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By Mark Nethercote, September 13, 2011 10:00 am

Thursday 9th September 2010

One year ago.

I dial and wait.

“Hello, it’s Shirley speaking,” says the voice in an Irish lilt.

“Hi Shirley, you’re Shelley’s supervisor?”

“That I am.”

“Are you all Irish there at Monash IVF?”
“No, not all of us.”

“Just the ones we deal with.”  She laughs.  “I’m just checking to see how our embryos are going.  Mark Nethercote and Susan Brock, IVF Numbers…”

“…Yes, yes, yes,” she says, imitating a leprechaun, “I was just looking at your little one.”

“Our little one?  Not two?”

“No, one didn’t make it.”

“I’m guessing that was the slower one?  It was only six cells on Day Three.  It had a bit of defragmentation,” I add.

“Oh,” she says, like I just told her our embryo had special needs.  “Just let me check the database.”

I hear clicking sounds in the background, her fingers dancing on the keys.  A moment later, she takes a breath.  “Yes, that’s right.  The six-celled one degenerated.”

I let out a little laugh.  “It degenerated?  Go on, Shirley, don’t sugar coat it for me.”

“Sorry?”

“I’m joking.  I’m just, it’s a new term.  I guess that degeneration is a few notches up from defragmentation.”

“Well, yes.”

“It doesn’t sound like a good thing.”

“No.”

“So what does that mean, exactly?  What actually happens?”

“Well, your embryo pretty much stopped dividing.  From day three to day four it only increased by one cell, and then there was no further progress.  And then on day five to six, it just sort of…fragmented and degenerated.”

“Okay then.  So, then – I guess you just dispose of them?”

“Yep.”

“Fair enough.”  Bye, fella.  “And the other one?”

“Oh, that one’s done really well.”

“How many cells has it got to?”

“It’s a blastocyst.”

“So how many cells is that?  I need numbers, Shirley.”

“Well, once they’re beyond about ten cells, they start to expand very quickly until they’re sort of like a blob of irregular jelly.  That’s a blastocyst.”

“Excellent.  So is our blob of irregular jelly doing well?”

“Yep.  No fragmentation.”  No special needs.  “It’s been frozen.”

“Great.  A Day Five Blastocyst.  And it’s frozen.”

“For a rainy day.”

“One rainy day out of two ain’t bad, I guess?”

“Nope.”

“And when it comes to thawing what’s the survival rates?”

“Oh maybe 70%.  No, in fact, it may be up to 85%,” she says, plucking a number out of her arse.

But I don’t care.

It’s not 20%.

It’s better than 50/50.

And beyond that, it doesn’t really matter.

“Excellent.  Thank you so much.”

“Any other questions?”

“Yes, actually.  I’ve just got a couple of questions after the other day.  About the transfer.”

“What about it?”

“Well, I was up the top by Suse, so I couldn’t really see what they were doing.  All I could see was the Embryologist passing a pick-up-stick to the Obstetrician, which disappeared for about thirty seconds, and then they checked under the microscope to see that it wasn’t there anymore.  How do they know that it went into the uterus, and that he didn’t drop it on the floor, or get it caught under his fingernail?”

“Well, the embryos are loaded into a very fine catheter, like a terribly fine drinking straw.  It’s placed into a bubble of media, which is sits in, right at the end of the catheter.  They check it under the microscope for its placement, prior to the transfer.  And they don’t inject that little bubble until the catheter is right inside the uterus.”

“Okay, that makes sense.”

“Does that help?”

“Sure.  I mean, on Monday, it just kind of looked like they were balancing Brock #93486 on the end of a stick.  And then he stuffed it somewhere and kind of went, ‘oh well, it’s gone.’ ”

“No, it’s a little more sophisticated than that.”

“I guessed it would have been,” I say, laughing.

“You didn’t feel like you could ask about it when you were in there?”

