Natural pregnancies after IVF
One of the hardest things to hear as someone who has endured years of infertility and resulting fertility treatments is, ‘You might get pregnant naturally now. I’ve heard it happens…” And while I know it comes from a place of hope, it can feel like everything you have been through has been totally minimised; like the enormity of what you have experienced has been completely lost and swept aside.
Of course we have all heard at least one story, so it can happen, but one successful pregnancy sadly does not guarantee another. It still only happens in around 15-20% of cases, and often only in younger women with a shorter duration of unexplained infertility. Where there is a definite reason - and one which can’t be resolved - such as refilling your knackered out ovaries with a glut of healthy eggs, it is highly unlikely to… and to suggest it will, just seems incredibly insensitive.
The reason for my own infertility is that I have an extremely low ovarian reserve. When I was 34, my amh levels were just above negligible. For the uninitiated into the world of infertility, amh is a protein hormone produced by cells in the ovary and one which can help assess ovarian reserve.
So if they were negligible at 34, now at the age of 40 I dread to think what they would be. At a recent gynaecologist’s exam, I also only had 3 visible follicles on my ovaries, where for my age group the average would be 9.
A second chance
At a time when all around me second babies were being born and conceived, I had been struggling with not being able to have a second child without IVF using donor eggs, or the process of adoption. I wasn’t sure either of those options would be right for us as a family - a huge part of that decision being the emotional toll it takes. I knew what IVF had taken from me last time and I ultimately felt we were blessed to have Jude.
As much as a sibling would be wonderful for him, and part of me felt I was selfish not to at least try to give him one, I believed in my heart that having a happy and present mother at such a crucial time in his little life was more important.
I couldn’t guarantee that the gruelling treatments wouldn’t have a negative effect on my marriage or relationship with the precious boy I already had, so I had been making my peace with the fact that our little family was already complete.
Yet not long after this, at the start of March, I tested positive on a home pregnancy testing kit.
To say I was blindsided by the glaring cross on the test would be an understatement; in fact just buying the test had seemed ridiculous. But the cross was definitely there, immediately, and I was excited and hopeful. It felt like this tiny ball of cells was destined to one day be in our arms, and teased and loved by it’s big brother. It had somehow got there above all odds and felt like it was meant to be. If Jude was our miracle, this one was even more so.
I made a card with Jude for an early Father’s day surprise, and in it included a photo of Jude holding the pregnancy test. It was such a different experience to finding out you are pregnant following IVF treatment, and no matter what happened beyond that, we will always feel blessed to have had that moment… and after years of feeling like my body had let us down, it felt like all of that could be erased.
But it wasn’t to be.
Not long after that, crippling anxiety set in. I was 40, miscarriage rates and further complications are sky high at my age, a lot higher than my chances of getting pregnant in the first place, and continue right throughout the pregnancy.
I hadn’t been taking folic acid, I had been drinking alcohol and eating rare meat and all the things you are not supposed to do. My pregnancy with Jude was a very difficult one, with multiple episodes of bleeding culminating in a premature birth, but I had at least started out on the right path. With this one, I had not and I was gripped with fear.
A tiny heartbeat
Still, when I was around 7 weeks pregnant, we had our first ultrasound as is the norm here, and there our tiny dot was, with a beautiful flickering heartbeat. We had a vague due date: somewhere between 15th - 20th November, and a photograph. It was really happening. In spite of my fears, my doctor told me that it was a gift and I needed to trust my body. I tried to believe her.
When we were already overwhelmed with gratitude for having Jude in our lives, and so many others were out there still struggling to become parents, close friends included, we couldn’t believe the universe would deem us worthy of being this lucky. Yet when the all day nausea and vomiting set in not long after, I began to believe it.
My mindset began to change. Maybe it wasn’t our luck this time, but Jude’s? Didn’t he deserve a sibling? Someone to help guide him through the muddy waters of this life. Someone to play with, laugh with, conspire with. Someone to be by his side when we cannot be there to help him. Didn’t he deserve that? And so, I began to hope that this tiny dot was meant to be after all. If not for us, for him.
Certainly the symptoms of this pregnancy were no different to the one I had with Jude, so I started to make a list of names, we planned out sleeping arrangements for our TWO children and I was reassured by my jeans getting tighter, my overwhelming fatigue, sickness and increasingly tender boobs, all which seems foolish now.
Loss
Not long after our ultrasound, my husband’s Mum died very suddenly and my husband had to fly home to be with his family. My panic set in again and that night I had a dream that I saw my baby on an ultrasound with no heartbeat.
As much as I tried to convince myself it was a reaction to the shock, not long after that, my nightmare would become our reality.
Not long after that, at our second ultrasound, I would lie there looking at our tiny dot - bigger this time - searching for that beautiful, flickering heartbeat. But there wasn't one. Just a blank white void of emptiness.
I would wonder at which point my husband, struggling to contain a rowdy two year old in his arms, and who had just lost his mother, would realise he had lost his future baby too. Yet I knew as soon as I looked at the screen. I didn’t need to wait for the doctor’s kind hand reaching for mine, or the sympathetic look in her eyes. I already knew.
A missed miscarriage
Our baby had stopped growing at 8 weeks, but since this was a case of a missed miscarriage and my body hadn’t recognised the pregnancy was no longer viable, my doctor advised a D&C procedure.
The added complication was that we were due to fly out the following day for the funeral and wouldn’t be returning until later the next week.
There was a very real concern that my miscarriage could start naturally in the coming days, and I didn’t want that hanging over our heads while we were away. We had enough to deal with.
My doctor had told me that I could expect to pass a lot of blood, large clots and experience a high degree of pain. While this can be cathartic for many, and might ordinarily have been for me, the thought of going through that at the same time as a funeral, or while on a flight was unbearable.
