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Choosing motherhood, Part II

Part I was about my choice of having a child without a partner before turning 35. Here I go more into detail about my fertility struggles. I am writing this for friends and family, for other women and couples who are going through similar journeys, but most importantly to one day tell that story to my little Cookie.

As I mentioned earlier, I started to seriously consider single motherhood in early 2016 and I formally started the process in October 2016 at the Erasme fertility clinic. I was 33 years old at the time, healthy and quite excited at the prospect of soon getting pregnant.

We always hear about those people who got pregnant after the first month of trying, but that’s because we don’t hear about those who didn’t. It’s not something that’s as widely advertised. The statistical chances of conceiving every month, on average, is about 15% (for young and healthy couples). If there is one thing I wished I had known before starting the process is how long it could take. It would not have changed my mind, but it would have helped me manage my expectations. I think the best way to recall this adventure is in chronological order.

I had my first appointment at the fertility clinic in October 2016. It was a two-hour “interview” with the clinic’s therapist, who gave the green light to my project. The discussion was focused on my motivations, the importance of my support network and finding the right way and the right words to explain my choice to my future child one day. The following months were filled with many blood tests, vaccine updates, and even a small surgery to take a very close look at my reproductive system in February 2017. Those tests included checking hormone levels (quality of my ovarian reserve), examining the uterus, the cervix and the fluidity of the Fallopian tubes. I basically went through all the tests infertile couples go through so that when I would start insemination, we would be fairly confident that it would work. Since all the tests yielded positive results, the medical team and I agreed that I should be fine with simple intra-uterine inseminations (IUI).

From a legal standpoint, I had to sign papers confirming I was choosing to be inseminated by an anonymous donor. In Belgium, it means the donor could never be traced back by myself or by the child.

And about the donor… Most of the time, that’s the first question I get. I chose anonymous, but that still means that the doctors make sure to match with the skin, eye and hair colour (they can’t make any guarantees, though). The donors go through an extensive battery of tests as well (psychological, genetic, diseases, etc.), so I was certain to get a healthy donation. It would come from the clinic’s sperm bank, but if I wanted and was willing to pay a higher price, I could’ve “ordered” sperm from a private bank as well. I chose to keep it simple because a healthy baby is all I was hoping for, but I understand the feeling or need of some people to know how the other half of the equation might look like. It’s a very personal choice: I know I will love that child, no matter what. I would’ve also consider adoption, but it can take much more time, is often more expensive and adoption agencies are not fans of single women.

I had my first IUI cycle in February 2017. If it didn’t work, I could try again the following month. From February to July, all I had to do was to check my LH hormone levels close to ovulation day (simple pee on a stick in the morning), and when it was positive, call the clinic so I could come in the next day for my IUI. I remember it as an exciting time: I was so happy and enthusiastic at the prospect of getting pregnant. I was also very positive, since I had been told that everything was fine and that it should work within six IUI cycles (so by July 2017). My main worry was not clinical: it was dealing with a couple of friends who did not approve of my choice. And as I was going through the cycles, learning to deal with the waves of emotions was also a challenge (excitement and joy on IUI day, deep sadness and disappointment on the day of blood test results).

During this process, a big part of someone’s life going through fertility treatments is based on cycles. Eventually, I figured out a coded way of stating on which side of the cycle I was on: the “sushi weeks” and the “quantum weeks”. From day 1 of my cycle until ovulation (about 14 days), I’m on sushi weeks because I’m not pregnant and therefore I can eat sushi. From insemination day until my next period (or the negative blood test results), I’m on quantum weeks because I’m both pregnant and not pregnant at the same time, since I don’t know (see Schrödinger's cat).

This was very useful because I learned early on that there is one very important rule for friends and family in the know: do not ask for updates. The reason becomes rapidly evident after a few failed cycles: when I was asked “so, so, so, did it work??”, I had to repeat the same sad news several times, and deal with several people that were disappointed with me, multiplying the disappointments all over. It’s not pretty, unfortunately unhelpful, and just gave much more weight to the failures. And as my wonderful therapist explained, it meant I had to manage my loved-ones’ disappointments in addition to my own. So if you know someone going through the process, just tell them you’re there for them if they need to talk, but don’t ask how things are going.

As you may have guessed from the above, it didn’t go as well as I had hoped. Back to the timeline: from February to July, I went through six failed IUI cycles. I then regrouped with the specialist, who suggested that we continue with IUI cycles, but with monitoring. That meant that as of September 2017, instead of relying on the pee sticks, we would rely on several blood tests and ultrasounds to determine my ovulation time, which would be more precise and give more data on my situation. The process is worth explaining to understand the ordeal and the emotional changes I went through in the fall of that year.

On day 1 of my cycle, I had to call the clinic and set my first appointment on day 10. On day 10 of my cycle, I would go to the clinic in the early morning for a blood test (to check my LH levels) and an ultrasound, which served to observe my growing follicles in my ovaries. They measured the size of my “winning” follicle (only one grows to maturity each cycle) and counted the rest. In the afternoon, they would call me to give the results of my blood test and depending them, set my next appointment either for the next day (if I have a good size follicle already) or the day after, if it’s too early. And then it would continue like this for several days: blood test, ultrasound, results, blood test, ultrasound, results, blood test, ultrasound, results, until my blood test showed a peak in LH and my follicle looked mature, at which point they would book me for an IUI the next day. A relaxant was prescribed to help to chill on IUI day, so I also had to take the day off.

