It has been 5 days since my retrieval and I am patiently (also anxiously) awaiting our final results. I have been sitting with my fertilization results for a number of days, not because they were bad but they triggered me pretty bad.
During our last cycle the attrition went like this:
13 Retrieved -> 12 Mature -> 10 Fertilized -> 2 blasts on day 5/6.
(I have been saying 1 blast actually, because the second blast was not rated something they’d normally even keep – I think they transferred it just as a hail mary).
We did a double transfer and nothing stuck. I got my period promptly on the day of my beta, and I knew I was out of the game.
This cycle I have been flip flopping between hope and despair. I am so fucking afraid that the same thing is going to happen. Having a repeat of last time despite all the changes we’ve maid is absolutely terrifying. If it does, this is our last cycle using my eggs. We have already began the process of looking at donor eggs (I’ll share more on that process below), and reading into the complexities and ethics of gamete donation. It’s a lot. The emotions this time are massive as a result. It’s like standing on a fence post and the smallest gust of wind can throw you on one side of the fence or the other. It’s completely out of your control and has the ability to completely change the direction of your life. Scary. Ass. Shit.
So here we are. I got my fertilization results the morning after my retrieval.
14 Retrieved -> 13 Mature -> 10 Fertilized
If the number was 9, or 11, I’d probably feel good. The fact that the number was 10 just threw me for a loop. One was not mature, like last time. Fertilization rate was slightly less percentage wise. This time we used ICSI again, but my husband did a 12 hour abstinence, instead of 2-3 days as normally recommended. Lower abstinence can result in less sperm, but it can prevent DNA Fragmentation which can be a cause of embryos dying off by day 5/6 or not implanting/developing properly. We also did Zymot, which is a chip/cartridge like thing that they drop the sperm into, and the ones who make it through are deemed the most fit/normal. It is supposed to help a lot as well. Yet the fertilization rate was slightly less at 76% vs 83%. Nervvvvves. It’s small but it still gets me after all this emotional trauma of infertility. Logically, it’s fine. Emotionally, it’s scary.
I am trying to counter my emotions with logic but I just can’t this time around. I refuse to fiend toxic positivity and hope because it’s just not how I am feeling. I am readily preparing for a call tomorrow that breaks me, and also preparing to call my clinic to begin our application for donor eggs. I’ll also note my car broke down last week, and is in the shop, and I got sick after my retrieval so I am a grumpy sniffly mess over here. A grumpy, sniffly, poor mess.
The biggest thing I am grappling with right now is financials – we’re very very lucky that we can use my husband’s income to support us on a pared back lifestyle right now and use my entire income (my ENTIRE income) to support our IVF journey. However, I have used all of my income I made this year on this process, and as we stare the donor egg scenario in the face, we are left wondering when is enough, and how the hell we’re going to afford to go this route. Our mantra has been “You can always make more money”. It’s true. But it’s anxiety inducing nonetheless. If we move ahead in that direction, I’ll be borrowing from next year for the hope of a baby that isn’t even genetically mine.
I’ll update you all in the coming days whether we get anything from this cycle or not.
So let’s talk donors. A LOT of people go into donor conception as a last resort. They are so drunk on the idea of a BABY that they don’t bother looking at the complexities around donor conception. It is one effed up industry, first off. But it does allow infertile couples, LGBTQ couples, and single parents by choice the option to grow their families if adoption isn’t for them. I’ll preface by saying adoption is absolutely for me, but we’re not ready for that yet – it’s part of my long term plan though, likely regardless of the outcome of IVF – it has been since I was a child. I always said I wanted to adopt one and have one. But adoption isn’t always ethical either, nor easy, simple, best for the child. So we were faced with what path to take now at this period of our lives and the donor route is it if it comes to that. We will also do the work to prepare ourselves for adoption one day if life allows, but it’s not a cure for infertility and there’s a lot of self work that has to happen before we consider it.
Donor conception can come in a few forms. Egg donation (from a known donor, a fresh donor or a frozen donor, and either a non-ID donor or an open-ID donor), sperm donation (similarly from a known, fresh, frozen, non or open ID donor), or the even more complex embryo donation (often non-disclosure, but sometimes known/open).
In Canada, it is illegal to get paid to donate any of the above, but you can reimburse the donors expenses related to donation – this more so applies to egg donation since it entails a retrieval like I just did, down time from work, travel, etc. But it’s super hard to find donors in Canada as a result. Most of the fertility clinics work with US cryobanks, which offer Sperm, Eggs and Embryos which can be bought, essentially. They also don’t come cheap.
The purchase of donor products is complex because the banks are poorly regulated on the number of times a person can donate (guidelines exist, but I’ve seen many stories where guidelines have been ignored), it’s hard to track if a person goes to multiple banks to donate, and thus hard to control the number of offspring from a single donor (this is a negative when it comes to the donor conceived person’s opinion in many cases, as it is jarring for them to have 50+ siblings across the world with new ones popping up each time). It is also harmful for egg donation especially to do more than 6 retrievals. It can effect the person’s fertility down the road, whether they want to birth their own children or not, it can cause medical complications at a higher rate, such as OHSS, and the procedure itself comes with risks which are often downplayed. Lots of donors do so not due to altruism, but due to the financial gain so they can pay for school or their bills (many are young, around 20-25 and need the money). One bank I looked at that my clinic partners with had all donors of Russian and Ukranian descent, which I felt was not a simple coincidence given the state of affairs in those countries. I could not find any donors of other backgrounds that matched my own.
