Depot Lupron: what doesn't kill you makes you...hotter?

I just started month two of the dreaded Depot Lupron to treat my stage III endometriosis and presumed beta-3 integrin deficiency. I don't know about any of you out there who've taken this, but for me this stuff is poison to my body and my mind. It honestly ranks up there at the top of the list of all-time unpleasant infertility-related activities for me.

I feel just completely taken over by Depot Lupron. This time most of the first month wasn't so bad physically (which is why you haven't heard me whining before this). For the first three weeks, I didn't seem to have many mood effects and experienced really no hot flashes. If it hadn't been for the prodigious three weeks of bleeding, I would almost have thought I'd gotten a bum batch of the stuff.

But all that changed about two weeks ago. Suddenly, the bleeding stopped, and instead I felt...hot and sweaty...had heart palpitations....and felt a profound bleakness descend (as evidenced in my last post).

Because I struggled when I took Depot Lupron last summer, I asked Dr. Schl. if there was anything I could take that would help ameliorate the mood and physical symptoms (apparently there is something, called "add-back therapy" that replaces a bit of the progesterone that your body isn't making). I asked for it not just for my sake, but for poor Will's and Moxie's sake. Not to mention the sakes of my patients and of the populace of the greater New York City metropolitan region at large. So this time, once the hot flashes and blueness descended, I started taking small doses of synthetic progesterone. It hasn't eliminated my symptoms, but I think it does lessen them a tad (hard to tell, but I haven't had to change clothes in the middle of the night because I'm soaking wet, or gotten super irritated at anyone, or killed Will, or taken a mental health day...so I think so).

So these little white pills seem to be helping, but the original prescription didn't include enough pills to do this twice (originally, we were only doing one dose because we were planning to cycle with the egg donor in December).  Given this, I called my nurse. You may remember, I haven't been thrilled about her from the beginning of our donor egg adventures...

When I reached her, I asked for a refill, and she said ok. But she also said (1) that I am the only patient she has ever heard of ask for a prescription for add-back therapy at the Denver clinic, and (2) that she thought it might decrease the effectiveness of the Depot Lupron for dealing with endometriosis and beta-3 integrin deficiency (I can't remember her exact words on this, but she raised it as a concern of hers). So I asked her to check on this and please get back to me.

I got off the phone and realized I was left feeling vaguely uneasy after our call. Why tell me I'm the only patient to ever request this? Her comment made me feel like I was asking to be coddled. Once I realized that's what was brought up for me, I was annoyed. Why shouldn't I be able to take something to make this a little bit easier if it's out there? Why shouldn't all of us?

And then on top of that, why opine that taking the add-back therapy might reduce this awful drug's effectiveness? Because the only thing worse than feeling like crap while taking this damn drug would be taking this drug and feeling like crap for no reason. And why would Dr. Schl. have prescribed the add-back therapy if it could cancel out the effects of the Lupron treatment?

Sigh.

Yesterday I got an email from her that Dr. Schl. said all is fine, nothing to worry about, take the add-back, the Depot Lupron will still do its job. So really, was all that necessary?

It's been an occasional pet peeve of mine throughout my medical journeys, this implying you are high maintenance for asking to have something suck just a little bit less. When I had lymphoma in my twenties, I had a mediport surgically implanted under the skin on my left upper chest to receive my infusions. For every chemotherapy treatment, the nurse would place a needle (called a Huber needle) through the skin that covered the port and connect it to my IV line. You should check it out, folks, because this is no ordinary needle; it's more like a thumbtack. And so it hurt. Especially because it was done every other week and your tissue really doesn't heal well when you're getting chemotherapy. I knew that there was a new cream on the market, a topical analgesic called EMLA. So one day I screwed up my courage and I asked if it could be prescribed for me. And I was told "That's only for pediatrics. We never prescribe that for adult patients." Which silenced me immediately. I felt like a big baby.

Similarly, after our first and second pregnancy losses at 7 and 8 weeks, my then-ob/gyn advised that I should have my D&Cs in his office sans anesthesia or any pain control beyond ibuprofen. So I did, twice, because I felt like such a wimp asking to be knocked out, when he'd made it so clear after I asked for an OR procedure that it should really be fine - and his other patients didn't mind it. Actually, I found the in-office D&Cs to be terrible, both physically and psychologically (especially because one time the equipment malfunctioned and he had to manually scrape the lining of my uterus). And consequently, I no longer use that ob/gyn. But why make it so tough?

