Sunday, January 15, 2017

IVF vs Adoption Waiting

Bryce and I were chatting the other day, the one where we thought our wait might come to an abrupt end if we were the lucky ones chosen. We were thinking on how different the waiting and process was with IVF from the waiting and process for adoption. It wasn't a comparison to determine which one was harder, but a comparison to figure out how we felt about each.

IVF Process and Waiting
- IVF is all about the calendar. You get on the calendar for a cycle after completing all the requisite tests or retests, and then you have a baseline to see where you are and if you can start. Sometimes you have to wait to get on that calendar, because of clinic scheduling issues or lab cleaning dates or your own personal timing. One thing I liked about IVF was that you could pick your timing, to an extent -- one month over another, avoid the holidays, do it over the summer so you're not teaching and can focus on the process. So that's a plus. If your clinic is busy and you have dates you want to do but they are not available, that's a minus.
- It's a whirlwind. You have the calendar and the injections and the calls from the nurses after blood draws and ultrasounds. You can see progress in those rising numbers (hopefully). You have specific dates to hang on to and there is a progression. However, you have to wait in between each ultrasound/bloodwork combo and hope that your ovaries are doing what they're supposed to. There is the possibility between each appointment that something can go wrong -- your lining might be too thin, your estrogen might be too low or too high, your follicles aren't growing at a consistent rate. There is the possibility of cancellation or a poor outcome, so waiting for those numbers and those doses can be very, very stressful. I never had that experience until the last year of treatment, when I had an estrogen crash and a lining that refused to cooperate. A cancelled cycle is devastating -- it's hope, stilted. It's medication, wasted. It's your body, refusing to do what you wanted it to.
- You have your retrieval and recover from that, and wait to see how many eggs were harvested, how many fertilized, if transfer will be Day Three or Day Five, and how many if any will be frozen for future attempts. This time is fraught with worry and possible disappointment -- and I was always loopy on pain meds and often trying to avoid OHSS symptoms, which magnified fears of the many possibilities for things to go awry.
- You (hopefully) have your transfer, and wait to find out what happened. This is that dreaded Two Week Wait, where you inspect your underwear for implantation bleeding and analyze every abdominal twinge or change in your boobs. This is where you hope and hope for the best, talk to your belly and try to encourage all that hatching and attaching and multiplying to happen, and attempt to not pee on a stick.
- Your blood test goes one of three ways (yes, three). You are given a negative and sink into shock and depression, and either stay there a while or immediately make plans for the next round (or next plan if this is far from your first rodeo). You are given a positive and are now faced with waiting for each beta to make sure all is good with the world and hope that this little babyling is here to stay, that you will be one of the lucky ones. OR, you are given one of those lovely, "It's positive, but..." calls where you are stuck in a horrid limbo of low beta numbers, waiting to see if this is a chemical pregnancy that began and ended all at once, if it is an ectopic pregnancy, if it is an abnormally developing pregnancy that draws out the period before you realize it's unviable, or if you are one of the rare lucky ones who has wonky numbers but everything works out fine.
- If your call was negative or turns out to be positive but fleeting, you have to wait to get in with your doctor or clinic for the "what just happened?" meeting. You wait to make a new plan -- maybe that involves surgery or testing before another round. Maybe they will suggest you try donor material. Maybe you decide you want to get second opinions, try another clinic. Regardless, you wait and start the whole cycle again unless you decide to exit this process.
- If you were referred to try donor material, a lot of these waits change. Scheduling is no longer up to you if it's egg donor -- you have to be fit in when a donor (that either you or your clinic chose) is available, when she can do another cycle (or her first), and you wait to see how she is doing with all the medications so that you can have the transfer. Gestational carrier is similar and actually can be laden with layers of timing issues if you are doing that AND egg donor -- so many schedules involved, so much out of your control. This is if gestational carrier is an option for you, fiscally and legally, as it's not truly legal in all states, and emotionally, too, as there's a lot that goes into that process. Donor sperm doesn't really change the timing of things in terms of the cycle, but you may have to wait for vials to become available and arrange shipping, which adds layers of stress.
- If your call was positive, you wait with baited breath to make sure it's TRULY positive, that you are really going to make it through this process. You know too much about what can go wrong. You have to decide for yourself when the point is where you can let some of that breath out -- is it a heartbeat? Is it 12 or 13 weeks? Is it anatomy scan? Is it viability? Is it birth? So many choices, depending on your history and the history of those you know. So you wait. And wait. And wait.

