Wednesday, 17 December 2008
On the pregnancy front, I am now a little over 22 weeks (although the bloody maternity jeans still won't stay up!). Everything looked as it should at the twenty week scan, and Mr H got to see the baby for the first time (he wasn't able to come with me for the nuchal translucency scan as he was away on work). We decided in advance that we didn't want to find out the sex: although I felt that I'd quite like to know, as parenting a boy or a girl each seem to me to pose their own unique challenges, Mr H was adamant that he didn't want to know - it would, he felt, be rather like knowing in advance what you're getting for Christmas.
At just over half way through the pregnancy, it feels a good time to try and reflect back over some of my feelings so far. There is a great deal of popular literature devoted to pregnancy, much of it emphasising what a special time this is in a woman's life. These guides are full of handy tips on how to nurture the unique bond between mother and baby.
In comparison with these somewhat idealised descriptions, my own experience of pregnancy has felt far more replete with anxiety.
In my weekly therapy sessions, I continue to worry that I do not feel the way the books tell me I should feel. I agonise over the fact that I was not able to experience such an immediate and instinctive bond with my unborn child. Did this perhaps mean that, even after all I have been through to get to this point, on some deeply unconscious level I do not really want this baby? In the session before we went for the 20 week scan, I voiced my deepest, darkest fears: what if the scan revealed that there was something terribly wrong with the baby? Would I be able to go ahead with a termination? If we decided not to terminate, how would I cope with raising a child with significant mental or physical disabilities? My therapist gently suggested to me that such anxieties were an inevitable part of the pregnancy process. While many women found them simply too terrifying to contemplate, others were more clearly able to acknowledge them.
I have found her remarks extraordinarily helpful in beginning to manage my conflicting feelings about this pregnancy. My previous experiences of infertility and miscarriage mean that pregnancy cannot be a time of unconditional joy; I remain too acutely aware of all that can go wrong. Somehow it still seems too much to hope that, in April of next year, I will give birth to a live and healthy baby. If I were to deny these anxieties, they would no doubt re-emerge symptomatically (perhaps in the form of postnatal depression, or else in my interaction with my child during the first few months of his or her life). But by exploring them, I can allow them to enrich and transform my experience of pregnancy and motherhood.
With my first pregnancy, I immediately expected to be transported into the state of blissful union that I had read about in the books. I felt an instant connection to that tiny little embryo burrowing its way into the deepest recesses of my body. That bond was abruptly shattered when I started bleeding. This time round, I could not allow myself to feel those emotions. For the first three months, I held my breath and I waited. And I felt guilty. I worried that I had in some way failed to 'bond' with my baby.
Now, however, I realise that pregnancy is a far more gradual process than the books would have us believe. Sometimes it takes a little time before we can allow ourselves to enter into such a fragile space of co-becoming. And it is only over the past few weeks, as I have begun to feel the first flutterings of the baby's movement, that I have been able truly to open myself up to the possibility of being transformed by the new life growing inside me.
Tuesday, 18 November 2008
The module I teach in the Shit Hot Critical Theory Department was so over-subscribed that this year they asked me to teach it twice over, to two separate groups of students. It is also running as an MA option, which means that I have had to organise further classes solely for graduate students: every week, I tie myself up in knots trying to explain complicated bits of psychoanalytic theory to them. I am also doing some further teaching at another institution altogether, supervising undergraduate dissertations.
I seem to be pursued from all angles by anxious students wanting to ask me questions: every time I check my email, I find my inbox full of communications all marked 'urgent query re: essay'; at the end of every class, there is inevitably a small delegation of people waiting to talk to me. This morning one of them even followed me into the toilet: 'Are you in there, Ms Heathen?' came a voice from outside the cubicle. 'Can I ask you a quick question about my essay?'
Mr H is still working away from home during the week. Because I do not wish what little time we have together at the weekends to be entirely taken up by domestic chores, I try to cram both housework and teaching preparation into the week, while my marriage is inevitably condensed into the weekends. There seems very little time left over for myself.
Somewhere along the lines, something has had to give. And that something appears to have been my own writing - both here on my blog, but also within my PhD.
I was supposed to submit my dissertation by the end of this month. I am not going to be in a position to meet this deadline, and so am going to have to apply for (yet another) extension. I have gone through this whole process several times already - firstly after my miscarriage and latterly when I was undergoing IVF. These extensions have to be formally approved by a special committee of senior academics: somewhere in the remote recesses of the University, there sits a body of men (and somehow I always imagine them as elderly men) who are by now intimately acquainted with the vicissitudes of my reproductive system. This time, however, I have a more immovable deadline than the one imposed by the University: somehow or other, the dissertation has to be finished before my due date of 18 April next year.
With every passing day, my list of unread items in Google Reader grows ever longer. My blogging friends have been such an incredible source of support to me over the past twelve months or so, and I feel simply horrible about the fact that I am finding it increasingly difficult to find the time to repay that support - to sit and wait with those who are undergoing treatments of whatever kind, to try to empathise with those who are trying to find a path through the labyrinth of adoption, or even simply to nod in agreement with those who voice the frustration and pain inherent in living with infertility.
Night after night, I lie awake, my mind racing with all that I have to do the following day. Often, I compose blog posts in my head, posts which then never make it beyond the draft stage. I started this blog because I wanted to try to make some kind of sense of my struggle with infertility and pregnancy loss. As I continued to write, I realised that what was also important was to feel part of a broader community of women. Those twin aims have not diminished. Of course, it would be perfectly easy for me to publish a series of posts in which I confess that, at the weekend, I gave into a craving for Brie and have been racked with guilt ever since, or in which I tell you about how I finally cracked and bought a pair of maternity jeans, which constantly threaten to fall down whenever I wear them. But I don't want this blog to turn into a laundry list of common pregnancy symptoms. The blogs which I most admire - and the one which I myself aspire to write - are those which offer a degree of reflection on ART, infertility, loss and life post-treatment: whether that life includes children or not. Thoughts on these issues continue to swirl round and round in my mind... it's just that I have too much going on in other areas of my life to begin to process them in any meaningful manner.
Bear with me until term finishes in three weeks' time....
Thursday, 6 November 2008
Mr H is stuck out in Madrid on a three-week assignment at the moment. Because of flight times, he cannot make it home at the weekends. This week is reading week for my students, which meant that I did not have classes to teach, and so I decided to fly out to see him. Coincidentally, last weekend also marked our fourth wedding anniversary.
We had a wonderful few days together. Although infertility and pregnancy loss have taken us to some pretty dark places, and have at times stretched our relationship almost to breaking point, we weathered that storm. After eight years together, we are still going strong and, perhaps just as importantly, we still actually like each other - I know that it's a bit of a cliche, but he really is my best friend as well as my lover.
While in Madrid, I also threw caution to the wind and ate a wide variety of cured meats. I also consumed a large and very bloody steak, which I washed down with half a glass of red wine. I cannot help but feel that much of the dietary advice aimed at pregnant women may be culturally specific - I can't really imagine that French women are warned of the potentially dire consequences of consuming Brie, or of not cooking their steak all the way through. One of Mr H's Italian colleagues did, however, inform me that there is an old superstition in Italy that, if you eat too many raspberries while pregnant, you will give birth to a bright pink baby! Given my fanatical belief in the anti-ageing properties of blueberries, Mr H is now worried that our baby may emerge looking a bit like Violet Beauregarde!
Wednesday, 22 October 2008
'Oh, I couldn't possibly,' she replied, 'I'm far too old for that type of thing. I'm practically twenty-three, you know.'
I said something to the effect that these things were all relative. 'It could be worse,' I pointed out, 'I'm practically thirty-seven.'
Her jaw dropped in what appeared to be perfectly genuine amazement. 'You're never,' she exclaimed, 'I don't believe it for one minute.'
