It was a very good year...

So...2012 wasn't the year that we welcomed our new baby into the world. Yes, it would have been cool for him or her to be born in 2012, as it was a Year of the Dragon, Leap year, Olympics year and presidential election, just like the year I was born, but thank you infertility for giving me some perspective on what is really important. (I'm even getting over the fact that 13 is recognised as being unlucky and is a prime number...) However the year still rocked for the following reasons:

• I am blessed with good health, and such blessings have been shared with my close friends and family
• I spent another year married to the love of my life. Infertility has only made our relationship stronger
• I am lucky to work in a job that I love with some amazing colleagues
• I have an awesome network of friends and family
• We attended the Olympic Games in Husband's home country
• I spent three days in Paris with my parents -memories I will always treasure!
• Ex-pats reunion at LA wedding  
• I completed 2 triathlons (sprint distance) 2 duathalons, (10) 10K runs, (1) 12K run over the Golden Gate Bridge and 3 Half-marathons (established new personal best!)
• Started competitive swimming; 2 short course meets, 2 open water events, One-hour postal swim and 400 KFT
• Another season with my field hockey team 
• Four close friends became mothers; I am proud to be an honourary 'auntie'
• Mummy to two sweet kitties. -you will always be my first baby! 
• My car's mileage hit 125K and is still running!
• With my dad's help, Husband and I renovated our kitchen
• Re-election of Barack Obama!
• While I am unfortunate to be infertile, I am fortunate to have the support of not only my Husband and close friends, but I am privileged to be a part of a larger online community. I continue to be amazed and inspired by you all!

Continuing with the words of Mr Sinatra... the best is yet to come!

Back in the game

Despite the advances of modern technology, it is still difficult to determine exactly when I going to ovulate. My clear blue monitor gives me a reading of low, medium and then high. The medium days are meant to warn of impending ovulation, but as I've ovulated anywhere from day 12 to 19, I've seen 1 to 8 medium days. As the monitor is somewhat less helpful in anticipating ovulation, I've learned to pay attention to other clues. I expected my cycle would be off more than usual following my miscarriage, and I almost didn't use the monitor, but I figured if I didn't used it, I would end up wishing that I had. One week after the miscarriage on day 8, it went to medium. As I had just stopped spotting a few days ago, I was still meticulously checking the toilet tissue. Mucus city. Maybe there was something accurate about the monitor. Day 9, still medium. I had to go to the hospital and I shared an elevator with a male nurse from the telemetry floor. Sadly, he was probably ten years younger than me, but he was rather cute and looks like he visits the gym semi-regularly. We began to engage is pleasant small talk, but my mind was thinking, hmmm...I could stop the elevator and we could... There was another sign of impending ovulation: wanting to bang anything that moves. Sure enough, the next day my monitor was indicating I was at my peak fertility. Later that afternoon I felt twinges of pain on my left side right where my ovary is. I had ovulated on the right side for the cycle that resulted in my miscarriage, so I knew it was the left one's turn. Co-worker was having her scan that day. I felt confident things would go well for her. As long as the odds were for us both to become pregnant, I felt they were longer for us both to miscarry. As she lost her father earlier this year, I felt she needed this more than I did. My phone indicated I missed a call from her and she didn't leave a voice mail message. Fuck. If everything went well, she would have texted. I called her back straight away. She had a slight laughter in her voice when she answered and I knew what she was about to tell me. She was pregnant with twins. I was thrilled for her. She wanted to have three kids, so this brings her closer to that goal. As I fear twins, I can honestly say that I'm not jealous, although I know it's going to be hard to endure all the attention she will receive when she makes her announcement. She was very open about telling everyone we work with that they were doing infertility treatments. Selfishly, I acknowledge that I will have more added to my workload as she will most likely be taking an earlier and longer maternity leave, which will suck if I am pregnant, and suck more if I am not. It makes my findings seem less significant, she's just learned she's having twins, and I'm getting excited over mucus, lustful thoughts, twinges and a fertility monitor reading, but at least it means I'm back in the game.

Destroying the Evidence

After taking the steps we did to move on after a miscarriage at six weeks, I can't even begin to imagine how much harder it is for anyone who was further along. The first step was divulging the bad news. Fortunately, we had only revealed to a handful of close friends. Is a text message an appropriate way to disclose a miscarriage? Well, I hope so, as that is what I did. I had brought home some pregnancy guidebooks that we give to our patients and Husband was diligently reading a chapter or two each night like a good student doing his homework. He tossed the books in my home office, letting them blend in with my other Ob/Gyn related text books. I had purchased some reading essentials too, Exercising Through Your Pregnancy, Runner's World Guide to Running and Pregnancy and Lose Your Mummy Tummy. I hid these books under my mattress like an adolescent boy would hide a dirty magazine. Although, I don't know if that reference is even relevant in this day and age of easy access to internet porn. Sigh, I'm dating myself. I received a Christmas card from Myrtle, which naturally featured a picture of little Myrtle. I vow that if I ever have a baby, I will not display him or her on our cards. She wrote in her message "who knew so much would happen in 2012, and now we are ringing in 2013, which I know will be your year. Good changes are coming for you as well!" I looked at the date of the postmark and tried to figure out if she sent it before or after she learned of my miscarriage. I sent her a text acknowledging that I received the card to see if she would offer any explanation; she didn't. I wanted to ask outright if she sent it after learning of my miscarriage. I couldn't endure any more of her blind faith and empty promises. Later that night I had a dream that we engaged in a bitter fight, and I decided it wasn't worth pursuing. I simply tore up the card and felt much better afterwards. There was something else I had to hide. I had pictures of my positive pregnancy tests on my iPhone. I couldn't delete them as it was the only evidence I had that I was ever pregnant. I emailed them to myself and filed it in my fertility related folder, which I named 'Garden'. I thought this was not only discrete, as I have files for other house related projects, but represents how I hope to implant something that will grow in my uterus. Finally, my home pregnancy test was negative, so I went in for my last HCG blood draw. The phlebotomist, who recognises me as a provider, smiled at me when I walked in. Her smile faded when she saw the numbers 634.92 as the diagnosis on my lab slip. As an experienced health care professional, she knew those numbers represented 'complete spontaneous abortion'. I walked out of the lab and pulled the tape off my arm. The HCG level would come back at zero, obliterating any evidence of the pregnancy. It would be as if it never happened.

Still Kicking (literally)

Swimming and I bonded later in my adult life after a few missed attempts in my youth. When I was 5 or 6, my mother enrolled me in swim lessons at the local community pool. After completing the first six week session, I was devastated when the instructor didn't promote me from the beginner "minnow" to the intermediate "guppy" group and I would have to repeat the "minnow" session. "But, you'll be a high minnow," My mother tried to coax me, but I was having none of it. Fuck that. Even at that young age, I still had too much pride and I refused to be humiliated by being the oldest one in the minnow group. Instead, I threw a screaming tantrum declaring that I would not be going back to swimming lessons, and my mother obliged.