“Oh, I would have.  But at the time, mostly we were concentrating on Susan not urinating on his head.”  Silence.  “That was taking up all of our… effort.”

“…Okay.”

“You don’t get that a lot?”  The line is silent.  “You don’t have women with their bladder… never mind.  Thank you for all of your help.”

“Okay, bye then,” she says, hanging up quickly, and writing a warning on our file in big red letters about our urine fetish.

* * * * *

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By Mark Nethercote, 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.

* * * * *

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By Mark Nethercote, July 27, 2011 10:00 am

Wednesday 28th July 2010

One year ago.

I sit in the pub, looking across the table.

“Just get on with it, I reckon.”  Dan finishes this declarative statement, in his Scottish lilt, and takes a swig of his beer.  “We did a lot of farting around at the start.  I mean, really, when it comes down to it, I wish we’d just had a crack at IVF from the start.”

“Really?”

“Yeah.  Absolutely.”

“I thought you started IVF pretty early?”

“Nah.  Fuck no.”

“What did you try before that?”

“All sorts of shit.  Including turkey basters.”

“Really?”

“Yep.”

“I never knew that.”

“You never asked.”

“I guess I didn’t.”  I take a swig myself.  “Well, I guess they didn’t really know what the problem was with you guys.”

“Exactly.  Unlike you guys, where you know you’ve got a blocked tube, we didn’t have that sort of certainty.  We lost our pregnancy, and no one could tell us why.  So we had to sort of start at the start.  We did a round of hormones, and then tried the dye test, and gave it a few more rounds, and fucked around some more.  And eventually we got onto the IVF.  Personally, I just wish we’d done it from the start.  It took us four rounds, after all.”

“Four harvests?  Really?”

“Where were you this last three years?” he jokes.

“Being a guy, I guess.  I mean, I guess I had just lost count.  I don’t think I realised it had taken you guys that long.”

“It seems to have flown by for you, doesn’t it?”

“Yep.”

“Funny that,” he says, laughing.  “You only know how shit it really is when you’re the one standing in it.”

I sigh, taking another sip.

“So how many weeks are you now?”

“Bel’s thirty-nine weeks today.”

“Bloody awesome.  I swear, you’re the only pregnant couple in the last year that I’m not jealous about.  You guys have put in the hard yards.”

“I know.  And some of our mates don’t even know how many rounds we did!” he says, in mock disgust.  “We were pregnant before anyone else,” he says, nudging Adam playfully on the arm.

Adam has been quiet throughout this whole exchange.  As the guy with a kid, he knows to lie low through the IVF talk.

I look back across at Dan.

“Where are you working at the moment?”

“The Women’s.  In the neonatal intensive care.”

“Will you be there next week?”

“Yep.”

“Really.  What days?”

“Tomorrow until next Tuesday.  Why?”

“Because Bel is being induced there next week.  I might see you.”

“You don’t want to see me, mate.  You don’t want to be coming to NICU if you can avoid it.  Which you will.”

“Good point,” he says, nodding deeply.  He takes another sip.  “So you’ve done all of your tests?”

“Most of them, yeah.”

“But what about you.  Have you done yours?”

“Wank into a cup?”

“Yeah.”

“Sure did.”  He takes another sip.

“So what’d you get?”

“Sorry?”

“What was your score?”  I look at him, suddenly understanding.

“What was my count?”

“Yeah,” he says, trying to sound casual.

“Ummm, I can’t remember exactly.”  For as traumatic it was, I’ve forgotten very quickly.  “Two hundred and something.  Two hundred and twenty, two-thirty?”

“Bullshit,” he says quickly.

“No.  No, I think it was.”

“I knew I shouldn’t have asked.”

“Why?  What was yours?”

“Not telling.”

He takes another sip.  We all do.

Nowadays, I can happily talk about wanking without getting embarrassed.

But, it seems, chats about sperm counts remain well out of bounds.

