Conversation Etiquette For Your High School Reunion

My 15 year high school reunion is coming up and I have to admit that I am excited about it, for the most part. I had a great time in high school and was actually really sad to graduate. I went to an all girls private school in the suburbs of New York, and it was the best decision my parents ever made for me. I am looking forward to seeing my classmates, some of which I haven’t seen since graduation.

The part I am not that excited about is the inevitable awkward questions that may arise from people I don't really know anymore. Recently hit with the knowledge that I cannot have any more biological children, I am dreading the seemingly innocent question, “So are you going to have more kids?” That got me thinking about all of my other classmates. I am sure there are painful and taboo topics that they all are struggling with in their own lives. Life is really hard for everyone for all different reasons. I am sure they have questions that they may be dreading getting asked themselves. It is not uncommon for women in their thirties to deal not only with infertility, but divorce, unemployment, illness, and loss of a parent, among other things. I came up with a list of ten questions to avoid asking others when mingling at your high school reunion.

Questions to Avoid Asking Others At Your High School Reunion

1.“Do you have kids? Are you planning on having kids (or having more kids)?” You never know who is struggling with infertility, lost a baby, had a miscarriage or just decided for whatever personal reasons they are not having kids. If people have kids, they will share it; if they don’t have kids, your high school reunion is not a good time to explore why, because this topic could be painful.

2. If someone has multiples, don’t ask them, “Did you have fertility treatments?” Even if you are undergoing fertility treatments yourself, that is still a highly personal question to ask someone else. The truth is that many multiples exist without treatments. And many people who have multiples with the help of fertility treatments do not want to share their story.

3. “Oh you have a baby? Are you married? Are you getting married?” People have babies and do not get married to the biological father for a multitude of reasons. Again, the school cafeteria is not a place to grill these hard working single moms about their personal lives.

4. “You have how many children? Oh my goodness you must have your hands full!” Don’t make moms who have big families feel alienated. Congratulate them on their family and ask them how they are doing, rather than assume how their lives are going.

5. “How are your parents doing?” I know many friends who have lost parents since graduation. I also have friends whose parents are dealing with serious illnesses. A better question is, “How is your family doing?” This allows room for the person to say, “They are doing great” without feeling like they have to open up.

6. “Where do you work?” I know it seems like an innocent question, but for someone who may be unemployed, whether recently or not, it could be painful and awkward conversation for them.

7. “Oh my goodness have you lost weight?“ “Have you had work done, you look so different?“ Don’t comment on people’s looks unless it is to say, “You look great.” Some women have gained weight since high school, some have lost weight. Some people have not aged at all, and some may have had a hard couple of years and look much older. Best not to say things like, “You look so skinny now” “You were so skinny in high school” “Wow I wouldn’t have even recognized you.” We all try to look our best at the reunion and we all have insecurities about how we looked in high school and how we look now. It is best not to bring any of those insecurities to the surface.

8. Don’t ask single people, “Are you dating someone?”. If there is someone special in their lives, they may talk about that person, but they also may choose not to. It is also a possibility that they just got out of a relationship or haven’t found the right person yet.

9. If a single person is dating someone, don’t ask her, “Do you think you guys will get married?” If the couple is planning on getting married or moving in together, she will choose to share that information if she wants to. I remember when a friend of mine was waiting for that engagement ring while everyone else around her was getting married. It was torture. The only thing more torturous was everyone asking, “When is he going to propose?”.

10. Finally, don’t ask questions like, “Remember when you fell off the bar with your pants down and vomited all over the police officer?” or “Remember when you got your period in gym and we called you “Bloody Mary” for the rest of high school?” Chances are that person will NEVER forget the most traumatic or embarrassing day of their life, but through therapy and personal growth they have moved on from the experience. It is probably best not to re-traumatize that person.

High school reunions are one of the only times the policy, “Don’t Ask, Don’t Tell” is a good idea. Instead of talking about the present or asking about the future, it may be best to talk about the past memories and good times you had with these people in high school. Have fun and keep it light!

