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Monday, October 26, 2015
Wednesday, October 21, 2015
Egg donor compensation - it's complicated
The question of how much egg donors should be compensated is a tough and complicated question.
The NY Times has published two articles about egg donor compensation after a group of egg donors filed a lawsuit alleging they were undercompensated for their donations. The first piece is a reported article about the topic, and the second an op-ed piece.
Personally, I feel of multiple, conflicting minds on this. My first reaction is that egg donors aren't donors in this country and should be able to name their price. But my second thought is that of a clinical researcher. Some of the trials I run offer clinical compensation, and I am expressly forbidden by the Institutional Review Board from offering too much compensation, because that might coerce someone to enroll in a trial just for the financial benefit who wasn't truly comfortable. So from that vantage point, it seems there should be limits.
As a potential user of donor eggs, I was sent an egg donor profile from an agency yesterday and the donor is requesting $35,000 compensation. That's on top of the hefty fees for the agency and the clinic. Which is OMG yowza. She is smart and attractive and she's cycled before, but $35,000 - really? Mostly I've seen agency donors receiving compensation in the $5,000 to $10,000 range. Besides $35,000 being way more than we could ever afford, it seems ethically dicey to be priced beyond a certain amount (on the other hand, I was saddened that at least one woman in the NYT article was compensated only $2,000 for her cycle, which seems far too little). The articles also raise the question of how much the agencies and clinics profit off of these women, and that seems a fair question. It shouldn't be that the agency gets $20,000 and the donor only $5,000, when she is the one going through a somewhat invasive and emotionally wearing process.
I don't have the answers, but of course this lawsuit, and these articles come at an interesting time, since we are considering this route ourselves.
I was curious what others think about egg donation and compensation. Should there be limits? What is fair to all?
Mo
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The NY Times has published two articles about egg donor compensation after a group of egg donors filed a lawsuit alleging they were undercompensated for their donations. The first piece is a reported article about the topic, and the second an op-ed piece.
Personally, I feel of multiple, conflicting minds on this. My first reaction is that egg donors aren't donors in this country and should be able to name their price. But my second thought is that of a clinical researcher. Some of the trials I run offer clinical compensation, and I am expressly forbidden by the Institutional Review Board from offering too much compensation, because that might coerce someone to enroll in a trial just for the financial benefit who wasn't truly comfortable. So from that vantage point, it seems there should be limits.
As a potential user of donor eggs, I was sent an egg donor profile from an agency yesterday and the donor is requesting $35,000 compensation. That's on top of the hefty fees for the agency and the clinic. Which is OMG yowza. She is smart and attractive and she's cycled before, but $35,000 - really? Mostly I've seen agency donors receiving compensation in the $5,000 to $10,000 range. Besides $35,000 being way more than we could ever afford, it seems ethically dicey to be priced beyond a certain amount (on the other hand, I was saddened that at least one woman in the NYT article was compensated only $2,000 for her cycle, which seems far too little). The articles also raise the question of how much the agencies and clinics profit off of these women, and that seems a fair question. It shouldn't be that the agency gets $20,000 and the donor only $5,000, when she is the one going through a somewhat invasive and emotionally wearing process.
I don't have the answers, but of course this lawsuit, and these articles come at an interesting time, since we are considering this route ourselves.
I was curious what others think about egg donation and compensation. Should there be limits? What is fair to all?
Mo
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Friday, October 16, 2015
Where things stand today
I just wanted to say a quick hello. I'm not out the other side of this loss emotionally, but if I waited to post until that happened, it might be a long wait until my next post. I think that most of the physical aspects of the loss are behind me: the night sweats have ceased and I think the majority of the steroid tapering yuckiness* too. The sadness persists.
I don't know where we are going to go from here. Whether we will decide to just have our family be Magpie and us or make another attempt, this time using donor eggs. I've been tentatively exploring various donor egg scenarios (frozen, agency, clinic, etc.) to behaviorally try out how I feel about that. I know that I would be ok with a donor egg baby emotionally, and finding the exact "right" donor doesn't seem to matter quite so much as it used to (Magpie makes it so obvious that each child just is themselves, regardless of where the egg and sperm come from).
I think I mostly wish I could know that if we go the donor egg route that it will work (is it too much to want a guarantee?!), and that we could relatively quickly move forward with our family. I don't think I have a whole lot more stamina left for multiple attempts, and financially it's a significant strain on our resources as well.