But, in spite of my student's disbelief (or possibly her shameless attempt at flattery), I will indeed be thirty-seven on Friday. I have now reached the age where, as Dr Abrupt once pointed out to me, my fertility begins to decline ever more sharply (in order to reinforce his point, he very helpfully drew a rudimentary graph on the back of my notes.)
Mr H is working in London this week, and so tomorrow I am going down to join him. I am to have a night in a fancy hotel, a birthday dinner at a Michelin starred restaurant and also intend to take in the Rothko retrospective at Tate Modern. We are then going up to Shropshire to stay with my father and stepmother for the weekend: I can only hope that they are more excited about our news than Mr H's mother - when Mr H told her that I was pregnant, she said very triumphantly, 'I knew it. I always said that all Ms Heathen needed to do was to relax!'
Thursday, 16 October 2008
The other night, I had a dream in which someone from the hospital called me to explain that there had been a mix-up with my records. They were terribly sorry, but I wasn't actually pregnant after all: they had accidentally confused me with someone else of the same name. She was expecting a baby, I was not.
There are some dreams whose meaning is so obvious that they do not require psychoanalytic interrogation. Even though I have had three scans, even though I have seen with my own eyes the visible evidence of my pregnancy, even though I have had three separate letters from three separate doctors confirming that pregnancy, I still find it hard to believe. Somehow it still feels as though the rug may be pulled from under my feet at any moment.
I am now a little over thirteen weeks' pregnant. Despite all my anxieties that something would go wrong, I seem to have made it safely into the second trimester. The sickness has all but gone, and the crippling fatigue appears to be lifting.
But somehow the lack of symptoms makes it all the more difficult to believe that everything is still OK. While I was battling wave after wave of nausea, I could at least reassure myself that that was a sign that all was still well. Now I simply have to try and put my faith in the fact that, deep within my body, this invisible and mysterious process is continuing.
Wednesday, 8 October 2008
Tuesday, 7 October 2008
The nuchal translucency was measured at 1.5mm. When combined with the results of my blood work, this gives us a 1 in 3,428 risk of having a child with Down's, and a 1 in 6,147 risk of Edward's or Patau's. I cannot even begin to convey how much of a relief these results are. Given my ovarian reserve issues, I have been worried that I may well be at increased risk either of another miscarriage, or of significant chromosomal abnormality.
But yesterday, as I listened to the heart beat, and watched my baby kick its legs and wave its arms, I allowed myself for the first time to fall in love with it just a little bit.
Sunday, 5 October 2008
By the end of Week 6, Emma has told all her family and friends that she is going to have a baby. In Week 9, she goes shopping with her mother for baby clothes. In Week 10, she has an argument with her husband over baby names: he likes Beth or Chloe, while Emma is convinced she is having a boy, and wants to call him Lewis or Cameron.
I find it difficult to relate to Emma's experience of pregnancy. Reading Emma's Diary, I feel as though I have been transported into a strange, parallel universe, where infertility and, in particular, miscarriage, simply do not exist. Is this publication simply describing what you are 'supposed' to feel during the first trimester? And why can't I too share in these unconditional feelings of joy and anticipation?
I feel guilty that I cannot whip myself up into a similar state of excitement. Measuring my own more complicated emotions against the fictional Emma's, I feel inadequate. If I haven't told everyone I know, and if I haven't as much as looked at a romper suit or thought about names, does that mean that I'm not happy enough to be pregnant? Am I in some way failing to 'bond' with my baby?
I am, of course, unbelievably thankful to have made it this far: every day of this pregnancy has felt like a blessing to me. But I cannot escape the feeling that the rug may be pulled from under my feet at any moment. For some reason, I find it very hard to believe unconditionally in a happy ending.
Tomorrow, I go for my nuchal translucency scan (I am having this done at the Fancy Private Hospital where I had my hysteroscopy, as it is not covered by the NHS). Where Emma would no doubt be looking forward to seeing her baby on the ultrasound, I have been playing every possible worst case scenario over and over in my mind. What if the foetus has stopped growing? What if its heart is no longer beating? What if the scan reveals that we are at high risk of having a child with a significant disability?
Tuesday, 30 September 2008
Over the past few years, I have seized upon every teaching opportunity that has come my way. When you are struggling with infertility, it is very difficult not to let those feelings of hopelessness and despair seep into other areas of your life. In my case, the profound sense of failure associated with my inability to conceive translated into an absolute inability to write. For months and months, I sat in front of a blank computer screen and cried. If nothing else, teaching forced me to get out of my pajamas and interact with the world: while I seemed to be going nowhere fast as far as the thesis was concerned, teaching became the one area of my life in which I could at least retain some sense of myself as a competent professional.
Even though I absolutely love teaching, I still find it just about the most nerve-wracking thing in the world. Every year, the responsibility that has been entrusted to me weighs heavily on my shoulders. As I take that first deep breath and bang confidently on the lecturn to call them all to attention, I am shaking inwardly. As I start delivering my lecture and as they start frantically scribbling down every word I say, doubts are running through my head: do I really know what I am talking about? Am I able to communicate what knowledge I do have effectively? Somehow, I can never quite escape the feeling that I will be exposed as a fraud, that the students will complain that they want a 'proper' lecturer.
This year, however, I had to contend with an entirely new anxiety. Over the past few days, I have been really struggling with morning (noon and night) sickness. Would I make it through a two-hour class without vomiting into the wastepaper basket?
Thankfully I wasn't sick, nor (to my knowledge) have any of the students complained that I don't appear to know what I'm talking about. And so I have managed to conquer my anxieties for another year.
Wednesday, 24 September 2008
Several of you suggested that this blog is my space, and that I should feel free to use it in whatever way is most helpful to me. On one level, this blog does indeed function as a kind of personal journal, in which I document my shifting experiences of, and feelings about, infertility. And yet there is, I think, an important difference between a journal and a blog: while a journal is primarily a private document, a blog is written (at least partially) with a particular audience in mind. Whenever we hit that 'publish' button, we do so in the full awareness that others may well read what we have written. Obviously, there is nothing to prevent me from using this space to chronicle my pregnancy symptoms in repetitive detail, but I think that we should at least try to be mindful of the effects that our words may have on other people (and, frankly, are any of you really going to be that interested in my sudden aversion to Marmite?). Perhaps I could follow Hekateris's example and start a new blog specifically about my pregnancy, but, as IG Lisa (as opposed to HMS Lisa, for this is how I think of you, my dears) pointed out, my experience of infertility has had a profound effect on the way I feel about pregnancy, and so it doesn't really make sense to try and separate them out in this way.
One of the reasons why I started blogging (as opposed to simply keeping a diary) is because I wanted to connect with others who were also struggling with infertility. In the process of sharing my story, I have come to realise that that story is part of a larger patchwork of stories, that I am part of a much broader community of women. But, as Luna pointed out, that community is necessarily a fluid one: some people stay just long enough to get that BFP and then move swiftly on, while others continue to ponder the profound impact infertility has had on our lives long after we have finished treatment - whatever the outcome of that treatment. We were all of us drawn to this community by a common inability to conceive, yet ultimately may end up in very different places. Although it can be difficult to accept, sometimes we may find ourselves on very different paths from those to whom we had previously felt particularly close.
HMS Lisa asked an interesting question in this respect: when someone who has struggled as we have finds success, are they capable of offering the level of support they offered when they were still struggling? It is a very tricky question to answer. I don't think that I will ever forget the depths of despair to which infertility took me. But if I offer my support to those who are in similarly dark places, do I run the risk of sounding pitying or patronising? Does the mere fact of leaving what I imagine to be a supportive comment inadvertently remind them of what they cannot have?
As Pamela Jeanne suggested, however, pregnancy/delivery don't have to be a barrier if both sides are sensitive to the difficulties and make the effort to be deferential and accept that that there will always be a modicum of guilt and envy regardless of the outcome. We're human and we make mistakes but we can always learn from them. And this really is perhaps all any of us can try to do: to document our own stories, while continuing to remain sensitive to the stories of others. And yes, Pamela Jeanne is right - we may make mistakes in the process, but that seems a risk worth taking.
