So, while Realist Maxi was evaluating all the options at the beginning of November, Optimistic Maxi was gearing up for trying again. As I mentioned in a previous post, I was hoping to get pregnant again within three cycles after the miscarriage. This could reduce my chances of miscarrying again or having other pregnancy-related complications.
Trying again meant visiting my Traditional Chinese Medicine (TCM) doctor twice a week for acupuncture, drinking a glass of TCM twice a day, and looking for all the usual signs of ovulation. Each morning I would wake up and take my basal body temperature (BBT) before getting out of bed. I would then use the bathroom and check my cervical mucus (CM) for consistency before warming up the TCM and jumping in the shower. I would then wash down my prenatal vitamin with the medicine and have breakfast.
As many women know, trying to conceive (TTC) requires some work and commitment.
Around the time of my fertile window, Ben I started the baby dance (BD). The book Taking Charge of Your Fertility (TCYF), suggests BD-ing every day that my basal body temperature remains low. Once my BBT increases, this would indicate that I have already ovulated, and the window for trying is closed. We started BD-ing on Friday, and I noticed egg-white CM on Monday, so I expected a rise in temperature either on Tuesday or Wednesday. However, Tuesday morning my temps were still low. They were also still low on Wednesday. Thursday morning, which was also Thanksgiving, my temps were… still low. So, Ben and I followed the advice of TCYF. It wasn’t until Friday that my BBT finally went up, but not as much as I expected.
For those who have never tried to conceive and may be lost by all the acronyms at this point, allow me to provide a little more background on signs of ovulation.
Cervical Mucus
I know this phrase may sound a little gross; the word mucus probably reminds you of when you have a cold. However, a woman’s CM is very important in the creation of life. During her 21 – 35 day cycle each month, a woman will experience changes in her CM. Sometimes there will simply not be very much. At other times of the month, there will be a lotmore, like when she is ovulating. Egg-white CM is called that because it looks pretty similar to egg whites. It is clear and stretchy, and it supports the transportation of sperm in their race to the egg. A woman’s body normally produces egg-white CM in the days leading up to ovulation, so that can be an excellent sign that she is in her fertile window.
A side note: Only after I started TTC did I learn about the changes in my CM. There is an unfortunate lack of information for women about how their body works. This lack of information had me visiting my university clinic worrying about infections I did not have. I was always surprised when the test came back suggesting that all was healthy down there. I did not know that at certain times of the month my CM would change in color, consistency, and amount. As such, those changes made me afraid that there was a problem when there was not. Also, knowing when your body is naturally lubricated can make for better BD-ing, even when the goal is not to make a baby.
Basal body temperature (BBT)
This temperature can be measured with a special thermometer in the morning after a good night’s sleep. It shows much smaller increments of temperature (at least to the hundredth degree), and the temperature is believed to have a noticeable and sustained increase after you have ovulated. For instance, in my case, my BBT may be between 36.10 and 36.40 degrees Celsius before ovulation (i.e. from my period starts up until I have ovulated), but then increase to between 36.60 and 36.90 (from ovulation until my next cycle starts). For many women, myself included, there is normally a decrease in temperatures (sometimes called a dip) before the rise. For instance, one month my temperature dropped to 36.14 before increasing to 36.65.
It is important to note that one’s BBT cannot tell a woman when she will ovulate. The rise means that she probably already has ovulated, and her fertility window has likely closed, hence the suggestion to keep trying every day a woman’s BBT remains low.
Of course, it is also possible not to ovulate in a given cycle. For instance, in October 2017, I came to learn that I had an anovulatory cycle. This is a cycle in which I did not ovulate. I know this to be the case because I went to the hospital every day to observe the development of my follicles, which normally release one or more eggs each month. That month, no follicles released an egg. My BBT this month reflected a very slow rise in temperatures. There was no sudden shift from one BBT range to the next as was common in the cycles I had logged before.
Unfortunately, my temps that Friday morning after Thanksgiving looked a lot like my temps in October 2017. My temperature then slowly continued to rise each day after that, and I was heartbroken.
Is acceptance acceptable?
Seeing these numbers, Realist Maxi was more convinced that I should be focused on evaluating other options. Ben and I had tried again this month, but all the BD-ing in the world could not make a baby if I did not release an egg.
As I grappled with my disappointment, I found this blog entitled “Accepting Childlessness After Infertility.” I loved this blog because the writer, who has endometriosis, spent a decade trying everything to conceive including TCM, diet changes, laparoscopic surgeries, intrauterine insemination, and intracytoplasmic sperm injection invitro fertilization. She had done everything that I thought of as a possibility to help me conceive my own children, and at the end of a decade, nothing had worked.
