The Pursuit of Motherhood Read online

  We look around in incredulous horror.

  ‘Is this it?’ I ask her.

  ‘I’m afraid so,’ she says. ‘Good luck.’

  We shut and lock the door.

  ‘How about I lay my coat on the floor?’ Peter says.

  ‘OK,’ I say. ‘Let’s give it a go.’

  Twenty minutes later and the deed is done. I don’t think either of us can get beyond the feeling that lying on Peter’s coat in what is essentially a broom-cupboard is not how it ought to be. But we also laugh a lot and feel triumphant at our success.

  As we emerge, specimen jar in hand, a nurse intercepts us in the corridor and offers to take it through to the lab. When I explain to her that I’m coming with it she looks uncertain, but a moment later one of the embryologists comes over and confirms that this has been agreed.

  Peter goes off to sit in the waiting room whilst I am kitted out with shoe covers and hair net and taken to a stool by a hatch that opens into the lab. I watch while the embryologist transfers the sperm into a test tube and then puts it into a machine which separates out the best quality ones. This all takes about fifteen minutes to complete. Afterwards she comes over and says that the sample needs to settle for a while before it’s ready to go inside me, and that it might be easiest for me to wait outside. She tells me that they need to start working on some other samples (she mentions that old patient confidentiality thing again) and assures me that the sperm won’t be moved.

  I reluctantly agree and go off to join Peter in the waiting room. Where we wait. And we wait. And we wait. I am acutely aware of time passing but keep thinking that someone will come and get us at any minute.

  More than an hour later no one has.

  I get up and go over to the receptionist to ask if she can find out how much longer it’s going to be.

  ‘What are you in for?’ she asks vaguely.

  ‘IUI. We’re just waiting to have our sperm put in.’

  ‘OK, I’ll check,’ she says, and gets up and goes out into the corridor.

  After a little while the doors open and she comes back in with a nurse who looks distinctly embarrassed.

  ‘I’m really sorry you’ve been waiting so long,’ the nurse says, flustered. ‘We’re just getting things ready for you now.’

  She turns and bustles back through the door.

  I lean over to Peter. ‘They’d forgotten us, hadn’t they?’

  ‘Seems that way,’ he replies.

  A few minutes later the same nurse comes back and calls my name. We are led through to the lobby area just outside the lab where I sat looking through the hatch earlier.

  ‘I’m sorry,’ the nurse says. ‘All our consultation rooms are busy right now. We’re going to have to do the procedure here. Don’t worry, though, we’ll bring a couple of screens through for privacy. Can you get up on that trolley, please? The doctor will be here in a minute.’

  I look at Peter. It is my second look of incredu-lous horror that day.

  ‘I’m sure it will be fine,’ he says quietly. But he doesn’t sound so sure.

  Then a doctor comes through and introduces himself. It’s not one we’ve met before. He scans my notes then calls out to the embryologist to bring the sperm over. Having waited for ages, everything is now happening very quickly. She emerges with a test tube that I instantly see isn’t the same one that I left over an hour ago.

  ‘It’s a different test tube,’ I blurt out.

  The embryologist looks defensive. The doctor looks confused.

  ‘You promised me it wasn’t going to move from the one that it was in,’ I say anxiously.

  ‘We have to transfer it into a different tube for the insemination,’ the embryologist says.

  ‘But why didn’t you tell me? Why didn’t you let me come and watch? I know you probably think I’m being irrational. Maybe I am. But can’t you see this is really difficult for me?’

  The embryologist looks defensive again. She moves towards the doctor, who still looks confused. As she does so, I turn to Peter.

  ‘I don’t think I can go through with it,’ I whisper.

  ‘You can,’ he says encouragingly. ‘It will be fine.’

  ‘No, I can’t.’ This time more definite.

  ‘Why don’t I ask them for a bit more time?’

  ‘No.’ I can feel the tremble in my voice. ‘This isn’t how it should be. This isn’t how I want it to be.’

