The matrix

"I don't know what's next and it scares me," I wrote last week.  In that post I hinted at some of the issues at play as we consider what to do about having a second child.

None of it is absolutely clear in my own mind, but I'm beginning to sort it out.  Some possibilities are easy to reject.  We would prefer not to have only one child, for example, at least while attractive options are still available.  Although working with a gestational surrogate would remove my physical risk, it seems impractical given the fact that my ovaries respond so poorly.  And experiencing pregnancy again is not important enough to me to risk it without some genetic connection, so donor embryos are out.

But there's still a lot to consider.  I've been making lists, trying to organize my thoughts, making an effort to state the pros and cons of every option fairly.  Because you've all been patient enough to indulge me as I work through this and kind enough to offer your own experiences as a guide, I thought I'd share some of my lists in draft.  Please keep in mind that I speak only for myself — not even for Paul — and my rather precarious positions should imply no judgment of anyone else's choices.

First come the pros and cons of adoption.

Pro	Con
No physical risk to me	No emotional satisfaction of pregnancy1
Careful selection can assure a good fit with the child's mother and extended family	Intrusive screening2
Child has equal genetic link to both Paul and me (i.e., none)	Child has equal genetic link to both Paul and me (i.e., none)
Everybody gains something	Everybody loses something: mother, child, and Paul and I
Gains weighted in our favor — we end up with a baby3	Losses to the mother are incalculable and lifelong.  Can I live with the knowledge that we've benefited from that?4

Notes:

1. Because didn't that rock?
2. Find a better hiding place for our cache of stolen gold bullion; remove trapeze from the bedroom ceiling for the duration; quash strong and fiery resentment of the entire process
3. Hard to think of a greater gain than "we end up with a baby," really
4. Biggest potential showstopper.  My morality is as convenient as the next guy's, but this gets me every time.

Moving on to IVF with donor eggs...

Pro	Con
Young, healthy eggs5	No guarantee of success even with a young donor6
Less expensive than adoption if it works	...if it works
Emotional satisfaction of pregnancy	Physical risk of pregnancy
Genetic relationship to Paul	Genetic relationship to Paul but not me7

Notes:

5. Did you know you can tell how fresh a donor's eggs are by looking at the number stamped on her carton?  It's true.
6. Also true: fresh eggs are almost impossible to peel when hard-boiled.  Silver bullet, my ass.
7. And how can I be sure that Paul and his get will not one day rise against me in a surge of clan-driven violence?  Look, I would if I were Paul.

Finally, there's the option of doing IVF again with my own eggs.

Pro	Con
Genetic relationship to Paul and me, and therefore also to Charlie	...not that Charlie would care
Emotional satisfaction of pregnancy	Physical risk of pregnancy
Excitement of cycling8	It's not exactly playing the nickel slots, Julie, you jackass.9
Vindication of my rather childish stubbornness if it works	Um...whatever the opposite of vindication is if it doesn't10
Emotional satisfaction of goading my recalcitrant ovaries into action by doing GOB Bluth's chicken dance	"Has anyone in this family ever even seen a chicken?"11

Notes:

8. Also exciting: entering my 1975 Pinto in a demolition derby.  Official team uniform: coveralls made of untreated cotton.  Official team beverage: Ronsonol.
9. We went to Las Vegas during the two-week wait after my first IVF.  I drank like a fish.  An alcoholic fish.  I guess it is fair to say I am a gambler.
10. Wait, the word has come to me at last: spinnbarkeit.
11. Everything I like gets cancelled.

But no decision is made in a vacuum (or as Charlie would say, bah ka yuum, as in, "Mama yuza bah ka yuum."  Chauvinist piglet — excuse me, pig a nit).  So I tried to compare the options in several categories.  Because I'm a visual person, and moreover a person who is currently putting off folding several loads of laundry and yuzing the bah ka yuum, the winners in each category are green, while the losers are red.  (Once again, please keep in mind that this represents only my biases.  I do still feel that a genetic connection to a child is worth pursuing; and that my not dying is preferable to wondering whether our baby might; and that 100% is a greater likelihood than any percentage of any variant of the Lord's name taken in vain.)

	Adoption	IVF, donor eggs	IVF, my eggs
Cost range	Almost nothing (foster care adoptions) to $40,000	At least $15,000 to $30,000	$8,429 plus meds and monitoring
Wait time	Indefinite to infinite	6 months to a year	You know, whenever
Physical risk	None	High	High
Genetic relationship	None	Some	Complete
Unresolved ethical questions	Many	Some	None
Likelihood of success	Approaching 100% with time and persistence	Approximately 50% live birth rate across patient population	Oh, Jesus gay, I can't even think about that

So you see, it's just not an obvious choice.  Clearly I have a lot more thinking to do, more lists to make, more work ahead.  It's not like that chicken dance is going to practice itself.

Posted by Julie at 01:47:53 PM in I've learned a lot...but I'm not sure it's worth it.

