Annajoy O’Gorman writes about when IVF doesn’t work, confronting the possibility of a childless future, and how Instagram provided the answer…[restrict]
Instagram has been around for ten years and I’ve been using it for eight. Ten years ago, I don’t think I even had a smartphone. And even though my relationship with Instagram started the same as most people’s — arty photos of flowers or my coffee blurred under folksy faux-Polaroid filters — it culminated, pretty much, in getting me pregnant.
This story sort of begins in 2015. I was thirty, flirty and thriving in New York City with my husband, living our best lives in Obama’s America. We had been together forever and decided we wanted a baby, a physical manifestation of our love and, ideally, a proud holder of an American passport.
We quit smoking. I got a personal trainer, went to the gym before work and used our blender to make thick, green whey protein drinks that we sucked down every morning. I downloaded an app to track my cycles.
We were baby making machines! We told everyone we met: “We’re going to have a baby!” The months passed. “It’s fine! It takes a while, even for the young and healthy!” There was a lot to distract us. We lived in New York; all our friends were either older or younger, no one had a baby. “It’s fine!” I told myself. “Sure I’d hate to be pregnant this Fourth of July weekend, this hen party, this wedding, this Christmas, this New Year’s Eve”.
Cut to 2017, back living in Ireland, I’d never been pregnant, and the realisation is dawning that something is wrong. We had tests done. My husband masturbated inside an anonymous office — funny. I had to be scanned over and over again with the horrible wand probe — less funny. At least he had an orgasm at the end. I felt exposed and, once his glowing results came back, like a failure.
We began our first round of IVF.
The process was brutal. The injections were the easy part. Thirty-six hours after the final “trigger shot,” once I could feel my ovaries pulsing inside my body, I got up very early for my egg retrieval. This is where they sedate you, push a needle through the wall of your vagina and and suck out each tiny oocyte to place in a petri dish for future fertilisation. This is really painful afterwards. On the bright side, though, we got 12 little eggies.
Did you know IVF only works 30 percent of the time? That seven out of ten times it doesn’t work? Or that on average it takes three full cycles to work, it takes three five-day-old embryos, blastocysts, on average, to make one baby? I didn’t know any of this.
The following day, the embryologists were supposed to call with my fertilisation report. Of 12 eggs retrieved from someone under 35, they would have expected about seven eggs to have fertilised, and of those seven around three embryos to reach blastocyst stage in exactly five days; embryos that develop either faster or slower are considered to often be defective. At which time they would be either frozen or implanted.
The call came late. Only two eggs had fertilised, a flustered embryologist explained. He said he hadn’t seen such low numbers before. He was sorry, he said, and you could hear in his voice he doubted there would be anything to freeze.
In the end, we had one six-day embryo to freeze. This wasn’t great, but it was something, and we decided to freeze it and try again straight away. Everyone assured us it was going to be okay; I just hadn’t responded well, they would adjust the drugs and inject the sperm into the eggs directly this time, a process called ICSI. The chances of it all going so badly again at our age, we were told, were low.
The day after retrieval, again the call came late, with the exact same results — only two eggs had fertilised. My doctor rang me from his car and I could hear the bafflement in his voice. And that time, on the fifth day, there was nothing to freeze.
It was like falling into a deep hole. I hated myself for wanting a baby so badly, I felt ungrateful for what I already had, I hated that I wanted more. I hated that I couldn’t give my husband what he wanted. And I hated that there were no apparent answers. I was isolating myself because I felt all this guilt and sadness and I couldn’t take anymore glib comments and advice. The spectre of childlessness scares a lot of people and the most they could often muster was a suggestion to try acupuncture or some inane story about their boyfriend’s sister’s friend who ended up with triplets.
I scoured websites, journal articles, r/infertility, and even started following an Instagram account run by an anonymous embryologist, called IVF Explained. To this day, I’m still not sure who they are or where they are based, but their content was reassuringly scientific and late one tear-stained night during the five-day wait on our second round, I sent a DM.
