Wednesday 4th August 2010

One year ago.

 

The Second Manual is a bit more juicy.  The ‘Treatment Cycle Handbook’ begins with some mundane details:

- the number of embryos transferred per cycle (one)

- freezing the embryos (yes, please)

- the use of donor sperm and eggs (no thanks, we’ll supply our own)

 

It then tells up about the sequence of steps:

- Grow follicles,

- Time ovulation with blood tests and ultrasounds,

- Collect eggs,

- Put them in a blender with your sperm,

- Wait five days,

- Reimplant,

- Worry.

 

It includes some interesting facts:

-  The follicles will be 18-25mm when they get them out, but the ovum within is less than the size of a pinhead,

 

As well as some information that I wouldn’t have even thought necessary to include:

- ‘One or two ultrasounds will be performed to find out how many follicles are developing, what size they are, and where they are growing.  The scan is done vaginally, where the scan probe is inserted into the vagina.  For hygienic reasons, the ultrasound probe is cleaned after each use and covered in a clean, disposable sheath for each patient, so there is no risk of developing infections from these examinations.’

Really.

 

* * * * *

It explains the steps one by one:

1.  First of all, they have to prepare the ingredients, starting with the eggs.  Sometimes, the mum-to-be will be given the pill or a nasal spray to suppress her cycle.  It’s kind of like the reset button on a computer.  Suse doesn’t need this, and some women don’t.  I guess her inbuilt reset button is functioning okay already.

2. After this, she is given something to get the follicles within the ovaries stimulated.  This, crazily enough is called Follicular Stimulating Hormone.  It’s a daily injection, with a pretty small needle into the bum.  This happens daily for ten to twelve days.  Meantime, they’ll suck your blood and variously use the condom-covered ultrasound, to monitor progress.

3.  When they’re close to ripe, the injections change to Orgalutran, our favourite transformer.   This is the hormone antagonist, used to stop the eggs from bursting too soon, which is what nature is hanging to do.  This way, as many eggs as possible will be ready for the picking on harvest day.

4.  Finally, for the 36 hours prior to collection, a third injection, Human chorionic gonadotrophin (hCG), is given as a final little kicker.  This ensures that they will be good and ripe.

5.  Today, after 10 to 12 days of injections, hopefully mum-to-be will have a bunch of 18-25mm follicles for collection.  You return to the hospital, where an unusually large needle will be used to collect aforementioned eggs.  This will be done under sedation, through the back wall of the vagina and directly into the ovary.

This is done by someone with a very steady hand.

6. Meantime, they casually mention that I’ll need to produce another sperm sample.  There is no mention of whether they’ve restocked their porn collection.

7. They promise to prepare my good-looking sperm, and give them a shampoo.   The ugly ones will go straight down the sink.

8.  If too many are ugly, they might ask for a second batch.

9. My remaining fresh and sparkly sperm will be put in the oven with Suse’s eggs.

10.  Leave them alone for 18 to 24 hours in a fertilisation medium.  I guess this is the romantic bit.  Despite the fact that it all happens in a petri dish, they leave them alone to get to know each other.

11. The next morning they check on them to tell you whether not they liked each other.  And, more precisely, how many of your eggs invited liked how many of your sperm.   This stage is called ‘pro-nuclei development’.

12.  They ring you with the results.  You’ll wait all day on the end of the phone for this one.

13. They then switch the surviving embryos into a new culture medium for the next two days.  Human albumin is used in the culture medium, spun down from human blood.  The go to acute lengths to explain that Suse may therefore be exposed to hitherto undiscovered deadly viruses, fungi, prions, or aliens from another dimension.

But they hope, almost as much as we do, that this won’t happen.

14.  On days four and five, they move our progeny into something called a blastocyst medium.  The change in the mediums simulates the hormones and enzymes that the embryos would naturally receive while travelling down the fallopian tubes and into their resting place in the uterus.  But, as we don’t have fallopian tubes, we’ll use test tubes instead.

15.  On day five, you get another call to tell you how many made it to day five.  It may be one, it may be five.  It may be none.

16a.  If there are none:

Cry.  Then, after a few days, pick yourself up, and return to step one.

16b.  If there is one:

Then it will be reimplanted on this day.  This time they use the medium sized needle.  Hang on, it’s not even a needle.  It’s just a pipette, to squeeze the little blastocyst back into the uterus.

16c. If there is more than one:

As for 16b.  But the leftovers go into the deep freeze for a rainy day.

17.  Hope.  Pray.  Do whatever you need to do.  Do whatever you can, to help that the blastocyst stick to the wall like silly putty.  Make your intentions.  Pray to your God.  Make offerings to your creator.  Make your choice.  Do whatever you feel, that will help you.

18.  Wait.

This period is filled with a lot of hope and anxiety, and they suggest keeping yourself busy.  You can have sex as soon as you like, but the woman is not allowed to play squash or gymnastics, or anything that can leave you gasping for breath.

Maybe they do it different to us.  Sex is about the only activity that does leave me gasping for breath.

But I guess they’re not talking to me.

19. A mere eleven days later, without anymore needles, ultrasounds, blood tests, or medical distractions, they do a pregnancy test.

20a.  If pregnant:

Laugh, cry, hug, be joyful.  Have trouble believing your luck, despite the eighty-one injections, twelve ultrasounds, two laparascopies, one dye test, and all of your prayers.

20b.  If not:

Try, try again.  If there are any left to defrost and reimplant, return to 12b.  If you’re out of stock, do not pass go, do not collect $200.  Go back to the start.

And cry.

A lot.

* * * * *

To be continued…