I’m 31 and I Deliver Babies For A Living. But I Can’t Get Pregnant

Welcome to Refinery29’s Fertility Diaries, where people chronicle their joyous, painful, and sometimes complicated paths to parenthood.
History: I’m a 31-year-old maternal-fetal medicine physician. I take care of pregnant women with medical, fetal, or obstetric complications. Yes, I think about pregnancy all day, every day for my job — all while I try desperately to become pregnant. I wouldn’t qualify for my own practice, as I’m a healthy 31 year-old woman — I don’t have a kidney transplant, a complex heart condition, or breast cancer like my patients do. Despite having all these conditions, they’re the ones who are pregnant. I smile widely while I move the ultrasound probe over each of their bellies. I eye their scars from open heart surgery. My responses are appropriate; I’m a great actress. “Look how cute she is,” I say. Or “We’ll help get you through the pregnancy safely.” 
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This farce is getting harder to maintain the longer my uterus remains empty. When I started trying to get pregnant in 2018, I assumed it would only take a few months — it’s been 11, and it feels like forever. At my age, though, going this long without a pregnancy doesn’t qualify me for treatment or even testing for problems under my insurance. The dreaded diagnosis of "infertility" requires 12 months of longing, tracking, and trying. 
I’ve done everything possible to manage my fertility on my own. I collect my urine in tiny cups and use strips from my work to test it for signs of ovulation. I put details regarding my cycle, cervical mucus, and sex life into multiple apps. I bought a $300 Ava skin temperature tracker that I wear nightly to track my basal body temperature. Watching it over time can help you determine precisely when you’ll be ovulating. I strong-armed a colleague into doing blood work, an ultrasound, and a semen analysis after seven months of trying. Everything was normal, but I’m still not pregnant.
I’m not used to having my efforts go unrewarded. I wanted to go to medical school, so I worked hard in college. I wanted to train as an OB-GYN at a world-class institution, so I worked hard and matched at the hospital of my dreams. This journey is not like that. I’m working so hard and I’m still not pregnant. 
Meanwhile, almost every day, I’m performing ultrasounds, providing prenatal care, overseeing unmedicated vaginal deliveries, and operating in complicated cesarean sections. Every moment of their joy is clouded by my envy. Every moment of their indifference is tainted by my anger. I want a baby so badly. Thank goodness I’m a good actress.
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Age: 31
Location: Chicago, IL
Occupation: Maternal Fetal Medicine Physician
Household Income: $300K
November 2018
I remove my IUD, and start trying to get pregnant
I just got home from a 10-day trip to Africa. My partner and I dubbed this our “pre-baby-moon.” It’s a Saturday night and I signed myself up to work an extra shift in our Labor and Delivery triage center. When I have a free moment at work, I wave over a resident physician on the floor. I tell her I need a personal favor.
Five minutes later, I’m legs up in the stirrups in our ultrasound room having my IUD removed. It’s fairly painless. I’m so excited that I send a picture of my cervical mucus-covered IUD to my husband. And to my best friend. And to my mom.
My husband and I have sex the next night. Afterwards, he jokingly says: So we’re pregnant now right? We laugh and laugh, but also hope and hope.
Cost: The IUD removal is free. My job has its benefits.
December 2018 
I start taking ovulation prediction kits
I got my period about two weeks after my IUD came out. I hadn’t had one in five years (Thank you, Mirena!), so it was very light. I wasn’t even sure it was a period, to be honest. My best friend and I are both trying to conceive, so we decided to do ovulation predictor kits (OPKs) together. Why bother our partners with the technical intricacies of getting pregnant when we’ve got each other? There are a lot of back and forth texts and photos of our kits, including a clearly very positive one for her right after Christmas. She has sex in the living room of her sister-in-law’s house. I tell her that I can’t wait to tell her child that if she conceives. (Spoiler: She does. I don’t.)
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Cost: I spend $16.95 for 50 cheap OPKs on Amazon. Then another $20 for more expensive OPKs from Target. I get both because I’m already becoming a little crazy.
