Reproductively Challenged

Ghostly patterings

2011-08-20T06:20:00.008+01:00

About a month ago, Mel wrote a post which has haunted me ever since. She addressed the phenomenon of what she called 'ghost blogs':

I'm talking about those strange places on the Internet that haven't been closed; they remain up, abandoned, their owners disappearing into the ether. There is no final post at the top announcing the cessation of the project. On the contrary, the most recent post (which is sometimes years old) usually gives no sense that the blog is coming to an end. It's like walking into a house and finding the table fully set with a warm meal but devoid of people.

I have a number of such blogs in my reader: mostly people who, like me, have gone on to parent after infertility. In some cases, we were brought together solely through the coincidence of cycling at roughly the same time, but there were others with whom I felt I had some connection beyond our common experience of IF. I still wonder from time to time how they are, how they find the experience of motherhood.

And I'm acutely aware too that this blog has also become one of those 'ghost blogs'. I've come back to it a few times since my daughter was born, but it has lain more or less dormant for a little over two years. I'm loath to take it down: it represents a very a significant part of my life, but I've also thought very long and hard about whether I want to start posting in this particular place again. After much consideration, I've decided to move to new digs, to reflect the fact that I'm now in a very different place to the one I started this blog from.

I hope that, if there is anyone out there still following, you will come and see me over at http://ifsbutsandmaybes.wordpress.com/, where I try to work out what led me to step away from blogging, and also what's brought me back.

Twas the Night Before Christmas

2010-12-24T15:35:00.003Z

Four years ago, I spent Christmas Eve curled up on the bedroom floor in floods of tears at the thought that I might never get to fill a stocking for my child, or eat the mince pie he or she had left out for Father Christmas, or watch his or her face as s/he opened her presents.

Three years ago today, I started my first cycle of IVF.

This afternoon, I helped my daughter place the fairy on top of the tree. I saw the tears in my father's eyes as he watched his granddaughter riding the tricycle he made for her. And I remain deeply, deeply aware of just how blessed I am in those moments.

Happy Christmas to all of you who may still be reading. May 2011 bring you your hearts' desires, whatever stage of the IF journey you may be on.

Snippets

2010-06-17T20:10:00.002+01:00

I went back to teaching part-time after Christmas. Shinejil is right. It is extraordinarily difficult to juggle motherhood and academia. Fitting in all the preparation and marking nearly did for me. But I also learnt that, much as I love being a mother, I also need to think, and write and teach.
Little Miss is now fourteen months old. She's just at that inbetween stage: not really a baby any more, but not yet a toddler either. She doesn't want to go in the buggy, but isn't yet steady enough on her feet to get out and walk. She doesn't want to be spoon fed, but hasn't quite mastered self-feeding. All this leads to much frustrated screaming.
But she is nevertheless the most enchanting little being. I don't think that I will ever take the miracle of her being here for granted. Things could have so easily worked out very differently for us.
We went away on holiday to Cornwall, where I discovered that I may be turning into a gardener. I made notes about planting combinations, and fretted about how my nasturtiums were doing in my absence.
Which leaves me with a dilemma about what to do about this blog. Increasingly, what I want to write about is my garden and the other things in life that give me pleasure. But there are also things that I'd only feel comfortable saying to others in the IF community. So I was wondering, if I started a new blog, would you all come and visit me in my new digs as well as continuing to read this one? Could I maybe try cross-posting from time to time? How might it feel to maintain two blogs?
If I am going to start a new blog, should I stick with blogger, or maybe try wordpress? Any thoughts?

On Losing Your (Blogging) Mojo

2010-03-31T19:45:00.004+01:00

Sooo. It goes a little something like this. You spend years and years longing for a baby, and then you finally have one. And despite the fact that you've had all that time to think about it, you discover that nothing can really prepare you for life with a newborn. The first few months whip by in a blur; you barely have time to clean your teeth, let alone shave your legs. And then it slowly begins to dawn on you that it's been a really, really long time since you were intimate with your husband. You make a bit of an effort to initiate things in that regard, but you're tense because you're worried that the baby's going to wake up at any minute, you're still healing after a c-section, and it just hurts. And so you think to yourself that you'll try again in a few weeks' time, but somehow the right moment never quite arises. And the longer you leave it, the more of a big deal it starts to seem. You make excuses - you're tired, you want to finish your book, you fancy a soak in the bath. You begin to notice yourself tensing up every time your husband touches you, in case that innocent cuddle turns into something more.

And it's really rather similar with blogging. The longer you leave it between posts, the more difficult it starts to seem to write anything, and so you're reduced to writing slightly odd posts in the second person. You feel similarly awkward about commenting; it's been so long since you did so that you now feel almost as if you're butting in on conversations to which you're no longer party.

Mr H took a lot of video footage during the first few months of Little Miss's life. I remember thinking at the time that he was like one of those foreign tourists in the Louvre, who are so preoccupied with videoing the Mona Lisa that they do not stop to look at the painting itself. I decided that I did not want to be like that - to be so busy trying to document my impressions of my daughter that I failed fully to live each moment with her. But now I find myself completely transfixed by that early video footage. As mothers, we spend so much time with our children that the changes in them are so gradual as to be nearly imperceptible. It is only when I look back over those videos of Little Miss that I can really grasp how much she has changed over this first year. How on earth did that tiny baby kicking about on a play mat turn into a little person who can empty an entire box of tissues out onto the floor in the time it takes me to pop upstairs to the loo, and who can devour a huge bowl of stew and mash for her tea?

In some ways, I do regret not having written more about the first year of her life. My memories of those first few heady months are already beginning to seem increasingly hazy. But I feel determined not to let any more time slip through my fingers, and so this is my first attempt to regain my blogging mojo.

Resurfacing

2009-09-12T04:56:00.003+01:00

Hello. Is there anybody still out there?

I'm a little shocked to discover that it's been over four months since I last posted - and this isn't because I have nothing further to say on the experience of either infertility or motherhood, but more because I simply haven't had time to transfer my thoughts from my head on to the page (I know that I've also been pretty lax with regard to commenting, but have tried my best to keep up with those whose stories I've been following for a while and have been thinking of you all).

Even though I'd spent years longing for a baby, I was somehow ill-prepared for the reality of life with a newborn. Throughout my pregnancy, I found it difficult to believe unconditionally in the idea that there would definitely be a baby at the end of it all. It really wasn't until they first handed Little Miss to me just after she was delivered and I looked down at this tiny little creature that I first realised that I was henceforth going to be a mother. And yes, it is more wonderful than I could possibly have imagined, but also more terrifying than I could possibly have imagined. Those first few weeks were truly hard. Mr H went back to work after his two weeks of statutory paternity leave, and was away throughout the working week. Little Miss H suffered from colic, and so we spent night after night pacing up and down, up and down - her screaming inconsolably, me crying with pain from the c-section.

But now the blurry intensity of those first few weeks, when day and night seemed to meld into one, has begun to fade. I won't go so far as to say that we are in a routine, but there is at least some rhythm to our days. Little Miss is now almost five months old, and it goes without saying that she is a source of extraordinary joy to both her parents. She smiles and laughs, coos and gurgles, and is intensely curious about the world around her. She is (for the time being at least) sleeping through the night, but the trade off for an unbroken night's sleep appears to be that she does not nap much during the day - she will only sleep when out and about in the buggy or car, and so I find myself doing endless circuits of the park while thinking about all the things I should/could be doing/writing if only I were at home.

But now I long to be writing again. I'm itching to get back to my work, and to finish the dissertation. I also have a series of posts in varying states of completion - my birth story, some thoughts on how it feels to be repeatedly asked when I will be having another baby and, since this is now inevitably going to turn into a 'parenting after infertility and loss' blog, one on my current obsession - weaning. What would you like to hear about first?

A sharp reminder

2009-05-18T17:53:00.002+01:00

I returned home from hospital with a new-born baby... and my very own sharps bin. Because I had a Caesarean section, I had to have daily injections of an anti-clotting agent for a week after giving birth. Before I could be discharged from hospital, the midwife looking after me insisted that I be shown how to administer these injections myself. Confidently, I hitched up my nightdress. 'I've been through two cycles of IVF,' I explained. 'I know what I'm doing in that respect.' But as I sat there, roll of thigh in one hand, syringe in the other, poised to inject myself, the full gamut of emotions associated with those two failed cycles came flooding back. I remembered the hope and the fear, the mounting sense of despair I felt as each attempt seemed to lead me further and further away from ever having a child of my own. And as I gave myself those daily shots, I thought of all the other women who were, at that very same moment, but for very different reasons, also psyching themselves up to inject themselves. I thought of the mixture of optimism and steely determination that had led them down this path. I thought of the boundless strength and courage of so many of my friends here in the blogosphere, who have been through more than I can imagine. And, once again, I thought of how lucky I am to have been given this chance at motherhood.

As I lay in bed this morning, nursing my daughter and watching the sky turn from darkest navy to palest blue, I wondered whether having a baby can be considered a 'cure' for infertility. It can, I think, go some way towards healing some of the emotional rawness. And yet it does not entirely negate all I went through to get to this point. Just as I carry the physical scars from both a laparoscopy and, now, a c-section so too do I carry with me the emotional scars associated with a six-year struggle to conceive and carry to term a child.

Baby girl

2009-04-29T17:14:00.005+01:00

Little Miss Heathen finally came into this world at 4.16 on Sunday morning, weighing in at 7lbs 10 and a half ounces. She was delivered via emergency Caesarean section a mere fifty three hours after my waters broke (my birth plan had by that stage pretty much gone out of the window!)

I will post more in due course, but at the moment am beyond tired, utterly besotted with this extraordinary little being I have produced and feeling unbelievably lucky to have been given this chance at motherhood.

Better Out Than In

2009-04-16T11:28:00.001+01:00

At 39 weeks and 3 days, a strange air of expectancy has settled over the Heathen household. Although I have treasured every moment of this much longed for pregnancy, I am increasingly uncomfortable, and anxious to meet this as yet unknown little being, who seems to spend much of his or her time kicking me under the ribs or else bouncing up and down on my bladder. Our tradesmen, who have heroically re-arranged their work schedules so as to do as much of the outstanding work on the house as possible before my due date, greet me every morning with the words, 'so you're still here, then.' I have had a couple of bouts of what feel like bad period pains, ensuring that Mr H is on a permanent state of high alert (he is now thankfully at home after several weeks away in London, although hogging the home computer after breaking his laptop - hence the blogging silence). My hospital bag is pretty much packed, my birth plan written, and labour is suddenly starting to feel something that I will - no matter what the outcome may be - definitely experience, rather than a mere hypothetical.

It strikes me that there are two very different ways of approaching giving birth. Either you can see it as something messy, bloody, painful and potentially dangerous, which needs to be sanitised away as much as possible; or you can view it as one of the most profound things you will ever experience as a woman. Within western culture, birth, like death, has become something from which we are largely insulated - for most of us, our own labour is the first we will experience – yet both are an inevitable part of the life cycle. Given our long struggle with infertility, conception became a hugely medicalised event – what is generally a private act instead required the intervention of doctors, nurses, embryologists and anaesthetists; what is generally an invisible bodily process was instead played out on screens for all to see. It is perhaps for this reason that I would like my birth to involve as little intervention from the medical profession as possible.

It is, however, a fine line to tread. As much as I want to trust my own instincts, and to believe in my body’s ability to birth my baby, I am also aware that sometimes things do go wrong, and that urgent medical intervention is required – for some women, having a Caesarean section is not a question of being ‘too posh to push’, but a life-saving procedure. Too many of the women in my yoga class appear to see the medical profession as the enemy, and determined to have a home birth, even when they have been warned that they are at risk of significant complications.

All of this does, of course, come down to a matter of personal choice; any woman will labour best in the environment in which she feels safest. But, having been through so much to get to this point, I am not willing to put either my baby or myself at what I feel to be unnecessary risk. If things go according to plan, I am hoping to give birth in a midwife-led birthing centre, which to me feels safer than a home birth. We went to look around the centre a couple of weeks ago, and both felt very comfortable with the level of care they offered. There has been much adverse publicity about the provision of maternity services within the NHS – basically, there simply aren’t enough midwives to go round, and postnatal care in particular is patchy to say the least. At the midwife-led centre, however, I am guaranteed one-to-one care during labour and delivery, which isn’t the case in my local hospital, where the chances are that one midwife will be trying to look after two, or even three, women at a time. I will also have my own private bathroom facilities (call me picky if you like, but I don’t particularly want to be trekking off down a hospital corridor in order to visit the loo in the middle of labour). Where our local hospital has only one birthing pool, each of the labour rooms at the centre has a pool. If things do go wrong, I will be a short ambulance ride away from hospital, during which time I will be accompanied by the midwife who has been looking after me up until that point. Although I had to sign a form accepting that I had understood that I was at increased risk of having to transfer to hospital owing to my advanced age(!), this seems a small price to have to pay for what seems a far more personal and homely experience.

So now, all we have to do is wait.

Thoughts On Mother's Day

2009-03-19T15:48:00.005Z

Mother's Day is fast approaching, and the nation is in the grips of the usual sentimental idealisation of the maternal role: daytime television shows compete to find 'Britain's best mum', while the shops are full of cards, gifts and flowers.

For those mourning their mothers, and for those who are remembering a lost child, however, this slow buildup to Mothering Sunday serves only as a painful reminder of all that they are missing. Just last week, Prince William gave a moving speech about the continuing impact of his own mother's death. "Never being able to say the word 'Mummy' again in your life sounds like a small thing. However, for many, including me, it’s now really just a word - hollow and evoking only memories." The Prince was speaking on the occasion of the launch of the Child Bereavement Charity's 'Remember on Mother's Day' campaign, which asks people to spare a thought for those mothers bereaved of a child, and those children bereaved of their mothers, this coming Sunday.

Yet it is not only these significant anniversaries that can serve to remind us of what we no longer have. Sometimes the most trivial of events can precipitate us abruptly back to an earlier loss.

Last summer, a fantastic new cafe opened around ten minutes walk from our house, serving the most wonderful cakes, pastries and coffees. We went there for Saturday brunch a few weeks ago, and I had a plate of pancakes served with maple syrup and fresh bananas. Earlier this week, I found myself dreaming about those pancakes. I tried to put the craving behind me, and to plod on with marking my final round of undergraduate dissertations, but to no avail. By eleven o'clock, I had managed to convince myself that I was craving pancakes for a reason - that this was my body's way of telling me that I was dangerously deficient in potassium. Clearly, the baby urgently needed me to eat a further helping of those pancakes and bananas! I grabbed my coat and set off.

It was only after I'd found a seat and ordered my pancakes that I realised that the cafe was full of women with small children. Even in my vastly pregnant state, I still had to fight those old familiar feelings of exclusion - of stumbling across a mysterious club that I would never be part of. Yet this time I noticed something different. Many of these women were accompanied by their own mothers. Looking around at all these grandmothers, mothers and babies, the question suddenly hit me: Without my mother to guide me, how will I know how to take care of my own child? How am I going to mother in the absence of a mother?

