Out of Our Hands

After having to reschedule twice, I finally had my phone consult with Dr. K the other day to discuss my miscarriage and next steps. He said the type of testing my local RE sent off for has a high chance of maternal cross contamination so the fact that the testing said normal, in his opinion, may or may not be correct. He said the way the baby always grew behind, was late to get a heartbeat, and had a slow heartbeat when it did indicates something "wrong from the beginning" genetically.

The fact that there were 10 embryos from this batch and not a single one resulted in a birth (between me and the surrogate the donor family used) and that the only one resulted in a pregnancy that was considered “embryonic demise” early on is strangely comforting. In my deepest heart, I feel that the embryo had some damage or mutation and that’s why I miscarried but it's still scary to not know exactly what happened.

He wants me to have a SIS soon to check for scarring/adhesions from my two d&c's and does want me to have another endo scratch this time (Darn, I hated it last time!!!).

I’ll feel unsettled until we have more sweet embryos, but I am feeling more at peace (although still sad). Dr. K ended the conversation with the exact sentiment that has been on my heart lately- how I can control things, he can control things, but in the end some of it will always be out of both of our hands. I pray God will have mercy on me and allow this next transfer to work!  

Check Yes or No

Do you love me? 

Do you want to be my friend? 

And if you do, well then don't be 

afraid to take me by the hand. 

I think this is how love goes. 

Check yes or no!

Nearly a week of silence since our clinic contacted the donors we are interested in matching with. Maybe they don't check their email regularly. Maybe they are busy with their big family. Maybe they are second guessing their decision to donate. Maybe they don't like something about us.

Eek! An email from the clinic... asking when we will choose a donor? Uh, we already did, and we heard you were emailing them! A response back from the clinic. Yep, they were mistaken. The donors were indeed emailed. Since it's getting close to protocol time, they will call them to check in.

Check email religiously all day. An email about a CEU for professional training. Boring! A junk email from Huggies. Don't know how they got my email. They don't how I have no reason to buy diapers right now. An email from my monitoring clinic with a breakdown of all the billing for the year. Wohoo! Another email about a CEU. I really need to get off some of these lists.

Once 4 PM hits, I know I won't hear anything today. It's 5 PM at the clinic.

The pressure mounts knowing a phone call was made. It may be easy to miss an email, but it's pretty difficult to miss a call. During the two times we were chosen, we heard back within two days. The time we weren't chosen, it took about a week to hear. In my mind, longer waits mean bad answers. So many things race through my head. I don't want any donor to feel pressured, but I sure would like to know if these are our embryos!

Maybe they emailed or called back once the clinic was closed (the donors are on Pacific time, the clinic is on Eastern time). Maybe they are on a fall vacation (does the West coast take fall breaks?!?)? Maybe their kids are involved in a lot of activities, or maybe one of them has been sick. Maybe it's just really difficult to finalize your decision with saying "yes, this family can transfer our embryos".

Lots of Small Updates

We're making slow but steady progress towards our third transfer. We officially told our clinic that we are interested in matching with Family D. D and I sat down in front of some profiles, read through them together, and both concluded that this family seems open, fairly similar to us and a plus is that they have a very good health history. Unlike Family A and Family C, they live completely across the country- on the West Coast.

Going into this the third time, I have lower expectations. Family A was everything we could have asked for, and although I think we will always have a relationship and keep in touch, we will never have a child in common. I think that hurt made choosing this time have less pressure. We just want to find someone we both agreed with. Obviously picking the "perfect" family for us didn't work out. That disappointment clouds our desire to look high and low for another "perfect" family.

So, now we wait for an answer from Family D. We received very quick responses from Family A and C (we had a wait awhile  to hear "no" from Family B). Family D has five kids, so they're probably pretty busy. I hope we don't have to wait too terribly long, though. The clinic said they emailed the family. I hope whichever parent they emailed actually checks their email! If someone emailed D about something important, they might wait awhile for a response! :)

After we both agreed to pursue a match with Family D, I talked with Carol, the embryologist about these embryos. Quality doesn't guarantee success, but we are interested in it. Much to my surprise, she said they are from an excellent clinic she's had good success from before. On top of that, all six embryos are very excellent quality. As in all the very best and second best a blast can be (multicells are rated less stringently, but blasts are rated 1-6 and then with two sets of letters A-C... so there are lots of ratings a blast can be- 6AA, 5AB, 4CC, etc). That makes us feel hopeful.

