An Exclusive Adaptation from Waiting for Daisy
By Peggy Orenstein
I MARRIED A MAN WHO IS FAR BETTER looking than I. It’s not that I’m a candidate for a dogfight, exactly, but no one’s ever going to confuse me with Heidi Klum. Meanwhile my husband, Steven, a documentary filmmaker, was once plastered on billboards all over America as part of a Gap campaign, the one featuring artsy types who embodied “cool.” On our third date, I showed him a snapshot of me in college, zaftig in a peasant skirt and my boyfriend’s ill-fitting crewneck sweater, my hair cut to resemble a Semitic cotton ball. It was part of what made him fall in love with me. “I thought it was brave of you to show me something that embarrassing,” he said later. “Brave, and kind of pathetic.”
There is only one thing about me that anyone has ever considered gorgeous. Three gynecologists have, upon intimate examination, invoked that word to describe my cervical mucous. I would have no trouble getting pregnant, they always informed me. I didn’t know at the time, nor much care, what cervical mucous was, but I would blush modestly anyway. I had reason, then, to think conception would be a snap — my gorgeous mucous would assure it. Besides, I deserved to have something go smoothly with my body: At 35 I’d gone through treatment for early stage breast cancer, and now, less than a year later, I was still running for cover when the microwave was on, holding my breath against the fumes of rush hour traffic. An easy pregnancy seemed only fair, a way to rebalance the scales of fate. And so one night — with no conception (ha!) of the six years of heartbreak, obsession, and marital strife to come, not to mention the nagging ambivalence about whether I even wanted a child — we began to try.
THERE IS THE FIRST TIME YOU HAVE SEX, and then there is the first time you have sex without birth control. On purpose. To make a baby. Both events feel transformative, but this time I didn’t feel the urge to jump up and phone my best friend when it was over. I touched Steven’s cheek as his hands traced circles down my body. “Here we go,” I whispered, and he smiled. We were making something more than love: We were making our child. I already felt pregnant with possibility.
Three months went by — not a long time, but I’ve always tended toward the anxious. I’d also known a number of couples who’d had difficulty conceiving. A friend suggested the book Taking Charge of Your Fertility. Taking charge: She was speaking my language. Plus, as a journalist, I’m a fool for research. The book explained that a woman doesn’t necessarily ovulate on the 14th day of her cycle — you might ovulate on the 12th. Or the 20th. When you do, the egg lives 24 hours max, but sperm can lounge around your uterus up to three days. It’s strategic, then, to have lots of sex before you ovulate so the guys are up there, ready and waiting, when the ball drops. What’s more, there are signs that a woman’s critical time is nigh. That cervical mucous my doctors swooned over? It miraculously changes in the days before ovulation, turning into a clear, come-hither liquid that helps speed sperm to egg.
So I began to take charge. I popped a thermometer into my mouth every morning before so much as kissing Steven hello. I plotted my temperature on a graph, carefully connected it to the dots of previous days, and pored over the results like they were rune stones. Had the temperature gone up more than two-tenths of a point since the day before? Had it stayed up for three days, indicating I’d ovulated and the procreative window had slammed shut? I spent an enormous amount of time in the bathroom poking my fingers up my vagina. Was my cervix open and low? High and closed? Was that even my cervix? Was my “fluid” (as Taking Charge referred to it — so much cozier than mucous) sticky? Creamy? The coveted clear and stretchy? Most of the time it looked to me like gunk.
I quit drinking coffee (which in massive doses impairs fertility), instead slugging back two teaspoons of Robitussin each morning. Its main ingredient, guaifenesin, thins and loosens mucous in the lungs; although there is no actual evidence, it’s thought to work similar juju further south. Meanwhile Taking Charge warned that lubricants — including saliva — could kill sperm, so I tossed out the Astroglide and swore off oral sex; if the going got rough, I squirted warmed egg whites (a chemical cousin to semen) inside me with a turkey baster. To add to the fun, I limited us to the missionary position, which, according to the book, was the most gravitationally correct.
“You’re turning this into a military maneuver,” Steven groused one morning.
“I’m 36 years old,” I said, without looking up. “We can be romantic the rest of the month.”
And yet, even as I did all this, part of me feared that I’d get what I wished for. On the days my writing was going well, I didn’t care if I ever got pregnant — in fact, I secretly hoped I wouldn’t. After an evening with my 3-year-old niece, who commanded me to sip from a play tea cup, pretend the liquid burned me, and shriek, “Oh no!” until I thought I’d pass out from the tedium, I felt relieved not to have a child. On the way to a last-minute yoga class, I’d congratulate myself on the serenity and spontaneity of my life. Then each month when I got my period, I cried.