Another consideration when going the donor route is how your child will feel as they grow up, and learn of their conception story. Many children have no qualms about it (hell, I basically had a sperm donor), but some do, and you have to be prepared for this. Best practices for donor conceived people include having an open knowledge from birth of their conception (age appropriate), and it’s absolutely best if the child knows who their donor is and has the ability to find them as they grow older – much like adoption. This tends to be a challenging thing for some donor recipient parents to deal with – the possibility that their child may also see their donor as a parent, as their “bio parent” and may want to harbour that relationship. Many donor conceived children want to at least reach out for medical history (although for egg donors anyway, a detailed history is provided but of course things can change). They may inherently seek out the genetic mirroring that a bio relationship provides, and they are likely to want to know their bio siblings.
Something that comes up when you want more than one child from a donor egg or donor sperm is whether the same donor will be available for multiple cycles – if you want your child to have a full biological sibling. This is often complex as you don’t know how many batches of eggs, vials of sperm, or embryos it will take to result in a live birth. And once again, that shit is expensive!
How expensive?
Last I checked a cohort of eggs (6-7 eggs) runs around 18-21k USD. That often guarantees you either two good blastocysts or one euploid blastocyst. No guarantee they will work though. Many cryobanks offer a guaranteed plan which runs around 35k USD, but you need to qualify for this based on your medical history, lining thickness, sperm quality, etc.
Sperm is a lot cheaper, around 1100-2500 CAD depending on the bank.
Embyro donation varies, and I know less about it, but usually the embryos are leftover from other couples who did IVF to grow their families and who did not wish to discard the embryos. Your child would thus have a full biological family outside of your own, much like adoption. The complexities of adoption often apply to this form of donation or “adoption” as it can commonly be referred to.
If you have a known donor, it is important to ensure they are comfortable with the possibility of the child pursuing a relationship down the line. There would be no financial ties for the donor, but it’s absolutely possible the child may want contact. And it’s always recommended that the child knows as much about the donor as possible so they can create their own self-identity around their existence. Same goes for the donors current or potentially future children (the donor child’s siblings).
Not everyone cares about these complexities. It’s easy to shut your brain off to them when you have a dream for a family. But I urge anyone considering donor conception to sit with these things for a while, and understand that it’s not about you, it’s about the child and the donor. Always. Some questions to ask if you’re considering donor conception:
- Why did the donor donate?
- Who is benefiting from the donation?
- Are they open to a relationship/are they open ID? (realistically, with DNA testing it’s very likely even non-ID donors will eventually be found, but it’s better to know from the get go)
- What are the traits that are most important to you and why? (height, hair colour, eye colour, medical history, lineage, ethnicity, education, etc.). Do they truly matter? How will your child possibly feel looking different from you or your partner?
- How many times has the donor donated?
- How many known siblings exist?
- What is the max number of donations the clinic allows? How do they ensure this isn’t abused?
- Do you want a full bio sibling for your child?
- Do you possibly know someone who could altruistically donate to you instead of purchasing eggs, and are they fully aware of the possible ramifications of the donation? (many donors don’t want kids, so they donate their eggs, but end up having “children” who want to know them anyway).
- Will your child know other DC children or will they be the only one?
- How will you navigate things if your child feels bitterness or resentment due to donor conception? It’s hard to hear the tough stories sometimes, but listening to donor conceived people is crucial if you go down this path.
So there’s my TED talk on donor conception. We’ve grappled with all of the issues and I have sought out guidance from donor conceived people about best practices for choosing a donor, a cryobank and how to navigate this next step should it be part of our path. I’ve had a couple of close friends take this path, and it has been eye opening to say the least!
I’d love to hear of any other considerations or resources you’ve found in your own journey if donor gametes are a part of it! Here are some I have found:
Resources:
Donor Conception Canada: https://dccanada.org/
We Are Donor Conceived: https://www.wearedonorconceived.com/
Donor Sibling Registry: https://donorsiblingregistry.com/
Parents Via Egg Donation: https://www.pved.org/
Donor Conception Network UK: https://dcnetwork.org
Donor Conceived Community: https://donorconceivedcommunity.org
Some articles:
How Do Individuals Who Were Conceived Through the Use of Donor Technologies Feel About the Nature of their Conception?
Shifting to a model of donor conception that entails a communication agreement among the parents, donor, and offspring
Donor conception and children’s rights: “First, do no harm”
Starting Conversations: Donor Conception Resource List
I used donor eggs. A few things I realized is to find out how many they have donated. Using a first time donor from the US is not recommended, especially if they don’t have a passport. I learned that the hard way. Our first donor backed out the day she was to fly to our clinic. We also wanted an open donor that would be cool to meet with any offspring. We did choose one donor but she was eliminated by our clinic for donating too much.