I have had hot flashes for quite a few months now. It all started with just getting warm a couple of times a day. Then it extended to waking up in the middle of the night with night sweats a couple of times a night. My cycles have also been quite sporadic in the past year. I don’t even remember the last time I had my period (maybe three to four months ago?). Finally this month my symptoms have reached a point where I feel like I should get some help. When I handle my wiggly kids I would all of a sudden get very sweaty all over my body while everyone else feels cold. This happens quite a few times a day. And in the middle of the night, I wake up about 4 to 5 times being totally wet from night sweats. My kids aren’t the ones who keep me up in the middle of the night. I am. I am still not bleeding (which is fine by me because it is so freeing and makes life so much easier). I consulted with Dr. E, my former RE, who confirmed with me that it is perimenopause. She suggested taking a low dose oral contraceptive to control the symptoms. I finally messaged my primary care physician this week about my symptoms and whether I should talk to a gynecologist. His first reaction was that I was too young to be in perimenopause, and wondered if these symptoms were due to something else. He discussed about hormonal replacement therapy. I wrote him back telling him that with my history of diminished ovarian reserve, I am quite sure that this is perimenopause. He suggested a anti-seizure medication that is prescribed to control hot flashes. I looked up the meds and saw that some of the side effects are dizziness and headaches. Those are things that I already suffer from so I feel that I should stay away from this meds. Dr. E thinks that a combi-patch or the pills would be more effective than the anti-seizure medication. I got my PCP to call in an oral contraceptive for me that will arrive in the mail next week. Dr. E said it’ll take two weeks to take effect. I can’t wait to not feel too warm or wake up drenching in my own sweat repeatedly again. I guess for someone who has DOR, 44 is not too young to go through perimenopause. It is surprising to me because my mom didn’t have these symptoms until her early 50s. People say look at your own mom to know how you will be. I don’t know why I am not like her in this regard or in terms of my fertility health. Oh well.
I am more into documentaries these days than feature films. So when my friend urged me to watch “Private Life” on Netf.lix, I was a little hesitant. One day last week I finally started watching it, but within the first six minutes I already complained to Bob multiple times about medical inaccuracies. My friend kept on telling me to ignore these and focus on the movie itself, I obliged and eventually finished the movie. I actually liked it. If you are going to watch the movie and don’t want a spoiler, come back to this post after you are done. This can wait.
What I like the most about the movie is its realistic portrayal of the emotions of this 40-something couple who started trying to have a baby later in life. Of course there were exaggerations for the sake of storytelling such as the accelerated timelines of TESE, donor eggs, etc. I ignored all of that, and found myself nodding constantly when the characters expressed their feelings as well as when seeing the disapproval and insensitivity of those around them. At a few points, I felt a little weepy as I saw parallels between my life (prior to my twins) and this couple’s lives. The couple was pursuing adoption simultaneously with fertility treatments. They were describing to an adoption social worker about a failed adoption which involved a birth mother who was matched with them but disappeared. It wasn’t clear if she was actually pregnant or was just pretending to be, but something that the social worker said stuck with me: “The emotional scams are really, really tough.” I found myself nodding nonstop. It reminded me of our experiences of our second donor disappearing after meeting with us, and about our current donor who was tested positive for cocaine during our cycle. It was already such an emotional roller coaster for us, and to have others kick us when we were down was almost unbearable. Watching this part made me relive that time of our journey. After the couple failed their first IVF, their RE pragmatically suggested egg donation as an option for financial reasons. The couple’s fight outside the clinic brought out a very common concern of female partner of losing their genetic material vs. the male partner’s ability to conserve his genetic link to their child. I wish the movie did go more in depth about the struggles and emotional turmoil a woman may experience before she says yes to pursuing egg donation, as the wife almost immediately dove into the world of donor profiles online after her initial struggles. But you know, some people get over that part quickly and some don’t, so it could still happen in real life. Regardless, I was almost teary-eyed when the wife scrolled through the donor profiles on her computer screen and read the details aloud to her husbands. That was us when we were trying to decide on a donor. We looked at countless profiles and tried to pinpoint what traits were important to us for passing on to our child. I remember how difficult it was to decide how to choose. I can’t say I totally understood the couple’s choice of donor, as I don’t know if I’d choose a family member myself if I had the choice, but nevertheless I was really rooting for them to finally have a baby. No such luck with that transfer as the fertilization rate was low and the niece was trying to be helpful and increased the drug dosage on her own. I could just see the numbness of the husband and the wife going through the motion of everyday life. That night, the couple had a conversation in bed. The husband expressed that he was actually relieved that it was over, that he didn’t have it in him to do this anymore, and that he didn’t even know if he wanted a kid anymore. He knew that he should console his wife, but he just didn’t have the energy to do that himself. I feel that it was heartfelt and realistically depicted how one would feel after trying so many things for so long without success. It also shows that IVF or DEIVF is not foolproof. Often times both of these fail and leave people with an empty bank account and no baby. As sad as I was for them, there was a glimmer of hope at the end of the movie when the couple got a phone call regarding an adoption and sat in a diner to meet with an expectant birth mother. It showed how the husband who originally sat across from the wife crossed to the other side to sit next to her and hold her hand. They were in this position and waiting expectantly facing the door of the restaurant. That was the end, and I love it that we don’t get to know what happened next. We don’t know if the expectant birth mom was going to show up, but it was so encouraging to see that 1) there is a chance that they will become parents and 2) regardless of the outcome, this pair who has gone on this incredibly difficult path together will be okay, as they are in this together. That was me and Bob, that regardless of the outcome, we were in it together. That has always been such a comforting thing for me, and I hope that those who watch this movie and are walking the same path of infertility also find comfort in that.
