The In-Vitro Play-by-Play: Act I

The Human Pin Cushion

For those of you who are squeamish around needles or thinking about needles, this is your chance to stop before you go too far. The In-Vitro fertilization process involves a lot of self-administration, and I’m about to describe the process in some detail. WARNING! THIS IS NOT FOR THE FAINT OF HEART!!!

On the first day of full menstrual flow, I administer a small amount of Lupron subcutaneously. There are many sites to choose from, but I like to use the most effective spot—about an inch or two from the navel, in the fat layer on my belly. Then, the next day I go to the clinic, have my blood drawn, and a baseline ultrasound. The blood test is to ensure that I am not pregnant, and the ultrasound is to provide an accurate picture of my ovaries as they are stimulated over the next week. Then, it’s onto daily injections of Follistim, which stimulates my follicles. Sounds hot doesn’t it? Well, this FSH (follicle stimulating hormone) treatment encourages growth in number and size of ova (that’s eggs for you and me) in preparation for harvesting. In the protocol I have to follow, this twice daily regime of injections sometimes amount to three or four shots. Thankfully they have designed this pen device which delivers the drug using a micro-fine needle. However, it’s still a sharp, pointy object that pierces through flesh. In addition I also have to administer morning injections of Lupron and twice daily shots of Heparin, a blood thinner which is used to reduce my elevated antiphospholipid antibodies. Along with baby aspirin, this therapy encourages my body not to coagulate around the embryo and prevent it from developing a blood supply. In the very first cycle I had to administer Heparin, I got a bit carried away and began injecting myself rather…adamantly, and ended up with a section of bruising to rival any kick boxer after a rough fight. My belly was black and blue, and some parts looked a bit greenish too. It’s a bit ghoulish, but I kinda liked it.

On day seven, I go in for the first of my daily trips to the clinic. Each day they take my blood to check my estradiol level and to check the maturity and number of eggs. Ovary hyperstimulation can cause a whole bunch of very undesirable effects, including pelvic pain or discomfort, fluid retention, fever over 100 degrees, and decreased urine output, resulting in possible hospitalization, and estradiol levels let the doctors know exactly how much they can push my system to produce eggs and not reach hyperstimulation. These daily visits vary from 3-7 days, depending on my response to the protocol. Then, when it’s time, Ben gives me a shot of HCG (Human Chorionic Gonadotropin) which releases the eggs to be aspirated and harvested using a long needle which is pushed through the walls of the vagina, and in my case, through the uterus. At this point you may shiver and make groaning sounds of pain along with me. Ready? Get Set. Go. AAAAAAAAAAARRRRRRRRGGGGGGGHHHHHHHHHHHH!

Thirty-six hours after Ben gives me this HCG shot in the ass, or intramuscularly in the upper-outer quadrants of the buttocks, I am to be harvested. At the first egg collection, we asked the nurse to draw bull’s-eyes for where Ben should administer my progesterone shots, and he immediately nicknamed the diagram, “Mister Ass.” I’ll leave the elaboration for Ben. I have one night free from injections, and then it’s the nightly shot in the ass with a long and thick needle full of progesterone suspended in sesame oil. How’s that for ethnic appropriateness? This oil is very thick, and requires a steady and patient hand—both qualities which my husband possesses. Sometimes, when he hits a nerve (the sciatic, I’m told), sharp pain jolts through me, but now I’m mostly immune to it. You see, I was meant to give birth. My pain tolerance is ridiculously high, and should be put to good use, n’est-ce pas? I shall leave the embryo fertilization and transfer process for the next post, aptly subtitled, “God, I don’t want to pee on him. He’s too cute!”