Women, fertility and blame culture…

Before I get on to the what happened next bit, I feel like I need to talk about this stuff. And when I say “stuff” I guess I broadly mean about the fertility industry and how it treats women. Arguably, I’ve had more interaction with this industry than most. I’ve heard it referred to as the Wild West, I’ve heard people say that it exploits women, that it uses experimental practices that aren’t proven as cynical money-making ventures, but I’ve honestly never felt I had that experience. You might think that having spent the best part of £100,000 – honestly, I don’t know, I’m guessing, I stopped counting mentally after I figured I’d reached about £50k – trying to have a baby, that I’d feel bitter. But until now, I never felt bitter, I never felt exploited, I never felt like a cash cow. I’ve defended – largely – the industry. For all that I’ve complained in the past that some people working in it seem to forget that their day job is the most important thing in someone else’s life, on the whole, I’ve never felt that decisions that weren’t in my best interest were being made.

That’s not the case any more. The clinic I’m with offers a package price. That price includes all scans and all blood tests. If I were being really cynical, I might suggest that if you can get away with doing fewer scans and fewer blood tests in a fixed price cycle, that means more profit on that cycle. I don’t know. I can’t tell you if what happened was intentional, careless, lazy, penny-pinching or whatever. But the upshot was the same. And it’s only because I’d been there before that I knew that what I was being told wasn’t right. And that’s one of the things that really bothers me.

Because say this were my first rodeo. Say I knew nothing about ovulation and oestrogen and dosages and all that. I’d have gone for a scan on day 18 and I would have been told that I’d ovulated and that as a result we couldn’t do a transfer that cycle. And I would have been made to feel that that was my body’s fault. Remember, I’d already been told that if I ovulated during that cycle it would be an “atypical cycle” Nobody would have told me that actually if they’d done blood tests they’d have known that my oestrogen levels weren’t as high as they needed them to be. Or that my LH levels were indicating that I was about to ovulate. I’d have been made to feel that my body had failed me.

And this matters, this really matters. Elizabeth Day has written and talked about this. About how the language around fertility is all about women being at fault. “Non-responders”, “inhospitable wombs”, “failed cycle” – it’s a burden that is placed on the recipient of the treatment, never on the treatment itself. It’s never “we didn’t give your body the right drugs for it”, always “your body didn’t respond the right way to the drugs we gave it.” Because at a really stressful point in your life, what you really need is to be made to feel that you could have done something different or better.

But it’s not just about the language that we use, or about victim blaming, it’s also about something else that’s just as important. There is a history of women not being listened to when it comes to their bodies and medicine. Caroline Criado-Perez has talked and written about this. Women’s concerns are routinely (& more so than men’s) dismissed when they report pain, or symptoms, or express concern about any aspect of their treatment. When women advocate for themselves in a medical context, they are very often not listened to.

I advocated for myself but I was made to feel as if I was being silly, neurotic, hysterical. Despite the fact that I knew my body. Despite the fact that I was drawing on information from doctors I’d worked with in the past who I’d trusted. Even when my ovulation stick showed I was ovulating, I questioned myself. And I continued to question myself right up until I had my consultant on the phone confirming that, as I had feared / suspected, the blood test and the scan showed that I was right, I was ovulating.

But even then, when she was telling me this, I was made to feel like my body was at fault. “Your oestrogen levels weren’t as high as they should be,” she told me. Not “we failed to do the necessary blood tests to ensure that we could see you were metabolising the oestrogen as we thought you would. And if we had done those tests, we would have known and could have adjusted your dosage accordingly.”

Coulda, shoulda, woulda. Through some combination of what I’m going to call their cock-ups and my experience / control freakery / attention to detail, we knew that I was ovulating and so we had a decision to make. Cancel the cycle and wait around six weeks until we could do another, or hit and hope…


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