We've already had our phone conference with the new contract mediator (the CEO who is covering). We prefer the same openness as with our two previous contracts but understand if this family isn't comfortable with that. She will discuss everything with Family D, should they agree to match with us. So, that's one more formality that's checked off the to-do list.

My weekly post-d&c pee stick this weekend was such a faint positive, that I'm sure by tomorrow it would be completely negative. I hope this means no more retained tissue and proper healing. I am so happy to have paid $2.40 rather than $484.00 to monitor this (not to mention the gas, time, hassle, and emotional distress to get to and from clinic).

After having to reschedule twice, I finally have my consultation with Dr. K this week on Wednesday. The genetic testing results came back with no answers. They didn't find anything genetically wrong with the baby. I have a whole list of questions typed up that I want to discuss with him. Please pray for him to have wisdom in my treatment. I'm sure he hates practicing medicine in the age of google and everyone talking to each other online- but I want to address my concerns and advocate for myself (and my future embryos).

Finding Our Embryos

I've mentioned we have to rematch with additional embryos. After the second transfer, we had no more embryos left with our original donors, Family A. Two died in thawing in May, two died after transfer in May. One died in thawing in July, one was a blighted ovum after transfer, and one was a miscarriage (like anyone reading could have missed that fact!). :)

We are still matched with our two back-up embryos from Family C. They are both multicells (3 days). NEDC requires at least 5-6 embryos to proceed with transfer (reason being, if embryos die in thawing, you don't want a wasted cycle when you get there day of transfer). So, we would need to find a Family D with at least 3-4 embryos.

But when we think about finding Family D, we think about finality, at least with this program/clinic. Perhaps Dr K will allow a fourth transfer since I had only one viable embryo my first transfer, but that's not a promise. This may be our last transfer.

When you think about two failed transfers, you think about what different could be tried to increase chances of success. In the cycle that worked, I did a scraping/biopsy. I won't be doing another, though- I can't imagine it would be healthy after two d&c's. I will ask Dr. K if he recommends any medication or protocol changes. I've already switched to full-fat dairy, more organic foods, and will get back on my routine of pilates/core work and walking. The only other thing to add to this scenario (other than maybe acupuncture which has mixed results and is not something I'm remotely wild about!) would be different staged embryos.

The standard protocol now is to create embryos and grow to 5 days (blast) before transfer. Technology has progressed enough to allow embryos to grow to that point in a lab. In an "old fashioned" cycle, the embryo is still in the Fallopian tube at day 3, traveling to the uterus. Day 5 is when it would naturally arrive and prepare for implantation. Of course, there are still plenty of IVF successes with 3 day embryos, and some speculate it's better for an embryo to be inside the mom rather than a dish.

That said, we feel since this is potentially our last chance with this clinic (and with this third chance goes away pretty much the rest of our savings), we need to maximize everything we can. So, we've decided to release our two current embryos back into the waiting pool and rematch with a family that has blasts.

This was a tough decision because we really like Family C, the embryos were actually created and frozen at the same clinic by the same embryologist we see, and they are both graded well. However, we don't want to have regrets. Another factor is that we've seen nearly all the multicell open profiles, and there isn't another family we'd want to match with as a backup.

We're not too picky as far as trying to match up hair and eyes of the genetic family to us. However, the range of openness varies so much among open donors. We prefer to match with a family that has the same level of openness as us. To each their own, but we don't feel it's in our potential child's best interest to meet their genetic family at a certain age (a lot of profiles say "meet at 13" or "meet at 18"). If we do open adoption, we want to be able for the child to always grow up knowing their roots and have the option to meet the genetic family when the time is right for both parties, not at a certain milestone. I think a milestone meeting could be a huge build up of stress for a child (just my opinion). I'd really prefer a family open to direct contact, as well. We've had that with both Family A and Family C, and I can't imagine using an intermediary to talk.

We've finally received some profiles. We're checking into one as a possibility for a match. I didn't want to have to find a Family D, but here we are. 

Happy Thaw Day Little Embryos, Part II

Today's the day that our embryos will begin thawing for transfer #2 (see transfer 1's thaw day post).

