Fertility: Maybe baby (+audio)

The author, Elisabeth Easther and her son.

On the eve of the opening of her award-winning play on reproduction, Elisabeth Easther looks at the business of fertility and asks why making babies can be so simple for some and so complex, expensive and heartbreaking.

Human reproduction is a mysterious business, to say the least. To conceive, ideally there'll be some love in the air or at least some lust. Then there are dates, both calendar and romantic, mix an egg with some sperm and, voila, you'll make a baby. No? Not to worry, throw in some old wives' tales and a few grains of truth, change your diet and think the right thoughts and you'll be up the duff in no time. Then if that doesn't do the trick, give acupuncture a go, take Chinese herbs, do the right sort of exercise, have the man eat more tomatoes or fish (they're both on the list of things a fellow should eat for optimum sperm health), have the woman avoid sugar and caffeine, wine and goodness knows what else, then throw a swag of hope into the mix - but try to avoid desperation because that's counterproductive.

And if all that doesn't produce a result, look to science and make an appointment with a fancy fertility clinic, where money will be spent at an alarming rate. There are no guarantees, however - only 4 per cent of woman over the age of 42 achieve a live birth using IVF. So if there's still no joy, return to step one, the start of the cycle, and repeat as required - because human reproduction is a mysterious business, to say the least.

When I was a child, my father, a doctor, would tell stories of women who failed to get pregnant after trying for 20 years, then they'd adopt and the next month they'd be pregnant with their own naturally conceived child. And many of us know couples who've tried round after round of IVF, until the woman's stomach is black and blue from hormone injections and, when it doesn't work or they run out of money and give up, they fall pregnant the old-fashioned way.

And why is it that people are said to "fall" pregnant, like it's something that takes no effort at all, like tripping over a log? For many people falling pregnant is much more of a struggle than the verb implies, becoming even more of a minefield when they really start trying. It's similarly complex when you know a friend is hoping to make a baby - the thermometer is by her bed, the chart and the pen beside it - but God forbid you should ask how it's going, because it's way too touchy a subject to bring up over coffee (decaffeinated, of course).

Although you do want to know, you want to be there for her, to support her, you can't ask how it's going because it doesn't work like that - heaven forbid your inquiry should add to her anxiety and, if you are able to talk about it, how many conversations begin and end with "it's a mysterious business"?

One day, about a year ago, I thought it was such a mysterious and interesting business, I decided to write about it, and Seed was born. I began collecting the stories of my friends and also made things up - artistic licence. And some things I learnt firsthand.

Years ago I saw a documentary about Nora Ephron who wrote and directed, among other things When Harry Met Sally. When her mother was dying, Ephron remembers her saying something along the lines of, "I hope you're taking notes, Nora, this is life, this is life" and that has stayed with me to this day.

So how do you make a baby? Having taken notes throughout my own life, I can confirm it's easiest to do when you're not really trying - I have the 8-year -old to prove that.

But what if you want a child and it's not working? These days, when a couple fail to conceive while employing the tried and true shag-a-lot method, following a few months or years with no results, a fertility doctor may well prescribe sex and drugs, which sounds way more rock 'n' roll than it is. This is the gateway to the world of reproductive medicine which, ironically, sounds sterile. A spot of unexplained fertility, perhaps brought on by not very active ovulation, and you'll be on clomiphene (an ovulation stimulant) before you can say "let's just take a look down there".

Listen to Hillary's monologue from Seed, played by Fiona Mogridge.

Next thing you know you'll be having very intimate scans to see if eggs are hatching, ultrasound wands wrapped in condoms covered in lube will be inserted within your nether regions and pretty soon your privates become the business end of reproduction. And, if you start going down the medical route, there's every chance you'll receive text messages telling you to have intercourse - which is quite a novelty to begin with. And if the drugs don't work, you may find yourself shepherded towards artificial insemination and if that doesn't work you might sign up for IVF - making eggs like a battery hen on steroids, which are then turned into embryos which will be transferred, frozen or fresh, when the time is ripe.

When people ask me if I have just the one child - often as if there's something strange about that, as if it's some weird choice I made - I never explain that I actually tried for more but a couple of miscarriages put an end to my hopes of siblings for my son. When asked if there's just the one, I put on a brave face and say something flippant about having made such a magnificent child, I chose to stop while I was ahead - never allowing the lump in my throat to turn into tears.

I also thought long and hard about whether to write this article at all and, if I did, how much would I feel comfortable about giving away, because so much of this information is usually kept tucked well away. Whereas by writing a play about reproduction I thought I'd be able to hide behind the fact that it's fiction.

