The Art Of Conception

The Art Of Conception

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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.



On Infertility and Magical Thinking

On Infertility and Magical Thinking

By Jennifer Berney


Infertility is a solitary pain. The body, alone, remains alone.


When I first began trying to conceive, I believed that I’d be pregnant within a month. For one thing I was only twenty-eight years old. Because I’m a lesbian, I had already worked out all of the logistics: I knew when I ovulated, and I knew that the donor sperm we had purchased was viable—our doctor had watched them swim beneath a microscope. Of the millions of sperm that would be delivered directly to my uterus, only one of them had to find my egg. What could go wrong?

Besides these clinical facts, I had stories I told myself around conception. I had already spent years of my adult life pining for a child. Surely this desire would inform my body’s ability to conceive. Though I understood that conception took an average of three to six months, I knew plenty of women who had conceived on their first try. I held their stories close to me like talismans. The first time I lay on the exam table for an insemination—my feet in stirrups, my partner holding my hand—I summoned a feeling of openness and joy. Of course this would work. Of course it would.

It didn’t. Months later, when I still wasn’t pregnant, my stories about conception changed. I no longer daydreamed about the women I knew who had conceived immediately. Instead, I imagined I was waiting for the right child to choose me. I pictured little baby-spirits, hovering, taking stock of all the candidates. Sympathetic friends tried to console me with their own magical thinking. “It will happen when it’s meant to happen,” some of them told me. “It will happen when you finally stop worrying about it,” others said.

The stories I told myself and the ones my friends told me had this in common: they imposed order on a process beyond our control.

Story 1: If a child-spirit chose me, then I would be a parent.

Story 2: A force called destiny would choose when I got pregnant.

Story 3: My thoughts controlled my womb.

I didn’t know what to think of any of these stories, these tropes of magical thinking, including my own. I didn’t quite believe them, and yet they haunted me. The third story was the least comforting of all. Surely my attitude was within my realm of control and yet, the more I tried not to worry, the more I worried, and the more I worried the more I blamed myself for worrying.

One day, after nearly a year of trying and failing, after having spent thousands of dollars on frozen sperm and monthly inseminations, I ran into an acquaintance at the grocery store. She had dated a close friend of mine not long ago, and so she was privy to my situation. “What’s going on with the baby thing?” she asked me. We stood between shelves of toothpaste and shampoo. I looked at my shoes and then back at her. “It’s just not happening,” I confessed.

“Well,” she said, her voice strangely chipper, “maybe you just weren’t meant to be a parent. Did you ever think about that?”

“Yeah,” I said. “I’ve thought about that.”

*   *   *

Now that I’m the parent of two young boys, there’s a mind game I like to play with myself sometimes. When my children are hugging each other on the couch or running ahead of me on a dirt road, I take a snapshot in my mind and offer it to my earlier self, the me of nine years ago. She is preparing to turn thirty and wondering what she will do if she’s not pregnant soon. Will she spend another small fortune on IVF? Will she apply for an open adoption and hope that someone will choose her? It is true that she has options; it is also true that none of them guarantee a child.

The me of nine years ago tries not to cry to her partner too often. Infertility is a solitary pain. The body, alone, remains alone. For two weeks of the month the mind hopes and imagines. With blood those hopes are dashed. Her partner, on the other side of things, continues in a body unchanged by the ritual of hope and disappointment. Her partner learns about the blood arriving, but is not the one checking her underwear every hour.

And so when I cried, my partner tried to comfort me by saying, “I’m not worried about it. I know that we’ll have a child. When it’s meant to happen it will happen.”

Destiny again. Magical thinking. These words didn’t help me nine years ago. The only thing that could have helped would have been a picture of my future life. With this evidence I might have waited calmly. But the snapshot of my children, handed through time, is a dream. In the real world no one can offer evidence. They can only offer hope disguised as certainty.

The longer I tried and failed to conceive, the more I saw that there were plenty of people around me who wanted children and would never have them. Some of them had never found the partner they were looking for, or they found that partner too late. Some of them conceived and lost a child and then couldn’t conceive again. Some of them pursued adoption but were never matched with a child.

This isn’t destiny, at least not in the benevolent sense of the word. It wasn’t the kind hand of the universe intervening for some unknown reason. Instead this was reality. Sometimes you want a thing very badly and still you don’t get it. When life presents challenges, when it drops bombs of longing and grief, we inevitably grow and gain depth. But this doesn’t mean that those challenges were pre-ordained.

