[Editor’s note: In 2009, shortly after marrying her (first and only) husband, Paolo, Elizabeth Heath was diagnosed with premature menopause and resulting infertility. Paolo and Liz are now parents to a baby girl, Naomi. In this series, Liz recounts the couple’s struggle with infertility, and how they finally achieved a successful pregnancy and parenthood.]
We started our in-vitro fertilization (IVF) cycle with several other couples. The initial stages of the process involved me taking medications intended to stimulate ovulation, not just of one egg, but of several. The more eggs, the better the chances of healthy embryos to transfer.
There were daily injections in the butt, handled by Paolo, and pills to take at just the precise hour of the day. Once my ovaries started to show some signs of life, I had to drive to the clinic every two days for an ultrasound, intended to monitor and measure egg development. Every time I’d go, either with Paolo or with his mother or cousin, I’d see the same hopeful couples in the waiting room, holding hands and looking anxious.
Because of my often-mentioned abysmal hormonal situation and ovarian reserve, the doctor at Chianchiano prescribed for me a protocol of the strongest possible variety: I was mega-dosing synthetic hormones in the hopes of stimulating egg development. Basically, I was given a dose of medicine that could have made a 80-year-old female gorilla start popping eggs like crazy. Me, being a normal human and all, should have produced anywhere from 8-16 eggs with this strong of a protocol.
My results, however, were lackluster. I showed up dutifully every other day for about 10 days. At first, two eggs showed up on the ultrasound screen. “It’s still early,” the doctor reassured, as she poked around with the ultrasound wand and dictated egg measurements to a nearby nurse. Two days later, four eggs appeared. Ah, a glimmer of hope! And that’s where I peaked. No more eggs, and of the four, there was no guarantee that all of them would develop to maturity and be suitable to harvest for fertilization.
The egg “harvest” took place a few days later. Again, we waited with the same group of couples, in a process that quite honestly was beginning to resemble a cattle call. In the waiting room prior to our egg retrieval surgeries, all the women were told that they needed to have full bladders. None of us had eaten that morning—doctor’s orders—and we all sat sucking on bottled water, forbidden to go to the bathroom. Those of us over 41 years old—and that was most of us, by appearances—were asked to pay our bills up front, and we quickly parted with 3,500 euro (about $5,000 U.S.). That part they didn’t make us wait for.
Finally, one by one, we were called to prep for surgery. Egg retrieval is a minor surgical procedure, but it requires—in Italy, at least—light anesthesia. While we were changing into surgical gowns, caps and booties—legs crossed all the while; still no peeing allowed—the men had their own work to do. Each was handed a plastic cup in a paper bag, and one by one, they went to the collection room, where, with a soft-core porn-assist, they produced the sperm needed to fertilize our waiting eggs.
I was still in the surgical suite when they roused me from anesthesia. I remember asking groggily, “How many?” in Italian, and heard someone respond, “Two.”
“Only two?” I asked, but by that time, I was being wheeled to recovery, and my question went unanswered. Two eggs. Out of four, just two. Two chances to get pregnant.
Two days later, all the couples reported back to the clinic for transfer, when the eggs, which were fertilized in the lab to become embryos, are inserted into the uterus. Italian law limits the number of embryos that can be transferred to three, and does not allow embryo freezing for future use. (It’s a Catholic thing, but that’s a story for another post.) So on the one hand, even had I produced 10 or more eggs, no more than three embryos would have been transferred. On the other hand, more eggs would mean that the reproductive endocrinologist could choose only those eggs most likely to fertilize and form into healthy embryos and ideally, viable fetuses.
Read Related: Facing My Infertility Part 1
So we all waited again, this time feeling more nervous than ever. Most couples held hands and talked quietly; a few of us chatted, or at least smiled hopefully at one another. I remember how much I hated one of the men who came with his wife. At every appointment, he’d sit with his arms folded across his chest, listening to his iPod at full blast. He didn’t hold her hand, speak to her, or even look at her. Did he not want a baby? Did he not realize how important and emotional a moment this was? His poor wife. I leaned over to Paolo and whispered, “It must be that he has bad sperm, and he’s ashamed of it.” (Not that I think having faulty sperm is anything to be ashamed of, but something was obviously bugging the guy.)
I was called into surgical prep, and again donned a gown, booties and a hair cap. I was led to a gurney, and wheeled into the suite. Another woman was coming out on a gurney as I went in, and we briefly grabbed hands and squeezed. It was just for a second, but I’ll never forget that moment, and how we both understood one another’s hopefulness and longing. I hope she got pregnant and is chasing after her toddler right about now.
I was awake during embryo transfer, which was completely painless; in fact, I didn’t feel a thing. A sweet Italian love song, Baciami Ancora (Kiss Me Again), was playing in the suite, and the doctor and nurses were humming along. It was a very tranquil environment, and I took this as a good sign.
Two embryos were transferred. I rested for a half an hour on the gurney, and was then told I could get dressed and go home. We checked in briefly with the pretty doctor, who told us to wait 14 days and then take a pregnancy test.