Reporter's Notebook

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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Uneasy About the Ethics of Egg Donation

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:

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.  ...

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:

A reader, Mimi Lee, introduces a new and rare experience to our ongoing series:

Ten days before my wedding, I was diagnosed with breast cancer. As a doctor, I naturally freaked out and quickly arranged my own lumpectomy within 48 hours of the diagnosis. I celebrated my new marriage surrounded by friends and family, wrapped in surgical dressings.

We returned from the honeymoon and embarked on a single round of artificial reproductive technology (ART) to preserve my fertility and our chances to build a future family. Meanwhile, I learned from a pathologist colleague that my cancer had not been completely removed, so after multiple consultations and opinions, I prepared for a mastectomy.

Amidst this whirlwind of uncertainty over the big C, I carefully emptied vials, mixed drugs, and prepared syringes for ART—only this time, it was not for any of the thousands of patients I had cared for as an anesthesiologist who specialized, ironically enough, in fertility. The prep was for me, inspired by the hopes and dreams of my own biological motherhood once I stomped cancer out of my life.

The ART went extremely well. At age 41, I had 18 eggs harvested. Twelve were fertilized and yielded five beautiful-looking embryos—my future babies. Two weeks after the embryos were frozen, I underwent my mastectomy.

A year later, after acknowledging that pregnancy was contraindicated for my type of breast cancer, my husband and I scanned gestational profiles at a surrogate agency. A year after that, he told me he wanted a divorce. After we separated, I underwent two more years of legal proceedings, which amounted to a full-time job, leading to a courtroom battle for the custody of the frozen embryos. My future babies’ lives hung in the balance.