Another New Address

It was lonely and weird without L. here to keep me company. Like Home Alone, or something. And I never did like Macaulay Culkin. He's creepy.

Anyway, I've continued my ranting over here. This blog definitely worked some magic. Half of Lisafer is pregnant! TTFN!

-J.

Seeing Double

I was feeling really lucky (and still am) and a little (okay, sort of a lot) guilty about getting pregnant when so many of my infertility-struck friends are still struggling. But on Thursday, we found out that we may have a permanent, lifelong reminder of our battle with infertility: twins.

That's right. I only had three follicles from the Gonal-F (go hamsters!) and thought there was just no way - after almost 24 months of having 0 good eggs, that 2 out of 3 would be "good." Oooops.

I know I should be overjoyed - and in some ways I am - I feel incredibly lucky to be pregnant at all, and even luckier that if all goes well, I might just have a complete family in one shot before I'm 40. But I'm also terrified. There's so much more risk for multiples - what if I can't carry them to term? Get diabetes? High blood pressure? What if my back - which has already been acting up - gives out? Will I have to quit my job? How will we afford or take care of two babies? OMG we need a bigger car! A bigger house! A bigger ME!! I mean, let's face it, only Angelina Jolie looks like that 8 months pregnant with twins (two twig arms and a perfect round belly). Chances are good that I'll look a lot more like a snowman than a stick figure. I already told my husband that if this works out, forget the diamond earrings - I want a tummy tuck.

I feel incredibly guilty voicing these concerns here - I know that those of you who are trying are saying, "SHUT UP! I'd give my left arm to have a baby, not to mention TWO!" But I decided to write because multiples are a real possibility if you're on hormone treatments, and I sort of wish I'd prepared myself for it. I think if I'd been doing IVF, I would have (we were on injectible FSH with IUI)prepared myself a little better for the possibility of multiples.

But having the ultrasound tech ask, "How many transfers did you have?" when I hadn't had IVF at all, was sort of a jarring way to find out that I'm carrying not one, but two, babies.

Not that they are babies yet, and I'm scared to death that I'll lose one or both of them. But in some ways it might have been easier if I'd read a little bit about this beforehand - had accepted that I might be in that "low" percentage who conceive twins, and readied myself for it. When they told me it was a possibility, I just said, "At this point, I'd be overjoyed about having twins, trust me!" I thought getting pregnant would be the end of my stress and worries - not an invitation to indulge in a whole host of new ones.

Overall, I am really happy and feel really lucky, and don't take any of it for granted. Even the vicious 'morning' sickness (named by a man who'd never had it, cause it lasts all day and all night) makes me happy because it means I'm less likely to miscarry, and reminds me that I'm pregnant - something I was starting to think I'd never be.

But as the saying goes, be careful what you wish for. Because you might just get it - get it, get it!
- L.

All Spermed Up and Nowhere to Go

So I was wrong. Follicles can shrink, but sometimes they're salvageable. And in this case, on Saturday, the call told me not to cancel but to trigger. I had a 16 mm follicle (not 14 as the tech told me...one more reason not to ever, ever listen to what the tech says) and my estradiol had plateaued. So I took the shot at 9 p.m. That shot could do me in someday, by the way. I think that after two weeks of shooting the hamsters so much depends on the hcg shot working properly that it drives me a little mad. Put it this way: I wasn't winning any "nicest wife" awards on Saturday night.

Anyhoo, went in Monday morning for the IUI. Husband went in and did his thing (I tried not to think about it - kept myself in denial that he was in that depressing little hospital room doing the deed with old porn mags), then we headed to the hospital cafeteria for what is becoming his customary (if doing something twice qualifies) pancake breakfast. I had nothing, since it was white carb city (can someone please tell me why on earth a hospital cafeteria serves nothing healthy?). Then at 9 a.m. headed up for the big event. Here's what I want to say about an IUI after more than two weeks of injections, vaginal ultrasounds, bloodwork, phone calls and angst: It is completely and utterly anticlimactic. You lay there, they put a catheter in there, it feels like little more than a pap smear, you stay still for 15 minutes and then you get up and leave. Nothing dramatic happens to your body, and no one claps for you as you exit the room. Even worse, from that point forward there is absolutely nothing else you can do. If you're at all action-oriented, if you've ever in your life been told that you can do anything you set your mind to with some hard work, this is a very troubling fact to live with.

Before my IUI, I bemoaned the fact that I had only one follicle, but the nurse assured me that one is totally enough, particularly for someone like me whose only issue is that I don't ovulate. I want desperately to believe her. Some fleeting minutes, I do.

-J.

Newsflash: Follicles Can Shrink

You know how they told us in Sex Ed how easy it is to get pregnant -- that millions of sperm are unleashed each time you have sex to attack the egg (which, for their purposes, seemed to be perpetually hanging out in there just waiting to be fertilized)?

I want my money back. That class was a whole bunch of BS.

Apparently, follicles can shrink. Just waiting for the dreaded call to tell me that shooting chinese hamsters into my stomach for over two weeks has been for kicks.

-J.

From Slapstick to Survival

Yesterday was practically slapstick. After my (by now practically daily) rendez-vous in the stirrups, I pulled a nurse aside and told her that I want Dr. Fabulous tracking my cycle. Who should walk by at the very moment I'm uttering these words but Dr. Distracted. Not that he cares -- it's not like my girl parts are so fascinating that this renowned surgeon needs them on his roster. But still. Later, as I'm on the phone with a nurse outside my office building, two men come and disturb my illusion of privacy by standing directly in front of me and photographing the building. I could almost hear the narrative: "Observe the infertile female in her natural habitat, hunting for her illusive follicle prey." I don't know what they were up to, but it made a weird day even weirder.

Today was a different story. Today, I found myself spontaneously weeping in the blood draw chair when the medical assistant asked me how the ultrasound went. I honestly don't know where it came from, other than pure emotional exhaustion. I didn't have any information other than that the follicles I had the other day are essentially the same size today. From then until 2 p.m. I felt this heavy resignation, that I was with every minute crawling toward the eventuality that my cycle would be cancelled. But then, as I braced myself for the worst, I heard the nurse tell me to take the same dose -- 75 IU -- today and tomorrow and come back on Saturday.

On Saturday, as I wait for my results, I can remind myself of these top things not to do while you await your fertility treatment monitoring results:

*Google *any* form of the word "follicle," in any context
*Call your husband every 10 minutes with an update on your anxiety level
*Watch A Baby Story
*Give your ovaries a pep talk with anyone in earshot
*Obsessively review the last cycles' dosing, follicle growth and results, creating charts and diagrams
*Call your doctor's office with a fake question attempting to trick them into spilling the results early.

Anyone have other tips on what not to do?

-J.

It's Over. Just Kidding!

Just when I thought I'd experienced all the random, cruel twists that infertility had to offer, today crept up and bit me right in the behind. It all started normal. In for some early morning stirrup action after they lowered my Gonal-F dose over the weekend. Got not my favorite tech but follicle beggars can't be choosers. She told me I had a 16mm follicle, so I spent most of the day prepared for a call telling me to come back in the morning for one last check before trigger (the target follicle size is 18mm for IUI).

Ha! Have these past seven months taught me nothing about trying to calmly predict where these cycles might go? The voicemail from the nurse went something like this: "I'm sorry to have to tell you this over voicemail, but we're canceling your cycle. Your estrogen level dropped, so that means the cycle won't move forward. We think maybe you should come in for a second opinion with Dr. Fabulous, another doctor in our practice, since she's a bit more focused in PCOS than Dr. Distracted. Call us back to discuss." The subtext? "You totally choked, we're scrubbing this cycle, you're bad luck and Dr. Distracted doesn't want your juju -- or your hoohoo -- darkening his doorway anymore."

Never one to take this kind of rejection without at least a wimper of protest and a neurotic question or two, I immediately hauled it down to my car (the only private place in the vicinity of my office) and called the nurse back. In between sobs, I told her I didn't understand why they would just give up on the cycle when I had a 16mm follicle. Didn't it at least have a fighting chance? Couldn't it be the little follie that could? She considered it for a moment and asked if she could call me back.

After an endless half hour, she called and -- just like that, like she flipped some kind of cartoon switch from cloudy day to sunny day -- said we were continuing the cycle and I was to take 75 IU (double the dose from the weekend) tonight and tomorrow and come back Wednesday morning. Apparently she checked with Dr. Fabulous (my new doctor, I guess) and she said no way would she recommend canceling the cycle -- she sees patients like me all the time and has no problem continuing with a long, slow cycle. My estradiol level went down because -- go figure -- they lowered my dose.

So where does that leave me tonight? With more hamster parts in my ovaries, a little less faith in the cycle and a whole lot of confusion about where to go from here. I do know that I'm so over Dr. Distracted. The next question is whether Dr. Fabulous is really the next big thing in my quest for a few good eggs.

-J.

A Second Address

Jennifer's posts have been so great I haven't wanted to add anything above them. But I've decided to start a second blog - http://www.twopinklinesatlast.blogspot.com/ (trust me, all short and normal ones were taken). Why? Mostly because while going through infertility, there is nothing more annoying (other than you mother in law) than blogs that purport to be about infertility, and when you arrive and start reading, they are all about pregnancy.

Not that I'm not happy for those women - I know they struggled, and I am honestly happy to read that sometimes all these treatments work - but that doesn't mean that when I'm looking for ideas to make giving yourself an injection easier, I want to read about baby names and cute maternity bathing suits (or the lack thereof, apparently).

So I thought I would keep writing at this address about issues relevant to infertility, but would move my personal updates (assuming everything keeps going well, fingers crossed) to the new address.

If you want to read about what's going on with me, or about (an admittedly slightly neurotic) pregnancy, check out twopinklinesatlast.

Until then, I'm raising a glass of seltzer (bo-ring) to those chinese hamsters - I think they are my new mascot.

- L.

Curious

I read today that Gonal-f is made out of Chinese hamster ovary cells. I have some questions.

Why hamsters?

