(A spoken word recording of this post can be found here.)
No challenge should be faced without a little charm and a lot of style.
And so, a quick recap… Four years ago, M gave me a beautiful silver bracelet to mark the day we decided to make beautiful babies together. By the time we left Israel two and a half years later, we’d had five IUIs and an IVF and as yet there was no baby in sight…
A couple of years after we’d jumped aboard the baby-making train, I realised that I’d taken my eye off the destination. I was having so many hospital visits, tests, drugs and injections that it all seemed to have become about the process rather than about what we were trying to achieve. I needed to start thinking about babies again. I was walking along Jaffa Street in Jerusalem one day when I saw, in a shop window, a miniature version of the ethnic slippers I’d been thinking about buying for myself. I bought them and arranged them on the coffee table in our East Jerusalem apartment as a reminder of what we were working towards.
Until a short while before our departure from Israel, we’d thought that our next destination was going to be Kampala, Uganda. I was thrilled at the prospect of living in Africa for the first time but a little concerned that assisted reproduction for over-privileged foreigners would be at the bottom of the list of Ugandan national priorities. Soon before we were to make the big move, however, M was offered a job in Geneva, Switzerland. And so those little sparkly orange baby shoes came with us to live in the centre of Europe, the continent which, at least in 2010, led the world in Assisted Reproductive Technology (ART). (http://phys.org/news197093421.html).
A good friend in Jerusalem had recommended her Geneva-based ART specialist to us and I was pleased to be told when I contacted him that he did not operate a waiting list; we were able to secure an appointment with him five weeks after our arrival in our new home. The doctor’s desk was decorated with beautiful lapis lazuli pyramids. I’m not really a crystal-healing kind of a girl so I won’t look for any symbolism in that, but I will allow them to at least give our doctor a name…
Dr Pyramid did not pull any punches during our first consultation. He said that at my age I had, at very best, a 10% chance of getting pregnant, and that each cycle would cost us 8,000-10,000 Swiss francs (that’s £5,500-£6,900, or US$8,900- $11,000). He also said that the HSG I’d had in Jerusalem could only detect 60% of any potential problems with my reproductive system and so suggested that I have a laparoscopy. This is a keyhole surgery in which a light source and a camera are inserted into the abdomen through the belly button to study the organs and tissues inside the abdomen and pelvis. The thought of it made my knees go queasy but we signed on the bottom line anyway and once again bought our season pass for the roller-coaster ride that is ART.
The next couple of weeks looked something like this:
October 23: During a pre-op consultation with the anaesthetist who would put me under for the laparoscopy, he put a stethoscope to my back and blithely mentioned that I have a heart disorder called mitral insufficiency. This is why I’ve spent my life staying as far away from doctors as possible. I’ve always believed my own press about being in perfect physical health but as soon as I started letting doctors anywhere near me they began to make lists of stuff that I should be concerned about.
October 25: I visited Dr Pyramid for blood tests and he said that he wanted to rule out any possibility that I’d inherited the breast cancer that had cruelly killed my mother when she was 41 years old. He made an appointment for me to have a mammogram the next day.
October 26: As I went past a construction site on the walk between the tram and the Clinique des Grangettes, I was hailed with the wolf whistles and shouting that anyone with breasts has become accustomed to. On the way back, when a mammogram and an ultrasound had confirmed that all was fine in my chest area, I wanted to whip out my X-rays and shout, “The doctor says I’ve got tremendous tits!” Sadly the construction workers all seemed to be on their lunch break.
October 29: M and I jumped on a train to Lausanne, where Dr Pyramid has his second office and where his embryologist is based. We were shown through a PowerPoint presentation of how the whole procedure works and what our various options would be if the process was unsuccessful at different stages, and given a rundown of the staggering costs that would be involved.
October 31: I checked into the hospital for the laparoscopy and was thrilled by the difference between hospital treatment in Geneva and Jerusalem. At Hadassah I’d had to walk through the hospital in a surgical gown and was expected to push my way to the front of the queue and shout louder than my sisters in infertility to get any attention from the hospital staff. In Geneva I was shown to a lovely private room with en-suite bathroom, given a menu and asked to choose the food that I’d like to eat post-operatively, plied with gorgeous drugs and wheeled down to surgery in my bed.
After I woke up, Dr Pyramid came to see me and said that they’d removed a couple of spots of endometriosis, and that all was well for another attempt at IVF in December. He also said that although they were unsure why, the laparoscopy itself often seemed to increase the chance of IVF success in the round that followed. So I felt positive as I tucked into the best hospital meal in the history of hospital meals – chicory salad with walnuts and blue cheese dressing, king prawns with a cream and lemon sauce, and apple strudel and proper coffee. You get what you pay for, I guess.
