by Suzy Becker
I immediately began conversations with Dr. Penzias’s insurance liaison. An injectible hormone cycle would run us $2,000 to $3,000 out of pocket; however, Massachusetts has generous infertility coverage. The liaison had worked with several clients in “our situation,” a.k.a. “women without exposure to sperm” in insurance circles. Since I was self-insured and at liberty to switch my coverage, she recommended a change. I would make the change after I got my Day 3 labs back, unless my Day 3 labs disqualified me. (GAME OVER!!!)
The lab results were on my answering machine. My follicle-stimulating hormone level had gone up from 8.8 to 10.4, but it was well below the cutoff. I switched my coverage, and while I was on a roll, I called Tom Mecke. Apparently, my communications alert had been downgraded. It was no longer necessary for me to speak with Tom; whomever I was speaking with could arrange my withdrawal.
“How many vials, and where are we sending them?”
“All of them, please. We’re going to store them at Boston IVF, just easier . . . ” as if I owed her an explanation.
I gave her the phone number for the andrology department, and the transfer was scheduled for August 29th. August 29th was a record hot day. I sat in front of the portable air conditioner in my studio, trying to unvisualize what was left of our microwaved sperm melting and pooling in the crevices of a taxi’s backseat.
Andrology called to say our thirty vials had arrived safely. The end of a bad chapter. Finally.
If at First Second Third Fourth Fifth Sixth You Don’t Succeed
We were coming up on Labor Day weekend, and I was getting ready to ovulate. Everything was in place for our OIOIUI (first official intra-office intra-uterine insemination): Boston IVF was open seven days a week, including Labor Day.
This time, the problem was me. I might be out of place, out of town; I’d bought tickets (my mother’s and mine) to the U. S. Open months ahead of time, and we would be in New York the first half of the weekend. I packed up my OPK and went, intending to bomb back home if necessary.
And, just in case I wasn’t already worried enough about surging, Boston IVF called to tell Lorene that if I wasn’t surging by Monday, I would need to come in for more blood work and an ultrasound.
I got the double-purple positive on my OPK at a rest area off Route 84 on our way home from New York. I practically skipped back to the car. My first insemination, tomorrow! There was a chance I’d eke out a conception in my thirties . . . I considered telling my mother, then thought better of it. She was what you might call generally supportive, not interested in the ins and outs, especially not the ins, of my project.
Inseminations took place two floors above Dr. Penzias’s office at the fertility center. It seemed like a normal waiting room from the other side of the double glass doors. We entered and I announced myself at the desk: “Suzy Becker—”
“Suzy B.?” the receptionist gently corrected, running her pen under the privacy statement on the clipboard. “Sign in here.” I signed in, and Lorene and I sat down below a poster that discouraged clients from bringing their children to their appointments, in deference to the difficulties other clients were experiencing conceiving. The sensitivity in the air was mildly oppressive.
“Michael R.? Heidi M.?” I looked. It was okay to look if someone was moving—taking a seat, selecting a new magazine, or getting up once their name was called. You just couldn’t ogle the people who were seated. What was the beginning for us was the middle or end of a long road for others. My infertility, if you want to call it that, is circumstantial, not biological.
“Suzy B.?” Lorene and I both stood. We got lots of glances as people made their guesses.
Jackie, our inseminator, told us all about herself on our way down the hallway. She had switched from pediatrics to become an IVF nurse after her own experience with infertility, which resulted in a healthy baby girl. She was very proud of her client-success rate.
Since she was so free with her experience, I asked her about my one fear. “Does this feel like the tube test?”
“Oh, no, nothing like that,” she assured me. “You know you can take Advil, right? I personally didn’t. Remember, though, only Tylenol once there’s a chance you’re pregnant.”
We entered the room and she closed the door. “All right! Before we get started, I need you to positively identify the sperm and sign this release.” Jackie held up a test tube full of cloudy water with Steve’s name on it.
Positively identify? Microscope, please! It didn’t resemble any sperm I’d ever seen. I looked at Lorene and then signed. Jackie handed me a johnny. “Undress from the waist down.” She turned her back to us, busying herself with the sperm. Then she turned around and patted the table. I laid down and put my feet in the stirrups.
Lorene held my hand. Jackie disappeared under the johnny, then bobbed back up. “Relax!” Lorene smiled. I breathed. I am relaxed. “Relax,” Jackie said again. “Relax your butt muscles.” The paper crinkled loudly as I dropped onto the table.
Jackie held up the empty syringe. “All done! Let’s see—56 million sperm, 40% motile—there are 21 million sperm racing for that egg. The rate of progression is 3 out of 4, 4 is Olympic. Three is almost, in training.”
I forgot all about the prescribed visualization.
“I may only have one tube—”
“One’s all you need.” She squeezed my toes. Lorene gave her a hug. “Lie there as long as you like, and take it easy the rest of the day. Schedule a pregnancy test for two weeks and call us if you have bleeding before.”
Lorene drove us home. I maintained a pelvic tilt, my feet on the dashboard, until the ride was over. We had a whole sunny Sunday and Labor Day Monday ahead of us.
