I may have set my expectations kind of low, but our wedding was—objectively, of course—one of the best weddings I’d ever been to. People had fun. We didn’t stop dancing. As a surprise, we’d hired an Elvis impersonator to show up halfway through the reception, and the crowd went wild for him. And the ceremony was so moving—we wrote our own vows, and I teared up as I was reading mine, and some of our guests cried too! I was just happy to be surrounded by so many people I loved, marrying the person I loved.
Then we left for our honeymoon to Reykjavík and London. After the high of the wedding, I thought, wouldn’t it be just perfect if I got pregnant on our honeymoon? Wherever we went, the specter of the nonexistent pregnancy was always there. I tried to reassure myself by telling myself that it had only been a few months, and we’d been “trying” before the wedding but not really trying, not like obsessively charting basal temperatures to know when I was ovulating or making sure we had sex multiple times during the so-called fertile window. We hadn’t been treating trying to get pregnant like it was our job. But when we got back, I thought, we could really start trying.
I had friends who had run the gamut of infertility experiences—miscarriages, IVF, struggles to get pregnant—but I also knew people who had gotten pregnant immediately, even well into their thirties. My friend Bridget told me I shouldn’t worry that I was too old to get pregnant easily. “You just have to have sex the day before you ovulate,” she said one night when we met for dinner. She was around my age and had a two-year-old. “I did that and we got pregnant right away. You’ll be fine.”
I got ovulation strips that would supposedly tell me the ideal moment to have sex. “I usually tell people to go to a reproductive endocrinologist after a year of trying, but at your age, you can go after six months,” my doctor said, when I asked her when we should start thinking about intervention.
Matt was convinced the problem lay with him. “I think it’s my weight,” he said matter-of-factly. He had lost weight in the months before I met him, but now was starting to gain weight again: “My balls probably get so hot, with all that extra weight.” I laughed. That couldn’t be true, could it? There were plenty of fat people, men and women, who managed to reproduce.
“I doubt it’s you,” I said. “It’s probably me, and my old eggs.”
* * *
—
IN JANUARY 2016, Karen had her baby, a girl. I happened to be in New York at the time and took the train down to Washington, D.C., to meet my new niece. D.C. had been walloped with a snowstorm that weekend, and when I got off the train at Union Station, the city seemed eerily quiet. There weren’t any cabs waiting in front of the station, so I decided to walk to their house, which wasn’t far. As I walked down the mostly unshoveled sidewalks, I thought, for the millionth time, about how my younger sister had managed to achieve so many life milestones way before me. Karen had always been much more type A than me, certainly, but she also had a nearly unshakable sense of self and thus has always been able to fulfill the promise and potential of the person she knew she was. She knew she wanted to be a lawyer from the time she was in high school and went straight to law school, and now, at thirty-one, she had her first child, a job as an associate in a corporate law firm, the top two floors of a townhouse in a charming neighborhood in D.C. I knew that I shouldn’t compare myself to her—although we were very close, we were also very different people. Her friends mostly worked in finance or law and had followed similarly straightforward tracks to the comfortable upper-middle-class lifestyle they aspired to. Still, it was hard to look at her life and not ponder the existential questions, like whether I should have gone to law school and maybe I *should* have married my college ex-boyfriend. I knew deep down that I didn’t want her life, but from the outside at least, it seemed so appealingly uncomplicated and fulfilling. Why did I insist on making things harder for myself?
My sister—who normally had everything hypertogether—looked exhausted. “The hospital was a shit show,” she said, sitting on the couch in their living room as she attempted to nurse the baby. “And we were trying to get out ahead of the blizzard, so everything was rushed and I got to the car and realized they had forgotten to take out my IV.”
“Shut up,” I said.
“Swear to god,” she said, rolling her eyes. “And I didn’t even notice because I was just so frantic trying to get out of there.”
“Ugh,” I said. “I’m sorry.”
Karen put away her boob. “Do you want to hold her?” she asked, holding the baby out to me. I took her from her hands and rocked her in my arms. She was tiny and soft. You didn’t exist outside of my sister a week ago, I thought. It was an obvious, banal observation, but somehow, seeing my niece here, in the literal flesh, was making me more emotional than I had expected.
I stayed a couple more days and then took the train back to New York, and on the flight back to Los Angeles, I got my period.
CHAPTER TWENTY-TWO
I probably should have started calling doctors right away, but I waited until the last day of April, when it was almost exactly six months from when I’d seen my OB, and called someone I found by looking in Los Angeles Magazine’s Best Doctors issue. She was in her sixties, very no-nonsense. She told me my uterus looked good, but to make sure, she sent me to get an exam during which your uterine cavity gets filled with an X-ray dye, to see if your fallopian tubes are clear and if anything else abnormal shows up in your uterus. At the same time, she sent Matt to get a semen analysis.
