fertility

The Myth of the Biological Clock?

Last year an article came out supposedly debunking the idea that it is more difficult to conceive after 35.  Women around the world cheered, and jubilant articles were written, applauding how science could finally free women from the pressure to start their families before they were ready and the guilt they might feel if they didn’t. Let’s celebrate ladies: the notion that our bodies are too old to reproduce is just another way the patriarchy has been trying to keep us down and out of the workplace.

Now, the articles and critiques are reappearing upon the publication of Tanya Selvaratnam’s book The Big Lie: Motherhood, Feminism and the Reality of the Biological Clock, which addresses the conflicting information women receive about the reality of their bodies and reproductive capabilities and the media focus on the many celebrities over 35 or even 40 having children seemingly effortlessly.  This morning I read an article in Salon by Mary Elizabeth Williams that criticized Selvaratnam for blaming feminism for never tackling the issue of fertility. My first issue with Williams’ piece was that I didn’t think her examples of previously-written articles did much to debunk Selvaratnam’s thesis. Secondly, this quote:

Can we stop setting up the straw man, as Selvaratnam does, that “Biology does not bend to feminist ideals”? Because I’ve got to tell you, I know a lot of people who’ve been to hell and back trying to become parents but I don’t know a single one who put off motherhood because she was a self-centered pawn of feminism.

Here’s the problem. I don’t think any of the journalists who write pieces like this have ever been to a fertility clinic. I have the dubious honor of having been to three different clinics on our 4-year journey to parenthood and I can assure you that at ages 28-31 (hardly a spring chicken), I was often one of the youngest patients in the waiting room. I joined fertility message boards and read blogs from other going through infertility and again, there is a decent number of women who were over 35 trying to conceive.

It’s kind of funny because when I was in the trenches and would read articles escoriating “those women” in fertility clinics for putting their jobs first and bringing their conception problems on themselves, I wanted to scream that not all women having trouble conceiving were older (age was one of the few things Jimmy and I had going for us). But that was the perception: trouble conceiving = advanced age = selfish bitch who put her career ahead of family.

So my question for Williams and others is just who are those women over 35 in fertility clinics? Why are they there? Was it because they just didn’t meet the right person until later in life? Maybe. But the bottom line is that for many women, they are in the clinic over age 35 because they put off having a baby for whatever reason. Maybe it was their career. Maybe it was because there were other issues. Maybe it was because they wanted to travel, see the world, whatever. It doesn’t really matter WHY; what matters is the fact that they delayed childbearing and then found themselves in a fertility clinic because they were having problems conceiving.

Now it appears the tables have turned and women supposedly have more time to conceive and woe anyone who dares to question that “fact.” Because science.  This change is troubling because, well, SCIENCE.  The fact is that while humans have made incredible gains in longevity, basic biology hasn’t changed. Maybe in a few thousand or hundreds of thousands of years, our reproductive organs will catch up to the fact that we can live longer lives, but the reality is that fertility declines with age, especially for women. And if you do conceive, you have a higher chance of miscarriage or having a child with a disability. I’m not going to cite the facts; you can read many of them here. Yes, yes. I know. We all know women who have conceived on their first month trying at age 40 and gone on to have a healthy baby. And of course, celebrities and their apparently amazing fertility after 40. Those are the outliers. Those are the examples that tempt us to believe we have more time than we do.

Selvaratnam is correct in that frank discussions about fertility are a feminist issue. We cannot change biology and the basic fact that the human body is best suited to reproduce in its 20s when we are busy building careers. Yes, I know that SUCKS, but feminism cannot change that and needs to acknowledge that. You know what feminism could change? Policies that make it career vs family. Policies that make it easier to delay childbearing because it hurts your career and earning potential to have a child. We’ve read the articles that tell us women who have children are often mommy-tracked and lose earning potential. That’s what we need to change. That it’s not career OR family but career AND family. The ability to downshift for a few years when children are young. Affordable, quality daycare. Supportive workplaces and flexible schedules.

At the very least, feminism could lead discussions about basic fertility. Why aren’t we taught more about our bodies beyond ovaries, eggs, fertilization and menstruation in school? Every one should be required to read Taking Charge of Your Fertility. I was amazed by what I learned about what my body could do and tell me (mine wasn’t working so well at the time, so it was mostly theory but still) and shocked that at almost 30, I knew none of that information. Put off having children if you want, but at least make that decision knowing the facts about female biology.

