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Wednesday, April 6, 2011

In the home stretch

I'm sure a lot of you have seen this donor egg child video, but for those who haven't - take a look! 16 year old Allegra gives great insight into what life is like knowing that she was conceived with help from an egg donor. I think it's so important for people to teach their children about their identity at a young age. There are age-appropriate ways to teach kids about egg donors, and my social worker was open enough to share some of these tactics during our first session. A few women have even made kiddie books to help parents talk to their kids about egg donation! Seriously, that book is too cute. I appreciate that Shady Grove takes the time to prepare their recipient parents on the multitude of obstacles they have to overcome - as well as their donors - which makes me even more confident that my eggs will be going to a great parents.

I can't believe the application process is almost FINALLY over. My last social worker appointment is this week, accompanied by my loving boyfriend, and I'm done!... Well, for now - then the real work begins!

Thursday, March 31, 2011

"Frozen Angels"

I was browsing through the Netflix library yesterday and came across a documentary about the development of reproductive technology in Los Angeles. "Frozen Angels" gives viewers multiple perspectives of people involved in the art of unconventional baby-making. The film follows a gestational surrogate & her recipient couple, a young man born with help from a Nobel Prize sperm donor (AKA "the Designer Baby"), a blonde haired/blue eyed egg donor (AKA the poster girl), several fertility specialists, and Bill Handel (a radio personality, and father of twin girls who were born through gender selection IVF). The film also examines ethical dilemmas with respect to genetic manipulation, and using egg donors/surrogates.

Kari, the egg donor, is definitely someone I can relate to. She has donated her eggs several times, and now receives up to $8000 for each donation. Described by the clinic as the "ideal donor," it seemed as though she was quickly becoming a hot commodity to couples seeking donors. The clinic she was involved with seemed much less sensitive to her experience as a donor in comparison to Shady Grove. I don't feel like she was as prepared for experiencing side effects from the hormones, and her clinic was more concerned with her making money than being safe and healthy through the process. To put it bluntly, she was treated somewhat like a prostitute in my opinion. It seemed more like she was going through a business transaction, rather than giving a gift as I like to put it. I truly hope that my experience will be much different.

Doron, the product of a Nobel Prize sperm donor, gives a great perspective into life as a donor child. Having an IQ of 180, he definitely takes after his biological father - just as his mother wanted. When asked how he feels about his sperm donor "father," he gave an answer that I thought was very interesting. His donor is just another person in the world, not his Dad, and that is all. I think this is a great way for a person to think about their donor. The donor gives a small piece of themselves for a child to be created, and that is all. I'll be in no way, shape, or form a "mother" to my potential donor child - and that's okay. Being able to give such a huge gift is a gift to me in itself, and I don't desire anything more.

Seeing Amy & Steve, the parents who receive a child from a gestational carrier, was particularly touching. After 15 years of failed IVF treatments, they made the decision to utilize a surrogate to carry their biological child. I can't imagine the pain they felt throughout those - gulp - 15 years, but seeing them with their baby was truly amazing. I went through about half a box of tissues... yeah, I'm a dork. I hope that my gift makes even a fraction of this impact on the lives of a couple struggling to become parents.

There is a lot more covered in the film than I have described here, but being out of the realm of my experience, I'll leave my description short and sweet. If you have Netflix, the movie is available for instant streaming - I highly recommend watching it.

Tuesday, March 29, 2011

Baby steps

I just got back from my first appointment with my social worker, which was pretty interesting. The whole meeting felt a little bit like a job interview, so I was somewhat nervous. I definitely understand why Shady Grove takes the extra effort to make sure they accept only the most responsible donors, and makes them aware of the magnitude of their decision to donate. I never thought this experience would be so complicated! But almost 3 months into the egg donation process, I am truly glad that I have taken the time to understand what I'm getting myself into.

The social worker spoke with me for almost an hour about things I may experience during and after the egg donation. She basically brought up a few hypothetical scenarios, and asked me how I would feel or react. For example, she asked how I would feel if the recipient couple wanted to meet me, and how I would react if they needed some kind of medical help in the future (like if their child needs a biological relative to donate bone marrow in the case of leukemia). I've thought a lot in the past few months about these type of scenarios, so it was easy to open up and tell her how I was feeling. The last step I have to take is to meet with her once again - with my boyfriend. I hope he's ready!

This whole process is feeling a little more real this morning. It's not out of the realm of possibility that someone could choose me as a donor within the next few months! This idea really sunk today, and I'm thinking about the adjustments in my life I'll have to make. Abstinence, injections, cutting back on physical activities, daily trips to the clinic... it's a lot to deal with. I'm an avid runner, and have a few team races scheduled in the upcoming months that I would hate to back out of, but it's a sacrifice I'm willing to make. The risk of ovarian torsion rises with physical activity and contact sports, so I'll have to hang out on the sidelines for a while. For now, it's back to waiting...

Tuesday, March 22, 2011

I've got a new favorite pair of jeans

It's official - I'm not psychotic, I have acceptable genes, and no infectious diseases! Hooray! I got "the call" from Shady Grove a week ahead of schedule giving me permission to take the next step in egg donation. I immediately made a call to my social worker to set up an appointment with her. I'll meet with her twice - once alone, and once with my boyfriend - and then I'll enter the donor database. I'm not really sure exactly what we'll discuss in our meetings, but I'm assuming we'll talk about the emotional aspect of egg donation. I am so relieved to have made this huge step... more so that my genetics test came back without any concerns. Big thanks to my Mom and Dad!

