Sunday, February 27, 2005

Books on donor egg

I have found relatively few books that deal exclusively with egg donation. In my list, I'm also including books of a more general nature if they have significant content devoted to egg donation or to the related treatment of donor insemination.

Please post if you know of another book that belongs on this list, or if you have comments on these books.

Mommy, Was Your Tummy Big?

Looks like a darling children's book! Can't wait to get it.

Having Your Baby Through Egg Donation

According to the publisher, the book "answers questions about age and pregnancy and parenting, about talking to children about their donor conception, about ethical and religious questions, about honesty vs. secrecy, about communicating with a parenting partner, and more in a compassionate, fully informed manner. Vignettes describing the decision-making and experience of others who have traveled this road to parenthood expand and exemplify research and philosophical resources.... It addresses such questions as: 'Should we choose adoption or egg donation?' and 'Should I ask my sister to donate and if so, how do I raise the subject with her?' and 'How do I evaluate a recruited-donor program?' I think it sounds like a winner.

Rewinding Your Biological Clock: Motherhood Late in Life : Options, Issues, and Emotions

Although I haven't read this book, from what is stated on Amazon it appears to be much more specific than what is indicated in the title. It includes technical information about assisted reproductive technologies (ART) as used in donor egg, interspersed with the fictional account of "Sarah," a 48-year-old woman who wants to have a child. Within this fictional account, some of the emotional and social issues surrounding DE are explored.

The book provides a broad overview of how menopausal or perimenopausal women can give birth, and devotes a final chapter to ethical issues. Reviews on Amazon are generally good, although one reviewer commented on the lack of coverage about the difficulty of Lupron downregulation therapy. I think I'll get this one. Thanks to Wessel for pointing me to this title!

Building Your Family Through Egg Donation: What You Will Want to Know About the Emotional Aspects : Including Disclosure vs. Secrecy and Guidelines for Telling Your Children

I highly recommend this booklet and its supplement, if you can get them. The booklet is no longer available through Amazon. I was lucky enough to obtain a copy directly from Dr. Friedeman, who met with me and my husband to evaluate our readiness to become donor egg parents. The booklet was first published in 1996, and Dr. Friedeman has also written a second pamphlet titled "Up-date on: 'Building Your Family Through Egg Donation.'" In that pamphlet is noted: "JOLANCE press books available through Baker and Taylor Books, selected bookstores or

When her book was first written, Dr. Friedman had worked with approximately 150 prospective egg donor families, allowing her a unique insight into the concerns we have in common. Her book is sensitively written and adorably illustrated by her daughters. The first chapter is on egg donor recipients, with topics such as "What general questions do most prospective ovum donor families ask?" and "What are they most concerned about?" A second chapter covers "Psychological screening and assessment of egg donors," with topics "Directed (or related) donors" and "Anonymous donors." Other chapters cover stress, cryopreservation of embryos, and DE parents' concerns about bonding with their babies. A favorite part of the book for me was the chapter on bonding, where Dr. Friedeman concludes, "In my experience, the bonding of egg donor parents to their child is as heartfelt as it would be in any well-planned, fully biogenetic pregnancy."

A significant chapter covers disclosure, privacy, and secrecy issues, followed by a unique section titled "The gift." This section contains Dr. Friedeman's ideas on how parents favoring disclosure can share their egg donation origins with their children at different ages. This section was written in response to multiple requests from families who wanted tangible guidelines.

One of the strengths of Dr. Friedeman's work is her fair treatment of both sides of the "tell" and "don't tell" debate. She presents the main reasons stated to her by parents who are in favor of disclosure (the rights of the child to know his or her origins and the dangers of family secrets) as well as those who favor non-disclosure (concern for psychological harm to the child and the privacy rights of parents).

However, "don't tell" parents should know that Dr. Friedeman's update summarizes recent publications by RESOLVE, ASRM and others that are more in favor of disclosure. She relates that in 14 years as a consultant to fertility programs, she has met with thousands of couples and the number of couples planning to disclose is increasing compared with 10 years ago, to about 80% today. She notes, however, that many couples may be stating they will disclose because they believe it's the "right" answer to give in their evaluations, when in fact they may be planning secrecy. Dr. Friedeman acknowledges that to date, few children from egg donation have been interviewed to assess their feelings about their origins, and that much more research is needed in this area. I highly recommend these booklets. They are the next best thing to sitting down and talking directly to DE parents.

