Wednesday, May 19, 2004

Blog Hits & IVF

So I installed a cool little hit counter (I found it perusing Julie's blog), and now it's telling me not only how many hits there are, but where they're coming from.

Currently they're coming from a couple of messages I posted on Julie's blog. And since my intuition is that it's mostly ladies coming here, a big Texas HOWDEE! to yall.

And just so you're not totally bored out of your gourd, since you're looking for IVF and infertility-related stuff, I'll share the thumbnail sketch of my story. The problem isn't mine, it's my wife's; but I chose her knowing full well, and now it's our story together.

Way back in the distant past she had what I believe now was PID that, for reasons I won't detail here, wasn't really treated right. When she was 18 (and by this time, married and not using birth control but not actively trying to get pregnant either), she developed a tubal cyst on one side. An emergeny procedure later, she emerged minus one cyst but also minus one tube. Six month later, it happened again on the other side. This time they removed the cyst but left the tube; in the process, though, they had to open the tube lengthwise. The scarring and adhesions from the two surgeries left her without hope of having children. At the time (early 1980's), IVF and related procedures weren't even on the horizon.

Life went on. In the mid-1990's, IVF was developed and my wife and her then-husband put together enough money to take a shot at it. But as they were cash pay clients, she a school teacher and he some kind of hourly repair technician, they only had enough money for one shot. I don't know the details of how it went; I only know that it failed.

For reasons not entirely unrelated, their marriage failed. She lived with another boyfriend for a time, and then met, started dating, and started sleeping with, me.

Confident, however foolishly, that we were disease-free, and knowing that she'd been completely infertile for the past 15 years, we skipped the latex and had our fun all-skin, as it were.

A couple of months after we started dating, our infertility journey began with a period that simply wouldn't quit. Four or five days was her max; I finally convinced her to go to the doctor after nine bloody, chunky days. (I still gross out thinking about it.) With no health insurance, we visited a local doc-in-the-box who sent us, do not pass go, spend lots more than $200, to the local emergency room, where she was diagnosed as having a miscarriage. (Incidentally, I met her oldest sister for the very first time sitting in the waiting room; she wasn't yet comfortable with having me in the examining room.)

Talk about a nightmare. The 15-year dream she could never have had been slammed on the ground in tiny little pieces. It took months to put it back together. In the interim, we made the perhaps foolish decision to again forego birth control, primarily because we hated condoms but also because other methods were also beyond our meager budget. And besides, if the best happened, we'd cope. The best did not happen.

The day after our little escapade at the emergency room, we had to spend all day meeting and greeting guests we cared nothing for and that I'd never met before at her parents' house, for an annual party they throw. I was asked not to eat until all the guests had eaten, because they were afraid I'd eat too much corned beef. Wait until after all the guests had eaten? What was I? Chopped liver? As someone once said, "How woooood!"

A while after we'd gotten married, we decided she wasn't getting any younger (at 37), and we also found out that (a miracle had happened!) her employer's health plan covered IVF, if you picked the right plan. At open enrollment, we picked.

We used the same RE (for the uninitiated, reproductive endocrinologist, a branch of medicine dealing with and treatment of disorders of reproduction) she'd used last time. My step-mom's research for a novel also suggested that these guys are the best around. (Our high-risk OB said that these guys could "get a rock pregnant.")

[The rest of this is written to condense over two years of real time into a few paragraphs. In all truth, I suspect that anyone reading this who's ever done an IVF cycle, success or failure, will be able to read the pain and ache and happy and glee between the lines.]

So, there we went. Ready and ... WAIT! HIV and hep screens. Semen screens ($75 please, insurance doesn't cover that!). Challenge-response test. More waiting. Shot-giving class, and don't forget your orange! Period. Birth control pills, ready set ovarian cyst! All stop. Shit, wait another month. Period. Birth control pills. It's a go! Head to the pharmacy.

What do you mean the insurance will only pay for two days' worth at a time? Damn. So, every other day, we make the 45 minute trip to the pharmacy for our little vials of egg powder and distilled water. Stand in line for an hour, kaching 30 bucks. 45 minutes back. Good thing we work nights. Every few days, another E2 and sono. Wow, lots of little follicles. Okay, showtime! (Damn, her butt looks nasty after all those botched progesterone shots. Good thing I kiss it before each one. Kiss, then alcohol swab, you moron.) [Pharmacist reminds us that this shit costs $58 per amp; we're shooting six amps a day; be thankful the insurance covers it at all.]

Shake and shake the ampule bottle. Don't use the 8g needle on her butt, dumbass. Yes, you really should use the 8g when drawing up the progesterone.

Jack went up the hill to catch a sample of semen. Actually, it was into his office, while his step-mom waited on the couch in the living room, because Jack had to work that day and couldn't take Jill to the retrieval. Without a doubt, his most un-romantic orgasm in history (thus far). At least the semen analysis was almost a giggle.

Retrieve 10. Fertilize 7. Wait wait wait wait wait. Only two made it; sit on a couple more to see if they can go on ice.

Implant, wait wait no survivors for the deep freeze. Wait wait wait. "I don't feel pregnant." Ding dong, the rabbit is dead; and the cycle fails.

So we go for the post-failure consult. "Everything looked okay, except that the cycle failed. Your ovaries responded like they were 41 or 42 years old, but you can try again any time you're ready."

