Can I Get a Witness?

Can I Get a Witness?

By Brett Paesel

Can I get a Witness ArtI have a three-year-old son, and I’ve come to the conclusion that raising a young child involves long stretches of boredom interrupted by flashes of terror and bursts of supernatural joy–which sounds awfully close to the definition of psychosis. And, also, I am told, combat. One would think that, knowing this, I would send my child off to boarding school and surgically ensure that I never have another child. But no. For a reason I cannot name, I am obsessed with having a second one.

For a year, I pee on all kinds of sticks. Sticks that tell me when I’m ovulating. Sticks that tell me if I’m pregnant. I get crazy about sticks. I buy them in bulk and pee on them even when I’m not ovulating or remotely close to being pregnant. I begin to live by the sticks.

I circle the best days in my date book for getting it on. I wake Pat in the middle of the night for sex. Because the stick says now. Then I lie on my back with my legs propped against the wall until they lose all feeling and fall onto the bed. I wake Pat again, pounding my paralytic legs with my fists.

I read adoption books and daydream about flying to India to pick up a little girl. I even talk to someone who has a baby connection in Nigeria. But I back out when I realize that we communicate only through his beeper and pay phones.

A year of this and no success. I am desperate–driven by a force beyond myself, like Richard Dreyfuss in Close Encounters of the Third Kind. So I decide to have my doctor run some tests that will tell me a little more about my chances of getting pregnant.

The day I go in for the results of the tests, I wait alone in the lobby. Pat and my son park the car while I sit on a brown leather sectional and start to finger the neatly placed magazines on the glass table in front of me. I consider reading the article on “Ten Things Men Would Like Us to Know.” But I’m not sure I want to know. I look up to see bamboo shoots in a glossy green pot on the corner of the table. Behind them is a painting of the Buddha done by my doctor, Dr. Sammy. He is a Buddhist, which is and is not a good thing in an OB. At his best, he is cool, detached, and amused. At his worst, he is cool, detached, and amused.

When I was looking for a gynecologist, I asked a couple of friends for their recommendations. The first said that she had a great doctor: thorough, no nonsense. “It’s just . . . “

“What?” I said.

“Well, it’s silly, really. It’s just that he has no sense of humor.”

“I don’t know that that would matter,” I said.

“Well, then, he’s your man,” she said. “It’s just that one time he was doing a Pap. I mean he was right in the middle of it. My feet are in the stirrups. And the lights go out all over the hospital. And he just . . . “


“Well, he waited until they came on again. He didn’t say anything. Nothing to break the tension. I lay there in the dark, my legs spread, and listened to him breathing, while the greasy speculum slipped out of me.”

“What happened?” I asked.

“The lights came on. And he finished the job. He just went on like nothing had happened.”

Not sure about that, I thought.

My next friend said that she had a great guy she had known for years. He was practically a friend.

“It’s just . . . “

“What?” I said.

“Well, his sense of humor is a little strange. It’s okay with me. But you might not like it.”

“Like what does he say?”

“Well, the last time I was making an appointment with him he said, ‘Great, I can’t wait to see that luscious bod. I’ll be waiting, with my tongue hanging out.'”


“He was just joking.”

Not my guy, I thought.

My next friend said that she had met her gynecologist in acting class. He was a Renaissance man–doctor, painter, actor–and Buddhist.

“It’s just . . . “

“What?” I said, weary.

“It’s just. Well, he’s handsome.”

“So what?”

“Well. Some people don’t like that in a gynecologist,” she said.

“How handsome is he?”

“Very handsome,” she said. “He played the Devil in a scene for acting class. And he was so sexy that the women couldn’t take their eyes off him.”

“Your gynecologist played the Devil?”

“He was good,” she said.

Pat and Spence join me in Dr. Sammy’s office. I look out the window and see sky clean as a blue sheet, sunlight bouncing off white squares of concrete in the street below, glinting cars maneuvering in a parking lot. I try to imagine Dr. Sammy as the Devil, and my mind skids to a short list of things I’d be willing to trade my soul for.

“So let me see here,” he says.

I hear him open a file, but I keep my attention on the sheet sky. Spence climbs into my lap.

“He’s three now?” Dr. Sammy asks.

I think, Get to it, get to it. What does the file say?

“Almost three,” says Pat.

“I’ve got some stickers,” says Dr. Sammy. He pops out of his reclining chair and sprints out of the room.

Spence squirms off my lap and on to Pat’s.

Is he stalling? I wonder. Are the stickers a delaying tactic while he gets up the nerve to say that while getting information about my fertility status, he found out that I’m riddled with cancer? It’s a brain tumor, I’m sure. I’m always sure it’s a brain tumor. Wait a minute–he didn’t go anywhere near my brain. It would have to be ovarian cancer. I see myself six months from now wearing a turban, looking thin and impossibly beautiful, being wheeled into Spence’s preschool graduation ceremony.

Dr. Sammy bounces back in with stickers and hands them to Spence.

“Stickers!” Spence says, sliding off Pat’s lap onto the carpet.

Dr. Sammy plops down in his chair, grabs the file, and leans back again.

I see Pat in my hospital room, moving the tubes aside, and carefully lying down next to my waif-like body. Hanging onto my last few breaths, I whisper, “I loved only you.”

“Your progesterone is good,” says Dr. Sammy.

Pat looks at me, smiles, and grabs my hand like we won something. It’s not cancer.

“Pat’s sperm is good.”

Pat nods like he knew that all along.

I look down to see Spence sitting in the middle of all the frog stickers he’s stuck to the carpet. He looks up at me and smiles. King Frog with his subjects.

“So what is it?” I ask.

“Well, Brett, it’s nothing really,” says Dr. Sammy. “It’s just that you’re forty-two and your eggs are old.”

“But I don’t look like I’m forty-two,” I say. “Forty is the new thirty.”

A patient smile spreads across his face. “Not biologically,” he says.

I realize at this moment that I hate him.

“Old eggs?” asks Pat.

“Mmm,” says Dr. Sammy, leaning forward, his beaky nose hanging over his weak mouth. “A woman has only a set number of eggs at birth. She loses these eggs as she gets older, and by forty, the eggs that remain are old. They’re tired.”

How old are they? I hear in my head. So old they need a walker just to get over to the uterine wall.

He goes on, “There’s a higher risk of chromosomal problems. And it’s harder to get pregnant.” I watch as he rests his talons on top of the file.

“Christie Brinkley had a baby at forty-four,” I say.

“I’m not saying you can’t get pregnant,” he says. “In fact, if I were to bet on a forty-two-year-old getting pregnant, I would bet on you.”

“You would?” I ask. My voice sounds girly and flirtatious, not my own.

“You’ve got everything going for you,” Dr. Sammy says. “You’ve got the blood pressure of a teenager.”

“I do?” I ask, giggling.

“And your uterus is in great shape. Pink and healthy.”

“Pink. Great,” I say.

Dr. Sammy is such a handsome, kind man, I think. We should have him over for dinner sometime.

Spence grabs onto my knee and pulls himself up from the frogs. Pat raises an eyebrow at me and turns to Dr. Sammy. “Well, we wanted to know what we’re dealing with because if it looks unlikely that we’ll get pregnant, we’re going to start looking into adoption,” he says.

Spence pulls on the neck of my shirt. “I want more stickers.”

“Just a minute,” I say, prying his fingers away. “Dr. Sammy’s talking to Mommy.”

Dr. Sammy laughs.

“Well, that’s a sure-fire way to get pregnant–start adoption proceedings.”

“Really?” I ask. I look at Dr. Sammy’s lovely, long fingers.

“Stickers,” says Spence, his voice insistent.

Pat reaches over and touches Spence’s hair.

“Just a minute,” I hiss. “So why would starting to adopt make me pregnant?’

“Well, it’s nothing scientific, right?” he says, winking at Pat. “It’s just the way the world works. You get what you want when you’re looking the other way.”

“STICKERS,” screams Spence.

“Spence,” I say. “This is my turn. I get to talk to the doctor now. You are not the only person in the world.”

Spence’s face drops and he sinks back to the carpet of frogs.

My heart lunges toward him. I want to take it back.

I want to say, “You are the only person in the world. That’s the problem. That’s why we’re here. I’m terrified that you will be alone some day. I can’t sleep, thinking of you alone in the world.” The truth of this hits me like a hokey God moment in a made-for-TV movie.

I hear Dr. Sammy intone more about my pink cervix and attractive follicles. I hear percentages and terms like “artificial insemination” and “donor egg.”

But most of this sounds like it’s bits and pieces from outside a door. Inside, I hold my answer. Turn it over and tuck it into my chest. My answer. The reason for this near-psychotic pining for a second child.

The reason offers itself up and I know that it’s been there since the day my brother was born. It is this: I want for my child what I have. A witness. Someone who will say, “Yes, it’s true. Yes, I was there. We were so very loved.”

Author’s Note: Dr. Sammy was right. The month we started to apply at adoption agencies, we got pregnant naturally. Having had two miscarriages, I was reticent to celebrate and I anxiously waited for blood to appear. When we hit the fifth month with no blood, I finally realized that we were actually going to have this child. We told Spence that he would soon have a brother or a sister (so longed for by me, so that he wouldn’t be alone), and he said that he’d rather have a dinosaur named Spencer.

Brain, Child (Winter 2004)

About the Author: Brett Paesel is a contributing editor to Parents and blogs at She is the author of “Mommies Who Drink.”

Illustration by Sarah Solie

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What Does Pregnancy Feel Like?

What Does Pregnancy Feel Like?

ART Doors of Italy

By Cloe Axelson

The waiting room at Careggi University hospital in Florence has all the charm of a Boston bus terminal: dingy, cream-colored concrete walls and steel benches with armrests so sharp they could puncture your skin. A few posters hang neatly. One offers assistance to Italian prostitutes, the others feature diagrams of pregnant bellies with a fetus tucked inside, but I can’t read them because I don’t speak the language. My husband Sam and I are in Italy for an eight-day vacation, our final getaway before we become parents. The hospital wasn’t our list of sites to visit, of course, but I’m thirteen weeks pregnant and noticed blood when I went to the bathroom, so here we are.

When we arrived there was only one other patient waiting on this Saturday afternoon in late July, a very pregnant Italian woman who was accompanied by her husband and four-year-old daughter. She looks unhealthy: sallow skin, swollen ankles, thick toenails painted a horrible metallic gold. She’s also missing teeth and every thirty or forty minutes she excuses herself for a cigarette, which she smokes, slowly, just outside the sliding glass doors. I can’t imagine a similar scene at my obstetrician’s office at home in Cambridge, Massachusetts.


As a kid, I didn’t daydream about having children. I was a tomboy, mostly concerned with how fast I could throw a baseball. In elementary school, I got my hair cut as short as my mom would allow, played on an all-boys little league team and wore a navy blue blazer with brass buttons, like my favorite boy cousins, to family parties. My parents later confessed they suspected I might be a lesbian, but no. I’d just decided that hanging out with the boys was much more interesting than watching them from afar or giggling when they walked by, as many pre-pubescent girls often do. Sam and I began dating our senior year in college. When I got married at twenty-eight, I skipped the wedding boutique circuit and bought a dress on eBay for $89.50.

In my early thirties, I thought childbearing was triggering an epidemic among my friends: suddenly they were giving up big jobs and adventure travel in countries with questionable water supplies for motherhood. My Facebook feed was littered with photographs of my friends’ distended bellies and, eventually, of their infants, red crinkly-looking things that became progressively more adorable and got pricey haircuts. Conversations about politics and career paths were replaced with chatter about nannies, breast-feeding and potty training. Some abandoned city living for the suburbs and bought battleship-sized SUVs. My friends were trading in their old lives for new ones—unrecognizable to me and, perhaps, to them. It was alarming.

And yet having a baby always lingered in the background, as something I would get to eventually, when the time was right. Once Sam finished graduate school. Once I’d run a marathon. Once we’d saved for a down payment. We were also busy: we’d lived in five apartments in three cities and held twelve jobs between us since graduating from college. We’d experienced 9/11 as New Yorkers. I’d traveled solo through Central America for three months. Sam had worked at the White House during the financial crisis. After dating for seven years and being married for five, expanding our twosome meant the end of an era. Having a family was something we’d talked about, but we wanted to be sure we were ready.

When we finally were ready, about three years ago, I discovered that getting pregnant wasn’t something I could do easily. That’s when I started paying much closer attention to my uterus.

I treated my uncooperative reproductive system like I treated any physical challenge, with determination and discipline. I did all the things the books tell you to do: took my temperature every morning to track my menstrual cycle and monitored my girl parts for slippery secretions, which I didn’t even notice I had until I read about them. I also quit eating so much cheese (which supposedly hampers fertility), tried yoga (to relax), drank less wine and, for a while, switched from coffee to green tea. My pillow talk, which was never very good, got worse—I instructed Sam to “plunge me” on more than one occasion.

I was characteristically practical and unsentimental about all the things I was doing, but none of my self-directed treatment seemed to be working. And after a year of trying and failing, it seemed getting pregnant wasn’t going to happen without outside help. I wasn’t ready to think about fertility treatments, so I started to see Lisa, an acupuncturist with an office in my neighborhood. I knew several friends who gotten pregnant after a few treatments and hoped it might work for me, too.

Lisa had a strong Roman nose and bright brown eyes. She’d been an acupuncturist for fifteen years after several years in “quality assurance” at a big pharmaceutical company. The minute I learned she was a national Kung Fu sparring champion, I knew she was the practitioner for me: no nonsense, tough, results-oriented. Once after a treatment she showed me a photo of one of her male sparring partners—his belly was stamped with a yellow-purplish mark exactly the width of her fist.

At every appointment, after I’d positioned myself at the end of her treatment table, she’d ask me a roster of questions about my sleep habits and stress levels and menstrual cycle. I took in the Eastern art hanging on the walls and tried to make sense of the human anatomy drawings with meridian maps overlaid. She told me to watch more television, to relax. When I told her I was training for a half marathon, she implored me to stop running so much and to devote my energy instead to believing my body could be a vessel for new life.  I nodded, but thought she sounded hippy-dippy.

I saw Lisa at least once, sometimes twice a week, for five months. (I even made Sam, an economist and Eastern medicine skeptic, go for six weeks as an act of solidarity.) At eighty-five dollars per visit, it cost us a small fortune. I felt great and could set a clock by my cycle, but it had become a comforting ritual that wasn’t getting me pregnant. With the supposed death knell of a woman’s fertility looming (my thirty-fifth birthday), I had to decide how committed I was to becoming a mom.  Mother Nature was pushing the issue.


It’s hour two in the cream-colored holding area and I’m beginning to wonder if I’ll ever be examined by a doctor. Especially since when we visited the registration desk, a nurse looked at me and said “La Americana? You sit a few minutes, please.”

I’d started bleeding a few hours after I’d gotten off the plane from Boston. I hadn’t had any medical issues in my pregnancy so far, so my sleep-deprived, jet-lagged brain went for my worst fear: miscarriage. Sam forbade me from reading anything on the internet, which has page after page of horror stories, and together we called my doctor in Cambridge, who instructed me to find a doctor in Florence immediately.

