Paul Bone

The End

Sat, 05 Dec 2020 00:00:00 +1100

The end of IVF

Back in August 2019 our doctor talked about doing one last IVF cycle as a last ditch effort to conceive our second child. That was at the moment that I’d, well snapped, and decided I was done with this. I was worried that by focusing too much on trying to conceive we’d not be "present" enough with the child we do have, and each-other.

Later that year we got pregnant naturally, which ended in miscarriage over Christmas. At the time I wrote how 2019 Sucked. 2020 wasn’t easy, we had it easier than a lot of people and I’m very thankful. Mostly 2020 was better since I felt like my marriage has been stronger, but 2020 had its own challenges, same as for anyone.

Our IVF story in 2020 was filled with delays. First medical delays while my wife’s body reacted to the last pregnancy and miscarriage with a hyperactive thyroid; which we had to wait to stabilise itself. Then COVID-19 shut down all elective surgery and we couldn’t proceed until September.

Our "one last cycle" had turned to "two last cycles" but I’m not sure where. Did I misremember something our doctor said or was something changed?

Our penultimate cycle (September-October) ended with no blastocysts developing far enough to be viable for transfer.

Our ultimate cycle (December) ended the same. 2 eggs were collected (lower dose hormones meant fewer developed, an attempt not to "overcook" them). One fertilised but developed abnormally, and the other wasn’t successfully fertilised. We got the news the day after egg collection.

Watching grief

We went into this knowing it would be the last time we take these steps, the last time I have to "produce a semen sample" into a sample container. The last time my wife may have post surgery Tim-tams (But the hospital took those away because 2020 sucks). We also went into this knowing the chance of success was very low.

Despite knowing this, it still hurts. I’m feeling a mix of relief and disappointment. I’ve mostly already processed this and I accepted that this is our family, we just aren’t able to extend it further. I think that I’m disappointed for my wife and our son, who both wanted to extend our family.

For my wife, well each time this fails she is hurt. And at some point after the bad news there’s an evening where I sit with her and listen. (2013-me would have been surprised to learn that that’s all it takes, and would even accuse 2020-me of not being supportive enough.) This time it’s different, this time it’s worse. This has hurt her so much worse, even though we knew the chance was low, it’s still heartbreaking for her. This was our last chance to use IVF, and the odds really are against us to conceive naturally.

I was going to describe some of her grief. But grief is different and specific to each person. It’s not necessarily going to help anyone. I knew it’d be different this time, and it is. After the other cycles I had learnt the pattern of grief, and come to understand the needs of my wife on different days "okay, this is the time when she needs me nearby to listen" etc. This isn’t following the pattern and I’m learning again like I had to at the beginning of our IVF journey.

Not together - the metaphor

The disappointing thing for me is that because I’m at a different stage myself, we’re not doing this together. I’ve found my way out of the jungle and I’m waiting by the beach for her to join me. I won’t proceed without her, I can’t pull her through (rushing it doesn’t work). I can support her of course, but it’s like I’m coaching her over the radio. I can’t properly be there with her and experience it because I’m not at that stage.

One question I had a couple of days ago is does she hate/resent me? I’m part of the reason why this was the last attempt because I said no-more, the other is the doctors just don’t know what to do/try. Does she resent me for putting an end to this? I don’t think so: each day we’ve had better interaction, it was just her mood, hopefully not how she feels about me.

Either way, it hurts me to see her hurt, but this is the way it is. This will always hurt in some ways, but we know it won’t hurt like this forever. It will be part of our history.

Where to from here

We’re going to keep trying naturally. With the knowledge that the chance of conception is low. I’m looking towards the future, having emerged from the jungle and looking at the beach wondering "what next". What does a family do at this stage? Plan more holidays?

Our son is now five and we still have a lot of the things from when he was a baby. We’ve lent things like the bassinet to other families, but kind-of don’t care if they ever get returned since we’re very unlikely to need them. But there’s clothes, wraps, toys etc that have been stored and some are sentimental. We may wish to reduce how much we have since we probably wont need them; but it’s not going to be easy, and there’s no rush.

I’ll wait here, out of the jungle, but I must be patient. And like all metaphors this metaphor is unsuitable, I may find that I am back in the jungle, or it has overgrown me.

I intend to write on this blog occasionally. Both as things come up, but also I have a backlog of ideas and thoughts that I’d like to share.

Mental Health Day

Fri, 24 Jul 2020 00:00:00 +1000

(Additional content warning: also grief and death of adults).

I know I haven’t written here in a while but that’s because I’ve been feeling pretty well actually. Sure 2020 sucks but mostly it’s been better than 2019 was. Today is still better than 2019 but not a good day.

Yesterday was the due date for the baby we lost in late 2019, My wife remembered, she’s grieving all this week, it’s normal. I’ve always felt that I’ve had an abnormal relationship with grief, I always felt just a bit empty but also matter-of-fact.

Grief

When my paternal grandpa died when I was a child my parents told me, I understood and comprehended it, said "Oh, okay", then turned back to the television (maybe this is actually typical for a kid).