  ‘I know,’ he says.

  ‘Will you tell them for me?’ I say with more urgency.

  ‘Are you sure?’ he says.

  ‘I’m sure I’m sure.’

  So Peter pulls the doctor and embryologist aside to explain while I get dressed. I start to cry. Quietly, but uncontrollably. They look puzzled and mildly concerned, but the doctor soon moves on to his next patient and the embryologist takes the test tube back to the lab.

  Looking back, I sometimes wonder what they said when they discussed my case in their weekly team meeting. That’s assuming they had a weekly team meeting at which they discussed me. Was I simply dismissed as being an overly neurotic patient? Or did they consider, even for a moment, that I was someone at the beginning of a frightening journey who perhaps needed just a little bit more support? I’m only human, after all.

  But I’ll never know. I didn’t go back. And they never contacted me again.

  The Infertility Diaries Part III

  When you look at all the people in fertility clinics today, it’s extraordinary to remember that less than forty years ago the world’s first IVF babies were received with so much fear and loathing. A headline on the front cover of the New York Times famously heralded the birth of the world’s first IVF baby as ‘FRANKENSTEIN MYTH BECOMES A REALITY’. Not so much a miracle, then, but a monster. Four million births later, I can’t help feeling that the atmosphere of fertility clinics today shows that somewhere, albeit subconsciously, that stigma still exists. One of the hardest things about starting fertility treatment is facing off the enduring opinion that human beings should never meddle with what nature decides.

  PETER AND ME

  Peter and I got together in what I can only describe as inauspicious circumstances. We worked together and were both in other relationships when we met. We always got on well, went out for the occasional drink to chat about the office, but it was never anything more than a vaguely flirtatious friendship. Then one evening, just a few weeks before I was due to leave the company we both worked for and move out of town, we ended up in a bar. Drunk.

  There were other people with us at first, but one by one they peeled off and went home until it was just us and a kiss that changed everything. As soon as it happened I grabbed my things, said I had to go, and ran out of the bar. I stumbled through the streets angry and ashamed. Peter ran after me, trying to console me and offering to take me home. I begged him to leave me alone. He eventually did.

  The next thing I could remember was finding myself lying amongst a heap of rubbish bags on the high street. I pulled out my mobile phone and rang my boyfriend, who was away that night on business.

  ‘Where the hell are you?’ he said.

  ‘I’m lying in a pile of rubbish,’ I said. ‘The most terrible thing has just happened.’

  ‘What?’

  ‘I kissed Peter.’

  ‘Peter who?’

  ‘Peter from work.’

  ‘Oh.’

  ‘I feel terrible. I don’t know how it happened. I’m drunk.’

  ‘Yes.’

  ‘Very drunk.’

  ‘Yes.’

  ‘What shall I do?’

  ‘Well, right now, you need to get up. You need to walk to the end of the street. And you need to get a taxi to take you home. The rest we’ll talk about in the morning.’

  He was a lovely guy, my boyfriend, but within a month I’d left him and Peter and I had moved in together. It wasn’t an easy decision. It was the hardest, most painful decision I’ve ever made in my life. But an unexpected kiss unleashed something
in both of us. There was nothing we could do but follow it.

  CHEMICAL ATTRACTION

  I’m not going to make the same mistake again. The next time around I do my research. I get a list of all the clinics in London, order them in terms of their success rates, and start to ring them one by one. The first question I ask is whether they will allow me to witness my treatment. At every call I draw a blank until, finally, someone suggests I contact a small clinic near Regent’s Park. They are prepared to consider it, and I make an appointment.

  I am already getting accustomed to the oddness of fertility clinics. This one is on the ground floor of a modern apartment building and has a distinctively Scandinavian feel, all blond wood and smooth lines. The doctor who sees us reviews the results of the tests we have already done. He picks up on the fact that one of the tests indicates that Peter’s sperm may not be very motile (in other words they don’t swim very fast). He says that this might not necessarily be significant but suggests that Peter performs a sperm survival test as a follow-up.

