great article for the libs to learn value of life: Pursuing a Baby to the Ends of the Earth
After $70,000 worth of unsuccessful fertility treatments, a Virginia couple resorts to 'reproductive tourism' for one last shot at pregnancy
By Suz Redfearn
Sunday, January 14, 2007; W16
I FIRST HEARD ABOUT THE CHARISMATIC PAUL LE ROUX AFTER MY THIRD IN VITRO FERTILIZATION ATTEMPT FAILED. My eggs, it seemed, were shot. Yet, at 39, I just couldn't seem to walk away from my intense desire to give birth.
With my husband Marty's acquiescence, I began looking into the world of donor eggs, which pairs the ova of another woman -- selected for her youth, health and often her education and looks -- with your partner's sperm in a petri dish. The resulting embryos are transferred to the uterus of the woman trying to get pregnant. The intended mom (me) loses her genetic connection to the child, but the man (Marty) doesn't, and you still get to experience pregnancy.
As far I was concerned, donor eggs were a mighty appealing option, except for the cost: $30,000 per attempt, with about a 50 percent success rate. Undoable for us, especially as we'd already spent more than $70,000 over the past five years on everything from IVF to acupuncture to expensive dietary supplements -- none of it covered by health insurance. We were, after all, just a couple of Washington area reporters with unimpressive salaries. We'd already plowed through some inheritance, accepted a family loan, plundered our savings and racked up credit-card debt. Yowza. We couldn't do much more unless we found a more affordable way.
Enter le Roux, a South African fertility specialist with a devoted following in the United States. I discovered his name on an online bulletin board for women with faulty eggs, where anonymous infertiles were chatting excitedly about escaping the high prices in the United States by jetting overseas. In what has been dubbed reproductive tourism, these women were flying all over the place: Argentina, Ukraine, Mexico, Greece, Spain and, most appealing to me, South Africa, where le Roux had helped a number of them get pregnant. His patients raved about how kind he was, how involved, compared with American reproductive endocrinologists, who more often than not are in a big hurry and are unwilling to do the hand-holding craved by those stuck in the grief-filled pit of infertility. Not so with le Roux, apparently. From what the women online said, he was the man.
The cost of his services? About $5,000. In the United States, that same $5,000 would pay only the donor's fee. And that doesn't include any medical services. Of course, we'd have to fly 8,700 miles across two hemispheres and six time zones to get to Cape Town and spend two weeks in a hotel there, which would run us $4,000 to $6,000. And, if we wanted to be able to see pictures of our egg donor as an adult and possibly even meet her, we'd have to use the one donor-egg agency that operates in Cape Town and is run by a Californian charging U.S. prices ($4,500). Or we could go with le Roux's donor pool (baby pictures of the donor only, no chance of a meeting).
Total out of pocket? About $14,500 if we used the Cape Town egg-donor agency, $9,500 if we didn't. Certainly not chump change, but still far less than what we'd pay in the United States. And we'd get a two-week trip to an exotic place we'd never been. We signed up.
MARTY AND I COULDN'T IMAGINE CREATING A CHILD WITH THE GENES OF SOMEONE WE COULDN'T LAY EYES ON. We both wanted to pay the extra money to use the Cape Town egg-donor agency. I obtained the password for Renew Fertility's online donor database and began poring over pictures and background information on dozens of young women. Most of them, I learned, were donating eggs for altruistic reasons, as the South African government limits donors' compensation to 5,000 rand, or about $700. That's not much money, considering what's involved for the donors. They inject fertility drugs to produce multiple eggs, then undergo a surgical procedure to have the eggs removed from their ovaries.
One day our donor's picture -- a new recruit with unproven eggs -- popped up on the Web site. She looked nothing like me. A blonde, while I am a brunette. Thin, angular features; I have full lips and bulgy eyes. But still, there was something about her that appealed to me. A kindness in her eyes? An intelligence? She was getting her master's degree in an outdoorsy field that could land her on Animal Planet one day. She also had curly hair -- something I had become very sad about not being able to pass on. And she was 22 and oh-so-healthy. I was smitten. Marty liked her, too. We wrote her the letter that was required by the donor agency. We told her our story and waited for her answer, knowing that this would be our last high-priced attempt at pregnancy -- the end of a long odyssey, no matter the outcome.
A few days later, we heard back from the agency. She'd said yes to becoming our donor. Yes, also, to meeting us while we were in Cape Town. We were on our way.
That's when the phone rang and our long quest for a baby took an unexpected turn. It was Marty's cousin, an obstetrician in South Carolina who'd been following our conception difficulties.
"I might have a baby for you," she announced. "Are you interested?"