January 2019 
I’m the only one who isn’t pregnant
My best friend FaceTimes me at 7:30 on a Wednesday morning with a positive pregnancy test. Her husband is still asleep. Laughing, I tell her she needs to go wake him up and pretend I don’t know yet. We text all day about our mutual excitement of hopefully being pregnant together.
February 2019
Waiting
I go to Vegas for work, and then to Miami and the Florida Keys for a wedding. I don’t drink because I’m post-ovulation and I’m so sure that this is the month I’ll find out I’m pregnant. I don’t know for certain that drinking prior to a positive pregnancy test is bad, but the potential is enough for me. 
March 2019
I buy a skin temperature tracker 
I turn 31 and throw myself a big pity party because I’m still not pregnant. I decide that I could be doing more to help my chances and spend $300 for a skin-temperature tracker. It’s like a watch that doesn’t tell time. I wear it when I’m sleeping and in the morning it tells me my basal body temperature. Tracking this daily allows me to confirm ovulation even more precisely.  My philosophy is that having more information is always better. 
I add this to my daily OPKs and the charting I’m doing in three (!) different fertility apps (Kindara, Fertility Friend, and Ava). My husband and I have a huge fight about how all this extra information is causing stress. He thinks it may actually be sabotaging our ability to get pregnant. I do not acquiesce. We go to bed angry, which is a great thing to do when you’re trying to conceive. The next morning my husband mentions something akin to this being my area of expertise (even though it’s not) and never brings up the tracker again.
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Cost: $300 for the thermometer. The apps are free. 
April and May, 2019
Boring sex
My husband asks if we can have “efficiency sex,” which is just as sexy and satisfying as it sounds.
June 2019
Acupuncture
I deliver a friend’s baby (not the one who got pregnant in January). It’s a beautiful, natural vaginal delivery. I cry because I’m so happy for her — and so sad for myself.
I decide to add weekly acupuncture to my regimen. I research fertility acupuncturists in my area and make an appointment. With some trepidation, I show up and let a man tap tiny needles into my forehead, ears, hands, and belly. He places a small heat lamp above my pelvis and leaves me to my thoughts for 30 minutes. I try so hard to meditate on a tiny egg and sperm being drawn together by the warmth, but instead I fall asleep. I feel good when I wake up, however, so I decide to keep taking these expensive naps.
We go on a vacation to Banff National Park. My husband is convinced that we’ve conceived and buys the cutest wool socks that say Baby Bear. (Now, they’re in a closet in our would-be nursery. I hate looking at them.)
Cost: $100 for initial acupuncture visit. $85 for every subsequent visit. I went weekly for three months, which adds up to $1,035. None of this is covered by insurance
July 2019
Fertility consultation and sperm analysis 
It’s officially been over six months and I’m overwhelmed by my own fertility knowledge. I regularly tell women that 85 percent of couples will conceive in the first six months of trying. I’m on the wrong end of this bell curve. I frantically email a colleague who specializes in reproductive endocrinology and infertility (REI) and ask if she would be willing to see me.
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During our consultation, I embarrass my husband by talking very openly about our sex life with our physician. We talk exceedingly fast in doctor lingo, which bothers my husband. Unfortunately, he doesn’t let me know this until long after we’ve left the appointment.
I have my blood drawn to check my thyroid and other hormonal levels. I also get a sonohysterogram — which is the equivalent of having a water balloon placed in your uterus and inflated. After this procedure, fluid is placed in my uterus to evaluate my uterine contour. As an added bonus, my doctor also shoots tiny air bubbles through my uterus and confirms they can exit via the fallopian tubes. It’s excruciating, and I’m embarrassed to behave like such a wimp in front of my husband. 
The good news is that my tubes are open, meaning there’s no scarring from inflammation or prior infection — open tubes are a necessity for conceiving. And my uterus looks normal, meaning there’s no evidence of fibroids or polyps that could interfere with implantation. I don’t mention to my new doctor that I already knew my uterus was okay, because I’ve been doing monthly ultrasounds on myself. In this moment, I think to myself that I’ve gone down a dark path.
