The Workup

Greetings from Germany! Peanut and I have been in Germany for almost two weeks now. Family and friends are stopping by to get to know peanut and I’m eating a ton of yummy German food.

Miami at 27 weeks

In the last post, I explained how I chose my sperm donor. Before I could try becoming pregnant, however, there was a list of things I needed to do first. Keep in mind that each person’s fertility journey is unique and every clinic has its own unique protocols. I can only speak from experience about my journey with the clinic I chose.

The R.E.I. Specialist

No, not someone who is really into camping and works at the Recreational Equipment Inc. but rather a Reproductive Endocrinology and Infertility specialist. First on the list was a consultation with an REI specialist. As I had mentioned, a lovely woman I met during residency, who was finishing up her REI fellowship, recommended I have a consultation with her friend and co-fellow. This was during the beginning months of the pandemic, so it was a virtual visit.

We discussed my general medical history, sexual history, and desire to conceive. She explained the process and the steps that would be necessary to move forward. She ordered some basic labs as well as labs more specific to fertility such as follicle-stimulating hormone (FSH) and anti-mullerian hormone (AMH). Sexually transmitted infections testing was also done. A pelvic ultrasound was ordered to take a look at my ovaries and uterus. A hysterosalpingogram (HSG) was ordered as well. An HSG is a radiological procedure where a contrast solution is injected into the uterus through the cervix to show the contour of the uterus and assess if the fallopian tubes are open.

I also opted to have genetic testing performed to look for an exhaustingly long list of recessive genetic disorders. My sperm donor did not have genetic testing done prior to being allowed to donate. The sperm bank I used now requires all new donors to be tested. I really wanted this particular donor and felt that if my recessive gene test panel was negative, then I could move forward with him. For those of you who don’t remember how recessive genes work, both parents have to have the recessive gene AND pass it on to the child for it to affect the child. So, if I wasn’t positive for any recessive genetic disorders but the donor was, my child wouldn’t be affected. They could still be a carrier for the disease but I’ll end the genetics lesson here. Thankfully, my entire workup was unremarkable.

The Cardiologist

Prior to my REI appointment, I had an echocardiogram done to assess my heart. I have always had somewhat hyper-mobile joints and am quite tall with low back issues at times. The possibility of Marfan’s disease had crossed my mind on several occasions. I was never too worried about it until I was seriously contemplating becoming pregnant. It didn’t necessarily help when a physician assistant at one of my rotations told me the story of how she knew a girl whose mother died during childbirth from aortic rupture due to undiagnosed Marfan’s syndrome. Thankfully, my heart is fine.

The Geneticist

Despite the normal echo, I also met with a geneticist to discuss genetic testing for Marfan’s syndrome and other connective tissue disorders. I had a genetic connective tissue disorder panel done. Again, thankfully it was all normal. Now I felt like I could definitely move forward with trying to conceive and carry a child.

The Psychologist

A mandatory step prior to trying to conceive with the fertility clinic was meeting with a specialized clinical psychologist. We discussed my desire to become a mother, why it hadn’t happened with a partner yet, and how I plan to raise the child. She gave me really great insight into several topics.

  • Motherhood: this means different things to different people. There are also different aspects to motherhood and you may use all of them or just some. Motherhood can mean contributing your DNA to create a child and/or being pregnant and/or raising a child. I am very, very fortunate to be able to have all three aspects with my child. Some people use surrogates or require an egg donor. Some (myself hopefully included someday) adopt and raise children. These people are all mothers. For some, certain aspects might be particularly important. I really wanted the experience of pregnancy and knew I would be very sad if I couldn’t.
  • Sperm donor children: apparently, there are online sites where you can register with your sperm donor’s number/sperm bank information and find other families that used the same donor. This way, the half siblings can meet up. I do not plan on doing this unless my child decides they would like to. Then, I’ll support it 100%. My family is big and I have a lot of friends, so I don’t currently feel the need to expand that even further.
  • Single mother by choice: there is definitely a community of women, like myself, who have decided to be single mothers. There are websites, forums, Facebook groups, etc. where I could go and find support should I need it.
  • Raising a donor child as a single mother: the psychologist told me that there are multiple children’s books available that address this topic. In today’s world, there are so many different types of family structures raising children: mom & dad, mom & mom, dad & dad, single mom, single dad, step-parents, grand-parents, aunts & uncles, etc. I have to raise my child showing them all these different structures so that they don’t feel like someone (“dad”) is missing.

