Creating lives - part 2: the confirmation

The nurse's call not only confirmed the positive test result but also reported that the "pregnancy hormone" (hCG) had not doubled in the past 24 hours, but tripled, which was a great sign. Wonderful! She asked me to continue with the intramuscular injections of progesterone until the day of the ultrasound. Now it was time to wait, again, another 6 weeks to do the viability ultrasound.

With the good result, my head started to remember every detail of the whole path that had taken me there. I remembered the sadness I felt when I went to purchase, again, three more "samples" of the donor I had chosen but him wasn't available anymore. That would be insemination number four. Sadly, I ended up buying three copies of the donor I had chosen as a second option, but it was a second option far from the first. The third time I needed to buy the "things" from the donor, I forgot to call to check availability and bought directly from the website. Shortly thereafter, I received a call from the sperm bank telling me that what I had purchased was not available (the second option). Extremely frustrated with everything, I remember telling the woman: "Don't tell me that I will have to choose a third option ?! Do you think that choosing a donor is like choosing papaya at the farmers' market?". The poor woman, who was not to blame for anything, was so embarrassed that she went to look at who had been my first choice and, to my surprise, told me that the donor whom I chose with such affection was again available. Now the treatment was successful and with the donor of my very first choice! It was as if happiness flooded every cell in my body. Now just needed to wait. "Just"...

In the meantime, and with the result of the triple numbers of hCG, a little itch in my mind arose and I went to research on hCG levels in multiple pregnancies. Something inside me suspected that I was carrying twins.

As my parents knew that I had undergone in-vitro fertilization, I told them that this time the treatment had worked, but I still didn't tell anyone else. I decided that I would only tell family and friends after the first 12 weeks if everything went well.

When I was five weeks into the pregnancy, I woke up bleeding. Bleeding a lot. Panic! All hope and happiness looked like it was being drained through a red river that stained pajamas, sheets, mattress. I called the fertility clinic to find out what to do. As always, the call goes on the answering machine of the nurses who return to you as soon as they are available in case of an emergency or up to 48 hours later if it is not urgent. Lying on the couch, tense, I managed to wait two hours before running to the hospital. I called a taxi and went to the emergency room of the college hospital where I did my master's degree, as I knew that there I would be cared for in English, as my French was still not good enough to deal with medical issues. The friendly taxi driver wanting to start a conversation, and I could only shake with fear and think that the path to the hospital seemed endless.

Arriving at the emergency, I stood in the triage line, which didn't take long. When I was called, the nurse asked if the bleeding was filling a large pad in less than an hour, I said no. She registered me, included the description of the bleeding I gave her and sent me back to the waiting room. Six hours passed, the anguish grew, and I had not been called in yet. That's when I got the call from the clinic. They asked the same question about the pad, anticipated my viability ultrasound for the next morning in the early hours, told me to lie down and rest assured that this type of bleeding was normal at the beginning of a pregnancy. Normal... yeah, right... only if it's normal for them! At the hospital, still nothing. I went to the screening nurse and told him that the clinic had called me back, that they would do the ultrasound the next morning, and asked if he had any way of knowing if I would be seen at the hospital right away. He looked at the computer, looked me in the eyes as if apologizing for something he didn't do and said that I'd better go home and do the ultrasound at the clinic in the morning because it would still take too long there and I might have to pass the night in the waiting room. I came home with a lot of anxiety, I couldn't wait for the next morning. That night I didn't close my eyes, there was no way I could do that. The only thing that calmed me down a little was that the bleeding was almost over, but that didn't lessen the fear that my dream was gone in those several millilitres that had faded during the day.

I arrived at the clinic very early in the morning and, again, the wait seemed eternal. When I finally entered the exam room, I ran into the doctor who had given me the treatment and accompanied me during these three years. It was the first time I had an ultrasound with her. Yes, because there at the clinic, you never know who will do your ultrasound and, in almost three years, it had never been with my doctor.