I do believe that the stories we make of our lives are important. But they are just that: stories. We reach into the chaos of the universe and try to pull out some meaning and order. Because my story has a happy ending, I can pretend that it was destined after all, that I was meant to be a parent. But the true story is this: I got lucky.

The me of nine years ago reaches forward in time. She takes the snapshot from my hand and reminds me of how badly I wanted the life I have now. She reminds me to listen in the dark as my children breathe. She reminds me of how tenuous all of this is, our lives together on this earth. We are the products of a series of infinite chances, bound to each other by the near-impossibility of it all.

Jennifer Berney is a Brain, Child contributing blogger. Her essays can be found in The New York Times MotherlodeThe Washington PostThe Manifest-Station and in the forthcoming HerStories anthology, So Glad They Told Me. She is currently working on a memoir that chronicles her years-long quest to conceive a child. You can connect with her on Twitter, or on her personal blog, Goodnight Already.

The House a Dream Built

The House a Dream Built

By Kirsten Piccini


What good was a fourth bedroom or a playroom with no one to play in it?


I could picture the house in my head—the white siding, black shutters and the red door I’d finally talked my husband into. I’d mentally positioned furniture and held my own internal debates about a shower door versus a curtain. For months it had taken up precious space in my thoughts, replacing the constant thrum of failure that pulsed just beneath the surface of my skin.

It was a fertile dream, this house, unlike so many others, one that was poised to come true.

So as I sat on the unmade bed, wrapping the crisp edge of the sheet around my finger only to unwrap it and then repeat the process, I felt the dream drifting away, fading like an old photo.

“Honey?” I said to my husband who was just coming out of sleep and regarding my tick with concern.

The night before at a Super Bowl party the hosts had procured entertainment for the women in the form of a tarot card reader who straightened the multi colored scarf on her head, shuffled her cards and read into the subtle clues I had worked hard not to give her.

“I see you spending a great deal of money very soon.”

I pictured four spacious bedrooms, the sunken living room and the stone we’d settled on for the façade and fireplace. The frame had been erected for a few weeks now and we had pictures on our camera capturing the big wooden skeleton rising out of the dirt and earth, ascending from a barren nothingness.

I mentioned the colonial and our recent down payments.

“But you’ll be moving things.” She interjected as her ringed fingers tapped the cards.

I kept my eyes down and listened to her honeyed voice drop, “The best way to explain it is to say, if you thought a cupboard would go on one wall,” she pointed out things in our imaginary kitchen, “you’ll find yourself putting it over here instead.”

I nodded, letting the words and metaphor sink in.

My hasty goodbye was born of a visceral fear she could hear my heart beating in my chest. Her words rang in my ears and nagged at me beyond the party, well into the night when we bedded down in a hotel room close by and even as I attempted sleep. I woke tangled, sweat-soaked and resolute.

“I’ve been thinking…” I whispered to my husband who was regarding me with a mix of confusion and fear.

Maybe that’s why he reached for me, perhaps he sensed something in my voice that I was too afraid to express or he simply wanted to comfort me, but I flinched involuntarily, backing away from his hand. I did not need soothing or sex, did not want either one and I know, now, that he didn’t either.

Sex had become a chore, an elaborate production that produced nothing.

Even here in the anonymity of a foreign bedroom, without the pressure of an ovulation calendar hanging over us I couldn’t recall a time when our intimate life had been satisfying; instead it was scheduled and predictable in the worst possible way. Our kisses had begun to taste of iron and desperation.

He pushed himself up on an elbow and waited. I thought about moving cupboards. Bile rose in my throat as I pushed the words out, “I think we should ask the builders to return our down payment. There’s still time to break the contract isn’t there?”

He nodded, resigned to simply listening.

My heart clenched when I pictured the back bedroom, the one I’d mentally painted the color of a spring meadow and dubbed “the playroom.” But the space was empty. The only echoes I could hear on those polished hardwood floors were our solitary footsteps. What good was a fourth bedroom or a playroom with no one to play in it?

“I want to do In-Vitro.” I said, with as much courage and hope I could muster.

In-Vitro Fertilization would be expensive, from a financial and emotional standpoint and we both knew it. There would be no money back guarantee if it didn’t work. But I wanted to try it; I needed to know, once and for all, if there were still reasons to dream.

He sighed.

Maybe that’s what surrender sounds like, or perhaps it’s really the vociferous noise of determination. As I watched his own part of our dream gasp a last shuttering breath, I heard, behind it, the smallest click—like an egg opening or a window cracking.

