For people who have no direct experience with IVF the whole test tube baby thing can be a bit of mysterious hoodoo. Most people know that the babies are created in the lab but the process by which they get to that point may as well be witchcraft. So, as we’re embarking on Operation IVF Sibling this month, I thought I’d shed some light on the topic and fill you in on what really happens from first jab to lab. I have to warn you that between the drugs and the unavoidable mind games it can become a bit of a decent into madness so prepare for a bit of a crazy journey.
It’s no secret that I’m a woman who does not suffer fools. My patience and tolerance are only fair to middling at the best of times, I’ve been known to put 2 and 2 together and get 46, so getting me hopped up on a hormone cocktail is really inviting danger. The effect it has on your body and mind is like a case of PMS on really kick arse crack and it can result in behaviour I’m not necessarily proud of. For the purposes of this study this will be rated on a Hormonal Hazard (HH) scale from 1 to 10:
1. No cause for alarm. Negligible urge to stab, punch or otherwise maim unless provoked with extreme stupidity, a reaction to which has nothing to do with hormones and everything to do with an inability to tolerate fuckwits.
5. Danger level moderate. Emotional and/or aggressive outbursts can usually be tamed with chocolate, compliments and carefully selected humour although it should be noted that one man’s witty jibe is another woman’s invitation to rip his head off.
10. Approach with extreme caution. May be prone to bouts of violence, rage, tears or a combination of any these without warning. Sudden moves are inadvisable as is turning your back. Know that you are wrong. Whatever it is, you are wrong. Accept this and shut up, this is not the time to be a smart arse, it’s not cute.
Day 1: Husband arrives home clutching a cooler bag full of needles and drugs and weirdly enough the mood is almost Christmassy, it’s like he’s brought me something pretty rather than pointy. My prevalent emotion is excitement, nervous excitement but excitement all the same. Until it’s time for me to shove a hormone filled syringe into my belly, then it’s more just the nervousness. It’s not like I haven’t done it before but plunging a needle into my own skin really goes against all of my natural, rational instincts to, oooh I don’t know, not plunge a needle into my skin…? After pacing the kitchen for a few minutes trying to overcome my instinctual aversion to pain in all it’s guises I’m still no closer doing anything productive with it. Husband offers useful doctorly advice like ‘just do it, it won’t hurt much’ and I’m tempted to ram it into him instead. You’d think that being married to a doctor I’d delegate this job to him but I still have rather fresh memories of his dart player-esque technique last time around that made me relieve him of those duties. I’ve no doubt he’s an excellent orthopaedic surgeon, which is a good thing because he’d make a shitty nurse (sorry honey).
HH level 1: Aside from that momentary threat with the needle (which he as was asking for) there is no present danger.
Day 3: Everything is going smoothly and I’m back to being an old pro with the injections. They need to be administered at the same time every evening so like the clever multi-tasking woman I am I deliver the drugs into my belly between dishing up dinner – ‘what’s for dinner honey?’, ‘tonight we’re having steak and shooting up darling’.
HH Level 2. Still no major emotional spikes, well none that are IVF related anyway. There was an incident involving a Telstra’s customer service rep but that’s a separate matter.
Day 5: Today is the first ovary inspection when I take my little egg sacks off to see how they’re progressing and hopefully see a flock of follicles growing in response to the medication (NB: I’m not sure that ‘flock’ is the actual medical term for a group of follicles but it sounds quite appropriate). There’s only one way to do this and it involves a pair of stirrups, an ultrasound probe and some KY jelly. Fortunately I’ve been through this process more times than I can count so I have no modesty issues with dropping my knickers any more. However, today was the first time I have seen a doctor use the finger of a latex glove instead of a condom to cover the probe and I can assure you it took all of my self-control to resist snickering and juvenile comments.
Childishness aside it looks as though I have about 5 or 6 follicles growing in each ovary. This is good news but, as I’d half-expected from our last IVF experience the eggs are still quite small thanks to my ovaries being lazy bastards. Doc decides to ramp up my medication to scare them into activity.
HH Level 3. More on the emotional than irrational side. Even though the whole slow growth thing isn’t a major and I half-expected it, I still can’t help sneaky little ‘what-ifs’ creeping in.
Day 6: The IVF protocol we’re using is called the antagonist approach that combines an initial drug to bully my ovaries into over-producing eggs and later, a second drug to stop them releasing those eggs prematurely. This is important because a). that would be a waste of drugs and eggs and stabbing myself and, b). if we got all carried away and did the wild thing unleashing millions of sperm with 12 eggs floating around things could get very messy. To ensure this doesn’t happen I start a second nightly injection from today but I’m not whinging about it because as much as I want another child, I definitely do not want 12 of them.
HH Level 3. No further cause for alarm today.
Day 7: I’m answering the daily 7pm drug alarm and as I have a needle halfway into myself Zara (who husband is supposed to be keeping at a distance) starts climbing my leg. This is far from fucking ideal as I explain to husband in very succinct terms and more needle waving threats. We are understood.
HH Level 5.8. Moderate with unpredictable spikes
Day 8: Second scan. It seems the wake up call from the extra dose of drugs is having the desired effect. My wee follicles are growing well and all things being equal we’re looking at an egg collection in about 6 days time. Husband has a conference in Sydney to attend early next week so the timing works out well for him to go and be back with his testicles in time for when he’ll be required to make his contribution to the cause.
