Day 314, Part 1

By , August 31, 2011 10:00 am

Friday 3rd September 2010

One year ago.

 

We sit down in the waiting area, the same waiting area as before.  The same place as for Suse’s shoulder operation.  The same as for her laparoscopy.

And now this.

I stare at my watch.

It’s 8.13am.

I jiggle my knee up and down.

“What’s wrong, love?”

“I’ve got to give them my sample, love,” I say, edgily.

“You’ll be fine.”

“Well, they told me I’ve got to get it to them by nine.  You know how I don’t like to be rushed.”

“You’re going home to do it?”

“Bloody oath.  I’m not doing it here again.  No more ‘MILFs in Heat’ for me.”

“Did you line anything up last night?”

“What do you mean?”

“Did you find some material on the internet to help you out?”

I feel something crawl up my back.  “I guess I didn’t plan that far ahead,” I say.

“You’ll be fine,” she repeats.

“Yeah, sure.  You know how much I love a dry wank.”  The man two seats down shifts uncomfortably in his seat.

Either he’s got piles, or he just heard me.  “I just love the pressure of all of this.  With $2500 riding on my performance.  I just love it.”

“Just, pretend it doesn’t mean anything.”

“Come on, Suse.  How about you do the same.”

She looks at me, in a look of truce.  “Just go up to the desk and ask them about it.  Find out the deal.”

I sigh dramatically, like a teenager whose just been told sense.  I stand, and approach the counter.  The man with the piles watches me warily as I go.

“Hi there,” I say in a low voice, “my wife is here for egg collection today, and I have a question about my sample…”

“…Oh,”  the plain looking lady interrupts, “I don’t know anything about that.  I’ll call someone down from Andrology.”  She refuses to meet my eyes.  “Just have a seat,” she says, shooing me and my dirty hands away from the desk.

I sit back down.

“What’s the go?”

“They’re sending someone down to give me a lecture on technique.  Probably Cheryl and her purple gloves.”

I pull out my phone and begin to play with it.  The plain looking lady and the man with the piles both eye me as I do.

“Anyone would think you were the one having the operation today,” Suse smirks.

“If it goes like last time, I might just need one.”

“Honey, if I had the choice between dry wanking into a cup and having a large needle stuck up through my vagina and into my guts, I’d happily swap.”

Yeah, yeah.  You got me on that one.

 

* * * * *

Two minutes later, an attractive young woman wearing surgical scrubs walks through the door.  She spots me instantly – like I’m exuding nervous adolescent pheromones or something.  She beckons me with a finger.  I follow her halfway down the hall.

“Hi, she says, “I’m Cynthia.  I believe you had a questions regarding your sample?”

“Yeah,” I begin, shifting edgily from one foot to the other.  “My wife is having harvest at nine a.m.  And it’s…”  I look at my watch.  “…8.19am already. I’ve got to produce my sample.  And I’m running out of time.”

“Running out of time?”

“Well, there’s only forty minutes to go.”

“Oh.  No, there’s no rush,” she says, smiling kindly.  “The sample just has to make it to us by eleven.”

“Really?  I’d been told to drop off Suse, go home, produce the sample and be back by nine.”

“Wow.  That’s some schedule.”

“Tell me about it.”

“That’s enough to put anyone off.”

“I know!”  I laugh with relief.

“We don’t even start preparing the sperm until early afternoon.  So, stay here with your wife, get her in for the procedure, and then produce the sample at your leisure.”

At my leisure?

“Okay.  I don’t know that I’ll do it at my leisure.  I’ll still get right onto it.”

“Whatever works for you.”

At my leisure.

Whatever works for me.

This is so much better than last time.

 

* * * * *

To be continued…

Day 313

By , August 30, 2011 10:00 am

Thursday 2nd September 2010

One year ago.

 

I walk down the footpath, staring at my feet as I go.

Each step, as I get a little bit faster, I realise how angry I am, how hurt I am.  What the fuck did I do wrong?  What the fuck did we do to deserve this?

I’m scared, and I’m angry.  We’re both doing everything right.  We’re both doing everything we can.  Each day, I pop a multivitamin, a vitamin D and two fish oil tablets.  Suse has her acupuncture, her Chinese herbs, and her specially compounded B6-free powder.  I’m exercising frequently and keeping alcohol intake to a minimum.  We’re eating right.  We meditate together, several times a week.  I’m ejaculating every couple of days to wash out my spazzy sperm.  And this week, I’ve stopped to build up the bank.

I’ve read all their material, I know what’s going on.  I’ve devoured the starter pack, the manuals, the pamphlets, and the drug information.  I even started reading the wax-covered book that Suse loved, getting through the chapter about the IVF kid that died, and the next one about the couple who took nineteen tries with donor eggs and donor sperm.

And then I stopped.

I don’t need to read hard luck tales to understand the risks.  I know what can go wrong.

I know the fucking risks.

Each night, the alarm goes off for an injection.  Each morning, the alarm goes again.  Last night, exactly thirty-eight hours before the egg collection, we gave the last injection.

And tomorrow, at exactly nine in the morning, we go to the bookie to collect.