Many years later, when I was in my second year at University, I developed a crush on a guy who was on the swim team. After hearing that I failed swim lessons, he offered to teach me with some hands on instructions. I would later discover that being in the pool together merely provided an opportunity to feel each other up in the water, but I did manage to learn the basics of each stroke and got to the point where I could swim laps. The swimmer and I went on a few dates and engaged in intimacy after the third or forth. The next morning he informed me, "I can't continue to see you anymore. You're interfering in my relationship with God." Thus, I stopped swimming to avoid potentially running into him at the pool.

Fast forward another 15 years. A friend asked me if I wanted to sign up to do a triathlon together. I've always been intrigued by triathletes, and had it listed on my life goals, but there was only one small issue. I couldn't swim. "No problem" she told me. She knew of a swim instructor who taught swimming classes for adults. I went to my first class thinking it would be like my sessions with the devoutly religious swimmer ex-boyfriend, only without the groping. Wrong. It was a masters swim class with mostly former high school and college swimmers. There were drills and training techniques. I went through 45 minutes of agony only to learn we hadn't started the main set, which is the bulk of the work-out! That would be (6) 1-2-3-4 IM's (25-Fly, 50-Back, 75-Breast, 100-Free) followed by (4) 4-3-2-1 IM's (100-Fly, 75-Back, 50-Breast, 25-Free). I plunged through it and did my best just not to drown. The humiliation I avoided by not repeating the "minnow" session was coming back to me nearly 30 years later. I was prepared to get dismissed from a swimming class for the second time in my life. "Well..." the instructor prepared her honest assessment, "Everything else is a disaster, but you have an awesome kick! I can work with that!" I had no idea that holding on to a kickboard and kicking in the water was something that one could be good at, but apparently one can and for some reason, I am.

So when it was announced that we would be doing kicking time trials in December, I knew it was my time to shine. After my miscarriage, I felt I needed to set a personal best and the experience would give me extra motivation. The whistle sounded, steady at first, you can't break any records on your first lap. Infertility sucks. kick, kick Having a miscarriage sucks. kick, kick, kick Having a miscarriage after infertility really sucks. kick, kick, kick, kick . It's not fair, it's just not fair. kick harder Damn you Universe, why did you get my hopes up only to crush them? kick harder, kick harder Michelle Druggar has 20 kids and counting, I only want to have one! more kicking Fuck you Universe, why do you make it so easy for women like Myrtle, and so difficult for others? Keep kicking Are we not deserving? What lessons are you trying to teach? C'mon KICK! Why? Why? Why? I am searching for answers that do not exist. Final 50 yards. K-iiii-ck My ovaries may be crap and my uterus may be weak, but my legs are strong. This is something I can do. I touched the wall and heard my time. 7:34 -a full 8 second faster than my previous best. It's not the same as dancing around my house after my BFP, but it's the happiest I've been since the miscarriage. I placed 5th out of 50 swimmers, and for the third time, beat Phelps -one of our fastest swimmers. "Wow" said a fellow swimmer. "The only time I beat Phelps was when she was pregnant!" I smiled to myself. Technically, I was pregnant during the two previous trials when we went head to head and I prevailed. I looked at my flat stomach, I won't have anything to show for this accomplishment in nine months, but I'll know. If I ever have a baby growing in there, her or she better be a good kicker... just like their mother.

A man, a plan, a canal, Panama!

I always ask my newly pregnant patients if they were planning a pregnancy at the time of conception, which is quite funny for infertile women, as all we are ever doing is planning. It's ultimately the process of planning a pregnancy, but it's about scheduling your next appointment, the next diagnostic test, the next treatment intervention, thinking about what the next step will be if that doesn't work out... Planning makes you feel proactive. Planning is hopefully bringing you one step closer. To some extent, planning allows you to feel that you have some control. We had a follow up visit with my RE to review where we were and to discuss our next steps. He admitted that he wasn't surprised we conceived spontaneously (although six weeks earlier he thought we would most likely need IVF/ICSI to conceive) but he also admitted that it may have been a fluke and wouldn't recommend trying on our own much longer. We would need to have at least one normal menstrual cycle before starting IUI, although it has a low success rate and he mentioned that some studies don't consider IUI to be an appropriate treatment for male factor infertility. He advised only doing 2-3 IUI cycles, but I think I would prefer at least 4. While he could appreciate our desire to avoid IVF if possible, he suggested that we shouldn't put it off beyond 2014, as success rates start to decline with each year. Husband also noted that the price increases once the woman reaches the age of 38, which will happen in 2014. The clinic offers the option of doing a split ICSI cycle, where some eggs undergo conventional fertilization, and others undergo ICSI. He brought up the issue of having frozen embryos available to have a second baby in the future, but we countered that as we are both only children, our plan is to only have one. To my delight, he informed us that "at your age, a single embryo transfer would be reasonable". I don't think I had yet heard any advantage associated with my age! He also agreed with my suggestion to do a sonohystogram to evaluate my uterine cavity prior to starting treatment. Meanwhile, Husband's mind went to work on a whole other aspect of these plans -the financing. There was one more obstacle in our planning. The Hawaii trip with my parents and in-laws. When my parents started discussing the trip with us, Husband and I vowed that we would not defer our conception attempts to work around the holiday. I thought of something clever, my mother's sister also has a time share that she can use in Hawaii, and I suggested that they use it at the same time. That way if we have a newborn or if I'm heavily pregnant, my parents can still have a holiday with my aunt and uncle. (Honestly, I don't think my in-laws are that keen to schlep to Hawaii after the long haul from England to California). I don't want to do IVF before we go, as I'll be so depressed if it fails, but if it works, I would still be really early and I wouldn't want to be away from my doctors, in the event that I miscarry again. I'd rather have something to look forward to for when we get back. It also allows us more time to save, there will be a lot less dining out and a lot more meals with beans and rice this year. Who knows? Maybe it will happen in Hawaii -at least that's what everyone seems to be telling me. No one is infertile in Hawaii -right?

And this Award Goes to ...

Is it just me, or is this holiday season the worst for infertile couples? Firstly, all you hear is that Christmas is really for children, making you wonder why you should even bother. A trip to the mall haunts you with the sounds of angelic voices singing carols as you pass the queue of children patiently waiting for their nostalgic photo with Santa. Sorry, I'd love to help the local economy, but there's another advantage to online shopping. Each day the post brings more cards with baby pictures. Okay, we get it, you had a baby this year. I saw your facebook post of the cord being cut and I got your birth announcement. Thanks for the reminder.

If these private moments of torture weren't enough, there's a public battle with your relatives waiting for you to answer the question, "So, when are you going to have a bay-bee?" If I had the resources, I would give some type of Golden Globe or BAFTA award to every couple who is able to hold it together and not breakdown in this siutation. I'm facing my challenge with my aunt and two grown cousins. The older cousin, who is a mother to two pre-teen boys started pestering me about having kids a few years ago by posting "When is the baby due" on my facebook page (that started fun rumours). The younger one experienced infertility and conceived her first with IVF and then conceived spontaneously at the age of 41. After conquering infertility her husband didn't think there was any reason to be sensitive and asked me about having children right in the middle of Thanksgiving dinner earlier this year. At one point, when we were thinking we would be pregnant but not disclosing at this time, Husband and I were looking forward to brushing off these questions while exchanging knowing glances. I was thinking I could drink out of the blue wine glass.