Why do they have to be Chinese?

How do my ovaries know what to do with Chinese hamster ovary cells?

Who thought of this?

Is it possible that there will be little bits of Chinese hamsters in my eggs? Because I’m not particularly fond of hamsters. Although they may be sold at PetSmart and kept indoors as pets for first graders, at the end of the day they are just small, furry rats.

Infertility is so weird.

-J.

Three Cheers for my Ovaries!

I knew they could do it. I waited four full weeks, which in infertility time is roughly equivalent to several decades, and got the payoff I wanted: This morning's ultrasound revealed my dysfunctional but eager ovaries to be cyst-free and ready for some follicular fun. Instructions for tonight: 37.5 IU of Gonal-F; return on Monday for bloodwork and ultrasound.

I hate it when something I didn't want to happen actually turns out to be a good thing, but I think the break has been good for me. I'm back and in fightin' form. Ready to kick some infertility ass.

-J.

PS Congratulations and good thoughts go out to Lisa! In addition to being genuinely happy for you, one infertile's success somehow feels like a victory for all of us.

Eggshells

I can't believe it and I'm scared to say it out loud (or even type it) but according to the blood test, I'm pregnant.

I'm excited and happy and I really can't believe it...but I'm also terrified. I keep going to the bathroom expecting to see my period. I'm terrified that things can't possibly go right - so many women have miscarriages, and we've had so much trouble - it just seems unlikely that things will actually be okay.

I don't mean to be ungrateful - I'm so, so happy to know that I actually can get pregnant, and feel so lucky that our fifth fertility treatment worked. My husband tried to reassure me by telling me that if something happened, we'd just keep trying. Then I told him that the law in Massachusetts defines infertility as "inability to conceive in a 12 month period" which means that if I have a miscarriage, we can't start fertility treatments again for 12 months.

He was a little shocked by that.

I guess excitement and happiness are trumping worry...sometimes. I actually feel sick a lot - but when I don't, I worry that it means that the production going on inside me has stopped.

My husband asked again when I'd feel comfortable and start to worry less - and I said, "In nine months." Which isn't totally inaccurate...but I will feel better after our ultrasound and MD appt on June 10th, and after 12 weeks, and after amnio...

- L.

One and a Half Pink Lines?

So, Sunday morning I woke up and decided that even though it was five days before I was supposed to get my period, I would take a test. I know, I know, they tell you not to...they tell you to wait for the blood test. But with all this stupid waiting, I decided to indulge. I got what I thought was a negative - there was the faintest, faintest hint of a second line, but I figured the test just always looked like that (you'd think I'd know - I've seen approximately 43 negative ones).

I got back into bed and whimpered to my husband about a million things, including that now if the IVF (in July) worked, I'd be having the baby at the worst possible time for me in terms of work, and I might have to quit my job...he consoled me, and tried to hide his disappointment, and we went back to sleep.

Sunday night, we went to friends' house in Wellfleet, and had an amazing dinner (complete with champagne and wine and after dinner drinks to celebrate their new house). The night was fabulous, and we decided to stay over. On Monday, we woke to the kind of day that really makes calling in sick worthwhile - crystal clear skies, light breeze, sun shining off the harbor. I decided to use the second test in the 3-test "value pack" (how $22 for something you pee on can be a value, I don't know). Nothing.

I didn't want to throw it away in their trash can (evidence!) so I wrapped it in a lot of tissue and stuffed it back in the box. A few hours later, as I was packing my bag, I decided that it was gross to put that in with my cosmetics, so I took it out to re-wrap it and throw it away.

The second line was there.

At least, I thought it was. It was fuzzy and wierd-looking, with undefined edges, but it was definitely there.

My husband was out getting coffee and bagels, and when he FINALLY arrived back, I said, "Can you look at this?"

"Oh my God." He said.

"It's positive!"

"Okay, that's sort of what I thought too, but I couldn't tell, it was such a wierd second line, and it's lighter than the test line, and..."

"I knew it! I knew it would work this month!"

We ate the best tasting bagels I've ever had.

But then, the doubts started.

What if it's just a chemical pregnancy? What if the HcG shot just made the test look positive? Even if I am pregnant, what if it doesn't last? What if I miscarry? If I miscarry, I'll have to wait 12 whole months to start fertility treatments again (thanks, Mass law and insurers!)!

My husband wanted me to blog that night, but I just couldn't. First of all, I'm not sure it's true. I get a blood test tomorrow, but I still won't feel 100% until I'm at least 12 weeks - actually, scratch that. I won't feel 100% until I give birth.

I'm so used to negatives and sadness and disappointment that I just can't let myself be happy yet.

Second of all, I feel guilty.

If I am pregnant, what about my friends who aren't? Before, we were bonded by our bad luck, bonded against the Bump Watches, and baby shower invites, and stupid comments from stupid people. I feel like a traitor.

My counselor at the Domar Center said a lot of women get more anxious after they find out they are pregnant, and I completely agree. After working so hard for something, is it worse to have it taken away than not to have had it at all?

As my husband would say, "happy thoughts, happy thoughts." I'll try.

- L.

Never Thought I'd...

...admit to doing this. I'm back at it - Googling and Yahooing til 2 a.m. - trying to figure out how early I might have signs of pregnancy. I know it's insane, a bad idea, stupid and won't help - and that it could hurt. I am so scared to get my hopes up...but I can't help it. I had gotten so used to my cycle - get period on day 29, ovulation cramps on morning of day 15, ovulate on day 15, iui on day 16, pimple on chin on day 23-24, cramps on day 28-29 and period again.

Then I started the FSH shots. And I ovulated (well, I triggered ovulation) on day 9, had the IUI on day 10, and on day 16, my chest became so sore that i can hardly stand to have a sheet on top of me. The nurse (who called me!) said it could be a good sign...and then I went with my sister to see her OB today, and asked her if it could be a sign, and she said it was too early for breast tenderness to be caused by pregnancy, and that most likely, it was a progesterone increase from the shots.

So what did I do? Instead of believing a really nice, kind, insanely smart doctor, I'm up til 2 hoping that Annie Lynn from Maryland, who had similar symptoms at 6 days "dpo" and then found out that she was pregnant, is more on target than a doctor whose been seeing pregnant women for 15 years.

The problem with hoping is the disappointment. The problem with not hoping is that I fear that pessimism could affect my chances of getting pregnant...

Ugh. I cannot believe that I am googling things like "sore boobs" (you should see what that brings up, by the way). I cannot believe that I am writing about it. What's happened to me?

I guess the only good news is that if you're experiencing infertility, you're not the only one fighting insanity at the same time!

- L.

Cysting Out This Month

Remember how I got my period a mere nine days after my IUI and the only thing keeping me from jumping out a window was the hope of a fresh, spanking new cycle? Not so fast, said infertility. You're getting too smug. Here's a dose of reality: Two huge cysts on your right ovary.

When the tech at my day three baseline ultrasound asked me whether I was in pain, I knew that couldn't be a good sign (in fact, I think that's #1 on the Top 10 Things You Don't Want to Hear When There's an Ultrasound Wand in Your Business). The nurse called me that afternoon and confirmed my fear: the cysts were too big to proceed with another treatment cycle, and I had to wait until they went away. I was benched for a month. When she told me to call them on the first day of my next period, I laughed out loud. "Where have you been?" I wanted to ask. "That won't happen," I actually said. "I'll need medication to bring one on." She told me to call back in 28 days.

It was all pretty dismal; she may as well have said, "Call back in an eternity." Infertility is a cruel exercise in forfeiting control for type A people like me, even when there's something you can actually do, like inject yourself like a champ every night. When there's absolutely nothing to do but wait? Well, it's almost unbearable.

I did some research and found that some docs prescribe birth control pills to eliminate cysts, and called back the next day. I spoke with another nurse who said that sometimes people like me can actually ovulate from the cysts, even if they wouldn't normally. She said she couldn't see why I'd need the Pill, suggested that I wait the month and said I was welcome to try the good old fashioned method while I waited. How quaint.

It's not in my nature to get too hopeful; the risk of being hurt is too great if I'm not prepared for the worst at all times. But somehow when it comes to wanting a baby I'm a glutton for punishment. I just keep thinking of what a great story it would be: "So we did the injections for a month, which didn't work...but the next month, without any medication, I got pregnant!" Not to mention the fact that I'd be all done -- no more medicine, ultrasounds, blood test, sadness. It's a lovely thought.

One more week to go. If no period by next Wednesday, I call for a blood test. We'll go from there. I'm learning not to assume anything anymore.

-J.

Insanity

Okay, it's official. I'm completely insane. Think I'm exaggerating? Listen up.

Last Tuesday, I was told that my follicles looked good (I had four) and that Wednesday night I should give myself the shot that would make me ovulate, and Thursday and Friday, go in for an IUI.

Tuesday night, my husband was unable to sleep because of excruciating pain in his shoulder. We spent Wednesday in and out of doctor's offices, going for an MRI, meeting with a neurosurgeon at 9 p.m. He told us that my husband had a ruptured disc in his neck, and had to have surgery immediately. As he pointed to the MRI and explained everything, I held it together. But a few minutes later, as he scheduled the surgery, I started to cry.

Was I scared that my husband was having surgery that had a risk of paralysis as a side effect? Worried about the pain he'd endure recovering from a surgery that required a 3 inch cut in his neck, and the moving of his vocal cords and spine? Concerned that the surgery involved removing a disc, grafting bone between his vertebrae and then holding the whole thing together with a metal plate?

Well of course I was. But was that why I was crying? Absolutely not.

I was crying because I'd given myself shots in the stomach and endured blood tests (my greatest phobia) and ultrasounds, and for what?

I hope that the hormones had something to do with my very selfish reaction - of course I was worried about my husband. I just wanted him to um, give me a sample before he headed for the OR.

