Archive for the ‘adoption’ Category
Making an Egg Donation Cycle Work. A brief look at what you might need to know to increase your chances of success!
January 19, 2012 | By: Liz
Through egg donation, many infertile women are now able to experience pregnancy: sharing their thoughts, feelings, blood supply and the sound of their voice with their baby, and delivering their child into the world. The success rates offered by many egg donation programs are somewhat staggering, making this a very popular option in family building, especially for women dealing with the NOvary™.
Egg donation is often so successful that some can potentially build an entire family from one egg donation cycle. Of course not every egg donation results in a pregnancy, but more often than not a carefully selected egg donor not only leads to the birth of a child, but will provide a family with extra embryos to freeze for future family building.
Such was the case for my former client Nancy. Her experience with egg donation provides a great example of the types of things someone considering using egg donation might want to take into account as they move forward on their journey to “Mama” (or “Dada”). Nancy, at the time her journey into egg donation began, was in her early forties. Like many women today, Nancy had waited to marry until she found the “right guy” and had established her career. After graduating from law school, Nancy decided that she wanted to put off starting a family until she had paid off her student loans, and had made partner in her law firm. She felt very strongly that it was important her career and financial life be stable before she became a mother. When she was 35 she met Daniel, and after dating for a few years they married when she was 38. Well aware of fertility landmines related to age, she and Daniel had discussed her desire to become a mother before they got married and agreed to start trying for a baby immediately after the wedding (Nancy, just like me, hoped for a honeymoon baby!). She was such a planner that before they got married Nancy went to her OB to see if she was facing any age-related infertility issues. Much to her surprise and relief, after her OB examined her, Nancy found out that it seemed like all systems were good-to-go; she appeared to have a healthy body, good ovarian reserve, and nothing standing in the way of her becoming a mother. Nancy’s OB recommended that the newlyweds try having unprotected sex for six months and if nothing happened to go see a reproductive endocrinologist (sounds like a good plan to me!). However, after six months of unprotected intercourse, Nancy and Daniel had not gotten pregnant. Proactive Nancy immediately contacted the reproductive endocrinologist her OB recommended.
The RE Nancy and Daniel saw recommended that they try assisted-reproductive technologies. Unfortunately after several failed IUI and IVF cycles, Nancy’s doctors told her that her best chances for becoming a mother were through egg donation or adoption. Although there seemed to be no medical explanation for Nancy’s failure to conceive, their RE didn’t think further attempts using Nancy’s eggs made sense. Despite her remarkably low FSH and good AMH results, her RE nevertheless attributed Nancy’s IVF failures to issues related to ovarian reserve and her age. Ironically, after all her efforts to detect infertility, especially age-related infertility, Nancy discovered that she was dealing with the dreaded NOvary™. (Just as side note, my definition of NOvary™ extends beyond ovaries that refuse to produce eggs because we are too old. However, in this case Nancy’s confrontation with the NOvary™ did seem to be related to the fact that she was in her early forties and her ovaries were headed into retirement.)
The RE suggested they consider using an egg donor or adopting.
Nancy was at first — like all of us — somewhat devastated by this diagnosis. She had done everything correctly, ate a healthy diet, exercised her entire life (in fact Nancy had almost become a professional dancer before going to college), she didn’t smoke, took yoga classes, and yet her body still seemed to be failing her. After discussing the situation with Daniel, Nancy realized that she really, really wanted to experience pregnancy (I can relate to that!), and so they chose to first pursue egg donation. N&D agreed that they would try egg donation one or two times and if they didn’t conceive a baby through egg donation, they would move on to adoption.
Nancy, however, was not prepared for the overwhelming information and advice she received once she had settled on using an egg donor. People told her different things: don’t use an agency, use an agency, don’t use an inexperienced donor, use an inexperienced donor. Everything Nancy heard seemed to be conflicting and confusing. Even worse was how overwhelmed she felt when she logged onto various egg donation agency’s databases. How on earth could she ever select a donor out of the hundreds that seemed to be available?
