UNCONVENTIONAL FERTILITY

Our 3^rd round of IVF failed and the whole thing has hit me like a bus. This is not a podcast episode because I am not able to speak about this without crying. And to be honest, even crying seems so overrated right now because what I feel is a deep sadness that crying seemingly cannot express. Since test day I have cried a few times but nothing like I imagined it in my head. I cried like a baby, while my husband held onto me tightly, for about 5 minutes the morning we took the pregnancy test. The crying after that caught me unaware; while I was drinking tea, drinking water, while I was eating, while I was staring outside or staring at my phone… and it was just tears rolling down my cheeks with no sound or body response at all. A slow release of the deep sadness which has engulfed me.

I contemplated about writing this – and it has nothing to do with shame. I just knew that writing this, was going to be very different. I am usually very positive, and I always like to pair my words with encouragement, but I contemplated writing this because quite frankly I do not have anything encouraging to say. I don’t feel encouraged and right now I don’t even want to be encouraged. I worried this round of IVF would ruin me – we had 2 embryos transferred, it was our third go, in my head I couldn’t imagine anything more cruel than it not working. And then it didn’t. And now I have to reconcile what was once genuine optimism with grief, yet again! I told my hubby mid-tears that IVF feels like I’m in prison and because of good behaviour there is a plan to release me soon but then test day (“release day”) comes and I find out something unknown sabotaged my case, and I am no longer getting out of prison and have to continue serving my life sentence. That is EXACTLY what IVF feels like to me. And I AM SO TIRED.

I have prayed. I have been positive. I followed my protocol. I’m a good person.  I don’t get it, what am I meant to be doing that I am not doing that is blocking my path to parenthood? Other people get pregnant SO easily, I have put in the time, surely I deserve this too? My whole life people have told me what a great mother I would be and it is honestly the only thing I have ever really wanted and now this is happening to me. To what end? What is the point of all this? What lessons am I yet to learn – that other people clearly don’t need to learn? It’s cruel, this infertility/IVF journey. It’s damaging to the spirit and we carry on because life must go on but how am I supposed to come back from this? And I don’t mean superficially come back, which I think many of us do, but how can one regain what has been lost – over the years? For the first time I really started thinking… I have never really heard anyone in the infertility/IVF community say “it’s worth it in the end” (although people who have never experienced either say it to me all the time) but I get it now, because I am not convinced that the day I hold my baby in my hands I will say it was all worth it. I will be grateful for the blessing, but I cannot assign the pain of this journey to the worth of my baby. I reject that. No one should have to pay a price like this (physically, emotionally, mentally & financially) just because they desire to have child. So no the infertility/IVF journey is not worth it. My baby will be worth a whole lot of something, but certainly not pain and ruin.

Everyone’s story is different and in all of it, the one truth remains that I KNOW I will be a mother – whichever way that happens. I have been comforted by this knowing right from the beginning but on the flipside, it makes the IVF failures harder to process because in my mind I’m thinking if not now then when? How far from now? How much more do I have to endure? I have a lot of younger women who follow my journey and although I lack the capacity to tell you this with conviction right now, please stay encouraged. It’s not the end unless you say it is. In an act of diving timing, a few days before our test day, I was led (by a close family member) to Gabby Bernstein, who has this wonderful talk on Oprah’s Soul Sessions & a book that is currently SAVING MY LIFE called ‘The Universe has your back’. I am not sure I would have the chance to make it out of this heartbreak if it wasn’t for the loving reminders to the spirit that I am reading in Gabby’s book. It’s very spiritual and it might not be for everyone but as it is literally saving me, I feel so compelled to share it in case it can do the same for someone else going through the anguish and heartbreak of infertility/ IVF. I have deeper love and respect for all of you who have walked or are currently walking this journey. Our resilience is unparalleled, and I have no doubt that our desire will be met. Make room. Make way. For love to lead. For your fears to be transformed into faith. I am saying all of this to myself as well. Because, cue Gabby Bernstein, “When we assume an energy of faith, we are receptive, released, and magnetic.”

Big love and thanks to the women who reached out to me during my 2 week wait and sent me care packages in the form of self-care gifts, text affirmations and check-ins, and love. Everything can be so shit but our #TTC community is so beautiful! Thank you so much x

Love,

Noni

Last week I sat on a panel organised by the HFEA, with doctors; Christine Ekechi, Raj Mathur & Yacoub Khalaf to discuss the HFEA’s latest report, ‘Ethnic diversity in fertility treatment 2018’ – UK ethnicity statistics for IVF and DI fertility treatment (Published: March 2021).

The report highlights disparities in access to and outcomes of fertility treatment by ethnic group from 2014-18 and I wanted to share some of my responses to the points raised but also just to share some of my reflections from reading the full report.

Please note my comments are based on my own experience of treatment – I am not speaking for all women. I don’t believe the ‘blanket’ approach for all has been working and I think the more visibility/voices we have of the nuances of our experiences the better we will be able to inform next steps for the HFEA, practitioners and all of us within our minority ethnic communities.

Additionally, my comments are bite-sized and I know in reality more elaborate discussions have to take place. I also appreciate that more research will need to be done to get more of the granular detail which will paint a clear picture of the various determining factors of the data.

A lot of women I have spoken to do not find the data surprising, with many telling me that they have been saying a lot of this stuff for a while – and that in itself says a lot. In any case, this was long over-due and it is great in some respects to finally have something tangible that hopefully will be acted on by all the actors in the fertility sector, patients included.

Black patients reported higher rates of tubal factor infertility, accounting for 31% of patient-based infertility compared to the 18% average.  

Do you believe it is public knowledge – that infertility prevalence varies by ethnicity? If not, what actions would be helpful to get this information to patients? i.e. info from GPs; charities; HFEA?

