The IVF Diaries: A Man’s View Of A Woman’s World
Part 2
Stick This One In Your Wife’s Butt
It was 8.07 pm.
We sat in the bathroom, Ludovico Einaudi softly serenading us through Spotify via our phones, lights dimmed, a towel placed on the floor acting as a makeshift doctor’s table, and a small candle perched on the bath quietly flickering away in an attempt to transform the anxiety-fuelled setting into a knock-off Lanesborough Spa experience for two.
Having a needle rammed into your skin is nerve-wracking at the best of times, let alone doing so on your own — without supervision — in the hope of eventually getting pregnant by initially stimulating the development of follicles into your system for the very first time.
Thoughts of fucking the whole thing up — setting the wrong dose on the purple ‘pen’ that looked better suited to a James Bond film, injecting it into the wrong place into Emma’s stomach, and even doing it at the wrong time — ensued.
Surely someone — a doctor, nurse, even my mum — would be on hand to check we were doing it right?
Alas, nothing; just Emma and I, who possessed the combined medical experience of the cardboard box our drugs had arrived in, sitting there hoping we weren’t falling at the first hurdle.
Fortunately, the onslaught of injections became less arduous and stress-provoking as injection number one turned into injection number ten which turned into injection number 87. Their relentless nature never subsided — towards the end of our fifth round of IVF, Emma was braving two injections a day along with eight other types of medication — but when you’ve learned how to mentally prepare for the task ahead, where to place the frozen edamame beans on your body to numb the skin, and the degree of force required to slide the needle in without leaving yourself in a pool of blood on the floor, you accept your daily morning and evening injection schedule — and looking like a sparse reduced-price freezer section in Sainsbury’s — like you do brushing your teeth.
We were undeniably one injection away from earning an honorary medical degree in anaesthesiology by the end of the recurrent ordeal.
Emma had insisted on performing the injections on her own, a decision that left me perched on the toilet seat, providing pep talks Neil Warnock would have been proud of and wishing, willing, and urging that needle to slide seamlessly into her skin without trouble.
While some women get their partners to do the injections for them, it can often seem, as the man (or other woman, of course), you’re consigned to the substitutes bench — or toilet seat — in this whole process, left to proudly put the packaging in the bin as if your life depended on it, and occasionally having to open YouTube to figure out how the fuck to get the solution into the needle.
At times, you wish you could do an injection yourself just to remove some of the distress; at others, you’re simply thankful you’re not the one experiencing the headaches, bloating, soreness, discomfort, and hormones running riot through your body.
Emma’s body had been battered and bruised by needle after needle and injection after injection by the end, often winding up looking like a used archery target in amongst the contusions and swelling.
There were injections in the morning, injections in the evening, injections in the right side of the stomach, injections in the left side of the stomach, injections to boost follicles, injections to prevent blood clots, injections to control ovulation, injections at specific times of the day, injections with needles that looked like she was shoving a cricket bat into her body, and, I swear, injections just for the sake of fucking injections.
She’d do injections at friends’ houses, injections at restaurants, and injections at weddings. She crammed needles and medication in her handbags — many, many handbags — and would set about mainlining herself in toilets and hotel rooms between courses of mushroom risotto and chocolate fondant every weekend.
We often felt like covert agents sneaking off to secretly enlist in undercover missions at weddings while everyone ricocheted off friends and family during boisterous remixes of Hava Negila, but nothing would stand in the way of us implementing the necessary steps to ensure Emma’s hormone levels, eggs, and embryos were receiving the right level of drugs they required to succeed — even if it did mean missing out on grace after meals on occasion.
We’d slink back into our seats upon completing our task as if nothing had happened, as though sheltering our secret endeavours from the masses would allow us a momentary escape from the hardship that now defined our lives.
On our fifth embryo transfer, I was forced to take the reins. As a married man of five years, it’s only natural to get excited at the words, ‘You have to stick it in your wife’s butt’; alas, to find out you’re stepping up because your wife’s arms aren’t long enough to inject herself in the upper right qudrant of her glute and it’s a measly needle filled with nothing but progesterone in oil is slightly disappointing.
This particular form of medication was the most painful Emma had experienced; her bum cheeks needing freezing to the point of paralysis to temper the sharp pain of the needle, her skin turning a red only reserved for that of a makeshift Elmo costume, and a dryness, itchiness, and achiness that meant she waddled around the house like an eighty-year-old woman by the end of each day.
I felt guilty. Very guilty. Alas, at least my newfound injection-taking skills were worthy of decorating my LinkedIn page.
