It’s my very first IUI. The clinic, which is in a hospital, is like a food stamp line in the former USSR. The ultrasound room is in the centre of the floorplan and other offices surround it, and surrounding that on the perimeter is a waiting area and the blood lab. We IUI or IVF women line up to get our gowns, to wait for a change room where there are no lockers or security, waddle through the waiting area in front of hoardes of patients that don’t have anything to do with fertility, and wait in the hallway for one of two seats where our blood is taken. Then we walk back and wait in another part of the hallway, in full view of patients not in those pathetic hospital gowns, for our turn with the wand. I feel like one of those people on a long term care ward, walking around with her gown open at the back, except of course mine isn’t. But other patients still give us querying looks because they’re not in gowns.

Finally I’m in the ultrasound room. But I don’t even get to see the doctor. A nurse and a fellow do everything. Like he knows what he’s doing. He’s a newbie! I’m sent out to change and someone will call me in the afternoon after all the charts have been reviewed with the actual doctor. I am immediately sceptical of this process and it turns out that I have reason to be.

My dose of Clomid is the same as everyone else’s and apparently I’m a super-responder. So my ovaries are blown out and they fiddle and fiddle with my cycle until it’s time for my ovaries to pop. I line up again for the actual insemination, which is done by the nurse and the fellow and it isn’t too bad at all. But I’ve had every possible side-effect. Migraines, dizziness (I was really worried about driving), loss of appetite and more. I’ll skip ahead here and tell you what you must already know: it didn’t work. And the following month, I got cysts from the Clomid, which is a typical side effect but they don’t warn you about it.

What really gets my goat, is that they don’t warn you about anything. Drugs are prescribed and it’s assumed you’ll just take them without question. No one sat me down and explained side effects and no one talked about the possible link to ovarian cancer. And this is an elective process, one for which we pay dearly. I don’t want one of those dear things to be my health.

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It’s our second visit to Dr. G. Guess what? We’re normal. Not a thing is wrong with us. We are so relieved, we’re smiling. In fact, we’re a bit smug. Ha! Take that, infertile world! We are normal!

But wait. If we’re normal and nothing is wrong… why is it not working? Dr. G- suggests that we head straight to IVF. Whoa there, Nelly! I am not — repeat, not — interested in invasive in vitro. That is like science fiction and we’re normal, right? Surely there has to be an easier way. In fact, says Dr. G- there is: intrauterine insemination or IUI. Although she recommends using Clomid, the success rates are low, about 10 to 15 percent for unexplained infertile couples. Apparently our diagnosis is “unexplained infertility.” It’s better than having something wrong with one of us, we think. How wrong we are, we find out much, much later. In the world of infertility it is much better to have a problem that can be fixed. But this is in retrospect. Way back at this second visit, IUI sounded like the perfect plan.

The husband is so grateful that I’ll try this — try anything at all — he is floating on cloud nine. Wow. Well, we’ll see how it goes, I think to myself and tell him that this is as far as I’m willing to go. How little did I know.

Thank god I took the day off work. Today was the first step in a horrifyingly undignified process of conception that will culminate in the most degrading act of all: birth. Most people think that having sex is the beginning, but no. I’ve learned – and perhaps I’ve come full circle to grasp hands with the desperate womenfolk desiring pregnancy (except I’m not doing this out of desperation) – that sex is simply a quick, painless tool to achieve the end result.

Somewhere in that process is a whole lot of cold steel, catheters, ultrasound wands and vomiting. If sex isn’t effective, as is our case, we need to find out why. And in this fast-paced world of medicine, my doctor has scheduled all the tests very close together. She’s not waiting to find out about the husband’s sperm motility; she’s having my insides evaluated pronto. I was leery of this at first because, well, it’s an invasive procedure and I’m pretty queasy about these things. After today all I can say is, the husband’s sperm had damn well better be swimming like Olympic medallists for me to have gone through this.

