Starting my 4th egg donation cycle

I've been busy with work, school, and buying a condo these last two weeks but I wanted to report that I just got the monitoring orders and legal agreement for my next cycle, my fourth. The IP's are based in Asia and the retrieval will take place at a clinic at the West Coast. The monitoring will be done in my hometown though, so I only travel for the retrieval.

I can't believe this is going to be my third cycle this year. I planned to do one in 2009 but my agency eagerly kept lining up new ones with very little time between the cycles until I told them I didn't feel confortable committing to cycles that would take place more than 8 months down the road. I would hate to disappoint an IP couple if I had to cancel an agreement because of a new job or other life changes, and I also can't predict whether my body would still want to do this after so many times. My general policy is not to sign the legal agreement for a new cycle until the previous cycle is successfully completed. So no more cycles lined up after this one, for the moment being.

However, I am very excited about my next cycle and will be posting about it here.

Donor/IP Confidentiality

Just how anonymous are anonymous DE cycles really? Not very much so, I quickly discovered. Unfortunately for those donors and IPs who really care about remaining unknown to one another, confidentiality seems to be superficial at best.

The first thing you do when you sign up with an agency to be a donor is fill out forms with your contact information. You provide your social security number. Medical records. Photocopies of your drivers license. You provide the same to the clinic...and your lawyer. There is no doubt in my mind that the professionals involved in third party reproduction understand their clients' desire for confidentiality and generally make efforts to safeguard the privacy of the relevant parties. But mistakes do happen.

As an anonymous donor I was surprised, for example, when I requested copies of my medical records from the hospital where I did my first donation and the medical chart had the intended parents’ cell, home, and work numbers scribbled on it. During my second donation, my lawyer sent me an electronic version of my legal agreement whose file name contained the names of the intended parents. I would not be surprised if similar errors compromised my identity as well.

But even in the absence of such mistakes, your identity can easily be established. When filling out my donor profile for the agency’s database, I took care not to provide any identifying information. But what, exactly, constitutes identifying information in the age of Google and Facebook? Between the name of my school, the year I graduated, and my major, it would be easy to identify me through my school’s alumni directory. The fact that I mentioned participation in a particular varsity team makes it almost ludicrously easy to identify me.

I personally would not mind if my recipients or their off-spring attempted to identify me. Quite on the contrary, I've come around to think that I would like the offspring to have the opportunity to get in touch with me one day in the future if they wanted it. However, I know that a lot of donors are scared of the possibility of being identified. If you fall into this category, think twice about donating, and do not take promises of "anonymity" at face value.

As far as I am concerned, the most serious privacy implications concern health insurance. What if my health insurance finds out I donated my eggs and denies coverage twenty years down the road if I happen to develop, say, ovarian cancer? While your medical treatment will generally be paid in full by the intended parents and supplemental insurance is purchased to plan for unexpected medical complications, there is a good chance that, if you do develop complications, your health plan will find out. After all, most of these supplemental insurance plans require that claims first be submitted to the patient’s regular health plan. All of this only occurred to me three days after my last retrieval when I developed OHSS symptoms and my clinic told me I should go to the emergency room. I ended up not going to the emergency room.

The agencies, lawyers, mental health counselors, and clinics I have worked with all made efforts to inform me of the medical and psychological risks of donating my eggs. The fact that confidentiality can not really be assumed was not addressed by one of them.

Thoughts about Anonymous Donation

I meant to write more about my second cycle tonight but felt I had to get something else off my chest first. Last night I dreamed that my parents announced to me, as an adult, that I had been conceived with the help of a gamete donor (it wasn't clear whether the egg or sperm was donated). Then it turned out that there was no way to track down or identify my donor. Speechless, I sensed a wave of existential nausea rise in my body, along with the slow realization that I had been cheated out of something really essential. Then I woke up, surprised by the dream and the depth of the nauseated feeling, which eerily persisted even after I got up to take a shower.

I find myself wondering whether I still really want to cycle with intended parents who are not clearly in the "tell" camp. For a long time, I did not seriously consider doing an open cycle, or even a semi-anonymous one, but I have been thinking lately about whether it's right on the part of intended parents and donor (often via a legal agreement) to deprive donor-conceived offspring of the option to explore their genetic relations. The more I think about it, the more I wonder to what extent it is ethical for two parties to enter into a legal agreement that deprives a third party, who is not a party to the contract, of knowing their genetic history / ancestry. I would not want this done to me and my dream rather forcefully hit this home.

