Thursday, December 23, 2010

If I was smart, I'd've bought stock in the company

*edited to fix the preg test day count

This is going to be a rambling post. I have a hard time being succinct about reproductive issues. I have so much to say and it is not a topic that I can filter easily. Bear with me.

I've spent hundreds of dollars on pregnancy tests. No joke. When you're infertile and you never get your period, Preg Testing happens... frequently. Very frequently.

In the beginning, it totally makes sense. You've been off the pill for a month. You don't get your period. So you test. Negative.

Negative, negative, negative.

Then you go one step further and buy the ovulation kits. Now if there's anything more expensive than preg testing, it's ovulation testing, because the levels of hormone they are designed to detect vary considerably through the day, and your chance of catching the peak can be slim. So you end up testing quite a bit.

In my case, you test several times, the ovulation predictor kit (OPK) says WINNER, you wait two weeks, don't get your period, get all excited, preg test, see that it's negative, then do another ovulation kit and vaula -- look, you're ovulating again! Amazing. Repeat ad nauseum. You decide you must be ovulating every 7-10 days. You must be super fertile! Tee hee hee.

And then you go to the doctor (many, many times), finally have the right blood tests ordered, notice that your LH to FSH ratio is a whopping 7 to 1 with a few other hormones through the roof, google yourself into a coma, and months later get the doctor on the phone to finally, officially, answer in the affirmative when you ask: "Do I have PCOS?". Duh. And then have her suggest you go on the pill to regulate your cycle.

(Glad she remembered it was an infertility consult.)


I've taken a lot of tests, pee-stick variety and otherwise. Our house was always littered with sticks. And my veins are getting slightly mangled. I had to have blood drawn the other day, and the phlebotogmist took one look at my left arm, frowned at the scar tissue, and asked if she could see the other one. I tried to add it all up and realized that in the 9 months that I was treated by the Big Guns Infertility Doc, I had something in the range of 50 needles inserted into the crook of my elbow, maybe more. Ouch.


There are many things I still feel resentful about, when it comes to my infertility. Much of my bitterness has faded, and we were so fortunate to become pregnant relatively quickly. Once we got to the Big Guns Doc, we had wonderful medical care. We gave birth to a healthy, happy baby... I'm not a religious person, but God, it's a miracle, it's such a miracle. The technology, the care, everything... it's just incredible that Jack is here. I am grateful for all of these things, yet I still know that the pain of my experiences will never fully recede. I am a member of the infertile world, and here we have a generalizable truth: infertiles are denied so much potential happiness.

One of the things I feel most bitter about being denied is the ability to be surprised by a pregnancy test. I never pictured what my wedding would look like, but I did picture what a positive pregnancy test would look like... I pictured a monumental moment, a shock, a realization, a permanent and sudden change.

Pregnancy tests ought to be cut and dry -- you either are you aren't -- but we lost the chance for things to be cut and dry a long time ago.

When you are undergoing fertility treatment, they often give you a shot of human HcG to trigger you to ovulate. HcG is the hormone that preg tests detect, so if you test in the 10 days window after the trigger shot, you might get a false positive, until the artificial HcG fades away and the embryonic HcG takes over. One cycle, I decided to test until the line went away. I was so sure that I would be pregnant. I figured I'd watch the line go away, and then it would be glorious to see that line get darker and darker as my pregnancy grew.

Well I didn't get pregnant that cycle and watching that little line go away was one of the most fucking depressing moments of my life. I don't recommend it.

Still, I learned that by day 5 or 6 post trigger, I'd be in the clear for preg testing.

Unfortunately it's not just about the trigger, though. There are ectopic pregnancies and chemical pregnancies and missed miscarriages and vanishing twins... There are beta values to be drawn, progesterone shots, injections and injections and ultrasounds and measurements and... worry, fear, pain.

During our IVF cycle -- the cycle that resulted in Jack, I waited 5 days after embryo transfer (10 days post trigger, 3 days post potential embryo implantation). I couldn't sleep that night. I think I woke up every hour. Finally, at 6am, I gave myself permission to preg test. There was a faint line.

I crawled back into bed.

"Well?" Said Greg.

"There's a line" Said I.

And we both knew what that meant: hope, and possibility of crushing disappointment.

It would be a while before I felt sure of my pregnancy. There would be many more preg tests, much posting to my online IVF support group, much worry and bleary eyed comparison of increasingly dark lines, values being reported back from the lab, more googling and calculation of doubling times, ultrasound results and tears and then happy news. Eventually I would feel fully and completely pregnant, but it would take months.

For some reason, I felt pregnant last week. Maybe it's my PCOS flaring up again, but I had some symptoms and I just... I just needed to test. In the minute or two before I had the results, I had a silly little dream enter my head. I imagined the test was positive. I imagined putting the test in a box, wrapping it up as a Christmas gift, and I imaged the happy news greeting Greg on Saturday morning. I imagined what his face would look like when he saw it. I imagined what my face would look like when I knew my body did something amazing. I imagined what it would feel like to not be an evolutionary dead end. I imagine something incredible: sex begetting baby. I imagined surprise and mystery.

Of course yesterday's test was negative. And I'm fine with that -- I have no wish to be pregnant right now, and I won't be upset to go through another or several other IVFs if I have to. Going through IVF was far easier than not being pregnant. But I know if I do it again, there will be apprehension and worry and the possibility of crushing disappointment and as I imagine this process... the feeling of trauma returns to me and I scurry into the tiny, protected corner of my brain, the part that knows with certainty it will not work, the part that cannot be hurt by continued failure.

So, while I feel the edge of (past? impending?) trauma, I also can't help picturing the other possibility. The other Rachael. The non-bitter, non-cynical one. The one who doesn't hate her reproductive self, hate her screwy hormone and lacking femininity. I can't help picture a pregnancy that I could feel confident in. I can't help picturing the awe and beauty of conception occurring in my own body.

I know that Rachael can't exist anymore. But the preg test yesterday made me imagine her for just a moment.

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