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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From those that remained, he drew about 200,000 sperm for each egg. Sarah’s three eggs, one to a petri dish, were suspended in the solution. Repp labeled each dish with Sarah’s name, the kind of medium in the dish, and a number for the egg. He then injected the sperm into each dish. The sperm, at that point about six hours old, dispersed and began a task dictated by eons of evolution. Repp placed the petri dishes in a small refrigerator-size incubator, where the sperm moved through the solution to the egg in the 98.6-degree temperature of the incubator’s profound and dark stainless steel womb. In about sixteen hours, the eggs would either be fertilized or not. Any one of them could be our future child.
They fertilized. All three. John Repp called the next morning to tell us the good news. We were all excited. He always got excited even though it was old hat to him. Repp knew his eggs. He was getting 86 per cent of the program’s eggs fertilized. But fertilization wasn’t the only step toward transfer; the eggs had to divide. To help them along Repp placed the fertilized eggs into a growth solution, which had more of Sarah’s blood serum. Then they went back into the incubator. Twenty-four hours later, Repp would look at them again.
When he checked the eggs the next day, they had begun to divide. Two were four cells and one was at five cells. Repp called them embryos when he gave us his report. We were to be at day surgery at six-fifteen the next morning so that the embryos could be returned to Sarah.
We arrived full of anticipation. This was the climax of the treatment, what all the stimulation was for—to get Sarah’s eggs, let them fertilize with my sperm, and return them to where they belonged.
I had heard that I could be in the operating room for the transfer, but I wasn’t so all fired up to be there. I didn’t know what Sarah would be put through. When Repp told me that two of the embryos were eight cells and one seven, though, I knew I would be there. I wanted to see them, our embryonic children. Hell, it might be the only time I would see any offspring that we’d ever have. Repp said it wasn’t possible. He had taken pictures, and we could have copies. Our first baby pictures. Sarah and I would be armed with something to pull out and coo over at friends’ homes. Vaughn came in and cut short my daydream by motioning us into the operating room.
Surgery was a room crowded with machines and trays arranged around an operating table. Lights and flexible tubes hung from the ceiling, and green-suited nurses crisply readied an altarlike table. Someone had tried to add human touches to the room by taping posters of hot air balloons and mountains to the glazed-brick walls. It didn’t work.
And so it was all business to the nurses when we entered. One rolled a stool to the head of the table and commanded me to sit. Another helped Sarah onto the table as the rigid polished arms that clasped the calf brace and stirrups were installed. The nurses positioned Sarah’s legs in them, and a green sheet was placed across her stomach. I was beginning to feel nauseated. Vaughn came in, gloved, and sat on a stool at the foot of the table. He had the table tilted up slightly and the lamps adjusted for maximum light. Repp entered, waiting for a signal from Vaughn to bring in our embryos. A nurse handed Vaughn as alien a piece of stainless steel as I had ever seen, a speculum. Vaughn’s head disappeared below the draped sheet that mercifully blocked my view. He nodded to Repp, who went across the hall to his lab and carefully picked up a wandlike catheter with a syringe attached. Before we entered surgery he had grouped the embryos together into one dish. He then placed the catheter into the giant drop of liquid. When he pulled back on the plunger, the catheter filled with Sarah’s maternal serum and the fertilized eggs.
Repp returned, cradling the catheter as he walked over to Vaughn. Like two brothers passing an infant, Vaughn received the catheter gently and removed it from a sterile protective sheath. He then leaned toward Sarah and asked her to remain very still. He eased the catheter past her cervix and into the uterus. He pushed on the plunger of the syringe and released the embryos into the natural void. The transfer took all of one minute and fifteen seconds.
As a precaution, Vaughn gave the catheter back to Repp, who went back to the lab. There, he would check the tube under a microscope to make sure that all the embryos were out. If by chance one remained, Repp would return the catheter to Vaughn to redo the transfer. But no eggs were left. They were somewhere inside Sarah’s uterus and to accommodate them, she was instructed to stay perfectly still. We did, Sarah inclined and me at her head, for about five minutes.