We’ve been good.  We’ve played by the rules.  We’ve done everything we should.  And yet, there’s only four.

Fucking four.

I’m tired, and I’m scared, and I realise as I walk that I don’t want it to be like this.  I don’t want some lab-rat to decide what kid I get.  I don’t want these odds.  I want it to be real.  To be natural.  To be loving.  To be normal.

But what choice do I have?  What choice do we have?

I don’t want it to be like this.

 

* * * * *

I open the door, slamming it hard behind.  I sit down, running my hands through my hair.  There on the couch sits the brown paper bag, stuffed full of drugs.  Sticking out of the top, in a clear plastic bag, is the specimen container, readied for tomorrow.

I take it and hold it in my hand.

It’s short odds we’ve got.  Four.  Shorter than we thought, but betting has closed.

Game on.

Tomorrow, we try to make a child.

Again.

 

* * * * *

Day 312

By , August 29, 2011 10:00 am

Wednesday 1st September 2010

One year ago.

 

Today is the first day of spring.

But, as I wake up at 2.11am to the sound of my wife crying, it doesn’t seem that we’re out of winter just yet.

I hug her to me.

“I feel absolutely awful,” she sobs.  I feel bloated like a whale.  My skin is crawling – tingling – like there’s ants all over me.  I feel like shit.  And I can’t get to sleep.  I’m exhausted, so exhausted, but, I just can’t fall asleep.”

She rolls into another burst of tears, like an overtired child who’s eaten too much birthday cake and drunk too much soft drink, and now she’s banged her head against the shed.

That’s how it is for Suse.

She’s just banging her head against the shed.  Over and over.   Just trying to get to sleep.

Within minutes, in my arms, she has sobbed herself to sleep.  She breathes heavily, deeply, in exactly the same way that banged-headed child would.

As I hold her, I love her even more, ever more.

This beautiful, imperfect wife of mine, who shares her fears, her insecurities, and her failings, only with me.

Only with me.

 

* * * * *

I get the call at work at about eleven.  “Hey love,” I say.

“Hey.”   She sounds washed out.  She sounds a million miles away.

Ironed flat.

“How’d the ultrasound go?”

“Well…”  She sighs deeply.  She’s sighing a lot at the moment.  “They said one was 22mm, one was 18, two were 16, and then there were three smaller ones that were all about 12.  So they reckon there’s only four that are going to be any good.”

I feel the frown on face.  “Which side?”

“What?”

“What side were they on?”

“I don’t know.  Does it matter?  All I know is that there are only four that are going to be ready.  Well, there are three more that are smaller, but it’s line-ball whether they’ll be big enough.”

“Right.”

“Are you disappointed in me?”

“What?  No.  I’m disappointed.  But not in you.  It’s…just…”

“…I’m disappointed in me.”

“Why?”

“If you had a low sperm count, you’d be disappointed in yourself.”

I catch myself nodding.  “I’m just…I didn’t expect this, I guess… Four?”

“I fucking know!  There were twelve good ones on Monday, and now there’s only four!  She said we were lucky, really, because any less than three and they don’t go ahead.”

“Way to go on the positive spin, Shelley.  Well we got that, I guess.”

“Yeah.  Woo hoo.  So.  I get my final injection tonight.”

“What time?”

“7pm.  Thirty eight-hours before collection…”

“…Which makes it 9am Friday.”

“Yep.”

“Okay.”

“Fucking four.”

“I know, honey, but we only want one baby at a time.  We don’t need anymore than that.”

“It’d be nice though, wouldn’t it?  To have a few spare on ice, so we don’t have to go through all of this again so soon?”

“We won’t need to.  We’re going to get pregnant.”

“Sure, sure.  Positive, positive, blah, blah, blah.  But if we don’t, you’d prefer it if you didn’t have to have me loopy like this too often, wouldn’t you?”

“Is that a question?”

“Oh, yeah, and get this,” she says, diverging.  “I told Shelley how shit I was feeling, and she was surprised.  Like this was unexpected.  Surely I’m not the first woman on IVF to lose it with the drugs?”

“I don’t know, Suse.”

“Anyway, I’m done for today.  I’ve called the girls at work, and I’m having the rest of the day off.”

“Good one, boss.”

“I’m getting a massage, and I’m growing these last three eggs to full size.  This is my priority.  I’m damned if I’m going to come out of an anaesthetic with only four eggs.  I’m planning on seven.”

“You go, girl.  I’ll back you all the way.”

“I’d better go.”

She sounds totally deflated.

“Love you.”

And so do I.

Fucking four.

* * * * *

 

Day 311

By , August 26, 2011 10:00 am

Tuesday 31st August 2010

One year ago.

 

Suse is all over the shop.

In the last two days, she’s smashed the Pyrex jug, made a cup of tea with cold water, left me several unexpected presents in the toilet, and strewn an entire box of used tissues all over the house.  She’s got a constant headache, her skin has broken out, she feels increasingly bloated and nauseated, and her memory is shot.

This morning when we woke, I could tell she was on edge.

“Remember I’ve got my phone thing this morning?” I said.

