Don't Count Your Eggs

Another insane moment in the world of infertility: an HSG adventure

The theme of ridiculousness continues. While many of the infertility struggles and procedures are emotionally and physically painful, they can also be quite comical. Not in a funny “ha ha” kind of way, but in an insane “I can’t believe this is my life” kind of way. We’ve had a ton of these moments over the past three years of trying to make a baby. They’ve made us closer as a couple and have shown us that how we perceive, interpret and react to a situation can determine whether it’s an awful, terrible dark moment or an absurd lesson in humility and patience. 

 Going for our second HSG X-Ray was one of those moments.  I thought I was going to die during the first HSG. The radiologist jammed a french tipped balloon up my privates and pushed ink into my lady parts. The results were iffy. (There’s a glamour shot from my first HSG in a previous post). In February, we started seeing a new doctor through Kaiser who wanted to do the HSG again. My first instinct was, “Um, no thank you,” but when he described that he would personally place the balloon in my uterus in a more gentle way and then take me over to radiology for the X-ray part, it somehow didn’t seem as bad. The pay off would be that if the tubes were open we would have more choices other than IVF again. Fine.

Here is a rather humbling clip of the process for HSG #2:

  

And the results were open tubes!

(That's what open tubes look like. The middle diamond shape is my uterus)

So we don’t know why this time my tubes were open. It could be that the procedure itself blasted through whatever was blocking them in the first place, or it’s possible they’ve been open all along. It could also be that the way the procedure was done and the time it took to be wheeled across a major LA intersection allowed time for my uterus to relax, thus decreasing chance of spasm. Bottom line is that it worked, and it gave Noah and I a story we will never forget. 

A Little Laughter

It's taken a bit of time for Noah to FULLY appreciate the tenacity and determination of a woman in the throes of infertility, but I think he now truly does. Though he feels his jobs aren't all that important, trust me, they are. Giving me shots and making me laugh are vital ingredients to this process and can be a challenge.  

The last video post was kind of heavy. But it was honest. That's my goal on this blog. To be honest and to normalize some of the challenges of infertility. But I promise it's not going to be all depressing and sad stuff. Don't get me wrong, infertility is a total nightmare, but being alive isn't. Having a loving family and a supportive husband and the occassional mint chocolate chip ice cream sandwich from Coolhaus are things to be appreciated. Listening to Louis CK do stand up and going to baseball games are also high on the list of things that help get me through the low moments.

Here is a short clip of Noah and I in the waiting room of our RE's office. It was our 3rd or 4th visit where we were attempting to start IVF. It felt like every time we checked my follicles there was a different issue that prevented us from getting the green light. 

 

The take home message is laugh. Find ways to step out of the daily grind of doctor's appointments and shots and night sweats. Take a break from worrying if this will finally be the time something works. If you conceived easily, then take a moment to be thankful and find a way to help a friend whose not having as much luck take a laughter break. 

Guest Post from The Husband

Hello. I'm the husband. I will be referred to in various ways on this site: "Husband," "Hubs," "Noah," or a jumble of expletives, depending on which round of medication we're dealing with.  And I do mean "we," not "she/her/wife/author". As difficult as it is to go through infertility, it most certainly is a "we" problem. The weight and pain and frustration is simply too much for any single set of shoulders.

As we've jumped headlong with just our flashlights and our love into the search to start a family, I've become more and more impressed with my wife. You see, by nature she's not a patient person. She gets upset easily when she feels she's been wronged or been dealt an unfair hand. Often, a woman with these qualities can be seen as feisty and headstrong as well as some other words. But throw a battle with infertility at her and it's a whole other ball game. The more women and couples I meet who have gone through this (or are going through it now), the more I am impressed with the strength of these women. I've given my wife upwards of one hundred medication injections in the last six months. I've seen her go from having six-pack abs, to a stomach so tight and bloated that I couldn't grab enough skin to jam a needle into it. And every needle and every time she cries and every time she yells for this nightmare to be over, I see her get stronger. As a man in this scenario, my medical involvement is, while important, quite minimal. I go into a strange room, close the door, and produce a "sample". That's about it. Sure, it sounds like hard work, but let me assure you that I've been practicing for these moments literally my entire life.

My point is, as a husband I find myself in an awkward position. I'm the hand-holder, the "everything will be fine" guy, the back-rubber, and the guy that makes the mistake of buying a woman bloated on hormones clothing to make her feel nice. I have very few jobs and I manage to mishandle many of them.  The job that I take very seriously, though, is to make my wife laugh. My job is to distract her from all of this and remind her to smile. And sometimes, I'm so dragged down in the frustraions and depression, too, that I forget to do my job. And then she cries because the drugs don't work or they work too well or it's just a shitty day. And then I need to do my job even better.

In conclusion, ladies, you're amazing. The way you don't throw punches when a friend with no infertility experience tells you, "just relax and it'll happen" is a work in monk-like discipline. I have never seen tenacity and strength in people the way I've seen it in a woman who's dealt with infertility. So guys, give her a kiss after every shot and tell her she's awesome, let her cry her ever-loving heart out on your shoulder, and when she yells at you for an hour because you left your gym shoes out, just remind her that it's the medication that's holding the knife and not her. And then pick up your damn shoes. You should know better.

Here's a picture of us two months before IVF. I have to remind her every day that we will one day be this happy couple again.

 

IUI Take Two

I'm in the waiting room of the doctor's office. Noah just went back to "collect his sample." It's moments like these--when a tired nurse hands him a plastic cup with his name on it-- that I can't believe this I how we're trying to make a baby. The whole process has become so clinical, I feel like I have to have doctor's order to ever have sex again. But maybe this time it will work. I keep imagining my little eggs falling down dark Fallopian tunnels like bullseyes, and the spermies are racing towards them at full speed. Like a video game. We just need one to hit. Just one.

There is a little more weight to this IUI because it's probably the last attempt we will make with my eggs. There are a variety of reasons why-- medication overload, suspicions about my egg quality, time. Most importantly, my younger sister has offered to donate her eggs and there is a very small window over the summer when she can do so, so if we want her eggs, we've got to do it soon. I'm going to write more about my amazing little sis who offered her eggs without batting an eyelash, just not this second. Now we focus on the task at hand. Well, that's what Noah has to focus on. The task in his hand... Poor guy. #NIAW #Infertility

Cautiously Optimistic

It’s the day before our second IUI and I’m desperately trying to figure out a way to be cautiously optimistic. It feels so...tentative. It’s hope on the defense. But I suppose that’s what happens when you’ve been stuck in the bipolar ups and downs of infertility treatments. I found some footage that illustrates this emotional roller coaster, and the reason why being hopeful feels scary. Post egg retrieval, the doctor would call us early in the morning to update us on how our embryos were doing. This clip is two of those mornings:

 

The truth of our situation today is that we should be excited, because we have more follicles of good size than we did during our IVF cycle. But neither one of us feels excited. It’s a practice in just being. We know that what we have today we may not have tomorrow, and I’m trying not to be too attached to the outcome, but how can I not be?

Today Noah and I went to see Pain & Gain, because Marky Mark is one of my guilty pleasures, and brainless movies help me get through the day. Tomorrow at this time we will be wondering if his (Noah's, not Mark Wahlberg's) swimmers are finally meeting their match. And either they are, or they aren’t. And that’s science and chance and life and miracles. And again, we wait.

Medication Nation

Days four and five of meds are somehow the hardest physically. I'm not yet officially half-way through, there are tons of hormones pumping through my body, and I'm just bloated, sweaty and cranky. I have to remind myself that there is nothing wrong with the way Noah grates carrots. That the world will not end if the DVR doesn't record both episodes of Parks and Rec. That Noah doesn't dump all his change on the floor on purpose, it just falls out if his pants, which he has DUMPED ON THE FLOOR! But it's ok... It's ok. Tomorrow will be day six of meds and that means the end is near. My mantra this week is "It won't be like this forever" and "He's not annoying me on purpose."

We saw the IUI doc today and he said the two hardest things to have while in this process are patience and cautious optimism. He's right. My follicles seem to be taking to the meds better this time around which is good. I've been drinking wheatgrass every day this cycle, which I read somewhere can be helpful. Who knows. I'm cautiously optimistic.

The first injection lesson: back when we were shot virgins

On the topic of now being seasoned veterans, there was a time when we were naive and terrified. Going through the footage from our documentary, I came across this clip of our first injection lesson:

  

No more sweaty armpits for me! Now, (and I say now because we are right back in round 2 of IUI) Noah wakes me up by rubbing a cold alcohol swab across my belly at 7:30am, and then he jabs me. It’s very romantic. Actually, there is something really sweet about how he wakes up early to prepare the shot in the dark so he doesn’t disturb me. He tip-toes up the steps and gently sits down and whispers, “Shot time.”   While I have absolutely no gratitude for this process that I’m in, I do appreciate my husband more and more every day. And I tell him that, occasionally, between my hormonal rages and my obsessive worrying about what may happen next. 

Insemination Proclamation

This is what an Intrauterine Insemination (IUI) looks like. Warning: It’s pretty hot: 

 

This is what finding out the IUI didn’t work looks like: 

Noah and I are used to disappointment, but more importantly, we are now accustomed to the various processes we have to go through. The first time around with any assisted reproduction intervention is scary and confusing. It involves needles, exact timing, and a variety of people in my privates. But now that we have one failed IVF and one failed IUI under our belts, we know what to expect. We know the norms, the limitations, and the language. Though we thought we would just be visitors in this land of infertility, we’ve officially become citizens. Green cards approved. We’re acclimated, assimilated, acculturated. Now how do we flee this place?

Welcome to Infertility-Land

 

Join the Movement: HOW AM I MAKING A DIFFERENCE IN WAYS LARGE AND SMALL IN THE LIVES OF PEOPLE WITH INFERTILITY?

I decided to launch this blog during National Infertility week because I wanted to find a way to make a difference in the lives of people who struggle with infertility. For the past almost 3 years now, my husband, Noah, and I have been exiled into this world of infertility against our will, and we’ve had to figure out how to survive with nothing but a shopping bag full of hormone shots and a calendar of doctors appointments. 

Noah is a television producer. I am a Licensed Clinical Social Worker. With his film skills and my strong belief in advocacy, we started documenting our process in April 2012, a year after we started “trying.” We shot the first doctor’s appointment with a Reproductive Endocrinoloist in Los Angeles, and continued to shoot every appointment, hormone induced argument, and trip to the pharmacy right through to our failed IVF cycle. We have also been interviewing other couples, who I think of as “survivors,” who have had to be creative in building their families. Our intention is to one day share our journey to parenthood, because even though we don’t yet know how we are going to create our family, we know that we will one day be parents. I have also been writing about our experiences, but the only person thus far who has read anything I’ve written is my dad. And my dad is not currently struggling with infertility, so my words are of absolutely no help to him. They actual just upset him because he is a helpless parent watching his daughter struggle. But he is a writer who has always encouraged me to write. So now I am taking the next step and learning how to use the internet so that I can share my writing with others who feel alone and isolated on a little life raft in the terribly choppy waters of infertility. 

The archive and video posts will tell you where we’ve been. The current postings will tell you where we’re going. Our adventures in Infertility-land started in 2011.

2011 was the year we tried to start a family.

2012 was the year we failed to start a family. 

2013 is TBD.

We officially got the diagnosis of “explained infertility” when I got an HSG X-RAY that looked like this,

showing only one wonky fallopian tube. Then I had a laparoscopic surgery that looked like this,

which reveled two wonky fallopian tubes as the doc couldn’t pass ink through either tube. With seemingly no functioning fallopian tubes, we moved straight to IVF, where I learned that I also have Diminished Ovarian Reserve (DOR), and even though I ate this for breakfast and dinner for ten days straight,

my few follicles hardly responded. On retrieval day the RE got 3 good quality eggs, all of which fertilized, none of which divided properly. We closed shop in early December before transfer day $16,000 poorer. 

This year, so far we’ve attended several meetings about adoption. We’ve discussed donor eggs and I’ve been learning to let go of my own biology and embrace the possibility of having a child with less neurosis and nice legs. I’ve had another HSG because I’ve become a fan of having French Tipped balloons shoved up my privates, which surprisingly revealed TWO OPEN FALLOPIAN TUBES and with that, the possibility to try IUI (Intrauterine insemination), which is much less expensive and less invasive than IVF.  I went back on a steady diet of post-menopausal nuns pee injected straight to the belly, which led to one dominant follicle. Only one. But it only takes one—or so I hear. I did the dirty with a turkey baster full of my husband’s best swimmers and now we wait.

Wait. Wait. Wait. 

In the three years that we’ve been waiting for this to happen for us, I’ve successfully shared our challenges with everyone I know, thus encouraging friends, family and co-workers to check their eggs and start the baby making process as early as possible. The result has been the birth of 48 (and counting) babies to said friends, family and co-workers. Though I may not have helped infertile couples, I’ve become quite the fertility charm for others, helping everyone else hit that developmental milestone of parenthood while Noah and I watch from afar. As an LCSW, I’ve tried to start a support group, but I’m in a strange position because I’m both a peer and a professional. I know once I find an end to this journey and a beginning to our family my career will lead me to help others cope. Because I know firsthand that this is not an easy ride.

So in the mean time, as we wait, I can offer my words. I hope to bring some sense of connection and moments of laughter as well as helpful resources and coping tools. I hope to become a part of the online community of support and advocacy. Infertility shouldn’t be an island. With over 7 million people struggling to conceive there’s no reason to feel so alone. 

                        Thanks to RESOLVE.ORG for being such a great resource. Check out

• http://www.resolve.org/infertility101  (Basic understanding of the disease of infertility.)
• http://www.resolve.org/national-infertility-awareness-week/about.html (About NIAW)

www.resolve.org/niaw

HITTING BOTTOM

Hitting bottom in IVF land isn’t when you can’t stop crying or you can’t get out of bed.  It isn’t when you try to sleep for more hours than you are awake because being awake is too painful. It’s not when you’re angry and full of rage or have semi-suicidal fantasies of throwing yourself in front of a bus so that your husband has a chance to procreate with someone else without feeling guilty for leaving you.  Hitting bottom is sitting in your doctor’s office listening to him talk about the expense of a donor egg and realizing not only will you most likely have to give up on your own biology, but it’s going to cost you a shitload of money that you don’t have.  Let me rephrase that. Hitting bottom is knowing you can’t afford to make a family the only way you’re being told you may be able to.  I was too shocked and devastated to even cry, so I asked the doctor questions that had no answers to.

Why did our embryos die? Jargon about cytoplasm and nuclei followed but no real answer.

Will this likely happen again? It’s very possible. I produce so few eggs, there isn’t much to work with. We don’t know if this situation was a fluke, that had there been ten embryos, these three would have been the three bad ones and seven would have been good, or if, no matter what, they would all have been bad.

How would you change the protocol to try and secure a better outcome? No significant change. Apparently I was on a variety of meds that should have done the trick. I’m a low responder. That’s it. 

What are our choices?

Every step of this process creates a new reality, a new crappier reality. There is loss and grieving that has to be done every step of the way as options get crossed off the list. All I can do is cry and feel sad, and look at what I have left, what I can salvage of myself and my body to try to make something work. Sometimes I still feel the sadness of not being able to conceive naturally, meaning in the same room as my husband, even though we are SO beyond that now. The feeling still creeps up every so often when I’m watching the funny way he brushes his teeth or when we’re lying in bed rubbing our feet together. The possibility of having sex to make a baby is almost a joke for us now.

Now I was being told I may have to let go of my biology altogether.  That’s how Dr. N led the debrief of what comes next.  The first step is to draw my blood and have a chromosome test called Karyotype, to see if there is an issue with my chromosomes.  It’s the only test we haven’t done. It affects less than 1% of the population, and is usually done after recurrent miscarriages. If it comes out that I have a problem, that may explain why our embryos were all bad.  The next step is thinking about  an egg donor. Dr. N seemed to think this is our best shot, given the finite amount of resources we have.  He said if we won the lottery he could see doing another IVF cycle with my body and eggs, but he knows the reality that if we did that and failed, we definitely wouldn’t have the $30,000+ it would cost for an attempt with a donor egg.  

