A MONTH AFTER the operation I’m in Dr. B’s office, snow jacket limp on the back of my chair. Outside, large-scale things are happening. Russian tanks are threatening Crimea. Greece is bankrupt and thinking of leaving the EU. Edward Snowden is in Hong Kong, scattering national secrets and the Scots are deliberating on whether to secede. In here, however, there is only one headline and that is that after weeks of monitering, my eggs are ready. This is it, says Dr. B. I can come in tomorrow and, after waiting for an hour for the sperm to defrost, finally get this show on the road.
“Oh,” he says, seeing me to the door. “One other thing.” And he asks if I’d like L to be present when the insemination takes place. He shrugs. “Some people find it nice to involve their partners.”
For the last few weeks, everything at the clinic has been blissfully dull. Fertility treatment is repetitive. You sit in the same reception area week after week, waiting for your name to be called. You go to the blood room, roll up your sleeve, offer your arm, make conversation with the nurse, go in for the ultrasound, make conversation with the nurse, go back to the waiting room, wait to be called by the doctor and finally go in to discuss the prognosis. In between these engagements, you watch TV in the waiting room and listen to the receptionist as she shouts, “YOU GOT YOUR PERIOD? OK, COME IN TOMORROW” down the phone, roughly once every six minutes. It takes me an embarrassingly long while to realize that each time this happens, another poor woman’s hopes have been dashed for that month.
The point of all this activity is to ascertain, to within a twelve-hour period and by measuring estrogen levels in the blood and follicle size via ultrasound, when ovulation is about to occur. I hadn’t even known, prior to this, that a woman is fertile only for a handful of days every month, nor that sperm can live in the body for up to five days. Now there is no corner of my fertility, no fluctuation in my blood, that can slink past the doctors unmeasured. There is still an element of guesswork; it is possible for the doctors to overshoot and miss ovulation, which doesn’t preclude a pregnancy, but is seen as a professional misfire. Otherwise, everything builds toward that perfect point in the month, the day before ovulation and the patient’s most fertile window: Insemination Day!
First, however, I must survive this moment with Dr. B at the door. Being tied to a schedule this month has been such a relief that I forgot there are still things to decide. The thing is, says Dr. B, that fertility treatment, particularly when there’s a donor element, can be hard and excluding, and involving the patient’s partner in the treatment room, even to the extent of inviting him or her to operate the syringe full of sperm, can give that person a feeling of inclusion. I feel myself blush. Clearly, he’s in favor of L’s being present, either because it gives him a warm, fuzzy feeling or to neutralize some latent ambivalence he has about helping to create single mothers. I try to imagine the scene: me, stressed out and half naked on a gurney; L, holding the catheter and rolling her eyes; the medical staff, milling around trying not to intrude on our beautiful moment. I don’t think I want her there—I don’t want anyone there; it’s embarrassing—but when I imagine asking L if she wants to be involved, I realize I don’t want to give her an opportunity to say no, either.
“Er, no, thanks,” I say.
“OK,” says Dr. B, maintaining eye contact for half a second too long. “As you like.”
In different circumstances, perhaps I would go in for the whole honey-you-detonate-the-plunger thing. Clearly it makes the doctors feel good and is helpful to some couples. And symbolism matters. The baby is learning to talk at the moment and he calls me Emma, or Amma, or sometimes, through early name confusion, Mamma, which makes L cross, a response I think of as ungenerous until years later, when one of my daughters goes through the same phase, and when she calls L Mummy I can’t stand it—can’t STAND it—at which point I have to laugh and acknowledge we have both been absurd. But these signifiers matter. They shape how we see things, how we decide where one of us ends and the other begins, and on that basis alone, having L involved in the insemination seems wrong. We are not doing this together. She is not my coparent. The symbolism needs to reflect that.
There is a cold, mean streak in me that thinks trying to involve the partner in the treatment room is ludicrous under any circumstances. Surely there’s a dignity in allowing things to be what they are? In recognizing that even if the doctors hand out cigarettes after the insemination, this is and always will be a medical procedure that involves only one half of the couple. Pretending otherwise—grafting on a parody of the “normal” way of doing things—risks making the treatment seem sadder, just as choosing a sperm donor will continue to feel sad, or bad, or weird, as long as it’s tied to conventions associated with choosing a spouse.
