Archive for the ‘IVF’ Category
April 17, 2013 | By: Liz | Filed under: Age and Infertility,Egg Donation,In the News,infertility in the media,Infertility on Television,IVF,Personal Musings,Thinking Out Loud,Uncategorized
So Halle Berry is pregnant at age 46. She’s approximately my age. Jealous much? You betcha! You all know I want another baby. It’s hardly a secret; certainly not from my kids, my dear husband (DH), most of my friends, and Dr. C. I have become somewhat preoccupied with the notion of being pregnant at such an advanced age — my BFF from High School and my BFF from College both think I am absolutely, completely and utterly insane to want to bear a child at this age. [btw, I have a college reunion coming up, whadya wanna bet that many of my classmates have just started down the path toward parenthood and have little ones?! I am taking bets!]
But clearly, if judging from no other demographic than my client base, I am far from alone at wanting a baby in my mid-forties. I was somewhat surprised but quite happy when I heard that ASRM just increased the recommended age limit — cutoff — for women undergoing ART procedures to something like age 55. While I am not sure my own mojo is going to keep me going for another 10 years, I am delighted that ASRM is now recognizing and giving an opportunity to all those healthy women who are in a deadlock battle with the NOvary because they decided they wanted a seat on the New York Stock Exchange before they wanted a seat next to a breast pump. And these days those goals can and do become mutually exclusive. Sheryl Sandberg aside — who managed to pop out her babies in her mid-late 30’s, and no doubt did her research about declining fertility before making an educated decision to have her children while she still had a decent chance at doing so using her own eggs — most women who truly want and love their careers, or who truly want to find the right partner, wind up face to face with their biological clock, otherwise known as the NOvary.
The NOvary, to remind you, is the ovary that says NO! I am not going to give you a healthy egg. My days as a functional ovary have ended. Didn’t you read the memo I sent you (and Sheryl Sandberg) when you were 35 and I was starting to explore ads for condo’s in Miami? I am the NOvary, I am in control of your egg quality and egg quantity and good luck trying to have a baby without my cooperation!
But thanks to egg donation and now expanded age limits by ASRM, those of us with career aspirations or who haven’t quite found the perfect partner have been given a reprieve, a few more years in which to squeeze in our baby-making, and laugh at or otherwise stare the NOvary down.
The funny thing was, as I sat down to tackle today’s blog I wasn’t sure whether I was going to write about choosing an egg donor and some recent hullabaloo over ads for egg donors that were posted at MIT, or whether I was going to explore the whole notion of whether someone can or should be deemed too old to become pregnant. As I perused all my research on age and egg donation, and age and parenting, I stumbled across an article from TheBostonChannel.com which I had printed out in February of 2012. “How Old is Too Old To Have A Baby? Older Celebrity Moms Blurring the Biological Lines.” Half way through the first page of the article I read the following:
“Since 1980, the number of women giving birth after age 35 had tripled, and after 40, guadrupled, as more women climb the career ladder and take longer to find ‘Mr Right.’ In the media, we are bombarded by images of glamorous, 40-something celebrity moms like Halle Berry . . . who make it all look easy.”
BINGO, topic decided. Clearly Halle and I have something in common and something of which I wish to speak. But before I do, I want to be clear and say that I have no personal knowledge of whether Halle used any kind of assisted reproduction to conceive her baby (despite the myriad comments on facebook from my colleagues — all of whom stop just short of stating she used an egg donor to avoid risking a lawsuit), but I do find it interesting that an article and quote from a prominent fertility doctor written a little over a year ago would mention Halle Berry as an example of celebrities who are blurring the lines between what can be achieved the old fashioned way, without medical technology. You do the mental computations on this one. Coincidence, or did that doctor know something and Halle’s hiding something?
For what it’s worth, I do have more than one personal friend who conceived on their own in their mid-late 40’s such that I do believe it is possible that Halle could have conceived without assistance, coincidences raised by the aforementioned article aside. But Halle is my blog inspiration for today because she is blurring the lines and that pisses me off.
The reality is that for most of us mid-forty-aged women, we will need an egg donor to conceive a child. The NOvary has hit her stride by the time we have hit 40 — let alone 45 — and she ain’t gonna budge from her beautiful condo in Boca no matter how much we beg and plead. As I have been working on my egg donation book recently, it has taken on a new meaning as I often find I am writing not just to a group of women whom I typically represent in my legal practice, but I am writing to myself and for myself. I also am finding my new book enriched by my own efforts to justify my decision to bring another life into the world at this age, and gaining a better understanding of how and where to conceive this new life. For example, I recently was astonished to learn that by the time a woman reaches age 40, her chances of conceiving using her own egg in any given month declines another 2-5% per MONTH. The NOvary is powerful and while one day I am sure science will find a way to stop her, right now my age alone pretty much guarantees that I need an egg donor. And Halle and I are in the same age demographic whether or not she hit the genetic jackpot and managed to defeat the NOvary by some major miracle which did not involve donated eggs.
