[ExI] Technology- When it works (A story)

[Amara Graps]

A story.

--------------------------------------------------------------------

Technology- When it works.

I think that Sunday, June 8 was destined to be an extra good day because
when I woke up, there was an email in my inbox from a 72 year old woman
in Latvia who told me that my smile in my pictures at my web site looked
just like my grandmother's smile. Since my grandmother died before I met
her, this woman was drawing on memories 60 years ago, when she had met
my grandmother, grandfather, and father in a Displaced Persons camp in
Esslingen, Germany, immediately after WWII;  her mother and my
grandmother sang Latvian folk songs in the DP camp together.  Would such
a contact have been possible before the Internet? Not easily. Today,
humans have the fragments of a network of a global consciousness, and
when it works, it works in surprisingly rich ways to enhance human
lives. When it works. You see for the technology to function as
advertised requires a godly amount of effort.

Today I gave myself my 88th and last hormone injection to support the
ten week old fetus growing inside of me. For this injection, I didn't
need any more the bulls-eye circles that I had drawn on my rear-end
starting in April because my bruises were guideposts enough to know
where to poke the long needle to inject the progesterone. But after
today, my base level hormones are enough for the fetus to continue
growing its placenta to protect and nourish it for the rest of my
pregnancy. So far, we succeeded, my extraterrestrial and I. Without the
extra medication, it is sure from the early IVF efforts that the fetus
would not have survived, and I would have miscarried, so I am grateful
that today's technology gave me this opportunity to start my family.
Twenty years ago I would have been imprisoned by my chronological age,
forever remembering my terminated teenage pregnancies, and the choices I
made in the following years to educate myself, get experience, build
myself in all of the ways that I wanted to be, in order to support well
a family.

Women have a bit of a conundrum, in this respect. All of their eggs are
formed before birth and their most fertile years are when they first
enter puberty while the age and number of their eggs are already on a
decline. Since thirteen year olds rarely have advanced their education
and experience to a PhD level, they lack the life skills to support well
(for the next 20 years) a family. So those women that want a family do
their best, making tradeoffs for how much time to spend on their careers
and how much time to spend on their personal lives, hoping that there
will be a convergence of education, experience, and partnership before
her time to reproduce is finished. By age 35, her probability to become
pregnant starts to steeply decline, so if she is not established well in
her career, her family choices steeply decline, as well.

I had thought I made all of the right decisions. I stopped my marriage
at age 36 because my spouse didn't ever want a family, I learned from my
work-related repetitive strain injury a few years before, that I need
more control over my work environment, and I knew that I could much
better support a family and have a longer career future if I took my
education to the next PhD level. So after reducing some of my crippling
debt, off to Germany I went, following the best advisor I could have
found and given a free education by the German government. Three years
later at age 40, I had a PhD and a clear financial story and I could put
the attention I needed to start a family. There was convergence too,
because I had found a partner, only it was a minor inconvenience that he
was located in Italy, but I could get a job there too, right? Right, but
one unable to support me. However, my partner who told me not to worry
about that because he would help me, moved me to his country, put a
deposit on the flat that we would share and I arrived with high hopes
for my newly enriched personal life and long scientific research life,
expecting that I would not need to make another international move.

The universe thought that I needed to learn more lessons however.
Because when I arrived for my new life in my new country, my partner had
'no time to see me', and with no visa and no job for anywhere else, in a
profession that was not supported by the country to which I had moved, I
was in a bit of a sticky situation. I tried to make the situation
function by working nights and weekends at other jobs, while watching my
bank savings lessen month by month. I became extremely resourceful too,
doing alot, on a little, and managing to not lose too much of my career.
But this left no time for my personal life and when my savings ran dry,
my desperation went into overdrive. After two years of concerted job
search, refining better each time what was the most appropriate job and
place for me after that experience, I'm in a recovery and healing phase,
in a country to which I didn't want to move, but one that _does_ provide
everything that I need to jumpstart myself to the next level, both
scientifically and personally.

When life gives you lemons, make limoncello. What I lost forever in my
previous life was my last chance to reproduce, but technology did offer
a possible solution, if I was willing to put in a godly effort, which I
was. Since there was a 1% chance of pregnancy success using my own eggs
due to my age, I decided the next best thing I could do is pay homage to
my ethnic roots with a Baltic baby. Today I am essentially a
womb-without-a view to an extraterrestrial (a little joke after my
Estonian doctor kept referring to the embryo transfer as "ET"), whom I'm
calling Myrtle, for now. That Myrtle exists seems like a miracle to me.
What does not seem like a miracle, however, was the discovery that
in-vitro fertilization, IVF,  has not advanced in its techniques and
methods in more than ten years. How is it possible, that for half of the
human race, their life choices are still restricted by their
reproductive lifetimes?  How is it possible that with all of today's
technology advancements, women must go through very long, physically
painful and psychologically distressing experiences in order to modify
their most basic biological function? How could the medical community
have dropped such a large ball? And where were the transhumanists during
all of this time? Isn't it exactly this type of situation that
transhumanists claim that they support?

If a woman today wishes to have IVF, she must carefully guide and
prepare herself at each stage of her monthly cycle with hormones, first
to suppress the follicles and egg production, then to stimulate them (if
she is using her own) for surgical extraction, then to bleed off the
uterus lining and build it back up for maximum thickness to be ready for
embryo implantation. Which, today, after all of her previous efforts,
has only a 10-20% chance of success. Hormone preparation requires daily
injections (because the hormones don't stay in the body more than 24
hours), either into the fat tissue (first phases) or injections into the
muscle tissue (second phases), and it's unavoidable to exit those phases
without bruises. If one doesn't care for the injections, one can try
suppositories, which usually leave rashes and sometimes, infections, so
the alternative is not comfortable either. Most women, who go through
IVF, are unsuccessful at pregnancy the first time.

