I'm Waiting For The Result Of My IUI, But I'm Already Grieving The End Of My Efforts To Have Another Child
Today is Tuesday. On Thursday, I’ll wake up at 6:30 in the morning and throw on semi-presentable clothes while my two-year-old, two months shy of three, still sleeps and while my husband is rousing. Then I’ll drive to my reproductive endocrinologist’s office for a 7:15 appointment to take a blood test to determine whether I’m pregnant.
I’ll be home by 7:45, just as my husband is about to head out the door to work. I’ll crawl back into my bed, a cup of coffee in my hand.
My son will follow me to my room asking, “Mommy, can we read books?” His morning hair will be defiant—single pronounced curls that spike outward in every direction. He’ll be clinging to Cat, his stuffed lioness, Zebra, his stuffed zebra, and Dusty, his stuffed kitten. They are a family, he tells us: Cat is the mama, Zebra is the daddy, and Dusty is the baby. His bed is full of other stuffed animals; none has been christened Dusty’s brother or sister.
Along with his animals, my son will have as many books in tow as he can manage. I will take his animal family, one member at a time, set them beside me, and then help my one child onto the bed. I’ll hug him to my body for as long as he’ll allow it. We’ll snuggle next to each other, covering our legs with the bedspread. It will be a three-book morning, at least.
The blood test will be negative. I already know this. I took a home pregnancy test on Monday. I took another today. Negative. Negative.
When I had the IUI two weeks ago, I knew that my chances for conceiving successfully were roughly five percent. My first RE informed me of these chances the first time we met; my second RE confirmed the percentile. For those who are not familiar, IUI, intrauterine insemination, is a procedure by which, in laymen’s terms, a man provides sperm—in this case the man was my husband. The sperm is washed clean; only the best sperm are inserted, by way of a catheter, into the woman’s uterus; these perfectly shaped, quickest swimming sperm are given a head start. They arrive within five minutes of their final destination, instead of entering with the usual twenty-minute commute they might make after intercourse. A woman hopes that one of these speeding sperm will fertilize an egg that is growing inside one of the follicles that is growing inside of one of her ovaries.
In my case, there was only one follicle. I have no idea whether the follicle actually contained eggs. More likely, it’s been forming into a cyst to be expelled during menstruation; that’s what I’m really waiting for, the bleeding.
To grow this one lone follicle, over the course of a week I injected an antagonist medication meant to shut down my pituitary gland’s overactive production of FSH, the follicle stimulating hormone. Once my FSH was, presumably, leveled out, I took a one-week supply of Femara, meant to stimulate the growth of follicles in my ovaries. The goal, my doctor had told me, was to “induce ovulation.”
Two weeks later, when I went in for monitoring, there were no follicles. Just an empty uterus, a gaping black hole inside of my body projected before me on the ultrasound monitor. I lay on my back staring up at the screen, my hand resting on my lower abdomen.
A few days later, I returned for more monitoring. This time, there was one tiny follicle on my left ovary. It was not nearly mature enough to justify moving forward with insemination.
“It doesn’t look like you’ll be able to do a procedure at this point,” my doctor told me. “I’ve tried the latest technique. You could also try the old-school approach,” she told me. A round of injectables. She added that I’d be looking at about five thousand dollars for that medication, and my chances would remain the same. Over the course of one year, I’ve spent about five thousand dollars already, that five percent chance of success weighing heavily.
“Nope,” I said. “I think I’m done.”
“If you’re really done,” she said, “you could, as a final measure, take a round of Clomid.”
My first RE had prescribed Clomid, and it had successfully stimulated the growth of follicles, plural, in my body; it had done a better job than Femara. But at the time, I was using the Clomid solely to grow the follicles; I was still trying to conceive the old fashioned way.
“We can see if the Clomid will help the one follicle keep growing,” my doctor offered. “And if it does, we can do a procedure.”
“I fully expected to come in here and see nothing,” I told her. To see the one follicle had thrown me. I concentrated on the small white mass, the size of a button on a child’s sweater. “Yes.” I said. “It’s thirty bucks. I can spare that. And then I’ll know I tried everything within my means and within reason for me.”
Another week later, my single follicle had grown, but it still wasn’t mature enough. I returned for yet another ultrasound. This time, the follicle was days away from measuring large enough for insemination. Not only had the follicle grown, but my uterine lining had also thickened, creating an ideal environment for implantation.
I returned for seemingly the hundredth visit three days later. My husband gave a sperm sample. When I was called into the examination room, I asked the technician, “Will it hurt?” I immediately chastised myself for the stupidity of the question. Who cares, I thought, if it helps me get pregnant.