  A few weeks later – test completed – we receive a letter. It says that whilst Peter’s sperm count is very good, and the motility reasonable, the survival rate is low. In fact, after twenty-four hours most of the sperm that were still moving were just shaking on the spot. We have to laugh. The thought of Peter’s sperm all lined up doing the hokey cokey but not actually getting anywhere. T-y-p-i-c-a-l.

  The main problem, the doctor explains at our next appointment, is that it takes twenty-four hours for the sperm to bury into the egg and fertilise it. If Peter’s aren’t able to survive that long it may be difficult for us to conceive naturally. But, at the same time, he makes a point of emphasising that it doesn’t provide a definitive reason as to why I’m not getting pregnant. With millions of sperm in every sample, all you need is for one of them to go the distance, and the probability is that there’s going to be at least one that will. Nevertheless, given that we have now been unsuccessfully trying to conceive for nearly two years, his strong suggestion is that we progress directly to IVF and, in our particular case, a treatment called ICSI (intra-cytoplasmic sperm injection). This is essentially just a form of IVF, but instead of letting the egg and sperm fertilise naturally in a Petri dish, an embryologist chops off the sperm’s tail and injects the head directly into the egg in order to aid fertilisation. The advantage of this, in our case, is that Peter’s sperm won’t need to keep kicking for twenty-four hours as there’s no swimming work required.

  ‘So?’ I say to Peter as we leave the clinic.

  ‘So what?’ he replies.

  ‘Do you think we should go through with it?’

  ‘Of course.’

  ‘You make it sound so simple.’

  ‘It is. We want a baby, don’t we?’

  ‘But like this?’ I say.

  ‘There don’t seem to be any other options.’

  ‘I suppose not. But what about the money?’

  ‘We’ll find a way.’

  ‘Maybe we should have tried on the NHS first.’

  ‘You’d have even less control if we’d done that. At least this clinic has agreed we can witness everything.’

  ‘Yes, but it’s obvious they think we’re a bit mad.’

  ‘We’re a bit mad?’

  ‘OK. I’m a bit mad.’

  He turns and looks at me. ‘A bit?’

  So we’re headed for our first round of assisted conception. I think for all women this must bring a mix of emotions: on the one hand, disappointment that you have to resort to this to make a baby; on the other hand, excitement that the baby you have been longing for might finally be made. The first step of the process for me and for many women is what is known as ‘down-regulation’. This essentially involves shutting off your normal reproductive cycle so that your doctor can take control of it. It may involve an injection or a rather undignified nasal spray. Once down-regulation has been achieved you progress to the stage known as ‘stimulation’, which generally takes about two weeks. This involves daily injections designed to stimulate your ovaries to produce multiple follicles and therefore multiple eggs. The whole premise of IVF is that as well as assisting the fertilisation of egg and sperm by doing it outside the body, it also works to increase the probability of success by enabling a woman to produce many more eggs than she would normally release in a single month.

  For the first week of our injections, Peter and I are away on holiday with a group of friends. We furtively administer the drugs in the privacy of our room, not telling anyone what we’re up to. It feels rather like a childhood game of Doctors and Nurses. I can’t help noticing that Peter seems to take particular pleasure in injecting me. As he draws the syringe and pushes the needle into my tummy, I close my eyes and think of George Clooney in ER…

  During the second week of stimulation, we start to make regular trips to the clinic to see how my follicles are developing. Apparently this helps to pinpoint the right time to trigger ovulation, which involves another injection that has to be performed exactly thirty-six hours before my eggs are collected. Our doctor says that everything is progressing nicely.