But that’s the point! Halle is blurring the lines especially for anyone who isn’t ready to face the reality of our rapidly declining fertility in our forties. I have reconciled myself to the fact that my peak fertility has long since passed and I acknowledge that I share the same spot in the waiting room at the fertility clinic — or should I say egg donation agency — as all the Sheryl Sandberg wanna-be’s and all the women who hold seats on the NYSE, or who have finally found their mate. I doubt that most of my contemporaries, however, even those who know and understand what I do for a living, truly understand just how high the odds are stacked against us. Indeed, at a recent dinner with a fertility doctor I sought to learn more about the advantages of egg banking — or more precisely the decision to freeze one’s eggs to be used later in life when a woman is ready, willing, and able to have a baby on her terms. The doctor explained to me that far too many women are coming to him to freeze their eggs in their late thirties or even early forties — an age at which he often won’t even discuss permitting them to freeze their eggs. What he was trying to tell me, and he is by far not the first fertility professional to tell me is this: women are thinking of using egg freezing to buy themselves more time but are coming to the fertility clinic when their eggs already have passed their expiration dates and when the NOvary has taken up residence in Boca. The women who wish to take time before becoming a parent and who should be freezing their eggs are at a minimum ten years younger than the ones seeking out this new “stop-the-NOvary” technology. And Halle’s miracle conception isn’t helping doctors explain to all the women asking to freeze their eggs at age 35, 39, and most especially at age 41 that it’s probably too late; its certainly too late to spend thousands of dollars freezing crappy quality eggs! Just because ASRM says we can continue to try getting pregnant using medical technology when we are 46, 49 or 51, does NOT mean that medical technology will involve the use of our own eggs. Just because Halle got pregnant at 46 (presuming she has used her own ova) does NOT mean that women can wait until whenever we damn well choose to have a baby.
I love Halle, I think she is beautiful and talented, and a great mother. And it’s none of my business how she conceived this child. Except that if she did use an egg donor, or any kind of medical assistance to conceive her baby, she has truly done every woman who looks to her as a roll model a huge disservice.
My other love, Jennifer Anniston, who I hope will be the next celebrity to announce her impending motherhood, has made remarks which lead me to believe that she recognizes biology is not on her side (and to be fair Halle did say she thought this phase of her life was over — but what phase of her life did she refer to? Getting pregnant the old fashioned way or changing diapers and breast feeding?).
I also get, as a reproductive lawyer, why Halle might not be able to say she used an egg donor. If she used an egg donor and entered into an anonymous egg donation agreement, she might be legally precluded from making any reference to egg donation when relating details of her conception story, lest she inadvertently reveal the identity of her egg donor. This is a discussion I have had with celebrities whom I have represented and who have used egg donors: Whether and to what extent they are willing to go public, as there are ways to go public while still protecting the anonymity of their egg donor. It can be done and I am hopeful that one of them will one day — when she and her family feel the time is right for their family — make some kind of public remark about how their family was conceived. I also understand, however, that to make that statement is to forever disclose very personal details involving their children. These are details that their children should have a right to agree to share with the public or request remain a private, family matter. But many of my colleagues feel that the minute Halle Berry accepted her status as a premiere celebrity that she lost that right to be private and even more, voluntarily gave up her right to privacy in the interest of promoting that status as a female celebrity roll model which she has so openly embraced. I think it’s worth exploring this aspect of egg donation in the celebrity community in a blog devoted more to legal and ethical issues that are discussed when drafting an anonymous egg donation agreement. But putting these dynamics and very delicate issues aside, there is no getting around the fact that Halle’s pregnancy is going to perpetuate the overwhelming misconception that women in their mid-forties can get pregnant with a healthy infant, carry to term, and live happily ever after. The percentage of women who actually achieve this, however, are less than 2% of the female population.
More and more young women are getting the message. But far too many women age 35 and older simply do not understand the ticking time bomb that is the NOvary and will look at Halle and think “see she did it! so can I!”
