Silent Sorority

Infertility Survivors Finally Heard

September 20, 2016

We’re Not Going to Sugar Coat Failed IVF: The Grief is Real

Updated 9/23/2016 with a link to The New York Times Letter to the Editor 


Welcome to the blog book tour for Avalanche: A Love Story

The links (below) contain book reviews and opinions and insights on Avalanche by author Julia Leigh. Please share your thoughts on the ideas raised.

Also, this blog’s readers were not the only ones who found Rachel Cusk’s NYT Book Review objectionable. My Letter to the Editor was one of several published in the Sunday, September 25, 2016 print edition. Let’s hope the letters and our blog tour help bring much needed validation to the real grief and emotional rawness Julia shared in Avalanche. It’s time for a much needed spotlight on the ‘fertility industry.’ This unregulated branch of medicine puts women in the unenviable position of determining when clinics put profits ahead of patient well-being.

Since the dawn of birth control and fertility treatment the cultural response to childless women — particularly those who tried and failed with fertility treatment — has amounted to a collective shrug. It has been acceptable to tune out, dismiss or, in the worst cases, shame or blame those who dared to speak up. For those who have felt the heartbreak and grief that Julia writes about, this is an opportunity to reshape the conversation. Our collective voices will help those who have not experienced failed IVF and its anguish. We offer a view into the premature empty nest syndrome and its ‘permanentness.’  Wouldn’t the world be a nicer place if it was no longer culturally acceptable to turn a blind eye, a cold heart or a deaf ear to those who dare reveal, honestly, the reality of aching loss captured in Avalanche?

Avalanche Blog Book Tour Stops

My review (below) was first published on Huffington Post: Have Fertility Treatments Become a Faustian Bargain?
Jody (UK) on Gateway Women:  The Private Hell of Failed IVF: A Review of Julia Leigh’s Avalanche
Katherine on Inconceivable: Julia Leigh’s Avalanche and  The Perception of Infertility Stories
Different Shores (Ireland): Rachel Cusk over-generalises over women, whilst judging them
Mali (New Zealand) on No Kidding in NZ: Avalanche – A Book Review
Cristy (Massachusetts) on Searching for Our Silver Lining: A Journey of Love – Review of Julia Leigh’s Avalanche: A Love Story
Lesley (UK) on Supporting Childless Women: An Interview with Julia Leigh
Jessica (UK) on The Pursuit of Motherhood: Australia Day
Loribeth (Ontario, Canada) on The Road Less Traveled: Avalanche – A Love Story by Julia Leigh
Lisa (California) on Life Without Baby: What “Just” Doing IVF Really Entails
Kinsey (Pennsylvania) on Bent Not Broken: Avalanche – A Love Story
Sarah (New York) on Infertility Honesty: Book Review – Avalanche: A Love Story
Sue (Oregon) Childless by Marriage: Books Offer Discouraging View of IVF

Return to this blog September 30. That’s when Julia Leigh shares her thoughts and answers blog tour participant questions.


[bctt tweet=”Avalanche lays bare the messy and complex issues and conversations that accompany fertility treatment #IVF #timeforfertilityindustryregulation” username=”PamelaJeanne”]

Have Fertility Treatments Become Faustian Bargain

The sun set as I finished reading Avalanche: A Love Story by Australian novelist and filmmaker Julia Leigh. With darkness falling my mind tried to make sense of the contradictions. While fertility medicine is typically presented in glowing terms, Leigh’s story opened a new window into the very real physical obstacles and anguish that accompany modern reproductive procedures.

A love story that ends with a baby, even one with Leigh’s accessible and lyrical writing is, well, ordinary. What is extraordinary about Avalanche  — and what gave this narrative added significance for me, and no doubt others who have entered into the unsettling realization that biology cannot be easily tamed — are the honest, gripping and disconcerting encounters Leigh describes while navigating the booming for-profit baby business.

But that comes later.

First, there’s the pivotal moment Leigh depicts, newly reunited with a college love, as she joyfully immerses herself in contemplating “Our child.”

“Our beautiful child, our destined child was called forth as a possibility, conjured out of the ether.”

Her tender language transported me to my own heady moment, the one when I once envisioned the magic and power of creating a new life with my beloved. Once inside Leigh’s head and heart I could almost feel, along with her, “the chemicals of love that spilled through my bloodstream.”

I willingly joined her on her journey to bring imagining and longing into reality. Her story moves from New York City in 2007 to South Bondi, a suburb of Sydney. Leigh’s expectant and heart-felt desire was tempered by the same reality that I once felt.