Checklist complete

Luckily, my entire workup was unremarkable and I received the green light from the psychologist to move forward with trying to conceive. I selected my sperm donor and ordered the sperm. Although the fertility clinic recommended I order four vials of sperm, I only ordered two. They had told me that most people conceive within three rounds of intrauterine insemination (IUI) (I’ll go into more detail about this in a future post). I was only going to be in the Ohio area for two more months before traveling and then heading out to South Dakota for work. If it hadn’t worked in two rounds, I would’ve established care in South Dakota and would’ve shipped more sperm there.

My appointment with the REI specialist was June 1st, 2020. My first round of IUI was July 14th. It took about a month to get the entire workup completed. I was then able to start the routine for the IUI. That will be the subject of my next post!

Svikki MD

On a different note, things are in the works for my next assignments! The first assignment will be somewhere in Ohio from September through December. In January, I will most likely be out in Oregon for 7 months! I’ll share more details once things are locked in.

As always, feel free to reach out with any questions you may have. I’ve really loved the outreach so far and getting to speak with people about sperm donor pregnancies. Really exciting news pertaining to this came out of France this week. France has passed a law allowing single women and lesbian couples to get fertility treatment! This was previously only allowed for heterosexual couples. Similar rights exist in 10 EU countries, the UK, Norway, and Iceland. Germany is unfortunately not one of the 10 EU countries that allow single women and lesbian couples to receive fertility treatments.

I am so thankful I was allowed to pursue my dream of motherhood on my own terms.

mfg

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So many choices

It has been a great 7 weeks so far as a mother. We took a two-week trip to Wisconsin to visit family and have been back in Ohio for almost two weeks now. There has been some increased crying over the past two weeks but the nights are still very manageable. We’ve applied for the American and German passports and received the American one in the mail yesterday!

Baby’s first flight

Ok, so let’s talk about the process of how I got pregnant a bit more. I’ll share different parts of the journey with each post. I already shared why I decided to become a single mother by choice in my previous post. As I had mentioned, I happened to meet a reproductive endocrinology and infertility doctor during residency. She gave me some recommendations on sperm banks she liked working with. That is where I began the journey.

Choosing a Donor

If you were to line up the men I dated over the past 10 years, you’d notice they are quite the diverse group of fellas. They all had fairly similar personalities, however. Something obvious would be that the majority of them were black. Over the past 10 years, when envisioning my future children, I often envisioned them to be mix-raced due to the men I was dating. When it came to choosing a sperm donor, however, I decided to choose a caucasian donor.

Although I mainly dated black men in my life, I did not think it was fair for me to have a mixed-race child that society would see as black and not have a partner present to help that child navigate the world (especially in the USA) as a black child. I don’t know what it’s like to be black. I’m aware I live in a world that (besides my gender identity), is built for me to thrive in and I do not have the same obstacles. Although I intend to adopt in the future and there is a chance my adopted child will be black, they already exist in the world and I am giving them a loving home to grow up in. In that case, I will also make sure they have exposure and connections to that community.

Taking care of business

So once I decided on my donor being caucasian, I narrowed down the list with a few aspects. I wanted the donor’s description to be as close as possible to someone I would be attracted to. I first narrowed it down to donors who are taller than me. Then, I eliminated the blondes. Although I’ve dated a blonde or two, they usually aren’t what I’m attracted to. That narrowed the list down to around 10 donors. I requested extended profiles for each of them.

Tell me everything!