That afternoon we loaded Vita, Mister, and Mister’s brother Hooley (ours for the weekend) into the back of the Subaru and went for an easy walk along the Nashua River. Five minutes from the parking lot, there was a loud cracking off to our left and we watched an old tree uproot and fall, slow motion, into the river. We stepped around the pile of sandy dirt where the roots had been and kept going.
A quarter mile later, we heard an ominous growling sound. I picked up the pace (not even close to running), and we came upon Hooley. The two flat-coat retrievers had been swimming. Mister, at sixty-five pounds, was scurrying up and down the banks. Hooley, at a hundred pounds, had gotten himself stuck in the mudslide he’d made of the bank. I reached for his collar and pulled; the force of his coming unstuck catapulted me into the river.
“My body really didn’t panic,” I found myself explaining to Lorene as I was walking back to the car in my soaked clothes. “I was surprised, probably a little shocked by the coldness of the water, but . . . ” I was not in zygote expulsion mode. Was I?
“Don’t worry; besides, there’s nothing we can do about it.”
For the next two weeks, I tried to remind myself that people had remained pregnant under far more abusive circumstances.
I just wouldn’t have been one of them. I got my period, done in by the Nashua River.
I turned forty in Vermont a few weeks later with Lorene, my sisters, Bruce, and the dogs. It felt like putting a period (not that kind) on the end of my thirties. I was happy to have the brain surgery and dating behind me. I had a feeling of fullness—love, stability, contentment—that kind. So I didn’t get pregnant in my thirties. Forty is only a couple months’ difference.
We tried again in October. My brother called halfway through the waiting cycle for my belated birthday. “I wish I could help, Sue-Sue. I have to be careful—I sneeze on someone and they’re pregnant.”
“You’re supposed to sneeze into your elbow now.” I was feeling optimistic at that moment; my boobs were swollen.
Pseudocyesis
Sympathetic or False Pregnancy
The erroneous notion of carrying a baby. An individual experiences all prevalent symptoms, except for presence of fetus.
Documented in:
• females bearing strong desire to conceive
&
nbsp; • male partners of pregnant women (also known as couvade)
• dogs, pandas, and other animals
Five days later, I got my period. This time there was no one, no incident, nothing else to blame. I looked at myself in the mirror.
I decided to grow my hair out, go for something more maternal. Lump the awkward-hair stage and the no-exercise-writing-a-book-butt stages together. I called Lorene to tell her my news—period and hair—and went back up to work.
An hour later, my sister Meredith let herself in the kitchen door. She called up, “Bad timing?”
I came down. “No . . . or yes. I just got my period.” She hugged me. “Ow! My boobs!” I held on to her and cried. “I’m sorry. I didn’t realize I was this upset. Did you have a meeting out here or— ?”
“This is bad timing,” she said. All of a sudden, I knew. “I’m pregnant.”
I’d imagined the scene at least a hundred times, except I was pregnant, too. “Oh my gahh!” I hugged her again. I was happy for her. “Wow, I didn’t know, you didn’t tell me you were trying.” We were so busy talking about my trying.
“We weren’t really, I mean, we were getting ready to. I was sure it was going to take forever,” she paused. “The baby is due on Dad’s birthday.”
I could never match that. “Want some coffee, no, wait, you can’t drink coffee, tea? Water?” She had to go; she just wanted me to be the first (after Jonathan) to know.
I went back up to my studio, as if I could work again, and cried some more. Everyone was getting pregnant—my doctor, my friend Michaela, my sister . . . Why does it have to be so hard for me?
Things could be worse . . .
It took Japan’s Crown Princess Masako eight years to get pregnant and then she gave birth to a girl, which was considered a failure. (Her imperial duty was to produce a male heir.)
I went back to work, looking forward to the glass of wine Meredith would not be having with her dinner.
In December, after our third try failed, we had another meeting with Dr. Penzias—the why-it-isn’t-working meeting. “Call it system design, or error: eighty percent of the time, between healthy, fertile couples in their reproductive prime, it doesn’t work. Simple as that.” Nature’s contraception. “Your age is a factor, we’ve got a possible tube issue—but we want to do better. We can do better. I’m going to write a letter to your insurance company and see if we can get that infertility diagnosis. We could start the hormones this month.”
We couldn’t. And I was disappointed. Now I wanted the infertility diagnosis; like the gynecologist had said, “It doesn’t change anything.” We want to get me pregnant.
“What about the two tries at home?” I asked the insurance liaison, the bearer of bad news.
“You can take it up with them yourself, but I’ll tell you ahead of time, even if you had documentation—they rejected one of our client’s claims. She had all of her sperm-bank receipts. They said it had to be an in-office, ‘medically supervised’ procedure. She yelled at them, ‘What do you think I’m doing, drinking it?’ They didn’t budge.”
We had Jackie the inseminator again for our fourth try. She was wearing a Santa cap but there was no ho-ho-ho to go with it. I was a success-rate spoiler. She looked at our paperwork, then she looked at us. “Why are you using just the one vial? Most people do two, at least two.”
