'Why we chose to say enough to IVF' - Ruth McKenna on ending her dream to be a mother

Through my twenties I was busy proving myself in the professional world. I got my first well paid job. I didn’t know if I particularly wanted children. I certainly hadn’t met a man who was up to the task of parenting with me.

I was 31 when I met the man who is now my husband. We talked about marriage, what it meant, if we wanted it…we discussed the possibility of being parents and of not being able to have children. We were both in good health, but had a niggling feeling that it might be difficult for us. Neither of us were hell-bent on being parents, we felt we could take it or leave it. Until we realised we might be forced to leave it.

A year or so after we married, we were faced with the reality that conceiving naturally wasn’t working. At the time we were living in Sweden; tests and medical appointments had the added challenge of a language barrier. It was a slow process. We relied on each other and Google Translate for support.

A move back to Ireland brought a further year of tests, tough conversations and some of the most incredible sessions with a counsellor I have ever experienced. We wanted to make conscious, intentional choices at every step and our counsellor helped us to find our way without losing ourselves or each other.

I soon realised how lonely this path was and decided I had something to offer women like me. I created an online programme called The Fertility Companion, to help women hang onto their sanity and build resilience for the crazy process of treatment. It helped me too; writing about my own experience was cathartic. Sharing my story burned away the shame that cloaks those of us affected by infertility. Our counsellor asked me if I would still want to do this work after we had children. I didn’t think to consider how I’d feel if we didn’t.

More than three years after we had first decided to start a family, all medical advice pointed to fertility treatment as our only option. We made the decision to try three rounds of IUI; a less expensive and less invasive option than IVF, involving “Intra-Uterine Insemination”, rather than the egg harvesting and artificial insemination that takes place with IVF.

This was truly a tough call for me. I never imagined I would need or want such treatment. I had a bias against medical intervention. I didn’t entirely trust the medical profession, but I knew that I had to now. I decided my attitude needed a reboot. Counselling, hypnotherapy and acupuncture helped me to prepare and get my head in the game. I tweaked my diet and focused on nourishing food to prepare my body for pregnancy.

Our first round was unsuccessful. We were gutted, but picked ourselves up and accepted this was just the first hurdle. In discussion with fertility clinic staff, it dawned on us how crummy our chances were. Given our situation and my (ever increasing) age, our chances of success with IUI were about 12pc. Ouch. We were advised to skip straight to IVF, where rates of success were closer to 25pc.

A few months later, we agreed we would try two rounds of IVF and then call it a day. I didn’t find the drugs that challenging. I didn’t turn into a crazy lady. I was tired and sensitive to touch. I had some headaches and nausea, but nothing I couldn’t handle.

The hardest part was the seemingly endless internal ultrasound scans. For about two weeks, I was in and out of the clinic most days for a scan and bloods. I had bruises in the crook of each elbow from blood draws. I have never met kinder midwives and nurses, but they couldn’t do anything about the probing ‘dildo style’ ultrasound.

Our egg retrieval resulted in 17 eggs, of which six fertilised. Embryo watch began.

Each day, the lab called me with a report. Each day, we lost one or two embryos as they stopped growing. They simply stopped growing. By day five we had one embryo, which seemed to have stalled too. We decided to wait one more day. Day six brought the worst news. None of our embryos were viable. We had nothing to transfer back to my body. There would be no pregnancy and no babies. We were heartbroken, again.

I decided to give myself a week to grieve and then begin to prepare for our final round of treatment. That single week of scheduled grieving didn’t go as planned. I learned that I had to simply sit with the sadness, without trying to fix it or hide it. I couldn’t put a deadline on that. In time, I felt lighter and ready to try again.

We discussed our options with the clinic. Three seemed to be an acceptable number of times to try. Our consultant mentioned that some women simply don’t respond well to IVF. We prayed this wasn’t me.

A new drug protocol was proposed, with gentler stimulation. I decided to spend three months preparing body and mind, with weekly acupuncture, meditation and a diet that would optimise my fertility. For three months I ate only nourishing foods. I gave up my beloved mountain biking to reduce adrenaline in my system. I built a fertility boosting yoga practice into every day. I went for long walks, had daily naps and plenty of sleep.

I did all the things.

When the time came to pick up the enormous bag of drugs from the pharmacy, I was ready. I welcomed every scan, every blood draw, every bruise on my belly from self-administered injections. Third time would be the charm.

Our egg retrieval harvested three eggs. Clinic staff were disappointed and warned that these were very low numbers. I was quietly delighted, it was precisely what I had been visualising. More is not always better. Embryo watch began again. I promised my bruised and swollen body that this was the last time I’d ask so much of it. I promised my womb, no more. Three days later, we transferred two beautiful, high-grade embryos back into my body. Fourteen days later, on Christmas Eve, I got my first ever, positive pregnancy result.

We were elated and shocked and delighted and stunned… and not the least bit surprised.

The treatment had worked. We would be parents, the best parents ever. Within days we had picked names and measured up the spare room for nursery furniture. ‘What if we had twins? We’d need two cots!’ The thought of twins no longer scared the bejaysus out of me. My Mum told me she had been minding a cot for us, just in case. If I could get through five years of fertility tests and treatment, I could parent twins too!

We celebrated the nausea and the fatigue. We knew there was a chance this might not last, but we consciously chose to enjoy every moment in those early weeks. We celebrated Christmas and New Year knowing we’d never have another quiet, lazy Christmas again.

At seven-and-a-half weeks, the day before our early pregnancy scan, I began to spot. I knew this was quite normal. That night I did not sleep as excruciating cramps wracked my body. The cramps were not normal. We rang a dear GP friend who, in a serious voice, told us to stay in bed. There was nothing to be done. The scan would tell all. So we waited, as I sweated and groaned.