Nothing had worked.
Sure, she had managed to get pregnant a few times, but they never made it to a live birth. She writes, “We were tired of living in limbo, and the heartbreak of losing more alpha pregnancies and IVF offspring was too much to bear – especially when most of the world didn’t recognize our losses or offer any of the support reserved for legitimate grief.”
“Legitimate grief.” This phrase really echoed within me. However, the greatest impact came from this paragraph:
“In making sense of and sharing what I’ve learned about disenfranchised grief (grief that is not acknowledged by society), I began to actively mourn the losses we’d endured and found peace. By giving voice to my experience, I tapped into a well of strength and resilience and cultivated a community of women whose lives don’t involve parenting. We see families of two where we used to see couples.”
Realist Maxi wanted to know how much I was really willing to put myself through before either accepting childlessness or becoming a mother another way. I had already tried acupuncture, TCM, and diet changes. I had already been through surgery and medically-induced menopause. How much more time, mental, and physical health was I willing to sacrifice in pursuit of giving birth to my own child? Or more generally, in pursuit of motherhood?
Could I, like this writer, accept childlessness? Could I see Ben and I as a family of two, not just a couple?
As I grappled with this question each night, I would walk back and forth in my apartment, weeping. I felt I needed to accept that I may never be able to conceive if I wanted to really consider other options or even to keep trying. I needed to accept that nothing may work.
The Results
Optimistic Maxi, of course, was not going to give up until the Lady in Red showed up. She argued that it was still possible that I had ovulated, and she went looking for any evidence to support the idea that there was still hope.
In this search, I found an article entitled “Basal Body Temperature: 5 Reasons Why It’s Bad for Tracking Ovulation.” The writers point out that charting your BBT requires you to get up at the same time every morning. So, this means having to wake up at 7am, for example, even on the weekends. Also, if you wake up at 5am to use the bathroom and then go back to bed, your BBT at 7am will no longer be the same as it would have been if you had slept through the night. This data point is, therefore, useless. It is a lot of work to ensure that you wake up at the same time every single morning. Also, I frequently wake up in the middle of the night to use the bathroom, which renders most of my data meaningless.
Realist Maxi responded to this argument by noting this article was written by a website selling a product for tracking your fertility. They are of course going to want to suggest the cheap, at-home methods like BBT charting are insufficient. However, this article did lead me to research that actually supported the idea that my BBT may not be a useful indication of whether or not I have already ovulated. Specifically, Ecochard et al. found that it may take my BBT more than two days after ovulation to rise. In other words, I could already have ovulated but still have low BBT temps. This would cause me to incorrectly assume my fertile window was still open when it had already closed. If my BBT was not a good indication of when I ovulated, was it a good indicator of if I had ovulated at all?
The researchers also found that egg-white CM was a much better indicator of when ovulation was going to take place. So, perhaps I had ovulated on Tuesday or Wednesday since I saw egg-white CM on Monday and Tuesday. Optimistic Maxi looked at this study and argued that my BBT may not be a good indication of ovulation, and since I did have egg-white CM, maybe I did ovulate this month. Ultimately, I should still have hope.
Realist Maxi was not convinced; however, at 7 days past ovulation (DPO), I peed on a stick. In truth, at 7 DPO your chances of getting a negative even if you are pregnant is about 85%. I also took the test at night time, greatly increasing the chances of a negative since my urine is least concentrated at night. However, I did it anyway to appease Optimistic Maxi. Sometimes it felt mentally less taxing just to take the test than to talk myself out of it using logic. I had also bought one too many home pregnancy tests on Single’s Day (China’s Black Friday), so I just went ahead and took the test.
I peed on the stick; it was negative. No surprises there.
I decided to take another test in the morning at 10 DPO. At that point, a positive was possible. Also, I was planning to go to the German Christmas Market that day, and I wanted to have my free glass of Glühwein. If I was pregnant, I would have to go with the children’s option.
That morning, I almost did not take the test. I was positive I was not pregnant. However, I again felt it didn’t hurt much to use one of my too many pregnancy tests. As I walked to the bathroom, I wondered who I could give all these tests to. I was sure that I would not need them in the future. All my mental work and reckoning was making me more comfortable with the idea of not being able to conceive, ever.
In the bathroom, I peed on the stick and set my timer. When the timer went off, I reached for the test in that careless, absentminded way one might reach for the toilet paper. I was so sure that the result would be negative as it had been three days before that when the positive registered, my hand started shaking vigorously.
I went and woke up Ben. We had done it. We had gotten pregnant again within three cycles after the miscarriage!
**The featured image is of cups of Glühwein Ben’s parents enjoyed. I had the kid’s drink option.
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