• I certainly don’t think it’s public knowledge, but I think as women are increasingly telling their stories more openly… the knowledge is being shared. A lot of the women I have spoken to on my podcast report fallopian tube complications, but I don’t think it is common knowledge before you start trying to conceive. A lot of these complications only become realised once one is trying to conceive. Outside of that, I think generally most women are non-the-wiser.
• In terms of what actions would be helpful, I have been thinking a lot about whether a fertility MOT of some sort, from a particular age (25?) would be useful. Something that is standard procedure whether you are trying or not, maybe in the category of a routine smear test. Because I think it’s important to know about your fertility health before you even start trying, because if we consider when people access treatment it is usually after years of trying and I am not convinced it is the best time to learn for the first time that your body (or your partner’s) has contributing factors. I think couples should be coming into fertility treatment empowered by the knowledge of their fertility health, not necessarily seeking it at the point of intervention. And for me personally, that’s where a lot of the focus in terms of education and awareness should be – before or as soon as a couple start trying naturally.

Black patients generally started IVF at later ages than other ethnic groups at an average age of 36.4, compared to the national average of 34.6 in 2018.  

What are your thoughts on why Black patients are starting treatment later than the average patient?

• So there a few reasons and there is usually a huge focus on external factors, but we must not underestimate the internal factors that are also at play. The cultural stigma around not conceiving naturally is huge. If I use myself as an example, I went through a period of intense denial for about 2.5 years – I was in denial of the fact that it was taking us a long time to conceive and it was only due to being admitted into hospital for unrelated pelvic pain that I was catapulted into the world of fertility treatment. I am not convinced that I would have sought treatment myself, at least not for another few years because as a black woman, motherhood is a huge part of our identity and we are apparently ‘hyper-fertile’ so when you don’t fit that narrative, there is real shame and quite frankly anguish because in our communities, you have no way to make sense of it, you have no logical framework to explain why you are not falling pregnant because no one is talking about it. For me, there were no references at all to infertility or people who had experienced that – everyone talks about babies, but no one talks about the process and that sometimes it’s just not that linear. So, for a black woman to access treatment, she has to process all of this in complete isolation from her community and that’s a very difficult thing to do.

What are actions that we as the regulator (or the fertility sector as a whole) should be taking to reduce any external factors that may play a role in delaying fertility treatment among Black patients?

• I think it’s important for the fertility sector as whole to recognise that there is a deep rejection of infertility in black communities because many people, and I am saying this from experience, think the infertility diagnosis is the end – that you will not be able to have children. When I first came out with our infertility story on my blog, I cannot tell you how many people told me “infertility is not your portion, it’s not God’s plan for you” when in reality it was, and it is. So, I really think there is scope for an education and awareness piece, targeted specifically at minority ethnic groups about the options beyond the infertility diagnosis.
• The language and the imagery in any campaign or information must represent ethnic minorities too. It sounds trivial but all the pamphlets I have seen relating to IVF have white people only and relate only to their lived experiences. So, it’s not that far-fetched that a lot of people in my community think IVF is for white people and a lot more do not realise that they can apply for funding via the NHS. (Eligibility however, depending on where you are in the UK, is a whole other conversation!)
• I also think the messaging around seeking help, from your GP as a first point of call, after a year needs to be stronger or clearer – is it 1 year or is it 2 years? And how is this being communicated to those who needs to know? In my podcasting experience, I have found that a lot of black women/couples are not aware of this.
• Additionally, and this might be a bit ambitious, but I think any awareness piece needs to engage community leaders, religious leaders & families (particularly matriarchs) because these are the people that a lot of couples go to when they are trying to conceive and if these trusted authority/compassion figures are ill-informed, the impact of that must not be underestimated. And I say this as a very enlightened, educated, liberal thinker… my desire to have a child definitely clouded my normally sound judgement about what was being said to me by various authority/compassion figures in my life.

Black patients had lower IVF birth rates: for Black patients aged 30-34, the birth rate per embryo transferred was on average 23% compared to Mixed and White patients at 30% from 2014-2018. 

Is there an argument to provide tailored success rates to patients based on their ethnicity following our findings?

• I personally would be interested to know the tailored success rates for my ethnicity. Even now as a 32-year-old patient, the success rate I have been holding onto for hope is the that 29% success rate but now with the findings of this report, I am wondering whether than even applies to me at all. And I think it’s important to stress I know that it won’t improve outcomes for me, so some might say well what’s the point, but in IVF, well for me anyway, knowing is all you have. There is no guarantee of anything so knowing how the odds are stacked for/against me, manages my expectations. All of us go into IVF hoping it will work the first time but when it doesn’t, I found knowing the success rate helped me process that. And also, if for example the success is in fact lower than 29% for me, that difference might determine how long I do this for, how long I keep trying via IVF or how soon I turn to other avenues towards parenthood. So I think it’s crucial information, personally.

Multiple births are the single biggest health risk in fertility treatment for patients and babies. This includes increased risk of miscarriage, high blood pressure, pre-eclampsia, gestational diabetes, c-section and a 2.5 times increased risk of maternal mortality for patients. In the report, Black patients had the highest multiple birth rates of any ethnic groups at 14%, compared to a national average of 12% from 2014-2018.  We also know that there is a higher prevalence of maternal mortality among Black women (5 times higher than that of White women).

Do you think patients are likely to agree with whatever is recommended by the clinic? Are patients provided with enough information from the clinic to weigh out the risks involved when making the final decision?

• I think there is scope for an awareness piece here as well because when you have been trying for years, especially for black women by the time they access treatment, let me tell you twins do not sound like a bad idea at all! Almost every black woman I have spoken to, on & off my podcast has said they would have preferred twins because then they would not have to do IVF again but also, I think with twins we often see the end result when they are born and growing and cute, not always the pregnancy and potentially the complications around that. So, there is quite a hype around having twins, especially in the IVF community and I hardly hear people talking about the risks. I am now in my third round of IVF and I asked for a double embryo transfer and my consultant was in agreement – and there was no follow-up discussion around the risks because I also think consultants struggle with the timing. Is that the best time for a consultant to bring up complications when a patient’s last embryo transfer failed, and they are keen to go again? And also, do you bring it up now, or when the patient actually falls pregnant? I think it can be tricky to find the right time because as consultants, they are already dealing with fragile patients, fragile in their pursuit of parenthood. Having said all that, with the higher prevalence of maternal mortality among Black women and us having the highest multiple birth rate, it is quite concerning, and I agree that more needs to be done to inform patients of the very real risks.

