Last week You magazine columnist and author Elizabeth Day told of her heartbreaking struggles to overcome the breakdown of her marriage. Today, in the second part of our exclusive extract from Elizabeth’s compelling new book, she reveals the torment of her failed attempt at IVF, the searing grief that followed and how she eventually came to accept she would never be a mother…
At the hospital they were always running late, so there was a lot of waiting. I would see other women with their partners, some with swollen pregnant bellies, others with a hollowed-out expression that I came to recognise as the sign of too much trying
I always thought I would have children. It was an automatic assumption, in much the same way as I grew up believing the sun would rise every morning and the world would continue to spin reliably on its axis. And I just assumed I’d get pregnant when I came off the Pill as if my fertility had been straining at the leash all these years and was desperate to be set free.
I’d done everything I’d been told to do: I’d got a good degree, I’d worked hard, I’d made a career for myself, I’d got married. Subconsciously, I suppose I expected to be rewarded for this exercise in box-ticking. That was misguided. Because fertility just doesn’t care.
The first I knew of this was when I went to the GP at 35 after two years of trying for a baby with my then husband.
There were blood tests, and further tests and an ultrasound scan. Then the consultant explained that my womb was bicornuate, which meant it hadn’t developed properly, and the top portion had a deep indentation, which might or might not affect my chances of getting pregnant. He advised going straight to a cycle of IVF.
In a way, I was pleased. Success, after all, was practically guaranteed. How could it not be when sperm and egg were literally being joined together by the hand of medical professionals rather than having to rely on finding each other in the badly lit corridor of my fallopian tube? Before the cycle started, I was booked in for a procedure which involved scratching the lining of my uterus to encourage it to grow thicker.
It was so painful – as if a giant claw had been scratching me from the inside – that I fainted on the hospital gurney.
I started my first IVF cycle in February 2014. The nurses talked me through the process: daily injections of hormones to switch off my ovarian function, followed by injections of follicle-stimulating hormones, followed by an injection to trigger egg release.
All of this would take place over two to three weeks, depending on how well I was reacting to the drugs. Every other day, I would go into the hospital for an internal scan.
Injecting yourself with hormones is not a pleasant experience. For a start, it’s strange to press a needle into the fleshy part of your stomach and feel a slight billowing in your bloodstream as the fluid sinks in, releasing a chemical smell redolent of bleached hospital corridors.
The hormones make you prone to mood swings, but it’s more than that: it’s a sensation of being overwhelmed and unable to keep things in perspective. You become a ricocheting pinball of emotion that takes you from crying to numbness in a minute. At least, that’s what it was like for me.
At the hospital they were always running late, so there was a lot of waiting. I would see other women with their partners, some with swollen pregnant bellies, others with a hollowed-out expression that I came to recognise as the sign of too much trying.
We never spoke to each other, these women and I, because there was more solidarity to be found in silence. We respected each other’s stories and our invisible scars.
As the days went on, my ovaries were stubbornly refusing to comply, so my drugs were increased. Follicles – the sacs in which eggs develop – appeared on the murky ultrasound screen but too few were of the right size to denote maturity. I cried down the phone to a friend. My husband had just started a demanding new job, so I felt very alone. I didn’t want to trouble him with too many phone calls or discussions, and I realise now that, while I thought I was doing the right thing, it’s possible that I was also excluding him and emphasising my isolation in the process.
After a few more days, I had three follicles that were deemed big enough to trigger egg release. I was given a new injection to administer at 9pm on a night when we’d arranged to have dinner with my husband’s work contact. So I went along with the drugs in my handbag and, at 9pm, I made my way to the toilet, into a grubby cubicle and twisted myself as best I could to plunge the needle into my stomach without touching any surfaces.
On Monday, I went into hospital for egg retrieval. When the nurse sedated me, she explained it would feel like drinking a couple of very strong gin and tonics – and after weeks of emotional stress, it was just as delightful as it sounds.
I came round in a curtained cubicle, and was told they had retrieved one egg. I felt groggily pleased. One was all I needed, after all.
Then there was more waiting. First to be told if the egg had fertilised (it had) and then to be told whether the resulting embryo was of a sufficiently high quality to be transferred into my uterus.
This usually goes on for five to six days, but my consultant decided to transfer it on day two, believing that to wait any longer would be to risk the sliver of a chance I had. The transfer was the most painless part of the whole thing.
I took a taxi home and crawled into bed in the middle of the day. For the next two weeks, I took things easy. I listened to audiobooks. I went for acupuncture. I didn’t drink caffeine. I felt great.
I felt, although I did not allow myself to say it out loud, pregnant. And technically, I suppose I was. My womb contained an embryo. But the embryo didn’t stick. For whatever reason, it took a long, hard look around my uterus and found it wanting. All I had to go on was a bloody discharge. My first IVF cycle had failed.
I signed up for a second cycle almost immediately. ‘Are you sure you want to do this straight away?’ my favourite nurse said. I nodded and blinked back tears.
‘I’m feeling positive,’ I lied.
Actually, what I was feeling was numb. Looking back, I can see that I was, if not depressed, then very low and difficult to reach. I was there, but I was not. I was not allowing myself to feel. The second cycle meant more drugs and more scans. This time two fertilised eggs were deemed of sufficient quality to put back in. This time, I thought proudly, I was technically pregnant with twins.
But exactly the same thing happened. Two days before I was due to go in for a pregnancy test, I started to bleed.
The consultant summoned me for a debrief. ‘At this stage, we don’t really know why you’re not responding to the drugs,’ he said. I hung my head, chastened. Bad body, I thought, not doing what it was meant to when faced with the sophisticated medicine that worked for other, better females.