Monday, 22 September 2008
Even here in the IF blogosphere, it is impossible to escape the feeling of being left behind. I know of several women who started blogging at around the same time as I did who are now parenting. Two women who were cycling when I was undergoing my first round of IVF have just given birth.
Lisa recently wrote an excellent post on this very topic, in which she described her reactions to hearing the news that another woman who has been dealing with infertility is now pregnant. She acknowledged that, although she is happy for them, she also struggles with her own feelings of sadness: I no longer think "I hope I can join them soon". My thoughts now are "why did it work for them when it won't work for me?" It's a reminder that these treatments can work....that they should work. So, why not me? I think I've tried hard enough. I think I've done everything I've been told. I think I've paid my dues. So, why not me?
I think that anyone who has ever been through a cancelled or failed cycle can relate to these feelings. But, as hard as it is to hear of other people's pregnancies, it can be even harder to continue to support those who have crossed over to the 'other side'. Sometimes it is simply too painful to look at pictures of scans and bumps, or to be confronted by one of those ghastly animated ticker things counting down exactly how many days are left until their little bundle of joy arrives. And, although I do feel guilty about it, I find that, in many cases, I simply stop reading. I can no longer really relate to what these women are going through. I have no opinion to offer when they ask for advice on what stroller to buy, or what colour they should paint the nursery.
On one level, I envy those who are able to make such a smooth transition from 'infertile' to 'pregnant'. For me, the journey is altogether more complicated. Over the past six years, my infertility has become - for better or worse - part of who I am. I cannot simply switch off those feelings.
And so I am struggling with the whole question of what it means to be pregnant after infertility and loss. How do I write about my pregnancy while remaining sensitive to the feelings of those who are still in the trenches? How much can any of you really bear to hear? Is there still room for me in the IF blogosphere? I am, after all, the woman who cried 'diminished ovarian reserve' and then managed to get herself knocked up without medical intervention. So many of you who read and comment on my blog have been through more than I can possibly imagine. I am humbled in the face of your strength and courage, and cannot help but feel guilty that I should have been the one to have unwrapped the bar that contained the golden ticket.
Thursday, 18 September 2008
Yesterday, I had my first ante-natal appointment with the midwife at my GP's surgery. She took several vials of my blood - far more than I have ever had taken as part of an IVF cycle. What on earth did she need it all for, I asked. She rattled off a huge list of things that I need to be tested for - including syphilis. In my mind, syphilis is primarily associated with nineteenth-century men about town: I think of Baudelaire, Manet, Toulouse-Lautrec and Maupassant. I explained as such to the midwife. "Oh no," she replied, "syphilis is becoming increasingly common here in the UK. It's all thanks to the Poles."
Even without this jaw-dropping aside, the appointment was a little overwhelming. We filled out a lengthy form about both my own and Mr H's medical histories, including all my previous surgeries, IVFs and my earlier miscarriage, and she also went through a vast amount of information regarding what care I could expect to receive during my pregnancy, what I should and should not be eating etc, etc.
There was also a great deal of talk about "when you go into the hospital to have the baby" and "after you bring the baby home".
This unwavering certainty that there would be a baby at the end of it is, I think, what troubled me most about the appointment. So far, I've been doing a pretty good job of living in the present of this pregnancy. I focus on making it to the end of each day, possibly to the end of each week. My imagination simply does not carry me any further than that. I cannot project myself forward to some mythical point in the future when I am safely delivered of a healthy baby.
But now it seems that this pregnancy has assumed a momentum independent of that which is going on inside my body. The form which I filled in with the midwife has been sent off to the hospital, and it will be logged in their registers. In due course, I will be sent a number of other appointments: for a 16 week check up with the midwife, for a 20 week scan at the hospital. I am 'officially' pregnant, and there is a paper trail to prove it.
And so, for the first time, I am beginning to feel the weight of the external expectations surrounding this pregnancy - and this before we have told either of our families.
Tuesday, 9 September 2008
As we walked the long, lonely walk down the corridors of the hospital to the Great Big Infertility Clinic, Mr H wondered how many times in total we'd walked that walk. Sitting in the waiting room, flicking unseeeingly through a magazine, I thought back to all the other times I'd sat on those sofas. I thought about how I'd started out on this particular journey with such high expectations, and how those expectations had rapidly spiralled downwards following two poor responses to stimulation, a polyp and a diagnosis of diminished ovarian reserve. My dates with the dildocam generally have not yielded positive results, and I worried about all that could have gone wrong this time round. Thoughts of a missed miscarriage swirled round and round in my head.
Eventually, the nurse called me in to see Dr Approachable, who was wielding the dildocam this morning. The heartbeat is still going strong, and the foetus has tripled in size over the past fortnight to 1.84cm in length. Based on my last period, I am currently 8 weeks and 1 day pregnant, however the foetus is measuring in at 8 weeks 3 days.
Afterwards, we had a brief conversation as to why this entirely unexpected pregnancy might have happened. Dr Approachable reckoned that it was all down to the removal of the polyp, and quoted various journal articles in support of his theory. I explained that I thought that it was thanks to the Chinese Fertility Goddess. Dr A conceded that acupuncture could be helpful in encouraging patients to relax. "Come on, Dr Approachable," I retorted. "If all any of us needed to do was relax, then surely you'd be out of a job?!?"
But then it was time for us to leave. "You will send us a picture in seven months time, won't you?" asked Dr Approachable, as he shook our hands.
And so I appear to have graduated from the Great Big Infertility Clinic. From now on, I will receive standard NHS antenatal care.
But, as we walked away down the corridor, I realised that, even though I may have left the Great Big Infertility Clinic behind me for the time being, it is a lot harder to leave behind the feelings associated with being infertile.
Friday, 5 September 2008
A few months ago, the cat developed a urinary tract infection. The vet gave her a shot of antibiotics, and recommended that we switch her from dry to wet food. Because I love my pet very much indeed, I immediately dashed off to the supermarket and bought the tastiest-sounding wet food I could find. It is conveniently packaged in individually portioned pouches (so no more wrestling with unruly tin openers) and comes in a whole range of gourmet flavours, including such delights as 'flakes of ocean fish with whole prawns in jelly' and 'succulent duck and turkey in a rich meaty gravy', all of which the cat absolutely adores.
The brand in question is advertised on television by a large Persian cat, a fact which may play a role in the current face-off: Mr H distrusts all Persian cats on principle, as he is convinced that they are all secretly plotting world domination. He feels that 007 made a fatal error in not recognising that the cat, rather than Blofeld, was in fact the real brains behind S.P.E.C.T.R.E.
Unfortunately for the cat, I can no longer stomach the smell of her food (the sickness has really kicked in this week), and so Mr H has had to take over on that front. He returned home the other evening bearing a box of supermarket own-label premium cuts in jelly. 'Look at these,' he exclaimed, 'they're half the price of those bloody gourmet things you insist on buying.'
Gone are the flakes of ocean fish, the recognisable prawns, the succulent duck and the rich meaty gravy. Instead, Mr H has served the cat a range of rather more prosaic (and far smellier) options - 'beef', 'lamb' or the generic 'poultry' - all of which she has so far refused to eat. She is digging her paws in; Mr H is digging his heels in. Both of them appeal to me: the cat cries piteously, while Mr H presents me with detailed costings showing exactly how much we could save over the course of the next six months, if only the cat could be persuaded to eat the premium cuts in jelly.
Though I have made it clear to them both that I do not wish to get involved in their dispute, I'm secretly convinced that the cat may prevail - she is capable of exhibiting, if not dogged, then perhaps catted, levels of persistence, particularly when there are gourmet pouches involved!
Monday, 1 September 2008
On Thursday of last week, I suddenly experienced a wave of intense anxiety. I crawled into bed and gave in to the fear that I would once again miscarry. "I can't lose this baby," I sobbed to myself. "I simply can't go through all that again."
