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David Baxter

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Getting off the infertility-treatment treadmill: How one couple decided to quit battling biology
By Kristin Kalning for MSNBC
July 5, 2007

Every day I see them, wedged between the mustard and half-empty jar of capers in my refrigerator. They?re the shots that could make me pregnant.

But each morning, as I grab the coffee creamer or the strawberry jam, I bypass the Follistim, a follicle-stimulating hormone that can induce ovulation. The shots don't expire until next October, so I still have time. But I?m never going to use those shots. I?m through with fertility treatments.

When my husband, Steve, and I started trying to get pregnant more than two years ago, I was 34 and Steve was 33. We figured my fertility was like a dammed-up river, held at bay for 15 years by birth-control pills. We had no reason to believe otherwise.

Of course, we'd heard the stories about other couples who?d had trouble conceiving. One acquaintance quit her job to focus on getting pregnant, cashing out her 401K to fund three rounds of in vitro fertilization (IVF). Another friend, who?d gotten lucky with just one round of fertility drugs, advised us to figure out our emotional and financial limits in advance ? and stick to them, no matter how intense things got.

We didn?t honestly think it would get that far. I was still relatively young and ?sickeningly healthy,? according to my gynecologist. But heeding my friend?s advice, we agreed that we?d draw the line at IVF ? too expensive, no guarantee of success.

Looking back, I realize just how naive we were. We knew next to nothing about luteal phases, hip-lifting pillows and spermwashing. And we had no idea how tough things would get.

Trying ... and waiting
Three months passed with no luck. Our friends laughed at our impatience: ?Your body's just adjusting,? they said. ?Give it at least a year before you start worrying.?

Six months went by. I started poking around the Internet, turning to message boards and blogs written by other infertile women. I learned some tips, and Steve and I grew more strategic in our efforts ? charting cycles, trying to plan my most fertile days. But still, my body, which had never failed me before, stayed resolutely pregnancy-free.

?Take a vacation,? friends advised. We went to Hawaii. Nothing.

?Relax,? my mother said. I took up yoga and started visiting an acupuncturist. No dice.

After 15 months, we decided that something was wrong. I went back to the Internet, typed in ?fertility clinics? and got pages and pages of results. Clearly, this was big business.

We chose a facility near our house and went to our first appointment. The nurse practitioner assigned to us had an impressive track record, and the first steps seemed proactive, not intrusive. I would get a full workup and Steve would get his sperm tested to see where the problem was. I felt relieved, triumphant over my stubborn, unyielding body.

That feeling didn't last long. Our tests revealed that Steve was A-OK, and that due to lack of regular ovulation, I was the faulty model.

This news devastated me. I felt ashamed. Old. Worthless. My body, which was made to conceive, carry, give birth to and feed a child, just didn?t work correctly, and we didn?t know why.

I started dropping hints to Steve that he should fly the coop, find a younger woman who could give him the family he wanted. To his credit, he was aghast ? and insulted ? by my suggestions.

?I don't just want a family ? I want a family with you,? he said. ?Plus, what if the problem was on my end??

A little nudge from science
Based on our results, our nurse suggested we start where lots of infertility newbies start: Clomid. The ovulation-inducing drug, which is administered orally and is relatively inexpensive, would also help our nurse determine what shape my ovaries were in. It seemed low-tech and not much like a ?fertility treatment? at all ? just a little nudge from science.

But Clomid was no picnic. I had constant headaches, intermittent nausea and dizzying mood swings. Steve joked that there should be a safe house for Clomid husbands.

Fitting in the appointments that went along with fertility drugs was a challenge, too. As a freelance editor, I?d been able to handle the midday blood tests or the last-minute ultrasounds. But then I accepted a full-time position at MSNBC.com, and I was reluctant to reveal too much about our efforts to get pregnant to my new boss and colleagues. It was too personal, this business with my faulty reproductive system. And work was my only escape from the whole disappointing process ? and the only place where hard work seemed to net tangible results.

Then, I got a terse letter from my insurance company. The prescription I?d submitted for my Clomid had tipped them off: My ?ovarian dysfunction? was infertility, and as such, they were through covering my tests, lab workups and doctor visits. I was on my own ? and on the hook for certain procedures already performed.

