The Miscarriage

 

I was lying on my back, with a layer of thin, crinkly paper draped over my bottom half, looking at my ovaries on the ultrasound machine, thinking “How in the world did I get here?”  I never expected to have trouble getting pregnant.  Married for the first time at 38, I thought I’d paid my dues.  It had taken me ten years longer than most of my friends to find true love.  I was sure God wouldn’t deposit me right back to a state of longing, with little control over the outcome. 

I’m not sure when I fully realized the gravity of the situation, that the word “infertility” applied to us.  It was a creeping awareness, like a bell you hear ringing in the distance and then suddenly you are in the bell tower, under the bell and it is ringing so loudly that you can’t believe you hadn’t heard it before.  Only this bell tower has a huge clock on it, and as I run from the sound, I keep looking over my shoulder to check the time. 

My husband and I both got good marks on the checklist.  Did I ovulate?  Check. Are my tubes clear? Check.  Did my husband’s specimen meet the standards?  Check.  Our infertility is unexplained.  I tried to deny it, chalk it up to nerves or fate or timing.  But, that bell keeps ringing and the hands on the clock keeps moving.  My doctor said, “If you were 29 and not 39, I’d tell you to go home and not worry about it.”  But, I was 39, and, I wasn’t getting pregnant. 

I was never one of those people who built motherhood up to be the pinnacle of a woman’s existence.  It looked hard, and sometimes downright boring, to me.  But, I figured that was because it wasn’t my time to be a mother yet; I never intended to skip it.  Joel says we’ll be ok if we didn’t have kids.  We’ll have a different kind of life, not better or worse than anyone else’s.  We can travel more and choose a home in an area we like, even if the schools are lousy. We can retire early.  And, I have to admit, when people hear we don’t have kids, some say, “You’re smart.”

We’ve given it a very good try, full of hope, excitement and pain.  It’d make a great movie, unless you’re a sucker for a happy ending.  First, we tried clomid.  Nothing was really wrong with us that a little hormone pill and well-timed “breedin’ sex” couldn’t fix.  Only, it didn’t.  Then we tried IUI—intra-uterine insemination.  I gave myself hormone shots for the first half of the month to help me create more eggs and then another shot to stimulate ovulation.  It is orchestrated, uber-conception.  Joel’s sample is placed at exactly the right spot—no swimming required on their part—and we wait two weeks to hear.  We got the news we wanted. 

I was at my desk around 1:30 when she called.  I saw Fertility Clinic come up on my caller ID and held my breath.

“Susan,” she said.

“Yes.”

“You’re pregnant!”

I was thrilled.  We’d done it.  It worked.  Just one more boost, the difference between clomid and the shots had done it.  There was really nothing wrong with us.  We felt like we’d won the lottery that day.  God, we were happy.  None of this is covered by our health insurance; an IUI cycle costs about $2,500 and a more complicated procedure, In Vitro Fertilization, costs $15,000 a cycle.  Never have I spent so much to get so little.  But, most of that money was safely in the bank back then.  We were pregnant.  We began to plan and in the next few weeks I bought two baby name books even though I promised myself I wouldn’t until we got to 12 weeks.  We even heard a heartbeat. 

Then I went to my 10 week appointment.  We almost made it to 12 weeks, which is important, because at 12 weeks we could have told people.  It would have been Thanksgiving.  Soon, I would have started showing and we would have been a step closer to having a child.  Our family would have grown from two to three. But, it was not meant to be.   

“I think we have demise,” my doctor said.  She used the word demise.  There would be no baby.  There are some days I wake up and still don’t believe it happened.  My due date has come and gone now and I still can’t understand why it happened.  I live in mortal fear that I’ll never be pregnant again.  That that feeling of joy, shared with so few, is gone never to return.  When people ask if we have kids, I say no.  I wonder if they can see the flicker in my eyes, if they can hear the momentary hesitation.  Almost. Once. 

We did two more IUI’s, thinking if it had worked once, it could work again.  One produced a chemical pregnancy that only lasted a few days and the other one produced nothing.  

I went to an acupuncturist and lay on a table while she tried to put my body into balance.  Traditional Chinese Medicine believes that the body has an energy force running throughout it called Qi (pronounced Chee).  Qi consists of all essential life activities which include the spiritual, emotional, mental and the physical aspects of life.  By having acupuncture, it is believed Qi is released and my body will be put into balance.  I must be permanently off kilter ‘cause it didn’t work.

People try to help.  Everyone has a story.  A friend of mine, who needed fertility to have her four children (including a set of triplets!) told me that the Bible says when Adam and Eve were in the Garden of Eden alone, they were a family.  A man and woman, without children, qualify as a family.  I try to believe that.  About 40% of the stories I hear are about success with fertility treatment; another 40% of the people try to give us hope by saying that once their friends stopped “trying”, they became pregnant immediately; and the last 20% talk about the joy of adoption.  Virtually no one talks about the other option:  life without children.  This is the option that we are trying to accept. 

