Baby talk 4: first transfer

Read the full Baby Talk series

Content note: this one involves my vagina, like, a lot. Also blood. And that whole infertility/anxiety thing.

Of our four fertilised eggs, two were deemed high-quality enough to proceed to the next stage, embryo transfer. The old days of putting multiple embryos back into your uterus to increase the chances of pregnancy are gone, apparently, so we were able to keep one, and freeze one as a backup. That provided a lot of reassurance, and even a tiny sliver of hope that we could think about having a second baby one day, without having to go through all this rigmarole again.

But first: the pessaries.

Between egg collection and embryo transfer the clinic gave me progesterone pessaries. “Luteal support” they call it. It’s great for maintaining a soft cushy lining in your uterus, and also for getting SUPER FAMILIAR with your own vagina.

I was on two pessaries, three times a day. You insert them much like a tampon, except it’s a small plasticky ball bearing (indeed, two small ball bearings) going right up to the edge or your cervix – and sometimes the little sods WILL try to follow your finger back out and sit uncomfortably like an over-full tampon right at the opening.

They warn you, “You’ll get some waxy discharge.” The pessaries are mostly made of vegetable oil, and that’s the part that doesn’t get sucked up your cervix. So it makes sense something’s going to come back out. Except you’re thinking “vegetable oil” and not “it will look like someone’s literally ground the end of a candle into your knickers”. It’s white. It’s solid. Bits WILL fall out of your labia or off your loo paper and float on the surface of the toilet like cut-price fake snow.

It is a deeply weird process.

My top tip? Set your timer ten minutes early. Use that time to cue up a podcast, get into your pyjamas (obviously for the last-thing-at-night round, but maybe also for the other two as well?) and go to the toilet, after turning the bathroom tap on to warm.

I was doing this as winter was threatening, and there is nothing that’s going to make this routine worse than washing your hands in icy cold water before they go up your snatch.

The transfer

Every other stage of the process has a heavy sense of ceremony, even though what’s happening is invisible. The daily injections. The close monitoring of your ovaries. The drugged-out ritual of egg collection.

Embryo transfer was simultaneously the most important thing we ever did, and the most trivial. No sedation, no long waiting period; you walk into the room under your own steam and lie down on the same bed, but fully aware of everything; you try to make out the shape of your own uterus on the ultrasound; and then there’s a long needle, a twinge, and a tiny white speck seems to float up into your body.

And that’s it. Get up, off you go. The paperwork is reassuring: literally, “don’t worry, your embryo won’t fall out”. They are very good at knowing what you’re afraid of. But I was already an overthinker before we started all this and after weeks of hyper-focusing on every little detail, worrying that anything could be The One Thing That Makes Or Breaks This – am I timing the injections properly? When do I need to stop eating? Are the pessaries in far enough? Have I lain down for long enough? Don’t forget you can’t lie down all the time, some exercise is good! But what kind of exercise? – having that microscopic dot so full of potential and hope sitting back inside your body really does feel like the one thing you cannot fuck up.

I’d seen it. It was really there, even if I couldn’t feel it. And everything rested on whether or not it would find a home in the lining of my uterus. I was the closest I had ever been to being pregnant, but things were still completely out of my control.

There was nothing to do but wait for the blood test that would seal my fate. (You could probably take an over-the-counter test but God, why do that to yourself?)

The wait.

Nine days later, I was 90% sure my period had started. But I didn’t want to think about that, so I ignored it, telling myself again and again that what mattered was the blood test, the phone call, the certainty of a clinician’s voice on the line, not my own total inability to determine if the smear on my pad was actually red (bad) instead of reddish brown (possibly good).

Some brownish spotting is normal, you are told. Or at least they phrase it, “some women do have brown spotting before a positive pregnancy test” but they don’t give you the exact numbers because like every other stage of this process it’s really just magic. It happens or it doesn’t. No one knows why.

Of course, for me and many other people who menstruate, brownish spotting is ALSO perfectly normal immediately before my period properly starts. So the past 24 hours was really fun: checking the paper every time I wipe, is that brown? Brownish? Is there a bit more pink than last time? Inserting pessaries becomes a whole new world of miniature gore when you get to pull out your finger and assess what’s trapped under your fingernail. Definitely brown. Reddish but brown. Definitely.

