What’s in a Gene?

What’s in a Gene?

By Alexis Wolff

whatsinagene“The geneticist is going to look at this and freak,” a woman who introduced herself as Veronica told me as we sat across from one another in her Manhattan office. On the coffee table between us sat my application, which I had been instructed to complete at a desk by the receptionist, even though I’d mailed in an identical one several weeks before. This new application sat opened to a grid where I’d filled in information such as the height, weight, hair color, and eye color of my sister, parents, and maternal grandparents. I left blank the boxes devoted to my paternal grandparents. I’d never met them.

“Let’s try to fill some of this in,” Veronica said, “or else the geneticist is going to have some trouble doing her job.”

“Well,” I apologized, “I’m not sure I know any more than what I put.”

“We can just estimate.”

I shrugged.

“So your dad’s mom,” Veronica continued. “Would you say she was small, average, or large?”

“I have no idea.”

“What would you guess?”



“And her hair color?”

“Maybe brown?”

And on we went. When we finished, Veronica flipped through the rest of my application, in which I documented my interests and talents, my ethnic heritage, and my personal and family medical histories.

“You’ve got a great profile,” she said, glancing up to look me in the eye. “I could match you in a day.” I supposed that was a compliment.

Veronica put down my application and shifted back a bit on the couch. “So,” she asked, “what made you interested in egg donation?” I hesitated. I knew that I couldn’t tell Veronica the whole truth. My interest dated back a few years to when I was a junior in college and the writer Gay Talese spoke to my English seminar class. The week before, we’d read Talese’s classic profile of Frank Sinatra, which Esquire had recently dubbed “The Greatest Story Ever Told.” We’d sat around the circular oak table discussing specific passages and techniques like peewee league football players watching Super Bowl clips.

A week later, Talese stood before us, wanting to hear about the pieces we intended to write. A sophomore named Lily spoke about the frequent ads in the Yale Daily News promising five-digit payments to egg donors. She said she didn’t understand why a woman would subject herself to such an invasive medical procedure, even for so much money. Talese nodded intently as Lily explained that she planned to interview donors and recipients to understand the process better. When she finished, Talese offered his advice: donate your eggs.

We knew that this kind of first-person participation was a central tenet of New Journalism, yet we chuckled. We were merely students, after all, just toying with the idea of being writers. We loved to read about Talese stalking a sick Sinatra after the singer refused an interview, or abouthim tagging along with members of the notorious Bonanno crime family for his 1971 bestseller, Honor Thy Father, but we wouldn’t have dared try either ourselves, and the thought of donating eggs just to get a good story was preposterous.

Two years later, I’d graduated from college and committed myself to being a writer. I was living in New York City—the same city as Talese, but in a far different world. I’d published a few essays for twenty five or fifty dollars, but professional success was nowhere in sight. As a graduate student with over sixty thousand dollars in debt, and more coming, money was a problem. So when I saw an ad online offering $8,000 for my eggs, I was tempted. I thought of Talese. I could use the money, but more importantly, I could use the story. But I knew I couldn’t tell that to Veronica.

“In college, I always saw ads offering tons of money for egg donors, and I told myself I’d never be a part of that,” I began. “It seemed like they were trying to genetically engineer a perfect child. But I noticed in your ad that recipients know nothing about donors except that they’re healthy and have similar ethnic backgrounds, which makes me think they’re seeking egg donors because they really need them.”

I didn’t say explicitly that I wanted to help such couples, but that’s what Veronica heard.

She nodded excitedly. As she expounded on the rewards of knowing you helped an infertile couple start a family, I felt a little dirty. I admired people with such motives, but for me, at least at this point, donating was about what I’d get rather than what I’d give.

I studied Veronica as she spoke. She was probably ten years older than me, wearing a mauve button-up shirt with shoulder pads. Her lips were painted a shade lighter than her shirt, and her eyelids a shade lighter than her lips. I thought of the advice I read once in a fashion magazine—makeup should match your coloring rather than your clothing. I wondered whether Veronica was judging me too. “So what I’m going to do now is tell you a little about the process,” Veronica said. I nodded as she recited, confidently and precisely, the evolution of in vitro fertilization from a procedure performed with a woman’s own eggs to one that frequently employs eggs from donors. As a donor coordinator, she’d surely given the speech dozens, or maybe hundreds, of times before, but her warm smile made me feel that she was truly excited to tell me.

