Another Child

It honestly feels weird to think about another child at this moment. Both because I am borderline overwhelmed with parenting the one and also because I am content. But I know I probably won't always be content. That's not a reflection on Garrison; I always wanted a big family. The itch for another child will return. I'm not sure when that typically happens. When do normal, fertile couples begin to think about trying again? Surely not at 5 months. But here's the thing. It took us almost four years to get Garrison. If we don't want Garrison to be starting kindergarten before a sibling arrives, it feels like we need to get started.

While in Jacksonville finalizing our adoption of Garrison, we stopped in at FIRM, the clinic where we did IVF. We have four (maybe three) embryos frozen there. We have decided that before we pursue any other family building opportunities, we will complete our frozen embryo transfers. In a lot of ways, these embryos feel like a weight. And that's totally not fair; I know. They are our children, long awaited for, fought for, prayed for, but it appears that it is very unlikely that we will ever meet them. The doctor confirmed that it is unlikely we will see a bring home baby out of this IVF cycle. And yet, we feel that we must give them a chance. 

When we completed our IVF cycle in January 2014, we paid to keep our embryos frozen for two years. At the time, it seemed like we would not need the full two years. We knew our embryos were lower grades and we figured that even if we got lucky, we'd try for a sibling within two years. But then the first transfer failed. And then the second. And then an entire year passed by. January 2016 will be here quickly. I know that as the months with Garrison just fly by. I feel as if I'm constantly sticking a round sticker on his onesie and exclaiming "another month went by so fast!" We have a few months to decide what to do, but the decision is (as always) complicated. 

We met with a different doctor for our consult as my doctor was out of the office and we were only in town the one day. This doctor was more of a straight shooter. He agreed that in light of our past transfers and the quality of our frozen embryos, the odds of success with any of our remaining embryos is low. He didn't really bat an eye at our request to transfer all four...that's always a really bad sign. He agreed that the Endometrial Function Test would be a good next step just to rule out any implantation issues. If something came up, he said we'd correct it and then his recommendation would be to transfer two. He agreed that our issue is very likely embryo quality (with a root cause in egg quality) but that if he had proof that there was a problem with my lining, he would be unable to say with certainty that our previous cycles failed because of embryo quality and transferring four would be riskier. However, his bet is that all is normal with my uterus and lining. That's my bet too, but I've never been one to turn down answers. 

And I guess this is where my ideas on family building and next steps are changing. I'm just not sure how much more money I'm willing to throw at my body. There are other ways to build a family, ways that I'm really open to and even excited about. I do believe that given all the money in the world there is likely a doctor out there with enough expertise to help me get pregnant with my own eggs and Sam's sperm. But we don't have all the money in the world, and if I'm being honest, there are other things I'd rather do with money (like pay off student loan debt) than throw darts at $30,000 a toss at a moving dart board with a shrinking bullseye. 

The doctor did mention and agree that this test for my lining (at $1,500) would be valuable information for later transfers, whether that's our embryos or donor embryos. And while IVF may be less and less glamorous to me, embryo adoption still holds a lot of appeal. So we have to decide if we want to do this test. It needs to be completed about 2 cycles before our transfer. We also have to decide if we want to attempt to transfer these embryos before the middle of January (when our payment runs out and we'd need to pay $500). To do the transfer without the test would cost approximately $2,500 including travel and medication. Adding in the test would bump that to about $4,000. That's a TON of money to come up with in 6 months, especially while paying for daycare at the cost of $10,000 a year. Which ultimately brings up the biggest  question: are we ready (and can we afford) another kid? Yes, the cycle is VERY unlikely to succeed, but I can't help feeling negligent if we don't calculate our ability to provide for another child if the cycle were to succeed. 

I have a feeling the answer is no. In fact, I know the answer is no. Daycare alone is almost $1,000 a month, and we don't have $1,000 margin in our budget each month. Will we ever? Absolutely. But in January, no probably not. The wisest thing to do would be to table the "another child" conversation and work diligently to pay off our student loans, start college funds, save for retirement, etc. But fear and doubt always wiggle back in from the depths of my mind when I think about postponing a second child. The doctor so kindly pointed out that "his recommendations would be different if we were having this conversation and I was still young." Gee, thanks. It's interesting that at 28 I was "so young and healthy" but at 29 I'm "no longer young." The clock is admittedly ticking (probably far faster for me as my egg quality already sucks) if we want to try IVF with my own eggs again. But even outside of IVF, I feel the clock ticking. Family building outside of the sheets takes time...lots and lots and lots of time. So do we table it, relishing in our current joy, and continuing to pay to have low quality embryos frozen? Or do we recognize (and maybe even embrace) our circumstances and the ways our family is likely to be built and begin the journey anew with the start of the new year by jumping with both feet back into the TTC game?

I have no answers. Time will tell. 

