When I was a teenager, I imagined I would be a young mother. I would have a baby in my early 20s, and every day I would sit in the sunshine by the ocean and breathe in the salt air. I would love every moment of having a baby inside of me, and I would never be lonely.
Things don’t always go the way you plan. I started my fertility journey at 33, the same year El Nino brought floods to Southern California — floods that made sitting by the ocean hazardous.
I’d been married three years earlier, and my husband and I had stopped using birth control immediately. An ectopic pregnancy years before had resulted in the loss of my left fallopian tube. I’d been told that this wouldn’t affect my fertility but, try as we might, nothing happened. Being a nice Jewish girl, I assumed it was my fault. I thought I was being punished for getting pregnant at 17 and for not having being in tune enough with my body to know I was pregnant, let alone that there was something seriously wrong. The half-life of guilt approaches that of uranium.
Fortunately, I have a very warm and comforting obstetrician. Dr. Warm suggested a complete work-up for both my husband and me. I had hormone tests, ultrasounds, a hysterosalpingogram (an X-ray), and a laparoscopy (a small telescope inserted through the navel). My husband, on the other hand, had to pleasure himself into a little cup.
One day I came out of a therapy session (where I’m sure I was lamenting my inability to conceive) and spotted my husband waiting for me in the parking lot. His head was down as he leaned against my car and told me he had a low sperm count. Now we both had to deal with guilt. Were his sperm lazy, weak, and deformed because of years of smoking grass? Jamaicans can keep their island populated despite the popularity of that drug. Was it the mumps he had as an adolescent?
Regardless of the cause, two things would happen now: we would both give up all our vices (including the ones that seemed benign, like caffeine) and my husband would share in the humiliation of having his genitals examined.
I went with my husband to the urologist. Fair is fair. He was by my side for every test I had to go through. Once again, he was given a little plastic cup and an Express Mail envelope crammed with girlie mags, and was shown to a private room. I was allowed to keep him company, and we determined that “Celebrity Skin” and anything featuring lesbians were the most popular magazines.
The urologist thought my husband might have a varicocele — a varicose vein around the testicle that keeps the temperature too high for sperm survival, easily corrected by surgery. A trip to a specialist ruled it out though. Although everyone knows about keeping the testicles’ temperature down, it seems there is really little to be done for the “male factor.”
Dr. Warm suggested intrauterine insemination (IUI), a process in which at the optimum moment of ovulation, the best sperm are inserted into the uterus. We eagerly agreed, feeling renewed hope. We were living clean, safe lives. We believed in technology. We felt we would be rewarded.
For five days, I took Serophene, a hormone pill designed to stimulate egg production. Two weeks later, I got a shot of hCG (Human Chorionic Gonadotropin) to drop the eggs. My husband did his thing in the cup. The lab “washed” the sperm, removing the misshapen and dead ones along with most of the liquid, to create sperm concentrate. After the wash, I was given a syringe of the freshly laundered sperm and told to keep it warm until we got to the doctor’s office.
Clutching a tube full of sperm inside my blouse, we raced to the doctor’s office. Once there, he used an instrument remarkably similar to a turkey baster to insert the little swimmers. It was, to say the least, unromantic.
The twelfth day after the insemination, a nurse drew my blood for a pregnancy test and said to call around 4 p.m. for the results. I stayed in bed, trying to distract myself with soap operas. My husband and I gathered around the speakerphone at the appointed hour, clutching hands. The nurse gave us the report but I couldn’t hear her because just then, the speakerphone cut out. I asked again and all she said was, “I’m sorry.”
The pain was excruciating. I felt like a failure. I was consumed with anxiety at having missed an opportunity. The percentages (a one in five success rate) led us to go through several more IUIs, but something was gone. We had lost faith. Our familiarity with the process made it easier to deal with, but we would no longer expect positive results. After three IUIs, we did not even go in for the blood test. We just waited for my period. Those periods, when they inevitably came, seemed almost vengeful.
After six cycles of hormones and four failed inseminations, we needed to move on. Reluctantly, we left Dr. Warm and met with Dr. Cold, a leading doctor at a prominent Southern California fertility clinic. He was a humorless man, utterly lacking in bedside manner. (This temperament is not unusual in this field. As the doctors themselves are quick to point out, they can’t get too involved. They’re technicians, not therapists. It’s about the numbers, not the drama.)
Dr. Cold explained the procedure. I would receive a series of injections (from my husband!) of Lupron to shut down my system, creating a situation much like menopause. Then, another series of injections (Fertinex) would stimulate egg production, after which I would go into the hospital and doctors would harvest the eggs. While I was getting the eggs sucked out of me, my husband would once again pleasure the cup. Then, through Intracytoplasmic Sperm Injection (ICSI), each viable egg would have a premium sperm injected into it. Doctors would watch the cells divide, take the best embryos for implantation two days later, and freeze the rest. Because the egg retrieval would deplete my hormones, I would replenish them with more pills and injections (progesterone) while waiting 13 days for the results. Oh, and each cycle would cost the equivalent of a small car. We decided to take some time off from the fertility roller coaster.
Ten months later, with the blessing of a health insurance policy that covered up to $25,000 of fertility-related expenses, we were back. The best thing we did was take that break. We came back with renewed hope and began the in vitro experience, a.k.a. my pincushion period. I was having blood drawn on a regular basis by a lab technician I dubbed The Mosquito. I had started a twice-weekly acupuncture program, part of my new determination that also included a vitamin regimen and yoga classes. And finally, I began receiving daily injections from my husband. Lupron, the hormone suppressant, is injected with a small, thin insulin needle.