It was an unpleasant passage of time. I was confused by an emotion that had raced through me during the transfer. I couldn’t pin it down. It lasted only about five seconds, but my throat thickened and my eyes teared when the transfer took place. It wasn’t joy or sadness. And it wasn’t hope.
I tried to mentally joke about this clinical sex, to overpower the wave that swept over me. I envisioned the nurses kicking back, lighting up cigarettes. We would all talk about how it was after the transfer. “Was it okay? Did you like it?” But my protective humor was thin. I couldn’t laugh. I couldn’t move. I looked over the sheet covering Sarah’s legs, toward the brick wall in the unfriendly blue-accented room. The shine of stainless steel was everywhere. I was very cold. The emotion again moved from my chest to my throat; my eyes misted. And then I recognized the feeling. It was shame.
Some nurses entered pushing a gurney. They slid it next to the table and tilted it. Sarah wasn’t to move a muscle. Vaughn and Repp adroitly slid her onto the gurney and rolled her to her room. She would be there for five hours, remaining still.
What happened when a fertilized egg was naturally released into the womb from a fallopian tube? What communicated between the folded uterine walls and the embryo’s gelatinous covering? What caused the two linings to intermarry, join, and develop? No one knew. Vital embryos could be transferred, but only a small percentage developed to join the living world as an infant. What happened to the embryo after the transfer was the enigma in IVF that sustained the low success rate. Medical science had done what it could. It was up to Sarah now.
She had talked to her sister, Mallory, in California before the transfer. She told Sarah to think good thoughts, relax, to imagine her womb as the best of all possible worlds, and other Californiana. For once I thought the advice was good. Sarah’s positive thoughts flowed while she lay tilted on her back: find a place, burrow deep. I accept you every one and hope you become my children. She tried to doze but couldn’t sleep.
Dr. Vaughn had prescribed progesterone to begin after the transfer. That might help reduce the chances of miscarriage. There would be an injection a day for at least two weeks, and I had agreed to give them to Sarah. I told myself that if I really loved her, I could do this. Some reasoning. Now my fortitude was deserting me. I had to get out of there. I drove around. Sometimes that helped; that time it didn’t. I went over to Kevin’s and smoked a couple of his cigarettes. I got nervous from being gone too long from the hospital so I went back.
Sarah was awake and still tilted when I returned. She said she wouldn’t mind if all three took, she couldn’t single out one to make it. Twins would be fine, especially since she wanted to have more than one child but didn’t want to go through IVF again. She was sure about one thing: if she got pregnant, she would stay pregnant. There weren’t any excuses of bad tubes to use now. I agreed, but I wasn’t going to get my hopes up. I just wanted Sarah to relax and was relieved that most of it was over, no matter what.
Sarah reminded me to go to the pharmacy in the hospital annex to pick up the progesterone. There I got a paper bag that contained a vial of progesterone and a two-week supply of syringes and needles. I took out the box with the vial of progesterone. Stuck inside was a yellow strip on which was emblazoned in bold type “Warning for Women.”
While reading the warning, I took a wrong turn back to St. David’s. There was much new construction going on, and I wasn’t paying much attention to my path because of the first paragraph on the flimsy yellow flag.
“There may be an increased risk of birth defects in children of women who take this drug during the first four months of pregnancy.” I walked up and down the same flight of stairs twice while I was reading. “These drugs have also been used to prevent miscarriage during the first few months of pregnancy. No adequate evidence is available to show that they are effective for this purpose.”
I raced across the courtyard to day surgery. I ran to the desk and read the warning to the nurse. “…one study fond that babies born to women who had taken sex hormones (such as progesteronelike drugs) during the first three months of pregnancy were four or five times more likely to have abnormalities of the arms and legs than if their mothers had not taken such drugs. Some of these women had taken the drugs for only a few days.” She discounted such foolishness with a shake of her head, “Don’t worry about it.” Dr. Vaughn had prescribed it, Ruby had approved it, the nurse said it was okay, and Sarah consented, at least tacitly. We had come this far without bucking the system, and we hadn’t been canceled. I followed the nurse into Sarah’s room.
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