The repetition of these lines tells of the desperation of the poet as she continues her transformation into a fish. These lines act as an introduction to the ultimate "unsexing"[link], the brutal and disturbing culmination of this transformation. "And now, and now" seems to be the echoing regrets or doubts she has, for in removing her menstrual cycle and sex organs she has completely transformed without any semblance of her femininity remaining. This is the final [link: it's done] step, one that cannot be erased, and her doubts tell of the difficulty of her situation, but also of the necessity of the transformation.