With a dose of caution, she (like many other earnest lovers) suggests the couple test the strength of their new-found relationship before introducing a pregnancy into the mix. She admits to the error of assuming there was time to spare. A year later, newly married Leigh’s story-telling takes on new urgency.

“Our child was not unreal to me. It was not a real child but also it was not unreal. Maybe a better way to say it is that the unknown unconceived had been an inner presence. A desired and nurtured inner presence. Not real but a singular presence in which I had radical faith. A presence that could not be substituted or replaced.”

Her first encounter with a fertility clinic evoked memories of my own solemn, off-putting episodes. Upon entering the waiting room, no heads turn. It was, she writes, “a temple of discretion,” a place “no one expected or wanted to be.” The doctor Leigh’s trusted friend recommended was not actually someone her friend liked, rather she said, “he’s the guy who got me pregnant.”

‘Avalanche’ Reveals Anguished Double Bind of Fertility Medicine

Avalanche lays bare the messy and complex issues and conversations that accompany fertility treatment. Complications ensue and Leigh’s relationship frays. Determined to persevere in making Our Child a reality the couple begins a series of surgeries, tests and protocol-driven procedures. Once the marriage unravels, Leigh continues in her baby quest.

The dream of a child is what propels people to fertility clinics. What we learn from her story is that the tantalizing promise of in vitro fertilization (IVF), marketed for nearly 40 years by a burgeoning industry more often ends — not with a baby — but in spectacular failure. The hope that science can outsmart Mother Nature is what keeps people coming back for increasingly invasive, even experimental treatments. This dreadful and difficult contradiction dogs you each step of the way.

It slowly dawns on Leigh as she confronts the devastating disappointment of one failed cycle after another that she is in the unenviable position of having to decide when enough is enough. She writes:

“In the IVF world we all have our parameters, our personal lines in the sand. At least we do when we start out, before the harsh desert winds cut across the dunes.”

Her story, I know, will be familiar to anyone who has ever entered into an uneasy and circular discussion with a team of ‘fertility’ specialists. Side effects to medications are glossed over. Statistics are generalized. Paperwork and legal release forms pour forth. Buried in the fine print were statements that the doctor managing Leigh’s care might have a financial interest in the clinic.

“With those consents I felt the same sense of empowerment, fair bargaining, ability to discuss and negotiate a document, as I did when I signed off blindly on the terms and conditions of the latest Adobe update.”

Leigh becomes an unexpected heroine. With each successive appointment she becomes symbolic of the tribe of women who have found themselves in the unenviable position of being damned if you do and damned if you don’t pursue IVF. I nodded as I read her words:

“In the public imagination — as I perceive it — there’s a qualified sympathy for IVF patients, not unlike that shown to smokers who get lung cancer. Unspoken: ‘You signed up for it, so what did you expect…?’”

Thus, begins Leigh’s Faustian bargain. Now in the grips of clinic operators who carefully polish their reputations as providers of goodness and dreams, Leigh switches from one doctor to another hoping for a better outcome. What she discovers is that there is little to no evidence to support “optional extras” sold by clinics — yet they’re made available to stoke the chances of a different outcome.

When requesting proof that assisted hatching or “embryo glue” increased chances of successes, Leigh’s doctor admitted there was no clear evidence, however, if Leigh proceeded with them she could say she’d done all she could. On the way out of the building following one embryo transfer Leigh noticed a Bentley in the parking spot reserved for Medical Practitioners Only.

Following six for six IVF fails her doctor was ready to sign her up for another cycle. Emotionally, financially and physically spent Leigh asks how many women her age at the clinic had taken home a baby using their own eggs. The answer: 2.8 percent for 44-year-olds, 6.6 percent for 43-year-olds.

The double bind, which slowly and painfully becomes clear, is while one harbors hope of becoming pregnant it feels awkward to talk about giving up. Leigh writes: “The struggle itself had been sustaining.”

As is confessed, usually anonymously, in the blogosphere with much astonishment, Leigh realizes she could not grieve sincerely knowing there was still a chance. “Half-grief, forestalled grief, was a kind of hell.”

Like those of us who have been trapped in the ‘what ifs’ of fertility treatment Leigh gets a moment of clarity. Tapping into a new vein of strength we realize it’s up to us to decide when it’s time to stop, to save ourselves, and to find a different way to love.

Much like Joan Didion brought new observations to grief, Leigh’s Avalanche adds new dimension to a little explored but visceral modern human experience.

Book Musings, Pop Culture 16 Replies to “We’re Not Going to Sugar Coat Failed IVF: The Grief is Real”
Pamela Tsigdinos
Pamela Tsigdinos
Writer, blogger and, oh, yeah, infertility survivor. My memoir, Silent Sorority, tells the whole story. There's a movie in there somewhere. Given the quirkiness needed to relate it all I'm thinking Jennifer Lawrence would be a good fit.


