The Loneliest Number

I have a drawer filled with used pregnancy tests. There are close to 40, and each one has notes scrawled across the handle in Sharpie: 5DPO. 9DPO. 12DPO. And, though my husband’s claims that I am a hoarder are not entirely without merit, this drawer represents my physical complications, not my mental ones.

I have polycystic ovary syndrome (PCOS), which is a hormonal disorder that, as the name suggests, causes ovarian cysts and can complicate fertility. My diagnosis was tricky because the syndrome is associated with obesity, excessive hair growth, and severe acne, which are symptoms I do not have. I was a healthy 28-year-old, so PCOS was initially overlooked, but after nine months of not getting pregnant, my magical, mystical acupuncturist suggested I mention it to my then-gynecologist, who quickly confirmed the diagnosis.

Though it was news to us, the syndrome affects 5 to 10 percent of women globally, and is hard to diagnose because of its wildly diverse (and common) array of symptoms. The other tricky part is some women with the disorder can still conceive, no problem. Once we knew what we were dealing with, I became a patient at the Endocrinology Division at The Johns Hopkins Hospital and quickly learned that getting pregnant was about to become my new part-time job.

For most people, having a baby requires a man and a woman with general knowledge of anatomy and a bed—or some mutually agreed upon surface. However, those of us dealing with infertility come out of the ordeal with a medical-school level knowledge of exactly how conception is meant to work, why ours doesn’t, the science behind making sure it does—and, you know, hopefully, a baby.

“Though it was news to us, the syndrome affects 5 to 10 percent of women globally.”

During our first appointment, my endocrinologist spent 30 full minutes walking us through female anatomy and reproductive cycles. My husband, Rob, and I were floored. Even for the most fertile couples in the peak of their baby-making years, there’s only a 20-percent chance of conception at a time. In most instances, despite what my Catholic education taught me, there is a very limited amount of time each cycle for that 20 percent to take.

“For many, conception does not happen right away,” says Dr. Endrika Hinton, a gynecologist at GBMC. “Approximately 10 percent of the population suffers from infertility.” She says couples under the age of 35 who don’t conceive after one year of unprotected sex are considered infertile.

Because we already knew I was resistant to a common fertility drug called Clomid, I was put on Letrozole, a drug created for breast cancer survivors with the side effect of stimulating ovaries, and was told to try getting pregnant the old-fashioned way. “You’ll be pregnant by the end of the year,” my doctor said with confidence.

And he was right. I got pregnant twice that year, both times ending in miscarriage. The first time was very early at three weeks, and the second was a much more difficult nine-and-a-half weeks. Much like my own anatomy, I hadn’t thought much about varying degrees of miscarriage before that point. The first was upsetting, but almost clinical. The second was emotional, defeating, and required a D&C, an invasive surgical procedure short for dilation and curettage. I remember waking up from the anesthesia and feeling totally alone. For nearly 10 weeks, I thought there were two people living in my body, and then I woke up to just me.

That’s the thing about infertility: above all else, it’s lonely. Even if you have the most supportive, involved spouse. Even if you have a team of health professionals at a world-class institution on speed dial. It all boils down to you, and the fact that you’re still not you plus one.

Outside of the miscarriage, the most isolating moment occurred when Rob received his sperm count analysis in the mail. It’s typical to check sperm count in infertile couples to get the full picture, and his test occurred after my first miscarriage. We spent the week waiting for the results, carefully not talking about it, too scared to face the much more complicated possibility of us both bringing faulty parts to the table. When the letter arrived, Rob was thrilled to learn that his count was great—obnoxiously above average, actually—and while he high-fived himself, I burst into tears. Until we got those results, I hadn’t realized that a part of me wanted to share the blame. The little island I was on got smaller, even as we got warmer.

The loneliness eventually drove me where it drives all millennials: to the internet. An “infertility” Google search led me to message boards, and once I learned the shorthand —“PCOS, TTC for 18 mos, DH SC good, IUI tomorrow with 2 15 and 17mm follicles. Send baby dust!”—I dove deep into conversations between strangers sharing war stories, looking for any scraps of information that reflected my own situation. Without any friends IRL to talk to, I pored over these posts for months, finding solace in our shared shorthand.

Local psychologist Steven Sobelman works with couples dealing with infertility, encouraging therapy as a way to handle intense emotions. “I try to assist my patients in understanding that their ‘personhood’ is housed in their mind and is totally separate from their body,” he says. Anyone dealing with fertility issues knows that this is one of the biggest struggles—how can I fail at something I am meant to do?

“We sipped juice and non-ironically ate eggs while we chatted about the absurdity of what he had just done.”

Once I was back on track after my D&C, my doctor recommended I graduate to the next level of fertility treatment: intrauterine insemination—or, as my message board friends called it, IUI. This involved more Letrozole, followed by early mornings at the Green Spring Station office for tests. Five to seven mornings a week, I’d wake up, hop on 83 North, get in a long line of bleary-eyed women, and wait for my turn to go back for testing. An ultrasound tracked follicle growth, and a trip to the first-floor phlebotomy lab kept an eye on my hormone levels. (On the plus side, the almost daily blood draws cured my fear of needles.)

