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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My newest adventure and greatest responsibility

For those who follow my Instagram feed, you probably already know where this is headed. At the beginning of last month, I was fortunate to experience something truly amazing. I gave birth to a healthy baby!

Many are probably asking themselves, “wait…what? I didn’t even know she was pregnant.” That was intentional. I really wanted to enjoy my pregnancy for myself, my family, and my close circle of friends and coworkers. Although I have a blog and social media accounts, I actually believe it is really important (and a luxury) to have some privacy and just enjoy life without being worried about posting or comments. This is obviously a personal decision and some people want to share every step of the pregnancy on social media.

I don’t think either way is right or wrong, it should be whatever the pregnant person is most comfortable with. As the belly grows and you begin to show, society already thinks they have a right to comment on your body and give you unsolicited advice. It’s up to you if you want to open that forum up on social media as well.

As a physician, I also am aware of what a miracle it is to actually become pregnant and then stay pregnant and ultimately deliver a healthy baby safely. There are a thousand things that can go wrong along the way. A danger of oversharing is possibly having to confront curious people if the posts suddenly stop because something went wrong. I was cautiously excited with every new milestone of the pregnancy: the positive pregnancy test, the 12-week mark, the genetic testing, the 20-week anatomy ultrasound, the 24-week viability mark, making it to full term. With each milestone, I became more excited. I was still cautious about my excitement until I held my healthy baby after delivery.

My Journey to Motherhood

A year ago today is when this journey officially started. It started with a telemedicine call with the University Hospital Fertility Center in Cleveland. I was visiting my father in Wisconsin at the time, it was the early days of the pandemic, so the newly widely available telemedicine really worked in my favor.

Although June 1st, 2020 was the official start, I have wanted to be a mother for as long as I can remember. I put it off during medical school and residency because I didn’t have the time or the means to have a child. Nor did I want to have a maternity leave of just 6 weeks. I also wanted to completely focus on medical school and residency because there was a lot to focus on. My plan had been to become pregnant about a year out of residency. However, my plan was also to travel a lot during that first year out. With the Covid-19 pandemic, that wasn’t really an option. So I figured, if I can’t travel, I can be pregnant instead and pulled by timeline up by a year.

The birds and the bees

A rather common first question after sharing that you are pregnant is “who is the father?”. Although I completely understand why that is the case, it was not the question I focused on when deciding to try to conceive. At least not so much WHO the father is but rather, WHAT his genetics are like.

You see, I’ve always envisioned myself as a mother, but not necessarily as a wife or partner. Sure, if I found the right person to raise children with, I wouldn’t be opposed to a relationship. However, I can’t say I was actively working on making that scenario happen. I’ve dated various men but rarely was it anything serious. And with those with whom it was, it didn’t work out for different reasons. That was never a major concern for me though. I have said for many years that I would use a sperm donor to conceive if the right man wasn’t in my life at the time that I was ready to have kids.

I’m very happy with my life not being in a partnership, I am grateful to be able to travel for work and I have a ton of projects I want to do around the world. Throw in having a strong personality, being a doctor, and a global pandemic, and the pool of potential candidates dwindles very quickly. But that’s perfectly ok by me.

37w4

Unconventional but On-brand

When I first started telling my family and friends that I was seriously considering a sperm donor pregnancy, I received a lot of support. I typically had to elaborate on my reasoning. Afterward, everyone could see why this was a good option for me. (At least to my face… who knows what was said when I wasn’t around.) Many weren’t phased at all by my plans because they had heard me talk about it before. I thought I’d get different reactions from people who didn’t know me that well, but to my surprise, many women said I was a genius and they wish they had done it that way. Baby-daddy drama is real, y’all.

I didn’t know anyone personally who had had a donor pregnancy though so I had a lot to learn. Luckily, a lovely woman I met a couple of years ago is a reproductive endocrinologist and infertility specialist. She was just finishing up her fellowship in Cleveland. She set me up with her good friend and co-fellow for my first consultation. Prior to my appointment, she gave me recommendations for sperm banks so that I could do a little research.

Sharing the Journey

I want to share my journey to motherhood on this site because I think its important for people trying to conceive to know that this is an option. Its definitely not for everyone but it might be for someone reading this that didn’t realize it was an option. It might also be educational for the rest. To protect my child’s privacy, I will not be sharing very specific information regarding the donor or my child. I will also not be sharing pictures of my child on any social media platforms that show their face. I grew up without an internet presence until about middle school at which point I was able to share what I wanted about myself (for better or for worse). I’d like to give my child that same opportunity. Although I realize it’ll be a lot harder in this technological day and age.

I’m pretty much an open book otherwise and happy to answer questions or help with information should you need some help. I am not shy about the fact that I used a donor (as evident by this public post) and actually am quite proud of it. So please don’t feel like it’s an awkward situation. As long as you are coming from a sincere place of wanting to understand and learn, I welcome any questions.

So over the next couple of months, I will share the various stages of my journey on this site as I enjoy time off of work and raise a baby!

32w3

Svikki MD

In terms of work, I plan on starting part time in September. I’m hoping to find a job for the rest of the year near my mother in Ohio. Starting January 2022, I’ll start 4-6 month assignments again. At which point, I would like to have a live-in German Au Pair nanny. I’ll give updates on jobs as they come.

mfg

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