MicroblogMondays: A Sort of Celebration

Last week I had a week off from therapy.  Before we ended our session the previous week, my therapist assigned me homework.  She noticed progress that I have made; changing some of the beliefs that I had for a long time, being able to let go of some of my fears.  She said that it is all worth celebrating. She wanted me to find a way to document this milestone.  It is some sort of a celebration to mark this point in my journey of becoming mentally and emotionally well.  She said it could be journaling, or going to a place that brings me peace.  It could even be another drawing that shows what I am learning or how I am growing.  It could be with or without Ursula, my inner critic.

Since I had two weeks to think about this, I decided to take my time in thinking about how to do it.  I eventually chose to draw it out.  It took one week to form an image in my head about what to draw.  Slowly but surely, a picture emerged in my mind and continued to take shape throughout the week.  I sat down after the kids went down for the night on Saturday and went to work. I got to say I thoroughly enjoyed this process and thought that maybe I should really pick up my coloring pencils and markers more frequently.  This is the finished product:

This is me and Ursula sitting outside of a cafe having a cup of coffee, a piece of pastry, and reading our own books quietly. I love coffee and I love books.  My inner critic and I are peacefully enjoying a quiet afternoon together doing something I love.  We don’t necessarily have to talk but it feels like we have a mutual understanding, like old friends.  This is how I feel, that I don’t have to fight what my inner critic is telling me.  I can still thank her for telling me things that I have to pay attention to and have a peaceful talk with her about how to approach these subjects.  This is how I feel lately, being able to have a dialogue with my inner critic in a healthy way.  I can’t wait to show my therapist this picture and see what she has to say.

MicroblogMondays: Inner Critic

My therapist told me that everybody has an inner critic.  This inner critic tells us things that we may not want to hear, like “You are an inadequate mother” or “You should have done better”.  You may want your inner critic to be gone but he/she is here to stay.  My therapist asked me to create an image for this inner critic, give her a name, and even think about what she may look like.  She wants me to befriend my inner critic because that will help with working on my anxiety.  She also asked me to thank my inner critic in my gratitude meditation exercises so that I can move towards living peacefully with her.  I have named my inner critic “Ursula”.  A long time ago when I was still trying to make some embryos to transfer into myself, I had recurring ovarian cysts.  My dear friend Jane Allen named one of my cysts “Ursula”.  When my therapist asked for a name, the name “Ursula” immediately popped in my head.  Her assignment for me this week was to create an image for Ursula.  Since I like drawing (but haven’t even done any since the babies were born), I decided to draw her.  This is the final product:

Doesn’t she look like a mean school teacher?

It was fun for me to draw her.  Now I have an image to look at, I wonder how that is going to help me on my journey to live with inner peace and harmony.

MicroblogMondays: Deepest Fears

I cried during my therapy session last Friday.  It was a soul-cleansing cry that was so unexpected but at the same time so good for me.

My therapist and I have been working on finding the cause(s) of my panic attacks or anxiety symptoms, such as heart palpitations and lightheadedness.  She suggested a book for me to read.  In that book there is a tool called a Daily Mood Log.  I have been using the daily mood log to document any upsetting events, my emotions surrounding them, and my negative thoughts about them.  After I write them all down, I am supposed to come up with neutral thoughts that are true 100% of the time to replace the negative thoughts.  (Instead of positive thoughts as stated in the log, my therapist suggested neutral thoughts because positive thoughts are not always 100% true.) So the last few weeks I have been finishing up two to three of these logs each week in order to understand more about my thoughts and feelings.  I noticed that the first couple of weeks most of the mood logs were about Okra’s tantrums.  Since his extreme tantrums have dwindled down, I find myself focusing more on the aches and pains I feel on my body and my negative thoughts and feelings surrounding that.  It is almost like because I don’t have to focus on Okra anymore, I have more room in my head to look for something else to worry about.  Last week all of my anxiety or worries had to do with any physical symptoms that I felt: throat irritation, phlegm, blocked nostril, gum irritation, skin irritation, muscle pains.  My mind would go really far and I would wonder if I had cancer or COVID.  Especially now that the COVID numbers have gone up in the last few weeks and with the new variant showing up in my area, I find myself having anxious thoughts even going grocery shopping.  After going grocery shopping last Tuesday, I panicked for a few second wondering if I caught COVID afterwards.  The following were the negative thoughts I wrote down: “I have COVID despite being careful”, “It is easy to catch COVID even if I wear a mask”, “I will get COVID no matter what I do, “I will get COVID even just grocery shopping”, and “I will die of COVID”.  I am also supposed to write down how much I believe each thought.  For these thoughts, I wrote down a range between 50% to 70% for each.

In the book that my therapist recommended, the chapter after the daily mood log is called “Uncovering Your Self-Defeating Beliefs”.  These are beliefs that are either about what you believe you need to be or do in order to be a worthwhile human, or about what you believe your relationship with others need to be like.  In the book, it explained that your self-defeating beliefs are always present, but negative thoughts only come when you are upset.  You use what the author calls “Downward Arrow Technique” to ask yourself that if a negative thought were true, “Why would it be upsetting to me? What would it mean to me?”  Once you come up with another negative thought, you ask the same questions.  You repeat this process until you eventually come up with your self-defeating beliefs.  When I first read that chapter, I just started doing my daily mood logs and felt overwhelmed by this process of “Downward Arrow Technique”.  My therapist told me to just get myself familiar with writing my daily mood logs first and not to worry about the next step.  Last Friday during my session, my therapist and I went over my negative thoughts regarding COVID.  After we talked about them, she asked me if I was ready to talk about finding my self-defeating beliefs.  I was like, well okay let’s try it.  She told me to pick a negative thought.  So I picked this one:

“I will catch COVID despite being careful”

She asked, “If that were true, why would it be upsetting to you?”

