Gambling on conception

You’d have to be pretty heartless to begrudge the blessings of fertility treatment after reading Michael Ryan’s new book. But what about the way medical technology drives eager couples to obsess every step of the way? “Baby B” follows the 13 weeks during which Ryan and his wife, Doreen Gildroy, conceive through in vitro fertilization and endure the roller-coaster beginning of a pregnancy. With the help of their larger-than-life fertility specialist, Dr. Lawrence B. Werlin (“This is the Whirl,” he introduces himself over the phone), the couple have four embryos in a Petri dish. They opt to have all four injected into Gildroy’s uterus. That’s almost a basketball team.

Yet Ryan tells us that “Dr. Werlin’s standard procedure for women in their late thirties is to transfer up to six embryos from dish to uterus, risking the chance of a multiple pregnancy in order to maximize the chance of a single pregnancy.” IVF, in other words, has much in common with playing roulette.

Gildroy is ready to spin the wheel: She’s almost 37 and has failed to conceive after nearly six years of trying, including nine intra-uterine inseminations (in which the sperm is deposited by catheter into the uterus to ease the first leg of the journey). Like most women who pay thousands of dollars for IVF -- Ryan doesn’t reveal Werlin’s fee, but the standard is at least $4,500 -- Gildroy is understandably desperate.

Ryan, a poet and English professor at UC Irvine, is 53 and didn’t want children for most of his life. But after two failed marriages, he wants Gildroy as desperately as she wants a baby, so he wants one too. “I was afraid of what the disappointment would do to her, and to us,” he writes, “afraid this could be one of those things that happen to people that they never get over.” Adoption gets only a cursory mention. Instead, Ryan describes in minute detail the daily hormone shots to the buttocks he dreads giving to Gildroy, who is phobic about needles.

At least the pain of the shots has a purpose. After the embryo transfer, Gildroy goes on 24-hour bed rest, flat on her back, which means flat on her sore spots. As Ryan observes, there’s no proof that bed rest after IVF helps women get or stay pregnant. Many doctors don’t even suggest it. But what choice do infertile couples have but to obey every command of their trusted specialist? If they don’t and something goes wrong, a vortex of self-blame awaits. So Gildroy suffers through sleepless nights listening to “I Love Lucy” reruns (she’s not allowed to lift her head to see the TV).

Ryan rubs his wife’s calves, waits on her and sometimes feels put upon. “I remind myself that if she can endure her pain I can certainly endure my exhaustion, but sometimes it owns me,” he confesses dolefully before feeding Gildroy dinner, forkful by forkful, then washing the dishes and doing the laundry.

When the ultrasounds begin in week six, the couple learn that they have one embryo with a heartbeat, then three embryos, then four, and then -- well, you’ll have to read that part yourself. “It seems like an evil fairy tale, where you get too much of what you desire -- except there’s no moral to the story,” Ryan writes.

Or at least, no moral in the hands of this author. A different writer might have taken the opportunity to ask whether infertility clinics use technology in a way that forces patients to know too much about the early stages of a pregnancy. As Ryan observes, peeking at a fetus through an ultrasound “is like studying Mars with binoculars.” If the binoculars show something is amiss, there’s no treatment, since no one has figured out how to help an embryo implant or to keep its heart beating.

Still, the ultrasound remains a weekly fix, sending them into a tailspin of emotion. Without the sonograms, Gildroy’s pregnancy would have offered little drama -- and probably no book material. But she and Ryan might have had more peace of mind.

As it is, Gildroy is sent back to bed and put on a high-protein diet to bulk her up by 55 pounds. This is what couples fall for when they’ll do anything to have a baby. A scene in which Gildroy fights nausea while Ryan encouragingly wolfs down pistachio nuts captures what the book offers. If you want thoughtful reflection about infertility and at-risk pregnancies, read the essays in “Wanting a Child,” a 1998 collection edited by Jill Bialoski and Helen Schulman (some of its best are written by men). If you want a blow-by-blow account of gambling on IVF and winning -- the couple had a daughter in November 1999 as a result of the IVF treatment -- read “Baby B.”

The main reason the book doesn’t achieve more is that Ryan doesn’t round out himself or his wife as characters. In his previous memoir, “Secret Life,” he dissected his addiction to sex with disturbing candor. He’s a lot less interesting as a puppy-like husband. When the old Ryan shows up in “Baby B,” it’s only a brief flashback. He first meets Gildroy when she is his 22-year-old poetry student and he is 38 and married. He utterly botches things when he tries to hit on her. A year and a half later, they meet again and she moves in with him. Writing-wise, the book is all downhill from there.

Smitten, Ryan turns Gildroy into the ultimate mother-to-be. “What I am getting out of this right now, no matter what happens later, is a deeper love for Doreen and a kind of awe at what she is able to do,” he writes. “She’s being more completely revealed to me. She’s using the pain to practice love. I never imagined I could love another person as I love her.” This from a poet whose previous memoir was full of searing and beautiful description.

Ryan evens seems to miss the point of one of the most poignant moments he describes. Waiting in the entryway of Werlin’s crowded Irvine clinic, he watches a toddler who is Chinese (infer adopted since his mother seems to be Caucasian) try to grab a banana from the purse of a woman who is sitting alone in a corner. The woman, who is in her 40s, takes the banana away from the child so that she can ask his mother if she may give him a piece. “ ‘My hands are clean,’ ” she adds for reassurance. “How lovely this one sentence was,” Ryan writes.

Maybe, but in the mouth of a middle-aged woman in the waiting room of an infertility clinic, it is also painfully sad. Already Ryan seems to have forgotten what it’s like to be locked out of the golden circle of conception. Marriage and fatherhood may be great for his mental health, but they’re not so good for his sense of empathy. *