Several people have asked me, "So how many are you transferring?" That's a complex question with an uncertain answer.  

We currently have five embryos: a 2PN (1 day old) and 2 multicells (3 days old) with Family A and 2 multicells with Family C.

The lone 2PN will be thawed today. If he/she survives the thaw, growth will continue til Wednesday to hopefully get the embryo to at least 8 cells (currently 2). I am most nervous for this embryo because last time, of the 3 2PNs thawed, only 1 made it. Our clinic has the highest success rate for this stage of embryo to survive a thaw (80%+); we brought the statistic down (33%).

The two Family A multicells will be thawed tomorrow or Wednesday morning. I thought multicells were thawed day of transfer but last time the multicell we transferred was thawed the day before transfer.

If all three of Family A's embryos survive the thaw, they will be transferred together. If two survive the thaw, they will, likewise, be transferred together.

If only one of Family A's embryos survive the thaw, Family C's embryos will both both thawed. Whoever survives that thaw will be transferred together, thus potential "mixing".

Possible Scenarios:
Three from Family A survive the thaw: we transfer 3
Two from Family A survive the thaw: we transfer 2
One from Family A survives the thaw along with two from Family C: we transfer 3 and get DNA testing at birth
One from Family A survives the thaw along with one from Family C: we transfer 2 and get DNA testing at birth
Only one embryo survives the thaw: we transfer 1
None survive the thaw: They have us transfer anonymous embryos that don't require matching; not likely

We originally did not want to consider transferring three at once. In fact, I was nervous about transferring two when we were originally making our decision. However, the way our embryos are divided and stored, we feel like this is the best option. We don't want to leave the Family A set with one lone embryo, so that opens up the potential for a transfer of three. Family C's embryos will be thawed if there is only one left from Family A, leaving us with another set of three. We wouldn't want to leave the Family C set with only one; not to mention those two are packaged together, so they have to be thawed together.

Who thinks about this stuff when they try to have children? It's crazy.

Ultimately, we trust that what should happen will work out. We trust our doctor's advice. He is pretty conservative in a lot of areas, and although number of embryos transferred isn't one of them, I think that's because this clinic transfers ANY viable embryos no matter the quality (eg: our two cell 3 day old embryo that was lagging way behind) whereas many clinics let poor quality embryos die or refreeze them to sit in a perpetual frozen state.

If I had to make a guess, I say two from Family A survive the thaw and we transfer two.... but I never thought we'd have two embryos die in thawing last time, either, so anything can happen!

Whiplash

I have whiplash.

Not, not from getting sidewiped by a hit-and-run driver yesterday (although that did happen... thankfully I'm okay, the car is okay, and I didn't have any embryos along for the ride).

I have whiplash from just another day in embryo adoption.

This morning we heard back from our clinic that the family we'd asked to match with (Family B, for clarity) did accept us but would not consent to "mixing" (if we were to have only one of our original embryos make it, we'd need to "mix" by adding an embryo from the second family). I can respect that viewpoint. It obviously isn't one we share, though, so we weren't able to be matched.

Failed match. 

I then called the clinic to discuss removing our two previous parameters (mother's age and one physical characteristic) and asked her to send all the remaining multicell profiles that would allow for mixing. This amounted to seven more profiles (for a total of 24 profiles we've viewed during this process).

As our custom, D and I were quickly able to narrow down which families we may be comfortable with and picked our favorite. I emailed the clinic back to let her know who we'd like to match with and expected to have a several day wait to find out.

Approximately 2-3 hours later, the clinic was pleased to let us know that they contacted Family C, and Family C was game for a match.

Match made.

Family C seems very open (they included a large amount of pictures, much like Family A). Also like Family A, they are an unknown but close distance from us, so hopefully they will be okay with that. Family C has two multicell embryos, which, added with our current trio, will bring us to five embryos.


Next steps will be securing contracts, which involves more phone calls to negotiate contract terms and notarizing our "property transfer" so the embryos can officially be "reserved" for us. We will know more in the next few days. Which is comforting to me since the real medication sprint starts next Tuesday!

The Bachelor and Embryo Adoption

I feel a bit like I am a contestant on the Bachelor (or the Bachelorette). 

