Thursday, March 03, 2005

Second Verse, Same as the First

Last Wednesday, we had a brief taste of spring, and several of the moms from preschool took their kids to a local park. We had a brilliant time, the kids got to run off their energy and the moms all shared their snacks and we all agreed to do it again as often as possible. (It turned freezing cold over the weekend so we did a playdate at our house yesterday. Afterward, Wilder threw up his chocolate milk and grapes and then took a nap. He threw up three more times before 11pm. Sigh.)

Also at the park, I had an hour-long conversation with one of the moms about IVF, IUI, and the relative merits of stims when your diagnosis is male-factor infertility. We talked about wand monkeys and sperm analysis and the state of my ovaries. The awkward part? The mom in question is 42 years old, trying for her second child, and swears six ways until Sunday that both her eggs and her (tested last year) FSH levels are good to go. Etiquette and common decency require me not to gasp at any claim by a 42-year old woman that she knows "tons of women who had [non-ART] babies in their mid-forties," and Good Lord, she knows her FSH better than I do. But because the woman in question wanted someone to agree with her that she didn't need stims "because our problem is male-factor, not egg quality," I was hard pressed to know what to say. After an hour, I had pretty much used up my time-tested variations on "well, I'm not an RE" and "I had a different diagnosis so I have no idea" and "It certainly sounds like you're making the best choices for you."

Finally, I lost my head and confessed that I knew of several women in their early forties whose FSH levels took dramatic turns for the worst with no warning (as opposed to, you know, those women whose ovaries sent up warning flares), and hinted that the general consensus in the infertile world would be to act fast whatever she wanted to do. I suggested that if she wanted to do IUI without stims (against the advice of her RE), she should do it soon. I suggested that she could try IUI with stims (as advised by her RE) and call off the insemination if she responded too well for her particular comfort level. I suggested that she was wise to get a second opinion if that's what she wants, but it was my best guess that most other REs would want her to move right along to IVF, and that I heard they did a mean PGD up at Shady Grove. I aplogized six or seven times if I'd overstepped my bounds.

I get approached a lot about ART. I take to heart the advice of other triplet moms that I tread gently when asked, "are they natural?" Sometimes, the answer to "why do you ask?" isn't just stuttering silence as the questioner realizes she's overstepped her bounds. But this is insane. I've now had lengthy conversations about secondary infertility with moms in all but one of the major venues: preschool, Kindermusik, and swimming lessons. (So far, no one has queried my sex life at church.) No doubt it's a reflection of the socio-economic status of the women I meet, because all three SIF moms had their first babies at 38 years old. Probably people "come out" about their infertility to me more than to other women: I doubt the mom in the Kindermusik room whose only child turns out to have been conceived in an FET would have said anything if the SIF mom in the room hadn't raised the topic. I'm glad I don't move through a world where infertility, and especially secondary infertility, is a silent menace. But it does raise some interesting etiquette questions.

Yesterday, the new mom at the preschool talked for rather a long time about how "she wouldn't recommend having your babies so close together" (her daughters are thirteen months apart in age) and I couldn't stop myself from thinking that SIF mom probably didn't need to hear that. It's not my job to educate other women about SIF (my claims to that status being highly dubious) but simply changing the subject felt wrong. How to stand up for my sisters in arms? I have no idea.

Unhappy sidenote: I'm not entirely sure I like being asked about IUI when the question is prefaced by, "I just don't think I could survive having triplets. How did you decide what to do when you were infertile?" I have a fairly complicated answer to that question, and I'm willing to share it, but at some point, how appropriate is it to ask about my responses to triplet motherhood when my kids are tugging on my pants and shrieking for another push on the swings?