“Hello, hello!” says Dr. B, breezing in. It is a week before Christmas and he is full of good cheer.
“Hello!” I reply brightly.
“So! What’s going on? What’s the gossip? What’s the news about Edward Snowden?”
“I could tell you, but I’d have to kill you,” I say weakly. While Dr. B moves around the room, assembling utensils for the insemination, we talk about Russia, and Greece, and then Scotland comes up and I stop blandly going along with his views. “It would be lunacy if they left,” I say.
“Not at all!” he says, holding up the vial of sperm, for me to check the details on the label. “They have the oil money, why shouldn’t they want independence?” He asks me what I think about Ukrainian sovereignty and I try and fail to summon an opinion.
“There’ll be another war,” says Dr. B darkly.
“Right.”
“Seriously. Figure out a strategy, because it’s coming.”
“What’s your strategy?”
“Ah. My strategy—my philosophy for living—is the three Gs.” He loads the syringe with a substance that is, gram for gram, more expensive than the world’s finest heroin, although less expensive, perhaps, than marrying someone you’re not into in order to have a baby—to shoot up through the catheter, to the cervix and beyond.
“What are the three Gs?”
Dr. B looks sideways at the nurse, who is absorbed in a task at the desk. “I’ll tell you another time,” he says and lowers his head. I look up at the white-paneled ceiling.
Doctors, like most creative professionals, have their own distinct styles and for his part Dr. B doesn’t favor the use of any particular catchphrase at this, the potential launch of new life. On the other hand, Dr. M, his partner in the practice, is known to say cheerfully at the moment of detonation, “Swim, boys, swim.”
I KEEP DRINKING champagne through the last week of December. The fact is I’m not ready to be pregnant and am banking on there being a few months of failed treatment for my mind to catch up with what my body is doing. As the year winds down and I scarcely look at the calendar, I joke to myself that if the IUI works, perhaps I’ll have an abortion. My dad and Marion come over for Christmas and we—L, the baby and I—spend a lovely day with them just north of New York, at the house of Marion’s daughter and her American family. A few days later, on my dad’s seventieth birthday, they all come into town and L throws him a bowling party, with printed T-shirts and a group photo that she solicits the waiter to take and that I know my dad, in his Englishness, finds simultaneously wonderful and completely alarming. The baby sleeps throughout, parked in his stroller a way back from the bowling lane, not even surfacing at the shriek from L as I lean in to kiss him with a mouth covered in wing sauce.
I have been emphatic to my dad that I am trying for this baby alone, but I know he thinks that eventually L and I will end up in a conventional arrangement—that this is a drawn-out interim stage that has somehow survived the birth of her own baby. He is too diplomatic to say this, but it is practically a generational impossibility for him to think otherwise. The person to go to for the alternative view is my mother’s younger sister, Fay, a favorite among her siblings and the only person in her family I’m still in regular touch with. My aunt is well up to speed on news of L and the baby and, a few days after Christmas, I call her in Johannesburg to fill her in on my treatment.
“I think it’s very enterprising,” she says airily. My aunt has a couple of dicey ex-husbands in her past, as do most of my aunts. “If I could have had my children without having any of them,” she says, “that would have been my preference.” Which is, of course, what I knew she would say and is precisely why I rang in the first place.
These are the last days of frivolity. Two weeks into January, I get my period and, just like that, I sober up. I stop dissembling about needing more time to adjust. I switch to Coke at the bar. Overnight, the sense of what it is to throw money at something with no definite endpoint becomes sickeningly real and I can’t believe I was so cavalier in the first place.
“OK,” says L, who is calm and sensible in the face of my panic. “So you’ll go another month and then you’ll see.”
“Early days,” says Dr. B. We are in his office, where he is reviewing the results from the blood test. “Your hormone levels look good, everything looks good.”
He exudes just the right ratio of confidence to uncertainty, but I still don’t trust large parts of this process. Like all for-profit industries, the fertility industry is set up to serve multiple interests, and at the back of my mind I have the uneasy feeling that when there is room for interpretation of the data, fertility doctors are incentivized to err on the side of positivity. (In America, that is. In England, it is the opposite: cost rationalization means that if you want a third, free cycle of IVF on the NHS, you have to lobby like hell to prove that you’re not a lost cause. I’m not sure which is worse in this instance, false hope or fatalism.) A doctor’s optimism needn’t even be cynical—it’s human nature to want effort to be met with reward—but it makes it hard for me to get a sense of what we are actually talking about. When Dr. B says my levels are “good,” does he mean good-good? Or does he mean good in the context of an overall bad business?
