ETHICS

Now that I am officially an IVF patient, I am finding myself having to challenge some of my beliefs and rethink some of the ideas I have been carrying with me throughout much of my adult life.

For example, "60 Minutes" did a story this past Wednesday night about how PGD is enabling couples to have an opportunity to choose the sex of their baby. It was fascinating, and if you missed it, here is the synopsis from the program. There was a featured couple, who had three healthy sons and decided to undergo IVF and PGD for the sole purpose of having a daughter. All I could think while watching this couple was "those selfish bastards!" I mean, come on, this couple is perfectly fertile and they have three healthy, beautiful sons, and they aren't satisfied? They need to use this technology to ensure that they will have a baby girl?

A few statements from the program that I absolutely agreed with were from Dr. Mark Hughes, one of the pioneers of PGD. He says “Just because you technically can do something, it doesn’t mean you should.” PGD was developed to help pre-determine if an embryo may carry or be prone to having a genetic disease or disorder. “I went into medicine and to science to diagnose and treat and hopefully cure disease,” says Hughes. “Your gender is not a disease, last time I checked. There’s no pathology. There’s no suffering. There’s no illness. And I don’t think doctors have any business being there.” There are those on the other side of the coin who are financially benefitting by fulfilling these requests, and they even claim that couples are actually requesting not only gender selection, but eye color, hair color, etc. I find it scary that the response given to these couples is to "Call back in five or 10 years.” *shudder*

Anyways, after watching the program, I couldn't help but think about people who are anti-IVF. On some levels, I must admit that I actually get it. I do not agree with or side with the anti-IVFers, but to some extent I understand where they are coming from. I mean, you can easily make the arguement that we are "playing God" when it comes to IVF.

We are creating life outside of the human womb - tricky moral ground for some.

We are selecting the healthiest of the embryos that are created - goodbye, natural selection.

We are, in some cases, "discarding" the weak and unhealthy embryos - again, difficult moral ground, especially for pro-lifers.

And with some IVF patients, the need for "selective reduction" may arise.

I myself am a self-proclaimed wuss when it comes to debating highly sensitive ethical issues. In fact, I usually choose to avoid the debate all together. I have my opinions on those trickiest of moral questions, but I usually keep these opinions to myself, because I also know that I have the right to change my mind at any time. To some, that may appear that I have no conviction, but how I appear to others is not my main concern; mostly, it is simply easier for me not to get into a debate in the first place, because I don't think there is a completely right or wrong side on these highly emotional issues. What is right for you may be wrong for me, and that is that.

I have said before and I will say it again, I have learned not to judge other people's actions unless I have walked in their shoes, because you just don't know how you are truly going to feel about a situation until you are in it yourself. Having come to this conclusion in my life, I have applied this point of view to those big hot button issues out there - abortion, the death penalty, euthanasia, etc.

Let's take abortion, for example. Here is generally the way I have always felt about this issue: I am anti-abortion, but pro-choice. I believe that life begins at the moment of conception, and therefore abortion is NOT the choice I would ever make for myself; but, it is also not my place to make that decision for anyone else. A nice, safe stance to take, I have learned, provided that I never find myself in a position where abortion would be an option for me. My point of view makes certain assumptions: That I will never find myself pregnant as a result of a violent rape. That I will never find myself with a dangerous pregnancy that could likely result in my death if I proceed with it. That I am never an IVF patient who needs to sign consent forms regarding selective reduction.

My dear friend Jen took a stance recently on the abortion debate by stating that it is possible to be pro-life and yet not be freaky-deaky-obsessed-in-your-face about it. It sparked a healthy debate, and I am proud of her for coming out and saying "hey, this is what I believe, and I am not afraid to say so." But it certainly got me thinking. Selective reduction. Selective. Reduction.