If implantation is successful, then the woman might rejoice that her
daily bruising injections can stop, but she would be wrong. Because she
skipped a step in her normal reproductive cycle of the egg dropping into
the uterus and shedding material that releases progesterone and other
nutrients that fetus needs for its placenta, the woman must supply it
externally. So more injections (or suppositories) for another two
months. Is she willing to do that? Of course she is, because it is for
the baby to survive.

However, would any young woman who is considering IVF, egg donation, or
egg freezing be willing to go through such a procedure, if she knew?
That is less likely. I did not succeed to convince the young scientific
women that I know that they would be performing an important insurance
for their life if they followed such a procedure as egg freezing. It's
too difficult, for even _these_ smart, young women.

For me, however, the technology offered a solution, and so far, my godly
effort paid off. I found my good Estonian fertility clinic during a
visit to my relatives while I was still living in Italy and facing
draconic Italian laws that forbade me Italian assisted reproductive
technology. I thought the clinic was superb and perfect for my plans for
motherhood, wherever I lived after Italy, but I admit that an 8 hour
time difference away was challenging. But the pieces started falling
into place when I arrived in Boulder. I found a fertility clinic near my
town that could support the efforts of the Estonian doctor, to write me
the necessary prescriptions (which more-or-less followed the local
clinic's own protocols). Setting up the communication between the two
clinics required finding the local key support staff and patience
through the bounced messages. I taught myself how to give myself my
daily injections using You Tube videos and asking many questions to both
fertility clinics' nurses. I followed both clinics' instructions
precisely. But even precise instruction-following can have some blips.

About the time of my 47th birthday, ten days before I was scheduled to
fly to Riga / Tallinn and then to the Tartu, Estonia clinic for the
embryo(s) transfer, I was riding my bicycle on the sidewalks like a
teenager and misjudged the distance  down the curb to the parking lot
pavement and the front wheel abruptly made the transition. So abruptly,
and since momentum _is_ conserved, that the back wheel made a glorious
arc over the front wheel, and I flew in a similar trajectory over the
handlebars. And landed on my head/helmet. The helmet was the smart part
(I _always_ wear one when I ride), otherwise I wouldn't be writing this
message now. No broken bones, no backbone out of alignment, amazingly.
But I gained a cervical strain that needed a couple of months to heal
completely and made it difficult to turn my neck in order to give
myself my hormone injections. But it certainly had an inoculating effect
on me, and how I must be careful, and it happened _before_ I became
pregnant, which wasn't the situation for the stupidity gene that was
expressed by my first egg donor.

My donor, at about the same time, was discovered to have became
accidently pregnant. She therefore eliminated herself from the clinic's
donor plan, and gave me the opportunity to upgrade to another donor, who
was in preparation for somebody else. That miraculous solution, since I
was hormone-ly 'prepared' for the embryo transfer and the new donor was
hormone-ly prepared at the same time to donate, still gave me a 50%
probability of pregnancy success, but I didn't have any more the option
of embryo cryopreservation (It's called a partial donor).

The rest of the plan proceeded on schedule. I flew from Denver to Riga
and then to Tallinn, passing through four countries' airport securities
with just one carry-on bag that included 13 syringes (2 inch long
needles) and several vials of hormones, giving myself my injections in
hotel rooms and disposing the needles into my substitute for a medical
disposal container, which was a honey jar. My 24 hour travel was the
route Denver - Toronto - Frankfurt - Riga - Tallinn, then a 2 hour bus
from Tallinn to the Tartu fertility clinic, where I stayed for two days
and had the embryo transfer procedure. The ET itself was a simple
outpatient procedure, but I stayed for longer in the clinic because I
needed a quiet, restful place to sleep. Then a visit to my relatives in
Tallinn, and back to Denver via a similar route and to wait. Did
implantation occur? Two embryos were transferred, so, if yes, how many
had implanted?

I passed through each step, slowly, anxiously, trying to distract myself
with the American Astronomical Society's Dynamical Astronomy Division
meeting, which my institute, SwRI was hosting, and answered reviews on a
paper that I had submitted with tons of errors, and wrote and submitted
another NASA grant proposal along with my normal New Horizons work.
After almost two weeks from embryo transfer, the first pregnancy test
revealed that I was pregnant. Since my Estonian doctor had completed his
role with the ET, the primary care role shifted to my Colorado fertility
clinic, where they picked up the responsibility for my full care. Three
weeks after the positive pregnancy test, the Colorado clinic performed
the first postET ultrasound, where I learned that I was carrying one,
not two, with a strong heartbeat and they considered my pregnancy to be
strong and viable. Then they handed my full care to a normal ob/gyn,
where I experienced more exams and I'm on my path to motherhood. What
remains are two prenatal tests to learn if the fetus has any defects. If
yes, then I will terminate the pregnancy, probably while crying my eyes
out, and start my godly effort all over again. If no defects, which I
don't expect, because my donors are young and healthy and I'm older and
very healthy, my pregnancy will proceed to around New Year's. At which
time, I will have the life in my hands that I created through a fair
amount of my and other people's godly efforts with technology that does
exist, today.

Amara Graps   (8 June 2008)


-- 

Amara Graps, PhD      www.amara.com
Research Scientist, Southwest Research Institute (SwRI), Boulder, Colorado