Tuesday, 20 August 2013

Ouch my ovaries hurt!

It seems like cruel torture that I can't un-know everything I've learned about tracking my ovulation. For the second month in a row, it's my left ovary that is massively swollen and aching. Last month it hurt for three days before ovulation. This month it was just really swollen and painful for one night (and starting to ache again today). We watched a documentary and something absurdly funny happened, and laughing HURT! In my ovary! Which was also funny since we were watching a documentary on the G-Spot!

I peed on my last ovulation predictor strip last night. I was saving it, in part because there was just one and if I tested too early and it was negative then what? Well, it was positive, but again, not very meaningful since it was the only one I took. I don't know if I was early in the lutenizing hormone surge, midway, or late! Anyway, it's gone. I just wanted to use it up.

Now I wish I would just hurry up and ovulate so my left ovary will stop aching. I mean seriously, it really hurts! I used caster oil packs every second day for about a week, in hope that I can naturally clear the blockage (I've got nothing to lose at this point), and I think the proximal blockage was on the right, so I hold on to this shred of hope, that just maybe it will happen. Meanwhile, I wait for ovulation to actually happen, feel grumpy and cranky and tired. I need to get out for some exercise. And I'm out of bananas. I wish I could be a fly on the wall at the fertility clinic, hear my case discussed, get some sense of when I'm going to get that consult. I'm going bananas. There was a time when I didn't know what this ache was, and that it will be soon followed by aching breasts. These things happened but I didn't pay attention and didn't know what it meant. And life was good.

Monday, 19 August 2013

What's going on in there?

When I was pregnant, I didn't feel my baby kicking until an ultrasound tech said "do you feel the baby kicking? she's kicking right now". Oh, that's what that is? So many things going on in there, most of it digestive functions, I didn't know how to tell the difference. I needed it pointed out.

Over the past year I've become more and more in tune with various sensations. But I'm not always confident. I think I've got gas figured out. I think I've got my ovaries figured out. Today, my uterus seems to be up to something, but I can't tell what it could be, that's the biggest mystery. Unless it's my bladder playing tricks on me. Hello in there, what's going on? I wish I was a trained ultrasound tech or radiologist and could just scan myself and take a peek. I wonder if they do that? I bet they do.

Thursday, 15 August 2013


So far today I've eaten cake and not much else. This may or may not be an improvement over yesterday, when I was eating the frosting direct from the can. Not my best days. And not helpful behaviour, I know this. Comfort eating gives short-term comfort and long-term pain. I know what I should do, but keep coming up with excuses. The current level of stress, anxiety, and uncertainty in my life... it's a wonder I can keep my cool when the phone rings and I get excited only to hear "Max" offer to clean my ducts again.

Being on the brink of depression seems like par for the course when it comes to infertility. There are many days when I don't want to bother showering, getting dressed, brush my hair, when I don't feel like "doing" anything. Days when I don't have any interest in eating. Days when I feel an overwhelming urge to binge on sweets or junk food. Days when all I really want to do is curl up in bed and cry. But I can't do that. I have to carry on. And this is how I cope, what I know I have to do to keep from falling into that pit.

1. Recognize the signs.
Some of the signs of depression have to do with change. Change in appetite. Change in sleep. For someone who has been trying to conceive for a long time, changes in appetite and fatigue were also "early pregnancy signs" that you learned were just hormonal responses to ovulation. It's the progesterone. That late luteal phase pms may also hit you at the same time you start to despair that yet again this isn't your month. Whammo! Time to nip it in the bud.

Another sign is loss of interest in the things you usually enjoy. It's a double-edged sword. On the one hand, the things you usually enjoy might be what keep you sane. That you let them slide is part of the problem. You need to kick your motivation into high gear and make yourself enjoy it again. Or do something else, anything else, to get some joy back in your life. If that fails, move on to step 2.

