Thoughtful Choices

Wheatgrass

It has been a week or so since my day in Tijuana, and I’ve had some time to reflect. Change is in the air or so the cliche goes. The biggest change for me is making the choice to begin an IVF cycle in November. We chose IMER or IVF Tijuana to continue our conception journey with in November. We did initially like the other clinic better because the doctor seemed extremely detailed-oriented and pointed out some interesting facts about early test results. But, the follow-up communication with the administrative assistant seemed unprofessional and this made us question our choice. While the communication with IVF Tijuana remained easy and clear, so in the end we chose them. Now, I need to go to the doctor to get birth control and complete an infectious disease panel in preparation. The decision feels good.

On the holistic side I’ve been slowly changing my relationship with food. All of my adult life, I’ve pretty much eaten and drank what I wanted without any real consciousness about the possible effects it might have on my body. This in many ways is not surprising, considering the obesity problem in the United States. Our food system, along with our healthcare system is messed up. There is something morally wrong about having to pay more for “real” food. Processed food with a lifespan of a Chinese dynasty is cheap, easy to come by, and lip-smackingly delicious. Fruit not ladened in corn syrup and other non-pronouncable words isn’t. Add the grind of daily life and easy to make foods become the least burdensome choice. So, I’ve been a part of the system. Now, I’m stepping back and evaluating what I eat. I’m taking it slowly because I want it to become a part of my life and not seem like a diet or that I’m depriving myself. Basically, my philosophy has been – if it isn’t alive, than I can’t eat it. I don’t mean that it has to be kicking and screaming or uncooked food; what I mean is food that is primarily fruits, vegetables, legumes, from the salt of the earth. It hasn’t been tampered with or frozen. Just plain old fashion food.

This has led me to the juice bar at Whole Paycheck. I’ve always resisted this place because of the overpriced food, and the fact that the owner doesn’t want to give his employees health insurance, but it is the only juice place close that juices fresh, non frozen fruits and vegetables. I ignore the price, figuring that every good thing I put in my body, is one step closer to my baby. One day I read an article about wheat grass and how it cured fertility in cows. So the next day I got a shot of wheat grass with my juice and surprisingly I didn’t hate it. I felt a surge of energy. My Tuesday and Thursday routine has become yoga, followed by a shot of wheat grass, then acupuncture. During acupuncture, I also practice visualizations that help me to imagine being pregnant and having a child. These changes have really helped to balance my emotions and become stronger. Yesterday, on Facebook, an old college friend that I haven’t spoke to in years, posted her first sonogram. I read her birthdate and it said, 8/17/1972. This means she’s three years older than me and pregnant. Instead of feeling angry or resentful that yet again someone else was pregnant, I felt joyful and assured that my time will come.

So these changes – decision to try IVF, changing my diet, and being consistent with acupuncture have made a difference.

A Day in Tijuana

We left our house later than expected, racing along I-5 towards the border. Clutched in my lap were maps to two clinics in Tijuana. The first one Reproductive Medicine Institute was in El Centro and not far from San Ysidro border crossing. We immediately got lost and had to ask for directions. Eventually, we found ourselves 30 minutes late and nestled into the doctors office.

The place matched the pictures online, except for the name of the clinic. IMER was the name on the doctor’s card and this did make me feel a little bit suspicious. But the doctor, Dra. Sandra Orendain Talavera, seemed professional yet friendly. Her English was quite good and my husband’s Spanish filled in the gaps. She reviewed my tests, gave me a thorough ultrasound, and promptly recommended IVF. This time I was ready. I mean, we had come just for that reason.

After going over the procedure (roughly 20 days) and asking all of our many questions, we were then sent to the accountant’s office for the bill. The amount was expected ($7,000 with medication). We left trying not to make any rash judgements. I did feel myself become excited. So far the office was clean, the doctor seemed good, and the price was affordable. My husband wasn’t exactly sold, and this I left unspoken.

We decided to leave our car in the parking garage, instead of navigating Tijuana’s busy streets. We promptly hailed a cab (a white one, without a meter). We told him where we wanted to go and he quoted a price of 100 pesos. Of course, we were getting ripped off; but this is the way of traveling in a foreign land at first. The other clinic was located closer to all the big hotels in town and next to a fancy mall that looked made more for the night than for day shoppers.

The new clinic, inside the Hospital del Prado was busy. We were sent to the fourth floor and found ourselves in Centro de Fertilidad Del Prado. This clinic was smaller with less locals lining the waiting room, but there was the smell of fresh coffee and the smiling face of Alexandra, the receptionist. Within minutes I found myself being weighed by an efficient nurse who used a clipboard like a shield. Eventually, we were called into Dra. Elena’s office for a consultation. Her English skills were definitely much better than my Spanish skills, and she primarily communicated with Cristian in Spanish. In many ways this was positive (even though, I had a hard time following the conversation) because it really helped Cristian to understand the process. Up until the first doctor’s appointment, IVF seemed as something an alien uses to land on Earth.