The extended profiles were about 30 pages worth of information on each donor. They covered information including:

  • Donor Fertility History
  • Donor Health History
  • Nutrition
  • Exercise
  • Medical History
  • Exposure History
  • Tobacco Use
  • Alcohol Use
  • Caffeine Use
  • Work History/Experience
  • Sexual History and Relationships
  • Family Health History
  • Ancestry
  • Children’s Medical History
  • Personal Essays
  • Personal Characteristics
  • Physical Features
  • Psychological Profile
  • Detailed Family History of Father, Mother, Siblings, Grandparents, Aunt and Uncles

As you can see, that’s a lot of information. I’d venture to bet that is more than some people know about the person they decided to procreate with.

My donor was the third profile I read from the ten I requested. Everything was perfect for me except for a cat allergy (and there is loratadine for that should my child inherit that particular trait). Some important aspects for me were Family Medical History, Psychological Profile and Physical Features. His personality is similar to mine and we have many of the same interests. The personal essays were interesting to read. While my donor had a very genuine and kind reason for wanting to be a sperm donor, others were less impressive. My favorite answer from one of the donors when asked why he wanted to be a sperm donor was “honestly, I didn’t know I could get paid for this!”. While I appreciate your honesty, bro, no thanks.

I was visiting my father at the time I was vetting through the profiles and would read them out loud to him. When I excitedly read my donor’s profile to him, he asked if I was choosing a donor or my next boyfriend. I guess that is a good sign.

Show me the money!

You can spend a fortune on choosing a donor if you so please. Firstly, different sperm banks have different prices for a vial of sperm. It was recommended that I order 4 vials. I only ordered two, but more on that in a later post when I talk about the process. The sperm bank I went with charges $500/vial. There are sperm banks that charge upwards of $1000/vial.

Besides the extended profile, the other extra thing I paid for was some childhood pictures of my donor. My sperm bank does not provide current photos of their donors but does mention celebrity look-a-likes. Other sperm banks do supply a current photo for a fee. The only other extra item my sperm bank offers is an audio file of the donor. I opted not to purchase that (although maybe I will in the future). Other sperm banks have a plethora of extras you can purchase. This can quickly make the sperm donor choosing process an expensive one.

Lake-side snack

Call me, maybe?

One last thing that was very important to me: an open donor. This was important to me and also strongly recommended by the reproductive psychologist I had an appointment with (more on that in a future post). This means that my child will have the option to contact the sperm bank and obtain contact information of the donor when they turn 18. In a day and age of DNA test kits, the last thing you want is your child to take a test, find their biological father and that person wants nothing to do with them. I will support my child’s decision, whichever way they decide to go with this.

What’s in a name?

That which we call a rose, by any other name would smell as sweet. That might work for Shakespeare and his Montague and Capulets. But what do you or your child call the sperm donor? Do you always say “sperm donor”? I don’t really want my child to refer to that person as “the sperm donor”. I still have a bit of time before this actually becomes a topic of discussion with my child, but currently, I am leaning towards referring to the sperm donor as their father when talking to others. When it comes to talking with my child about it, I still haven’t decided how exactly I’ll refer to the sperm donor. Supposedly there are children’s books available for these situations. I’ll have to find and buy them soon.

I feel father is a formal name for a person whose DNA helped create a child. The term “Dad”, in my opinion, is reserved for the person who raises the child. There are many different family structures in the world and I’m interested to know how other families have decided to handle their titles.

Gratitude for the Donor

My fertility journey could not have gone more perfectly than it did. I had an amazing pregnancy, wonderful delivery experience and now have a beautiful, healthy child to hold and call my own. Although I don’t know who the sperm donor is, I am grateful for him. I’m grateful that he decided to become a donor. The other candidates I looked through weren’t nearly as great on paper. In a way, I know a lot about this man from the information in his extended profile (granted he was truthful about his supplied information).

Potentially I’ll get to know more about him in 18 years if my child decides to reach out. But even if that doesn’t happen, I am content with the information I do know and believe that he is a person I would enjoy being around. I’m sure I will see glimpses of him and his family in my child when I don’t recognize certain aspects as being from me or my family.

One thing I do know, is that I will speak kindly about this man to my child because without him, my child wouldn’t be who they are.

mfg

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