Sunday, March 20, 2011

This is your brain on eggs:

It's been almost 2 weeks since orientation now, and still no call back. Most of my friends know that I absolutely HATE waiting for surprises. This year I convinced my boyfriend to let me open all of my gifts a full week before Christmas... I know, I have a problem. Needless to say, the suspense is killing me. I know Nurse Connors told me to expect results back in 3 weeks, but I'm really hoping I get a little relief early.

This waiting period has given me a lot of time to think about what I'm hopefully about to do. Lately, I've been thinking about what couples look for in a donor. Is it hair color? Height? Religion? Athleticism? Or do they focus in on the essay portion of the application? What makes ME a good donor? I'm not totally sure, and I would love to get some feedback from women who have looked through the database of donors. If I needed to resort to using donor eggs, I think I would want to use eggs from a woman who looked like me. The essay portion would also weigh in on my choice - Personality definitely matters. Brains definitely matter to me too, so I would definitely take academic background into consideration.

I'm also curious to hear what recipient couples would be curious to know about their donors that isn't covered in the application. Would they want more details about what I look like? My IQ? My personal style? Would they want to see a current picture of me, instead of just my baby pictures? I would personally be interested to know these things... I know this issue is pretty controversial, but I'm also curious to know whether recipient couples would be interested in meeting their donor in person. Part of me thinks it shouldn't really matter what kind of person is donating their eggs, so why bother meeting them? Sure, their kid is getting my DNA, but they're the ones responsible for really molding their child into the person he or she will become - not me. I'm not sure if I would want to meet my donor if I were in the recipients' shoes for privacy reasons, but I would definitely be curious as to who she really is. I appreciate the anonymity of the process, and I don't think I would ever want to meet whoever gets my eggs. I'm donating my eggs, and nothing more, and that in itself is a gift.

Wednesday, March 16, 2011

Staring doesn't make it boil faster

It's been a week since my Donor Day orientation, and I'm doing my best to restrain myself from checking my phone every 5 minutes for missed calls. I'm feeling confident that my MMPI scored fine, because I haven't received a phone call for a disqualification notification. Hopefully I'll hear back with good news with regards to the genetic tests within the next two weeks so I can schedule my appointments with the social worker. This will be the last step I have to take before I officially enter the donor database! The suspense is definitely weighing down on me.

I've been thinking a lot about the genetic tests this past week, so I did a little research about the diseases that Shady Grove tests for. It's amazing to me that ANY baby is born completely healthy with the multitude of genetic diseases that exist. Some of the conditions are pretty debilitation, or even life threatening. I can't imagine having any of these issues myself, or putting a child at risk of being born with one if I happen to be a carrier of the gene. I'll do my best to decipher all of the medical jargon...

1. Beta Thalassemia is a blood disorder that causes the body to make an abnormal form of hemoglobin. Hemoglobin is a protein that gives red blood cells their distinct color, and enables the cells to carry oxygen. Without normal hemoglobin, a person will develop anemia (lowered capacity for RBC's to carry oxygen to tissues/organs) and may experience hemolysis (premature breakdown of RBC's). This disease can be life threatening, but can be treated with blood transfusions and bone marrow transplants.

2. Bloom Syndrome is a disease that commonly affects individuals of Jewish descent. These individuals have "breaks" in their chromosomes, which causes many physical deformities. The most noticeable symptoms include a red facial rash when exposed to sunlight, narrow face, and short stature. They often have a higher risk for leukemia, other types of cancer, and life threatening infections.

3. Canavan Disease is a metabolic disorder in which an individual lacks an enzyme to break down aspartic acid. This can lead to deterioration of white matter in the brain, leading to severe mental retardation. While some individuals are able to live into young adulthood with this disorder, most die within 18 months of age. The MRI pictured shows significant damage within the brain, in comparison to the normal brain.

4. Cystic Fibrosis is a disease that causes a build up of abnormally thick mucus in the lungs and digestive system. People with CF have a persistent cough and abnormal bowel function, as their body is unable to rid itself of the mucus. The symptoms of CF can be alleviated with respiratory therapies, and diet regulation, but most die by the age of 35 from respiratory complications. I had a childhood friend pass away from CF at age 15, and I know how hard it was to see him & his family endure the struggles associated with his disease.

5. Familial Dysautonomia affects the development of nerves, and commonly affects people of Jewish descent. This disease has a variety of symptoms associated with the central nervous system, and only half of sufferers live to the age of 30.

6. Fanconi Anemia Type C causes individuals to have a lower levels of white blood cells, red blood cells, and platelets (clotting agents). People with this condition have a higher risk of developing leukemia, but are typically able to live normal lives with blood transfusions/bone marrow transplants.

7. Gaucher Disease is yet another metabolic disease that typically affects people of Jewish descent. Individuals lack an enzyme, which causes a toxic build up of substances in the liver, spleen, and bone marrow, thus preventing them from functioning normally. Enzyme replacement therapy has extended the lives of those affected by this disease, but they may also need bone marrow transplants at some point in their lives.

8. Tay Sachs is a disease of the nervous system that is particularly devastating. 1 in 27 people of Jewish descent carries the gene, and those affected typically die by age 5. Tay Sachs causes deafness, blindness, decreased muscle tone, dementia, seizures, and even paralysis. Currently there is no treatment.

9. Mucilipidosis is a genetic disorder that causes mental retardation and progressive loss of vision. People with this disease are unable to break down carbohydrates and lipids normally, which causes a build-up of intermediate substances. Accumulation of the substances can cause organ damage, corneal clouding, and cognitive delays.

