by Sara Connell
We ate dinner at home, turned off our phones, and watched a few sitcoms. At eight forty-five, we laid out the HCG vials and Bill began mixing the powder with a saline solution. I read the instructions out loud, checking both the manufacturer’s instructions and the packet from RMI. I bounced my legs nervously while Bill prepared the syringe. At eight fifty-nine, I pulled down my jeans and turned my backside toward Bill. At nine o’clock exactly, Bill was still fiddling with the syringe and I started to panic. He’d found an air bubble and was flicking his finger on it, trying to get it to burst. I recalled horror films where people injected an air bubble into someone to murder them. I hadn’t asked Tracey or Rachel about air bubbles. Could this injection kill me? The seconds ticked forward, and Bill squirted some air out of the top of the needle.
“Honey!” I yelled at Bill. “Don’t lose any of it! It won’t work if I don’t take the whole dose”—as if he didn’t know this as well as I did, as if he had an interest in anything other than success. Bill flicked the plastic tube again and the bubble burst. With a steady hand, he plunged the needle into my backside. I felt a small jolt of pain as the liquid entered the muscle. We counted to three and Bill removed the needle and massaged the area, as the packet instructed. He wiped the site with alcohol and I pulled up my pants and took over rubbing my behind. I wrote down the time on our chart. It was still exactly 9:00 PM.
When I called Dr. Colaum’s office to confirm our HCG injection time the next morning, Tracey told us to arrive no later than 8:30 AM on Saturday for the retrieval. “Wear something comfortable and remember not to eat or drink anything after midnight tonight.” The RMI packet also instructed me to remove any perfumes or nail polish. Later that day I got a message from an anesthesiologist with more instructions: not to swallow any water, even after brushing my teeth.
“They say that so you don’t puke during the procedure,” Bill said when I told him about the call.
When we arrived at RMI on Saturday, the office was already bustling. The overhead lights were on, and half a dozen staff members buzzed about the hallways. “Do you work every weekend?” I asked Rachel, who met us at the front door and gave us more forms to sign.
“We schedule all our patients’ cycles in sync so that we work two weekends a month and have the other two off,” she replied. I would not have wanted to work that many weekends; I was grateful for their dedication.
Rachel walked Bill and me past Dr. Colaum’s and Rinehart’s offices, past the lab where I’d had my blood drawn, and to the back of the clinic, where the procedures took place. I’d never been to this part of the office and was surprised by how big it was. A central space formed the nucleus for three patient waiting areas, a procedure room, where Dr. Colaum would perform the retrieval and transfer, and the fertilization lab, where embryologists, who’d taken on mythical qualities in my mind, introduced eggs and sperm to each other to create embryos.
Rachel escorted us to one of the waiting areas, a three-by-four-foot space partitioned off by curtains. Inside were a La-Z-Boy and a straight-backed chair, plus a shelf with a fanned-out row of magazines and a stack of surgical clothes: a cap, gown, and pair of socks for me. She handed Bill a cup for his “donation” and instructed me to change into the light blue ensemble. Bill slumped in the chair, holding his cup. “I’d almost forgotten about my part,” he said with a weak smile.
“We need to get moving,” Rachel said. “Dr. Colaum is almost ready.” I donned the cotton gown, cauliflower-shaped paper cap, and terry cloth socks with rubber strips on the soles.
An anesthesiologist named Dr. Samuelson started an IV, which was attached to a pole with wheels. Rachel instructed me to wrap the light cotton blanket they’d provided around my waist and follow her to the procedure room. “The whole procedure only takes about twenty minutes,” she said. The blanket trailed on the ground, and I had to focus not to trip. “But you’ll be groggy for a while afterward.”
Tracey was waiting in the room and helped me onto an operating table. Dr. Samuelson put an oxygen tube in my nose. “Just a precaution,” she said. “I have your heart on a monitor, and I’ll be right here with you the whole time.” After the hysterosalpingogram, I’d been happy to hear that I wouldn’t be awake for the retrieval. Now, however, I was scared. Last time I’d been put under anesthesia like this, I’d woken up with one less ovary.
