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A guide for relatives, friends and acquaintances who wish to remain relatives, friends and acquaintances:
1. Just relax and it'll happen
2. It (the miscarriage) was meant to be
3. Have you tried having lots of sex?
4. You're trying too hard
5. You just have to try harder
6. Forget about it and it'll happen
7. You've left it too late
8. Don't panic
9. I told you that you should have started earlier
10. I can't imagine what it's like but then I fell pregnant first go with all four of my children
Further explanations that may be necessary for R, F and A's that still don't get it.
To make a point let's substitute the struggle to conceive with the struggle to pay off a steep mortgage, with a few alterations to the above comments.
1. Just relax and it'll happen
2. It (the large mortgage) was meant to be
3. Have you tried earning lots of money?
4. You're trying too hard to pay it
5. You just have to work harder
6. Forget about it and so will the bank
7. You've left it too late - you'll never be debt-free
8. Don't panic even if your house is repossessed
9. I told you you should have bought a house earlier
10. I can't imagine what it's like but then I own four houses and have mortgages on none of them
What are the myths and what are the truths surrounding pregnancy loss?
Miscarriage Myths:
1. It is the woman's fault. New research suggests that it is not just the egg but the sperm that can be defective. For instance, older fathers means older sperm (although nobody told Rupert Murdoch or Rod Stewart) and it can contribute to defective zygotes, a common cause of miscarriage. Similarly men who smoke, take drugs or drink heavily can contribute to miscarriage although this is perhaps compensated for by also having sex a lot and therefore still producing quantities of children equal to or higher than the general population.
2. Long car trips cause miscarriage. This was vehemently told to me by my mother-in-law who was pregnant in the early sixties and this was information being sternly imparted by doctors at the time whilst they were writing thalidomide scripts. If there was any truth to it back then, it may have been to do with the way they made cars then but roads and suspension have come a long way.
3. Lying down can stop miscarriage. I have been vertical, horizontal and on the incline throughout my three miscarriages, but mostly horizontal and I can vouch for the fact that it makes no difference. Once a miscarriage has started there is little you can do but wait and see, as difficult as this is. Obviously if there is just some slight bleeding it is advisable not to persist with concreting the pool or chopping firewood but remaining flat and still achieves nothing but boredom at the least and mental disturbance at the worst.
4. You should just go ‘it was for the best' and get over it. No, everyone has a different response to the loss of a pregnancy. Go with what feels right - if you want to stay in bed for a week, do. It's the only way to heal.
5. If you have one miscarriage you'll have more. The vast majority of women have one miscarriage and then have normal pregnancy/s. I wasn't one of them but you need to keep the faith and keep trying, it's part of the healing process.
Miscarriage Truths:
1. Despite being experienced by hundreds of millions of women worldwide it is one of the least talked about issues, which is why I've discussed it openly in my book In Vitro Fertility Goddess »
2. You cannot stop a miscarriage from happening, nor can any medical practitioner.
3. You are more likely to suffer a miscarriage over the age of 35. The rates are - Over 35 - 25%, Over 40 - 33%, over 45 - at least 50% of pregnancies ending in miscarriage.
4. If you have 3 in a row it is termed ‘Recurrent Miscarriage' and doctors will order tests to see if there is an underlying medical reason as I had.
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Just when you think the odds are against you, think again. This true story is a triumph over everything that shouldn't have happened and did, an extraordinary beating of the odds. It's along the lines of a person cutting off their own head, eating it and surviving - just as strange, but in this case true.
Right. Take a seat while I try and work out where to begin. Pour yourself a drink if you're in between IVF cycles. OK, here goes.
A 57 year old woman, Susan Tollefsen from Romford, East London walks into an IVF clinic in Russia, hoping to have a child with her 46 year old partner. At this point her odds of achieving a pregnancy with IVF are zero with her own eggs, and, using the rates of success in Britain at private clinics treating women over 50, roughly twenty five percent with donor eggs.
