Avalanche (6 page)

I longed to ask Paul once more for his frozen sperm but knew it would be pointless.
Our child
clung to me like a ghost.

One morning I woke up and noticed a tiny black mark on my palm, like a nascent melanoma. Maybe a blood blister. I waited to see if it would sink away but after a week it hadn't changed. Then it started to grow bigger, almost imperceptibly, the way the body usually changes. I tried scratching if off but that didn't work. Something else: it was hard, not as soft as a mole. I hoped it would go away. Instead it kept growing, it reached the size of a small coin and then it started to thicken, protrude. It took the shape of a spike or a blade, there in the hollow of my palm. I had to walk around with my hand curled into a fist in order to hide it. Late one night, when I couldn't sleep, I turned on my side and began pounding the bed, the empty space where my husband used to lie. I had grown my knife, now I was compelled to use it. I was sure that was the only way to get it out of my hand. My father used to complain that my mother hit him in his sleep. Back then I'd never understood it.

A prince came to my rescue. I walked up to his castle, knocked on the door. We'd had a dalliance some twenty-odd years earlier and since then had kept in touch. I told him of my predicament. In turn, he grilled me about why I wanted a child. He wanted to know the state of my finances. He reminded me that having a child wasn't all fun and games, wasn't easy. “Take your niece home for two weeks or two months, see how you like it. Your whole life will change.” He said he'd think it over—and soon came back saying yes, I deserved a chance, he'd help me.
Darling man!
The good news was that he already had frozen sperm in storage, at another clinic, so hopefully I wouldn't have to wait out the quarantine period. His one condition: he wanted our arrangement to be strictly confidential—for the first three years of the child's life. I wouldn't be able to tell anyone he was the donor. I agreed. We drafted a legal document that extensively outlined the expectations of the Mother and the Donor, pre- and post-conception. Basically it said he would have no financial responsibility, no custody: he would not be the legal parent. I think we did discuss trying to get pregnant the good old-fashioned way—sleeping together—but under the law that would mean he would have
unwanted responsibilities. We took a very straight, strict approach.
Strait is the gate
. I felt hopeful and grateful when I signed on as the Mother.

The Mother. I allowed myself some small leeway to identify as a mother, to peek through the door. Both my sisters had set an example. I am enchanted by my nieces and nephews. For many of my nephews' early years I was living overseas and didn't spend that much time with them. My nieces were born when I was 41 and 44. Their mother was intimately aware of my difficult circumstances. I had a choice: I could distance myself from her pregnancies in order to spare myself pain, or I could embrace them. Today I am so glad that I did not hide away, cut myself off, that I chose a path that at times was excruciating, bittersweet. There were nights when I was babysitting and would cry when checking on the sleeping child, there were days when I couldn't stand another minute in the swarming playground. Birthday parties remain a bridge too far. In spending time with the baby girls a new kind of love was revealed to me, one that emanated directly from the chest, something uncomplicated and all-forgiving. It was different in tenor to the
great love I'd had for my husband—which also emanated directly from the chest but which, I am not proud to say, proved more complicated, less forgiving. This new way of loving was something gentle and constant. A plain good thing.

P
ROSECUTOR:
Why did you persist in wanting to be a mother?

D
EFENSE:
I refer you to Exhibit A. Conversation with Elsie, age 2.

—Let's play doctors and mices! Doctors and mices!

—OK, what's that?

—You say, “A mouse is coming!”

—A mouse is coming!

I make my hand into a mouse, creep it close to her, then run the mouse-hand under her arms, begin to tickle. Soon
the mouse-hand bounces up and down on her tummy.

—I'm not a trampoline! I'm not a trampoline! I'm not a trampoline! I'm a person!

—Oh, OK.

—Do it on your nose!

The mouse-hand bounces up and down on my nose.

—Your nose is a trampoline!

Mother's Day was a punch in the gut.

I had a friend also doing IVF but in Europe, who was much more sanguine. She said her whole family was in good health, she had amazing friends, she loved her work, she lived in a wonderful city, and after much heartbreak she now spent every day alongside her beloved new husband. “Too much for one person, don't you think?” They were seriously considering adoption. Perhaps if I'd had that option—adoption—I would have been less fervent. In a country with extremely tight adoption laws I reckoned my chance of adopting at approximately zero. Anyway, selfishly, at the outset I wasn't that keen on adoption.

