Fertility doctors don’t like it when you refer to a cycle of IVF as an experiment. I know this, because I’ve accidently called it that in front of them. However, if it’s not an experiment, then I don’t know what is. And in case you’re wondering, I definitely know what an experiment is, because I’m a scientist. In my head, the clinicians treating me are testing a hypothesis, or, more simply, asking a question: can we get this woman pregnant? To answer the question, they follow a protocol, and wait for the results.
It was two years after being awarded my PhD, after taking up a post carrying out cancer research at a university hospital, that we were diagnosed with infertility. Reluctant to jump straight into IVF, and with the devastating information that my husband’s sperm count was zero, I requested a referral to a Urologist instead of a fertility clinic. Immediately, I began obsessively searching PubMed (like Google for biomedical research papers) for relevant research. I wildly abused the institutional subscriptions that allowed me to pass through the paywalls that normally prevent the general public from reading scientific research, with knowledge feeling like the only thing that could give me back any control over this nightmare situation.
I kept feeling awkward and anxious about clinical appointments. On the one hand, my PhD in Biomedical Science meant that I understood all the words they were saying, and I was familiar with things like odds ratios and pedigree diagrams, but on the other, I am not clinically qualified. I needed their insight, their experience. My husband is not a scientist, so he often felt like the dunce in the corner, as consultants discussed things with me as if I was their peer rather than their patient. Possibly because of this, he constantly wonders how anyone who doesn’t have a PhD manages to make it through the system and get treated.
When we finally began treatment, I felt calmer. We were starting the protocol, starting the experiment. I wasn’t even fazed by the needles; in their familiar BD blister packs, these were the tools of my trade. There was something comforting in calmly assembling needle and syringe, mixing and drawing up solutions, marking off on my treatment schedule when the drugs were administered. I cannot say as much for the abrasive nasal spray, or the enormously distasteful progesterone pessaries. On the day of egg collection, when they ask you to confirm your name to the waiting embryologists, I wanted to be on their side of the hatch, not mine. I could see the cell culture hoods and incubators behind them, and I still wonder exactly what kind of plasticware they grow our embryos in. I’ve never been brave enough to ask.
I’ve handled a blastocyst before. It belonged to a mouse, and I was using it to make stem cells. I often thought how my blastocysts looked exactly the same down a microscope. I have frequently felt like a laboratory mouse. I am grateful to those wee beasties, though. IVF was developed in them. Without them, I wouldn’t have my baby.
A significant part of me cringes on behalf of the embryologist when they come in with the precious embryo nestled in a catheter. I am poised, ready, legs spread and knickers long gone. I’m aware that, like me, they’re not clinical trained, but there I am, in all my messy, embarrassing nakedness. I watch them trying really hard not to look at my vagina, and instead to smile at my face, which is somewhat further from them. I’ve considered retraining as an embryologist, but I decided that I couldn’t handle that much pressure. When my experiments go badly, it’s only time and money I’m wasting. They hold life in their pipettes, and more even than that, hope and love.
If my ability to reproduce was an experiment, I’d have abandoned it years ago. It is not a fruitful avenue of investigation. Every time, they tweak the protocol a bit, hoping the result will be better next time. Once, it was. But five other times it wasn’t. Ten embryos have been carefully placed inside my womb, and only one made it out alive. One more than many people ever have.
They say Einstein said that the definition of madness is to repeat the same action and expect a different result. Well, Einstein wasn’t a biologist. Luckily for me, he wasn’t a fertility doctor, either.