10. Niemann-Pick Disease causes lipids (fats) to accumulate in the liver, spleen, and brain. This progressively causes motor skills to decrease, seizures, tremors, intellectual decline, and other neurological issues. Severe cases typically cause death by age 3, but those with mild cases may survive to the age of 20.

11. Sickle Cell Anemia causes red blood cells to form an abnormal crescent shape due to an abnormal form of hemoglobin. The fragile RBC's can't deliver adequate amounts of oxygen to tissues of the body, and can easily clot in small blood vessels. Sickle cell can be treated with dialysis and blood transfusions, but may still be life threatening.

12. Spinal Muscular Atrophy causes muscle degeneration which leads to poor muscle tone, breathing/feeding issues, and progressive muscle weakness. Most individuals only live to 2-3 years of age because of the lack of treatment for this fast acting disease.

13. Fragile X is caused by a defective gene located on the X chromosome, and can affect both men and women. Some with this disease often suffer mental retardation, or experience symptoms similar to those with autism. They often very tall, have long faces, and low muscle tone. Men with Fragile X are typically more drastically affected in comparison to women with the disease because they have only one X chromosome. You can see the "fragile site" located at the bottom of the chromosome, which appears to have broken off.

If I was a carrier for any of these genes, I would definitely want to know. However, awareness of that fact could bring a new set of challenges down the road when I choose to start my own family. It was emotionally painful just to get through this post after seeing photos of people affected with these diseases, and I know I would never want to put a child through that struggle. For now, I'm hoping on good genes!

Thursday, March 10, 2011

Protecting The Nest

During Donor Day, Nurse Connors addressed one of my biggest concerns about donating my eggs - ovarian hyperstimulation syndrome (OHSS). I was relieved to hear that only a single woman experienced severe hyperstim at Shady Grove during her time at the clinic. Whew, that's a relief! However, in her next breath I was made aware of another risk even scarier than OHSS - ovarian torsion. Ovarian torsion is basically when an ovary twists in a way that cuts off it's blood supply, which can lead to tissue death or necrosis. After taking the hormones that prepare a woman's body for donation, the follicles of the ovary grow exponentially large in a short amount of time. As a result, the enlarged ovary obviously needs to shift around in the body to get a little more comfortable. If it happens to be pushed in a certain way and twist over on itself, the ovary is in deep trouble. The good news is that if it is caught in time, the ovary can be saved with surgical repair. If a significant amount of necrosis occurs, it may be necessary to remove the ovary. On the bright side, a woman can still become pregnant with one functioning ovary, and torsion usually only happens to a single ovary at a time. Still, it's a pretty big risk to take on. Ironically, something that is intended to increase another woman's fertility could potentially decrease my own.

I've had a lot of people ask if egg donation could potentially affect my fertility. I guess when you consider risks like ovarian torsion, the answer is in the grayer area of yes... Yes the risk exists, I get that. If you were to ask me if egg donation could affect my chances of becoming a parent, the answer is clearly a big NO. Lets say hypothetically I unfortunately experience ovarian torsion, lose my ovaries, or because of the procedure I am consequently unable to get my ovulation cycle back into gear. Would I be devastated by the thought of being unable to have a biological child of my own? Absolutely, but because of these tragic events, I would be able to adopt a child who otherwise wouldn't have been. I find that when I look at the bigger picture with respect to these "risks," I see more opportunity for wonderful things to happen.

Tuesday, March 8, 2011

Let's Talk Hormones!


I'm going to do my best to follow in the footsteps of my health class teacher to explain the ovarian cycle and how it relates to egg donation. The chart above is a great illustration of what really goes on with respect to hormones. As you can see, there are four main hormones that control the female reproductive system. Follicle Stimulating Hormone(or FSH) stimulates the growth of immature follicles in the ovary. The follicle is an oval shaped structure, filled with fluid and cells, where a single oocyte (or egg) develops. The second hormone is called Luteinizing Hormone (or LH), which triggers ovulation when the egg reaches maturity. As you can see on the chart, there is a huge surge of LH in the middle of the ovarian cycle, which is when the egg leaves the ovary and the woman is able to get pregnant. The third hormone is Estrogen, which is responsible for overall regulation of the female reproductive cycle. Finally, we have Progesterone, which is responsible for preparing the female body for pregnancy. Progesterone levels rise after ovulation, and build up the wall of the uterus to make it more suitable to an embryo if it is fertilized. If a pregnancy does not occur, progesterone levels drop and the woman gets her punctuation. Simple enough right?

When I'm chosen by a recipient couple to donate my eggs, I'll have to take two different injections to prepare my ovaries to develop multiple follicles. The results of my ultrasound indicated that I have 17 follicles available, which makes me a good candidate to donate eggs. (Acceptable donors need to have between 15 and 30 follicles.)By taking shots of pure FSH, marketed under the names Follistim and Gonal-F, my ovaries will grow many more follicles and mature eggs than it normally would. I'm expecting to take a shot of Gonal-F daily, injected by yours truly, for about 2 weeks. During that time, I'll have to make trips out to Shady Grove every 1-3 days so we can monitor the amount & size of my growing follicles. This gives the clinic an idea as to how many eggs I'll be able to donate. There may be some physical discomfort during this phase... If you can imagine, the normal follicle is about 1 centimeter in diameter and only one matures to this size during normal ovulation. However, if I have SEVENTEEN of these babies growing to 1cm each, making my ovary into a huge raspberry-like structure, it's pretty big! When my follicles reach the size the doctor's feel is adequate, I'll give myself a single intramuscular shot in the bum of pure LH, marketed under the names Lupron or Luveris. This triggers my body to plan to release the eggs, and 36 hours after this "trigger shot" I'll be in the stirrups for retrieval.