It was only later that I realised that I was at that point six weeks and four days into the pregnancy - the exact time at which I began bleeding last time round.
But I didn't start bleeding. And somehow it feels very significant to have made it beyond that point. I have only just realised that I have been so completely focussed on the idea that I would miscarry, that I haven't really considered the possibility that I might not.
But now I am entering into the seventh week of pregnancy. I am sailing into uncharted waters. And, although I remain acutely aware of all that still could go wrong, I am no longer as convinced that it will necessarily all go wrong. I am slowly learning to balance the terror of another miscarriage against moments of unconditional joy, when I am able to accept the fact that, against all the odds, and without medical intervention, I am in fact pregnant.
Wednesday, 27 August 2008
But the gap between fantasy and reality is inevitably huge. And so this morning I did not march into Dr Abrupt's office and tell him where to stick his dildo cam and his syringes of FSH. Instead, I babbled about possibly faulty pee sticks. I told him about a dog I had as a child that suffered from repeated phantom pregnancies. Fortunately, he cut me off just as I was about to launch into a story about Anna O, Joseph Breuer's famous patient, and her hysterical pregnancy. "Why don't we do a scan and see what we can see?" he asked patiently.
And there it was - what Dr A described as a 'perfectly normal and healthy six week pregnancy'. He pointed out the pregnancy sac and, nestled inside the sac, was a little tiny bean just over 1/2 centimetre in length. Could I see that small pulsating dot, he asked. "That's the baby's heart beating."
And that tiny flickering somehow made it much easier for me to believe in this pregnancy. Obviously, it's still incredibly early, but my sense of hope is growing stronger along with my symptoms.
Dr A told me that I should now go ahead an appointment with the midwife at my GP's practice, as there are decisions we need to make with regard to antenatal care. "If I had conceived through IVF, you'd scan me again in another couple of weeks here at the Great Big Infertility Clinic, wouldn't you?" I asked. "Not necessarily," he replied, "if we see a heart beat and everything looks normal at six weeks, we'll generally just refer you back to your GP." "But what about hysterically over-anxious women who've already had one miscarriage?"
"Oh, well," he smiled. "We do make an exception for them. We can fit you in for a second scan on Tuesday 9 September, if you like."
And so it seems that I am destined to continue to living my life in two week increments.
Wednesday, 20 August 2008
And yet the past week has passed by at a crawl. With every passing day, I grow increasingly anxious that I am about to miscarry for a second time. Every twinge, every cramp, sends me scuttling off to the bathroom to check whether I have started bleeding. The time between now and next week's scan seems to stretch out into eternity.
Time is thus at once speeding up and slowing down. Were I a quantum physicist rather than an art historian, I could no doubt come up with a complex mathematical equation that would neatly encapsulate this paradox (possibly I would also find it easier to find gainful employment once I have submitted the thesis). Instead, I seek to distract myself during this seemingly endless wait by knitting and by watching the Olympics. Mel wrote last week about how we inevitably find ourselves viewing the Games through the lens of infertility. She pointed out how hard it can be to watch those who are at the pinnacle of bodily achievement when one's own body is not co-operating, how difficult it is to see other people achieving their dreams when one remains so far from achieving one's own.
When watching the Olympics, my feelings aren't with those standing on the podium, but with those who were pipped at the post. All of the athletes competing at the Games trained for years and years to get to that point. They made great personal sacrifices and poured all their energies into achieving that one thing. In many cases, their dream is over in a matter of seconds. And I cannot help but worry that the same may be true of this much longed for, but entirely unexpected, pregnancy.
Intellectually, I know that, if this pregnancy is viable, then it will continue. If it is not, then I will miscarry, and there will be nothing I or the doctors can do to prevent it. And so all I can do is to hope with all my heart that I make it to next week's scan, and that everything looks as it should.
Thursday, 14 August 2008
By the end of last week, I was anxiously awaiting the arrival of my period: the plan was that I would ring the clinic when it arrived, so that we could start a natural cycle FET. I normally have a 26 day cycle. Day 26 came and went, with no sign of my period. It didn't show up over the weekend, although I did experience some on and off cramping. We went out to lunch on Sunday, when I noticed Mr H staring admiringly at my chest. "Is it me, or are your breasts bigger than usual?" he asked. When I came to think about it, they were feeling pretty tender.
Late period, cramping, sore breasts... the idea popped into my head, but I dismissed it. I know you hear about women who suddenly get pregnant without medical intervention even after several failed cycles of IVF, but that's just an urban infertility myth isn't it? "I'm sure it's just this top," I told my husband. "Now, what are you having for your main course?"
I began to roll the possibility over and over in my mind. At first, I was too scared to test: I was convinced that it would be negative, and I just wanted - however briefly - to enjoy the fantasy that we had somehow managed to beat the odds and conceive spontaneously, before my period arrived and all my hopes came crashing down.
But by Tuesday my period was five days late. And so I took a deep breath and POASed. Straight away a line showed up in the 'pregnant' window. I woke Mr H up. "Look at this," I demanded. "It must be a faulty test."
I took another test yesterday morning - again a clear and unambiguous positive. I still couldn't quite believe it, so phoned up the Great Big Infertility Clinic to demand a beta. The nurse explained to me that it wasn't necessary. Two positive HPTs were proof enough. But what if my HCG levels aren't rising, I asked. What if I'm about to miscarry? What if it's ectopic? Should I perhaps start the progesterone pessaries? She explained that, given that I had conceived spontaneously, my body should be producing all the hormones it needed to sustain the pregnancy. "Just try to relax and not to worry too much," she added.
But I have been here before. I am all too aware of just how abruptly these things can come to an end. I feel as though the rug could be pulled out from under my feet at any moment. And so I'm not going to jump up and down screaming hysterically about my 'big fat positive'. Instead, I'm going to hold my breath and wait very quietly until I go for my first scan on 27 August.
Wednesday, 6 August 2008
Mr H is away on work, and so I walked the long lonely walk down the corridors of the hospital by myself. I passed the NICU and the delivery suite before pushing open the double doors to the clinic. I sat down in the waiting room and read the December 2006 edition of Marie Claire magazine. Eventually they called my name and I went in to see Dr Abrupt.
Dr Abrupt and I appear to have reached a rapprochement. I wrote to him and explained that I was unhappy that he chose to communicate information about my treatment to my GP and not direct to me; he wrote back and apologised. We have agreed that, if the FET is not successful, we will arrange a longer appointment to discuss where we might go from here.
The baseline ultrasound revealed that I had ovulated from my right ovary this month, and that my lining was good at 14mm. Dr A reassured me that everything looked entirely normal, and that he is happy to attempt a natural FET on my next cycle.
But I cannot escape the feeling that we have been here before. I always manage to pick up the December 2006 edition of Marie Claire in the waiting room; my baseline ultrasounds always look 'entirely normal'... and then something always seems to go horribly wrong: either my ovaries don't respond to stimulation and the cycle has to be cancelled, or else a polyp suddenly shows up in my uterus.
And so it is difficult for me to believe that everything may go according to plan this time round. Our one embryo was frozen at pronucleate stage (Dr A explained that this is the clinic's usual policy if they know for sure that they will not be proceeding to transfer, the thinking being that embryos are more robust at this earlier stage and so are more likely to survive the freezing process). It not only has to survive the thaw, but also to go on to cleave. I find it hard to allow myself to believe that it may actually make it out of the freezer unscathed, yet alone develop into a viable embryo that is able to be transferred.
Sometimes people tell me about the power of positive thinking. But it's hard to remain positive when experience has taught you otherwise. Somewhere along the lines, I've lost my IVF innocence. Of course, I still hope that this may work, but I no longer believe unconditionally in happy endings. And if all it really took was a bit of positive visualisation, then surely we'd all be pregnant by now?
