Tuesday, September 18, 2007

The Beginning

Well, today we started the "process." By that, I don't mean that today was the day that we started trying to conceive (far from it). Instead, today was the day that we finally saw a doctor to find out why it's not happening, and what we can do about it.

The story so far:
I went off the pill in September of 2005, after being on it for the better part of 10 years. I don't really remember when I started taking the pill, but it was somewhere around 1995, when I was about 18, not because I needed birth control, but because my cycles had always been so irregular. My gynecologist told me that it was unhealthy to have as few periods as I was having (he said something about uterine cancer, which may have reflected medical opinion at the time, but is not generally thought to be a big risk anymore). The pills were just supposed to regulate my cycles. Ever-worsening migraines eventually made me bounce from one pill to another, hoping to find one that wouldn't leave me in agony for two weeks every month, before eventually stopping them all together sometime in 1998. Off the pills, my cycles resumed their original weirdness, being extremely unpredictable but typically lasting 60+ days. My doctor at the time told me that it was okay to have fewer periods, but that I may have trouble conceiving a child some day. I took this news with a shrug -- I was barely 21 and still in college, certainly not worried about having kids. I stayed off the pill until 1999, when I decided that I *did* want them for birth control (you know, just in case - ha!) and finally had a gynecologist who knew what he was doing and could prescribe one that was better for migraine sufferers.

I stayed on those same pills until 2005, when my husband and I decided that we were ready to start a family. We both knew that it might take a while, but didn't expect any *real* problems. Months earlier, my friend K had recommended the book "Taking Charge of Your Fertility", which had helped her to understand her similarly irregular cycles, and I had dutifully bought a thermometer and tracked my temperatures for a few months while still on the pill, just to get in the routine.

Off the pill, my cycles once again reverted to their natural state. My first cycle off the pill was a respectable 35 days. The next one was over 70. My temperatures were spiking the way they were supposed to, but they were highly variable and abnormally long. After a year of blissfully having lots of sex and taking daily temperature readings, with no pregnancy, we decided to be more proactive. I started charting my cervical mucuous, which I had resisted doing when I thought I wouldn't need to know the *exact* day, but which now I hoped would help me to make the most of the measly 6 cycles I have each year. My charts now showed my mucuous "peaking" every 4-5 days, then disappearing again only to peak again... every week, convinced I was about to ovulate, we would have night after night of sex (normally enjoyable, but with the added pressure of *having* to do it, constantly, it was a bit of a drain)... and every week, the mucuous would dry up, my temperature would stay low, and we would start again a few days later. Since the mucous peaks when I ovulated and the ones when I didn't looked the same until several days later, we had to assume that each peak was going to be the real one. And for each one, I got my hopes up, calculating eventual due dates should that time be "it." Each night after sex, S. would kiss me and say, "Just think -- we may have just conceived our child!" I admire how he kept up enough hope to say this month after month.My charting got more obsessive, and we started to look for other things we could do to increase our odds. I cut out alcohol and caffeine, with the unfortunate side effect that many of our friends assumed that I was already pregnant, a painful thing to have to disavow your friends of when you really are desperately trying. I made S. switch to boxers. I started using ovulation predictor kits, an expensive habit for someone with highly variable cycles, since they come in packs of 7, but I often needed 3 or more packs for a single cycle. I elevated my hips for 15, then 20, then 30 minutes after sex. After reading an article that Advil and other painkillers can prevent conception, I stopped using painkillers, suffering through my usual migraines without any relief.

By the summer of 2007, I was done being blissfully hopeful. Almost every single one of our friends was pregnant or had small children, and after each happy announcement and baby shower, I came home and cried. We had told only one friend, back in November 2006, that we were trying to conceive. The rest of our friends, and all of our family, assumed that we weren't. Over this summer, they all decided that they needed to convince us of why we should have children. I dreaded being constantly asked how it was going if they knew that we were trying, thinking that this would just add to the pressure (and I really didn't think I could handle the suggestions, comments, and pity that would inevitably come once they all found out we were having trouble) so instead, we had to just grin and bear all of the comments about what great parents we would be -- don't you want to have a kid yet??? Particularly hard to deal with were my in-laws, who desperately wanted to be grandparents, and didn't hide their belief that the only reason we didn't already have children was that I was selfishly focusing on my career.So, we decided that 2 years would be it. If we weren't pregnant on our own by September, we would make an appointment to see a doctor. I ovulated in August, our "last chance" to do it on our own. For the two weeks between when I ovulated and when my period confirmed that I still wasn't pregnant, I did obsessive research on the web. I read about different kinds of fertility treatments. Advantages and disadvantages of each. What kind of doctors I could/should be seeing. What types of therapy are typically tried first, and how often they succeed. What drugs are used, and for what. I read blogs about women dealing with infertility. I made lists of questions to ask the doctor. I researched our health insurance to see what would be covered, and how much we could expect to spend on our own under different scenarios. All of this I did while whispering, "just in case," and wondering how far we would really be willing to go in order to get pregnant.

So, today we started the process. We haven't made any decisions about we will eventually be willing to do, should each progressively complicated technique fail for us. Instead, we've agreed to take it one step at a time, seeing how each thing goes, and seeing whether I want to put my body through whatever the next thing is. For now, we just keep telling ourselves that we just want to know "what we're facing." We're hoping that it has a name, so that the doctor can say, "Oh! You have X! Here's the way to get pregnant that works for people with X!"We met with Dr. M. this morning, and he described the first several steps of the process. The tests on me need to be done at particular times in the cycle, so I'm starting on progesterone in order to force my period to come soon, rather than waiting 2 months for it to happen on its own. S. will do the usual blood test and sperm analysis in the mean time, so that we can hopefully rule out any problems from him (my weird cycles should be enough for us to deal with, I think). Since my cycles are so long, one of my problems (hopefully the only one, but we don't know yet) is clearly ovulatory, so I will take Clomid during this next cycle, to try to encourage my body to have a more predictable cycle. I'll be monitored throughout that cycle, so that they can see whether I'm really producing any eggs. Then, we'll discuss a game plan for actually fertilizing 'em.

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