I remember seeing two "dark bubbles "each with a mass inside shaped like a seahorse. She showed me and said it was the embryos, that they hadn’t left in the red flood the day before. Confirmed suspicion: twins! Happiness!!! I took a breath relieved but still tense, because we still needed to know if they were all right. She continued the exam and found a heartbeat in both. Crazy thing to think that two little things of that size already have a heart. Okay, not yet a fully developed heart with its four cavities, but it already beats. Still it is very crazy! Nature is amazing! 

I left the exam, relieved and happy that they were still there, firm and strong, growing cozy inside of me. The clinic scheduled a second ultrasound for when I completed eight weeks to confirm that everything was still fine and the doctor recommended that I continue with intramuscular injections of progesterone until the end of the third month. Okay, what would be another six weeks of measuring the outer upper quadrant of the butt and do the self-application for someone who had been doing it for two months already?! She also said: "that was my fear of implanting two embryos, of you having twins as a single mother". I only replied that, after so many years, after so many unsuccessful attempts and with such tiny chances of a single embryo implanting itself, I did not imagine that the two would implant, but that I was beyond happy with this gift from the universe! She congratulated me and wished a good and "as smooth as possible" pregnancy. She gave me a hug and we said goodbye. I didn't see her after that.

I came home happy as a queen! Apprehensive, afraid of another bleeding and knowing that the verb of the hour was still: "to wait", the difference is that now the wait was full of happiness and love.

(To be continued in chapter 3.)

Creating lives - part 1: how it all began

 Since I can remember, I've always wanted to be a mother. As with almost everyone who aspires this dream, I hoped that life would bring someone to share it with me. Yes, life brought me some relationships, only one seemed to go in that direction but, unfortunately, we ended up following different paths. The years passed and no one else appeared. Then I decided to go on this journey alone.

My first instinct was to inform myself about adoption. There are so many children in the world in need of affection, love and attention, so why not try to give one of them a home? That's when I found out that the adoption process, here on Canadian lands, costs almost the full amount of my annual salary. And that covered only the beginning of the process, apart the bureaucracy in case I decided to adopt a child from a foreign country. Since adoption would not be financially possible, I informed myself about the remaining option: having a biological child.

This second stage brought good news: the provincial government covered the costs of some attempts at artificial insemination, on my part I would only need to pay for the donor's “sample”. Great! With the biological clock ticking, close to entering the "cougar age" - I was 38 then - I started the long path that would be the realization of this dream without any guarantee that it would work.

My first visit to the fertilization clinic was strange. I didn't like the doctor who was assigned to me, and on the second visit I had already switched to a much more friendly doctor. She asked me for several blood, urine, cytology and imaging exams, and even a consultation with the psychologist (mandatory, around here, when opting for assisted fertilization). Until all the exams were ready and a new appointment was made, a few months passed. The doctor and I decided the way forward and another step was taken towards possible motherhood. Now came the fun part of the process: looking for a donor that I liked.

Refining the search on the site by hair color, eyes, skin, ancestry, can even be fun if seeing it as a game, but the refinement of the search does not filter by personality, interests, etc., which are the most important traits in a person. For a week I was looking for the "sample" that I liked best. I was looking for someone with artistic tendencies and some interest in humanities. I found a profile that I immediately liked when I read the essay written by the donor about his reasons to join the sperm bank, and the fact that he was a yoga instructor and played the piano just made him even more attractive.

Having decided on the donor, I bought his "sample" and, following the doctor's advice, I waited the following month to begin the physical process that would culminate in the artificial insemination. Then the hormonal dance began: subcutaneous injections of estrogen to stimulate the maturation of my eggs and, on the exact day marked by the doctor, another injection to start ovulation. 48 hours later, insemination would take place. At home, on my own, I had been taking supplements for months to improve the quality of my eggs and thus try to help the process in a "natural" way.

