What is IVF? (and ICSI)

You can have both God & Fertility treatment – Noni Martins

IVF seems to be this big secret that is only shared in the TTC community and the information never gets passed down and across to people outside of the TTC community. Almost everyone I have spoken to either has no idea what IVF is or has serious misconceptions about what it actually is. This is compounded in the African community which means people end up saying really irrelevant things to myself or my husband because they just don’t know anything. My mum, being a nurse, has been so keen to absorb everything about the process and I have enjoyed ‘schooling’ her on this because it is really fascinating and wonderful just what science can do for humanity. So this offering is really to explain the IVF process in simple language (where possible) and I hope you will learn something from this post. We are still learning and still discovering and still being wowed by the possibilities that science has to offer. As I mentioned in a previous post, we will NOT be blogging about our IVF journey in real-time and we will not be sharing the success/failure of our process until we feel ready to do so. I am however going to write this post from my own understanding of the IVF process as pertaining to our situation. This does not mean any or all of this has happened, I am just explaining it the way it was explained to us by our nurses.

So what is IVF? IVF stands for in-vitro-fertilisation which basically means fertilisation ‘in glass’. It is a method of assisted reproduction where a man’s sperm and a woman’s egg are combined in a laboratory dish, where fertilisation is expected to occur. For a couple with a male-factor or male infertility, there is a slight variation to this part called ICSI which stands for intracytoplasmic sperm injection. Treatment will be exactly the same as with IVF. The only difference is that instead of mixing the sperm with the eggs and leaving them to fertilise, a skilled embryologist (embryo specialist) will inject a single sperm into each egg. This maximises the chance of fertilisation taking place as it bypasses any potential problems the sperm will have in getting inside the egg – (Via HFEA). Once the referral has been made by your GP/specialist to a fertility clinic and all the paperwork has been completed and processed (please see our fertility timeline so far), IVF starts off with a consultation with a head nurse who will go through the forms you have filled in, confirm details, take more signatures and give you an overview of what lies ahead. At this consultation, you are advised to notify the clinic on the first day of your normal period which will set the date for the whole process to kick off. Everyone’s IVF journey is very different and some people (like me) have a short protocol IVF and others, a long protocol IVF – I still don’t know what the difference is but click the link for information on the long protocol. In my situation, because my AMH is very high, there are concerns that I may have an excessive response to the stimulation, something called Ovarian Hyperstimulation Syndrome – OHSS (more below). Anytime there is such a concern, the short protocol is applied.

So on day 1 of your period, you ring the clinic and they book you in for a drug appointment which is basically to talk through all the drugs you will be administering for that round of IVF and the nurse teaches you how to do the injections because they are slightly different depending on what you are having. Sorry, before your drug appointment, the clinic writes to you with an invoice for the medication – you pay for your medication even for an NHS funded cycle. I opted for the NHS prescription pre-payment certificate which works out cheaper and it cost me £30 for 3 months and I can get as many prescriptions as I want, even non-IVF-related ones. My drugs would have cost me £50 and If I needed more for whatever reason I would be required to pay more so I would highly recommend the pre-payment certificate for anyone doing IVF via NHS (or anyone who has to pay for repeat prescriptions generally!) At the same drug appointment you are given dates of when to start the medication and when to come back in for transvaginal scans – this is how they check progress, internally! The real IVF starts when you go home and map out your life for the next 4-6 weeks and start your medication – I will share my self-made colourful IVF calendar, which I am very proud of, at a later date!

Our protocol will follow the general timeframe below but as with all things IVF, this can change and vary quite a bit depending on how one responds to treatment:

  • Day 1 – 10 – Take Norethisterone 3x a times a day with food – this is a pill to induce a withdrawal bleed to thin the uterus lining
  • Day 11 – 15 – Withdrawal bleed – the shedding of the uterus lining
  • Day 16 – Transvaginal scan to confirm uterus lining is thinned
  • Day 16 – 25 – Bemfola stimulation injections x1 every evening
  • Day 21 – Transvaginal scan to check the progress of the follicles
  • Day 21 – 25 – Cetrotide stimulation injection x1 every morning
  • Day 25 – Transvaginal scan to check number and size of follicles
  • Day 26 – Trigger injection to mature the eggs (must wait to be notified by the nurses what time to take it!)
  • 36 hours later – Egg collection under general anaesthetic – this is when ICSI for us will take place, fertilising the egg and sperm in a laboratory dish
  • Between 3-5 days after egg collection – transfer of 1 embryo into the womb.
  • 2 weeks after Transfer – pregnancy test at the clinic

On paper, the process seems quite quick but as I said, things can vary with IVF and sometimes there can be delays in terms of how you are meant to respond to treatment and how you actually respond to treatment. For example, you might not have your withdrawal bleed within the 5 days after Norethisterone. Or in a much less preferable situation, you could have Ovarian Hyperstimulation Syndrome which puts a pause on the entire process. Because my AMH is high, it is likely that I could get OHSS which is when the ovaries develop too many follicles as an over-response to the medication. When this happens, fluid from the blood vessels may leak into your abdomen and in some cases into the space around the heart and lungs. The kidneys and liver may also be affected, but this is usually mild and will settle without medical intervention. Approximately a third of patients will have mild symptoms, with only 2-8% of patients needing medical intervention (via NHS). They warned me about the risks related to OHSS and made it very clear that I should let them know if I start to get any symptoms. They stressed even more that if do end up over-stimulating – that is, 19 follicles or more of 11mm plus in size, the transfer would be cancelled, the embryos would be frozen (FET) and I would have to wait 6 weeks before the process continues. Not ideal but they need to make sure that my body is fit enough to hold and carry the baby for the 9months.

This is one IVF cycle in a nutshell from start to finish but like I said can be different from one couple to another. If a cycle is unsuccessful, the clinic will do some investigating into potential reasons why and any information from this will be taken into consideration for the next attempt. If you have any embryos remaining which were frozen from the first round of stimulations, you do not have to go through the stimulation process again and you can just have another transfer at a suitable time when the uterus lining has been thickened again ready to receive an embryo. An interesting little fact I almost forgot to mention is that my clinic uses Embryo glue when they do transfers; EmbryoGlue is a medium developed to closely resemble the environment in the uterus at the time of implantation. It is not a glue in the common sense, but acts as an adhesive by increasing the chance of implantation of the embryo to the uterus. The embryos are placed in the solution and allowed to soak in it for a fixed duration of time prior to the transfer (via NHS). However, like most things in the IVF world, (and as you will see when I share information from the Fertility Festival which I attended), there if a conflicting body of evidence about it’s effectiveness and further research is required. I think it’s still cool though! Ha. Another thing to mention, is the success rates of IVF as they are not as high as everyone thinks. How successful IVF will be depends on the woman’s age and the cause of infertility. The below percentages show the average chance of a birth from IVF treatment. These figures are for women using their own eggs and their partner’s sperm and use the per embryo transferred measure (via HFEA).

  • under 35: 29%
  • 35-37: 23%
  • 38-39: 15%
  • 40-42: 9%
  • 43-44: 3%
  • over 44: 2%.

For context I thought it might be worth sharing our journey so far minus the IVF bit (click here) – just to show a timeline of things and potentially for anyone looking to go down this route, to show how long it can take. I think we are very fortunate living up North because there was no waiting list for our referral and so everything has moved quite fast. Just after the new year, I had a bit of a meltdown when it started to hit me that we are ACTUALLY having IVF, it wasn’t hypothetical anymore and I just started getting really anxious to the point where I was struggling to sleep. At the time I did not have any of the information above and so I think it was just the enormity of the unknown and feeling so in the dark about what was to come. I sat down with my husband and told him how I was feeling and he did a mixture of comforting me but also scaremongering because in his mind it was better that I was prepared for a bad experience but we obviously hope for an okay experience _ I was going to say ‘good’ experience but I think that is asking for a lot! It’s very hard to tell what IVF is going to be like until you start going through it… it does not matter how much reading you do, how much information they give you, how many youtube videos you watch, you can never know how YOU are going to be, how YOU are going to experience it, it is such an individual journey and I cannot tell you how grateful I am to be doing it with someone else. I personally would not be able to do this without my husband and our life experiences have been so instrumental in our coping mechanisms because we accept things for what they are and work on solutions and being informed rather than dwelling on outcomes, which are often out of our control.

I hope this has been useful to some of you and an interesting read for the rest of you. I am more than happy to answer any specific questions in my DMs and I am always happy to chat, especially about this so honestly feel free 🙂

love & light

Noni x

Our fertility journey so far…


End of March 2019  – I was admitted into hospital via A&E with a second episode of pelvic pain (the first episode a couple of days before, I had waited 5 hours in A&E and left before I was seen as the pain had calmed down).

While in hospital this second time – In my discussions with the consultants & nurses, it became apparent to me that I had waited too long before seeking help with fertility, at this point we had been TTC for 2 years 3 months.

