Contorted into a yoga-like position, my body reminds me I am not the twenty-year-old, flexible human I once was. Elevated legs, straight up. Toes pointed to the ceiling hint at the thirteen years of dance I once had. Hands underneath my pelvis for added support during the dozen or so minutes I rest, hoping and thinking about the possibility of a life we have dreamed of. My eyes lock on the wall directly behind me. Hanging above our bed are three canvases, a wedding picture bookended by our vows. In attempts to deflate the tension, to deflect from my fear, I conjure up a nonchalant tone, push the doctor’s words aside, and return to that time when we knew less, when we would playfully imagine our house filled with the laughter that children could bring, when all the things seemed possible. And I ask a simple, yet taxing, question:
“Will you read your vows to me, again?”
Perhaps I wanted to hear his voice, to feel his commitment to me, and by extension, his commitment to this. Perhaps I needed the reminder that he loved me, no matter how my body had failed me, had turned its back on our dreams. Or perhaps I just wanted to pass the time with him by my side. Regardless of my reasoning, I ask, and he reluctantly complies, fumbling for his phone, tucked away on the nightstand, becoming a co-conspirator in my futile efforts to ignore the obvious. Half-dressed, he opens the note that he had lovingly typed two years earlier. Going through each line, he falls into a robotic tenor, in part out of his boredom and in part to push my buttons. His words wrapped with his silliness transport me back, back to that summer evening, him in his grey suit, and me in my ivory French-laced dress and the Mississippi heat bearing down, back to a time when we had our entire future of happily-ever-after ahead of us, back to that place when anything we wanted felt within our grasp. The serenity of that day mimicked the blue hydrangeas that I held, soft yet vibrant, familiar yet new, fragile yet fixed. But his promises this afternoon induce a stillness that envelopes my core. He concludes, “I love you. I will always love you—without end and without condition.” Without condition. That unconditional stamp that marks partnering off, journeying through many seasons, and growing with each other. The “I love you, no matter what” holds more weight now than before.
My torso drops to the bed, and I snuggle into his chest. We both, in our own ways, dwell with the complications and beauty of our past, present, and future, a future that I clinch to so tightly that our days, nights, and afternoons revolve around our efforts to create.
*****
We had been trying to become pregnant for about nine months. Nine. Emotional. Months. The irony. I’ve had moments of crazy, moments of concern, moments of indifference, moments of trying too hard, then trying not at all. Moments of hope, exhaustion, excitement. And tears. Lots and lots of tears. In my car, in the store. At work, at home. While reading. While grading. His strength mixed with his acceptance would impress me. At times, his constant assurance would catapult me into overdue states of calm, sprinkled with just pinches of restlessness, a restlessness that never quite dissipated. Other times, his demeanor made me question whether he was “all in” or not. He knew my emotions were all over the place. Maybe that is common. Or maybe I could, and should, blame the calculated efforts or even the medicine.
Everything is so timed with fertility treatment. The sex. The pills. And eventually, the shots.
Take one pill, 50 mg, on days 3 through 5.
Side effects include spontaneous rides on the pity wagon, bloodshot eyes that cannot quite reveal the depths of my ache, and a constant pit in my stomach that lingers no matter how much I hide behind positive affirmations. I try to trust the doctor and to acknowledge that this is her expertise. Yet, I question everything. The diagnosis, the dosage, the likelihood that this will help. I even question whether this whole process is attempting to force something that just is not meant to be. I bounce through a myriad of states, fluctuating vastly with my own beliefs. One minute I’m dissecting nuanced questions related to inviting science into the equation, and the next, I’m praising how far modern medicine has come. Despite it all, or perhaps because of it all, I try my best to stay fixed to our love and to the feeling that this tiny energy, this tiny soul will one day find us and that he and I will love that soul with our entire being.
Perhaps these ups and downs, and everything in between, are simply preparing me for motherhood. Or perhaps my brain is pulling double-duty to compensate for other organs (primarily, ovary one and ovary two) that refuse to cooperate. Decreased ovarian stimulation with a FSH (Follicle Stimulating Hormone) of 14 was the initial screening—a borderline number that teeters on a low success rate of fertility help. And there you have it. For five mornings, as directed, I pop a pill, swallowing a piece of my womanhood. And wait. A wait that we had grown accustomed to. A wait that led us to the fertility referral in the first place. A wait that allowed us to learn more.
Diminished ovarian reserve, to be exact.