  The day of egg collection comes. We arrive at the clinic early. First up, we have to produce a sperm sample. The clinic has agreed that we can be together for this, and we are taken to a small room. This time we’re not in a broom cupboard but it’s still tiny. There’s an incredibly uncomfortable-looking chair, which we avoid, and a hatch between the room and the lab from where we can hear the embryologists chatting about what they did over the weekend.

  It takes us a long time. The more we worry about how long it’s taking, the longer it takes. But we get there in the end and Peter heads to the lab with the little pot, promising me he won’t lose sight of it. I am then taken through to a cubicle, told to get undressed and gowned up, and before I know it I’m lying on an operating table.

  I’ve never had an operation in my life and everything is new to me. The room is filled with people who introduce themselves in turn. I’m rather touched that they’ve all turned out, just for me. There’s our doctor, a nurse, an embryologist and the anaesthetist. (Ah, the anaesthetist, the man of my dreams. One of the great things about egg collection is the anaesthetic: it’s the best sleep you’ll ever have.)

  Within seconds of getting settled, they’ve strapped a plastic mask to my face and I can feel myself going under. The next thing I know, I’m back in my cubicle coming round. I have no idea how they got me here. They must have picked me up off the operating trolley and carried through my leaden body, arm trailing on the ground. In my half-conscious state I immediately start to wonder whether they struggled to lift me and had to call in additional resources. I grimace at the embarrassment. Later I find out that they pushed me through on a trolley, but the space is so small, the corners so tight, I still don’t quite understand how.

  Peter is there when I wake up. It’s so nice to see him. I feel as if I’ve been on a long journey and he’s waiting at the arrivals gate to welcome me home. A nurse brings me a cup of tea and some biscuits. It’s the best cup of tea and biscuits I’ve ever tasted.

  I’m starting to like this IVF thing.

  Then I remember our sperm. Peter assures me he’s been with it the whole time and that as soon as I’m properly awake we can go round and see it. Half an hour later, sperm checked, we head out of the clinic for something to eat. It’s a beautiful day and we wander over to Regent’s Park and have lunch on the terrace of the café in the inner circle. It is as if we’ve just been through some sort of initiation ceremony and we’ve now moved on to the celebratory feast. It feels good to be alive, with all the possibilities that lie ahead.

  After a couple of hours we are back at the clinic to witness the embryologist, Rob, injecting Peter’s sperm into my eggs. We’re taken through into the theatre where my eggs were collected earlier. It now feels eerily empty and quiet. Rob turns on a television monitor and then disappears into a side room. From here he talks us through the process as we watch
what’s happening on the screen. First he shows us Peter’s sperm sample, with lots of tiny tadpole-like creatures swimming around. He chooses one of these at random, chops off its tail, which immediately paralyses it, and then sucks it up into a needle, with which he inserts it into one of my eggs. It’s the most extraordinary thing to watch and, bizarrely, I actually start to feel lucky that we’re conceiving a baby through IVF. Imagine being able to tell your children that you witnessed the moment when the sperm and egg that made them were first introduced. Incredible.

  After each of my eggs has been injected, Rob carefully places them in an incubator that is heated to the exact temperature of the human body. He locks and seals the door, and promises that it won’t be opened again until we come back tomorrow. As good as his word, the next day he breaks the seal and carefully removes them to see which have fertilised. Those that haven’t are discarded and those that have are returned to the incubator, which is resealed. Rob assures us that they will not move again until they go back inside me. At this point I learn that today, the day after egg collection, is known as Day 1, and that the transfer of embryos generally takes place on Day 2, Day 3 or Day 5. (I forget to ask why they skip Day 4 – one to google later, I guess.)

  In our case, on Day 3, they decide that it’s already clear which of our embryos are the best quality. They photograph all of them and show us the two they have chosen to put back. One of them looks like it should be in a textbook. The picture shows six perfectly drawn circles shaped like the head of a flower, five around the outside and one in the middle. It’s beautiful, and Rob tells us it’s a grade one embryo – their top score. Result!