IVF Update: Third Time Unlucky

Many of you already know how this story ends. Until I wrote about our struggle to conceive on my blog, only our immediate family and best friends were aware of the emotional events occurring behind closed doors. Then I pressed publish and broadcasted our private pain to the public.

Part of me expected some criticism: people who disapproved of us airing our fertility-related laundry; those who believed we should accept nature’s choice; being accused of using our story to get attention. It seems silly when I type out those fears now because we’ve received nothing but kindness and compassion from everyone, including strangers, some of whom thanked us for articulating their experience, particularly as an Indian couple. While an increasing number of Indian people are breaking their silence about alternate routes to parenthood, infertility remains a stigmatised subject among BAME communities. It’s ironic given the pressure to procreate from the day you get married, but I’ve tackled that topic in other articles.

“Familiarity with the process completely altered my approach to this cycle.”

We were hoping to start our third round in April 2019. As always, life had other plans. For three months, I’d go into the clinic a day after my period had made yet another unwelcome appearance to determine my FSH level via a blood test (Follicle Stimulating Hormone, which indicates the growth of ovarian follicles). It was the same story every time: the figure was too high, so treatment was postponed for another month. Which is crushing enough during your usual routine, but even more so when you’ve had to cut short your long overdue weekend break in Brighton with your best friend. (If you’ve read my original post, you’ll know that Neil and I celebrated our 10^th wedding anniversary in Brighton as it fell during a two-week wait, so the city evokes happy-sad memories for me.)

When we finally got the green light, I was having brunch with my mother-in-law. Having waited for what felt like forever to receive this news, I practically ran back to the clinic, credit card in hand, eager to get injecting. As the nurse ran through the schedule, gave advice on what to do and what to avoid and timings before handing over the large bag of medications, I caught my mother-in-law’s bewildered expression. When I’d sat in the same room for the first time, I’d undoubtedly had the same look on my face. There was so much jargon flying at lightning speed towards me and most of it had zoomed over my head. However, this wasn’t my first fertility rodeo and my joy was palpable.

Familiarity with the process completely altered my approach to this cycle. As did my sheer enthusiasm. This may sound strange to some, but after months of inactivity, I was so excited that something positive was finally happening. We were back on the TTC (Trying To Conceive) treadmill and maybe, just maybe, we’d get lucky, it being our third stab at IVF (pun intended, obviously).

There was one dark cloud on the horizon, though: I was unemployed for the first time in my adult life. My account management role at a digital marketing agency was being phased out for financial reasons. Even when you know your job is at risk, it still comes as a shock. Ultimately, it was a blessing in disguise as I had the time and energy to fully focus on fighting infertility. No chasing clients, no meetings, no content/strategic planning; just me and my Marylebone clinic for a month.

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So it was back to the daily blood tests (for 11 days, with some repeat tests on the same day), ultrasounds on alternate days and multiple medications every day (including 2-5 different injections throughout the day at specific times and a cocktail of pills and pessaries). We also accepted a couple of add-ons: a two-hour IVIG drip to neutralise my elevated cytokines, i.e. natural killer cells, and a procedure involving inserting Neupogen into my uterus to thicken the lining prior to embryo transfer.

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It also meant the reappearance of the two-inch intramuscular needle. I may be very comfortable with doing subcutaneous injections, but this nasty needle will always fill me with dread. Neil bravely administered them again, for which I’ll be forever grateful. Knowingly inflicting pain on someone you love, steeling yourself as you slowly sink the long needle into their skin and wiping away their tears while crying your own inside is unbelievably difficult and real testament to his strength and love. So much attention is given to women when heterosexual couples undergo fertility treatment, and understandably so, but our partners’ emotions also need to be acknowledged. They too are suffering, having to watch and wait, staying strong while simultaneously falling to pieces.

“Out of adversity comes opportunity.”

My taking round three in my stride made Neil feel considerably calmer. That said, there were some moments when panic set in. One was when he was late home after a dinner. Which isn’t usually an issue, but when injections are time-sensitive, you can’t mess around. After unfairly shouting at him down the phone, I prepped my nemesis needle and tried to psyche myself up to do the deed. Each time I brought the sharp point close to my thigh, I felt the fear rise higher and higher, the tears gradually building up, until I lost my nerve. Neil didn’t hold my outburst against me, of course, but I still feel ashamed of the things I said when he was enjoying a rare evening with friends to take his mind off the rigours of IVF for a few hours.

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I also freaked out at the Taste of London festival. In hindsight, I probably shouldn’t have been in a situation where there was a risk that I couldn’t note down my clinic’s instructions for the day or easily inject, but it was summer, the clinic was a 10-minute walk away and I needed distractions. On one day, I was so nervous about missing the call that I became sensitive and snappy. Neil has always been calm in a crisis and successfully brought me back to myself by using food-focused strategies. On another occasion, I panicked when I left the festival for the clinic, only to find it closed. My sister watched as I spiralled, unsure about where I could safely take my injections within the instructed timeframe (these ones had to be reconstituted, which you don’t want to/can’t do in any old toilet). Thankfully, another clinic was open and all ended well.

Except things didn’t end well overall. On the big day, Neil couldn’t accompany me due to a work emergency, so I sat solo in my regular post-blood test café waiting for The Call. My mobile rang and yet again I heard the words, “We’re so sorry, Mrs Savla, but your pregnancy test came back negative. We’ll be in touch to arrange a post-cycle consultation within the next two weeks.”