I don't know how he did it with all the pain he was in - but he did. The morning was an exercise in comedy - I had to go to the Old Person Medical Supply Store to buy sterile cups from a kindly 78 year old with white hair, a malfunctioning hearing aid and poly blend pants ("What do you want dear?" "Um, a sterile cup?" "What for?" "Uh, like the kind you use for urine samples." "Urine samples? You should get those done at your doctor's office, usually..." I wanted to scream at her: IT'S FOR MY HUSBAND TO JERK OFF IN!! BECAUSE I CAN'T GET PREGNANT AND I NEED THE THING RIGHT NOW BECAUSE I HAVE EXACTLY 48 MINUTES FOR HIM TO GET OFF UNDER THE INFLUENCE OF OXYCONTIN AND CARRY THE SAMPLE IN MY BRA TO THE IVF CLINIC!Any more questions?")

and then race them back to the house where my poor husband, who was in torturous pain, had to produce the sample, which I then raced to the clinic.

As I handed the sample to the lab tech, I was laughing so hard she likely thought I was... insane. But she laughed too when I told her the story, and said, "If you'd gotten pulled over for speeding you could have given theg cop the best story of his career!"

Anyway, part of me thinks this month will work because there is just no way it should. And I think my priorities are back in place...but we'll see what next month brings.

Q and A about FSH and IUI

Ah, more alphabet soup! And more blogging from me (can you tell that I'm done with school for the summer?) - I've had a lot going on recently.

Luckily, the injections worked! Well, insofar as they produced four follicles. Before starting this cycle, I knew basically nothing about how this all worked - so I thought I'd share what I've learned this week.

1) What is FSH with IUI?
My insurer requires that I do two cycles of IUI (intrauterine insemination) with FSH injectibles before I can do IVF. My doctor says this is a waste of time (see below, #2).

2) What is the success rate of IUI with FSH?
For me (no known problems, and husband with excellent sperm counts and motility) apparently it's about 20% per cycle. This means that after two cycles of FSH with IUI, 36 out of 100 women will be pregnant (20% the first month, and 20% of the remaining 80 the next month). Clomid with IUI was about 10% per month for me, which means that after three months (I did three cycles) of Clomid with IUI, 27 out of 100 women will be pregnant.

3) What is FSH with IUI?
FSH is follicle stimulating hormone, and I get it via injection. I use the Gonal-F pen, and started injecting myself once a day (they tell you to do it between 5 and 10 p.m. and I've been doing it at about 10:30). It looks like a pen - and you just push it onto a needle (it's short, and skinny, not that bad) and then inject the dosage that your doctor prescribed (mine was 112). Then you inject yourself in the thigh or stomach (they told me to do it in the stomach).
You do this starting on day 3 of your cycle, and on day 7, they started giving me blood tests and ultrasounds. Once follicles are the right size (see #4 below) I give myself a HCG shot, which induces ovulation. On the next two days, we'll take a sperm sample to the lab, where they'll "spin" it, and then inject it directly into my uterus (painless - unless you're in the 1% of women who have a prostaglandin reaction - which I am - and then you'll have very bad cramping for about 3 hours after the IUI. They can improve that by washing the sperm twice - which they did for me last time, and I had almost no cramps!).

4) How many follicles are you supposed to produce and what size should they be?
According to my nurse (and the internet) they like to see about 4 follicles for an IUI cycle. Any more just increases the risk of multiples, and doesn't improve pregnancy rates. They like the follices to be close to 20 mm (or at least for the largest one to be). Follicles are the little sacs that the eggs sit in - without drugs you'll usually produce one per cycle.

They see and measure the follicles via ultrasounds (not the over the belly type either - this is a nice wand that goes...guess where?). They measure your estrogen level by taking blood.

So for me, today (day 8 of my cycle) I had one follicle that was 18 mm, one that was 16 mm, one that was 14 mm and one that was 13 mm. I had two on each side. My estrogen level was 568 (what?) - apparently it's about 200 per mature follicle. So I'll do another shot tonight, and assuming the follicles grow at the rate they have been (about 3 mm per day for me) tomorrow I'll have a 21, 19, 17 and 16 and by the time I take the HcG shot, they'll be a little bigger.

The needle for the HcG shot is a little scarier, but like I've said before, you can pretty much do anything you set your mind to...

My last question is whether my total cycle length will be shorter (for vacation planning purposes of course! You can't really leave your doctor's neighborhood during days 7 - 14 or whenever you are ready for ovulation and IUI). I usually ovulate on day 15 of my cycle, and get my period exactly 14 days later. This time I'll be inducing ovulation on day 10 of my cycle - so based on me in the past, I should get my period on day 24.

Do you care? No way. Unless you're about to go through this, in which case, you're probably like me - googling "FSH and IUI" to death.

Hopefully this was helpful...and hopefully I'll be in that elusive 20% this month.
- L.

Happy ISD

Happy Infertility Survival Day! That's right, it's May 4th (the first Sunday in May - before Mother's Day). And hey, we use acronyms for everything else in our lives (FSH, IVF, IUI, DPO...) so why not Infertility Survival Day?

Doesn't really have the same ring as "Happy Mother's Day" does it?

I have to admit that I never thought I'd need a national infertility survival day - or be sort of glad that someone (the author of Infertility Sucks) came up with one. But I've been dreading Mother's Day without realizing that I'm dreading it.

I realize that there are all these dates and events for which I thought I'd be pregnant (my high school reunion, weddings, Christmas, etc.) and as we were planning trips, I'd think things like, "well, Napa would be a bad idea because I probably won't be able to drink wine."

Mother's Day 2008 was one of the days for which I had a different vision. When we got married two years ago, I figured we'd need a babysitter along with dinner reservations to celebrate our second anniversary. And last year on Mother's Day I thought, "yikes, next year maybe I'll be getting a card!"

Instead, I'm writing about Happy Infertility Survival Day. Not really what I was expecting - no pun intended.

- L.

Getting Used To It

You can get used to anything. This is my lesson for this week. If someone had asked me last year if I'd ever be able to give myself a shot, I'd have said NO WAY. I get queasy and lightheaded just thinking about syringes, and I faint every time I get my blood drawn (no donating for me).

But last night, home alone, I gave myself my first shot. My husband had a baseball game, and I didn't really want him to see me grabbing an inch of fat on my stomach and jabbing a needle into it, anyway.

The wierd thing was, I wasn't that nervous. At least, I wasn't until the minute I was supposed to give myself the shot. I'd been watching that PBS series, "Carrier," about life on a Navy aircraft carrier. The chaplain had just given a speech in which he said, "If you think you're biting off more than you can chew, maybe you've underestimated the size of your mouth."

I thought about that, and figured my mouth is pretty enormous, and there's a good chance I can handle giving myself shots.

But then I got the needle ready (I'm using the Gonal-F pen, and frankly, it's not that scary - sort of like an Epi Pen I think) and sort of lost my nerve. I moved from the bathroom to the bedroom in case I needed to lie down right afterward. I didn't - but the hardest part was the two minutes before I injected myself. I must have cleaned the skin six times.

Once I took the plunge, so to speak, and got the needle in (I jabbed way too hard by the way - your skin isn't made of metal - all it takes is a little poke) it didn't hurt at all. In fact, the hardest part was getting the stupid needle off after I injected myself!

While I'm not looking forward to doing it again tonight, I've already learned that minimizing the waiting is a good idea (think, Just Do It) - get the pen ready and just go ahead and stick it in.

I have to admit that I cried after I did it. It just made it all so real - I can't get pregnant. I so really can't get pregnant that I have to give myself shots in the stomach.

The online videos definitely helped, and now I just have to come to grips with handling the blood tests I'll have to have next week. The worst part for me is that they have to be done early in the morning - and my first fainting episode coincided with getting my blood drawn early in the morning (it was a disaster - I keeled over and there was blood everywhere when I came to). I guess I'll just have to convince myself that I can bite off more and keep chewing...

In the mean time, it's ten p.m., which means it's time for shot #2.

- L.

You're Not Crazy - Everyone IS Pregnant

You'd think that the most popular purveyor of caffeine - Starbucks - would be free from pregnant women. You'd be wrong. Today at Starbucks I saw seven pregnant women. Seven! And last week, as I sat quietly grading papers, a group of three pregnant women sat down next to me, and started complaining about all kinds of things I've never heard of, but which apparently have something to do with pregnancy.

I'm starting to feel like the kid in The Sixth Sense , except instead of seeing "dead people" I see pregnant women. Everywhere.

Just when I thought it was Just Me - that it was like fifth grade when my mother wouldn't let me get clogs and suddenly everyone had them, or when I got engaged and suddenly cute guys were everywhere (especially in the places where there had been none when I was single)- and then I read that there really are pregnant women everywhere.

According to the CDC, the total fertility rate (birth rates for american women between 15 and 44) is the highest it's been since 1971. It's also the first time since 1971 that the birth rate is higher than the "replacement rate" - the rate at which a generation can replace itself.

Still, I can't help being worried that I won't benefit in this Baby Boom. I was never very good at science, but I do remember learning that all populations control themselves (whether it's insect populations dropping because of a cold winter, animal populations dropping because of an increase in predators, or human population falling victim to plague). I worry that maybe the worldwide decrease in sperm counts and the scores of couples I see crowding the waiting room of my IVF center are part of our population starting to control itself.

If Jamie Lynn Spears and Ashlee Simpson and ______ (you can insert names of a hundren unmarried starlets here) can't control themselves, maybe nature will take over and control the population for us.

I don't want to be part of that population control, but as I get my period yet another time, I can't help worrying that maybe I am.

Ironically, I ran out of prenatal vitamins today. I was taking them for the folic acid - and the bottle contained 500 vitamins. That means I've been trying to get pregnant for 500 days - not counting the days I forgot to take my vitamin.

I'm starting to think I should follow Jamie Lynn and her teen mother companions and throw the stupid vitamins out, drink too much and act irresponsibly. That's just about the only thing we haven't tried yet.

- L.

So Not Pregnant

Well, that ended badly.