It’s been interesting to support my cousin alongside her on her fertility journey. Although she has been trying for more than a couple of years, she hardly ever reads any blogs or joins any online groups. In those 5.5 year of trying to become parents, I was on many online forums, joined many FB groups, and was a regular reader of many many blogs. Because of that, I feel that I have a lot more knowledge regarding things like the IVF process. Many of the questions that she has asked me are ones to which she’d know the answers if she had been following infertility blogs. I am happy to answer them. It is just interesting to see the differences in our approaches dealing with our fertility issues. And now that she is pregnant, it feels even more obvious that she doesn’t know much. Every time she gets her beta results, she’d ask me if they numbers are good. I have to reassure her that the numbers have been beyond good. Here is the lowdown:
Second beta on 10dp5dt: 577
Third beta on 16dp5dt: 5582
Those are crazy numbers, aren’t they? When I saw that her second beta was over 500, I couldn’t help but wonder if the embryo had split. This value was even higher than Annie’s second beta of 464 on 10dp5dt, and Annie was carrying twins for us. Dr. E, my RE, said that there is a 1% chance that the embryo would split, so it could still be one very strong embryo. One day my cousin was scaring me though. She messaged me to ask if she should do an injection of progesterone in oil that evening. It was already 11pm her time. She was supposed to insert one progesterone suppository in the morning and two in the evening. She only had one left in the evening. A shipment was supposed to arrive that day but didn’t get delivered on time, so she ran out of the suppositories. She still had PIO at home from previous cycles so she asked if she should inject some. I asked Dr. E who answered me right away (you got to love her for her fast response). Dr. E said that missing one dose of progesterone could cost her pregnancy, and urged her to inject the PIO right away. My cousin did. Then she told me that she wasn’t too worried about not receiving the shipment since she still had PIO at home. It was just that the suppositories were not covered by insurance and would cost $1100, so she asked around and someone was willing to order some for her and ship them to her. Of course the shipment was messed up. And now knowing that skipping a dose could cost her pregnancy, saving that $1100 doesn’t sound like it’s worth it at all. I just told her to always have progesterone around until her placenta takes over.
It does look like her pregnancy is going well. I can’t wait to see how many babies they see on her first ultrasound!