– a love letter to my community

Dear Black People, we need to break the stigma and misconceptions. We need to check the misinformation we have held onto for generations. We need to become more critical and progressive in our thinking because in doing this we will be able to see unconventional journeys towards fertility – or anything else – contextually, and not through the lens of our projections and societal conditioning.

– Noni Martins

Had my story been different I would have never known just how misinformed we all are when it comes to fertility health. I am writing this letter from a place of love and compassion because I realise the tension between black/african couples trying to conceive and their families and wider community needs to be addressed. What couples tend to do when they find themselves at the trying to conceive stage and things are taking longer than they thought, is to keep quiet and smile on the outside as their loved ones say all kinds of inappropriate things, while fuming or even crying on the inside. First thing is first, and I say this with all due respect, my womb and its reproductive ability or lack thereof is my own business. My husband’s sperm and its reproductive ability or lack thereof is his business, and together as a couple trying to have a baby together, both those things – are OUR business. I know that a child belongs to the family and it takes a village to raise a child but the process of doing that is mine and my husband’s. The best way to think about it is if you are not there when the love making is happening or when sperm is being inseminated (IUI) or when an embryo is being transferred (IVF) – just conclude that it is NOT your business. For too long, couples trying to conceive have tolerated unsolicited advice/comments from people who “mean well” but really don’t have a clue about what is really going on, and worse still don’t have the courtesy to actually ask. As a community we project our own ideas and experiences of pregnancy onto others, but we have to realise that everything is contextual.

Take for example, our male factor infertility. My husband has low sperm concentration (count) and low sperm motility (movement) due to the fact that he has been on dialysis for over 10 years. Male factor infertility is a medical diagnosis – it is not a stab at his manhood. Our bodies are biological – male factor infertility has nothing to do with who he is a man or a husband, that’s a societal construct. And that is something that we as the society/community need to deconstruct. The same man who has a low sperm count and low movement is the same man who fertilised 19 of my 20 eggs that were retrieved at egg collection. The same male factor infertility is the same that gave us 10 good grade embryos. What happened between 19 eggs being fertilised to having 10 embryos is a matter of biology and science – and has absolutely nothing to do with my womanhood or my husband’s manhood. We need to deconstruct this – making babies is biological i.e. you don’t have much of a hand in this – raising them is societal and you have more influence over this. The two are different and the thing to remember is that even when trying to conceive naturally and much more easily, the same biological process has taken place. The only difference with infertility cases is the use of medical interventions that mimic what happens naturally and sometimes assist the process to improve the chances of a pregnancy. None of this takes away from anyone’s worth or validity as a man or woman.

So how about the female factor? The majority of what we know and believe about this as a community is WRONG. Do you know that research has shown that male factor infertility accounts for about 40-50% of all infertility cases? This means that if there were 10 couples dealing with infertility – i.e. struggling to have a child – 4 or 5 of these couples would be because of male factor infertility. The biggest myth of all in our community is that all infertility issues stem from the woman. This is largely in part due to the patriarchal societies we live in but is also due to the fact that we refuse to think critically and progressively – I mean honestly, in what real world would all infertility issues be caused by female biology. To what evolutionary gain? It actually doesn’t make any sense. Sometimes, question things you have always known to be true, we live in the age of information – seek it. In case you haven’t got my point – it is possible to have issues with conceiving when there is NOTHING wrong with the woman in the equation. If in doubt, think of me as a real example. Apart from an irregular cycle, which is insignificant by the time you’re having IVF, there is nothing biologically wrong with me that could affect my ability to have and carry a child (as far as all the investigations I’ve had show). The reason we are having IVF is due entirely to the male factor diagnosis. How’s that for some myth busting?!

Another key thing to mention is that infertility is a thing between 2 people. I can have contributing factors as an individual but until I am trying to conceive with someone, they are just factors. Using my husband again, what he has is a standalone medical diagnosis – so for example the reduced sperm concentration is called oligozoospermia and the reduced sperm motility is called asthenozoospermia. These are medical conditions that exist whether in the context of trying to conceive or not. Semen analysis is based on a standard of normal levels and so even if you are not trying to have a baby, you can still have tests and stand-alone diagnosis for how much you deviate from these ‘normal’ levels. It is only in the context of him trying to have a baby with me that it becomes male factor infertility. So, I never separate myself from that diagnosis, it is OURS, not just his. We are trying to conceive together; I am not doing this alone and neither is he. To put it simply, someone in my situation could potentially get pregnant easily, with a donor sperm for example – which is an option that has worked for so many couples! But again, everything is contextual – we are not there (yet) as we have 9 embryos frozen and have only used 1 of 3 of our NHS funded cycles. The point I am trying to make is that, just because we have male factor infertility, I don’t remove myself from the situation because infertility belongs to two people, what affects him – affects me – affects us. Other examples include women with PCOS, endometriosis or fibroids – many women know way before having babies is on the agenda but it becomes a different kind of problem at trying to conceive stage.

Which brings me onto my last point. It would appear that me talking male factor infertility has triggered a lot of people in my community. I’ve had quite a few messages from people asking me whether I have “permission” from my husband to blog about our story and others saying “you are very lucky that your husband let’s you do this”. This language is triggering for me! Permission… let’s me… Look, I appreciate that I am fortunate to have the kind of husband that I have, that has never wanted me to be anything else but myself but we need to check our patriarchal complex here. It should not be a luck thing for a husband to “let” his wife do anything. And I also don’t believe in permission. The undertone of this kind of thinking feels very much like people would rather believe that I am a disrespectful wife who blogs about this stuff behind her husband’s back, than to believe that my husband is a progressive man who feels no shame about our male factor diagnosis! Again we need to deconstruct these patriarchal systems of the man as supreme and the wife subservient to him and his command. For the sake of speaking with love and compassion and fostering deep understanding, I’ll say this. Way before any of this began, I had multiple conversations with my husband – because it is not about permission, it is about discussion for us – and only when we were BOTH comfortable with the idea of sharing our story did I decide to do it. We both had to be comfortable, I am also in this process too and I had to think long and hard about opening myself up in this way. I am lucky in the sense that my husband is not ashamed at all, and he has never internalised the ‘male factor’ element of our fertility diagnosis.