Her gut reaction was to work with her RE’s “in-house” egg donor program as they would select the donor for her, thus ensuring that she had a fertile donor and, more importantly, Nancy wouldn’t feel she had to cull through profile after profile. Nancy just wanted someone to make the decision for her so that she and Daniel could move past infertility and onto pregnancy!
After doing her research (if we haven’t already established it, I want to remind you that Nancy is quite the type A person and she is proud of it! I can relate, as I too am rather Type A) Nancy, however, decided instead to work with an egg donation agency. Although many “in-house” programs are flexible, Nancy felt that she had more options when working with an egg donation agency. While Nancy felt that she was giving herself more legwork to locate her own donor and dealing with the accompanying stress, Nancy felt that by working with an agency she had greater flexibility in choosing her donor. What had first seemed so attractive — having someone present her with an “egg donation goddess” (her words not mine) — in reality turned out to concern Nancy. By relinquishing control to her RE and his staff, she lost the flexibility to request a donor who had an athletic background (not only a former dancer, both Nancy and Daniel are self-professed exercise junkies, and Daniel had played some serious basketball in college), or to use an egg donor who has an “artistic” personality (the dancing thing turned out to be really important). She also seemed to have a harder time finding a college educated egg donor through her RE and in the end having a “smart” donor also turned out to be very important to both Nancy and Daniel. Their RE’s in-house program would be able to provide them with a donor who already had been screened for fertility (a huge plus by many standards) and who physically resembled Nancy and Daniel (another huge plus for most people), but with the in-house program she couldn’t request an “athletic, artsy, super-smart” donor. Using an egg donation agency gave her the freedom to be more selective than she initially thought she would need or want to be.
Nancy also didn’t have to share eggs with another infertile family which was a requirement at her particular RE’s in-house egg donation program (off topic for a moment: shared egg donation cycles are a common effort by clinics to help reduce the cost of an egg donation cycle but being “required” to share a cycle isn’t common). Nancy also realized that working more independently meant she would have greater control over their finances.
With a limited budget because they were also considering the possibility of adoption, most of the agencies she spoke with recommended that N&D select a donor who lived near the clinic she would be using, thus avoiding substantial travel expenses. Using an agency, Nancy also had a greater selection of donors with compensation rates to fit her budget, compared with the fixed rates offered by Nancy’s and many in-house egg donation programs. By selecting a “local” donor with a lower compensation than that which her RE’s in-house program requested on behalf of its donors, Nancy was able to save a couple of thousand dollars and put it in what she called their “adoption bank.” It did take more time finding that “artsy, athletic, super-smart donor” than she had anticipated but Nancy felt the time was worth it given that she didn’t think she would know “enough” about her egg donor’s background had she chosen the egg donor recommended by her RE.
One donor Nancy considered, I am going to call her Lucy, was twenty-seven years old, single, had been a dancer in high school and had attended a Seven Sister’s college (rock on to all women’s colleges!!). Lucy had graduated at the top of her class and was attending graduate school in journalism (did I mention that Daniel is a news columnist?!). Despite Lucy’s outstanding academic credentials, which often result in a higher requested compensation, Lucy’s “requested comp” (egg donor industry lingo) was on the low side. Side Note: The Society for Assisted Reproductive Technologies’ (SART) has guidelines that recommend egg donors receive between $4,OOO-$7,000 per donation.
With Lucy’s dancer’s background and desire to be a journalist like Daniel, Lucy seemed like the perfect donor. Lucy, however, had no track record donating eggs. With their tight budget and limited time factors — N&D were also concerned that if they waited much longer their age might preclude them from working with certain adoption programs and they very much wanted to preserve this as a family-building option — Nancy and Daniel instead decided to match with ”Lauren.” While Lauren also was twenty-seven and had attended college where she played soccer, Lauren had a three year old daughter and had conducted one prior egg donation cycle that had produced a lot of eggs. Although they didn’t know whether that egg donation cycle resulted in a live birth, Lauren was clearly fertile and was likely to respond well to medication. To Nancy and Daniel, this made her a better candidate.
Both Lauren and Lucy were requesting $5,000 as compensation for their cycle and lived relatively close to Nancy’s and Daniel’s clinic (no overnight travel was involved).