“Sure.  But you’ll be done by 9.15?”

“No, it might take till 9.30.”

“But last night, you said you’d be done by 9.15.”

“No, last night, you heard that I’d be done by 9.15.  I very definitely said it might take till 9.30, because I thought it might be an issue.”

“But you’ve got to give me my injection!”

“Which I’ll do at 9.30.”

“But I’ve got to go to work!”

“And I’ve got to be on the phone.”

“Don’t you want to have a baby?” she said, breaking into tears.

It’s like a dose of turbo-charged PMS.

 

* * * * *

PMS is the acronym for Pre-Menstrual Syndrome.  We all know what it is, but approximately 5% of the female population know better than most.  According to Wikipedia, PMS is ‘a collection of physical, emotional and psychological symptoms that are related to a woman’s menstrual cycle’, above and beyond the normal discomfort expected of menses.

There are well over two hundred symptoms that have been attributed to PMS.  And these don’t include any of those experienced by their partners.  As an interesting aside, there is thought to be an evolutionary function to PMS, as it only occurs when a woman is about to menstruate, thereby reminding all around her that she has not fallen pregnant.  If her male suitor fails to impregnate her on a monthly basis, then irritability, tension and mood swings are potential motivators for rejecting him out of hand, making way for a more virile partner to move in, get her knocked up, and get on with the breeding.

Ain’t nature grand.

Technically, PMS is a phenomenon isolated to the final days of the Luteal Phase, the period between ovulation and menstruation.  And right now, thanks to our suite of injections, we are well and truly in the trenches of the Follicular Phase.

So, I can’t truly say that this is PMS.  While the symptoms may be similar, it’s a slightly different beast.  In fact, what’s going on here is a fully-fledged dose of POS: Pre-Ovulation Syndrome.  Or, as I like to call it, thanks to the drugs, PT-COS:  Pre-Turbo-Charged Ovulation Syndrome.

With Suse, PT-COS has been triggered because they are totally messing with her hormones.  She’s getting extra doses of some, and antagonists to others.  And while this may sound counterintuitive, it’s not.  It’s actually fascinating.

Unless you’re Suse.

The system in the body that controls hormones is known as the endocrine system.  The adrenals, the thyroid and the testes and ovaries, among others, are examples of endocrine glands.

Endocrine glands receive messages in the bloodstream from other organs further upstream.  At the top of the message system, unsurprisingly, is the brain.  A part of the brain known as the hypothalamus releases a whole bunch of hormones, including one called Gonadotrophin Releasing Hormone (GnRH).  This then floats downstream to the pituitary gland, which sits right at the base of the brain.  When the pituitary gets the GnRH signal, it releases two more hormones:  Follicular Stimulating Hormone (FSH) and Luteinising Hormone (LH).  These, in turn, circulate in the blood stream until they reach the ovaries.  The arrival of FSH and LH is like the green light for ovulation, and on getting this message, the ovaries begin to release their own hormones, estrogen and progesterone. These enter the blood stream, and float all the way back to the hypothalamus, like a messenger letting headquarters known that the signal got through.

The whole thing is a finely tuned balancing act.

Except in IVF.

 

* * * * *

With IVF, we’re messing with the whole project.  We’re deliberately unbalancing the whole act.  For the last five days, we’ve been injecting FSH straight into Suse’s belly.  Her ovaries, being obedient little things, have start to ripen the follicles.  This is all good and well, except that it means we’ve got extra estrogen and progesterone leaching all around the circulation, having a right old party.  The messengers are telling the hypothalamus to slow down the GnRH release, but with two of the follicles already at 16mm, the message isn’t getting through quite quick enough.

So this is where the Orgalutran comes in.  If you read the pamphlet, you’ll see that it’s ‘a GnRH antagonist, modulating the hypothalamic-pituitary-gonadal axis by competitively binding to the GnRH receptors in the pituitary gland’.

And while it sounds more like something that might occur to insurgents in Afghanistan, what it really means is that we’re blocking the release of anymore GnRH from the brain.   We are competitively antagonising those receptors.  And we wonder why my wife is moody.

LH is the enemy here.  If LH levels get too high, then the follicles will burst early, and we’ll lose the eggs.  So we’ve highjacked the system.  We’ve closed down the natural release of FSH and LH by stopping the GnRH with Orgalutran, and yet we’re continuing to pump her full of pharmaceutical-grade FSH to ripen her up like a battery hen.

And then, in two day’s time, we’ll give her one last jab of artificial LH, to get those grapes good and ripe, and thirty-eight hours later, they’ll pounce.  They’ll grab the biggest needle they can find, and suck out as many as eggs as they can.

But only after she’s knocked unconscious.

 

* * * * *

So, it’s semantics, really.  Whether this is technically PMS or not, we’re messing with Suse’s hormones.  We’re blocking the messages to her brain, and we’re overdosing her with messages to her womanly bits.

And if there’s one thing I have learnt about my dear wife, it’s that when we mess with her hormones, I will surely know about it.

* * * * *

Day 310

By , August 25, 2011 10:00 am

Monday 30th August 2010

One year ago.