The American Society for Reproductive Medicine (ASRM) estimates that donating my eggs would take approximately fifty-six hours over about two months, Veronica told me. It would begin with a series of physical, gynecological, and psychological examinations to determine my eligibility. Once I passed and was matched with a recipient couple, I would receive an injection to halt the normal function of my ovaries. This would help control my response to the fertility hormones I’d have to inject for ten days, and allow my cycle to be coordinated with that of the recipient.

I thought about that recipient. She’d likely be coming to the clinic the same days as me, maybe even at the same time. I knew I’d be looking around at the clinic’s other patients and wondering who would receive my eggs, and I guessed she’d be searching for me too. I began to feel fond of her, whoever she was.

On the coffee table, Veronica set a glossy black and white paper facing me that showed ten small and seemingly identical slides. The replication made it look looked like Andy Warhol’s version of an ultrasound.

She pointed to six dark blurs in the last slide. “Here we see six mature eggs,” Veronica said. “Look here and here and here and here and here and here.” I looked. Normally, a woman develops and releases only one egg per month, she explained, but under the influence of fertility hormones, multiple follicles develop. I pretended I could see the difference between this slide and the one before it. Pictures like these would be taken of me too, she continued, because after I began taking fertility hormones, I’d come to the clinic early in the morning every few days so ultrasounds could monitor my eggs’ progress.

“Since you’re young, you would probably have even more eggs than this donor,” Veronica said. Most women on fertility hormones produce as many as twenty-five or thirty mature eggs per cycle.

Veronica set another glossy paper before me, this one a color cross-section illustration of the female sex organs. The image looked only vaguely familiar, like something I was supposed to memorize in ninth grade biology. Veronica explained that when the doctor decided the time was right—just before my eggs would have released into my reproductive system—he would inject me with another drug to prepare them for retrieval. After sedating me, he would insert a needle up through my vagina to coax them from their follicles. After I left his office, my eggs would be mixed with sperm and incubated for three to five days before being implanted into the uterus of the recipient.

I’d already read about this process, but hearing it aloud made it more concrete. This was really going to happen. A part of me was going to become a part of someone else—that amorphous woman I had started to feel affection for. I really did want to help her. Still, the thought of giving away a part of myself to a stranger made me feel a little uneasy.

“The procedure can be done in fifteen minutes, and it definitely shouldn’t take longer than an hour,” Veronica said. “And because you’ll be given a sedative to help you relax, we ask that you have someone to accompany you home that day.”

I froze. That was going to be a problem.

I hadn’t told anyone about this meeting, not even my boyfriend, and if I ever told him, I couldn’t imagine doing so until after I completed the procedure. I knew that he, an internal medicine intern at a hospital just down the street, would shake his head in disapproval and tell me that money’s not everything, that a good story’s not everything. Then he’d invoke medical jargon to make his case for what a bad idea this was. He’d remind me that it was possible (albeit extremely unlikely) that the fertility drugs could over-stimulate my ovaries and require me to be hospitalized, and that the retrieval procedure could (in even more rare cases) result in an infection that could affect my future fertility. I suspected that by reiterating the risks, my boyfriend could talk me out of it, and I wasn’t sure I wanted to be.

“Oh, and one other thing,” Veronica said. “The day of the retrieval procedure is when you’ll get your check.”

I’d already done the math. The $8,000 payment I would receive for approximately fifty-six hours of my time worked out to just under $150 per hour—ten times more than any employer seemed to think I was worth. My boyfriend’s objections aside, I’d have to give this some serious thought.

On my subway ride home, I sat across from a woman who looked seven or eight months pregnant. I stared at her swollen belly and then followed its curve up to her glowing cheeks. She noticed me and smiled. I grinned back. Then I tried to imagine if the exchange happened a few months down the road, after I underwent the procedure; I wasn’t sure the moment would have felt so sincere. Would I wonder if it was my baby the woman was carrying? Would I wonder this about every pregnant woman whose path I crossed, and later, about ever baby, every toddler, every child? Was that anxiety worth $8,000?

It was certainly a lot of money for not a lot of work. In Canada, Australia, and parts of Europe, offering money for donor eggs is illegal. In Germany, Norway, Sweden, and Japan, the use of donor eggs in IVF is forbidden. The United States is, in fact, the only major country with no national policy on IVF, even though nearly 41,000 children were conceived via IVF in the United States in 2001—6,000 from donor eggs. The United Kingdom, on the other hand, not only has a policy but a federal agency—the Human Fertilization and Embryology Authority—that, among other things, sets caps on payments to egg donors.