The doctor understood and phoned the clinic, pulling some strings. I could go immediately. All I had to do was hand over a slip of paper with the doctor’s name on it, and someone would be waiting for us.
And they were.
The hospital was beautiful, ironically the one I had chosen to give birth in. Shortly after arrival I was taken to a room with a view that would rival those of many 5* hotels. It was going to come at a price; in Switzerland any costs related to a pregnancy or miscarriage before 12 weeks, are not always covered by your medical insurance. But I didn’t feel I had a choice.
At best these situations are beyond confusing and full of despair, but when you are trying to communicate in a different language it is infinitely harder. Despite this, I felt nothing but incredible kindness and compassion from all the medical staff.
We may have struggled between each other with our words, but they were incredibly tactile and it was of a huge comfort, especially at a time when I was so far away from home.
The procedure itself was quick and painless; I experienced mild cramping and some bleeding similar to a period afterwards, but I didn’t feel groggy from the anaesthetic. Instead I felt an odd sense of peace and an uncomfortable relief...and all I wanted was to wrap my arms around my beautiful smiling toddler, who was oblivious to it all.
This pregnancy was so very wanted. I had dreamed of it and hoped for it when I knew deep down it would be impossible. I had vowed to be more relaxed and less anxious and embrace every moment with positivity should I ever be so fortunate for my dream to come true.
But I couldn’t do it.
Instead I had put my life - and Jude’s on hold with anxiety and awful sickness. I had failed to be fully present for my husband when his mother died because I was so caught up in the fear for our unborn baby.
Moving forward
My texts to the handful of people I told were heartbreaking to make, but filled with strength and positivity. I was allowed to go home a few hours later and insisted we went to a food festival on the way home. Life had to go on, for Jude…but also for us.
I threw myself into packing for our trip, getting hung up on which cars to take for Jude, and how many pairs of knickers I should take given that I didn’t know fully what to expect from the bleeding over the next few days…and then I went to bed.
But instead of sleeping, I carried myself off to the spare room with Mabel. My Mabel with her beautiful soul, who had stayed unusually glued to my side for days, sniffing my growing bump, and I broke.
I listened to Jude crying out for his ‘Mama’ in the night, and I ignored him.
I didn’t know how to comfort him, when I was breaking.
Recovering
The next day was hard. None of us had really slept and we had a long day ahead of us. Jude was sick and we had to finish the last bits of packing and get Mabel to the dog sitter’s.
Physically I felt fine. There were virtually no side effects from the D&C - the mild cramps were subsiding, as was the bleeding. I no longer felt much morning sickness, which did help, although later each disappearing pregnancy symptom would put me further and further away from what had been, which in turn made me hurt even more.
Emotionally though, I was feeling a lot more wobbly than the day before when everything had happened so fast and we hadn’t had time to process any of it.
It’s hard to explain being pregnant and nervously awaiting your next scan at 10.30 in the morning, imagining that you will at last have some positive news to share with relatives when you go home, to by 3pm in the afternoon having been under a general anaesthetic to remove all traces of your pregnancy.
The day before I had thought I was coping okay but in reality I had just been overwhelmed with the sheer enormity of it all. Over the coming days I could anticipate a lot more of these emotional wobbles.
Not long after we got to the airport, Jude vomited all over himself. I’d never seen him as ill and it felt irresponsible to be flying with him, for him and the other passengers, but we didn’t have much of a choice.
We couldn’t leave him in Switzerland, and we couldn’t not go to my mother in law’s funeral, although nor could I get my head around going to my mother in law’s funeral when I was also grieving for the loss of my baby.
If that day was hard, the days following that were harder. I couldn’t stop seeing our tiny dot, with it’s unbeating heart. I couldn’t shake the image of the stillness on the screen. Or the silence around us. Being in the half dark was the worst as it seemed to mimic being in the ultrasound room again.
During the day it was easier to keep distracted but the nights were the hardest and that’s when the thoughts haunted me: was it my fault? All the baby had ever known was fear, why would it want it stay? How could I find my peace again?
Knowing that it wouldn’t ever be possible, although I desperately wanted another child, I didn’t ever let myself fully imagine what our lives would be with one. It seemed too painful to imagine. Yet now I had been there… I’d seen a different kind of future and I wasn’t sure how I could come back from that. I’m still not.
Going back home to Switzerland felt harder still. The period of limbo was over. Normality will have to resume... but I feel changed. I’m not sure what our normality looks like anymore and every time I look at Jude, I feel beyond sad that his chance of a sibling has been taken away. I feel selfish for bringing him into the world knowing he would be an only child.
As incredibly hard as it is though, and the sense of loss a tangible ache, it has not been as emotionally devastating as when our first IVF failed. It may be that we have had so much loss to deal with at the same time, and starting to process it all hasn’t happened yet: it’s difficult to know where to even begin.
But I can wake each day and put one foot in front of the other, albeit a bit less confidently than before. When our IVF failed, I couldn’t do that. It completely floored me.
It has not been as flooring as that - and the reason is Jude. He may always be an only child but we are incredibly lucky to have some amazing friends and family who will be by his side, just as much as they are by ours.
This time I do have a babe in my arms, not just in my heart, and if anything is going to get me through this, it is that… and that on some level, maybe our loss has spared someone else the pain. Maybe the universe might just have given the viable embryo to the right person this time. Who knows?
Enduring a miscarriage is never fair, but I can’t allow myself to get sucked into the darkness. We have Jude and he is our hope.
I am 1 in 8•
I am 1 in 4••
but I am more than a statistic and there is hope.
There has always got to be hope.
•women who suffer from infertility
** women who have experienced a miscarriage