Archive for the ‘Age and Infertility’ 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
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
March 28, 2011 | By: Liz
I am getting over a pretty nasty bought of pneumonia. And as a result, I have had a lot of time to think.
To think about everything that I should be doing in the office but can’t. To think about everything that I need to be writing: my e-book on egg donation is pretty much finished but I haven’t had time to input the final edits or to speak with my design and production team about getting it ready for the marketplace; I have an article on egg donation and surrogacy contracts that is due to the American Bar Association in a matter of days; I have to talk to my publisher about revising The Infertility Survival Handbook; I want to write a blog about a RESOLVE event I co-hosted on March 24th at Bis.Co.Latte Cafe in NYC regarding the legal issues egg and embryo donation; and oh yeah I am supposed to be teaching a class on third-party assisted reproduction at a law school and I have to prepare the syllabus (that one may not happen).
To think about all the contracts that I need to draft and edit for clients.
To think about the new series of blogs I am working on (perhaps it too will become an e-book?) on the mind-body connection in dealing with and resolving infertility. Thanks to a Facebook friend, I discovered a wealth of information on something called “Conscious Conception.” I have a ton of research to do on Conscious Conception, it is a seed germinating in my mind and something I very much want to talk about. Just this morning I was staffing out work in the office and we got into a long conversation about how much I believe faith plays in people’s ability to deal with and overcome fertility.
And yet, all I am capable of on this gorgeous sunny day is to THINK about the overwhelming amount of things that are filling my proverbial plate. I am utterly and completely without the ability to deal with any of it today. For today my goal is to be able to breathe. One of the fundamental things in life which I must attend to if I am going to get back to these things, yes? Yet, instead of recognizing the very important need to take care of my own health, I have been beating myself up for my inability to do my work. I feel like I am drowning, literally and figuratively.
It was only upon stumbling across an issue of the Wellesley Alumnae Magazine and its cover article about “When Life Doesn’t Measure Up” and reading about how, when and why so many of my fellow Wellesley sisters feel like failures, that I realized that I feel like a failure for having pneumonia and not being able to do my work. And with that thought, I was off and running on a journey of self-analysis that of course brought me right back to the world of fertility and the feelings of failure that come with it.
Apparently, my college magazine conducted some kind of a poll asking graduates to discuss their feelings about their satisfaction with their life and feelings of inadequacy, failure, or success in a variety of different contexts. I don’t recall receiving a questionnaire in the mail or an email like this — must have missed out on contributing my own thoughts to this very profound poll. The reasons women gave for feeling like a failure were incredibly diverse. And yet, despite the very diverse reasons or situations my Wellesley sisters gave when describing their own issues with failure, including dealing with chronic illness, the article did not mention infertility or an inability to have children (or the choice not to have children) as raising issues of failure. Certainly, someone among the thousands of Wellesley graduates has experienced difficulties conceiving and must have felt like a failure. I did. I do. Why didn’t someone else talk about it? The Dixie Chicks talk about it in their song “So Hard” . . . a ballad that haunts me every time I hear it. It’s all about the feelings of failure and loss we have when we can’t conceive. One out of every 8 Americans is dealing with infertility. Why didn’t the Wellesley College Alumnae Magazine talk about it? Especially at an all women’s college, you would think that a topic like infertility and failure related to something so integral to being a woman would be recognized and not continue to be shrouded in secrecy. The article talked about the shame my sisters felt about their various failures, the secrecy that surrounded them but infertility was not among them. What gives?
The secrecy and shame surrounding infertility is pervasive. Just as for my sisters who are wrestling with their own failures of a different nature, the article pointed out that all of them felt better by talking openly in the article about failure and its impact on their self-perception.
Indeed, the magazine itself was often a cause for Wellesley alumnae to feel failure. By hearing about the success stories profiled in the magazine many women admitted that they felt that they had let down the school or that they failed to measure up to the “Wellesley standard” of being or becoming another Hillary Clinton. The article concluded with the following statement:
“But maybe what we don’t know is what failures happened to those women before they became household names that eventually brought them to the point of celebration. And until we hear those stories, too, we can’t begin to make new templates for success that acknowledge the inclusion of failure as part of a life well-lived.”
And this leads me to the following conclusions:
Until we hear stories about our feelings of failure and inadequacy arising from our infertility, and our subsequent success at overcoming them, we cannot begin to make those new templates for success that acknowledge how much stronger or sensitive we have become as a result of our infertility.
Until we hear stories about our feelings of failure and inadequacy arising from our infertility, we cannot begin to find faith that our own journey will end in success. We need to be inspired by the success of our sisters (and brothers) who have gone before us and achieved that which we long for — a baby — even if that success means embracing an alternate route to parenthood such as surrogacy, egg or embryo donation, or adoption.
It is, as my Wellesley sisters say, in embracing the loss in which we gain the faith to succeed. I wish there was no stigma to being infertile but I must confess that the lack of mention of infertility in this article really drove home for me the sense of the overwhelming stigma with which we live. I have a serious issue with the Wellesley Alumnae Magazine for not bringing to light a discussion of how failing at something as intrinsic as becoming a mother can be so devastating to our sense of self-esteem, to our marriages, and to our sense of failure as a woman. (I cannot fathom that not one woman responded to that poll and didn’t mention infertility and if that was the case, I am even more troubled by the statement that makes regarding how much we hide about our infertility).
Learning from others who share their own shame or other sense of failure about something with which we are all supposed to be able to do — conceive, carry and give birth to our children — is what will carry us through. For others it is not necessarily biological or medical failure but a sense of frustration at being unable to conceive because we lack the essential components — we are socially infertile. And learning from others who find ways beyond our social infertility will give us ideas and strength for achieving that which our sexual orientation precludes us from obtaining.
