Spring 2020
It’s the first weekend of lockdowns and we all are trying to grasp our unprecedented reality.
Just a week prior, my mornings started at 5am. I would rush to the cafe to start brewing coffee for the breakfast rush. Balancing the operations of a busy cafe, catering, and a large staff was a rewarding challenge, to say the least. I’d wonder why my eye would twitch, not realizing that caffeine, stress, and adrenaline were the culprits. We were located in a business park so as Covid started to surface, so did rumors of our building shutting down. It was only a matter of days before life went from 100 mph to zero.
Despite the fears of the unknown, it’s hard to deny the enjoyment of the change of pace. Sleep felt abundant and caffeine consumption, finally, was not. I was experiencing some strange symptoms that I attributed to the sudden change in lifestyle, especially after several negative pregnancy tests. Of course my body is out of whack – the entire world is, I’d remind myself. A few days pass, and Scott and I prepare for our virtual movie club. Each week a group of us would watch movies and review them on zoom for our social distant happy hour. We were on the couch waiting for the zoom to begin, and suddenly a wave of emotion flooded through my body. What started as a thought, sent shockwaves to my neck, down my spine, and when it hit my feet I ran to the bathroom to take a pregnancy test.
I can’t explain this, but I need to do this – I yelled behind me as Scott shouted that the zoom began, wondering where I was going. I rush back to the couch with the test in hand, smirking, knowing that Scott was live and unable to question my antics. I prop the test upward so we could discreetly read the results. A few minutes later and the wave of emotion returns. I grab Scott’s knee, trying to remain calm, as the test turns from a flashing clock to YES.
The zoom couldn’t end fast enough, it didn’t help we were reviewing Uncut Gems, the least rated movie of our series. We slam the laptop shut and jump into each other’s arms. We’re pregnant.
The next morning I called the doctor, who surprisingly was able to schedule me for an appointment just three days later. Our evening turned into a weekend of bliss, as we told my in-laws the news and continued to carry our excitement. A few days pass and I’m confident, calm, yet nervous with what to expect as I wait for the doctor to confirm the good news. Instead, though, she enters the room, takes a seat, and asks if I ever heard of a chemical pregnancy. My eyes began to swell as I processed the doctor explaining that a chemical pregnancy is a very early miscarriage. She then went on to explain that there was nothing more they could do for me, and our best course of action is through a fertility clinic. A familiar wave of emotion rushes through me, but this time of shame. I felt a burden to my doctor’s time at the early stages of a pandemic, I felt ashamed of the family portrait we painted through conversation all weekend, and embarrassed of the newborn onesie I ordered to surprise an expecting friend.
I could not have gotten home and into my bed fast enough. When Scott came home he saw the empty milkshake on the nightstand surrounded by bunched up tissues. I explained to him that today starts my day of grief, the day I allow myself to feel however I need to feel and with that, do whatever I need to do for comfort. Even if that includes splurging on a delivered half melted milkshake.
When I reflect on that day, I do not get emotional about the chemical pregnancy, the disappointment felt at the doctor’s, or the baby purchase I made. Instead, I think about declaring my day of grief, because little did I know how comforting those days would be as we began our journey with the fertility clinic.
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The following month we take the doctor’s advice and call the clinic. It was a two month process to become patients and start the “checklist” which entailed the steps we would take before getting a diagnosis. These steps start with my cycle day 3 blood work, which determines a baseline about hormonal levels and ovarian reserve. Scott was also scheduled for blood work and a semen analysis. The next on the checklist was a hysterosalpingogram (HSG), an unpleasant procedure to determine if my fallopian tubes are open. The remaining two items on the checklist were day 21 blood work, which confirms ovulation, and genetic carrier screen testing, which was the only optional item on the checklist.
After my HSG procedure, the next on my list was Day 21 blood work, but to my surprise, before I had the chance to make the appointment I got a call from the doctor with my diagnosis. He said based on my infertiliy, my elevated Anti-Mullerian Hormone, and the abundance of follicles on my ovaries, he is confident I have polycystic-ovarian syndrome (PCOS). He explained someone my age should have an AMH level of 2.5 ng/mL and 5-8 follicles per ovary – but my AMH is 5.8 and my total follicle count is 33. He explained PCOS is a hormonal issue that can impact ovulation and explain my irregular menstrual cycles. However, despite the diagnosis, my androgens and other hormonal levels were normal – which is often not the case with PCOS. He also assured that Scott’s tests came back within normal range. I remember his words exactly, it’s not a matter of if you’ll get pregnant, it’s a matter of when. He suggested ovulation induction treatments, but encouraged us to begin when we felt ready.