But…wait! What about those treatments in the fertility clinic? They allow women to have babies. It’s cool. I can just saunter into a clinic and have IVF whenever. Maybe even get twins! Fertility treatments let us overcome age and are actually a source of empowerment! Oh dear. Bless your heart. Reproductive technology is awesome, and I salute science for helping me to overcome my fertility issues to have my son. But folks, it is not a panacea. Clomid != baby. IUI !=baby. IVF !=baby. What assisted reproduction does is give you a chance, increase your odds.  The stats surrounding success rates for these treatments are fairly dismal. You may have a 0% or 10% chance on your own; IVF may increase it to 30%.  Yes, those are improved odds but not necessarily ones I’d take to Vegas. If I saw we had a 30% chance of it raining, I’d assume that rain was unlikely.

Age rears its ugly head in fertility treatments too. Over a certain age, you may not produce many eggs and the ones you do may not fertilize or develop.  The doctor may tell you your best bet is to use the eggs from – wait for it – a donor who is 10-15 years younger than you are. The only reproductive organ age doesn’t impact as much or can be overcome more easily is the uterus, which is why you read about 60 year old women carrying their own grandchildren. Part of the problem is that beyond concluding that eggs are old and of diminished quality, doctors really don’t know much more about egg quality and why some IVFs work and some don’t. What they do know is that their success rates decrease dramatically for women using their own eggs over 35. Frankly, successful conception is a crap-shoot for everyone, regardless of age.

Speaking of empowerment, there is little empowering about fertility treatments. I did 6 clomid cycles, one injectable IUI cycle, 2 fresh IVS, and 1 FET. I’ve also had a HSG, 2 laps, and a lot of pain. I have one child. I can think of little that is empowering about the following:

  • Feeling rage, hot flashes and irrational while taking Clomid.
  • Having a doctor tell you that maybe the excruciating pain you feel that makes you seriously contemplate a DIY oophorectomy is normal for you
  • Bleeding daily for months
  • Finally being in a position to afford children only to have to pay exorbitant sums to attempt to have a child (outcome not guaranteed)
  • Feeling depressed and unable to focus at work because you are focused on how you feel less of a woman; you are supposed to be able to do everything – why can’t you have a baby? And why isn’t your career enough for you?
  • Hating your body because it failed you so spectacularly (hardly body acceptance)
  • Accepting that your only path to a biological child is for another woman to carry your child (are you Mom Enough? Apparently not)
  • Looking like a heroin addict thanks to daily blood draws at the clinic
  • Two weeks of painful shots of progesterone-in-oil (PIO) in the butt
  • Becoming comfortable dropping trou and extremely familiar with the “dildo cam”
  • Lack of focus at work because you are in and out for doctor’s appointments and waiting on the daily call on your hormone levels; sobbing uncontrollably when the levels don’t cooperate
  • Having little control over your reproductive outcomes; that control resides in the RE, usually a man, which isn’t necessarily bad, but it does reinforce a power differential
  • Having your clinic break up with you because you are a hopeless case and they don’t want you to ruin their stats.

Those are just a few I can think of based on my own experiences. Others have more examples I’m sure.

The point of this post is not to blame or shame. Do what you want, wait as long as you want, but do so armed with information. Understand that every decision has consequences. Understand that it sucks for women because our biology pits us against other goals we have that don’t involve children.  And it isn’t talked about. Not as much as it should be.  Ann-Marie Slaughter alluded briefly to the fact that she waited until her mid-to-late 30s to have her children and did experience trouble conceiving, but that tidbit was lost in the brouhaha about how she dared to tell women they couldn’t have it all and that they needed to think carefully about their choices.

So maybe feminism didn’t lie overtly to you about putting off having babies, but at the very least, it was a lie of omission. We can do better than that for each other.

 

WTF is Wrong with People?

I think we entered a wormhole or something similar because that is the only way to explain how the day passed so quickly, yet with so little accomplished. It was also a day that made me wonder whether it wouldn’t be better if the zombies did take over the world.

Exhibit A

We saw this sticker on the car next to us when we picked up my car at the dealership today.

Fat chicks sticker

WTF?

 

This sticker was on a shitty Honda that looked like it could barely hold the driver let alone anyone else regardless of weight. I was astounded that someone had the audacity to put such a sticker on his or her car. Really??? In what world or circumstance would anyone possibly think that sticker was funny or acceptable? Substitute “fat” with “black” or “gay,” and I wonder if he or she would have had any scruples preventing him or her from not putting the sticker on the car. Wow.  Oh, and Jimmy told me later that the bumper of the car had a sticker of fingers making the “shocker.” Clearly we are dealing with a classy individual. And no, I’m not explaining what the “shocker” is. You’ll have to look it up!

Exhibit B

Today was the day we set aside for finishing our insurance open enrollment. We were both already in less than stellar moods going into it because open enrollment is always. such. fun. This year was going to be even more fun because Jimmy’s company was switching plans, and we needed to figure out whether it made sense for him and Daniel to stay on the new plan or move to mine which was also making changes. Yay insurance!