When my paternal grandma died I was an adult living by myself, and although I can’t remember the moment it would have been over the phone. I accepted it and kept on going.

I didn’t stop for grief for either of them, and maybe I’m weird? Maybe our relationship wasn’t that strong? I don’t know, grief is weird.

I also lost my maternal Grandfather "Pop". This was the first funeral in my family that I actually attended, I was a pallbearer and I wept so much I couldn’t see where we were walking with the coffin.

This loss

There is a unique pain that comes from preparing a place in your heart for a child that never comes.

— David Platt

Anyway, my wife remembered this expecting date, and felt it. And I didn’t, I didn’t remember it, or feel it. And maybe it was like when I lost my paternal grandparents, that it was just the kind of grief that I never had, or was already "done with". And that fits, since last year I was "done with" IVF and infertility and just wanted to move on.

…and then I did feel it, I think? I don’t know. Maybe it’s just empathy for my wife’s loss. Whatever the cause, my mood is low. I’m crying when I see the flowers our friend sent or the messages my wife’s friends are leaving for her.

Or maybe I’m grieving but not for the babies we didn’t have (there were two miscarriages), but instead grieving for the lost time spent in infertility treatments and planning. We haven’t put much on hold, but even so you put yourself into a frame of mind where you’re waiting, and then maybe you don’t take opportunities or miss stuff because you’re /busy/ waiting (not really busy, it’s hard to explain).

Or maybe I’m grieving for my son (5) who is very likely to grow up an only child. It’s not the end of the world being an only child, I know several who have become great adults. But he desperately wants a brother or sister and invents imaginary ones, last weekend we just got a new one and I think the count is at 10, although half of them are TV characters he likes to imagine are with him.

Or maybe it’s a combination of the above plus the general "watching the news and feeling isolated in 2020" feeling. Which is the other reason I haven’t done much writing. I don’t want to bring y’all down while 2020 is going on. Whoops.

Anyway, I don’t know the exact cause, and figuring it out doesn’t seem very practical (in this case), so I’ve chosen to accept that I don’t understand it beyond "grief is weird"

I didn’t see it coming but I’m taking a mental health day today and feel good about it. I’ll be doing some things that make me happy, supporting my wife, writing this and putting the olives in their final brine.

My thoughts are also with everyone else doing it (any level of) tough in 2020, take care.

March Update

Thu, 26 Mar 2020 00:00:00 +1100

It’s already time for an update. I posted the last article on the 28th of January. But in my mind that left the story in mid-January. I’d like to enumerate some things since then, and provide a bit of an update of where things are at.

Recap

I’d probably recommend reading that article so that this one makes sense. If you have and you’d like a recap briefly my wife and I have unexplained infertility. We have one son (now age four) who was conceived through IVF and since then we’ve had to return to IVF to try to have a second child. Last year we had many "weird" IVF results and two pregnancies, one at the beginning of 2019 and one at the end, that both ended in miscarriage. In between these I had an episode of burn-out, and wished to stop trying to grow our family further. And from my perspective, that second pregnancy was unplanned as we weren’t expecting to fall pregnant naturally.

The last pregnancy probably failed on Christmas Day but we didn’t know until the 31st when my wife saw the doctor and then passed the fetus that evening. I closed that article saying that we haven’t yet made our plans certain. And that I’m now in a better place emotionally than I was in mid-2019, and continuing to put things in place to improve that further.

Other stuff

I was going to write at length about some other events, because they’re definitely going on and have an affect on how much energy we have for IVF. But it was too difficult to keep it succinct enough while still providing a satisfying amount of detail. So instead:

There were layoffs at work.
I was reassigned between teams, without being asked, found out via rumour & my new team is not related to my background, skills or career goals.
A family member made a suicide attempt.
I have recurring blocked saliva ducts, causing intermittent pain.
All three of us in the family had some dental stuff in the last few weeks.

Where we’re at

As of February we’ve had some discussions about what we each want. Back in August our doctor had talked about one more cycle with less/lower dose hormones. My wife is ready to give this a shot if it has any chance of working, and I’m finding it hard to summarise my position. If it were up to me alone, I’d say no. I’m done with this phase of my life and I’m ready to move on, focus on the son we have and our relationship and other goals. But this isn’t a hard "no", and so I’m willing to go on a little longer because I believe it’s what’s best for all three of us.

What I’m dead-against is going on and on and on, and this never ending. I need my wife to accept "an end" and move on at some point; but that isn’t today.

What we’ve agreed to is to do one more cycle of IVF, and try naturally until the end of the year and "revise" what we want then. I’m not happy with this, I’d prefer to have that hard "We’re done" at the end of the year. Mostly because I’m afraid we’ll get there and say "one more year", I can’t imagine ever agreeing to that and I’m fairly sure my wife knows this. So revising it at the end of the year will just end in "no" anyway. Maybe what we can agree on is "If nothing changes then we stop", my guess is that what she wants is to be able to revise things if something comes up.

