the infertile soul

So far - knock on wood - I've 'overcome' (ahem ahem) infertility.

But I still feel like an infertile.

Even though, after extensive medical investigation, it turns out that I'm not physically infertile. It was my husband's medical issue.

Even though I'm almost 20 weeks pregnant with a delightful little spud.

Even though I should be trying to block out the seven years of wandering in a desert.

Recently, at a family wedding, one of my younger cousins - along with her pram - came by to say hi. Loaded in the carriage was her new baby, who was due four days before my first baby would have been born. Her third child. I couldn't talk to her. She gave a birth announcement to my parents, who laid it on a shelf in the living room. I placed another picture (of people I didn't know) on top of it.

As well, I found out that one of my nieces - who has zero fertility problems - is expecting another baby, and that she's due shortly after I am. I was ragingly jealous. Isn't that ridiculous? But I was colossally upset, anxious, and envious. (She had no issue getting knocked up. And if anything happens to my little Ninja, I will have an awful reminder.)

After physical infertility seems to have been overcome, I wonder if the infertile 'feeling' ever goes away? Certainly it has become modified a bit. Now I'm more than fine with talking to fellow ('former') infertiles about pregnancy and babies. As well, I can now handle seeing regular pregnant women and talking with young moms. To a certain extent. I'm still uncomfortable, and feel as though I'm an imposter, and think that I'm jinxing my situation, but I can get through it.

But my feelings at seeing that baby carriage and reading my niece's news (on FB, of course) was like nothing I've ever experienced before.

passing IF on to a son: something i wonder about

Source: http://www.msnbc.msn.com/id/26680088/ns/health-pregnancy/

Pass it on: Sons of infertile men may be next

Scientists worry that boys born after treatment inherit dads' problems

JoNel Aleccia
Health writer

More than a dozen years after fertility specialists learned to turn all-but-sterile men into fathers, scientists are awaiting answers to a looming question: What about the sons?

The first few babies born using a process that transformed male infertility by allowing doctors to use sperm from men with impossibly low counts and other problems are now turning 15. An even larger crop of so-called “ICSI babies,” children conceived with the help of intracytoplasmic sperm injection and in vitro fertilization, or IVF, are just approaching adolescence.

For the daughters born to these dads, there appears to be little problem. Research suggests that, in general, techniques such as IVF and ICSI are safe and effective, although some scientists say there's not enough data to be sure. One of the central concerns centers on the possibility of chromosomal abnormalities leading to male infertility.

As puberty kicks in, scientists believe they may start to see sons who’ve inherited the problems of their fathers, an issue that many couples may not have considered in their quest to have children.

“This is the generation we’ve created,” said Dr. Tommaso Falcone, who chairs the obstetrics and gynecology department at the Cleveland Clinic and directs the Reproductive Endocrinology Research Laboratory. “We may have tens of thousands of boys born with infertility.”

Genetic fallout for ICSI sons is still a largely unexplored issue in the field of infertility, which affects an estimated one in eight couples in the United States, or about 7.3 million people, according to RESOLVE, a national infertility group. Up to 40 percent of cases are attributed to problems with the man, including damaged sperm, low sperm or no sperm at all.

Of the more than 52,000 babies born using IVF in the U.S. each year, between 8,000 and 9,000 are the offspring of male factor fathers, according to Falcone.

“We tell parents there could be a genetic cost to this,” he said.

Basic facts about infertility are fueling scientists' concerns. In women, infertility is most often caused by a physical problem such as blocked fallopian tubes or scar tissue caused by endometriosis, issues that aren't likely to be inherited by their daughters . When IVF was pioneered three decades ago, it solved many of those problems by providing a way to get the sperm and egg together outside the woman.

In men, however, it's not so clear cut. Doctors don't know what causes infertility in about half the cases, but think that many men's infertility problems may be rooted in their genes.

Last year, Danish researchers reported that levels of the male sex hormone testosterone were lower in baby boys produced through ICSI than in those conceived naturally. Until more boys mature, however, they can't be certain if that will hold true in older kids or what form other problems might take.

