Two sides of the story

One couple’s experience of coping with infertility and IVF treatment

When novelist Johana Gustawsson, 41, and her husband Mattias, 42, an investment banker, found out they couldn’t conceive naturally, they began fertility treatment. But the couple discovered the path to parenthood was more challenging than they’d imagined, seriously testing their relationship and mental health. Photography by Jasper Fry

‘The emotional pain and frustration of infertility and IVF are things no couple should experience’

Johana

The spring day in 2013 when I found out I was pregnant should have been the happiest of my life – but the overwhelming emotion I felt was relief. Here was proof that the two gruelling rounds of fertility treatment I’d been through were not in vain. It was also a chance for me to tackle the growing distance I felt between my husband Mattias and me. He’d always been everything I wanted in a partner – strong, caring, kind – but fertility treatment had built a wall between us.

We started trying for a family shortly after our beautiful wedding in France in 2010, and assumed it would be easy. But after six months without success, we went for tests. I was extremely stressed because I was sure I was the one who was unable to conceive; my mother had difficulties conceiving my sister and me.

When the results arrived, I was stunned. I was fine – it was Mattias who was infertile. But from that moment I poured all my fear and sadness into action as I sat with Mattias by our computer, researching our options.

We arranged to discuss fertility treatments further with a doctor at a private clinic in central London, and even in that first appointment I sensed an unbearable sadness in my husband, which I understood: we both knew it wouldn’t be his genes that were passed on to our children. ‘But I want Mattias’s baby,’ I said forlornly. The doctor replied, ‘The baby will be both of yours. Being a parent is educating, caring, feeding, supporting, encouraging, nurturing and loving your child, not just planting a seed.’ It was a comforting thought and cemented our decision to use donor sperm and try intrauterine insemination [IUI, which involves directly inserting sperm inside the uterus]. We settled on an anonymous donor, and began the process immediately.

At that point we were incredibly close as a couple, but the next three months were taken over by ultrasounds, blood tests and visits to the fertility clinic every other day. I hadn’t imagined it would be so intense. I also had to inject myself with hormones once a day, so if I was out I’d have to carry the syringes in my bag and find a public toilet where I could inject myself. My stomach and bottom were soon covered in bruises and the effect of those hormones was terrible: nausea, shortness of breath, night sweats, swelling and bleeding.

Despite all of this I was embracing the process as I knew it would be worth it if it resulted in becoming a mum. But it was around this time that Mattias and I stopped looking at each other as a couple. At least I did. Soon our life revolved around work and fertility treatments – I was on a special diet, seeing an acupuncturist twice a week, having reflexology and doing everything I could to improve our chances.

I was also overwhelmed by an enormous sense of pressure and responsibility: our fertility treatment cost us £50,000, wiping out our savings. I felt I had to do everything I could to make it work. Some days I felt like a walking uterus.

With all of this going on, there was no time for self-pity or looking at our feelings, and at first I didn’t notice that Mattias wasn’t doing well emotionally. He was feeling terribly guilty and depressed, and I didn’t see it.

Even when I discovered I was pregnant in February 2013, I still didn’t notice. I told Mattias and he was over the moon, but in the coming weeks I felt more stressed, as I knew the first 12 weeks of pregnancy were the highest-risk. We rarely discussed how we felt, instead pouring all of our efforts into hoping our baby was growing healthily.

At 14 weeks I noticed that Mattias seemed nervous, but I put it down to him being concerned about losing the baby. One evening, however, I was talking about my latest tests and he wouldn’t look me in the eye. Suddenly I was terrified that he was being unfaithful. I decided to confront him there and then. ‘Something’s not right,’ I blurted out. ‘You look guilty. Are you having an affair?’

He was horrified and told me I couldn’t be more wrong, explaining that he’d been feeling guilty watching me go through the fertility treatment. Finally, he admitted that he hated seeing me endure endless tests and scans and injections, and knowing that it was the doctors and embryologists in medical gowns, not him, who had helped conceive our child. I reached over and hugged him, instantly relieved, but also so terribly sad to have not seen sooner how depressed and unwell he’d become. ‘But wasn’t it all an act of love?’ I said to him. ‘Much more passionate than making love to conceive, don’t you think?’ I didn’t say that to make him feel better – I really believed it. You have to love each other immensely to go through those treatments and that type of conception.

