I wish there was a way to warn young girls about infertility without ripping away their innocence and creating fear and panic and the possibility of crushed dreams. There isn't. There is no way to be prepared for the onslaught of emotion that having difficulties trying to conceive creates. Even if you could find the right words, nothing...absolutely nothing...would actually prepare you for the pain.
It is a pain that is constant, although it varies in intensity. It creeps up on you in the most inopportune moments. A tear slips down you face in the middle of the work day. You lose an entire night's sleep from the ache and panic. The bitter bitter jealousy of the newborn in the supermarket needles its way right into the deepest caverns of your heart. You feel alone. Utterly and completely alone... which is ridiculous because your husband is going through the same thing... kind of. But he has the ability to push it away instead of letting it eat at him day in and day out.
After a few years of "not trying," you realize something isn't quite right. you stopped taking birth control 3 years ago...sure, there's a method to the madness, a timing, but there's no way in 3 years you haven't had sex at the perfect time. But nothing has happened... you start trying to figure out your body on your own. 7 ovulation predictors every month...they add up...but are the cheap ones actually detecting your surge? Hmm, it’s a bit different every month, is that normal? Days, then weeks, then months go by of taking your basal temperature every. single. morning. Entering the data on your app. oh, and your second app. because who knows how accurate those things are. Oh, you had sex? Open the app, mark sex. Still nothing.
The 2 week waits start to sting. The day when the cramps start sneaking in slowly and you tell yourself it's nausea...it's gotta be morning sickness, not menstrual cramps...that's the day that your world starts turning gray. And then it's confirmed and you're buying boxes of tampons instead of pregnancy tests. Those first couple of days of your period are bleak. It’s hard to get past the funk. It sits like a heavy cloud over everything you do. It is inescapable.
You realize you aren't getting any younger and you start seeking help. It’s even better when you wait until you're older to start trying. That biological clock ticks...and not so subtly...in your ear day in and day out. Your husband has a semen analysis and the results are in. your gynecologist says it is all him and sends you to a fertility doctor without testing you at all. The fertility doctor claims it is NOT your husband...his results are actually fine, so it's obviously you. All of a sudden, you are being poked and prodded, pumped with fluids, being stuck with needles, samples taken. Invasive tests make you feel like you have no more dignity.
But....you're normal. Everything looks great! The doctor is positive... you want to scream, because if everything was fine, why would you be here?!?! You clearly aren't pregnant. He mentions that you have hypothyroidism, puts you on thyroid medication. He says in some women, it causes ovulation issues. Your hopes soar. You take the medicine diligently. Your energy day to day increases and you feel great! You have your blood retested and the levels are perfect...you have sex exactly when you are supposed to. And then your period starts as scheduled. Screw it all.
A few more cycles pass on the thyroid medication and you are still not pregnant. You got back to your doctor. Every time you see him, you feel so positive. He is so good at his job. The next step is an ultrasound (on your period, no less) to make sure you have no cysts and everything is healthy and then ovulation inducing medication. 5 days of it. When you reach your pharmacy after your appointment, they don't have your medication in stock. Cue mental breakdown in public. the girl at the counter says they are due the next day and you clench your fists and try not to let your voice come out high pitched and desperate as you tell her your doctor instructed that you MUST start taking it today or you'll have to wait until the next cycle. You tell her to call all the other pharmacies in an hour radius and dread the drive to who-knows-where. Luckily, they find 2 pills. You can pick up the other 3 tomorrow. Take a really deep breath or you are going to pass out.
After 5 days of the ovulation medication, there are 3 weird days of nothingness. Are you sure the doctor said to start the medicine the day of your appointment? Did you get it right? Then you head back up to the doctor on cycle day 12, 13 or 14 for a second ultrasound. This one checks to make sure you actually produced follicles and that those follicles are above the minimum size. IF you have one and IF it is, you get an HCG injection in your butt and get to enjoy the next few days with your husband.
