Yes, I would like a child, please.

After some serious contemplation, I have decided that, yes, I really truly want to raise a child with my husband. These are the sort of events that I would love to experience in my life:

• Dressing our baby up like a bear.
  
• Seeing them asleep in my arms.
  
• Helping them assemble a rock/stick/leaf/shell/etc collection.
  
• Make them laugh.
  
• Reading to them and seeing their imagination soar.
  
• Listening in awe as they speak a second language.
  
• Seeing their faces as they discover new places.
  
• Creating new family traditions together.
  
• Involving them in making family decisions.
  
• Helping them figure out how the world works.
  
• Doing my best to answer the question "why?".
  
• Making a train-shaped birthday cake.
  
• Watching the private world that they create with other children.
  
• Learning from their unique insight and experiences.
  
• Watching their personality develop into a whole new person.

Even if we do have a child, there is no guarantee that we will experience any of these moments. How do you decide to welcome a new person into your home that you have never met? How do you decide that the benefits outweigh the risks? Mel wrote about this leap into darkness a few days ago:

I think it’s brave to put your heart out there, to want something so badly, to allow your entire being to get wrapped up in the potential life of another person. If we make that leap to love a partner or family member or friend, we do so knowing that person, having met them, knowing our compatibility or history. But when we put our entire heart into the idea of a child, we do that bravely. Without answers or information or sometimes even a true understanding of what it will be like to parent.

With this confirmed desire, I called the fertility clinic to schedule our next IUI. However, I learned that this cycle needs to be pre-approved by our health insurance, which means a delay of at least another month. So more waiting and day dreaming for me.

Will we be happier with a child?

Having children is a life changing event. Suddenly, there will be this new person in our family. My husband asked me to take a moment to stop and really think about if I truly want a child, or if I am just getting mission-orientated.

Julie addressed the question of "is it worth it?", and one commenter wrote:

This one is tough for me, too. And it's tough because, as much as I truly, madly, deeply love my children, I now realize how much of my own life--a life I really loved--I gave up in being a parent. I miss that life. And I sometimes think that if I didn't get the diagnosis "Infertile," if it had felt like a free choice and not a need to prove something to myself (I'm classic overachiever; having children was the one thing I couldn't 'get right'), maybe I would have made the decision to be childless. And maybe I would have been equally happy, or even happier. That's a hard truth to face.

So I am taking a few days to line up the pros and the cons of bringing a child into our family. Here are the most commonly cited reasons for having children or being childfree:

Reasons to have children	Reasons to be childfree
An additional way to express love for spouse	Less global overpopulation
Increased closeness with friends with children	More energy and fewer illnesses
More fulfillment and meaning to life	More freedom and spontaneity
The experience of parenthood	More money
The opportunity to provide and receive love	More privacy
The pleasure and pride of raising children	More sleep
To develop personally by interacting with children	More time for hobbies
To have a relationship with children	More time to develop career
To transmit ones own ideals and beliefs	More time with adult friends
	More time with spouse
	No problems associated with children

I also ploughed through the literature on happiness, marital satisfaction, and freedom in parents, the involuntary childless, and the voluntarily childfree. It appears that parents and voluntarily childfree couples are as happy as each other, and are both happier than the involuntary childless. Some studies suggest that marital satisfaction may be slightly lower for parents than for voluntarily childfree couples. Mothers state that they have less relaxation, independence, and freedom than voluntary childfree couples.

Outcome	Sex	Parents	Involuntarily childless	Voluntarily childfree	Ref
Well-being	M	47.8	not included	45.0	1
Life satisfaction	both		not included	3.5	2
Global well-being (1-9)	F	6.44	6.28	7.06	3
My life is disappointing (1) to rewarding (7)	F	5.42	4.68	5.18	3
Satisfaction with personal success (1-9)	F	5.94	5.50	6.37	3
Life satisfaction	both	23.7	not included	25.2	4
Happiness	both	0 (a)	-0.17	-0.14	5
		-0.18 (b)
Depression	both	0 (a) 0.05 (b)	0.09	0.07	5
Life satisfaction	both	0 (a) -0.30 (b)	-0.46	-0.22	5
Depression	F	1.68	1.73	not included	6
Life satisfaction	F	3.18	2.89	not included	6
Marital satisfaction	M	33.0	not included	31.7	1
Marital satisfaction	both	5.95	not included	6.00	7
Positive marital interactions	both	3.49	not included	4.32	7
Unhappy with marriage	both	7.4%	not included	0%	8
Marital satisfaction (1-5.7)	both	4.50	not included	4.75	2
Satisfaction with marriage (1-9)	F	6.96	7.84	7.37	3
Marital satisfaction	both	91.9	not included	93.6	4
Marital satisfaction (6-45)	F	38.2	not included	40.0	9
Marital satisfaction (6-45)	M	37.6	not included	38.8	9
Amount of relaxation in life (1-9)	F	4.26	5.81	5.28	3
Amount of independence and freedom (1-9)	F	4.90	6.69	6.46	3
Amount of friendship and love in life (1-9)	F	6.72	7.43	6.90	3
Satisfied with childbearing decision	both	3.87	not included	3.73	2