Everyone tells me not to worry, it’s not a big deal, it just seems that way. Well, they are wrong. First of all, I’m in the medical imaging center for hours. The initial ultrasound isn’t so bad. In fact, it’s like sticking a vibrator up there and waving it around for a few good uterine close-ups. But then we get to the tubal patency test, which means a lot of instruments and poking about in a region that generally doesn’t like that kind of interference. Perhaps it’s different for each woman. For me, it takes the doctor five tries to insert the catheter after so much prodding and poking that my cervix is bleeding. At the fifth attempt, I am honestly thinking of telling the two doctors and one tech to just forget the whole thing because I can’t even hold my legs up in those stirrups for another minute (it has been 40 minutes at this point). My legs are aching. And then, the catheter slips in and stays in; but the balloon is inflated, my insides completely revolt and I yell bloody murder. Not intentionally, of course. It’s a bit embarrassing, but it hurts like hell. I can only imagine what birth feels like, and I am not interested in feeling it. What are they thinking, telling me this feels like a mosquito bite? Apparently they’ve never had the procedure, otherwise they’d know that it’s worse than a thousand mosquito bites. It feels more like the worst day of my PMS cramping times a hundred. Of course, my blood pressure plummets, I’m sweating buckets, and my legs are shaking. After the whole thing is over, I’m so faint I vomit. The technician doesn’t even allow me to get up; she makes me lie down for a half hour. She brings me cookies and ginger ale – what an angel – and hails a cab to take me home.

Bottom line: reproductive medicine is barbaric. I can hardly believe that a nose puff has been developed to help men with erectile dysfunction, but no one has thought of a way to anesthetize a woman’s uterus during an invasive, painful procedure.

September

Oh gosh, it’s time to face the music and even I — the penultimate denier — know it. My husband and I are having a very uncomfortable conversation. It’s the one about seeing a fertility specialist. I desperately do not want to go. The roles here are reversed: usually the man is the one that’s reluctant to get tested. I’ve always been squeamish about medical stuff and now we’re talking about a very private, internal part of my body. Let’s just say the imagery is not enticing.

But the husband is visibly frustrated. Why, oh why, I wonder, can’t things just be easy for once? Why do I always come to the fork in the road where I either have to do something unpleasant in this baby business, or I have to contemplate divorce? It’s a question that will recur many times in the future on this crazy journey. Honestly, I have no idea if divorce is a palatable option to the husband, but I know the stats. The main cause of divorce is money; the second is children. I am painfully aware that marriage is a partnership and that this is one of those huge compromises that I’ll be making if I want to stay married. And I unequivocally do.

This is why we end up in Dr. G’s spartan office that’s painted hospital-issue-peach with its pathetic baby wallpaper trim and 1980s computer monitor that looks like it can’t turn on, never mind compute. Ugh. I am not inspired nor confident. Oh, but she is! She is horrified that we have waited so long to conceive and lectures us on the stats. We leave her office crestfallen, with requisitions for a battery of tests, mostly that I have to do. (One thing I cannot get over is how nice other specialists are and how forceful and superior infertility docs are.)

I don’t know what to think at this point. I am disbelieving of the fact that I could be infertile. I mean, how is this possible? There is no infertility in my family; my mom had her last child in her thirties! Can it be that I’ve reached the past-due date? Are my eggs shrivelled up, grey-haired little things that don’t have the strength to pop out of my ovaries? Am I all cobwebbed and mothballed inside? Has that ambivalence I’ve always felt indeed an indicator of the fact that perhaps I’d never been fertile in the first place?

Well, we are about to find out. Oh joy.

June

It’s ten months since we started TTC and things are progressing albeit slowly. I think I’m actually with the program now! The husband jokes that for someone that likes change, this is one change I clearly have not wanted. Yep, it’s taken me quite a while to get comfy with the idea of being a mommy. TTC every month is just a matter of fact now; instead of being freaked out at the consequences of pregnancy I am calm. The workouts have helped immensely; besides the endorphin boost, I feel like I’m being proactive. It’s so important for me to know I can control something.

The other thing is that I am starting to notice kidlets everywhere and I see that people manage somehow. I’ve also seen the husband with our friends’ kids and he has such a good time. They adore him. I still do not like other people’s children. Don’t you love it when parents say, When they’re you’re own, it’s different. Actually, not so much apparently. According to G- you do have an innate irrational love for your kids but that doesn’t change the fact that when they are being monstrous little devils, you can have second thoughts! And G- is a real bona-fide mommy. So you see, I have not been worrying about parenthood in vain.