The whole IVF process is very time critical, once you set the wheels in motion it really does have to take precedence over everything else. There’s no arranging things to suit busy schedules, when those eggs are ready to be harvested there’s no fucking about. Husband has his work on a watch and act alert for next week as he’ll be required to take a day off and play his part at relatively short notice.
HH Level 3. The growth in follicles is reassuring and I’m feeling like things are going well and a mood of calm descends. For now…
Day 9: I’m feeling full and fat. My belly is getting rounded, there’s a sensation of heaviness and a constant dull ache in my lower abdomen where I’m assuming all the eggs are starting to jostle for space. Given that there’s about 12 times as many eggs as there would be in a normal month this makes sense I guess but I almost feel as if I should rattle when I walk. There’s also a rather artful dot to dot pattern of bruises spattering my stomach, most likely from my poor needle technique, apparently I’d make a pretty shitty nurse too. Just as well, I can’t stand blood and gore.
Whilst perusing food porn sites this evening I’ve discovered there is an amazing new breed of locally made coconut milk ice cream on the market. I think I may have seen it on sale at the posh grocers up the road and although it’s 8:30pm, and the likelihood of the shop being still open is slim, I need husband to go and check just in case. I explain the urgency of this task to him; he thinks I’m joking. I’m not laughing. He goes.
HH Level 7.5. Spikes are becoming more frequent and severe and can alternate between eerie tranquillity and very stormy waters. Don’t get comfortable.
Day 10: Wine. I miss wine. It’s Saturday and I want wine. Just a really nice glass of red in the evening would go down a treat. While there’s no hard and fast rule stipulating that teetolling is essential I just feel like I need to abstain to give this thing the best possible chance of working. I’m fucked if I want to put any more needles into myself than strictly necessary. I’ve also put the kaibosh on Husband imbibing any more than the bare recommended minimum. I do not want drunk half arsed sperm cocking this up either. That being the case I’ve installed childproof locks on the wine cupboard and they’re not for the small person’s benefit. I’m not one of these generous, big hearted blah blah people who will selflessly say to others, no please go right ahead. Nope. If I’m not drinking wine, no bastard in this house is.
HH Level 8.3. Stroppiness is not helped by reluctant sobriety
Day 11: Husband leaves town for the night to attend a conference. Again I issue strict instructions about caffeine and alcohol intake and the punishment he will suffer if he provides inferior sperm, i.e. my wrath. I think he understands it’s not worth taking the risk.
HH Level 8.9. I’m starting to feel a bit terse so it’s probably for the best that husband vacate the building for a bit to avoid any chance of me injuring his testicles so close to them being needed.
Day 12: Scan the third. All systems are go and tonight we pull the trigger – literally. I have to take yet another injection tonight which is actually called the trigger shot – I kinda like this one because it sounds so badass. This is effectively the starting gun for ovulation when all those eggs I’ve been so busy growing will be released. The timing for this is very specific and is must be taken precisely 36 hours prior to egg collection so that the follicles will be unloading just as a gloved doctor will gazing into nether regions ready to relieve me of my precious cargo.
With the time critical nature of this injection I’m feeling the pressure. I spend a good half hour perched on a stool in the kitchen with my eyes glued to the clock waiting for the exact moment to take it. Husbands attempts a conversation are quickly shut down with a shush and ‘that’ look
HH Level approaching 10, high alert for DEFCON 1, an explosion is imminent.
At around 2am it happened. The she-devil reared her head. Poor little Z is unwell and the nights have been a bit rough. Although it breaks my heart to see her sick and unhappy, at 2am when I still hadn’t been to sleep it was also breaking my spirit and I lost the plot a little bit. OK, quite a bit and husband copped it. While I’d like to claim the artificial hormone cocktail swimming round my body was entirely to blame I think there was an element of good old-fashioned parental exhaustion at work as well. Kudos to husband though, he took the child and not the bait and I finally got some sleep.
Day 13: So the good news is that no injections today, the less good news is that this is kind of the beginning of the hanging around waiting, hoping, wondering, waiting, hoping, wondering phase. After lasts night’s tanty I make a sheepish morning apology to husband and mutter promises about sexual favours to make it up to him.
HH Level 5. Middle of the night venting has minimised my urge (and right) to be stroppy.
Day 14: Egg collection. It sounds so innocuous, like some nice egg man will knock on the door and I’ll hand him a little crate full of my DNA. It does not imply that I’ll be knocked out cold while a big fuck off needle is inserted into my ovaries to suck those little guys out, which is what actually happens.
As I enter the operating theatre I resist the urge to seize my doctor by the collar and tell him to be very VERY careful with the precious cargo he’s about to extract from my body. Any parent will tell you that the protective urge you feel for your child is incredibly primal, god help anyone who would do them any harm. While I know that these are eggs and not actually children I still have a lot emotionally invested in their potential. It’s quite bizarre to be entrusting them into the care of a group of medical professionals for the next few days who’ll arrange a blind date with a whole lot of eligible sperm and hopefully turn them into embryos. It’s like a very unconventional (not to mention bloody expensive) babysitting arrangement.
My Doc (the baby one, not the husband one) gives me the post-op update that they retrieved 16 eggs. It’s definitely a good start. But it is just the start of part two. The eggs are sent on their way to meet with husband’s swimmers and now, as with most of the IVF process, it’s out of our hands from here. Over the next 2 to 5 days we’ll find out how many eggs first fertilise and then survive each stage of development. I’ll update you on that next post but ‘til then think fertile thoughts for those little guys in the lab.