For the first time, I truly understand how our finances are going to dictate how our family is made. I knew this was the ultimate truth, but to really feel it was infuriating. If I didn’t have a chromosome issue and I did have unlimited cash, I could very likely eventually, have a child that is both mine and my husband’s. It may take a few more rounds of this hormone-induced madness, but eventually it is likely we would get one good embryo in our small cohort. I was praying for a chromosome problem so that we could have a definite answer that would knock me out of the running. Otherwise, how could I move on to someone else’s eggs without knowing if the next round of this would have, could have, produced our baby. I was more desperate for a definitive answer, some clarity perhaps, than I was for my eggs to be useable. 

I brought up the idea of using my sister’s eggs.  Hana had said she would give me her eggs, but not until her family medicine residency and her board exams were officially over, around June.  She was 29 (closer to 30), brilliant, kind, generous, and beautiful.  My sister is a better person than I am. She always means well and is thoughtful and calm and meticulous.  She saves lives every day while I am lying around at home plucking my eyebrows and eating ice cream. It’s such a conflicting feeling to be both sad about losing my own biology while at the same time feeling grateful and blessed that I have such an incredible younger sister willing to do this for us. But Dr. N said he didn’t think she’d be an ideal candidate.  She was already almost 30, she was stressed out with her job and not always eating well, which affects egg quality. She’s never been pregnant and she’s genetically related to me, meaning we don’t know if her eggs would make good embryos.  He suggested paying a little more money and going with a repeat donor, someone who has already successfully made a healthy baby for someone else. Our potential baby would have some biological half-sibling or siblings somewhere in the world. The thought of it all creeped me out. 

“Wait, stop. I’m not there yet. I’m just not there yet. With my sister, I can wrap my head around it. Some 20-year old stranger…I’m not there yet.” 

Dr. N stopped talking and nodded.  He understood. Because he does this every day, delivers disappointing and freakish news to struggling couples, the words fly out of his mouth with ease and authority. He knows what is going to give us the best chance. But my ears and my heart and my brain were just not there yet.  Not today. Maybe tomorrow.  The amount of time it now takes me to accept our new reality has become shorter. But it still takes time.  There are so many levels of coming to terms and letting go. There are so many steps between receiving bad news and gearing up for whatever comes next. I’d like to say with each situation it somehow becomes easier, but it doesn’t. I’m just less shocked.  

We are completely immersed in this new world where the laws and rules make no sense.  There are no tangible answers and no logical conclusions.  There is no sense of fairness or justice and what is truth one day may be totally different the next.  No one can make promises, and decisions are made purely on what is the best worst choice.  The baseline of this world is one of trauma and despair and hurt and loss and confusion, so that every step forward or backward is just a step in a different direction, a step towards less pain or more pain, until you get pregnant, survive the nine months, and have a baby.  Then you can graduate to a new reality that is more familiar to the real world.  But only then. All the feelings that would seemingly be normal-- resentment and fear and anger and sadness don’t serve you, but they never go away.  They just linger and then become less potent when you get a piece of good news.  Right now, good news would be that after we spend $2500 to screen my sister as a donor, she checks out and can possibly do this for us. In the context of our current life, that is good news.  In the context of life, that is terrible news.  It’s all relative.

But that’s what we’ve got today, in this moment.  In this moment I have a sister and she is willing to try and help us.  I have a husband who loves me and who has working sperm. That’s what we have at this moment.  The next may be different.

 

 

LIFE GOES ON

Going to work felt like I was coming out of rehab, telling co-workers I was “taking it one day at a time.” I tried to stay present and devised an insanely neurotic mindfulness practice of labeling everything I was feeling and doing in a given moment. Now I’m walking through the halls. Now I’m searching for my keys. I feel sad but my face looks neutral. I don’t want to be here but I am. 

I sat at my desk, staring at all my unread emails and I thought about how the only time I feel safe and comfortable is when I’m at home, alone, thinking about the day our last embryo died. I didn’t want to talk to people and hear them tell me how much they “admire my strength.” What does that even mean?!  I didn’t want to open the email that announced yet another new baby or invited me to a baby shower invite. I just didn’t want to do it. But I have to. This is life. This is my job.  This was my life and job on IVF. I imagined hell as being forced to wear a wool turtleneck and go through IVF cycles for eternity, but hell may actually be rejoining society the week after an IVF failure or a loss, and wearing a wool turtleneck for eternity.  

There is a specific moment when your immediate experience becomes part of your past. Being home in the disappointment and sadness, it was still happening. Being at work and describing what happened and saying, “I just didn’t have any embryos to transfer back in,” all of a sudden turned my present into a story. I was officially one step removed. I wondered if, like a trauma narrative, retelling my story over and over would help me feel less traumatized, as it became something I lived through rather than a reality that was constantly assaulting me. I couldn’t talk about it much; it was still too raw.  So I saw my clients and I did my paperwork, and I continued my neurotic mindful labeling. 

SEARCHING FOR OPTIONS

Noah told me not to obsess. He said we have to get some space from all of this so we could thoughtfully plan our next course of action. But when have I really listened to him? A gal can only cry so much before she has to DO something, right?

So what could I do? I couldn’t make a baby. I couldn’t get in touch with my sister who was holed up in a yurt somewhere in Mexico at a month-long yoga retreat, so I couldn’t secure a verbal pinky promise that instead of a gift card from J CREW this year, she would give me her eggs for Hanukkah. I couldn’t get any real tangible answers as to what happened to our embryos until we saw the doctor on Monday to debrief. But, I COULD look things up online, all through the day and night. So that’s what I did.

My first search was for orphanages in Ghana. Up popped an adoption agency that worked with Ghana, among other places. On the site were dozens of photographs of children from all over the world who needed homes, all of them with some kind of physical or mental disability.  I felt like maybe it was our destiny to adopt a child who needed food and shelter and love, but the scrolling photos of disabled children was too heartbreaking. I wasn’t there yet.

My second search was embryo donation or adoptions. I read somewhere that many couples who successfully conceive will donate their embryos to people who need them. It is totally strange to be carrying another couples complete baby, but then again, what is adoption? Only this way there are less legalities because I would be the birth mother and I would have the opportunity to carry. But that would be more expensive than doing another IVF round with just us! It would be upwards of $17,000! Which does NOT sound like any kind of donation! 

The third search was for grants and scholarships.  I Googled “IVF grants” and found a few. Most were state specific and required a lot of financial information. I figured we may not qualify based on household income but there were two that would be worth a shot. I bookmarked those pages and noted the application deadlines and tried not to feel like I was trying to get the IVF equivalent of food stamps. 

The fourth search was for the pharmaceutical companies that administered the injectable medications. There were a few companies, Ferring, Design RX, and Serono. Serono offered an application to apply for one free round of IVF meds and happened to be the one company that did not manufacture any of the meds I was on. 

The fifth search was for cute pictures of otters. Dailyotter.org is my personal favorite website. 

The sixth search was “IVF medical tourism” which landed me on various sites that helped book travel to different countries based on need.  Dental implants, liposuction, IVF, it was all there. There was a site that listed comparison average costs for IVF per cycle in 2009 by country. Argentina $4,160.  Austria $3,600.  China $2,400. India $3,238. Japan $4,067. Korea $1,781. Netherlands $2598. Pakistan $1618. Russia $3,400. Turkey $3,000.  And so on and so forth, until you get to the very bottom. USA $12,146. God bless these United States. I could have four chances at this in Qatar for the cost of one round here at home.  I started thinking more and more about Israel and put “re-consult with Dr. Kol in Haifa, Israel” on my to do list.  Last we spoke via Skype, I believe he said one round including meds would be $6,000. 

The seventh search was “IVF memoir” and after writing down a few titles, I decided to turn the computer off and crawl out of the IVF cyber sink-hole I was in and walk to the local library to try to find the books. 

The little local library in Marina Del Rey is a total dump.  It’s a place for the partially homeless to stay warm and read comic books.  Old men with bloody scabs on their cheeks from nicking themselves with a rusty razor.  Young tattooed tweakers using the super-slow plug in internet to check Craigslist.org for used skateboards. Borderline mentally ill women with wildly colored hair and shopping bags full of stuff looking through the video selection.  Depressing.  The library carried none of the books I wanted so I got a Walter Mosely novel and walked over to the bulk candy aisle at Gelsons to stock up on cinnamon gummy bears that make me salivate and sweat the second they hit my tongue.  

When I got home I figured I had enough of a break from my research and I went back at it. 

My eighth search was on other IVF doctors I had heard good things about to look at their success rates, to try and decide if we want to get a second opinion. Dr. N has been great and we wanted him to be our doctor, but as a consumer, it might be a good idea to get another perspective. 

My ninth search was Travelocity and Expedia in search of estimated plane costs to Israel—the possibility sinking further into my mind. 

My tenth search was “What to do after a failed IVF cycle?” but the minute hundreds of blogs and infertility chat room sites popped up, I aborted my mission and closed the window. 

THE FAT LADY HAS SUNG

Sunday seemed to go on forever. It was a gray day with bouts of light rain.  I did everything I could to distract myself, but nothing really worked. I tried to practice mindfulness, breathing in I would notice what I’m doing, breathing out I would just focus on that thing.  It becomes really hard when what you are doing is obsessing or wondering.  In this moment I have a slow growing embryo in a dish with my name on it.  That is all. I tried to tell myself it was over.  That the chance of a miracle was slim so I could start preparing to let go. We were on life support but the chances of recovery were almost nil.

  How was I going to break the news to my grandmother, who has been so hopeful and excited by modern science? How am I going to go back to work, and just go about my life as if nothing were different?

  I had a hard time falling asleep and tried to imagine Dr. N’s voice going in either direction. “Good morning Maya, good news…” or “Hi Maya, is Noah there too? Unfortunately…” When he calls, I try to decode the cadence of his voice to detect a tell in a subtle pause or inhale as his brain tells his mouth the news he must share. A momentary hint of what I’m going to be feeling for the rest of the day. His entire day is spent in a “good news bad news cycle” so he’s gotten good at covering up any hesitations or expressions of emotions.  We know he wants this to work for us. We know he understands our disappointment and our excitement.  But for him, it’s just another day at work. 

           That night we prayed. I lit a candle and rang a bell and said Nam-Yo-Ho-Rehn-He-Kyo to summon my Buddha nature. It was a Japanese prayer my mother said at different times, but often when things were not going well or for protection when we were afraid. It seemed like the right thing to do.  Noah read the Serenity Prayer out loud and we went to sleep.

            When the phone rang at 7:12am I took that as a good sign. I decided if it were good news he’d call the second he got into the office and knew what was going on. If it were bad news, he would wait until around 7:30am, guaranteeing we’d be up and expecting his call. If it were 7:30am on the dot then it was definitely bad news. I made up all kinds of arbitrary rules to the lawless land of IVF. I picked up and waited for him to talk. My brain created a crazy situation where Dr. N started saying --though it’s never happened before-- the lab made a mistake.  The other embryos in the lab that he thought were someone else’s were actually mine, and they mixed things up.  I felt awful for thinking that, but hoped so badly he would say it. Someone else was going to get bad news today, but not us.  

“Well…” Dr. N began.  I never heard “Well…” before. He proceeded to tell us our six-cell embryo was now a nine-cell embryo and should be around 100.  He said it “probably” stopped growing but he wanted to look in on it one last time at noon just to make sure.  He didn’t want to give up either. He was grasping at straws just like us. How comforting.

          “But it’s basically over,” I said.

  “It’s not looking good,” he agreed.

Convincing myself that it was a lost cause the day before was actually helpful. I was a little more desensitized. I was expecting the worst, hoping for the best. The best didn’t come. 

            I scooped up all the empty boxes of Menopur and the leftover progesterone and estrogen patches and shoved it into a bag and hid it in a little closet we have under our stairs. I didn’t want to look at it anymore, but I couldn’t throw it out.  I immediately started looking up adoptions agencies, embryo adoptions and other IVF doctors who could give us a second opinion. I started making a list of things we could do. I wondered if my sister had good eggs and when we could get them. My mind went into overdrive, trying to find something we could control, some action we could take to keep the momentum going, but in this moment there really wasn’t anything to do but peel the last two sticky estrogen patches off my back and try to scrub off the lint crud outline the adhesive had made from my clothing. 

            I’m trying to tell myself we are not at Square One. That we have more information and can revise a plan, come up with a new protocol using the experience we just had. But maybe it’s too soon to reason with myself. I feel we are indeed at Square One, back to zero. We set out to make a baby and I didn’t even get a chance to have anything put inside me to try that. It felt horribly unfair but I can’t say it was a waste, it was just unfortunate. This was our only choice for a biological baby, so we tried it and we failed. Maybe it would work on the next round. Maybe it wouldn’t. Maybe we are meant to adopt. In this moment, I don’t know. Noah says we have to put everything on hold to get some perspective, but nothing is on hold for me. Just because we don’t have an immediate game plan doesn’t give me space and perspective; it gives me fear and panic. We’ve been floating along and Noah wants to come up for air, but I don’t know how to do that, how to be normal and not drown.

            How do we regroup and move forward? How do we make a plan and process that we’ve just been spit out on the other side of this empty handed and heartbroken? I’ve known exactly what I was supposed to do for some many months, decrease stress, go to yoga, don’t drink caffeine, take herbs, go to acupuncture, inject shots, go to the doctor.  Now I don’t know what to do. I’m on self-inflicted bed rest with no good reason other than I don’t know where else to be or what else to do. I’m going to have to pick myself off the floor, get myself out of bed and rejoin society. 

            Maybe I will do it tomorrow. 

HANGING ON FOR ONE MORE DAY

Noah woke up and said, “November can suck a dick.” Then Dr. N called. 

“Well, I have good news and bad news,” he began. We couldn’t write a more dramatic screenplay if we tried. 

The bad news was that the fragmented embryo had died, or stopped dividing, or arrested—there are so many terms to keep straight.  The good news was that one of the other two fertilized eggs that were dormant yesterday started splitting and was now six cells at day three.  Huh? There were a thousand questions I had but Dr. N stopped me by saying he couldn’t really answer most of them.  We don’t know why.  We don’t know what it means exactly. Could there be something wrong with it? Very possible. Could it go on to be a viable pregnancy and health baby? Perhaps. He gave us three choices:

The first was to genetically test it to see if there was indeed a problem with it.  It was an expensive procedure (around $5,000) and may not be worth it for one single embryo. The second option was to do the transfer today, get it back into nature’s incubator and see if my body could sustain it. The risk of that would be not knowing if it was strong enough, not knowing if it started to fragment and do weird things which most likely wouldn’t take, but I’d have to wait two weeks before I’d know.  The third option was to wait until Monday to see if it makes it to the blastocyst phase, which is when it splits so much that the embryo itself looks kind of like an unused condom. If it makes it to that phase we will have more information about it.  Only a small percentage of embryos make it to this stage, so there is a risk of letting it stay in the dish. But the ones that do are more likely to produce a pregnancy. He told us to discuss it and he’d call back in 20 minutes.

  How do we make this decision? How do we make any decision? Dr. N said he would wait until Monday because he felt seeing it until then is better, but he would understand if I wanted to just get it in me and test for genetic problems later if it took.  He said if I was “comfortable with uncertainty” I may want to do this. Noah agreed with the doctor, 100%. He wanted to let it sit and not rush to put something into my body, another procedure, if it turned out to not be good.

  Comfortable with uncertainty I definitely am not.  I’m slowly learning to tolerate it because I have no choice. Life and creating life is uncertain.  But I had this gut feeling that we should just get it in my body. My body would love it and all would be OK.  Maybe our baby was just a little slow to start, kind of like his/her dad. Or again, stubborn and non-conformist like his/her mama. But thinking that maybe it was in fact a him/her scared me enough to put my desperation aside and vote with my husband. We will wait until Monday. The chances are slim, but there is still a chance, another string of hope, dental floss thin.  Maybe this was our little fighter, maybe it was just another few blows to the face before the final knockout. 

I was mad at myself for feeling optimistic. For seeing how from a story aspect this is actually really intense and obviously has to end up in a beautiful baby, or even better it could split and become identical twins, and even more ironic for Noah, twin girls, like the two stars of his reality show that drive him absolutely insane! How do I stop my brain from coming up with a thousand different scenarios? How do I convince myself there is value to the lesson I am learning in extreme patience and acceptance of the unknown? It’s like exposure treatment for anxiety—I’m being exposed to the most exhausting, emotional mindfuck and if I don’t have an aneurysm and die then I live to see another day. Bad news or rapidly changing situations will no longer startle my psyche to its core. Que sera sera.  I try to just tell myself that today we have a six-cell embryo. We hope it is bigger and better tomorrow, but it may not be, and we’ll deal with it, but I don’t believe myself. I am wishing and hoping and praying and planning and totally obsessed.  The only thing to do is distraction. Movies, food, exercise.  