 

We sit down in the waiting room, our bums hitting the cushions on the plush Ikea couches.  Sitting opposite, three women look Suse up and down in unison.

“They check you out,” Suse said one day, apropos of nothing.

“Who?”

“The other women.”

“What other women?”

“At IVF.  They size you up.  All of them.”

“Really?”

“Not in a bad way.  If anything, it’s a good thing.  We all sit there, comparing ourselves to each other.  We’re all in this shit predicament together.  And so it’s kind of comforting to look at someone else and think, ‘Okay, I wouldn’t have picked her as having problems.  She looks normal.  Maybe I’m not so weird after all.’ ”

I watch as Suse pretends not to notice, as the three women peer over the top of their magazines, giving a first, a second and a third look over.  Having convinced themselves they’re not so weird, they return to their articles on overly-famous twenty-somethings who have fallen pregnant more readily than they sneeze.

 

* * * * *

I glance around this buzzing hive.  Nurses, radiographers and reception staff weave in and out of past each other, like they’re doing the Dosey Doe.  There are about fifteen women in this morning, all at various stages of ultrasound, blood test, and management plans.  It takes about the same number of staff to ensure that it all goes smoothly.

It’s a living, breathing organism.

The couches are arranged in two semicircles;  the ones we’re in, just outside radiology, and ones closer to the curved desk in front of the logo.   I look down the corridor to Andrology, the arse-end of this living being.  As I do, I see a man emerge, beenie on his head, a blank expression on his face.  He probably just flicked through ‘MILFs in Heat’.  He doesn’t seem to be holding a pot, but fiddles nervously in his pocket all the same.  He disappears back up the arse of Andrology, only to emerge a few seconds later, looking even more confused.

“Susan?”

We both jump up, causing all three women to again look over the top of their magazines.  ‘Ah, yes, Susan,’ they think in unison, ‘if someone called Susan can have troubles, then I must be okay.’

We walk into radiology, eyes boring into our backs, and past the impossibly tall, pencil-thin radiographer who called us in.

“Do I need to go to the toilet again?” Suse asks, like a little girl on her first day of school.

“Do you?”

“Yes.”

Suse scurries back out past the women, while I enter the room and sit down in another Ikea seat, facing towards the wall.  I crane my head back over my neck, and smile like an idiot.

“You can look straight ahead,” says the Pencil lady.  Obediently, I do.  As I do, I realise there is a 32 inch-plasma screen, lit up with the ultrasound view.

“Do you know Susan’s birthday?

“23rd Jan.”

She taps away at her keyboard.  “Very good.”

“Sorry?”

“Most men don’t know their partner’s birthday.”

“No, that’s Suse’s job,” I say, looking straight ahead, not sure if I’m allowed to turn.  “She can’t remember my birthday, and she can’t remember our home phone either.”

“I’ll be back in a second,” Pencil lady says, slightly bored.

I sit there for a moment, in this darkened room.  There’s the screen, a hospital bed to my right, and the white ultrasound machine on the other side of that.   It is connected to a big probe which sits, unceremoniously, in a clear jug of liquid.

It looks like a flight-deck controlled dildo made by Apple.

Suse hurries back in, with Pencil woman right behind.

“Just remove your bottom half, sit up on the bed, and cover yourself with the sheet.  I’ll be back in a second.”  Pencil woman leaves once more.

“She reckons most partners don’t know their wives birthdays,” I say.  “What’s mine?”

She hesitates.  “29th May?”

I smile.

Pencil woman comes back in for the third time, and sits at her computer.  Suse lets out a little whoop, like she’s been winded, and from the views on the screen, I see that there’s no time for foreplay here;  the Mac computer is already in use.

We both stare at the screen, watching Suse’s uterus as it comes into view.  A cursor runs across the screen and then it marks it out, like some weird medical version of Space Invaders.  Pencil woman moves quickly across to the left ovary.  There we see a multi-loculated thing, a balck bunch of grapes, coated in white.  She shoots at it with her cursor.

“They look big,” I say.

“They are,” says Pencil.  The image is frozen still, like she’s pausing.  The cursor draws cross hairs on the screen, and then we’re back to moving images.   She repeats this six times in about a minute;  like she’s going for the world record.  Numbers leap onto the screen, as if to score:

‘R 16, 16, 12, 10, 6’.

“Sixteen millimetres?” I ask.

“Yep,” Pencil woman says without breaking stride.

“Already?”

“We’ve only had four injections,” Suse says, a hint of urgency in her voice.

“Well, they’ve come up pretty quickly then, haven’t they?”

“We only want them to be eighteen, don’t we?” I say, equally anxious.

“If you read the textbooks, eggs ovulate anywhere between seventeen and twenty-seven millimetres.”

With that, Pencil woman goes silent, again attempting for a personal best.  We watch in awe as she does.  I expect to see ‘Triple High Score’ come up, but instead, as she taps, more numbers appear:  ‘L 13, 9, Total 7’

“There’s actually more on this side,” Pencil says, “but they’re smaller.  Five on the right, and seven on the left.”

“Twelve in total?”