3rd April 2019 – Gynaecology appt – referral by my GP – which was initially to discuss the unexplained pelvic pain but became more of an investigation into our fertility.

In-between April & August – I had many blood tests done on me, ‘Day 3’ blood test to check my hormones, full blood count, HIV test, all of it

6 August 2019 – Transvaginal scan to rule out PCOS which I do not have, however, they found a mass of some sort but the test was done just before my period was due and it turned out to be a collapsed follicle – confirmed by a second transvaginal scan at a different time in my cycle. It is worth mentioning here that I have an irregular cycle!

24 September 2019 – We got the results for hubby’s sperm analysis via our GP and discovered we have a male factor (low count & poor motility) which significantly reduces the chances of spontaneous (natural) conception. It became clearer to us after research and discussions with Hubby’s renal consultant that dialysis does affect sperm count and most people on dialysis need IVF to assist. Normal fertility is restored if a patient has a transplant.

30 September 2019 – Final appt with our gynaecologist to confirm results of sperm analysis and advise the next steps. He referred us for IVF on the same day and advised that our chances for success were high because I just haven’t been exposed to healthy sperm and there is nothing that has come up in my investigations that might hinder implantation.


3 October 2019  – We received forms and a questionnaire to fill out from our local NHS Clinical Commissioning group which would be used to confirm our eligibility for NHS funding – we also had to enclose copies of our ID/residency (we are both British citizens).

15 October 2019 – We received confirmation that we met the criteria for NHS funded treatment and that our Clinical Commissioning Group will fund up to 3 cycles which we must have received before we reach the age of 40.

22 October 2019 – We received a letter from the Fertility Centre welcoming us as new patients and directing us to their website to watch the information videos. This letter also contained an appointment for me to attend for some blood tests (which I had already done previously but they need to do their own tests.

31 October 2019 – Blood test appointment to test my AMH – which came out quite high.

18 November 2019 – We received a letter from the Fertility centre informing us to ring them to book an appointment to start our NHS IVF treatment, accompanied by LOTS of information sheets/leaflets and LOTS fo consent form to fill out.

Consent forms (we had one each of the following);

  • Acceptance of NHS funding and consent to pay fees not covered by NHS
  • HFEA Patient information form
  • Accounting for interests of the child
  • Consent to Chaperone
  • Checklist confirming you have received all the information sheets and understand the nature, purpose and implications of treatment
  • HFEA Consent to disclosing identity information
  • HFEA Men’s consent to treatment and storage (IVF and ICSI)
  • HFEA Women’s consent to treatment and storage (IVF and ICSI)
  • Embryo freezing and thawing consent
  • Consent to treatment, process and risks of IVF & ICSI

December 2019 onwards – to be shared at a later date.

The Show Must Go On

And then I surrendered. To the soft. And the sweet. And the sorrow. Not shying away. Allowing each inhale and exhale to source a new life in my cells from their exchange. Let this teach you. Within each release, lives an offering. What we let go of creates room for beginnings… Your winter may last for days, months, lifetimes. But do not mistake this as a dead bloom. Forever closed off to others. For this season isn’t for rising, just yet. This season is for letting the light pour itself into our emptied hands. Let this teach you. – @danielledoby

When we got the confirmation that IVF would be our only option, I felt I needed a break. From blogging. From talking about fertility. I just needed time to sit with everything, the last few months, everything that had come to light and everything else in-between. I always said that with blogging about fertility that I would write when I feel like it, when it comes to me, because the thing is our lives are so multi-dimensional and multi-faceted and so are we as people. And so while yes, dealing with infertility has been a real struggle for me, the break from it all gave me a renewed perspective about how much light we let in or don’t let in into our lives sometimes because we are holding onto a feeling, a struggle. Making room and time for other parts of my life made me feel whole again, functional, instrumental in the construction of who I am trying to be and the life I am trying to lead. I’ve been able to make time for joy too, meeting/connecting with my friends and occupying spaces that remind me of who I am. A long while before this I had unfollowed all the #tryingtoconceive hashtags on Instagram because I found it overwhelming to be trying to conceive yet seeing sad stories almost daily from the trying to conceive community. I fully sympathize with everyone in this community and I fully understand just how hard it can be but the sensationalism that can come with social media was too much for me. I am exactly the same with the News, I don’t watch or read the News… because my spirit cannot handle a constant stream of bad/terrifying messages, I am just not made for it. And I have always been one to choose my wellbeing over ‘general information’.

When we first began our investigations, I was very keen on knowing everything. I googled everything, I read and watched everything I could find but none of it ever made me feel at ease. What pacified my anxiety was attending each of our appointments and finding out more about our fertility health. The KNOWING, that real concrete knowing about our situation SPECIFICALLY put me more and more at ease with each appointment. Because the thing is, what you find on google is often generalised, and what you find on IG is often unique to that individual/couple. If your own fertility issues do not apply to either you can often be left feeling more in the dark and feeling like something is really wrong with you. And so now, I have really come into a space of surrendering. To the truth. Our truth. Not speculation. Not generalised information. Even up to now we are still finding out and learning new things with each of our appointments. At my last one, at the IVF clinic, I found out that I was VERY fertile. Something that I feel contradicts what the previous specialists were saying to me regarding my irregular cycle. They told me I was so fertile that they are worried I might over-respond to treatment which would not be ideal and so I will be having a milder IVF than normal. In March we thought we would have had one cycle of IVF by now and we were wondering what it would be like to be pregnant around Christmas. The point I am trying to make is this… surrendering does not mean you are giving up hope, not at all, for me, it simply means I am giving up trying to dictate the eventualities and timeframes around our fertility journey and just giving it all up to God, to science, and to intention. We have a true desire to be parents and I believe God will meet that desire and the science will facilitate our preferred outcome.

I mentioned before that I haven’t cried about this for quite a while now (about 5months) and some of that has to do with my puppy Leo, the sweetest puppy you will ever know!, but a lot of it has to do with just resetting my mindset. When I went to my first appointment at the IVF clinic, I went on my own, it was just a blood test so I figured I’ll be fine but when I got there I got overwhelmed with so much emotion and the other people in the waiting room were all couples and I started welling up and before things got out of hand, I got called in by the nurse and she was very matter of fact about everything – because I mean it was just a blood test – and I left after like 5mins and I just thought to myself, what on earth was all that near-crying about!? Our minds can trick us into emotion but we can also use our minds to control our emotion and I’ve really been trying to practice this. I have been thinking a lot about if/when I actually fall pregnant and have a baby and I keep imagining myself holding this baby and looking back at how s/he came about and I would hate for the memory to be that of pain and sorrow. I want my children to be conceived/birthed from a place of balance, a place of intention, the right energies, a place of faith. I think often about how when you are trying to conceive and there are no issues, you are making love or enjoying the pleasure of connection between you and your significant other. I think so much about the fact that we don’t have that opportunity and we won’t have the wonderful surprise of taking a test and voila! The IVF process is a process of scheduling, everything is controlled and dictated, to the T. So my mind has really been centered on how can I recreate the bliss of spontaneous (natural) conception in this simulated and very unnatural process. Disclaimer; I say bliss to mean just the sheer unknown and I say unnatural for the lack of a better word – all routes to parenthood are valid. When you go through IVF you know too much because EVERYTHING is scheduled and because it seems so scientific and fool-proof (which it really isn’t – 38% success rate for under 35s)  it can be very hard to deal with when that doesn’t work out. And I feel that my surrendering to the smaller unknown that you have with IVF will help me accept any eventuality with grace.

Because the truth is… The Show MUST Go On. Right after my near-crying blood test appointment, and I mean 2 mins after I got a call for an interview for a job which I went on to secure. A job opportunity that has been a long time in the making and I am so excited for. Like I said before we are so multidimensional and we live multifaceted lives and the one thing infertility has taught me is to keep it moving. You simply do not have a choice, because you still have to work, be a wife, be a friend, a sister. We allowed our desire to become parents consume a huge part of our lives and we put a lot of things on hold because were always planning for that baby. I don’t subscribe to that way of living anymore and instead, I want to be like water; occupying spaces that welcome me and moving past ones that do not. I also want balance. My only life mantra is to always seek balance in EVERYTHING. While my desire for a baby is very real and very strong, I also desire to be happy with what I have, as I am. As we approach our 3-year mark (in Jan 2020) of trying to conceive, ‘I will not mistake it as a dead bloom. For this season isn’t for rising, just yet.’ But in other aspects, January marks new beginnings, which one must make room for, for the light to enter; starting IVF and starting my new job.

The Show Must Go On. ‘And I surrender to the soft, the sweet and the sorrow’. Have a wonderful Christmas with your loved ones and a happy arrival into the New Year.

