Ok, settle down class - come on, stop making that racket. Concentrate. Thankyou. Let's begin.

Now, can anyone tell me what's happened here?

Have a guess. Anyone? I won't bite your head off... yes, Bea.

"I'm not sure. Is it a chemical pregnancy? Or a miscarriage? When does a chemical pregnancy turn into a miscarriage?"

Well, to answer that question, we first have to know the definition of those terms. Can anyone define miscarriage? Ok, let me.

The most common definition of miscarriage is simply the loss of the products of conception before 20, or some say 24 or 28 weeks gestation. But there are many different kinds of miscarriage. You can have early miscarriages, late miscarriages, complete and incomplete miscarriages... Some people even use the term 'menstrual miscarriage', which is the same as a chemical pregnancy - ie a loss before implantation. So you see, the word 'miscarriage' can be quite a broad term, ecompassing many different situations. So let me go back to my original question: can anyone tell me what's happened here?

Silence? No-one. I see. Ah, over there - yes?

"I just don't feel comfortable using the term 'miscarriage'. I mean, it seems kind of dramatic."

Well that's ok. I don't think you have to use the term if you don't want to. Maybe you can think of another term you'd rather use?

Take a little time to think if you need to.

"Miss, was I pregnant? Because if I was, you could call it a 'Very Early Pregnancy Loss'."

You could indeed. Well, let's answer that first question, then, shall we? What do you think?

"The clinic said I was pregnant."

Very good! Anything else?

"Well, I had symptoms of pregnancy. I felt pregnant."

Ok, so what do you think?

"I think I was pregnant. For a little while. And then it was lost."

So shall we call it an 'Early Pregnancy Loss'? Yes, ok, I think we all agree on that one.

So we've had an Early Pregnancy Loss, or Very Early Pregnancy Loss, as Bea put it. Can anyone explain why? Bea?

"No."

Very good. That's the correct answer. What would be a better question?

"How?"

That's right. There are many different ways in which a pregnancy can be lost at this stage. The most common method is through some sort of chromosomal abnormality. The embryo develops as normal until it needs the faulty gene, at which point everything falls apart. What's by far the most common reason for a chromosomal abnormality?

"Chance event."

Very good, Bea! So it's almost always a random mistake, made somewhere along the line. Of course, there are tests which can indicate a high level of DNA fragmentation in the sperm, which may show an increased chance of this sort of thing happening, but recent studies show the test is more difficult to interpret than previously thought. And since the problem can show up in both normal and abnormal semen samples, there's no real reason to assume that this is a problem for you, just because your sperm is abnormal in other ways.

Can anyone tell me another way in which a pregnancy can be lost this early? Yes?

"Failure of implantation."

That's right - and what's the most common cause of a failure of implantation?

"Chance event."

Correct. Ok.

There are lots of other 'hows' in the question, 'How did this happen?' but many of them are quite rare disorders or problems we know don't apply to us. Statistically speaking, unless this happened several times in a row, there would be no reason to suspect any kind of underlying pattern to these events. So wrap it up for me now, what's the main lesson for today?

Come on, you were doing so well. Alright - yes?

"What happened was a Very Early Pregnancy Failure, probably due to some Chance Event."

Very good. And what does that mean?

"Well, it means we're no better or worse off than we were this time last month. We just need to pick ourselves up and roll the dice again."

Right. So that's what I want you to do for your homework. Any questions? Good. Class dismissed.



I wrote out the invitations to my 2WW sleepover party weeks ago, and I invited a whole lot of people. But they never turned up. Even when it started getting late.

I felt sure "Obsessing Anxiously Over Every Twinge" would be here. And especially "Frustration About Having To Wait". I've never seen her miss ANYTHING like this before. But the only person who turned up was Maternal Instinct, who I'd never really talked to in the past. In fact, I wasn't sure I could remember asking her to come...

"I know you didn't want me here," she said after an awkward period of small-talk about the asparagus rolls and my general concerns re overcatering.

"It's not that I don't like you," I explained, after an embarrassed pause. "I think you're great. It's just..."

"I'm sometimes superfluous," she finished, letting a wry smile play across her lips.

"And SOME people might have inferred that they find you a TEENSY BIT overbearing - at times. If you're sensitive to that kind of thing."

"You know I held back their invitations."

"You...?"

"Work at the post office." She waved her hand dismissively. "Anyway. It was me." There was a stunned silence whilst I digested this information. At length, she added, "I'm sorry about all the asparagus."

"It's not the asparagus," I replied, shaking my head in bewilderment. "Or even the miniture quiche lorraines. It's just... but... why?"

She heaved a great sigh and ushered me into a seat.

"It's like this," she began. "You didn't want me here. Felt maternal instinct had no place in a two week wait for embryos which probably wouldn't survive. Thought it would be easier to think of them as "things" and not "babies". Thought it would be easier to take the clinical point of view - how many days left to wait? How many signs and what do they mean? Didn't you? Isn't that what you thought?"

I nodded dumbly.

"Well, you were wrong. These embryos are individual. They're the closest thing you've got to children. They're important. And when the doctor did the transfer, he didn't just transfer a few cells. He transferred the responsibilty for taking care of them. No-one else can do that at the moment. No-one except you. That's why I'm here, whether you like it or not."