Experiences of Donor Conception: Parents, Offspring, and Donors Through the Years

Lorbach is mother to three children conceived using donor sperm, and works with the Donor Conception Support group of Australia. Her writing style is informal, interspersing her own commentary and summaries with quotes from parents who have used donor insemination, donor egg, or donor embryo. Her book draws on the experiences of 94 parents from Australia, New Zealand, Canada, the United States, and the United Kingdom to tell the story of donor conception. Chapters include: Male Infertility; Women's Infertility; Making the Decision to Use Donor Conception; Choosing a Donor; Donors; Telling Others; Treatment, Pregnancy, and Birth; To Tell or Not to Tell; Telling Our Children; After the Telling; Discussion with Donor Offspring; and Thoughts and Experiences of Donor Offspring.

When I was making the decision to use donor egg, this book was invaluable. In one way or another, it covered every issue that plagued me. Granted, it draws mainly on the experiences of couples using donor insemination. But because many of the social and psychological issues are identical between DI and DE, the book was right on target in many areas. In addition, it gave me what I had found nowhere else: The experiences of the children.

By definition, of course, Lorbach recounts the stories of children who know their biological origins, and that leads to my main criticism of the book: It is far from even-handed in its treatment of the "tell / don't tell" debate. The chapter "To Tell or Not to Tell" is heavily slanted toward the "tell" camp and awards only two paragraphs to parents who believe it is best for children not to know their method of conception. The book would have been much improved if the author had tried to locate parents who made this choice. She writes, "I have never spoken to a parent who was 100 percent sure about keeping the truth of donor conception from their child."

This is likely true, since parents who have decided not to disclose and are comfortable with and committed to their choice, are less likely to join an organization such as the Donor Conception Support group. Still, if you can get past Lorbach's bias in this area, the book excels in recounting the personal experiences of those who've used donor conception. My husband and I read the book separately and then discussed it. Our talks on this book allowed us to resolve most of the concerns we had about using donor egg.

Confessions of a Serial Egg Donor

I haven't read this one, but I probably will. Besides the roadkill fascination of a confessional and the blog-like insouciance of chapter titles such as "Laying Eggs," this book offers a serious point for consideration to prospective DE mothers: How much responsibility do we have toward these young women who offer us their eggs? The book rightly points out that the provision of eggs to we desperate masses has become a highly profitable industry -- an unregulated one, rife with the potential for abuse of both egg donors and egg recipients by unscrupulous clinics, agencies, and sinister "brokers" such as Derek's Ruth.

I nearly fainted with horror when I read in product reviews that as an impoverished college student, Julia Derek somehow managed to get a doctor to take eggs from her twelve times, to the point where her body started shutting down. As a future donor egg recipient, I'd like to believe -- and my clinic assures me -- that my donor is mainly motivated by the desire to help women like me, and that the money she'll receive is welcome but is no more than a fair compensation for her time, discomfort, and risk. Based on my clinic's policy of allowing a donor to participate no more than five times, and the fact that the fee my donor will receive is modest compared to others I've read about, I am confident that I am in no way taking advantage of this generous woman. Yet in reaching this conclusion, I'm completely at the mercy of my clinic and of the donor herself for the information they provide.

Derek's story does remind me of the extreme youth and economic vulnerability of some of these donors. At the ripe old age of 40, I find myself saying of any 21-year-old, regardless of her legal status or her maturity: She's just a baby. And she's someone's baby girl. We owe it to ourselves as future mothers to do whatever is in our power to ensure that our clinic's or agency's policies are sound and are being followed; and that our donor is someone who, while she might welcome the fee, is not wholly motivated by greed or--somehow worse--by need in making her gift to us.

Choosing Assisted Reproduction: Social, Emotional & Ethical Considerations

According to editorial reviews, this book covers the "medical, legal, ethical, and psychological implications of assisted reproductive technology (ART)." The first part of the book is devoted to treatments with one's own eggs, while the second part concerns third-party parenting options such as sperm donation, ovum donation, surrogacy, gestational care, and embryo donation. Apparently, the authors "provide guidelines and suggestions for openness with children born as a result of ART, strongly urging truth concerning genetic origins." Chapter Six is devoted exclusively to Ovum Donation, but based on the list of topics, it seems to cover the same ground as Glazer's new book, cited first in this article. I'll probably get this one at some point.

