by Sara Connell
The most common complaint I’d heard from people who’d gone through fertility treatments was how difficult it was to schedule the “scheduled sex.” “After a while it really stops being fun,” one of my clients lamented after her fourth round of stim.
Each month we had a forty-eight-hour window during which we were supposed to have sex three times. Our first time around, the window happened to fall on a weekend. We’d purposely not scheduled anything else, and finding the time was easy. The following month’s window came on a Wednesday and Thursday. Bill had client meetings booked for months, I had already scheduled clients for sessions, and Bill’s father and stepmother were coming to town and were staying with us.
Over a late dinner the week before his parents’ visit, Bill and I compared calendars. We’d lit a large pillar candle, and aside from the small radius of its glow, the room was dark. The light from our cell phones illuminated our faces in the semidarkness as we scrolled through our schedules for the week. Once we’d overlaid our commitments and the parental visit, we identified two twenty-minute windows, in addition to late nights, which had never been our ideal sex time.
“I guess we can do it after breakfast the first day my parents are here—and then again before dinner the next night, as soon as you finish your five o’clock session.”
I looked at Bill and shrugged. “We’ll make it work,” I said.
The first morning of his parents’ visit, over an awkward breakfast of muffins and fruit, Bill talked really fast and I lost the thread of the conversation several times as Bill’s stepmother told me about a show opening soon at the Cincinnati Museum. Bill and I had let his parents know that I had a “conference call” at 8:00 AM that I needed to take upstairs, “because the reception was better.” At seven fifty-five, I went upstairs and then, as planned, called down to Bill to ask if he would help me with calling in to the conference line through my computer. We were like bad actors in a play. I had no idea what his parents were thinking.
Bill tore into our bedroom, where I was already lying naked, holding some organic lubricant. I’d removed the fertility goddess in favor of a single red candle, only to burn my hand trying to light it. We did our best to be amorous, but I felt the time pressure. So we just did what we could (quietly) until we reached our goal—like athletes racing in a sprint.
We did not become pregnant that month, either.
As we continued, the scheduled sex became more like regular sex. We planned around and for it, streamlined our travel schedules, and spent more weekends in Chicago, nesting at home. On the prescribed injection days, I gave little more thought to the nightly jabs than I did to flossing my teeth or taking out the garbage. I experienced no hormonal mood swings or noticeable side effects from the medication.
Dr. Colaum adjusted our dose of Follistim each cycle. “We’re looking for your magic number,” she said. “Too little, and you’ll have less egg/follicle growth. Too much, and you’ll hyperstimulate and we’ll have to cancel the cycle. We didn’t hyperstimulate the first time, but I did develop some tissue buildup, like debris in a river, which took a few weeks to clear. I felt afraid of hyperstimulation, mostly because it meant another month that we wouldn’t be able to be pregnant, as well as potentially an additional month off to rest in between—a wash of that precious investment of time. My trust in Dr. Colaum and her many years of experience was what allowed me to be more optimistic than worried.
In November, during our fourth cycle, I flew to New York City for a friend’s bachelorette weekend. Amanda had become my best friend in the sixth grade, when I transferred to public from Catholic school. She was consistently the smartest person in the class and a consummate athlete. The boys in our school loved her for her long, shiny, super-straight hair and sculpted calves. Her father was a skilled painter, and through her family I explored art and had my first contact with artists like Monet, Miró, and Picasso. We’d remained best friends through high school and kept in close touch during college. We’d both taken jobs in advertising right out of college and somehow, by some generous cosmic gift, we had ended up in London at the same time. Amanda had met her now fiancé while we were all living there, and when he proposed, she had called me from their flat in North London and asked me to be her maid of honor.