My insurance was offering major discounts off of the monthly premium if I completed a health assessment among other things, so I opened it up to fill it out because it would keep me at the same level of plan and save me $13 a month.  This was the third question:

do you plan to reproduce question

Second WTF moment

 

Um…what? I get that this is a health assessment and I’m sure they wanted to assign me a “risk” level based on whether I was going to be having a baby in the next year (higher risk!), but wow, that question put me in a foul mood. I didn’t even know how to answer it since at least 2 answers fit my situation. It felt invasive and insulting. All this to save a damn $15 a month. I’ve decided that next year it isn’t worth it for me to save that money. Damn.

Danielisms

However, Daniel is always good for lifting our moods and making us laugh. A few Danielisms from today:

“I’ve learned about God and mammals” – what Daniel says he’s learned in school.

“Mommy, stop saying bad things to daddy” – what he says to me if I become slightly animated during conversation.

“Mommy, I pressed the ‘X’ for ‘cancel’ on this conversation”- what he said when my conversation bored him.

“Mommy, I think I have too much energy” – said after he became bored with quiet time and demanded to be liberated.

Maybe the zombies can stay put for a bit longer. Or maybe we’ll just make sure our house is fortified. Everyone else, you’re on your own.

So I’m Having Surgery Tomorrow, No Big Deal

I’m having a laparoscopy for endo tomorrow. It’s my second one. The first one was 6.5 years ago in January 2007. It’s time. I have been having increased pain for about a year now, the kind the lasts for weeks and requires lots of Ibuprofen just to take the edge off.  I finally went to the doctor and as I suspected, I have a cyst on my right ovary. My right side is the troublesome side. What I didn’t expect is that I have an even larger cyst on my left ovary.  Unlike the right side, the left side is very quiet. That’s the freaky thing about endo: you cannot ascertain severity based on pain level.  Of course, the cysts could be the tip of the endo iceberg, so the doctor decided another lap was warranted and then we can manage the endo through hormones until menopause.  It’s my own fault. I had enjoyed not being on any hormones after IVF for our surrogacy cycle 5 years ago this month (!). The downside was that no medication meant that I essentially gave endo a permission slip to cause trouble.

I had been fairly nonchalant about my upcoming surgery. I’d had a prior lap, so the procedure wasn’t a mystery. My first lap had been for diagnostic purposes, so in addition to the physical recovery, I had the emotional fall-out of coming to terms with the grab-bag of problems that had been discovered.  This time is different. It is for pain management for me and quality of life instead of preparing for more fertility treatment. Plus, we have Daniel now. In 2007, we received real answers on what was going on with me as well as acknowledging that our journey was going to be even harder than we ever anticipated. This time, I’m approaching my lap knowing that my treatment days are over. We have 5 frozen embryos and no plans for further treatment.  I shrugged and told everyone it was no big deal. I’ll get up on Wednesday, have the lap, come home and sleep the rest of the week.

And then the anxiety started to set in. A lot of it has revolved around Daniel. He will be spending the rest of the week w/ MIL, who will take him to and from school and try to preserve his routine. I have uniforms to pack, regular clothes to pack, books, toys and a billion starfish to pack, and instructions to write about schedules and lunches. He also had a teacher workday on Monday, so the routine was already disrupted for the week. We’ve been talking to him about the lap and what’s going to happen this week, and he has been asking questions about it, and I’m worried about being away from him and him being away from us.  It doesn’t help that the routine upsets and what I think is his worry have led to a very rough Monday evening and Tuesday morning with him. I feel horrible and guilty that we aren’t able to assuage what I think is his fear as well as the fact that he’s being unreasonable and well, FOUR, which is driving us up the wall, which then makes me feel even worse because I don’t want our short time together this week to be full of tears, yelling and grumpiness.

And then I worry about the lap itself. What will they find? Am I in worse shape than any of us thought? Jimmy and I’ve had the pleasant “If, then” conversation about a few different scenarios so he can make an informed decision. I can’t have anything to drink or eat after midnight tonight, and I’m already feeling thirsty in anticipation of not being able to have any water. My brain has dusted off the memories from my first lap, and I remember the shoulder pain from the CO2, the pain I felt after I woke up, the scratchiness from the tube down my throat, the worst pain that always seemed to hit in the middle of the night and left me writhing in agony because I couldn’t get the dosage on the pain meds correct.

Inhale. Exhale. Chances are that everything will go as expected. Daniel will have a great time w/ MIL and come home full of piss, vinegar and sass. My job is to rest, take it easy and maybe, just maybe, begin reading Game of Thrones.

We check in at 9:30 tomorrow, if you could spare a thought around 11:30, I’d be very grateful.