Frozen Hope

by Jacqui Cooper

  At six weeks I was booked to do a special presentation at the Crown Palladium venue in Melbourne. It was a women’s showcase, a kind of variety show where the speakers go on stage and do fifteen minutes of their best material. I was on the bill with former police commissioner Christine Nixon, PR manager Ann Peacock, peacekeeper Matina Jewell and expedition leader Rachael Robertson. It would be an easy presentation, in great company, and I was pretty relaxed, but I always do a ‘nervous wee’ before I start just to be on the safe side, so I ducked into the toilets.

  Blood. With shaking hands, I texted Roshan. The sluggish pregnancy hormones had been a warning and now here was confirmation that this pregnancy was on the skids. Meanwhile, I was about to go on stage in front of 1500 people. If the bleeding had started half an hour later, I would have been able to cope a whole lot better. Thank goodness my lapel monitor was switched off because I was swearing like a trooper (‘I CAN’T $#@*ING BELIEVE THIS!’).

  My athletic brain took over and I went out there and presented on autopilot. I rang Roshan when I came off the stage and he said to get myself to the clinic for a scan straightaway. The image revealed a pregnancy sac, but no heartbeat.

  In an unfortunate coincidence, the City Fertility Centre ‘Congratulations on your pregnancy!’ letter arrived the same day. Terrible timing, just as it had been in my first miscarriage. I continued to bleed but the pregnancy hormone was still going up slowly. Some women bleed throughout pregnancy and have a perfectly healthy baby so Roshan held off on performing the D&C. I went in for tests every second day and eventually the hormones stopped climbing and a scan showed that the sacs had stopped growing.

  Roshan ordered a D&C for 6 March 2014 and I requested that he perform a laparoscopy at the same time. Once again, I felt we needed answers. I kept coming back to recent figures that only 8 per cent of women will have two miscarriages in a row and only 4 per cent will have three in a row. I had a history of defying the odds, but this was definitely not the right time to be doing it.

  Not only was this miscarriage a statistical rarity, but we’d also transferred two advanced hatching embryos. Roshan was as baffled by their failure to thrive as I was. I was glad to be having another laparoscopy because I’d become pregnant with Madeline after the first one. To me it was the equivalent of an internal renovation, leaving everything fresh and geared up for action. Despite our declaration that this was to be the last attempt, I was ready to go again. Every time I had crashed, got knocked down or was injured in aerial skiing, I had got up, brushed the snow off and done another jump. I had to. I wouldn’t allow a bad day, a bad jump or a bad injury beat me. The two miscarriages were not going to stop me from seeing this though. We still had three embryos in the freezer, and after coming so close to a second baby there was no question we would give it another try. Who wouldn’t?

  Unfortunately, Mario had just left on an interstate business trip when I had to go into surgery. We spoke on the phone and he said he’d fly back but I thought I could get someone to mind Madeline for the day and I’d be back home from the hospital that evening. I didn’t realise that having the two procedures together meant I’d need an adult at home to ensure that I wasn’t the only person responsible for my small child. As I was filling out the hospital release form just before the surgery, it dawned on me that I was going to have to stay in overnight. I rang my neighbour, who was minding Madeline, and she was happy to look after her. Phew.

  We hadn’t been telling anyone about these latest cycles, not even family. I didn’t have the heart to explain why we felt compelled to keep going after three failed attempts. It was a lonely time. I knew my loved ones would berate me for going through it on my own, but I was feeling hopeless and I didn’t want to hear anyone suggest that I should give up this last-ditch attempt for another baby. It would be wonderful to have a non-judgemental person standing by to catch you if you fall, but it’s a rare individual who can hide their concern and refrain from expressing their opinions about what you’re putting yourself through.

  Roshan recommended I take a few months off before the next cycle and I readily agreed. There was no doubt that this was crunch time and I needed to recover as much as I possibly could.

  One of the first things I did was source a new acupuncture specialist. I’d stopped having acupuncture when Maddie was born. When I decided to return to acupuncture, I thought I’d try someone closer to home. I found a woman online who specialised in helping IVF patients. Her rooms were very clean and clinical – I was impressed! Although she offered herbs to aid the process, I stuck solely to the acupuncture and continued to eat warm foods to help warm up my ‘oven’.