Dr. Colaum entered the room with her usual good cheer and verve. Her long hair was tucked into a surgical cap; her dimpled hands looked poised and precise. “Are we ready to get those eggs?” she asked, smiling. I smiled back at her and tried to focus on Tracey’s face. Someone, I guessed it was Rachel, dimmed the lights and Dr. Samuelson told me to count backward from ten. Somewhere around seven, I was out.
“Time to wake up.” I tried to open my eyes. Rachel’s voice sounded gooey and slow.
“You did great, honey!” I could hear Bill, but I couldn’t turn my head to see him. I blinked, trying to adjust my eyes to the light. I looked down. We were in the same patient area we’d been in earlier and I was wrapped in the blanket, reclined in the La-Z-Boy. “Dr. Colaum retrieved nine eggs!” he said. I struggled to open my eyes and focus on Bill.
“How long have I been out?” I asked.
“Um,” Bill said, consulting the clock on the wall, “about twenty-five, thirty minutes.”
“That’s all?” I asked. I felt as if my arms and legs were being weighted down. I experimented to see if I could lift my hand. I raised it a couple of inches and then dropped it to the creased leather arm of the chair.
Tracey arrived with a bag of animal crackers and a 7UP. Rachel gave Bill strict instructions to call if I experienced heavy bleeding, high fever, or severe cramping. “Most likely you’ll just feel tired and sleep a lot,” Rachel said. “And one of us will call you tomorrow to let you know how many embryos we have. If everything looks good, we’ll transfer in the next few days.”
I contracted at the word “if” and tried to turn my mind to another subject.
“How did your donation go?” I asked Bill.
“Time of my life,” he said, rolling his eyes and sticking out his tongue.
RMI policy required that I be delivered to the car in a wheelchair, which Lorelai from reception volunteered to push. “I’m praying for you guys,” she told me as Bill brought the car to the front entrance. “Thank you,” I said. “We’ll take all the prayers we can get.”
Of the nine eggs Dr. Colaum retrieved, five were fertilized successfully and were vital embryos the next day.
“Our guys like each other!” I said to Bill, holding my hand over the phone while Tracey gave me the details of the fertilization. I pulled the phone back to my ear, catching Tracey midsentence: “ . . . Dr. Colaum scheduled your transfer for noon on Tuesday, so be here by eleven fifteen with a big bottle of water. You’ll be awake for this one, and we need you to have a very full bladder by noon.”
I felt giddy as we arrived at the office on Tuesday. Rachel took us directly to the same partitioned patient area we’d used for retrieval. Bill rifled through the magazines on the shelf, and I bounced a liter of Evian on my lap. We had five thriving embryos, one or more of which would be implanted in me in less than an hour.
Rachel introduced us to Carli, an embryologist from the lab. She pulled back the curtain and thrust a small square of paper at me. “Those are your embryos!” she said.
Bill and I stared at the image: three amazing circles captured by microscope, our potential future children—all five, six, or eight cells of them.
“Dr. Colaum wants to transfer all three of these embryos to maximize your chance of conception,” Carli said. “Rachel has the paperwork for you to sign. Keep drinking your water. We’ll be ready to go in twenty minutes.”
We had already agreed to transfer three embryos if we had them. If we had additional embryos that looked healthy for freezing, we could store them with the lab to use in a future cycle. “These three were the strongest,” Carli said, pointing out the optimal
shape and formation of the cells.
I nodded without looking up. I was mesmerized by the images on the paper. I regarded this moment as a gift of IVF. How many people had the opportunity to see a visual image of their potential child at the moment of conception? I changed into a paper gown, hat, and socks similar to the ones I’d worn on Saturday. I felt hyperalert and appreciative that I would be awake for the procedure. I didn’t care if it hurt—I wanted to see everything.
The clinic’s policy was for the partners to wait outside in the patient areas. Still, I wished Bill could be in the procedure room, to be there as Dr. Colaum transferred the tiny potential lives to my body.