“Yep.  The trick is now to get them all to be about eighteen millimetres without some bursting.”

“Sure.”

The probe comes out, and is dunked in the jug with a splash.  I feel like I should click a stopwatch somewhere.

“That thing did have a sheath on it, didn’t it?”

“It did.  It’s already off.  I’m pretty quick.”

I know.  I’m an idiot.  I laughed when this was included in the manual.

And yet I still had to check.

Clearly I’m not the only one.

 

* * * * *

Within moments we’re out the door, just seconds after Suse gets her undies back on.  We’re ushered to the couches;  this time to the next set along.  Within another two minutes we’ve been called back in, directly beyond the slogan desk and into the pathology room.  A woman distracts us with questions about the weather, while sticking a sharp object into Suse’s arm.  She draws the blood, stands us again, turns us around, and frog marches us back out the door before we even learn her name.

And we’re back in Ikea land.

Five more minutes pass, just long enough to piece the events together.

And with that, there is another call.

“Susan?”  We both jump like it’s an Army drill.  “I’m Amy,” says another woman, would you like to come through?”

Holding hands, we run through the door of Room Number Three.

“Have you started the Orgalutran yet?” she says before we even sit.

“No, I’ve only just started the Puregon,” Suse says.

“Well, we’re going to give you the Orgalutran right now.  Are you okay with that?”

“I…I guess so.”

“Is sixteen millimetres too big this early in the treatment?” I ask.

“No, that’s fine,” Amy says, “we just need to get onto it.  Everyone is different.  Can you lift up your shirt, Susan?”

Again, the needle is out of its packet in microseconds;   this lady would be an asset at Christmas.  Again I hear Suse let out a whoop, as the needle goes into her belly, plunger pressed.  It’s out and in the bin before I even see it.

“You might get a bit of redness and itching with this one.”

“Really?  Are there any other side effects?”

“Oh, if you usually notice things before your period, then you might get a few things like that.”

“Okay,” I say.

“So, Shelley will have your blood results this afternoon, and then she’ll give you a call you to let you know what’s happening.”

“So at this rate…”

“…Egg collection will be on Friday or Saturday.”

“Yeah right,” Suse says.  Her eyes go wide.

And with that we’re out.

Ultrasound, blood test, injection and consultation in an hour.

You don’t get that in the public system.

 

* * * * *

A few hours later, I’m at work when the phone rings.

“I just spoke to Shelley,” Suse says.

“Was she in a whirlwind mood too?”

“No, she was happy to answer questions.  But she said that they’ve upped the ante.  I’m going to get both.  Orgalutran in the morning, and Puregon in the evening.

“Two injections per day?”

“Yep.”

“An antagonist and a hormone at the same time?”

“Yep.”

This is going to be fun.

* * * * *

Day 309

By , August 24, 2011 10:00 am

Sunday 29th August 2010

One year ago.

 

We’ve hit our groove.

After watching the DVD, we reassured ourselves that we didn’t do anything wrong.  The pen does require plastic-bending levels of pressure to dial down in an unreassuringly, flimsy manner.  I’ve also improved my grip.  The pen really needs a firm grasp on the barrel, and a thumb on the plunger, while the other hand secures it at the skin.  And, even better, if you let the thing defrost first, it isn’t quite as lumpy on the way in.

Suse already feels bloated, and we’re only about a third of the way through the injections.

“Already I feel twice as heavy as what I do before I ovulate.  This is going to be shit.”

Suse will have an ultrasound to examine her follicles tomorrow.  As we’ve been told, she’ll get Puregon until her follicles are 13-14mm, then three to five days of Orgalutran, then one dose of the Ovidrel.  By then, they’ll be about 18mm each and ready for collection.  That could mean ten follicles all up, five on each side, each nearly two centimetres in size.

According to Shelley, there really aren’t any side effects to the Puregon, other than fullness in the belly.

Try telling Suse that.

She’s cried three times since the injections began, and says she feels like absolute shit.

I’d tell her that it was all placebo effect.  But I want to keep my marriage.

And I know this isn’t a great analogy, but if I had five cysts growing on each of my balls, I think I’d be pretty emotional too.

 

* * * * *

Work is keeping me going.

I went out on a trip yesterday to retrieve a baby that was born in the back of a taxi.  His parents were on the way into hospital when things got a little out of hand.  They ended up pulling into the carpark of the closest local hospital, where they had their little girl.  She was thirty weeks.  That’s two-and-a-half months early.

I sat there, listening to the call as it came in.

“Oh, hi, this is Jonathan, one of the Emergency Consultants,” he said sounding somewhat flustered.  There was a lot of commotion in the background.  “We’ve just had a baby deliver in the car park.  And we don’t have a paediatric unit here.”

“How’s the baby doing?”

“It looks pink and is breathing on its own.  Pretty well, I think.  You wouldn’t believe the commotion it has caused.”

By the time we arrived, there were about fifteen people in the room.  Nurses, doctors and ward clerks all swarmed around, all keen to help.

“I’ve been here twenty-two years,” said a battle-hardened nurse as I fought my way through, “and I’ve never seen this happen here.”

