fertility meds


when i didn’t turn up pregnant after taking clomid and gonal-f in the spring of 2005, dr h upped the ante: i went straight to gonal-f. do not pass go. (definitely do not collect $200.) i was on a fairly aggressive regimen (the logistics of which i have blocked) but it did what it was supposed to: it produced a nice lining with a few good-looking eggs, which opened the door for those timely “relations” to seal the deal.

the hardest thing about this sequence was that dr h, who had been in my city in 2004, had moved in december 2004. out of state. not super far out of state, and both his new practice and my home were each fairly close to our respective state borders. i could get to his office, barring bad traffic, in about 40 minutes.

but since i was being examined every 48 hours the drive was starting to feel like a little much. and because the drive was starting to feel like a burden, so was the whole protocol. so somehow i was not surprised when it didn’t work.

it seemed time to revisit the whole scenario. we had failed to conceive twice, even though the medical medicated odds were in our favor. this was pretty new for us. while we had certainly gone months before without conceiving, that usually only happened when s was in the hospital or otherwise recuperating from his nasty cycling accident that had punctured his lung and fractured his elbow. if we both were feeling good and bothering to have sex, we generally wound up pregnant, if only for a few weeks or months.

i was beginning to feel like a science experiment gone bad. how much crap was i supposed to fill my body with in order to make it do something it normally did quite well on its own? how long was i supposed to let my body refuse to cooperate before acknowledging failure? s and i had one answer to these questions: quit the meds and go back to “normal.” our new version of normal was hard enough; we didn’t need this extra stress and uncertainty and disappointment. but dr h had another answer: up the ante again. get serious. force the body to work.

yikes. i’m darwinian enough that this made me really nervous. s too. so we took a much-needed vacation (to alaska! alaska in july is the place to be, i tell you) and as we hiked ourselves into a blistery exhaustion we decided to let dr h proceed. we’d follow his lead for a little bit longer. but we knew that we didn’t have much more in us.

so we returned home to those nasty fertility meds, round 3.

i’m determined to keep 72 hours between my tests (the deadbabymomma’s version of a hairshirt), so in the interval, some more history:

spring 2005

earl’s delivery was very easy, but my recovery from it was hell. i had only started wearing maternity clothes 2 days before she was delivered, so my shape and size hadn’t changed much. i had gained 8 pounds total and they were all in my belly, so i figured they would slide off easily and i would quit looking pregnant and boy, wouldn’t that be great because then people would quit asking me when my baby was due. ha. for the next three months i lost and gained back those same 8 pounds roughly every week. i still needed my maternity pants. that sucked.

but that was nothing compared to the bleeding. my post-partum bleeding had practically stopped after 2 weeks when i saw my ob, which he considered great news. but instead of actually stopping it kept going and going…and going. my uterus, like my weight, was totally out of whack for the next 12 weeks. yes, that’s what i said: twelve excruciating weeks — 94 days — of non-stop bleeding.

nine weeks into this ordeal i went back to the doctor to ask, tentatively, if what was happening was, you know, normal. he smiled his smile at me and said “no, not really,” which i heard as “good god you insane woman why didn’t you call me four weeks ago?” he put me on a 5-day course of progesterone to stop the bleeding.

it didn’t.

one week after i stopped the progesterone, still bleeding, i started another 5-day course of progesterone. to stop the bleeding. which it didn’t do.

but the third time worked. only by now my doctor had decided that the best thing to do, since i was obviously in distress and had to fight tears every time i sat in his office and saw all those pictures of living, full-term babies and their exhausted but elated parents all over his walls, was for me to get pregnant. and since my cycle was obviously not reliable, he decided the best way for me to conceive was using fertility drugs. and he thought we should start NOW because not only did he think it would be nice for me to be pregnant before earl’s due date came around (it was still two months away), he himself was leaving on vacation soon and thought ideally i’d be pregnant before he left. that way he wouldn’t have to monitor my meds from afar.

his decision was confirmed when he started staring at my ovaries and saw those tell-tale “pearl-like” strands of eggs, all underdeveloped, in both ovaries. he had been treating me with progrestone based on the diagnosis of luteal phase defect; now, he told me, i had polycystic ovaries. this would make it even harder to get pregnant. the meds were definitely a good choice for a woman like me.

i’ll make the shameful confession that i had a hard time wrapping my mind around this. i wasn’t infertile — i’d been pregnant four times in less than two years. how were drugs going to help me? i needed help keeping the babies i’d conceived, not conceiving in the first place. i was still learning the ropes of my “new normal” as a the mother of a dead child. i was. not. ready. for my new normal to include infertility.

but i liked my doctor and while i was his patient i dutifully did everything he told me to. so i started clomid and then upped the ante with gonal-f shots. he didn’t like the looks of my lining on day 17 or so, but decided a few days later that it was time “to have relations.” which we did (me & s, not me & the doc), also (and sadly) pretty dutifully. we really thought we’d get pregnant — remember, doc, conceiving is not our problem? — but we sure as hell didn’t like being told when and how to do it.

i know there is a lot of research (some real, some really bad) about the ways our minds influence our bodies. when it comes to fertility i believe some of the hard science — like since the hypothalmus has a both a role in fertility and in regulating stress, then *actually* reducing various kinds of stress can improve fertility. (in this, i really really trust alice domar and not well-meaning fertiles who tell us just to relax. SO not the same thing.) anyway — when i’m being rational, i do not believe that having a bad attitude about sex, or medication, or about life in general, can prevent pregnancy. (too bad, though, ‘eh? there would be WAY fewer unwanted babies in the world were that true.)

and yet. yet there was a part of me that june that thought i was somehow to blame when i didn’t show up pregnant. i mean, i had taken the meds! i had science on my side, for godssakes!

sometimes i miss those long-lost days of innocence. of thinking things might be easy, or predictable. of easy diagnoses and sure-fire treatments. not that they did any good — more on my pcos status in another post, i promise — but still. it was easier to hope with stats on your side. i miss that ability to hope.