Double Taboo

No preface. But it has to be said.

We live in a world where infertility is a taboo. In many cultures that I’ve studied during my years in college, the very idea of being a woman is defined by motherhood (You can find numerous examples of this from the Bible to so-called primitive cultures around the world). In some countries and cultures the concept is taken further than in others.

During my junior year in college I wrote a paper examining certain aspects of a small Senegalese Tribe called the Seereer Siin. In that society becoming a man or becoming a woman are not things that automatically happen at a certain age, but require going through a specific, very physical ritual. After the successful completion of the ritual your status in society and in the community changes. Boyhood is something you literally cut away in the form of hair and girlhood is left in the woods upon going through labor and delivering your baby alone (Kalis 1997).

I have also studied India (though I claim no expertise on the entire continent and its long history and tradition) and the ‘traditional’ role of women as son-bearers and defining women through their marriage and their husbands. Many aspects of organized religion also paint the picture of the demure, silent woman whose will is expressed through her husband and whose womanhood is defined by her functioning reproductive organs… But since I don’t have a pile of essays here to reference and to quote, I’ll leave the search up to you.

Even in our Western society, despite the much more equal status of women where you can theoretically choose building a career instead of raising a family, you don’t HAVE to stay at home looking after 8 small kids, you can wear whatever you want to and even choose what to believe in, there’s still that unspoken question and assumption on everyone’s mind.

It’s sort of an extension of heteronormativity–where the unspoken assumption that everyone abides by traditional gender norms and relationships are always formed between cis-men and cis-women. That having children is automatically a result of a long-term relationship or marriage (and I could go on a long thing here about biological vs. chosen families, but I’m not going to) and if for some reason a couple DOESN’T have kids, it’s assumed it’s only a matter of time. Of course Lucy and Peter are going to give us grandkids! They just haven’t gotten around to it yet!

Just to be clear, there is no Lucy and Peter.

Children (and I’m talking about the concept of children here) are not just the magical and sometimes accidental result of a passionate moment: they represent the future and the continuity of humankind. Lee Edelman has all sorts of things to say about this idea of “reproductive futurism, ” that I won’t get that much, because I was never that adept at psychoanalysis and getting through even a chapter of his book was a challenge! The short point being that a child is always more than just a child. It becomes the Image of the Child that keeps the machine of the governments running… But think of the children!

Image

Photo from here.

I can’t speak for any other experience than my own, but in our little corner of Europe infertility is not something that you talk about. In fact, couples (especially single women!) trying to get pregnant rarely talk about it at all until they are securely 3 months pregnant. Because being infertile is such a taboo! Included in it is of course hidden that no one wants to have anything less than a perfect pregnancy. Miscarriages are also taboo because they break down the idealized picture of the Mother of the idealized couple that is fulfilling that societal expectation. Because perhaps in a way, we (secretly) believe we are not women until we become mothers?

So what do I mean by a double taboo? It comes back to Lee Edelman and also some volatile current topics. What about when you’re gay? The assumption of heteronormativity also assumes the reproduction of straight couples. The whole debate around the issue of gay marriage seems to come back to the idea of gay people having kids (oh, but it’s not natural! But think of our children who will be traumatized and will grow up thinking it’s okay to be gay!). That assumption of reproduction doesn’t generally seem to apply to us…or then again?

When I came out to my mom the first thing she said (in tears) was: “I’ll love you no matter what, but I’m just so sad you won’t ever have kids.” My dad’s response was: “Oh, I don’t care if you’re with guys or girls, as long as I get to be a grandfather someday!”

So maybe our parents just want to be grandparents and want to ensure the continuation of the family line…and of the entirety of humanity! Okay, but seriously, reproduction isn’t what society expects fromus anymore. Suddenly it doesn’t matter how reproductively able we are. (And yet gay people have kids all the time…)

I’ve already established (well, sort of, at least) that in some way motherhood becomes a definition for womanhood. Also, infertility is taboo because of the assumption of heteronormativity and the continuation of the human race .. and that gay people theoretically pose a threat to that continuity. We literally represent No Future.