She was right. I'd been naive to think she wouldn't come. "But why send the others away?"

"Because we don't have time for them."

Maternal Instinct looked at me steadily. I stared back, striving for comprehension.

"You have the rest of your life to analyse signs, to wait in frustration, to worry, to despair, to hope, to grieve, to want. To cry. To heal. You have maybe only a couple of days left to care for these children. So for the next couple of days, it's all you have time for."

I knew she was right.

I didn't even have time for another asparagus roll.

We had a family sleep in on Saturday. Then we watched a children's cartoon movie and ate Thai takeaway.

On Sunday we listened to music and played with the dog. And we smiled. And we laughed. And we sung happy songs, and sad songs, and told stories together.

Because soon, it seems, it will be too late.



Two days til followup beta...



"Congratulations! You're pregnant!" I exhale slowly, tilting my head back and closing my eyes against welling tears of joy.

"You're pregnant!" I laugh. It explodes from my lungs and richochets around the room.

"Congratulations!" I am seized with anxiety. This is only the beginning... the full weight of all that could still go wrong descends upon me.

"You're pregnant - how exciting!" I agree, then return to my work, unmoved by the revelation.

"Good news! It worked!" I feel like a traitor to all those who wished me luck on my journey, and got left behind in the world of AC.

"It's positive, but only just..." I feel a sense of desperate fear well up inside me.

"You're probably pregnant...." I feel confused, upset.

"It's negative. I'm so sorry." I nod complacently. It's not really news to me.

"Oh honey - you're not pregnant." The disappointment envelops me, cutting off my air.

"I'm afraid you'll be trying again next month." I can smile again. The uncertainty is over.

"Hello Bea? Yes, let me find your results...."

Two days to go.




Time #3
10 days til beta...


I had a dream. In my dream, I remembered I was once a child, drifting off to sleep, listening to my mother sing her favourite lullaby...

"Try not to get worried
Try not to turn onto
Problems that upset you..."

I woke an adult. An adult with children, however small, to nurture and comfort. Softly, I took up the melody.

"Don't you know everything's alright
Yes, everything's fine..."

And as I sing my body feels them drift away.




"Close your eyes, close your eyes and relax, think of nothing tonight...."





It is said

- and don't quote me on this, because I certainly haven't exactly quoted the original saying so much as cobbled together a rough gist of the sentiment -

that if we were all given an opportunity to exchange our problems with others, we would all walk away with our own.

In 2006 this led, in the true spirit of scientific investigation and entrepeneurial can-do, to the First Annual Problems, Troubles, Woes and Annoyances Swap Meet (FAPTWASM). Of course, I had to go.

On the first day I merely browsed other people's problems. Some of them were pretty out-there. At one point I saw Ricky Lake actually beat a Jerry Springer crew member with a microphone in a bid for exclusive coverage. And then there as this one guy whose main problem was pink snot. I know. He ended up swapping with a girl who had blue snot.

On the second day I decided to take a different tack. I set myself up in the corner of one of the satellite tents and proceded to hawk my goods. Or my bads, as it were. I was rather hoping to give my troubles away to someone who wanted a gift for their cheating ex, possibly in return for Being So Gorgeous And Intelligent People Sometimes Find Me Intimidating.

Around lunchtime this guy came up to me. He looked about 45, although his face was so weathered it was within reason to think he might be as young as 30, or as old as 52. He wore a wide-brimmed hat, which was frayed and tattered, and a set of clothes which were ground with dirt. He looked at me for a moment, and then pointed to my wares with his chin.

"What you got?" he asked.

"Infertility," I answered. "Male Factor."

He nodded, and prodded it thoughtfully with his foot.

"I think that's it," I added, "but it's only fair to warn you we haven't been tested exhaustively."

He shrugged a littled and mused, his head to one side.

"I mean, we haven't had any tests done for DNA breakage or anything. Or immune problems which may cause recurrent miscarriage."

"Ever had asthma?" he asked.

"No."

"Funny. Lotta folks have."

I paused slightly at this apparent non sequitur.

"Anyway, I thought it was fair to warn you. I even heard of a woman who, despite a half-dozen IUIs and a whole lot of pelvic ultrasounds, didn't know she had a thin uterine septum until they did a hysteroscopy. And then there's all the things they can't quite explain..."

The sudden and explosive throat-clearing of my wizened customer brought a stop to my train of conversation. I ceased, and looked up at him. At length, he looked up at me.

"You know what your problem is?" he asked.

"Well..."

"You read too much. You ask too many questions. You spend too much time thinking. That's your problem."

For a while we just stayed there. Staring at each other, like players at poker. Til at last, I folded.

"Thanks," I said, gathering up my stuff. "I'll keep it."


Awake. Would that I could reassure myself by creeping, softly, to watch my children sleep. Touch their brow. Listen to their silent slumber. Know they are well.

Instead I stare at the dark. Afraid. Unsure even of where they are.

A man who calls himself "The Doctor" tells me they are ok. But they're not coming home. Not yet. Perhaps not ever. I'm not allowed to see them.

I want them with me. I long to feel them and watch over them. They tell me they're out there - I ache to have them in here.

I would rather hold them, dying, than stare into the black.


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