The following are the negative thoughts that I came up with after asking that question repeatedly with the “Downward Arrow Technique”:

“I will get very sick”

“I will die”

“My kids won’t get the care that will get from me because I am dead”

“My kids will grow up without me”

“My kids will be miserable growing up without their mom”

“My kids will be miserable, unhappy adults, and not be able to life a fulfilling life without me being around”

……

When I got to that point, I started tearing up.  I tried to hold back my tears but the more I wanted to, the more I felt like crying.  I ended up sobbing uncontrollably for a few minutes.  Why?  I asked myself.  I felt this deep pain inside of me when I dug deeper and deeper into my fears: me being dead and not be able to watch my kids grow up.  I was ugly crying while trying to catch my breath so I could talk.  I was crying and talking and crying and talking.  I told my therapist that mortality had been on my mind because I really want to live to see my kids be adults and want to be with them every step of the way.  It is not that I don’t trust my husband.  I do.  I am sure that the children would grow up to be happy, healthy adults even without my presence.  BUT, I so want to be here to witness it and be an integral part of their lives.  The thought of not being around for that really pains me.  I told my therapist that this probably has everything to do with me bringing them into this world after all these years of infertility.  I feel a tremendous responsibility to be healthy and alive in order to take good care of the two human beings that I so desperately tried to bring into this world.  I tried so hard to have children early on but infertility happened and I was already 43 when they were born.  When they grow up, if I am still alive, I will be in my 60s.  I have this fear that I won’t live to see them get married and have kids.  It hurts my heart to even think about leaving them behind.  This is why every time I think about my health, I go into this deep fear of something really wrong with me.  I am afraid that my kids, who were conceived with the help of an egg donor, would grow up hating me for bringing them into this world without me being around to protect them.  I was so surprised by these tears.  I did not even know that I had these fears.  I wonder if I didn’t have any fertility challenges, if these kids were made with my own eggs, or if I had them in my 30s, I would still have these fears.

My therapist is so good.  She waited for me to cry and to finish my thoughts while looking at me with so much compassion and empathy.  She then said to me, “You must have been carrying a lot of pains all these years.”  She suggested that I be kind to myself and practice self love by writing myself a letter about all the fears that I have. She also suggested I write the grownup version of the kids a letter, telling them things that I want them to know if they were to grow up without their mom. Before we parted, she kindly said, “Take good care of yourself this week.”

After we ended our session, I just sat there and was in awe of all that was uncovered.  Therapy is powerful.  This tool is powerful.  I didn’t know that infertility and the pain associated with it still haunt me.  Now that we have uncovered my fears, maybe this is the light at the end of the tunnel for reducing and eventually eliminating my anxiety symptoms?  I sure hope so, but I know there is a lot of work ahead of me in order to reach that place of wellness.

MicroblogMondays: Therapy, Again

As mentioned last week, I got a list of therapists to contact in regards to my recent panic attacks.  The first person I wrote did not accept new patients.  The next person I contacted did not return my message until a couple of days later.  The third therapist on the list has a website that seems to focus on parent coaching, although I still wrote her with my details asking her if she sees adult clients with anxiety issues.  She returned my messages in a timely manner.  I am glad to find out that she does see adult clients and has been in practice for over 10 years.  After chatting with her on the phone for 15 minutes, I decided to give it a chance.  Originally she offered me choices of morning slots.  I asked for an afternoon time slot because of child care issues in the morning.  I am glad that she is able to accommodate me.  Our first session was last Friday.  I filled out a questionnaire the day prior and really had to think about all the questions.  One part of the questionnaire asked to check off if I had any of the symptoms or experiences in the last month.  Some of them are the obvious ones: anxiety and panic attacks.  Some required me to think twice about clicking, such a “fear”.  I only experienced fear when I was in the middle of my panic attacks, wondering if these symptoms indicated a health problem, especially a heart problem.  Same with difficulty concentrating or thinking.  This happened only during my panic attacks.  But I did ultimately click on all the ones that I hesitated about.  I was so used to seeing my previous therapist in person that it was quite an interesting experience to do therapy online.  Since Bob has lunch late in the afternoon, I wanted more privacy so I placed a little table and chair in our bedroom in front of the window and logged on early to wait for my new therapist.  She was super punctual herself.  She spent a few minutes to go over the items on the agreement.  After that, we went right into what had been going on with me.  She also asked for clarifications on the items that I clicked on the intake form.  After all of that, we had probably 8 minutes to go over strategies.  Her impression of me was that I am quite in tune with my own feelings and sensations, which is a plus in my journey to learn how to cope with/alleviate/prevent these panic attacks.  She went over a little bit of how the brain works: the fast brain, which is the amygdala vs. the slow brain, which is the prefrontal cortex.  She explained that when the lid on the amygdala is blown off, or when I experience the emotions that require me to fight-or-flight, the slow brain, or the logical/reasoning brain takes time to tell my fast brain to calm back down.  She said that many of the things that I do already are the things that she’d usually suggest people to do: breathing exercises, yoga, journaling, etc.  She told me to continue to do breathing exercises, and do them during my calm time repeatedly so that if I experience another episode of panic attack, I will go to my breathing practice more readily.  The one practice that she recommends is 3, 4, 5, which is to breathe in while counting 3, hold for 4, and breathe out while counting 5.  She also recommends a book to me that she said has been helpful to many of her clients.  It is called “When Panic Attacks”.  I just received it in the mail yesterday so I will start reading it.  She and I will talk about the strategies in the book next week when we have our session.  A couple of days ago I had an experience that resembled another panic attack.  This time the duration was shorter, and I was able to use the 3,4, 5 breathing exercise to ease myself back into my usual calm self.  These attacks come out of the blue.  I can’t wait for them to just disappear all together.  I know that there is some work ahead of me to make them go away.  I hope that my therapist and I can work well together to achieve just that.

