How Did I Get to Thirty-Five Without Really Understanding My Reproductive System?
I wanted to know more about my fertility because I thought it might help me prepare for a someday I wasn’t willing to give up on.
This is My Future, My Fertility, a monthly column in which Karissa Chen wrestles with her questions about fertility, motherhood, and future-planning after thirty-five.
no white pants todayis this bad stretch hormonal or environmental or chemical?stop legislating my womb
Taking Charge of Your Fertility
. Here’s to taking control of the life you want, in more ways than one
Why didn’t I know any of this before?
I can’t wait to implement all of this.
Over time, I began to see patterns. I began to correlate my body temperature spikes with other symptoms my body was producing: fatigue, moods, breast tenderness. Of course, I had noticed some of these things before, but now I could correlate them more precisely rather than wave them all off as “PMS.” I felt like I was doing something useful, important, even empowering. Sometimes I opened up my chart on my phone and just scrolled through it, because looking at it gave me the same click of satisfaction I felt when I planned out my week’s tasks in my calendar.
But even as I meticulously observed, charted, and reviewed my data, a small voice inside me asked: What’s the point? What did it matter how long my luteal phases tended to be, what my body felt like as I approached ovulation? Why track so carefully which days I was fertile, when I wasn’t going to use that information to get pregnant any time soon? Sometimes, thinking about the futility of it all, I couldn’t help but despair.
The truth is, at first I wanted to know more about my body because I thought it might help me prepare for a someday I wasn’t willing to give up on. It was a practice run, I thought, for when I wanted to get pregnant. If I was being forced to take this time, why not arm myself with as much knowledge as I could, so I’d be ready for whatever might come?
But over time, I became lazy. I’d sleep through my temperature alarm. I wouldn’t bother to check my cervical fluid. Occasionally I tracked symptoms like moods and cravings and oily skin, but I stopped double-checking my predicted fertile days. And it was okay. A relief, even, to not have to think about what my body was doing, every day, all the time. There’d be time for that later, I thought.
To accept that my reproductive system is in decline is to accept, at some level, that I have little control over it. When I was in the early phases of considering egg freezing, I talked to a doctor who told me that no lifestyle change would affect my eggs’ decline in quality. It didn’t matter if I exercised regularly or drank less alcohol—the eggs would continue to go bad, one by one, as time went on.
Even though I know I have no control over this, I keep reading other studies, learning other statistics, trying to understand the way my body works. This is still about control, of course: Knowledge offers a sense of agency, even when we don’t have much of it. It’s why a person checks WebMD when they have unexplained medical symptoms; why a person who has been cheated on wants to know all the painful details. When the future cracks open into a wide chasm of terrifying possibility, knowledge is often the only thing that offers us some footholds. For someone like me, who loves having a plan for the future, knowledge makes me feel like I can make an educated choice.
The things I want to know are numerous: I want to know why fertility dwindles with age; I want to know what, if any, options I have in the face of this. I want to know if acupuncture can be useful for the health of my womb. I want to know how the science behind egg freezing works. And yes, I want to know more about how my body works—a body that, I’m beginning to realize, I don’t know very well at all.
Nowadays, even without constant charting, I do know my body more intimately. I’m more attuned to its changes each month. Even when I don’t consciously look for signs or chart the data, I can say with a degree of certainty where I am in my cycle. I have a better sense of what factors are contributing to my overall sense of well-being. And I can picture for myself where all of this is happening—in that miraculous universe I’d once seen on screen. Maybe this knowledge isn’t useful for conception right now, and maybe there’s still much more I could learn—but what I know now is already so much more than I knew before. And that, in and of itself, feels empowering.
I want to end with a story from several years ago. One morning, I woke up to horrible cramps. I had just arrived in Beijing, where my mother lived, the day before, and I’d felt nauseous during the entire sixteen-hour plane ride. When I stumbled to the bathroom, I discovered thick, dark blood in my underwear. My period was a week early.
I put in an ultra tampon, the most absorbent kind on the market (up to eighteen grams of blood, versus nine grams in a regular tampon), and then lay back down. I’ve always had terrible periods, but this was particularly vicious, worse than any I had ever experienced. My uterus felt like it was being sheared from the inside out with a vegetable peeler. I finally took an Advil, and after twenty minutes, the fist of pain began to loosen slightly. By then I had fully soaked through my tampon. For the next several hours, I was in the bathroom every half an hour, the stash of tampons I had brought with me from the States fast dwindling. Four hours in, I pulled out another fully absorbed tube of cotton, and clots the size of silver dollars fell out of me. I stared in horror, fearing that something was terribly wrong.
Nowadays, I do know my body more intimately. I can say with a degree of certainty where I am in my cycle.
Three days before I’d gotten on that plane, I’d had a bit of spotting. It was two weeks too early for my period; unusual for my body, which typically ran like clockwork. I’d Googled and found a variety of possibilities—endometrial cancer, thyroid issues, a decaying womb—as well as the far more common possibility: implantation bleeding. I checked Clue, the app I used to track my period, and according to its algorithm, I’d probably been fertile the week before, when I’d last had sex. I hadn’t taken a pregnancy test, because my period was still too far away, rendering results unreliable, but the possibility that I was pregnant loomed large in my mind as I flew over the Pacific several days later, as unexplained nausea brimmed in my throat.
Now I wondered: What if I was having a miscarriage, and I didn’t know it?
The terribleness of that period lasted for two days. Two days of feeling like my uterus was going to push itself out. Two days of soaking through tampons at an alarming rate, though by the second day, the clumps stopped coming. Because I was in a foreign country, I didn’t call a gynecologist, instead hoping the period would resolve itself. On day three, the bleeding tapered down to more typical amounts, and a few days after that it finally stopped.
I still think about this period sometimes, wondering what it was or wasn’t. If it was simply a stress-induced atypical period, due to hormones gone awry, or if it was, indeed, something more. A clump of irregularly dividing cells. A potential life, unviable. I’ll never know, of course, and that’s mostly okay. The uncertainty is perturbing, though less upsetting than if I’d known for sure a miscarriage was happening.
I used to wish I had known more about my body before it happened. Maybe if I’d known more—about how to track for ovulation, of how to pay attention to my body’s ever-changing physical symptoms—I would have known for sure. Maybe if someone had taught me, from the moment I got my first period, how to understand my body’s unique signs, I wouldn’t have spent those two painful days oscillating between worry over the possibility that I had a serious medical condition, and sorrow that I was losing something I wasn’t even sure existed.
But maybe that’s not the point. Even armed with all that knowledge, maybe I couldn’t have known for sure, and I would have wished for even more—more knowledge, more certainty. Or maybe I would have known for sure that it was a miscarriage, and then irrationally blamed myself for something I’d been powerless to prevent. There’s always too much we don’t know, too much we can’t control. Now, all I can promise myself is this: I’ll do the best I can to prepare for what I can’t predict. But at some point, I have to let go of those footholds. Jump into the chasm and trust that I’ll be ready to face whatever I find there.
Karissa Chen's fiction and essays have appeared in numerous publications, including Gulf Coast, PEN America, Guernica, and Longreads. She was awarded a Fulbright Fellowship to Taiwan in 2015-16 and received a 2019 Fellowship from the New Jersey Council on the Arts, and is a proud Fellow of both Kundiman and VONA/Voices. She currently serves as the Editor-in-Chief at Hyphenand a Contributing Fiction Editor at Catapult. She is working on a novel.