Expectations: IVF in our future

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In the days leading up to Charlie’s next insemination, we’re even more tense and frantic than we have been so far, because we’re about to run out of sperm, and Don is still traveling. If it doesn’t work this month, we’ll have to decide whether to wait an indeterminate length of time for his return or find a different sperm donor.

This seems like a good time to reevaluate our approach to conception. We’ve been discussing the idea of IVF for a while, but we were both hoping it wouldn’t come to that. A cycle of IVF has a higher success rate than IUI for people in Charlie’s age range, but it’s still not a guarantee of pregnancy–and it’s way more expensive. How would we pay for it? We joke about having an IVF Kickstarter, with benefits like “You get to touch Charlie’s pregnant belly and live to tell about it” and “You can give us your opinion on breastfeeding.” I’m pretty sure people have actually done this.

In the car with my mom on the way to the movies, I confess that trying to have a baby has taken much longer and cost much more than we anticipated, and that we’re both feeling a sickening combination of anxious and burned out. What if it never works? I ask, starting to cry.

“You’re not out of options yet,” she says. “You’re going to have a baby, and once you see your child, you’ll be so happy for everything you went through because otherwise you wouldn’t have ended up with that child.”

“Do you think so?”

“Definitely.” She reminds me that she lost a pregnancy in between my two brothers. “If I’d had that baby, I wouldn’t have had Sam. I was heartbroken when it happened, but it ended up being for the best, because I wouldn’t trade Sam for anything.”

“What’s so great about Sam?” I say. (JK, my brothers are the best human beings in the world.) But I see where she’s coming from. If you end up somewhere happy, it doesn’t matter how long and hard the journey is to get there. The problem is that Charlie and I haven’t yet ended up anywhere we want to be.

The reproductive endocrinologist thinks that Charlie has polycystic ovarian syndrome and that’s why he’s having difficulty getting pregnant. Because PCOS can cause insulin resistance (despite the fact that Charlie’s labs show totally normal blood sugar), she prescribes Metformin, which is normally a diabetes medication. She also tells Charlie to lose weight. Although both Charlie and I are skeptical of the way “be less fat” is prescribed for everything from strep throat to a splinter, there is some evidence showing that weight loss can improve the odds of conception, so he agrees.

Metformin is awful, and this experience will definitely be filed away for guilt tripping our future child. Charlie is nauseous all the time. His doctor explains that this is a fairly common side effect of the medication and can be mitigated, although not completely resolved, by cutting out all grains and all sugar. Charlie has to stop eating cereal, bagels, ice cream – even quinoa. A lesbian giving up quinoa, folks. THIS IS HOW MUCH WE WANT A BABY. Charlie also proves that I made the right choice in marrying him, as though I had any doubts, by making me a peach and fresh mozzarella pizza from scratch on my birthday even though he can’t eat any of it.

At the same time, Charlie buys a bicycle and starts commuting to work on it. It’s close to an hour-long ride, and it contains a couple of steep hills that might make a less motivated person give up. Charlie tells me that every time he powers up that hill, he gives himself a pep talk: “This is going to help me get pregnant and it will all be worth it.”

Even though Charlie is busting his ass to lose weight and increase our chances of conception, we’re still hyper-aware that there will be big decisions to make if the next IUI doesn’t work. We schedule an appointment to consult with the reproductive endocrinologist after our next and possibly final insemination.

“We want to know what you think about our chances,” Charlie says. “We haven’t been successful yet, obviously, and if this isn’t going to work we might as well go ahead and try IVF.”

“It might be more successful if you lost weight,” says the RE, which we already know and which is not really an answer to the question.

Charlie asks, “At what point would you say that, if it hasn’t worked, we should go ahead and switch to IVF?”

“It’s hard to say,” the RE responds. “There are other fertility medications we could try.” After several more minutes of this back-and-forth, it is painfully clear that she will never say we should do IVF instead, possibly because her office does not provide the procedure and would not make any money on it. She wants us to keep trying IUI using injectable fertility medication, which will dramatically increase our monthly costs. We tell her we’ll think about it.

“Well, maybe we won’t have to make the decision,” I say in the car on the way home, my voice bright with forced cheerfulness. “Who knows? Maybe this time it worked, and a little blastocyst is implanting itself in your uterus as we speak.”

“Implantation doesn’t happen until several days after conception,” Charlie says. “The sperm might not have even found the egg yet.”

“Thank you for missing the point,” I say. “I’m just saying, if it works this time, we’re off the hook – no big decision to make.”

It does not work this time. Charlie’s period comes with depressing predictability. We decide we’re tired of this; we want better odds. We don’t want to spend any more weekends crying on the couch watching Juno. And we’d really like to never talk to our RE again. It’s time to find out more about IVF.

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