After nine days of obsessing, riding a roller-coaster of hope and despair, and generally driving myself and my husband crazy, I got my period. It started yesterday morning as what I thought (it was a moment of hopefulness) was an encouraging sign: spotting, which can sometimes indicate that an embryo has taken up residence in the uterus. I called the nurse and asked her about it. She asked for a lot of detail about its appearance, which made for an awkward time out on the busy sidewalks of town (I hope no one was eating).

As a side note, it's more than a little embarrassing to not know what a normal period is supposed to look like by now. I mean, I thought by now I'd have moved a bit beyond the whole "Your Body is Changing!" days of prepubescence health education, but having an ovulation disorder really kills the whole idea of "typical" and "normal." Every month is a surprise, and not the kind you look forward to.

Anyway, the nurse thought that what I had in the morning seemed normal so I went about my workday, oh so innocent to what lay ahead. By the time 5:30 rolled around I was ready to go home, so I ran to the ladies room before the ride home. Since I've only done the whole two-week-wait thing once before, I was totally unprepared for the icy knife that cut into my chest when I saw that I'd really gotten my period. I just sat there, staring, for a few minutes until it sank in. It was over.

At least it had the decency to wait until the end of the day, so I could go home and have a proper breakdown. The sadness of this kind of loss -- and even when there isn't anything there to begin with, it still registers as a loss -- is startling and suffocating.

Of course I assumed the worst -- now I have luteal phase defect on top of everything else. Because I wasn't having enough fun with the PCOS and anovulation. But the nurse I spoke with today said the doctor is unmoved by this news. Apparently these injectable drugs shorten the luteal phase in the majority of people, and though nine days is a bit shorter than they'd like, they're not all that concerned. They're going to give me progesterone following my next IUI to try and lengthen the cycle. Oh -- and that medication? Comes in suppository form. Because, you know, my hoo-ha hasn't been having enough fun with all the other goodies, like ultrasound wands and catheters. It was just waiting for the addition of a nice, big glob of goop twice a day to really get the party started. Good times.

The next cycle starts tomorrow with a baseline ultrasound and another round of gonal-f. Maybe that's why I'm not jumping out the window. "There's always next time" must be the motto of infertiles everywhere.

-J.

The Seven Stages of Fertility Treatment

Okay, so here's what went down. I went in last Saturday morning for another ultrasound/bloodwork. By then, I had eight follicles, five of which were big enough that they had to be taken into account, including one at 19 mm. My doctor had said that five would be the most he would consider moving forward with for the IUI, so I went and spoke with the nurse. She dropped the "m" word -- multiples -- and made sure we were aware of the risks. But as she also pointed out, they've been trying to get me pregnant to no avail, and this seemed to be a good opportunity.

I got a bit stressed about the multiples warning and did some thinking as we left the office. I do want a baby, but I don't want five, and certainly not at once. But the nurse spoke with my doctor and called back later that afternoon, with instructions to take just half the dose of HCG to trigger ovulation that night at 9 p.m. It seemed clear that we should go for it, and with the dosage halved to mitigate the threat of high-order multiples, I felt better.

Luckily, Saturday night brought us to an event in New Hampshire with our friends Chris and Robin, who just happens to be a nurse. Having only used the Gonal-f pen for injections previously, I found the whole mixing the HCG powder and using a real syringe more than a bit daunting, so at 9 p.m., me, my husband and Robin trekked out to the car for a celebrated Saturday evening pastime: subcutaneous injection to stimulate ovulation. Thirty-six hours later, at 9 a.m. on Monday morning, I had my first IUI. And that brings me to the Seven Stages of Fertility Treatment:

1. Euphoria. I just had a fertility treatment! Washed sperm are swimming around in there just jonesing for a rendez-vous with my ripe egg.

2. Confusion. Wait, that's it? I'm just supposed to go about my day now? Shouldn't I do something else, like stand on my head or keep my legs in stirrups all day?

3. Disappointment. I thought there'd be something more dramatic about this. I can't tell what's going on in there and I don't feel that excited about what's going on anymore.

4. Delusion. I am going to have to stay calm for the next two weeks. No snapping at people, yelling at people on bikes who get in the way of my car. No feelings of anxiety, worry, sadness, anger, negativity allowed. My body must be a temple for conception to take place.

5. Doubt. I don't feel any different. My boobs are sore but I can't tell if that's from poking them a hundred times to see if they're sore. I bet it didn't work.

6. Pessimism. Damn it! What if it didn't work? Yet another failure to add to the long list.

7. Hope. But actually, there's still a chance! In less than two weeks, I'm going to get a call from my favorite nurse going something like this: "I'm so happy to be the one to give you this wonderful news. You're pregnant, and we can tell there's just one (or two) in there!"

Repeat #s 6 and 7, alternating, thousands of times per day. That's about where I'm at right now.

-J.

The Long Race

Okay, so I was a little loopy yesterday. Anyone would be. This week has been the definition of "emotional rollercoaster," and I truly am exhausted from all this thinking about follicles. Here's where I am right now: Yesterday's results showed that I have four follicles on the right side, all at about 12 mm. My estradiol level is in the 200s, which the nurse said is "perfect" for where I am. They had boosted my gonal-f to 112.5 iu on Monday and kept me on that dose last night and tonight. Going back in the morning for another ultrasound/bloodwork round.

One thing I've learned is to stop asking for and/or listening to the ultrasound technician's read on the situation. With all due respect to them -- because some of them are great and very professional -- they are not doctors. Yesterday, the tech asked me if my ovaries were very sore, because "you have a lot of follicles." I immediately spiraled into despair -- clearly, we were back in the same situation again.

I asked to speak to a nurse when it was over, and she talked me down from the ledge. I have four in the lead, and if they stay in the lead I'll be good to go. I also spoke with my doctor yesterday. I just really wanted to hear what he was thinking. He said he, too, is concerned that I seem to either overrespond on the higher doses or respond too slowly on the lower ones. But it's entirely possible, he said, that these four follicles will make it to the finish line before the others get big enough. He said he'll trigger (take the HCG shot to trigger ovulation before an IUI) with up to five follicles. Anything beyond that, he said, and the risk of multiples is just too great. For now, we just play the waiting game. It takes a lot longer to get to the end when you're on the lower doses.

Today I'm feeling...well, I don't really know what I'm feeling. I go from optimistic to despondent in a matter of minutes. I'm just really hopeful that we can actually get to another opportunity to get pregnant. After all the hard work (and sometimes it really does feel like work) of the last few months, I've only had one opportunity (in late Dec./early Jan. when I ovulated on Clomid) to get pregnant. One. I'd be grateful for more. On that note, I'm really considering converting to IVF if I overrespond this cycle. Like my follicles, I'm eager to get to the finish line.

-J.

An Update from Follicle Hell

This is how I could go crazy:

Ultrasounds every day
Follicles too big, too small
too many, not enough
All follicles all the time
Start seeing follicles everywhere
Follicles start talking -- taunting me

In the event of the above, will somebody please make sure my room at McLean's is stocked with plenty of magazines and lots of salty and chocolatey snacks? If I go crazy, the diet is so over.

-J.

Calling the Insurers OUT

As I've said before, I'm angry. And now I have an outlet for that anger - an outlet that absolutely, really and truly deserves it. The insurance industry.

I met with my doctor on Thursday, and he told me that he wanted us to start IVF right away - that at my age (37, 38 in May) and with our test results, we'd likely have a 40% or higher chance of getting pregnant on the first IVF try.

But we can't do IVF right away. Instead, because my insurance mandates it, we've wasted three months on Clomid and IUIs, and are now going to have to waste two more months on FSH and IUI. So I get the worst of IVF - injecting myself in the stomach every night - without the benefit - the high success rate.

Why?

Because my insurance company, like many in Massachusetts, blatantly violates the law and puts all sorts of limitations on infertility coverage. Apparently the insurers sat down with fertility experts (including my doctor) fifteen years ago, and asked them what their different treatments were. And, fifteen years later - a thousand years in fertility treatment improvement - the insurers are still requiring the same protocols.

In 2008, this is like iTunes suddenly refusing to allow downloads: "Welcome to iTunes! From now on, you can only buy 8-track tapes here!"

I live in a state with some of the best doctors and hospitals in the world. But because of the insurance industry's stupidity, I might as well be getting treatment at a small clinic in a developing country.

And the most infuriating thing is, IT DOESN'T SAVE THEM MONEY!! If they had let me go ahead with IVF right away, they wouldn't have had to pay for all the doctors' visits, ultrasounds, blood tests, medications, IUIs and other expenses over the past four months.

I am going to do something about it.

The law in Massachusetts is crystal clear: health insurers who cover pregnancy-related expenses must cover all medically necessary costs of infertility diagnosis and treatment. ALL.

My insurer - Harvard Pilgrim (I have a PPO plan) - is violating this law. My doctor says that IVF is medically necessary - and my insurer says, "too bad."

They also put caps on coverage - 6 IVFs. And age (when the woman turns 40) will trigger all sorts of requirements - for example, they can cancel a cycle if my test results aren't equal to their mandated levels.

What I want to know is this: if a pregnant woman is having her seventh child, do they refuse to cover her hospital costs?

"Sorry! You've had six kids - that's our limit!"

Do they kick 20 year olds out of the hospital five hours after giving birth?

"Well, you're young and strong, so we only cover you for five hours of recovery!"

Do they refuse a pacemaker in a 70 year old because even though the technology exists to make his heart beat like a 30 year old's, it's his age's fault that his heart is old?

If my eggs are old, but technology can make them act young, isn't that just like a pacemaker (or Viagra, or eyeglasses, or hearing aids or knee or hip replacement)?

I'm sick of the double standard, and I'm not too embarrassed to fight it. The insurers seem to be banking on a few things:

* infertile couples are just too ashamed to take their plight public
* the insurer can take up to 90 days to review a claim - so if my doctor told them that he wanted me to go directly to IVF, we'd waste three months - so I might as well do the FSH and IUIs
* once a couple does become pregnant, they want so badly to put this all behind them that they won't take up a battle against the insurance companies
* people won't learn their rights and will just assume a denial is a denial and there is nothing that can be done about it

Well, as my friend Lyle would say in a southern accent that can make any swear sound like sugar, "I call bullshit on that."