  Roshan was fine with these preparations. I’ve heard him describe complementary therapies as ‘the icing on the cake’. He says there is not a lot of factual evidence that they are beneficial, but as long as it doesn’t harm the patient or reduce her chances of getting pregnant, it’s fine by him. ‘Anything that promotes the patient’s positive outlook has got to be a good thing,’ he said.

  I began working with the acupuncturist straightaway, knowing I would be heading into a seventh cycle soon. I needed to throw everything at it. I also booked a short family holiday in Singapore. A change of scene always worked wonders for my state of mind.

  In mid-May, when Roshan was starting to profile my hormones for the seventh cycle and transfer, we got out our diaries and began ticking off the dates. I realised that our Singapore holiday was going to clash with the blood tests that were required every second day to predict the timing of ovulation. Roshan was due to be away the following month, so if we delayed now, we wouldn’t be able to start again until August.

  ‘Let me see what I can do,’ said Roshan.

  It turns out that Roshan has strong family connections in Singapore and has spent a lot of time there. He contacted a Singapore-based colleague and asked for his help, and they arranged for me to take a blood test every second day at a clinic that was close to our hotel. The results would then be faxed back to Roshan in Australia.

  During the trip, we regularly messaged each other and Roshan let me know that it looked like I was going to ovulate the day after I returned from the holiday. We wouldn’t have to do the transfer until five days after that so there was plenty of time.

  I came back buoyant and rested. Everything was ready for the transfer in a few days’ time. Roshan and I had spoken at length about the transfer and discussed thawing and implanting only one embryo. Roshan had told me: ‘It is very unlikely that you will miscarry three pregnancies in a row; if one or two of the embryos implant it should be a healthy pregnancy.’ He thought that transferring one was the safest and the best plan for the pregnancy, the potential foetus and for me. He got all of the paperwork together, ticked the box for one embryo and signed off on it. I also signed it. I just needed Mario to sign the paperwork too. The City Fertility Centre consent form sat on our kitchen bench for a couple days, lost among unopened mail. I needed Mario to sign the paperwork and get it back to City Fertility so the embryologist knew how many to thaw for the transfer. When I pushed Mario for a signature, he quickly read the paperwork, took out his pen, crossed out where it said ‘thaw and transfer one embryo’ and corrected it to ‘thaw and transfer two embryos’. That was a bombshell I wasn’t quite ready for. But I decided not to overthink it. In the back of my mind I was very excited about the prospect of two embryos implanting and that my childhood dream of having twins might come true.

  Mario had changed the consent form, and indicated what he wanted for this cycle, but at the end of the day the final medical decision does stand with the treating fertility specialist. Roshan thought about my advanced maternal age, my fertility issues, plus the recent failed cycles and agreed to two embryos.

  I was full of hope as I lay on the chair in the City Fertility transfer room, waiting for the embryologist to ‘load’ my two little precious embryos, handpicked the night before. After they successfully placed them inside me, in the best spot possible, high up in my
uterus, they gave me two photos of the embryos. They looked perfect. I stared at those two balls of cells, thinking about what they might look like nine months from now.

  I was cautioned to take it easy for the next couple of days, giving these two little ‘embies’ the best possible chance of nestling in. Again, I was hyper-aware of what my body was doing. Two days after the FET, I felt the ‘bite’ (which was great) but also some ominous heavy cramping (which was not), although there was no sign of a period as the 2WW progressed. I kept up the acupuncture and was moderately busy with work, but there was no interstate travel.

  We made it to the end of the two weeks. I rushed to the pathology centre for an early morning test, and then the phone call came that the pregnancy test had come back positive. I was pleased and relieved but knew better than to get too excited. The nurse on the phone told me that the hormone level (HCG) in my blood tests was high, indicating pregnancy. Normally, the first blood test to determine pregnancy is at two weeks after an embryo transfer. Evidence of a pregnancy are levels over 1000IU/L; mine came back at 1400! Tempted back to the internet, I used the online HCG calculator to look up the typical level fifteen days after transfer. There were plenty of warnings that the tool was meant as a ‘guide only’, but I nearly passed out when the levels indicated that I was having triplets! Again, this was a stress that I could have (and should have) avoided by staying away from the internet.