Each time we’d order a new batch of drugs, a crammed cardboard box would arrive on our doorstep delivered by courier; the Deliveroo-vibe of it all somewhat baffling.
An extensive scientific process with seemingly more logistics and intricacies than that of building a space shuttle, but a care-free and lackadaisical nature to shoving indispensable — and expensive — pills and solutions onto couples who can barely pronounce their spelling-contest-like names, let alone be trusted to handle them appropriately.
How was this legal, let alone safe?
We’d additionally be presented with pieces of paper with colourful grids and boxes by each clinic, detailing the doses and times certain medications were meant to be taken, along with the names of drugs that made no sense other than appearing to be one vowel away from adorning the back of the shirts of the Armenian national volleyball squad.
Some drugs lived in the bathroom, some in the fridge. Some were injections; some were suppositories. Some were straightforward; some were not. The ones delicately placed in the fridge looked cute next to the courgettes and pickled cucumbers.
If you think IVF is as easy as binding sperm to an egg and pulling a baby out of a hat, you’re mistaken.
The injections, tablets, and pharmaceuticals aren’t really mentioned in the cogent IVF holiday brochure. While visions of scientists, laboratories, and babies are anticipated, syringes, pens, vials, and Lubion Subcutaneous Kits aren’t. Headaches, lethargy, and bloating are buried in the small print of each intervention, and the relentless worry and anxiety that arrives with undertaking and performing medical procedures are concealed behind sure-fire promises of photoshopped babies on persuasive advertising boards and website testimonials.
I luckily, however, now know how to spell progesterone.
There exists a continual nagging doubt as to whether what you’re doing is actually worth it. Are we being conned into parting with thousands of pounds simply because we believe this particular clinic knows what they’re doing? Do the ever-changing consultants, nurses, and specialists we’re meeting with every week know anything — or even care — about our situation? Are they providing us with the right type and amount of medication?
We’d stumbled upon our first fertility clinic through nothing but a passing recommendation from a gynaecologist. Emma had subsequently scoured the internet for reviews, like she does when we consider what Air BnB apartment to rent — although this, perhaps, taking on more significance than whether the bathroom has a wall mount, rainfall, or handheld shower head — but given this particular clinic had the words ‘IVF’ plastered all over their website and according to Google maps was a 6-minute drive from our house, we signed on the dotted line with little thought for whether this was the right fit for us.
‘Damn, think of the money I’ll save on petrol’, I thought.
After our third failed transfer, mired in perpetual disappointment and frustration, we eventually changed facility, hopping on and off the IVF clinic open-top bus, hoping this particular stop — albeit a now 45-minute drive from our house — would grant us a different view of the infertility tour we found ourselves on.
‘Damn, think of the money I’ll now have to spend on petrol’, I thought.
Our frozen embryos tailed us by courier to our new fertility home— closely followed by the fifteenth fucking Zara package making its way to our front door that week.
There doesn’t appear to be an industry standard with each IVF journey, each clinic providing a different outlook on how to coax couples towards their destination, like two different contestants on Countdown getting to the same mathematical answer with varying routes of adding and subtracting. Some prioritising holistic approaches, others pushing non-medicated cycles; some offering different waiting room coffee machines and others supplying better porn magazines than others.
You merely hope the relentless consultant appointments, various protocols, and differing opinions get you there somehow, each diverse perspective suppressing those hounding reservations that plague your every move and decision.
Of course, you’re only truly content when you reach the finish line. You hold onto that specific protocol, marked with those exact drugs and timings, and quietly say to yourself, ‘That was what worked for us.’
It’s just a shame you must face the onslaught of consent forms, appointments, failings, different clinics, various doctors, and hundreds of nurses to actually get there.
The Question
Emma and I find ourselves out for lunch one bright, Saturday lunchtime. Halfway through devouring a jackfruit bao bun (not a typical item on the menu of the places we frequent, it’s worth noting), an elderly lady approaches our table, vociferously claiming — as one does — I look just like her grandson, Timothy.
Emma and I, polite as ever, nod along, feigning interest in her alleged grandson’s escapades at Cambridge University and — much to her excitement at informing us — her apparent incomprehensible wealth.
‘Who the fuck is this woman, and why is she ruining my bao bun eating experience?’ I ponder.
Then, unexpectedly, The Question.
The question to end all questions. The question no one — not even those who can get pregnant — wants to hear. The question that serves no place in human interaction, a query so naïve and abrasive it should be banned from all forms of communication — sliding into DMs included — whether delivered with innocence or not:
‘So, any kids on their way soon?’
