Daddy Graham and I first began talking about having a child when we made the decision to go off birth control in August of 2016. I had been on birth control intermittently throughout my 20s and 30s as a means to control an irregular and often errant period. I was diagnosed with PCOS (Polycystic Ovarian Syndrome) pretty late in the game which means that I rarely ovulate on my own, and so we knew that it wouldn’t necessarily be an easy path to pregnancy.
Understanding that both Daddy Graham and I were staring down the barrel of 40, I went to my OB/GYN for my annual checkup right after I went off birth control to discuss the odds and practicalities of beginning to start a family. She suggested we try for a year before we pursued any sort of official fertility interventions. It felt like too long to me – if we were in our early 30s and without PCOS, no big deal. So, we compromised with six months of trying to conceive. And try we did.
To no avail. But man, we did have fun trying.
I proceeded to get a referral to a local fertility clinic that blends both eastern and western philosophies – treating body and mind simultaneously, which felt (and feels) right to us. The facility also may be the nicest doctor’s office I’ve ever been in – a fireplace, plush leather couches and chairs, even chair massages when the masseuse was in the building. I went in for my initial consultation in late January of 2017, where all the different options available to us were described (and drawn) in great detail – timed intercourse, intrauterine insemination (IUI), in vitro fertilization (IVF), etc. Daddy Graham and I decided that we wanted to first try timed intercourse with the aid of a drug to stimulate ovulation – letrozole.
Before I go into some details, a warning: fertility is not for the faint of heart nor the squeamish. Nor the modest, but that’s for another time.
I had the first of several diagnostic tests in beginning in February of 2017 – a full blood panel, a vaginal ultrasound, as well as an HSG (hysterosalpingogram) to check my fallopian tubes and uterus. Having blood taken has never been easy for me – it’s not a fear of needles, or an aversion to the sight of blood. I have tiny veins and the process of finding the vein, the pushing on the tender crook of the arm repeatedly to check for vein bounce back, can send me over the edge. Six vials of blood later, I had one nasty bruise. The vaginal ultrasound isn’t exactly, well, pleasant, but I was fascinated by being able to see my ovaries and uterus not to mention completely baffled by how the RN could determine follicles from, say, other black dots on the screen. It all looked the same to me. Lots of follicles on this initial ultrasound, so lots of potential for mature eggs. The HSG was probably the most uncomfortable physically, as a small catheter had to be inserted into my cervix to release the dye that would enable the doctor to see my tubes and uterus. In order to get the best picture of this, I had to lift my pelvis off of the table for what felt like forever, nearly kicking the doctor in the face as I struggled through a charley horse. But I did get to see my fallopian tubes light up on the screen, and was happy to hear that there were no blockages and that all looked well. All in the name of good things, I am always quick to remind myself when uncomfortable.
Daddy Graham also went in for his testing to make sure that he was ready to go. I’m not sure I can do his story justice, as he does a much funnier job of relaying having to race to the doctor’s office which a sample cup between his knees to keep it warm. The long story short is that he had to be tested twice – the first time his sample came back with low motility (16.5% on average) The second time everything checked out fine – apparently it all depends on the day – with a motility of 49.5% on average.
All in all, we were good to go – the doctors explained that I had a suitable ovarian reserve and that all of my hormone levels, while indicative of PCOS, didn’t preclude me from getting pregnant. Daddy Graham’s swimmers were given the thumbs up. We were given a prescription for the letrozole, a trigger shot, as well as endometrium, which is a progesterone suppository. More on that later.
Daddy Graham and I talked about optimal timing for when to start – given that Daddy Graham’s work schedule is such that he is in another state for most of the week during the academic college year. And so, we chose to begin in May of 2017.