Love & (all of the) Light(s)

Noni x

Unfertility X Love Laid Bare

I had the pleasure of sitting down with Dionne LDN of Love Laid Bare and we talked about my infertility journey so far and everything else in-between. Her line of questioning really made me stop and think and I felt so safe to share with her.

You can listen on Soundcloud, Spotify & Apple podcasts.


Please also checkout Dionne’s blog & instagram for more podcasts on other really important matters for our generation.

D, thank you so much for this opportunity to tell my unconventional story. The work that you are doing is important and I want you to know that we see you, and we need you.

Noni x

God, Infertility & Me

Oh, the blessing. Oh, the blessing.

Can’t you see, what God has done.

– Jesus Is King, Sunday Service Collective

So the truth is, I hadn’t really been into the ‘Christian God’ thing for quite a while… I was always spiritual to a degree, spiritual including feeling things from my ancestors and I always believed there was/is a higher power, something bigger than us, something we owe our own individual power to. Organised religion was and still is not for me… I think when you know too much it becomes increasingly difficult to continue to believe in a concept that just doesn’t ring true to you. And although I was raised a Christian, this is how I feel about organised religion; the focus is way too much on the church and the pastor and other physical things of the world than it is about a true one-on-one relationship and experience with God. So I don’t subscribe to the organised (for man) part of religion and when I initially intended to write this post I had very different feelings about God and in particular where fertility was concerned. However, dealing with infertility, led me down a path of seeking, of searching for understanding and it is from that space that I reached out to God.

I was watching Bishop TD Jakessermon today and he said that God is a God of intention and that he sets things up, sometimes to prepare you for something bigger and sometimes to show you that he is still God even if, as in my case I wasn’t really checking for him at the time. It made made think about the time I ended up in hospital with pelvic pain which I talked about in my first blogpost and how at that point we had been trying to conceive for over 2 years and how even then I had no intentions of seeing someone about our struggle because in my mind I had planned to see someone if we were not pregnant by January 2020. But out of nowhere I had this pain I have never had in my entire life, which was preceded by 7 days of light spotting and ended up in hospital for 2 nights and at the end of it had senior nurses and senior doctors telling me that 2 years is too long to be trying without seeking any medical help and that they will be referring me to a gynaecologist. Note how they did not give me the option to do so myself via my GP. As I was listening to TD Jakes I realised that if that hospital incident did not happen, I would still be in the dark about ALL that we have discovered about our fertility in the last 6months, we would still be trying not knowing that we have a male factor which significantly reduces our chances for spontaneous (natural) conception, because in my basic mind, we were going to seek help in January. Are you getting what I’m saying right now?! We are on the verge of starting IVF treatment and God-willing having a family soon, and the thought that if that incident had not occurred we would still be where we were in March, right now, fills me with tears because God in his omniscient mind made sure we were on the trajectory that we are on now. God is in the detail.

When we started our investigations, I was initially okay but with the waiting and the results, and another day/month not falling pregnant, it increasingly became very difficult not to be consumed by everything and I started looking for churches in my area. But again when you know too much, and know yourself too much I didn’t want to go to a church and pretend to be connecting and experiencing God when I wasn’t and I honestly have no shame about knowing what I am seeking in terms of the presence and experience of God and I remembered how Bishop TD Jakes’ ‘Woman Thou Art Loosed’ album saved my mother through what was such a painful and horrible time for her. It was the 90s and I was very young at the time but now as an adult, knowing what it was she was going through and how we spent full days in worship to this album over the school holidays in my Dad’s apartment in South Africa (while he was at work) and how she held on to God during this time. In my search for God, I searched for that same God that was there for my mother and I searched in Google for the ‘The Potters House’ UK because I knew that was the name of TD Jakes’ church and I thought he might have some version of his church somewhere in the UK, the same way they have Hillsong Churches everywhere now. What I found was even better… something he has been doing but I had no idea was available, I found his YouTube channel with recorded sermons from his church which were uploaded every Sunday. I could have cried seeing this and I internally wrestled with the tradition VS unconventional way of connecting with God argument and that whole notion that church is where 3 or more are gathered played on my mind and I kept asking myself, if I am going to watch this alone at home, is it right? Will God connect with me? But I asked myself the more important question; what rings Truer to you? That is, what will foster a genuine connection and experience with God that is personal and about YOU & GOD? Then I thought about the unconventional in un_fertility and I thought I am out here campaigning essentially for unconventional routes to fertility yet I am here wrestling with the idea of an unconventional route to God. When TD Jakes said God sets things up…. He wasn’t lying! God is in the detail.

So for the last few months, I have been tuning in every Sunday to Bishop TD Jakes’ sermons on YouTube and it has been the weekly dose I need/ed to gain renewed perspective on our fertility journey. I talk a lot about the everyday of infertility being hard but because God led me/us on this path of discovery and the investigations and the outcome, I have found the journey less hard because we know now… we know what the issue is and what the “solution” is. I initially started watching the sermons on my own but now my husband sometimes joins me and he takes away his own perspective. For me personally, coming back to God… I don’t really like the word ‘back’ in this because back implies you are returning in the same way and to the same thing which for me is not the case because I am completely re-innovating the way I seek and receive God. But anyway coming back to God has shown me even when I am wavering, he isn’t, that even when I am not seeking him, he is constantly seeking me… a few days before I got married, one of my really good friends Kudzi said to me “I want to pray for you because I feel like you don’t think or realise what God can do for you. Is there anything in particular you want me to pray for?” At the time as I previously mentioned, I wasn’t down with God like that and I wasn’t even thinking about God to be honest and what she said is only making sense to me now, because it’s true I did not believe that God did things for me, I believed I made decisions that bear different consequences and that the Higher Power gave me that freedom and power to exercise. I did not believe in a God, I believed in an ideology of a higher power, something abstract, something very general. But I replied to my friend and I said “I am worried I won’t be able to have children” – this was 15months ago when I said these words and even with that frame of thinking it was not until 6 months ago that God forced me into a position that I had to be referred for fertility assistance. I can’t say this enough, God is in the detail.

I was talking to Dionne of Love Laid Bare during a recording of a podcast (coming soon) and I was telling her the story of how un_fertility came about and I was just explaining to her that for a long time before I started it I had this strong pulling towards something but I didn’t know what, all I knew was I needed to be doing something ‘meaningful to help women’, this was all the clarity I was getting from the energies I was receiving and at the time I was barely on social media, in fact I despised it and the more clarity I gained, it was Instagram that I was going to use. And here is something I haven’t told anyone yet, in my quest to find this meaningful concept/platform/business for women, I actually began preliminary work and research on a clothing line for “unconventional” women like me. I had spoken to different designers, I was getting a logo done, a manifesto, a business plan etc… this all started in February. And in March that’s when I ended up in hospital – on abcompletely different trajectory. God. Is. In. The. Detail. I have a lot of women following my story who have their own private stories which they haven’t shared with me but they are learning/becoming informed or gaining perspective through my story. I have met women who have shared their IVF success stories with me, one who I consider to be my mentor in all this. I have had opportunities to speak on radio and a podcast about infertility – opportunities to break the silence, shame and stigma. All of this would not have happened if I had not been willing to share my story and more importantly all of this would not have happened if I had not been receptive to what God was trying to show me and where he was leading me. The entire 6month journey would have not have happened If I had missed him – in the detail – because I was so focussed on the outcome I wanted.

I still believe that as christians we are constantly telling couples who are dealing with infertility to pray, pray and pray and not telling them to seek help. I do not subscribe to that way of thinking because it encourages denial and perpetuates the stigma around infertility. Even with God in your life/heart, I encourage anyone to seek medical help for medical problems. Although I have reconnected with God, I have not prayed the prayer asking Him for a child/ren, what I have prayed for is understanding – I have prayed for God to equip me with the mind-frame I need to endure this process, and more so now as we enter the realms of IVF. I have prayed for acceptance, for peace in our current reality, I have prayed to maintain joy outside of this process. And with all that God has shown me in the last 6 months alone, I pray for His will to be done and I pray I continue to be receptive to his will.

Because God is in the detail – and not in the outcome alone.

Final results (part 3)

“You know, your husband’s reaction just reaffirmed to me that God is out there working on us. How his experience readied him for this situation, how God brought you two together so that you wouldn’t have to deal with fragile masculinity while also navigating through this challenge. God knew what he was doing when he brought you two together.” – @anisiamichael

So let’s take things back to a couple of weeks ago… It was a Friday and we had our appointment at 3.30pm to get my husband’s semen results. Already I knew something wasn’t right because they had called him to come in to ‘discuss’ – usually if it’s all good they will just tell you that it’s looking good over the phone. Anyway I went to work and for pretty much the whole day I was having anxiety attacks. But the thing is I wasn’t worried about the results – I was worried about my husband and in my mind I kept playing the scene where he gets the bad news and I thought how am I going to be able to be there for him ENOUGH for him not to internalise this. I worried about him and for him as a man, as a Nigerian man but also just as my husband receiving not so good news. I am not even joking when I say I had to keep going to the toilet at work just to do breathing exercises so I didn’t self-combust. Eventually, the closer it got to 3.30pm my anxiety had calmed down and I was in strong supportive wifey-mode at this point and I met him at the surgery.

