We Wanted a Test Tube Baby
The doctors warned us that it wouldn’t be easy. We didn’t know how right they were.
On March 10, 1984, my wife hemorrhaged from an ectopic pregnancy. We rushed to the hospital emergency room and met with Sarah’s doctor. After a brief examination Sarah was taken to the operating theater on the third floor, where the doctor performed abdominal surgery that evening.
Two hours later the doctor came out to the waiting room an told me about the surgery. He explained that in most cases the egg is met by the sperm in the fallopian tube, where it is fertilized and then travels down to implant itself in the uterus. In Sarah’s case, however, the fertilized egg didn’t make it to the uterus. For some reason the embryo implanted in her right fallopian tube, where it stayed and grew. Within a week it had ruptured the walls of the pencil-size tube, and in less than an hour Sarah lost more than a quart of blood.
The doctor tried to save the tube. He worked to stop the bleeding three times—applying pressure to the tube, milking the blood free, and compressing the tube. Each time blood seeped in, filling the tube. It just wouldn’t stop. Finally, he took the tube out.
The doctor’s voice became a whisper. We were alone, but we sat hunched toward each other, inches apart, under the cool fluorescent light in the center of an empty waiting room. He had known Sarah and me for four years, for almost as long as we had been trying to have children. He had done everything within his medical powers to help us have those children. He had run numerous tests on us. When endometriosis blocked both of Sarah’s fallopian tubes, he had opened them up, hoping that they would remain open long enough for us to conceive. He had been with us when she first miscarried. Now, when Sarah had become pregnant again at 32, the embryo had burst through her fallopian tube and almost killed her.
It was late. Darkened hallways ran from the elevators to lighted outposts where nurses worked quietly. The waiting room, an open area lined with settees and sprinkled with religious pamphlets, was cold. The darkness seemed to close in around us. My throat was tight, my hands trembled. I asked about the left tube. His eyes answered before he spoke. It was a mass of adhesions, twisted like an old garden hose. Scar tissue covered the left ovary; he hadn’t been able to see it. He paused. I could say nothing; what was there to say? The doctor knew how badly we wanted children. He really wanted us to succeed. That was when he first mentioned in vitro fertilization and embryo transfer (IVF). He said there was a program starting here in Austin that might offer us another chance to have children. He said we should think about it, that the IVF procedure was our only remaining hope—that, or a miracle.
Sarah and I had heard of the in vitro fertilization and embryo transfer technique. Infertility was newsworthy in the eighties. Couples usually had their children while they were in their twenties and early thirties. However, as our population aged, couples had been postponing their childbearing years. That gave women more time to develop endometriosis, pelvic infections, or ovulation problems. Younger women, those between the ages of 20 and 24 who were having children, were experiencing increased infertility because of smoking, drinking, drugs, promiscuity, contraceptives, and overexercise. In men, a decreased sperm count was noted. America’s fertility rate was on the wane.
Infertility, however, had stimulated research and new techniques. In vitro fertilization and embryo transfer is one of the latest methods to combat this epidemic. It was for couples who because of damaged fallopian tubes, a low sperm count, endometriosis, or some unexplained infertility, couldn’t have children any other way.
What sounded so simple—the fertilization of an egg outside of the womb and its transfer back into the uterus—had resulted from years of research continually besieged by ethical questions, technical difficulty, and risk. It was only marginally successful. But Sarah and I knew none of that when we considered in vitro fertilization. We wanted a baby; IVF gave us a chance.
IVF grew out of ten years of collaboration between a physician and a research scientist, Dr. Patrick Steptoe and Robert Edwards, in London. The world’s first “test tube” baby was born in 1978; since then, more than a thousand children worldwide have been the result of IVF.