Don’t worry, part of me definitely wonders if this is Too Much Information. But I really do wish I’d known about some of this in advance. I wish I’d spoken to my friends who have also gone through IVF about these small mucky details – but that’s a whole other difficult topic. The point is, what the clinic are going to tell you is the cool, clinical (sorry) details. However compassionate they are, there are just details you don’t hear about and have no way of anticipating.

The literature they give you is full of reassurance. It’s normal to overthink things. It’s normal to worry, or cry, or take a day off work. Normal normal normal.

But when it’s your first time, nothing is normal. And every abdominal twinge, every damp feeling in your knickers, is either a sure sign you’re pregnant and it’s wonderful OR a definite sign you’re not and you’ve failed again, and you swing between the two on an endless painful oscillation that only ends with time.


The phone call came. And it was not good news.

Baby talk 3: the eggs, the lube, the triggering

Read the full Baby Talk series

So we took a bit of an unscheduled posting hiatus there; but more on that later. Today we’re talking eggs, lube, and triggers.


Just as the self-injection routine started to get good and routine, and I wasn’t having a total emotional break on a daily basis, came the sharp reminder that this was only one stage in a massive project, and things had to be kept on track. At this point, that meant an ultrasound, and not the television-friendly wand-on-the-tum kind. The question was: were my ovaries responding properly to the hormones, and growing a whole bunch of eggs?

They were.

I got to see the swollen follicles myself, gaping black voids on the surface, a definitely upsetting experience for anyone with trypophobia (the fear of lots of little holes). They were measured and found to be sufficient in quantity and size by the doctor – who was not my usual consultant; and a bit of warning might have been nice, given he was a man.

A note on lube

Now, I have nothing against cis men – like Cher, I love dessert – but there’s a distinct difference when it’s a guy controlling the plastic wand going up your groin. On the social conditioning side of things it just feels very very awkward to be giving guidance like “a bit lower; no, that’s too hard; yep, that’s it” to someone I have zero, possibly even negative, sexual interest in.

On the physical side of things, there’s lube.

I’m just going to put it like this. If you are a medical professional who does not now have, and never has had, a vagina, and your work involves putting things in other people’s vaginas, you need to lube that wand like it’s going up your own butt.

IVF is a process that involved a lot of vaginal ultrasounds so I can definitively say, from the other side of it, I would rather have to wipe some excess gel out of my labia afterwards than feel like screaming “what’s wrong with a kiss, boy?” in my best John Cleese at a thoroughly professional clinician.

Anyway.

Things looked pretty good, so I was sent home with more drugs, ready for the next stage.

And there was not much to do but sit at home and be consumed with ~feelings~. It’s a paradox: after so incredibly long, thinking about nothing but wanting this and trying for this and counting days and degrees and becoming an expert on one’s own cervical mucus, we’d overcome one of the big hurdles … and I wanted things to slow down.

From deciding to go private to the first consultation was only a few weeks (longer than usual due to COVID); from consultation to first injection was only a week after that, thanks to a well-timed menstrual cycle.

Then it’s one more week, and you’re on the doorstep of egg collection and insemination (and handing over another couple of thousand dollars) and a whole new cycle of waiting and hoping and not being able to do anything to affect the outcome, until you get told if you’ve been lucky, if there’s an embryo, if they can try to plant something back into you that might become the baby you’ve ached for and you have no idea what you’ll do if you can’t make a home for it inside yourself.

It feels impossible that everything can move so quickly after it’s taken so long to get here. It feels unthinkable to process it all in just a few weeks – when you couldn’t even start to process the idea of being infertile for a decade.

Triggering

There’s an obvious internet-discourse joke to be made here. I will refrain.

Once the ovaries were signed off and the blood tests were checked, we were on a rigid timeline. The New Injection, Ovidrel, had to go in at 9pm sharp. It’s a “trigger” injection that tells your eggs to get ready to rumble after they’ve been hanging out on your ovaries, refusing to go anywhere. That was the easy bit after a week of practice with Gonal-F: same pen shape, same needle tip.

