I realized shortly after the second insemination of this cycle that I have been so focused on making sure we’re doing all we can to avoid getting pregnant with higher-order multiples that I haven’t spent a whole lot of time considering the fact that this may not work at all. Yes, I’m acutely aware of our limited supply of our Donor #2 and how that is affecting the choices we’re making around cycle timing and assisted-reproduction type, but I haven’t really thought about the possibility of it simply not working.
When we first started thinking about trying to conceive over four years ago, of course I had the fantasy of it working the very first time we tried. But with every passing cycle that was followed by a negative pregnancy test, my hopes of success became more and more diminished. Ten months and seven cycles later* I had come to expect that the pregnancy test would be negative, and we would simply take a day to be sad about it and move on to the next one. On our 7th cycle, I remember we had an appointment on a Monday for a beta-hCG pregnancy test that was scheduled for 18 days-post-insemination, and for the two weeks between insemination and that appointment, I was trying to think of something fun to plan for that Monday night, to get our minds off of the disappointing result I was anticipating. Unbeknownst to me, Molly got up early the Saturday morning before that appointment and took a home pregnancy test, then woke me up with the surprising (positive!) result. I remember feeling immediately confused (I had just woken up after all), then excited and in disbelief (you mean it actually worked?!), then relieved that I didn’t have to think of something distracting for us to do Monday night (which was only two days away so I was running out of time to plan something anyway), then I immediately became optimistically cautious.
For the first three months of the pregnancy with the twins, I was so worried about something bad happening at some point in the pregnancy (miscarriage, pre-term labor, birth defect, etc.) that I hardly allowed myself any space to be happy about it. In the beginning, I was so overcome with anxiety that I let the normal woes of pregnancy drive a wedge between me and Molly, so much so that I secretly sought out appointments with a therapist at my school’s counseling center. Through talking with the therapist, I came up with some strategies to employ when faced with this overwhelming anxiety, and things rapidly improved. Still, for the rest of the pregnancy, I kept myself very guarded and somewhat emotionally distant, because I was still afraid of getting “attached” to something – someone(s) – that may be taken from me before birth. I didn’t want to – I couldn’t – assume everything was going to be OK, because I couldn’t bear the thought of dealing with the level of disappointment and pain that would come if things weren’t OK. I felt that if I kept at least a little bit of distance between me and those unborn babies, I would be more prepared in the event of an unforeseen tragedy than if I had loved with reckless abandon, simply because I would have less to lose. Sure, overall I was optimistic that things would turn out all right, but for a while, I was so focused on the potential for bad things that I lost sight of all the good things; even after shifting my framework around three months (mostly due to my therapy appointments, but also probably because that’s scientifically when the risk of miscarriage decreases), my emotional state during the entire pregnancy with the twins could definitely be described as being dominated by caution. I remained acutely aware that anything could go wrong at any time.
My outlook on this second go-around on the trying-to-conceive process has been quite different. Instead of optimistically cautious, this time around I feel like I have been more cautiously optimistic. A lot of that I’m sure is wrapped up in knowing we have both a proven donor and a “proven womb;” we know our donor’s guys swim, and we know that Molly is indeed able to carry a pregnancy (twins to term no less!), which the first time around were only hopeful assumptions. We also know that gonadotropin injections and IUI worked for us last time, so it feels comfortable and safe starting there. Molly and I have talked about our desires for one more but have also mutually agreed that we would be willing and able to handle twins again if that were to occur.
So I feel very settled in all of the decisions made to get us here. I was prepared to administer the nightly gonadotropin injections and attend almost daily appointments at the fertility center. I’m ready to be the nagging voice of “did you take your prenatal vitamin today?” I have my anxiety-coping mechanisms in my back pocket should I need to whip them out. I know where to find all of the maternity clothes packed away in the garage. I’ll punch a doctor out if they even try to give Molly opioids after the birth. I even feel (mostly) prepared for handling two infants should we be blessed with twins again. But after the second insemination of this cycle, it hit me like a ton of bricks that, unlike the many cycles before conceiving the twins, this time I have done nothing to mentally prepare for a negative pregnancy test.
This realization instantly took me back to my emotionally-distant state and from primarily optimistic to primarily cautious in a matter of seconds. The thought of being caught off guard by a negative pregnancy test, when I’ve felt so confident in our approach this time, was scary. The cycle we got pregnant on with the twins was the first cycle we actually knew that both sperm and egg were actually present at the same time…so knowing it is the same case for this cycle makes it difficult to understand and accept that it’s not a guarantee and that it just might not work. I’m happy about starting this trying-to-conceive process as cautiously optimistic, instead of optimistically cautious, and I want to continue to approach any future cycles we may need in a state dominated by optimism. But I’m still scared. And every day that passes is one more day towards when we’ll do a home pregnancy test, one more day I’m convincing myself the results will be negative, and one less day I have to plan something fun and distracting for the day we get the results.
Perhaps I shouldn’t wait to bring out those anxiety coping mechanisms and just start using them now.
*I fully recognize that in the grand scheme of things, seven cycles over 10 months is actually not that long, considering many people try for years with no success. The point is that repeated “failures” can be harmful to anyone’s psyche.