This spring I am almost thirty-nine, the cut-off age for success with most infertility treatments. Under thirty, thirty to thirty-four, thirty-nine and under, forty and up — these age categories used to seem so arbitrary, but now the startling difference in success rates between the last two is a measure of how much hope I have left.
My first artificial insemination did not take. I lay on the table, feet in the stirrups, pelvis obligingly tipped to accommodate the catheter, and rested as the sperm cells made their uphill swim. The nurse left with a kitchen egg timer in the pocket of her white coat, its relentless tick-tick — so like a baby’s heartbeat — marking off the twenty minutes until she returned. When the timer went ding! however, my eggs were not done.
Pregnancy without artificial insemination is impossible given my husband’s condition. Five years ago, Samuel was treated for prostate cancer. The radiation destroyed the cancer but rendered him sterile. He banked his sperm beforehand, and this nonrenewable resource is our last chance.
For my second artificial insemination, I ovulate on a Saturday, when the regular hospital staff is off duty, and it falls to a young resident with a smooth baby face to “do me.” I climb onto the examination table in the quiet, windowless room with nothing on the walls but a poster of pale yellow daffodils. To make conversation, I tell him that I will be flying to England in two days.
“Is that so?” he says from his position in front of my crotch. “My fiancée is from Liverpool. You’ll have a nice time.”
Legs spread in the stirrups, speculum shoved up my private parts, I am envious of this Liverpool woman, who must be considerably younger than I, who will soon have this man’s gentle touch, and his presumably endless supply of motile sperm.
I will never be twenty-five again.
“Here you go,” says the young resident, and he shoots Samuel’s specimen — which has been thawed at room temperature for nine minutes, then warmed for seven in a special gizmo — up my cervix. “Good luck to you,” he says as he leaves me to my twenty minutes of quiet time lying flat on my back.
My academic degrees and life experiences mean nothing to the sperm traveling up my womb. The places I have been and the books I have read mean nothing to the egg dropping down from my ovary, an egg I imagine as a dowager in a bustled dress, holding on to the railing as she descends the stair into a ballroom where smooth-skinned women dance on lithe feet.
These are the same smooth-skinned women I see in Harvard Square: The woman with a gold navel ring walking hand in hand with her mohawk-haired boyfriend. The woman in a plaid jumpsuit and penny loafers, carrying a knapsack on her back. The woman stepping out of a red Miata with a high laugh and a toss of her permed hair.
One of these women may be my friend Simone’s egg donor. “She’s twenty-four,” Simone told me, incredulous, describing the anonymous woman whose eggs the clinic will harvest and then, fertilized with Simone’s husband’s sperm, transfer into Simone’s waiting womb. “Twenty-four,” she repeated. And we both laughed at this amazing fact — that in this world there are women who are still twenty-four.
Two days later, I come upon six dazzling white swans at a pond’s edge in London’s Kensington Park. They are the queen’s swans — web-footed, downy necked, and fat. It is late afternoon, and I have been in England for seven hours. For some reason I walk directly into this flock of swans, but the giant birds go on nipping at the short green lawn; occasionally one raises his long neck, opens his sharp beak, and lets loose a brash warning honk.
Ostensibly, I am in England to calm my friend Lauren’s fears; she has come over on a book tour and is terrified of flying. But the trip is also an opportunity — an extravagant, indulgent one, admittedly — to distract myself during this interminable waiting period between insemination and pregnancy test.
As I stand and stare at the waist-high birds, I think how a sperm cell must penetrate my egg follicle, how the cells must divide into two, four, eight as the fertilized egg falls down my fallopian tube, and how that microscopic embryo must implant itself in my uterine lining. This seems like a tall order. I am a little awed to think this elaborate hidden process might be happening within me now as I admire the swans’ perfect plumage and supple necks, an April mist falling on the shoulders of my wool coat. They give off a damp, moldy scent, these otherworldly creatures, and they eat the vegetation with tremendous energy and purpose. I can barely breathe, they are so new to me.
Leaves rustle in the distance. A woman, her long white hair flying in all directions, emerges from the trees chasing a shaggy red dog.
“She won’t hurt you!” she cries to the swans, who suddenly waddle down to the shore, push off, and glide across the water.
“My dog won’t hurt a thing,” the woman says to me, gasping for breath. She is wearing a corduroy coat, and her thin lips are painted a garish red. “But she scared away the swans, poor things.”
“They’re amazing,” I say.
She touches my arm in alarm. “You shouldn’t get too close to them this time of year. The females are all pregnant. The males get especially protective, you know.”
“Really?” They did me no harm; I hope it is a sign. Maybe the swans know, I think, outlandishly hopeful. Maybe they know I am like them.
“You were lucky,” the woman says.
Lucky. Lucky would be to have a human fetus curled inside my belly, floating in a bubble of amniotic fluid.
“Look,” the woman says, pointing to her dog, who is gleefully sniffing the short grass the swans have just vacated. “She just has to smell them.”
“She’s pretty,” I say, for she is, all perky ears and curly tail and burnt red coat. As we stand admiring the woman’s progeny, as it were, a large white dog runs over to the red dog, jumps on her rear, and starts thrusting.