For the past few weeks, I have been attending antenatal classes. The other women in the class talk about how their mothers have offered to help out after the birth. For some, the thought of having their mothers on hand in this way is an evident relief; for others, it seems an intrusion or irritation. Would I welcome the help and guidance of my mother, or would I be adamant that I wanted to find my own way of doing things? The truth is, I simply don't know. She died during my late adolescence, at a stage when I was struggling to assert my independence from her. I never had a chance to rebuild my relationship with her from the perspective of an adult woman. Yet this gap, this lacuna, does not stop me fantasising about what might have been. And so I find myself grieving anew for my mother. And not only that. I find myself grieving on behalf of my child, for the grandmother he or she will never know.

On surrogacy and sensationalism

2009-03-12T12:14:00.005Z

My experience of being part of the IF community has taught me that there are many, many different ways of building a family - whether that be through fertility treatments such as IUI or IVF/ICSI, the use of donor gametes, or else via adoption or surrogacy. Each and every one of these potential paths to parenthood brings with it its own highly complex set of choices, its own unique dilemmas. Yet it seems that, by focusing on only the most extreme stories, media coverage of these issues all too often fosters misunderstanding and suspicion, rather than promoting any real acceptance.

As many have already suggested, the recent furore surrounding the birth of the California octuplets is, of course, a case in point. The media coverage of this event here in the UK has been marred by an erroneous use of terminology (viz., the persistent use of the word 'implant' to describe the transfer of embryos into a woman's uterus), and has sparked a pronounced backlash against the use of assisted reproductive technologies (after the Nadya Suleman story first broke, I caught the tail end of a radio phone-in on the topic of the octuplets, in which caller after caller suggested that IVF should be outlawed on the grounds that it interferes with the laws of nature. Many of those who rang in to voice their opinion were of the view that, if a woman cannot have children, she should simply 'get over it', or else adopt.)

On Monday evening, a documentary entitled 'Addicted to Surrogacy' aired on Channel 4. While this could have been a golden opportunity to explore this complex and emotive issue from the twin perspectives of both the surrogate and the intended parent(s), it all too quickly descended into sensationalism, with the filmmakers choosing to focus only on the most extreme cases.

Firstly, it presented to us Jill Hawkins, a woman who is described on the Channel 4 website as Britain's most prolific childless surrogate, having 'given away' seven babies over the past 18 years. The programme followed the forty-four-year-old Ms Hawkins as she described the process of home insemination and then waited to carry out a pregnancy test, which turned out to be negative, leading the programme makers to ask, Is it finally time for Jill to wean herself off her need to have babies for other people, and start living her own life? Once again, then, we are back to that time-honoured stereotype: that of the baby-hungry woman trying desperately to drown out the ticking of her biological clock.

Next it turned to the case of Janie and Peter, a couple in their fifties who have been trying to have a baby through a surrogate for three years. After several [unspecified] bad experiences in the UK, Tammy Lynn in Kansas is now having twins for the couple, and they've travelled the 5,000 miles to be with her at the birth.

After that, we moved to Essex where Amanda - a first-time surrogate - is having a baby boy for Stephen and Olga. With Olga and Amanda not always seeing eye-to-eye, we witness the complex and emotional journey that leads to having a surrogate baby.

I found these latter two cases particularly hard to watch, although for different reasons. While Janie seemed anxious to forge a relationship with Tammy Lynn, and to maintain some contact with her after bringing the babies back to the UK, in order that they might grow up to have a sense of who their 'tummy mummy' was, Tammy Lynn resisted all overtures on her part. The second intended mother, Olga, on the other hand, seemed at times to behave with gross insensitivity towards her surrogate, and in particular her surrogate's children, refusing to allow them to say goodbye to the baby. Although I have obviously never been in the position of having to negotiate such a complex relationship, from reading other people's stories here in the blogosphere, I do have a sense that many surrogates and intended mothers are able to form a more productive connection. But I guess that those cases don't make for such compelling television.

As if these cases were not quite gripping enough, the programme was then rounded off by an interview with Carole Horlock, the world's most prolific surrogate, who tells the story of her career-low: when she discovered that a baby she had given birth to had been accidentally conceived with her own partner.

While one could argue that any television programme that explores some of the issues raised by infertility and assisted reproduction is a good thing, it saddens me that all too often their aim is not to foster awareness or understanding, but rather to provide an hour's entertainment. It seems to me that much media coverage tends to reduce infertility and its treatment to a circus sideshow, rather than acknowledging it as a genuine medical condition.

Things I have learnt from having the builders in

2009-02-24T13:23:00.002Z

That all tradesmen can drink copious amounts of extremely strong tea and are 'quite partial to a biscuit should you happen to have any in the cupboard, love.'
That the plasterer does not hold with women working. We should all stay at home and bake cakes, apparently.
That the plumber is 'so fertile that he only has to look at his wife to get her pregnant.' He has as a consequence had a vasectomy. So too has the plasterer.
That the electrician is a man of few words. For this small mercy, I am grateful.
That the joiner is a huge Michael Jackson fan and can hit nearly all of the high notes when singing along to 'Bad'.
That, given all the dust, noise and general upheaval, it is now looking increasingly unlikely that I will manage to submit my PhD dissertation before the baby is due.

Home improvements

2009-02-12T10:18:00.004Z

On almost every pregnancy-after-infertility blog that I have ever read, sooner or later it becomes time for the obligatory 'decorating the nursery' post. Even now, I find these posts difficult to read. I look at the photographs of the crib, of the rows of little outfits hanging expectantly in the wardrobe and of the lovingly stencilled bunny rabbits scampering around the newly painted walls, and I wonder, how can you forget so easily? How can you read of the terrible losses that occur each and every day in our little community and somehow assume that you are safely immune from such tragedy?

At a little over thirty weeks, I have yet to buy so much as a bootee. I still find it difficult to make the imaginative leap from 'pregnancy' to 'baby'.

My husband, on the other hand, has decided that we need to start Making Plans For When The Baby Arrives. We live in a teeny-tiny, two-up, two-down terraced house that was initially built by an enlightened Victorian factory owner to house his workers. For the two of us, it is perfect. Factor in a child, however, and it starts to seem very cramped indeed. In the current economic climate, now does not seem the right time to attempt to sell the house, or indeed to take on a bigger mortgage in order to buy somewhere larger, and so Mr H has decided to embark upon a series of home improvements, designed to ensure that we have room for a baby as well as for all of our existing stuff.

I currently use the second bedroom as a study. Now, however, I need to be re-homed so that the baby will have somewhere to sleep. Mr H has hit on the bright idea of turning the cupboard under the stairs into a workspace for me. This in turn means that we have to find somewhere to put everything that previously lived under the stairs. Mr H's master plan is to incorporate into the house as much built-in storage as possible. In addition to my new under-the-stairs workspace, we are having additional shelving built in the living room and new wardrobes fitted in our bedroom. His plans for the re-model have got progressively more ambitious and now also include having new flooring fitted throughout the house, as well as additional lighting in the dining room and kitchen. Last week, he decided that, while we were having all the work done, we might as well also have the boiler replaced and the kitchen ceiling replastered.

Having formulated this master plan, he then promptly disappeared to Geneva on business, leaving me to schedule these various works. The joiner is currently assembling the new bedroom wardrobes, the electrician is chasing holes in the dining room and kitchen walls, while the plumber appears to flit between the kitchen and the loft. Tomorrow, my band of merry men will also be joined by a plasterer, who will begin making good where the other tradesmen have been. I have had no heating or hot water since Tuesday, and the entire house is covered in a thick layer of dust. Various radios, all of which appear to be set to competing stations, are blaring forth, and the loo seat is permanently left up.

The cat and I have retreated to my study, which we now share with a mountain of precariously stacked boxes. In the evenings, we move downstairs to the living room, where, after having wiped up the worst of the dust, we huddle together for warmth under a blanket. Mr H certainly knows how to schedule his work assignments!

Family planning

2009-02-10T09:53:00.004Z

While waiting to see the midwife a couple of weeks ago, I read a magazine article which suggested that having four or more children is, in certain circles at least, regarded as a symbol of both wealth and status. The author of the article interviewed several women who were married to high-earning bankers or lawyers, and who commented on how lucky they were to have been able to afford to have a large family without having to continue to work themselves. The article went on to contrast their situation with that of 'most women', who choose only to have two or, at the most, three children, for primarily financial reasons.

Reading this article, I realised how alien the whole concept of 'family planning' now feels to me. When you are dealing with infertility, you hold tight to any possibility of having a child, no matter when or how that possibility comes along.

I was reminded of this article over the weekend. My old friend from university and her fiance came up to visit (let's call them Jane and Patrick). The four of us went out to dinner to celebrate Jane's 37th birthday, which was on Saturday. Over the meal, our conversation turned to the topic of children. Jane and Patrick are 'definitely' going to start trying for a baby in around eighteen months or so. First, however, they want to get married and then move to a bigger house. Jane has a very successful career as a lawyer, and also wants to try and make partner before she has to go off on maternity leave.

I have another friend, Victoria, who is around the same age as Jane and myself. Victoria is an academic, and about to publish her first book. She then wants to secure a promotion at work and apply for a period of research leave. She thinks that she'll probably start a family after that, once her second book is well underway.

It strikes me that both Victoria and Jane have fallen for one of the great urban infertility myths: that it's OK to wait, because even if things don't happen naturally, there's always IVF. Over dinner, Jane made a comment about wanting to 'get it all over in one go', by having twins or possibly even triplets.

But it seems to me that my friends are taking one hell of a risk with their fertility. I want to grab them by the shoulders and tell them that, at the age of thirty-seven, their fertility is already in decline. I want to tell them that IVF is by no means a guaranteed treatment, and that success levels fall rapidly once you are in your late 30s. I want to tell them about my own diagnosis of diminished ovarian reserve, and about how, after two poor responses to stimulation, I was forced to think long and hard about whether it was worth continuing with assisted conception.

But is that perhaps the equivalent of someone with no apparent fertility problems suggesting to me that I should simply relax?

The Scarlet Letter 'I'

2009-02-03T15:36:00.007Z

When I was caught up in the day-to-day struggle of infertility, I tended to avoid the company of those who were either pregnant or raising small children. Sometimes, it was simply too painful to be confronted with such a tangible reminder of what I myself could not have. At other times, I found myself bored by lengthy conversations about the intricacies of weaning or potty training - let's face it, other people's children's toileting habits just aren't that interesting. But what used to infuriate me the most was the ever so slightly smug, self-satisfied and patronising attitude that certain (though by no means all) women with children tend to adopt towards those without children. I can well remember having a (rather one-sided) conversation with a fellow PhD candidate who had recently given birth herself about the joys of motherhood. 'Of course,' she said to me confidentially, 'you'll only really understand what I'm talking about once you have children of your own.' I resent the underlying implication behind such statements: that those who remain childless - whether by choice or as a consequence of infertility - are somehow to be considered 'less womanly' than those who are mothers.

But I also found that my resistance to spending time with these women was often matched with a certain discomfort on their part. As we grow increasingly vociferous about our condition - whether as individuals or as a community - we force others to confront an uncomfortable truth: that infertility can happen to just anyone. We serve as visible reminders of the fact that it could just have easily have been them with their feet in the stirrups. To certain members of the 'mummy brigade', the realisation that pregnancy and motherhood are by no means a 'natural' or inevitable stage in every woman's life strikes deep at the very core of their identities.

Yet now I find that my pregnancy appears to have afforded me automatic entry into a club that had hitherto eluded me: other pregnant women catch my eye in the supermarket and smile conspiratorially; harassed mothers struggling to deal with tantrumming toddlers ruefully tell me that I 'have all this to look forward to.' For the past few weeks, I have been attending a weekly 'yoga for pregnancy' class. I'm finding it helpful not only to stre-e-e-e-e-tch, but also to pick up practical tips on how best to prepare for and cope with labour. But on another level, I find it difficult to accept that I really belong in this room full of pregnant women. I cannot escape the feeling that I still have a scarlet letter 'I' for Infertile emblazoned across my chest for all to see, and that, sooner or later, I will be found out and asked to leave.

Great Expectations

2009-01-07T15:15:00.004Z

Infertility has made me feel a failure - as a woman, as a wife, but also as a daughter.

My father and, perhaps more particularly, my stepmother have for some years had a palpable longing for a grandchild. While many of their friends have gone on to become grandparents, they have been forced to sit back and watch helplessly. My two stepbrothers show absolutely no signs of settling down in stable relationships, let alone reproducing, and so all their hopes have been pinned on my rapidly ageing ovaries. Although they have been very supportive of our decision to undergo IVF, in all the time I was struggling with my own complex feelings of guilt and failure in relation to my inability to conceive and carry to term a child, I was also acutely aware of just how disappointed they too were.

Eventually, they befriended a French couple of around the same age as myself and Mr H whom they met on holiday. I met this couple for the first time over the summer - they are lovely people, who have clearly been to hell and back as far as infertility is concerned: after several failed cycles of IVF, they eventually adopted two little boys from Estonia, a process which took them over four years (the question as to why we too couldn't 'just adopt' has often seemed to hover, unspoken yet reproachfully, in the air). My father and stepmother absolutely dote on these two children: they go to visit them as often as possible, and have even talked about moving to France permanently in order to be close to them. Their house is filled with photographs of the French family, and every time I go to visit them I feel even more guilty for not being able to provide them with the one thing that they seem to want above all else.

Since we told them that we were expecting a baby, they have been absolutely beside themselves with excitement. While we have yet to buy a single piece of baby-related paraphernalia, their plans for the new arrival seem to be well under way: my stepmother has already knitted a small stash of hats and bootees, while my father has been leafing through back issues of 'Practical Woodworking' in search of something he can make for his first grandchild (we had tactfully to reject a rather wonky looking crib on health and safety grounds).

Yet somehow the sheer weight of their expectations continues to press heavily upon me. Even at 25 weeks, I find it difficult to believe unconditionally that there will be a baby at the end of this process. While everyone around me makes plans, I am still very much living from moment to moment of this pregnancy.

In which Mr H puts his foot in it

2009-01-02T15:23:00.003Z

When you yourself are battling infertility, it can be very difficult to feel much sympathy for those who moan on endlessly about their pregnancy symptoms. I have in particular very little patience with those who complain of feeling fat and unattractive during pregnancy. About eighteen months ago, we had an extraordinarily difficult weekend visit from Mr H's best friend and his pregnant girlfriend, who spent the whole time going on about how big she thought her arse was. It took every ounce of self-control that I had not to tell her to shut the f**k up. 'Why can't you see just how lucky you are?' I felt like shouting at her. 'Have you any idea of what I would give to be in your shoes right now?'

During my own pregnancy, I have been determined not to fall prey to such culturally induced self-loathing. I have tried very hard to embrace my changing body shape, and to focus on feeling voluptuous and womanly. Yes, I have suffered some minor discomforts, but they seem a small price to pay for the privilege of becoming a mother.

My fragile self-confidence has, however, recently taken a knock. The other day we went round the January sales. Hr H pointed out a cardigan that he thought I might like. 'You'd probably still fit into that,' he commented.

The cardigan in question was in the window of a shop specialising in plus-size clothing. I am a UK size 8 (around a US size 6); this particular store starts at UK size 18 (US size 16). Once this was pointed out to my darling husband, he immediately started back pedalling. He wasn't for one moment suggesting that I should try on the cardigan; he was simply pointing it out as a particularly fine example of its kind.

My position on the moral high ground of the relationship is now assured for the next few days at least. From my vantage point, I am rather enjoying watching him squirm!

