Yesterday was our meeting with the staff psychologist at our current clinic. Back in December, I met up with the donor ovum coordinator to discuss about the cost and the process of fresh and frozen egg donation at UCSF. Since I am fully Chinese, in order to be on a wait list for an Asian donor, and a Chinese donor in particular, we would need to meet with this psychologist to discuss about topics surrounding ovum donation before we could get on the egg donor wait list. We originally made the appointment for early January. After discussion of the timing of my potential transfer and beta in January (not knowing that we would actually have road bumps along the way that prevented us from moving forward with a transfer), we postponed the appointment to February 6th. However, due to “scheduling conflict” of the clinic, we were again rescheduled for February 20, which was yesterday. Since we haven’t done our transfer yet, and hence do not know if we’ll have to pursue donor egg cycles, everything that we discussed yesterday was hypothetical.
Our clinic has partially moved to the newly built location. I am not used to going there because our cycles are still handled at the original location, which is three blocks away from my work. In order to go to the new location for the appointment, I had to drive to a mid-point to pick up Bob who traveled from his downtown office. Then we drove another 15 minutes to the new location. I remember when I was there last time I parked at one of the few non-metered parking spots. We lucked out again as we found a street parking space.
We arrived on time (Thanks to Bob for being on time!). I anticipated to be asked to pay the fees that I was told we’d have to pay. I already asked Bob to get his HSA card ready. However, nobody asked us to pay up. I don’t know what the deal is but I am happy that we don’t have to pay.
The psychologist came out to lead us to her office in the back. The hallway was filled with rooms and felt like a maze. When we entered her office, I first noticed children’s books displayed on the window sill that are written for the purpose of sharing with children about egg donation. The psychologist invited us to describe in our own words our journey so far, although she had already read our clinic file.
I went ahead and told her our history. An abbreviated version. From three years ago. Trying naturally to IVF treatments to our loss exactly one year ago (to the date of the appointment; creepy). And fast forward to our current state of waiting to transfer our embryos. Interestingly, I thought I would get emotional, but I didn’t. I just reported on our history matter-of-factly.
The psychologist asked me when I started thinking about egg donation. That was easy. It was back in July last year after one of the doctors with whom I consulted suggested it due to my poor responses. I started doing research and considering the possibility of it. We seriously discussed about it and also began our process to save up for that goal. I told her that I am ready to go for egg donation if our own-egg cycles fail. Some of my friends who also have diminished ovarian reserve feel that they don’t want to pursue egg donation because they may be jealous of their husbands or partners for their sole genetic connection with the child. I told her that I am the opposite. I actually crave that genetic links that the child will have with at least one of us. This is why I would like to pursue egg donation before we consider embryo adoption.
She turned to Bob and asked how he feels about egg donation. When he responded that he was “open to it”, I almost burst out laughing. My husband has been more than ready. He has even been more ready than I have. He sometimes gets frustrated with the waiting (for the cysts to go away, for my cycle to regulate itself) and suggests that maybe we should just go directly to egg donation. So it’s funny to hear him say that he was “open” to it. My husband actually is also very open to embryo adoption or traditional adoption. I am confident that he will love any baby that God puts in our family.
She asked us to tell her our concerns, if any, for egg donation. I talked about a few things. I am actually not concerned if I will bond with the baby or if I would feel that the baby doesn’t belong to me. I feel that once I get pregnant with the baby, I am going to know that I will be the baby’s mother. I am more concerned about disclosing our choice of egg donation to others around us as well as to the child. I have been quite open about our fertility struggles especially with friends and family who would pray for us. I crave prayers from them and I am thankful that they are willing to intercede for us. However, when it comes to making a baby with donor gamete, I suddenly feel the burden and the confusion of how much and with whom to share, since it does not only involve the two of us, but also a third person, namely the baby.
The psychologist spent quite a long time discussing this topic. She actually recommends disclosing to the child as early as possible. How she puts it is that it is never “too early”, but it could be “too late”. Studies find that children who find out about the facts of their birth in their teenage years may feel hurt, betrayed, and confused. If parents start talking to toddlers early on about how they came to the world, it will show them that it’s not something treated secretively and has always been part of the story of the family. Parents can put it very simply that a nice lady helped create the family. They can use children’s books to talk about it. And they can continue the dialogue with the child as he/she grows up. As for disclosing to other people, the psychologist said that it is good to share with a set of close friends and family so that the support is there. They can also choose to share with a larger group of people if they are comfortable. One point that stood out to me is that she said that having a child via donor ovum is only a part of the family’s story and does not define the family. You can talk to friends and family about it, but it doesn’t have to be something that is brought up over and over again.