See, D and I have picked a back-up donor family we'd like to work with. Now, the clinic will contact the family to see if they want to match with us. They will get some pictures of us along with a short profile we sent. I honestly forget what pictures and what information we gave to the clinic back earlier this year, so I'm not exactly sure what they'll be seeing.

This family has 4 multicells which would give us, again, a total of 7 to work with (they also have two blasts that couldn't be used this cycle).

Last time it took about a day and a half to hear back. I wonder how long it will take this time. We're going into the weekend, so I expect it will be next week at the earliest.

I didn't realize how hard this would be. Luckily, D and I are likeminded on what we're looking for, so the selecting part is easy. We can pretty easily narrow down what we are comfortable with and what we aren't.

What is difficult is to know we've had to select a second family when we still have embryos with the first family. It almost feels like being on the Bachelor or something. Two relationships, two potential outcomes, so much unknown. I don't like the feeling. It's so weird to be in this limbo of not knowing.

What a Day!

The morning started out with taking (and thankfully, passing) a professional licensure exam, so I am now a LCSW. Wohoo! 3 hard years of work, and I finally have it. It's so strange to be anticipating it for so long, and I now suddenly have new letters after my name.

I always said I wanted to have my LCSW the time we had kids. I had several delays with the testing process, and obviously have had several delays with the whole kid process, too, so maybe I got what I wished for...

This afternoon has consisted of an email with profiles. Yay, right?? This should compound my joy, but I'm honestly just frustrated. The profiles that were sent to us will likely only afford us a second try, and I want to think further than that. I hope we don't end up with multiple more tries, but I'd like to use our money wisely (as well as just time and emotional energy) in case we do.

The whole embryo coordination was the worst part of cycle #1. The night I wrote the poem, I really was spinning. Logistics and coordination are not my thing. It's like playing checkers or tic-tac-toe. I tend to get overwhelmed. I'm not a genius, but I feel like I'm pretty smart in a lot of areas. But true story: I was a camp counselor in college. I had sixth graders routinely beat me in checkers all summer, and I didn't even try to let them win.

Add in miscommunication/misunderstanding with our clinic... and the fact that I am still "new" to the game and don't full know all the rules and implications of what this fee entails or how to get the "right" combination for us... I could pull my hair out. Not really. But pretty close.

This whole process is really the weirdest thing. Some days it is fascinating and inspiring, and some days it just sucks.

It sucks having to pick a donor. It feels the same way as picking what situations you're open to in traditional adoption. No guess work with most "typical" instances of adding a child to your family. It sucks especially to pick a second donor. We love our current donors. Picking a second donor is acknowledging the truth that it might not work with our current embryos. It sucks doing fertility treatments "long distance". Yes, there are pros of being at a clinic like we are, but it's difficult to have life-changing communication primary by email. It sucks being so jaded. 3 IUIs with an average statistic of 20% success rate + 1 IVF with a 20% success rate. We should be 80% of the way towards a baby (or 94.2% with the situation we were shown for). But some people get lucky the first time, and some people never get lucky. I wonder what the future will hold for us.

These are the things that run through my head and exhaust my mind and heart.

Post-Transfer Consult

I had the phone consult with our doctor. D was already on his way to work, so I held down the fort for us.

We live in the sticks, so I don't get great cell phone service inside the house. So, I sat on our back deck, with a nice cool breeze and birds chirping up a storm. Each minute crept by, until Blake Shelton belted out a tune on my phone... in other words, I had the call!

Things went pretty much as I expected. There were no issues with my lining, the transfer, or with me post-transfer. Our greater than 8 cell embryo was "good but not great" and the 2 cell little guy, bless his heart, was "not very good". Since I transferred two and one was not good, he felt like my chances to be successful this cycle was only 20%. Double rats! The verdict, then, is to just keep trying.

He did say that although there is a three transfer attempt rule, they also take into consideration the quality of the embryos transferred and would like each person to have the chance to have 5-6 good embryos transferred before turning them away. Since we only went with transferring two and since one wasn't good, that leaves us at only 1 good embryo transferred so far, at this point.

Do I want to keep going back? No. Am I ready to have a child? Absolutely. But, I will also absolutely transfer each of our three remaining embryos, even if 3/4 of their siblings didn't give us a "good chance". I'm too committed to them (and their genetic parents) to just switch to a new set.