My attitude has changed since last year, I feel like there are two reasons for this: I’m a lot less tightly-wound now than I was last winter, and I think our relationship is in a better position, with more communication, more quality time, and more trust.

What do the natural pregnancies "mean"?

You may be wondering, as I was, why we had two natural pregnancies last year but no success with IVF. Surely IVF should have been more successful. I asked our doctor and she said that it’s likely to be luck in which eggs develop during each cycle, not all eggs are equal so it’s just the way luck worked. I think it’s also partly why next time she wants to try a less hormone-heavy treatment, and not (as I like to say) "overcook" them and end up with abnormal nuclei.

Latest appointment

Now in March we’ve had our latest appointment and set about this plan. There were two interesting conversations during the appointment and one interesting outcome.

The first is that our doctor when proposing the treatment asked us what we thought. I told her what I’ve written above and in the last article, and she was concerned until I clarified that I do think it’s best for our family. It also occurs to me why this is so weird to describe. It’s not a matter of whether we want children or not, it’s what we’re willing and able to handle to get them.

The second is how our doctor pitched the plan. One thing that had me feeling a bit more positive about going ahead is how our doctor pitched the plan. We’d give it one more shot while making sure our health and well-being was as good as it could be. Then if it fails we can walk away knowing we’ve done our best. This is maybe 60-70% bullshit, yes health and well-being have an impact, but I don’t believe it’s going to make a significant difference for us. But I’m not a fertility specialist so maybe it will. Nevertheless I feel like this attitude will make it easier to finish, it may help my wife feel like we’ve done our best, and it helps me feel like I’ve not pulled the plug too early and hurt my wife.

A minor interesting point here was that I remember our doctor saying "one" and my wife remembers "one or two". Other than our discussion about what we each remember we’ve not spoken about whether we’d be willing to do a second final try.

The third is part of our doctor checking everything is "ready" was re-running bloodwork for both of us. My wife’s results showed a hyperactive thyroid. We’re now figuring out why that is and what it means, we cannot begin our final cycle until that is solved.

2019

Tue, 28 Jan 2020 00:00:00 +1100

The Bone Family didn’t have a great 2019. This is the story so far of trying to conceive a second child, covering 2018 and 2019. The TL;DR is that this sucked, and 2019 sucked in particular with two miscarriages, several IVF cycles ending in weird results and one more-intense-than-usual IVF cycle (a down-regulation cycle), feelings of isolation and marital stress and coming to terms with being just a family of three. There were moments that were good of course, but this post is about getting my head around the negative, and sharing that experience.

Background and family

Many people who know me, know I have a four year old, Mr 4, probably because I mention him every chance I get: I just love him to bits. Mr 4 was conceived via IVF in 2014, after seven rounds of assistive reproduction (three IUI and four IVF with ICSI). My wife and I have "Unexplained infertility", we just don’t know why conceiving naturally doesn’t work. We’ve had some different hypotheses along the way, but the short story is that we just don’t know.

Anyway, we eventually conceived our son, and while that’s a miracle, let it be known that IVF is still challenging even when things work out. It’s also challenging because you’re doing this in addition to the rest of your life. In 2014 I also had kidney stones and hyperparathyroidism and ended up with more hospital visits than my IVF-patient wife!

2018

2018 went like:

August

IVF+ICSI cycle, out of about a dozen eggs collected, zero developed.

October

IVF+ICSI cycle, out of about a dozen eggs collected, two eggs developed, one transferred (that’s what they call it when they put the zygote into the woman’s uterus. The other frozen.

At this point there are two zygotes, which means we have a conversation about what we do if this cycle is successful and we still have one in the freezer, would we try for a third child (something I had always been against), but yet it feels wrong to "waste" it. These are big ideas, and serious conversations! So is normal family planning, the difference is that you know there’s a potential human (not a human yet) in the hospital’s freezer.

The pregnancy failed with a negative pregnancy test. (They test via blood, or the woman just gets a period before the blood test date.)

Note

It’s probably not normal to write "the pregnancy" at this early stage, since if you weren’t using IVF there’s a good chance you wouldn’t ever know that you were pregnant. And yet, there’s a developing human, even if only 3-7 cells big, inside the woman’s uterus. So I suppose this is the "technically correct" way to say it.

January 2019

We started the year pregnant, but we didn’t know it at the time. We naturally got pregnant, which was a huge surprise on top of the surprise of being pregnant at all.

There’s a bit of a trope around this that a couple have their first child via IVF, then their later children naturally because the IVF somehow "fixed" something, or showed their body how. I’ll explain the problems I see with this in a future article, But the short answer is to imagine yourself as someone that can’t possibly get pregnant naturally (for whatever reason) and someone is saying "Don’t worry, miracles happen" meanwhile you know it’s untrue.

We have unexplained infertility, which means that we don’t know why it wasn’t working naturally, but that it was never actually impossible, it was just really really unlikely. Let’s say that (population average) people have to roll a 1 on a six-sided die each month to see if they fall pregnant in that month. But my wife and I have to roll a 1 on a 20 sided die each month, (I’m mostly inventing convenient numbers, but they’re in the ballpark). Using IVF is like paying $12,000 per month ($4,000 is reimbursed by medicare) to use the hospital’s 10-sided die, rather than the 20-sided die we have at home, it just improves the odds over what we can do naturally. And it’s still not as good as the 6 sided die our friends are playing with (which is not their fault).

