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