Tuesday, 01 July 2008

Bits and pieces of hope

Some interesting articles relating to infertility recently. Here's a digest:

1. Potential for a new kind of pain relief - aromatase inhibitors (those currently used in treating breast cancer) have been shown to be very effective for relief from endometriosis-related pain.

2. PGS does not improve pregnancy rates, or reduce miscarriage rates. The British Fertility Society strongly recommends it is not offered to women unless as part of a defined clinical trial. I think we kinda knew this one - I've certainly seen comments to this effect, but important if your doctor is currently suggesting it.

3. Australian scientists are engaged in a long range study to look at what genes are expressed in blastocysts, and how these vary between blastocysts which turn into live take-home babies, and blastocysts which fail to implant or to turn into embryos which survive through the pregnancy. Very interesting story, which has already identified (no shit Sherlock) that genes involved in cell adhesion, cell communication, and response to stimuli, are all involved. They've also found that up to 20 cells can be removed from the cell lining layer of a blastocyst with no adverse effects. They are aiming to promote single embryo transfer - but arguing that for this to be widely accepted, couples need to have greater faith that SET is likely to work. What I don't quite get is how to transfer this to the clinic setting, as you would presumably have to do the gene amplification within a day so that you could put the blasts back before they start trying to implant. Or perhaps they plan to work backwards so that you could take a cell from a day 3 embryo and test it against their findings.

4. In the realm of "Thalia feels very smug," a finding that many doctors are moving away from ever recommending IUI, and going straight to IVF, which in the long run is often cheaper and less traumatic for couples as it's more likely to work. I've always thought IUI is a waste of time, given how little it improves your chances over trying alone, even with the addition of clomid and/or injectibles. It's also more likely to lead to higher order multiples in the hands of over-eager docs in the US, so a good thing if it's on the decline. Old-fashioned technology.

5. Data that says that IVM may not be the way to go in many instances. Eggs matured in the petri dish have a different pattern of development than those matured in vivo. Which also means that labs should be working to develop culture media that better replicate the ovarian environment.

6. Feed your male partner folic acid. It reduces the level of DNA abnormalities in sperm.

Wednesday, 25 June 2008

We're back on

This used to be an infertility blog, right? Anyone ready for a return to the regularly scheduled freak-outs that that topic encourages? Yes? No? Well, it's coming anyway.

I seem to have neglected to blog about our visit to Dr Candour when Pob was about five and a half months old. He told us not to stop breastfeeding in order to get pregnant - that a few months would not make a big difference, and no one ever wished they'd breastfed for less time. He considered that we had a good chance at number two, given that I've responded fine on three IVF cycles, we have a few embryos frozen (I think about 6 although some are crappy looking), and Pob is the evidence that there are good eggs in there somewhere. He ordered an hsg and a scan for when my periods had returned, and we went away happy.

I've now had three periods since I stopped breastfeeding. Each time I've had clear signs of ovulation, we've made the most of that opportunity, and my period has sadly showed up 12-13 days later. I'm back on my usual schedule. I had the hsg and the scan during my last cycle, and both were fine. The scan even showed a very healthy set of antral follicles - at least 5 on each ovary - which delighted me.

We reviewed those results with Dr Candour yesterday, and agreed that the next step was a fresh IVF cycle, starting with my next period. It all seems a bit sudden to me. And oddly enough, while I have hope each month we try that I'll get pregnant again spontaneously, I'm not that hopeful about an IVF cycle. Dr Candour says their stats for women my age are 22% for an IVF cycle, whereas the chance for trying naturally is certainly no higher than 10%, if that, so, in his words, "IVF is a lot more efficient in a specific month than trying on your own." He recommends trying a fresh cycle, partly to see what my ovaries are capable of, and partly to keep those frozen embryos in reserve, given that they aren't getting any older, while my ovaries clearly are. He also recommends trying as soon as possible, because at this point, months probably do count.

This was the same conclusion H and I had come to before we showed up in his office, but I left the meeting yesterday feeling just matter-of-fact - this is something we have to try, not something that I put a lot of hope in. Which is correct, because 22% isn't that good a statistic, no? And let's face it, IVF hasn't exactly been the golden ticket for us previously.

