FSH: When numbers don't matter.

Scanning the latest email newsletter from the American Fertility Association, I came across this article. In it, the author discovers--through an answering machine message left by her doctor--that at 35, she has an FSH (follicle stimulating hormone) level of 14.5. For those of you not up on your hormones, this is high. And the author is devastated.

I was right there with her, but for a different reason. Back in the day, during my infertility "journey," I got similar calls from my doctor. But in my case, the news was "good": my FSH, at 41, hovered around 5. It still took us 11 cycles of IUIs to conceive our son. A few years later, trying to conceive #2, the news was similar: Again, my FSH was around 5-6, sometimes as low as 4. The IVF doctor shook his head. "You have the biological makeup of a 35-year-old." He had never seen anything like it. And yet, it didn't make a difference. Nine IUI cycles, 3 rounds of IVF and 2 more IUI cycles (one resulting in a miscarriage) later, I still hadn't conceived. It didn't matter what my numbers were. There was to be no sibling for my son.

So what's the point? The point is that we really have no control over whether we're able to conceive or not. It's a total crap shoot. People we consider to be unfit parents pump out babies, while the dearest, most caring people we know can't conceive their own biological children. It's not fair. There's no explaining it.

Last week during my small group bible study, we were talking about the movie "V for Vendetta" and spiritual crucibles, about radical turning points that changed the course of our lives. I don't have a "road to Damascus" moment, but infertility was my crucible, and the realization that there are many, many things over which I have no control--a lesson I forget over and over again--was a turning point for me.

I live in an area where people believe without a shadow of a doubt that they can succeed if they're smart enough and they work hard enough. It's a lie. You can have "everything" going for you, including a low FSH and "beautiful" ovaries (see an earlier blog post). And you can still "fail," if the rubric is the number of children to whom you can give birth. So the only way to keep your sanity is to let go. Most of the time, I can.

You know you're infertile when...

From the "Finding a Resolution for Infertility" on the Resolve online support community:

You know you're infertile when...

You use and understand more acronyms than the government space program.

You know that cycling has nothing to do with a bike.

You list your IF stats like a pro baseball player.

You hate at least one person that's pregnant.

You have long since learned to check your pride at the door (stirrups anyone?).

You think of expenses in terms of IVF cycles (i.e. 3,750 Starbucks coffees = one IVF try).

You readily admit that you're a powder keg and nothing you say should be taken personally.

You'd like to throttle your parents for how easy they made it sound when you were 16 and they wanted to scare you out of having sex.

At one point or another you want to smack just about everyone you love, but then we cry over the failed fertility treatments of perfect strangers.

More than 100 rude responses jump to mind when people ask why you're not pregnant yet. And some of them make even you blush.

And here's mine:

...almost two years after you throw in the towel and decide you're "over" IF, the news of yet another birth can throw you into an unexpected tailspin.

(More on that later.)

Got a good "You know you're infertile when..."? Send it to me. Or join this Resolve board. There were many more funny, moving and heart-wrenching contributions. Many thanks to Laura143 for starting this thread...

AFA Event: Martinis and Manicures in SF

Attention all San Francisco Bay Area readers: The American Fertility Association is holding its popular free Martinis and Manicures event on Monday, June 9, at Nova Nail Spa in San Francisco. This your chance to get your questions answered about the reality of your biological clock, the effect of STDs on your fertility, environmental toxins and more fertility-related topics--all in a fun and friendly atmosphere. Here's the 411 from Vivian Rodriguez of the AFA:

What: Manicures & Martinis*, a 90-minute conversation and Q & A with Marcelle Cedars, M.D., UCSF Center for Reproductive Health

Where: Nova Nail Spa, 811 Mission Street, San Francisco, California 94107

When:Tuesday, June 9th, 6:00 PM – 7:30 PM

Why: Because wise choices now improve your chances of having a child later.

Who: Women in their 20s and 30s

Cost: Complimentary! A credit card is required to hold your reservation. A fee of $50 will be charged if you no-show.

* Also available: The “Fertilitini”, an organic, alcohol free cocktail!

To make a reservation please contact Vivian Rodriguez at 646-861-3226 or vivian@theafa.org. For more information, please visit www.theafa.org.

And here's some information about the Manicures and Martinis event in Denver.

I'd like to go to the event, although evening events in San Francisco are hard for me these days what with my job and such. But if I go, I'll post a report. And if you go, send me yours!

The unfairness doctrine, revisited.

Back in March, I wrote about "The unfairness doctrine." As in, "It's just not fair that [insert name of unfit parent here] gets to have children, and I don't." Of course, we infertile people don't like to admit that we even have this thought, but we do.