My aunt, who is completely disorganised, doesn't own a proper set of wine glasses. It's a hodge podge of glasses from various vineyards and other collections. So three years ago, it wasn't unusual to see my younger cousin drinking from a blue wine glass. It wasn't until I was helping with the dishes that I discovered she was actually drinking apple juice. Sure enough, she announced her pregnancy at Easter. It could have been my turn for the blue glass, leaving my aunt and cousin to wonder. I may still use the blue glass, just to fuck with everyone. Infertility brings such misery, I'll take any fun any way I can. My plan is to bring along my friends wine and sarcasm. I would love to tell eveyone to mind their own fucking business, but that would just announce that we are experiencing fertility problems. If the question comes up, I'll laugh it off, "Are we going to have a baby? Why, do we need one?"

I need to have this strategy as it's not always been easy to keep my cool. When my dad came to visit a few months ago, he asked my uncle about spending his summer vacation week with his grandchildren fishing with him. I looked at the steak knife on the table, wishing I could just stab myself in the heart rather than listen to my father solicit surrogate grandchildren as his barren daughter can't give him any. Even more painful, my uncle was oblivous to my dad's needs and just bitched about the difficulty travelling with pre-teens. I started to clear the table just to get out of the room, but I was soon joined by my father and his sister, who was discussing her shocked response to my cousin's pregnancy. My dad asked "How does a pregnancy happen after infertility? Is it because you're relaxed?" "NO!" I exploded, and then launched into a lecture about subfertility, timing and gamete quality. I dismissed myself to the bathroom to escape for the second time that evening. I wondered how much I just revealed with my outburst, my aunt is pretty astute, but fortunately I have a reputation for being a know-it-all, especially when it comes to my profession. I just discovered I had more reason to be testy as AF showed up. Could this night get any worse? Maybe, but at least I could face it with a glass of wine...

I'll See You in my Dreams

Myrtle sent me flowers, because it was something that Myrtle would do and it is why I will always love her. I burried the products of my pregnancy. I felt silly doing so for a few reasons. Firstly, I'm not religious and I wasn't that far along. I salvaged it for the long shot of being able to send it to pathology for chromosomal analysis, but my RE confirmed my suspicion that it would most likely be insufficient. I didn't want to throw it in the regular rubbish bin, as it was biohazzard material, and I didn't want to bring it into work, just to place it in the correct recepticle. I couldn't bring myself to flush it down the toilet as if it were a goldfish, although a goldfish is something that was actually alive. I know there was no life within that tissue, but it represented something that could have produced a life. I held no love for it, but I knew how capable I would have been to love our baby. The anticipation of the experience, feeling the baby move, hearing the first cry, watching him or her grow, was all very real. There is a spot on the very upper edge of our back garden that overlooks the San Francisco Bay and enjoys a beautiful sunset each night. Now all of our memories and associated hopes and dreams remain in that place. I laid Myrtle's flowers on the replaced dirt. As touched as I was by her gesture, looking at the bouquet only served to remind me that I had reason to feel sad. Additionally, I didn't want to see them wilt and die and need to be discarded. I didn't cry and I didn't leave any words, but I'll close this post with some lyrics from a song written by Isham Jones in 1924, which was featured in a recent episode of Boardwalk Empire:

Lonely days are long,
Twlight sings a song,
Of the happiness that used to be,
Soon my eyes will close,
Soon I'll find repose,
And in my dreams, you're always near to me,
I'll see you in my dreams,
Hold you in my dreams...

At least you can get pregnant...

I heard those words from Husband, Myrtle, my RE, Co-worker and three other Ob/Gyn colleagues. It feels like the worst consolation prize ever, although it does carry some merit. In obstetrical nomenclature, I'm now a G1 P0 (Gravida-1, Para-0). I thought that I would never be able to be pregnant. Now, if nothing else happens, I can say that I was. I know some infertile women who were not able to conceive express an unusual wish to experience a miscarriage just to give a tangible event to their sense of loss. I remind myself that when I first discovered I was pregnant but knew the outcome was uncertain, I told myself to be happy just to have had the experience of a positive pregnancy test. But now I want more. I've been given a taste of the joy a pregnancy can bring and I want the end result.

However, knowing "at least you can get pregnant" seems to open more questions than provide any answers. Will I be able to get pregnant again? If so, how? We conceived spontaneously, despite Husband's low count and my unpredictable cycles. A look at the calendar notes that we conceived on our 7th attempt, which isn't too bad considering our diagnosis. Should we try to continue on our own for a little while longer, or was this our once in a life time opportunity to conceive spontaneously -if at all? What does this mean for our odds of conceiving with IUI or IVF? Furthermore, if I am able to get pregnant again, will I miscarry again? The clinician in me knows that the miscarriage was most likely due to chromosomal factors mitigated by the poor quality of our gametes and doesn't cast a poor prognosis for a future pregnancy. Yet the clinician who is also a vulnerable patient can't stop wondering if there were other contributing factors. The pregnancy seemed to stop developing at 5 weeks and I started to pass it a week later. Maybe my uterus just won't support a pregnancy. I know it's irrational to think this way after only one miscarriage, but every woman who experiences recurrent pregnancy loss starts with her first miscarriage. Another weird aspect is that I actually feel more pressure on myself from those in the small circle who know we are trying to conceive. Now that I've proven that I can get pregnant, they will expect that it will happen again. My astrology minded friend texted me, "Are you sure you're ready to try again so soon? You're looking at Virgo or Libra territory. Maybe hold out for a Scorpio or Sagittarius." Oh, if only it were mine to command...

Hitting the Reset Button

Back when Husband and I first started TTC we would discretely refer to AF's arrival as "resetting". The day after my miscarriage, I hit the reset button literally on my fertility monitor. I opened the period log app on my iPhone and took one final look at the message "Your period day is due by 16 days". I figured the only time I would ever see this reminder again was if I became pregnant, or if we stop trying and I no longer give a shit about my cycle. Although I rarely drink coffee, I stopped at Starbucks on my way to work for a grande sized latte... just because I could.

I called my RE to give him the update. I stared out the window and let my mind drift as he started the spiel. I've given the news of a non-viable pregnancy and impending miscarriage to hundreds of patients, and as experienced as I am in breaking the news, it has never gotten any easier since the first time I stumbled my way thought it. Even though I knew exactly what he was going to say, it wasn't any easier to hear. That this was likely due to an underlying chromosomal or developmental abnormality. Nothing I did or didn't do caused the miscarriage to happen. He added, "I know there is nothing I can say that will make you feel any better", which I thought was a pretty good line to use and I may adopt it. He continued, "Someday when you're thirty weeks pregnant, this will seem like a distant memory". Dude, slow down! Thirty weeks? I just want to get another BFP.