End of term

2008-12-17T13:04:00.003Z

I have made it to the end of term with my sanity still reasonably intact. The flood of anxious emails has slowed to a trickle, and I at last have time to breathe, to think and to write.

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.

Spreading myself too thin

2008-11-18T17:53:00.004Z

I am at that stage in my academic career where, if someone asks me to do something, I am scared to turn it down, just in case I am never asked again. The result is that this semester I have taken on Too Much Teaching.

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....

Jetsetting

2008-11-06T13:26:00.004Z

Don't worry - I haven't turned into one of those bloggers who finally gets that elusive BFP, promptly forgets that they were ever infertile and then skips off into the sunset to decorate the nursery...

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!

Another year older...

2008-10-22T14:51:00.005+01:00

Last week one of my students asked to speak to me after class. She had various questions she wanted to ask with regard to assessment, but also wanted to say how much she was enjoying the course. 'I'm just so interested in all these women artists,' she exclaimed. I suggested that, if the module had whetted her appetite that much, she could always think about applying for a Masters.

'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!'

An irrational thought

2008-10-16T13:26:00.003+01:00

What if there's been a mistake? What if I'm not really pregnant?

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.

A difficult decision

2008-10-08T17:43:00.008+01:00

On the weekend when we discovered that our second attempt at IVF had gone really disastrously wrong, we were desperate to find some respite from the hell we were experiencing. We hit on the plan to drive out into the Yorkshire Dales, and to have Sunday lunch at a pub we know that serves excellent food. As we drove into the village where the pub is, we spotted a man walking a Welsh terrier. To most people this would not be cause for undue excitement, but I am absolutely crazy about Welsh terriers: every year, I sit through the whole of the television coverage of Crufts, just in the hope of catching a glimpse of black and tan, bearded gorgeousness (picture above, for those who may be unaware of just how adorable Welshies are).

By the time we had parked the car, the Welshie had caught up with us. And so I did a very bold thing: I went up to the owner, and told him how much we liked his dog, and commented on how unusual it was to see a Welsh terrier (they are not a terribly common breed). He replied that it was even more unusual to meet someone who actually knew what type of dog she was: most people tended to assume that she was an Airedale puppy. 'Oh, I like Airedales,' I remarked, 'but I much prefer Welshies.' 'Me too!', the Welsh Terrier Man exclaimed. By now, we had clearly bonded, and so he told me all about his dog: how her name was Jenny, how her beard wasn't normally that colour, but she'd been eating beetroot that morning, and how she was Very Good With Children. Then he asked me if I would mind very much looking after Jenny for a couple of minutes, while he popped into the village hall to deliver some leaflets.

And so, for a brief moment, I got to live out my fantasy of owning a Welsh terrier. Jenny stayed with me trustingly, and I got to see her being Good With Children.

When the Welsh Terrier Man returned from dropping off his leaflets, he mentioned that they were thinking of breeding from Jenny later in the year, and would we perhaps be interested in taking a puppy? We said that we certainly were, and gave him our email address.

Since then, Mr H has attempted to buoy me up with thoughts of Welshie puppies. I, on the other hand, have tried not to dwell too much on the idea. I presumed that the Welsh Terrier Man would have got home and promptly forgotten about or lost the piece of paper with my email address on it.

But then, a few weeks ago, we received an email from the Welsh Terrier Man saying that Jenny had had a litter of five puppies, and asking whether we were still interested in taking one.

Mr H has been all for the idea of a puppy. But Mr H spends at least three weeks out of every four working away from home. He was down in London last week, and is in the Hague this week. He then has another fortnight's work in London, before heading out to Madrid for three weeks. Were we to take one of the puppies, that puppy would therefore be primarily my responsibility.

My heart has been saying, 'puppy, puppy, puppy, yes, yes, yes.' I have dreamt of owning a Welsh terrier for years and years, and now I have the opportunity to buy one that has been that has been reared in a home environment, rather than by a professional breeder. I have met the mother, who is a family pet rather than a show dog, and am confident that she has a beautiful temperament. Were I not pregnant, the decision would have been made in a flash.

But I am three months' pregnant, and so our circumstances may well change radically in another six months' time. As I mentioned above, Mr H works away from home a lot, and so I will be flying solo for much of the time. In all honesty, I'm not sure how I would find the time and energy to walk a dog twice a day while also caring for a new-born baby by myself. It doesn't seem fair to make the commitment to having a dog knowing that I may subsequently not be able to honour that commitment. It would break my heart if we finished up having to re-home our beloved Welshie because we could no longer cope with him.

And so I have just taken a deep breath and rung the Welsh Terrier Man to explain the situation, and to tell him that we will not be able to take a puppy after all.

Please tell me that I have made the right decision!

12w2d

2008-10-07T18:14:00.002+01:00

Yesterday's scan revealed that the baby had grown to 64mm and that its heart rate was 162bpm. The nasal bone, stomach, bladder and brain were all clearly visible and, in the words of the consultant obstetrician who performed the scan, I therefore appear to be carrying a 'perfectly normal and healthy baby'.

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.

Emma's Diary

2008-10-05T17:40:00.001+01:00

Emma's Diary is a free publication, routinely given out to all UK women at their first ante-natal appointment, and seemingly designed primarily to hook them as potentially lucrative consumers of all things baby related. Among the numerous adverts for haemorrhoid cream, breast pumps and nappies, it contains factual articles on topics such as maternity rights and benefits, and exercise during pregnancy, as well as a week-by-week guide to pregnancy, written from the perspective of the fictional Emma.

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?

Back to school

2008-09-30T14:47:00.003+01:00

It's THAT time of year again, when universities the breadth of the country are once again flooded with a fresh intake of students. Picking my way through the crowds to my first class yesterday afternoon, I was once again led to ponder that perennial question: are students getting younger, or am I getting older? At nearly 37, I am now at least fifteen years older than the third years whom I teach; in many ways we are of different generations. I wonder whether I must seem terribly old in their eyes.

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.

Further Thoughts on Crossing That Line

2008-09-24T11:16:00.005+01:00

I am so grateful to everyone who commented on my last post. I am glad that my words were received with such sensitivity, and found each and every one of your comments helpful in enabling me to clarify my feelings on this very complicated topic.

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.

Crossing the Line

2008-09-22T10:09:00.003+01:00

One of the many difficult things about infertility is the feeling that you are standing still while everyone else is moving forward with their lives. While many of my contemporaries have now completed their PhDs, and in some cases even published their first monographs, I instead embarked on a gruelling round of tests and treatments. Over the past six years, I have stood by and watched while many of my RL friends have gone on to have babies. One of my closest friends, who started trying after we did, now has a son of school age and a daughter aged three.

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.

Blame it on the Poles

2008-09-18T13:03:00.005+01:00

The past few years have seen increasing numbers of migrant workers (particularly from Poland) seeking employment in the UK. These migrant workers tend to do the type of poorly-paid, back-breaking jobs that many Brits seem to consider beneath them. The situation has sparked any number of jingoistic, xenophobic articles in the tabloid press: many commentators seem to feel that the UK is being invaded by vast numbers of Poles who are stealing 'our' jobs, and taking up beds in 'our' hospitals, etc, etc. These hard-working individuals are blamed for any number of social ills - from increasing knife crime to the number of uninsured drivers on the roads. And now they are also apparently to be held responsible for the rise in the number of recorded cases of sexually transmitted infection.

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.

Graduation day

2008-09-09T11:56:00.005+01:00

Today, we got up at 5.30am in order to do what I like to term the early morning Dildocam Dash.

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.

Man vs. Cat

2008-09-05T13:30:00.003+01:00

Mr H and the cat are currently locked in a battle of wills.

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!

Uncharted waters

2008-09-01T11:37:00.002+01:00

I am now beginning to understand how my experience of this second pregnancy has been overlaid by memories of my first pregnancy.

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.

Six weeks and counting

2008-08-27T11:13:00.005+01:00

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.

Ms Heathen's Theory of Relativity

2008-08-20T15:51:00.003+01:00

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.

Against all odds

2008-08-14T09:49:00.002+01:00

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.

Groundhog Day

2008-08-06T14:27:00.004+01:00

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?

Building bridges?

2008-07-31T13:25:00.004+01:00

Luna recently wrote a thoughtful post in which she asked why she found herself unwilling or unable or unprepared to approach certain topics on her blog. "Is it simply a matter of time? too soon or too late? too personal? too overwhelming, complex or confusing? Am I too lazy? too defensive or protective? too afraid (and if so, of what)? Am I not in touch with how I feel enough to articulate it? Am I trying to retain some sense of privacy that is forever lost when sharing an intimate thought or fear? Am I simply trying to exercise some discretion? Or are there just certain words that must remain unspoken, at least for now." She came to the conclusion that it was perhaps "a bit of everything".

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.

It's a mixed up, muddled up, shook up world

2008-07-25T17:04:00.005+01:00

Sometimes I wonder what the world is coming to. First there was the whole waxing incident, and now this.

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.

Is nowhere safe?

2008-07-22T15:25:00.004+01:00

I have just got back from having my monthly brow and bikini wax.

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.

Happy birthday, Louise Brown!

2008-07-15T08:58:00.003+01:00

Louise Brown, the first ever baby to be born as a result of IVF, is thirty years old today.

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.

When is it time to let go?

2008-07-10T10:23:00.012+01:00

Last week, many British newspapers featured an item about a woman who had just given birth to a daughter conceived after she had advertised, first in the window of her local newsagents and then on the back of a London bus, for an egg donor. She was fifty-six years old.

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?

Telling it like it is

2008-07-07T14:13:00.004+01:00

After our first cycle of IVF was cancelled, I asked Dr Abrupt whether my poor response could be down to diminished ovarian reserve. He replied that, at that stage, he could not be sure. All we could do was to try again with a different protocol and an increased dose of stimulants, and to hope for a better response next time round. After our second cycle yielded only three mature eggs, I again raised the possibility of diminished ovarian reserve, this time with Dr Approachable. Was it time for me to give up, I asked. Just last month, Dr Approachable suggested that my antral follicle count was such that he did consider it worthwhile me pursuing further treatment.

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.

Hasta la vista, polyp!

2008-07-02T11:26:00.003+01:00

My polyp is no more. It has ceased to be. It is, in fact, an ex-polyp.

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.

June is the cruellest month

2008-06-25T14:11:00.005+01:00

This month marks the anniversary not only of my miscarriage, but also of my mother's death.

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.

Halving it all?

2008-06-23T14:02:00.007+01:00

Thanks to Bitch PhD, I came across an interesting article in the The New York Times about shared parenting.

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.

Infertility and the City

2008-06-19T17:18:00.008+01:00

Even among its detractors, it is generally acknowledged that, in its frank portrayal of female sexual freedom and unconditional friendship, Sex and the City was a ground-breaking television series. As well as some amazing outfits, it also covered some pretty serious issues along the way: the challenges of combining motherhood and a career, breast cancer and, something particularly close to my heart, infertility. The title of this blog was indeed inspired by Charlotte's infamous comment that she wasn't barren, just reproductively challenged.

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.

In remembrance of things past

2008-06-12T12:27:00.004+01:00

Once upon a time, I was one of those women - you know, the ones who we're all secretly convinced are in fact an urban infertility myth - the ones who get pregnant just before they're about to start their first cycle of IVF.

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?

Polyp watch

2008-06-09T13:17:00.007+01:00

On Saturday morning, we returned to the Great Big Infertility Clinic, where a scan revealed that, despite my best attempts to jiggle it loose via an extended session on the Powerplate at the gym, the polyp still continues to cling stubbornly to the wall of my uterus.

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.

What I learned from Voltaire about infertility

2008-06-02T13:36:00.018+01:00

For my French A level, I studied Voltaire's satiric novel, Candide. Its eponymous hero is at the outset a rather naively optimistic young man, who has been brought up to believe that everything happens for the best. Over the course of the novel, he undergoes a series of ever more improbable adventures, and witnesses the widespread and random destruction caused by both war and natural disasters such as earthquakes and tsunamis. He is captured and tortured by the Inquisition, before making his escape to South America, where he acquires - and loses - a vast fortune. On his adventures, Candide also meets a number of different characters, who try to engage him in philosophical debate as to the broader meaning of the events that constantly overtake him. At the end of the novel, he is reunited with his great love, Cunegonde, and his old tutor Pangloss. He has also had enough of philosophical debate. 'That's all very well,' he says to Pangloss, 'but now we must cultivate our garden.'

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.

In which Ms Heathen lets off steam

2008-05-23T13:14:00.004+01:00

Sometimes I wonder, is this really any sort of world to bring a child into?

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...

Reality check

2008-05-21T09:16:00.003+01:00

When I switched the cooker on last night, there was a loud bang from inside the oven... and then nothing. The hob and the grill still appear to be working, but now the oven will not heat up.

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!

A rose is a rose is a rose is a rose

2008-05-15T14:10:00.008+01:00

The ever-thoughtful and generous Luna has given me a pink rose!

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.

When is enough, enough?

2008-05-14T09:08:00.005+01:00

At what point do you decide that enough is enough? When do you accept that it is time to let go, to move on?

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.

Forbidden fruits

2008-05-12T11:13:00.003+01:00

Hidden down a quiet side street, yet only five minutes' walk from the Minster, lies one of York's best-kept secrets: a tiny, but incredibly good, delicatessen that specialises in Italian artisan food. If you venture right to the very back of the shop, you will discover a small terrace, where they serve simple food such as salads and crostini, all made with the very best of ingredients.

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.

A glimmer of hope

2008-05-07T10:12:00.003+01:00

Much to our surprise, they managed to retrieve six eggs yesterday.

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!

A kick in the guts

2008-05-05T15:01:00.003+01:00

I feel - literally and metaphorically - as though I have been kicked in the stomach.

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.

In which things go from bad to worse

2008-05-03T12:03:00.008+01:00

For the past week, I have been taking the maximum recommended dose of 450iu meno.pur per day. Today, we went back to the Great Big Infertility Clinic, where the dildo cam revealed that I have precisely two viable follicles, each measuring 16mm. There is another one currently limping along at 11mm, and a number of smaller ones which will not catch up in time for retrieval.

As if that was not bad enough, a polyp has suddenly appeared on the wall of my uterus.

We are going ahead with retrieval on Tuesday. Even if the two viable follicles do both contain fully mature eggs, and even if those eggs then fertilise, any resulting embryo(s) will have to be frozen until the polyp has either been shed with my next period, or surgically removed.

Crap. Crap. Crap. Crap.

Dr Approachable tells me that I should not give up all hope. He is not willing definitively to diagnose diminished ovarian reserve until after retrieval, at which point they will be able to assess the quality of my eggs. There is still a chance that the two follicles may yet yield two high quality eggs, which may well go on to fertilise. He reassured me that, if this is the case, our chances of a successful pregnancy will not be substantially reduced if we do have to freeze the resulting embryos. But I am not getting my hopes up. It seems that more and more obstacles are being placed in our way. And so, on the way home in the car, we had our first serious conversation about what we will do if we cannot have a child through IVF/ICSI: do we go down the donor egg route, do we begin to explore adoption, or do we start trying to come to terms with involuntary childlessness?

In which Ms Heathen feels sorry for herself (it may well be the meno.pur talking)

2008-04-30T13:44:00.001+01:00

I am now on Day 4 of the meno.pur injections, Mr H is still in Rome, and the cat is ill.