Coming Home Empty Wombed: Our Final Infertility Journey

Three years ago, my husband and I found out that I have a translocation, which is a genetic mutation with the majority of my eggs that leads to recurrent miscarriages or a baby with fatal birth defects. Three months ago, my husband and I found out we are not able to have any more biological children. The first diagnosis was really hard to accept, but we were grateful that we finally had answers as to why I had suffered three miscarriages in a matter of five months. Our most recent news, though devastating, offered closure to a difficult eight year journey battling infertility.

Between the fall of 2008 and winter of 2009, my husband and I had gone through so much to get pregnant. Though conceiving my daughter in 2007 was by no means easy (we used IUI to get pregnant), I couldn’t understand why I kept miscarrying during that following year. In January 2009, my husband and I had tried, for the first time, using IVF to get pregnant that cycle. The doctor let my embryos grow for five days before transferring one into my uterus, and then he cryogenically froze the rest of them. At the time, I was grateful to not only have this one embryo implanted in me, but to have six others frozen for future pregnancies.

Needless to say, the IVF resulted in a miscarriage -- my third in five months. It was then that the doctors decided to send my blood work to be tested for a translocation, which they suspected might be the reason for all of my miscarriages. The translocation diagnosis came back positive, and the doctor said that the only option left for us to have another biological child was to undergo another IVF and then, when our embryos were three days old, get the embryos biopsied and tested for the translocation. If any of the embryos were viable, then they would be transferred to my uterus. I felt overwhelmed by the process, but grateful there was a solution. Geneticists and doctors seemed hopeful that I had a good chance of having a healthy baby with this option.

I asked my doctor about the embryos from my first IVF, the six I still had frozen. My doctor told me that they could not be tested because they were frozen on day five, which means they were too advanced to undergo the long test for translocation. If I just had the embryos transferred without testing them, I would most likely have yet another miscarriage or risk having a stillborn baby or a baby that would die soon after birth. We ultimately decided to keep the embryos frozen, with the hope that in time, medical advances would lead to the possibility of safely testing 5-day-old embryos for translocation.

Three years went by and my husband and I continued along an arduous journey. We had two more IVFs done, resulting in 28 biopsied embryos. We also had one naturally occurring pregnancy. All of the biopsied embryos had the translocation and were not viable, and the naturally occurring pregnancy resulted in my fourth miscarriage. We decided that we were done with IVF treatments. Now we only had the matter of our six frozen embryos to figure out.

According to my doctor, and many other doctors I consulted with, our only solution was still to transfer to my uterus three embryos at a time and hope they didn’t have the translocation and would lead to a viable pregnancy. Because I knew the odds were that they would not be viable, I was hesitant to sign myself up for a possible fifth and sixth miscarriage. Yet, I wasn’t ready to just assume they were not viable. I couldn’t just discard them. I still had a shred of hope; what if one of them were good? What if one of them would turn into the little person we were waiting for?

I tirelessly researched the internet trying to find another solution. I started reading about doctors in Australia who were routinely doing biopsies on five day embryos with great success. This gave me hope. I then found an amazing genetics lab in Chicago, called the Reproductive Genetics Institute. I contacted them immediately and talked to one of their genetic counselors. They are innovators in their field. They told me that not only do they routinely do biopsies on five day old embryos, but they had the facilities to test the embryos for the translocation and also transfer any healthy embryos, all on site. My dream from three years ago of testing the 6 frozen embryos was now a real possibility.

The process was not going to be easy. I had to prepare for an embryo transfer just in case there was a viable embryo after testing. Since I would be doing the transfer in Chicago, but preparing for the transfer here in New York, I had to work carefully with both teams of fertility specialists and make sure they were always on the same page. And we had to ship our embryos from New York to Chicago, which was scary and traumatizing. Talk about a fragile package!

The time leading up to our trip to Chicago was grueling and emotional. Physically prepping for the transfer was difficult for me. I had to take shots of pure estrogen, which didn’t agree with my system and left me very emotional and tired. Every day would bring more phone calls I would have to make to ensure that everything would be in place for our trip. Some of what I was trying to accomplish had never been done before in this way. But somehow the logistics all fell into place. I am grateful to the countless number of people who made this difficult ordeal easier by their professionalism, their sense of humor, their positive attitude and their compassion, especially to those at Westchester Fertility in New York and the Reproductive Genetics Institute in Chicago.