New Ways of Making Babies: The Case of Egg Donation (Medical Ethics)

I'm not planning to buy this one due to its high price tag of $56.95. According to the product description, it "discusses ethical, legal, and policy issues surrounding egg donation and new reproductive technologies, describes procedures at four egg-donation centers in the U.S., and presents a report and recommendations on oocyte donation by the National Advisory Board on Ethics in Reproduction. It contains a series of essays by numerous experts, with titles such as "Moral Concerns about Institutionalized Gamete Donation" and "What is Wrong with Commodification?" Might be worthwhile reading if I can find it at a library.

Helping the Stork: The Choices and Challenges of Donor Insemination

As the title indicates, this book concerns donor insemination, but I'm putting it on my list because I think so many of the parental and privacy concerns would be similar, and because the book is quoted or referenced in many articles that I've read. I'm always interested in "stories from many families who share their insights and experiences," and in particular, I'd like to read Chapter 8, "Changing Families, Different Challenges."

Lethal Secrets: The Psychology of Donor Insemination
by Annette Baran and Reuban Pannor

I can't find a lot of information on this book other than one review posted on Amazon that states it "takes a long range look at donor insemination by interviewing donor offspring, donors and parents years after the fact." Apparently this book is strongly in favor of disclosure to donor offspring.

The following books may be helpful for parents who have decided to tell their children about their donor egg origins:

Flight of the Stork: What Children Think (And When About Sex and Family Building)

A book for parents (not children) about where children think babies come from, illustrated with interviews with children. Bernstein identifies six stages of mental development and illustrates how children think about reproductive issues at each stage. The book apparently contains some information on adoption and assisted reproduction. This sounds like good reading for parents who've decided to disclose their child's origins to the child and need help figuring out how to do that in a way that makes sense to a young child.

Sometimes It Takes Three to Make a Baby
by Kate Bourne

This book sounds like just what I'll be looking for in a few years to share with my child: "An illustrated guide for young childen, explaining in simple language the process of egg donation." However, it looks like it will be tough to find this book. Sources online indicate it can be purchased from Melbourne IVF.

Let Me Explain: A Story About Donor Insemination

A book for children in which a little girl explains how she was conceived through artificial insemination and that although she has genes from her mother and a donor, her dad is her father. Reviews posted on Amazon are not 100% positive, but since books of this kind are few I decided to list it.

How Babies and Families Are Made: There Is More Than One Way!

This book has good reviews at Amazon and covers various ways that families are made (artificial insemination, IVF, adoption, stepchildren, and more). It does not appear that egg donation is mentioned specifically.

Mommy Did I Grow in Your Tummy?: Where Some Babies Come from

This book is no longer available through Amazon and the only used copy lists for $145. A book list at the Donor Conception Support Group site describes it as: "simply and sensitively written to help parents explain to young children about the different ways babies may be conceived, including IVF, egg and sperm donation, and surrogacy. It is well illustrated, and also describes adoption in an easy to understand way."

Friday, February 25, 2005

Why do I want a baby, anyway?

Do I have to answer that? Jeez. Well. I just do.

That was my first answer, when I began to ponder this question. And that may be answer enough for a lot of women who decide it's time to have a child, and who do so with little difficulty.

But I think infertile women owe it to themselves to dig a little deeper. Back when donor egg was something I could only think about sideways, for about five seconds, the answers to this deceptively simple question could have helped me decide: How far should I go in trying for a baby with my own eggs? What would life be like if I -- go on, say it -- considered other options?

I first thought and wrote about this question months ago, in response to another woman's post on a support board I frequent. You can read that post and the rest of that excellent discussion if you like, though I've made free with updates here. With nothing else to do but sweat under the influence of Lupron, I thought it might be useful to revisit my list of reasons.

We get so caught up in the process of infertility treatment that we rarely stop to consider why we're doing it. Why are we fighting so hard to become mothers? What need speaks so loud inside us that we can't accept this limitation of our bodies without a fight? We must ask ourselves, as Dr. Phil would put it, "What's the payoff?"

And there is a payoff. Some kind of emotional cash we put in our pockets when we finally achieve our baby dream. We don't like to admit this. We are Americans and we belong to the Cult of Mom. Whether we worship or revile the flesh-and-blood woman who is our mother, we share a common idea about what makes a Good Mother: She puts the kids first. It's all about them.

And when we become mothers, we tell ourselves, we will be Good Mothers. No question. We infertiles, in our deadlocked bargaining sessions with God, think things like this: "If you will only give me a baby, God, I will be the best mother ever. I will give up my daily mocha latte or my smokes or whatever my jones is, and with that money I will buy Hooked on Phonics and Baby Mozart. I swear."