The irony, too, for many of us is having tried so hard to not get pregnant for so long - and failing sometimes, if we're honest, and dealing with that too - we suddenly find it so complicated to make a child when we do want one. It just doesn't make any sense.

Listen to Virginia's monologue from Seed, played by Alex Ellis.

Yet often, when the time comes to start a family, people find it isn't as easy as when they weren't trying. And don't even start me on how much more complicated romance is for women in their 30s who've always had breeding on their life's list of things to do. They meet someone and want to have fun but the clock is ticking, so they try to be cool, nonchalant - but how can they be if that's what they're after, a family that is?

I fell pregnant with my son quite unexpectedly. A lovely French doctor in London assured me I wouldn't conceive easily and, as I'd never given parenthood any thought, I took her diagnosis in my stride. I was about 30 at the time and it really didn't bother me.

Fast-forward five years, I'm feeling queer, go to said French GP, she does a few tests and tells me I'm pregnant. Having not had it on my list of things to do, I took to the prospect of motherhood in about 30 seconds and was as delighted as could be. And that particular turn in my life is one I've never regretted.

Further down the track, again I wasn't anticipating having a child, yet still I "fell" pregnant. Once again I embraced the news swiftly, having already discovered motherhood was right up my alley and this time it was twins - twice the fun. Delight was all I felt at the first scan. The excitement continued until a 12-week scan showed their hearts were no longer beating. My doctor suggested the best thing to do would be let nature take its course. As a rule, I like that plan of action - I'm a big fan of nature - but retrospectively I wish I hadn't. Up the top of Mt Albert, reading Canvas no less, nature took its course so violently I was quickly in hospital, an experience that was much worse than labour.

Listen to Maggie's monologue from Seed, played by Janine Burchett.

You know it's serious when you're zoomed straight to the front of the line at A&E, slumped in a wheelchair, whisked up to your own private room while all the broken, cut and dazed look on with envy, wondering what you did that was more impressive than breaking a limb.

Following that loss, I found myself quite focused on trying again. The next time I miscarried I wasn't so into nature taking its course and had a D&C, which is kind of the same as an abortion only the cells being removed are no longer viable, so no one judges you.

Happily this procedure is done under a general anaesthetic. I love a good anaesthetic, counting backwards from 10, trying to stay awake to prolong the buzz, but not this time.

I cried all the way down and I was still crying when I regained consciousness and for quite some time afterwards too.

Anyway, enough about me. In the play, Seed, one character is trying to make a baby but can't, so tries all the medical options available to bend nature to her will - I know plenty of women in that boat. Then there's the woman who hasn't met Mr Right but she refuses to let that stand in the way of her breeding plans - not so uncommon these days.

The third woman falls pregnant to her husband, only she's adamant their family is already complete, while the fourth character learns the hard way that contraception isn't always reliable.

The last character was based on the experience of a friend of mine who conceived with an IUD at 42. And that's no isolated incident either - just two weeks ago one of my best friends was over (she knows my play is about reproduction but not the ins and outs, as it were) and we were chatting, as you do, when she mentioned a termination, as if I knew about this episode in her life. An IUD pregnancy followed by an abortion.

Listen to Shelley's monologue from Seed, played by Renee Sheridan

What? When? No, I didn't know and then it dawned on her, that when she had come to tell me, to cry on my shoulder, that I was in the middle of another miscarriage and in her mind, my misery trumped hers so she kept her pain to herself.

There are so many stories like that floating around. Just the other day in this very paper, there was an article about a woman advertising for sperm, because the queue for donors comes with a two-year wait. Then there was another about how the abortion rate for women in their 40s is rising because having been told so often that fertility is declining, older women mistakenly assume they're unlikely to conceive. As for the terrible tale of two Italian women who were undergoing IVF and the doctors muddled the embryos, one of the women lost her baby, although it wasn't her genetic material, and the other woman is pregnant with twins - they're not hers either but Italian law says the woman who carries the babies has the rights to them.

The last I heard she's not giving them back to the couple whose egg and sperm created them. Which is just too awful to contemplate.

But it's not all doom and gloom. When Seed won the Adam Award for new writing earlier this year, there was a ceremony at Wellington's Circa Theatre, where the play was given a public reading. Afterwards, the mother of one of the actors came up to me and said if I'd told her 20 years ago, when her son and I were at drama school together, that she would one day watch her boy simulate masturbation on stage and she'd have tears of laughter running down her face, she wouldn't have believed me. But it happened, and I'm relieved the play is funny because I do believe, in the midst of life's more challenging trials, sometimes you just have to laugh, then say something along the lines of "human reproduction is a mysterious business, to say the least".

Elisabeth Easther's play Seed.

Seed is at The Basement Theatre, Auckland, from June 17-28. Tickets $20-$25, iticket.co.nz