My tubes were clear, but a polyp had come up on the exam, and I’d need to get it removed before I could potentially start fertility treatments. Meanwhile, Matt had gotten the results of his semen analysis, and they were not good, just as he had suspected. I hated that he had been right about this, but the doctor downplayed the notion that he had a low sperm count because of his weight. “We just don’t know why,” the doctor said. “It could be any number of things.” Our official diagnosis was male factor infertility, and my doctor said that we would have a less than 1 percent chance of conceiving without medical intervention. All those months of dutifully checking ovulation strips and having scheduled sex had been pointless.
I started an accordion file with our test results and diagnoses, and notes from the doctors. I was ready. I would be the General Patton of infertility: organized, efficient, ruthless. Infertility had no idea what it was in for.
I quickly learned that infertility laughs in the face of plans. Every step of the way, it seemed like there were roadblocks. My ob-gyn didn’t do polyp removal surgery, so I’d have to find someone else. I finally found a surgeon who would do the operation using my insurance, and the morning of the surgery, Matt and I took a selfie as I waited in the pre-op bed. This would just be something to check off the list, and then I would be able to start IVF treatments and then I would get pregnant and we would have a baby—right? I didn’t want to let myself think about what would happen if it didn’t work. I was finding that the more complications that came up, the more I wanted it to work, and the more it seemed incredible that people had babies without medical intervention. Imagine, just having sex and getting pregnant! It seemed so easy, and so cheap, and so unfair that it wasn’t accessible to us.
Still, it was hard to actually picture what motherhood would be like. It seemed so far off in the distance. I had so many hurdles I had to overcome before I held a baby in my arms that I felt like I needed to just focus on the here and now: Get this blood test, have this surgery, meet this doctor. Picturing a future that might not exist for me was too overwhelming, but I could schedule an ultrasound. That was something that was still in my control.
Soon, we met our new doctor, who came recommended by one of Matt’s friends. Matt had been much more open about our struggles getting pregnant than I was. He told me he’d brought it up at his weekly poker game and was surprised to learn that three other people at the table were either currently und
ergoing treatments with their partners or had done fertility treatments. He talked about it on the podcasts he recorded, joking about his “dumb sperm.”
I was more circumspect. I told some close friends, but I hadn’t written about it online or on social media. I didn’t want to admit it to myself, but I felt like a failure just by virtue of having to do infertility treatments, even if they were ostensibly because of Matt’s “dumb sperm.” All the times I had felt like I hadn’t gotten the memo about some unwritten “girl code”—whether it was about shaving my legs or trying to not date a guy I worked with who lived with his girlfriend—seemed like they had now converged on my fertility. Maybe my ovaries hadn’t gotten the memo either.
And I wondered if we’d be in the same position if I had frozen my eggs. Then I wouldn’t have to go through the egg retrieval now, three years later. I had thought doing an egg retrieval at thirty-five would be the same as doing IVF at thirty-nine, but they weren’t the same at all.
Our doctor was a tall, thin, bald man who wore glasses. Matt disliked him immediately. “He didn’t laugh at my jokes,” he said when we got home from our first appointment with him. “He’s a robot.”
“God forbid someone doesn’t laugh at your jokes,” I said. I didn’t find the new doctor particularly warm, but he seemed careful, methodical. “We need a doctor, not an audience for your jokes.”
* * *
—
TO PREPARE FOR the egg retrieval, I had to inject myself for ten or so days with a cocktail of fertility meds to help my follicles develop. The meds made me nervous. They were expensive—we had no insurance coverage for them, either—and they required me to be exacting, injecting at the same time every evening with a specific, and often changing, amount of drugs. I worried that I would spill them or inject myself with the incorrect dose. At each ultrasound appointment, my doctor seemed pleased by the progress of my follicles, and as the scheduled day for the retrieval approached, I was cautiously optimistic. Matt seemed optimistic, not even cautiously.
“I think we’ll get four embryos,” Matt said.
“How will we choose which one to transfer?” I asked. “If we get four embryos, what will we do with the extra ones?”
“I don’t know,” he said. “I guess we’ll figure it out.”
On the third day after the retrieval, after all the eggs had been fertilized and were growing in the lab, we got an update that there were nine embryos that were still growing, but by day five, there were only four. Then the four were biopsied, and we waited for the genetic testing results that would tell us if the embryos we’d created were viable. We finally got the results: Just one embryo was genetically normal.
I couldn’t believe it. How had we gone from nine embryos on day three to one normal embryo? It seemed mathematically perplexing, but that was infertility math—like the hardest, most ruthless math you’ve ever encountered. My doctor didn’t have any real explanation, just telling us that there’s no way to predict how many normal embryos you’re going to end up with, and there’s always a large drop-off between the number of eggs you get and the number of normal embryos you get.
Finding out the biological sex of the embryo from just a few cells is truly a weird experience. I’d asked the clinic to withhold the sex, but when they had emailed us with the results of our genetic tests they had referred to the embryo as female. Of course, what I was afraid of happening, happened: I started thinking about a little baby girl, one who would have dark hair like Matt and me. She’d be smart, funny, kind, and hopefully not as moody as I had been as a teenager (but I’d definitely get her on antidepressants if she needed them). Matt’s vision of our daughter was a funny tomboy. “You know that means she’ll be super into, like, princess stuff,” I told him, but he shrugged. We’d come up with a list of names—Matt was pushing for Regina or Gloria, after his grandmothers; I liked Alice, or maybe a name like Estelle or Annette, something that sounded like it could have belonged to one of my grandmother Jeannette’s friends.
