Raising Children

How our IVF Journey Began

I’ll try to use my personal journal to proceed in chronological order — we began knowing little about IVF, and research took some time.

I haven’t made much of it here, but my husband of 15 years is a guy, which I think, unless the PC terminology has changed recently, makes us a gay couple having children. Our new neighborhood of 60 or so houses has two other gay couples with children already in residence, so we’re not unusual. This street has many children already and more on the way since the schools are considered top-notch and we’re within easy commuting distance of San Diego’s high-tech employers.

The first reason we started to think about kids was the experience of raising two puppies. I haven’t had a pet since I was five, and the sense of taking care of and training a young animal is similar enough to raising children that I realized we would enjoy it (after the initial unpleasantness!). We had both had some desire for kids earlier in our lives, but the hurdles then seemed insurmountable and of course we were busy with work.

First entry from my personal journal, June 5, 2019:

I checked again to see if it’s too late for us to have a kid of our own. No *outright* reason not to, except the $150-200K to order up a donor egg, IVF, and surrogate mother, *and* I’d be feeble long before the child left for college. Not that upper class families shrunk from sending their kids to boarding school at 12. If you’re not independent enough by then, you soon will be. 🙂 Kid would get a nice trust fund and of course lots of attention. I can’t get anything done anyway, might as well nurture, no?

As of two years ago, we were both retired from normal full-time work, so it now seemed practical to handle the baby years. Half the stamina, but two people home most of the time!

I found some online sources, and a surrogacy agency supportive of gay couples (and run by two gay dads.) Near enough, in LA, so I talked to them and they referred us to a West LA IVF doctor to get started.

July 2 2019:

I was going to write something about our Skype meeting with the LA baby consultants coming up later, but running out of time. We’re far from designer babies, but the current crude technology and regulation does let you 1) seek out and pay a premium for the egg donor with rare characteristics (it’s a hoot that Ivy League Asian women are the gold standard for certain seekers and so get the highest payments), and 2) you can’t do gene tests of the eggs yet without damaging them, but you can test embryos by removing a few pre-placental cells early, seemingly doing no harm at that stage. By choosing those without gross abnormalities you can reduce miscarriages and select for sex. We might try for twins, actually, for that 1.5x the costs for 1 and the sibling experience….

[Husband] is onboard. Which suddenly changes our plans for later life. Sort of like a Hail Mary pass on your last down, I’m starting to downgrade my expectations for my own work to put effort into the fresh new entrants in the race. They, at least, won’t be crippled by a lack of early support.

We found out later that multi-embryo surrogacy (hoping to improve chances of having one, but often ending up with twins) is no longer considered wise; this is partly because the technology has improved so 50-60% of screened and well-timed implantations result in a healthy birth, just as high as for multi-embryo attempts which risk twins and complications. Our meticulous IVF doctor won’t do multis anymore. This became the consensus in the last five years or so. Other changes in the technology made it just as safe to freeze embryos after 5-7 days of development, which allows the implantation at the perfect time for success. So our process was 1) freeze sperm, 2) have the egg donor provide eggs, and 3) fertilize eggs with sperm via ICSI (which is now standard for late-in-life IVF — ICSI is “intracytoplasmic sperm injection,” where the lucky sperm is injected into the egg by a very fine needle.) The resulting zygotes are cultured and observed for 5-7 days, graded on an A-F scale for viability, and genetically tested to improve likelihood of a successful birth.

micorphoto of needle injecting egg with a spermatozoa]

Needle injecting a single spermatozoa into an egg.

In hindsight, the natural process for prime-aged young people is error-prone and hit-or-miss, resulting in early miscarriages and other bad things. Nature’s Way includes Nature’s Punishments. Typically the natural way is to try many times and succeed enough to keep the species going, and the winnowing process sifts out most”tries” — either the4 egg doesn’t get fertilized, or if fertilized doesn’t implant, or if implanted doesn’t develop properly, and is expelled via silent miscarriage before the mother is even aware of being pregnant, or develops long enough for underlying defects to cause a later miscarriage. The latter feel like tragic losses, but it’s part of the natural process and no one’s fault.