Dra. Elena reviewed my lab tests and questioned the amount of sucrose in my blood. This piqued my interest, not in the least because diabetes was mentioned, but because perhaps she was really looking at my tests. I will have to be tested again. She gave me a short ultrasound, but she did take pictures to use later. I forgot to mention that in my previous appointment Dra. Talavera found 7 to 8 follicles and this really raised my hopes. This could mean the possibility of 8 eggs being harvested. The more eggs, the better chance at having quality embryos for transfer.

At the end of the consultation and IVF being the recommendation, Alexandra gave us a sheet all in Spanish listing the cost and what it included. Basically, the same as the first clinic, except they will include a FET transfer (without medication) if there are eggs leftover from the first cycle.

After the appointments, we left in a daze and walked towards the fancy mall. We quickly decided we wanted to eat like the locals and hailed another taxi. The taxi driver’s recommended the Mole House. Inside the Mole house, which was really a house complete with a piano in the corner, we were seated at a table for four, close to an older couple kissing.

The prices were average San Diego lunch prices and we hoped for a delicious offering. We then compared the clinics. Fortunately, both seemed like decent options. Unfortunately, this made the choice harder. The first one is a part of RedLara and the doctor gave a thorough ultrasound. And all the information was in English. The second clinic had more of a down-to-earth atmosphere and the doctor really seemed smart and analytical.

We have a tough choice.

Once we navigated the border, which brought to life all the NPR specials I had heard of long waits, vendors, and disabled people, we made it back to the U.S., marveling at how we had just navigated a foreign country less than an hour before. To our surprise Tijuana wasn’t a scary border town with renegade thieves trying to steal our goods, but a city alive with real people. In fact, we made a grave error by leaving our car past closing time in the parking garage and the owner waited for us to return. He even had gone to the clinic looking for us. Upon parking we had asked him for directions, so he knew where to possibly find us. His thoughtfulness was touching and one positive sign for the first clinic.

After a restless nights sleep, we decided to visit one more clinic in the San Diego area. HRC Fertility in Oceanside. http://www.havingbabies.com I had written this clinic off because of the distance, but now if I’m contemplating going to Tijuana, Oceanside seems close. Also the prices listed are half of the other clinics. Yet, this makes me leery because there is always more not included. Regardless, I’m going to pay the $315 consultation fee, just to make sure that Mexico is the way to go. I think this will put any lingering doubts at bay.

So, by the end of the week, we should have come to a conclusion.

The Journey

Dance Camp

My fertility journey began over two years ago when we finally made the decision to start a family. Like most people I believed becoming pregnant would happen easily and this is why the decision to finally start took so long. I was under the false impression that becoming pregnant was within my control. I believe this came from a few different factors. My parents had a friend growing up who had a baby at 38. I remember as a young girl, at ten or twelve, wondering why the adults kept saying, “I know she’s 38. And the baby is healthy.” This planted the kernel that I could wait too; after all if it happened once, it could easily happen again.

I grew up in a small town and in high school when a girl got pregnant we used to say, “It must be in the water.” Becoming pregnant seemed easy and in many ways undesirable because it altered your life plan. There were also countless stories of celebrities who gave birth in their 40s to healthy babies. I thought if they can do, I can too. Of course, there were no mentions of IVF or donor eggs in these articles, words that had I read them at the time, would have sounded like Chinese to me. Less understandable than the squeaks my cat makes when I pet her.

But, perhaps, more than these factors the reason for my delay is that I wasn’t ready. I wanted to travel, to study, to discover more about myself. And I did. I made choices, one after the other, right or wrong, and these choices have led me to this point where I have to make some hard decisions.

After making the decision to start a family, to my surprise I become pregnant quite quickly. In fact, I was in denial for a few weeks, even though my symptoms told me otherwise. Once I allowed the truth to sink in, I began to become very excited. There are some moments in one’s life that happen that feel exactly right and bring a sense of honey bliss that this feeling is all one thinks about. This was one of those moments. Since I’m a book-worm and extremely analytical, I took to google research with the fingers of a wizard and gobbled up everything I could about early pregnancy, what to do lists, and information on miscarriages, the latter with some trepidation. I had more than a few friends who had miscarried their first child, so for me I took this as a real possibility. Due to my age or the clinic I went to, I started seeing nurse practitioners almost immediately. My life began in a very short amount of time to revolve around this baby that was coming. And even though I had read it was better to not tell people you were pregnant until after the first trimester, I gushed the news quite quickly to my family and close friends.

