Another three months later, Dom’s fears were realised as we arrived at FertilityPLUS and he was asked to take off his clothes and put on one of those sexy hospital gowns that tie at the back.
He lay down on the bed and was given some paracetamol. Soon after, he had a shunt inserted into his hand to administer IV drugs. He was wheeled into the operating theatre and I was allowed in, too. I can’t recall exactly how many people were there but I’d guess about five others. One was administering pain relief, a nurse was assisting the doctor who would perform the TESA. There was also an embryologist and probably one other person in the room.
I sat next to Dom’s head, much like a husband might sit next to his wife while she was giving birth. He was very docile and numb by then. He tells me he has absolutely no recollection of what happened in there. The doctor stuck a long needle into Dom’s testes and he wailed loudly at the pain. Like I said, he doesn’t remember so that’s okay, but I was cringing for him.
The doctor was happy to show me what he was doing up close, even though I could watch some of it on a screen. He had sliced into Dom’s right testicle and pulled out the vas deferens—the tubes that move sperm towards the urethra in other men. He cut a small piece off and put it in a dish that the embryologist was holding. It looked gross and painful. Dom was going to have very sore nuts after this!
The operation only took about 20 minutes and then Dom was wheeled back into recovery. He was awake the whole time but he didn’t realise what was going on until about half an hour after the procedure had finished. He felt tender down there and looked down to see he was wearing a sanitary pad! I couldn’t help laughing, but he didn’t find it that funny.
He was ordered to wear a sanitary pad and tight undies for a couple of days and to avoid exercise and lifting for two weeks. As I’ve already mentioned, Dom runs marathons—he runs almost every day and he was not thrilled to be couch-ridden. The next day he was pretty much back to his normal self, no swelling or infection. He was just a little bit sore and said it felt as if he had been kicked in the balls.
Dom’s TESA had resulted in five straws of sperm and some of it was motile! The team at FertilityPLUS decided they had enough to work with and his piddly amount of sperm was frozen for later.
IN HIS OWN WORDS—DOM’S JOB
On the one hand, the nurse was asking me to perform a sexual act on myself, which was quite a titillating thought. On the other hand, there was absolutely nothing sexy about it—nothing flirty at all as I sheepishly walked towards the wank room with an empty jar in hand. Luckily, the specimen room is private—only one wanker at a time.
The room had a La-Z-Boy chair with a hospital sheet draped over it and a selection of well-thumbed magazines that looked as if they had been motivating men for decades. I resisted touching the magazines and used my imagination.
I also decided to stand and deliver. I was sure the sheet over the La-Z-Boy must have been changed on a fairly regular basis, but you never can be too certain, can you? In a matter of a few minutes I had managed to fulfil my obligations. A good game’s a fast game. At least I think that’s the saying.
It was surreal. Being male means spending quite a bit of time avoiding being caught playing with yourself—first by parents or siblings, then by flatmates and girlfriends. With IVF you are thrust into this situation of going into a small room with everybody outside knowing exactly what is going on in there. Still, that few moments of possible embarrassment is a small price to pay. The lion’s share of the work is forced upon the lioness.
First IVF cycle
It was a new year, 2007, and we were ready to get going. All the testing had been done, we had sperm in the freezer and now it was my turn to get involved. Like I said, it’s mostly about needles and I’ve never enjoyed being used as a pin cushion. Some days it didn’t hurt much; other days it felt as if the needle had gone through the vein, the muscle and out the other side of my arm. The pain shot through me like an electric shock. But nothing could have prepared me for the hormone injections that I had to give myself. In order to stop my cycle (to prepare it for IVF) I had to inject buserelin acetate into my stomach every day for ten days—I actually had to learn to jab myself on a daily basis! Buserelin is supposed to put the body into a menopausal state so the timing of a cycle can be artificially controlled.
