Michelle Tea: The Cruel Calculus of the Fertility Clinic
Before my sister leaves town she confers with me about Dashiell.
“Dashiell is AMAZING,” Madeline says, her voice full of wonder. “Do you know what she did at pancakes, when you went to the bathroom?”
Apparently, Dashiell leaned across the table and said, ‘I really like your sister,’ in this earnest, sincere way, which is Dashiell’s only way.
“It was so . . . old-fashioned!” Madeline exclaims, delighted. “No one has ever done anything like that before!” She is nodding in approval. “This is the one.”
She even conferred with Rhonda at the tea party, and Rhonda concurred, saying, “I’m done. Dashiell is it.”
I’m touched by everyone’s investment in my having a happy romantic life, and by their embrace of Dashiell. But of course, I expected as much. If you don’t like Dashiell, you clearly have a problem. A deep, spiritual problem, like maybe a dead or evil soul. Madeline tells me she is brainstorming with Walden a reality show that Dashiell could possibly star in, because she is so incredibly and uncommonly beautiful.
I get an LH surge on Monday, the day we have long-standing, irreversible reservations at the motherfucking French Laundry, for Bernadine’s birthday. We’ve had these reservations for months, because it takes months to get them. Which is handy, because then you have time to save up / work around to accepting that you are about to spend THREE HUNDRED DOLLARS on dinner.
Bernadine is a wild foodie, and it’s because of her that I have eaten at all the nice and/or cool restaurants I’ve eaten at – Le Bernadin and Momofuku in New York; Acquerello here in San Francisco.
Our reservations are early, and the drive north is long, so Quentin graciously comes over ON HIS LUNCH HOUR to knock me up! We are cutting it very close – Bernadine and Tali will arrive exactly one half hour after insemination. Go, Quentin, go! I pull my satin and leather dress above my hips and Dashiell inseminates me. I have my tights and booties waiting right beside me so I can just fly out of bed and downstairs to the rental car.
How was French Laundry, you may want to know. Well, out of like a million courses only two were kind of MEH, but when you are paying that much money for a dining experience it is sort of imperative that every single dish brought to your table is a religious experience.
In my opinion, the lobster was tough, and not the butter-dunked delight I expect from a lobster, and the deconstructed Caesar salad clever but the chicken kind of gross. Also, the deconstructed funnel cake did not live up to the wild excitement the thought of such a desert generates.
There were some nice moments, and it is a heady, giddy experience to do something that for me is luxorious enough to feel transgressive. I can say that I ate at The French Laundry. Hey – I ate at The French Laundry! There’s something I’ll never do again, despite Bernadine’s blissful calculations that if you never ate out ANYPLACE ELSE and cooked inexpensive meals at home 361 days a year, you could actually dine at The French Laundry seasonally.
I am happy I did something so decadent before I have a baby and can never again spend money on anything that does not support the higher person of my child’s eternal happiness and success.
Speaking of the spending habits of the upper class – it’s time for my telephone intake with Dr. Evangelista! Dr. Evangelista is very no-nonsense. I wonder if she questions my commitment, having selected the free phone consultation over the put-your-money-where-you-mouth-is $300 live consultation with complimentary ultrasound!
I’m just kidding about that. Nothing in this situation is complimentary. (Incidentally, The French Laundry does give you ‘complimentary’ donut-holes to dunk in an espresso cup full of semifreddo, AND cellophane-wrapped packages of their famous shortbread and a souvenir print-out of your menu, so you leave feeling like you got a bunch of stuff for FREE, but you really, really did not.)
“Before we begin, are there any questions I can answer for you?”
Of course there is really only one question – how much does this shit cost? I ask Dr. Evangelista, minus the expletive.
“An IUI cycle with Clomid will go between $800 - 1,000; a cycle with HGC is between $2,500 – 3,500. Plus another $1,500 in both instances, for donor screening.”
My body fills so completely and instantaneously with dread, it’s like I’m a dread balloon. A dread balloon on a little string of dread, bobbing lowly, hopelessly, skimming the pavement.
If it was a one-time thing, this expense, I’d do it. But I can imagine how hooked in you get. IUIs often don’t take the first time, and after making an $800 commitment to go that route, what are you going to do when you learn it didn’t work? Give up? No way - you’ll feel like you REALLY wasted your money if you give up. Like a gambling addict, you double down, trying to win back your losings with a BABY.