Unfortunately, I didn't have to look too far to find one. My RE wanted to see my HCG level reach zero, and I didn't want to bruise my arm with multiple draws, so I decided I would go to the lab once my home pregnancy test was negative. The persistent blue line on the stick that once caused such elation is now pissing me off. Go the fuck away. It is so agonising to have a positive test, when you know you're not really pregnant. Once it becomes negative, I'll know the reset process is complete. I had one more thing to do to get ready to move forward. I finally went to the Pharmacy to pick up my prescription for Femara. It was dropped off in anticipation of my IUI cycle the day before the initial BFP. I also added one more song to my 80's playlist. Another English band (the Brits so rocked the 80's) with a song that represents our situation:

No, I don't know where I'm going,
But I sure know where I've been,
Hanging on the promises,
In the songs of yesterday,
An' I've made up my mind,
I ain't wasting no more time,
Here I go again, here I go again

Fail Fast, Fail Cheap

Once I arrived home, I had to break it to Husband that this pregnancy wasn't viable and there wouldn't be any good news awaiting us in a week's time. My main concern at that time was excluding a possible tubal pregnancy, which could impair our fragile fertility even further by damaging a tube. I just wanted this pregnancy to be resolved as soon as possible so we could move on as quickly as we could.

"Fail fast, fail cheap" Husband commented, describing how pharmaceutical companies acknowledge that if a test drug is bound to fail, they want it to occur early without a major investment of time and money. "Firstly," I told husband " I want to be resolved by next week, so I can set a personal best during kicking time trials at the pool next week. I have 400 yards to release all our frustrations related to infertility and the miscarriage." He just looked at me and said "I love you." Above all else, I would always know how blessed I was to have such a loving and supportive husband.

I woke up the next morning and discovered that the bleeding had become heavier. What a difference a day can make. The pink spots that brought terror and panic have been replaced with bright red streaks that are welcomed and encouraged. Despite the immense disappointment and sadness, I feel that I am fortunate is some ways. I'm relieved that we learned the pregnancy was not viable sooner rather than later. It could have been so much worse if we had seen a heartbeat on the initial ultrasound, only to have the pregnancy go on to fail. I'm happy that nature seems to be taking it's course and I won't need a D+C. We will be able to try again soon, and won't be loosing much time.

As frustrating as it is to miscarry after finally having a spontaneous conception, and thinking we could have avoided the costs of infertility treatments, I can't help to think it would be harder to process if we had paid for an intervention. I'm glad that the bleeding started before my scheduled appointment. It was much easier to face the ultrasound anticipating bad news, rather than believing that everything could be well and being disappointed before my eyes. I also learned for possible future reference that it is best to schedule any ultrasound appointments at the end of the day, when I don't have to go back to work. I'm happy that at this point in the process, I can ease my sorrows with a glass of wine. At quarter past eight on Tuesday evening, I miscarried my pregnancy.

Outlook Not So Good

A few hours later, it was my turn to be a patient. I reviewed the dates with my RE. I was 6 weeks by my last menstrual period, but by date of conception, I was actually 6 weeks and 2 days. I knew exactly what I should see on the ultrasound monitor. I had an initial sigh of relief when I saw a single sac inside the uterus, but then a larger concern set in. The sac was too small. It looked more consistent with five weeks. There was no yolk sac nor fetal pole to be identified. There was little decidual reaction and the sac appeared closer to the lower segment of the uterus. Everything about the image looked wrong and I knew it. I might as well have been looking at a Magic 8 ball to return a verdict of "Outlook not so good".

The RE reviewed the findings with me. He couldn't exclude the possibility that ovulation or implantation could have been delayed and this may be an early pregnancy, but he also couldn't rule out an ectopic pregnancy. We would have to come back in a week to see if there is any progression. It's the dance of due diligence. The pregnancy is most likely non-viable, but more time is required to make that determination. I've been in the same situation with some of my patients and it is the shittiest thing to do to a couple. It is the worst wait of all. I would almost rather be able to give the bad news at that moment, than make them go through a week of agony before the eventual disappointment. I've seen things work out well if the woman truly has irregular cycles and often the couple wasn't trying to conceive at that time, so they don't have a refernece for conception dates. I knew there was no possible error in my dates. The following week, Husband was away in Seattle for a night and then to Santa Barbara for the weekend. I don't think we had sex until after I learned I was pregnant, but I was too embarrassed to disclose that to my RE. I nodded and smiled in front of him and at least for that moment, I believed that maybe this could be an early pregnancy and we weren't doomed yet.

As soon as I got in my car to drive home, the realisation set in. This pregnancy wasn't viable. I was going to miscarry. I went to the coping method I often use after a bad day at work; listen to some good music loud and sing at the top of my lungs. I recently participated in an 80s themed run and made a playlist for the occasion. I figured any song that came up on the random selection would be sufficient, but the one that came up was especially fitting:

Ain't nothin' gonna break my stride
Nobody gonna slow me down, 
oh no I got to keep on movin'

Spots of Terror

It was Monday morning and I still had the energy to get up at 0525 to go swimming even though I was six weeks pregnant. Six weeks pregnant. It seemed so hard to believe I could actually say that. Just for fun, I flipped on my fertility monitor to see that I was on day 43 of my cycle and the display was flashing that it needed to be reset.

I arrived at the pool and our instructor announced we would be doing sprints. I'm the best sprinter in my lane, but I knew I was supposed to be taking it easy, so I told my lane mates "these are going to be some pretty weak sprints." However the coach whistled and I got a good start off the block, after the first 50 yards I looked over and saw I was matching strokes with a male swimmer in the next lane. It just feels so good to beat a guy and I felt I had it in me to do so. I pushed the tempo and touched the wall ahead of him. "1:18!" exclaimed my lane mate "Weak sprints, my ass!"

At the end of practice, I went off to the showers to get ready to go to work, and I noticed there was a drop of water in a perfect circle on my bag. I'm not sure why, but this drop make me think I needed to check for spotting. My instinct was correct, there was a slight pink tint to the toilet tissue when I wiped. I nearly burst into tears at that moment, but quickly calmed myself down as I went to the shower. Think about what you would advise your patients, spotting is quite common at this time. I felt a slight stinging sensation when I started to wash my hair and I looked at my thumb. There was a small scratch. I must have grazed it when I was on the diving block, and that probably explained the pink tinge on the toilet tissue. I let out a deep sigh of relief -what a funny story to tell!

However, I kept pressing on my thumb and there was no blood expressed. I got out of the shower and went back to the stall -this time I wiped with my left hand. The pink streaks were still present. I told Co-worker (who is our advice nurse) as soon as I got in. "How many times to do see this and it's nothing?" she reassured me. I agreed. The light pink stuff wasn't concerning, but it worried me as this is exactly how AF presents herself. I feared this was merely heralding heavier bleeding. I sent a message to my RE, admitting that I probably pushed my heart rate more than I should have during my sprints, which may explain the spotting, but I wanted his thoughts. I received a prompt call back from the receptionist who offered me an appointment for an ultrasound. "We always hold slots for situations like this so we can relieve anxiety" she explained.

Anxiety. That's really all it was. I knew at this point the pregnancy was either viable or it wasn't. There wasn't anything that could be done at this time. I asked her to hold the latest appointment for me. I would have to shift around my own patients, but maybe the spotting would stop and I wouldn't need to come in. I looked at my schedule, I would need to reschedule the last two patients. One was a brand new patient; never a good impression to cancel at the last minute. The other was a new OB. She had a prior miscarriage and just had a baby seven months ago. Still breastfeeding, she had no idea how far along she was. Here was another woman just as anxious as I was, and I was about to cancel on her. The guilt was overwhelming. Husband and Co-worker tried to reassure me that I needed to take care of myself. I couldn't bear to hear my medical assistant call to reschedule my patients, so I went off to the bathroom. The light pink streaks had now turned to bright red spots.