So, yeah, obviously this phone call touched a nerve for me. And Depot Lupron has the effect of exposing all of my nerve endings and making everything feel...well...hotter. This nurse isn't so bad, but I do wish she'd keep her opinions, especially when they aren't based on scientific evidence, to herself.

Looking forward to finishing the dreaded Depot in about a month. Really hoping my sister checks out and can cycle so we have something to transfer, and then hoping that these two months of suffering help implantation go at least a little better than it might have.

I wanted too to say thank you guys for all of your comments and thoughts on the last post. It helped, it really did, to read that you all get it, or that you might not totally get it but you realize that. It means so much that you've stuck with us even though the tough times, that you're still reading and rooting for us. We appreciate it more than we can say.

Mo

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Lament of the end-stage infertile

The holidays are a tough time of year for Will and me. November is the anniversary month of two of our pregnancy losses - our first miscarriage and our sixth. It is a time of taking stock of the last year, and of time passing in general: of where we are versus where we wish we were, where we had hoped to be.

The holidays are a time when we are surrounded by family and friends, which is wonderful. We are lucky to have the friends we do and are grateful to have our families. But it is also true - and exquisitely painful at this point - that nearly all of our family and friends, literally almost all of them, have children or are expecting (even the infertile ones).

Two of my close friends are currently pregnant after struggling with infertility. One of them reached her due date yesterday. She and her husband underwent a solid year of IUIs before becoming pregnant. She lives out of town and has been very compassionate in her dealings with me. (For example, although we are close, she did not invite me to her baby shower. And I was grateful for this.) I spoke to her over the weekend and almost had the sense she would not have talked about her pregnancy at all if I hadn't asked. And when I did (of course I did!), she told me how she was feeling physically and how excited and scared she and her husband are. And then she went back to talking about her new hospital position and parents and sisters and her apartment. Throughout our conversation, this friend very kindly did not gush about her pregnancy. She did not tell me how everything up until this point in her life pales in comparison to preparing to welcome her firstborn, that having a baby infuses her whole life with meaning. Which I greatly appreciated, which I imagined was tough not to do, and which allowed me to gush for her and on her behalf.

My other dear friend is just at the beginning of her second trimester. She also underwent several IUIs and had two early pregnancy losses. And then she did a single IVF and got pregnant. And unlike us, she has stayed pregnant.  She is just at the point of buying new clothes because her old ones don't fit. She is elated; she is still terrified after having had two losses; she is right where I would expect her to be. And this friend, God bless her, very much wants to convey to me how - although she's pregnant and seems to be staying pregnant prior to having a baby - she is Just Like Me. 

Only problem is, every time she tries to join me, I feel ever more alone. I love this friend, but I want to tell her that she is not like me. She is on her way out the other side and will almost certainly have a baby, a baby who is her genetic child, a baby whom she will deliver with her own body. I want to tell her that 33 with no cancer history is not the same as 39 status post chemotherapy. I want to tell her that although she has deeply grieved her two pregnancy losses, she cannot imagine what it feels like to have had six losses. I want to gently say to her that her one experience of IVF doesn't feel anything like going through IVF seven times.

But this isn't quite right. It is actually not at all what I want to tell her. Because in truth it's not about how many losses she's had or how old she is or how many procedures she's undergone. It's something more ineffable. 

It's the fact that she did one IVF and actually thought it would work - and it did. She has struggled and suffered and grieved but she has not had to so keenly feel the sharp pain of hope fading at each IVF failure, after each successive loss. But in spite of this, and for reasons that are unclear to me, she desperately needs to assure me that our experiences are the same.

What she doesn't - and cannot - know, thankfully, is the gut wrenching place of hopelessness, the place where the doctors at the best clinics look you in the eye and say they don't know how to advise you, that the prognosis is grim, despite looking so promising on paper.  The feeling that there is no way out to the other side, no matter how much of your savings you use up or what clinic you go to or what diet or acupuncture regimen you try. That chromosomally normal embryos won't work, that even a perfect-seeming 23-year-old egg donor won't help, because there is always still something wrong, some amorphous and unnameable thing that will trip things up and make your dream of parenting unattainable. 

