My Weird Body

What I have is PCOS.

That's what they call it, anyway.

What's happened is, I've never had anything approaching a regular, 28-day period in my life. As a teenager, this didn't bother me at all. I'd get a period maybe four times a year, and I was happy about that. I think then I saw menstruating, disdainfully, as a girly thing, something that would bring me down (I thought the same thing about having kids, then, too).

At doctor visits they inevitably asked me when my last period was. And when the date was two or three months before, they'd give me the raised eyebrows and ask if I was pregnant. When I said no they'd pause, lean in closer and ask, "Are you sure? What birth control are you using?" Seventeen-year-old, self-righteous, nerdy me would answer, "Uh, abstinence?" Sometimes it took several rounds of this to get out of there without having to take a pregnancy test.

Every health care professional I encountered between puberty and age 25-ish seemed quite concerned that I might be hiding a pregnancy.

But no one ever, ever seemed concerned about naming or fixing the problem of my infrequent menstruation. I'd occasionally hear, "Oh, we'll worry about that when you want to get pregnant."

When, in my mid-twenties, my periods became even less frequent and I started to worry about my fertility, it took visits with three ob/gyns and a great deal of insistence on my part to get anyone to even attempt a diagnosis.

PCOS is a syndrome, not a disease. Which means we don't know what causes it, and in fact it's likely that as the syndrome becomes better understood, docs will break it down into a couple, or several, different diseases, each with different causes.

For now, they toss everyone who has certain symptoms into the PCOS bin. I don't have some of the more common symptoms, like extreme acne and hairiness, high body mass, insulin resistance, or thyroid problems. What I do have is infrequent ovulation and a nice set of cysts of different sizes on my ovaries.

The PCOS diagnosis is firmed up by the fact that I seem to respond somewhat well to the drug metformin, which seems to help a lot of folks with PCOS ovulate.

Yep, that's right. It made me ovulate. I think. Not once, not twice, but three times. The story is:

Last September, after five months off the pill with no ovulation and no period, I did a cycle of Clomid. No egg.

November: Clomid cycle two. No egg.

January: convinced my ob/gyn I should give the metformin a try despite my lack of the "classic" PCOS symptoms. Started the metformin.

End of February: ovulated after having given up on ovulating.

Mid-April: ovulated again, had tons of well-timed sex, spent thirteen days in a state of complete obsession over the fact I might be pregnant, then got my period.

Late May: ovulated again, on cycle day 30, same as last cycle, but my husband was away the entire fertile window.

Mid-June: met our RE for the first time, and, all cocky and convinced I was on a regular 44-day cycle, elected to put off treatment and see if one last "natural" cycle would work.

And did I ovulate on cycle day 30 as hoped and expected? Of course not. Did I ovulate at all? Of course not. Day 40 - almost three weeks ago now - I threw in the towel and demanded Provera. Took the pills for seven days as directed and waited for the promised period. And waited. And peed on home pregnancy tests (well, one). And huddled in the corner of the conference room at work to have furtive phone conversations with the nurses at the RE's office about the precise color of the spots of blood that every now and then eek their way out of me, and the stunning increase in breast size that the fertility gods have granted me in the past week.

I am still, in fact, waiting for my period to start, now eleven days after finishing the Provera. And I would really, really, please, like it to come so I can go ahead and take the Clomid (which is supposed to be extra-super-powerful when taken in combination with metformin) and commence the regular ultrasound viewings of my ovaries, and get with my husband at the right time, and become all round and glowy and pregnant and pop out a lovely baby, et cetera.

But for now I am waiting to bleed.

Wait up.

I suck at waiting.

Too bad there's so much of it to be done.

Mr. Jae and I have had a number of conversations about my low reserve of patience in general. He and I and my friend R (who shares the desire to see everything in the world hurry up a bit) have had a number of conversations about R's and my "journey to patience." Usually they end with R or me whining, "Are we there yet?"

Though I can't say I'm liking all the waiting I've got to do, or even tolerating it very well, I am starting to become aware of the great variety of textures and types of waiting. I could make a list like you'd find in the pillow book of Sei Shonagon:

The long, constant waiting where you are checking for something that might actually be there, like stretchy cervical mucous as a sign of ovulation, or a high temperature in the morning, but really it doesn't come for months and months and the waiting becomes a low drone under all the other types of waiting.

The shorter, but still legato waiting where you are checking for something that is definitely coming, like your period after taking Provera for seven days.

The mind-spinning, bounded waiting to find out whether something is, when any signs that can mean yes can also mean no.

The short, adrenaline-loaded, eyes-averted waiting in the RE's waiting room with the racks of noticeably non-child-related magazines and not enough to do with your hands.

The fed up waiting for something that should have happened three days ago but hasn't yet, like when you thought you'd ovulate on cycle day 30 and here you are eggwhite-y as hell and still with preovulatory temperatures on day 35, or like when your period should have started within a few days of quitting the Provera but it hasn't yet and neither Smart Nurse Jill nor Dumb Nurse Lisa can figure out why.

The flash of waiting between peeing on a stick and seeing one pink line appear.

The long, high note of waiting over it all, the arc of waiting from the day you start hoping to be pregnant to the day you stop.

I blew the nuts off the cake.

On my twenty-ninth birthday, my mother-in-law baked a flourless chocolate cake covered with slivered almonds and powdered sugar. She put in twenty-nine candles, and lit them, which made the whole thing bright and hot. I put on sunglasses in mock awe of my advanced age.

I made a wish. Then I blew so hard that the powdered sugar erupted off the cake in a cloud, coating the sunglasses and my nose and upper lip, and the slivered almonds took flight in what I'm sure would be a great model of some sort of catastrophic geological event, and landed in about a two-foot arc on the far side of the cake. We have photographs of this: the almonds in flight, me blushing.

One candle stayed lit. My wish was to get pregnant and have a baby.

And that was before we knew for sure it would be hard to do. We suspected it might not be a breeze. I figured I ovulated irregularly on my own, if at all, but had heard magical things about anovulatory women coming off the pill and conceiving immediately. When I stopped taking the pill about two months after the cake incident,my husband and I both felt like we were getting on a train without knowing which direction it was moving, or how fast.

Now we know. Well, we know more. It's been sixteen months since we pulled the goalie. I've taken my waking temperature approximately four hundred times; become more acquainted than I'd ever hoped to be with my cervical fluid; swallowed metformin, provera, and clomid (not to mention profuse quantities of green tea and grapefruit juice and the occasional robitussin chaser); and popped a grand total of three eggs out of my sluggish ovaries. None of which found its way to a happy union with any of my husband's many eager little soldiers of love.