I am calling bullshit. I have already written to two state senators (one of whom called me back and was furious and is going to look into all of this, and is going to work on the currently existing bill in Massachusetts - Senate Bill 599 - which would change the law's definition of infertility from inability to conceive for 12 months to inability to carry a child to term - because the definition currently allows insurers to refuse infertility coverage for 12 months after the cruelest fate of all - a miscarriage for a couple who has fought so hard to get pregnant).

I am going to find a class of plaintiffs, and I am going to fight the insurance companies.

I may have spent my most fertile years getting a law degree, but now I am going to use that law degree to get the fertility coverage that is legally mine.

- L.

It's All a Mystery. Period.

Sex and the City fans: Remember when Charlotte was with Trey, who had "performance issues?" In one scene, Charlotte berates him and his obsession with his “John Thomas.” “That’s all you ever think about!” she screams. “Be careful, don’t say anything bad around it, don’t want to make it unhappy!”

That’s how I felt last week about my period. All that waiting and it never came. I tried thinking positively. Tried not thinking about it at all (impossible). Tried visualizing, coaxing, reasoning with it. Nothing. I tell you, I have never thought so much about it in my life. And I’d be happy to go back to not thinking about it at all. It’s unpleasant, and it’s boring.

All the thinking mattered not a bit. Turns out, contrary to what we’ve been taught, it’s just fine that it didn’t come. I went in for bloodwork on Saturday and got the green light to start another cycle of Gonal-F. My hormones reflected the beginning of a cycle and my uterine lining was thin – good conditions for ovulation induction. I asked what the doctor made of the fact that I didn’t get my period. “He’s not really sure what to make of it,” said the nurse. Comforting. But I was getting the green light for another go at it, so arguing about whether or not I’d gotten something not-so-fun seemed sort of beside the point. It’s a mystery that will have to go unsolved.

They started me on 75 IU of Gonal-F, which is half the dose that caused the follicle overload last month. For some reason I’ve found myself feeling more anxious this time – about the needles, the dosing, etc. But I’m working through it. Went in on Wednesday for bloodwork and ultrasound and I had only two follicles this time, both at 10mm. They cut – that’s right, cut – the dose based on that. I’m now on 37.5 IU, the lowest possible dose. I guess the idea is to recruit a couple more follicles and then grow them at a slower rate than last time, while keeping my estradiol level under control (this is the hormone that indicates the rate at which your body is developing follicles -- it skyrocketed last time). I’ll go in for another round of bloodwork and ultrasound tomorrow morning.

Last night, as I was explaining the above to my husband, something strange occurred to me: Some people just have all of this stuff happen naturally. Follicles grow, one starts leading and eventually is released. All on its own. No drugs telling things what to do. Their body just works.

To me, that is the biggest mystery of all.

-J.

I realized that in my last entry, I was complaining about...complaining. So - enough complaining. How about something positive for a change? No, I'm not pregnant. But last week in my Mind/Body Class, we talked about reframing negative thinking. In addition to spending 75% of our daily conversations on negative topics (let's face it, we have more fun joking with coworkers about That Jane and her New Office and how She Thinks She's So Great than we would talking about how nice it is that our assistant always makes sure the water cooler refill is changed), when dealing with infertility, it's pretty common to have a constant negative loop playing in your mind.

For me, the hard part is trying to stay hopeful (if you think you'll get pregnant, you will sort of thing) while not getting my hopes up to the point where I'm really let down every month. And I can't help it - negative thoughts creep in all the time.

Here is the exercise that we did, and I highly recommend it:

Write down three frequent negative thoughts.

My three were:

1) It won't work for us ("it" being IVF or IUI or anything)
2) It's my fault because I'm fat
3) Maybe this means that my husband and I aren't supposed to be together

I feel the worst about #3, but I share it with you because several of the women in my group told me that they had the same thought! And almost half of us had either #1 or #2 - so if you were thinking any of these things, you're not alone.

Next, ask yourself the following questions about each of your negative thoughts:

1) Is this thought true?
2) Where did I learn this thought (where did this thought come from)?
3) Is this thought logical?
4) Is this thought contributing to my stress?

For me, thought #3 was not true and not logical, was contributing to my stress - and I guess it came from not being able to find any logic or make any sense out of why, when so many abusive, neglectful and hateful people can have children, my husband and I can't.

I'm still working on dealing with thoughts 1 and 2.

The next step was to reframe the thoughts. For #1, it was pretty easy: how will I know the technologies won't work for us? They might not work, but they might work! We have good numbers, no known problems, and have a good chance of having an assisted technology work.

With number two, I decided that my weight is one of the very few things in this whole that I can actually control. And while it's probably irrelevant, why not take control?

Now I have reframed thoughts to combat my negative thoughts:
It won't work becomes it might work.
I'm too fat becomes I'm doing something to try to lose weight and get into better shape.
Maybe we don't belong together becomes Thank God we have each other - no one could help me through this in the way that my sweet husband has.

- L.

This American Life of Complaints

When I'm driving, I usually listen to NPR. I love the intelligent reporting (it doesn't matter what you look like on the radio, so brilliant newscasters aren't cast aside to make room for skinnier, younger, blonder and perkier replacements) and am a sucker for Wait, Wait, Don't Tell Me! and This American Life. NPR also gives me hope: listeners have soared in recent years - all without Fox sensationalism (FOX ALERT!! Obama missed church one weekend in 2002!! FOX ALERT!!), or It Bleeds It Leads or faux "investigations" aimed at luring the lurid (Our hidden cameras follow the crew of Girls Gone Wild - are underage girls being victimized? Warning: For mature viewers only).

But in the past few weeks, there have been several NPR programs featuring new books having to do with child-rearing (one about whether it's better to be a young or "older" parent and another about returning to work after a decade of stay-at-home-parenting) and I find myself becoming really, really annoyed listening to all the parental complaining.

It's boring.
You never get to sleep.
They suck the life out of you.
Having a child changes your life forever.
I just want an adult to talk to.
We haven't had sex since the kids were born.

And on. And on. And on.

These people sound so selfish and self-centered: they are complaining about what I so desperately want and can't have. Yes, I understand that being a parent is the hardest job anyone will ever have, and that it's misery to get 31 minutes of sleep a night and spend all your waking hours changing diapers, cooing, holding, feeding, changing, etc.

On the other hand, complaining about it to a national audience is sort of like complaining that your dinner at Le Bernadin was a wee bit salty to an audience which includes homeless people who are eating one meal a day if they are lucky.

No one thinks about it this way, of course, because no one talks about infertility in public, so no one thinks about those who can't have children, and really can't handle hearing another single, solitary woman who cries that she hasn't left the house in four months in anything other than formula-covered sweatpants.

I blame this partially on famous people - those who are already getting press (BUMP WATCH UPDATE!!) and could be honest and say, "yes, I'm 42, and I needed help to have a baby." I'm sorry, I know they have a right to keep their reproductive life to themselves, but I just don't buy that J Lo, Marcia Cross, Mia Hamm and the myriad other famous women who have given birth to twins in the past year didn't have any help in the form of fertility drugs or IVF.

The only good thing to come out of this whole infertility thing is that I will be much slower to complain about sleepless nights, tantrums, colds or allergies. I'll think twice before going on about my stretch marks, boring days doing finger paints, and how annoying Barney is.

Okay, I take that back. Barney is really fucking annoying.

But in the same way that I am careful not to constantly complain about married life or gloat about its wonders to my single friends as we all near 40, I'll be slow to complain about something that so many people will never have the luxury to complain about.

- L.

Is There Life Beyond Babies?

Let's review history for a moment. What started the women's movement? Women everywhere were at home, caring for their children, husbands and homes, just as their mothers and grandmothers had done before. But that generation of women gave voice to the thoughts their mothers wouldn't allow: Is that all there is?

I don't know what's happened over the past few years, but if you pick up any women's magazine, you might find yourself checking the date (1958 or 2008?). Anyone know if Jessica Alba is starring in a new movie, working on a new project, launching a new perfume, perhaps? I can't tell you anything about what she's doing as an entertainer, because all of that is drowned out in favor of hearing about how much she loves her new, huge belly, her growing feet, her "fashion challenges" due to her new, extremely pregnant state. Did she mention that she's pregnant?

And it doesn't stop there. We read all about bump watches (it's two inches bigger than it was last week!), buns in the oven. We hear about breastfeeding, middle-of-the-night changes. Blow-by-blow labor & delivery stories.

I was at a professional communicators networking event last week -- one of the last baby-free zones, I thought, safe from the pregnancy- and baby-laden rest of the world. I thought it would be kind of an even playing field -- all of us professionals there to talk about our careers, not kids that we may or may not have. I was so, so wrong. One mention of someone's kids and they were off. Sleeping habits, the best nursery schools, crazy schedules filled with practices and lessons. One member of the group, perhaps noting my bored, faraway look, asked me directly: "Do you have any kids?" In the past, I would have dropped in a qualifier with the answer, "No -- not yet," to make everyone comfortable. I'm all done with that. "No," I said. Just no. It took everyone a moment to figure out what to say, but they all finally chimed in, "Oh, enjoy your life now." "Everything will change when you have kids."

To get there, these people that I hardly knew had to make two significant leaps: they assumed that I wanted kids but was deliberately waiting, and that fertility was not even a question. Bold assumptions among a group of acquaintances, don't you think? But typical.

How have we become so baby-obsessed? Why is talking or reading about pregnancy and babies suddenly more compelling than movies, books, art, culture, careers? Here's what I find interesting: biographies. The Presidential campaigns. Home improvement shows. Improving my golf swing. How many stretch marks you have? Not so much.

I want a baby, desperately. But it's not all there is. It can't be.

-J.

If At First You Don't Succeed...

So I pretended to be all pessimistic and sure that the IUI and the Clomid wouldn't work, but really, I thought they might. I just thought maybe on our own we'd been doing something wrong (like what, I'm not sure) and so with 33 million chances, there was just no doubt that one little swimmer would find his way.