IVF CYCLE 1: HOW QUICKLY GOOD NEWS BEOMES BAD NEWS

I woke up the next morning at 6:00am on the dot. I was used to waking up early now because of the shot schedule, and for a moment I felt extreme gratitude that that part was behind us.  I made pancakes because I was in a good mood.  My plan was to go to the market to buy bed rest food, finish cleaning, and have a facial/meditation session with Elisa, my facialist/esthetician/baby whisperer.  I wanted everything to be in the right place for the big day. 

One bite into my chocolate chip pancakes the phone rang.  It was Dr. N with an update. Noah and I huddled around the phone to get the news. 

  “Unfortunately, I don’t have good news,” Dr. N began.

  This is something you NEVER want to hear from a doctor of any sort.  I felt my throat close and my eyes well up. Dr. N had been honest and realistic all along the way, so we know whatever he would tell us to be exactly what is. 

  Two of the embryos weren’t dividing and the one that was looked very fragmented, getting a grading of a B/C. Fragmentation could indicate abnormalities, and he wouldn’t want to put something back in me that wouldn’t at least possibly yield a healthy baby. 

Time burst into a kaleidoscope.  Shards of the last two years, broken scenes of the operating room, the laparoscopic surgery months ago, the empty syringes dumped in our little biohazard container slashed through my mind.  Our wedding picture, the itemized pharmacy receipt, fully clothed nuns peeing in jars while standing. Our clean sheets, boxes of Junior Mints, my 92 year-year old grandmother’s bad knees. The bruises on my belly, having sex and then standing on my head, the rubbery slabs of Thanksgiving turkey. My uncle Yuki’s cremated ashes in a freezer sized Ziploc bag crammed into my mother’s carry-on luggage. My two responsive follicles on the ultrasound machine, like black bubbles floating in a sea of muscle and tissue and blood. The smell of Gill’s tea and my BBT calendar from 2010, temperatures carefully marked and charted. $15,000 in cash spiraling around a toilet bowl.  The image our fragmented embryo getting washed out in a sink, the Petri dish being carefully placed into a dishwasher. My husband’s graying sideburns, the logo for earlypregnancytests.com, the sound of rain coming down hard for the first time this winter. The taste of my creamy tears, salty and thick, mixed with my face lotion. Sensory overload. Piercing cries and gasping breath, it’s me but sounds like it’s coming from somewhere else, someone else.  That horrible desperate cry can’t be me.  But our flowers bloomed and our Junior Mints tasted sweet. Last night we held hands and smiled and wished our babies-to-be good night and sweet dreams. Noah’s blue T-shirt splattered like a Rorschach test with the heartbreak from my eyes. Pushed against his chest, my despair faded to black.  

And Dr. N said we should check in tomorrow. Sometimes embryos corrected themselves, but it was rare, and it wasn’t looking good.

  I blamed myself for sending emails about Junior Mints and planning the next email, a request for friends and family to chew Doublemint gum so our twins would stick, so I felt like I jinxed it. And Noah went to work. And I cleaned the bathroom and cried. I brushed my hair and braided it to the side and ate a persimmon. I Googled “fragmented embryo” and sunk into the abysmal underworld of online infertility blogs, full of acronyms and desperately sad women TTC.  I listened to the rain and tried to convince myself this will pass.  I tried to see the bigger picture. This is another setback.  If it actually worked this time, it would have been a fairy tale.  After all this shit, our story would be a fucking fairy tale.  My book would be a few thousand words short. I thought about our new normal, trying to figure out a way to regroup. A way to let go and begin to embrace a Plan B.  At least I still had a uterus, and legs, and sperm, and parents who invested in artwork thirty years ago that they are willing to sell for another attempt at this. I reminded myself we would have a baby and asked the universe for help to find some kind of hope or curiosity or silver lining, but all I could do was scrub the toilet. 

Noah and I said we’d remain hopeful, however grim the situation, until the plug was pulled. The plug wasn’t completely pulled yet, but it was close. Teetering floppily out of the outlet. Even if the embryo corrected itself, did that mean it wouldn’t result in pregnancy? Or if it did would I miscarry? Or grow full term only to give birth to a baby with some genetic deformity? 

Everyone did everything they could. I couldn’t help but wonder if we were foolish to push so hard against nature. If there was something inherently wrong with my eggs.  If this was going to be a painfully long process.  I guess we won’t know.  Our doctor, our wallets and our instincts will have to come together and make final choices for what we can and can’t do.  Until then I cry.

IVF CYCLE 1: EGGS OUT!

The night before the egg retrieval I got in bed at 9:00pm and listened to my Meditation for IVF CD on repeat. The soothing female voice told me there was nothing to do in this moment. She instructed me to relax my body and imagine the medications pumping through my blood into my ovaries, making the best eggs possible.  Noah went to a Soundgarden concert. He got tickets with a group of friends months ago and had been looking forward to the show for a while.  He hadn’t seen Soundgarden since 9th grade, and I didn’t give a shit. As long as he didn’t wake me up when he got home he could do whatever he wanted.  Maybe a little rock n’roll would energize his sperm.

But he didn’t make it to the show. He drove out to Hollywood and then turned around and came home.  I was still up, on my third round of “IVF For a Fertile Soul.” He crept upstairs and put his head to my stomach.

“Hey guys. This is your daddy. We need you to be big and strong tomorrow. The doctor is going to come and get you so we can have you soon,” he whispered to the follicles that felt like little rocks in my ovaries. Little tiny water balloons pushing the latex to the absolute limit. 

“You’re home so early?” I questioned.

“I wanted to be here. We have to be up early. It’s a big day,” he said, taking off his clothes and getting into bed.

We snuggled up tightly. The two of us and our bursting follicles. And when the alarm went off at 5:00am, we popped up. Noah reminded me not to eat or drink anything and I had this overwhelming rebellious feeling that my mouth was going to eat something, as if it were detached from the rest of me, trying to sabotage us.  

It was pitch dark when we left the house. We drove the familiar route down Venice, up La Cienega. The streets were empty and quiet.

  “I’m surprised you came home last night. Did I make you feel guilty for going out?” I asked. I was surprised. Noah never leaves a rock show or a baseball game early, let alone drive all the way out there only to turn right back around. He loves a night out with his boys and had been looking forward to this show. But I was glad he came home. It felt like he was being responsible and helping me to not worry about missing our alarm or about him being too tired to properly perform the next morning. I felt like he was prioritizing us and what we were going through, and that he really did want to support me and be with me.

  “There were three shows going on in Hollywood and all the parking lots were totally full.  I was so fed up trying to park and work was blowing up my phone, I just decided it wasn’t worth it,” he said.

  Just like I thought.  He wanted to be with me and he was prioritizing our big day.  

When we got to the office Noah almost immediately went in to make his sample in a tiny sterile room with a little DVD player and a few sticky magazines. I went into a pre-op room and got undressed from the waist down and covered myself with a little gown.  My cousin Howard is Dr. N’s anesthesiologist, and he came in to prep me. Howard was the one who suggested I come in to see Dr. N about eight months ago, and we’ve been waiting for this moment ever since. Everything else was a blur. When I woke up, Dr. N seemed excited and surprised.

           “We got five eggs!” He said. “One excellent, two good, two poor. But the poor ones could potentially make good embryos. You never know.”

FIVE EGGS?! From where? My body? What secret Santa snuck in two extra eggs in the night?! Dr. N said that the best and biggest follicle actually had a poor quality egg in it, so you really never know.

  He then told Noah that his sperm were “awesome” and the report was worthy of being put up on the fridge so he could walk by it and puff his chest like a peacock. Noah beamed, a home-run, dimple-faced smile plastered across his face. He had done his part, and he’d done it well. 

I was afraid to be too excited. I didn’t want to count my eggs before they……fertilized, but it really couldn’t have gone much better, given what we started with. Do I celebrate the milestones and the small victories or do I keep a straight face knowing it could all fall apart tomorrow? When we get too happy, the crash feels that much harder.  Is there a way to be thankful in this present moment only and not start thinking of baby names and how many embryos to put in? Nothing may fertilize.  It has happened. Once, in Dr. N’s career, many years ago.  A good egg can meet an “awesome” sperm and tell it to go fuck itself.  An embryo can start out looking good, but then stop dividing.  There could be genetic issues, who knows?  But in this moment, after Noah rushed off to work and I spent the day rolling around in bed, we came back together and smiled.  We got through one hurdle, but there are a lot more ahead of us, and we’re hopeful and we’re grateful. We could very well be making a baby while Noah was directing a scene at work and I was emailing my dad in Poland to tell him the news.  His sperm could be canoodling up to my little eggies and creeping their way in, creating the miracle that is life, in a little dish in an incubator in a cold sterile lab in Beverly Hills.  How romantic. 

I spent the next day cleaning the house and washing the sheets. I wanted to prepare the house for when I was on bed rest, in case we had any visitors.   I bought a pineapple because Gilli told me to eat the core after the transfer to help with implantation. I emailed the few friends I had that had gone through IVF, asking their advice about how many embryos to transfer.  We, or should I say I, wanted twins, but thought maybe we should put in all three, even though there was a risk to that. I was excited. Everyone was excited.  Throughout this process I was sending update emails to family and friends, asking them to buy themselves “follicle flowers” to send blossoming energies to my follicles when they were growing well.  When we got the five eggs out, I asked them to get Junior Mints and pray that our little embryos would grow big and strong.  People sent hysterical pictures of themselves and their pets with the Junior Mints. Everyone had a good feeling. Noah was in such a good mood the day after.  I found two little turtles carved of stone that I had and we slept with them that night, a symbol of fertility and of our two babies. 

IVF CYCLE 1: THE WORST THINGS TO SAY TO SOMEONE GOING THROUGH IVF

Our appointment on Saturday went fine.  The two big follicles were up to 15 and 16 mm and the runt was at 11mm. We went to the pharmacy (one of two in our area that dispenses these drugs) to pick up our extra two days of meds, for $1150.95, and for a moment I felt super depressed, yet super connected.  There were a few other women in there, all looking agitated and hormonal, picking up boxes of Menopur and bags of syringes.  I made eye contact with one woman across from me, and tried to wish her good luck with my eyes. She looked back at me, perhaps wondering why I am so young and doing this, perhaps wishing me luck as well.   Only those who go through this can truly understand the absolute desperation and fear and sadness and frustration that infertility brings into one’s home. 

  Even though people and friends try to understand, they just can’t, and there is an isolation that comes with not being understood that is both unavoidable and understandable. I can’t blame people for not knowing what to say or saying things I think seem stupid and trite.  I can’t imagine being terminally ill, or watching a loved one through a terminal illness.  That complete fear and hope and struggle to get through each day is unfathomable to me. But we can only do our best to be sensitive and comforting. I know that I’m on edge and nothing anyone says or texts or emails feels right, but everyone is just trying their best.  I made a short list of the worst things you can say to a person going through IVF:

1)  Hang in there! Hang in where? This is something you say to someone who is annoyed by their desk job and has to put in an extra two hours before heading home.  Hang in there feels dismissive and almost cheerful. Better to just say, “Don’t kill yourself, you won’t be in this hell forever.” That’s essentially what is meant by “hang in there,” right?  That it will be over soon, and by soon you may mean 2-15 years? “One day at a time” sounds like rehab talk but even that’s better. 

2) God has a plan.  Just don’t.  We can all find reason and lessons in the things that happen to us, but it’s not for anyone else to tell me.  Unless you have a direct line to God and he told you, in his OWN words, not through a cherubic baby angel or a patron saint, his plan for me, then don’t tell me God has a plan.  Tell me “this may make sense one day down the line,” because it may.  But it also may not. It may just be a shitty few years Noah and I will have to write off as the dark infertility years. 

3) I know this is going to work! No you don’t.  You absolutely don’t know anything is going to work.  Tell me “this has to work” or “this better f*&^ing work” or that everyone is “hoping this is going to work.”  That’s fine.  The only thing anyone can say to me that they actually know is that it’s going to be expensive, painful and terrible.  That’s what I appreciate most about the few women I know who have gone through IVF.  They just say, “It’s terrible.  All of it. Period. The end.”  They also tell me that I will have a family.  Somehow, some way.  And that is helpful.  There are babies in this world that people don’t want, and I can one day get one. This is true.  So don’t tell me this is going to work, just tell me I will be a mom one day.

4) How exciting! Let me correct any misconceptions here.  There is not a single aspect of this process that is exciting.  I get it, people were excited when we could finally move forward with starting IVF and they were excited to find out I had more than six eggs.  Little victories are still victories, but nothing, NO THING is exciting.  Everything is measured on a scale from terrible to God freakin’ awful.  There is no room for excitement.

5) Have you considered NOT having kids? No. Fuck you.

  We continued the shots and I imagined one of the nighttime shots, Ganirelix, that is designed to prevent ovulation, as a steel door.  When I get it shot into my leg I envision a door slamming down with my eggs on the other side freaking out that they are trapped.  Then the Omnitrope and the Follistim and the Menopur start to invade the ovary like tear gas through a rowdy crowd, forcing them to grow and bulk up, like the Incredible Hulk.  What a horribly violent image. By the time we went to our appointment on Monday, the two big follicles were at 20mm and the runt caught up and was at 16mm.  16mm is the cut off, that’s what we were hoping for.  Then there were three.

  It’s crazy how quickly bad news really does become good news.  Leaving the office with three follicles and a plan felt like a victory, even though that same number felt like total defeat a few days prior. It really is a matter of acceptance and perspective, and perhaps choice.  We can’t always choose what we get (as the old children’s song goes, “You get what you get and you don’t get upset”) but we can choose how to perceive it. How we view a situation is the only thing we have control over. If it’s a crappy situation, then call it for what it is, crap.  But if it’s crappy with potential, or crappy with a silver lining, or 90% crappy with 10% possibility, then we have to aim that flashlight on the 10% and be excited that it’s not just crap.  

My mom came over that Monday with Tupperware full of food.  Food is how my mother expresses love. She made me chicken soup with cabbage and udon and rubbed my back until I fell asleep.  Because that’s what moms do.  They love you and hold you and make the shittiest of moments a little softer, a little warmer, a little tastier.  One day I will be a mom.  I will have a child that experiences some kind of pain, and I will have to accept that the only way I can make it any better is to just be there.  I will sit with that child and think about suffering as just part of the deal of being alive. And then I’ll make something delicious and leave him or her to make sense of the world. 

We were running out of space on my legs and tummy, and by the last night, the night of the dreaded HCG shot, everything was sore.  I took a deep breath and Noah stuck me one last time and lo and behold,  the shots were over. My body got to retire as the human pin cushion.  Ten days. $4,888.45. Three purple bruises.  A dozen little red bee sting needle pricks. One blood blister. A biohazard box full of empty syringes. Three ripe follicles.  Training camp was over. 

I finally put our extensive IVF schedule away.  For a moment I thought, “The worst is over,” but I quickly corrected that thought in fear that the universe may want to prove me otherwise. I’d become a bit superstitious.  There are so many worst parts to all of this, and so many potentially worse parts. Infertility/IVF is the perfect destruction of the emotional, physical, financial, mental, relational, spiritual self. Only in complete destruction can we really let go and rebuild, perhaps. 

After disposing of that last syringe Noah pulled out a prescription bottle with four red pills jingling around in it and sighed loudly.  He circled his neck and rolled his shoulders like he was about to do something physically strenuous, like chop down a tree or run a marathon.  He puckered his lips and exhaled loudly.

“Alright, I’m really doing this,” he said with a sly smile.  He dramatically popped open the bottle, biceps flexed, both elbows pointing at opposite walls, then he stretched out his jaw. 

“Oh stop it!” I yelled laughing.

  There were two things on our IVF schedule that Noah had to do (other than shoot me).  One was “EJAC” three days prior to retrieval, and the other was to take an antibiotic the day before.  “EJAC” (short for ejaculate) was already crossed off the list. And even that I had to participate in, so I can hardly say it was something just Noah had to do.  Somehow even on Noah’s to-do list I am the one being poked and prodded.  But this last job of his, swallowing two small pink pills that night and again tomorrow morning, that was all him.  I could just stand back and watch him “contribute” and “participate” physically, as he claimed.

