While doing a light-of-day re-read of my feelings, I realised that I've missed out a fairly major part of the narrative - what we're actually doing.
(Is there anything more horrifying than the saying "there's more than one way to skin a cat"? I just typed 'there's more than one way to science a baby' then I thought of that saying and truly, why would anybody ever say that? There should be no ways to skin cats. Nobody should skin cats. That is my feeling on cat-skinning. Are you supposed to write out your process like this? What on earth made me think I had the right to be a blogger?)
When it comes to making babies, there are many and varying ways in which science can help. Your first stop is always with a specialist fertility doctor person, who will take a look at your history and the issues you're having and design a little treatment programme that custom fits what your family needs (sounds like I'm trying to sell you a Casper mattress). Basically, no matter what your issue, Fertility Associates has your solution. IVF is the solution most people have heard about, but it's only one of many. I'm going to take you through my understanding of the various levels of intervention, then through our doctor's plan to impregnate my wife. I have got a very long book that they gave us called "Pathways to a Child" which has lots of information in it but we're packing to move so I'm just going to write what I can remember. Some of it might be very wrong.
Before you even start any interventions you get tests to make sure that you have ovaries if you're the kind of person that's expecting to have ovaries, and if your sperm is functional if you're the kind of person who has sperm. Based off these and your AMH and medical history and other things, you launch into an intervention of your doctor person's choice.
The two least invasive interventions are restricted to people in heterosexual relationships - monitored and medicated cycles. In monitored cycles the person with the uterus gets daily blood tests to determine the optimum moment to bang* the person without the uterus in order to make the baby. In medicated cycles, drugs are given to increase the hormone responsible for egg production which is great for people who ovulate at wonky times or don't always ovulate or who only want to bang once a month so they wanna make sure it's gonna WORK asap so they can stop banging and get back to being a gay person trapped in a heterosexual relationship hahahaha just kidding. The medication that increased your egg production is called clompihene and it totally fucks with you emotionally which is just so great because trying to make a baby is already a totally chill time.
From there we move up to IUI - intrauterine insemination, also known as artificial insemination, also known as fancy turkey-basting. This also comes in two forms - simple (unmedicated) and medicated (medicated). Simple IUI is just the same as a monitored cycle except at the end instead of banging you get a phone call telling you that you've got two hours to get to Fertility Associates so that a nice nurse can inseminate you using a tiny lil baster that goes up through your cervix to increase the odds of the sperm hitting the tiny eggy target. Medicated IUI you use the same medications as with a medicated cycle but you trigger your body to release the eggs to coincide with your insemination appointment. This way you can be sure that both a) there is an egg where it needs to be at the right time and b) that live sperm are making it to that egg.
Unfortunately, sometimes, even when we put the sperm right up in there just as the egg is emerging, they don't/won't/can't come together. The uterus can be a spooky place and not always conducive to conception (which, like, no problem, it's only its entire job, whatever). That's where we meet IVF. In IVF, you do medication to stop the natural process of ovulation so that your ovaries don't go spitting out the eggs before you're ready, as well as the extra-eggs medication, then when you're ready for 'retrieval' you do another medication to make your eggs finish ripening or something. Did I mention yet that all of the medications I'm talking about are injections? Into your stomach? That you just do, yourself, at home? This is when you know that you really want a baby. Anyway, then you go in and they pull the eggs straight out of your ovaries with a needle (I hear the drugs are top-notch which is the only way I can type that without screaming). Then they pop your little eggs in a very comfortable and conception-friendly wee dish and put some sperms on them and give them some privacy and then hopefully maybe some of them will turn into embryos! You pop the embryo into the uterus a few days later, and freeze any extras in case that one falls out.
