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My partner and I recently walked down the path of IVF, a winding that is beset by confusion, traps and unexpected confrontation.
In what seemed like a move out of character, my partner G asked me to write my perspective on our progress through IVF. G likes her privacy, while I will gabble on about everything, but it was a strange request. G isn’t a creative writer, so when I help with something as simple as a thoughtful birthday card message I think it helps both of us understand each other. G enjoys that I can articulate experiences in a way that helps her find her own words and perspective.
We have been trying to have a child naturally for around two years. I was surprised to discover that 18 months isn’t unusual, and there is a history in both of our families of taking longer than normal. I am 40 and G is 36, so we were keen to get started. After our initial tests with a fertility specialist, we were defined as “infertility unexplained”. This just means that according to all tests we should be able to have children. But we haven’t. We did have one miscarriage. There was sadness and disappointment but at the time I think I was particularly guided by G’s philosophical approach. She believed that the experience meant that becoming pregnant was possible, just not this time.
Our problem might have been anxiety, it might have been too many mid-week wines, a lack of exercise, or it could have been the combination of busy social and work lives. I am not going to fall into the trap of ruminating over psychological obstacles. There is a strong enough trend to find any pop-psych piece of bullshit to help turn the blame back to the mother-to-be. We didn’t really know what the problem was, and we were doing what we could to reduce all of the commonly understood issues.
What is more interesting to me is an investigation of what involving ourselves in the IVF process means to our experience and ideas of fertility, family and relationships. This includes such things as my joke of having my healthy sperm analysis framed while our GP rolled her eyes so hard she almost sprained something. Also, discussing the option of adoption and the ethical issues behind bringing another child into a resource-strained world.
Most interestingly, I have started considering the silent changes in our behaviours and the unspoken thoughts. For instance, we have both become clucky as hell. At a social gathering, I’ll often lose G only to find her sitting with a friend’s child where she is completely lost in their world. I am often lifting boys and girls alike into their favourite superhero pose so they can swoop about the house. Friends notice, and wonder. I have had people vaguely hint at the conversation and I’ve let the bait float by.
Consider that. They haven’t even entered their mother’s womb and they’ve already embarked on the great march toward the rank and file.
The decision to have children barely needed discussion. Coming off contraception was suggested by G and I agreed. We slowly introduced the recommended supplements and G was tracking her fertility with an app so we knew when to get busy. As we became aware that we weren’t going to become pregnant as easily as many of our friends had, G took up the research process. I worried that this might feed her anxiety around having children. Meanwhile, and with full awareness of the irony, I worried my laid-back approach could be seen as avoidance, absentmindedness or at worst, laziness. During this time, any relationship begins to shoulder the burden of a variety of questions that you can only give so much airtime before you get exhausted. Are we having enough sex? And at the right time? Is this killing our intimacy? Are we thinking about sex too much? You see, this is what I was trying to avoid. Turning this article into a blow by blow of the rabbit hole of overthinking. I suppose this is a good demonstration of that process. Even when you consciously decide to become more present with the world, like a defiant toddler your brain is back picking at the scab.
At 18 months we thought we would have the initial fertility investigations done and really “get to work” for six months after that. As mentioned, all tests regarding any organic obstacles to having a baby came back negative. Did I already mention that my sperm was healthy? When we weren’t successful after approximately two years of trying, we figured we would revisit the fertility specialist. G had chosen a place nearby to her work as she’d heard the regular visits for IVF treatment would require somewhere convenient. Convenience led us to the most expensive private clinic in Sydney. Within a week there was a well-publicised television investigation into the questionable nature of over-priced IVF procedures, and after investigating alternatives, we ended up choosing a bulk-billing clinic that had been recommended.
Unfortunately, the process of IVF, particularly in a busy bulk-billing clinic, can cause stress in itself. The specialist is rushing, even in the private practice. And the nurses are rushing. But the bigger issue is that almost everyone involved in the bulk-billing clinic is assuming just enough knowledge of the patients that leaves you a little bewildered after an appointment.
If you can only afford the cheapest option, read up before you go in. And the magic question that you should ask at the end of every appointment is “so what do we do next?”