So it goes. Our ideals of motherhood mean we have a hard time admitting that mothers get something out of the deal. But c'mon. If we truly got bupkiss in return for being parents, we wouldn't do it. They'd have to pass laws to make us do it. To quote Carol Burnett: "Giving birth is like taking your lower lip and forcing it over your head." And, kids are hard work. They're expensive, even if you're fertile. They can drive you absolutely crazy, and they're a lifetime hitch. No parole, no retirement, no time off for good behavior.

Now, do I think parents get more than they give? No. Not by a long shot. But for me, when I first allowed myself to think, "Maybe I could do donor egg...." it was really important to define why I wanted a baby in the first place. Knowing that, I could figure out whether being a donor egg mother would meet my needs. Yes, I write that proudly: My needs. I've got 'em, and you do too.

It was hard to tease honest answers out of my brain. I found to my faint embarrassment that quite a few of my motivations are less than noble. But here is . . . cue the music . . .

Why I Want to Have a Baby

1. I just want one. Trying to not want a baby would be like trying to be left-handed. You're supposed to have a baby. It's instinctive. An animal thing.

This one might have a grain of truth buried in its neurosis. But I also know, way down deep, that there's no use fighting it. There aren't enough therapists in the world to make me budge on this issue.

2. I want to give and receive love in the special way that is unique to mother and child.

Whew. The Good Mother speaks. Hope she's around when I give birth.

3. I want to enrich our family with the presence of a child, and with all the experiences that come with raising a child. I feel this need every time I look into the small, smiling face of one of my nephews or my niece.

Go, Good Mother! You rock.

4. I want to have a baby so that I will feel I made a difference in this world after I'm gone.

This, despite the fact that after I'm gone -- as in, dead -- I'm unlikely to care one way or the other. But these reasons don't have to make sense.

5. I want to have a baby because I know that if I don't, I will always feel regret and sorrow, as if I missed out on something essential.

I am very good at kicking myself. So, best to go ahead and have a baby, if I want to avoid a black-and-blue ass for the rest of my life.

6. I want to give my husband a baby so I won't be "less of a wife" than his ex, with whom he has a son.

Sick little issue. But hey, it's honest.

7. I want to have a baby so I won't be "lacking" in comparison to most of my friends and my brothers.

Did I mention sick little issues?

8. I want to have a baby so I can create the family I never had when I was little (I come from a family of divorce).

Now, I know from being a stepmom that when I'm running late, and the kid's poking along not brushing his teeth in the morning, I open my mouth and start channeling my mother. So wherever you go, there you are. Even if one of my genetic babies had lived, I doubt I could have created the nauseating TV sitcom family of my dreams. And that's probably for the best.

9. I want to have a baby so I can stop feeling like a "failure" as a woman, in the biological sense.

See, and we all thought it was breast size that determine's a woman's entire self-worth. Turns out it's the condition of her ovaries and uterus. Go figure.

10. I want a genetic child so that my children won't experience "issues" when they're older about their origins. So that they'll "truly belong" to my family.

Ouch. That last one hurts. It is the only need -- besides the ones that are petty and must be dealt with in counseling lest I become the dreaded Bad Mother -- that cannot be met by becoming a donor egg mother.

It will be my task to ensure that my children know they are loved beyond all reason. That they belong in our family because we want them here. That I loved them enough, even before they were born, to admit that my eggs were doing harm to my babies, and to ask for help from another woman to be a mother.

So that's my list. I think, measuring my choice to be a donor egg mother against my reasons for wanting a child, that I've made the right decision. For me, that is.

If anyone's out there reading this: What would your list look like?

Thursday, February 24, 2005

Lies and damned lies

Yeah, I admit it. In my restless and all-consuming quest for pregnancy, I've become a Google slut, constantly on the stroll for links that will do me. Tonight I found me a stud: Assisted Reproductive Technology Success Rates > 2002 National Report > Section 4: ART cycles using donor eggs.

Some of the information therein amounts to stating the obvious: "Are older women undergoing ART more likely to use donor eggs or embryos?" Why yes, genius -- because we're old, and our eggs are poached. By the way, thanks for the reminder about that old thing. Love you too.

Of more interest to me was this byte: "Thus, the live birth per transfer rate for cycles using embryos from donor eggs varies only slightly across all age groups. The average birth per transfer rate is 50%."

Fifty percent? As in, heads-you-win-tails-I-lose? As in, I hope my uterus gets half full, but it might stay half empty, even after I give you $15K that I can't really afford?

Suddenly, reality bites.

