Today is the point in my wife’s cycle where she finally begins her course of IVF medication – or, as I prefer to tease her, she’s snorting drugs twice a day (the first course of hormones, nafarelin acetate, has to be taken nasally). This means, for the first time, we’re actually doing something practical towards baby making, beyond paperwork, consultations and tests. Okay, I’ll rephrase that – for the first time, we’re actually doing something practical and effective towards baby making, as failure to produce babies in the past has certainly not been caused by lack of trying.
Which made me think – what the hell is IVF, anyway? For me, it’s a process which I’ve been deeply involved in (as much as the male participant can be, anyway), so I’ve come to get familiar with a whole host of complex and unfamiliar terms, but for the casual reader there’s a whole bunch of new and unfamiliar language which they may or may not be aware of. Just to cover all bases, we might as well actually explain some of them. IVF stands for In Vitro Fertilization; “In Vitro” is Latin for “within the glass”; in other words this means a petri dish in a lab, as opposed to In Utero Fertilisation, which takes place “within the womb” and means, well, humping. You know, in the traditional manner. IV Fertilisation is not quite as you’d expect – only in extreme cases do they actually jab the egg with a needle and inject a sperm cell, as you see on TV and most people imagine; most of the time it’s just (ha! “just”!) a case of harvesting eggs, placing them on a Petri dish, taking a dropper full of freshly provided semen (Ah! this is where I come in!) and making the relevant introductions:
“Egg, Sperm. Sperm, Egg. Egg, Sperm has brought quarter of a million brothers and sisters with him, I hope you don’t mind. Sperm, Egg is here all by herself and can be quite shy. Anyway, I’ll leave you alone – I’m sure you’ll get on famously”.
Cue smooth jazz.
Even for the most stubborn gametes, when an egg is being submerged in the stuff, sperm/ovum interaction is pretty likely! Assuming fertilisation occurs, a zygote is created. A zygote isn’t quite an embryo yet, but it has the genetic material of both parents: basically, it’s a fertilised egg. All it needs to progress to being an embryo is a suitably warm, moist, womb-like environment, which the obliging fertility lab helpfully provides. Correctly marked and labelled, it is placed in a warm cabinet, and monitored over the length of a few days for signs of cell division. The most promising zygotes are selected for insertion into the womb where they should then progress into embryos. The lab we’re using only ever inserts one promising zygote, as twins (or triplets) have their own problems during pregnancy and frankly we’re not in the business of making things more complex at the moment. One is enough for the time being, thanks! That’s not to say that twins can’t happen – identical twins can be formed through a zygote fully splitting into two separate embryos – but that’s a normal process and not something the lab has that much say over. Any spare zygotes may be kept on ice, which is useful in case one of us wanders under a truck and the other is still keen on having kids. It can also speed up the process the second or third time round if there’s sufficient promising zygotes/embryos, as there’s no harvesting involved.
The main problem, as far as I can work out, is the drugs in the lead up to it all. Extra eggs have to be produced in order that they can be harvested, and that’s what all these hormones are for: to stimulate a menopause, which causes her ovaries to scattergun eggs out at a rapid rate – normally, in a mature woman, this is the body’s last-gasp attempt at reproduction before the body is too old to support childbearing. This is coupled with a rapid increase in sex drive in order to ensure that these eggs are fertilised. In our case, it allows the lab to harvest a larger number of eggs for in vitro fertilisation; a wider selection allows them to choose the most promising zygote for insertion. The side effect of these drugs is – well, it’s the bloody menopause. It’s only day one of the drugs routine and already Mrs Astronomer is techy, annoyed and a tad hormonal. It’s only going to get worse from here. Having said that, it may also be because I’ve not done the dishes this evening.
One incredible upside of IVF is that they actually take a photo of your zygote as cell division is taking place. First off, that’s amazing. It’s sci-fi. To me, it’s incredible that you can take a picture of someone whilst you can still count the number of cells they have on one hand. Okay, they’ve still got to get through that difficult first trimester, but still – one day, well, that might well be a person, with their own wants, desires and personality. Neat. Second, it gives you the opportunity to one-up every single one of those smug couples who post that irritating first ultrasound on facebook as soon as they announce they’re pregnant:
“I know its a bit early, but we finally get to say this but were expecting! So totes excited to meet ourlittle 1 for the first time!!!1!!!1 She has her mummys nose LOLZ!!!!!”
I’d love to be able to reply:
“Congratulations – fantastic ultrasound. Here’s a picture of our little one at about 12 hours after conception, right after first cell division. I think there’s a bit of a family likeness, but we’ll let you know in a few months once we get an ultrasound and they’ve developed limbs”.
I know that’s tempting fate to an unbelievable degree – 60% of IVF attempts fail after all – but I’d love to be able to do it. Common sense and a hormonal wife, however, dictates that it may be a silly idea. Oh well, I’ll just have to accept that one day it might make a brilliant first page to the baby photo album…