The End of the Road
And the beginning of a new one
“I think I’m done,” I told Seth as he stirred under the covers to turn off his alarm clock.
He rolled over in the early-morning light and squinted at me, rubbing the sleep out of his eyes. I was uncharacteristically wide-awake for 6am. My bladder had awoken me in the wee hours, and unable to fall back asleep, I had been contemplating the future of my fertility.
His brain was still in dream-mode, but Seth registered what I’d said with clarity and rolled over to give me a hug. “OK,” he told me, as he kissed my forehead.
The week before, we’d hit another roadblock in our infertility saga when our intrauterine insemination (IUI) procedure was canceled for the fourth time in six cycles because I’d ovulated early. It was supposed to be our last try, because of the ongoing cost and string of disappointments and low chances of success. “Diminished ovarian reserve” is the official term for what happens when a person with ovaries approaches the end of their egg supply. Our ovaries contain 1-2 million eggs when we are born (and up to 6 million when we are in utero), but we lose about 1,000 of those eggs with each menstrual cycle over the course of several decades until our ovarian reserve runs out, which marks the onset of menopause. My mom and her sister went through menopause in their mid-40s, so I may be closer than I’d like to think.
The odds were stacked against me since I started fertility treatments in March of 2022: high AMH, low FSH, and an antral follicle count of 1. Those numbers mean that I don’t have many eggs left, and the eggs I do have are likely to develop chromosomal abnormalities that lead to non-viable pregnancies. From our first meeting, my fertility doctor told me that my odds of a successful pregnancy were between 1-5%. That was a week before my 42nd birthday, and it crushed me. We went on to get pregnant with our very first IUI procedure in April 2022, defying the odds, but the baby’s heartbeat stopped around 8 weeks, just like our first pregnancy. Those were the only two babies whose heartbeats we heard; the others were considered “chemical pregnancies,” lost before a heartbeat was detectable.
The feeling of being done with fertility treatments was visceral, palpable, almost instinctual. After going to great lengths to improve my egg quality and burning myself out with all the Extreme Woo I tried, after putting my life on hold for three years in the hopes of starting my family, and after six straight months of medications and blood work and procedures and disappointments, my heart and mind knew that I couldn’t do it anymore. When my period returned last December and I canceled my road trip to Baja to pursue fertility treatments, I gave myself 3-6 months to try. By the beginning of June, that clock had run out. I can’t explain exactly how I knew, but it was clear to me that we were moving into a new phase.
It was unclear what that new phase would entail. I knew I was done with Clomid and Letrizole, the fertility drugs that had taken me on a hormonal rollercoaster ride for six months. I knew I was done with expensive IUI procedures—paying a nurse to squirt my husband’s sperm through my cervix with a miniature turkey baster—because we seemed to have equal or better luck getting an egg fertilized on our own, and more than half of our IUI procedures got canceled because I ovulated early (which is another symptom of diminished ovarian reserve). I knew I was done with life being dictated by my menstrual cycle, having to plan and replan everything so I could travel hours away on short notice for blood work, follicular ultrasounds, IUIs, and diagnostic procedures.
Waking up that morning knowing I was done felt liberating, even joyous. The waiting, wondering, and worrying evaporated. It was like changing a channel on an old TV from a staticky show you don’t want to watch to a feel-good movie with great reception. It was time to start planning again; to start living. It was time to reclaim my body and mind. It was time to commit to the adventure I’d been dreaming of for years: I could finally plan our honeymoon to Alaska!
The certainty of stopping treatment was confirmed in a session I had with Julia Indichova in her Fertile Heart OVUM program. Julia uses a technique she calls Body Truth, where we tune in to our own energy to help guide our decisions when it comes to our fertility. I mentioned on one of the Fertile Heart group Zoom calls that I was struggling with the decision to end fertility treatments. Julia asked me to name the different thoughts I was having and determine if each one came from the voice of the part she calls the Orphan (the young, scared part of us) or the Visionary (our mature, loving True Self).
“I don’t want to take the fertility drugs anymore because I don’t like what they do to my body and mind,” I said. Julia asked me, “Is that the Orphan or the Visionary?” I checked inside and decided it was the Visionary looking out for my well-being.
“I don’t want to keep putting my life on hold for the treatments,” I told her. Again, she inquired, “Is that the Orphan or the Visionary?” This, too, felt like a solid truth with Visionary energy, I said.
“But I’m afraid that if I stop trying, it will be my fault if I’m childless for the rest of my life,” I confessed, choking back tears. I noticed others in the Zoom room wiping their eyes.