My point is that we can conceive naturally, but that the probability is lower, and that this pregnancy was definitely a surprise, and feels miraculous, but isn’t actually a miracle (the impossible happening).

28th

Positive urine test

29th

Positive blood test

February sucked

1st

Miscarriage.

Bleeding started, then got a little heavier. My wife went to the hospital, I stayed home with our son. A friend met her at the hospital so she wasn’t alone. Blood tests confirmed that hormones were dropping and she was no-longer pregnant. From memory we were about 5 weeks pregnant. That might not sound like a lot, and didn’t seem like a lot to me at the time, but it’s enough.

It affected my wife more deeply than I knew, and for longer than I would have expected. It wasn’t as if I was naive enough to think she’d walk it off, but after the IVF to conceive Mr 4, then again to try to conceive #2, I didn’t know how deeply it would affect her. We’re still both learning just how deep this cuts.

And it affected me. I’m never really sure how much things affect me until I do something stupid because I just can’t think right. I think that happens because I don’t make the space or time to process it (which is another reason why I’ve started this blog, it’s how I’m processing all of it). It isn’t just that I don’t make the time to process this kind of thing, but that I expect that time to be granted to me for this, that for some reason the rest of my life with pause and I’ll be able to take a breath.

A few days later, a friend invited us to a pool party, which is great. Who doesn’t like pool parties, but my wife isn’t allowed to swim and is feeling uncomfortable: biologically a miscarriage is somewhere between a really heavy period and childbirth, she can’t swim.

So, I have unprocessed grief, a grieving wife, a three year old (who needs just as much attention as ever but he’s also confused about why mummy is sad and daddy is tired). So parenting around the water is my job, which isn’t a problem. However I’m now using 100% of my concentration on parenting, on being near other humans when I’d really rather just be left alone, on following the commands of my wife and trying not to snap at her, and struggling with my eyesight in the lighting of our friend’s backyard. So I have no concentration left to think about what I’m doing myself that I forget to take my phone out of my pocket. I utterly drowned a perfectly good Pixel 2. I know that’s not the end of the world, and I’m sad for the phone. I’m annoyed at my own stupidity to leave it in my pocket, and frustrated at yet another thing gone wrong.

It’s a symptom of where I was at emotionally, I should have pushed back on what was being asked of me. Not to the extent of staying home because I really wanted my son to be able to swim and have a chance to see his friend, especially since his mum and dad had been no-fun lately. But I could have pushed back on how we do swimming, and spoken up saying that I can’t manage myself, our son, and my wife’s needs in that environment at that time. It’s just one way in which I hadn’t realised I didn’t have the energy.

February - March

We’re back to trying again.

So we had a zygote in the freezer. It gets defrosted and transferred….Negative pregnancy test.

March

Another IVF cycle, several eggs extracted, zero develop.

That’s weird, another cycle with 0 eggs developing?!

IVF jargon

It’s time to explain some jargon.

After her period, the mother begins a course of hormones to grow a whole bunch of eggs (usually the ovaries only grow one at a time). And yes, they’re all present at birth but they need to grow a little further before being released. Then the night before she takes another hormone injection called a trigger, this is the prompt for the ovaries to release the eggs. This trigger is timed to be a specific number of hours before the surgery, and can be amusing when your wife has to duck out of a Hunters and Collectors concert to go take an injection in the storeroom of the theatre at precisely 7pm.

To extract the eggs the following day the doctor guides a needle through the vagina, up into the uterus, then pushes the needle through the uterus wall into each of the ovaries to take the dozen or so eggs that the ovaries were timed to release.

At this point the doctor has a rough count of how many eggs were extracted, and may know their sizes (how developed they are). Hopefully the doctor speaks to the mother when she wakes up, but sometimes gives this information in writing. While the mother is recovering the eggs are either placed with the sperm, or for ICSI (our case) the sperm are selected and placed inside each egg. They’re put in an incubator and left overnight.

In the morning (day 1) they’re checked, the eggs are now zygotes and should be growing and getting ready to divide. So when I wrote above "zero developed" in two of the previous cycles that means that of the 12-or-so none developed into zygotes or continue growing properly. At this point the doctor will phone us and tell us the news (positive or negative). There’s normally some loss at each step, including this one, but zero is a bit, terrible, and weird, and the doctors don’t know why.

May - June

Another IVF cycle, several eggs extracted. This time in the phone call (day 1) the doctor tells us that there’s only one developed. Because there’s only one there’s no point waiting the normal four or five days before transferring it to partner’s uterus, so they’ll transfer it tomorrow (day 2). Normally when there are a few you can wait a few days and see which ones continue to live and transfer the strongest one(s).