"Um . . . what?" I sputtered.
A young woman had come into her practice. She was 14 weeks along and wanted to place the baby for adoption. The father, 19, was not in the picture, and the birth mother -- a cute, healthy, 23-year-old named Laney who worked in a restaurant and still lived with her mom -- did not want to be a single parent. She was willing to place the baby privately with a couple like Marty and me. Were we in? Could we get a home study done really quickly?
"Um . . . what?" I just kept saying.
Adoption was not something I'd wanted to do. In fact, for years, I was wholly unable to picture it. One day, you are most decidedly not a parent, and then the next day you are? How was I supposed to wrap my head around that? Plus, something deep within me wanted to be pregnant -- needed to be pregnant. Badly. Just once. I could see adopting later. But not now.
And yet, when our third IVF attempt had failed, and Marty and I had sat there on the couch stunned, staring blankly at the home pregnancy test with just one sorry, stupid line on it, we decided to open the door to all possibilities, to all ways to be a family. Adoption was one of those ways.
I called Marty, then called his cousin right back. "Yes, yes, we're in," I told her.
We'd do both, Marty and I decided. We'd hedge our bets, pursuing both this adoption (which could be done without an agency and, thus, inexpensively) and the donor-egg cycle in South Africa. If the adoption fell through -- and they often do, we were told -- we'd still have the donor cycle. If the donor cycle didn't work, we'd still have the adoption under way. The baby in South Carolina was due July 22, 2006, six weeks after our scheduled return from Cape Town. Should all efforts be successful, we'd have two babies, spaced seven months apart.
Or, um, three babies, should the South Africa experience result in twins, as many IVF cycles do. I took a deep breath, then laughed. Two babies? Maybe three? After this huge drought? Were we in?
Yes, definitely.
LANEY WAS SIX MONTHS PREGNANT WHEN MARTY AND I WENT TO MEET HER IN SOUTH CAROLINA OVER THE EASTER WEEKEND. We'd spoken on the phone with her twice, 45 minutes each time. She told us all about herself -- that she was a workaholic, loved to shop, wanted to go to culinary school, took after her Norwegian grandmother looks-wise. Her parents were divorced. She considered her mother her best friend. The birth father, Laney said, had made himself scarce after she told him about the pregnancy. Her 20-week ultrasound indicated she was having a girl.
A girl. I swooned hard. A girl was exactly what I'd hoped for.
By the time we met her, Laney was already huge and seemingly resolute about placing her baby with us. We shared several meals with her and her mother, which went beautifully. In Laney I saw echoes of myself at that age: honest, open, filled with energy and verve, but somehow scattered, not quite on track. She was pretty and petite. And she had curly hair. So did the father of her baby, she told us. She showed us a picture of him on her digital camera. He was almost a dead ringer for handsome Adrian Grenier from HBO's "Entourage."
Marty and I didn't tell Laney about our impending trip to South Africa. We weren't sure how she'd react to it; plus, there was no guarantee that I'd come back pregnant. Almost without realizing it, the adoption had become much more than a backup plan for us. We were ecstatic about the prospect of adopting Laney's baby, but we also were scared to death. We'd heard that birth mothers could be filled with conviction and resolve, and then, after they'd given birth and held the baby, that something primordial kicked in and they changed their minds. We'd had so much failure in our quest for parenthood that we couldn't help but feel this would happen to us.
To keep those thoughts at bay, we turned our attention back to the trip to Cape Town.
I STUMBLED DOWN THE GANGWAY IN JOHANNESBURG PUKING INTO AN AIRLINE-ISSUED VOMIT BAG. I guess it was the Ambien I'd taken to help me sleep on our 18-hour sojourn from Washington to South Africa. Or maybe it was all the estrogen I was taking to prepare my uterus to house the embryos that would be forming in a few days. But I couldn't help thinking of my uncharacteristic retching as a good omen. Was the universe telling me that, in a few weeks, I might get to vomit even more? Because that's what I wanted. Morning sickness and lots of it.
The morning after our arrival in Cape Town, we climbed into a cab, eager for our first meeting with Paul le Roux. When the cab pulled up to his address, we saw a giant Pic 'n Pay grocery store with an office building above it. A fertility clinic and a grocery store sharing space? Was there some mistake? No, there wasn't.
On the second floor of the office building, we found le Roux nestled in a modest office. He was thin, wearing a sweater vest. He welcomed us warmly, asking about our flights and seeming to care about the answers. He had a nature just as nurturing as I'd been promised. Maybe that's why the bad news he delivered didn't hit me that hard at first.