The other way I know I’m with the program is dinner conversations with friends have changed. A few months ago I lost my appetite talking about this and believe me, I am still horrified at times. But here’s an example.

We’re having dinner with same couple from last December and they want to know how it’s going. It’s obvious we’re not yet expecting a little bundle of joy. So they think we need more pointers:

  • Every TTC couple needs a thermometer. The mommy-to-be takes her temperature every morning at exactly the same time and records it in a chart. after about 4 months you’ll get the hang of your ovulatory cycle. Apparently when the temperature is at a certain point you’d better book off some time for TTC sex or you’ll miss your two-day window.

I raise an eyebrow and look at the friend’s wife. She’s a busy lawyer. “Do you have time for this?”

“God, no!” she says. “But some people have sworn by it.”

I know it’s not going to work for me, because I don’t have the time or inclination to do it!

  • Get a pregnancy book; apparently these also come with thermometers and charts and advice — whose advice, I’d like to know?

You know it’s an industry when there are baby-planning books in pink and blue binding at the local book shop. Argh. Are they more informative than the baby boards online? If they’re written by anyone like my doctors then they haven’t got a clue. Besides, why does everyone take such a happy tone in these types of things?

  • Ovulation predictor kits take the guesswork out of the temperature method and they are quite expensive unless you can get them in bulk. I can imagine the mail carrier’s smirk. Although peeing on a stick beats a thermometer.

All this I can handle but here’s the one that makes me choke on my food:

  • Egg whites are your new best friend. If you are beat from trying and just can’t get excited anymore, egg whites are a similar consistency to mucous. Unlike other gels, egg whites won’t hurt hubby’s swimmers.

I guess we haven’t arrived at the point where sex is awful. Wait — this means there actually is such a point. I cannot believe they’re telling us this and secretly hope that  we never have to resort to it otherwise I’ll never eat eggs again.

Oh, dinner table conversation: so honest, so appalling.

Late December

The husband and I are having a big fight. I am absolutely furious with him. It’s only been four months since I went off the Pill and it feels like Everyone Knows. It’s the last thing I want. I want us to feel no pressure. Not from family, or friends, or colleagues. It seems that pressure is the one thing that does not help get anyone pregnant and not that I’m in a hurry, but I don’t want everyone to know about my personal life. I’ve read enough of the desperate mommy web site forums that I know I don’t want people to feel sorry for me if I don’t conceive ‘according to schedule’. I do not want people talking about me behind my back and how ‘sad our situation is.’ I’ve heard enough talk like this to last me a lifetime.

To make things worse, it seems that sometime in the past two months, the husband has let the word slip to his mother. Every time she phones, there is a tentative and slightly insinuating, “Anything new?” I wondered what that was all about until I heard the husband and the mother-in-law on the phone the other night. “No, we’re not pregnant yet,” said the husband. “We haven’t been trying that long. Anyway it’s a major lifestyle change for her, so we’re trying to get her used to the idea.”

I almost freaked out right there.

Then tonight, the husband raises it over dinner. Over dinner, of all places! I almost slide under the table.

The odd thing is, our friends – who are really the husband’s friends so I don’t know them all that well – they were all ears. They are eager to hear all about it. It’s like we’re in some sort of “Trying Couples” club. They have lots of free advice to offer: stories of fabled conceptions, surprise miscarriages, the best herbs, foods, drinks, etcetera. I sit politely and stone-faced throughout this ordeal. I want to change the topic as fast as possible.

As we get into the cab on the way home, I spit my venom. I don’t care that I berate the husband in front of the cab driver.

“Can’t this wait until we get home,” the husband tries to shush me.

“Who cares?” I say. “Everyone else knows! Why not the cab driver?”

“Damn it! You’re blowing this all out of proportion. My mother deserves to know, doesn’t she?” I shoot him a dagger glance.

“No, no she doesn’t”

“Well, she’s my mother and I can tell her things that are important to me.”

“No, you can’t. Not if they have to do with me! This is between you and me and no one else. If someone is curious, that’s too bad. Maybe some day I’ll be comfortable speaking about it, but I am not. Comfortable. Right. Now. Can’t you understand that?”