(a) = close ties to their adult children (standardized to 0)
(b) = distant ties to their adult children


1. Magarick, RH & Brown, RA. 1981. Social and emotional aspects of voluntary childlessness in vasectomized childless men. J. biosoc. Sci.13, 157-167
2. Burman, B & de Anda, D. 1986. Parenthood or Nonparenthood: A Comparison of Intentional Families. Lifestyles: A Journal of Changing Patterns. 8, 2, pp. 69-84
3. Callan, VJ. 1987. The Personal and Marital Adjustment of Mothers and of Voluntarily and Involuntarily Childless Wives. Journal of Marriage and Family, Vol. 49, No. 4, pp. 847-856
4. Somers, MD. 1993. A Comparison of Voluntarily Childfree Adults and Parents. Journal of Marriage and Family, 55, pp. 643-650
5. Connidis, Arnet I., McMullin, JA. 1993. To have or have not: Parent status and the subjective well-being of older men and women. The Gerontologist; 33, 5; pp. 630-640
6. Schwerdtfeger, Kami L. and Shreffler, Karina M.(2009) 'Trauma of Pregnancy Loss and Infertility Among Mothers and Involuntarily Childless Women in the United States', Journal of Loss and Trauma, 14: 3, 211 — 227
7. Feldman, H. 1981. A Comparison of Intentional Parents and Intentionally Childless Couples Journal of Marriage and Family, Vol. 43, No. 3, pp. 593-600
8. Ramu, GN. 1984. Family Background and Perceived Marital Happiness: A Comparison of Voluntary Childless Couples and Parents The Canadian Journal of Sociology / Cahiers canadiens de sociologie, Vol. 9, No. 1, pp. 47-67
9. Lawrence, E, Rothman, AD, Cobb, RJ, Rothman, MT, Bradbury, TN
2008. Marital satisfaction across the transition to parenthood. Journal of Family Psychology. Vol 22(1), Feb 2008, 41-50.

Not pregnant, but alive

I caught two trains in Belgium today to get to the fertility clinic - one at 7:30, the other at 9:30. On my way back, the train was travelling very slowly, and I noticed several men in bright yellow vests walking along the other tracks. As it was snowing quite heavily, I thought nothing of it.

Then on I saw the news item "25 dead in train crash outside Brussels" flash across my desktop. My husband was also due to catch a train that morning, and I had not heard from him since I left the house. My hands were shaking as I called his work, and I was so happy to hear his voice on the other end. He had not heard about the crash, and once I told him the news, he was so glad that I was okay, too.

While I was on the phone with him, I got the call from the clinic telling me that I was not pregnant, and they suggest one last shot at IUI with injectable Menopur.

But all in all, I feel extremely lucky today.

Endometrium thickness

Does clomid really thin out the lining more than injectables? The literature says that it only does this when taken on its own, but not when supplemented with estrogen.
From Dickey and Holtkamp, Human Reproduction Update 1996, Vol. 2, No. 6 pp. 483–506

Does endometrium thickness affect IUI outcome? Yes, significantly (p < 0.01). IUI birth rates per cycle for endometrium thickness at time of HCG trigger:

Regimen	6 mm or less	6 to 8 mm	8 mm or greater
Clomid	0%	7.0%	14.0%

From Dickey and Holtkamp, Human Reproduction Update 1996, Vol. 2, No. 6 pp. 483–506

At my scan yesterday (CD14) my endometrium thickness was 6.9 and my dominant follicle measured 19.6. We triggered last night, and the IUI is today. Looking over my last three cycles, I analysed my data and saw that, while Menopur thickened my lining more quickly, I also ovulated earlier at CD9. For all three cycles, my lining is around the same thickness right before ovulation, and it is far below average. At least this time it's above 6, which means we have a shot.