Baby talk 4: first transfer

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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.

Laurel Hubbard is a trailblazer

Laurel Hubbard has qualified to represent New Zealand at the next Olympics (whenever or wherever those happen) in women’s weightlifting.

Virtually no one would have paid any attention to this – weightlifting not being one of the three sports (cricket, netball, league) New Zealanders actually care about – if it weren’t for the fact Laurel Hubbard is a trans woman. The first, in fact, to qualify to compete at the Olympics, despite trans athletes being technically allowed to compete, under certain restrictions, since 2003.

Keep that in the back of your mind, yeah?

This is a tremendous achievement for her and if she’s in serious contention for a medal it’s great for New Zealand, right?

Except this is a pretty bad time to be a visible trans woman, and especially a visible trans woman in sports. What generously gets called “a debate” about trans women’s (never trans men’s, keep that in the back of your mind) participation in sport is nothing more or less than the wedge issue for organised transphobic activism, right after stirring up baseless moral panic about public bathrooms.

The farcical “arguments” offered are like most transphobia: rooted in bog-standard, basic sexism. You have to accept the idea that men are inherently faster, stronger, taller and more powerful than women; that testosterone is a magical wonder drug that confers superhuman powers on anyone who gets enough of it during puberty; that the chromosomes or genitals you’re born with are the primary factors determining if you’re good at sports or not.

The transphobia is also basic. It’s simply about insinuating, inferring and outright stating, from behind an army of newborn Twitter sockpuppet accounts, that trans women “are men” and for a trans woman to compete against cis women is thus “unfair”.

A picture is painted of a terrible world in which no cis woman ever wins any medals because trans women (dogwhistle: “cis men pretending to be trans to win all the medals”) “dominate” all the sports. Except … remember how trans athletes have been able to qualify for the Olympics since 2003? And it’s 2021? And Laurel Hubbard is the first?

So … where are all these cis men lining up to win all the medals if it’s so simple?

There is literally no basis for this fearmongering beyond that primary-school level, “boys have testosterone and that’s why they’re strong; girls have estrogen and that’s why they love babies” understanding of human biology. I shouldn’t have to explain why this is pretty much the opposite of any credible feminism.

So Hubbard’s achievement has been immediately framed in the context of that “debate”, and that’s incredibly sad and concerning. She and other trans women – and cis women who look “too butch” because that is an obvious side consequence of transphobic gender-policing – are literally put in danger by this rhetoric, not just denied the ability to live their lives to the fullest.

She is a trailblazer. She deserves to be counted among all the other people we hold up as Kiwi heroes because they overcame tremendous odds to be The First In The World, without the shadow of nasty, petty sneers and abuse from cowards who want to reduce womanhood to a quivering pair of ovaries, crying for the patriarchy to protect them.

And you know that they don’t even really care about sports, right?

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

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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.

Benefits, Budgets and b***s***

Are they going to do it?

At long last, isthe Labour government going to significantly increase base benefits and ensure that people actually have enough to live on, reversing the stagnation that’s existed since the horrors of the 90s?

People say the signs are there. I hope they’re right. I desperately hope that after so long, we will see genuine action, a real shift, something that we can hold onto during the lean years when National inevitably get their acts together (sorry, that was an unintentional pun) and regain the Treasury benches.

But the bar is pretty high.

The Welfare Expert Advisory Group report recommended increases to the various benefits of between 12 and 47% (note this is from 2019 and just think about something random like how much housing costs have increased since then.)

The head of the Auckland City Mission put the figure at $200 a week.

Either of those would be pretty amazing, and change a lot of people’s lives. And while I find it a bit gross how often we talk about “child poverty” as though it’s fine for adults to go cold and sick and hungry and homeless in our country, it would do incredible good for thousands of New Zealand children.

It might even be enough to save Jacinda Ardern’s legacy as the Prime Minister who anointed herself Minister for Child Poverty Reduction.

But still … I’ll be a bit angry about it.

Angry because it has simply taken too long. It is year four of the Great Transformational Kindness Ardern Government, and I simply reject the idea that the first three years don’t count because mean old Uncle Winston said “no” and there was just no way to negotiate, bully, build popular support to shift the narrative, or otherwise make it happen despite him. To accept that excuse would render all those global accolades for the PM’s amazing leadership meaningless; and that would be terrible. 

Angry because I know how the story will go. Labour will trumpet it from the rooftops. Look at us, the bold, the brave, the transformational (or whatever word we’re using now), we are the good ones, we understand how terrible poverty is in this country, we are the government who cares and will make a difference, let’s do this, hashtag he waka etc.

And it will be like the last four years never happened.

Because this is one of Labour’s weird psychological foibles: they cannot never acknowledge that their decisions to date are in any way flawed, or insufficient. Until they do a u-turn, and then it’s like it never happened.

