Notes

First Drafts, Conversations, Stories in Progress

Your Stories of Infertility
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Readers share their struggles and successes with conceiving kids. To share your own story, please send us a note: hello@theatlantic.com.

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When the Children of Sperm Donors Want Answers

A reader, Erin, raises a really interesting concern among the estimated 30,000-60,000 Americans born every year from artificial insemination:

I’ve seen several of the posts in this infertility series pop up in my social media feed and was wondering if you’ve considered sharing the perspectives of adults who were created using 3rd party reproduction methods, such as donated eggs or sperm. If you are attempting to engage in a conversation about ethics, I believe that is a vital piece of the puzzle. Please don’t forget that infertility “treatments” like egg and sperm donation affect the people they help to create. It’s worth noting that the majority of people conceived through anonymous sperm donation do not support the practice.

Indeed, according to a 2010 study written up in Slate by two of its authors, Karen Clark and Elizabeth Marquardt, “About half of [people conceived via sperm donors] have concerns about or serious objections to donor conception itself, even if parents tell their children the truth.” More of their findings:

Two-thirds of adult donor offspring agree with the statement “My sperm donor is half of who I am.” Nearly half are disturbed that money was involved in their conception. More than half say that when they see someone who resembles them, they wonder if they are related. About two-thirds affirm the right of donor offspring to know the truth about their origins.

Regardless of socioeconomic status, donor offspring are […] more than twice as likely to report having struggled with substance abuse. And they are about 1.5 times as likely to report depression or other mental health problems. As a group, the donor offspring in our study are suffering more than those who were adopted: hurting more, feeling more confused, and feeling more isolated from their families.

Read the rest here. Clark and Marquardt conclude that the U.S. “should follow the lead of Britain, Norway, Sweden, and other nations and end the anonymous trade of sperm.”

Circling back to our reader, I asked Erin if she has personal ties to the issue of sperm donation, and she replied:

After we published a story from a reader who had ethical qualms about using a donated egg that became her daughter, a bunch of readers in the TAD discussion group debated the question, “Is egg donation unethical?”—especially since thousands of dollars are typically given to the donor. Below are some of the best comments and personal stories from those readers, edited for concision. Here’s Terri:

My only real concern is compensation. Selling to the highest bidder for significant profit is risky and unseemly. It has to be regulated in a manner that protects both parties.

Another reader takes a more libertarian approach:

As long as all parties consent and the child created is loved and taken care of, then all is good. What’s unethical is bad parenting.

Jim compares egg donation to adoption:

The financial aspect of donation is no more fraught, to my mind, than adoption fees. The stickler is setting a fair price for the not inconsiderable pain and discomfort the donor experiences, as well as screening donors to make sure they are psychologically secure with the process.

Egg donation, fertilization, and implantation is essentially a rich person’s ethical problem, if that. Many women and their partners beggar themselves financially in an effort to become pregnant. If they can afford it and they want to, why not?

This next reader complicates Jim’s characterization that it’s “a rich person’s ethical problem”:

I am part of an IVF support group, with 10,000-plus members, and I’ve undergone IVF myself. The large majority of us are not affluent.

Also, it’s not fair for people who have never struggled with infertility to imply/demand that those of us who suffer from infertility settle with adoption, as if it’s an easy solution. We just want the same chance fertile people have—a chance they didn’t have to fight for or pay for, or suffer from.

Another reader also isn’t troubled by egg donation:

Is it less creepy than adoption? Prospective parents are also given dossiers of babies/kids they would like to consider. It shouldn’t be creepy to “choose” a child. We choose our mates, after all, and the initial attraction is mostly superficial there too. Is a child that arises from such a pairing not “chosen” as well?

It’s not uncommon in egg and sperm donations for people to search for donors who bear some similarity to them. Since the child will not have a genetic connection to the replaced parent, isn’t it better that they at least have some physical similarities? This is supposed to make life easier for the young kid, so they are not wondering why they look different or being teased as school for looking different (young kids can be merciless to their peers).

Finding physical similarities and other preferences is a big part of Gail Sexton Anderson’s job. She runs Donor Concierge, a service that matches intended parents with egg donors and surrogates.

Race and ethnicity is a big part of that process, which Gail addresses in this blog post:

For many intended parents having a sense of continuity within the family blood lines helps them to come to terms with going forward with an egg donor. I have had many intended parents tell me that they would like to find a donor who is Irish, Welsh, Italian etc. so that they can share stories of their heritage with their child and not feel they are being false to their child who shares their family but may not have similar ethnic heritage.  ...