The transfer didn’t go according to plan. We got a message/phone call the next day (day 2) saying the procedure had been canceled because the zygote has deformed nuclei. We don’t know what that means, only that it can’t be transferred. Bugger.

The doctor is confused and doesn’t know why this is happening. And in that message or call (I can’t remember) to say that it couldn’t be transferred she says we may have to resort to "more extreme methods". My wife and I don’t know exactly what "more extreme methods" are, but we suspect it’s donor eggs, or exploratory surgery or something of that magnitude.

Each try ends in disappointment and sometimes heartbreak, to some extent you get used to it, but in other ways it’s a cut that has not finished healing and then you scratch it again and it opens again and it’s a bit more pain. In these cases with the "zero developed" or "abnormal nuclei" it cuts differently: it’s not just a matter of bad luck as it appeared to be in 2014, but we don’t know what "it" is or maybe it is bad luck?!

According to my calendar this was most-likely June 7th. I didn’t have time to process it before I had to fly to Canada for business on the 17th. This was just enough time to put myself together enough to function at work meetings and with so much face-to-face time at work (usually I work from home). Oh, and I was also managing the construction of a deck on our house.

July: Down-regulation

So the cycle that our doctor wants to try is a down-regulation cycle. This is where the woman takes a longer course of hormones, starting with the pill to stop her menstrual cycle. Then starting up her cycle again via other hormones and then followed by the usual IVF hormones and cycle. I forget what it’s supposed to do medically, apart from "turn it off and on again" to see if that helps.

My wife has used the pill before, and we knew she had some side effects, but never really noticed the side-effects this heavily before. The big one was her anxiety, she’s always been somewhat anxious but that got dialed up to 11. We both noticed and found it quite difficult to manage. I don’t remember the other symptoms specifically, but I noticed that we were having more trouble communicating and getting along with each other. It felt as if she wasn’t her normal self (personality change).

I’ve had enough

It’s hard to explain this without all the details which is an article of its own. So instead I’m going to need to leave that for later and give none of the details, but a bit of the feeling and conclusion. Hopefully I’ll get the details untangled enough to write about in the future.

Our everyday working relationship had deteriorated (we still functioned, but most interactions were either "meh" or negative), due to a few factors but the big one was IVF, it’s stresses and the effect of the various hormones on my wife. The other factors were:

The relationship with my wife:
- not spending quality time,
- communication.
Work stresses including some miscommunication.
Social isolation.
Poor support network.

This all added up to IVF is no-longer worthwhile for me. The cost is greater than the potential benefit, meaning that.

I didn’t want any more IVF cycles after this one
I hoped that this cycle would fail so that we wouldn’t then have to deal with the pregnancy and infancy of a new child. Why? Because I was all out of spoons due to dealing with IVF+life. I could not foresee having enough spoons to be a dad for a new baby.

This also meant that I had finished the grief of not being able to conceive a 2nd child and reached the "acceptance" stage. We were a family of three, and that was it, it was good, I was happy with that. (I know that sounded sarcastic, but it’s not, I really was/am happy to be a family of three.)

One thing remained though, I didn’t want to tell my partner and break her heart. Not only would that hurt her, but it would be me that hurt her. After each cycle with the doctor giving bad news I didn’t want the last stab in her heart to be from my words. And how would she react? Would she hate me? Would she leave me? Would we remain together but gradually build more and more resentment? These seem less realistic now (but still possible), but at the time these were very real possibilities.

I did tell her this though. One day it all exploded over something tiny and in the following hours, between sobs, I told her how I felt. Without sounding like a Christmas special the most amazing thing happened; she listened. She listened to how I felt, and she could see that I didn’t want to hurt her and yet honestly felt this way. She did not process it as me breaking her heart, but as me opening my heart (and struggling to do so!). My wife is the best I could possibly deserve.

It is possible to abort an IVF cycle. Either one of us can withdraw consent, it doesn’t have to be something we do together. However I would not do this, when the cycle started I had committed to it, and so I would follow through.

Meanwhile I’m scared that if we continue with IVF after this cycle that it’ll take all of my energy/time/patience, and that I won’t have any more of these, or any more love, for my wife and son. And I’m scared of loosing them because we’re trying to chase a potential second child.

August: Down regulation - continued

Back in June we’d started the down regulation cycle, now it’s August and finally my wife’s mood is improving. Her mood is not just improving from the down-regulation cycle, but also since the miscarriage in February. We’d noticed when now in August she’d been listening to more up-beat music, and singing along, and it was lovely to see her in a happy mood. But it also showed us just low long it’d been since she had been in such a mood.

18th August: Egg pick-up day. What’s the result of this extra-difficult cycle?

Six eggs extracted, Five fertilized, and again we got the phone call the following day to say that zero developed.

At this point we’d kind-of come to expect it, so it didn’t hurt too bad. On top of that I was also relieved, for which I felt guilt.

September: The end

Over the next couple of months my feelings begun to relax a bit more. Our doctor has recommended one last cycle, with a simpler/easier protocol. Lower hormones so as not to "overcook" the eggs. My wife wants to try this one last cycle, even if there’s a small chance of success she wants to try. I don’t want to.

