Actually it is not the first time. In 2010, my Mirena IUD needed switching. Which was sort of like a joke because I was not sexually active, but still. The GP started advertising a new sterilization procedure which is 100% effective (yes) and is done in an outpatient setting without side effects and complications, unlike tubal ligation. "You have such beautiful children", the GP said, urging me to submit to the procedure. At that time I was severely depressed, without an AD, sleeping or lying in bed until 3-6PM (yes, PM, not a typo). I was jobless, having lost a very job because ex dictated conditions of my return which were impossible to fulfill (then p-doc wrote in her note whatever ex wanted). And the future was very very bleak. But I still despite severe depression cared enough to say "No, I want a new IUD", and the explanation I gave her was "I prefer to have no period because it is so convenient" (30% of Mirena IUD users have no period) and she said "That is true... if you do sterilization, your period will come back". So she swapped my IUD. So I preserved fertility even during the bleakest times. It has always been important to me.

And... good news. My son IS talking to me! And I will manage a 20 year old son and a baby, if only I get lucky enough to get pregnant without genetic abnormalities.