In the U.S., the price for donor eggs has increased tenfold since the mid-1980s, when donors received about $250 to compensate for their time, transportation, and other incidental costs—about $4.46 per hour, a dollar and change above minimum wage. Donating back then didn’t have a significant financial incentive; most early donors acted out of altruism. Most donors still act out of altruism, Veronica led me to believe, but as time passed and the demand grew, donors began to expect compensation not just for practical sacrifices but also for the emotional burden and medical risk associated with donating.

Today, payments average between $1,500 to $3,000 dollars, depending mostly on the location of the clinic. In major metropolitan areas, payments are higher. Highly desirable donors—Ivy League students, models, athletes, accomplished musicians, and so forth—are frequently promised even more. Offers of tens of thousands of dollars are not uncommon, though some infertility experts maintain that advertisements like the ones Lily noticed in the Yale Daily News are usually not legitimate. Women who respond are often told that the ad has been filled but that other recipients are still seeking donors. These other recipients, however, always seem to offer substantially less money. As an Ivy League graduate living in Manhattan, I would be compensated well above the national average for my eggs. Given my doubtful professional situation, it felt nice to have someone recognize my worth, even if she was a faceless IVF recipient.

Two weeks later I was back at the clinic, this time to meet with a psychologist. Dr. Jones (as I’ll call her) led me to the same office where I’d met with Veronica. She sat down, crossed her legs, and set a white legal pad on her knee. “So, what can I do for you?” she asked.

I was taken aback by her question. I explained that I’d met with Veronica about the possibility of becoming a donor, and, as I understood it, this was the next step. Nodding, Dr. Jones explained that donors usually undergo physical evaluations first, but after looking over my application, she wanted to meet with me.

“Do you have any concerns about being a donor?” she asked as if she already knew I did. I could have easily recited Veronica’s speech about the virtue of egg donation, which I could relate to now more than I expected I ever would, but I remembered my reaction to the pregnant woman on the subway and decided to be honest. I told her I worried that I might suspect every pregnant woman I saw of carrying my baby.

“That’s a very real concern,” Dr. Jones said. Although my future feelings could not be predicted, she said, how I ultimately felt about donating was likely to be related to how I now understood my role in the procedure. Donating was more likely to be a positive experience if I believed I was giving a piece of myself for the possibility of life, and if I believed that my involvement ended there.

“What do you mean by ‘possibility’?”

“Success rates for in vitro fertilization with donor eggs are about fifty percent,” she said.

I was shocked. I knew that success rates for IVF with a woman’s own eggs hovered around thirty percent, and I knew that using a donor’s eggs increased the chances of success, but I assumed the increase would be more significant. To my surprise, I was also relieved. After the procedure, it would be just as likely that someone wasn’t carrying a child conceived from one of my eggs as that someone was.

Donating might be a negative experience for me in the long run, she added, if I believed a child with my genes was my child.

“I wouldn’t want to find the child and claim it,” I clarified. “It’s just that there might always be a latent curiosity.”

Dr. Jones suggested we table this issue and move on to my family history. She asked about the abnormalities in my parents’ histories documented on my application (both of them). I told her the details without much emotion; after all, I’d recited the information at nearly every doctor’s appointment I’d had over the last decade. I told her that my mom had battled cancer twice, first of the breast and then of the cervix. Dr. Jones seemed alarmed, both by the rarity of those two types of cancer afflicting the same person and by my nonchalant recounting of it. But to me it was just an empty fact: I didn’t remember my mom being sick, and now she was completely fine. When Dr. Jones asked if there was anything she should know about my dad, I chronicled, just as flatly, that he’d become addicted to cocaine when I was two, divorced my mom when I was three, lost his law license when I was ten, was homeless for a while, and then, when I was seventeen, became a used car salesman.

“Is he clean now?”

“Well, he’s held the same job for five or six years, so I think he probably is. But you never know, do you?”

Then Dr. Jones wanted to know about my sister. I mentioned her allergies and her attention deficit disorder, for which she’s been treated since third grade. Dr. Jones wondered aloud whether my dad has a learning disability too.

“My mom’s always suspected he does,” I said. “His mind jumps a lot. But maybe that’s because of the drugs.”

“Could he be depressed?” she asked.

“Maybe,” I conceded.

Dr. Jones’s pen stopped moving. She shifted in her seat and sat staring at her legal pad.