I started the nafa.relin nasal spray on Saturday, and the meno.pur injections on Sunday. Because I am taking such a high dose of the meno.pur, the nurse at the Great Big Infertility Clinic recommended that I do two separate injections - each with three vials of powder diluted in one ampoule of solvent. If I did a single injection containing all six vials of powder, I ran the risk of boils at the injection site, she explained. Superstitiously, I aim one injection in the general direction of each ovary. The increased dose does seem to be bringing with it increased side effects - nausea, an angry rash at the injection site, and tenderness in my abdomen (not ovulation pain, more a feeling of soreness), but only time will tell if it also results in more follicles.

Mr H phoned yesterday afternoon to say that the new firm was asking him to commit for a minimum of three years. How did I feel about that? I explained once again that I was concerned about how it would affect our relationship, particularly our plans for a family. He said that he would talk things over again with his new boss. When he rang back again, he said that he had told his boss that we were currently undergoing fertility treatment, and that we were very much hoping to have a baby. His boss had reassured him that family was the most important thing, and that, providing he gave them notice, his schedule could be adjusted to fit around treatments.

As several of you said in your comments, a potential move down south may well bring new opportunities. I've felt for some time that, once I've submitted my thesis, I would like to make a clean break from the Shit Hot Critical Theory Department. The Shit Hot Critical Theory Department seems to be full of recently qualified PhDs, who hang around like dogs at dinner time fighting over any scraps of teaching that are handed out, hoping against hope that they will be offered a permanent contract. The longer they stay, the more bitter they become. I'd far rather submit, and move on to somewhere where I may be seen as an academic in my own right, rather than 'Professor So-and-So's student'. A move down south would take me closer not only to a number of other universities, but also to the major museums and galleries, which would open up a whole range of new career opportunities. As shinejil says, it would also mean that I could look for a more responsive clinic. I also quite liked Luna's suggestion that I could possibly accompany Mr H on some of his trips so that we can keep trying naturally - but knowing my luck, I wouldn't get to go to Paris or Rome, but would probably end up trying to plan a romantic tryst in a Travel Lodge somewhere near Milton Keynes!

The decision has now been made, for better or worse: we talked it through again yesterday afternoon, and came to the conclusion that Mr H should take the job. He has now signed the contract, and is flying home later this afternoon.

Amongst everything else, the cat is ill. She seems to be spending an inordinate amount of time in her litter box, but doesn't appear to be peeing. I'm assuming that she may have a urinary infection, and so have booked an appointment at the vet's later on today. She is currently asleep in a small patch of sun at the end of the bed, unaware of the trauma that awaits!

The times they are a-changin

2008-04-28T11:15:00.003+01:00

Mr H and I both work from home. Every morning, he goes off to the dining room to do his mysterious job in IT, while I retreat to my study, where I pretend to write my PhD. We break for lunch at around 1pm, and occasionally knock off early to go to the gym.

Today, however, I am Home Alone. Mr H is in Rome (once again, I seem to have drawn the short straw). He has been head hunted, and so has been flown out to Italy to meet his new boss and to finalise the details of his contract of employment. This new job is a fantastic career opportunity for him; it is with a small and progressive company, and offers both more responsibility and more money.

The downside? He will be required to travel extensively throughout Europe and the Middle East. He will be away on business for an average of 17 days out of every month. Although we have agreed not to make any decisions in this respect until after I have submitted my PhD, in the longer term, it may well make sense for us to relocate down south - the company's HQ is situated on the outskirts of London, and the chances are that a fair proportion of their UK work will be in the capital. It would also make things easier if we were within commuting distance of an international airport. Proximity to Heathrow also, however, means proximity to his mother and to his endlessly and effortlessly reproducing friends.

Although it is undoubtedly a great opportunity for him, I am also worried about the effect that all of this will have on our relationship. We are in many ways quite a self-contained couple; even before infertility led us to retreat in on ourselves, we preferred time spent together to endless hours socialising with other people. I'm not sure how either of us will cope with spending a lot of time apart - on the one hand, it may encourage us to make the most of what time we do have together; on the other hand, we may end up leading increasingly separate lives.

My major concern, however, is how it will effect our plans to have a child. Having conceived 'spontaneously' before, I still hang on to the hope - however remote - that I may do so again. Our odds will be considerably reduced if Mr H is going to be away much on business much of the time. How will we manage even to fit in another cycle of IVF around his work schedule?

More to the point, what will happen if we do have a baby? I will effectively be a single parent for much of the time. When I'm struggling to cope with little sleep and a crying baby, will I wind up resenting him? Will he feel that he's missing out? Will I unconsciously shut him out?

We have talked and talked about this, and both of us feel that he should take this job - it really is too good an opportunity to turn down. Our relationship is - we hope - strong enough to survive. I am trying to look on the bright side - when he is away, I can have time for all my little projects around the house and garden. I may well sign up for an evening class - I quite fancy learning to sew. Plus, of course, there is the small matter of the PhD - perhaps it will encourage me to knuckle down and get the last chapter finished.

Infertility makes it extraordinarily difficult to make other plans. I feel like we've been living in limbo for the past five years. We've talked about moving house on several occasions, but have always decided that it wasn't the right time. There is, after all, not much point in buying a much bigger house if it's just going to be the two of us. Now, however, Mr H's new job is making some of these decisions for us. I can only hope that some other pieces of the jigsaw also begin to fall into place.

A small scratch?

2008-04-24T13:18:00.005+01:00

The Great Big Infertility Clinic requires all couples to have an HIV & hepatitis test before starting a cycle of treatment. After our unfruitful meeting with Dr Knows Best on Monday, we duly trooped off for our blood tests.

I drew the short straw, and got the evil, stabby nurse, who took two attempts to find a vein. By Tuesday morning, I had a huge bruise on my left arm. If you factor in the additional bruise I have on my right wrist after one of the students hit a nerve in yesterday's acupuncture session, I look like I've already been through the IVF mill - and all this before I even draw up a syringe of Menopur!

Mr H, on the other hand, got Nurse Small Scratch. There is not a mark on him.

While I don't want to wish unnecessary pain and suffering on my husband, this does strike me as somewhat unfair!

Doctor Knows Best

2008-04-21T11:17:00.005+01:00

Now here's a sentence I thought I'd never write: I miss Dr Abrupt. His secretary called on Friday afternoon: Dr Abrupt is away at a conference all this week, but he had asked her to telephone me to let me know that he had received the results of my Day 3 bloodwork, and that everything looked fine. He had passed my file over to his colleague Dr Knows Best, who would be seeing us for our Day 21 appointment.

This morning, we got up bright and early for our appointment at the Great Big Infertility Clinic. After waiting over half an hour, eventually we were called in to see Dr Knows Best. I renewed my acquaintance with the dildo cam, which revealed that I had ovulated from my right ovary this month (so still no confirmation that my left ovary is in fact functioning as it should). After some prompting on my behalf, Dr Knows Best volunteered the information that I had 9 follicles on my right ovary, and 5 on my left ovary. I said I thought that, given my anxieties about diminished ovarian reserve, this was a good sign. 'Not necessarily,' said Dr Knows Best. 'It doesn't matter how many follicles you have, if they don't respond to stimulation.'

After I'd put my knickers back on, we then sat down to discuss my protocol.

Dr Knows Best explained that I would start taking the nafarelin nasal spray on the first day of my next period. The dose would be 3 sniffs per day. At this point I interrupted. Did that mean I was doing a regular dose, rather than a micro dose, flare? 'You've obviously been spending too much time on the internet,' replied Dr Knows Best. 'Why don't you let me worry about what protocol we're doing? All you really need to know is what dose of drugs to take, and when to take it.'

He proceeded on with his explanation. I would start the Menopur injections on day 2 of my period, and would come in for a scan eight days later. I explained that, given my poor response last time round, I didn't feel terribly comfortable about being left to stim for eight days; I would prefer to be more closely monitored on this cycle. Dr Knows Best informed me that the Great Big Infertility Clinic no longer performed scans earlier in the stimulation phase; they did not feel that they were of any use in monitoring patients' response (they also don't appear to check E2 levels either). I was on the maximum dose of Menopur, and after eight days they would know whether I had responded or not. If I hadn't responded, then there really was very little more they could do for me. He then smiled, and asked us whether we had any further questions.

Why are you such a pompous and patronising ass? What the fuck are we doing here? Instead, I asked him about my day 3 bloodwork. What were my FSH levels this time round? 'I really don't think it would be helpful for you to know these,' he replied. I disagreed. I said I thought that knowing as much as I could about my treatment was very helpful. Grudgingly, he told me that my FSH was 6.

On the way home in the car, we decided that this is very probably the last cycle of treatment we will undergo at the Great Big Fertility Clinic. Neither of us can escape the feeling that we are paying vast amounts of money for what seems to be very cursory treatment. I have no sense that I have been given a protocol that has been tailored to my individual needs; instead Drs Abrupt & Knows Best appear to be trying a series of default options. Possibly my feelings about them both may change if I get a positive result from this cycle - it's just, at the moment, that feels a fairly remote possibility.

Displacement activity

2008-04-15T14:30:00.004+01:00

It is a truth universally acknowledged, that a woman about to undergo a cycle of fertility treatment, must be in want of distraction.

Over the weekend, I attended a 'learn to knit' workshop. I can now cast on, knit, purl, cast off and read a simple pattern. Armed with this new knowledge, I plan to make a scarf. Secretly, I imagine myself as Madame Defarge from Charles Dickens's French Revolutionary novel A Tale of Two Cities. Madame Defarge was one of those strong, revolutionary women who so fascinated and appalled nineteenth-century commentators such as Dickens. She incorporates into her knitting the names of those whom she considers to be enemies of the revolution, but as I click slowly away with my needles, I think of all those who have offered me their unsolicited assvice on the topic of my infertility - were I to include all of their names in my knitting, it would be a very long scarf!

Mr H is claiming a sudden allergy to anything made out of wool (my new-found hobby has uncovered some hitherto repressed memories of being forced as a child to wear a succession of misshapen, stratchy tank tops knitted for him by his grandmother). He is, however, currently re-reading the final Harry Potter novel, and so has taken to appropriating my knitting needles to use in the manner of a wand. 'Pregnum!' he exclaimed optimistically after dinner last night, pointing his makeshift wand in the direction of my abdomen. 'Prrrrregnum!'

Would that were all it took!

Lost for words

2008-04-07T15:38:00.005+01:00

Out here in the blogosphere, all we have is words. And yet there are times when that doesn't seem nearly enough.

At the weekend, Mr H came into my study and found me in tears. What was wrong, he asked. I explained that I had just found out that Luna had received a negative from her final cycle. Luna has been through so much over the past six years, she has been so generous in her support of others in the blogosphere, and this FET was her last chance for a baby. I had been hoping and willing with every ounce of my being that this cycle would work for her. Mr H could not understand why I was so upset. 'But you've never even met this woman,' he reminded me, gently. 'You live on opposite sides of the Atlantic. You very probably don't even know each other's real names.'

Mr H is, of course, right. I have never met Luna, or indeed any of my other blogging friends. And yet I feel a deep connection with you. In many cases, we have shared interests that extend beyond the common thread of infertility - we would, I like to imagine, get on well if we were to meet in Real Life.

You have all been a tremendous source of support to me over the past few months - not only through your kind comments here, but through your own posts. I have in particular learnt a great deal from Luna's wise and astute writing. And this is why, at this particular moment, I feel so powerless. I can find no words of comfort to offer her.

It strikes me that society in general isn't particularly comfortable with grief. Mourning is seen as something that should be hurried through as quickly as possible - 'coming to terms' and 'moving on' are seen as the ultimate goals for the recently bereaved.

And yet in our little community, it seems that grief is always just around the corner. And so perhaps all any of us can do is to acknowledge each individual loss, and to sit and mourn quietly with those whose hopes and dreams are not now going to come to fruition. Phrases like 'I'm sorry' and 'I'm thinking of you' may not seem much, but out here in the blogosphere, all we have is words.

Back on the treadmill

2008-04-02T16:14:00.007+01:00

Today, I went to have my Day 3 bloodwork taken. At our review appointment, Dr Abrupt reassured me this was nothing to worry about - repeating the test was standard procedure for anyone about to embark upon a new cycle of IVF. In one of his rare flashes of bedside manner, he informed that it was, 'statistically speaking', highly unlikely that my FSH levels would have risen dramatically since they were last checked in November.

And yet I am worried. Since my first cycle was cancelled, I have been searching for a reason as to my poor response. There is a small part of me that accepts that this may have been because I was either over-suppressed or under-stimulated, in which case I may do better on a shorter protocol/higher dosage. And yet, from the reading I've done, there does seem to be a clear correlation between poor response and diminished ovarian reserve. And so, lying awake at night, I have managed to persuade myself that my ovaries are on their last legs (last week, I was even convinced that I was suffering from perimenopausal hot flushes, until Mr H confessed to having turned the central heating thermostat up!) I am worried that the lab may have made a mistake with my previous tests, thereby lulling me into a false sense of security. I am worried that this test will reveal that my FSH levels have shot up over the past few months. I am worried that, even if my hormone levels are within the prescribed range, I still won't respond to the stims. I am worried about the longer-term effects of taking such high doses of fertility drugs.

When I started out on this process just before Christmas, I was scared at what I was about to put my body through, but I was also relieved finally to be doing something that might actually have brought us closer to having a baby. I wasn't banking on it working first time round, but I was banking on IVF at least being an option for us. But now, I've lost my IVF innocence. I'm going into this cycle with my eyes wide open. Fertilisation reports, transfer, 2wws - at the moment, all of these seem like things that happen to other people. I'm just focussing on making it to retrieval this time round - a few good follicles, two or three mature eggs would do me fine.

My baseline ultrasound is scheduled for 21 April. If everything looks OK then, and my bloodwork is within the normal range, I will begin the treatment itself when I get my next period.

The assvice just keeps on coming

2008-03-28T13:36:00.003Z

Yesterday I went to the acupuncturists. Because it is a training clinic, each week, I am initially seen by a group of students, who ask me a number of questions about my general well-being, listen to my pulse and look at my tongue, before going off to report their findings to the Chinese Fertility Goddess herself. The CFG then comes in and repeats the whole process, before deciding on a course of treatment. She then supervises while the students insert the needles.

Yesterday, I was seen by a new group of students. How old was I, asked one of them. 'Thirty six,' I answered. 'Oh, that's no age at all,' he exclaimed, 'the newspapers are always full of stories about women having babies in their fifties: it's marvellous what doctors can do nowadays, isn't it?' 'I think you'll find those women conceived using donor eggs,' I explained, testily. 'Not necessarily,' he answered, 'I have a couple of women friends who both conceived naturally at the age of 44.'

How can this possibly be considered a helpful thing to say to somebody who has just undergone a cancelled cycle of IVF, and who is worried that her poor response could well be a sign of diminished ovarian reserve?

After the treatment, the same chap came in to remove the needles. 'Are you absolutely sure you want a baby?' he asked. 'Raising a child can be awfully hard work.'

Really? And there was I thinking that it was going to be a walk in the park! Does he not imagine that, after five years of trying to conceive, and the best part of three years of psychoanalytic psychotherapy, I have never before stopped to question my motives for wanting to become a mother?

Why am I surrounded by people offering unsolicited assvice? Why does everyone I encounter seem to have an opinion on my infertility?