Sadly, the reality is that Halle is (again assuming this is an old-fashioned conception) one of an extremely small number of women who get pregnant in their mid-forties. She is incredibly lucky. The kind of lucky that wins the $110,000,000.00 lottery. Congratulations to Halle (and my thoughts and prayers are with you Jennifer and Justin), but to anyone who looks at these women and think they are representative of the general population, or that they indicate a realistic chance for conceiving a baby using your own eggs at the same age as has (presumably) Halle, please do your research. By the time we turn 30, 90% of our good, genetically normal eggs have joined forces with the NOvary, by the time we are 40, 95% of those eggs have moved into that plush condo in Boca. The older you are, the more risk you face of serious infertility issues related to egg quality and quantity, and high rates of miscarriage due to chromosomally abnormal eggs. Halle may have won the lottery. That she is healthy enough to carry a pregnancy I have no doubt, but that she had healthy enough eggs to easily conceive this baby, that was a real long shot and if she did get pregnant using her own eggs, she is one helluva a lucky lady. Because 99% of the rest of us aren’t going to be so lucky. Please don’t look at Halle as your inspiration or roll model, whatever it was that led to the conception of this child defies the laws of fertility. I want all of us to have babies regardless of whether we are 35, 45, or perhaps even 55. But using our own eggs at those ages is something we must face as increasing unlikely as we increase in age.
Donor egg, and even egg freezing, give us the chance to wait until we are 46 to have a baby. Whether or not Halle is one of the many, many women who chose donor egg to help them conceive is something we may never know. But a word to the wise: don’t assume she conceived that baby without the help of medical science and/or another woman’s healthy egg. As I said in the beginning of this blog, a little over a year ago Halle Berry was cited as an example of the women in Hollywood who are blurring the lines and confusing women into believing our fertility exists far longer than it realistically does. What an interesting coincidence that a year later, she is announcing that she is pregnant and that a wonderful miracle has taken place.
All babies are miracles, the question is whether and to what extent Halle’s pregnancy and her little miracle will continue to confuse, confound, and frustrate all of the women who look to her as a symbol of fertility, of a fertility that frankly does not exist for the vast, vast majority of 46 year-old women. The odds of someone like me conceiving using my own eggs? Let’s just say I don’t play the lottery. If I choose to have a baby at any point in the coming months or years, it will be from the miracle gift of egg donation. I’d rather bet on the odds of having a 75% chance of conceiving and carrying to term than the 95% odds against me being another Halle Berry.
April 2, 2013 | By: Liz | Filed under: Check This Out,Deadly Silence,Egg Donation,In the News,infertility in the media,Infertility on Television,IVF,Personal Musings,Recurrent Pregnancy Loss,The Infertility Survival Handbook,Thinking Out Loud
We are rapidly approaching National Infertility Awareness Week (April 21-27); a week that is devoted to raising awareness of infertility and its impact on our lives. This is an important week, not just because we are discussing infertility on a national level, but because many of us may are faced with thoughts and memories that have long since been buried. Or have they? Many an infertile woman will understand very clearly what I mean when I refer to that which I call Post Traumatic Infertility Stress Disorder (PTIFSD). This is the part of our lives where we are periodically haunted by our infertility (IF) treatment, sometimes years after it has ended. Regardless of the outcome of our treatment, PTIFSD is signaled by a random flashback to one of any number of emotionally devastating moments during infertility treatment, a flashback that comes out of nowhere and is so vivid and acute that it catches our breath and momentarily disables us.
The first time I encountered PTIFSD was about two years after I had stopped IF treatment. One day I was holding my baby while on line in Starbucks and a woman came in bursting with news for the friends who were waiting for her: she was finally pregnant with twins and her beta was high! Upon overhearing this news (along with everyone else in Starbucks, most of whom probably had no clue what a beta is or why it was relevant) I had an immediate flashback to a time I too had learned I was pregnant, had a high beta and was probably carrying twins. My flashback delved further, rapidly scrolling through memories of the messages on my answering machine, including those from three nurses at my clinic to congratulate me and share their excitement about my pregnancy. Two of them gave me information that initially had not been shared with me, information which confirmed that I “must be” carrying twins, although that would later be confirmed by ultrasound. My brain spun with these memories and I became disoriented. It was only when the child in my arms, my child, grabbed my hair to get my attention that I snapped out of my seemingly trance-like state. I forgot where I was in time. I forgot I had a child. All I could remember were those happy moments of learning that I finally had a healthy pregnancy under way and the devastation that followed approximately 9 weeks later when I learned that I had to undergo yet another D&C and that my dreams were once again, dead.
While some of us do emerge emotionally unscathed from infertility treatment, many of us carry battle scars that last a lifetime. There is a cruel side of infertility treatment that people don’t often talk about and it involves the emotional scars we are left with, sometimes years after our treatment has ended and we are supposed to have “made peace” with our family building. Not many people will acknowledge that they still have bad days, get jealous or angry (sometimes very angry) over something small and seemingly benign but nevertheless powerful enough to cause a shock wave of traumatic and painful memories from our days undergoing infertility treatment to overtake us and send us into a tailspin, the likes of which we haven’t felt since. . . well since our days of infertility treatment. It has been a long time since I had a PTIFSD encounter but sadly, I had one recently and it was no easier to tolerate than was the Starbucks encounter I described above. And what struck me most was that while I understood that my infertility might still be fresh in my mind less than two years after my husband and I walked away from our IVF Clinic, I didn’t expect those same memories to carry with them the same ferocity so many years later. I mean, it has been over ten (10) years since I underwent an IVF cycle. Certainly time must have tempered my feelings, yes?
