Miscarriages and IVF: chasing a rainbow baby (and when to stop)
I always wanted a big family, but trying to give my 3-year-old a sibling has been heart-breaking
Isabel Hayes with her baby when he was then 13-months-old
There’s a photo on my noticeboard that gives me a pang whenever I see it. It’s an ordinary photo of an ordinary moment, in which I’m standing in my kitchen smiling down at the 13-month-old baby in my arms.
My boy still has his mop of curls - an adorable head of hair that used to bring strangers in the street to a halt. In his chubby fist, he is clutching the first strawberry he ever tasted.
To an outsider, it might not appear to be a particularly memorable occasion, but I remember the moment vividly.
Unbeknownst to anyone else present that day, my smile contained more than just motherly pride. I was hugging a secret, that I was two months pregnant with my second child. I was nauseous but excited - confident and exhilarated that our plan for a big family was coming to fruition.
Nearly three years later, I look at that photo and feel sorry for my innocent younger self. And envious of her carefree smile. What made her so arrogant as to think that life goes according to plan?
Three heart-breaking miscarriages and two failed IVF cycles later, that baby in my arms is now a rambunctious, excitable three-year-old boy. Not a curl in sight. And no little brother or sister.
It’s the little, everyday things that hit you when you’re longing for another child. When you’re grieving lost babies who left an empty space in their wake that somehow can’t be filled. When it seems likely the big family you hoped and planned for isn’t going to happen, but you’re in danger of spending the next decade trying for it anyway. Just in case.
Little, everyday things. Photos taken in the happy moments of pregnancies that didn’t work out; watching my son playing with younger kids and wondering if he’ll ever have siblings of his own; casual conversations with people who routinely ask, “Is he your only one?” or “Is he your first?”
They’re just innocent questions from well-meaning people making small talk. They don’t know that all I hear is “only” and “first”, that their words form a knot in the pit of my stomach and create a lump in my throat.
Yes, he is our first. We only have one. We don’t know if there’ll ever be a second. So far we’ve spent three years and close to €15,000 trying to make it happen.
Not to worry, the doctors say. You’re only 34. You’re still young. You’ve plenty of time.
My heart sinks at the thought of it.
“He’s so cute! You should make more just like him,” suggests a woman in our local toddler group.
“Ah, he’s getting big now. Would you not give him a little brother or sister?” asks an old lady on the street.
We have been trying for another baby since he was six months old. My first miscarriage occurred a week after that photo in my kitchen was taken, when I was nine weeks pregnant. I was so excited and confident at the thought of having two children under two. I felt stupidly invincible - as if having one healthy pregnancy under my belt meant I could come to no harm.
“I’m sorry.” the sonographer looked up from the ultrasound screen. “There’s no heartbeat.”
At first, I didn’t know what she meant, couldn’t bring myself to understand her explanation - that the baby inside me had in fact died a few weeks previously. The next minute, I was clinging to her, sobbing uncontrollably.
When it happened again just six months later at my three-month scan - “I’m sorry. There’s no heartbeat” - I didn’t cling to anyone. Even my husband, who came towards me with his arms outstretched. Instead, I turned on my side and howled.
“We get one or two of these a day,” the sonographer said matter-of-factly.
I was a freelance journalist working from home around the time of my second miscarriage, but afterwards the walls of our home closed in on me. I needed distraction - a workplace with assigned tasks.
Within two months I got a short-term contract in RTÉ for the 2016 general election and found out I was pregnant again. Briefly.
I discovered it was game over with pregnancy number four the night before a 12-hour shift. I was only five weeks pregnant. The next morning, I cried the entire train journey into work. “Come home,” my husband texted. “No job is worth this.”
I’m no good at being stoic and I’m never loath to call in sick. I still don’t really understand how or why I made myself get through that day.
It was later I fell apart. My contract ended and I was supposed to be freelancing again. My husband had to go to Australia for a month within days of the miscarriage - my third in nine months.
Each morning I would get up, drop my son off to childcare, go home and try to work. Mostly I just went back to bed. I often woke up crying.
One day I drove to Woodies (crying) and spent the rest of the day painting my bedroom mantelpiece (still crying). The mantelpiece turned out quite nicely, but it was around then I realised I needed help.
