Wednesday, December 13, 2006

THE FIRST CANDIDATE

Before I can explain how my thinking on the donor-recipient relationship evolved, I need to tell you about the first couple to contact me. Identifying details have been changed to protect their privacy.

On paper, they sounded fine. Two women, one of them Jewish, together over a decade. They have a pre-school aged daughter and want her to have a sibling. Like all the other couples who contacted me, they describe their daughter as begging for that little brother or sister.

There were a few warning signs from the first email that this was not the ideal recipient couple for our embryos. They live in one of the two states in the country that explicitly prohibit second-parent adoption by gay partners. They had done multiple IUI, IVF and FET cycles without success. The potential recipient was in her late-40's. And there was a huge age difference between the partners.

This was to become a theme. We found it odd because none of the many lesbian couples we know have big age difference between the partners. It makes sense, though: when you set out to find infertile lesbian couples, there has to be a reason why both partners are infertile. The typical story we found from the couples who contacted us was one much older partner who was infertile due to age and a younger partner who had a problem such as severe endometriosis which made pregnancy difficult.

For most couples, the age difference was within ten years, which seemed alright. With this couple, the age difference was more than 15 years, and they had met each other when the younger partner was a teenager. This struck us as a bit...off.

But who are we to judge? The adoption problem had been cleverly solved by this couple by an out-of-state adoption. They seemed stable, they had a nice home and good careers, and they already had a daughter, so they knew what they were getting into. If they were bad parents, there would be some sort of problem with their adoption proceedings, but there apparently was not.

Last, and most petty to even mention, their emails contained grammar and spelling errors, as well as poor sentence structure and conceptual errors. This seems silly, but it was a factor in my unease with this couple. Our fertility doctor had told us "intelligence is hereditary, pick a smart sperm donor" and we had. The donor and I both have IQ's which are two standard deviations above the mean. His IQ just hits genius level. Mine tested at a few points below. If children result from my embryo donation, I want them to be raised by smarter-than-average people who can stimulate their minds and keep up with them mentally. This couple was not going to hit the mark.

Ultimately, we wanted to get rid of the embryos, and these women met our basic criteria. The concerns we had seemed relatively minor. Maybe we could get the donation over with quickly. After a brief email exchange, we emailed them out recipient wish list and waited to hear what they thought.

Here is what I wrote to them:


I hope this donation can work out. I have a few questions. Would you be willing to use our clinic? They do an assessment at their clinic, then work long distance with couples all over the country who are monitored at home, then the patient comes to the clinic at the end of treatment just for the transfer. Her pregnancy is monitored at home.

The reasons I would prefer our recipients use our
clinic is:

* better not to ship embryos
* our clinic has this country's best success rate with frozen embryos, and a 95% thaw rate, which is exceptional
* our clinic specializes in working with older women and difficult cases
* our clinic has a well-developed donor egg and embryo program
* many people from out of town use our clinic specifically because it is among the least expensive while still being one of the most successful

The clinic is near the [area where you completed your adoption].

Also, instead of legally transferring all 3 embryos to you at once, I would have my lawyer prepare 3 identical contracts and start by giving you one embryo.

Because I work with so many children who were preemies, and because so many of them were from multiple births, I want to give the recipient one embryo at a time. If you have more, the clinic will
insist on thawing them as "spare" embryos and suggest you implant two or more at a time, greatly increasing your risk of multiples.

Since my clinic has a 95% rate of thawing frozen embryos and getting viable embryos, and since my embryos theoretically have twice the viability of most embryos used in IVF, you have at least a 50-50 chance of getting a baby using only one of these embryos. If you don't, we can repeat the process.

I know this might be a deal-breaker for you, so I thought I'd put it out there before we got too far into this. Like you, we have both been through several IVF cycles and we want to avoid problems we have seen through our experience.

Let me know how you feel,


They did let me know. More on that, and our reaction to it, next time.