Five months, six, seven, eight. “Would this be good news or bad news?” the checkout clerk boomed as she rang up the home pregnancy test.
“Um, good, I think,” I stammered, making a mental note not to get in her line if I ever I bought hemorrhoid cream.
“Best of luck, then,” she said, grinning.
I shook the box, spun it in my hands like it was a Magic 8 Ball. What if I were pregnant? What if I weren’t? Finally, the suspense (and two cups of tea) got the better of me. I peed on the stick. Then I ran to my car, sped to Steven’s office and held out the result.
We were thrilled. We were terrified. And, a few weeks later, when I tottered green-gilled to a routine ultrasound appointment, we were full of confidence that all was well. It wasn’t. The fetus had stopped developing two weeks earlier. I went through the rest mechanically: the D & C, the bleeding, telling our families and friends. And just that quick, we were back to the business of trying.
Three more months. By now I was 37. Thirty-seven and a half, actually. For the first time since I was five, half birthdays mattered.
CLOMID WAS MY GATEWAY DRUG: THE one you take because, Why not — everyone’s doing it. Just five tiny pills. They’ll give you a boost, maybe get you where you need to go. It’s true, some women can stop there. For others, Clomid becomes infertility’s version of Reefer Madness. First you smoke a little grass, then you’re selling your body on a street corner for crack. First you pop a little Clomid, suddenly you’re taking out a second mortgage for another round of in vitro fertilization. You’ve become hope’s bitch, willing to destroy your career, your marriage, your self-respect for another taste of its seductive high. Here are your eggs. Here are your eggs on Clomid. Get the picture?
Clomid works by tricking your brain into thinking it’s not making enough estrogen during the first half of your cycle. That puts into overdrive the alphabet soup of hormones that affect egg development, creating bigger, better ovulations. Nearly half of women who try it get pregnant, most within three months. The trade-off can be hot flashes, blurred vision, “emotional side effects,” and (Lord have mercy) twins.
“I thought you said that drug caused ovarian cancer,” Steven remarked.
“Only if you take it for more than a year,” I said, more blithely than I felt. “The longest I’d do it would be six months.”
I didn’t tell him the other part — that Clomid also appears to raise the cancer risk for women who never ultimately bear a child, though it’s not clear whether it’s the drug or the infertility itself that’s the culprit. No problem, I thought, it just has to work. Talk about ratcheting up the stakes. Swallowing that little white pill was the first time I did something I’d vowed I wouldn’t in order to get pregnant: I willingly put my health on the line. It was in that moment that desire and denial merged to become obsession; it was then, right then, that doing anything to get pregnant, regardless of the consequences, became possible.
”YOU’RE TRYING TO CONTROL ME!” Steven yelled.
“I am not!” I said.
“Yes you are!” He’d been pedaling his exercise bicycle in our den, something he did for a half hour each day. Now he swiveled to face me. “First you told me no jockey shorts,” he said, enumerating on his fingers.
“You never wore jockey shorts,” I interrupted.
“Still, you said it. Then you said no hot baths.”
“You’re not supposed to heat up your testicles. Hot baths kill sperm for three months.”
“Men in Japan take hot baths every day. If that were true there’d be no Japanese children.”
“They don’t have borderline sperm.”
“The doctor said my sperm was fine. Now every time you walk by this room you look at me like I’m killing our chance to have a baby.”
“It’s proven that men who ride bicycles have lower sperm counts,” I said, my voice shaking with anger. “You know that. And you’re deliberately riding that bike. I’m taking a pill that’s doing God knows what to my body so that we can have a baby and you can’t even give up that fucking bike for a few months.”
“Then come to me like a person and talk to me about it instead of giving me your little looks. I am not doing this to hurt you. And anyway, it isn’t going to make any difference.”
“You’re being ridiculous. If you don’t stop this, I’m not having fertility sex this month.”
“You cannot ride that bike! You cannot ride that bike! You cannot ride that bike!” I shouted.
Never mind cancer. Clomid’s hormones made me a raving lunatic. I may have been right about the bike lowering sperm count (it does, really), but lately my response to any challenge, no matter how small, was rage. The way Steven chewed his toast in the morning infuriated me. When he commented on a sloppily folded T-shirt, I dumped a basket of laundry on him. My hostility peaked around ovulation. “Why don’t you just get a porn video and watch it in the other room,” I said. “When you’re ready, I’ll be in bed.”