Let me pause here to explain something. Most insurance companies don't cover infertility treatments. Consultations cost upwards of $150 and each and every ultrasound costs $175. While the ovulation medication is a cheap prescription, the HCG injection is $100 at a random clinic your office picked because it is the absolute cheapest place to find it. They mail it to you before your appointment. So given what I've explained, 1 cycle of the "cheap" way to go for fertility treatments is upwards of $450. Unless you have avoided the typical throes of life and have landed the perfect job with 6 digits salary annually and have 3 cars and a house already paid off, this makes life extremely difficult. Especially because your doctor is over an hour away which means serious gas money and you are constantly leaving work early to make an appointment during hours.
Meanwhile, the whole world is telling you to relax. @#$#@ you. You’re told that you are trying too hard and if you would just stop trying, it will happen. Everyone has a boyfriend's sister's best friend who was going through THE EXACT SAME THING AS YOU and as soon as she stopped trying, she got pregnant. You try not to be catty and spiteful and mean, and although your personality is ANYTHING but, it is extremely difficult not to lash out. You relaxed and tried to "let it happen" for 3 years before seeking treatment. You tried that. It didn't work. But everyone else knows better. Everyone else knows that it "just must not be time yet" or "God has bigger plans for you." Disclaimer. I love God. I trust Him on most of my good days. And I know Him well enough that He tells me no. a lot. I mean, that's my fault. I ask for a lot. I’m human. But He does say no. to lots of people. There are so many women who have gone through exactly what I have...God fearing women...who prayed diligently. Who have kept their resolve and their faith and their composure so much more than me...and never had a child. I’m an optimist, but, thanks to my parents and the intelligence they passed through their and my DNA, I am also a realist. Just because I really want it, just because I’ve prayed, does not mean it will happen. Ever.
Those are the things the people who know of your struggle say to you. I’m not sure if they or the clueless people are worse. The constant "when are you going to have children?" and "you're not getting any younger" and "now that you're married, what's the next step? A family?" questions are debilitating. Because you can choose to pretend you just haven’t made that decision, pretend you're waiting and just "enjoying being newlyweds" or you can divulge your deep, dark, bleeding secrets.
Don’t get me wrong. The vast majority of these people - the clueless and the clued-in - are well-meaning. But they've never fought this battle. They have never wanted to stay in bed all day because you are incapable of doing what a woman was created to do. You lose friends...or at least drift from them. There are a number of reasons. Sometimes, you're just plain mean. You snap at their encouragement and you argue with their logic. They retreat. Sometimes, they just don't know what to say. They’d rather avoid pain and live naively and so they exit your less-than-perfect life. And sometimes, you just stop talking. You can't explain another time. You can hardly breathe. You feel as if all you do is expel negativity and you are saving them from it by quietly letting them slip away. And then... then you are even more alone. You are empty. Because the people in your life that you usually turn to are the people you can no longer face and there is just silence.
I digress. You had 2 follicles develop on the medication and they are BOTH above the minimum size. You get the injection from a bubbly nurse who is positive and tells you to call in a little over 2 weeks "when" you get the positive pregnancy test. you have to quietly asked what you do if you start your period instead and with a downcast look, she tells you to make sure to call on the first day of the cycle and you can start over. She injects a singsongy, overly positive note to the end of her sentence. But at this point, you are elated! The medicine did what it was supposed to. It made your body do what it was supposed to! There is a definite chance! You go home and proceed to make love (and hopefully a baby!) all weekend. Your husband and you wonder if it matters how many times a day you try or if it's once a day on the suggested days. Not wanting to miss out, you do the deed as many times as possible each day until both of you are so sore, you decided to take a WEEK off to let the bruising heal. Your butt and your hip are so sore from the intramuscular shot that you actually walk with a limp, but you did it.