Bob then went ahead and talked about his family. As you may know, his parents are traditional Hindu and were opposed to our marriage. They were against us getting married because 1) they wanted to arrange a marriage for him with an Indian girl from the same caste who is a few years younger, 2) they dislike the fact that I am 3.5 years older and anticipate us to have a hard time making a baby, and 3) I am Chinese. Because of the anticipated judgment that would come from them regarding my diminished fertility, Bob has not mentioned to them anything about our struggles or treatment in the past three years. He mentioned to the psychologist that he will eventually tell his parents if we do succeed in making a baby with donor gamete. He joked that maybe he would need to use the same kind of simple language that he would with a child: there is a nice lady who helped us expand our family.
We don’t have to worry about my side of the family as my parents and brother and sister-in-law are all supportive of our decisions. As a matter of fact, my mother once said that she would love our baby all the same even if we had to go with a Caucasian donor in the Czech Republic. I am lucky that my Chinese mother is so supportive.
My other concerns about egg donation are mainly about finding the right donor, the fear of interruptions with the cycle once a donor is chosen, the fear of a failed cycle as we only have limited funds, and the choice between fresh cycles vs. donor cycles as influenced by our desire to have more than one child.
The psychologist thinks that finding a Chinese donor is more difficult than finding a Caucasian but it is not insurmountable. If we can’t find one that we like, we can always go with an agency donor. She suggested two agencies that have successfully matched Chinese or Asian donors for patients. We should discuss among ourselves about what traits we most want to see in a donor. We may find that we may be fine with a donor that is mixed with some Chinese. Then we’ll have more choices that way. A donor that shares a little bit of my cultural heritage but has many of our desirable traits may be better than a fully Chinese donor whose strength is just that, fully Chinese. It’s a very personal choice. So we’ll have to go home and talk about what we both want.
As for the concerns of failed cycles, she reassured me that although there is never any guarantee of a successful cycle, the chances of getting pregnant are so much higher with donor eggs than not. There are two reasons that I want to use a donor from the clinic’s in-house pool: the in-house donors have gone through a strict process of testing before they were put on the database and it costs less money to use an in-house donor as opposed to paying a fee to an agency. One of the fears I have is that we’d be out agency fees if the donor doesn’t work out at any stage of the donation. Many first-time agency donors have not gotten tested before they are chosen by intended parents and the risk of something going wrong is higher. The psychologist agreed with me that she also feels more comfortable with in-house donors for the exact same reason, that only the ones who meet strict guidelines get into the program. However, she said that this problem can easily be overcome by using a proven agency donor who has already gone through the process and knows the ins and outs of egg donation. She feels that the agency fee is only a little bit more than using an in-house donor. It’s worth considering.
I told her that we discussed about doing fresh cycles rather than frozen cycles because we desire to have more than one child. However, Bob always said that since this process has been so long and difficult, we may just want to aim at having one child and be done. How does one choose fresh vs. frozen as the difference in the cost of them is so huge? The psychologist said that there are too many factors going into choosing a donor. We should go with the first donor that we like. If it’s a donor with frozen eggs, we should go with her. If it’s a donor who only offers fresh cycles, then we should go for that.
The psychologist advised against looking at any more donor profiles online. Since we’re still pursuing my own eggs, we run the risk of being attached to a particular donor who may or may not be available if/when we are ready for egg donation. And there may be more available donors that would suit our criteria if/when we are ready. She also suggested that if/when we fail at our own egg attempt, we should take some time to sit and let it sink in rather than moving onto egg donation the very next moment. This process provides a closure to a chapter of our fertility journey. It may take one day. It may take a few days. It may take a couple of months. Whatever length it may be, it is always good to reflect on this process and agree that “we are done” before moving onto the next thing.
We are automatically put on the in-house wait list yesterday since we completed the appointment. I wrote an email to the donor coordinator today to confirm that it is the case. The coordinator with whom I met in December is no longer working there. So I needed to confirm with this new coordinator that I could backdate my priority to August 2014 as I was told during the December meeting since we started cycling there in August. I guess there is not much we need to do until we are ready for egg donation. Then we’ll email the donor coordinator our interest in a particular donor and see how long the wait may be.
The whole meeting took about 45 minutes. When the psychologist walked us out, she told us that it was very nice to meet us. She thought that we were a very strong and resilient couple. She was confident that we would make great parents. Bob said that maybe she was just being nice to us, but I do think that this journey has really made us a stronger unit. It was very nice to hear from a mental health professional that she thought that we would make good parents. On our way out, she gave us a fact sheet labeled “Talking with Children about Ovum Donation” by the American Fertility Association. It will be an interesting and useful read for the future.
So now we wait. Wait for our cycle to take off. Wait for the lining to be good. Wait for the transfer to be done. Wait for the beta to be positive.
May the advice and information we learned in this meeting be something not at all needed in the future.
Hopefully we’ll find out in three weeks.