See, here's the thing. Many of us who choose donor egg think of it as the safe harbor for our sinking infertility ships. When we get the Dread DE Speech from our reproductive endocrinologists, they hold it up like the Holy Grail: "With your own eggs, your chances of becoming pregnant are about three percent. And if you do get pregnant, the chance of miscarriage in your age group is fifty percent. But if you use donor eggs, your chance of pregnancy is...fifty percent! And your risk of miscarriage goes down to that of your young, nubile, robustly healthy, did I say young? donor! And you can drive it off the lot today!"

Okay, I added those parts at the end. But you get the idea. When they're throwing all these stats at you, "fifty percent" sounds so much better than "three percent." And they push the idea so hard and are so upbeat about it, versus the wrinkled brows and long faces they pull when you venture that you might want to try to conceive a child with your own crappy 39-year-old eggs.... You start to get the idea that if you can only bring yourself to accept it, donor egg is the Way and the Life.

But. Fifty percent. That's a flunking grade. That's an effing coin toss, and I am not known for my luck. Suddenly I am so freaking depressed.

And it gets worse: "For all ages, singleton live birth rates (average 29%) were lower than the total live birth rates (average 50%). Singleton live births are an important measure of success because they have a much lower risk than multiple-infant births for adverse infant health outcomes, including prematurity, low birth weight, disability, and death."

Waitaminit. What's this 29%? I am a very dim bulb when it comes to mathematics of any kind, and I hope someone, someday reads this blog and enlightens me. But it seems like they're cooking the books to get their holy fifty percent number. If twins count as two live births for one ART procedure, what's the real success rate per procedure? The report goes on to note, "In 2002, 4,195 pregnancies from ART cycles that used fresh embryos from donor eggs resulted in live births...slightly more than 42% of these live births produced more than one infant (about 40% twins and about 3% triplets or more)."

I am so screwed. But it's too late to choke on the digits now. I'm facing down Dirty Harry's .44 Magnum: "You've got to ask yourself a question: 'Do I feel lucky'? Well, do ya, punk?"

No, I don't, Mr. Eastwood. In fact, my uterus is notoriously unlucky. But then there's this one, by Benjamin Disraeli (a British statesman) and quoted by Mark Twain in his autobiography: "There are three kinds of lies: lies, damned lies, and statistics."

Wednesday, February 23, 2005

ICSI, you see

I found out today we'll be ordering off the a la carte menu from the lab. My husband's semen analysis came back, and apparently all is not well with his swimmers. The count's good, the motility's good...but the morphology (that is, the shape of the sperm) is not so good.

Our doctor has said we'll need to use intracytoplasmic sperm injection (ICSI) to fertilize our donor's eggs.

Big sigh. Well, I was running out of things to worry about, anyway, in between the sweats and headaches caused by my favorite drug, Lupron.

I talked to the egg donation coordinator, and she says this is not a bad thing. Many programs routinely use ICSI for all donor egg procedures because it maximizes the success of a very expensive treatment option....

My husband's more cheerful about it than I am. I told him the results and he said, "See, I'm getting old too." Nice, honey. Very nice. But he meant well.

I'm not sure how I feel about this. We used ICSI in one of our pregnancies -- for our little boy, lost at 9 weeks. I certainly can't blame ICSI for the miscarriage; that was most likely due to my defective oocyte, given that I produced a grand total of one egg during the whole IVF cycle. Surely the problem was with my egg, and not my husband's sperm. Surely....

Oh well. Nothing to do but keep going. I hope someday that I'll have a baby in my arms and all of these dark hours will be like watching daytime TV with a sinus infection--nothing but a bad memory.

Tuesday, February 22, 2005

Grieving the genetic link

I just watched George Cukor's 1944 gothic masterpiece Gaslight, starring the luminous Ingrid Bergman. She won that year's Best Actress Oscar for her taut, unnerving performance as a Victorian woman being driven slowly mad by...well, that would be telling.

A couple of months ago, we watched SciFi Channel's Earthsea, starring Bergman's daughter Isabella Rossellini. Regrettably -- because Ursula K. Le Guin's novel A Wizard of Earthsea and its sequels are so outstanding -- Rossellini's performance was the only memorable one in the miniseries. Perhaps that's why I thought of her as I watched her mother on screen. Film is a time-flummoxing media. Before my eyes was a mother, younger by years than the daughter I remembered from another film. I was struck by the echoes of the one in the other. Their voices, their eyes, that distinctive shape to the mouth....