The following reader tells the story of her long battle with infertility that culminated with the successful use of donated eggs. But despite the happy ending, she struggles with uneasy questions about the ethics of the donor industry and the “massive resentment” she harbors toward her husband. She prefers to stay anonymous here “in order to protect my daughter’s privacy”:

I met the love of my life late, at age 36. Two years later, we were married and trying for a baby. In retrospect I wish we had started to try as soon as we decided to spend our lives together, but hindsight is 20/20. I had several friends conceive without difficulty in their late 30s, so I was confident that we still had time and that it would happen.

But it didn’t. For three years we did the usual fertility treatments, including three rounds of IVF, with one heartbreaking early miscarriage. The treatments just didn’t work.

Early on we had discussed backup plans, though we weren’t crazy about any of them. Adoption was potentially just as expensive, difficult, and heartbreaking as fertility treatments and it could take years, particularly if we wanted infant adoption. The thought of starting from scratch with a whole new cycle of hope and disappointment was daunting. But we didn’t much like to face the prospect of childlessness either, since both of us had long dreamed of having a family and desperately wanted to raise children together.

A friend in her mid-40s told us about donor egg programs. She had a successful pregnancy using donor eggs and strongly recommended it. Our initial reaction was “no way, no how.” We wanted our own genetic child, and my husband balked at the idea of “having a child with another woman.”

But as the years wore on, and after our final disastrous round of IVF, we weren’t ready to give up yet, so we faced a choice: start from scratch with the long complicated process of adoption, or go with donor-egg IVF.

The upside of donor eggs was a massively increased chance of success, since the donor would be under 30. So long story short, we went with donor eggs. It held the highest chance of success with the least chance for heartbreak (a huge consideration given that we were already worn out by the stress of the previous attempts). It would allow our child to have a genetic relationship to one parent. And, I would be able to have the hoped-for experiences of pregnancy, childbirth, and breastfeeding.

We now have a beautiful daughter who gives us joy every day. I wouldn’t trade her for anything. But at the same time, I still have very mixed feelings about the process:

A reader revives our series with a rare perspective we haven’t heard from yet—a lesbian couple struggling to conceive:

I’ve read many, many of the stories you have posted regarding infertility, deciding to have children, and adoption—mostly to find answers to my own questions. The stories seem to be consistently from heterosexual relationships, and while I can relate to these on some level (infertility, financial strain, marriage), I am at the same time seeing them at such a distance. My experiences are not the same and I have many of the same options, but they are altogether different.

My wife and I have been married for three years. We decided to have children, and, as lesbians, were sent directly to a reproductive endocrinologist. We kept trying to tell the doctors and nurses (and each other) that we weren’t infertile ... we just didn’t have sperm!

Except it appears we are somewhat infertile. After four failed IUI cycles using my uterus and donor sperm, we reached the point at which we were told, “If it was going to happen this way, it would have already.” Our 20 percent chance was knocked down to 10 percent for further IUI, and they suggested IVF—or, to change tracks and let my wife become pregnant.

My wife is somewhat gender nonconforming, and her view of becoming pregnant herself is that she would do it if it were necessary for us to have a child—something we both want. But she is uncomfortable with the idea of being pregnant. I can understand her feelings and empathize with the choice. As her wife, I don’t want her to do something she isn’t excited about.

Here’s a very rare experience we haven’t seen in our reader series yet: embryo adoption. It’s a middle ground between having your own biological child and adopting one: You adopt an embryo created from a donor egg and sperm and bring the fetus to term in your own body, thus experiencing the biological aspect of motherhood when it comes to pregnancy and childbirth. But let our reader tell it:

My husband is infertile and didn’t know it when he married his first wife (college sweetheart). Her sadness/bitterness was a leading cause of her leaving him after 13 years of marriage.

When we met several years later, he told me early on about his infertility “in case it’s a deal breaker.” I said it wasn’t, given our ages (36 and 45). Fast forward five years to today, married four years now, and we have a beautiful son born of “embryo adoption.” We met our son’s genetic parents through friends of friends and have an open adoption relationship (even though legally, it was just an embryo “donation”). They had leftover embryos from their own IVF and we adopted all three (and we’ll give our last one a chance at life next year). The four of us have become good friends and are like an extended family. We are ALL thrilled with this arrangement.

Success factors: (1) Embryo adoption/frozen embryo transfer is much less expensive than full IVF because the embryos already exist. (2) Neither my husband nor I are genetically related to our son, so it feels like “equal footing.” (3) We got to experience pregnancy, birth, and breastfeeding like genetic parents. (4) It aligned with our ethical beliefs that embryos are humans; we didn’t create more to be discarded. (5) We are not overly enchanted with our own genes; we were happy to adopt others.