Ignorance is Bliss

It's the two week wait revisited. After surviving the first 2ww to get to the BFP, there is another waiting period to determine if the pregnancy is viable. This wait is a little different as each day could bring you closer to good news, or bad news. I wasn't experiencing any symptoms, no nausea, no fatigue, although I knew it was still rather early. I was still meticulously inspecting toilet tissue every time and so far all was clear. I thought back to last New Year's Eve. After kissing at midnight, Husband whispered to me 'this time next year, we'll be a family of three'. We were closer to fulfilling that promise. I had a dream about my scan. It was quite weird; it was the day I was meant to go in to start my IUI cycle, but the Nurse was the one who was scanning me. She commented "um, you're already pregnant" but couldn't tell me anything else. However, I could see the image and there was a viable 9-10 week fetus. The timeframe didn't fit my situation, but I would take the dream as a good omen. When the pregnancy of Catherine, Duchess of Cambridge was announced, Myrtle texted me "You'll be pregnant at the same time!" At last I could feel validated taking my prenatal vitamins. The cartoon drawing of a heavily pregnant woman was no longer mocking me. I received an invite to a baby shower, but didn't have the familiar feelings of dread and distain. I was able to shop for Christmas gifts for my nephews and little Myrtle without the overwhelming feeling of sadness. I was so tempted to start purchasing a few things for my little one, but I know better than to tempt fate. Last year, just before we started TTC, I saw some onesies and a few stuffed toys that I couldn't resist and I started a little hope chest for our baby. I hid it deep in my closet when my parents came to visit, which is also when we started to realise we had fertility issues and I haven't touched it since. The one purchase I did have to make was getting a new bra. I've always been a borderline A/B size and I've been noticing marks on my skin at the end of the day. Finally time to upgrade to a B. I passed a baby store that was going out of business and all items were 40% off including prams. This seemed to good to pass up! But how would I know which was to get? How was I going to know about anything I would need for a baby, much less how to care for one? I slapped myself on the wrist to bring me back to reality. After all, my scan was still three days away.

Shut the front door!

It always seemed that whenever I received some disappointing news about my prospects for pregnancy, Myrtle would unknowingly give me an update with her good news. The day I received the call from my RE indicating that we would likely need to do IVF with ICSI, little Myrtle's birth announcement arrived in the post. Now I was causing that situation for Co-worker. She was in her two week wait after her third IUI attempt and had a BFN on the morning I announced my news. A few days later, things got worse for her as she started experiencing pains and an ultrasound confirmed that her ovaries were hyper stimulated with 6 cm cysts on each side. Her RE's plan was to start her on birth control pills for three months and to continue her evaluation with a laparoscopy and hysteroscopy prior to starting IVF. Is there anything more depressing than taking birth control pills when you want to be pregnant? The only words I have for her is to remind her that sometimes you need to take a step backward in order to move forward.

As the work week drew closer to Friday, I thought of something else: I reminded her that she could still drink. She looked at me sheepishly and then indicated that we needed to go somewhere private to talk. It was the end of her 2ww after her IUI and her RE asked her to do one more pregnancy test. It was faintly positive and her first beta was 151. "Shut the front door!" I exclaimed, adopting one of her favourite expressions. If my pregnancy was seeming to be too good to be true, this now felt like a dream. We were both pregnant! How would the office manager react when we informed her? What would be the impact on the office with us both out on maternity leave? None of that really mattered at that moment. I couldn't have been any happier. Myrtle would always be my best friend, and while it would have been fun to be pregnant at the same time as her, I treasure my friendship with Co-worker and am so excited that would be experiencing our pregnancies together.

Too good to be true

171. The result of my first beta HCG level validated all five regular and two digital home pregnancy tests. I was officially five minutes pregnant! For any woman who has struggled to get to this point, it is the most surreal feeling and carries mixed emotions. Infertility has become part of your identity. You have become accustom to disappointment and it is almost more comforting to believe that you won't even be pregnant. Infertility has an amazing way of bonding couples who are experiencing similar struggles. My co-worker and I became close friends as soon as started working together, but when we started encountering infertility at the same time, it brought each even closer. We both believe, that while unlucky to have fertility issues, we are fortunate to have each other during this time. Additionally, I re-connected with two old friends who had hinted at their fertility struggles via Facebook posts and I joined an online infertility forum and have forged friendships with women I wouldn't recognise in person.

My pregnancy brings relief, but it also carries a form of survivor's guilt. Informing Co-worker would be hard. I know she will be genuinely happy for me and be supportive, but I also know there will be some jealousy and difficult moments for her if my pregnancy progresses. Husband describes that it feels like we won the lottery, as not only will be be having a baby, but he mentions multiple times that we've just saved 20 grand by not needing IVF. As I nervously await my second beta results, I keep reminding him that we're not out of the woods and we haven't gained or saved anything yet. This can all be taken away from us at a moment's notice. However, my HCG is 344. Near perfect doubling in 48 hours. It feels too good to be true.

No. way.

It was Sunday morning and there was still no sign of AF. I was annoyed with myself for using the progesterone supplements to manipulate my period. I needed my period to start yesterday or today as I had an appointment with my RE on Monday to scan my uterus and ovaries in preparation for my first IUI cycle. Despite the previous challenges with the holiday weekend, some logistics were working in my favour. Just before the appointment, I had a department meeting right next to my RE's office and I was already scheduled to be out of my office. There was no need to lie about a "dentist" or "eye doctor" appointment.

Just as I did every morning of AF's expected arrival, I started the day by peeing on a stick. I set the test on the counter and sat on the closed lid of the toilet to read my email. I glanced over at this stick and saw the single pink line. I replied to a few messages and then got ready to throw the stick away. I took a closer look at it, there appeared to be a faint blue line! I immediately started running another test, and then a third, and forth and fifth. The blue line appeared on all of them! I thought the only way I would ever see a blue line on a pregnancy test would be to draw one on! I looked at myself in the mirror and began to laugh "HOLY SHIT!" I exclaimed! I knew who I needed to call first. I called Myrtle, who was immediately excited for us, and resisted any 'I told you so' comments about conceiving on our own.

I knew husband was busy with his hockey games so I emailed him a picture of my positive test. I had an appointment for a bikini wax (in anticipation of my appointment) which I decided to keep. My phone rang four times while I was getting waxed. I figured he had seen the email. I called him as soon as she was done. "Is that what I think it is?" he asked. When I confirmed it was, he admitted he had a few tears in his eyes. I quickly reminded him that it was too early to get excited. This could be a chemical pregnancy, it could be ectopic and given my age, the possibility of a miscarriage is very real. I knew I would discover what the outcome would be in the next few days or weeks, but for at least that night, I could feel happy. I was pregnant -it said so on the digital test. At least I had this moment. I had the knowledge that I can get pregnant -on our own too! We were now one of those stories friends could tell about someone who conceived right when they were due to start treatment. No matter what lies ahead, I knew that nothing could take away the joy I felt at that moment.

