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.

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