Adoption Process and Waiting
- Adoption is all about completing paperwork and being ready to accept a child, but not having any clue when that will happen. This is based on our experiences with domestic infant adoption -- I don't know enough about other processes to speak intelligently about them: so you get mine.
- First you register with an agency, filling out (in our case) 22 pages of paperwork. You wait to be scheduled for a consultation where you get your handbook, your folder of paperwork for homestudy completion, and talk through your decision.
- You fill out the massive amount of paperwork for your homestudy, and schedule your education classes.  Hooray for something on the calendar! You can't schedule your homestudy visit until your paperwork is complete and you've finished your classes. You wait to be matched with a social worker who will do your home study and then wait for the dates put on your calendar for those actual meetings.
- You meet with your social worker and try not to freak out that you feel very much evaluated and scrutinized, even though that's not technically why they are there. They are there to make sure you can care for a baby and you are prepared for the realities of parenting an adopted child, and you have thought through your Child Interest Grid, the most stressful part of the paperwork. How do you decide what you will consider and what's beyond your scope? How do you not feel like a fascist? This is when you start seeing the irony of going all organic and getting rid of all plastic food storage in favor of glass when it was you who might have been pregnant, and now seriously thinking, "Well, heroin exposure's not THAT bad." You discuss all these things and then wait for your report to come out, hopefully favorable.
- While you are waiting to be homestudy approved, you make your profile book. Or you make it earlier. I waited until we were waiting for the report, because I'd heard it took 4-6 weeks, and then our social worker was a beast who handed it in about a week later so all of a sudden we were homestudy approved but NOT profile-ready. Whoops. Making the profile book is a special kind of hell, but that's all on you. So if it takes longer, it's your own making, but you want it to be the PERFECT representation of you as a family for this mystery baby, so rushing is not an option. Questioning every decision, every photo, every spread is totally an option. Examining your life and declaring yourself old and boring is an option. Crying and wailing "Who's going to want to pick US?" is also an option. But then you pull your shit together, get people to look at it, get it approved, and then hit PRINT AND SHIP and know that it is what it is. Our life in a 20 page picture book.
- And then...the waiting begins. There's no more dates until you reregister and update your homestudy, which you hope to the high heavens that you DON'T have to do, but know in the back of your mind is entirely (and likely) within the realm of possibility. It's just an endless sea of waiting.
- Your books are at the agency, and you hope they get the chance to be shown, but you fear they just sit in a drawer and molder while younger, more religious, less boring couples fly out the door. You wait and wait for a call that your book is going out.
- And then it happens! You get a call. You get the details, you write them down frantically and then call your husband or wife or whoever else is in this with you. You decide if you will accept the opportunity or not -- sometimes you have over a weekend, sometimes you have until the next morning, and in a situation like this past week, you have very little time at all to decide. You call the agency back, and if you said wait. (Unless it was a blind profile, in which case you find out that you are chosen already and you are matched, waiting for placement.)
- For all other calls, you wait and wait, maybe for a very short time if it's last minute, maybe for a few days, maybe for a week, or in some cases, even longer. The longest we've waited is two weeks. It was a very long two weeks. I know people who never got a call back, because it was an indirect opportunity through an adoption attorney's office in another state, and they don't always follow up. Which is weird, to get a call that you're being considered and then have it just vanish into the ether. Waiting for that call is torturous, because there IS NO TWO WEEK WAIT. There's no marked calendar day to look forward to or dread. It could literally come at any time. You see the area code for your agency and hope it's the "results" call, and then wait for them to tell you it's a match or you weren't chosen.
- If it's a match, which I have zero experience with, you wait some more. Maybe you meet with the expectant parents. Maybe you go to appointments. Maybe you wait to be told she is in labor and find out when you have to be near the hospital, because it's not a given that you'll be welcome IN the hospital. Those plans change. It's a very difficult time for the expectant mother, and your job as an adoptive parent (potentially) is to go with the flow, to accept that this time is very emotional and physically difficult and things can change quickly. Which means more waiting. And hoping that you leave that hospital with a baby, even though it means you are leaving behind someone instrumental to this process who is grieving and leaving without the baby they've carried all this time. It's bittersweet, I can imagine. Then you wait for the revocation period to end (which in NY is 30 days) which is followed by the wait for finalization, when the baby truly becomes YOUR baby, legally. That can take months and even a year or more depending on the situation.
- If it's not  a match, if the answer was "she chose someone else," you try to hold your shit together on the phone so that you sound disappointed but optimistic, so that you sound well-adjusted, and you ask if there's any info that can be shared about why you weren't chosen (sometimes it's there, sometimes there's really nothing other than that the book that "got it" somehow was more connected, which leaves you with nothing to cling to), and then you say "I hope to hear from you again soon, thank you!" and gather yourself before you tell your partner that it was a no. And then you wait for the next call. Maybe it comes a few weeks later. Maybe it's a month. Or, maybe, it's a long spell of no calls, like March to January (which was our case). And then you wait with absolutely nothing to hold on to, no calendar, no sense of when the next call will come, and you call the agency from time to time to remind them that, you know, you exist.

