Sunday, October 17, 2004

Not exactly offended

I stumbled into blogs via infertility, specifically a very funny set of infertility tickers at a little pregnant that showed up on the Triplet Connection back in August. That was right around the same time the Amy Richards selective reduction fracas was winding down, so it was an interesting time to plunge into the world of blogs. It's just taken me awhile to work up the nerve to join the fray myself.

It's pretty clear that first postings go unread, so rather than do some silly introduction, provide a raison d'etre sort of thing, I'm going to respond to one of the (infertility) blogs on triplets that I managed to dig up while scrounging around infertility. But before I get to that, I'll acknowledge the possibility that I should just leave those infertility blogs alone. There are plenty of parents who comment at all the great infertility blogs (who wouldn't want to befriend some of those amazing women?) but still, shouldn't I keep my kids out of those women's faces? I don't know. I do know that no one like GetUpGrrl lived anywhere near the internet I knew, back in 1999 and 2000 when I was trying to conceive. I hate to miss out on knowing her just because my timing was off. And to paraphrase Tertia, "I am still infertile, I am just a mother, too."

But I'm going to leave the whole question of secondary infertility for another day.

Meanwhile, I want to address some of what Patricia wrote about triplets. Because I have them, triplets that is. They're three and a half, two girls (let's call 'em Gemma and Elba), one boy (Wilder? I'm straining for pseudonyms that feel like acceptable proxies for these kids with very specific and named identities), and they're wonderful. The conception, the pregnancy, the NICU? Not so much. But worth it. And not really deserving of these comments:

Don't people know the risks involved with triplets? The birth defects? The long term medical issues? Health care costs? Triplets are not something to celebrate! They are something to avoid.
Wow. Why does that feel like such a punch in the gut? Maybe because my kids only seem like something to avoid when they've gone too long without food, and they're in that blood-sugar-crisis mode so beloved of all preschoolers. Maybe because yeah, I was intelligent enough to manage my infertility, I wasn't a complete moron about the risks attendant thereon. Or maybe because what Patricia wrote was followed up by this comment from Pazel (whose history with IUI was not entirely unlike our own):

How could a mother put her children's health in such jeopardy? Who would risk such a thing and call themselves a loving parent? For most, there are ways of preventing multiples in advance of their conception so selective reduction doesn't have to be a question
Well. At least that gives me a way to begin to address this. I can start by explaining how I failed to prevent my multiples, and to explain how I could risk carrying all three of them to term while still calling myself a loving parent.

Start with this: the first serious comment I made when I met my RE was, "we will adopt rather than conceive high-order multiples." Yes, I had done my reading, I knew the terminology. I was a lingering ABD graduate student, the husband (Calder? hmmm) is an only child with marginal feelings of affection for infants, and neither of us wanted the hassle, the career interruption, nor the potentially devastating medical costs attendant on triplets, or--God forbid--quadruplets. The RE was optimistic, I jumped through the requisite HSG hoops, Calder got the good news on his "great sperm," and we went to work seducing my reluctant ovaries. First, a round of clomid to confirm what the incompetent OB had already wasted a year proving: that Clomid didn't work.

As an aside, two questions about REs? Why are they all men, when obstetrics in general has become a field for women? And do all REs require their patients to write the depressing news, "many less than ten," onto the charts, or were my REs especially sadistic?

So, no go with the Clomid, indeed, no discernible activity on the old ovaries whatsoever. On to Follistim. Oh, wait, Fertinex. Because our pharmacy didn't provide Follistim, a tiny detail they didn't share with us in any way more informative than making the substitution inside the bag. Late on the Saturday afternoon we were supposed to begin injections. Oops. So, make that one vial of Fertinex (aka hamster pee) for 17 days, get that estradiol up to 384, push one of those follicles all the way up to 14mm, talk about doing the HCG shot in two days--and wham, watch the estradiol drop back down to 37 on day 18.