Thanksgiving weekend

I was so looking forward to having four days off from work. Husband was going to be away at a field hockey tournament, and as much as I love him and knew how much I would miss him, I was happy to have some time to myself. On Thanksgiving morning, I ran a 10K "Turkey Trot". Prior to the race, the organisers held a "Little Turkey's 100 year dash". I watched as parents lined the course to cheer their kids and a lone tear ran down my cheek as I wondered if I would ever be cheering for my own 'little turkey'. I finished the race and was looking for my official time, when I heard the announcer at the finish line congratulate an 8 year old girl who had just finished her first 10K. I looked toward the finish line. Her father ran over to her and scooped her up in his arms and starting twirling in circles. I thought he might explode with pride. They were joined by her mom, who was probably 7 or 8 months pregnant, and her little brother. It was a touching family scene that completely overwhelmed me. The tears were swelling in my eyes. I ran to my car without checking my own time and broke down crying as I drove away.

I pulled myself together and got cleaned up to go to my aunt's house. I was spending Thanksgiving dinner with my cousin and her new baby from her spontaneous pregnancy at age 41. As we were finishing dinner, her husband started discussing how their new arrival was such a good baby. I could see where he was going with this from a mile away, so I decided to bait him by countering that maybe it only seemed easier as they were more experienced than when they brought home their first son. He decided to stop being subtle. "So are you two thinking about having kids?" I was so tempted to reply "Actually, we're infertile, and so were you at one point, so why don't you shut the fuck up." However, I managed to keep my composure. "We have two cats". He didn't get the hint "Cats aren't kids!" he followed. My cousin came to my rescue. "They have two cats" she told her husband while flashing him a STFU look. I mentally high fived her for that.

I develop agoraphobia on Black Friday. I have no desire to face traffic or crowds of people and so I spend the entire day at home doing cleaning and yard work. However my main mission was to avoid getting my period. I kept examining the toilet tissue looking for any evidence of AF's warning spots. I was counting every AF free hour that passed. Finally made it to midnight! I was sure she would arrive the next day, as I was running a half marathon and AF has a knack for my race days. I felt really good during the run, my legs were a little stiff from running two days ago, but my stamina was high for all thirteen miles. A month earlier I ran a half the day before AF's arrival and felt tired and sluggish and had a horrible time. I had started to wonder if it was a sign of a possible pregnancy. Nope. AF showed up on time just to rub salt in the wounds of my disappointing race. I wasn't pregnant, I just sucked. Still no sign of her. I'm beginning to think that I may have over cooked myself with the supplemental progesterone. Maybe it wasn't such a smart idea.

Scheduling Conflicts

Initially, Husband and I decided to wait until the new year to start IUI. Not only would it avoid a potential due date close to the Hawaii holiday and a potenital visit with my in-laws, but we were still paying bills from our kitchen renovation and our flexible spending accounts would be available in 2013. However, after the failure to launch episode and not wanting to endure another month of baby dance stress, we were keen to move forward with IUI.

I looked at the calander to see when AF would start. One great advantage of TTC and using a Clearblue fertility monitor is that I've been able to predict when my period will start almost to the hour. Her arrival was expected on November 23 or 24th, which was the Friday and Saturday after Thanksgiving. I sent a message to the office, explaining the situation that we would like to start IUI if the office is open that weekend. The front desk receptionist responded that she would send my chart to the Nurse and to the woman who does insurance authorisations. Well, she didn't answer my question about if they were open of the weekend, but I thought they must be if she was sending work to her colleagues. I received a call from the authorisation representative, and I asked about the office's hours over the holiday weekend, explaining that I wanted to save her time and trouble if the office were closed. "Oh, I don't know if the office is open over the holiday weekend" she replied. Seriously, you work in this office and don't know if you have a long holiday weekend coming up? I can't believe no one in this office seems to be able to read and comprehend a message. It's starting to make me worry if they'll manage to get the right stuff in my hoo-ha.

I later spoke with the Nurse, who seems to be the most competent one. She informs me that yes, the office is closed over the long holiday weekend, and the RE likes to scan on day 2, but could do day 3. So if AF starts on Friday, this cycle is out, but if she arrives on Saturday, we may have a chance. As if we don't have enough challenges from our flawed gametes, logistics aren't working in our favour either. Then I got an idea. During my first clomid cycle, I started supplemental progesterone after my LH surge and it delayed AF by one day. I'm starting to feel satisfied that maybe I can outsmart Mother Nature.

Bonds of Disappointment

From the first time I heard Adele’s song for ‘Skyfall’, I couldn’t wait for the premier of the latest Bond movie. Husband ordered our tickets days in advance. I looked at the calendar and noted that I could be ovulating that weekend. I thought back to where we were a year ago, needing to use Plan B after a Bond film got us into trouble. Maybe Daniel Craig could get redemption! My monitor went from low to medium on day 11, and then on day 12 (the night of the film’s premiere in the states) I got my peak fertility reading. My ovaries were actually cooperating with the plan to conceive on the night of Bond!

However, it was a typical Friday. Busy day at work, I left the office late and didn’t have a chance to grab anything to eat before the movie. Husband and I found the movie to be disappointing. Of course it’s hard to top Casino Royale, but it was such a weak story and I thought they were trying to re-create the too much of the 'old Bond’ which doesn’t fit with Daniel Craig. We ended up getting a drink and some food at the late night happy hour in a bar by the cinema. I saw the window for sex closing quickly. I was initially planning not to tell Husband that it was a high fertility day, but now I know he’ll figure it out when I’m trying to seduce him at 12:30 AM. I gave him the news and saw him suppressing a sigh. We were both exhausted from a long day and still recounting our disappointment in the movie. Husband made a valiant effort. The rocket ship was on the launch pad, but wouldn’t blast off. “Fuck it,” he said “I think doing IUI or IVF is going to be much easier”.

In Shelly Snowdon’s e-book “The Fertility Diaries” she describes her experience of looking for ovulation predictor kits in Spain only to be told no stores sold them as the Pharmacist explained “In my day, you didn’t need such things, you just made love and got pregnant” It seems like such a simple concept, but is it really? When you have a narrow window each month, how do you make things do your way, like being in the same state, not being exhausted and maybe actually being in the mood and enjoying the process? It almost seems like a romance novel concept, the stars align on your O night and you two make beautiful love that magically results in a baby. It provides us with some comfort to know that it probably would be difficult to conceive even without the male factor issues, we’re two active people who live in the real world and not a Danielle Steele Book. Maybe if we started this process years ago the blind pig would eventually find the acorn, that one of the limited bullets would hit the moving target. For now, fertility drugs, porn, a masterbation room, transvaginal ultrasounds and a third person in the room are starting to seem much more practical..

To IVF or not to IVF...

I did something really cheeky. There is a large REI group in our area that we give patient referrals (and unfortunately aren’t in my insurance network) I’ve often corresponded with them regarding our referrals and follow up from their newly pregnant patients, so I sent an email asking for advice on a “patient” who was really myself. The most senior doctor concurred with the recommendations from my RE and added “I wouldn’t wait much longer”. Armed with a second option, Husband and I started talking about the inevitability of doing IVF.

