Control

I started acupuncture right around the time I started trying to get pregnant. I'd never tried it before, but a friend swears that acupuncture made her second IVF attempt succeed. So I figured, why not? I found an American acupuncturist who'd worked in a fertility clinic and had special protocols for women trying to conceive. She prescribed herbs to take twice a day (two formulas -- one for before the insemination, and one after).

When I got pregnant, I had been taking the herbs she gave me. But I ran out just as the test turned positive, and by the time my new supply arrived, I felt intuitively that I shouldn't take them. So I didn't.

The acupuncturist also advised against going running after ovulation. I've heard this elsewhere, but my OB at the time (Dr. Unsympathetic) thought running was fine. After I found out I was pregnant, I went running a few times, because I really wanted to.

After the miscarriage, I tried a few more times and wasn't getting pregnant, so I decided to see a different acupuncturist -- a older Chinese woman whose ability to get infertile women pregnant was legendary. She had, apparently, a more traditional approach: you were instructed to bring a jar of urine to each appointment. She'd take the jar, shake it up, and assess you based on the bubbles. That's right.

Here are some of her suggestions:
Don't exercise: during your period, around ovulation, after ovulation.
Don’t eat: sugar, dairy, anything cooked in the microwave, beef and poultry if it wasn't organic.
Eat: yams, seaweed, papaya, shrimp, seafood, fruit.

She didn't prescribe herbs (they took too long to work, she said, but if you really wanted them, you could go see her sister), and she advised against taking a prenatal vitamin (I acquiesced and switched to simple folic acid). She also suggested I lose 10 pounds. (Whatever. Losing weight while trying to conceive is generally frowned upon.)

Acupuncturist #1's treatments were relaxing. Number 2's were downright unpleasant. They were painful, and there was a lot of yelling. "GET A COLOR. Cervix is LIGHT LIGHT BLUE. Uterus dark blue. Fallopian tubes light blue. Ovaries dark dark blue." Then she'd wiggle the needles -- nicely positioned around my uterus and ovaries -- in such a way that I'd feel a shock. "TURN TO GOLD!", she'd yell. I'd arrive home exhausted.

The hardest thing about #2's advice was following her dietary restrictions. I'm a girl who enjoys her chocolate cake, so avoiding sugar entirely was really challenging. And it was hard to reconcile the advice -- she wants me to eat sweet potatoes, but she doesn't want me to cook food in the microwave. If that's the only way I'm going to eat them, does the benefit of the sweet potatoes outweigh the cost of the microwave?

I actually did a pretty good job, for a while, of cutting way down on the sweets (though not cutting them out entirely) and eliminating some dairy. I found a seaweed snack I liked and a form of papaya I could tolerate, and ate seafood that's low in mercury. I definitely wasn’t perfect, but I tried. But with all of that effort, I didn't get pregnant.

During this journey, having new things to try, like acupuncture and Clomid, has been a real comfort. It’s nice to feel as if you can control the outcome, in truth, you can’t. When I miscarried, Dr. Unsympathetic was adamant that there was nothing I could have done during my pregnancy to change the outcome. I believe her. So at some point, as I spent weeks munching on seaweed and passing up brownies, I realized that the problem with Acupuncturist #2’s approach was that it gave me the illusion of too much control. When I miscarried, it wasn't because I went running, and if I didn't get pregnant, it wasn't because I ate a KitKat bar. While cutting down on the sugar is, for me, a good idea (I have a little bit of a problem with the chocolate-chip cookie dough), blaming my sweet tooth for my infertility isn’t. I mostly eat a healthy diet, but women across the country get knocked up eating junk.

A friend told a story of another friend, S., who was having trouble conceiving. S. had cut out running but eventually started up again, reasoning, ‘I’m not getting pregnant by not running, so I might as well run.’ (She eventually did IVF and has twins.) I didn’t get pregnant following Acupuncturist #2’s recommendations, and when I started on the fertility drugs, I stopped seeing her, knowing that she would disapprove.

I haven’t gone back to see Acupuncturist #1 in a while. (I never thought I was the kind of person who'd have not one but two acupuncturists.) It’s hard to schedule, especially given all the schlepping I have to do for the rest of the project. I still occasionally eat sweet potatoes and dried papaya, and the seaweed snack is a keeper. But I’ve given up the illusion that my diet will be the determining factor in whether a healthy egg meets a healthy sperm, fertilizes, continues to divide, and seven to 10 days later, finds a nice comfy uterine lining in which to implant. Sometimes it’s a relief to accept the things I cannot change.

