Fertile Ground (11 page)

Gina scanned the form again. “Where are these kept?”

“After the embryo transfer, it’s added to the patient’s file in our central filing system. During the course of the IVF, this form stays in the lab. The attending physician also keeps a copy for patients currently undergoing IVF.” She tapped the blue loose-leaf folder in front of her.

” “IVF—DO NOT REMOVE FROM OFFICE.” “

Gina read aloud the words handwritten in thick black ink on the binding. “What happens if this is removed from the office? It self-destructs?”

“Actually, there’s a tiny transmitter embedded in the folder’s metal rings for tracking purposes.”

The reporter stared at Lisa. “You’re pulling my leg, right?” When Lisa nodded, Gina chuckled and shook her head. “Not bad. I thought doctors were humor challenged.”

Lisa smiled. “I guess you haven’t met the right doctors. You can keep the form if you like.”

“Thanks.” Gina folded it and slipped it into her bag. “Can I take a look around the clinic?”

“What would you like to see?”

“Anything that will look good on camera and give our audience an insider’s view of what you do. Down the line, I’d love to film an egg retrieval with the ultrasound, a fertilization, an embryo transfer. The works.” Her voice and eyes were animated.

“I’d have to check with the board and staff. And you’d need formal, written consent from the patients.” Most

patients. Lisa guessed, would be reluctant to give up their privacy.

“Of course.”

Lisa pushed her chair away from her desk. “Ready for the tour?”

They stopped first at one of the ground-floor rooms where the embryo transfers were performed. The reporter glanced at the muted mauve walls, decorated with framed pastel watercolors; at the upholstered armchair in the corner; at the bleached oak dresser.

“It looks like a bedroom.” Gina sounded surprised.

“That’s the idea. We want this to be a pleasant experience. The partners can be present during the transfer, by the way.”

“Are the delivery rooms on this floor, too?”

“Second floor. The delivery rooms are the operating rooms. Many patients use their own obstetricians to manage their pregnancies outside the clinic. Some want us to manage pregnancy and delivery.”

She showed Gina a delivery room, then led her downstairs to the lab. “The scene of the crime,” Lisa said and was rewarded with a quick smile from the reporter. “The door’s always kept locked—obviously, security is very important.”

“Who has keys?”

“All staff physicians and lab techs. Everyone has to sign in and out.” Lisa knocked on the door. A moment later Norman Weld’s pale face appeared in the door’s small, rectangular window.

The lab assistant opened the door. “Hello, Dr. Brock man.” He gazed at Gina curiously.

Lisa performed introductions. “I’d like to show Ms. Franco around, Norman, but I don’t want to interrupt any sensitive procedures.”

“Actually, everything’s quiet right now.” His voice was cotton-ball-soft. He pulled the door open wider and stepped aside.

Lisa ushered Gina into the short, narrow anteroom and was wondering how to ask Norman diplomatically to leave, when he said, “Excuse me,” and disappeared into the lab.

From a carton on the floor she handed Gina a green gown, cap, and pair of booties and took a set for herself. “Standard procedure before entering the actual lab,” she explained. “The techs work with eggs and sperm, and the environment has to be sterile. And warm. You probably noticed it’s hotter here. We try to simulate the womb temperature.”

“Thank God you told me! I thought I was having premature hot flashes.” Gina grinned.

Lisa laughed. “I worked in a clinic where the lab director kept the temperature at ninety-six degrees. Talk about hot.”

After both women put on the paper clothing, Lisa pointed to the cabinets against the opposite wall. “Storage for needles, probes, petri dishes, etcetera.” She placed her hand on a microscope sitting on top of a cart. “This is what the tech uses to examine the eggs in the operating room. And this part is a portable incubator.”

“What’s that?” Gina pointed to a black volume resting on one of the counters.

“A record book. It follows the Julian calendar—how many days into the year, not which month. It lists the patients seen each day, in the order in which they were seen, and mentions what procedures were performed.”

She took Gina inside the actual lab and introduced her to Charlie and the two other lab techs—Margaret Cho, a slim, tiny brunette, and John Sukami, short and barrel chested, with shiny black hair and a matching mustache.

