My IVF lifeFertility problemsJean Hannah Edelstein continues the complicated journey to conceive using in-vitro fertilization – and takes readers with her
I’m going to build a shelf, E announces. It’s a few days before I am – we are – due to start IVF injections. E is good at building things. Maybe it’s his love language.
I don’t want a shelf, I say, I don’t want this to become a permanent part of our apartment!
But I thought I was going to be in charge of organizing the medication, E says. (He’s also good at organizing things.)
It’s true that this is what we’d agreed to, after our intro class, but now that I’m about to start treatment I don’t know what I want. I’m anxious and angry.
Maybe not, I say, maybe I just want to do this all on my own! It’s my body!
I know, E says, but how else can I be part of it?
In the end, we compromise. I let him buy a large plastic box from the Container Store, I let him organize the boxes of medication and syringes and alcohol pads. He stacks the drugs that need to be kept cool in the fridge, next to the yogurt. When the time comes for the first injection, I am too afraid, and ask him to do it. E is kind enough to accept the job without mentioning my change of heart.
This is the plan for my egg retrieval cycle: each evening E injects me in the stomach with two drugs. They pause my normal menstrual cycle and stimulate my ovaries to grow multiple egg-containing follicles to maturity. In the morning, I go to the hospital before work along with dozens of other women who are also having egg retrievals, some for IVF, like me. Some to freeze unfertilized eggs for future use.
At the hospital the other women and I have blood drawn, to check our hormone levels, and we have transvaginal ultrasounds, to count the number of egg-containing follicles that are growing in our ovaries. The ultrasounds are invasive, but by the fifth or sixth day become routine. I ignore the feeling and scrutinize the screen as if I’m an aspirant sonographer. The doctors doing the ultrasounds take screenshots of the follicles. Each morning I feel like the count is not high enough, although I also don’t know exactly how many I should be aiming for. “You just need one” is something that people write in IVF forums online, to be encouraging. It’s technically true, but statistically unlikely.
The benefit of having treatment in a large teaching hospital is access to great doctors and cutting-edge research. The drawback of having treatment in a large teaching hospital is that it is very crowded. One weekend morning I find that there is nowhere to sit in the waiting room because so many chairs are being occupied not just by the women who are being treated, but by their male partners who have accompanied them.
I regard the men with rage while I, and several other women, lean against the wall. I text E, who is not there, because the hospital is an hour-long subway ride from where we live. It had not occurred to me that he should come along.
If you were here, I write, you would not have a chair! I would not allow it!
Of course not, he replies.
The hormones are making me moody.
They are also making me doughy. My jeans no longer fit comfortably and when I get home from the office in the evening I lie on the sofa and watch Sex and the City until 9.30, when E draws the drugs into the syringes and injects me again. A third drug is added, to stop me from ovulating too soon. I feel like a pallid, slow version of my former self. I can’t exercise, in case my swollen ovaries twist. I don’t want to see friends or go out to dinner or walk the dog.
I can’t exercise, in case my swollen ovaries twist. I don’t want to see friends or go out to dinner or walk the dogI go to an additional appointment to the doctor, a standard procedure to check my uterus for obstructions that could make it hard for me to get pregnant. Take some ibuprofen afterwards, the doctor advises, and I do, and I go to my office and am overcome an hour later by cramping so excruciating I assume this must be what it feels like to go into labor.
After 10 days the follicles are large enough for the eggs to be retrieved. It is time for the trigger shot, which ripens all of the follicles at once so that they’re ready. E and I brace ourselves and he stabs the large needle into the flesh of my bum at the appointed time. It’s an act of love.
Isn’t it funny, I say, that some people have sex to have children! We laugh.
Thirty-six hours later, we return to the hospital for the retrieval. I will go under twilight anesthesia so that a doctor can pull the eggs out of my ovaries with another big needle. E will go into a small room with pornography to produce a semen sample. Our respective products will be combined by someone in a lab, to try to make embryos.
The man in the queue for the small room behind E has the same first name as him.
I hope they don’t mix your sperm up with Other E’s, I whisper to E.
We’ll never know, he whispers back, that guy also looks like a Jew from New Jersey.
Five days later we have the results. Eleven eggs were retrieved. But only two of them survive until the fifth day, which is how long they have to grow before they can be biopsied for the genetic testing, which is the whole reason we’re doing IVF in the first place.
The odds of one of our embryos having the gene for Lynch syndrome is 50%. Two embryos is not enough. I feel despondent. I thought that we were halfway through the process, but now we’re back at the beginning. In the days since the retrieval, the effects of the withdrawal from the hormones are worse than the ones I had from the injections: I’m doughier than ever, exhausted, depressed. This news does not help.
I’m sorry, the doctor says, when we have a call to discuss it. You can do another round next month.
OK, I say. Yes.
This week I learned: it’s not uncommon for numbers of potential embryos to drop by at least half from egg retrieval to fertilization, and the same again from fertilization to day five.
Jean Hannah Edelstein is the author of the forthcoming This Really Isn’t About You
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