“Get off now!” the woman yells, running over to shoo away this would-be rapist, mad to impregnate a female. “Get going, you!”
She manages to separate the dogs, and they all hurry away into the mist.
Back at the hotel, I tell Lauren about the swans and the woman’s warning. “Swans don’t get pregnant,” Lauren says matter-of-factly. “They lay eggs.”
“Maybe she didn’t mean pregnant exactly,” I say. “Anyway, the egg is fertilized inside the female before she lays it, right?”
But a pregnant swan seems no more far-fetched than what I read in the Times the next day, about a grandmother pregnant with her own grandchild. I am fast losing whatever rational beliefs I once had about procreation.
Spring, whose late arrival this year I have taken personally, is finally here. In my yard, I dig into the dirt, drop in tiny seeds for nasturtium and phlox, and sprinkle them with water. Earthworms wriggle along my trowel. I dig up clumps of hardy day lilies and hold their brown, bulbous roots and hairy tendrils. I stroke my cramping belly.
Everything depends now on what my body will or will not do. Four more days. I visualize white, white underwear with not a spot of red.
Three days. My breasts swell, heavy with water. I dart into the bathroom to pull down my underpants: no blood.
Two days. I grow puffy, my belly cramps. I slip into the bathroom to pull down my underpants: nothing.
Samuel returns from his lab. “Your period come?” he asks, trying to sound casual.
My breasts smart sharply. I slink into the bathroom to pull down my underpants: still no blood.
I walk around lightheaded and bloated, thinking, Maybe this is what’s it’s like. In the morning, I open the refrigerator and don’t feel like eating. Is that the faintest tinge of nausea in the pit of my stomach? I go outside to look at my marigolds, and the sun warms my shoulders and back. Whatever happens will happen, I tell myself, but I think, Fecund, filled, abundant. I think, Gravid, heavy, rich.
I go to the bathroom to pee. A warm breeze blows in through the open window, bringing with it the lilacs’ sweet perfume — they are at their peak now, the cascades of pale purple blossoms drooping under their own weight. I pull down my pants and sit down on the toilet, and there it is, a spot of bright red.
Nothing I can do, nothing I can do.
I feel my breath deepen and my muscles relax.
So this is the way it’s going to be.
In a little while I’ll call the clinic to make one last set of appointments — three insemination cycles is all our semen supply allows — but for now I stay slumped on the toilet, my jeans twisted down around my knees, the morning sunlight slanting off jars and tubes of cosmetics.
I enter this third and final cycle with considerably diminished expectations. Hope has become painful. But the good news is I’m more aware of my body. My legs pump the bicycle pedals; my arms reach for weeds in my garden; my breath comes deep; my heart beats steady. Samuel strokes my breast and my nipples harden. My hair grows longer. My skin tans. Food is delicious. I appreciate these pleasures more keenly for the anxiety and disappointment they must assuage.
Time weighs heavily on me. There is the thirty seconds it takes to wash down a Clomid pill with a glass of water, and then there is the rest of the day. My next ultrasound appointment, to measure ovulation, seems eons away. And the more time passes, the more infertile I feel. I begin to wish for a fertility ritual, something irrational and unproved to lessen my plight. The rituals I already have are mere routines, really: on the trip to the hospital, I always stop at the same corner store for a muffin to eat in the car; in the hospital lobby, I always buy a newspaper; I always take a particular elevator.
When I was a child, my family lived for a time in a small village in western Nigeria, where my father taught math at a high school he’d helped to found. On weekends, he and my mother were forever loading my sister and me into the back seat of our white Rambler and traveling miles and miles of Yoruba bush roads to search out some new sight. Once, we visited a fertility shrine. We walked over the lush green grounds down to a rushing river and then up a narrow path to a mud-walled courtyard. There, we saw three women, their eyes gazing inward, a grave sadness on their faces. One woman fell prostrate to the earth while the other two wept and wailed and beat the heavy air with their arms. I felt I was witnessing something utterly private and extremely fierce.
Recently, my parents gave me a Yoruba fertility statue, a kneeling woman with an infant attached to her back. Her head is covered with ornate braids, and on her lap she holds a bird with a fan-shaped tail. The bird lifts off to reveal a round, receptive bowl. On the woman’s enormous, jutting breasts rests a medallion.
“She has such a presence,” says my friend Nadine. “You’ll get pregnant with her around.”
It is a presence that stirs something in me for which I have no name. She is not beautiful; the expression on her face is wise, sad, and mysterious. Do I imagine it, or does the energy in the house subtly shift so that all currents flow toward this strong woman?
I look up African fertility rituals and read that, in one tribe, butter, for its wetness and contribution to fatness, is linked to semen; that, in another tribe, women who want to conceive keep sacred clay pots hidden in the bush. I learn that blacksmithing, for its ability to forge new forms out of melted iron, is associated with fertility; that deceased ancestors have the power to “close the womb” of a female descendant or make a man impotent. I do not read about the beliefs of Lagos professors or Ibadan lawyers, people who are more like me. Mostly I read about agrarian communities, people who raise cattle, grow crops, and live in grass huts. Their idea of fertility is not merely the wish for children, but a generalized desire for crops to flourish, cattle to multiply, food to be plentiful. Fertility is a man with many wives and a fat stomach. Fertility is a woman with fire to light her cooking pots. Fertility is a party with plenty of palm wine.
