Trying

I have a follow-up appointment with the midwife a few weeks after the D&C. The appointment is supposed to be with the surgeon, but he is stuck at the hospital for something. I wait in the room for about twenty minutes before a midwife sticks her head in.

“I’ll be in with you in just a second,” she says. “I’m gonna fill in.”

She comes in a few minutes later and runs through a checklist of questions. Am I still bleeding? Any pain? No and no. She clears me for intercourse. I’ve already filled out the postpartum depression screening (did you know you can get postpartum depression after a miscarriage?) and I assume she’s already looked it over. Sad? yes. Depressed? No.

She wants me to have a full cycle—so two periods—before conceiving again. I don’t really get periods very frequently, so we make a plan to induce those periods with progesterone.

She takes out a piece of paper and writes down the timeline with the plan to add in letrozole after the second period. Letrozole is a medication that tells the brain to tell the ovaries to ovulate.

“I strongly recommend you do the follicle ultrasounds too,” she says after I ask if they are actually necessary.

I know it’s highly unlikely I will be able to get pregnant without all this intervention. This is how we got pregnant last time, several months earlier.

I take the piece of paper from her and study it in the car. So this means potentially getting pregnant in February. Maybe. If it works.

February feels far away. I’m in this weird liminal space between “no longer pregnant” and “going to be pregnant soon-ish”.

***

On Christmas day, I take a pregnancy test.

I don’t know why…I know it will be negative, but there’s a big part of me that’s just hoping all this fertility medication won’t be necessary and we’ll get pregnant on our own, on an off chance. And wouldn’t Christmas be the perfect day for such news?

It’s negative, even when I squint really hard.

***

In January, I fully expect to get my period the day after stopping progesterone. That’s what happened last time. But four more days go by, and nothing.

I wonder if maybe, hope of all hopes, I’m actually already pregnant. I take a test and I’m not.

I get my period the next day, the day I’m leaving for a weekend visit to see a friend.

I’m supposed to take letrozole on days 3-8 of this cycle, so I’ll be home by the time I need to take it, but I pack it in my suitcase just in case my flight home is canceled and I’m stuck there an extra day. Then I move it to my carry on bag just in case my suitcase is lost.

I have a dream that I lose the bottle of letrozole and the midwife refuses to prescribe me any more of it.

***

I go in on cycle day 12 for the first follicle ultrasound.

Emotion catches in my throat as I wait for the tech to come back in. This was the same room that we saw Isla’s beating heart up on the screen. This was the same room that we saw Isla’s heart not beating on the screen.

Does the tech remember hugging me? She must see a lot of patients, so I don’t know that I would stand out. I look rather ordinary.

I have three follicles growing, all three contenders to ovulate.

“Your lining is really thin,” the ultrasound tech says in a voice that does not sound positive.

***

Thin lining, the OB tells me in a portal message after I ask, can be a sign of low estrogen. It’s harder to get pregnant with a thin lining. We may add in estrogen in the next cycle if it stays thin.

I think about it all day. I can’t believe I have a new problem I’m dealing with. I already have a hard enough time getting pregnant—staying pregnant—and now this? It feels so unfair.

I take a shower that evening and cry for a good thirty minutes. I feel angry at God. This thin lining thing feels like a personal affront.

“Why are you so mean?” I ask aloud. I cry some more. “Why did you let my baby die?”

Ohhh, so I’m not crying about the thin lining. I’m crying about the miscarriage. Okay.

***

Two days later, the next follicle ultrasound.

“Your lining really thickened up!” The tech says, “Nice and juicy now.”

I have one follicle that grew. Measuring at 17 mm. Has to be between 20 and 30 to rupture.

The tech tells me to have sex every day over the weekend. I can never not see the humor in that advice coming from a medical professional.

***

But I don’t get a positive ovulation test over the weekend. I test twice a day, looking for an LH surge, but it never comes.

So I guess ovulation failed?

***

Monday morning, another follicle ultrasound. I’m nervous that because I didn’t get a positive LH test, that maybe the follicle just stopped growing.

I wake up very ill. I have diarrhea and I’m vomiting. I bring a bag in the car just in case.

The follicle didn’t rupture, but it grew. 24 mm.

“Any day now!” The ultrasound tech smiles. “Keep having sex every day until I see you again. Don’t miss a day.”

I throw up in the trash bag as I drive home. I don’t know what’s going on with my stomach, but it is not happy. Don’t miss a day?

Two hours later I get a call from a nurse. She tells me the OB wants me to a do a trigger shot. A trigger shot tells a lazy follicle to rupture.  I’ll need to pick it up from the specialty pharmacy ASAP and then she’ll instruct me how to use it over a telehealth appointment later that afternoon.

“You don’t have to do the trigger shot this cycle if it’s too last minute. We can do it next cycle,” the nurse says, “but the doc thinks it would be a good idea for you.”

My mind races. I’m still throwing up and I’ve been on the toilet with the runs since I got back. But the thought of “next cycle”—of doing this all over again—makes me say, “Sure, I’ll go pick up the shot. I’ll do it.”

***

How many prayers does God receive from the bathroom?