Then put 36 hours on the clock for egg collection. It’s a weird time span to think about. Doing something 24 hours beforehand? Easy, that’s how time works. Doing something this evening to prepare for the morning after tomorrow morning is confusing as hell. I don’t know how many times I checked the instructions and the calendar and the time – yes, Stephanie, today is TUESDAY so the after tomorrow is THURSDAY and you are taking the drugs at the right time, that’s why the text message from the clinic says TONIGHT, just like that, in all caps.

They’re used to these kinds of meltdowns.

On Wednesday, do not eat after midnight (and make a Gremlins joke). On Thursday morning, clear liquids only and three paracetamol.

Off to the lab. Local anaesthetic. Sedation. Prepping for a needle to go all the way into my ovaries and burst those little black bubbles – so huge on the monitor but only 2cm across in reality. Which may or may not be huge in the context of an ovary. I don’t even know how big an ovary is. Call myself a feminist!

And hopefully, the bubbles contain eggs, which the clinic pulls out of me and introduces to J’s elite swim team; and Mum picks me up and takes me home and I sink into an indulgent haze of tea and biscuits and awful television.

That was the plan, and clearly everything went according to it, but I simply don’t remember. It’s like having your wisdom teeth out: I have such a vivid memory of the dentist telling my mother, “I’ll give you the instructions because she won’t remember”, and I scoffed, and after that … nothing.

I took a very bleary selfie in the prep area. I stared at the bizarre curtain patterns. I walked myself into the procedure room, very proud of not being the slightest bit dizzy, and then … not a freaking clue. I don’t even know if I got tea and biscuits.

End result: four eggs, which didn’t feel great. From that, four fertilised eggs, which felt miraculous.

And then we waited, to see how many would survive the first five days, and be viable to be implanted back into me.

It always comes back to waiting.

Baby talk: the needles

Read the full Baby Talk series

(Content note: infertility, IVF, injections)

I definitely didn’t plan it this way, but here we are carrying on with the anniversaries: because it was a year ago today that I found myself wandering down Victoria Street carrying five thousands dollars’ worth of the less fun kind of drugs.

The first big piece of the IVF puzzle is the eggs. You need to stimulate the ovaries to produce as many as possible, then collect them so they can be fertilised in the lab. And that means playing with hormones – which is exactly what you need on top of all the emotional and psychological pressure of nearly a decade of trying and failing to have a baby.

Put it this way: I needed to start taking the first set of jabs on day 1 of my menstrual cycle. And as everyone with a period tracking app knows, day 1 is counted from when you get full or “normal” flow – for your typical cycle – before noon.

So when my period started at 12:30 on a Saturday, I naturally had a minor breakdown about how to count days, and also time. Did that count? Was it day one??? How heavy was a normal period for me anyway????

J gave me a very firm look and said “It’s full flow before noon. That means day one is tomorrow.”

On the plus side, I impressed the Fertility Associates nurse with my quick command of popping a needle onto the drug pen and jabbing it into a weird beige eight-by-five centimetre piece of demonstration “belly” skin. It felt like a weird magical ritual, and also too easy, but also the most difficult thing in the world. At least I knew that my feelings were very normal, based on how many times the nurse reassured me that I definitely wasn’t going to screw it all up.

I didn’t. My hands didn’t even shake. But that didn’t stop at least some part of my brain from freaking out anyway; I spent the rest of the evening walking around with incredibly tensed posture, like my belly was made of porcelain and any movement might shatter it. Porcelain with a very very sharp little mosquito bite in it.

My medication plan involved taking the injection (Gonal-F) for a week, and on day 6 adding another one (which hurt like hell) to make my ovaries hold on tight to all those precious eggs they were (hopefully) prepping.

When it came to it, I once again forgot what counted as day 1 of my cycle, and/or how to count to 6, and ended up calling the clinic just to double-triple check the very clear instructions I had already been given verbally and in writing.

They are very, very accustomed to those kinds of phone calls and were very, very kind about it. It didn’t stop me feeling bloody silly. How on earth was I qualified to have a baby if I couldn’t manage something this simple?

You’d think that by day seven it becomes old hat, nothing to worry about, you’ve nailed this process. You’ve got your little prep ritual ready, with a comfortable place to sit and a cup of peppermint tea at the ready to stave off the nausea.

But with IVF there’s always the next step in the process to worry about. And the next step was an ultrasound scan to see if my ovaries were cooperating. Something I could not see or control or have any sense about until it happened.

