The Wetzels immediately took to Michael Graubert, a young fertility doctor who was just setting up his practice in Miami Lakes. His Palmetto Fertility Center of South Florida was also close to her shop -- important because Lori would soon be popping in for checkups almost daily.
Wetzel was not the ideal IVF patient. Not surprisingly, since he banked after one testicle had been removed, his samples had a low sperm count -- 200,000 moving sperm. (Most men have between 10 and 30 million sperm in one sample.) In addition the sperm was frozen, and only four vials of the stuff existed. Therefore the couple elected to choose the most aggressive form of IVF to ensure the greatest chance of success.
The first step was for Lori to take hormone shots to increase her egg supply. The shots increase the number of eggs a woman produces from one a month to anywhere from two to twenty. Until recently the shots were made out of the urine of menopausal nuns in France. Menopausal women produce large amounts of a female hormone secreted in the brain, and it signals the ovary to produce eggs. The nuns would sell their urine to make money. The hormones would be isolated in the urine and injected into women having trouble getting pregnant. In the last four years, the hormones have been manufactured in labs.
The shots -- administered by her husband twice a day for 12 days -- gave Lori wicked headaches, but they did the job: She soon had 14 plump eggs in her ovaries. Graubert was pleased; that's far more than most women produce.
Graubert monitored Lori closely; she stopped by the center nearly every morning before work for blood tests and ultrasound, which track the development of the eggs. Finally she was at her peak. It was time for the eggs to be harvested.
Graubert cautioned Lori not to wear any makeup, hair spray, lotion, or perfume because the eggs are sensitive buggers. After anesthetizing her, Graubert inserted a phallic-shape ultrasound probe into her vagina. The probe is attached to a TV monitor and leads the doctor to the eggs. He then sucked out the eggs using a needlelike device attached to a machine. Fourteen microscopic eggs, immersed in a blood-tinged pale yellow liquid, were plopped into a petri dish.
While Lori was in the operating room, Bill was picking up his sperm at the Repository and bringing it to the fertility center. "All I had to do was take my sperm over in a little suitcase," Bill later cracks. "She did all the work."
Lab technician Fred Miller slowly thawed Wetzel's sperm in stages, in the same way the sperm bank froze it in stages. At the same time, Graubert handed the eggs to Miller through a window in the operating room. It was time for the Big Moment.
In standard IVF the eggs and sperm mix together on a petri dish, and nature takes its course: The sperm swims to the egg and penetrates the outer core. But in the Wetzels' case, because the sperm count was low, the couple decided to use a five-year-old procedure called ICSI (intracytoplasmic sperm injection), which cost an extra $2000. In this procedure doctors help nature along a little.
Miller sat in front of a large microscope atop a 1000-pound table to ward against potential vibrations and began his lengthy "video game." Joysticks attached to motorized robotic arms stick out of the sides of the microscope. One robotic arm has a miniature needle attached; both have suction. Miller stuck the petri dish containing the eggs and sperm under the microscope's magnifying glasses. With the left joystick, he suctioned the egg to keep it in place. Then he located the fastest-moving sperm and used the other joystick to suck up those sprinting sperm and push them over to the egg. Pushing a button on the joystick, Miller injected the sperm inside the egg wall. He repeated this process 14 times, for each of Lori's 14 eggs. It took an hour and a half.
Over the five years Miller has been using this apparatus, he has grown quite adept, says Graubert. "He's probably very good at pinball games now," the doctor laughed.
Miller then stuck the petri dish in an incubator, where it was kept at body temperature -- 37 degrees Celsius -- and humid, as in a uterus. He left the dish overnight so the sperm and eggs could get acquainted in peace. Upon arriving at work the next morning, the first thing Miller did was check the petri dish to see if the cells had divided -- the sign that fertilization had occurred.
He's been working in IVF for 18 years, practically since the beginning, but Miller still calls the process "a miracle" and revels in his godlike role as an eyewitness to the most wondrous event in the history of the world: the creation of human life.