The Pursuit of Motherhood

by Jessica Hepburn

  At the risk of sounding evangelical, what the world needs is a place where infertile couples can go to talk through all the options early on, with someone who is knowledgeable and understanding, who can listen to their story from all sides and explain all the possibilities. If this had been readily available to us we might have made different choices. Maybe we would have a family now – even if it wasn’t biologically our own. Maybe we would have lived our life of infertility in a different way.

  The Infertility Diaries Part XXVIII

  The thing is we’re all just specks. Specks in an infinite universe. In a hundred years’ time it won’t matter who had a baby and who didn’t. It doesn’t now. It only matters to me because in my world I am enormous. So I am trying to put things in perspective and it helps to think of myself as a speck. The important thing is to make the most of the short time I have here: to relish all the options that are possible.

  601 DAYS

  My dad’s funeral was a perfect day. I know that sounds wrong but it’s true. I read a poem; Peter did the eulogy; Frank Sinatra sang Moon River. I think when someone dies at ninety-two you have to make it a celebration of a long life lived. I like to imagine my dad lying there listening. He wouldn’t have believed that it was him we were all there for. ‘Amazing,’ he would have said, in the way that he did, wide-eyed, lingering over the letters ‘a’ and ‘z’.

  My dad would have made a wonderful grandfather. He had a childlike quality and was a cross between a teddy bear and a little boy. Children loved him. And he loved them. But one of the things that made him special is that he never made me feel like I’d failed him by not giving him grandchildren. He was always proud of the things that I had done, and never thought about the things that I hadn’t.

  A few days after his funeral I come to a decision: it’s time to stop writing. Death is a time for new beginnings, even if they’re not the small pink ones I was hoping for. I always thought that as long as my story had a happy ending then I would be able to accept, maybe even appreciate, everything I’ve been through. I have kept writing in the hope that it would happen; that this would eventually become a book of triumph over adversity, like so many of the best life stories are. But it seems that for now, at least, it isn’t.

  Of course if we had considered some of the other options earlier I could perhaps have written an alternative happy ending. We might have had a little army of adopted children and I could have achieved my childhood dream of a family with seven siblings (any one of whom would legitimately have been able to win the school pumpkin).

  But we never did. The fact that our infertility was and remains unexplainable; the fact that our eggs and sperm seem to make perfect embryos in the laboratory; the fact that in those early years the biochemical pregnancies, ectopic pregnancy and miscarriage seemed to be a clear indication that things would work out well in the end – these were all reasons why we continued on the fertility treatment treadmill.

  One of the things I’ve learned during the last seven years is that there is still so much we don’t know about infertility. IVF has become a ubiquitous treatment and it is undoubtedly one of the phenomenal medical success stories of the twentieth century. Since the first IVF baby, Louise Brown, was born in 1978 it is estimated that over four million babies have now been conceived through the treatment. It fills me with wonder and gratitude for Dr Robert Edwards, who pioneered the process that was initially so controversial he had to use his own sperm in his experiments. But at the same time I can’t help thinking about what the next thirty years will bring. As we identify the real causes of what is now described as unexplained infertility we might also learn that IVF isn’t always the solution. For many women of my age, who are struggling with infertility, it’s sad to think that lots of new discoveries will be made during our lifetime but it will be far too late for us to benefit from them.

  Yet, whatever mysterious thing is going on that has made it difficult for Peter and me to conceive and carry a baby to term, our ages are now undoubtedly coming into the equation. Many of the women I know who are a generation younger than me are starting to get pregnant. They are all in their early thirties and discovering, for the first time, the world of the ovulation predictor kit and sex-to-schedule. I can’t help but feel that we’ve gone and missed our baby-boat.

  Another cruel irony of this situation (if another were needed) is that, because I don’t have children myself, none of this generation of younger women thinks I have any advice to give on the subject of trying to conceive. The truth is, I probably know more about trying to have a baby than most people – even those with pramfuls of them. So, just for the record, and especially for the women who are starting to experience the symptoms of infertility – the silent epidemic of our modern world – here are some of the things I know:

  • Choose your clinic carefully. As consumers of the infertility industry we are still far too powerless in the face of the doctors who hold our happiness in their hands. Success rates are important but so are other things. For me, at the beginning, I needed a smaller clinic that allowed us to be involved in every aspect of our treatment. Latterly, after years of failure, I was prepared to forfeit involvement for a busier clinic that provided intensive monitoring. My dream would be to find a clinic that provided both, but as far as I know it doesn’t exist yet. However, if as customers we start to demand better environments and a more individualised approach to our treatment, it will eventually happen, and with it I’m sure results will improve.

  • If you are diagnosed with unexplained infertility I would certainly recommend trying natural IVF before you enter the world of high levels of drugs and intervention. Natural selection does make sense – after all, that is how it’s meant to work normally. So don’t let a doctor make any assumptions about what you need until you’re certain you really need it.