Julia paused, then asked gently, “Is that the Orphan or the Visionary?”
“That one is an orphan,” I said, recognizing the fear, shame, and sadness welling up inside of me.
“I think you have your answer,” she told me. “It’s time to stop the treatments.”
I was surprised to have a person in the fertility space tell me to stop going to the fertility clinic, but Julia’s work is all about tuning in and making choices that feel right for us, regardless of what our doctors or friends or family or society tell us. It is the reason I was drawn to her framework. I didn’t keep up with the visualizations and exercises I was supposed to practice every day, but I did appreciate her assurance that it’s OK to believe what my body, mind, and heart know to be true.
I had acupuncture the day after the Fertile Heart call, and in my Visionary energy, I decided that it would be my last session. After my acupuncturist Gary had removed the needles and ushered me out of the treatment room to pay and schedule the next session, I told him I would be traveling and was going to take a break from treatment. I stumbled over my words, feeling the breakup energy of “It’s not you, it’s me!” as I overexplained myself. Gary had spent months trying to convince this very Type-A person to relax and nourish my yin, and I didn’t have the heart to tell him I might not be back. I mumbled the breakup equivalent of “Let’s keep in touch” and “I’ll call you sometime” as I awkwardly waved goodbye and closed the door.
Taking weekly acupuncture sessions off my schedule and out of my budget turned out to be another huge relief, so I knew I was heading in the right direction. A lot of people had recommended acupuncture, so I had tried it, but I just couldn’t do it anymore. I felt more relaxed after a long bike ride or a hike with my dogs than lying on a table for an hour with needles sticking out of me, trying not to think or move. Like many other things I tried in my pursuit of the Extreme Woo, it just didn’t feel like me.
I did have travel plans the following week, taking my mom to the beach in Maine for her birthday. But there was one last item on the fertility clinic checklist: a saline sonohysterogram to check my uterus for scar tissue and determine if I’d need another surgery before moving forward with donor-egg IVF in the future. I thought the timing would work out to do this diagnostic procedure before I left for Maine, but once again, my cycle did not cooperate and my period came too late to fit it in before I left. This also foiled my plan for Seth and me to try to get pregnant on our own that month, as I would be away the whole week leading up to ovulation. I was OK with it, though, because I was still trying to understand what “being done” meant: was I just stopping fertility treatments but continuing to try on my own? Or was I done with trying to conceive at all?
The trip gave me a week to sit with that question, but by the time I got back and saw Seth, I figured it was too late in my cycle to even worry about it. For months I had been ovulating really early, between cycle days 5-7, and I returned home from the trip on cycle day 9. Once ovulation happens, an egg is only viable for about 24 hours, so I thought mine must be long gone. Seth and I were excited to see each other and get frisky, but the questions loomed: were we “trying” this month? Or did we, in fact, want to avoid pregnancy and the trauma of another miscarriage while we were preparing for our honeymoon in Alaska?
The night I returned, by the time things got hot and heavy, there wasn’t much capacity for rational thought between us. I had this twinge of anxiety that I didn’t want to endure another two-week wait, wondering if I was pregnant or not, curtailing my activities, and worrying what would happen if I miscarried again—especially if it happened on the road to Alaska. I mentioned this to Seth, and he told me, “We’re pretty good at NOT getting pregnant,” so I decided not to worry about it.
Two weeks later, I was impatiently waiting for the start of my period so I could schedule the sonohysterogram before I left for Alaska. I took a home pregnancy test on the day I expected my period to arrive and it was negative. I went in for blood work and my estrogen was elevated, which it shouldn’t be so late in my cycle, but that had happened the month before and my doctor had a theory that my aging ovaries were working overtime to get the next egg ready. I repeated the blood work a few days later to see if it was safe to schedule the procedure. I impatiently checked the lab results in my portal while I was waiting to hear from the clinic, and my jaw hit the floor: I had an hCG level of 22.8. Human chorionic gonadotropin (hCG) is the hormone produced by the placenta during pregnancy. My hCG should have been zero. It was not zero.
I was pregnant.
It was 4pm on a Monday and I was about to start packing the van for our trip to Alaska. I wasn’t supposed to be pregnant. I’d had no fertility medications, no procedures, and I didn’t even time it right. I ran to the bathroom to pee on a stick and saw the faintest second line on the test. I called Seth in disbelief. “Of course,” we agreed. “Of course it would happen the minute we stop trying. Of course it would fuck up our trip to Alaska.” I called the clinic and the nurse congratulated me and told me to start progesterone and baby aspirin to support the pregnancy, and we would schedule the ultrasound in a few weeks.