“I give myself permission to cry, scream, laugh, dance, eat and do all the things that this dynamic body needs and demands”

– @siphokaziveti

Once we started our IVF treatment, the whole thing just felt like a dream. It feels real but not real at the same time and it kind of felt like we were in this game where you are almost about to have your baby and boom you wake up and realise it is not a dream and you do not have the baby because the pregnancy test was negative. I am conscious that when Mr Un_fertility and I did our Instagram live it was easy to walk away thinking that “aw they will be fine, they will be parents soon, they seem very with it” – please allow me to say the IG live was just a glimpse of our IVF journey and no day is the same. Certainly not the day we had to take the pregnancy test after our frozen embryo transfer (more on that in the next update). I remember it so vividly, and I remember it all because I only need to close my eyes to see my husband’s face when I said ‘it didn’t work’. Breaking his heart in this way will stay with me forever. I woke up at 9am and went straight to the toilet on test day, he was awake waiting for me in bed, I had left the test on top on the toilet so I wouldn’t forget to test with my morning pee (AS IF one would ever forget this in IVF!). I peed and I covered the test window with a piece of toilet paper and started the countdown, when the time was up I didn’t want to reveal the window. I thought about how many test windows I had seen before, all of them so willing to break my heart, I thought God please let this one be different…

I mustered up the courage, unveiled the test and there it was, in as black and white as it gets! ‘NOT PREGNANT’. My immediate response was to shut down all feelings and I just went numb – I have been doing this since I was a kid. I walked out of the toilet, my husband’s head rose up in hopeful anticipation (the most hopeful I have ever seen him) and I said the words “it didn’t work”, he collapsed into his body and I quickly looked away, went to my side of the bed and covered myself completely and closed my eyes. As much as I wanted to be there in the capacity of a comforting wife in that moment, I genuinely did not have anything left in me. I wanted to pray, meditate, sit still, sit in silence, scream, cry all at once. But instead I just shut down. My husband left the bed shortly after I got into it and went downstairs. As selfish as it sounds, I was relieved to be on my own because if the urge came, I could cry without him there. I didn’t want to add to any hurt he was already feeling. So I lied there so still, I didn’t move, I didn’t speak, I wept for literally 20 seconds – and I was weeping about breaking the news to my husband not the fact that I didn’t have a baby in me – then I wiped my tears and that was ALL the emotion I had that day – and ever since. I realised then just how cried out I had become, over the years, over the months that have made up 2020. So much crying that I didn’t have much cryfest in me bar the 20 seconds of weeping.

As if telling my husband wasn’t enough to bear, I remembered that I had told my mum + sister that I would ring them at 9am as soon as we found out. Again, numbness came over me and as much as I knew my mum was waiting for that call with as much hope as my husband, I couldn’t bring myself to call her. There is something about calling your mum that brings out the cryfest in you and I didn’t want to cry, as in I really did not want to cry. I just kept thinking okay cry and then what?! That’s not going to give you a baby. It’s done. Get over it. Yes, this is how not-gentle I was with myself. Again, numbness. Complete shutdown of the softer parts of me. Fight – Flight – or Freeze. So anyway, I didn’t call my mum, I put my phone on DND and I went back to sleep. When I woke up, I had kind of forgotten the morning, then I remembered, and I had this knot-feeling in my stomach and I felt so shit. I didn’t want to go downstairs because my husband was there, and I just didn’t have it in me to comfort him or even to seek it from him. I just wanted to forget this ever happened. So I took a shower with some music on and started feeling like myself again – (you guys need to understand that my black girl joy series is an actual lifeline! As funny and crazy as it is) – and I left the house to go park somewhere and called my mum.

I would say that phone-call with my mum + sis was the most ‘matter-of-fact’ I have been in my entire life. My mum was all mum-like and she was being very emotional, and I was literally responding to her with the science, the facts, 29% success rate and all that. Deflection. The more emotions I got, the more factual knowledge I dropped. Listen, I had zero capacity in me to ‘honour my feelings’ or the feelings of others – and even worse, I had no capacity to feel guilt for being this way, in that moment. It’s not necessarily something I feel needs an apology but taking my mum + sis, and my mum in particular on this IVF journey made me realise that when I made that decision, I took on the responsibility for their feelings too – which is something I had no business doing. My pain about not being pregnant was also a very real pain for my mother and I was not and still not in the right frame of mind to comfort her grief. And it is grief, for all of us. My counsellor said IVF patients harbour heavy emotions not realising that a lot of it is grief, even though we never met the baby, even though our embaby didn’t implant in my uterus, it is still a grieving of the possibility. Everything about IVF is centred on the mere possibility, that chance will work in your favour. And as we all know grief is not the easiest of emotions to process. And everyone handles grief differently. What I know now as an IVF patient, and as the one who has to carry the baby… I am in no position at all to be responsible for the feelings of others and the person I really need to look after and focus on is myself. As women we fall into these superwoman narratives so easily but trust me IVF will show you just how important it is to be a bit selfish. Because sis, you can’t come and die!