And as the wheels started turning and hit overdrive as I considered the article and my own sense of failure because I have pneumonia and am unable to work (and am thus letting down my clients to whom I truly want nothing more than to help have a child), and considered once again the stigma with which we live, I couldn’t stay silent. I pulled out my laptop and curled up in bed to “think through” this article and my situation and put together the pieces of this puzzle. My blog will now not only be devoted to discussing the concepts behind Conscious Conception, but it will be devoted to de-stigmatizing this disease. I know there is a Wellesley sister out there somewhere who is struggling to defeat the NOvary™ or endometriosis, to locate a birth mother, to navigate the increasingly complicated red tape of Ethiopian adoption, or to find a way to establish the fact that she and her partner are both the legal mothers of the child one of them delivered and which they intend to parent together.
So in my failure of having pneumonia, new ideas and inspiration have been born for my blog and thus my day has turned into one of celebration. And I ask you to please not be silent. I took the pledge with RESOLVE not to remain silent and today my failure in being human and having pneumonia has given me an idea of how I can fulfill my pledge to RESOLVE. My blog is a safe place where I hope to support people walking with me on this path, and to provide the occasional nugget of legal or medical information to move us another step forward on the path to parenthood. And thus I ask you to talk about your shame. Talk about your sense of failure. Talk about your frustration, your anger or confusion. (And if you are a Wellesley alumnae, help me convince them to let me write an article about infertility). Share your story here wherever you may be in your journey. And I will try and find people to share with you how they conquered the NOvary, endometriosis, found birth mothers, survived the red tape of Ethiopian adoptions, or proven their joint parentage.
Because I know that if we continue to be silent and give in to this crazy stigma, we will never know what failures happened to those women (and men) among us before they became mothers (and fathers), and that eventually brought them to the point of celebration. And until we hear those stories we can’t begin to make new templates for success that acknowledge the inclusion of infertility as part of a life with children.
And now for some random FAQ’s and reminders:
Yes, you can establish your parentage if you are a same-sex couple and one of you has a baby. Depending on where you live the mechanisms for doing this will vary. In some states you can file a legal action to have your parental rights established, in other states you may need or want to adopt (even if you are not married). In some States and in some circumstances you may need or want to do both.
If you have a functioning uterus, egg donation is perhaps the most successful route to pregnancy for women who have issues with the NOvary™. At many clinics, with a properly screened egg donor, live birth rates per egg donation are in the 60% range. Yes, you read that correctly, you could have a 60% chance of conceiving a baby using an egg donor. And among those that conceive using an egg donor, the rate of twin conceptions is in the 40% range (making a strong case for single embryo transfer).
If you are considering adoption but have financial concerns or are worried about wait times, relinquishment risks, or red tape, embryo donation is a rapidly growing path to parenthood. Using embryos donated from another family who has cryopreserved embryos which they no longer wish to use to build their own family, you may have a 40% chance of conceiving a child. In addition to the affordability of embryo donation and the high success rates, you have the opportunity to carry the child, control the uterine environment, and may have the ability to conceive more than one child (this will depend on the type of embryo donation you enter into, as well as the number and quality of the embryos donated to you).
If you don’t have a functioning uterus, gestational surrogacy is another option for becoming a parent. Using either your own gametes (genetic material), or an embryo created from egg or sperm donation (or sometimes both), another woman can carry a child for you and you will have all legal and parental rights upon that child’s birth. Surrogacy laws vary by State, and it’s far from inexpensive, but when done correctly, surrogacy is a wonderful means of building a family.
And let’s not forget what is now almost considered boring: IVF. If you have a viable uterus, eggs and/or sperm but for other reasons have difficulty conceiving on your own, with the assistance of In Vitro Fertilization, your chances of conceiving get better every day. With the improvement of the culture medium used to nourish embryos, together with advances in reproductive medicine, some families will have as high as a 70% chance of conceiving. Although the vast majority of families using IVF will need more than one attempt before conceiving, this is a technology that should not be ignored.
Other things to consider are:
PGD, (Preimplantation Genetic Diagnosis). This enables you to select only those embryos that appear chromosomally normal for embryo transfer in an IVF cycle. For older infertility patients, those with a family history of hereditary illness, or those with recurrent pregnancy loss, PGD can increase your chances of conceiving a healthy baby.
ICSI, (Intracytoplasmic sperm injection). This is where doctors inject the sperm into the egg to help facilitate fertilization. For families with male factor infertility this can help side-step problems with sperm that might prevent it from fertilizing an egg.
DNA Fragmentation Assay. This is a test performed on sperm to determine whether the sperm are chromosomally normal. Although there is a large range of “grey area” where it is unclear whether the sperm are going to cause problems with conception or pregnancy loss, this is proving to be a very important aspect in solving cases of recurrent pregnancy loss, IVF failure, or otherwise diagnosing “hidden” infertility issues.
Blood Clotting Disorders and other immune issues. Do you have unexplained pregnancy loss or IVF failure (with an egg donor)? Go get a work-up from a hematologist or other doctor specializing in diagnosing harder to find infertility issues. Sadly many physicians routinely overlook or discredit the influence or impact of blood clotting and/or immune issues on the ability of an embryo to implant in the uterus, or to the ongoing development of a baby.
Are you going to stay silent, or are you going to talk with me here about what you are feeling, what you are trying to do to overcome your infertility, or what you did that helped you overcome it? Speak. If not here, then find somewhere. Please.
Filed under: adoption, Age and Infertility, Deadly Silence, Egg Donation, Faith and Infertility, IVF, Peace to Parenthood, Personal Musings, Recurrent Pregnancy Loss, Sam Sex Parenting and Reproductive Law, The Journey to Parenthood, Thinking Out Loud, Third-Party Assisted Reproduction, Treatment, Uncategorized