* * * * *

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By Mark Nethercote, July 21, 2011 10:00 am

Tuesday 20th July 2010

One year ago.

I leap up the escalator, two steps at a time, checking my watch as I do.

It’s 4.57pm.

I’ve been running down Chapel Street for the last twelve minutes, having parked my car dangerously up on the curve, a couple of kilometres back, way back past the tram, and the stream of peak hour traffic snaking behind.

The doors slide open, allowing me entry into the sterile world that is Medicare.  Five women sit behind desks, each staring forward, turning their heads from side to side, waiting for someone to place ping-pong balls in their mouths.  I take a ticket from the wheel, like I’m about to order ham, and I wait.

None of them even pretend to look busy.

* * * * *

I stare up at the red lights on the wall, waiting for it to tick over to mine.  F903.  F904.  F905.  There’s no one else in the whole office.  F906.  They all stare forward, doing nothing.

‘F907.  Counter 2B.’

I look around, trying to locate 2B.  There are five counters.  And I’m looking for 2B.

“Hello?”

“Ah, hello,” I say.  “You must me 2B.”

“Yes.”

“I’m here for my refund.”

She looks at me, breathing deeply, like it’s all she can do to stop herself from picking up her staple gun and flinging it directly at my head.  Eventually she holds out a hand, fingers snapping for the form.  I hand it over.

She stares at it, before frowning.

“That’s funny.”

“It wasn’t all that funny, really.”

She looks at me before rolling her eyes.  “No, I mean.  It’s a 20H.  It’s funny.”

“And like I said, it really wasn’t that funny.”

“What do you mean?”

I raise my eyebrows saying nothing, and she looks back at the A4 sheet.  I watch as her pupils dance across the page.  A second later, her eyelids widen, and then she flashes me a glance.  She blushes.

“A 20F is something…”

“…No sir, it was my fault.  I… I didn’t see what it was…  I mean, I didn’t…”

“You hadn’t registered the test.  For the sample.”

“I… I guess not.”

She tries focusing on the screen, like it’s the first time she’s ever seen the green and black display.  She punches numbers erratically, her eyes glazing over as she goes a shade of white.

It’s like some new form of seizure.

Petit Wank Epilepsy.

* * * * *

Eventually, she takes the piece of paper, filing it in a draw at the bottom that hasn’t been opened all day.  She then hands me the cash, and a docket, being careful not to make contact with my hands.

“Will that be all?”

“Can I have my Medicare form back?”

“You’ve got your docket now,” she says, pointing with hands kept close to her body.

“Can I have a copy?”

“What for?  You’ve got your docket.”

I look back down at my hand, receipt sitting crumpled under the coins and notes.

“I guess I like to keep a record.”

“Docket,” she repeats, her whole body shrinking away.

Lepers are treated with more respect.

I throw the coins into the other hand, freeing up my right.  And I reach over, shaking her hand vigorously.

“Thanks very much.”

I turn, and exactly 5.04pm, I walk out of the door of Medicare.

And I guess that about sums it up.  Two weeks ago, I handed a cup to a woman wearing purple gloves.

And now, all I have as proof is a hand full of change and a docket.

* * * * *

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By Mark Nethercote, July 20, 2011 10:00 am

Saturday 17th July 2010

One year ago.

“Did you say that Western medicine has done fuck-all for you?”

I look across at Pete.

And I’m a bit pissed.

* * * * *

It’s a Saturday night.  Suse and I don’t get out much anymore. And neither do our friends.  We’re like a Harry Connick Junior remake of a once-great song.

And yet, we find ourselves, at this swanky French restaurant in Drummond Street, Carlton.  Pete and Cath have got babysitters for the night.  Elle has left Dave at home to look after their sick child, and Carrie is over from Tasmania for the weekend.  They’re all friends from Uni.  And they’re all doctors.

I look at Suse.

Here we go.

“Yeah, that’s what I said.”  I say it with a bit too much animosity.

“I’m just clarifying,” he counters.

“I mean, I know it might sound hypocritical when we’re about to start IVF.  But to this point Western medicine has done fuck-all for us.”

I look around at the table, this table of Western medical doctors that I trained with.  Each face sits somewhere between offended and amused.

“So that’s why you bought the candles and the salt?” asks Carrie.

“Yep.  I mean, on the day we moved into our new house, Suse started bleeding from her ectopic.  And since that time we’ve had – I don’t know – maybe ten, fifteen things that have gone wrong with her health.”

“So you really believe that there was a curse put on your house?”  She can’t stop herself from letting out a laugh.

“I don’t know.  But, like I said, everything that we understand, everything that makes sense to us, everything that science has shown us, has not been able to help us out.”  I hesitate for a moment.  “I actually think we’ve lost some of our wisdom.  In the last three hundred years, we’ve come to think that science has the ultimate answers.  And like all people falling into any trap throughout time, we think we’ve got it all sussed.  We think we understand it all.  I actually think we know less now than we did two thousand years ago.”

I look around the room, at this table of highly-trained, highly-intelligent human beings.  I don’t know how open they are to left-field shit like this, as I’ve never asked.  But I’m on a roll.

Shit, I’m on a roll.

“So is that the same as religion?” Carrie continues.  She’s the only one more pissed than me, and therefore the only one willing to walk into this conversation;  the rest of the table sees the warning signs.

“No,” I say, again with more venom than I mean, “don’t get me started on religion.  This is about spirituality.  There are people in this world who think that ‘The Power of Now’ is the best book in the world, and there are people in this world who think it’s a crock of shit.”  I look around, getting the distinct feeling that ‘shit’ is the group consensus.  “I just think that there is a whole lot of stuff that we don’t understand, I think that the way we practice is different to the way we will in thirty years, and I think that in thirty years, we’ll look back on ourselves and say, ‘Fuck, why did we not think more about Eastern Philosophies?  Why did we think we knew everything?  Why did we work so strongly to the evidence-based doctrine?  Why did we have to prove something to think that it was possible?’ ”

I look around the room.  Everyone is silent.

“I was just clarifying what you said,” says Pete, slightly bemused.

“Yeah, well, maybe I misread it.  I guess that this last year has really shaken everything we believe in.  And I guess – given the fact that Western Medicine hasn’t given us the answers – that we’re more than happy to whip out and buy a three-buck candle and some salt and burn it, if it gets us pregnant.  Shit, I’ll do it every day if it works.”

“So this is about faith?” Carrie asks, still wanting to understand.  I can almost hear the held breath of the table, hoping my rant is done.

“Yeah, I guess it is,” I say.  I smile.  “So, not bad weather we’re having, is it?”

I hear the table exhale in unison.

I take a piece of bread.  I take a bite, looking over at Suse.

She gives me a wink.

* * * * *

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By Mark Nethercote, July 13, 2011 10:00 am

Monday 5th July 2010

One year ago.

“Hello, Cleo speaking.”  What a cool name.

“Hi there, I had a semen analysis on Friday, and I was just wondering about the result.”

“Name?”

“Nethercote.  N for November…”  You know the rest.

Cleo taps away for a few seconds.  “It was all normal, Mr. Nethercote.”

“Great.  Can I have the results?”

“Normal.”

“Yeah, but, what were the numbers?”

She pauses.

“Dr. Fleischer is away at the moment, so I won’t be able to release them to you.”

“Can I have a verbal?”

“No.  You’ll need to send in a letter, requesting release.  Then I will email Dr. Fleischer to see that she is happy for them to be released.”

“Great.  That sounds great.  Thanks for that.”

I hang up the phone, check a number and redial.

“Hello Andrology?”

“Hi, this is Mark, one of the Doctor’s at Cremorne Street.  I was just wondering if I could have some results on a patient?”  No lies here.  I’m a doctor.  I live in Cremorne Street.  And I want some results.