MicroblogMondays: Complex Emotions

Microblog_Mondays

Ever since we started this surrogacy journey, I have experienced a whole gamut of emotions.

Of course there are the positive emotions, such as hopefulness, excitement, and gratitude that a person such as my gestational carrier has such compassion for us that she is willing to go through pregnancy for another person.  This is sometimes too profound of a concept for me to fathom and to grasp.

Every single stage of the journey also invokes fear, worry, and anxiety, such as our donor’s egg retrieval, fertilization rate, number of embryos remaining, potential weather issues, thawing of the embryos, the transfer itself, waiting for beta, and waiting for ultrasound.

And then there is this deeper emotion of joy that is much greater than the temporary feeling of happiness.  This joy that comes from witnessing the miracle of life that is growing inside of our gestational carrier and from the hope and the promising future of our children being born into this world and meeting us face-to-face.

What surprised me was the sense of loss that I felt during our epic first ultrasound while experiencing this tremendous joy of seeing the two heartbeats that were flickering on the screen.  I didn’t know that those two complex emotions could exist in the same moment, but they did, because I experienced them.

Seeing those two heartbeats was one of the most exhilarating and monumental moments in my life.  The tears that were shed were definitely tears of joy.  However, seeing Annie’s name on the screen and the ultrasound photos brought me back to the reality of what my body will likely not ever be able to accomplish.  It was supposed to be my name and my date of birth printed on the photos.  If I could have my way, it was also supposed to be my eggs, my uterus, and my pregnancy five years ago.  While being super excited and joyful and amazed, I was at the same time tremendously sad.

But I believe that God’s plan for us is perfect in every way and His ways are higher than our ways (Isaiah 55:8-9).  I believe that this is what needs to happen for us to have our babies.  And I fully embrace that.  But it does not mean that I will not continue to have a sense of loss that I have to grieve.  What I need to do is to continue to process my feelings with the help of my therapist.  And I did exactly that.

My visit to my therapist was highly emotionally charged.  It was just so exciting to be able to finally share good news with her after having to tell her heartbreaking news over and over again in the past two and a half years.  But at the same time, my biggest need was to process my grief and sadness with her.  I even cried when I was telling her that.  I knew that sadness and joy could exist simultaneously but it was reassuring for a professional to confirm it with me.  She told me that it is very common for intended mother to feel a sense of loss while expecting via a surrogate, especially when the surrogate starts to feel the baby or babies.  There is the loss of the sense of control because it is not my own body.  There is nothing wrong with these feelings.  It is just part of my reality.  I told her sometimes I don’t know how to feel.  And she said that it is okay to not know how to feel.  She said that as the pregnancy progresses, I may find myself feeling jealous, annoyed, or frustrated with Annie.  But at the same time, I would continue to feel grateful, joyful, and excited.  The key is to feel all that I need to feel and to tell myself that it is okay to do so.  She has heard enough from intended mothers about these feelings, but she kind of experienced it first hand when one of her best friends was expecting via surrogacy.  The second and third trimesters were kind of difficult for her friend.  And I am sure that it will be similar for me.  I don’t know if this sense of loss and the grief will ever completely go away but maybe it will diminish with the birth of the babies.

In terms of my fear that something bad may happen to the pregnancy, my therapist reminded me that I have lived in the unknown in the past few years.  Treat this the same way.  Embrace the unknown.  Whenever I find myself having these thoughts, ask myself if they are helpful.  If they are not, acknowledge them and then let go.  And if anything bad were to happen, I would be able to deal with it just like how I have been dealing with bad news in the past few years.

One interesting thing is that, ever since the news of us expecting twins, my attitude towards pregnant women has changed for the better.  It has been easier for me to chat with my pregnant coworker.  It has even been easier for me to accept pregnancy announcements.  It is quite eye-opening for myself to see the immediate change in my thoughts and feelings.  I know that the sting of infertility doesn’t totally go away, but it’s surprising for me to be able to feel more positive or at ease with other people’s pregnancy in such a short amount of time.

What I am trying to say is, our pregnancy is not always going to make us feel positive and excited.  There are also fear, worry, jealousy, sadness, and anxiety.  But having these feelings doesn’t mean that we are ungrateful about where we are now.  The reality is, we are human beings and have complicated emotions.  The key to maintain emotional health is to address these feelings rather than brushing them aside so that we are ready to welcome the babies in every way possible when the time comes.

Getting Used to This Space Of Uncertainty

My husband asked me last week, “Why don’t you schedule an appointment with S?”

S is my therapist.

My husband is lovely that way.  He knows what I need.  My therapist is my sounding board.  Whenever I encounter moments of struggles or difficult decision-making, a visit with her often clears my mind or untwines the knots in my overly analytical brain.

That was the day that I was feeling the most down and depressed. I inquired about a therapy session with her.  Unfortunately she was all booked at the times that were convenient to me.  Seeing her is important enough that I rearranged my work schedule so I could fit in a session in an early afternoon on a workday.

In the two years that she’s been my therapist,  this was the first time I sat down feeling like I didn’t know where to begin.  So much had happened since I last saw her.  I thought that things would be straight forward once we choose a donor and wait for a cycle to begin.  Nothing about this is straight forward.

It took the bulk of the session to fill her in about what had happened: finding the donor, questioning about the donor agency owner’s credibility, the misunderstanding of the donor’s availability, finally making a decision to book the donor, the change of FDA recommendation for travels for egg donors due to Zika virus, the growing fibroid, the cancellation of the biopsies for the endometrial receptivity array test, the possibility of needing an abdominal myomectomy to remove the fibroid, the timeline of the surgery (to avoid recovery while in-laws are in town), the possibility of delaying this cycle once again until September.  On and on and on.  I am tired just typing it out.

Bob and I do not create drama.  But it seems like drama comes to us.  This journey has not been straight forward for us.  The twists and turns sometimes make me wonder if this is God’s way of telling me to quit trying.