Apparently the answer was a resounding “no”. I was checking my email one morning when I received a surprise baby-on-the-way announcement from one of my childhood friends. She and I not only went to kindergarten together but we went through infertility treatment together. Despite having similar diagnoses, she went on to achieving several successful pregnancies via egg donation. I was so happy for her that I knitted a little sweater for her first born. What I experienced upon opening her email a few weeks ago, however, was hideously painful and I was left depressed, lethargic, moody and frightened. My friend had gotten pregnant by accident, in other words, without medical assistance. Indeed, much to everyone’s stupefaction, despite her age and many infertility diagnoses, she is experiencing a very healthy twin pregnancy. As I sat there reading her email I was happy for her, but at the same time I was overcome by memories of us holding hands while waiting to have our blood drawn in the morning, and the time she called in tears because she finally had to face the fact that she needed to use donor egg if she wanted to achieve a pregnancy (or so everyone thought at the time). And as I relived those memories (emphasis on the word relive) and read her email again I suddenly was overcome by anger and jealousy that I was not the one sending out the email. Out of nowhere I was overcome with a jealous rage that bordered on hate. Hatred for someone I have loved since I was so small a person? Yes, if I am truly honest I have to admit that I felt inklings of hatred for her. For the next day or so I had mood swings and bit people’s heads-off for no reason. It was only when I finally told my husband what I had received in that email that the feelings became less intense. Somehow by acknowledging my feelings I was finally able to begin to move away from this non-stop video memory spinning inside my head. Somehow this email had me caught in a perpetual mental loop of painful and devastating memories from my IF. As the memories subsided, I remembered a conversation with a therapist I had seen during and after my IVF days. During one of my sessions, she commented that what I was experiencing seemed a lot like post traumatic stress disorder; and so she and I created a new diagnosis, Post Traumatic Infertility Stress Disorder or PTIFSD.
I now have learned how to recognize and embrace the PTIFSD memories and use them to remind me of the joy that surrounds me. I hope my PTIFSD is now truly at rest in my past. But it’s okay if it is not. Because I know where these feelings come from, and that they will go away. These feelings do not control me, nor does my infertility continue to define me, instead it is the genesis of my growth as a human being, a woman, and a mother.
I recently had dinner with an infertility doctor. He asked me why I wrote The Infertility Survival Handbook and whether it had been cathartic. I told him why I wrote it – to let other women know they were not alone – but I also acknowledged that writing it wasn’t the least bit cathartic. My healing process is one that continues. Perhaps writing The Infertility Survival Handbook was my way of starting the healing process but I would be lying if I said I was finished with it.
The Infertility Survival Handbook was released during National Infertility Awareness Week (NIAW) in 2004. Today as we approach NIAW, I am thinking of all of the women (and men) who are currently struggling to have a baby. Now on its’ ninth (yes 9th!! Woot! Woot!) printing and as I contemplate writing an updated version, I think of all those women who have read my book and have emailed me, messaged me on facebook, or even called me (on a private number at home at 6am); women, who like me, struggle with the emotions that linger even after they have become mothers. PTIFSD is not yet in any diagnostic manuals, but I wish it were. I had two wonderful therapists who helped validate the emotions I was experiencing both during my treatment and well after it ended; therapists who believe in PTIFSD and its power. Not everyone has people in their lives like my therapist who invented PTIFSD, or someone that understands and “gets it”. And it is for those women I write this blog.
No you are not alone. Being unable to conceive a child when you so desperately want one, is painful. You are entitled to express that pain. You should not be shushed or told to “just relax” so you can get pregnant. And yes, that pain can stay in your heart and mind and hide there waiting to jump out and catch you off guard. That too is normal and you are entitled to express that pain as well. You should not be shushed or told “it’s over now just forget about it”.
You are not crazy. Infertility is a part of your life regardless of the ultimate outcome. It is an experience that shapes you and has the power to disfigure you – to change who you are – if you let it. If you think you might have “Post Traumatic Infertility Stress Disorder”, talk to someone. Get those feelings out. Give your feelings a name. Sometimes just by having a name, a reason, or a diagnosis gives you closure and helps you move past the feelings and you experience a sense of relief that allows you to let go. I may not be like my childhood/IF buddy who is on the verge of delivering twins. But I also am no longer be at the mercy of my memories. By being reminded that my reactions and feelings when confronted with things that trigger painful memories has a name, PTIFSD, I have been able to regain my balance. Or perhaps it is simply the understanding that, like anyone who goes through a very traumatic experience, I am bound to (at some point) relive that trauma, which has enabled me to begin to heal on a new, even deeper level.
