When, on my seventh cycle of clomiphene citrate – and the third round at 100mg doses – my period didn’t arrive when expected on day 28, I didn’t panic. The previous month it had extended my cycle to day 30, so I didn’t worry. I took a HPT which was negative and went about my business. When it didn’t arrive on day 30, I didn’t panic either, thinking it would happen any minute. But on day 32, when putting on a sports bra to jog was nearly unbearable, I took another HPT – got two lines – then panicked. I purchased a different brand HPT and took it in the afternoon the next day. Two lines again – positive. Having just begun to accept that the natural odds were stacked against me I had to unwind all of my thoughts and start preparing for the next whirlwind of steps. I called my clinic and was scheduled for my first blood test early Tuesday morning.
After a six hour wait for the test results, my nurse called with the news exactly at the time she said she would. “Congratulations! You are pregnant. Your hCG level is at 80. We will have you come back in two days to check your levels to make sure everything is rising.” W-o-w. There was no more denying it. I googled an expected due date (end of November). Based on my calculations I should have been, technically, about four weeks pregnant. On the ride home that day I thought twice before sticking a piece of gum in my mouth, wondering if the artificial sweeteners and chemicals in it were safe to ingest. I thought better of it and put the gum down, despite the Pavlovian need I have to chew gum while driving home. I was determined to give this pregnancy every possible chance to succeed.
In those first few days I had mild cramping, deeper and higher than usual PMS cramping, which started on day 32 and lasted until the day after my first blood test (day 36). Everyone told me this was normal to experience, and at best it was distracting, at worst mildly irritating. But in my mind, as long as I felt cramps, something was growing. So when they topped part of me was relieved (maybe I could finally concentrate on work), but part of me knew something wasn’t right that they had stopped so soon. I don’t know that I could call it women’s intuition, but I guess I’ll just say my fears were confirmed with Thursday’s test result phone call, which took at least three hours longer to get than Tuesday’s: “Your hCG is rising but it’s rising abnormally. It’s at 96. We would expect the number to have doubled by now, somewhere between 150-160. We need you to come back in two days.” By now the inside of my elbow was bruised, but at that point I knew and started to prepare myself that things weren’t going to last. I waited another 48 hours for my third set of results. The number then was only 123. This is the point at which they start to prepare you for the worst – that it’s ectopic, meaning in the middle of my only good tube, which has a danger of rupturing the tube and could be fatal. I panicked, backed off my exercise routine and waited another five days for my next appointment – an ultrasound.
I didn’t know what to hope for from that appointment. I hoped that it wasn’t ectopic. I hoped that it was in a place where there might be a fighting chance. I hoped I hadn’t done something wrong to cause the word “abnormal” to become the situational descriptor of choice. But nothing prepared me for the sight on the screen – an empty gray and white cavity (my uterus, which the doctor and nurse had both concurred, “That sure doesn’t look unicornuate from that angle”), and a dark spot barely discernible by even those who stare at these kinds of pictures all day long in the top left corner. It was like trying to find the big spot on Jupiter, if Jupiter’s atmosphere was entirely as orange as the spot is. “We think that’s it,” the nurse said. “It doesn’t look ectopic but we can’t be sure. We would call this a ‘pregnancy of undetermined location.’ But your levels are still not rising as they should. If it doesn’t take care of itself naturally, we’re going to have to give you some medication.”
I went home to tell my husband and to prepare for what I knew would be coming – the reality of this pregnancy being non-viable and the side effects of methyltrexate. In typical fashion, my husband was optimistic. “This is good,” he said. “That’s okay if this doesn’t work out. What it means is that it’s possible – that it could happen. This is all right. This is for the best.” I wish those feelings came as naturally to me as they do to him. That’s why I fell in love with him.
Three days later, the miscarriage started just as it had four years earlier. I updated the folks on the message boards I belong to, who had been sending positive thoughts and well wishes my way since the start. And there, one of the women gave me a new meaning that eased my pain and gave me the strength to move on:
“Maybe somebody out there doesn’t want you to give up.”