“A little discomfort. That’s it,” she said before she left the room. I undressed from the waist down, rested my feet loosely in the stirrups, propped my upper body on my elbows, and waited for the doctor.
After she entered the room, the doctor held up the plastic cup of sperm. “Do you want to watch it go in?” she asked. Thick, pinkish liquid filled a fraction of the cup. “There are 77 million sperm in here,” she told me. “We hope for a minimum of 5 million.”
I allowed myself feel hopeful after nearly two months of trying not to feel hopeful. “Sure. Why not,” I answered.
“Some women want to see, and some don’t. So I always ask,” she told me.
She inserted the catheter, and I commanded my muscles to relax while I concentrated on the monitor. I watched the sperm enter my uterus, a frantic burst of white scurrying into the blackness like the Milky Way was entering me.
My hopefulness stuck. Before I ever took the two home tests, I was convinced I was pregnant. My sense of smell has been stronger. Just today, the usually undetectable scent of sweat on my dogs’ bodies after a few minutes out in the Texas heat made me want to gag, a sure sign.
I wasn’t going to take a single home test. I was going to make myself wait until Thursday. But I opened a drawer in my bathroom yesterday, and there were five tests individually sealed in shiny pink and white plastic, taunting.
I’ve considered canceling the appointment on Thursday, but somewhere in the well of my heart, alongside my longing for a second child, for a sibling for my son, for the promise that he will never be alone in the world regardless of what may happen to me and my husband, for a family that is full, there is still the slightest stubborn drop of hope. I don’t know if it will ever evaporate.
On Thursday, long after my son and I have read books together in bed, when, later in the day, he goes down for his nap, I’ll begin sorting through baby clothes and baby toys and all of the paraphernalia—the hardly used Ergo and Moby wrap, the cloth diapers I washed and disinfected methodically two or three times a week for nineteen months, the Boppy pillow with its deliberately selected tasteful, neutral covers, the turquoise blue Bumbo seat, the milk bottles with extra nipples, their flow sizes labeled on the outside of Ziplock bags, everything packed neatly into Rubbermaid bins.
I will spend the weekend continuing to reexamine all of these precious items—everything tiny and clean and preserved for that single drop of hope, my future baby—now dumped into piles: Donate. Give to a Friend. Sell. Sorting through the belongings, I’ll mourn the nonexistence of my second child the same way I once mourned my mother’s death.
“At least you have one,” a friend said to me over dinner a few months ago. “I think it’s worse to want one but not be able to have one at all.” I nodded, too tired to explain my wanting.
On Thursday, I’ll tell myself that, from now on, it’s okay to spoil my son. Why shouldn’t I? I’ll tell myself that I can focus on writing; I won’t have to take a nearly two-year hiatus again. I’ll say that I’m blessed to not need the resources for another childbirth and more childcare, that maybe I’ll be able to afford Montessori school for my son. I’ll promise myself adventure trips; I’ll fantasize about the three of us, our family unit, setting off to South America and India and Europe to live for months at a time. These things will come true, I’ll tell myself; these are successes I can guarantee.
I won’t think of my nephew, my sister’s only child, who died a car accident when he was just twenty. I’ll shove that nasty memory and its haunting effect into the deep recesses of my psyche.
I’ll read more books to my son. In the mornings, outdated Curious George stories with strategically omitted phrases and, before bed, All the World with its illustrations of the circle of life and our connectedness to each other and the universe made so simple.
I’ll wonder, all the time, how my husband and I ever conceived our son; I’ll wonder whether my one child is living proof that I have already defied the odds against my too-soon dwindling egg supply, my Primary Ovarian Insufficiency, “which is not the same as premature menopause,” my second RE had emphasized back when I hung on every word of every explanation, when those words mattered.
The only words that will matter now are “only child.” They’re words I’ll need to redefine. Perhaps “only child” will be synonymous with, just once, unknowingly, gloriously achieving my five percent chance of success, before I even knew with certainty whether I wanted to be a parent, before I knew if I’d be a good parent, before I was fully convinced that a child would be a choice I never regretted. I harbored so may doubts during my pregnancy but so little joy.
Today, it’s not my living, breathing, growing child, but the waiting that I regret, the years, thirteen in all, of hemming and hawing—Do we want a child? Do we not? In the second month of my son’s life, he looked at me one day, his eyes transfixed by mine; all my years of doubts vanished.
After the birth of my son, with his presence in my life, my knowing drives my wanting more achingly than my not knowing before the birth of my son ever drove my doubts. This discovery is a pill to swallow, as bittersweet as the ounce of hope I try to ignore even as I continue to take my prenatal vitamin each night.