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Free Range

Published : May 25, 2016

Picture this: a beaming, first time mum breastfeeding. She’s made it through a protracted struggle getting the baby to feed properly so now, two years later, she’s ‘milking’ the experience for all it’s worth. There’s just one strange detail: she’s having hot flushes.
by Amy Bachrach
 
This story is not as uncommon as it once was, as evidenced by the growing number of
 
volumes with names like Warm Bottles, Hot Flashes, but it did take me by surprise.
 
I was nearly 39 and living in my hometown of New York City when my partner and I got
 
together. Six months later I was living in Perth. We knew we didn’t have all day if we wanted
 
to have children, so we got married and down to business. Because of my age, I was
 
prepared for a long practice period. That was our first surprise. I conceived my daughter
 
immediately and naturally just after my 40 th birthday.
 
Unfortunately, the second child we hoped for did not come as easily as the first, and after a
 
year of trying on our own – the advice I knew at the time – we sought help. On my doctor’s
 
recommendation, I stopped breastfeeding even once a day to see if that would make the
 
difference, but it didn’t. And I needn’t have stopped at all because my next blood test showed
 
that the reason I wasn’t conceiving was that I was in menopause.
 
Eggs Over Early
 
“As for my eggs, it appears that I either have none left or they just don't feel like
 
coming to the party.  In any case, we got results yesterday that the 10 days of 
 
hormones I've been injecting, and which should have resulted in follicle growth, have
 
not been working.  I'm being told that means that I don't have any eggs or they're just
 
old and tired or something. In any case, at least for today, Simon and I are abandoning
 
hopes of having a second baby that is genetically mine.”
 
- Email to a friend
 
What do you mean the party’s over? I had only just become a mother and was in love with it
 
and my daughter. I wanted to feel a child hiccupping inside me again, give birth with my
 
midwife again, breastfeed an infant again and watch a baby grow again. I wanted my
 
daughter to have a brother or sister to play with, to fight with and to compare notes with later
 
when reminiscing about their childhood.
 
I couldn’t accept even a fertility centre’s confirmation that I wouldn’t be able to conceive with
 
my own eggs and set about doing my own research, mostly on the internet. Googling the
 
phrase “Over 40 High FSH” took me to the website and message board where I was to spend
 
a great deal of time over the next few months. It was on this board that I connected with
 
many other women who, like me, were trying to conceive against the odds. It was on this
 
board where we turned to each other in desperation with innocent questions about the
 
possibility of ‘reversing menopause’, reducing levels of FSH (follicle stimulating hormone), or
 
in any way, capturing what remained of our eggs’ reproductive nature and becoming
 
pregnant. It was also here that I was exposed to some of what natural medicine had to offer
 
in my situation and I engaged the help of a local wellness centre that offered me Traditional
 
Chinese Medicine to supplement my conventional fertility treatments.
 
1 Nancy London, Celestial Arts, May 2001
 
Maybe something would have worked to revive my depleted eggs, but we didn’t know what it
 
was. In the end, I think my eggs were just too old. Reluctantly, my husband and I accepted
 
that we would not have a second child that was genetically mine.
 
Paula’s Follies
 
“Bit crampy, headachey and I got a sore back but its fine! I’m gonna need a really
 
good massage afta this!  “
 
-- text message reply from Paula
 
If we’d been living in the US, we would at this point have entered into the bustling market in
 
donor gametes. In the land where everything is for sale, businesses compete to market their
 
ovum donor clients through a fully searchable egg donor database, so you can scrutinise the
 
skin, eye, or hair colour, and health, academic or professional track record of the donating
 
women and then purchase the genetic inheritance of your choice.
 
Here in Australia, there is an acute shortage of both sperm and eggs available for couples in
 
need. Fortunately for us, we had an angel -- our good friend Paula who came forward and
 
offered us the gift of life -- the eggs we needed to make a baby.
 
But that was just the beginning.
 
Before being allowed to proceed with ovum donation, a couple and their donor are required to
 
undergo counselling during a six-to-nine month cooling off period. During that time we were
 
asked to consider some confronting questions:
 
For us: Could I love a baby that was genetically my husband’s but not mine?
 
How did I feel about mothering a child that was genetically another woman’s? How do we
 
feel about Paula’s genetic inheritance? What would we tell the child, and our daughter Abby,
 
about the baby’s beginnings? Did we understand the process might well be unsuccessful?
 
How would our families deal with the genesis of this child?
 
For Paula: How would she feel if she were never able to have a child and her only one is
 
ours? What if she donates the eggs in vain? What if we do not remain friends? What if we
 
move to where she cannot see the child? Does she have faith in our child rearing practices?
 
What expectations does she have about her relationship to the child? How does she feel
 
about our child learning that she is its biological mother? And for Paula’s partner: how did he
 
feel that she would have a baby that was biologically, but not legally or socially, hers and not
 
his in any way?
 
Donor Kebab
 
As anyone who has experienced it will testify, there is nothing romantic about trying to
 
conceive a baby through IVF. First, Paula’s eggs had to be harvested. This is not a pleasant
 
experience and involves injections first to super-stimulate the ovarian follicles so they produce
 
a large number of eggs, then triggering the release of those eggs so they can be captured
 
and fertilised.
 
Simon’s contribution was less odious. His sperm had to be, well, ejected, collected, and
 
connected with Paula’s eggs.
 
Out of this, eleven eggs were fertilised and grew into seven blastocysts – five day old
 
embryos. Some of these embryos didn’t make it and in the end, we had three chances to
 
create a baby.
 
Since I was no longer cycling naturally, my uterine wall also had to be thickened with
 
estrogens to create the spongy environment necessary for welcoming, holding and nourishing
 
a transferred embryo.
 