  He made a big scene, stretching his body and shaking the bottle around, pretending to look nervous, telling himself, “I can DO THIS!” I just laughed, which hurt my stomach to do.  The HCG shot was burning the inside of my leg like there was a party of red fire ants burrowing into my thigh. He tilted his head back and popped two pills in his mouth, then looked at me with panicked eyes.

“Can you get me a glass of water?” He mumbled.

“Oh for fuck’s sake! Are you serious?! Do I have to be involved with EVERYTHING!?” 

He shrugged. Indeed I do. 

IVF CYCLE 1: THE WORST THANKSGIVING EVER

We went to the doctor’s office the morning of Thanksgiving.  I was six days into medication and aside from being constantly exhausted, I was feeling fine.  Noah had gotten good at the injections and I didn’t gain 30 lbs and only mildly broke out in teenage-style acne.  I asked some of my girlfriends to buy a bouquet of nine flowers, one for each of my follicles, and meditate on them. Sing to them, talk to the smaller buds, tell them to grow and send me positive blossoming energies.  

            Noah and I were planning to hit the doc and then head down to the Ace Hotel in Palms Springs to sit in the sun and get away for an overnighter.  But it felt like the doc hit us instead. We did our follicle count and it appeared that only two follicles were growing. Two out of nine! How was that possible?!   I was on SO much medication and human growth hormone crap I could probably hit an old school, Barry Bonds style home run out of AT&T park!  Dr. N wasn’t in the office that day, but he phoned in from wherever he was vacationing with his family.

            “So we have two choices,” he said on speakerphone. “One is to convert this cycle to an IUI (turkey baster) and the other is to do IVF, even though we have a very small number of follicles.  Both options are a compromise.”

            I immediately started crying hysterically.  I knew an IUI was not really an option for us. I have one possibly functioning Fallopian tube, but it’s clearly wonky. We had been trying for two years with good sperm and no luck, so it seemed to me like the bridge from egg to uterus was broken.  IUI would be a waste of time and hope, and both of those were running out. We had already gotten this far, so it felt like all we could do was put all our eggs—both of them --  in one sad little basket.  I tried not to think about retrieval rate and egg quality and the likelihood of fertilization and division. 

            “We have to do IVF,” I cried into the speakerphone. “What more can we do right now?”

            Dr. N extended my medication for a few more days so that the two follicles that were at 13mm could get closer to 20mm and the 7mm could possible catch up so we would be going for three instead of two.  He told me to relax and have a nice Thanksgiving.

            Noah drove while I clutched the cooler holding my shots and wept.  I called Gilli and she sounded disappointed but still hopeful.

            “Mayale, you need one egg for one baby. Don’t give up;  your babies need you to be strong,” she said.  Gilli had become my headlamp through the dark tunnel that is IVF land.  She had been through this with other women and seen all different kinds of dire situations as well as magical miracles.  I trusted her as much as I trusted my own mother.  My mother, interestingly, said almost the same thing.

            “OK. Two is better than one.” 

            We stopped at Hadley’s Fruit Orchard and I got a date shake.   Ever since I was a kid, it’s been a family ritual when we drive to the desert.   The thick, creamy sweetness calmed me down just enough for us to drive into the Ace parking lot in total silence.

            Poor Noah.  All he wanted was for us to have a nice time together, sitting in the sun and relaxing.  But all I could do was crawl into the bed and go to sleep. 

            I tried to convince myself not to get too attached to good or bad news.  In IVF-land, good and bad news are both so fleeting.  Emotional rollercoaster doesn’t even really capture the experience; it’s more of an emotional seismograph, with sharper,  more aggressive ups and downs.  It makes you sick to your stomach because your feelings are jetting up and down so quickly that your brain barely has enough time to process and make sense of it all.  Needless to say,  I had an incredible migraine by the time our Thanksgiving room service meal arrived at the door.

            It looked like airplane food -- two slabs of turkey smothered in gravy, over cooked green beans, and pumpkin pie wrapped in Saran Wrap.  We ate it wearing matching bathrobes and tried to strategize on how we were going to get our optimism back.

            “What else can we do,” Noah said between bites of grossly thick mashed potatoes.  “We have to be optimistic.  It’s not like there are no follicles.  Whatever we’ve got we’ve got.  We give it our all. We don’t give up until someone tells us to.”

            I’m so glad his brain works like this. It gives me hope for our potential children. 

            No more than ten minutes after we finished our meal I started feeling sick.  It wasn’t the food, it was me.  I felt poisoned by sadness and knew what was about to happen.

            “I’m going to throw up,” I said.

            Noah looked at me. It had been less than week from the time he was up all night barfing his feelings.             

            “We’re the barfing family, this is how we handle things,” I said, clutching my stomach, waiting.

            And sure enough, I ran to the bathroom and hurled.  Spewed.  Upchucked.  Ralphed.  Blew chunks. I puked the entire turkey and every last soggy green bean.  All undigested, all slow and thick and chunky rose up out of me.  It was disgusting and painful but afterwards I felt better.

            Noah was right. We had to be optimistic. Those two follicles may very well be holding our two babies. Dr. N is the best guy to free them from their follicular prison.  If we do more meds we could even get one more follicle to work with.  We have to believe this.

            So we went to bed believing our babies were slowly taking their sweet time to form.  That my follicles were stubborn and defiant, like me, and didn’t like being told what to do.  As sensitive as I am to most things, like sound and light and alcohol and annoying people, somehow my body was taking these meds in stride.  We said a prayer that Noah’s sperm wasn’t like him, laid back and slightly passive. And we talked about how so much of this journey has been about us finding a way to meet in the middle and truly balance each other out.  We agreed that one day we would be chasing our twins around the Thanksgiving table, reminiscing on the worst Thanksgiving ever.  In retrospect, this may even seem funny. 

 God bless retrospect. 

IVF CYCLE 1: THE SHARPSHOOTER HAS FEELINGS

The night before Noah was to give me my first shot on his own, he lined everything up on the dining room table.  Three little vials of Menopur, one vial of sodium chloride, check. The syringe and the (thankfully smaller) swap-out needle, check.  The Q-cap to get the medication from the vials into the syringe, check. The alcohol swabs and the red biohazard waste container that Noah wanted to keep to use as a “piggy bank” instead of for disposing of our hazardous debris, check.  He read over the directions twice and we went to bed.

            At 3:17am Noah jumped out of bed and ran to the bathroom to throw up. He was coughing and hacking for several minutes before I knew what was happening.

            I went into the bathroom and he looked green.

            “Are you OK?” I asked, groggily.

            I wondered what might have poisoned him.  We both had eaten all the same thing the night before, so I didn’t think it was the chicken.  But he had no other symptoms except for an upset stomach and vomiting.

            “I don’t know,” he hurled.

            “Did I poison you? You can’t die, I need you to shoot me this week.”

The look on his face said he wanted nothing more than to shoot me, right NOW!

            “I was having a dream that I was doing my schedule at work and everything was conflicting with our retrieval date.  I was so anxious in my dream, my nerves woke me up,” he said.

            His nerves woke him up?  Was Mr. Nerves of Steel, Mr. Hasn’t-shed-a-tear-since-some-random-Giants-game-in-the-mid-1980’s, having an anxiety attack?   No way!  

            “Maybe I didn’t cook your piece of chicken all the way. I’m sorry,” I said bringing him a glass of water.  Though his dream, or perhaps nightmare, wasn’t too far off from reality, there was no way it would wreck him like that. 

            We got back into bed and I ran my fingers through his hair. He wasn’t sweaty or hot, but he looked…sad.

            “I’m supposed to shoot the day of the retrieval. The other producer is out of town so it’s just me. We’re on such a tight deadline,” he mumbled, falling back to sleep.  

            “Well, if you can’t make it for your big debut, we can always ask Gabe to step in and fill the cup for you,” I joked.

            Noah ran back to the bathroom and threw up three more times.

            “Maybe I took my vitamins too late,” he said getting back into bed.

            Neither of us really slept that night.  Noah had been holding us together for the last two years, and was grasping at whatever he could for the last six months.  He was working like a dog so we could afford for me to work part time and take care of my body, and for us to be able to enter the very elite world of IVF.  He wanted nothing else but to be there for me, always and every day, but he had a responsibility to the show he was working on and to the ridiculous whims and demands of his impossible stars.  I wasn’t always easy on him.  IVF was a priority, but it wasn’t the only thing on his plate.  No matter how the hormones made me feel, I knew I had to do my best to channel whatever I could to be on good behavior.  

            At 7:00am sharp, his alarm went off and he went downstairs and started assembling the shot the way a sharpshooter would put together his gun the day of a big assassination. Cool, calm, collected, he double checked the directions and flicked the syringe the way they do on those medical shows.  He pushed up on the bottom part to let the air bubble out and called me down when he saw the first drop of liquid come out of the needle.  

            I shuffled downstairs thinking that while most normal people are having their morning cup of coffee I’m having my morning shot of hormones. I didn’t feel the unfairness of it, it was just fact now.

            “Ready?” He said, his hair standing straight up.

            I lay down on the couch and he measured two fingers away from my belly button, pinched the skin, and angled the shot in at 90 degrees, exactly as he had been taught by nurse Danielle.  

            He took care to cover my tummy back up and he walked over towards the biohazard box to throw the syringe away.  We had come so far together.  I remembered a time in our lives when it was a big deal for him to see me pee, and now we’re doing our very own little science experiment on my body, which requires intimate and invasive moments between us.              

            We ate the leftover chicken for dinner that night.  I asked him if he thought I should just throw it out, not to risk another night spent leaning over the toilet, but he insisted that he didn’t think he had food poisoning. It was a case of extreme emotion, the kind he’d never known before. My unemotional island of a husband was so overwhelmed by the stress of trying to balance life and work, of the worries he had about what the medications may do to me, of the frustrations of the past two years and the responsibility he had to somehow make this OK for us and our family to be, that for a moment he broke.

            But just for a moment.  We had grown up together over the past thirteen years and somehow this moment, of him walking away from me holding the empty syringe, felt like the culmination of it all.  The true entry into adult world.

            I watched him gather the little vials and other scraps of plastic from the table.  With my entire family out of the continental U.S. and unreachable, it really was just the two of us. I felt so proud of him and so thankful that this is the man that will one day be the father of my children. I almost got teary, but maybe it was just the hormones.

            He walked towards the trash and hesitated, syringe and trash in hand. 

            I could see he was contemplating just tossing it all in our regular trash.

            “Noah?” I said, the way a schoolteacher says the name of a student on the brink of getting into trouble.

            He rerouted himself towards the hazmat box and tossed the dangerous waste in with a disgruntled exhale.

            “I just really wanted to keep this as a piggy bank,” he mumbled, defeated, and walked away.

IVF CYCLE 1: SHOTS AND PATCHES AND PILLS, OH MY

On a Saturday morning in November, the week before Thanksgiving, we got our chance. A shopping bag filled to the top with $3,737.50 of medication was delivered to Dr. N’s office, and Nurse Danielle laid everything out.  There were syringes and alcohol swabs and things that needed to be refrigerated and things that needed to be shoved up my privates and patches and oral medication and baby aspirin for after the transfer and valium for the day of. There was one little prescription bottle of antibiotics that Noah will have to take the day he gives his sperm sample; everything else was for me. Nurse Danielle carefully went over each step on our very extensive calendar.

            The first shot is Menopur. It comes in powdered form in little vials and we have to use the syringe to mix three vials with sodium chloride, change the gigantic needle to a smaller, friendlier one, and then Noah shoots the stuff into my stomach.  At our “injection lesson” I could tell he was nervous.  There were a lot of steps and he wasn’t sure if I’d have a reflex reaction of punching him in the face. Nurse Danielle instructed him to pinch my belly fat, which he did the way a mama tiger would carry her cubs by the neck, and then he stuck the needle in.  My eyes were closed the whole time so I’m not sure what happened.  It hurt and my tummy was sore after, but Noah was very proud of himself. We’ve both felt so helpless, but now he could do something to be helpful. 

            The next shot was the Follistim Pen.  This was kind of complicated too, but Noah loved it. It was like a little action figure doll from his childhood that had removable parts—like a transformer that went from robot-man to airplane. He removed some parts and attached the thin vial of liquid into the Pen, like he would an ink cartridge in a regular pen.  Then he put it back together and set the dial for the amount he wanted to dispense, and then he stuck it in my leg and pushed the medication in.  The injection itself didn’t hurt, but it stung for a few minutes after.  Part of me was waiting for the hormones to kick in, and to feel rage or extreme irritability as soon as the shot went in, but I didn’t feel anything. I kept asking if a beard was sprouting as I imagined one of the shots to my leg would result in a Chia Pet-like goatee within seconds. 

            We will go back to the doctor to have my follicles monitored and to introduce new medications. Looking at our schedule for the next 10 days is overwhelming, so we just have to take it one day at a time.

IVF CYCLE 1: LET THE GAMES BEGIN

Noah and I drove to Dr. N in complete silence. 

            We had felt disappointed at every other Dr. N appointment, so all I could do was hope that this day would be different.  I was exhausted. I had spent most of the previous day crying and hadn’t slept much the night before. I kept wondering if the cyst was still there, and what we would do if it was. I wondered if my follicle count had dropped back down, or if the additional month of herbs and acupuncture had improved it. Wonder wonder hope wonder.

            All I could think of in that moment was that we were driving.  Then we would be parking. Then we would be in the office. Then I would do the ultrasound.  One step at a time. 

            When we did the follicle count, I had nine. When we looked for the cyst, I had none.  Nine follicles, no cyst.  The tea Gilli had me on had worked.  Eating loads of seaweed and healthy whole foods, burning moxa over my legs and belly, sleeping with a heating “pat” on my stomach—whatever it was, it had worked. We got the green light.

            “You ready to do this?” Dr. N asked. He was much sweeter when he had good news.  He was excited and could see that Noah and I were ready.  I was calm, Noah was present, we were both focused.  Game time.  

            Nurse Danielle accompanied us into the office where Dr. N went over the various contracts and authorizations. I had to sign something that acknowledged that I am a low responder to treatment and the chances of having no embryos to transfer back in are high. We designated the highest number of embryos we would want put in (3-4), and initialed that we understood various protocols and disclaimers. They ordered the medication and sent us home with an appointment the follow day for our “injection lesson.” I asked Nurse Danielle if the meds were made of bovine urine or something gross like that, and she looked at me with a straight face and said, “Actually, I’ve heard its made from the urine of post-menopausal nuns.”

            And that was it.

A WELCOMED BURST

I don’t know if I was becoming extremely attuned to my body or a hypochondriac, but after learning about the cyst I started to imagine it, and sometimes think I felt it weighing down on my ovary like a paperweight.  It was unfortunate that the news of the cyst and what that entailed derailed us from being excited about the increase in my antral follicle count. Going from 6 to 9 was a big increase, and I believe that it was the acupuncture/herbs and change in diet, lifestyle, and perhaps attitude that got my count up. While different studies have different findings on how acupuncture contributes to IVF success rates, what I know is that acupuncture has been around a lot longer than IVF. There are no side effects or downsides to trying it. And it got me more follicles.  It just takes more time than modern day humans are used to. We want a pill to make whatever pain we have go away, NOW. Sticking needles into the body today so that we can feel relief a month later, even if it’s longer lasting, doesn’t appeal to all folks.  But Eastern medicine works with the body’s natural cycle and healing process and works to promote balance.  Take it or leave it. I’m taking it. But maybe it’s easier for me to believe in forms of natural healing because I grew up with them.

My mother is a somewhat of a witch doctor. If she were Latina she would be a curandero. But she’s not Latina, she’s Japanese, and she always believed that medicinal herbs and various plants could heal most ailments. 

When I started feeling a sharp pain where I knew my cyst to be, I immediately called my mother. 

“My side hurts.  It’s been a dull pain for a few days and now it’s sharp,” I complained into the phone. My mother never really cares about the specifics.  She will always start by telling me to heat it.

“Put the heating pat on it,” she said.  I liked that she calls it a heating pat rather than a pad. I had already called my sister-doctor three times but she had not returned my calls. 

“I know. I have it on,” I whined. 

“Do you have the black liquid?” Mom asked.

Ahh. The black liquid.  It’s a mixture of rubbing alcohol and the water of boiled leaves from a loquat tree, which supposedly has medicinal anti-inflammatory properties.  