More stories of embryo adoption, and donation, are here.

The beginning of our reader’s note mentions how her husband’s first wife ended the marriage due to his sterility. We’ve previously heard from readers on how infertility has variously ruined marriages and strengthened them. Below are three more readers along those lines. The first one attests to how struggling to have a child forged an even stronger bond with her husband—partly because both of them have infertility issues:

I take strong issue with the urban legend that IVF can destroy a marriage. IVF is simply one of those major life events that will test the depth of a relationship and the maturity of the people involved in that relationship.

Yesterday we heard from a reader with uterus didelphys, a genetic condition that forms two vaginas, two cervixes, and two uteri—each linked to an ovary through its own fallopian tube. It’s difficult to determine exactly how common the condition is, but it’s between one in every 2,000 to 3,000 women, including the following reader. Her uterus didelphys went undetected for many years—and nine months:

I have wanted to share my story since it happened to me, to let other women know it’s OK to have uterus didelphys and that you can successfully carry a baby to term even with the condition.

This spring I was 36 weeks pregnant when my doctor came in with some very scary news. My baby was slowing down on the growth curve and they didn’t know why. There were many possibilities, from genetic disorders to the more probable explanation that my placenta was not giving my baby the nutrients he/she needed. We ran tests and monitored the baby, and the whole while I knew something was different about my pregnancy.

I only ever felt the baby kick on my right side, and we could only ever find the heart beat on the right side.

A reader writes:

I have uterus didelphys—a.k.a. having two uteri, two cervixes, and two vaginas. (On top of that I have a hormonal imbalance, which one doctor said was PCOS [polycystic ovary syndrome]—I had a trans-vaginal ultrasound done and my ovaries are riddled with cysts—but a second doctor said it’s not PCOS.) Each of my uteri is smaller than a normal-sized one. But my menstrual cycle is like clockwork, and there are no other downsides besides high-risk pregnancy.

The doctor told me that the organs of the female reproductive system are duplicated at one point during development, but eventually the organs merge and become one. For mine to have not merged is like a mutation! I’ve thought of it like the X-Men. It’s pretty cool, IMO, because I can break the ice by telling people I have two vaginas.

Among the many emails we’ve received from readers struggling with infertility, one of the emotions that keeps coming up is envy—unspoken envy toward people who seem to have no trouble conceiving and giving birth to healthy children. As one of our previous readers put it:

I also struggle with jealousy. “Oh! We weren’t even trying to get pregnant!” Even a good friend of mine at age 42 is about to have a baby girl via IVF. I think of her every day and hope I am so lucky.

Another reader can relate:

I am in my late forties. I have not been on birth control since my early twenties and have been married 17 years. We have been through IVF three times.  I would have thought the next step was adoption, but my husband said that was a deal breaker. I was not willing to get a divorce over it, so I just suppress my feelings of wanting to be a mother and channel them into caring for three dogs and a horse.

Everyone automatically assumes you can just get pregnant whenever you want. People even say to me they got pregnant just by talking to their husband. It’s very hard to hear that as someone who has tried so hard and has been through so much. I can’t even tell you how many pregnancy tests I have peed on—a ridiculous amount of hope each time, only to have a huge amount of disappointment and tears after. Not to mention the money we have poured in.  

I gave up in my late 30s. Having a family should have just been easy—something everyone assumes will happen if you want it. I do feel I have been successful in other areas in my life, but it still is hard seeing all of my friends and their happy families.

This next reader’s excitement over being an aunt was clouded by her feelings of jealousy:

In five days, I’ll have my second FET (frozen embryo transfer) and I feel I like I should be excited, but I’m just numb.

Below are two very different reactions to our previous note, “When Infertility Threatens Marriage,” which featured a reader expressing anger toward her husband for persuading her to wait until 35 to try for a baby; another woman who broached—with studies to back it up—how infertility can ruin a couple’s sex life, and marriage overall; and another reader describing how infertility led to her friend’s divorce. The second reader featured below is outraged over that note—“disgusted” even—because she believes it perpetuates myths about infertility.

This first reader, however, exclaims, “OMG that note is exactly right; infertility is brutal on marriage.” She elaborates:

My husband had an undescended testicle at birth and testicular cancer when he was an adult. Despite those issues (should have been red flags), we didn’t get tested until well over a year after we started trying to have a baby.

I had turned down several good career opportunities to conceive. When my tests were fine, but his weren’t (they were all over the map), he blamed it on me, saying I stressed him out. He also flatly refused to see a specialist, so I left and took a job I loved far from our home.