“Sure,” comes the easy reply.

“Great.  Can I have them faxed through?”

“Sure.”

Piece of cake.

* * * * *

* * * * *

So, all up, I’m pretty happy.  The volume was adequate, even though it was nothing like the fire-hose-volume of the dude on the 34cm screen last Friday.  But, I’m not trying to be a porn artist here.  Just a Dad.  Concentration was pretty good, no need to call the World Health Organisation over that one.

My progressive motility was 72% and total motility 76%, which can only lead me to believe that 4% of my sperm are unprogressive and likely to vote for Liberal. My pH is normal, most of the swimmers are alive, and I haven’t got any sperm antibodies.

But my abnormal forms are at a whopping 83%.  This means that five out of six of the little dudes are weird looking;  even if three quarters of them can swim, the majority of them will bump into the wall at the end of the pool.  But, in this plastic, hydrocarbon, pesticidal, long-haul-flight, mobile phone-carrying world, apparently we still call that normal.

Just let me remove my phone from my pocket.

There we go.

* * * * *

But, the flip side is that if I’m going to have 83% spazzy sperms, at least I’ve got 221 million of the little suckers, and not 39 million.  When the time comes, if we put 221 million in a Petrie dish with Suse’s eggs, then that’s 37 million normal looking sperm.  I think that should do.

The only real disappointment, in fact, was the comments section.  I was really hoping for something more.  Maybe along the lines of: ‘Well done, Mark!’ or ‘Way to go, champ!’  Or maybe, ‘Great volume, mate, bummer about the spazzy ones!’ or even, ‘Good luck with the healing, buddy!’

But I guess this is a lab.

Not a pub.

And I’m normal.

Numerically, anyway.

Phew.

* * * * *

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By Mark Nethercote, June 21, 2011 10:00 am

Monday 21st June 2010

Gestation: 38 weeks, 3 days

One year ago.

We sit there, in the back of the speedboat, drinking in the afternoon sun.  As we head out towards the coral reef we wind our way along the waterline, passing the island’s main resort – twenty times the size of the one at which we’re staying.

As the boat picks up speed, we pass a ten-year-old boy.  One arm is waving, the other is pushing straight down into the water, holding something under.  His mother, without even looking, yells something incomprehensible between drags on her cigarette.  With that, his arm goes slack, and a smaller boy comes up gasping, arms flailing like a stabbed octopus.  Again, without looking, we hear the mother shriek:

“Good boy, Jy-dyn.  Good boy.”  I’m don’t know the spelling, or whether the boys were named Jy and Dyn.  I can only guess.

Jy looks pissed.

Dyn just looks waterlogged.

I look back at Suse, a grin across her face, before noticing the couple facing us, shaking their heads, the man mock-wiping at his brow.

“We left our little blighters back in Queensland with their Victorian aunt,” say the smiley man, just portly enough to lend his face an inviting quality.  “They love her, and she loves them.  We paid for her plane ticket.  And she pays us back many, many times over.”  His wife chuckles, never taking her eyes off her feet.  Her eyes are grey, deep bags under each.  She looks like Dyn would if Jy repeated his tricks for twenty-four hours straight.

“Happy to be away?” I ask.  She nods deeply.

“Well, hang on,” says the husband, “don’t get us wrong.  Have you got kids?”

“No, we haven’t,” I say, jumping in quickly.  “And we appreciate this time while we don’t have them yet.”

“Oh, it’s fantastic,” he continues, championing the cause.  “I love my kids.  In fact, having them was the single most amazing and life-changing thing we ever did.  Wasn’t it, Darl?” he asks, without waiting for a reply. “Kids bring a life to you that you just can’t imagine until you have them.  It is absolutely amazing.  No – in fact, I’d say it’s magical.  Absolutely magical.”  He stops for a moment.  “You guys should consider it.  You really should.  Don’t be put off by what we say.”