It took my first ever counselling session last weekend to understand that I have PTSD. IVF is an abnormal experience that you get thrown into with absolutely no experience at all and no training.  And the worst part of it is that there is no real end in sight so when you enter the world of IVF, you are signing up to lose all your power, your freedom and all spontaneity. The IVF journey is often likened to a marathon because it is long and so much mental, emotional and physical energy goes into it, but the key difference is that you are not getting rid of this energy as you would in an actual marathon. So the brain has to make a decision, is this a good challenge or a bad challenge? What does this body need to survive this and get through it? – this is where the primitive – fight / flight / freeze concept comes in and in order to main either of these states, the brain tells the body to produce adrenaline as an automatic physiological response. People with PTSD have been found to continue to produce high amounts of stress hormones even when there is no danger and it is thought this may be responsible for the numbed emotions and hyperarousal (feeling on edge). And adrenaline can cause other issues like anxiety, insomnia, panic attacks etc.

My key takeaway from my counselling session was when she said, the IVF episode is the opportunity to practice being parents before the baby is here – it is the chance to parent each other, to be the soft place for your partner and vice-versa. Because that is the role we will play for our baby. I thought this was so powerful and it filled me with a new sense of purpose because I don’t want to be this numb version of myself when I have a baby. I don’t want to be this numb version of myself in general. So as part of my mental and emotional health treatment, she encouraged me to practice (re-claiming) my soft place with hubby before I restore it in my other relationships with family and friends. I’ve said this before, but I will say it again, our story is real and it is unfolding in real-time and no doubt this is the hardest thing I have ever gone through. And you have to navigate the IVF within the context of normal life and work and relationships and it gets so overwhelming because I am constantly feeling like I cannot catch a break, if it’s not a work deadline, it’s an appointment, it’s an injection, it’s looking after the home, the puppy, it’s feeling so sick on the medications, it’s the physical pains, its friends and family still expecting 100% from you. It is just too much. My point is please practice patience with your loved ones going through IVF, if you feel the friendship has changed, or I don’t attend enough family things, or we hardly talk now… just remember that I am emotionally, mentally, spiritually and physically trying to have a baby every minute, every hour of every day. All my energies are channelled towards this desire and the small bit of leftover energy (if any) is just enough to keep my head above the water.

“Let us hold fast the confession of our hope without wavering, for He who promised is faithful” – Hebrews 10 v 23

I say this all the time…  I wasn’t always this believer (in God). I believed in a higher power of some sort and felt no need to be definitive about that. And I strongly believed that I am, everyone is, the orchestrator of their own life. What you put in is what you get out. But after a couple of years of putting in the work to get pregnant, my once fool proof belief systems started to the unravel at the seams. I don’t doubt for a second that God put me through all of this to remind me that HE IS. Yes I can live intentionally, yes I am a good person, yes I put in the work but this thing we call life is not all linear. There are some detours and obstacles that we don’t ask for and I don’t necessarily believe that God intentionally tries to make things difficult for me but what I do believe is that he does help me get through it – and usually in ways that make no logical sense at all. A non-linear solution for non-linear problems.

A year and a half ago, I would have never referenced God, His love, His light, His might, His promise in anything. But even through all of that, he remained faithful and kept showing up for me even when I wasn’t showing up for Him. I have seen God’s work in my mother’s life, raising my sister and I as a single parent, I have seen God’s hand in my own life, but still, it took a struggle get me on my knees and back to him. It took a struggle to strip me off my worldly pride and wisdom and surrender to Him. The fact that people write to me now and say things like “thank you for your Godly joy” still stops me dead in my tracks because I literally no longer recognise my former self. As if this wasn’t all well and good, God said ‘I want to take things up a notch’ and led my spirit to hosting IG lives with 3 wonderful women who spoke to my spirit in ways that a bible verse or sermon couldn’t have. And I am forever changed by the conviction and trust in God’s promise that these women showed.

@vanessahaye is generally just a force to be reckoned with and the same is true for her faith in God. When we first started speaking, Vanessa mentioned God a lot and I was still going through the transition. Fast-forward to our IG live and I remember finishing the live thinking, well damn Noni… you think you believe but you set limits on your expectations from God. During her IVF journey, Vanessa challenged God and told Him that if He blessed her with a child, she would praise His name for the rest of her life. First of all, I was like wait, I can challenge God like that? If you watch the live you will learn quickly that Vanessa does not come out here to play! I was so moved by this concept that a relationship with God is two-way, it is not just about one-sidedly hoping conservatively that God gives you want you want in abundance (this is also okay) but it can also be an exchange where you tell God what it is that you want and say God I am going to do my part, and leave you to do your part. I then realised that for a very long time, I had equated believing in God to mean relinquishing all my authority over my own life. Vanessa made me realise that, no no honey, God wants you to OWN the authority you have over your life but he wants you to give HIM the glory.

@faithledfertility’s story is one that needed to be heard. With all Dannika has been through, she is the most upbeat full of life sister in this journey, always hopeful and always looking for ways she can be better and do better to increase her chances at motherhood and always so willing to share the knowledge. I was moved by Dannika’s unwavering trust in God, after multiple miscarriages she is still holding onto God’s promise. Hearing Dannika’s story, comforted me and if I do happen to this in this for a long run, Dannika’s faith will remind me that not all is lost. Dannika made me realise that I was only at the beginning of my journey because unlike Dannika I have never been pregnant. And as we all know, the story as far as struggles and anxieties go, does not end once you are pregnant. This is not to say I expect to be this in struggle forever but seeing her and connecting with her made me realise that however the story unfolds, I am going to be okay. This was the affirmation I didn’t know I would need weeks later when my pregnancy test after the first embryo transfer came up negative.

@themissusv’s story added a different angle of the journey to motherhood. As I said before, the struggles do not always end once you are pregnant and this was certainly true in her case. I knew nothing about the world of premature babies and when you are trying to conceive you get so caught up with getting that positive pregnancy test that you just don’t have the capacity to consider the actual pregnancy. I am grateful to Nyasha for always speaking openly to me about her pregnancy because I am one of those people who prefers to know things that could potentially happen (I know that is not for everyone). In our IG live Nyasha spoke with the same openness only this time it just felt so much closer to home because she was speaking as a mother, a mother who had spent 78 days in a preemie ward with her daughter, with zero guarantees about anything. Much like infertility, we don’t talk enough about all the unexpected things can happen once you are pregnant. And again, Nyasha held onto God. I just think there are certain things where science will not be enough, the love of a partner/family will not be enough, your wisdom or good nature will not be enough. There are things that require something so much bigger than us. I felt this in Nyasha’s story and it affirmed my journey back to God.