After that conversation I felt so much closer to him and things improved between us. Then, at six months, I found I was bleeding heavily. We were terrified we’d lost our

‘I didn’t notice that Mattias wasn’t doing well emotionally. He was feeling terribly guilty and depressed’ Johana and eldest son Max at home

child and shaken to the core, even when we found out our son was OK, but this time we supported each other through it.

That first day we held Max in our arms, all of the pain and fear magically disappeared. I never worried about him not being biologically related to Mattias. One day a friend – who didn’t know how Max had been conceived – even commented that he looked just like his father and nothing like me.

We discussed whether we wanted more children and at first decided against them – I couldn’t face going through the treatment again, plus my career as a novelist was taking off and involved travelling. But then, in the summer of 2016, I changed my mind. We waited a few months to be sure, as I was painfully aware from last time of the impact it would have, then began a more intensive form of IVF, because I was older and needed drugs to help me produce viable eggs. This time we stuck together and I didn’t feel Mattias pull away at all, even though he hated seeing me go through it all again. By the time our twins William and Alexander were born, we were stronger as a couple.

Looking back, Mattias and I have undergone an incredibly tough start to parenthood. The emotional pain and frustration of infertility and IVF are things that no couple should experience, let alone in the early years of marriage. But through it all, we never stopped loving each other. And now we’re through the other side with three gorgeous children, I feel like there’s nothing we can’t achieve together.

Mattias

When the receptionist at the fertility clinic called in June 2012 to say that our test results were back and that our problem conceiving was down to me, I was shell-shocked. It was such a surreal moment that I had to ask, ‘What do you mean?’

We’ve never learnt why I was infertile; it was just terrible luck, but a diagnosis like that can really hit your sense of masculinity. Around that time I started having counselling once a week. I was in such a state of shock. I was able to speak to the therapist, but found it very hard to express how I felt to Johana. Partly that was because I couldn’t work it out myself. Was it anger, disappointment or just sadness? I couldn’t differentiate.

At that point I still wasn’t ready to talk to Johana. I felt we weren’t in the same place, and that we were on different journeys.

Another part of the problem was that I felt overwhelmingly guilty; I was the one who was infertile and it was my fault Johana would have to undergo such invasive procedures. I couldn’t go to the clinic for her, do the tests or feel what she felt. I still vividly remember the day the box of drugs arrived at home for the first time and watching her injecting herself and swallow all of those pills. I found it very difficult knowing that there was nothing I could do apart from support her.

Choosing the donor sperm was also a terribly difficult process, because the sperm bank makes you feel that you are doing your grocery shopping: they make it emotionless when in fact it’s the most harrowing thing we’ve ever had to do.

Looking back, perhaps I should have dealt with all of these feelings before we began talking to fertility doctors, but I wanted to plough on and have a child any way we could.

I’d always wanted to become a parent. My father died when I was young, and I dreamed of having a big family, and all of the chaos and buzz that comes with it. As soon as I met Johana, in 2005 at a party in London, I knew she was the person I wanted to have a family with.

The day Johana told me she was pregnant, she’d arranged to meet me for a coffee at Canary Wharf, where I worked. When she produced two little pairs of baby socks – one blue and one pink as we didn’t know the sex at that point – I felt overcome with amazing relief and happiness. I had a new confidence in our relationship – that we had achieved this difficult thing together.

Even so, it wasn’t all easy from there onwards. But then, after eight weeks, we were discharged from the fertility clinic and went to the NHS for the pregnancy follow-up, like any other couple who had conceived naturally, which in itself was a relief and gave us a sense of accomplishment.

Six years later, we are a happy family of five, and though I did once feel a sadness at not being able to pass on my own genes, especially as I resemble my late father, I don’t dwell on any of that now.

From the start, we’ve been open with the boys about where they came from. Johana and I tell them about the special journey we went on to have them. Not every newlywed goes through the physical and mental turmoil that we did. I believe we are stronger as a result.

‘We never learnt whyiwas infertile, but a diagnosis like that can really hit your sense of masculinity’ Mattias with twins William and Alexander

Johana Gustawsson’s new novel, Blood Song , is out now (Orenda Books, £8.99)