“Really?” I say, trying to sound interested.  “Do you think we could clear the room just a bit?”

“Yeah, where do you want us to put Mum?” she said, her eyes never leaving the baby.

I pause for a moment.

“I’m fine with Mum being here.  It’s everybody else.”

“Right.  Yes, of course.”

It’s not just us.   Everyone is excited at the prospect of new life.  Even medical staff who’ve seen it all.

There really is nothing quite like the magic of a brand new baby.

 

* * * * *

Day 306

By , August 23, 2011 10:00 am

Thursday 26th August 2010

One year ago.

 

I sit there on the couch, as I hold an oddly-shaped needle threateningly in front of Suse’s belly.  She pinches some skin between her fingers, while looking suitably threatened.  I pause for a moment.

“You have used one of these things before haven’t you?” she asks.  I hesitate.  “Haven’t you?”

“Well, no, not really.  Not exactly like this.”

“What sort of a doctor are you?”

“Hang on.  We don’t use this sort of thing.  I mean – this is exactly like a diabetic’s pen.  But I’m used to bog standard needles and syringes, not fancy blue plastic pens with spikes on the end.”

“Okay then,” she says, even less reassured.

Trust is a big thing for Suse.  It’s the first thing that comes up when there’s something new.  I mean, I know it does for all of us, but Suse’s trustometer is super-sensitive.  At the first sign of something unusual, her trust levels drop,  scouring for signs of danger.  And right now, I’m holding a sharp weapon in front of her guts.

“That’s good,” I say, shifting into doctor mode, “the way you’re holding your tummy.  That’s perfect.”

“I’ve been growing a bit of padding just for this,” she jokes.

I pick up one of the alcohol swabs and tear it open.  At least that’s the same.  Everything else about this set up feels totally foreign.  I’m in my own living room, about to inject my wife.  Shelley gave us instructions on how to use the pen, but all the same, right now, it feels kind of flimsy.

Suse wants me to do the injection, but she was adamant that she was going to assemble it.  So, as the alarm went off at 9pm, I watched as she silently got up, walked to the fridge, and came back with the chilly bag.  She opened it up and began unpacking boxes like it was Christmas.  She opened the Puregon cartridge and put it in the pen’s barrel.  She took a new needle and screwed it on the end.  She dialled it up to 300 units.  And that was when she handed it to me.

“Can you pinch up your skin again?” I ask.  She does this obediently, as I take the alcohol swab and wipe.  And then I take the pen, and plunge it through her skin.  I press on the plunger, but it won’t budge.

“Ow,” she says.

“It’s hard to…”

I press some more.

“Ow,” she repeats.  I press even harder, the plunger slowly giving way, twisting as it goes, undialling.  But it does it in a weird way, in a flimsy plastic way, in a ‘feels-like-it-might-break-off-in-your-wife’s-belly-because-you’re-not-doing-it-right’ kind of way.

“Owww!” she says.

I just keep pressing.  It’s all I can do.  Pushing all the way, threatening the plastic as I do, forcing the plunger down, until I hit zero.

“One, two, three, four, five,” I count, trying to sound calm.

“That really hurt,” she says, a hint of hysteria in her voice.   “Was it meant to hurt that much?”

“I’m not sure.”

“You were wiggling it around in there.”

“Sorry.  I wasn’t that easy to press down.”

“Did it work?”

“I…I don’t know,” I say out loud.

“What?”  I meant to think that.  Not say it.  “What?”

I look at the side of the pen, to see that a third of the cartridge is empty.

“It must have worked.”

“This is really starting to hurt.  Should it hurt that much?”

“I’ve just injected a couple of mils under your skin, hon.  It’s not going to tickle.”

“But it really hurts.  And it feels really cold.”

We both look at each other.  “Weren’t we meant to leave it out of the fridge for a few minutes?”

“Yes.”  Suse has that mistrusting look.  “Does that mean it’s not going to work?”

“It’ll work.  It’s fine.  We’ll make it room temperature tomorrow.  It just kind of felt like the pen was going to break.  Like it wasn’t quite right.”

“Really?”

“Yeah.”

We both sit there, staring forward.  I look at the detritus in front of us.  There’s a chilly bag, an ice pack at its base.  There’s nine cardboard boxes, in a variety of colours of the rainbow, each full of drugs.  There’s alcohol swabs.  There’s a swanky pen case, like it’s a Mont Blanc or something, not a flimsy piece of shit.  There’s even a sharps bin.  And then, there’s my pot, ready and waiting for my sample, in about ten days time.

 

 

“Which of them go back in the fridge?”

“You’re kidding me,” she says.  “You don’t know?”

“Should we watch the Puregon DVD?  Just in case?”

“I think that’s wise.”

Right now, I feel like we’re the Puregon people.  The woman is smiling, but it’s a grimace of fear.  She’s cropped from the shoulders down so we don’t see that in fact she’s holding a piece of cotton wool over her belly where her husband just stabbed her.

And I’m the Puregon guy.  Just sitting here, by her side, feeling a bit weird and awkward.

And this is only Day One.

