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By Mark Nethercote, September 6, 2011 10:00 am

Saturday 4th September 2010

One year ago.

“The phone’s ringing, honey!”

I run into the lounge room, where I find Suse holding the phone like it’s a bomb.  After a moment, she depresses the trigger.

“Hello, Susan speaking.”

“Hi, it’s Shelley here.  From Monash IVF,” she qualifies, like we haven’t been waiting for two hours for this very call.

“Hi Shelley,” we say together, the tension pluckable.

“Well, I’ve got some great news.”  Suse and I look at each other.  “All three of your eggs have fertilised.”

“Really?” Suse asks, grabbing my arm tightly.

“So, now you just need to come back at 2.10pm on Monday, and the implant will happen at three.  You’ll need a full bladder, but not too full.  So I advise that you go to the loo before coming in, and take a bottle of water and start drinking it here.  And then you’ll start the progesterone gel on Monday night.”

She stops.

There is a void.

We’re both mute.  Suse continues to grip my arm.  “Hello?”

“All three fertilised?” I hear myself asking.

“Correct.”

“That’s a pretty good result overall, isn’t it?”

“That’s a great result overall,” she corrects.  It’s the first time I’ve heard her genuinely animated.  Ever.  “To put it into perspective, I’ve just come off a call to another woman who had sixteen eggs collected and only two of them fertilised.  Three out of three is a fantastic result.”

Suse’s hand grips ever tighter.

“And so, I guess, from here, what should we expect on Monday?” I ask, my head swimming.

“Sorry?”

“I mean I don’t want to be pessimistic, but I want to be realistic.  Should we expect one of them left?  Or two?”

“Well, I’d be hoping there’d be at least two on Monday,” she says.

“Okay, okay, that’s good.  I mean…we’re just…we’ve just had a bit of a rough road, and this is all just a bit surreal.  There’s been a few set backs along the way.”

“That’s IVF,” she says plainly.

“Yes.”

“And this is a great result.”

“It’s quality, not quantity,” I chime, as cheesy as a box of Twisties.

“Exactly.  And then on Monday, after the implantation, we can talk about what to do with the spare ones with refreezing.”

Spare ones?

Two hours ago, I’d been considering that there might be none.  And now we’re talking about spares.

“Of course.  Of course.  We’ll talk about that with them on Monday,” says Suse, keeping it together.  “Thank you so much, Shelley.”

“Yes, well,” Shelley says, a little uneasy in this emotionally-charged territory.  “Good luck with the transfer on Monday.”

We hang up the phone, and it drops to the floor with a clack.  We rise in embrace, hugging each other, jumping up and down, in an adult version of ring-a-ring-a-rosy.

We bounce, and we bounce, and we bounce.

“Oh my God!” Suse says, grabbing my face.

“I know!”

“One hundred per cent!”

“I know!”

All morning I’d been imagining three fertilised eggs.  I knew that there might be none, but I’d just kept closing my eyes, and seeing the dish, and seeing all three.

“Do you think they’ll let us visit them?”

“Not yet, honey,” Suse says, “you’ve got to wait till they’re Day Three before they make it to the nursery.”

We both laugh, like dizzy little kids, so hopeful, yet still hardly daring to wish.

Three embryos.

One hundred percent.

Wow.

* * * * *

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

Friday 3rd September 2010

One year ago.

The instructions reiterate that I wash my hands, like I’m not about to touch my own penis.  They ask me to print my name on the pot and the consent form.  I one-up this by writing my full name, date of birth, ID number, wife’s name, and her ID number.

I’m not taking any chances.

I turn on the TV, and open a web browser.

I Google: ‘Porn’.

I open about ten tabs.

And then I sit there, butt naked, the heater on full, scanning through free porn, in the comfort of my own home, and knob myself.

And I do a very good job.

* * * * *

I head to the bathroom, again slowing as I pass the candle.  It flickers as I go.  The pot sits in the warm palm of my unused hand while I use the other to clean up.  I return to the living room, holding my pot, before re-dressing in the clothes that are strewn across the floor.

The pot goes straight into the jeans pocket.

‘Keep warm after production,’ the instructions warn, ‘but do not heat above body temperature.’

I grab the keys, the consent form and the biological hazard bag, and I jump back in the car.

It’s 10.02am.

As I drive back up the road towards the hospital, the sample jar sticks uncomfortably out of my jeans pocket.  At the lights, I wrestle it out and check the lid one more time.  I hold it up to the light to check the volume, surprised to see a few bubbles.  I guess anything liquid that sits in your jeans pocket is likely to bubble a little.