It hit me hard, a hammer blow: I will never see in my donor egg child those echoes of myself. The genetic link is lost.

Grief, the experts tell us, comes from loss. Any sort of loss, though death is the most commonly discussed type. When I think of the grief I feel at not being able to have a genetic child, I also feel guilt. As if I should be so happy and grateful to have a child by any means, that I have no right to these feelings. As if, by feeling this grief, I label my donor egg baby as "not good enough." And so I thrust the grief away from me. I try not to own it.

Yet it is still here, like a piece of furniture I keep tripping over in this house of infertility. And, all experts in the field agree: A woman must "work through" her grief at the lost genetic link before she is ready to be a donor egg mother.

Madeline Feingold, a clinical psychologist with a specialty in reproductive medicine, offers this: "...couples must grieve so that the loss of their genetic child does not cast a shadow that negatively interferes with parenting and loving the child that will be their own" (Disclosing Origins: Children Born through Third Party Reproduction).

Oh, my God. I'm already a bad mother. One look at Ingrid Bergman and all my grief work is unraveled. I am crushed. Amputated. Something vital is gone, and can never be regained. But what is it? I can get neither my hands nor my head around it. I have to ask myself: What have I lost? Who died?

Many proponents of donor egg insist there is no loss, or none that matters. I will have the experience of pregnancy, that some call the "gestational link." I will give birth. I will breastfeed at 2 a.m. and hover anxiously over the crib while my baby sleeps, making sure that little chest rises and falls. I will churn through rolls and rolls of film, create silly Web sites devoted to my offspring, and someday join the homework and soccer-practice grind. I will be the only woman my little one knows as "Mom." I will love my child like a lioness, fiercely and without reserve. If I consider only the act and experience of motherhood, then I will have lost nothing by being a donor egg mother. Thank God.

Yet, for me, there is a loss. I have lost the ability to pass on my genes, and to mingle them equally with my husband's in the creation of our child. My body has failed to do its full duty in this process of conception. Because of that, what should be emotionally simple, even joyful, becomes complex and fraught with doubts and fears. I would not be human if I didn't wonder, "Will I bond with this child as I should? Will my child resent me for my choice?" And a whole host of other worries that I can come up with in the wee hours of the night. These are not the concerns of a mother who conceives with her own eggs, and the loss of that simplicity is grievous.

Recently, I found the article Infertility and Aftershocks, by Patricia Irwin Johnston. In it, she writes beautifully and sensitively of the impact of unresolved grief for the lost genetic link on the lives of adoptive parents and children. I hope Ms. Johnston would forgive me for quoting from her article and substituting "egg donation" for "adoption," because I believe the issues are the same:

"It's like this. Egg donation makes us parents, but it doesn't make us fertile. Much as we might wish differently, egg donation, despite giving us parenthood, cannot change the facts of those several other losses associated with infertility -- the loss of control over many intimate and practical aspects of our lives; the loss of genetic connection and immortality; the loss of the opportunity to create a new person who is the genetic and symbolic blend of love we share with our life's partner. . . . Egg donation can't give us these things that infertility took from us."

When I first realized what diminished ovarian reserve meant, there was black terror in knowing that when I die, I am extinct on this earth. Genetically, I am a dead branch. I will not continue. That reality scared me, deep in the gut. I am far from superb as a genetic specimen, and in my rational moments I know that I will leave my legacy in other, more important ways. But the loss is still felt.

It helped me to realize that it's a two-way street: We grieve that we will not pass on the traits we like about ourselves or our birth families, but we may feel a (guilty) sort of relief that we can avoid bequests such as alcoholism, depression, or--believe me, I've pondered this one--a genetic predisposition for early menopause. And "traits" are not all passed on genetically. Values, habits, mannerisms . . . all these come with family, and will be available for good or ill to my child.

Another element of the genetic loss is familial. I have a nephew who is the spitting image of his grandfather. That will never be, for my baby -- unless he looks like my husband's dad. My family is proudly Irish and has a 200-year history in one Southern city. It saddens me to think of taking my child there, or to Ireland itself, and having those places mean nothing to him. I ache at the thought that my child, no matter how much loved and welcomed by me and all my family, will be different than her cousins. I don't want that difference for her. I want her to merge into our family like a raindrop into a river and never worry or wonder about where she "comes from." That is simply not to be for my child. I feel as if I should take her in my arms right now and say, "I'm sorry. I'm so sorry I could not give that to you."