To my surprise, I woke to a reply. The person behind the account reassuringly agreed that mine was a strange case, but that because our first round had one blastocyst, there was hope — if we had a higher fertilisation we could achieve (theoretically) a 50% success rate. We messaged back and forth. They recommended we look into a treatment called Artificial Oocyte Activation, an experimental treatment where they add a substance called calcium ionophore into the eggs and sperm mixture which works as an activating agent, jolting the process of fertilisation into action. They suggested I check out a website called Fertility Friends and search AOA options around Europe.
I found via Fertility Friends a small group of women who had all experienced the same shock of low or zero fertilisation, feverishly messaging each other about a Ghent, Belgium-based embryologist named Bjorn Heindryckx. Heindryckz developed a unique form of AOA where he injects eggs with the calcium solution at the same time as the sperm. This method, according to his numerous, peer-reviewed papers on the subject, had a much higher success rate than the commercially available method of AOA which merely washes the eggs. I read paper after paper, and slowly I realised that if I was to ever sit with a childless future, I needed to tell myself I had tried everything. I found his LinkedIn and emailed him directly and (again to my surprise) he replied requesting my history and asked if we’d come to Belgium for a consultation.
The cost of the treatment in Belgium was a little less than treatment in Dublin. Plus flights, accommodation and having to pay for the drugs out of pocket, though, it added up. We scraped it together with help from our families, our savings and the Credit Union. We were aware at that stage that this was it. We were not going to get a second chance.
On our first visit to the hospital they really ramped up the “experimental treatment” vibe by asking my husband to make a “deposit” that they were going to inject into mouse eggs. To see, yes, how many mouse eggs he could fertilise.
Lots, as it turns out.
He achieved the maximum amount of possible human-mouse embryos. This bizarre discovery supported the theory that the issue was my eggs, rather than his by then mouse-egg tested sperm.
A few months later, after signing a dizzying amount of waivers all literally in Dutch, handing over a vast sum of money, visiting the underground pharmacy, dragging bags of ice-packed drugs through Brussels airport and back again and several weird nights on my own in the hospital Holiday Inn, I booked an Airbnb in Ghent for three weeks and settled in for my ultimate Hail Mary. It was weirdly fine. My parents visited and did charming holiday things with me like shopping and river cruises, we looked at the old masters and ate chips and waffles in the sunshine.
It was better than crying in a car park in Dundrum.
Egg retrieval day rolled around. Terrifyingly, they called it ‘the puncture” and even more terrifyingly, I was awake the entire time.
With my husband holding one hand and a nurse holding the other, an extremely eccentric man sucked the eggs out of my ovaries, all the while talking to me about Brexit, Scottish independence and British imperialism’s negative effect on scientific research in the EU. It was distracting, at least.
The following day we learned we had 50% fertilisation, a huge jump for us, but we still had to wait to see if we had a blastocyst by day five. We were told to travel to the hospital for 9am in five days’ time and if nothing had survived they’d call us that morning. The distance between the Airbnb and the hospital meant that no matter what we’d have to leave before they could call.
We got on the tram, they didn’t call. We sat in the canteen and ate dry pain au chocolat, they didn’t call. We were directed into a waiting room with four other women and their partners and they didn’t call. Finally, we were called into a small room where a tiny, extremely effusive woman greeted us and breathlessly told us we had the most beautiful blastocyst. She gestured to a screen where an image of a large circle of cells came into view. I took off my coat, hopped up on the table and spread my legs.
Two weeks later, we were back in Dublin and my phone was vibrating. IVF Explained was messaging to check in. I replied that I had been too scared to take a pregnancy test — the prospect of that huge effort, cost and emotion all being for nothing was too much to contemplate. Gently, the internet stranger pushed me towards a decision. The following day I woke up and forced myself into the bathroom. The test line came up before the control line; I was five weeks pregnant and I stayed pregnant for a million weeks. And on the 1st of July, 2019, I gave birth to my giant, delicious daughter.
There are many paths to parenthood and many people struggle along the way. If I hadn’t had so much information available to me so easily, or I had been born just 10 years earlier, I might not have had my daughter. Access to treatments like the one that worked for me depend on money, location, information (even via Instagram) and the confidence to attempt to find an answer.
Ultimately, though, it still might not have worked. A lot of people put just as much of themselves into this journey as we did.
We just got really, really lucky.