Monday 31 August 2009

Must be more careful what I say around children...

So, I was at a party last night and got to have a little cuddle with a twelve day old baby. A couple of other people came over to admire him, and I said, "Isn't he gorgeous? I think I'm going to keep him."

Unfortunately, that was the end of my cuddle time. The baby's 5-year-old sister heard my comment and got a bit upset, saying, "Mummy, go and get our baby back from that lady NOW!"

I hope it doesn't take me too long to lose my baby-stealing reputation among the pre-school community...

Saturday 29 August 2009

My cloak of invisibility

A couple of weeks ago, DH and I looked after my sister's three small children for the weekend.

On Sunday morning, we took them to Mass. We sat next to another family, and the father struck up a conversation with DH.

There was a visiting nun there making an appeal on behalf of the missions, and at the end of Mass she stopped us and commented on how well-behaved the children were, and chatted a bit to the 5-year-old.

Several people caught our eyes, smiled and said hello.

The following week, of course, we were back there without the children. The visiting nun was there again, and she didn't meet either of our eyes at all. Nobody struck up conversation with us, and nobody smiled and said hello.

It also struck me that even though we attend this church regularly (not every week, as we live halfway between two parishes and often go to Mass in the other parish) nobody asked where the children had come from, or where they'd gone - because without the children, nobody noticed us at all.

I was reminded of the time many years ago when I lived in France. Every week for four months I sat in the same pew, and every week the same family sat in front of me, and turned round to offer me the Sign of Peace.

After four months, the congregation were invited to a special celebration after Mass, and I stood rather awkwardly wondering how to break into a conversation and introduce myself. The mother of the family that always sat in front of me, who had shaken my hand every day for the previous four months, came up to me and asked if this was my first visit to the parish.

I've heard some mothers complain that they seem to lose their identity when they have children, that to the general public they are seen as 'just' somebody's Mummy, and that nobody is interested in them for themselves.

Well, my experience is that unless I make a real effort, the general public doesn't see me at all.

I've given up going for coffee after Mass in my parish - when I first moved here, before I was married, I would sometimes go. Nobody would ever come up to me and initiate conversation, and if I approached somebody, the first question they would ask was, "Do you have children?" When I said no, they soon lost interest, and the following week when I saw them and smiled there would be not a flicker of recognition.

Yes, I have some wonderful friends - some Catholic, some not - but I didn't meet any of them at church. Because it seems that in church, childlessness acts as a cloak of invisibility.

Friday 28 August 2009

Part 3 - Thy Will be done

There are those who say that if you find out you're not able to have children, you should just accept that this is God's Will. Perhaps He wants you to adopt, or to do charity work, or to be the one out of all the siblings who is available to look after your parents when they get old.

I read a comment the other day that some people are given a greater capacity to love other people's children, and that if that's your vocation, you should work on just becoming the best teacher/aunt/confidante that you can. And there certainly is value in looking at things that way - when DH and I got our diagnosis, we made a list of all our options, and "Just be the coolest aunt, uncle and godparents ever" was on that list. But it was right at the bottom, after exploring all other options.

The Pope has also talked about infertile Catholic couples taking up the cross, accepting their infertility and living with it.

And people talk about scientists and people who pursue IVF "playing God" in the laboratory and trying to overrule God's Will.

So why would I continue to try to have children, when it's clear I'm never going to become a mother naturally? Am I doing wrong? Am I ignoring God's Will, or even worse, trying to overrule it?

Well, let's think about this. We have a medical situation here. My husband isn't producing enough sperm. The ones he does produce are clumsy, misshapen little chaps that swim aimlessly round in circles, when they can be bothered to. Meanwhile, my egg cupboard is almost bare.

If someone isn't producing enough insulin, nobody tells them to accept God's Will and embrace their non-functioning pancreas. They're given insulin, blood tests, dietary advice, and everything they need to enable them to live as normal a life as possible.

So why is it different just because it's sperm and eggs that we're not producing in sufficient quantities? If God has allowed a treatment to be developed, why should we not allow ourselves to benefit from that treatment? OK, my life isn't threatened by my inability to have children - though at the moment I often feel as though my sanity is. But that doesn't mean it's not a medical problem, or that it doesn't cause me any pain.

I'm reminded of the story of the devout Christian who took every opportunity to tell people of his confidence that God would provide for him. One day, a great flood came to his village. As the water rose in the street, someone pulled up next to him in a car and offered to take him to safety.

"No," said the holy man. "God will help me."

The water rose to the level of his second floor windows, and as he sat in his bedroom watching the water rise, a boat stopped by his window. The boatman again offered to take him to safety.

"No," said the holy man. "God will help me."

The water continued to rise, until the man's house was almost fully submerged. He climbed out onto the roof and clung to the chimney pot, where he was spotted by the pilot of a rescue helicopter. A rope ladder was let down, and the pilot called out to the holy man to grab hold and climb up into the helicopter.

Once more, the holy man refused, saying, "No, God will help me."

The water continued to rise, and the holy man was drowned. On arrival in Heaven, he confronted God, saying, "I was always faithful to you, and I always trusted in you, but you let me down. How could you let me drown like that?"

And God replied, "I sent you a car, a boat and a helicopter - what more do you want?"

Yes, we have to have faith in God - but we also have to recognise the help that He is offering us, and not turn it down out of some misguided scruple.