We put off the decision for a little while. We’ve been taking breaks between cycles like this the whole time, to give us both time to recover emotional energy but also to give Liz’s body time to relax.

We had initially decided that if we do try again it’ll be in November, and then found that our schedules had filled up and it would need to wait until February 2020, or risk pushing us both too far.

November: pregnancy

18th: After some early pregnancy-like symptoms my wife did a home pregnancy test. Just like in the beginning of the year both of as are thinking "it can’t be" and "we’re just ruling it out". But the test was positive and confirmed by a blood test the same day. This is another spontaneous pregnancy, that’s two in twelve months and zero success with IVF.

This did my head in. Like I had said, I wanted the IVF stuff to end and I didn’t want it to end with a pregnancy because I did not think that I had enough emotional energy to care for a new baby. Part of being "done with IVF" also meant that I was "done with pregnancy/babies". Now that I’m writing this several months later I cannot properly remember what I was thinking at this time. My best guess is that because we have infertility then the way to have children is to use IVF. I want no more IVF so in some flawed logical induction that means I want no more children? Maybe this is only temporary and I might want children once other feelings calm down? Or maybe I can’t remember because I was afraid to really acknowledge some of it, because it means disappointing my wife / breaking her heart and to some extent "standing up to her" (asserting myself more)? Or maybe I was still caught up in the feelings of July-August and thinking irrationally?

Here is where I needed, and still want, the support of other men in the same position. I saw a counsellor, and that was okay I guess, but what I really want is to speak to someone who has been through something similar, or just know that they exist.

Anyway a new baby is coming, and I was very much at a stage of disbelief. As a partner of a pregnant woman, I find that it’s easy to forget that a baby is coming until your partner really begins to show, and everybody starts saying "congratulations". So most of the time I forget. When I do remember I’m terrified.

When my wife was pregnant with our first child I felt the general terror that any new parent feels. Plus the additional fears and worries that our child would inherit my eye conditions. This time I had some very specific fears: I’m scared that I’ll lack the emotional energy to take care of the new baby, to be patient when they cry because their tummy hurts, because I’ve already been operating beyond my limits since June. I was absolutely terrified that I wouldn’t love them enough, that I don’t have enough love in me to give out, because I gave it all out already this year. Or would I have enough energy/love for the new baby but have none left for either my wife or Mr 4 and it’d drive us apart.

December

I had been working on reminding myself that a baby was coming and talking myself through the feelings above. I wasn’t finished this process, but I was no-longer terrified. Hearing the heartbeat and talking about how Mr 4 would have a little brother or sister helped.

Meanwhile my wife’s anxiety had become worse again. Some of that is the hormones of pregnancy (the same way the pill affected her in July). A lot is also because she’s worried about loosing the baby, particularly with the shadow of February’s miscarriage hanging over us.

Being IVF patients we had the first two scans with our IVF doctor before being referred to the obstetrician for care. The first scan (6 weeks) showed a fetus/embryo, with a heartbeat, but also a haematoma. This is a blood clot caused by bleeding between the uterine wall and the gestational sac. This is a risk to the pregnancy, but it’s hard to say in what ways at this point.

The second scan (7 weeks) shows the fetus growing, but a bit more slowly than it should be. The haematoma is also growing. The doctor says that we have a 30% chance of loosing the pregnancy. That figure upset me, I guess on top of everything else I did not want this baby/pregnancy to break my wife’s heart: I’m afraid of the now very real possibility that it will (at this point a typical couple has a 10% chance of miscarriage). Our doctor attempts to reassure us that there’s a 70% chance that it’ll come to term. But it still feels like my heart just got punched in the nuts. Besides, even within that 70% what are the chances of other complications? or health risks for the child later?

Note	At this point I noticed that the doctor was not saying "baby", but "pregnancy". I’m sure that’s deliberate and I think we can all guess why.

Our next scan (9 weeks) is with the obstetrician, on Christmas eve. The trend continues. Baby/fetus is not growing as fast as they should (now measuring eight weeks and two days), and the haematoma is growing, it is now twice the size of the embryonic sac. But the heartbeat is very strong and we even saw them move! After the appointment we drive to my parents place in East Gippsland for Christmas.

Bushfires

You’ve probably noticed that Australia has had some pretty awful bushfires this summer. We checked the warnings before we left home and it was safe to travel. While we were there the smoke continued to increase. We had a lovely Christmas (especially Mr 4) and left there on the 29th.

29th: When we got back home to Melbourne we saw the warnings, all tourists to leave the East Gippsland area (a popular spot that time of year) because if it turns bad the emergency services people just won’t be able to help residents plus tourists.

30th: The warnings got worse again. Asking residents to make (and act on) their go/stay decisions and other preparations. My parents chose to stay.

Miscarriage

31st: Some light bleeding had started over Christmas and when it got heavier on the 31st we called the obstetrician and booked a scan. That morning we joked that "well, if it’s a miscarriage it’s sneaking it in right at the end of 2019. (2019 sucked) We also spoke about how it might just be the haematoma "going away" and everything will be okay.