Or not.

In a way, taking the pregnancy tests every day was a good idea - each day I was let down a little bit more - instead of being depressed all at once when the wierd cramps, tiredness and bloating were just my period arriving again. You can take drugstore pregnancy tests as early as five days before your period is supposed to start - but only 58% of women have pregnancy hormone by then (and 63% the next day, and 83% after that, and 93% percent the day after that, and then 98%...so you see what I mean about being let down incrementally).

The worst part (other than not being pregnant, of course) is that now I worry that something really is wrong. Maybe it's something they'll never figure out, and never be able to fix. The not-knowing is the really hard part of unexplained infertility.

I hear all the statistics - only 25% of couples undergoing fertility treatments will "take home a baby" (something about this lingo - "take home baby rate" really bothers me - like it's a drive-through or something). Or that each month with IUI, I have a 9% chance of conceiving (this is the number my doctor gave me - of course, I did a ton of internet research and have read books, and the number they give seems to be 20% per month). And, like most couples do, apparently, we figure that we are in that 20 or 9% - that the other 80 - 91% must have something really wrong.

Or not.

It's so frustrating because WHAT IS WRONG?? In my life (my Dad is a doctor) when you have something physically wrong with you, you go to a great doctor, and they solve your problem. When I had nine strep throats in one winter, a fantastic surgeon took my tonsils out and I have not (knock on wood) had strep throat in 23 years. When I kept breaking my right ankle, another world-famous surgeon took a half inch off of one of my foot bones, built me some new tendons, inserted a pin, and voila. Within 6 months I was playing lacrosse and wearing high heels without fear.

I could go on, but you get the point. The progression is: realize you have health issue, find best possible doctor and hospital, follow instructions, wait a bit, and your reward is a cure.

SO far, I've found the best doctor and clinic, done everything I'm supposed to, and still, nothing. And the worst part is, no one can tell me what is wrong. If I just knew, I'd fix it.

Instead, I search for answers. I've quit smoking, cut back considerably on drinking, cut out more than 50 mg of caffeine a day, worked on my diet, taken pre-natal vitamins, and taken the Clomid at exactly the same time every night for five nights. I've started exercising more, but not at too intense a level.

Lately, I've decided that my BMI is too high (ideal BMI for conception is between 21 and 24 apparently). So that's what I'll work on next.

And maybe the hard work will pay off. Or, for the first time in my life, maybe hard work will have nothing to do with it.

- L.

Clear Your Cache

Over the past week, in between beating myself up incessantly, weeping uncontrollably and talking nonstop about passing up the IVF option, and against the advice of my husband and friends who've calmly but firmly advised me to step away from the computer, I have been obsessively lurking on infertility message boards, blogs and websites, on which you find advice from people with signatures like:

Jane Doe
TTC #1 since the beginning of time
Clomid 50 mg BFN
Clomid 50 mg IUI BFN
Every single thing I've ever tried - BFN

...all replete with emoticons and graphics illustrating their long and fruitless attempts to get pregnant. I don't know what it is about reading these boards, but even though they usually leave me feeling discouraged and depressed, I am oddly addicted and have been reading them nonstop. I find them by Googling every possible combination of search terms that might yield some nugget of truth that will foretell my ultimate success, like "IUI + PCOS" and "IUI success rate" and "IUI didn't convert to IVF but got pregnant the very first month tried IUI."

But here's a good reason to stop, and let this be a lesson to all of you obsessive Googlers out there to make sure you always, always clear your Google cache when people beyond your husband (who already knows you're nuts) are going to be in your home. On Thursday, against my better judgment, I allowed my husband to invite two colleagues from India, who have been working out of his office, to our house for dinner. Everything was going fine until someone started talking about the population of India, which led my husband to power up our computer and look it up. A few minutes later, one of our unsuspecting dinner guests then went over to said computer, pulled up Google, and began trying to hunt for a song he'd heard for the first time on MTV. It took me a while -- too long -- to realize what was happening, but by then it was too late. I could only imagine what that poor guy had seen.

Later, I opened Google and began punching in letters to survey the damage. I think it can be summed up with this one, priceless search term, which I'm sure left our poor guest with a disturbing image of American women to take back to India:
Gonal-F + sore boobs.

Clear. Your. Cache.

-J.

Goldilocks and the Eighteen Eggs

It's only been a few days since my last post, but it feels like a lifetime of things has happened. Remember how I couldn't ovulate on Clomid? Yeah, um, not my problem on Gonal-F. Turns out I am a follicle producing machine.

My ultrasound/bloodwork last Thursday showed that everything was progressing nicely -- I actually heard the words, "You're doing great" from a nurse's mouth for the first time. When I returned on Saturday, though, the pendulum had swung too far -- I had too many follicles growing too quickly. They told me I could either "coast" -- not take any more medicine -- or convert to IVF, because there was no way they were going to give me an IUI with that many follicles. After a lot of deliberation, I decided not to take the medicine that night, which I thought was ruling out the option of converting to IVF. I went back on Sunday and my levels were still high so it didn't look like coasting was going to work. The options -- if you can call them that -- were to cancel the cycle or I could still convert to IVF. In a fit of optimism and exuberance, I took the medicine (though a sharply reduced dose -- 37.5 instead of 150 cc) thinking I would go for the IVF.

Yesterday, I went in for a "pre-op" and to sign a dozen forms basically agreeing not to sue them if anything catastrophic happened (those possibilities were spelled out in detail). That's when I really started to freak. First of all, I am phobic of anesthesia, due to a traumatic experience when I had my tonsils out at the tender age of 9. I guess these things stick with you. Quite simply, I don't like the idea of not being in control of my brain at all times. And they can call conscious sedation "a nap" as much as they want, I know that's not what it is. The other option for the egg retrieval is a spinal, which they don't like to do and therefore aren't shy about describing the dangers of.

Also, I made the serious error of searching on the Internet about the actual egg retrieval procedure, rather than listening to my doctors. As a result, I became terrified of a series of bad to disastrous things that can go wrong, which I won't describe here because if I shouldn't be thinking about them (the odds are less than one percent), you shouldn't either.

Overall, something about it just wasn't sitting with me right. It felt awful -- so wrong -- to be passing up such a tangible opportunity to finally get pregnant. But it felt like rushing into something that may not be necessary. We hadn't had time to make a decision about whether IVF was something we even wanted to do -- hadn't fully explored this stage before rushing into the next. I think IVF is a wonderful thing for people -- maybe me -- who need it, but if there's a way for me to get pregnant through a bit of a lower-tech method, I'd like to see that through first.

Next steps: Wait for a period. No sex (unless 18 children appeals to me -- yes, I have 18 follicles growing in there). I don't even have to wait a month, I can jump right into the next cycle when I get a period. Meanwhile, I guess I'm the Goldilocks of infertility treatments -- not enough, too many eggs -- until I find something that's just right.

-J.

Kid-Free Zone

Here’s an open request for all the parents out there: Please refrain from bringing children to an infertility clinic (as someone did to mine this morning). It’s like walking into a Weight Watchers meeting with a dozen Krispy Kreme donuts – it’s just plain wrong. I love kids – that’s why I’m going through this hell – but I don’t need a reminder on how far removed motherhood feels when I’m about to be poked, prodded and get intimate with an ultrasound wand digging around for follicles.

I get that you might be going through secondary infertility, and I’m sympathetic. Really, I am. I can get my mind around the fact that being unable to have #2 would be really, really hard, particularly once you’ve had the taste of pregnancy and motherhood. So if I can make that leap from here, can you please stop and think for a moment that bringing a baby into a room where women are gathered because they can’t have one might be just an eensy weensy bit insensitive?

Infertility is hard enough. Please don’t add insult to injury. Find a babysitter.

-J.

Does the House Always Win?

You'd think I'd have learned that I'm a really bad gambler when, the first time I was in Vegas, a dealer tried to help me while I was playing Blackjack. That's right - I had 16, and said "Hit me!" (mostly because I'd learned the hand signal for "hit me" and having had at least 123 free drinks, thought I was cool knowing the hand signal). The dealer said, "You have 16." And I said, "Hit me." And he said, "You have SIXTEEN." And I said, "Oh - stay."

Uh huh. And frankly, my luck hasn't really improved since that summer in 1990. When I buy scratch tickets, I never even win the price of the ticket back. The people scratching on either side of me are winning left and right. My husband got me a lottery season ticket - think we even won a free ticket? Nope - not even after a whole YEAR.

Plus, I'm bad with numbers. Math just isn't my thing.

But yet, like a gambling addict, I couldn't resist playing the numbers. I thought, "This time it'll be different - this time I'll win my money back, I just know it!" Uh huh.

The game this time was a little different - definitely no free drinks, no good music, no fun cards to handle, levers to pull or numbers to pick. Instead, I decided that if 69% of pregnant women get a positive pregnancy sign four days before their expected period, I'd be in that 69%. I mean, I'm four days from day 28, and I've had the worst ovarian pain torturing me since day 16. It was so bad on day 23 in fact, that I thought I was losing my appendix. They couldn't really find anything on an ultrasound - just a follicle that hadn't collapsed (who knew they did that? Who knew you had follices? Sex Ed in high school was really a Cliff Notes version, wasn't it??).

So of course I thought, gee, must be pregnant.

Well, unless I'm in the 31% (is that math right?) I guess I'm not.

Which is sort of terrifying, because until now, I've been able to blame it on bad timing. But this month we did IUI + Clomid, and my husband's "counts" were "excellent" and "well beyond what we look for!"

So, I sat down at the $6 First Response Early Pregnancy Test table (apparently the government did a study in 1999, and that was the brand that was the most reliable and actually had accurate results early - which of course I'd researched for three hours - after reading blogs where women said that when they got pregnant, they'd had bad ovarian pain...) and rolled the dice (or peed on them, as the case may be).

And....one pink line.

If I ever do have a baby, I think I am going to paint two giant pink lines around the top of the nursery in celebration.

