Chapter 1 – “The end.”
When I—we—struggled to get pregnant, and I’d read a story about infertility, I’d skip to the end to find out how an individual or couple resolved their infertility. If you want to skip to the end, then yes, I got pregnant. I had a baby who is now a happy, healthy, bright one-year-old. It took three years, and it was super fucking hard.
Chapter 2 – “We can’t make a baby, but we can make our own language.”
A brief set of terms you’ll find in this essay:
IF – Infertility
Infertility is known as IF in online support lingo. (Can we send that back to committee? Of all acronyms, is this the best we can do?)
RE – Reproductive Endocrinologist
Fertility doctors make a shit ton of money.
TSH – Thyroid Stimulating Hormone
The thyroid is a butterfly shaped thing in your throat that controls multiple functions in your body and if it’s off in the slightest, your body is fucked.
CD – Cycle Day
The days in your menstrual cycle.
IUI – Intrauterine Insemination
IUI is the opposite of a honeymoon baby. Your partner stops off at the doctor’s office and watches porn so he can leave his sample. You drive over on your lunch break and get up in stirrups. You sign a bunch of consents. The nurse comes in and inseminates you while the Beach Boys play overhead. After it’s done, you text your partner and he texts back and you talk about what to make for dinner.
PCOS – Polycystic Ovarian Syndrome
A blanket term for fucked up hormones and ill-functioning lady parts.
HSG – Hysterosalpingogram
Get thee in thy stirrups again! Dye is injected into your uterus to look for blockages in your fallopian tubes or other uterine abnormalities. A charming weeknight activity.
IVF – In-Vitro Fertilization
Egg and sperm are joined together outside of the body and graded. Hijinks ensue.
OPK – Ovulation Predictor Kits
It’s like taking a pregnancy test only it’s to tell you you’re ovulating (or not). Certain tests give you a smiley face if you’re ovulating. If it’s not a smiley face, it’s empty. Sometimes, they make you feel empty.
Chapter 3 – “The Internet Says.”
An average healthy couple during peak fertility years will only have a 20 – 25% chance of becoming pregnant each month. One in eight couples will struggle with infertility. One third of the problem originates from the female, another third is the male, and the final third is a sweet, unknown combination of both partners. Infertility can have a common cause such as PCOS or endometriosis or unspecified male factor. Sometimes no medical reason is found and a couple is considered “unexplained.” Infertility is ageist. If you or your partner are under 35 and it takes you longer than one year to conceive, you are considered infertile. If you’re both over 35, knock six months off. IF is also defined as having recurrent miscarriages (Resolve.org). Infertility is you are not pregnant when you want to be and everyone else is.
IF is all about numbers. I am hypothyroid, meaning my throat’s butterfly-shaped thing isn’t the being all it can be, so my TSH was measured every six weeks and my meds were adjusted or left alone. Progesterone, estrogen, insulin, other various hormones were measured each medicated cycle. My first doctor thought I was PCOS, so she put me on Metformin. Another doctor said I didn’t have PCOS, so she took me off Metformin. After my thyroid was balanced, I had near perfect 28 – 29 day cycles making the lack of pregnancy ever so much more perplexing. I counted cycle days and ovulation days. I started on 50mg of Clomid. Bumped to 100. Bumped to 150. Side effects. Moved to letrozole. Moved to injections. Progesterone suppositories. Follicle counts. Timed intercourse became IUI became “just in case” financial planning for IVF. First semen analysis measured count, motility, and shape. It was near perfect. Repeat semen analysis because the first one was outdated. Near perfect results as well. I turned 33. I turned 34. I turned 35. I turned 36. It was after my third scheduled IUI, one hundred and seventeen pregnancy tests later, that I saw two pink lines.
Chapter 4 – “The Shame Performance.”
IF is a disease, a shame cycle. Obsessing about something out of your control. Examining your body piece by piece, holding it up to the light, and screaming at it to please make some fucking sense. A horrible place you go to in your mind when you want to rip yourself to shreds. A secret. You hear about women (and men) discussing their IF after the fact. As in: it’s something that happened to me. It is not something that is happening. IF exists in the past tense. I’d often sit in the RE’s waiting room and watch other women or couples come in, and think about saying something or winking or nodding. Solidarity. I never spoke to anyone and often got the impression no one wanted to be spoken to. IF makes you feel not normal. Or do you make yourself feel not normal? Or does society, with all its emphasis on Natural Pregnant Mother Goddess (except for paid family leave and post-partum depression resources, which is another talk for another day) make you feel not normal?