Befuddled with exhaustion, I felt displaced as though walking around in a diving suit. And I was £8,000 poorer (we weren’t eligible for IVF on the NHS).
It had been my certain belief that I wanted to be a mother. Now, I slowly came to terms with the thought of not having children. Months passed. We went on holiday. I had a work trip to Paris for an interview.
In the hotel, I got my period. You again, I thought. Hello.
After the interview, I had a cup of green tea at an outside cafe table in the Place des Vosges. I felt sick and couldn’t finish it. The period I thought had started the night before appeared to have tailed off. And then I remembered having read about implantation bleeds, when about six to 12 days after conception, the embryo will implant itself into the wall of the uterus, breaking down blood vessels. Many people mistake it for the onset of menstruation.
Now, when I went into the same hospital where I’d had IVF, everyone was so nice to me. Finally, I had been admitted into the masonic society of glowing, fertile mothers-to-be (file image)
Surely, I couldn’t be? But then again… I had been feeling extremely tired, and if I counted back six to 12 days, it was when we had been in Spain on holiday. Could I have conceived naturally?
At home, I took a pregnancy test and there it was: Pregnant, three to four weeks. I did not feel elation. I felt shock. And uncertainty. But gradually, over the ensuing days, the idea settled itself.
As soon as I informed my GP, a whole set of systems clicked into place and I was being sent leaflets for ante-natal classes and breast-feeding support groups.
Now, when I went into the same hospital where I’d had IVF, everyone was so nice to me. Finally, I had been admitted into the masonic society of glowing, fertile mothers-to-be.
We had an early scan at seven weeks because of my history. There, on the dark screen, was a pulsating dot of white against the black. A heart. A dazzling, beating heart. The sonographer smiled.
‘That’s a great sign. It means that, at this stage, the chances of miscarriage are less than five per cent.’
So we allowed ourselves to think about names. We told people. But on a long weekend to Barcelona with a friend, I began to feel anxious. It was a gnawing at the edge of my consciousness that I couldn’t ignore.
Something felt amiss, but I convinced myself I was worrying about nothing. My 12-week scan was scheduled for the following Monday and I told myself I just had to hang on until then. Then I started to bleed.
Back home, I took myself to A&E for an ultrasound. This time I wasn’t shown the screen.
‘I’m sorry to say that the embryo has stopped developing,’ said the sonographer. ‘We call it a missed miscarriage.’
Miscarriage. Missed. I’d even failed at that.
‘I’m so sorry,’ she repeated, and I started crying. ‘I’m fine, I’m fine,’ I kept saying, even though I clearly wasn’t. ‘Sorry.’
I was booked in for an operation to remove ‘early pregnancy remains’ – the baby now reduced to a cold, administrative phrase, a thing that needed to be tidied away and got rid of – and the sonographer warned me I might start miscarrying naturally between now and then.
My friend Bex came to pick me up from hospital. She understood, without my having to explain, that all I needed was for her to be there and allow me to weep. My mother met me at home. Thank God, I thought, for the understanding of women. On Saturday, halfway through brunch with a friend, I felt my stomach cramping. In the bathroom, I saw I was bleeding. We got a taxi to the hospital. It still seemed to be happening to someone else.
I was put in a private room, where I spent one of the most gruelling nights of my life. I was alone. Every few minutes, there would be a surge of severe cramping pain in my lower abdomen.
The pain was so acute I had to get out of bed and curl over myself while gripping on to the wall. I had been given a cardboard tray in which to keep the bloodied discharge. The baby that had two or three potential names, that had an imagined future, that had grandparents and half-siblings and a cousin, was reduced to a coagulated mass of dark reddish clots.
The next morning, there was more waiting. My operation was not an emergency so kept being pushed further down the list. Finally, in the early afternoon, I was wheeled down to surgery, given a general anaesthetic and passed out. When I came round, my womb was empty once again.
I can’t write with much precision about what happened next. The grief that did come my way moved in slow motion, and I can only acknowledge it as grief in retrospect. At the time it felt as if I were coping. I wasn’t.
Unwittingly, I shut my partner out of my sadness. It seemed easier to deal with on my own. It wasn’t. Four months after my miscarriage, my marriage ended.
My life did a handbrake turn. My future began to look completely different to the one I had always naively imagined.
It took me a long time to be at peace with that. After all, childlessness is still seen as an oddity. There’s a bone-headed assumption that a child-free woman is some kind of ambitious harpy with no maternal instinct who must be a bit weird.
I’m hopeful that this sort of prejudice will soon become outdated, if only because of shifting demographics: a fifth of British women are now child-free in their early 40s. We cannot be ignored.
Just as my mother’s generation fought for their daughters’ rights to have a career, I’m fighting for a woman’s right not to have daughters and not to be judged lacking because of it. I’m fighting for her right to be acknowledged, valued, heard and not treated as ‘less than’ simply because she’s ‘child-less’.
In truth, I do not see my failure to have babies as a personal failure. While I would love to experience motherhood and like to think I would be a good mother, it’s not a necessary step in how I define myself.
I have my writing, which gives me purpose, and two nieces and nine godchildren, so children are very much a part of my life.
I have a life full of wonderful gifts, including friendships, professional success, financial independence and good health. How lucky am I?
© Elizabeth Day, 2019
l How To Fail, by Elizabeth Day, is published by Fourth Estate on April 4, priced £12.99. Offer price £10.39 (20 per cent discount) until March 31. Pre-order at mailshop. co.uk/books or call 0844 571 0640; p&p is free on orders over £15. Spend £30 on books and get free premium delivery.