I’ve practiced this a thousand times in my head. The answer I want to give to a question so provoking it strikes a dagger through your heart, even before you’ve learnt you’re unlikely to conceive naturally. I want to hurl these words right back at such an asinine line of enquiry with such force it leaves a gaping hole in the interrogator’s self-respect and apparent lack of embarrassment.
‘Unfortunately, not. Do you know how fucking expensive IVF is?’
That’s the repartee — accompanied with my semen analysis pdf and IVF invoice on a ‘go fuck yourself’ platter — I so desperately want to serve back. A question so ignorant, distressing, and intruding it deserves an answer of equal asperity.
Enquiring into a couple or individual’s plans for pregnancy isn’t akin to asking someone’s age, salary, or sexual orientation; these don’t evoke feelings of true sadness or pain, like intentions — and potential failings — for making a baby do.
It hurts, regardless of your ability to fall pregnant — a lot. Not everyone wants a baby, nor has had the chance to create one yet. Not everyone is mentally in the right place to have a baby, nor wants another baby. Not everyone is in the right place physically to have a baby.
Not everyone can have a baby.
When plagued with infertility, it’s excruciating when faced with The Question — a solemn reminder of the gaping hole burning through your life from the inside out. You want to scream from the rooftops that you’d like nothing more than a baby launching that bao bun halfway across the restaurant while simultaneously shitting their pants on the plush leather sofas you’re sitting on.
And from ‘Timothy’s grandmother’, a woman I’ve known long enough to know she’s able to ruin my bao bun eating experience? No, definitely not.
Alas, I respond in the way only a polite Northwest London Jewish boy knows: with a brave smile, a muted façade, and the two simple words, ‘Not yet!’
It’s the only way you can reply. It’s the only way you can suppress those true feelings surrounding such an innocent yet hurtful query and come out of the situation with any level of dignity.
Timothy’s grandmother assumes she must assuage our supposed waiting by explaining it took her three years to fall pregnant with her first child and a further eight with her third.
Thanks. Thanks a lot.
These questions, passing comments, and cavalier remarks never let up. They arrive from all angles: work colleagues, clients, friends, and random men and women who barely know your birthday, let alone your views on pregnancy. Of course, these arrive from a place of sincerity, like asking someone what they watched on Netflix last night, but seldom are they worth the breath required to articulate them.
I get it: children are the logical next event in the line of life events following engagements, weddings, and getting your front patio done; asking The Question is a perceived show of affection, curiosity, and interest in someone’s life. It seems the chivalrous thing to do.
Given IVF is discussed as much as periods, sexual kinks, mental health, and embarrassing illnesses, it’s only reasonable to see why these curt utterances are banded around with such absent-mindedness. People simply don’t know. If you’ve never experienced the story of IVF, know anyone who’s weathered the quest, or even know infertility is a thing, why would you know not to ask? Why would you avoid The Question?
If all you’ve ever known is pregnancy being as straightforward as wiping your arse, how can we possibly expect people to traverse the topic with the understanding and empathy the infertile seek?
My advice: avoid The Question at all costs.
It doesn’t need asking. It may seem like you’re making conversation, showing interest, and displaying endearment to the ones you love, but chances are, it arrives with more issues than it’s worth. You don’t know what’s going on behind the scenes; what potential pain or turmoil certain couples are going through, or whether certain people even want children.
The majority of the time, The Question may be a fair question to ask; unfortunately, the one time it isn’t, it will only serve to create a lasting and painful memory in your relationship with that individual. I can quite clearly remember every single person — and the exact circumstance — who asked me when I planned on having kids, and I still hold a little resentment towards them for doing so.
Think it, by all means — we all have — but don’t confront those with no children — or even those with children — with it. Keep it to yourself until you’re in a quiet corner, maybe don’t have your phone to scroll through, and have nothing better to think about.
I promise you, The Question — any question surrounding children, in fact — doesn’t need even considering, let alone asking.
Why The Fertile Just Don’t ‘Get It’
There’s a certain stigma surrounding IVF. No one talks about it. No one knows how to broach the topic, nor knows what to say when unexpectedly faced with the difficult conversation.
The pain runs too deep in those going through it; the discomfort of discussing it too delicate in those who aren’t.
While the odd Instagram account detailing an IVF journey, a rare poorly-edited podcast sharing personal stories, or short novel shoehorning the process into the storyline pops up, the world of infertility is shrouded in secrecy.