The student in question informed me that yesterday was his last day in the clinic for the time being, so hopefully our paths won't cross again - otherwise I would have requested that he had no further involvement in my treatment.

I do, however, have every confidence in the Chinese Fertility Goddess. Yesterday, she spent some time explaining how she plans to tailor my treatments to support me through my IVF cycle. She also told me that I should cut down on the amount of dairy products I consume, and eat more seeds and nuts - in particular walnuts.

Such is my faith in the CFG that I immediately went out and bought a large bag of walnuts, which I am chomping through as I type!

Friendships lost... and found

2008-03-26T13:22:00.006Z

I've been a bit hopeless at posting over the past week - I begin composing posts in my head, but then never get round actually to writing them. Instead, I've been mulling over all the assvice I received last week from our friends and family - and this in turn has got me thinking about my best friend, Stella.

Stella and I met on our very first day at university. We lived in the same halls of residence, and were doing the same degree course. Our friendship really cemented itself, however, after we left university. We saw each other through shitty jobs and broken hearts. We went out dancing, and stayed up all night talking.

After dating a number of inappropriate men, and crying on each others' shoulders when it all went wrong, we both settled down with our respective partners. Eventually, the inevitable happened - Stella invited us round for lunch, and told us that she and her husband were expecting a baby. I held it together all the way through the meal, but then fell apart in the car on the way home. 'Don't you understand that that's the way it's supposed to happen?' I shouted at Mr H. 'You come off the Pill and then you get pregnant a few months later. It's not supposed to take eighteen fucking months.' Up until then, we'd been doing a pretty good job of pretending that we didn't have a problem - Stella's pregnancy was actually the catalyst that led us to make that first appointment with the doctor.

Eventually, Stella had her baby - a boy. Eighteen months later, she had a little girl. In the meantime, we underwent the standard battery of tests, and were placed on an NHS waiting list for IVF. As time went by, my weekly telephone conversations with Stella became more and more one-sided: she talked about her children, while I listened.

And then I had a miscarriage. We hadn't told anyone about the pregnancy - we'd agreed to wait until we were safely into the second trimester - but Stella was one of the first people I had planned on sharing my news with. After I lost the baby, I couldn't face picking up the phone to let her know what had happened, and so I sent her an email instead. Over a week later, she sent me a text message: 'I hope you're feeling better now'. When she did eventually ring me, I explained that I was a little hurt that she hadn't got in touch sooner. She then proceeded to tell me about an article she'd just read in a magazine, which suggested that a miscarriage was a bit like having a particularly heavy period. After that, I didn't really feel like phoning her again.

That was just over two and a half years ago. Stella has not made any effort to contact me since that last phone call. I've sent her Christmas and birthday cards, but she hasn't responded. I really thought that we would be friends for life, but it turns out that our friendship wasn't strong enough to survive me losing a baby.

As I fell further and further down the rabbit hole of infertility, I felt increasingly isolated. And then one day, I stumbled across the infertility blogosphere. I couldn't believe it - here was a group of articulate, angry, witty, sarcastic women who were just as pissed off as I was! For a long time, I lurked, silently and nervously - it seemed such a tight-knit community, would they let me in?

Eventually, I took a deep breath and started writing. It felt a bit like throwing a message in a bottle into the ocean - I had no idea whether anybody out there was actually reading. But then Melissa actually mentioned something I'd written in one of her Friday roundups! Gradually, the comments started to come and I began to realise that I was in fact part of an extraordinary grass-roots movement. When my first IVF cycle was cancelled and I put out a plea for help on Lost & Found, so many people whose blogs I'd never even visited before rallied round to offer their support and advice. After I'd been away for a few days last week, several people stopped by to say 'welcome home' - and at the moment, this does feel like home. I know that, here in the blogosphere, I will meet with more support and understanding than I have received from the majority of my 'real life' friends. I'm sorry that I haven't been around over the past week - I've been lax at commenting, as well as posting - but just wanted to say thank you, all of you, for being there.

Assvice

2008-03-19T09:12:00.006Z

Over the course of the past few days, it has been suggested to me that, if only I could 'just relax', I might still manage to conceive 'naturally'. I have been regaled with tales of a friend of a friend of my sister-in-law's who apparently did just that, and who then miraculously fell pregnant just before she was due to start her first cycle of IVF. I have been asked to consider the possibility that perhaps we are not meant to have children of our own and that, given the circumstances, we could always 'just adopt'.

All of the above is, of course, standard assvice. Anyone struggling with infertility will doubtless have heard similar things before from their own friends and family. But why is it considered helpful, or even acceptable, to say these things? Do these stock responses in fact say rather more about their embarrassment and discomfort, than about my infertility? It strikes me that there is at the moment no broader discourse on infertility and loss - or rather, that in the act of telling our stories and sharing our experiences, we are in the process of creating one here in the blogosphere. Unfortunately, however, the ripple effect seems slow to spread. Perhaps in time, people will begin to have greater understanding of the difficulties associated with infertility, and will stop and think before coming out with this crap.

Surprisingly enough, none of this came from my mother-in-law, who managed studiously to avoid the topic of our infertility - instead, she spent much of the weekend criticising Mr H and cooking up the type of highly-processed food that I never buy at home - over the course of the weekend, I've eaten more saturated fat and refined carbohydrates than ever I would in a month of Sundays.

I am accordingly both exasperated and bloated, but indescribably relieved to be back home!

My mother-in-law

2008-03-12T10:31:00.006Z

Mr H's mother is a woman of firm and decided opinions, many of which appear to have been gleaned directly from the pages of the Daily Mail. She is a devout Catholic, I am a committed feminist. There are many issues on which we do not see eye-to-eye: a woman's right to choose, UK immigration policy.... I could go on.

Mr H is one of five children - a fact which may well be attributable to his mother's religious beliefs, rather than to any strong maternal instinct on her part. She fell pregnant with Mr H and his brother soon after getting married and, in her own words, was 'absolutely devastated' to discover that she was carrying twins: 'I didn't want to be pregnant at all, let alone be having two babies'. Ten months after Mr H and his brother were born, she gave birth to a daughter. After what one can only assume to be a period of some twelve years' abstinence, there then followed two further babies - a girl and then, five years later, a boy. Although I can accept that ambivalence plays a necessary and important role in mothering, and that coping with three young children ten months apart in age is in particular a lot to contend with, from what Mr H has told me about his childhood, his mother reminds me of nothing so much as a turtle, who swims up to the beach, lays her eggs and then basically f**ks off and leaves her offspring to get on with it.

I will draw a veil over many of the more tactless remarks she has made over the time we've been struggling with infertility - suffice it to say that our difficulties in conceiving have not met with any degree of understanding or compassion from Mr H's mother. After I miscarried, she sent Mr H an email (she apparently could not be bothered to pick up the phone to speak to either of us in person). One particular sentence will forever be engrained on my memory (and please bear in mind that, at that stage, we thought we were dealing with male factor issues only): 'it is good that Ms H has finally relaxed enough in order to be able to conceive. Maybe next time, when she is less stressed about her studies, she will manage to carry to term.'

I was - and still am - speechless at her insensitivity. Had she perhaps been reading one of the many Victorian medical textbooks that warn of the dire effects of intellectual work upon a woman's reproductive system, or was this something she'd picked up from the Daily Mail? Does she in all honesty believe that my eggs have been addled by too much thinking?

Mr H has a few days' holiday left, which have to be taken by the end of the month. We are accordingly going down south to spend a long weekend with his parents. When you also factor in the smug fertiles and their intrusive questions, I think it will be a miracle if I get through the next four days without losing my temper and telling someone exactly what I think of them.

Letter to my body

2008-03-10T10:25:00.007Z

We've been together a long time, you and I. Like many long-term relationships, ours has shifted and developed over time.

In my teenage years, I was very bothered about how you looked. I spent a lot of time comparing you to other women's bodies. I measured you against the bodies of my friends, and against the bodies of the airbrushed models in fashion magazines, and I felt inadequate in comparison - somehow, you didn't quite seem to measure up. At that stage in my life, I was hung up on external appearances; your internal rhythms remained a mystery to me; your monthly bleeds were nothing more than a messy inconvenience.

In my twenties, a late period was a cause for panic, rather than optimism. The decade seemed to pass by in a whirl. I stayed out late, and subsisted on coffee and KitKats. I took it for granted that you could handle whatever I threw at you. I didn't treat you with the respect you deserved. For all the Big Macs and the tequila slammers, I am truly sorry.

In my thirties, I began to take better care of you. I ate right, and exercised. And I grew increasingly angry with you when you failed to repay that care. I felt frustrated and betrayed by your inability to do what you were designed to do - to conceive and sustain new life. Paradoxically, it was only after I suffered a miscarriage that I was able to let some of those negative feelings go. The only way I could begin to come to terms with having lost a baby was by trusting in you - by accepting the fact that you had recognised that the foetus was not viable, and so had dealt with it as quickly and efficiently as you could. I decided that I needed to have a little more faith in you; I learnt to respect your rhythms and chart your cycles. But the odds were stacked against us - tests had revealed that there were fairly major problems with Mr H's sperm. And so we felt we had no option but to turn to ART - ICSI, to be precise.

Over the past three months, I've put you through a lot. I've pumped you full of artificial hormones designed to put you into a temporary menopause. As if that wasn't enough, I then took even more drugs designed to make you work overtime, and to produce more eggs than ever you would when left to your own devices. And, perhaps understandably, you rebelled. You failed to respond to those drugs.

Next month, I'm going to ask you to do the same thing all over again - only we'll be using even more drugs. And this time round, I need you to trust me; as alien and as counter-intuitive it might feel to you, this seems to be the only way for us to have a baby. Please, please work with me on this next cycle.

Yours, hopefully,

Ms H xx

The Letter to My Body project was initiated over at BlogHer. My own letter was prompted by Melissa's thoughtful post on how infertile women in particular view their bodies. You can read Mel's own letter, as well as links to those of other women struggling with infertility and loss by following this link.

Plan of action

2008-03-06T11:28:00.006Z

Yesterday, we returned to the Great Big Fertility Clinic for our review appointment with Dr Abrupt.

Dr Abrupt, I am now beginning to appreciate, responds better when confronted with specific questions, as long as they are not overly emotive, and are couched in relatively scientific language. 'Are my ovaries on their last legs?', for example, will not meet with a good response. If, on the other hand, this same question is rephrased as, 'How worried should I be at this stage about diminished ovarian reserve, or could my poor response to the last cycle simply be down to either over-suppression or under-stimulation?', he is more willing to engage in dialogue.

His answer to the above was that, at this stage, we simply don't know. Once again, he reiterated that my FSH levels (7.6 in March 2007, 5.6 in September 2007) did not appear to indicate any underlying problem which could have been anticipated before we started treatment in December; we simply have to try a different protocol and see what happens this time round.

He recommended that we wait another month before trying another cycle. This time round, we will do a shorter, 'flare' protocol, and will triple the dose of Menopur from 150iu to 450iu. I did ask why he thought Menopur was the best option - would I perhaps respond better to a recombinant? He referred to an unspecified meta-analysis (as anyone who has read of my prior dealings with Dr A will know, he is very keen on statistics and meta-analyses) which suggested that the choice of either a recombinant or a urinary based stimulant did not appear to have any major impact on success rates. Having had such a poor response to the Menopur last time round, I do feel a little bit iffy about taking it again, and will perhaps raise this particular concern with him at our next appointment.

He also suggested that, this time round, we would definitely proceed to retrieval, whatever my response. We are now at the stage where he feels it necessary to have a sense of the quality of any eggs I do produce - that way, he will be able to advise us on whether he feels that there is any point in us continuing treatment.

Such a lot is riding on this next cycle. Although there is a tiny voice inside me telling me not to panic, that I could well be OK on this new, more aggressive protocol, there is a far larger part of me that is trying to begin to find a way of processing the fact that this cycle could possibly mark the end of the road for us.

The (Infertility) Time Warp

2008-03-03T15:09:00.007Z

Last week, I stepped off the treatment treadmill. I drank coffee! And wine! Had I been able to find anywhere in Granada that served sushi, I'd have probably eaten that as well... but instead, I gorged myself on tapas - salt cod croquetas, albondigas, calamares and pulpo alla gallega. We visited the Alhambra, and had a memorable meal in a Lebanese restaurant in El Albaicin, the old Moorish quarter of Granada (as you may be able to tell, Mr H and I lay down our holiday memories in terms of what we ate - a week in Nice, for example, is now largely defined by an exceptional tarte au chocolat, which still sparks fond reminiscences two and a half years later).

But the best thing about going away? Spending time with my husband. Infertility, I have come to realise, can make it extraordinarily difficult for one to live fully in the present. Instead, I seem to spend much of my time trying to second-guess what the future may hold. The reality is that at the moment we simply don't know whether we will have a child or not, and so we have endless conversations about whether we should move house, or whether we should wait until things have resolved themselves one way or another. I worry about whether I should go all out to get a permanent job, or whether I should put my career plans on hold while I focus on IVF.

As soon as I realised that our first cycle of IVF was going to have to be cancelled due to my poor response, I was looking to the next cycle. What will we do differently next time? How soon can I start treatment again? Even when we are not undergoing treatment, I find it difficult not to think in two-week increments; either I am awaiting the moment when I am ovulating, or I am looking out for the signs of early pregnancy - and then my period starts, and the whole cycle of hope and disappointment begins all over again.

I'm so busy thinking about what is currently missing from my life that I don't spend nearly time appreciating what I do have. But last week, I realised how lucky I am. I am married to a wonderful man, who makes me laugh. Even after seven and a half years, I can still get butterflies in my stomach when I look at Mr H across a room. We can stay up late into the night talking, but equally we can sit in companionable silence, each lost in our respective books. Things will undoubtedly be different if we don't have children, but our lives will not be over. And so I have resolved to stop endlessly trying to project myself into the future, and to focus more on enjoying what is going on in the here-and-now.

Bloggering off!

2008-02-24T11:17:00.004Z

For much of the past week, York has been enveloped in a fog of Dickensian density - and so we are fleeing south to warmer climes for a week's holiday.

We've managed to get a cheap flight to Malaga, and from there plan to make our way to Granada.

Sunshine and tapas here we come!

Does my bum look big in this?

2008-02-21T13:19:00.008Z

Yesterday, I called in at the supermarket. In addition to a vast array of highly processed food stuffs, it also sells a range of clothing for both children and adults. It currently has in stock some long sleeved tops designed for little girls of age 5 and under. Emblazoned across the front of these tops, in pink glittery writing, is the question 'does my bum look big in this?'

Do we really need to instil body consciousness in children so young? Or is that in fact the way the beauty/diet industry works - by catching them at such a tender age? By the time our girl children start school, have they already learnt to measure their own bodies against the airbrushed images offered up to them by an ever-more celebrity obsessed culture? Do they even then feel inadequate in comparison?

Other people's children

2008-02-19T11:08:00.004Z

I tend increasingly to make excuses not to see friends with children. As time has gone by, I find that we have less and less in common. Where they have progressed smoothly down the road to parenthood, we somehow took a wrong turn and found ourselves on the lonely and inhospitable path marked 'infertility'.

On Sunday, however, our friends Jonathan and Amanda came over for the day, bringing with them their son Richard, who will be three in April.