You talk as if you are pregnant. He talks as if he made a baby. You notice you've started letting your hand rest on your abdomen whenever you are relaxing, daydreaming about your belly expanding and life growing inside. You experience some cramping several days later and of course, you googled it. It sounds like implantation cramping!! You’ve got to be pregnant!! Your appetite is kind of weak and you don’t' feel good every day after a meal. Oh this is so promising! Your basal temperatures are on a steady rise and you abstain from alcohol that weekend when you get together with good friends. You tell one (finally) about the cramping and temperatures and the hope! The next day, 7 days after the injection, your basal temperature drops, just slightly. You swallow hard. It could be a fluke. You’re able to push back the fear for a day and just concentrate on "I am pregnant, I am pregnant." you're able to stave it off all day, but you absolutely do not sleep that night. you heart is pounding out of your chest with anxiety and the few times you doze off, you wake up drenched in sweat.
the following day, your temperature drops again and the fear and utter despair starts sneaking in. your temperature pattern is following EXACTLY with every previous cycle you've had and you know...you know that your temperature increases when you become pregnant. You are stunned. You had finally let yourself believe that you could possibly be pregnant. A little more than could possibly, you tell yourself...you had really started to believe it. The hardest part is, you have to wait another 7 days. 7 days before you can test for pregnancy...or your period starts. The HCG hormone that was injected into you is the same hormone that your body produces when you're pregnant. Testing early results in an early positive and you know that your heart can not handle that self-induced roller coaster and you know you will not test until the day instructed. but you are only halfway through the 2 week wait and you're fairly certain that the first week, filled with hope and positivity went a lot faster than this terrified, hopes falling week is about to go.
But the pizza you ate last night didn't really settle in your stomach and you had to take an antacid and you can't remember the last time you had to do that... so is it still possible that a tiny itty bitty baby is growing? "SHUT UP SHUT UP SHUT UP" you scream at yourself. There is no room for those thoughts. You must try to clear your mind of ANYTHING pregnancy related. You must purge all of the thoughts, positive and negative alike, or you might just explode. And then you panic more because your stressed body is going to be a hostile environment to try and grow life. Don’t stress. Don’t think. Ignore it. and then your husband comes up behind you and wraps his arms around you and places his big, strong, calloused hands on your abdomen an says "there's a baby in there." and you pretend for a minute that there is and you give him a face-splitting grin and lean into his comfortable arms. But when the moment is over, you feel yourself deflate. There’s no use in trying to explain your temperatures to your husband. He doesn’t' see the science in it all. He just believes it's going to work this time.
You ask your best friend who has had 3 children what her earliest symptoms were, trying to line up some of your possible ones with her. Instead of mentioning things that sound familiar, she said she didn't really know, with all 3 of them she just knew...just had a feeling...that she was pregnant. "You’ll just know when it happens" she says brightly via text. And your whole world collapses in on you. There is no "knowing" in your life. There is no "feeling" that you are pregnant. Therefore, you must not be. But you must wait another week to find out. And somehow, for those 7 excruciating days, you must pretend that life is normal. You must pretend that you are happy. You must pretend that your heart isn't being ripped from your chest still beating and that your world isn't crumbling beneath your feet. Because, if in 7 days, you are not pregnant, you are not sure how you are even going to stand on two feet. You are not sure how you are even going to make it to work that day. You wonder if you will have to call off. And you aren't sure if you can swing even one more round of the treatments because your checking account is almost empty and you've already borrowed from your savings. So you must hold your chin up high and pretend you are somebody you are not just so who you are doesn't break.
and then...when you think that you might...just might be able to hold it together for 7 days, your high school best friend who you are only in slight touch with sends you a picture message of 3 positive pregnancy tests. She got pregnant on her honeymoon, the first time she had slept with her husband. You had been in the middle of checking your Facebook. The couple you had met and enjoyed long talks about pregnancy and trying with on your honeymoon posted a beautiful picture of her, 8 months pregnant and absolutely glowing. a girl you went to school with who has been dating her boyfriend for 1 month posts her gleeful announcement "I’m 7 weeks pregnant!" and your world does go black. You jump up from your chair at work and stumble to the bathroom, trying not to let anyone see your face. You sit down on the toilet and cry, but it is not a relieving cry. It is an empty, hollow, heart wrenching cry and it just make you want to cry more. It makes you want to self-inflict pain to distract from this searing inner pain. It makes you want to scream and curse the God you have loved and followed your whole life. But instead, you get up. You walk to the sink. You splash cold water on your face, fix your makeup, and go back to pretending to be someone you're not. 7 more days.
