The Mother Project

1.

How do you know you’re infertile?

Someone professionally straightforward tells you you’re infertile, that’s how you know. Perhaps in a medical facility of the standard nondescript variety, like this one I’m in right now. Nondescript, but already in the top two most hideous rooms I’ve ever sat in, nonetheless. Currently I can’t hear anything except the whooshing of my own blood – that happens sometimes when you’re delivered earth-tiltingly bad news that you weren’t really expecting. Unfortunately, this ain’t my first rodeo. My husband Mr B is definitely saying something soothing, because he’s rubbing my back whilst doing so, but I’m deafened by hot white noise and instead focus on his adam’s apple bobbing as he gulps something down repeatedly – ah yes, the taste of abject disappointment and distress. That’s because this just happened:

‘I’m afraid your ultrasound showed no ovarian function, in fact your left ovary was not visible at all. And your AMH and FSH blood test results also demonstrate that you are infertile.’

Infertile. A somewhat vague diagnosis that kind of makes the room warp in on itself while Mr B rubs my back, and no one rubs his. My hearing returns just in time to catch him saying, ‘Well, you’ve been through worse, eh?’ Oh Christ, I should have stayed deaf. In this moment, when I’m imagining my future hurtling down a toilet, it’s safest to avoid comment. I glare at the poor man and then at the doctor. Dispassionate doctor with your face set to ‘patiently waiting for news to register’ whilst preparing leaflets on egg donation. OK, yes, I have – literally speaking – been through worse: the breast cancer, chemo and radiation that apparently fried my fertility and put me in this position in the first place. But still, I don’t think it’s appropriate to park me anywhere on the bad news emotional acceptance scale whilst I’m smack bang in the middle of processing this bit. Right now, as a woman finally ready to start celebrating my traitorous body again by making a baby with my lovely husband, nothing feels worse. I can’t make a baby. My body has let me down again, and so I fucking hate my body right now, along with everyone else in this room. It’s my right as a female human being. It’s what everyone does. It’s been my end goal, my dangling carrot to get me through the last five years of remission therapy, and now I’m here, I’m ready. And I can’t do it?! OK, this may not literally be the worst thing in the world, but it’s the worst thing in my world right now. This is just … well this is, just … this is not fucking FAIR.

Uh oh. I’m having an internal tantrum. I can feel the rage building at the same time I imagine the doctor going through his Kübler-Ross stages of grief checklist. ‘She’s skipped denial and gone straight to anger, so she’ll be on to bargaining shortly, I’ll wait.’

I’m not interested in bargaining. I want to go home and get into bed and cry for a hundred years. Instead I stand up abruptly and walk out of the room, while Mr B makes my apologies and follows me to the garden bench outside, where he disregards his own feelings to try and soothe mine. I know that this man crouching at my feet is the only person who understands what to do with me right now, he knows me better than anyone. He already understands that he said the wrong thing on the spur of the moment, and he’s explaining that he panicked. He wanted nothing more than to shine some light onto a deeply dark situation, to put it into perspective in the only way he knew how. By telling me I’m not dying this time.

Yes. Yes that’s true. *Sucks in deep breath*.

There is a similar kind of finality though. The no going backwards-ness. Once again my whole life has hit a trajectory I was not expecting, one I do not want, one that changes things forever. I’m angry at him because I won’t ever see what my own child looks like, and he still might see his. And even as I’m thinking it, I know it’s not fair. Even as I’m thinking it, I know it’s our child I wanted to see, that beautiful and unique mix of me and him. And, if I can just clear some of this rage from behind my eyeballs, I can see that that’s what he’s lost too. Even right now, on this stupid garden bench, while I’m making a snotty spectacle of myself in front of the hospital-goers, and the doctor is still waiting for us inside.

*Sucks in deeeep breath*.

I close my eyes and stand up to give him the cuddle he also needs, and we go back in to talk over our options. Ha. I skipped depression and went straight to acceptance, Doc. I defied the linear laws of psychological grieving, now give me all the fucking egg donation leaflets so I can go home and cry for a hundred years.

In reality, I went back to work as if it were a routine blood test I’d just left the office for (‘denial’ you’re thinking) and on the way I went about assessing what brought me here.