16 thoughts on “We’re Not Going to Sugar Coat Failed IVF: The Grief is Real

    Author’s gravatar

    Thanks again for facilitating this book tour! I just posted my review….I’d hoped to have it live at midnight, but life intervened.

    I can’t wait to read all of the other reviews too!

      Author’s gravatar

      Kinsey: I am truly touched by the power of our collective voices. As I commented on your blog to your review:
      ” Right on, sister!! I am so glad you made time to participate (thank you!) as your review goes a very long way in tackling many of the issues that I’ve also struggled over the years to put into words. What to call the ‘childling’ that was so very real to us then (and now) as I watch all the children born in the same years that we were engaged in Clomid, IUI and IVF cycles. It fills my heart with joy that we can so passionately protect and defend our ‘sisters.’

      The silver lining in this entirely surreal human experience is that I’ve come to know and love so many women (and men) — present company included! — who allowed each of us to find our way back to some new normal. It is no easy feat to mend heartbreak and discover new ways to love all the while get clubbed over the head by cultural norms that marginalize us. And just to make the task a bit taller: educate on the shadow side of modern medicine all at the same time. But we could not ask for more courageous and loyal friends of the heart, could we?”

    Author’s gravatar

    Pamela, I’m so grateful you are hosting the book tour. On the heels of Rachel Cusk’s review at the New York Times, it is sorely needed. Julia’s book lays bare the journey many women facing infertility will take. It also illustrates all the emotions that go along with it and gives and inside view to what the treatment process is actually like. Though she’s not the first author to write on this topic, her work is no less important, especially as her journey ends without this much desired pregnancy.

    Thank you, thank you, thank you for hosting and writing such a powerful review.

      Author’s gravatar

      It bears repeating, Cristy… as I noted on your blog:

      “I am overwhelmed and gratified by the blog book tour participation! Thank you, Cristy, for promoting and partaking in the discussions. I’ve said it before and I will say it again: you are a change agent who brings added weight and acknowledgment to all outcomes on the fertility spectrum. Your support for women who came away without the ‘childings’ that were so tangible to us is doubly validating.

      It takes us a little longer to come through the healing process when our IVF fails — the permanent-ness + raw loss — hits us like anvil on the head … but finding our way back to love is made much easier with the supportive community who keep us close even when we’re prickly and hard to be with. xo”

    Author’s gravatar

    This is a beautiful review, Pamela. And yes, that line about the Bentley really hit me between the eyes when I read it too.

    I’m glad Julia’s book is getting such focus. I was sent a review copy several months ago, and so reviewed it there and then. ( I could very much relate to the real presence of the imagined child.

      Author’s gravatar

      Me, too, Mali! While I wouldn’t wish the experiences we’ve had on anyone, I am humbled and grateful to have the depth of compassion and caring that this writing/blogging community offers to those who venture to say, “I hear you, and I understand.”

      Those powerful words and the compassion that accompanies them have transformed my very existence…

    Author’s gravatar

    Great review with some wise insights, Pamela. I am so glad you organized this book tour — I have missed the ones Mel used to do!

    Like you & Mali, the Bentley story resonated with me — mostly because dh & I noticed the exact same thing outside our RE’s office when we were in treatment!

    I have no doubt we will continue to see progress on this issue, because — while there’s obviously still more work to be done — we’ve seen so much change & progress and increasing awareness over the past 10 years already. You’ve been a big part of that! :) — so thank you, again, for all you’ve done to raise awareness and support for this increasingly not-so-silent sorority. :)

    Let us know where we can find your NYT letter when it’s published. :)

    Author’s gravatar

    Thanks so much Pamela for including my post on Rachel Cusk’s review on the blog book tour. This is such a great way to gather together all the insights and comments! I’m looking forward to working my way through them all

      Author’s gravatar

      Your post added greatly to the conversation. I still marvel over Rachel Cusk’s inability to see the double standard she was applying to Julia’s memoir. Truly stunning. As you wrote, “We are complex beings, and cannot be lumped together under one un-nuanced, unsubtle generalisation.”

      So very true!

    Author’s gravatar

    I just love that you organized this blog tour, Pamela!! I think galvanizing those of us floating around in cyberspace every now and then is a good thing. I hope we can do something similar again sometime.

    I’ve been slowly working my way through everyone’s posts and thoroughly enjoying our different and shared view points, perspectives that exactly mirror mine as well as ones I haven’t thought of.

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