No pressure.

Mother’s Day

(Content note: infertility, mental health, motherhood)

My first post about our ~parenting journey~ is here.

Mother’s Day has never been the most problematic artificially-hyped-to-sell-stuff-parental-celebration holiday for me. I grew up ~without a father~ (he bailed; his loss) so it was always the unthinking way we/marketing departments assume that everyone has A Dad to celebrate, and the consequent erasure of dudes who play an amazing role in kids’ lives, which irked me on an annual basis.

But once we’d started trying to have a baby, and the years of it just-not-happening ticked over, Mother’s Day took on a more personal impact. I wanted to be a mum, and it felt further and further away every year, which was only added to by the doom-and-gloom messages that are constantly around about Women’s Fertility Crashing And Burning Further And Further Every Day You Age Past 35 27 23 18 your own birth.

(This cropped up again last week when TVNZ Breakfast were doing a series of stories on infertility, which were really important but also managed to screen each morning at exactly the time I was feeding the baby and trying to find something to watch on TV. Here’s the thing: the “at 35 your fertility dies” trope is not exactly scientific and we need to have way better conversations about why people actually delay having kids – even if you don’t have to pay tens of thousands of dollars for fertility treatment.)

A part of me assumed I would just never be a mother. Even once we had the resources to do IVF, the odds felt too great. If the grand narrative of my life was going to go one way, it just felt far more likely I’d end up with She Desperately Wanted Children But Could Not Conceive than the Hallmark/Lifetime/TLC movie After Years And Against All Odds, A Miracle.

I’ve had anxiety and depression all of my adult life, so the horrible little voices at the back of my brain telling me I’m doomed are so familiar it’s almost comfortable. And they just got louder every time the TV filled with images of blissful mums-and-bubs and saccharine time lapses of The Most Important Relationship You’ll Ever Have.

(Shout out to the current Pandora jewellery campaign for casting a mother and daughter so close in age appearance that I still can’t quite parse the timeline of your ads!)

Often it felt like a grand signal from the universe to just give up. Because the odds are so against you. Because the obstacles are so real and so high. Because if it doesn’t happen – especially after putting yourself through the ordeal of IVF – haven’t you just wasted years, and money, that could have gone to something better, something more productive?

(I still haven’t even begun to unpack the way my brain obsesses about “productivity”.)

I have many friends who did exactly this. Drew the line in the sand and said, enough. But always with a huge amount of sorrow. That was why we struck that deal with ourselves: three rounds. Enough to say we tried, we gave it our best shot, but it wasn’t meant to be and let’s now focus on what the rest of our lives look like without children.

I honestly don’t know right now if I would have been able to stick to it, or how long it would have taken me to let go, if I could even let go. I didn’t have to find out. We got very, very lucky.

So this year, I celebrate my first Mother’s Day. But not just that: it’s my mother’s first Mother’s Day as a grandmother. My grandmother’s first Mother’s Day as a great-grandmother. As horribly commercial and transparent as it is, that feels very important. At the same time, it brings up everything I’ve been through not just over the past year, but all the years of trying before that, and all the years of wanting and hoping before we could even try. I’m an only child: if I didn’t have a baby, my mother would never be a grandmother. I’m the eldest of my cousins and none of them seem to be interested in having kids any time soon: would we ever have gotten that gorgeous four-generations-in-one-photo?

(And again: let’s talk about how saddling young people with hundreds of thousands of dollars of debt, in order to get jobs with no long-term security or career path, while housing prices skyrocket, might have the teensiest impact on why millennials and zoomers keep Putting Off Having Children, yeah?)

It should feel like a happy ending. It does. But at the same time I don’t know when I’ll ever stop being just a little bit in mourning for all the grief and stress and painful, painful absence that this day represented for me for so long.

So this one goes to all the people who are still there. Who want to be mums, and can’t for whatever reason, and have to deal with the unthinking assumptions of our culture not just on this day but every other day of the year. It sucks. It doesn’t necessarily get better. I know there’s nothing that can really soothe that hurt because even holding onto hope feels like self-harm sometimes. Look after yourself.


I wrote the above a few days ago. Today, Michelle Duff published an incredibly important article about the Corrections department’s practice of shackling and handcuffing prisoners as they are giving birth, or breastfeeding.