You would think that infertility after cancer is a given, but it really isn’t. It depends on your cancer, your age, your treatment, your resilience, and I was reassured by my nurses that because I was only thirty at diagnosis, there was a strong chance of my reproductive system being spared, remaining unaffected. I guess because of my age I also had a strong chance of not being struck by cancer in the first place, so I shouldn’t have rested so easily on those odds. In hindsight, I have to wonder if they were trying to appease themselves as much as me, because somewhere along the line, someone forgot to offer me my egg-freezing option. ‘Sophie, you have cancer, we’re going to ravage your body with toxins, would you like chocolate sprinkles and pre-emptive egg freezing with that?’

I’m not sure if I would even have said yes, knowing now that it would have delayed treatment by a few weeks. I was terrified and I wanted to put myself in the hands of the doctors, but to this day about 12 per cent of my midnight neuroses is dedicated to regretting that neglect. I wish I had had the information and the option. I might have been infertile, but I might also have had a portion of my own potential future preserved in a lab somewhere. At the very least, I would have had autonomy over making that decision and closing my own doors, rather than anger at whoever carelessly slammed them shut for me.

But that was then. Now, better, I genuinely thought I would be starting the IVF process after this appointment. A controlled conception because the logistics are a factor: I’m on ten years of endocrine therapy, meaning I have to take daily hormone pills to suppress the oestrogen that my cancer was receptive to. But if there is one key ingredient needed for baby making, it is oestrogen. My new hospital (I was rescued from the neglectful one by the Royal Marsden, but that’s a whole other story) approved a one-year break in my treatment to try and start a family. I would do IVF to control the timescale. Around 80 per cent of couples fall pregnant naturally within a year of trying, but those stats don’t work for someone with a hard deadline to get back on important medication, so assisted conception would save the day. I was to go and make sure everything was in order, and boom, we’d be on our way. When I took my last hormone tablet before the appointment, I remember thinking, ‘Imagine! I’ll have a two-month-old baby by the time I have to take another one of these.’ Ha!

I have a fistful of leaflets in my bag, so I start to skim them. I have the option to try carrying my own child, an embryo created by introducing my husband’s sperm to an egg donated by a stranger. In which case, maybe I still could have a two-month-old baby in a year. How long does this egg donation process take? I recognise that my Kübler-Ross acceptance model may not fit the linear path of least resistance, but my psyche still ticks those bloody boxes. This is the bargaining part. I recognise it because I do it all the time; I bargain with myself in order to move on from the scariest part as fast as possible. It’s a well-practised subconscious method. If I slow it down and write it out, it works something like this:

BAD NEWS! The worst news, in fact. How will I ever feel OK again?

Me, to myself: ‘You need a plan. A quick and foolproof plan that means this needn’t be the worst news after all and you can be yourself again as quickly as possible. Shove it in a box, as they say.’

Me, back to myself: ‘OK plan plan plan, ah! So I can’t have my own genetically related child with my husband, but – and at this point this feels kind of gross – I could still have another person’s child with him. How about that?’

Me again: ‘You’re right, there is something gross about that. But crucially, don’t tell anyone it feels gross because they’ll judge you. How about we reframe it as “I could still have a child with my husband?”’

Me: ‘How about I could still have my child, and skip straight to the accepted part of acceptance? Be done with all this unnecessary gut-wrenching? You’ll feel that way in the end anyway.’

Me: ‘Deal!’

Smashed it.

And so, with a bargaining (that in retrospect looks suspiciously like denial) plan in place, I am able to go back to work after the appointment. I am able to be totally normal and effective in meetings. It’s just a pure coincidence that when a colleague booked fish for the photo shoot catering, knowing full well that I don’t eat fish, that I lost it. And, um, when she argued with me in a meeting room, it was a totally unconnected resulting panic attack that made me shut myself in there so no one else could make me feel bad today. Must be my time of the month, eh? Oh wait, I don’t have those anymore. I’m infertile, remember?

In some situations, a plan is not enough to paper the cracks. You can’t kid the kid-less, this situation is quite horrible. Not horrible like I’d imagined when I sometimes thought of other people being infertile, like Charlotte from Sex and the City, say. But worse. It’s worse than that, because it’s me. I am the centre of my own universe and my universe just got sucked into a black hole. There is nothing for it but to go home and mourn what we both just lost, together.

