We have now been walked through the steps of In Vitro Fertilization (IVF) four times. Once by each of the IVF clinics we met with and once by the surrogacy agency. Even more times if you count our discussions five years ago.

So I’m going to attempt to recount the process here without consulting Wikipedia.

The first step is for the carrier and the donor to sync their womanly cycles (if you want a more technically precise description of IVF, click here). The carrier goes on low dose birth control pills to suppress her own ovulation. Her eggs are not welcome here. The donor takes fertility medications that cause several of her eggs to become ready at once, instead of the usual one at a time. From what I’ve heard, a cheaper method to sync the cycles would be to have the donor and the carrier become college roommates, but I guess that’s impractical.

Next, everyone travels to the clinic for what is called a “fresh transfer”. The donor’s eggs are retrieved through the use of a hollow needle inserted into the pelvis. The natural father’s sperm is retrieved through the use of pornography.

The clinic combs through the sperm (multiple people who have described this process to me have used the word “comb” which is an interesting visual image) to find the most desirable specimens. Apparently, even healthy semen contains sperm that is deformed or lazy. The ones that are leaping around like golden retrievers are segregated from the ones that look like they’ve just smoked a bunch of weed. At this point, the doctor can either place the energetic sperm in a petri dish with the eggs and let them do what comes naturally, or he can pick up individual sperm and forcibly inject them into the eggs. The latter is more expensive and time consuming but usually results in a greater number of viable embryos. I prefer the second method because I have a suspicion that if we use the first method, my sperm may ignore the eggs and just try to fertilize each other.

Then we wait. I’m not sure if the carrier will be in town yet. It seems like she could arrive late to this particular party. The donor and the intended parents have to stick around to provide a second set of eggs and sperm if the first round fails to produce enough viable embryos. I don't think we'll be hitting the town together. That might be awkward.

We can choose to wait for three days or five days while the embryos grow. I guess if we wait five days, the doctor will know more about the embryos he chooses to implant in the carrier. Presumably if one of them starts to look like it might develop into a professional athlete or brilliant artist, that’s the one that moves to the head of the line. Yes, it is a sign of our era that we’ve started to assess a child’s potential when he or she is still smaller than the head of a pin.

Now, a choice. The doctor can implant any number of viable embryos into the carrier (technically they are “blastocysts” at this point, which just sounds cool – like the little guy is going to be piloting an X-wing through the carrier’s uterus – but I’m going to continue to call them embryos because that’s a term more people are familiar with). Most doctors limit the number of embryos they will implant to two, because they don’t want to have an Octomom situation on their hands.For infertile hetero couples, using their own eggs and sperm, doctors sometimes implant more embryos, but our embryos are more likely to develop into successful pregnancies, because they came from two fertile people.

So the decision is whether to implant one embryo or two. The downside of implanting one embryo is that it has only a 40% chance of success. The downside of implanting two embryos is that it is much more likely to result in twins. (Why is having twins a downside? There are medical reasons but I’ll just cite parental stress as the overwhelming reason why we would prefer a singleton.)

If the first IVF cycle is unsuccessful, we have to start all over. It is likely there will be embryos left over from the first cycle, so the donor and intended parents may not have to return for round two. Any left over embryos are frozen after the transfer, and our IVF clinic has a similar success rate with "fresh" and "frozen" transfers. (In fact, the reason we chose our IVF clinic is because they do not have a preference for fresh transfers, which means that if the carrier and donor are on different schedules we don't have to chose a different donor; we can create the embryos and wait for the carrier's body to be ready.) But a failed cycle is money and time wasted. The carrier needs to wait at least two months before her body will be ready to try again.

For this reason, we have decided to implant two embryos. The odds are about a 40% chance of twins and a 40% chance of a singleton, with a 20% chance of no child at all. If it has to go to a second cycle and we implant two embryos again, there is an overall 94% chance of success. If that also fails and we have to go to round three, the overall chance of success is above 99%. If that fails as well it means God doesn’t want us to be parents and we need to reassess our lives.

We are willing to have twins. Despite the added stress, we know we want to have more than one child and, given how expensive this journey is, twins would kind of be like a buy-one-get-one-free Safeway Club Card deal. Nevertheless, we strongly prefer a singleton.

My mother-in-law is praying for twins. I ask that all who read this try to counteract her by praying for us to have a singleton. But overall we would appreciate your prayers for us to have healthy children in any number.