I also don't know for sure how Will is feeling about the possibility of using donor eggs. I think he is open to it, but like me he is tired and worn down by the past years trying to conceive (8 years and 9 pregnancies. Gah). He's also a very interior person and so I know there is definitely a process going on inside of him, but I know enough to leave him be and not prod him to try to talk about the process too much too early, especially as right now I'm a bit all over the place, which he would find challenging to tolerate.
Poor Will has been down with an awful GI bug on top of everything else, so it is definitely not the right timing to discuss this on multiple levels. He knows I'm thinking about the donor route (and I'm guessing he is too, in his own way), and he knows I've made an appointment for us at a well regarded local clinic that has a fairly open policy about donor eggs. It's in mid-November and so we should have genetics back by that point, and I'm guessing I'll know how I feel by that time and that we will have been able to have a few conversations about it. I already know for certain I don't want to linger too long here in grief and indecision land, no matter what direction we are heading in.
I will try not to lapse into blog silence as I'm in this difficult place.
I greatly appreciate all of your thoughts and comments. So thank you.
Mo
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* "Yucky" is one of Magpie's current favorite words. I don't know where she learned it, but it's her go-to word to express that she is upset or doesn't want to do something. "That quesadilla is yucky" (I don't want to eat it). "Mommy, you are yucky!" (I'm asking her to do something unbearable, like put on her pajamas). Ah, to be almost 3.
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I don't know where we are going to go from here. Whether we will decide to just have our family be Magpie and us or make another attempt, this time using donor eggs. I've been tentatively exploring various donor egg scenarios (frozen, agency, clinic, etc.) to behaviorally try out how I feel about that. I know that I would be ok with a donor egg baby emotionally, and finding the exact "right" donor doesn't seem to matter quite so much as it used to (Magpie makes it so obvious that each child just is themselves, regardless of where the egg and sperm come from).
I think I mostly wish I could know that if we go the donor egg route that it will work (is it too much to want a guarantee?!), and that we could relatively quickly move forward with our family. I don't think I have a whole lot more stamina left for multiple attempts, and financially it's a significant strain on our resources as well.
I also don't know for sure how Will is feeling about the possibility of using donor eggs. I think he is open to it, but like me he is tired and worn down by the past years trying to conceive (8 years and 9 pregnancies. Gah). He's also a very interior person and so I know there is definitely a process going on inside of him, but I know enough to leave him be and not prod him to try to talk about the process too much too early, especially as right now I'm a bit all over the place, which he would find challenging to tolerate.
Poor Will has been down with an awful GI bug on top of everything else, so it is definitely not the right timing to discuss this on multiple levels. He knows I'm thinking about the donor route (and I'm guessing he is too, in his own way), and he knows I've made an appointment for us at a well regarded local clinic that has a fairly open policy about donor eggs. It's in mid-November and so we should have genetics back by that point, and I'm guessing I'll know how I feel by that time and that we will have been able to have a few conversations about it. I already know for certain I don't want to linger too long here in grief and indecision land, no matter what direction we are heading in.
I will try not to lapse into blog silence as I'm in this difficult place.
I greatly appreciate all of your thoughts and comments. So thank you.
Mo
-----
* "Yucky" is one of Magpie's current favorite words. I don't know where she learned it, but it's her go-to word to express that she is upset or doesn't want to do something. "That quesadilla is yucky" (I don't want to eat it). "Mommy, you are yucky!" (I'm asking her to do something unbearable, like put on her pajamas). Ah, to be almost 3.
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Monday, October 12, 2015
Crash landing
I saw my wonderful OB on Monday for what was supposed to have been my 8w1d first OB appointment but was instead a discussion on whether to medically terminate pregnancy #9 or have a D&C. She graciously offered to fit me in the following day for a D&C in the OR, and I opted for that. I don't know if getting the genetics on this pregnancy back will help me with healing and moving on, but I figured it cannot hurt. On the off chance this pregnancy was chromosomally aneuploid, that information would help. And if it is euploid again like loss #6, well... more complicated, but more information is more information, and I'm a big information seeker, even if that information is too late to help me. I think. To be honest, I'm not sure, but in case it could help me accept this better, I thought I'd rather know.
