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Book Review: Avalanche – A Love Story

9 January 2017
Appeared in BioNews 883

Avalanche: A Love Story

By Julia Leigh

Published by Faber and Faber

ISBN-10: 057133329X, ISBN-13: 978-0571333295

Buy this book from Amazon UK

Avalanche is a courageous and intimate account of Australian novelist Julia Leigh's attempts to have a child through IVF.

Writing in the immediate aftermath of her decision to stop treatment, Leigh exposes the raw realities of her experience: feelings of pain, loneliness and disappointment: emotions often hidden away by the more mainstream narratives of conception.

Leigh's 'Love Story' begins with a racy and romantic account of her relationship with Paul, a former university boyfriend with whom she reconnects with at the age of 37. Leigh recounts the soft and blissful days that follow their reunion, culminating – at least for Leigh – in a spectacular engagement. 'The sun exploded then reformed,' she writes.

Married, and with unblemished optimism to start a family, the couple soon visit an IVF clinic in order to reverse Paul's vasectomy. Leigh's child, or rather their child – 'the treasured child-to-be' – seems like it might finally be. The forgone inevitability of Leigh's child-to-be, much like that of her relationship with Paul, however, is misconceived. Paul leaves Leigh after her creative career takes off; he perceives a de-prioritisation of the relationship when Leigh takes a six-month break from attempting to procreate, and deems this too selfish for him to bear.

Knowing how desperately she wants a child, Paul freezes some of his sperm for Leigh. But he whimsically dangles his consent for her to use this in her face, before snatching it and 'their child' from her shortly after. Leigh is devastated. Aged 42, and after several setbacks, Leigh finds a new and suitable donor.

Aged 44, after six years of attempting to fall pregnant and six gruelling rounds of IVF, Leigh decides to stop trying for a baby. Avalanche details the highs and lows of Leigh's IVF journey in a feverishly solipsistic and personal account.

Leigh's writing style is engaging not only for its rawness and humanity, but also for its scientifically informative approach. The account is punctuated with statistics, clinical procedures and test results, providing a unique insight into the world of IVF itself.

'A second needle was introduced to my nightly regime. I would continue with the Gonal-f but add Orgalutran, which would stop the eggs from releasing: they had to remain in place for collection. That needle was a little more difficult than the Gonal-f. The needle tip itself was thicker and it required more force, more overcoming to puncture the skin .... I carried out my instructions with the precision of an astronaut.'

The pace of the narrative is thrilling. And the abundance of treatments that Leigh receives is relentless: like an avalanche, one might say. This multiplicity of treatments also raises ethical questions about the costs of IVF and of a market that preys on our most elemental desires.

'We discussed my options for the next cycle. I'd do a new egg collection. She raised some "optional extras" that were available as part of the service .... For $265 I was also offered "assisted hatching" ... and on top of that – if I wanted – I could try "embryo glue" for $150, this was also supposed to aid implantation. I asked her whether there was evidence for increased chances of success with the assisted hatching and the embryo glue …. She said there was no clear evidence but that if I went ahead I could say I'd done all I could.'

Leigh's account also raises important questions over the way those pursuing IVF are treated by wider society, and of the stigma that still surrounds the process. When her luggage containing progesterone pessaries goes missing on a flight from Sydney, the ER doctor's response whom Leigh accosts for a new prescription is resoundingly dismissive: 'We treat sick people here.'

Leigh also speaks of the isolating effect of the process even amongst her friends: 'I didn't want to tell people because I thought that unless they were involved in that world themselves they wouldn't want to listen.'

By the end of the book, Leigh appears to have made peace with the frustrations of her failed IVF, and commits to unshackling herself from the great love that she had wanted to give to her own child. The honesty that Leigh displays in Avalanche makes it a deeply human account. I'd highly recommend it to anyone to read.  

Buy Avalanche: A Love Story from Amazon UK.

5 December 2016 - by Lucas Taylor 
There is a lack of quality evidence on the benefits of almost all fertility clinic add-on treatments, a study published in the BMJ has suggested...
5 December 2016 - by Professor Adam Balen 
Professor Adam Balen argues that the recent Panorama investigation into the use of add-ons in fertility clinics is a misrepresentation of these clinics and a misunderstanding of the data...
5 December 2016 - by Dr Jane Currie 
Panorama's investigation into the use of 'add-ons' in private fertility clinics is a novel mixture of undercover journalism and a high-quality systematic review of the clinical evidence...
6 June 2016 - by Dr Mary Yarwood 
An Australian documentary has claimed that women over 40 are being misled about their chances of conceiving via IVF treatment when using their own eggs...
23 May 2016 - by Lone Hørlyck 
A number of fertility specialists have raised concerns over private clinics offering expensive 'add-on' treatments to patients, sometimes without sufficient evidence of their effectiveness...
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