Bringing in Finn (11 page)

“Is this really necessary?” Bill asked, as we sat side by side in the lab, our veins popping from the rubber straps banding our biceps.

“It's the FDA's rule, not ours,” Rachel said. After she'd finished filling the requisite tubes of blood, she handed Bill a plastic cup. “We always take a backup donation precycle,” she said, “in case someone is unable to perform on the day.” She motioned to the hallway. Bill trudged grudgingly toward the “man room,” his shoulders hunched.

“Men can be babies sometimes,” Rachel said. “Wait until he sees what you have to go through.”

With these preprocedures completed, we would begin our actual IVF cycle in March.

 

But I continued
to feel unsettled. I told him I just needed a little time to assimilate to the regimen that was coming. I prayed and meditated in the mornings, asking for courage and alignment with whatever we needed to do to have a family. I felt no different after the meditations, but by the Monday morning of our first Lupron injection, something had shifted. I woke feeling committed, like a warrioress going into battle.

If stim was like taking an intro-level class on fertility, IVF was a PhD program.

The first two weeks were easy. I went to the doctor's office for a monitoring ultrasound once a week. Each morning at home I injected five milligrams of Lupron into my abdomen and took a birth control pill and seventy-five milligrams of dexamethasone. On the fifth day of the cycle I stopped the birth control pill and my period started—right on cue. During week three, the medications increased. I continued the Lupron and dexamethasone in the morning. In the evenings I took Follistim, Repronex-Menopur, and an injection of estrogen on alternating days.

I guessed this was around the point in the cycle where people started having meltdowns or freaking out. A friend of mine told me she experienced paranoia and obsessive thoughts just from taking Clomid, and a friend of hers said IVF drugs sent her into a depression. Rachel had cautioned me about side effects ranging from sore breasts to bloating, and noted I might feel more easily overwhelmed than I typically would.

Aside from some general, low-grade anxiety over the process and
a full feeling, as if my stomach had been inflated a few times with a bicycle pump, I felt normal. Tracey and Rachel seemed surprised.

“Do you think it's because I meditate?” I asked my friend Sandy over the phone. We'd met at a life-coach-training program the year I moved back from London and had become immediate friends. Sandy had been meditating for over twenty years and had often spoken of the benefits she experienced from her practice. When she moved to Santa Fe, I started to visit two or three times a year and we set up a monthly phone date.

“It might be the meditation,” she said. “I think it's also the way you're approaching this process. You and Bill have chosen to be positive and let this bring you closer.” I could envision Sandy on her back porch, drinking hot water with lemon, her cropped blond hair catching the light as the sun rose over the arroyos and canyons of the Sandia Mountains. I longed to be there for a day or two, to lay my body on the desert floor, to go hiking at night and see the thousands of stars in the black sky.

Sandy was one of the only people I told we were doing IVF. I no longer felt ashamed of our decision; I just didn't want people asking me if we were pregnant or when we would know. I found it challenging enough to be with the thoughts in my own head, the hopefulness tinged with fear, the useless attempts to not think about the outcome. We'd been general with our parents, too, sharing only that we were doing fertility treatments and we'd let them know when we had any news.

I tried not to think about catastrophic outcomes as I dutifully injected my abdomen each morning and night. As we neared retrieval (the procedure in which Dr. Colaum would go in and extract the eggs), my abdomen grew sore inside. The injections made constellations of angry red dots across my stomach, and in one or two places I had small purple bruises where the needle had punctured a capillary.

“Is there a way to avoid this?” I asked Tracey at one of my appointments.

“I'm afraid not,” she said. “It just happens sometimes. It's nothing to worry about.” The “injection site,” as the instructions called my stomach, did not exactly hurt. But the skin felt itchy and stung when I rubbed it with the alcohol swabs.

Dr. Colaum measured the growth of my follicles and counted my eggs. I tried to count along with her but could still make out only fuzzy circles on the ultrasound screen. I would have guessed seven, but she consistently came up with nine. When the largest egg grew to her desired measurement, she would set the date for retrieval. We would transfer three days later, she told me,
if
we had embryos.