My wife went to have the scan and I stayed home with Mr 4. The fetus now measures 8 weeks 3 days. It had grown one "day" bigger in 7 days' time. There was no heartbeat. We’d lost it. 2019 sucks. Both our hearts had been punched in the nuts again. A D&C was booked for Friday.

That evening I watched the emergency reports as the bushfires got closer and closer to my parents house. They were precisely in the path of the fire. They had been sending some pictures of the column of smoke blowing over them, with embers falling on/near them starting spot fires.

I heard the NYE 2020 fireworks outside at about the time the wind would have changed for them and blew the fires in a different direction. As far as I can tell a major fire was between 10 and 20km of their home.

2020 & The future

The wind changed for mum and dad and blew the fire away.

My wife passed the fetus at home, and was able to fish it out of the toilet and take it to the hospital where they can run tests. No D&C (the procedure where they vacuum it out) was necessary.

I’m in a better place now than I was mid-2019. That’s why it’s even possible for me to write this now, which I could not have done earlier. I don’t know how easy "feeling better" will be to maintain. But it’ll have to be something I work at, especially if we continue trying to grow our family.

Since June and those "abnormal nuclei" we’ve both been preparing ourselves for this being the end. We’ve started giving away the baby furniture and cloth nappies. We haven’t decided if we’ll do that "one last IVF cycle" that our doctor pitched back in August. What I know for certain is that I don’t want "one last try" then "one last try" again and again. I don’t want to wait for our lives to change and I’m ready to move on to the next phase: watching Mr 4 grow up. But we need to make a decision together.

At this point anything could happen. IVF might work, a pregnancy might go to term, or nothing at all.

Thank you

Thank you for reading. If you found this interesting or moving please share it. More people need to hear stories like this to remove stigmas from infertility, IVF and miscarriage.

There’s plenty of side-points to discuss, and even some main ones, I hope to publish more articles in the future.

Men

Sat, 11 Jan 2020 00:00:00 +1100

Usually I write about compilers/languages etc, and so I’ve created a new part of my website for real life posts like this one. Feel free to head on back to the normal content if this isn’t your jam.

Since you’re still here I’d like to talk about infertility, miscarriage and such. Most articles are about women and infertility. In fact anything to do with reproduction tends to be about motherhood, birth etc, and when it’s about general parenting it’s often written with words like "Mum" rather than "Parent". There’s two things I hope I can achieve by writing posts like this one.

We can improve equality by talking about parenthood or fatherhood in addition to motherhood. If you don’t know what I mean consider a female CEO who is a mother. People ask "How does she find the time to be a mum and a CEO?" But male CEOs who are fathers escape this question. Talking about fatherhood and parenthood is one way we can make people’s expectation of gender roles more equal.
By talking specifically about fatherhood, men’s health, infertility & men etc, maybe other men in similar situations can feel less alone.

I’m going to be writing in heteronormative terms. That’s what I experience and can talk about with any level of authority. I apologise for not being even more inclusive.

Infertility

When we first saw our family doctor when we were unable to conceive after some months, she referred us both for tests. The initial tests looked like there was something "not right" with my sperm. One of the three tests ran was not within the nominal parameters. So until we knew otherwise that was our assumption. I don’t really remember how I felt about this, other than being annoyed that I may have to give up both caffeine and alcohol to "help". (Yes, these are minor compared to the whole journey, this was my thoughts at the very beginning.)

I do remember meeting some friends (all male) for lunch and telling them, Of course they all took it in their stride, it wasn’t happening to them, and didn’t say much. At the time I remember feeling a bit foolish for mentioning at, what’s it got to do with my friends after all, it doesn’t affect them. It felt a bit awkward and the conversation switched back to video games or something. Looking back on it, I was looking for support and didn’t find it in those friends, I also understand that it’s hard to know how to give support.

We were referred to a fertility specialist at an IVF clinic and she looked at the same tests, she thinks that it’s probably not sperm, the test is only slightly abnormal and doesn’t really point to a problem. However, all of Liz’s tests/data looks okay too. Our infertility is "unexplained infertility", this means that our likelihood of conceiving naturally is lower than typical, but we don’t know why. Yes we were having sex "correctly", our doctor checked (they ask you how, you don’t have to show them), yes this is a joke that I’m equally amused by and tired of. We don’t know if it’s a egg thing, a sperm thing, something to do with how they combine, something to do with how the blastocyst develops?

IVF

When you’re a couple undergoing IVF for unexplained infertility the (would be) mother is the patient. The appointments are her appointments, under her name. That makes sense for hospital visits like taking the eggs out of her ovaries or hormone medications she has to take. It’s this way because that’s how medicare, insurance and such is all set up. That’s not okay (in my opinion) when it’s a consultation appointment,

(Sorry I don’t know what happens when there are donors or surrogates, maybe that’s a different situation and this doesn’t apply.)

Having a family is something my partner and I do together, and yet our doctor (technically my partner’s doctor) praises me for coming to the appointments, and my wife and I joke about how I should be in the room when she becomes pregnant.

