Mal’s on and off heats finally came to an end—after a long week spent mostly on his own, the stimulation period was over. Dr. Kanna had collected his ova and fertilized them with the donor sperm Mal had chosen after hours of scrutiny. Six days following fertilization, the two embryos that had developed were transferred. Logically, Mal knew that it was too early to tell if the embryos had taken or not, but it hadn’t stopped him from glowing for the last several weeks, certain that this time, he’d get good news.

The two-week wait was always the hardest part. Seated in the waiting room of Dr. Kanna’s office, Mal watched the time tick by. He’d already done this twice before, and he knew the routine. One of Dr. Kanna’s assistants had already performed a blood draw—now all he had to do was wait while the sample was analyzed. If pregnancy hormones were detected in the sample, then the IVF had worked, and he could expect to be a father in nine months’ time. If the tests came back negative…

Mal didn’t want to think about it.

There was no way that could happen, anyway. Today was his birthday, after all—the big five-oh. The universe owed him a gift.

Five minutes passed, then ten. At the fifteen-minute mark, Dr. Kanna opened the door leading to the back offices and smiled kindly at Mal. “Mr. Collins?”

Mal stood and came to join her at the door. “Hello, doctor. I hope you’re doing well.”

“I am. It’s nice to see you again.” Dr. Kanna gestured down the hallway. “Let’s go sit in my office. There’s something we need to discuss.”

That was new, and new was good. Mal perked up and followed her. By now, he knew the way to the small, inoffensive office at the back of the building. Its walls were painted an eggshell blue, and the trim matched the furniture—white, all of it. Dr. Kanna kept a succulent on her desk. Mal had no idea what kind, but its thick, green, symmetrical leaves were a pleasure to look at. He’d stared at them more than once while Dr. Kanna sat him down to deliver bad news and discuss his options.

How pretty would they look when he heard the news he’d been waiting for?

Dr. Kanna showed him to his chair, then went around the desk to sit on her own. There was a closed patient folder on her desk, labeled neatly with a white sticker on its tab that read COLLINS, M. Mal looked at it once he was seated, then back at Dr. Kanna expectantly. Her short black hair was cut rigidly in a dynamic, trendy way that Mal thought suited the angles of her face, and her expression, although always friendly, seemed stern in ways it had never been before.

“We’ve had time to analyze the blood sample you provided,” Dr. Kanna said. She folded her hands upon the desk. “I’m sorry to say that the procedure didn’t take, Mr. Collins.”

The news hit Mal like rebar swung at his chest. His lungs tightened and his stomach clenched.

Maybe he hadn’t heard her correctly. It was his third treatment. It had to have worked.

“I’m sorry,” Mal said with a small, nervous laugh. “Can you repeat that? I didn’t catch it.”

Dr. Kanna frowned. “There have been no changes in your hormones. I’m sorry, Mr. Collins—the procedure didn’t take.”

That couldn’t be right. Any second now, Dr. Kanna was going to burst out laughing and pat his arm and tell him that it was all a joke. But the stern, almost apologetic look on Dr. Kanna’s face didn’t give way. It remained flat and stagnant, and Mal was forced to confront it.

The IVF had failed again.

“Then we’ll start another round of stimulants, right?” Mal sat a little straighter in his chair, as if proper posture might help him figure out the best course of action. “I’m a pro at the injections by now. I can start them again, and then you can retrieve the eggs that develop, and…”

Dr. Kanna shook her head. The stern look on her face degenerated into sympathy. “At this point, I can’t recommend that you go forward with another treatment, Mr. Collins. I’m sorry. The more stimulants you receive, the higher your risk for adverse effects. The pseudo-heats you experience from the injections will only strengthen over time, and your quality of life will degrade the worse they get. At your age—”

“At my age, I need to go forward with this!” Mal stressed. His heart had taken off at a sprint and left his body behind—a strange, chilling numbness spread through his chest in its absence. “I can’t stop now. I can’t.”

“And at this point, I can’t continue.” Dr. Kanna’s frown was apologetic, but it did little to soothe the anguish and panic building inside Mal. “I can’t continue to treat you knowing what effects it will have on your general health. I’m sorry, Mr. Collins.”

It was a no.

After all the treatments he’d been through—the public humiliation, the anxiety, the fear—nothing more could be done. Mal parted his lips to speak, but there were no words. No syllable could encapsulate the heartache of being told the family he wanted was out of his reach. What did his health matter if he had no one to share his future with?

A lump rose in Mal’s throat. Tears dotted his eyes, and he blinked them away.

People made babies accidentally all the time, but here he was, still barren, despite medical intervention and ideal conditions.

What was wrong with him? What part of him made him so hostile to life that he couldn’t conceive under perfect circumstances?

A single tear rolled down Mal’s cheek. He hurriedly brushed it away with his hand. There had to be another way—a way that Mal couldn’t see through his distress. If he could calm himself down, he could have an honest conversation with Dr. Kanna and figure out the best way forward. All he had to do was think.

Mal let his shoulders slump. He took a slow but steady breath in an attempt to refresh his body and mind.

“Are there other fertility clinics you could recommend?” Mal asked at last. He kept his voice as even as he could, refusing to let his emotions get the best of him. “I know that at my age, there may be some practices unwilling to treat me, but… but there has to be someone else, right? Another option?”