Around nine weeks, I had a spontaneous abortion or miscarriage that started at work and went into the middle of the night. I went to two different emergency rooms and by the dawn of day I was no longer pregnant. I remember my husband asking the ER doctor when could we try again and this forever sealed our fate. I was devastated by the loss, but not completely overwhelmed with despair. I would become pregnant again. Soon. Or so I thought.

Around the time that I was pregnant the first time, other friends had become pregnant as well. So instead of going through the process with them, I was now left behind. Reading their posts on FB and looking at their ultrasound pictures began to wear on me a little, but I felt reassured that I would become pregnant again soon. But their babies were born and I was no closer to my desire than before. Each month I went from hopeful to emotionally wrecked. Nervous breakdowns became a part of my existence and their wake was something I didn’t share with anyone. You see, as much as people love you (family and friends), they each have their own feelings and thoughts about motherhood, fatherhood, babies, fate, etc. Some women can’t possible understand what is like to struggle to conceive because they have never experienced it. Or women with children who find it difficult to be mothers themselves, view you as lucky. Some people view parenthood as a wrong choice for the planet. So this made me feel all alone. Also, fertility is a deeply personal issue, one that I find hard to share with just anyone. I did have one really close friend who was going through the same thing as me. I spoke to her daily and found as I became more and more obsessed she did too.

Then one day, she called me up to tell me the big news. I responded shrilly with what I hoped sounded normal, “Congratulation. I’m so happy for you.” It wasn’t that this wasn’t true, it was just I knew deep down that my journey towards motherhood had only just began. She had gotten a ticket off this boat of statistics, wrinkles, and defeat. She was on the other side with the fertile women; whereas I had no idea when I would be allowed to leave.

After that, I found it difficult to talk to her. She would call or email me but I couldn’t rejoice in what I knew was wonderful and exciting for her. Unfortunately, this only made me feel even more alone. This is when I began Bikram yoga. I pulled in front of a studio I found on the Internet and decided to do 30 days in a row. There were more than a few days where tears rolled out during the breathing exercises at the end. But yoga made me stronger, more capable to handle the stress of monthly tries and consistent arrival of the defeating no. I started a writing group, in hopes of surrounding myself with strong, creative people. I found that it was a band aid. Then, one of the women in the group became pregnant and naturally I found this hard to handle. After this, I made the decision to finally go to a Reproductive Endocrinologist. I had numerous tests done and basically the outcome is that I have diminished ovarian reserve. During this consultation, I was given the option of IVF with my own eggs for a whopping $28,000 (all the bells and whistles, of course) and IVF with donor eggs for $38,000. I asked how most people paid for these treatments to warm but apologetic accountant who then pushed towards me a brochure for a medical loan. The IVF with my own eggs has a 40% chance of success and IVF with donor eggs has a 80% of success. So, do you buy the trailer next to the sand dunes or the lake house next to the pond.

My choice seemed grim. Not just because of the price tag, although this was an important factor but because I had now been distilled down to a series of numbers. Yet, there was something reassuring about being in the hands of a RE, a IVF Coordinator, an accountant that gave me the impression that I could be fixed.  There was a path to a baby. After all, 80% is a high number. It’s much better than playing black jack or even flipping a coin (something my husband and I did later at home to check our odds. Sadly, I called tails four times and it hit heads each time). You can’t laugh at 80%. But you give up your genetics, this connection that stretches back generations. Although, there are a few genes in my pool that I’d rather leave behind, so perhaps this isn’t such a bad idea. I do have the annoying habit of twirling my hair constantly. Oh, and there are a few cases of mental illness.

Right around this time, through reading numerous blogs, I came across a book called Inconceivable by Julia Indichova, who was diagnosed with poor ovarian reserve like myself who eventually conceived naturally at 42. As I write this, I haven’t finished the book but it has planted the seed that I might have given up on myself too early. Perhaps, my eggs are still good. Perhaps, there is a moment where I too, like millions before me, can get off the infertility boat. It is possible. I just don’t know where to get off.

This has begun my research into medical tourism. I’ve decided to take a two-pronged approach. One that is natural and includes acupuncture, yoga, visualizations, proper diet, and mental practice. And one that utilizes the latest medical advances in fertility. I know that I can’t afford IVF in the United States. To be honest, the loss would be even more devastating because of the cost. Not only would I put myself through weeks of procedures that would stretch me emotionally, physically, and spiritually, only to be possibly wrecked financially in the end. The same procedures in clinics with the same or better care exist in many countries outside of the United States. In fact, the quality of care that I have received in the medical system in the United States has been appalling and shocking at times. So, my first step is to research clinics in Mexico. I live in San Diego, so this seems like a natural choice.

This blog begins at this point in my journey. I hope that those who are delayed mamas find some peace and reassurance in my words. My heart is with you. And for those who are supporting men and women struggling with trying to conceive, I want you to know that you’re not alone.