat that got the cream and I know that the known donor arrangement, especially with them, makes a huge difference to how she feels. I am feeling really comfortable about our choice too and do feel such gratitude for our donors and the seemingly ultra-healthy dynamic we’ve got going with them.
We both freaked out that we’re about to start. It’s such a wild proposition that we could be pregnant in less than a month, or that we could be starting on a very long and emotionally draining rollercoaster of ttc efforts that will span many months. Sitting equally open to both eventualities is a tough ask. But we’re excited. In her phone conversation, Dr Young & Funky said ‘boy, six months is up already? that passed fast!’
It hasn’t from our perspective. Not at all. But it’s been very good to have a pre-ttc sabbatical imposed on us. So long to read, think, plan, prepare, become ready.
We’re ready. Let’s go.
Tight timing
It all seems to be about time at the moment. Our sperm comes out of quarantine on the 25 July. The final requirement is another HIV, Hep C etc test for our donors before the clinic will allow us to inseminate. As I expect our insemination will probably be around the 17 August, I thought we had a decent window to get the tests done. But: the clinic wants the test results before we can even ‘book-on’ for our cycle that month – i.e. around 1 August. Which makes timing incredibly tight.
Our donors have been wonderful throughout the process and have been pretty complicit with all the administration required. But we have project-managed the process pretty carefully the whole way along: booking appointments, writing instructions, calling ahead to the clinic to ensure the bill is fixed up. We wanted to make sure there was as little impact on them as possible. When they undertook all the screening and depositing in January I wrote them up a little chart with each appointment, what to expect, where to go etc. Like most men, they loved being taken care of like this. But now they are overseas, we have a lot less control over arrangements, and hell, I have no idea where they should go for a blood test. They had said they would take care of it, and I have no doubt they will, but they had also expressed some doubt about the pathology services where they are and how quickly the could get results. Now that we have such a short timeframe (i.e. the 1 August one) my nerves have set in about we can get a blood test taken and pathology results in a developing country and faxed back to Australia in a 5-6 day timeframe.
(insert interlude) …. rather than writing about my problems, I decided to take matters into my own hands and, thanks to some good internet research, I have just called up the 24 hour private hospital there and got put through to one of the laboratory technicians, a delightful man called Jessie. I am sure getting a call from some random Australian was the highlight of his night shift. The good news is: they can do all the tests we need and have results ready in 24 hours! And it won’t cost a gazillion dollars. I am so glad. And the fact that it’s 24 hours means that our donors can go in on the Friday evening to get the tests done. Meaning, we should be able to go ahead for August! And I can relax. Almost. Just waiting on the final tranche of consent forms to come back from them. And sorting out our future.
So, Inshallah, we have one month until lift-off.
Buffy, the sperm nurse
We went for our orientation at the fertility clinic today. We’re this ridiculously zealous pre-inseminating couple. We’ve still got six weeks until the sperm can come out of storage, and probably about eight weeks until we do our first IUI. But, as we’ve been waiting since last December, we’re eager to be as prepared as we can. So off we went for our first glimpse of the place where our sperm is waiting and where we’ll be inseminating. It’s a pleasant clinic. Neutral tones. Down lights. Quite glamorous really. Although the room where we’ll be inseminating looks a bit like a kitchen with a set of stirrups in it. I am planning on taking Stephanie Brill’s advice and making it our own, bringing in our insemination playlist.
Our Nurse Coordinator’s name is Buffy. I love this and loved her instantly because of it. I was imagining a funky, young dyke, but she’s actually a kindly and delightful middle aged woman, who is so neutral and non-judgemental. (Lo later tells me that Buffy is a well-known shortening for Elizabeth, but I never knew this and am still captured by the novelty of my kindly sperm nurse Buffy.)
In our last appointment with Dr Young & Funky, we decided on starting with a stimulated IUI. You can read about my grappling with whether to use drugs here. Even though most of the advice we received from other tccing lesbians was to the contrary, Lo & I have decided to go straight to stimulated IUI. I noticed that most advocates of no-drugs IUI had ended up having to ramp up their attempts to using drugs and IVF after a few unsuccessful cycles, and because time is of the essence for us, with an overseas move at the end of the year, and our sperm is frozen, thanks to known donors who are in another country, we’ve decided to go straight to what we think will work best with limited intervention and less ethical complexity than IVF. We figure that we’re not trying to recreate heterosex and would like to give this the best chance, and shortest timeframe, as possible.
So we’re going to be using Puregon, at a very low dose (50), and then a trigger shot and then something for a few days after the insemination (possibly the trigger shot or the Puregon again?). There will be a regime of blood tests and ultrasounds. I have completed all the blood tests and ultrasounds that are required before starting treatment, and just need to have my HSG (I have been waiting until closer to the time, as apparently if it’s had close to the time of insemination it increases your chances.)
Reading other blogs out there, including Vee and Jay’s staggering running total, we’re so fortunate to live in a country where our Medicare system covers most of the costs involved in this whole process. There’s a lot we had been shelling out for earlier in the process (sperm analysis, sperm storage and a plethora of tests for our donors) but thanks to the system here we’ll probably only end up out of pocket about $300 per month for over $2000 worth of treatment. Perhaps less with our health insurance on top of that.