The whole issue raises the science-fiction prospect of a society in which many men can’t father children naturally. According to one estimate in the journal Nature Genetics, if even half of affected men used ICSI to have kids, the incidence of severe male factor infertility could double nationwide within seven generations. But it also raises more practical questions for the families of the boys who might be affected: How do they feel about transmitting the struggles of infertility to their sons? And what do they tell the kids about the birds and the bees?

“The puberty talk is usually: ‘You can get someone pregnant,’” Falcone said. “But with these boys, you can't.”

No different than getting glasses, dad saysAt least one father of a boy born after using ICSI said he’s not worried, even if he did pass on a genetic trigger for infertility, because there are increasingly successful treatments to deal with it. “The basic feeling I have is that it’s like eyeglasses now,” said the father, a 41-year-old professor at a well-known eastern university, who has two ICSI children, a son, 6, and a daughter, 4. “Generations ago, if you had bad eyesight, it was a problem. Now, it’s just not anymore.”

The father agreed to discuss his son’s future fertility only anonymously because it’s such a sensitive issue. “I don’t want his girlfriend googling him when he’s 13 and finding out his father’s infertile,” he said.

The professor and his wife turned to ICSI nearly a decade ago after trying unsuccessfully to become pregnant for more than a year. Tests showed that he had a sperm count far below the 20 million per milliliter necessary for normal conception.

“It was in the 100s or the single digits. I don’t think they count that low,” he said. “But all it takes is one.”

Indeed, his wife got pregnant on the first cycle with their son, using ICSI, the procedure that snags a single live sperm and injects it directly into the center of a human egg. The technique even produced embryos to spare. They froze four and, three years later, conceived their daughter from the same batch.

“The whole process of treating infertility is no big deal in the grand scheme of things,” he said.
In the early-to-mid 1990s, scientists developed the ICSI technique. The first babies were born in 1993; many more have followed.

In general, between 70 percent and 85 percent of eggs are fertilized in an ICSI procedure, resulting in a pregnancy and birth rate of about 43 percent. The New England couple was fortunate in their experience, but the dad said by the time his son requires treatment, if he does, the success rate likely will be much higher.

Even now, ICSI is now used in 62 percent of all IVF cases and in 86 percent of male factor infertility cases, according to 2006 statistics, the latest available, from the Society for Assisted Reproductive Technology.

Specialists worry, however, that some sons and even grandsons may inherit genetic problems, such as the microdeletion of a gene on the Y chromosome; troubles with androgen receptors that help regulate certain sex characteristics; or congenital problems, such as the absence of the vas deferens, the tube that connects the testes with the urethra.

Little research exists about the potential problems, primarily because the children haven’t been mature enough to test. Once enough boys begin producing sperm and agree to be studied, scientists say they'll learn more.

In the meantime, they worry about problems that remain undetected, said Dr. Pasquale Patrizio, director of the Yale Fertility Center.

“We are helping men to have a baby, but we don’t know why they don’t make sperm,” he said.

Stats on women in the workplace, the rate of assisted reproduction, numbers of twins and triplets, and much more.Parents considering treatment might benefit from a session with a genetic counselor to talk about their child’s future fertility, among other issues, noted Steven Keiles, president-elect of the National Society of Genetic Counselors. Early analysis can flag potential problems that parents might not have considered.

"I'm not so sure people think that far ahead," Keiles said.

Other specialists caution, however, that parents who use ICSI and IVF shouldn’t worry that the procedures will result in a child with an abnormality.

“We wind up having these discussions and people suddenly panic and wonder what they’ve done,” said Dr. Howard Zacur, director of the Division of Reproductive Endocrinology and Infertility at the Johns Hopkins University School of Medicine.

Nor should parents imagine that specialists are seeking to create their next generation of customers.

"I can't even remotely think that way," said Zacur. "You're really trying to help a couple. You're really giving them a chance to have a child."

Still, it is important that parents understand the real risk that genetic problems — including infertility — may be inherited and consider every option, warns Art Caplan, director of the Center for Bioethics at the University of Pennsylvania and an msnbc.com columnist.