We walked out of the hotel hand-in-hand and slowly began to tear down one dream and sketch another with shaking hands, in pencil, with an eraser ever at the ready.

Three months later, on the night before Mother’s Day, my husband slid a thin needle into the fleshy part of my stomach. Medication rushed my system, the sting in my side matching the one at the corners of my eyes, on its journey to my ovaries.

Five months later, two small ovals appeared on a black, grainy screen, their small shapes morphing, twisting, and growing from a barren nothingness. Their small hearts flashing like beacons.

We hardly knew what it meant then, but yes, oh yes, our dream had found purchase. We had built something of our own.

Kirsten is a wife after decades of dating, a mom after years of infertility and a writer after filling a lifetime of notebooks. She writes about love, life, and mothering her 6-year-old twins conceived after infertility on her blog The Kir Corner and weaves romantic stories on her fiction blog: Kirsten A Piccini. Find her on Facebook or on twitter @KirstenPiccini

What’s in a Gene?

What’s in a Gene?

By Alexis Wolff

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

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

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

“We can just estimate.”

I shrugged.

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

“I have no idea.”

“What would you guess?”



“And her hair color?”

“Maybe brown?”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I froze. That was going to be a problem.

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

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

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

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

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

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

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

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

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

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

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

“What do you mean by ‘possibility’?”

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

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

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

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

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

“Is he clean now?”

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

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

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

“Could he be depressed?” she asked.

“Maybe,” I conceded.

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

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

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

I sat on the couch, stunned.

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

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

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

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

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

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

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

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

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

Brain, Child (Winter 2007)

The 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

Childlessness at the Crossroads

Childlessness at the Crossroads

By Katy Horan

Child and Young CoupleThree months after our third and final in vitro fertilization cycle had failed, Dan and I had returned to the fertility clinic, its Seattle Zen decor designed to pacify our sorrows and forget the fortune we had spent trying to quench our baby lust. A medical assistant with a sweet smile ushered us into a consultation room with faux shoji doors that whooshed with relief as we were closed in. Dan looked as if he might bolt if the doors weren’t closed.

Four weeks prior during a tickling, teasing bedtime conversation, I had convinced Dan that we should pursue egg donation as our final effort to get pregnant. My forty-year-old eggs were too old; they had been shoved to the back of my ovarian refrigerator, passing their “best by” date as I buried myself in medical residency, pulmonary fellowship, and serial dating. When I met Dan, we were both on the north side of thirty-five and had no luck getting pregnant the old fashioned way. A willing participant in the “natural” approach to babymaking, Dan had struggled with the “unnaturalness” of every step that we had taken so far: reversing his vasectomy, intrauterine insemination, and the three in vitro fertilizations. He had wanted to pursue adoption from the very start. But, each step along the way, I had convinced him that we should try one more technique to have a child. Weeks before, I was stunned when he consented to try egg donation, but on the morning of the appointment, whatever charm I had cast to change his mind had unraveled. When the alarm startled us from sleep, we were camped on opposite sides of our bed—in retreat to our strongholds.

In the consultation room, I stared out the picture window at the grey clouds that obscured Mt. Rainier. Early on in our infertility treatments, I had seen the volcano as a good omen and would stare out the window at her, willing her to help us. She is the “mother of waters” and on her eastern flank, she carries “Little Tahoma” on her hip. Despite my prayers, neither she nor any god had interceded on our childlessness. Warm tears slid down my cheeks. I glanced at Dan with his jacket zipped up to his Adam’s apple and his brow furrowed. His eyes met mine and he winced at my tears.

“I’m sorry, this room always makes me cry,” I said, my voice flat without a tinge of sincerity. A little insincerity seemed better than screaming, “I’m crying because you are acting like a big jerk, like you don’t want to be here, like this is some chore, or torture that I’m putting you through, and it’s so unfair that I have to carry this weight all by myself.”  I wanted to stomp my feet and rattle the shoji door until the assistant came running, panic fading her sweet smile. Instead, I took his left hand, which was cold and clammy, and traced the groove in his wedding ring.

The coordinator entered. She was friendly and spoke in a kind, modulated voice, intentionally oblivious to the crackling tension between Dan and me. She explained the process and the success rates while writing out notes in her loopy, fat handwriting. She described the egg donors as altruistic, graduate students who wanted to make a little money while helping the childless. Dan scowled with distrust. I sniffled and asked about a documentary that I had watched that sensationalized the egg donation process as an “Eggsploitation.”  The coordinator nodded and explained that those things happened in California and New York where egg donation had created a capitalist mayhem with the scarce “best” eggs fetching $100,000. Not here in Washington, she explained.