2. Exercise is a mood enhancer.
Go ahead and google it if you don't believe me. There are literally thousands of medical studies showing reduced depression symptoms in various patient populations following a wide range of exercises, from low impact meditative exercises like Tai Chi and yoga, to more intense cardio. It also enhances cognitive functioning. Often my excuse not to get the exercise I desperately need on any given day is that I have high priority desk work to finish. But if I just took a nice long break and exercised, I'd get through it more efficiently when I come back to my desk! I just did this today, and it really did help. I was pretty down in the dumps (I ate cake for breakfast and lunch, remember). I was getting mentally sluggish, but I forced myself to go for a nice walk, and now I'm feeling better. Not as great as if I'd gotten my...

3. Vitamins.
If I'd eaten more fruit and veggies today I'd be feeling even more alert, energized, and my mood would be better. I swear by a banana a day to keep my mood at it's best. But I also take a B6/B12 supplement. Of all the vitamins I've taken during this fertility journey, that is the only one I took for non-fertility benefits. B6 is not water soluble, meaning you don't just pee out excess; I stick to a maximum of 100mg/day.

Sometimes the circumstances that cause us extreme stress and give us plenty to be depressed about are beyond our control. So we have to do our best to keep our bodies and minds healthy to get us through the storm. Eating healthy and exercising are a good start. Stress, anxiety, and depression can also tempt us to engage in unhealthy behaviours - comfort foods, smoking, alcohol... these things might feel good and helpful in the short term but it's an illusion, they all leave us worse off and prolong or worsen the depression. Life sucks sometimes. Acknowledge it, give yourself a few minutes to experience the sadness, but then you have to pick yourself up and carry on!

Wednesday, 14 August 2013

Seeing Red

My inbox tends to be full of junk. Junk I subscribe too, but junk nonetheless. Too much of it is baby crap, or related online shopping crap. I should unsubscribe or flag it as junk but I'm not ready. I still cling to hope that I might want to buy something else from early-pregnancy-tests.com or babysteals.com but the regular reminders that I'm not pregnant and nothing they sell can fix that is something from which I soon will need a break. And gap.com - I really only need one deal a week, if that, we all have too many clothes, every closet in my house is stuffed.

But this was just too funny. I check my email and there is the regular (luckily not too regular) email from early-pregnancy-tests.com (FYI - shipping to Canada takes way too long and not worth it to save a few bucks on test strips). The email advert included the following:

"Well, researchers have found that the color of a woman's clothing may also be a fertility indicator. Women are more likely to wear red during their most fertile period, and men usually find women in red more attractive. Men are even more willing to spend the big bucks on a date when you wear red!" 

And why is it funny? Because with no thought put into it whatsoever, I grabbed a red t-shirt this morning. And my cervical fluid is screaming for Barry White and that bottle of Rosé in the fridge. Plus, it's our anniversary and we're going out for dinner. I guess I should wear the red dress tonight, not the black. And here is the actual research study, if you like reading that sort of thing (I know I do). It's an easy read, and a simple design. I can also easily think of improvements to the design, but the numbers are pretty striking. I could probably do a quick replication over on my ttc forum.

So, what are you wearing?


This morning I had my long awaited ultrasound. It was far more comprehensive than I expected, but I'm glad (not sure what they're looking for on my kidneys, but at least they are both where they should be). As usual, the lovely tech (who is very lovely because that was very warm belly jelly) couldn't tell me anything about what she could see or couldn't see, aside from the fact that my c-section scar will remain visible on the scan until my womb is as dusty as an egyptian tomb, and the blood flow to my right ovary is so fantastic I could hear my heartbeat! It didn't occur to me until I got home that I could have asked for a picture, although I'm not sure what I'd want to see. I don't really have the trained eyes to see anything meaningful if there is no baby. So no answers today, just more sit by the phone and wait. After an HSG though, internal ultrasound is downright pleasant, nothing but warm and fuzzies!

Ultrasounds can be torturous though. First there is the whole "arrive with a full bladder and then sit there and wait, trying not to burst" thing. On top of that though, when it's an ultrasound for infertility, sitting in a waiting room full of pregnant ladies is also torture. Plus they give out number cards in random order just to mess with you. Everyone else is there with a support person, sometimes with toddlers in tow, which is something I don't really understand. I guess they needed the support person there more than they needed the support person to watch the kids at home.

