Misconception

by Jay-Jay Feeney

  Mum ended up staying for most of the year, until about November. She loves cleaning and got a few jobs cleaning houses in the area. Another bonus of having Mum at home—I didn’t have to clean my toilets anymore!

  Dom was adamant we should try Fertility Associates for our fifth cycle. The original doctors at Fertility Associates, Richard Fisher and Freddie Graham, introduced in vitro fertilisation to New Zealand in 1983. Fertility Associates went on to become the largest provider of fertility services in New Zealand. I had to agree with Dom—it was time to try something new.

  It had been almost two years since our last cycle so I called Fertility Associates and made an appointment with the legendary Doctor Richard Fisher. He saw us within a couple of weeks. Our first appointment was for 8 May 2012.

  At Ascot Hospital we took the lift to the third floor. When the doors opened I immediately thought, Wow.

  FertilityPLUS is in the public sector and the clinic is at Greenlane Hospital. It’s quite small and dowdy in comparison to Fertility Associates, which is spacious, bright, clean, modern and expensive looking. There’s money to be made in baby-making! The walls were curved and the couches were curved, too. There was a lot of space so you could sit far enough away from other waiting couples to feel comfortable. At Fertility PLUS, there were about ten chairs in the waiting room, all next to each other, so your elbows often brushed other waiting couples, which was awkward in a room where no-one speaks to each other. It’s not like a normal doctor’s surgery waiting room where children play on the floor and you may smile across at a waiting patient and maybe even get chatting. Nobody talks to each other in a fertility-clinic waiting room. It’s a bit weird because we’re all there for the same reason and we all know why we are there.

  Richard Fisher glided out of his office and walked toward us beaming. My heart leaped because I had seen him in magazines and on TV so many times that it felt like I was meeting a celebrity. I meet a lot of celebrities in my job but I still get excited! Richard reached his hand toward us for a handshake and said, ‘It’s great to have some celebrities in here.’ What? Celebrities—us?

  He said he’d seen our Sunday documentary and quite a few of his clients had made reference to it. Here I was excited to meet Doctor Fisher and he was equally excited to meet us—that was unexpected. He led us into his office and we sat down on the couch.

  Dr Fisher asked us lots of questions about our previous IVF cycles. I didn’t realise how bad my memory was until then. I really struggled to recall lots of important details so we decided to get our files from FertilityPLUS sent over.

  I asked Dr Fisher what he thought about acupuncture and visiting a naturopath. So many people swear by both and I wanted to make sure I had done everything I could to help us succeed. He explained to me that even though some people have success, he questioned whether they could put it down to acupuncture, massage or reading a book, but he agreed that taking the time out just for you is beneficial. You needed relaxation time and time to de-stress. And if acupuncture made you believe you were doing the right thing, go for it. I decided then and there that a massage sounded like a much better idea than acupuncture.

  After a bit more chitchat about the possibilities of a cycle of IVF at Fertility Associates, we were sent to meet one of the nurses for even more information. Linda Taylor took us into a room and gave us an information kit with a DVD, a magazine and a price list. She confirmed Dr Fisher would get our files from Fertility-PLUS and have a meeting with all the surgical team and doctors to determine which course of action to take. She told us to expect a phone call later in the week. Our appointment took half an hour and cost $230. Medically assisted baby-making is not cheap.

  Eight days later, on the following Wednesday night the phone rang. It was Dr Fisher. He said he’d looked at our records and thought it wouldn’t be unreasonable for us to try again. However, he warned us we’d have to reduce our likelihood of success based on the number of cycles we’d already had and the fact that two of them ended in miscarriage, even though we’d had good-quality embryos.

  At thirty-seven, my chance of getting pregnant would normally be 35 to 45 per cent, but the team at Fertility Associates felt my chances were at the lower end and would only be 35 per cent—the same chance as a 40 year old.

  Dr Fisher thought that the improvements in technology since our first attempt would help nurture better embryos, but he thought our problem was more likely to be about the sperm than the egg—the opposite to what Brad Crouch had said.