"I'm so sorry to say the donor" -- whom we were scheduled to meet the following week -- "hasn't produced very many eeeeeggs," le Roux told us from across his desk. "There are only four or five right now, with a few more that may catch up."
Bad news, indeed. In the United States, doctors tend to prescribe high doses of fertility drugs to donors, causing them to produce, say, maybe 15 eggs on the low end and maybe 35 on the very high end. That way, couples have a lot of eggs to work with and, perhaps, some embryos to freeze to create future children. In South Africa, we learned, they keep the drug doses lower, believing that it's safer for the donor. And getting, say, 10 eggs from a donor is a good thing there. We were okay with that. But four or five eggs?
Le Roux also told us the donor's eggs were developing faster than normal -- another possible sign of compromised fertility -- and that they were being surgically removed the following day. Could we be there at 9 a.m. the next morning so Marty could produce the necessary sperm?
After we agreed, the doctor had me hop up onto an ultrasound table so he could check the thickness of my uterine lining. It was a healthy and embryo-ready 10.5 mm. That was the visit's only uplifting news. But I decided I wasn't going to freak out. After all, if things didn't work out here, we had the adoption to fall back on, right? And I was going to enjoy this vacation no matter what happened, dammit.
"Four or five eggs -- that's not good," Marty said as we left the office.
"No, it's not," I said. "Want to go take a cable car to the top of Table Mountain?"
BY 9 A.M. THE FOLLOWING MORNING, WE WERE BACK AT THE PICK 'N PAY. Marty disappeared into a tiny "collection room" equipped with only cabinets and a chair.
The donor was to have her eggs extracted at 11 a.m. Marty's sperm needed to be washed about an hour before that. "Washing" in the infertility world does not involve suds; it involves separating the actual sperm from the seminal fluid via a spinning process, which also extracts the dead or misshapen sperm.
In a few hours, once Marty's sperm and the donor's eggs were ready, an embryologist would capture individual sperm and inject one into each egg. This is called intracytoplasmic sperm injection and is usually employed only if there's a problem with the sperm cells (low count, weirdly shaped, not moving around normally, etc.). There wasn't, but we were opting for it this time because we'd had so many failures in the past. Le Roux thought it was a good plan.
Our work there that day -- well, really, just Marty's work -- was done in 15 minutes. On our way out, le Roux gave us multiple needles and progesterone suspended in peanut oil. Every 24 hours, Marty would have to inject one cc into my butt. This would help support a pregnancy, if one occurred. We were used to this. During our previous IVF cycles, Marty had probably done such injections 45 times. He was a master. And I was a pincushion.
THE NEXT DAY, WE WERE HALFWAY THROUGH LUNCH AT ONE OF THE WINERIES OUTSIDE CAPE TOWN WHEN OUR CELLPHONE RANG. It was le Roux. Marty took the call. I tried to read his face as le Roux talked, but all I could pick up was utter confusion.
"Here, let me let you talk to Suz," was all Marty said.
Le Roux said: "Suz, hello, yes. I'm calling because it seems that, out of the four eggs we got yesterday from the donor, only two were mature. Both of those have fertilized, but I'm concerned. Two is not really enough to work with."
I felt an uncomfortable heat spread across my middle, and then suddenly all my viscera seemed to be dropping fast, as if I were on a roller coaster that had just rounded the top of its worst dip. But there wasn't time to say anything before le Roux swooped in with a possible fix. It seemed that, coincidentally, he had another donor, one who was ready to have her eggs extracted in a few hours, and her recipient couple had canceled at the last moment. She, too, had a small batch of eggs coming along -- maybe five or six. Would we like to have her eggs as backup? At no extra cost?
My stomach stopped dropping. The roller coaster hung in midair. Le Roux was the man.
"Uh, what is she like?" I asked.
"Oh! Quite nice!" le Roux gushed. She was one of his favorite donors, he said, with coloring more similar to mine. He could show us a childhood picture if we came in, he said. This donor was 28, very sweet, worked in computers. She was pretty and fit, maybe a bit taller than me. She had donated twice before, and pregnancies had occurred both times -- one of which resulted in twins.
In an instant, Marty and I found ourselves saying yes. Never mind all our careful combing over donor pictures and profile info before coming here, painstakingly considering the genes we would carry forth into a new generation. Never mind that it felt as though we were cheating on our original donor, whom we'd be meeting soon. This called for a snap decision, and we made it.
"Okay! Lovely! So you have to be here by 3:30. We need more sperm then," le Roux told us.
I looked at my watch -- 2 p.m. I told him we'd see him soon. I hung up and was immediately racked with sobs. Not from sadness; that hadn't downloaded yet. Rather, from impact, as you do in the instant after another car collides with yours, but before you know whether you are hurt. Within seconds, I was laughing. A second donor? What are the chances? The part of my brain that was searching for signs that everything was going to be okay took this as a big one.