Thursday, 31 July 2008
I too am struggling with similar questions. I started blogging in a bid to try to make sense of what I was going through, and also as a means of connecting with others who were in a similar situation. And in the process I have found myself part of a much larger, grass-roots movement. It strikes me that part of what is happening here in the blogosphere is what second-wave feminists might have termed 'consciousness raising': in sharing and analysing our own personal experiences, we are in the process of creating a discourse on infertility and pregnancy loss, and that awareness of these issues is - however slowly - beginning to filter out into wider society.
On another level altogether, I often experience a sudden flash of recognition when reading other people's blogs. Sometimes it seems that others are able to articulate what I cannot: it is only through reading other women's stories that I am able to gain access to parts of my own life narrative.
What we cannot or will not say can be as revealing as what we do say. I often have ideas for posts that I don't write - this may be because I simply never get round to it, or because after a few days whatever it was I wanted to say no longer seems that important. But there are other things which I consciously avoid writing about, most notably my work. I am anxious lest anyone should search for either my real name or my research topic and be led here to my blog.
And yet it is becoming increasingly difficult for me to maintain such a clear cut separation between my interests as a feminist academic, and my lived experiences as an infertile woman. In the spirit of Mel's latest initiative, I want to try and build bridges between these two areas of my life. And so I am beginning to gather material for a book that examines the feminist discourse on infertility (or, perhaps more accurately, the lack thereof). I'm interested in the fact that, while feminism has been quick to embrace the possibilities represented by ART (ART has been seen by many feminist theorists as a positive thing, in that it loosens the ties that bind motherhood to biology), it is noticeably silent on the impact that infertility can have on our identity as women.
Friday, 25 July 2008
Since when did daily hormone injections and scans take the stress out of trying to get pregnant?!?
For the love of g*d! IVF isn't a lifestyle choice for celebrities who are "too impatient" to try and conceive a child through good, old-fashioned, loving sex, or who just want to "knock out" two babies in one go, so they can reach their target number of kids. It is a MEDICAL treatment, which was developed to help those with MEDICAL conditions.
No wonder we have to keep spelling it out.
Tuesday, 22 July 2008
When I arrived at the salon, there was no-one at the reception desk. All of a sudden, a very bright and smiley woman appeared from out of nowhere. Was I there for my ultrasound, she asked.
Like many women, I like to have a little tidy up before my dates with the dildo cam. I generally make sure that I book in for a wax the week before my first appointment at the clinic. Had I somehow mixed up the two appointments in my diary? I stopped for a moment to double-check. I was definitely in the beauty salon, and not the Great Big Infertility Clinic.
No, I was fairly sure that I had a waxing appointment, I replied.
"Take a seat in the waiting area," the smiley woman said, ushering me into a room full of women in varying stages of pregnancy.
"Are you here for a scan, too?" asked the woman next to me, happily stroking her belly. "I'm so excited, I can't wait to see how much the baby's grown."
By this stage, I was beginning to feel like I had stumbled into the Infertility Twilight Zone. All became clear, however, once I finally got in to my appointment. The therapist explained to me that they had decided to rent out a room to a private medical company that performs those 4D scans where you get to see the baby suck its thumb, yawn etc, etc.
And so it seems that nowhere is safe. I can't even get a wax without being surrounded by reminders of my infertility.
Tuesday, 15 July 2008
The BBC news coverage of her birthday celebrations highlights the fact that, although IVF was pioneered in the UK, the majority of cycles undertaken in this country are paid for privately. Professor Robert Edwards, one of the doctors responsible for developing the treatment, voiced his regret that IVF was not more widely available on the National Health Service (NHS).
In 2004, the National Institute for Health and Clinical Excellence (NICE, the financial watchdog for the NHS) recommended that all infertile couples in which the female partner is aged between 23 and 39 should be offered three fully funded cycles of IVF.
The NHS is administered by a number of different Primary Care Trusts (PCTs), each of which is responsible for delivering health care to their local area. Each individual PCT manages its own budget and sets its own priorities. What this in effect means is that access to certain therapies - and even to certain drugs - is determined by where in the country you live (the so-called 'postcode lottery').
Figures recently released by the government have revealed that, out of a total of 151 PCTs, only nine are offering the recommended three cycles of IVF. About two-thirds of the trusts offer only one cycle. Four offer no funding for IVF whatsoever. More than half reject those who already have children, including those from previous relationships. Many impose additional social criteria: 35 trusts specify that neither partner must smoke, 30 say that patients must be in a stable relationship, and 33 impose age restrictions beyond those in the NICE guidelines.
We have been on an NHS waiting list for IVF treatment since October 2004. During that time, we foolishly decided to move house. Our new PCT was not willing to take into account the time we had already spent on the waiting list in another area, and so we went to the bottom of their list. In May 2007, we received a letter explaining that, owing to financial difficulties, the PCT had taken the decision to withdraw all funding for assisted conception treatments. That funding has yet to be reinstated.
We are fortunate that we have been able to save the money to pay for private treatment. But, to many couples, an NHS funded cycle represents their only chance for a baby. Whether or not they get that chance is determined by where in the country they live.
But, regardless of the iniquities of the postcode lottery, today I would like to propose a toast: to Louise Brown, and the 3 million other babies that have been born as a result of IVF, and to Robert Edwards and his colleague Patrick Steptoe, who together pioneered the treatment, for giving infertile couples the hope of having a child.
Thursday, 10 July 2008
This story could - and should - have generated debate about the severe shortage of both egg and sperm donors in this country. Instead, it provoked a range of predictable concerns about the so-called 'selfishness' of women determined to extend their reproductive life beyond what is 'naturally' possible. I listened to a radio phone-in on the topic, in which several callers pointed out that the woman in question would be in her seventies by the time her daughter was a teenager, and would in all probability not live long enough to see her mature into an adult woman.
This is, perhaps, a legitimate concern. Having suffered the effects of premature maternal bereavement first hand, I know how traumatic the loss of a mother during late adolescence/early adulthood can be. My mother was first diagnosed with breast cancer when she was thirty seven, just one year older than I am now. She died two months after her forty-fourth birthday. As I have grown older, I have become less convinced that I am destined to follow the same way, and yet it is always in the back of my mind: if I have a child now, and die at the same age as my mother, then that child will be just seven years old. In my experience, mothers do die, and leave their children before they are ready, and I cannot help but worry that that may happen again.
But this case also sent me back to the perennial question, when is enough, enough? At what point do you decide to let go, to move on, to build a life for yourself beyond infertility? I seem to have spent much of my thirties trying unsuccessfully to have a baby. And I am tired - I am tired of the endless monthly cycles of hope and disappointment. I am tired of the repeated minor surgeries, of the injections and internal scans. I am tired of having to plaster a pleased expression on my face whenever I hear about someone else's surprise pregnancy. I am tired of crying all the time. I am tired of feeling a failure. I don't know how much longer I can keep putting myself through this. I cannot imagine that in another twenty years, I will still be plugging away at fertility treatments, still living from cycle to cycle.
Given my most recent prognosis, I can no longer believe unconditionally in happy endings. Of course I have hope that I may yet have a child, but I am also beginning to confront the fact that childlessness remains a very real possibility. I know that I will be forever scarred by infertility. I feel that it has robbed me of a major part of my identity as a woman. There will, of course, always be reminders of the baby I lost, of the children I might have had. And yet, I hope that, over time, I will journey towards some kind of acceptance. My life will follow a different course from the one I had envisaged, but it will continue nonetheless.
But what happens if, when other women my age are seeing their children off to university, or even welcoming their first grandchild, I am still longing for a baby? What if that deep, visceral ache for a child never subsides?
Monday, 7 July 2008
This morning I received a copy of a letter sent by Dr Abrupt to my GP (general practitioner), informing her that he had performed a hysteroscopy to remove my polyp last week. He also took the opportunity to fill her in on my most recent cycle of IVF, and to tell her that he considers my poor response to stimulation to be a reflection of 'reduced ovarian reserve, reduced ovarian function and reduced fertility potential of the eggs within the ovaries.'
