We Wanted a Test Tube Baby
The doctors warned us that it wouldn’t be easy. We didn’t know how right they were.
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A couple of months later Vaughn examined Sarah, and the following month we took in $100 to apply to the program formally. Then it was my turn to be scrutinized. Though I had a twelve-year-old child and had been through tests two year earlier, when Sarah and I started trying to have children, St. David’s wanted fresh information. In other words, semen analysis.
I had an appointment to meet St. David’s IVF gamete physiologist, John Repp, the “egg man.” He would check my sperm count. He would be the one who would eventually take my sperm, Sarah’s eggs, and commingle them, which I likened to a game of red rover in a petri dish.
It’s all numbers with spermatozoa. The more you have, the better your chances are of getting what you want. To fertilize an egg, a range of 20 million to 150 million sperm per cubic centimeter is considered acceptable, thought some IVF programs can work with less. But numbers aren’t enough. The sperm also have to be forward-swimming (motile) and at least 60 per cent must look normal.
I arrived at the hospital apprehensive. It was hard to believe that everyone didn’t know why I was there. I went to Repp’s office. Behind a crowded desk in a pinched room was John Repp’s sympathetic face. Too sympathetic. Like he was doing his damnedest not to laugh at my embarrassment. We shook hands. He, like Vaughn, was quiet-spoken. I asked my question about natural selection again, explaining my dismay at sperm being dumped on the egg like pepper on a sunny-side-up, with no differentiation between the bad sperm and the good sperm—sort of like a microscopic equal-opportunity plan. Repp said that the sperm would have some competition in reaching the egg but we didn’t have time to philosophize.
He took me next door and unlocked the masturbatorium. It was a closet jammed with a hospital recliner, a wall rack spilling Playboys and one dog-eared, loathsome-looking Penthouse. On top of the magazine rack was a portable radio. Wasting no time, Repp pointed out a specimen cup, the sink, a mashed tube of K-Y jelly, and the lock on the door. I got the point. He left and shut the door.
As I fiddled with the lock, I heard him reenter his office. Our rooms shared a wall. A wafer-thin wall. His chair squeaked as he sat down. I could hear him scratching notes with a pencil. The radio’s purpose became clear. Suffice it to say that the Mormon Tabernacle Choir’s exaltations were ludicrously received.
My sperm count checked out okay—low average but high motile. I took that to mean what they lacked in number they made up for in spirit.
In April the IVF team reviewed our application. Though the files had already been screened and had been tacitly accepted before the meeting, the review gave all the doctors another opportunity to recommend other treatment. Most of the time, the one to five files per meeting are given five-minute summaries and then accepted. Our file was no exception.
Sarah decided to start IVF toward the end of May, to coincide with her summer vacation as planned. What a vacation! At least she wouldn’t be surrounded by first graders every day; we would be surrounded only by our friends, all pregnant and dropping kids like crazy.
It was the baby boom’s baby boom, and we were right smack-dab in the middle of it. The great issues of the day? Diaper service versus disposable diapers, not the federal deficit. Strollers and battery-operated swings. Each baby shower or visit with friends emphasized our social uniqueness. We were the ones without kids. Our friends knew our situation and weren’t so foolish as to tiptoe around us. We didn’t want that. There was just a hint of something, a subtle inadequacy, an inability to share. It wasn’t dominant, but it was pervasive.
In May Sarah and I met Ruby in her office. She gave us a booklet about in vitro fertilization and embryo transfer and a general treatment calendar. As we looked over the schedule, St. David’s program started to look like boot camp.
The intensity of it slapped me hard. There was a month of injections. Sarah abhors shots. One of the syringes was on the table. The needle was one and a half inches long. Sarah shuddered. One option was that I could give Sarah the progesterone injections. Were they kidding? A shot a day for as long as four weeks?
