Several bloggers have talked about past griefs and upheavals and how it's helped them cope with their current infertility. And that's not to say it was always worth it. Some lessons just aren't worth the teaching. Nevertheless, at times like these you come to see these tiny, silver linings on that long, black cloud. For me the long black cloud was my mother's breast cancer.

To put it bluntly, my parents handled the whole thing badly. It took an awfully long time for our family to repair the fallout from that episode, and thank God we had the chance. During the seething years that followed her illness I nurtured a fervent wish to come down with some horrible, life-changing medical problem, just so I could show them how it should be done.

I know - serves me right, huh?

You see, I believe a patient has responsibilities. Responsibilities towards those who want, and try, to help. Responsibilities which, if carefully observed, will be rewarded a hundred times over in the kindness of friends and family. Because let's face it - even those who've walked in your shoes can easily forget what it's like. The rest have no hope. And few of us are lucky enough to know that one-in-a-million person whose talent it is to soothe. So if you can stand being lectured for a moment or two, I want to give you my opinion on how to be a model patient.

The biggest mistake my parents made was withholding information(1). We were given the barest essentials - less, I would say, than the essentials. Our parents would retreat pointedly to their bedroom to discuss specifics. Conversations were whispered around us. My mother was "going out" today. She would "be in hospital for a few days". With a few extra words we could have been told, quite straightforwardly, that she was having chemo, undergoing surgery, being treated with radiotherapy. Questions were not invited. Any sort of curiosity about the subject was actively discouraged. Yet when our behaviour clashed with my mother's treatment - when, for example, I asked to go out in town with friends in the middle of, unbeknownst to me, my mother's radiotherapy and high risk period for everyday infections - well, let's just say things went badly for me. The lesson is this: in order to demonstrate care you need to know there's a problem. And the more educated you are about that problem, the more likely you are to succeed in helping. As a patient, you have a responsibility to provide people with the information they need to support you. You have no business getting angry with someone who doesn't know better, unless you've first tried to make them understand.

Of course, it can be hard to rehash every aspect of your latest treatment to everyone who remembers to ask, and nobody wants to give a Problem X 101 lecture or Q&A session to every new person they tell. You need to provide this information in a way everyone will feel comfortable with. A list of resources to consult, or an appointed "public liason" officer who is equipped to pass on news and answer questions. Someone who can give out advice on what to do for you, and when, and how.

You also need to spare a thought for how your supporters feel. Perhaps they're not hurting like you, but hurting they are. Hurting, and feeling bad for focussing on themselves in your time of need. You need to give them permission to process how they feel about this. Permission to turn to someone for their own support. If you can find the energy to care for them a little, you will get it back in spades when they return, refreshed, to care for you. When my mother had breast cancer, we had no-one. Shortly after her diagnosis, she sat us down and theatrically ripped up a Kid's Helpline poster, saying, "If my children have problems, they come to me and no-one else." It was as if she was afraid, already, of disappearing from our lives. In the end the person she hurt most was herself.

Lastly, you have a responsibility to direct and correct the help you are given(2). No-one will learn how to treat you unless you teach them. Don't make them guess, and don't let mistakes become habit. Give clear and specific directions, and if people do something wrong, correct them kindly and immediately. Then praise them for trying. You don't need to get nit-picky - if they're improving, reward them and leave it at that. Next time you can expect better again. It sounds tiring, but it's less tiring than seething in resentment over inappropriate remarks. If you can't summon the energy to explain yourself, you need to tell people to leave you alone. When you do this, ask them to check back in at a specific point in the future - tomorrow, perhaps. Or simply ask them to talk to you only via your liason officer. Far from thinking you demanding or ungrateful, your supporters will be relieved to know where they stand. Believe me, I know.

For my part, I think I'm doing ok. Not "model" perhaps, but it's clear I've gained something from what our family went through. And it's worth it. For everyone. Especially for me.


---
Today is the day I would have been due if our first pregnancy hadn't been "chemical".

I'm not saying this because I'm having a hard day. There is no unresolved grief here. Still, it didn't seem right to let it go by without mention.