We are a committed Catholic couple, who vowed before God and before all our friends and family on our wedding day that we would accept children lovingly from God, and bring them up according to the law of Christ and His Church. Any child born as a result of our treatment will be a child of God and will be born out of our love for each other as much as it would be if we were fortunate enough to be able to conceive without any help.

So I reject the idea that seeking treatment for a medical problem is opposing God's Will.

We've prayed a lot about this decision, and we continue to pray that God will guide us down the right path and that He will eventually bless us with children - if that's His Will.

And so we come to the next point - are we trying to "play God" and overrule God's Will?

Have you seen the odds for success in IVF? We have way less than a 50% chance of this treatment being successful. We will ONLY have a child if God wills it. There is no way that we can force Him to give us a child, whatever we do. Only God has the ability to give life, and we know that it is God, and not science, that should be glorified if we do eventually become parents.

And what about this business of overruling God's Will? Should we just roll over and accept that because it's not happening naturally, we were not meant to be parents?

Think of the prayer that Jesus prayed in the Garden of Gethsemane:

"Father, if you are willing, take this cup away from me. Nevertheless, let your will be done, not mine."

This is the prayer that I pray. God knows what we want. And only He knows whether it will ever happen for us. If it's not His Will that we become parents, it won't happen. In that case, I pray that we'll be able to accept that decision and build the life that He wants us to lead. But it's not wrong to pray that He should give us a child, if He is willing. And nor do I believe it is wrong to seek medical treatment for a medical problem.

"If you're a mother, you'll understand"

When I was a little girl, I prayed and prayed for a little sister, and ended up with two. As my sisters got older, I spent more time with my small cousins, then friends began to have children and nieces and nephews came along.

And here's one of my guilty little childhood secrets - one of my favourite books as a little girl was 'Dr Spock's Baby and Childcare". I pored over it, loving to read all the advice about how to wean a baby, how to know when you should stop sterilising, what the baby should be doing at various developmental stages - and I knew the information would be useful to me when I had the first of my own six or seven children way off in the future when I was in my twenties.

Only, of course, the six or seven children never happened, and my fountain of book knowledge, combined with my observations of all the children I knew, were useful only to allow me to take some part in conversations with my Mummy-friends.

I've changed the nappies of dozens of babies. When I visited my friend with her newborn a couple of weeks ago, I showed her another way of winding the baby which demonstrated its effectiveness when the baby gave the biggest burp of her life so far. I've developed a patented method of helping a baby to get off to sleep (my brother once called me the Baby Whisperer).

I've looked after newborn twins (yes, night-time too!), taken a 16-month-old on a trip to Northern Ireland and a 3-year-old on a trip to Jersey (same child, different occasions), regularly had my three nieces overnight, starting when the youngest was just a few months old...

Some of my friends who are parents have never really been around babies and small children until they had their own. I'm painfully aware that I don't have the depth of experience that they have, but I do have the breadth - very often when they're tearing their hair out over an issue that has arisen with their child, I've seen it before and am able to help.

And yet people with children so often feel the need to point out that their experience is so much richer and more fulfilling than mine. The Stirrup Queen wrote yesterday about this article, and naturally I clicked on the link and ended up feeling like something you might wipe off your shoe after a walk through the exercise yard at the local kennels.

My mother would tell me I should be thicker-skinned - but the comment that "no, nieces and nephews aren't the same as having your own kids" really upsets me, as does the reminder that I've never experienced motherhood.

Then there are things like this - number 2 digs the knife in deeper. I don't think I've ever offered unwanted advice, and I would never criticise anyone directly for the way they look after their own child, but I do have experience which has been helpful to some of my friends in dealing with situations that have arisen with their children. I don't pretend to have all the answers, but I do have some - and my childlessness doesn't make my experience any less valid.

I've had my fair share of the "you can't understand, because you're not a mother" comments in real life. I've also been offended by the series of adverts which were run a few years ago for Calpol (UK equivalent of infant tylenol), which had the tagline "If you're a parent, you'll understand" - with the implication that if you're not a parent, you have NO idea.

Every childless person has his or her own story. Some are genuinely child-free by choice. Some claim to be child-free by choice because they don't want to have to explain their pain and worries to all and sundry who ask. Some are consumed for practically every waking moment with their longing to have a child and their worry that it will never happen. Some have come to terms with the fact that they will never have children, and some have not yet reached that stage and are living a rollercoaster of emotions as they face disappointment after disappointment and decision after difficult decision.

If I could teach the super-fertile anything, it would be that your friend, or sister, or colleague, who doesn't have children NEVER needs to hear about what she's missing, about how much richer her life would be if she had children, or about how she can never understand what you're going through because she's never been a mother.

Either she's happy with her child-free life and really doesn't care, or she longs to have a child and your words are causing her more pain.

So at best, you're wasting your breath.

And at worst, you're twisting the knife.

Wednesday 26 August 2009

Ouch!

So, I've just been to the clinic and had my chlamydia swab done - part of the compulsory screening before the treatment can begin. I'll warn you now before you read any further that you might find the rest of this post a bit too much information...

A bit of history for you - I once went for a smear test and found it incredibly painful, and they didn't manage to get whatever it was they needed, so the whole thing was a complete waste of time. Following that experience, as I was not sexually active (and never had been) I decided that I wouldn't go for smear tests again.

