Content warning – experience of infertility and pregnancy loss
I write this as fertility awareness week approaches and find myself reflecting on the past seven years. How did that happen? My primary reason for sharing my experience is to raise awareness and because although it was painful, I feel I can share it, whilst others cannot. I feel like being more open about what infertility was like for me will help destigmatize it; and maybe someone going through a similar journey will feel less alone.
Spoiler alert – I now have a turbo-charged, head strong toddler after IVF eventually resulted in a successful pregnancy. If you need to stop reading because this is now one of many infertility stories that includes success, then I 100% support that choice. One source of frustration for me during infertility was the absence of stories from people who underwent years of treatment and chose to stop without having a child. It felt as if these people didn’t exist, yet I felt they must (they do!) and I wanted to hear how they scaffolded their way out of the sinking sand of infertility treatment. Their stories are so important in a society which seems to ask women at every turn when they are having children or why they haven’t had them yet. (If this is something you think you might be guilty of doing, even with close friends or family, please stop) The weight of expectation from society is a lot to carry on top of the ache from within to become a parent.
This is Llansteffan beach. It was here, settled on the same bench, that I realised I had visited for the past 4 years, almost to the day, each year. I would sit here gazing at the water, fiercely close to bursting with emotion, an outward calm belying what I now recognise as a response to trauma. As a write I feel this is sounding a little dramatic, but I am working on being kind to myself; a part of that is being honest about what a destructive experience it was to go through infertility and subsequent treatment, in order to carry and give birth to a child.
One thing which is helping me process the experience is recognising that not getting pregnant every cycle, over years, became a monthly hop on the grief train. Grief, with all its stages and visceral extremes, was triggered each time I was not pregnant. The hope attached to the possibility that this might be the time my period wouldn’t come and I could take a test, was lost each time. The meaning held within that, the imagined future that disappeared with a grimly comic ‘POP!’ every month. I am not a particularly superstitious person, but it became very difficult to shush the thought that this was punishment for something, that the universe had somehow found me not deserving of becoming a parent. That self-kindness, I mentioned earlier? I am trying to apply it to those sorts of thoughts.
After not being pregnant for a long time and after repeat trips to the GP, I was referred to a fertility clinic for further investigations, along with my partner. After several procedures, including surgery, we were given a diagnosis of ‘unexplained fertility’– yes that is an actual diagnosis – with a 13% chance of successful conception with treatment. I want to say that hearing that percentage was a hammer blow, but in reality I was so worn down and used to the loss of hope by this point that I don’t think I engaged with the bleakness of it until much later.
Having already spent years trying to start a family by this point, and after the invasive procedures for diagnosis, we decided to give IVF a try despite the low likelihood of success. Living in Bristol we were entitled to one round of treatment on the NHS. This started in early 2020, so I was administering the hormone cocktails by daily injections while watching our government pretend there wasn’t an incredibly worrying virus sweeping across the world. I started working from home during this time as I was worried about getting unwell while in treatment. This was coupled with regular visits to the clinic to check how my ovaries were responding.
After the course of hormones came to an end, I had the procedure to harvest eggs; the embryologists did their (amazing) thing and an embryo started to develop in the lab, and I went back in to have it implanted. Two days later, the country went into lockdown and everything stopped. I was lucky that I had been able to get that one embryo implanted before the clinic had to close. What followed was the ‘two week wait’ – the window after the embryo transfer when you wait to take a pregnancy test to see if it has implanted.
You’re meant to spend that time doing nice relaxing things, such as being creative, and distracting yourself. Like everyone else at this time my main distraction was watching the government bungle its way through how we should be behaving, how we could protect ourselves and one another, and how we must stay at home. Work turned out to be a great way to occupy my mind since there was so much opportunity to pitch in and do whatever needed doing to help teaching move online – it was far from relaxing though.
The two weeks passed painfully slowly, before test day eventually rolled around. It was negative. It ‘doesn’t count’ as a loss, but after two weeks of behaving like I could be pregnant it certainly felt like one. That loss of hope emerged again; the single funded cycle was now complete with nothing to show from it. The other two embryos that had started to develop in the lab had stopped a day later – the day before lock down – so there was nothing in the freezer to transfer. That was it.
