By Zahie El Kouri
Two years ago on a rainy Tuesday in February, I spent several hours studying the Facebook profiles of female relatives who lived in Amman, Jordan, second cousins I had met only once ten years earlier. I was looking for a taller, sleeker, more symmetrical version of my physical self, someone who might consider being an egg donor.
When I joined Facebook, I had no idea it would be so useful in shopping for genetic material. Here, along with friends and acquaintances, were all the female relatives who liked me enough to “friend” me, conveniently displaying their photos in casual clothing, swimsuits, and formal wear, like a Miss Levantine Arab pageant in which they did not know they were competing.
As you might imagine, there are challenges involved in searching for an egg donor on Facebook. Just as I narrowed my cousins down to the two between the ages of 18 and 30 who were not married, I remembered that we had spent only a week together ten years earlier, and that I did not speak Arabic, and that I did not know how much medical English each of these young women spoke. I considered the logistical challenges involved in flying one of them to the United States for treatment, not to mention the dozens of transvaginal ultrasounds and needles involved, and I logged myself out of Facebook for the day.
I thought I had no intention of looking for an egg donor. I was sure that if IVF didn’t work out for me, I would turn to adoption. So why was I spending all this time trying to find my perfect genetic stand-in?
It all started with a well-meaning doctor. I had been through two rounds of IVF, one frozen transfer, and three miscarriages, and I was looking for a place to have either another frozen embryo transfer, or my third round of IVF. Three was all I could take, I had decided.
The doctor was a slight, young-looking Asian man who spent over an hour taking a thorough medical history, writing copious notes in blue pen on a stack of unlined white paper. When I described the last miscarriage, technically a chemical pregnancy, he nodded patiently, and said, “I see the problem.”
The doctor started a list on a fresh sheet of paper: the endometriosis, the miscarriages, the chemical pregnancy, and at the bottom of the list, he wrote the number 37, and next to it “Advanced Maternal Age.”
“As you get older, the percentage of aneuploid, or irregular, eggs increases,” he said, circling the number several times.
“So I would recommend doing genetic testing to see if you can gener- ate any normal embryos at all. Because if we do another round of IVF and we test the embryos, and because of your Advanced Maternal Age, none of them are normal, maybe you want to move to donor egg.”
“Actually,” I said. “I don’t want to do donor e-“
“No one wants to go to donor egg,” he said. “But it can be a really great option for someone of Advanced Maternal Age, particularly if you have a younger sister or cousin.”
I took a deep breath here. The doctor and I had just met, and he didn’t know my history. He didn’t know that, at this point in my life, whenever I heard the words Advanced Maternal Age and Donor Egg, I felt like the person using them was screaming YOU ARE A FAILURE. The doctor didn’t know that I dream of having my own sister or brother, someone who shares the common culture of my nuclear family, someone to mourn my father’s recent death along with me and my mother. He didn’t know that I was an only child, and, if I could have any children at all, would do almost anything to have more than one, so they could provide these things for each other. He didn’t know that during the first year after my infertility diagnosis, I was in a support group with several women who were trying to get pregnant using donor eggs. He didn’t know that I had already met with two adoption agencies and read several books on donor eggs and surrogacy. I knew that using donor eggs was an option, but I had already decided it wasn’t for me.
But that seemed like a lot to explain, so instead I said, “But I don’t have a younger sister, and I don’t have a cousin I would be comfortable asking.”
And the doctor said, “Are you sure? Because all women are worried about using a donor egg, but if you have a younger sister, you’d be surprised by how much DNA you share. My brother and I, for instance, are very similar, because we share so much DNA. It’s just a great way to preserve your genetics.”
He went on at some length about how lucky we were that modern science offered such a miracle as donor egg while I became progressively more despondent about my lack of a sibling who could donate an egg to me.
When I left the appointment, I told the doctor I would be in touch soon but I knew that I could not work with him. I cried all the way home, and then got under the covers with my puppy. This next round of IVF was my last chance to have a child who would be genetically linked to me, and, even more importantly, a child who would carry some of the genes of my father. But what was pushing me forward, since this path of assisted reproductive technology was so full of heartbreak? Was this drive to share genetics with my children a biological imperative? A complicated manifestation of love and belonging? I did not come to a conclusion in that moment. I could recover from the conversation with the doctor there, in my bed with my puppy, and I did not have to grieve my genetics yet. My next round of IVF could work, after all. But infertility and my father’s cancer had taught me to plan for the worst, and the doctor’s words were making me second- guess my decision about donor eggs.
I ran through the conversation with the doctor again. Was I sure I didn’t have a cousin who shared enough of my DNA to look like me? I thought through my family tree. I had lost touch with the first cousins on my father’s side who lived in the United States and couldn’t imagine reestablishing relations just for this purpose. I had lost track of my first cousins in Syria as well.
I turned to extended family, widening my search beyond the US I had one second-cousin in Italy who was hovering around 30, but there was no point in having her as an egg donor since she looked nothing like me, being blonde and button-nosed rather than dark- haired and Mediterranean-looking. I paused, peeking out from under the covers. Is that what was important to me? A child who was dark-haired and Mediterranean-looking? Well, if that was true, I knew where the good genes were. They were in Jordan, in the biology of the second cousins from the Palestinian-Lebanese side of the family, in the twelve or so female cousins who were the kind of women I might ask to play me in a movie.