Infertility awareness requires not only an understanding and recognition of the disease itself but of what that disease can do to us. So if all the media coverage regarding infertility in the coming days (of which I hope there is a lot), finds you feeling a little more blue (or red) than normal, a little bit more withdrawn or melancholy, remind yourself that this media coverage is triggering some old buried memories, just as that woman in Starbucks and my friend’s email caused me to become momentarily blinded by sadness, grief, and anger. It is okay that our infertility causes some of us to experience things and feel emotions long after we thought they were over. That can be a part of infertility too, PTIFSD; and it too deserves some recognition during NIAW.
The point of NIAW is to help us recognize that we should not suffer in silence, that we should band together and make people aware that infertility is a disease. What I wanted to share with you, and make people aware of is not just the medical diagnoses, but the sometimes unbearable emotional pain we feel. We also should not be forced to suffer the emotional pain in silence.
February 15, 2013 | By: Liz | Filed under: Current Affairs,Deadly Silence,Faith and Infertility,infertility in the media,Infertility In The Movies etc.,Infertility on Television,IVF,Miscarriage,Peace to Parenthood,Personal Musings,Recurrent Pregnancy Loss,Stillbirth,The Journey to Parenthood,Thinking Out Loud,Third-Party Assisted Reproduction
The shrowd of silence around stillbirth and pregnancy loss finally is being lifted. Someone is making a documentary about miscarriage, recurrent pregnancy loss, and stillbirth. This morning I watched the trailer of “Still” a documentary devoted to raising awareness of the pain of the loss of a pregnancy, a child born too soon, or a stillbirth. I think “Still” may focus more on stillbirth or pre-term delivery, but some of the articles I read as I researched its production indicated that the documentary intends to address recurrent pregnancy loss and/or miscarriage more than is touched upon in this trailer.
As I watched the trailer I was reminded of a long call I had with a new client this week. It is rare that I have a client who has a similar background to my own experience with infertility. Like me she has experienced 12 unexplained pregnancy losses (although I sort of stopped counting about a year ago when I went through it again . . . something about hitting the number 13 and I really decided it didn’t matter how many I had, I have had enough, one is enough). Only in addition to experiencing a number of first term (non-chemical) pregnancy losses, my new client also lost pregnancies in the second trimester and near the beginning of the third trimester. We had a lengthy conversation about how isolating it is, how lonely it is, how there is no person other than your partner or spouse who “gets it” (and even then sometimes perhaps they don’t totally get it because it isn’t their body), and how the silence that surrounds pregnancy loss can engulf one’s life, one’s existence. Our call also reminded me of a blog I posted about a gravestone I once saw that marked the death of fetus. As I commented in that blog, it wasn’t a pro-life stunt. It was a family who had been given permission not only to mark the death of their baby while in utero (or loss of their pregnancy) but to recognize all those other families that have suffered the same pain. In silence.
Reproductive medicine has provided so many advances to assist infertile couples in achieving their dreamed of family but recurrent pregnancy loss remains largely unexplained. While theories abound, there are far too many of us who don’t know why this happens to us, repeatedly. Reproductive medicine and reproductive law now give us the option of having our biological child carried by someone who is likely to deliver that child when we can’t. Indeed, the option to use a surrogate after experiencing pregnancy loss is perhaps the driving force behind at least half of my clients who come to me to assist them with legal agreements as they begin their journey using a surrogate. As is the case with the call and the client I just mentioned.
As many of you know, in the absence of an explanation of why my babies die, I was too frightened that a surrogate might lose my child. I couldn’t ask another woman to risk experiencing the pain I have dealt with so many times. Adoption was always something my husband and I had wanted to pursue so when we were faced with the [dreaded] conversation where our doctor told us we were out of options other than surrogacy or adoption, it was a no-brainer for us. It was going to be adoption. And as one of the women in the trailer for “Still” points out, I wouldn’t turn back the clock or make different decisions; because without those pregnancy losses I wouldn’t be parenting the two beautiful children I have now. I cannot imagine a life without these particular little souls in it. It seems like a heartbreaking price to pay but as I told my new client, one day when this is all over and you are holding your baby in your arms, it will make sense and you will know that but for all that came before (all 12 of those horrendously difficult pregnancy losses) this little baby wouldn’t be yours.