It helps to realize that grieving a lost genetic link is not unique to donor egg mothers. Adoptive parents and children have struggled and made their peace with it for years. I have a friend whose husband was adopted, and he has none of the issues I fear will afflict my child. He looks on his place in his family as "adopted into the clan" in the Scottish sense: "...the chief of a clan would 'ingather' any stranger, of whatever family, who possessed suitable skills, maintained his allegiance and, if required, adopted the clan surname." Now, that's the right idea.

A last and somewhat ignoble loss is this one: It just wasn't supposed to happen this way. If in fact Change = Loss = Grief, then I have sustained a heavy loss: The idea of my life as it was supposed to be; as I expected it, dreamed of it, worked toward it. The hard part was supposed to be finding someone to be a father to my children; I never imagined that I would have to go to such unusual measures to have them in the first place. There's a not-very-grown-up person inside me who wants to be just like everybody else, with a mate and a cottage in the suburbs and 2.5 adorable children who may someday say to me after a tussle over curfew, "I hate you!" but who will never say, "You can't tell me what to do. You're not my mother." The woman who strove for that life will never achieve her goal, and I feel badly for her, even as I have to tell her, "Oh, grow up."

It occurs to me to measure my progress against the famed Five Stages of Grief. Am I still in denial, refusing to acknowlege my loss? No, I don't think so. How about anger; am I still asking "Why me!" or wailing "This isn't fair!" I must plead guilty on that one. I will probably be angry about my reproductive fate until love for my donor egg baby makes that feeling meaningless. Am I still striking bargains with God, promising to cure world hunger if he will only give me a baby? No. My miscarriages cured me of that one. If God were going to come through with a genetic child, surely it would have been one of those. My personal favorite -- depression, suffered while we mourn not just the loss but our dreams, hopes and plans -- still dogs me every day. Without it, I don't think I'd be writing this.

And so we come to acceptance, the state of finding comfort and healing from grief, and the ability to reframe the situation to see its positive aspects. Here I would have to say, "I'm getting there." The truth is, I will cycle through these stages of grief many times as my donor egg journey continues.

The one thing I cling to, that I read over and over again on one support board that I visit, is this: Once you have your baby, all the doubts and fears go away. Amen, wise sisters.

Monday, February 07, 2005

Whose baby is it, anyway?

Not much going on today with my own donor egg cycle. I started injections of 10 units of Lupron yesterday and this I can tell you: Lupron = instant menopause. I'm sweating like a pig and my face looks like I've had three glasses of wine before breakfast, and I nearly cried at a red light this morning on the way to work.

Over the weekend I happened on a couple of news stories that made me think about an important question for donor egg mothers, and for egg donors: Whose baby is it, anyway?

In a recent California case, the court has said that a lesbian egg donor who donated the eggs used to impregnate her partner has no parental rights to the resulting twin girls, whom she helped to raise for five years until the couple split up. The case is to be appealed to the California Supreme Court. (For more on this case, see this article and this one.)

The ruling was made in part because the woman signed a standard egg donor agreement at the couple's fertility clinic. Although both state laws and the text of clinic donor agreements vary, all stipulate that the egg donor relinquishes parental rights to any children born of her donation. Under the Uniform Parentage Act, maternity and parental rights can be established by genetic testing, completed adoption, or by giving birth to the child. Approximately 19 states have adopted a version of the Uniform Parentage Act. In one infamous surrogacy case, Buzzanca v. Buzzanca, the court initially ruled that a child born of an embryo donation via surrogacy had no parents. In a later ruling, the court determined that "parental relationships may be established when intended parents initiate and consent to medical procedures, even when there is no genetic relationship between them and the child." The court quoted a legal commentator on the subject, saying that the intended parents are the "first cause, prime movers, of the procreative relationship."

In a disturbing opposite view, however, a Pennsylvania court ruled that a sperm donor must pay support or twin boys born of his donation. This case was a "he said, she said" situation in which the man alleged there was a verbal contract stipulating he would not be obligated to children born of his donation, while the twins' mother now says there was no such agreement. She filed for child support five years after the twins were born in August 1994.

Once I chewed all that up and digested it, I felt a lot better as a future donor egg mother. I am indeed a "first cause"; a "primary mover" -- I will be my child's mother not only by giving birth, but because I want to be. Sadly, not every child's mother can say that, no matter the method of conception.

I do feel very sad for the lesbian mother who has been torn away from her children, but she was not the "usual" egg donor, who has no desire to have a child that particular month and to whom an egg is just an egg. And I feel sympathetic toward the man forced to pay child support for children that he did not plan to raise as his own.