In the mornings, I read Zen axioms about being flexible with desires and supple as a reed, but as we neared the hoped-for retrieval and transfer dates, I felt like a violin whose strings were wound a few turns too tight.

 

When I was
working, I focused on the work, but the drive back and forth to Evanston every other day gave me an abundance of unstructured time in which to fixate on our fertility process. My least favorite part of the drive was the long, utilitarian strip of Ashland Avenue that took up about twenty minutes of the commute. I logged the landmarks as I drove: car wash, a White Castle drive-through, and several blocks of sad, neglected-looking storefronts. Once I turned onto Ridge Road, though, in Evanston, the scene became more picturesque. The bare street opened onto a wide, tree-lined drive, and the long driveways and expansive lawns calmed my mind, so that by the time I reached the parking lot my spirits had lifted somewhat and I could breathe fully into my belly again.

On the drive back, I would feel calmer still, by a decimal point or two, having seen with my own eyes that the follicles were developing,
that we had not hyperstimulated, that the eggs were growing “beautifully” (as Dr. Colaum liked to say), and that in about one week's time we would be ready for retrieval.

I didn't ask Bill to accompany me to the appointments. The frequent visits were disruptive enough to my routine, and we agreed it was better for him to work. In some way that I never named aloud, I felt that the monitoring was my responsibility: The eggs were growing in my body. I began to think of the appointments as part of my preparation for motherhood. When we had a baby, there would be errands and classes and check-ups at the pediatrician. IVF was like an early-start parenting program. I was taking care of our child before he/she was even conceived.

At night, as I lay in bed, I would imagine myself lying next to Bill heavily pregnant, feeling a tickle of excitement run up and down the front of my body. I knew what I was doing was a risk. The 33 percent statistic flashed in my head as a reminder. I would have been wise to keep my mind open to all possibilities, to stay in the moment, to be at peace with whatever was coming. But my heart already beat with these visions of pregnancy, and I started to find it hard to imagine that it could be possible
not
to be pregnant, after doing
all this.

 

On my way
home I stopped at Whole Foods to pick up groceries: bread, eggs, tea, spinach, and Ben and Jerry's frozen yogurt for Bill. I had told exactly one friend—Sandy in Santa Fe—that we were attempting pregnancy with IVF. I'd felt unburdened after I called her and longed for more connection as I sat in my car in the parking lot. Impulsively, I picked up the phone and dialed my parents' number.

“What a nice surprise,” my mother said upon answering. I heard the score of some musical in the background. “Am I interrupting dinner?” I asked. It was five thirty in Chicago, and I sometimes forgot to factor in the hour time difference.

“Your father is out fighting for one of his causes tonight, so I'm going to get out of my work clothes, straight into pajamas, and eat a big bowl of cereal.” She sounded thrilled.

“I wanted to share that Bill and I are doing IVF,” I offered, bypassing any small talk. “We have two procedures—retrieval and transfer—sometime next week.”

“How are you feeling?” she asked, continuing the conversation seamlessly, as if we'd just discussed fertility treatments the week before, instead of a single time many months earlier.

“A little anxious—about being pregnant but also about the retrieval procedure,” I said. “I'll be out with general anesthetic while our doctor retrieves the eggs from the follicles.”

I considered telling her about the eggs, how Dr. Colaum was pleased that I had so many. I began to, but stopped. If for some reason we couldn't complete the cycle, I worried I'd have her disappointment to contend with as well as my own.

“It's amazing what modern medicine can do,” my mother said.

“I know. Thanks for letting me share,” I said.

“It sounds like you're doing great, honey. We're praying for you. Keep us posted.”

 

The following Wednesday,
the first week of April, Dr. Colaum scrutinized the ultrasound screen and pronounced us ready for retrieval. I could make out the individual follicles on the monitor now and counted eleven or twelve viable eggs, ranging in size from nine to twenty centimeters.

“HCG tomorrow night,” Dr. Colaum said to Tracey.

