I flew to Greece and began solo IVF. Then the world shut down
Fertility treatment is a peculiar experience at any time. In a pandemic it becomes surreal
‘I walk on beside the sea, past young couples, hands entwined, and think of how clinical and lustless the IVF process is.’ Photograph: iStock
It is 7.53am, the last Wednesday in March, and at a courier depot in Athens, the sperm of a Bermudian mechanical engineering student arrives, carried in a nitrogen tank. For the last three days, I have followed the tank’s journey across Europe, loading and reloading the courier website as it made its way from a cryobank in Denmark through Germany to mainland Greece.
The continent has been shutting down, borders closing as coronavirus spreads, and as the days have passed, the improbability of this delivery, its chances of ever reaching its destination, have seemed increasingly slim.
It has one final leg, a short hop from Athens to the island of Crete. But today is Greek Independence Day, a national holiday, and so all through Wednesday and long into Thursday the sperm waits at the depot. I call the courier company. All planes being grounded, it will travel to its destination by boat, the handler says brightly. “It is very urgent,” I tell her. “It’s for a medical procedure.” She is reassuring but noncommittal. What I do not tell her is that, on Friday, I will have my eggs collected at a fertility clinic on Crete, and it is crucial that the sperm of the engineering student be there to meet them.
Undergoing IVF at any time is a peculiar experience. In the midst of a pandemic, it becomes surreal. In early March, as the world shut down, I imagined my scheduled treatment would be postponed, but to my amazement the clinic said it would proceed. And so one Saturday afternoon, as the virus gathered pace and airports acquired a new and fearful mood, I took one of the last flights from London to Heraklion. I was making this trip alone; my local health authority does not treat single women.
With its own health system buckled by years of austerity, the Greek government had moved quickly to prevent a coronavirus outbreak of the magnitude of those in Italy or Spain. The evening I arrived, March 14th, Greece was on its way to lockdown, and Heraklion’s shops, bars and restaurants stood newly shuttered. I let myself into my rental apartment, ate the kalitsounia left by my host, and wondered what on earth I was doing.
For some reason it is always taxi drivers who ask the question, though I imagine they are only voicing what others wonder: “Why don’t you have children?” I suspect many assume I didn’t want to be a mother, that I was too caught up in my career, that I left it too late. None of this is true. Having multiple miscarriages over many years, for which no medical investigation could find a cause, has been an exhausting, distressing and intensely lonely experience. And though my life has been rich and rewarding in many ways, the absence of a child is a sadness that has gnawed the edges of all other joys.
WHEN I WAKE, it is to the sound of wood pigeons, and piano practice, and Sunday church bells. The day is bright and warm, and for some time I wander the city’s empty, sunlit streets. The supermarket is closed, but I find a minimarket to buy a few groceries. Bread, feta, tomatoes. The owner regards me darkly across the counter, locking eyes as he sanitises his hands.
So far there are only a handful of cases of the virus on the island. Soon there will be the first death: a German professor visiting the university for a conference. There is no room for tourists now. The swingers’ festival has been cancelled; the beaches have closed. They will introduce a mandatory quarantine for new arrivals, close the hotels and the parks. I retreat to the apartment. That night I lie awake, listening to the wind and the cats yowling in the darkness.
I hear IVF clinics around the world are closing, treatments being postponed indefinitely, and am filled with gratitude
The clinic is a large, grey, modern building not far from the port. It takes 20 minutes to walk there in the rain, a fierce wind whipping in off the water. At the reception desk, I am told to stand behind a line as they fire a thermometer gun at my head, then permit me to ring the fertility centre doorbell. I fold the sleeve of my jumper over my thumb to press the buzzer.
I will admit that I have not read up extensively on IVF. I have taken a strictly need-to-know approach, avoiding online message boards and support groups, spurning offers to bond with friends-of-friends over their own experiences. Each person is different, I have argued, each body is different. Still, as I stand waiting at the door, I realise that this means I have little idea of what to expect.
A foreign clinic is disorienting when you are accustomed to another medical system: the rhythms are subtly different, the smells, the light all wrong. I notice the cigarette smoke on the senior nurse’s breath, the junior who chews gum behind her mask as she draws my blood. Even the tourniquet strapped around my arm feels flimsier than back home. “Take a breath,” the nurse says solemnly, as she inserts the needle. She leaves a small trail of blood along my skin, then dispenses the contents of the large syringe into several containers; a spring-like gurgling sound that I find oddly hopeful.
I walk home along the backstreets, past ageing stucco apartments and the sound of a couple arguing through an open window. When you are not familiar with a culture or a language, your senses become heightened – the colours louder, the sounds and scents more pronounced. I try to notice the details: the hover of wasps over the bowls of water left out for street cats. A snail on a bright blue wall. The firebug on an orange tree. It stops my mind from spiralling. I stop by the supermarket, where they are already limiting the number of customers, and plastic gloves are mandatory. But the shelves are full and no one is stockpiling.