I tried not to make a huge fuss about it in case he was worried but while we were waiting to be seen, I just said to him “Whatever the results babe, it doesn’t matter. We are going to be parents and I would hate for you to internalise any part of this process because we have many options ahead of us. It doesn’t matter what we hear today, what matters is KNOWING what is available to us and what to do next.” My husband, being the chilled guy that he is, was like “I am not even worried… I have dealt with devasting news before (when his kidneys failed at 22) and I was in it alone, this time I’m not on my own and I am more emotionally evolved. I am not internalising this at all.” I know my husband and one might think oh maybe he was putting a brave face on but I felt it in him – he had a real acceptance of the dissonance that can happen between one’s physiology and one’s own vision of how it should be. And to be honest, at the very beginning of this process, the gynae had said that having been on dialysis for over 10years now, it is likely that his sperm will have been affected by this over time. Anything that affects the general health or natural functioning of the body can affect sperm quality. Just a quick one on dialysis – what my husband has is Renal failure which is when one or both your kidney fails i.e. stops working completely. In my husband’s case both his kidneys failed when he was 22 and at the time he didn’t really know what was going on but he wasn’t feeling well and he went to see a doctor and his BP was incredibly high and they were shocked he was still conscious. So when your kidneys don’t work properly you have to have dialysis a certain number of times every week; which involves being attached to a machine to remove waste products and excess fluid from the blood. You are connected to the machine via 2 needles linked to 2 tubes; one to take the blood out of the body into the machine and the other to bring the clean blood back into the body. Because Afro-Carribean people generally do not donate their organs, my husband has been on the waiting list for a kidney transplant for about 8 years because he has the rare blood type that is commonly found in Afro-Carribean people.

Studies looking at the sperm of men receiving dialysis treatment do show that many men have reduced sperm counts, and the sperm that are present are underactive. This seems to be due to failure of the sperm to develop in the testicle. Sometimes there is associated testosterone deficiency, but it is not clear from research whether testosterone treatment restores the numbers and function of sperm in men with kidney failure. After successful kidney transplantation, sperm numbers generally rise and there are reports of men who were infertile whilst on dialysis fathering children after transplantation. (© National Kidney Federation). So a huge part of me, although I hadn’t even looked this up at the time, wasn’t entirely shocked by the results because I mean 10 years of anything will have an effect on someone’s physiology. The GP basically explained to us (what most studies which I have now read up on say) that my husband’s sperm count was low and the motility (movement) wasn’t great either and that this significantly reduces our treatment option down to IVF. My husband did have some good sperm in there, what they call ‘progressive’ sperm and with IVF they would only pick the best sperm out of the lot to use for fertilisation with my eggs. Not long after seeing the GP we also saw the gynae who reiterated the meaning of the results but he said something that gave us so much hope… he said “The reason you haven’t fallen pregnant is because you haven’t been exposed to (healthy) sperm and since we pick the best with IVF for fertilisation, I don’t see any reason why the embryo would not embed itself in your uterus once we put it in the right place – because you have no underlying condition that might affect that process. So the chances for successful IVF are very good in your case.” It was so good to hear this but of course we know we have to maintain a level head because as we all know it is not always successful. I should add at this point that I had another transvaginal scan that did not show anything this time and whatever they saw last time was gone (YAY!). It is most likely that it was a collapsed follicle before my period.

So what is IVF? The process of IVF involves retrieving eggs from the ovary and combining them with sperm in a dish. If they fertilize, one or two embryos are returned into the womb to, hopefully, produce a healthy baby. We are doing IVF under NHS so we should be getting 2-3 cycles which is basically works out as 2-3 egg retrievals. Any embryos that are not used are frozen, so even if it is successful the first time any remaining embryos are frozen and stored for future use. I will do a full post on the IVF process as I know it but for now, in a nutshell the IVF process is as below:


A lot of people have been asking me how I am and how I feel and the truth is I don’t necessarily feel anything. And a huge part of that is just so I can maintain a level head about it all. I want to be prepared for both any good or disappointment that can come with this and I just feel that not getting ahead of myself and also not over-worrying is a good place to be. What I am happy about is the KNOWING, I talk a lot about the gift of knowing on this blog and for me that has been the best thing to come out of this journey. A knowing about our fertility health, about the options out there and more so the options available to us specifically because every case is different. My worst fear was to get to the end of all this and be told that we have unexplained infertility – for me personally – I wouldn’t have known how to process that. Although yes the results were not good news, they are concrete and something we can actually work with and I’ll be honest there is an element of relief on my part that we are going straight to IVF because after almost 3 years of trying the last thing I would have wanted is another prolonged process of trying out all the other treatment available before IVF and then not having success with that and then having to face IVF carrying all that disappointment. Going straight to IVF means the trying process is not extended and also there is a cut-off with IVF because once your cycles are done you have to re-evaluate and decide where or not you want to self-fund and go private or become parents in a different way. I personally want to be able to draw the line at some point and I feel the benefit of being funded by the NHS vs the cost of self-funding makes you consider drawing the line at some point. That’s not to say we would never go private if the NHS cycles were unsuccessful, but the end of the cycles offers a chance to just stop and figure things out as opposed to a long and disappointing stretch of failed treatment. I don’t know if I’m making sense but there is some relief for me in this being our only ‘assisted’ option.

I am however, extremely anxious about shutting down my natural menstrual cycle and the hormones that do all that (more on this in next post). I have always been quite conscious about what I put into my body and even when I was on contraception, I had the copper coil which releases no hormones at all because I can’t be sure what all these hormones are doing to our bodies. So that part I am worried about and there are so many stories from women who’ve had IVF and what it did to their bodies before they even fell pregnant. But the desire for a baby outweighs all of the anxiety and I have to deal with it, obviously. I don’t know exactly what to expect and as they say, ignorance is bliss so at the moment, I’m seeking solace in that. Of course this ignorance can’t last forever and I will have to have a moment of reckoning but for now, having signed the dotted line on the referral form and begun this journey, I am taking it one day at a time. I would like also like to add at this point that I will NOT be blogging about our IVF process in real-time – my husband and I would like to have that experience in private (the same privacy afforded to people who conceive naturally) because we don’t know what lies ahead and protecting that outcome, whichever way it goes is important to us. I will continue to blog about in/fertility related stuff but nothing about what is going on with us until we see it fit to do so again. Please know that this is in no way a response to any stigma, or shaming or silencing. Silence is okay if it is your own choosing and in this case,  it very much is my/our own choosing. I hope to be telling you good news in the near future and if that is the case, I want this time to be about my family – and not about the blog. I will continue to be here for any questions, suggestions for posts or one-to-one chats.

Please keep us in your prayers – for God’s will to prevail.


Noni x

Results (part 2)

“Infertility reveals the darkest & most vibrant days of your life. Lean in & honour both” – @mstiagendusa

When I began this investigative journey, I went into all my appointments not expecting them to find anything or pin-point anything. I just expected the worst-case scenario – which for me would be to find out that our infertility is “unexplained”, because I mean what do you do with that?! In the same breath, however, I feel like each time I see someone or have some sort of test, SOMETHING always comes up – almost as if my body wants to deduce it to SOMETHING and consequently influencing the specialist to think the issue is “this” then it’s “that” then again “maybe this!” So I am a bit anxious now when I go for any testing because there is always something!

So the first thing that has been ruled out is PCOS – I do not have the 2 features to meet the criteria as explained in my previous results post so that’s good – all I have to contend with is the irregular periods (and suspected irregular ovulation). Turns out though, in ruling out PCOS, something else was discovered in my right ovary during the transvaginal scan. I quote ‘There is a 22mm x 22mm x 10mm area of increased echogenicity on the right ovary with peripheral vascularity on colour doppler. Collapsing follicle or Endometrioma?’ I knew something was off when the surgery called to say the doctor wanted to see me to discuss my scan results because usually when there is nothing to raise an alarm, the secretaries tell you or they arrange a telephone call with the GP. But still, I was very chilled when I went in for my appointment until she mentioned endometriosis. Up until that point, I genuinely knew nothing about endometriosis – I had heard about it and knew people who suffered from it but I knew nothing about it especially in the context of trying to conceive. So obviously I asked the GP lots of questions and she basically explained that Endometriosis is a condition where tissue similar to the lining of the womb starts to grow in other places, such as the ovaries and fallopian tubes (NHS). And potentially this might be what is going on in my right ovary. We also started discussing my stint in hospital (that birthed this whole journey) and how the pain was on the right side of my pelvic area and even that morning before I saw her and the 2 days previous, I had this tinge of pain in my right pelvic area where the ovaries are located but I just put it down to ovulation ? I don’t know. And it’s a pain I often have but it’s such a slight pain (compared to period pain) that I have always just brushed it off. Also, I have very painful period pains which is another symptom of endometriosis. We both agreed that the coincidence was a bit much BUT she also explained that because of the timing of the scan and where I was in my cycle (I had just ovulated – the nurse confirmed it at the time which made me so happy!) that it could be the collapsed follicle when the egg is released and if not fertilized results in a period. And this would make sense because a few days after my scan my period came.