---
(1) I feel I should explain here, because it sounds like I'm making an in vs out of the closet argument. Most people don't know about our IVF, and I'm happy with that decision. Moreover, those that know don't know everything. We don't generally give them cycle dates dates. We don't discuss our diagnosis. I certainly don't give my mother daily cervical mucous reports, complete with details of whether there could be any "semen confusion" or not.

The point I'm trying to make above, is that you should give someone the information they need to support you. Or else stop expecting their support. For example, you might just want to tell them you're having a difficult time at the moment, and are expecting it to continue for a while. You might want to say it's about infertility, but go no further. Or you might say you're doing IVF. There are resources which address all these levels of detail, from general-purpose supporter tools to books on the medical process of ART. I don't think you should be more specific than you feel comfortable with, I just don't think you should leave them hanging.

I also think if your situation directly impacts on someone, they have the right to extra information. If your mum is taking you to the hospital for your retrieval and looking after you for the week afterwards, you really need to explain a few things to her so she's equipped and organised to help you. That you're having an IVF retrieval, for example. In other words, you need to give them a level of information which is appropriate to the level of support you're expecting from them. In much the same way I thought I, as someone living with a cancer patient, had the right to know they were having chemo on a certain day. When someone goes through pre-treatment stress and post-treatment sickness, it has a direct impact on their interactions with those living under the same roof.

I also think you should encourage people to ask questions (but not to expect answers). Asking questions shows they care and want to find out how to help you. People generally respect non-answers such as, "That's not important," or, "I don't really want to go into all that." If you give these non-answers, make sure you actively affirm it was still ok to ask. The important part of the dialogue - the subtext of showing you care enough to keep up with each other - doesn't need details. (Ok, you can go back.)

(2) As in, for example, the help registry. (Ok, and back.)

I was still mulling over our failed May transfer, when yet another wise person said to me, "Well, it's better than nothing!"

An idea started to form in my mind. Carefully, I put aside the teensy bit of pregnancy I'd had and waited.

When we had a miscarriage at eight weeks, sometime later, I added it to my little stash. The nurse at the clinic said she was sorry for our loss, and praised us for how well we were holding up.

A couple of months of straight negatives went by. I debated whether to keep them or not, and wondered how you'd judge their worth. In the end I kept them, just in case.

Then we hit the jackpot. Second trimester miscarriage. As the anaesthetist placed my catheter for the D&C the nurse soothed me. "This must be awful for you," she said.

I shrugged resignedly. "At least it's better than nothing," I replied. She gave a couple of startled blinks, then her expression transformed into one of sympathy, and she patted my shoulder kindly as I went to sleep.

It wasn't long after that we made it. The nurse from the clinic called to say our latest pregnancy was over, at only 6 weeks, 3 days. She asked if I was ok.

"I'm good," I told her, grinning. "I'm coming down - I've got something to show you."

When I arrived I handed them all over for her approval - nine month's worth of pregnancy, all present and correct. I expected to haggle over the straight negatives, but 36 weeks is almost as good as 40, so I was feeling fairly confident. I even picked up my dear husband on the way, so he could be there when they handed us our baby.

But the nurse just shook her head. "It doesn't work like that," she explained.

"But they all said... everyone told me it was better than nothing!" I was crushed, the tears were welling in my eyes.

She took my hand and rubbed it gently between hers. "Honey," she said. "I don't know what to tell you. They were wrong."

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.

Heading for a BFN, sometime within the next week.

Finally, the End of Time.

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...

I went in a day early.

"It's positive, but only just..."

I feel a sense of desperate fear well up inside me.

I feel confused, upset.



Four 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.

I am in
"The Good Place"
I am
Prepared!
for what may come.
I am
Convinced!
I will be ok.
I am
Surrendered...
To my Destiny.
I am
I am high
On Oestrogen.


I am in
"The Bad Place"
I am
Crying,
Hourly, daily
I am
Angry and
Despondant
I am
So Not In The Mood
I am
I am low
On Progesterone.

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.

We would like you all to know that we are expecting a child on the X of XX.

I'd also like you to know it's been hard. For a start, we've spent years living in uncertainty, and then there was the IVF and the complications of IVF and the being bedridden in hospital for ten days on morphine unable to even pee for myself, month off work and stop me now before I bore you blah blah blah blah blah.

Why am I telling you this?

