The News That Done Broke

As advertised, Steve and I went to see the reproductive endocrinologist yesterday.

I started to write up all of the details last night but bored myself into a heavy slumber. I only awoke when my face smashed down on the keyboard, leaving me with two black eyes and a thirst for fortified gin. Everything after that is a dim memory.

The RE's office had an impressive collection of scuba-related reading material and six chairs in the waiting area. The place was deserted. The chairs were arranged in sets of two and were so close together that, had there been another couple present, we all would have been touching knees. It was setup for a prayer circle, maybe, or a rugby scrum.

We met with the nurse first and she reviewed the medical history form I had filled out. It was tedious. She read over my list of pregnancies and said that we had been through a lot. I said, "Yeah, I guess" and looked out the window. I felt quite remote, like we were just pretending to be infertile in order to come back and rob the place later (Ask Me About FOLLISTIM LUPRON Name-Brand Drugs Rock-Bottom Pricing.) She repeated my answers to each line with an upwards inflection and I said "Yep" to indicate that I had not been dishonest when I filled that form out two weeks ago.

What? Gall bladder surgery in 1997? Did I say that? Well, that was a fucking lie, sorry.

Eventually, mercifully, we were released to the RE and he cut right to the bone of the matter.

"You are in a unique situation," he started. "Unique, but not rare."

Steve and I quirked an eyebrow apiece (two eyebrows in total) and let it pass.

"You have three options."

Steve leaned forward; I leaned back.

"One: Keep trying on your own. There is no technology we can insert into the process that will increase your odds of a healthy pregnancy.

Two: Try IVF with PGD. IVF is (blah blah.) PGD is (yeah yeah.) The problem is that your odds of success are worse than they should be. For reasons as yet unknown, balanced translocation carriers not only produce unbalanced rearrangements they also produce a disproportionately high number of embryos with other genetic anomalies. A couple in your age range has about a 50% success rate with IVF. For you I would halve that. Say 1 in 4.

Three: Donor sperm."

Clear? Clear. As I see it, we have a better chance each cycle of producing a healthy baby via the traditional "Slammin' the Wall" method than through IVF. The probability of producing a genetically normal embryo is identical. MORE genetically normal embryos might be produced with IVF but the advantage of that would be offset by any of the non-genetic factors that can cause an IVF cycle to go awry. Do you see what I am saying? If conception occurs then an egg will either have been fertilized with a genetically normal sperm or a genetically abnormal sperm. The cells will then divide properly or improperly. IVF under these circumstances just adds additional risks of either not getting to a point of conception at all (a canceled cycle) or having the created embryos deteriorate as they await genetic testing. At least that's my thinking. Bear in mind I am just an English major. And, of course, the miscarriage rate is much higher for our natural pregnancies than it would be for an artistically staged one. We knew this already.

After he presented our options, I told him we wanted to have Steve's sperm tested to determine what percentage of abnormal gametes we are dealing with. He did not understand, I must have phrased it poorly, so we tangoed around his small office knocking over pictures and lamps until I shamefully pulled out this research article I had hidden in my handbag. I was hoping it would not have to come to that, but once I drew his attention to the table on page 6 things improved dramatically. "OH!" he said "OH! How interesting! I am surprised I missed this article." Yeah, well, we cannot ALL be on top of the latest research in reproductive endocrinology, don't feel bad.

He said he would talk to his cytogeneticist the following morning and get that guy's thoughts. Either they could do this or they would find someone who could. Okey-dokey. Mission accomplished.

He left a message this morning saying that they could perform the test here, and that the genetics guy thought it was a terrific idea. Steve emailed me this information after deleting the voicemail. I said, great, but what exactly are we supposed to do? Who do we call? Who can help me work this through the insurance company? Where do we take your sperm and in what container (a horseradish jar? a Dixie cup?) and when? Details, I know, but someone needs to think of these things.

And yes, Steve often communicates with me via email despite the fact that he is within shouting distance ALL THE TIME. Freak. Oh, maybe that was hurtful, you know, since he is an actual freak. I should email him about that.