These back-and-forth at the hospital for about a week, never knowing exactly when or how long it will go on, are usually what end up being the worst part of the process. I would compare it to the Chinese water torture: a drop on your forehead is almost meaningless, and definitely painless. But constant drops of water over a long period of time will drive you insane. It’s the same thing: going to the clinic is simple. Blood tests and the ultrasound are painless, and don’t take more than a few minutes each. But back-to-back, and repeat over a few cycles, and you may finally understand the ordeal of weeks of hospital visits in the mornings. A big part of it was also the unpredictability: I was basically at the mercy of my cycles. It made it much harder to plan anything more than a month in advance. For a frequent traveller like I am, that was pretty challenging.

So from September 2017, I went on with the Chinese water torture, completing 10 failed IUI cycles by December. By November, my doctor, still baffled by the results, recommended we move to in vitro fertilisation (IVF) the following year. It is quite unusual to go up to 10 IUIs: normally, doctors recommend IVF after about 6 failed attempts. But I was still young, we knew by now that I had beautiful follicles every month and perfectly normal hormone levels at every possible point of time in my cycle, so the failures couldn’t be explained.

It was a tough time: I had to deal with lots of disappointment, monthly little heartbreaks and managing the rest of my life, which felt hijacked by the impossibility of planning. It’s trying to find the right balance between not letting the desire to conceive overpower everything, and continuing life as if it wasn’t happening. The levels of unknown, uncertainty and lack of control would be a test on the most well-rounded, sane person. I learned a lot about myself through my growing intolerance towards people who didn’t understand what I was going through, didn’t say the right thing or said the wrong thing at the wrong time, or who would be cross with me because I couldn’t plan much in advance anymore. It was difficult to witness myself become insensitive to most of my friends’ troubles, but it helped me work on my openness and empathy over time. I eventually understood I had to focus on the (mostly) good intentions behind my friends’ words and actions, rather than on how hurtful they could be at first sight. Ultimately, it prepared me to tackle the next step in my journey towards motherhood with greater peace of mind: IVF.

I had to wait a couple of months before starting my first IVF cycle because more tests had to be run and more paperwork had to get processed, but I finally got everything ready for that first cycle in February 2018. In essence, the process would be similar to what I was already doing (in terms of monitoring at the clinic), but in addition, I would be injecting myself in the belly with hormones every day for two weeks, trying not to kill someone in that period, and if successful, get many eggs extracted, matched in a petri dish with vigorous sperm and then I would get inseminated with my best embryo a few days later. If I had “leftovers” (more good quality embryos), they would be frozen for potential future use.

A combination of factors made this process much easier than anticipated. I felt much stronger and stable psychologically, it felt like a fresh start, I had renewed hope and it was a positive step forward. In addition, the needles were really not an issue for me (it was much easier to inject myself than I thought), my body reacted well (no hormone hyperstimulation, steady follicle growth) and I had planned an impossibly time-sensitive holiday in Australia only days after my embryo transfer, but planning that trip got me happy and excited as well.

In summary, I started my IVF cycle on 21 February, got 14 eggs (!!!) extracted on 6 March, 13 fertilised (!!!) and I had 9 good embryos three days later, when I they transferred the champion embryo on 9 March. I was on a plane to Melbourne on 11 March, in the absolute best setting to be in a good mood and to get my mind off things. That day, my remaining 7 (!!!) good quality embryos were frozen. My greatest hope was to have as many good embryos in the freezer so that I wouldn’t have to go through hormone treatment every cycle: I would only need to get one of them transferred at the right time. My results were pretty high above average, which felt really good and reassured me for the next steps.

I am extraordinarily happy to report that I got even more than I wished for: that single champion embryo stuck around, and I am now officially the motherly oven to a little Cookie cooking in my belly. I got the test results while I was still in Melbourne: it would be an understatement to say that it was one of the most beautiful moments of my life.

I was promised that one amazingly forgets about all the struggles once the miracle has happened. I am slowly starting to understand, as I wade in the peaceful waters of happiness and natural little worries linked to pregnancy. However, I don’t think I will ever forget the strength I gained this past year, nor the lessons in empathy and patience. I feel even more prepared for this precious baby and I can’t wait to introduce him or her to all the wonderful people in our lives who will also love him or her to death. The mandatory “proud-mommy-to-be” ultrasound picture above was taken at 12 weeks.

I will keep my blog updated with the classic parenthood milestone pics and posts. I also want to thank all those incredible friends and family who supported me through this process, and who continue to support me now. I feel lucky to have been able to rely on such love and care through the tough parts, and to be able to share the joy and happiness that came with little Cookie. Here’s to a new beginning (quite literally)!

P.S. Yes, I still have those 7 embryos in the freezer. Unless I find a good partner in the next five years, I don’t think I will use them, but the good thing is that I will be able to donate them in due time, which I will be very happy to do (I can’t imagine the struggles of couples having to hunt for embryo donations, so it would mean a lot to me to be able to help).

Choosing motherhood, Part I

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