The unfairness doctrine raised its ugly head for me again when I found out recently that a family friend is pregnant with her second child. She's a wonderful person and a great mom, so normally, this would be cause for celebration. And I am happy for her. Really. But here's the thing: She got pregnant during a visit from her estranged husband, who lives on the other side of the country.

So my first thought when I heard this news was: It's just not fair. I mean, on our third and last IVF, which was medicated and timed to the minute, we transferred four embryos and a goddamned blastocyst, and I still didn't get pregnant. And I'm married to a guy who's one of the best dads I've ever seen. If anyone "deserves" another baby, it's him.

But then I noticed something else. This time, the unfairness doctrine only lasted for a second. (OK, maybe 5 seconds.) It resolved quickly into an internal shrug of the shoulders and the thought, Oh well, who can explain how the Universe works? I didn't feel that blow to the heart that I used to feel when hearing or reading about someone else's pregnancy. Could it be that I've actually come to terms with my infertility, and with being the parent of a singleton?

A lot of doors have opened for me since we stopped trying to get pregnant. I finished a book, signed a contract for the next one, and had a short story (which the publisher wants me to turn into a novel) accepted to a publication. In my "other" life, I also got a great new job that I'll start Monday. Not everything's perfect (witness my thigh and my sex life), but it's pretty good.

I will always wonder what our second child would have been like. And it's hard not to be aware of one's cycle, or worry about what you eat and drink. But in some ways, I'm moving on.

I was also going to talk in this post about one of the great panels I attended at BlogHer '08: called "When the Road to Motherhood is Anything But Smooth: Infertility, Adoption and Miscarriage Bloggers." But this post is getting long...so hang on to your horses. I'll talk about it, and the fabulous Sex and Relationships meet-up I sat in on, in my next posts.

Boston Globe's Ellen Goodman on the globalization of surrogacy.

I'm not just a little offended by Ellen Goodman's tone in her April 11 Boston Globe essay, "The globalization of babymaking."

It would have been nice if she had actually talked to some couples who turned to surrogacy. I can assure you that no infertile couple travels halfway around the world, and gives up their dream of biological children, "in search of lower-cost ways to fill the family business."

I can assure that by the time a couple gets to this point, they've probably exhausted all other options. No one chooses voluntarily to "outsource" conception to egg donors and sperm donors.

She say she doesn't "make light of infertility." Then she does exactly that.

About the new kid in town.

My friend Peggy described Sparky as my "late transfer in."

"It's like the guy who joins your classroom after the semester has started because his family just moved to town," she said.

I'm just hoping the new guy will end up being class valedictorian, prom king and the quarterback of the football team.

My life is turning into the mid-life version of a John Hughes movie. Fabulous.

An interesting turn of events.

So I'm driving to work this morning when Dr. P calls. And believe me, whenever your IVF clinic comes up on your caller ID, you take the call.

"Is this a good time to talk?" he asked, ever polite.

"Sure!" I said. I would hang up on George Clooney, my spiritual soulmate*, to talk to Dr. P.

He gives me an update on the seven 4-cell embryos we had left over after our embryo transfer. (No, they didn't let us take them home in a doggie bag. At Dr. P's suggestion, we left them in the lab to see what would happen.)

"One of your embryos developed into a blastocyst," he tells me. At this point my mind goes all fuzzy, because I thought the chances of this happening were somewhere between slim and none. He continues: "This gives you three options. First, you could let it expire in the lab. [I know that sounds kind of brutal. Those weren't his exact words, but as close as I can remember. Like I said, my mind got all fuzzy.] Second, you could freeze it for future use. Third, you could come in and we could transfer it."

As usual when processing a critical decision, my mind goes blank. "What would you do if you were me?"

"I would choose option three." I realize that this is what I was hoping he'd say.

"When would I come in?"

"Now!" He says, laughing.

What seems like a very stupid question enters my mind, but I have to ask it. "Will transferring this one hurt the other four?"

"Not at all," he says.

So I make a u-turn and drive back to the clinic. All goes well. Dr. P addresses my concern that the five embryos will be jostling each other like some sort of uterine mosh pit. "The relation of the embryos to the uterus at this point is like 5 ants to a football field," he tells me. As the daughter of a couple who had season tickets to every sports team in San Diego, I get this.

And now I have five embryos racing toward the end zone in the fertility equivalent of a Hail Mary: the four transferred Friday, and today's blastocyst, who I have named "Sparky" because of its sheer pluck. According to a chart I found on IVF-infertility.com, at my age, Sparky has about a 7.5% chance of being born. And if we make it that far, let's not talk about the chances of twins (or more). An article about multiples that appeared in yesterday's San Jose Mercury News gave me pause, let me just say.

Luckily, I'm not a math person, and I dropped my college statistics class. I get analogies (ants on a football field). I have to ignore statistics.

* Second only to my dear husband, of course.