Finally the time came to fly to Chicago. The first step in testing the embryos is unfreezing them and seeing if they survive the thaw. Right before we boarded the plane, we got word all six survived and were looking great. Upon arrival in Chicago, we waited in the hotel for the phone call from the Reproductive Genetics Institute. This call would tell us whether the 6 embryos that were being tested were viable. It would tell us once and for all if we had a shot at having any more biological children.

We had prepared the few people we told for bad news. The truth was that all of the pregnancies I had had, and all of the embryos that were tested, were not viable, so the chances werethat these would not be viable either. Our parents told us not to be so negative, to have hope. It could work out. The embryos could be good. We had one daughter already after all. If I was being completely honest with myself, I would have to admit that I really did have hope. On the flight out to Chicago, I couldn’t help but hope that I would have another passenger growing and hopefully implanted inside of my womb on the flight home. When I got pregnant with my daughter through IUI in 2007, I remember seeing six eggs in the scan right before the insemination. She ended up being one of those lucky six that made it. Now we had another six embryos being tested. One of them definitely could be lucky.

I also started to feel like I was in a Lifetime movie. We had been through such a difficult journey these past few years. Almost always in the movies, the characters hit rock bottom, but through perseverance, hope and determination, things seem to turn around. I had thoughts of the hundreds of people who all did their part to get me to this point, from the doctors and their staff, to the person making sure the embryos were delivered safely, to the flight attendant who got me to Chicago. This was it, the moment we all had worked for. I kept thinking how wonderful it would be to surprise our friends and family with pregnancy news around the holidays as I would be just ending my first trimester. I would then recount the epic story of how it all came to be.

My husband and I were watching "The Hangover 2" in our hotel room when we got the call, much earlier than expected. As if the movie wasn’t punishment enough, more bad news was coming our way. None of the embryos were viable. That was it. It was over.
Tears were shed for our lost embryos and ultimately for our lost dream of having a family in the way we always thought we would. We had been mourning this dream for a long time now, and mentally had expected this outcome. This was the final piece that was left to be resolved. This was our closure. We now had officially done everything physically and humanly possible to have more biological children. But it just wasn’t meant to be.

I was sad for weeks and both emotionally and physically drained from the whole experience. I have to say, though, that I also felt immediately grateful and relieved to be officially done with my journey with infertility treatments. I feel a lot lighter knowing that I am done with tests, shots, doctor appointments, arguing with insurance companies, dealing with pharmacies, surgical procedures and just feeling like my body is not mine. I have recently been talking to friends going through infertility and I can see the physical toll all of this takes on them. I was that person for over eight years.

Most of the crying I did in the hotel room in Chicago following the news was truly tears of gratitude for my daughter. I don’t know how she got here to us. She is amazing, healthy and happy, and she brings so much joy into the world. We are so very lucky to have her. If we choose not to expand our family through other ways, we still will have more love in our lives than we could have ever imagined. We are certainly blessed.

My husband and I had gone out to Chicago on a hope and a prayer that our crazy plan could work. We came home hoping and praying that time would heal our hearts and open them to whatever was next on our journey. Now that three months have passed since our return from Chicago, I can say that I am doing better. I feel stronger, more hopeful and happier than I have been in a long time. I am looking forward to a 2012 that doesn’t involve surgeries or daily vaginal ultrasounds. I was very happy to give away all of my maternity clothes. My family and I have two goals in 2012, to have more fun and to see where this broken road may lead us. And I have a feeling my Lifetime movie will not end here.

Coping with Loss and Infertility Around The Holidays

Loss is a difficult thing to deal with at any time, but around the holidays, when it seems like a requirement to be cheery and happy, dealing with loss seems that much harder. Having suffered four miscarriages myself, I know it is hard not to think about the “could haves”, “would haves” and “should haves” of life and of course, the “what ifs”. I am sending my love to all of those who have suffered through pregnancy loss and who are dealing with infertility this holiday season. Know that you are not alone.

The Occupy Uterus Movement: An Infertile’s Thoughts on The Duggars’ 20th Child

I am protesting the latest pregnancy announced yesterday by the reality show stars, Jim Bob and Michele Duggar. At the risk of sounding like a sore loser, their pregnancy makes me angry . I am not proud of this statement, but the fact that they are expecting their 20th child makes me feel like a teenager whose prom date left her there for another girl.