“Take a pillow case and soak it in the black liquid and put it under the heating pat,” she instructed. Mom loves to deconstruct pillowcases, towels, sheets and dad’s T-shirts. Ripped up pieces of fabric are stacked in their linen closet, so that if you go to grab a towel, you’ll often end up with just a rag or half a T-shirt. Occasionally you’ll find squares of flannel from a pair of boxer shorts or old pajamas. My poor dad will be looking for specific articles of clothing for weeks, never realizing mom has some weird concoction or medicinal leaves buried in what used to be his bathrobe, being used to warm her kidneys or heal a slight sprained wrist. 

“I’m not ripping up a pillowcase,” I responded.

“Ok, just rub it on your tummy with a cotton ball.” There is usually a much less complicated way to apply the herbal salve, which makes me think mom uses her witch medicine remedies as a way to clean out dad’s closets.  

I rubbed the black liquid on my tummy and curled up into a ball, trying to decide at what point I would go to urgent care. I googled “cyst rupture” and spent an hour self diagnosing and cursing my sister for becoming a doctor and not being at my beck and call. Then I went to see Gilli.

Gilli agreed that maybe my cyst was draining or bursting. She pushed firmly, exactly where the pain was, just as my mother would have done to confirm that it hurt, and in her Israeli accent said, “put a heating pat on it.”

I knew why I was starting to feel genuine love for Gilli.  She was rooting for me and was a constant source of support and advice, but she also reminded me of my mother.  Though they were decades apart in age and on opposite ends of the cultural spectrum, they both shared the belief that the human body could heal itself, and that natural methods could assist in that healing process. 

When Hana and I were kids, mom had all kinds of natural healing methods, all of which burned, smelled funny, and tasted gross. 

She had a remedy for a throat ache that would make a child protective service worker suspicious. I have enlarged tonsils, so my childhood was filed with sore throats.  Most mothers would give their child a cough drop, maybe some Sudafed or a throat spray to help the inflammation go down. Not my mom.  My mom grated fresh ginger root and tied the pulp around our necks with a bandana, not letting us remove it until the burning and stinging sensation on the delicate skin of our necks had subsided leaving us red and slightly itchy and smelling spicy.  To her credit, after a day or so of this remedy mixed with a ginger, lemon, honey tea, our sore throats would be gone. 

Bronchitis (or a cold that is more in the chest) was treated with a mixture of powdered mustard and flour slathered on cheesecloth and applied directly onto the chest.  Again, we had to wait until the stinging stopped and our chests were sunburned pink before we could remove the poultice.  After several rounds of this followed by a bath in either ginger or boiled loquat leaves and that chest cold would be long gone. And so was wearing any kind of V or scoop neck shirt that week. 

An ear infection, sprained ankle or wrist, or ingrown hair: Treated with taro potato, grated into a mushy wet mess and wrapped around whatever body part with a scrap of flannel sheet and an ace bandage. The potato is kind of mom’s go to.  She has it stored in old yogurt containers and spaghetti jars in the fridge turning various shares of mucous white to gray. 

A headache, toothache, stomachache or basically any other ache was treated with Umeboshi, a little salted plum that we’d either eat, drink or tape to our temples with band-aids. Umeboshi is her Tylenol. It’s her panacea and tastes like a sour gumball rolled in seaweed.  Hana and I got used to it and ate it often for tummy aches.  If Umeboshi didn’t work mom, told us to go sit on the toilet while dad told us to stop complaining and go to school. 

That was how sickness was healed in our home. Dad didn’t always agree and I remember a few occasions where we were miserable for days on end with an ear infection and crusty potato crud oozing out of ace bandages around our heads and dad would insist we see a doctor. But going to the doctor was rare. 

Finally, my sister-doctor returned my call.  I was in bed with my heating pat noticing that the pain in my side had significantly subsided.  I wondered if I imagined the pain just so I could have an excuse to lay in bed all day with a good book.

“God, what took you so long? I almost died,” I complained, taking a sip of tea and earmarking the book I was reading.

“I was on night float. We had a crazy night. One of my attendings delivered a baby and the mother was bleeding out so I had to resuscitate the baby. It was blue and not breathing. It had poop in its lungs and trying to intubate it was almost impossible.  I was going to call for a code because it wasn’t breathing at all but then I got it to breathe.  It was scary. Then we had five new admissions…why are you dying?” She was tired. I had done nothing more than complain about my side pain, eat almond butter on toast, and write a few emails while she was saving babies. Getting her eggs would be a solid upgrade.

“I think my cyst exploded.  Wait, did the baby die?” Our conversations are always so strange when she is on night float.

“No, its fine. It was a huge baby. A really stressful delivery. Where does it hurt, closer to your ribs or your pubis?” She asked.

I loved that she said words like pubis now instead of “privates” or “chee chee,” or my current favorite, “homey chow chow.” 

“It’s like just next to my hip bone closer to the…coin purse,” I said with a smile. She brushed over the reference without so much as a giggle.

“That’s either your intestine or the ovary.  It could be gas. If it hurts and then stops a lot, the ovary might be twisted. That probably won’t happen though. The cyst was pretty small.  Does it still hurt?” 

“It’s better now.”

“Did you tell mom?”

“Yeah.”

“Let me guess, you’ve been heating it. Did she suggest a castor oil pack made from dad’s underwear?” She said.

“No,” I laughed, “but that’s a good idea.”

“You’ll be fine. But if you’re not then go to urgent care.”

“We don’t go to urgent care. I’d have to have my arm severed off to end up at urgent care!”

“Fine. Then eat two Umeboshi and call mom in the morning.”

AND THEN THERE WERE NINE FOLLICES…BUT…

Gearing up to see Dr. N the following month felt easier. I had made a promise to myself that I wouldn’t drive my hard-working husband absolutely insane talking about feelings and doubts, so we just lived our lives, as if, and it worked.  There was nothing left to hold on to. Whatever was going to happen was going to happen regardless of what either of us projected, thought, hoped, worried about, so we walked on the beach in Laguna and ate fried chicken at a fancy restaurant. We knew that any day now we’d have to go back in and hopefully start the shots. 

And when the day came, we were ready. But Dr. N wasn’t. He was at a fertility conference in San Diego and would have to phone in after we got the ultrasound. 

The ultrasound went as it usually did, except for two things:

Instead of six or seven measly follicles, I had NINE! Nine glorious follicles! One or two of which could be our baby! Gilli’s magic had worked, perhaps my body just needed a little more time to adjust to the months of needles and teas. It’s typical with acupuncture that it takes a few months because it treats the whole system. My follicle count increased by 1/3, which would give Dr. N more to work with.  

But…and there is always a but with this business, I had a cyst. A cyst in or on my ovary that was over 3 cm big. Which meant we couldn’t start injections. Noah and I nearly laughed. Obviously I had a cyst. Obviously we can’t start injections because…I don’t even know exactly, the cyst would steal all the hormones from the other follicles and then get so massive? I won’t even speculate. Bottom line was that we couldn’t move forward with this thing in the way, so our choices were:

1. Wait. Cysts like this are apparently common and often dissolve on their own.
2. Aspirate it.  Ass per wha? Have a procedure, not unlike what the egg retrieval would be, to drain it. I would be put under and it would cost close to $3,000.

Noah and I left with instructions to think about it and call the office by 3pm to let them know if they should schedule the procedure.  We got in the car and couldn’t even think. Who could we call for advice? Will this thing just be gone next month? If it is, will my nine follicles also be gone? What if it’s still there, we will have lost another month? We tried to sit with the information for a few minutes and listen to our gut. We were both ready to start this. At some point you have to pull the trigger and just do something. Dr. N could actually do something here, he could get rid of this thing and then I could start injections. And then we could have a family and be done with this mess.  Let’s do it.

I looked at Noah, and asked, “What are you thinking?”

We caught eyes. He was tired. I could see how frustrated and helpless he felt. Over the past six months, he was starting to get small wrinkles on the sides of his eyes and gray hairs had begun to poke out from his beard around his side burns. We wanted out. An aspiration would move us one step closer towards our goal, towards getting out.

“Let’s go for it.” 

He grabbed my hand and I could feel how sorry he was that my body had to go through all this stuff. He knew I was sorry that we were having this conversation rather than planning our annual winter holiday out of the country, a promise we made to each other when we got married. 

“Okay.  I just want to check in with Gilli to see what she thinks, but then we’ll schedule it,” I said, smiling.  I was about to schedule to have some kind of tiny vacuum suck a cyst out through my vagina and I was smiling. Oh how far we’d come! 

I called Gilli and left a message. She called me back immediately.

“Mayale,” she said. We had gotten close enough for her to have an affectionate pet name for me. “What’s one more month, can you wait? Cysts come and go. Why can’t you wait to see if it goes away by itself next month?” Gilli asked.

Because we don’t want to wait? Because we want what we want and we want it now? Because we are eager and ready and want to move on with our lives? Because I am finally relaxed and eating well and exercising regularly and taking care of myself!

It dawned on me in that moment that I was looking at this all wrong. I was looking at my life as being in this holding pattern, which it was, but that somehow, once we had a family, everything would be perfect and I wouldn’t have to be so concerned about my stress level and my health. I was looking at doing IVF like it was a marathon. Like I was training for this singular event and yet what I was really in training for was how to be a sane, loving, patient, flexible, accepting, healthy, calm person-wife-parent. It’s not a goal, it’s a way of being. Of existing. Of living! It not something I need to DO for just one, two, three more weeks. It’s something I need to be! And for Noah, there was a lesson in this as well.  That he can’t control everything. That life issues are not going to fit neatly into his ever hectic work schedule and he would have to find a way to prioritize me, us, our family. Not just for another month, but forever. 

“Can you be patient, Mayale? It’s just one more month. You’ll be holding your baby one day and it won’t matter. Come get a different formula of tea and give your body a little time to get rid of the cyst,” she said. My voice of motherly reason. 

Noah and I hung up the phone and looked at each other. And then we laughed. We had made a decision and then negated it within four minutes. That’s how this process goes. You have to trust your gut and your village. We needed to get outside ourselves for one minute to realize that waiting actually did make the most sense for us. Why not see if my body could deal with the cyst naturally, especially if that was very common and one of Dr. N’s options? Why do anything more invasive or expensive than I need to? If the cyst persists after a month I’ll have to deal with it and we’ll have to make a decision, again. 

Yes. I can be patient. 

A PUNCH TO THE GUT

I assumed my usual position in Dr. N’s dark ultrasound room. The big Egg Reveal! Gilli was aiming for ten.  I would be satisfied with eight or nine.  Anything more than the measly six that I started with.  

I don’t even feel the dildo camera anymore. It moves to one side, one ovary and we see a few Junior Mints.  Three.  Tiny ones. Maybe four if you count the little speck in the corner.  The lab technician measures them and we move to the other side. Three.  Big ones.  Dr. N refers to them as cysts and his eyebrows go soft. 

“Get dressed and come back to my office,” he says.

Why are there only seven? Why are some so big? What does this mean?

It means we’re a no go. Dr. N explains that the big follicles are already too big and after stimulation meds, they will, basically be rotten eggs (though he didn’t use that term) and he will only have the three-four puny ones to work with.  If you go by statistics, by the time the eggs are out and fertilized, chances are high that there won’t be anything to put back in.  

“If you’d won the lottery and it wasn’t as emotionally and physically difficult on you, I would say let’s give it a try.  Miracles do happen. But if you were my wife, I wouldn’t do this right now,” he said.  

I appreciate his honesty. I appreciate his success rate, and the fact he doesn’t want me bringing it down. I appreciate his willingness to do it, if I believe in miracles.  But I don’t.  I believe in getting what I pay for, and it seemed that I would pay for this round of IVF in more ways than one, and most likely have nothing but more heartache on the other end.  We decided to wait one more month to see if maybe next month there might be more follicles of similar size.

I called my parents crying. My dad offered to call to talk to Dr. N, as if he were a school bully, messing with his little girl.

“Dad, call him and say what?! You’re not understanding. It’s like I have a bag of six avocados and three of them are already super ripe.  If I need to make guacamole on Saturday, those three are going to have gone bad and taste slightly like smoked bacon.  The three unripe ones will be ready to go but then I’m hardly going to have enough guacamole!” 

My parents were completely helpless. It’s not a feeling any parent wants to have. Parents want to do things to protect their children from hurt.  My dad immediately began searching for adoption options.  He sent me a variety of emails, one entitled “Jews” with a link to a Jewish adoption agency, and the other with a question in the subject header, “Do you want an Inuit baby?” My mother-in-law jumped on the same bandwagon and sent a link to an adoptions agency in Northern California that works to get babies from Japan. With my ½ cup of Japanese blood, I may have a chance at a Japanese baby. 

Our families were trying to help but the message they were sending was the same as the one my brain was sending me. We’re fucked. Game over. This isn’t going to work. Try something else. Babies exist, my follicles don’t. When all else fails, our capitalistic society teaches us to just buy it.  But we wanted to continue to just DO IT! I didn’t want an Inuit baby, or a Japanese baby. Not yet.  I wanted my husbands baby.  I wanted my own baby.  Our baby.   And I wanted it yesterday.

I cried for the entire week.  I had a busy work week and cried between clients.  I cried in the car, I cried in the shower, I even cried at the gym after a yoga class.  At night  I cried onto Noah’s chest until he had to get a towel to wipe off.

I cried because I didn’t know what else to do.  Our one chance to make a baby that’s ours seemed to be IVF and now we were faced with the reality that that may not be in our cards. 

I felt like we needed some kind of plan, a real solid plan, just so we knew what the steps were going to be.  So much is up in the air, I felt like I needed a step-by-step game plan, even though I know full well things rarely work out as planned. 

Plan A) Some kind of miracle occurs and my one questionable tube opens and we make a baby the way most other people make babies.

Plan B) I have enough follicles for Dr. N to feel it is worth it to try IVF.  Now here’s the rub.  In the end, it’s up to us. He is going to tell us the percentages and statistics, and we are going to have to make a decision.  If there is a 99% chance it won’t work, there is also a 1% chance that it will.  You never know what side of the percentage you are going to be until you try.  And Noah feels try we must, or we’ll regret it.  I feel…similarly sometimes, but other times I see the diminishing pool of money we have and try to see what the best choice we can make to get a baby.  But alas, perhaps here is where my husband I differ slightly. My urge is strongest for being a mother. His urge is strongest to pass down his biology to some unfortunate child who will get flat feet and a concave divot in his chest. I’m not going to lie, not that I think I’m the cat’s meow or anything, but I also want a biological child. So there is two votes for IVF. Plan B was whatever it takes to combine my biology with my husbands.

Plan C) My poor sister. My generous, loving, brilliant sister offered her eggs.  Well, not really. The conversation happened about six months ago when things were not going so well but asking for eggs still seemed a little bit like a joke.  In a fit of tears and despair I called her and said, “If I’m sterile and broken you’ll give me your eggs right?” To which she responded with a yes, just to get me to stop crying. Now that this may in fact be a serious reality, I can feel there are moments when she is back peddling a bit.  Like when I asked her again, to think about it, to talk to her boyfriend (hopefully future husband) about it and she said, “Well, I still think you should try, a few times, with your own egg, don’t you?” I’m asking a lot.  The hormones, the doctor’s appointments, the procedure, the genetic piece of information that will make a baby that is biologically hers and my husbands. For a third year medical resident what I was asking was impossible until the summer of 2013 when she would be out of residency and possibly able to move home for a month to be harvested. What I was asking from another person who potentially wants her own children, was a piece of herself she may not want to give.  This is all assuming that my sister, three years my junior, doesn’t have the same low follicle count condition I have. How do I carry my sister and my husband’s baby and not feel like some kind of freak show? How do I not resent the fact that may parents, Noah’s parents, and Noah all get a biological grandchild and child and I don’t? What if, god forbid, my sister can’t have kids when she is ready? Will she feel like I, literally, robbed her of her own opportunities? Having my sister’s eggs would be an amazing gift. It would be a hell of a lot better than having a stranger’s eggs or no eggs.  Both of which are also possibilities in Plan C.  

Plan D) We adopt. We may want to sign up for an adoption agency if Plan B fails, so at least that is in the works.  Plenty of people do Plan D.  It’s just, well, a Plan D.  

Plan E) I kill myself. (Just kidding.)

Now that we had a plan, I needed to get through the next three weeks without obsessing. I needed to cultivate the hope and optimism that I just needed one good follicle with one good egg to make one good baby.  That’s it.  One.  I have a friend who did several rounds of IVF and produced 15-20 eggs each round, but all her eggs were bad.  She pointed out that one good egg is better than 20 bad ones. True.  