Of course, I'm now married. Before our wedding, I was actually really nervous about making love with my husband, because of the excruciating pain of that failed smear test. It has been a pleasant surprise to me that it has not only not been painful with him, but has actually been very pleasurable.

However, I have had little frissons of concern when I read that embryo transfer was "no more uncomfortable than a smear test".

After today, I'm terrified! The chlamydia test is done in the same way and was as painful as I remember the smear test being years ago. I also had the added excitement of feeling that I was about to wet myself for as long as the speculum was in there.

The nurse explained to me afterwards that I have a tilted cervix and it's quite hard to find. She said when I do go for smear tests, I should make sure I go to someone very experienced, because I will probably feel excruciating pain with someone less experienced and they're likely to end up being unable to find my cervix, so that it will all be for nothing (which is what I assume happened last time). She also said that because of the angle of everything in there, the other feeling of discomfort was caused by the fact that the speculum was pressing quite hard on my bladder.

During the embryo transfer, not only do I have to have the speculum put in and the consultant digging around to find my inconveniently tilted cervix, but he's going to guide the catheter with an abdominal ultrasound - which requires me to have a full bladder.

I'm terrified now of the pain I'm going to experience that day - and I'm perhaps equally terrified at the thought that if the speculum is pressing down on my probably overfull bladder in the way that it was on my nearly empty one today, I could well end up weeing all over the consultant.

Oh, the indignity!

Little update on various things

Someone brought her baby into work yesterday, and everyone was gathered around cooing over the two of them. It's funny - I love babies, and I'm absolutely fine visiting friends and relatives with babies, seeing their photos, cuddling their little ones and generally enjoying being with them.

I found it a lot harder being around this baby that I'm probably never going to see again, and actually avoided going over to say hello to them at all. I was the same when someone else went off on maternity leave a couple of weeks ago, and I find it difficult to talk to another colleague who has just become a father. I just so badly want it to be us.

We signed all our forms for the clinic on Monday, and this morning I'm off to have yet another screening test which is required before we start, so I'll drop the forms off at the same time.

We struggled with the HFEA embryo storage form - we had to say what we wanted done with any frozen embryos in the event of my death. The options were destruction, donation or research. In order to choose donation, you had to be registered as a donor - and I've been told I wouldn't be allowed to donate because I'm too old.

That left us with a bit of a dilemma, but I've also been told I'm very unlikely to have any embryos left over to freeze, and I'm not planning to die in the next five years, so hopefully it'll be a non-issue. We've already told the clinic that we don't want any embryos destroyed - if that means not fertilising some of my eggs in the unlikely event that I produce a whole basketful of them, then so be it.

I had a chat with one of my neighbours this week. He and his late wife suffered multiple miscarriages and the death of one baby two days before its due date. They ended up adopting a child. We had a very interesting discussion (brought up by him, but very relevant to me) about how people react to major and potentially life-changing situations.

He said until you're in a particular situation you can't really know how you're going to react. You can do all the fine moralising you like, you can be absolutely adamant that you'll do X rather than Y, but until you experience it, you have no idea whether that's what you'll actually do. It's quite an important lesson about not judging other people's actions, and I hope this whole experience will make me more charitable towards others.

And thinking of being judgemental, another thing has happened which makes me very glad that I've started this new blog and not linked in any way to my old blog. I received a couple of rather nasty and very judgemental comments on the old blog - you know, from people who claim to be following the teachings of the Catholic Church but forget that its biggest message is one of love, and that Jesus Himself said you shouldn't judge others.

Fortunately, I have comment moderation enabled on that blog and so I just haven't published them. But it does make me wonder why some people who claim to be faithful Christians have so much hate in their hearts.

Monday 24 August 2009

Part 2 - infertility in the Bible

Obviously, we can't find any direct references in the Bible to IVF, since nothing like that existed in Biblical times. However, fertility struggles are nothing new - in fact, the first time infertility is mentioned in the Bible is in Genesis.

First we have Abraham and Sarah - Sarah is 'past the age of childbearing' (Genesis 18:12) and has given up hope of ever having a child when Isaac is born. Before his birth she has suggested in desperation that her husband should sleep with her slave-girl, Hagar, saying, "Listen, now! Since Yahweh has kept me from having children, go to my slave-girl. Perhaps I shall get children through her." (Genesis 16:2) Hagar conceives a child, following which "her mistress counted for nothing in her eyes". Yep, that smug attitude of some fertile people who think their fertility is a sign of superiority has existed since time began!

Then there's Isaac's wife, Rebekah. Genesis 25:21 tells us that "Isaac prayed to Yahweh on behalf of his wife, for she was barren. Yahweh heard his prayer, and his wife Rebekah conceived." She conceives twins - Jacob and Esau.

The next generation also struggle. Jacob falls in love with Rachel, but is tricked by her father into marrying her older sister, Leah. He then also marries Rachel, and loves her more than he loves Leah. Honestly, have a look at Genesis 29:31-30:24 - it's like a soap opera! There's more surrogacy through the slave-girls, there's jealousy between the two wives, there's despair as Rachel cries out to Jacob, "Give me children, or I shall die!" - and there's the final triumph when Rachel bears a son (and is dissatisfied with just one, immediately wanting another one). And of course, that first of two sons borne by Rachel is Joseph (he of the amazing technicolour dreamcoat), who is Jacob's favourite son.

Samson's mother was barren, until the Angel of the Lord came to her and promised that she would bear a son, and gave very strict instructions about how she was to behave and how her son was to be brought up (Judges 13).