I don’t know much about the Duggars, but what I surmise from their situation is that they seem to be nice people. They don’t abuse their children as far as we know. Their children seem to be polite, educated individuals who will most likely grow up to be contributing members of our society. The Duggars can afford to have many children. Their children aren’t starving or neglected. They have a home big enough to accommodate such a large family. There are those of us who may question their ability to be there as a parent to each individual child, or challenge the fairness of the roles the older siblings play in the younger siblings' lives. But for the most part, the way they live as a family seems no more or less destructive than other families .

So why does this make me angry? Oh wait, maybe it is this quote taken from cbsnews.com, “The 45-year-old mom told the "Today" show she was surprised to discover she was expecting at her age. 'I was not thinking that God would give us another one, and we are just so grateful.'" They have openly stated that they leave their family planning to God. Well, why isn’t God handing out babies to me? Why do they get 20 babies and I only get one baby? Having suffered through infertility, I have had to leave my family planning up to God, my reproductive endocrinologist skilled surgeons, and many genetic labs and geneticists across the country. Even with all of those hands working on my and my husband's situation, we have come up empty handed in our quest to expand our family.

So am I really mad at the Duggars? Probably not. If I didn’t suffer from endometriosis and have a genetic defect with the majority of my eggs, I may have popped out 24 kids and had my own reality show. So does this mean I am mad at God? No, because unlike the Duggars, I don’t think God “gives” people children. If he gave people children, it would mean he would also purposely not give people children, or take them away. That is not the God I believe in.

So who I am angry at? I think I am just angry at my situation. It sucks that I have had four miscarriages and had over 30 embryos tested, all genetically unviable. It sucks that I cannot have any more biological children. It sucks that my husband and I have had a long, exhausting journey with infertility. It sucks that my daughter will never have a sibling. And it sucks that I have no one to blame.

When I hear the Duggars are expecting their 20th child, it reminds me of my inability to have more children. I feel like protesting the fertile inequality when you compare their family and my own. Maybe I should make an “Occupy Uterus” sign and set up camp. In reality, if I thought setting up a tent outside their compound would land me a baby, I would. But it won't. I know on some level, sometimes, we all need to vent about how life is hard and sometimes unfair.

The truth is, there are probably a lot more people who have more of a right to whine about how unfair their life is. I have a beautiful daughter, who somehow made into our lives, despite all of our infertility issues. I have a supportive husband, who often listens to me whine without complaint. I have a roof over my head and besides an aching desire to have more children, not another complaint in the world. I am pretty lucky, all things considered. Even if I could trade lives with Michelle Duggar and have the mystical power of being able to produce babies with the blink of an eye, I wouldn’t. Though I have had a difficult journey and carry some sadness and pain over my infertility issues, I have to have faith that I am exactly where and who I need to be at this moment.

Top Ten Signs You Are Going Through Fertility Treatments

10. While driving to the store, you start sobbing when you hear Demi Lovato’s new song “Skyscraper” on the radio.


9. You write your father a 100 word emotional, sappy birthday message…on your face book wall.

8. Your husband wears two different shoes to work--two days in a row.


7. If the fertility treatment does not result in a pregnancy, you’re considering a career in the adult film industry with your new hormonally enhanced breasts.

6. You cut off all contact with family and friends, and limit your contact with the outside world to watching shows on the WB.


5. Instead of playing minesweeper or solitaire, these days you procrastinate by obsessively calculating your potential due date on various pregnancy websites.

4. The ultrasound technician at your fertility doctor’s office has seen you more with your pants off than your husband has.


3. You declined an invitation to your co-worker’s baby shower due to a serious, highly contagious, mysterious virus you suddenly came down with.

2. You haven’t cooked a meal or gone grocery shopping in weeks.


1. Your parish priest slips you a drug intervention pamphlet on the way out of church, after noticing the needle marks on your arms and legs from all the blood tests and injections.