She has already tried a few other ‘foreign' clinics over several years without success. She undergoes treatment and has 2 embryos implanted.
The first miracle occurs - she achieves a pregnancy but less than four weeks after transfer starts bleeding and miscarries. The odds of miscarrying at 45 or over are greater than fifty four percent.
Her GP confirms the miscarriage as does a negative home pregnancy test. (HPTs are 99% accurate in the lab but do have a higher rate of false negatives than positives).
Susan reluctantly relinquishes her dream.
Fast forward to twenty-four weeks later when she has been suffering from a swollen abdomen and presents at hospital with what her GP cited as a ‘hard abdominal mass'.
The fear is that she has ovarian cancer - the odds being high for a 57 year old with a swollen abdomen who has never been pregnant. It is the fourth leading cause of cancer death in women of this age.
She is fully expecting the sonographer to relay some grave news but instead he says, "Congratulations. You are pregnant." Thirty weeks pregnant to be exact and the baby is healthy.
Susan has now given birth to her first baby, a girl she has named ‘Freya'.
And if that's not a miracle, I'm not sure what is.
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Anger and infertility go together like a horse and carriage, love and marriage, like bad hair and Donald Trump. Don't let anyone tell you otherwise. Whilst there may be serene and blissful pregnancies the battle to conceive is anything but.
I don't think I was ever so cranky as when I was trying unsuccessfully to have a baby, culminating in the IVF process. And giving IVF drugs to an already emotionally fraught woman is like waving a red flag at a mallee bull.
For the first time in his life my two metre tall husband was actually scared of me. I'm not sure what he thought I was capable of but he didn't want to find out. Which is why, when we were halfway up the mountain on our weekend away and I yelled that we had to turn back as I'd forgotten my basal thermometer, he did. Without arguing. Just went a little pale before putting the indicator on and doing a swift U-turn.
In a past life, BTTC (before trying to conceive), it would have been out of the question but this was now, I was mad and he was nervous.
Not that I ever shared what was going on in my head or anything. No, I kept the homicidal thoughts towards pregnant women, people who blew smoke in their children's faces and power walking pram groups to myself. Nor did I share any of the ideas I had about what should happen to people who abused their kids, Courtney Love, Jordan and other abysmal celebrity mothers.
Then there was the small stuff - the ‘you left the light on', ‘you forgot to buy parmesan cheese' and so forth. It was quite fortunate by the time it came to IVF and no sex was required because there couldn't have been any with my moods, unless it was of the make-up variety. But you better get in quick, I just spotted a mould spot on the ceiling and it's making me furious.
Seriously though, why do we get so angry? And why do we get so down on ourselves for being that way? The answer to the second question probably lies with the fact that there is still some expectation, stemming from last century that women aren't supposed to get really angry. Bulldust!
All those 1950's magazines with the perennially happy homemakers, grinning whilst they ironed, beaming while they vacuumed, twinkling as they fetched their husband's scotch and slippers set some pretty warped notions of how we should be. Had there been IVF then, no doubt the woman would have been pictured there in backless gown and matching paper hat sunnily beaming her way through the egg pick-up, or smiling beatifically in wasp waisted dress as she injected herself with Puregon.
As for why we get so angry, well, aside from the sense of injustice that this is happening to us, and the lack of understanding and insensitivity we often experience from others, including loved ones, anger is a part of grief. A healthy part.
The grieving process comprises four parts - denial, anger, sadness and acceptance and when we suffering infertility which is something we struggle to deal with we will experience these emotions before we can either resolve or learn to accept the situation. Anger has as much of a role as sadness though different people experience each in different measures.
In accepting that anger is OK you can start to tame the beast, not feel so out of control with it. This doesn't means trying to suppress it - it will reveal its ugly head again later anyway, usually when you're at an important work party with your husband.