I’d rifled through our guidebook for a recommendation and ended up here: the Accettazione Obstretica at Careggi University Hospital, fifteen minutes by taxi outside the city center, away from the tourists and crowds.

The smoking, gold-toed pregnant patient is still here, though her husband and daughter left an hour ago. She doesn’t seem troubled by the long-wait. We’ve also been joined by a couple who appears to be in their mid-thirties, like Sam and me. The woman, an Australian, has bottle-blond hair and looks to be about six months along. Her husband is fluent in Italian, and he tells us there are only two doctors on call and that two women are in the early stages of labor, hence the delay. I’m trying to stay calm. Sam is reading a biography of Lyndon Johnson in between games of Scrabble on our iPad.


After acupuncture, my first stop in the baby-making industry was my OBGYN’s office. She had to complete several tests before she could ship me off to the fertility specialists, where the real work would begin. She took pints of blood, scraped samples from my insides and dyed my uterus with an eggplant-colored ink. The tests showed nothing: by all measures, my uterus and ovaries were just as they should be. One nurse even exclaimed mid-exam in her thick Boston accent, “Gorgeous, just gorgeous!” Sam got tested, too, after I suspected that his habit of working for hours with his laptop on his lap was frying any potential offspring. But he also checked out as normal. The basic tests completed, we were referred to a fertility clinic with the diagnosis of “unexplained infertility.”

Millions of words have been written about the strange and scientific voyage to parenthood taken by the infertile couple. The werewolf-like rage brought on by hormone treatment, the endless blood draws, shots and ultrasounds. The anxiety and heartbreak of failed treatments. I suspect most infertile couples go about their business in silence, but some make art out of their struggles: a photographer in California documented her journey using eggs, rose petals, tampons and pig fetuses as her subjects.

I didn’t want anyone to know what was happening because it was painful and awkward to talk about. When friends and family asked, “Are you guys going to have kids?” I wanted to tell them to fuck off, but instead I laughed and said, “Oh yeah, we’re on it.” I worried about seeing someone I knew at our clinic and I refused to discuss it, even with close friends. My parents knew things weren’t going as planned, but I didn’t share details, lest they start offering advice. They did anyway. One cold late winter afternoon, my dad and I were at the dog park. I was about to toss a tennis ball when, mid-throw, my father, a soft-spoken Midwesterner in his mid-sixties, said: “You know, you and Sam ought to try facing north. That’s what your mother and I did when we were trying to get pregnant.” I thanked him, but didn’t start bringing a compass to bed.

Our fertility clinic was located at an office park in Waltham, MA, less than half a mile from Interstate 95. It had the feel of a nice department store: high ceilings, lots of natural light, bright cloth chairs in primary colors, two flat screen televisions and dozens of magazines. The place was always busy; dozens of people, just like us, waiting to be seen. In spite of its creepy, factory-like feel, there was something awesome about the cool efficiency of it all. I imagined entire wings of the building packed with cabinets of frozen embryos, lined up like computer servers.

The fertility doctor we were referred to, Rita, was in her early forties with shoulder length dirty blond hair, a wandering left-eye and an easy laugh. She made it clear we had garden-variety infertility, a sensibility I found simultaneously reassuring and insensitive. Rita recommended we try artificial insemination first, moving on to in vitro fertilization (IVF) only if three rounds of insemination didn’t work. We agreed.

Sam would “produce” the sperm specimen at home, then race up I-95 to get it there within the sixty-minute limit before semen starts to sour. He started giving his sperm a pep talk before we dropped them off, holding the plastic cup a few inches from his face and rooting them on with a fist pump, as if each one was Michael Phelps swimming for gold. The insemination procedure takes about five minutes. A nurse would summon me to a private room where I’d undress from the waist down, cover myself with a sheet and prop my feet in stirrups. One time I was on the phone while she took a syringe of Sam’s semen and inserted it, turkey baster-style, past my cervix for a potential rendezvous with an egg. Sometimes, I’d feel minor cramping, but nothing painful; the real agony was waiting for the result.

I’d hold my breath for two weeks. The Google-search history on my phone during that time included things like “what does week one of pregnancy feel like?” and “can you feel an egg implant?” Month after month, after a blood test to check for pregnancy hormones, I’d receive a phone call from a nurse telling me I wasn’t pregnant.

Irrational self-flagellation followed. Maybe I shouldn’t have run that half marathon. Maybe there really is something seriously wrong with me. Maybe the universe is trying to tell me I’d be a terrible mother. With each unsuccessful attempt, my attitude hardened: I started to anticipate failure because it made me less vulnerable to the sting of negative results. Preparing for the worst made me feel in control of a situation that was far beyond my influence.

After our third failed insemination attempt, I needed time away from the fertility factory line. I’d started to peer jealously at pregnant women and stare wistfully at the little leaguers in the park. I was resenting people in my life, as if newly pregnant friends and family were conspiring against me. I was angry with Sam for not being able to bear children, a fact he certainly couldn’t control. I’d become just as preoccupied with not being able to get pregnant as my friends with kids were with nap schedules and play dates.

Within three months, though, I decided I was committed enough to becoming a mother that I was ready to go forward with IVF. This time, I told close friends and my parents what we were up to. It felt good to have a team of people pulling for us. We also made our fertility project the priority. Sam canceled a business trip to Miami and I skipped out on my employer’s big annual conference, things we never would have done before because it belied how much was at stake.

I’ve heard stories of women going through three, five, seven, eleven rounds of IVF. I don’t know how they find the strength. We were very lucky. I was grumpy, anxious and bloated, but after just one round, I got pregnant.


We’re on hour three in the waiting room and the pregnant Italian woman has excused herself for six smoke breaks. Yes, I’m counting. I can smell it on her clothes when she walks by me and it makes me want to retch.

The Australian couple is much more talkative than they were an hour ago. We’re all chatting, they’re asking about our trip and where we’re headed next. It’s already six o’clock: our first full day in Florence, gone. I’m not in pain, but I am jet-lagged and tired, entering hour forty-two without sleep.

Sam and I are contemplating whether he should run out to grab slices of pizza when I hear the front desk call a version of my name: “Ax-sel-son? Clo-way?”

“Yes!” I say, jumping up. We high-five the Australians on our way out of the waiting room.

The doctor’s name is Ippolita D’Amato. She appears to be in her late-thirties with short, brown hair that falls into her eyes and stylish, thick-rimmed glasses. She carries two cell phones, one in each of the pockets of her white doctor’s coat.

Italian is usually a wonderfully lazy language. People take their time, pronouncing every letter, elongating the vowels, every word a song. But Ippolita is on a long, busy shift and her version of the language sounds much less romantic than any Italian I’ve heard before—a rapid bark punctuated by o’s and e’s and heaving sighs. I decide this is probably how real Italians talk. Maybe that’s one bright spot: we’re having an authentic Italian experience.

Ippolita ushers Sam and me into an examination room and instructs me to sit on the edge of a bed that’s hidden behind a blue curtain. A nurse asks me to remove my underwear, hike up my sundress and lie back. I can’t help but think that if I were home, I’d be wearing a gown and have a sheet draped over my naked lower half, the lights would be on, the door closed. Ippolita begins performing a pelvic exam while the nurse revs up an ultrasound machine that, by the size of it, looks to be about twenty years old When one of the phones in Ippolita’s pockets rings, she answers it—”Pronto!” she barks into the receiver—while she’s peering at my cervix. I laugh at the absurdity of it all.

Next comes the ultrasound.  The cool gel on my belly, my bare lower half still splayed out on the table.

“You know you have due, yes?” she says.

“Yes, we’re having twins,” I say.

“One heartbeat and…two heartbeats. Bene, bene,” she says.

There is something miraculous about seeing your child (or in my case, children) inside your body, especially when they’re so tiny you can’t feel them move. But there they are, heartbeats flickering steadily on the pixilated screen. Alive. I feel a tremendous sense of relief. The two peapod-sized, thirteen-week beings are jiggling around in their amniotic sacs, just as they should be. I want to hug her. I briefly consider naming one of the twins after her, then quickly dismiss it. Ippolita is a tough name for a kid.

She says the bleeding I had was normal and that everything looks fine. She thinks it was the result of a long flight, dehydration and exhaustion. I didn’t drink enough water on the plane and I’d worked on my computer almost the entire flight. Our hotel room was being cleaned when I arrived from the airport, so I’d walked around Florence for a couple of hours in 100-degree heat. It’s something I wouldn’t have thought twice about before, but is now apparently beyond my physical limits.

She tells me I must be calm. “No running to the top of the Duomo,” she says. “Don’t get too hot. Drink lots of water.  Clo-way, remember your body is not your own.”

I read once that being pregnant means you are never alone. Sitting there underwear-less, eyeing Ippolita, it occurs to me I have yet to accept my new reality.


I’d only told a few people I was pregnant before our trip to Italy. I was still able to fit into my clothes and could hide the growing bulge in my abdomen. For all the pain and hassle I’d endured to get pregnant, actually being pregnant was relatively uneventful: I was constantly nauseous (but not vomiting), cringed at the smell of grilled chicken and craved watermelon, but that was it. After three years of trying and failing, I didn’t quite believe it was happening. And as much as I wanted kids, I didn’t want to broadcast the news because I suddenly didn’t feel ready for it. I was worried how people would react once they found out. It’s only natural that children don’t consider who their mother was before she became their mom. My identity as an independent, ambitious, active person would be beside-the-point to the twins. I wondered if my friends and family would also dismiss the pre-kid me in the same way.

I tried my best to heed Ippolita’s instructions. I let Sam carry my suitcase and sent him up the rickety stairs of every cathedral to take pictures from their domes while I stayed below in the shade, a bottle of water between my knees. He hiked while I sat under an umbrella at the beach. And in the early evenings, before dinner, when Sam went out to explore, I napped or read in our hotel room. I hated not being able to move far or fast.

I was happiest once we escaped the triple-digit heat of Florence for the Cinque Terre, five tiny towns perched on the craggy peaks of Italy’s northwest coast. There, I discovered the one physical activity I could enjoy: floating in the salty Mediterranean. I didn’t mind being still as long as I could be in the water. Our last morning on the coast, I sat on a jetty that cut into the blue-green sea and dipped my feet in the cool water. I can still hear the waves, with their persistent rhythm, breaking against the shore, filling the space between the rocks and making their retreat. I knew it’d be a long time before we’d visit again.

The journey from the Cinque Terre to our next stop, Siena, was about three hours by car. Our rental car was only slightly larger than a golf cart and not nearly as comfortable: the air conditioning blew hot air and my knees hit the dashboard. Making things worse, the waist on my shorts was starting to cut into my stomach, even with the button undone. I was already hot and grumpy when I read this sentence from our guidebook aloud to Sam: “When possible, avoid driving in Siena.”

Unfortunately the guidebook was right: no one should attempt to drive in Siena where the streets, which are pedestrian-only, are little more than fifteen-feet wide. Once we entered the city limits, it took us another three hours to find our hotel. As we drove in circles, I told Sam that the map was fucking useless, that I hated this stupid fucking vacation. I twice ran out of the car on the side of the road, heaving and kicking at the dirt like a toddler throwing a tantrum. I felt myself losing control, but couldn’t stop a frustration that made my whole body vibrate.

By the time we checked into our hotel, I was bleeding again. I hadn’t followed any of Ippolita’s instructions: I hadn’t stayed calm and my babies-to-be knew it.

Sam was exasperated and went out for a walk. I took a bath. Our hotel was a one-hundred year old villa once owned by Sienese aristocrats, and the heavy wooden shutters in our room opened up above the patio that overlooked the picture-perfect Tuscan countryside: a puzzle of vineyards, green hills, winding roads and stone cottages.

I could see patches of the late afternoon blue sky from the bathtub. I cupped the warm water over my growing belly, rubbing it with both hands, back and forth, coaxing calm as I looked at my toes peeking out at the far end of the tub. My iPhone, sitting on the ledge of the antique marble sink, played Bon Iver. “Someway, baby, it’s a part of me, apart from me,” one song began. I was overwhelmed by waves of anxiety, the selfish but real fear of losing myself, of never again being my own person. I wanted to be a mom, but I resented that everything I’d once thought was important might soon feel irrelevant and small, as I shed an identity I knew for one I knew nothing about.

A few tears dripped off my cheeks into the water, as I began to plead with my uterus, the organ that had been defiant for so long, and the tiny beings inside. “I’m sorry,” I said out loud. I promised to keep them safe. To be more gentle with myself. To be vulnerable, finally, to the reality of becoming a mother and all the change that would bring. “O.K., guys. I get it now,” I said, my words echoing off the tile. As the sun dipped lower on the horizon, the bubbles lost their fizzle and the water cooled. I could see how my body was changing as new life took root.

I didn’t know then that the two beings floating inside me were girls. Or that my body would stretch to an unfathomable size to accommodate theirs. Or that the toughness required to run a marathon is nothing compared to the toughness needed in labor, and to survive the ragged first year of new life.

I didn’t yet know the sense of accomplishment I would derive from tandem breastfeeding and coordinating nap schedules. The delight I’d feel in watching my daughters feel grass or see the ocean for the first time. The pride in looking at their tiny features and seeing my own in miniature. In being someone’s mom.

The things I used to worry about do seem frivolous in comparison to the relentlessness of motherhood. But I now know that is the natural order of things, even as I sometimes miss the body and life that were once mine alone.

Cloe Axelson lives with her family just outside of Boston. She is a student in Lesley University’s MFA program in nonfiction writing and works for a national education-focused nonprofit.



The Art Of Conception

The Art Of Conception

P1160166 (1)

By Sarah Bousquet

After almost three years of trying to get pregnant, my husband and I find ourselves standing in a church called St. Lucy’s in Newark, New Jersey two hours from our home. My mother’s colleague has recommended the church, specifically the shrine to St. Gerard, patron saint of motherhood, where a relic, a prayer card, and possibly even a miracle can be obtained. This colleague received her own miracle, became pregnant after years of infertility, shortly after visiting the shrine. I may have rolled my eyes at my mother, who tells me not to be so “pinched,” to “stay open to the universe.” But my mother doesn’t know the way my blood courses with longing and sadness, frustration and jealousy, things that make a body constrict.

The odds were not against us, but we were approaching our mid-thirties, biologically shy on time. I had just turned thirty-four, my husband thirty-three, when we married on a sunny September day and then flew to Aruba to honeymoon, so quintessential, so predictable–surely, now that we’d found each other, life would continue to unfold this way. Adrift in the clear water, my arms encircling his neck, smiling into dark brown eyes, droplets of water suspended from thick lashes, I imagine our baby with the same brown eyes, his easy temperament.

On the beach, we watch a burrowing owl dig a nest in the sand. A lazy tourist walks up from the water and sinks her foot into the hole. I rush over, kneel down and gently clear the sand away, reveal the tunnel to the nest. Together my husband and I build a sandcastle wall around it, adorn the wall with sticks and sea shells and seaweed. Everyday we find the nearest palapa and keep our watch. It feels like a promise. Already, I am looking for signs.

