IVF, personhood, and the Two-Week Wait.
I looked up from the notebook where I'd been writing and sketching zygotes—did she say she creates life?—but then Ramos went on to talk about the life of the family: mothers and fathers and children, or mothers and mothers, or fathers and fathers, birthdays and holidays, traditions passed on, one generation to another. That is the life she helps create, the life she or another embryologist offers me and my husband.
Near the end of my visit, our conversation turned from the theoretical consideration of morulas and blastulas to the specific realities of my own condition and treatment. Very politely, Dr. Ramos asked my age, and I told her. "Now is your time," she said.
She is probably right. Our two-week wait is over, and—as I have come to expect—we are still TTC. Visiting Dr. Ramos did not answer my questions about money or the use of resources or the exposure to heartbreak. But in my waiting moments, in the space of what if, I can picture myself receiving a phone call from her. "Beautiful embryos," I picture her saying, a bossa nova melody playing in the background. I picture the embryos themselves: round blastulas, with evenly divided cells.
Though even then, we would still be waiting.
My doctor sent me an email about waiting. The word obstetrician, wrote Dr. Young, has as its Latin morphemes ob, which means across, and stare, which means to stand. An obstetrician is someone who stands across from his patient, waiting to bring forth her child. (And then there is that word, patient, and all that it implies.)
Dr. Young waits, too, but not in the same way. He practices not as an obstetrician but as a reproductive endocrinologist, a doctor who diagnoses and treats long periods of waiting, and who waits for women like me—waffling, indecisive, fearful—to decide what to do. When his patients become and stay pregnant, they eventually "graduate" to an obstetrician, who will be the one to deliver their babies. Dr. Young waits for the correct combination of treatments to take effect—he waits, like us, for the pregnancy.
I have been diagnosed by Dr. Young with a luteal phase defect, meaning that my endometrium, my uterine lining, does not wait long enough before shedding each month. This has been treated through progesterone supplements, which I take after ovulation. My cycle is now a regular 28 days; my endometrium waits properly—two full weeks—for the blastula to implant.
Except that it doesn't. I have never been pregnant—at least, I have never confirmed a pregnancy through a positive E.P.T. or First Response testing kit. In fact, I have taken very few pregnancy tests in my years of reproductive maturity—once when my husband and I were living in Brooklyn, and three times in the 47 months we've been trying. I take my temperature every morning, and usually, near the end of my cycle, I will see a pattern of falling temperatures—98.5, 98.3, 98.2—that tells me the Two Week Wait is nearly over.
In this way I’m unusual. On message boards and in the support group I attend, TTC women talk about testing daily, even twice a day, during their Two Week Wait. Sometimes they are waiting for a positive result—usually, the soonest that home pregnancy tests can detect hCG in a woman's urine is 10 days past ovulation—but other times they are confirming and reconfirming a positive result. I've heard of women taking two or three tests to prove—to celebrate?—what one test showed: the dark line, the plus sign, the word pregnant.
I can well understand that this is soothing to them, comforting in the same way that Dr. Ramos' evenly dividing embryo cells were to me. Because the embryo and the changes to the body are longed-for, expected, and (at this point) invisible, TTC women desire anything that makes the pregnancy seem "real." Of course, she might not share this information publicly—most agree that waiting until the end of the first trimester is wise—but among her TTC associates, other women who are waiting to hear the results of her treatment, she will probably share. Online, such news might be delivered through an exultation—"Yippee!!! BFP!" (Big Fat Positive)—or an image: a photograph of the home pregnancy test, or a smiley-faced icon of a pregnant woman holding her rounded belly.
Infertility and assisted reproduction can be difficult to talk about with fertile people—they may not understand, may not want to talk about it, or may be too busy raising their own families to offer much support. A message board or blog is a safe place to talk about injectable medications, IVF cycles, or the question that plagues every Two Week Waiter, no many how many movies she's seen or yoga classes she's attended: Am I pregnant—or not? Though mediated through a computer, the support offered by women on these boards is conversational—filled with sentence fragments, terms of endearment, urgent questions, and exuberant punctuation. Their messages are decorated with animated GIFs that are like body language or gesture in a face-to-face conversation: cartwheeling or cheerleading smiley faces, illuminated BFPs, shimmering baby dust.
On the website Lilypie.com, a TTC woman can create a custom ticker—a colorful graphic image that counts up or down—to appear below her posts to infertility and assisted-reproduction message boards. As I visit these boards, I often see, below a list of relevant details—ages, medical conditions, number of months or years TTC, the dates and results of various IUI or IVF cycles—these small, rectangular banners, frequently more up-to-date than the posts themselves.
Tickers can provide a digital reminder of all kinds of things—vacations, anniversaries, birthdays, and graduations are all popular events to anticipate via ticker—but they have a particular significance and prevalence in the infertility community, where conception and pregnancy are marked by a series of emotionally fraught, unseen events that might be shared only in anonymous places like Internet message boards. Like medieval manuscripts, the tickers are illuminated with images that represent the text, pastel pictures you might see on any baby shower invitation: infant clothes, a pram, smiling cartoon storks. On Lilypie, you can choose to mark a menstrual cycle from 15 to 80 days long, using a variety of backgrounds: butterflies, the city at night, a cabbage patch, or stars. (Fertile days in a cycle might be marked with hearts or a sprinkling of baby dust.) The "slider" is the image that will mark where you are in the cycle, and it's customizable, too; choices include a gleeful rabbit, a woman jumping through a hoop, or a variety of cartoon pairings: bees, ladybugs, a man and a woman holding hands, two women holding hands, or even two men holding hands (presumably, they are marking a surrogate's cycle).
Belle Boggs is the author of Mattaponi Queen, a collection of linked stories. Her fiction and essays have appeared in the Paris Review, Orion, Harper's, the Oxford American, and other publications.