"It is true that future fertility techniques may well be able to help a sterile or near-sterile child reproduce but that may be an outcome that parents do not want to risk and they may instead turn to a known-to-be-fertile sperm donor," he said. "I think every program using ICSI should disclose this possible set of risks and offer alternatives including anonymous or identified sperm donation."

Specialists and parents say there are no rules about when — and if — to tell a child about potential fertility problems. Like all information about the circumstances of conception and birth, it depends on the age and maturity of the kid.

Although it would be possible to test the boys' sperm count when they reach adolescence, few doctors now recommend that. Zacur said he doesn't even advise routine screening for certain root causes of infertility in his male patients because the tests can be expensive and inconclusive — and they don't alter the final treatment.

The professor father of the ICSI boy said he likely won’t tell his son about potential problems until he’s grown and facing questions of fatherhood. And it certainly won’t be part of early adolescent discussions of sex.

“I just don’t see any reason to burden him with this concern,” the dad said. “If you know about it, you alter your behavior.”

When he does divulge the news, he’ll likely remind his son — and his daughter — that any problems likely can be corrected through the technology and medicine that created their family.

“I do sometimes imagine have how sad it would have been to have been born in an earlier era,” he said. “There are an awful lot of people who wouldn’t have been around without this.”

© 2009 msnbc.com Reprints

Minus the cool factor

I think I must be a funny sight today.

Cruising in my sports car, windows rolled down, Metallica blaring, hair waving in the breeze ...

... car pulls up to the library, of all places, and a pregnant woman - briefcase in hand - stumbles awkwardly onto the curb.

trying to keep some perspective because i am ready to blow

I will try the proverbial 'counting of blessings.'

I am grateful for:

1) the kind neighbour who showed up today with homemade food: buns and an ice cream pail full of carrot-and-sausage soup, all of which was delicious;

2) the sunny day amid all the cold weather we've had this summer;

3) my DH, who - with a gleeful look on his face - rubs my belly at every opportunity;

4) no unmanageable pregnancy symptoms (I still feel ridiculously normal - I don't feel pregnant at all when I wake up in the morning);

5) all of the in-laws who came to help us with our mountain of housework;

6) the indigo flowers in my front yard;

7) the fresh peaches on my kitchen counter and the chili simmering in my crockpot;

8) my four-year-old nephew, who yesterday called me "sweet hot Auntie OHW!" (LMAO!);

9) the fact that I have a job, particularly when teaching positions are so difficult to find; and

10) my dear friend R, who is giving me a cell phone in case I get stranded during a storm while commuting to work.

not baby-related; just venting

I'm feeling as sour as expired milk.

We moved into our new place, and my family DIDN'T HELP. Not one iota. Even though most of them work in the town in which we're living! And even though I'm quite pregnant and couldn't paint or lift heavy boxes! I asked for assistance and was even turned down by my SIL, and my parents only sent a weak offer to help AFTER we had already cleaned, painted, and moved our stuff in. (I even asked my dad if he'd help me with just the baby's room, since he's quite artistic and I thought he'd enjoy painting and decorating with me, but he said he didn't have time in his schedule.) I'm so hurt and disappointed.

Yet, my brother and SIL will want our help with their house, plus my parents will want our help this fall with shingling their house and butchering a hog or steer. Well, normally I'd be the first person there to lend a hand - I usually do all the cooking for the crew - but now I'm too busy. And that makes me even more upset, since I hate being that way! If someone wants me to help, I want to be there! But I'm putting my foot down. I'm going to be too busy now, too.

Almost all of DH's family, on the other hand, showed up throughout the week to clean the place, paint the main floor, move our belongings, and unpack. Every day. Nobody asked them to come; they just did. Even his brother and SIL who are in the middle of HARVEST, for goodness sake (when it's harvest, it's harvest - most people on farms don't do anything else at that time). It was embarrassing to try answering their wonderings about where my side of the family was. (Um, I don't know...) Anyway, thank goodness they were so charitable to us, and I hope I can return the favour one day.