“They do? Can we? Let’s!” we said. We weren’t buying it by the vial; it made complete sense. Steve had deposited ten at a whack. Why didn’t you mention it the first time?
“I can’t, it’s too late for this insemination. Something to keep in mind for the next time.” She’d already written this time off.
We minimized our table time; Lorene had to get back for work. We assumed our positions in the car—Lorene at the wheel, my feet on the dash—and rolled out of the garage. Lorene wondered out loud, “What else don’t we know?”
She dropped herself at the shop; I drove home. The house looked beautiful. Lorene had already hung the Christmas greens. The tree (Lorene’s pick) was smaller and fatter than in years past, and fuller than ever with decorations. We wouldn’t have had room for the stork ornament I bought back in November. I’d given it to Meredith; I could always buy another one for us.
I had less holiday stuff left to do than usual, but I still could’ve used another week, just to get in the spirit. I was dealing with the cumulative effects of four months without exercise, without getting pregnant, and I was no better at retail widowhood the second time around.
Next Christmas, the brain book would be in the bag. The baby question would be answered. It would be Meredith’s baby’s first Christmas. Next Christmas, I promised myself, we’d have a Christmas.
I recorded these things as if by identifying them, I might, at some future date, be able to retrieve them. Lorene and Vita were sleeping crown to crown, sharing a pillow on the couch in the Christmas-tree firelight. I squished myself in next to the two of them. This is enough. We are enough.
With the holidays behind us, I went into work overdrive. The brain book was due mid-February, and I needed to do a chapter’s worth of finished art (twenty spot illustrations) daily to stay on schedule. The work endorphins gave my psyche a lift. At chapter three, I got my period; I didn’t bother to tell Lorene until she got home.
From:
Steve
Subject:
Thinking of you
Date:
January 3, 2003
Hi Honey, What’s happening? I realize this has to be ten times harder for you. The trick is to see the humour, though it’s not always easy. Sometimes I worry we won’t be friends if there is no baby. (No pressure!) If you want to debrief or if you feel like a chat, I could ring on Thursday or Friday. Big cuddles to you, Lorene and even those funny dogs, Steve
We had to cut our Martin Luther King getaway weekend short to do our insemination. Meredith and Jonathan, and Lucy and Jim, the proprietors of the Burlington B&B, gave us a seven o’clock send-off in the snowy circular driveway that Sunday morning. We intended to be back by late afternoon: Lorene would drive and I’d do my reverse shotgun—but we lost steam.
We had requested three vials for our fifth try. Before our inseminator let them fly, she observed that their rate of progression was neither, to borrow Jackie’s terms, “Olympic” nor “in training.” At a rate of two, they probably cut gym. “Next time,” she advised us, “you should request a minimum rate of three.” Lorene and I looked at each other. Still, it was twenty-seven million sperm, and we only needed one . . .
This time I called Dr. Penzias’s nurse and asked her, “What else don’t we know?” She suggested we come in and pose the question to Dr. Penzias. He found it “interesting” that we’d been told we could increase our chances by using more sperm, and certainly a higher rate of progression was desirable, but common sense—a layperson’s intuition—didn’t really apply here. There is little evidence to support the claim that either piece of unauthorized advice significantly improved our chances of getting pregnant.
He reviewed our plan. “If you aren’t pregnant, which you may well be,” he smiled, “we have one more IUI. And if that’s not successful, which it may well be, then we can begin the hormones.”
That night, Lorene and I watched ER. I’d started watching in 1995, during my days teaching in a charter school, when it was relaxing to watch people doing a job that was more stressful than mine. Lorene and I had watched Kerry, the lesbian head of the ER, inject herself with hormones before undergoing IVF (off camera). Last week, she’d miscarried. This week, her partner was giving her a consolation gift. Kerry snapped, “This is to be expected! Thirty percent of IVFs end in miscarriage.” I blanked out the next couple of scenes.
“Wait, what was it, only fifteen percent of IVFs work, and then thirty percent of those end in miscarriage?”
“We’re not going to do IVF,” Lorene said, and kissed my knee.
When our January attempt failed, our February IUI morphed into one last t
hing we had to do before we could get started with hormones in March.
A week after the insemination, Lorene had made a fire in our bedroom fireplace. She’d kept it going for two full days; the room had never been so warm. It was hard to think about taking the dogs out in the morning. We lay in bed talking over their barking. “I’ve been thinking,” she said. “We can’t go to California in April. What if you’re pregnant?” Or, what if the dogs quit barking and brought us breakfast in bed?
“What if I’m not pregnant? We’ll just miss a month of trying.” We were supposed to meet my friends in Joshua Tree; it was their wedding present to us.
“I’m just worried about taking the time off now; after we have the baby, I’m going to need lots of time off and—”
“I’ll take maternity leave, you won’t have to—”
“But I’ll want to.” She seriously thinks I’m going to get pregnant.
“I think I really need the trip,” I said. “Don’t worry.” It’ll never happen. “It’ll work out.”
Instant Convert
Dr. Penzias made the doctor issue of Boston magazine. “Look, he’s cute as a bug’s ear,” Lorene said. I looked again, more for a point of self-comparison.