I feel a creeping over me, as I look to my right and see a woman in her car, staring.

Her jaw wide open.

The lights go green, and I floor it round the bend, pressing the jar against my warm palm.

* * * * *

I sit in the same seat, near the receptionist with the allergy to sperm, like I’m waiting to see the principal.  Occasionally she looks across at me, forcing a smile when I catch her staring at my Biological Hazard Bag.  I keep it on my lap like a loin cloth, ensuring the pot is upright.

My phone rings.

“Hello, is that Mark?”

“Yes.”

“This is Dorothy from Monash IVF.  I believe you were going to provide us with a sample?”

“I’m holding it in my hands as we speak.”

“Oh.  Are you on your way in?”

“I’m here.  I’m waiting for someone to come down and collect it.”

“Where are you?”

“In Day Procedure waiting room.  My wife is getting her eggs collected right now.”

“And where is your sample?”

“In my hands.  I’m holding a jug of sperm in my hands.”  The receptionist looks up like I just swore.

“Right.  Sorry.  I didn’t realise.  Someone will be there in a few minutes.”

I hang up and look around.  The waiting area is filled with seventy-year olds getting their hips screwed and their colostomies hemmed.  Not one other person in the room has a jug of sperm in their hands.  I concentrate very hard on the middle distance, staring carefully like there’s something important for me to see.

Eventually, a woman appears.

“Mark?”

She beckons me to the same corridor, forty-eight eyes following me as I go.

“Is that the sample?” she asks, pointing from hands hinged close to her body.

“Yes.”

She takes out a pair of purple gloves, putting them on theatrically.  “Could you repeat your full name?”

“Mark Edward Nethercote.”

“Date of birth?”

“29th May 1975.”

“ID code.”

I pull out the card from my wallet, repeating the number.

“Great, thank you.”

“It comforts me that you do that,” I say.

“Do what?”

“Check my details.  To make sure you’ve got the right person.”

“It’s not something we want to get wrong.”

With that she turns on her heels, and leaves.

I stand there for a moment, before turning back towards the waiting room.

Everyone is watching.

Everyone.

I wave.

Three of them wave back.

* * * * *

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By Mark Nethercote, September 1, 2011 10:00 am

Friday 3rd September 2010

One year ago.

Suse’s name is called, and we follow an impossibly small nurse wearing oversized Crocs through the doors and into the next section of the maze.  She trips on her own tiny feet;  in even the smallest sized shoes she wears two pairs of socks, and yet she still trips every three or four steps.  When we sit, requisite questions follow about Suse’s teeth, her lack of pacemaker, if her blood pressure is always that low, and whether we’d like them to pinch her jewellery while she’s asleep.

Suse then follows the tripping nurse to the change rooms, and returns wearing a large art smock, a hair net, and cloth foot covers.  She looks like a lunatic art teacher who works part time at the deli.  We sit for two more minutes, and then we’re ushered through to the departure lounge, where she gets the chair that goes up and down, and I get the footstool.  In turn, we sit here for a few minutes in awkward repose, until a man who has been passed several times finally gets the courage up to say hello.

“Hi there, Susan, I’m Martin.  Martin,” he repeats, turning to me.

“Mark,” I say.

“No, Martin,” he says once more.

“And I’m Mark.”

“Right you are,” he says, laughing awkwardly.  He crouches close.  “Now I think you guys are aware that Dr Fleischer won’t be performing the procedure today?”

“Yes.”

“And that Professor Vermeulen will be supervising?”

“Supervising?  She’ll be doing the procedure, won’t she?”

“No, I’ll be performing the procedure while she looks over my shoulder and says, ‘yep, great, looks good.’  Do have a problem with that?”

I look at Suse, her eyes having gone wide.

“No disrespect to you Martin, but I’ve only just met you, and I have a great deal of respect for Professor Vermeulen.  She was a lecturer of mine at University.”

“And you would like her to perform the procedure?”

“We’d feel more comfortable with that, yes.”

“So in that case, I’ll be looking over her shoulder while she performs the procedure, and I’ll be saying, ‘yep, great, looks good.’ ” We all laugh easily at the break in tension.

“Do you have any questions, Susan?”

“If you could just walk me through exactly what will happen, that would be great.”