It is a pain that is constant, although it varies in intensity. It creeps up on you in the most inopportune moments. A tear slips down you face in the middle of the work day. You lose an entire night's sleep from the ache and panic. The bitter bitter jealousy of the newborn in the supermarket needles its way right into the deepest caverns of your heart. You feel alone. Utterly and completely alone... which is ridiculous because your husband is going through the same thing... kind of. But he has the ability to push it away instead of letting it eat at him day in and day out.
After a few years of "not trying," you realize something isn't quite right. you stopped taking birth control 3 years ago...sure, there's a method to the madness, a timing, but there's no way in 3 years you haven't had sex at the perfect time. But nothing has happened... you start trying to figure out your body on your own. 7 ovulation predictors every month...they add up...but are the cheap ones actually detecting your surge? Hmm, it’s a bit different every month, is that normal? Days, then weeks, then months go by of taking your basal temperature every. single. morning. Entering the data on your app. oh, and your second app. because who knows how accurate those things are. Oh, you had sex? Open the app, mark sex. Still nothing.
The 2 week waits start to sting. The day when the cramps start sneaking in slowly and you tell yourself it's nausea...it's gotta be morning sickness, not menstrual cramps...that's the day that your world starts turning gray. And then it's confirmed and you're buying boxes of tampons instead of pregnancy tests. Those first couple of days of your period are bleak. It’s hard to get past the funk. It sits like a heavy cloud over everything you do. It is inescapable.
You realize you aren't getting any younger and you start seeking help. It’s even better when you wait until you're older to start trying. That biological clock ticks...and not so subtly...in your ear day in and day out. Your husband has a semen analysis and the results are in. your gynecologist says it is all him and sends you to a fertility doctor without testing you at all. The fertility doctor claims it is NOT your husband...his results are actually fine, so it's obviously you. All of a sudden, you are being poked and prodded, pumped with fluids, being stuck with needles, samples taken. Invasive tests make you feel like you have no more dignity.
But....you're normal. Everything looks great! The doctor is positive... you want to scream, because if everything was fine, why would you be here?!?! You clearly aren't pregnant. He mentions that you have hypothyroidism, puts you on thyroid medication. He says in some women, it causes ovulation issues. Your hopes soar. You take the medicine diligently. Your energy day to day increases and you feel great! You have your blood retested and the levels are perfect...you have sex exactly when you are supposed to. And then your period starts as scheduled. Screw it all.
A few more cycles pass on the thyroid medication and you are still not pregnant. You got back to your doctor. Every time you see him, you feel so positive. He is so good at his job. The next step is an ultrasound (on your period, no less) to make sure you have no cysts and everything is healthy and then ovulation inducing medication. 5 days of it. When you reach your pharmacy after your appointment, they don't have your medication in stock. Cue mental breakdown in public. the girl at the counter says they are due the next day and you clench your fists and try not to let your voice come out high pitched and desperate as you tell her your doctor instructed that you MUST start taking it today or you'll have to wait until the next cycle. You tell her to call all the other pharmacies in an hour radius and dread the drive to who-knows-where. Luckily, they find 2 pills. You can pick up the other 3 tomorrow. Take a really deep breath or you are going to pass out.
After 5 days of the ovulation medication, there are 3 weird days of nothingness. Are you sure the doctor said to start the medicine the day of your appointment? Did you get it right? Then you head back up to the doctor on cycle day 12, 13 or 14 for a second ultrasound. This one checks to make sure you actually produced follicles and that those follicles are above the minimum size. IF you have one and IF it is, you get an HCG injection in your butt and get to enjoy the next few days with your husband.