I had always been calm when I shared things with my therapist.  But this time, after I finished telling the whole story, tears finally came down.  I told her that I have been trying my best to cope, but still at times, I feel emotional and anxious.  I told her that I don’t like feeling anxious at all and I just wanted it to go away.

My therapist is wonderful.  She asked, “Why wouldn’t you cry?  It is highly emotional.”  She told me the following:

  • I am a very methodical person.  I analyze things in a very systematic way.  Of course it makes me anxious that things are not going the way I want them to go.  Overanalyzing things makes a person anxious because of a sense of lack of control.
  • Since having unknowns is my reality, she told me to learn to live in this space of uncertainty and to get used to it.  Accepting this will help me cope with my feelings and ease some anxiety because expecting it will make it less overwhelming for me.
  • She said that being in the midst of it, I might not see it, but sitting across from me she sees a very resilient person.  Looking at our past of handling twists and turns in life, we know that we can handle them.  She told me to expect more twists and turns on this journey and to know that we can handle whatever that comes our way.
  • She told me to not to worry about the donor right now.  Instead, focus my energy on healing my body from anything that could interfere with a pregnancy, such as the fibroid and the surgery.
  • She told me not to focus my mind on my timeline or to worry about milestones or my age.
  • Deep down I believe I will be a mother.  She told me to hold onto that, and not to forget to tell myself that I am doing everything I can to reach that goal.
  • When I have anxiety or worrying thoughts, ask myself if they are useful.  If not, acknowledge these thoughts and let them go.
  • People often look at signs to make sense of things.  Having twists and turns does not mean that I am not meant to be a mother.

At the end, she reminded me to take deep breaths, and that I am doing a great job with whatever that we are facing.

Emotional ups and downs are inevitable, but it brings me comfort to know my therapist is always there when I need help to sort through my feelings.

At least today, I feel that I can tackle anything that may come my way.  I will call that a win.

Wise Words

Last week, I had another session with my therapist to address my issues of having fears about the upcoming donor cycle, which I described in this post.  Prior to last week’s session, I naively thought that since I had accepted our path of using donor eggs as our means to hopefully have a baby, I wouldn’t need to talk to my therapist anymore.  Boy was I wrong.  I think that I will probably need to talk to her on a regular basis for a while.

What I described to her was what I wrote in the post.  I am scared.  I am scared that even egg donation won’t bring us our baby.  I am scared that I will fall into the other side of the stellar donor egg IVF statistics.  I have been basically operating on a mode of failure because that’s what I know and am familiar with.  I haven’t been able to get myself out of that mode.  I am still stuck at the phase of Isabelle’s-eggs-suck.  I know how to do infertility.  I don’t know how to anticipate success and pregnancy.

Well, I told my dear friend A. a few weeks ago how I felt.  What she told me is so so true, that I have to remind myself over and over again.  These are her wise words: “You’re conditioned for heartbreak.  It’s hard to think differently.  Just remember that you’re not playing the same game anymore.  New stadium, new sport entirely.  Look at it with fresh eyes.”  

Yes.  I am so used to bad news, heartbreak, being on the wrong side of stats.  It seems to be an impossible thing to imagine the outcome to be different this time.  But she’s right.  We are talking about eggs from a 24-year-old donor.  My eggs play no part in it anymore.  I really need a paradigm shift.

My therapist agrees with A.  She reminds me that this is a totally different ball game.  I have to consider the fact that we have chosen somebody who is young, so statistically, the chances of her eggs are normal are much higher.  Look at her donation history: pregnancy was achieved at both of her prior donations.  The chances of it working for me are so much higher than when I was using my own eggs.  She thinks that my fear may also stem from the lack of control.  When I was doing my own egg cycles, I had total control over the timing of injections, taking medications, being on time for monitoring appointments, and other aspects of the process.  I currently have no control over what our donor will or will not do.  I can only exercise my faith that she will have the integrity to follow through with everything.  I have no control over when the clinic can schedule her for what appointment.  My therapist told me to keep in mind that my clinic may not update me on the progress as much as I would like.  That will continue to play into my sense of lack of control.

Since those are the things I really can’t control, my therapist told me to focus on what I can control.  We all know from the operative hysteroscopy that my uterus looks good.  In fact, my surgeon said that there is no reason why I can’t get pregnant with such nice looking uterus and lining.  My very wise friend A. once compared the ovaries to uteruses.  She thinks that woman is fickle and complex, hard to read, hard to please, like ovaries.  To her, uterus is like a man, easy to treat and manipulate, resilient, reliable, and simple.  Both A. and my therapist reminded me that I should look at my situation like it’s brand new because my baggages and bad experiences have been brought on by my own eggs, which have been completely removed from the  current equation.  My own eggs do not play a role in the upcoming donor egg cycle.  All I can do is to make sure that I am taking good care of myself and my health and do everything in my power to make sure I follow my RE’s instructions to grow the best lining that I can.  

My therapist once again reminded me to do this: when I have these negative thoughts, ask myself if they are helpful to my situation.  If they are not helpful, acknowledge the thoughts and feelings then file them away.  Don’t think about them until my scheduled “worry time” at night.  So I have been asking myself that same question whenever I fear that the upcoming cycle won’t work: Is this thought helpful to my situation?  No?  Okay, then I won’t worry about it until 10pm tonight.  It has been helping.  Rather than constantly worrying about the what-ifs and things that may not ever happen, my mind has been mostly freed up during the day from these fears.

At the end of the session, my therapist reminded that I have something positive and beautiful happening in my life.  A new possibility that was not available to me in the past.  For such a positive thing, I should surround myself with positivity rather than negativity.

Very wise words.  Something to think about.  I feel very fortunate to have wise friends like A. and a wise therapist who truly understands this process of ups and downs during infertility.  I have been feeling much better ever since the last therapy session.  I am sure I will feel the struggles and have fear again.  The good thing is, wise friends and my therapist are going to be there when I need them. This thought is very assuring.