Endometriosis does not necessarily cause infertility but there is an association with fertility problems, although the cause is not fully established. Even with severe endometriosis, natural conception is still possible. As the severity of the endometriosis increases, scar tissue (adhesions) become more common and the chance of natural conception can decrease. There is an association between infertility and endometriosis, but the cause has not been fully established. Minimal to mild endometriosis sufferers have an almost normal chance of conception but some sufferers are infertile for unclear reasons. In cases of moderate and severe endometriosis chances of natural conception are reduced. This is because there are more adhesions that can trap the egg and stop it from moving down the Fallopian tube. Drug treatments have not been found to improve fertility. However, the removal of cysts, adhesions and nodules during surgical treatment has been found to increase chances of conception. Endometriosis can cause delay in getting pregnant, but once you are pregnant, pregnancy is expected to be no different from normal. There are reports of women who had more pain in the first few months of pregnancy. In general, pain improves, but may return after giving birth as periods return. © Endometriosis UK

It’s easy to speculate and run wild with explanations but speculations serve as assumptions to be confirmed or ruled out so I will be having the scan again but this time at a different time in my menstrual cycle, however, I have to see my gynae first who will further interpret the scan results and perform the second scan himself. This won’t be until the end of September because our appointment was booked 8 weeks in advance to give time for my hubby’s sperm results to come back. That’s another thing, sperm analysis results take the LONGEST time! Had I known this we would have started the investigations with him. Another update – regarding my blood/hormone results – I saw my gynae who interpreted the results and said my hormones look fine and do not suggest PCOS or a hormonal imbalance of any kind. Again – good! I then asked about what my GP said that I may not be ovulating and he said well because of your irregular cycle you are ovulating irregularly we know that but what the GP meant is that it is harder to know with your cycle when you are actually ovulating, is it slightly earlier than the norm or much later, we cannot guarantee when you will ovulate like we would be able to with a more regular cycle. So on this point I just want to stress the importance of specialism in medicine – my GP is not as equipped to make a gynaecological diagnosis from my hormone results as someone who trained in that specialism. So GPs speculate because that’s the nature of their investigations as GENERAL practitioners but a specialist like a gynae can give you more (dare I say accurate) insight on your results because that’s their forte and they will know, having dealt with thousands of samples of data and outcomes what is a red flag or not. My gynae was very calm and satisfied with my blood results that it put me at ease. My husband then asked about what our options are likely to be in terms of treatment and the gynae advised that it now depends on the sperm analysis; if my hubby’s sperm analysis is abnormal then our only option is IVF but if his sperm is normal then there could be interventions available to us before IVF such as hormonal treatment (clomid) for me to regulate my irregular cycle or IUI which is basically intrauterine insemination of my hubby’s semen into my womb at the optimal time for potential fertilization. My husband has been a dialysis patient (due to renal failure) for over 10 years now and he has regular dialysis which the gynae advised can affect sperm quality so there is that speculation – hopefully to be ruled out! (I will write about dialysis in another post at another time because I think that’s a condition that almost no one knows about – even I didn’t know before I met him – and it can happen to anyone and both my husband and I are big on raising awareness about kidney failure).

So, sperm analysis tests for several markers of sperm health, including:

  • the number of sperm in 1 milliliter (ml) of semen
  • the size and shape of the sperm
  • the ability of the sperm to move correctly

In couples that have been unable to conceive, some estimates suggest that there is a male factor present in 40 to 50 percent of cases, resulting from one or a combination of:

  • low sperm count in a sample of semen
  • poor sperm movement, known as motility
  • abnormal sperm size and shape, known as morphology

Sperm count or concentration

World Health Organization (WHO) guidelines suggest that a normal sperm count is at least 15 million per ml or no fewer than 39 million sperm per sample. Having less than this indicates a low sperm count.

Sperm motility

Sperm motility is the ability of the sperm to move efficiently. Low motility can reduce the sperm’s capacity to move through the female reproductive system to fertilize the egg. In a typical sample, at least 50 percent of the sperm will demonstrate normal motility.

Sperm morphology

Morphology refers to the size and the shape of the individual sperm. Normal sperm have a long tail and oval-shaped head. Abnormally sized or shaped sperm can have difficulty reaching, penetrating, and fertilizing the egg. Normal semen contains a minimum of 4 percent sperm with standard form.

© Medical News Today

So this is where we are so far… I have generally been quite busy (enjoying my love affair with SUMMER) and haven’t really been thinking about this too much but I was with my puppy (Leo) the other day and I realised that I haven’t cried in months about this infertility thing. My husband initially said I couldn’t have a puppy years ago but I’m now thinking how strategic his change of mind was when he told me in April that he would be getting me a puppy. I had been in hospital, I had been so down, had cried so much about this infertile life but I kid you not I have not cried once since Leo came into our lives. I don’t know if my hubby knew the effect a puppy would have but it has worked. Obviously, he is not a real baby and he will never replace the desire for one but now I am never home alone, or upset for too long because I just see his face and all is well in the world. Even now I’ve been typing for a couple of hours, he has been whining the whole time and he is giving me the sad puppy eyes. As well as filling my heart with a new kind of joy he has kept me so occupied that I haven’t spent much time feeling childless.

All in good time. This I know.

love & light


Results (part 1)

“Infertility breaks us down, but if we allow it, also reveals our true selves by allowing light into the dark parts. We become whole when we accept ourselves fully, the good with the bad, the highs and the lows, not just our shiny exteriors” – @infertileafcommunity

You never really know what to expect when you begin your investigative journey under the care of a gynae or fertility clinic. When I last saw my gynae, he asked me to have a Day 3 blood test which is basically a blood test on the 3 day of your period. At the time I didn’t even ask what it was for – but I have now learnt from Vanessa Haye, to ALWAYS ASK questions so you know exactly what is going on. Just a quick one on Vanessa… she is a fellow #brownskingirl I found on Instagram at the time that I started un_fertility and she was the only black/African I found visibly talking about infertility and her IVF experience. Her story has been featured on Sky, BBC & Metro. You can follow her story on her IG page. THANK YOU Vanessa for paving the way for people like me, and for accepting my call and giving me a fertility pep talk.

So the day 3 blood test (she says after much research online) is to test 3 important fertility hormones. The day 3 fertility test is normally the first test that is performed in any investigation into female infertility. It is performed 3 days after the start of your period (but it can also be taken on day 2, 4 or 5) during the follicular stage of the menstrual cycle. The aim of the test is to check that hormone levels can support the maturation and release of a healthy egg from the ovary. Follicle-stimulating hormone (FSH) is released from the pituitary gland to stimulate the ovary to start maturing an egg. Luteinising hormone (LH) is required for the final maturation and release of the egg from a follicle, while oestradiol both stimulates the growth of the follicle and prepares the uterine lining for a pregnancy.©Medichecks.com Ltd 2019. I had not heard from my gynae for a while so I decided to book myself with the GP as an impromptu visit because I could not see my test results online and I was hoping the GP would be able to tell me ‘everything looked ok’. I wasn’t worried, and I just went in there thinking, at the very least he is going to book me in with the gynae again, which is what I wanted. This is where all the things Vanessa said to me made ALL the sense. My gynae had written to my GP explaining things so far; based on my hormone levels (the 3 I mentioned before), my GP said to me in these exact words, “we cannot guarantee that you are ovulating every cycle based on your hormone levels. There is a certain threshold which we can be sure that you are ovulating but with yours we cannot be sure and if you are not ovulating every cycle this could explain the irregularity of your cycle.” So obviously I then asked him, so can I get a period without an ovulation and he point blank said “YES. It is called anovulation.” Before I explain what that is, am I the only person completely mind blown by this? Not so much the fact but the MISINFORMATION we hold onto as truth. I mean being exposed to the #tryingtoconceive community now, I had seen some people talk about period without ovulation but I thought it was a very specific condition that causes that and I paid no mind to it, but it happens to all of us at some point in our lives. When it occurs as a one-off it is not an issue but if it is chronic, it can obviously affect fertility.