Let me pause here to explain something. Most insurance companies don't cover infertility treatments. Consultations cost upwards of $150 and each and every ultrasound costs $175. While the ovulation medication is a cheap prescription, the HCG injection is $100 at a random clinic your office picked because it is the absolute cheapest place to find it. They mail it to you before your appointment. So given what I've explained, 1 cycle of the "cheap" way to go for fertility treatments is upwards of $450. Unless you have avoided the typical throes of life and have landed the perfect job with 6 digits salary annually and have 3 cars and a house already paid off, this makes life extremely difficult. Especially because your doctor is over an hour away which means serious gas money and you are constantly leaving work early to make an appointment during hours.
Meanwhile, the whole world is telling you to relax. @#$#@ you. You’re told that you are trying too hard and if you would just stop trying, it will happen. Everyone has a boyfriend's sister's best friend who was going through THE EXACT SAME THING AS YOU and as soon as she stopped trying, she got pregnant. You try not to be catty and spiteful and mean, and although your personality is ANYTHING but, it is extremely difficult not to lash out. You relaxed and tried to "let it happen" for 3 years before seeking treatment. You tried that. It didn't work. But everyone else knows better. Everyone else knows that it "just must not be time yet" or "God has bigger plans for you." Disclaimer. I love God. I trust Him on most of my good days. And I know Him well enough that He tells me no. a lot. I mean, that's my fault. I ask for a lot. I’m human. But He does say no. to lots of people. There are so many women who have gone through exactly what I have...God fearing women...who prayed diligently. Who have kept their resolve and their faith and their composure so much more than me...and never had a child. I’m an optimist, but, thanks to my parents and the intelligence they passed through their and my DNA, I am also a realist. Just because I really want it, just because I’ve prayed, does not mean it will happen. Ever.
Those are the things the people who know of your struggle say to you. I’m not sure if they or the clueless people are worse. The constant "when are you going to have children?" and "you're not getting any younger" and "now that you're married, what's the next step? A family?" questions are debilitating. Because you can choose to pretend you just haven’t made that decision, pretend you're waiting and just "enjoying being newlyweds" or you can divulge your deep, dark, bleeding secrets.
Don’t get me wrong. The vast majority of these people - the clueless and the clued-in - are well-meaning. But they've never fought this battle. They have never wanted to stay in bed all day because you are incapable of doing what a woman was created to do. You lose friends...or at least drift from them. There are a number of reasons. Sometimes, you're just plain mean. You snap at their encouragement and you argue with their logic. They retreat. Sometimes, they just don't know what to say. They’d rather avoid pain and live naively and so they exit your less-than-perfect life. And sometimes, you just stop talking. You can't explain another time. You can hardly breathe. You feel as if all you do is expel negativity and you are saving them from it by quietly letting them slip away. And then... then you are even more alone. You are empty. Because the people in your life that you usually turn to are the people you can no longer face and there is just silence.
I digress. You had 2 follicles develop on the medication and they are BOTH above the minimum size. You get the injection from a bubbly nurse who is positive and tells you to call in a little over 2 weeks "when" you get the positive pregnancy test. you have to quietly asked what you do if you start your period instead and with a downcast look, she tells you to make sure to call on the first day of the cycle and you can start over. She injects a singsongy, overly positive note to the end of her sentence. But at this point, you are elated! The medicine did what it was supposed to. It made your body do what it was supposed to! There is a definite chance! You go home and proceed to make love (and hopefully a baby!) all weekend. Your husband and you wonder if it matters how many times a day you try or if it's once a day on the suggested days. Not wanting to miss out, you do the deed as many times as possible each day until both of you are so sore, you decided to take a WEEK off to let the bruising heal. Your butt and your hip are so sore from the intramuscular shot that you actually walk with a limp, but you did it.
