And so it was, in July of 2017, we found ourselves diagnosed with ‘unexplained infertility.’
After one year of unsuccessful babymaking, we were officially given our graduation papers from ob/gyn to full-on fertility specialist.
For me, the squeeze of infertility really started with this diagnosis. On a practical level, it’s just more of a pain. You have to make and attend more appointments. Insurance stops covering anything, so you have to pay out of pocket. And, you have to grapple with the reality that “failed” months now come with a great deal more emotional burden than they ever did before.
Our fertility journey was two years from start to finish.
I don’t have brilliant insights to share, only one more story to add to the tapestry of tales women are now boldly sharing – and thank goodness, as it helps all of us feel less alone.
August 2017: Clues in the ink
We were your prototypical ‘unexplained fertility’ case. My counts were fine. His counts were fine (with just a touch low motility).
“So, what’s the deal?” we asked the amiable Dr. Klatsky at Spring Fertility – a cheerily-branded clinic in the middle of San Francisco.
“Let’s find out,” he replied.
The odds were good given our age, he assured us, and he talked about an Indiegogo campaign he had run for a charity as he threaded a catheter through my cervix into the uterus and released a dye that slowly spiderwebbed its way into my fallopian tubes.
It was a procedure called a Hysterosalpingogram (HSG), checking for roadblocks in the fertility highway the egg travels. Turns out, more than a quarter of female infertility is from tubal issues.
I was nervous for the procedure as I’d heard it could be painful. But I felt nothing as we watched the dye flood in, and it seemed to meet no obstacles. But, he observed, it wasn’t settling evenly in the uterus. It looked less dense in a few spots, and to his eye, this looked like polyps. More than one.
“They think I have a polyp!” I told Johnny, cautiously optimistic. It was sunny and the courtyard fountain smelled like a pool. I sat on the edge and filled him in.
After a year of mystery, we finally had a thing to grasp onto – a literal stalactite of hope protruding from my uterine wall. Because polpys essentially act like IUDs – something stuck into your uterine wall – they can cause infertility by making your uterus uncooperative for implantation of the embryo.
A polyp to me was so much more than a fleshy nodule – it was a thing to solve.
November 2017: Into surgery I go
I booked my hysteroscopy for November. This other long H-word procedure is where they enter your uterus with a laparoscoopic camera, check for abnormalities in the uterine wall (polyps, bleeding, the like) and if discovered, can address the issue at the same time. For polyps, they can snip them then and there.
At this point, we still didn’t know if I had polyps. It was Dr. Klatsky’s experienced guesswork. The other big question was, if I did have them, would it even help to remove them? My ob/gyn gave me the neutral advice that “sometimes polyps interfered with implantation, and sometimes they didn’t.”
So, I was about to undergo surgery that might mean nothing at all. But it was all I had.
The day arrived, and we parked in the tony Presidio Heights neighborhood and made our way into California Pacific Medical Center. We walked past stroller moms, and Starbucks into the SF hospital affectionately known as the Baby Factory, where 8,000+ babies make their way into the world each year.
In our room, we discovered an amazing contraption that plugged into your gown and inflated it with warm air. I waited for my surgery as a cozy stay-puft marshmallow (wo)man. “I need one of these for my home,” I told the anesthesiologist, who fake-laughed.
After a short while I was walked into the surgery room. It feels weird to walk into surgery – generally you envision getting wheeled in with people hovering above you calling out, “I love you, it will be OK.” But being able-bodied, I walked in, holding the sides of my paper-thin gown (no longer a heated igloo) in an effort to avoid flashing skin to a medical team that would see me stark naked in just a few minutes.
Bright lights shone down, and my heart started beating faster at the thought of the general anesthesia to come.
My ob/gyn came into the room and explained that the procedure would take about 45 minutes. I said I was ready, and the mirthless anesthesiologist placed the mask on my face and gave me the countdown.
10, 9, 8 – and I was out.
And, then, I wasn’t. My bed was parked in a row of post-recovery patients, and a nurse came over as soon as I stirred. I ached all over, but there was only one important concern.
‘Were there polyps?’ I stuttered. She said, yes! There were four. And Dr. Franca got them all.
Tears rolled sideways down my face, and wet the folds of my gown.
I laughed-smiled. They gave me a printout picture of my shiny clean uterus – a bored-out tunnel of health and perfection. It was done.