Anonymity used to be one of the most important things for me when I first started to think about donating my eggs, but I really sense my feelings shifting on the subject lately. I am curious to hear how other people feel about this subject.

Doing it again...

I started thinking about donating again about a year after my first retrieval. I was bored with the shallowness of corporate life and needed a change of scenery. I decided that donating a second time would be and a nice way to do something that actually makes a difference in someone's life. Something that matters.

So I started to research agencies.  This time around, I was looking for one that would allow me to travel out of state for the retrieval and that was a little more flexible in terms of the compensation. In this process, I found that most of the agencies that let donors set their own fees all in all did not come across as trustworthy establishments and that I really did not like them. I did, however, find one I liked in the end and I have been with them ever since. 

The application process was more rigorous this time. More pictures were required, including pictures of family members (which I categorically refused to provide), along with proof of test scores, transcripts, diplomas, etc. I felt vaguely uncomfortable sending in all this documentation but eventually decided to go along with it.

As with my first donation, I was matched with a couple very quickly - more quickly than I would have thought - about three weeks after I submitted my application. Yay! 

Internet Resources for Egg Donors

An avid user of the Internet with an irrepressible Google reflex, I have naturally tried to rely on the Internet for information on egg donation. Which agencies out there are donor-friendly? What are the most common medical protocols for donors? What really are the risks of egg donation? Before long, I found that Internet resources specifically targeted towards donors are hard to come by. Other than the websites of donor agencies, which primarily serve as marketing tools and frequently display a commercial bias, there seem to be barely any websites devoted to donor issues. 

So where does a donor go to obtain unbiased authoritative information on egg donation?

I have come to rely on www.fertilethoughts.com for user-generated information on protocols, the injections, and other medical aspects of fertility treatment. Greateggs.com provides an attempt to rate agencies - though mostly the comments come from the IP rather than the donor perspective. And then there are a few great egg donor blogs. All in all, however, I have missed a central information platform where donors can obtain, generate, and share information on egg donation and their experiences with it. 

This blog is in part an attempt to redress this situation and to add to the information resources for both experienced donors and for those who try to decide whether ovum donation is for them. One of my next projects for this blog will therefore be to compile a number of links on egg donation with information I wish I had had when I first became a donor. Stay tuned and check the Donor Resources feature.

Recovery

The recovery from the retrieval proved to be my least favorite part of the cycle. I developed a moderate case of OHSS and wasn't able to even stand up straight without a knife-like pain in my ovaries and side stitches in my rib cage for a week. I even had to cancel a job interview! Of course I was terrified that I would somehow end up in the hospital and have to tell my parents about the donation. Luckily, that didn't happen.

All in all, I was happy and proud that I had donated. There was something very gratifying about being able to give a childless couple hope that they might become parents after all. A day after the retrieval, I received a lovely thank you note from the intended parents, along with a gift card for a book store. I cherish that note and still look at it once in a while, nearly three years later. 

I enjoyed my first cycle and loved the intensity of the experience, although it was also stressful. I moved abroad for a job soon after the donation and did not think I would donate again. I was wrong....

My first retrieval

The morning of my first retrieval, I was nothing short of terrified. I sat in the waiting room at the clinic in cold sweat for a half hour before I was escorted into the surgical suite. 

From there, things improved. Once I was resting on the gurney in a fashionable surgical gown with matching socks and an IV drip on my arm, the nurse gave me a tranquilizer, which made me feel pleasantly fuzzy. I remember being walked into the surgical room and installed on the stir-ups. Then, suddenly, I was out in a sleep so deep and delicious that I was somewhat disappointed when the doctor woke me up to tell me they had retrieved 28 eggs. I was back in the post-op recovery room, with a hot bottle on my somewhat crampy belly and a blanket over my body. Next, the nurse gave me a glass of apple juice and animal crackers. I rested for another half hour, and then I was dismissed. 

A car service my agency had hired drove me home and I went straight to bed. Other than slight cramps, I did not feel a thing. "A piece of cake," I thought...