The procedure was uncomplicated and straightforward and I had no problems from the anesthesia, so that was good. Strangely I woke up from the procedure physically sick with a head cold that I hadn't had a single symptom of one hour prior, and I've been sick the remainder of the week, with Magpie sick and out of school today as well. It's a real cold, not psychosomatic, but pretty incredible it came on so suddenly and at that specific time.
So I've been at work, and have been somewhat crampy since Tuesday afternoon, and I have a head cold, and I'm dragging a bit and very sad. Some of the dragging is the cold, and I think some of it is that I'm tapering off of prednisone. And my hormones are crashing, so I've been having drenching night sweats as well, which is emotionally painful because it somehow simultaneously makes me think of my upcoming menopause and reminds me of the drenching night sweats I had after I gave birth to Magpie, both of which are hard to think about right now.
Speaking of Magpie, I've been hugging her extra tight and smelling her Magpie smell and rubbing noses with her and giving her butterfly kisses with my eyelashes against her eyelashes (no wonder the poor kid is sick). And she's thrilled I can pick her up ("The doctor says you can hold me again? Really? Oh!!") And it helps. It helps so much that she is here. I think I would be beside myself in grief otherwise, because that's what used to really flatten me, the fear that we would never have a child, never make it out the other side, that our problems were insurmountable. They still seem that way but she is here, and she is so real and present and wonderful and alive and herself. I am so grateful.
But despite that, do you want to know the honest truth? I'm not doing so great over here.
I'm also kicking myself a little while I'm down, questioning why I ever thought I could hold onto a pregnancy and what in the world was I thinking? I'm terminally infertile. How could I not know this? How could I get my hopes up again, even in the limited way I allowed myself to? But of course those thoughts are not helpful, and they are probably not even accurate, although it is hard to tell what is accurate these days.
So that is where things are at today. Hopefully tomorrow will be better.
Mo
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The procedure was uncomplicated and straightforward and I had no problems from the anesthesia, so that was good. Strangely I woke up from the procedure physically sick with a head cold that I hadn't had a single symptom of one hour prior, and I've been sick the remainder of the week, with Magpie sick and out of school today as well. It's a real cold, not psychosomatic, but pretty incredible it came on so suddenly and at that specific time.
So I've been at work, and have been somewhat crampy since Tuesday afternoon, and I have a head cold, and I'm dragging a bit and very sad. Some of the dragging is the cold, and I think some of it is that I'm tapering off of prednisone. And my hormones are crashing, so I've been having drenching night sweats as well, which is emotionally painful because it somehow simultaneously makes me think of my upcoming menopause and reminds me of the drenching night sweats I had after I gave birth to Magpie, both of which are hard to think about right now.
Speaking of Magpie, I've been hugging her extra tight and smelling her Magpie smell and rubbing noses with her and giving her butterfly kisses with my eyelashes against her eyelashes (no wonder the poor kid is sick). And she's thrilled I can pick her up ("The doctor says you can hold me again? Really? Oh!!") And it helps. It helps so much that she is here. I think I would be beside myself in grief otherwise, because that's what used to really flatten me, the fear that we would never have a child, never make it out the other side, that our problems were insurmountable. They still seem that way but she is here, and she is so real and present and wonderful and alive and herself. I am so grateful.
But despite that, do you want to know the honest truth? I'm not doing so great over here.
I'm also kicking myself a little while I'm down, questioning why I ever thought I could hold onto a pregnancy and what in the world was I thinking? I'm terminally infertile. How could I not know this? How could I get my hopes up again, even in the limited way I allowed myself to? But of course those thoughts are not helpful, and they are probably not even accurate, although it is hard to tell what is accurate these days.
So that is where things are at today. Hopefully tomorrow will be better.
Mo
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Monday, October 5, 2015
8w1d no heartbeat
As feared, today's ultrasound showed that this pregnancy is not viable. Sac had grown but was still on the smaller side, yolk sac had not progressed, no fetal pole. Definitely no heartbeat.
I am waiting to meet with my OB to discuss.
I will call my local RE when his office staff arrives to see if I can get scheduled this week for a D&C.
Will and I are sad, but also really used to bad news at this point. The fact that this pregnancy never looked right from the beginning meant we've been tempering our hopes.
There were no tears, more a sense of sad resignation on both our parts.
