In 2013, nearly 50,000 women underwent IVF here in the UK. This year, I joined them.
At 32, the last place I expected to find myself was in an assisted conception operating room, half conked out on anaesthetic with a lubricated ultrasound probe and an egg-retrieval needle passed through my vagina, but here I am. And there's my husband beside me, watching awkwardly.
I'm back again, two days later, this time to transfer the fertilised egg back to where it belongs. My feet are up in stirrups. "Can you see it?" the doctor asks, crouched somewhere between my splayed legs. I glance to a screen at the back of the operating theatre and suddenly the tears roll down. Yes, I can see it: a grainy splodge on the monitor. My husband and I are face to face with our two-day-old embryo. I close my eyes and say a prayer for our microscopic universe in a Petri dish.
It hasn't been easy to get here. Over the last two months, self-administering 55 hormone injections and undergoing two invasive procedures, I've battled through IVF – or "in vitro fertilisation", to give it its formal name. IVF is the process by which an egg is fertilised by sperm outside the body in a test tube. There aren't any assurances that it will even result in a pregnancy, but it's a very common procedure: The Human Fertilisation & Embryology Authority (HFEA) states that in 2013, 49,636 women had a total of 64,600 cycles of IVF and ICSI here in the UK. According to Dr Allen Pacey, fertility expert at the University of Sheffield, that means cycles are "now performed more frequently than other well-known procedures, such as having tonsils removed". How often do we hear these women's stories? Be honest: How comfortable are you at the prospect of hearing mine?
Despite constant news stories, it's hard to find one woman's narrative among the clinical statistics and clumsy opinions that fill newspaper columns. I know: I've googled and throughout this two-month emotional and physical slog I've felt increasingly isolated. The outside world, at times, reminds me of the time my dad didn't know how to deal with my first period. It's awkward. Friends often aren't sure what to say. Behind closed doors, online messageboards quickly became my main source of real dialogue and reassurance. IVF, like infertility itself, is a whispered anguish. For many women, in vitro is yet another experience that is endured silently, without complaint.
IVF comes with a stigma. Mention those the acronym and judgements abound. 'She's left it too late.' 'It's unnatural.' 'It's a desperate last resort and the chances of it working are nigh-on-impossible.'
But wait: Let's look at the actual demographics. According to the HFEA, 43.7 percent of women who received IVF treatment in 2013 were aged between 18 and 34. We're having IVF while my husband undergoes chemotherapy, but it's worth considering that fertility problems affect one in seven heterosexual couples at any age. The number of single women seeking help has increased significantly, too – a 22 percent rise in just one year – and the same goes for same-sex couples.
Then there are the success rate stats: I'm under 35, fit and healthy, but I still only have a 32 percent chance of conceiving through IVF. Doesn't sound great, right? But here's a thought: for all those who have struggled for years to conceive naturally, that 32 percent is like holding one of Willy Wonka's chocolate bars. Yes, the probability is there may not be a golden ticket waiting for us inside and we're well aware of the challenging success rates, but at least we're back in with a fighting chance.
Speaking to Infertility Network UK's chief executive, Susan Seenan, I ask how we can shift the narrative away from the kind of negative language that makes so many of us feel judged, pressured and responsible for our own biological shortcomings: "IVF needs to be seen as a solution to a medical problem", he says, "with realistic links to success rates. It's not anyone's fault, no one is to blame for being unable to conceive any more than they are to blame for having any other medical condition."
A recent Guardian article entitled "A Day in the Life of a Fertility Clinic" followed a fertility unit in Oxford "on an out-of-town industrial estate", and picked up on this devastating blame game. In it, the nurse manager says: "They like the anonymity of this place. For many people, IVF is a sign of failure. It's not something they talk about, and they want things to happen in as discreet a way as possible."
Anonymity. I couldn't help but remember this word when I arrived at the Assisted Conception Unit for the first time two months ago, hidden at the back of the hospital between some shipping containers and the delivery loading bays. "Is this it?" I asked my husband. "I guess so," he shrugged.
IVF can be the loneliest journey if you feel you can't share and normalise it – when it becomes some kind of shameful secret. Just like me, most women arrive at clinic, undergo their uncomfortable transvaginal pelvic ultrasound, get on the bus and return to work. Hormone injections are a daily covert operation. Some women inject their hormones in their office toilet between meetings. Some, like me, get up at the crack of dawn with only a husband and the blackbirds as quiet witnesses. I'd never self-injected before and the process was traumatic. I lost count of the mornings I clumsily punctured my thigh, half-asleep, and yowled as the liquid hormone slunk in with a sting in its tail. I hid my "sharps box" for used needles in the airing cupboard whenever friends came over. I put up with the hot flushes and cursed the air conditioning. I blamed the painful bloat on last night's pizza and I laughed over the cracks. The needles stung and the bruises mottled me. Thighs swelled. I cried, I laughed, I cried again.
If there's one word that's synonymous with IVF and infertility it's "failure" and, believe me, I've felt it intensely over the last few months. The cruel nature of the in vitro process is that it sets you up to feel so many self-perceived mini-failures in addition to the giant-failure of having to resort to medical-intervention in the first place. For context, let's rewind to last month. After 14 days of single daily injections to suppress my natural cycle to give me, as the nurse kindly put it, "a mini menopause", a transvaginal scan gave me the go-ahead to double my injections each day. For the next fortnight I added a human follicle stimulating hormone that would hopefully boost me to produce enough egg producing follicles to rival my neighbour's clucking hens next door. Only, ten days of painful double-injections later and the follicles weren't growing. Failure. They upped my dose. Progress was slow and my exhaustion was beginning to make a simple trip to the Co-Op feel like wading through gelatinous mud. Failure. Over the weeks the doctors plotted my follicles on a graph like I'm some kind of underperforming science experiment. Failure.
When your body is the vessel and it fails to respond, find me a woman who doesn't chastise or blame herself in some way and I'll show you a fembot.
My IVF counsellor talked about the importance of "grieving" before I began my cycle. My loss is my inability to conceive naturally and the sense of bereavement is so deep that on some days it has threatened to consume me. Way back in 1949 Simone De Beauvoir asked "What is a woman? ...She is a womb..." and yet nearly 70 years later women are still defined as walking wombs and paying the price for the disservice. When our wombs fail us, we don't just blame ourselves: we question our womanhood. The pressure to reproduce perfectly before we hit 35 is daily media fodder. It's time the language changed and it's time we listened more.
As Susan Seenan says: "If you haven't been through infertility, it's hard to understand the emotional and physical impact, so people find they don't get the support they need from others who just don't 'get' the effect it can have."
Call me naive, but I hope I'll never see my IVF cycle as a failure, whether I succeed or not. And I refuse to stay quiet. I may have handed the keys to my ovaries over to science, but the control is mine.
Which leads us back to this moment in an operating theatre in south east London. Our tiny embryo is passed through a hatch. One doctor, an embryologist and two hopeful parents-to-be wait. We count together, 1-2-3, and a 4-celled wonder hurtles down a catheter and into my womb like a silent explosion on the ultrasound screen.
There is no failure. There is always hope.
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