"You can get dressed, come through and we'll discuss the findings."
Once those words are spoken I exhale and wonder why my doctor always says "the findings". Am I his lab rat? It's just so, umm, experimental, I suppose. I brood over it as I hop down onto the lino flooring. Leaning forward I separate the jumble of clothes left dumped on the metal chair, promising myself that next time I'll fold. The phrase flips over and over in my mind; I decide that I am okay with it. At least, I muse, it sounds as though he is taking this baby making extremely seriously. Pulling my jeans over my cold knees I try to imagine what I am going to hear. My mind flips back to a few minutes earlier, I think of the click-click-clicking of the button as Mr T flipped through the dark spaces that represent my follicles. Just moments earlier, I was staring hard at black follicular spots on the screen, my neck ached from the strain as I tried to count them all. But, as always, the doctor was too fast for me to memorise the numbers that flashed past or to note all the little white lines that marked the spots. Click, click, click, click, click and we were done.
I close the examination room door behind me, attempt a confident smile and place myself on the seat opposite the doctor. Clattering from his keyboard fills the tiny room as he inputs the findings from my ovaries into an electronic file. I breathe slowly, notice the expensive watch skimmed by an expensive shirt and use the spare seconds to silently speculate about what car he might drive. I am just deciding on Mercedes when my train of thought is broken by his eyes flicking from the screen and directly toward me; my mind whispers "stay calm, look confident, relax". I wonder why I so desperately feel the need to maintain my composure in front of this man. He starts to speak and I nod mechanically.
"Your current cycle is quite different from your last."
I continue nodding, "Oh."
"Your last cycle was very good, you had plenty of follicles and we retrieved 16 eggs."
I'm still nodding and force a smile, "Oh."
I wonder if I am nodding too much, shift my position in the chair and brace myself for bad news.
"This time you have 7, maybe 9, follicles and we would expect to get approximately 7 eggs."
I am not nodding anymore, "Oh."
I blink through his explanation that every cycle is unique, that it doesn't mean there is anything wrong with me and that if we did another cycle it may all be wonderful again.
My mind screams: Another cycle, doctor?
Mr T continues to rattle off the plan from here on in: one more day of stimulating my ovaries, two more days of suppressing the egg release and then, finally, the trigger. Yup, we are at the big one. The trigger shot will help the few eggs to mature and get ready for collection on Friday. Yes, on Friday!
As my ovaries no longer seem to be enjoying the IVF game, the considerable meds I bought from the dodgy perfectly respectable Internet pharmacy were not nearly enough. Mr T takes me down to the nurses' station and arranges for more drugs to be sold. I make a mental note that I will have some updating to do on my IVF cost tally.
I thank every one in the clinic, including the receptionist and the doorman from the apartments opposite, at least ten times each and head back to the underground station in the rain, hoping for a miracle on Friday.
Last year, when I took my slightly battered car for its annual service, the mechanic cheerfully informed me that I needed four new tyres. He kindly explained that standard tyres would be acceptable but extra special non-slip tyres would be so much better. He thought that regular tyres were okay, of course, but, if it was his car, the better tyres would be fitted without a doubt. Towards the end of our discussion, just as I was leaning towards the fancy tyres, he dropped in that the better tyres also had a mightily spectacular price. Hum, decision made, I was pretty sure my little car will be alright with the basic tyres.
Haven't we all enjoyed similar conversations with garages, or car salesmen, or even kitchen fitters? However, I was knocked-off-my-feet surprised when I had the same experience with my IVF clinic. Yes, I am not joking, it really did happen.
Yesterday I went for scan number two of my current IVF cycle. There were the usual dilemmas: Is it acceptable to make small talk whilst the doctor is lubing up a condom? Can I shriek "Youch" when he presses too hard on my left ovary? Is it okay to ask why my doctor decided on a career where he spends most of the time looking into ladies' private parts? You know, the usual stuff. But on this occasion, during our familiar wind down pleasantries, Mr T looked down at his hands and started to mumble. There was clearly something on his very thoughtful mind. Huh, he's got something awkward to say, I thought, wonder what it is? I hope I haven't got a large growth hiding in my uterus. The doctor shuffled in his chair, frantically tapped away at his keyboard and finally brought up the subject of two "optional" treatments. What?! There's more stuff they can do to me? Well, as it transpired, not me exactly.
The first addition up for discussion was Early Embryo Viability Assessment (Eeva). If you think it sounds fancy, that's because it seriously is. Eeva is a method of continuously monitoring embryos during their first moments and days of development. The very scientific theory goes that by scrupulously watching their every move and division you can tell which embryos are the good ones. And, based on a complicated mathematical algorithm the embryologist can, potentially, choose that elusive embryo capable of yielding a golden pregnancy. Good, huh?
Source
The second super-dooper IVF improvement is called EmbryoGlue. Yes, the marketing bods really have named the "optional" treatment EmbryoGlue. Who is going to turn down the opportunity to glue their embryo to their uterus? The science is a bit, but not much, more complicated than just gluing one thing to another; it involves adhesion molecules and carbohydrates but, in a biological sense, sticking things together is exactly what it does. A-ma-zing! Just look at the title of their movie clip. Who wouldn't want that?
Source
What's the catch? Well, there really isn't a lot of evidence that either of these things will definitely make me a pregnant lady. And, not surprisingly, they come with some pretty yikes-inducing price tags.
As I listened to Mr T enthusing over the benefits of these two IVF advancements, I couldn't hide my scepticism; I was the same with the mechanic. As my eyes grew wider and wider, my lovely fertility specialist finally cracked and said "Well, it certainly won't hurt". Losing control of myself for a moment, I let out an involuntary snort - always attractive - and Mr T conceded that it would most definitely hurt my pocket.