“Is he your only one?” asks one woman knowingly, as she watches him chatter confidently to all the adults at a party.
“How will he ever cope when you have another?” laughs another mother, when he clings to me for a third hug before playschool.
In 2016, I silently marked three baby due dates. Three days in January, June and October when I was due to give birth to our second child.
Just one per cent of couples have three miscarriages in a row, at which point it’s diagnosed as recurrent pregnancy loss.
After the third miscarriage, we ran the gamut of usual tests and were told there was no obvious reason why I kept miscarrying. For us, it was seemingly just bad luck and we were told to keep trying.
“Maybe your next pregnancy won’t work out, or the one after that,” the consultant - a lovely, warm woman - told me frankly. “But you’re young. Your chances of having another successful pregnancy sometime in the future are good.”
We were filled with horror.
To think we had to keep trying to conceive, keep testing, keep hoping, keep getting pregnant, keep experiencing that awful fear of loss and then the crippling pain and grief of miscarriage until something finally clicked into place and we got “lucky”.
It didn’t bear thinking about.
And yet in the wake of the miscarriages, the urge to be pregnant again was primal, visceral and overwhelming.
It seemed to override even the basic instinct of self-preservation, or at least the preservation of my mental health. For me, taking a break from trying for another baby was just as unthinkable as going through more miscarriages.
Perhaps my body knew better in the end. We spent nearly a year trying to conceive for a fifth time, but it didn’t happen. So we decided to embark upon IVF.
“I waited four years myself until I had my second,” confides a complete stranger in the playground, when her two girls approach my lone boy playing with his diggers. “It’s not easy having a baby is it? I don’t know how those women with two under two cope.”
There’s a reason most IVF clinics offer couple counselling (at extra cost). It is hard bloody work. It’s gruelling on your body. It messes with your mind. It f**ks with your relationship.
You’re pumped with so many hormones you can’t think straight; you put on weight until you look like you’re four months up the duff; you can’t drink alcohol or coffee; you have to eat the perfect blend of nutritious foods; you have to get out and exercise but make sure you don’t overdo it.
You have to treat the bloated body you now intensely hate like a blessed temple and all before you’re even close to achieving pregnancy.
Did I mention the cost?
I never imagined we would end up doing IVF. But another option, our consultant told us (apart from “keep trying”) was PGS IVF, or pre-implantation genetic screening, in which the embryos are screened for chromosomal abnormalities that cause miscarriage.
It’s still not widely available in Ireland and it’s costly (starting price: €8,500). But as the year wore on and we got increasingly stressed trying to get pregnant again, we decided to do it.
And so began a lengthy round of nightly injections, followed by twice-daily injections, followed by a bunch of scans in which I would trek across the city at dawn to have my ovarian follicles counted ahead of egg harvesting.
My ovaries reacted a little too well to the injections and garnered a bumper harvest of 31 eggs (the average is between 10 and 15). These resulted in 12 embryos that made it to day five - the blastocyst stage when when they can be biopsied, frozen and tested.
“An incredibly high number,” the embryologist told me repeatedly.
Two weeks later, seven embryos came back as euploid - or chromosomally normal. An amazing result. Too good, in fact. For healthy people our age with no fertility issues, the average euploid result is 50 per cent.
It meant chromosomal issues most likely didn’t cause the miscarriages and something else must be wrong.
“So what’s the story, are you going to have more kids or what?” shouts a mate over the background roar of the pub. “I thought you wanted a big family?”
We had two choices after those results - carry out a range of expensive blood tests to try and identify other problems that may have caused the miscarriages, or transfer one of our seven embryos.
We knew we might have other issues working against us, but we opted to go for an embryo transfer anyway in the hope that a chromosomally “normal” embryo would succeed.
And so started another cycle of drugs, in which I took hormones to thicken my uterine lining to get it ready for transfer. There were no injections this time, but those innocuous-looking pills managed to affect my mood far more than any needle.
I was angry and I was sad. Everything seemed to be a struggle. I snapped at everyone and had a constant angry monologue going on inside my head.
After three weeks, I was more than ready for embryo transfer. But as I prepared to leave the house, I got a call from the clinic.
There had been some equipment malfunction. My embryo was okay (it hadn’t been thawed yet) but the entire cycle had to be cancelled. I would have to do it all again in about two months’ time.