Sometimes, though, THAT doesn't work either because for some reason, the sperms just nope right out of going into the egg no matter how comfortable the little dish is and that's when you move up the scale even further. ICSI (intra-something sperm injection) if your next step, which is where you do the whole IVF bit again (nightmare, are you feeling the nightmare scenario building here?) except instead of just leaving the sperms and eggs to make friends overnight you JAM A SPERM RIGHT INTO ANY EGGS YOU GET OUT WITH A TINY NEEDLE so there is no noping out option available. It still might not turn into an embryo but at least then you know it got in there. If THAT doesn't work or if they think the reason it's not working is because some of the sperm is a bit bung, you can do IMSI which is the same thing but they put the sperms under a huge microscope and choose the best-looking one to out in the egg. I'm not kidding. The best-looking sperm. This whole thing is ridiculous. I cannot believe accidental pregnancy is a real thing.
If some of your bits just flat-out don't work you can get a donor for whatever bit is letting you down - a sperm donor (hi Buzz!), an egg donor, or surrogate if your uterus just womb-goofs out every embryo or if your relationship has no uteri in it (Hi Michelle!).
So! Our plan. The fun thing about our plan is that it has all of the above bits in it! We're starting with simple IUI - Linda gets blood tests starting a few days after her period finishes, they tell us the right time to come in and we race to Fertility Associates and do the IUI thing. We have one more round of that to go, then we move to medicated IUI to boost our chances. We do two rounds of that, then, because our sperm is limited due to neither of us being a literal sperm factory, will move onto IVF which has much higher odds and uses less sperms.
So that's us! Thank you for all the love after our last post, and I hope this fills in the gap about what it actually is we're doing. Cross your fingers real hard for us that this last round of unmedicated IUI works.
*In TTC circles this act is called 'BD'. I imagined any number of things this might stand for (Bang day? Bonk donk? Bed date?) Turns out it means 'baby dance', which is apparently the act of having hettie sex at the time the doctor/your blood tests/your at-home ovulation tracker tells you to. Straight people. I cannot even.
(Is there anything more horrifying than the saying "there's more than one way to skin a cat"? I just typed 'there's more than one way to science a baby' then I thought of that saying and truly, why would anybody ever say that? There should be no ways to skin cats. Nobody should skin cats. That is my feeling on cat-skinning. Are you supposed to write out your process like this? What on earth made me think I had the right to be a blogger?)
When it comes to making babies, there are many and varying ways in which science can help. Your first stop is always with a specialist fertility doctor person, who will take a look at your history and the issues you're having and design a little treatment programme that custom fits what your family needs (sounds like I'm trying to sell you a Casper mattress). Basically, no matter what your issue, Fertility Associates has your solution. IVF is the solution most people have heard about, but it's only one of many. I'm going to take you through my understanding of the various levels of intervention, then through our doctor's plan to impregnate my wife. I have got a very long book that they gave us called "Pathways to a Child" which has lots of information in it but we're packing to move so I'm just going to write what I can remember. Some of it might be very wrong.
Before you even start any interventions you get tests to make sure that you have ovaries if you're the kind of person that's expecting to have ovaries, and if your sperm is functional if you're the kind of person who has sperm. Based off these and your AMH and medical history and other things, you launch into an intervention of your doctor person's choice.
The two least invasive interventions are restricted to people in heterosexual relationships - monitored and medicated cycles. In monitored cycles the person with the uterus gets daily blood tests to determine the optimum moment to bang* the person without the uterus in order to make the baby. In medicated cycles, drugs are given to increase the hormone responsible for egg production which is great for people who ovulate at wonky times or don't always ovulate or who only want to bang once a month so they wanna make sure it's gonna WORK asap so they can stop banging and get back to being a gay person trapped in a heterosexual relationship hahahaha just kidding. The medication that increased your egg production is called clompihene and it totally fucks with you emotionally which is just so great because trying to make a baby is already a totally chill time.
From there we move up to IUI - intrauterine insemination, also known as artificial insemination, also known as fancy turkey-basting. This also comes in two forms - simple (unmedicated) and medicated (medicated). Simple IUI is just the same as a monitored cycle except at the end instead of banging you get a phone call telling you that you've got two hours to get to Fertility Associates so that a nice nurse can inseminate you using a tiny lil baster that goes up through your cervix to increase the odds of the sperm hitting the tiny eggy target. Medicated IUI you use the same medications as with a medicated cycle but you trigger your body to release the eggs to coincide with your insemination appointment. This way you can be sure that both a) there is an egg where it needs to be at the right time and b) that live sperm are making it to that egg.
