Chapter 11: Square One

It had taken us five years to find our son, I’d prefer it take less time to find our next child. I had agreed to try IVF after we adopted, so we went all in. We met with our fertility doctor and she started us out with IUI’s (IntraUterine Insemination). This is the fun part for Justin, because he gets to give the clinic sperm samples before each insemination. We tried this three times. Added hormones, went on a special diet. No success. I guess we ARE doing IVF. This included about a dozen more blood tests, uterine tests, sperm tests, test, test, test, test. All clear. We are a normal fertile couple. Says science. Before the day came to start the added drugs for IVF, the specialist ordered one more blood test. This test finally showed what was causing our infertility. THANK GOD! Yes, I was relieved. I finally had an answer. It wasn’t my diet. It wasn’t my lifestyle. I wasn’t too fat. I wasn’t too skinny. I wasn’t gluten/dairy/soy/meat intolerant. Being “relaxed” wasn’t going to make a difference. While not completely infertile, scientifically, our chances of getting pregnant was significantly lower -- not zero, but close. 

What I have is a rare chromosomal disorder called Balanced Translocation. Basically, of my 23 pairs of chromosomes, two of them are a little wonky. This could have been inherited or it could have started with me in utero.

Time for a review of 9th grade biology: I have Balanced Translocation of Chromosomes 3 and 4 which means a little material from chromosome pair number 3 leaked into chromosome pair 4 and vice versa. When an egg is fertilized genetic material is taken from both parents -- one chromosome of the pair from me, and one from Justin. So with Balanced Translocation, there are four possible scenarios: I could give the normal one from pair 3, and the normal one from pair 4 -- this along with Justin's two normal one would result in a child with no balanced translocation; I could give the translocated one from both pairs which would result in a child with the same balanced translocation as me; I could give the translocated one from pair 3, but the normal one from pair 4 or vice versa -- these two scenarios would either result in either the egg not being fertilized or an embryo that results in a miscarriage. So you might be thinking that this results in a 50% less chance of getting pregnant (or staying pregnant), but our doc explained that the data shows a 75% reduction in our chances.

So while couples our age had a 25% chance of getting pregnant each month on a natural cycle, our chances were about 6%. Since my age at the time was 33, I was getting closer and closer to that age where fertility automatically drops again. Even with IVF, our chances of retrieving even one viable embryo was about 25% whereas “typical” families dealing with IVF get two to three embryos (obviously varying based on their infertility reason). Now, if we were able to get one genetically tested healthy embryo, our chances of pregnancy and birth were around 85%. That’s a lot of numbers, but all I saw was 25%. That’s a lot of chance for failure. Not to mention to cost of all of this. The cost of what we had already put in and the cost of our future adoption, if that ever came to fruition.

I’m not much of a gambler, but to my husband he saw a chance. I saw likely failure. The way I saw it, the odds we could see were stacked against us. Who knows what other underlying issues we may have. We had only done about half of the millions of fertility tests even available. Our fertility costs were a constant burden, financially and emotionally. We could at least agree on one thing: we wanted more children. 

My vote was for the route of adoption again. Justin was less than thrilled. He was fearful of the potential heartache with meeting a child and potentially losing a child like had happened in the past; he was worried about having another forced complex relationship; he was worried about having two siblings use their respective birth parents as ammunition in normal sibling rivalry. The list went on and on, but in my mind, miscarriage was still worse. At least with adoption we would be dealing with the issues together, whereas with fertility treatments I felt that I would be suffering alone. I would be the one taking all the hormones which included several shots a day for months at a time. I was the one who would be worried about every drop of blood that would show up in my underwear. I was the one who would Google every potential ache and pain and try to assess what it means. Who knows the emotional toll it will take on me personally and our marriage. 

We spent about a month talking about our options, when I started looking into a newer method to adopt: Embryo adoption. The cost was significantly less and the pregnancy rate was about 40% -- which is higher than the 25% we were given with IVF; we wouldn’t have to go through the six month legal process; we wouldn’t need to manage a complex relationship; and siblings are going to be siblings regardless. Did it matter to us that we had a biological child? To Justin, I believe it did. To me, it did not. Another child is what we wanted. A family is what we wanted. We wanted a sibling for our son. So Justin agreed to embryo adoption. 

We went through a national agency that helped families adopt “snowflakes” (frozen embryos). The summer our son turned two, we had planned to transfer our adopted snowflake embryos. We received four embryos from a family in Maryland. The embryos were over 10 years old and frozen solid. It’s crazy to think that our potential child's’ first ten years were spent in a clinical freezer. How would we explain this to them? Either way, I was excited to start the process and potentially become pregnant. At the time, Justin was frequently traveling to Maryland for work. He contacted our adoption agency and asked if the donating family would want to meet with him. The donating family agreed! So he got to have dinner with our future child's biological family. We were pretty excited that we could have a semi-open relationship with this future child's biological family, including their two full biological siblings. 

First we transferred two embryos, waited on pins and needles for two weeks to see if they took, my pregnancy test came back “barely positive.” After another blood test two days later, it was found I was not in fact pregnant. But I was excited to know that even for a moment, I was pregnant. It was the most pregnant I had ever been. We transferred the second pair of embryos a few months later, same result. Almost pregnant, not really pregnant, definitely not pregnant. 

Back to square one. 

The snowflake agency we went with offered a sort of “insurance policy” where the cost was significantly less to be matched with another family. The first match was so quick and painless, I wasn’t worried, but maybe I should have been. After six months of sifting through potential matches, nothing was fitting. I started pushing Justin toward domestic infant adoption again, but he was adamant on staying the course. Something I wasn’t so good at and something my “Type A” husband was exceptionally good at. 