This is all so weird sometimes. So many decisions. So much ethics. So much a mixture of scientific knowledge with good old fashioned luck.

It's still up in the air if we can get in for the July transfer. I am trying to get matched with a backup group of embryos, but it seems like everything is just dragging slowly, and it's all out of my control at this point.

Whirlwind

It's been a whirlwind. We got an email with 11-12 donor family profiles on Tuesday afternoon. More specifically, I got them on my email on my phone and started browsing. We had a training for our adoption agency that night, so when I met up with Daniel after work, he looked over the profiles, too. Within 45 minutes, we had both agreed on the same first and second choice. I guess with all the talking about sperm donors and potential adoptive situations, we've wound up very much on the same page.

We didn't feel like we needed to sleep on it, because we have pretty certain specifications of what we are and aren't open to, and both of these families aligned with them. I emailed our clinic to let them know our choices Tuesday night. (The choosing a family was the easy part... the difficult part was understanding the logistics behind the different stages of embryos- this set has embryos in two stages- and the implications for transfer and needing a back up).

From there, the clinic has to contact the the donors and send some information on us, to see if they want to match with us. They are able to ask questions of us before they say yes or no. We expected to hear back in several days, or maybe a week or longer.

Bright and early Thursday morning (so really just a day later), I had an email saying our first choice donors accepted us: "I wanted to let you know that donor xxxx has gladly accepted you as recipients". Big horray #1!

The open agreement/contract mediator followed up with us later that afternoon to let us know the donor family actually lives within an hour of us and wanted to know if that was ok. Fine by us! Again, we wondered if this would be a roadblock. But, we heard back within several hours that they, too, are okay with the proximity: "I am happy to tell you that I received a prompt response from the donors.  They state that they 'don't have any problem with the geographic proximity' and are 'good to proceed'." . Big horray #2!

Now the next step will be that our mediator meets with them to see exactly what openness they forsee, and then meets with us to do the same. She will write a legally binding contract. We will all agree to it (hopefully). Then, the set of embryos from this family will be "reserved" for us, and we can proceed with transfer in the May cycle!

Twas the night of the profiles...

Twas the night of the profiles, when all through the house
Sara was overwhelmed, she needed her spouse.

Needed his insight to make things more clear,
In hopes that a child would someday appear.

The cats were nestled all snug and ready for bed,
While visions of 2PNs, multicells, and blasts danced in our heads.

Embryo Adoption Consult

Well, we had our embryo adoption consultation! Instead of having the consultation in May as originally scheduled, we will actually be back at the clinic for transfer in May (if all goes well).

We drove the night before since, although the clinic is only a couple hours away, we had an early morning appointment, were losing an hour for a time zone change, and I had to have a full bladder for the appointment.

When we got there, we had dinner at O'Charleys and burned nervous energy the best way I know how- walking around Target. We went there for some bottled water for me to drink in the morning and ended up buying random groceries that were on sale. There's just something so comforting about walking around Target!

By this point it was past 10 PM, so we thought it was ready to settle down. I set three alarms because I was nervous we wouldn't wake up. I woke up every hour starting at 2 AM and never even needed an alarm at all!

I tried to eat breakfast while chugging 60 oz of fluids. I was nervous when we arrived at the clinic because I hadn't felt any of the fluids hit me... but by the time we waited in the waiting room, met with the doctor to go over my medical history, and got back to the exam room... I was in pain. The doctor said I had the fullest bladder of the month award and he could tell I was an overachiever (yes, yes I am!). They did some testing (SHG and trial transfer) which was uncomfortable but not painful.

The doctor said he doesn't see anything that's a concern, so there's no reason I couldn't carry embryos. The next step will be our adoption agency doing the update/addendum to our homestudy... then we can start picking out embryos! If I respond well to the medication and there are no issues with embryo selection, I would have a transfer in May.

Although there's a 50% chance the transfer won't work, there's a 50% chance it will... which is way more hope than I've had in a long time. This is so scary because it feels like putting so many eggs in one basket, but everything has worked out so smoothly thus far, more so than any other direction we've tried up to this point.

I hope this really was a positive omen, but as we walked out of the clinic lobby, "As Long As You Love Me" was playing. Anyone who knows me knows would associate Backstreet Boys with me as I was a fanatic for a lot of years, and this is my favorite song by them.