We return from our honeymoon to muted northeastern skies, cool air, falling leaves, and the first negative pregnancy test. We think nothing of it and continue to float on anticipation. But after a few months, I consider being less casual. A friend recommends the book Taking Charge of Your Fertility, and it becomes my Bible. I chart my cycle, take my temperature every morning and record it with a tiny dot, connect the dots and watch the hormonal flow rise and dip, just as it should. My cycle is like clockwork, ovulation predictable. Tick-tock, tick-tock. Every month that fall, that winter, that spring, I take a pregnancy test. Every month, it is negative. The seasons undulate on waves of hope and disappointment.

There is nothing in my history, personal or familial, that hints I will have trouble conceiving. My mother birthed four children, my grandmother seven, my great-grandmother thirteen. But even beyond that, there is the simple and singular fact, the unequivocal knowing, that written on my heart, etched in my bones is mother.

A year and a half passes amidst a flurry of pregnancy announcements, those of friends and sisters-in-law, and I find myself repeating the word “congratulations.” I want to touch their happiness, want my smiles to feel less forced. Other lives flow forward while my own becomes snagged, suspended. Surrounded by excitement and burgeoning bellies, I shrink against the swell.

A family member recommends an acupuncturist for my migraines, and although I do suffer from migraines, I understand that we’re speaking in code. Once a week I drive an hour from my office to the acupuncturist, who is also a chiropractor and clairvoyant. She begins with an adjustment, heaves my leg over her shoulder and twists until my spine cracks. Next she cradles my neck gently before snapping it to one side, then the other. After all the cracking, she presses at my shoulders, my legs, my ankles.

She stands at my feet and becomes still. Inhales dramatically and closes her eyes. I lie in the dim, expectant. There’s a shuffle of feet in the hallway. A patient coughs, waiting in another room to be seen. The acupuncturist’s eyes flicker open, bright with a message from the other side. As she sticks long needles into my toes and ankles, she says, “I see you with a little boy.”

She crouches to get more needles and begins sticking my thighs, my belly, my hips. “You’re holding a boy. And he’s definitely yours.”

I want to ask questions, the air has gone out of my lungs.

“I can’t tell you how soon,” she says, “But he is yours. You will have a son.”

It is imminent. He exists. I stretch myself across the space-time continuum to meet him. An image forms. I am holding a small boy. And he is mine. Needles in my fingertips, needles in my chest. Needles behind my ears and in my forehead. She dims the lights and leaves the room. I lie in the dark, a still and hopeful porcupine.

Two years and one new job later, we luck upon health insurance that includes fertility coverage. Once a week, in the early morning hours before work, we drive to the endocrinologist, where we sit in a dark exam room watching the soft shapes of my ovaries bobbing on the black and white ultrasound screen. I can never make out what the doctor sees, those orbs of negative space he measures and records.

There is weekly blood work and a battery of tests with names so long and complicated, I jot them down in my notebook phonetically before the doctor offers the acronyms. He will flatly recite grim statistics, that after two years of trying, our chances of conceiving on our own are now between 1-2% percent, and that IVF, our best option, gives us a 35% chance. My handwriting slants into a scribble as I copy down the numbers.

We never make it to that best option, IVF. Our insurance coverage is exhausted on months and months of ultrasounds and tests. Tests that ultimately provide very few answers beyond the diagnosis of “unexplained infertility.” The endocrinologist loses interest in us as our coverage bleeds out.

On my desk at work, I keep one framed picture, a snapshot of my husband and me taken one afternoon on a hike through the woods. We are young and rosy-cheeked in knit hats and scarves. I stare at the photo as if it’s not us and think, that nice couple is going to have a baby, of course they will. They look like they’ll have all the luck in the world.

I continue to research, change my diet to gluten-free, caffeine-free, alcohol-free, sugar-free. Mix maca root and water like a magic potion. Nail a wishbone above our bedroom door. Pray Catholic novenas, Lakota blessings. Meditate. Wish on eyelashes and dandelions. Build cairns on the rocky shore. Omens arrive as great blue herons, roadside signs, changing weather. On a walk through a field of tall grass, I swear I hear my future self whisper, Everything is about to be beautiful.

We take the last bit of insurance money to a new doctor, who is friendly and more hopeful. He begins by running blood work, the same blood work I’d had seven months before with normal results. It feels familiar, no anxious anticipation, no heart-in-my-throat while I wait.

I’m at work when the doctor calls. “We received some unexpected results,” he says.

I walk from my office into the hallway and down the stairs as if perhaps I can outpace his news.

“Some of the numbers have changed. Your AMH levels are very low, which indicates a low ovarian reserve.” His tone is calm and measured as he gives me the exact number.

I press my hand against the cool hallway tiles to steady myself. Suddenly, I have almost no eggs left. Even if we had additional fertility coverage, I would not be an ideal candidate for IVF.

Inside the church, the lights are dim. Nuns in habits fill the first three pews. The priest is reaching the end of his homily. We move quietly along the side aisle, find the shrine in a separate room to the left of the altar. I stand and stare at the ornate tiles, the looming statue, not quite knowing what to do, twelve years of Catholic school deeply engrained and yet very far away. I know I am supposed to ask for the relic and the cloth and the prayer card, so I walk over to the only door and knock. An altar boy answers and I make my request. He returns and quietly hands me a white package, then disappears. I assume the items have already been blessed, are already imbued with the magic and luck that I need.

I lower myself to the kneeler before the statue and whisper prayers. I beg of the saint, I beg of my childhood religion, I beg of the universe. We stuff dollar bills in a gold box and light candles. Then I notice two small wooden staircases on either side of the statue. Are they meant to be climbed? Does proximity to St. Gerard’s face mean something? I’m not taking any chances. I ask my husband to climb one set of stairs and I’ll climb the other. He sighs and smiles but doesn’t protest. We climb the stairs and meet at the top. I reach for his hand. I make up my own prayer and I say it out loud. I ask St. Gerard to please bless us with a baby. My atheist husband says, amen.

It is a Tuesday morning, a regular day, and we’re getting ready for work. My cycle is seven days late. I feel like a fool as I tear open the foil wrapper on what feels like the millionth pregnancy test. My husband is in the shower, and I raise my voice above the noise of the water, “I’m taking the test!”

In the kitchen I pull a pan from the cabinet, start breakfast while I wait for the result. Hope, that irrepressible little drummer, thumps in my heart. I return to the bathroom to check the test, not wanting to look, wanting to suspend that tiny hopeful feeling and hold it a little longer. When I return to the bathroom and pick up the test, I blink at the pink plus sign. I scream and I jump and jump. Elation will send a body straight into the air. My husband pulls back the shower curtain with a smile and says, “I knew it.”

Author’s Note: As it turned out, we had a girl, born with the same brown eyes and easy temperament as her dad, just as I’d imagined years ago on the beach. This essay began as a poem, a whisper of the search. A search that altered my conception of self, of the world around me, and of faith, that elusive shape shifter. Just when I thought I’d lost faith, there it was again. The trick was to find it every time, and to follow it forward.

Sarah Bousquet is a freelance writer living in coastal Connecticut with her husband, daughter and two cats. She is currently at work on a memoir. She blogs daily truths at Follow her on Twitter @sarah_bousquet.



The Bird Family

The Bird Family

WO Bird Family ArtBy Liz Blocker

In the thick heat of a June afternoon I walked out my front door and down the stairs and nearly stepped on a dead baby bird.

I saw it just in time, and stopped, my foot hovering over the tiny, flattened thing. The sun baked my neck and shoulders; sweat dripped from my scalp onto my forehead. Careful, slow, I withdrew my foot back to the bottom step. I wanted nothing more than to escape into the cool air-conditioning of my car. But still, there was this thing, this dead thing.

The baby bird was small, barely the size of my palm, and half-naked. That was my second thought: why is it naked? Its pink skin was patchy: in some places downy with new feathers, in others, bare and bald and shiny, like the scar from a terrible burn. I wanted to cover it up, dress it, shroud it in feathers. But feathers would have meant it was ready to fledge, and then it wouldn’t have been there at all. It lay on its stomach on the sidewalk, neck weirdly twisted, wings stretched out across the ground as if, at the moment it fell from the nest, instinct took over and it made a first, impossible attempt to fly.

I should move it, I thought; I can’t just leave it here. But no, I’m skipping ahead. That was my third thought.

First there was the rush of nausea and the burn of bile in my throat, and then I thought, the universe has one sick fucking sense of humor.


My wife and I had been watching the robins for months. First, in early April, there were just the two adult birds. They were nearly identical, with glossy grey backs and warm orange breasts. The female was slightly smaller, and slightly duller than the male – or at least, that’s what we guessed, standing at our bedroom window the day they first arrived, watching our guests busy themselves on our front porch. The world was still cold and gray, and the arrival of two robins, family-bent, seemed like the first true sign of spring.

“Which one is the female?” I asked, craning my neck to look over my wife’s shoulder.

“They look the same. Maybe the smaller one?” she answered after a moment.

“Maybe they’re both male,” I said.

“Gay robins, hon?” Jen turned her head back to look at me, smiling, teasing.

“Maybe not,” I laughed, and slid my arms around her waist. “Maybe she’ll get pregnant the same time we do,” I whispered. I couldn’t help but feel a little envious of the robins: they, at least, didn’t have to find a donor and make ovulation charts and, eventually, enlist the help of doctors to start a family. With a sigh, I laid my hand over my wife’s flat belly.

She leaned back into me, warm and soft against my chest. “Maybe they will,” she whispered.

“So – we let them stay?” I phrased it as a question, even though it wasn’t, really.

In the silence that followed, we considered the birds, framed against the backdrop of a clear spring sky. Our front porch was small and already crowded; seated on the two wide chairs, we’d be less than a few feet away from the new family.

“We can’t sit out there with them,” Jen said. Again, it wasn’t a question.

“No. They might attack us,” I said, drawing on something I thought I had seen or read, sometime, somewhere.


I nodded. “Birds can be very protective of their young,” I said, and my wife accepted my guess as fact. I was the resident animal nerd, the only member of the household who considered watching an episode of National Geographic the perfect way to unwind.

The problem was that we loved that porch. When the weather was mild enough, we ate breakfast and dinner there in relative solitude, relaxing as the sun rose or set over the city, and watching below us as our neighbors walked with strollers or dogs into the large, quiet park behind our house. In Boston, the months of warm weather were brief and altogether precious. We rarely missed a chance to sit outside.

I looked at the robins on the porch; they were busy. One – the male? – brought long strands of thread, straw, and grass, while the other bobbed and pecked and wove everything into a surprisingly solid little bowl.

“We’ll eat inside,” my wife said, and I agreed. We both knew there was no way we’d kick them out now.


If I leave it, there will be flies. I stood above the little corpse, long past my first and second and fifth and tenth thoughts. The seconds ticked by, measured in drops of sweat. I had to move the dead nestling; I couldn’t move it; it had to be moved.

I’d tried to do something, three or four thoughts ago. I’d stepped with care onto the sidewalk next to it, found a stick – there was no chance I could touch it with my bare hands – and bent down to prod it. Where to, I didn’t know. My plan hadn’t progressed beyond the stick. But as my face drew closer I could see the wrinkles on its snapped neck, the dull yellow glaze of its eyes. I reared up and dropped the stick, and stood still again.

Who could I ask? Our dead-end street was quiet and still in the suffocating heat of the afternoon. No dog-walkers or babies to be seen. The only person nearby was my wife, and she was out of the question.

My wife, I thought. Shit.


Late April, and the robins were well-established on our porch. We knew there must be eggs, because Birdy – the female robin, whom Jen named in a burst of creativity – spent all day and night sitting on the nest. Mr. Bird – the male, whom I named in an equally creative burst – took over for small amounts of time, most likely when his mate was off finding dinner for herself, but he was always nearby. (It wasn’t until later that I realized we had effectively named our pair of robins the Birds, which made the female’s name Birdy Bird, poor creature. I tried to rectify this, but it was too late. The names, as they have a habit of doing, stuck.)

Weeks passed. We checked the nest obsessively, emailing and texting each other updates:

“Birdy isn’t on the nest! How long can she leave the eggs? I hope they’re OK.”

“Mr. Bird just took over. Birdy is hungry.”

“Nothing yet. I’ll keep watching.”

We knew we were too involved, but we were helpless to stop ourselves. We watched the robins as if they were our own personal Downton Abbey: desperate for updates, obsessed with the plot twists, hanging on every hint and gesture for a sign of life. It was thus far much more productive and successful than our own year-long attempts at nest-building.

One morning in early May, on my way out to my car, I saw a speck of blue on the ground. I was running late, but the color was so bright that I stooped down for a closer look. It was an egg: tiny, speckled blue, and shattered. The shards were bright against the dull pavement; the yellow yolk was brighter. The colors were beautiful and vibrant, so different from the brown and pale green of early spring. In a twist of irony, those broken pieces seemed more alive than anything else on the street.

Later that evening, we found two more eggs, scattered in pieces along the concrete. The nest was empty, the robins gone. We stood at our window, staring out at the porch as the sky dimmed towards night.

After a long time, Jen asked, “Do you think they’ll try again?”

I shook my head, and closed my eyes, and turned away.

It was no more than a few weeks later that I glanced out the bedroom window and saw Birdy standing on the nest. She fluffed her feathers, shuffled her feet, and settled down on three round blue eggs with a little shimmy of satisfaction.

I pumped my fist in the air, and I swear Birdy winked her round black eye back at me. “Us too, Birdy,” I whispered, and grinned.

The Birds were back, and everyone was pregnant.


I stood on the sidewalk, sweating in the June heat, thinking. There was no reason for Jen to come outside. Not now, not today, not while she was still recovering. But tomorrow – or the day after –

Flies were gathering around the dead bird already. Crawling on its pink skin, sucking liquid out of its eyes, laying eggs. There would be maggots soon. Without thinking, I clapped my hands at the insects. They rose in a wave above the body, then resettled, slowly, like leaves floating down to the earth.

I couldn’t bear the thought of Jen seeing this; I knew I had to move it myself, now. If I couldn’t protect her from loss, at least I could protect her from this.

I shivered in the heat. The thought was clarifying, cleansing. It removed the paralysis and freed my body to act.

There are so many things that could have happened in that moment, so many ways I could act. There is the action that I took, for example, and then there are all the actions I could have taken, that I wish I had taken – a wish so fierce that as time passed it became palpable, visceral, like a memory itself.

This is what I wish had happened:

With slow, methodical movements, I walked to my car. Found a plastic bag. Walked back and picked up the stick. Didn’t think about the Bird family, the broken eggs, the weeks and months of patience and hope. Laid the bag on the ground, open, like a hand. Used the stick to push. Closed my eyes when the flies rose in a protesting cloud. Ignored the scrape of skin against the concrete, the dark patch staining the ground. Didn’t flinch when the wing got stuck on the bag, had to be jostled, then shoved, then tossed in a flopping movement of skin and bone and flies. Held my breath. Tossed the stick into the bag. Tied it. Didn’t think about Jen, or the Fallopian tube she no longer had, or the living bulge inside the tube. Didn’t consider that just yesterday a doctor had gathered up a different body, also tiny, also now dead, also the result of weeks and months of patience and hope, and disposed of it. Didn’t think, didn’t breathe, didn’t look around, walked to the trash and opened the lid and dumped the bag and ignored the flies that slipped inside and put the lid back over the hot dark hollow of the bin and let out a breath and walked away.