I think the only thing I’m more scared of than childbirth is having no money. I recall a friend of mine who sobbed on the IUI table, thinking that they were injecting $800 dollars straight into her vagina. She does, however, have a baby now. She spent most of her MacArthur Genius Grant getting the thing, but now she’s got it. I wonder if I have time to become a Genius before menopause sets in.
Back to Dr. Evangelista, who delivers her information with a hint of defensiveness in her voice, like she is used to delivering unhappy news to people, people who then try to beg some hopefulness out of her, but Dr. Evangelista is a DOCTOR, not a Life Coach. She does not traffic in optimism.
“In your 20s and 30s your body is at its peak fertility,” She reality-checks me, “And even then your chances of getting pregnant are about 25-30%. By 37, that drops to 15%, and by 40 you’re at 5%.”
I won’t understand until later, when I talk to Madeline, that the Dr. means EACH CYCLE. So, your odds improve the more you do it. As a 40-year-old, I don’t have a static 5% chance; after four months, I’ve got a 20% chance, almost as good as a drunk 20-something who forgot to make her hook-up wear a condom.
Those seem like okay odds, and they’ll will continue to climb as long as I can keep luring Quentin into my kitchen! But again, I don’t realize this until later, so my dread now morphs into a stunned numbness.
“The quality of your eggs depend on your age and your hormones,” Says the Doctor. “The first thing we’d do is an ultrasound of your ovaries and see what they look like.” There is also the Hysteroalpingogram, which is not a way of communicating with Victorian women who have been committed to remote, Alpine sanatoriums to convalesce from Hysteria. It’s a procedure in which radioactive dye is shot into your cervix and spills into your fallopian tubes.
How come, if I’m bringing my own donor, I have to pay $1,500 for a screening? The whole point of having a known donor is that is ISN’T thousands of dollars. I mean, it’s my body, I’m clearly comfortable with having this person’s body fluids inside me, can’t I decline a pricy screening? Nope. Because money is changing hands, the government is of course involved, and the FDA is required to certify that Quentin’s sperm is up to their standards, and this costs $1,500.
It seems crazy that I could just have SEX with Quentin (something my very own MOTHER suggested) and get preggers, but if I want his seed catapulted into me via the miracle of modern medicine, the FDA wants to get involved.
Dr. Evangelista tells me I would have a week period wherein Quentin could come into their office and bank as much sperm as he can muster, but once we run out of that supply, he would need to be re-tested, at $1,500.
It would be nice – really nice – if fertility clinics had customer appreciation cards. Like, get 9 IUIs and your tenth one is free? Two-for-one Donor Screenings? Whatever. I ask Dr. Evangelista how much the odds increase by utilizing these procedures.
“Well, your odds on a natural cycle are 5%,” She reiterates, twisting the knife. “An IUI without drugs will increase your odds to 8%. Add Clomid and you’ll likely produce two eggs, and the more eggs you produce the greater your chances. That would up it to 11%. An HGC injection will produce 3-5 eggs and you go up to 12%. If you want to look at IVF – “
I don’t, I don’t want to look at IVF, it’s fucking outrageously expensive, literally beyond my means. If I could spend THAT kind of money I’d hunt down some Doctor internationally who practices Egg Fusion, where they take my egg and Dashiell’s egg and they smoosh them together, making a little girl with both our DNA. I mean, if money was not an object THAT is what I’d be doing. But money is an object, in spite of what may be surmised from my dining habits.
“With IVF your odds go up to 25%. But – “ She pauses, lest she’s accidentally inspired hope - “At your age range you are dealing with a 40% chance of miscarriage.”
I sit mutely on the phone. I think I’ve gotten all the information I need.
“At your age,” The Doctor continues, perhaps mistaking my glum silence for quiet calculating, “You’re at a critical point. The difference even between 40 and 41 is significant.”
“Okay,” I say.
“Any more questions?”
“Nope. I’ll just, um, think things over,” I lie. There is nothing to think over. I am not going to this, or possibly any, fertility clinic. I’d be better off taking my savings to Vegas and sprinkling it over roulette tables. The odds are superior, and once I’m rich I can just go buy a million babies like Angelina and Madonna. Right?
“Okay, well, best of luck to you.” YOU’RE GOING TO NEED IT, I imagine Dr. Evangelista cackling over her phone as she hurls it into the cradle. ANOTHER POOR, BABY-MAD HAG GETS HER COMEUPPANCE!
NEXT WEEK: Mucus!
Oh, hey Readers – I’ll be touring the US and Toronto reading from Getting Pregnant with Michelle Tea throughout April on the Sister Spit Tour! Come say hi! Tour dates here.