“Don’t worry, we won’t,” I say.  “We will.  When the time’s right,” I finish, completing the lie.

Suse and I smile, and look out to sea in unison, our body language sealing the conversation dead in its tracks.

Before the virtues of family life can be extolled any more.

* * * * *

Four hours later, we are in the restaurant, looking out over the palm-scattered lawn to the beach beyond.  The tropical breeze brushes against our faces as we sit by the light of the torch, like we’re on the luxury couple’s honeymoon-version of ‘Survivor’.

Through the darkness emerges the smilingly pudgy guy.

“How are you, guys?”

“Great,” I say, resisting the urge to lean over and pinch his cheeks.

“Look.  I’m sorry about what I said to you before,” he says apologetically.  “The second we were on our own, Michelle went through me.  She said: ‘It may have been magical for you, but it wasn’t for me.  For me, it was bloody hard work.  I didn’t sleep right for years.’   So I’m sorry.  When I said they were magical, I really should have said that they are bloody hard work.  That’s what I really meant.  Not magical.  Hard work.  That’s what I should have said.  So sorry about that.”

He stops, looking slightly confused, as if trying to remember a second part to his message;  one that has since flown the coop.  “There was something else,” he mutters.

Suse and I look at each other and smile, acknowledging that thing which Michelle saw that her husband did not.  There’s something in the sisterhood – maybe in the way that Suse and I sat in the boat, maybe our reactions, maybe the whiff of parental pheromones leaking out of our every pore – I don’t know.  But there was something that caused her to see.  To see the elephant in the room.  To understand where we are in our plight.  And as the brains behind the mouth, to demand a public broadcast of the not-so-pleasant side of the equation.  If even just to take the sting out of the barb, just a little.

The man continues to stand for a moment, squirming in his undies, his palms finally rising up in contrition.

“Nope.  It’s gone,” he says, almost to himself.

“That’s okay,” Suse says, “we’re under no delusions.  And like we said, when the time comes, we’ll be in for as much of a shock as anyone is, I guess.”

“Yeah,” he says, benignly.  “Anyway, I just didn’t want to… you know… My big mouth, and all that.  I just wanted you to… you know.”

“Thanks, mate,” I say.

He turns, a slight furrow on his brow, and walks away.  He falters on his fourth step, like he’s about to turn and add something, before deciding better.  As he disappears into the blackness of the night, he scratches as the back of his rich brown hair, formulating his story, ready to pitch to his wife, about just how little he’d managed to fluff his meaningful, yet unnecessary apology.

* * * * *

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By Mark Nethercote, June 13, 2011 10:00 am

Monday 14th June 2010

Gestation: 37 weeks, 3 days

One year ago.

I pick up the phone and ring.

“Hi there, I was just ringing to find out about the Victorian IVF treatment cycle costs.”

“Yes?”

“Well, I’ve just been trying to get some information about how much my Private Insurance will cover me for.  And they suggested that I talk to you, as they weren’t able to tell me anything more than the item numbers.”

“Sure.  What would you like to know?”

“Well, they’ve told me that they won’t cover item numbers 13200, 13202, 13206, 13209, 13221, 13290, or 13292.  But they will cover 13212, 13215 and 13218.  But they couldn’t tell me what all of those meant.  Seems that they don’t go beyond numbers.”

“That would be right,” says the voice at the other end.  “Well, I could go through all of the numbers, but the long and the short of it is that they don’t really cover for anything.  The things they will cover you for are retrieval of eggs, preparation of frozen or donated eggs and transfer of embryos.  But only if you are an inpatient.  They can’t cover for outpatient work.”

I process this fact.  “Which is basically everything, right?  Pretty much all of this stuff is done as an outpatient, right?”

“Yep.”

“So why am I paying a premium for Private Health Insurance for IVF cover?”

“In case…”  There is silence at the other end.  “In case your partner needs inpatient work.”

