Monica Halem calls it the “fertility train.” Every woman who embarks on a cycle of in vitro fertilization is familiar with the ride: the multiple cycles of hormonal stimulation, the pain of the injections, the discomfort and the bloating; then the delicate harvest of eggs to be fertilized outside the body, and the anxious wait for genetic testing on the embryos to make sure they have the right number of chromosomes before they are transferred back; and then, if all of the embryo tests come back abnormal, or the embryos don’t implant, or the pregnancy ends prematurely in miscarriage, the process starts all over again.
“It’s a lot of highs, right?” Halem says. “You’re getting excited, you’re ready. And then when it doesn’t work, which is more times than not, it’s a very low low. Such a depressing low. I mean, there’s-been-times-I-couldn’t-get-out-of-bed low.”
She is sitting at the desk of her office in the dermatology clinic she runs on Fifth Avenue, right across the street from the Metropolitan Museum of Art, with its endless rooms of Madonnas bouncing Renaissance bambini on their laps. It is a hot June afternoon, and Halem, 47, looks youthful and sleek in a black summer dress, her skin preternaturally smooth (what do you expect from a board-certified dermatologist?). But tears form in the doctor’s eyes as she relives her ride on the train.
“And to pick yourself up, you’re like, Okay, what’s the next step? And the next step is to try again. And you end up just going and going and going.” Halem first climbed on the train in 2009, and it was a rocky journey — over the next six years, she would visit five different fertility centers, go through dozens of IVF cycles, and endure seven miscarriages. “And it’s so … ,” she adds in a whisper, “so devastating when it doesn’t work.”
Then again, as the baby pictures and crayon drawings that decorate the walls of her office attest, it did work for Halem. In 2012, after an estimated 15 to 20 cycles of IVF and six miscarriages, this single mother became pregnant — at age 42 — and gave birth to a daughter in February 2013. A year later, she tried to get pregnant with a leftover embryo from an earlier cycle and suffered another miscarriage. Then, toward the end of 2014, at age 44, Halem decided she still wanted to try again.
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