The Shunnamite woman in 2 Kings 4 is barren, until she gives a home to Elisha and he prophesies that she will hold a son in her arms within a year.

In 1 Samuel 1, we again see the pain of the infertile woman in some detail. Elkanah has two wives, and Peninnah, who has children, taunts and provokes Hannah because of her barrenness. Hannah suffers the taunts of Peninnah, the patronising of her husband ("Why are you so sad? Am I not more to you than ten sons?") and the misunderstanding of the priest, who thinks when she is praying in a state of great distress that she is drunk. Again, the barren woman is eventually blessed with a son, Samuel, and she dedicates his life to Yahweh.

There is one infertile woman in the Bible who isn't eventually blessed with a child. In each of the stories above, the infertility has been a source of great anguish, and the infertile woman (and often her husband as well) is described as praying for relief from her barrenness. The story of Michal, wife of King David, is different. She is a shrewish woman who criticises her husband for making an exhibition of himself as he executes a dance of thanksgiving (2 Samuel 6:12-23). The story ends with a slightly throwaway line saying that Michal never had children, and it seems that this is a punishment for her contemptuous behaviour. Not a happy story, but one which again shows that childlessness is an affliction.

And then we come to the New Testament, and Mary's cousin Elizabeth. Luke 1:6-7 tells us that Elizabeth and Zechariah "were upright in the sight of God and impeccably carried out all the commandments and observances of the Lord. But they were childless: Elizabeth was barren and they were both advanced in years". Then Zechariah is told that his prayer has been heard, and that they are to have a son - "He will be your joy and delight and many will rejoice at his birth" (Luke 1:14).

What do we get out of all this? Well, there's obviously a clear understanding in the Bible about how painful the experience of infertility is - how desperate a couple, and particularly a woman, can be when they are unable to have children; how much pain can be caused by the lack of understanding of other people; how an infertile woman can feel taunted by the fertility of others (and yes, although I love being around the children I know, like other women who are struggling to have children there are times when I find it almost unbearable to be around pregnant women or to hear another pregnancy or birth announcement); and the great joy that an infertile couple can experience if they do eventually become parents.

Infertility is depicted as a struggle, an affliction, a source of great sadness, and something from which people pray to be delivered - and there's great rejoicing when they are delivered from this affliction. It's also something which is not well understood in medical terms, and we can compare its depiction to that of diseases for which there was at the time no known cure, such as leprosy - again, a source of distress, and an affliction which was sometimes cured through prayer (there being no other way to escape its effects).

And look what special children those were who were born to women who had suffered years of infertility - Isaac, Jacob, Joseph, Samson, Samuel, John the Baptist.

So, is prayer the only way we should deal with our infertility? Should we, as has been suggested to me, "take up the cross of infertility" and accept that we just weren't meant to have children? There's certainly no suggestion in the Bible that any of these women accepted their situation with equanimity - they prayed, they cried, they pleaded, they never gave up - and they were eventually rewarded for their persistence.

If Elizabeth hadn't been pregnant when her young, unmarried cousin Mary got knocked up and turned up on her doorstep, would she have been able to welcome her with quite such open arms? Might she have pasted on a smile to greet her and then made an excuse to go off to another room, to have a little cry about the unfairness of life?

And if IVF had been available, would Rachel, who thought she would die if she couldn't have a child, have turned it down?

Saturday 22 August 2009

First in a series

I always said that whatever happened, I wouldn't do IVF, because the Church didn't approve of it. I'd followed its teachings on sex before marriage, and DH and I were both virgins on our wedding night (and for about a week afterwards, until we finally figured out how to do it!). Because of this, our advanced age on marriage and the problems that we had conceiving, the teaching on contraception was never an issue for me, but I was quite happy to accept as many children as I was given, and hoped to have at least five or six children.

When it became clear about nine months after the wedding that we really weren't in line for a honeymoon baby (my mother reckons you're a bride for a full year), I had a chat with a priest while going to Confession. I said that we were trying for a baby and nothing was happening, and I asked him if it would be very wrong to pursue any sort of fertility treatment. At that time, we were thinking maybe we might need a helping hand from something like IUI.

He said that infertility was a medical problem like any other, and that seeking medical treatment for that medical problem was no worse than seeking treatment for any other sort of problem. He said the Church had a problem with IVF because of the embryos that can be destroyed in the process, but as long as we weren't destroying any embryos we should feel free to pursue whatever treatment we needed.

Really, that should have been that. A priest speaks with the authority of the Church, and I really shouldn't have questioned what he said. Unfortunately, I had already read some articles on the internet which contradicted what he had told me, and I was fairly convinced that IVF was an absolute no-no, and was comfortable that I would never pursue it.

Fast-forward a few more months, and we're in the consultant's room being given the devastating news that there is no realistic possibility of us ever conceiving without the help of IVF with ICSI. Before the appointment, I imagined this or a similar outcome many times - but I never really believed it would happen to me. And because I always retained that secret hope - secret even from myself at times, and hidden deep in my subconscious - I never imagined quite how crushing it would be when that little bit of hope was taken away from me.

Suddenly, I was faced with a stark choice - do I oppose what I know to be the Church's teaching on this issue? Do I pretend I haven't done all that reading and accept what the priest said to me a few months ago? Or do I accept the Church's teaching and therefore accept that we'll never have our own children?