A few of the thoughts swimming in my head include:
Thank you for all of your thoughts and support. They help.
Mo
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I am waiting to meet with my OB to discuss.
I will call my local RE when his office staff arrives to see if I can get scheduled this week for a D&C.
Will and I are sad, but also really used to bad news at this point. The fact that this pregnancy never looked right from the beginning meant we've been tempering our hopes.
There were no tears, more a sense of sad resignation on both our parts.
A few of the thoughts swimming in my head include:
- Nine pregnancies, one living child. Wow, we are really not good at reproducing.
- Magpie is a miracle.
- And the final thought, now what? No answer to that right now.
Thank you for all of your thoughts and support. They help.
Mo
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Saturday, October 3, 2015
Weekend away
I left Thursday to spend a long weekend out of state visiting my sister and helping her with her new baby boy.
I've been taking one of the overnight feedings to give this new family a break, and really enjoying getting to spend time with my new nephew and my sister and her husband. I thought it might be excruciating to be around my sister's baby, given our state of pregnancy limbo, but it's ok. I'm able to put my own situation out of my mind and focus on her and her new babe.
Spending time with them, though, it is remarkable to me how much easier he is to care for than Magpie was at this age, and it has been brought home to me how severe her feeding issues and my breastfeeding difficulties were. This little guy is three weeks old and a champ at the breast already. My sister is dealing with oversupply, which isn't entirely fun, but she can provide an entire feeding in 15 minutes, or pump several ounces in that amount of time on a regular (not hospital pump). I am impressed! Contrast that to me taking 40 minutes to pump with a Medela Symphony, and Magpie taking another 40 minutes to an hour to eat, and wow, I don't know how we did it. I'm so glad my sister has had an easier time of it. It's lovely to see her just getting to enjoy parenting, even this early on. She is so happy, which is just awesome.
Her new little guy is so cute, and it's adorable to see him and my sister together. It's also nice to feel like I know what I'm doing around a baby. I'm sending my sister and her husband out for a lunch alone today (their first time alone since giving birth). And I'll be making dinner for everyone tonight. It's nice to be here and to be useful.
In the meantime, I'm mostly trying not to think about my own limbo pregnancy. I was fearful on the flight here, as I was cramping quite a bit, and worried I was going to miscarry while on this visit with my sister, which would be awful on multiple levels. As soon as we landed, the cramping subsided and hasn't returned. There's been no spotting. So I'm not dwelling on it. We will see what we see on the ultrasound on Monday. I remain not very hopeful, but I'm certainly open to being proven wrong!
Mo
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I've been taking one of the overnight feedings to give this new family a break, and really enjoying getting to spend time with my new nephew and my sister and her husband. I thought it might be excruciating to be around my sister's baby, given our state of pregnancy limbo, but it's ok. I'm able to put my own situation out of my mind and focus on her and her new babe.
Spending time with them, though, it is remarkable to me how much easier he is to care for than Magpie was at this age, and it has been brought home to me how severe her feeding issues and my breastfeeding difficulties were. This little guy is three weeks old and a champ at the breast already. My sister is dealing with oversupply, which isn't entirely fun, but she can provide an entire feeding in 15 minutes, or pump several ounces in that amount of time on a regular (not hospital pump). I am impressed! Contrast that to me taking 40 minutes to pump with a Medela Symphony, and Magpie taking another 40 minutes to an hour to eat, and wow, I don't know how we did it. I'm so glad my sister has had an easier time of it. It's lovely to see her just getting to enjoy parenting, even this early on. She is so happy, which is just awesome.
Her new little guy is so cute, and it's adorable to see him and my sister together. It's also nice to feel like I know what I'm doing around a baby. I'm sending my sister and her husband out for a lunch alone today (their first time alone since giving birth). And I'll be making dinner for everyone tonight. It's nice to be here and to be useful.
In the meantime, I'm mostly trying not to think about my own limbo pregnancy. I was fearful on the flight here, as I was cramping quite a bit, and worried I was going to miscarry while on this visit with my sister, which would be awful on multiple levels. As soon as we landed, the cramping subsided and hasn't returned. There's been no spotting. So I'm not dwelling on it. We will see what we see on the ultrasound on Monday. I remain not very hopeful, but I'm certainly open to being proven wrong!
Mo
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