WA Public Fertility Clinic

We finally had our appointment at the Reproductive Medicine Clinic at KEMH this afternoon. They took a full history of all of our diagnosis's, previous treatment cycles, and current medical status. We met with a resident, then Dr Richard Muphy, and finally Prof Roger Hart, to talk about our treatment options.  They all think that we have a great chance of falling pregnant through fertility treatment with such significant weight loss.

The problem is that the hospital outsources its public IVF to Concept Fertility, and as of July they have suspended the program due to disagreement over costs. So essentially there is currently no publicly funded IVF program. The doctors are hoping that it should be resolved soon, but they initially thought it would only be for a few weeks and that has stretched out to four months at this point so I'm not holding my breath.

I asked about if we could do donor insemination in the meantime, and surprise surprise, the health department doesn't include DIUI under their public fertility services anymore. So really our options are just to keep trying naturally, however unlikely that is, and also to do every screening and diagnostic test under the sun to make sure nothing has been missed along the way. That means having a specialised 3D ultrasound to make sure that everything is perfect in my uterus and to monitor blood flow. I'm also getting tests done to check my blood clotting and insulin levels.

The one thing that they all agreed on is that I'm a different person now physically to what I was when we went through all of our other treatment cycles, and that we need to treat any fertility treatment from now on as a fresh start. Everything we have done in the past, while important, isn't nearly as relevant because it was essentially done on a different person.

The news about not doing IVF straight away isn't as devastating as it potentially could have been, thanks to a very positive adoption meeting that we had this morning. More coming on that very soon!!!

The next steps - planning for placement

We are booked in to see the placement coordinator on November 11th to discuss what our preferences are for placement. We have been emailed two forms to read over before the meeting to help us decide what will and wont work for us in a placement.

The first form is mainly about birth parents contact and adoption plans. How often do we want contact, what type of contact (email/phone etc), and what would be no-go's for us e.g. violence, partner in jail etc. This is something I've thought a bit about and we feel relatively comfortable that we could provide an open adoption with a reasonable amount of contact as long as it was safe for our child. We would also be happy to provide extended birth family members with contact with our child, once again on the proviso that it is a safe environment.

The second form we received is a little trickier for us to work through. As we have been approved for moderate special needs, we need to complete a checklist of different health issues that we will and wont be prepared to work with. This includes the parents alcohol/drug history while pregnant, through to intellectual and physical disabilities the child might have.

At this point, we sat down separately to do our lists so that we wouldn't influence each other. Our lists for the most part were very similar, although mine was slightly more inclusive whereas Murray made some strong arguments on some of the health conditions that I hadn't thought of.

It's terribly hard. A friend of mine recently had a baby with Down Syndrome, which was unknown prior to birth. I admire her for how she is handling everything, and I am hopeful that we would cope as well if we were to give birth to a child with DS, but if you had a choice, would you actively choose a child to parent with DS if you knew that in advance? Or Spinal Bifida, Muscular Dystrophy or Cerebral Palsy? Those are four of the conditions we have chosen not to be eligible for, however I doubt they would be considered 'moderate' special care needs anyhow.

Some of the things we have included in our special needs list include health conditions like Asthma, Albinism, physical birth defects eg missing a limb or cleft palate, hearing loss, global development delay, Hepatitis B Carrier, sleep apnoea, or at risk of childhood cancer.

We are lucky in the sense that if we adopt, this will be our only child, and we will be able to invest time and resources into getting our child the best assistance possible. Regardless of our child's health, we can't wait to be a part of it!

The legal side of things

52 . Prerequisites for CEO placing child for adoption
To place a child for adoption, we need to:
• Show that our marriage is stable
• recognises the value of, and need for, cultural and ethnic continuity for the child
• show a desire and ability to continue the child’s established cultural, ethnic, religious or educational arrangements
• can meet the wishes of the birth parents in relation to the child’s upbringing and the preferred attributes of the adoptive family
(ADOPTION ACT 1994 - SECT 52)

Another really interesting section is schedule 2 of of the act:
• A significant feature of the infancy stage is that the child needs to be able to trust others to care for and nurture the child. The child has the right to be cared for and nurtured; and to develop attachment to the adoptive family without undue disruption by the birth parents.
• Before consenting to the child’s adoption, the child’s birth parents have the right to make an informed and unpressured decision about the child’s future. After consenting to the child’s adoption, the child’s birth parents have the right to negotiate as to the provision of information and the extent of any contact between the parties.
• There is no right to adopt a child. The adoptive or prospective adoptive parent with whom the child is placed with a view to the child’s adoption has the right to bond to the child.

