AI or IVF

Jess and I decided to skip AI. Not artificial intelligence – artificial insemination. I always think of a turkey baster when I think of AI. I don’t even really know what a turkey baster looks like, to be honest. But I imagine some version of one. I know that in reality AI is far more sophisticated and controlled than the turkey baster (when done in a fertility clinic – there are some couples that undertake to do it at home, and kudos to them. I’m sure they don’t use a turkey baster either. I think I should stop mentioning turkey baster. Turkey baster. Okay, I’m done).

At first I thought AI might be a good option for us. AI has a number of advantages: It’s a lot cheaper than IVF. It’s also far less invasive. (There will be a lot of gaps in my knowledge around talking about fertility for a number of reasons – most obvious among them: I’m not a fertility specialist. Another reason: It feels like we discussed the various fertility options a long time ago. Last but not least, I’m quite sleep deprived and everything feels more difficult when you’re short on sleep, including remembering details. So back to that gap in knowledge…) AI is less invasive than IVF as it doesn’t involve any operations. I can’t remember if there’s a non-hormone option and a hormone option. I think there is but I can’t be sure since Jess and I never went down this route. We also didn’t shy away from hormones (a personal choice). We were quite the opposite: We told our doctor – give us whatever hormones you need to give us the best possible chance of a healthy pregnancy.

I thought AI would be a good option for us because I’m a very optimistic person. The stories of AI working first or second time are wonderful (and easy, if easy can ever be associated with fertility). But there are a fair amount of stories of couples or individuals trying 5 or 6 times. When you have experienced the long (read excruciating) wait until you can do a pregnancy test with each AI/IVF cycle, you will understand that going through that 5 or 6 times would be horrendous. Jess and I knew couples in both categories: The “lucky” first-timers and those that had to go through AI 6 times before switching to IVF.

One of the main reasons we opted for IVF is because we decided to use a sperm donor from a USA sperm bank. This meant that each vial cost a lot (exchange rate, shipping it here and so on). Although AI is a lot cheaper than IVF, the expensive vials had to be taken into account. Then there’s the success rates. IVF has a much higher success rate than IVF. I won’t go into percentages here because I don’t know them and if I Google them, the figures may not be accurate as there are so many variables. Another reason we skipped AI and went straight to IVF (that sounds like monopoly): with IVF we could ‘bulk’ fertilise eggs. That is, one vial could be used to fertilise 15 retrieved eggs, for example. This, as compared to AI where you use a vial every time you make an attempt. Our vials cost a lot. We couldn’t be willy nilly (pun intended) with them. If we had free healthy sperm (like some heterosexual couples) we would have definitely given AI quite a few goes before moving on to IVF.

Oh and another reason we went right to IVF: Our ideal scenario would have been reciprocal IVF, which means I wanted to carry a baby genetically linked to Jess. From the way I phrased that sentence you probably picked up that that is not what happened. That’s another thing about fertility ‘journeys’. They don’t often play out the way you imagine they will. We were fortunate enough to get that advice before we began our journey. My dad happened to have a school friend that became a fertility doctor in the states and he was kind enough to have a video call with us. He told us that couples often have a very precise plan about how things are going to unfold and they learn that they have to adapt along the way. That is certainly true for us and our idea of reciprocal IVF.

I thought of another reason. (You see, this is the thing with fertility, there are so many considerations to factor in). We knew we wanted at least two children. We could maybe ‘get away’ with AI for our first but by the time we tried for our second, we’d be older and our fertility would’ve followed the graph downhill and so we thought the safest option for us was to freeze embryoes. That way, we wouldn’t be relying on our future selves to produce good quality eggs – we’d go get them ‘now’ and use them later.

But I think I’m getting ahead of myself… Let’s go back to the beginning. And I suppose the true beginning is that Jess has always wanted to have children. And I have always wanted to have children. We established that very early on. When I say early on, I mean that we established this even before we met. How? Over WhatsApp. You see Jess and I were set up and Jess cancelled on me 6 times before we finally met (a whole other story). Months passed before we actually met in person, and in those days and weeks, Jess and I got to chatting. Slowly at first and then frequently, and then we chatted on most days. One of the things that came up: Do you want children? Not in a ‘do you want to have my children’ kind of a way, but as an independent question: In your life, do you want to have children. We both did. (I remember having this discussion (unrelated to Jess) with a friend of mine. How do you approach the topic of children when you’re dating at a certain age and don’t really want to invest in someone who doesn’t want children. You just straight up ask, my friend said. And we did (Jess and I). We asked. And the answer was a strong yes.

Cut to our fertility doctor’s room. I still remember one of the first things our doctor said to us. She said that she meets so many women that wait for everything to have lined up before trying for a baby. They wait to find the ideal partner and that great job and the house and to be financially stable, and when all this finally lines up, they start trying to have children and they’re 41 and for some, it’s too late. I use 41 arbitrarily. Some women fall pregnant at 41 easily. My cousin just had twins at 45. But she is the exception. Women’s fertility generally takes a downturn at 35 and continues that way. When we heard this (or confirmation of this because, of course, we knew this on some level but I don’t think either of us had ever seen it represented on a graph), Jess was 36 and I was 35. We decided right there in that appointment that we didn’t want to wait any longer. At that stage we hadn’t chosen a donor. What could we do in the interim? Egg retrievals. Jess went first. She’s a year and a half older than I am and though that age difference is so minimal, in fertility terms it counts.

I’m going to end there for tonight. I’ve covered a lot of bases, I feel. I’ll talk about egg retrievals next (not necessarily tomorrow or the next day, but soon). I’ll talk about how each of those retrievals played out for us.

For now, goodnight.

Photograph of the day: Kit and Jess, backlit, walking through sunbeams.