*As published on IVF Babble.

Last month at the Fertility Show, we bumped into a brilliant woman, who has written a book based on her own fertility journey. Rachel Cathan kindly gave us some signed copies of her book that we gave out to our readers.

The response was amazing. The book, 336 hours offered so much comfort, so we realised we had to spread the word! We dropped Rachel a line and asked her to tell us more about herself and her book.

Firstly, we have to say that we were immediately drawn to the beautiful pineapple on the front of your book! For anyone who doesn’t know about the connection between the pineapple and the TTC community, can you explain its meaning and importance?

In Southern America, the iconic pineapple has long been regarded as a symbol of friendship and hospitality, and it has now been adopted by the TTC community to represent solidarity amongst all those affected by infertility.

For me, it also represents the armour you need to step into each morning when you’re dealing with infertility, simply because it wouldn’t be possible to get through each day if people could see what was actually happening to you on the inside. Without that kind of armour, how would any of us endure the pregnancy announcements, the invasive questions, and the arrival of another unwanted period in the work toilets?

But the number one reason I chose the pineapple as such a prominent feature on the front cover is because of the popular rumour amongst fertility forums that consuming pineapples (or specifically pineapple cores) can increase the chances of an embryo implanting into the lining of the womb (much the same as they are said to help pregnant women go into labour naturally). I know I ate a fair few pineapples while I was trying to get pregnant, and it always made me smile when I saw another woman carrying a pineapple in her shopping trolley (particularly if it was accompanied by brazil nuts and full-fat milk), and I’d wonder if maybe we had something very personal and important in common.

What does the 336 hours on the cover refer to?

It’s the notorious and dreaded two-week wait. In an IVF cycle, that’s the time between egg collection (EC) and the official test date (OTD), and it’s an emotional and psychological challenge that it’s hard to imagine unless you’ve experienced it firsthand.
I chose 336 Hours because it so accurately reflects the experience – a nail-biting hour-by-hour trial, where time appears to be almost standing still, and where you can feel hopeful and excited at 3pm, and by 4pm be plunged into a pit of despair. The final 72 hours in particular (as charted in the book) can make you seriously fear for your sanity – that’s the time when you often have the least contact with your clinic and probably your family and friends, and also the time when I found I most desperately needed support.

Is 336 Hours a strictly autobiographical account?

No. It’s heavily based on my own experiences, and of course the emotional content is 100 percent real. But I’ve made it a story about the experience of going through a two-week wait rather than a blow-by-blow account of exactly what happened to me. My priority was to write a story that would resonate with anyone going through IVF.
I’ve also changed all the names of characters and places because it’s a very honest book, and it was important to me that my friends and family might still speak to me after reading it…

Can you tell us about your own fertility journey?

My fertility journey spanned four years, and took my husband and me to a total of seven different fertility clinics, and eventually to a clinic in Greece, where we met the fertility specialist who diagnosed why we weren’t getting pregnant. Prior to arriving in Athens, I had been preparing myself for the fact that it was probably never going to happen for us: I’d never been pregnant, we had failed IUI and IVF treatments behind us and, in spite of all the specialists whose expertise we’d sought, we remained completely and totally ‘unexplained’. This lack of a diagnosis was a riddle that tortured me, and saw me scouring the internet late into each night, desperate to discover the answer that I knew had to be out there.

In the end, the answer was one I had been carrying with me all along.  For as long as I could remember, my periods had been ‘abnormal’. I experienced up to seven days of spotting prior to my period’s arrival, followed by agonising uterine cramps and (strangely) very light bleeding. I had mentioned it to every doctor we had met, and was always reassured that it was nothing to worry about and probably just a sign of my age (I was in my early thirties at the time). Unconvinced, I had turned to an acupuncturist and nutritionist who both specialised in infertility, and they had both agreed with me that it was absolutely not normal and was an important clue that my body was trying to send me. Over the next twelve months, they had treated me for hormonal imbalances but, sadly, the abnormal periods and the inability to get pregnant persisted.

Looking back, this is no surprise. As it was finally revealed in Greece, my womb was covered in scar tissue (despite showing a ‘perfect triple-striped lining’ on ultrasound during our IVF cycles), the cause of which was probably an undetected infection which had wreaked havoc with my reproductive system. The treatment was surprisingly simple: a course of antibiotics for both me and my husband to eliminate any infection that might be present, and an operative hysteroscopy to remove the scar tissue and reveal a fresh lining that an embryo could hopefully burrow into.
That treatment transformed my life. From that first month until today (more than five years later), my periods have been normal: no spotting, no ‘old’ brown blood, and no need for painkillers. And, two months after returning my Greece, I stood in my bathroom on a Wednesday morning at 3am, my husband at my side, looking down at the small plastic stick in my trembling hand – a small plastic stick that showed, for the first time in my history, two very clear pink lines.

My fertility specialist in Greece had felt certain that we could get pregnant naturally, but we had one embryo in storage in the UK – an embryo that we had been waving to and talking to each time we’d passed the clinic for the previous six months – so we decided that our best chance was to have a frozen embryo transfer (FET) while we knew my womb was in the best shape possible. Nine months later, our son was born. And a year after that, just as our fertility specialist had predicted, we fell pregnant naturally with our daughter.
If there’s one thing I’ve learnt from our journey, it’s to trust your gut instinct – and not to be dismissed by anyone (specialist or not) who claims to know your body better than you do. Every single IVF patient is unique, and what works for one couple won’t necessarily work for another, but what’s important is that you find a doctor who will listen to you, treat you as the individual you are, and tailor treatment to give you your best possible chance of success.