If you are interested in how adoption in works in Western Australia, you can read the
Adoption Act 1994 which has all the details.

Approved

So we are approved. Basically that means we can become prospective adoptive parents for:

• One child or a sibling group of no more than two children
• A child or children up to 36 months (3years) of age
• A child or children with normal or moderate care needs
• A child or children born locally in Western Australia

So what does the normal and moderate care needs mean?

• An adopted child with normal care needs is defined as a child who requires a level of personal, emotional and physical care needs consistent with which would be expected for their age group and experiences.
• An adopted child with moderate care needs is defined as a child who because of disabilities or medical and/or psychological problems, requires a level of personal, emotional and physical care beyond which would be expected for his or her age group and experiences.

What happens now? Well we wait to hear from adoption services to work on our profile. I don't know if there is other paperwork or anything else that we need to do, but I guess we will find out.

We also need to tell adoption services if there are any changes to our situation that might impact on the care of an adopted child. That includes changing jobs, moving house, other people living in our house, health issues, changes to financial circumstances and major changes to our extended family. Here's hoping for none of those things happening!

Disbelief

We were expecting to hear back from the panel early this week- they like to get the letters out within two weeks of the committee meeting. We were so nervous, I asked my friend who lives next door to check the mail each day and let me know, so I could prepare for coming home on the day we got the news. Each day came and went without any news, and the coordinator had said the letters would be sent in Tuesdays mail so when Friday lunchtime they hadn't arrived, I rang up the department.

Our usual coordinator doesn't work on Friday's so I spoke to the duty officer and practically begged to find out the result. I even offered to drive over there so that I could pick up the letter directly from them if that was what they needed. He told me he would call me back in half an hour. I was sitting in a training course on a new software program when the call came through, and so I ran out to a free meeting room to await the news.

First he made me verify my identity to confirm it really was us. Then, very casually, he said "Well, you're approved". I burst into tears, sobbing down the phone, unable to get a word out. The guy on the other end seemed really surprised by my reaction and asked if we didn't think we would be approved. I explained between sobs that we had to present to the committee and there were six different points that they were considering not approving us on. He then said that we must have done very well with our presentation because the committee doesn't often change their minds. I thanked him, and he said he would email through a copy of the letter for our peace of mind.

I just couldn't believe it. I couldn't stop crying, I was overwhelmed with so many emotions all at once: relief that we could stop trying to prove ourselves, joy that we might actually become parents, and utter amazement that this was happening, despite everything that we had gone through. Te only way I can compare the joy is that I felt as happy as the moment we got our positive pregnancy test. That moment of knowing that you are going to be parents. It's amazing.

Murray was in class teaching at the time so the only way I could contact him was to send an email and hope he looked at it during class, as he can't check his phone.

I simply wrote APPROVED!!!!!!!!

It seemed like an age before I could talk to him, but in reality it was only 20 minutes. I cried on the phone to him, and he had his workmates all around him cheering. It was such a precious moment. I also got to speak to my Mum and Dad who were thrilled to bits and overwhelmed with the news as well. I also told my friends at work and the whole department are so excited for me. Lets just say I spent a fair chunk of my afternoon with tears in my eyes!

We feel completely blessed, our prayers have been answered.  There is still a long road ahead. Being approved doesn't guarantee that we will be placed with a child. Unlike international adoption where you are on a waiting list and eventually it will be your turn, local adoption is more like a pool of applicants. Then when a child is placed for adoption, the birth parents get input as to what environment they want their child brought up. For example they could say they want a young married couple who can't have kids - hey that's us! From that, the department decide on a couple of applicants to put forward and their profiles get shown to the birth parents who make the decision.

So although we are approved, we don't know if or when we will have a child placed with us. It could be six weeks away, or three years, or possibly never if there isn't a good fit for us. But equally, it could be any day. That thought fills me with joy. Our child could have been born today! Or even already to be alive and in foster care. I offer up silent prayers for the children, of which one may end up being our son or daughter.

Today is a joyous day.

Approved!

I have so much to write and I'm headed to bed so this will be brief. It has been such an amazing day. We have been officially approved as prospective adoptive parents! I broke down in tears when we finally got told. After going through this process for so long, coming on four years now, I can't be that this could actually come to reality.
So much to say, but today we feel truly blessed. We might finally get to be parents!

MIA

I've been keeping things low key around here lately. The days are slowly getting longer and the weather warmer as we move closer to the end of another year.

