Got Eggs?

I was nineteen when the phrase "egg donation" first entered my vocabulary. At Smith, a progressive women's college, issues of women's rights were always a hot topic. The article vacillated between two theories: was egg donation a compassionate gift which allowed other women to conceive and bear children through IVF, or was it exploitation of young college students? This was not the first negative press I would see on egg donation, but I wasn't phased. What I remember most poignantly from that article was the remark of one egg donation recipient, now pregnant with her child. She claimed egg donation had changed her life and that it had given her hope when she had run out. "I could help someone like that," I thought. I wasn't swayed for one moment by the whispers of exploitation. As an informed, educated woman, I didn't see how the choice to help another woman could be considered exploitation. I did my research, I read about the time commitment, the medical procedures, the financial compensation. I never did end up donating that year, but the idea of egg donation was always in the back of my mind, especially after I had my own son. When Dylan was about a year and a half, I started to research the process again. After several months, I registered with a few agencies, but also decided I wanted to be more proactive then simply sitting at home and waiting for someone else to match me. I created my own extensive profile, got all my college transcripts and medical records together, and placed an ad on a popular egg donation and surrogacy classified site. If I was going to help another couple have a child, I wanted to get to know them. I wanted to talk to them directly.

I placed my ad in mid-November. On December 25th, after several potential matches fell through, I heard from Jennifer,* the woman who would later become my IM, (intended mother.) We clicked immediately. This was the first egg donation cycle for both of us, but we were both straight-forward, proactive, and organized. We knew almost immediately that we wanted to work together and she put me in touch with her clinic. I was able to do my initial screening at my local hospital and, after a pap test, 24 vials of blood, and a medical history examination, I was declared medically fit to be a donor. Jennifer and I initially were synchronized with oral birth control pills and, once we were at similar points in our menstrual cycles, I started my injected medication. The first medicine I took was Suprefact, a GnRH agonist, which would shut my system down, in effect putting me into early menopause. After taking this medication my hormones would be "baseline" and the Reproductive Endocrinologist (or RE) would be better able to monitor my reaction to the stimulant medication and egg production. The syringes were tiny – I injected the Suprefact with the same needle that diabetics use to administer their insulin. However, gathering my courage to do that first shot was not easy. Something just seemed incredibly foreign about sticking a sharp object into the flesh of my stomach. Finally, after about 20 minutes of stalling, my pulse racing and heart pounding, I took the plunge. I didn't feel a thing – not even a prick. I would later find out that was just dumb luck – some days I couldn't feel the Suprefact or Lupron shots at all, others I would hit a small nerve and it would feel like a bee sting. The stimulant medications were a slightly different story.

After being on the Suprefact for about a week or so, I went to a local monitoring clinic for my suppression check. I had a transvaginal ultrasound performed, which revealed the number of antral, or resting, follicles in my ovaries. Hopefully, those follicles would grow as I took the stimulant medication and yield mature, healthy eggs. I also had my hormone levels tested. Everything looked good – I had a decent number of resting follicles and my levels were nice and low. It was time to start stimulant medication. I stayed on Suprefact to keep my body from ovulating prematurely, but now I added two more injections to my daily regimen. In addition to the Suprefact I began taking an FSH (Follicle Stimulating Hormone) medication, Puregon, and a FSH/LH (Follicle Stimulating Horomone/Luteinizing Hormone) medication, Repronex. The FSH was administered with a pen, and was incredibly easy to take. However, the Repronex required me to mix a liquid with a powder, use one needle to draw up the mixture, and a second needle to inject. Unlike the Suprefact, I could feel these medications as I injected them into my stomach. They burned like fire, especially the Repronex. The side effects began a few days after I started the Suprefact. I began to get headaches on a daily basis. I was grumpy, irritable, and far more emotional then usual. However, the worst part was the fatigue; even pulling all-nighters at Smith didn't compare to the complete and utter exhaustion I felt while on the medication. I began to look forward to the day I would fly out to my recipient couple's location – I had arranged childcare for my son and for about a week all I would have to do would be to go to daily monitoring appointments at my recipients' clinic and rest. After I had been taking the stimulant medication for four or five days, I began to feel very sick to my stomach. At first I thought I had caught the 24 hour flu, but the nausea was more similar to the morning sickness I experienced my first trimester of pregnancy. Around day 5 of the stimulant medications I was checked at a local clinic, and prepared to fly to my recipients' location the next day. That night, I got a call from the clinic – apparently, I responded very well to the medication, and my numbers were already quite high. The next day I flew out to my recipients' location and met Jennifer and her husband. They were both amazing, and I knew without a doubt that I was doing the right thing. I had felt connected to Jennifer previously from our phone conversations, but meeting her in person blew all my expectations away. I saw in her many of the qualities to which I aspired. I felt flattered and humbled that this incredible, giving woman had actually picked me to help her complete her family. At that moment, the intensity and importance of what I was doing hit me fully. It was one of the most emotional days of my life.

