How Mother Nature will often trump science when it comes to fertility
Fertility can be unpredictable. My mother married at 23, had a miscarriage at 25, a baby at 26, two more babies subsequently, and then (without recourse to contraception), 10 years of what she called "normal married life" without a pregnancy.
Then, in her 40s, she surprisingly - and to her great annoyance - conceived again. That was me. My father was 67 and delighted. Ma could never figure out why she could go a decade without a pregnancy, and then it happens.
The boffins are aiming to make fertility an exact science, so that those who do not want babies shall not have them, and those who do want babies shall have them. The focus has now switched from contraception to fertility. And the immense degree of human hope and striving that goes into achieving fertility is powerfully illuminated in a new play about a couple's struggles with IVF, The Quiet House, by Gareth Farr (currently playing to packed houses at London's Park Theatre).
Gareth Farr has drawn directly on his own experience in telling the story of Dylan and Jess, both 34, who are undergoing in vitro fertilisation (IVF), in an increasingly strained effort to have a baby. The emotions and the stress are acted out convincingly: belief, despair, conflict, pain, loss, and yes, drama.
A clock ticks on stage, as well as internally, as the couple wait two minutes to see if the egg (or eggs) have been fertilised and the pregnancy test is positive. This is true drama. When it registers 'no pregnancy', it is a terrible moment, and the couple's attempt at cheerfulness turns to a howling rage.
As many who have undergone IVF attest, it's no fun having sex to order, at exactly the right moment when fertility is due. And, as Dylan bursts out in anger and frustration at one point, he sees himself as little more than, literally, 'a w*****'. "I have no part in this," he shouts, utterly exhausted with the whole process. "I w***. That's what I do. That's how you described my part in all this." Dylan is slightly less committed - "We have one another" - and wants to keep everything private. He's also under pressure at work and has to juggle with travel commitments.
Dylan needs his wife's constant reassurance, especially when he calls himself "a Jaffa - seedless". They love and hug and fight and shout at each other: he administers her painful stomach injections that should boost her egg potential.
There's a neighbour with a baby, and the sight of the infant in her mother's arms is as painful to Jess as any number of needles into her stomach. There are five embryos in the lab, awaiting re-implantation in Jess's womb. Then there are three, as two perish, or "become unviable", as the jargon puts it. When alone, Jess talks to the embryo (an embryo is a conceptus up to eight weeks). "I know you. You. Your personality and I know your sense of humour. I do. I know your love … I know your love and I will know your face. I will know your voice."
When the embryos perish, the preciousness of a pregnancy so ardently wanted is overpowering. They're in grief. Jess's desire for a baby is eloquently, even desperately expressed. "I want a baby … I want one more than you could possibly ever imagine. More than I thought I could ever want anything. So much so that it hurts me. It causes me actual physical pain …"
Do they succeed in achieving a pregnancy? They almost feel they can't face another IVF cycle, and then they try one more time: and we are left in suspension.
In real life, the story turned out happily for Gareth Farr and his wife Gabby Vautier, when they eventually had twin daughters. Like many couples, they'd had "unexplained infertility" - there was no evident reason. They hadn't been prepared for what Gareth, who is 39, has described the embarrassment, the invasion of privacy, the stressful impact on their relationship (and, for many couples, the cost).
In an era when we talk about gender equality and the fluidity of sexual identity, it can be a shock to realise that although conception should be a shared experience, in IVF, the focus is on the woman and her body. It may be claimed that a woman is in charge of her own body, but with IVF, her body becomes a laboratory of both nature and science. All the man has to do is produce the sperm, and after that he can feel redundant and uncertain about what's expected from him.
The Quiet House (too quiet without babies, is the implication) is highly contemporary in its focus, too, on the modern couple, and their expectations. But do this gilded young duo expect too much? They've been accustomed to the idea that they have "the right to choose", but the brutal truth is that nature does not always award choices, and wanting something very desperately does not always mean getting it.
Medical science can help but not always provide a remedy. A young couple I know of went through three cycles of IVF, to much anguish and no outcome. They gave up the process, and then suddenly, when the woman was 40, a pregnancy occurred naturally and a lovely baby daughter was born. A few years on, and the same woman has unexpectedly had a second baby.
As my Ma discovered, first to her fury, and afterwards to her pleasure, nature can still pop a surprise.