My first IUI was cancelled because the day we’d planned to make it happen, my OBGYN’s office called and said I had an abnormal pap and needed a colposcopy, which is a deeper look at your cervix. Because of course that would happen to me. Instead of going to the RE’s office, I detoured to the OBGYN’s office. I was ok, right? It was just a tiny setback, right? Before your doctor does a colposcopy, you have to take a pregnancy test. Mine came back positive because of the shot I had to take to trigger ovulation. The trigger shot that is hCG, the hormone measured on pregnancy tests to determine if you are/are not pregnant. The nurse told me this, and I completely lost my mind in front of her. Cried into my hands until she found some tissue for me. Monologued three years of IF leading up to this IUI, which was now fucking cancelled and the money wasted. The colposcopy was negative, but the cycle was a wash, and we didn’t have money for the next month, so fuck life.
This is about the time I went public on Facebook. Sorry, I don’t have baby shoes to show you even though everyone stopped asking me when I planned to have kids like two years ago because I assume they assumed I didn’t want kids but I just couldn’t have kids so, people: maybe think about that when you badger friends you haven’t even seen since high school and don’t know anything about now, when it is they’re having kids, like maybe they’re trying and it’s not happening and you’re making them feel worse. But I did have massive credit debt and empty trigger shots, so cheers for the struggle.
Sharing your IF story opens you to judgment. You’re negative. You focus on the crap parts. God doesn’t mean for you to have fertility treatment. Pregnancy is a natural process. Why don’t you adopt? Often, IF couples do choose to adopt or foster or both, but, um, that choice isn’t another method of getting pregnant. Couples choose to foster or adopt because of their will to become parents.
That said, going public also opens you to support. It allows others to share stories with you. We are all struggling. Solidarity. Becoming a parent, in whatever form you choose to let it happen, is hard. If you want to become a mother, you will become a mother.
My IF resolution did not happen when I got pregnant. After my second failed IUI cycle, the time we got to go through with it but it didn’t work, I lay in bed on a day when the outside world was all nice and I was crying about how not nice my body/God/everything was. Again with the crying. It’s a theme, that crying. Sobbing snotty blubberings about failure and brokenness. One heaping plate of self-pity, please. My partner handed me Kleenex. One after another. He didn’t say a word. He just plucked another tissue and gave it to me and listened to me repeat the grief loop that ran in my head. When I was done, he said, “I’m upset too, but we’ll try again.”
Trying again: More drugs. More cycles. More counting. More stress. More shame. I didn’t want to do it anymore.
We took the afternoon to go outlet shopping. He needed sunglasses. I needed to get away from myself. The Gap store where I bought a shirt put the shirt in a baby Gap bag. I asked them if they had any other bags. She said no, sorry. Like, no, sorry, here it is in your face. And it was such moment after all the other horrible moments that I thought it was almost funny. I laughed. I propped it up on the table where we ate lunch and took a picture.
Then one of the anonymous IF bloggers I followed became pregnant. She announced her pregnancy in the way all us IF folks do by prefacing it with an apology. Pregnancy announcements are tough anyway, but often, an IF blogger pregnancy announcement often felt like betrayal. These ladies are your tribe and one of them skips out early and that’s not fair. She’d been through the shit. I’d been through the shit. I’d followed her through the shit. Her pregnancy was a triumph. Young parents with young kids are coming out of the walls, but you don’t know what it took for them to get there.
Closure happened after accepting failure. I let go.
Chapter 5 – “It happened so fast!”
Stop drinking coffee. Start drinking coffee again because you read that small doses of caffeine help the body. Wheat germ is high in folic acid. Sprinkle wheat germ on everything. Eat full-fat dairy because you read a study that found lab mice who ate full-fat dairy got pregnant more easily. Stop eating full-fat dairy because you quickly gain seven pounds and obesity reduces your risk of becoming pregnant. Stop thinking about it so much because you’re obsessing. Think about it all the time because maybe The Secret works. Pray because your Catholic upbringing thinks you should. Stop praying because your education says it’s useless. Listen to meditations about visualizing the egg meeting the sperm. Start acupuncture. Look into Chinese herbs. Decide against Chinese herbs. Too expensive. Too woo-woo. Continue to research Chinese herbs in spite of previous decision. Agonize over all decisions past and present and possible future fuck ups. Feel like the Chinese herb thing has escalated to one of those unstoppable mental crises that makes no sense when spoken aloud. Cross off year one. Move into year two. It will probably happen in year two.