Over the past two and a half weeks, the fertility-challenged portion of my life has felt like someone is permanently holding down the fast-forward on the TiVo remote. "Guess what, you'll be doing IVF this year!" "Guess what, let's begin as early as September," and most recently after my RE appointment this past Wednesday, "Guess what, on second thought, let's not wait until September, let's start with your August cycle!" I feel like I am on speed. I have had to frantically educate myself and arm myself with as much information on IVF as possible, in a very short time frame. So much of this is new territory for me because IVF was something that I thought would only remotely, potentially, be IN THE FUTURE. It was never something I expected to need. It was never something I thought we'd get to so soon. I thought I had time to learn. I was wrong.

The odds we have been presented with are these: we have a 50% chance of IVF working for us, given our health, our age, and our frustrating diagnosis of "unexplained infertility." My clinic will only transfer two embryos, and that being said we have a 25% of becoming pregnant with twins. As I was reviewing all the consent forms (hurry hurry, rush rush, got to get them all in before we start in two weeks!), the section on selective reduction stopped me cold. If one of the two embryos is developing poorly, it may cause harm to the other fetus and to the mother. In this case, we may choose selective reduction to remove the unhealthy fetus. As far as I am concerned, this is an abortion, something I claimed I would never, ever, allow myself to do.

Now, I am not so sure. Granted, these are extreme circumstances, and this is why I have tried to leave myself an "out" on these tricky ethical issues - an opening to allow myself to change my mind.

Anthony says, but what are the odds we'll actually have to make this decision?

We know they will transfer two embryos. We have been told that we have a 25% chance of having twins. The way I see it, that means there is a 75% chance that one or both of the embryos will not make it, and thus the decision to selectively reduce becomes a very prominent reality for us.

It has been easy to have an opinion on a subject that hasn't personally touched me. In fact, lots of people have opinions on lots of things that they have no first hand knowledge of. But staring at one of these hot button items head-on, it is tough.

If we find ourselves in the situation where it is wise to selectively reduce (kill) one of our babies, we will do it. I will be devastated, I will grieve, and I will not go a day in my life without thinking about that poor, helpless baby.

But I will justify it to myself and to others that I was doing it for the purest of all reasons - for the relentless quest to acheive a baby of my own - a healthy, biological baby. This cannot possibly be a bad motive, can it?

God, being infertile is just so hard in so many ways; I continue to learn about new hurdles and challenges with every passing day.

I will emerge a stronger person because of it. Cliche for sure, but man it is so true.

BACK AWAY SLOWLY FROM THE BABY-BAGS...

Tax-free shopping apparently can make some people lose their minds. Present company inclusive.

I drove into the city this morning, parked at the garage at the Boston Common, ready to do my tax-free shopping. I strolled through the Boston Public Gardens - it was absolutely beautiful. I browsed the shelves of Burberry and Kate Spade - it was absolutely beautiful. But, I nearly committed a horrendous misstep.

While in Kate Spade, I almost purchased a diaper bag. Yup. A diaper bag. KS calls them "baby bags," but nevertheless they are intended for mommies to have a bag to carry diapers and bottles, and they come with a handy changing pad in case you get stuck out in the world somewhere and need to change your little one's diaper.

I kept telling myself "I'll just use it as an oversized tote bag for now, and by the time I actually have a baby it will probably be out of style anyways." I can justify almost anything to myself if I try hard enough. Suddenly, though, common sense began to creep in and take over.

Hello? What was I thinking? No diaper bags in my house, even if they are cleverly "disguised" as tote bags. Not yet. That may be more subconscious wishful thinking than I can truly handle right now. I put the bag down (eventually), before I had the opportunity to ask the price (reminding myself of what my mother taught me - if you have to ASK what the price is, it means it is too expensive). A narrowly averted disaster.

Later in the day I found myself in Bloomingdales and apparently someone had given me a lobotomy when I wasn't looking, because I was about to do the same thing again. "Do you have this bab...um, this BAG, in red? I only see it in tan, black, and pink."

"We're all out of red right now," the cheery sales clerk informed me. Ah. I put the pink bag down. I had not regained my senses, I just simply want the bag in red is all.