My favorite aunt, my mom’s younger sister, died of cancer at 52. Her older daughter is a couple of years younger than I am. I’ll call her Jeannie. I always think of her as very young, but of course it is no longer the case since I am already in my 40s. She lives on the east coast so I don’t get to see her much, but I love her dearly as I loved and will always continue to love her mother dearly. Jeannie disclosed to me a while ago (when we were expecting twins via gestational surrogacy) that she had not been successful in getting pregnant with her partner for quite some time. Her fertility issues are similar to mine (minus the uterine problems): diminished ovarian reserve. She had tried a few cycles of IVF using her savings. Since she and her partner are both small business owners, it has been hard for her to come up with more money for more cycles after spending her savings. It has been extra hard knowing that each cycle she may or may not make an embryo (you know, that’s the nature of diminished ovarian reserve). She knows the details of our journey and knows that the twins were conceived via donor eggs, so she knows that it is within the realm of possibility. With limited funds, she had to figure out with her partner how to proceed with treatment: continuing with her own eggs, donor eggs, or donated embryos? Or adoption? Everything cost money and she wanted to be pregnant and have a baby like.. yesterday. So how does one move forward when money is short? Being disappointed over and over again with her own eggs (just like me), she was more and more open to third party reproduction. Her friend’s friend offered her a frozen embryo for donation but she later found out that it wasn’t good enough for a transfer. Dr. E (my RE)’s patient had a set of Caucasian/Asian mixed embryos available but for various reasons that didn’t work out either. Watching her walk this path and walking alongside her every step of the way brings back so many memories of our journey. There are so many similarities, and it does pain me to see her on the same path as well. At the same time, because I have walked this path, I am so glad that I can be here for her whenever she needs me. I know the emotions behind it and I have practical suggestions and recommendations for her. I analyzed the pros and cons of fresh vs. frozen donor eggs for her. She eventually decided to go with a set of 6 eggs from a local program because the cost is lower. Bob and I offered to gift her a sum to cover a part of the cost but she graciously declined. She chose a first time Chinese donor who hadn’t started the cycle yet so there was a chance for Jeannie to get those 6 eggs fresh. To me, having fresh eggs to fertilize is better than thawing frozen eggs. It’s amazing that with her young donor, 4 out of 6 eggs fertilized normally, and three became blastocysts. Out of the three blastocysts, two were normal. I can’t help but be very happy and relieved for my cousin. We had 18 (out of 23) mature eggs, 17 fertilized, and we had 6 blastocyst at the end. Four were normal. So compared to our stats, my cousin’s donor eggs did fabulously. Jeannie just had a transfer of a 512 (5AB) embryo a bit over a week ago. Her beta was last Friday, which was 7 days past 5 day transfer. I don’t know about you. I find it a bit odd that beta was so early for her. But no worries, as she got positive results for the first time in her life! Her hCG was 80, which was a fantastic number for an early beta. When I heard the news, I was so excited for her and at the same time emotional. I’m just so relieved that the first hurdle is over. Her second beta will be today some time. I can’t wait to see how it progresses and I can’t wait to see my cousin become a mother finally. I hope that this pregnancy will be smooth sailing from this point on.
Recently a college friend of mine who lives in Asia traveled to the Bay Area for a work-related trip. Since her schedule was so tight, the only time that worked for us to meet up was during my twins’ afternoon nap time 40 minutes away at a coffee shop. During our phone call to plan for a meet up, she asked, sort of innocently, “Do you have to bring the babies?” This kind of made me laugh. I have known my friend since we were 18. She and her sister were both very good friends with me in college. Their divorced parents had a volatile relationship so my friend never believed in marriage. She herself was married for a brief period of time (which was done secretly and was shocking to friends in our circle) and is now in a relationship with a woman. Her sister, on the other hand, got married early and now has two kids in elementary school. My mom found it super odd that my friend preferred to meet with me without the babies. She asked, “Won’t she want to see your babies?” Being familiar with my friend, I knew that she wouldn’t mind not meeting my babies at all since she has never been a baby/kid person and never would want offsprings of her own. On the other hand, her sister would have wanted to come and meet with my babies. We had such a great time chatting for about hour and a half. Our conversation naturally turned to our journey making these babies and the cost of it. She asked, “Is it worth it?” Her attitude was genuine without judgment. She really wanted to know as she’d never understand the desperation and emotions behind our decisions in the 5.5 years of waiting for these babies. To her, she has never remotely wanted to be a mother let alone in our 40s. She found it amazing that we were willing to raise little babies at this age and devote our time, energy, and our hard earned dollars on them for the next 18 to 20 years. She found it even more amazing that I didn’t get to share genes with these babies or carry them. I told her that it really doesn’t matter as I am no doubt their mother. She asked, “How about travels, comforts, and career?” I told her, “See, this is the beauty of the world.” There are so many different kinds of people wanting to do many different kinds of things. She can feel free to enjoy her time and freedom without offsprings. I had the freedom all of my life to do whatever she is doing now so I can feel free to spend all my resources on the babies that I had longed for all my life. Just like I don’t see anything wrong with her wanting to be childfree, I don’t see anything wrong with us trying so hard and devoting so many of our resources in having children. What’s the use of having a nice car or a bigger house without these kids? To each their own, yeah? It was a genuine and deep conversation and I am glad we had it. The funny thing was, when she messaged her sister the photo that we took together at the cafe, her sister’s first question was, “Where are the babies?” It really shows how some people care about kids and some don’t. And there is nothing wrong with it. Like I said, this is the beauty of the world.