That’s the culprit.
I do not recall what we were told exactly about what most “healthy” women my age would have in terms of reproduction. But a quick exploration highlights that women in their upper 30s should have about 10 antral follicles, in each ovary, totaling a good double-digit chance. Yet I am among those who are not so lucky. Three follicles. That’s me. Not in each ovary. That’d be a delight. Just in one. The second ovary must be on an eternal strike. In addition, these would have to be healthy and grow big enough to release an egg before meeting up with the sperm. To add to the complexity of the lack in number and quality, my cervix is wonky with peaks and valleys, making any swim an arduous one and suspecting that matters fizzle out when timing is key. Then, you add in an aging body, and our odds of pregnancy without any assistance was explained to be slimmer than slim, if at all.
After that diagnosis, I relied on daydreams and pillow talk to mitigate the fear, trying to tease out any hope by visualizing what the future could potentially hold—trusting to one day hold our child. When doing so, I admit that I would drag my husband along this imaginary world, talking endlessly about “what if” scenarios. I am sure he grew weary of these conversations, but the truth is that I needed them, that they were my grasping at straws when my cup felt empty.
I would imagine our child’s hair color, personality, and hobbies, and I would share endless statements with my husband about what will be, how life may change, who our child will take after. I would make him pinky-swear that he will pass on his positivity and shield our babe from my anxiety. These words morphed into prayers, promises for our future, a list of whispers to our child:
“You’ll have your father’s energy and my creativity. You’ll learn to quiet your insecurities, to embrace chance, and to find replenishment in nature. You’ll possess an unwavering work ethic—while always making room for laughter. Your spirit and love will be infectious, and your adoration for the arts, insatiable. You’ll be sensitive without losing sight of yourself. You’ll have a tender heart and gentle, yet courageous, hands, ones that will be capable of breaking walls and mending misfortune. Or so I hope.
You’ll challenge us, and you’ll surprise us, with a personality that we never could quite anticipate, becoming someone who is uniquely you. And through it all, we’ll be enamored by you, your ways, your fingers and toes, your voice and curiosity, while trying our best to model strength and humility and trying to tackle that thing called parenthood. We’ll waver; we’ll stumble. We’ll make mistakes—and apologize when we do. We’ll let you down, let you learn, and let you be. We won’t sugarcoat the hard truths, yet will encourage you to fly. You’ll cry and question—yourself, others, the world—and we will support and love you, no matter what.
More blood work and an HSG, a hysterosalpingogram x-ray of the uterus and fallopian tubes.”
That was the next step, the next tester of my faith—to even see if I was a candidate for treatment. That day was quick; the room, sterile. Yet my husband’s smiles, eyes, and hugs gave reminders of how deep he loves. We both felt the weight of yet another screening. And the thought of only producing three follicles each month, not even knowing if any of these three could grow to release viable eggs, crushed me. Thus, when we discovered that intrauterine insemination (IUI) was a possibility, we opted to proceed in efforts to increase the number and quality of follicles, and thus, eggs in our fertility basket, so to say.
Throughout the process, we tried to remain positive, tried to focus on success stories. We would even try on different names for our future child. Margaret. Elise. George. We have our favorites. When we first visited the center, I used to list four or five possibilities at once, making sure they had a rhyming factor and swearing that we would have quadruplets or quintuplets. My insistence on multiples would spiral my husband into his own what-ifs. “How can we handle that many?” he’d say. “You’ll have to quit your job and become a stay-at-home mother,” he’d threaten with a smile. “We’d be outnumbered,” he’d declare. “We’d have to move closer to one of our families just to get some help,” he’d persist. I would egg him on, inquiring whether we’d relocate closer to his parents or mine, delivering a case for the latter.
Inject 50 mg of Gonal F for six days and return for bloodwork and ultrasounds.
The hypothetical of twins was something that scared my husband, yet I fully embraced. Twins run on my side, and I had oddly had two distinct and conflicting feelings since childhood: that I would one day have twins and that becoming pregnant would be hard, if possible at all. It is uncanny how close to home these feelings grew to be during my adult life.
Returning for ultrasounds and bloodwork kept a close eye on the progress of matters, and any banter about twins was silenced by new directives with the stark reminder of my medical results—one nonfunctioning ovary decorated with cysts and one ovary barely producing enough follicles to count. Three. Maybe two some months, or perhaps four, others. Three was what they saw and expected to be typical each month, but not guaranteed. But even with the added regiment of pills and injections and constant monitoring, I kept wondering if this would work. Perhaps I should talk to the follicles, encouraging them to be healthy, to be strong, to prepare for conception. Perhaps if I love them enough, focus on them enough, they will be enough.
