by Julia Leigh
I asked the doctor if for this last cycle we could increase my Gonal-f dosage from 300 to 350 IU. A last hurrah. She agreed. But on the night I was due for my first injection I got cold feet. I’d read somewhere about high doses affecting egg quality—and I also got nervous about over-stimulation. So I only took 300 IU. The next day Dr. Nell assured me 350 IU wasn’t considered especially high and I should be fine at that dose if I wanted. Snow fell in the night, it stormed. At my first scan I had nine large follicles and the nurse commented, “You’re responding well this cycle.” Nine eggs were collected. Six were injected with sperm and showed signs of fertilization. This time, by Day 5 I had two blastocysts. One Grade A blastocyst and a “very early blastocyst.” The “very early blastocyst” was looked at by two scientists and judged to be on the wrong side of the borderline for freezing. The doctor asked if I’d like to transfer both embryos. I dreaded twins—highly unlikely—but couldn’t face discarding a blastocyst so agreed to transfer both. When the image of the first magnified blastocyst came up on the monitor the doctor said, “There’s the baby, see that clump of cells at nine o’clock?” After the transfer I went to the acupuncturist. I tried everything. But did I? Did I really?
I felt it—the twinge of implantation. I actually felt it.
Good morning, babies. I had the exquisite pleasure of greeting my babies-to-be each day. I was hopeful and shameless.
I ran into an acquaintance on the street. He was in the mood for a chat.
—How’s things?
—Hard. With the IVF.
—I heard you were doing that. How many tries did you do?
—Two IUI’s and six egg collections plus transfers.
—That’s hard.
—Yes.
—Well, I have friends who did it twenty times and in the end they had a child. It was a real victory. It’s worth it if you keep going. Are you going to try again?
—Probably not. I don’t really want to talk about it.
—I have a picture of their kid. Do you want to see it?
—No.
—There’s a guy who went to Thailand, a rich Japanese guy, and he had fifteen children. Used surrogates.
—He wanted to father fifteen children?
—He said he needs them.
—Oh.
—Having a kid isn’t always that great. My son hardly ever calls me. So with the IVF—
—Sorry, I don’t want to talk about it.
That night I had a horrible dream in which I told a woman, a mother of four, that my final attempt didn’t work. “It’s a heartbreaking pity, a heartbreaking pity,” she said. And she kept repeating, “It’s a heartbreaking pity” with a sliver of glee. “What a heartbreaking pity.” I shrank from her mummy-schadenfreude.
I felt so sad when I had to tell Elsie that qcumber was spelled “cucumber.” In other words, the world does not make sense.
We talked about her birthday cake. We could make a marshmallow cake. “And a flower cake, a remote control cake, a sofa cake, and a shoe cake,” she added.
My pregnancy test fell just before Father’s Day. I knew this because The Morning Show on the TV in the waiting room was devoted to a Father’s Day special. I thought about the Taoist parable of a man who wouldn’t be angry if an empty boat collided with his own skiff but if he saw a man in the boat then he would shout and be angry at that man. I’d long understood it to mean that if you were hit by empty circumstances then there was no cause for anger—fate, so be it—and you should apply this same monkish acceptance to those circumstances in which you could identify whom or what had hit you. But in fact, no. The parable goes on to say that if you can empty your own boat crossing the river of the world then no one will oppose or seek to harm you. It was hard then and it’s hard now, emptying the boats.
Rebecca asked me if I’d done a test at home. No.
—Have you had a bleed?
—No.
—I don’t want to be a Negative Nancy but sometimes the progesterone can stop you getting your period.
She took my blood. Careful, gentle. As I was leaving I stopped by the door.
—Thank you. I don’t think I’ll be seeing you again. Thanks for all your help. You were great.
My eyes flushed with tears, hers too.
—It’s been my pleasure.
Reprieve or delight, reprieve or delight. While waiting for the nurses to call I tried to fool myself with a win-win outcome. I’d arranged to spend the day with my sister. When the phone rang I picked it up as if it were hot to the touch. And learned I was pregnant. I can’t remember exactly how the nurse phrased it, something like, “It’s a positive result but it’s not clear. You have an hCG level of 10.5, which is very low. Your progesterone is 75, which is good. You’ll need to come back in for another test on Monday.”
Her news was confounding. I knew the hormone hCG (human chorionic gonadotropin) was produced by the embryo and measured in a pregnancy test but I didn’t realize the test could be unclear.
—Well, what would you call a good level of hCG at this stage?
—75.