We did see a specialist in the city I was working in and he was optimistic about IVF-ICSI, since my numbers were fine and age was on my side. Then I had an HSG (x-ray to see how the tubes and uterus are) and I got what was later confirmed to be a false positive. My husband was weirdly satisfied, but IVF was still on the table. I ended up leaving my job for a job where I would travel to work and back home, week on, week off. He was paying for the flights. While I loved my job again, the cost was insane. So I moved back.

In hindsight, I should have just called it quits and got my dog, moving on. After all, I had a husband who would not support fertility treatment or my career.

This next reader shows a lot of self-awareness and self-reflection over the trying process he put his wife through, and what they endured together:

I have a genetic abnormality which results in the absence of the vas deferens (the duct which conveys sperm from the testicle to the urethra). This means that IVF—via medical extraction of sperm directly from the testicles—was the only way for my partner to get pregnant with our child. It also meant, ironically, that many prior years of contraception to avoid getting pregnant was pointless.

I still feel guilty about the IVF process my partner had to go through, which was entirely because of me. Lots of time consuming and distracting medical appointments. Lots of effectively voluntary medical procedures. Increased risk of various forms of cancer.

All I needed done was an extraction needle-gun shot into my testicles every now and then, to get the sperm out. (Although yes, that was as painful as it sounds—give me a basketball or a football to the groin any day.)

The IVF treatments became an obsession. Everything else —jobs, friends—took a back seat. We were initially cautious and put back one embryo each cycle, but it kept not working. Time was getting away from us (my partner was approaching 35), so we started putting two embryos in each cycle.

This story from a 39-year-old reader is utterly heartbreaking. He and his wife not only struggled for years to conceive—suffering a miscarriage along the way—but also struggled to adopt. (Perhaps they can find some helpful insight from our reader series on adoption or the one on miscarriage.) Our reader begins his story plaintively: “Being a father was always the thing I wanted the most, from childhood on up.”

I was an only child to an only son from my grandfather who had lost a courageous battle of MS over ten years before I was born. My nuclear family connections were important and I wanted to have a good job, but not a great job because I wanted to have the freedom to be there for my kids when they needed me, like my family had been for me.

I got married pretty much straight out of college and my wife wanted a professional career that required a master’s. We put off starting a family until she was done, after we’d been married three years. We were both 26 when she went off birth control.

The following January we were pregnant. The following March we were not.

The product of our conception slipped away, and we were excoriated for not visiting the emergency room instead of urgent care. We knew that miscarriage was common, so we chose not to tell anyone (or nearly anyone) that we were trying, nor that we were unlucky.

Kacper Pempel / Reuters

A reader writes:

I’m 36 and I’ve been struggling with infertility for a bit over a year now. I say “I” because from my point of view, this is much more my problem than my husband’s (yes, he’s had tests done and all is normal). I know many men are as heartbroken as their partners over trying to conceive, but that hasn’t been my experience, nor my friends’. My husband loves me and wants me to be happy, but it’s very simple for him to say “we’ll adopt” or “we’ll have a baby some way; you’ll be a mother.” It’s very different to be the one who feels that her body doesn’t work; who doesn’t feel like a woman; who feels as if life is passing her by every day that passes without a baby.

I feel guilt and anger every day about waiting so long to try to get pregnant; anger at my husband for persuading me to wait until we were 35 to start trying; anger at myself for listening to him when having a family is my life’s goal.

I also struggle with jealousy. “Oh! We weren’t even trying to get pregnant!” Even a good friend of mine at age 42 is about to have a baby girl via IVF. I think of her every day and hope I am so lucky.

That reader’s marriage doesn’t seem to be imperiled, but we’ve heard from other readers about the damage that infertility can inflict on a couple. Rachel has seen it secondhand:

I’ve known a few people who have done IVF. What people don’t talk about much is the high level of divorce correlated with the procedure. Couples are three times more likely to divorce [at least according to this 2014 study of Danish couples]. The impact of the hormones often leads women to have harder time moderating feelings, and feeling out of control is compounded with an impact on sex drive that reduces the sexual relationship to mechanics. [This 2010 study from Stanford backs up that last assertion.]

It’s an interesting choice: your marriage or a child.

The high cost of IFV—for example, one of our readers spent $15,000 on it and related measures—undoubtedly strains a marriage as well. Has infertility ruined, or nearly ruined, your marriage? If so, and if you’d like to talk about it anonymously, please send us a note: hello@theatlantic.com.

Here’s another reader who witnessed the detrimental effects of infertility on marriage: