Baby talk 3: the eggs, the lube, the triggering

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So we took a bit of an unscheduled posting hiatus there; but more on that later. Today we’re talking eggs, lube, and triggers.


Just as the self-injection routine started to get good and routine, and I wasn’t having a total emotional break on a daily basis, came the sharp reminder that this was only one stage in a massive project, and things had to be kept on track. At this point, that meant an ultrasound, and not the television-friendly wand-on-the-tum kind. The question was: were my ovaries responding properly to the hormones, and growing a whole bunch of eggs?

They were.

I got to see the swollen follicles myself, gaping black voids on the surface, a definitely upsetting experience for anyone with trypophobia (the fear of lots of little holes). They were measured and found to be sufficient in quantity and size by the doctor – who was not my usual consultant; and a bit of warning might have been nice, given he was a man.

A note on lube

Now, I have nothing against cis men – like Cher, I love dessert – but there’s a distinct difference when it’s a guy controlling the plastic wand going up your groin. On the social conditioning side of things it just feels very very awkward to be giving guidance like “a bit lower; no, that’s too hard; yep, that’s it” to someone I have zero, possibly even negative, sexual interest in.

On the physical side of things, there’s lube.

I’m just going to put it like this. If you are a medical professional who does not now have, and never has had, a vagina, and your work involves putting things in other people’s vaginas, you need to lube that wand like it’s going up your own butt.

IVF is a process that involved a lot of vaginal ultrasounds so I can definitively say, from the other side of it, I would rather have to wipe some excess gel out of my labia afterwards than feel like screaming “what’s wrong with a kiss, boy?” in my best John Cleese at a thoroughly professional clinician.

Anyway.

Things looked pretty good, so I was sent home with more drugs, ready for the next stage.

And there was not much to do but sit at home and be consumed with ~feelings~. It’s a paradox: after so incredibly long, thinking about nothing but wanting this and trying for this and counting days and degrees and becoming an expert on one’s own cervical mucus, we’d overcome one of the big hurdles … and I wanted things to slow down.

From deciding to go private to the first consultation was only a few weeks (longer than usual due to COVID); from consultation to first injection was only a week after that, thanks to a well-timed menstrual cycle.

Then it’s one more week, and you’re on the doorstep of egg collection and insemination (and handing over another couple of thousand dollars) and a whole new cycle of waiting and hoping and not being able to do anything to affect the outcome, until you get told if you’ve been lucky, if there’s an embryo, if they can try to plant something back into you that might become the baby you’ve ached for and you have no idea what you’ll do if you can’t make a home for it inside yourself.

It feels impossible that everything can move so quickly after it’s taken so long to get here. It feels unthinkable to process it all in just a few weeks – when you couldn’t even start to process the idea of being infertile for a decade.

Triggering

There’s an obvious internet-discourse joke to be made here. I will refrain.

Once the ovaries were signed off and the blood tests were checked, we were on a rigid timeline. The New Injection, Ovidrel, had to go in at 9pm sharp. It’s a “trigger” injection that tells your eggs to get ready to rumble after they’ve been hanging out on your ovaries, refusing to go anywhere. That was the easy bit after a week of practice with Gonal-F: same pen shape, same needle tip.

Then put 36 hours on the clock for egg collection. It’s a weird time span to think about. Doing something 24 hours beforehand? Easy, that’s how time works. Doing something this evening to prepare for the morning after tomorrow morning is confusing as hell. I don’t know how many times I checked the instructions and the calendar and the time – yes, Stephanie, today is TUESDAY so the after tomorrow is THURSDAY and you are taking the drugs at the right time, that’s why the text message from the clinic says TONIGHT, just like that, in all caps.

They’re used to these kinds of meltdowns.

On Wednesday, do not eat after midnight (and make a Gremlins joke). On Thursday morning, clear liquids only and three paracetamol.

Off to the lab. Local anaesthetic. Sedation. Prepping for a needle to go all the way into my ovaries and burst those little black bubbles – so huge on the monitor but only 2cm across in reality. Which may or may not be huge in the context of an ovary. I don’t even know how big an ovary is. Call myself a feminist!

And hopefully, the bubbles contain eggs, which the clinic pulls out of me and introduces to J’s elite swim team; and Mum picks me up and takes me home and I sink into an indulgent haze of tea and biscuits and awful television.

That was the plan, and clearly everything went according to it, but I simply don’t remember. It’s like having your wisdom teeth out: I have such a vivid memory of the dentist telling my mother, “I’ll give you the instructions because she won’t remember”, and I scoffed, and after that … nothing.

I took a very bleary selfie in the prep area. I stared at the bizarre curtain patterns. I walked myself into the procedure room, very proud of not being the slightest bit dizzy, and then … not a freaking clue. I don’t even know if I got tea and biscuits.

End result: four eggs, which didn’t feel great. From that, four fertilised eggs, which felt miraculous.

And then we waited, to see how many would survive the first five days, and be viable to be implanted back into me.

It always comes back to waiting.

Baby talk: the needles

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(Content note: infertility, IVF, injections)

I definitely didn’t plan it this way, but here we are carrying on with the anniversaries: because it was a year ago today that I found myself wandering down Victoria Street carrying five thousands dollars’ worth of the less fun kind of drugs.

The first big piece of the IVF puzzle is the eggs. You need to stimulate the ovaries to produce as many as possible, then collect them so they can be fertilised in the lab. And that means playing with hormones – which is exactly what you need on top of all the emotional and psychological pressure of nearly a decade of trying and failing to have a baby.

Put it this way: I needed to start taking the first set of jabs on day 1 of my menstrual cycle. And as everyone with a period tracking app knows, day 1 is counted from when you get full or “normal” flow – for your typical cycle – before noon.

So when my period started at 12:30 on a Saturday, I naturally had a minor breakdown about how to count days, and also time. Did that count? Was it day one??? How heavy was a normal period for me anyway????

J gave me a very firm look and said “It’s full flow before noon. That means day one is tomorrow.”

On the plus side, I impressed the Fertility Associates nurse with my quick command of popping a needle onto the drug pen and jabbing it into a weird beige eight-by-five centimetre piece of demonstration “belly” skin. It felt like a weird magical ritual, and also too easy, but also the most difficult thing in the world. At least I knew that my feelings were very normal, based on how many times the nurse reassured me that I definitely wasn’t going to screw it all up.

I didn’t. My hands didn’t even shake. But that didn’t stop at least some part of my brain from freaking out anyway; I spent the rest of the evening walking around with incredibly tensed posture, like my belly was made of porcelain and any movement might shatter it. Porcelain with a very very sharp little mosquito bite in it.

My medication plan involved taking the injection (Gonal-F) for a week, and on day 6 adding another one (which hurt like hell) to make my ovaries hold on tight to all those precious eggs they were (hopefully) prepping.

When it came to it, I once again forgot what counted as day 1 of my cycle, and/or how to count to 6, and ended up calling the clinic just to double-triple check the very clear instructions I had already been given verbally and in writing.

They are very, very accustomed to those kinds of phone calls and were very, very kind about it. It didn’t stop me feeling bloody silly. How on earth was I qualified to have a baby if I couldn’t manage something this simple?

You’d think that by day seven it becomes old hat, nothing to worry about, you’ve nailed this process. You’ve got your little prep ritual ready, with a comfortable place to sit and a cup of peppermint tea at the ready to stave off the nausea.

But with IVF there’s always the next step in the process to worry about. And the next step was an ultrasound scan to see if my ovaries were cooperating. Something I could not see or control or have any sense about until it happened.

No pressure.