Spend a weekend in tears while Calder has long conversation with RE about whether we can thread this needle, walk this line, figure the damn thing out. Decide to switch to two vials of Gonal-F, add Lupron (to shut down whatever biological urge messed with the estradiol first time out the gate), and throw in Metformin for good measure. And yes, we worried a little. When your first goal (if you're Calder) is to get one baby, international adoption looks like a fine alternative to gambling with touchy ovaries. What if two vials pushes us from stagnant to teeming, from no follicle activity to septuplets? But I had fantasies about a cute little Calder clone singing "Away in the Manger" at the Christmas pageant, and the RE said two vials was nothing. Especially not for a woman who hadn't ovulated in ten years.

Lo and behold, the RE is correct. Two vials does the trick, I never once have to inscribe "many less than ten" on my chart, and at day 17, there's one lovely beautiful almost-mature follicle floating on the U/S screen, but four little 14mm thugs waiting to mess things up if we wait any longer, so even though two lovely beautiful almost-mature follicles would be better, it's time to move. Calder gives me the most painless HCG shot in the ass in recorded history (no kidding, Calder's an ace with needles apparently, or maybe it was just the hugeness of my long-suffering ass), we go in for two lovely IUIs, and two weeks later, to the day, I'm sneaking a store-brand pregnancy test into the bathroom and coming out with two faint lines. Or, as the nurse at the RE's office said, "you've won yourself a blood test."

Of course, the lab messes up the assay and I have to wait until the next morning (when I was promised a phone call by 2pm) but two more EPTs have already confirmed the original finding and when we get word that my beta is 182, it's a bit of an anticlimax. Go back for my tracking betas, levels climbing steadily but not in a multiplicity-type way, and then at 5 weeks pregnant (some funny accounting going on there, don't you think?) -- U/S shows one lovely sac and a little tiny shadow. It's a shadow, RE says. Come back in 2 weeks so we can make sure everything's going well, make sure there isn't a second baby lurking back there, I'm 98% sure it's just a shadow.

Calder's aunt, informed of medically-assisted pregnancy, asks, could you have twins? Oh, no, no, no, we say. We didn't do those irresponsible things that cause multiples. We were smart, we were careful, we have bloodwork and an adorable ultrasound image and an RE spouting 98% confidence in one.

Get home at 4am from vacation (it was the first of the United Airlines summers in hell), get up four hours later to pick up dog and drive to RE's for promised U/S -- by myself, this is routine, I've been too exhausted and nauseous not still to be pregnant -- and the minute RE graduates from the vaginal probe to the abdominal scanner: whammo. Three little sacs floating in space.

So that's how you can conceive high-order multiples while simultaneously not acting like a child-endangering idiot. It's taken me forever to type this, so I'll save the decision to attempt carrying all three of them to live birth until tomorrow.


Meh said...

People can be a bit quick to judge, if they don’t know the background. I know, after I conceived the quads I am sure many people pulled up their noses, but after 7 IVF’s and 3 IUI’s (all neg or MC) wouldn’t you / any one also put back four day three embies, I mean really, what are the chances of all four taking? Clearly more than I thought in my case.

Happy blogging!

Anonymous said...

I am truly sorry that my post felt like a punch in the gut. Really, that was never my intention.

If it helps at all I don't mean that your three beautiful children shouldn't be celebrated, because they should. I just meant that I think society oftens looks at triplets and quads as the greatest thing, when I think it is something to be feared. It is a scary and dangerous thing to try to carry three or four babies to term. As you clearly know yourself - it is no picnic, and I feel the media glosses over that sometimes.

And my post was judgmental. Obviously everyone has different circumstances that are to some degree beyond their control. I'm all about low population growth, but if I got unintentionally pregnant with triplets, I do not know for sure if I could "reduce." I have not walked in your shoes.

Again, my apologies for any hurt feelings.


Jenplus3 said...

I stumbled upon your blog by accident. I also post on TC, and as soon as I started reading the blog I KNEW it was you. You are such an amazing spokesperson HOM Moms. I admire your spirit and appreciate your classy & intelligent representation.
I am glad to know you are here.
Thank you!
By the way, did you ever write the rebuttal to Amy Richards' piece?