So it has come to this. I am forced to make decisions about whether I take the gamble and pay the money for experimental treatments that might - Mr T says probably - improve my chance of a pregnancy. I can't help feeling that this shouldn't be my decision. Surely this is either the best treatment, in which case sign me up, or no-one really knows, in which case, do the bloody trials.
The cost for both treatments would be £1200 (approximately $1800 USD) and, if I choose both, could increase my pregnancy rate from 50% up to a staggering 80% (possibly).
If I turn it down and I don't get pregnant will I beat myself up and think I should have done more, spent more, tried harder? Of course, the lovely fertility specialist was very careful to say my current plan, without the bells and whistles, is perfectly good - nothing wrong with it - but, in his opinion, the extras would make it better.
I don't know, I really don't. Any advice? What would you do?
Why do people voluntarily ride roller coasters? Perhaps if the aliens land tomorrow they will think that, if they base their assessment on the roller coaster riding alone, the people who inhabit this planet are bonkers. The creatures from Mars will see that, before the earthlings climb into the buckets, they are trembling and, once seated, they will scream, nausea will rise from their guts and, if it's a good one, even cry. However, once it's over, you will hear the riders say how thrilling it was, oh it was such an adventure, they'll say; get right back in line and hop on again for one more go. In short, the exciting, thrilling, exhilarating, wonderful feelings outweigh the fear, vomit and scream-inducing gut-wrenching stuff. Maybe that is why couples keep on putting themselves through one IVF cycle after another: the hope that, one day, after all the rain they'll get a turn at dancing in the sunshine.
This week I had the first scan of my current, it's my third if your counting, IVF cycle. I tried to remember how many scans I have had throughout my infertility journey but I can't, there have been just too many. After the first scan of my last frozen cycle I wrote down my thoughts on the scan process and, lucky reader, you can read all about it below:
"On the train back home from my clinic I couldn’t help thinking about how odd these scan sessions are. Maybe it is just me but they are weird, aren’t they? I find it all so awkward and slightly hysterical at the same time. I spend a good ten minutes in the morning checking everything downstairs looks okay, like anyone cares, and the thought that it isn’t pops into my head many times during the day. Then, once I get to the clinic, I spend several moments debating whether it should be socks on or socks off, wondering if it matters, and trying to remember if my nail varnish would be suitable if I do dare to go socks off. Finally, I make a socks on decision, clamber onto the chair, or maybe it’s a bed – I am not sure what it is – and I attempt to maintain some semblance of dignity whilst desperately trying to balance in the stirrups. Once I think I’m safely in, I have to call out “I’m ready” at which point I panic wildly, think Mr T won’t hear me so call out two more times with increasing volume and desperation. The whole humiliating process culminates with, what can only be described as, an eye-wateringly large dildo like probe which, to add insult to injury, gets lubricated and covered with a condom! Then the lights go down, I half expect Barry White to start playing, and we get to spend several minutes examining my inadequate innards. Like I say – odd!"
I had the exact same feelings again this week - nothing changes. Except this time, instead of excited anticipation, I am nervous and a little bit scared. The scan went well, I have 8 resting follicles (that's okay, apparently) and none of my internal organs had left the building - I wouldn't blame them if they had, I think they've had enough. But this time I have prior knowledge of what lies ahead; I know that IVF is hard and it makes me feel like this:
Oh before I forget, the financial round up:
1. IVF meds: £1092
2. IVF cycle: £3275
3. HEFA fee: £75
4. Train fares: £28
Total: £4470
It turns out that having a text speak name, being very cheap and only existing on the Internet doesn't mean that you are an untrustworthy outfit run by a gang of Internet fraudsters, living off great piles of cash sent to you by desperate infertile couples. It also seems that my inability to get things done any quicker than your average snail, or get things done at all, hasn't brought our IVF cycle to a grinding halt. No idea what I'm talking about? Then see here. For the rest of you:
We have drugs and lots of them too. Look at them all.
It is mind-boggling to think that in four weeks time, if everything goes according to plan, all those little beauties will be inside me - they shouldn't be in me all at once, some of them have better be metabolised or else I am one odd fish. Those drugs you see right there will, oh so hopefully, have made a baby or two or three or four or more. Yes, I know embryos aren't the same as babies but, please, work with me, I am writing out my dreams here. The great and good Mr T, our fertility specialist, seems to think he has got me all figured out this cycle. No need for guess work or buying our fertiltiy meds one syringe at a time. So, we've only gone and bought them all at once. Yikes! Oh Lord, I hope that doctor is worth the megabucks. In case you are wondering what the plan actually is, and it seems obvious to me that you must be, I have handily prepared a flowchart, not including scans which are randomly placed throughout:
In other news, my period kindly arrived. I apologise if you were still hanging on the edge of seat after my "could I be pregnant?" post. Hope can be a terrible thing. Maybe I should have cushioned the blow for you? Next time, although I'm hoping next time I will be screaming from the roof tops "I'm bloody pregnant!", I will gently sit you down, offer to make you a cup of tea and say "I have some bad news, you know that baby you wished I was making? I am afraid it's not going to be this month, dear". More importantly, the arrival means that I can take a trip to London tomorrow to see the magnificent Mr T in person. I get to spend some quality time with him and his magic stick (always enjoyable); then, assuming my uterus hasn't jumped ship when I wasn't paying attention, I will have the joy-inducing opportunity to hand over a ton of money.
For those who are financially minded, and so it reminds me to behave responsibly and not book a random weekend break, I will be tallying up the credit card bill as we go along. Here comes the first total:
IVF meds: £1092
Total: £1092