ON OUR SEVENTH DAY IN SOUTH AFRICA, WE PULLED UP TO THE PIC 'N PAY FOR THE LAST TIME. Inside, le Roux showed us into an exam room, where we were scheduled to transfer the most promising-looking embryos into my uterus.
"Suz, please have a seat on the exam table," le Roux said solemnly, scaring me. What -- had all of the embryos died? "Marty, please pull up that chair."
In the end, le Roux said, our original donor had produced one viable embryo, which looked stellar. It had been growing for four days and had become a morula, an advanced stage of growth that can indicate health and heartiness. The second donor's eggs had produced three viable embryos, which were three days old and were still coming along nicely. Two looked good, while the third had the embryologist a little worried because it was a bit oval, not perfectly round.
Now we had to choose which embryos to use. It's standard practice when using an egg donor to transfer two embryos to the uterus. More than that and you risk triplets; fewer than that and you risk no pregnancy at all. But should we use the two most robust-looking ones, even if they were from two different donors? What if I ended up with twins, then, with different biological mothers? Le Roux said he worried that could be difficult to explain to the children.
That made sense to us. Plus, we knew the second donor's eggs had produced nothing but pregnancies. "We'll go with the two best from donor No. 2's batch," we said. "And we'll freeze the rest."
Le Roux wheeled in his ultrasound machine. I lay flat on the exam table. Marty held my hand. The embryologist came in with the embryos loaded into a syringe. Le Roux fed a catheter through my cervix and up into the uterus, watching the whole thing on a screen to get the positioning right.
Finally, he pushed the embryos through the apparatus and into me. A bright little flash appeared at the end of the catheter.
Life! Well, maybe. We wouldn't know for 10 days.
WE PULLED INTO THE PARKING LOT OF A CAPE TOWN RESTAURANT WITH A QUAKING NERVOUSNESS. Did we have to do this? What was the point of meeting our original donor now? It was too late, though, to back out.
"You go first," Marty said as we walked toward the restaurant.
"No -- you."
"No -- you," he urged, half-kidding, half-not.
I crossed the gravel courtyard beyond the restaurant's bar, and then I saw her about 50 feet away, sitting on one end of a picnic-table bench. I recognized her from pictures on the Web site. We introduced ourselves. She radiated a remarkable sincerity and was far more beautiful than her pictures let on. She had big, round, gorgeous green eyes, and her hair was the exact texture of mine -- fine and curly-wavy, bordering on frizzy, only blond.
Shyly, looking at the table, she said she was so sorry her donation to us hadn't worked out. I told her not to worry. I gave her the present we'd brought for her -- a tent, which she needed for her fieldwork. It's customary to give the donors here a fairly expensive gift, because the government prohibits them from getting much in the way of a donor fee.
We asked her about her work, and she regaled us with details about her time spent deep in the bush. She was wonderful -- exactly the sort of young woman you'd want to replace your genetic material with. I started to get a sinking feeling.
When we all stood to leave, she gave me a present wrapped in opalescent paper. A present? For us? I'd never heard of a donor giving the recipient couple a present -- only the other way around. I thanked her profusely, without opening it. My sinking feeling deepened.
In the car, I opened the present. It was a copy of Rudyard Kipling's Just So Stories, a collection of sassy, fanciful tales about how various jungle animals came to have their traits -- how the leopard got his spots, how the elephant got his trunk. "This book was read to me over and over as a child," her card said. It also said, "Thank you for allowing me to share in such a wondrous process of creation. To you and your baby to be, all my love . . ."
THE FLIGHT HOME WAS WORSE THAN THE FLIGHT TO SOUTH AFRICA. The excitement was over. And my peanut-oil-filled butt made it impossible to get comfortable. I spent the better part of 20 hours shifting from one cheek to the other.
Three days after we arrived home, I stood in my bathroom with a home pregnancy test. I'd been here so many times before, each one filled with a mixture of anxiety and hope. Marty waited outside the door. When I was done, he came in. We hugged as we waited the obligatory three minutes. When it was time, I broke loose and picked up the stick.
Not pregnant.
My legs suddenly wouldn't hold me. I sank down onto the toilet seat in total disbelief. "No," I said, thinking there just had to be a mistake.
"How?" Marty demanded. "How? After everything we did? After going this far? How? Why?"
"No," I said again, staring at the side of the tub.
The next day an official blood test at my old IVF clinic's office in Annandale confirmed the results: We weren't having a baby.