Wandering around Target to get bottled water... and trying to make sure I wake up on time!

After appointment pizza and ice cream

Plan B

A promising opportunity has been presented for us. When couples go through in-vitro (IVF), they often have leftover embryos. There are an estimated 400,000+ embryos frozen and stored across the US. Families can pay to store the embryos indefinitely, donate them to research, allow them to die... or donate them to other families.

One of the largest and most successful clinics for embryo adoption (NEDC) happens to be only a couple hours from our house. A homestudy is required- which we already have- so we will need a simple addendum to proceed. Also, since  our agency partners with this clinic, they would allow us to continue to remain a “waiting family”, so we could continue to be presented to birthmoms in the meantime. 

Of the options we have been looking at the past few months to widen our opportunities to be parents, this seems like the best option for us right now. For the first time in a while, I feel hopeful. It's busy clinic, so when we contacted them, the soonest they could get us in was May 8 (which happens to be D's birthday...). Then earlier this week, I got a call that they have a cancellation, and now we are scheduled to have a consultation next week.

We will continue to remain active with our agency, and should a birthmom choose us, we would go through with the match. If we are not chosen by the time we select embryos, we will proceed with the embryo adoption and medical procedures. As Daniel says, “It doesn’t hurt to try”. We will be parents, one way or another. We’ll see if embryo adoption is the means!

 

Brief Overview

 More Detailed Video

I'll Take That As a "Probably Not"

The expectant mom in Situation #3 who is looking at our profile book is still looking at books, and may want to look at books out of state. I'll take that as a "probably not". I still wish her much peace in making a decision. There are over 100 waiting families in our state alone, so that must be a painstaking decision.

We're still exploring and working towards a concurrent route for adoption in addition to waiting with our agency. More about that to come shortly!

2013 is there and gone

2013 summed up would be "a year of waiting". We try not to put our lives on hold for the adoption, but certain things like trips, home improvement, and even career direction are at a standstill for now. Our energy and finances are all directed towards a hopeful adoptive placement.

Although we have been "frozen" in aforementioned areas, we have still had a chance to grow over the past year as a couple (the adoption process is great for developing communication skills, and the stress can be a refining fire to a marriage!) and spiritually as we've become more involved with our church and community group that is a huge blessing.

This time last year, we had just closed our home to foster care and were preparing to attend the orientation at our current adoption agency. This year has felt underwhelming and disappointing in many ways. Our profile book has been looked at only once, and we still don't have an answer if we were chosen. We applied for two situations of already-born children with a private attorney, which didn't pan out. I have looked into numerous situations through other agencies and private attorneys that have never worked out.

As 2013 has ended and we begin to walk through 2014, we continue to wait. We want the situation that is best for our family, so we accept continuing this chapter. Over the past several months, we've explored adding other routes in addition to our local agency such as signing on with other agencies, doing private networking, and some other routes.

Please pray for us to make wise decisions. We really don't want to get in debt or jump into a situation that isn't right for our family. I appreciate those of you who pray regularly and provide ongoing encouragement!!

And, for a summary of this blog for 2013, here are the top 5 posts (most read):
5. My Lucky Day- Probably the most stressful day in our journey so far.
4. Genes, Mental Illness, & Adoption- The scholar in me loves some good research.
3. Situation #1- We had so much hope when we overnighted that thick packet to Florida...
2. Work Family- We were shown love by my generous co-workers!
and the number one most-read post of 2013 is...
1. Profile Photobook- Our hearts in book form!

And for 2013, we've had over 6,500 views!

To-Do

I crave planning and lists. Procrastinating makes me nervous. So, I compiled a to-do list for things to do once the homestudy is done... while waiting, once matched, and after placement. Please feel free to suggest anything I should add. Also, feel free to make copies of this list. Hope it helps!

Adding An Agency

We are in the process of potentially adding ourselves to the waiting list of another agency. It's another fairly locally based agency. We basically pay an application fee to get on the list, and they will use the homestudy we already have. We will stay with our primary agency, too. This doubles our exposure. There are other ways to do this (like networking websites, word of mouth) that we are not all together opposed to, but adoption is like going to a casino... it involves financial risk, and you have to weigh your risks.