Side note about my ovarian cyst: Nurse Connors told me that my estrogen levels were slightly higher than average, probably due to the cyst. However, she said I shouldn't be concerned with it's presence, because it is so tiny and they typically go away on their own. A follicle that is larger than normal is deemed a cyst... I think it has to be over 1 centimeters in diameter. Mine is only 1.3cm - pretty tiny. So as for now I'm in the clear!

Monday, March 7, 2011

Donor Day Orientation - Over...Easy!

My day started bright and early at 8am to get ready for my Donor Day orientation at Shady Grove's Rockville location. I set myself up with a GPS, and my brand new XM radio for a little entertainment during the hour and a half drive. My heart was pounding the whole way, and I'm glad I wore a sleeveless top because I would have been drenched in sweat by the time I arrived. I signed in and settled into the cozy waiting room while nurses and doctors buzzed by. After a few minutes, I was greeted by the lovely Margaret Connors, RN., and ushered into her office. Nurse Connors started off by asking me why I chose to apply to the donor program. I explained how I had considered the idea of donating eggs a few years ago, and finally decided to muster up the courage to take on this journey. Maybe I should have told her about the blog... She then told me a little bit about SG's history, and how they have become a leader in the world of IVF with one of the highest number of IVF cycles completed per year & one of the highest percentage of successful births. People from ALL over the world have come to SG because of their reputation, especially those from the UK and Canada. People living in countries who have nationalized health care have to wait about 4 years to utilize IVF with donor eggs! It is illegal for women to receive compensation for their eggs in the UK, so there is a huge shortage of donors compared to the US. It's easy to consider the fact that few altruistic women exist who would go through this lengthy, risky process with zero compensation. I have read a few accounts of British women who have traveled to the US in order to donate to take advantage of the financial perks. They make it sound so scandalous!
Next we made a paperwork exchange - my huge packet for her MMPI (AKA the personality test, woo hoo!). We reviewed my family/medical history, and I shared my career goals and status in school. She left me to start filling out the 567 question MMPI while I waited for the lab to finish up with the other two donor day girls. The test is pretty tedious, and consists of true false questions that seem pretty random. They range from asking if you love your parents, to if you hear voices, to questions of morality, to if you get embarrassed talking about sex (you can guess my answer to that one). Any hint of mental instability will disqualify donors from the program obviously. A social worker, who works independently of Shady Grove, evaluates the MMPI's and will (hopefully!) call me to schedule two future appointments. The first with me alone, to discuss the emotional implications of egg donation, and the second with my boyfriend & me together to make sure he is on-board with the process as well.

After I got through about 40 questions, the lab technician came to whisk me away. My favorite two lab experiences - giving blood (7 vials this time! ouch) and peeing in a cup - were overshadowed by the genetics test. Another thing that can disqualify a donor is testing positive for a marker for about 13 genetic diseases, meaning that they are a carrier for the undesirable gene. I thought initially that I would be simply swabbed on the cheek with a Q-tip, but I was very wrong. I had to spit into a tube, which under normal circumstances wouldn't seem like an unconquerable feat. However, when you aren't allowed to drink for 30 minutes and have to be Chapstick-less, it is pretty difficult to fill up a test tube. The lab tech suggested I think about lemons, which actually helped. After I finished this VERY classy test, I went into another room with the other 2 prospective donors to continue with the MMPI.

I said hi to the girls, and was thrilled when I was greeted with a water bottle by Nurse Connors. We listened to Nurse Connors describe how the donor process works, options for the IVF couples (which I've described in previous posts), and what hormones we'll be taking if we're chosen to donate. I'll go into detail on the hormone talk in the future after I do a little more research. We all learn basic reproductive education in school during health class, but I seriously learned a lot about the female anatomy in this short lecture. I remember thinking at one point how ANYONE gets pregnant with the level of complexity involved in conceiving a child. It's fascinating to me. After the chat, me and the ladies had a pizza party lunch and finally completed our MMPI's while Nurse Connors took a break.

Nurse Connors came back about 45 minutes later with a bag full of syringes and training vials...GULP. It became obvious that this was the moment I have been dreading - Injection Training! We started off by checking out 2 different sizes of needles we'll be working with, and the basics of handling a needle. We learned how to measure our dosage of medicine, how to draw up the liquid, where to inject, and how to combine medicines that require mixing. After we all got this down, we did a test. We had to get a certain dosage of water into our needles correctly without any help. What happened next almost made the girl next to me cry and run out the door. In order to pass our test, we had to give ourselves the injection of water in our stomachs. Truly, it was a piece of cake! I didn't even give myself an opportunity to think about it... I just stabbed it in a pushed the plunger. It was no worse than a pinch. As for the other contestant... it took the poor girl about 10 minutes of convincing and I still thought she was going to lose it. This experience definitely calmed my fear of giving myself an injection.

We ended the day by signing one final consent form. If all goes well, I'll get a call back within 3 weeks saying that my genetics/infection/MMPI tests were all great. The next step is scheduling my social work visits, which will be nothing compared to donor day, and I'll get my profile published on the database! Who knew there would be so much WAITING involved in this process?

Saturday, March 5, 2011

Can't I just take a pill?... Please?