Then today I found out that my schedule for work has changed and NOBODY TOLD ME. I just happened to find out when I e-mailed my new principal to clarify a detail about my courses and he mentioned it in passing. Oh, and I'm teaching 4 classes (full-time), not 3, as I had been told! (But only getting paid for .875.) What???????? School starts next week!

And ... still no final decision from EI on DH's status. They keep flipflopping, and everyone says something different. I have forbidden DH from talking to any EI people on the phone or in person. All correspondence must be done via e-mail, so as to keep a written record of who is saying what. In the meantime, I'm going to have to pull our first mortgage payment out of my a$$.

If you made it to the end of this post, thanks. I have to blow off steam, but have no one around at the moment who has time to listen to me. I'm worried about the effect my stress is having on the baby. :(

thesis

Just finished my thesis draft and sent it off to my committee. Hallelujah. Now I have to wait 2 to 3 weeks to get their feedback so that I can do revisions and then book a date for my defence.

However, I've missed the deadline to graduate in October, so I'll have to pay continuing fees for two additional semesters. How fab. If it weren't for the IVFs, I would've graduated already. But if it weren't for the second IVF, I would not be knocked up right now. So I'll deal with it, since obviously I prefer the latter choice.

I don't know, though, if the finance department will be ok with my late submission: since I had external funding, I was supposed to have graduated by now. I'm scared that I'll have to pay back a bunch of the funding dollars, and that would be a big chunk of change. I'm hoping that I can appeal by giving the reasons for the delay, which are, of course IVF, miscarriage, FET + BFN, and IVF #2. All within 9 months. That's a good enough reason for a slowed-down timeline, isn't it? I sure hope they will be understanding.

stressed, but have my eyes on the prize

Fast update. I'm so far behind.

--Working on the house. Cleaning and repainting the interior.

--Haven't really started prepping yet for teaching. Don't have time. This is bad. But I still have 3 weeks until the first day of classes.

--Haven't had time to finish thesis, for a variety of reasons. Thumbs waaaay down.

--Employment Insurance (which is a government program into which most Canadians pay) is denying DH's claim, even though he was honest and did everything to the letter. Basically, since he's setting up a business, the local EI folks told him he wasn't allowed to look for work until he finishes writing his business plan, but today the federal EI person who called said that he WAS supposed to be looking for work all along, so they denied his claim. So we have no income until I get paid at the end of Sept, and we haven't had a paycheque since June. (He was entitled to 39 weeks' worth of paycheques, which we now have to kiss goodbye.) I just cried about that all morning - I'm so pissed about it - and DH is very overtired and grumpy, which doesn't help. Plus my SIL was there, and her cheery response was: "Don't worry, the Lord will provide!" That made me even more upset, since DH did everything legally - even though he could be working under the table and not paying taxes - but now he doesn't get insurance money that is rightfully his because of a miscommunication at the EI office. So it was easy for her to say that.

But baby is good, and that's the most important thing. (And physically I feel great.) I don't feel him a lot yet, but it's so cool when I do. For a moment he was really busy last Sunday; it was like popcorn bubbling in my womb. Made me laugh and then cry with joy.

Am starting to get his room ready. He won't be in it for a long time, since I'm planning to co-sleep for a year or more, but I figured we should prep and paint since we're doing all that to the rest of the house, anyway. So DH, as we speak, is painting the walls a medium-dark tan and the trim/doors a bright white. I want to decorate the room with orange, turquoise, and green. Good for a boy or a girl. The colour combo will be very modern and 'hip baby.' I don't really want it to look too 'babyish,' if you know what I mean, because I'm not into murals and other things that will have to be changed in a few years. I do want it to look beautiful.

What I'm setting up, basically, is a Montessori nursery (information about Montessori can be found in The Joyful Child). Maria Montessori was an amazing educator, doctor, and philosopher who had many influential ideas about childhood development, many of which I'm borrowing for the nursery. Everything must be tactile, safe, beautiful, and accessible. Cribs aren't used, so as not to hinder the infant's exploration of her immediate environment. I found out that my SIL used a Montessori nursery for her four children, and she loved it. Also, I discovered that another SIL is planning to use this method when she has kids (and she was surprised to hear that anyone had an actual label for it, since she says that in her culture that's what everyone does: co-sleep for a few years, then use a mattress on the floor).

