Every time I have done IVF, it has shattered me a little on the inside. It shatters—and exhausts—me because I know for the next four weeks, Bitter and Hope will be coming to stay as houseguests. Hope is great—she really makes such an effort, is so encouraging to me with gentle words and whispers like, “it’s okay that you have to cancel your plans to go to that wedding—remember the big picture is that you could be pregnant in a month.” Bitter, of course, is more of a bitch as a houseguest: “Ha—you are getting bruises from the progesterone shots and you won’t even turn out to be pregnant. It looks like a fucking firing range on your belly.” And the two constantly battle it out in our home—fighting over who gets to sit on the sofa next to me, who gets to eat with me and who is going to go play tennis or walk the dogs with me. It’s hard to ignore those two and each time I did IVF (I am about to start my ninth—and final— round), Bitter got louder and more aggressive and Hope became more of a recluse, hanging out more in my room and, though still sweet, I felt like a distance had grown between us.

My first round of IVF, when I was 39 and decided to freeze my eggs in a rare show of good planning, Hope was the only one who arrived at my door and encouraged me with my needles. Because she was there and put me in such a good mood, I didn’t mind giving myself the daily shots and found they did not really hurt at all (it helps having a belly). Even when I was nervous about taking the Ovitrel (the shot that releases the eggs for collection), which has to be taken exactly 36 hours before your retrieval appointment, she was awesome, making jokes and relaxing me. When the eggs were taken out and frozen, Hope stood by me and was excited that there were five. But it was that day at the clinic, when I was still groggy from the anesthetic (like, the only good thing about IVF), when Bitter popped in for the first time. “Boy, nothing like being down to the wire on this one, Brownell. One month from now and you would have been screwed,” she said, wearing a leather skirt, tank top and filing her nails, which pissed me off because it’s supposed to be a sanitary environment. (In the UK, you cannot freeze your eggs if you are over 40 and I had stupidly waited just a month before my 40th birthday to do the freezing).

I had had brief meetings with Bitter over the years—she especially stuck close when I was in my early 30s and so many friends were getting married and starting families and I was still single—and I was not a big fan. But Hope and I walked right by her on our merry way out of the clinic, hand in hand and excited about the possibilities. The next time these ying-yangers showed up was my first full round of IVF, when I was still single and using donor sperm. Hope arrived first, unpacked her bags and helped me keep my mind busy during those first two weeks of shots and drama. We went for ultrasounds together, we went to the movies—it was all good. Bitter did pop in every few days, to tell me how sad it was I was trying to get pregnant on my own, but I told her to piss off each time and Hope and I would go on shopping excursions.

I got pregnant and Hope was on fire—she was totally there for me when I wanted to eat sushi but I couldn’t and any time Worry (a constant companion who is not even worth mentioning because she is like my Siamese twin) put her two words in, Hope was there to shoot her down. We were ecstatic, contemplating names, where to have the baby (London or the US), what schools might be good and how much fun it was going to be to go baby clothes shopping. But, ding-dong, Bitter stopped by about six weeks in, when my blood levels weren’t as high as they should be for a pregnancy. And she fully dropped her bags and started squatting in my house when I found out I had to have a DNC because the pregnancy was not working.

Bitter and I took off for Thailand for three weeks afterwards and she was a constant drinking companion. Hope didn’t even bother to show up, going off and gallivanting with some other happy pregnant woman, which upset me because I wanted her to be there for me. Bitter would grab me by the shoulders and say, “Screw her, she’s a fair weather friend, but I am always here for you when you need me” and make me take a shot.  Luckily, I decided to leave Bitter in Thailand and hoped she would stay there for good. Later that year I fell in love and a year later got married. Hope was invited to the wedding and she was an amazing guest, chatting it up with everybody and helping me with the train of my dress. My husband and I, because of my age and history, had to start doing IVF pretty much from the start and Hope was there, excited and happy to be back. But as each round proved unsuccessful (some rounds were partial IVF with freezing while a few were fresh transfers), Bitter took a fast plane from Thailand or wherever she had been hiding. “You idiot, you waited too long to get married and you put your career and travel ahead of children,” she told me pretty much every day as I would take out the meds, mix them like a damned chemist and jab myself.