The takeaway for all of us? Read the fine print. In neither of these cases was there a legal contract that correctly laid out the wishes of those involved. I think tonight's bedside reading might include the recipient contract I signed, and (if I can get it) a blank copy of the donor agreement that Our Donor signed. Because the truth this point, I'll sign anything to be a mother. But I'd still better know what it says.

Saturday, February 05, 2005

I'm not even there

This morning my husband went to our fertility clinic for a pre-cycle semen analysis, while I stayed home to wait for my Fed Ex package of injectible medications.

I'm a little depressed. I've gotta say, this is worse than sleeping through it. This time, I'm not even there.

A few thoughts occur to me. One is, if there's any compensation to be had for all those years -- before I grew out of it -- of being embarassed to buy feminine protection products from male store clerks, this has to be it. Most of the technicians at our clinic are female.

In fact, riddle me this, Batman: In this large and busy clinic, most of the employees are female, except for the almighty doctors. I can't even think when I've seen a man in there other than the doctors, and the slightly shamefaced husbands trailing after their wives, avoiding the eyes of all others. Go figure.

So, I'm imagining this: My husband walks up to this strange woman, says, "Where do I go to...?" and gets his little cup and magazine or whatever. He must feel.... Hold up. What am I saying. He's not me, he's a man. He's probably enjoying the whole thing. *sigh*

One of the subtle humiliations of infertility treatment is, your sex life (what's left of it) and your privates are everybody's business. People call you in your cube at work to ask about your last period, or to scold you for having unprotected sex during a cycle. Now that's hilarious, that is. You're infertile and someone's on you about unprotected sex like it's prom night? Not to mention how often you have to climb into those stirrups. I wish they gave frequent flyer miles for those things.

You can't help but distance yourself from this process. You have to set aside modesty and pretend that no, it's not you half naked and exposed in this room with a doctor, a medical student, and a nurse who stands against the wall with her hands behind her back, watching your crotch intently to make sure nobody misbehaves.

Yep. In so many ways, I'm not even there.

Friday, February 04, 2005

Just say "yes, please" to fertility drugs

Drugs for me? $350. Drugs for her? $1,300. Having a baby?


Today I gave my Visa card number, along with enough information to steal my identity (yeah, right, like anyone would want to be me) to a nice woman at a pharmacy in Pittsburgh. She promised to send a happy meal of infertility drugs for me, with a supersize for Our Donor and a side of syringes for each of us. Our Donor is the stranger in my city who, God willing, will provide the oocyte -- an egg, a female gamete -- that finally allows me a healthy pregnancy.

God, I can't believe I'm doing this.

Today is the first day of my egg donation cycle, but only the newest day of a long infertility journey. In August 2003, when I was 38 and had been married for six months, I was diagnosed with diminshed ovarian reserve. In other words, the doctors said, my own eggs were hard boiled. My uterus was fine and I could easily carry a child, but my ovaries had shriveled up like a pair of raisins. My best options for motherhood were adoption, or egg donation with in vitro fertilization (IVF). I was told that I had a 3% chance of delivering a healthy infant with my own eggs. I was in shock. I was in denial. And if you'd asked me then whether I knew the meaning of "egg donation" or "IVF," I'd have said, " about we Google that?"

Fast forward. I have acquired an infertile woman's vocabulary, bristling with acronyms like ZIFT and GIFT and ICSI. I can chart my basal body temperature with precision equal to an atomic clock...a broken one. And I've spent oh, let's say $10,000 of my own and my insurance carrier's money. I've undergone two IUIs and one IVF with my own eggs. Miraculously, with only one healthy egg each cycle, I conceived twice. And I lost both to miscarriage after seeing slower-than-normal heartbeats, at 8 weeks and 9 weeks.

To me those were my babies. My children. They had names, and possessions, and my husband and I had even had a few fights about them. With the last baby, we were able to do a chromosomal analysis. We learned that we had a son, and that he had an abnormality that meant he couldn't live. I knew it was because of my defective egg. I was devastated. I felt like a child abuser. As if I'd fed him spoiled food, or left him naked in the cold. I will never stop grieving.

So now, far from being an obscure search engine result, egg donation is all that I think about. It is sleeptime, mealtime, downtime, car time, any time. It may be the most important, life-defining thing I ever do.

So I've decided to write these days as they happen. I need to understand how I came to this day, when I'm willing -- more than willing; I'm perishing -- to carry a child made from my husband's sperm and another woman's egg, and love it as my own.