Each of these options seemed equally painful to me, and for the first time I found that, rather than being a comfort and a source of hope and inspiration, my faith was actually causing me deep and real mental anguish. What made it worse in many ways was that my husband said he trusted me and would be guided by whatever I thought was right.

I can honestly say that the ten days that followed were, if not the worst period of my life so far, certainly up there in the top three. I certainly can't think of any other time in my life when I've cried so often and so easily, had so much trouble sleeping, and been so emotionally wrung-out and exhausted.

On the tenth day, which was a Sunday, I had the opportunity to spend most of the afternoon surfing the internet and thinking about what I'd read. By the end of the day, I had made my decision, and made my peace with it. I talked through it with my husband, and explained my reasoning. He said he had never had any doubts that the route we were now heading down was the right one, but would have been guided by me if I had thought otherwise.

Over the next few days, I'm going to go through some of my reasoning and explain how and why I came to the decision that I did - it's way too long for a single post.

And another dream...

Last night I had another IVF dream. This time I was up on the bed with my feet in the stirrups - I'm not entirely sure what for. What I do remember is that the nurse hadn't been able to find a babysitter and had brought her baby to work for the day. While she was doing whatever she had to do to me, she shoved the baby into my arms and asked me to look after it.

I wonder what my subconscious is trying to tell me now...

Friday 21 August 2009

I have a dream

In all my months of trying to conceive, I've never once dreamt of being pregnant, or of getting my BFP. But last night I had my first IVF dream - oh, the excitement!!

So, did I dream of giving myself injections? Going to the clinic and having scans? Egg retrieval? Embryo transfer?

Nope - my dream last night was... that I was in the two week wait.

I'm even DREAMING about waiting now - I despair!!!

Wednesday 19 August 2009

An answer at last

I have two pieces of good news tonight - first, the consultant is still happy to go ahead with the treatment next month. He said my AMH levels were disappointing, but not totally unexpected, and as he's prescribing the maximum dose of drugs for me anyway, we might as well give it a go.

And second, the nurse who is our main contact at the clinic really cares about the people in her care.

This morning she said she'd ring back at some stage this afternoon, but couldn't promise when - Wednesday is their busiest day, and they have appointments right up until 8 pm. She had warned me she might not have a chance to ring before about 7:30.

7:30 came and went, and I was on tenterhooks all afternoon, finding it harder and harder to concentrate on anything other than willing the phone to ring. When poor DH got home from work, he asked if I'd heard anything and I burst into tears - as I said to him, he's probably going to have to get used to that over the next few weeks.

8:00 also came and went, and I resigned myself to the fact that I would probably have to try to phone from the office tomorrow, in between my teaching - not ideal, especially if the news wasn't good.

At 8:45, the phone rang - and it was the wonderful wonderful nurse. She said it had been a busy day, and she had got halfway home and then remembered that she hadn't rung me - so she'd turned round and driven all the way back to the clinic to make the call. I thanked her profusely and she said, "Well, I know it's all you can think about at the moment, so I couldn't make you wait."

I'm so grateful that we're going to get the chance to have a go at this, even though I know the odds are stacked against us. And even more than that, I'm hugely grateful that we have such a caring person looking after us. I'm also grateful that poor old DH was so lovely when I got off the phone and promptly burst into tears all over again. It's definitely going to be a hard journey, but I couldn't haven't better companions along the road (and that includes you, Jeannie).

How to wish your life away

First, spend 15 cycles trying to conceive a baby. Make sure you have a few problems along the way (retarded ejaculation, necessitating a bit of DIY artificial insemination, for example), but get your hopes up every single month without fail, only to have them dashed to the ground every single month without fail.

Finally admit that you might have a problem and arrange an appointment at a fertility clinic. Wait a month or so for that, and fail to conceive another baby while you're waiting.

Go to your appointment, to be told your only hope of conceiving is IVF with ICSI, due to your husband's disastrously low sperm count - 0.6m/ml (should be >20 m/ml), motility 30% (should be >50%), morphology 3% (should be >30%), volume 1 ml (should be 2 ml), progression 1 (should be 2 or 3). IVF can only go ahead if your hormone levels are OK and DH's genetic testing (required because his sperm count is so low) comes back normal, so you...

Wait a few days, then phone for results of your FSH/LH/oestradiol testing. FSH is 13.2, LH 5.3 and oestradiol 156. A bit of googling tells you that this is BAD, but you...

Wait a few days for the next appointment and hear that DH's karyotyping and Y deletion tests came back normal - the first (and so far only) real bit of good news. The consultant agrees with you that the medical term for the state of your ovaries is probably "old and knackered", but is happy to go ahead with IVF, putting you on the highest dosage of drugs possible to kickstart your old, knackered ovaries, provided your AMH level is OK. So you get another blood test and...

Wait a few days for the planning appointment with the nurse, where she takes you through all the paperwork and explains what's going to happen next. Unfortunately, the AMH result isn't back yet, so you...

Wait another day, then ring her to see if the result is in yet. She calls back to say your level is 3.69, which is in the low fertility range. She thinks the treatment can still go ahead, as the consultant already knew your ovaries were old and knackered and this test has just confirmed it, but she needs to talk to him to confirm that, so you...

Carry on waiting for her to call back with the news that will either allow you to carry on waiting a bit longer for the treatment to begin or completely crush you.