Once N&D selected Lauren as their donor, the egg donation agency presented them with a list of attorneys to help prepare their egg donation agreement, and it arranged for Lauren to be represented by an attorney as well. I am working on a blog on egg donation agreements and why you MUST have one so I am not going to go into it in depth here. I actually had already met with N&D before they got the list of attorneys from the egg donation agency (and my name was NOT on it grrrr), but I did help them prepare their anonymous egg donation agreement with the woman we are calling Lauren.
Once the egg donation agreement was signed, their egg donation cycle got underway. Lauren didn’t produce as many eggs as N&D had hoped; Lauren “only” produced eleven eggs but all eleven fertilized (Side Note: 100% fert rates are not something you should expect, it doesn’t always happen that all of a donor’s eggs will fertilize. Nancy and Daniel got lucky). Nancy conceived twins from the first embryo transfer (now that is something you should expect and should discuss with your RE if you don’t feel prepared to parent two at once). After watching the remaining pre-embryos which were not transferred to Nancy’s uterus, the clinic froze five blastocysts. Off topic again: Nancy’s RE performed a day-3 pre-embryo transfer which, for reasons that exceed the scope of this blog, I am at a loss to explain. Despite Nancy’s disappointment with the number of eggs retrieved, I would have thought the clinic would have done a day-5 or blastocyst transfer??
Nancy and Daniel are very happy and currently are considering whether or not to use their frozen pre-embryos.
If you have any thoughts or comments to add about your experience, please feel free to share them. This blog is designed to help people achieve success in egg donation and if there’s something you think might help someone, go for it!
p.s. I don’t know whether any of this sounded familiar to you, but I did think that Nancy’s and Daniel’s decision-making process and the issues they faced, particularly those Nancy faced, were typical and helpful enough that I wanted to share them. Nancy and Daniel’s story is discussed in much greater detail in my next book if you want to learn more about what they went through when finding their donor and negotiating their egg donation agreement. More details about pub date to follow (I am under an editorial deadline which is a good thing because it means this thing will finally be finished!!! I’ve only been working on the book for three years. Enuf is enuf!).
Filed under: adoption, Age and Infertility, Announcements, Egg Donation, In-House Egg Donation Programs, IVF, Personal Musings, The Journey to Parenthood, Third-Party Assisted Reproduction, Thoughts on Choosing an Egg Donor, Thoughts on Donor Egg Recruitment
Tags: age-related infertility, Donor Compensation, donor eggs, Egg Donation, egg donor, finding an egg donor, infertility, premature ovarian failure, selecting an egg donor, success
I got Baby Proofed!
September 23, 2011 | By: Liz
Summer reading lists. What was on yours? I read several great books including one which much to my surprise dealt with infertility, adoption, egg donation, embryo donation, sperm donation, single parenthood, and child-free living AND didn’t offend me!! Not only did it manage to avoid offending me (a pretty hard thing to do when you are writing on topics so near and dear to my heart) but it dealt with these topics with such accuracy and such insight that I had to ask my colleagues what the deal was — had this author been infertile and I didn’t know about it??????
The book is “Baby Proof” by Emily Giffin (author of Something Borrowed, recently made into a movie with Kate Hudson).
Written in the first person, the author is struggling through marital problems and decisions about whether or not to have a child. As she is trying to sort out her own issues, her sister is going through treatment for infertility. Author Emily Giffin does an amazing job of both describing the issues a person faces when contemplating living a life without having children (and the condemnation that may come with that decision). And she does an even better job describing what her sister is going through and issues involved with egg donation and the dreaded NOvary, fears about birth mothers, open adoption — heck she even accurately addresses the differences between embryo donation and embryo adoption and the misuse of terminology . . . . Seriously, you cover that one accurately (as did Ms. Giffin) and I HAVE to put you on the Stork Lawyer’s recommended reading list!!
Baby Proof is a great read and one that very clearly articulates the very complex landscape of third party assisted reproduction and adoption. I tend to be really harsh and judgmental when it comes to reading other people’s — especially fertile people’s — interpretation of my world (both the part I live on a day-to-day basis and the part I work in) and my hat’s off to Ms. Giffin! Baby Proof is politically and legally correct down to its core and it is still a fascinating read.