  • If at all possible, take some time off and dedicate yourself to your treatment. There’s an argument that says it’s not necessary, maybe that it even puts too much pressure on the process (and I do acknowledge that it didn’t work for me). But remember that this is one of the most important and (if you’re doing it privately) one of the most expensive things you’ll ever do. You’ve got to give it your best shot. That means eating and drinking well; doing whatever helps you to relax; getting a regular eight hours a night. It’s just so hard to do all these things when you’re also juggling a stressful full-time job. So don’t, at least for a while. Even if it’s just so you don’t have any regrets later.

  • Although it’s not something that is yet fully understood or acknowledged by the medical profession, I have no doubt that you need to treat the mind as well as the body. So get some help – and not just the counselling session that your clinic may or may not offer (and in my experience is unlikely to encourage actively). Infertility has a huge effect on your mental health and on your relationship. It can bring you together. It can push you apart. Either way, I can’t recommend highly enough the benefits of having an independent, unbiased, non-judgemental witness to help you process what you’re going through.

  • And finally, talk about it. To yourself; to friends and family; to other people going through infertility. It took me such a long time to do this. I didn’t want anyone to feel sorry for me. I didn’t want to be anyone’s source of schadenfreude. But over time the truth seeped out. Sometimes via circumstances I had no control over, sometimes when I made a conscious decision to be open. Looking back, I believe that the years of hiding the truth had a profound psychological and possibly physiological effect on my ability to conceive. The more we open up, the easier it is for ourselves and others. Of course no one yet knows what effects secrecy and shame have on fertility, but I bet they don’t help. That’s not to say you have to start wearing the infertility badge with pride. But put it on. Recognise it is part of who you are. It will make it easier for others to do the same.

  So, having made the decision to end it – this story, that is – I go to a café after work one evening, open
my laptop and put fingers to keys.

  Nothing comes.

  For the first time in years, I realise there is no plan formulating in my mind about what to do next. Should we try again? Should we give up? Or has the moment finally come to explore all the alternative possibilities – including a life without children? And maybe I don’t want a baby anyway? Do I really want to have my sleeping patterns disrupted; become acquainted with the perils of childcare; give up my evenings and weekends to swimming lessons and games on Wii? Childlessness is actually starting to feel comfortable.

  In a few weeks’ time Peter and I have our follow-up appointment at the clinic. Will our 100 per cent fertilisation success using conventional IVF rather than ICSI give us anything new to go on? Or will we continue to be a complex case that no one seems fully able to understand or explain? Time is ticking and I know that someone soon is going to say that it’s up; that sadly my age and medical science ultimately failed to coalesce. There are only 601 days to go. Six hundred and one days until I reach that all-important number forty-three.

  I close my laptop and head home for supper. Peter’s cooking what we call a ‘Peter Special’ from his repertoire of six dishes. We open a bottle of wine and toast my dad and the future. Later that night, as I get into bed, I look at the little pile of list books that is always on the table beside my pillow. I pick up the one with all the countries I’ve ever visited and then go and get our atlas from the bookshelf in the hall. I open it and start to trace my fingers across the coloured continents. I remember how as a teenager I told my careers adviser that I wanted to run a theatre or become an expedition leader. How motherhood never figured.

  Sometimes the things you take for granted in life end up being the things you want the most and have least control over. But if I haven’t had a baby by the time I’m forty-three, then perhaps I can travel the world instead. By my latest count I’ve visited thirty countries, which leaves about another 170 to go. Being able to say I’ve travelled to every country in the world – now that would be something.

  The Infertility Diaries Part XXIX

  Infertility has made me into a gambler. I have started to buy lottery scratch cards in the hope of winning £100,000 to feed my IVF habit or, alternatively, buy a round-the-world-ticket when I’m forty-three. Today I won £1. At least it’s a start.

  BLESSINGS

  I’ve recently started a new list book. I call it my Blessings Book. It’s become an important reminder for me that, despite my infertility, there’s still something to bless in every day. Sometimes a day seems so perfect that I have to include every detail. Other days it might be just a great cup of coffee, the colour of spring blossom, or the kindness of a stranger.

  Looking back, there are many reasons to bless my infertility. If I had got pregnant when we first started trying I’m not sure I could have carried on doing the job I do now. Peter and I have visited some incredible places that we probably would have never been able to go to if we had children. And I now know so much more about myself than I did before I started this journey. If I’m given the chance, I’m sure that it will make me a better mother.

  In the darkest moments, my Blessings Book has become a reminder of all the things in life to be grateful for. If you desperately want a baby but can’t get pregnant, it’s going to be one of the really sad things in your life. But juxtapose it with everything that makes life worth living. We’re not working towards a happy ending. Life is not linear. There will be good times then bad times. Bad times then good. So count your blessings wherever you find them and enjoy the journey wherever it takes you. Because life is a blessing that has been given to us by our parents. Even if we can’t pass it on as parents ourselves.