As in retrieval, the lights dimmed. To me, the room took on a reverent feel, like a sanctuary. Dr. Colaum arrived in her scrubs and asked how I was feeling. “Full of emotion,” I said. She patted my upper arm. Tracey turned a flat computer screen toward me, and Dr. Colaum told me that I could watch as our embryos shot into my uterus.
From there, the procedure took on a well-practiced rhythm. Tracey positioned me at the edge of the exam table and put my feet in the stirrups. Carli stuck her head through a small window in the door that stood between the procedure room and the lab.
“Please state your full name slowly and clearly.”
The doctors and nurses turned to me. “Sara Connell,” I said. The process felt as if I were taking a wedding vow.
“Thank you,” Carli said, and disappeared from the window.
“It’s a double-check to ensure we transfer the correct one,” Tracey explained. How awful, I thought. I’d never even imagined the possibility of a mix-up.
The activity in the room made me temporarily forget about the two liters of water sloshing around in my bladder, but now I felt the building pressure. The urgency to urinate increased, and I wondered if anyone had ever peed on the table. Tracey held up a plastic instrument that looked like a vacuum attachment, which was attached to the ultrasound machine. She squirted gel onto the roller and began to move it back and forth across my abdomen with firm pressure.
Now I really had to go.
“Good work!” Dr. Colaum said. She turned the screen farther in my direction. “The more full your bladder, the better I can see where I’m going.” I stared at the screen, trying to make out the outline of my uterus. All I could see were fuzzy white pixels against black, like a photograph of outer space.
The window in the door opened again.
“Loading embryos,” Carli called from the lab.
“Inserting speculum,” Dr. Colaum announced, and deftly inserted the metal contraption and a small tube. “The tube goes through the cervix into the uterus,” she explained. “I want to get them up high along the back wall.”
I imagined the embryos like shooting stars being launched into the vast inner space of my uterus.
“Embryos ready,” Carli said from the window.
“Ready?” Dr. Colaum asked me. I could just see the top of her gray hair peeking out from the surgical cap.
“Ready,” I said. My throat was dry and my voice came out raspy.
I felt the light grip of Dr. Colaum’s hand on my ankle. I lay back and tried to relax. Come in, babies. Come in, I repeated over and over in my mind.
“Transferring three embryos,” Dr. Colaum said. I felt the cool line of the catheter tube inside me, and then, “Nice!” Rachel said from somewhere behind the table.
“Nailed it,” Tracey said, pointing at the screen as if Dr. Colaum had just stuck a difficult landing in Olympian gymnastics.
“Doesn’t get any better than that,” Dr. Colaum said, attempting to show me on-screen where the embryos had landed.
I still wasn’t sure I could see them, but I exclaimed, “Wow!” nonetheless.
“The rest,” Dr. Colaum said, “is up to—”
“The Universe,” I suggested, trying for something neutral. Dr. Colaum was a scientist, and I wasn’t sure where her spiritual beliefs lay.
“—to whatever decides these things,” Dr. Colaum said, gesturing upward and shrugging.
Carli closed the door to the lab window. Rachel and Dr. Colaum filed out of the room behind me. “See you outside in twenty minutes or so,” Dr. Colaum said, squeezing my shoulder as she passed. Tracey stayed for another moment, removing the extra exam paper from the table, putting the metal instruments in a BIOHAZARD bin for cleaning, returning the ultrasound roller to a hook on the side of the machine. She tilted the bed even farther back so that my legs were up higher than my head. “Do you think you can hold it?” she asked.
The persistent thump in my bladder had escalated to a scream.
“Um-hmm,” I said, willing my body to relax.
“See if you can rest,” she said, and closed the door quietly behind her.
I heard Dr. Colaum’s voice from outside the room and then Bill’s laugh. One thought played over and over in my mind: We might be pregnant. We might be pregnant. I looked at the screen again and tried to quiet my mind. I stretched my hands across my belly the way I imagined I would if I was seven or eight or nine months pregnant. A lullaby came to mind and I started singing. I lay staring at the screen, feeling the pulse of my fingers and hands on my belly, humming and singing, welcoming this life the way I would want to be welcomed, in deep, soothing tones.