Everyone is pregnant all the time. Every couple you know. For like a year straight every mass text, email, and FB post was another charming-as-fuck pregnancy announcement. If you see another picture of baby shoes next to mommy and daddy shoes, you will kick your computer in the face.
“I didn’t think I’d get pregnant so fast.”
“It happened really fast.”
“Just like that.” *Snaps fingers.*
“We didn’t even mean to get pregnant.”
Say you’re so happy.
Say you’re really thrilled.
Don’t say fuck you, and fuck you, and fuck you too, oh, and fuck you.
Go to therapy. Take fish oil. Take another brand of fish oil. Take a prenatal. Try another prenatal. Try another one. Try a supplement regimen. Stop the supplement regimen. Feel sick and google “early pregnancy symptoms.” Feel tired and google “first trimester.” Start your period and google “missed miscarriage.” Brush your teeth and feel sick and google “strange ways you knew you were pregnant.” Read hundreds of posts by women who ask: “Can you get your period and still be pregnant?” Stop going to therapy because your insurance doesn’t cover it. Have a total meltdown about not being able to sit in front of a professional who does not judge your meltdowns. Feel like you can’t even do the things you need to do to help yourself. Feel like a failure. Sit in the upstairs bathroom at a party and look at yourself in the mirror and feel super fucking pathetic, and by the way, fuck year two. Year three it is.
Hear people tell you the story of their friend who couldn’t get pregnant but adopted a baby and then got pregnant. Hear people tell you they couldn’t get pregnant for like five years for no reason and then suddenly they were pregnant because they relaxed. Hear people tell you that kids are a fuck of a lot of work anyway so you probably don’t want them. Hear people tell you that fertility treatment is not natural, ergo, your child won’t be natural if you get pregnant anyway.
Read about teen moms and drug moms and babies taken away from moms because their moms had seven kids with seven dads who all live below the poverty line and left them alone for hours while they went out partying with the soon-to-be eighth dad.
Read about the Duggars. All those Duggar babies year after year. Just—too many Duggars. Fuckers.
Analyze your cervical fluid on a daily basis. Chart your temperature. Obsess over a .5 degree change. Start taking an EPT on Cycle Day 26. Get an app where you can chart your fluid and your temperature and your mood. Open the app 24 times a day and analyze your charts. Copy your charts and plug them into the Internet and see if anyone else has a chart that looks like yours who ended up pregnant. Escape to Target to treat yourself to a new nail polish because Kick Off Your Shoes is the ticket to better self-esteem and better self-esteem is the ticket to balancing your body’s chemicals and balancing your body’s chemicals is the ticket to getting pregnant. The woman next to you looks younger and she’s at least eight months along and she grabs the same nail color, and think, son of a bitch. She got the golden ticket.
Cry before and after your friend’s baby shower. Cry because you’re failing your partner, and you feel guilty for crying. Cry because you’re crying.
Laugh at something on TV and then feel like you don’t deserve to laugh.
1) you know you’re getting your period but think it might be implantation bleeding.
2) you’re symptom-spotting, and you promised yourself you would stop symptom-spotting.
3) it’s a week before you get your period and you get crampy because you know that means for sure you’re getting your period.
Stop crying a little bit when you actually get your period because your hormones even out and you feel dumb optimistic about a new cycle.
Fuck that last cycle. Fuck it to hell.
Buy an expensive purse.
Shame. Grief. Relief.
Wash. Rinse. Repeat.
Read anonymous IF blogs.
Start your own anonymous IF blog.
Chapter 6 – “12 Months and Counting became 24 Months and Counting became Infertile is the New Black.”
Yesterday afternoon, I bought salmon to make for dinner. The manager’s special at Fry’s gave me six dollars off a big slab of it. At my boyfriend’s place, I cut some potatoes into thin slices, oiled and salted them, and put them in the oven for thirty minutes. The smell of fish clung to the grocery bag I packed the salmon in and immediately stunk up the kitchen. The salmon might be bad. Meat specials at the grocery store mean they’re trying to get rid of it. I decided to cook it anyway.