I collected my chilly bag of medicine, which I had to store in the fridge at home, and a box of syringes from FertilityPLUS on 6 February 2007. Every night at 6 p.m. I had to fill a syringe, squeeze a bit of fat around my belly and stab the needle in. The first time I did this was frightening. I had never stuck a needle into anyone before. I gripped my tummy fat with my left hand and with my right hand held the syringe above the bulge. They say the harder you squeeze your tummy fat, the less it hurts. I was prepared to give myself a good bruise.
I stood there with the needle hovering for ages, desperately trying to psych myself up to stab myself. So many times I started to thrust and then would pull back just before the needle made contact. It was horrible. A lot of women ask their partners to do it for them but there is no way I would let Dom stick a needle into me—he’s very clumsy and I can just imagine the mess.
I heard of one woman who was so scared she drove herself across town every night to see her friend who was a nurse and could do it for her. Some women choose to drive to the clinic every day so the nurses there can do it for them. I decided I would harden up and do it myself.
Eventually, I just did it. I took a deep breath and stabbed myself in the stomach. There was a slight sting, but it wasn’t nearly as bad as I had anticipated. And it was all over in a few seconds. The first time is always the worst and it didn’t take me long after that—just a few deep breaths and I was done.
After almost a couple of weeks of buserelin injections, I started on another drug called Gonal-F to grow my eggs. I then had three internal scans over the course of a week to see how many eggs were growing and how big they were getting. The internal scans are invasive. They are similar to a smear test—you lie back on a bed with no pants on, just a sheet covering you, your legs up on leg rests while the doctor inserts something into your vagina. A long wand-like instrument is pushed around your ovaries on each side so they can be seen on a screen. It’s not comfortable. It feels like they’re playing tennis in there!
When the doctors were happy with the size of the follicles, I was declared ripe for the picking. The follicles hold the eggs that are too small for the human eye to see. Unfortunately, they don’t always collect a viable egg in each follicle, but the more follicles the more chance of eggs.
The night before the egg collection, I had to give myself a trigger injection of Ovidrel to prepare the eggs for harvesting. By then, my insides were so swollen and tender I felt as if I had two rugby balls inside. I couldn’t even do up my jeans because I didn’t like anything pressing on my tummy. I only had four follicles, but I felt as if I must be housing hundreds. Eight is about average, but this was my first cycle so they kept the drug doses low.
The odds of getting pregnant in your first cycle of IVF are small. In fact, they say the average is about three cycles, but I was holding out hope that, like the rest of my family, I was super fertile and with this little bit of assistance I’d be knocked up in no time.
Egg collection is a full-scale operation. You can’t eat or drink beforehand and you can’t wear make-up or perfume. I arrived at the hospital and had to change into a very unattractive gown. I was given painkillers and a shunt was inserted into my hand. I walked into the operating room and lay down on the bed. I was given amnesiacs and a mild anaesthetic, so I would still be awake through the procedure. They can’t anaesthetise your ovaries so they anaesthetise all of you. The amnesiacs were supposed to make me really drowsy and make it so I would not remember what happened in that room—just like when Dom had his TESA.
The difference is I remember what happened. My legs were open and I was naked under the gown. The doctor inserted a wand with a needle guide
on it. The wand went up my vagina and the needle went through the wall of my vagina and into my ovaries to collect an egg. This was repeated until all the mature eggs had been collected. I felt each egg being collected and remember sitting bolt upright and wailing at the pain—it was like the most crippling period pain you can imagine. It hurts just thinking about it.
Later, I learned that access to my right ovary is difficult because it is hidden behind my uterus. I decided there and then I would be knocked out if I had to go through that again.
From the four follicles that looked good to go, three were collected and injected with Dom’s thawed sperm. Sadly, we didn’t get a great report from the single straw that was defrosted for this occasion. We took it to mean ‘we’ll be lucky if this works’.
I was sent home to recover. I felt sore and tender while my eggs and Dom’s sperm were meeting in a set of Petri dishes. We had to wait overnight to find out if the eggs had been fertilised.
In the morning the hospital called to tell us just one egg had fertilised. We had to wait a couple more days to see if it would continue dividing and become an embryo. Luckily, it did and I was primed and ready for implantation! This cycle, we had one chance but we were feeling positive.