So anoluvation or an anovulatory cycle is a menstrual cycle with no ovulation. This means an egg cell wasn’t released by the ovaries which normally happens at the end of the first stage in the menstrual cycle, known as the follicular phase. Ovulation is necessary for conception, as pregnancy happens when sperm fertilizes an egg cell – so you can’t get pregnant when no egg cell is released. Anovulatory cycles are pretty common and most women will experience them throughout their fertile lifetimes. – NaturalCycles Nordic AB ©. In a normal menstrual cycle, estradiol (the main estrogen hormone) increases steadily during the first half of the cycle. Estradiol helps to build up the uterine lining. Increasing estrogen levels help to trigger ovulation, which is the release of an egg from a follicle in the ovaries. After ovulation, the spent follicle transforms into something called a corpus luteum, which secretes the hormone progesterone. Progesterone levels are high during the second half of the cycle. This is important because one of the primary purposes of progesterone is to provide structure for the uterine lining built up earlier in the cycle. If the egg is not fertilized, then the corpus luteum shrinks and stops secreting progesterone. Without progesterone maintaining the uterine lining, it can no longer be maintained within the uterus, so it sheds in the process you will recognize as your period. If you did not ovulate, no corpus luteum is formed, and no progesterone is secreted. So, while the first half of your cycle was spent building up the uterine lining, there isn’t a hormone signal for maintaining it without ovulation. The uterine lining still has to be shed, and you can still experience bleeding that looks similar to your period. – © Ava Science Inc.

I don’t really know how to explain how it made me feel being told that the very thing I needed my body to be doing and that I assumed my body was doing, is probably not happening! I had/have so many conflicted feelings about it. The first thing that came to my head was “ok it’s me, not him (hubby), that’s good”, my husband is OKAY with everything and even the eventuality of him having a/the contributing factor, he is at peace with any scenario and does not need my cushioning but in MY mind, I feel that it would be better if our cause of infertility was with me. Maybe because there would be more treatment options on my end but also because I think I would start over worrying about him internalising our infertility, which by the way he hasn’t given me any reason to think that. But I care about him and I don’t want him to overthink any of this, I am happy to do that for the both of us. Crazy right – he is probably thinking the same about me! (We haven’t got his results yet). The second thing that came to my mind was, TWO AND A HALF YEARS and no ovulation! OK yes, that is a bit dramatic, because I’m sure I have ovulated, albeit sporadically, in that time but it just felt and sometimes still feels like time WASTED. Again, I started thinking about why I didn’t seek any help sooner. This is greatest takeway to anyone else out there dealing with infertility; as soon as you reach that one year mark of trying naturally, seek medical help. It might be a simple process or it might not be but I do think it would be better and that I would feel better if I was hearing this after only a year of trying. Another thing I felt was, how did my body not communicate this with me? How is this something one would only find out like this? My periods have always been irregular, does that mean all this time I wasn’t ovulating, where were the signs, I felt a bit let down by my body and even worse felt like I wasn’t in tune enough with my body. Because a few times people have said to me, “oh can’t you tell when you’re ovulating?” and the truth is I CANNOT. There are no symptoms that have been consistent enough for me to say yes that’s ovulation and if I am not ovulating that would make sense. I can tell when I’m about to go on my period, literally the day before or the day of but I cannot tell when I am ovulating. For people who might be confused, this is not the same thing i.e. does not happen at the same time. Your period usually comes 10-16 days after ovulation. Now that I think about it, we do need to be more sensitive with our words, I am happy for you if your body is like clockwork and communicates with you but that isn’t everyone’s experience and when I am already battling with the lack of synergy between myself and my body, it does not help when you are made to feel that ‘as a woman’ you should just know these things.

The flipside to all these feelings I felt was the sense of empowerment, from the KNOWING. I talk a lot about knowing and knowledge when it comes to fertility (and in general) and the information given to me by the GP motivated me. I remember coming out of the surgery and calling my mum and giving her this drill-down of everything I had learnt in the 20mins I spent with my GP. My GP explained that “if this is the only issue, we can give you medication that will induce ovulation, it a very simple solution.” So although the news was quite a blow if you really think about, in another light if that is the only issue that would be the best outcome from all this because potentially, as my GP asserted, all I would need is for an egg to be released and the hormones at the right levels. Obviously, in reality, it is not that basic and I am fully aware of that but coming from 2.5 years of trying unsuccessfully to a potential treatment option of taking some medication to make my body do what it needs to, it would be a huge step in the right direction. However, because of all my symptoms, even though my hormone levels do not necessarily reflect this, both the GP and my gynae suspect that I might have polycystic ovarian syndrome (PCOS).

The 3 main features of PCOS are:

  • irregular periods – which means your ovaries do not regularly release eggs (ovulation)
  • excess androgen – high levels of “male hormones” in your body, which may cause physical signs such as excess facial or body hair
  • polycystic ovaries – your ovaries become enlarged and contain many fluid-filled sacs (follicles) that surround the eggs (but despite the name, you do not actually have cysts if you have PCOS)

      If you have at least 2 of these features, you may be diagnosed with PCOS. – NHS.

I hadn’t even considered the possibility that I might have PCOS and my GP even commented on the MISINFORMATION out there that makes people think that only excessively hairly women, or women with high testosterone levels, or women with acne have PCOS. Again, this is not true as some women have ‘milder’ forms of PCOS and as clearly stipulated in the features above, you only need to have 2 to be diagnosed with it. Already I have one of these features so I will be having a transvaginal scan to rule PCOS out. A transvaginal ultrasound is an internal examination which involves the insertion of the transducer into the vagina to produce incredibly detailed images of the organs in the pelvic region. Only after this will I know for sure whether I have PCOS or not. Fortunately the trying to conceive tool that I am using at the moment called Ovusense is suitable for women with PCOS if it turns out that I do have it. In fact it might be Ovusense’s biggest selling point because other trying-to-conceive tools are not always suitable for women with PCOS. (Next week I will do a detailed post on the trying to conceive tools I have tried and the ones I haven’t tried).

So this is where we are so far. I will be having more bloods done and this is by no means the full picture but it is reassuring to know that things are moving towards fertility/assistance. And interestingly we have relaxed a bit more in terms of timing the fertile window and scheduling the ‘trying’ (those who know, know!). For me, I’m not going to lie, it is partly because I kind of think, well I might not be ovulating anyway but also and perhaps more importantly, because I believe that the more we know and discover through science, the better help we can get and this is just the beginning. I still chart my temperature with Ovusense everyday because the picture from those stats is equally important in this process (and for my own my knowing/learning of my body). And look, I am fully aware that it is not all rosy from here (any altering of the natural functioning of the human body isn’t) but the thought of having a better chance at pregnancy fills me with renewed hope.

In my feelings

“Infertility is accepting and grieving one door closing, yet mentally and physically preparing yourself for what’s next. Your heart is breaking and also slowly being pieced back together again with hope of what the next chapter might bring. So many of the triggers lie in this middle place. It can feel like the world doesn’t acknowledge the middle. It feels like you are being rushed through the emotions you shouldn’t be feeling.” – Missconception Coach

I am one of those people who tends to have a delayed reaction to things. Well, maybe not delayed but I spend a lot of time meditating on words, energies that I am receiving over any period of time. This has been the case for the last 2weeks or so…

I shared my story and received an overwhelmingly supportive response and at different intervals this has brought me to tears. Tears of… I can’t exactly call it joy obviously because nothing about this is joyous… I think it was relief that I will be able to continue to tell my story because it is as much for others as it is for myself. Another big part of the relief is that for the most part, people understood me and why I felt this was important. But of course, with any kind of sharing there are others kinds of energies that I personally have struggled with.

The thing that gets me the most, in life, in general, is being misunderstood. I know that in life it’s a given, and it happens but when I think back to all the times I have been really upset or angry it is because someone misunderstood my intentions. I struggle with this and I know that about myself. Over the last few weeks, there have been moments where I have felt misunderstood just because I spoke out about infertility. By saying that we are black/African and dealing with infertility, quite a few people have assumed that we have given up. I find this confusing because at no point did I even suggest this. It made me realise just how strong the stigma around infertility is and how the long-held beliefs within African communities dictate how people respond to a discussion on black infertility. When I put my story out I had an idea of the stigma, but I hadn’t imagined the depths of it as I now know it and feel it.

There are a few things I specifically want to address that have been said to me. I want to add at this point that I am aware that people “mean well” when they say things to me but I think a lot of that has to do with the fact that couples have been tolerant of these statements because usually, they are hiding their infertility issues. So because my/our story is out in the open I just feel that I have some responsibility to challenge these statements and shed some light on what and how it feels like on the other side because maybe people don’t actually know. This is by no means an attack or retaliation (Noni claps back! – LOL), everything about un_fertility is about offering perspective from the angle of someone who is actually dealing with infertility.

  1. I am sure B (my husband) still loves you anyway.

This was a real mind fuck for me. On the one hand because of who said it and the fact that we had the same upbringing in Zimbabwe and we are similar age, I just did not expect that all. But on the other hand because of the cultural context she lives everyday in Zimbabwe, I couldn’t even blame her for not seeing how flawed her statement was.