I want to thank my sisters @vanessahaye @faithledfertility @themissusv for holding space with me on Instagram live and inviting God to the conversation. In the same way God was using me to shed light on your unconventional stories, God was using you as testimonies to show me who He is. To show me what he can do if I expect it, if I believe it, if I ask him for it. I said a while ago that I actually hadn’t prayed the prayer asking God for a baby – I was being so conservative in my faith. But I know now that big big faith gets big big things. And God is not a God of small things. The Man likes to show off! And me too I should meet him on his level with violent faith. Boundless expectation for a boundless God. I don’t say this to imply that everyone needs God. But I need him. I have never needed him more. My friends and family love me but no one can give me the peace/healing I need in this journey, no one’s love is like His, no one’s promise is like His.

He is faithful, to the very end.

Love isn’t cancelled

Music isn’t cancelled

Dancing isn’t cancelled

Progress isn’t cancelled

Meditating isn’t cancelled

Dreaming isn’t cancelled

Self-care isn’t cancelled

Reading isn’t cancelled

Having fun isn’t cancelled

– @insta_holaa

What a year it has been already… and I am really not sure why and how a non-UK Mother’s Day has triggered me. I don’t remember being this triggered in March when it was the UK Mother’s Day but in the lead up to today (Sunday) I have just not been myself. Even my husband asked me today if I was okay because I’ve been “a bit off for the last 2/3 days”. I told him I didn’t know how I felt and truth is I don’t but there is something about going through Mother’s Day after spending 2 months on hormones to produce eggs, having an egg retrieval, only to be told weeks later that everything is now on hold indefinitely due to COVID-19. On top of all this, my grandfather passed away during this time and my puppy died only days after our treatment was put on hold. I mean can a girl get a break!? So I did take a break for about 3weeks I switched off the part of me that is always preoccupied with baby-making and I just got on with my life like I wasn’t planning on having a family. This is after a lake full of tears and silence and more tears and just silence. I am never quiet so when I’m silent, things are really not okay.

And guess what? The ‘switch off’ time was quite literally the best few weeks I have had in a while. I zoned in fully into working from home and working out and I have a really good balance and consistency now. I even got a pay-rise during this time which is testament to how much I gave in to my work life. I felt great, I felt so balanced – something I am always striving for and I just started to really see myself again. Not through the lens of ‘you are not a mother yet’ but more ‘sister honey girl, your life is full and it is wonderful just the way it is.’ Being in lockdown has meant I have spent more time with my husband than usual and that too has been wonderful, and it has been enriching to spend time together without the ‘baby making’ cloud over our heads… just chatting like old pals and reconnecting without the burden of timed injections, hospital visits and the horrible waiting has been the break that I didn’t know I needed.

For such a long time I had reconfigured my life to fit around ‘baby making’ that so much of my Self was lost in the process but when you’re in it you really don’t realise it. My first day in my new job on the 6^th of Jan was my first day of IVF! I remember having to call my new boss to ask her if it would be okay for me to start a bit later on my first day, my first few weeks in the job were filled with hospital appointments all of which had to be during the work day usually mid-morning and in February I missed my first board meeting because I had a week off for my egg retrieval. I am lucky that I landed wonderful bosses who have been incredibly supportive of our IVF but I say all this to paint the picture of how IVF consumes you. So this break, although forced upon us, has really been that pause that we never stopped to take for the last 3 years of journey. And only now it is making sense to me.

I was doing so good because everything was out of my control until they announced that clinics could apply to reopen from 11^th of May. And all those feelings I parked on the 17^th March after crying myself tired literally just came back flooding and are damn near drowning me at this point… I was doing so good and now I have the added layer of weighing the risks of C-19! We have all seen the stats that suggest black people are more likely to die from C-19 than their white counterparts, add the cases of the black pregnant women who died (may they rest in peace). My clinic hasn’t even called me yet and I do not know what their plans are but these are all factors I now have to consider in addition to the factors that already come with IVF and pregnancy in general. Needless to say, I am freaking the fuck out! On the one hand having a baby is everything I have ever wanted, on the other hand do I want to try to get pregnant with the added anxieties around C-19?! My husband’s protective instincts have already kicked in and he feels so strongly about the risks of C-19 and thinks we should wait. The situation is less clear in my mind, while C-19 gave me the pause I definitely needed it is now putting this horrible hesitation in my mind about how much I want to have a baby and at what cost? The effects of C-19 are making me question the one thing I never thought I would even have a second thought about.

Mother’s day when you have all these thoughts in your head hits differently. I was off all social media when the UK one came and I think for as long as I am not-pregnant I might make it a point to be off social media in the lead up to and on all Mother’s Days. The strongest feeling was that I felt bad for being triggered by other’s people’s day of joy and gratitude and actually, I think a lot of people don’t get this about the #ttcgang, when we are triggered by your mummy joy we genuinely feel so bad and it is that guilt that eats me up more than anything. The second feeling was that reminder; another Mother’s Day and I am not pregnant, and I don’t even know when the possibility might be real again. C-19 took away the mere possibility from me and when you are trying to conceive by assisted means, the possibility is quite literally ALL you have. My sister-in-law tells me off for saying our IVF was cancelled, she always corrects me with ‘postponed’ but without the pending possibility, to me it has felt like it’s been cancelled, much like 2020 so far!