It was that thought that sent me straight to my computer on that rainy day two years ago to spend the next few hours on Facebook looking at Jordanian cousins. I discovered that Facebooking relatives is the gateway drug of a donor egg search—when I decided that my relationship with my Jordanian cousins was too tenuous for me to ask one of them for such a gift, I found myself craving more and more donor profiles, and I soon found myself looking at donor egg websites.
Most of these are password-protected, and I wasn’t willing to admit to anyone that I was even investigating the possibility of considering using a donor egg in order to get a password, but I was able to find a few public sites with pho- tos of the young women interested in sharing their eggs. I did not immediately find a donor who looked like me among the featured profiles, which were mostly of women of Scandinavian or Anglo- Saxon origin, so I narrowed the search by ethnicity. I sorted for Middle Eastern and Arab women to reflect my father’s Syrian/Palestinian/Lebanese genes; I sorted for Italian women to reflect my mother’s genes; I sorted for Spanish women to reflect a possible combina- tion of the two. I expanded my search even further to include Persian women and Greek women, who did not look very much like me, but more like me than those of Scandinavian or Anglo-Saxon extraction.
I had no intention of actually going through with a donor egg cycle. Or did I? And if I did turn to an egg donor, did I want one who looked like me, or one who shared my ethnic or cultural heritage, since I was now assuming I couldn’t have both? Was there a rea- son I started my brief egg donor search with my beautiful Palestinian-Jordanian cousins? Did I secretly think that biol- ogy was a kind of golden ticket to being a part of the ethnic subcultures of the Middle East and Arab America? Do olive skin and dark eyes ensure the experience of dancing in a circle to the beat of the dirbekeh, of being a part of something?
My experience tells me no. Myprotean Mediterranean looks give me only a momentary sense of belonging to gatherings of Christian Levantine Arabs, of Greeks and Persians and Italians and Spaniard, but the sense of belonging does not last, since I am not really fully any of these, not raised immersed in any one language and cul- ture and set of traditions. Instead, what I have is an appreciation for the idea of belonging itself. So I don’t think my drive to have a genetically linked child is about being or looking Arab or Italian or Italo-Arab-American. Maybe it really is about the people who came before me, the people who made my parents and their parents and those beyond.
Every day I look in the mirror, and I look more and more like my father’s mother, the Syrian/Armenian woman who died long before I was born. I also look like my mother’s mother, who maybe had something Levantine mixed into her Venetian blood. There is some- thing powerful in this resemblance, in this connection to the past, a sense of history and belonging. Maybe it isn’t about intellect or rational thought, maybe it is about the visceral, the bio- logical drive for connection and continuity. Maybe having a child who looks like you satisfies this drive even if that child is not genetically linked to you. And maybe that is just as valid for those who need medical assistance in having a child as for those who do not.
A few months after my Facebook egg donor search, I got pregnant through my next round of IVF using my own eggs. My son’s looks change from minute to minute, but today, he has my Levantine eyes and my husband’s cupid bow mouth. Every day, I notice his beauty, and from time to time, I ask myself about it. Do I think he is beautiful because he looks like my husband? Do I think he is beautiful because he looks like me? Or do I think he is beautiful because I love him, because I am an attachment machine, because every day I wake up grateful that I no longer have to be sad about not having a child? I know the answer is the third of these options. I know that if we weren’t able to make him using my eggs, I would have grieved my genetics and moved on to adoption. I would have loved the child I adopted just as much as this child. I have no doubts about this. But I understand the drive to keep going past the third round of IVF, to make a child who looks like you and your partner and your parents. I understand the desire to move on to an egg donor instead of adoption, to have a child who looks like you even if that child does not share your genes. And I can easily imagine another version of myself, searching the internet late into the night, for months on end, looking for a girl with Levantine eyes, one who could act as bridge between the past and my future.
Double Take: Read another perspective on this topic: Matchsticks.
Author’s Note: I was inspired to write this essay by “Donor Agent Provocateur,” the April 8, 2012 Ethicist column in The New York Times. A couple wrote asking for advice about working with a fertility consultant to find an egg donor who matched some of the female partner’s diverse ethnic background, which was part ethnic Hawaiian. The consultant did not find a match, admitted that she did not search any Hawaiian donor agencies and refused to refund the retainer. The ethicist pronounced the behavior unethical but went on to give the couple a lecture about the ethics of looking for a racially similar egg donor. Perhaps the ethicist was trying to be kind and helpful, like the young doctor, like so many people who tell infertile women to “just relax,” but the idea that the couple who wrote to her hadn’t already thought about the complexities of race and donor eggs is the height of insult.
About the Author: Zahie El Kouri’s work has appeared in Mizna, a Journal of Arab American writing, Memoir Journal, Dinarzad’s Children: an Anthology of Arab-American literature, Brain, Child: the Magazine for Thinking Mothers, Garbanzo Literary Journal, Ars Medica, and Full Grown People. Her new e-book: Don’t Tell Her to Relax: 22 Ways to Support Your Infertile Loved One Through Diagnosis, Treatment, and Beyond, is available through Amazon, IBooks, Kobo, and Nook.
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