This isn't entirely unexpected news, and yet it still came as a shock to see it written down in such bald terms. It is, moreover, entirely unacceptable that Dr Abrupt saw fit to communicate this to my GP, yet apparently did not think it worth his while to explain it directly to me, his patient. It also raises the question of whether or not we should go ahead with another cycle, as recommended by Dr Approachable, or whether it is in fact time for us to begin looking into other options, such as egg donation.
But, however angry I may be at the manner in which it was communicated to me, the facts of the matter remain. My ovaries are on their last legs. My eggs are past their use-by date. I have in all likelihood left it too late to have a baby.
Wednesday, 2 July 2008
I went in on Monday to have it removed. Fortunately, my private health insurance agreed to cover the cost of the hysteroscopy, and so I was able to go to the Fancy Private Hospital just over the road from the Great Big Infertility Clinic. Dr Approachable is away on his summer holidays at the moment, so the procedure was carried out by Dr Abrupt (who, incidentally, is far less abrupt when working out of the Fancy Private Hospital; perhaps the coffee is better over the road, or the chairs in the doctors' lounge more comfortable?)
Having had a laporoscopy in the past, I had been gearing up for something similar this time round, so was pleasantly surprised to learn that a hysteroscopy is a far more minor procedure. I was able to come home within a couple of hours of waking up, and spent much of yesterday on the sofa, reading magazines and catching up on the second series of Brothers and Sisters. I feel pretty much back to normal today, though.
Dr Abrupt came to see me just before I was discharged. He said that he'd taken the opportunity 'to have a good look round in there', and that everything looked perfectly fine. The polyp appeared benign, and my two small fibroids do not seem to be affecting the endometrium in any way. He is happy to attempt a natural FET on my next cycle.
And so, after the best part of two months on the bench, I will climbing back on board the ART rollercoaster.
Wednesday, 25 June 2008
It is seventeen years today since my mother died. She had just turned forty-four. I was nineteen.
In the first few weeks and months after her death, I thought that I would somehow sense her presence, or hear her voice. It took me a long time to accept the finality of death, that my mother had gone and was never coming back. Even now, I still dream about her. In those dreams, she hasn't come back to pass on some significant piece of advice or family lore, instead she is just simply there - sitting at the kitchen table drinking a cup or tea, or else stirring something on the stove. I wake up and, just for a split second, I am able to believe that she never really went away. But then the fact of her dying registers with renewed violence, and suddenly I am reduced not even to a young woman struggling to find her way in the adult world without a mother's guidance, but to a little girl who wants her mummy.
As many feminist psychologists and psychoanalysts have suggested, the experience of motherhood inevitably stirs up a woman's memories and fantasies surrounding her own mother. In becoming a mother herself, a woman identifies--whether consciously or unconsciously--with her mother. She tends to use her childhood experiences as a blueprint for her own mothering. For the motherless woman, motherhood thus holds out a particular promise: it enables her to re-enter the mother-child relationship, and hence to reconnect with her own mother.
Infertility has robbed me of that chance. Instead, as I mourn both the mother I once had, and the child I might have had, I feel that my links with what Jungian analyst Naomi Lowinsky calls the "motherline" have been irrevocably severed. I feel lost. Cast adrift. And it is at moments such as this that it seems that all I am ever going to feel is grief, loss and emptiness.
Monday, 23 June 2008
In parts, the article makes for depressing reading. It cites some recent research carried out by the University of Wisconsin, which revealed that the average wife does 31 hours of housework a week while the average husband does 14 - a ratio of slightly more than two to one. As one academic interviewed for the article points out, this ratio has not altered substantially over the past ninety years: back in the days when women had to tend fires and put clothes through the wringer and then hang them outside to dry, the average woman spent 50 hours a week on housework, and the average man 20.
The article set me thinking about the division of labour within my own marriage. Our current lifestyle is by and large enabled by two things: Mr H's salary, and my unpaid domestic labour. Although I do some part-time teaching when the opportunity arises, to all intents and purposes Mr H is the sole earner. He has assumed full responsibility for covering all our monthly outgoings while I am writing up my PhD. Looking at other postgraduate students, many of whom are struggling to hold down several part-time jobs while also trying to write up, I realise how lucky this makes me.
In return, I do the bulk of the shopping, cooking, cleaning and laundry. Sometimes I resent this - particularly at weekends, when he is sitting in the living room watching the television, while I am scrubbing the bathroom or changing the bed linen. Once I am able to take on more regular paid work and am contributing to the household finances, the situation will have to change. Either we will have to divide the chores more equally, or we will have to use some of that extra income to pay for extra help around the home.
But how would this change if we were to have a child? For the purposes of the University of Wisconsin survey, housework was defined as things like cooking, cleaning, yardwork and home repairs. Child care was an entirely separate category: where the housework ratio was two to one, the wife-to-husband ratio for child care in the United States turned out to be closer to five to one.
For the NYT article, author Lisa Belkin interviewed a number of couples who were determined to buck the trend, and to take equal responsibility both for parenting and for domestic chores. What I took from the article was just how hard they had to work to achieve this - not because of any ingrained resistance on the part of either partner - but because of a marked reluctance by employers to afford their employees, whether men or women, the right to flexible working.
One of the couples interviewed said that, before having children, they had decided to get a dog. The husband explained that it was a kind of 'test' to see how willing they both were to change their schedules to accommodate this additional responsibility: "we would have to decide who would take the dog out at night, who would walk her early in the morning, who could work with vomit.”
Although Mr H is very good at dealing with vomit, the cat remains by and large my responsibility: I am the one who remembers to buy more cat food, who knows when her vaccinations are due, who arranges to take her to the vet. Interestingly, the cat herself appears to perceive me as her primary care giver: when she decides at 5 o'clock in the morning that it is in fact time for breakfast, it is me who is awoken by a polite but persistent paw tapping at my face!
Would this also be the case if we were to have children? I think that both of us would have to work very hard to ensure that it did not become so. As Bitch PhD points out, if equal parenting is going to work, both parents have to want it equally. On this issue at least, "feminism needs men, which means we *all* have to get over our gender essentialism."
Both Mr H and I are the products of very traditionally gendered relationships: both of our fathers were the sole earners, while our mothers assumed full responsibility for the home and for childcare. For better or worse, that remains our model of a successful marriage. There are moments when - in spite of all our intentions - we tend to fall back upon stereotypical ideas of what constitutes "men's work" and "women's work": he takes out the rubbish and checks the oil in the car, while I do the laundry (I do, however, draw the line at ironing his work shirts!). The knack is, I think, to be aware of what kind of assumptions underlie these decisions, and to continue striving towards a relationship in which we are both equal partners and peers - even if this is sometimes easier said than done.
Thursday, 19 June 2008
But SATC was also ultimately a fairy tale, a fantasy in which no-one ever so much as popped out for a pint of milk unless they were wearing full makeup and a pair of Manolos. And that is why those who criticised the ending of the original series were perhaps missing the point. As all little girls learn very early on, at the end of every fairy tale, the princess settles down with a handsome prince and lives Happily Ever After. Carrie was always going to end up back together with Big, and even Samantha was probably going to fall for someone at some point (although that particular plot line said more to me about how uncomfortable our society continues to be with actively desiring women once they reach their forties and fifties - once female sexuality is no longer tied to its reproductive function, in other words).
But sometimes we could all use a bit of harmless escapism. Mr H started his new job this week, and flew out to Madrid first thing on Monday morning. In his absence, I am struggling on with the slow, hard slog of writing. Home alone, I find that my inability to conceive or to carry to term a child is weighing even more heavily than usual. And so I decided to take myself off to the cinema, to renew my acquaintance with Samantha, Charlotte, Miranda and Carrie. All I really wanted was to forget about the PhD and the failed cycles of IVF, and to enjoy a couple of hours of fashion and frippery.