But as she journeys toward that day where she hopefully does feel that sense of peace and gratitude for the child in her arms, she is left with a huge void. She has no one to talk to. I had no one to talk to. Even my best IVF friends didn’t understand how I felt. Excuse me: how I FEEL. I still feel pain on a day that one of my longtime friend’s celebrates, the day she heard the heartbeat of each of the babies she was carrying. I don’t begrudge her that joy. I celebrate with her. But for me, inside, it always is a reminder of the miscarriage that I experienced just a few days earlier. My client and I share a special bond, one of knowing what each carries inside her and the thoughts that creep into our mind throughout the day. Thoughts that largely go un-shared with anyone.
Will “Still” do justice to this topic, to this diagnosis, to the countless women and men who have endured the loss of a life growing inside them or one that came into the world far too early to survive? I think so. I hope so. Because I would like nothing more than for women like me who are going through what I went through, women like my new client, to have a voice in the reproductive community. To have doctors pay attention to our kind of infertility. To have better resources and support groups. To just plain have a voice to express their pain. Amazing options for family building notwithstanding, the pain associated with recurrent pregnancy loss, miscarriage, and stillbirth shouldn’t continue to be shrouded in silence.
And so today I thank the people behind this documentary entitled “Still”. THANK YOU for initiating a dialogue that is long overdue.
And one final note, to all those physicians who have dedicated their careers to exploring the mystery of recurrent pregnancy loss . . . THANK YOU.
If you would like to watch the trailer click here
December 7, 2012 | By: Liz | Filed under: adoption,Check This Out,Current Affairs,Egg Donation,Financing Fertility Treament or Adoption,In the News,IVF,known sperm donation,Personal Musings,The Journey to Parenthood,Third-Party Assisted Reproduction,Thoughts on Choosing an Egg Donor,Uncategorized
Every once in a while I have true conflicts between my self as a former infertility patient and my career as a reproductive lawyer and adoption attorney. A couple of years ago, I wrote a law review article on the disposition of frozen embryos, and whether or not talking about embryo adoption was legally correct whether the better, more appropriate terminology was/is embryo donation. There are hundreds of thousands of frozen embryos in cryopreservation in this country where the intended parents of those embryos no longer wish to use the embryos for their own family building. These embryos are often referred to as “leftovers” a term which somewhat disturbs me but is strictly speaking, accurate. These embryos are “leftover”, after a family was created through IVF and now remain in a state of frozen suspension. Many of those embryos could be used to help build another family, and be donated to an infertile couple. There was some confusion as to whether these embryos should be placed for adoption or donated in a similar manner to egg and sperm donation and I wanted to resolve that confusion — at least for myself. I ultimately drew the legal conclusion that the term embryo adoption isn’t really accurate because there isn’t a human being to adopt. I could go into a lengthy analysis of how I came to that conclusion but your eyes would roll back in your head and you would probably start drooling from boredom. So let’s just defer that analysis and argument for another day. If you are interested, you can get a copy of the article on the web (click here). I now happen to be a huge advocate for embryo donation. I think it is a fabulous way to build a family. However, these are musings for another blog. But my article did provide some clarity to those medical facilities which are banking those frozen “leftover” embryos.
So here I have been sitting happy as a woman with a barren uterus could ever be, contemplating my holiday shopping safe and secure in my belief in, and advocacy of embryo donation. And then I hear about this doctor in California who has a new kind of embryo bank.
Before I heard of this physician in California, I was aware of only one type of embryo bank; one where frozen “leftover” embryos are being made available for donation to infertile families. These frozen embryos were the subject of my law review article. This new embryo bank, however, does not contain any of these “leftover” frozen embryos. This bank is comprised of embryos which were recently created using carefully selected donor eggs and donor sperm. The donated eggs are fertilized with the donated sperm and the resulting embryos are frozen for future selection by hopeful intended parents. Let’s stop briefly and note emphasis on the words “future selection”. We will circle back to why this is relevant but I wanted to point out that these embryos are being created for future selection by wanna-be-moms and dads.
This physician has created his embryo bank in a manner to facilitate selection for all types of characteristics — everything from physical traits like blond hair and blue eyes to religious ethnicity. Jewish embryos, who knew? Actually, this could be fantastic for Jewish couples who need a single Jewish egg donor, and/or want to further ensure a connection with Judaism by having a genetic connection on the sperm side of life. You have no idea how hard it can be to find a specific ethnic donor and this is something I gather this doctor has identified as a plus to his business model. Speaking of business models, he also offers a money back guarantee. You choose a batch of embryos to use to try and get pregnant. If you don’t get pregnant the first time, you get two more tries using different batches of embryos. If you don’t get pregnant, you get 100% of your money back (approx. $12,000).