Tuesday, 13 August 2013

Support for adoption

Shortly after I began trying to conceive, I joined online communities. At first I would just read all these posts and answers. And then I began participating. Whenever you google "is X a pregnancy symptom" you get these forums. Why? In part because search terms we use as laypeople is not the medical terminology, so we don't get the medical literature (when I want medical I go to pubmed.org). For about a year I played the symptom spotting game with other members of the ttc community, but then they would get pregnant and go away and I'd be left feeling very old and cranky and sad. I started visiting the fertility treatments forums, but as I wasn't being treated for anything, and still not, I didn't feel like I belonged there either (although they helped me to know what to expect). But then I started perusing the adoption boards.

What are the adoption boards like? Well, strange. There are many things happening on the adoption boards. There are prospective adoptive parents looking for support or with questions about issues or concerns from their perspective. These can range from sadness about an adoption falling through, or behaviour challenges in an adoptive child with an attachment disorder or a disability. There are young women considering giving up their child and still on the fence or wanting to know where to go and what to do. This combination - the pregnant mom and the prospective adoptive mom brings about the creepiest of posts - the too-much-information-please-pick-me audition. I call it creepy because the moment a young women posts that she's thinking of putting her baby up for adoption, there is this vulture-like response of "I'll take your baby!"

I get it. I really do. My gut says the same thing, but it's still creepy. I'll be going through extensive screening. Social workers will "match" a child to our family. I can only imagine how frightening it is for a young woman to go online and ask questions only to be leaped on by random strangers who want her baby. It's all I can do to keep from doing it myself, but I know the helpful thing is not to volunteer myself but to share the relevant information. And the most relevant information I can share, is that you need to get information relevant to your jurisdiction, your community even. I can dream about some random pregnant teenager reading my posts and deciding I'm wonderful and wanting me to raise her baby. It's not going to happen like that. I'll complete my intake, home study, and PRIDE training. Then I'll wait for a call. It's going to take time, but I'm patient.

The third group that live on adoption boards are those with adoption-gone-wrong stories. They are hurt, either because they were birth moms who were coerced into giving up a baby, or a few were adopted by families that weren't as well screened as they should have been. The board I frequent has a core group of these ladies who are vicious as snakes, biting the would-be adoptive moms and frightening the pregnant ladies. Because of these ladies, I sometimes think there need to be three unique boards to provide support. On the other hand, we need to have this three-way dialogue. We need to hear the concerns of the birth moms. We need to hear the concerns of the adoptive moms. And we need to hear the horror stories so we make sure their experiences are never repeated. There was a recent discussion on assisted reproduction on the CBC Radio programme Line In The Sand. The discussants were bioethicists. One of the bioethicists kept coming back to adoption, and the ethical responsibilities we have towards children that are already here with us on this planet, and the imbalance that exists that makes artificial reproduction more accessible than adoption. In Ontario, 50% of children who are "crown wards" are available for adoption, yet only 9% get adopted.

I know exactly why everyone wants a baby, the earlier the child enters your family the more he or she is moulded to your family. If the placement is before 6 months you have no reason to be concerned about attachment issues. If the placement is before 3 years, the child likely will have no memory of prior experiences, but may have some behaviour patterns. The older the child, the more there are entrenched behaviour patterns. I grapple with this too. But then I grapple with the older child who needs a home and feel just as much a deep desire to make that happen. If you are open, you'll be matched quickly. We don't get to pick our biological children, we shouldn't turn adoption into a shopping experience either.

Wednesday, 7 August 2013

Back to square one...

Update - it was a cruel two-day tease. Back to square one. Would I like a glass of wine with dinner tonight? Yes please! And an extra helping of chocolate.