This is the place where Will and I often live now. When we face it squarely, our pain is so intense as to be immobilizing, almost like staring into the sun. The feeling is blinding, and it doesn't help us navigate a way out of the situation we find ourselves in. We gaze straight into our deepest fears that maybe we will never be parents. Maybe there is no "out the other side," even though bearing children is my biggest hope and desire since I was a young girl.  We have times of hope, of thinking we can still succeed somehow, and we are strong-willed enough to keep trying to move toward a solution (such as having my sister donate eggs) even if that solution seems improbable and filled with peril. 

I want to make it clear that I wouldn't expect my friend - or most anyone, actually - to understand our situation fully.  It is an incredible gift when someone "gets it," and many of you readers are among those whom we have felt truly understand (thank you, truly thank you, for that). It's this friend's continual attempt to empathize by comparing the two of us that is so painful. 

It is an unfortunate truth that as Will and my infertility has gone on and on, we have become more withdrawn from others and felt more alone. It is increasingly difficult to go to the many child-focused activities we are invited to. And it is hard to be honest, even if others do want to know how we feel, because we know our sadness is tough for them to witness. 

My sister is still waiting (seems like forever) for her period after going off of birth control pills. Will is looking at agency donors again as a back up (I just can't bring myself to). We've perused the CCRM database but have not found a good match for us there. We are still corresponding with a potential gestational carrier. 

So things are nowhere near the end, but gosh it sometimes feels like it. It feels impossible to imagine coming successfully out the other side, impossible to imagine getting past this painful place in our lives.  

They've barely begun, but already we are looking forward to the holidays being over. And we are wishing with everything we've got - even as we fail to be able to imagine it - that this time next year finds us in a much different place.

Mo 

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And the psychologist sez...

Will and I met today with a NYC psychologist who specializes in infertility to discuss using my sister as an egg donor. We wanted to get a sense of  the issues we should make sure to consider that we might be overlooking.

We really liked this psychologist. Were impressed by her (and as a fellow psychologist, I can be sometimes be a tough sell). She was a good mix of smart and practical and just empathic enough without overdoing it, and she kept us on track when we started to veer.

Her bottom line was fairly simple, and she stated it a few times in case we were slow learners.

She said emphatically that barring a substance abuse issue or major mental illness in my sister, using my sister as our egg donor is an ideal next step, a potential solution to the very tough situation we find ourselves in.

She reiterated variations on this theme a few times throughout the meeting. That assuming that my sister is on board with this idea (and my sis is downright enthusiastic), and assuming Will is ok with it (he is), this is a wonderful, wonderful option.

How nice to hear. I'd half expected to hear the creaking sound of Pandora's box opening and of us being faced with cold, hard issues we'd somehow missed in our exhaustive attempts to think through every nook and cranny of this decision.

But no. The psychologist said it sounded really good (even with our faults and my sister's imperfections). And that it shouldn't substantially change our relationship with my sister.

Her take home message was that my sister's ability to donate eggs to us would be a gift, an amazing gift. And one that we might need to work a little harder on just learning to receive and say thank you for, rather than analyzing it and then analyzing it some more.

The psychologist gave us permission to stop all of the second guessing as well as my specific tendency to think I need to decide for Will and me and also somehow decide what's best for my sister, too.

The psychologist offered to meet privately with my sister when she's in town sometime and then meet with the three of us to discuss again as a group if we wanted. But basically, she gave us the psychologist's version of her blessing.

Still processing this, but generally it feels like a huge weight has been lifted off of my shoulders. Like we've been given approval to go ahead, and that I will not harm my sister by accepting her offer, or scar my child, or any other negative and scary outcome.

Feels like a big relief to get an expert's opinion that yes, this makes sense, that yes, it is a good idea.

Now let's just hope Marina can pass through the gauntlet of testing that faces her and come out the other side successfully.

Here's hoping.

Will and I at the psychologist's...
Can you guess who is who?

Mo

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For your amusement

Made me chuckle (and a little sad, too) thinking of all the time we've spent doing IVF cycling and me shot up with depot lupron, or recovering from procedures, or on pelvic rest waiting for my beta...all the while poor Will waiting patiently, his sperm starting to look like this...

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Sister egg donation musings

Still working over here on the veeeerrrry sloooooow process of getting my sister screened as a potential egg donor for us. She's getting some blood work done locally in the next few days and Will and I are slated to meet with a psychologist Monday to talk about what we (and my sister) should consider before moving forward.

We saw my sister this weekend and she is still cool as a cucumber about donating her eggs to us. Basically said she made the decision a few years ago before she approached us the first time and hasn't flinched or second guessed since then.

