Reminder

em·bryo (em bre o) n. pl.-os’ [[ME embrio ML embryo < Gr embryon, embryo, fetus, thing newly born, neut. of embryos, growing in < en-, in + bryein, to swell, be full]]

 

I recognized the clinic’s letterhead on the piece of mail John was reading and I reached over his shoulder to take it from him.

“Give that to me,” I said. The paper made a snapping sound as I yanked it from his hand.

John startled, then laughed. “It concerns me too, you know,” he said.

But I’m the clinic’s patient—even now, five years later—and the letter was addressed to me.

“Read it out loud,” John said.

“Okay, just give me a minute,” I said. I sat down and tried to tune out the shrieks and stomps of our son Brennan, four-and-a-half, and daughter Liddy, three, as they raced through the house. The letter was a full page long, single-spaced. The words IVF and embryos rose off the page. A familiar anxiety pricked my skin.

I have, for years, nursed a secret fear that a letter or phone call would come informing John and me that our three frozen embryos have been lost or accidentally destroyed. But the hard truth is that such a devastating event would also bring an end to the decision that lingers, unmade, at the edges of our lives as we go about our days raising our two children.

“We have enclosed this letter as a reminder that you currently have embryos frozen and stored at [our clinic],” the letter began.

Five years ago, I lay on my back in a dark examining room with John sitting beside me. We stared at an ultrasound monitor, at a cluster of bubbles in black-and-white: my egg follicles, swelling a little more each day with the help of the hormones I’d been injecting into my belly. Each follicle held an unseen egg within it—our unconceived children, John called them with a wry laugh.

We’d been driving to the fertility clinic every day or two for ultrasounds to monitor the egg follicles’ growth. The ultrasound technician clicked her mouse to move an arrow across the screen. “Fifteen millimeters,” she said today. She moved the arrow to the next follicle. “Another 15 . . . 14 . . . 15 . . . 13 . . . 12,” she murmured, nodding. Once the follicles had reached 18 millimeters, the eggs would be mature enough for “retrieval,” when a surgeon would draw them from my swollen ovaries with yet another glistening needle.

Two days later, I emerged from the fog of anesthesia to hear the far-away voice of the surgeon: “I took 19 eggs from you.” Nineteen. He had taken every one he could reach, but I knew from talking with the doctors that only ten or twelve of them would be mature enough to fertilize, and maybe half of those, if we were lucky, would begin to grow.

Three more days passed as we waited, imagining the microscopic cells of our embryos growing and dividing in the clinic laboratory. A nurse called to tell us that 12 of the eggs had successfully fertilized and seven were growing. We returned to the clinic for the “embryo transfer,” and a doctor I had never met sat beside me to tell me about my embryos. He showed me a hand-drawn sketch of a healthy three-day-old embryo: eight cells, smooth and round and even-sized. He held the drawing alongside sketches of misshapen embryos: splintering cell walls and multiple nuclei. Two of my embryos had this shattered appearance; they were “thrown away,” he said. The five that remained were rated based on their development. Eight is the highest rating, the perfect score in the world of a three-day-old embryo. My best two, the ones they would transfer into my uterus through a catheter for my first IVF attempt, were an eight and a seven.

After the transfer, I went home to rest and wait again. But within days I began to feel the first twinges of cramping. I started bleeding after ten days, and the nurse had to convince me to come in for the required pregnancy test. I submitted to the blood test in silence and the nurse thanked me, saying she knew I didn’t want to be there but they needed the pregnancy test results before they could begin to prepare me for next step, another transfer using the three remaining embryos, which had been frozen in the lab. She said she would call me later in the day with the results. By the time I got home the cramping was so severe I took four Advil, stepped into a hot shower, and watched bright red blood stream out of me. I went to bed and wept into my pillow until sleep came. Later in the afternoon I woke up to the phone ringing.