Luna and Pamela Jeanne have both recently written thoughtful posts on this very topic, in which they suggested that what is difficult isn't necessarily the children themselves, but rather their parents. Mr H has a tight knit circle of friends who I have labelled 'the smug fertiles'. Since the first couple announced they were expecting a child, there has been something of a domino effect amongst the smug fertiles - whenever we see them, someone else is either pregnant or has just recently had a baby. Last time round, it was Mr H's best friend and his wife who were expecting - after telling us the news, he actually said to us, 'don't worry, I'm sure you'll be next.' ('I'm sorry,' I replied acidly, 'I didn't realise that it was a race to the finish.') To some of the smug fertiles, our infertility has become the elephant in the room - they will go to any lengths to avoid mentioning it. To Mr H's best friend, on the other hand, it appears to be a source of some considerable fascination - he likes to ask detailed questions about our treatment plans, most particularly about their cost. Perhaps he is trying to show concern, but his questioning comes across as, at best, patronising, and, at worst, prurient.

Jonathan and Amanda, on the other hand, are different. Jonathan was left completely infertile after treatment for testicular cancer at the age of eighteen, and Richard was conceived on their fifth and final attempt at IUI using donor sperm. Unlike the smug fertiles, who appear to see parenthood as an automatic right, they take nothing for granted. On our walk into town, Amanda confided in me that she would never forget what they had to go through to build their family. And this is why I find it far easier to be around them, and to share in the joy they have in Richard. The last time I saw him, he was still a baby. Now, however, he is an excellent conversationalist, who asks questions ('why don't you have a playroom? where do you keep your toys?') and has decided opinions ('this isn't fizzy water; it tastes like it's from the tap').

Within five minutes of their arriving, the living room was strewn with toys. I tried not to wince as Postman Pat's van was crashed at high speed into my antique side table. After they had left, we scraped the mashed banana out of the carpet, cleaned the sticky hand prints off the TV screen and spent half an hour coaxing the cat down from on top of the wardrobe, whence she had fled in fright from Richard. Parenting a toddler was, we decided, a non-stop activity.

After a day in Richard's company, we were both struck by the enormity of how much our lives would change should we be lucky enough to have a child. We would surely learn to be less precious about the house. Time to ourselves, both individually and as a couple, would become a thing of the past. We would make sacrifices, and in return we would be rewarded by watching our child grow. Yet the moments of joy and unconditional love would doubtless be tempered by moments of boredom and frustration. And I could not help but wonder, am I ready to become a mother? I have spent the last seven years slogging away writing a PhD. I have just had my first piece of research published. How would I balance an academic career and a child? If I have a baby, would there perhaps come a moment when I longed to leave it to cry, to go into my study, shut the door and get on with my research?

Strange sightings and new experiences

2008-02-15T14:46:00.008Z

Yesterday, I followed two Viking warriors into town. They were evidently off-duty, because they were carrying their helmets and daggers with them in carrier bags; one of them was on his mobile phone, while the other was drinking a cup of takeout coffee. Eventually, I turned off the main street to go to the acupuncture clinic, while the Vikings continued on into the centre of York - possibly to rape and pillage, but more likely to entertain the vast queues of school children waiting to visit the Jorvik Centre.

At the acupuncture clinic, I saw the Chinese Fertility Goddess, who is now back from her holidays. She listened to my pulse and looked at my tongue, before pronouncing her opinion to a hushed and reverential group of students. I'm not sure whether I understood exactly what she said - something about liver qi stagnation and blood stasis, perhaps? - but she did pick up on the fact that the pulse in my left wrist was much fainter than that in my right. When I mentioned the fact that my left ovary had not responded to the Menopur, she didn't look at all surprised, and promptly stuck two needles in its vicinity - when she put them in, a great pain shot round to the back of my body. I also had needles in the crooks of both my knees, on both calves, my right foot and my left wrist, all of which were designed to encourage the qi to flow more freely around my body. The CFG warned me that I would feel very tired and emotional after the treatment, and I did indeed have to have a sleep yesterday afternoon.

But when I got back from town, I discovered that the bread maker had arrived. So now, I may not have a bun in the oven (is that a uniquely British colloquialism for pregnancy?), but I do at least have a loaf in the bread maker!

Tagged!

2008-02-13T11:18:00.006Z

The lovely Luna over at Life From Here (who has just won a well-deserved E for Excellence Award) has challenged me to tell you a few random facts about myself. The rules are as follows:

1. Link to the person who tagged you.
2. Post the rules.
3. Share 6 non-important things/habits/quirks about yourself.
4. Tag at least 3 people.
5. Make sure the people you tagged KNOW you tagged them by commenting on what you did.

So, here goes:

I am extremely allergic to horses (think full-on asthma attack!). In adult life, this is not a major problem; I simply give them a wide berth. As a child, however, I took it very badly. I read every single one of the Jill of the Gymkhana books, and bitterly regretted the fact that I too could not be off having jolly pony-related adventures.
In the last year of my undergraduate degree, I applied to go to law school. I was offered a place, but then at the last minute I decided to do an MA in Feminism & the Visual Arts instead. I have never regretted not pursuing a career in the legal profession.
I have ridiculously small feet (a UK size 2.5, continental size 35). This means I struggle to find shoes that fit me. People tell me that I am fortunate because I can buy cheaper, children's trainers. But I do not always want to wear kids' shoes. Sometimes, I want to wear impractical, high heeled, strappy evening sandals.
According to Mr H, I compensate for not being able to find shoes that fit by buying Too Many Handbags. Mr H and I have very different ideas about what constitutes Too Many Handbags. Mr H does not understand that different occasions may require different handbags; one handbag should, he thinks, cover all eventualities.
My life increasingly revolves around what's for dinner. I cannot walk by a restaurant without stopping to read the menu; I always like to choose what I would have if we were to eat there. I also love to leaf through recipe books and plan what I could hypothetically make to eat. In my mind, I plan fancy dinners which are far more elaborate than anything I would normally cook.
I am a nervous flier. As soon as I get on board, I read the safety card. I also always check that my life jacket is in fact under my seat where it's supposed to be. Once up in the air, I like to remain in my seat, gripping the armrests, with my seatbelt firmly fastened. If at all possible, I will avoid going to the toilet during the flight - I am frightened that I may somehow get sucked out of the plane, or that we will crash while I'm in the loo, and that my body will be found in a tree, forever frozen in the act of hitching my knickers up (my anxieties in this last respect are not helped by Mr H, who likes to reassure me that, were the plane to plummet from the sky, the chances are that the sudden loss of pressure would cause my body to disintegrate before hitting the ground).

This particular meme does seem to have done the rounds quite thoroughly, but I'm going to tag Lisa at Infertile Ground, Malloryn at Quest for a Lifetime and the anonymous lady over at My Baby Quest, in the hopes that they will be up for the challenge.

Give us this day our daily bread (but no sodium stearoyl-2-lactylate)

2008-02-11T14:17:00.001Z

I read a lot. Weighty academic tomes. Impenetrable critical theory. Students' essays. Other people's blogs. Recipe books. The occasional magazine. Contemporary fiction. I have a particular weakness for vast, sprawling, nineteenth-century novels and for biographies of obscure women modernists.

When there is no other printed material to hand, I will even read the small print on the backs of packets and jars. And so it was that I discovered that the loaf of bread I bought from the supermarket last week contained stoneground wholemeal wheat flour, water, yeast and salt. No surprises so far, then (although I would not necessarily expect a single slice of bread to contain nearly 1 gram of salt).

But then I continued to read the list of ingredients. In addition to the above, my '100% wholemeal, farmhouse loaf' also contained mono- and diacetyl tartaric esters, sodium stearoyl-2-lactylate, calcium suphate and calcium propionate.

I do not know what any of the above are, but they sound like they belong in a chemistry lab, and not in a loaf of bread - 'farmhouse batch' or not.

Like many people we try to live sustainably. Wherever possible I buy locally produced, seasonal produce; bread is one of the few 'ready made', processed foods I still purchase from the supermarket.

The sodium stearoyl-2-lactylate is, however, the Last Straw. I have gone online and ordered a bread maker. From now on, I will bake my own bread - that way, I can be sure of what has gone in it.

And OK, I admit it - it did also cross my mind that the nasty chemicals we've been consuming along with our daily bread may be responsible for both Mr H's wonky sperm and my recalcitrant ovaries. There is a small part of me that is hoping cutting them out may obviate the need for further medical intervention!

An alternative view

2008-02-08T13:54:00.001Z

From my obsessive Googling, I've discovered that acupuncture may not only help with implantation but, more importantly in the light of my recent experiences, may also encourage follicle stimulation and improve the quality of the endometrium. Having overcome my squeamishness about needles, I decided that it was perhaps time to give it a shot (no pun intended!).

I had my first consultation yesterday, having discovered that there is a large training college situated just fifteen minutes walk from my house, which offers treatment at reduced rates.

I was seen first by two second year students, who went through a standardised questionnaire with me. I was asked to outline my symptoms, and then to describe how they effected me on a day-to-day basis. What effect did they have on my emotional state? Looking into the future, how would I feel if I was still experiencing the same symptoms in five years' time?

I pondered this one for a minute. At the moment, I cannot see an end to this. I cannot fast-forward to some fantasy point in the future where everything has worked out and we finally have our longed-for child. But equally, I cannot bring myself to think that the time may come when we have explored every treatment option, and are having to learn to live with involuntary childlessness. How might I feel in five years time? Bitter, angry, dejected and exhausted, were just a few of the adjectives that came to mind. My eyes filled with tears. 'What you're describing is a chronic condition,' said one of the students, gently. It was at that point that I decided that maybe they might actually be able to grasp something of the impact of infertility.

We were then joined by a third-year student, who led the consultation, and by a training supervisor. There was a slightly disconcerting moment where I was asked to stick out my tongue, and all four of them gathered round to stare at it, and then the third year student and the training supervisor asked me a number of questions about the various treatments, tests and diagnoses we've had so far, and then a series of more detailed questions about my menstrual cycle. I'd also taken my BBT charts from the last six months with me, which the supervisor seemed particularly interested in.

Where Dr Abrupt appears to see only a malfunctioning uterus & ovaries, the acupuncturists seemed to see a whole person; they listened to my body differently. I am to go back next week for my first treatment, but at the moment feel very positive at having taken this step.

I walked home through the park. York is enjoying a spell of unseasonably warm weather at the moment, to the point where I could take my coat off and carry it with me. It is somehow easier to be optimistic when the sun is shining and the first snowdrops have appeared, and so I resolved to try to leave all the negative feelings associated with the cancelled IVF/failed IUI behind me, and to focus on moving forward to the next cycle.

Big. Fat. Negative.

2008-02-04T13:41:00.002Z

The title pretty much says it all. The IUI didn't work - AF arrived with a vengeance at the weekend.

I knew it was a long shot, and yet I hoped. After all the unrelenting shittiness we've experienced so far, I thought that maybe, just maybe, we deserved a bit of a break - a bit of good luck, for a change.

But I was wrong. We're not even back to square one - it feels that we've slipped even further back than that. Now we have to deal with my poor response, as well as Mr H's wonky sperm. Our dreams of becoming parents seem further away than ever before.

Looking back to the past

2008-02-01T09:17:00.002Z

This week marks the first anniversary of what would have been my due date.

I have thought a great deal about how to phrase that sentence, but however I try to express it, it sounds awkward. There is no cultural ritual that would enable me to mark an event that never took place. There is no commonly held discourse through which I might explore my feelings about that not-yet-baby who never fully formed either in my body or in my mind.

When I think back to my pregnancy, I cannot think beyond seven weeks. My imagination does not carry me on into the second trimester, to seeing my belly visibly swell, to feeling the baby move for the first time. I cannot imagine myself preparing for the birth, or bringing a baby home from the hospital. I cannot picture myself as mother to a one-year-old child, making plans for a birthday party.

Instead, I am precipitated back to that hot, airless weekend in June when I miscarried. I remember the cramps that first alerted me to the fact that something was desperately wrong. I remember how, after the bleeding started in earnest, I lay in a small patch of sun at the end of the bed, knowing that my body was ridding itself of the baby I had so desperately longed for, and that there was nothing I or anyone else could do to halt the process. I remember being faintly surprised that losing a baby was such a slow and insidious process - my sense of what it might be to miscarry had up to that point been largely gleaned from television dramas, in which actresses collapse suddenly and dramatically, clutching their stomachs.

Everyone, even Dr Abrupt, tells me that the fact that we did once conceive spontaneously is cause for optimism. But I am haunted by the possibility that that could have been my only experience of pregnancy. What if that was my one chance? Would all the subsequent BFNs be easier to handle if I had not had that one positive?

Facing the future

2008-01-28T14:12:00.002Z

Reading other peoples' blogs, I am struck by how many of you feel that infertility has brought you closer to your partner. Our difficulties in conceiving have, I think, ultimately strengthened our relationship, but they have also at times stretched it to breaking point. We have very different ways of coping - where I search for a reason as to why this had to happen to us, Mr H has somehow managed to achieve what seems to me a zen-like level of acceptance.

Over dinner last night, we had a variation on a conversation that we've already had several times before, and which neatly encapsulates our different approaches.

Me: Do you think that we will ever have a baby?

Mr H: I can't answer that question. We'll have to wait and see.

Me: But what happens if we don't? What happens if a different protocol doesn't work? What happens if IVF isn't an option for us? What happens if we go through this whole process, and we don't end up with a baby at the end of it all?

Mr H: Then our lives will follow a different path from the one we had originally envisaged.

Me: But won't you regret not having had a child? Don't you feel that something will always be missing from our lives?

Mr H: That's a difficult question to answer. How can I know if I'll miss having something I never had in the first place?

When I was nineteen, my mother died of breast cancer. Over the past sixteen years, I have grieved deeply for her. It was a shock to realise that last year would have been her sixtieth birthday. I realised that I had very little sense of what she might have been like as a sixty-year-old woman; in my imagination, she is forever frozen at 44. I do not know what kind of relationship I might have had with her as an adult woman. But I do know that I miss her. I missed the fact that she was not there to help me plan my wedding. I miss the fact that, if I have a child, she will not be there to hold her grandchild, or to offer me advice, or to tell me that I used to do the same thing as a baby.

And in the same way I know that, even if I never fall pregnant again, I will still miss not having a child. Watching other people's children grow up, I will always be reminded of the baby I lost, of the children I might have had. I'm not sure whether it is ever possible fully to come to terms with involuntary childlessness. I may learn to live with it, but I know that I will always carry a certain sense of loss with me, in much the same way as my grief at my mother's premature death has become woven into the very fabric of my being. Like that other, earlier loss, it will shift and change as I shift and change.

Loribeth recently wrote a courageous post about finding her voice as a childless/free woman. She spoke about the social stigma attached to involuntary childlessness:

Society at the moment is so fixated on pregnancy & parenthood that a baby is seen as the only outcome of fertility treatment that can be considered a success. Childfree living just doesn't provide the requisite happy, fairytale ending - even though most of us (eventually) go on to lead happy & productive lives after we abandon treatment - & our dreams of having a family.

Loribeth went on to suggest - and here I hope that I am not putting words into her mouth - that the discomfort that surrounds those living childless/free after loss and infertility is sometimes particularly marked here within the IF community. 'I'm not always entirely sure,' she writes, 'that fellow infertiles want to hear what we have to say about life beyond infertility treatment (and there IS one out there!!). I can remember, on one of the boards I post on, that someone once wryly referred to us as "the black sheep of the infertility community."'