“Okay,” he says, beginning to move his hands animatedly, in a game of Charades.  “We’ll place a needle into each of the follicles, and see how many of them have eggs.   For someone like yourself who has limited follicles, we’ll puncture each of them, even though the smaller ones probably won’t have eggs in them.  We’ll flush them out, searching for eggs – just in case.  To get as many as we can.”

“Sure,” I say.

“You’ll be under a light anaesthetic, you see, and you’ll be out the other end in no time.  You may have a bit of spotting and some period pain for a couple of days, but it should all settle down pretty quickly.  Do you have any questions?”

I look across at Suse, who is staring blankly ahead.

“I’m fine.  Suse?”

She shakes her head.   Martin gets up and disappears as quickly as he arrived.

“Are you okay, honey?”

“Well, for someone like me with such limited follicles, I guess I’m as good as I can be.”

* * * * *

I drive down the back streets towards our house.  As I brake behind the one-hundred-and-seventy-year-old man they hire specifically to piss off the residents of Richmond, I quell the urge to beep.  I ride the break down Lennox Street, through the repeated roundabouts and over the speed bumps towards Swan.  Eventually – despite having until eleven – I overtake him, almost causing him to crash.  I round the corner, heading west up Swan before pulling down our street to the end, squealing the breaks as I zoom under our roller door and pull up hard.

As I enter I walk slowly, careful to not blow out the candle that we lit last night.

Suse has always been a candle-kind-of-girl, but ever since the clairvoyant at the café with the salt and the candles, I’m also a convert.

“Let’s light a candle for incubation,” she said last night, out of the blue, “inviting a soul to join us.”

We lit it together, both striking the match, both saying something softly as we did.

And while I don’t know anything about the rules for this sort of shit, accidentally blowing out our candle when I’m – blowing out my own candle – would surely not be good karma.

I pass the quiet flame and walk towards the kitchen bench.  I take the pot out of the plastic bag and unscrew its lid, placing it down on the couch.  I pull out the consent form, reading the instructions:  ‘How to Wank 101.’

I’m not joking.

There are instructions.

* * * * *

To be continued…

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By Mark Nethercote, 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…

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By Mark Nethercote, August 5, 2011 10:00 am

Wednesday 4th August 2010

One year ago.

From heavy-hitting Section Five, they move to the big guns in Section Six:  Statistics on Congenital Abnormalities.

Before you try this at home, you should know:

Of naturally conceived pregnancies,

- 1 in 6 end in miscarriage

- 1 in 14 will be premature

- 1 in 30 will have a birth defect of a moderate to serious nature

- 1 in 100 will die at or around birth

- 1 in 400 will have cerebral palsy

And with this fun-filled stat grab, know that IVF and introcytoplasmic sperm injection have a 30-40% higher rate of congenital abnormalities.  That takes the numbers from 3-4% to 5-6%.  Is this because of the subfertility or the IVF itself?  It’s hard to know.

If you’ve take our broken parts and can’t make them work again, does that mean they’re bad mechanics?  Or just that they’ve done the best they can with what they had?

But there are other conditions, like Beckwith-Wiedemann and Angelman syndromes that may well be switched on by the culture products in the lab.

That freaks me out.

That really does.

And there is a list of other chromosomal problems that come with the territory of ICSI, where the sperm haven’t worked properly in the first place.  Thankfully, for me, this doesn’t apply.

Then there’s the risks that are inherent from multiple pregnancies, which occur more commonly with IVF.  Twins occur in 1 in 80 in the general population.  It’s 1 in 10 with IVF.  That leads to smaller babies, premature babies, more cerebral palsy, more perinatal death.  Not to mention the risks to mum’s physical health, let alone her mental health.

Twins would be Suse’s ultimate nightmare.

But regardless – regardless of everything we do right and what we eat right – IVF babies remain three times more likely to be premature, and of low birth weight.  We’ve cut out the smoking, drinking, becoming fat, smoking pot, injecting poisons, eating ratsack, mainlining crystal meth.

We’ve stopped doing all of that.  They’re no longer on our to-do list.

* * * * *

And then there’s the risks for Suse.  The risk of Ovarian Hyperstimulation Syndrome.  The theoretical risk of cancer due to IVF drugs.  Breast cancer. Ovarian cancer.  Cervical cancer.  Take home message:  Breast and ovary cancer are no higher in IVF women, but unexplained infertility can have a higher incidence of ovarian and uterine cancer.  Just because.

If you’re unlucky in fertility, you’re just unlucky, it seems.

Oh, yeah, and also, cancer sucks.  Don’t get it if you can avoid it.