Unfortunately, sometimes, even when we put the sperm right up in there just as the egg is emerging, they don't/won't/can't come together. The uterus can be a spooky place and not always conducive to conception (which, like, no problem, it's only its entire job, whatever). That's where we meet IVF. In IVF, you do medication to stop the natural process of ovulation so that your ovaries don't go spitting out the eggs before you're ready, as well as the extra-eggs medication, then when you're ready for 'retrieval' you do another medication to make your eggs finish ripening or something. Did I mention yet that all of the medications I'm talking about are injections? Into your stomach? That you just do, yourself, at home? This is when you know that you really want a baby. Anyway, then you go in and they pull the eggs straight out of your ovaries with a needle (I hear the drugs are top-notch which is the only way I can type that without screaming). Then they pop your little eggs in a very comfortable and conception-friendly wee dish and put some sperms on them and give them some privacy and then hopefully maybe some of them will turn into embryos! You pop the embryo into the uterus a few days later, and freeze any extras in case that one falls out.
Sometimes, though, THAT doesn't work either because for some reason, the sperms just nope right out of going into the egg no matter how comfortable the little dish is and that's when you move up the scale even further. ICSI (intra-something sperm injection) if your next step, which is where you do the whole IVF bit again (nightmare, are you feeling the nightmare scenario building here?) except instead of just leaving the sperms and eggs to make friends overnight you JAM A SPERM RIGHT INTO ANY EGGS YOU GET OUT WITH A TINY NEEDLE so there is no noping out option available. It still might not turn into an embryo but at least then you know it got in there. If THAT doesn't work or if they think the reason it's not working is because some of the sperm is a bit bung, you can do IMSI which is the same thing but they put the sperms under a huge microscope and choose the best-looking one to out in the egg. I'm not kidding. The best-looking sperm. This whole thing is ridiculous. I cannot believe accidental pregnancy is a real thing.
If some of your bits just flat-out don't work you can get a donor for whatever bit is letting you down - a sperm donor (hi Buzz!), an egg donor, or surrogate if your uterus just womb-goofs out every embryo or if your relationship has no uteri in it (Hi Michelle!).
So! Our plan. The fun thing about our plan is that it has all of the above bits in it! We're starting with simple IUI - Linda gets blood tests starting a few days after her period finishes, they tell us the right time to come in and we race to Fertility Associates and do the IUI thing. We have one more round of that to go, then we move to medicated IUI to boost our chances. We do two rounds of that, then, because our sperm is limited due to neither of us being a literal sperm factory, will move onto IVF which has much higher odds and uses less sperms.
So that's us! Thank you for all the love after our last post, and I hope this fills in the gap about what it actually is we're doing. Cross your fingers real hard for us that this last round of unmedicated IUI works.
*In TTC circles this act is called 'BD'. I imagined any number of things this might stand for (Bang day? Bonk donk? Bed date?) Turns out it means 'baby dance', which is apparently the act of having hettie sex at the time the doctor/your blood tests/your at-home ovulation tracker tells you to. Straight people. I cannot even.
So educational thank you! What costs can one expect going through these?
ReplyDeleteOh, heck, that's a whole other post! Depends on lots of factors - it's cheaper for heterosexual couples, and for two-uterus couples it depends on whether you have your own donor or you're using a clinic one. Roughly for us it cost $5k to get up and running, each round of simple IUI is running us around $1.5k, medicated IUI should be around $2.1k, and if we have no luck then IVF will be starting around $8k per try (more if we use ICSI or IMSI). The milky bars are NOT on us. (my next post really will be about this in a lot more detail!)
DeleteHey thanks for sharing this. I got to know new treatment today turkey basking. Even though I work at ElaWoman which deals in facilitating ART services such as IUI, IVF and surrogacy. But seriously I was unaware of this term. I loved this piece of information.
ReplyDelete