ANTICIPATION ANXIETY (Trying to start IVF)

We have about two weeks before we go in to see if the last two plus months with Gilli have paid off. We are hoping for more than 6 follicles. We are hoping for good quality eggs. We are hoping Dr. N doesn’t have more bad news, more frowny faces. 

The anticipation has brought up all these other feelings and questions and worries.  If I have the exact same number of follicles, I feel like I’m going to be upet.  I’ve been drinking dirt tea and meditating and doing yoga and watching my diet like crazy for three months! I’m anticipating feeling defeated before we even go in there.  And I’ve taken to reading about low responders again, and I anticipate being upset by having to sign a waiver that I acknowledge that I’m a low responder and the injections may not even work for me. 

The only antidote is to stay present. In this moment I am not injecting myself in the stomach. In this moment, no doctor is telling me I need to move on to another option. In this moment I am not defeated. That’s not to say I’m never going to be, but all I have is right now. Somehow reminding myself I could be hit by a bus and die tomorrow is helpful.  You know you’re in a crap place when that is a helpful thought. 

One helpful thing I’ve been able to do to cope is just let myself feel whatever it is I feel.  Not fight against it, or tell myself I “shouldn’t” be angry or “there’s nothing I can do.” I just acknowledge when I’m having a harder moment. I tell Noah when I’m feeling emotional. I go with whatever I’m feeling and I don’t try to pretend it’s something that it’s not.  That wouldn’t be genuine. I still try to make myself feel better and I still try to stay active or treat myself to things, but I do it with the intention of taking care of myself, not with the intention of making the bad feelings go away.  Because in a way, they’re always there. Sad feelings have kind of become my baseline, so it’s just a matter of trying to make them less strong.  

There is not way I’m not going to be anxious about what lies ahead.  There’s no way I’m going to be happy or excited. But there is a way to go with the flow and keep myself busy and appreciate the present moment.  It’s just a constant challenge.

IVF BOOTCAMP (WITH GILLI, THE INCREDIBLE ACUPUNCTURIST)

Dr. N sent me to Gilli for 2-3 months before we were to attempt an IVF cycle.  I don’t know if it was because he could see I was completely freaked out that in the time span of two months we’d gone from “don’t worry, let’s just do some little tests” to “welcome to the world of IVF,” or if he had confidence that Gilli would whip me into mental, physical and emotional shape.

Gilli is an Israeli acupuncture doctor and herbalist who specializes in fertility and women’s health issues. I had seen several acupuncturists before her, but none of them remotely compared. Gilli is a thin, curly-haired mother of three (boys!) with a calming presence and a direct approach. She tells it like it is and doesn’t really see the point in complaining.

Noah and I arrived at her office bright and early on a Monday morning.  She gave me all kinds of forms to fill out, checked my tongue and my pulse and diagnosed me with a variety of imbalances including a kidney yang deficiency, a cold uterus, and some blood flow blockage. In Chinese medicine, the kidney system is connected to the reproductive system and it is affected by anxiety and stress. The remedy was to eat only warm foods (no salads, sushi or frozen yogurt), cut out sugar, caffeine, dairy, refined carbs and anything else delicious. And to drink Gilli’s special fertility tea three times a day, which tasted like there should be an earthworm at the bottom of each cup. And to take specific vitamins including coenzyme Q10, fish oil, vitamin C, and a prenatal. And to rub a burning incense stick that contained an herb called moxa over my lower tummy for twenty minutes a day. I was prescribed a meditation CD and instructions to chill out. 

Taking care of my imbalanced kidneys and cold uterus became a full time job, and eventually a total obsession.  I channeled all my energies into being well, which was perhaps better than Googling “common causes of cancelled IVF rounds.” But being obsessed still meant being unbalanced. Being resentful that I had to do all these things still meant I had not fully accepted that this is our path. Being doubtful still meant I didn’t believe this all was going to work. 

But how could I completely believe? Having six follicles essentially meant by the time they take them all out and see which ones are of decent size, maybe there are four to work with. Then your mix those four with sperm and maybe two or three take. Then you wait until they start splitting and are lucky to get one Junior Mint to put back in.  All that effort, the hormone shots, the thousands of dollars for being lucky to get one? Yeah. I had doubt, resentment, and fear. 

Gilli agreed that six follicles was not a good number.  

“We want to go ten-seven-three,” she said, while putting needles in my stomach and hooking the few over my ovaries to what looked like a small car battery to provide electro-stimulation.

“Ten-seven-three? OK.” That sounded better than six-three-one. 

Gilli seemed confident.  That’s why I was there. To stimulate my ovaries and get more follicles. So I would do my part and she would do hers. If she told me to eat rat poop I probably would have done it. At that point, I needed a team of believers and doers. 

The first week with Gilli went great! My mom and my aunt Mari came over to cook all kinds of Japanese veggies—kabotcha (pumpkin), seaweed, burdock roots and carrots—it was delish and I felt healthy. I ate whole organic cooked food only and only had a mild sugar/caffeine withdrawl headache. 

Week two was fine. I stopped craving sweets and ate lots of farmer’s market veggies. The tea was more bearable and I committed to reading a book called “Way of the Fertile Soul” without cynicism. I spent half my days cooking and taking yoga class and felt grateful that I had this time to focus on myself. I lost a few pounds and was sleeping better.

By week three I lost it. I was so bored with my diet, so angry that I had to do this, so fed up with the meditation CD.  PEOPLE ON CRACK GET PREGNANT! This seemed insane.  I was deprived and obsessive and so resentful that this is how I spent my days, cooking azuki beans and brussel sprouts. I wanted to contribute to the world in a more meaningful way. I wanted to feel like it was okay to go out to dinner with other people without being one of those, “is there cheese on that?” people.  I wanted a fucking cupcake! 

Luckily we were headed North to Seattle for the weekend for my brother-in-laws wedding where there were ample cupcakes, of which I had my fair share. It felt so freeing to splurge on scones and, dare I admit, a cup of coffee! The caffeinated kind! Four days of non-restricted eating was the most thrilling thing to happen to me for months. But when I got home, Gilli knew.

She read my pulse, hesitated, and looked me in the eye.

“What?” I asked. “Can you…tell something?”

She exhaled loudly and said, “Your pulse is faint. You haven’t been eating quality food.”

How did she know!! Are a half a dozen cupcakes standing in the way between me and my Petri-dish baby? I guess I have to get back on the wagon, just for a little while. 

DOUBLE EXPLAINED INFERTILITY (D.O.R?! WTF?!)

The third appointment with Dr. N included an vaginal ultrasound to count my follicles and series of smiley or frowny faces that Dr. N drew on a piece of paper.

My FSH level: 4.8 mIU/mL.  Smiley face.

My Inhibin B level, which helps determine egg quality: 79 pg/mL. Smiley face.

My Anti-Mullerian Hormone, which helps give an estimate of the remaining egg supply: .31 ng/mL.  Frowny face.

My Antral Follicle Count, the number of follicles seen during the ultrasound: 6. Frowny Face.

Having two Alaska Airline Visa cards, one American Express, one Virgin America Visa, and one Discover card: Smiley face.

So the big deal about my tubes being unexplainably blocked no longer seemed to be the issue.  The bigger problem was my egg reserve.  With such a low follicle count there is a high probability that I will respond poorly to the stimulation drugs and a higher rate of IVF cycle cancellation. Seriously?

Dr. N explained the process, but what I heard was out of 6 follicles we may retrieve 5. Out of those 5, 3 may be of decent size. Of those 2, 1 will actually be able to meet the sperm and divide properly. But then that one will deflate and turn into jiz foam that the doctor will dump on my head and a bell will ring and everyone in his office will yell, “You Lose!” But I am dramatic and pessimistic.

What Noah heard was that we still have a chance.

What Dr. N then recommended is that I take two-three months to try some alternative medicine solutions, like acupuncture, to get my body and mind right. Then we have to move quickly. My reserves are running out.

I figured I would give myself three days to be angry and doubtful.  Three days to inundate myself with Internet “research” that just reiterates how minimal my chances are, and then I have to refocus.  I have to see the glass half full.  I have to believe and imagine that this will work. I have to have faith and hope.  Maybe this is my life lesson.  Maybe finding optimism is really what this is all about. So I can create a home for a baby who may go on to do great things because of his/her positive attitude and determination.  I’m determined but defeated. 

And this is only day two. So I can question and obsess and be negative and hopeless and angry for another day and a half.  So here goes:

Why is this happening? Why is this so easy for some people? Why is my body broken? Am I going to start carrying a cat in a onesie around in a baby bjourn? The Internet says a normal total antral follicle count is between 15-30. And that a count less than 6 indicates a poor prognosis. FUCK FUCK FUCK!

There’s more where that came from but I need to move on. Operation optimism is in full effect. But how? My logical brain, my rational self can see my numbers and understand the science behind my actual odds. But the tiny drop of spirituality that lives deep inside my soul knows how badly I want a baby.  It knows that there is a psychological component to all of this.  There is power in hope and healing in positive energy.  This situation has given me no choice but to learn to cultivate some of this optimism that is buried deep within my cynical, charcoal heart. 

In order to actually do this, I need a plan. I have two plus months of IVF prep to increase my shitty egg situation through calming my body and tricking my mind into believing I’m an optimist.  No wait, that sounds like a pessimist in sheep’s clothing.  I have to create a two month mental and physical training program to help me battle any doubtful or negative thoughts and learn to become a more open and hopeful person.  That sounds better. I wish I could just buy optimism on the Internet. Maybe in a tincture. 

It’s not totally true that I am a negative person. I’m selling myself short. Being a psychotherapist, I HAVE to have hope.  Hope that my client’s can get better, that life is worth living. And I do. I just have a tendency to forecast the worst possible situation. 

So I need to start utilizing some of the cognitive-behavioral strategies I teach to my clients. The worst thing that happens is IVF doesn’t work. We will have lost time and money, and I’ll probably have a few bruises on my belly, and we’ll be back to square one in our attempt at figuring out how we’re going to build our family. 

The best case scenario is that I learn to relax. I learn to cultivate hope and acceptance of what is. I learn to love myself and my imperfect insides and I have faith that somehow the universe and my Doctor and my husband and my huevos  will band together to make me a baby. 

 

STOP TELLING ME THIS IS GOOD NEWS (THE HSG and BEYOND!)

In March of 2012 we finally went to see a fertility specialist, Dr. N.  After 21 months of being in this process it was time to see someone who could tell me more than “just relax.” 

Dr. N broke it down for us pretty simply.  We first had to get a few more diagnostic tests.  Depending on how they came out we would have choices of trying some medications, a combo of meds and Intrauterine Insemination (IUI) if needed, and as a last resort IVF. That was the tentative game plan. 

Dr. N told us (and by “us” I mean me. As much as Noah wants everything to be a “team” effort, let’s cut the shit, 99.9% of everything that happens, happens to my body. The most he needs to do is drive, jerk-off into a cup, or hold me) to get a hysterosalpingogram (HSG). It’s an “unpleasant” procedure that shoots dye into the uterus to see if there is any blockage in the fallopian tubes.  Since I never had a history of surgery or STD’s or symptoms that would indicate endometriosis, he said it would probably not reveal much but it was good to do.  He wanted that done as well as bunch of blood tests.  At the end of our appointment he handed me a tissue to wipe my eyes and assured me I will have a baby.  He assured me that I’m young, I’m healthy, we have sperm—all was good.  

I scrambled to find a way that some of the tests I needed to do could be covered by my insurance (they couldn’t) and then bit the bullet and had the HSG done the following Tuesday.  Let me correct anyone who believes having a #5 French balloon tipped catheter inserted into my uterine cavity, which is then inflated while the dye is injected into the body is an “unpleasant” experience. It was painful as shit! No amount of valium or ibuprofen (both of which I took in excess) helped the piercing pain and complete panic that overwhelmed the lower half of my body when sharp objects were inserted into my lady parts.  The radiologist wouldn’t say a word to me other than “try to relax.” YOU TRY TO RELAX! YOU’RE SHOVING A PITCHFORK WITH A BALLOON AT THE END INTO MY VAGINA YOU DEVIL WOMAN! When I started squealing, “I can’t I can’t,” the nurse in the room instructed me to breathe.  I took a deep breath and turned my head towards the monitor that showed what was going on in my insides.  There was a little shape that looked like a moth flying off to one corner, and then one windy-looking string attached to it that bubbled at one point and then looked to have exploded. When she was done I was handed a towel to hold at my privates and the radiologist started to bolt out of the room. 

“Excuse me. Wait. Can you tell me what you saw?” I was confused.  The image on the screen didn’t look like the classic images of a uterus and fallopian tubes that were in textbooks.  A round blob with elephant trunk-like arms on either side with dangly fingers floating towards the ovaries.  My shit looked like a moth kite on a tangled string. 

The radiologist stopped at the door.  She didn’t want to discuss her findings.  That was my doctor’s job. 

“Please, just tell me what you saw?”

“The left tube did not visualize. There was only one fallopian tube that was open.” She walked out, seemingly annoyed.

One fallopian tube? Where’s the other one? Was I born this way? Were there cysts or fibroids or peanut butter jammed into my tubes? Why would that be? I hobbled towards Noah, holding a bloody towel to my privates, passing an old man waiting to have his foot X-rayed and a young man with his arm in a sling. 

Noah ushered me into a small dressing room and helped me get dressed.

“There was only one tube,” I said.

“Where’s the other one?”

Exactly. Where’s the other one.  At our follow up with Dr. N two days later he didn’t have an answer, but his tone was different.  He didn’t like that my uterus was so far off to the right.  He didn’t like that the one tube that was seemingly open looked to have some blockage as well, like a bent hose it bubbled up and then burst. He didn’t like that there was only one tube. I don’t like anything Dr. N doesn’t like.  

He wanted us to do more specific blood work to see how my egg quality and hormones were and he discussed laparoscopic surgery to see what was really going on inside and to rule out pelvic adhesions. 

I went back and consulted with my OBGYN, Dr. E.  He wasn’t that concerned with my pictures. But he also wasn’t that concerned that after almost a year-and-a-half I still wasn’t pregnant. 

“It could be a spasm,” he said, looking at the images.  

“Well what if it’s not? I’ve been having a sharp pain on my side since the procedure.  Could there be an infection? Maybe I have endometriosis—I get really bad back pains, could that be what’s going on? How can we see if I have that?”

Laparoscopic surgery could help us see what might be going on. Two docs. Two votes for laparoscopic surgery.  I called one more doctor, my best friend Gabe’s dad, an OBGYN in Chico, CA.  I explained where we were at and sent him my pictures. 

He said the problem looks to be with my plumbing. Vote #3 for laparoscopic surgery.

We scheduled for a Tuesday, but since my period came early we had to move the date up.  Noah would still be in Louisiana, “gator-gliding” with his 5-month pregnant reality TV star for the show he was producing.

“Should I just do it?” We were on Face Time, where many of our life decisions are made.

“I wish I could be there but if it has to be now then do it. Then we will know. “

The plan was for Dr. E to put a camera in through my belly button and make a small incision below to see what was going on.  He would cut any adhesions that may have been growing like a spider web, potentially connecting my left fallopian tube to my uterus, burn any lesions or endometriosis type gunk, and re-do the dye test to see how the tubes were flowing. My sister was in town and since she’s a doctor, she was designated as the best person to be with me that day. 

I thought I’d go in, get my one tube cleaned up, and be able to work the next day.  It was outpatient. How bad could it be? We got to the hospital early and played around with the blood pressure equipment until Dr. E got there.  He smiled. He said, he’d pass the dye through, clean up anything that may be causing pain, and free up the tubes best he could, if that was in fact the issue. 

I lay back on the bed waiting for the medication in my IV to kick in.  Worst case scenario is that there is in fact only one good tube. If he cleans it up, then I’ll have to go on the dreaded Clomid again, but then we could try naturally for a while, at least on the months I ovulated from the right side. And if that didn’t work we’d move to the turkey baster.  I was ok with that.

I woke up with an oxygen mask on.  My chest felt like I had been punched in the sternum and then hit by a bus.  

“Please get my sister,” I called.  The nurse moved about quickly, telling me to stay calm.  I couldn’t breathe. My mouth felt like I had been eating toxic paint chips and cardboard. 

“Please, get my sister.” 

Time stopped. All of my organs and insides had been displaced by air so they could see my uterus et al. They put a catheter in my bladder and a breathing tube down my throat. It was excruciating but crying was not an option. Moving was not an option.  My sister came running in and got me some water and juice.  She held the cup to my mouth.