The insemination itself takes a few seconds, and the whole process takes about ten minutes, but it is a rather strange experience. Everything happens in a medical room just like the ones where we women do our annual exams: only instruments around that table with leg supports that always remind me of those chicken skewers. The doctor enters, checks the patient's name, confirms with the patient the number of the donor and prepares the catheter. In seconds, the "specimen" is already inside the uterus and the doctor asks you to wait 10 minutes in bed, then you can leave and resume normal activities. Everything is very "romantic".

Procedure done, the excruciating two weeks of waiting to see if it worked, if the anxious egg and the thawed sperm met. Ah! And of course, hormones - now progesterone - are continued to prevent the menstrual cycle from continuing and to support an environment conducive to the embryo that, perhaps, started to develop from this encounter that, perhaps, happened, of the egg with the sperm. During these two weeks, progesterone causes effects that simulate a pregnancy: weight gain, nausea and super sensitive smell were my companions in the 14 days of waiting.

The day of the blood test to see if the procedure had been successful arrived and anxiety takes over. Test done, it was time to wait a few more hours to get the result. I left the clinic and went back to work. The day would go on as if nothing had happened. Only as if...

The nurse's call comes a few hours later and the result was negative. The process was not successful and now I would have to wait a few months before I could try again. And, of course, another appointment with the doctor needed to be scheduled.

This ritual was repeated 6 more times. With each procedure done, my reactions changed in the 14 days waiting. After the third attempt, I was not even anxious anymore in those two weeks, it was as if nothing had happened. The only thing that broke this illusion of "nothing happened" was the fact that I had to take hormones every day.

For personal reasons, I followed this path in silence, only two people knew that I was actively pursuing the dream of being a mother. So I decided to avoid any non-constructive criticism, because the process itself is already stressful, anguishing and difficult enough, I definitely didn't need extra stress coming from outside. My intention was to communicate only the good news when, or better said, if everything went well.

I heard from a friend that I needed to relax for things to work out. It's easy to say, difficult to do. When trying to get pregnant with a partner, it is easy to relax because the whole process is fun, even if you don't get pregnant, the "procedure" was enjoyable. In the case of assisted fertilization, there is no way to relax simply because there is no way to forget, there is a time for everything: the exact time of the estrogen injections, the exact time of the injection to stimulate ovulation, the exact time of the insemination itself (not to mention how "romantic and pleasant" it is to be lying down in a cold office for 10 minutes), the exact time to take the progesterone pills, the exact time to do the blood test, etc. To relax? Impossible.

A few days before traveling with my mother, on an adventure we talked about for years and only recently had the opportunity to make it happen, I went through the 7th insemination. While we were visiting the Big Apple, my period came, which meant that the last procedure once again didn't work. That's when I decided to tell my mom about my decision and what was going on.

Her reaction was more neutral than I could ever imagine, which, in fact, did me good, as I expected bad criticism and more bad criticism, but no, she was calm and neutral. Maybe she understood how important that was to me.

Back in Montreal, I decided to try in-vitro fertilization. However, this procedure was not covered by the province and I had to resort to a bank loan to be able to pay for the first attempt.

Unlike insemination, in-vitro fertilization uses heavier drugs for a longer period of time. After a few months had passed for the body to recover and all the necessary blood and physical tests were redone, I started again with subcutaneous injections of estrogen, this time in higher doses. Along with them, I was given aspirin 80mg daily. Supplements to improve eggs continued to be taken every day, without fail.

A few weeks and several injections later, the day to harvest my eggs arrived. That day, I had to go to the clinic with a companion because I would be medicated so as not to feel pain at the time of retrieval, I would need help to return home safely. I took the day off from work, because I knew I wouldn't be able to return. My father, who was visiting in Montreal, accompanied me and stayed by my side until they called me into the operating room. I didn't fall asleep with the medication as they said it could happen. I was awake throughout the procedure but I did not feel any pain. I watched, on a screen inside the operating room, each egg being removed. Each carried a small piece of hope with them. Right there, the doctor gave me the result of the number of eggs retrieved, in my case there were 30. They would call me later to say how many eggs were ripe and then how many had been fertilized.