Upon hearing of this embryo bank a part of me was disgusted and a part of me . . . well I was excited. Super excited. Especially about the money back guarantee.
The infertility patient part of me sees this as a great opportunity to get pregnant. Frozen embryo transfers — while statistically less successful than fresh embryo transfers — can be lot easier to go through than an IVF cycle. For me having the embryos created using donor gametes isn’t a big deal. But if it were, I would be able to select an embryo based on whatever I might deem important. So, yeah baby! Let’s have another baby! Give me this doctor’s number. I am in! Or perhaps it would be better to say the embryos are [going to be] in [me]!
But the legal scholar, academic, intellectual, lawyer part of my brain is sitting here vomiting and is pissed that I am putting these thoughts onto cyber-paper and making an argument in favor of this horrific new kind of embryo bank. Stork Lawyer Reality check: It is pretty much illegal to create embryos without first having identified intended parents as recipients for those embryos and from what I understand, there are no intended parents waiting for those embryos when this doctor is creating them. The intended parents don’t enter the picture until the embryos are selected from the database and someone signs up with this program to undergo an embryo transfer procedure. This is where that whole “future selection” comes in.
The laws regarding assisted reproduction essentially come down to intent to parent before conception: in a third party assisted reproductive arrangement there is supposed to be a contract or other document signed before the embryos are created, whereby intended parent(s) agree to be legally and morally responsible for the embryos and children that may result from the ART process. In this case there is no such contract or preexisting intended parent. The embryos subject of my law review article all had intended parents before the egg and sperm came together to create the now frozen “leftover” embryo. But this new type of embryo banking lacks that component. There are no intended parents choosing the eggs and the sperm with the immediate intent to parent.
And speaking of all those “leftover” embryos shouldn’t we first be dealing with and using all the existing cryopreserved embryos before we go about creating them? And what about the potential that this doctor may be creating even more “leftover” frozen embryos (what happens to those embryos that don’t get selected)?
Let’s not analyze whether this is baby selling. I can’t, or won’t go there, although many others have. Consanguinity, or the risk of an individual created through donor gametes marrying or having a child with a genetic sibling is another issue that has been raised. The number of families that are created using any individual egg or sperm donor’s genetic material is a concern not to be overlooked or ignored. These donors presumably are also donating through egg donation agencies, fertility clinics or sperm or egg banks. We all have been astonished by stories of men who have discovered that they have fathered over a 100 children as a result of their donation to sperm banks — there is a significant risk that through this new type of embryo banking program not only will children have multiple full siblings running around but that egg and sperm donors have created half siblings through other programs.
Even more, if I understand this program correctly (and I am pretty sure I do) batches of embryos are being created which contain embryos which are full siblings to embryos which are contained in other or separate batches of embryos. It sounds like it is possible that three separate donations could take place using these three batches of embryos. Okay, follow-me slowly here for a minute because this is a little bit like playing Twister. In other words, three batches of embryos each of which contain embryos which are full genetic siblings to embryos in other batches, could be donated to three different families thereby creating three separate families whose children are all full genetic siblings to each other!
Do the recipients of these embryos know how many full genetic siblings their child may have? Are the donors aware?
It is supposedly almost impossible from a statistical standpoint for one of these children to marry its full sibling. But when you add in the half siblings that could be created through other donation programs, and/or smaller ethnic groups for whom donation can be a challenge because of the limited number of donors available matching their ethnicity, doesn’t the risk become somewhat more than insignificant? And even if it doesn’t, I worry that people don’t have enough information about how many genetic siblings are out there whether they are full or half siblings.
But I get it, I get why he did it. Especially for someone with an ethnic background this type of program would be hugely popular and let’s not forget the money back guarantee. We’re all broke after trying IVF multiple times, why the heck not take out a second mortgage if you know you will be able to pay it back if you don’t get pregnant? Sounds pretty good doesn’t it?
I am at war with myself. I want to go running to that clinic and pick out an embryo tomorrow. And then my lawyer (self) tells me to stop and think about whether I want to participate in, and thereby endorse a practice which I believe, in my own legal opinion, is legally impermissible, and legally and medically unethical. Is my desire to be a gestational mother stronger than my moral center? Good question.
The views expressed in this blog are the views and opinions of this author and are not intended to provide or constitute legal advice or a statement of the laws as they may pertain third-party assisted reproduction within the United States.