Firstly it implies, not even implies, the statement places the fault and consequence with me. This was without any confirmation of the contributing factors in our situation (because we don’t even know yet), this was without any suggesting on my part that, it was an outright statement which had the intention of reassuring me but if I was a different person or if I was feeling insecure in marriage could have had a damaging effect on me.

I want to add at this point that infertility affects both sexes. That is, the contributing factors can come from either the man or woman. Africa. Africans. We NEED to stop placing the blame on women as a default starting point. It is actually inaccurate and even in the case where the women has a contributing factor this can’t be how we treat her when she is already dealing with a lot of feelings of inadequacy and shame internally. This kind of ignorance is more than just words, it is someone’s life.

There is also another element to this statement that even though in my case is not entirely relevant, but it made me think and I spoke about this on radio. For Southern African women whose spouses pay lobola (bride price) for them, infertility comes with another dimension where a woman can feel that she has to prove/show her (bride price) worth by giving the man a child/children. So in the context of infertility, like in my context, my husband paid lobola for me and although I am evolved and liberal and his family is incredibly supportive about our situation, internally in the back of my mind I have thought about it. Growing up I used to hear stories of women being sent back to their families because they couldn’t fall pregnant and the man’s family demanding their money back. These might have been just stories but even then why such stories? And just imagine the lasting impact of such stories – I am almost 30 now. I know for others the issue of inlaws and our cultures is a lot more complex than mine – I am very lucky. But my point is, when we make statements without thinking of the woman’s perspective, we might be having the opposite effect of our intentions.

We need to be conscious of how we reassure a woman/man/couple dealing infertility. And if all else fails – ASKhow can I support you?

2. I just feel that you should relax. You are very young and have all the time.

This will be debatable I’m sure, but I hate anyone saying this to me and it actually really upsets me. I heard this so much last week and each time I would just end the conversation or agree because I did not want to break down. But then I did break down… Last Sunday my husband could tell I wasn’t really okay and the day before he had told me someone had told him to tell me to relax I have time. I was trying to keep it moving and keep my shit together, but my husband asked me again “Are you okay?” You know when someone asks you that and you are actually not okay, the flood gates open. I looked away from him and said “I am fine, I am going to Tesco”. I got into my car tears were literally gushing out of me and I was still trying to fight it. I got out of my car  and walked back in the house and said to my husband, “I will go in 5mins, I just need a minute and I looked away from him again and I just started crying. Inconsolably. My husband was so confused and kept asking me what is wrong and I couldn’t even stop crying for long enough to tell him. Eventually I did. Anyway back to the point. Here is what I feel when people say “relax”. Again I know people “mean well” but it does not mean their words always have that effect when they are received. Telling me to relax because I am young and I have time feels like people are saying you have time to keep trying so even if it takes 7 years of trying I will only be 37. Here is something you need to know – EVERYDAY of infertility is painful. Don’t forget that a couple dealing with infertility already has issues with time because of the menstrual cycle and the fertile window that only comes for up to one week in a whole month. So when it doesn’t happen this month, I/we have to wait a whole month to find out if we will be lucky the next month. We are dealing with time already and I personally don’t need to be told that I have time. Knowing that I have 10 years of trying in me because I am only “young” doesn’t make it any better and is not reassuring, I just want to make that clear.

We have made infertility about age – yes the contributing factors can be affected by age – but the experience is a very individual experience. I know someone who was 22 and married and ready to start a family and they struggled to fall pregnant. I know someone else in their late 30s who is struggling to fall pregnant. To make it about age is to say that it is easier for the 22year old because she is younger – it is NOT. They both have/had to deal with disappointment each month, seeking help, medical interventions, the emotional side of it, the mental side of it. The infertility experience is not about age – it about the individual/couple. And as an individual I don’t find being young and having time reassuring. When you trying to have a baby, each month is a TRY – that is – each month you are hoping that you will be lucky. No one wants to do this for 2, 5, 10 years. On the point of “just relax”… I actually get weak with this one because you have already made the assumption that we are not relaxed just because we have accepted where we are on our fertility journey. I actually need to make this point – accepting our infertility does not automatically mean that we are not relaxed. It simply means we recognise that we might need some medical assistance. And that could just be hormone therapy to regulate my cycle. Or it could be the full works; IUI or IVF, wherever the science leads us. Anyone who knows me and my husband knows that we are so chill so relaxing is not an issue. But even if we were not relaxed or on the days that I am not relaxed, I am a human being who goes through the motions like everybody else. “Relax, it will happen” is easily served when you haven’t had to do deal with what we deal with. And no offence but so far it is people who have children already who have said this to me which for me takes away from the intention because I just feel that you don’t understand. Which is fine – if it wasn’t being rubbed in my face. When you tell infertile couples to relax and that they have time, it makes us feel that anything we feel outside of this is not valid or that we are not allowed to not be relaxed. But I ask on who’s terms? Unless you have walked the walk – I mean I am yet to meet another person/couple who have children and went through what we are going through say that to me. I am confident that they could never say such a statement, based on their own experience. Again when your own dialogue fails you – ASKhow can I support you?

3. Then there was the ones that did not say anything at all.

I just feel like there were so many people who saw my story and probably read it but they didn’t say a word to me about it. Some haven’t even spoken to me since. Now I am not saying EVERYONE should have said something but I can guarantee that if I had made a pregnancy announcement those very same people would have had something to say then. This was the first form of silencing I experienced and for me this is the strongest. I’m talking about close friends and family members who in the midst of other life issues I have gone to and I have leaned on them. Their silence has made me feel that I cannot speak about my story with them or that I should be not be doing so at all. And this is how silencing happens because you feel that you make people uncomfortable by merely talking about what you are going through. The family members one for me is important because sometimes contributing factors of your infertility might be rooted in the history of your family health, for example uterine fibroids can run in families, so when families cannot be comfortable with discussing fertility one can be in the dark about their family history and lack the insight that might be important for diagnosis/treatment. The friends element, I know people choose what they want to be involved in and that is their prerogative but if a close friend was dealing with something like this, I want to think I would do more than say nothing. I am aware though that people lack the dialogue to talk about infertility but we need to get comfortable with the uncomfortable so we don’t ice people out with our silence that might seem harmless but is having the opposite impact on someone we claim to care about.

4. The word taboo came up a lot when I first shared my story

This blew my mind. I knew infertility was a taboo topic in black/African communities but when people were saying it, it really hit me and speaks to the rejection of the infertile experience in our communities. This is not an assertion towards the people who used this word, I am actually glad you did because it highlighted important realisations about my experience. Discussing infertility on radio as well gave me so much perspective.

There is a very strong rejection of infertility among black/Africans and this is due to the long-held beliefs that all black men and women are hyper-fertile beings. So when you don’t fit that narrative, there MUST be something wrong with you or your partner. When I was on radio, Kiki described a situation with a group of friends who started treating one of their friends differently when she could not have kids and they all had. They would not want her to touch their children. This blew my mind. After radio a few people actually told me of other similar stories where the infertile woman was (mis)treated as though she was cursed. Guys the stigma is HUGE. When I started un_fertility I was tunnel-visioned in the sense that my experience of infertility was an internal battle as opposed to the external battle that many women are facing. I felt shame, not because I was being made to feel ashamed externally, but because I was ashamed within myself. But I had to ask myself where I was getting these feelings, and when I read the word taboo the first time it hit me, all those years growing up in Zimbabwe, the indoctrination, especially as a black African girl, and the whole idea around servitude to the man I marry and his legacy, what we are taught about womanhood and the strong focus on motherhood as huge part of that. My feelings of shame, and the silence I maintained were rooted deep in my upbringing, even when my current living is that of a liberal surrounded by other liberals. Our cultures play a big part in who we become and what we subconsciously believe and hold onto. The word taboo frightened me actually… but it woke me up so that I could really unravel my own programming. It woke me up to the revised purpose or maybe additional purpose of un_fertility to be a space where we can unlearn old ways of feeling and learn new ways of being – individually and collectively. As couples dealing with infertility or friends/family/communities supporting couples in their unconventional fertility journeys.

To finish off I would like to encourage all of us to be more mindful of our words, our actions or lack of, towards people who are dealing with a very difficult process. Couples dealing with infertility make it look easy because life must go on but infertility is painful and it’s long. We need to be conscious that we are not projecting our own feelings on infertility and imposing them onto people who no doubt have ALL the feelings about their infertility, and rightfully so. We must be careful not to impose how we think we would deal infertility as superior to how a couple might be choosing to deal with it. Because yours is hypothetical, ours is real. There is fundamental difference.

