Day 7: "Ah, my arch-nemesis. We meet again."

I have decided that the doctor who did today's ultrasound is my sworn bosom enemy.

I'd already taken against her for her dippy behavior when we learned my last pregnancy was failing. And I'd been exasperated when, before IVF #3, she couldn't figure out how to work one of those newfangled, high-tech blood pressure cuffs. (Special hint, doctor: It's called Velcro.)

But today she just pissed me off more.

First she didn't even try to show me the ultrasound screen as she scanned me. "I'd like to see, too, if we can angle the monitor," I asked, knees akimbo. "Sorry," she said, "but if we angle it, I can't see." Of course, every other doctor in the practice — and I assume the ASRM — has figured out where to stand to offer the patient a look without compromising the doctor's view. Maybe it's unreasonable of me to want to see what the doctor is basing her decisions on. Maybe it's presumptuous of me to want to see my own engorged ovaries.

But that's not what really sent me stratospheric. That came later, when I asked a question and she looked at me vaguely, asking, "Have you done IVF before?"

The IVF coordinator and I were both surprised into silence by this question. I finally mustered an annoyed snicker in answer. "Um, yes."

Now, okay, I realize this is not, alas, a Juliecentric universe. While I do have some nominal control over the tides and the changing of seasons, the rest of the world does somehow manage to turn without my express consent. But come on. "Have you ever done IVF before?"

My clinic does no more than 150 cycles a year. Three of them last year were mine, and each of them went haywire in a different and unusual way. For one of them, she did the retrieval. On another, she presided with unseemly cheer over a very disturbing ultrasound. And then there was that very tense conversation about my egg quality after IVF #3 — she got defensive, I got mad, and we both went away feeling misunderstood.

Either I'm really unmemorable, or she's a total goddamn space case.

It doesn't feel good to know that a doctor who's empowered to make decisions about my treatment doesn't know who I am or why I'm there. I'd expect that in a larger practice, might even prefer it at this point — the personal touch has proven so far to be a bad, bad touch. ("Julie, show the nice police lady where the scary people touched you.") For added expertise, it would be a worthwhile tradeoff. But if I'm not getting state-of-the-art care at the moment, at the very least I expect the doctors to act like I matter.

So, without further ado, I declare a blood feud.

The scan and bloodwork looked fine. My follicles are growing apace and it looks like we may trigger Sunday night. Next appointment: Sunday morning, 8:30. If they're running late this time I swear I will commit mayhem.

Maybe I went too far

Yesterday the nurse who drew my blood told me this story as she swabbed my arm:

"A patient was in here earlier with her four-year-old son. He didn't mind the needles and wasn't fazed at all by the blood. What got him was the smell of the alcohol. His eyes got really big and he asked, 'Is that alcohol?' When I told him it was, he looked very concerned, and asked, 'Do you carefully put that away so that children can't get it?'"

And I thought, yeah, all the children running around unsupervised in the infertility clinic.

I said, "I hope you told him, 'No, we store it in a big open barrel surrounded by balloons and streamers and a big blinking sign that says, Bob for Prizes Here!'"

She laughed nervously and changed the subject.

Day 9: I knew it was too easy

This morning's appointment went great. I was the first patient seen, and the two doctors on duty were total sweethearts, patting me and making much of my admirable work thus far. "Excellent stim," said one, squeezing my shoulder. She said she thought we'd likely trigger Tuesday night, with either four or five mature follicles in play. I left with a warm glow and a pleasantly purposeful feel in my pelvic region.

But then, splashing ice cold sulfuric acid all over my lovely glow, she called later with my estradiol level. It's gone from 641 on Friday — respectable and encouraging — to 490 today.

You may not know this if you haven't run the gauntlet of infertility treatment, but your estradiol level (E2) is supposed to increase until ovulation, at which point it'll go down and progesterone will begin to rise. A drop in the E2 level likely means that my uppity ovaries are ovulating, long before they have been given official leave to do so.

I don't know what else it could mean; the doctor said something vague about a couple of follicles possibly having petered out. I was too stunned by the news to ask many questions. I'll be back in the office tomorrow morning for more bloodwork. The progesterone numbers should tell us one way or the other. I am preparing for disappointment once again.

Worst sex ever

Last night my husband and I had what might be the worst sex we've ever had.

Now let's get this straight from the start: I am crazy about Paul. He makes me feel understood, which is a rare talent. He's kind and not at all shy about showing affection. He's brilliant — the smartest person I know, and I am not a gentle judge — and has a sly sense of humor that often catches me by surprise, much to my delight. I am grateful every day that he loves me. ("But why?" I've asked him. "You're nice," he answers. So demonstrative language isn't his strong suit. Big deal.)

But we've known each other for about eight years now. When we were first together, we couldn't keep our hands off each other (to say nothing of our mouths). Now, well, we're used to each other, and while the sex we do have is warm and exciting in a still-waters-run-deep kind of way, it's not as frequent nor as intense.