Wishing for something doesn’t make it so, of course. Why must some lessons be learned over and over again, before we remember them? I don’t know what happened to the tiny dead bird, the lost child of our robin family. I don’t know, because I wasn’t the one who laid it to rest.

This is what really happened, regardless of what I wish was true:

I shivered in the heat. The thought of Jen seeing the body was clarifying, cleansing. It removed the paralysis and freed my body to act.

I looked at the corpse, already dotted with flies. I looked up at the sky, hazy and blue, and felt the sun wash my face with heat. And then in spite of that clarifying thought, in spite of everything, I walked to my car, and drove away.

When I came back hours later, the body was thick with flies. They rose in a protesting cloud as I passed, then resettled, slowly, like leaves floating down to the earth. By the time I’d opened the front door and disappeared into the cool dark inside, they were feeding again, but I didn’t look around to watch them. I turned away, and left them behind.

They were still there the next morning, and barely moved when I walked past them and got into my car. I shouldn’t know this, because I turned my face away when I walked past, but I remember that there was no movement in the periphery of my vision; the flies knew I wasn’t going to bother them.

Later that morning, Jen went for a walk, slow and careful, with a friend. The baby bird was there when she left, darkening the sidewalk with its cloud of flies. It was still there when she returned from her walk, but when I came home hours later, the body was gone.

We wondered who had moved it. Maybe it was a dog-walker, rescuing the corpse from the jaws of her pet; or maybe it was our neighbors, cleaning up the sidewalk for their upcoming open house. Whoever it was, I like to imagine that they were gentle and careful; that they disturbed it as little as possible as they scooped up the tiny body and threw it away.

All I know for certain is that by the time I got home that evening, the only thing left on the sidewalk was a small, dark stain; and even that disappeared in the next cooling wash of rain.


And this, too, really happened, two or three days later:

Outside, the air blazed with heat. Inside, I stood in the air-conditioned break room at work, staring at the long list of texts on my phone. Picture after picture came flying in from Jen: Birdy and another, much smaller bird standing on the porch; Mr. Bird perched on a telephone wire, watching, a worm dangling from his beak; Birdy and Mr. Bird and two little fluffy feathered babies hopping down the sidewalk towards the park.

The pictures scrolled by quickly, too quickly to believe. I went back to look at them, again and again, but they didn’t change. It had cost them multiple losses and patient effort, and taken three months – an eternity in bird years – but the Bird family had fledged at last.

And one day, I thought, ours would, too.

Author’s Note: Fourteen months to the day from when this story took place, my wife gave birth to our own nestlings. A sweet, calm boy and a feisty little girl sleep peacefully behind me as I write this note. Soon, they’ll wake, and with wide open mouths will call to their parents, demanding and insistent as only the very young can be. I can’t imagine any better ending to this story.

Liz Blocker lives in Boston with her wife and newborn twins. Her essays have been published in The Toast, Role/Reboot, and in the forthcoming issue of The Dallas Review.

Excerpt: Don’t Tell Her to Relax

Excerpt: Don’t Tell Her to Relax

BMP- Don;t tell her to relax

By Zahie El Kouri

Chapter 3: Empathize with Your Infertile Loved One’s Sense of Urgency

While many women won’t want to discuss their infertility, some will eventually confide in close friends or relatives, and others will be open about their difficulties with getting pregnant from the first sign of trouble.

If you know your ILO is having trouble getting pregnant, whether she has told you or you just suspect, it may be very tempting to tell her to relax. You are not alone. As a society we seem to have decided that, “Just relax and you’ll get pregnant,” should be the automatic response to a confession of infertility.

Variations on the theme include, “If you go on a vacation, I just know you will get pregnant.”

Or, “If you start the adoption process, you will get pregnant.”

Or, “The minute you stop trying to get pregnant, you will get pregnant for sure.” All of these statements sound fine in the abstract.

It’s true that many women get pregnant while waiting to be placed with a child through adoption. It’s true that relaxation is key to good health, and good health is important for the reproductive system. It’s true that vacations are generally excellent, and your ILO probably deserves one.

But the reality is that true infertility is a medical condition, and relaxation will not cure any of the underlying physiological problems that cause it. Adoption is a long process, and some women will get pregnant while waiting to be placed with a child just because of how long it takes. But if your ILO has primary ovarian insufficiency (formerly known as premature ovarian failure), no amount of relaxation or adoption paperwork will help her conceive a child.

Even if your ILO knows you mean well, try to hold off from offering this kind of advice. It can sound flippant and smug, even if you don’t mean it that way. And even if relaxation would help, your directive will not help your ILO relax at all, and will probably make her feel as though you don’t understand her sense of urgency and panic about having a child, in turn making her feel less supported rather than more supported in her situation.

Takeaway Tip: Never say, “Just relax, and you’ll get pregnant.” Concentrate on other aspects of your relationship, or gently ask, “Do you want to talk about your fertility treatments?” You can always remind your ILO of the following: “I want you to know that I am not bringing up babies because I don’t want to be nosy, but if you ever want to talk about them, I’m here for you.”

Headshot Zahie El KouriRead our Q&A with the author.

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Author Q&A: Zahie El Kouri

Headshot Zahie El KouriWhat was your inspiration for writing Don’t Tell Her to Relax?

During my many years of struggling to get pregnant, I experienced a great deal of frustration with friends and relatives who really wanted to be helpful and compassionate, but who kept saying the wrong things. I was painfully aware that these people cared about me and would have said something less hurtful and more helpful if they knew what that might be. I imagined a sign I could carry around listing my top 5 requests for human communication during this time, and that imaginary sign turned into this book.

What was the hardest part to write?

It took a few drafts to sort out my feelings about interacting with people while wanting a child and not being able to get or stay pregnant. I really had to use my novelist’s brain to put myself in the shoes of all the nice people who meant well but who said things that I found hurtful and frustrating.

What was the greatest challenge in bringing the book to market?

The greatest challenge was my own attachment to the traditional publishing model. It was difficult for me to let go of the idea that someone else had to say the book was good enough to merit publication.

What do you hope the reader will take away from your book?

I hope readers will learn some simple, concrete actions they can take and meaningful, compassionate things they can say to be supportive of those who are experiencing infertility.

What book(s) had the greatest influence on you?

If I had to narrow the list down to three,

  1. Gish Jen, Typical American, for its portrayal of the immigrant family experience.
  2. The Unusual Life of Tristan Smith by Peter Carey, because Peter Carey is amazing.
  3. Mei Ling Hopgood , How Eskimos Keep Their Babies Warm, for its reminder that almost all parenting truths and methods are culturally constructed.

How do you balance writing and motherhood?

Now that I am a mother of infant twins in addition to a toddler, I am able to balance writing and motherhood with a lot of child-care help from my husband, my mother, and assorted babysitters. I also am really working on defining success both as a parent and as a writer on my own terms. Having worked so hard to have a child and being an older parent has made me both more comfortable with my current work-parenting balance (which currently involves more parenting than work), and more eager to get back the time I invested in fertility treatments and logistics.

What is your advice to mother writers?

Ask for the help that you need. Ask for the time that you need to do the things that will make you a balanced person and better parent.

BMP- Don;t tell her to relaxRead an Excerpt from Don’t Tell Her to Relax.

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Raising an Only

Raising an Only

Raising an only art 1by Jody Keisner

I look past the doctor sitting across the desk and focus on the floor-to-ceiling bookshelves behind her. My eyes skim over the medical books and land on the framed picture of her two young sons, both of them tan and dressed in preppy pastel shirts. They look about two years apart and have the doctor’s thick brown hair and dark eyes. She’s talking about saline infusion sonograms. Saline? I think. The stuff that I rinse my contacts with at night? I should pay attention to what she’s saying, but instead I picture her boys riding bicycles down a suburban neighborhood street, past trees and children playing on lawns. The older one calls over his shoulder to his brother, Come on! Faster! I imagine the younger one pumping his legs, his feet becoming a blur going round and round with each spin of the wheel. Now the younger one stands up on his bike, giving everything he has to catch up. Maybe this moment will mean something to the boys later in life, maybe it won’t, but the camaraderie they’re experiencing means something now. Then I picture my daughter, Lily, a few years from now, the same age as the oldest boy, pedaling down our street alone.

“…if your uterus is healthy enough to support a pregnancy.” The doctor looks at me intently. She’s noticed my drifting.

Because of a mix-up with the date of the appointment, Jon is at his job as a drywall installer, and I feel like I need to explain this so she will know that we are in this together, though we aren’t sure that we are. “My husband really wanted to be here,” I say.

She nods. “Do you have any questions, Jody?”

I do have questions, loads, but not the kind she can help me with. Do I want to pursue more medical intervention? Do I even want another baby? Or are we already complete, my family of three? I should know the answers, considering I’m sitting across the desk from a fertility specialist. Correction: infertility specialist. Given my age, 39, and Jon’s, 42, and my history of infertility, our chances of conceiving without medical intervention are around 1-5%, she says. I didn’t know our chances were so grim. She hands me a fertility menu: artificial insemination, in vitro fertilization, zygote intrafallopian transfer, donor eggs and embryos. The long list of interventions and the high price tags overwhelms me. So many options, each increasing in degrees of separation from what Jon and I are supposed to be able to do in the bedroom. Must I decide the future outcome of my family right now? Is it even my decision? Perhaps nature has already decided and science won’t be able to circumvent its choice. I set the fertility menu on her desk.

“The saline sonogram will tell you more about my uterus than the X-ray dye-test? And it will hurt less?” I ask.

She nods again. “It will cause less discomfort than the hysterosalpingogram.”

Why does it matter to me if it hurts less? Before I had Lily, I would have undergone any test. I would have allowed any number of transvaginal wands to probe me. I would have increased my risk of developing ovarian cancer which, according to unpopular research, I did every time I subjected my body to aggressive fertility drugs. I would have put up with any amount of “discomfort,” as all of the doctors that I saw preferred to call it, even while I lay on the metal examination table writhing from the uterine cramping caused by the catheter and iodine dye used during the hysterosalpingogram. Then, my ink-filled fallopian tubes, lit up uterus, and the black void on the computer screen resembled a Rorschach test. The first word that sprung to my mind when I looked at the screen was “hurt” so I willed into its place “baby.” But now, thinking of all the testing and hour-long drives from my job to the fertility clinic, I feel tired. My pain matters.

“Intrauterine insemination will increase your chances of conceiving each month by 3-5%,” the doctor says.

My eyes start to well. These are still terrible odds. I discreetly wipe my face and remind myself that I’m not in the same place that I was before Lily was conceived, throwing negative pregnancy tests in the trash month after month, only to have the resulting pregnancy one year later end in miscarriage. Then I felt hopeless and desperate, seeing each pregnant woman in the grocery store as a threat: I was the negative statistic, the infertile one, the one who couldn’t make things grow. I pleaded with Jon to consider international adoption, to consider anything short of snatching a baby from a discount store parking lot so that I could be a mother.

But now I am a mother. I have Lily, delightful, pretends-to-be-a-robin-at-storytime-and-flaps-her-arms-around-her-bedroom-Lily. So why am I sitting here in this office? My friends and family wonder the same thing. “You are so blessed, Jody,” my mother tells me. “You should be happy that you have that little girl. She’s a miracle.” My mother had suffered three miscarriages before adopting me and then surprised herself when she gave birth to my sister a year later.

A colleague of mine, a woman in a same-sex marriage who had struggled to bring a baby into her union and now embraced a child-free life, said, “Why do you need another? You have one perfect child.” I didn’t disagree. Lily is healthy in every way. She’s a happy child, too, who snuggles and offers up hugs like sticks of gums. My pregnancy with her, two months after the miscarriage, felt nothing short of miraculous. Is it selfish of us to want another one? Parents of larger families seem to think it’s selfish of us not to. It doesn’t help that we live in Nebraska, one of the most enthusiastic baby-having states in the nation.

“When are you going to give Lily a brother or sister?” asked my friend, Laura, herself a mother of two. Our three children were on a playdate.

I didn’t know what to say, so I shrugged and said, “We’ll see what the universe has in store for us.”

“Brandon and Caroline are best friends,” Laura said, smiling at her offspring, who at the moment, were engaged in a heated tug-of-war over a naked doll. Lily sat close by, sucking on the index and middle finger of her right hand, entranced by the unfolding drama. Brandon gave one final yank and pulled the doll, minus one arm, away from Caroline. She used the severed limb to whack him on the head. “Well, when they aren’t fighting,” Laura added.

I can’t remember a time when my sister and I didn’t fight as children, and we aren’t especially close now. There are no guarantees.

“It’s about time you started thinking about your next one,” a father of three young boys said at a work picnic. He had casually asked me my age earlier in the evening. He glanced at Lily who was being chased around an evergreen bush by his youngest son and then at his watch. Was he looking at my biological clock, and if so, could I have a peek? He couldn’t have known that Jon and I been actively “trying” for the past seven months, that we’d already exhausted the final three rounds of fertility drugs that my gynecologist would willingly prescribe before considering them a failure. Us a failure. After that, my gynecologist recommended the infertility specialist. Like many fertility challenged couples, we had once mistakenly assumed that pregnancy was a biological given. Jon and I were both good students. If my gynecologist advised us to have sex every other day for our ten “fertile” days each month, told me to eat unappealing high fertility foods like kale and told Jon to give up his nightly beer, we did exactly those things, expecting nothing less than the hoped-for outcome. We had never considered the possibility of no outcome.

But this time is different. We haven’t failed; we have Lily, with her charming daily inspection of the ladybugs in our hosta garden. But after months of unsuccessful attempts to conceive baby number two, we began to have doubts. We found reasons to move on with our life, as is. “Adding another baby will change the family dynamic,” I said one evening. Jon agreed, “Our marriage feels like it’s a priority again.” We are learning how to make time for each other. We’re content. Our house no longer feels topsy-turvy with the round-the-clock demands of a baby, who is the most inconsiderate kind of roommate a person can have.

Besides the added stress to our family dynamic, there are the usual suspects: the financial strain that having another baby will bring to a middle class family like ours, and less time for a career I love. “I can’t think of anything more important than being a mother,” a mother of three children said to me after I had confessed my work-related worry. Sometimes I fear the divide between mother and academic is too wide to cross. I want time for my research and writing endeavors; I want time to advance my career. It all matters, regardless of how idyllic the frolicking family of four on the cereal commercial looks.

Most concerning, I know that breastfeeding and bonding with a new child will mean less time for Lily. “You have enough love for Lily and for a new baby. You do,” one mother told me. I’m not so sure. My love for Lily is fulfilling and also…so consuming.