Charlie was eager to show Gina the apparatus in his kingdom: the incubators—gray for the eggs, white for the sperm; the “sterile hoods” where work with sperm and eggs was done; a stage heater microscope that maintained an embryo-friendly environment; a microscope with a teaching arm that enabled two people to view the same specimen simultaneously.

“This TV is connected to the microscopes,” Charlie explained, pointing to a monitor on a high shelf. “And we use that VCR to tape actual procedures.”

“What’s that?” Gina pointed to two large metal canisters in the corner of the L-shaped room.

“Carbon dioxide. The yellow one is five percent. The gray one, a hundred percent. All the incubators have a constant flow of carbon dioxide to simulate the womb’s environment, plus almost one hundred percent humidity.” “Like Miami?” Gina quipped, but she was clearly impressed.

Charlie showed her the round vats where the frozen embryos and sperm were stored in liquid nitrogen. She asked more questions, then talked to him about the logistics of bringing in a film crew, camera angles, lighting.

Norman Weld, Lisa noted, had been looking dour throughout their dialogue. He probably didn’t appreciate Hollywood. When he approached Lisa while Gina and Charlie were talking and leaned in close, she tensed, prepared for a complaint.

“I know how worried you must be about Dr. Gordon,” he whispered. “I want you to know he’s in my prayers.”

“Thank you, Norman.” She was touched by his concern and rested her hand lightly on his arm. His cheeks and high forehead turned pink, and she wondered if she’d made a faux pas, but then he smiled and bobbed his head.

“I can see why you’re proud of your clinic,” Gina told Lisa a while later as they took the elevator to the ground floor. When they were back in Lisa’s office, the reporter bent over her notebook, flipping pages, inserting words.

Finally, she looked up. “I wanted to make sure I could read everything I wrote. Ready to continue?”

Lisa sighed. “I thought we were done.”

“Just a few more questions.” She smiled. “The clinic literature mentions egg donors. Whose name goes on the eggs’ labels if the eggs were donated anonymously?”

“Some clinics use the names of the patient and the donor. To protect the donor’s anonymity, we use only the patient’s name. Or patients’ names, if the eggs are going to different women.” Who had received Chelsea Wright’s eggs? One woman? Two?

Gina flipped to the beginning of her notebook and ran her finger down the page. “Right. A ‘shared donor program,” the brochure calls it.” She looked up. “A little weird, isn’t it? Two women giving birth to babies who are genetic siblings.”

“No weirder than two women adopting children from the same birth mother.” Lisa had often wondered whether she had siblings or half siblings, whether they looked like her. She’d wondered what it would be like to meet them. “The recipients share the eggs and the donor-related costs. It makes the process more affordable.”

“But hardly inexpensive.”

“Unfortunately, no.” She wished there were some way to make fertility treatments affordable for more couples. Matthew shared her concerns. Thinking about him brought another stab of pain to her chest. She eyed the phone, but told herself that if Selena had heard something, she would have buzzed Lisa immediately.

Gina referred to her notes again. “Ten thousand dollars per IVF cycle at some clinics, if the couple pays up front. Twelve thousand at others. Fifteen thousand if they try to go through their insurance company. But few companies insure for IVF, right?” Her voice had taken on a harder edge.

“Again, unfortunately, you’re right.”

Gina shut her notebook. “My best friend and her husband had four IVF cycles. Sperm analysis, blood tests, fertility drug shots, and all the crap, if you’ll excuse me, that goes with it. No baby. They refinanced their house, spent sixty thousand. They’re willing to adopt, but now they can’t afford to.”

Lisa linked her fingers and leaned forward. “I won’t

apologize for the costs of assisted reproduction, Gina. They are high, but justifiably so. We make no guarantees. We’re up front about our statistics for live births. We always mention adoption as an excellent option. But the couples we see are desperate to have their own biological child. They’re willing to take their chances, and pay the price.”

Adoption was a wonderful option—for the adoptive parents, for the child they adopted. Though she’d been shocked and upset to learn she’d been adopted, she’d soon realized how lucky she was. She wondered sometimes where she would be now if her parents hadn’t adopted her and raised her with unconditional love, wondered what direction her life would have taken.

“And they pay that price two and three and four times, right?” Gina said with pointed criticism. She paused. “At least you offer a money-back guarantee. I guess that helps some couples if they qualify.”