ANOTHER THREE MONTHS WENT BY. My progesterone was pumping. My mucous was gorgeous. Still, nothing happened. My gynecologist, Risa Kagan, recommended we add intrauterine insemination (IUI) to the Clomid using Steven’s sperm. He would get busy with a Dixie cup, then she’d inject his boys directly into my uterus, giving them a running start. The cost would be minimal, about $350 a month, but we’d crossed another critical threshold: Sex — or at least intercourse — was no longer a precondition of conception. We’d become a threesome, though not the fun kind. I lay on an exam table, shivering in my snowflake-covered hospital gown, legs in stirrups. Steven stood by my head, holding my hand. Risa threaded a slim plastic tube through my cervix. It cramped a little. Afterward, I stayed prone for 15 minutes, my tush propped on a cushion. Steven kissed me, but I couldn’t shake the idea that Risa might have just fathered my child.
My 38th birthday came and went. “I’m aggressive with this in your age group,” Risa said. “You need to think about a specialist.” She gave me the number of a local guy. “Maybe you won’t need him, but he’s booked months in advance. If you make the appointment, you’ll have it just in case.”
THE DESCENT INTO THE WORLD OF INfertility is incremental. Those early steps seem innocuous, even quaint: IUI was hardly more complex than using the turkey baster. You’re not aware of how subtly alienated you become from your body, how inured to its medicalization. You don’t notice your motivation distorting, how conception rather than parenthood becomes the goal, how invested you become in its “achievement.” Each decision to go a little further seems logical. More than that, it begins to feel inevitable. My hesitations about motherhood hadn’t disappeared, but they were steamrolled by my drive to succeed at pregnancy.
By our last round of Clomid, we’d completely mechanized the attempt to conceive. The drug controlled the development of my follicle, the fluid-filled sac that contained a microscopic egg. Risa measured it every few days with an ultrasound. When it was ripe, a nurse injected me with a hormone that triggered ovulation. Twenty-four hours later, Steven headed to the lab for another date with his hand. His sperm was washed and spun, the Olympic contenders separated from those doing the dog paddle. That was my cue: I tucked the vial of his best stuff inside my bra (now the most erotic part of the process) to keep it warm while we race-walked out of the lab, past the Whole Foods and the Chevron station (at which point I clapped my hands across my chest, to protect our future child from any toxic emissions), up the stairs of Risa’s building and into an exam room, where she transferred the contents to my uterus.
I didn’t get pregnant.
It is one thing, I was discovering, to think, Maybe I won’t have kids, and quite another to be told, “Maybe you can’t.” This is how impatience turns to desperation.
DR. ALEKSANDR STAWECKI CAME OUT to greet us, an Eastern European man whose ring of white hair, white beard, and white jacket suggested both a guru’s wisdom and a physician’s expertise. According to him, our main problem was that I was 38 (and a quarter). “You’re born with all of your eggs, and they age with the rest of the organism,” he explained in his clipped accent. “As they do, there are more errors in the chromosomes, and the embryos derived from those defective eggs ultimately won’t be successful in implanting a healthy pregnancy.”
He pulled out a graph to illustrate his point. It showed a gentle downward slope in the rates of healthy pregnancy between ages 18 and 35, then — whammo!
Steven looked stricken. “It’s like our chances are disappearing by the minute,” he said, softly. “Yes,” Dr. Stawecki (not his real name) agreed, seeming oblivious to our dismay. He pulled out another piece of paper and a pen. “Given your track record, Peggy, I calculate the odds that you’ll conceive on your own as…” he paused a moment, “less than 10 percent.”
I nodded, chastened by my own failure.
“If we add injectable medications with intrauterine insemination, your chances would increase to about…15 percent a cycle.”
“With in vitro fertilization…” Dr. Stawecki paused again, “the odds are closer to 30 percent.”
Thirty percent? Coming in here, that figure would’ve made me blanch — the likelihood was 70 percent that we wouldn’t have a baby — but suddenly it sounded pretty good.
“One in three?” Steven said. “That’s not so terrible.”
He was optimistic. I was guilt ridden. We were sold.
FOR NEARLY TWO WEEKS, I INJECTED myself with the purified urine of postmenopausal Italian nuns — that’s what the first drug prescribed to me was originally made of. Why Italian? I don’t know. Why nuns? Postmenopausal women produce massive amounts of the hormone that stimulates egg growth in a futile attempt to revive the ovaries. They excrete the overrun in their pee. Retirement convents offer the most efficient one-stop shopping for elderly women (though I can’t quite picture how they gather the goods). We get pregnant; they get enough money for a new stained glass window. Everyone wins.
My second drug was equally bizarre, derived from the ovaries of Chinese hamsters. Why Chinese? Again, no clue — though, since Steven is Japanese-American, I hoped it wouldn’t hold a grudge against his sperm. Neither nun pee nor hamster ovaries came cheap: Three vials injected morning and evening plus another drug to suppress my natural cycle ran more than $350 a day. A girl could buy a lot of shoes with that kind of scratch.