I used to do something "special" for myself at the end of every failed cycle. A consolation prize. Preferably something I would be giving up "when I'm pregnant next month"... a nice bottle of wine, sushi, smoked salmon, decadent coffee, dye my hair... it's getting old and I've run out of ideas. For the first time though, I'm not sad. My mind wanders instead to never having to give up coffee, or trying that 30 day abs plan I saw online. I think with time I'll come to accept my infertility, even if the IVF opportunity doesn't materialize in time.

Monday, 5 August 2013

My love-hate relationship with BBT

I've been tracking my cycle for about 8 years (or most of my post-pubescent life if you include circling a date on my calendar with a red pen - but I didn't keep those, that was just for month-to-month use). For 7 years I used an online program named "mymonthlycycles" that was good but had the most obnoxious pop-ups. I've printed out the data so I never need to go back. When I started trying this time around I had a smart phone and tried using some apps instead. The first few I tried were garbage, either that or I didn't get the hang of using them properly, but all the data from the first two months entered was lost. Then I made a breakthrough. I discovered Fertility Friend. I had tried basal body temperature charting before, using pencil and paper. If you've never charted basal body temperature, it's based on the basic principle that during the follicular phase of the menstrual cycle, estrogen is dominant and rising as the dominant follicle grows. This increasing estrogen causes other changes to occur that can also be charted - namely to the cervical position and fluid. Then, when ovulation occurs, the follicle that released the egg becomes what's called a corpus luteum, which produces progesterone instead. The abrupt shift from an estrogen producing follicle to a progesterone producing corpus luteum causes an abrupt shift in the basal body temperature, the body's temperature at rest. The role of progesterone is to prepare the body for pregnancy and it's also to blame for all those fun pms symptoms and early pregnancy symptoms we can't distinguish from pms symptoms. So when charting, you look for a series of lower temperatures followed by a series of high temperatures. The last day of low temperatures is the most likely day of ovulation.

I was charting before I conceived my daughter, but ironically not the month she was conceived. To make a long story short, we were going camping and I didn't want to bring it with me so I didn't bother. Fertility friend had a great online tutorial that helped me get back into the practice, and by entering the data in the app, all the guesswork was taken away. It was so easy. I just set my alarm, enter the data, and voila! It took no time to pin my ovulation day and know my luteal phase length. Then came the first time I was "one day late" and the temperature was still high. It came on month 6. I had one day of serious excitement followed by devastation. Instead, I had to accept my luteal phase had a margin of error. Two months later the same thing happened, high temps for one extra day (from 12 to 13, and now 14). What the heck, right? I was going crazy. I thought my pregnancy tests were defective so I went to the store and bought the premium tests. Still negative. I just didn't get it. Then four reasonably normal but disappointing months. I was truly getting the hang of this charting though. I no longer needed ovulation prediction kits, I knew when it was happening as it was happening. I was in tune with my body. I also didn't need to waste any money on early pregnancy tests, my chart always delivered the bad news with the same temperature drop on the same day. One month, I was even one more day late, but that time the temps were low so I didn't get excited. I didn't know what was going on, but assumed it had something to do with vitamin experimentation. I had mastered the art of temperature charting. But I was determined to keep at it. All that time and effort, I wanted to see my pregnancy chart. I didn't want to stop charting and then get pregnant (although if I thought it would work I'd try).

So why is it a love-hate relationship? I love the sense of control and knowledge it gives me. I know when to expect the cycle end, within a day. I hate that randomly it will throw me a curve ball, give me false hope. I know that the most likely explanations for those two wacky months are either changes to my vitamin regime or a small short-lived corpus luteum cyst. Or the least likely given my blocked tubes - a failed implantation. False starts, as I like to call them, are incredibly common. It's the same reason why not all the eggs retrieved and fertilized for IVF will grow. Some eggs are duds. Some sperm that make it to the finish line are still duds. Some don't come together properly. Most don't make it, and we never know. Estimates are as high as 75% or as low as 40%, but it's pretty hard to get a good estimate.