Yeah, so tax-free day really didn't work out for me. I ended up at the flea market where I bought a knock-off coach tote bag for $30. But the flea market is always tax-free, I reminded myself. And knock-off bags are tax-free because, well, because they are illegal, but let's not go there.

I heard that there was a line out the door of the local Costco all day today.

I mean, this tax-free thing is a nice gesture and all, but we're really talking about saving a few dollars when it comes right down to it. I would have saved maybe seven dollars total if I had purchased that bag today. I spent almost that much on coffee in the last two days, I think!

When all was said and done, I had a wonderful day off, and I filed that pretty diaper bag away as a potential purchase for another day. And hopefully, when that day comes, the bag won't have to disguise itself as anything other than what it is - a BABY bag.

ABSENTEE BLOGGER

I feel like I have abandonded my blog this week. I wrote a couple of posts here and there, but really, truthfully it was hard for me to find any time for my blog this week. And that sucked!

First of all, tomorrow will be my first day off of work in twelve days. Last weekend the IT department had to put in some marathon hours to get a project completed. We worked our normal hours last Friday, and then continued to work from 5:00PM until 1:30AM on Saturday morning. We managed to race home to catch a few hours of sleep before returning Saturday morning and putting in another full day, only to repeat the whole process again for Sunday. By the time Monday rolled around I could not even keep my eyes opened. Monday, Tuesday, and Wednesday evenings, however, welcomed various contractors and/or real estate agents through our home in prep of the upcoming push to sell this place on our own. By the time last night got here, I was so excited to finally, FINALLY, have one night off to just "chill."

Ring!!

Anthony on the phone. "Um, I missed my train, and the next one doesn't leave for an hour and a half...could you, um, maybe..."

"I'll be right there," I said, hanging up the phone. Off to Boston I went to retrieve my husband for the evening.

And now it is Friday night.......ahhhhhhhhhhh.............

Aside from continuing work on this house, I have NOTHING that I HAVE TO DO this weekend, and that feels fantastic.

I must go shopping tomorrow. In fact, I have absolutely no choice in the matter. As a "thank you" to the citizens of Massachusetts for putting up with the DNC last month, Gov. Mitt Romney has declared tomorrow "Tax Free Day" in our lovely state. Yup, no taxes. You cannot go out and buy a car (your item must be less than $2,500.00), and it does not apply to gasoline. So I am thinking about strolling down Newbury Street tomorrow. They have a kate spade shop. Even better, they have Burberry. I need a new wallet to go with my fab bag. Anthony insists that, just because tomorrow is tax-free, I don't NEED to go shopping. (I beg to differ). I may even hit the flea market to browse the assortment of "knock-off" designer bags. Maybe.

All I know is that I have not STOPPED in nearly two-weeks, and I definitely need the break. I am so looking forward to this weekend. And to getting back to blogging. I miss it when I am kept away from it, I really really do.

DON'T SHIT ON MY LAWN

Does anyone know if it is illegal to install one of those electric fences on my lawn in such a way that it prevents other people's dogs from walking into our yard? You know, the reverse of their intended use, to keep dogs from leaving their own yards?

Just wondering.

THINGS THAT MAKE YOU GO HMMM...

Is TOYOTA actually TRYING to make the worst TV commercials ever? Is there a prize for the company with the absolute worst marketing strategy? Because they seem to hit the low mark all the time.

Anyways, I awoke in the middle of the night with a thought. I am having surgery one week from today to remove a polyp that my RE says she suspects she saw in my last ultrasound at the end of my last IUI. She wants to do this to ensure that the path is "clear" for an IVF cycle to have the best chance of working.

Yet before I switched insurance companies, before we discovered I was newly approved for IVF, we were about to start an IUI cycle. In fact, we could have started one in July, except that Anthony and I voluntarily elected not to for sanity's sake.

So what woke me up in the middle of the night was, if my RE saw a potential regrowth of this polyp in my uterus after the final ultrasound from IUI #1, why am I only just hearing about it now?

Would we have proceeded with IUI #2, all the while with my RE knowing (and us NOT knowing) that there was a growth inside of me that would most likely make the IUI fail?

Am I having this hysteroscopy because my new insurance is covering it? If I wasn't on new insurance would we have skipped this procedure?

I am confused. It is a bit unsettling.

I trust my RE, I really do. But I've got a few questions for her in my pre-op appointment tomorrow.

BIOLOGY

"So you've NEVER met him?"
"You've never even seen a picture of him?"
"Do you know if you look like him?"
"Do you have any desire to ever reach out to him?"
"Aren't you at least a little curious about him?"

Well of course I am curious! Just not curious enough to do anything about it.

I am speaking about my biological father. To answer the above questions (all of which I am asked when I mention him):

No, I have never met him.
No, I have never seen a picture of him.
Yes, I know that I look exactly like him.
No, I have no desire to ever reach out to him.

And yes, I am curious about him. When I start trying to search for answers to explain intimate things about myself, I immediately think of him and wonder if he holds the answers that I seek.

I guess I should back up a bit. My mother was married, at what I consider a fairly young age, to him, and not long after they were married she became pregnant with me. The problem is, many people in her life, including her father, tried so hard to talk her out of going through with the wedding because they just felt that he was "trouble." She was blinded by love or so excited about the prospect of getting married that she didn't see what she was getting herself into until it was too late.

They had barely been married a month before the violence started. My mother claims that the second they were married he turned into a completely different person, but I don't entirely believe that. I choose to believe that she didn't want to see the bad in him, and that it became impossible to deny once the wedding bliss was over. But back in those days, how do you admit you've made a mistake when you are only one month into a marriage? She tried to tell people, who dismissed her by saying "marriage is work, you aren't trying hard enough" to keep it together.

She became pregnant, the violence continued. He drank all the time, came home many nights at four in the morning stinking of booze and women. And he would always walk through the door ready for a fight, knowing he was in the wrong, but completely in defensive mode. He would greet her with screams and with fists. And this happened with regularity.

It wasn't until after I was born that the sense of urgency to "get out of the marriage" hit my mother. I was a newborn baby and his horrendous behavior did not change, not for a second. One such night got so bad that she put me in a stroller and tried to walk to her parents' house, across the Harvard bridge in Cambridge, at 2:00AM. She needed to get out of that apartment and protect her baby. She didn't have her own car back then; she was young and she was poor and her husband spent what money they had God-knows-where.

She had only made it halfway across the bridge when his car screamed up alongside of her, and he jumped out (still completely drunk). He grabbed me out of the stroller and threw me onto the front seat of his car. (No car seat, no seat belt, and yes, he was still drunk.) He pulled a knife on my mother and said "You try to take Dawn away from me again, and you'll never see her again, because I will kill her."

And with that he sped off, leaving my mother standing on the Harvard bridge with an empty baby stroller, panicked.

She (quickly) walked home to find him sitting in a chair in the middle of the living room: me on his lap, knife in his hand. She knew there was no reasoning with him, he was a drunk and he was impossibly cruel. He was violent and he was capable of anything. She retreated to the other room and patiently, patiently waited for the inevitable - she waited for him to pass out.

At this point she had to be oh so careful. If she woke him up, there was no telling what he would do. He had already threatened to kill me, and there was no reason to doubt his threat. She cautiously removed me from his lap - careful not to wake him as he snored, his hand still firmly grasping the kitchen knife. As soon as she had me she ran. She took no stroller, no coat, no food for the baby. She took what was in her arms - me, her entire life - and she ran. Ran to her parents house, praying the whole way that he wouldn't wake up and come after her with the car again.

A divorce followed, and although at first he would show up at my grandparent's house demanding to see me, he gave up after not too long. He was not that committed to actually seeing me, I don't believe, I think he used "seeing me" as an excuse to hopefully see my mother and continue the cycle of violence and control.