The following day, I return to the clinic. My blood test results have proved heartening and my consultant tells me he hopes for 15 or 16 eggs. He chatters warmly as he performs my ultrasound: about his time living in London in the days of disco, the fact that English women never cook. “I like to cook,” I tell him. “What do you cook? Sandwiches?” he asks, then reels off the measurements of my ovaries to his assistant. When I leave, the senior nurse gives me a face mask, ties it tightly so that it covers my nose, and rubs my back with a kind of tenderness. “It’s for you,” she says. “Make sure you wear it.”
There is little new I can tell you about IVF medication. The basic protocol is to stimulate the ovaries to produce eggs, which are then removed, fertilised and returned; a further array of drugs help make the pregnancy sustainable. And so for the weeks to come my days are measured out in injections, pills and pessaries, in the fiddliness of mixing powders and solutions, of needles and small glass vials. Soon my stomach is puffy and bruised; my body feels distorted and misshapen.
Meanwhile, I follow news of the pandemic on my laptop. I look at graphs and statistics. I listen to the BBC. Mostly I watch the UK with horror: its slow route to lockdown, the mad rush at the supermarkets, the people who flock to pubs and parks, and jostle over toilet roll. There is none of that here. Rather, people move with a kind of quiet obedience. When my flight home is cancelled, I feel something like relief. I feel safe here.
On March 23rd, Greece grounds all flights to the UK and docks all boats to the islands. I can now only leave the house for an hour each day: to buy groceries, seek medical treatment or take exercise, and must first text the government for permission. A strange serenity settles over these days of confinement: I sleep well and long, read, work, take afternoon walks down to the waterfront. I do not return phone calls from well-meaning friends; texts and emails go unanswered. I feel beholden to nothing besides my own body, feed it yoghurt and oranges and sesame snaps. One day I read that IVF clinics around the world are closing, that treatments are being postponed indefinitely, and am filled with a great swell of gratefulness.
I have a talent for choosing unsupportive men who will find commitments more pressing than helping you through a miscarriage
When I return to the clinic for my second ultrasound, my consultant is in a less jovial mood. He scowls slightly, as if I have disappointed him, tells me the ovarian stimulation has not been as successful as expected; he now hopes for five eggs.
I am accustomed to sitting in doctors’ offices receiving bad news. To be told repeatedly that you have lost your baby, that there is nothing they can do, that your identical twins have no heartbeat, develops a kind of composure. I have learned how to imperceptibly bite my lip, and close my eyes, and know that the grief will come later, far from here, when it will be solitary and wild and flailing.
That I have done all of this alone is testament to what my friends call my terrible taste in men. I have a particular talent for choosing unsupportive partners, men who will ask you to choose between your baby and them, who will miss hospital appointments, and find commitments more pressing than helping you through a miscarriage.
Last summer, I sat in my GP’s surgery and told her I wanted to pursue solo IVF. I pressed my fingernails into my palm to steady myself as I spoke. She was supportive and kind, and made a referral to the fertility department at the local hospital.
I was not technically single at the time, but two weeks later I left my boyfriend of four years. Some months earlier I had learned that he had cheated on me, constantly, for the entirety of our relationship, including while I was pregnant. I had loved him more than I had loved anybody, and perhaps this was the reason I had tried to make things work, but the days had soon settled into a kind of mute despair.
It was liberating to feel in charge of my own destiny again, and for the three months while I waited for my first appointment with the fertility clinic, I felt thrillingly alive. When it came, that appointment was dispiriting: the nurse explained my local health authority’s policy on treating single women. She was sympathetic, ordered a range of fertility tests, cautioned against using a donor I knew, and suggested I look at clinics abroad. “Greece,” she said. “They have some good clinics there.”
There followed several months of waiting – for test results, for a round of MMR vaccinations (my GP had no record of my ever having had them). The new year turned and it was almost spring. I told the clinic in Heraklion, chosen for its impressive success rates and peaceful location, that I would come in March. I had not heard of coronavirus then, though already in China the disease was spreading. It seemed very far away. I focused instead on the small, steady world I had created, of fertility acupuncture, sobriety and sperm selection.
It is easy to get lost in the process of choosing a sperm donor, to dwell upon academic qualifications, professions, favourite pastimes. The more you pay, the more you know: baby photos, adult photos, voice notes, family medical histories. Some cryobanks will supply handwriting samples and outline drawings of your donor’s face in profile; this can have the strange effect of making everyone look like a criminal.
Above all, I decided, let him be kind. From hundreds of donors, I whittled it down to two: the mechanical engineering student whose profile was somewhat restrained, but about whom the staff appraisal spoke glowingly; and a Danish musician with wavy hair who talked about his love of nature and art. “He sounds like the kind of man I would date,” I told my friends. This was not necessarily a good thing, they pointed out. That night I lay in bed and imagined their profiles being read in the voices of my very worst boyfriends. I chose the engineer.