Our early pregnancy scan confirmed that I was in the process of miscarrying.

What is it with that word? Miscarry. It sounds like I messed up, doesn’t it? That I carried those babies incorrectly, somehow. ‘Losing a baby’ feels the same; I didn’t lose anything. Maybe they

lost me? For two weeks I bled and cramped and cried. By some small grace, I didn’t need any further intervention. I was saved from more needles, more scans, more procedures.

One in four pregnancies ends in miscarriage, did you know that? Even if you haven’t had the conversation, chances are a woman in your group of friends has lost a baby. Why don’t we talk about it? What are we to do with our grief? How do we navigate a path like this in silence? I know that I could barely string a sentence together for the first two weeks, apart from long rambling late night conversations with my husband. He handled the phone calls, he delivered the news as I sat beside him in tears.

For those on the outside, miscarriage can seem like a stepping stone. “You can get pregnant, this is great news! You can try again and next time it’ll work!”   For us, miscarriage was different. Our only option for having a family is fertility treatment. Relaxing, letting everything go and trusting in the universe will not result in a pregnancy for us. ‘Trying again’ means thousands of euro, months of preparation, weeks of drugs, scans and needles.

There are options we have declined, tests and procedures we could consider. We are aware of all of the options out there. Where should we draw the line? When is enough enough? Should we sell our car, move into a cheap bedsit, work two jobs each? Maybe… maybe we should make those sacrifices. I know couples who do and their determination astounds me.

The message to “keep going, don’t ever give up!” is the one we always hear. What about that small quiet voice that says “enough, it’s ok to stop”?

There are so many strands in the ‘why’ of deciding against further treatment. In those days and weeks after our loss, we talked late into the night about what we might do next. We asked ourselves and each other if we could go again. We had made the decision, when we first stepped onto this conveyor belt, that we’d try three times and that’s what we had done. Had we done enough? Would we regret our decision in five years, when it would be too late? Knowing I could get pregnant almost made the decision harder. Surely, surely, next time our baby would stick. I felt like a gambler, addicted to the high stakes game we were playing.

While the babies we dreamed of were dangled just out of reach, in my gut I felt that I had done enough. I remembered the whispered promise of ‘no more’ to my womb. In my heart I wanted to keep that promise. I wanted closure… I was so, so tired of waiting and hoping and praying for a life that might never be realised. I was worried about the impact of more treatment on my health.

A review meeting at the fertility clinic a couple of months later brought things into focus for us. We were gently told that there was no medical explanation for our loss. We could open Pandora’s box, but there was no justification for further testing. The only advice was that if we wanted to try again, come back soon. The same drug protocol would most likely be recommended and fingers and toes would be crossed. Maybe it would work next time, or the time after that, or the time after that.

We couldn’t do it. We couldn’t put our marriage and our own wellbeing on the line, for the sliver of hope that treatment might work. We both valued our own health and happiness too much. We chose to say ‘enough’.

Saying no more to IVF is more than saying no to children. It’s saying no to early morning giggles, to sticky hands grabbing my legs as I cook, to conversations about cloth nappies and breastfeeding. Saying no more is saying no to evolving as a parent with the man I love. Saying no more might exclude us from baby showers, naming ceremonies and kiddie birthday parties. Saying no more changes the way other women perceive me; I cannot possibly understand their life. I envy the mess, the learnings, the struggles, the joy, the laughter and the love they have. They envy my clean sofa, beautiful artwork and long lie-ins. Despite our very different lives, I am determined to love and support the ‘Mamas’ in my life and I hope that they can love and support me too.

Four months on and my heart is still broken. The moments of sadness take my breath away and buckle my knees sometimes. I actively choose to take pleasure from the smile of little children and the beautiful innocence in their faces. It’s either that or bitterness and resentment, and those feelings don’t sit well in my body. I believe that is a choice I get to make.

When we began this journey, I naively thought that if it didn’t work out for us, we’d get some counselling and move on. We’d choose new adventures and creative projects. Maybe we’d get a puppy or a kitten. Life would be rewarding and fulfilling in a different way. The truth is, exciting holidays, beautiful furniture and spiritual journeys will never replace the children we dreamed of and almost met. I hate the decision we have made and yet, it is a decision I am certain is the right one.

I think the sadness will always be with me. I believe I have a choice to hold that sadness alongside the joy and love in my life. The learning curve is steep and I am doing my best to figure it out with an open heart. I don’t regret a single moment of the last five years, but I am glad it’s over. I’ve also decided that I cannot continue to offer support to women who are on their own fertility journey. Not just because I’d feel like a fraud (and I think a part of me would) but because it would hurt too much. Showing up every day for women who are trying to get pregnant would deliver daily injuries to my heart and my heart needs healing.

I’ve chosen to share my story because I want to shake off the taboo, the shame around infertility and miscarriage. It doesn’t serve any of us. My hope is that my story offers comfort to those who have been in my shoes. If you haven’t been there, perhaps you’ll consider offering a warm hug to the person in your life who’s struggling. We are up to our ears in advice and cures; what we need is kindness and empathy. Please, instead of telling us about your friend’s success story, simply say “I’m so very sorry. I can’t imagine how it feels for you, it must be so hard.”

* INM has a dedicated section independent.ie/babyloss where parents of all ages can share their stories of miscarriage, stillbirth and neonatal death. The section will serve as a testament to the women and men who share their stories, a memorial for the babies lost and as a resource for other people who have gone through or are going through the experience.

Your stories can be anonymous or on the record and nothing will be published in any format without prior consultation with you. If you would like to be part of this and tell your story, email Yvonne Hogan at yhogan@independent.ie

Ruth’s website and blog remain and the programme can be purchased there as a self-guided experience.

www.myfertilitycompanion.com