Returning to the Routine

This time is different, or at least I am experiencing in a new way. Over the past 13 years I’ve been through a number of cycles of violence between Israel and its neighbors. I don’t spend too much energy debating how it should be handled because I don’t have a good answer. Like most Israelis I do my best to continue with my life and pray that an enduring and peaceful resolution can be reached.

As a resident of Jerusalem, my daily routine continues: I continue to work and socialize almost as usual. Yes, I make sure that I know about safety precautions and the nearest bomb shelters when I am away from my home, but for the most part my life continues. When I hear a siren indicating that rockets have been launched in the direction of Jerusalem, I make my way to the shelter and wait until I can safely return to whatever I had previously been doing. I’m not suggesting that it is easy and certainly not ideal, but I, like many Israelis, continue to continue. People still go out to pubs and events – though a few larger events have been postponed or canceled due to safety concerns – there are still tourists on their summer vacations, and the World Cup is part of daily conversations. There is a real effort placed on maintaining as much of a normal routine as possible.

My routine involves IVF treatments and those continue as before but they may be my biggest challenge in dealing with this outbreak of violence. My Facebook feed is full of comments by parents forced to wake their sleeping children in the middle of the night to bring them to the safety of a bomb shelter. There is a part of me that is grateful to have been spared the fear of parent who finds themselves apart from their child at the sound of a siren. Still, the fear and violence affects my experience in fertility treatments. I fear the day that when I have to rush my child to safety.

Optimism and hope are what push me forward through the hardships of IVF. It pushes me through the stress of the treatments and allows me to see beyond my immediate situation. Unfortunately, it is precisely these two feelings that are most difficult maintain while standing in a bomb shelter. I do hope to bring a child into the world, but I’m concerned about the world that he or she would enter. Optimism is hard to maintain given the daily news cycle. Devoting significant energy to creating life seems trivial amidst the violence.

I return to the IVF clinic accompanied by two prayers: that this IVF cycle will be met with success and that my children will inherit a world where peace is routine.

For My Birthday

People who know me well have probably picked up on two things: I love to celebrate my birthday and I seek meaning in the numbers associated with each year. Both became more pronounced when I realized that anywhere outside the United States my date of birth is written 5/6/78 – I’ve yet to get over how unique that is and it makes me feel pretty cool. I went a bit overboard in the year 2012, on my 34th birthday, I insisted that a toast be made at both 9:00am and 9:00pm, thereby associating and celebrating all the single digits with related to my birthday.

The Hebrew language makes these associations all the more interesting because each Hebrew letter has a numerical value and adding significance to the birthday. Many people know that 18, Chet and Yud,  spell chai meaning life.  I know some of you believe this to be nonsense but I have observed these numbers playing out in my life. Take for example the number 28, its Hebrew letter equivalent is Kaf and Chet,  which form koach (strength); the year after that birthday was difficult and I needed a good amount of strength to push through. My favorite is 32, Lamed and Bet, lev (heart). Tommy and I met when he was 32 and I was 32 when we married. Maybe this is all about self-fulfilling prophecies, but either way I enjoy it.

All this brings me to this year, today, my 36th birthday- 18 is life and so 36 is double life. No, that is not a plea for twins and yes, I do know the risks of playing around with fertility drugs. Usually my birthday celebrations are quite standard: food, cake, wine …. This year, however, we’ll be doing things a bit differently as Tommy and I will spend a good portion of today trying to get pregnant. This is all absent of any romance you might imagine because this process involves: fasting, an IV, anesthesia, a couple of doctors, quite a few nurses, bed rest and mostly patience. It was not the celebration that I  had envisioned, but my body calls the shots on this one.

Tommy and I celebrated a few days early and I may arrange a belated birthday related event- with daily visits to the fertility clinic this past week I have  not found the head space or energy to put it together. For now, I am just focusing on today, this moment and all the hope and potential it holds.