I got a pretty extensive packet of paperwork earlier this week, which describes the itinerary for my 5 hour day of orientation on Monday. I filled out yet ANOTHER questionnaire about my medical/family history, and a W-9 tax form. Next I filled out the "Risk Factor Questionnaire," which went into a little more detail about my sex life that I would have liked. I guess I need to get used to people asking about my reproductive organs on a daily basis... The information packet, which was about 20 pages long, answered a lot of lingering questions I had about the donation process. In addition to the Shared Risk Program, Shady Grove offers couples an opportunity to decrease the cost of IVF by opting for a Shared Donor Egg agreement. Basically up to 3 women share the cost of using one donor egg cycle by splitting the eggs retrieved. In addition to relieving some of the financial burden, most (if not all) eggs are used for IVF as opposed to being donated to research or discarded. This definitely makes me even more confident that I am making a good call for choosing SG as my first choice clinic.

One thing in particular has been on my mind about orientation - Injection Training. As part of my homework, I had to watch a few videos. If you can handle it, watch the injection videos on Lupron and HCG. I'm not positive, but I'm pretty sure these are the hormones I'll be taking at some point. I'm curious to see exactly how injection training is gonna go... do I have to practice?! I'm sure once I get over the initial shock of actually giving myself the shot it'll be a piece of cake, but that doesn't make me any less nervous. I'm accepting nurse applications by the way...

Monday, February 28, 2011

IVF means "I'm Very Frightened..."?


I did a little research this week on In Vitro Fertilization to try to understand what women with fertility problems have to endure.

So, what exactly is IVF? IVF is basically when an egg is fertilized out of the womb, in a laboratory dish. The culture in the dish enables the embryo to develop in vitro (literally meaning "in glass"). Much like any other egg being coaxed into "hatching," the embryo is incubated and monitored while it's cells divide. Once they have divided into about 8 cells about 5 days later, they are implanted into the uterus. Up to 4 embryos are usually implanted at one time to avoid producing octomoms. Simple enough right? What is not so simple is the reasons why couples may have to choose IVF...

The majority of average couples are able to conceive within a year of unprotected sex. I can imagine that even a few months of failure can be pretty frustrating and stressful for couples trying to start a family. There are multiple reasons why women may need a little boost to get pregnant when the old fashioned way alone isn't working out. Women with endometriosis, ovulation problems, blocked or damaged fallopian tubes, or an abnormal uterus may all have trouble conceiving a child due to their anatomy. Considering the other team member, women with a partner who has a low sperm count or sperm motility problems (AKA they aren't very good swimmers) may also need IVF to conceive because the man's sperm die before they can reach the egg. Not all women who undergo IVF need to use donor eggs. Just as I will need to take ovulation stimulating hormones to produce multiple mature eggs, women utilizing the IVF procedure take hormones to produce as many eggs as they can. This ensures that they will have a higher chance of producing a healthy embryo to implant after it is fertilized in the lab.

I hope my ability to write about this subject (or lack thereof)didn't confuse you even more. Bottom line - IVF is pretty stressful for couples on multiple levels. The costs, both financially and emotionally, are pretty intense (more than I could ever imagine). I've heard stories about women who are able to conceive naturally after IVF failures, and even adoption. Maybe their bodies just needed a little kick start, or worked a little better once the pressure was off? Who knows. I'm going to try to send mine off with a little love and hope that the couple gets lucky the first time!

Wednesday, February 23, 2011

IVF Cycle: $27,000. Family: Priceless.


$27,000!? That's right. The estimated cost of ONE in vitro fertilization cycle with use of donor eggs is definitely not cheap. Most insurance companies cover nothing with regards to these types of fertility problems, so having a baby with IVF can be quite a financial burden for a couple. I recently became aware that Shady Grove has implemented an amazing "Shared Risk Program" for couples who have no fertility insurance coverage. Couples who are accepted into the program pay a flat fee, and if they do not conceive a child after 6 IVF cycles they receive a 100% refund. About 70% of SG's clients choose this option because of the amount of stress it relieves concerning the cost of IVF. If you're interested in seeing the complete break-down of the costs of IVF, and the options available to couples struggling with fertility problems, click here and then on "Donor Egg Financial Program Guide" PDF.

After reading through the estimated costs for IVF, I felt pretty guilty for even thinking about the money that I will receive when I donate my eggs. Just for applying to the program and being accepted, I got a check in the mail for $50. Once I complete my Donor Day orientation, I get another $450. To top it off, my eggs get me a staggering $6000 on the day of retrieval. Refer a friend? $250. And if I ever get picked to donate again, I get $6500 for each additional cycle (I believe up to 6 cycles are allowed). Potentially, I could earn $39,000. Wow.

I know I probably shouldn't feel this way, but looking at the numbers on paper almost makes me feel like I'm stealing. It's obviously not my fault that I was blessed with being fertile and another woman was not, but I can't help but feel that I don't deserve to be paid for something like this. I've been trying to brainstorm ideas pertaining to what exactly I should do with the money... Maybe this is another opportunity to "pay-it-forward"?

Tuesday, February 22, 2011

Egg-cellent Hormones


I was very surprised when I received a call back from Shady Grove yesterday, just a few hours after my appointment. Apparently my small ovarian cyst was nothing to worry about after all, and my hormones levels tested great! I have been scheduled for my "Donor Day" appointment for Monday, March 7th. Only about 20% of women who apply to the donor program make the cut, so I'm really excited that I'm one of the lucky few. My next visit to the clinic will be a day-long process, and I'm planning on being there about 4-5 hours. I will be screened further by a nurse practitioner for a variety of infectious diseases, as well as many genetic disorders. You can see the full list here if you are interested: Donor Screening. I also have to bring along a copy of my pap smear results from this year, otherwise I would have to get another test at the clinic, AND pass a drug test. Does anyone else hate peeing into a cup? It's probably one of the most awkward experience at the Dr's office... well, maybe besides the ultrasound. After all of this I get to learn how to give myself the hormone injections. This should be interesting to say the least.