“I don’t think …” she began, her voice low, “that you’re going to be able to help us.”

She paused for what felt like minutes. “It’s really too bad,” she continued, now looking me in the eye. “We would have loved to have had you, but if there’s addiction or learning disabilities in two generations, well, it’s a liability issue for us.”

I sat on the couch, stunned.

“If your dad had just dabbled in drugs we could maybe overlook it,” Dr. Jones continued, “but from when you were two years old to five years ago, and maybe still ongoing—that’s a prolonged problem.” Drug abuse is linked with ADD, and if both are heritable.

I would also learn from the medical journals that my dismissal, though not legally necessary, wasn’t unfounded. Research suggesting an influence of genetics on addiction is amassing. In March 2006, for instance, the British Institute of Psychiatry released a study that found that variations in the genetic code for the DAT protein, which controls dopamine levels, can cause a person to become addicted to cocaine more quickly. According to these findings, if the suspect gene were passed from my dad to me, I would be fifty percent more likely than my peers to become dependent on the drug. Other studies have produced similar results. I stared blankly at my computer’s screen. This discovery stung worse than the rejection of my eggs.

Over the next few weeks, that statistic haunted me. A baby born of my genes would be fifty percent more likely than average to abuse cocaine. Though my boyfriend and I were far from thinking about having children of our own, I wondered how he might react to this news. Would he pull out now, knowing he didn’t want to have kids with someone whose DNA was so flawed? He, of course, could have children with someone else, but I would always have these genes. This was my lot. I wondered whether it was irresponsible of me to even consider reproducing.

One day, out of nowhere, it occurred to me that I could have lied. The clinic’s screening process was based on information provided by me. My prior medical records weren’t required, and neither were those of my family. Maybe the clinic’s staff wanted me to lie. Maybe that’s why Veronica had me fill out multiple applications and why Dr. Jones asked me to recite the family history I had already listed twice. Maybe they were waiting for my story to change, and maybe I missed the cue that it was supposed to. After all, Veronica made quite clear in filling the blank boxes of my paternal grandparents that veracity was beside the point.

Maybe Dr. Jones and Veronica knew that heredity isn’t all there is to addiction. Variations in my genetic code related to the DAT protein, if I do indeed have them, might make me more susceptible if I tried cocaine, but I haven’t. I haven’t because addiction isn’t just about an abnormal gene, it’s also about the factors that make drugs tempting. Disorders like ADD and depression can influence a person’s decision to turn to drugs, as can environmental and social factors, which also influence drugs’ availability. If addiction is about nature, it’s just as much about nurture. My dad and I—genetically speaking—were equally susceptible to addiction, but he became entangled with drugs while I didn’t, probably because his parents kicked him out when he was sixteen, and remained estranged from him to their deaths. I, on the other hand, was guided through childhood and adolescence by my mom, a positive role model who offered sound parental guidance. That, it seemed, has made all the difference.

But science is cold, definite. Genetics play a role in drug abuse, period. Nurture is unpredictable. It’s the job of Veronica and Dr. Jones and the clinic’s geneticist to play the scientific odds. It’s the statistic that matters, and a baby born of my genes would be fifty percent more likely than average to abuse cocaine. For weeks, that statistic echoed in my mind every time I passed a child in the park, on the sidewalk, or riding the subway. I thought, too, of how it felt to be rejected for a job that I’d nearly thought I was too good for.

If troublesome genes are to be shunned, a scientist might forever doom the future of the Bonanno crime family based on whatever genetic abnormality makes a person more likely to lead a life of crime. But science doesn’t always have the last word. After publishing Honor Thy Father, Gay Talese allocated some of his royalties to the Bonanno children. One of them used the money to go to medical school and is now a successful physician. His story would be unremarkable, discouraging even, to those who think genes are destiny, but to a writer—or me—he’s a goldmine, because in literature it’s the people who defy the statistics that count. This is the way of thinking I prefer.

Author’s Note: Shortly after writing this piece I stumbled onto a list of thirteen characteristics of adult children of alcoholics; characteristics that also apply to the children of drug addicts. I was skeptical at first. How many people aren’t either extremely responsible or extremely irresponsible from time to time? Who wouldn’t, at some point in his or her life, proclaim that they have difficulty with intimate relationships.  But I couldn’t ignore the fact that every characteristic listed seemed to apply to me. Some were more true than others of course, and some might have been true in the way that the intuitions of fortunetellers are. But I saw too much of myself in the list to laugh it off completely, and I realized that my desperate pursuit of experiences about which to write, like donating my eggs, was silly. I already had a story to tell. I’ve read memoirs about families affected by substance abuse, but never about the longer term affects on various family members’ personalities and the life each ultimately chooses to lead. I’m working on a memoir now. Writing this piece helped me get there. 