And now it was my donor's turn to begin his visits to the clinic. He had an appointment with the doctor; an appointment alone with the counselor; and we did a joint counseling session together. There were consents to consider. (A donor always owned his sperm and could withdraw his consent at any time.) The quarantine had to be
verified and the blood work reviewed so that it met all the standards of my clinic. His genetic screening also had to be reviewed. It turned out that since we'd both done our initial screening for cystic fibrosis a new test that covered a greater spectrum of mutations had become available and we needed to do that. I also redid my AMH and a lot of other things. Because of my donor's family history the genetic counselor advised we needed to consider a range of potential chromosomal problems. There was a test that could be done at a hospital lab on the other side of town. I hesitated to overburden my donor, fearful he too might change his mind, so I decided I would be the one to take the test. If the results proved negative—which I expected—then the genetic counselor had advised I could put it out of my mind. Both parents needed to have the mutation for there to be a risk of passing it on to the child. Another thing had changed since my donor first froze his sperm. The law now required that at birth all donors be registered so that a child conceived with donor sperm could one day trace the father. He was happy with that.

The straws of sperm were shipped from one clinic to another. One precious straw was tested for the sperm's motility and possible deformations. Under the microscope
everything was swimming. When it was already too late I was ready to go.

After consulting with the doctor I chose to proceed with an IUI, intrauterine insemination, at a cost of AU$2,040 (US$1,832) of which around $670 (US$602) would be reimbursed by Medicare. I would do it with a nudge of Gonal-f, 75 IU, to boost my chances. On Day 9 the clinic would start monitoring me for my LH surge. I also had an ultrasound. It was similar to using a turkey baster at home (although I had heard the best way wasn't a turkey baster but a plastic syringe acquired at any local pharmacy). Why did I involve the clinic, why not try at home? Well, I wanted the donor's sperm to have cleared the HIV risk, and—more than that—I wasn't sure he would have been comfortable making home deliveries. And why not go straight to IVF? My thinking was that my eggs had never had a chance: the problem had been my husband's lack of sperm. I hoped that if my egg was exposed to healthy sperm then I wouldn't need to undertake the more invasive, and expensive, IVF.

On the appointed day of ovulation I arrived at the facility. A nurse—there was no doctor involved—tried to
insert a fine plastic tube into my cervix but after a good ten minutes of prodding, failing, she gave up, apologized and left the room to find another nurse.
Alone, alone
. The second nurse had better luck. The thawed sperm—which had also been rinsed and concentrated—was injected directly into my uterus. It was uncomfortable, like having a bad period cramp. I asked if I could keep lying down for fifteen minutes. Quietly excited, I tried to visualize conception, the sperm and the egg. I placed my hands on my belly and sent loving energy to the womb. My doctor had said I could stand on my head and meditate if I wanted but that kind of thing wouldn't make any difference. I paid no heed. After I left, in a lane off the main road, I found a paperbark tree and peeled away some bark, placed it under my T-shirt, gently rubbed my skin in a circular motion. Absurd—but who cares. It was soothing. I believe in ceremony. Anything to counter the unnatural situation.

My friend in New York paid a surrogate. “She lives in a beautiful place, interstate, so much nature. The whole thing felt really natural.” Nature. Natural. She continued to repeat the word “natural” like a nervous tic or mantra.

The day after the procedure I called my sister in an embarrassed small panic. I'd absentmindedly eaten some sushi, which was a no-no according to one of the books I'd read,
What to Eat When You're Expecting
. “Oh my god, you're fine,” she said. “You can snort heroin for breakfast at this stage and you'll be fine. Don't be insane. It's not going to be like this the whole time, is it?”

Good morning, darling
. Every day I greeted my belly as if an embryo had implanted. Disregarding the odds of success I directed a loving monologue to what I hoped existed. I'd long harboured a platonic crush on my donor, considering him a trusted battle-worn compadre, and I believed the child of our friendship was also meant-to-be. (Did I still carry grief for the lost
our child
? Yes, of course I did.) During that first two-week wait I had a heightened awareness of my whole body. Rarely did I ever stop to consider how my body was functioning, what my cells were doing. Typically I completely ignored the subtle movements that go on all the time: the inflating, deflating lung; the inch of chyme through the intestine; the tremors of the liver
and the kidneys. Not that I actually felt these things, but I pictured them, sensed them. What is that way of knowing? Out on the street I noticed that all the babies, toddlers, and pregnant women had cloned themselves so now they were everywhere. I smiled at young mothers. I was soft and optimistic, the holder of a wonderful secret. It's easy to do anything once.