There. Both hard, right? Here was our determination:

IVF waiting is predictable, but hard. It's physically hard, but you do have timing to hang on to. You have a defined process. There are steps and things happening ALL THE TIME that make you feel like progress is being made, even if ultimately it's not and you get no after no. When waiting with IVF, you blame your body for everything. You look for what it's doing or not doing that could lead or not lead to your pregnancy. You and your body are intricately woven together in this wait, and if it doesn't work out, you feel personally responsible (even as you know that's not logical). It's a defined cycle of waiting that repeats, over and over, until you decide that you've had enough -- or you are a lucky one and get pregnant and hopefully exit with a baby. You have time to get used to that baby, because you have a pregnancy. Some of the hope and joy in that pregnancy has been tainted with the possibility of loss and hardship and the scars of all you went through to get here, but you have some idea of when this tiny human is arriving, and you can get used to the idea. In theory.

Adoption is an all or nothing process. There is absolutely nothing to hold on to in terms of your calendar. There is no guarantee of when calls will come, and even less that you will be the lucky one chosen. The good thing is that your body is completely removed. You do not have that sense of being somehow personally responsible. It is, however, very hard to have your life rejected. Okay, maybe that's harsh. Not rejected as much as passed over, because it could be, "hey, these people look great, but these OTHER people have that something I just can't pass up!" It's very, very hard not to take it personally. I have a tendency to look at our book when we're waiting and think of all the reasons why we wouldn't get picked, which is crazy, and our social worker has told me that that really doesn't accomplish anything and that our book is fabulous (please note that I couldn't help telling my social worker about this not so great habit, oh well). It is very hard to feel like your life wasn't up to snuff, even logically knowing that every expectant parent has different criteria and what might stand out one time will be different another, and it could be something as simple as they had a dog and we don't, or they had lots of cousins for the baby to play with, or, as we are finding is the case more frequently than makes us feel good, they had a child already and so siblings are a given. We can't offer that. So we wait. And wait. And wait. And then have the possibility of going from not-parents to parents in a very short period of time, without the benefit of a pregnancy with a known end date (even knowing that that baby can come early, you have a sense of timing about the whole thing). There can be no grace period. And if there is a grace period, you're waiting to see if this is really going to happen. You have to temper everything, or risk becoming completely emotionally exhausted.

I guess that's the difference -- with IVF you are physically exhausted and emotionally exhausted, but you have dates to hang on to. You have a chance of success as often as you can schedule a cycle. With adoption, you are emotionally exhausted because you are waiting with nothing to hang on to, and things can change very, very quickly. Or you can think you're all matched up and ready to go, and minds can be changed. You have to wait knowing these things, but it's a very different thing to know that difficult situations can happen and then to actually live through them. In IVF it's your body on the line -- will it do what it's supposed to, or will it screw you over? In adoption it's your state of mind and a sense that your life is up for review and coming up lacking somehow.

They are both very, very hard. It's incredibly exhausting to have gone through all the waiting of IVF and been left empty-handed, and now have all the waiting of adoption and emotional rollercoasters that accompany that process: all the uncertainty and waiting for something without any kind of due date or treatment calendar. We are resilient, and we have bounced back time and time again. It just seems like our ball bounces just a tad less high each time. Seven years of waiting in one form or another is an awful lot to endure -- you can't keep it up forever and stay intact. I hope we get the chance to end this waiting, to begin a life free of all the uncertainty of whether it will happen and with all the regular uncertainty of "am I doing this parenting thing okay? Is my child safe and healthy? Am I making the right choices? Are they?" that is to come, should we be so lucky. And if we aren't...if our ball no longer bounces but rolls half-heartedly on the floor, then we will have a life free of uncertainty -- one we didn't plan for but can certainly enjoy just the two of us, finally free from the hell that is waiting.


