Two weeks ago, I turned 33. It didn't get a lot of fanfare; I was insanely busy with work and none of the friends we've celebrated with in the past were remotely close enough to come for a party. So I had a quiet day with K and B, got a few books and some nice cards. Nothing exceptional. Except that for the first time, I've started to hear the ticking of the biological clock.
I hadn't worried about it the first time. I was 28 when we started trying and had more than enough to worry about with PCOS. The thing about being infertile is that you're much more concerned about dealing with the reasons for that than worrying about age-related fertility issues, particularly if you're on the near side of 30. But now it's occurred to me that I'm only two years away from the point when they start recommending the thorough prenatal screenings and considering me elderly. And that chances are that as time goes by, I'm unlikely to get _more_ fertile, so if trying for another baby is going to take as much time and assistance as last time, I should get cracking.
Fortunately, I'm finally feeling like I'm ready to consider trying. I hadn't planned on thinking about it until this summer anyway because I would like at least three years between children. And after unemployment, a major move, adjusting to a higher cost of living and dealing with the death of a parent, it just wasn't practical to start trying until now.
However, I'm painfully aware that being mentally ready for another baby doesn't remotely equal actually getting one any time soon.
For those who weren't reading last time around, my reproductive history in brief: I have Polycystic Ovary Syndrome. The brief version of this is that due to a missing enzyme, I don't respond to insulin as well as I should. This results in my pancreas pumping out higher levels of insulin to compensate, which in turn results in weight gain, blood sugar issues and massive hormone problems (and in my case, debilitating fatigue, to the point that I was disabled). The hormone problems are what causes the infertility, but the best way to address this is to get to the root of the problem, the insulin resistance. So I've been on a diabetes medication for the past five years which increases my insulin sensitivity and it works pretty well - I'm able to maintain a stable healthy weight, my symptoms are pretty much in check and when I went off the pill, I had regular periods. But it wasn't quite enough, because I apparently wasn't ovulating very often. So after over a year of trying, I took clomid and got lucky the first time out.
So you can see how contemplating a second baby isn't as easy as just going off birth control for me. It doesn't help that I have absolutely no idea what my current fertility status is. My current birth control is a Mirena iud, which has the salubrious effect of eliminating periods, so I havne't had a period since January of 2006. In the past, I've said I prefer birth control methods where I still get my period because it's a useful indicator of how I'm doing health-wise, but honestly, I've been enjoying the honeymoon from the monthly bloodletting. I haven't been having any other PCOS symptoms to speak of, so I decided to have a nice vacation in the land of Not Worrying. But now I have to start worrying and while I didn't miss my period, I kind of wish I had some way of knowing what my hormones are going to do.
The current plan is that I have a doctor's appointment in two weeks for my annual lady parts inspection and I'll ask the doctor to take my iud out and wait for my period to come back. If it doesn't come back or six months goes by without anything happening, I'll get more proactive and go back to the doctor. I may throw in asking the doctor if we can start testing to see if I'm ovulating as soon as my period comes back. But I'm not waiting a year again since I don't have as much time to wait.
It's hard to know how to feel about being infertile sometimes. I didn't have nearly as hard a time getting pregnant as many do; once we sought treatment, it only took one dose of Clomid. Comparing that to stories of ivf and miscarriages, we got off pretty easily. But that doesn't mean it was easy, or that it won't be harder next time. I also get to worry about the fact that PCOS raises your miscarriage risk by quite a lot. One weird thing is that many women don't find out they have PCOS until they try to get pregnant and can't. It's only then that they go on metformin, and since it doesn't usually work immediately, they still need a lot more intervention. But I was diagnosed with PCOS because it was making me so very ill that I couldn't possibly ignore the symptoms. And if I had been trying to get pregnant then, I would have had an absolutely miserable time of it. But instead, I was on metformin for three years, got back down to a healthy weight and mostly straightened my hormones out before trying. It's a weird position to be in: infertility made me absolutely horrendously miserable for several years. I just wasn't trying to conceive during most of them.
In any case, there's no point in obsessing about any of this until I get my iud removed. Not that I'll let that stop me from running a constant low-grade worry.