“The unknown variable is egg quality, right?” I say.
“Yes. Without IVF, there’s no way for us to determine the quality of the eggs.” We sit in silence for a moment and my face must fall because Dr. B gets up and goes to the Keurig machine in the corner of the room. “Coffee?”
“I thought I wasn’t supposed to drink coffee.” He returns with two cups.
“If you were drinking eight cups a day I might suggest you cut back. But otherwise it’s just . . .”
“Needless masochism?”
“Exactly.”
I have to smile. Ordinarily, I’m a big fan of needless masochism. Show me an opportunity to deny myself comfort and I will show you a happy woman. But after my meeting with the guru in London, I made myself promise I’d resist superstition. I wouldn’t go nuts and buy raspberry tea, or start eating pineapple at certain points in the month, or sit in the Fertility Chair at work—a chair in the London office in which the last three women who’d sat had got pregnant. I would cut back on alcohol, but unless the doctor told me to, I wouldn’t give up coffee or make any other adjustments, and I’m delighted when Dr. B approves. From then on, every time I go into the clinic, I carry a large cup of Starbucks, to ward off the evil eye of fertility mania.
In the weeks that follow, the rhythm of the clinic syncs with my own. The clientele grows familiar. There is the woman who comes in with her sister. There is the one who never looks up from her BlackBerry and complains at the desk about the clinic’s late running. At eight a.m., half of us still have wet hair from the shower and several sit with their eyes shut until the nurse comes to fetch them. I had wondered in advance if there’d be hostility among us, because statistically if one woman gets pregnant it would seem to lessen the chances for the rest of us. But this isn’t the case at all. With each passing week, we register one another’s ongoing presence with smiles of quiet solidarity.
The worst thing about treatment at this stage is the time commitment. Timing is everything in fertility and if the timing is off—if your eggs aren’t ready to drop on the day you go in for the insemination—you are sent home and told to return the next day. Even when the timing is right, there is a lot of hanging around. It is like having a second job, one with irregular shift patterns and a lot of strip searches. Here I am, at nine-thirty a.m. on yet another cold Thursday morning, longing to be at my desk drinking coffee but instead lying half naked in stirrups while four people peer up my fanjo.
“Imagine if, every week for a month, you went into an office so someone could stick something up your arse?” said a friend of mine to her husband recently when he implied that what she was going through for IVF wasn’t that big of a deal. She said he looked a little shocked; the penny had finally dropped.
My actual job, meanwhile, gets crammed into the far corners of the day. It’s an advantage of being almost forty and doing this that I can tread water for a while without fear of slipping. I can’t imagine having had fertility treatment—or a baby, for that matter—during the years when I was still anxious about work. The only thing I hope is that no one cross-references the column I write with topics on the Today show, which in January through February become eerily aligned. Diets, figure skaters, sleep studies, winter Olympic backgrounders; for six weeks Matt Lauer’s producers do half of my work for me. (I never get a single idea from TMZ; thanks for nothing, guys.) The only items I don’t take up are the ones about babies. When they come on-screen, which they do at regular intervals—cute babies, miracle babies, sick babies, talented babies—all the women in the waiting room laugh or make cooing sounds to puncture the awkwardness of ten strangers whose thoughts suddenly align. Then we spin off into our own thoughts again.
One Saturday midway through my second cycle, I go in for blood work, and because we’re en route to Costco in her car, L comes in with me. If this story were Greek myth, going to Costco would stand in for our archetypal journey; some part of us is, has been and ever will be on the road to Costco. It’s where we have our best conversations, looking not at each other but out of the window, absolved of the need to make eye contact. That morning, however, I’m anxious. When L brings the baby into the waiting room, it feels undiplomatic. (There are, I know, fertility clinics with signs on the walls asking visitors not to bring in their kids, which strikes me as even more embarrassing for the patients than the presence of an actual child, like having a sign up at a funeral home saying DON’T MENTION THE DEAD.) As it turns out, the other women couldn’t be nicer, cooing and spoiling him, and then Dr. B comes out to shake L’s hand and greet her warmly.
“That was weird,” I say afterward, as we head out of town in the car.
“Yeah,” she says.