I was supposed to be in Alaska in a few weeks, and between now and then, I was supposed to drive solo for 5,000 miles to get there, pulling 5-10 hour days behind the wheel of my 1999 Roadtrek camper van, and pick up Seth at the airport for our two-week honeymoon. I was supposed to go hiking in Denali National Park. I was supposed to be breathing Canadian wildfire smoke and drinking water from 24-year-old plastic RV pipes and eating microwaveable meals and Impossible Whoppers. I shouldn’t be doing any of those things in my first trimester of pregnancy. Depending how tired and nauseous I got, I didn’t know if I could do those things even if I wanted to.
I had just started to feel happy and excited about life again while planning our big adventure, after three years trapped at home conceiving and losing babies. I had just started to let go of the need to have a biological child and accept the reality of my aging ovaries. I had just decided that the trauma of another loss outweighed the infinitesimal odds of having a baby. I had finally gotten off the fertility rollercoaster that had been jerking me around for years. I finally had a plan.
The Universe had another plan, and I knew it was fucking with me. After four previous losses, I knew the odds of this pregnancy making it to term were in the single digits. If I had believed that positive pregnancy test equaled baby, I would have been ecstatic. But for me, positive pregnancy test equaled weeks of anxious waiting and then enduring another painful loss. Depending how far it progressed, the loss could involve severe hemorrhaging, physical and emotional trauma, and the possibility of emergency surgery, sepsis, or even death. This was NOT the vibe I wanted to bring on my trip to Alaska.
Instead of feeling joy, I felt resentment at my elevated hCG. I didn’t believe it meant that I was finally going to be a mom. I believed it meant that I was going to have to cancel the trip of a lifetime and sit home for the rest of the summer waiting for the ultrasound, wondering if there would be a heartbeat, and worrying I’d start bleeding before then.
And yet, a part of me desperately wanted to be wrong. That part whispered: “Maybe this is the miracle you’ve been waiting for? Everyone always says it happens as soon as you stop trying!” Was that all it took to get pregnant—a healthy dose of surrender?
When Seth got home from work, we lay on our bed and stared at each other, dumbfounded by our luck. “Here we go again” was our unspoken refrain. “Maybe it will be different this time” was our silent prayer. I made him take a selfie with me and the barely-visible lines on the pee-stick. “Look happy!” I told him, imagining that we would post this picture in a few months to announce our miracle baby.
We nicknamed the baby Winnie, since she was conceived in our 1991 Winnebago that’s parked in the driveway at Seth’s parents’ lake house. I opened up the pregnancy apps and calculated my due date: March 15, 2024, two days before my 44th birthday. I read and re-read the same Week 4 pregnancy updates that I’d memorized by now about fertilization and blastocysts and implantation. I optimistically sneak-peeked Weeks 5 and 6. I didn’t dare go further; I’ve never made it past week 8. I know the baby grows from the size of a poppy seed to a sesame seed to a lentil to a blueberry to a raspberry, but I have no idea what happens after that.
That night, I stopped packing for Alaska. I piled up the guidebooks and maps that were scattered across the coffee table. I checked Amazon to see if it was too late to return all the gear I’d bought. I felt ill.
Canceling the trip made me really mad. If I never made it to Alaska because I had a baby, that would be one thing. But if I never made it to Alaska because of another miscarriage, that was just plain cruel. I knew this might be our only chance to take the trip, because if we decided to move forward with donor egg IVF, I would be spending next year in the lengthy process of getting matched with a donor, timing our cycles, taking fertility drugs, scheduling the procedure, taking more drugs, waiting to see if it worked, and starting the process all over again if it didn’t. This belated honeymoon was the mental and geographical break I needed to grieve the loss of my own eggs, wrap my head around using someone else’s, and prepare myself for that process. But we couldn’t just wait to see what happened with this pregnancy and leave for the trip in a month or two—it was now or never. Alaska is not someplace you want to be camping in a van past September, and it would take at least three weeks to drive there. If I couldn’t go now, it would be too late to go at all. I went to bed with my head and heart churning, feeling the pull of two competing dreams: parenthood versus life on the road.
