It is a month after my 40th birthday and I have come to Valencia on a job, staying on for the appointment at IVI, the local branch of the Spanish fertility facility, known to insiders as miracle clinics.
It has taken almost two years of sleeplessness to make this decision, to face the truth of my situation. While friends' lives have moved forward in unison and in neatly defined chapters – marriage, first home, first child, second home, second child – I have been unable to move forward with them.
Alone at night, the thick walls of denial crumble down and I am paralysed with shock. It is as if I have crash-landed into my own future to find myself 40, single and childless. The sound of absence is deafening: like white noise, a droning, gentle at first, then louder like the song of the cicadas as dusk turns into darkness. "How did I get here?" I ask myself over and over. "How did I get left behind?"
In my 20s and early 30s, I felt few maternal urges. The idea of breastfeeding, like a sow suckling a piglet, made me nauseous. Prams triggered low-grade, non-specific anxiety: they were vehicles of entrapment. The concept of a creature growing inside me was terrifying. But not as terrifying as the stagnating, desexualising effect that I feared nursing a baby would have on my relationships and my life.
And so the years passed. But when, at 39, I split up with my boyfriend (his betrayal), the sadness hit hard. I mourned him, but the grief was magnified by a new loss: the option to have a family. I had lived 20 years of manic self-fulfilment, but now all those experiences I had so carefully curated for myself seemed egotistical, empty, without someone to pass them on to. I felt a new longing, not from my body, but from my heart and mind.
So I have found myself stranded, single and 40, crushed up against the glass ceiling of my own biology. The passivity feels profoundly humiliating: a progressive draining of dignity and power. I cannot turn back, nor can I find it in myself to settle. I need to fall in love again, to have a baby. But the last year, punctuated by a chain of woeful dates, has been a painful process of letting go. My new love isn't coming. I know I must set myself free. If I have left it too late to have children, it is better to know, and try to move on. I'm scared that the sadness might overwhelm me. But there is no time left for denial. For the first time, I hear the sound of the clock.
I am finally called into the doctor's office. Sick with nerves, I distract myself by imagining I'm a character in a Pedro Almodóvar film. We talk in English, but during the scan he dictates my follicular counts in Spanish to the nurses while I stare at the collage of baby photos on the wall. These will predict my fertility levels. When I overhear "muy, muy bueno", I hold my breath.
My follicular count is 18, above average for my age. I have a good chance of getting pregnant, though I must also do hormone tests. If I decide to wait for a partner, I can freeze my eggs with a good chance of getting eight to 10, the ideal number to store, in one round. After years of agonising, my life has been changed in a few minutes. The fog in my brain evaporates. My future is opened out again.
Back in London, I wait for the results of my hormone tests. My follicle-stimulating hormone count is 6.75 (the lower the number, the better) and my anti-mullerian hormone is 9.2. I spend the night Googling fertility sites and chatrooms, opening me up to an underworld of older women, desperate to conceive, their biological chances reduced to a confusing set of numbers.
Both my counts turn out to be excellent for my age. I find research done at the Advanced Fertility Centre in Chicago: in under 35-year-olds, the number of eggs retrieved in women with a follicular count of 16-22 is 10; the IVF success rate for the same number of remaining follicles is 51%.
I begin searching under the term "egg freezing". Two thousand babies have been born to date worldwide from frozen eggs for medical – fertility preservation prior to chemotherapy – or social reasons. But in the UK, up to December 2012, only 20 babies have been born to women from their own thawed eggs.
But a new method freezing eggs, vitrification, in which eggs are flash-frozen in liquid nitrogen, has improved the chances of them thawing intact to around 95%, compared with 65% using the previous slow-freezing method. Moreover, trials in New York in 2006 found the same pregnancy rates occurring in IVF rounds from frozen eggs as fresh ones. Another study of 900 babies born from frozen eggs shows the same level of birth defects as babies derived from fresh ones. The technology is there and it is improving all the time.
I ring private clinics worldwide. A nurse at a Californian centre tells me that of the 150 women whose eggs it has frozen, 21 have returned and 15 have had babies. The Lister Clinic in London, by contrast, has done only 20 thaws, with one pregnancy which ended in miscarriage. At IVI Spain, 800 women (mostly between 36 and 38) have frozen eggs for social reasons in the past four years, but only 21 have returned for treatment. Five healthy babies have been born from these.
My best chance of having a baby, of course, is to get pregnant now, on my own. I try hard to contemplate this. But it's a decision that seems just too big and impractical for now. My course of action seems clear: freeze my eggs, and if I don't meet someone in the next few years, have a child with a sperm donor. After years of stasis, I have a clear goal. And it seems like the most important one of my life.
Article: 14th December 2013 www.theguardian.com
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