Baby Proof gives us a multi-faceted view of the myriad of complicated emotional and legal issues faced by infertile couples and singles. If you are going through infertility don’t be afraid to read this book. It’s not preachy, critical, judgmental, hurtful, or voyeuristic. Baby Proof looks at the issues infertile women face every day and with the precision of a plastic surgeon and her scalpel, the author manages to peel apart the very delicate skin (issues) involved when you’re dealing with ovarian reserve issues, third-party assisted reproduction, adoption, as well as the concerns women face as their biological clock ticks away and they lack a partner to help make a baby.
It’s a fun read and manages to be educational at the same time. I totally was caught off guard. I thought this was going to be some light chic lit for summer vaca. Was I ever wrong! For the first time in a very long time, I wound up thinking and marveling at the ability of someone who doesn’t live my life to totally understand my life.
I may know that she interviewed a reproductive lawyer but I still have to believe that she knows more about this topic than what one can learn from spending an afternoon being educated by someone like me. I can’t help but think she must have more insight into infertility than just an interview would bring. I mean she really GETS IT. I tend to think that you can only understand this pain if you’ve lived it. Granted the character in the book is going through a life crisis and is incredibly intellectual and so these issues are discussed through a filter of self-analysis . . . but even that, the self-analysis part of it, leads me to wonder if there isn’t some personal connection to infertility that I am unaware of. Maybe I will re-read the acknowledgment section? Maybe I missed a thank you to someone who shared their heart. But if I didn’t miss it, then this is one book that understands the infertile woman (and maybe will help people find their way through their infertility to consider an option of family building that without this book they might not have understood or considered).
It’s been a long week and I am brain dead. I hope I made the point I wanted to . . . I don’t typically think that it’s possible to understand what we go through and I don’t typically find that people get the legal issues involved in what I do everyday. You know I analyze every movie and magazine article looking and hoping to find an accurate portrayal of the path to parenthood when you’re not a fertile person. Did I finally just find one??
I think so. Maybe I won’t just re-read the acknowledgments. Maybe I will re-read this book. This might be a first.
Thanks Emily. You done us proud.
Filed under: adoption, Age and Infertility, child free living, Egg Donation, infertility in the media, IVF, Personal Musings, Thinking Out Loud, Third-Party Assisted Reproduction, Thoughts on Choosing an Egg Donor
How art imitates and informs our life as prospective parents.
May 26, 2011 | By: Liz
I have periodically blogged about how Hollywood portrays infertility, but I have never really focused on how Hollywood or television portrays parenthood. There are tons of great movies and t.v. shows about parenting, but there isn’t a ton that really addresses the transition people go through when they become parents: The Leap from Infertility to Parenthood. Granted there are fantastic movies like Juno that really capture aspects of adoption, but until now I haven’t really seen a movie or t.v. show that helped me understand (even as Monday Morning QB) what the transition — the Leap — is like. I am always “warning” my clients to be prepared for life with baby, but I previously have not had anything I could tell them to watch which accurately represented or characterized the Leap.
Well that has all changed. Last weekend I was watching a movie with my DH (Dear Husband). He had rented the film and I had agreed to watch it (despite an initial lack of interest) because the main character was played by Katherine Heigl, who is as we know, an adoptive mom. Not only do I love her films in general but I always am willing to watch a movie where the actor is in real life a parent through ART (assisted reproductive technologies) or adoption. And I am especially interested if the film involves parenting or the formation of a family. Putting aside a desire to escape my life and enjoy the movie, I always wonder whether the actor’s personal experiences with infertility, ART or adoption will influence his or her choices as an actor.
To be honest, when DH proposed watching this film I had no idea what it was about. I was inclined to pass as I had a vague recollection that the film had not been a tremendous success at the box office. But when I heard that Katherine Heigl (who ranks #2 behind J.A. as one of my favorite female actresses) was one of the lead actors, I caved. And what a good decision that turned out to be!