IN A CHARLESTON, S.C., COURTROOM TWO WEEKS LATER, LANEY WADDLED TO THE WITNESS STAND. She was so heavy with child that I was afraid she'd topple off her black platform sandals.
Marty and I watched nervously as she raised her right hand and swore to tell the whole truth. Our lawyer had assured us that this particular adoption proceeding was just a formality. And, through phone calls and e-mails, Laney still seemed resolute about the fate of her baby.
"Is it your intention to place your baby with this couple?" said the lawyer, motioning to us.
"Yes, sir," Laney answered.
"When is the baby due?"
"In a month, sir."
"You feel that it is in the best interest of the child to be placed with this couple?"
"I do, sir."
The prospect of this adoption was allowing Marty and me to stave off complete despair. "Marty, let's call her Evangeline Virginia," I'd said to him not long after the devastating pregnancy test. "Evangeline after the Longfellow poem, and Virginia after your grandmother. Then we can just call her Eve for short."
"I love it," Marty had said.
We still weren't entirely confident that Laney would hand us her baby and make us parents. All we could do was hope. It's all we'd ever done.
On July 25, the day Laney was being induced by Marty's cousin's partner, we sat in the hospital waiting room with Laney's relatives and three of her best friends. The initial awkwardness disappeared quickly. Over the course of the next 12 hours, we played cards, asked about each other's work, took bets on how much the baby would weigh. Laney's dad gave us some children's books he'd illustrated. Her cousin, an aspiring artist, showed me her work on a Web site. They embraced us as family, which felt right. After all, this was to be an open adoption, and in a matter of hours -- if all went as planned -- we'd be linked forever.
Laney's labor seemed to take forever. The double doors didn't fly open until 10:30 p.m., when Laney's shellshocked-looking aunt, who along with Laney's mom had been there for the birth, announced the news: The baby was here, but she was in some distress. She had been born face-up, the cord wrapped around her neck. Her arm had come out next to her face, and she had a fever and jaundice. She would probably be fine but needed to be watched closely. Laney, we were told, was exhausted but doing well. Her aunt then collapsed in a corner.
Marty and I were the last to be called in to see Laney that night. It was 1:30 a.m., and the baby had just been placed in Laney's arms after hours and hours of testing. She was beautiful, with wide-set eyes, a gorgeous nose and porcelain baby doll skin. I'd gotten her a onesie that said "Movie Star," and it seemed apt. Laney held tight to her. We fussed over the two of them, wondering when Laney was going to pass the baby to us for a few minutes. But she never did.
"I'm sorry. I can't. Not yet. I'm sorry," she said, on the verge of tears.
Marty rose to the occasion immediately. "Okay, sure -- we understand. Whatever you need to do. Whatever makes you comfortable."
I started to feel pressure mounting in my head like a kinked hose on full blast. I held it all back until we got in the car. Then I sobbed and ranted. What did it mean? Was Laney keeping the baby? Was this all for naught, too? What the hell had we done to deserve all this?
We slept a few hours, then woke and showered, moving around heavily as we got ready to head back to the hospital. As I pulled on my shirt, my cell rang. It was Laney. She sounded completely different -- cheery.
"Hey! Are you guys coming? We've pulled a rocker in here for you to sit and feed the baby. Come on over and start bonding with Eve. We can't wait to see you. Come be with your baby!"
"What did she say?" Marty asked me after I hung up.
I couldn't answer. All I could do was cry.
IT IS HALLOWEEN NIGHT. EVE HAS JUST TURNED THREE MONTHS OLD. I parade her up and down the block in our Falls Church neighborhood, thrilled to participate, for the first time, in this parental ritual that had always eluded me. We have a baby. And here she is, dressed up as a chicken. Neighbors coo. Passersby swoon. But no one admires her as much as I do. She is everything we could have wanted -- healthy, sweet, mild-mannered and, yet, feisty, curious, smiley. She has the eyes of an old soul.
With Eve's arrival, my visceral desire for pregnancy has vanished. When I see pregnant women now, I no longer feel the painful tug that was with me for so long. Instead, I find myself thinking: Man, that seems like a pain in the ass. And then I look at my baby, and she lights up, legs kicking involuntarily from delight, blue eyes sparkling.
The other day, when I handed Eve to a friend, the baby started to cry. Perplexing, I thought. She just ate. She just napped. She's not a big sobber. What gives? Then the same thing happened a few nights later when we handed her to Marty's aunt. Sob, sob, sob. What's this? we puzzled. But when I took her back into my arms, she quieted right down. Then I understood: She wants only to be held by us; we're her parents.
Suz Redfearn is a freelance writer who lives in Falls Church. She can be reached at 20071@washpost.com |