For now, it looks like I'm going to have to stay in gambler's purgatory. Because hey, tomorrow, 83% of pregnant women get a positive test. And the day after that, 93% of women do!

Clearly, I'm not an addict.

Really, I'm not.

I don't have a problem.

Maybe I'll just buy a different brand of test - move to a different table, with a luckier dealer. Yeah, that's the ticket!

- L.

A Sticking Point

Giving yourself a shot doesn’t require any particular talents, but it is a bravery test. I passed last night – still can’t believe I was able to do it myself. But I guess there are a lot of things you become willing and able to do, against all odds, in order to have a baby.

Here’s what I’ve learned so far: like shopping at Wal-Mart, the key is to get in and get out. Don’t spend a lot of time looking at the needle, thinking about how you’re going to do it, deliberating over when and where to put it in, saying “Oh, I can’t believe I’m going to do this.” Just stick it in. The anticipation is much, much worse than the reality. I did have a bit of stinging last night and a tiny, itchy bump where the shot went in. But honestly (and I am a huge, huge wimp), that’s it. It’s not as bad as you think (and believe me, I thought it would be pretty bad).

It helps if your husband is with you, making you laugh by mocking the voiceover lady in the instructional video on the pharmacy’s website (“Make sure that the DOSE is lined up with the ARROW. Count to five…one. Two. Three. Four. Five.”).

-J.

Hope Springs Eternal

Infertility feeds on hope. Each new cycle offers a clean slate, a reason to put aside grief over the last failure and start daydreaming once again about getting your “Big Fat Positive” and sharing the good news with family and friends. It’s been a while since I’ve posted, mainly because several weeks ago I got news that, for a brief moment, made me feel that all that hope was unwarranted. And writing about it seemed not only impossibly difficult, but also moot.

I had a bad feeling in my gut about the last Clomid cycle, which began in mid-January. Although I had ovulated in December – for what I believe may have been the first time ever – my first ultrasound of the January cycle showed follicles that were slower in developing than what we’d seen the month before. I returned on the morning of January 28 for a follow-up and was told that I had three follicles – a 13 mm, a 12 mm and a 9 mm. For those of you not schooled in all things follicular, those are still on the very small side and should have been much larger – ready to rock & roll – at that point (day 17).

Based on this news, I expected the nurse calling later that afternoon to tell me that the cycle was cancelled and we would need to move on to a stronger Clomid dose next month. Instead, the not-so-nice nurse (through this process you learn the precise definition of bedside manner, and that a health care provider is either going to have it or not) told me they were cancelling the whole megillah. In addition to producing less-than-optimal ovulation results, Clomid was thinning out my uterine lining, which is not such a good result when you’re trying to get an embryo to attach to it. So the fertility drug was making me less fertile. Because what would an infertility experience be without a healthy dose of irony?

Here’s what ensued following that phone call: hysterics. I did not know a person could cry like that. Several times, I thought I might puncture a lung or otherwise injure internal organs. I cried because I honestly, honestly thought Clomid was going to work. I put on a good show of pessimism (cautious realism, I like to call it) – but it doesn’t take Freud to tell you that has defense mechanism written all over it. Underneath that, I had been hopeful to the core. I was genuinely fearful of moving on to the vaguely ominous world of injectible medications, the next step once you call it a day with Clomid, which in my mind – beyond seemingly absurdly complicated – could make me the proud mother of a litter of six babies.

After several days of moping and obsessing over what had been lost – namely, a relatively easy journey in the land of infertility – I started to perk up. Partly because I talked myself off the ledge of despair and slowly back into the realm of hope (This will work BETTER than Clomid! And with fewer moodswings!), and partly because I had to perk up so I could get on with my life instead of sinking into a deep depression. I started reading Dr. Alice Domar’s book, Conquering Infertility (Lisa – you are so right about her – she is a living, breathing genius. This should be required reading for anyone going through this.) I started reading about the gonadatropin (injectible) drugs and found encouraging info. And I had another rendez-vous with my good friend hope.

I started Gonal-F last night – this is the drug that will stimulate my ovaries to produce follicles for ovulation. I must stop right here and say that I never, ever thought I’d see the day when one of the things my husband and I would do in the bedroom would involve a needle, some alcohol wipes and a pinch of fat from my lower abdomen. Hilarity ensued when he got ready to inject it, holding it like a dart aimed at the bullseye of my stomach. Once I convinced him to use a more humane grip, sweat literally ran down my forehead as he prepared to put it in, following the video instructions on my pharmacy’s website. But then: Almost nothing. The slightest pin prick and a count of five and it was all over.

The plan is to take these injections for four days, with an ultrasound scheduled for Thursday morning to see how things are coming along. I can handle this. I have all the hope in the world.

-J.

And now, for some good news!

If you're dealing with infertility, most of what you read and hear is probably very discouraging. I was shocked when I learned that having not conceived after trying for a year meant that we only had a 2% chance of conceiving per month. TWO PERCENT!? This 2% apparently accounts for those all too common (and really frankin annoying) stories("my friend Angie tried for years, and as soon as she adopted, she got pregnant!" "I know two women who just stopped trying and stopped thinking about it, and voila - pregnant!")


But today I read something that amazed me: in the United States, women in their 40s have more unplanned pregnancies than anyone other than teenagers! Not that I'm rejoicing in unplanned pregnancy - but I am pretty damn happy to read (for once) that lots and lots of women over 35 get pregnant - even (or especially, since the statistics no doubt reflect not using birth control) when they aren't trying.

So, for today, a statistic that should make us feel better about our fertility - finally!

- L.

Clomid Isn't the Devil Afterall...

I'm starting to realize that most of my assumptions during this whole fertility/infertility process have been completely wrong. I was deathly afraid of Clomid - having (stupidly) trawled the internet for whatever I could find, I was sure I'd be bathing in a tub of ice to get rid of the hot flashes, be sick to my stomach all day, be unable to go to work because the bloating would prevent me from fitting into anything but pajama bottoms. Instead, I felt a little sick the day after I started taking the Clomid (100 mg dose, for those of you who know about this stuff) and had a headache off and on all week. But other than that, nothing. I definitely felt what I assume was ovulation (on day 16, which is about 3 days late for me) - pain in an area that just has to house my right ovary - so hopefully the Clomid worked.

Unfortunately, the IUI surprised me in the opposite way. I expected it to hurt when the nurse inserted the tube thingy (I really have no idea what it's called - it's certainly not a needle but not a tube either, really) but that didn't hurt at all - in fact, I didn't even feel it. Then she said, "okay, now you should notice that the cramping will subside." Instead, I had severe cramps that were so bad that I threw up! Apparently I had a reaction to the prostaglandins - the stuff that they couldn't spin out when they separated the sperm (for those of you who are new to this, IUI means intrauterine insemination, and basically, they take your partner's sperm sample, "spin" it so only the sperms are left, and then they insert those directly into your uterus). When I looked up prostaglandins I saw why - they are used to induce labor! Basically they force contractions - lovely.

I have yet to talk to anyone who has had an IUI and has had this happen to them - most women don't even feel it. Lucky me! I felt like such a baby - crying on the table and unable to walk (until I had to get to the bathroom for an ahem emergency).

All I can say is, I really, really hope this works - because if it doesn't, I'm really going to dread the next IUI.

If you're about to have an IUI, don't worry - apparently very, very few women have the problem that I had...but I'd take a few Tylenol just in case!

Out of Control

I think a lot of what is so difficult about infertility is the lack of control. I decided where I wanted to go to college, where I wanted to live and work when I graduated, that I wanted to go to graduate school and where and when I would go, and who I wanted to marry. I've decided where to work, play and live. When I decide I want to do something, I make it happen (well, okay, I don't look like Heidi Klum yet, but I've decided to work on making myself accept that).

I studied like crazy for the LSATs and got myself into a good law school. I decided I wanted to make some money and work at a big law firm, and I worked hard to get interviews and to get offers out of those interviews.

At each stage of my life, for the most part, I've had control. I guess I would have liked to have met The One a little earlier in life, but in retrospect, why? I was having a great time with my single friends, travelling, studying, exploring, enjoying. I wouldn't trade it for anything, even now that I have lost control over something I really, really want.

I think at some point, evolution will catch up, and instead of having 15 year olds get pregnant by breathing the same air space as a boy, our bodies will adapt to accommodate the reality that a 35 or 40 year old woman is much, much better equipped to become a mother than a 16 or even 22 year old woman is. I mean, people used to have a life expectancy of about 50, and so everyone was married by 17 because you were elderly in your 30s.

I saw Idiocracy this weekend - the premise of which is that in 2500 the earth is populated by the lowest common denominator (to put it nicely) because all of us smart yuppie types waited too long to have children and were infertile by the time we got around to it (nice, huh?) while the uneducated intellectual lottery-losers had 12 kids by the time they were 20. It was sort of insulting (the rest of the movie was funny in a stupid way - it's a good time waster) but made me think that at some point, our bodies will evolve.

In the mean time, I can't control the fact that I'm 37, or that I didn't meet anyone worthy of marrying until I was well into my 30s. But in the last three weeks, I've done a lot of things to take as much control as I can, and it's made me feel 90% better (there's still at least 10% of me that is miserable and actually glared at a woman with three kids under 5 yesterday - three! Three!!! I only want one, God. Really!).

My husband mentioned that coming home has been a pleasure (which made me feel good and awful too - imagine if staying at work was preferable to coming home to your psycho wife) since I started the Domar Center's programs.

Here is what I have done, and so far, it's made a huge difference:

I changed doctors and hospitals. Why should I slog through heinous traffic to find no parking to be sat in a waiting room with pregnant women for 2 hours to see a taciturn and mean doctor who treated me like a lab rat? No, thank you. I looked for a program with both body (excellent doctors and facilities) and mind (the belief and services to support the belief that you need emotional help with this, too) programs.

I started a Mind/Body program, which has weekly meetings and "homework" - which includes guided meditation (something I have never been able to do without laughing or falling asleep and have frankly never really believed in) and a great book by Alice Domar. The CDs and the book are available to anyone - go to bostonivf.com and follow links for the Domar Center.