There are things you can do to take the edge off it - yoga, various forms of exercise, boxing, counselling, just putting headphones on and going off for a walk.
And if it's your partner that bears the brunt of it, talk. Tell him that this is how you are right now and it's not about him. It's about the situation. 
Unfortunately for him you can't shout at your ovaries or your IVF doctor.
The other thing to know is that it will pass, either when you fall pregnant or when you have worked through the process and reached a new place to be in.
Unlike Donald Trump who is stuck with his hair forever, you won't be stuck with the anger.
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Wednesday 5 March, 2009
Pictures of the frail Suleman octuplets, born nine weeks early and only as heavy as 1½ pounds, have been beamed into lounge rooms around the world. The newborns who came from six embryos, two of which split into twins, have sparked a heated debate as to whether the US should follow the cue from lead of Sweden and Belgium and replicate their laws that limit the number of embryos that can be transferred during IVF.
Lawmakers in two states have already introduced bills to limit embryo transfers: Missouri will demand that fertility clinics follow American Society for Reproductive Medicine or ASRM guidelines which allow for one or two embryos in patients under 35 and up to five in women 40 and over. Georgia has upped the ante by limiting women under 40 to two embryos and those +40 to three.
Pictures of the frail Suleman octuplets, born nine weeks early at weights as low as 1½ pounds, have been beamed into lounge rooms around the world. The newborns who came from six embryos, two of which split into twins, have sparked a heated debate as to whether the US should follow the cue from lead of Sweden and Belgium and replicate their laws that limit the number of embryos that can be transferred during IVF.
Lawmakers in two states have already introduced bills to limit embryo transfers: Missouri will demand that fertility clinics follow American Society for Reproductive Medicine or ASRM guidelines which allow for one or two embryos in patients under 35 and up to five in women 40 and over. Georgia has upped the ante by limiting women under 40 to two embryos and those +40 to three.
But a growing number of women who have concerns about multiple births are opting for a relatively new approach called elective single-embryo transfer or eSET.
While 10 years ago, transferring a single embryo would have been deemed inappropriate given the slim success rates, progress made since then have significantly improved the chances of younger women achieving a successful pregnancy with only a single embryo transferred. The journal Fertility and Sterility recently reported that eSET patients had the same pregnancy rate (65%) as those who transferred two embryos. But the big difference was that while only 1% of eSET patients had twins compared with 44% of the women who had received two embryos.
But the incentives faced by American patients to transfer more than the recommended number of embryos are too great to be ignored because large numbers of IVFers lack appropriate insurance for a procedure that costs about $12,500 a cycle. Many view twins as "two for the price of one" or see multiple transfers as increasing their chances of conceiving at least one healthy baby. And for fertility doctors, there's the incentive to boost transfer numbers in a bid to increase their success rates and their clinic's appeal to future clients.
Barbara Collura, the executive director of the infertility group Resolve, believes there is necessity to encourage women to take out insurance first because restricting embryo transfers without first addressing the insurance issue "is going to create more trauma and more problems. When you get to the point where this is covered by insurance, you have a completely different attitude, you're not as desperate."
Sean Tipton from the ASRM says that in Connecticut, health plans that cover maternity care must pay for IVF, but they can limit the number of embryos transferred to two. Governments can also intervene directly as is the case in the Netherlands where while there is no strict legislation on the number of embryos transferred, the government says that the transfer of more than two embryos shouldn't be reimbursed by national healthcare. And that's a strong disincentive.
Resolve urges women to consider their health and their baby's health when contemplating the transfer of more embryos than recommended by the ASRM.
But that is easier said than done as it's often hard to deal with them in a rational way when they're in perhaps the biggest crisis of their life.
And at the end of the day, while some fertility clinics support eSET, it's not always the case because fertility doctors only have to deal with patients up to the time they become pregnant, that's it. After that, they are out of their hands and they don't have to deal with the consequences of multiple births.
Sarah Williams