A Place At The Table

In vitro fertilization wasn’t for me. Until it was.

August 2012

In January 2010, two months after the third miscarriage, we entered Dr. Minjarez’s office for the first time and took seats in the russet-colored leather chairs. The possibility that we might not be able to have a second child was becoming very real. Would a time come when a family of three felt complete? We were blessed to already have a healthy, thriving daughter, but when friends and family reminded us of that fact, it made me angry that Ella was somehow considered a consolation prize.

I dreaded the inevitable question: Would we consider adoption? Though a perfectly reasonable query, it felt both extreme and shallow to have to answer. It wasn’t that we were opposed to adoption—not in the least. It’s that, somewhere inside of us, there was still hope that we could right our toppled world. We needed to exhaust all of the medical options before exploring alternatives.

We explained our situation to Dr. Minjarez, who took notes as we spoke. She had a wide, welcoming smile, and her demeanor was easy and empathetic. We liked her immediately. Our story, very simply, was this: We were fertile, and I could sustain a pregnancy. Our breakdown lay deep within our genetics. What we needed was the assurance of a healthy embryo.

That last detail was critical—and it was our reason for choosing CCRM. The clinic, founded in 1987 by Dr. William Schoolcraft, pioneered the technology of preimplantation genetic screening (PGS), in which embryos’ chromosomes are counted and evaluated. (The correct number of chromosomes is 46, or 23 pairs derived from the male and female, respectively.) Whereas most couples seek in vitro fertilization solely to improve their chances of having a viable pregnancy, we required the next step: We needed IVF to create embryos so they could be grown in Petri dishes and their chromosomes could be evaluated. PGS technology isn’t perfect, but the 90 percent accuracy rate beat our natural chances of conceiving a healthy baby.

We underwent physicals and were poked and prodded. During the exams, Dr. Minjarez discovered I had a wall of tissue, either a natural septum or an accumulation of scar tissue (possibly from the multiple D and Cs), that closed off part of the uterine cavity. It had to be surgically removed. We learned this information in late February, just as we finished signing the IVF and genetic screening consent forms—50-plus pages outlining the risks, the procedures, the protocols, and, ultimately, our assumption of responsibility. It was more intimidating than buying a house.

Given that IVF is an elective treatment (no one needs to get pregnant like they might need, say, open-heart surgery), insurance coverage is nominal. I switched from United Healthcare to Heath’s insurance (Anthem Blue Cross Blue Shield) in hopes of a more progressive plan. In the end, with the three miscarriages, we incurred close to $35,000 in medical expenses. For the roughly $30,000 we spent on IVF and the corresponding drugs and procedures, we received two reimbursement checks. Both were for $40.

On March 14 at 8 p.m., Heath and I stood in our kitchen with an alcohol swab, a glass vial of Lupron, and a syringe. Ella was asleep upstairs. This was the first of 45 injections in 23 days. Several days earlier, we’d spent four-and-a-half hours at the clinic learning, among other things, how to give the injections. My stomach had been in knots ever since. On our nurse’s recommendation, we practiced on an orange.

Now it was time. I pulled up my shirt, pinched my abdomen, and squeezed my eyes shut. The hormone felt cold under my skin. When Heath removed the needle, a bead of ruby-red blood stood on my skin. The used syringe rattled when we dropped it into our red plastic “sharps” container. Eventually the plastic box would be so full I’d have to ask a nurse for a new one. I drew a fat X through Day 1 on the calendar.