I’d practiced giving injections on an orange. Let me tell you something. Cellulite aside, your thigh is nothing like an orange. For one thing, it feels pain. For another, it’s yours. The first night, I meticulously laid out my supplies: alcohol wipes, the vials of powdered medication, the sterile water to dilute them, and two syringes, one for each drug. I twisted a long, thick needle onto the first syringe, and, snapping the glass tops off the vials, I drew up some water, squirted it into the first vial of powder, and gently swirled until it dissolved. Drawing up the mixture, I repeated the process with the next vial and the next. I changed to another needle, about a half inch long, tapping the syringe briskly until all the air bubbles disappeared. I felt very Medical Center. Then I pinched some skin with my free hand, took a breath, and jabbed. I couldn’t do it. At the last second, I pulled my hand back and the needle bounced, barely nicking my flesh. I reminded myself grimly of how much I wanted to have a baby. No, truth: how much I wanted to accomplish pregnancy. I gritted my teeth and jabbed again. Only about 50 more shots to go.
THREE MORE YEARS WENT BY, years punctuated by more treatments (Eastern needles as well as Western), by faith and grief, miscarriages and self-recrimination, by the near unraveling of my marriage, and finally, joyfully, by the arrival of our daughter, Daisy.
“Aren’t you glad it all worked out?” I asked Steven a few days after her birth. We were sitting on the couch taking turns holding her, watching her face as avidly as if it held the secret to the cosmos. His eyes narrowed. “Don’t go getting revisionist on me,” he said. “I don’t want you to forget what actually happened and start thinking it was all worth it.”
“I’m not,” I protested. “I’d never do that.” But I knew I was busted: I’d been busily rewriting our history in my head, justifying all we’d gone through. It’s true that I love being a mom, more than I ever expected. Sometimes, sitting at a miniature table, covered in Play-Doh and reading Where’s Spot? for the 30-zillionth time, I don’t recognize myself — and that’s not a bad thing: Identity, I’ve learned, can be sliced many ways, and there is gain with every loss. Even so. Becoming a parent can’t give me back the time — the entire second half of my 30s — that was obliterated by obsession. It doesn’t compensate for the inattention to my career, for my self-inflicted torment, for the stress I put on my marriage. Steven and I may never reclaim the ease of our pre-infertility days. All we can do is move forward — tenderly, kindly, with mutual forgiveness. And with the knowledge that our love for each other has never, ever flagged.
There are now more than a million fertility-related medical appointments made each year, and it’s unclear how many of them are necessary: One recent large-scale study found that 90 percent — 90 percent — of women in their late 30s will get pregnant within two years of trying (assuming their partners are also under 40). Yet infertility in this country is defined as failure to conceive after just one year, and many couples, as we did, storm the clinic doors after just a few months. So what’s a girl with a ticking biological clock to do? Until the workplace better accommodates mothers (and guys pick up more slack at home), there’s no good answer. Nor can you count on the specialists to provide one: Their half of the doctor-patient relationship is too easily influenced — if only subtly so — by profit motive and the vagaries of self-regulation. As ever newer “cures” are dangled before us, such as the much-hyped potential of egg freezing, it’s up to the consumer to be alert to their pitfalls, to the lure of perpetual hope. I wish I’d understood that.
That’s the insidious thing about infertility treatments: The very fact of their existence, the possibility, however, slim, that the next round might get you pregnant creates an imperative that may not have otherwise existed. If you didn’t try it, you’d always have to wonder whether it would’ve worked. That’s how you lose sight of your real choices — because the ones you’re offered make you feel as if you have none.
Nine years ago, before this all began — before I imagined it ever could — I considered myself a lucky person. But what I meant by that was that I was unmarred by fate; so mine was a callow good fortune. Even after cancer treatment, I resented the assumption that I ought to be more appreciative of life than my healthier friends. I was only 35 then, not ready to acknowledge life’s fragility. But now I wake up every day — every day — feeling transcendently blessed. Don’t get me wrong: No one’s going to crown me Miss Inner Peace. I still curse out drivers who leave their left-turn signal on for three miles, but my pettiness is dwarfed by a sense of reverent, radiant gratitude that’s sweeter for having experienced its opposite. Mine is the luck of realizing that happiness may only be the respite between bouts of pain and so is to be savored, not taken as an entitlement.
That much I do now understand. And although in many ways I’d give a lot not to have learned it, I’m grateful for the lesson.
© Peggy Orenstein. All rights reserved.
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