Alexis Wolff holds a BA from Yale University and an MFA from Columbia University. She has previously been published by the New York Times, the Los Angeles Times and in the Best Women’s Travel Writing anthology, among others.

Brain, Child (Winter 2007)

The Girl with the Levantine Eyes

The Girl with the Levantine Eyes

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.


Want to read more thought-provoking essays? Subscribe to Brain, Child: The Magazine for Thinking Mothers and see why we’ve been receiving awards for literary excellence since 2000.




By Becki Melchione

They were striking:  two matchsticks on fire dancing, melding, rushing down the subway stairs together. Their flaming hair, freckled noses, and infectious smiles lit up the dark underground labyrinth. One was thin and spry, a crimson braid down her back, her hair a lighter shade than the other’s which was auburn and cut sensibly, shoulder-length. They headed across the platform, arm in arm, chatting like best friends.

The author's twin daughters

The Author’s Twin Daughters

That undeniable mother-daughter pair sits on an unattainable pedestal in my mind. When two in vitro fertilization (IVF) cycles failed and my own eggs were determined not to be viable, the hope that one day I would have my matching flame died.  The only option was an egg donor.  My first inclination was to find a donor as close as possible to my own genetic background.  Who better than my two-and-a half-years younger sister, Cara?  We share similar genes; I know her medical history and her family’s medical history, and more importantly for the future, I would know the second it changed. My husband was reluctant, worried that she would feel that the resulting child was hers. “Are you kidding?  They’re eggs, cells!  The baby will be yours; I already have my own two kids,” she laughed. But upon initial fertility testing, we discovered that she suffered the same problem as I did, low ovarian reserve.  Her eggs were just as damaged as mine.  We could try, we thought. Perhaps she would produce more than the one delicate egg I had.  But the cost was a factor.  We could not afford to try again and lose.

Plan C, then, was to find an anonymous egg donor. But how should I choose the woman whose genes would be a replacement for my own?  Should I look for my doppelgängermy unrelated twin in the world?  Should I search for someone with dark curly hair, brown eyes, petite but curvy body, and olive skin with freckles across her nose? Or should I look for someone with the characteristics that I would have liked to have,  height more than my 5’4″ frame, straight hair, a decent singing voice or artistic talent?  And what about personality or spirit?  How could I possibly determine strength, courage, generosity, loyalty, empathy, determination, curiosity or perseverance from an online profile?  Initially, I decided to search for my look-alike, but as my husband and I viewed hundreds of profiles, we began to rate them in four areas: health, personality, physical appearance, and experience.

As a young adult cancer survivor myself, I wanted to know that the egg donor and her family (siblings, parents, grandparents) were free of hereditary cancers, mainly ovarian and breast, and other serious genetic diseases.  Grandparents who were in their 90s and still alive, or parents in their 60s and 70s without serious health problems were a definite plus. (Full disclosure here: my husband is a doctor and reviewed the medical information for us, noting what diseases and medical issues could be hereditary and therefore potentially problematic for our offspring.)

Although there is definitely a nature vs. nurture argument to be had about personality (several studies I found indicated that nurture is stronger than nature), I do believe that all people are born with innate personalities.  Some are fussy, some relaxed, others hyperactive.  Some are blasé about the world, some interested in everything around them, and others want to touch everything within sight. The question was how to determine a donor’s personality based on a seven page questionnaire.  Few of the questions offered room for philosophical insight, so I looked closely at the potential donors’ answers to questions such as “What goals do you have in life and have you achieved any of them?”, “What do you like to do in your spare time?” and “What is your philosophy of life?”  Answers that were thoughtful, honest, open, and positive gave me confidence in the donor.

I couldn’t help it, but I wanted my child to look somewhat like me, so I looked for donors with olive complexions and dark hair.  If the prospect had an Italian heritage, that was a plus in my mind because, I imagined, somewhere in her gene pool were traits similar to mine.  But I also dreamed of my child’s having my husband’s crystalline blue eyes — eyes that have compelled even muggers to comment on them while robbing him.  So with my vague fifth grade recollection of a Punnett square of recessive and dominant genes, and the higher likelihood of a particular outcome if a recessive gene comes from both parents, I also searched for blue eyes in the hopes that our child might inherit them.