“Definitely.” The guarantee had been Edmond’s idea, a response to the bleak prognosis reported in the News week piece and the subsequent drop in patients. Lisa had reservations about the refund policy—it seemed to her to be more about business than medicine. But Matthew had loved the idea, and it had brought in many new patients. “The patient pays a set amount, depending on her age, which has to be under forty. If she doesn’t achieve a twelve-week gestation after one retrieval cycle and embryo transfer, including the transfer of all thawed embryos, she receives a ninety percent refund of the base cost of the cycle.”

“Why a twelve-week gestation?”

‘ The miscarriage rate is higher with IVF. Of course, the refund doesn’t apply to medications, medical screenings, anesthesia, or pregnancy management.”

“Of course. “Beware of fine print,” ” Gina said dryly. “Still, it’s a better deal than most. And the statistics here are better than those at other clinics. One out of three or four, as opposed to one out of five. Maybe my friend should’ve come here. Then again, maybe not, given the recent allegations.”

“Unfounded allegations. Allegations made by ‘unnamed sources.” ” Lisa pronounced the two words with sarcasm.

“Sometimes people are afraid of retaliation.”

“Sometimes they’re lying.”

“Why, Dr. Brockman?” The reporter sat forward and rested her elbows on her knees. “Why would someone spread false rumors about embryo switching? It makes no sense.”

Lying in bed last night, wondering whether she’d ever see Matthew again. Lisa had thought about this, too. “Our clinic has an enviable reputation. Patients come here from all over the world because of our success rates. And as you said, they spend a lot of money. It’s possible that another clinic, hoping to attract patients, did this to damage our reputation. All it takes is rumor. In your line of work, I’m sure you know that’s true.”

“Is that a dig. Doctor?” Gina cocked her head.

“Just a fact. Well, maybe it is a dig.” She smiled.

“Okay.” Gina smiled, too. “Are you referring to a specific rival clinic?”

“Just speculating.” She was tired and thirsty. She glanced longingly at her empty coffee cup but decided against having a refill. “There’s another possibility. Some patients leave our doors childless, in spite of our best efforts. They’re disheartened, upset. Sometimes they’re angry at us and at those women who have become pregnant, and they need to lash out at someone, anyone.” She thought about Cora Alien, who was certain someone had stolen her embryos. Maybe Cora needed to believe that;

it was easier than facing the reality of several failed IVF cycles.

“Why would that person spread rumors about the clinic?”

“To punish the clinic that failed her. To punish other patients who were successful, by filling them with fear about the status of their children, born or unborn.” Lisa shrugged. “Here’s a better question: Why would a clinic like ours jeopardize its reputation by switching embryos? That would be so stupidF’

“Maybe a patient who doesn’t have viable eggs pays a staff member—a doctor, nurse, tech—to get her some.”

“Come on, Gina,” she said impatiently. “You saw the documentation. You saw the procedure.” “I saw paper. Doctor. Paper can be manipulated. Procedures can be circumvented. Labels can be switched, and doctors and techs have keys to locked labs.” She leaned against the chair back. “Maybe money isn’t involved. Maybe the doctor or nurse feels torn for this woman so desperate for children. So he takes viable eggs from patient A and gives them to patient B.” “How does he account for the missing eggs?”

“He tells patient A he harvested fewer eggs than he actually did. He only does it with patients who have yielded a lot of eggs. Most of them will be fertilized and frozen anyway.”

Lisa thought for a moment—she wanted to be fair-then shook her head. “Maybe before the law was passed. It’s too risky now.”

“There are ways,” Gina insisted.

“Maybe. But it didn’t happen here.”

“Where’s Dr. Gordon? Rumor has it your nance’s flown. Doesn’t that make you wonder about him? Doesn’t that make you think the allegations could be true?”

Lisa blinked, unprepared for the attack. “Did you read about our relationship in the clinic brochure, too?” She felt betrayed by the question, foolish for having let down her guard, for thinking the reporter hadn’t done her homework and learned that she and Matthew were engaged. “I warned you there’d be some tough questions. I had to ask.”

“If you knew Matthew, you’d know that the clinic is his passion, his life,” she said urgently, realizing as she spoke that she was probably wasting her time trying to convince this woman with anything but facts. “I’ve filed a missing-persons report with the police. I know he met with foul play.”