Taking a seat before me, her husband gives her hand a quick squeeze of solidarity as she struggles to gain composure. In silence she pulls some papers from her bag and places them in front of me, a brief glance shows me a list of names; Courtney Cox Arquette, Madonna, Nicole Kidman, J K Rowling, Halle Berry and several more.
“It doesn’t seem fair,” she says, anger touching her voice as it breaks, “these women have everything.….” Her husband takes over the story at this point. She is visibly shaking and this consultation is clearly costing her dearly in both emotional strength and in the speaking out-loud of how her dreams of the future are yet to be realised.
I hear about the chapters of her life. This lady believes she has failed. She is a very successful business woman, having worked her way there by none other than hard work. Financially independent, driven by success and career-wise beyond where she hoped she would be. The dream house purchased and renovated, the world well-travelled. She tells of her good fortune in marrying her college sweetheart. Then she speaks again of these celebrity women. The women who in her eyes have it all. And despite her myriad of success and achievements she believes she has nothing.
The one thing all these women have which she doesn’t is children. This was meant to be her next chapter, her happy ever after.
When I was at medical school we learnt about sub-fertility and the possible ovulatory disorders, tubal disease, uterine pathology and male factors which could be responsible. We learnt of the investigations into ovarian reserve and semen motility. What we never touched on was the future, why would we, and how could we have known what was round the corner. Only now this future is today, the modern day. The age of delayed fertility, the age when women want babies in the absence of a male partner and same sex couples are looking towards parenthood.
At the age of 43 years this lady is not alone in thinking all good things will come to those who wait. Fecundity doesn’t wait. Year on year it goes down. At the age of 43 the chance of natural conception each month is around 1%. The chance of IVF being successful 5%. The statistics are frightening when you look into them. What is perhaps more frightening is that these are not as well publicised as the news of Halle Berry expecting her second child at 46 years old.
“What happens now?” asks my patient. She’s handing over. Her months of agonising waits for that life changing blue line are over. She feels she has done all she can and is handing over to me to make this right.
Sometimes this letting go is enough.
If only we could turn back the clock for these patients. Edit the chapters of their life so instead of living in the future their “forever is composed of nows”.