When it was ready, we both took a bite and decided it didn’t taste right. The potatoes came out over-oiled. The cheesecake he bought for dessert became dinner. I failed dinner and by the way, I’ve also failed at having a baby, and so I cried for two hours. I left his house and he was like, what the fuck is happening, and I came back and I was like, I’m having this huge issue because I want to have a baby and can’t and he was like, you will be ok, and I was like, I don’t believe you, and he hugged me said we’d do it together.
I’ve spent my whole life being responsible. I went on birth control when I started college, and even then, I insisted on condoms. I did this even through my marriage. I dated my husband for a year. We lived together for a year. We were engaged for a year. I wanted everything to be right, to be perfect. I wanted to wake up and say, look what I did. I have a house and my husband has good insurance and we have a spare bedroom and he makes good money and I have a flexible job. We were falling apart before the nonbaby, but the nonbaby was like an intangible tangible thing we could blame. I don’t love you anymore isn’t enough.
I’ve met this amazing guy. This like instant connection thing. This like, oh that’s what it really feels like guy. We’re not married, but we’ve been not trying/not preventing for going on six months now.
This is hard. I’m isolating myself because I am embarrassed. I’m using this to hate myself. I should just start by saying hello, I don’t want to tell you my real name yet, and I am infertile.
Chapter 7 – “Sometimes they leave.”
My first RE sat behind a big desk. Her degrees framed her face. She had children. Boys. She asked me to call her by her first name, Margaret. We were going over the results of a second round of imaging I had done because the HSG lit up a uterine septum. I had a heart-shaped uterus. Oh my god, how adorable. Except a heart-shaped uterus, space wise, isn’t your ideal womb setting for a growing baby. The second round of imaging took place at an ultrasound center. I sat in a waiting room with pregnant women. That sure felt amazing.
I kept the appointment with Margaret because I wanted to hear results of exactly how much my precious heart-shaped uterus was impeding my pregnancy journey, but I had some news for her.
“My husband and I separating,” I told her. “We will not be pursuing treatment anymore.”
She said, “I still haven’t met him.”
“Now I guess you never will.”
“How are you doing?”
“Good,” I said. “Great, actually. It’s kind of a relief.”
She stared. I’m one of those anxious people who can’t deal with silence or with people staring. I have to fill all the space. Stuff it with unnecessary chatter. Over explain myself so I am not judged.
“I mean, we struggled, and I guess it’s sad. I should be more sad but I’m not sad. Well, I am because he’s a friend, but that’s the problem he’s just a friend, and you can’t really just be married to your friend. I mean, you can, you should be friends, but I guess I mean he’s a friend and that’s it, and I guess I was the one who made the call because someone had to. We were just not happy, and you have to be happy. Well, you don’t have to be but you should be.” I gestured with my hands. I fidgeted.
Finally, she spoke. “A few years ago, I worked with a couple who got all the way through to IVF. We were about to do a frozen embryo transfer. Their second attempt. They got up from the waiting room and left and said neither wanted to continue to pursue pregnancy. Sometimes they just leave,” she said. “I witness a lot of grief, and it can be overwhelming.”
Later, my ex-husband would offer to pay the co-payment on that appointment. That was nice of him, and I told him so.
Another year would go by before I went back to the doctor, this time with a new partner. My original RE left her practice. The alternate doctor they assigned me to also left the practice, so then I left the practice. We had to do all the tests over again with the new RE. A new semen analysis. A new ovarian reserve test, which showed significant hormonal and follicle decreases from the one I’d had two years prior. Take a step back to take a step forward, and so on, and so forth, and life is often a motherfucker for no reason. I had surgery to resect the uterine septum and remove a polyp; I changed meds and protocol. I called my credit card three times and asked for bumps in limits.
On top of the emotional shitshow you endure on the daily, infertility is a huge logistical ordeal focused on timing. Sex is timed. Hormones are timed. Follicle counts are timed. Ovulation is timed. Trigger shots are timed. Wake up in the middle of the nighttime to give myself shots. One of those times, I was so tired and out of it, I just sort of stabbed and injected and left myself with a brilliant purple bruise that didn’t go away for a month. That’s a long time. I spent chunks of my time waiting at specialty pharmacies for my hormones.
Oh, the fucking hormones. I swallowed them. Inserted them. Shot them into myself like a tragedy.
Chapter 8 – “The grass is always greener.”
A pregnant girl in my prenatal yoga class said she’d taken Plan B. She patted her belly and said, “I guess this is Plan C.” She took drugs to end her pregnancy. I took drugs to achieve pregnancy. We were both pregnant. The world is a funny fucked up place.