“You only need one.” That was my husband’s go-to phrase.
After six days of injections, we were not where we needed to be and were told to do two more days of injections and return and maybe then the dominant follicle will be big enough to do the trigger shot before returning for the procedural insemination.
Conversations continued to play out, as if on repeat. Our made-up scenarios were cautious yet constant, subtly woven into our dinners, car rides, and morning routines. I would insist that our child would take dance, play baseball, or both, and that we would take annual trips to the beach—the Atlantic coast and the Gulf. We’ll travel abroad, sharing adventures with our little one. Maybe our babe would grow to become a pianist, or a painter. I talked. A lot. Sometimes I would sense my husband’s ambivalence to my being so verbal. (I know now and knew then that was just his desire to protect us, to protect me from disappointment.)
“Have no expectations,” he would stress. But yet he would tag along this make-believe world I had created. Even when my imagination and tongue ran a bit too wild for his comfort and for his patience. And he would listen. He always listened. In part because I gave him little choice, and in part because he has a gentleness about him. But mostly, he probably just recognized how much I needed to talk about matters, how doing so helped to soothe my spirit, and how our little talks morphed to pep-talks, bringing the idea of a child a little more into existence and getting me to the next appointment.
Obtain and prepare sperm and undergo insemination.
Our procedure was not the magical act that one considers when they think about a conception story. There was no in-the-heat-of-the-moment or passionate encounters, yet we tried to make the process as intimate and special as we could. We did lunch, or brunch, and had a quiet walk. Yet despite the connection, I wondered if the trigger shot worked, if the timing was accurate, if the post-appointment-sex would be enough insurance. I did not want to disturb the mood with my feeling as if my body would betray us, more than it already had.
I am relatively healthy. I exercise, at least occasionally. I eat right, most of the time. And my size five feet are just enough to support my 5’2” frame. I told myself that plenty of smaller women have had successful pregnancies, with or without fertility assistance. Yet, at times, I wondered if my body was even capable of carrying a child. All the years of being called “cute” and “tiny” had knocked my internalized image of my maternal-self down several notches away from anything close to womanly on the body spectrum. Yet family, friends, society pried with innocent questions and implications that reminded me that women can and should bear children—whether people recognize that not everyone is capable or that not everyone even wants to
Emotions, of every degree, would crush my chest as I tried to compartmentalize and dodge any interrogation during treatment. I often fell short and fell back on trite replies: We will one day. We have a five-year plan. If it’s meant to be. Yet my heart knew what my lips kept hidden.
I moved about my days, as if nothing was askew, as if nothing was bothering me, as if nothing was in me. Truth be told, nothing was. No bun in the oven. No bundle of joy. No baby.
Unsuccessful attempt one.
The world whispers, no, yells that I am well past my prime. All the medical tests proved it. And our first attempt reiterated it. Nothing happened. Despite the success stories and the doctor’s confidence, we knew from the start that we would have three attempts before chances of success went exponentially down. Our first unsuccessful attempt meant that we were one-third of the way done. And nothing. The idea of a family began to feel farther away even as I reminded myself what I knew about modern motherhood, namely that women were waiting to partner off, waiting to start families, waiting and turning to science due to all-too-common fertility issues.
Yet I felt as if I was somehow to blame. I felt as if I should have known more, done more.
Thirty-eight years young, and I was stamped high risk before even hearing a heartbeat. Thirty-eight young, and I had to look up what is meant by decreased ovarian stimulation and diminished ovarian reserve. Thirty-eight young, and I was learning more about my reproductive health than ever before. Thirty-eight, and I imagined myself approaching sixty at my child’s high school graduation. Thirty-eight, and I held to the wonderful thought of a chaotic life, one filled with sleepless nights, hectic schedules, and surprising stumbles. Thirty-eight, and I knew that I was as ready as ever.
Time, I’ve come to learn, is that fickle friend; it teaches as it ticks away. My husband and I probably would not have ended up together had we met earlier. Yet my head turned over this worry that our lateness will be at our child’s expense. I buried the regret with platitudes while being sincerely grateful for our struggles that led us to each other. I reminded myself that each heartache, each dead-end path, each growing pain had to happen. All of those experiences—the good, the bad, and the in-betweens—molded us into who we are, the couple who will never take the other for granted, the partners who have vowed to change together, the parents who will raise and love a child, in every sense of that word, without end and without condition.
