Monday, August 31, 2020

If At First You Don't Conceive, Try, Try Again

After an MRI and consultation with four different doctors who were unable to diagnose the mysterious bump on my forearm, it vanished as quickly and inexplicably as it had appeared.

My health restored, my husband and I refocused on the baby-making efforts. Since we’d canceled our IVF cycle out of fear that I had cancer, we started trying the old-fashioned way. It wasn’t going well. Sex had devolved into a mechanical exercise, the sole purpose of which was to unite sperm and egg. It was joyless, frustrating sex, and when my period came like clockwork in June and July, I wasn’t surprised.

The vasectomy reversal had been a waste. We were reproductively stuck.

At church every week, the lights went out toward the end of Mass for a minute of silent prayer. While the adults quieted down, I could still hear all the restless little kids in the sanctuary. It made me feel sad, sitting there with my empty lap. I felt like someone was missing and I didn’t know if they were going to come back.

“We’ll get there one way or another,” my husband said. I knew that was true – if only because I’m stubborn AF – but to quote Veruca Salt: “I want it now!”

I soon discovered another baby-making alternative: donor-donor (or double-donor) embryos. Author Elizabeth Katkin turned me on to them in her book Conceivability: What I Learned Exploring the Frontiers of Fertility. In a section on the future of infertility treatment, she mentioned a California clinic that matched intended parents (IPs) with embryos created with donor sperm and donor eggs.

Before we go further, a clarification: “embryo donation” and “embryo adoption” usually refer to a scenario where IPs receive an embryo from a couple that already went through IVF and have extra frozen embryos (or “snowflake babies”) that they don’t plan to transfer. Similar to domestic or international adoption, IPs may be required to have a home study with a social worker and a criminal background check. Legal contracts are executed and contact parameters are hammered out. Some families maintain lifelong connections so that the genetic siblings may know one another.

“Donor-donor embryos” are created in a lab and matched with multiple IPs. The process is anonymous all around and attorneys are not involved. A child born from a donor-donor embryo might have a genetic sibling (or siblings) born to other IPs, but they’d have to do some digging through the Donor Sibling Registry, a gene-mapping service like 23andMe, or private Facebook groups to find and connect with them.

I explored embryo donation/adoption by setting up a profile on the National Registry For Adoption (NRFA), a site that matches formerly infertile parents who have extra embryos with IPs. It’s like for the reproductively challenged. I contacted several couples who had embryos to spare and quickly discovered the problem with embryo donation/adoption was that most people wanted to believe they were capable of giving away their snowflake babies, but when push came to shove, no IPs were “good enough” to give them away to. (For the record, I wouldn’t be able to handle donating my embryos, either, but I also wouldn’t pretend that I was capable of doing so and giving people false hope in the process.)

Most couples I contacted ignored my messages completely; the few who responded said they were already considering other IPs to donate to (and yet, their profiles remained live on the site) or that they were only willing to donate to IPs who did not already have children, like myself (understood, but still discriminatory). One Minnesotan mom and I exchanged several emails after discovering we’d both gone to the same college at the same time and had probably crossed paths but didn’t remember one another. She suggested we get together for coffee, then ghosted.

So embryo donation/adoption was nice in theory, but in reality, it was like finding a needle in a haystack.

While Katkin seemed to dismiss donor-donor embryos as an eerie, questionable practice (which seems judgmental coming from someone who went through as much as she did to have her babies), it seemed practical to me. It was less expensive and had better success rates than IVF would be with our own gametes. It didn’t require a couple’s approval or a home study.

The clinic she cited (which I’ll call West Coast IVF) offered two donor-donor embryo packages rather than cycle-by-cycle pricing. The first package was $15K and included three transfers with either one or two embryos per transfer. The second package was $21K and included three transfers with one PGS-tested embryo per transfer, as well as gender selection. Medication and travel costs were all out-of-pocket, but the clinic offered a guarantee – if you completed a SIS (Saline-Infused Sonogram, which I had already done with Dr. Gerber) at its clinic before treatment began, and you did not sustain a pregnancy past 12 weeks after three transfers, all or most of the package’s cost would be refunded.

Financially, this sounded fantastic to me. There was barely any risk. My husband agreed that it was a great deal. But emotionally? It made me uncomfortable. Two people who never intended to have a baby donated their gametes, which were made into an embryo at clinic, which I was going to carry and birth? There was no love involved in the conception; would that have some kind of cosmic repercussion? Would God be OK with this? (Then again, hello! The Virgin Mary was a surrogate, and there are a lot of other reproductive workarounds in the Bible.)

The lack of genetic connection troubled me, too. Would we bond with the baby despite different genes? Would she be resentful that we didn’t know who her donors were? What would our family members say when they found out? (We’d kept everyone in the dark about our baby-making plans except my teens.) Would she look so wildly different from us that even strangers would know we didn’t conceive her?

On the other hand, both my husband and I kind of liked that both of us were being left out of the gene pool. We agreed that it would feel weird for me to get pregnant with an embryo that he had created with his sperm and an anonymous woman’s egg, just like it would be awkward for him to see me get pregnant with another man’s sperm. This way, the baby would be neither of ours, genetically speaking, but she would be "more ours" than a donated/adopted embryo with whose bio family we had to maintain contact.

The biggest advantage of donor-donor embryos was that they were as healthy as can be. This is opposed to embryo donation/adoption, where the couple donating the embryos likely struggled with infertility, and therefore might be older and/or have health issues.

Receiving a donor-donor embryo would also be less taxing on my body than traditional IVF. There was no ovarian stimulation medication or egg retrieval needed. I would still have to use a variety of fertility drugs to prepare my body for the transfer, but the transfer process was much less invasive than a full IVF cycle with my own eggs. A donor-donor embryo would allow me to stop obsessing about my fertility and just let the clinic do the work of making the baby so that I could focus on housing her (yes, we were already determined to have a girl).

Also, because I had a history of miscarriage, I felt reassured that if I got pregnant with the first or second transfer and miscarried early on, I’d have another chance to get pregnant. Having three tries took so much pressure off my body to perform.

I started to feel like maybe my mystery bump – and its ensuing drama – had happened for a reason. Only something as serious as the suggestion of cancer could have made me cancel the IVF cycle. And since we canceled, I was now open – and still had the money – to consider this new donor-donor embryo option.

We decided on the $21K package because of the PGS testing and gender selection. I knew if we chose the $15K package, I’d be tempted to transfer two embryos at a time just to increase the success rate, even though there was no way we could afford or be able to care for twins. I also decided to forgo the refund guarantee because I’d already had an SIS and didn’t want to cram in an extra trip to California.

I filled out a lengthy intake form, transferred all my medical records, and completed an hour-long informational interview with West Coast IVF’s treatment coordinator. The phone call left me with hope – hope that we could make this happen, hope that we were going to have a healthy baby, and hope that we were one step closer every day to meeting her.

There were just a few more hoops to jump through first…

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