  I had uneasy visions of my own family history repeating itself: a single child followed by triplets. The idea of having four little kids to care for at once did not appeal in the slightest and for a couple of weeks I gave Mario heaps: ‘This is your call. YOU are responsible for this! You changed the consent form at the eleventh hour!’

  But I still had to get over the six-week hurdle, where I had fallen twice before.

  On 25 June, Roshan made an appointment for me to get the six-week scan. This scan usually shows the first signs of a heartbeat, which will indicate a viable pregnancy. In my case, there was a little more to this appointment; Roshan would be looking to see if there was one heartbeat or two. As I lay down on the table and as the internal scan began, I fixated on the monitor. Given my history and previous miscarriages, I knew what to look for; I needed to see a dark round sac with tiny pulsating flashes of light. As Roshan moved the internal probe inside my vagina, I could see two sacs on the monitor. I looked at him and he looked at me, and he said, ‘There are two pregnancy sacs there, Jacqui. Now let’s see if we can find a heartbeat.’

  My heart was in my mouth. I don’t know what I wanted to see at that point, one heartbeat or two heartbeats. I just wanted Roshan to find something – quickly.

  As I stretched my neck so I could see what Roshan could see, I was elated to see the flicker of two tiny, precious little heartbeats. My first thought was my childhood dream: ‘TWINS! TWINS! TWINS! I want to have twins when I grow up!’

  I gathered my belonging and my thoughts, and then I jumped in the car and called Mario. He knew what time I was having the scan so he was expecting a call. When he picked up, he didn’t say hi or hello; he said, ‘Is it a single or a double?’

  I said to him, ‘There are two in there. We need a new car. We are having twins!’ Then I said, ‘That’s blown my nice neat little family! Can’t fit in a single row on aeroplanes anymore. One too many kids for the family discount tickets at the zoo, too, dammit. What on earth were you thinking?’

  I was thrilled and freaked out at the same time. Three kids under three? Yikes.

  I could tell from Mario’s voice that he was excited about the news of twins. He didn’t seem nervous at all, just happy. Our twins were due on Valentines Day, 14 February 2015.

  June was a reasonably relaxed month on the work front because it’s at the end of the financial year. On 30 June, morning sickness struck hard. I was about to drive to a bank in the city to take care of some important business that needed to be done on the last day of the financial year. Driving with morning sickness was not a good idea. I figured it would pass soon, but how could I get to the bank? We still hadn’t told anyone because I was only six weeks pregnant, but I decided to ring my sister Fiona and ask if she could give me a lift. Luckily, she agreed. When Fiona arrived to drive me to the bank, I had made up a little gift box with a note tucked inside saying ‘Twins due 14 February 2015’. I more or less tossed it at her between retches. She knew what the box meant straightaway, but her jaw dropped when she learned that it was twins. ‘No wonder you’re so sick!’

  The nausea this time was relentless. With my first pregnancy I would regularly take half an anti-nausea wafer to try to control my heaving stomach. Now I needed to take two and a half at a time to stop the constant retching. There was no doubt I was in for a bumpy ride.

  15

  Blessed

  Even though it was a public holiday, everyone was at the hospital within a few hours. By early evening we were all set and ready to go when suddenly another patient started haemorrhaging. She needed immediate emergency surgery so they put me on hold. I wasn’t really fussed about missing the Australia Day birthday. I figured the twins would have 27 January, which was the same number date (but different month) as Madeline, so all of the kids would be ‘same, same but different!’

  Then one of the nurses told me that it was quite a big deal to be born on Australia Day. The kids would be eligible to become members of the 26-ers Club, receive a birthday card every year inviting them to a special cake-cutting ceremony and get to walk in the Australia Day parade.

  I said, ‘Right, these babies are coming out tonight!’