My husband does a “home collection” of sperm for his part in this. I do not wait for the doctor to look at his results. I log right into my electronic medical record and look them up myself. Desperate times. His count, motility, and shape are normal, the doctor says. 
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After this work-up, we have a frank discussion as a couple about whether I want to move forward with fertility medication or other therapy. Since there are no glaring medical problems stopping us from conceiving, I elect to continue trying the old-fashioned way. My husband defers to my “expertise.”
Cost: $50 copay for the visit. The rest is covered by my incredible insurance.
August 2019
More sex
We go on another vacation to the Azores. We have sex every single day. Some of it is actually enjoyable. I ovulate during the trip so, again, I’m convinced we’re pregnant. We aren’t.
October to November 2019
Fertility drugs
Another red spot in my underwear. It reminds me of seeing red marks on your homework or exams. Its says to me, “You got this wrong.” I stifle a sob and text my partner that I’m sorry. This cycle marks another failure. We’re not pregnant.  
I log my period into my apps, pull my itchy scrubs back up over my treacherous underwear, wash my hands, and walk back to labor and delivery.
I reach out again to my reproductive endocrinology and infertility physician to let her know we’re ready to move forward with next steps. I come in on the second day of my period to have a baseline ultrasound. My uterine lining is measured and the follicles (or pre-eggs) in my ovaries are counted. Measuring the uterine lining now, and again after I start medication, helps confirm whether or not my body is responding properly to the treatment. The results of the follicle count tells us that I've got normal ovarian reserve. I already know most of my doctors and nurses because I rotated in this clinic as a resident. The person doing my ultrasound actually taught me how to do the procedure four years ago. Because of this, everyone is very nice. Too nice. “It’s so good to see you — how are you?” Pissed off if I’m being honest, I think to myself. 
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My doctor puts me on the drug Clomid, which is a medication that increases your body’s production of eggs in a cycle. Because of this, many people end up with twins if they conceive on the medication. As much as I want to be pregnant, I really don’t want twins. I see complications from pregnancy every day, and know that twin pregnancies are much more complicated than singles. To mitigate my concerns, my doctor and I agree that I’ll have another ultrasound prior to ovulation to make sure there aren’t too many eggs developing.
I return to the clinic on the 12th day of my cycle to find only one mature follicle on my right ovary. One is better than three, in this case. When I get home, I give myself a trigger shot to induce ovulation and prepare my husband for a few days of sex. He’s overly confident in a way that I can not emotionally reciprocate after so many months of yearning. He names the egg “Chloe” and spends many days talking about how sure he is that she is the one. It would have been adorable 11 months ago, but now it makes me sad. 
In two weeks, we’ll know if we’re pregnant. 
Cost: Appointments were covered by insurance. The Clomid + HCG Trigger shot were $26 after insurance
Total Cost: 1,547.95
Reflection: 
I would love to say that I’m grateful for this journey and that it’s made me feel closer to my husband. I’d also love to say that, as a result of this journey, I’ve become a better doctor. But none of that is true. I’m angry and sad on most days. At my best, I’m forlorn and unattached. My husband and I are emotionally spent, both individually and with one another, and sex is now reserved specifically for procreation. My work is suffering; I’m no longer happy doing ultrasounds or deliveries. It’s getting much harder to fake it. 
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I recently shared these emotions with a coworker who stated, “I would have had no idea you were suffering.” I think that speaks volumes to the magnitude of this problem. Women (and men!) don’t share this struggle. We grieve in silence. 
Many people struggle to navigate the healthcare system or to afford the evaluation and treatment recommended to start their family. In that respect, I feel privileged. This nightmare would be so much more difficult if I did not have the knowledge and resources I have. I hope that sharing some of that here will empower others to talk to their loved ones and advocate for themselves in an intimidating medical system. We need to support one another.
While in the waiting room for my baseline ultrasound, I ran into a coworker who is a neonatologist. She smiled wryly. “We’ve got to be crazy trying this hard for something so complicated,” she said. I smiled back because it’s so true. Conception, pregnancy, parenthood, and life are incredibly complex, yet we chase them with unmatched tenacity.
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