My own recent experiences have brought home the fact that, where infertility is concerned, there are no guarantees. A life without children suddenly seems a far more vivid possibility.

And this is precisely why I am grateful to women such as Loribeth and Pamela Jeanne, who tell their stories with such honesty and courage. This post has perhaps been a rather roundabout way of saying that, although I may lurk more often than I comment on their blogs, I think that they are a very important part of the IF community - as Melissa said in her comment on Loribeth's post, maybe if more people spoke positively about their childlessness, and if there was more support available for those who decided to stop treatment, then maybe it would become easier to accept childless/free living as a potentially creative way out of the pain of infertility.

On not counting your eggs before they're retrieved

2008-01-27T17:20:00.001Z

Over at Just One Bean, the lovely Katarina recently shared a story about a woman she had encountered on a message board. This woman was due to start an IVF cycle in March, and wanted to know if it would be OK to take a trip to Disneyland the following month, since by then she would be six weeks' pregnant. My own obsessive Googling has recently unearthed a similar post from a woman who was just beginning her first cycle of IVF here in the UK. She was overjoyed to report that she had managed to get all of her maternity wear for less than half price in the January sales.

I've been thinking a lot about these women over the past ten days or so. When I read Katarina's post, I prided myself in not sharing what I considered to be the Disneyland woman's misplaced optimism. I was not nearly so naive, I told myself. I was not jumping ahead of myself and making plans that very probably would not come to fruition. When I started IVF, I was daunted by the enormity of what I was about to put myself through, physically and emotionally. The only way I could make sense of it all was by breaking the cycle down into a series of smaller stages. I was, I wrote on Katarina's blog, focusing on getting to the next stage - on making it through the next injection, the next scan. I could not, I suggested, project myself forward even to the point where I might take a pregnancy test, let alone imagine myself six weeks' pregnant.

Yet now I wonder, am I really so different from those women on the message boards? It never crossed my mind that this first cycle would have to be cancelled because I did not respond to the drugs. All the tests I had had led me to believe that everything was OK - my FSH levels were good, I ovulate regularly. There was no sign of any underlying problem. And so I presumed that IVF was an option for us. I presumed that, if I did not get pregnant this time round, we would be able to try again - perhaps initially with a FET, and then with a second, or even a third, cycle. I suppose that, deep down, I was presuming that this would all work out for us and that we would one day have a child.

But now I realise that there may not be a happy ending. Maybe the IUI will work. If it doesn't, then maybe I will have a better response on a different protocol. But maybe I won't. Maybe, just maybe, this could be it.

On being a 'good' patient

2008-01-22T09:44:00.001Z

Thank you all for your supportive comments about my difficulties with Dr Abrupt - his ears must have been burning over the weekend!

Hekateris mentioned that she had had similar problems at another UK clinic, but didn't say whether she was being treated as a private or an NHS (National Health Service - i.e. state funded) patient. We are paying to have private treatment in an NHS clinic, which I think may go at least some way to explaining Dr Abrupt's attitude. I don't want this to turn into a lengthy post about the shortcomings of the NHS, so will only say that there is huge pressure on resources, and the impetus seems to be to get people in and out as quickly as possible. We were aware of this when we chose this particular clinic, as opposed to the fancy private one fifty miles further away; we decided that it was more important to be treated in a research-led clinic, rather than somewhere that offered fluffy dressing gowns and up to date magazines in the waiting room.

This does not, however, entirely excuse Dr Abrupt's behaviour on Saturday. I left the clinic feeling profoundly infantilised. Obviously, this may say rather more about me than it does Dr Abrupt - I was, after all, brought up to be a good little girl, and not to bother the grown ups. And yet it also says something about the authority patterns that continue to subtend our dealings with our doctors: however well-informed we may be, we are still led to believe that the Doctor Knows Best. As many others have already stated far more eloquently than I ever could, one of the most difficult things about infertility is the loss of control. In our bid to have a child, we hand our bodies over to the medical profession; we obediently take the drugs they prescribe, drugs which disrupt the cycles we have so painstakingly learnt to chart (one of the most difficult things about the last few weeks has been the feeling that I no longer understand what is going on inside my own body). We are rendered not only emotionally but also physically vulnerable, as we lie on their couches with our most intimate parts exposed. One of the ways in which I have tried to claw back some control is by finding out as much as I can about my own condition. I am an academic, and I approach infertility in the same way as I do any other unfamiliar topic: I read around the subject, and then I ask what I hope are intelligent and informed questions. And that is precisely why I do not like being patronised and dismissed.

We returned to the clinic yesterday for the IUI, still prickling with resentment towards Dr Abrupt. Despite some anxieties in the car on the way over, Mr H rose to the occasion and came up with the goods, and then at 1pm sharp we were called in for the treatment itself.

The whole thing felt a little perfunctory. I thought that they might do another scan to confirm that we were all ready to go, but no-one even asked if I had done the trigger shot on Saturday evening. We were both asked to confirm our full names and dates of birth, then Dr Abrupt got busy with the speculum. The procedure itself was over really quickly, and was far less uncomfortable than a smear test. From behind the curtain, I heard the sound of Dr Abrupt removing his latex gloves. I should lie there for about five minutes, and then I could leave, he said. I then heard the door opening. 'Dr Abrupt?' I called. He stuck his head round the curtain. I took a deep breath. 'I feel that our appointment on Saturday raised more questions than it answered, and I just wanted to make sure that we would have chance to talk through some of those issues in more detail before we started another cycle of IVF.'

'If the IUI doesn't work, then of course we will arrange a longer appointment in a few weeks time to talk about what we learnt from this cycle, and to think about what we'll do differently next time. But for the time being, try and think positively.' He even managed a reassuring smile.

Obviously, he does have something resembling a bedside manner!

Five minutes later the nurse came in. If I hadn't had a period in a couple of weeks, I should probably do a home pregnancy test, she informed me. Would I not have to come into the clinic for a beta, I asked. 'Oh no,' she replied, 'that's only if you were doing IVF.' Should I start using the progesterone pessaries, I asked. She did not know, but would go and ask Dr Abrupt. She returned a few minutes later. 'Oh no,' she answered - you've guessed it - 'those are only if you're doing IVF.'

So now we wait.

Fourth appointment - at which more questions are asked than answered

2008-01-19T16:21:00.002Z

We got up early this morning, and reluctantly drove the 25 miles to the Great Big Fertility Clinic for our appointment with Dr Abrupt.

Afterwards, we conducted a lengthy postmortem over lunch. Was I being unnecessarily pushy and demanding, I asked Mr H. 'No,' he replied, 'but Dr Abrupt did a pretty good job of making you feel that you were.'

Mr H has up to this point been a major apologist for Dr Abrupt. Dr Abrupt has, Mr H has consistently pointed out, an excellent reputation. He runs one of the largest and most successful IVF units in the UK outside London. For those who set store by such things, he was last year listed as one of the seven best fertility experts in the country by Tatler magazine. More importantly, Mr H recognises in Dr Abrupt a fellow man of science. Like Dr Abrupt, Mr H does not deal in what ifs or maybes; he prefers cold, hard statistics.

But today, Mr H came away from our appointment feeling as non plussed as I did.

The dildo cam revealed that three of the follicles on my right ovary had grown to 19mm, 14mm and 13mm respectively. The remaining two follicles hadn't grown beyond the 10mm stage. 'We have seen this sort of thing before,' Dr Abrupt blithely commented. 'Some couples like to go ahead with egg retrieval, but others prefer to cancel and start treatment again in a few months. What would you like to do?' 'What would you recommend we do?' I asked. He did look pretty shocked to have been asked such a direct question, but eventually conceded that it would probably be best to cancel, given that I only had one fully mature follicle. At this point, I raised the possibility of an IUI. He went along with the suggestion, but does feel that the chances of success are pretty slim given Mr H's swim up analysis. Dr Abrupt would, we decided over lunch, have made an excellent politician, given his seeming inability to respond to any question directly, but instead to quote statistics or to else draw graphs on the back of patients' charts.

'Can you give me some reason as to why this might have happened?' I persisted. 'Is a poor response always indicative of a diminished ovarian reserve?' He replied that a first cycle of IVF was as much a test as a treatment, that they had gained some important information about our fertility levels as a couple, that they had put me on a standard protocol based on my Day 3 FSH levels, that they could safely increase the dose of the stimulant drugs next time, and that they had many different protocols they could use. At this point, I saw my chance and asked him whether those different protocols included a shorter, 'flare' one.

By this stage, it was becoming apparent that I was beginning to get on his nerves. Dr Abrupt, I think, looks at his patients and sees only a set of reproductive organs which will or will not do what they are supposed to. He does not realise that those organs are housed in an individual, an individual who has endured years of heartache before she winds up in his clinic and who will, in all likelihood, have spent some of that time finding out as much as she possibly can about her own condition. He retorted that he had a waiting room full of other couples and so was not willing at this stage to get into discussions about my next cycle, that we would have to wait a couple of months at least before resuming treatment, and that he would explain the short protocol to me nearer the time.

My many questions will evidently have to wait until Dr Abrupt is ready to answer them. But I am not going to be intimidated: I will store them up, and keep asking until I get a satisfactory response. You've all been so helpful with your comments and suggestions, and I'm reassured to learn that several of you have bounced back from a similar situation. Based on some of your comnments, I'm quite reluctant simply to go with an increased dose of Menopur next time round, and will be pushing for a different stimulant.

In the meantime, however, we are going ahead with an IUI - I will do the trigger shot at 10pm this evening, and then we will return to the clinic on Monday morning.

Thank you

2008-01-18T11:29:00.002Z

After spending much of yesterday crying, and cursing my lousy fucking ovaries & the lousy fucking doctors, I went to bed at 10pm with a splitting headache. I logged on this morning to find all your fantastic messages of support. I want to thank each and every one of you for your kind words - it means a great deal to know that there are so many of you out there rooting for me.

Luna asked about Mr H's SA. Based on the tests we've had done so far, his count ranges from between 17 & 19 million, and motility between 54% & 76%. The main problem seems to be with morphology (the results have consistently showed around 75% abnormal forms). They also do not appear to hang around for that long - when we switched to this particular clinic, they performed a swim up test which showed that, two hours later, most of them are dead in the water.

And yet, in spite of Mr H's wonky sperm and my now seemingly recalcitrant ovaries, we did manage to conceive without medical assistance (I then lost the baby at seven weeks) - which is what led me to think that IUI might be a way of salvaging something from this cycle.

I've spent the morning obsessively googling such cheering phrases as 'IVF poor response' and 'diminished ovarian reserve', and have come up with a list of questions ready to ask Dr Abrupt tomorrow:

Is it possible for us to convert this cycle into an IUI? And secondly, what are the costs involved in doing this? As Claire so rightly acknowledges, money is an issue in all of this. If we cancel this cycle prior to retrieval, we still have to pay £1,000 plus £500 for the drugs (the bulk of which I have now taken). If we go ahead, we are looking at £3,000 for a complete cycle plus the £500 for the drugs. Working on the assumption that we are unlikely to get a positive result with this first cycle, then it makes financial sense to cancel & focus our efforts on the next cycle, rather than paying out for something that probably will not work.

Other questions for Dr Abrupt:

Why did I have such a poor response to the Menopur? Is this an indication that my eggs are in fact past their sell by date, or do they simply need to adjust the meds?

And finally, leading on from this last one, do they have a protocol in mind for next time? As both Mel and Luna asked, is there a particular reason why they seem so intent on Menopur? Would a shorter, 'flare' protocol perhaps produce better results?

From what I read, it seemed that acupuncture may help - does anyone have any thoughts, positive or negative, on this one?

Dr Approachable said that I should in the meantime carry on with the Menopur injections, which I have been doing. But all we can do now is to wait - tomorrow's appointment will presumably resolve things one way or another.

Third appointment - at which I am proved right, shit does happen

2008-01-17T14:49:00.001Z

This morning, I headed back to the Great Big Fertility Clinic for another scan.

After a full week on the Menopur injections, I have managed to produce a sum total of five follicles. On my right ovary, I have two follicles measuring 10-13mm, plus another two measuring 8-10mm. On my left ovary, I have one follicle that is well under 10mm.

We are to go back to the clinic on Saturday morning for another scan, however at the moment our options - as outlined by Dr Approachable, who was wielding the dildo cam this morning - are as follows:

1. They go ahead and retrieve the eggs from the two largest follicles early next week. Given that we were scheduled to do ICSI, which requires fully mature eggs, and there is a further chance that the ICSI process may itself damage a certain percentage of those eggs, the chances of fertilisation look fairly slim.

2. We cancel this cycle owing to my poor response to the stims, and start all over again with a more aggressive protocol in a couple of months.

I did suggest a third option, that we turn this cycle into an IUI, but Dr Approachable pretty much ruled this out owing to Mr H's poor swimmers.

While I sobbed into a tissue, he made all sorts of reassuring noises - my most recent bloodwork showed that my FSH levels were 5.6, which he considers good for my age (I've just turned 36). Based on those results, he told me that there was no need for me to panic about having a diminished ovarian reserve. It was, he suggested, by no means the end of the road for us; next time round, they would simply increase the dose of Menopur.

But I still don't understand why this has happened. Did I do something wrong? Did I administer the injections incorrectly? I've spent the last three and a half weeks pumping myself full of drugs - why didn't my stupid, fucking ovaries respond?

I thought that starting IVF would take us one step closer to having a baby, but that now seems further away than ever. Before today, our problems never seemed insurmountable. I checked out fine; all our difficulties seemed to lie in Mr H's wonky sperm. ICSI would, we thought, enable us to bypass that particular problem. We weren't naive enough to think that it would work first time round, but we did think that eventually it would. 'Maybe it'll take us two or three cycles,' we told ourselves, 'but we'll get there in the end.'

But now we're facing an entirely new and unexpected problem. The door hasn't exactly been slammed in our face, but I do have a sense that it's drawing slowly shut, and right now it seems that there is very little I can do to stop it.

Caring and sharing

2008-01-15T14:03:00.001Z

In bed this morning, Mr H had the temerity to complain that I had not shaved my legs. 'Please don't cuddle me,' he implored. 'When you wrap your legs around mine, it feels like you're stabbing me with hundreds of tiny needles.'

I managed to resist the temptation to load up a syringe of saline solution and stick him there and then. Instead, I brandished my IVF goody bag at him and shrieked, 'How would you like to find out how it REALLY feels to be stabbed with hundreds of tiny needles?'

I guess I can now add irritability to the list of side effects from which I am suffering.

Over the next hurdle...

2008-01-11T13:30:00.001Z

This morning, I got all psyched up to inject myself for the first time. I unpacked my IVF goody bag, assembled my sharps bin (just the IKEA bookcase to go, then), read through Melissa's fabulous advice, snapped the top of the little vial, drew up the solution, mixed it with the powder, switched needles, got rid of the air in the syringe, loaded up the Autoinject pen, took a deep breath... and fired!

Using the Autoinject pen made the process a lot easier: I'm sure I would have been even more freaked out had I actually had to watch the needle going in...

But that first injection really did feel like a rite of passage - I'm half hoping that I may now be invited to join some secret IF society that no one has told me about before!