The Infertile Egg Hunt Part 2 of 4 : Egg Donation

In the past three years my husband and I have suffered four miscarriages and have had 28 embryos genetically tested, only to find out they were not viable. This is because I have a translocation, a genetic mutation which causes the vast majority of my eggs to be genetically unsound. Egg donation, embryo donation and adoption are the only options left for my husband and I if we want to expand our family. This week I talked to Dr. Michael Blotner, Medical Director of Westchester Fertility, about egg donation. Dr. Blotner and his caring staff helped me get pregnant with my daughter four years ago. He was gracious enough to answer ten questions I had about the process. Egg donation is a viable option for women like myself, who can carry a baby to term, but cannot provide quality eggs.

What type of fertility issues would cause a woman to consider egg donation?The primary reason for a woman to seek an egg donor would be infertility caused by a very low egg reserve, which also implies a decreased egg quality. This will be reflected in an elevated FSH (follicle stimulating hormone) or a low AMH (anti-mullerian hormone). Also in the cases where in vitro fertilization has failed multiple times, eggs from a donor may be appropriate.

What is a snapshot of the “typical” egg donor like?
The typical egg donor is a woman over 21 years of age, commonly in graduate school or pursuing a career. While financial compensation is a central motivation, there is often an altruistic desire to help other women conceive.

Does health insurance cover any of the costs of retrieving eggs from the donor?Unfortunately, health insurance can only be used for tests and procedures that involve the recipient(not the donor). The costs include those for mandatory laboratory screening; intake appointment and physical exam; medications involved in stimulation of the donor; monitoring hormone levels and ultrasound development of the follicles; the actual egg retrieval with anesthesia and donor compensation for going through the process.

How extensive is the screening for egg donors? Are donors checked for genetic abnormalities that could cause miscarriage or life threatening illnesses in the baby?The donors are screened for sexually transmitted diseases (HIV, Hepatitis B and C, etc) as well as genetic testing for chromosome analysis, cystic fibrosis, and hemoglobin abnormalities. Other genetic tests may be obtained when applicable(ie: Tay-Sachs screening for Ashkenazi Jewish descent).

How are donor eggs retrieved?The egg donor is stimulated with injectable hormones (FSH and LH) on a daily basis from the early phase of the menstrual cycle, and she is monitored every few days by serum estrogen levels and ultrasound evaluation of the ovaries. At the same time the recipient’s uterus is being prepared with hormone supplements to ultimately receive the embryos. When the eggs are deemed mature, the donor undergoes general anesthesia for 15-20 minutes while the eggs are retrieved by transvaginal ultrasound and a needle aspiration of the eggs from each ovary.

What happens to the donors’ eggs after they are retrieved?The donor eggs are isolated in the laboratory and injected with the sperm of the recipient’s male partner (or sperm donor, as indicated). The resultant embryos are monitored and allowed to develop to an appropriate stage for transfer into the recipient’s uterus. Often extra embryos may be present to be cryopreserved (frozen) as a back up for additional attempts or future pregnancies.

Can the egg donor donate multiple times? Do the couple receiving the eggs know about the other babies that have been born using the same donor?Egg donors are allowed to cycle several times. Information regarding prior successes is available, but the specific information regarding other patients and their offspring is protected under HIPAA.

How does a person choose an egg donor?Egg donors are recruited by agencies specifically for this purpose, and are generally selected by the recipients based on shared physical characteristics, desired educational or ethnic backgrounds. Extensive family history screens are also presented for review.

What are the challenges in using a donor’s egg? (monetary, physical, emotional)Donors may be local, which makes monitoring easier, or they may need to commute or even fly from their place of origin. This requires coordination with a fertility center in their locale. This also requires lodging and accommodations for the donor during the time of the egg retrieval. This adds to the financial burden of the entire process. The recipient and her partner must also be emotionally ready to abandon the idea of conceiving with her own eggs.

What are the benefits of the egg donation process?While adoption is an option for many couples, the use of an egg donor provides the opportunity for the male partner to contribute to the genetics of the offspring. The recipient is also able to experience pregnancy and childbirth and bond with their child in that time. The chance of conceiving through donor eggs is approximately 50-60% per transfer, as opposed to less than 5% using her own eggs.

At the end of the day, egg donation is a viable option for couples in our situation. But as Dr. Blotner mentioned, there are many challenges to this option. The expense of using an egg donor is huge, costing anywhere from $25,000 to $30,000. Also dealing with the loss of the dream of having a child with your genetic makeup is something the egg donor recipient has to come to terms with. In the coming weeks, I will explore both embryo donation and adoption.