FRIDAY MORNING, the day of my egg retrieval, and the donor sperm has not arrived. The courier office can tell me only that it has left Athens. I take the coast road to the clinic, walk slowly through the uncertain morning, and try not to think about the catastrophe before me. The air is sweet and soft, the sea a searing blue. I am watching the light play on the waves when, just beyond the port, I see the daily cargo boat approaching the shore, bringing supplies from the mainland: food and medicine and a nitrogen tank of donor sperm.
In the days that follow, I like to think of my eggs in the laboratory, cells dividing, happily gathering into blastocysts. It makes me feel less alone. I await news from the embryologist, sleeping, eating, taking long walks. One morning, I wake to a ruffling sound beyond my bedroom curtains. It is a bird, I think, that has flown into my courtyard. But when I look I find it is rain: heavy, plump drops on the corrugated iron roof and the broad leaves of the potted plants. That day the embryologist calls: transfer will be in two days’ time.
Another flight is cancelled. Getting home will now take some 42 hours, several changes of plane, and hundreds of pounds. “Do I need to come and rescue you?” an ex-boyfriend emails. I tell him he should know by now that I am not someone who takes well to rescuing. Perhaps if I did, I would not be here doing IVF alone in a foreign country in the first place.
I am worried about the pigeons. The square outside the cathedral, in normal times surrounded by busy restaurants, lies quiet; deprived of their usual scraps, the birds seem bewildered. They flock near the cathedral steps, as if hoping for mercy. I take to feeding them: crusts of bread and old kalitsounia that brings them flocking around my ankles, burbling and fluttering as they eat. I feed the cats, too, their thin little bodies winding against my calves.
I am the only patient at the clinic on the morning of my embryo transfer. The number of treatments is dwindling as no one can travel and there is too much uncertainty. My consultant, the junior nurse, the embryologist and I gather in the operating theatre. The embryologist plays Mozart through her phone to drown out the whirr of the generator. It is a simple procedure – the embryo being transferred to the womb via a catheter. “There!” the consultant says. On the screen I watch a small dot make its way across the darkness and then settle.
For the next two weeks it will become the pale white dot upon which I live. I think about my tiny speck of hope as I follow the growing bleakness of the world: nurses in London wearing bin bags and scuba masks, the want of ventilators in New York City, the death toll in Italy that rises and rises. I try not to think about how I will get home, about the potential dangers of travelling across a continent, newly pregnant, in a pandemic.
In my isolation chamber I feel like a Russian doll, inside me another smaller me, confined in her own small isolation. I have been pregnant enough times that this state feels familiar: all-engulfing, electric. And yet I have miscarried enough to know that nothing is certain. I have often thought that the two-week wait between conception and pregnancy test is like being alone in a strange house: every sound, every shadow, can convince you that someone is there.
For a week I feel truly pregnant. And then suddenly I do not. One day I wake to feel a tangible distance between the synthetic hormones and my own body. I do not tell anyone. Instead I walk down to the water, stay out far beyond the mandated hour. I marvel at the flicker of tiny fish moving between the boats in the harbour. I look at the bright yellow tangle of fishing nets, the deep pink of wooden shutters, the distant mountains, snow-peaked against the bluest sky.
I walk on beside the sea, past young couples, hands entwined, and think of how clinical and lustless the IVF process is. Of how a week ago I sat in a room that smelled of disinfectant, wearing a thin blue gown and a surgical mask. How there was no one’s hand to hold, no love in the room. In the streets outside, spring had begun. There was the smell of orange blossom, and violet carpenter bees danced between branches. I stared up at the voluminous petals of bright red flowers, at stamen and pollen and anther and stalk, and thought that this was how reproduction ought to be: stickiness and scent, warmth and desire, all the senses colliding at once.
On the day I get a negative pregnancy test, 717 people die of coronavirus in the UK. For a long while, I sit on the edge of my bed and try to balance rationality and sorrow. I look at pictures from Italian hospitals, follow the upward curves of the latest graphs. Friends have lost loved ones, I tell myself; I have lost someone who barely ever existed. And yet I walk out into the cool sun of my courtyard and cry.
Some years ago, the writer India Knight published a self-help book, In Your Prime, in which she discussed the way that in adulthood our lives diverge into two camps: the have-children and the have-nots. For those caught up in the business of parenthood, she wrote, “there is no especial pleasure to be had in a single and/or childless person banging on about the minutiae of their small, unpeopled little life”.
The phrase has stuck with me. As my friends have paired off and become parents, I have seen them less, travelled more, grown quieter. I cannot hope to understand the dramatic shifts and expansions in their lives, just as they are unlikely to understand the reduction of my own.
And as the weeks of lockdown rolled on, that phrase has returned to me anew; I came to think how all our lives have grown small and unpeopled. How we have come to find pleasure in the minutiae: the slow drift of days, the unfurling of blossom, a street filled with clapping on a warm spring evening. And sometimes, too, when all seems lost, a small patch of blue sky above a courtyard in Greece. – Guardian