TTC

Spring of 2014 I was finishing my intern year of Family Medicine residency.  I would be turning 34 in July, and I was FREAKING OUT.    You see I had gained enough medical knowledge to understand all the things that could go wrong in pregnancy and delivery.  I also knew because of my PCOS I had lower fertility than others my age; also I was 1 year away from the dreaded AMA.

-AMA stands for advanced maternal age.  The term for when you will deliver over 35.  Of course with the update of the diagnostic codes it has been changed from the sad but acceptable "Advance Maternal Age" to "Geriatric Gravida"  which is infinitely worse-

Thankfully I had a visit from a friend who just had her first child who helped put my anxiety to a little bit of rest.  "If you guys have kids you will be great parents and it will be wonderful.  If you don't have kids you will continue to be great people and it will be wonderful."  So I allayed my fears for a few more years and made a plan.   The main way I deal with my anxiety is by making plans.

I figured I'd give myself 18 months to see if I could conceive (by which ~91% couples do).  So in typical fashion I started to research.  I started Pintrest boards, a Amazon wish list for possible registry, and started following some blogs.  I had already been following my cycle since I had an IUD and I added a few more apps specifically for tracking.  There was a whole set back with the Nov 2016 election.  (see Nov 9 2016 330 am)  After that experience I realized that though attempting to have a kid may be a fundamentally bad idea (given the fact that the world is pretty actively terrible), If we the US was not in nuclear holocaust by July 2017 would try anyway.

Armed with 2 new apps I entered a new world of acronyms and short hand.  If you are not apart of this world I will give you a taste because they are truly non-intuitive:

• AF - though I initially thought this was the more common "As F**k" it actually means "Aunt Flo" or period.   
• BD - Baby Dance.  Why people can't just say sex, intercourse, nookie, or any other euphemism I don't know. 
• Baby Dust - Not to be confused with BD-  It is wishing someone good luck, though I sometimes think of it as fairy dust and is therefore wishing more GLBTQ children into the world for fun. 
• DPO & CD - Days post ovulation and Cycle day.  These actually make sense and are useful
• DH - Dear Husband - I first came across this one in wedding groups.  Still don't like it. 
• TTC - Trying to Conceive.  Which is what most people are trying to do on these groups anyway and I'm not sure why this is an acronym.  There should be one for the folks who are not trying.
• BFN/P - Big Fat Negative or Positive in reference to pregnancy tests.  Why they have to be "big and fat'  I am unsure. 
• TWW -  Two week wait.  Also known as the truest purgatory known on earth.  It's the two weeks after ovulation and before your period.  It is HELL.
• EWCM - Egg White Cervical Mucous.  Yep it's what it sounds like.  

So now I'm apart of this very strange community of people actively trying to get pregnant and generally complaining about it/confused/wondering if they can check a pregnancy test 2 days after ovulation, "I mean I know it's really early, but. . . "  

I started out doing more stealth doctoring.  "You know the best medications for PCOS is Metformin low carb diet and exercise."  "There is no evidence to having your legs elevated after sex to insure conception." "No a BFN two days after ovulation does not mean that you have not conceived this month."

I've found that there are 3 large categories in these groups.  1) TWW screams from purgatory:  to check or not to check, how sucky this, I just checked but I can check again.  2) What to try next: better supplements,  fertility meds experiences,  should I go to the doctor?  (I generally answer yes) 3) Hoping: baby dusting, wishing they could by baby clothes, hoping this is the month.   

Then I realized this is a group of strangers who don't know I'm a doctor and I can ask stupid questions that I also already know the answers to.  I also realized that though there is a group of people going through the same thing, TTC is a very isolating experience.  Though my partner is amazing and there is a group (though sometimes questionable) of people going through the same thing, at the end of the day it's still what's going on with my body.   While I can track my basal temperature, check my cervical mucous, take my meds, try to exercise and fit in nookie with my new grown up doctor job which inconveniently schedules events every fertile weekend so far, it still feels wildly out of my control.  I'm still AMA, PCOS, in a high stress job, and my body doesn't seem to like to cooperate. 

It's a month to month rollercoaster over 4 weeks ultimately waiting to find out if I am infertile enough to get help or will it magically happen.  Using my planning skills I have kept myself on track with adding something every 2 months or so.  First adding cheap ovulation tests, then the expensive ovulation tests. 

(Can we take a minute to talk about how unreasonably expensive conception items are.  American consumerism truly makes all large events in life more expensive than needed:  Weddings, TTC, actually having a baby.  I mean really. It should not be 45 dollars for 1-2 months of ovulation tests and 39$ for one month of a supplement that actually has medical evidence.)  

But I digress

After 4 months I added Pregnitude which actually has evidence of supporting ovulation for people with PCOS. Then after 6 months I officially get to go get the whole fertility work up as appropriate for people over 35 TTC.   I am hoping that with the work up that more things keep getting added, because I need a plan, and my plan runs out in January. 

I realize I'm only 5ish months into this journey and I'm already over it.  I would like to know if my body will cooperate or not.  I also feel comfortable with my limits.  I'm not doing IVF or any truly invasive procedures.  If I'm in that 9% then I shouldn't be having kids I can just get an IUD and a dog.