By these standards, I am fertile indeed: My refrigerator is full, my oven is lit, and my wine rack is well stocked. In the West, I’m considered affluent, but in African society, where children are regarded as wealth, I would be considered poor indeed.
At seven o’clock on a Sunday morning, I roll out of bed and drive the forty-five minutes to the hospital to have my egg follicles measured by ultrasound. The ultrasound technician swaggers in a half-hour later: thin, blond, arms lined with ropy veins, bluejeans tucked into work boots. I have never seen her before. Her demeanor indicates that I have interrupted her Sunday morning.
I undress and lie back, feet in the stirrups, as she smears the condom-covered probe with lubricant. In my previous soundings, a kind of etiquette has been observed: I inserted the phallic probe, and the technician then cruised my insides looking for eggs. But this woman shoves it up so roughly I gasp. Then she proceeds to bump my vaginal walls and click on the keyboard attached to the monitor as if I were a video game she must beat. When it’s over, I stagger off the examination table, and she hands me a towel. “Here,” she says. “Go wipe yourself off.”
I go into the bathroom and wipe, but there is really no mess. I want to cry. During this final cycle of inseminations, my confidence has dropped considerably. I feel weak, weary, worn out. I carry the ultrasound results upstairs to the nurse on duty. Alas, my egg follicle is a full centimeter short of the two-centimeter width the clinic insists upon before attempting insemination. We will postpone the procedure one more day, to give the follicle more time to grow. Tomorrow, say the instruments, I will be more fertile.
The next day, I take my place in the stirrups like an old cowhand. I lie on my back and thumb through magazines, filling my mind with fashion tips and celebrity gossip — the more banal the better. This is no sacred moment. If a new life is to begin inside me, I think, it will have to happen the way the poet W. H. Auden understood suffering to take place: “While someone else is eating or opening a window or just walking dully along.”
Yes, someone has turned on a radio down the hall. Its tinny tune reaches me through the thin walls as I thumb the glossy pages, not daring to hope.
What about the Old Testament?” Samuel says when I tell him about my search for a ritual. “The Bible is full of difficult conceptions and pregnancies, miraculous births: Hannah, Rika, Sarah.”
“How can I read anything?” I say. “I can barely get it together to make dinner. I cried all afternoon. I’m starting to lose it.”
Samuel has heard this from me before. He, too, is weary — weary of my tears, weary of hope being replaced by disappointment.
Before Samuel became a computer scientist, he studied the Talmud and read Jewish mystical texts. “In the Kabbalah,” he says, “the smoke from the animal sacrifice is believed to rise up and tickle God’s nose, causing him to ejaculate over the earth; his semen comes down as rain to fertilize the land.”
“Really?” I ask, surprised.
“Well, yes, in the Kabbalah. If you want our history, though, check out the Bible.”
A couple of days later, in the Old Testament, I find my private struggle writ large: fertility and conception as crucial to the survival of the species and the clan. In the story of Jacob, whose twelve sons became the ancestors of the twelve tribes of Israel, I read about the unending rivalry between the sisters Leah and Rachel: Leah births seven children with ease, seven times shaming childless Rachel, Jacob’s second and most beloved wife. Rachel, of course, suffers great pain while she is barren. When she finally does give birth, she proclaims, “God has taken away my shame.”
I recognize that shame.
One week passes.
The grass grows faster than we can mow it. Orange day lilies break into glorious blossom. Fat bees fly into and out of the house. We eat fresh green salads, thick-crusted bread, a slippery bass fresh from the sea.
The second week passes.
My period arrives.
So this is the way it’s going to be.
Three times, we’ve struck out. We can no longer afford to use our dwindling semen supply on artificial inseminations, but must move on quickly to in vitro fertilization, where sperm and egg are united in a petri dish, then placed in the woman’s body. This procedure will allow us many more chances. We will go to yet another clinic. I feel numb with dread yet doggedly hopeful. It is the end of May. In July, I will turn thirty-nine.
On Sunday evening, PBS airs a show called The Nature of Sex. I pry Samuel away from his computer screen, and together we watch the intricate mating dances of damsel flies, who scratch tiny holes in leaves to lay eggs; Australian bats, who mate while hanging upside down from trees; and bay whales, who travel thousands of miles to mate once a year at a specific breeding ground. The female seahorse drops her eggs into his pouch, and the male carries the eggs for fifty days before “giving birth” underwater. Porcupines have only twelve hours in which to mate. We are fascinated by these facts, and in particular by this one: that fertilization first took place outside the body. In the sea, where life began, water mixed sperm and egg. Only when creatures left the water did they have to touch to reproduce.
This essay is adapted from Karen Propp’s forthcoming book The Pregnancy Project (Duquesne University Press , 600 Forbes Ave., Pittsburgh, PA 15282), which will be published next spring.