Back in the days when I thought I didn’t think I wanted to have children, it was so easy to say “I’d never do IVF”, but like other women making family planning decisions, it is one thing to say what you would to in a hypothetical situation and quite another when it is presented as your reality. Could we really be considering taking this leap? There are so many things to consider about IVF. The first big thing is the cost. While we’re fortunate that we are in a position to be able to manage financing two cycles of IVF, I still hear our RE’s estimate of a 40% success rate with IVF. Who would be willing to place a $10,000 bet when you have less than 50 percent odds? I recall how outraged people were when Mitt Romney wagered a $10,000 bet with Rick Perry during the Republican Primary debates, and ten grand is pocket change to him! Getting a BFN is disappointing enough when it doesn’t cost anything, how do you reconcile such a large deficit in your bank account if you don’t have anything to show for it?

My other concern is questioning if we are violating the natural laws of science. Maybe our DNA just isn’t meant to splice and that’s why we’re not getting pregnant. Maybe we would produce a sickly child who would have a poor quality of life and we’d feel so guilty about bringing him or her into the world. I also struggle with the extra risks that are taken in order to increase chances for success, performing ICSI if male factor is present, transplanting more than one embryo… My most vain concern is about the weight gain associated with hyper stimulation that occurs before you even get pregnant. I can only imagine how chubby I would look to Myrtle’s mother. I also fret over the notion of not only being considered a “high risk” pregnancy, but feeling that I have a price tag on the pregnancy. If I didn’t follow every single rule, Husband would remind me that I’m not only carrying our child, but also our investment. It’s the ultimate game of high risks and high rewards. Are we really willing to take this gamble?

Socks

Shortly after bringing her baby home, Myrtle was at that point of feeling overwhelmed, emotional and sleep deprived and called me in a state of panic a few times. I’m not sure why she thought I would be of any help to talk to, but for some reason the things I said were of comfort to her, and it gave me the feeling that I might actually be able to do this mother thing if I ever have the opportunity.

Although she couldn’t quite figure out why we still wanted to have a baby after the reality she had been describing for us. Myrtle continued to ask how things were going in that department. I was too embarrassed even to tell her about sleeping through the window of opportunity last month, which now felt like a non-issue given my last conversation with my RE. I gave her a quick recap. “I’m sorry you’ll have to do IVF, but that what I thought you were planning to do” I silently sighed to myself. I think I must have explained the difference between IUI and IVF to Myrtle at least five times. I need to remind myself that the language of infertility is completely foreign to her.

“Will you try the socks theory for me?” she asked. I wasn’t sure when she became involved in our conception process, but I was curious enough to keep listening. “I’m sure you’re going to laugh” she started. “You need to wear socks after sex. If you keep your feet warm, it leaves more blood to flow to your uterus to help things stick”. I’ve only been practicing in women’s health for ten years, but after getting pregnant once, she seemingly knows more than me. At the same time, I was also a little annoyed that she held out on her fertility secret for so long. She went on to describe that yes, it was November in Connecticut and she didn’t know what she would have done if she was still trying to conceive in July and had to wear socks in the summer heat. I realised at that moment that she seriously thought the socks helped her conceive. She couldn’t appreciate that she conceived because she and her husband had working parts and good gametes and would have conceived with or without socks. More so, she still didn’t understand that our challenges required more than an old wives tale.

That night I send her a long email complete with an infertility primer and I concluded ‘I know you think we’ll conceive naturally, and I hope you’re right. I do appreciate all your faith and good wishes, but I need to be realistic that we’re going to need some form of assisted reproduction. Your socks tip was cute, and no it won’t hurt, but the reality is that we need more help than socks’ She sent me a text the next day with the message “I’ll call you later, I want to be there for you like you were for me” I felt like I finally had a break through with Myrtle.

Needs Improvement

Do you remember when you were in grade school and your teacher wanted you to know when your work wasn’t good enough? You received your paper with the words “NEEDS IMPROVEMENT” branded with the red marking pen. It is starting to feel that way each time we receive Husband’s semen analysis results. The RE noted that his endocrine tests were borderline low and referred him to a male fertility specialist, who started him on Clomid. I enjoyed joking that he was going to ovulate since I apparently wasn’t very good at it. He was told that he could expect to see a difference after three months, so we deferred starting IUI until he was optimised on the Clomid. In the meantime, Husband googled ‘healthy sperm’ and started taking whatever supplements he could find at GNC.

We anxiously waited the results of his first post Clomid WIAC (Wank In A Cup) test. I listened to the voicemail from my RE who reported that there was only a slight improvement. His total count reached his highest ever at 17 milling and it was also the best motility at 61%, but the RE only noted that his progression went from ‘2’ to ‘2+’. He might as well have written it the red marking pen. “It’s something in the right direction!” I commented, but the RE failed to laugh at my joke. He expected a better response from the Clomid –to bring his count to 30 million or more. Then he gave us his honest assessment. We could try IUI, but he didn’t have high hopes that it would work and wouldn’t advise doing more than 2-3 cycles before moving on to IVF with ICSI.

My mind shut off after hearing the acronym ICSI. It felt that in four months we went from not having a diagnosis to facing what seemed like the worst case scenario. I felt confused, “So do we now have a diagnosis?” I asked, while realising that sounded like a dumb question. He started reviewing the statistics of normal fertility starting with women in their twenties. I didn’t need to hear it. “I know the stats and I know I’m old!” I snapped. The RE cut to the chase: we are officially infertile due to male factor. Wanting to change the topic, but probably wanting more to get off the phone call, he mentioned that my insurance authorisation had expired. After Husband was started on Clomid, I sent a message to the office indicating that we would be starting our IUI treatments toward the end of the year. A few days later I received an insurance authorisation starting in August and going through October. I was a bit annoyed as it seemed that the staff member didn’t even finish reading my message to note when I would be starting treatment, but I figured I would rather the staff error on commission rather than omission. Now it was a point of contention for me. “I don’t know why the authorisation was issued during that time frame when I indicated we wouldn’t start treatment until December!” I snapped again, just in case it wasn’t clear that I was pissed off.

The IVF inevitability. Husband and I had started to accept this as we talked with each other, I just wasn’t ready to hear it in such an official context just yet. Also, I behaved petulantly in front of someone who is not only my doctor, but also a professional colleague. Not my finest moment.

Trying too hard...

There is a phrase worse than telling an infertile couple, “just relax and let it happen”. Insult can be added to injury by being told “you’re trying too hard”. Just to make sure you didn’t already feel that you were doing everything wrong. To prove his or her point, the well meaning friend may tell you about a couple they knew who tried to conceive for years, then decided to stop and magically became pregnant after that. I can’t resist pointing out the obvious, that if the couple conceived, then they didn’t actually stop trying. (Unless said couple did actually start using birth control; in which case, I’m sorry but the Universe is just fucking with you) Seriously, what other situation would anyone offer the advice of “give it up and maybe it will happen for you!” I can appreciate the well meaning intent behind the “just relax” advice and I think the underlying sentiment advocates that a couple should not overly focus on the procreation process to the detriment of other interests and activities. However, it is also possible to overly distract yourself.