Yes, I thought, we of the Subaru and Seattle Nice, we would never exploit innocent young women for our own gain. She slid the notes across the table to Dan. The shoji doors swooshed closed again.

I watched a fat tear splatter on the coordinator’s notes and tracked its journey back to Dan’s red eyes. This was new. Whereas I always cried in the consultation room, Dan never broke his tense stoicism.

Unable to speak, he slid the tear stained notes toward me. We could use frozen donor eggs and fertilize them with Dan’s sperm until we created a single embryo (70% success). We could pay for a donor to go through an IVF cycle then use Dan’s sperm to create related embryos (80% success). Or, we could use another couple’s unused embryos (75% success). Dan had scratched notes next to each option. His notes were spartan: D + ? vs. D + ? vs. ? + ?.  He had come full circle from not wanting children, to not caring if they were genetically related to us, and now to wanting our child to reflect both of us genetically, or nothing at all.

After a two hundred and sixty dollar consultation about egg donation, 3 IVFs, 2 IUIs, and 3 years of trying, we were no closer to having a child.

People ask us, “Why don’t you just adopt?”  I’ve noticed two important points about the “just adopters.”  First, they have never adopted because if so, they would understand that you can’t “just adopt,” because adopting isn’t like going to the SPCA and picking out a dog and filing an application with a $210 check. Second, the “just adopters” often have their own biologic child perched on their hip. While the “just adopters” are well meaning in their question, they did not grow their family through an arduous process by which strangers dissect their finances, their pasts, and their current life choices. The “just adopters” didn’t pay $4,000-$45,000 for said drooler on their hip.

Maybe they are aware of the expense of adoption. Maybe they know that in addition to the adoption application fees and costs, in the foster to adopt program, prospective adoptive parents have to childproof their home for all ages and complete >30 hours of training. Last time I checked, no training was required of fertile couples. No applications, no courses, no home visits. Hence the chip on my shoulder—the infertile have battled childlessness for years, paid tens of thousands of dollars in medical bills, but still we have to prove that we deserve to be parents? Yes, why not just adopt? That way, I can wait years to adopt a child and then have it happen all of a sudden, have to leave work without the usual 9 1/2 months notice, and not qualify for paid maternity leave because the infant that is finally wiggling in my arms didn’t get there by way of my vagina or an incision in my abdominal wall.

These are all very minor inconveniences when at the end, you have a child and you are a parent. And that is what we want. We want to be parents. But, why? This is another question that fertile couples never have to answer, but prospective adoptive parents do.

Why do I want to have children? I would argue that I want a child for the same reasons that we all want children. They smell bad in a good way.

I can’t speak for Dan. I worry that his drive to be a father is more out of empathy for my unquenched desires. But, I have never doubted that he would be a great dad. He has a blanket approach to love, consistent and meticulous, whether he is loving me, a handmade bike, or our dog. I’ve watched him get down on his hands and knees with our friends’ kids and zoom, zoom, zoom a fire truck along the floor. But, when he stands back up, he isn’t intoxicated by the nearness of their toddler chub like I am. Baby lust overwhelms me. I want to satisfy that desire.

I want to spy trillium on a forest hike, with my child leaning into me to share my gaze. I want to puree food that Dan and I make only to find it cemented to the under side of the kitchen counter weeks later. I want to hear a whiney, “Up, up,” and know that it is only me, my hip, my arm that is wanted. I want to wrap myself selfishly around my child, and then have Dan layer on, a second coat of snuggle. I want to kiss the stitches on a tiny forehead and watch the sweet scar fade as that face matures. I want to discover the patience I have never had while ferrying a surly teen to soccer games. I want to complete the triangle: Dan, me, and the kid. I want to see Dan zoom, zoom, zooming with our own child.

When I think about what being a parent means, I crave parenting in its totality: the mundane, the grotesque, the wonder.  Although I would love to watch a pair of violet eyes flicker and then slam shut against the first light outside my womb, the act of carrying our baby within me isn’t that important to me.  I’ve read books and articles by women torn apart by their desire to give birth and I’m turned off by their single-mindedness. I stand back, cross my arms, and smirk, “I’m not like those crazy women—giving birth it not what it important to me—I just want to be a parent.”  Then I catch myself in my lie.  If I really didn’t care about giving birth, why didn’t we adopt three years ago?