And if the completely crushing answer comes through, the waiting won't stop either, because then it's a question of looking further into donor embryos, then waiting around for that, and if that's not a goer, looking further into adoption and waiting around for that.

I never knew how exhausting waiting could be, or how all-consuming - I CANNOT concentrate on my work today, and I know I'm going to suffer for that tomorrow when I'm standing in front of a class with nothing to say.

The real killer is that at the end of all this waiting and hoping and praying, there is absolutely no guarantee that we'll have a baby - by whatever means. I could be expending all this emotional energy in vain. And I'm so so tired already - how much more of this do I have to take?

It's official - I'm old

The nurse from the clinic just rang back with my AMH level - 3.69. She said this means I'm in the 'low fertility' range, so I presume this is the scale they're using (apparently there are two different scales for AMH).

Optimal Fertility: 28.6 pmol/L – 48.5 pmol/L
Satisfactory Fertility: 15.7 pmol/L – 28.6 pmol/L
Low Fertility: 2.2 pmol/L – 15.7 pmol/L
Very Low/Undetectable: 0.0 pmol/L – 2.2 pmol/L

She needs to have a chat with the consultant to see if this changes anything, and will hopefully ring me back late this afternoon or this evening. She said because I'll be on the highest dose of the drugs anyway following my rubbishy FSH and oestradiol levels, she thinks he'll just say go ahead - but it's not certain. Presumably even if he's happy to go ahead, with this sort of level the treatment is less likely to be successful.

So another dip on the old rollercoaster, and I'm back on my knees praying for the right answer this evening.

Telling the tide not to come in

The biggest source of tension between my husband and me is that his family Do Not Plan. I like to be spontaneous, and when we have a free day we'll often do something on the spur of the moment. But with a family and circle of friends as large as mine, I have to plan ahead or there are many many people I'd never get to see.

DH's family canNOT be pinned down to any firm arrangements for anything. Major birthday coming up? Silver Wedding anniversary? Christmas? Easter? DH and I keep the weekend free just in case anything is planned at the last minute. The bonus is that if no plans are made, we have an unexpected free weekend - but if we've turned down other invitations in the meantime in order to keep the weekend free, it does get irritating.

I, on the other hand, like to give people a bit more of a heads-up about when something might be going on and what it's likely to be. OK, I only booked the spa day for the weekend before my birthday (that is, the Saturday after next) yesterday, but the people who are coming have known about it for at least a month - and I've had the plan in my head for ages. And that's important to me too - call me a control freak (you wouldn't be the first), but I like to know what I'm going to be doing, and when.

The other piece of advice the nurse gave us yesterday was that we should take this process one step at a time - one injection, one scan, one procedure at a time, and try not to look ahead too much at what's coming next. Well, DH can probably do that quite happily. Me? It's like telling the tide not to come in, or telling the rain to fall upwards.

I've already sat with my calendar a few times, counting forward and trying to work out the approximate dates at which I'm likely to reach each stage (and when we could try again if this cycle fails, and how that fits in with our planned holiday in the autumn).

CD 1 of my next cycle should be around 9 or 10 September. I'll have to go down to the clinic then to have a scan, pick up my prescriptions and learn how to do my injections - and I've noted that this fits in OK with my work schedule, as I'm teaching every day that week, but only in the afternoons.

That would make egg retrieval and embryo transfer presumably about 14 days later - I usually ovulate on day 13, though I don't know exactly what the drugs will do to the timing. The clinic only does procedures on Mondays, Wednesdays and Fridays, so if egg retrieval is on a Wednesday, embryo transfer will be on the Friday. Monday of that week is almost certainly too early for egg retrieval, but Wednesday is a possibility, and if not Wednesday I'm sure it'll be happening on Friday.

And wouldn't you know it - that Friday is a hugely important day in the life of one of my very good friends. I've been invited to the ceremony that day and a huge party the day after - I'm godmother to one of their children, and they see me as part of their family. In fact, they see my entire family as part of their family, and my parents are also invited to this event. I'll be kind of sad if I can't make it, and I know they'll be pretty upset too.

And here's the other thing - I'm not sure I'd want to tell them why I'm not able to make it. They're so matter-of-fact about everything that I think they'd expect me just to get on with things and be hurt that I'm not making the effort to turn up anyway, at least to the party on the Saturday - but I just know that I'm going to want to lounge around with my feet up for a couple of days at least after the embryo transfer, and a huge party doesn't really figure in my plans.

Hmmmm - maybe this is why the nurse said to take things one step at a time. I mean, I might not produce enough follicles and the treatment might be abandoned. I haven't had my AMH result back yet, and the whole thing might have to be rethought if that's too low. This current cycle might be longer or shorter than normal. It might take longer to get to the egg retrieval stage than I'm expecting.

I wish I could just go to sleep for the next six weeks or so. Oh, and wake up pregnant - that's the important bit...

Tuesday 18 August 2009

All systems go

I've just got back from a meeting with the nurse at the clinic, and suddenly this is all seeming very real. We've come away with a huge sheaf of papers to read and sign, and we'll be starting the short protocol on day 1 of my next cycle - which should be around 9 September. I'll have approximately two weeks of daily injections and every-other-day scans, hopefully culminating in egg retrieval in the last week of September and embryo transfer two days later.