Scott was at work during the call, so when I caught him up to speed I summarized this as I have too many eggs, I am too fertile, and we will get pregnant one day. I felt a weight off my shoulders as I began doing my own research which validated that we can get pregnant with PCOS with the understanding it may take us longer.
I went to the website to schedule my Day 21 blood work, but after a week, I never heard back. I easily could have called and made the appointment over the phone, but I took the silence as a sign. We were getting ready to reopen the restaurant post lock-down, summer was about to begin, and we now have some answers. Scott agreed that we put this on the back burner until the end of summer, and who knows, perhaps the summer of slow pace is what we need for a miraculous pregnancy.
Summer 2020
It was a summer of slow pace indeed. We were operating the restaurant with a skeletal crew and minimal sales, which was a stark difference from the busy start of the year. We were not alone, though, this was the story of business across the globe – a small comfort in uncertain times.
While we enjoyed the leisure, three months pass with no pregnancy. Relax and you’ll get pregnant, I’d say while rolling my eyes because clearly that did not work.
As the end of summer approached, we were surrounded by glimmers of hope. Business was growing, schools were reopening, and our schedules started to seek normalcy after we increased our operating hours. Perhaps this hope is what we need to resume testing and discuss treatments with the fertility clinic. Perhaps this hope comes from my love for the end of a season.
I have always been motivated by the change of a season even as a young girl. I remember the end of August organizing my school binders and labeling my dividers with anticipation. Similar to how I now use the last week of summer to bring forward my fall cookbooks, flipping through my comforting collection, being inspired by the season ahead. Back then, I’d call this my back to school mentality. Today I recognize the beauty in a cycle of change and how every ending is followed by a new beginning.
That’s exactly why the end of August felt like the perfect time to pick up where we left off. Luckily, I remember exactly where that was. Even more lucky, the fertility clinic called me before I had the chance to call them. This is off to a great start I thought.
I explained to the nurse that three months prior I went to schedule my Day 21 blood work, but never heard back. She apologized for the miscommunication, though I was adamant an apology was not necessary, as I could have been persistent. I asked if I could schedule the appointment with her then, but she explained that Day 21 blood work is not necessary. That is just to see progesterone levels to confirm ovulation, she said, and through treatments we supplement you with progesterone regardless. Instead, you need to do your genetic carrier screen testing – the test that I recall being optional.
I was seeing an incredible acupuncturist, R, who specializes in women’s health and fertility. She was looking forward to the results of the blood work, and equally confused as to why the clinic dismissed them. R explained that the blood work could reveal whether or not my body produces enough progesterone on its own, a hormone crucial for implantation, and could give insight to our struggle.
R knew our anticipation to begin treatment, and understood when we surrendered to the nurse and scheduled the genetic carrier blood test.
Along with the blood test, the clinic instructed us to schedule a mandatory appointment with a genetic counselor to review the results, a standard procedure for every patient. We got our genetic carrier blood work done and scheduled the follow-up appointment for three weeks later. This was an optional test on the checklist and the least worrisome to our understanding, so for those three weeks we never gave this a second thought…until we realized we scheduled the telehealth follow-up during a camping trip with limited cell-service.
A few days before our trip/appointment, we had a brief moment of panic but quickly made a plan: we’d each leave work early to arrive at the campsite an hour before the appointment, giving ourselves plenty of time to sort out the WiFi. It’s the day before the trip and we seem to have figured out all of the last minute kinks. I am at work when I receive an unexpected phone call from the fertility clinic.
Nurse: Hi Lindsay, this is your nurse. I am calling to see if you have the appointment with your genetic counselor.
Me: Yes! Tomorrow at 4pm.
Nurse: Your results just came to us. You are a carrier for an X-linked recessive disorder. The doctor advises you stop having unprotected sex immediately.