The next day, I received the call from the clinic: of the 30 eggs, 15 were mature but the "donor specimens" were not swimming enough and the team needed my authorization to do the fertilization manually in a process called ICSI (intracytoplasmic sperm injection), I obviously agreed and, at the end of the day, received the news that the 15 had been successfully fertilized. They also said that they would call in 5 days to inform how many embryos have developed successfully. At the end of that week, news came that 10 out of 15 embryos were developing very well and would be frozen. The last phase was now beginning - or at least that was what I expected.

During the week following the retrieval of the eggs, I felt really ill. Doctors say that you can get back to your normal activities, with the exception of exercising, the day after the harvest, but I couldn't go back to work for a week. I felt bloated, nauseated, had headaches, tired... calling the nurse at the clinic, she asked me to go in and get checked. As it could happen when trying IVF, my ovaries were overstimulated and that was the reason I was feeling so sick all the time. In my case, they were "mildly overstimulated", thank goodness because when they are "highly overstimulated" one has the risk of dying!

A month after the eggs were removed and fertilized, the injections started again to prepare the uterus to receive the embryo, but this time with something new: intramuscular progesterone injections that should be given every day at the same time for a month. And the courage to inject me with something intramuscular? I had to look for super desire and hope, now almost erased. Firm and strong, endowed with an enormous desire to be a mother, every day at 8 pm, there I went to the front of the mirror to calculate the first outer upper quadrant of the butt, take a deep breath and inject myself.

The day of embryo transfer finally arrived. Unlike the insemination that is done in an examination room, the transfer takes place in the same operating room where the eggs were removed. On the screen that I saw the eggs being removed, this time I was presented with the embryo that would be transferred and I was able to follow the entire procedure. Again, I had to lie down for 10 minutes, before I could leave and go on with the day. And, again, the wait to know the result, only this time, it would take only a week.

With this new procedure, I was not able to be as calm as in the others. There was, again, a certain expectation. The day of the blood test came, the hope was there, hidden, timid, already tired of so many frustrations. At the end of the afternoon the news: the procedure was unsuccessful. This time I cried, perhaps more due of the tiredness of so many medications, exams, comings and goings from medical appointments than because of the unfulfilled dream.

In consultation with the doctor, to review the options and the path I would take - whether I would give up or try again - I decided to make one last attempt, as I would no longer be able to afford the costs. If it didn't work, I would have to give up on my biggest dream. After so many years and attempts, I told the doctor that I would like to transfer two embryos and not just one. The chances of one embryo developing are already so small, that transferring two would slightly increase the chance of one staying and triumphing. She agreed, and after a few months, I started all the treatments again, but now, there was no need to remove eggs since 9 embryos, from the previous attempt, were still frozen.

This time, I asked for two days of vacation at work. My plan was to do the procedure and, the next day, relax on a quick trip to New York where I would watch an artist I love, Sasha Velor, on her solo show: Smoke and Mirrors. And, in addition, get a new Art Nouveau tattoo with a German tattoo artist residing in the Big Apple.

On the day of the transfer, oddly enough, I had no expectations. I was taken to the preparation room and, a few minutes later, I was in the surgery room waiting patiently for the doctor to start the procedure.

For the first time since the beginning of this saga, in addition to the consultation with my doctor, the ultrasound exam to see if the uterus was ready and the transfer were all performed by women. I felt protected, supported, understood and blessed. There is a certain bond, an unexplained connection between us women, something that I have never felt before and that I cannot explain, but it is as if there was a complicity because we know exactly what this quest, this desire means, and how much only we, women, really understand, deep down, the delicacy and strength of our bodies. I can't explain it, but the feeling of being cared for by women from the beginning to the end of this last transfer was magical.

In the operating room, that same small television that accompanied the removal of my eggs and the unsuccessful transfer of the previous embryo now showed me two little embryos. I remember finding it interesting that, although both were 5-day embryos from the same harvest, one was very white and the other grey. I also remember thinking "hi little ones, I am your mommy".