So I've got the prescription, and we've got the consent forms, and H is off to do a sperm test early next week. I really really want another baby. I have hope that there is a possibility we might have one, not a lot of hope, but some. I'm just not sure that IVF will get us there. But it's worth a try.

Sunday, 22 June 2008

On a lighter note

The UK cover of Lauren Weisberger's latest (it's not nearly as good as 'The Devil wears Prada,' I wouldn't bother) has a rather nice diamond ring on it
Harry winston uk



















The US version, however, has three, rather larger ones.

Harry winston us



















What does this say about our cultures?

PS I think I like the green shoe better. You?

Saturday, 21 June 2008

Hillary and Feminism

So I owe you all a response to those very thoughtful comments on my Hillary post. I'll let you know where I ended up, but I'm a little worried that (i) I remain not terribly well informed on this, and (ii) not terribly well informed on up-to-date feminist theory - it's a long time since I read any. So please forgive any errors.

I think at least part of the reason that Hillary lost is due to misogyny. And I think that being a feminist means voting for/selecting/appointing a female candidate wherever possible - yes, even if the male candidate may, in some ways, look more qualified (although no, of course not if the woman candidate is clearly unqualified). You have to dissect why he looks more qualified and bear that against generations of prejudice. And no, I don't believe this weakens women and their cause. If you look at it the other way round, for hundreds, if not thousands of years in most positions, people (men) have believed they have a good reason for appointing a man. Of course he is better qualified. He is more rational. He has greater vision. His experience goes beyond hearth and home and raising children to issues of state. He is more intelligent. And so on. Some of these world views persist into today, almost without our noticing them. So we have to work to redress the balance, and only then we can go into a contest and not worry about gender, because we'll know that there is no aspect of our gender biases biasing our decision. But until women are 50% of the decision-makers in any particular institution, we are not equal, we are not being judged equally, and we should be aware of that and make decisions accordingly.

Let me tell you a story. My mother is an academic. In the late 1970s and 1980s she was a lecturer at a UK university. In early 1980 she was up for a promotion to senior lecturer in her department. She didn't get the job. When she asked for feedback, she was told that although she had been one of the two strongest candidates, they gave the job to the man concerned because after all, he had a family to feed. At the time my mother had 3 children. In 1983 she acted as head of department for a year while the existing head of department took a sabbatical. But she wasn't given the title head of department. The assistant to the old head of department told her she had taken minutes in the meeting where this was discussed, and the powers that be had decided not to formally appoint her interim head of department because if they had, she would have had to be appointed to the university's guiding council, and she would have been the first woman there and they didn't want to set a precedent. In 1983. In 1986 she applied for a year's sabbatical and was denied as her teaching contribution was thought to be too important. Despite the fact that her direct contemporaries had both had a sabbatical in the last 3 years.

Yes, that was 25 years ago, but that's just one generation of university graduates, do you think we have removed ALL those attitudes just yet? I deal with sexism every day at work, in little ways. Much much less so than my mother, but present nonetheless. When one of my colleagues calls me 'strident', do you think he would make the same comment about a man? Have you looked at the composition of the boards of the Fortune 500 recently? At the composition of the US Senate? Of the UK House of Commons? Until those attitudes are all gone, I do think it is our responsibility to do whatever we can to redress the balance.

And yes, black men were often not included in that power base, so I quite see that this applies to discrimination against blacks as well. But in this case, I think the comments made against Obama (mostly) did not come from the world view that he had fewer of the qualities required for the job because he was black - almost the opposite. Whereas the concerns raised about Hillary did come from that world view. She's too aggressive. She's too political. She's not warm enough (aka, I don't like her enough), - not to mention those which were obviously sexist - calling her 'Mrs Clinton' where the other candidates were referred to as 'Firstname Lastname', jeers at debates of 'iron my shirt'. As this article at MSNBC points out, a jeer of 'shine my shoes' was never made at Obama. Racism is perhaps easier to spot, these days. None of those concerns would have been raised about a man. Yes, some of the concerns about her - particularly her earlier vote on the Iraq war and how she spoke about that subsequently, and the comment on the last post about how Hillary hadn't responded to a constituent - seemed quite gender-free. But many were not.