Dr. Kanna’s gaze was set on the succulent, as if she found comfort in its symmetry, too. “I’m sorry.” Her tone was laced with finality.

“Is this really it?” Mal bit the inside of his lip, trying to keep himself in check. “There’s nothing you can do to help?”

Dr. Kanna sighed. She looked off to the side, then ran a hand nervously up her arm. When she met his gaze again, Mal saw the hesitance in her expression. “There is one last option.”

“Tell me.”

Dr. Kanna traced her hand back down her arm until it came to rest at her wrist. “One of Aurora’s pharmaceutical companies is holding a clinical trial for a new fertility medication. Allegedly, the stimulant they’ve developed doesn’t only encourage the body to produce viable ova, but augments the chance that the embryos produced by those ova will attach and result in pregnancy.” Her dark eyes turned obsidian. “The drug is in phase one testing, and the trial is looking for suitable patients of all ages and genetic varieties. Those selected will be the first human patients to receive treatment.”

“The first?” Mal studied her face in an attempt to parse her reactions. Did she look so stern because she was fearful of the risk the trial posed, or was it because she didn’t think he could be part of it? Mal didn’t know.

“There’s no telling what could happen,” Dr. Kanna admitted. “The literature that was sent with the invitation for referral was solid, but there is always a risk when human lives are drawn into the equation.”

“But it might work?” Whatever problems he’d encounter would be worth the risk. “What about the baby? Are there any side effects for the baby?”

“None that have arisen pre-human trials,” Dr. Kanna said. “But, as I said, there haven’t been any studies done on human patients. It’s impossible to say for sure. If you choose to participate and are selected as a candidate, the doctors who are working on the clinical trial can tell you more—I only received their reports and findings, enough that I feel comfortable recommending the process to child-bearers who are struggling to conceive.”

“How soon does the trial begin?” A rush of fear swept through Mal, stirring the hairs on the back of his neck and tightening his muscles. It was followed closely by adrenaline. If traditional IVF wasn’t going to work for him, this was his last chance to conceive. The dream that had crashed and burned today had one last chance to rise from its ashes.

She studied him, meeting his gaze fearlessly, but Mal would not be discouraged. He matched her intensity and returned it until, at last, she spoke. “The trial will begin in mid-March, approximately two weeks from now. Candidates are being selected from a pool by referral only. If you’d like, I could submit your name for consideration.”

Two weeks had stretched into forever after each embryo transfer, but objectively, Mal knew it wasn’t a long time. In two weeks, he’d find out if he was selected, and from there, the process would begin again.

New doctors. New medication. New hopes…

“Yes, please.” Mal didn’t hesitate. “I’ll sign whatever papers you need me to.”

“I will be upfront with you about the process.” As Dr. Kanna spoke, she opened one of her desk drawers and withdrew a packet printed on crisp white paper. It was stapled together on the top left corner. “When the application is submitted, it will include your full medical history, including the treatments that you’ve received here in the clinic. You may not be selected. The first pool of candidates is generally small in a clinic trial. The odds are stacked against you.”

“I understand, and that’s okay… but I have to try.” Mal accepted the packet from her. The front page, upon first glance, seemed to be a detailed account of the proposed clinical trial as it related to potential candidates. “Thank you. I know that it’s not likely, but… it gives me hope.”

“I only hope that your choices lead you to what you want, Mr. Collins. I urge you to read through the attached literature and make the decision for yourself. This could be the solution to your struggles with fertility… but it could lead to more heartache as well. If you choose to do this, your heart and your mind need to be ready.”

Mal nodded. He looked down at the packet, then up at Dr. Kanna. “I understand. I’m prepared.”

Dr. Kanna offered him a thin smile.

“Should I fill it out in the lobby?” Mal asked. “I want to submit it as soon as possible, since the trial is starting so soon.”

“The lobby is fine. The receptionist on duty will set you up with a clipboard. You can return the document to her once it’s completed, and the clinic will submit it for consideration.”

It was everything Mal needed to hear. He nodded. The glowing hope he’d walked in with had decayed, and in its place was wavering, muddled anxiety that was lined with uncertain excitement. What if he wasn’t selected? What if he was? What if something went wrong with the procedure? What if the problem was that something was fundamentally wrong with him?

There were no answers in the present, and no solace to be found in speculation. If Mal didn’t try, he’d never know.

He reached across the table to shake Dr. Kanna’s hand. Her grip was firm and certain, and in it, Mal found the courage he needed.

It had taken him decades to quiet the demons inside him. Even following in-patient therapy, he’d struggled with issues of self-worth. But now, though those demons still whispered to him in his dreams, he was ready. He was strong and capable. He was resilient.

He’d chase this clinical trial relentlessly—the pursuer instead of the pursued.

He’d start his family the way he wanted.

And if his plans didn’t work out the way he hoped they would, he’d find other ways to start the family he wanted. Surrogacy, foster care, adoption… he’d find what was right for him and make it work.

Today’s news wasn’t the birthday gift he’d been anticipating, but he was hopeful for it all the same. One step backward wasn’t so bad when he’d taken three steps forward. Despite his setbacks, the universe was on his side—as long as he continued to persevere, nothing was out of his reach.