It is easy to blame infertility.

First you have the treatments, which are stressful and sometimes painful, hardly conducive to lust. Then, in my case, you have the aftermath — a month at a time when my body has been healing from some insult or other. Finally, if you're delusional enough to feel there's a chance you might conceive during the rare months when you're not in treatment, you'll be doing it under duress: sex on a schedule without even the spur of hope that fertile couples feel when they see that clear and stretchy mucus.

I am going somewhere with this.

In case I did ovulate over the weekend, it seemed like we should cover our bases, no matter how futile a pursuit. So I left off my impenetrable Polarfleece pajamas, took a deep breath, and gingerly crept across the mattress to where Paul lay.

I have to confess it was awful.

Sad and freaked out to begin with, I felt no desire whatsoever. I felt entirely goal-oriented. (This can be an exciting approach to sex, but it does tend to dampen the mood when you bite your tongue to keep from asking, "Are you close? How 'bout now? Okay, now?") My body didn't respond to any of the usual suave blandishments — anyone who tells you that high estrogen levels increase your natural lubricity has never visited the Mojave that is my vagina these days.

But to accomplish the goal, the well-placed deposit of a copious spermy payload, I willingly played along. What else could I do but pretend to enjoy it? The goal was indeed accomplished, with heroic effort and no small relief.

I lay awake for a long time afterward. Not only did my body feel misused, not only did I feel angry and sad about the likely failure of this cycle, but I also felt small and dishonest to boot.

I'll make it up to us both sometime, once I stop believing this fiasco has eradicated all sexual feeling once and for all.

Day 10: Great, more bad sex

"You know, everything that can go wrong with you does," my doctor just said on the phone.

That's right, friends: I ovulated.

My estrogen had increased slightly, but what was really telling was my progesterone level, which was at 4.5.  Anything above 1 is apparently a reliable indicator of ovulation.

As soon as I heard his voice on the phone I knew it couldn't be good news.  His recommendation was that we have sex tonight and hope that I can "pull a rabbit out of my hat" as I've done before.  (You know, "pull a miracle out of thin air."  Or perhaps, in my current mood of misplaced rage, "pull the poor blameless UPS delivery man's spine out through his rectum.")

I asked my doctor if he would recommend a different course of action on a future cycle — closer monitoring, a change in protocol, anything.  He said he'd want to check my progesterone throughout the cycle, which isn't normally done at my clinic, but didn't offer any other thoughts about how we could keep this from occurring again.  "It's just one of those things," he said.

One of those $2,000-in-drugs, crush-my-hopes-up-but-good things.

There's no point in even bothering to do an IUI at this point.  We're not likely to have more than one egg in play for this cycle, even if Paul's rather immotile sperm can get to it.  I can't even talk about how disgusted and angry I am, at my body and at the world.

Hey, look, people name their kids Brandy and Chardonnay...

Just on the infinitesimal chance that last night's connubial tussle produces a twin pregnancy, I am already prepared with names:

Vodka and Astroglide

Who says I'm a pessimist?

Take that, Fred Phelps

God loves gay people and I have proof.

My cousin J. is a middle-aged single man living in New York. The only people in the family to be surprised when he came out were his parents and my grandfather. (The other member of the oldest generation, my grandmother, took it with characteristic aplomb, but then I can't be sure she really understood what he meant. My grandmother is a shining exemplar of the power of peaceful denial.)

The rest of us sort of rolled our eyes and said, "Well, yeah, and...?"

J. is going to have a baby. He found a surrogate who lives in the Midwest, provided her with the necessary biological product — sorry, I can't really think about a family member's semen without cloaking it in several layers of protective euphemisms — and, voilà! 40 weeks later, he's going to be a father.

See how easy that was?

Now it's true that individual gay people are just as prone to infertility as breeders. (Get it? Infertility? Breeders? Hah? Hah?!) In fact, PCOS seems to be twice as common in lesbians. But in any given gay couple, what are the odds that both partners will be infertile?

If you're a lesbian with blocked tubes, your partner could still conceive a child. If you're a gay man with a low sperm count, it's probable that your partner has no such handicap. Let's face it, with two sets of ovaries at your disposal, you can afford to cherry-pick. With four testicles in play, your specimen cup runneth over.

In either case, you're still going to need to involve a third party, so the necessity for ART is a foregone conclusion. That third party is likely to be healthy and fertile — he or she wouldn't be in the running otherwise. And needing medical intervention of some kind doesn't exactly come as a shock when, you know, we're talking two men or two women.

Straight people in monogamous relationships don't have these advantages. First, you just have one set of each flavor of gonads. If my ovaries are tapped out, I can't really turn to my husband and ask him if I can borrow his. Second, the notion of turning to a person outside your partnership for help is an awkward one for many couples. Third, we're brought up to believe that any man and any woman can reproduce, and we grow up expecting we'll be no different.