*******Note to readers: Normally, my posts describe events that have already transpired and I don’t anticipate that changing moving forward. I felt a need to share colliding of events because they could not be ignored. This is not an invitation to ask if I am pregnant or if it worked. I will let you all know, at some point. For now send good vibes and happy thoughts.

Sharing the Burden

Nothing beats a moment of clarity. We all have them every once in a while: after mulling over different options or scenarios you know with absolute certainty how to proceed. This week I had one of those.

For the past couple of months I have felt ambivalent about this whole process. Last May we put a nice stash of embryos into the freezer and over the year completed 3  transfers. I was even pregnant a couple of times, and then not. I have yet to formulate the words to describe the emotional roller coaster that we have been on.

Suddenly, we found ourselves back to almost square one. However, by this point I was tired, uncertain, skeptical, scared and unmistakably aware of the toll that it was taking. “Keep at it” the doctors say we’ve only done two rounds and have had some “promising” results. Still, inside I was relieved that we would be taking a couple months off. It gave me time to forget,  escape and reclaim my body.

As Passover came to a close I started to dwell on the inevitable, the day I would walk  through the double doors of the fertility clinic and start the process all over again. As much as I knew what I had to do and all that it involved, I could not accept it. My energy reserves were all cashed out and I did not know how I would do the seemingly impossible.

I kept hinting to Tommy, but I was torn because I also knew that we were not ready to stop. I just could not figure out how to begin.

It hit me as I sat in a course given by the university’s psych. services designed to help staff members recognize and respond to mental health issues among students. As I listened to the psychologist speak about identifying the needs of a student in distress, I thought “what do I need?” “how do I move forward?” This time I had the answer: I needed Tommy.

The first step in IVF, and various other fertility treatments, is to track the woman’s cycle up to the point of ovulation. It involves a blood test and ultrasound every few days. It’s pretty straightforward and therefore many women do this stage on their own. It didn’t make sense for both of us to miss work and Tommy’s presence was not required.

Something had changed and Tommy’s presence had become absolutely critical. It was the starting point because I knew that he would have the strength to open those cumbersome double doors and share the burden. The rest was on me, but this he could and would do.

I sent Tommy a text with my realization and the bottom line: “I need you.”

Thirty seconds after I received his response: “No problem.”

Anything You Say….

Discussing fertility or IVF in Hebrew is like playing with fire.

Here’s why:

Hebrew word for ova (plural of ovum)= ביציות beitziot

Hebrew word for both eggs (gobble gobble) and testicles= ביצים beitzim 

And so as I discussed IVF with a group of women this evening I mentioned that  “In my last round of IVF they retrieved 6 testicles.”

So my list of embarrassing moments is just that much longer.

Under My Umbrella

My phone rang as I made my way home from work yesterday. It was Tommy.

Tommy: “Are we still going out tonight?”

It’s cold, wet, and hailing in Jerusalem these days and the only thing that I wanted to do was go home and hang out in fleece pajamas under a warm blanket.

Me: “Um, I think we are going to have to rethink our plans. Can you pick up dinner on your way home? Thanks.”

Like many couples we plan  “date nights” when we go out and do something new together to enjoy each other’s company and break up the routine. Making these evenings happen is an important part of everything that we are going through; they are little escapes from the disappointments.  But most importantly they are reminders of all  that we have in each other. I usually walk away with a half full glass – though if the evening involves a good bottle of wine the glass is definitely empty by the end of it!

Both of us were looking forward to an evening out. The week has not been easy. My body and  its constant changes have left me feeling physically and emotionally out of control – you never know if it’s the hormones affecting you or something else. After our most recent appointment with our doctor, we have been mulling over some big decisions and feel mostly left in a haze of uncertainty. The idea of going out to a nice dinner and just forgetting it all was exactly what we needed.

My commitment to date night aside, the weather put a real damper on things. While you can’t complain about rain in Israel  (we desperately need it these days), I don’t feel obligated to venture out in hail. Date night would have to wait. I made my way home on the bus and the phone rang again.

Tommy: “Where are you? Are you close? It’s pouring outside and I don’t have an umbrella.”