Even then you may also benefit from asking, “And then after that?”
It’s valuable to confront the fact that small things can be oddly stressful. IVF is a big unknown to many and it is better to be prepared than traumatically sideswiped. It helps to be aware of how very fortunate we are to be able to access the technology at all.
G has suffered all the quiet social pressures that most women in her position experience. Watching people around her easily becoming pregnant, someone offering the requisite “go on a holiday and forget about it” advice, and of course the more insidious internal torment of “well this must be all my fault”. The escapes that the medical industry offers are varied, with IVF being one of them. As is usual with medical interventions they are necessarily invasive. Consider the messed-up symbolism of this: social pressures insinuate themselves into your head and in order to do something practical about it you have to let other things invade you physically.
The start of this process is eight days of hormone injections. Supplementing three of those days is an extra needle and on the final day, a “trigger” needle. We all know the brief pain of a needle delivered by a professional, but it’s different altogether, self-administered. (Diabetics everywhere, we salute you.) Worrying over air bubbles in the needle, feeling the cold medication bloom under the skin. It wasn’t just the regular use of needles, but the slowly building hormones in her system that led to the production of a number of eggs simultaneously. Then the risk of over-stimulation which could have her in hospital, just as her friend had experienced only a few weeks before. A blood test revealed the same issue for G, though, fortunately, she was spared the need of the emergency department. In this case, a different needle was needed, and a different course for the process.
Magic rule number two, remember the types of needles and mouthful-names of the medication too, just to keep up with the path you’re supposed to be going down.
I don’t want to scare people off the process but I think it’s valuable to confront the fact that small things can be oddly stressful. IVF is a big unknown to many and it is better to be prepared than traumatically sideswiped by an experience. Be alert, but not alarmed. It helped both of us to remember why we wanted to do this in the first place. It helped us get to that place of excitement and fascination. It helps to be aware of how very fortunate we are to be able to access the technology at all.
We all know the brief pain of a needle delivered by a professional, but it’s different altogether, self-administered. (Diabetics everywhere, we salute you.) Remember the types of needles and mouthful-names of the medication, just to keep up with the path you’re supposed to be going down.
The day procedure where eggs are collected is another strangely distant-future type process. I am glad we checked YouTube after the procedure. With G under anaesthetic and the guidance of a manual CT scanner they put her in stirrups and used a needle to extract the eggs from each follicle in both ovaries. In the recovery room there were three other couples fresh off the production line and G was very pleased that she seemed to have been far less physically effected by the whole ordeal.
While this procedure is going on, the men are left to grin stupidly at each other and make jokes about going to “level three”. The sperm collection lab has a series of rooms, all furnished with vinyl, dentist-like chairs and a mounted touchscreen television that is “connected to the Internet”. One poor man ended up having a faulty television and was forced to use his imagination for the first time in quite a while. Accidental misclickery on my behalf has me fearing the development of a strange new fetish which I won’t go into here.
It helps to keep in mind, the process is a much individualised one. The things which went smoothly for us may not go well for you. Every step is another with a different outcome. Imagine reading a choose-your-own-adventure book except a doctor is hovering over your shoulder, reading each page with you, and then upon hitting a series of options, they ask you to turn to the page they’ve decided. It’s your story, and they wouldn’t dream of reading it for you, but they’re the author and, well, you’re better off following their advice. I’m utilising this odd analogy because you go into the process with a series of expectations and, even after explanations of how it should work, it may not go that way. The risks are explained (of course those forks in the road are explained ahead of time), but unfortunately, the impact of them when they come around can make you feel a little helpless.
Currently, like a good Catholic family, we have seven children on ice, after 14 eggs were extracted and “fertilised”. All eggs have been classed “Grade One” – the highest-allocated grading – which we’re told is kind of unusual and is a great sign for the process.
They haven’t even entered their mother’s womb and they’ve already embarked on the great march toward the rank and file.
G & I hope this provides a forum to start a conversation with your loved ones, as opposed to being some kind of definitive medical guide and above all, we hope this helps.