Blood. Bloody hell. Hopes raised, hopes dashed. But I wasn't devastated: no need to take a fall straight out of the blocks. My mother was right when she said “It would have been an absolute miracle.” I opted to immediately do a second IUI, again supported with nightly injections of Gonal-f. It was impossible to gauge the quality of my eggs with only one try. I was monitored regularly—but not daily—and when the nurse called me with my scheduled time for the procedure I queried if the time wasn't too late, if it were possible the LH surge could have begun on the day before when I wasn't tested, if too many hours could have passed between an undetected surge and the procedure. She referred me to the doctor. He said: “I've seen the numbers a thousand times. This is how we do it. You have to trust me.” I
asked him to quickly explain how the time window worked. “If you don't trust me,” he replied, “we can cancel.”

The second IUI failed. As a next step Dr. Rogers recommended I use my frozen eggs and also do a fresh cycle at the same time. I took that to mean I'd do a new cycle, collect a new batch of fresh eggs, inseminate them, and at the same time, thaw the frozen eggs, inseminate them too.

—Why not just use the frozen?

—You get more with both.

—I've already got five frozen so why do I need more?

—Up to you.

—Is there a difference between fresh and frozen?

—There are no second-class children.

—I mean, is one more viable than the other?

—Not much difference.

—OK, I'll just do frozen.

—Whatever you want. That's reasonable.

Up to you. Pick your own misadventure.

Coffee. At the orientation the dietary advice I received from the clinic was to moderate my coffee and alcohol intake and take folic acid, 500 mcg daily. I asked what was “moderate” and was told one cup a day would be fine. A million websites and bulletin boards advised no coffee. They also advised countless other things. Stay alkaline. Wear a lead-lined apron on airplanes. Avoid bananas. I decided to cut out coffee completely. After three months of IVF failure I reverted back to one cup a day. I trawled the Internet and found the study about caffeine . . . it concluded that five cups a day was to be discouraged. Sometimes I felt guilty when I had my morning coffee: what if this coffee was the one thing between me and pregnancy? Most times I thought if one coffee a day kills my chance that dear embryo-darling wasn't strong enough to last the nine months anyway. I oscillated between guilt and pragmatism, and that movement, that kinetic energy, helped drive the little engine of endurance.

I saw Paul at the pool.
Vampire! Monster!
I swam as if I were drowning, thrashing the water, wild-armed, wrenching my head from side to side. I moved fast. No chance to ruminate. At the end of each lap I paused to catch my breath. Exhausted.

The month after the second failed IUI I readied for a frozen egg cycle at an out-of-pocket cost of AU$2,705 (US$2,597). Again I was monitored closely so that we could time the transfer of the embryo to be in sync with my natural cycle. The frozen eggs would be thawed and artificially inseminated the day I naturally ovulated. I was told that three out of five eggs had survived the thaw and they had been injected with sperm selected under digital high-magnification by a scientist, a procedure called intracytoplasmic sperm injection or ICSI. Actually I always did ICSI—the doctors never recommended straight IVF, which is where the sperm fight it out in the Petri dish en route to the egg. ICSI cost an additional $730 (US$701) which in the scheme of things felt nominal (how quickly the scales transmogrify). Later I read a study that questioned why so many doctors always recommended ICSI, speculating there may be some benefit to a stronger, fitter sperm fighting its way to the egg in the Petri dish, just as it did under the auspices of Mother Nature. Overnight one embryo showed development—but it was atypical. “It contains three pieces of genetic information.” Three pieces of genetic information! The nurse told me that it couldn't be transferred. My sister and I joked about dirty pipettes but in fact my egg had
divided abnormally and carried an extra set of chromosomes. The nurse had further bad news: my remaining two embryos had shown no development. They would be kept another night and checked in the morning to see if there were any changes: I was warned this was unlikely but not impossible. I had been out on a boat that day, up and down, up and down, rolling on the heavy swell, and come evening I had full-blown vertigo. If I dipped my chin an inch to look at a screen I felt as if I were about to pitch face-first off a cliff. The next morning, in my vertiginous state, I got the polite, carefully delivered news that there were no signs of improvement. All five embryos were to be “discarded.” All five—gone, tossed away,
discarded
. For a long moment I was silent and then I quietly asked the lab assistant, “You definitely destroy them?” It troubled me how invisible everything was: how would I know what they really did with my embryos? Who monitored the checks and balances? Scenarios for horror movies made themselves known. Evil lab assistant sells embryos on baby black market; evil doctor fertilizes eggs with own sperm to create own private colony of children; evil research director conducts clandestine experiments to grow babies full-term ex-uterus . . . As
it happened, in all my five subsequent egg collections I had a much better success rate with embryo development, always ending up with something that could be transferred.