After only two months of marriage, a 40 year old friend of mine got pregnant.  It was like a hot poker to my heart.  Was it envy?  Who knows, but it was as real as getting mugged.  It left me shaken and sad; afraid and worried; insecure and aching.  Her happiness was just another reminder:  it doesn’t have to be this hard.  She tried to console me by saying that she knew how I felt because she hadn’t gotten pregnant the first month they tried. We’ve been trying for more than two years.  She encouraged me to do more fertility treatments because we are “running out of time.”  At some point, you stop listening to well-meaning people.  Most of them simply have no idea what they’re talking about.
There was one more thing to try, In Vitro Fertilization or IVF.  Again, there are the shots, but many more of them.  Shots to increase egg production and shots to slow down ovulation.  IVF is science’s way of monitoring and controlling Mother Nature’s alarm clock.  It will still go off but not until the doctor is good and ready.  And, the doctor sets all his patient’s clocks to go off at the same time, picking one week a month for hopeful mommies-to-be to show up to have our eggs “retrieved,” “fertilized” and then “transferred” back into our bodies as embryos.  All of us show up at the same time, our abdomens bulging with eggs, holding our husband’s hands and trying to avoid eye contact with each other.  It’s a game of odds and we all know it.  Some of us will be lucky and some won’t.  There’s no point in pretending we’re rooting for each other.  We’re not.

For women 40 and over, the chance of conception the old fashioned way is about 2% each month.  With IUI, about 20% of our doctor’s patients get pregnant each cycle and with IVF about 40% of the patients in our doctor’s practice get pregnant each cycle. 

When it came time for my “retrieval,” the news was great.  I produced 21 eggs.  In my anesthesia-induced fog, I looked at my husband and said, “isn’t that two dozen?”  The doctor and embryologists were all optimistic.  Of the 21 retrieved, eleven were immature, didn’t fertilize when they met Joel’s sperm or just stopped growing once they became embryos.  That left us with 10.  Three days after the retrieval, we went back to the doctor’s office for the “transfer,” putting the embryos into my uterus. 
We were advised to put in five.  Our embryos looked great.  We were told they did not look like the embryos produced by a nearly 41 year old woman.  We were doing better than average in the egg production and fertilization department, but I was right on course in the miscarriage department.  We hoped we’d have twins, so Joel and I agreed to put six embryos in my uterus and agreed to freeze the other four.  We actually watched them move into my body.  1, 2, 3,4, 5, 6.  Six little blips, like pac man targets, moving into my body.  I sent six prayers with them.  Then, it was 48 hours of bed rest at home and 12 days of waiting.  I tried not to react to every twitch in my breast and every flutter in my uterus.  What felt like my period coming could be implantation; what could be implantation could feel like a period cramp.
Two days before my 41^st birthday we got the news.  It hadn’t worked.  Six embryos—egg and sperm having already met—put right where they need to be and no pregnancy.  You can take the horses to water but you cannot make them drink. 

Every baby girl is born with all the eggs she will ever have.  From day one, you have your allocation.  And, if you end up marrying at 38, the days between birth and wedding are days of lost motherhood potential.  I was starting to read the writing on the wall.  And, I was starting to hear another bell: the one that says time’s up, game’s over.  It’s time to quit and move on. 

The definition of insanity is performing the same activity over and over again and expect a different outcome.  When I pull my hair back into a ponytail now, I often see the gray in my part.  The time between the appointments to color my hair is shortening as the time between my periods increases.  My body is functioning perfectly, and I am fighting its pace. 

The doctor told us that not only had I used up much of my egg supply, but the ones left are old.  The few precious eggs I hadn’t squandered with contraception for nearly 20 years are flawed.  This was why we had the miscarriage and why we couldn’t get pregnant again.  The doctor talked about egg donors and surrogates but I wasn’t listening anymore.  I was beginning to accept our family of two.

We used the frozen embryos a few months later.  When the nurse called to say that the pregnancy test was negative I was actually surprised—which was also surprising.  My capacity for hope astounds me.  What made me think this time would be any different? 

I called my counselor the night we found out the “frozen transfer” had not worked.  When I went to my appointment the next day, she said she heard something in my voice mail message that she hadn’t heard before.  She said it sounded like I wanted to be the person I’d been before all of this started.  I think she’s right.  That person is a woman, a wife, a daughter, an aunt, a sister.  She is smart and witty; she is emotional and hopeful.  She is happy and fulfilled; she is disappointed and realistic.  She is not a mother.  I look forward to getting to know her again.