Adding to another agency
Positives: It is a non-profit agency so we don't lose any money if an expectant/birth parent changes their minds. They have a lower amount of waiting families and a higher amount of placements per year.

Negatives: The placement fee (if we get a placement through them) is significantly higher than the agency we are with now.

We're going to make a financial plan to make sure it would be feasible to adopt through this agency, if we were chosen. If we figure something out, we will be sending that application on in.

6 Months of Waiting

Another month has passed with absolutely nothing happening with our profile. Our book is still sitting very lonesomely at our agency. We've been waiting exactly six months since our homestudy was approved. It's been two years since we began the journey to be parents (5 months with the fertility center, 2 months of transition, 8 months in foster care, and 10 months with our current agency).

This month has been discouraging in many ways. Our agency has made so few placements this year and has added so many families that it would take 4 years for just the current waiting families to each receive one placement (For comparison, I think around this time last year when we were researching agencies, the wait was about 2 years based on the number of waiting families and average placements they had been doing).

Things weren't totally still this month, though. We did get a homestudy addendum... or partially, anyway. Our agency added some new situations we are open to, but they left out some situations we were originally open to, and they checked off the box that said we are certified for international adoption. So, the hopefully correct addendum part two should be mailed soon.

This month, I applied for two adoption grants. We should know if we receive them by January. We also canceled our gym membership and switched from cable tv to satellite tv (these two changes will save us about $1,500 over the next 12 months). We are trying to do all that's in our power to be completely prepared when a situation does present itself.

On another positive note, even though waiting is hard and making decisions when there are thousands of paths is exhausting, life is still wonderful. This is my favorite time of the year... and I've indulged in two bonfires, a Halloween costume party, and doing some photography for a dear friend in beautiful fall scenery. I still need to get to Dairy Queen before the end of the month for my beloved Pumpkin Pie blizzard!

Gardening

I got some disheartening agency news today. It makes me question if we are waiting in the right place. Pruning can be a good thing sometimes, right?

"I am the true grapevine, and my Father is the gardener...He prunes the branches that do bear fruit so they will produce even more...Remain in me, and I will remain in you. For a branch cannot produce fruit if it is severed from the vine, and you cannot be fruitful unless you remain in me".- John 15:1, 2b, 4 NLT

Genes, Mental Illness, & Adoption

Under normal circumstances, once one conceives a child, they pray for 9 months that the child is healthy and happy. There are no guarantees in life, but there is a definitive time frame for resolution (once you're pregnant... there's no going back) and fewer choices (usually you combine your and your partner's genetics and what happens, happens).

In adoption, you open yourself up to so much uncertainty. You have to make so many decisions. It's both an emotional and logical process to decide what situations you are comfortable with and how to proceed: what type of adoption? race? family history of mental illness, medical conditions, or intellectual disabilities? STDs in expectant mom? criminal history in family? conception through traumatic circumstances (sexual assault, incest)? when and what to tell child about adoption? what to tell others about child's history? how much contact to have with birthfamily after placement?

These are all things we discussed with our caseworker during the home study process and decisions we made. Obviously, it can't be decided lightly. I did a lot of research. One of the big decisions is how to proceed considering mental illness the in birth family.

Genetics of mental illness is not a cut and dry science, and research is always coming to new conclusions. I want to compile some facts and considerations to hopefully help others who may be in the adoption research process:

-Although the exact cause of most mental illnesses is not known, it is becoming clear through research that many of these conditions are caused by a combination of genetic, biological, psychological, and environmental factors -- not personal weakness or a character defect -- and recovery from a mental illness is not simply a matter of will and self-discipline. Source  

-Many mental illnesses run in families, suggesting they may be passed on from parents to children through genes. Genes contain instructions for the function of each cell in the body and are responsible for how we look, act, think, etc. However, just because your mother or father may have or had a mental illness doesn't mean you will have one. Hereditary just means that you are more likely to get the condition than if you didn't have an affected family member. Experts believe that many mental conditions are linked to problems in multiple genes -- not just one, as with many diseases -- which is why a person inherits a susceptibility to a mental disorder but doesn't always develop the condition. The disorder itself occurs from the interaction of these genes and other factors -- such as psychological trauma and environmental stressors -- which can influence, or trigger, the illness in a person who has inherited a susceptibility to it. Source