Still, we kept at it, with more expensive tests and more rounds of Clomid. At our nurse?s urging, we attempted intrauterine insemination, where a washed specimen of sperm is injected into the uterus. I had five healthy follicles and Steve had above-average swimmers. I didn?t even blink as I wrote out a check for $800. I was so sure we?d get pregnant this time.

We didn?t.

?Diminishing options?
After this failed attempt, our nurse told us she couldn't do anything more for us. She suggested some big-name reproductive endocrinologists and we made an appointment, although Steve and I were already starting to verbalize some of our doubts. What were we doing? Why were we trying to force my body to do something it so clearly didn?t want to do? Would we change our minds and try in vitro? And the big question: Was our reluctance to go that route an indication that we weren?t cut out to be parents?

We went to our appointment with the big-time doctor, who seemed chagrined by our refusal to do IVF. She sent us on our way with a prescription for Follistim and urged us to ?think hard about our diminishing options.?

When the Follistim arrived via FedEx two days later, packed in ice and with a handbook of instructions, I put it in the refrigerator and told Steve it was there, ready for us.

?Let's take a break,? he said. ?I think we need some time off from this stuff.?

We took a break from the fertility treatments ? and from each other. Steve and I retreated to opposite ends of the house throughout last winter, stewing in our thoughts, our grief and the knowledge that had been crystallizing for months: I was probably never going to give birth to our child.

Sure, the science existed to make us pregnant, but Steve and I knew we?d had enough. We didn?t want to throw tens of thousands of dollars at procedures that had no guarantee ? not when there were so many children in the world that needed homes.

In February, Steve and I went on a cruise to the Caribbean. The winter break from the Seattle gloom is a gift that Steve?s company gives to its employees and their families every year. I had been dreading it for months, sure that I'd be tortured by the pitying looks of the new moms at the company. I was certain I'd feel trapped, a childless outcast surrounded by happy families.

Not just about giving birth
But a funny thing happened on that boat: I loved it. I loved watching the kids play, and playing with them. I delighted in kayaking with our friends' sixth-grader and playing sea monster with another friend's 6-year-old. I realized that in all my feelings of loss and loneliness, I'd forgotten the most important thing: I wanted to be a mother more than I wanted to give birth.

I got an e-mail the other day from a dear friend of mine. His wife had just delivered their third child. I felt a little pang as I clicked on the pictures of their new, beautiful baby girl ? but I don't have much time to feel sad these days. Steve and I are immersed in conference calls and mountains of paperwork. We're full-tilt down the path to international adoption.

It's been almost two-and-a-half years since Steve and I started our quest to be parents. And at this rate, it'll probably be another 18 months before we have a baby in our arms. But this time around, we're OK with the wait.

At the end of this long road, there's a child waiting for us ? the child we were meant to have.

Kristin Kalning is a technology editor and games columnist for MSNBC.com. She lives in Redmond, Wash., with her husband, Steve, her dog, Sophie, and her petulant cat, Jinx.
 

David Baxter

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Not giving up hope for a biological baby: One woman reflects on her infertility struggle ? and why she's still trying
By Lorie A. Parch for MSNBC.com
July 5, 2007

It was four years in April. Four years since I started trying to have a baby.

In that time, I?ve seen seven doctors in three states, a naturopath, a few acupuncturists, a Reiki practitioner and a handful of massage therapists. I?ve had 11 intrauterine inseminations, taken oral medications and given myself injections to coax my eggs, done one round of minimal-stimulation in vitro fertilization (IVF), popped supplements and brewed herbs, given up caffeine and alcohol (at times), switched to mostly organic food, modified my exercise habits, quit a big job and moved to a new state in part to reduce stress, and undergone innumerable blood tests to tell me what my hormones are up to that day, that hour.

When I started I was 37. In August I?ll be 42 ? the age when fertility clinics don?t want to know you (not that you?re too popular at 39, 40 or 41, either).

And after all that, I find myself seriously considering another round of IVF this summer. Why?

That?s tough to answer. When you spend so much time, energy and money trying to have a baby (I?ve laid out about $30,000 as of this writing; one more round of IVF would raise it at least another $15,000), it?s easy to lose perspective.

Once you?re on the fertility hamster wheel, in pursuit of the dream shared by most of the human race ? to be a parent to your biological child ? there?s no one who can tell you it?s time to get off of it. Americans are, after all, raised on the notion that with hard work, you can do anything ? except, apparently, turn back the clock on your ovaries.