“Alright, alright,” he sighs. “I guess you’re right. I can see that it’s not fair to you.”

“Damn right, it’s not fair!” I shoot back. “And what’s up with raising the topic with them? This is the 21st century – conception is not a community event!

“Oh c’mon. They’re good people. They care. And I didn’t raise the topic, I’ll remind you. They asked if we’re considering kids and I simply told the truth.”

“Well, sometimes you shouldn’t tell the whole truth,” I say acidly. “Sometimes one should avoid a conversation.”

I run up the five flights of stairs, let myself into the apartment and slam the door. We had agreed we weren’t going to be One of Those Couples…. And here we are. Our intimate details being shared with other couples that want to share their intimate details. I guess the husband got the message, because during the next conversation with the mother-in-law, I hear him telling her that he’ll inform her if we have news, and otherwise not to ask about it.

Sometimes I wonder what to tell my thirty-something friends who long to find their ideal partner and get married. It sounds too precious when I ask them why they desire marriage. Unfortunately, marriage is not the romantic voyage DeBeers makes it out to be. Now that I’m grappling with my feelings about motherhood, I am acutely aware that marriage is, more than anything else, a contractual agreement. That’s why I should have been paying more attention to the priest in our marriage class. I’ve realized that life is a set of circumstances and marriage is a matter of two people’s goals fitting those circumstances at the same time, with some lust sprinkled on top. As a goal in itself, marriage is sublimely absurd. Yet some of my friends – female and male alike – cannot articulate why they strive for it.

I always joke and say, why get hitched? It’s a hassle. Anyway, marriage is not better than being single – it’s just different. Just like the saying the grass is always greener on the other side. You can meet a compatible partner and not get married. But a wedding is always seen as The Next Step. Matrimony is so accepted as an ideal measurement of happiness and fulfilment, that we don’t question it. Instead, we use it as a yardstick to measure ourselves and others. And after marriage, the yardstick is family – how soon, how many, how good, how smart are your kids? There are so many people who want to jump on this train, I always feel like an oddball when I question why the tracks have been laid this way.

Often, I have long discussions with a colleague over lunch. N- just doesn’t understand my ambivalence about marriage and children. Ever since he joined the office, he wanted to know all about my life and how I managed to get married and stay married. This is all coming from a man who is only thirty years old but thinks he has so many issues that he sees a psychiatrist every two weeks. He appears completely normal to me, with exactly the same issues all middle class children have, except perhaps his guilt over being middle class is a bit out of whack. Perhaps it’s his deep Russian soul that’s causing all the trouble.

Actually, I should clarify that I met N- when he was twenty-nine. His complaint was, “I’m turning thirty and I’m not married yet! I’m not even in a long-term relationship.” His constant questions were, How do you meet the right person and how do you have a happy marriage? About my notions, he just said, “But you are married, and you’re happy. How can you have an ambivalent or negative attitude towards something that makes you happy?”

“Marriage doesn’t make me happy. My husband does.”

“Ah, yes, but would you get a divorce just to prove you don’t need marriage?”

“Well, no. I’ve worked hard at my marriage and I’m proud of our relationship. But it was very hard in the beginning. I felt those matrimonial bonds as if they were steel shackles on my wrists. You can’t just do whatever you want whenever you want. You have to put the other person first. Do you have any idea how hard that can be?”

“But one should already do that if one is in love with someone,” he insists.

“Of course, but one shouldn’t feel duty-bound; it should be a by-product of love.”

“My father would say you are like a little bird that flits this way and that,” he jokes.

“Ha! He sounds like my grandmother.”

“I can’t believe it! I get it – I get it, and here you are and you don’t get it, yet I’m the one that’s not married!” he whines.

“Listen, you should stop spending all that money on psychotherapy and spend it on a woman. Then see how fast you’ll get married.”

“Ha, ha. You have no idea how many issues I need resolved.”

“Well, maybe I should see your shrink before I start pulling Lucy Ricardo stunts on my unsuspecting husband.” He arches an eyebrow and gives me a look.

“I’m kidding,” I say. “Really.”