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!

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"?

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.

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!

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.

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.

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...

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.