After I arrived at their clinic, I was given another ultrasound and my hormone levels were checked– the clinic dropped my medication dosage almost immediately, and in the next few days would continue to drop it until I was coasting without any medication. At this point I was exhausted, bloated, nauseous, and feeling pretty miserable. After only a few more days, I was ready for my hCG trigger. That evening, at a time dictated by the clinic, I gave myself my final injection of the cycle. This last medication would mature the DNA in the eggs and, 35 hours later, they would be ready for retrieval. The retrieval is an outpatient procedure, performed in a manner that outwardly resembles a GYN exam. The doctor uses a needle, guided by ultrasound, to enter the ovaries through the patient's vaginal wall, puncture each individual follicle, and aspirate the fluid within the follicle. The fluid is then analyzed by the embryologist and, hopefully, contains a mature egg.

To say I was nervous when I went to the clinic for my retrieval would be an understatement. I had already been informed that I would be awake for this retrieval and would be given morphine to relieve the pain and a sedative to relax me. Thank goodness for the sedative. The morphine dulled the pain, but the rhythmic needle puncture of the follicles caused me to cramp in a way that reminded me of labor. However, it was fascinating to watch the needle enter the follicles on the ultrasound screen. In the end, 24 mature eggs were retrieved and I wept with joy for my recipient couple. I tried to explain to the nurses that I was crying because of the hormones and because I was happy – I so wanted my couple to become pregnant. With 24 mature eggs they would have a good chance of that happening. I'm not sure if the nursing staff really got it – because they gave me some more sedative.

Several days after retrieval I heard from Jennifer: out of 24 eggs, 18 fertilized, resulting in 16 "excellent" embryos 5 days after retrieval. I was so excited for Jennifer on the day of her embryo transfer, and reassured her that very soon she would be looking at baby clothes. A few days later, roughly a week after my retrieval, I still looked several months pregnant. My ovaries had not gone down in size, and I was incredibly tired and sore. Sunday morning, exactly one week after retrieval, I woke up with a very full bladder. I leaned over to turn of the baby monitor next to me and felt excruciating pain sear my side. I sat up and tried to catch my breath, but the pain wouldn't stop. I emptied my bladder, thinking maybe that was the problem, but still no relief. I spent the day in the emergency room, on a morphine drip. After taking my blood and doing a series of x-rays and ultrasounds, the ER doctor determined I had mild to moderate ovarian hyper-stimulation syndrome, the most common complication of IVF or egg donation. The sudden pain I felt probably happened when my full bladder compressed a follicle and caused it to burst. I had some fluid in my abdomen, but none in my lungs. Fortunately, I was able to go home that day and, with a week of bed rest, my OHSS had resolved itself and my body started to go back to normal. In the worst cases of OHSS, an extended hospital stay is required and fluid must be drained from the abdomen and lungs. Severe OHSS is rare, but can be very dangerous if untreated.

Towards the end of my donation I was contacted out of the blue by another couple. I frequented several egg donation support boards during my cycle and through one of my posts, Carolyn* found my personal website that contained pictures of me and my family. Her email to me was sweet and moving. She knew I was in a cycle with another couple, but my childhood photo resembled the child she and her husband already had themselves. They couldn't have anymore children without the aid of egg donation. After my cycle, would I consider donating for them? I tentatively agreed, and she and I begun to correspond. The emails were sporadic at first, and conversational. Carolyn was interested in my progress through my first cycle, and she loved hearing about the excitement and fears an egg donation cycle can bring. A few days after my first retrieval, I agreed to cycle for her and her husband once my body was back to normal. I have to admit, my OHSS scared me. For a second, I even considered not doing another cycle. However, I felt connected to this couple, whose own child bore a natural resemblance to me. I also felt that now I was experienced, and I would know what to look out for. I knew this second clinic wouldn't use anywhere near as aggressive a medication protocol since I had responded so quickly previously. In fact, for the remainder of my cycles, the medication dosages were roughly half of the dosages given my first cycle. So, despite my OHSS set back, Carolyn and I began to work on the next contract and to make the required appointments at her clinic.