* * * * *

Day 303

By , August 22, 2011 10:00 am

Monday 23rd August 2010

One year ago.


“So this is the needle,” says Shelley, pulling out a blue, wide-barrelled pen.  I look across at Suse, who wears a glazed expression.  It’s not that she’s concerned about the needle, it’s just that she’s a little overwhelmed with information.  “You open the container, take off the cap, undo the chamber, pull out the cartridge, and place it in here.  Then you take a needle, and you screw it on here – after you’ve wiped it with an alcohol swab.  When you’re done with that, take off the plastic lid, revealing the needle.  Dial it up to 300 micrograms, just like this.  If you overdo, it, wind it further, like so, and just reset it, like this.  Take a grab of some of your stomach – anywhere below the belly button line – and place it in, inject, and hold for five seconds.  Take it out, recap the needle, unscrew it, and put it in the sharps container.  And then do the same the next night.”

I look at Suse.  Her eyes are open, but not much else is.  Shelley does this for a living, but somewhere along the way, she’s forgotten that this is the first time we’ve heard any of this.  I’m a doctor, I’m familiar with injections and this equipment, and yet I’m running to keep up.  Shelley’s explained the pack, our terms and conditions, the costs, and she’s up to our regime.  We’re to start on the Puregon, and then the Orgalutran.  After this, we’ll have Ovidrel, and then finally the Crinone.

We’ve got a pretty simple regime.

Supposedly.

“Make sense?”  I look across at Suse, and she looks back at me.  I expect to see fear.  But I don’t.  She’s clearly overloaded, but I see that twinkle.

She’s excited.

“You’ll remind me of anything I this that I don’t remember?” she says.  I nod.

“Good,” says Shelley quickly.  “So, you get four boxes, three of the 900 microgram chambers, three uses each, and one of the 300.  Got it?”

Again I nod.

“Good.  So onto the Orgalutran.  This is a once-only use.  The needle is slightly bigger and hurts on the way in, more than the Puregon, which is more like a diabetic’s pen.  So in that way it’s similar to the Ovidrel – which is the one we give exactly thirty-eight hours prior to collection,” she says pointedly.

I look and nod.  Shelley’s voice trails off.  I watch her animated movements, almost like a cartoon.  Someone has their hand up her, controlling her like a puppet, but there’s no body attached to the hand.  Or someone has pressed play on a tape, and although her lips are moving, the sound has gone dead.  I look across at Suse.  This time she’s the one listening.  She’s nodding with every word, taking it in.

This is my permission to vague out.

I look out the window at Melbourne below.  It’s sunny and warm, the warmest day in weeks.

It’s nine days till spring.

“Does that make sense, Mark?”

“Absolutely,” I say unconvincingly.

“So the Crinone is inserted with this applicator.  It releases progesterone directly through the vaginal wall…”

I look across at Suse, who smirks at me, the good student who knows how not to get caught.

Hopefully we can share our notes before the exam.

 

* * * * *

On the way out, Shelley hands us another folder.  I think that makes three that we’ve been given along the way, as well as two more we’ve nbought ourselves, just to hold all of the information.  This one is white with a peach trim and banner, declaring the motto of our year:

‘Life Starts Here’.

When I open it up, I see that it is full of brightly coloured drug flyers, interspersed with admission paperwork, some after-hour contact numbers, and, just for good measure, yet another document reminding us of potential risks.  This one quotes the incidence of twins from IVF at 16.4%.

Fuck me.  First it was 3%, then 10%, now 16.4%.   By the time we have a baby, it’ll be 1 in 2.

Luckily, there’s even a DVD on how to use the Puregon Pen.  Clearly, no one can stay awake for all of Shelley’s talk.

The drug propaganda is worthy of note:

PUREGON: A green covered booklet, with a simple yellow heading.  The drug name is at the bottom centre.  As it’s a plastic pen they’re selling, the name is written in cursive, as a reminder that you’ll be stabbing yourself with a biro.

In the centre is a picture of a couple.  They’re sitting on a set of steps, with smiles on their faces.  They’re well cast; he looks a little bit weird and awkward, like maybe his sperm count is a little low.  The hints of highlight in her hair are almost mistakable for grey.  The shot is cropped just below the shoulders.  I can almost hear them saying, ‘We may be thirty-eight years old, but we’re happy, even though we haven’t had kids.  If you want, imagine I’m thirty-eight weeks pregnant, or if it helps, I’m still barren.  We’re unassuming, and normal.  Apart from my impotent husband, that is.’

9 out of 10

 

ORGALUTRAN: By the same company, this one is has a yellow background with orange writing.  The drug name is in smaller print, again centred at the bottom.  The picture at the top is one of a dirty great needle, photographed on a clinical white background.

Read:  ‘This is a needle that you have to have.  And it will hurt.   No point bullshitting.’

8 out of 10 (for honesty)

 

OVIDREL: This one’s by a different company.  It’s an all black background, the drug name written vertically down its right hand spine.  To its left is the photograph of a stunning woman in a red dress, her hands under her chin in clutched prayer.  It looks like an ad for a new brand of Christian fashion apparel.

3 out of 10.