And then it happened. Even sitting in the dark at the cinema, I am apparently not safe from the news of other people's surprise pregnancies. Perhaps I should have been better prepared for Charlotte's little announcement; as I wrote above, happy endings are, after all, pretty much inevitable in SATC land.
What saddens me about this aspect of the film was the inference that adoption didn't quite provide a happy enough ending, and that the best possible outcome to an infertility storyline is a child that is genetically related to both its parents. What kind of message does that send out to those who have adopted, or who are considering adoption, or indeed to those who are themselves adopted?
But what really, really angered me about it was that, in breaking the news to Carrie, Charlotte went on to say that, according to her doctor, this happens all the time, that lots and lots of previously infertile women suddenly get pregnant just after they've adopted (Really? Does anybody out there know anyone in this situation? No? Me neither!), and that sometimes all you need to do is to stop trying so hard.
So, according to Sex and the City, all any woman struggling with infertility needs to do is to relax! Sound familiar?
When even such an influential cultural product as SATC continues to perpetuate such myths, then it becomes difficult to hold out much hope that social attitudes towards those struggling with infertility will change at any point in the near future.
Thursday, 12 June 2008
The month before we were due to start treatment, we went on holiday. I'd stopped charting at that point, so it wasn't until we got back home that I realised that I was a whole week late. Prompted by Mr H, I took a home pregnancy test for the first time in my life. I sat and watched incredulously as that magical second line appeared. Just to be sure, I took another test the following morning - and there it was again. I went to the doctor's, where a third test confirmed that yes, I was in fact pregnant. For two whole weeks, I hugged the precious secret of my pregnancy to myself. With every wave of nausea, it started to seem more and more real.
And then the bleeding started.
They booked me in for a scan later on in the week, but by then I already knew that I'd lost my baby. 'You've been a very lucky girl,' said the sonographer. 'The evacuation is more or less complete; you won't need surgery.' And so, two years ago to this day, I was discharged from the early pregnancy assessment unit at our local hospital.
That was it. My one brief experience of pregnancy.
And two years on, two attempts at IVF down the line, I can't help but wonder whether that was in fact my one shot, my only chance. Would all the subsequent BFNs somehow be easier to deal with if I hadn't had that one brief positive?
Monday, 9 June 2008
How was I, asked Dr Approachable.
I explained that, after two poor responses, I was wondering how many more times I could put myself through all this. Was it perhaps time to start exploring other options, such as egg donation?
And then Dr Approachable uttered the magic words, 'Well, I'm not willing to give up on you just yet.'
Although he and I both now agree that my left ovary does not appear to be functioning as it should, the (Day 9) scan revealed eight follicles on my right ovary. Dr A considers this an indication that there is still clearly something left to stimulate, and so is not willing definitively to diagnose diminished ovarian reserve. He has a plan of action:
First of all, I need a hysteroscopy to deal with the polyp. I phoned my private health insurers this morning to check if this is covered under my policy. They will not pay if it is being done as part and parcel of fertility treatment (UK health insurers will not cover anything whatsoever to do with assisted conception), but will do so if Dr A is willing to recommend that it is an abnormality which should be investigated and removed regardless. If they won't pay, then we will have no option but to find the money ourselves, or else to sit it out on an NHS waiting list.
Once the polyp has been dealt with, we will then attempt to thaw and transfer the one embryo that resulted from this last cycle. Since I ovulate regularly, Dr A suggested that we do a natural cycle FET. I am more than happy to go along with this, as I am reluctant to pump myself full of yet more drugs - particularly when there is a possibility that that one embryo may not survive the freezing process.
If the FET doesn't work, then Dr A recommended that we try an antagonist protocol next time round. In contrast to many of our previous appointments at the Great Big Infertility Clinic, where I've barely had a chance to put my knickers back on before being hussled out of the door, he was in particularly relaxed and chatty mode (perhaps it being a Saturday had something to do with it), and explained in detail the different effects of GnRH agonists and antagonists on the pituitary gland. Given that I haven't responded particularly well either to a long or a short GnRH agonist protocol, he feels that an antagonist protocol may be a better option for us.
We also had a lengthy conversation about the pros and cons of urinary vs. recombinant FSH. Dr A remains a fan of urinary FSH, as he believes that it has the added benefit of LH, which may help with the quality - if not the quantity - of eggs produced.
I'm still struggling with the question, when is enough, enough? But I think I'm coming round to the idea that all any of us can do is take things one step at a time, one cycle at a time. So, first things first, I'm going to deal with the polyp.
Monday, 2 June 2008
Voltaire is right. We can waste an awful lot of time wondering 'why?' and 'what if?'. Sometimes terrible things do just happen. Our infertility was not caused by anything we did or did not do; it is rather just a piece of biological bad luck, a random instance of dodgy plumbing. And there are indeed times when all any of us can do is tend to our gardens.
We live in one of a row of small terraced houses that was initially built by an enlightened Victorian factory owner to house his workers. What my father somewhat grandly refers to as my 'courtyard garden' is in fact a small back yard, which would originally have housed the coal shed and the outside privy, but which is now filled with an ever-expanding collection of pots, in which I attempt to cultivate a selection of flowers, vegetables and herbs. Although my efforts pale in comparison with those of some of my fellow bloggers, I am quite happy pottering about in my yard.
I do have one raised bed, which has largely been taken over by a very vigorous passion flower that has a tendency to choke all other plants in its vicinity. At the weekend, I went out into the yard armed with a pair of secateurs, intending to chop it into submission. But then I discovered a small nest right in the very centre of the plant. Inside the nest are three bright blue eggs.
I am trying very hard not to attach any wider symbolic significance to the eventual fate of these three eggs.
Friday, 23 May 2008
A Very Nice Man has just been to mend my cooker. 'Don't worry,' he exclaimed, peering into the nether regions of the oven. 'I know exactly what the problem is. I'll have you up and running again in no time.' He explained that the element had gone. 'I see this all the time. How long have you had the oven for?'
'Three years,' I replied.
'That's about the length of time I would have expected,' he answered. 'Manufacturers no longer build these things to last; instead they hope that, when they do break, you'll just go out and buy another one.'
Since he left, I have been thinking about this a lot. Apparently, we now live in such a disposable culture that, when something breaks, we simply replace it with a newer model. But what happens to everything we throw out? We live on an extremely small island; all this rubbish has to go somewhere. All morning, I have been haunted by visions of vast stacks of discarded white goods being piled up in fields across the country. If we do have a child, will it grow up to consider itself fortunate if it finds an abandoned chest freezer to live in?
The ice caps are melting, the polar bears are drowning, and yet we carry on consuming. The way in which we lead our lives really does seem to me fundamentally unsustainable. It is at moments like this when I am sorely tempted to decamp to a small holding somewhere in the wilds of Wales, where I can grow my own vegetables and spin my own yarn...
Wednesday, 21 May 2008
And so we decided to go out for dinner. As we settled into our seats in our local Italian restaurant and ordered a bottle of Chianti, we suddenly felt carefree and childfree, rather than gloomily childless.
But, over the course of the meal, our conversation inevitably turned to the topic of our infertility - in particular, what we might do should the FET be unsuccessful. I said that I thought that there was still an outside chance that we might conceive spontaneously; we managed it once before, after all. "I think we're about as likely to spontaneously combust," retorted Mr H.
As he himself is fond of telling me, one of the main reasons I married my husband is for his excellent sense of humour!
Thursday, 15 May 2008
The Pink Rose Awards were inaugurated by Kymberli, who blogs over at I'm a Smart One. She explains why she started this fantastic initiative:
In this blogosphere we read and feel each other's joys and pains. When people can't hope for themselves, we try to have hope for them, even if we feel that all hope is lost on our own situations. No matter how we express it, what I think we feel but do not often say about hope is this: we hope will have the strength to live through whatever is handed to us, and that come what may, we will be alright. How many times have you wanted to let someone know that they are appreciated and that you find them and their words beautiful? How many times have you wanted to lift someone up and said a silent prayer that she or he would be able to heal? How many times have you felt a fellow blogger's isolation and wanted reach out to let them know they weren't alone? Here's your chance. Give the Pink Rose Award to those who inspire you or need to be inspired, to those who have encouraged you or those who need encouragement.