And then, it launches into the final stinger:

The likely outcome of the whole thing.

Of all the eggs we get and fertilise, 2/3 will make it to day three, and only 1/4 will make it to day five.

Of those we freeze and rethaw, there is also a one-third attrition rate.

So, to use an example, if we get twelve to start with, and a quarter make it to day five, that’s three all up.  We implant one of them, and freeze the other two.  And there’s a chance that only one will re-thaw properly.

Shitbags.  That’s way worse that I thought.

* * * * *

So, like I said, this is our last month.  In a few more days, Suse will ovulate from the good side.  The egg and the sperm, should the twain both meet, could avoid this whole hullabaloo.

We should be so lucky.

If not, maybe I’ll read the IVF Friends newsletter and pretend I’m in the snowfields.  Or I could try some of their distraction techniques.  I’m already meditating, but they suggest massage, aromatherapy and low impact exercise.  And apparently reading helps.

Maybe I do need to look at Suse’s wax-covered book.

* * * * *

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By Mark Nethercote, August 4, 2011 10:00 am

Wednesday 4th August 2010

One year ago.

This is a cycle.  You’ve got about a 30% chance each time.  That means a 70% chance of crying each month.

Sounds about right.

So, if we don’t get pregnant first time, Suse repeats urine and blood tests.  No more injections.  When she’s ready to ovulate, they thaw out one of our little friends, and repeat.  This, we call the Natural Cycle.  Snap freeze, then thaw slowly up to ninety-nine months later, microwave for twenty seconds, then put on a delicate cycle.

Air dry for best results.

* * * * *

The next section is my favourite bit.   It’s the Male Partner Information Chapter.

It begins slow:

‘Male partners with low sperm counts, and/or low sperm motility and/or abnormally shaped sperm and/or who have antibodies against their own sperm, are classified as “male factor” patients according to the World Health Organisation Guidelines.’

I imagine the guy with the low count, low motility, abnormally shaped juzz and antibodies is really glad that he just has ‘male factors’.

After this, they lay it on a bit thicker:

‘Please ensure 3-5 days of abstinence from ejaculation prior to your partners e.g. collection date.  Do not abstain for longer than 5 days.

Okay.  Ground rules are good.

‘Prior to producing your sample, please urinate and wash your hands.’ Before or after I touch my penis?

‘Label the container with your full name, date of birth, partner’s name and time of collection.  Unlabelled specimens cannot be used.’

Fair enough.

‘Ensure you have removed the top from the jar.’

What the fuck?

‘After you have produced your sample, we ask you wait approximately half an hour while we assess the sample.   You will be notified if a second sample is required, if not you may leave.  If you have been asked to produce a second sample, you will not be required to wait for the results, but will be asked to provide a telephone number.’

So that someone can laugh at you over the phone.

‘We understand that providing a semen sample on the day of the egg collection can be embarrassing and stressful.  We will endeavour to make this event as easy as possible for you.’

Except for providing any porn that won’t make you ill.

‘The semen sample may be produced at home and brought into the clinic in the appropriate sterile container.’  As long as you remembered to take the lid off.

‘It must arrive within one hour.  Alternatively, the sample can be produced at the clinic and your IVF Nurse can book an appointment for you.’

This is a service I was not aware of last time.  It probably costs extra.

‘When men are anxious and having difficulty producing a sample, a couple of hours break (i.e. a walk) may help.  Please inform our staff, so that they can adjust their laboratory schedule.’

If you have stage fright, just give us a call, and everyone in the lab will move their lunch break around, so that they can applaud when you turn up with your unlabelled pot without a lid on it.

* * * * *

To be continued…

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By Mark Nethercote, August 3, 2011 10:00 am

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…

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

Wednesday 4th August 2010

One year ago.

So we’re into our last month of trying naturally.  August is our last chance before beginning IVF.  It’s the eleventh hour for nature.  The whole process is kind of surreal, to be thinking that September brings with it a genuine timeline for attempting conception – since we’ve been doing little else for the last 279 days.

And yet, after talking to Shelley, I’m kind of freaked out by the imminence of it all.  It’s weird that I could be, given how much I want it.  Had we managed to fall pregnant in the last few months, we’d now be well on our way.  If our first pregnancy hadn’t been an ectopic, then right now we’d have a five week old, we’d be sleep deprived, and on the precipice of our own insanity.

But instead, we’re not.

Instead, we’re still the infertile ones.

