Saturday, June 15, 2013

Second Opinions and Second Thoughts

May 17, 2013 -- I met with my second opinion Friday and it was like meeting the face of the baby reaper. I knew from sitting through Dr. M's seminar that he doesn't put pretty bows on the realities of trying to get pregnant in our 40s. I appreciated that. I want the facts regardless of how painful they are to accept. So I braced myself for bad news. And he delivered.

I told him he was my second opinion, and I gave him the lowdown on my stats. Good health otherwise, but nightmarish AMH numbers and barely countable follicles.

He was blunt and straight with me. He didn't think egg freezing was the best plan for me, unless of course I wanted to go through the process multiple times. If I'm only retrieving one to three or four eggs in a cycle, he didn't think it was worth it at my age. Each cycle costs $10,000 to $15,000. To have even a decent chance of a successful pregnancy from egg freezing (excepting a lucky miracle), I'd need to have 20 to 30 eggs in the freezer. As Dr. M said at the seminar, 80 to 90 percent of 40-plus year old eggs are abnormal, meaning even if some of my eggs fertilized and actually implanted in my uterus, they would spontaneously abort. If by chance an abnormal egg hung in there, growing into a fetus, chromosomal tests during pregnancy would detect those genetic abnormalities and I would be faced with whether or not to abort my problematic baby.

But he was not encouraging. In fact, reading between the lines of his tough love, he was trying to tell me that my chances of getting pregnant are not good. He did not want to give me false hope. Nor did he want me clinging to it in ignorance or, let's be honest, denial.

I was resistant, saying that I had heard follicle counts can vary month-to-month. His face scrunched up a little as he shook his head. “Not by much.” He wanted me to look at the facts before me: low AMH numbers and low follicle counts.

I jumped in excitedly to tell him about the AMH study I discovered, the one that gave me so much hope a month ago. I told him that the fertility field's accepted belief that low AMH is a good predictor of low egg production was wrong when it involved women past 42-year-olds. “The whole picture changes after 42,” I exclaimed, nearly leaping out of my chair. I was gonna educate this doctor too! I told him the study showed that women over 42 with low AMH numbers but normal FSH actually produced “excellent” eggs! Egg counts comparable to women much younger with normal AMH. And and and...

He heard me out, but then shrugged. “Yeah, but the proof is in the pudding.” He reminded me that I only had one follicle, and then a total of three tiny ones even after stimulation drugs. In other words, You're not producing “excellent” eggs, dear. My almost undetectable AMH was a good predictor that my ovarian reserves are tapped.

That brutal fact I had yet to fully face. I had been clinging to that study as a life raft, and I was unable to see the big hole right in the middle of it. Looking into that big hole now, I knew I was close to drowning.

Sounding a little weak and confused, I asked why then did Dr. P want me to move forward with egg freezing. Dr. M did not bring up the lucrative profit factor, he simply said “because no one wants to be the one to tell you to stop trying.”

All doctors know sometimes people get lucky. Unexpected things happen. Sometimes, “there's a good egg floating around” in a 42-year-old's body and by lottery winning like odds, it becomes a baby. No doctor is going to tell a woman who is willing to put herself through prolonged hell to get that miracle baby that she should give up. Perseverance sometimes pays off. The question is how much money and other sacrifices are we willing to expend to make a miracle.

Dr. M said his best advice for me was to try to get pregnant with the few eggs I have left now rather than go through the process of trying to freeze them first. He even suggested we try insemination with a sperm donor first before moving to IVF.

Whoa. He takes my false hope away and now he just yanked away that year or two I was hoping to give myself by freezing my eggs. Someone stop the room from spinning.

“Now” really is the moment of truth. If I want a baby, I need to get fucking serious and do it. No more delaying. No more waiting for a better situation. No more hoping I'll have a man in my life who wants to be my partner in it. The imperfect situation is what I have, and if I want a baby, I will have to bring the baby into that imperfect situation. If I think the imperfect situation is too imperfect for me to raise a child, well, then maybe it's time I face that fact and kiss this dream good-bye.

I've heard countless times from friends, family and strangers: “There's never a right time.” People have babies because they want babies regardless of their life situation. They make do. The desire to make a family overrides fears or anxieties about a less than ideal situation.

So I have to ask myself the question: Is my desire to have a child that strong? Is my impulse for it so powerful that I don't care what the consequences are? Am I willing to just leap for what I want regardless of all the other things I DON'T want that will come along with it? The answer, I must admit is still, I don't know. I simply do not know if I can do it. I'm not sure I have the strength, the energy and the necessary patience in me.

I have to be prepared to raise this child on my own. I have to be prepared to care for a newborn ALONE. God help me if the process gives me twins, which regularly happens in fertility treatments. One of my 40-year-old friends is pregnant with twins from IVF. I fear it. I really do.

It would be easier if my financial and career situation were more stable. I gave up a good career as a newspaper reporter several years ago and moved across the country to pursue a new career as a writer for film and TV. It was a wild leap of faith, especially since the odds of success are so miniscule. The average time that it takes working writers to make their first sale in Hollywood is 10 years, but most never do. I sold a small project to a small production company after about a year, but since then I've had to make ends meet with freelance work supplemented by my dwindling savings. This financial instability is supposed to be temporary, until I can better establish my new career. But how long that will take, or if it will ever take, is hard to say.

If I was willing to give up my professional dreams, it would be easier to take a steady job doing something else and build a more secure home for a baby. But I'm not willing to do that, not yet. I want it too much. Plus, I've worked too hard, put in too much time and am too close to the final bell to throw in the towel now. Besides, I don't think giving up my ambitions as a writer to have a child is a wise or healthy choice. It would only breed resentment and create an unhappy mother.

So my question is, can I figure out how to do both? If I really want a baby and my career, I will have to carve out a baby “room” in my small studio apartment in the heart of Hollywood, learn to write in between diaper changes and feeding sessions, and live on rice and beans so I can afford proper baby food and pediatrician visits. Millions of single moms make do. Some of the best people are produced from difficult lives, right? Obama. Bill Clinton. John Lennon.

But I'm guessing that those difficult situations were thrust onto their single moms. The single women who choose to have children are usually in relatively stable situations, at least compared to me. They probably felt ready to do it on their own.

I don't feel ready. I feel scared. I feel confused and worried I will create a bad situation for my child and for me. I feel a horrible paralysis in my chest, locking up my ability to move forward confidently in either direction. I don't know what to do. I am disappointed and angry with myself and my imperfect life. I feel totally alone facing the unpredictable prospects. And I wonder how the hell I managed to so thoroughly fuck up what seemed like a very promising life not too many years ago. As Richard Byrne sings, My God, what have I done?

Boo freakin' hoo, right? Yet, all of this wringing of hands does illuminate the very real emotional, financial and logistic obstacles that block my path. I might make a giant leap above them to pluck a baby out of the clouds, but both of us will come crashing right back down to this road. Alone.

I hate to admit it, but my fears and reluctance to walk what will clearly be a difficult path might make me decide that it's unfair to both of us.

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