Therapy – Round Two Session Two

Session two with  my therapist was very productive, as usual.  She started out asking me how I had been feeling.  Honestly, I thought that I would be more sad than how I have been feeling.  I am very surprised that I can carry on my life like usual.  I don’t think I am being avoidant by brushing aside my feelings.  My therapist wondered if my calm feelings have to do with my mental and emotional preparation for egg donation since last July.  I have had so many months to get myself ready for it.  Now that the time has come, maybe the shock is not as great?  That may be the case.  I just know that I have been feeling good in general.  I am still not ready to contact the donor coordinator at my clinic.  I still have not written an email to donor agencies.  I haven’t even asked for our money back from the clinic.  I am not ready for these steps yet, but I feel good in general.  My therapist did mention that some women may feel periodic sadness during the egg donation process because it would start to feel real.  I will wait to see if that is true in my case.

I still feel a need to be distant from Chloe, my friends who said some hurtful things to me.  When Bob and I talked about plans for the summer, driving up north to visit with her and her family was one of the options.  After our little incident, I am not ready to see her.  Hence we decided to go to Chicago instead.  I told my therapist that I really don’t want to risk being there with Chloe in the middle of a egg donation cycle.  I don’t want to hear anything negative about what I am going through, although I believe that she’ll be very careful from now on when she talks to me about my fertility journey.  I just don’t feel like taking a risk.  My therapist told me that it’s okay to guard my heart and protect myself.  I somehow feel a little guilty for not going to see my friend, but then I really feel the need to take care of myself.

My biggest question right now is how to go about choosing a donor.  Given the few choices at our current clinic, do I have to venture out and check out donors at agencies?  One night Bob and I were lying in bed looking at all the choices at my clinic.  Now that he has to pay for the cycle for real, he is vetoing all the choices.  I don’t know if he’s joking or not.  But he has his criteria.  At the same time, he also brought up doing what Aramis did, which is to cycle at the Czech Republic, purely for the more affordable cost.  The only problem is that, it’s going to be even harder to find an Asian donor all the way in  Europe.  That would leave us with non-Asian donors as an option.  I actually thought really long and hard about it.  We not only have to think for ourselves and our lives, but also our future child’s life.  We are accountable for creating his/her story.  One day, we are responsible for telling our future child how and why we chose our donor.  I do not want to tell the child that the only reason why we chose to find a donor in an European country is because of its low cost, especially when we have the financial means to cycle here in the US.  It’s another story if we don’t have enough funds for that.  I am really mindful of the impact our choice has on our future child.  So I am going to try in all my power to decide on someone who has some connection to my ethnic background.

My therapist gave me some good points to think about.  She asked me to whom I feel the most connected out of the three potential donors.  Setting aside how “Chinese” these donors are, I feel the most connected with a first-time donor who is currently cycling.  I like her looks, her age, and her educational background.  The most important thing is that I love how she answered her questions in her profile.  Her responses are so thoughtful.  I want to be able to tell my child in the future the specific reasons I chose a particular donor.  I want to be able to say what I loved about her.  Of course I know that not every single donor would work out but I want to let the child know that we take this selection process very seriously and it has been done with love.  My therapist said that this is exactly how she wants me to start thinking about it: the reasons why we want to choose a particular donor.  She wants me to be able to tell my future child the story of choosing a donor with confidence and the particular quality that we find appealing about the donor.

My therapist asked me to think about how I usually make my decisions in life: with many choices, or a few choices.  Thinking back, we usually had three to five choices when we tried to decide on a fertility clinic both the first four rounds and the last four rounds.  Any more than that, it just felt too complicated and dizzying for me to process all the information.  If that’s my pattern, then my therapist thinks that having three potential donors to think about is a very good first step.  She said that some people bring in a whole spreadsheet of donor choices to show her.  To her, that will make it even harder to make a choice because the information of different people may get mixed together.  I am not someone who would create Excel spreadsheets for choosing a clinic or a donor, although there is nothing wrong with that if it’s your style.  So I will stick with the three potential donors that I have right now.  My therapist told me to continue to use my own intuition as I am quite in tune with my feelings.  She said I would know if I want to venture out to find more choices.

We also talked about transferring one vs. two embryos in the future.  I feel strongly about avoiding carrying twins because of the higher chance of premature birth and complications for both mom and babies.  I would rather do eSET repeatedly until we get pregnant.  Although Bob really wants twins and supports transferring two embryos, my therapist told me that it’s perfectly fine for me to be firm on my stance because I will be the one carrying the child.  I am afraid of the chance of an embryo splitting into two.  A single embryo transfer is the safest way to go.

Finally, we discussed about my fight with Bob the previous weekend.  I forgot what exactly we were fighting about.  But it seems like every fight comes back to the struggles of infertility.  Bob is still trying to resolve his feelings regarding the failed cycle and all the time and money that we have spent cycling with my own eggs.  During the fight, he asked why we did not consider adoption or egg donation sooner.  It sounded to me that in that moment, he regretted spending time and effort on these own egg cycles rather than focusing our energy on the other means to get us a baby.  I don’t think he truly regrets it.  But he has been angry with not being able to have a baby and it’s natural to think back and wonder about all the what-ifs and what-could-have-beens.  I do not regret a single thing that we did.  I reminded him that we made the best decision given the information that we had in the moment.  I would not change a thing about the past.  It was the past that brought us to this moment.  We prayed and we had peace about every single step.  I believe that we’re led down a path that will eventually guide us to our baby.  However, it was tough to emphasize on this point when he was angry.  My therapist said that it seems like Bob just wants a sense of control, because this process does not provide him (or anyone) with any control of the situation.  This is why he finds comfort in striving to reach our financial goals, because they give him back the control that he can’t have with the reproductive process.  However, it’s not good to have regrets.  So it’s important for him to work on getting over these feelings.  In terms of what means we use to have a baby, my therapist said that she usually asks if carrying a baby is important to the couple.  If it is, she would suggest egg donation or embryo adoption.  If it’s not, the adoption would be a logical choice.  I have been feeling strongly from day one about two things: being able to be pregnant and carry to term and having at least the genetic links to my husband.  Since these things are so important to me, egg donation is the logical choice for me.  Then we should focus our energy on grieving the loss of my genetic links and our effort on pursuing egg donation.  I know that Bob has the fear of failed cycles after spending all the money on egg donation.  We have to have faith in God for carrying out His plans, whatever they may be.  A couple of days after the fight, I asked him how he felt about egg donation, he said that of course we would proceed with it when we are ready.  So we are still on the same page about the next step.