I love the consistency of most of my charts. I hate the odd-ball charts. You want to read into them. Like today... I'm 13 days post ovulation so I should be flatlined at 36.5 or so. Instead my temperature shot up this morning. I got excited of course and ran to pee on a stick. Negative, no doubt about it. Then I heard number one daughter coughing and realized my allergies, which have been unbearable all summer but vary day to day, might not be allergies (this weekend anyway). The last time I had a cold (Feb - 2-3dpo), my temperature spiked the same. It must be that, right? I have two blocked tubes, that is the only reasonable explanation for such a high temperature so late in the cycle.

And this is what I hate. I'm expecting to see red every time I go to the bathroom today. I don't need a virally-induced temp spike giving me false hope. I love you Fertility Friend, I love the various features in your charting app and on your website, and I've relied on you for more than a year now. But I need to quit you. I put a lot of energy in hopes of seeing a pattern emerge that was different from the rest, one that you would change from a black line to a green and congratulate me on my pregnancy. But with two blocked tubes, that's just not going to happen. I can hold onto hope in the back of my mind that it's a misdiagnosis, that only one tube is hopeless, but I can't fixate on it day after day as I have.

It's also very hard to put fertility challenges out of your mind when you have daily reminders of your cycle day. When you are charting, you have a daily reminder. I would spend hours on the site, and others, obsessing over every sign. Until I get my first IVF treatment, my sanity needs me to move on. If I magically get pregnant when I'm not looking (some call this stop trying and you'll get pregnant - BS if you ask me), I'll be mad that I didn't capture it on a chart!

Saturday, 3 August 2013

Dialogues and Secrets

A lady on one of my fertility treatment message boards posted this link to a beautiful essay about infertility, aimed at helping friends and family understand. Click here to read the essay.

I've had many a conversation, online, about how to discuss infertility with friends and family. Note, all these conversations were online. Why? Because we didn't tell people we were trying to have another child. Like so many, we just assumed it would happen and then we could tell them when one was on the way. I told exactly one friend. We were trying at the same time, both for number 2. Then she succeeded. Month after month she would ask how it was going, if I was pregnant yet. If I felt up to talking about it, and certainly in the early months I did, back when I was stepping up the game, she'd tell me I was trying too hard. Tell me to relax. Kiss my dusty old womb! It's a good thing I wasn't relaxed, that I was charting and knew my cycle inside and out and knew exactly when I ovulated and when to consider myself "late" and knew when something was wrong. I was mad. How dare you tell me to relax. What do you know about it? There is no such thing as trying too hard. You can drive yourself crazy, but you can't try too hard. Knowledge is power. So this is what it was like trying to discuss my failing month after month, with one of my best friends. I'm a pretty patient person, but if I had to listen to such painfully unhelpful crap from people I don't love quite as much, I might have snapped. At least I'm an atheist. I feel so sad for the ladies who think God is punishing them or doesn't think they are worthy of parenting. Or worse, they get that from so-called loved ones. So that's why I don't talk openly about the struggle. I think that is one of the reason so many don't talk about it. Or hide in online forums.

But we need to talk about it. We need an open dialogue about infertility. It's not just about age. There are many many causes, some more treatable than others. When I was young and wanted children but wanted to accomplish other things first, I was painfully aware of the age factor but had some misconceptions. I thought IVF was something "old" ladies did because they waited too long. I didn't know at the time that it's the age of the eggs that matters more than the age of the womb, and that IVF with 40+ year old eggs doesn't have a very good success rate. In general, fertility really doesn't take a nose dive until 42-43. In my late 30s, I still have a reasonably good chance with IVF if the only problem is my tubes being blocked, since my hormone tests all came back great. According to the stats published by my clinic, the IVF success rate for women under 35 was 47%, for 35-39 year olds it was 40%, and for women over 39 it was 18% (2009-2010 data). As I read it, those were success rates per fresh cycle. Very encouraging, although clearly I've got very little time left. But what is also clear is that the vast majority of IVF was among women under 35, nearly 2:1. There are so many causes of infertility, I don't think I could do it justice. My point is that we need to open the dialogue, the public dialogue, about the diverse causes of infertility, and the pain that couples experience. Fertility is sometimes tied so strongly into our sense of what it means to be a women (or a man). When I couldn't breastfeed, it was a huge blow to my sense of what it meant to be a woman. I felt so deficient, and I had such a profound sense of failure as a mother. This is what distinguishes a woman from a man and I failed. Infertility is the same, once again I feel broken, and like less of a woman. It's a devastating feeling. I imagine men with infertility feel the same way, it's why they don't want to get vasectomies even though it's so much easier and safer a procedure than getting one's tubes tied. Nature tied up my tubes without my permission. I'm angry. I cry a lot. I don't know what to do. Because it's secondary infertility, I have a basement full of maternity clothes and baby things that I don't want to give away but I have such a deep fear that they are going to waste. I loved pregnancy. I want that again. I want to be able to talk openly about my struggles. But I can't. I'm afraid. It's intensely private because it's also about your sex life with your partner. And don't get me started on how it can ruin your sex life (I'll save that for another post).