Up until today I hadn’t realised that I had never even entertained the thought of me being pregnant. My default coping mechanism is to not let my mind go there at all… I have not even imagined what a pregnant belly would look like on me, or what my baby’s nursery will look like or even who the baby will look like. The minute we got news we would be starting IVF my husband already started compiling a list of essentials, the only reason I got involved was because I had to help him make sure everything was on the list otherwise my coping mechanism just won’t let me go there. People say things like you have to envision it to fruition, but those people will not be there when I need to drag myself out of a dark hole when disappointment strikes. My embryo transfer would have been around this time and the only thing I had done which even now seems so stupid to me is I had bought a couple of floaty work dresses for ‘when I start to grow’. That’s as far as I will allow my imagination because it’s a practical alternative to my work jeans (well seemed so at the time). All that day-dreaming about my pregnancy and being a mum blah blah blah can never be me. I am not strong enough for that and that is why Mother’s Day today was so difficult because my timeline was filled with those kinds of images and theirs were actual REAL.

I’ve also been thinking about the similarities between most people’s experience of C-19 and my experience of IVF; much of it feels like you are in a trap where you are literally hoping for the best, a big part of it is just a waiting game with absolutely no guarantees, both mess up with most of your plans and take away life’s small pleasures. I think for the first time, the world is experiencing what most women going through IVF feel – a shutdown of sorts of life as you knew it and a long game, seemingly unending and all you can hold onto is hope. IVF does not physically kill you but the emotional ride that comes with it can kill your spirit, even when nothing is happening AND in the context of normal life that must carry on. I remember having a split second moment when my puppy Leo was hit by a van and died where I really felt I was going to lose it – it is less about the puppy and but more about the lack of control over one’s own fate. I had to decide very quickly in that moment which path I wanted to take and sometimes it is not about choosing to do or be better, sometimes it is about saying I CAN’T do this anymore and I WON’T. And just checking out – taking time out to restore, recover, refill. And reminding oneself that not all is lost or cancelled.

I cannot tell you what is next for me/us. I wish I could say ‘yes we are definitely going ahead as soon as they call’ or ‘no we are waiting until they have more data to base their contingency planning on’ but I can’t say either. In true coping mechanism fashion, I will deal with it when I get the call from the clinic i.e. when it becomes real. My husband was keen to agree a decision about it and I said to him we’ve been doing this trying to conceive thing for a while and if there is anything I have learnt is not to get ahead of myself. I could make a decision about proceeding with treatment and spend the next few weeks anticipating the call from the clinic and struggling to sleep etc due to worry or excitement or I can just surrender to the now and hear what their plan/process is when they call and make a decision then. They may even call to say they are not reopening, or they are not doing transfers and I would have invested in a possibility that is taken away from me, again. My only focus now, is WHAT IS REAL RIGHT NOW.

Sending love to all my IVF sisters… whatever decision you take, it is yours to make. We have made it this far and although it may not always seem like it, we have so much more in us to carry on. All my love & all the Light x

“There is a life to be lived right here in the waiting.” –@morganharpernichols

Before we began I spent a lot of time worrying (and being actually terrified at one point) about what it was going to be like, what I was going to be like. Having gone through the first half now I can say that it was not what I was expecting in the sense that it was not as bad as I expected. I had definitely allowed my mind to get the better of me before we began. So I started off on a pill called norethisterone for 10 days which was okay initially then it made my breasts so heavy and I had the worst backache for a couple of days but after that I was fine. The backache was something else and I’m still traumatised about it now! A few days after the pill I had what they call a withdrawal bleed; the whole point of the pill is to induce a bleed so that IVF can start from a baseline when your uterus lining has shed. At the end of bleeding, I would say on the 5th day, I was instructed to start the first course of injections (Bemfola) and I was to inject myself for 10 days every night. Of course I did not inject myself! My husband did – because I can’t even look at the needles when I’m having my bloods done. I also thought it would be a way for him to feel involved in the process and feel a sense of utility in all of it. On the 5th day of Bemfola, I was instructed to start another course of injections (Cetrotide) to be administered every morning. Both these injections had to be done within a half an hour window of the same time each day so we did 5am and 11pm which suited our life/work perfectly. Over the course of these 10 days, I had 2 scans; one on day 6 and another on day 10 (which was meant to be my last day on injections but they wanted me to do 2 more days of stims (stims = injections). The scans were done at intervals; Day 1 scan – after withdrawal bleed to make sure uterus lining had thinned; day 6 scan – I had 24 follicles; day 10 scan – is when I found out that I had too many follicles and there were going to apply the freeze protocol to prevent ovarian hyperstimulation; day 12 scan – after an extra 2 days of stims for my eggs to mature I was given a date for egg collection. By day 12 I was definitely feeling the effects of the stims, my ovaries were full and it was slightly uncomfortable but nothing I couldn’t handle. I was then instructed to take a trigger shot injection (Buserelin) that night and my egg collection date was exactly 36 hours later. On the day of the egg collection, I felt awful – I felt nauseous, I was VERY hormonal and I just wanted it to be over and done with.

The egg collection for me was by far the worst part of IVF (first half anyway!). I was already quite hormonal by that point and now looking back everything just seemed overwhelming to me in that moment. We were asked to come in an hour before our appointment to do more paperwork and prepare for the collection. I was given strict instructions not to wear any jewellery, nail varnish, deodorant/perfume or anything with a scent or alcohol in it. I was also told to bring some bedroom slippers and a nightgown. When we arrived we were taken to our own private room and I was asked to change into the hospital gown. It was at this point that hubby had to go and do his thing and provide a sperm sample. When he got back we were called into theatre (is that what the room is called?) and I kid you not there were about 7 people in there and when you are hormonal, lying down on this bed while they strap your legs in position, with all of them watching over you and doing different things, IT IS TERRIFYING. I was so scared I was tearing up when they were asking me to confirm my name and details. When they asked my hubby to leave the room, I almost unshackled my legs ready to follow him out. I understand all of these people need to be in the room, like the anesthetist, nurses, consultants, but I feel like they should all come in once you’re knocked out because it was the most intimidating feeling and made me worry even more about what they were going to do to me. Anyway, not before long I was completely knocked out and got woken up when it was all done. At first, I couldn’t keep my eyes open and they kept trying to wake me up (at one point I even held my eyelids opens like they do in cartoons, which made them all laugh), when I did eventually snap out of the slumber they were asking me questions and I could not speak. The words were playing in my mind but I literally could not speak – I was trying to move my mouth but I don’t know what was happening no words were coming out. The combination of realising this lack of speech and suddenly remembering where I was and how I was feeling before I got knocked out, the shock of it all sent me into inconsolable tears – I justcouldn’t stop crying. I got even worse when I saw my husband and it was just coming out of me like a waterfall. I think for much of the IVF process I was keeping it together (because I was actually okay) but something about going through a procedure like egg collection makes it VERY real that hey girl, you’re an IVF patient and this IS a big fucking deal.