He was standing under a covered walkway between our apartment and the bus stop.

Me: “I’ll be home in ten minutes and yes I have my umbrella. Wait for me and we can walk home together.”

I stepped off the bus and saw Tommy standing in a tiny haven from the storm. In truth I was skeptical that we would be able to share my small umbrella and assumed I would end up soaked. I handed him  the umbrella and we started to walk, he put his arm around me to both coordinate our pace and to maximize the umbrella’s coverage. At a certain point he started to sing. You’re crazy, I thought. Then I joined him. There we were: one umbrella, torrential downpour, and singing. I wished that that moment would never end because I felt complete, wanting for nothing, and happy beyond my wildest dreams. It lasted a mere two minutes but in that brief period, we escaped, together.


The other day, I went to the IVF clinic for the routine blood test and ultrasound and as I waited for my turn I watched the morning news show on the television. I think everyone in the room was watching because at the time the “hot topic” of Israel’s news cycle was all about the new law related to IVF coverage. Until recently most people believed that women in Israel were entitled to coverage for unlimited rounds of IVF – not entirely accurate as a doctor, and often a board,  always had to determine that the woman was candidate for IVF. Now the popular misconception is that a woman is only entitled to eight rounds of IVF and then she is left with no recourse.

The segment that morning involved an interview with both a woman who gave birth after her 10th round of IVF and a reproductive endocrinologist. The last words of the interview came from the doctor who advised viewers, “do yourselves a favor and have children early.” Thanks, that was helpful because there are absolutely no women who have fertility issues in their 20s!!

Annoyed and frustrated does not adequately describe my reaction to the media’s need to sensationalize this story. So I beg and plead that it stop and will now set the record straight. For starters, the law doesn’t state that a woman is limited to eight cycles of IVF, but rather it qualifies that if a woman does not become clinically pregnant (referring to the appearance of a gestational sac) after eight rounds her case will be evaluated by a committee. Additionally, the law specifies that if no embryos are available for transfer after four cycles, then the case will also be reviewed by a committee – I believe this was previously part of the law. Finally, the law allows women who are passed the age of 42 to begin IVF treatment immediately and not go through the previously required stages of fertility treatments such as IUIs.

Over the past year and a half, we have completed three IUIs (required by the law) and are in the middle of our second round of IVF (a round includes the transfer of frozen embryos). Since the law has always limited the number of cycles that a woman can do in one year, it would take at minimum two years to complete what is now covered under the new law. I know that people spend years trying to have a baby through IVF, but eight cycles would in many cases still cover years of treatment.

I do hope that this law impacts fertility treatments in the country in a positive way by encouraging both doctors and women to take a closer look at their treatment and consider various options. At times I feel like my clinic is a factory and I struggle to receive personalized care. The treatments and approach are standardized and the doctor believes that eventually it will work – there is all the time in the world! As an optimist I want to believe that the new law will encourage doctors to take a closer look at their patients and, when possible, seek more specified treatments.

When we started this process, Tommy and I discussed how long we were willing to try IVF. I knew that it would be taxing – though I had no concept of the extent to which that would be true – and I needed to set a limit. In our situation eight rounds will suffice regardless of whether we have a biological child. I am not suggesting that that approach will work for everyone but it was essential for me. We know that there are multiple paths to parenthood and though each has its obstacles, we will get there one way or another.

While people are welcome to disagree with my take on the new law and its consequences, one thing that is rarely debated is that stress never helps the situation. So I return to my initial point and ask that the media refrain from sensationalizing this story. Anyone who has been through this process knows it is best when approached one day at a time.

Between Dos, Don’ts and Empathy

Weekly phone or Skype conversations with my mother have been a tradition since I moved to Israel.  Sometimes these are great and last hours and other times they go more like this:

Mom: “Hi Toby. What’s new?”

Me: “MOM! That’s such an annoying question!”

Doesn’t she get that I don’t feel like talking about that right now?! She’s walking into a minefield at times and  can’t win, but I do love her for trying. I suspect that over the years she has  mostly learned to interpret my responses and she proceeds with due caution – mostly.