There are 125 registered American Fertility Society IVF programs in the United States. Two years ago Houston and Dallas offered IVF programs at six hospitals. Houston had the better-established programs, with Baylor, the University of Texas Health Science Center, and Woman’s Hospital of Texas successfully performing IVF treatments. But if we were going to leave town to enter a program, we could as easily look into out-of-state programs, searching for the best. That meant enrolling in the Eastern Virginia Medical School’s IVF program in Norfolk, Virginia. It was the first American program. It had nearly 130 IVF-conceived babies to its credit. Repeating the procedure so many times had helped make the Norfolk program the best; simple practice goes a long way toward perfecting technique.
In 1984 some infertility specialists teamed up at St. David’s Hospital in Austin to start an IVF program. Although its success rate was unknown, the program in Austin meant that Sarah and I wouldn’t have to leave home and spend weeks in a motel near a medical complex in an unfamiliar city. We decided to see what St. David’s had to offer.
Our real introduction to IVF was a Nova documentary about couples going through the first American IVF program, in 1981. As Sarah and I sat in an empty hospital classroom watching two televisions mounted on poles, the information we were getting floated past as if in a dream. Though the technical aspects of fertilization and transfer captivated Sarah, she sensed that the film wasn’t giving her the whole picture of the process. I couldn’t keep my mind on technicalities. I drifted past the low success rate and the number of ifs that built up as couples went through the program. All I saw was medical science to the rescue.
I was struck by one part, in which five or six couples were together in a motel room waiting for a doctor to call about some tests. They were expecting to see who would be selected, who would be the lucky one to win the baby. There was a subtle desperation in their waiting. Desperate for hope, desperate from the finality of their infertility, desperate from wanting a miracle. Their desperation made me wonder why we had to suffer through this at all.
“Lo, children are an heritage of the Lord and the fruit of the womb is his reward.”
I kept wondering whether I was being punished by God. Isn’t there a reason for everything? I had been married once before. Had a daughter. Gotten divorced. Failed as a father. Sarah’s and my misfortune happened because I didn’t deserve to have any more children. In a church sermon, I had heard that God didn’t work that way. He didn’t seek out and punish. Did He therefore not reward? Was life merely an accumulation of catenated events or a dadaist’s collage?
Sarah’s views on life were more accepting. Though she questioned, sometimes tearfully, “Why me?” she knew there was no answer. IVF was her only chance to have a child biologically; wondering why it had come to that was useless.
The tape ended. Afterward, we met briefly with Ruby Fischer, the program coordinator. Sarah told her that if we were accepted into IVF, we would like to start in the summer of 1985, since she would be on summer vacation from her job as a teacher. We made an appointment with Dr. Thomas Vaughn, the program director, to review our case.
The first meeting didn’t go well for me. I hate waiting. In a doctor’s office, you wait. After nearly an hour we met Dr. Vaughn. Thomas Vaughn, in his late thirties, had a boyish face that seemed at odds with the air of somber concern and general weariness that accompanies good doctors. And Vaughn was supposed to be one of the best.
He flipped through Sarah’s medical history and asked a few questions. Had we done the pertinent fertility tests, sperm counts, endometrial biopsies or temperature readings? Any previous surgery, IUDs, pelvic infections? What was Sarah’s menstrual and ovulation history, her general health? Did we smoke or drink, do drugs? Sarah, aware that the answers were already in medical files, answered patiently. She began to wonder if anything in her medical history would keep her from being accepted.
Dr. Vaughn asked us about our families. Any history of Down’s syndrome, multiple sclerosis, birth defects? Then he asked whether we had any questions. I had one, though I couldn’t state it very well: did the IVF process circumvent natural selection when the sperm and the eggs were mixed? Of course, I didn’t ask it like that. I took about five minutes and used my hands a lot, but Vaughn figured out where I was headed. He said that he didn’t know. We paid fifty bucks and left.
As we walked down the hallway of the medical building, Sarah told me she was irritated by my barking at Dr. Vaughn’s receptionist when we paid the bill. I had been too impatient. She was used to waiting in doctor’s offices; she had been in so many. That only added to my inchoate feelings about in vitro fertilization. I knew things weren’t going to get any clearer. Looking back now, I can see that the visit was a great introduction to the expense, the waiting, and the unknowns of IVF.
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