  Dr Fisher couldn’t be sure—he thought Dom’s sperm should be okay, but testicular sperm can’t be tested for DNA integrity. We agreed to testing Dom’s hormone levels to determine if he was still producing sperm.

  We also discussed other options. Things get more complicated when you consider using donor sperm or egg.

  At our next appointment I told Dr Fisher we had been taking vitamins from Brad Crouch. He jokingly asked if we rattled when we walked down the street.

  ‘We’re all ready to go!’ I announced.

  Then he talked about how he’d like to proceed. I’d had some basic blood tests, including for anti-Müllerian hormone (AMH). The test for AMH gives an indication of how many eggs a woman has in reserve at a given time—we are all born with a finite number. Dr Fisher said this time he’d like to try a ten to twelve day course of injections leading up to egg collection. This time he felt there was little difference and he wanted to focus on quality over quantity.

  With the long cycle the ovaries are, more or less, put to sleep and then woken up again. With the short cycle, the ovary stays awake and when it’s ready to rock the team set to work. I wondered why no-one had suggested this to me before and Dr Fisher pointed out that it was a reasonably new practice—it’d only been around for about three years, and his confidence in it was increasing.

  I told him I’d started taking Citalopram two months earlier and he assured me it would not effect IVF outcomes or pregnancy. He also confirmed that Dom would need to have another TESA and his sperm frozen in advance—there’s no difference in outcome whether you use fresh or frozen sperm and it takes the pressure off us if we’re not both under the knife at the same time.

  Dom always squirms when he thinks about his nuts being cut open, even though he’s in la-la land when it happens. While we are waiting to see Dr Fisher’s nurse, Linda Taylor, to talk through the next steps—mainly payment—I admitted to being excited all over again and asked Dom how he was feeling.

  ‘Oooohhh, nervous now! I don’t want to get my nuts chopped into again,’ he squealed. Then he joked, at least with a short cycle, if it didn’t work we could book in quickly and have another go.

  We agreed that, at $12 000 per go, we’d have to think about that later and, anyway, we shouldn’t be assuming it wasn’t going to work. After all, we were in a new place, with fresh ideas and a different approach.

  Talking to Linda we were told we needed fresh blood tests—all the usual, including HIV, HBV, Rubella, HCV, VDRL/TPHA and other things I had no idea about. She gave us consent forms, a couple of dates for follow-up appointments, some brochures and the payment options. Ouch.

  Payment options? We’d been lucky enough to have government funding up until then and had not understood the real costs of all the treatment we’d had. When we found out it was going to cost $15 000—much more than we expected—we were surprised. Luckily, we had exactly $15 000 saved up but it hurt to empty out the savings account.

  But the most important thing Linda explained to us was how the shorter cycle works—my egg collection would be within two weeks of the first day of drugs. The second-most important thing was the different drugs I’d be taking this time—Gonal-F again and Cetrotide, an alternative gonadotrophin-releasing hormone antagonist.

  Linda explained I’d have to mix the Cetrotide myself, starting on day six, and I would have to go into the hospital to be monitored for 15 minutes after taking it for the first time, because many years ago someone had a serious reaction. />
  I asked Linda what she thought about taking False Unicorn root—Chamaelirium luteum—recommended by Brad Crouch as an anti-miscarriage herb. She said the question to ask was whether or not it would react with the IVF drugs I was about to start taking. I certainly didn’t know the answer and neither did Linda.

  I believe in naturopaths and I pointed out that Brad had been adamant that False Unicorn root would be fine but, at the end of the day, I had just paid $15 000 to Fertility Associates so they had my full attention. When Linda called me later to say Dr Fisher advised I stop taking the False Unicorn root, I stopped taking it.

  IN HIS OWN WORDS—PREPARING FOR A FIFTH IVF CYCLE

  We had mutually decided that the fifth round of IVF would be our last one and, through luck, if that is the right word to use, it was going to be the first round we would pay for. It ain’t cheap—it was going to cost serious money—so we were throwing absolutely everything at it, leaving no stone unturned.

