Robin Cook – Vital Signs

Taking off his coat, Dr. Wingate slipped on a clean white lab coat, then washed his hands carefully. He could have waited for morning, but after getting the eight superb mature eggs from Marissa that day, he was eager to check on their progress.

That afternoon, after having dealt with the unfortunate Rebecca

Ziegler affair as best he could, he’d returned to the lab to find that the nurse-technician had done a fine job preparing the sperm. By two P.M. all eight eggs had been placed in a meticulously prepared insemination medium contained in separate organ culture dishes. To each dish Dr. Wingate had carefully added roughly 150,000 capita ted mobile sperm. The eggs and the sperm had then been co-incubated in 5% CO,. with 98% humidity at 37 degrees Centigrade.

Turning on the light for his dissecting microscope, Dr. Wingate opened the incubator and removed the first dish. Placing it under the scope, he looked in.

There, in the middle of the microscopic field, was the beautiful egg, still surrounded by its corona cells. Looking more closely as he deftly handled a micro pipette Dr. Wingate experienced the thrill of creation as he observed two pro nuclei within the ooplasm of the egg. The egg had fertilized and looked entirely normal.

Repeating the procedure with the other dishes, Dr. Wingate was extremely pleased to see that all the eggs had fertilized nor many. There had been no polyspermic: fertilization, in which more than one sperm penetrates the egg.

Working deliberately, Dr. Wingate transferred the fertilized oocytes to fresh growth medium containing a higher concentration of serum. Then all the fertilized eggs went back into the incubator.

When he was finished, Dr. Wingate went to the phone. Despite the hour, he called the Buchanan residence. He reasoned it was never too late to relay good news. After the fifth ring, he wondered if he’d made a mistake. By the sixth ring, he was about to hang up when Robert answered.

“Sorry to be calling so late,” Dr. Wingate said.

“No problem,” Robert said.

“I was in my study. This is my wife’s line.”

“I have some good news for you folks,” Dr. Wingate said.

“We can use a bit of that,” Robert said.

“Hold on, IT wake Marissa.”

“Maybe you shouldn’t wake her,” Dr. Wingate said.

“You can tell her in the morning or I’ll call back then. After what she’s been through today, perhaps we should let her sleep.”

“She’ll want to hear,” Robert assured him.

“Besides, she can go right back to sleep. That’s never been one of her problems.

Hang on.”

A few moments later, Marissa’s tired voice came over the line as she picked up an extension.

“Sorry to wake you up,” Dr. Wingate said, “but your husband assured me you wouldn’t mind.”

“He said you had some good news?”

“Indeed,” Dr. Wingate said.

“All eight eggs fertilized already.

It was very quick, and I’m optimistic. Usually only eighty percent or so fertilize at best. So you got a particularly healthy crop.”

“Wonderful,” Marissa said.

“Does this suggest the transfer is more likely to be successful?”

“I’ll have to be honest,” Dr. Wingate said.

“I don’t know if there is any association. But it can’t hurt.”

“What made it different this time?” Marissa asked. In the last cycle none of the eggs had fertilized.

“I wish I knew,” Dr. Wingate confided.

“In some respects, fertilization remains a mystifying process. We don’t know all the variables.”

“When will we do the transfer?” Marissa asked.

“In forty-eight hours or so,” Dr. Wingate said.

“I’ll check the embryos tomorrow and see how they are progressing. As you know, we like to see some divisions.”

“And you’ll be transferring four embryos?”

“Exactly,” Dr. Wingate said.

“As we’ve already discussed, experience has shown that more than four has a higher risk of resulting in a multiple pregnancy without significantly raising the efficacy of the transfer. The other four embryos we’ll freeze. With this many good eggg, you can have two transfers without having to undergo another hyper stimulation

“Let’s hope this transfer is successful,” Marissa said.

“We’ll all be hoping for the best.”

“I was sorry to hear about the woman who killed herself,” Marissa said. The tragedy had been on her mind all evening. She wondered how many cycles the poor Ziegler woman had endured.

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