It was the summer of 1994 and the gardeners were mowing the school sports field topless. “Let’s get down to some reproduction!” said our legendary biology teacher Mr S, steeling himself for the lessons ahead.
Tasked with educating a rowdy bunch of 14 year old girls about sex – the poor bastard – this incredible man discharged his GCSE dual award duty with humour and no embarrassment other than his own. As we embarked upon the much anticipated sex education module, mantra “DON’T GET PREGNANT”, one of my finest (?) school moments occurred. Demonstrating the condom on the frighteningly 90 degree angle Durex model, I advised my compadres to “pinch the teat and roll down.” All those years of reading Just Seventeen finally paid off! Sad to say that I have never put this life skill into practice; apparently men can put their own condoms on. I’ve also never felt a penis that was as unforgivingly, unapologetically erect as the Durex model. Gutted, but secretly relieved. There’s been enough ram it up there scans, thanks. Can we get a refund now Durex?
Infertility had a brief mention in the biological sense, and we all knew of parents’ friends of friends of friends who had never had children but the basic assumption at that point was we would get the babies when we wanted them and did I mention DON’T GET FUCKING PREGNANT. This was Bristol in the 1990s and being a teen mum had not yet made the notoriety / celebrity of MTV.
So much for not getting pregnant shagging your teenage or twenty something boyfriend. You spend decades trying not to get up the duff until you do. These days it seems like everyone wants to get locked and loaded. Fertility clinics are rammed. The chairs in the waiting room are full. People are standing. Some patients are even coming back to try for a second, a source of much silent waiting room wistful eyes.
A brief synopsis if you’ve not had the pleasure of intervention. A standard IVF round goes medically something like this: put the woman into temporary menopause to ‘flatline’ the system ready for egg stimulation (usually pills). Once scanned to ensure everything is quiet, egg stimulation injections every day to grow your existing follicles ready for ovulation to be triggered. Prepare to feel bloated (read: everything from manageable bloat to extreme discomfort. What with the hormonal avalanche, I likened it to hatching aliens and wanted to throw myself under a bus five days before egg collection). Once follicles are ready, a trigger injection is given 36 hours before egg collection to release the eggs. Getting to the egg collection itself is the best bit. I looked around five months pregnant and felt like I was about to burst. The general anaesthetic to knock you out is heavenly, the tea and biscuits after taste Michelin starred. Relief is a great ingredient.
Just as you and your partner are recovering (he has a wank while you’re under, I know who I’d rather be), you’re told how many eggs they have retrieved. From egg collection you begin progesterone either in the form of pessaries up every orifice, pills and / or inter muscular injections. At this point the embryologists are already working their magic, trying to make sperm meet egg to create a healthy embryo. The five days after egg collection are critical, with 48 hour updates to see how your embryos are faring. If you’re going for a fresh embryo transfer, this is transferred – if all goes well – as a day 5 blastocyst. A frozen embryo transfer allows you to recover your physical equilibrium a bit before you start drugs to thicken up your womb lining for the embryo transfer. From embryo transfer, there it is a 10 – 14 day wait to do a pregnancy test. This is all without bonus extras, such as a womb biopsy to ascertain natural killer cells, pre-genetic screening of the embryos to try and reduce miscarriage and intralipid drips. Unless you’ve been through it, the sheer onslaught and not knowing every step of the way is almost impossible to understand. Feeling nervous or reading this with the wry smile of a fertility treatment warrior? You won’t have any problem with needles (size and length of), injections, internal scans, biopsies, black stomachs, sleepless nights and pep talking yourself through fear by the end of it.
Is it possible to feel nostalgic for IVF? Wonder medicine and an absolute assault on the woman’s body, sense and sensibility with the added emotional gut punch that this process could be game over at any point? I had some of the best and worst times of my life in our hospital’s Assisted Conception Unit. The consultants, embryologists, nurses, counsellors, porters were among the finest people I have ever met. Their care was exceptional. How they handled hundreds of emotionally and hormonally charged women with the kindness, dexterity and toughness – yes, these ladies were not afraid of the tough conversations – it was clear their job was an absolute vocation. At times we wondered if they even went home.
Claire* gently persuaded me that at 35, it was time I got on with it if I wanted to become a mum. Phoebe*, our consultant, was one of the unit’s stars, overseeing our care, speaking to me above and beyond and carrying out several of my embryo transfers. She was our good luck talisman. “You will have a baby”, she told me, and I hope she will still be proven right. I had an all-female team for my egg collection, overseen by Phoebe, including an anaesthetist who asked what my favourite alcoholic drink was before putting me under. My husband wondered why I was returned to the ward, practically shouting “champagne”. I did my pregnancy test in the disabled toilet a day early, having gone in because I had suddenly and very uncomfortably re-bloated. Sarah* scanned me before and after my embryo transfer and was the first person to show us our baby’s beating heart. Joanne*, the unit’s counsellor, sat with me throughout some of my darkest moments in the years and repeated failed embryo transfers afterwards.
Their work, care and dedication ultimately gave me one of the greatest gifts of my life: our baby. Even though he isn’t here with us today, I still celebrate this. I want to celebrate it, that for three utterly wonderful months I was his mother. We met him four times. An embryo embedded into my womb to the primeval sounds of music that sounded like it could have been from the Lion King – most surreal when having a long rod with aforementioned baby put up you. The second time, at six weeks five days when I rushed to the hospital early on Saturday, convinced something was wrong. Again, at nine and a half weeks, when his little pulsing heartbeat made him look like ET. And finally, in a new hospital, just after I had been booked in at twelve weeks.
We called him Pumbaa. It was my husband’s idea. Not because he was destined to be a farting warthog, but because the combination of progesterone and pregnancy meant I had the worst trapped wind and it made us both laugh. Who would I be without having known that experience, that love? Certainly not the woman I am now. I carried him and it was an absolutely joyous time of my life, enabled by a team of extraordinary people who had brought my husband and I such happiness as I moaned about giving up caffeine, missed the alcohol, couldn’t do up my jeans, couldn’t take a proper shit, ate all the time and demanded more food. I knew why I was here and that was to carry, nurture and birth him.
What can I tell my fourteen year old self who for years lived with ‘the fear’ of accidentally getting pregnant and saw herself with two kids by now? My first pregnancy was beyond precious. After four years of living with this grief I refuse to look at our time together with our child and think anything else. The cliff edge that came at the end was hell, one of Nature’s cruellest tricks.
Let’s have an open conversation with our pre-teens and teenagers now about fertility, about the trade-off in our twenties and thirties between careers, finances and the desire to start a family. In tandem we need real talk about Earth because we are decimating our planet, its resources and its wildlife. Are those of us struggling to have children doing the world the biggest fucking favour right now, paid for by our current inability to conceive or maintain a pregnancy? On my better days, this gives me scant comfort.