  First we would get some new people on board. We decided to go with Fertility Associates and Dr Richard Fisher. Whenever there is a story about IVF, sperm or fertility, he is the go-to guy for a comment. He is thought of as a rock star in fertility circles. Jay-Jay was reluctant to change because of the relationships she had formed with the staff at FertilityPLUS, but I thought it was time for some fresh ideas. When the All Blacks lose four games in a row, the coaches make changes, or do things differently. If we did the same things with the same people, we could end up with the same outcome!

  There was no guarantee this new crew could help us get a different result but there was no way I wanted us to end wondering if there was something, anything, we could have done differently.

  Dom’s delivery

  As the day for Dom’s TESA approached, you’d be forgiven for thinking he was about to give birth. Here are some typical Dom comments about the impending operation, even though it wasn’t going to take longer than half an hour unless the little buggers are hard to find.

  ‘I’m getting my nut sack cut open again!’

  ‘I haven’t been able to have a hot bath in ages because I’m getting my balls chopped into!’

  ‘There’s no point going to this party if I can’t drink. Humph!’

  Dom wants a baby more than anything but he also wants it known that he’s not happy about making this sacrifice. I reminded him that if I was lucky enough to get pregnant, I would not be drinking for a year, I would get fat, I would have stretch marks, morning sickness, haemorrhoids and whatever else comes with pregnancy and then I’d have to push the baby out. I also told him I was certain I’d rather trade all that stuff for a trip to la-la land and a half-hour operation of just one small incision even if it is in a place most people don’t see.

  Dom was booked in for his TESA at 2 p.m. on 31 May with strict instructions not to eat after 8.30 a.m. that morning. That meant it was work as usual and, while we were in the studio with a song playing, I asked our co-host, Mike Puru, how he thought Dom was feeling.

  ‘No man wants to get his nuts cut into,’ he said in support of Dom.

  I considered getting a medal made up for Dom, for when he came to after his operation—he clearly thought he would deserve it. In the end, I made a note to myself to be more sympathetic and, maybe, buy him a get-well card for afterwards.

  We arrived at the hospital and were led into a private room with a couch and a relaxing-looking chair with a built-in side table. We were given a few forms to fill in—consent forms for IVF, TESA and the freezing and storing of sperm. Some of the questions on the form seemed really hard to answer right at that point, but we had to do it.

  Should the woman die and embryos are stored: will Fertility Associates dispose of the embryos OR will the embryos be made available to the partner?

  Tough one. Did I really want Dom putting our embryos in another woman and having our children long after I’m gone? Would he even want the embryos after I’m gone? We decided the answer was yes.

  Should the woman’s partner die: will Fertility Associates dispose of the embryos OR will the embryos be made available to the female partner?

  Same dilemmas. But we agreed that the living partner could have custody of the embryos should we be lucky enough to have any spares.

  And then the big question,

  How many embryos to transfer?

  Well, first of all, we’d only had one embryo in cycles one and three, and two in cycle four good enough to implant. And we have no reason to expect to be inundated with embryos this time. Shirley Greenwell, the nurse with us at that stage, told us we’d need to decide if we would want one or two embryos implanted and the answer would depend on whether we were open to multiple pregnancy. She reminded us that it came with added risks. Multiple pregnancy? Beggars can’t be choosers, as the saying goes, but I preferred just one for now, thanks! However, I asked Shirley if we could make that decision later and she said that would be okay.

  What should the clinic do with any eggs or embryos that are not viable? Dispose of them, let us take them home in a jar, or donate them for training purposes?

  Dom joked, ‘You can poach them, do what you want with them. Put some hollandaise sauce on them, if that’s how you like your eggs!’ Gross. What a thought. Actually, we quickly agreed that leaving them for training purposes was a good move so student doctors and nurses could learn how to handle them.