So we wait ... period pills run run run. More E2's, more sonos. We become intimately familiar with both sides of unlubricated Trojan condoms (the red ones, if you've never used one). But it's not all bad. Ever had sex in your ER's office? That was fast, but that was fun too. You are there to get pregnant, after all.

This time Jack gets to go to the retrieval, and while the "pump-and-dump" is slightly less disgusting because step-mom isn't waiting in the next room for it to finish, it is hysterically funny to see all the other couples sitting in the waiting room, holding hands, she holding the blanket and pillows, and he holding his little white paper sack (containing, inside, a biohazard bag, which in turn contains a sample cup and, presumably, his "sample").

Two embryos, two to save to see if we can ice them. In they go ... wait wait wait. More progesterone shots and more butt-bruising and butt-kissing. Poor girl couldn't sit down. And AH-HA! She barfed!

The test is positive. Do the sono and ... oh dear ... twins. But one seems to be smaller than the other. So, back in a week for a repeat sono. This time they're the same size, but one has a heart beat ... and the other does not. Doc says we're free to go to the regular OB, and off we go, and we learn something we did not know about obstetricians offices: A 10:00 A.M. appointment really means any time between 11:30 and about 2. It just depends on how many women he's got in labor at once.

Sleep sleep sleep barf barf barf. Go to a restaurant. First thing he does is check out where the bathroom is in case she has to make an emergency run for it. This tactic pays off more than once. A month to go, name is selected, known to be a boy. Amnio is a wonderful thing. But suddenly, a problem: PIR. Pregnancy-induced retardation. The hormones have made her unbearably stupid and forgetful. But, alas, we love her for what she's been through, what she is, and what she means to us. So we overlook her stupidity, hope it goes away when the pregnancy ends, and hope for the best. But another serious problem crops up at 8 months gestation: Pregnancy-induced hypertension.

[For those who don't know, PIH is a potentially life-threatening problem. Untreated it can lead to organ failure, heart attacks, and strokes. While it can be managed to a certain extent, the only effective treatment is to end the pregnancy. Given its devastating consequences if left unchecked, doctors jump all over this at the first sign of it. At 36 weeks, we were well within the "red zone" of end-of-pregnancy, so our doctors elected to go with an induction. However, a word of caution goes along with this: When you reach the see-you-every-week point in your pregnancy, take your packed hospital bag -every-single-time-. We had no warning she'd be admitted to the hospital during the visit, or that the baby would be born the next day. As a second side-note, he was born on his great-grandfather's birthday; his great grandad is still alive and smiled for the first time in years.]

Baby comes no sleep no sleep no sleep. Life calms down, return to normal.

We want more kids. So we do it again. This time we are amused to learn that they've taken our baby announcement and photograph and put it in our file. They love to receive them, and they ask for them when they do the post-pregnancy follow-up, but they are never placed where patients can see them, only in the break room for the employees to see. A kindness to those who try and try and try and fail.

Period. Pills, E2 sono shots run run run. Don't forget to swing by the pharmacy. But this time we hafta juggle child care too! And wait, they changed the drug protocol! Micro-dose Ovidril. That's new. So instead of a single trigger shot, now there are three, and it's not intra-muscular, it's subcutaneous, so she can do it at work and he doesn't have to drag the kid to work to stick her in the ass in the dark parking lot.

Wait wait wait ... it's time to retrieve.

This time he makes another discovery, which he passes on to those using the same ERs. They have a tiny room with the innocuous sign, "Endocrynology Library." And it includes a hard bench about two feet long, and a sink. And a little nightstand-like thing.

This is the whack-off room, where men go to "produce a sample." Inside the nightstand is an appallingly paltry selection (three individual issues, if I recall correctly) of porn mags. You'd think doctors understand that some (many?) men need some kind of stimulation in the sterile environment of a doctor's office, and this particular situation, the wife's help is unwelcome (must be a "clean catch"). So my suggestion to all you guys out there who are in this situation: If you need to "produce" at the office, and have any hesitation whatsoever that you might not be able to make it happen on cue, and you find pornography helpful ... take your own.

This time, two embryos and one on ice. Sleep sleep sleep barf barf barf. No sign of PIH, but the PIR is back with a vengence. God this lady gets dumb when she's knocked up. And this time, we get invited in to test for PIH at 33 weeks ... so we go to OB triage at the hospital, they hook her up to the monitor, and say, "Did you know you're in labor?"

This hospital doesn't do high-risk (meaning before-34-weeks) deliveries. Ever. Those are sent downtown to the high-risk specialists. In meat wagons. This time, thankfully, with the lights off.

And it's twins: A girl and a boy, in that order. And we're finally done with the story.

Anybody who's ever done any of this knows how hard it is for everybody involved. That, then, is my bit of our collective tale, for all to read. I have nothing but respect for all the people out there still trying ... still trying ... still trying ... despite all their mis-steps and failures. Both the girls and the guys deserve something special for all their effort, win or lose in the infertility lottery. Gotta love 'em all.


  1. [...] ey and jabbing her ass with gigantic needles filled with nasty smelly oily yellow gunk and “producing a sample” in a cup and all that garbage. i dunno the solution excep [...]

  2. [...] e admirable help of my wife) two ivf’s ending in healthy live births. read about it here. while julie and tertia and cec proceed with their respective pregnancies apace, and [...]