We had both done sperm tests. [Husband] did fine, I did not — my test report was stamped “azoospermia,” which means zero spermatozoa in the sample. Turns out my decade of testosterone supplementation (“exogenous testosterone”) was the cause; complex feedback loops shut down both endogenous production of T and sperm production, which made drug companies run studies of such sufferers hoping to find the male Pill. No such drugs were found, but the cause and recovery are thoroughly documented in medical journals.

So I was hoping I could catch up with time and treatment — younger men in the same boat can have fertility restored in 3-6 months, but as the doctor warned me, that doesn’t mean an old man can recover as quickly, or at all.

[Husband] went ahead and started the process by driving to LA to deposit his contribution.

Aug 8 2019:

Project stall: [Husband] drove all the way to West LA (2+ hours) to make a 10:30 AM appointment to give a sperm sample for freezing. Two hours later, he’s told “we need more than that, could you come back next week?” The legally-required FDA paperwork only lasts 7 days so you can’t wait longer or you have to pay for it again (several hundred dollars?) So he goes back Tuesday leaving here at 6 AM. At least the doc complimented him on his youthful motility.

Meanwhile, I’m just working on producing a gamete or two. Tap tap tap.

[to be continued: “How We Did It,” in installments.]

August, 2019 – Deciding to try IVF

We did a lot of research before starting the IVF process. The difficulty of adoption in the US in this era is comparable to or worse than IVF, and it’s almost as expensive, so we didn’t go that route — and besides, no one in my family is carrying on the family name, so we’d prefer to have my ancestor’s genetic threads continue.

We searched online for an egg donor. This is still an unregulated business, with some effort made to provide a code of conduct from a nonprofit organization of donation agents, but couples looking for Only The Best eggs clamor for Ivy League, Asian, accomplished concert pianist donors; which means a donor with those desirable characteristics can charge far more for her donation. Some agencies advertise “$50-100 thousand dollars for your eggs,” which is well beyond the guidelines.

We found a great donor but at one of the more mercenary agencies; she’s a graduate of a great but not Ivy League science-oriented college, she has a high IQ, and she was not that expensive as a first-time donor. “Proven” donors (after at least one successful donation) can charge more, but this was her first time. We had the agency’s help and did Skype calls to see if we liked her and vice-versa. Contracts had to be drawn up (there are lawyers for both sides at every stage of the process!) and signed.

Recognize that this isn’t easy for donors — they have to put up with medical, psychological, and genetic screening, making many visits to clinics, taking precisely-timed drugs to mature their egg follicles in abnormal numbers for a carefully-timed harvest. Our donor had to fly cross-country twice. The harvesting procedure can be painful and the wrenching-around of body chemistry can result in bad reactions. Fortunately, none of that happened and she was very successful. (And we had to have her back for a second donation when only one embryo came of the first, for reasons that I’ll describe in a later post.)

Our IVF doctor is semi-famous: “IVF doctor to the Stars,” kinda, with past clients like [redacted] and numerous Hollywood types. His office is in West LA on Wilshire, almost to the Santa Monica border, so we visited several times.

Genetic screening is a big part of the matching process. Both egg donor and sperm donor are screened for genetic abnormalities; many people harbor genes that can produce syndromes or diseases that would cause miscarriage if combined with similar genes from the other parent.

My Counsyl gene tests showed three more-or-less damaging flaws; fortunately, none of these overlapped with similar flaws in the egg donor, so we were cleared. I had two recessive conditions, plus a third which apparently is held back from the report for laypeople because it’s too diffuse a danger (sufferers live long enough to reproduce but are extra-susceptible to emphysema and liver failure.) I carry one copy of the good gene and one half-good gene (S) which means it would be wise to avoid hooking up with another carrier (and even wiser to splice it out for good, but we don’t do that yet.) https://ghr.nlm.nih.gov/…/alpha-1-antitrypsin…

Then I got my first sperm count of zero! That will be the subject of a later post — male factor infertility and remedies.