I know there is some humor in this. Me, praying on the toilet that I can stop shitting myself long enough to have sex later? Yeah, there’s some humor in it. But I’m too miserable to laugh.

***

The nurse is very patient with me as she teaches me via the computer screen how to inject myself. I’m not great with needles, so I have purposely not thought about the fact that I have to stab myself with one until this moment. I’m clumsy with it but I fake confidence.

As the needle goes into my stomach, I think, I hope this is the last time I ever have to do this.

“You’ll most likely ovulate 24 hours after this,” the nurse says, “if not sooner.”

***

What on earth is up with me? I keep throwing up—even small sips of water—and now my stomach is cramping so badly that I tell Rob I need to go get fluids at the ER. It’s an expensive trip just to feel a little better.

We go and a few hours later I feel like a new person with two liters of fluid and a pop of Zofran into me.

“Did you know you’re pregnant?” The ER doc asks.

I wave my hand dismissively. “No, no. I just gave myself a trigger shot. That’s what that is.”

“Ahhh” she says, “Gotcha.”

I’m grateful I know that the trigger shot has hcg—otherwise I would’ve been really confused. Not pregnant, just full of hcg.  

***

I get a positive LH test the next day.

That night, curled up next to Rob, I dream that the OB tells me that when the egg is released, if sperm doesn’t catch it, the egg will come out of one of my ears. So I have to be sure to use q-tips in my ears to catch any loose eggs.  

***

Last follicle ultrasound and I’m so nervous. What if it failed? What then?

The tech tells me that it ruptured.

I ovulated. I want to shout it from the rooftop. I ovulated, people! Stop the presses! There’s a chance!

I call Rob on the car ride home.

“Okay, so you did your part,” he says, “Now it’s just up to my swimmers.”

***

I make a promise to myself that I won’t get so caught up in this process that I am not present with Rob and the boys. I have so much to be thankful for, I remind myself again and again. I am not going to be so distracted that I miss out on what is right in front of me. I want to be emotionally and mentally present.

Right?

***

I’m still having stomach cramps. I’m not throwing up anymore and the diarrhea subsided, thankfully, but there’s still pain. I go through the laundry list of possible causes. Infection? One of my Bipolar meds? Gluten?

Part of me wonders if it’s stress. Like, my body knows I’m stressed about this process and that stress is manifesting itself in my stomach? It’s possible, I suppose. I didn’t think I was stressed…maybe my body knows better.

So of course I google, “can stress cause infertility?”

***

I just went through a whole first trimester with Isla. Almost made it to 13 weeks.

The morning sickness was rough that time around. I can’t believe I have to do it all over again.

But, I tell myself, if I do get pregnant, I won’t complain. Because at least I’ll be pregnant.

When I tell that to Rob, he just says, “Sure.”

***

Oh yeah, so with the trigger shot, you have to wait a full two weeks before taking a pregnancy test. The trigger shot is hcg, so I could get a false positive if I take it any sooner. Any symptoms could just be from the shot as well.

So gotta wait until February 13. That’s really annoying, I have to say.

With Isla, I got a positive test at 9 days post ovulation, but I won’t be able to test that early again.

Of course, I could get my period before the two weeks is up. That’s a real possibility.  

But since I’m taking progesterone now, I may not get a period even if I’m not pregnant. May or may not.

Ugh. I just have to wait. For the test or for blood.

***

“What if we didn’t have enough sex?” I ask Rob.

“We did, Anna.”

“What if we did it at the wrong times?”

Eye roll.

“What if me getting sick made it so it won’t work?”

“Then we will try again.”

“What if you getting that cold affected your sperm quality?”

“I don’t think that’s a thing.”

“It’s hard not knowing.”

“I know.”

“What if we miscarry again?”

“I know, baby, I know.”

***

I keep thinking that I will feel less sad about the miscarriage when I’m pregnant again.

But that’s not true, is it?

The sadness will probably just be replaced with anxiety about another miscarriage: sadness reincarnated.

***

I’m trying to tell myself it’s okay if we don’t get pregnant this cycle. And it will be okay. We will just keep trying. I’ll keep pumping myself with hormones, going to those early morning ultrasounds, and I’ll try to be patient.

I feel sort of crazy. But when you want to be pregnant, and you’re doing the fertility treatments, it’s hard not to feel, well, crazy. I remind myself I just injected myself with hormones a week ago, so it’s normal to be feeling a bit emotional.

I keep praying about it. I pray for hope; I pray for peace; I pray for trust. Of course I pray that we get pregnant too. I pray for a healthy baby. I pray against miscarriage.

I don’t understand prayer in the slightest. I don’t know what good it does, if any. But I keep doing it.

***

I write this because I think this stage—this phase of life—can feel rather lonely. And because it does make me feel borderline crazy, this trying-to-get-pregnant thing. I know, though, that I can’t be the only one. So I hope that giving you a peek into what it’s been like can make you, and me, feel less alone. I probably should wait to post until I have more information about the success or failure of this cycle, but I don’t want to wait. I don’t know how long this trying process is going to take, and I want to document in the meantime.

Hugs to you all.