So we’re on our way. It’s finally coming into sight. And I am so excited. There’s still mountains of administrivia before we’re home. Such as discovering a whole bunch of consent forms the clinic was meant to get our donors to sign when they deposited were not given to them to sign, meaning we are now having to send them across the world for them to sign (and find a witness for – which will be tricky for them to explain) and return. We also have to arrange their final blood tests and ensure that a third world doctor’s testing and diagnostic procedures are reliable enough to satisfy our doctor. And we do all this just to get to the starting line…
So far, our donors could not be more perfect. Lo and I are both a besotted with them. As such decent human beings. As such wonderful men. They have been so willing to go through this process so openheartedly. And for that we are grateful. Originally, our first ob/gyn (who we saw for our first appointment) said that we had to choose from one or the other and we were a bit trapped in a cycle of weighing up attributes and sperm quality. But we have since decided and told the clinic that we want to alternate between the donors each month. This was a bit of a revelation, but works for us. Because we entered into this with them as a couple. Because we equally couldn’t decide between one or the other of them, nor did we want to. Because storing two types of sperm protected us from waiting six months to find out that the sperm didn’t work so well. Because ideally we’d like for Lo to have our next baby with the other of them’s sperm. Because having this concept of a donor-couple really waters down the biology of it all. It’s our baby, but our friends are helping us. And such wonderful friends they are.
Even though I had been the original proponent of using an anonymous donor, I am so glad about how this has worked out for us so far. With the right men, known donor arrangements can work so well. As we all know, with the wrong men, they can be disastrous. I think distance always helps.
So that is where we are on a Thursday evening in June. It’s so cold outside. Lo is out for the evening. I am listening to a wonderful CD by Geoffrey Gurrumul Yunupingu and contemplating a pile of dishes.
And the countdown is on.
Six month snapshot
Since my last post, a lot has happened. I’ve moved the blog over to this new page, which I prefer. I have missed covering some big steps in our TTC process; but I guess we’ve been so busy doing them I haven’t had a chance to write about it! That’s going to change from now. Blogging for LGBT families day is coming up, and I want to be part of the fun. Also, now that Lesbiandad has gone on a prose diet, I have the time I would have spent reading blogs, to start writing mine. Here’s the past six months of our TTC journey in snapshot:
- Nov 07: Faced with a three month wait to get an appointment with the lovely Dr Heavenly, I called around and got an appointment for early December with another ob/gyn who was leaving town shortly, and therefore had appointments available. The deal was that we would see her for our first consultation and then our case would be taken over by her replacement. The catch: this clinic only works with known donors…
- We had been open to the idea of a known donor (in fact, Lo was very much in favour of this option), but had not been able to come up with a suitable candidate. We had a shortlist of possibles, but none were perfect. Except for this lovely gay male couple friend of ours who we had thought were ideal, but we knew they were going to be away when we were planning to start. In fact, they were going overseas in mid December for six weeks, and then would be back in town for only three weeks before taking off for a three year work assignment overseas. We had always thought that this timing would have made it impossible for them to be involved.
- We were at a party, and it was one of those parties where all of a sudden you realise that everyone is having babies or is pregnant. One member of our couple friend (X) was also there. He starts talking about our plans to TTC (which he knew about) and how he loves babies, and how he would like to have children one day, but was not sure what that would look like.
- · I went home and spoke to Lo about it. We decided that we would take the plunge and ask X if there were any synergies between their plans or thoughts and ours. We thought that if we kept open and non specific about our intentions, they could be candid about what they wanted and we could see if there was the potential to work together on this. If they were set on having a co-parenting arrangement three nights a week, we would know that wasn’t for us. But at least we wouldn’t have missed an opportunity to consider creative solutions that may work best for us both.
- I met X for lunch and asked him. He was thrilled, surprised, and taken aback. He responded very positively, but took it on notice to speak to his partner. He said that practically, they would probably be more interested in making a donation, than anything more involved. Great from our perspective. He suggested what was our ideal model. We arranged to have dinner that Friday.
- They came over and I cooked duck with blood orange and star anise and Chinese pancakes. Before they arrived, I swept the front path, cleaned the house meticulously and felt like a heterosexual woman for the first time in my life. They were both excited. They both wanted to donate and wanted us to choose which one of them we wanted (he’s cuter, they said, yeah but he’s buffer). Ideally, they were interested in being a birthdays and school concerts , and general good male role model figure, with our permission. They were so perfect in all the ways they responded. So honouring, so decent, and are generally such good wholesome men, delightful.
- We agreed that they would think it over while they travelled overseas for 6 weeks, meanwhile we would line up all the appointments for both of them to undertake in the 3 weeks they were back in town before heading overseas. They could opt out at any time.
- Dec 08: We had our appointment with the ob/gyn. She was nice. Surprised by our two donor model, but decent and pleasant. She arranged all the forms for them to complete the tests, screening, donations.
- To complicate matters, I find out that we will be going overseas for three years with a work assignment, starting Jan 09. Workwise, it’s a great opportunity, and we’ll be going to a good, liberal, western country which is GLBT friendly. But it complicates the TTC plans a bit. Ideally, we’ll need to conclude TTCing and fall pregnant before we go – by Dec 08. Also, I’ll only be able to take 12 weeks off work when the baby arrives. We decide that I will still carry the baby, and Lo will take some leave without pay from her job to stay home with the baby after I go back to work. I think I am going to find this hard, but I think it will be really good for ensuring that we both share a bond with the baby.
- Jan 08: We had a busy January, with X&Y making the deposits, doing blood screening, us having the obligatory counselling sessions with what must have been our city’s worst psychologist, and a few clinic mishaps including the clinic running out of dry ice the day before they were due to deposit (?) and then they left.
- · The sperm must stay in quarantine for six months, so it will be ready for use in July, after they complete a final blood test which we have arranged for them to do while away.
- · April 08: We met the replacement ob/gyn. She’s young, funky, and a bit off-hand. I preferred the motherly nature of her predecessor. The sperm is plentiful, and of good quality. We now just have to decide how we want to inseminate, when to start, and which of our two donors to start with…
No wonder I haven’t had time to blog!
