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  • Writer's pictureErin Stevens

Fertility Variability

positive pregnancy test
Faint but present

TW: (in)fertility, pregnancy

Even though it's a medical term with a specific definition, I avoid the word "infertility". It feels very definite, so final. It feels like telling someone, "You CANNOT have babies." Besides the fact that most cases of fertility struggles can be circumvented with assistance by modern medicine, the fertility journey for one pregnancy can be so different than that for another. "Infertility" is rarely an end. Most OBs can think of a patient who went through in vitro fertilization after years of difficulty to get to one pregnancy and then ended up with a surprise, spontaneous pregnancy later on. Most of us also have patients who conceived easily and then went on to require assistance, even without new medical problems, changes to periods, or aging significantly. Fertility is complicated and inconsistent.

I've shared the difficulties in fertility that I experienced leading up to pregnancy with my daughter. Long story short, we tried longer than average, used medications, and miscarried before having a happy, healthy term pregnancy. I felt like there was something very wrong with me, like I was inherently flawed. I internalized a deep sense of failure.

I always knew I wanted two children, but I was truly terrified about what would happen when we tried for the next one. I didn't know if and for how long I could endure struggling again. I didn't know if I could handle the possibility of another miscarriage. I was traumatized by our previous experience. Knowing that I wanted my children to be close in age and that it was possible that it could be a while again before we were successful in conceiving, I wanted to open up the opportunity as soon as I felt at all ready but was also nervous to do.

Our fertility journey started very much the same way it had before - with me manually removing my IUD at home (not a medical recommendation; please do not try this at home; do as I say, not as I do). I was very happy to do so as the copper IUD I'd had placed postpartum contributed to heavy, crampy periods that I HATED. At the time I removed my IUD, I'd started decreasing the number of times I was breastpumping in a day. Oddly, with my decrease in frequency and amount of pumping, my periods were actually getting farther apart. My next period after removing my IUD came 43 days after the one preceding, the longest stretch I'd had since my periods returned postpartum. Because I'm paranoid and wanted to make sure there wasn't anything unusual going on, I talked to my OB/Gyn and had an ultrasound done in our office to check out the goods. Everything looked normal, and that ultrasound happened to be timed just right as it ended up showing that I was likely to ovulate in the next few days. I was pleasantly surprised by that, because that ovulation timing would have been consistent with textbook timing in a normal menstrual cycle and not, say, a 43 day cycle.

About two weeks after that ultrasound, my boobs started hurting a lot. When it went on for a few days, I peed on a stick. Faint as it may have been, there was a line.

After everything we'd been through before, here I was, pregnant soon after stopping contraception, essentially right when we started "trying". I couldn't believe it. It was hard to be happy. In some ways, I felt guilty. I assumed something would go wrong.

I had some spotting one day. This is it, I thought. It's over, just like I assumed. Nope.

The breast tenderness went away completely. Okay, here we are. The inevitable. Nope.

I performed an ultrasound on myself at just over 6 weeks. We generally wait at least a little longer than that, because even in a very normal pregnancy we don't always see all the reassuring features we want at that point...and that's when an ultrasonographer is performing the ultrasound on a patient, not when an anxious person is trying to perform a transvaginal ultrasound on herself. Shocker, I unnecessarily freaked myself out, just like I warn patients can happen if we do an ultrasound too early. I went home and cried to my husband that it was definitely a failed pregnancy. Nope.

We spent time with family over Christmas later that week. It was way earlier than I wanted to spread our news (I waited until I received my genetic screening results back at 11 weeks with my previous pregnancy), but that crew would have known something was up with me avoiding certain types of merriment, so we told them that I was pregnant. Since we shared with that side of the family, we shared with the other. We then went ahead with attending a destination wedding out of the country, another circumstance in which my condition would have been all too obvious, so I told the friends that were there too. Having told so many people so early on, I knew the pregnancy would end soon. Nope.

I assumed my genetic screening or spina bifida screening results would come back with an abnormality. Nope.

I slipped on the stairs carrying my daughter down one morning, and I worried that the heartbeat would be gone when I checked the next day at work. Nope.

I had my anatomy ultrasound last week and was certain there would be a terrible finding with dire consequences. Nope.

Things have just...kept going well. This is a healthy, normally-growing pregnancy. I feel her little movements. The space she requires makes me pee all the time and is starting to contribute to aches. My hair is in the lustrous, actually-holds-a-curl phase.

Yet with all of the physical and medical data, I have a hard time believing I'm pregnant. Sometimes I almost actually forget. Even at nearly halfway through, I feel like if I let myself be too excited or happy that this will go away because it wasn't supposed to be easy for this flawed body.

At the same time, I find myself trying to blame myself even more for the fertility struggles we did have in the past. Clearly I must have been doing something wrong then for everything to just be fine now. Obviously I was the cause of my own failure. What could I and should I have changed? Others can reinforce this negative (and illogical) line of thinking. Someone flippantly said that "when you're not stressed about it, things just fall into place". But...I wasn't stressed when we first started trying before. I was excited and hopeful. The stress came once the struggle began, it didn't cause it. I try to remind myself that I was doing everything I could have and that our difficulties weren't my fault.

I want to be very clear that this is NOT meant to be a complaint. This is meant to highlight that fertility and pregnancy can be complex, emotional, difficult experiences and that that can be true for so many people with so many different types of journeys to their babies. We can't assume to know anyone's perceptions of or reactions to their own experiences. We can't compare one path to another.

I am so grateful for my daughter with her amazing little personality and all the joy she brings to my life. I am thankful for my daughter-to-be and can't wait to find out who she is. I realize I am incredibly lucky to have this growing family full of love.

I wish that luck to everyone who is hoping for pregnancy, whatever their circumstances.

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