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It's funny sometimes how you want an answer to something so desperately and when you finally get it, all you want in the world is for it not to be true. In my case, it was the answer to why I couldn't get pregnant.
All my life I have wanted children. I have aligned almost everything I’ve done with that hope in mind. I generally eat right, exercise, and control my stress; I even distance myself from Wi-Fi routers (perhaps that is a little neurotic).
I always thought about how my choices would affect my fertility and did whatever I could to increase my chances of one day having a healthy baby. Little did I know nothing I did mattered, and that my eggs were a silent ticking time bomb of futility.
When I was 25, I was lucky enough to find an incredible man to make my dreams of starting a (bigger) family come true. He was, and still is, a dream. We got married when I was 29 and decided to wait until the following spring to try for a little one.
I literally counted down the months and weeks on my cat calendar until we could get try to get pregnant. I was deliriously excited. I hoarded pregnancy books. I fastidiously used ovulation prediction kits to track my hormone patterns and committed myself wholly to taking my basal body temperature every single morning to wait for that blessed thermal shift. I was going to get pregnant within three months come hell or high estrogen.
The first month of trying to conceive was fun! Magical even. I got a BFN (that’s big fat negative) in the form of an unusually spotty period.
The second month was fun! I attributed that BFN to training for and completing a triathlon. I reduced my exercise.
The third month was . . . fun! I remember clearly blaming that failure on cleaning out my family’s rental properties. The spotting increased.
The fourth month of trying was decidedly un-fun because I knew something was wrong. Being a pretty open person, I started revealing our struggles to family and friends.
Some politely attributed our failed attempts to my overtly type A, impatient (on the best of days) personality. I, of course, blamed myself a lot during those months, and thought it was my obsessing that prevented me from getting pregnant. Here are some well-intended, but decidedly unhelpful suggestions I often heard about how to get pregnant:
"Go on vacation!"
"Buy some sexy undies!"
"Oh, it took my cousin long, too, but she just stopped trying and that was the month it happened!"
"Have you tried Vitamin B complex/DHEA/Vitex/herbal tea/fish oil? It worked for me."
"Keep your legs up after; that’s how I got your aunt pregnant . . . three times."
And the old classic:
After month six of trying, I made an appointment with my ob-gyn. A little preemptive, but again, my intuition was telling me something was wrong. I was spotting like I never had. My period had also become shorter and just different. My OB told me since it hadn’t been a year of trying (insurance won’t diagnose you as infertile until 12 failed cycles), there was nothing that she could do.
With not unkind eyes as I sat with sweaty hands choking down a knot of worry, she advised me to stop monitoring my fertility signals and, essentially, to relax.
In the meantime I had turned 31 and went to my birthday dinner with a sinking heart. This is not how it was supposed to be.
We tried again and again. The excitement and then despair of each cycle was wearing on me and my husband.
I finally made an appointment with a highly recommended fertility clinic, to see what the RE (registered endocrinologist, or a fertility specialist) had to say. Our RE, Dr. K*, is a kind, straightforward man. I went in for my Day 3 blood work panel and they took so much blood I had to lie down.
The ultrasound was fine, revealing eight follicles and ovaries that “looked good.” No chromosomal abnormalities, no anti-sperm antibodies, no vitamin deficiencies, no male factor. A hysterosalpingogram revealed no issues. I fully expected the RE to say, “It’s all in your head, crazypants! LOL! Try yoga!” How I wish that were the case.
I was at school when I saw my results posted on my clinic’s patient portal. As any savvy millenial would do, I asked Dr. Google what he thought of my lab results, specifically my level of FSH (follicle stimulating hormone) of 22.6. Forums and medical studies spat back a barrage of discouragement:
“. . . under age 30, FSH should be below 10”
“elevated levels of FSH indicate premature ovarian failure and/or diminished ovarian reserve”
“. . . my doctor immediately pushed using donor eggs”
“. . . our clinic will not proceed with infertility interventions with an FSH level above 16”
“After 6 years we finally gave up . . .”