“Which we’ve already said is bugger all of IVF.”

“Yep.”

I sigh, feeling a headache coming on.  With ample due diligence, Suse and I ensured that our Obstetric cover included IVF cover.

We just never asked what that means exactly.

Answer: fuck all.

“So what don’t they cover for?”

“They won’t pay for ovulation monitoring services, or oral induction medications.  They won’t pay for ongoing planning and management by your specialist, and they won’t pay for assisted reproductive supraovulation,”

“Sounds like something out of a Marvel comic book.”

“Yep.”

“And they won’t pay for any of your requirements either, sir.  Preparation of semen, collection of semen, or analysis and storage of semen.”

“Right.  Collection of semen has it’s own item number?”

“Of course.  Everything has an item number.”

“But separate from analysis and storage.”

“Yep.”

“And preparation of semen also has an item number?”

“Yep.”

I pause.  “Do I not prepare and collect the semen myself?”  There is silence at the other end.  “I mean, I’ve been told that I need to get a sterile pot, and deliver my sample to you guys in it.  I prepare the sample – as I have been everyday for the last twenty years in my testicles – and then collect it in a pot.  Which I give to you guys.  And then you analyse it and store it.”

There is a laugh at the other end.  “It’s not exactly what those items numbers are about.  But I get your point.”

“No seriously, what are those numbers about?”

“I’ll let you check that out.  It’s all on the net.”

“Okay.”   I pause again.  “And so what do you think about the whole funding issue?  The Government having dropped funding by two-thirds six months ago?”

“I think it’s disgusting.  Personally, I do.  I think it’s immoral.”
“And the Police Check we have to do?”

“Again, I feel for you guys.  You don’t need a Police Check for anything else.  You don’t need a Police Check to be treated as a criminal in jail.”

“No kidding.”  I rub at my brow again.  “So, the take home message is that we’re paying for Private Health Insurance that covers us for pretty much nothing.  Everything else is covered by Medicare.  And with this, the Government dropped funding by two-thirds, just six months ago.”

“Pretty much.”

Pretty much.

* * * * *

I later look up the item numbers.  They are as follows:

13221

PREPARATION OF SEMEN for the purposes of artificial insemination

13290

SEMEN, collection of, from a patient with spinal injuries or medically induced impotence, for the purposes of analysis, storage or assisted reproduction, by a medical practitioner using a vibrator or electro-ejaculation device including catheterisation and drainage of bladder where required.

13292

As for item 13290, under general anaesthetic, in a hospital.

* * * * *

So, if I required someone to use a vibrator to get a sample of my sperm, I would have to pay for it.

My Health Insurance would only cover me if this was done under anaesthetic.  If I’m awake during the experience, they expect me to pay.

They are smarter than you might think, these guys.

But I think I’ll save everyone the bother.  I think I’ll prepare and collect the sample myself.

No really, I don’t need to be paid $48 for it.

I’ll do it for free.

Really.

* * * * *

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By Mark Nethercote, June 2, 2011 10:00 am

Saturday 5th June 2010

Gestation: 36 weeks, 1 day

One year ago.

“This period’s dicking around with me,” Suse says, emerging from the bathroom.  “When’s it going to come?  It’s late.”

I look at Suse, my face blank.  Again, this is one of those moments.  I think about hair product, then filling the worm farm with scraps.  Anything that won’t betray emotion.

Make no sudden movements.

Suse has been on the rampage the last few days.  Five days ago, she uttered those fateful words:

“My period is due this week.  So I might not be at my most tolerant.  Especially since Fleischer fucked with my hormones.”

Suse is off her progesterone, which has, for the last few years, helped significantly to regulate her mood throughout her cycle.

So for the last week, I’ve been waiting.  The bomb hasn’t gone off yet, but I’ve almost hit the tripwire a couple of times in the last few days.

All right, let’s be real.  I have hit the trip wire.  Twice.