I also didn't think the comments about a Clinton dynasty were fair. She's married to the man, not descended from him. She's established a political career in her own right, using her own skills. I imagine that for some voters, the fact she had Bill on her side was a bonus, but for many others I imagine it wasn't - so I don't think it's reasonable to not vote for her because she is married to a politician.

So while I agree that misogyny wasn't solely responsible for her defeat, I absolutely believe that it was a contributor. Obama has clearly touched something that Americans need right now - a vision, an inspiration. But 'more qualified'? No, he simply isn't. He has less experience, and getting stuff done in politics takes experience. Many of his policies have less thinking behind them than Hillary's. I understand voting for the inspiration. I just don't know what a woman - any woman - would have had to have done to be seen as that kind of leader. It may be that Hillary just doesn't have the right skills to touch that nerve, but I also believe that as a woman, she had her work cut out for her to be seen in the role of visionary leader. People didn't want to see her in that role, they wanted the nurturing, emotionally open, vulnerable woman who displayed her feelings near the end of the campaign - and her numbers went up. But I don't think that's the whole story of who she is, she didn't maintain it and it was probably too late anyway.

So that's what I think. You all helped clarify my thoughts a lot, so thank you. I hope this won't be seen as an attack on any of your comments, you all voted thoughtfully, with concern for your country and the world as a whole. I'm someone who is watching from the outside, someone with a particular world view, and this is just my opinion.

Thursday, 19 June 2008

Another step away

Pob has been trying to crawl for about two and a half months now, if you start counting from the time she started getting on all fours and rocking backwards and forwards, as if she was a dinky toy and trying to wind herself up enough that she'd eventually start moving. She has yet to actually crawl. What she did learn to do about 10 days ago was to pull herself along the floor on her arms. It's as if she has designed the most energy-inefficient model for movement, just specially to make life difficult for herself. She gets onto all fours, rocks backwards and forwards, sometimes moves her legs forward, sometimes moves an arm, then collapses down onto her tummy, and pulls herself bodily across the floor, as if she was a little mini-soldier, crawling under the barbed wire.

Until this morning, the only time she would actually move was when there was something she's not allowed to play with within body-distance - a coffee cup, a blackberry, a phone, a remote control, or some paper (any paper, she's not really fussy). Then she can move like lightning. If we put her on her tummy without one of these things being within 2 meters or so, she just wails. Then this morning, I walked in the door and she immediately wiggled out of H's arms and started pulling herself across the floor, to me. I've rarely been so gratified. And delighted, because I hadn't seen her for 48 hours.

Yup, I just left my baby for the first time. It was very very hard in the anticipation, and I missed her ever so while I was away, and I started nearly crying this morning when the usual mess up occurred at Heathrow and we couldn't get off the already-delayed-by-2-hours plane. But actually, while I was away, it wasn't too bad. I went a long way, to a meeting which wasn't that good, but where I got to have some important conversations with some people who have a lot do say about my future career. So it was worth it. I missed her, but it was ok, better than I thought it was going to be. We coped. I'll be away from her again soon, it's just a fact of my job that I have to travel. But now I know I can do it, hopefully the anticipation of the next trip won't be as bad.

Tuesday, 10 June 2008

Something to celebrate

Thank you so much for all the thoughts on my last post. They've made me think a lot and I will get back to them, but I feel drawn to do something else in the meantime.

As most of you know, an expectant mother has recently chosen the lovely Flicka and Sarge to be parents for her baby boy, to be born in 2 weeks' time. Flicka hasn't shared the details but I'm guessing that the mother is very clear she will not decide to parent given the way Flicka is writing about things.

Flicka is away and hasn't had the chance to register properly, so I think we need to throw her a proper internet shower. Here is the link to what is on her registry, but there's other stuff they will need which isn't there yet. So please email me if you want to participate, and we can discuss how best to meet their needs.

Monday, 09 June 2008

I need an explanation

Dear Americans and those of you following the US democratic nomination process. Could you let me know what happened to Hillary? Because from my uninformed position it looked like a lot of misogyny and I'm a bit stunned that all these impressive Americans I know, particularly women, decided in the end that Barack Obama had more to offer. I do fervently hope that he wins, but I'm very sad that she didn't get the nomination. I'd love to understand what went wrong.

You are not alone


Journeying for the second time


On their way


Been there, done that


Didn't need to go there


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