The embryo replacement is a fairly simple procedure, very similar to a pap smear. No drugs are given, but once the embryo was inserted I was given progesterone pessaries to poke up into my vagina three times a day to provide the right amount of hormones needed to sustain a pregnancy. I went into the hospital again, this time with a full bladder so the doctor could have the best view of my uterus. Embryos are too small for the human eye to see so they are placed gently onto the wall of the uterus using a long tube that is put up the vagina. The whole process can be seen on a screen.
It was amazing to see a tiny little blip get released from the end of the tube and float over to the wall of my uterus. There, it nestled itself in and I was done. Free to pee and free to leave. That was that. The hospital’s job was done. It was now up to me to make this baby grow.
The next two weeks are known as the dreaded ‘two-week wait’. They count it from the day of egg collection. We had to wait two whole weeks before I could have a pregnancy test to see if the embryo transfer had been successful. A positive result would mean I was six weeks pregnant already! The two-week wait seems to take forever. And it’s all you can think about.
It felt like the longest two weeks of my life stretched out in front of me.
However, it was worse than that because I didn’t have to wait that long. Nine days after the embryo transfer, I started bleeding—two days short of my pregnancy test.
Sadly, the embryo did not make itself at home in my uterus. I was devastated. It was at this point that I wished I hadn’t told the world I was having IVF. Now I had to tell everyone it was over. I started with my family and close friends. Everyone felt for us, of course. We were all so hopeful and excited. People kindly sent us flowers. I mentioned it on my website, radiochick.co.nz, and got the most amazing support back from readers who helped get me through. I was able to pick myself up again fairly quickly because of all the incredible support and advice I was given by friends, family and complete strangers. If I had been going through this alone, I wouldn’t have been able to cope.
IN HIS OWN WORDS—FIRST IVF CYCLE
I probably wasn’t thinking about the full repercussions. You hear about IVF and it sounds like a fairly simple thing to do. A lot of people our age talk about it and say things like, ‘Oh, well, if I can’t have a baby, I’ll just have IVF.’ It always sounded like an easy option. When you start getting into it, you realise there’s more to it than meets the eye and there are no guarantees it will succeed.
Second IVF cycle
Disappointed but not put off, we booked in for our second round of IVF straightaway. Luckily, the waiting list was quite short and we got a place in July. We still had some of Dom’s frozen sperm available, much to his relief!
The best things about the second cycle were that we knew what to expect and we knew some of the staff at the clinic, so they knew us and what worked and what didn’t last time. This time, we felt quietly confident.
I started injecting buserelin again, at double the dose of my first IVF cycle. Instead of Gonal-F to stimulate egg production I used Puregon. I don’t really know why that was changed—I just took it!
I was booked to go to Queenstown for a girlie weekend with my friend Sarah the night I had to start Puregon. I arrived in Queenstown, beautiful scenery with snow all around, and I realised I’d come without the Puregon. Panicking, I called FertilityPLUS and spoke to my favourite nurse, Penny Lewis. She was my saviour and told me she would courier the Puregon pen to me. It arrived just in time to keep our plans on track. Phew! I could relax and enjoy the break from everyday life.
Despite the fact that I couldn’t imbibe the delicious local wine, Sarah and I had a great, sober time. We took full advantage of the hotel’s amenities, wandering around in our robes and slippers, ordering room service and in-room movies. During the day we did a few tourist activities that didn’t involve leaping off high ledges. We stuck to indoor mini-golf and riding the gondola. We knew how to rage it up!
As soon as I got home, I was back into full-on preparation for the IVF routine again. As I promised myself the first time, I was not going to go through the pain of the egg collection again awake so I asked to be given a general anaesthetic. It is a far more intense procedure and they don’t always recommend it. Maybe it’s cost related—it’s all over in about 20 minutes but you need a full team on deck to make it happen to give a general anaesthetic.