Choices

At 19 I had a pregnancy scare. I had a boyfriend, the condom broke, and I spent $20 -- a huge sum to me at the time -- on a pregnancy test that didn't provide an intelligible result. Fortunately, I got my period a few days later. But I wouldn't have hesitated for a moment to get an abortion, even though my Catholic boyfriend told me later he would have been upset about it. My body, my responsibility, my choice.

Yesterday's New York Times magazine has an interesting and maddening article about an anti-choice movement that claims abortion harms women psychologically. The movement relies on debunkable, quasi-scientific studies that say women who've had abortions have more psychological problems than those who didn't. One of the main characters in the story is a woman who's had four abortions and mourns them; she now organizes memorials for aborted embryos. She has three daughters and didn't teach them about contraception, because, she says, "“Abstinence works better than birth control, really. It’s just that people don’t do it.” So, big surprise, her 17-year-old daughter got pregnant. It makes me crazy to think there's a woman out there who claims to be advocating for women's health, yet failed to teach her own children about contraception.

I deeply mourned my miscarriage -- a spontaneous abortion in medical parlance -- at eight weeks. It is possible I would have mourned an abortion when I was 19, but I can guarantee you that whatever psychological harm might have been induced by that procedure would have been far eclipsed by the harm -- both to me and to a child -- of regretfully becoming a parent as a college sophomore.

I don't disagree with Bill Clinton's position that abortion should be "safe, legal, and rare." Abortions will be rare when women are educated about birth-control options, when more men start being willing to wear condoms, and when both sexes have access to affordable, effective contraception.

Until that time -- and even after -- let's celebrate. Today is the 34th anniversary of Roe v. Wade. Here's to many more.

Datebook

If you're trying to get pregnant my way, you get a whole set of special tasks to handle each month. Let's take a tour, shall we?

Day one of my period: Call the doctor's office to tell them the news. Schedule ultrasound appointment. Call the sperm bank to buy some more sperm (sorry, I just can't call them swimmers). Refill prescriptions.
Day two: Pick up first prescription (Clomid), but learn that the insurance company won't refill the second prescription (for the ovulation-trigger shot) for another nine days.
Day three: Begin taking Clomid, at twice last month's dosage.
Day six: Call the insurance company to request coverage for the upcoming IUI. Convince partner to scribble authorization code as we drive through pouring rain the day after Christmas.
Day seven: Call sperm bank to arrange pick-up of giant nitrogen tank containing expensive sperm. Call doctor's office to arrange drop-off.
Day nine: Go back to the pharmacy to retrieve the second prescription.
Day ten: Go to doctor's office for ultrasound, which indicates a good number of good-sized follicles (which contain eggs). It also indicates a thin uterine lining, a side-effect of Clomid, which the doctor declines to do anything about (I used an estrogen patch to treat this at my last doctor's office, but this guy tells me "we only do that with IVF." WTF?) Doctor repeatedly warns of the risk of twins (from the multiple follicles whose presence is thanks to Clomid) and says, with absurd optimism, "it's very likely you'll get pregnant this time."
Get told to take shot, which I've brought with me in case a qualified nurse can be convinced to administer it. Get turned down, but learn that the pharmacy has sold me the wrong needles for the shot. Get the right needle from a nurse, drop the needle on the floor, get another one, do the shot. Schedule IUI for the following day. Then, leave the office, drive across town to the sperm bank. Pick up the nitrogen tank, which is supposed to remain upright yet tips over in the car, spewing white smoke. Panicking, find parking space. Carry (now very cold) giant tank two blocks to the doctor's office. After the lab removes the sperm, carry tank to car, and drive it across town back to the sperm bank. This little errand takes three hours to complete (minus the 10-minute detour for a croissant).
Day eleven: Go in for IUI.
Days twelve - twenty-five: Await news of success or failure, indicated either by continuing high temperatures or the arrival of blood. Try to avoid the temptation to take a pregnancy test before it's reasonable, as doing it too early is both expensive and nearly guaranteed to disappoint.