-Researchers say there seem to be hundreds of genes involved [in the development of mental illness]. Source The brain is the most complex object of investigation in the history of biological science. Its development depends on complex, often non-linear, gene–gene and gene-environment interactions, as on stochastic processes associated with the interconnection of 100 000 million or more neurons. Source

-It is well established that the risk of mental illness runs in families. Family, twin and adoption studies have shown that, for schizophrenia, autism, manic depressive illness [bipolar disorder], major depression, attention deficit hyperactivity disorder, panic disorder and other mental illnesses, the transmission of risk is due to heredity. Source 

Depression: 

-Twin studies have recently concluded that the heritability of depression is about 40 percent. This may sound fairly high, until you realize that heritability refers only to an underlying risk of depression, not to depression itself. Source

-Biology is not destiny: a child born of any parent (depressed or not depressed), has about a 16.5 percent (one in six) chance of experiencing a depressive episode during his or her lifetime. Source

-Depression is not a single phenomenon, which makes it all the more difficult to figure out the cause.

What’s clear is that for most people, depression appears to be more a result of environment and experience than of one’s inherent nature, which means that “upbringing,” to use an old-fashioned word, still matters. If you do things halfway right and there are no unforeseen traumatic occurrences, like crucial losses or undue stresses, chances are good — better than 50-50 — that the child of a depressed parent will grow up to be a nondepressed adult. Source

Bipolar disorder

-Studies report rates of bipolar disorder between 4% and 15% in children with one bipolar parent, compared to 0% to 2% in the offspring of parents who don't have the disorder. And if both parents are bipolar, rather than just one, a child is about 3.5 times more likely to develop the condition. Source

-Some hereditary factors are strong indicators of whether someone will develop bipolar disorder or not. Identical twins have a 70 percent higher chance of developing bipolar disorder. If one parent is bipolar, there is a 7 to 10 percent higher risk of getting bipolar disorder. If there are two parents, there is a 20 percent chance of developing bipolar in the offspring because of the multiple genes. Source

Schizophrenia  

-Schizophrenia definitely has a very significant genetic component. Those who have a third degree relative with schizophrenia are twice as likely to develop schizophrenia as those in the general population. Those with a second degree relative have a several-fold higher incidence of schizophrenia than the general population, and first degree relatives have an incidence of schizophrenia an order of magnitude higher than the general populace. It is of much interest, though, that the correlation of schizophrenia between identical twins, who have identical genomes, is less than one-half. This indicates that schizophrenia is NOT entirely a genetic disease. Source

 

Other Things to Consider When Adopting:

-Having mental illness does not mean your life is over. Many people comply with treatment and live healthy, functional lives.

-Like stated above multiple times, genetic predisposition alone is often not enough to trigger illness. Although this is strictly anecdotal, my experience with folks who with are acutely ill and are in a state of very poor functioning is that the majority have a great deal of trauma and dysfunction in their past (abuse, very stressful family dynamics) and many are co-occuring meaning they use substances (although it's a chicken or egg question- did they use to self-medicate for symptoms they already had? or did their use trigger symptoms?). I think in making your decision, you can't look at just statistics alone, you must look at the environment you hope to provide. Stable environment doesn't guarantee anything but it negates risk.

-Consider the accuracy of self-report. The majority of information provided to adoption agencies from expectant parents is self-reported (possibly for themselves, most likely for the rest of their family). I am not saying the expectant parents "trick" the adoption agency, but it is very common for people to assign themselves diagnoses they have heard about or that a practitioner may have casually mentioned as a possibility (or as a soapbox, as a PCP may have decided to treat although they should really reserve for a mental health professional- just because you can doesn't mean you should... stepping off soapbox). How many people have mood swings and say they are bipolar or have a short attention span and say they are ADHD or are a perfectionist and say they are OCD?

-Questions to ask the agency when there is a family history of an illness: Who made the diagnoses and when? How does the illness affect their functioning- on disability? attempt suicide? frequently hospitalized?  Information like this may give you a better picture of what is really happening.

-Ultimately, you have to do what you feel comfortable with and equipped to handle. Talk with friends and family who you trust. Schedule a meeting with a doctor or mental health professional to discuss your concerns. Examine what support and resources are in your community if your child were to develop a chronic mental illness (eg: if you live in a very rural area, there are probably few resources).