Have sex after the insemination—doctor’s orders.
*****
Holding me a bit longer after having finished his vows, my husband squeezes my hand and then crawls out of bed, leaning over and kissing my forehead gently. He knows that his warmth soothes me, even if for a moment. I remain in bed a bit longer, with my hand on my belly, wondering if this second attempt with the IUI took and convincing myself that the post-IUI-sex-protocol adds an element of mystery to it all. I remain nestled in the blue sheets a while longer, holding to this moment when a baby could be more than a figment of my imagination.
*****
Years have gone by, and our bed has never felt smaller.
Five years since that moment have passed. Our vows still hang over our bed; my husband remains my rock, entertaining my imaginative scenarios. I still daydream. I still worry. Albeit everything is different these days. The biggest change is that our bed and hearts are fuller than we could have ever conjured up. I never would have dreamed the events that occurred since that first and second attempt or the life that has unfolded for us.
We were thrilled to learn that the second attempt took, and we were pregnant. However, that was short-lived, as my bloodwork soon indicated an issue, and we eventually found ourselves grieving a miscarriage. Despite the positive explanation of this showing that my body could become pregnant, my heart hurt more than ever, and it took months before I was ready to try again. Even when I thought I was ready, I made one appointment and then could not bring myself to return for the next. Perhaps it was still too close to the miscarriage, or perhaps it was also the idea that this next round was our last attempt. Regardless, I eventually followed through and found myself repeating matters once more, feeling like a pro at administering injections to myself when the first few times had seemed so tough and tear-inducing.
Little did we know that attempt three would yield the expectation of twins. Baby A and Baby B. A boy and a girl, or so my heart expected and head imagined. Little did we know that we would lose Baby A around week 11. Little did we know how this grief would feel completely different from our first loss. Little did I know how much the gratitude for our growing healthy baby girl would carry me throughout the rest of the pregnancy.
We delivered her at the end of September in 2019 and felt deeply that it was always supposed to be her. This vibrated in my core. Yet I simultaneously longed for her twin soul to have a sibling. However, I let that go, putting that idea to rest, knowing that I did not have it in me to undergo any future treatments. I accepted and adored our family, loving it and our unit of three wholeheartedly. Life may not be completely as planned, yet it is beautiful. And I decide daily to see that beauty. And our girl with her sunshine smile and bouncy blonde curls made it easy to love the hand we had been dealt. She became our middle penguin.
As soon as you think you have things figured out, life throws you a curveball.
During the fall of 2022, my doctor left a voicemail: “I’m shocked. I’m shocked. How did this happen!?” And almost nine months later, June of 2023, our hearts explode as we learn a new normal. And I cry. I cry for the life we had and for the one we will have. I cry for how wonderful our daughter has been this past month and for how we have worked together during an array of emotions. I cry because I miss her and our seemingly endless mother-daughter time together. And I cry because I am grateful for wishes we never thought possible, for dreams I thought my body could never hold, and for the family of four we never knew we needed.
Our surprise, no fertility, son was born this past May—with a dramatic entrance into the world. His cord was wrapped tightly around his neck, and his oxygen levels had dropped significantly. Someone, either the triage doctor or a triage nurse, said with an urgent tone, “Your baby needs you to push him out now.” I felt as if his life depended on me and on that push—and with their help, he is here, and he is healthy. And our family of four is adjusting.
Some changes have been easy, while others have involved trial and error. Among the latter is bedtime. It did not take long for our carefully constructed bedtime routine to be thrown out the window, as we juggle life and work to figure out how to fulfill the needs and desires of two tiny humans. Some nights, I fall asleep exhausted from the day. Other nights, I lie awake, staring at my son on my chest, holding him with one hand and using my other to pass my husband a kiss before brushing my fingers through my daughter’s hair.
My tears extend to my knowing that our bed holds more than we could have ever imagined years ago, a bittersweet feeling that means letting go of what was to fully hold to what is. And I am humbled, reminding myself that we can do this and that bending is not breaking.
Life, wrapped in all its wonder, can be hard. I know that, and my children will learn this. I cannot stop them from having disappointments or from becoming hurt, but I can and do promise them to be there for them, always and forever, as long as I live. I vow that they will always have my love—without end and without condition, no matter what.
- JourMS - 