I have been busy completing all of the tests requested by the public IVF clinic before we meet with them in November. As expected I still have textbook PCOS ovaries, but my insulin levels are now perfect which is great news. Unfortunately Murray's sperm has degraded further with motility of only 2% and reduced count and morphology as well, which puts paid to any ideas of not using a donor. And finally, something called SHBG which is Sex Hormone-Binding Globulin is quite high, which is actually the opposite of what happens in PCOS, and increased levels can be as a result of long term calorie restrictions, which surprise surprise is from my weight loss surgery. In terms of impact on IVF, I believe this lowers testosterone and estrogen, which obviously would impact on fertility. I will have to wait and see what the doctor has to say before I get too concerned about it.
In adoption news, we presented to the adoption applications committee on October 1 and now we are just waiting for the official word as to whether or not we are approved applicants or not. We went well over our assigned 20 minute slot and talked to most of the points in our report. I still am not sure one way or the other as to if we will get approved, but I can honestly say that we have done everything possible in this process. If we don't get approved, then that is what happens and I will try my best to accept that decision.

Our submission to the adoption panel

The report to the adoption panel is ready to go and will be submitted in the morning. W have an email from Murrays parents which confirms an inheritance that we will receive in the coming weeks from his recently deceased grandmother. We also have a letter from Murrays Dr about his current health with his kidneys and prognosis (ie he is perfectly fine). The report itself is 13 pages long and hopefully addresses every issue they have concerns about.

On Tuesday 1st October, I will be going to the adoption panel meeting to present for 20 minutes on why we should be approved as adoptive parents. It is our last attempt to be approved. Once that is done, all we can do is await the outcome and know that we did our best.

Murray asked me today what would happen if we don't get approved despite everything we've done. I can only hope that we will be strong enough to deal with it and accept it for what it is, whatever the outcome.

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Adoption progress

There is so much that I haven't written about, and blogging hasn't been the soothing balm that it once was for me. I've just been living day-today, and taking whatever comes at me, one thing at a time.

The adoption process isn't over though which is amazing.

As expected we were given an outcome of 'considering not approving' us as adoptive parents. What surprised us was the reasons given for this decision. In the original assessment report, the only red flag raised was our finances. Well that wasn't a factor at all in the panels decision! They said that it was a concern but that our submission to how we would manage time off and money was well thought out and they were happy with that. Hooray!!! I was thrilled with that! What came next was a surprise.

The committee believed that we had demonstrated capacity to only meet 3 out of the 10 adoption competencies!!! Three!!! There were five areas of concern:

1. Not enough evidence that demonstrated regular experience caring for young children either in a professional or personal capacity
2. The committee questions our motivation to adopt as we have been so focused on IVF over the years
3. Ongoing stress and tensions within my family (My brother and father)
4. Ongoing treatment for depression
5. Murray has a kidney disease which means that he may need a kidney transplant or dialysis in his 50's or 60's

So completely different to what our report had said! The panel members suggested that the report wasn't detailed enough in these areas, so perhaps we weren't actually deficient in these areas, but the report didn't tell them what they needed to know.

The letter stated that we had three options that we could take up. The first was to attend a meeting with two of the panel members to clarify their concerns. The second is to complete a written submission to be given to the panel to address their concerns. The third is to attend the final panel meeting and make a presentation up to 20 minutes long basically talking to our submission, which I guess adds a human face and that extra explanation of difficult things.

We will be taking up all three options, and have already met with the panel members last Wednesday, which we were very apprehensive about going into it. After all, here are two people that just judged you and decided you weren't 'good enough' to be parents! But it was actually really helpful for us. Of all the issues raised, the one that is going to be hardest to sway them is Murray's kidney problems. He has Polycystic Kidney Disease (PKD) which basically means he has little cysts on his kidneys which turns into Chronic Kidney Disease later on in life. He has no symptoms and takes blood pressure medication which is standard treatment to help the kidneys cope, and we are lucky that he has known from early on as his Mum and Uncle also have the disease (hereditary condition). Although Murray hasn't needed to see a specialist, the panel want him to see one to get a report on his prognosis and what potential treatment options are available. I guess for them, it is important to know that he will be around to help raise our child, which we understand.

Anyhow, as I said, one day at a time. We are slowly working on our submission, and we have requested a copy of the minutes from the panel meeting which we can receive to see what specifically they were concerned about within those broad topics and where to focus our energies. Murray is booked in for his specialist appointment on October 15, and I am doing a million blood tests for our Public IVF clinic appointment on November 11. Everything is happening all at once!

I feel immensely grateful to God that we have been given this opportunity to address the issues raised and hopefully be approved to be adoptive parents.

