IVF Journey — Donor Eggs
Egg production in the human ovary

Oocytes and egg production

[cont’d from How our IVF Journey Began]

While we waited for husband’s second attempt at providing sperm, we started looking for a good egg donor. It’s kind of the Wild West, with little regulation and some donor agencies placing ads in college newspaper to entice young woe=men with promises of large fees (as much as $100K!) for “suitable” donors — there is great demand for certified excellent donors, with advanced degrees, Ivy League schools, being Asian (much IVF business in LA serves Chinese clients, who want a baby with US citizenship but are wary of having a child who doesn’t appear “different.”) The LA IVF clinics do a thriving business with the Chinese who have their IVF babies born in LA for US citizenship. Not to mention the thousands of Chinese birthmothers who fly in for a few week stay to have their babies here. Few countries would allow a mother to fly in as a tourist to have their children with automatic citizenship; various moves to limit birth citizenship in the US to those who have a permanent tie to the US (legal residence, employment in the US, etc.) have been floated but are quickly shot down as “xenophobic.”

IVF was pioneered and perfected in several countries, but LA has become a world center for intended parents from around the world(from Vogue): How California Became the World’s Fertility Treatment Destination “For a growing number of women worldwide, the often emotional struggle to get pregnant is leading to Los Angeles. With its top-notch tech and liberal laws, is California changing the business of giving birth?” Yes, it did.

July 4 2019

Spent the morning looking through egg donor listings. One was trying to impress with her educational accomplishments but used an apostrophe wrong — “Not today, Satan!”
Most impressive so far — young lady who grew up in the Central Valley / Fresno area, first to go to college, now at UCLA grad school in neuroscience, statistics. No glamour shot with eye makeup like most, no desire to stay in touch, cites Steven Pinker as her fave author. Swoon!

That egg donor did not pass further screening. We were looking for someone as intelligent as we are, to give the children the best chance at good genetics for learning and accomplishment. The egg donor sites are full of heavily-made-up and processed young ladies who pick glamour shots to represent themselves; Instagram and the like have trained young women to strive for this look. It’s a bit offputting.

July 12 2019

There are apparently 500,000 frozen embryos waiting for disposition in the US. This article jumps off a celebrity court battle to make some ethical comments: [Sofia Vergara’s Embryos Join Father Nick Loeb In Suing Her To Let Them Live]

Some Hollywood women have their children by surrogacy to avoid career interruption (they are paid enough so I hiatus results in lost income and career damage.) But the Intended Parents [IP] are treated the same in Family Court, so such children are given child support from the wealthier partner. A situation with divorce followed by one parent disowning the embryos and another wanting them decanted gets into ugly territory.

Note also the egg freezing that young career women are advised to do if they want to have children in later life. Eggs begin to deteriorate after the age of 30, so women, correctly believing they will be viewed as less serious and reliable if they pause to have children, postpone becoming mothers for a more convenient time. By waiting until they are well-established to bear a child, they can avoid loss of career momentum before they have established themselves. You can have your cake and eat it too by freezing your eggs when they are most viable and bearing them much later — much less risky than waiting to 45 or 50 to try for natural children. Many older couples end up doing IVF because of male factor infertility or poor quality eggs.

July 17 2019

The IVF clinic had a notary on staff to help you notarize a flurry of legal documents via Skype. 75 pages of legal and disclosures, initial every paragraph, sign about 10 times.
Very Brave New World. Reminds me of Heinlein’s The Door Into Summer with the frozen lives and contracts at the cryosleep place. Was strange visiting westside LA and seeing all the street names Heinlein had borrowed for characters, like Sawtelle. I remember them all from when I was 12.
— quote —
We understand that under California law our unused cryopreserved embryos, eggs and sperm are our property, subject to disposition under California Probate Code §6400 et seq., and California Family Code §2010, and that we jointly have the right to exercise decisional control over the disposition of our frozen embryos, eggs and/or sperm. We further understand that this Agreement is required to be provided to all IVF patients by CFP pursuant to California Health and Safety Code §125315, and that the possible choices for disposition of our embryos are dictated by that statute. We also understand that the disposition choices for our frozen eggs and/or sperm, although not specifically referred to in California Health and Safety Code §125315, will be treated in the exact same manner as our frozen embryos. We further understand that the legal status of cryopreserved embryos, eggs and/or sperm, and the use, custody, and ownership of said embryos, eggs and/or sperm is complex and unsettled in the law. We are making the choices indicated herein to avoid the complexities and ambiguities inherent in the process, and to ensure that our joint written directives regarding the disposition of our unused cryopreserved embryos, eggs and/or sperm are followed.

There are also many contracts required for egg donor agencies and donors, gestational carriers and their agents, escrow companies (where intended parents deposit what is promised to carriers and donors so that they can proceed without worry someone won’t be able to pay as promised.)

July 22 2019

Another fresh new experience – went to an IVF clinic in Palm Springs to have a sperm count done. 11 AM is too early for this kind of thing, and a white room with a foot-thick selection of reading material (on top: Hustler. It’s still a thing?) is hardly romantic. We survived, though. Results to be faxed to LA doc tonight or tomorrow. BTW, I tried to schedule this through my official doctor, and it took them days and they only found a LabCorp place in Riverside, an hour drive each way. This place I found myself was $140 cash each and you got an appointment the next business day. I’m guessing the insurance route would have cost $300.

Other patients there for IVF were about half foreign. Not obvious where from, but not Chinese. One couple was speaking Italian.

We found a new egg donor candidate at one of the more mercenary agencies. She was 29, had an impressive background at a well-known B-level STEM college, and was in mid-career in the video game industry. She was motivated by a desire to help people without herself having to go on hiatus before she was secure, plus of course the fee for her egg donation. We had a Zoom call with new egg donor (who lives in another state.) She was extremely impressive on call, polished and intelligent. Looking like a great choice.

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 the 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.