The majority of my day will be spent with a social worker/psychologist. I have to take the Minnesota Multiphasic Personality Inventory, also known as the MMPI, which is basically an extensive personality test to weed out any crazies that made their way into the clinic. The psychology nerd in me is actually thrilled to take the REAL MMPI after studying it in class for a few semesters.

I came across a sample donor profile, which is the form you have to initially fill out when you apply to become a donor. Pretty extensive huh? I knew this would be a long process when I first applied using this form, but I definitely wasn't aware of the full extent of the journey I would be taking on. And that's just considering MY end of the bargain! Considering all of the time and effort it takes to create a life in the case of IVF, I'm really hoping that whoever gets my eggs gets lucky the first time... and maybe even a second.

Monday, February 21, 2011

Always check the carton!

Well, today is the day I have been waiting for. I got to Shady Grove at about 7:30am... I can't remember the last time I've willingly been up at 6am. With the adrenaline pumping, it wasn't too painful. I was pretty nervous when I walked into the packed waiting room. I couldn't help but notice how anxious everyone else in the room looked. I fit right in! I buried my head in my iPod for a little distraction. Overhearing women talking to their husbands about multiple miscarriages, I couldn't help but getting a sinking feeling in my stomach. Sitting across from multiple glowing pregnant women rubbing their bellies must be really hard for these women. I got a sense of hopefulness from them at least. Shady Grove does have a 62% success rate with the Donor Egg Program. Pretty impressive.

I was called back to the lab by a pretty animated technician. I filled out some paperwork, and made small talk with her while she took 2 vials of blood. She complimented me on having nice veins, and I thanked her for not giving me a blown out vein like Patient First usually sends me home with. The clinic will evaluate my blood for several hormone levels - Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), estrogen (E2), Thyroid Stimulating Hormone (TSH), and prolactin. I was ushered over to second waiting room where a few girls were chatting with their doctors. I got the feeling that these girls were also donors, only further along in the process, and they seemed pretty familiar with all of the doctors. It was comforting to see how personable all of the doctors were.

I was called into another for the transvaginal ultrasound. Kind of intimidating huh? Honestly it was nothing to stress over. The doctor was pretty friendly, and made a few jokes to make light of the obviously awkward situation. "This is your first time? Great, mine too!" First he took a picture of my cervix, and my right ovary. He said that I have a small ovarian cyst, which is pretty common and nothing to worry about. He also complimented me on having several great follicles (seriously, what's with all the weird compliments?), which are the structures where the eggs develop - Hooray! My left ovary was a little less cooperative, and took a few minutes of moving around to get a clear picture. The whole process took less than 10 minutes, and was nothing worse than a typical OB/GYN visit. The doctor said that I would be called with the results of my exam & blood tests, and if all goes well I will set up a "Donor Day" appointment for further screening and the MMPI. I'm a little nervous to hear whether the cyst will affect my status as a donor... All I can do now is wait for my call-back. Cross your fingers!

Thursday, February 17, 2011

It's all about the paprika really...


When I first started this blog, I was worried about the reactions I would get to sharing something so personal. To my surprise, I have an overwhelmingly positive response! Still, I am glad that there have been a few people who voiced their concerns and doubts about why I'm really choosing to pursue egg donation. It's so easy to get caught up in the moment and overlook certain risks when a crowd of people are cheering you on, and it's important to hear the few voices who may not be so convinced to make you more aware of the magnitude of your decision. If it hadn't been for those few voices, I may not have called the clinic to learn more about what I'm really in for. Luckily, I am more confident than ever about my decision. So what if I get OHSS? I'll deal with the pain, and get better! So what if this causes some catastrophe within my body, and I have trouble getting pregnant in the future? Sure I will be devastated at missing the opportunity to have a pregnancy of my own, but I'll be able to adopt an orphaned child who otherwise wouldn't have been. Whatever obstacle is thrown in my way, I can say with confidence that I will be ok.

I have read a few other blogs of women who have donated their eggs with complete anonymity. For whatever reason, they have chosen not to tell anyone - not even their families - about donating their eggs. A few even traveled out of the US to Canada to undergo the procedure because some states don't allow compensation for egg donation, particularly when the purpose is solely for research. (Some feel that this may encourage the exploitation of women in financial need, which I think it likely does.)Whether they were embarrassed, just out to make extra money, or didn't think their decision would be widely accepted, I don't know and it's not my right to judge. However, I know that I would personally not be able to get through this without the support of my friends and family.

My mom was actually the last person that I told about my decision. I wasn't sure how she would react, and that definitely made me so reluctant to tell her. When I did break the news to her, she reacted with the same questions everyone initially asks: Will it hurt? Will it affect your own fertility in the future?... Once I assured her that I am confident in my choice regardless of what may happen in the future, she told me that the was proud of me for doing something so brave. In the same breath she asked, "Have you told them about your teenage years? You will make someone very happy... but another little Michelle? haha!" Thanks Mom for making me a little "deviled."

I would tell anyone who is thinking about donating their eggs to reach out to their friends and family, and to not be afraid of the reactions they may receive. The magnitude of this journey is more than I could have ever imagined, and I am glad that I have people who have lovingly supported, and lovingly doubted me too.