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Guys, can you go over to my sweet, sweet friend's blog and give her some love? She just miscarried again and is having a really rough time. My heart is absolutely broken for her. I know she'd appreciate some love and support during these hard days. She was ready (like really ready) to start her long-awaited cycle at CCRM only to discover she was pregnant...surprise. But now it's over and it's so hard to answer the big questions when what appears to be the greatest blessing ends in more despair.

Hard Choices

For the sake of simplicity in this post, I'm dividing our next steps into two groups: group 1- we both (Sam and I) have a genetic relationship, and group 2- one and/or both of us do not have a genetic relationship with our child.

I'm currently struggling with our next steps. Unfortunately, I don't even really know what I want, which makes it particularly hard to agree (or disagree) with Sam about any of it. Every time I try to talk about any of the options, I start to cry. I'm feeling particularly vulnerable at the moment and all possible plans make me feel even more so. But I like to have plans, so I continue to think through them even if it's uncomfortable.

There are things that I like and don't like about each of the possible plans. I like that domestic infant adoption feels quick(ish)… it's certainly not a guarantee, but the possibility is there. I like that IVF gives me the potential to overcome infertility. I like that donor embryos is a cheap less expensive option. But with all the plans that fall into group 2 (donor egg, donor embryo, domestic and international adoption) I have a couple of things that I really don't like, a couple of things that I'm afraid of and can't seem to work through.

I've said several times before that adoption has always been a part of my family building plan. In my teens and early twenties, my dream was for 4-5 biological children first and then 1-2 adopted children, specifically via international adoption. To say I had a rose colored glasses view of adoption would be an understatement. I had never heard of adoption scams, or stealing infants from hospitals. I would never have dreamed that there was an underground rehoming network taking place in my own country. Adoption just seemed beautiful: it was all about rescue and redemption. I never thought I might need adoption in order to have a family, so it seemed almost ministerial rather than simply family building. 

My view of adoption has slowly changed. I'm honestly a little afraid of adoption. I'm afraid of getting in over my head, of unknowingly contributing to crime, of separating a child from his/her first family unnecessarily. In no way do I mean to say that adoption is bad. I have many, many friends who have or are currently adopting. I've seen adoption work. I've seen adoption be beautiful just like I imagined. But I've also heard things that make me nervous, things that seem to freeze my feet in place. 

My greatest fear with adoption seems to be spreading into all forms of family building that don't have a genetic connection, essentially all plans in group 2. My greatest fears center around the third party... the biological mother and/or father. Whether you want to admit it or not, adoption, donor embryo, and donor egg/sperm all have a third party involved. The fact that I would not have a genetic reflection in the face of my child isn't what I'm afraid of... looking at my child and not seeing high cheekbones or thick brown hair doesn't frighten me. What scares me is how the third party (or lack there of) might affect my child. How not knowing anything about his biological mom might forever leave a giant hole in his life. It seems to be a nonissue for some kids and a giant deal for others… I'm not sure if the difference is in the children or how they are raised.

In donor egg/sperm situations there is almost always no information available. In some instances, the couple receiving the eggs only knows height, weight, hair and eye color, and education level. Other than that, they simply know the donor passed whatever sort of preliminary tests required of donors. Unlike is most adoptions, even once the child turns 18, there is simply no additional information to provide the child… she will never know more about the woman who helped create her. The lack of information is typically to protect the donor from a child/children hunting for her years later. I don't think this eliminates donor eggs for us, but it's certainly something to think about, something to prepare for, something to process.

If the fear of raising a child who feels like a giant piece is missing from her life due to the lack of information frightens us, it seems that our next steps should be some form of open adoption or open embryo donation. But the moment I hear "open" an entire new set of fears arise.  I'm not sure if it makes me insecure or shallow but the idea of my child knowing and/or seeing his biological parents scares the dickens out of me. My dream of parenting never included a third party... the "adoption triad" as it's called. I understand why it's often the best situation for the child, but oh my heart. I'm not sure if I'm mature enough to handle that dynamic... I imagine I would forever be jealous of any connection my child might have with his/her biological parents. Meeting up at a park or inviting them to birthday parties scares me... and not simply because our parenting styles might be different or they might not be people I'd naturally choose for my child to hang out with. My biggest fear is that my child would prefer them over me. (insecure much?)

I can literally hear it ring in my ears, "you're not my mom." She might scream it as she turns, flouncing her hair, and slamming her bedroom door. The words probably came following a fight about boys or make-up. I'm pretty sure I said equally mean and hurtful things to my parents growing up, but that phrase might just rip my heart out if I ever hear it. It might be my biggest fear about losing the genetic connection with my kid(s). I certainly don't want to raise kids who feel incomplete, but I'm also afraid of allowing the biological parents into our lives. I'm afraid of how the third party would change my relationship with my child. It all just feels scary and foreign in ways I wasn't prepared to feel until group 2 was really right in front of me.