Three weeks of Lupron made me meaner than a junkyard dog. I felt menopausal, empty and dry, unable to concentrate. It was during this time of acute irritability that I discovered that everyone has an opinion about infertility and is eager to share it. My acupuncturist said my poor diet prevented me from getting pregnant, though my diet was, in fact, quite balanced. A neighbor advised, “If you just relax, you’ll get pregnant.” Even if this were the path to pregnancy, how was I to do it? Didn’t they think I wanted to relax? I found myself focusing on couples who’d adopted, and on childless couples who seemed happy. Still, I wanted to raise a child. That was the goal, and while adoption was not out of the question, I didn’t want to miss out on the earliest bonding experience. So, we stayed on our path.
After my hormones were properly suppressed, I graduated to the twice-daily injections of Fertinex, a complicated procedure that involves mixing two vials of powder into one vial of liquid, then switching the needle on the syringe. Fertinex stimulated egg production and, after weeks of Lupron, this drug felt like heroin. I was my old self again. In fact, I was Wonder Woman!
Every few days I would have blood taken by The Mosquito, then see the doctor for an ultrasound exam with the wand we called the “dildocam.” Luckily, I produced eggs like a hen. There were so many big ones that I almost looked pregnant. Then came the mother of all shots, the hCG injection, which was administered with a huge needle and had to be given at midnight, exactly 12 hours before egg retrieval.
That night, I made an audiotape of sweet nothings for my husband. (We felt that I should be there in voice and spirit if we were making a baby.) The next morning, while I was given a sedative and wheeled to the operating room, my husband took my tape and a plastic cup into a private room. Dr. Cold was late, but the retrieval went well. I had two dozen eggs. I was told that Dr. Cold would be out of town three days later when the implantation was scheduled, and that a colleague would perform this procedure. Had I known how precise the procedure for implantation is, I would never have let a doctor who had never examined me do it.
I called the hospital every day to see how many eggs fertilized and how they were growing. Twelve fertilized well. Doctors allowed four embryos to continue growing and froze eight. On implantation day, we got to the hospital and I was given a Valium. The embryologist arrived, showed us the embryos under the microscope, and gave us photos of what we’d just seen. Baby’s first photograph.
I was told the implantation of the four embryos would, at worst, be as mildly uncomfortable as an IUI. In fact, it was the most painful thing I’d ever experienced. The Valium had no effect. I was crying out in pain, gripping my husband’s hand almost to the breaking point. It turned out that a crucial procedure called a mock transfer, which allows the doctor to create a road map in advance to ensure a smooth delivery of the actual embryos, had somehow never been performed on me. Therefore, the substitute doctor, Dr. Cow, as we came to call her, was unaware that my cervix is tilted and just tried to brutally muscle her way in. Though we didn’t know it at the time, there was no way a fragile embryo could attach in such a pain-ravaged environment. I went home and endured daily shots of progesterone, an oil-based substance that goes in very slowly, then basically stays in one spot — by far the most painful of all the injections.
After two weeks, we went to the lab at 8 a.m. for the blood test and went home to wait for the doctor’s call. We were told that the results would be in by 4 p.m. I remember someone telling me that they call the people with good news first, and my phone didn’t ring until nearly 5 p.m. A nurse gave us the bad news. I was shattered. I wanted to talk to the doctor but he refused. When we finally saw him, days later, he had the audacity to say he didn’t call because, and I quote, “I get depressed, too.”
Though my demand for an apology was never met, and my request for financial restitution for the botched cycle ultimately resulted in a measly $125 discount on the next cycle, Dr. Cold knew that his failure to perform the mock transfer was a serious enough lapse to merit a lawsuit. From then on, I was handled with kid gloves.
We agreed to go through an extra month of progesterone injections (three in all) to make the uterus hospitable for the implantation of the frozen embryos. I began seeing a Chinese herbalist, who put me on a strict no-sugar, no-spicy-foods diet and had me drink an odious herbal brew three times a day. I started yoga with a Hindu Sikh who specialized in fertility issues.
My hope had faded. I was worn down. My husband and I decided that this was it. No mas. After we used up the frozen embryos, we would not do this again.
Five embryos survived thawing and Dr. Cold would implant them all in one last try. We arrived at the hospital with pictures and scarves to decorate the room, and Billie Holiday for our boom box. My husband read Rumi, my favorite 12th-century Sufi poet. The nurses brought in a small statue of a fertility god. This time, the procedure went like clockwork. I went home and rested for several days.
I was still too afraid to get my hopes up. We continued with the shots. My butt was sore and bruised. I drank my herbs and dutifully went to yoga to meditate. But my mind was not quiet. I calmed myself by thinking of the next steps. We could go to an orientation on adoption. We could travel to Europe. We would have no ties.
The night before I went in for the blood test, I took a home pregnancy test. The nurses had told me not to do this because of the high incidence of false negatives. We looked at the urine-soaked stick and saw a faint positive line. Could it be? We refrained from getting too excited. We took another test the next morning before seeing the doctor. We got the same nebulous result. There was a very subtle blue line.
On our drive to The Mosquito, I saw a pregnant woman outside my car window. Could this be a good sign? I still couldn’t get my hopes up. We told the nurses of our vaguely hopeful result on the home pregnancy test. They almost seemed to squeal with excitement. I was still having no part of it. I wanted to, but I couldn’t afford to raise my expectations. We went home and lay in bed until noon, when Dr. Cold called. I had a split second of hope knowing that he was calling me first — or was it just my threat of a lawsuit that made him attentive? All he said was, “Congratulations.”
I was pregnant!
For the first three months, I endured progesterone shots and took estrogen pills. I had a terrible rash from the hormones and morning sickness all day long. All that aside, I am in my fifth month now. I received the results of the amniocentesis a few days ago. I wept with joy when they told me I’m carrying a healthy girl.
We’re going to call our daughter Hope.