And then – rejoice! – the sixth round of IVF produced a pregnancy. Kate emerged from the two-week wait without having bled, and when she took a test on the fifteenth morning, she did not cry but sat there, on the toilet, in a state of shock for several minutes. When she went back into the bedroom to tell Jake, they both burst into tears.
‘You clever thing,’ he whispered into her ear. ‘You clever, clever thing.’
But although Kate wanted to feel uncomplicated joy, she couldn’t. She was too aware of what could go wrong, and had been robbed by all her previous experiences of the ignorant bliss that is afforded other prospective parents. She wished she could be that naive, that she could unlearn all the unwanted and unasked-for knowledge that had been foisted on her by circumstance. But every time she went to the loo, she checked for blood, and every time she felt a cramp or a twinge, she feared the worst and had to confront, yet again, the essential truth that the world could fall apart with no warning.
Mr Abadi put Kate on steroids and blood thinners, which she injected into her stomach each morning just as she had done throughout IVF. The needles left pockmarked bruises either side of her navel like an astral map of some undiscovered galaxy. Everyone was telling her she was pregnant, but Kate didn’t feel pregnant. She felt no different. She squeezed her breasts, checking for tenderness. She longed to be nauseous at the smell of coffee. She wondered why she wasn’t as exhausted as the internet forums had led her to believe she would be.
In search of reassurance, she joined one of them with an anonymised username and asked whether you could be pregnant but not feel pregnant. The replies flooded in.
‘Wouldn’t worry hun. I didn’t have any symptoms until week 8 and my dd [darling daughter] is asleep upstairs. She’s five now’ wrote @ivfwarrior
‘Anxiety is 100 per cent a symptom!’ added @ttctlc
‘If you’re worried have a chat with your consultant,’ said @cyclingunicorn. ‘But it’s very early days, so try not to stress!! Get your OH [other half] to give you a nice relaxing massage! Put your feet up! You’re carrying precious cargo!! xoxoxoxo.’
The messages each came with a lengthy addendum underneath, in the style of an email signature. There, the women (and it was always women) would outline their own fertility histories in baffling detail, listing MCs (miscarriages) and BFNs (Big Fat Negatives) and numbering each failed IVF cycle, some with DEs (donor eggs). Within each footnote was a story of exhaustion and grief, reduced to a few minimal sentences, and after a while, Kate’s vision grew blurry and she shut down her laptop and went to bed.
She made it to week seven. Mr Abadi asked her to come in for an early scan, and she was scared but hopeful. Jake was outwardly confident, and told her everything was going to be fine, but she couldn’t believe him. When Mr Abadi placed the probe inside her vagina, she noticed the tell-tale seconds of silence before he spoke and she already knew it wasn’t good news.
‘There is a gestational sac,’ he pointed at the screen with his latex gloves. ‘But I’m afraid there is no embryo, Kate.’ He spoke with a gentle accent, his Ts sounding like stones skimmed over water. ‘We would expect to see an embryo at this stage, and what this means is the pregnancy has not developed as it should.’
‘Could it just be developing more slowly?’ Jake asked.
‘In the event of a natural pregnancy, yes, we could see that being a possibility. There is always some leeway around dates of conception. But in your case, we know exactly when we introduced the embryos, so …’ He shook his head. ‘I’m very sorry.’
‘It’s OK,’ Kate said, and then she didn’t know why she’d said it. Because it wasn’t OK. It wasn’t OK at all.
He talked her through the next steps. Either she could wait to miscarry naturally, although there was no way of knowing when that might happen, or he could give her drugs to induce a medical miscarriage. She opted for the latter, wanting now to be rid of her false hope as quickly as possible. The idea of carrying a dead thing around in her for an unspecified number of days and weeks seemed inhuman. Mr Abadi warned her the pain would be intense, that it would build to a climax in the first twenty-four hours, but then the worst would be over.
They went home and drank wine and the next morning, Kate prepared herself with a towel over the sheets and a Netflix box set. She turned her phone onto airplane mode and she placed the first pills up her vagina, as instructed. Then she waited. She took paracetamol. And waited some more. About two hours after inserting the pills, the cramping started. It was as if dirt were being excavated by an industrial digger from inside her womb. The pain was so severe she thought she might pass out. It came in waves, cresting and receding, and at one point she threw up into a basin. Jake, who had taken the day off work to tend to her, would come into the bedroom pale and worried, asking if there was anything he could do, but there wasn’t because Kate knew that to get through this, she had to go to a place where no one else would be able to follow her.
The pain surged in peaks for the next hour and a half and then it went away, becoming milder with astonishing rapidity. The bleeding got heavier and she did not allow herself to look as she passed clots and scraps of what might have been into the toilet bowl. She did not allow herself to think of what it represented. Of the names they might have chosen. Of the child they might have loved.
It took a week for the bleeding and the pain to subside completely. The experience had been barbaric. She was appalled that women went through this and angry that no one had told her and she knew, without doubt, that she could not endure this again.
Mr Abadi gently suggested that they start thinking of alternative options.
‘It’s been four years now, hasn’t it, since you’ve been trying?’
‘Yes,’ Kate said, thinking of how much had happened in that time and how little had been achieved. It seemed to have lasted forever but it had also gone by in a flash.
‘Donor eggs might be something you would like to explore, although, as discussed, you have some scarring in the womb that suggests you will not be able to carry a baby, Kate.’
Carry a baby. It was such an odd expression. You carried shopping. You carried burdens. You carried viruses.
‘So, depending on what feels right for your particular circumstances,you might want to consider surrogacy. Or adoption.’
When he spoke these words, Kate was appalled that her first feeling was relief. Relief that she wouldn’t have to do it again, that she wasn’t expected to keep trying and trying and then processing the terrible pain and sadness she felt when it didn’t work. She glanced at Jake, who was massaging the back of his neck, his face expressionless.
They thanked Mr Abadi, although Kate didn’t know what for. They walked out of the clinic, leaving the baby photos and the potted plants behind. Adoption had always been their final option, the thing they would turn to last, and it felt strange to have heard it voiced out loud as part of the next stage. They sat in the overpriced cafe and drank cappuccinos and ate the free amaretti biscuit that came with each cup.
‘How are you feeling?’ Jake asked. She was leaning on the table and she noticed he did not take her hands in his as he might once have done. The procedures had drained him too. His face had lost its ruddy complexion and there were horizontal lines across his forehead she hadn’t noticed before. The strain sat oddly with the rest of his body, which was lean and muscular. He had worked out more as a way of dealing with the emotional stress, pumping iron in the gym and going for long runs and boxing with a personal trainer every Thursday morning. He had invested in ever more sophisticated gym clothes: athletic brands that had to be ordered from America, with discreet yet noticeable logos, and mesh trainers with light soles intended to recreate the experience of barefoot running through the Masai Mara. He drank protein shakes and ate chicken breasts, leaving the skin on the side of his plate so that when Kate swept it into the bin, she felt silently judged by its goosepimpled presence. He looked great, objectively, but she missed the comfort of his softer chest. Now it was hard when she lay her head across his heart, and when he held her in his arms, his grip felt too tight.
Her own body had become alien to her. She had always been toned, with neat muscles in her arms from yoga and the faintest tracing of abdominals on the skin across her ribs. But now her belly felt flabby and filled with fluid. She was convinced her hips had spread morewidely. She hadn’t exercised regularly for months. She was sure that she was fatter and that the effort of becoming pregnant and the shadow effort of losing each pregnancy had left a physical mark. She didn’t realise until later that none of this was true.
‘Kate?’
She realised she hadn’t answered his question.