Just because you expect to hear this news doesn’t make it any easier to digest. I was hoping that my positive, calmer approach would yield a positive result, but no such luck. Shocked, I went back to scheduling my social media content for the week. When reality finally hit me, I rushed to the toilet, locked myself in a cubicle and cried. Those tears were full of anger, disappointment, sadness, shame and emptiness.

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The tears continued to flow when I later met a favourite cousin-in-law for lunch at The River Café. Apart from Neil and the clinic, she was the only person to know the date of our pregnancy test – I’d shared everything with everyone until this point, but wanted to have time and space to process the outcome. I’d warned her that I might be elated or devastated, to which she replied that she could handle both scenarios. To her credit, she did, and we indulged in red wine, rare beef and steak tartare and scallops, all of which were now safe to consume.

I would’ve gladly gone home to prolong the pity party, but once again, life had other ideas. Our failed cycle coincided with Neil working in Germany for a week and urgent repairs to our garden stairs, which saw two workmen traipsing through our home for several days. At a time when all I wanted was to be with holed up with Neil, drinking wine all day and feeling sorry for ourselves, I had to put on a brave face for strangers.

” You WILL be parents; it’s just a question of how.”

As I was out of work, I sat on the couch and devoured ‘Meant To Be’, Lisa Faulkner’s account of her IVF experience at my clinic. After three unsuccessful rounds, she went on to adopt her daughter Billie, a story which gave me a glimmer of hope as I processed my pain alone (before Googling local adoption agencies). At certain points, I wondered whether the workmen were judging me for lounging around while Neil was hard at work. Yet another layer of guilt on top of the pre-existing ones. It took considerable effort to push this unfounded judgment out of my head; chances are they were only thinking about the job at hand.

Aside from catching up with my cousin-in-law, another well-timed moment of comfort came in the form of my best friend’s spontaneous trip to London. By coincidence, when I messaged her the sad news, she was en route to visit her sister, who happens to live 10 minutes away by car. On seeing them, I burst into tears before we embraced in silence. Life can be so cruel, but sometimes, you’re given what you need when you need it the most.

As the sharp sting of failure slowly subsided, we found ourselves back at the clinic for our debrief. In short, there was no reason not to undergo another fresh cycle; my ovarian reserve was low, but I was still producing viable eggs. The alternative was to use donor eggs. There was just one problem: our clinic only works with known donors, meaning we’d be responsible for finding a donor. A few immediate candidates came to mind until the doctor explained that the donor would have to be aged 35 or under and already have at least one child. Well, that ruled out our initial options.

But to quote Benjamin Franklin, out of adversity comes opportunity. And this was the perfect opportunity for a new start. Now that I had a few rounds under my belt and had been openly discussing and learning more about fertility for months, I felt confident enough to “shop around”. I started with Fertility Fest, where I participated in a Race, Religion and Reproduction workshop, listened to spoken poetry by men and attended panel discussions. This was followed by The Fertility Show, which, along with thought-provoking debates, gave us the chance to meet other clinics.

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We narrowed the list down to two clinics, both offering fresh and anonymous donor cycles. But from the moment I crossed the threshold of the first clinic for their open evening, it was game over for the competition. They say you know when you’ve met “the one” and I immediately felt the attraction. The space is modern, open and simply decorated (the walls are free from baby photos, which may give some women hope, but they irritate me as they’re a constant reminder of my shortcomings), the team friendly and caring and the information clearly and calmly delivered. During our consultation, not only did they carry out an ultrasound and mock transfer to tackle any issues early on, they finished with these encouraging words: “You WILL be parents; it’s just a question of how. It might not be what you’d envisaged, but there are many routes to parenthood if you’re willing to consider them.” I was ready to sign on all the dotted lines.

“Quite frankly, it’s a relief to speak openly.”

At the time of writing, I recently had my eggs collected and am waiting to hear how our embryos develop. Even if they become beautiful blastocysts, my transfer is now delayed due to COVID-19. If we go on to chalk up another failure, it’ll be time for Plan B. While using donor eggs would wipe out my genetic link to Baby Savla, my desire to be a mother is stronger than my sadness at losing the biological bond. The act of carrying the baby would be enough for me. I appreciate that not every woman feels this way and so needs time to mourn the loss of the family they’d envisaged before moving on. There are also concerns surrounding if and how to inform the child about how they were conceived, the fear of rejection, the selfishness of using anonymous donors and the judgement of others. As this is currently a hypothetical situation for us, we’ll navigate these issues if/when the time comes.

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It has been a year today since we shared our story. Countless online and offline conversations, several podcast interviews, articles and a video campaign later, I’m very comfortable talking about IVF to almost anyone and everyone and proud to be fertility advocate and supporting others going through similar struggles. Quite frankly, it’s a relief to speak openly. However, I still experience moments of overwhelming emotions: feeling sad and sore after having my Fallopian tubes checked; jealousy whenever I hear a pregnancy or birth announcement and see scans and baby bumps on social media; frustration when people repeatedly moan to me about their children; endless shame about my body’s inability to conceive, even with the best medical invention; guilt about the lack of grandchildren for our parents; regret for not taking action sooner. Keeping the bitterness at bay is no mean feat. But as long as we’re both still breathing, there’s hope.

LINKS:

Me, Myself and IVF, 5 Places to Eat in Brighton, HuffPost IVF & Indians article, Netmums IVF & Indians article, Fertility Fest 2020, The Fertility Show 2020, TTC Community: Instagram, UCL Fertility Study (short online questionnaire)

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