Staring down the barrel of a long and ugly battle against cancer, Dorothy McLean and her partner laid the foundations for a family – with a little help from science.
One Wednesday evening in early summer, I informed my father-in-law that he was about to be a grandad.
“In about 17 days,” I told him. “Before Christmas. Unfortunately, you won’t get to meet them for a while.” Beside him, my partner looked on the verge of tears.
My father-in-law shook his head.
“I’m so sorry. I don’t know what to say. This is terrible news! When they say invasive, do they know how far it has spread?”
***
At some point, all parents must answer the dreaded question. Where did I come from? Sometimes, we make up lies. You grew in the cabbage patch. You were delivered by a stork. Fiction is poetic. The reality is often harsher. Your daddy and I got drunk. Your mummy wanted to make me marry her.
Around half the humans that walk this Earth are in its blueprints. The rest are the result of chaos, accidents, human failure. Planned or not, we’re all part of the patchwork. The world is a fluid mosaic of self-interest and altruism, of individuals with their own agenda-forming units, colonies and tribes.
Some of us have no desire for parenthood. Some of us fall upon it regardless. Many find their stride. Some do not. Some of us are ambivalent, sitting on the fence until they fall. Some go forth and multiply, happily and freely. Then, there are people like me. I always wanted kids. My body had other plans.
I’m not sure if it was altruistic – the desire to nurture and mould another life – or selfish – the desire to replicate my genes. Perhaps there’s no distinction. Maybe it doesn’t matter. Regardless, my desire was visceral – a sort of welling in my breast. Unfortunately, one of my breasts wanted the same thing.
Or at least, that’s how it started. Once upon a time, there was a little duct cell who dreamed of becoming something more. Frustrated with destiny, she decided to rebel. Silently, she mutated the genes that were keeping her in check. Then, she replicated her DNA – mutated genes and all – and cleaved her cytoplasm in two.
Her daughters stood side by side, gazing into the lumen of the duct. They knew that they had only one purpose in life – to breed. First, they would take over the duct. Then, they would infiltrate the other ducts. Eventually, their great grandchildren would venture to the lymph, floating through its currents to colonise distant lands.
And so, it continued, a multiplication and division of cells. They built their own canals – rivers of capillaries, a matrix of lymphatics – and used my hormones to grow and divide. At some point, they recruited some immune cells as their personal bodyguards. By the time I found them, it was almost too late.
One day in late November, I found myself sitting in a surgeon’s office, listening to sentences that I’d never wanted to hear directed at me. He could kill little duct cell and her daughters, he said, but it would be ugly. First, they’d throw in chemical weapons – mustard gas derivatives, mixed with yew and bacterial toxins. Then, they’d bomb the cities – demolishing all the structures where the duct cells used to reside. Then, they’d blast the ruins with x-rays, in case any of little duct cell’s daughters were hiding in the sewers. Finally, they’d shut off my ovaries, starving the cells of the hormones they needed to grow. I would lose the breast, along with my hair and eyebrows. The drugs would make me violently ill. I would come out in radiation burns. My immune system would be compromised, forcing me to avoid social interactions. My baby-making plans would be on hold for five years, until I completed hormone therapy. By that time, I would be 38 – possibly too old to conceive naturally. In addition to this – there was a high chance that the chemo would leave me infertile.
I shook my head. I want kids, I told him. I wanted to freeze my eggs before chemo robbed me of the possibility. The surgeon nodded. That, he told me, was something he could arrange.
A day later, my partner and I saw a fertility specialist. The doctor handed us an A5 card with a coloured graph that looked like an inverted traffic light. Dotted lines represented percentiles. On the card, he wrote the number 45 – the level of anti-mullerian hormone they had found in my bloodwork. It was a good number, he told us. I was near the 90th percentile for women younger than me. As a result, I should respond well to the IVF treatment.
How many eggs would I get from a single cycle? Fifteen was a conservative estimate, he told us. More likely, I could be looking at low 20s. Some would be immature, and perhaps a third would fertilise. Nevertheless, the numbers were looking good. Once my cancer treatment was over – if I survived – there was a great chance that we would be parents.
He led us to the nurse’s office, where we were taught to self-administer hormone injections. Each night, I would inject follicle-stimulating hormone into my belly fat. The hormone would make my ovaries produce multiple follicles. After five days, they would add a second injection to stop me ovulating. I would also take letrozole – an aromatase inhibitor – to stop my ovaries from producing too much oestrogen. Ten days later, I would inject the pregnancy hormone – HCG – and my developing follicles would mature. In 12 days, they would harvest my eggs, fertilise them with my partner’s sperm, and freeze the resulting embryos.
***
On Monday 12 December 2022 – Easter Monday, I called it – I arrived at the clinic for my egg-yeeting procedure. The Christmas tree at Fertility Associates was adorned with gold and silver balls. Some of them had bobble eyes and sperm-like tails.
A window-sized hatch in the operating theatre opened into the embryology lab. Beside me, next to the gurney, I saw a very long needle, an ultrasound probe, and several empty vials. The nurses positioned my legs in stirrups and pushed sedatives through my IV line. The room dissolved into a blur, and the doctor went to work, draining my ovaries of their eggs, one follicle at a time.
After a few minutes, I heard a woman on the other side of the hatch call out “one!”
“That’s the first egg,” the nurse told me.
I felt my body tense beneath me.
“There’s only one?”
“It takes them a while to count.”
Through the hatch, the woman called out ‘two, three, five… eight… 15… 22…’
“We need more vials!” The doctor yelled. “Can you give me another eight?”
By the time I toddled to recovery, they were at 24 and counting. They gave me a heat pack and blanket and escorted my partner to a small room with magazines: it was time for him to do his job.
While he was away, the recovery nurse came in and told me the news: they’d retrieved 39 eggs from me. It was a great number: over three times the average haul.
The next day, the lab called. Twenty-three of my eggs had fertilised. The numbers might dwindle over the next few days. On Sunday, they would give me my final numbers.
I imagined my 23 embryos, growing and dividing in a petri dish. The visceral welling flooded through me – a sea of grief, gratitude, heartbreak and hope. I was perhaps the most fertile woman in a clinic that mostly deals with infertility – and yet, I had no prospect of carrying a pregnancy for five years. Part of my body was actively trying to kill me – and yet, my ovaries had over-performed.
The next day, I found out that little duct cell’s daughters had made it through my lymphatic system, and that my doctors would need to treat it aggressively. I thought of the little embryos and reminded myself that there was a fertile life awaiting.
One day, I’ll tell my children that they were grown in a lab. I’ll tell them that they spent the first five years of their life frozen. That we made them because we loved each other and wanted them more than anything else. I’ll tell them that their conception was a marvel of modern science – a miracle, really. For them, I would fight anything – you should see what I did to those little duct cells.