IVF? Adoption? These tools for becoming a parent are discussed openly. But using another woman's eggs to get pregnant? It's the new taboo.
By:
Suzanne Schlosberg My husband, Paul, and I launched Operation Procreation in perhaps the least romantic spot in the Southern Hemisphere: the windowless room of a $10-a-night hostel in Chile, decorated with faux oak paneling, brown industrial carpeting, a blinding overhead fluorescent light and, on the night table, a statue of the Virgin Mary. Paul was so creeped out by the stained, scratchy bed sheets that as I undressed, he disappeared, fully clothed, into his sleeping bag.
Married one year, we were on one of those last-hurrah vacations—what we expected to be our final chance, before retirement, for a kid-free, carefree, overseas holiday. My monthly window of opportunity landed on a weekend when every hotel room in town was booked; but at age 37, with my biological clock ticking loudly, I would not be deterred. Scratchy sheets or silk, we were going to have sex.
I managed to lure Paul out of his sleeping bag ("We can keep the lights off!" "Remember, I'm almost 38!"), and as we struggled to ignore our surroundings, we laughed nervously, like two novice skydivers about to jump out of an airplane. "Oh my god!" I said. "What if this procreation thing works?"
We never thought to ask: What if it doesn't?
What if it doesn't?
In every fertility book I've read—and I've read plenty—there's a final chapter called "Other Paths to Parenthood" or "There's More Than One Road to Motherhood" or something similar. These chapters talk about egg donation and adoption, about grieving the loss of your fertility and accepting a different path. When you're starting fertility treatment, these are the chapters you avoid. You think they're for other people—women who began trying to conceive at age 42 (Hey, what did they expect?) or who lost an ovary to cancer (Unfortunate, but at least they have options). You suspect it would be awful to be in their shoes, but you barely give the scenario a passing thought. Given all the high-tech procedures you've heard of—IVF, ICSI, PGD—you're confident that something will work for you. Maybe not on the first try, but eventually.
At least that's how my own thought process unfolded. Then one day, a year and a half after our trip to Chile, Paul and I found ourselves in our fertility doctor's office facing bewildering news: We'd never conceive using my eggs. After four cycles of intrauterine insemination and two miscarriages, we decided to try in vitro fertilization, but we crashed right out of the starting gate. All 11 of our embryos, the products of Paul's sperm and my eggs, had flunked genetic testing. There was no point in transferring any of them to my uterus, the doctor said, and there was no point in trying again. Although I was barely 39, it appeared that my eggs already had exceeded their use-by date.
"I'm sorry," the doctor said, gently. "I didn't expect this at all. But you'd be a very good candidate for donor-egg IVF."
At every stage, Paul and I had been in sync, emotionally, about what to do next, but that changed the morning the embryo transfer was canceled. My sweet redheaded husband had burst into tears, and despite my hugs and assurances that we'd figure something out, he seemed inconsolable.
Nothing's so bad that it couldn't be worse
I was deeply disappointed, to be sure, but I wasn't devastated or even shocked. After four years and 50 dead-end blind dates on Match.com, where Paul and I ultimately met, I'd developed an all-purpose coping strategy: expect disaster. If you prepared for the worst and got something better, I figured, you could only be pleasantly surprised.
I immediately thought of my Grandpa Julius' favorite saying: "Nothing's so bad that it couldn't be worse." It was true. I hadn't been attacked by flesh-eating bacteria or kidnapped by terrorists or diagnosed with cancer. Surely there were circumstances more dire than harboring expired eggs.
These days, in vitro fertilization is so common that the stigma has virtually vanished; of my six friends who underwent IVF, only one kept it quiet. But donor-egg IVF is a different story. According to the U.S. Centers for Disease Control and Prevention, a substantial 12 percent of all IVF cycles in the U.S., about 16,000 a year, involve eggs retrieved from a donor; and donor-egg IVF has the highest success rate of any fertility treatment—52 percent nationally, upward of 75 percent at the top clinics. Yet few women admit to going this route.
Plenty of celebrities—TV commentator Nancy Grace, political wife Elizabeth Edwards and actress Geena Davis, among them—have given birth in their mid- to late 40s, and you can bet that nearly all have used donor eggs because the odds of a woman 44 and older conceiving via IVF with her own eggs are 0.8 percent, according to CDC statistics. But no one has come right out and said so. Desperate Housewives star Marcia Cross, who gave birth last year to twin girls at age 44, came the closest, telling the media, "When a woman gets older, they get donor eggs, which doesn't make the baby any less beautiful or perfect. One's own eggs only last so long." But she has never indicated whether she used donor eggs herself.
Even at my own fertility clinic, when a pregnant donor-egg IVF patient "graduates" to the care of a regular obstetrician, the doctors ask, "Do you want your OB to know you used a donor?" They seem to view egg-donor IVF as a touchy subject. Remarkably—alarmingly—some women who use donor eggs don't even tell their own children.