In the month leading up to my appointment with the infertility specialist, I struggled to tune out well-meaning voices so that I could figure out what I really wanted. I had been certain that I wanted another baby, but now I was unsure. I began to look for signs from a Higher Power. “God, please give me a sign. I want clarity. Is Lily meant to be an only child?” When my prayer went unanswered, or perhaps I neglected to listen, I considered seeing a psychic a friend recommended. Ultimately, I couldn’t manage to find the time in my jam-packed schedule. Was that, in itself, a sign? My interpretation of “signs” changed from one minute to the next. Collecting a pair of Lily’s socks from the laundry basket, thinking of her stubby toes, this little piggy goes wee-wee-wee, I ached for another baby. This sign said yes. Then, in another moment, Jon and I both weary from a full workday, arguing with each other over who would make dinner while the other tended to Lily’s diaper and bath, Lily stomped her foot and screeched, “I WANT MY GOLDFISH CRACKERS!” Then she crumpled onto the kitchen floor and sobbed. When I reached for her, she flailed her legs, kicking me in the nose. Maybe this is a sign saying no, I thought.

One evening after Jon and I had read Lily stories, sang songs, and kissed her night-night—a ritual that usually left me feeling peaceful—I went outside for my walk and instead paced the few blocks on my street. My pacing soothed me in the way it mimicked the pacing my mind was doing, too. My neighbors probably thought Jon and I were having marital woes, but we weren’t. We were having only-child woes, worried we weren’t yet a real family. We weren’t child-free nor were we child-full. During our early courtship, six years ago, Jon and I had agreed that two was our number, and I struggled to reconcile that early shape of our American Dream with our current reality. The only sound I heard came from the summer cicadas, buzzing so loudly that I entered a kind of trance. Did I want another child in case something happened to Lily? It was then that I realized that maybe I didn’t want another baby as much as I wanted to clone Lily in case the unthinkable happened. It’s silly: there is no back-up Lily. Nothing could ease the despair of losing her. Once I vocalized it, Jon admitted he shared my worry, too. “If something happened to her, I wouldn’t be Dad anymore.” Being so vulnerable terrified me, but I knew having another child would only increase my vulnerability, not lessen it.

Then how to explain the fact that I’m sitting here in this doctor’s office, seeking more invasive medical intervention to help get me pregnant? The myth of the only child syndrome doesn’t worry me: extroverted Lily isn’t socially inept. Toddlers are supposed to be spoiled, and developmentally they’re all selfish. Most of the only children that I’ve known have grown into thoughtful, intelligent adults.

I’m concerned about the other consequences of Lily growing up an only child. Will her childhood be lonely, spent longing for a sibling to torment? Will holiday celebrations with only the three of us feel too small, somehow unfinished? Will she feel overburdened as Jon and I grow elderly? Will Lily be alone after we die? Perhaps the answer to all of these questions is “yes.” The bigger question: Can I live with that?

I have so many questions and none of them have to do with the semen analysis the doctor is requesting for Jon or the blood work she’s ordering for me. Earth to Jody. I focus back in on the doctor across from me. I look at her skin, clear and smooth, unlike mine which has been blotchy ever since my pregnancy with Lily, over three years ago. I like the doctor. She’s straightforward but upbeat. She’s someone I could imagine myself spending time with outside of this situation we’ve found ourselves in. But I know that we won’t.

“Do you have any questions?” the doctor asks again.

For the first time today, I know what I want. I want to leave. I want to see Lily. I want to touch her and smell her hair. I want to spend the rest of the day focused on the family that we already are instead of pursuing the family that we may never be.

“I don’t have any questions,” I say, and at least in the moment, it’s true. “Thank you.”

I practically run to my car. It’s a mild late-summer day, ideal for a walk to our neighborhood park, the same place where Lily slid and swung and climbed for the very first time, holding our hands and squealing. Weather permitting, we’ve walked there every week since she’s been born. More than once, I’ve hit the top of my head on one of the climbing structures, a painful reminder that the park has been built for very young children. As a new mother, I cut my teeth at this park. It both saddens and delights me to know that Lily will outgrow it soon.


Jody Keisner’s work has appeared in Literary Mama, Women’s Studies, Studies in the Humanities, and elsewhere. She teaches courses in creative nonfiction at the University of Nebraska at Omaha.

If I Don’t Get Pregnant Again

If I Don’t Get Pregnant Again

By Debra Cole

debracoleIt was a word I never wanted to hear, let alone see in print.


That it was preceded by the word “secondary” was small consolation. My obstetrician handed me the referral for a hysterosalpingography, a fancy medical term for a simple procedure that uses x-ray and a water-based contrast to see if the uterus and Fallopian tubes are obstructed.

“I’m not worried at all,” she said, glancing at my nearly two-year-old son, Henry, playing happily with a dirty truck in the otherwise sterile exam room. But it was best to be proactive. I was, after all, almost 39.

The Mayo Clinic defines secondary infertility as “the inability to get pregnant despite having frequent, unprotected sex for at least a year by a couple who previously had a child.” After I gave birth to Henry at age 36, my husband and I planned to wait until he was two before trying for our second child. We both have siblings between four and nine years older or younger, gaps we valued at the time and in retrospect. We wanted to give Henry the opportunity to be a baby for the entire time he was allotted. Besides, why would we choose to have two children in diapers simultaneously?

Given my age, I agreed, instead, with my doctor’s recommendation to go off the pill in a year and “see what happened.” Truthfully, I wasn’t the slightest bit worried. I had conceived Henry without issue. As he approached nine months old, however, first-time mama friends began announcing their second pregnancies. Even the ones who had been ambivalent about wanting another. For a moment, I panicked.

“It’s not a race,” my husband reminded me.

We stuck with our plan. At Henry’s first birthday in December 2012, I went off the pill and weaned him. And in a twist whose irony I would only understand in hindsight, I secretly prayed I would not get pregnant right away. Never the conformist, I did not want two children under two like the rest of Brooklyn.

Months passed, and worry crept from the edges of my consciousness to its center.

I began to avoid friends who were pregnant again. I did not go, bearing gifts, to see their newborn bundles. I was paralyzed, Elphaba-green with envy, disgusted with myself.

I started using a home ovulation prediction kit, dutifully peeing away my dignity atop a plastic stick in the privacy of my own bathroom each day. The reality of the cliché washed over me. For most of the prior 22 years, I had ingested manufactured hormones like a dairy cow or insisted on condoms at all points of my cycle, because you never know. Yet there I was, holding my breath for a little plus sign that would tell me whether I should have sex with my husband that day. Forget being in the mood; this wasn’t the movies.

After a year, I threw in the towel and began testing. The first two tests were relatively non-invasive: a blood test to check for hormone levels—early menopause?—and the hysterosalpingography—tubes obstructed?—both of which returned normal.

So here we are. My son is 25 months old, and I am confronting the possibility that he might be an only child. I stroke his blond hair, inhale his sweet scent and giggle as he places his face inches from mine and sings the ABCs off-key. Was his creation a mere fluke, a happy accident? Have I taken him—and the joy he has brought me—too much for granted?

To cope with the possibility of permanent infertility, I retreat into my mind, groping for elusive control over irrelevant details. I am signed up in November 2015, for example, for the New York City marathon, a ten-year veteran of my personal bucket list.

If I don’t get pregnant by July, I won’t have time to train for the marathon.

The insignificant gap between 39-and-11-months and 40 yawns before me, cavernous.

If I don’t get pregnant by June, I won’t have the baby before I turn 40.

I stress about the “inconvenient” timing that prevents me from re-starting my career. I went back to work part-time when Henry was 15 months old and intended to return to the workforce full-time only after our second child turned a year.

If I don’t get pregnant soon, my career will grind to a halt.

I despise my smug 36-year-old self, so sure of her own fecundity, so casually willing to tempt fate. Because advanced maternal age is one of the main causes of infertility, shouldn’t we have been trying for—or at least not preventing—conception as soon as we were able? How selfish to seek to avoid the inconvenience of the dreaded two-under-two scenario. How sad that in endeavoring to give Henry time to be the only baby, we may have ensured his lifelong singularity.

If I don’t get pregnant again, my son won’t ever be a big brother.

I should be grateful, I tell myself. Content to have one healthy child in the face of the many couples who cannot have any. Instead, I remain suspended in a peculiar, liminal space, neither embarking on parenthood nor finished creating the family I always believed I would have. I feel at once greedy and isolated, hopeful and impossibly sad.

I imagine my ovaries, worn and tired after nearly 30 years of work, squeezing out the last few potential cells of life. I wonder how far we will go down the path of artificial conception. Do I take fertility medication, brow-beating my body into overdrive? Do I undergo IVF with its attendant stress, cost and shots in the derriere? Do I stymy my rapidly declining fertility by freezing eggs now for future use?

Or do I reimagine my life as a family of three?

Debra Cole is a freelance writer and blogger who lives in New York with her husband, son and a neurotic corgi. She blogs regularly about modern parenting (with a side of humor) at Urban Moo Cow.

The Right Time for The Talk

The Right Time for The Talk

By Ellyn Gelman

Women Driving no 6I sat next to my mother at the kitchen table, our eyes glued to the bulky television on the Formica countertop. It was the summer of ’78 and the lead story that morning was the birth of the world’s first test tube baby. My mind could not shake the image of a little baby trapped in a test tube waiting to be born. I turned to my mother and with all the confidence of a sixteen-year old, proclaimed, “I would NEVER do that.”

It’s funny that word ‘never.’

In July 1992, I gave birth to the first of my three “test tube” babies. I was blessed with a son (now 21) and four years later, twins, a daughter and son (now 17). They were all conceived through the miraculous science of In-Vitro Fertilization (IVF).  The ordeal of conception that had consumed my life for ten years was over; the memories stored away in the attic of my mind like the box of high school keepsakes stored in the attic of my home. My focus now was ‘full on’ motherhood. I rarely gave IVF a thought until the first time I was asked, “Mommy, where do babies come from?”

At first I kept it simple.

“Well there’s a mommy and a daddy and they love each other and then they have a baby.”

When they were older I told them about sperm and eggs and which body parts needed to connect to make it all happen.  Their wide-eyed surprise about these simple facts stopped me from adding; “and sometimes the baby maker parts are broken and you need a Petri dish (aka ‘test tube’).”

It became more complicated as my children’s minds and bodies morphed into teenagers. No one, including me, wanted to talk about sex and reproduction any more than was absolutely necessary. So I stuck to the minimum “what teens need to know” script. The problem with this action plan was that everyone in my family knew the story of my children’s conception, everyone that is except my children. It had never been a secret, but it started to feel like one. Visions of them learning about their in vitro beginnings from an innocent remark or a tongue loosed by libation began to consume me. I realized my children needed to hear their story from me, to know the love and the longing and yes, the hard work that it took to bring them into this world.

How to tell them became a single grain of worry in my mind, just like an oyster worries a single grain of sand. Eventually, an oyster produces a pearl; I was producing an ulcer. How would my kids react to the news of their embryonic beginnings? Would they feel like I did at sixteen? In the early hours of the morning, I would lie awake and fabricate irrational fear-based scenarios.

Scene 1:  Alone in their room, my oldest son, or my twins, would search IVF on their computers and IVF mix-ups (incredibly rare, but easily found on Google) would be the first pop-up on the screen. Would they question whether I was their “real” mother?

Scene 2: I imagined them feeling lost and confused, like that famous little baby bird that sized up a bulldozer and said, “Are you my mother?” My insides felt like a jellyroll; creamy insecurity wrapped in a layer of vulnerability.

I planned a lunch date with my oldest son after a routine dentist appointment. He was home from college for the summer.  My plan was to tell him his conception story during lunch. I had rehearsed the words and knew it was time.

“I hate going to the dentist,” he said as he slipped his nineteen-year old lean, muscular man self into the passenger seat.

“Everyone hates going to the dentist,” I said.

We were barely out of the driveway when I just blurted out his story, so much for my original plan.

“You know,”‘ I said, “One of the happiest days of my life was the day you were born.”

He smiled and touched my shoulder.

“Aw,” he said.

“There’s more,” I said. “Dad and I had some infertility issues. It actually took us five years to finally conceive you with the help of a lot of Doctors and shots and stuff, IVF stuff.” IVF stuff came out garbled, a bit drunken, like “ivyfshtuff.”  Silence, our eyes focused forward as if the road ahead demanded it. Great job! Now he’s going to think his conception was like the creeping plant that grows up the side of our house I thought.

“So, um, they took out some of my eggs and then took dad’s sperm and injected one sperm into each egg. Lucky us, one little embryo formed in a Petri dish and was put back into my uterus and that was you, our miracle.”

I could have been reciting the recipe for pretzel chicken.

“That’s why Grammy always calls me her miracle baby,” he said as if it was all starting to make sense somehow.

“So what was the problem?” he said.

“We both had problems,” I said. “But the biggest problem was that dad’s sperm just didn’t move, low motility they call it.”

“Oh my God, do I have that?” He recoiled against the car door, both hands protecting his genitals.

“No, you don’t have that”

“Are you sure I’m never gonna have that?”

I thought about my answer.

“Pretty sure,” I said. I am no longer comfortable with the word ‘never’.

We pulled into the parking lot.

“So, um do you have any questions?” I said.

“Nope, I’m good, it’s kind of cool to be a miracle. Love ya mom,” he said as he opened the car door and headed into the dentist.

God I love that kid.  One down.  Two more to go… someday.

Ellyn Gelman is a freelance writer living in Connecticut. She is a frequent contributor to

Love On The Rocks

Love On The Rocks

By Beth Kohl

summer2009_kohlI am a person with too many items in storage. There are reminders of late relatives, like my grandmother’s chipped porcelain tea cups that call to mind her living, breathing, sipping mouth upon their rims, the wrinkled half moons of coral lipstick still barely perceptible. There are framed photos from my parents’ lost marriage, my dad in a white tuxedo jacket and my mom with a startlingly chic pixie cut, his arm draped comfortably around her tanned, rounded shoulders, all of these souvenirs from my past that I’ve stowed until I decide what to do with them.

I’ve meticulously packed and labeled things—the Chinese figurines from my deceased grandmother’s condo and the belongings I’d salted away when my mom decided on a near whim to sell the house—as if I knew it’d be some time before I’d look through the neglected intentions idling in storage. I hope someday to amass the guts to go through the boxes, plucking out and remembering an item’s former life, displaying the meaningful or using the practical until the luster of nostalgia rubs off and expediency sets in.

Among my array are seven frozen embryos. They’re at a fertility clinic, stuck inside a capillary straw suspended within a nitrogen tank until my husband and I decide what to do with them. They are leftovers, seven untapped yet potentially fruitful embryos from our various in vitro fertilization (IVF) cycles. Unlike the inert objects up in the attic, the Betamax and LPs, the moth-eaten coats and the collar from a dead pet cat, the embryos have the possibility of an entire life before them, requiring neither resurrection nor retrofit.

*   *   *

The embryos exist precisely because we’ve been successful at IVF. We underwent five attempts, ending up with a beautiful girl on try number three, and twin ones on the fifth. My ovaries had been easy to stimulate, and each cycle produced a bounty of eggs, many of which fertilized. Each cycle, we chose to transfer three embryos from the Petri dish into my uterus, the right amount to up our pregnancy chances while not risking a too seriously complicated one. The day of each transfer, we were asked our intentions for the remaining embryos. My husband and I, discussing it briefly and always at the very last minute when I was already undressed and ready to get the procedure under way and over with, when we only just learned how many embryos had continued to develop overnight and how many cells they contained, agreed on cryopreserving the surplus. It was the only decision among those presented—donation to research or another couple, or destruction—that preserved them as ours until we were ready to make a thoughtful, measured choice.