I followed this regimen for a few months, and nothing was ever quite “optimal” for conception. Apparently, we’re incredibly fickle creatures and need conditions to be biologically perfect before we even consider gracing a uterus with our presence. One month, I didn’t have a large enough follicle (which releases an egg and needs to grow to a certain size to be considered viable) and another my hormone levels were off. There was one round where my hormone levels were adequate, but I’d overproduced follicles, so I decided not to move forward, lest I end up with a litter of humans instead of a reasonable one or two.

Then, finally, like a really great ski day, the conditions were perfect. My arm had a permanent little dent from all the blood draws, my body was tired and unfamiliar from the drugs, but look! One flawless, viable follicle showed up on the screen, and my hormones were somewhat interested in behaving. I was sent home with a syringe full of something meant to be injected into my stomach and instructions to return the next morning for my IUI. His undergraduate art history degree precluded Rob from being my most-qualified assistant, so I enlisted the help of my best friend, whose obsession with pimple popper videos and medical dramas was the exact pedigree I needed for the job. I drank a fortifying glass of wine (as did she, I recall), and we talked ourselves into the injection. It was as unpleasant as I’d imagined, although I think she secretly enjoyed the power trip of potentially playing god.

The next morning, we went back to the office, and while Rob made his frustratingly straightforward, non-invasive contribution to this whole thing, I had coffee and tried to stay calm. After his appointment, we sipped juice and non-ironically ate eggs while we chatted about the absurdity of what he had just done and the enormity of what I was about to do.

Once our weird breakfast was finished, we had to retrieve the sperm, which in my mind had been spinning in a centrifuge, I assume weeding out the high-school dropouts and giving future MIT grads the chance to spin to the top. Given how scientific and exact everything had been up to this point, I imagined highly trained nurses would deliver the vial to my doctor’s office in a briefcase, unlocking the handcuff chain before clicking open the case to a satisfying “hiss” as a portable hyperbaric chamber released the specimen. Instead, the receptionist handed me a tiny, fragile vial that potentially contained half the ingredients of our future child and advised me to “stick it in my bra” for the walk back to my doctor.

Rob had a meeting, so he dropped me at the doctor and, while he was miles away, I was impregnated by another (far more educated) man. For just this once, he approved.

“Then, finally, like a really great ski day, the conditions were perfect.”

The two week wait, or TWW in internet shorthand, is the dreaded fortnight during which your body might be pregnant but it won’t show up on a test. It’s grueling and upsetting and can’t even be smoothed over by wine, because, hello, there could maybe be a baby in there.

This is where my drawerful of pregnancy tests comes in. Whatever dark magic was in that stomach shot from the night before caused my body to think it was pregnant. I therefore had to “test out” of the medicine, which took several days to leave my body. Meaning that, while I was two years into desperately wanting a baby, I had to trick my body into thinking it was already pregnant, see the oh-so-longed-for positive results on tests, and then, over time, watch the line fade back to “not pregnant.” Then I had to keep taking the tests to hope the line would appear again, this time because of a zygote, and not because of a shot.

So we waited. And watched the line disappear. I took my meds, went to work, tried to think positively. On the tenth day after my IUI, I tested in the morning, wrote my little Sharpie note, and as I went to toss it in the drawer, I noticed a line. Nothing major, but enough of a line that Rob could see it too in the picture I texted. The next day, the line got darker. A series of bloodwork confirmed that I was pregnant, and that it might be viable.

We held our breath for six weeks until the first ultrasound, which showed a tiny, steady flicker—the cells that had impossibly, miraculously, joyously joined together to create our son’s heart.

If Lou’s conception was a lumbering, years-long emotional trainwreck, my daughter, Edie’s, 13 months later, was a Japanese bullet train. I felt incredibly lucky that we were able to have one baby and decided to limit myself to six months of trying for a second. This time, we went into it knowing which cocktail of drugs and procedures worked, and—despite an ice storm and my race to ovulate before my doctor’s office closed for the holidays—I somehow got pregnant with Edie on the first try. We’d braced ourselves for the worst, and, 16 months after her birth, I still can’t believe she’s here.

Infertility is painful. Those two years with Lou were hard, and not just because I felt alone or hopped up on drugs. But because it was the first time in my life that I couldn’t equate hard work with success. It felt so unfair—it was so unfair—but I know how lucky we got. I know that some couples reading this are dealing with much more complicated situations that require more money, more procedures, and more time.;

“The phrase ‘I’m not my body’ is positive, where ‘I’m a failure as a person because my body won’t give me a baby’ is negative and faulty thinking,” advises Sobelman. “I teach my patients to control what they can and not put a lot of energy into controlling what they can’t.”

So my drawer of control stays filled with those pregnancy tests, and while not super hygienic, I can’t bring myself to throw away the first signs of life from my kids. They’re smoke signals from my babies, beacons of hope that assured me I was going to be rescued—and, more importantly, a mom.