All of these thoughts have been swirling around ever since I wrote "Plans G-K". I had asked Sam several weeks ago to start thinking through our options so that we could discuss it soon. We finally talked about how we each feel about the different plans this past weekend. Essentially, I feel like we have six options (not including another FET or living child-free).

1. Expensive IVF: Somewhere with GOOD statistics like CCRM or maybe Advanced Fertility Centers of Chicago
2. Cheap(er) IVF: It would be $1000 less to go back to FIRM (which was already a fraction of the cost) for another round
3. Domestic Adoption
4. International Adoption
5. Donor Eggs
6. Donor Embryos

It should be shocking to no one that Sam and I didn't list our options in the same order. That would make things way too easy.

Sam's list: 3, 5, 6, 1, 4, 2
Amanda's list: 1, 5, 6, 3, 2, 4

Sam likes adoption for two things: he thinks it will be faster and that it's more of a sure thing.
I like IVF with CCRM (or other really good clinics) because it eliminates all of my above fears and allows me another shot at beating infertility (I'm not normally so competitive). International adoption is at the bottom of my list because, if this happens to be the only child we ever have, I don't want to miss having a baby. And I think repeating IVF at FIRM is at the bottom of both of our lists because of my poor response. It just seems dumb to repeat the same thing and hope for different results.

So how do we move forward from here? Obviously, we arm wrestle for it. I think the best move from here is to research each of our top options first. We might have a phone consult at CCRM and go to a few informational meetings at a couple adoption agencies. I've just finished reading Called to Adoption: A Christian's Guide to Answering the Call. I'm on the hunt for other good reads. I don't think we're in a desperate hurry to make up our minds… I'm in a desperate hurry to have a baby, but as all options cost a good chunk of change, it won't be any time soon. We've got time to research and talk and pray… hopefully our next steps will seem clearer to both of us with time. I do think I'll schedule a consult with Dr. Duffy at FIRM in the coming weeks to at least discuss the possibility of transferring all four remaining embryos. If he likes that idea, that may be our next step as it's certainly the cheapest and we'll have fully exhausted our options before moving forward.

Essentially, all of these are good options… there's no bad option here is it brings us a child of our own. But that doesn't mean choosing is easy… these are hard choices to make. These are decisions that I never in my wildest dreams thought we'd be making, not even when infertility was dumped on us. I'm still trying to wrap my mind around the reality of our life. There are moments when I just want to cry, tell God he's completely unfair, and refuse to give up any more than I already have. In those moments I just want a baby without stress or fear, without worry or heartache… I just want it to be simple. But simple it is not. I certainly don't believe the old saying that the Lord won't give us more than we can handle… I think the story of Job pretty clearly disputes that. But I do think wherever He leads me or allows my life to go, He'll see me through. He's allowed infertility to be a part of my life for one reason or another… I have to believe He'll see me to the other side, hard choices and all.

Plan G-K

Our Plan A went out the window a long time ago... we all know that. It was just over two years ago that we moved onto Plan B also known as Clomid, but it seems ages ago... like seriously, lightyears ago. But it is what it is; plans change and we have to adapt and change with them. When one door closes, you can either try to pry it open, or you can move onto the next one.

My dear sweet husband has calmed my ever increasing anxiety over our FET by reminding me that it won't, in fact, take half a year or more to save up the funds. I completely forgot in my absolute panic that we take money directly out of my check each month and place it into our health savings account... $500 to be exact. Add in the fact that Uncle Sam owes us big time, and well, the FET isn't too far away after all.

Speaking of tax refunds: whoa friends, itemizing medical expenses is about as much fun as a root canal. Seriously, it took us all weekend to do our taxes. And while we are getting a pretty decent refund, it was also immensely depressing to see where all of our money went last year. In case you didn't know, if you spend a large chunk of change on medical expenses, you can choose to claim those as deductions if you itemize your taxes. And by large chunk of change I really mean it. You used to be able to claim medical expenses if you spent over 7.5%, but of course that recently went up to 10%. I don't understand tax jargon, but the 10% is based off of your adjusted gross income... whatever that is. Sooo, all of this is to say that we spent almost 40% (37% to be exact) of our income on medical expenses in 2013. And no, I did not have chemotherapy, a boob job, or get a lung transplant. Nope, that's 99.9% infertility treatments and testing. Lovely. Oh, and that doesn't actually include our entire IVF... everything that we paid for after December 31, 2013 doesn't count towards that total... we're just getting a jump on next year's tax return. But like I said, at least there is a refund with our name on it. It won't make up for not having infertility coverage, not by a long shot, but at least it's something.