“What did Dr. E say?” I gasped between sips.

“Are you sure you want me to tell you now?” She said, disappointment in her voice.

“What?”

“He couldn’t get dye through either tube. They were both blocked. He seemed surprised.  The uterus was good, no adhesions.  He said you are probably a good candidate for IVF.”

“What?” 

She pulled out color picture of my insides. She showed me where the dye bubbled and became blue but didn’t flow through the tubes the way it was supposed to.  I never thought of that. If one tube was open during the last X-ray, why was it closed now?  He didn’t know. She didn’t know. But what I knew is that all the options that seemed so terrible, going back on Clomid, having to be inseminated by a man not my husband, all of a sudden sounded like a dream compared to IVF. 

Please can we just take a step back?  Remember when I was being bratty because Clomid made me hormonal and moody? Remember when I was complaining about that gooey feeling the vaginal progesterone gave me? It’s fine.  I changed my mind! Please, let one of those things work. I’ll go on it at double the dose. Please. 

I felt like someone beat the shit out of me and then forced me to buy a very expensive one-way ticket to invitro-ville where I would be forced to live in exile with nothing but a bag of hormone shots and a calendar full of doctors appointments. I will stop complaining about how long this is taking. It can take another year, just let us make a baby on our own.  

I got home and took as much Vicodin as my sister would let me. I got a letter in the mail fro my insurance company that said that even though they formally approved the surgery, they may not deem it as “medically necessary”, so it may not be covered.  A very helpful letter to receive after surgery has taken place.

Hana broke the news to Noah while he was in a crew van driving from Hammond to New Orleans, Louisiana while my parents got in my bed with me so they could perform their version of “Reiki” on my bloody belly button and stitches. 

My dad balanced his clumsy paws and sausage fingers over my clavicles, which felt like they were broken in two, my mom placed her warm hands on my belly under the heating pad and together they closed their eyes and sent their love and healing energies to my broken heart and my failing reproductive system. And then I started to feel the weight of my father’s massive hand start to collapse on my chest, and my mother nervously began to pick at the band-aid over my belly button. Enough was enough.  I started to laugh and cry and yell at them to get off me, it nearly split my stitches. 

I wrote to my in laws and other family and friends.  But I started to see how very hard it is for a) anyone who is not going through this to understand or relate and b) for those same people know what to say to me.  

In general, there was a lot of support and excitement that my uterus seemed to be in good shape and that IVF was going to be this awesome new adventure. Like all they had to do was take an eye-dropper and plop a dollop of baby potion into my belly button and wa-la! Like all I will have to do is swallow a few watermelon seeds and say some prayer in Hebrew and nine months later Junior Mint will be! IVF is NO JOKE. It’s great that I MAY be a good candidate depending on how my blood tests come out, but I’d much rather be a good candidate for board member of the otter society or chief cup-cake taster at Sprinkles Cupcakes.  It’s like each step takes us father away from this happening. Each step that some possibility gets checked off our list (bye bye IUI) you look at what you do have. I have legs! Yay, score! One point for Maya. Noah has a penis.  Hey Five points for team Junior Mint! And…wait for it….we have a uterus!!! Next week I should find out if I have decent egg quality (though you can never really know until you actually take them out I believe) and then maybe we’re in business.  We can scrape together something that resembles a baby embryo in a dish and jam it into my apparently functional uterus and pray that $15,000 doesn’t get flushed down the toilet with my next period.  Are you kidding! This is what I’m excited about? All the kind friends and family who have “faith” that I will be a “mother” and that we will have a “beautiful baby” of our own.  To what end? And how many rounds? For how many months? As what cost to my body, mind and marriage? And bank account! And it will all be “worth it” And I “won’t remember any of the pain I went through when I look into my crying baby’s eyes at 3am?” The hell I will!!! 

Remember when babies were made when a man loved a woman and they made sweet love to each other and nine months later they became a family? How do I get that? With each thing I do, each bit of information I get I fall deeper into the abyss of barren “auntie” Maya-land. Can no one be sad with me for a moment? Does everyone have to be a cheerleader and identify that “at least now we know!” I long for the days of confused trying, standing on my head after sex, feeling hopeful. That’s not really true, it’s better to know, but it sucks. And it’s sad. And it seems like Noah and I will never rub our parts together and make a baby. And I have to stay optimistic and hopeful. And I have to believe. But I also have to mourn this loss. At least for a little.  When my stomach doesn’t feel like someone took a bike pump to my asshole and blew me up, maybe I can get a good cry in and then move on. 

LAST GAL STANDING

I work at an agency that provides mental health services to kids and families. I also work with over 90% women, 80% of them are mothers, and a good chunk of those mothers have become so in the time that I’ve been trying.  Granted, my math may not be totally accurate, but I know it feels like we are always having baby showers and special announcements at out staff meeting about expected babies. I also know that a handful of other women at my office have struggled with similar issues to what I’m going through. Many have shared their stories and hopes for me. For that I am grateful.  But we are still the minority. The majority of women at work were popping out babies like rabbits. At least that’s how it felt.

I tried not to feel resentful or jealous, but how could I not? No one wants to admit they are jealous. No one wants to feel jealous. We make up all kinds of excuses, “No I’m not jealous, I’m just reminded of what I don’t have.” “No, it’s not jealously, it’s just a surprise that it was so easy for them.” “I’m not jealous, I’m sooo happy, they totally deserve to be soooo happy.” Forget that. It’s jealously. Pure and simple. It’s not like I’m choosing to be jealous. In fact, it’s one of the uglier emotions to feel and is totally useless and just creates more anger and self-loathing, and thus more jealousy. A vicious cycle of ugly. And I want to be happy for other people. I want to go to baby showers and buy cute clothes and talk about names and rub people’s bellies.  I was able to for a while, but there comes a point where another baby shower or pregnancy announcement became overwhelming and upsetting for no rational reason.  I noticed myself avoiding pregnant women in public and staying out of the staff kitchen at lunch so I didn’t have to hear the complaints from new moms about having to pump in their office or being kept up at night by their newborns.  I wanted to pump. I wanted to be tired from caring for a baby instead of crying for a baby. 

I hated that this process had made me this way. I felt angry all the time. Displaced anger at my mom for asking a question about a pregnant friend. Anger at my husband for not being more eager to have sex when I was ovulating. Anger at myself for being the kind of person who is jealous of another person’s blessings. I’m not normally a jealous person, so this new…personality trait was not only not very becoming, it sucked. I sucked. I felt snippy and nasty and bitter.  Infertility turns you into a person you never would choose to be, and it takes almost all your willpower not to give pregnant strangers the stink eye. 

But how could I expect to feel at this point? After a year plus of trying and not getting much help from doctors it just seemed like every month was this desperate futile attempt.  And every month I did everything I was supposed to do. And I waited and I tested and I hoped, and then some bitch at work or in my condo or in my circle of friends would announce they got pregnant, “without really trying.” Giggle giggle laugh laugh, OMG! And I say bitch with the most sincerest of apologies. I’ve become a terrible person. 

Noah kept telling me what happens to other people has nothing to do with our lives. People in Wyoming win the lottery and it doesn’t affect us. Friends land great jobs, move into awesome homes, and take fabulous vacations and we are super happy for them. But somehow this feels different. I just couldn’t explain it to Noah, who saw the red flags of my increasing baby obsession. 

I would come home screaming when I learned of a new pregnancy. I tossed baby announcements in the trash, with not so much as a glance at the sleeping new born or his tiny feet.  I was paranoid to go to dinner with couple friends in fear that someone would say, “We have something to announce.” I just couldn’t handle it. And Noah couldn’t handle me. I was paranoid, isolating, and angry. He started shielding me from baby news, which was kind of easy since I’m not on Facebook or other social media outlets. I can’t imagine if I was linked in to social media, I would be snooping around like a crazy person counting all the people I went to high school with who had babies.  It’s so useless. I had other hobbies: yoga, pottery, bike rides and beach walks, cooking. But all I could really do was obsess about babies and think about how unfair it was that we couldn’t have one when we wanted one. How self-centered and self-pitying.

Infertility had gotten the best of me, and this was well before we even really started on our infertility journey. I was hard to talk to and difficult to be around. Even when we did other things, I was still always thinking about why I couldn’t get pregnant. 

Noah also started to think about why this wasn’t working for us. The only thing more ironic than me working with kids and families was the fact that my husband, who usually produced reality shows starring professional surfers, musicians, or aging celebrities, was working on a show with twin sisters, one of which was several months pregnant when the show began following their lives. The second twin would go on to have a baby as well, and he would go through two births of his reality co-stars before we would even figure out what we needed to do to attempt pregnancy. 

By day Noah would have to deal with a pregnant diva who was delusionally convinced she was the first woman on earth who ever had the burden of carrying a child for nine months.  She demanded special foods and cancelled shoot days because of fatigue and started all sentences with, “Now that I’m about to be a mom…” as if she was the Virgin Mary. Noah shot her doctors appointments, her interviews with doula’s and midwives. The show organized and covered her baby shower and “baby-moon” and all the moments leading up to the birth. Noah was inundated by all the excitement and anxiety that surrounds becoming a mother and creating a television show around that, and at night he got to come home and hold me while I cried about how I couldn’t become one. 

It all seemed so completely and totally ridiculous and unfair. And rather than banding together, our relationship felt strained. I constantly felt guilty about feeling so sad and angry and he constantly felt helpless and exhausted by his work and our life. By this point, we had been together for over ten years. We’d been through brief break ups, losses of grandparents, job transitions, my graduate school, being so poor we had to sit in the car in our neighbor’s driveway just to get internet on our laptops.  We’d traveled to different countries and gotten lost in places where no one spoke English and we didn’t know which way was out. We bought our first home together and moved into it on a wickedly rainy day with nothing but garbage bags full of clothes. We’d been through a lot. And we were always able to go through tough times with curiosity and laughter, and confidence that we would figure it out together.  Somehow, some way.  But the constant stress of baby making was a different beast. This wasn’t a moment of crisis, but a continuous beating of our spirits that came like clockwork, every month. This wasn’t something that had alternative creative solutions, there was just one, and until that happened it seemed like this rut would continue to sink deeper.  By the time I did finally get pregnant, I feared I would end up being a single mother. 

We wanted to connect. We wanted to have fun. But I don’t think Noah could ever really feel what I was feeling. He wanted this madness to end.  He wanted a to be a dad, to have a child he could play ball with.  He thought it would be fun.  I NEEDED a baby to feel like a whole person. I NEEDED to know my body wasn’t totally defunct and that we would get a chance to continue the human race. My need versus his want was hard, because he could never feel the intensity that I felt. We started arguing over stupid things.  How frustrated I was that he wasn’t more interested in reading the websites and books I was reading about infertility.  We fought about how he wasn’t that interested in my cervical mucous and about how he wasn’t as upset as I was when someone else got pregnant. I snapped at him when he rode his bike too much or when he worked with his laptop on top of his lap. I resented all that I was doing to keep my body healthy and functioning and how he didn’t have to do much. We fought about how much more I thought about all of this and how unfair that was. It was ridiculous and terrible.

And a moment came when we both decided this couldn’t totally be our life. Noah had faith that our time would come when it was supposed to, and ultimately, I had faith in Noah. So we planned vacations and weekends away. We went to rock shows and listened to comedy podcasts at night. I started cooking more and made a point of going on beach walks with friends. I began working part time at the agency to decrease my stress level and started a small private practice with a girlfriend so we could do different groups with kids. 

Life went on. And it was just the two of us. And the more I observed how my husband reacted under stress—calm, calculated, compassionate—the more I loved him and wanted to make a baby with him. My desperate frustration continued but I did my best to spare him from it. And there were moments of relief, and dare I say it, fun. 

Our ship seemed to be slowing sailing on.   

 

THE TIMES I THOUGHT THIS HAD TO BE IT

Noah always explained baseball to me as a game of failure. Even the best players strike out 7 out of 10 times. A batting average is considered high if it’s in the 30 percentile. And with only three strikes until you’re out, chances are slim of actually making contact. He learned this in elementary school during the lesson on statistics. I learned this as an adult when a prerequisite for our relationship was that I became a die- hard Giants fan.  

Noah was born in Sacramento, CA in the late 70’s. He grew up in an idyllic childhood setting. Tree lined streets, neighborhood block parties, friends in the neighborhood he could ride his bike to and play baseball or GI Joe’s with.  And of course, there were the San Francisco Giants. 

He remembers going to his first baseball game with his dad and brother. It was 1987 and the Giants were playing the Braves at Candlestick Park in San Francisco. He doesn’t remember who won, he thinks the Braves did, but it was souvenir watch day and he got a plastic digital watch with a black band and a Giants logo on the face. He’d never been to a stadium, so the size was overwhelming. At eight years old, my lanky husband probably weighed no more than 60 pounds, and he remembers vividly the feeling of being so small, yet so connected.  They were sitting in the upper deck and had to take a huge escalator all the way up.  Then he looked down from the top and realized how big it all was. He said he was always a kid who liked baseball, but after that game baseball was everything.  He went to many a game after that and his dad said he used to cry when the Giants lost. 

It was easy for me to become a Giants fan, because I went to college in the Bay Area and it seemed like a good way to fit in during those trying college years where one doesn’t always feel like they belong anywhere. I was born and raised in Los Angeles, and the Dodgers suck. So I became a fan of the game of failure, and found myself rooting hard for a team that often fell short. 

When we started trying to make a baby, I realized that doing so was kind of like baseball: a game of failure.  That sometimes people hit a homerun their first at bat, but more often than not they struck out. Time and time again. There is often a losing streak that happens and then some change in momentum. Some player gets hot and the team follows.  

We had been on a losing streak. A LONG losing streak. So I figured it was just a matter of time before our luck turned around.  

Extra Innings

When the Giants won the National League Pennant in 2010, I thought my husband broke my rib.  We were visiting my sister, now a family medicine doctor, in Santa Rosa, CA and headed to a local bar to watch the game because my sister had a piano instead of a television.  

The place was packed with Nor-Cal locals in various decades of Giants apparel.  We ordered a plate of fried foods but Noah didn’t touch a single thing. He was nervous.

Anyone who knows my husband knows that he doesn’t normally get nervous or express much emotion. His lack of emotional range is one of the three arguments we frequently have, the other two being the way he falls asleep the second his head hits the pillow, even if I am mid-sentence, and the way he says he’ll do something but then gets distracted and forgets. 

It was a tie game in the top of the 8^th inning against the Philly’s. Giants were batting with two outs when Juan Uribe smacked a solo home run into right field. It just cleared the wall and the Giants won that game 3-2.

When the game was over, Brian Wilson crossed his arms over his chest and pointed to the sky, a gesture to acknowledge his father. The Giants were going to the World Series. The bar had erupted and we were high-fiving strangers and listening to older men talk about how they have almost waited a lifetime for this moment. Noah grabbed me around the chest and squeezed me so hard I started coughing. For a moment I thought I saw a tear in his eye. The only tear I’ve ever seen.

It was the perfect moment for him. He had been waiting for this since he was a kid in his Will Clark jersey and oversized baseball cap. When we got home that night I just had this feeling.  It was the perfect day. The perfect moment to break the news that he was going to be father.  It was just about that time for me to be able to test, and obviously, I brought along the super expensive, super-sensitive pregnancy tests that I had bought in bulk on-line. 

I snuck into the bathroom, peed, and waited. Nothing.  We got ice cream sandwiches and I made a promise to myself to STOP thinking about the PERFECT time to find out I was pregnant.  There is no such thing as perfect timing.  Any time is perfect.  I had to let go of that romantic ideal about how things should be discovered or created, because time after time it just became a humiliating feeling. Sitting over a little stick, pee dripping from my hand, undies around my ankles. Embarrassing. 

Cut to almost a YEAR later. Well over a YEAR of the tortuous cycle of ovulation, forced sex, waiting-hoping-praying, then disappointment, I was still believing in the perfect moment. I was still believing that our luck would change.

It was a Monday.  I peed on the ovulation strip and had two solid purple lines.  It was go time and Noah was working late. When he got home I bum rushed him as if he were completely irresistible in his rolled up jeans and bike helmet, sticky with sweat from his ride home.

“You’re ovulating,” he said, knowing better than to fall for my awkward seductions. Sex had become a chore. He knew why he was there and there was no fooling him.  

He took off his helmet and walked towards the TV.

“Giants are on. Game’s almost over,” he said, leaving me standing there.  