So what if you’re gay AND infertile. Is there even a place for you in society? That’s the double taboo. I’ve been trying to break the silence by talking a bit about our process, trying little by little to ‘normalize’ it. After all, one thing I’ve discovered in this past year is that, this affects a whole LOT of people.

Apologies too all scholars of Lee Edelman for myover-simplification and non-academic rendering of this great work.

IVF: Becoming a pincushion

It was a relief to take the summer off from treatments, because you realize that the past six months of your life have been measured in two-week increments and bi-monthly clinic visits. Especially with the hormone treatment, this is what an average month would be like: upon getting your period, you call the clinic to make an appointment for an ultrasound around the time you’d ovulate. You go into the ultrasound around 8-9 days post menstruation to see how well the follicles have developed, and at a precise instant a few days later you inject the Pregnyl after which precisely 36 hours later we would go in for the insemination. And then you wait. You get paranoid about experiencing signs of early pregnancy. The first week flies by, the second week you wake up each day hoping you won’t get your period, which of course eventually you do and you start the cycle all over again.

Over our month of summer holiday, during which the clinic was also closed, we had time to reflect and prepare for the next set of more intensive treatments: IVF. I had a lot of mixed emotions about this: mostly fear and worry about the discomfort, but also about the cost. It ain’t cheap makin’ babies, that’s for sure. On the last day of our holiday I experienced the most severe cramping I ever had before and had to go in to see a doctor, who of course wouldn’t/couldn’t believe that it could possibly be related to menstrual cramps. (It was).

Upon returning home, I immediately made an appointment with my doctor who confirmed that my endometriosis had flared up, and was the source of my pain. She thought I should get a second opinion. Also, she thought it was wise to first take care of my pain and only then continue with the treatments. After preparing for it emotionally for a month, we felt disappointed and very unsure: the second opinion could mean being put in line for surgery…which would effectively force us to take a break from treatments until the following summer!

Luckily for me, pregnancy (if possible!) is actually a great temporary cure for endometriosis. Without the hormonal fluctuation of the menstrual cycle, the endometriosis chills out, dries up and can greatly be diminished. Our second opinion doctor showed us the green light, and two days later we are purchasing hundreds and hundreds of Euros worth of injectible hormones. (Thanks to the health care system, I only pay a small fee for ALL prescription drugs for the remainder of the year!).

On the second day of menstruation I took the first shot: Elonva to stimulate follicle growth. Five days later began five consecutive days of injections of Orgalutran to keep me from ovulating. On the last two days, I additionally injected Puregon to boost the rest of the follicles. On the 6th day at precisely 10pm I injected a full dose of Pregnyl to release the eggs for the harvesting on Monday. Three days into the Orgalutran injections I had had an ultrasound, where they discovered about 15 follicles. To ensure the maximum amount of mature follicles, the doctor calculated their growth rate and debated whether or not there would be enough on Friday–eventually she decided on Monday.

I had anticipated extreme discomfort and swelling to the point of being unable to work. Instead, the only side effects from being a pin cushion seemed some minor mood swings and a significant increase in sexual appetite (insatiable!). Not so bad 🙂

On Monday, after being a nervous wreck all weekend we arrive at the clinic in the morning. I’d taken a few days off work since I was expecting some soreness and my wonderful partner had taken that Monday off work completely to be with me. After a little bit of waiting we were called into the “resting room” where they prepared a cannula in my hand for the medication. And then they called me in! I climbed on to the exam table and immediately I was prodded and poked and washed. I was injected with a sedative and pain killers… and they administered a local anesthetic to the vaginal wall. Soon the sedative started to have effect… as they began the ultrasound and the harvesting from my right ovary. Unfortunately the machine got stuck and the sedative and pain killer started to wear off… so when they resumed I felt very distinct pain. But soon they gave me more things to calm me down and the rest of the procedure went quickly and painlessly. All in all it took about 20 minutes.

While I was blissfully unaware of what was happening, they managed to extract 14 follicles, of which 7 had an ovum. They immediately took them to get fertilized and I went in to recover.