The nurse who took us through all the details helpfully pointed out that by the time the treatment starts, I'll be over 40, since my 40th birthday is at the beginning of September. This means that, provided I produce enough eggs, they could transfer up to three embryos (the maximum allowable in the UK for those under 40 being two). We turned that down - we don't know whether this cycle will be successful and if it is, how many embryos will 'take', but I don't want to risk having triplets at my age and with a family history of high blood pressure.

She asked how many people we'd told that we were going through the treatment. I said most of our families knew, and we'd both also told people at work so that we could get a bit of flexibility for appointments. She actually advised us against telling too many people, as every person who knows you're going through treatment is another person you have to tell if it fails.

So although lots of people know that we're going to be going through some form of treatment, we're going to try to keep the timing of that treatment a bit more under wraps as far as we can, and because I have an endless need to think and talk about what's happening to us, I'll be unloading myself to cyberspace instead...

Saturday 15 August 2009

Babies all around

Today we're going to a barbecue at a friend's house, to meet her new(ish) baby - born in May. Last week I met another friend's baby, born in June. And last weekend we had my three nieces, aged 14 months, 2 and 5, to stay for the weekend.

In terms of the infertility blogs I've been reading, we haven't been trying all that long - we only got married in May last year, and have been trying since then. However, I have known all my life that I wanted to be a mother.

The only reason I didn't try earlier was because I hadn't met the right man - and not for lack of looking, either! There was absolutely no way I "put my career first", "put it off until it got too late" or in any other way made any choice about this. But here I am, three weeks off my 40th birthday and with a diagnosis of diminished ovarian function and male factor infertility to boot.

One of the things that my husband and I have said to each other often is that we're very lucky, because even if we never have children ourselves, we will always be surrounded by children. We have 15 nephews and nieces between us. I have six godchildren (two of whom are my nephews), all of whom have siblings. And we see several other friends with children regularly. We have so many children in our lives that we have a well-used cot in our house, two highchairs, a changing mat, and a storage cabinet full of toys in our sitting-room.

I can't imagine shutting myself off from children just because we can't have any of our own. That really would be like cutting off my nose to spite my face. Occasionally I have to put up with thoughtless comments - people talking about how easily they got pregnant and how maybe I just need to relax and then it'll happen (no, you can't cure a medical problem just by relaxing); people saying how upset they'd be if they accidentally got pregnant again; people making comments about our hedonistic lifestyle (it isn't at all) and how we can't understand what it's like to be tied down and unable to do what we want when we want to. I'd LOVE to be tied down in that way, and I'd love to get accidentally pregnant.

But still - do I need to shut myself off from the children I love because their parents can sometimes be insensitive? Absolutely not - the unconditional love that I get from those children, the school plays and sports days I get invited to, the First Communions I go to, the birthday parties, all the big and little events in their lives that I'm able to be part of make the burden of my own childlessness less.

Why would I deprive myself of the pleasure of cuddling a new-born baby, seeing an older baby laugh as I play with it on my knee, being given a squashed daisy that a toddler has just picked for me, reading a story with a five-year-old, building lego with a six-year-old, just because I'm not their mother?

I know it's made easier for me because I don't keep it secret that we're trying and now that we're having problems. I don't talk incessantly about it, but it does mean that when I'm sitting with someone else's baby on my lap, nobody will thoughtlessly say, "So, when are you going to have one?" or "You really should try to have one - it's so worth it" or any of the other comments that can hurt an infertile person without meaning to.

Some people think they can't take the 'pity'. I haven't come across any pity yet. I've come across sympathy. I've come across some people who try to understand but aren't able to because they fell pregnant straight away and have no idea what we're going through. I've come across indifference and people who with the best intentions have unwittingly made hurtful comments (but hey, some people just seem to choose the wrong thing to say no matter what!). I've had people empathise and share their own stories with me. I've been surrounded by love and friendship. But pity? I don't think so.

I have chosen carefully who I've told - or rather, who I haven't told. I have one friend who loves to gossip, and I made a very conscious decision not to feed her gossip machine. There's an elderly friend of the family who would be very upset if she knew, so I haven't told her. But unless there's a reason to keep it from someone, I haven't.

Will it be hard being around my friend's baby today? Well, no - I've been the childless one at gatherings with children for years now. The eldest children of my friends and family are now in their mid-teens. So I'll do as I always do - I'll have a nice cuddle with the babies, a bit of a romp with the toddlers, and play or chat with the older children.

And I'll thank God that even though I'm childless, my life is far from child-free.

Thursday 13 August 2009

Fellowship

It's amazing how the stories come out of the woodwork when you start to tell people that you're not going to be able to have children naturally. People have shared stories with me of multiple miscarriages, premature births and subsequent deaths, failed adoptions, their own stories of infertility - and not in a way that says "worse things can happen, you know", but in a way that says "I feel your pain".

Today I was at a family funeral and was talking to a relative of my parents' generation whom I've only ever met once before, at my grandmother's funeral a few years ago. A propos of nothing, she made a jokey throwaway remark about the fact that she'd never had children. She then seemed to check herself, paused and then said in a small voice, "Actually, I'd love to have had children, but it didn't happen."

I nodded, also paused, and then said, "We're about to start IVF."

She gave me a huge hug, and I just knew two things - first, she knew exactly what we were going through. And second, that if we don't go through with this treatment, we'll regret it for the rest of our lives.

Wednesday 12 August 2009

And we had a laugh too...