The rules are as follows:
1. On your blog, copy and paste the award, these rules, a link back to the person who selected you, and a link to this post: http://smartone.typepad.com/smartone/2008/05/pink-is-my-favo.html. You will find the story behind the Pink Rose Award and other graphics to choose from there.
2. Select as many award recipients as you would like, link to their blogs (if they have one), and explain why you have chosen them.
3. Let them know that you have selected them for an award by commenting on one of their posts.
4. If you are selected, pass it on by giving the Pink Rose Award to others.
5. If you find that someone you want to nominate has already been selected by someone else, you can still honor them by posting a comment on their award post stating your reasons for wishing to grant them the award.
6. You do not have to wait until someone nominates you to nominate someone else.
I would like to send a whole bouquet of pink roses right back to Luna, not least because today is her birthday. Luna has been through so much over the past six years, and I wish with all my heart that things could have turned out differently for her. She writes so movingly and yet so beautifully about the intense pain of infertility, and I feel that I have learnt a great deal from her wise meditations on grief and loss.
I'd also like to send a rose to Pamela Jeanne: another brave woman who tried and tried. On her blog Coming2Terms, Pamela Jeanne explores how infertility continues to take its toll long after treatment has stopped. As motherhood begins to seem an increasingly remote possibility, I am grateful to Pamela Jeanne for reminding me that life can and does go on, even if that positive pregnancy test never happens. PJ is a wonderful writer, and I hope that she finds a publisher for her book very soon.
Finally, I'd like to send some roses to two other bloggers who are having a tough time at the moment: Malloryn and the Babychaser. Malloryn had a particularly difficult Mother's Day, yet responded with tact and dignity to some highly insensitive comments made to her by her mother and aunt. The Babychaser recently received a negative from her third IVF cycle, and is struggling to remain positive as she heads towards a FET. I think that both of them deserve a bouquet of flowers.
Wednesday, 14 May 2008
Over the past couple of weeks, I've found myself inexplicably drawn to the IF message boards. I spend hours scrolling down through the animated emoticons and the liberal sprinklings of baby dust searching for women in a similar position to myself. What I suppose I'm really looking for is hope: hope that our one embryo may emerge from the freezer unscathed and then implant, hope that I may yet have a better response on a different protocol. I read about wheatgrass, DHEA supplementation and oestrogen priming protocols. I torture myself with stories about those who had repeated cancelled cycles, and who then went on to conceive naturally after a course of acupuncture. The boundaries of what is possible with ART are constantly being pushed forward, and the temptation is to assume that there must be something else out there - a different clinic, an experimental new protocol, or some kind of complementary therapy - that may make the difference for us.
A few months ago, several British newspapers reported the story of a couple who had eventually conceived after fifteen attempts at IVF. Over a ten year period, they had spent nearly £65,000 on fertility treatment. They had twice remortgaged their home, and had each worked two jobs to cover the cost of those repeated cycles. They finally brought their baby daughter home from the hospital in January of this year. Implicit within this story was the assumption that, if you want it badly enough, and if you just keep going, you'll get pregnant in the end.
It's an assumption which, it seems to me, also haunts the infertility community. I've recently read a couple of posts written by other IF bloggers wondering whether or not to put themselves through another cycle. In these posts, I could not help but detect a certain note of guilt and anxiety lest they should be perceived by others still in the trenches as having 'given up' too soon.
There is no set number of treatments you should have to go through before you decide that enough is enough; each of us has our own individual limits. Given my poor response on these first two cycles, the chances are that I will be prescribed high doses of FSH on any future cycles. I remain concerned about the possible long-term effects of those drugs. If I choose not to put myself through repeated high-dose stimulations, then it doesn't mean that I want a baby any less than someone who is willing to undergo multiple cycles of IVF. Stopping treatment does not in any way deaden the aching desire to become a mother; in many ways, it brings it into even sharper relief.
I'm not ready to let go just yet: while we still have that one embryo on ice, there is still hope. But I think that I am beginning to move towards an ending, and to acknowledge that that ending might not necessarily be the one that I'd hoped for.
Monday, 12 May 2008
We went there for lunch on Saturday, and ordered a selection of cheeses and cured meats from their tasting menu. They brought us ruffled slices of prosciutto and bresaola, a hunk of wild boar pate, a mild yet unbelievably creamy goat's cheese, another, rinded soft cheese that oozed invitingly across the plate, a particularly pungent blue cheese, olives, preserved artichokes, sundried tomatoes, and a basket of wonderfully fresh bread.
They also serve a wide selection of wines by the glass, and are more than happy to offer recommendations based on your own individual preferences: Mr H, who likes big, heavy, full-bodied reds, had a glass of Barolo, while I chose a Sangiovese. One of the benefits of not drinking regularly, we decided, was that the occasional glass of wine feels like far more of a treat.
As we sat out in the sunshine, sipping our glasses of wine and talking about Mr H's new job, the dark cloud of infertility lifted - just for a moment, I felt almost like a normal person again. And so, without agonising about it too much, I ordered a double espresso.
Wednesday, 7 May 2008
The embryologist has just phoned. Three were immature, one was damaged as a result of the ICSI procedure, one showed initial signs of fertilisation but did not develop overnight, but one fertilised. The resulting embryo will be frozen, and put back in a later cycle, once we have dealt with the polyp. She also said that she did not think that there were any major problems with the quality of the eggs retrieved.
Obviously, there is still a long way to go - there is a chance that our one embryo may not survive the freezing process, let alone implant. But today I am going to allow myself to feel hopeful that we have this one chance, and grateful that I am part of this community: I went into retrieval knowing that you were all there with me, willing this to work out. I like to think that all those waves of positive energy made the difference!
Monday, 5 May 2008
As I continued on with the meno.pur injections over the course of last week, my abdomen grew progressively more tender. I interpreted that pain and discomfort as a sign that the drugs were working as they should. With every twinge, I visualised the follicles appearing on my ovaries. I imagined them growing to a good size. I attended Saturday's scan feeling optimistic. I was expecting a better response than last time round.
Since our first attempt at IVF was cancelled, I have trod that fine line between hope and caution. I have listened to those who told me that there was every reason to expect that I would have a better response on a shorter protocol, and with an increased dose of drugs. I have done everything I possibly could to try and ensure that this cycle worked. I have given up alcohol and caffeine. I have eaten as healthily as I possibly could. And nothing - not the weekly acupuncture sessions nor the expensive anti-natal vitamins - appears to have made any difference. The polyp is just the final fucking straw.
Yesterday, we toyed with the possibility of simply cutting our losses, of not going ahead with the retrieval. After my lap & dye test three years ago, I suffered a particularly bad reaction to the anaesthetic. I am exhausted by the prospect of having to undergo two sedations, and two unpleasant and uncomfortable gynaecological procedures in a short space of time: one to retrieve the eggs, another to get rid of the polyp. Neither of us are optimistic that this cycle will result in viable embryos. I have only two follicles, either or both of which may turn out not to contain a fully mature egg. Even if we get two eggs, they may not fertilise, or may be damaged as a result of the ICSI procedure. Any embryos we do get may not survive the freezing process.
I suspect that there may well be a problem with the quality of my eggs, as well as with the quantity. I have reached the point where I need to know whether there is any point in us continuing treatment; I'm not sure whether I can go through all this again. If we go ahead with the retrieval, then at least they will be able to give us some indication as to whether we have any chance of having a child that is genetically related to both of us. And so, at exactly midnight last night, I stabbed one final needle into my bruised, aching and swollen belly and administered the HCG shot. We will return to the Great Big Infertility Clinic for retrieval tomorrow morning.
Right now, I just want this to be over. I feel angry, let down and betrayed by my body, empty, barren.