The bachelorette fell during the final two days of my stim injections, requiring me to bring the medication with me and to leave earlier than I’d originally anticipated on Sunday (to make it home in time for Bill and me to have sex). Dr. Colaum upped my dose of Follistim. She approved me for travel but encouraged me to listen to my body in terms of activity. “Be sure to take your injections at the same time as you would in Chicago, and keep the medication cold.” Follistim required constant refrigeration—so I needed to find a discreet place to store it in flight and during our hotel stay. I wondered about flying with needles, but was able to find a note on the American Airlines website informing me that as long as I could produce a prescription for my medications, I could bring them with me on the plane.
On the Friday of the bachelorette weekend, I rubber-banded the medication, needles, and prescription labels between two ice packs and left for the airport.
I arrived early and alerted the officials at security that I was traveling with injectable medication. The guard waved me through and didn’t even ask me to unpack the package or for a prescription. The flight boarded on time, but we sat for over an hour on the tarmac as the Follistim box grew wet with melting ice.
Once we took off, I wrestled with whether to bother the flight attendant for ice. I walked toward the back of the plane ready to offer a heartfelt appeal, and found the flight attendant in the galley, standing in front of the beverage cart, flipping through a magazine. I’d barely made it through the word “medication,” when she held up her hand, as if to spare me from any further explanation, removed two club sodas from the ice drawer, and laid the Follistim package with care in their place. She handed me the sodas and told me she’d put some ice in a bag for me when I deplaned.
I was touched by the flight attendant’s kindness. My throat tightened into a knot. I began to thank her, but she waved me back toward my seat; the extra hormones may have finally started to affect me. By the time I reached my row, I was wiping tears from my face with my hand. I pretended to be looking for something in my bag, sticking my head in as far as I could to give myself a few seconds to catch my breath. When I emerged, I made a show of blowing my nose as if I had allergies, in an attempt to assure fellow passengers that they were not flying with a crazy person.
The bachelorette party’s gathering place was the Gansevoort Hotel in the Meatpacking district. We’d booked a suite for seven of us who were traveling in from out of town. The eight other guests, all New Yorkers, would join us for various events throughout the weekend. Pastis was a hive of activity across the street, with paparazzi staking out the front entrance. I experienced the jolt of energy I always felt in New York, but it gave way quickly to a wave of dizziness and fatigue. If I didn’t know every minute detail of my fertility status, I might have thought I was pregnant.
I found out at the front desk that Amanda and several others had already arrived, and I made my way to the room on the fourth floor. I heard laughter coming from the room and hesitated in the hallway amid the mod carpeting and silver-framed black-and-white photographs on the walls. Another wave of fatigue rose up and passed; my mind felt fuzzy. The other women coming this weekend were mainly acquaintances, mostly single or newly married. The wet bag in my hand made me different, someone with a secret agenda. I didn’t want to arouse any questions. I hadn’t even told Amanda we were trying.
I stashed the bag with the Follistim in the minibar fridge, wedging it behind the beer cans and Orangina bottles in the back. The first night we convened at the pool bar on the roof deck, which made it easy for me to run back to the room at 8:00 PM to take my injection without anyone’s noticing. But the next night presented a challenge. As eight o’clock approached, the larger group gather
ed in our hotel suite to hang out for a few hours before going out to a late dinner. I waited for the bathroom to become available. Four additional people had joined the party for the evening, coming in from Philadelphia and Boston. Everyone needed to shower.
By the time I got into the bathroom, the counters were covered with toiletry bags, makeup, and hairbrushes. I peered out into the bedroom before closing the bathroom door. Quickly, I set up the needle, Follistim vial, and pen on a tissue. I swabbed my skin, ratcheted the medication to my new dose, and stuck the needle into my stomach. I didn’t hear the door before it swung open. Amanda’s college roommate burst into the room. “I’ll be right ther—” she called out to someone down the hall. And then she stopped. “Um. Oh my god. Sorry.” Her face reddened as she took in the case of needles and the pen jabbed into my stomach.
I blanched, feeling as if I’d been caught shooting up.
“It’s fine, really.” I contemplated telling her it was insulin, for diabetes. “It’s fertility medication,” I said.
“You don’t have to—oh, wow, really? You’re trying to get pregnant?” she asked. I nodded, inwardly cringing.