If we don’t get pregnant this month, injections will begin in about three weeks, we’ll collect the eggs in about five, and we’ll be reimplanting them in just under six.

In less than six weeks time, we will be trying to get pregnant.

Again.

With a little help from our friends.

But it all depends.

* * * * *

It depends on how many embryos survive.  In the time from egg harvest to reimplantation, the remaining numbers may be less than half.  Say they get ten eggs in the first place, more than five of them could be gone by day five.  Maybe all of them will.  It’s a tough battle at the beginning, especially when you’re living in a beaker.  We could go through a whole cycle, and get nothing.  Thank Christ the Government is footing the bill for the Orgalutran.

Suse has been urging me to read more.  She’s had a book by her bedside table, which has discreetly made its way across to my side, the cute black and white infant on the cover staring at me plaintively.  In it, a bunch of unlucky suckers recount how fucking hard IVF is.  I know that Suse gains solace from their hard luck stories;  it makes her feel less alone knowing that others have suffered too.  I just don’t know that I’m quite the same.  I don’t know that I need to learn the hard instructions.  I think I already know that.  Being a doctor kind of shows health’s short straws every day.  I really don’t think I need to read about them to know that they exist.

So instead, I turn to the manual.  I’m a manual kind of guy.  This is where we differ.  While Suse would choose to read a beautifully wax-covered collection of miserable anecdotes on the travails of being barren, I’d prefer to read the manual.

Men prefer manuals, women are from Venus.

So today, I open the labelled manila folder.

Yep, we have a labelled manila folder.

* * * * *

There are two manuals.  The first is called, ‘Guide to Getting Started Handbook, Version 3.1’.  The second is called ‘Treatment Cycle Handbook, Version 1.’  Both are A4 spiral-bound with a clear cover;  not dissimilar to my recent work contract.   Along with this I find a ‘Fact sheet about the Victorian ART Bill Update’, explaining why we’re being treated like criminals who need both a Police Check and a Child Protection Order.  There are also a smattering of pamphlets on ovulation induction, assisted conception, instructions for male patients, and long term sperm storage, in case I want kids when I’m seventy.

There are also the two editions of the newsletter that we have begun to receive from ‘IVF Friends’.  On the front cover of the July 2010 edition is a red British letterbox in a blizzard, piled up with snow.  The windblown side is almost snowed in;  Dr. Who’s door side is not.  On the August edition, we have a golden retriever, again in a field of snow, a small snowman plonked on his head.  Symbolically, I can only imagine that being barren is like a long cold winter, and ‘IVF friends’ are a communication group that you can use to call on friends.  As well as this, they will put up with you dumping your shit all over them.

* * * * *

I sift through more of the paperwork, to find ‘Treatment Cycle Costs Analyses’, another ‘ART Bill fact sheet’ (again apologising for suggesting we may be criminals), a ‘Service Agreement’, a ‘Safety Net Rebate Timeline’, and then the heaviest of them all, the ‘General Information Consent Form, Assisted Reproductive Technology Procedures Form’.

But first, the manuals.

The ‘Guide to Getting Started Handbook’ is a fluff piece.  Well, as far as instructions booklets go.  There’s the introduction, the Mission Statement and a Welcome Chapter.  They tell you who they are, and where they’re located, which is interesting, as we picked the book up from the clinic.  They spruik their research and development credentials and give percentages for causes of infertility (40% her fault, 40% his fault, 20% can’t blame anyone, damn it).  They talk about what tests needs to be done, what they do, and how big the needles are.

Check.

The most interesting chapter explains the history of the place, their impressive fertility rates claiming to be higher than other services in the state, and list their groundbreaking achievements since Carl Wood and John Leeton began Monash IVF in the 1970s.  They include:

- the first frozen embryo birth in the world

- the first donor egg baby in the world

- the world’s first pregnancy and birth from a sperm retrieval operation

- Australia’s first surrogate birth

- Australia’s first open testicular biopsy twins

- Australia’s first blastocyst baby.

About the only thing missing on that list is ‘first IVF baby’ – that honour taken by

Steptoe and Edwards in Manchester in 1978.  And while the claims five and six are getting into the ‘Guinness World Record for the Most Pikelets Eaten on a Thursday in St Kilda’ Type Categories, the first four are bloody impressive indeed.

This here is a world-class facility, which all began in a world-class University built out of brown brick in a suburb called Clayton.

For real.

* * * * *

To be continued…

Comments (0)

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.

* * * * *

Comments (0)

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.

* * * * *