I told them we had finished considering all other past inquiries before discussing a donation to them. Over the course of the two weeks we had been writing to each other, several other couples had contacted me. I told each one that I was in serious discussions about donating to Erin and Jenny and offered to retain the new couples' information in case things did not work out. Some accepted this offer, some declined.
In terms of what my wife and I were looking for, that was simple: good parents who were lesbians. One or both members of the couple would ideally be Jewish. Honesty within the family about the children's conception was crucial to me.
The rest of their questions were pretty intense. I would only answer them if I made up my mind that these were the recipients for my embryos. Before that could happen, there were a few final questions Jenny and Erin would need to "get right". I continued:
I will answer your other questions in detail. In the mean time, a few more from me:
When you say you want to move is that to a bigger home in your city, to another city in your state, to another state or to another country?
How would you discipline your child(ren)?
What are your plans for childcare after the birth of your child(ren)?
Under what circumstances would you abort or reduce? In other words, would you carry twins? Triplets? Quads (possible even w/3 embryos due to increased risk of identical twins from each IVF embryo). How disabled of a child would you be willing to raise or to abort (Down's syndrome; Deafness; congenital malformation etc). We have no medical issues with our kids or other kids in our family but you never know what could happen and I'm just wondering about your thoughts on this.
I had liked this couple's attitude and goals so far. These final questions were crucial to me. Was the move they were considering to a US state with better laws and social climate for gay families? They seemed pretty rooted in their conservative Southern home state.
For the abortion question, I wanted to make sure I did not contribute unnecessarily to a child's pain or disability. It was important to me that the recipients I chose would do everything they could to avoid carrying twins or triplets. Every couple trying to start a family through IVF think that twins would be ideal. If they end up with twins they soon change their minds.
Our clinic, like many others, suggests women transfer three embryos at a time. The reason is the clinic's "success" is judged by how many women get pregnant on the first embryo transfer attempt. The government's analysis of IVF clinic success rates shows that in 2004, half of women under 35 who became pregnant at our clinic had twins or triplets. In nature the rate is under 3%. Because the clinic transfers several embryos at once, they artificially raise the rate of twin and triplet pregnancies by more than a thousand-fold. That is unsafe, unhealthy and unnecessary.
I have worked with too many patients who were disabled solely because they were part of a multiple pregnancy. There is no reason to subject a child to permanent disability by implanting too many embryos per cycle. The success rate at our clinic is 15-20% per embryo transfered. That would hold true if those embryos were transfered one-by-one or simultaneously.
It is more expensive to do three 1-embryo transfer than one 3-embryo transfer but the rate of live births that result is ultimately the same. And when the huge incidence of birth trauma-induced disability among twins and trips is considered, saving two or three thousand dollars with a multi-embryo transfer doesn't seem like such a bargain.
The fertility clinic had a different agenda than the recipients and I. The clinic wanted to look good to future patients by putting in too many embryos at once and getting the recipients pregnant right away with multiples. The recipients and I wanted a healthy baby to result. Would these recipients agree to transfer the embryos one at a time? If they somehow ended up with triplets would Jenny and Erin reduce to save the other two kids?
My same concerns applied to a pregnancy where the embryo was so disabled s/he could die upon birth or live in pain for a short time. I would hate to subject a little baby to a miserable, brief life. Would these recipients spare their child this torture?
Speaking of torture, what were their thoughts on discipline? If they admitted to thinking that spanking, under any circumstances, was an appropriate method of correcting a child, they were out. I have two children who are one and two respectively. They can be quite a handful. I have never hit either of them and I never will. This was another important issue to me.
My last question was about childcare. My wife and I have taken on a huge financial burden by foregoing her income for several years while she stays home and has the primary childcare responsibility during the day. If these recipients were planning to stick their baby in day care as soon as possible or rely primarily on a nanny I would not feel comfortable giving them the embryos.
These were the final potential barriers to my donating embryos to Jenny and Erin. They seemed like great women. Would they pass these last tests?