One part of this whole process that feels uncomfortable is the financial aspect.   I am going to pay someone a considerable amount of money for her “pain, suffering, discomfort, inconvenience, and the medical risks assumed” (according to the contract), but to be honest, what I am really paying for is the amount of viable eggs that I would like to receive.  If a finder’s fee, donor’s fee, and in vitro fertilization cycle costs somewhere in the vicinity of $25,000, I want as many viable eggs for that investment as possible.  If a donor cycles and only produces 10 eggs, that is it.  Others donors produce 30.  The average is somewhere in between.  There are hormone tests to estimate the ovarian reserve (or amount of eggs in the ovaries), but they aren’t a guarantee of the outcome and I will have already spent a considerable amount of money by the time I get to that point.  So we decided to lower our risk by searching for someone who had cycled before and had produced a good number of eggs.  If the donor’s eggs resulted in a live birth, even better.

When we finally narrowed down our potential donors to two, we were torn.  One looked almost exactly like me with olive skin, long, dark curly hair and an altruistic vibe I just loved (one of her profile pictures was of her volunteering on a farm feeding a baby goat).  But she had never cycled before.  The other woman had a similar facial structure with straight, dark hair. Most importantly, she had cycled successfully before.  At that point, it had been over fourteen months since we started on this long detour to parenthood.  We chose for the donor who had cycled before.

A few days later, we received an email from the egg donor agency with the message “Good News! Donor 783 would like to work with you!” and eight images attached, photos of our donor from birth to adulthood.  Like a high-speed slideshow of her life, the images skipped every few years.  From a sleeping cherub with cherries on her pink pajamas to a one-year old with a Mickey Mouse birthday hat and a piece of chocolate and vanilla ice cream cake, her blue eyes staring directly at mom behind the camera.  At age four or five, she stands with her hands on her hips in a little blue sundress, bright white teeth gleaming from her smile, like she could fix the world.  A few more years, at maybe eight or nine, wearing a luscious blue velvet dress with a lacy bib, she looks more demure, looking to the camera with calm, confident eyes, her smile peaceful.  For prom, she wears an ice blue gown and that same glorious grin.

From an adorable little fairy to a beautiful young lady, she has always had dark hair and crystal eyes, cheeks that plump into giant pink gumballs when she smiles, and a smile that reminds me of the Mona Lisa’s, not because hers has that slight mischievousness quality, but because you can recognize it anywhere.  It is iconic.

As a woman, donor 783 looks to have a relaxed style, wearing a black sweater and jeans with her hair tied back in a ponytail, bun or twist, that highlights her face.  She wears no make-up, but is radiant. For years in high school, college, and beyond, this was my look, jeans and a black sweater, turtleneck or t-shirt, my hair tied back in a loose bun.  In this one photo, she looks like a version of me, living the same life, ten years later.  She is a kindred spirit.  If I’m completely honest with myself, this photo of her is the reason I am confident with her as my genetic stand in.

Thinking of that mother and daughter set and my egg donor’s photos, I feel that the pieces of the genetic puzzle I’m trying to assemble are falling into place.  With her dark hair, blue eyes, build, and personality, mixed with my husband’s genes, we’ll produce a similar-enough looking whole.  Although my child and I won’t look exactly alike, it is my hope that strangers glancing at us won’t doubt for a second that we’re related, just like those flaming matchsticks.

Double Take: Read another perspective on this topic: The Girl With the Levantine Eyes

Author’s Note: It took a medium-sized village, many small miracles, and unbelievable generosity on the part of total strangers for my twins to be born.  Delivered into this world on April 2012 through a wonderful gestational carrier with donor eggs and my husband’s sperm, my daughters are pure joy.  Now that they are almost five months old and have inherited my husband’s striking blue eyes, people always comment how much they look like him.  Thus far, I don’t mind, but I hope that as they grow, they’ll look at least a little like me.

Becki Melchione lives with her twin daughters and husband in Baltimore.  After spending years in arts administration and non-profit management, she is quickly becoming an expert on baby management.  She writes about motherhood, technology and culture and is working on a memoir about the hope and courage it takes to face young adult cancer, infertility and twin motherhood. You can  visit her website at http://www.beckimelchione.weebly.com