I started acupuncture. So far, no miracles, but I like it. I thought I'd hate it - but the needles are the size of a strand of hair, and the acupuncturists are so professional but warm and nice that i look forward to it.

I started yoga. So far, only one class, but it's nice to be doing something that is 100% for ME and which is working my body without the goal of getting it skinnier.

I started sleeping again (okay, I still fall asleep to the meditation CD, but hey, it's much better than not sleeping at all or waking up at 4 a.m.).

I cut myself some slack. Don't feel like going to that thing because I know there will be babies or annoying friends of my parents who will ask annoying questions? Good. I'm not going. Laundry piling up? So what? Who suffers? Me because I have to wear that ugly orange top? So I'll wear an ugly orange top that I should have given away a year (okay, five) ago. Look at what my coworkers wear. That orange top is pretty nice when I think about it that way.

All of these things have helped me to feel more in control in a time when I have not much control over the "no one knows" answer to my question: Why can't I get pregnant? and I recommend them - or any method - that makes you feel calmer, less worn out, and less crazy.

- L.

Luck Is No Lady

Before I even had a chance to pee on a stick, my period arrived late on Saturday. To say I was surprised is a huge understatement. First of all, I just don’t get periods without direct medical intervention – usually by the name of Provera. And second, I was ready for it to possibly appear this week, but it never occurred to me that it might come before then.

I wouldn’t have said it out loud, but the optimist in me (there is a small one…somewhere) was really, honestly hopeful that it would work this month. That I would be able to say that the process was, all things considered, relatively easy. That once we got the Clomid dosage thing down I was, as it turns out, actually a fertile myrtle within the infertile set. And that part of me cried on Saturday night over the loss of that hope.

But the realist in me is calling the shots, and I am, on the whole, okay with it. It would have been wonderful and truly lucky if it had worked this first month of actual, “game-on” trying. But even people without fertility problems usually need to try a few times before it works. Luck was not on my side this month, but there’s always next month – it’s out there, looming and hopeful. And without the added step of Provera to induce a period, I move right to Round 2 (new Clomid cycle – still 100 mg, days 5-9 since it worked) starting Wednesday. What’s more, the fact that I got a period on my own means that I did, in fact, ovulate – possibly for the first time in my life. Which is a feat I honestly was not sure my body was capable of. And I’m so, so proud. And encouraged.

By coming on Saturday, my period saved me the $15 I would have wasted if I’d taken that ept test that was all queued up and ready to go Sunday morning (incidentally, can someone please tell me why they are so expensive yet so inadequate? We’ve sent people to the moon – supposedly – but cannot come up with a home pregnancy test that doesn’t require you to wait until a missed period, when you pretty much can figure it out anyway?). It would have been another indignity in a long list.

-J.

Afraid of...I'm Not Sure What

So I chickened out. After waiting for day 3, waiting at CVS at 10:30 at night on a day when I'd been at work til 9, and after Yahoo-ing "Clomid side effects" for three hours, I chickened out and didn't take the Clomid.

I don't know what happened to me - whether it was part of this infertility insanity or what, but all of a sudden at midnight on Tuesday, I panicked. I made my husband hook up the DVD player in our bedroom (it's been sitting there unused since we moved in August) and dug out the "Understanding Infertility" DVD that I'd been given at the Domar Center in hopes that it would answer my questions about Clomid.

I know practically everyone takes it - and everyone undergoing infertility treatment certainly does - and my friend CC swears that half her friends use it as birth control (i.e. they don't take it unless they want to get pregnant). And my doctor never mentioned side effects or dangers, and no one else really has either (other than the people I know who are on it, who have told me plenty about hot flashes, night sweats, headaches, mood swings that are straight out of the Exorcist). But on the internet, little words here an there stuck in my mind.

"Effects on children conceived using Clomid: unknown."
"Changes in cervical mucus may be permanent and woman may not be able to conceive without IUI or other assisted reproductive technologies."
"Ovarian cancer..."

Plus, it was literally the worst week of the year for me for workload, and I just couldn't face getting up in front of three back-to-back two-hour classes full of grumpy law school students (grades were posted on what would have been Day 4 of my Clomid round - the day that side effects tend to be at their worst, apparently) while having nasty hot flashes and a headache and nausea and blurred vision (that's right, I'm an optimist) after a sleepless night (in addition to having to grade papers all night I fully expected to be in a bath of ice cubes, like Cheryl-Lynn from South Carolina who posted her story on an internet site - her husband Dan had to put her in an ice bath on her third night on Clomid because she was so hot she couldn't stop throwing up).

So I chickened out.

My husband was great about it - he watched the video with me (which said not a thing about Clomid side effects) and told me it was my body, and what was one more month, and I should find out as much as I could about it and then make my decision.

All that being said, I feel a little silly. Everyone else pops the pills like they were Skittles, and seems to think nothing of it. I guess it's the lawyer/professor/researcher in me - I have a hard time making any big decision before I know every last detail.

I'm going to call my doctor, and when I have answers to my questions, I'll share them here. Until then, it's sushi-city, and I'll be cracking a beer at the Patriots playoff game tonight, without worrying that anything other than the Jaguar's running game might make me sweat.

- L

Living Day (28) to Day (28)

Okay, you know you are officially insane when you hear that someone has a follicle that large and you put on a party hat. I'm not kidding, Jennifer, I'm sitting at my computer in a party hat leftover from New Year's, and I'm very excited and happy and hopeful...

and I could not agree with Jennifer more - the waiting and the not-knowing are definitely two of the things that make those of us dealing with this the craziest. Unlike Jennifer, I ovulate (or at least they think I do), so I live in 28 day cycles (or sometimes 27, or in one case, a very cruel 32 day cycle).

Days 1-5 are spent starting a new 28-day calendar, figuring out when day 13/14 (when I usually get two purple lines on the ovulation predictor stick) will be and where we'll be for those days, and what else we have going on during that week (do I have anything due at work that will make me pull an all-nighter - never conducive to wanting to have sex - or will my husband (who is a lawyer) have a trial? Will someone be visiting us - and therefore staying within inches of our bedroom? Does it fall on a weekend when we will want to be at our ski house, with its paper thin walls and 100% guarantee of house guests?

Days 6-10 are spent impatiently waiting for day 10, when I will start to pay attention to the "egg white" situation and maybe will part with some of those very overpriced pee sticks on the off chance that I ovulate early.

Days 10 -16 will be spent dutifully having sex every other day, or sometimes every day or every third day depending on our schedules. Fun. Wahoo. Sex On A Schedule - I've heard there's a new porno out with the same name.

Days 18-28 are then spent waiting. Waiting for what I know will come - even though I try to tell myself that if I assume that I'm not pregnant, I won't be. I don't even bother with the home pregnancy tests anymore. It's too painful to get all hopeful and "cheat" early with a test only to have disappointment arrive a few days early.

And so this is my life. This fall, we stopped "trying" - or rather, we decided to forego fertility treatment for a few months to recover from Dr. G. I told myself we wouldn't think about it - we'd just live normally. After all, that's when you get pregnant according to everyone and your mother in law. When you just "relax" and "don't think about it."

But honestly, unless I go back on the Pill, I can't not think about it. I just can't. I know exactly what my body is doing and when it's doing it and that little spot of hope is always there, so I have to take advantage of it.

I think with anything in life, it's the Not Knowing that is the worst part. I've always thought it would almost be worse to have your child kidnapped than anything else - the Not Knowing would literally make me 100% insane. Because with Not Knowing, you can never grieve, never move on, never Get Over It. Not that you ever get over the loss of a child or the loss of the ability to have a child, but there is something about Not Knowing that adds to the emotional insanity that is Infertility.

I'm terrified that this insanity is going to destroy my marriage, and change me permanently. I can only imagine what it is like for people who have gone through this for years - I honestly think they are the strongest, most amazing women I don't know (very few people talk about this) because if I had to ride this roller coaster in hell for two or three or four or five years, I'd be a shell.

But for now, it's not two or three or four or five years. It's just 23 days, cause I'm on Day 5.

-L

How to Become Patient (or Lose Your Mind) in 18 Days

On New Year’s Eve, I went in for my follow-up ultrasound prepared to leave the office in tears and collapse in a heap of despair over failure to ovulate while the rest of the world (except my husband, who would have to deal with me) rang in the new year. When the doctor said, “We better get you home – you’re about to ovulate,” I had to ask him to repeat himself and say it two different ways before I was able to process it. Because although I respect science and medicine immensely, and I’m seeing a well-regarded expert in this area, I never, never thought this would actually work. I think my nature is to prepare myself for the worst in every situation – and infertility seems to reinforce that tendency with all of its accompanying sadness, disappointment and irony.

But there it was – a 20 mm follicle taking over the ultrasound screen. We were told to go home and do the deed every other day for a week. Suddenly, a different kind of pressure – the pressure of success. I had this budding follicle in there and needed to get the sperm to meet it at the right time. Oh, if I could only see in there and cheer them on from the sidelines – “go spermies!” - or do anything that would lend me a modicum of control when all I’ve been instructed to do is have sex and hope for the best.

Now I know what everyone’s been talking about – this time of trying, of real trying steeped in reality, when it’s actually possible that it could work – is all about “hurry up and wait.” Meanwhile, I must avoid, in the following order: alcohol, sushi, ibuprofen, really any painkiller of any kind, soft cheeses. I tell you, I’ve never wanted a red wine and sushi dinner so badly in my life. And the thing that kills me is this could all be for nothing – a cruel exercise in self-deprivation for another disappointment. But I’m trying to stay positive.

The week is over and now we wait another week and a half to confirm what’s happened. I think I’m going to test on Sunday at home, though even then the results won’t be conclusive. But the waiting is the hardest part, as they say. Perhaps infertility is mother nature’s way of giving parenthood-required patience to those who lack it. Okay – I get it, mother nature. Now give me two pink lines.

-J.