It has been eight years since we froze five of the embryos and nearly ten since we decided to save the first two (a clinic mishap accounts for those older ones). In that time, our children have grown from babies to toddlers to these fantastic kids who are loveable and proficient at assorted skills, the sorts of people we enjoy conversing with, helping with homework, and treating to nights out at restaurants or the movies. We’ve even gone on a couple of not-disastrous trips and fantasize about other places we’d love to see together. We’ve forged unique relationships with one another, developed a kind of family linguistics of silly nicknames for commonplace items based upon charming toddler mispronunciations, the sorts we have difficulty dropping around other people who assume my pronouncing garbage as gawbage is a speech defect rather than simply a charmed mother.

We have a shared history, all five of us pulling away from those tough early days. When our eldest daughter was two, she had some seizures and a couple of emergency surgeries to remove infected masses in her bladder. And my pregnancy with the twins had been nearly catastrophic. After almost miscarrying them at twenty-one weeks’ gestation, I spent months on bedrest, scared stiff that my cervix would give way and too-young babies would come tumbling out. But we all survived, the eldest daughter given a clean bill of health, the twins emerging at week thirty-five. We’ve been a family with three children under two years of age, with twins who had various preemie issues, and who had weathered the typically “Terrible” years. We’ve outgrown the reflux and grown out the self-inflicted haircuts, and we’ve all gotten used to the idea of us as a completed family unit with a keen memory of dodged bullets and tested fate.

*   *   *

But my mind is far from made up. I’ve been mooning over those seven stragglers, missing the excitement and heightened physical sense that pregnancy, labor, delivery and nursing bring. I’ve been toying with names and the possibility of loving another child the way I love my daughters. True, the stage we’ve reached is a relative piece of cake compared with the relentless exhaustion of raising three very young children or those dark early days when I thought I’d never get pregnant. And I’m back on track with my own career, able to work while the kids are at school or asleep not just for the night, but for the whole, uninterrupted night. Our social life is once more in blossom. More importantly, my husband and I now have the time, and inclination, for a sex life. I remember, now, why I fell in love with him in the first place. He is funny and smart, warm and sexy, more than just another set of hands. And he is the only being in the house who smells like neither powder nor dog. I take him in and recall our early, heady days together, marveling that parenting could have obscured them.

Adding another child not only would upset our balance and boomerang us back to overwhelmedness, it’d tip us into another category: that of the Big Family, the sort that, despite how well-behaved the children or how fantastic the wife’s guacamole she brings over, simply entails too big a crowd. We would once more be anchored down by a needy, bawling, sleep-ruining infant who would inevitably turn into a demanding, throwing-silverware-on-the-floor-just-to-see-her-mom-fetch-it toddler. He or she would wind us back up and tether us back down to just the sort of enforced domesticity we’ve blissfully started to outgrow.

All the same, I’ve been eyeing babies for a couple of years now. The ones in my friends’ arms or in strangers’ shopping carts, the ones asleep in their strollers or crying on airplanes. I’m keen for the infinite shapes of their heads, the lengths of their eyelashes, their curled toes and grabby fists, and I’ve convinced myself that my attention is a sign to not give up the embryos unless I’m positive using them isn’t the best, most well-considered and most ethical option.

Indeed, my ethics seem to have shifted since we froze the embryos. Or maybe it’s just that the once-bright line separating more Platonic ideals of Right and Wrong from my own personal yearnings has dimmed, leaving me in the dark about the difference between doing what’s best and doing what’s right. Perhaps realizing that my children were once, even if only for the most fleeting of moments, cell clusters identical to these seven provoked this change. Intellectually, I appreciate that embryos are not very young fetuses, the storage containers at the fertility clinics aren’t nitrogen-rich orphanages, and thawing them out and letting them languish doesn’t amount to a prenatal massacre. Fertilized embryos are cell clusters, raw ingredients rather than a realized being. But I also know that frozen embryos have the potential, given the right conditions, to become fetuses who (that word creeps in) have the potential, given the right conditions, to become human beings.

We made our decision to freeze our embryos from a place of innocence and ignorance, a matter of putting practicality over bioethical or moral considerations. At that point, we didn’t know whether I’d end up pregnant, and the last thing we were willing to do was squander any unused potential children. I also couldn’t have deduced how deep my connection to my children would be before having them, or how frequently I’d think about the frozen embryos before creating them. But becoming a mother and loving my children has breathed life into what—when I was in an exam chair, trembling from nerves and drafts blowing through my untied and over-laundered hospital gown and being asked to make profound bioethical decisions—turned out to be an inert, unexamined personal philosophy and an abstract sense of the ethics involved.

Also, until becoming a mother, I couldn’t have anticipated how powerfully motherhood would impact my perspective on all sorts of things, bioethics and cryopreservation among them. Like an inmate who finds religion in the slammer, being a mom has caused me to reevaluate how I live my life and to think more about why I believe what I believe. For example, why had I assumed I’d have no problem donating biological matter, let alone my daughters’ full genetic siblings, same vintage and all, to an unknown lab for unknown purposes? Why hadn’t I at least recognized that, good cause or not, handing them over would be to extinguish them?

Looking back, I think it’s because I’ve always been pro-choice, pro-science, pro-pragmatism. Those were my fallback positions, ones I inherited and proudly averred. But becoming a mother has taught me that I am also vehemently pro-family and pro-child. Which, alas, leads me back to the quandary of what is the right and best thing to do, not only for our own family, but for others? Would helping to care for a new baby, exhausting as it would be, be a boon for our crew? Would we all look at each other and marvel that our beloved daughter or son, brother or sister, might never have been? (Family! Family! Sis Boom Bah!) Or would the time, energy and finances that a new baby would divert, particularly in these rough economic times, cause us to regret having chosen this path?

To be clear, I’m drawing a distinction between personal values, on the one hand, and fundamental morals on the other.  The former is a personal code of conduct derived from multiple influences (parents, teachers, religion, philosophy, civics, etc.). It’s the code that allows you to figure out where you stand when there are good arguments to be made for multiple courses of action. Morals, by contrast, are less optional, a code of conduct that (ideally) would be espoused by all rational people. I view my frozen embryo dilemma as existing along the ethical continuum. Donating them to science, therefore, is an ethical course of action. But the way in which my personal ethics have evolved leads me to believe that donating them may not be ideal, at least not for a person who, like me (and unlike, say, Nadya Suleman), has physical and mental health, a manageable number of healthy children, resources to care for all of my children, and a helpful and willing family.

*   *   *

Putting aside religious doctrine (which I did many years ago), I am left only with my subjective sense of right and wrong. I am not capital P, capital L Pro Life, all of a sudden, at least not in the way of Phyllis Schlafly or Sarah Palin. But I recognize not only intellectually, but in a more complex way involving my heart, spine, and stomach, that fertilized embryos are not mere cellular gobstoppers.

Scientific progress requires experimentation and a whole heaping mess of trial and error. So even though I’ve always believed it’d be wasteful to destroy the embryos—a brash smiting when scientific research was such a good option—I’m no longer as certain that scientific advance trumps baby number four. Certainly, if every scientific test yielded definitive, productive results, and if somebody could guarantee a medical breakthrough before dismantling our embryos, plucking them apart cell by cell or injecting them with an experimental solution, I’d likely feel differently about ceding them. But knowing that scientific advance is a matter of baby steps and missteps, and also recognizing that the symbolism of these embryos—the not insignificant space they’ve occupied in my mind and heart all these years—will be lost on whoever it is doing the dismantling, makes it that much harder for me to surrender these potential children and/or stem cells to the trial and error heap as if they were any other specimen.

Like the irrationally protective mother I can sometimes be, I have nightmares in which they end up in the wrong hands. I imagine unsmiling, begoggled technicians using them in unsavory experiments involving combinations of human nuclei and chimpanzee lysosomes. I envisage them for sale on black markets to skin care companies formulating embryonic potions for the wrinkle-phobic, or classified CIA-type operations trying to create a frozen embryo bomb, or simply misplaced or left to wither when somebody mistakenly unplugs their tank.

*   *   *

But I also have misgivings about keeping them around indefinitely. At $500 annually, it’s expensive. And as a mother who remembers keenly the miraculous moment when we first heard our daughters’ hearts beating, a sound we’d sought for so long and through such adversity, I tend to think magically about these cells. I think about them daily, envisioning them stuck to the sides of their straws inside their container, one shiny scuba-tank-looking receptacle among hundreds, within which lurk thousands of teeny tiny surplus. I wish I was copacetic with the idea of keeping them around indeterminately, dashing off that annual check and viewing them as thoroughly modern and ultra cool mementos of the earliest moments in our children’s path towards life. I wish I could see them, as my fertility doctor does, strictly as a perfect source of stem cells should any of the girls need some, or (and here the bioethical dominos start to topple) a potential child for one of my daughters should she inherit her mother’s fertility issues, end up in a same-sex relationship, or desire single parenthood.

But I can’t. The seven embryos remind me too keenly of the precise moment when the development towards life begins to unfurl. They also cause me to dream of flutters, kicks, contractions, tugs on my lactating nipples, teensy fingers wound into my hair. They represent seven potential daughters or sons, sisters or brothers, pureed peach-loving, hair-pulling, bathing, crying, sleeping, thinking, growing, struggling, achieving, sensing, smiling, brawling, bawling individuals.

But defrosting them and going for that fourth baby forces other sorts of ethical reckoning. The first dilemma surrounds how many to thaw, since not all embryos survive the process. It’s the cooling and thawing that cause the destruction. Even assuming a seventy-five percent thaw survival rate (the statistic our fertility clinic uses for embryos frozen at the blastocyst stage, as ours were), it’d be tough to decide how many to thaw in order to end up with one or two quality embryos. If we defrost them individually and they don’t survive, I’ll have prepared my uterus with a month’s worth of potentially cancer-causing injected hormones for naught. But if we thaw them out in slightly larger batches, I may end up with pregnancy upon pregnancy, or multiples upon multiples, and more children than we can reasonably handle. On the other hand, if we were to thaw them all out and implant only the best one or two, we’d need to dispose of the extras—you can’t refreeze them once thawed, nor can you donate them to science or even to another couple at this point, unless you have a buddy with a prepped uterus willing to accept the embryologist’s B team.

*   *   *

I’ve heard stories of how other people deal with their untapped, unwanted frozen embryos. I have a friend who retrieved her and her husband’s three extras from the clinic, wrapped them in a tiny drawing of rainbows made by her twin daughters, and prepared a box for them to be buried in. It was neither fancy nor macabre, involving neither decoupage nor a miniature casket. Rather, she used a metal tooth fairy box with a screw-off lid that she said a blessing over and buried in the backyard beneath a favorite tree. I have another friend who, after delivering two sets of twins and a singleton to boot, gladly signed the form to donate her two surviving embryos for research. She figured she owed her largesse to science, and if those two embryos were to offer any sort of scientific boost, their existence would not have been in vain. I’ve also learned of women who have their frozen embryos transferred into their bodies at a point in their cycles when pregnancy likely won’t occur. They say this feels like the most natural and least violent conclusion.

I do not, however, know anybody who has donated her leftovers to another couple, something I considered only briefly and then dismissed as not for me. The idea of somebody else raising my biological child under these conditions bothers me. In part, it’s because I fear a molested conscience, the monotony of what if, what if. Putting aside the pure desire other couples have for taking frozen embryos off someone’s (sinful, selfish, blasphemous) hands, I don’t think I could give them away to another potential family when ours is relatively high-functioning and my uterus is still intact. Perhaps if there were a test we could conduct, a way to predict my pregnancy chances versus that of a potential donee, I’d be amenable to giving them away for a likelier shot at life. But all things being equal, I’d be hard-pressed to let another couple raise our children’s full genetic siblings. I can’t help imagining what those brothers or sisters would think if they looked us up one day, got our address and drove up and saw our plenty big-enough house, the charming public school down the tree-lined street, and the couple of dogs lying around the well-kept yard.

Perhaps I’ll reach a point when the idea of not using them doesn’t bother me. But I don’t have the luxury of much time. If I’m going to have another child, I’d like for him or her to be as close in age as possible to the current pack (me and the mister included). And if I’m already convinced these embryos are potential people—which my current baby lust and the fact my mind jumps so easily from the babies I encounter to my own supply of raw material proves—isn’t it safe to assume that I’d mourn their loss, even if giving them up proves most practical?

But there are other risks beyond exhaustion and upset balances. Fertility drugs are potentially dangerous to the women who use them, upping the odds of ovarian cancer, this when the usual odds strike this semi-hypochondriac as scarily high. Worse are the ongoing, multitudinous studies on the health risks to children resulting from IVF. While there’s no unequivocal correlation, several world-class institutions have found convincing relationships between assisted reproduction, particularly IVF and its component procedures, and rare childhood diseases, retinal and bladder cancers chief among them.

I remember the terror of having a daughter with serious medical problems and how I’d automatically assumed the IVF was to blame. When her doctors shook their heads, unable to pinpoint the source of the troubles—the seizing was neither from fever nor epilepsy, just anomalous shakes that disappeared as quickly as they’d come on; the cysts were remnants of an embryonic structure that should have turned into the bladder by birth—I’d suppressed the urge to comfort them by letting them know she’d been conceived using IVF and therefore undoubtedly had been packing some not-completely-normal parts.

But my children seem so normal. Beyond normal, really. They’re extraordinarily kind, sociable, and clever. And I’ve pored over them, their bodies, and their development. They’ve hit the normative milestones, crawling and walking and talking according to schedule. They’ve learned how to read, beg for turtles, guinea pigs, and rabbits, and have started wondering where babies come from. I observe each landmark with a mixture of celebration and relief, hoping that, someday soon, expediency will set in, and I’ll start to forget about unexploded landmines and other thorny residue.

*   *   *

Still, knowing what I now know, having read the studies and experienced the anguished helplessness of having a sick child, how could I choose to use these possibly toxic embryos. Not only had they resulted from IVF, but they’ve been frozen for the better part of a decade. If the dusty taste of waffles that languish in the freezer are any indication, quite possibly there would be something “off” about our preserved embryos, too.

I imagine an alternate, more perfect world, one without ghosts or the pain of lost lives. In it, every maternal woman would be gloriously fertile and no child would ever know disease. I’d be a young, energetic mom with three healthy and happy children who resulted from spontaneous and hot, hot sex. There’d be no health risks associated with producing life, no overwhelming decision still to be made about the fate of cells that are too often viewed as property, and not enough like somebody’s past and future. Our cat would still be alive, jumping up on the kitchen counter as I pour tea into my grandmother’s cup. She’d be sitting at a table near the window, smiling as she watched her great-grandchildren run around outside, then raising the cup to her mouth, stamping another coral scallop upon its rim.

*   *   *

Author’s Note: I wrote the bulk of this essay long before the term “Octomom” entered the lexicon. And as I say in the piece, I feel like I’m in a completely different logistical boat than Nadya Suleman, making my decision a matter of choosing amongst decent options as opposed to forging ahead without due consideration and ignoring practical considerations to a harmful degree. Having said that, when I heard Ms. Suleman talking about her frozen embryos as her future children, I couldn’t help but empathize. I know what she means, even though she took her argument, and then its consequences, to a point far beyond the limits of my ethical comfort zone.