“That’s so rude!” I said, imagining my egg falling through my fallopian tube at top speed. I never knew how long I ovulated for.  I had so much anxiety about the exact right time to do things and didn’t want to waste a good load too early, or wait too long so that the egg was already gone. My best solution was to do it just after I got two SOLID purple lines and then the next day and the day after. 

“What’s rude is pretending that you want to have sex with me for the sake of having sex with me,” he responded.

“That’s not rude.  That’s just…trying.” I felt bad.  I always felt bad. This was how it was now. Sex with a purpose is the worst kind of sex.  And after more than a year of this kind of sex it was almost hard to remember what it was like before. 

I sat down next to him. Giants were playing the Nationals and were down 4-0 in the 8^th inning and it wasn’t looking good.  

“Fucking Giants,” he said.  Game after game the Giants seemed to blow their opportunities. They weren’t playing nearly as well as they were last season.  A lot of guys were out due to injuries and the team was dragging.  It was how Noah and I both felt, out of steam and disinterested. 

We sat and watched for a while.  I started yawning and was afraid I would fall asleep before I got sperm in me if we didn’t do it soon.  Noah, usually a trooper, was absolutely not in the mood. 

I started to nuzzle up to him. It was all too obvious. All too desperate.  Noah laughed at me and then gave in.  We kissed and laughed and took off our pants. He had no choice but to give in to how lame and predictable the process had become. 

Suddenly in the background we heard the crowd cheer. The Giants had just tied the score up in the 9^th inning. Noah paused, my legs wrapped around him.

“They tied it up, no shit,” Noah reached to get the remote and turn up the volume.  We listened while we did it and as much as we were rooting for our team, it really felt like we were really rooting for Junior Mint to be made. We needed to be reminded that even when things were looking bleak and when disappointment and loss loomed, there was still a chance at a miracle. 

I assumed my should-stand position. Before the game was over we sat on the couch, Noah in his underwear, me pantsless with my legs in the air. It was totally ridiculous but we held hands and watched intently until almost midnight when in the bottom of the 13^th, Freddy Sanchez hit a breaking ball walk-off double that won the game for the Giants.  

It felt like an impossible victory! I put on bottoms and we jumped up and down and yelled like it was some huge deal even though it wasn’t.  For us, winning when you’re down was what we needed to see. I was convinced that this was it. This had to be it. 

This must be it

But it wasn’t. The Giants continued on a losing streak and so did we.  I got positive sign on my ovulation test strips several days early so we went for it.  And for some reason we started going at it standing up but I panicked that gravity was going to work against us so before the grand finale we hopped across the room, naked and attached, and Noah tripped over my shoes and we fell, face down onto the bed, and laughed.  And we laughed and laughed and lied there and laughed. 

And I thought that had to be it. Noah was leaving on a work trip the following month so he’d be away for my next ovulation, which meant this HAD to be it. I couldn’t possibly live through a skipped month, not even being able to try.

No, now THIS time HAD to be it

I lived through a skipped month. Barely.  And then I started Clomid.  I saw the Doc on a Tuesday, Valentine’s Day, and again on a Thursday and he measured my eggs on both day.  I have five eggs total the first day, the largest measuring 1.97 millimeters or whatever.  By Thursday the smaller eggs didn’t grow much but the one “viable contender” was about 3.67 or something. The Doc felt good about it but I kept wondering why we didn’t measure and see what was up there before the Clomid? These kinds of things become so frustrating you don’t know if you’re doing the right thing or trusting the right doctor. It’s all so confusing and there is no part of you that wants to even consider that something could actually be wrong. 

For now we were going with it.  And it was kind of amazing to see.  The little Junior Mints like bubbles all clustered together.  I was amazed at my body and the feeling that it constantly changes and can potentially—hopefully-- create life. I felt open to this as my process and a little more excited about the possibility.  Maybe my eggs were stronger now, maybe this was the boost I needed. 

MISCONCEPTIONS ABOUT CONCEPTION

In high school you are told getting felt-up in a movie theater will get you pregnant.  When you’re 33, getting felt-up in a movie theater is a distant memory and getting pregnant can take a lot more effort.  Noah and I started officially “trying” in January 2011.  It was then that we learned:

1. Having sex a ZILLION times may NOT make a baby.
2. MANY people are LYING when they say they got pregnant on the first try.
3. You have ZERO control over the situation.

In the beginning of our journey I was open about it, joking with co-workers about doing it all the time.  But as each month went by with the same result—no result-- I became more reserved, more embarrassed and essentially more alone. 

By April we started calculating my ovulation cycles online and using ovulation test strips. We had been doing it EVERY DAY so we thought the chances of it all working HAD to be like, 99%, even though I know chances in healthy couples are only about 25% each month.

Pregnancy was on my mind all the time.  I stopped drinking coffee, eating sushi, and candy with artificial coloring.  I started taking foul smelling vitamins and eating more foods with omega-3.  I was hyper-conscious of everything I consumed; it’s hard not to be consumed with this when you are consumed by what you consume because you think that one bite of un-pasteurized cheese may result in a baby with one eye and two penises, or worse, a miscarriage. (I’m not totally sure if a two-penis Cyclops is actually better than a miscarriage).  

I am a practicing psychotherapist who knows you should never become obsessed.   Having said that, I became obsessed.

But obsession would have no bearing on when that magical seed would finally wed its hopeful egg.  (It’s like pushing the elevator button repeatedly in the hopes that the car will come sooner.)   In fact, I read that stress may actually prevent pregnancy.  Maybe it’s the womb’s way of protecting an unborn life from having to marinate in cortisol and listen to the external vibrations of an anxious woman keeping her husband up at night, asking questions like, “What if it has two penises?”  The hardest part of all of this is relaxing and letting go.  Trying to excite your spouse while wearing striped pajama bottoms and a ratty T-shirt runs a close second.

It’s all so disappointing. When you get your period you have no choice but to get through the week the same way you have since you were twelve, minus the gigantic pads, and get back on the horse (and by horse I mean husband).  I started doing more “research” and collected all kinds of information. I read about positions to try, products to insert into your vagina to “help semen pool against the cervix after ejaculation” (ew!) and special lubricant to help the “swimmers” glide to their final destination.  I found products that test your pee, your spit and your temperature and learned that for $249 you can buy a fertility monitor that looks like an iPod, and will track your most fertile days. I had no idea this was such an industry!  There are all kinds of fertility teas, supplements, and dream catchers that come with free shipping and a “packet of good luck baby dust.”  Noah and I both had all these expectations initially, and just assumed things would work as we wanted. Want. Hope. Plan. 

Sigh.

By May, Noah had completely dumped all soy products, switched to loose fitting boxers, and evicted his cell phone from its cozy pocket-home.   These suggestions were all recommendations to keep his sperm “robust.”  Meanwhile, I was on a strict diet of trying to “chill-the-hell-out.”  I started to feel really defective and depressed.  All my creative efforts were focused on how to keep sperm in my vagina at exactly the right moment in time and space.

The next month, as I was lying in bed thinking of what body parts I wanted Junior Mint to inherit (his father’s nose, his mother’s feet), we got the text that little Butterbean was born to our neighbor.  I was overjoyed with happiness for them but also sad.  I remembered the day she had told me she was pregnant and had said, “You guys should get pregnant too so we could have babies together!” I had no idea her baby would be born while my baby was still a figment of my imagination. 

All the babies being born at our condo made the situation worse. More people have babies than front door mats. I thought drinking the water around here would be enough to knock me up, but I guess not.  Being surrounded by babies and being constantly asked when we were going to have a baby wasn’t helping. When did it become okay for strangers or the guy who lives on the third floor to ask about my sex life and fertility? When asked about when we were going to have a baby, I said we liked our life the way it was, and in doing so, I suddenly understood why people lie about this stuff.  It was somehow shameful.  Like there was something wrong with us. Like my husband’s virility and my womanhood were in question.

By June I started seriously wondering if something was wrong. I worried if Noah’s little soldiers were being pulled downstream towards the exit screaming, “No, not yet! We don’t want this! We like going to rock shows and movies!” Or if they were just like him-- moving slowly, cruising along my Fallopian tubes, stopping for a burger and a drink, forgetting their critical assignment.  Or maybe they were indecisive, similar to me at times.  “Should we go over there? I don’t know.  It looks kinda dark and scary.”  

The following month I assumed that for the majority of the 48 hours when I would be ovulating, Noah would be working out of town.  I hear this issue of timing is especially challenging for flight attendants, astronauts and people locked in mental institutions, but it’s an issue for regular working folks too.  One’s ovulation schedule doesn’t always match up with one’s work schedule. 

Although it’s normal to be trying for a year, after about six months my mental health felt far from normal and I made an appointment with a gynecologist, an acupuncturist, a therapist, and my primary care physician. By Month Six the only thing I had to show for my efforts was a urinary tract infection--the peeing razors and Red Hots kind of UTI. I got through the weekend drinking cranberry juice and trying to laugh at the irony of my life. Once my pee stopped feeling like acid rain, I could almost crack a smile.  

On Monday morning I went to the gynecologist.  I sat on the table wearing only the paper-thin gown, open-side up, listening to the doctor tell me about all the things that could possibly be going wrong:  my hormones could be off, there could be “blockage,” I may not always ovulate, there could be a thyroid problem, I might have Polycystic Ovarian Syndrome, Noah’s sperm may be slow, my egg quality may be poor. Though I know she said it was normal that it was taking this long, all I could hear were the words “infertility write-up.”

We ended up getting a handful of the preliminary tests and everything was apparently fine. It was a relief, on one hand, but even more frustrating on the other.  If everything looked fine, what was going on?

And then my period was late. I tested, but no second line.

My period was late another day. I felt like I hadn’t peed regularly in a toilet in months. The sacred morning- pee is only made in the special little cup and all over my wrist.  I peed through almost all of my early pregnancy tests. 

When I didn’t get it the morning of the next day either I started thinking this may be it!

But by the afternoon my body informed me otherwise. Yet again. 

That night I spent some time with my upstairs neighbors holding their new baby.  She cooed and snorted and fell asleep in my arms and it felt so good yet so far away.  I wasn’t sad, I was happy holding this other baby and started thinking I might be okay with adopting, if it came down to that.    

Noah and I stayed up and discussed it.  We figured if we didn’t succeed in the small construction job in my uterus, we could forego the small construction job in our house, and use the money saved to pay for a baby.  We talked about what country we would want to adopt from, and jokingly came up with culturally inappropriate names. Nevertheless, we still wanted our own.

And then I learned the acronym TTC, Trying To Conceive, and snooped on a message board full of totally crazed women.

And then two women at work announced that they were both three months pregnant. 

And my therapist continued to listen to me cry and validated this biological urge to procreate.

And my acupuncturist put needles in my feet and gave me some herbs called, “warm menses.” 

And we did it again when we were supposed to.

And I got my period. 

And I bought a book called, “Taking Charge of Your Fertility,” by Toni Weschler, and I read about cervical mucus, and basal body temperature, and started charting and self-diagnosing. If things worked out when we started all this madness I would be giving birth sometime this month. 

And then I experienced “fertility envy” when one of my closest girlfriends told me she was pregnant.  The combination of bitterness, jealousy, and guilt mixed with the desire to be happy for her was overwhelming.  “It just happened!” She exclaimed.  I wanted to punch her in the face and I hated myself for it.

My sister is a doctor in Northern California, and she told me to stop reading garbage online, but she didn’t have any solutions for me either. She’d been listening to my complaints and my theories about what may be wrong and she simply said, “Sometimes it just takes time.” 

And then I started seeing a different but more expensive acupuncture doctor.  She felt my pulse and said she detected “anxiety pulse” and thought most of my problem with getting pregnant was probably in my head.  NO KIDDING!  Ya think?  She talked about being on birth control for so long and how stress is a key factor and said she sees so much more infertility cases now because women are trying to get pregnant much later in their life. Then she said,  “Your body is good. Your head, not so good.  Too busy.  When you have extra time, stop folding pants. Listen to music.  Talk out loud—talk to God.  Relax.”  Talk to God and stop folding my pants. This is what’s going to get me pregnant.  

We’d been trying for eleven months when Noah had to go to South Africa for work. I knew if I got my period before he left we’d officially be labeled “infertile” by definition of trying to conceive for a year with no luck. For women over 35, that “diagnosis” comes after only six months. 

According to the Center for Disease Control, in 2002, 2.1 million married women between ages 15-44 were labeled infertile. In 2011 that number was 6.1 million. The reason for this increase may be emotional, psychological, biological, environmental—or all of the above.   

On the day Noah was set to leave for his trip, I got my period a few days early.  The feeling of heartbreak and disappointment continued to be unbearable and being hopeful started to feel humiliating and pathetic.

My hormones were fine. Noah’s swimmers were fine. So what’s wrong? Everyone kept telling me to “relax,” but how? 

I called my parents, crying hysterically again.  My mom echoed the acupuncturist while my dad made some strange analogy about beetles in his pine trees out back.  

“Why do our pine trees have beetles but the neighbor’s pines just next door don’t? That’s nature. Can’t explain it but it’s going to cost me a fortune.” Sure, Dad.  That’s nature.  But all the logic in the world doesn’t help.  The only thing that makes it feel better is to cry it out, and by Month Eleven, even that was getting old.

On Month Twelve, Noah witnessed his first pelvic exam. We went to see a new OBGYN to “discuss our options.”  Our first option was a drug called Clomid, which does something to stimulate ovulation.  The doctor showed us his little pictures of ovaries and the yellow spongy popcorn flower corpus luteum the ovary becomes and we sat there confused until he told me to put on a paper gown so he could do a pelvic exam.  Confusion led way to horror when I realized Noah was about to watch this guy stick his hand up my privates.  

A nurse came in and there we were, listening to the doctor identify that I did indeed have a uterus and tubes in the right place. Noah was squished into the corner of the room as if he were trying to will himself to magically disappear.  Clomid treatments would be $500 and the office would call to find out how much my insurance covers.  Happy holidays.

That was it.  There we were. 

And we went off to our happy holiday in Barcelona. 

The day before we left for our trip, two things happened.  One, I got a pretty bad head cold and two, I realized that I would most likely be ovulating on our 11 hour flight and during our 4 hour layover in Paris.  Flash-forward to that layover where I was red in the face and sneezing my way around the Charles De Gaulle airport, looking for a single stall bathroom suitable for copulation.  

“I found a handicap bathroom we could do it in,” I wheezed.

Noah took a good look at me and just said, “I can’t.” 

I thought about how hard I’ve been pushing all this and how I felt about taking medication to up my egg ante.  I couldn’t believe this is how we’ve spent the last year. We were both exhausted. 

But how do you stop thinking about making a baby when you can’t? How do you make sense of the fact that 85% of healthy couples conceive within a year and somehow for some reason you are in the 15% of others?

When we got back from a deliciously gluttonous two-week trip, I came down with the most horrendous stomach bug—a parasite called Cryptosporidium.  I was cramping and having hot flashes and spent most of my day in the bathroom.  I went to work because I had used up all my vacation days, and at night I cried and sat on the toilet.  Before I realized this affliction was parasitic, one of my co-workers, who had recently had a baby, suggested that maybe I was pregnant.

Wait!  This is how you feel when you’re pregnant? Nine months of that could literally kill one or both of us!

My illness just kept getting worse so by Thursday I went to the doctor who told me he needed a stool sample. I was sent home with a plastic container the doctor affectionately referred to as “The Hat,” and three little containers I was to scoop my poop into using a tiny flat spoon the size of my pinky nail.  At 1:00 am, my opportunity arose.  I ran to the bathroom, got “The Hat,” and proceeded to have the most traumatic and disgusting twenty minutes of my life.

Noah woke up to the sounds of my gagging and crying and came to the door and said, “Alright, just come out. I’ll do it.”

Then I cried harder and felt so in love with him and disgusted by myself that the two conflicting emotions just caused me to sweat and throw up.

“Noooo!!! Don’t come in here!” 

“If you’re going to be a mom, then you’re going to have to be okay with some of these gross things,” he said.

In that moment I suddenly knew everything was going to be okay.  I knew that one day I would be a mom and he would be a great dad with good instincts and good caretaking abilities.  He would be there to figure out what to do in the hard times and he would step in to scoop poop. 

Neither one of us would be ready for much of what might lie ahead. Being flexible and patient were two things that I was going to have to practice from the get-go--with myself, with my body, with Junior Mint. I got my period four days late and for the first time in months I didn’t cry about it.  It’s just not our time yet.