I asked our embryo adoption agency if we could get on their domestic adoption list as well. Their policy was a solid NO. They didn’t want us getting a domestic adoption placement while also having four embryos on ice waiting for us. They didn’t want us to get in over our heads. The way I saw it was, I need to build my family in any way possible, so I toed the line and called another agency. We were able to get on the adoption list of a different local adoption agency while also staying on the embryo adoption list with very little extra funds required. Neither agency knowing about the other. This is family planning in the infertility world -- I don’t get to accidentally get pregnant. I have to make intentional plans for my children to come to fruition. I’d like to build my family before I turn 50 if at all possible. At the rate of one child per five years of trying, it will take another 15 years. 

Quick Sidenote: While I had been told by well meaning friends and family that adopting a child will likely increase my fertility because then I would “just relax,” that was not in fact my reality. I do know couples this has happened to, but this is in no way the majority, and is purely anecdotal -- there is no evidence to support this notion. So please stop telling your infertile friends to adopt so they can get pregnant. In fact, you are only allowed say, “I’m sorry you have to go through this, let me know how I can be there for you,” and hug your infertile friends. That is the extent of the advice they need. They have Google and they probably have a damn good doctor, so keep your anecdotal opinions to yourself. Seriously. 

Now we were receiving embryo situations and domestic infant adoption situations. All of which just didn’t fit. It’s not like we were being super strict with our choices either. One embryo situation came up: It was a family going through divorce and the embryos were part of the divorce. They were 15 years old and we were willing to take them. But then the mother requested she have access to the medical records of the child throughout their childhood -- she was a nurse and wanted to be able to help with medical decisions. We felt very uncomfortable with that and she wouldn’t budge, so we walked away. I can’t imagine her need to be involved would stop at medical records; she clearly wasn’t ready to make this decision. Another embryo situation came up where the couple was young and fairly healthy. Our fertility doctor reviewed the medical records and found the possibility of CMV, a potentially deadly virus. I knew too well about this issue as a friends daughter had just given birth to a CMV positive baby. They were struggling. Again, there was no guarantee the child would survive the pregnancy or birth. The health records were unclear whether the embryo would have it or not, so we chose to pass. We were willing to parent disabilities, but we were not willing to set ourselves up for a pregnancy loss. 

We got about one potential situation a month between embryo adoption and traditional domestic infant adoption. Most traditional situations we said yes to, unless there was severe drug use, but we were never chosen by the biological families. The business of adoption was slow to say the least. Finally, just before my sons third birthday, we were placed with a set of four embryos. There might be hope after all. 

These were top of the line embryos. Grade AA. (Yes, just like your regular store bought eggs.) The couple got pregnant their first round of IVF and then conceived naturally after that, so these were basically foolproof super embryos. My fertility doctor wanted to run some brand new tests on me first to help with our success rate. Endometrial Function Tests. Basically, it’s a soil test for your uterus and the seed is an embryo. I still don’t really understand how it worked. It took about six weeks to prep for the test. Cycle, Hormones, Test. First test came back abnormal. As in, the soil was not ready. Not ideal for an embryo transfer. Another six week test. Cycle, Hormones, Test. This test came back normal. So I was a day late. As in, most frozen embryo transfer patients transfer five days after starting their progesterone shots whereas I will be doing six days of shots before transferring embryos. This should have any affect on us getting pregnant naturally, but in regards to frozen embryo transfer, it could mean a positive pregnancy. 

I’d been dreaming of having a large family. I knew what I was getting into by signing up for both adoption agencies and I was secretly dreaming of having four children. 

During this whole time, I knew I only had a 40% chance of getting pregnant with these embryos. So out of the four embryos we had, science says we could produce 1.6 babies. As we told our friends about this, everyone was certain we would be carrying twins. I was certain I would be carrying twins. Say I have twin babies and end up getting placed with a baby through domestic infant adoption - tada - four babies. Family created. Maybe faster than I had hoped, but nonetheless all very much planned. 

A month before the embryo transfer was to take place, I was arguing with the domestic adoption agency. After six months of working with them, they still hadn’t completed our home study (which usually takes three months), yet they were sending us potential adoption situations to review. When I would ask them about it, they would say, oh we can pull together a home study over a weekend if we need too. I wasn’t convinced. Since I had been with them in the past six months, some shady things were taking place. Our seemingly awesome social worker was fired out of the blue and when we went to the agency looking for our home study (because at this point we were going to transfer to a different agency, but couldn’t do that without a complete home study), they didn’t have it. They said our previous social worker never submitted it to them. So they gave us a new social worker and had to completely redo our home study. One thing after another. 

One summer morning my brother called me to tell me his wife, my sister in law, hadn’t been speaking to me over something I said to her a few weeks back. I had no idea. I was distracted so much by what a mess I had gotten myself into that I hadn’t even noticed that one of my best friends wasn’t speaking to me. I was devastated. I was pissed off at infertility for putting me in this position and while I can’t remember what I had said to make her so angry, it pushed me over the edge. Between the failed transfers a year ago, the lengthy adoption process and mounting costs of fertility treatments, I was exhausted. It’s not unlikely that I did say something insensitive to her. She was pregnant after all and I still get squirmy around pregnant people -- even if they are my best friend sister in laws. 

I spent that morning sobbing. I met my best friend, who just happened to be in town for a few hours, for lunch and cried with her while she reassured me that everything would turn out as it should. We did some retail therapy and got lattes. My latte dropped all over the floor of target, because that’s how my morning was going. I was so grateful to have her with me in this moment. I couldn’t handle being alone with myself a moment longer. All I did was make mistakes. To me everything was falling apart. 

During that very lunch, I received an email from my adoption agency that would change the trajectory of our journey. 

You’ll find out more about that next week.