Failing to get pregnant is often viewed as shameful. That no one in the billions of years the world has existed has ever experienced the same failures as you. That you’re a little bit fucking shit for not being able to continue the human race as easy as it is losing the TV remote control for the eleventh time that weekend.
It certainly felt that way, which is why we were apprehensive about sharing our newfound situation with others at first. I barely like people knowing my name, let alone the fact my sperm have the mobility of an ever-aging Harry Maguire, so sharing such personal information — and the risk of the whole of the North West London Jewish community knowing so along with it — didn’t sit at the top of my priority list.
While our parents inevitably knew from the outset, we slowly filtered the news through to immediate family — and eventually a few friends. Emma was more willing to share what we were going through with others as the heavy infertility storm rolled on; I, however, a man who likes to barely acknowledge the existence of any additional emotions beyond ‘Get in, QPR won this weekend’ or ‘Fuck, QPR lost this weekend’ — let alone discuss them in any great detail — was reluctant to entrust the information with others, and was quite content keeping the conversation limited to Curb Your Enthusiasm clips and Sydney Sweeney’s boobies with friends instead.
Admittedly, we couldn’t continue keeping such a secret from our closest circle of support, lying about why we couldn’t see them one evening and why we literally didn’t give a fuck about their job promotion. Our muted responses of, ‘Oh, nothing much’, when asked how we were concealed a much darker secret.
The truism, ‘you really don’t know what’s going on in people’s lives,’ none more so prominent than now.
It’s no secret that men bear the stereotype of bottling emotions up or ‘getting on with it’, and I most certainly fall into such a category. While I’ve no doubt there exists psychological ramifications and potential future problems with adopting such a hard-lined approach to dealing with the complex tree of life’s plights — and not talking about things — I also think it’s actually OK to be OK.
We don’t always have to search for fashionable mental health issues to analyse or say we’re ‘struggling’ just because it looks cool on social media. Men don’t have to shirk away from the struggles of failing to get pregnant, nor disregard the colossal mountain we have to carry on our backs to support the ones we love, but we, similarly, don’t have to admit to feeling feelings if we’re actually the strong, resilient, supportive beings we’re meant to be.
You can feel the pain of infertility but also be accepting of it, too.
Plus, Sydney Sweeney’s boobies are nice to look at.
You’d assume friends would be the calling card needed to navigate the heart-rending process of an infertility experience. They’d be a shoulder to cry on, a WhatsApp conversation to click on, a phone call to engage in, or a body to hug.
Much like they say you should never meet your heroes, however, it became apparent you shouldn’t rely on friends to help you through an IVF journey.
Emma quickly discovered that infertility support, unfortunately, came in scattered spurts and often with the comfort of a sodden sock in a wet shoe. People thought she could rely on let her down; the relief and reassurance she desired left ashore. Perhaps — and she’s admitted this — her demands were too high; perhaps she was expecting too much, and she assumed others cared more about her situation than she’d have liked. But, often, the words she needed to hear, the protection she sought, and the calming advice she fiercely desired were nowhere to be found.
Which was hard. Hard, when the people she thought she could count on — the people she needed — left her stricken and alone, like stripping her naked and leaving her wallowing in the middle of a cold Bushey High Street, which, for those of you who know Emma, is undoubtedly her worst nightmare; far worse than crossing paths with Russell Brand in a dark alleyway on a Tuesday night.
Lines such as ‘I wish there was something I could do’ offered the comfort of a visit to Carandiru Penitentiary, and the all-too-familiar ‘I don’t know what to say’ left you wanting to rub that particular person’s face down the side of a cheese grater.
Hot Tip: Don’t ever fucking say, ‘I don’t know what to say’.
Others, unfortunately, went to other extremes and sounded like they’d been mouth-fucked by The Secret: ‘Just stay positive; you must believe it will happen!’ which was nothing but — positively — infuriating, let alone unhelpful.
Messages never came, and words at the right times seldom emerged. Emma often felt like she was battling everything on her own, like trying to shift a twelve-tonne truck with the strength of a butterfly wearing slippers.
People became too scared to say the ‘wrong thing’, often working themselves up to a level of anxiety that meant they ended up saying nothing at all. They couldn’t face dealing with a sobbing Emma or having to confront a situation filled with negativity and discomfort, so they neglected to address the situation at all.
When people can’t relate to a situation, they shirk away from even trying to relate to it at all.