In an IVF cycle, HCG has to be injected at a precisely scheduled time, down to the minute, exactly thirty-six hours before the retrieval procedure. Unlike the other injected medications in the cycle, HCG is injected intramuscularly, which means in the buttocks, or in the
“love handles,” Rachel told us on the day of our first IVF consultation. “For you,” she said, assessing my body, “I recommend the buttocks.” Bill and I had henceforth referred to HCG as “the butt shot.”

Our time for the butt shot was nine o'clock on Thursday night. I let Bill administer this one because the needle was longer and I couldn't work out how to twist myself around and inject the shot in either cheek. Bill said it would be fun—for him, at least, trying to make light of it—but I was jumpy all evening. A lot rode on this shot. I thought of the hours spent driving back and forth to Evanston, the month of injections, the lab tests, the $1,500 worth of extra procedures RMI included as part of its IVF package that insurance did not cover. If we screwed up, all of our efforts to this point would be wasted.

We ate dinner at home, turned off our phones, and watched a few sitcoms. At eight forty-five, we laid out the HCG vials and Bill began mixing the powder with a saline solution. I read the instructions out loud, checking both the manufacturer's instructions and the packet from RMI. I bounced my legs nervously while Bill prepared the syringe. At eight fifty-nine, I pulled down my jeans and turned my backside toward Bill. At nine o'clock exactly, Bill was still fiddling with the syringe and I started to panic. He'd found an air bubble and was flicking his finger on it, trying to get it to burst. I recalled horror films where people injected an air bubble into someone to murder them. I hadn't asked Tracey or Rachel about air bubbles. Could this injection kill me? The seconds ticked forward, and Bill squirted some air out of the top of the needle.

“Honey!” I yelled at Bill. “Don't lose any of it! It won't work if I don't take the whole dose”—as if he didn't know this as well as I did, as if he had an interest in anything other than success. Bill flicked the plastic tube again and the bubble burst. With a steady hand, he plunged the needle into my backside. I felt a small
jolt of pain as the liquid entered the muscle. We counted to three and Bill removed the needle and massaged the area, as the packet instructed. He wiped the site with alcohol and I pulled up my pants and took over rubbing my behind. I wrote down the time on our chart. It was still exactly 9:00 PM.

 

When I called
Dr. Colaum's office to confirm our HCG injection time the next morning, Tracey told us to arrive no later than 8:30 AM on Saturday for the retrieval. “Wear something comfortable and remember not to eat or drink anything after midnight tonight.” The RMI packet also instructed me to remove any perfumes or nail polish. Later that day I got a message from an anesthesiologist with more instructions: not to swallow any water, even after brushing my teeth.

“They say that so you don't puke during the procedure,” Bill said when I told him about the call.

When we arrived at RMI on Saturday, the office was already bustling. The overhead lights were on, and half a dozen staff members buzzed about the hallways. “Do you work every weekend?” I asked Rachel, who met us at the front door and gave us more forms to sign.

“We schedule all our patients' cycles in sync so that we work two weekends a month and have the other two off,” she replied. I would not have wanted to work that many weekends; I was grateful for their dedication.

Rachel walked Bill and me past Dr. Colaum's and Rinehart's offices, past the lab where I'd had my blood drawn, and to the back of the clinic, where the procedures took place. I'd never been to this part of the office and was surprised by how big it was. A central space formed the nucleus for three patient waiting areas, a procedure room, where Dr. Colaum would perform the retrieval
and transfer, and the fertilization lab, where embryologists, who'd taken on mythical qualities in my mind, introduced eggs and sperm to each other to create embryos.

Rachel escorted us to one of the waiting areas, a three-by-four-foot space partitioned off by curtains. Inside were a La-Z-Boy and a straight-backed chair, plus a shelf with a fanned-out row of magazines and a stack of surgical clothes: a cap, gown, and pair of socks for me. She handed Bill a cup for his “donation” and instructed me to change into the light blue ensemble. Bill slumped in the chair, holding his cup. “I'd almost forgotten about my part,” he said with a weak smile.