Contemplating IVF

adoption

The journey to adding a child to our family has not been an easy one. Our original plan was adoption. We wanted to adopt a child, or siblings, five years of age or older with special needs. The process quickly got complicated.

The short version is that our adoption process was stalled indefinitely when five minutes into our first visit with the social worker she decided that in order for us to adopt I should sign up for life-long counselling because of a medical history that included a rape that happened 17 years ago. I was shocked, appalled and frustrated. You can read about that here. Not because I have anything against counselling but because of the judgement that this decision made about rape victims’ (1 in 4 women) capacity to be parents. We fought on for some time and tried to get CAS to clarify what type of counselling they would accept (psychiatric, psychologist or counsellor) and to this day we are still waiting for a response to that question. We could have pressed harder, we could have followed up more. But, we didn’t. We got tired and frustrated. We gave up.

The backup plan to adoption was simply – ha! – to have a baby ourselves. My mother had me and my brother later in life, there was no indication of any problems on either side, so we never thought this would be a problem.

Infertility was a subject that was as foreign to us as miscarriage (as discussed earlier).

IVF 242Perhaps another theme of this blog is taboo subjects. Infertility certainly falls into that category. The lack of discussion on infertility baffles me. I have learned more in the past year about the human reproductive systems than I have in my entire life. And, none of it is, difficult for a 14-year-old girl (or boy) to grasp. Why we are not taught these things as part of sex education is beyond me.

The whole infertility subject lies in a black box. Women and couples who are dealing with infertility are relegated to special doctors, clinics, online forums and Dr. Google. Dealing with infertility is scramble to try to find some – any! – reliable, publicly accessible information. Knowledge seems to be firewalled behind medical institutions and, as a patient, you simply cross your fingers and hope that your doctor is up to speed on all the advancements and treatments.

There is also isolation. Suddenly a feeling of being alone. You can’t simply look at another woman or couple to know if they may have had a similar experience and might be able to offer some guidance or advice.

Our journey from infertility diagnosis to contemplating In Vitro Fertilization (IVF) was thankfully a short one. I say this because I now know that many women and couples face a much longer road.

ivf-fertilizedOur first pregnancy was assisted by Clomid and we were successful on the first round. Unfortunately that pregnancy miscarried and the miscarriage follow-up tests showed that I had cancer and a bilateral tubal blockage. This means that both fallopian tubes are closed making it physically impossible for my body to transport an egg through the tube to the uterus to be fertilized.

The silver lining in all of this is that a complete bilateral tubal blockage is one of very few situations where the Government of Ontario will pay for IVF.

Deciding on IVF has been difficult. If the government did not offer coverage for IVF then my answer would be a simple no. This would be based on a financial decision. After blood tests, hormone tests, lab fees, sperme and egg storage and the IVF procedure itself most couples in Ontario are facing somewhere between $15,000 – $20,000 per IVF cycle. And, that’s before the medications. That’s simply not a financial reality for me.

public_funding_ivfHowever, the government does pay for it. I feel like not taking the opportunity is a slap in the face to couples who would give almost anything to be in my position. Not to mention the people who worked very hard to convince the government to cover IVF (in some limited cases, so far). It also falls under the regret the things you do, not the things you do not do category. In a way I’ve won the IVF lottery and walking away from that feels senseless.

One question I’ve been asked a few times is: how will IVF treatments affect the cancer. I have a team of doctors at Mout Sinai and at Princess Margaret. The agreed consensus is that cancer treatments would seriously diminish my chances of successful IVF procedures. While IVF treatments may post a slight risk to cancer, but are not considered serious.

More difficult, and I hate to admit that I am influenced by this, is the social stigma. I have been told by many friends that they would simply never do IVF. In all cases these are women who have never had to make the choice between: do IVF or do not have a child.

Infertility AwarenessHearing these statements is difficult. It’s difficult because I know they are said from a place of caring. I assume the person saying them is trying to comfort and connect with me about this difficult decision. But, I don’t think it’s a statement that anyone who is not themselves faced with the choice can make. I certainly didn’t think about IVF until it became a choice between trying IVF or not having a child. I don’t think anyone comes to IVF without facing that choice. IVF is a measure of last resort and you have no idea what your measure of last resort is until you look it in the face.

It’s also difficult to hear because in many ways I think choosing IVF or any other fertility treatment should have no more social stigma to it than choosing to go off birth control or to not wear a condom.

poster_knocked-up-3Perhaps the most infuriating thing I hear women say is It’s always the ones who aren’t trying who get pregnant. Why, is it more socially acceptable to seemingly get pregnant by ‘accident’ than to make an informed and eyes-wide-open mutual decision to have a child?

These statements reflect a bizzarre social norm where when a woman pursues fertility treatments she is crossing a line and using science to do what her body cannot, and this is bad, taboo and stigmatized. But,  at the same time unplanned and surprise pregnancies are socially acceptable and celebrated to the point that they make up several mainstream blockbuster movies. It all feels very Kafkaesque.

I’m sure there is a feminist thesis in here about our social valuing of women being able to control their reproductive rights. But, I will leave that for another time.

Today, I acknowledge my internal conflict over the offer of funded IVF treatments. I acknowledge the tremendous amount of work that has been done by scientists, doctors, women before me, advocates and policy makers to allow me this choice. I don’t take this choice lightly. I will likely try at least one IVF treatment, because in the end I want to know I used all the options available to me. I am in a place where I can accept they may not work, but cannot accept that I did not try.

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6 thoughts on “Contemplating IVF

  1. Honestly I think you could be the feminist Kafka at this point but if you wrote it all down in a novel people would think it unacceptably outrageous. My goodness. I am (as always) sorry you’re going through all this trouble, you deserve some peace for a while. I truly appreciate your blogging about it, these issues need more voices like yours.

  2. It grieves me that you have to go through any of this. Your writing is wonderfully lucid and insightful; thank you for sharing it.
    There are those( myself included ) who would just turn our backs on this crap and red tape and try another outside the loop means but I think it is amazing that you are doggedly fighting it and carefully picking your way through the landmines. A tribute to your courage.

  3. I’m curious what context people add to telling you they’d never do IVF? It’s never seemed like something stigmatized to me.

    I mean, I’d never do IVF, but that’s because from everything I’ve heard about it it’s incredibly unpleasant, and I’m essentially selfish. Of course, my essential selfishness is why I’m also not interested in having children. But that’s no reflection on you and your choices.

    • It’s a bit ironic that I’ve never heard this comment about ivf from someone who I know is childless by choice. I’d hazard a guess that there are a number of reasons for this starting with if your childless by choice you’ve likely already made a decision not to comment on how other people choose to add children to their family.

      As to why it seems to be the most common comment I get from other women (and from what I hear from other women who have talked to friends about ivf it’s pretty much the most common comment), I’m not really sure. It’s generally a stand alone comment. I think it’s maybe supposed to be recognition that it’s a difficult process, but it comes across as a personal judgement.

  4. Hi Sarah, I’ve recently found your blog and I am amazed by your courage for putting such personal things out there. I think going the IVF route is incredibly brave of you and I will be sending warm vibes your way.

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