The Struggles of IVF

Finding out that you are not able to conceive naturally is probably one of the hardest things a woman has to hear. The road to trying to have a baby can be difficult for a lot of married couples; with procedures like IVF (in-vitro fertilization), the road should become less difficult. Right?

For Chicagoan and writer Nadine Kenney Johnstone, it was not. After learning that she and her husband were not able to conceive naturally, they looked towards using IVF.  However, after a procedure that caused severe internal bleeding and a six-inch scar on her stomach, Johnstone had a difficult year ahead of her that almost threatened her marriage.

As this year’s CWA Book of The Year Award winner for Indie Nonfiction, CWA chatted with Johnstone about her struggles with IVF, how it affected her marriage, and why she decided to share this with the world.

How does Chicago influence your writing or writing life?

Chicago is my writing life. I got my MFA at Columbia College and was so grateful to be in the classrooms of great Chicago writers like Randy Albers, Patty McNair, Megan Stielstra, Joe Meno, Sam Weller, Alexis Pride, Eric May, Christine Rice. I lived in a tiny studio apartment in Lincoln Park, interned at Chicago magazine during the day, went to school at night, wrote at coffee shops in the city on the weekends and did it all over again the next week. When I moved to Massachusetts for six years, I so missed that Chicago energy and support that I moved back here with a husband and baby in tow and revised the hell out of the manuscript that became Of This Much I'm Sure. Most of that book was rewritten at the Starbucks on Montrose and Wolcott in Ravenswood. Almost every single literary experience I've had has been in Chicago. Seeing my former professors and fellow writers kill it every day with publications and story performances motivates me to be a better writer.

Give a general overview of your work. What are your main concerns, ideas?

I'm working on an essay collection called Try Again Politely. Whenever my son asks for something but does not use his manners, I say, "Try again politely." So, if he says, "I want milk," I say, "Try again politely." Then he'll say, "May I have more milk, Mama?" I think that second chances usually work better than punishment or silent treatments. So, as I started writing different essays, I realized that this saying applied to other contexts, as well. In life, we can always try again politely. The collection is about giving and receiving second chances in parenting, marriage, and friendships.

Tell us about the inspiration behind the title of the book. How did you come up with that title?

When I was at the lowest point in our journey--I’d almost died after the egg retrieval procedure, I was an anxious mess, my marriage was near dissolving, I was jealous of every mother I saw, all the doctors were telling us how low our conception odds were--I got an email from my husband’s cousin Amy. She’s a life coach and a doula. Her first sentences were: “You will have a baby, of this much I am sure.” I cannot tell you how hopeful and uplifting it was just to hear someone speak in affirmative, confident language. I repeated this so much that I believed it. I didn't know what the road would hold for us--more IVF, or adoption, or a miracle, but I tried hard to believe that our lives would include a baby. Now, when friends and strangers tell me about their infertility struggles, I repeat those same words. "You will have a baby of this much I'm sure."

Tell us about the events that led to you writing Of This Much I’m Sure: A Memoir. What has been the most interesting?

I decided to write this book because I felt like I was carrying a secret. Going through IVF (in-vitro fertilization) felt like having an affair. I was living a double life. During business hours, I was a university lecturer, but, before work at 6:30 in the morning, I’d be at the blood and ultrasound lab. Then, in the afternoon, I talked on the phone to the nurses about my results. In the evenings, I did my injections. It was all-consuming, and we told no one besides a couple of family members. But then, when I almost bled to death after my egg retrieval procedure, I needed to talk about it because I was fighting for my life. I was in the hospital for five days and then out of work for two and a half weeks. I could have lied about why I was out of commission, but I suddenly realized that our infertility struggles were nothing to be secretive about. Was I not allowed to talk about our story because, god forbid, it involved reproductive organs?

So, I started talking about it, and I started writing about it. I published an essay in PANK about our frozen embryos and the mental anguish of infertility, called “Nine Babies On Ice.” When I realized that our journey could fill a whole book, that’s when the memoir was born.

How long was the writing process for Of This Much I’m Sure? What kind of research did you have to do? What was the most challenging part?

I took a year to write a very crappy rough draft and then a year to heavily revise it.  I relied on journal entries I had written, but there were some things I had to research, like all of the IVF drugs I had to take and the procedures I had to undergo. I had blocked out a lot of that. The most challenging part was adding other layers to the book. I wanted it to be about many things, and I had to keep those storylines going (like my relationship with my mom, my marriage, my homesickness for Chicago) while also following our infertility journey. I kept adding and cutting. At one point the book was almost 500 pages and I made it my goal to get it as close to 300 pages as I could. That was painful. I had to cut some important scenes and characters, but in the end, I know the book is better for it.

In one sentence, what is Of This Much I’m Sure: A Memoir about? Tell me what interests you about this book – or tell me other things, besides books that might constellate around it.

One sentence: After an IVF procedure leads to near-fatal internal bleeding, I must ask myself if the journey to create life is worth risking my own. I appreciate, though, that readers realize that it's not just about IVF. One reader told me this, which was such a beautiful compliment: "This book is about so much more than IVF — it’s about coming of age as a woman, a daughter, a sister a wife, a mother, and, ultimately, a human."

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