It was quite touching, too, the efforts made by the doctor to chivy us together, and afterward, I feel bad for him. Then I feel bad for us. The failure, it seems to me, is less in the nature of our relationship than in our ability to give an adequate account of it, and as we wander around Costco, L pushing the cart, me hauling stuff into it, I wonder again how we look from the outside. Within a few weeks, Dr. B has stopped referring to “you both” in my posttreatment debriefs and started addressing his remarks uniquely to me.
“By the way,” I say to him. It is a Friday morning, the final ultrasound before my second insemination.
“Hmmm?” he says, eyes on the screen.
“You never told me what the three Gs were.”
His eyes zip across to meet mine and for a moment he looks at me, as if trying to figure out whether he can trust me. “Go on,” I say.
“It’s kind of a joke.”
“What?”
“I’m not being entirely serious, so don’t—.”
“WHAT?”
He grins. “Guns, gold and a getaway plan.”
A FEW DAYS LATER, I’m in the waiting room looking at the Christmas cards still tacked to the wall and texting Oliver a link to a piece about “sweat shaming.” (It’s for a fantasy Web site we operate called ThankYouForYourContribution.com, an anthology of the world’s worst opinion pieces, and the fact that it exists only in our minds doesn’t stop us from lovingly curating it.)
“Good luck today!” says Oliver. “If that is the appropriate statement of support. You may think luck has nothing to do with it.”
“Thanks.”
When I go into the treatment room, Olga, the nurse, is at the desk leafing through a large book. I like Olga. She has been working in IVF since the 1980s, at the very dawn of the technology, and is due to retire any day. A few weeks earlier, I’d been waiting to go into the ultrasound room and heard a woman crying on the other side of the door. “Ach, it can be hard,” said Olga, with an air of deep tragedy I found somehow consoling. The expression on her face, which is etched with compassion, implied what does any of this matter, we’ll all one day be dust.
The book Olga is reading is a photographic account of life inside the womb, featuring vivid color images of babies in utero and which, as I undress, she holds up to show me. I murmur appreciatively but inside I recoil. Those pictures of pink fetuses, curled over themselves like shrimp, have been so co-opted by the antiabortion lobby that you can’t look at them now without visualizing some spit-flecked nutter waving a placard outside a clinic in Wichita. In any case, I don’t want to think about the “miracle” of conception; the whole enterprise is improbable enough without adding a supernatural dimension to it. Olga shuts the book and we chat for a few moments before Dr. B comes in, followed by a nurse, who, once again, holds up the vial of sperm for my inspection. This checking protocol has been in place for two decades, ever since a lawsuit was brought against the clinic by a white couple who unexpectedly gave birth to a black child. “So you’re waiting nine months to see if you’ll have a baby of the wrong race,” I say to Oliver later that day.
“Now, then, Brockesy,” says Oliver. “I think we both know there’s no such thing as the wrong race.”
The procedure feels like nothing at all; a tiny bit of cramping and then, “Can you see them?” says Dr. B, indicating the screen. Sperm are, apparently, surging across my system like deer on the Serengeti.
“Oh, wow!” I say. (I can’t see them.)
“All you have to remember is not to get your period!” He sweeps out of the room, taking the nurses with him.
You are supposed to keep still for ten minutes after the insemination and I lie in the semidarkness, looking up at the dusty collection of fertility dolls arranged on a shelf above the desk. One has a bow and arrow. One is dressed in some kind of folk costume. All look as if they have the potential to come alive at night. I think about the Christmas cards in the waiting room, which feature family photos from grateful former patients. That’s nice, I think. All those success stories. Although there is something a little proprietorial about the montage, a little preening. From the clinic’s point of view, I don’t like the egotism of that wall—look at what we made!—and I don’t like being lumped in with a bunch of people on the basis of fertility. This isn’t a church, I think grumpily, it’s a business; they should be grateful to me.
I don’t know how long I’m lying there, but when Sophia, one of the nurses, comes back in she looks surprised to see me. “Hey,” she says, tapping me lightly on the knee. “You can put your booty away now, honey.”
I get up, redress, put on my snow boots which are standing in a puddle under a chair in the corner and leave the ultrasound room. On the way out, I glance at the wall of Christmas cards again and notice something I had failed to see earlier, even though it is the most prominent thing about the display: the sheer number of photos with more than one baby in them.