I wish things were normalised for men so that both partners were equally involved. Even by making the appointments under the mother’s name, it’s easy to fall into the assumption that the father is less involved and merely "supporting your partner in". I sometimes catch myself thinking "Oh, I have to go to her appointment" with the tone of one resenting a family obligation, I consciously tell myself that we’re going to our appointment, and I wish I could do more, like take on some of the side effects of the unpleasant hormones or post-surgery pain. And I’m not the first Dad to wish he could take on some of the pain/work of childbirth.

Guilt

When things don’t go so well, or even when they do but it’s just hard work it’s natural to take on some stress, some fatigue and even grief. I’m assuming that my wife and I have taken on equal stress / mental fatigue. There’ve been moments when each of us haven’t handled it well (to my wife’s credit she also had hormones on top of that).

When I’ve handled my stress poorly it’s been followed up by feelings of guilt.

"It’s not my body having large hormone doses, why am I the one not to control my emotions?"
"It’s not me that wants children this badly, why am I the first to burst into tears at a loss?" (It’s true, my wife wanted children more than I did.)

And.

"Why can’t I be the strong one? I’m a man."

Yeah, you guessed it. I wouldn’t call it toxic masculinity, but it is definitely an unreasonable idea of masculinity that I (and everyone else) had grown up with. There’s absolutely nothing about gender/sex that says men can’t feel and express emotions.

I still feel this way sometimes, I have to talk my way out of it (or ask for help).

Recently my friend commented that he saw a big muscle-man working in a cafe. He noticed that the man had a tattoo, it said "boys don’t cry", the word "don’t" was crossed out.

Involved Dads

Before our son was born I was given a pamphlet and other flyers about being a dad, maybe even a book. They were my "dadding" books/papers, because it was specifically written for Dads. I honestly couldn’t think of the correct word, I’m going to blame the new parenthood sleep depravation but I don’t think the time-line supports that excuse. Anyway, what I meant was "parenting" (or I suppose "fathering"), how to be a parent, how to do it intentionally and really lean in to the role.

There are some things I do think of as specifically dadding and not just parenting: things that all parents do but dads do them a bit different. The textbook way to wash baby’s hair is to hold them in one hand, with their head supported by your thumb while your fingers curl around their torso. Their bum, tummy and back are all in the water while their shoulders are out. With your other hand use a cloth/cup to wet their hair, then shampoo it. It’s okay, except my son always felt unbalanced in my hand.

The dadding way is to hold them upside down (their body is in a towel to keep warm) and dunk their hair (not head) into the water. They love it and they’re balanced along your forearm. Plus by being able to drunk their hair rather than run water from a cup or cloth over it it’s much easier to wash out the shampoo.

How dads wash hair

The dadding pamphlets don’t talk about how to wash hair like this, or how other stuff like this. So what do the dadding pamphlets actually say? I remember one emphasised how important it is to be present/involved. With a bunch of statistics about stuff like "Kids who have a dad in their life get better grades". These are good reasons to be in your kids' life, I’m aware that people have unplanned pregnancies, but when it’s planned why would you not be in their life anyway?! Why do you need a pamphlet to guilt you into being involved with your family?! I don’t know what I wanted to find in such pamphlets, and there probably was some good/useful stuff, I just don’t remember it five years later as I write this.

I’ve got one more gripe from those early months. Our local council organised some classes for us, with general advice like vaccine schedules, when to start solids and stuff like that. They suggested all of us new parents could swap details and form a group. I call it a parents group, some of the other members call it a "mothers group", begin discussions online with "Do any of you other mums have advice for…". I don’t mind replying to such posts ore reminding people that it’s a parents group, but it’d be nice if I didn’t have to and if I wasn’t the only dad.

Other than my disability I’m seldom in a minority group and I’m aware that I’m complaining about the kinds of things that other minority and underrepresented groups face, including women in tech. However if we can be better at saying "parents group" then maybe more dads will want to join. The more dads that join such groups and talk about dadding (or remember the word parenting), then the more dads will be able to talk about parenting, want to be involved and will feel more comfortable taking parental leave from work. The more that happens the less people will ask the female CEO how she manages work and family (without also asking the male CEO the same).

Now that our son and his friends are older I think there are more involved dads. I speak with other dads when we arrange a play for our kids or they take a class together, It’s become easier to make other dad-friends, and they seem equally involved as the mums. This was what I was looking for in those early months, dad-friends with which to discuss how to wash hair and the best lullaby (Iron Man by Black Sabbath (seriously, it works)).

This is why

All this is why I’m writing this blog. I want other men, in a similar position to me to have one extra tiny resource. I’m not an expert in any of this stuff, I’m not a fertility specialist, a obstetrician or psychologist. So I don’t think this blog’s value is going to be all that high. But hopefully by talking about this stuff, adding one tiny extra voice, there’s more conversation about this and men in a similar situation can feel not-alone. Because in 2019 (next article coming soon) that’s what I needed, and didn’t have.