“How are you doing?” the nurse asked, and I described the pain and blood. “I’m not sure how to tell you this, but the test was positive,” she said. I asked her to repeat herself and she continued, “The numbers are lower than we’d like to see, and given the cramping and bleeding we don’t know what the ultrasound will show. But right now, what we know is that the test was positive.”

I called John. “The pregnancy test was positive,” I said, my voice flat and far away, even to me.

John was silent for a moment. “I don’t know what I’m supposed to think,” he finally said.

“Neither do I,” I said. “Neither do they.”

But, somehow, either embryo seven or embryo eight had survived the wringing cramps and wash of blood, had nestled in and begun to grow. I was pregnant.

Months later, John and I sat on the beach in Maine, nausea moving through my body in unrelenting waves like those driving onto the shoreline. In the morning, at the motel, John fed me diced watermelon and dry Captain Crunch as I hunched in bed trying not to throw up. I’d bought him a chess game for his birthday and he taught me to play as he sat across from me in the dimly lit room, the rain pounding the roof and windows. A weather report on the television described storms in the northeast, a widespread blackout. A paranoid, electric panic pulsed through me. “Our embryos,” I said.

“I’m sure there are backup generators,” John said. “In that place, of all places.” Still, I had him connect his laptop so that I could read the Globe and see that Boston had not been affected. “You know,” John said later, “we don’t even know exactly where they are.”

After our son Brennan was born, we talked little about the embryos except to joke about them.

“We have to pay rent for them!” John complained, when I reminded him we would be responsible for a six-hundred-dollar storage fee after the first year. “We can barely pay for this place. Can’t we just keep them here?”

“Brennan,” he joked, “Close that freezer! You’ll defrost your siblings!’”

That fall, when Brennan was seven months old, we left him with my mother and returned to the clinic for the first time in a year. We were ready, already, to try again—or so we thought.

But: “We’ll need you to stop breastfeeding,” the doctor said. “And insurance won’t cover your costs until you’ve tried again for a year.”

In December, my right ovary burned with the first ovulation since the needles had drawn out those 19 fragile eggs. My period never came. I bought a drugstore pregnancy test, like an ordinary person, took it in private, on my own, and stared in secret awe at the pink positive lines, thin but vibrant.

And so, on her own, Liddy came to us. Two babies in 18 months—a son and a daughter.

“Are you done?” people ask us all the time. We offer vague, non-responses or jokes in reply, and then we change the subject. We never ask each other aloud, “Are we done?” Still with us is the debilitating nausea of that second pregnancy, when I was too dizzy to stand up some days and my mother spent week after week with us, taking care of Brennan. And then, Liddy came, with complications and severe reflux that jeopardized her breathing, eating, and growing her first 18 months. Liddy is happy and healthy now. But I saw a woman tend to an arching, crying newborn the other day, and the pain of remembering swelled my throat, burned my eyes.

With the clinic’s letter in hand, I say to John, “You have to hear this,” and begin reading aloud. “We hope you will decide to use these embryos soon,” I read slowly, dramatically, “But, if you do not—” I begin to list the options they have laid out in absurdly simplistic terms. I am laughing despite myself. “Option number one,” I read. John is shaking his head. Brennan and Liddy are clattering around, neglected, in the living room, and John tries to stop me, but I keep reading. “Continue to freeze and store the embryos and—this part’s in italics—pay the embryo storage fee when you receive the bill in approximately three weeks.” John is laughing. “Option two, donate your embryos for use or research. Option three, authorize disposition of the embryos by”—I pause here for emphasis—“visiting the clinic homepage and clicking on ‘frozen embryo disposition form’.”

“Click on the frozen embryo icon,” John interrupts, “and drag it into the trash can on your desktop.”

We sit at the table and laugh hard enough that I have to wipe tears from my cheeks. The raucous voices from the living room grow too loud to ignore.

“So when is the rent due?” John asks finally.

I smile. “August first.” I fold the crisp white letter away into its envelope, and with that we have decided that we are still not ready to decide.