Where are you at now?

I’m sitting here now waiting for my husband to return from the weekly Tesco shop with our four year-old and two-year old in tow. I’m living a life I couldn’t have imagined five years ago. It certainly isn’t perfect and it’s now filled with all the challenges of parenthood, but that’s okay because these are the challenges that you can joke about with other parents during the school pick-up or even complete strangers that you pass in the street.

For the most part, parenthood is unifying; it offers a level playing field where everyone has an experience to share that others can relate to. Infertility is the opposite. It’s isolating, it makes you feel shut out from the lives of everyone around you, and often leaves you making up excuses for your life, fearing how others would react (or the unwanted sympathy you’d receive) if you told them the real reason why you don’t have children yet.

This is why initiatives like the #IVFstrongertogether campaign are so important. Pinning that pineapple badge on your coat offers people a subtle nod of camaraderie, and you never know how much of a difference that can make.

I still vividly remember commuting to work straight after our first failed IVF treatment, and having to get up to offer my seat to a pregnant woman (someone who, at that moment, felt more important and more deserving in every possible way). I wonder how differently I may have felt had I spotted another passenger with a pineapple pin that day; somebody who would know, without saying a word, exactly how it felt to be me in that moment). Or perhaps I would have noticed that the pregnant woman herself was wearing a pin, and it might have given me hope that maybe she was pregnant following many years of heartache and treatments, and that maybe one day I would even be sitting in her place.

When did you decide you wanted to publish a book about your fertility journey?

Writing has always been a big part of my life, and I had actually been working on a completely different novel when our fertility journey began. But then of course the quest to get pregnant took over and the fertility journey was the only subject on my mind. Since I was thinking about it 24 hours a day, I figured I might as well write about it, although I reassured myself that it was okay to write a no-holds barred account because I wouldn’t ever let anyone actually read it.

To start with, it was just a diary for me, and I stopped writing it around the time I gave birth to my son. But then a year later my dad (the only other person who had read this diary) died following a three-year battle with cancer, and I found myself dusting off that first draft of a manuscript that had been lying at the bottom of a drawer. Partly, it was because my Dad had told me that I really had to do something with this book (and I knew that he had a lifelong habit of being right about this kind of thing). Partly, it was because he’d always advised me that we’re so much more likely to regret the things in life that we don’t do, rather than the things that we do. And partly it was because losing a parent gives you a wake up call like no other, and a painful reminder that life is unpredictable, our time here can be short, and that if you have any small contribution to make, you had better act quickly and get it out into the world while you can.

Has it been quite a cathartic experience, documenting your experience? Has it helped you cope?

It’s been an overwhelmingly positive experience. Writing the book has helped me to make sense of our journey and to understand all the complex emotions that are tied up in an infertility diagnosis. It’s helped me to forgive myself for ‘handling it so badly’ (as I always believed I had) and to truly appreciate why infertility is quite rightly described as a life crisis. It has been incredibly freeing to be honest about what we went through emotionally, and to be able to offer that to other people who are on their own fertility journeys now. My hope for 336 Hours has always been that women will read it and realise that they are normal, that they are not alone, and that all of their darkest thoughts and feelings are experienced by pretty much everyone diagnosed with infertility. I also wanted it to be a book that women could pass on to their friends, family and even partners, and say: ‘It’s really hard for me to talk about all this right now, but this is basically what I’m going through.’

Were you open about your struggles to conceive from the beginning, with friends
and family? Did you talk to many people?

Most people knew that I wanted to have children, and my close friends knew that I was keen to start trying as soon as my husband and I got married. Inevitably, they realised that nothing was happening, and a few of them were aware of every single stage of our journey. I don’t regret being open and honest with these select few – but sharing my fertility journey with my fertile friends forced us all to endure some very difficult times. They had to agonise over when and how to tell me about their own pregnancies, and at times I had to withdraw, as it was simply too painful to be around these mums and pregnant women without being able to join their club. I think for many women, the circle of people who know about your fertility problems grows bigger and bigger, particularly as it starts to impact upon your work, your social life, and pretty much everything you do. But then, some of us also reach a point where that circle starts to close down, becoming smaller and smaller as infertility changes our lives completely. For me, this happened once I quit my job and pretty much stopped socialising altogether. I remember that during the final ten months of our fertility journey, the only people I was in regular communication with were the women on my fertility forum. This was the time when I desperately needed to talk to people who could truly empathise with what I was going through, and I’ll never forget what a lifeline these women were to me when I needed them.

What responses are you having to your book?

For readers who are currently going through IVF, the feedback is always ‘Oh thank God, I thought I was the only person who thought all that stuff!’ It’s a relief for women to know that they are not monsters for having terrible thoughts and feelings about other people, and that infertility really does change every friendship and relationship in your life. People who don’t have any first hand experience have told me it’s been a complete eye-opener, and that they now have a much deeper understanding about what their loved ones (who are enduring infertility) have been going through. Readers from both camps always tell me how much the book made them laugh, which is so important on the IVF journey. I tried to include as much humour as possible because, just as when we’re dealing with any major challenge that life throws our way, a sense of humour can carry us a very long way. And God knows we all need a laugh or two when we’re up against infertility…

Where can people buy your book!!
You can buy 336 Hours from all good bookshops or on Amazon

People can also get in touch with me via my website  – I’m always very happy to answer any questions or chat to anyone who’s on their own fertility journey.