Black/African & Infertile

“If I have to be the poster child, I will become that poster child to get women to talk about their struggle… At one time, my fear was talking because I didn’t want people to gossip about me. Now, my fear is women not talking.” – Nichelle Polston

For the past 2.5 years I have been dealing with infertility and now more than ever, I feel compelled to share my story because someone out there needs to hear this.

Black women don’t talk about infertility.

And I want to clarify that statement first. 1. Infertility is not about race, I appreciate that, it’s not a black people, white people thing but I do feel that black/african women experiencing infertility, have to contend with a cultural dimension that needs to be challenged. 2. The word infertility itself, comes with so many pre-conceived notions, all of which immediately exclude a woman from the prospects of becoming a mother. The WHO definition of infertility is the inability of a sexually active, non-contracepting couple to achieve pregnancy in one year, that is, a couple is deemed infertile if they have been trying for over a year by natural means. Now there are numerous reasons why this could be happening, there’s irregular cycles, PCOS, fibroids, low follicle/sperm count etc… but in all of these scenarios, pregnancy is still possible. Not always, but the possibility is there whether naturally or by facilitated means.

The problem for me is the dominating single story of pregnancy. Like Chimamanda Ngozi Adichie asserted, any single story is dangerous because it breeds misconception and misinformation. There is a strong denial and rejection of a different pregnancy story in our society where in/fertility is concerned and this is incredibly isolating. It is precisely because of this, that I hope to create an inclusive support space with un-fertility because I consider what I am experiencing to be an unconventional route towards fertility. I want to foster a more open approach to infertility, particularly among black/african women, to be able to talk about it, sometimes be upset about it, sometimes cry about it but most importantly feel no shame in doing so because you are not broken and you are not alone.

So my story begins January 2017 when my husband and I (he was my boyfriend then) had a long chat about life, as we often do, and we decided that we would be happy to start a family so I got the coil taken out. A few months later he proposed to me and we got married in September 2018. For the last 8 years, I have used a charting app called Flo to log my periods and in Jan 2017 I had a good handle of my cycle and I knew that I had bit of a longer cycle than most people. So for the first year I was just basing my fertile window on what the app was telling me which fell around 2 weeks before my expected period. And because I had been using this app for years, my period usually came when it predicted +/- 1-2 days so I could be somewhat sure that the fertile window was also accurate because my luteal phase was/is generally 13-14 days long. 2017 came and went -and nothing. 2018 came and even though I was planning our wedding we were still trying. After our wedding, close to 2years trying at this point, I knew I had to do something else. Bearing in mind that I did not at any point in time think I needed to see my GP. Denial – but I will touch on this later.

Almost 2 years in I started doing a lot of research, I had more time in my life now and the researching just took over – articles, youtube, personal stories on instagram… #tryingtoconceive – all of it. I then discovered Natural Cycles which is basically an app that comes with a thermometer that measures your basal body temperature (BBT). I bought the pack and started using that from November 2018 and with this you have to take your temperature every morning before you get out of bed. In my eagerness it started off really well and I was remembering every morning, all good… The one thing the Natural Cycles app showed me, which for some reason I hadn’t picked up on before was that I had an irregular cycle – and this is VERY important to know when you are trying to conceive. My cycles can be anything from 33 days to 42 to 56 days – every month is different. So I did the temping for a few months, never quite getting ovulation confirmed each month and it discouraged me and I started slacking. What I also realised with Natural Cycles is that it seems to be based very much on a 28 day cycle and I think it would need years of cycle information to learn to make better predictions for someone like me with an irregular cycle… so it wasn’t a right fit for me personally (I’m sure it has worked for some people). Also it seems to market itself more as natural contraceptive than a trying to conceive (TTC) tool so perhaps it works better that way round. Long story short it didn’t work for me. All the while I continued to use Flo which as previously mentioned had a wealth of information about my cycle.

Early 2019, when it hit me that another year had gone by I went back to the drawing board and found the book+app Taking Charge of your Fertility by Toni Weschler. I wish I had found this book in the earlier days because it is a big book with so much information and illustrations and hard science – I still haven’t finished it but I would highly recommend it. So Toni’s method is basically the old school method (the Fertility Awareness Method – FAM) of checking your cervical mucus and position every day and logging this information. This can be accompanied by the BBT if you so wish. I did try this, I really did for about 6 weeks, but I couldn’t distinguish the different cervical indicators so AGAIN I was back to square one. Natural Cycles predictions were not accurate for my cycle and maybe that was down to me but also remembering to take my temperature before I got out of bed eventually was just not happening every day. The Fertility Awareness Method was just not practical for me (you have to insert your finger into your vagina every day!) and I didn’t feel confident about what indicators I was looking for. About February this year I discovered yet another TTC tool called Ovusense. Now this one will be strange for some people but Ovusense comes with a sensor in the shape of a sperm and you insert this in your vagina overnight (or whenever you sleep) and take it out in the morning and tap your phone on it (after washing it of course!) with the app open and it downloads all your core body temperature logs and produces a daily graph to identify when you are most fertile in real time. Same as before, this started off really well but then I had a phase earlier this year where I just felt so discouraged that nothing had happened that I stopped using all this tech so I cannot vouch for it’s effectiveness as yet. I am now using Ovusense again because it’s just more convenient as it does all the work for me. It’s a bit like wearing a tampon so nothing unusual there for most women – obviously you don’t use it during your periods or during sex! (I will do a more detailed post on these TTC tools).

In the period I wasn’t using any TTC tool, I inexplicably (even until now) ended up in hospital with severe pelvic pain which carried on for 3 days, this was preceeded by light bleeding for 7 days which wasn’t my period. After being admitted, being seen by several doctors, and having an ultrasound done it suddenly hit me that I had waited over 2 years to actually speak to someone about my/our infertility. Each time a medical professional asked me when I had come off contraception and I would reply over 2 years ago their faces were so telling and it’s only then – only then – that I realised that I had waited for too long before seeking help/advice. And there are many reasons for this. For the most part because of the general denial and rejection of infertility in society, more so black/african communities, I was playing a part in that in my own denial and rejection of what was actually happening. I discounted our first year of trying by coming up with justifiable reasons why maybe it didn’t happen but they were all to make myself feel better about not falling pregnant. The second year of trying I labelled that our real year of trying – you know before you can be deemed “infertile”. The other reason is the complete isolation one can feel when experiencing fertility, especially as a black/african, it is lonely and no one I know in my immediate or even secondary circle has experienced this so I had no one to talk to about it who would understand. Most of the people I have confided in have told me to pray about it, or told me I shouldn’t accept infertility as my reality. (I will speak about God and infertility in another post because while people mean well, the idea of waiting for a miracle from God and encouraging denial can be problematic).

Another reason why I think infertility is hard to accept is, as I mentioned earlier, the dominating single story of pregnancy. A girl I work with started trying at the end of 2018 and I bumped into her not long ago and she told me she was 16 weeks pregnant (now 24 weeks), I screamed the office down because I was genuinely happy for her, but I was happy for her as if she had been through what I had been through but she obviously hadn’t been trying for that long. I kept saying the words I’m so happy for you, and I started crying with the words “we’ve been trying for 2 years so I am really happy for you” coming out of my mouth. It was very awkward but I couldn’t help that my own sadness about my experience was stealing from the joy I really felt for her. The single story of becoming pregnant, that is get married or decide to have a baby (for most people), try for a few months and voila, baby! – while it is truly wonderful for those people and I mean that – it is linear and it further perpetuates the stigma around infertility and just magnifies the shame that women who are trying can feel. Couple that with the cultural dimension, particularly for me as a black/african woman – and I come from a family of VERY fertile men&women – in our communities infertility is not even recognised let alone acknowledged/understood because “black women and men are hyper-fertile beings”. Yet studies suggest black women are more likely to experience infertility yet less likely to seek fertility advice/treatment than their white counterparts. Our reluctance to seek help and even talk about infertility is culturally ingrained because for most black/african women, the ability to become a mother is closely tied to our identity as black women – we are raised in this way. So you start to breed feelings of real shame for not fitting that ‘hyper-fertile’ narrative.

I mean it took being admitted into hospital and being told point blank that 2+ years is a long time to be trying that I actually sought the help I/we need. We – because infertility does not fall on the woman alone – are now under the care of a fertility clinic going through investigations which take TIME and it makes me regret all the time spent without seeking medical/professional help. At my first appointment, because I had to be seen first for the pelvic pain episode I had had, I looked the fertility doctor in the eye and asked him, is 2 years a long time to be trying? He looked at me with compassion and said, it is a long time and there could be contributing factors but we have options don’t worry.

Those words have stayed with me and carried me on the not so good days. I hope sharing my story with you, whoever you are, wherever you are, will give you the courage to do the same, the courage to accept your unconventional fertility and the courage to seek help/treatment.

Sending you all the love, light & baby dust!

Noni x

Further reading: Why Are So Many Black Women Suffering Through Infertility In Silence? – Women’s Health Mag, Oct 2018