Like many women, I waited too long to start trying to get pregnant, hoping that I?d find a great man to marry and do things the conventional way. But when I hit 35 and Mr. Right wasn't in sight, after much internal debate I decided to pursue matters on my own. I not only truly wanted to be a mother, I knew I?d be a good one and any baby entrusted to me would be lucky.

Little did I know then that I?d be the one praying for luck.

Now, four years into my journey to conceive, an anniversary ? even a sad one ? seems a good time for reflecting on the lessons I?ve learned so far, including the things I?d do differently.

Find a doctor you believe in
My first doctor in Santa Monica, Calif., was thoughtful and attentive, with an Ed Harris sort of look and a kindly, if somewhat passive, approach. The fertility practice he was part of had wonderful nurses, a sleek, minimalist aesthetic and a reputation for a celebrity clientele.

My second doctor was in Arizona, a blowhard with pictures of his success stories (i.e., babies) insensitively plastered on the walls of his tacky Southwest-d?cor office. (Please don?t make infertile women look at photos of other people?s kids, I wanted to scream.) After keeping me waiting for 45 minutes, his first words on hearing my history with the L.A. doc were that I should have done a single round of IVF instead of the seven inseminations ? I would have been more likely to get pregnant, he said. Very helpful, I thought, since I can?t actually turn back time. I disliked him immediately.

But who do I think was the better doctor for me? Probably Dr. Arizona. The truth is, in retrospect, I should have had a doctor who was much more aggressive. Though I had no history of any sort of physical problem, I believe I should have started drugs much sooner, and my L.A. doctor should have tried to make a case for IVF rather than simply swallow my (admittedly defiant) declarative that I would not do anything high-tech.

In short, I might have benefited from someone I didn?t just like ? but someone I truly believed in.

Never say never
I said I?d never do IVF. Never. That was when I was 37, when it wasn?t so much that I had hope as that I had no doubt that this would work. It wasn?t even a question in my mind.

I was as healthy as they come, so when the inseminations with anonymous sperm didn?t make me pregnant month after month, I was perplexed, but it never occurred to me that it wouldn?t happen at all. But that prospect gradually became more and more real. Talks with doctors turned to going on injectable drugs to grow more follicles for inseminations, then IVF.

It took me a couple more years, but last fall I did a modified version called minimal-stimulation IVF (fewer drugs, much lower cost) with a doctor in New York. Now, nine months later, I find myself researching a regular round of IVF for this summer, complete with turbo-charged drugs. I?m also debating paying another $5,000 for preimplantation genetic diagnosis in an attempt to help determine if any embryos are viable.

Don?t tell everyone
I am very lucky. I have a lot of friends and a not a small number of acquaintances and colleagues. Over the past four years, pretty much everyone I know knows that I?m trying to have a baby and have been unsuccessful.

So when I did that first round of IVF, I told everyone. I had some notion that their collective energy would be the tipping point into getting me pregnant. I just knew this was going to work so I didn?t spend much energy thinking about how I?d deliver the news that my two lovely embryos hadn?t, in fact, turned into a viable pregnancy. But they didn?t, and I had dozens of concerned, good-hearted folks wanting to know what happened, and then offering their condolences.

The thing is, though, that people don?t always say the thing that you really want to hear right then. In the middle of your despair you?ll probably hear five well-meaning versions of ?Have you thought about adoption?? and a dozen variations on ?I know a woman who was [fill in any age from 40 to 55] when she got pregnant for the first time.?

But all a woman wants to hear is, ?I am so sorry.?

I do understand that others see the obvious next step as adoption. I have sent away for the information packets from agencies (they sit unopened), and I've put meetings about international adoption in my calendar (I?ve never gone).

The truth is, I haven?t felt a call, for lack of a better word, to adopt. If I'm being honest, I also feel so worn out from the last four years that the idea of embarking on another byzantine, capricious process where I'd have to expose my whole life to more scrutiny ? especially after experiencing the discrimination of doctors who refused to treat me because I'm a single woman ? is anathema. Then there is the $25,000 or so I'd have to come up with.

