“No, thanks.” Hannah leans down to the table: Tatler, Harper’s Bazaar, Country Living, Elle. She slides out Elle and flips through it, aware her breath is shallow and short.

Nathan comes over with a small white plastic cup.

“This coffee’s terrible,” he says accusingly. “How much do they charge?”

“Seven thousand.” She speaks quietly, but precisely. He knows this. She knows he knows this.

“Wonder what the rent is on this place?” His voice is a little too loud. The couple on the other side of the room lift their heads. The receptionist pokes her head around the door.

“Dr. Gilani will see you now.”

Hannah stands, smoothing down her skirt. “Thank you.”

Nathan follows her up the stairs. “Nice paintings,” he says, as they pass a series of lurid abstracts.

Dr. Gilani sits behind a broad desk in a huge room. He is a large, smiling bear of a man. He leans forward to greet them, grasping their hands in his paws. “Good to meet you,” he says, and looks as though he means it. “Please, sit down.”

“So,” he says, as they sit. “I’ve been reading through your notes. As you know, Hannah, there is a large proportion of women like yourself for whom there is no known cause of infertility.”

Hannah nods.

“And the fact that you have been pregnant once already, despite the miscarriage, is a good thing. The good news is that you might still conceive at any time. The bad news is that there is nothing, other than the usual, that we can tell you to do to help. But”—he smiles—“we are very well equipped here.”

Nathan looks around the room, as though scanning it for equipment, but the room, despite its vast size, looks empty.

Dr. Gilani runs through the treatments he can offer that the National Health Service cannot: the time-lapse cameras, the frequent scans, the womb scraping, the egg transfers on the weekend. All of it adding up to success rates in the 30 percent range, for patients of Hannah’s age.

“What’s womb scraping?” says Nathan. “It sounds barbaric.”

“It’s a technique,” says Dr. Gilani, “that has been shown to help with implantation. Here.” He passes a piece of paper over the desk. He has underlined the numbers: 32 percent pregnancy, ages 35 to 38. The live birth rates that follow are lower. The fee is in small figures at the bottom of the page.

“Can you give me an idea . . .” says Nathan. “A breakdown of the costs?”

Dr. Gilani’s smile is immovable. “Of course, I can have my secretary prepare it.”

“It’s just—it’s an awful lot of money,” says Nathan. “Isn’t it? For something that is 70 percent likely to fail.”

Hannah presses the nail of her thumb into the palm of her opposite hand.

“I understand.” Dr. Gilani gives the smallest of glances to the clock on the wall. “Many of our patients use their insurance to cover—”