I hated this. I didn’t want to be asked about our progress at the wedding the next month or in the group emails that circulated over the years, usually when someone got engaged.
“That’s so great,” she said. I hurried to pack up the kit and store the needle in the Ziploc bag I would take back to Chicago, since I couldn’t throw them away in the regular trash. (Braun had provided Bill and me with our own superhandy biohazard container for disposing of needles at home, but it was too bulky to take on the plane.)
“And you have to take shots?” she asked, as she watched me swab off my abdomen and pull down my dress, which I only then realized was hiked up around my neck. I flushed and hurried to pack up my kit.
“Do they hurt?” she asked. I wondered if she really wanted to be having this discussion or was just trying to normalize the situation for me.
“Not much,” I said, although my lower-right abdomen had been feeling tender since earlier that evening. I wasn’t sure what was causing the pain. It felt internal, and that made me nervous. In my mind the word “hyperstimulation” loomed. Abdominal pain was one of the symptoms listed in the packet from RMI.
“I hope it works,” she said, her eyes full of goodwill.
“Thanks,” I said.
I thought about asking her not to tell anyone, but decided not to ask someone I barely knew to keep a secret for me.
“You didn’t tell me you’re trying!” Amanda gushed, running up to me as soon as I reemerged. “And you’re doing fertility treatments?” she asked, dropping her voice and pulling me to the side of the room.
“We’re a few months in,” I said. I felt exposed, and fatigued. When I added up the years of acupuncture and more recent doctor assessments, it seemed like we’d been doing treatments a lot longer than that.
The conversation around the room quieted, and I was aware of being the focus of attention. I’d married Bill at twenty-six, years before most of the rest of our peer group had entered marriages, and was perhaps the first in this circle to have entered into fertility-treatment territory. I felt obligated to say something. I made a few jokes and hoped the topic could be closed.
Satisfied, the group turned our conversation elsewhere and we went out into the night—to Morimoto’s, where the bathrooms had cherry-blossom holograms and European bidets, so beautiful and warm that we lingered at the sinks, warming ourselves before reentering the frigid air-conditioning blasting through the restaurant.
By the time dinner ended, it was eleven o’clock and the group was moving on to a club. I couldn’t imagine dancing at this point. The fatigue had started again, and the tenderness in my abdomen had progressed to a consistent dull pain. I was concerned enough about hyperstimulation and the similarities, although faint, to the pain from my ovarian cyst in high school that I called Dr. Colaum’s after-hours service and was put through to Lisa Rinehart, Dr. Rinehart’s wife. Lisa had started RMI with her husband and had none of his or Dr. Colaum’s scientific reserve. She wore bold print shirts and perfume and bright nail polish, and once she got to know patients she greeted them with motherly hugs.
“Sara?” she asked. “How are you?” I dropped back from the group and waved my hand to Amanda to indicate that I would catch up. I pressed the phone into my ear and covered my other ear with my free hand, trying to hear Lisa’s voice over the din. The connection was staticky and cut in and out. Lisa took me through a symptom inventory.
“Does the pain feeling sharp-shooting or consistent?”
“Consistent.”
“Intense or low-grade?”
“Medium.”
“Anything else?”
“Yes, the area around my lower-right abdomen feels hot,” I said, pressing my palm over the skin. My ovary felt like a furnace.
“You’re at the peak of your cycle,” Lisa said. “Your symptoms are normal for a stim cycle. We won’t know until you come in, but I don’t think you’ve hyperstimulated. Have you taken some aspirin or Tylenol?”
I had not. I’d wanted to make sure I could feel what my body was doing. “Call if it gets any worse, honey,” Lisa said. “The best thing you can do now is to take it easy.”
I was glad that Lisa could not see me through the phone. I’d had to pick up my pace so as not to lose the group. I kept an eye fixed on the bobbing image of Amanda’s orange dress in the crowd ahead, moving into a half-run every time I thought I was about to lose them. I didn’t know what Lisa had made of the background noise (I hadn’t told her I was in New York City), but I doubted walking seventeen blocks to a club to go dancing at eleven o’clock at night was what she had in mind when she said “take it easy.”