The movie in question is “Life as We Know It” starring KH and Josh Duhamel (JD). You can check out a trailer at http://lifeasweknowitmovie.warnerbros.com/dvd/
In this movie KH and JD play the close friends of a couple who pass away, and who name KH/JD as their baby’s legal guardians. Romantic comedy aside, the movie is a fantastic and very realistic portrayal of the Leap, and how the relationship between the parents can change. As I was watching this movie, both my DH and I were struck by how much the movie reminded us of what it was like to suddenly go from being wanna-be parents to BOOM being parents.
I think the movie really resonated for me because I am an adoptive parent who had very little notice of our pending adoption and I had never really focused on what it would be like to be a parent (let’s face it I spent the entire time wanting a baby and never realistically envisioned what it would be like to have the baby and be a mom). Once the movie really gets past the characters’ acceptance that they are now parents, there are some very insightful moments about the reality of being a parent and how different that reality is from your expectations. Whether or not you take a baby care class as part of your adoption plan, I highly recommend this film because I think that it really shows you — and in a humorous, light-hearted manner — what you are in for when someone hands you that baby! From changing that first poopy diaper, to installing baby gates and midnight runs to the pediatrician, I think that Life as We Know It is a great primer for prospective parents through adoption or assisted reproductive technologies like gestational surrogacy.
Most people who have gone through infertility tend to have blinders on about the reality of parenting. Whether you only have 24 hours notice or ten months to prepare for your baby’s arrival, this film has some very poignant moments about what the transition feels like and what surprising issues parenting can present us with. Best of all it’s fun to watch. It is a surprisingly good romantic comedy, Josh Duhamel is total eye candy (and I won’t hold it against my DH that he thinks Katherine is eye candy too), and it’s sweet, has a happy ending and all that stuff. So if you are on your way to parenthood after experiencing medical or social infertility, I think this movie is a Must See.
And not to totally discredit my intelligence, my DS (Dear Son) has turned me on to SpongeBob SqaurePants. I had the unexpected pleasure this week (while cleaning up a child’s puke) of watching an episode of SpongeBob involving a baby scallop and SpongeBob’s experiences as a new parent. This episode of SpongeBob presents a similarly hysterical and informative perspective of what the Leap is like to being a full time SAHM. I can’t remember the title of the episode off the top of my head (I will check the DVR and post the name of the episode if I can find it), but suffice it to say that I could relate to SpongeBob’s adjustment to caring for a baby all day and all night while Patrick (his best friend) goes off to work every day as they simulate and satirize what its like to be new parents.
I totally and completely remember that in the beginning of my “maternity leave” I had a rough time. By Wednesday night when DH walked through the door, I was an exhausted mess. Thursday night, when DH returned from work and walked-in the door, I handed over DS and went upstairs to have a good exhausted-woman-cry-in-the-shower. By Friday night, I was prepared for the hand-off at the door, and upon hand-off I bolted out of the house to have coffee at Starbucks (decaf of course b/c I was breastfeeding).
So what am I getting at? “Life as we know it” as parents is very different from life as we know it while waiting for the Stork. I don’t really care whether or not you are taking baby care classes or infant CPR (although I think both are excellent ideas) because the reality of life as a new parent is vastly different than anything we can ever learn in school. As infertile prospective parents we tend to be so focused on our goal of becoming parents that we lose sight of what we are in for when we are parents. It is a transition the likes of which you just can’t understand until you are living it and why I call it the Leap. Life As we Know It and even (surprisingly) Master SpongeBob, have nailed it on the head and I highly recommend watching them (when I find out the title of that SpongeBob episode, I will post it and maybe you can find it somewhere and watch it). Both are totally and completely worth watching.
p.s. please note that I am not complaining about being a parent. I love every minute of this crazy, full-catastrophe life I am living! I want more kids and my attitude now is much more about enjoying and being mindful of the joy in this experience. I am just saying that these movies can help prepare you for the full-catastrophe aspect of parenting.
p.p.s. If you have any other movies that you think are good to watch as prospective parents, post them here. Maybe we can start a list of “Movies to Watch During the Wait”!!
Filed under: adoption, In the News, Infertility In The Movies etc., Infertility on Television, IVF, Peace to Parenthood, Personal Musings, The Journey to Parenthood, The Two Week Wait Care Package, Thinking Out Loud, Third-Party Assisted Reproduction, visualization
