Book Excerpt, 'Choosing Naia'

Almost on a whim, Tierney decided to break out the last in-home pregnancy test in her medicine cabinet. She had already gone through nearly a dozen, each one a disappointment. Tierney's urine had never revealed a pastel stripe, a red cross, or any other indication that parenthood was in their future. Tierney had equally low expectations for the plastic wand she held in her hand. She suspected that she had ovulated when she was out of town for several days on a business trip, costing them yet another month.

Tierney and Greg had known each other for almost nine years. They had been in love for eight, married for nearly four. A graduate student, Greg was thirty-four. A corporate manager, Tierney was thirty-one. They'd trash-canned their birth control almost a year earlier, feeling ready to start working on their imagined ideal family: three children, two biological and one adopted.

When Tierney hadn't become pregnant during the first few months of trying, both of them had grown anxious but neither felt panicked. Tierney had been on the Pill, and they knew it might take six months or so for her body to readjust its cycles and begin ovulating normally again.

When those six months passed and nothing happened, Tierney sought answers from her obstetrician/gynecologist, Dr. Michael Bourque, whom she had known since she was nineteen. A battery of tests showed that she still wasn't ovulating, so Bourque had started her on a relatively low dose of a fertility medicine called Clomid, a synthetic compound in a class of drugs called antiestrogens. Clomid is a first-line offense against infertility, designed to trigger a woman's body to produce an egg ready for fertilization.

Bourque had told Tierney not to worry, but it wasn't easy as more months came and went. She and Greg began wondering if they'd ever be able to conceive. They started thinking about costly and invasive fertility procedures. They discussed whether a sperm or egg donor might be necessary, or whether they might have to adjust their family plans altogether and go straight to adoption.

By spring, Tierney had reached what Bourque said was the highest dosage he would prescribe of Clomid before sending her to a fertility specialist. He knew that among patients treated with Clomid, 95 percent who become pregnant do so within the first six months of taking the drug.

As part of her treatment, Tierney was monitoring her body temperature every day, charting the peaks and valleys that indicate ovulation — the magic formula is a sudden dip, followed by a three-day rise of at least two-tenths of a degree over the highest temperature recorded during the previous six days. One sign that ovulation has been answered by conception is the woman's temperature doesn't drop back down after the three-day rise. Tierney doubted it meant anything, but that's what seemed to be happening the April night she took out her last e.p.t.-brand home pregnancy test.

Tierney went into the bathroom and shut the door. Watching her from the wall was a black-and-white photo of jazz trumpeter Dizzy Gillespie, his eyes closed and his cheeks pregnant with air. She followed the instructions — allowing the wand's absorbent tip to sop up some of her urine. She left the test kit on the counter for the two-minute lifetime it would take to show positive or join its predecessors in the garbage.

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