Friday, March 22, 2013

Babymaking, the Final Frontier

From the moment we begin to even ponder the idea of sex, we are typically perpetually plagued by one overwhelming, overriding fear: pregnancy.
We are constantly reminded: It only takes one time. And there are certainly enough after-school specials to prove it. OK, wait, I dated myself there. There are enough episodes of Teen Mom to prove it.
We spend much of our teenage years and, often, early 20s or well beyond, terrified that we might get pregnant. In college, I had a friend who was worried she might be pregnant because she had fooled around with her boyfriend in a hot tub. (Um, yeah, sperm may be good swimmers, but they're not Ryan Lochte, sweetie.) In high school, one of my friends and her boyfriend would run water through their condoms just to make sure there were no holes.
I had another friend who was so worried about getting pregnant that she and her husband used condoms even though she was on the pill. After all, as the ubiquitous "they" always remind us, abstinence is the only 100% effective birth control.
And then, one day, we decide, we're ready. Unbatten the hatches. Pull the goalie. Take off the helmet. It's babymaking time.
We plan it all out. Let's get pregnant during "x" month and then we can have the baby during "y" month and that will work well because of "x" "y" and "z." No problem. Just a little quick math, subtract 40 weeks, and boom, let the fun begin.
For some, it is that easy. For many, it's anything but. For all those countless cautionary tales, the harsh reality is that getting pregnant is very, very hard, and sometimes the process is anything but fun.
Every month, there is a very tiny window during which a woman can get pregnant. Once a woman ovulates, her egg survives for only maybe two days. A sperm can survive two to three.
Timing is everything. So we buy basal thermometers and keep temperature charts to try and determine when we typically ovulate each month. (Your temp spikes after ovulation.) We buy ovulation predictor kits, some of which cost upwards of $30! (And some of which don’t sell refill strips, forcing you to shell out another $30 even though you already have a strip reader. Bastards.)
For me, predictor kits never worked, so I had the privilege of having blood drawn by my doctor every day to try and determine when I ovulated.
We even go so far as to (TMI alert!) check our cervical mucus, as it tends to get thinner as we near ovulation and then get thicker as we near menstruation. Oh yeah, let me tell you, there’s no greater turn on than telling your partner, “Hey honey, can you see if my cervical mucus is the consistency of egg whites yet?” Meeeeeeeeow.
But here’s the rub. Even if you time it perfectly, you still only have about a 25% chance that the sperm will fertilize the egg. And that’s for a perfectly healthy young couple with absolutely no issues who is actively attempting to conceive and times it perfectly. For someone who is just regularly sexually active, the number drops to 11%.
And for those over 30 or with any fertility issues whatsoever, the number tends to be just as disheartening.
Once upon a time, my greatest fear was glancing down at a pee stick and seeing a positive sign. As my husband and my quest for a baby began stretching on long past our planned baby dates, my ongoing waking nightmare was just the opposite, endless negative signs and/or waking up to find my dreaded “friend” had arrived.
After about nine months or so of actively trying and becoming increasingly discouraged, we sought out a fertility specialist. Babymaking had officially shifted from the bedroom to the examination room, and the fun had gone clinical.
First it was testing. Extensive bloodwork for both. Semen analysis for my husband. An HSG, which is a really fun procedure that involves pushing dye through your fallopian tubes to make sure everything’s flowing as it should. A polypectomy, after an ultrasound revealed a couple polyps that could, possibly, maybe be getting in the way.
Throughout, I secretly wished they would find something wrong with at least one of us. At least then we’d know what was wrong, and maybe we could fix it. But all we got was a frustratingly ambiguous diagnosis of unexplained infertility.
Next began the treatments. My endocrinologist suggested trying metformin, as he thought maybe I was demonstrating some signs of very mild polycystic ovary syndrome (PCOS), though I had no ovarian cysts. Fun side effects included a few weeks of cramps and becoming close with my toilet as my stomach adjusted to the medicine.
Then came our attempts at IUI, intrauterine insemination, or basically a turkey baster approach with supercharged semen, scrubbed of all impurities and lazy swimmers, coupled with clomid, or basically speed for your ovaries, forcing them to churn out a few extra eggs.
Each month, we hoped anew, but each month, that hope became more and more difficult to muster and the results more and more heartwrenching. I couldn’t help but perseverate on one thought: What was wrong with me? I was convinced it was my fault, and I simultaneously loathed and pitied myself for it.
Each failure made it more and more difficult to appreciate others’ successes. A friend told me she and her husband were starting to conceive. The next month, they celebrated. My brother and sister-in-law announced the impending arrival of their second. I congratulated them and ran to the other room and sobbed.
I couldn’t help it. Rationally, I could appreciate their happiness, but I just couldn’t truly be happy for them. I was too jealous, too frustrated, too angry, too mired in self-pity. Why would God make this so difficult for us? I knew that we would be wonderfully loving and giving parents, how could he make this seem like such an impossibility?
After two rounds of IUI, we opted for IVF, and in this, I feel incredibly blessed. One, that science has evolved such that these processes are available. Two, that my job afforded me insurance that would pay for almost all of what is an incredibly expensive procedure.
The process itself certainly takes a lot of the fun out of creating a baby. First, there’s the two-and-a-half hour lecture/Q&A and the three-hour class that provides all of the how-to’s of IVF. Then there are the initial daily shots in the abdomen, on some days both in the morning and afternoon.
Next, the surgical procedure to retrieve the eggs and the transfer a few days later, provided there are positive results with the retrieval and fertilization. Then, the really fun shots begin, the daily doses of progesterone suspended in nice, thick oil, administered slowly with a syringe with a lengthy needle.
In truth, the whole process actually wasn’t all that bad. I didn’t react to any of the medications, and a little ice on my tushie helped with the progesterone shots. Plus, I earned one of my more colorful nicknames: Auntie Bum-Bum.
My husband was in India for the first two weeks of my progesterone shots, which you can’t administer yourself, so my brother and sister-in-law were stuck sticking me. They would also redraw the circles on my butt that indicated where to stick, though my brother sometimes took the term circle a bit liberally and got a bit, um, creative. My nephew was fascinated by the circles and thereby dubbed me, for quite a few months to come, Auntie Bum-Bum.
I was also blessed in that I worked with the UConn Center for Reproductive Services. For anyone seeking out help, I cannot say enough wonderful things about Dr. Engmann or any of the staff at the Hartford or Farmington offices. Beyond being skilled, they are genuinely caring and empathetic.
It also helps to know that we’re far from alone in our experiences. Countless friends and acquaintances have struggled in much the same way and have shared their stories. Many also conceived through IVF, and many with the same doctors.
There are times when I’m a little saddened that I’ll never experience that classic TV show moment where the couple huddles expectantly over the pee stick and suddenly erupts into tears of joy after seeing the positive sign slowly appear or that our conception story is not exactly romantic.
But more than anything, I am incredibly thankful. Our story is one of trials and tribulations, but ultimately one of triumph and love. Our heartache and frustration were temporary, and for that I feel blessed. I know that not everyone is so lucky. My heart goes out to those individuals, and I hope that they are able to build their families through other means. Everyone deserves the opportunity to experience the overwhelming emotion of being called “Mom” or “Dad.”

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