—And what level would be called a negative pregnancy result? Zero?
—No, 2.
—In your experience does someone with as low a level as mine have a viable pregnancy?
—Not usually, but we can’t rule it out.
My sister wanted to know the result. I said, “I have a very complex answer to a simple question.” We were in disbelief. She turned to Dr. Google and on a bulletin board found a woman who said she had an initial hCG level of 10.5 and then went on to have a child. Hope.
I called my doctor. Asked for clarification.
—If we wait over the weekend it will declare itself, we want to see the hCG level rise. Keep up the pessaries.
—What would you be happy with, level-wise?
—I’d be happy if it got to 25. But I should let you know it could be a biochemical pregnancy.
—What’s that?
—It’s when there’s a positive result, there was implantation, but it might not be viable. Still, fingers crossed, this is the best result we’ve had so far.
—OK, I’ll work on it . . .
There was nothing I could do except wait. It snowed all weekend. On Monday morning I woke to find the whitish sea mist had filled the valley. I went for a walk along the cliff tops and marveled that the ocean—flat, calm—was covered in a layer of snow or perhaps had turned entirely to snow. White, gently undulating, all the way to the horizon.
That afternoon the second pregnancy test came back negative. It was as if I were in the path of an oncoming vehicle and just before the moment of impact I vanished. I went to bed and sobbed until I was exhausted. Felt no reprieve, only despair. My snuffling tears—as a response—seemed hopelessly inadequate. I was thinking: I will never meet that little person. I didn’t move for a long time. Then I called my sister, who offered to come over and collect me. “Oh darling,” she said, “I’m so sorry.” My next call was to Dr. Nell. Her tone was measured, kind. I tried to match it.
—I’m six for six fails. What should I do?
—Well, while you’re still giving me blastocysts there’s a possibility. I don’t know how you are financially . . .
—I’m OK. It’s my mental and physical health that’s a wreck.
—Yes, you always told me this would be your last go. Is it because we got close this time that it’s harder?
—That positive result threw a spanner in the works. I mean, what are the odds for me? A near miss is still a miss.
—With a Day 5 blastocyst there’s a 40 percent chance.
—But I’ve transferred blastocysts . . . that figure doesn’t seem right. Is that for women of all ages?
—Yes.
—Then what are the real odds?
—It’s hard to say.
—What would you do if you were me?
—I think you should try again and if it doesn’t work then that’s the end. Unless you want to consid
er a donor egg.
—That’s not an option for me now.
—Well, I’d try once more. Why don’t you think about it. Give me a call if you have any questions.
My sister was frustrated that the doctor had suggested trying again.
—If you were in the natural world you wouldn’t have even known about that positive result! It’s only because you’re doing IVF that you even know! You need to find another way to be happy. And if you really want a baby then use a donor egg. That’s the only way it’s going to happen for you.
—I don’t want a stranger’s egg.
—My friend got a huge thick file about her South African donor. She knows everything.
—I bet they don’t run checks on the background. Anyway, I don’t think I could ask a woman poorer than me for her body parts. Makes me uneasy.
—I’d do it for you, when I finish breastfeeding.
—You would?
—But only if you build up your strength. You need to be strong to carry a baby.
—I’ll think about it.
—Good. Maybe now you’ll do what I’m always telling you.
I drank half a bottle of Scotch and spent the night laid out dead on her sofa.
A few days later I wrote to ask the doctor a very specific question that I hadn’t thought—or dared—to ask before: In the last year, what percentage of women my age at the clinic had taken home a baby using their own eggs? Her answer: 2.8 percent for 44-year-olds, 6.6 percent for 43-year-olds. I wish I could have known what the exact figures were for women my age producing five-day Grade A blastocysts but that number wasn’t at hand.
What to do? What to do? Where does this stop?
My inner compass went berserk. Should I try one last time with my own eggs, transfer another blastocyst? But remember: a near miss is still a miss. So near and yet so far. Quixotic. Dame Errant. I have tried, I have tried. And could I really take my sister’s egg and my friend’s sperm and make a baby? Or was that a little too Frankenstein, too much? Did I sincerely believe that childling was meant-to-be? And could I bear to stay in limbo for months while I waited for my sister to finish breastfeeding? And what if something happened to her during the egg collection, what if something went wrong? Around and around. I became immaterial. I had to hold myself back from vanishing between the tiles on the bathroom floor, from slipping through the typeface. It was hard to give up, truly hard to give up the struggle. The struggle itself had been sustaining. “This time I’m not lucky” was a hard thing to say.
