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.

 

* * * * *