  I WAS DOING EVERYTHING I possibly could to keep the babies happy and the pregnancy was progressing well. I was getting as much rest as I could (with Madeline running about), I was exercising lightly and eating well, and I was spending a lot of time with my local acupuncturist. When morning sickness hit, she used specific acupuncture locations on my wrists to help deal with the nausea. I was seeing her three times a week, sometimes more, to manage the nausea. This was my weekly routine up until the fourteen-week mark when Roshan recommended I increase the dosage of anti-nausea medication to get me through. Although the retching definitely tailed off as the months went by, the queasiness never went away altogether. It was a real endurance test getting through some days.

  However, I relished the sickness because the only other time I’d experienced it was with Madeline. During both miscarriages I was nausea-free, which led me to believe that there simply wasn’t enough hormones present to sustain those two pregnancies. They just weren’t meant to be. For me, sickness was a positive sign of a healthy pregnancy as the hormones surged through my system.

  My mum never thought I would be able to have biological children. She said that she knew when I was sixteen years old that it would be tough for me. Not menstruating like my triplet sisters was a red flag, and she feared that I would never be able to have the one thing I had dreamed of since I was a little girl. That weighed heavily on her as I matured and met a man I wanted to start a family with. So when Madeline arrived, Mum and my step-dad, Ken, felt blessed. They always said, ‘She is a treasure. She is our little miracle.’

  One of the greatest gifts I have ever given my mum was the news of our twin pregnancy. After the twelve-week scan and NIPT test (a non-invasive pregnancy test to screen for common genetic conditions) showed all that things were well with the developing babies, I couldn’t wait to tell Mum my news. I had been bursting at the seams with excitement for months; I couldn’t hold it in any longer. I invited Mum and Ken over for afternoon tea the next day. I had made delicious homemade scones, and just as my mum was enjoying a mouthful of jam and cream I gave her ‘the box’.

  Mum was beside herself with excitement when I gave her the news. As one of the original members of the Australian Multiple Births Association, she was proud that I would carry on the tradition for her. She and five other women who she met in the early days at AMBA still meet the first Tuesday of every month, just as they have for more than f
orty years. There are strong bonds and great friendships between those women. Strangely, not one of them ended up having multiples among their grandchildren – I was going to be the only direct descendant to have twins.

  Mum was a fountain of knowledge when it came to dealing with multiples. She was a great comfort because she was so positive about the experience; she felt special as a triplet mum and that made me feel special to be a twin mum.

  Now that Fiona and Mum knew our big news, it was time to let Sarah, my triplet sister in Sydney, in on our very special secret. Every time I spoke to her on the phone I wanted to tell her but this news was too big and too special to give over the phone. I hatched a plan and decided to fly up to Sydney to celebrate my nephew’s birthday in the second week of August. Madeline and I flew up to Sydney on an early morning flight just two days after the all-important twelve-week scan. Knowing we had two healthy babies in there (the scan gave us a green light), I couldn’t wait to get there. When we arrived, Sarah and my niece Sophie were waiting with the car out front. At twelve weeks pregnant I was starting to show, so I used Madeline as a tummy shield so my bump would go unnoticed,

  Sarah had arranged for all of us to head out to dinner with friends of hers to celebrate Ryan’s birthday at a local restaurant. Wanting to tell her over dinner but not knowing her friends all that well, I decided to tell her the news at home before we joined everyone at the restaurant. When I got Sarah alone in her kitchen, I told her I had some news. She immediately looked at my tummy and said, ‘You’re pregnant.’ I said, ‘Yes, can you believe it?’ She was so happy that she was almost in tears. She went on to ask me all sorts of questions, like when the baby due was due, how was I feeling and who knew the news. I let that conversation go on for a while, but then I said, ‘I have more news.’ She didn’t understand where I was going, so I blurted out, ‘It’s twins.’ Sarah turned white; it’s safe to say she was in shock. Those happy tears turned into real tears. She was actually panicked and worried for me. Her big concerns were coping with twins at an older age, and my health too. She got herself in such a stressed state that she forgot what she was doing, where she was going and what restaurant we were going to. She lost the plot. She didn’t tell the other guests at the birthday celebration why she was out of sorts. Months down the track, when everyone knew about the twins, her friends said they thought she was acting oddly that night; it was like Sarah had been drugged!