November 8: M and I had an appointment with Dr Pyramid, and in one of the more surreal half hours of my life, he showed us through detailed photographs of my internal organs. The good doctor revised the drug protocol we’d used in Jerusalem and confirmed that we were good to go.
When M took me on a surprise birthday trip to Rome the following week, I packed all the vials, syringes and sterile wipes that I’d need to begin the new drug regime during our stay in the Eternal City. (I also packed a letter from the clinic that I could wave under the noses of the Italian authorities if they thought they’d happened upon the world’s unlikeliest international drug smuggler.) The drug that I’d start with was Cetrotide, which suppresses the body’s natural production of hormones so that its goings-on can be chemically controlled by the physician. (I tried not to think too much about the long-term effects that all these drugs might have on my body.)
I know that a lot of women hate the hormone injections associated with IVF and of course I completely understand why – stabbing yourself in the stomach with a needle full of hormones on a twice-daily basis isn’t exactly the dream. But I have to admit that, in a weird way, this is actually my favourite part of the process. While IVF has forced me to reluctantly confront the fact that I have absolutely zero control over my reproductive destiny, doing my own injections at least makes me feel as though I’m taking active steps towards achieving my dream. I’m very lucky that I don’t seem to be blighted by the terrible mood swings and weight gain that some women suffer (although M might tell a different story…). For me the weeks of hormones are a positive time during which I can live in hope that this time Lady Luck might be on our side.
It seemed, when I had the next appointment with Dr Pyramid two weeks later, that my positivity might be justified. The blood test and ultrasound revealed that all was as it should be, and Dr P prescribed a new drug that was supposed to stimulate the production of fewer but better quality eggs.
My positivity started to wane, however, when after five days of Menopur injections it became evident that there were only two eggs. Dr P doubled the dosage. But two days later he declared that despite the doubled drugs, there was now only one egg. It wasn’t worth going through the egg retrieval. So after weeks of hormone injections, the IVF cycle was cancelled. Dr P would give us an IUI instead (at our vast expense, of course) as a sort of sad consolation prize.
Meanwhile, back in my adopted homeland of the UK, Kate Middleton announced her pregnancy. In a brief moment of bitterness I wrote and submitted a letter to the Guardian’s “What I’m Really Thinking” column. The paper wrote to say that they were considering it for publication but they never printed it in the end. It’s probably just as well; I wouldn’t want to bring down the national mood. My letter read:
So Kate Middleton’s pregnant. How wonderful. Now not only will it seem that everyone in the world has babies apart from me but the whole country will be nattering about what a joy they are. Don’t talk to me about it! I already know! Otherwise I wouldn’t have spent three years and the GDP of a small country trying to have one!
People with small children tell me how much they envy my lifestyle. I can (and do) pop to Paris or Rome for weekends, I sleep when I want to and I’m not being crippled by childcare costs. “Want to swap lives?” they ask. Well, yes, I bloody well do! Superfluous sleep and weekends away are just consolation prizes; I want to be woken up at five o’clock on a Sunday morning by my child stomping on my head but that joy is being denied me so I go to Rome instead.
Some friends who know that I’ve been having fertility treatments for years try to console me by saying that you can still live a happy and fulfilled life without children. I’ll take that from friends who are childless, by choice or otherwise. But if another person utters those words while bouncing their beautiful baby on their knee I might just have to suggest that I take over the parenting of their child, then. They’d be just as happy and fulfilled without the baby, right?
Forgive me. It was a bad day.
And needless to say, the second-prize IUI didn’t work.
Without going into any further tedious detail, we had another round of IVF, which went right through to egg retrieval and embryo transfer, several months later. My eldest sister, who here I’ll call Luli, as our brother used to when he was a baby, had planned to come and visit us, and by coincidence her holiday ended up exactly coinciding with my surgery and our two-week wait. She was there when my bed was wheeled down to surgery (when M had had to go off to Lausanne to leave his contribution with the embryologist), and when I was wheeled back, fighting my sleepiness so that I could catch up with my beloved big sister. She was there a few days later when we went to Lausanne for the transfer of three healthy embryos. She was there for the duration of the stressful two-week wait, as I struggled between a desire to be optimistic and a fear that again we’d be disappointed. And she flew out on the day that we received the test result to say that the IVF hadn’t worked.
One day soon after, M and I went for a walk in the hills around the beautiful nearby village of Chanaz, and I lost my Silver Bracelet.
The fact that we remained optimistic is both a testament to the human spirit and a boon to the IVF industry.
We wouldn’t give up.
To be continued…