I need a few more people to lead me out of my closet. I'm not brave enough yet.

The big decision

IVF vs adoption

I always said I wouldn't do IVF, that I would adopt if it came down to it. There are so many children in my community, Crown Wards, in need of a Forever Family. It just makes sense to give them a home before going to the huge effort and expense of creating a new life. Hypotheticals are all fine and dandy, but it took no time at all to change my tune. But it wasn't easy. After the diagnosis, I told my partner and we waited until later in the evening to talk about it. He wanted to know what it entailed. I'd already read everything about it on my hospital's website, and I was unsure but tempted. The more we talked, the more adoption seemed like the "right" choice.

But the next day, all I could think about was what I was giving up. My first birth was not what I wanted. I went into preterm labour at 31 weeks, and while they stopped the labour and stabilized me for a few days, my water broke, the baby was breech, and an urgent c-section was necessary. I remember one of the nurses commented that I was surprisingly calm. My response was that there was nothing I could do, it's happening. Call me crazy, but I want to experience childbirth, natural childbirth. So I spent much of the past year worried about whether or not I would qualify for a vbac - a vaginal birth after cesarian. I found the vbac rates for my hospital (encouraging). I found a website that calculates risk (less encouraging). I held on to hope and knew that in the end it would depend on factors that can't be known yet. I held on to hope that a full-term vbac would also give me a second chance at breastfeeding. When I had my preemie, I spent a lot of time researching factors related to milk production and breastfeeding success with preemies. I didn't come up with much other than a basic belief that preemies are one of the reasons formula exists.

I wanted a second chance at both. This is what I was giving up by passing on the IVF opportunity. But I grappled with this decision. I knew that this was ultimately a selfish choice. I would have to come to terms with that, and explain it to my partner. This is selfish for me, not for him, it's entirely my physical experience that I want, he doesn't get to experience it. He's concerned about my health, the risks of IVF to me. I'm apprehensive about the process, giving myself needles, and the ethical questions of what to do if there are any "leftover" embryos. The options are freeze and use in the future, donate to another couple, or donate for medical research (stem cells, precious stem cells - I support that research in theory, but will I support it personally, physically, directly). I think I'd be getting ahead of myself to make that decision now, I don't even know if IVF is an option, I have to wait for the consult. And if I go through with it, there might only be a small number of embryos. And the more I think about it, the more I want to try.

It's no longer IVF versus adoption in my mind, it's "and". I can do both. I want to do both. I've already contacted a social worker with the Children's Aid Society, and because of certain situational factors we need to wait another 3-5 months to get started. I'm waiting for the IVF consult. I hate waiting, but I know ultimately the time will pass, it always does. Meanwhile, number one daughter has gone from wanting 3 sisters to 5! I think the adoption intake worker will like the sound of that, but we will need a much bigger house!

In the beginning...