As the protracted journey dragged on, Emma relentlessly sought a new voice to talk to seemingly every other week, hoping — praying – that this was the supportive and loving friend she’d stumble across that would be there for her in her time of need.
Luckily, she has a lot of friends — although, not so lucky when you’re invited to eighteen fucking weddings a year.
Towards the end of her journey, she had finally assembled a small, dedicated and compassionate network she could lean on — our own team of superheroes. These were the true friends and immediate family who knew what to say, knew how to act, knew how to listen, and knew to send us chocolate and dinners in the post. It just was a shame she had to work her way through her never-ending list of Facebook friends to get there.
It’s worth noting this, categorically, isn’t a slight on those unschooled and ignorant to the situation; those who couldn’t meet the sky-high expectations Emma possessed. How the hell were they meant to know what was going on behind the scenes? What was happening every morning and evening while we crammed used needles into sharps bins we kept neatly tucked away in the bathroom cupboard? What we were feeling every time a friend announced their pregnancy, or we had to endure the devastation of another failed embryo transfer?
My own knowledge of IVF prior to starting was as extensive as my knowledge of the rich history of trainspotting, so expecting others to know the ins and outs of what was going on and the feelings Emma experienced all day, every day, was foolish.
How were they meant to know what to say?
And, because of this — because no one talks about IVF and injections and pain and failure — people’s views on the process are distorted.
They just don’t ‘get it’.
When we’re told of IVF, we’re told at the end. When there’s a happy, smiley baby to cuddle and everything is alright with the world. We assume people struggle to get pregnant, they turn to IVF, and a baby appears through the art of witchcraft and wizardry. We conclude the process is as flawless as checking out a Sainsbury’s online order, and drugs, medical procedures, time, and feelings don’t occur.
We infer the toil and heartbreak barely exist, scarcely registering that, in fact, it’s all that exists.
Why do people feel the need to check in, ask how you’re doing, or provide support when, well, they’re unaware of even a small percentage, let alone half, of what’s going on?
I have no shame in admitting that, should I not have borne this unwanted experience, I would have undoubtedly displayed the same ignorance and disrespect to any of my close friends going through the same journey. I, too, would have been the one letting friends down. Fortunately, I now possess the understanding and empathy of the struggles people now suffer, and I make it my priority to check in, message, and support those living with such hardship — men, importantly, included.
It’s a shame that we’ll only ever truly understand the struggle when we endure the struggle.
It was striking how little support and words of compassion I received throughout. I’m not necessarily saying I wanted those words of support and compassion — I typically replied with the words ‘I’m fine, thanks!’ on the rare occasion I was asked — but it’s scary to think how little regard 50% of the partnership is held in.
Yes, Emma braved the majority of the journey — both physically and mentally — but that’s not to say men aren’t bearing the weight of such an unpleasant experience, too.
As we delved deeper and deeper into the world of infertility — and quickly became known as ‘The Ones Who Struggled To Get Pregnant’ amongst our wider group of friends — it became both apparent and shocking to discover how many other couples were experiencing — or had experienced — infertility struggles. People would come up to me at weddings, eager to tell me their current story; people would slide into Emma’s DMs explaining their situation and seeking help, while others would nonchalantly say, ‘Oh, we had fourteen rounds of IVF, too’.
It’s why I can guarantee that at least one of your best friends, one of the couples in your circle of friends, one of your family members, or someone you know of has played some part in the ongoing infertility epidemic.
It’s why I truly value the teaching of this process and all that goes with it. It’s why I’ve learnt to always reach out to those in their time of need. It’s why I’ve learnt that infertility isn’t a topic to be swept under the carpet.
While everyone handles their infertility — or even other related traumatic — experience differently, all people often require is a check-in. A simple, ‘How are you doing today?’ An understanding, ‘I know, it must be awful to feel this way.’ A compassionate, ‘You will get through this, I promise.’ A straightforward, ‘Good luck for the scan today.’
People going through IVF don’t need the world.
They don’t need a therapist’s psychoanalysis, a full-blown counselling session, or a forty-page cognitive behavioural therapy dossier breaking down how best to change thoughts and emotions. They just need you to say something. Something, regularly, to fill the air and assuage those fears, doubts, and relentless pain.
They need you to embrace the discomfort of talking about something so painful, to fight through those awkward moments and be prepared for them to potentially break down in front of you. They don’t want you to hide from those occasions. They also need regular meals cooked for them.
While I don’t think the fertile will ever ‘get it’, I firmly believe we can all do that little bit more to help them take one small step closer to getting it.