Second appointment

2008-01-10T13:17:00.001Z

This morning saw our second visit to the Great Big Fertility Clinic. Dr Abrupt wasn't on duty this time, so we got to see Dr Approachable instead, which meant that I had a chance to raise some of the questions I didn't feel able to ask during our last appointment. The scan confirmed that I was ready to start the stims, and the nurse taught us how to administer the Menopur injections. Having shown us how to prepare the shots, she then did the first one for me, so I have still to get over the hurdle of injecting myself - I'm sure tomorrow morning will find me dithering anxiously in the bathroom, syringe in hand!

Our next scan is scheduled for a week today, with the retrieval tentatively planned for 21 January - gulp!

We were done at the clinic by just after 9am, and I then popped into work to collect a pile of marking. Because Mr H had taken the whole morning off work to come with me, we decided that we had time for a quick trip to IKEA to purchase an extra bookcase to house our ever-burgeoning book collection. Two years ago, we bought a new kitchen from IKEA. I will not re-hash the whole sorry tale again, but suffice it so say that I made so many trips backwards and forwards from IKEA at that time to choose the kitchen, order the kitchen, pick up extra pieces of the kitchen that were not delivered at the time, and to return bits of the kitchen that we did not order, that I am now like Pavlov's dog - as soon as I draw into the carpark, I start salivating because I think I am going to get a hotdog soon!

My aim is to get my marking done before I go back for my next scan. Am now accordingly eyeing up the pile of essays with trepidation - did I actually manage to teach the students anything at all last semester?

Forward planning

2008-01-08T09:52:00.001Z

Normally, when I get to the end of a box of tampons, I buy another box – that way, I won’t get caught short the following month.

This month, however, I paused and thought about it some more. If I get a period next month, it will be because this cycle of IVF has failed. Should I remain optimistic, and work on the assumption that I may not need said tampons? If I buy the tampons, am I admitting to myself that I won’t get pregnant as a result of the treatment? Will this then become a self-fulfilling prophecy?

I want – no, I need – to believe that this will work. I do not want to think about how I will feel if I get a negative result. I am terrified by the thought that I could put myself through all this, and still be left with nothing at the end of it. And yet I know that, statistically speaking, a negative is a more likely outcome than a positive. Obviously, there are plenty of stories with a happy ending out there. But there are lots of others that don’t end so well: I am not naïve enough to think that this will definitely work out for me.

Mr H tells me that I am a born pessimist - that I could make Eeyore look cheerful. But experience has taught me that shit does happen, and that it’s best to be prepared. And so I bought the box of tampons.

Is it me, or is it hot in here?

2008-01-03T13:05:00.001Z

I am now - hopefully - past the half-way point in the down regulation phase. I've been taking the Nafarelin spray for ten days now, and the side effects seem to be kicking in nicely.

I'm getting a lot of headaches and hot flushes (hence the title of this post!). I also feel terribly depressed, and I cry at the least thing. I don't know whether this is because I AM depressed, or whether it's because of the meds - somehow I feel horribly out of control, both of my body and my emotions.

This first phase of the treatment seems to be really dragging - I still have another week to go before our next appointment at the clinic. Hopefully then they will confirm that it's OK to start the stims - maybe then I will start to feel like a bit more is happening.

Taking stock

2007-12-31T13:02:00.001Z

When we first decided that we wanted to have a child together, we thought that we'd just stop using contraception and wait and see what happened. A few months went by, and I didn't get pregnant. Christmas came and went, and we told ourselves, 'maybe this time next year, we'll have a baby.' Since then, another four Christmases have gone by. Many of our friends now have children, while we have gone for appointment after appointment, endured test after test, and been put on waiting list after waiting list. Our conversations about our future have slipped from 'when we have children' to 'if we have children.'

When you are dealing with infertility, Christmas, New Year, birthdays and anniversaries become endowed with a new significance: they remind you that another twelve months have gone by, but you are still no closer to fulfilling your dream of becoming a parent.

This last day of 2007 thus seems an appropriate time for taking stock. Looking back over the past year, I realise how much of my energy has gone into trying - and failing - to conceive a child. I never knew how exhausting infertility could be - and here I don't just mean the countless trips backwards & forwards from the clinic, or else the invasive and painful procedures which many of us have to endure in order to have a child, but also the endless cycle of hope and disappointment that one lives through on a monthly basis.

If infertility has taught me one thing, it is that, even with the best will in the world, you cannot always achieve what you set out to do. This year, I won't be making any new year's resolutions. Instead, I will hope...

I will hope that this cycle of IVF takes us one step closer to our dream of having a baby.

And I will hope that all of you out there who are longing for exactly the same thing will finally get that BFP.

The devil makes work for idle hands

2007-12-28T08:18:00.001Z

Mr H has taken the period between Christmas and New Year off work. He has decided to take this opportunity to re-build our home PC, and to upgrade to Windows Vista.

When I work, I surround myself with pieces of paper - previous drafts of chapters, photocopied articles - as well as great tottering stacks of books. I look at my desk, and see a carefully ordered work in progress. Mr H looks at my desk, and sees a mess, which needs to be cleared out of the way before he can begin to check his email or do anything else on the computer.

The Great Upgrade has been going on for several days, and is apparently now pretty much complete. The PhD has survived intact, and I now have email again. Chapter Three, however, is still randomly piled up in a corner of my study.

All this does explain why I have not had a chance to thank all those who took the time to stop by and wish me luck for our first appointment. I really do appreciate all your kind words of support: somehow, it is easier knowing that I am not the first person to go through this process.

First appointment

2007-12-24T16:15:00.001Z

When I was three, Father Christmas brought me a doll's cot. It was painted lemon yellow, and was made up with teeny-tiny sheets and pillows, and a patchwork quilt (I later learnt that my grandmother had made all of these, and had sent them up to Lapland for Santa to deliver). When I peeked under the quilt, I found a ragdoll lying there fast asleep. I immediately named her LoobyLoo, and she remained one of my most stalwart companions over the next few years.

A few years ago, when my father moved house, my doll's cot was unearthed in one of the farthest corners of the loft. My father and stepmother insisted on packing it up and taking it with them to their new house, 'for when we have our grandchildren over to play'. It now sits, empty and reproachful, in their garage. Unfortunately, LoobyLoo has gone forever; she did not come to light in the move.

Thirty-three years later, the doll's cot remains My Best Christmas Present Ever. This morning's IVF goody bag does not come close: unpacking my very own miniature sharps bin does not fill me with anything like the same sense of wonder and excitement. I thought I would feel more gung-ho about finally starting treatment, but have to say that the whole thing felt like a bit of an anti-climax. We had been told that the appointment would take about an hour, and I'd assumed that the consultant would spend the time talking us through the protocol he had prescribed for us, and that we would have time to ask any lingering questions. In fact, we were in and out in fifteen minutes: a quick probe with the dildo cam confirmed that I had ovulated this month, and was OK to start treatment, and then the rest of the time was taken up signing various consent forms.

For the down reg phase, I was given a choice between Buserelin injections, or Nafarelin nasal spray. Because I'm still a little freaked out by the thought of injecting myself, I elected to go for the Nafarelin (3 sprays a day, eight hours apart). Have taken my first spray, and am now waiting for the first of the long list of side effects listed in the information leaflet to appear!

What my unconscious is telling me

2007-12-21T14:51:00.001Z

In waking life, our impeding cycle of IVF continues to have a vague air of unreality about it: I still cannot quite believe that our first appointment is on Monday morning.

In my dreams, however, the anxieties come thick and fast. I dream that I am in the bathroom, syringe in hand, but that I cannot bring myself to inject myself. I dream that I do not fully understand what medication I am to take when, and that I inadvertently miss an injection, thereby screwing up the whole cycle and sending us back to the very bottom of a six-month waiting list. I dream that I am to give a lecture on my experiences of infertility: the lights in the lecture hall go down, I open my mouth to speak, but no words will come out.

I suppose that what all these dreams are telling me is that I'm scared: I'm scared of the injections, I'm scared of the egg retrieval, I'm scared it won't work, and I'm scared that if it does work, I may miscarry. I thought I'd feel ready to do this, but I don't.

Literary confessions & opening lines

2007-12-19T14:23:00.002Z

In one of David Lodge's comic novels about academia, a group of English literature professors play a parlour game in which they each have to name a book which they really should have read, but haven't. As Lodge recognises, academics cannot resist a bit of professional one-upmanship, and so they are all only too ready to admit to the gaps in their literary knowledge. The game culminates in one of them confessing that he has never read Hamlet and, if my memory serves me correctly, losing his job as a result.

Because I blog anonymously (Ms Heathen is not in fact my real name, nor is it to be read as a statement about my religious beliefs), I can here confess with impunity that I have never in my life read a word of Derrida. I am writing up my PhD in a department that has a formidable reputation when it comes to critical theory, and this would be considered a scandalous oversight by many of my peers. I am sure that one day I will be caught out: I will be asked a tricky question about deconstruction at a graduate seminar, and my ignorance will be exposed for all to see.

I have also never read anything by any of the great Russian novelists. It was with this in mind that last week I bought a copy of Anna Karenina (Derrida, on the other hand, I think I can manage without).

I was hooked from the moment I read the opening line:

"All happy families are alike; each unhappy family is unhappy in its own way."

Along with Gertrude Stein's "rose is a rose is a rose is a rose", this is one of the sentences I would most like to have written. On its own, it stands as a concise yet profound statement on the intricate dynamics of our relationships with those to whom we are inextricably tied by our upbringing. As the first sentence of a novel, it introduces a theme and opens up a world for me. Already I know that, whatever unhappy family I am to encounter between the pages of this novel, it will be more interesting than any conventionally happy family.

Countdown to Christmas

2007-12-13T14:35:00.001Z

Christmas is a difficult time for those struggling with infertility - somehow it reminds you of all the things you can't have. A while ago, Loribeth had a great post which neatly captured all poignancy of a Christmas without children, which I went back and read as I began to think about our own plans for the holiday season.

Over the years, Mr H and I have created our own Christmas routine. We try not to get caught up in the relentless consumerism that appears to grip the entire country at this time of year. Going round the supermarket yesterday, I was faintly sickened by the excess of it all - the shelves were groaning with processed, over-packaged, fat-laden, Christmas-themed goodies (stilton & cranberry flavoured crisp anyone, or perhaps a white chocolate topped mince pie?). People were already beginning to stockpile loaves of bread, and a couple were having a bitter exchange of words next to the packets of bread sauce mix. Looking around at the overflowing trolleys in the queues for the checkouts, I couldn't help but wonder: how much of this food will go uneaten into landfill sites when people clear out their fridges and cupboards in the new year?

We don't bother with turkey and all the trimmings; for the last couple of years, we have instead had a shellfish platter from the fabulous Ramus Seafood Emporium. We generally treat ourselves to a bottle of champagne, or else a really good dry white wine, and buy each other one small gift each. We spend most of the day lazing in front of an open fire, reading, chatting or watching the television (if I have my way, we will also play board games, although Mr H is not as keen as I am!) If the weather is nice, we may go for a walk in the afternoon.

This year, however, I am counting down to Christmas for a very different reason: our Day 21 appointment is scheduled for 8.20am on Christmas Eve.

Dashing about...

2007-12-05T09:48:00.001Z

Over the course of the past ten days, I have:

1. Driven from York to London.

2. Coped with my mother-in-law for three days (coping with Mr H's mother in fact warrants a separate post in its own right, or even a separate blog - possibly entitled 'You'll never believe what my mother-in-law has just said').

3. Been asked a series of intrusive and insensitive questions about our forthcoming fertility treatment by Mr H's friends, who are henceforth to be known (with a nod to Helen Fielding's Bridget Jones's Diary) as 'the smug fertiles'.

4. Held & admired the smug fertiles' six month old baby.

5. Dealt with nos. 2, 3 & 4 without losing my temper or crying.

6. Taken a group of 15 students around the Louise Bourgeois show at Tate Modern.

7. Driven back to York from London.

8. Spent a day battling around the shops in York looking for something suitable to wear to a funeral.

9. Spent £50 on a black jacket I didn't particularly want, and couldn't particularly afford.

10. Been awarded a £30 parking ticket (suddenly, that jacket got even more expensive).

11. Driven from York to Shropshire in order to attend a family funeral.

12. Driven back from Shropshire to York.

13. Prepared for and taught a four hour class on women's art practice in the 1960s & 70s.

In the midst of all this dashing about from one end of the country to another, I have lain awake at night, my mind racing with all the things I have to do and places I have to be, my body tense with stress. I always thought that I would reach some magic place where I felt physically & emotionally ready to undertake IVF. Instead, I'm going into it exhausted from a term's teaching, and worried about the fact that I have been too busy teaching to make as much progress as I would have liked on my PhD. So now I'm lying awake at night, going over and over the possibility that, if the IVF doesn't work, it will be because I'm too stressed... and if Mr H's mother tells me once more that, maybe if I just relaxed and stopped working so hard, I would somehow magically manage to conceive, then I really will find it difficult not to tell her exactly what I think of her!

1 in 6?

2007-11-22T13:16:00.001Z

Sometimes I wonder: where are all the other one in six couples who have difficulty in conceiving? When everyone around you seems to be reproducing effortlessly, it's difficult not to think that you're the only ones going through all this. But then last night, we went to an information evening hosted by the unit where we're going for treatment, and suddenly we were surrounded by other infertiles - a whole lecture theatre full of them, in fact. Like us, all of the other couples there were pinning their hopes and dreams on the three figures who were there to talk us through a typical IVF cycle. My god, the air in that room was thick and heavy with heartbreak.

The lights went down, and the entire procedure flashed before my eyes in a series of bullet points and diagrams. And I had to stop myself from holding up my hand and saying, 'Excuse me, but I think there's been a mistake. I don't really think we're supposed to be here. This isn't the way we'd planned on conceiving a child.'

Preparations

2007-11-15T10:19:00.002Z

We are starting to gear up for IVF next month. Last week, I went to have my Day 3 bloodwork done. This week, it was Mr H's turn. On Tuesday, he went off to the clinic for an up to date semen analysis. He tells me that they operate a queueing system akin to the deli counter at the supermarket - i.e. you turn up & take a number. When that number is called, you are then ushered into a small room & expected to do the business.

Not for the first time, I am struck by how very different male sexuality is to female sexuality!

The next step?

2007-11-09T13:17:00.001Z

AF arrived bang on time this month, and so I took a deep breath and phoned the clinic to confirm that we would be proceeding with a cycle of IVF/ICSI next month (my first appointment will be on Day 21 of my December cycle, so a few days before Christmas).

I'm finding it difficult to see this as the next step in our journey through infertility - somehow it seems more like the end of something: as though we're now officially giving up on the idea that we might manage to conceive without medical assistance. It feels like we're admitting that we've failed, and that we can't do what seemingly everyone else out there can.

Infertility has taught me a great deal about my body; I have learnt to respect its rhythms and chart its cycles. Now I feel that I am going to have to give up control of that body, and hand it over to the medical profession. It is hard to accept that conceiving a child, which should be a private and intimate act between me and my husband, is going to be such an intensely medicalised and public process.

Perhaps as the IVF draws closer, I will be able to cling on to the feeling that at least we are actually doing something that will take us closer to our dream of having a baby. At the moment though, it feels more like we've come to the end of a particular road.