* * *
—
WE DID ANOTHER retrieval that summer, and that yielded us one normal embryo and one “inconclusive” embryo. I got an email from the clinic’s embryologist that read, “A segmental error was reported on the second embryo, indicating that part of one arm of chromosome 2 in the biopsied cells from that embryo was deleted. Chromosome numbers were normal, but a chromosome segment was partially misrepresented…Our industry is still trying to define which of the segmental errors are of clinical significance. Some may self-correct, and some may not translate to errors in the fetus (which is a good possibility with this particular deletion). In short, based on the current genetics literature we can speculate, but cannot ascertain with certainty, which errors might be associated with abnormalities in offspring.”
In other words: They had no fucking idea. All I wanted were concrete answers, and it was becoming increasingly clear that when it came to fertility treatments, there were no concrete answers. There often weren’t any answers, period.
As the summer wore on, I started noticing that more and more people were responding to Matt on social media about going through fertility treatments. I was getting more frustrated—that it wasn’t working, but also that our health insurance didn’t cover any of it. I tweeted about my frustration, and to my surprise, the responses were sympathetic and kind. I started wondering if I should be talking about what we were going through more openly. I had been nervous about being more public about our struggles, but now that I had, I was relieved. And I felt a sense of kinship and community with everyone who tweeted back at me. They got it.
But I was also sensing a shift in myself, in how I was starting to feel about doing IVF. It may not have been working yet, but by talking about it publicly, maybe I was giving myself space to be who I really was.
I suggested to Matt that maybe we continue talking about doing IVF—on a podcast. Together. In real time.
“No one wants to listen to us talk about IVF,” he said.
“I think they do,” I told him. “Look at all the guys responding to you on Twitter about how they’re so glad you’re talking about it.”
“I guess there aren’t a lot of men who talk about infertility,” he said. “I don’t care, I’ll talk about my dumb sperm all day.”
“There aren’t a lot of women who talk about it openly, either,” I said. “It’s got such a stigma attached to it.” I paused. Did it really, though, or was it a stigma that I had attached to it? I wondered, Would doing a podcast together help me work through some of my own insecurities around doing IVF? “I really think we should do a podcast. Why don’t you do a Twitter poll and see if people want us to do one?”
“Fine,” he said. “There’s no way that they’re going to say they want one.”
But people did. The official results of the poll were 80 percent in favor, 20 percent opposed—more in favor than I had even anticipated. We launched Matt and Doree’s Eggcellent Adventure in October 2016, a few weeks before my first embryo transfer.
“We’re not sure how long this podcast is going to last,” I said on the first episode. “Maybe it’ll be a limited series. Like six episodes.”
It seemed like a reasonable number.
CHAPTER TWENTY-THREE
The prep for an embryo transfer is similar to the prep for an egg retrieval, with one significant difference: You inject your shots in your butt. Well, not exactly your butt, but just above your butt, like the back-butt region. The needles for this injection were scarily long and the angle for the shot required some creative contortion. Matt ended up doing most of them, but as the day of the transfer approached, he asked if it would be okay if he went to Las Vegas with his friend. I said okay, even though I was a little annoyed that he would even ask. I couldn’t just up and go to Las Vegas; it was yet another example of the ways in which this whole process affected the two of us so differently.
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sp; That night, I twisted around and tried to find the exact angle that I was supposed to be injecting—it would be really bad to hit a muscle—took a deep breath, and plunged it in. It definitely did not go in correctly. When I took it out, the needle was bent at a ninety-degree angle. “Fuck,” I said. I’d probably failed to inject the correct amount, and as an added bonus, my ass was now on fire.
I called Matt, crying. “I just tried to inject myself and I bent the needle, and I don’t know if I got the progesterone in, and WHY AREN’T YOU HERE!” I’d once thought that I could approach IVF like General Patton, but maybe I was actually more like Napoleon, cocky and overconfident, only to suffer ignominious defeat at my Waterloo, aka my bathroom. And right when I needed Matt the most, he was probably sitting at an Iron Man slot machine, losing money that we would need for our inevitable next round of IVF.
“I’ll come home,” he said.
“You don’t have to do that,” I said, sniffling.
“No, I’m coming home,” he said. “I shouldn’t have gone anyway.”
The transfer itself was relatively straightforward. There was no anesthesia; I just got wheeled into the OR and lay there, watching on a monitor as the doctor inserted a catheter into my vagina and deposited the embryo, and then he handed me a printout of the embryo. And then came the wait, an agonizing ten days where I had to continue doing the progesterone shots to support the embryo that may or may not have implanted. It seemed like it had to work—why wouldn’t it work? It was a genetically normal embryo and there didn’t seem to be any other issues.
Thanks for Waiting Page 15