  Shirley explained what would happen in the operating room—sticking a line in Dom to give him some drugs. Dom wanted to request the doctor operate on his left testicle. He gets phantom pain in his right and thought it might be a good idea to provide a bit of balance.

  A man Shirley called Bert popped in to say hello and introduced himself as our embryologist. Later, Shirley told us everyone calls him Crazy Bert, not to make us nervous—not at all!

  We were also introduced to Annie, who was to be our very young and pretty theatre assistant. Dom’s eyes lit up. ‘Oh cool. You’re about to see my nuts!’ he joked. Annie laughed. Thank God, these people weren’t all serious and stuffy—I just wouldn’t cope and nor would Dom.

  Crazy Bert, in his broad Gavinish accent, asked Dom for his full name and date of birth. Dom replied and asked if he was making sure Dom hadn’t sent a stunt double or imposter. Bert said, ‘Yes,’ then asked Dom to confirm he was having a TESA. Dom thought he said TASER. Ouch. We all laughed—there was a lot of nervous giggling coming from Dom and me that day.

  Dom confessed he’d prepared for the operation by shaving himself ‘down there’. Oh my God. He can be so embarrassing. Luckily, everyone found it amusing. Then everyone left the room and we were alone.

  ‘That was a whirlwind introduction!’ I said. ‘It’s like a well-oiled machine around here.’

  Not long after, we were taken into the operating theatre where Dom wandered into theatre in his hospital gown tied at the front with just his undies underneath. There, he was asked to lie down on the bed. The nurse asked me to help her pull Dom’s undies down. It was quite amusing as we each had one side of his undies and shimmied them down his legs, and off.

  Then the nurse threw a surgical sheet with a hole in it over Dom to cover him from the waist down. Dr Fisher was ready to go and started by pulling Dom’s penis and testicles up through the hole in the surgical sheet. The operation went well and Dr Fisher was very pleased with the results—six straws of sperm.

  Bert the embryologist told us he found hundreds of thousands! I was really excited but, all of a sudden, I was scared. What if it worked? I’m not used to it working. What if I actually had a baby? Wow!

  I was recording the operation with my microphone and we used some of the audio to play back on our radio show the next day—we’re always looking for original content! And, yes, we’d said we wouldn’t tell people we were doing IVF, so we told our listeners Dom was doing this in preparation for our next cycle, whenever that may be. Mike Puru, our co-host, started the ball . . . ha ha . . . rolling.

  ‘I’ve got a theme song for you Dom.’ And
then he hit off that ghastly AC/DC song ‘I’ve Got Big Balls’.

  ‘That’s really inappropriate, Mike,’ I said ‘Take that song off!’

  ‘He’s talking about soccer balls, and tennis balls and snooker balls,’ Mike tried to convince me.

  ‘Keep it clean, please,’ I begged. ‘That’s unlike you.’

  Mike was laughing. He thought he was being hilarious. Dom thought he needed to explain why Mike was playing that song.

  What followed was a rare thing—Dom, ever the joker, the prankster and the chief piss-taker of our trio, talked frankly to our listeners.

  ‘I was away on Thursday because I had a surgical procedure on that particular part of my body. It was a thing called a testicular biopsy.’

  Mike shuddered aloud.

  ‘And this was all part of IVF,’ Dom continued. ‘For couples with fertility issues, this is the process you have to go through if you want to have a baby.’

  ‘Not everyone has to get the operation there,’ I interrupted.

  ‘No, luckily . . . It’s a reasonably unpleasant procedure, which I won’t get into in great detail, but it’s probably similar, I’m guessing, to a vasectomy, which is something no guy looks forward to, let’s be blunt about that,’ said Dom.

  ‘But a lot of guys do it and they survive through it, Dom,’ I reminded him. ‘They put a pack of frozen peas on it and then they’re off again.’

  After a bit more discussion, Dom said, ‘This is likely to be the very last one’. He’d done it again—told the world we were about to make a final attempt at IVF. I shouldn’t be surprised—he says it every time. I, too, hoped this would be our last attempt because I was hoping we would have a baby at the end of this cycle.