That is why even a week before this Budget (assuming this Budget does significantly increase benefits) the answer to any criticism of their failure to substantively deliver on welfare was still “but we did a $25 a week increase. We introduced the Winter Energy Payment. We indexed benefits.”

Sometimes they throw in a line like, “we know we need to do better” or lean hard on the phrase “we’re making progress” so the audience infers that more things are happening behind the scenes. But the overall tone is still: look at what we’ve done! We’ve done the good things! Stop asking questions about the other stuff, it’s so unimportant I’ll ignore it entirely!

There is never an acknowledgement that $25 a week ain’t much; only a Steven Joyce-esque assertion that it’s “the biggest increase made by any government” (biggest doesn’t mean sufficient). There is never an acknowledgement that the Winter Energy Payment is a pretty sad $20-30 a week for only five months of the year. The indexation of benefits – which is good insofar as it stops the increasing cost of living from creating real-life benefit cut, but does nothing to repair the damage done in the 1990s and 30 years of stagnation on top of that –  gets cynically trumpeted as “increases” rather than adjustments.

But here’s the thing: if we get what we want on Thursday, all this will be wiped away like tears in Grant Robertson’s rainy day.

It happened with the hated 90-day fire-at-will “trial periods”, which Labour resolutely campaigned against for years, only to turn around and suddenly decide really, the issue was “fairness”. They ultimately retained the trials for small businesses. 

It happened with the Trans-Pacific Partnership, which saw massive popular opposition, leading to Labour setting down five strong bottom lines prior to the 2017 election. These were possibly mostly met, if you believe Stephen Jacobi, and mostly weren’t if you believe Jane Kelsey, but either way it took Newshub to check because Labour never mentioned them again.

It happened in record time recently with the public service pay freeze: on day one Chris Hipkins was bold as brass, calling out the Public Service Association (the largest union in New Zealand representing more than 75,000 workers) in Question Time thusly:

I’d also say to them that the guidance is consistent with the decision last year by the Remuneration Authority that Ministers and MPs would not be getting any pay rises for the next three years because of COVID-19 and the decision by the Public Service Commissioner, who sets the pay of Public Service chief executives, who will also not be increasing any of their pay.

…directly comparing a pay freeze for staff on $60k+ to a couple of other pay freezes for elected officials and CEOs on $150k+.

Then after the apparently unexpected backlash it became (from Grant Robertson):

“I understand this has caused distress and upset, I obviously regret that deeply, but we are not talking about a pay freeze here, we are talking about a process or guidelines for negotiation.”

It’s not a pay freeze, it’s just guidance, a starting point for negotiation (unless you’re a nurse) and frankly we should be apologising to him for the misunderstanding.

The trick Labour does is not to simply change their minds – anyone can do that, and if it follows reflection, research, fact-finding or a change in circumstance, it’s admirable. No, instead Labour engages in a form of gaslighting – pressuring people to disbelieve the evidence of their own eyes and experiences by insisting that reality is otherwise. We never said 90-day trials were completely terrible, we just want them to be fair. We have bottom lines – no, we just want a fair deal for New Zealand. We’re implementing a pay freeze, take that, unions – the unions are our friends and we love working with them and also never announced a pay freeze (it’s the media’s fault you think so!).

Let’s do this. Actually, we’re not able to do this and never made any commitment to any particular timeframe. 

And so it will be, after  Budget. If (and I still would not put money on it)* the Government delivers a massive boost to benefits, we will be scolded for daring to suggest that the past four years of inaction happened at all, that the WEAG report has largely languished, that concrete steps to implement it have been actively countered,** that the child poverty indicators are going nowhere. “We’re tackling child poverty and ensuring New Zealand is the best place in the world to be a child!” the social media accounts will announce. That will be the new reality and you will be the obstacle to real progress for remembering differently. 

Why does this matter? Because Labour’s consistent refusal to actually be a progressive, transformative, caring-for-people government is a recipe for disaster. It is an open door to National’s penny-pinching benefit cutting ways. It is an excuse for every swing voter to say The Two Parties Aren’t Really That Different, Right? Wouldn’t Mind A Tax Cut Actually. It is tinkering at the edges, leaving the shattered, gutted sense of community and fairness lying on the floor instead of taking the opportunity they were given – four years ago – to reshape this country in a better direction. To actually do all the good things they campaigned on doing! To live the values they happily slap on tea towels and Facebook shareables.

I really hope they start to prove me wrong tomorrow.

~

*Okay, I’ll put $1 on a marginal, but insufficient, increase in benefit levels nevertheless touted as the biggest, best, most poverty-eliminating increase ever, and then next February the Salvation Army’s State of the Nation report will point out that too many families still can’t actually afford the basics and Jacinda Ardern will furrow her brow and insist that those statistics don’t count because the Budget 2021 package hasn’t been fully implemented yet.

**Yes, that is the Labour government pulling the same “fiscal veto” that Bill English used to defeat increasing paid parental leave to 26 weeks. 

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.