Pressing Play on Getting Pregnant Again

My second embryo transfer was an altogether lower key affair; no more an “event” than the 30-plus other appointments I’ve had at the fertility clinic since October 2020. 

The first time around I’d stayed the night in London with my mum, not sure how frazzled or vulnerable I’d feel after the procedure. That trip was during a strict COVID-19 lockdown but as I was traveling for medical treatment, we were legally allowed to make use of the blissfully quiet motorways and city streets. Some friends lent us their apartment a 10 minute walk from the clinic, and we ordered takeaway tonkotsu ramen for dinner, a rare treat for small-town dwellers. The whole trip felt like a mini-break in a ghost metropolis, punctuated by a brief, painless interlude to have a five-day old embryo implanted in my uterus.

I got pregnant from that first transfer but, as I wrote about at the time, only stayed pregnant for about two weeks before miscarrying. 

In March, almost five months ago now, I tried again. The second embryo was also five days old, meaning it had been left to develop in vitro (literally, “in glass”) after fertilizing with my donor sperm. A strange thing I realized then is that if a five-day-old embryo takes root, because of the vagaries of how gestation is calculated, you instantly become about three weeks pregnant. 

No one came with me the second time. My parents were abroad and I dropped my 3-year-old at nursery by 8:30 a.m. that day as usual. Then I drove to London, listening to podcasts and feeling bored by the familiar route. The roads and the city were busier. 

At the clinic, a handsome Cypriot doctor introduced the second embryo into its potential new home. After, I drove back down south, arrived in time for nursery pickup and took us home for cheesy pasta and peas. This was how I wanted it. I needed “trying to conceive” to become more of a background experience; a sustainable and indefinite facet of life, for as long as necessary—certainly longer than I’d first anticipated. After the first attempt, I’d realized the highs and lows were only going to remain bearable if I made a conscious effort to keep them in perspective and in check. 

It had only taken one unexpected bump in the road to flip my mindset from excited anticipation to cool pragmatism. There’s nothing quite like a miscarriage—no matter how early and, therefore, undramatic—to flatten your confidence and prove that none of it is, in reality, under your control. 

When you’ve never had fertility issues, or any kind of health problem, it’s tempting—not to mention, in an ableist society, easy—to take uncomplicated health of all kinds for granted. Maybe we even feel like we “achieve” good health and are entitled to. We might not like to admit it or even realize it, but I think most live under this illusion until direct, personal experience teaches us otherwise. It’s a shocking lesson but a necessary one. 

Deep down, intense emotions like hope, longing, impatience remained. But from then on, they absolutely had to be bottled up. They were bearable as mine and mine alone. Processing and relief would come eventually, I kept reminding myself whenever I daydreamed about getting back on T, but not right now. Other people—a small handful—would still know what was happening on a practical level. We’d just talk about it as if it was no more consequential than a mild weather forecast.

“Maybe it’ll happen, maybe it won’t,” I said to my mum on the phone the evening of the second transfer, with skin-deep nonchalance. 

“Exactly,” she replied, affirming the factual correctness of this, as well as my convincing tone. 

Well, it did not. My menstrual cycle even started early, as if to put me out of my misery. I actually still got mild pregnancy symptoms but only because the fertility drugs can have those side effects. It’s a shitty joke.

Cue the loss of all hope. I spent about 48 hours in existential gloom, intercut with spasms of self-pity. The same thought kept torturing me: the first time I tried to conceive, when I was 31, it only took six months. And it worked first time. Now I’m 34 and it’s been a year! I’m fucked!

That’s when it hit me. I’d known this all along but it suddenly seemed stark, emerging like a stone tablet out of a fog of anguish and confusion. My age wasn’t the only difference—the treatment had changed too. I’d chosen to try IVF this time, not because of infertility but because it meant more gos at trying to conceive from my final vial of donor sperm; multiple eggs plus one vial of sperm should equal multiple embryos to store up. In contrast, one shot at insemination (IUI) uses a whole vial up in one go.

Now, I was asking myself: what if my body just doesn’t like embryo transfers? What if it’s like: “Hey, let me do my thing—just gimme some sperm”? 

I rang my mum.

“Why don’t you try insemination again?” she said, beating me to it.

“That’s actually what I was thinking.” 

“It worked the first time and it’s so much simpler.”

“Yeah, I know. I just... I don’t have any sperm left. That’s why I created embryos... to make my last vial go further. Plus, I thought embryo transfers had a higher chance of working…”

“Well, if the sperm bank has more, buy some. I’ll help.”

Four years ago, I purchased that single vial after the birth of my son, knowing I’d probably want to try for a sibling in the near future. At the time that was all they had and I’d found this genuinely scary. Wow, I thought, I have one future shot at using this same donor.

But this year, thanks to a UK system I’d previously overlooked called ‘sibling reservation,’ which is designed to limit the number of families created from a single donor, they had more, and I was entitled to buy them. 

I don’t know why my mum’s offer of help felt so full of hope. There was no more guarantee of it working. In fact, statistically, there was less. Across the population, including people with complex fertility issues, insemination (IUI) has a roughly 17 percent success rate, compared to 35 to 40 percent for embryo transfer (IVF). And yet, were these stats actually applicable to me, a queer person without infertility, who just happens to lack sperm on tap? When I asked myself this, I suddenly wondered to what extent the data around fertility treatment reflects reality for LGBTQ+ people more broadly, if it does at all.

In truth, my hope was partly relief at someone offering to share the financial strain. Apart from my parents struggling when I was little in the late 80s and early 90s, I’ve never experienced severe financial hardship. Yet self-funded fertility treatment involves spending that none but the truly wealthy can budget for. Shocking amounts demand to be splashed with each cycle of treatment, once testing, meds, admin fees and the treatment itself are factored in. In the UK, it’s up to roughly £5,000 per IVF treatment cycle. So, if your circumstances are complicated or if you’re simply unlucky, you can easily spend more on trying to conceive than it costs to buy a new car or put down the deposit on a house. 

Since the failure of my second embryo transfer, I was spending a lot of mental energy knowing that I was approaching my savings limit while also keeping this knowledge from giving me a panic attack at any moment. By offering to cover some of the cost of trying IUI again—a change we’d both intuited might be what my body needed—my mum lifted a huge mental and financial burden. Afterwards, I couldn’t help but think about this being another example of my generation and those younger relying on generational or inherited wealth to achieve ordinary milestones. Of course, fertility treatment wasn’t as much of an option for older generations, but if it had been, would they have had to choose between a family and home ownership, or would they have been able to carefully budget for both on a normal, i.e. comfortable, middle-class salary?

Maybe, but I am no longer in any position to complain. I have family support, emotionally without limit and financially enough to stave off the panic attacks for a while longer. Anecdotally at least, these are still very rare things for prospective trans parents. 

Next, I would try IUI, the fertility equivalent of low tech and old school. In my mind, certainly, IUI felt like “old faithful,” if only because this was the process that brought my first born into the world. I knew I had no empirical reason to feel quite so optimistic but I couldn’t help it. I was over a year off T and far adrift in a stormy sea of dysphoria and self-doubt. A loved one had just thrown me a life raft, in the form of three vials of donor sperm. It just needed to be deposited in the right place and my body would do the rest, like I knew it could. It had to work.

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