September 18, 2012 | By: Liz | Filed under: adoption,Current Affairs,Deadly Silence,Egg Donation,Faith and Infertility,I'm Just Another Angry Infertile Woman,In the News,infertility in the media,IVF,Personal Musings,The Journey to Parenthood,Thinking Out Loud,Thoughts on Choosing an Egg Donor,Thoughts on Donor Egg Recruitment
You know it’s not that often that I see glaringly offensive comments or information from professionals in the infertility world. Most of us know to be very careful with the language we use so that we don’t inadvertently hurt someone’s feelings. Today I was surfing Facebook and someone to whom I was connected (I am no longer “friends” with her) posted a comment about egg donation, adoption, and infertility. I thought at first she was referring to a blog and was hoping she was quoting someone else. Alas, I was very wrong and the link she posted was to an egg donation agency based outside of the United States (thank goodness for that — didn’t want to be running into her at any upcoming conferences lest I let her have it to her face) and the post was pretty much designed to bring attention to her agency. I am not a big believer in the old adage that any attention is good attention or that negative publicity is still publicity. In this industry, offending people is the kiss of death and well let’s just say I’ve been kissed.
I really don’t like the word “barren”. It’s an ancient reference to women who were unable to conceive and it dates back to a time period when women had no rights and would sometimes be replaced by another woman if she was unable to conceive a child. The Sixteenth Century this is not and I would have hoped that in the Twenty-First Century we would be a little bit more aware of appropriate terminology. I guess not because this FB poster (who shall remain nameless even upon kiss of death) seemed to think that all women who are having difficulty conceiving should be considered BARREN.
I don’t think so. Having difficulty conceiving does not mean we are barren. The word barren actually has many definitions (http://www.merriam-webster.com/dictionary/barren ) including “lacking inspiration” or “lacking charm”. For the record, I don’t consider any of my infertile clients, and certainly not my own bod, to be lacking in charm. Some of my clients are downright amazingly gorgeous women with incredible resumes and great personalities. In this case they are hardly barren are they? They also usually go on to become mothers which would seem to indicate that they are in fact capable of producing offspring (please note Miriam-Webster dictionary says nothing about those offspring needing to be biological children — at least its editors “get it”). But the word was used nonetheless in this FB post. The fact that the post tried to be “neutral” and present all sides of debates as they pertain to third-party assisted reproduction was totally lost on me by virtue of the selection of this word to describe me. Because that is who she is describing, me. The last time I checked I am still considered to be infertile.
The other problem was that this poster and her choice of words — and barren was by far the least offensive of them — revealed her own underlying belief that women who have difficulty conceiving, women like me who are infertile, are somehow lacking, less than other women, and are desperate. While she notes that “an element of respect” should be offered to these women, in and of itself that remark too is offensive. I am only entitled to “an element of respect”. 7 IVF Cycles, 9+ miscarriages (I stopped counting but there were more), three adoptions, and I am only entitled to “an element of respect”. Seriously?
Additional comments were made about whether decisions to use an egg donor were interfering with the “divine plan” for that woman’s life; and that what transpired to finally bring this barren woman to the point of actually considering using another’s genetic material could only be understood by the woman herself. Here I do agree with the post. However, I would prefer that she had not characterized the decision to choose egg donation as an act of finality, desperation, or somehow jumping off of the cliff of normalcy. Families are built in countless ways and all of them are normal.
Egg donors also were attacked for their decision to share themselves with other people. Let’s be clear that egg donation does not involve any kind of “sharing”. Egg donation agreements are clear that when a woman donates her eggs she relinquishes all rights to the resulting embryos and/or children. Egg donors do not share in the day-to-day life of the intended parents’ pregnancy, or their life as they raise their child. And let’s place the emphasis where it belongs, on “their” child, not the egg donor’s child. If this woman is counseling egg donors — and I fear she may be — then she is sending the wrong message to these selfless and generous women who donate their genetic material, their ova, to an infertile couple. They ain’t sharing those eggs or themselves with anyone.
Let’s not even discuss the offensive descriptions attributed to adoption. I will have a stroke.
I understand that this woman was trying to raise a debate, trying to draw attention to her business and what she does. But the choice of words she used as a professional in this industry was astonishingly rude and clearly revealed her own underlying biases. She is entitled to those biases. But as a professional she had a responsibility to keep them private and not mislead egg donors or intended parents. I also think it was a poor decision to use such inflammatory language if she was trying to promote her business. In all likelihood she sent potential clients running in the opposite direction.
I hope that the other people who read this post are wearing running shoes; they need to run as fast as possible. Most likely the very charming, inspirational women who read this post pulled their flats or sneaks out of their gym bag and took off their Jimmy Choo’s, and headed in the direction of a more sensitive egg donation/surrogacy agency, a therapist (I may need a session), shopping (in which case maybe they should leave on the Jimmy Choo’s), or a glass of wine and some Oreos.
For all those who read that post and felt in any way diminished as a human being because of their infertility, let’s get one thing straight: anyone who can get through this stuff is one tough, rockin’ mama. Emphasis on the word “mama” because that is what you will one day be called.