Dr. Ob-gyn had barely walked into my hospital room that sad day after I delivered Katie in August 1998 when I had asked him, "When can I try again?" I was 37 years old, we had been trying 2 & 1/2 years on our own before I finally got pregnant. I knew the clock was ticking & there was no time to waste. At the same time, I figured we hadn't been particularly strategic in our approach to getting pregnant until now. Surely if I read a few books and educated myself on fertility issues, tried a few simple things, we could slash that time considerably. Couldn't we?
We used rudimentary birth control until we'd hit the three-month mark, to give my body a chance to heal. I was home on leave for about 10 weeks, & I had lots of time to read, research and reflect. I hit the Internet with a vengeance, & joined a private e-mail list for subsequent pregnancy after a loss, which included women in pursuit of a subsequent pregnancy as well as those already subsequently pregnant. I remember buying a basal thermometer (& the first of many, many boxes of ovulation predictor tests), and a copy of "Taking Charge of Your Fertility" by Toni Weschler. I ripped the chart at the back out of the book & (lacking access to my office photocopier) on the September day I went to see Dr. Ob-gyn for my six-week postpartum checkup I took it to a Kinkos office near the hospital & had a dozen copies made. Hopefully, I wouldn't need them all...
Over time (even while in infertility treatment), I tried other "home remedies" I'd heard about (although I didn't go to quite the extent I've read some people doing). I bought a saliva microscope (which was essentially a waste of money). I guzzled Robitussin by the gallon, watching drugstore flyers for sales & stocking up. I kept taking prenatal vitamins, with their extra dose of folic acid, as a pre-emptive measure.
But as the one-year anniversary of Katie's stillbirth arrived, I could feel my anxiety mounting. I was 38, with 39 fast approaching, & dh was 42. We'd been trying for 10 months, with no success. Maybe there was some simple issue preventing me from getting pregnant that could be easily fixed. Didn't we owe it to ourselvces to investigate, to at least find out what the problem(s) might be, see what our options were?
Dh, like many husbands in our situation, was less enthusiastic than I was to press the matter, but agreed we should probably look into it. And so, on September 20th, 1999, I made The Call to Dr. Ob-gyn's office. (As a reporter, I've long been in the habit of planning my phone calls & writing down all the points & questions I want to cover before picking up the phone, as well as taking notes during the conversation, & my notes are transcribed into my diary.) I reminded his receptionist who I was, explained that it had taken me 22 cycles to achieve my first pregnancy, & I was now on cycle 10 and 38 years old. "I'm not sure how far we want to take this," I said, "but we'd like to have some fertility testing done to uncover any issues and find out what our options are."
The next available appointment was in six weeks. Six weeks??! Oh well. I took it.
It was a Thursday morning, October 28, 1999, when I finally got to see Dr. Ob-gyn again. I brought copies of my charts, but he barely looked at them. He did a Pap test (surprise!), and suggested we start with an HSG next week (Nov. 3), & that dh arrange to have a sperm analysis done through our family doctor.
After consulting my Internets, I took a couple of ibuprofen a few hours before the HSG, and also some amoxicillin, in deference to my very mild heart murmur. I had an "OW" moment when the clamp was placed on my cervix, & the liquid dye injected inside me felt cold, and I had some very mild cramping later, but otherwise, it really wasn't that bad. I watched in fascination as my bicornuate uterus -- which had been detected mid-pregnancy with Katie -- gradually popped into view. It looked like a Y or a slingshot. The dr concluded that the left tube was blocked -- although at our next meeting, he said that after looking at it again, it was actually fine (!). (This was not the first nor the last time that one of my drs said one thing one time and another thing the next, which I found incredibly maddening & frustrating.) He told me to call if/when I got my period & we'd try another test next cycle.
That was Nov. 22, & I dutifully called the office. The next step, I was told, would be a post-coital test, which we scheduled for Dec. 6. No sex for two days, then sex precisely two to four hours prior to my 10:15 a.m. appointment. Since our usual commute is 60-90 minutes, the logistics took a little thinking through, but I dutifully reported to the office on time.
Dr. Ob-gyn looked at my sample & said he detected some movement but "not quite as much as thought there would be." Dh had been procrastinating on getting tested, & Dr. Ob-gyn recommended he do so ASAP, "before we hammer you over the head with anything more." He was going away between Dec. 18 & 28th, & we were going to my parents' for Christmas, so we agreed that I would call him when I got my period (or got pregnant) in the New Year & figure out our next steps.
I called on Jan. 4th (2000). Dh (still) hadn't been tested, but my journal notes say he had PROMISED me he would do so that week or the next. If memory serves me correctly, he wound up taking an entire day off & getting it done on my birthday (!).
To be fair to him, it wasn't (just) squeamishness on his part. Trying to figure out the logistics of just how to do this was challenging, and actually somewhat ridiculous. When you're under the care of an RE & fertility clinic, everything is laid out for you, but we were pretty much on our own. I had asked whether he could do it at the hospital where Dr. Ob-gyn practiced but for some reason, that option was not deemed do-able. He got a sample bottle from our family dr, & I called around to a couple of medical labs close to where we lived to find one that would do the analysis, looking at clinic hours & figuring out how long it would take him to drive there with his precious cargo, keeping it at body temperature in our sub-zero temperatures.
On Jan. 20th, about a week after the deed was (finally) done (and I had totally forgotten about this until I went back to re-read these diaries), our dr's receptionist called us. She had the results from the lab -- but all the envelope contained was a blank piece of paper (!). I told her what I knew, & she promised to call me back. I couldn't believe it -- was dh going to have to through this whole rigamorole AGAIN??
She called me back later in the day: they finally faxed her some results, but now the dr would have to look at it. Four days later (!), I called to find out what was going on: the dr STILL hadn't had a look at the results -- & probably wouldn't for a few days, since he was heading out of town.
Meanwhile, I was scheduled for an endometrial biopsy on Jan. 25th. By Feb. 4th, I still hadn't received any results, so I called Dr. Ob-gyn's office. I was told the results were fine, & the next step would be to start clomid when my next cycle began.
My notes indicate that I talked to Dr. Ob-gyn himself later that day. He said he could put me on clomid & we could try that for a few months, "but I'm not sure there's any value in that. Or," he continued, "I could send you to one of my buddies in the infertility field."
I was 39 years old, & had been puttering around with testing for almost five months now. My biological clock wasn't just ticking, I could hear the alarm ringing. I had been on enough Internet forums to know I didn't have any more time to waste, & that an RE was the way to go. I asked for a referral. His secretary called me back later that day with a name, address, phone number and date: Feb. 24th at 1 p.m.
"Keep trying," Dr. Ob-byn said. "If nothing happens, you still have the appointment."