  The Infertility Diaries Part XXX

  And…if I’m blessed with a miracle in the next 601 days, I’ll be the happiest person alive. But you won’t find me posting our scan photos on Facebook or rubbing my burgeoning belly in meetings. I’ll always be the Infertile Mother. It’s who I’ve become.

  EPILOGUE

  601 days and counting (down)

  When we go to see our consultant she says that our results are unfathomable. Like us, she is astounded by our 100 per cent fertilisation success rate with conventional IVF. But she still doesn’t have any answers. In fact, to our shock and surprise, her conclusion is that the time has come to give up. She says there’s no scientific explanation for why we can’t conceive, but there’s no denying ten rounds of unsuccessful treatment either.

  When she sees our crestfallen faces she softens slightly and suggests that we go for one final opinion. She recommends a doctor who has been having phenomenal results with an obscure form of mushroom therapy. I know. Mushrooms. Are there truly no limits to which women will go to have a baby?

  This particular doctor’s practice is in the picturesque village of Petersham, although it looks like it should be in the Hollywood Hills. The front door opens on to a long, white, roof-lit corridor lined with contemporary art. It’s achingly cool and modern.

  He reviews our history with interest – even calls over his nurse to look at the grainy picture of my abdominal ectopic, describing it as extremely rare and absolutely fascinating. I puff up with pride. He then says that he thinks the results from our past treatment are collectively significant and that he would like us to do another round of tests before coming back for a full diagnosis. He says that he’s pretty sure we are creating perfect embryos, but something is happening when they get to my womb that is stopping their growth and survival. He’s convinced that the reason why our ectopic embryo did so well is because it was outside my womb, where it was safe.

  So we do the tests and, astonishingly, one of them throws up a result – it’s an obscure immune test that we’ve never had before, not even with the controversial Mr T. And this new doctor, who I have decided is just a little bit magic, gives us the first ever definitive diagnosis of our case.

  It goes like this.

  When you have an embryo developing inside your womb, you rely on your immune system to tell you to protect it and not to fight it. Most of the fertility immune testing that is done at the moment (and remember there isn’t very much of it) measures the cells that fight. Hardly any measures the cells that protect. In our case the fighting part of my immune system seems to be fine but the protecting part is atrocious.

  The doctor tells us that he is convinced that the result is important and that there is no point in trying to get pregnant, either naturally or via IVF, until the problem is resolved. He even says that, starting from today, we need to discount everything that has gone before – all seven and a half years of it – because today is the first day of our new pregnancy journey.

  After all this time, to be finally given an answer – whether it is true or not, curable or not – is incredible. It should feel unfair, upsetting, un-understandable, but in fact it’s liberating. No more IVF. No more unexplainable disappointment. Not until we fix the problem. If we can.

  The doctor then tells us that there are currently only two, scientifically unproven, ways to do this. The first is his bizarre concoction of Chinese mushrooms. The second is an even more bizarre and controversial process which involves removing Peter’s or another man’s white blood cells and injecting them into me. He says he’s convinced that if either of these treatments works then we will get pregnant and might not even need IVF.

  I’ve been through enough to know that it’s far too risky to believe in miracles, but after years of knowing nothing it’s just wonderful to think we might finally know something. And when you think about it logically, it does kind of make sense that your immune system would have an important effect on your fertility. After all, it’s supposed to fight off illness and infection, and an embryo is essentially an alien cell. It figures that your body needs to be able to tell itself to protect and not to attack.

  So right now we’re on those mushrooms, and if that doesn’t work we’ll contemplate the blood transfusion. I quite like the thought of Peter’s
blood cells mingling with mine, making friends, and encouraging each other to protect our foetus when it comes along.

  We shall see. From now on, it’s all about the number forty-three. My own special ‘prime number’, divisible only by me. It’s when my pursuit of motherhood ends and a new life begins – I just don’t know yet whether it’s going to be my life or someone else’s.

  ACKNOWLEDGEMENTS

  Special thanks to my friends – Beth, Ella, Tara and Vicky – for agreeing to appear in the book and for all their support over many years. Thank you also to all the other friends, family and colleagues who make anonymous appearances. I am also extremely grateful to Price Pritchett for allowing me to reproduce excerpts from his book Hard Optimism (these are used with full permission of Pritchett, LP and all rights are reserved).

  For their brilliant professional advice, thanks to Diana Beaumont, Polly Courtney, Charlotte Macpherson, Helen McCusker, Richard Spence, Emily Sweet, Justine Taylor and the whole team at Troubador Publishing.

  And finally to Peter. For being my first reader and supporting me to tell our story in my words.