At the end of the session, I felt a lot better about my ability to navigate the world of egg donation in the very near future when I am ready.  I also felt that it might be beneficial for Bob to come to a session once with me so that we could both talk about our feelings.  Unfortunately, my therapist is about to go on maternity leave and doesn’t have any early evening time for us.  She gave me the names of a few therapists in town that also specialize in infertility.  I am sure I will seek help if I need it.  But I’d rather not go with Bob to see these new people as they don’t really know me.  I do feel equipped to move forward when the time comes.  I just have to wait for the right moment.  I hope that moment comes soon.

“Keep Doing What You Have Been Doing”

Although I hadn’t been feeling too sad, I was looking forward to seeing my therapist.  My three sessions with her last year were so beneficial to me for sorting out my thoughts and feelings.  I was hoping that I could get a few sessions in before her maternity leave.

I arrived early as usual.  Knowing that she is eight months pregnant, I wasn’t worried about my reaction to seeing her bump.  I have to say that she did not look like she was about to give birth.  She seemed to be very mindful of her choice of clothes as her sweater was big and did not hug her body.  My pregnant coworker who wears tight fitting clothes probably shows her bump more than my therapist does.  I commented on how great my therapist looked at this late stage of her pregnancy and asked how she was doing.  She said she was getting a little bit tired but overall had no complaints.

Once we sat down, she said that it was great to see me but she was sorry that it was under these circumstances.  The first 30 minutes were devoted to telling her about all that had happened in the past eight months since I last saw her.  The last time we saw her, we had not even started with U.CSF yet.  And I bet she wasn’t even pregnant with IVF yet.  It really had been a long time.  I updated her on the following:

  • First cycle in August was canceled because of a cyst
  • First cycle take two in September went well with four eggs, three fertilized eggs, and three embryos to freeze on day two
  • Second cycle in October with our surprise eggs from two little follicles so three eggs turned into two fertilized eggs, and then turned into two four-cell grade one embryos
  • Third cycle in November was long drawn out due to lack of response to Clo.mid and a subsequent natural IVF cycle yielded two follicles, one egg, and none fertilized
  • Intended fourth cycle could not take off due to lab closure for the holidays
  • Intended fourth cycle still could not take off in January due to a cyst, decided to move on with the cycle anyways, ovulated before cycle day eight, tried to grow follicles in the luteal phase, eventually follicles shrank, bled three times and ovulated twice in 23 days.  My body was screaming “GIVE ME A BREAK”
  • Finally fourth cycle started in February, unfortunately with a cyst again.  Still decided to move forward with natural IVF without medications.  Grew two follicles on my own.  Despite Gani.relix to hold off ovulation, ovulated prior to egg retrieval.  Still tried to retrieve but there was no eggs. Converted to IUI with 20 million sperm post wash.  Transferred all five embryos due to lab error of thawing more than we wanted.  Negative beta.
  • Met with Dr. No Nonsense to discuss egg donation

As I recounted all the details to her, I was a little choked up.  I didn’t cry as I didn’t feel like it.  However, I was a little emotional.  We went through a lot as a couple.  Since the very first cycle with Dr. E until the last cycle with Dr. No Nonsense, we have always had to make many last minute decisions that could alter the outcome of each cycle, hence the pregnancy outcome.  Through all the ups and downs of this roller coaster ride, my heart is set on not spending more time and energy on my own eggs.  I feel very strongly about that.  I really cannot bring myself to go to a monitoring ultrasound to check my antral follicles, to take any oral meds or do injections to boost follicle growth, and to wait and hope that I haven’t ovulated prematurely/we get eggs/the eggs fertilize/the eggs continue dividing/we have embryos to transfer.  I really cannot go through with this process again.  However at the same time, I still feel sad that other people achieve what we can’t.  I see other ladies with diminished ovarian reserve who have better cycles than we do and they miraculously get pregnant.  I fall into that trap of wondering “why them and why not me?”  Despite these feelings of inadequacy, my quest to have a baby with my own eggs has ended.  This is a very personal decision.  I am sure that many women in my situation would choose to try a few more cycles.  However, to me, doing fertility treatment with my own eggs for eight cycles is enough to tell me that it is time to move on to the next chapter.

And I am very grateful that my therapist is there to help me sort through these thoughts and feelings.

I told her all the things that I have been feeling and all the things that I have been doing to help myself feel better.  I cry when I am sad.  I talk to people.  I take time off when I need to.  I told her the whole thing with my pregnant coworker as well as my out-of-town friend who said mean things to me.  My therapist gasped and agreed that my friend’s statements were hurtful and insensitive.  She told me that it’s important to set healthy boundaries with people, including pregnant coworker and this friend.  I told her that I am feeling okay.  This time it feels so different from last year.  We have a plan.  I have been mentally preparing myself for egg donation since last July. So it feels like I have had a lot of time to digest the possibility.  I also firmly believe that my emotional stability has to do with all the prayers that we have received since the beginning of our journey with U.CSF.  God really has watched over us and been with us every step of the way these many months.

