Thursday, June 26, 2014

Everything you ever wanted to know about my fertility but never asked*

(*because it's weird to ask someone about their fertility unless they decide to blog about it, right?)

In the summer of 2011, I saw pregnant women everywhere. They were walking past me down the street, their painted toes in flip-flops; hand-in-hand with their husbands, swaying as they walked.

I saw pregnant women everywhere because I desperately wanted to be among them. I had gone from casual "I'll just stop taking the pill and see what happens" to slightly more focused "I'll just use this Fertility Friend app to track what's going on so far" to all-out deranged "I'm going to pee on this stick every morning to find out if I'm ovulating."

I had reason to suspect that my ovaries were not in prime working order. Still, when you spend the bulk of your 20s diligently trying not to get pregnant, it's a startling shift in thinking to find out you might not be able to. When my OB gave me a referral to a reproductive endocrinologist (that is a fancy term for a fertility doctor), I remember thinking that if this were 100 years ago I'd be doomed to be childless forever.

In theory, trying to get pregnant should be fun (wink wink). In reality, it's draining. (Literally -- I once had 18 -- EIGHTEEN -- vials of blood drawn in a single lab visit.) My RE was trying to prescribe enough Clomid to help me ovulate, but not enough to produce twins. My other RE -- Dr. Google, of course -- suggested that I start "charting," which basically consists of taking your temperature every morning immediately upon waking to help you track incremental changes in body temperature that signal when ovulation has occurred. Charting works best when you take your temperature at the same time every morning before getting out of bed, which is a problem when one wakes up at 4 a.m. needing to pee like a racehorse. Dr. Google's other helpful suggestion was to begin tracking patterns in cervical mucus, which I don't even want to get into right now because it is exactly what it sounds like. I don't know how women charted before smartphones, but fortunately -- like everything else -- there's now an app for that.

So I charted. I took my temperature every morning and then peed on a stick that I scanned into a fertility monitor. Then in the afternoon I peed on a different stick (an OPK, or "ovulation predictor kit," that would display a smiley face if I was allegedly ovulating. (I say "allegedly" because I also got to visit the RE every week or so for a sonogram to see if I had legitimately ovulated or if my pee just made my ovulation sticks artificially happy.) Once, I accidentally dropped a Clomid pill (one in a 5-day cycle) down the sink drain. I was heading to Vermont for the weekend and I had to go to the pharmacy and beg the pharmacist for a replacement. I remember saying, "Would I really come in here and try to scam you out of a single Clomid pill?! Do you think I am selling individual Clomid doses on the black market?"

Every day there was a new Facebook pregnancy announcement, another pregnant teacher at school. One day while I drove to the RE's office on Long Island I cried to the Florence + the Machine song on the radio: "It's hard to dance with the devil on your back..."

Now that I have a child, I have absolutely no problem at all revealing that Eli is a Clomid baby. But when you are "TTC" (trying to conceive, in BabyCenter abbreviation parlance), it's a weird thing to talk about. Like, I can easily say, "I'm going to the dentist," but no one wants to hear, "I'm going to have my hCG levels checked to see if I ovulated!" There was a certain level of resentment and self-pity involves, which feels very ugly and lonely.

When you're charting, Fertility Friend will take note of a big drop in body temperature followed by a spike and helpfully mark it with a huge red crosshairs, meaning: You have ovulated! But the only sure way to determine whether or not you've ovulated -- well, besides getting pregnant -- is a blood test. So I had a lot of those, during which I tried very hard not to faint.

Once you have confirmed ovulation, you are in what BabyCenter message boards refer to as the "TWW" -- the two-week wait before you will either "POAS" (pee on a stick) or "AF" (your period) will arrive. (BabyCenter uses a lot of acronyms). During this period you'll misinterpret every minor bodily malfunction you have as a pregnancy symptom (am I imagining this, or do my boobs hurt?). Fertility Friend will also inform you that "if you conceive this cycle, your due date will be _____," so you start daydreaming of having a winter baby. Or a spring baby. Maybe early summer. Really any kind of baby would be fine.

One day at a sonogram in early November the RE informed me that my ovaries were characteristically empty. "Nothing is going on," he said benevolently. "Come back next week."

But by my next appointment, I had already ovulated. (I knew this because I was such a diligent charter and pee-er on OPKs.) I kept taking my temperature every morning -- during this "luteal phase" of your cycle, you're looking for your temperature to stay high (unless it drops one day and spikes the next, which can be indicative of an "implantation dip," meaning the egg has implanted itself into your uterus, in which case woohoo!). When your temperature plummets, it's baby game over.

At 3 a.m. on the day I expected my temperature to drop, I woke up and I couldn't help it: Instead of going back to sleep like a rational person, I stuck a thermometer in my mouth. Still high. I was no longer keeping pregnancy tests in the house, but do you think I went back to sleep and waited until morning? No. I walked to Duane Reade, and I bought a 5-pack of pregnancy tests because they were on sale and by that point I figured I'd need more of them.

I admire women who have the self-control to surprise their husbands with the news that they are pregnant. This is how Phil found out: At 3:30 a.m. I burst sobbing into the bedroom, flipped on the light and thrust a Clearblue stick in his face.

The sonogram at which we saw Eli for the first time was during Hanukkah. The RE was Jewish, and somehow he knew we were Jewish (we give off a vibe, I guess). I remember thinking about how he must have seen thousands of blurry, black-and-white, blinking blob fetuses by then, but he still managed to be amazed by ours: "Ah, see there?" he said, pointing out the screen. "You can see the heart beating already. Marvelous, marvelous."

On our way out the door, he handed us a tiny snapshot and wished us a happy Hanukkah. Then he winked at us. "Ah, but," he said, his eyes twinkling, "the miracle has already occurred."

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