It was probably a mistake to read that on my phone, with baby in arms, right after a feed.

Like I said on Twitter: everyone involved in this – the officers in the room, their direct supervisors, their direct supervisors, and anyone else who had knowledge of this and did nothing to stop it – needs to be fired, possibly into the sun.

It is simply unacceptable that we keep getting these stories coming out of Corrections. It is simply unacceptable that Corrections, and its Minister depending on where we are in the media cycle of any given scandal, thinks they can treat the public like marks who’ll swallow any horror if it has the phrase “security concerns” slapped on it.

This practice is against Corrections’ own stated policy and yet, AND YET,

Children’s Commissioner OPCAT inspectors found prison officers had varying interpretations of when prisoners were “pregnant” or “giving birth”.

ARE YOU KIDDING ME?

The officers involved in these situations are either ignorant of the basics of their own jobs, or know they’re doing the wrong thing. Either way, they have no place holding those jobs. And their senior leaders, including Kelvin Davis as the Minister responsible, need to stop pretending there’s some third option where oopsie, well-meaning people with the best of intentions just accidentally did a human rights violation oh well let’s commission another review to tell us what we already know: Corrections is not fit for purpose. It is not keeping New Zealanders safe by repeatedly and deliberately brutalising prisoners and lying about it to the public. It is not delivering care to the people it laughably euphemises as such. When pregnant, labouring people are shackled like animals and bullied in their most sensitive moments, Corrections is actively undermining any chance for those people and their families to rehabilitate, to build positive relationships, to feel like they can be a part of our communities.

This cannot be reformed without drastic and immediate action. Call it some kind of transformation rooted in kindness and strengthening the Māori-Crown partnership.

So, Kelvin?

Corrections Minister Kelvin Davis was not available for an interview.

Oh.

A year ago today

Read the full Baby Talk series

(Content note: infertility, IVF, fatphobia)

A year ago today, my partner and I “properly” began the journey to become parents. We’d been on the path for a very long time: first trying, and trying, and trying, and failing, then trying to get help, and facing some pretty gross obstacles to that; and finally being in a position to overcome those (with money, which tells you how unnecessary those obstacles were in the first place) and then having incredible good luck and at long last, after wanting and hoping and waiting and longing, just over a month ago, she arrived. Our baby. The tiny helpless bean who has completely turned our lives upside down. (Sorry, spoiler alert: this one has a happy ending.)

Of course, I wrote it all down. Even the bits I don’t even want to look at, myself, because they’re too raw. But there are parts I do want to share, and thus my blog is getting resurrected because I’m too much of an old school millennial to do Substack even if they weren’t currently tanking as a platform after pandering to transphobes.

(Yes, even in the posts about how much I love my baby, there will always be politics. You know where you are, right?)

As for the timing: I couldn’t bring myself to post this stuff earlier, unlike my good mate Dave who had the incredible courage-slash-lack-of-filter to write about his and Kim’s journey as it was happening. On top of all the other layers of anxiety we were going through, it just felt like it would be unlucky; or at the very least, it might force us to reveal things we weren’t ready to, even if just by the lack of posting at a critical moment.

But she’s here now, and she’s as close to perfect as she needs to be, and even though I still have that fretful voice in the back of my mind telling me not to count my baby chicken even though she’s already hatched, I think it’s the right time to start pulling all these scattered drafts and notes together – not to mention an essential outlet for my brain as I’m at home on paid parental leave, desperately trying to work out what my life looks like now I’m a mother, and feel almost incapable of considering myself having any other role in the world.

So here’s (most of) what I wrote after that first “proper” consultation – the one where you go to Fertility Associates with a lot of money and say “help us make a baby”. With a few editorial comments from Stephanie-Of-The-Future.

The first consultation is like an infomercial which demands your most intimate details. But wait, if you throw in even MORE money we can take time-lapse photos of the embryo to make sure its legs are on properly. And there are lots of options for freezing the eggs we HARVEST OUT OF YOUR BODY after an unspecified course of drugs and scans that get right up ya.