While we're on the topic of sister egg donation, I wanted to share a New York Times "Modern Love" column from 2010 that Mommacommaphd recommended.


I like some of the questions it poses about using a sister as a donor (in this essay, it's for her gay brother and his partner): "She was young and unattached. She wanted her own children but wasn’t ready. So was she prepared for someone else to have her child? And how would she explain this particular brand of baggage to a potential husband someday? Most of all, would she be satisfied always being Aunt Susie to this child and never, you know, the m-word?"


I wish I could follow this couple and find out how it all works out for them and their twins. 

But just to read this slice of their life was really nice, and I recommend it for anyone considering using a relative as a donor. Made me feel like it's not a freakish choice but could actually be, well, just lovely.


Mo


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Remembering

Today we are also remembering, one year ago today, the loss of our sixth pregnancy.

Can't believe it was a year ago.

Can't believe we are still in this mess.

Can't believe we are still nowhere in terms of taking a next step.

Taking some time to grieve this loss, and the hits to each of us emotionally as individuals, the impact on us as a couple.

Here's hoping with everything we've got that by this time next year, we are out the other side.

Mo

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What would you do in our position? The Denver staff weighs in

After E.'s karyotype came back and we learned we couldn't use her as our egg donor, I spent a long time on the phone with the genetic counselor in Denver.

We talked about the different paths in front of Will and me, potential frontrunner options being: transfer some of our normal embryos back into me since I'm on depot lupron and prepping for a transfer anyway, find a new egg donor - such as potentially my sister, or go straight to a gestational carrier.

The counselor and I mused about what a great story it would be to transfer our own embryos after this donor fell through and have at least one healthy child from the five embryos. That it would feel like it was "meant to be" that the donor fell through (a concept I don't so much believe in usually). It would be a really lovely ending to a harrowing four-and-a-half year story. Because those embryos are so precious and are basically irreplaceable, I thought of maybe putting in a couple of the more wonky ones, in particular, one or two of the day 7 blasts.

At some point in our conversation, I told the genetic counselor that she is one of the few people who truly understands the medical complications of our situation - my cancer history, the reality of having five frozen chromosomally normal embryos that may or may not be able to make a living child, and whether or not that would need to happen in someone else's body or not. I asked her, since she understands the nuances of our history, what she thought she might do next if she were in our shoes.

She said she didn't know. She also said she thought it was a really good question.

She said what she wanted to do was write up a one-page summary of our history, embryology reports from our blasts, and the options before us, and she was going to convene a meeting with the head of genetics (who also has a PhD in embryology) and Dr. Schoolie himself and let them talk about what they recommend, how they see the situation, etc.

I was so, so moved by this, nearly brought to tears. It's things like this that make me feel the Denver clinic truly has our backs. Our situation still stinks, but it is helpful to know this.

So they met, and then they got in touch. Everyone agreed that we face a tough situation with no obvious answer.

Forced to give an opinion, the head of genetics said she didn't know what to recommend, but felt strongly that if we wanted to transfer our normals, we should transfer the best two or three. Problem is, there are only really two good ones, the rest are not so hot. So it seems terrifying to risk them in my body when we don't know if I can carry a baby to term.

Dr. Schoolie said what I thought he would say (and what my rational side had already told me): nothing about our situation had changed. He thought Will and my idea of trying an egg donor was a very, very good one, one that could scientifically answer the question of whether I can carry a baby or not. Given this, we should just gather ourselves emotionally, pick a proven donor from their in-house pool, and run this experiment asap. (No problem!!)  Sounds good from a scientific perspective but misses entirely the fact that it is not so easy for us to find a donor we feel comfortable with. God help us, but we're skittish about this; it took months of searching through multiple agencies to find E. And...well, we know how that turned out. The sister donor idea, he said, was also not a bad one, assuming she is fertile enough and that it makes sense for us and our family psychologically.

Bottom line, there were no clear cut answers, but it was really great to hear their thoughts. Even more than this, though, it just meant so much to Will and me that they took the time to discuss our case and weigh in on it. This is one of those reasons why it would be very, very hard to leave the Denver clinic. They get that we are a tough case with potentially multiple reasons why conception and carrying has been such a struggle. Their medical care is excellent. And then on top of that, they really want us to succeed.

I'm not sure there is much more I could ask for from a clinic. (Unless maybe they could relocate to NYC. Now that would be pretty cool.)