The line outside the club snaked around two blocks, but someone had called ahead to get on the VIP list, so we were ushered right into the club’s velvet mouth. Inside were dance floors, a lounge area, and three bars. I was sober, having had only a few sips of wine at the restaurant. Bodies pressed against me from all sides: men in suits and hipster sportswear, women in short dresses and ultra-high heels. I cupped my hand over my low abdomen and tried not to get jostled.
As we waited in line at the bar, I asked around for some aspirin. Gen, a striking woman who worked with Amanda in London, offered me a travel pack of Tylenol from her purse. “I heard Mary-Kate and Ashley Olsen were here last week,” a woman next to us gushed to her friend.
“Who cares?” Gen whispered to me, nodding in their direction. She hailed a bartender with a hundred-dollar bill. “As if that’s a reason to come here. Get your own life.” I laughed. I gave her some money for the champagne she was buying for the bride-to-be and ordered a club soda for myself. I took the pills, swallowing the water in large, urgent gulps.
I found our group toward the left side of the dance floor and looked around for a place nearby where I could rest. “You okay?” Amanda mouthed, waving to me from the throng. I nodded yes. Gen passed around champagne glasses and we toasted Amanda’s upcoming celebration. “And here’s to Sara getting knocked up this week!” Amanda’s college roommate added as a PS toast, yelling it out, her voice carrying over the thumping beat. I spit the last of my water onto the floor. Gen saw me and held up her glass. “Nice,” she said.
The pain in my abdomen had subsided. Either the Tylenol had kicked in or my ovary had settled. I felt an impulse to dance. I laid my glass on a table in the lounge and joined the swirl of the crowd. The music was so loud, the lyrics were inaudible. All I could hear was the pulse of the bass and the rush of blood in my ears. A new song emerged, a popular summer anthem. The crowd responded and began to chant the chorus. We moved as a group, snakelike, to the center of the pulsing floor. Raising our arms, we danced for Amanda’s marriage, her happiness, her future, stomping our feet, laughing, encircling her as a tribe.
Back in Chicago, I took the rest of the Follistim and the HCG hormone and Bill and I had sex. I pro
pped my legs up on the wall over our headboard and tried to visualize being pregnant. Sunrays streamed through our wall of windows. It was the one room we’d never quite decorated as we’d worked systematically through the main house, doing improvement projects as our budget allowed. Our bedroom was therefore an eclectic hodgepodge of traditional European pieces mixed with an Asian wedding cabinet we’d found on Portobello Road and a neutral rug. A framed oil painting of a small village in the South of France hung over our bed. The sheets and duvet, tangled underneath me, were all white, my favorite. It was a happy room, spacious and not too rigidly defined. I willed myself to feel open to possibility, but still, my visualization felt halfhearted.
I didn’t know if I was having a hard time envisioning pregnancy because stim hadn’t worked or if I just didn’t believe stim was going to work for us at all. After each cycle, when my period would alert us that Bill and I were not pregnant, I would call Dr. Colaum’s office to let them know, and then Bill and I would drive to Evanston for another consultation.
The meetings in Dr. Colaum’s office were already beginning to feel repetitive. Dr. Colaum would walk us through the treatment, doses, and possibilities and make a recommendation for next steps. On our fourth consultation, on a warm day in late November, Dr. Colaum leaned forward at her desk and got straight to her point.
“We can keep going with stim,” she said. “You’ve given it a good try, but I think you may need something more.” I sensed what was coming.
A year or so earlier, a few months before I’d seen Dr. Bizan and then Dr. Colaum, a friend of Bill’s father had taken us to dinner and asked bluntly why we didn’t have kids yet. I had yammered something about working on it, and he’d said he didn’t see why anyone who didn’t get pregnant within a month or two on their own wouldn’t go straight to IVF.