I have had a lot of questions and quizzical looks when I explain what we're signing up for with In Vitro Fertilization. I thought I'd take a moment this week to break it down for one and all.
The first step is to make my ovaries go nuts making eggs. On a natural cycle, several eggs start to develop at once until one finally releases, and the others quickly sit down and shut up. (In the case of natural fraternal twins, two eggs accidentally release spontaneously, before the "I got this!" message could be sent around.) In our IVF cycle, I will inject myself daily with drugs to make my ovaries triple this process of development while simultaneously taking another drug that shouts into a bullhorn, "Hunker down! Nobody let go!" During this time, I'll need to go in for daily ultrasounds to monitor my hardworking ovaries and tweak my drug regimen. If they don't develop eggs quickly enough, we may not have adequate material to work with in the next step. If they develop too quickly, I can get a painful and life-threatening problem called Ovarian Hyperstimulation Syndrome. So easy does it, here!
When my ovaries start to look really beautiful (or insane, depending on your viewpoint), they'll schedule the egg retrieval, and I'll take a "trigger" shot telling my ovaries to leggo my eggos. The doctor will put me under, then use an ultrasound-guided needle to suck up all the good looking eggs he can find. If we're all doing a good job, then we might get as many as 30 eggs! Around the same time, Jake will need to give the clinic a cup of his "special" sperm. Both eggs and sperm then go to the beauty parlor and get totally prettified for their big date on the petrie dish.
Now, with well-adjusted sperm and eggs, you can usually just introduce these gorgeous kids and let nature take its course. They're in the prime of their lives, after all, and have never looked better. However, Jake's sperm is too socially awkward for these subtleties. They'd sit around all night just looking longingly at my eggs and wishing they were less homely. So our doctors actually plan to pick up each sperm by the scruff of his neck and stuff him right into each egg. I know. So much for cellular foreplay.
After that, we put the newly created embryos in special "grow, baby, grow" juice and cross our fingers. Within 48 hours, each should have multiplied into 6-8 cell organisms (many won't). We can implant then, but if many are looking hardy, we'll wait until day 5 when we might have a few blastocysts (80-100 cells). We'll select the very best of the bunch, and if there are some good runners-up, we'll put those on ice for another time. The doctors will send our over-achiever up the birth canal and into the uterus where we hope it will find a warm place to burrow and sleep. I'll probably continue with a few drugs to keep my uterine home nice and comfy for as long as the doctors see fit. Then the dreaded two week wait.
The rest of the story is undoubtedly familiar to you: tests, celebration, reading, registering, showers, shopping, joy, pain, cuddles, milk, kisses, perfection.