Michael Blotner, MD, is board certified in obstetrics and gynecology and reproductive endocrinology. For over 15 years, he has been helping patients in his care achieve their goal of having a child through state-of-the-art infertility treatment. Dr. Blotner has dedicated himself to providing personalized professional care in a relaxed environment. www.westchesterfertility.com

Volunteering Post September 11th, Then and Now

I have been having such a difficult time writing about my experiences on September 11th. I usually don’t write about something difficult or painful until I have perspective and understanding of the situation. I have realized that no matter how much time will pass, I probably never will understand the events of September 11th. I don’t have any have perspective. All I can think about is the pain and suffering of all of those families who lost loved ones that day. I also think about the first responders who have since died or have life threatening illnesses due to inhaling toxic fumes at Ground Zero as they selflessly worked night and day to recover the victims from the rubble. As my husband went into work this past Friday in Lower Manhattan, blocks from the site, I also still have the fear and sense of powerlessness as security is heightened due to threats made to New York City.

But in darkness, there is always light. The light I choose to think about is the heroic acts that saved lives that fateful day. I think about the amazingly strong wives and husbands who have carried their families through the loss of their spouse. I think about the countless individuals who have channeled their loss and personal tragedy into creating non-profits that strive to make the lives of those affected by September 11th more tolerable. All of these souls inspire me. They are my heroes and I feel encouraged to participate in acts of kindness and volunteerism on September 11th in their honor and in honor of those lost.

Like every person in America, I remember exactly where I was when I heard about the twin towers being attacked on September 11th. I was sitting in one of my Graduate Social Work classes at Fordham University Lincoln Center in New York City. An administrator came into class to say that two planes hit into the twin towers and was believed to be a terrorist attack. I immediately called my parents on a pay phone to let them know I was okay. I also called my weirdly calm fiance who was still sitting at his desk in his office, in the heart of Times Square. He said people were staying at work and he was going to wait and see how things unfolded. I told him I was coming down to get him.

I ran down town to get him, fighting the crowds of people who were walking uptown. When I got to his office building he was standing outside with many others, clearly in shock, watching the recap of the planes hitting the towers on the Jumbo Screen. We ran back uptown to Fordham to get my car and drove home out of the city.

I went back to my future in law’s house and watched the news for hours and felt scared, helpless and powerless. I watched the recap of the towers falling again and again. After two days of sitting watching the news, I needed to do something to help. I heard there were crisis centers set up in lower Manhattan for rescue workers and families of the missing. I thought my social worker skills could be useful. I took the train down the city and walked downtown hoping that through divine intervention I would be led somewhere that I could be helpful.

I found a crisis center at Chelsea Piers. I talked to the woman in charge of mental health there. She first said she was only going to take people already with their masters who were licensed, but for some reason she let me stay. I first worked with families who came looking for information regarding their missing loved ones. We tried to comfort them and gave them the latest information on where to go and who to call to try and locate the missing. Sadly as more and more time passed, and the search went from rescue to recovery, there was a greater understanding of the unimaginable casualties that were the result of this horrendous attack.

I spent my days at the crisis center listening to rescue workers who were seeing unspeakable scenes of devastation at the site. I also talked to people who were at the scene during the fall of the towers and witnessed horrific images that will haunt them for the rest of their lives. I worked along side caterers, massage therapists, other mental health workers and other people who came because they felt like I did, helpless and powerless. Helping, even in a small way, made us feel less helpless and more in control. I set up a paper wall outside of the Pier which people could sign and write prayers and tributes to those lost.

I know the volunteer work I did following September 11th was so insignificant compared to the work many did following the attack. I am in awe of those selfless firefighters, police officers and other emergency responders who gave their lives to help others that day(and every day). I would like to think though that all of the small acts put together added some goodness into a suffering, broken and devastated city. I think doing special acts of kindness on a day that signifies such a deep, painful loss for so many is something small that can honor the memory of lost loved ones. Love, resilience, strength and compassion brought New Yorkers together on September 11th. These traits still bring light to our mighty, yet still healing city today.