  1. I have no personal experience with the adoption process outside of researching agencies, getting fingerprinted and reviewing the process (homestudy, preparing a profile book and a general timeline), so I really appreciate your perception to both processes.

    I think the big thing is that with IVF, one can feel that there is so control. You have dates and plans as well as options. With adoption, outside of the initial homestudy and paperwork, it's entirely outside your control and you are very well aware of that.

    And isn't it amazing to think of heroine as not being that bad?!? For a hardcore drug, there doesn't seem to be major developmental effects, but to even have that line of thinking. I marvel about it too.

    1. I so agree with you on the perception of control with IVF. I feel like for me that was dangerous, and I did a lot of crazy things that assumed control, which only made the negatives more devastating because I truly believed it was my fault. It's both harder and easier with adoption, because there's no real way within the agency process to feel like you have more control, to influence anything other than making sure you're real happy with your book, so you are swimming in a sea of uncertainty, and the only thing you can examine is the life you've built up until now. You can't control the fact that you don't have a child already, or that your future kid has no same- or similar-aged cousins, or that much of the extended family lives in other states. It makes you feel better and worse all at once. :) Yeah, it was really eye opening to see that long term, the worst is really alcohol. To go from controlling everything that went into my body and even outside of it (organic bodywash!) to being okay with levels of drug exposure is beyond surreal. I can't imagine whispering in the IVF me's ear all of these revelations and seeing what she'd say. :)

  2. I think you captured the IVF part really well! All the waiting, trying to figure out the best time to do it which can also be out of your control (waiting for AF or your clinic might be closed for for a few weeks), then once you start going through it, like you say, there can be a feeling of progressing, moving forward.. But then if it fails, you are back to square one, feeling clueless and blaming yourself. I remember ages ago seeing a blogger who had compared it to the boardgame Snakes and Ladders. So you might have several steps forward then come crashing down (e.g if your cycle gets cancelled or nothing fertilizes). I can see how adoption is similar, when you might be in the running for being matched only to have it not work out. Seven years is a very long time of waiting! I hope your wait will end soon.

    1. Thanks so much! That back to square one part is rough about IVF. I liked what Cristy said about thinking you have more control with IVF. OMG, I LOVED Snakes and Ladders! It was my favorite game! Not so much now that it is the perfect analogy for the IVF rollercoaster... Thank you for your thoughts and your well wishes that our wait ends soon. I wish the same for you!

  3. I can only imagine which pale, I am sure, to the reality.

    May your waiting end soon(er).

    1. Thank you so much...I hope it ends soon, too, in the best possible way.

  4. I've often wondered how you were coping with the waiting. It occurred to me that the waiting might be the difference between acute and chronic. IVF has bursts of waiting. It's acute, and intense for those short periods, although there's always a degree of underlying, but less painful, waiting, when you know the outcome can't change any second.

    Adoption waiting sounds to me to be chronic - always there, always just at the surface, an ache, sometimes with bursts of acute and very painful waiting, and ever present, when all of a sudden you could get "the call" that changes everything.

    Regardless, they both involve you putting your life on hold (to an extent), and that is never ever easy.

    Hoping too you don't have to wait much longer.

    1. Thank you so much, that's exactly it. Even though I am not living in a world of medical intervention where I'm living my infertility every day through injection jabs and appointments, I am still very much on hold. We try to do this living our lives thing, but it's hard. Last week was another reminder that this really could change on a dime, and so it's hard to think about doing anything too crazy.

      It's a lot of waiting to endure over time. I would say as to coping, that I vacillate between very hopeful to pragmatic to just exhausted and wondering if this is ever going to end. The hope is there, but it ebbs and flows. I hope there's less time between profile opportunities in the new year, because I think that makes coping easier even though the rollercoaster is faster -- at least it feels like another opportunity could be right around the corner. 10 months was a long time to wait for another call. Sigh. Thank you for your thoughts!