My Story

So much for adolescent egocentrism, call it adult egocentrism, I never thought it would happen to me. I make jokes about dusty old wombs and stale eggs, but at the ripe old age of 37 my doctor delivered the blow - rush referral to IVF. When I was younger, naive, I always said that wouldn't be me. I wouldn't wait to have kids until I was too old and needed IVF, I said. No kids after 40, I said. If the choice was between IVF and adoption I'd adopt, I said. Little did I know that IVF after 40 solves nothing, it's the stale eggs, not the dusty womb that's to blame. My eggs are just fine and dandy, and I'm not quite 40 anyway, no, the problem is my tubes. I never considered that somewhere between my first child and trying for a second that my tubes would get completely and utterly blocked.

I started to suspect something was wrong at about the sixth month of trying. The first three months were passive - not trying not preventing. I gave it three months au natural. Then I pulled out the big guns. I started charting basal body temperature again - I'd tried it before using pencil and paper so I knew the basic ideas, but now there are apps for charting that make it even easier! I used Fertility Friend, a site and app I absolutely love. I set my alarm faithfully every morning, even on weekends. I even impulsively bought a digital ovulation prediction kit (on sale). I joined online forums and learned all the ins and outs of using the kits, buying bulk test strips online, and thought I'd finally take control and it would happen! No. That first month of charting I ended up in the emergency room with a hemorragic corpus luteum cyst rupture. Let me tell you, you walk into the ER and tell them it feels like labour but you're not pregnant (yet), they don't leave you in the waiting room very long. I was an occupant of the ER for 18 hours. Then suddenly, around midnight, a doctor walks into my room (that's when you know it's serious, they put you in a room with a door and private bathroom rather than a bed behind a curtain, or maybe that's just because it was clearly gyno), tells me the diagnosis and says I can go home. Still groggy from the morphine, no questions answered (like why did it take 3 ultrasounds and a CT to diagnose it?), I get a cab home, sleep it off, and was fine in the morning.

So the six month mark coincided with a doctor's appointment to follow-up on the cyst rupture. I had a basic work-up, ultrasound, and pelvic exam. My doctor seemed pretty confident I'd be pregnant within the next 3 months because all my tests were fine. Off I went with the well-meaning but incredibly condescending, annoying, irritating, etc advice to have lots of sex and be patient. If you're reading this and you've ever said that to someone, know that in their head they gave you a mental smack. Yes, those were daggers in her eyes.

Four months later, I was back in the doctor's office, this time with a reluctant partner who really didn't want to have his man juices questioned, who really didn't want to have to produce a sample, bring it to a lab, and wait for results. No wonder he dragged his heals to do it, but it had to be done. I requested more tests for me, a hormone panel, and an x-ray of my tubes. The hormone panel was fine. The man juice was plenty manly. The referral was put in for the x-ray, an HSG, that first required a specialist referral, was a long depressing wait. It took 5 months to get the appointment. Five months of experimenting with vitamins and old wives tales (what better cure for a dusty old womb than an old wives tale, right?) all the while still charting basal temperature, peeing on sticks, and mastering the art of cervical position. I even had high hopes for the "stop trying and go on vacation" trick, but no. It was great to get away and have a vacation though!

The day came for the specialist appointment. I was full of hope again. We went together. She ordered up an even more comprehensive hormone panel for me, another man juice analysis, and the HSG. The HSG is a pain in the butt to schedule. It took 6 more weeks to get that scheduled. I'd read many accounts of it, some painful, some not. I wasn't anxious, I was eager. It's not fun, I won't lie, but I'm a trooper. My goal is childbirth, after all, I can handle getting poked at with a catheter. The test works like this. A dye is pushed into your uterus, and it should flow back out through the fallopian tubes (referred to as spillage). It was pretty clear that one side had proximal blockage, nothing was going in. The other side was unclear, and I was told to wait until the radiology report. A week later, in her office, is when I got the news. All the hormones look good. Everything else is good. Except the tubes. The radiology report said no spillage. Both sides blocked. Recommendation - IVF. And now I wait. First I need an ultrasound, to check for fibroids and polyps because the uterus also didn't look right during the HSG. Another two weeks.

So I wait. Maybe putting it out of my mind would help, that's my other half's strategy for life. Drives me crazy. I want to plan. I want to be prepared for every possibility. Maybe I'm ruminating. I hope this is therapeutic instead.