We let the clinic know by email and were given a phone appointment with a consultant at the clinic. She was clinical about it all and explained that the first cycle was often more diagnostic than anything, and on average they advised people to try at least three cycles of treatment with adjustments based on what they learned from previous ones. This was news to me! I felt like I’d been duped into some medical (and financial) lottery where if I just tried once more it might just work out. You’ve had the first go, keep going!
The clinic could not open for further treatments until four months later so we had some time to think about what to do; we decided we could afford to fund one more cycle ourselves, so we contacted them in July and started the process again. This time, the doses of hormones was changed to increase the chances of having more eggs to harvest, which worked. A bit too well.
I started to feel unwell with six days left of treatment. The clinic ordered blood tests which showed my hormone levels were higher than they should be. My treatment was tweaked but I was advised to keep injecting the hormones and go for egg retrieval on the planned day. This time, they got more eggs and were really pleased but I had to be helped out of the clinic to the car with a lovely cardboard bowl to throw up in on the way home. Over the next two days at home, I felt even worse. It then became clear I had ovarian hyperstimulation syndrome (OHSS), which meant I could not have any of the three embryos that had developed transferred and they were all frozen instead.
The COVID-19 measures were still in place at this point so my partner was not allowed into the clinic, and they didn’t want to admit me to hospital if they could avoid it because of the COVID risk at Southmead. As a result, my partner drove me to the clinic every morning for observation, and blood tests. In addition to this exhausting routine, we had to be on standby to go into hospital each day depending on the test outcome which came at lunch time. After five days of this, I was starting to feel better and was cleared to rest and relax until I felt back to full health, which I chose to go and do in Llansteffan.
After a couple of normal menstrual cycles, I was allowed to have an embryo transfer in early December 2020. The best graded embryo was defrosted and transferred, starting that two week wait period again. I was resigned to it not working this time so was absolutely floored to be staring at my first ever positive pregnancy test two weeks later. I lived in a weird daze, keeping away from people as COVID surged again and not quite believing I was finally pregnant. On 22nd December I started bleeding and called the clinic, who said it sounded like a chemical pregnancy. A chemical pregnancy isn’t considered a miscarriage, but to me it was (and is). Because of it being by IVF, I know the would-have-been due date for that embryo and that day will never pass without me thinking of what may have been. Christmas was shit.
We had another decision to make. Our remaining embryos were frozen and stored at no cost for one year, but we had to fund any further transfers, so we decided we would transfer those embryos before the year was up and then call it a day. In early April, after further normal menstrual cycles, we had the best graded embryo of the remaining two transferred and started yet another two week wait. It passed much more quickly this time and I found myself staring, once again, at a positive pregnancy test. I felt numb, until a couple of weeks later, when I suddenly lost my appetite, developed a strong aversion to any food with flavour, and started to consider that this might actually be a real pregnancy. A seven-week scan at the clinic showed that everything was as it should be at that stage – a blob of grey fuzz on a screen as far as I could tell – and my morning sickness continued. I was released from the clinic’s care and entered the care of midwifery, the most wonderful women and best medical care I have experienced. After the occasional event during the pregnancy, my son was born on Christmas Day 2021.
This is one woman’s experience of infertility and IVF, statistically unremarkable, as according the NHS ‘1 in 7 couples struggle to conceive’. I’m conscious that my experience as a cis, white woman in a heterosexual relationship – and that 1 in 7 statistic on the NHS site – only shows a small part of the picture of infertility, a subject that is so infrequently discussed with much feeling and one that brings plenty of other challenges – and battles – for people in different circumstances. That said, more people sharing their stories can only be a good thing and this is mine.
As you can probably tell this experience still feels very raw for me and raises resentment, confusion, guilt, sorrow – to name a few of the complex range of emotions I am slowly working through. Having my son had an amazing shrinking effect on the space that it takes up inside me, and he brings me joy every day. Imagining becoming a parent was something I stopped myself from doing when it became too painful, but occasionally my son will do something, or we will be in a moment together, and I will realise I had daydreamed about it years ago. That is a warm feeling.
Sarah Salter
Senior Project Manager – Digital Learning