Monday, February 14, 2011

Sunny side up


After a long phone conversation with Shady Grove today, I feel like I am beginning to have one of my biggest concerns resolved. In my last posting, I talked briefly about worrying whether my eggs will be subject to stem cell research or not. The answer is a little less cut and dry than I would have liked to hear. I made the mistake of believing that when my eggs are retrieved and I sign over my rights to them, they become property of Shady Grove. What is actually true is that the eggs become property of the recipient couple, not the fertility clinic. Here is a hypothetical scenario to clarify the journey of my eggs when my work is done:

After my retrieval procedure, my lonely oocytes will be fertilized with either the recipient's husband's sperm or even a sperm donor. At this point, they become viable life forms or embryos. Say that five of my eggs are successfully fertilized. With the help of their fertility doctor, the couple will choose how many of the embryos to implant into her uterus. In this hypothetical scenario, lets assume they choose to implant three. What happens to the other two? This decision is completely up to the recipient couple, and Shady Grove will have no control over the destiny of those eggs. The couple can choose to do three things.

1. They can cryogenically freeze the eggs for later use. If the woman doesn't conceive, miscarries, or wants to have a second (or third!) child that will be a biological sibling of her first child, she can try again to get pregnant in the future.
2. They can opt to donate or "adopt" the fertilized embryos to another couple. It's pretty amazing that they have the opportunity pay-it-forward!
3. They can donate the embryos to the clinic for stem cell research, or discard them. This is the gray area for me...

From what I was told by Shady Grove today, option 3 is not very common but it is a possibility. The couple obviously wants to keep as many of the embryos they can, in case they are needed to help expand their family. I wasn't aware that they had the option to adopt the embryos out to another couple, and I am thrilled by the possibility! Who knew that one donation could potentially affect more than one family? Wow.

So, really... will my eggs my eggs be subject to research? Maybe, but not likely. I hope that people who have any reservations about my decision to donate with this possibility lingering can truly accept that what I am doing is right for me. The possibility of joy and life outweighs the possibility for a life to be short lived for me. I hope that any woman considering donating her eggs is completely aware of these possibilities, and makes the decision that is right for her as well.

Sunday, February 13, 2011

Feeling a little scrambled


Reality is setting in a bit after committing to visit the clinic for the first time. I must admit, I'm a little nervous. One of the biggest concerns I have is how this experience may affect me beyond the month-long donation period. First, OHSS (Ovarian hyperstimulation syndrome) scares the crap out of me. OHSS is a complication caused by taking stimulatory fertility medications, which I will be stabbing into my stomach and thighs daily. Fun. Basically what happens is that your ovaries get stressed out, swell, and accumulate fluid. What does this mean for me? Lots of pain, sweat pants, and salt infused Gatorade. Gaining 10 lbs in 3 days is possible?! Yes, if you have OHSS. I trust that the clinic has enough experience with women who deal with cases of OHSS, and that if it does unfortunately happen I will be taken care of.

I can't help but think about the potential recipient when I consider my own risks. Sure, OHSS is definitely not an enjoyable experience... but does it really compare to the pain an infertile woman experiences? I think not. I can't really grasp how it must feel for a woman to be told that she can't have a child that is biologically her own. I would be beyond devastated. Being told that I can personally help a woman overcome this pain is what drives me to want to donate.

Another concern that has been brought to my attention is the potential to feel a loss for "giving away" my biological child. My response to this - I am NOT this child's mother, so how could I feel a loss? Truthfully, I will definitely be curious to know what became of my eggs. Reality is, I will probably never know. After all, the clinic won't disclose to me if a child was successfully conceived or born. We all have mysteries in life, and this is one I can live with. I have enough joy in my life, and being able to share that joy is fulfilling in itself. I don't need to know the details of what that hypothetical child came to be. I have faith that I gave them the potential to be great for enabling them to exist, and that's all I'll ever know with complete certainty.

Finally, I am considering the morality behind egg donation. Before my retrieval procedure, I'll have to sign a waiver stating that once the clinic takes possession of my eggs they become their property. Not all of my eggs will ultimately be fertilized, and not all of the embryos that are fertilized will be physically implanted into the recipient. So... what becomes of the lonely, unused eggs? Most likely they will be discarded or used for research. Does every viable life have the right to live? Absolutely. Everything has purpose in life, and I am comfortable knowing that if my eggs purpose was to live a short life, yet contribute to the development of potentially life changing research, I am willing to bear the weight of that sacrifice. Obviously, egg donation is becoming a little more challenging than I thought...

Friday, February 11, 2011

Cracking The Questions


I still have a lot of unanswered questions about this whole thing, as I'm sure you do too. Hopefully as I go through this process, I will be able to get more information to share with you. Here's a list of the biggest concerns/questions I have:


1. Will this hurt?
Stabbing myself daily with needles and multiple blood tests... sure, but I think this is quite bearable considering I'm not the one having a baby exit my body (yet). I can imagine the transvaginal ultrasound will be a little uncomfortable, maybe a little embarrassing even, but I don't expect it to be any worse than my annual ob/gyn appointment. As for the egg retrieval, I'll be under light sedation and some type of anesthesia so I won't feel a thing! My clinician informed me that I should expect some bleeding afterwards and moderate cramping, which again is nothing out of the ordinary... I hope.

2. Will you have a teenager knocking on your door in 18 years calling you Mom?
Most likely - No. I will be an anonymous donor. The couple receiving my eggs will have no present pictures of me, only baby photos to judge how lovely their bundle of joy will come out to be. My mom is going to LOVE digging out the old photo albums to pick the most embarrassing shots. Luckily for me and my ego, I will ultimately be the one choosing which to reveal to the couple.