But they spring up out of nowhere, those pesky wires.  I swear.

“I don’t know, hon,” I say.

“What?”

“When your period is coming.”

“You’re answering a question I asked five minutes ago?”

* * * * *

Maybe I’m pre-occupied.  After all, Suse ovulated from the right side this month.  The blocked side.  And because of this, we resolved to not get pregnant this time.  To try again next month.

But it’s doesn’t always work that way.  After all, it’s sometimes easier resolving to not do something, than it is to not do that thing.  Because, as a couple who are desperately trying to get pregnant, contraception is not our number one priority.

And usually I am reliable.

Very reliable.

Except, of course, for last time.

* * * * *

We’d had a little debate at the start.  Do we?  Don’t we?  Do we risk it on the blocked side or not?  We came to our conclusion, as we came to our conclusion.  Suse said yes, then no, and I said no, but then…

I may have been a little slow on the uptake.

“Did you?”

“No,” I lied.

“Good,” she said, falling onto her back.

Let’s say I was about 90% successful.  Problem is, the first 10% may have not ended up where it was supposed to.  Which – given what we’re desperately trying to achieve – is exactly where it is meant to end up.

No wonder we’re confused.

In a nutshell, I blew it.  Literally.

And then Suse ovulated about two hours later.

* * * * *

She looks at me, shaking her head.

“Did you hear me?”

I do the worm farm thing again.

“Ummm…”

“…Where do you go to when you’re not listening to me?”

I’m worried that I got you knocked up on the blocked side.

On the side that will pretty much ensure that you have another ectopic.

So that you’ll need more surgery, where your tube will be removed.

Forever.

That’s all.

“Dunno,” I say, stupidly.

She frowns and walks away.

And I concentrate on worm food.

Not surgery.

* * * * *

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By Mark Nethercote, April 18, 2011 10:00 am

Monday 19th April 2010

Gestation: 29 weeks, 3 days

One year ago.

“Hi there,” I say, taking on my doctor’s voice, “I’m a doctor from Richmond Community Health Centre.”  I glance around my home office.  In Richmond.  “I was wondering if I could book in a patient?”

“Certainly,” the secretary replies obligingly.

“This is Leslie Fleischer’s rooms?”

“This is Dr. Fleischer’s IVF Clinic, yes.”

“Great.  I’ve got a patient who had an ectopic pregnancy, and has been having some difficulty getting pregnant.”

“No problem.”  She pauses for a moment.  “The first available is at 3pm on the 19^th May.”

I quickly scan my own diary, ensuring that I’ll be able to make myself free on that day too.

“Excellent,” I say eventually.  “So, only a month away?”

“Yes,” she replies.  “And I’ll place your patient on the cancellation list too.”

I pause for a moment.  “You get a lot of cancellations?”  Is this woman not as good as we’d heard?

“Yes, plenty.  Women get pregnant all the time while they’re waiting to see Leslie.”

“Of course they do,” I say.  I breathe, a little relieved.  “Will Leslie need any bloods done before the appointment?”

“No, that can all be done on the day.”

We discuss out of pocket expenses and I give her our mailing address.

“And who will be the referring doctor?”

“Well, that’s the irony,” I say, finally fessing up.  “I’m her husband, and also the referring physician.”

Even after twelve years of being such, it still feels like cheating.

I don’t know why, it just does.

“Very good,” she says, actually meaning it.  “That’s convenient, isn’t it?”

“It is,” I say. “Well, sometimes it is.  But sometimes it’s not.”

“Right,” she says, fully understanding that we won’t be continuing this line of conversation.

“So do I need to fax the referral now?”

“No, just bring it along on the day, doctor.”

“Very good.”

I hang up the phone.

Four weeks, or earlier if there are cancellations.

I resolve to get over myself.  It’s not like this is insider trading.

There’s got to be some perks for being the Paediatrician who can’t have kids.

* * * * *