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.

dr l is pretty adamant that i need to wait three cycles before trying again. i am pretty adamant that one (now passed) is plenty. he has research on his side. i have nothing much on mine. except, perhaps, a little more control (!?) over when to get on with it.

so we agreed to wait for divine intervention another opinion: dr s, the not-so-researchy, has-a-few-people-skills perinatologist that i have now been referred to. i have promised to abide by what he says. ( if for some reason he thinks three cycles is NOT enough, i will quickly forget i ever made such a promise.)

dr l thought this was a great compromise, since he figured i wouldn’t get in to see dr s for at least a month, which would put me close to my third cycle anyway. but crafty me: i got an appt for december 4. which would be in time to catch cycle #2. which would make me very, very, happy.

in the meantime, i have been ok’d to dose up on 400 IU vitamin e; 1000 mg vitamin c (no linus pauling prescription doses for me, i guess); and whatever i want to take for folate. that one, really, just cracked me up. the difference between 400 mcg and 4 mg — that is, the difference between a standard prenatal dose and a megadose for mthfr patients — is pretty big, at least the way i do the maths. but the difference between 400 mcg and 1 mg — the difference between what i took with ruby and what i took with mairin — is, according to dr l, “clinically insignificant,” especially since i’m not starving to death on non-folate-supplemented food. “for all i know,” dr l smiled at me, “you get way more than you need just from your diet.” it’s true that we eat pretty well in our house, but still. that seems more sunnily optimistic than medically reasoned. oh well.

duirng our chat dr l did focus a bit on the “clinical insignificance” of my ruby-dose, though, which is about as reassuring as anything can be. (that is, not reassuring at all, but still recognizable as an attempt at reassurance, and also recognizable as information that should be reassuring, so there is something nice-if-not-reassuring about his having said it.) so i’m taking about 1.6 mg, which everybody agrees is low enough to be safe but high enough to help me feel better.

in the meantime, as we prepared our house for guests over the weekend and dug through still-unpacked boxes of bathroom linens and toiletries, i found two unused hpts. we’re set. for whenever.