The logical next step
After our fertility doctor broke the news, we told him we'd mull over the idea of using an egg donor and get back to him. But I was already sold. Unbeknownst to Paul, a few days earlier I had scrolled through an egg-donor website—just in case—and surprised myself by how quickly I warmed to the concept.
Before we'd started down the road of fertility treatment, I had this vague idea that egg-donor IVF must feel like a second-rate option, a distressing last resort. But as I perused the donor database, it seemed nothing of the sort. It simply felt like the logical next step—between IVF and adoption—and I was grateful that technology offered us a back-up plan. Of course, some of the donors needed some serious help in the marketing department (one English major described herself as "calm, cool and collective"), but overall they seemed like an endearing bunch. A law student/snowboarder, a nurse with a flair for graphic design, an aspiring writer who'd climbed mountains—certainly among them was a worthy substitute for me, if it came to that.
And so, when it did, I was a step ahead of my husband. Paul had never considered that we might flunk out of IVF and at first couldn't fathom using an egg donor. He couldn't quite articulate why, but when I pressed, delicately, I got to the bottom of his objections: He worried he wouldn't love our children as much if their DNA wasn't entirely ours. He thought we should consider trying straight-up IVF again, on the off chance that a healthy egg or two would surface, but I vetoed that idea, pointing out that I was not a pincushion.
The doctor had told us about one couple with our diagnosis who had nonetheless tried again four times and ended up using donor eggs anyway. Given the physical discomfort of daily shots, the emotional costs of another failure and the high price tag—about $15,000 each time—no way was I going down that road.
Besides, who could say the Schlosberg genes were better than anyone else's? Certainly we have our strong points, including longevity; even my grandma Ruth—a lifelong chain smoker who stocked her Oldsmobile with emergency fudge cookies—lived to nearly 90. But in my clan, we also trend toward bunions, psoriasis, uncontrollable hair frizz and barely enough collective mechanical aptitude to operate an electric toothbrush. If somebody's DNA had to be sacrificed, I reasoned, better mine than my husband's. At least the undesirable traits in Paul's family—voting Republican, a fondness for holiday lawn ornaments—were not genetic.
If all this sounds entirely too rational, I did eventually have my own meltdown. A few days after the appointment, I spent a morning sobbing, mostly over having to wait so long for what came so naturally to others. I even resented couples who'd succeeded with regular IVF. No lawyers, psychologists or donor agencies involved—how easy they had it!
Pressing on...
But these feelings faded after a few days. I defaulted to the approach I'd relied on during my dating days: press on, and meanwhile, do something fun. When I was single, I'd taken up road-bike racing. I'd quit competing before our trip to Chile, but now, with several months to wait before we could try with a donor, I cranked up my training. Better, I figured, to be infertile and fit than infertile and flabby.
Besides, becoming parents was still well within our control, something I had decidedly lacked during my quest for a mate. Sure, infertility sucked, but it sucked a lot less than my years of dating guys with the emotional depth of a dust mite. After all, there aren't any adoption agencies for husbands.
What I liked best about donor-egg IVF was that we'd both get to play a role in the creation of our child. Paul would provide the sperm; I'd provide the womb. Now all we needed were a few good eggs—that and my husband's blessing.
Given the depth of Paul's despair, I was surprised when after just a couple of weeks, Paul announced, "Let's do it! Let's find a donor." On our doctor's recommendation, he'd read a book about egg donation and felt we could be as happy as the families included in the book. He saw online that there were plenty of smart, athletic donors to choose from, but what really made him turn the corner, Paul said, was the procedure's high success rate. There was a great chance that we'd make a quick transition from being fertility patients to being parents.
Months later, Paul told me that from the beginning, he knew he'd come around, and he thanked me for giving him space to go through the decision-making process at his own pace. I never told him how hard it had been to keep my mouth shut.
Finding the right donor
With donor-egg IVF, you have two options: finding a donor you know or selecting an anonymous donor through an agency. Most friends assumed we'd prefer a familiar donor. Three even offered me their own eggs. (I thanked them profusely before explaining that they were, oh, about 15 years too old.) Several people asked whether I'd considered my younger sister as a donor. But the very idea of mating my sister's eggs with Paul's sperm would complicate our family dynamics in ways I didn't even want to imagine. "At least you'd know what you were getting," one friend said.
Comments like that drove me nuts. What DNA merger isn't one big roll of the dice? In some respects, though, I understood the sentiment. After all, we did find it comforting to have even partial genetic input and to know that our baby would be exposed to all the right nutrients in utero. Still, we harbored no illusions that we had more control than any other couple trying to have a baby.
And so, Paul and I began our donor-egg hunt, securing the passwords to several agency websites so we could get beyond the headlines and read the complete donor profiles.
Back when I was active on Match.com, I'd been clear about my search criteria: I wanted a smart, athletic guy who could use "I feel" in a context other than "I feel like pizza tonight." But now? What exactly were Paul and I looking for? Someone who looked like me? Someone who looked like Julia Roberts? How much weight should we give a donor's GPA or SAT score or the disconcerting revelation that her favorite food is "anything from the Olive Garden"?
