It was the perfect embryo, full of possibility
At the end of my first round of IVF, the doctor handed me a black-and-white photograph and explained that I was looking at the embryo he was about to implant in my uterus. It was printed on the same thin shiny paper that hospitals use for take-home ultrasound images, and maybe that was why I expected to see the beginnings of a body: some sort of lumpy elongated form. I knew better, but it was still a shock to see a perfect circle holding eight overlapping circles. It looked, I would joke to my husband later, like modern art: minimalist, abstract, pure shape.
“This is a perfect embryo,” the doctor said.
Its eight cells indicated a healthy growth rate, the doctor explained. The cells were symmetrical — another promising sign. We had been trying for a baby for about two years, and with each failed attempt, it was harder to keep our spirits up. It dawned on me that the doctor was giving us the hospital version of a pep talk.
When we started trying to conceive, I tracked my cycles like a hunter armed with chemical-laced sticks. In each ovulation window, when the peedupon stick displayed a smiley face, we had sex no matter how much or how little we felt like it. We had no pregnancy to show for it, month after month.
When we decided to get doctors involved, we realized how lucky we were to live in the hospital mecca of Boston — in one of the few states with a strong mandate for insurance coverage of fertility treatments. Still, nothing was guaranteed.
The myriad tests that my husband and I took at the hospital found nothing wrong, so our next step was IUI. (For those uninitiated into the alphabet soup of fertility-world, IUI stands for “intrauterine insemination,” a procedure that shot a curated team of my husband’s gold-medal swimmers into the uterus.) Three rounds of IUI proved equally futile. I learned not to get my hopes up when we began trying IVF.
But now here it was: a perfect embryo.
The transfer was quick and painless. Anticlimactic, after the hormone shots, the pills, the trips to the hospital for transvaginal ultrasounds every morning before work. The egg retrieval that left my stomach so painfully swollen that I looked pregnant, which felt cruelly ironic. I’d worn baggy clothes outside the house to avoid wellmeaning questions about how far along I was.
When my husband and I got home after the embryo transfer, we weren’t sure what to do with ourselves — or with that glossy picture. We clung to our flimsy scrap of proof that we had finally reached the starting line. That photo was the most sentimental thing about the process. We were stat hounds, and we knew the numbers were not on our side. In our scenario, the embryo had a 1 in 3 chance of making it from the transfer to a successful birth. With those odds, we weren’t going to risk wasting the one name the two of us agreed on, so we called it “Brio,” Italian for “liveliness,” and not too far removed from “embryo.”
We didn’t want to get ahead of ourselves, but a positive attitude was supposed to improve your chances. In a concession to hope, we hung the picture on our fridge. The circle of circles floated next to the Magic Marker drawing my friend’s daughter had made of the two of us, two stick figures standing under a rainbow.
When the pregnancy test came back negative, I grasped at illusions of control. I analyzed everything I’d done since the transfer. Had I been too stressed? Failed to meditate enough? Did I eat too much sugar? Walk too fast? How had I lost the perfect embryo? My doctor reassured me: That’s just how it goes. Most of them aren’t cut out to make it. I appreciated the matter-of-fact way she demystified a process that has so much failure built into it.
Back to the beginning: another round of IVF, another month of shots and morning trips to the hospital, another egg retrieval.
At the next transfer, the doctor on rotation handed us two pictures, each showing a circle crowded with circles of different sizes. If the last embryo was perfect, it didn’t take a medical professional to deduce that these were not. The doctor explained that the hospital’s algorithm had suggested transferring both. This was no pep talk; this was the hospital version of dancing around a poor prognosis. We nicknamed these embryos Ember and
Rio, but — lesson learned — the latest pictures went into a cupboard, out of sight.
Two weeks later, my pregnancy test came back positive. One of them had made it. My husband and I were shocked, elated. Cautious. At 36, my age bracket had a 20 to 30 percent miscarriage rate.
Five weeks into the pregnancy, I was on a business trip when I went to pee and found my underwear soaked with blood. I walked in a daze to the emergency room across town, where the attending physician examined me and announced between my splayed knees, “Given the amount of blood I’m seeing, it’s likely that you’re miscarrying.”
I froze and then grasped at the hope buried in “likely.” I lay on a stretcher for over an hour dreading the ultrasound that would determine whether I was losing the pregnancy. What exactly would I be losing? I asked myself. My husband and I are not religious. That circle full of circles: We never called it a baby. It wasn’t even a fetus yet; until the 10-week mark, it would still be an embryo. I was prepared for devastation.
For us, it wasn’t a baby but the possibility of one.
That was what I would be losing.
At last, my stretcher was wheeled out of the brightly lit hallway into a small dark room. Warm gel squirted onto my belly, a plastic wand pressed down, and a blackand-white image of my uterus flickered onto the screen. I couldn’t make anything out. The ultrasound technician slid the wand around. After an agonizing silence, she pointed and said the embryo was still there. A bloodfilled sac had caused the bleeding — technically, a subchorionic hematoma. These things happen, the doctor would explain. The image on the screen didn’t look like anything to me, but it didn’t matter: The possibility was still alive.
My body worked for nine months transporting nutrients and oxygen through my bloodstream to the embryo that became a fetus, until the day when the doctors cut me open and pulled out a chubby body with a puffy red face screaming louder than anything so tiny ought to be able to do, and it finally felt real: I have a baby!
I was holding my son, 6 months old and quick to grin, trying oh so hard but failing adorably to crawl, when I saw the headline on my phone: “Alabama Rules Frozen Embryos Are Children, Raising Questions About Fertility Care.”
What? I thought. No, this is a child, this baby in my arms.
The chief justice of Alabama’s Supreme Court wrote, “Even before birth, all human beings bear the image of God, and their lives cannot be destroyed without effacing his glory.” He specified, “We believe that each human being, from the moment of conception, is made in the image of God, created by Him to reflect His likeness.” Clinics in the state abruptly stopped offering IVF due to the liability risks, leaving frozen embryos trapped in legal limbo.
I kissed my baby’s soft warm head and thought about the embryos that had been created outside my body to get to this point. Ten or so cells each. The brain of a fruit fly contains 200,000 cells. I would almost understand if someone imagined evidence of a higher power in the face of my son — he is that cute — but I am in good company with many people of faith who find no image of god in these dots, who interpret their chosen scriptures otherwise.
Before I had my son, I worried that becoming a mother would make me go sappy about conception and pregnancy, but when I look back at pictures of my IVF embryos, I absolutely cannot fathom calling any of them, in the language of the Alabama ruling, an “extrauterine child.” No, that’s what’s smiling at me from the playpen as I type these words, my sweet son, light of my life, who would never have been born under the legal chill that settled over Alabama.
Lisa Allen is a freelance journalist who lives in Boston’s Hyde Park neighborhood with her husband and son. She is writing a book about the nourishment women artists’ work has provided on her journey through infertility, pregnancy, and new motherhood.