Oh such great neglect on the blog front! Apologies all around, but I’ll blame a consulting trip overseas to East Africa and getting wrapped up with friends in my ‘home away from home.’ In the midst of these travels, there has been some fabulous news on the fertility front. I think my last post on infertility (Baby Drama in the Single Lane) brought you up to speed on my struggles to date. To recap, four inseminations, 3 IVFs and 1 miscarriage within a 2 1/2 period had left me gasping for air with a very real sense of being doomed to fail. But given that I am a type-A personality, who doesn’t like to take no for an answer — after each disappointment, I got up, brushed myself off and forged ahead to the next step. What’s it going to take to make this happen and I’ll do it. I will admit that over time, I’ve become emotionally detached from the end goal of pregnancy and motherhood,which in a double-edged sword kind of way makes me feel like a bad mother. I don’t plan or think about what pregnancy might bring and I certainly can’t think about what happens if this doesn’t all work out. Surprisingly, I’ve discovered that I can compartmentalize just as well as any man. Honestly, the idea of never being a Mom or having my own family is too difficult to contemplate. And every disappointment chips a little more away of my hope and belief. If I crack open the door to the serious emotions, I’m afraid the door might be wiped out by a flood and I won’t be able to push it all back into the nice little compartment I’ve created. But the end appears near….
After the 3rd failed IVF late last year in the US, I wanted my next move to feel more definitive with win-win situation. My doctor proposed that I could attempt another IVF. Sometimes you get better quality eggs in another cycle, but I didn’t believe it was worth the financial and emotional risk. Which left me with three options: egg donor, surrogacy and adoption. Adoption is my last resort, so to speak. As a single woman in her early 40s, currently unemployed and unhoused I couldn’t even think of applying until I got those ducks firmly in a row, plus I could be looking at a process of 2-4 years. Surrogacy – I didn’t see the point, because the doctor keeps saying that he sees no reason why I can’t get pregnant. So that left donor egg. I struggled with it for a month. Since I am the only parent in this scenario, a large part of me really wanted that genetic angle. That’s my legacy, what could be carried on. Giving up that idea was tough. I also thought that now I would bring into the world a ‘different’ baby than the one I would have brought in using my own egg. A friend helped me to overcome this fear when she told me, “Margaret, your baby girl’s soul is up there waiting for you. It doesn’t matter how she comes – with your egg or someone else’s. It still the same soul.” I found that comforting, so after a month of dragging my feet, I opened up the egg donor database.
This egg donor database was established through my clinic, so it provided a limited group of 60 women, all between the ages of 22 and 33. The women are tested left, right and center for every possible health issue that impacts the reproductive system. The clinic provided an extensive family medical history, physical attributes, baby pictures and a full barrage of interview questions that explained the donor’s current job, likes/dislikes, personality traits, activities and why she’s a donor. It was more challenging to pick the egg donor than the sperm donor, because in this case I was looking for someone just like me. And let’s face it – it’s hard to find your own doppelganger, let alone someone close to that in a group of 60 women.
I finally picked one donor who turned out to be no longer available. Back to the drawing board. I thought I hit the jackpot with the second donor because she looked even more like me as a child. The clinic contacted her, she agreed and 48 hours later called back to say she had a family emergency and had to leave the state for 4-5 months. Ugh! Picking this donor was not a straight forward endeavor, but the third time was the charm.
Since I was traveling overseas, I decided to retrieve the eggs from the donor, fertilize and then freeze the embryos. There is relatively no difference in pregnancy success rates between live transfers and frozen transfers and freezing allows you to store the embryos until you are ready to go. So I authorized the medications for my donor and somewhere in the state of Colorado, a woman began injecting herself with hormones to ramp up egg production. I learned that the donor I selected had donated three times before (the max is six) and she also had 2 children of her own, so I was informed about her past history of egg production; ‘anticipate 18 eggs,’ the nurse told me. After having only ever produced 4 mature eggs myself, 18 would be like hitting the jackpot. So when the embryologist called to inform me that the total number of retrieved eggs was 35…well, I was a little dumb-founded.
One of the continual debates I had been having up to this point, was the ever present ‘Should I plan for the possibility of a man in my future? a.k.a. a man that wants children.” It’s the never-ending, hope at the end of a stick, what if scenario. What if I meet some guy down the road (ok, at least in the next quarter mile of the road) and we hit it off, become a couple and he wants kids? This dilemma presented itself to me in the form of a choice: I had the option to freeze some eggs and then fertilize the remainder which would be frozen as embryos. This would cater for that What if? factor. But it really depended on the total number of eggs and considering that ultimately, when the eggs are chosen for fertilization – you don’t know which eggs are the best and will ultimately end up fertilized. So it’s a bit of a risk on all fronts. In the end, I chalked it up to “Carpe diem!” and fertilized the whole batch.
It’s amazing to think about the technology around fertility these days and what’s possible. At the same time, it’s also disturbing to watch nature take its course, implementing it’s own survival of the fittest and decrease the odds in diminishing returns. My first report from the embryologist was the number of eggs retrieved (35) and the number of mature eggs that could be fertilized (25). By day three, the embryologist sent me a report outlining the number of eggs that had survived fertilization (19) and were now multiplying as expected. The cell count should divide and double each day. I was told how many cells each embryo had, as well as the level of fragmentation. Ideally, you want the embryos to have less than 20% fragmentation in this process. Of the 19 embryos, 17 were meeting the ‘good quality’ criteria for day 3. The goal is to take the embryos to blastocyst stage which usually occurs around day 5/6. It’s at this point the embryos are frozen.
My final report came on day 6. On this day, each of the embryos is given a grade just like the chicken eggs – which I actually find kind of funny. It’s a double grade – AA followed by AB, BA and BB. Obviously, AA is the best, but anything else in that grade range is generally considered good quality. By day 6, I had 13 lucky little embryos. Now they sit, frozen and waiting for a chance to become something. Given that the transplant will likely only involve 2 embryos at a go, there are possibilities ahead. It seems motherhood is fast becoming more of a reality! Liftoff this summer…stay tuned.