I told her that I am still not ready to write to the U.CSF donor coordinator or to contact any donor agencies yet.  I haven’t even written the billing lady at the clinic regarding our refund for all the procedures that we didn’t do (no eggs, no culture, no ICSI).  I am simply not ready.  She told me that it’s totally okay to take time for myself to be ready for the next step.

We discussed a little bit about choosing a donor.  My husband and I finally looked at the in-house donors again.  We used to joke about having donor 1 or donor 2 as our donor.  And now that we really have to pay big money to find someone, Bob all of a sudden becomes picky.  My criteria come down to proven fertility and decent person with decent height.  Bob seems to have a longer list of his wants.  There is a full Asian donor (half Chinese) who is really young (21) and had four donations that resulted in four pregnancies.  I think she could be a good choice, but Bob has reservation because she did not go to college. She is so young though.  You just don’t know what she’ll do in the future.  Anyways, Bob vetoed almost everyone on the list and wanted me to consult with donor agencies.  My therapist told me that my choices and Bob’s choices will be very different because women usually value proven fertility more, and men just want to find someone who is like their wife.  So we will eventually have to come to a mid point.  Nobody is perfect, but we will really have to be comfortable with our choice.  The therapist thinks that I am very in tune with my feelings.  So she is confident that I will come to a choice with whom I am comfortable.  She also told me to consider my feelings around my future child(ren) having half siblings running around due to the donor’s successful history.  I haven’t really thought about that, so I’ll have to give it some thoughts.

At the end of the session, my therapist asked me about the timeline, i.e. when we’re looking into doing a DEIVF cycle.  I said three to five months.  She was relieved to hear that.  She said she was worried that I would say next month, because she thinks that I will still need some time to grieve and have closure for the loss of my genetic links to my future child(ren).  And then she told me this:

“Just keep doing what you have been doing.  I am here to help you.”

I come out of the session feeling empowered.  Life is full of possibilities again.  And I get to talk to her again next Wednesday.

I am grateful for that.

Strong and Resilient (Getting on the Egg Donation Wait List)

Yesterday was our meeting with the staff psychologist at our current clinic.  Back in December, I met up with the donor ovum coordinator to discuss about the cost and the process of fresh and frozen egg donation at UCSF.  Since I am fully Chinese, in order to be on a wait list for an Asian donor, and a Chinese donor in particular, we would need to meet with this psychologist to discuss about topics surrounding ovum donation before we could get on the egg donor wait list.  We originally made the appointment for early January.  After discussion of the timing of my potential transfer and beta in January (not knowing that we would actually have road bumps along the way that prevented us from moving forward with a transfer), we postponed the appointment to February 6th.  However, due to “scheduling conflict” of the clinic, we were again rescheduled for February 20, which was yesterday.  Since we haven’t done our transfer yet, and hence do not know if we’ll have to pursue donor egg cycles, everything that we discussed yesterday was hypothetical.

Our clinic has partially moved to the newly built location.  I am not used to going there because our cycles are still handled at the original location, which is three blocks away from my work.  In order to go to the new location for the appointment, I had to drive to a mid-point to pick up Bob who traveled from his downtown office.  Then we drove another 15 minutes to the new location.  I remember when I was there last time I parked at one of the few non-metered parking spots.  We lucked out again as we found a street parking space.

We arrived on time (Thanks to Bob for being on time!).  I anticipated to be asked to pay the fees that I was told we’d have to pay.  I already asked Bob to get his HSA card ready.  However, nobody asked us to pay up.  I don’t know what the deal is but I am happy that we don’t have to pay.

The psychologist came out to lead us to her office in the back.  The hallway was filled with rooms and felt like a maze.  When we entered her office, I first noticed children’s books displayed on the window sill that are written for the purpose of sharing with children about egg donation.  The psychologist invited us to describe in our own words our journey so far, although she had already read our clinic file.

I went ahead and told her our history.  An abbreviated version.  From three years ago.  Trying naturally to IVF treatments to our loss exactly one year ago (to the date of the appointment; creepy).  And fast forward to our current state of waiting to transfer our embryos.  Interestingly, I thought I would get emotional, but I didn’t.  I just reported on our history matter-of-factly.

The psychologist asked me when I started thinking about egg donation.  That was easy.  It was back in July last year after one of the doctors with whom I consulted suggested it due to my poor responses.  I started doing research and considering the possibility of it.  We seriously discussed about it and also began our process to save up for that goal.  I told her that I am ready to go for egg donation if our own-egg cycles fail.  Some of my friends who also have diminished ovarian reserve feel that they don’t want to pursue egg donation because they may be jealous of their husbands or partners for their sole genetic connection with the child.  I told her that I am the opposite.  I actually crave that genetic links that the child will have with at least one of us.  This is why I would like to pursue egg donation before we consider embryo adoption.

She turned to Bob and asked how he feels about egg donation.  When he responded that he was “open to it”, I almost burst out laughing.  My husband has been more than ready.  He has even been more ready than I have.  He sometimes gets frustrated with the waiting (for the cysts to go away, for my cycle to regulate itself) and suggests that maybe we should just go directly to egg donation.  So it’s funny to hear him say that he was “open” to it.  My husband actually is also very open to embryo adoption or  traditional adoption.  I am confident that he will love any baby that God puts in our family.

She asked us to tell her our concerns, if any, for egg donation.  I talked about a few things.  I am actually not concerned if I will bond with the baby or if I would feel that the baby doesn’t belong to me.  I feel that once I get pregnant with the baby, I am going to know that I will be the baby’s mother.  I am more concerned about disclosing our choice of egg donation to others around us as well as to the child.  I have been quite open about our fertility struggles especially with friends and family who would pray for us.  I crave prayers from them and I am thankful that they are willing to intercede for us.  However, when it comes to making a baby with donor gamete, I suddenly feel the burden and the confusion of how much and with whom to share, since it does not only involve the two of us, but also a third person, namely the baby.