The next morning, I awoke with sudden clarity, just like the morning I knew I was done with fertility treatments: I could call the Universe on its bluff! I would rather miscarry in my RV toilet on the side of the Alcan highway than miss my honeymoon, I thought. I could deal with having the ultrasound in Anchorage, and having to drive 10,000 miles nauseous and exhausted. I could deal with exposing my fetus to burning forests and endocrine-disrupting plastic chemicals and whatever they cook their fries in at Burger King. If this kid was conceived in an RV, she could sure as hell be gestated in one! I immediately googled “pregnant van life” and followed a bunch of Instagram and YouTube accounts of adorable families on the road. I scattered my books and maps across the table again. I was going to be a Road Mama!
The next day, I called a clinic in Anchorage to transfer my records for an ultrasound. I also went into my local clinic for follow-up blood work to see if my hCG was rising. I was worried that my at-home pregnancy test lines hadn’t gotten any darker, but the blood work showed a moderate increase in hCG. I was still pregnant, but the nurse said that the hormone levels weren’t quite as high as she expected, so we would keep monitoring. Now that I was excited about taking my fetus with me to Alaska, I wanted the pregnancy to stick. But I also realized that if it was destined not to—if the chromosomes misaligned—it would be best to know sooner rather than later. I made peace with either outcome. Meanwhile, I took the dogs for a walk (jogging seemed too risky) and started packing the Roadtrek.
Just like my last pregnancy, though, my dance with hope was short-lived. The next day, the second line on my home pregnancy test was lighter. By Friday, it was barely visible. I went back in for blood work that confirmed what I already knew: my hCG was dropping.
My baby was gone. Again.
But a strange thing happened this time: I chose to feel relieved. I managed to suppress the intense grief and anger that consumed weeks and months of my life with my previous losses. I laughed at the Universe’s cruel joke, as if the hidden camera crew had just been revealed and Ashton Kutcher jumped out of the bushes to tell me I’d been Punk’d. I wanted to slap him in the face, but I pretended it was hilarious.
Seth stopped kissing the baby goodnight. I filled my purse with maxi pads and waited for the bleeding to start. I wondered if it would happen the day I was supposed to be at the summit of Mt. Washington to celebrate with 77-year-old Pamela Clark as she took her final steps on the Appalachian Trail. I took solace in the fact that this one ended quickly; that the chest-crushing anxiety I’d been suffering all week would not go on for months. I had to accept the outcome. There was nothing to do but get back to planning and preparing for our trip. On Saturday, I woke up and made the campground reservations for Denali.
What was noticeably missing after this last miscarriage was the desire to try again. When I logged in to my fertility app to report my pregnancy loss, it prompted me to update my status: was I “Recovering from Loss,” “Trying to Conceive,” or simply “Tracking my Cycle”? After my first couple of miscarriages, I clicked the recovery track and saw articles about grief and how to get support. After my third miscarriage, I didn’t want to linger in the loss space, so I jumped back on the conception track and saw posts from women in their 40s showing off their positive pregnancy tests. This time, I couldn’t handle any of that. I chose cycle tracking, so I could figure out my next steps without the app telling me how I should feel or what I should do.
I also knew that I was done with choking down a dozen pills a day to boost my ailing ovaries. I packed up the bottles of fertility supplements I’d been taking for over a year and slid the clear plastic bin underneath my bed with the dust bunnies. If another egg wanted to take a shot at life, she was on her own. I’d help her out by continuing my prenatal vitamin and omega-3, but that was it. I decided to let my aging eggs ditch the platinum hair dye and finally go gray.
A part of me always knew I’d have five miscarriages. After the first one in January 2021, I had researched and calculated the odds of it happening again. The internet told me that each pregnancy had a 15% chance of miscarrying (I’d later learn that at my age and in my condition, that figure was more like 90%). But there were horror stories about people who’d had two, three, four, even five losses. One dead baby was bad enough, but five? Inhumane. Yet somehow I knew I would win that lottery. It’s a curse of mine to be right about everything.
The only solace in pregnancy loss is the cliche “You can always try again!” (Please don’t ever say that to someone who’s just lost their baby. They will want to smack you.) I can confidently say that after five miscarriages, you don’t want to try again. The moment that second line turned pink, my lungs constricted, my breathing got shallow, and I felt like someone was strangling me from the inside. Every moment after that, I waited, worried, wondered. Mostly I thought, “How am I supposed to live with this fear for the next 9 weeks, or 9 months?” Recurrent loss robs you of the anticipation of pregnancy—making lists of baby names, buying maternity clothes, decorating the nursery (ask me how many baby clothes are hidden in a corner of my closet). It turns what should be the greatest joy of your life into the biggest trauma of your life. And it’s happened to me five fucking times.