Driving to IVF clinic

Downtown LA as seen from highway

Having Children – Progress Report

I generally write on attachment theory and relationship topics to report on research results and the personal experiences of others. I try not to let my own personal experiences show too much because I’m trying for a neutral, nonjudgmental view. I have been too busy with other projects to keep up the writing and reporting here — but in a few years there will be enough new research to do another book on attachment. But for now I have more important projects!

It’s perhaps slightly embarrassing that I have weighed in on child-rearing topics but never had children until now. So we’re almost too old to undertake such a project, but we have the time and the space for it now.

The first few minutes of Idiocracy humorously cover the modern issue of long-delayed (and often foregone) children amongst the highly-educated, well-off young people of today, who may well stay in academia and avoid commitment until they are in their 30s and 40s, thinking “we must have stable jobs and resources before we have a child.” This is biologically risky since women’s eggs begin to slowly decline in quality after 25, and drastically after 40. Males, too, decline in sperm quality with age, though not as quickly (since sperm are generated from stem cells on demand, rather than being stored as buds from birth as eggs are.) Couples who want to have children but find their fertility has waned sometimes use IVF. A would-be mother whose eggs are too dicey can use a donated egg, and if unable to carry, a gestational carrier (the modern term for surrogate.) Anonymous male sperm donations are (compared to eggs) relatively cheap if it’s the male who has the issue with fertility. IVF procedures have improved greatly in this decade, and it’s a good thing because women are tending to postpone children for careers and men’s sperm is rapidly declining in potency. In a few generations perhaps most children will be IVF babies — presuming the price declines from the current $40-100K per child.

So I’m going to write more about these much more personal topics. We have (as mentioned elsewhere) embarked on our first child; we started in August of 2019, and our first is due in April of 2021 (21 months after our decision, delayed by COVID-19 shutdowns and other snags.) We found a great egg donor and have a second (and perhaps third) frozen embryo ready to start this month. The embryos have been screened and graded, and PGT-A genetic tests (not completely reliable) say they are all healthy boys.

20 Week Ultrasound

Ultrasound at 20 weeks

We moved from a comfortable home on a golf course in the Palm Springs area because public schools weren’t very good there, and since there were no children in miles (the average age of our neighbors being 70), we moved to Carmel Valley in San Diego, which has fantastic schools and a neighborhood that will have hundreds of children within walking distance. We want them to grow up like we did, free to roam the suburban area by bike and walking, to build peer relationships with a wide variety of other children.

I’m planning to post the history of our IVF experience before the first baby arrives. The initial 6 months of caring for an infant are pretty much all-absorbing, so I won’t have time to post much until after that.

Kramer vs Kramer, children of divorce.

Reader Mail: Recovering from Attachment Issues (and Helping Children!)

Interesting message from a reader who thoroughly absorbed the lessons of Avoidant and Bad Boyfriends.

I haven’t been able to reach her to get permission to quote her, so I’ll paraphrase and remove any distinctive information.

Thank you for setting out this masterpiece of attachment theory and its connection to the success or failure of relationships.

I feel deeply grateful for your work and I am, at the same time struggling with conflicting feelings of encouragement and also sadness at the reality of what I’m facing, and what my children are facing.

I’ve been working my entire life since a teenager when I read the works of Montessori… and determined that I would make my life better for my children….

I decided in my mid twenties, when I first started counselling, that “the buck stops here” and I started all of the work I could do, including EMDR, CBT; whatever was available on myself, so that my childhood would not be repeated in my innocent children’s lives.

However as your book illustrates so beautifully, the automatic attachment style that I had kept me at the fringes of healthy social relationships, and I have yet to learn how not to be a target for predators.