I don’t remember the exact moment—I’m not sure there was an exact moment—but I resolved to stop everything.
In the distance I heard a loud rumbling crack.
“The boys love you,” said my sister. “You’re an important part of their lives.” I was grateful for this consolation. She was the first person I told about my decision to stop. Dearest sister, who had been my steadfast companion through the long treatment, who had seen me cry more times in the last couple of years than at any other time of my life. Telling people was a way of fixing my decision. Marking my grave. My parents were kind. My friends too. Some of the mothers cried—tried not to cry and failed—we pretended not to cry together. Not alone, not alone. A friend said—rightly, with compassion—“Darling, you’re in peril.” Another friend said, “I’ve seen the scar on your back, it’s enormous, you shouldn’t even be alive. Be grateful for the life you have. I never knew how you could even talk with all those drugs you put in your body.” I told her I was thankful she’d said that because I didn’t want to feel like I was wimping out by giving up. “Oh my god, that’s crazy.”
Sometimes—with people who didn’t know the whole story—the conversation went like this:
—I’ve decided to stop treatment. It didn’t work.
—You can always adopt.
—I’m at the end of my journey.
—Oh.
Shopworn maybe, but that’s the way I phrased it: I’ve reached the end of my journey.
I bought some extravagant presents for my donor and took him out to lunch. We raised a glass to “the brilliant and beautiful concept that didn’t work.” I loved him.
Even after I told everyone there was a part of me that still couldn’t fathom it.
In my heart of hearts I always knew this, it wasn’t a revelation: I have to save myself.
So keep writing. Stay near. Capture these strong feelings before they are blanketed by time.
Soon after stopping I was haunted by the IVF. All the Googling I’d done about pregnancy-related topics came back in the form of advertisements for things like Clearblue pregnancy detectors or maternity clothes. I took care not to expose myself to painful situations and made a mental note to avoid grocery shopping at 3:30 p.m. which was also school pickup time when the streets were running with kids. I expect I’ll need to manage the terrain in this way for quite some time. Most of the baby things I’d collected I gave away. There were moments when I wanted to take my coffee cup and hurl it against the wall, moments that flickered within a deepening acceptance. My health was a ruin. I was totally worn down, worn out. My skin was bad and so were my hips. It could just be a function of my age but my physiotherapist said she sees a lot of women doing IVF for hip pain. She thinks the hormonal changes exacerbate pain in the joints and ligaments. One of my ovaries, about two months after my last egg collection, was uncomfortable and twice the size it was before treatment. There are cysts that weren’t there on my initial ultrasound. I was worried about some sort of permanent damage but Dr. Nell advised the size of the ovaries naturally rose and fell depending on where I was in my cycle. That made sense—but I continue to harbor a small fear that in the future I might be unpleasantly surprised by some latent side effect of all the medication and surgeries. I did ask for copies of my medical records just in case.
I reminded myself that since I’d been prepared to be a single mother, since I’d so ardently wanted to change my life, I must also have divined an access to some tremendous reservoir of energy that would have made these things possible. My wish: it was a reservoir and not a mirage.
On the afternoon of my 45th birthday I went over to visit my sister and the little girls. Elsie, age 3, insisted we play a game. I had to lie down and pretend to be asleep. She came into the room calling out, “Wake up! It’s your birthday!” In her hands was a large cardboard box which she solemnly passed to me as a present. “Oh, a present! Oh, what is it? What could it be?” I slowly, slowly opened the box. Her eyes widened with delight. Inside were some pieces of a pink jigsaw puzzle. “It’s a box of babies!” said Elsie. She and her baby sister were now sharing a bedroom and so Elsie was obsessed by all things baby. We played with the jigsaw babies for a long time and I did not flinch. That would have been unthinkable a year ago. I was suffused with a burning tender love for that astonishing girl.
What I try to hold onto—now that the treatment has failed—is a commitment to love widely and intensely. Tenderly. In ways I would not have previously expected. I to You; I to We; I to This. To unshackle my love from the great love I wanted to give my own child.
After the avalanche, the bare face of the mountain. Under the sun and the moon.
Sydney, January/November 2015
ALSO BY JULIA LEIGH
Novels
Disquiet
The Hunter
Screenplay
Sleeping Beauty
Avalanche is a work of nonfiction.
Some names and identifying details have been changed.
The author recognizes her shaping of the story may
differ from that of other characters depicted in the book.
Copyright © 2016 by Julia Leigh
All rights reserved
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