Don’t get me wrong—Hope for sure was around and was encouraging, but her voice was becoming weaker with each failed IVF and when I was hormonal, stressed or sad about the process, she seemed distracted and a bit distant. Bitter, meanwhile, seemed to be growing, becoming louder, bumping my dogs off the sofa to sit closer to me and reading Facebook over my shoulder. She would make comments like, “oh, look at that—your friend X is complaining about her kids waking her up on the weekends—don’t you just hate it when you, who cannot seem to get pregnant, have to read that?” She would jab her finger in my business and say, “IN YOUR FACE, girl! Doesn’t it anger you? Hey, and look here, a FB post of a funny mom blog where the mother is writing an ironic letter to her kids about being their maid over the summer. Hahahaha, you’ll never know that will you? It’s like they are taunting you. Look how much money you have spent on IVF and you have nothing to show for it and meanwhile your friends have a quick fumble with their husbands or boyfriends and get knocked up—for free!” Bitter smiled and took a swig of beer and lit up a cigarette. I kicked her out, telling her no smoking in the house. She went outside, cracking up.

But, to be honest, I was angry and bitter about it, though I was at pains not to let myself feel that way. It pissed me off and seemed so unfair (not that life is fair but…). And it also made me sad me how silent women are  about things like IVF and miscarriages. It’s great that Mark Zuckerberg, the founder of Facebook, recently publically shared he and his wife’s pain after several miscarriages. But so many women I talked to had gone through IVF, and there is this embarrassment (and bitterness) about the process that seems to make women (and men) unable to discuss everything from finding out you might only get pregnant via IVF to being ashamed and silent when it doesn’t work. I started thinking, “why is there shame in talking about IVF?” Sharing problems, acknowledging what a bastard it can be and what great, deep heartache it can cause when it goes wrong should be something we can talk about freely and openly. I found it really helped to talk to friends (some people I think are shocked and surprised how open I have been with my fertility struggles) to ask questions about their experiences and expectations. So I decided to write a book, something that will look at the social history of IVF—from the death threats that Louise Brown’s mother received after it was announced that she had given birth to the world’s first “test tube baby” to how these days on the streets of Manhattan you seem to see more twin babies every block or so being walked in a stroller by their older mothers—to examine how much has, and has not, changed in the almost four decades since IVF first worked.

Bitter came around again this summer, when my last IVF did not work. My doctor and I had been experimenting with her putting me through menopause and then dosing me up with drugs in an attempt to boost my LH numbers (I am too lazy to explain). The day before my egg collection  (which had screwed up my summer, making me miss my beloved 4th of July in Michigan and giving Bitter a good hearty laugh) she called me while I was watching a tennis match at Wimbledon, saying that this should likely be my last full round. My age meant my eggs were getting less likely to work (and the big myth is that IVF is super-successful, when actually only about 10-20% of women who do IVF actually have babies to term) and maybe it was time to focus on using our frozen material—my eggs from when I was 39 and a few frozen embryos we had left. It was such a strange experience–listening  to such disappointing and sad news while simultaneously hearing the clapping from the crowd over some good play on Court 1 by Rafal Nadal.

But as she was telling me all this, you know who showed up? Not Hope.  Not Bitter.  Not Worry—but Relief. Relief came over, gave me a massive bear hug and said to me through my tears that if this round did not work, I didn’t have to poke myself any more with those fucking needles and so wasn’t that nice? She told me I didn’t have to sob anymore every time I took a pregnancy test and saw it was negative. That I  didn’t have to listen to Bitter laugh when I heard that some friend of a friend accidentally got pregnant with her fourth kid and was bummed out about it. Relief wiped my tears, and told me that this wasn’t the end, I just needed to recalibrate my thinking.

I didn’t get pregnant on this last attempt over the summer, though I did have a funny story about having to inject myself with Ovitrel in the middle of the Taylor Swift concert in Hyde Park. I had to take the shot at exactly 9pm–I think she was singing “Blank Space”–and so I wandered over to a relatively dark corner of the park to give myself the shot but, to my horror, I saw that I did not have the syringe. Since I had to keep the serum cold, I had taken the Ovitrel out of the box so it would not be so bulky in my bag, and enveloped it in a bag of frozen peas. But I had accidentally thrown the needle out, which you have to screw on right before you inject. But, like some needle nob, I had a used syringe from an earlier injection I had had to take during the day. So I just screwed the old needle on and, like some heroin addict, injected myself right in the middle of the park with people looking on. It was one of the few times that Hope, Bitter and I all cackled together.

Bitter showed up a few weeks later– when I was finally in Michigan on vacation– after I took my pregnancy test which was negative. She mocked me for having been on hormones for two months, all which had turned out to be all for naught. But I shoved her aside as Relief and I took long walks on the beaches of Lake Michigan, talking, thinking and healing. My husband and I have reassessed how we are to become parents. I am doing another last IVF attempt to farm more eggs for surrogacy, which is the path we have decided on for now. Bitter stills shows up at our door from time to time, but I slam the door in her face. Luckily, Hope hangs out a lot more now, doing yoga with me, running and getting massages. She’s really is a good friend. I won’t let Bitter ruin Hope for me any longer.