Beth Kohl lives in Winnetka, Illinois with her husband and three daughters. She is working on her first novel.

Brain, Child (Summer 2009)

Adventures in Fertility and Mortality

Adventures in Fertility and Mortality

By Zahie El Kouri

spring2012_elkouri“Do you believe in an afterlife?” the doctor asks.

I’m lying on an examination table, wearing a sweater and socks, my feet in stirrups. A nurse has given me a folded, translucent square of paper, and I choose to leave it folded to cover my lap effectively rather than unfold it to cover more of my body while leaving nothing to the imagination. The doctor slides a special probe up what the truly educated are now calling the vajayjay. I am about to start my second round of in vitro fertilization, and the doctor is doing a baseline transvaginal ultrasound to see if we can go forward.

For some women, this kind of ultrasound is no big deal, but for me it is so uncomfortable it verges on the painful. I know I’ll be less uncomfortable if I relax, but I can’t do that because the doctor and I are talking about my father’s death.

My husband, John, is sitting by my side, and he squeezes my hand when he hears the doctor’s question. John is sad about my father’s death, sad that I have to go through all this medicalized stripping down, sad that sex has been taken out of our procreative equation. But he is also tired of being sad. That’s why minutes ago, before the doctor arrived, when I was crying while taking off my clothes, he tried to distract me by singing the tune of what he says is the music one finds in porn. Bam ba dah bam bah. Humor is the way he copes with stress and sadness, and the doctor has undone the moment of laughter John and I shared in his absence.

“So, how long has it been since your father died?” the doctor asks. He is looking from my vagina to the monitor and back again, and pushing buttons on a side panel. His glasses are smudged, and through a trick of the light, I can see my reflection in them, even though he isn’t looking at me.

“About six months,” I say, even though I know the answer down to the day.

“Was it a long illness?”

“No, just ten weeks. Pancreatic cancer.”

 *   *   *

In many ways I’m a typical fertility patient, if there is such a thing. I am thirty-six years old. I have been trying to get pregnant for three years. Seven months earlier I lost my first pregnancy, achieved through IVF, to miscarriage. Two weeks before this appointment, I started injecting myself with Lupron, which has put me into temporary chemical menopause, a condition that, ironically, will help me get pregnant through IVF, even though the associated mood swings and headache may also alienate everyone who has ever loved me.

Fertility and mortality are not the only things on my mind. Just a few months after my father’s death, John and I moved to this new city for his new job. My mother is staying with us because she is too sad to be alone, and my in-laws are visiting, and all the parental attention only highlights my father’s absence.

In many ways, I am alone in my grief, and in my mind having a baby has become all tied up with my father’s death. A grandchild was perhaps the thing he wanted most in life, and I feel like a failure for not finding the right person to marry earlier, for not having a baby before his death. I can blame the weepiness and the irritability on the chemical menopause (and I do), but I know that I am sad and desperate because I am still trying to redeem myself.

I want a baby—I have always wanted a baby—but the truth is that, without my father’s death, I might have chosen not to do all of this. I might have chosen adoption. The truth is that, yes, I do believe in an afterlife, in a religious sense, but that belief does not save me from my grief. It does not keep me from missing my father. The truth is that I am loath to start injecting myself with drugs that will hyperstimulate my ovaries. I am loath to go from chemical menopause to chemical super-fertility in ten seconds flat. But the most important truth is that right now, I am willing to do anything to preserve my father’s genetic legacy—other than my memories, the only piece of him I have left.

“Well, do you believe in an afterlife?” the doctor asks.

There is a long pause, and eventually, John answers the question for me.

“Yes,” he says. He takes my hand and squeezes it. “She does. Her priest really helped us through it.” John leans toward agnostic, but he, too, is transformed through this experience of death. He prefers humor, but he knows when to step in and be serious.

I cannot look at John without crying, and I don’t want to answer the doctor’s question, so instead, I spend my time coming up with all the possible reasons for the doctor to ask me this question at this particular moment. I come up with three:

1. The doctor may think that making any conversation will distract me from what is going on with my body, and therefore relax me (like a Caribbean vacation with no hurricanes).

2. The doctor is particularly curious about my unique presentation of the human condition. The doctor has lost a loved one, and has found solace in his belief in an afterlife.

3. The doctor is bored because he has seen too many vaginas.

I begin by considering reason #1. Maybe the doctor has had success with making small talk while doing transvaginal ultrasounds. Maybe, after dealing with thousands of women desperate for a child, he believes that having a conversation about something other than fertility will relax me, reduce stress, and increase my chances of getting pregnant. Maybe he sees himself as part therapist, and knows that I am in desperate need of some therapy before I should be allowed to get pregnant.

This may all be true, but I still rule out rule out reason #1, as it is unlikely that anyone would think that asking about a patient’s father’s illness and death would distract her from a penis-sized plastic probe up her vajajay.

I next consider reason #2. I vaguely remember this doctor mentioning losing his own parents. Maybe he struggles, as a man of science, with issues of faith and mortality. Maybe creating fertility miracles every day has given him the intellectual space to consider the possibility of an afterlife. Or maybe it is the opposite. Maybe he doesn’t believe in an afterlife, but he envies those who do?

If I were being rational, I might conclude that I can explain the doctor’s behavior with reason #1 or reason #2. He is a warm and friendly man. Like my husband, he’s sad for me. But I don’t want to dwell on these possibilities because they are just too painful, so I go with reason #3—the doctor has simply seen too many vaginas.

Now, to be clear, my doctor is a board-certified reproductive endocrinologist with an excellent record of successful IVF pregnancies, so he sees more vaginas than say, your average neurosurgeon. He probably also sees more vaginas than your average obstetrician/gynecologist, as your typical patient comes in once a year, takes off her panties, and that’s it. She might get pregnant, in which case, she would be coming in every now and then for exams, and then there would be the labor, where the doctor would see a whole lot of her vagina, but still, most women don’t go through labor more than once a year. Unless they have multiple uteruses, but that might present other issues that might also require a specialist.

It’s not that I think my vagina is anything special, or that I don’t appreciate the square of paper or the fact that my doctor will spend the extra ten minutes talking to me about my IVF cycle or inquiring as to my state of mind and grieving process. I respect the Swedish position on nudity and the time-honored tradition of skinny-dipping. It’s just that I miss the days when the only naked conversations I had about the afterlife were with my husband. I am tired of being physically and emotionally exposed. I don’t know how to talk about my feelings about death while trying to create new life.

*   *   *

In the next year and a half, I manage to get pregnant and miscarry twice more. I travel to another state for even more specialized medical treatment, coming back to the afterlife doctor for early-pregnancy monitoring when I get pregnant for the fourth time. In the appointments, he is still friendly, though he discusses work with John instead of discussing death with me. When I’m eight weeks pregnant, he sends me on to an obstetrician, wishing me the best.

That pregnancy took, and I gave birth to a healthy baby boy in June of that year. Soon after, I see this doctor again, as John and I leave the office of a lactation consultant who shares his waiting room. The doctor’s receptionist sees us walking by and sends him out to see us while we’re trying to get our crying baby into his car seat. The doctor approaches and greets us with a smile. After asking permission, he takes the baby and dances around with him. The baby stops crying and looks at his reflection in the doctor’s smudged glasses.

“How are you feeling?” he asks.

“I’m great,” I say. “Tired, but happy.”

“That’s good to hear,” he says. “Isn’t that good to hear?” he asks the baby in a sing-song voice.

John and I smile at each other.

“Who do you think he looks like?” the doctor asks, looking from the baby to my husband, and back to me. “I see bits of both of you.”

“He looks like Zahie’s father,” John says. I have never heard him say this before. “It’s nice.”

I stare at the baby with new eyes. I have been so sleep-deprived since his birth, so focused on the work of keeping him fed and clean and making sure he is still breathing, I haven’t really studied his features.

John is right—there are my father’s big brown eyes, his full lips, his round face. I hope to see my father in the afterlife, but I am happy to have these pieces of him here with me now.

*   *   *

Author’s Note: “Once infertile, always infertile.” That’s what my friend used to tell me when she was pregnant and I was still in the midst of my infertility struggle. At the time, I thought she was a little crazy, a little whacked out on pregnancy hormones, but now I know what she means. My ongoing mental state of infertility, which persists despite the presence of my vocal, playful baby, leads me to check the infertility message boards every day, and to pay special attention to any personal essays about infertility or fertility treatments. I’ve noticed a trend lately of comments on these essays saying that women who go through IVF to get a child instead of adopting are selfish. Was my desire to see my parents in my child selfish? I think about this question all the time. I wish more peace in this question for others, and I hope that this essay will give a sense of some of the emotions connected with wanting a child with a genetic link to you—and the ways in which those emotions are so much more complicated than the word selfish might ever contain.

Brain, Child (Spring 2012)

Zahie El Kouri writes about family, fertility, and immigrant culture. As the child of a Syrian/Lebanese/Palestinian father and an Italian mother, she has a special interest in the experience of second-generation immigrants, within the family and without. Her creative non-fiction has appeared in Memoir Journal, Brain, Child, Garbanzo Literary Journal, and Ars Medica. Her short fiction has appeared in Mizna, a Journal of Arab American Writing and the second edition of Dinarzad’s Children: an Anthology of Arab-American literature.  She holds an MFA in creative writing from New School University and lives in Austin, Texas with her husband, the novelist and legal theorist John Greenman, and their son. You can read more about Zahie at

Fair Embryo

Fair Embryo

By Ellyn Gelman

Virus and Bacteria CellsI don’t want to get out of bed on my 30th birthday.  My soul feels bruised in some places, fractured in others.  I have been adrift in the sea of infertility treatments for five years.    I have ridden the waves of hope with my husband Dan, only to be pulled down into an undertow of disappointment.  We have come to the end of available procedures, discharged by the specialists.  We are not candidates for IVF.  For us it is over, until it is not over.

“Ellyn, phone call, outside line.” My curt, often abrupt administrative assistant stands in the doorway.

“Ok” I say.  I do not look up from the tedious monthly report due today.

My office reeks of cigarettes, I smoke them one after the other.  I have quit so many times I no longer consider the possibility.  Smoking temporarily fills the cracks inside me.

I hit the button on the phone connecting me to the outside line

“Hello, this is Ellyn.”

“Hi Mrs. Gelman, I am calling from the IVF clinic in New York.  How are you?”

“Okay?” My heart begins to pound.

“Great.  I’m calling because we have a new IVF procedure and we were wondering if you and your husband are interested in participating.  It is still considered an experimental procedure………” that is all I hear.  My mind shuts down, numb, unfocused.

We have been accepted into their zona drilling experimental program.  The zona is the outermost layer of the ovum (egg) and also worth 13 points in a scrabble game.  It is experimental because they have not yet had any success stories.  This is how it works.  Multiple eggs will be removed from my ovaries.  One sperm will be chosen for each egg and a tiny hole is “drilled” in the zona layer to enable fertilization (no need for a fast moving little tail).  The only thing the egg and sperm have to do on their own is, divide.  This all takes place in a Petri dish during the time an embryo is usually traveling down the fallopian tubes on it’s way to attaching to the uterine wall.

“I can’t do it.  I can’t handle the disappointment anymore.” I say. My head rests on Dan’s shoulder.

“Yes you can.  It’s going to work this time.”  Ever the annoying optimist, he wraps his arms tight around me.  We debate and I cry for hours.

I concede, “Okay one time, I’ll do this one time, promise we’ll stop here if it doesn’t work.”

“I promise,” he whispers into my hair, just above the top of my ear lobe.    Silently, I make a pact with God to never smoke another cigarette.

So it begins.  It turns out that a fast, hard thrust of a hypodermic needle hurts less.  It takes us three days to figure this out.  Dan’s first attempt to inject my butt with the prescribed hormone cocktail takes two tortuous hours.  I lay on our bed, pants pulled down, one butt cheek exposed.

The first hour we stare at the syringe. The needle is sharp and long, meant to reach muscle.  The liquid in the barrel contains all the hope we have for a child.

“You can do it,” I say.  I place the syringe in his hand.  We are both graduates of a one-hour course on “how to give an injection.”  Sweat is visible on his upper lip.  I look at him with as much confidence as I can muster.  His short dark curly hair sticks out in places, a result of his clammy hands nervously combing through it.  I know this is hard for him.  He is completely out of his element, but he loves me and I love him.

“Just do it, jam it in.  I won’t scream, I promise,” I say.  Irritation over time replaces fear.

“Let’s just go to the emergency room and ask a nurse to do this,” he says.

“Are you kidding me? We have to be able to do this. If we can’t do this, we are not meant to have a child.” I say.  I know these words hurt.  I am baiting him.  Maybe if he gets mad at me, he will just stab me with the damn thing.

He doesn’t bite.

“Okay, okay,” he says.  He repeats these same words many times.  I am still lying on my side.  The room smells like rubbing alcohol.  He has swabbed the injection site with alcohol twenty thousand times.

“Just do it,” I say.

Finally, he jams the needle into my butt, and pulls it right back out.  Every drop of liquid is still in the barrel.  We stare at the syringe.

“That’s it, I quit.”

“Okay, okay. I’m sorry, one more time” he says and pushes the needle where it needs to go.  The liquid causes my muscle to cramp but it feels good because it is done.  I roll over.  Dan looks like he’s going to throw up.  He runs to the bathroom.   Bent over the sink, he splashes cold water on his face.

“You did it!” I say.

I follow him and hug him tight from behind.  It is done, only nineteen more days of this to go.

“Thirteen eggs” Dan informs me when I awake from the anesthesia.  My ovaries, once the size of blueberries, are now baseballs. They hurt.

“Everything go okay with you?” I ask

“All good” he says with a laugh. “Let’s hope they pick some good ones”.

I smile.  His part in this is hard too.  While I am in the operating room, he goes alone into a room set aside for ejaculating into a sterile plastic cup. Then he passes the carefully labeled jar to a technician.  Through it all he maintains his sense of dignity and a sense of humor.

We wait for two days.

“You have a call, outside line”

I pick up the phone, “This is Ellyn.”

“Hi Mrs. Gelman, I am calling from the IVF clinic.”

I am cold, sweaty and silent.

“I am calling to let you know that there is one fair embryo”

“What does that mean?” my voice is barely a squeak.

“Well, it has not divided as many times as we like to see by now, but if it is still viable (able to grow) in the morning, it can be transferred into your uterus.  Don’t get your hopes up though, it is only one fair embryo.”

“Okay” I say.

Dan holds my hand as Dr. Ying transfers the microscopic fair embryo into my uterus. It pinches and I feel my uterus cramp. I like this doctor.  He is a mixture of eastern and western medicine.  He believes in visualization.

“For twenty four hour, think Velcro.  Embryo is like Velcro, needs to stick to uterus.” he says.

I don’t understand at first.  It’s sounds to me like he is saying WelKWo.  I stare at him.  He mimes Velcro. I get it.

“Remember, think Velcro,” he calls after me as I leave the procedure room.  For the next week, I pray and visualize Velcro like it’s my job.