I’ll admit it, I am not completely over the idea of being pregnant, giving birth to a baby made of us, and nourishing her with my breasts. An empty womb is a vacuum, and like any vacuum it demands to be filled. At times, my baby lust beats as if a second heartbeat. If I could isolate the parenting rhythm from the giving birth tha-thump, I’d be ready to adopt. But, the rhythm in my head is far more complex and keeps me dancing between the options.

In the nine-month lull between our 2nd and 3rd IVF, Dan and I went to an informational session at a local adoption agency. We brought our friend, Jessie, who was thinking of adopting as a single woman, and the three of us got lost in the narrow streets of the aging suburb.  When we finally found the adoption agency in its dingy forgotten strip mall, there was a single anonymous door open. It felt like an AA meeting. We were late and as one of the counselors rounded up 3 extra chairs, I sized up the competition:  a young pierced and tattooed lesbian couple, an obese heterosexual team whose smiles gleamed in every direction, and a well-preserved 65-year-old grandmother whose leather mini dress gave her a Tina Turner-esque appeal.

“We want you to open up your minds and hearts to the children who are desperately waiting for families,” the young social worker sang out from the front of the room. The slides clicked past with children of every color and age, occasionally in wheelchairs and leg braces. “We feel that it is our mission to place every child and to encourage you to be open to adopting children with special needs as well as older children who might never find a family without you.” She beamed at each one of us.

I squirmed in the plastic chair. “Why do I get the sense that I’m a horrible person for wanting a healthy infant?” I whispered to Jessie.

The social worker asked us to take out the grid out of our packets that compared their overseas programs. Although we had RSVP’d for the informational meeting, they were out of packets when we arrived so the same harried counselor who had found us chairs handed a copy of the grid to us to share. With a pencil, I marked out the programs that we didn’t qualify for: Korea (Dan would be too old by the time of the adoption), China (Dan and I hadn’t been married long enough following his divorce seven years ago), India (we needed 5 years of marriage), Cambodia (Whoops, sorry that one is closed).  “Finally,” I checked the 2nd to last column and showed it to Jessie and Dan, “Bulgaria wants us to have their babies.”

Our giggles earned us an unexpected glare from the earnest social worker. She continued with the next slide of a five-year-old Ethiopian girl in a wheelchair. “Now, many countries will overlook some of the requirements if you are willing to take a child with serious health or developmental difficulties.”

My heart sank. I am a sucker for the underdog. I tear up at stories of perseverance and bittersweet victories. But this felt wrong. Adopting a child should be joyous, not a preparation in lowered expectations and guilt. After more than two years of infertility treatments, I didn’t need this grid to tell me that I was unworthy; my unworthiness was tattooed to my soul. After stumbling down the cobblestoned road of infertility, the earnest social worker was asking us to walk barefoot across the molten coals of an international, special needs adoption.

She cleared her throat, and smiled her practiced smile. “Let’s talk next about the travel requirements. If you are adopting from Russia or the former Soviet Republics, you will need to travel for two separate two week trips that will be scheduled with very little notice.”

I grimaced at Dan. Enough!   Neither of us had jobs that allowed us the freedom to fly off Russia for two weeks without advanced notice to our employers.

Following the informational meeting that night in bed, guilt and doubt ricocheted through my brain and kept me awake. Why wasn’t I a better wanna-be mother?  Why was my heart so small that I couldn’t give up work for one month to pick up my fetal-alcohol-syndromed-22-month-old child in Moscow?  I grabbed my Kindle, and downloaded The Idiot’s Guide to Adoption. “Adopt the kind of child that you want, not the child that is pressed upon you…” recommended the author.

I know myself and I know Dan. If we had a biologic child or an adoptive child that fell ill, we would care and love the child just the same. But, fertile couples don’t wish and pray for a toddler with health concerns, and we agreed that it was okay to want a healthy baby.

So here we are parked at the crossroads of adoption vs. egg donation unwilling to commit to either. Egg donation takes us further down the road that we have been on, tweaking the biology that predicts that we are too old to be parents. Dan is stalled on the idea that a child from donor egg would not have my DNA, but the DNA of a woman who gave up her eggs for a mix of altruism and cash. I’m stuck on the unknowns of adoption: how long will it take for a birth mother to select us, can I wait four years, will our child be healthy and whole?

I think of a truism that my friend Kate learned from her Czech grandmother—if the church collection basket allowed you to unload your greatest sorrow, then asked you to pluck a sorrow from the same basket, you would search out your own worried stone nestled amongst the others. Our childlessness is our sorrow. Ours. Dan and I have gone through this together. And we are still together. I wouldn’t want to do it with anyone else. And the story isn’t over yet, so for now, I think we’ll hold onto our sorrow and explore how many question marks we can handle in our quest for parenthood.

