[Editor’s note; In 2009, shortly after marrying her (first and only) husband, Paolo, Elizabeth Heath was diagnosed with premature menopause and resulting infertility. Paolo and Liz are now parents to a baby girl, Naomi. In this series, Liz recounts the couple’s struggle with infertility, and how they finally achieved a successful pregnancy and parenthood.]
When I first met with a reproductive endocrinologist while still living in Florida, he immediately tried to set me on the direction of getting pregnant with the use of donor eggs. I wasn’t anywhere near ready to consider this alternative.
DONOR EGG 101
Simply put, the donor egg process involves stimulating ovulation in a donor—always a young, reproductively healthy woman—as if she were going to have IVF. So she takes the drugs, the hormone injections, and has routine ultrasounds to check her progress, just as any woman doing IVF would do. The donor’s eggs are harvested and fertilized with the male partner’s sperm. The embryos are left to develop five days in vitro, and are then transferred to the uterus of the infertile woman. The donor does the hard work; then, hopefully, the infertile couple finds out they’re pregnant when they test 14 days later.
Most clinics recommend transferring a maximum of three embryos, as the risk of multiples—twins or triplets—is so high. And I say risk because, despite the excitement and the “two for the price of one” bonus with twins, multiple pregnancies are considered high-risk, as they pose greater health problems for the mother, and a greater likelihood of premature delivery and health complications in the fetuses.
In some cases, if the couple seeking IVF with donor eggs is very fortunate, there will be an excess of healthy embryos—more than they want to transfer at one time. (This is assuming they don’t want to end up like Octomom, who had a medically-irresponsible eight embryos transferred, and all eight took.) In such cases, the remaining embryos are cryogenically frozen. So if the first attempt at donor egg IVF does not result in pregnancy, or a couple decides later on to give little Junior a brother or sister, they have the embryos—Junior’s biological siblings—on ice.
If a couple freezes embryos and decides later that they no longer need them, they’re either disposed of, donated to other infertile couples, or frozen indefinitely. That is, at least, the case in many U.S. states, where embryonic stem cell research is still an unresolved issue. In countries that allow embryonic stem cell research, the cells from those five-day-old embryos are the master cells for everything the human body will become as it develops. They’re invaluable as the genetic material for which to develop replacement cells for spinal cord injuries, traumatic brain injuries, and healthy cells to fight cancerous ones.
THE MORAL GRAY AREA
And here’s where it gets tricky, depending on one’s moral stand on stem cell research and relatedly, abortion. Proponents of stem cell research see its limitless potential for addressing a multitude of life threatening conditions—the ability to grow new, healthy cells for virtually every organ and system of the human body has profound possibilities.
Read Related: Facing My Infertility Part 2: Wanking at Straws
But to harvest the cells from those five-day-old embryos, the embryos must be destroyed. For opponents of abortion, this is tantamount to murder. It’s the killing of one human life in order to potentially save other human lives, and as such, unjustifiable. And in a Catholic country such as Italy, it runs afoul of the Church, which still has a heavy—too heavy, some say—influence on the politics and laws of the nation.
That’s why IVF with donor eggs is illegal in Italy. That’s why, even if I had popped 10 or 15 healthy eggs when we did a round of IVF in Italy, the RE would have selected only three to fertilize. Because if more than three were fertilized and more than three developed, some of those embryos wouldn’t make the cut, and they’d be at risk of being destroyed, or frozen and later destroyed if we decided we didn’t need them. So rather than allowing them to “play God” as the popular expression goes, Italian law prohibits the fertilization of more than three eggs. And because IVF with donor eggs is often so much more successful than routine IVF (using my withered 43-year-old eggs, for example), its potential for multiple viable embryos just doesn’t fly in a country where crucifixes, statues of Jesus and paintings of the Madonna adorn every public hospital, school, government office and courtroom.
And it’s why Italian couples, who can’t get pregnant with IVF or other means, go to Spain, where donor eggs are legal.
So when Paolo and I were lying in bed, pondering our future after a failed IVF attempt and a short-lived pregnancy and he suggested we go to Spain, he wasn’t talking about a vacation. To this day, he doesn’t remember where he heard about it, but somewhere he learned about the abundance of fertility clinics offering donor egg IVF in Spain, and the high rates of success with this procedure.
I was against it from the start. As ego-driven as it sounds, it didn’t sit well with me that I might carry a baby in my womb that had 0% of my DNA. Half Paolo’s, yes, but none of mine. I know it shouldn’t have mattered, but it did. It also felt wrong, to me, to go to all that effort and expense to create life when the universe was telling me that pregnancy was just not in the cards for me.
ADOPTION NOT AN OPTION
I wanted to explore adoption instead. But that was short-lived research. Italian law (again, think of the firm hand of the Pope on the shoulder of these lawmakers) prohibits adoption for couples married fewer than three years. Single parents or gay couples? Yeah right; find yourself another country. And, the law further insists that orphaned or otherwise unwanted babies be available for family members to take them in at any time. Let me be clear: even if relatives don’t want the orphan, he or she can’t be adopted by non-blood relatives—couples like us who could provide loving homes—so long as there is a living relative. The result? Italian orphaned babies and children languish in orphanages run by the Church, unwanted by their blood relatives and ineligible for adoption. So for the roughly 11,000 couples in Italy seeking to adopt, there are fewer than 1,000 babies or children available for adoption. Couples who have the time and the money to invest—and who have been married at least three years—seek adoption abroad, mostly from nations in Southeast Asia and Africa.
So we were back to square one, because we’d been married less than a year, and would have to wait another two years to start any adoption process.
We spoke to one more reproductive endocrinologist, an occasional visitor to our town who runs an IVF clinic in northern Italy. He came to our house one evening, along with our town doctor. (That’s just how it works in a small Italian town.) We showed him all the paperwork from our IVF attempt, including the strong battery of drugs I’d taken to stimulate ovulation. He looked at the report, and studied the photos of the two fertilized eggs that were transferred and didn’t take. He closed the folder, exhaled, and looked at me directly.
“Go to Spain,” he said.