And all of that costs more money on top of the money you’re already putting in. And will it increase your chances of success? Those chances which are already worse than a coin flip? I could see the value for people who know they have specific genetic conditions, who have already tried and failed a few times – but when it’s your first turn on the carousel it feels like cynical upselling, and in a way, it hurts that early relationship with your doctor, because they’re not just there for you, y’know?

J hates every bit of it and I can’t really blame him. He’s “the problem”. The reason we couldn’t just make a baby the fun way.

And this never stopped being incredibly difficult for both of us.

And the money. Everyone says oh there’ll never be a good time to spend all this money – whether you have to have All The Medical Assistance or even if it just pops out of its own accord, babies are expensive – but it’s so difficult to pull the trigger when maybe if we just wait until THIS contract renews or THIS job offer arrives or THIS chunk of the mortgage is paid off … and of course the Clock Is Ticking and that stupid dotted line on that stupid fucking Probability Of Success Based On Age of Woman graph keeps edging down and down and down.

I will always wish we’d been able to do this sooner. I will always wish that we were in a situation to do it again, to consider having a second baby. What I can tell myself – now, in 2021, with my actual baby coma’d out in the living room after a healthy feed – is that things happen for a reason and if things had happened differently maybe we wouldn’t be here at all.

I’m the problem too, of course. The Aging Woman who didn’t chop her leg off five years ago to qualify for public funding – because that would have been fine, you see. It’s not actually relevant how big my belly is, it makes no difference to the chances of success. BMI is literally just picking one variable – fatness – out of the hat in order to “ration” public healthcare. The best bit is it’s completely fucking racist but our society is so comfortable with openly hating fat people we can get away with pretending it’s not a hatred fundamentally rooted in racism, classism, and body-hating white supremacy.

I could have lost a limb in a terrible accident and the health system would say oh okay, you’re obviously Healthy Enough to have a baby on us.

I could have starved myself, vomited every meal, taken amphetamines, and it would have meant we could have a baby, sooner, and cheaper, and without anyone questioning how it happened – because losing weight when you’re fat is Always A Good Thing.

Jarrod interrupted the doctor to say that I’m a pole dance teacher. I was annoyed. I don’t need to fucking prove my fitness to her. It wouldn’t matter if I’d just won a marathon. Fertility Associates are getting the money one way or the other.

So this is going to be a pretty major theme. Our health system, wonderful and public as it is (except for GP appointments and many prescriptions and don’t start me on access to contraception and abortion services even AFTER we supposedly decriminalized) uses the unscientific quackery that is BMI to ration access to fertility services, which is baseless, harmful and transparently racist. This was not our first visit to Fertility Associates, not even the fifth – this was just the first one where we were allowed to progress past the basic tests into actually doing something towards making a baby.

Because despite being the picture of health – perfect blood pressure, non-smoker, and, yes, being literally paid to perform and teach pole dancing and being able to bust out twelve burpees in a minute at one particularly energetic cardio class – my weight, alone, divorced of context or nuance was the reason we couldn’t get public assistance for our infertility. The only advice? Lose weight.

But how? It’s a post for another day, but let me simply assert a simple fact at this point: diets don’t work. Not predictably, not sustainably, not healthily. And not if you call them “lifestyle changes” or pretend that counting “points” isn’t the same as counting “calories”. And even if they did, I want to be really clear: no one at the District Health Board (adios) or the Ministry of Health was going to check how I lost the weight, if I did.

And that’s why I wrote that, a year ago: I could have lost a limb and as far as a health system, using BMI to ration services, is concerned, that would have been enough to get public funding for our IVF. The numbers have nothing to do with health or probability of success or anything except using our society’s hatred of fat people as an excuse to cut costs.

So.

That was a whole extra mindf*ck to take going into a process which already carried so much emotional and psychological baggage. With such low odds of success regardless of my dress size. And we knew so many people who had gone through it, and failed, and failed again and again, and seen the toll it took. So I just had to keep reminding myself, as we left the clinic that day filled with a mixture of hope and dread:

Three rounds. That’s the deal. Even though we probably can’t get the lootbox deal (pay for three rounds now, and get a refund if they all fail – or lose it all if you succeed first time). I can’t do this for the rest of my life. I don’t even want to be doing it now.

And that’s why I waited a year to write this. Because there’s been a lot of strife and plenty of tears but at the end of the road, we got her.

If you like this post, feel free to spot me a virtual coffee.