My mother remarried when I was three years old. She married a wonderful man with whom she had two more children, my sisters Eileen and Cheryl. My father legally adopted me as his own child and I acquired his last name. It was a remarkable gesture and I think the hopes were that it would erase the past.

But some things are not erased.

I love my dad. He is a wonderful person and I the only father I know. But we don't have the same relationship that he has with my sisters - his biological daughters. I can't put my finger on it, but there is just something slightly strained between the two of us, and I can't ignore it. We have always had a slight awkwardness in our relationship and we probably always will.

I always wished I had a closer bond with him. My mother and I are impossibly close, but my dad and I have to often work hard at it.

And then there are the problems I have with myself that bring up all sorts of questions.

Am I just like him? I have his genes, I have been told I look like him. What if I am just like him?

I have so much anger, I have always had it. We always thought that my early years and the turmoil I was surrounded by as an infant may account for my anger. But what if the simple explanation for my anger-issues is the fact that I am his daughter and I am just like him?

Anytime I drink too much I find myself wondering if I am being "like him." He clearly had a drinking problem. I always kept that in the back of my mind which is probably why I didn't start drinking until I was seventeen. Sad, that I consider seventeen to be "old" to start drinking, but most of my friends were drinking by age fifteen and I was terrified that I was biologically predestined to alcoholism. Every once in a while I still wonder this, when I have had one too many. Chances are that I have simply just had one too many, but the mind can't help but wonder...

Once, I had a fight with my mother and she looked at me, extremely hurt, and said "you get a look in your eyes sometimes that reminds me of HIM." Oh, the guilt I shouldered with that one. I am a constant walking, talking daily reminder of a person that terrified and tormented my mother. Great.

Where am I going with this? Hmm...sort of not sure anymore.

All I know is that, despite the fact that I have only heard one side of this story, I have no reason not to doubt my mother's version of history. I wonder about him a lot of the time, but not enough to do anything about it. I wonder about what I could learn from him about myself. Was there a history of infertility in his side of the family? Did his sisters have trouble conceiving? My mom told me his sisters were - um - well endowed, which explains MY proportions compared with my mother's.

I know he had brown eyes - like me. I know he had blonde hair - like me. I know he is part American Indian, but we don't know how much or what tribe. (This upsets my husband a lot because we'd love to try to cash in on some of that casino money out there!) I know the story I have related above. And that is all I know.

I am grateful for my dad and for his generosity of bringing me completely into his life, name and all. But I crave the bond - that bond that my sisters have with both their mother AND their father.

There is a lot to be said about biology. It can answer a lot of questions, both good and bad. My biological father seems to me to be a "bad person," and I wouldn't want to be friends with him let alone claim him as my dad, but not knowing him leaves me with so many questions about myself. Where do I come from? Where did I inherit my personality? What nationality am I? What is my family's medical history?

I guess what I am trying to say ultimately in this very long post is that I think it is so important for me to try to have a baby that is biologically mine and Anthony's, because I know how hard it can be to have so many questions about one's own history. I want my baby to know everything they can about mommy and daddy, and not spend years wondering. I am so conflicted on the whole adoption issue. I don't know if it is what I want, because then my child will lack that biological bond that I have craved my entire life.

I don't regret what my mother did, not at all. If she hadn't married him, I wouldn't be here. If she hadn't left him, I may not have survived my childhood. If she hadn't remarried, I wouldn't have my dad and my two sisters.

But I want my child to never have to wonder about where they came from. I want my child to be mine biologically because I didn't have that. Is it the job of all parents to want their children to have what they didn't have? It sure seems that way to me.

I guess I can't be exactly like him. I can't be. After all, I would understand and appreciate the value of a child and clearly, he did not. He threatened to kill me, used me as leverage and barely tried to connect with me after she left him. It would drive me crazy to know that I had a child "out there" in the world that I didn't know.

I must be different than him, there is no doubt. I will value my child. Biological or not, I will value my child.