Mo

p.s. My sister has passed the paper and phone screen...we are trying to get some of her bloodwork drawn locally as soon as possible and then get her in for a one-day-work-up. Fingers crossed.



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Motherhood as a shade of grey: could my sister be my egg donor?

Several of you guys are really good guessers! Much better than I was at this game! When I'd imagined the acceptance rate for egg donors at the Denver clinic, I'd guessed something like 20%, which I thought sounded really strict...but turns out is really lenient, or more lenient at least than the Denver clinic people are. So a shout out to those who guessed the true number: Only 5% of people pass the screening process to donate eggs at the Denver clinic. Kudos to Nikki, Strong Blonde, and Anonymous for their correct guesses.

Now, when I think about this 95% rejection rate, I wonder just who are these people who are applying? I fantasize that like maybe half of them really have no chance in the world of making it anywhere (sort of the medical/genetic analogue of someone with a C or D average applying to Harvard). Like maybe many of them are 37-year-old chain smokers, or were born with six fingers on each hand, or have parents or siblings with medical histories longer than mine... probably not, but maybe...

We've started looking at the Denver in-house donors, but seriously? Kind of slim pickings there. And then the photos of these women as two to seven year olds - 1987-1990ish vintage, usually small and dark and grainy - make it impossible to tell what each donor might have looked like as a kid, let alone get a sense of how their features ended up later. So we aren't ruling this avenue out and will keep checking back on Thursdays, but we weren't really drawn in so far, despite these women's obvious genetic, medical, and fertility superiority to me and the general population.

In the meantime, we are moving forward with my sister as a possible donor. She is 31 years old and single, and lives about four hours away. I'm going to call her Marina here, which is something I used to call her when she was about three years old, when her favorite story was Hans Christian Andersen's The Little Mermaid.

My sister looks remarkably, incredibly like me, including features, posture, mannerisms, voice. As in, when I went to see her while she was studying abroad in Europe, people in the neighborhood where she lived set eyes on me for the first time not knowing I was coming or even that she had a sister and said, "You must be Marina's sister." At her recent graduate school commencement, a professor came up to her and asked if her sister was there. She said she saw me from behind and heard me speak and just from that was absolutely certain that Marina and I must be closely related. We have even been asked if we are twins (although this seems like a stretch). Not in a while, mind you, but very heartening when you are 8 years older than your sibling. Probably tough for her to hear, though! We also share a similar sensibility, similar wry sense of humor, similar ways of speaking and moving through space and waving our hands in front of us when we talk. We aren't identical by any means, but definitely sisters through and through.

Perhaps having someone who is so similar to me physically and psychologically is part of what has made it hard to go the third-party reproduction or adoption route. I like this added connection, enjoying looking back through old family photos and seeing various family members' features reflected in ourselves and our relatives. You are guaranteed to share 50% of your sibling's genes, and our child (Will and mine with my sister's egg) would have the same grandparents, and same relations throughout the extended family, which seems good for the child from a "Who am I?" perspective. The child would in fact be at least 25% related to me and so if you think of relatedness and parenthood as a Venn diagram, both Marina and I would share relatedness to the child, which is a comfort to me, and seems like it wouldn't be so hard to adjust my mental image of what immediate family is and include her in the genetic parenting picture. Sort of a "motherhood as a shade of grey" rather than a black or white you're either the genetic mother or you're not.

Because she's my sister and will always be close in our lives, using her as a donor would also be more complicated than using an unknown donor. We would want our child to know from the beginning that Marina played an important role in bringing them into our lives and realize they might feel a stronger attachment to her for it than they otherwise might.

Which often feels wonderful, and occasionally feels a little scary. One of the scarier 3:00 am thoughts is: What if my child prefers Marina over me? She is after all, younger and definitely the cooler, more fun, more dramatic, more artistic, let-it-all-hang-out sister. I'm the overachieving, overresponsible, more subdued one (and who in the world would prefer that?!). Whether she donates her eggs or not, Aunt Marina is likely to be the favored Aunt. And I reassure myself that alas, my child would be stuck with me, and be rewarded with visits to Aunt Marina on a regular basis. I am joking about the "stuck with me" part. Mostly.