I can only say that I was positively surprised at how easy and painless this whole procedure was! To any of my readers about to go through this: It’s really not so bad!

A few days rest at home and three days later we returned (yesterday) for the implantation! Of the seven ovum, five had split from the nucleus and were unusable, but two were prime 8-celled little embryos! Because I’m not very tall, they only implanted one.  The procedure was comparable to an insemination: A quick stretch and a wash and catheter in, catheter out–look at the little embryo on the ultrasound screen…And now we have a picture of this light blob in my uterus.. possibly the very first picture of our future baby!

Until I get to take a pregnancy test, I’m inserting a progesterone tablet three times daily to support implantation…and injecting a few shots of Pregnyl over the next week to support my short cycle.

So all that’s left to do is WAIT.

I’d appreciate your support!

So it begins: 6 inseminations

January 2013: The time has arrived. The talking and the planning finally boil down to baby making.

We have our first insemination halfway through January. Towards the end of the two week wait before taking the pregnancy test I get ridiculously moody, like the worst PMS I have ever experienced. A day after non-alcoholically celebrating my 29th birthday I get my period.

We are not crushed. Just disappointed. We didn’t think it would have been THAT easy anyway.

We try again in February. They told us at the clinic, that on average couples get pregnant by the third try, so we are hopeful. Throughout the process we’d been bounced about from doctor to doctor (our regular doctor always seemed to be away at conventions or trainings or on holiday, and eventually we find out she’s quit). The third doctor that is assigned to us suddenly notices something strange in my cycle: my luteal phase is abnormally short, despite my cycle being of normal length (though on the short side). Now for a fertilized egg to have time to travel to the uterus and implant, it needs at LEAST 12 days, preferably more than 14. If a woman’s luteal phase is normal, she’ll take a pregnancy test 14 days after insemination to figure out if she’s pregnant. My luteal phase is only 10 days: two days shorter than what is already considered to be challenging and only one day more than impossible. In other words, short of a miracle, there is no way I can get pregnant naturally. My uterine lining starts to shed 4 days before even the most accurate pregnancy tests can detect an early pregnancy.

Enlightened by this knowledge, for our third insemination in March, our doctor prescribes me progesterone to hopefully lengthen my luteal phase to allow for a pregnancy to begin. To our dismay, the progesterone only lengthens my cycle by one day, and I get my period days before the date of the pregnancy test.

For the next round we take things a step further. I get an ultrasound a few days before my natural ovulation but my body is tricked into ovulating sooner with the use of a hormone injection. This makes the egg(s) mature quicker and release sooner. This particular time, I had two mature eggs, so our chances are doubled! Precisely 36 hours after the injection we go in for the insemination. Ideal circumstances for a baby to happen, right? I continue to inject half a dose of Pregnyl (2500UI) two more times in four day intervals to support and lengthen my luteal phase, succesfully. The week leading up to the pregnancy test I experience nausea, breast tenderness, aversion to certain smells and tastes, and a strange heaviness in my lower abdomen. I have vertigo. I cannot stop reading online forums for the earliest signs of pregnancy. I feel an odd protectiveness, that I’ve never felt before. As someone who trains hard at the gym, I find myself not wanting to do so. I’m convinced this time, we had success!

Until a day before I’m to take the pregnancy test I wake up with horrendous cramps and heavy bleeding. I am in so much pain, my partner drives me to the doctor and I get a pain killer injected straight into my buttocks. I take the day off work to recover.

We try again in May, and the last time in June. Pregnyl helps, but each time I get my period a day before or the day of the pregnancy test. Our doctor says we cannot keep doing this to ourselves like this anymore, and it is looking more and more likely that my endometriosis is somehow causing infertility. We have no choice but to consider IVF as our next step.