The other form of toxic positivity around pregnancy loss is the cliche “You can always adopt!” (Again, if you say this to someone who can’t get pregnant or has lost their baby, you’d better be wearing a mouth guard.) Please understand: this is not true. Private adoption costs $30-50,000 and is contingent on the adoptive parent being approved by the agency and then selected by a birth parent who does not change their mind (in some states birth parents have several weeks after birth to demand their baby back). This makes adopting a newborn cost-prohibitive and emotionally-prohibitive for many people, and even in successful cases, the process can take years. Adoption through the state foster care system is free, but all of the children have been through severe trauma (both the trauma of losing their birth family, and whatever trauma or abuse led the courts to terminate parental rights). Most are older children; the babies in the system are, more often than not, born to substance-addicted parents, and may suffer developmental delays as a result of in-utero exposure to drugs and alcohol. Seth and I have spent six months getting certified to adopt through foster care, and we are still waiting on our approval. My case worker disappeared for two months after our last meeting and then came back with more questions about my mental health. She could decide that my history of anxiety and depression make me unfit to be a parent. And if I didn’t have a husband with a job, I would definitely not get approved, as I wouldn’t meet the income guidelines on my own.
Adoption is not a sure thing. Egg donation and other forms of assisted reproduction are not a sure thing. A miracle fifth pregnancy is not a sure thing. The other day, my fertility doctor reassured me: “You will get your baby one way or the other! There are always options!” I smiled and nodded when I really wanted to launch into a diatribe about race, class, gender, disability, and privilege and all the reasons why people who want to be parents end up childless.
I’m feeling that anger now. It’s been simmering beneath the surface ever since our last IUI got canceled; ever since the adoption worker demanded records of my 2017 mental-health breakdown; ever since the pregnancy test turned positive and canceled my Alaska honeymoon; ever since it turned negative and crushed my hope of giving birth to a biological child. There’s a lot to be pissed about. It’s not helping that as I write this, my neighbor’s twin 18-month-old grandchildren are shrieking across the street. Their son (the twins’ dad) was in grade school when I bought this house with the dream of raising children here. Their double-stroller is full; mine is still on the wish-list for my imaginary baby shower.
Shrieking babies visiting the house across the street every day is one of many reasons why I need a break from this place and from this life and from showering every day in the bathtub I bought fifteen years ago to wash my children in. There are other reasons why I need to get away, and I’ll be sharing those soon in a private post that will be available to readers who’ve pledged to support my writing (you can click the button below to join the Inner Circle as a paid subscriber and get access to my most personal stories):
Mostly, though, I hope that driving to Alaska will give me a mental reset. Long road trips—like long backpacking trips—bring me into the present moment, focusing on how far I’ve got to travel that day, what to eat, and where to sleep. By the end of the first week or two, I’ve run through the looping reel of rumination enough times that it begins to slow. New thoughts and feelings have space to enter, inspired by new experiences. I leave the past behind as I traverse the landscape. Every day is a new day. Every moment is a new moment, with something new to see and feel and believe.
I still haven’t resolved the question of being “done” with the fertility stuff. I stopped bleeding this week, and I’m approaching my next ovulation. This is one of the last eggs that benefitted from my month of Extreme Woo, and it might have better odds of being viable. I wanted to have sex with my husband before leaving for Alaska, but as we snuggled up, the questions loomed: Do I want to risk going through this all over again? Am I ready to hang up my hat and give up on trying to conceive? Or should we go for it? (“Don’t give up!” is the other infertility cliche, even when giving up could be the healthiest thing for a person who has struggled for so long.)
Seth and I rolled around under the sheets, dancing around the big question. I wanted to be done done. I wanted to be free from the stress and anxiety and uncertainty of maybe getting pregnant and maybe losing another baby and maybe needing another surgery while I was traveling across the country. But then I had a vision of my Instagram feed with the baby bump and the car seat in the camper and my kid crawling around in the dirt looking up at Denali.
“We’re pretty good at NOT getting pregnant, right?” I said as I winked at Seth and pulled him close.
Wow, what a wild emotional ride this was even to read, let alone to live. This was heartbreaking and hilarious by turn, and very relatable even though I’ve never lived this particular journey. Thank you also for the context on adopting and what not to say; I have friends in that situation and that helps me be a better friend.
Finally, this image made me laugh out loud: “I decided to let my aging eggs ditch the platinum hair dye and finally go gray.” I hope you have a spectacular trip to Alaska.
Thanks so much for sharing your heart Liz. It is so comforting to read stories of women experiencing similar challenges to my own. 🥰