Imagine our surprise and delight.

Now, according to the people who make my holiness their business, aren't straight married couples supposed to be favored by God? Aren't we supposed to receive all sorts of divine fringe benefits because of our unimpeachable piety? If God's so crazy about us hetero marrieds, shouldn't he be giving us the cosmic high-five every time we do it on cycle day 14 — or at least every time we turn, defeated, to infertility treatment?

But noooo. It's gay people who have the reproductive advantage!

The only conclusion I can draw from this is that God actually prefers gay couples. He loves them so much, He wants them to be fruitful and multiply. I just knew the homophobes were wrong.

Update: J.'s baby was born on January 27. Beautiful, beautiful family.

I don't even know what to say

What was this person searching for, and why did this term bring him here?

A woman becomes pregnant quickly and her abdomen is blown up

Now, maybe I'd understand his arrival here if he'd searched for

a woman isn't pregnant after a year of high-tech treatment and yet her abdomen looks like unbaked, overproofed pain au levain

The state of the uterus address

In no particular order, some thoughts from the last few days:

My breasts are tender and enormous, not unlike the hyperbasted upholstery of a Butterball turkey. I can't seem to find the plastic pop-up timer the package promised, but I'm told I'll be done when my thigh joint wiggles freely in its socket.

I know that after ovulation, the corpus luteum produces progesterone. What I don't know is whether ovulating from many follicles produces a whole mess of corpus luteum cysts — did you like how nimbly I managed to sidestep coming up with a plural for "corpus luteum"? — and therefore a greater surge of progesterone than usual.

Last time I was pregnant, I tested positive on ten days past ovulation. I don't know how many days past ovulation I am today. After I learned that I might have ovulated early, I started to feel it happen: imagine the sensation of bubble wrap being popped in your pelvis. But those were the tiny follicles, as the big one was already gone by then.

In conversation I called the big one a red giant, which made my geeky husband snort with surprised delight.

I don't have plans to test this cycle. I am psychotic enough to be hopeful, but sane enough to be pragmatic.

This doesn't mean I won't test. It just means I don't have six pregnancy tests lined up in a ready phalanx under the bathroom sink. That space is currently occupied by the half-dozen empty boxes from the tests I used last cycle. I must make plans to sneak them out discreetly.

The cool thing about ovulating early is that I can expect my period earlier. I would prefer not to bleed in February — nothing would please me more than keeping the disappointment confined to January, which has proven so far to be no more than a hateful extension of a hateful, hateful 2003.

I always look for the silver lining.

I want to be pregnant this cycle just so I can earnestly tell my doctor I'm sure it's sextuplets.

Spent too much time dicking around online: -1

When my friends want to comfort me, they tell me, "You'll be a great mother." The unspoken "...someday" doesn't bother me. I prefer to focus instead on the affirmation, the confidence that I might not ruin my children beyond repair. Not immediately upon returning from the hospital after their birth, anyway.

Because, see, I have my doubts. At bedrock I'm a very selfish person. I have moments of breathtaking irresponsibility. I care too little about what other people think, especially important people, especially authority figures. I'm careless about money. I still call my brother names, and I don't like to share.

I seldom floss.

Sometimes I try to look objectively at my fitness to be a parent. Some days are better than others. Today, so far, I appear to be coming out ahead.

Activity	Score
When awakened by the hungry cat, grouchily swatted him away, muttering, "Jackass, you can wait."	-5
Remembered not to use all of the hot water, conserving it for Paul’s shower	+7
Added to hot water reserves by flushing toilet during Paul’s shower	-2
Successfully soothed scalded husband, avoiding an inconvenient trip to the emergency room	+6
Put on yesterday’s clothes again today because, hey, I didn’t sweat much	-1
Carefully separated lights from darks before loading the washer	+3
Missed a red dish towel	-3
Did not rebleach the load, deciding that wearing pink underpants would not significantly undermine Paul’s masculinity	-2
Baked a batch of brownies just because Paul hadn’t had a treat lately	+6
Surveying the chocolate supply, said, "Fuck it," and used the Callebaut	+8
Said "Fuck it" aloud	-1
Ate breakfast, the most important meal of the day	+2
It was brownies…	-1
Four of them.	-3
Upon receiving new school pictures of every child I know, mounted them dutifully on the refrigerator	+3
Tossed the older pictures in the garbage instead of lovingly preserving them in acid-free lightproof boxes	-1
Paid the monthly bills….	+2
December’s monthly bills	-5
Swigged deeply from the week-old bottle of wine on the counter before tipping the remainder down the drain	-3
Had a week-old bottle of wine on the counter to begin with	-3

However, I cannot say what the rest of the day will bring. Every moment is ripe with possibility.