Besides the actual injections, there were all the hormones that would be administered. Chemicals, lots of them: progesterone, Pergonal, and clomiphene. What were the side effects? One was an increase in emotional highs and lows. Just our expectations of the program yielded enough depression, joy, and anxiety without any chemical assistance. Would depression become melancholia? Would apprehension twist into paranoia?
There were also rare physical side effects. Hyperstimulation syndrome: dangerous swelling of the ovaries and fluid draining into the abdomen. Shock. Blurred or double vision. One death had been recorded when Pergonal was first used, before the drug was monitored. The probability of severe side effects was minimal, but not minimal enough for us to overlook it blithely. As for the more possible side effects, Sarah could expect headaches, tenderness, bloating, cramping. And, of course, pain.
Then there was surgery. Somebody would be cutting into my wife. I remembered her first operation. I waited outside and envisioned Sarah’s lying on a black-padded stainless steel table, and nurses lifting her limp body, positioning her. The utter helplessness of it all. The image overwhelmed me. I could never forget it.
And then there was the waiting, waiting to see if you got past one stage, if you could go on to the next. Eight out of ten couples failed IVF—the 20 per cent success rate is based only on the number of pregnancies. If you made it past the injections, the side effects, the surgery, the waiting, you would have spent a little under $5000, you would both be emotionally pulverized, your wife’s arms and hips would be bruised, and she would be either pregnant or not. That, in a nutshell, was in vitro fertilization.
I looked at Sarah. Though she had been listening and taking notes, she seemed astonished. She was thinking about the manipulation from the chemicals being injected every day into her 115-pound body. Everything had to be ready at the right time for that to work. Half seriously, she said she was wondering whether she would survive it all. She laughed apprehensively, then quieted, her lips pursed tight in determination.
Then we saw under item number four in the risks and hazards section of the IVF consent form: “In addition, there is the possibility that the early embryo(s) may implant in a fallopian tube causing an ectopic (tubal) pregnancy that would require surgery for treatment.”
I came unglued. Overprotection, lack of trust, insecurity, ignorance, fear, and anger—it all boiled out. I saw my wife being used as a guinea pig in an experimental program. It was barbaric, medieval, and fly-by-the-seat butchery. Why didn’t they perfect this on animals before they did it on humans? Why did they feel that 20 per cent was an acceptable success level to offer us? I didn’t consider 20 per cent to be a solid record of achievement. They might as well wave a smoking stick in the air and mutter incantations to Niobe. The program amounted to about as much. Did they really expect us to judge something like IVF rationally? Infertile couples who want children don’t make rational decisions; they don’t use logic. Put reason up against emotions in such a situation, and nine times out of ten reason gets decapitated.
Sarah let me spew. She was used to my narrow-minded, cynical tirades. She didn’t say much, just laughed nervously. Though she was becoming acutely aware of the physical and mental sacrifice, she saw the possibilities. I only saw the pain she would suffer.
My philippic exhausted me. I had assailed Ruby, but she had heard it before. There was another reason my frustration churned into anger. I didn’t like being put in the position of having to make a decision to resort to IVF. Ruby and Dr. Vaughn sympathized with our frustration, but no one really could understand until they shared our anguish, until they went through something like this.
The next night I told Sarah that I didn’t want to go through with it. Too many chemicals were required to make her body do something it couldn’t do. I wasn’t comfortable about the side effects, even though statistics indicated the low odds for the severe effects. But my wife wasn’t a statistic. And there were the shots that she would have to have, some that I would have to give her. I would be hurting her, and both of us knew it. Would she hate me just for that moment during the shot? IVF was too new and its standards were too broad to cover all of the gray area where decisions were made. Let St. David’s get some treatments under way first. The more research that was done, the more chance there would be for a medical breakthrough. We had time, at least a couple of years.
I held Sarah by the shoulders. We wanted children, of course, but not at her expense. The risks were too great for the slim chance of success. That was my argument. I had only one other thing to say: the final decision had to be hers. It was her body that would be mortified; her sacrifice would be far greater than mine. She had the right to decide whether we would go through it. I asked her not to tell me right away.
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