An FSH as elevated as mine was unusually — and some would say, catastrophically — high for my age. High FSH is a secondary issue; it indicates essentially that eggs are either bad quality or there’s very few of them, so the pituitary gland “kicks up” its production to try to stimulate their release. It’s like flooring the gas pedal in neutral. FSH fluctuates, so we waited on my AMH (anti-mullerian Hormone) levels, which some research asserts is better at gauging egg quantity and quality.
It came back just as bad — an almost undetectable 0.31, when at my age it should be around an eight. A natural pregnancy with those levels is just about impossible to occur and if I ever were to get pregnant, miscarriage would likely result.
These results, as Dr. K said, are clearly the cause of my infertility. Problem solved. But there isn’t a great solution, as women with Premature Ovarian Failure do not usually respond well to Assisted Reproductive Technologies.
This can’t be real, I thought. I am 31. I haven’t even opened that wrinkle-cream sample. I was supposed to be pregnant by now, nesting away in this bitterly cold winter. I have a secret drawer of maternity clothes in a room painted a soothing yellow and a hand-me-down Pack-N-Play in my basement and three sets of very hopeful parents quietly wondering what the hell is going on.
As to why my eggs are so damaged, there really is no answer why. A nurse the other day mentioned she is seeing more and more young, healthy women with eggs in similarly bad shape. Perhaps there is an environmental or genetic link, but worrying about that will get me nowhere. We just have to move forward.
My husband and I, along with our very supportive families, have decided we will do whatever it takes to help me get pregnant. We have decided to undergo an Intrauterine Insemination (IUI) cycle first to see how I respond to the meds. If a few of those doesn’t work, we’ll proceed with an aggressive In Vitro Fertilization schedule.
IVF is not covered by my insurance, and each cycle could cost up to $12,000 each. The odds are not great but Dr. K says as I am “young,” it is very possible that I could get pregnant. I never dared to ask him a percent chance.
The IUI meds arrived the other day in a box big enough to fit five shoeboxes. How I wish they were sandals and peep-toe pumps and not Menopur, Follistim, and syringes. Can you imagine injecting an ottoman-size box of medications into your body? The thought of what is in store for me physically and mentally is unsettling.
Currently, I have the (very expensive) follicle stimulators in my refrigerator with leftover pizza slices sitting on top. It’d be funny if it wasn't so profoundly depressing.
At home when I bring up “The Situation,” my husband quietly envelops me in hugs. Sometimes I just push him away as I feel claustrophobic and restless, and ask him why he has to touch me every time I talk about it. He says it’s the only thing he can think of to do.
I am pursuing natural remedies and often visit a great acupuncturist named Wayne. As he pricks thin needles into my abdomen and leaves me in that room with air soaked in lavender and mint, I feel trapped in my thoughts. I think about the possibility of never having a genetically-linked child; of not seeing my extroversion or small nose or loud Italian mouth passed down; of never seeing my husband’s adorably skinny legs or athleticism or quiet confidence in a little boy or girl.
I think of the days and years stretching out before us without mushed-up Cheerios and pale pink onesies and fat little hands and the TV blaring the Disney channel. I think often of those mundane depictions of life with children that some may take for granted but I so desperately want.
And on very melodramatic days, I gaze into my dog’s eyes and loud-whisper, “Well, this is it. You’re all I’ll ever have.” My husband feigns frustration and laughs as he hugs me and brushes the hair out of my face.
Tomorrow the clinic will check my FSH level. If it is low enough, we will proceed with the IUI. It may work, it may not. Sometimes I feel enraged, sometimes I feel guilty and weepy, but mostly I just feel numb.
However, I never forget that I have many wonderful things in my life — a great career, my health (and health insurance), our parents’ support, and a husband who helps me push through the dark cloud of pessimism and focus on our bright future, even though it may never look just as I had always imagined it.
*All names have been changed