At any rate, I'll try Montessori for the room's design, but if it doesn't work for our kid, I'm willing to go buy a crib or a Pack 'n' Play. I'm flexible. And just so you know, I do have a lot of experience with infants, so I'm not completely delusional. lol I've cared for newborns (i.e., baby-sitting) since I was 10 years old, and often overnight. Yes, since I was 10 years old! Isn't that crazy? I was a very responsible kid, though. Am not sure that I'd allow any 10-year-old to care for my baby, though!

award

Ok, now that I'm sort of caught up on blogging, here's my final hurrah for the day!

The lovely and talented and discerning Wiseguy has given me a 'One Lovely Blog' award. Thank you!

The rules of the award are: Accept the award; post it on your blog together with the name of the person who has granted the award, and his or her blog link. Pass the award to 15 other blogs that you’ve newly discovered.

I'm cheating, however. I can't pass the award because I don't have enough internet time these days. (Currently I have the worst internet connection in the western world. We've been living with my parents, who don't have internet, and the connection at the local library fades out almost every day.) Yes, I'm a bad person. Oh well. I'll catch up in the fall.

17 weeks

I'm wondering a bit what to do about buying baby gear. I'd rather not buy anything until after the baby comes, but obviously that's not practical.

Problem #1: With a full-time teaching position about to start, I know I'm not going to have much time in the late fall to pick up the stuff I need.

Problem #2: I won't get a paycheque until mid-September. DH still has not received an unemployment cheque, and probably won't for another month, thanks to the federal dimwits at Employment Insurance (they keep saying he's missing paperwork, though he brought it in 6 weeks ago). And he can't start his business, either, until he gets approval from said dimwits. So we're living on the credit card.

Problem #3: Baby-gear-buying should take place 4-6 weeks before baby arrives, but that will be Christmas time. Holy broke-ness, Batman!

Problem #4: My baby shower will occur 2-3 weeks after baby arrives (as long as all goes well). This makes no sense to me, but that's the custom around here, so apparently that's what's going to happen.

I'm not planning on spending a bundle on the baby - e.g., I'm happy to use second-hand items, I'm not making a formal nursery, and I probably won't even buy a crib - but apparently we'll still need to shell out more than just a few bucks. lol

I have decided to make a list of bare essentials - which is still a long list - and to purchase a few items every week until we've got what we absolutely must have; e.g., medical supplies, car seat, snowsuit, etc. Also, my MIL is making the diapers (and hitting up second-hand stores for snow gear) and SILs are also thrifting and making a few items (e.g., one is sewing all the receiving blankets, which will be hilarious because I picked out a baby pirate pattern with skulls and crossbones).

Today, I bought the following items: Vitamin D drops (essential for winter newborns in the Great White North, as people are telling me), organic diaper rash cream, Ivory soap, and a fast-acting thermometer (since I doubt that my 3-minute TTC thermometer will do the trick). Good things to start with, no? Not a huge investment, but they're all necessities, and in the event of misfortune, they can be returned or given away.

So I got home and mentioned to DH the following: "I started up picking up baby stuff. I also filled up the car." He gave me a panicked look, which I found odd, since even though we're broke, he's never been a penny-pincher. I added, "Well, I wouldn't have had enough gas to get home if I hadn't!"

But this is what he heard: "I started picking up baby stuff and it filled up the car." He imagined my little car bursting with strollers, cribs, high chairs, and what have you. Hahahaha! It took a while for his heart to stop racing!

