As a writer, I love words. I love letters and combining them to build meaning.

But there are four letters I don’t like when arranged in a certain order.

PCOS.

The acronym doesn’t roll off the tongue. It’s an unpronounceable blob of letters that probably don’t mean much to the majority of readers.

But to me, they have a meaning: polycystic ovarian syndrome.

And they have an underlying meaning: fertility struggles.

It’s not something I’ve talked about publicly. In fact, it’s not something I’ve talked about much at all. Aside from a handful of family and friends, most people who know me don’t know about the PCOS diagnosis.

It’s a mostly invisible health issue. The only outward signs I show are a thin patch of hair on my scalp (yep, hair loss is a symptom), slightly oily skin, and weight gain (which I’m slowly but surely overcoming … six pounds down, about a hundred more to go …).

None of those signs shout to the world, “This person is dealing with a health issue.” Especially since the thin patch of hair can be hidden by pulling my hair into a ponytail and the oily skin can be scrubbed and patted down with a matte makeup.

And it’s not like anyone can see my irregular (see also: practically nonexistent) menstrual cycles. Having four to five in a given year is a plethora where I’m concerned.

And where there are few menstrual cycles, there are slim opportunities to get pregnant.

My husband and I have been trying for several years now to expand our family of two into a family of three or more. Over the years, I’ve tried to keep my eye on the bright side. When we got promotions, I told myself it was good we hadn’t had kids yet because now we would be more financially stable. When we bought a house, I told myself it was good we had “waited” (ha … as if my body had given us a choice) until we were settled into our new home because now we had a spare room to serve as a nursery. Not to mention we finally had a home a family could grow into.

But all of those paper-thin excuses got torn to shreds every time another Facebook friend made an “I’m pregnant!” post and I felt simultaneous pangs of jealousy and guilt over not being happy for them.

The twinges of watching everyone else’s pregnancies pales in comparison to the pains of what I’ve come to call the “ups-and-downs,” though.

The ups-and-downs are a regular cycle for me now. A menstrual cycle starts. There’s hope of ovulation. We try to get pregnant, and up go our hopes. Then I take a pregnancy test, and there’s one pink line telling me Not Pregnant, and down crashes hope. Until the next menstrual cycle. Then up again and down again.

The most recent heartbreak was after a third round of Clomid, an estrogen modulator drug used to treat infertility. The husband and I diligently counted days in my cycle, and on Day 21 I had some spotting. Since I read implantation can occur on Day 22 in a standard 28-day cycle, hope radiated from me. Could it be implantation bleeding?!

I waited for Day 28, and then I started counting forward. I told myself I wouldn’t buy a pregnancy test until 10 days later to give time for the HCG hormone to build up in my system in case I was pregnant.

On the tenth day (January 3), I was unbearably excited to go to the store and pick up the pregnancy test. I got out of bed, got dressed, fixed my hair, fetched my coat and purse and keys …

Out of habit, I stopped in the bathroom before heading out the door. (All those years of Mom making us go to the bathroom before getting in the car sticks with me today.) That stop in the bathroom ended my plans to go to the store. Because the toilet paper had a streak of red on it.

Another cycle started. Down crashes hope.

Reset to Day 1.

On the bright side, I suppose, I saved a little money that morning. And I was spared another disappointing two minutes of hoping and praying and pleading for two pink lines to show up on a plastic stick.

Because there are never two pink lines. It’s one pink line. Over and over and over. Month after month after month.

My 31st birthday came and went in the midst of the latest infertility disappointment. Each passing year adds to my silent fear that the opportunity for pregnancy will pass us by once and for all.

But I keep telling myself there will be another cycle. There will be another chance.

Maybe there will be a day when PCOS stops meaning infertility and a baby in my arms means I overcame it.