The way egg collection works, is by draining the egg follicles that the injections stimulated and the eggs are contained in these follicles. I had an amazing egg collection result of 20 eggs!!!! I owe this amazing result to my faith, my high AMH and I think as well to the supplements I was taking during stimulation and 3months prior (which I bought at the Fertility Festival in London for £90 for 3). There is some research out there that retrieving more than 15-20 eggs does not improve pregnancy outcomes so we are just so pleased to have that ideal number from the get-go. Back to the day, after all my crying which went on for about 30minutes, the nurses brought me some food because, oh yeh I forgot, you cannot eat past midnight the night before egg collection and you cannot drink water past 2 hours before egg collection but food was the last thing on my mind but my hubby forced me to eat. I then realised that I was having a bit of bleeding down there so I put a liner on and I peed (something they made sure I did before leaving). Getting off the bed and peeing was painful so I just moved at snail pace. Not long after I peed we were released to go home and I was advised to take a few days off and just rest my body. My egg collection was on a Thursday and on the Friday the clinic rang me to confirm that 19 eggs had been fertilised and 13 embryos had made it to day 1 and that they would call me on day 5/6 to confirm how many made it to freeze. On day 6 the clinic rang again and this time I was back at work and I had spent the last few days just worrying about the outcome out of our embryos… but won’t He do it… the clinic confirmed 10 embryos made it to freeze meaning we had only lost 3 embryos over the 5/6 days. I immediately called my husband and we were both just in shock and deeply grateful after so long to be at this point now, with viable embryos waiting for us. I thank God for his intervention and his promise.

When they say a story is too good to be true, it usually is, in our case more like too good to carry on. As a result of producing so many eggs, our transfer (putting the embryo in my womb) which was meant to take place 5/6 days after egg collection was cancelled due to a standard protocol they follow that if you have 18 or more follicles of 11mm+ in size, it’s an automatic freeze to prevent ovarian hyperstimulation and the negative effect it can have on implantation. I could have been pregnant by now (if this cycle had been successful) but the clinic wants to make sure that my body recovers from all the stimulation and resets before we continue the process again. So that’s where we are now, in the break in between and actually it has been really restorative having this break, although I was upset initially. And there is research (although not conclusive) that suggests that freezing all embryos for later transfer might improve implantation and pregnancy rates and increase the safety of IVF. It is an odd place to be though… so close and yet not quite there yet… and we will have to do more stims (injections) to prepare for the transfer and then there is the worry of losing embryos in the thawing process but I learnt very early on with all things infertility, to SURRENDER, to God, to what is meant to be – will be, surrendering to our medical professionals because they do this everyday, surrendering to the present. I try and just focus on one day at a time when it comes to IVF and as it stands we don’t really know yet when our embryo transfer will be, and you know what, that’s okay.

I am finding it A LOT more difficult now to be ‘not-pregnant’. There is something about trying to reconcile being an IVF patient with the fact that others are having babies naturally, JUST. LIKE. THAT. Your friends, people you know, and it’s everywhere. Don’t get me wrong I am very happy for my friends when they fall pregnant, carry to full-term and give birth to healthy babies but each natural pregnancy is a reminder that I am not a mum yet and that I won’t be able to fall pregnant naturally – it is actually heartbreaking and that is not to take away from someone else’s joy, it is a strong realisation of the lack of it (in the form of a baby) in my own life. Being an IVF patient, without your success yet is SO damn hard to live with when you have to live it in the real world of other people having babies seemingly easier/quicker. The raw honest truth is that it always makes me feel better when someone’s pregnancy has a backstory of infertility, because I can relate to it then. And that’s REAL – If no one else will say it, let me be the one to say it. In addition to all this, I now have people/family asking me about children. Much of my turmoil with infertility was internal for pretty much most of the 3 years but now and I realise this is because we have been married over a year now, people bring up babies all the time. Every family gathering I have been to in the last 6 months almost all the women who know me like that have asked me 2 questions; ‘How is married life?” And ‘Where are the babies?’ This one particular incident literally happened 2 weeks ago at my mum’s… if you know me you will know I like wearing loose clothing and flowy shapes, anyway, one of my mum’s friends made an assumption that I was pregnant because I was wearing a kaftan and literally my mum had to come up to me and scrunch the kaftan to one side to show my ’no belly’. This is a true story. And listen I’m not mad at all this, I’m actually not and in fact, I actually couldn’t stop laughing at the time. I mean yeh partly because of the audacity of it all but I realise as Africans we think we mean well when we do this, the women in our lives want to be encouraging about having babies and this is how they communicate this. What upsets me is the fact that it is never the right time and place for me to educate people on infertility and it’s a whole entire culture to dismantle. My mother’s generation is from a different time and I cannot be angry with them for what they know or don’t know. I know a lot of people my age who don’t know anything about infertility especially those who have had natural pregnancies and they too cannot be expected to understand the sensitivities of infertility. Unless we educate them.

All this to say, there are compounding elements that are making me feel more ‘not pregnant’ than ever before and making me question when? and if ever? but I still choose to practice compassion, towards others and towards myself. I make every effort to honour each day as a gift, for there is a life to be lived right here in the waiting and one day, soon enough, I will be a mamma.