Comments

The matrix

"I don't know what's next and it scares me," I wrote last week.  In that post I hinted at some of the issues at play as we consider what to do about having a second child.

None of it is absolutely clear in my own mind, but I'm beginning to sort it out.  Some possibilities are easy to reject.  We would prefer not to have only one child, for example, at least while attractive options are still available.  Although working with a gestational surrogate would remove my physical risk, it seems impractical given the fact that my ovaries respond so poorly.  And experiencing pregnancy again is not important enough to me to risk it without some genetic connection, so donor embryos are out.

But there's still a lot to consider.  I've been making lists, trying to organize my thoughts, making an effort to state the pros and cons of every option fairly.  Because you've all been patient enough to indulge me as I work through this and kind enough to offer your own experiences as a guide, I thought I'd share some of my lists in draft.  Please keep in mind that I speak only for myself — not even for Paul — and my rather precarious positions should imply no judgment of anyone else's choices.

First come the pros and cons of adoption.

Pro	Con
No physical risk to me	No emotional satisfaction of pregnancy1
Careful selection can assure a good fit with the child's mother and extended family	Intrusive screening2
Child has equal genetic link to both Paul and me (i.e., none)	Child has equal genetic link to both Paul and me (i.e., none)
Everybody gains something	Everybody loses something: mother, child, and Paul and I
Gains weighted in our favor — we end up with a baby3	Losses to the mother are incalculable and lifelong.  Can I live with the knowledge that we've benefited from that?4

Notes:

1. Because didn't that rock?
2. Find a better hiding place for our cache of stolen gold bullion; remove trapeze from the bedroom ceiling for the duration; quash strong and fiery resentment of the entire process
3. Hard to think of a greater gain than "we end up with a baby," really
4. Biggest potential showstopper.  My morality is as convenient as the next guy's, but this gets me every time.

Moving on to IVF with donor eggs...

Pro	Con
Young, healthy eggs5	No guarantee of success even with a young donor6
Less expensive than adoption if it works	...if it works
Emotional satisfaction of pregnancy	Physical risk of pregnancy
Genetic relationship to Paul	Genetic relationship to Paul but not me7

Notes:

5. Did you know you can tell how fresh a donor's eggs are by looking at the number stamped on her carton?  It's true.
6. Also true: fresh eggs are almost impossible to peel when hard-boiled.  Silver bullet, my ass.
7. And how can I be sure that Paul and his get will not one day rise against me in a surge of clan-driven violence?  Look, I would if I were Paul.

Finally, there's the option of doing IVF again with my own eggs.

Pro	Con
Genetic relationship to Paul and me, and therefore also to Charlie	...not that Charlie would care
Emotional satisfaction of pregnancy	Physical risk of pregnancy
Excitement of cycling8	It's not exactly playing the nickel slots, Julie, you jackass.9
Vindication of my rather childish stubbornness if it works	Um...whatever the opposite of vindication is if it doesn't10
Emotional satisfaction of goading my recalcitrant ovaries into action by doing GOB Bluth's chicken dance	"Has anyone in this family ever even seen a chicken?"11

Notes:

8. Also exciting: entering my 1975 Pinto in a demolition derby.  Official team uniform: coveralls made of untreated cotton.  Official team beverage: Ronsonol.
9. We went to Las Vegas during the two-week wait after my first IVF.  I drank like a fish.  An alcoholic fish.  I guess it is fair to say I am a gambler.
10. Wait, the word has come to me at last: spinnbarkeit.
11. Everything I like gets cancelled.

But no decision is made in a vacuum (or as Charlie would say, bah ka yuum, as in, "Mama yuza bah ka yuum."  Chauvinist piglet — excuse me, pig a nit).  So I tried to compare the options in several categories.  Because I'm a visual person, and moreover a person who is currently putting off folding several loads of laundry and yuzing the bah ka yuum, the winners in each category are green, while the losers are red.  (Once again, please keep in mind that this represents only my biases.  I do still feel that a genetic connection to a child is worth pursuing; and that my not dying is preferable to wondering whether our baby might; and that 100% is a greater likelihood than any percentage of any variant of the Lord's name taken in vain.)

	Adoption	IVF, donor eggs	IVF, my eggs
Cost range	Almost nothing (foster care adoptions) to $40,000	At least $15,000 to $30,000	$8,429 plus meds and monitoring
Wait time	Indefinite to infinite	6 months to a year	You know, whenever
Physical risk	None	High	High
Genetic relationship	None	Some	Complete
Unresolved ethical questions	Many	Some	None
Likelihood of success	Approaching 100% with time and persistence	Approximately 50% live birth rate across patient population	Oh, Jesus gay, I can't even think about that

So you see, it's just not an obvious choice.  Clearly I have a lot more thinking to do, more lists to make, more work ahead.  It's not like that chicken dance is going to practice itself.