Wednesday, 27 August 2008

Six weeks and counting

For years now, I have harboured secret fantasies of defying the odds and falling pregnant without medical intervention. Latterly, these fantasies have also involved my triumphant revenge over Dr Abrupt. I imagined myself breaking the news of a spontaneous conception to him. That would be him well and truly shown and told, I thought to myself.

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

Ms Heathen's Theory of Relativity

As the date when I am supposed to submit my thesis draws ever nearer, time seems to slip more and more rapidly through my fingers. That I will meet my self-imposed deadline of having a completed draft of the thesis written before I start teaching at the end of September is already seeming an increasingly remote possibility.

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

Against all odds

Something entirely unexpected has happened, which I am strangely reluctant to write about - it feels almost as if saying it out loud may jinx it.

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

Groundhog Day

This morning, I found myself back at the Great Big Infertility Clinic.

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?