The period between the embryo transfer and the beta, or blood pregnancy test of the recipient, is commonly referred to as the dreaded 2ww: two week wait. It takes about two weeks for the embryos to implant in the uterus and begin to produce enough hCG to be detected with a blood test and confirm a positive pregnancy. About a week after my OHSS scare, I got the call from Jennifer. The test was negative. She wasn't pregnant. I was stunned and devastated. Never for a minute did I actually imagine it wouldn't work. I was completely unprepared for the fact that she would call me with negative results. All that time, that money, the side effects, and it didn't work. Jennifer had already been subject to more then her share of disappointments, and was outwardly calm – and even optimistic. She talked about doing a frozen embryo transfer immediately with the remaining embryos. All I could think was "is this my fault? Could there have been something wrong with my eggs?" I couldn't help feeling like I let her down. Not just because she had failed to get pregnant, but because I had been so POSITIVE she would get pregnant, and had reassured her when she expressed doubts to me. After I hung up the phone and got myself together, I though "Oh, God. What if it is me? What if it somehow is my eggs and I've already committed to this other couple? What if I let them down, too?"

When I told Carolyn about the news, she assured me that she and her husband still wanted to proceed with me as their donor. There is only about a 60% percent chance with any egg donation cycle that it will actually work, and they were willing to take their chances. I felt grateful for their confidence in me, and I was committed and dedicated to the cycle, but I couldn't bring myself to be anywhere near as excited as I was for my first one. I was so afraid of being let down again and letting them down. This couple was within driving distance from my home, so to save them remote monitoring costs I drove 3 hours to the monitoring appointments at their home clinic. I did this every other day, for about two weeks, but this time I was on a much lower medication protocol and the physical experience was like night and day compared to my first cycle. I still had the fatigue, headaches, and irritability, but I had no nausea and very little bloating. I was also able to "sleep through" this retrieval with a twilight sleep anesthesia. I kept myself somewhat distanced emotionally from the outcome of this cycle, so when I heard that they retrieved only 12 eggs, I was very disappointed, but not devastated. Carolyn faithfully kept me posted on the results of the eggs and the embryos, and when she told me they had decided to transfer one single embryo, I had to feign my excitement. In my heart, I prepared for disappointment, thinking it was unlikely anyone would become pregnant with just one embryo. Usually, the recipients transfer two, or even three, embryos with the hope that one will implant. Transferring one embryo reduces the risk of multiples, but often also lowers the chance the couple will become pregnant.

You can imagine the surprise and pure joy I felt when I received an email with POSITIVE in the subject line from Carolyn. They did a home pregnancy test a few days before their beta, and it came up positive. They were pregnant! I literally jumped up and down and hugged my laptop. This was it. This made it all worth it. The injections, the side effects, the disappointment and fear – I would do them over hundred times for this feeling. She was pregnant!!!! My faith was restored in the process and in myself. My eggs weren't a failure after all. I followed her pregnancy with joy and with hope. This child was true miracle. Not just for Carolyn and her husband - but for me too. I was able to be a part of something that was bigger then me. I was able to make a difference in the lives of two wonderful people. I was privileged to the pain of infertility, and able to witness the joy of someone triumphing over the disease. The experience was liberating, life affirming, and humbling all at once.

I went on to donate four more times, all very individual, unique and wonderful experiences. Egg donation has changed me in too many ways to count. Now, years later, I'm confronting my own demons. Not in getting pregnant, but staying pregnant. Looking back, I wouldn't change a thing. I'm so glad I experienced egg donation while I was able. Especially now, I'm comforted by the idea I was able help another woman face her demons. I continue to feel privileged that I was able to play a part in the journeys of my IP's.

* Names have been changed