“Fingers crossed, legs in the air!” -- - A friend’s good luck message
 
Then, it was time for the transfer of the embryo – an amazing process. With the help of
 
ultrasound, the fresh embryo was guided into my endometrium. After that, the only thing left
 
to do was endure the 2WW – the online acronym for the excruciating Two Week Wait
 
between transfer and pregnancy test.
 
I'm broken even though I so adore my 3-1/2 year old. I'm so full of envy for women on
 
the [email] list who are pregnant that I can hardly read it anymore. And I'm so envious
 
of women who are pregnant or have second children, it's a hazard for me to walk down
 
the street…But here we are. One left -- might thaw, might not. Might work, might not.
 
-- email to a friend
 
When we had exhausted the last of our embryos, Paula offered to go through the process of
 
harvesting more of her precious eggs. At this point, and with huge sorrow, we declined.
 
It was a very difficult decision not to take every last opportunity to conceive a second child,
 
but that process had begun to feel like a second child all on its own. With so many hormones
 
and visits to doctors, so much time spent on the internet and recovering from disappointments
 
– it was all distracting me from the beautiful daughter I did have.
 
I was torn between feeling ungrateful, and unlucky. The women in my mums group were off
 
having their second children. Everywhere I looked I saw pregnant women, mums holding one
 
child by the hand and pushing another in a pram. I was flooded with righteous indignation
 
when I’d hear mothers complaining about how difficult it was with two children. The places
 
I’d loved to go with Abby – Wiggly Woo in Mt Hawthorn, the Beach House in Osborne Park –
 
became emotional minefields.
 
A Blast from the Past
 
Sometime later another option emerged. The Pivet Medical Centre, the first fertility centre in
 
WA, had been in existence long enough to have some extra blastocysts that were no longer
 
needed by the couples who had created them in IVF cycles. Did we want to try to conceive
 
with an embryo that wasn’t derived from either my husband or me? Ultimately, we declined
 
the offer. And it wasn’t because the child wouldn’t be genetically ours. Our time had just
 
come and gone.
 
The Safety Net
 
The discovery of being infertile, whatever the cause, can be devastating and the world of
 
fertility questions, options and acronyms overwhelming. I would have been completely at sea
 
had it not been for the online communities of women who shared my plight.
 
The first online community I discovered was the Over 40 High FSH network
 
http://www.network54.com/Forum/53068/. Immediately I knew that I was not alone.
 
Complete with its glossary of reproductive technology jargon, I was welcomed by the great
 
many women who were TTC (trying to conceive) in the face of an elevated level of FSH
 
(follicle stimulating hormone) that would keep them from even commencing IVF. I learned
 
about BMS (baby-making sex) and was coached on the right questions to ask.
 
But when it became clear that my only realistic option was to try to conceive with DE (donor
 
eggs), I needed to find a new support network. MVED - Mothers Via Egg Donation
 
http://health.groups.yahoo.com/group/MVED/ was that group. There, women trying to
 
conceive with donor eggs were sharing information – both research and experiences –
 
regarding such medical matters as whether bed rest was indicated after embryo transfer,
 
what the likelihood was of conception with fresh versus frozen embryos, which fertility
 
protocols seemed to be most effective, which clinics and countries allowed the transfer of the
 
greatest number of embryos at once (to increase the probability of conception), whether
 
acupuncture seemed to increase the chance of conception, and emotional matters such as
 
how to gather the nerve to question your doctor’s opinion and how to cope with the roller-
 
coaster of hope and disappointment endemic to the process.
 
Inspired by the commitment of the women facilitating these websites, I determined that I too
 
would put my experience to use for other women. These and other websites proved
 
invaluable then not just for me personally, but for the development of the article that I was
 
fortunate to have published in April 2006 in the Medical Journal of Australia.
 
Grade ‘A’ Choice
 
In my life I’ve found that if I really wanted something important, I was able to get it. Whether it
 
meant mobilising my intelligence, time, social support, or finances, somehow I have been able
 
to get it. All up until now.
 
Our efforts to conceive a second child were unsuccessful. That is partly because of choices
 
we made – not to try the full course of natural solutions available to us and not to continue
 
with another round of IVF. There is reason to believe these may have worked. But if
 
physiological maturity was the initial reason I did not conceive again, emotional maturity was
 
the ultimate reason. In the end, I accepted that there were limits to my power, that I could not
 
have everything I wanted, at least without making unacceptable sacrifices.
 
Even though we never did conceive as a result, the time and effort I spent to conceive a
 
second child and to learn what was happening in my body were not in vain. I have always
 
believed that my well-being is my business and that it is too important to leave in the hands of
 
a doctor, however expert she or he might be. Does this make me a difficult patient?
 
Perhaps. But I also emerge more empowered and better able to make informed choices. It
 
also leaves me better able to support others, and that’s a good result for me.
 
Fertile Ground: Community Resources
 
Family Planning WA
 
http://www.fpwa.org.au/
 
70 Roe Street Northbridge WA 6003
 
PO Box 141 Northbridge WA 6865
 
Ph (08) 9227 6177
 
Women’s Health Care House
 
http://www.whs.org.au/
 
100 Aberdeen Street, Perth 6003
 
9227 8122
 
Health Information Resource Centre (KEMH)
 
c/o King Edward Memorial Hospital for Women
 
374 Bagot Road Subiaco
 
Western Australia 6008
 
Telephone (08) 9340 2222
 
Mothers Via Egg Donation
 
http://health.groups.yahoo.com/group/MVED/
 
Genesis Support Network (WA) http://www.users.bigpond.com/Genesissupport.htm
 
Access – Australian Infertility Support Network
http://www.access.org.au/



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