16w6d

Went to the bank today to sign mortgage papers, and got a real kick! If I hadn't noticed the tapping before, I couldn't have missed this one! DH was very proud and said that the baby is headbutting me because he doesn't like me. lol

August 7, 2009 (16w3d)

I'm rockin' a beer gut, yet sadly have few clothes to wear. lol

So one of my sisters-in-law - the one who's endured 4 miscarriages and 2 stillborn babies - took me along with her and her 2 kids to the U.S. for a day. So that I could shop to my heart's content. Isn't that wildly gracious of her? And now my credit card hates me. lol It wasn't really that bad, though. For $165 USD (plus $40 CDN in duty and taxes) I got everything else I needed for my work wardrobe. I can mix 'n' match everything, and most of it is fairly cute stuff - much better than anything I have seen in the Great White North - and besides that, I estimated that I saved about $250-$300.

The best part of the shopping expedition? Laughing at my 4-year-old nephew who trailed his mom in the stores, exclaiming, "Where's my momma? My sweeeeeet hot momma!" He's a troublemaker, just like my DH's side of the family!

And then it got even better. On the way home, I felt the baby move for the first time. :) :) :) Just 3 or 4 very soft taps inside my uterus, but it was the best feeling in the world.

august 4, 2009 (16 weeks)

Had a midwife appointment today. All was well. The midwife spent most of the hour asking questions about my family support, my relationship with DH, my attitude toward being a mother, and so on. Very interesting that she's as concerned about my emotional and mental well-being as my physical health.

She gave me a copy of a birth plan to fill out. After I got to my car, I sat for awhile and looked at the plan. I dug out a pen and began to make check marks and notes. Then, as I began to really process what was being asked of me (e.g., Do you want access to a mirror? Do you want to touch the baby's head as it's crowning?), and imagining it, I burst into tears and cried all over my car. lol I can't believe this is real, and that it might really happen.

16 weeks today

Waiting for quickening. I hope it happens soon.

Stressed about our financial situation. All at once, we've had to pay for: moving expenses, down payment for a house, lawyers' fees for said house (around $3000), truck repairs ($2000), my upcoming continuation fee at the university, and start-up costs for DH's business. And I need to buy a car soon, otherwise I won't be able to drive to work (since there is no transit system around here!). Oh, and DH hasn't received any unemployment cheques yet, plus I don't get paid until mid-September. Hurray. lol No pity, though! We will be ok - it's just gloomy to be so far in the hole.

I kind of wanted to start picking up a few baby things - since I will be too busy teaching in the fall to go shopping - but that will need to wait. In the meantime, my MIL is making fitted cloth diapers for Ninja, plus she's going to look for an infant snowsuit (and make a toque, scarf, and mittens), and my parents will likely buy us the crib for a Christmas present. I've also got a lead on a cheap travel system. So that helps a lot.

My mom - after a great travail of a dialogue (the details of which weary me to death, so I won't go into them) - is going to throw a shower for me, which is lovely. I don't want the 'stuff'' nearly as much as I want the celebration of a new life. I don't have many girlfriends in my immediate vicinity, which is most unfortunate, but my sisters-in-law will come, as well as my nieces, my zillion aunts, my MIL, a few of my cousins, 2 close friends, and my other 3 or 4 adopted 'moms.' (I hope DH's aunts come, too, because they are a riot.) So that will be wonderful, I think, even though the idea of sitting at a baby shower in my honour will scare me to death. I've never actually attended a baby shower, believe it or not, since I've spent most of my adult life trying unsuccessfully (and miserably) to conceive.

All righty, I should get to work. Got a midwife appointment at 4 - including a physical - so I'll keep ya posted!

long time no see!

I'm definitely not exaggerating when I say that I have very little internet access these days! lol

Anyway, things are pretty much the same, except that we just bought a house. Waiting to see if the financing will go through. And so we are very, very broke right now. Eek. But it's cool to walk into the second bedroom on the main floor and think: If all goes well, my baby will sleep here one day.

Baby is good - I'll be 16 weeks on Tuesday, hurray! (I have my second midwife appointment this week, during which she'll do a physical - my gp says I'm measuring 2 weeks ahead, so I'll be interested to hear what she has to say about that.) I still feel fine. Just tired and thirsty. I guess I'll start to feel Ninja move soon, and I can't wait for that.