In a recent conversation, we discussed the fertility treatments and I made a slightly sarcastic comment. My mother was about to disagree with or otherwise correct my statement and stopped herself mid-sentence. Instead she said something like:

“You know what? I really have never been through this myself so I can’t really tell you how to feel.”

I was filled with warmth and love. It was all I needed to hear at that moment.

So, what should you say, or rather not say, to me as I share my struggle with infertility? Quite a few lists out there address the dos and don’ts when speaking to a couple or person going through fertility treatments, or any other of the numerous trials we all face in life.

Though these lists can offer someone going through a difficult time the comfort of knowing that others have been there too, I don’t find them  particularly helpful in actually knowing what to say. Why? Because the experience itself cannot be conveyed in a list. My emotions are fluid. Our path to parenthood has turned into a lengthy and trying process. What was painful to hear yesterday is hilarious today and vise-versa. As far as I am concerned, there is no rulebook for relating to me – except maybe this one –  you just have to feel your way through it. Don’t worry, I don’t bite. Often.

Where does this leave you though? In the dark? Maybe. Here is a hat tip to  Naomi Weiss (my self-professed biggest fan) for sharing this:

‘Nuff said!

Both Sides of the Coin

Who doesn’t like a snow day, or two, or three….?I think I’ve done  a good job making the most of mine: slept late, drank hot chocolate, caught up on TV series, made waffles.  I don’t have any real affinity for snow in and of itself. My parents never took me sledding – not a complaint, just a fact- and I have no real love of snowmen. Tommy, my Hungarian husband,  believes that the snow is not fun here, it’s better in Hungary but here it is just a nuisance.

To be sure the Jerusalem municipality did a dismal job of cleaning up the snow and all that came after:

2013-12-16 11.52.34

Though I like these relaxing days for what they are: me days!

Then I go to Facebook and I see the pictures my friends have posted: baking cookies, sledding, building snowman, making memories – all of it with their children and it looks like so much fun, maybe more fun because it is with kids. I can’t help but wonder when it will be my turn to create these moments with my children? I even find myself hoping that this is not a one time event for Jerusalem – though please not in the near future!

I ask Tommy: “Will we take our kids to play in the snow one day?’

“Of course,” he answers, “in Hungary.”

I know that there are two sides to this story. Parents are at their wit’s end trying to figure out what to do with their children going into the fifth day straight of school closures. I’ll wake up at 9:00 am tomorrow morning – an hour that parents of  young children can only dream of – I won’t have to deal with children climbing the walls. Childcare is not a concern for us on those days when Tommy and I need to work and schools are on vacation. We are flexible and free to do what we want when we want to and we enjoy it.

Still, one day I plan to take my kids sledding, perhaps in Hungary.

Reassuring Information

The following is an actual conversation I recently had with a friend, I find it very telling:

      Friend: “So who is your doctor?”

      Me: “Dr…..”

      Friend: “Oh, he got all my friends pregnant!”

Can’t beat a man with a reputation!

Words Of Wisdom

Early in our relationship it was obvious to me that Tommy and I were on the same page when it comes to the big things; that’s why I married him. Sometimes life gives you those little reminders of what you knew to be true and why you first fell in love.

I’m sure that it comes as no surprise that the two of us spend a lot of time talking about the fertility treatments and our hopes of becoming parents. It’s not the only conversation that we have, but we do talk about it on a fairly regular basis. Today, Tommy and I were having one of those “big picture” conversations and Tommy came to the following conclusion:

“What really matters isn’t what you don’t have, but what you already have and how you feel about it.”

He posted it on Facebook but I wanted to be sure it received a wider audience. This process makes it easy to obsess over details that are often out of our control: Follicle size, number of embryos, quality of embryos, the effect of freezing on embryos, and finally the “big one,” will an embryo decide to stay awhile in my hormone enhanced uterus?

It’s nice to know that we are both able to help each other keep a perspective on what really matters.