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10/10/2007

Final score: "desperate" 4, "implant" 4, Oprah 0, Alexis kind of a lot

So after our long journey out of the muddy hole of Satan, I found myself safely back in Oprah's studio being introduced to Alexis Stewart.  "She's 42, she's single, and desperately" — that's two — "also wants a child of her own."  Stewart, we'd already been told, spends $28,000 a month trying to have a baby.

It's the first thing Oprah said at the very top of the broadcast, and I think it was supposed to shock us.  But to a repeat IVFer, a fellow poor responder, it's truly not so shocking.  I've checked the numbers myself.  Here is what I came up with, based on my own experience:

  • Medication, maximum dose for a poor responder from a discount mail order pharmacy: $6,000, plus or minus
  • IVF, including monitoring, retrieval, anesthesia, fresh transfer, and hospital fees (Cornell as of 2004): $9,619
  • Assisted hatching (Cornell): $1,500
  • ICSI (Cornell): $2,500
  • PGD (Minnesota clinic): $5,000
  • Donor sperm (half-assed Googling): $200-500

...for a total of something upwards of $25,000.  Assuming that Alexis, daughter of media mogul Martha Stewart, goes to a clinic even slightly more expensive than Cornell, it is not at all difficult to believe that a single cycle could cost so much.  So, Oprah, I'm not shocked yet.

Oh.  Wait.  I'm supposed to be shocked that she does it, given the cost, and not that it costs so much?

Well.  Er.  How embarrassing.  Because I'm not.  In fact, the only thing that really shocks me is that I...kind of...almost...well, I liked Alexis Stewart, despite her giant diamond earrings, incongruous given the previous segment, and her utterly flat affect.  (So robotic did she seem that I think my TiVo might have developed a teensy crush on her.)

She began by declaring she'd waited too long to decide she wanted children.  "The aura around the whole thing is that you can wait," she said.  "You get distracted.  We have jobs, we have other things to do, medicine seems miraculous, you can do what you want..."  She pointed out that movie stars have babies late, and charged the media with perpetuating the myth of endless fertility for older women.  "You don't hear the stories of the people who can't have babies."  Stewart thought she had time.

"But very few people can have their own baby at 45," she warned.  "They might have surrogate eggs [sic]."  I found this misuse richly amusing, as if Stewart herself had never been given the donor egg speech. ("I think they're called something like donut eggs, but I certainly wouldn't know.")  But I appreciate anyone, anywhere telling the truth about declining fertility, so I restricted myself to a kindly chuckle.

Throughout this part of the conversation, Stewart was straightforward and matter-of-fact, quite a contrast to Jennifer West's visible emotions in the earlier segment.  "I'm a very calm, steady person," she explained, "so I treat [infertility treatment] as a job.  If I get too emotional about it, I'll be unhappy all the time, or freaked out all the time.  You have to look at it whatever way you can handle."  Curiously, this made me like her more, her unapologetic focus on the goal instead of the process.  And perhaps just a little bit envious of her ability to compartmentalize.  "You're on a mission," Oprah summed.  "Correct," agreed Alexis.

Still desperate, though, Oprah hastily pointed out at 46 minutes in.  (Three.)

They talked a bit about the cost of cycling.  "I am very lucky that I can afford this," Stewart said, confirming that her mother's contributions have helped.  Since Stewart's eggs are, as she described them, "hard and crusty," her protocol involves all of the extras above: AH, ICSI, and PGD.  It was never explicitly stated how many cycles Stewart has done, although she did say she'd had three implantations (aaand that's four "implant"s) of 3-5 "eggs" each, with none of them actually implanting.  She also revealed that on her last cycle, she had no embryos available to transfer, which makes at least four cycles so far.

Alexis walked us through her drug regimen, showing the various vials and needles.  Here is where she almost lost me, describing Lupron as a drug that's given during IVF "to make sure you don't get endometriosis."  Yes, and birth control pills are given to make sure you don't get pregnant.  And those ooky progesterone suppositories are given to make sure you allow no one within twenty feet of your vagina.  Jesus gay, Alexis, don't put this shit in your body if you don't know what it's for.  But I was immediately back to loving her when Oprah asked her whether the injections were easier if you did them where you had some fat.  "Maybe," said the wraithlike Alexis.  "I don't know."

Given the cost and the slim chance of success, Oprah asked whether Stewart had considered other options — measurably less bold than she'd been with the Wests earlier, stopping far short of "Why don't you adopt?"  (Draw your own conclusions about what the relative clout of her guests has to do with that.)  Stewart said she hadn't.  "I'm doing this now."  When it's time to do something else, she might, she said, but for now she is focusing on this.  Which is a really nice way to tell some nosy talk show host to step off, if you ask me.

So even while finding her a little bit loopy, I was already kind of liking Alexis Stewart for her candor, her determination, and her willingness to talk about a subject far too many public figures avoid.  That kind-of-liking turned to full-on love when Oprah introduced her next guests, a young couple sitting in the audience.

Tracey and Jaime Hanson are about to embark on their first IVF, and have taken out a home equity loan to finance their attempt.  Tracey admitted to being concerned about all that the cycle would entail, but said she was counting on the support of her husband to see her through it.  And, Tracey continued, her doctors had told her she's young, she's healthy, she'll have no problem.

And this is where Alexis jumped in.  Being healthy has nothing to do with it, she told the audience.  And "you can be 28 and be almost at menopause."  Though I cringed for poor nervous Tracey, because it seemed Stewart was speaking directly to her, eager to dash those newbie notions most of us once held dear, Stewart's overall point is vitally important: that infertility affects people of all ages, in all walks of life, even the young and otherwise healthy.  And who else on the national stage is saying such things so candidly?

And damned if I don't like her fatless robotic ass for it.  Even if her mother is yearning "desssperately" (four) for grandchildren.

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