While we were sitting in the treatment room waiting for the nurse to come and stick needles in my arm, I pointed out the ultrasound machine to my husband. I pointed out the wand, and told him what the consultant had done with it on our first visit.

His response?

"It looks just like my electric toothbrush."

It does, too.

Now I know why they call it a rollercoaster

So, we've been trying for months and months and months, and have been a bit in denial about whether we have a problem. Eventually, we get round to booking an appointment at a fertility clinic - ten days after we get back from holiday, so we're all fresh and ready for whatever hits us.

Or so we thought.

When the consultant told us that we had pretty much zero chance of conceiving without help, the bottom fell out of my world. I couldn't talk about it for several days without bursting into tears. My husband struggled in his own way, and from little things he said I knew he felt as bad as I did. He also felt guilty, because at that stage the only known problem was on his side.

Just as we were getting used to that idea, we were plunged further into depression by the news that my FSH and oestradiol levels were too high, indicating that I had poor ovarian function. It seemed even the ICSI treatment that we had thought of as pretty much a last resort might be denied to us, and I spent a week googling frantically to try to interpret the innocuous-sounding set of numbers that the nurse had given me over the phone.

This evening we had our follow-up appointment with the consultant, and the dread in the pit of my stomach increased with each hour that dragged past. Would he tell us we hadn't a snowflake's chance in Hell and should just go home and buy a cat?

And then finally, we got our first piece of good news. The chromosome tests that had been ordered for my husband came back normal. And the consultant wasn't too concerned about my FSH, although he did acknowledge that I may need a higher dose of drugs than someone with younger, fitter ovaries. But hey, looking on the bright side, he said he considered it highly unlikely that I would get OHSS - my ovaries just won't get that excited.

And because the NHS won't pay for our treatment and the clinic is small enough not to have huge waiting lists, we can start pretty much straight away. They took some more blood from me to test my AMH, and we've got our planning appointment next Tuesday - by which time the AMH result should be back. It'll be just too late for this cycle, as today is day 23 of a normally 26-day cycle. But it should be all systems go for a September cycle.

And suddenly it sounds like really good news that I'm going to get to inject myself every day for a fortnight or so with drugs that can have horrible side effects, have to juggle work with regular visits to the hospital to have an ultrasound wand stuck up my bits, and then go through a minor surgical procedure followed by two weeks of holding my breath to see whether it's worked (and if all goes well, another nine months or so worrying about what else could go wrong).

We know all the risks, we know how likely we are to fail at each and every stage of the process - but for tonight, we're elated, because 20% chance of success is 20% more than we have at the moment.

Tuesday 11 August 2009

Defining me

Normally when your body lets you down, you talk about having a particular illness - 'I have a cold', 'I have pneumonia', 'I have cancer'. With some lifelong syndromes, you can talk about having that illness - 'I have diabetes', 'I have asthma' - or you can define yourself in terms of your illness - 'I am diabetic', 'I am asthmatic'.

Last month, I found myself a new label. I don't 'have' infertility - I 'AM' infertile. And I think that use of language is telling. This is a lifelong position I now find myself in. My husband and I may or may not end up with a child to bring up. It may or may not have our genetic material, and I may or may not carry it in my womb for nine months. Those are details - painful details that we have to work through as we move from Plan B possibly on to Plan C, then Plans D, E and F. But the pain of being told, as the culmination of 16 cycles of raised hopes and crushing disappointment, that I will never become a mother without the help of a hefty dose of science - and maybe not even with it - is something that I think has changed me for ever.

I'm beginning to learn who my real friends are, who I can rely on for support, and who can be either deliberately or unknowingly hurtful and must be avoided for my own self-protection - I'm dealing with too much myself to be able to make allowances for those people at the moment.

I've also had to battle with my conscience. For a Catholic to be told "your only hope is IVF ICSI" is perhaps doubly painful, because for the first time I find myself truly at odds with my Church's teaching. Do I become one of these 'Cafeteria Catholics' who pick and choose which bits of the Church's teaching they follow? Or do I pick up my cross and resign myself to the fact that the Church says that a loving, committed Catholic couple with a genuine medical problem can't get help for that medical problem, even though that help is available?

Before this became a reality for us, we had discussed the possibility that we might not be able to have children. We had agreed that we would like to adopt, because the important thing is not necessarily to pass on our genetic material, but to make a family for ever.

But nothing prepares you for the shock of the actual diagnosis.

Nothing prepares you for the feelings of utter devastation that go through your mind, that wake you up in the early hours of the morning to lie weeping silently beside your slumbering husband.

Nothing prepares you for the hurt of well-meaning comments from people who don't understand.

Nothing prepares you for the way this one issue crowds all other thoughts out of your mind, the way it consumes you, saps your energy and sucks away your concentration.

Nothing prepares you for the moment your husband apologises for letting you down, and you have to find the right words to explain to him that this is OUR problem, and not just his or mine, so nobody has let anybody down.

Nothing prepares you for the anger and pain you feel when you hear about children being neglected, see parents ignore their babies' cries as they waft cigarette smoke around their heads, hear mothers shout at their toddlers in words that no child should ever hear, and wonder what you did wrong that these people have been able to have children and you haven't.

Nothing prepares you for the moment your husband says, "Maybe we should just give up and accept that we'll never be parents."

Nothing can ever prepare you.

And that's why it's right that at the moment I define myself in a new way.

I don't HAVE infertility.

I AM infertile.