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  After seven years of tears, a childless couple ponders next step By Gary Rotstein, Post-Gazette Staff Writer
Stephanie Brant lies on the surgical table with one arm draped disconsolately over her forehead. Her husband Brian, quietly nursing a cold and fever, sits a few feet away with arms folded over the winter jacket in his lap. The young couple plagued by infertility have just received their latest disappointment, on a cold January morning that will soon see them shedding tears -- her in a restaurant, him at his workplace. Dr. Michael Pelekanos, preparing to inject Brian's sperm into Stephanie's uterus in a procedure called intrauterine insemination, had detected a few minutes earlier how lifeless most of the sperm appeared when magnified 400 times. "What's going on? . . . Um, this isn't good," the tanned, floppy-haired obstetrician-gynecologist had commented at a microscope out of the Brants' earshot. In five previous IUI attempts, Brian's sperm had never been deemed a factor in failure. Pelekanos gave the Brants the news in a sober tone, explaining that he'd proceed with the insemination, but that chances for pregnancy had decreased from already slim odds. It's the latest exasperating twist in a journey consuming nearly seven years of examinations, drugs and surgeries related to Stephanie's obstructive endometriosis, a leading cause of infertility in women. "It's just like everything that could go wrong with this has gone wrong," Stephanie says in a half-moan, with her lower body covered by a sheet, her blonde, curly tresses spilling over the head of the table. Brian, cross-armed, is looking at the floor in front of his shoes. A few moments later, Pelekanos inserts a pediatric catheter between his patient's legs. She grimaces. He reminds Stephanie, who has just been through two disruptive weeks of fertility drugs, blood tests and ultrasounds, that the procedure is still worth a shot because "it only takes one sperm." Using a syringe, the doctor shoots a solution containing her husband's sperm through the catheter inside her, past her cervix, about 8 centimeters into her uterine cavity, short-cutting the trek to the egg thought to be inside. Pelekanos has built up years of trust from the woman lying vulnerable on the table, who refers to him affectionately as "Dr. P." He urges her to relax despite the discomfort. She eases. "She's a trouper," the doctor observes. For Stephanie Brant, after all, the unnatural instrument inside her is the least of her pain from infertility.
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