Once again, I was nil-by-mouth the night before. Once again, I had to put on a hospital gown. Because I was going into a surgical room this time, I also had to wear covers over my shoes and a cap that looked a lot like a shower cap—I was definitely not dressed for a beauty pageant!
Looking around the room reminded me of a scene from ER. There were machines beeping and tubes and trays of instruments. There seemed to be about ten people in the room. I can’t even tell you who they all were or what they did but there was the anaesthetist, the doctor who would remove my eggs, a nurse to assist, the embryologist, and a few others—it’s a bit of a blur. I think they may have even had a student or two observing! My recollection is vague because, within about 20 seconds of me lying down, they had the oxygen mask on me and the drugs down the tube attached to the shunt in my arm. I was asleep in about ten seconds.
Next thing I knew, I was being woken up by a nurse in the recovery room. I was incredibly drowsy and wanted to be left to go back to sleep, but for some reason they insisted on getting me up and awake and out of there as quickly as possible. I was still in the hospital gown, with the addition of a giant sanitary pad shoved under me. There is no dignity in hospital!
The nurse told me to get up, put my clothes on and go and sit in a chair. I really just wanted to go to sleep—my eyes were heavy and I felt weak. My insides hurt. But I did what I was told and as a reward I was given a cup of tea and a biscuit.
I chose to be anaesthetised to avoid the pain of the egg collection, but it felt as if the doctor had been a bit more aggressive with Sleeping Beauty. I felt swollen, bruised and beaten.
The rewards, however, were much greater this time. They had harvested eight eggs. Wow, I was over the moon.
The embryologist injected all eight eggs with Dom’s defrosted sperm and we got five embryos! This was really exciting. I started daydreaming about the possibilities. Would we put one or two back in? Would we freeze the rest and go for more babies? We couldn’t help but feel absolute relief.
I waited by the phone for the daily call from the nurse at FertilityPLUS. I was in a good mood when the phone rang because I was expecting her to tell me the embryos were all strong—fighting it out over who would be chosen to be deposited back into my welcoming uterus. But, instead, I got bad news—the worst news possible.
‘I’m so sorry Jay-Jay. None of your embry
os have survived. They’ve stopped dividing.’ At this point I wanted to burst into hysterical laughter. Surely, it was a joke? But fertility issues are no joking matter and there are no comedians at Fertility-PLUS. I think once the news registered what I actually said was, ‘Nooooo! How can this be?’ And then I burst into tears. I felt my heart tighten in my chest as the news sank in—there was to be no embryo transfer. IVF cycle two was over—null and void.
We had spoken about our fertility openly on the air and online. We seemed to have become the go-to couple for fertility stories and comments in the media but right then I was too upset, too tired and too sore to speak.
Once we had gotten over the grief of failing a second time, things got better and Dom and I did our first big magazine story with Katherine Granich for OHbaby! By then, we had also begun to look forward to a third IVF cycle.
I loved the way the article turned out in OHbaby! I wasn’t nervous about sharing our story and I knew Katherine and her editors would treat it with respect. We had so much positive feedback and so many people reaching out to us after the story was published. It made me feel good—like we were connecting to other like-minded people.
IN HIS OWN WORDS—SECOND IVF CYCLE
Getting serious, everyone assumes that having male infertility would challenge my masculinity, but it doesn’t. Guys who think that way and start to feel sorry for themselves need to realise that their partners are going through a lot worse than they ever will with IVF.
After two rounds of IVF, you start clutching at weirder and weirder advice—if someone told you eating bananas with the skins on would make a difference, you’d do it.
You get to the stage where you listen to all sorts of advice and you think, ‘What have I got to lose?’ That question is easy to answer—nothing to lose and everything to gain.
Third IVF cycle
Once we got over the grief of failing a second time, we booked in for a third attempt. The odds, we figured, are so much better by the third cycle and we were feeling confident of success this time. Fortunately, because the second cycle was not completed, we were told we’d be eligible for another fully funded attempt. That was a huge relief.
Misconception Page 4