How babies are made.

"Mommy, how are babies made?"

"Well, sweetheart, when a mommy and a daddy love each other very much, they go see a doctor."

...

This is not exactly what I had in mind when we started discussing family. But after talking to doctors and hearing anecdotes of women scheduling their c-sections and such, I almost wonder if this isn't the direction we're headed as a species. I don't know whether to be proud of us (as a species) for the advancements we've made, or horrified that we've jumped feet-first into the lab without knowing all the ramifications. I'm leaning towards proud, but I have to admit a bit of personal paranoia on the subject.

We saw a fertility doctor today. It's kind of funny that though I always expected to have a bit of trouble conceiving, I never, never, never thought I'd end up talking to a fertility specialist about IVF. I tend to be a little hypochondriac about medical stuff (ask my Mom how many times I told her I had a brain tumor as a kid), but it always turns out to be nothing. (No brain tumor.) I'm a bit gratified to be right about something, but totally pissed that it's this. Couldn't I have just had West Nile instead of a cold that time?? Obviously, I'm kidding. But this is frustrating so I feel entitled to make jokes.

The first step is another round of tests. Blood work, again, but more sensitive than the tests my OB/Gyn did. Hooray, more needles. </sarcasm> The good news is that an FSH level of 10.1 isn't terribly troubling. This is really good news. She said she would maybe be more worried if we had never conceived and I had a level of 12 or something. Basically, FSH is your brain telling your ovaries, "Hey! Time to make some eggs!" As you get older, your brain has to speak up - your ovaries become hard-of-hearing, apparently. So, elevated hormone levels mean your brain is having to shout, which means your ovaries ain't as young as they yousta be. (I'm not sure why ovaries are crotchety old southerners...) At any rate, my doctor said my hormone levels indicate some age-related infertility, or at least a decline in fertility. But overall, I'm still under 35, my hormone levels are really borderline and the prognosis is good. Getting to the "good" part might require some work though...

Given that, she went to IVF fairly quickly. But really, it seems like there are two stages to infertility treatment: fertility drugs (and various methods of insemination - sorry for the ick factor, but there you have it), and IVF. There are a few different combinations of fertility meds to try, but basically the whole thing boils down to: try meds for 3-6 months and if that doesn't work, IVF. Not exactly what I was hoping to hear.

 Actually, I'm not sure what I was hoping to hear.

Our doctor seemed very concerned with making us aware that IVF was a good thing. A good alternative. As it turns out, 16 year olds have a 20% chance of getting pregnant each month, whereas normal adults under age 35 typically have about a 15% chance each month. With IVF, otherwise healthy adults have a 50% chance. These are good odds, statistically speaking, but the realities of IVF are too much for me. You have hormone injections and monitoring and such, fertilize embryos in the lab, implant a few, hope at least one takes... And the cost. The average at our fertility clinic is $10,000 per attempt. And given their statistics, at least 50% of couples who do IVF aren't successful the first time around. Emotionally, I can't get involved in IVF. And financially, well, I'd rather put that money into adoption.

The doctor also seemed pretty interested in us getting genetic testing done. We declined for several reasons. First, we're not doing IVF. So testing embryos for genetic abnormalities is not something we need to worry about. Second, I'm not really sure all the potential future ramifications of having your genetic predispositions on record somewhere. Maybe it's not a big deal, but maybe we'll end up like Gattaca. Kind of paranoid, I know, but I just don't want to go there right now. Third, and probably most important for me, is that getting this kind of testing done opens the flood gates for any future pregnancy. If we are genetic carriers for some kind of disease, then we will be more likely to have testing done while pregnant. And if it turns out that our unborn child has some kind of genetic abnormality, what then? I just don't want to discuss the potential ramifications of that. If we had a biological child with Down's Syndrome or whatever else, we would still love them and be grateful to have them in our lives. Aborting a not-perfect fetus so we can try again is not an option for me. The emotional bill is higher than I can afford. Our doctor said "knowledge is power," and while I generally agree with that statement, right now I feel like, with genetic testing, "ignorance is bliss."

I've felt that way a lot recently. The more you find out, the more you have swirling around in your head every day. It would almost be easier to just be that couple who never had kids, instead of knowing that there is something wrong with me. On the other hand, I have to be grateful that medical science has progressed to the point where we can more easily control our own fertility. And I know there are literally thousands of women out the who are so grateful to have these options and who have had positive outcomes. I'm just not sure it's something I want to pursue. I'd love to get pregnant. I'd still love it if it required a bit of help to happen. In fact, I'm pretty sure I'd be happy/relieved/excited/ecstatic no matter how it came about. But right now, I'd rather focus our attention on adoption and leave the doctors out of our marriage.

So, step one is more testing. Step two is unknown right now. It kind of depends on the test results. But step two is most likely Clomid (or other fertility drug) for 3 months. Then... Frankly, I'm not even positive that I want to go much farther down this path. Tests? Fine? Clomid? Erm... Maybe? IVF? No. This is part of the reason we ultimately decided on the Waiting Child program - it gave us time to explore the fertility issues to their logical conclusion. Our doctor thinks this means a pregnancy. I think it means a few more tests and that's probably it. Fertility doctors are in the business of helping women get pregnant. Period. They are a bit more proactive (or aggressive, depending on the doctor), because age is the single biggest factor in fertility. And fertility doctors are becoming fairly mainstream nowadays. Around 3% of all babies born in the US are conceived with the help of a fertility specialist (according to our doctor). This is encouraging and hopeful, but I'm just not at that place. Maybe when I hit 39 I'll be signing up for IVF, but not now. I'm waiting for my baby, but I'm pretty sure he'll be born in China sometime in the next year, and I'll meet him (her?) in 2 years.

See you then, kid.