We started renovating our kitchen over Labor Day. Husband and I are actually quite skilled at DIY projects. We weren’t planning to renovate the kitchen for a few years, but when we started TTC, I decided to start painting the cabinets, figuring I wouldn’t have much time to commit to the task after the little one’s arrival. When my father, who is a general contractor, visited in the spring, he saw what we were doing and started drawing plans to build a new island. I don’t cook, and I often joke that the only reason I have a kitchen is because it came with the house, but the finished product turned out really well. It is all consuming to do the work yourself. It eats up your weekends. Evenings after work are spent painting boards or repairing dry wall. In a sincere effort to show interest, Myrtle often asked about the kitchen project, which always seemed to remind me that I wasn’t preparing a nursery. AF arrived twice during the project, but I wasn’t as disappointed to see her. For two months we hand washed all dishes in our guest bathroom sink. The refrigerator was kept in the garage. Our kitchen cabinets were all emptied into boxes that filled the dining and living rooms. I was making coffee in the hall and preparing a salad on my table saw. It wasn’t that long ago, but I look back and can’t believe we lived like that. Towards the end, I was getting frustrated and testy. I can only imagine how much more annoyed I would have been if I were pregnant at that time.

One weekend in October, we gave ourselves a break from the renovation. I was competing in a swim meet and husband had to umpire a field hockey tournament. I had been using my Clearblue fertility monitor and was getting consistent results. When the monitor didn’t move from low to medium until day 13, I figured it would be another long follicular phase cycle. However on day 15, there was my high fertility reading, after only two ‘medium’ days. I got the result at 0530 on a Sunday morning as I was leaving for my swim meet. Husband texted me later that day asking ‘what was your result?” I replied to him with my swim time, and as soon as I did, I realised that he was asking about the fertility monitor. How funny that it wasn’t my first thought. We made it home later in the evening and felt exhausted after our busy days. We both feel asleep on the couch soon after finishing dinner, but woke up later to move like zombies to the bedroom where we resumed our restful sleep. The next morning I was back in the pool at 0600 doing my warm up labs. I noted that I hasn’t checked my monitor that morning, I had put it away. Why did I put it away…OH SHIT, WE FORGOT TO HAVE SEX!! I am feeling like the world’s biggest dumbass at this point in time. As if it weren’t frustrating enough to miss opportunities due to our travel schedules or limitations in our gametes. I feel like someone who banks on winning lotto, but never buys a ticket. That night we did the baby dance, despite my skeptical feelings that it’s too late to work, but it didn’t matter as Husband’s ‘stuff’ fell out (sorry TMI). We inadvertently successfully used the ‘pull out method’. I am beginning to think that we are the most pathetic TTC couple ever at this point. Husband tries to console me by saying “Someday we’ll look back on this and laugh…”. “Why wait?” I replied. “Let’s laugh about it now.”

Myrtle's Delivery

After giving me daily updates about how her cervix was progressing, Myrtle texted me on due date to announce the arrival of little Myrtle. My heart was immediately overjoyed while at the same time it sank into my stomach. I was surprised by my own reaction, I knew this event was coming, why was this news feeling hard to process? I think at that moment, it felt more elusive for me. After all, pregnancy is just a means to an end, the baby is the real goal and here she was holding hers in her arms, while my uterus is still empty and the prospect for pregnancy is bleak. I held it together to the end of the work day, but burst into tears as soon as I got home.

I realised that I was jealous of more than just her baby. She conceived quickly, had an easy pregnancy with no morning sickness, she looked great despite going over her recommended weight limit, she kept the gender a surprise, which was something I planned to do. She had a girl. We had once discussed that while adopting the “along as it’s healthy” attitude, we both really imagined ourselves with daughters. Now she had a textbook vaginal delivery on her due date. Could anything be more fucking perfect! This was my field of expertise. I worked in labour and delivery for over four years and delivered over one hundred babies, how could she have done it so well when she didn’t have my knowledge and experience? I felt like I was being beat on my home turf. The other thought running through my mind was that if I did ever become pregnant, our mothers would talk and compare us, just as they’ve done all our lives, and how could I ever compete with Myrtle’s fucking perfect pregnancy.

Damn you infertility! What have you done to me? I’ve been replaced by this petty insecure jealous bitch! The next morning I received a text from Myrtle informing me that little Myrtle was in the newborn ICU. When I spoke with her yesterday, she mentioned that she was having trouble breathing and was taking to the NBICU as a precaution, which sounded fairly routine, but now it seems that she may have an infection and has been started on antibiotics and a full septic workup. The news hit me like a slap in the face. Every petty, jealous bitchy thought I had was out the window and the person I like to believe I truly am returned and I was determined to be the friend Myrtle needed me to be. Myrtle and her husband faced one of the roughest crash courses into parenthood as little Myrtle needed to be hospitalised for ten days after her birth, but as an epilogue, is now thriving. I felt so guilty for thinking that everything was so swimmingly perfect for Myrtle.

I also felt really badly for her as I learned from my mother, that her parents didn’t go to the hospital until the day after the birth. They live less than an hour away. “Well it was raining…” was the excuse from Myrtle’s mother. My mother told me “If you lived an hour away and just had a baby…” She didn't need to finish her sentence. I live on the other side of the country and I knew that if I announced the arrival of their grandchild, my parents would drive to the airport and hop on the first flight they could. Myrtle’s mother didn’t go back to visit for another week. My mother asked “how can you stay away?” She responded “I just don’t want to get stuck there…” Stuck helping your daughter cope with a difficult situation? Stuck looking at your beautiful granddaughter? I finally realised that whatever feelings I had from my own infertility, it wouldn’t ever change my friendship with Myrtle, and she really needed her friend right now. I also felt so badly for my mother, who I know was experiencing a form of grandmother jealousy. I wished I could reach out to her and allow her to vent. I’ve been fortunate to find a great support group within my own friends and through an online infertility forum. I hope my mother was able to find such support.

Phantom Due Dates

While it was a fantastic experience to attend the Olympic games, there was a voice inside my head that wondered what could have been, if we hadn’t used the emergency contraceptive Plan B nine months ago. A few days after our first month of officially TTC failed, we received a ‘Save the Date’ announcement for a September wedding. I looked at my phone app and noted if we had conceived, the due date would have been the same date as the wedding. We would have much rather been welcoming a new baby, but would have been gutted to miss catching up with old friends. This wedding became the first of many silver linings that we would find after each month’s disappointment.

We did thoroughly enjoy ourselves during that weekend, but it felt like a weird milestone. Here was the day that could have been my due date and I wasn’t even pregnant. A few days after we returned, I ran into a former work college who was 8 months pregnant. When she told me when she was due, I recognised the date right away. It would have been mine if my first Clomid cycle had worked. I know I have to stop looking ahead as I can drive myself mad with extra reminders of disappointments, but one of the most frustrating aspects of infertility is feeling like your life is on hold. Future vacations and athletic competitions all have to work around a possible pregnancy that may or may not happen. In case we didn’t endure enough family fun in England, my father started talking about planning a trip to Hawaii with us and my in-laws. Husband and I agreed that we were absolutely not going to try to defer pregnancy around another trip, but the reality is that we have to be mindful of the need for my parents and in-laws to book their flights months in advance. Husband suggested letting our parents in on our situation, but I refused. Firstly, we don’t need any additional pressure on ourselves. My parents think that I’m just not keen to have children, so I hope to be able to give them the surprise of their lives. I feel that so much of this process is not going the way that I wanted, so I don’t want to let go of this aspect. So we continue with our plans to try to conceive and will just wait to see what happens.