Because I've noticed it's customary, when couples announce their pregnancy, for people to say, "Congratulations!" as in "Aren't you lucky!" And we are lucky, truly. There are many infertile couples who are worse off than us, and many things unrelated to our infertility that we have to be thankful for.

But, you see, we're not just lucky. We're People Who Have Lived Through And Worked To Resolve Their Infertility. And frankly, that makes us pretty damned fucking good.

So a mere "congratulations" isn't going to cut it here. I want nothing less than, "Congratulations, you guys are freaking awesome and you rock."

Love,
Bea and Mr Bea at some point in the future

So this is what it feels like to die.

It's not really painful, or at least not all the time. It's hard to maintain the panic. It tends to bubble in the background, a constant stream of stress. Stress. Sssstressss.... I'd only realise its presence by its absence.

Mainly, it's slow.

It's slow, and it's tedious. And it's pointless. And it's inexorable. And it's inevitable.

Waiting.

Waiting to die.

All my life I've been free to move through space. Which has been great. But I've been locked in time. I can only go one way, and only so fast. Oh sure, sometimes things seem to move more quickly or slowly, and overall I think I might be speeding up, but it's pretty much a steady march from day to day.

So last night I got to swap. One of my current dimensions for time. I chose width.

I was going to choose height, but when I thought about getting steadily higher and higher or, worse, lower as... height went on, it freaked me out a bit. Width I thought I could handle. I've never been weight-conscious anyway.

Of course, the first thing I did was go to ET. It was a longer walk than I'd originally planned, but at least I could get there and back. And I can't tell you how great it was to finally get there. The only problem was this: my body couldn't go with me. Durrned thing is designed all wrong. Bit useless, then, really.

So in the end I swapped back. It turns out it's better to stick with the way things are, tedious as that might seem.

I'm older than I've ever been and now I'm even older...

"It's normal to wake up in the middle of a panic attack because you know you'll be starting again soon." My inner psychoanalyst says so, and she's always so calm and rational and, well, right.

"Things have been peachy whilst you've been on break. Why wouldn't your subconscious be freaking out at the thought of going back there? Why wouldn't you feel like you are being sucked whole into a vortex of doom?"

This is why I keep this woman on. Vortex of doom. I hope she's going somewhere.

"But you see, you're not going back."

I'm not?

"You're going forward."

Hmm. Intriguing, if slightly too much like something trite my high school English teacher would have come out with. And to complete the impression - an assignment. I busily write down the ways we have progressed in our adventure to parenthood so far:

1. Have shaken that silly notion that sex leads to children. Took a while to kick that, too, having been fed the tripe since approximately age seven.

2. Will never have to go through any low-tech ART again. Stuff's for pansies.

3. In effect, have stopped TTC using any method other than IVF.

So you see, not so much a break as a big goodbye to a doomed project and a big hello to one that's much more likely to succeed. As a bonus, we've

4. Stimmed for the last time in a long time. Although if this results in a long, drawn-out pattern of failed FETs, chemical pregnancies or miscarriages, I'm not sure it'll be much of a consolation.

5. Sorted out any future contraceptive disputes once and for all. I was not looking forward to having that "vasectomy" discussion and now I don't have to.

6. Got a really nice dog.

I had to do this roleplay where I walked out of a room which represented our pre-IVF TTC efforts and into a new room which represents our future post-IVF TTC efforts. So instead of a whirling, screaming, sucking vortex, I now have a sunny new infertility office. With a view. Of a lake.

My inner psychoanalyst had one more task. I had to tidy up the new room. You see, when I arrived it was strewn with books. One was a story about how our BFPs all turn into blighted ovums. The next, not to be outdone, was filled with ectopic pregnancies and tubal resections until eventually there's nowhere for an embryo to implant but inside my uterus which one after another stubbornly refuses to do. There was an even more gruelling tale of ovarian cancer, picked up on our first routine scan at our first FET.

I had to burn them all. I just don't need them at the moment. Maybe in my next office, if I get one.

So here I sit. There's a phone with a direct line to my FS. There's a list on the wall of Things To Do Instead of Obsessing About TTC. And there's a cute little teleporting device which I can use to get back and forth from the real world when I need to. My inner psychoanalyst encourages me to use it frequently, and with enthusiasm.

Maybe tomorrow.

Just now I'd like to sit. Waiting for the next part.