This was like Match.com all over again, only it wasn't. I wasn't seeking a date or a friend—just a batch of healthy eggs. Did it really matter if the donor was funny or adventurous or "cheerful, athletic and goal-oriented"?
Somehow, I came to realize, it did. I was drawn to women I could relate to, like the bike racer/schoolteacher who was lousy at math and who wanted to use her $5,000 egg-donor fee for a cycling tour of Spain. Paul, meanwhile, drifted toward women who looked like that blonde criminologist on CSI: Miami. He was particularly enamored with a pretty, green-eyed donor who appeared to be my polar opposite—an aspiring chemist in possession of her low-voltage electrician's license. Though I was hardly aiming to clone myself—ultimately I found hair and eye color were low priorities—the idea of using her eggs didn't exactly excite me because we were so different, and I wanted to feel excited about my choice.
Like the best of the Match.com guys, some donors clearly had put effort into their essays. Others, though, were coasting on their genes, like Sage, a 5-foot-10 volleyball player with hazel eyes and a strikingly angular face. She left blank the questions about her aspirations and fondest childhood memories, revealing little besides the fact that her brother is a 6-foot-4, blond lifeguard.
"Man, who does she think she is?" Paul said.
Narrowing down the list
After three months of searching—and learning that our top choices had a long waiting list—we narrowed our list to two available donors. One was the blonde chemistry student; I had to admit she was smart, cute and well rounded, plus her family had impressive longevity. The other was the bike racer who loathed calculus. She wasn't available for three months due to her work schedule, but I was willing to wait because I liked the idea that we seemed similar—we competed in the same sport and shared a fear of indefinite integrals.
We contacted the aspiring chemist, via her agency, and learned she was available right away. But my gut pulled me toward the bike racer. I simply had a good feeling about her, and in the end, that was enough for me. Paul deferred to me.
We chose not to meet our donor. Some therapists strongly advise a get-together, on the theory that it will be reassuring to the child to know that his or her parents met and liked the donor. But we already had several pictures of our donor. We knew she had a master's degree and a National Geographic subscription, a fondness for Hugh Grant movies and "an outdoorsy and outgoing family" with no known medical problems. We knew she was willing to meet our child, if he or she so desired, at some point in the future. What more did we need? What if we met and had a personality clash? Why jeopardize the good feelings we already had about her?
Following my clinic's instructions, we consulted with a therapist, who told us most recipient couples don't meet their donors, and she felt that was a reasonable choice. Once we signed a contract with our donor—she relinquished all rights to any embryos created; we paid her $5,000 fee plus travel expenses to my clinic, 200 miles from her home—the process went smoothly. For six weeks, Paul injected me daily in the stomach and hip with drugs to suppress my ovulation and prepare my uterine lining for the embryos. Meanwhile, the donor, supervised by my doctor, took hormone injections that stimulated her ovaries to produce extra eggs.
The morning her eggs were surgically retrieved—six months after our canceled IVF, two years after our trip to Chile—they were fertilized by Paul's sperm. Five days later, we had 18 embryos. During a short procedure, the doctor inserted two of the most robust ones into my uterus. The rest were frozen.
I spent the next two days on bed rest, mostly watching reruns of The Office on TiVo. I knew the odds of success were high, but as usual, my gut said: expect disaster.
When you have an IVF transfer, the nurses implore you not to take a home pregnancy test and instead to wait for your blood test 10 days later. Some urine tests aren't sensitive enough to detect pregnancy hormones so early; why risk unnecessary disappointment?
The moment of truth
But the day before my blood test, I impulsively dug up an old pregnancy test in my bathroom and went for it. Instantly, the stick turned blue, and for the first time, I let myself feel optimistic. The next day I received the official results: not only was I pregnant, but my hormone levels were sky high, suggesting twins.
My boys arrived loud and healthy, and they're now 12 months old. Ian is the fearless one, diving off steps, pinning his brother in a headlock and mowing down whatever or whomever happens to be in his way as he crawls across the room. Toby is the softie, always showering his family with Oprah-style hugs and slobbery kisses. I adore them more than I could possibly describe.
I'm immensely grateful to our donor, and I hope that she did not endure too much discomfort and was able to use her $5,000 for that bike trip to Spain. Still, I rarely think about her, and I imagine the situation is mutual.
In a few years, Paul and I will start telling our boys about the circumstances of their conception, a conversation likely to evolve in interesting ways and span well over a decade. We'll tell it to them straight and hope that they grow up feeling as we do: that our family was lucky enough to benefit from some remarkable technology and the kindness of a bike-racing schoolteacher named Jill.
When a friend said to me recently, "I'm sure your boys will be tall, like you are!" I nodded before remembering, and reminding her, that genetically, my children aren't related to me. I had to laugh. When you're busy playing hide-and-seek and reading The Very Hungry Caterpillar and scraping peas off the floor, the last thing you think about is your babies' DNA.
Labels: Dr. John Hesla, egg donation, IVF, oregon reproductive medicine, Suzanne Schlosberg