When not working as a pulmonary physician, Katy Horan blogs about infertility at www.fruitfulearth.word  She also shares stories and recipes about discovering vegetables at

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Welcome to IVF

Welcome to IVF

By Karen Dempsey

dreamstime_s_3413964“If we have a baby, we can tell it, ‘This is the desk you were conceived on,’ ” I say.

The desk is where we sit for the injections that will pump my little eggs—our unconceived children, John calls them—with hormones so they will grow big and strong.

I hold the syringe like a dart and stab it in two inches from my navel. The fatty flesh of my abdomen offers little resistance, and the sinking of the half-inch needle is oddly painless. Watching, John reminds me to release the pinch of flesh. Then, sensing somehow that my instinct is to draw back on the syringe, he tells me to press down to release the single cc of clear liquid. I fumble, too many fingers and thumbs. My skin resists the plunging, and I really have to press

“This part hurts.” I tug the needle free from my skin. “Done.”

Tender bruises mark my belly from three months of injections. We have spent more than half a year in infertility treatment, but with this cycle we graduate to IVF, in vitro fertilization. We have tried oral fertility drugs and a procedure called intrauterine insemination. If we are going to conceive a child, IVF is our best and last hope.

My doctors can only guess at what is causing my infertility. Eight years ago, when I was twenty-three and single, an odd, painful pressure began in my pelvis. A surgeon threaded a tiny camera into my abdomen and saw dense endometrial tissue, not lining the uterus where it belongs, but running over my right ovary and fallopian tube and binding them together. “We’ll do everything we can to protect your fertility,” the doctor said. Her words frightened me enough that I opted for the most aggressive treatment option, a harsh course of steroid injections to induce temporary menopause, shrink the errant endometrial tissue, and allow my body a chance to heal. I endured intra-muscular injections into my buttocks, suffered hot flashes and night sweats. But soon enough the pain in my pelvis went away. I felt like myself again. Cured.

Today, we know that my fallopian tubes are clear and that John has plenty of enthusiastic sperm trying to reach my eggs. But we are in our seventeenth month of trying, our seventh month of treatment, and still there is no baby.

I entered the world of infertility treatment with a prescription for Clomid, a low-dose, oral medication that puffs up the ovaries and helps them release a fat egg or two each month. I had read the literature on fertility drugs and their frightening side effects—bloating, cramping, exploding ovaries. Triplets. But I had also talked with a woman who’d struggled with infertility thirty years before me, whose marriage ended as a result. “If I’d had the options you have today,” she said, “I would have pushed the sky.” So I swallowed the pills and pictured my ovaries inflating a little each day, like a slow balloon. I bought the ovulation predictor kit. I swelled. I cramped. I had sex. And then I got my period again.

I counted the days to my next ovulation and called in a refill of the Clomid. At the pharmacy, I learned that the store had run out of the tiny white pills. I would need to return the next day, delaying my planned departure for an out-of-town weekend. “Half the people in this town are on Clomid,” I told John.

It is true that at times infertility treatment seems to have caught on like some sort of fad. But it also seems I am surrounded by babies, in strollers and grocery carts and those little baby-backpacks people wear. I ride to work on the subway and watch two little girls whisper conspiratorial, nonsensical things to each other as they wind themselves around their father’s limbs. I sit alone, my lap holding only my overstuffed work bag. It is hard not to feel I’m the only one.

When the second round of Clomid failed, I had a late-night phone conversation with my ob/gyn. We talked about further treatment, which would involve my seeing a specialist at an infertility clinic. In the meantime, I would try Clomid one more time, at double the dose. Before hanging up, my doctor promised that pregnancy is in my future—a matter of when, not if.

The night I took the last dose of Clomid, I woke from a deep sleep, felt my way down the stairs from my bedroom in the dark, and flipped on the bathroom light. It flashed and flickered. I suspected a dying bulb until the hallway light did the same. Electricity’s going out, I thought, listening for wind or thunder. I moved through the house flicking switches. By the time I reached the dining room, everything in my peripheral vision quivered, like the view through heat rising off highway blacktop. I stared at our oil painting of a Hong Kong street scene; it seemed to ooze grays and blues and yellows. Gas leak, I thought. I tested the black knobs of the stove and checked the carbon monoxide detector. Then I got it. The drugs.