The psychologist spent quite a long time discussing this topic.  She actually recommends disclosing to the child as early as possible.  How she puts it is that it is never “too early”, but it could be “too late”.  Studies find that children who find out about the facts of their birth in their teenage years may feel hurt, betrayed, and confused.  If parents start talking to toddlers early on about how they came to the world, it will show them that it’s not something treated secretively and has always been part of the story of the family.  Parents can put it very simply that a nice lady helped create the family.  They can use children’s books to talk about it.  And they can continue the dialogue with the child as he/she grows up.  As for disclosing to other people, the psychologist said that it is good to share with a set of close friends and family so that the support is there.  They can also choose to share with a larger group of people if they are comfortable.  One point that stood out to me is that she said that having a child via donor ovum is only a part of the family’s story and does not define the family.  You can talk to friends and family about it, but it doesn’t have to be something that is brought up over and over again.

Bob then went ahead and talked about his family.  As you may know, his parents are traditional Hindu and were opposed to our marriage.  They were against us getting married because 1) they wanted to arrange a marriage for him with an Indian girl from the same caste who is a few years younger, 2) they dislike the fact that I am 3.5 years older and anticipate us to have a hard time making a baby, and 3) I am Chinese.  Because of the anticipated judgment that would come from them regarding my diminished fertility, Bob has not mentioned to them anything about our struggles or treatment in the past three years.  He mentioned to the psychologist that he will eventually tell his parents if we do succeed in making a baby with donor gamete.  He joked that maybe he would need to use the same kind of simple language that he would with a child: there is a nice lady who helped us expand our family.

We don’t have to worry about my side of the family as my parents and brother and sister-in-law are all supportive of our decisions.  As a matter of fact, my mother once said that she would love our baby all the same even if we had to go with a Caucasian donor in the Czech Republic.  I am lucky that my Chinese mother is so supportive.

My other concerns about egg donation are mainly about finding the right donor, the fear of interruptions with the cycle once a donor is chosen, the fear of a failed cycle as we only have limited funds, and the choice between fresh cycles vs. donor cycles as influenced by our desire to have more than one child.

The psychologist thinks that finding a Chinese donor is more difficult than finding a Caucasian but it is not insurmountable.  If we can’t find one that we like, we can always go with an agency donor.  She suggested two agencies that have successfully matched Chinese or Asian donors for patients.  We should discuss among ourselves about what traits we most want to see in a donor.  We may find that we may be fine with a donor that is mixed with some Chinese.  Then we’ll have more choices that way.  A donor that shares a little bit of my cultural heritage but has many of our desirable traits may be better than a fully Chinese donor whose strength is just that, fully Chinese.  It’s a very personal choice.  So we’ll have to go home and talk about what we both want.

As for the concerns of failed cycles, she reassured me that although there is never any guarantee of a successful cycle, the chances of getting pregnant are so much higher with donor eggs than not.  There are two reasons that I want to use a donor from the clinic’s in-house pool: the in-house donors have gone through a strict process of testing before they were put on the database and it costs less money to use an in-house donor as opposed to paying a fee to an agency.  One of the fears I have is that we’d be out agency fees if the donor doesn’t work out at any stage of the donation.  Many first-time agency donors have not gotten tested before they are chosen by intended parents and the risk of something going wrong is higher.  The psychologist agreed with me that she also feels more comfortable with in-house donors for the exact same reason, that only the ones who meet strict guidelines get into the program.  However, she said that this problem can easily be overcome by using a proven agency donor who has already gone through the process and knows the ins and outs of egg donation.  She feels that the agency fee is only a little bit more than using an in-house donor.  It’s worth considering.

I told her that we discussed about doing fresh cycles rather than frozen cycles because we desire to have more than one child.  However, Bob always said that since this process has been so long and difficult, we may just want to aim at having one child and be done.  How does one choose fresh vs. frozen as the difference in the cost of them is so huge?  The psychologist said that there are too many factors going into choosing a donor.  We should go with the first donor that we like.  If it’s a donor with frozen eggs, we should go with her.  If it’s a donor who only offers fresh cycles, then we should go for that.

The psychologist advised against looking at any more donor profiles online.  Since we’re still pursuing my own eggs, we run the risk of being attached to a particular donor who may or may not be available if/when we are ready for egg donation.  And there may be more available donors that would suit our criteria if/when we are ready.  She also suggested that if/when we fail at our own egg attempt, we should take some time to sit and let it sink in rather than moving onto egg donation the very next moment.  This process provides a closure to a chapter of our fertility journey.  It may take one day.  It may take a few days.  It may take a couple of months.  Whatever length it may be, it is always good to reflect on this process and agree that “we are done” before moving onto the next thing.

We are automatically put on the in-house wait list yesterday since we completed the appointment.  I wrote an email to the donor coordinator today to confirm that it is the case.  The coordinator with whom I met in December is no longer working there.  So I needed to confirm with this new coordinator that I could backdate my priority to August 2014 as I was told during the December meeting since we started cycling there in August.  I guess there is not much we need to do until we are ready for egg donation.  Then we’ll email the donor coordinator our interest in a particular donor and see how long the wait may be.

The whole meeting took about 45 minutes.  When the psychologist walked us out, she told us that it was very nice to meet us.  She thought that we were a very strong and resilient couple.  She was confident that we would make great parents.  Bob said that maybe she was just being nice to us, but I do think that this journey has really made us a stronger unit.  It was very nice to hear from a mental health professional that she thought that we would make good parents.  On our way out, she gave us a fact sheet labeled “Talking with Children about Ovum Donation” by the American Fertility Association.  It will be an interesting and useful read for the future.

So now we wait.  Wait for our cycle to take off.  Wait for the lining to be good.  Wait for the transfer to be done.  Wait for the beta to be positive.

May the advice and information we learned in this meeting  be something not at all needed in the future.

Hopefully we’ll find out in three weeks.