The next step

So, the decisions were made and it was time to make a move. A year earlier actually, we had gone in to talk and get a consult at the clinic and at that time we were considering my partner as the one to get pregnant. I remember one tense drive to my partner’s grandmother’s house in a different part of the country around Easter 2012 where I finally blurted out that I was uncomfortable with the idea of her being pregnant–instead of me. Somehow, even though I was never much of a “baby person” or even necessarily thought I’d ever had kids, if we were actually going to be doing this, then it would have to be me. Not something I can really explain logically; some people want to have kids because they have a strong nurturing drive or because they really love kids, but I just kind of really want(ed) to be pregnant.

So with that decision made we booked appointments at a clinic, which we’d heard great things about from other lesbian couples, to get all the necessary tests done. Where we live they require several necessary steps before you can start your baby process:

1. Getting tested for all possible STI’s

2. Testing that your fallopian tubes are open and working properly

3. Getting all the necessary hormone levels checked at different points of cycle to for example, ensure ovulation.

4. A 1,5hr meeting with a psychologist to make sure you know what you’re getting yourself into–and also them assessing your suitability to parent!

Autumn of 2012 was filled with blood tests, ovulation tests, many internal exams and tests to see if everything was working right. It was. So as 2012 came to an end, the only thing that was left to do was to order sperm. Like any couple, we wanted our donor to resemble my partner as closely as possible. Unlike in many countries where you essentially have a Facebook-type catalog of sperm donors including childhood pictures and voice samples, in our European country all you get is ethnic background, height, and the color of their hair and eyes. That’s it.  And the cryobank had one match.

So in the history of all awkward phone calls, imagine this: you’re sitting in packed bus during rush hour when your phone rings. I often don’t take calls while using public transportation, but as I was expecting this particular call, I answered. The somewhat one-sided conversation went about like this:

-“Hi! Is this xx? This is xx calling from the lab at the fertility clinic”

-“Yes, this is she.”

-“So I was calling about ordering semen for your upcoming treatments”

-“Yes, great”

-” So we found a donor that matched your wishes. Tall, of European decent, brown hair, brown eyes. Is that correct?

-“Yes, perfect”

-” So how many vials would you like to order?”

-“Ummm… four?”

-“Okay, four vials of semen.  It will be one vial per treatment, so hopefully you’ll have some left over. So the quality is very high–we test for mobility and wash it to ensure the best possible results.”

-“Sounds good.”

-“Your order should be available to use at the clinic just after the holidays”.

OF COURSE you imagine everyone on the bus hearing the other person talk about semen and insemination and sperm donors… so perhaps the feeling of awkwardness was mostly just on my part, trying to keep it cool stuffed in my winter coat on this packed bus.

Introducing our story

I suppose this story starts like so many other stories: you’re nearing 30 or in your 30’s and it’s time to think about babies. As two women, this whole baby thing isn’t exactly something that just accidentally happens, but requires a great amount of planning and investment (both emotional and financial). So the discussion revolved less around WHEN to have a baby and went more like: “How are we going to have baby, and are we going to involve other people? Should we ask one of our friends to donate or should we go for an anonymous donor? Who’s going to carry the baby? Are we going to inseminate at home or use a clinic? For whom would it be easiest to stay home after the birth?”.

Quite surprisingly and eerily accurately we received an email a week after our commitment ceremony, from a gay couple that we knew of through other friends. In this email they in all essence asked if we wanted to make babies with them. Now straight couples will probably get questions after they’re married about when to expect the pitter patter of little feet—but for gay folk, we go straight to the point 🙂 We had at that point only just begun the process of thinking of expanding our family, and we openly accepted the boys’ invitation to get to know each other and consider starting a family with them. Through nearly a year of discussion we eventually came to the conclusion that we wanted different things (my partner and I wanted to be the sole guardians of the child(ren) and they clearly wanted a family of their own).

We had previously also brought up the idea with a (gay) friend of ours, thinking of him as the only person we would ever ask or want as a donor. He accepted…but as things got close to decision time he backed out worried how a mutual child would affect our friendship and his possible plans to have a family of his own someday.

No problem–considering all the things we wanted and our only possible donor out of the picture (in that capacity, not out of our lives!) we decided going for the anonymous donor route. Simplest (most expensive!), and easiest. And this is where the story really begins.