I flicked the lights a few more times, then crept back upstairs and under the covers, trying not to wake John. I wanted to show him the view from inside my head, but instead I closed my eyes and tried to sleep. Tilt-a-whirl. The room began to dip and spin. I lay flat on my back, breathing. I pressed gently on my frightened eyelids, my popcorn ovaries.

My vision had returned to normal by morning, but I called an ophthalmologist, convinced that I had somehow detached a retina. He had me come right in. His assistant took my medical history. She skipped through a list of questions in a cheery voice, her words layered in a brogue that lent drama to even the most innocuous phrase. “Clomid … Now what is that for?” she asked. “Right! Thank you.” She dripped some cold drops into my eyes to dilate my pupils, and I sat back with a copy of the New Yorker to wait for the doctor. A haze settled over my dilating pupils, and the print on the pages blurred.

“I’m not used to seeing younger people in here,” the ophthalmologist said as he looked at my file. He sat in a chair opposite me and pulled forward until we were almost knee-to-knee. Through the haze he looked like a rounder Steven Spielberg.

“How are you doing with the treatment?” he asked. I hesitated. He went on to say that he and his wife had gone through five and a half years of infertility treatment. “Look,” he said. “We are of a generation. I don’t even raise an eyebrow anymore when I see a thirty-one-year-old woman on Clomid.” He said infertility treatment has just become part of the process for some of us. He said it in a way that acknowledged the sadness of it all but made me feel a little less like an aberration, a little less crazy.

He examined my eyes and told me they looked great. “Now let me say this,” he told me. “You are going to have a baby. Unless there is something radically, radically wrong, and that’s almost never the case, and you’d know it by now. You are going to have a baby. This”—he gestured, capturing the bigness of infertility, the way it permeates a life—”it does fade into the background. And then you have all the other traumas and stresses and worries. I would want to say this to you anyway because you seem like a nice person, but I’m saying it to you as a doctor and because I’ve been there and because it’s true.

“Your eyes are fine,” he said again. “Come back after you have your baby.”

The infertility clinic was located in the same building as my ob/gyn, just down the hall from his office. I glanced in his window as I passed by. I missed him.

In the clinic waiting room, patients sat singly and in pairs, avoiding one another’s eyes. One woman strayed from this code of behavior and scanned the faces in the room. I pretended to read a magazine. Beneath it lay an envelope of x-rays. The films showed a foggy envelope of a uterus and tendrils of injected ink flowing freely—healthily—through my fallopian tubes.

John describes our first conversation with the infertility specialist like this: When you first walk in, you believe that you are there to learn about a whole host of new options. IVF still sounds to you like something out of a science fiction movie, something you might need to consider in the distant future. But then you sit down with the doctor and review your file and discuss the statistics that you face. The likelihood that you will conceive on your own at this point: two percent. The success rate for intrauterine insemination, combined with hormone injections: maybe eighteen percent. In vitro success rates: forty to forty-eight percent. By the time you walk out of there, IVF has become your best friend.

The other option, IUI, is a type of artificial insemination. Doctors use a catheter to boost the sperm up into the uterus, nearer to the fallopian tubes. But the egg must still travel down through the tubes from the ovary. If the path is imperfect, if the ovary is displaced or the tubes marked by scar tissue, the egg can lose its way. Based on my history and medical testing, the doctor suspected that my eggs weren’t surviving the journey. In vitro fertilization—fertilization outside of my body—might give my eggs a chance. She pushed us toward IVF.

Our treatment plan was not her decision and it was not our decision, either. While we are fortunate to live in a state that treats infertility like the medical condition that it is and mandates that health insurance companies cover treatment, we also have to follow the insurance company’s timeline. My doctor would pitch the case for IVF to my health maintenance organization. And, she said, she would probably lose. Even though she was convinced that only IVF will work in this case and even though the IUI cycles require the same painful injections, the same numerous ultrasounds and blood tests, she believed my HMO would make us try it.

She was right. When she called to tell me that the insurance company had mandated two IUI cycles before we could try in vitro, she reminded me to save my energy for IVF. “Think of these next two months as something you just need to get through.”

I am okay with needles as long as I can watch them go in. When nurses stick me with a flu shot or probe my veins to draw blood, I stay relaxed as long as I can monitor their efforts. So while John and I waited to meet with Paula, the “patient educator,” for our “injection demonstration,” I told myself I’d been preparing my whole life for this and I tried to remember that people jab themselves with needles all the time. Insulin, I thought as I went into the office and saw the syringes laid out on the table. Heroin, I thought when I held one and pulled off the plastic cap.

