Tuesday
Oct072014

That There Would Be Better  Pornography

Barbara Duffey


 

That the infertility clinic had sent me an IVF schedule, including my due date.  That I had begun following the Lupron protocol:  that I would inject myself with 10 units of leuprolide acetate every night for two weeks.  That I used an insulin syringe.  That it shut down my ovaries so they would not release an egg prematurely.  That I went to IVF class at the infertility clinic.  That on November 4th I would begin mixing my injections, five units of Lupron now but mixed with follicle-stimulating hormone (FSH) and human chorionic gonadotropin (hCG). 

That I would take the bottle of hCG liquid from the fridge.  That I would take five units of Lupron into the insulin syringe.  That I would inject it into the first vial of FSH powder.  That I would take one milliliter of hCG liquid and inject it, too, into the first vial of FSH.  That I would swirl the vial.  That I would take up the mixture in a large syringe.  That I would inject it into the next vial of FSH.  That I would need fewer than six vials of FSH, since four is the most, the doctor said, that has ever been shown effective.  That I would respond to FSH this time.  That I would repeat injecting the mixture into the vial, swirling, and pulling it back up into the syringe until I’d gone through all six, I mean, four vials.  That I would unscrew the long needle on the end of the syringe.  That I would twist on the shorter needle.  That I would wipe my belly, two inches from my navel, with an alcohol wipe.  That I would inject the FSH, hCG, and Lupron mixture subcutaneously.   That I would swipe my belly with alcohol again.

That two days later, after mixing the shot and giving myself the injection each night, I would go back in for blood work to measure my estrogen level.  That they wouldn’t call to tell me to increase my dose of FSH.  That I would increase my dose enough that I would respond.  That two days after that I would lie on the table in Exam Room #1 and the doctor would insert the ultrasound wand and we would look at my ovaries on the screen, I at the screen on the ceiling and the doctor at the screen on the computer, and there would be follicles growing in my ovaries.  Each follicle can grow an egg, but does not grow one necessarily, and that egg is not always a mature or good egg.  For IVF, one should have at least three follicles of a certain size.  That I would have three follicles of a certain size.  That I would not have just one.  That I would not be told that we could no longer do IVF.  That I would be told to come back in two days for another ultrasound because the follicles were growing nicely but we wanted to make sure they looked good for IVF.

That I would come back in two days for another ultrasound.  That my follicles would be plentiful and would be at least 16 millimeters in diameter.  That my blood would be drawn and my estrogen levels would be good.  That two days after that, I would take the trigger shot of hCG, ten times the low dose I’d been using in my daily injections.  That I would stop the Lupron, stop the FSH, stop the low-dose hCG.

That the next day I would take a pregnancy test to see if the hCG worked.  That it would work.  That I would call the nurse if it didn’t.  That the day after that, I would go in for my egg retrieval.  That they would give me a Valium and take me into the small operating room at the clinic.  That they would insert a needle attached to a vacuum into my ovaries.  That they would insert the needle into each follicle and remove each possible egg.  That I would have many eggs, ten to twenty, but at least three.  That the embryologist would take them into the lab—“in vitro” is Latin for “in glass.” 

That my husband would give them his semen sample.  That they would have better pornography in the overly-bright, overly-clinical collection room with the window with the wooden door next to the sink next to a button, the button you push after you’ve put your sample in the window so the technician can open the other side of the window and take out the sample. That my mother, who had planned to come to take care of me after the invasive surgery and decided to visit anyway because it would have cost too much to change her plane ticket, would drive us home.

That they would look at my husband’s semen under a microscope.  That they would, with a microscopic glass needle, pick out the best-shaped sperm.  That they would cut off the sperm’s tail so it couldn’t move.  That they would take the sperm up into the microscopic glass needle.  That they would insert a sperm into each egg.  That the eggs would fertilize.  That the embryos would grow.  That they would call us that night and tell us how many eggs fertilized.  That it would be many.

That the next day we wouldn’t hear from them at all.  That the day after that, they would call and say how many embryos had grown and of what quality:  poor, fair, good, or excellent.  They rarely see excellent embryos, and babies have been made from poor-quality embryos.  That we would not have poor-quality embryos.  That we had many embryos that were all good or excellent. 

That they would decide whether to transfer the embryos into me based on the number and quality of embryos.  If two embryos were better than the others, they would transfer those embryos into my womb.  That I would go back into the operating room.  That they would put the embryos in a catheter.  That they would insert the catheter through my cervix and into my uterus.  That the embryos would implant.  That the rest of the embryos would be frozen.  That my mother had not visited for no reason and would drive me home.

That if all the embryos were of equal quality, we would wait for two days to see which formed blastocysts, which is the first growth in an embryo past just the splitting of cells.  That the blastocyst embryos would be put in the catheter and I in the operating room on day five of their growth.  That the blastocysts would be transferred to my uterus via catheter.  That the rest of the embryos would be frozen.  That my mother would drive me home.

That I would go on bed rest for two to three days and take baby aspirin to avoid miscarriage.  That I would take progesterone inserts vaginally:  that I would unwrap the inserts, a cylinder with a twist-off top on one end and a bulb at the other.  That I would prick the bulb with a pin since I live at high altitude.  That I would twist off the top.  That I would insert the cylinder.  That I would put my thumb over the hole in the bulb and push the bulb until the progesterone was inserted.

That I would insert the progesterone every day for two weeks.  That at the end of the two weeks we would go in for a pregnancy test.  That it would be positive.  That I would be just like other people, other people who could think about the future because their genes would be in it, in their children.  That I would have the same chance of miscarriage as everyone else.  That I wouldn’t miscarry. That I could feel human and like a miracle of science.  That I would be a miracle of science, a mother.   That I wouldn’t be without any mooring to the world because I had no one to take care of—