Not a No, Not a Yes

We haven't received our letter from Adoption Services yet but I finally got the courage to call the department. The adoption worker said that at this stage the panel agreed with what our assessor had said, however it was not a complete rejection at this stage, and she asked if we would like to meet two of the panel members to hear from them what their concerns are and how we can demonstrate that we are suitable adoptive parents.

So we are booked in on September 4th to meet two of the panel members. Hopefully it is a positive meeting and we are able to show who we are and convince them that we are suitable adoptive parents. I'm not pinning my hopes on it though. I'm making myself as numb as I can through this part of the process. If I have to process fully what this finding means for us, I'm not sure I would get through. Much easier that I allow myself to not think about anything too hard right now.

An outsiders view

During the adoption assessment process, Murray and I talked a lot. We talked about ourselves, our backgrounds, what made us love each other, how our relationship has coped with different stressors, and about our life plans. You don’t really think too much about some of these things, after all they have happened to ourselves – why do we need to talk about them if we have experienced them directly?

While obviously we didn’t get the recommendation that we wanted from our assessor, the report we received was a very interesting read. It was like reading about these completely different people. You recognised yourself and your partner, yet it was a strange feeling seeing us through someone else’s eyes. Especially when that someone else is a psychologist without any other knowledge of who we are.

While the report itself is private and not for sharing willy-nilly, there are some bits that I’d like to share, if only to help me remind myself of what we have achieved – a resilient marriage filled with respect and love for one another.

“Murray presents as a softly spoken, reflective and caring man - exuding a warm, gentle and kind nature. Rebecca appears to be the more confident of the two, often taking the lead in conversations. She is clearly very caring, intelligent, warm and friendly in her communications and interactions”

“In observing their demeanour both applicants appeared to have an easy quality to their communications with each other. They appear to communicate openly with each other on most things and generally agree on what they considered to be important.”

“Rebecca and Murray were able to listen to each other’s view point and yet arrive at their own conclusions on issues or topics. In situations where they did not agree they were able to discuss the situation and their differences openly and respectfully and where appropriate good humouredly.”

“Rebecca and Murray appear to have a very solid and secure relationship based on close friendship, mutual respect and love. Most importantly they appear to have a realistic view of marriage and their commitment to each other and appear to be happy and content in their relationship”

The adoption panel met today. We don’t know the result yet, and we might not know for up to two weeks, until we receive a letter with the final determination. We know it is unlikely we will be approved. But I still have hope. And I have my husband. And my God. That’s all that matters.

The trifecta: Holidays, adoption and fertility treatment

Our application to adopt goes to the aptly named Adoption Application Committee on Tuesday. We wont find out the result for a week or two afterwards as they write a letter which explains the outcome and what our options are.

We expect that we will not be approved as prospective adoptive applicants, due to the lack of a recommendation by our assessor. We have written an addendum to the report to give our perspective on how we would raise a child and our financial status, but we don't how much, if any, impact that will have on the panel. Whatever happens, we know that it's not up to us anymore. Now we hope and pray that they will see us for the parents we could be.

In other fertility related news, we have our appointment date for the public fertility clinic - 11th November. There are a bunch of tests we need to do before the appointment, so I will get onto those shortly. I will be having a pelvic ultrasound, and I'm really interested in seeing how my weight loss has affected my PCOS. So far my ovulation appears to have been restored, with very regular cycles of around 28/29 days, so I wonder if I still have the classic 'string of pearls' follicles on my ovaries.

It is also nearly 12 months since I had my gastric sleeve surgery and I have lost 51kg to date (or 112 pounds for my US friends). I'm feeling great, and have posted some photos over at Lose and Hope if you want to pop over and look.

In other news, we spent the July school holiday's in Melbourne and Sydney, which was really nice despite having Bronchitis the whole time. I got to attend State of Origin game 3 which New South Wales unfortunately lost, plus a Friday night football game at the MCG! We went and saw King Kong at the theatre which was incredible, and I got to spend lots of quality time with my youngest brother Daniel who lives in Sydney. Time for some photos!

Snow cuddles!

At Mt Buller seeing snow for the first time

A little slice of Mexico in Melbourne

Waiting to go in at the theatre

At the MCG

Our hotel room in Sydney - I highly recommend the Swissotel!

The Rocks - a lovely spot for a walk on Sunday afternoon

Walking back from Chinatown

We had perfect weather nearly the whole time we were there

Darling Harbour

Sydney Aquarium

Swimming with the fishes...

My brother and I

Off to State of Origin

Daniel and I chilling out

Lunch in Cronulla

Mmmm icecream!

Walking by Cronulla Beach