John practiced first, on a rubbery blue pillow that looked like a miniature waterbed. He held the needle over the pillow, hesitated, and cast an anxious, guilty look my way. I took my turn next, and then Paula suggested that I try a practice injection on myself, on my actual flesh. I rolled up my shirt, watched my belly rise as I inhaled, pinched my skin, and sailed the needle in without flinching. Then I pulled it out and stuck myself in the finger.

In the room where we planned to put the crib, we now keep a mini pharmacy. A desk holds alcohol prep pads, sterile bandages, and tiny plastic bottles of Gonal-F and Pregnyl and the sterile water used to dilute them. Plastic syringes lie next to dozens of needles in two different sizes and a red plastic container, the size of a shoebox, marked “Biohazard Infectious Waste.”

Two months of injections, ultrasounds, and inseminations. Of blood tests and, ultimately, the cramping and bleeding that signal another failed intervention. Two failed IUI cycles. And now we have graduated to IVF.

Through the ultrasound, my ovary resembles an insect’s eye, holding countless eyes within it: my exhausted eggs, my tiny, un-conceived children. Every few days we’re up at six to drive to the clinic and check the swelling of the egg follicles. Twelve millimeters, thirteen and a half, fifteen. When the follicles reach eighteen millimeters the eggs within them will be mature enough for a surgeon to extricate them from their nest, from among their too-small sibling eggs, with yet another glistening needle.

When we last counted the eggs and saw that some of the smaller ones had ballooned, I looked away from the ultrasound monitor to see John’s eyes, wide with something like alarm. In the car he sat for a moment and rested his hands on the steering wheel. “You’re going to have triplets,” he said. It is a bitter irony that we live with limited chances of conceiving at all and still struggle with the possibility of multiples. But later he kissed my tired face and said, “Tell the twins I want them to come straight home from school today. I’ve got things for them to do around here.”

The day after my final injection of the cycle, I sit in my office and sense the last bits of my energy seeping away. I leave work early and struggle to walk the few blocks to the station where I catch the subway. I feel I am in danger of floating away, like a helium balloon: empty. I move among a crowd of people who all seem grounded, held by gravity, and I think that I am linked to this earth only by a ribbon-thin string. I board the train holding onto this image of the string linking me to earth, and I somehow find a seat and count the stops until I am home.

Along with the isolation, the depression, the sheer physical exhaustion of infertility comes the overwhelming feeling that my body has let me down. But as I look back over the past months and consider what infertility treatment has required of me, I think about the strength it must have taken for my body to have endured—to have survived each cycle of aggressive treatment and tremendous disappointment, to have recovered from it and readied itself for the cycle to begin again.

A good friend who experienced infertility repeated to me something she had heard from another survivor: “IVF will bring you to your knees,” she said. And I have watched infertility bleed over into my entire life—my relationships, my work, my way of being in the world. It has worn me down a little more each day.

Has infertility brought me to my knees? I think it has. But on the morning of the surgery to retrieve my eggs, I rise and shower and put on my favorite sundress, and I know that I have pulled myself back up.

At the infertility clinic, we are greeted outside the surgery by a nurse named Amy, who says in a soothing but serious voice, “Welcome to IVF.” John and I roll our eyes at each other, but Amy understands that we have arrived here after a very long journey. We are ready. Amy holds my arm as we glide around a wide, white room, me in my hospital slippers, she in her soundless white sneakers. Here is the scale where we check your weight. Here is a tiny locker for your things; I will keep the key for you.

John sits beside me until he is banished to the waiting room. When they come for me, I feel a bubble of nausea rise up from my stomach. The operating room is cold, and the lights blind me as I lie on a table waiting for the anesthesia to take. A woman appears at my side: “I am the scientist who will take care of your eggs.” She and the nurse speak in murmurs that grow softer. I think about my little eggs and of John in the waiting room, thinking of me, holding the ribbon-string that tethers me to the earth, holding me fast and safe as I push the sky.

Author’s Note: I wrote much of this essay during a writing workshop that coincided with my infertility treatment. I wrote on the subway between home, class, work, and home again, and I scribbled notes after appointments and encounters with people whose words and gestures had an impact on me. In one of the few morning classes I managed to attend when I wasn’t at the infertility clinic, I met the remarkable woman who told me she would have pushed the sky to have a child. I survived infertility, in part, because of a few generous people who, like her, experienced infertility before me and shared their stories with me. 

Brain, Child (Spring 2005)

Karen Dempsey’s writing has appeared in The New York Times, Babble and other publications. She lives in Massachusetts with her family. Follow her on Twitter @KarenEDempsey or read more of her work at





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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