Under strict instructions not to exercise, lift anything heavier than fifteen pounds, drink alcohol, or have sex, I went about the next week in a state of wired anticipation. “Don’t even think about trying to tell if you’re pregnant,” Rachel had told me, after I’d been allowed to go to the bathroom. “The hormones you’ve been taking can feel exactly like pregnancy symptoms. Your breasts will be sore, you will feel bloated, you could even come up positive on a pregnancy test because you took HCG—so don’t take one.” Home pregnancy tests were off the table at RMI. Rachel sounded like the seasoned parent of an adolescent, giving instructions on what not to do before she went out of town.
I filled my days with client sessions and preparing a talk, “The Feminine and Creativity,” that I’d been asked to give for a local women’s group. Many times a day, though, I’d stop in a hallway or when I was walking down the street to put my hands on my belly and squint my eyes, concentrating hard to discern any new sensation, any movement, as if there would be some way to feel cells dividing or the implantation that could be occurring at that very moment.
“Cut it out!” Bill yelled when he caught me standing in the doorway of our house, holding my hands on my belly, the Friday before our pregnancy test.
“My friend Michelle said she felt the moment of implantation!” I yelled back. “I haven’t felt anything. I don’t even feel the pregnancy symptoms from the IVF drugs that Rachel said I might feel.”
“Those people are delusional about the timing,” Bill said.
“What about my mom?” I said. “Is she delusional?”
My mother had long claimed to have known immediately when she was pregnant with me when she woke up and did not want a cup of coffee for the first time in her adult life.
“She was probably four weeks pregnant by the time she felt pregnant. These people did not do IVF. People who are one week pregnant have no freaking idea,” he said.
I tried to calm down, especially because I still had to make it through the weekend. RMI policy was to administer two pregnancy tests. Our first, which RMI would not tell us the results of, was on Friday. The “official” pregnancy test, as Rachel referred to it, would be on Monday. I tried to pretend the Friday test was just a fertility monitoring. I arrived at Dr. Colaum’s office on my own at 8:55 AM and offered up my arm. I assisted the nurse, who was new to the staff, in labeling the vial with my name and birth date, ensuring my information appeared on my tube of blood. Before I left, Rachel explained that to confirm an advancing pregnancy, they would be looking for the level of the human growth hormone to double each day between tests.
I drove to Dr. Colaum’s again early Monday morning. Bill and I both decided to work for the first par
t of the day. I met with clients in Evanston in the morning. At two thirty, I drove home and ate a late lunch, and then took my laptop upstairs to our bedroom to try and write. I stopped ten minutes later and alternated between reading and sending emails and folding the laundry that had piled up on top of the dryer. Bill was working in his office down the hall.
Three thirty slowly turned to three forty-five, and then it was four o’clock and four fifteen. I started to fear that Dr. Colaum’s staff had left for the day, but I couldn’t bring myself to call. Bill came into the room every ten minutes to check.
“Anything?” he asked.
“Not yet.”
As the hour approached five o’clock, I figured we weren’t going to hear from RMI. I scrolled through the numbers on my phone to find the after-hours number, when I saw an Evanston area code number come up on my cell phone.
“Sara?” Tracey’s voice came singsongy through the phone. “Is Bill there with you?”
“I’m here,” said Bill.
“We know we’re calling a bit later than expected, but everybody wanted to be here.”
“Everybody?” Bill mouthed to me. I shrugged. I was standing on my tiptoes, holding the phone up closer to Bill’s and my faces.
“Hi, Sara!” I recognized that voice as Rachel’s.
“We all wanted to be here to tell you . . . that . . . ”
“Yes?” Bill said. I thought he might hyperventilate.
“You’re pregnant!” The four or five voices on the phone announced this in unison. I dropped the phone and jumped onto Bill, straddling him with my legs, attacking him with kisses. He held on to the bedpost to steady himself, kissing me back and screaming, “Oh my god!”