Two weeks later, our pregnancy test is positive.  I am once again reminded by the IVF staff not to get my hopes too high, it is still early and this is a fair embryo.  There is nothing “fair” in the world of infertility.  Hope and faith is plain necessary, because the dream of having a child is too big for science alone.

We are their success story.  Our fair embryo implants and develops into a strong healthy baby boy.  He enters our world on July 11, 1992.  All the cracks in me begin to heal the moment I hold him. I never smoke again.

Ellyn Gelman is a freelance writer living in Connecticut.






Breeding Habits

Breeding Habits

By Andrea Vij

Breeding Habits ArtI tried to shoo them away, but they wouldn’t leave.

They arrived on a Saturday morning in early spring. It was cloudy and cool that day, a gray start to what I hoped would be a quiet weekend. Harv had gone out to get coffee, and I was folding laundry on the sofa when I heard a strange noise coming from the bedroom. I stopped to listen, but it went away.

I reached for another towel and folded it. As I set it aside, I heard the noise again, low and throaty, like a pigeon or an owl: “Coo-OOO-ooh. Coo-OOO-ooh.”

Then silence.

After it sounded again, I decided to investigate. I peered into the bedroom and tiptoed cautiously forward. Pausing at the foot of the bed, I listened. Nothing. Then, just as I turned to leave, I heard it again. It seemed to be coming from outside the north window, so I crept over and moved the blinds to one side.

Wings flapped, twigs scattered in every direction, and something about the size of a robin darted away before I could get a good look. I scanned the courtyard, then glanced down to find a haphazard pile of twigs resting on our windowsill. So that’s it, I thought. Some little bird wants to build a nest here in the ivy.

Annoyed, I opened the screen and brushed the twigs away. I knew about birds. They rise at dawn. They warble and fuss when you’re trying to sleep. They shit with abandon. I brushed every trace of nest from the sill, then walked away assuming I was done.

But I had underestimated my adversary, who rebuilt within the hour. A great battle ensued, taking my quiet Saturday morning and turning it into a dramatic, hours-long confrontation between woman and bird. No … make that birds. By noon, I figured out there were two of them. And they were stubborn, too, like those steely people who insist on riding out hurricanes. They built, and I brushed it all away. And they built, and I brushed it all away. And they built, and built, and built, until I finally just gave in.

“Honey,” I said to Harv, “it looks like we’re going to have a bird’s nest on our windowsill.”

His eyes lit up. “That’s great! Nature in action.”

*  *  *

Our fertility doctor was a rock star. I turned on the news one day and saw him there, explaining the latest advances in fertility prediction. I realized that if the same technology had been available fifteen years earlier, I could have walked into a clinic at age twenty-five and requested a blood test to find out how many eggs I had left. The results would have told me how long I could expect to remain fertile. But I’d have had nothing to gain but false hope. I never lacked for eggs. The problem was my chromosomes.

I learned about it from a series of blood tests for an unrelated condition. Shortly after Harv and I decided to get married, I explained. “I have a chromosome abnormality called a reciprocal translocation. It’s harmless for the most part. I’m not sick. But it could make things difficult if we want to have a child.”

He listened, intrigued as both scientist and potential father.

“It’s kind of complicated,” I added. “At conception, genetic information gets passed on through our chromosomes, right? With an abnormality like mine, sometimes the information ends up in the wrong place. Sometimes it’s incomplete. If that happens, the pregnancy terminates on its own.”

He nodded. “Don’t worry. We have access to the best doctors in the world. We’ll figure out what to do.”

He was optimistic, and I loved him for it.

*   *   *

Several hours after the little fiends finished their nest, I found a picture of them on a birding website. Beneath the photo appeared their scientific name, zenaida macroura, and below that, their common name, mourning dove.

My new neighbors had an identity.

According to the article, mourning doves are abundant throughout much of North America, primarily because they breed up to six times a year. They’re known not only for their plaintive coo, but also for their relentless nest-building behavior, and for the unique squeaking sound made by their wings during take-off and landing. While mourning doves will occasionally take over the unused nests of their fellow birds, most pair up and build on their own, sometimes in awkward locations: inside mailboxes, on fence posts, in hanging planters, and yes, on windowsills.

Over the next few days, I gathered information obsessively. I read about mourning doves’ habits (prolific breeding and little else), their diet (primarily seeds), their preferred habitat (cities, rural areas, woods, meadows), and their close relationship to the passenger pigeon. I learned that mourning doves mate monogamously and share equally in the duties of parenting. I couldn’t help admiring them for that.

I also couldn’t help noticing that the birds on our windowsill bore little resemblance to the noisy brats I had first expected. They cooed softly now and then but otherwise kept silent. We hardly even knew they were there. And if they shat, I couldn’t find evidence of it. I joked to Harv that they were the cleanest, quietest neighbors we’d ever had.

“They’re kind of cute,” I admitted one evening as we set out for a walk.

“And just think,” Harv said. “We can watch our own episode of Wild Kingdom without ever leaving the bedroom.”

*   *   *

Crossing one leg over the other, I peered out over my copy of Good Housekeeping. The clinic waiting room featured a cascading water wall, a collection of lush green plants, several kidney-shaped coffee tables stocked with glossy pamphlets (“Stress and Infertility,” “Benefits of Acupuncture,” “Fertility Treatment: A Patient’s Guide”) and seating for at least fifty. A surprising number of seats were occupied this morning, primarily by women.

I considered making myself a cup of tea at the beverage station, but decided against it because I would have to throw it away as soon as my name was called. I had come for my second ovarian ultrasound, a procedure that would tell my doctor just how enthusiastically my reproductive organs were responding to the powerful cocktail of hormones I mixed each night and injected into the soft, fatty skin around my belly button. He would study the grainy, black-and-white photos and, based on the number of follicles he could see developing on each ovary, adjust my treatment accordingly. But what the pictures would not tell him, or me, or anyone else, was how to solve my chromosome problem. For that, medical science had little to offer. All we could do was jolt my ovaries into high gear and hope for the best. More eggs, better odds.

A woman in pink scrubs approached the reception desk and reached for a clipboard. “Jennifer P,” she called out, checking a name off the list. I watched as Jennifer P. rose from her seat and walked toward the desk. With bracelets jangling and thick blond hair tumbling down her back, she looked attractive, vibrant, and healthy. How could someone like her be infertile?

Flipping through the pages of my magazine, I waited.

“Maria T.”

“Constance M.”

“Jason R.”

I tried not to stare, wanting to avoid the temptation to make comparisons between myself and the other patients. But as I sat there in my blue-upholstered chair pretending to read about Thanksgiving centerpieces, I considered all that Maria, Constance, Jason, and I had in common, even if our official diagnoses were quite different. Like everyone else in the waiting room that day, we had come to the clinic to get help from a specialist, not because we were dying or in physical pain, but because we longed for something that most people can have without medical intervention. We wanted kids.

Science tells us that the urge to procreate lies deep in our DNA. Living organisms share a common biological imperative: reproduce or your species will cease to exist. Call it a primal urge, a deep-seated desire, or even an outdated societal expectation. Ignore it altogether if you like. But somewhere within our every cell lies a drive to procreate, to pass our genes to the next generation. Nature provided this urge so we could survive as a species. Unfortunately, for those of us in the waiting room, nature had failed to take the next step.

*   *   *

With an embarrassing lack of originality, we named our new neighbors Mr. and Mrs. Birdie. Both had soft gray-brown wings mottled by a dozen or so darker spots that looked like they might have dripped off a wet paint brush. Their cooing soothed us and made us laugh. And even though we hated to disturb them, we couldn’t resist going to the window to check on them several times a day.

They had been perched on our windowsill for about a week when Harv beat me home from work one day. He caught me as I walked in the door. “Guess what I saw,” he teased.


He held up two fingers. “Two eggs!”

“No way!”

“Yep. I went to the window to check on them, and they must have been trading off or something. There was nobody on the nest for about thirty seconds, until Mrs. Birdie flew in and sat down.” Again he held up two fingers. “I saw two eggs, and they were white.”

I thought back to my research, and his story held up. Mourning doves typically incubate two eggs per clutch, and the parents alternate at the nest, with the male on duty by day and the female by night. Harv must have opened the blinds at precisely the right moment to see the eggs exposed.

I went to the window and pushed the blinds aside. From her perch, the mama bird looked up at me with one solid, unmoving black eye. “So that’s it, Mrs. Birdie,” I said gently. “That’s why you’ve been so quiet. You don’t want anyone to find your eggs. Well, don’t worry. We’ll protect you.”

At last I understood. Of all the windowsills in the world, Mr. and Mrs. Birdie had picked ours, and within a week or so, they would be nursing two tiny, down-covered hatchlings right out- side our bedroom. This was no accident. Harv and I had been chosen.

“Those little eggs are going to hatch,” I said to Harv. “And we’re going to be parents.”

*   *   *

I lay on the exam table awaiting a verdict. Mary, the ultrasound technician, finished her maneuverings and snapped off her disposable gloves.

“You’ve got seven follicles on the right ovary,” she said, “and four on the left. I see a few other small ones that will grow over the next couple of days. They’ll probably call you back in tomorrow.”

I thanked Mary and got dressed. Seven plus four, with more on the way. After three cycles of treatment, my best count so far. I walked to the car and called Harv. “Good news, honey. No wonder I feel bloated. I’m cranking out eggs like you wouldn’t believe.”

*   *   *

Figuring something could happen any day now, I began rushing home from work. Every afternoon I would run inside, kick off my shoes, hurry to the window and push the blinds aside. Perhaps I imagined it, but whoever happened to be sitting on the nest would look up at me with an expression of complete trust. I spoke in my most soothing voice. “Hello, little bird. No chickies yet today? Maybe tomorrow.”

This went on for several days, until one afternoon I happened to come home earlier than usual. I went to the window, half expecting to find two squawking baby birds with their harried parents.

Instead I found a bare windowsill. No birds, no nest, no ivy, nothing. For one confused moment I thought that maybe I had dreamed the whole thing, that there had never been any birds. But no, they had been there just this morning. The babies were due to hatch. Something was wrong. They couldn’t have just disappeared.

I flung the window open and leaned outside, looking for any clue as to what had happened. Bizarre explanations darted through my mind: a strong wind had blown them away, a bird of prey had swooped in on them, a cat had somehow climbed two stories and discovered them. But nothing made sense.

I ran to call Harv, who was in the Jeep on his way home.

“The birds are gone,” I blurted out when he picked up.

“What do you mean, the birds are gone?”

“They’re gone!” I was beginning to feel frantic. “I don’t know what happened.”

“Okay. Take it easy and I’ll be home in a few minutes.”

I grabbed my keys and ran downstairs. I went out into the courtyard to find something, anything that would tell me where the birds had gone. I looked from the trees overhead to the ground below, from the brick wall to the neighbor’s fence, from the rose bushes to the hydrangeas, searching every corner. Then I saw it. On the ground below our window sat a pile of tools—shears, hedge cutters, and other fierce-looking things with sharp blades—and next to the tools, a ladder. The ladder was propped up against a bare brick wall, and below it someone had heaped a large pile of freshly cut ivy.

“No,” I thought, horrified. “They did not cut down the ivy, not today of all days.” The condo association had told us they couldn’t afford to have any extra yard work done because we needed a new boiler. But apparently someone had found the money.

I looked up at our window, longing to see one small patch of ivy stuck to the wall, just enough to protect a nest. But there was nothing there but bare bricks and mortar. The birds were gone.

I made my way upstairs and waited for Harv. By the time he walked in, I was in tears. I told him everything, about the bare windowsill, the ivy on the ground, the ladder and the tools, the sharp blades, and the brick wall. He listened, his face grim.

We walked into the bedroom and stood together staring at the window. Had we given it any thought, we would have realized that with the approach of evening the mother bird would come home, expecting to relieve her partner for the night. As it turned out, her arrival took us by surprise, leaving us to stand there helplessly as she landed on the bare windowsill. Her head jerked back and forth from the spot where the nest had been to our figures looming before her in the window. We shook our heads sadly, wanting to tell her that we were sorry, that we didn’t do it. She flew away to land on a tree branch a few yards away, then flew back, as if expecting the nest to materialize if she tried again. We stood by as she repeated this ritual ten, maybe twenty times. When we could no longer bear to watch, we closed the blinds and walked away.

*   *   *

The pile of ivy sat dead on the ground in the courtyard for several weeks before someone finally hauled it away. Harv told me he searched through it one afternoon but didn’t find anything. With no evidence to tell me otherwise, I decided that Mr. and Mrs. Birdie eventually found each other, maybe out in the courtyard later that evening. And since their hatchlings couldn’t possibly have survived, I assumed that, driven by their natural urge to parent, they tried again right away.

As for Harv and me, after battling my chromosomes for over a year, we finally made the tearful decision to stop. The next day, we went online and ordered a copy of Adoption for Dummies. By the time the book arrived on our doorstep, we had already found an agency and set up our first appointment. But things moved more slowly after that, and we waited almost two years for a referral.

Today our beautiful son is almost three, and I find it difficult to remember a time when he wasn’t part of our lives. Even before the courts allowed us to bring him home, we thought about him daily. Before that, we longed for him.

When we first talked about having a child, like so many other prospective parents, I assumed this would mean a child with my chin and my husband’s nose, with my long legs and my husband’s dark hair—a child I could know viscerally from the moment its cells began to divide. This wasn’t meant to be. But now, when I look at the sweet and playful boy we adopted after so many months of heartbreak and uncertainty, I feel a sense of completion I never knew to expect. He is our son in every way that matters.

We moved last spring, into a house surrounded by trees and the many birds that reside in their branches. Every so often when I take my little boy out for a walk, he says, “Mommy, the birds are talking,” or, “Cheep, cheep, cheep,” as he hops through the grass, arms outstretched like imaginary wings.

The first time he heard a mourning dove, he looked at me. “What’s that sound?” he asked, reaching for my hand.

“It’s a mourning dove. Before you were born, some mourning doves built a nest outside our window. They say, coo-OOO-ooh, coo-OOO-ooh.”

“Oh,” he answered. “Like this?” And then, in a high-pitched staccato that sounded nothing at all like a mourning dove, he offered his own rendition. It was as if he had heard something completely different, or perhaps wasn’t interested in meeting my expectation of how a mourning dove should coo. And I knew to let it go.

Author’s Note: When I first began writing scenes for Breeding Habits, I didn’t know where the story would lead, but I knew I had to share it. In the end, it took over four years of writing, rewriting, workshopping, and rethinking before I finally had a cohesive essay that said what I wanted to say.

Life can seem so unfair inside the world of fertility treatment, but it is natural—indeed, it is rooted in nature—to want biological children. In my case, I had to let go of that desire in order to become a parent. Once I did, adopting my son turned out to be the most amazing experience of my life, and being his mother, the most rewarding. That, in part, is why I felt compelled to write Breeding Habits. I wanted to say that yes, infertility is unfair. But sometimes, when things don’t turn out the way you want, they turn out even better.

Andrea Vij lives in Wellesley, Massachusetts with her husband and son. Her essays have appeared in Literary Mama, New York Family, Bay State Parent, Adoptive Families, and

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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.


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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