Procedure performed, I went home in peace, quiet. Something inside me seemed to have settled down and everything that crossed my mind was "if it works, it worked, otherwise, then it wasn't meant to be". I came home looking forward to the next day's trip.

I went to New York without thinking about transfers, treatments, frustrations, nothing that reminded me of several years of trying. I just thought I would enjoy those three days before going back to reality. No sooner said than done, I arrived in the city that never sleeps and went straight to the studio to meet the tattoo artist. 5 and a half hours later, I left there happy and carrying a new art in me. I looked forward to the performance I would see the next day.

I woke up with an excruciating hunger, which never happens to me in the morning. In general, it takes me about two hours after waking up to feel hungry. I went out for breakfast, walked around town, went back to rest before the show, got ready and went to watch Sasha Velour.

Smoke and Mirrors was a masterpiece that I had the opportunity and the happiness to watch. Sasha makes us laugh, cry, think, reflect ... I haven't seen something so good and powerful in years! The three-day run to "New York, New York" was well worth it. I left the theater hungry again. I ate a large pizza, alone, in the hotel room in just a few minutes. I went to bed exhausted, and the next day, I took one last walk around town before heading home.

Back in Montreal, I just had to wait another 3 days to do the blood test and see if, this time, the transfer had been successful. I continued as I was during the trip: at peace, quiet, without anxiety, without expectation and very hungry.

Blood test done, the end of the day reserved a surprise in the clinic's call: the test was positive. I held on the celebration, as I was supposed to return to the clinic the next day to do a new test and see if the hormones had doubled in volume in the next 24 hours. Until then, no celebration.

I arrived at the clinic with that little bit of hope that insists on showing up even when we don't want it around. Test done, hours of waiting, call from the nurse congratulating me because I was pregnant! Now I had to wait 6 weeks to do the viability ultrasound, but the dream was feeling a bit closer.



(To be continued in the next chapter ...)

When the world stopped

For some time the world has been going through a scenario that seems those of science fiction. Just as the images of the twin towers falling seemed like scenes from Hollywood films, watching, not only on television, but on a daily basis, deserted cities all over the world is something very strange.

The day before yesterday I ventured to the bank branch, as I needed to go to the ATM. Seeing one of the city's main avenues completely empty, without a single soul, reminded me of that Brasilia from 30 years ago when everyone left the city as soon as the school holidays started and, consequently, the city looked like a ghost town.

Visits to the pharmacy and supermarket also seem surreal. At the same time that everyone is in solidarity with each other because of the situation in which we find ourselves, these same sympathetic looks have fear behind them. People greet each other on the streets, remain polite to each other, but their eyes seem to see each other as a potential host for this invisible enemy.

This same bleak scenario creates tragicomic situations. The other day, at the bakery, everyone respected the distance of 2 meters between each customer until an old gentleman came in and coughed once, only once. Immediately everyone, absolutely everyone, jumped back at the same time. If a choreographer had tried to achieve such synchronicity in a rehersal, they would not have succeeded.

It is strange to see the military in special yellow clothes like those in the 1995 film Outbreak disinfecting Brasília's bus station. It is weird to look out the window and see the block completely empty.

Here at home the human population comes down to my mother, me, my little ones, and Maria, our beloved helper. We are lucky to have company. I think of those who are alone at home. I think about what it would be like if I were in Montreal alone with my babies. I would have to go to the supermarket and pharmacy with them and thus expose them even more. At that moment, I think it was good to decide to spend some time of my maternity leave in Brasília with my parents. On the other hand, now that I am close to my friends, it is only possible to meet them virtually as if I were still in Canada. Yes, it is great to have the technology we have to communicate with everyone we love and who are far from us, but virtual contact is not and will never be the same as personal contact. In fact, that's the worst part of it all: not being able to meet, hug and laugh with friends.

When all of this is over, I just hope that we all realize how much time we spend looking at mobile screens and not at a friend's face. How much time we spend looking at social networks on devices that take our whole attention even when we are in the presence of others. I sincerely hope that we will relearn to value personal contact, leave the screens aside and enjoy each other's physical presence.