 

CRINONE: By the same company as Ovidrel.   Yet another good-looking woman in a red shirt, this one with her arms wrapped around her unpregnant midriff like she’s got a gut ache.  And yet she’s grinning as she stares at the ground like she’s just seen $100 – not like she’s just sprayed a dose of PMS up her vagina.

2 out of 10.

 

When you open the Crinone and Ovidrel brochures, on the first page we get to meet the Merck Serono Fertility women, each with their own name.  As well as Ovidrel and Crinone, we have Cetrotide, Gonal-F, Luveris, and Serophene.  Each of these oddly named women is a vacuously ecstatic twenty-five year old model.  Cetrotide is touching her declotage like she’s just can’t believe how good it is to be alive, and Serophene holds her head in her hands like she’s just won the Miss America pageant.  Liveris is clapping her hands with glee, her mouth wide open as people only ever do in photo shoots, while Gonal-F is pumping her fists at her side, with an expression like she is actually having an orgasm.

I want to punch them all.

Drug companies, read this:  IVF is hard.  It may be about women’s health, but for God’s sake, don’t trivialise it down to a tampon commercial.  I want odd-looking, late-thirties couples and a horse needles on your branding, not models having orgasms.

This is IVF.  We don’t do regular orgasms any more.

 

* * * * *

 

Day 301

By , August 19, 2011 10:00 am

Saturday 21st August 2010

One year ago.

 

Frequent Ejaculation Improves Sperm Quality

‘Cosmos’, Wednesday, 1 July 2009

PARIS: Men who want to become fathers should have sex or ejaculate daily in order to maximise sperm quality, scientists report.

Australian fertility specialist David Greening recruited 118 men whose sperm had a higher-than-normal level of DNA damage.

Before the test, 34% of the group’s sperm was rated as damaged, meaning that it was classified as ‘poor’ in quality. For individuals, 15% to 98% of their sperm were classified as such.

The men were asked to ejaculate daily for seven days, but were not given any drugs or told to make any changes to lifestyle. After seven days, their sperm was examined again. The average of damaged sperm fell to 26%, placing it in the category of ‘fair’ in quality.

Greening presented his findings the European Society of Human Reproduction and Embryology in Amsterdam, The Netherlands on Tuesday.

Dr. Greening says the improvements were “substantial and statistically highly significant” and that daily ejaculation not only boosted sperm quality for most of the men, it also helped sperm motility, another big factor in successful fertilisation – even though the volume of semen declined.

 


* * * * *

 

Suse isn’t interested in sex every day.  I’m yet to meet a woman who is.

So I improvise.

In the lead up to the big day, I’m doing my utmost to improve my quality.

It’s important.

 

* * * * *

We’re sitting in bed reading the paper, when Suse turns to me.

“So when you have to abstain for four days, are you going to get cranky?”

“Sorry?”

“Before the sample.  Are you going to get cranky again?”

“What do you mean, again?”

“Like last time.  ‘The horror, the horror’ time?”

“I was nervous about wanking in hospital, hon.  I don’t know that I was cranky.”

“You were cranky.”

“Really?”

“Really.  Is this news to you?”

“I’m not sure what the right answer is here.”

“Well, let me tell you.  It’s like a barometer with you.  When you don’t get it, you get grumpy.”

“Not all the time.”

“Really?”  I look at my wife.  “Let me test you out then.  How long has it been?”  I pretend to think, like I don’t know the answer.  “How long since we had sex?”  Again, I look at my fingers like I’m trying to figure it out.  Like I don’t know.  “Go and do your duty for this family, and come back when you’re less cranky.  I swear, Mark Nethercote, bodily functions and you.  When you haven’t eaten you get cranky, when you haven’t had a shit, ditto.  And when you have to hold off for four days…”

“…What?”

“I’m just saying.  You’re a bodily function kind of guy.  And when you delay your bodily functions, you get cranky.”

 

She’s spot on.  Absolutely spot on.  I can tell you exactly how many days it’s been since we had sex.   I know I’m supposed to be all cool and relaxed about it, like I’m not quite sure, like it’s not important to me.

I’m not counting.  Consciously, I’m not.  But the point is, all guys are counting, even if they don’t know it. We’re all aware.  It’s instinct.

“Go and clear the pipes, and come back to me in a better mood.”

IVF has taken the romance out of things somewhat.

But from a pragmatist’s viewpoint, it’s right on the money.

 

* * * * *

Day 299

By , August 18, 2011 10:00 am

Thursday 19th August 2010

One year ago.


I dream that I’m angry.

I dream that I’m furious about all of this.  About having to do IVF.  About all of the forms.  About al of the rigmarole.  I dream that I wish for a simple life, for a simple pregnancy, for falling pregnant naturally.  I dream for living in a world where there isn’t any scientific meddling, where I’m allowed to have what I want without asking for it, without having to prove my worthiness, without filling out more forms than I did to buy my house.

And then, in my dream, I have a child.

Simply, and easily.

Naturally.

I have my child.

And then I wake up.

And I realise that it’s not a dream.  Not the first bit, anyway.

 

* * * * *

 

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