The hormone-fuelled rage and disappointment is impossible to describe.
But I did go through it all again (free-of-charge this time). I waited two months, took the pills, fought the constant waves of irrational anger, trekked across the city for more scans.
One day, during a bus and train strike, I had to walk a 12km round-trip to make it to the clinic in time for a vital scan. In the end it was all for nothing, as my uterine lining failed to respond.
That cycle got cancelled too.
“A three-year age difference can work really well,” yet another mother-of-two tells me earnestly. “You should think about it. It’s great for them to have someone to play with.”
After one particularly stressful morning in the IVF clinic, when the chance of our second cycle succeeding was looking grim, my husband turned off the mournful music in the car and played the La La Land soundtrack instead - “Something more cheerful”.
It was a beautiful day. I dropped my husband off at work, went home and lay in the garden in the sun, listening to that soundtrack over and over while my son napped.
These days when I hear the upbeat La La Land opening number, what springs to mind is a memory of the sun beating down on my face as I lay in the grass that day. A feeling of despair and desperation building with the relentless beat of the music.
When am I going to get off this f**king merry-go-round?
When you decide to press stop, comes the answer from within.
Because we are the lucky ones, of course.
Even as we revelled in the miracle of our first pregnancy, our first baby, this little being we managed to create together, even as we kissed his perfect fingers and toes and nuzzled the downy hair on his head - we could not have known that for us, he would be truly exceptional.
It’s only now that we fully realise what a miracle he is, this little boy who made us parents. Somehow he managed to survive what the others who came after him inexplicably could not. How close did we come to never having a baby at all?
We make the most of the little things. We have slowly come to accept that this may be our only experience of parenthood. The years are already slipping by so fast, and if we don’t watch out, we will have spent them in a fog of IVF treatment.
This weighs on my mind.
“You’re not going to stop at just one are you?” asks a friend incredulously, as we toast another new arrival. His wife just gave birth to their third.
After the second cycle was cancelled, we carried out further investigations, including the expensive and controversial Chicago immune tests (cost: More than €1,000).
These tests revealed I have elevated natural killer cells, which some specialists believe can cause the body to attack embryos upon implantation. It’s a controversial area of science and the treatment is by no means proven.
But we are at the point where we have to do whatever it takes.
And so for the next cycle, we will take extreme measures to combat my unco-operative body.
There will be steroids, blood thinners and activated folic acid, along with the usual hormones. There will be injections that will catapult my body into a temporary menopausal state and pills that will kick-start it again.
There will be a series of intralipid infusions, an emulsion of soy bean oil and egg yolk that costs €300 each time the nurse comes to my house to give it to me, but which will apparently help to stop my body from attacking the embryo.
There are no guarantees. The cycle may fail and we will have to go through it all again. If it results in pregnancy, I am still at risk of miscarrying for a fourth time.
Either way, I am filled with fear.
We always envisaged a chaotic and noisy home in our future - siblings squabbling, toys and sports equipment all over the house, notice boards strewn with party invitations and diaries filled with matches and parent-teacher meetings.
It’s impossible to quell the hopeful feeling that just one last effort might achieve this dream and it’s gut-wrenching to contemplate leaving our remaining embryos behind.
But we cannot spend the next decade trying to have another baby. Quite aside from the fact that those efforts would amount to tens of thousands of euro, we can’t afford the emotional toll it would take on us as a couple and as parents.
We worry about our boy being an only child. It’s not what we wanted for him. I fear he will be lonely, or selfish, or any of the other labels pinned on “only” children.
But I can’t spend his childhood in a haze of fertility drug-induced rage, fear and sadness either.
They call them rainbow babies, the ones who are born after infant loss, stillbirth or miscarriage. Something to do with rainbows coming after a storm. I try to remind myself that newborn babies are not the calm after the storm. They ARE the storm, gale force 10.
It doesn’t work of course. I don’t think we’ll ever stop wanting a rainbow baby. But there is only so much more we can give towards realising this dream.
The time is fast approaching when we have to put it aside, make the most of our only boy’s childhood and embrace our life as an extremely fortunate family of three.
“Actually, he’s probably our only one,” I say. “Turns out he was a bit of a miracle. We’re very lucky.”