Anyway, moving on. The FET will (fingers crossed) be my next cycle... which should start the first week of March. If not, then I'm certainly hopeful it will be the next cycle. But as I've said before, I can't get too excited about the frozen embryo transfers. Not with day 3, grade 3 embryos... it feels like a long shot at best. To keep myself from spiraling into the abyss that is "woe is me" I'm trying to look into some backup plans incase IVF and all subsequent FETs are a bust for us. I know that the research doesn't actually do anything, but it eases my mind just a bit to feel like there's a plan. If I focus all my energy and hope into these precious embryos that struggled for just three days of life, I will fall into despair at the mere suggestion that they will fail. But if there is a backup plan, failure doesn't seem quite as hopeless. Make sense? No, I didn't think so.

So what would be next for us after these FETs? I feel like we've been here before... in fact, I'm pretty much sure of it. "The plan" was to do one IVF, if the IVF failed (which it did) we would systematically move through the available FETs. If all of those failed (which they might) we would move on to adoption. Eeek! Screech! Bang! That's me putting the breaks on. Six months ago I was ready to dive into adoption. But I suddenly feel anxious when I think about adoption... I've got to sort through my feelings on this before I can definitively say that it is our next step. I've got to think this through a little bit. And wouldn't you know, Mr. I Don't Know How I Feel About Adoption, is ready to move forward. But suddenly, adoption seems very scary, very foreign, and very overwhelming to me. I can't explain why exactly, it just does. But I'm not eliminating it, it's definitely still an option, it's just... there are other options.

Typically, lists start with A or 1, but let's be real... none of these are our first option for our first baby. We'll start with G, that seems about right.

Plan G: CCRM... I know, I just said one fresh IVF. One and done, that was our deal. Whoever said IVF was addicting... they were right. A small piece of me doesn't want to give up the dream of our baby inside of me. A bigger piece of me wants to beat infertility. Like knockout style. I don't want to go out on a losing note. Is that reason enough to haul our butts all the way across the country to a place where I will most assuredly be unhappy (I get the feeling CCRM and I won't get along) on the chance that they can do better with the dreadful eggs my body offers up? I guess that's to be determined. Cost for IVF at CCRM approx $26,000… not including travel.

Plan H: Donor embryos. For some reason, donor embryos have been on my mind a lot lately. I love the thought that I can save someone's embryos from being trashed. I don't love the thought that we might be buying embryos of poor quality. I know that you know the grades going in, but let's be really honest: those embryos are another infertile couples' leftovers. Everyone works through their embryos best to worst, so it is safe to assume that any remain embryos are the poorer quality of the bunch. I'm sure some are excellent and destined to be beautiful children, but some are most likely not. However, donor embryos is significantly cheaper than many other options, so it's probably the most feasible for us. In addition, it gives us the added bonus of experiencing a pregnancy. Admittedly, this is probably a little more important to me than Sam, but I think a pregnancy would be special to him too. Cost for donor embryos approx $6,000-10,000.

Plan I: Donor eggs. This would essentially solve our two greatest desires for Sam and I... genetic connection for him, pregnancy experience for me... at a cost. A significant one at that. I think the most likely scenario for us would be to return to RBA and use their My Egg Bank program with frozen donor eggs. The cost is significantly less than a fresh donor egg cycle, but you only get 6 eggs... scares the dickens out of me. Cost for frozen donor eggs approx $16,000-18,000. Cost for fresh donor eggs approx $30,000.

Plan J: International adoption. It was always part of my dream. And maybe it still is. I don't know. I think I kind of had a rose colored glasses type of perspective on international adoption. I still think it's beautiful, I'm just not sure how to ensure it's beautiful rather than painful, violent, or heartbreaking. Jen Hatmaker's series on international adoption opened my eyes and I can't close them back. And there's the price tag, and the hurdles like: we're not 30, and we haven't been married 10 years, or another 800 things some of the countries require... I don't know if we'd even be accepted into an agency at this time. And lastly, at least for our first child (looking like only) I really just want a baby, not an 18 month old, not a four year old, a baby. Cost for international adoption approx $25,000-40,000.

Plan K: Domestic Adoption. Again, the blinders are fully off. I've known quite a few people who experienced failed adoptions last year... it's not as simple as it looks. And if I'm being abundantly honest, I'm kind of afraid of what it would feel like to raise a child who wants to know their "real mom"... I'm afraid I'd constantly have to compete with "the other mom". And we're quite a number of steps between now and bringing home an infant via adoption... no social worker would clear us in our current living arrangements. So a house or a much nicer rental location is required before we could even start the process. Cost for domestic adoption approx $30,000.

So like I said: when one door closes, you can either try to pry it open, or you can move onto the next one…. we haven't decided which plan we're going with. We might try to pry open the stubborn door of IVF with our own eggs and sperm, or we might move on to a different door. And who knows, we might circle around the doors a few times knocking to see if there's a bring home baby behind one. But for now, I guess we're focusing on FET #1… and researching on the side just in case.