These aren't noble reasons and I know that I may change my mind down the road. I have a fantasy where I pull a Jolie-Pitt, skipping the onerous adoption process mere mortals face, and someone hands me an orphan from Darfur or some other godforsaken place and says, "Love him, care for him, give him a good home," and I do, in a heartbeat. But that, of course, is not how it works and just now I don't have the wherewithal to start all over.

Start sooner
If I had it to do over again, I?d have gotten checked out by a doctor at age 35, which was my original plan. But I was living in London at the time, being driven into burnout by a 70-hour-a-week job. (If only I?d known at the time that infertile people in the U.K. are entitled to a free round of IVF!)

By the time I was settled in a more laid-back job in L.A., two years had passed. When I started trying to get pregnant, most of my worry was reserved for the kind of mother I?d be and how I?d afford to raise a child. Little did I know that 20 percent of people diagnosed with infertility get the wholly unsatisfying designation of ?unexplained infertility.? Sorry, we don?t know what?s wrong with you. That ended up being me.

I like to think that had I figured this out sooner, something could have been done since there is nothing ? nothing ? so important to fertility as a woman?s age. We?ve heard it a million times, but many women think, as I did, ?That won?t be me.?

In truth, the anecdotes you hear about women driven to tears by hormone shots and relationships rent asunder from the strain of on-demand sex and unwanted childlessness are just the publicity shot of infertility?s toll. They?re just a small part of what happens, especially when all the shots and blood tests and invasive procedures don?t get you any closer to being a parent.

The reality that you will never have a child of your own, like any life-changing loss, is only made tangible over a lifetime of not having what you so deeply wanted.

Then there are the days (most, in fact) when I have more perspective ? I?m not living in Kabul or Baghdad, after all ? and I find a way through the morass of ?why me??

I start to consider a life where I?m not a mother and won?t be. It seems doable. I remember that there?s a lot about my life that I love; I would never bring a child into a life I wasn?t mostly happy with. But then I realize that I?m not quite there yet, not ready to stop.

So I will likely do one more round of IVF in August. I think it may empty out my coffers, both financial and emotional, once and for all. But I don?t expect the peace that some people say they get once they?ve tried everything they can.

I?ve only found less peace in the past four years, not more, and I don?t expect the end to bring me more.

Maybe, though, it will bring me a baby.

Lorie A. Parch is a writer and editor in Scottsdale, Ariz., who has written for Women's Health, Town & Country, Shape, Prevention and Conceive.
 

Daniel

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I must say the first article, which concludes with adoption, seems more rational than the "never give up" approach. From a simplistic, ethical point of view, the world doesn't need more children, it needs more parents. Of course, the desire to adopt is not something most people have.
 

Daniel

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Well, on the positive side:

MYTH #7 — The World Is Getting Too Crowded

We've heard protests about this for decades: News articles warn of "the population bomb," and "a tidal wave of humanity," and plead: No more babies.

The world population today is more than 6 billion. It seems like so many people. But who says it's "too many?"

There are lots of problems all over the world caused by too many people.

But there's no space problem. Our planet is huge. In fact we could take the entire world population and move everyone to the state of Texas, and the population density there would still be less than that of New York City.

But, you might wonder, won't we run out of resources, like food?

Paul Ehrlich wrote the book "Population Bomb," and warned 65 million Americans would starve in a "Great Die Off" in the 1980s. The 1973 movie "Soylent Green" predicted food riots would erupt in the year 2022 but it doesn't look like that will happen.

According to media mogul and philanthropist Ted Turner, population growth is "a time bomb waiting to happen." If it continues, at the current rate, according to Turner, "Eventually you stand around in a desert with nothing to eat." But that too is a myth. We see the pictures of starving masses in populous places, but the starvation is caused by things like civil war and government corruption that interfere with the distribution of food.

With more people, we also have more smart ideas. Every year we learn how to grow more food on less land. Thanks to improved technology, the United Nations now says the world overproduces food.

About 15,000 babies are born every hour. But they are not a burden, they offer more brains that might cure cancer, more hands to build things, more voices to bring us beautiful music.

JOHN STOSSEL Commentary - ABC News
 

ThatLady

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The really heart-warming part of this whole story is that there is a little child out there, somewhere, waiting for Steve and Kristin to love him/her. Nothing as wonder-inspiring as an answer that holds promise, and hope, and wonder, and love for everyone involved. :)
 

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