Bruising, IVF, and Being 'Over Sensitive'

One of my favourite authors, Barbara Trapido, has a wonderfully on-point description of the way women are encouraged to feel about medical appointments. ‘One always apologized for calling out one’s GP to a fever, making the assumption that what one’s doctor both liked and deserved was patients who didn’t get sick’. This sentence went round in my head, as I cut toast into soldiers for my daughter to dip in her boiled eggs for breakfast.

Over the last few weeks I’ve been doing IVF. It’s my second cycle since last winter, and this time, the doctor was upbeat. She took care to tell me how much better things looked than last time. One of the things I hate about egg collection is the sedation. Apparently, for some people, it’s like being a bit sleepy, but it knocks me out; I don’t remember things very well. So I find it difficult to retain information afterwards, and at my clinic, the procedure seems to be to tell patients how things went while they’re still coming round. They did this last time, and for ages I kept having to ask for the results to be repeated: I just couldn’t keep them in mind. That time, they told me they’d collected 8 mature eggs. This time, they said the number was 6. My friend, who drove me to the clinic (you can’t drive for 24 hours after sedation) remembers that I asked the nurse whether or not these were mature eggs, and the nurse didn’t know. Neither of us knows whether I asked the embryologist when he spoke to me, because I can’t remember, and she wasn’t brought into the room with me. I assumed, based on the way the clinic reported the numbers the previous time, that they meant 6 mature eggs. This matters, because if you have a very small number of fertilised eggs, you have a very short window of time - the remainder of the day, before they ring the next morning - to decide whether to continue to genetic testing, or whether to do an untested transfer (as many people will, if the numbers are low). 6 eggs. I repeated it and repeated it, trying to fix it in my shaky memory.

This morning, the clinic rang, as expected, to say how many fertilised. ‘Oh, actually, there weren’t six, only three,’ the nurse said. ‘Two weren’t mature, and one was an empty shell. Now, do you still want to do genetic testing?’

One of the things I’ve found hardest about doing IVF is the assumption that, if you feel sad or bruised by the process, you’ve somehow failed or let the side down. (I will admit, for me, some of this has to do with things beyond the control of the clinic, and which I’m not going to post about right now.) IVF can absolutely flatten you - it’s physically quite hard; I lost three stone in three months and afterwards, I bled so heavily I got dizzy when I lifted my hands over my head. But the physical side felt easier, for me, than the relentless pressure to be emotionally impervious, no matter what gets thrown at you.

Last time I did IVF, in December of 2024, I got four good embryos, and I was so excited. And then the clinic rang to say they’d tested them, and none was viable.

I got this news while I was at work, and I was, frankly, knocked over by it. I knew, statistically, that at my age about 50% of eggs are not viable, but I had hoped that, with four blastocysts, we had a decent chance. (I did not know, at this point, that paternal age over 55 has quite a big effect, and there was a lot going on to make the whole situation more emotional than it might otherwise have been.) The next day was Saturday, but I woke up to an email - sent before 9am; clearly urgent - asking me to sign the form to destroy these unviable embryos. I signed, but quickly got a follow-up email chivvying me: the clinic needed signatures from both of us, and it was extremely urgent: ‘you will be expected to pay for the storage months you have used at £30 per month, so we encourage him to complete the consent at his earliest convenience’.

I found this upsetting, and I found it more upsetting that, even though I’d responded to a request to sign a consent form, the email began ‘Thank you for informing the clinic you wish to remove your embryos from storage. Unfortunately, we cannot carry out your request until [he] completes his form’.

At the time, I was still reeling, and trying to understand the accuracy rates of PGT-A testing, and I wasn’t at all sure I did want to remove the embryos from storage - but we hadn’t been given a choice. I felt oddly hurt by the framing of this as my ‘wish,’ and by that word ‘unfortunately’. After some thought, I wrote back. Because I research infertility, I was well aware there’s an ongoing debate around language use. But, of course, that voice in my head was there.

What one’s doctor both likes and deserves …

Very diffidently, I wrote that I hoped it didn’t seem silly, but I wondered if the clinic might consider changing their language a little. And I made sure to thank them for their care.

Oh, came the response. ‘It was an email template we use. I appreciate your feedback.’ There was a sort of non-apology (‘I apologise if my email upset you …’) and then, cheerily, ‘Have a lovely Christmas!’

I really thought that last bit would have stopped stinging, eight months on, but you know what - it hasn’t.

In her thoughtful and important book about pregnancy loss, psychotherapist Julia Bueno discusses the disposal of embryos during IVF, commenting on a conversation she had with a representative from the Human Fertilisation and Embryology Authority (the body that governs decisions around this subject in the UK). She was researching patients’ emotions. The man she spoke to laughed at the idea.

I posted recently about the way we judge and guilt-trip women for having emotions ‘too early’ in the progress towards having a baby. When I did IVF last December, I felt as if it was important to paper over the hurt I felt at it not working, to prove that I was ‘good enough,’ unemotional enough, to be a mother. Not that unemotional is quite the right word: there’s a whole industry that relies on telling women they need to cultivate a correctly positive mental attitude if they want to get pregnant.

What one’s doctor both likes and deserves …

As a society, we are invested in the myth that women today are over-sensitive - and this extends to all aspects of obstetric and gynaecological medicine. I have friends with children and friends who have no children, and it is the one constant: come to a doctor with ‘woman’s problems,’ and you are rolling the dice in the hope that this time - for once - you won’t be dismissed as ‘emotional’ or ‘sensitive’ or fobbed off with a reprimand: other women don’t feel like this, it’s just you!

It isn’t just us, though, is it?

***

Two things to note. Firstly - and I really do mean this - my clinic is in many ways good, sometimes excellent. It’s not that clinics, or medics working in them, don’t care. But there’s a culture of treating women as if we ought to feel very lucky for what we get, and we ought to put up with careless treatment from busy, important medics, and I really do struggle with this. Secondly: the thing that really lifted my spirits this morning was a reminder of how wonderfully collegial and supportive researchers in this subject can be. It wasn’t a big deal - just a few thoughtful, helpful comments - but it made me aware of how much this community matters.