June 2018: Our first IUI
We were advised to let things heal for a few months after the surgery, and then try naturally for a while. The polyps were gone – why shouldn’t things take root now?
Well, the natural way wasn’t ours, and in May, we found ourselves back in Dr. Klatsky’s office, ready to embark on the first of our fertility treatments.
They recommend you start with a series of three intrauterine inseminations (IUIs). If this doesn’t work, you move onto IVF. Of course this sucks because if you pay for all the IUIs and they don’t work – you are still out that money and then need to pay for the IVF. That’s a lose-lose but it’s the recommended approach.
Luckily we were at this point in the incredible position of having our infertility treatments covered through Lyft’s insurance plan. Johnny had started working there that spring, and received $30,000 in coverage for infertility. We were both so grateful, and felt more than a little guilty. There were so many people I knew who needed this more than us. It shouldn’t just be already privileged tech workers who access these kind of benefits – it should be everyone.
Since we felt we had the luxury of time and money, we decided to start with the IUIs. IUIs come with increased odds of multiples, which is pretty terrifying when you live in a one-bedroom apartment in a very expensive city. But thankfully, Johnny reviewed the statistics closely and explained to me (many times) why the odds were still incredibly low.
An IUI is essentially a turkey baster approach. The guy goes to the clinic in the morning to make his “deposit.” They clean and centrifuge it to get the best sperm, and the woman comes in later that day to receive the deposit directly into the uterus. Add a cocktail of fertility drugs, and see what you get.
Emotionally, I found I needed to dip my toes in gently, so we started with unmedicated IUI. That’s basically just turkey-basting at the right time of month. It doesn’t increase your odds much. But it put my mind at ease as we made the transition into treatments.
At this time, I also drastically changed my diet and alcohol habits. I started eating meat, and stopped drinking for several weeks of each month. I ramped up my yoga and we went on lots of hikes. I’ll never know if this mattered. But it was a change I could make and control.
And of course our unmedicated IUI had predictable results: none.
We opened a bottle of wine (or two) and moved on.
July 2018: Add the clomid, please
We moved swiftly into our first medicated IUI. In my case that meant five days of Clomid to stimulate ovulation, followed by a shot of Ovidrel which causes the growth and release of an egg.
The Clomid gave me mega energy, and I luckily didn’t have the emotional mood swings that many women get (making a tough time even tougher). The Ovidrel, however, made me feel like I got hit by an angry truck.
On a foggy afternoon in July, I slumped my way over to Spring Fertility and got my second IUI. I went home, and began the ever-dreaded two week wait.
August 2018: A different result
After about 11 or 12 days later I was very positive I wasn’t pregnant. We went on a six-mile hike in Fremont, uphill in the blistering heat, and then I poured two stiff cocktails down my throat. I had begun the monthly mourning I knew so well.
A few days later I took a cursory pregnancy test before jumping in the shower and BAM. Two pink lines. I was shocked to the core and I walked around shaking, saying ohmygodomygodohmygod for a good five minutes.
Johnny came back from his run and I waited for him in the bedroom. I had always envisioned doing some elaborate thing to tell him, like hiking to our favorite part of Land’s End and holding up the stick like Simba in the Lion King as we gazed off the cliffs into our future.
Instead, I just shoved the stick in his face the second he came into the bedroom. He started laughing maniacally. We laid on the floor and ugly-cried.
We called in sick and ate beignets at Brenda’s. We talked about the future in a totally new and different way. We laughed about our trip to Spain the next month and how I’d be puking on palazzos. Everything was technicolor.
9 months later: Waiting on the new addition
I’m posting this just shortly before the arrival of our little girl – we had a relatively easy and healthy pregnancy, and she’ll greet us and the world any day.
In the end, infertility is just a day by day thing we all find our own path through. For me, the toughest mental battle was one of comparison, wondering why it seemed so easy for everyone around me. (We lived in a four-unit house and every single one of neighbors got pregnant while we were trying. One of them moved out, someone else moved in, and they got pregnant. The rage was undeniable.)
But, you get through. Women are stronger than anyone ever gives us credit for.
But, our hidden stories are real and deep. And the best takeaway I can share is that acting with empathy and kindness towards everyone is the only thing that matters – you never know who needs just a little more compassion and kindness along the way.