When I finally crawl into bed and cry into my husband’s neck, I feel better because I’m there, but I can’t seem to stop. It’s the plan. It’s sort of stuck in the back of my throat. I’m crying about my past and my future at the same time. We’re going to need more tissues.

At some point during my treatment – it’s hazy, because that is what chemo does to your memory – I found myself in the mahogany-panelled office of a fertility doctor, prompted by my kind breast-care nurse and my sister. The former suggested I might want to speak to someone about starting a family once all of this grim, life-saving treatment was over. The latter, because my sister, Amy, had offered to freeze her own eggs in lieu of anyone offering to freeze mine. Amy is four years older than me, she has two beautiful daughters, and I knew that in the case of my own eggs being off the menu, as it were, hers would be the next best thing. It felt hopeful and lovely.

So, I was quite thrown when this particular expert told me he very rarely worked on cases of intra-familial egg donation. ‘What?’ I said. ‘Surely that’s the most obvious and common solution. Surely that’s the closest infertile people get to ever having their own genetic children?’

And therein lies the obvious issue. ‘Think about Christmas,’ he told me. ‘Your whole family gathered in one place. Think about the times your child – because this will happen – tells you he hates you and runs to his auntie for a cuddle. Think about a scenario where you want to discipline your child and your sister chastises you for it, or makes any comment on your parenting whatsoever. It’s common among normal families, of course, but in this case that kind of behaviour would have such extreme connotations.’

Click! Of course.

I went home and repeated the obvious flaw in our thinking to my husband. ‘Thank god,’ he said. ‘I did not want to have a baby with your sister.’ It was funny at the time, but even that comment sucked me into a thought tornado for a few days. He had gone along with my emotionally charged plan B because he knew I needed it, even though he had an uncomfortable gut-reaction. But how do you say that to someone you love in that kind of situation? It’s intricate and messy and primed for an explosion. I appreciated his stance as soon as the doctor cleared the sentimental detritus and let me see it logically, but what if he hadn’t? Would Mr B have said no further down the line? Or would he have gone along with it and compromised his own instinct. Either option is insurmountable, so we would have been somewhat screwed.

The doctor had explained to me that it is possible, of course, but we would all three have to have separate counselling, group counselling, and something about presenting our case to some kind of ethics committee to consider the moral and psychological implications. I’ve researched it since and I can’t find any set precedent on whether or not he was entirely right. Except for one study that mentioned some UK clinics operating a pool egg donation system, offering recipients a choice of using their relative’s egg (generally a sister’s) or that of an unknown donor from the pool. Interestingly, most people chose the stranger.

There are many pro schools of thought when it comes to sibling egg donation, and many against, but in the end it’s kind of moot. My husband and I always seem to agree on the big stuff, and we’d independently realised this was not the way for us to go. Thank you Amy, it was an amazing gesture and we’re forever grateful, but you don’t need to procreate with my husband. Chances are, I’d be able to do it myself when the time comes anyway, I’d thought.

But the time came, and I can’t, so here we are. Crying in bed, considering our options. Now the tables have turned a little. I know egg donation is our next best option, but currently my gut reaction is similar to his when he was going to have a baby with my sister. My instinct is to not say it out loud. Bury it. Bury it. Bury it Sophie. It’s not a nice stance to have, it’s an amazing, fantastical, progressive opportunity and I feel … jealous. Which makes me feel ugly. And so I cry a bit more and say it out loud, ‘I’m sorry, I just don’t want to have to have someone else’s baby in my belly. It feels gross. I don’t know why I feel like this.’

Mr B looks at me and says the very thing that lets me know I was right to marry him. ‘I know. It’s because it is a bit gross.’ Oh my God, he gets it. It’s a similar thing, he is adjusting to this infertility diagnosis. It’s a massive discombobulating lurch for him too. He loves me, he loves my face (thank you for that), he wants to have a baby with me, he wants it to have my eyes or my smile and definitely not his nose, but he wants it to be ours. There is a lot of emotional adjustment to considering an alternative route to baby making. The semantics are tricky to get your head around. There is guilt in suggesting a child made up of anything other than our combination of genes would not be ‘our child’, but it takes some getting used to. Of course, people adopt children and they are a million per cent their children, but it doesn’t happen overnight. It took those altruistic people a little while to get there, too.