Your story about the owls gave me a metaphor for much of what has happened in my life. The abundance of untrained owls in the forest looking down and seeing a runner stimulates their automatic hunting instincts. The relationship that begins when there’s a pattern of being attacked and the fears that become programmed create a social structure that seems to be difficult to change… I now run through the forest of social gatherings, trying not to flinch when people approach, and it seems I just make myself more of a target.

I am 62 years old, I’m a Montessori preschool teacher, and I’ve raised my own five children from two different fathers, usually alone as a single mother. I’m still in counseling and I have made progress with my emotional regulation and a meaningful life, but not yet with a significant relationship.

All through my life, the rare men who do initiate relationships with me have each been human beings who were on the dark side pathologically, very good at appearances just like my father who was a well respected professional… and a pedophile.

Beyond my own personal struggle to find healthy attachment relationships, I am deeply concerned about the state of the culture. I researched ACES in my graduate program. I see the trend growing as each year more and more children in my work as a Montessori preschool teacher come in with serious dysregulation, much of which comes from attachment difficulties. Like your young Owls, they are untrained, and they seem to not know their own kind, attacking their peers and teachers and even parents, and are very distrusting.

My long-term goal is to create an organization that works to strengthen understanding of attachment, and to help parents and communities to increase their skills of attachment.

Do you think there is hope? What do you see? Do you have any suggestions, either personally, or for my work with children?

You have already accomplished a great deal in bringing up your children with a special effort to protect them from the consequences of absent fathers. I grew up unfathered, my mother worked hard to support us and I lacked a lot of skills and emotional support good parenting can provide. While a conscientious single parent can create a nurturing environment for children, having two parents gives a child a better chance of having at least one parent who can be relied upon as a safe emotional base. Notably, the absence of a father’s guidance can leave children to the mercies of peer groups and lacking self-confidence to grow into adulthood with a sense of responsibility and the tools to nurture their new relationships and children.

This post featuring a “Fiddler on the Roof” song gets at the responsibility we have to heal our own attachment issues or at least shield our children from them. You have chosen to work on yourself and work to limit the damage your own issues caused, and deserve to have all your work recognized. It’s hard to go through life, much less raise children, with absent or estranged partners. Your life has been meaningful and your work with children no doubt improved the lives of hundreds. Give yourself permission to feel proud of the good you have done in your life.

As I am near your age and was also raised by a single working mother, I thank you as I would my own mother, for all the toil and burden you shouldered. You took a problem and made it a mission!

As for relationships, some of my reviewers were appalled when I wrote about how the odds are stacked against you if you find yourself alone in later life. If you are aware of your own tendency to be attracted to Dark Triad types, you can learn to notice the less obvious, more reliable men who would make good partners — there are always people coming out of good relationships through death or divorce of their spouse, and late-life second, third, or fourth marriages can be the best — because both partners are wiser and often have learned from previous relationships how to be better partners. Resisting your attachment habits of gravitating to the most dashing and apparently capable men will serve you well.

It’s most important of all that you find your partner fun to talk to and be with — after all, the rest of life will be spent less driven by hormones and career, and more by companionship and cozy familiarity. Happiness is someone who understands you and will listen, while being there when you need him.

Your idea of an organization to raise awareness of attachment issues and promote healthier attachment among children and families is a good one, and please let me know if I can help. I and my partner are planning to have two kids by IVF (this late in life that’s safest, with youthful eggs from a donor.) I was one of the very few children in my generation who did not have two active parents, but by now divorce and migration are so common that the rate of underparented children has skyrocketed. And as parents themselves grow less responsible and take less time with their offspring, through economic stress and selfishness, the harm done grows. It only takes a few troubled children in a class to divert so much attention that the rest are neglected. Some inner-city schools that bear the brunt of this phenomenon are mainly run as daycare for children, with little education going on. The societal damage is enormous, with the well-off segregating themselves and their children in (sometimes literally) walled enclaves where public and private schools are still good.

Best of luck on your already-well-lived life. Be happy — you have better chapters ahead.