The recipients will have no revealing information about me, and vice versa. I'll actually never know if a baby was even successfully conceived by them! In case of dire emergencies, like if I or the couple was in need of bone marrow or a kidney transplant, the clinic may contact either party in the future. However, there will never be any direct contact between me, the recipients, or the genetically privileged baby.

3. What happens to the unused embryos/eggs?
This I'm not 100% sure of. I know that unused eggs may be donated for stem cell research. Whether they're embryos or unfertilized eggs... that is yet to be discovered. I'm personally accepting of this fact, but I understand the controversy.

4. What are the risks involved?
Well, pregnancy on my part for one. While it may be challenging, Chris and I have agreed to practice abstinence the second I stop taking birth control pills. With so many ripened eggs floating around, we are NOT ready to risk me getting pregnant. The risks of ectopic pregnancy (when embryos develop in the fallopian tube instead of the uterus) is also great. The best way to avoid these risks is to play it safe! Hey it's only a month after all.

I can imagine pumping myself full of follicle stimulating hormones may also make me a little uncomfortable. The biggest risk concerning the hormone injections is ovarian hyperstimulation syndrome. Basically, the ovaries can become swollen, which is quite painful from what I have read. If this happens, I'll have to stop taking the hormones and close up shop. After ridding myself of the hormones, OHS should resolve itself.

5. Will donating affect your own fertility?
From the research I've read - Nope! The average woman has millions of eggs... I think I have enough to share. In a study conducted in 1992-2001 with 169 donors, none of the women who participated had any trouble conceiving if they tried. In fact, half of the donors were able to get pregnant within 3 months of donating! 84% were able to conceive within a year of donating. Check out the study in more detail here: http://www.ivf1.com/egg-donor-risk/

Have any additional thoughts or questions you think I should ask at my initial appointment?

Getting the eggs rolling...

The process of egg donation begins with finding a fertility center willing to take you on as a donor. Filling out online questionnaires can be pretty tedious, and rather time consuming. If you choose to follow in my footsteps, be prepared to answer endless questions about your medical past, family history, and lifestyle. How tall is your maternal grandmother? What color are your father's eyes? Have you spent more than 3 months in Europe? Ever been bitten by an animal suspected of having rabies, or taken an injection of bovine insulin? The list goes on and on... for about 20 pages. After submitting the application, you wait for the approval of the fertility clinic.

After about a week, I got the call back from Shady Grove Fertility: Where families begin... I have applied to 2 other clinics, but Shady Grove is by far my favorite. Egg donation is a pretty intense process, and a huge commitment. The coordinators of the clinic seem to be pretty knowledgeable about fertility in general, and I feel comfortable that they will help me tremendously while I ripen my little oocytes. I still have a lot of questions about the process which I will be asking at my first intake appointment bright an early on the morning of February 21.

The initial intake appointment can be a pretty stressful experience, from what I have heard from the coordinators. The appointment is made on the last day of your period, or day 7 of taking placebo pills if you are on birth control pills (which I am). When I arrive at the clinic, I will give one of MANY blood samples taken throughout this journey to test my baseline hormone levels. I expect my arms to look like those of  a heroin addict at the end of this. This blood sample will help the doctors determine which hormones, and at what strength, I will take during the "harvesting" month. Did I mention these hormones will be INJECTED daily into my stomach/upper thigh by yours truly? If you are not needle-friendly, egg donation is not for you. I will also have to review my medical history with the nurse practitioner, and take an MMPI, which is a personality test. I guess they don't want any crazies at their clinic... During this time they will also mentally prepare me for the idea of donating my DNA to a *lucky* couple, and teach me how to give myself injections.

The next part of the intake appointment involves a rather intimidating probe. Boys, you may want to stop reading here...The nurse practitioner will insert a transvaginal ultrasound to check out my ovaries. She will look for any abnormalities that would disqualify me from donating. This procedure will happen many times to check on the developing follicles, to make sure they are growing big and strong. I'll be sure to update after the 21st and let you all know how it goes!

You can visit Shady Grove's website here: http://www.shadygrovefertility.com/

Initial Thoughts

Have you ever wondered what it would be like to have a child somewhere in the world that was genetically yours, and get paid for it? Well... I have. This seed of thought was planted in my brain when I was an 18 year old college student. One day I happened to be sitting in the campus lounge, and spotted a flyer that offered thousands of dollars to college girls for donating their eggs. Seriously... THOUSANDS? Without putting much thought into it, I was eager to sign on the dotted line right away. Lucky for me, I was too young at the time to do something so profound. That thought stayed in my brain for a few years, and a recent Anatomy lecture prompted me to reconsider the idea of egg donation.

What exactly is egg donation? Well, its pretty complicated actually. It all starts with a woman in need. There are a lot of reasons why some women need a little extra help to conceive, which it out of my personal realm of knowledge. University of MD Medical Center has a great informational website that presents a description of the process of egg donation better than I could ever explain.
Visit this site for the gory details: http://www.umm.edu/fertility/timeline_egg_donor.htm

Why exactly am I doing this to myself? There have been times in my life where I have been rather selfish. About 2 years ago, I met someone who gave me a metaphorical slap in the face and told me so. My boyfriend, Chris, is one of the most generous people I have ever met, and he has since inspired me to change my ways as a somewhat self centered woman. Don't get me wrong, I have a loving heart and a kind soul, but I didn't always make the extra effort to extend a helping hand when I have been so fortunate to be well off. I have since decided to find several outlets to help those in need. This is one of those outlets. I can donate money, time, material things, even blood... but what better thing can I donate to someone than a family? The idea of giving that opportunity to a needy couple truly makes my heart melt. I would love nothing more than to give someone a chance to have a family as loving as my own.