You talk as if you are pregnant. He talks as if he made a baby. You notice you've started letting your hand rest on your abdomen whenever you are relaxing, daydreaming about your belly expanding and life growing inside. You experience some cramping several days later and of course, you googled it. It sounds like implantation cramping!! You’ve got to be pregnant!! Your appetite is kind of weak and you don’t' feel good every day after a meal. Oh this is so promising! Your basal temperatures are on a steady rise and you abstain from alcohol that weekend when you get together with good friends. You tell one (finally) about the cramping and temperatures and the hope! The next day, 7 days after the injection, your basal temperature drops, just slightly. You swallow hard. It could be a fluke. You’re able to push back the fear for a day and just concentrate on "I am pregnant, I am pregnant." you're able to stave it off all day, but you absolutely do not sleep that night. you heart is pounding out of your chest with anxiety and the few times you doze off, you wake up drenched in sweat.
the following day, your temperature drops again and the fear and utter despair starts sneaking in. your temperature pattern is following EXACTLY with every previous cycle you've had and you know...you know that your temperature increases when you become pregnant. You are stunned. You had finally let yourself believe that you could possibly be pregnant. A little more than could possibly, you tell yourself...you had really started to believe it. The hardest part is, you have to wait another 7 days. 7 days before you can test for pregnancy...or your period starts. The HCG hormone that was injected into you is the same hormone that your body produces when you're pregnant. Testing early results in an early positive and you know that your heart can not handle that self-induced roller coaster and you know you will not test until the day instructed. but you are only halfway through the 2 week wait and you're fairly certain that the first week, filled with hope and positivity went a lot faster than this terrified, hopes falling week is about to go.
But the pizza you ate last night didn't really settle in your stomach and you had to take an antacid and you can't remember the last time you had to do that... so is it still possible that a tiny itty bitty baby is growing? "SHUT UP SHUT UP SHUT UP" you scream at yourself. There is no room for those thoughts. You must try to clear your mind of ANYTHING pregnancy related. You must purge all of the thoughts, positive and negative alike, or you might just explode. And then you panic more because your stressed body is going to be a hostile environment to try and grow life. Don’t stress. Don’t think. Ignore it. and then your husband comes up behind you and wraps his arms around you and places his big, strong, calloused hands on your abdomen an says "there's a baby in there." and you pretend for a minute that there is and you give him a face-splitting grin and lean into his comfortable arms. But when the moment is over, you feel yourself deflate. There’s no use in trying to explain your temperatures to your husband. He doesn’t' see the science in it all. He just believes it's going to work this time.
You ask your best friend who has had 3 children what her earliest symptoms were, trying to line up some of your possible ones with her. Instead of mentioning things that sound familiar, she said she didn't really know, with all 3 of them she just knew...just had a feeling...that she was pregnant. "You’ll just know when it happens" she says brightly via text. And your whole world collapses in on you. There is no "knowing" in your life. There is no "feeling" that you are pregnant. Therefore, you must not be. But you must wait another week to find out. And somehow, for those 7 excruciating days, you must pretend that life is normal. You must pretend that you are happy. You must pretend that your heart isn't being ripped from your chest still beating and that your world isn't crumbling beneath your feet. Because, if in 7 days, you are not pregnant, you are not sure how you are even going to stand on two feet. You are not sure how you are even going to make it to work that day. You wonder if you will have to call off. And you aren't sure if you can swing even one more round of the treatments because your checking account is almost empty and you've already borrowed from your savings. So you must hold your chin up high and pretend you are somebody you are not just so who you are doesn't break.
and then...when you think that you might...just might be able to hold it together for 7 days, your high school best friend who you are only in slight touch with sends you a picture message of 3 positive pregnancy tests. She got pregnant on her honeymoon, the first time she had slept with her husband. You had been in the middle of checking your Facebook. The couple you had met and enjoyed long talks about pregnancy and trying with on your honeymoon posted a beautiful picture of her, 8 months pregnant and absolutely glowing. a girl you went to school with who has been dating her boyfriend for 1 month posts her gleeful announcement "I’m 7 weeks pregnant!" and your world does go black. You jump up from your chair at work and stumble to the bathroom, trying not to let anyone see your face. You sit down on the toilet and cry, but it is not a relieving cry. It is an empty, hollow, heart wrenching cry and it just make you want to cry more. It makes you want to self-inflict pain to distract from this searing inner pain. It makes you want to scream and curse the God you have loved and followed your whole life. But instead, you get up. You walk to the sink. You splash cold water on your face, fix your makeup, and go back to pretending to be someone you're not. 7 more days.