Marina has no children yet and is unsure if she wants them. We've offered to pay for her to do a cycle, freezing her eggs if she would like, and at least for right now, she is not very interested. She thinks if she does decide to parent, she'd probably like to adopt. Which is funny, right? That a genetic connection is so important to me and here she is likely able to have such a connection and really doesn't care? The world is an ironic place.

We've thought of using her as a donor since she approached us and offered us her eggs a couple of years ago, but I always held off because of all of my "What Ifs." Being the older sister, I worried that her giving us this gift might somehow cause her suffering later, or maybe she'd regret it, or maybe it would complicate our relationship in some negative way. We will explore all these areas with her and with a mental health professional, but somehow it doesn't seem so difficult to imagine anymore or so fraught with danger. Maybe opening our hearts to E. as a donor has made us more open to alternative paths in general, I'm not sure. I am sure that this seems the right path to take at this moment in time.

Here's hoping my sister can be in the Denver's 5% - or at least be deemed suitable to donate to me. They've already approved her family medical history, despite the fact that we all have six fingers on each hand and her older sister Mo has a medical record a mile long.

Mo

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Should I stay or should I go?

Thank you guys for your thoughtful comments - it really helps to read your take on our situation, your encouragement, and your questions. We appreciate it.

One of the questions you so thoughtfully asked was about whether we might want to leave the Denver clinic, since they are so stringent in donor screening and gestational carrier screening and preparation.

That's a good question.

Part of me is glad that if there is a chromosomal problem with the donor we wanted to use that we found it, and part of me is frustrated, since the finding is of unknown significance. But knowing what we now know, we wouldn't want to go with her without screening the embryos. And apparently, the CCS testing cannot pick up this problem (one thing we considered was seeing if we could go forward and just discard the affected embryos). Denver won't let us so it's a moot point anyway, and no other clinic we know of can do the CCS testing - even if they did, starting over from scratch with a new clinic would take a lot of time and $$$.

But going forward, the question remains: Would we maybe want to go with a different clinic?...tempting.

The problem is, the Denver clinic's stats are so darn good.

Here is a link to the top 10 egg donor clinics in the U.S. Denver is number 9 (lower than I would have guessed). But they also have a much larger sample size, so I trust their numbers more than some of the other clinics listed (and besides, they are still the closest to us of those listed...)

But really, maybe many other clinic's numbers are so close that it doesn't really matter significantly, right? So we looked in to this...There are two clinics in NYC we would consider, our old clinic and one other very reputable clinic. Our old clinic's success rate is 12% lower than Denver's (plus they don't vitrify embryos, which is really a deal breaker). The other NYC clinic's success rate is 8% lower (not as bad, but truly significantly lower, plus, we'd have to basically start over, which is expensive and time consuming).  Also, have you noticed how unlucky we are? We sort of think we need the stats as much in our favor as possible.

I also looked into the best clinic near where my sister lives in case we go in that direction, since it would make her life so much easier if we kept things local for her. Sadly, the best clinic where she lives has a success rate that is 20% lower (shocking!! I'm a little embarrassed for them, actually). No way we could do that.

Based on all this, at least for now we're thinking of staying. Not totally happy with this, but don't see a great alternative  either. I want to move forward as quickly and successfully as possible. I am beyond frustrated. I can't believe how difficult this is, how mired our situation feels to me.

In terms of alternate paths, we are anxiously mulling transferring some of our normals to me...so more on that soon. This scares us though, as we really don't know if I can carry or not, and at almost 40 now, I may not be able to replace those embryos (not to mention that I don't have the psychological stamina left to do more IVFs). I would hate to throw such carefully acquired and irreplaceable embryos in my old death trap uterus if there is no chance at life there, you know?

So that's where we are today, although things change frequently around here. We have emails in to the Denver clinic to find out more about the process/screening requirements involved in a sister donation and to find out the password to the Denver in-house donor pool (it would be great if we found someone suitable, although I'm not so optimistic about that since there are less than 60 women in the pool). Call also in to a psychologist for Will and me to talk to about the emotional complexities of a sister egg donation versus using an unknown donor. We want to be thoughtful about this decision, or at least screw up our kids thoughtfully, you know?

Everything remains unclear, but damn I'm trying to move forward anyway.

Mo

P.S. Guess what percentage of donor applicants passes the screening process at Denver? ...if you leave your guess in the comments, I'll post the answer soon. I think you might be surprised - I was. Known donor screening is different apparently (thank god!!), so hopefully not as steep of a hill to climb. Major kudos and a shout out to the closest guesser!


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