Cover

For Infertile Couples, Heartache and Hope

Despite the discomforts and the long odds, would-be parents turn to doctors and donors to deliver what nature could not

Patricia Chisholm December 6 1999
Cover

For Infertile Couples, Heartache and Hope

Despite the discomforts and the long odds, would-be parents turn to doctors and donors to deliver what nature could not

Patricia Chisholm December 6 1999

For Infertile Couples, Heartache and Hope

Cover

Despite the discomforts and the long odds, would-be parents turn to doctors and donors to deliver what nature could not

Patricia Chisholm

They are so young and pretty, these infertile women gathered in a Toronto office, describing the grief and anger and desperation that blights their lives. All five have careers—they work in health care, finance, human resources. But none fits the cliché of the mid-40s executive who has postponed childbearing until it is too late, and who then goes shopping for an egg from a blond-haired, blue-eyed college student. The oldest is 38 and has been attempting to start a family since she married at 34. Another is 32 and has been trying since her mid-20s. “People think I’m just a happy career woman,” she says, smiling grimly. Most of her friends and colleagues know nothing about her as-yet-futile efforts to produce a child using the new technology. “I couldn’t give a shit about my career,” she says, her emotions spilling out. “I just want a family.”

The others nod, knowing the feeling. Most stopped attending friends’ baby showers and kids’ birthday parties years ago because it was just too painful. Instead, they have immersed themselves in the dispiriting pursuit of a medical solution to fertility problems caused by everything from malfunctioning fallopian tubes to premature menopause. “It’s very hard,” says a 34-year-old woman in the Toronto group who has made several attempts at in vitro fertilization. “You start to feel that everyone else is going to have a good life except you. For some reason, the world has passed you by, and it’s very depressing.”

For infertile men and women, baby-making can be a miserable business. The problem is as old as life itself, but nowadays those afflicted are given hope—sometimes false hope—that science can deliver what nature cannot. As a result, many spend years consulting doctors, trying to pinpoint their problems and pursuing remedies by modifying their diet or taking fertility drugs. At the end of that road are high-tech, low-percentage options that involve repeated,

hours-long visits to fertility clinics for endless tests, and twoweek series of hormone injections. Many people exhaust their savings and remortgage their homes to pay for treatments that, for the most part, are not covered by medicare.

It is tough on marriages, too. Normal human relations are taken out of the home and placed in the antiseptic confines of the laboratory. Worst of all, the invasive, wildly expensive procedures usually don’t work. Pediatrician Patricia Baird, the University of British Columbia professor who headed the 1989-1993 royal commission into reproductive technology, estimates that over a single cycle, only about 14 per cent of couples succeed in having a child using the new technology. That compares with about 20 per cent for fertile couples having sex without birth control for one cycle.

The good news is that science is gradually improving those odds, and specialists say they hope Health Canadas imminent legislation to regulate reproductive technologies does not restrict their ability to help couples make babies. “For many people, having a child is the defining event of their life,” says Roger Gosden, the renowned British fertility researcher and author of Designing Babies. “The fertile population must be careful not to set up unfair barriers, if all that is needed is a little bit of technical help. That could create major injustice.” Gosden recently joined McGill University to escape the negative image of his field held by the British public. “There are few moral absolutes in this area,” he notes, pointing to the evolution in social attitudes

on issues like gay parenthood and genetic testing. “We should use laws for things we really don’t want, like cloning, not for setting limits on I VF services.”

That said, the issues are complex. And Diane Allen, who used high-tech help to conceive her 14-year-old son, Chris, although no donors were involved, has found that many couples’ feelings about donor issues change once they succeed in having children. “Having my son helped me realize that we have to put the interests of children conceived this way first,” says the Toronto woman, who founded a national support group called The Infertility Network. “They are individuals in their own right. But I think it can be very hard for people who don’t yet have children to see that.”

Such insights inevitably spark debate over whether children should have a legal right to information about their genetic background, the dominant trend in modern adoption practices. But most parents have little to tell because there has not been a formal, nationwide registry of donors.

A 17-year-old B.C. girl whose parents used a sperm donor told Macleans that she “absolutely, without a doubt,” has the right to know about her genetic father. She requested anonymity because, even though she has always known about her origins, she still fears the attitudes of others.

“Parents who hide this think it will be OK, the child has two parents,” she says. “But they don’t realize that the child will become an adult. They don’t have the right to make that decision for them.” She says she is grateful that her own parents have been open with her. But as far as she knows, there are no records that could shed light on her medical history, much less provide a name. “It’s not working the way it is

Fighter restrictions on compensating donors for eggs could drive some couples to the United States

now,”she says. “Something has to change.” Some donors echo that view. Small businessman Wayne Velestuk, 50, estimates that he donated about 120 times during the mid-1980s when friends who worked in a Vancouver hospital told him about the program. He has no regrets about making the donations—“I’m sure there are a lot of people out there who are

happy I was there for them”—but in hindsight, he now believes strongly that recipients should receive more intensive counselling so that they have carefully considered what it means to raise a child that is genetically linked to someone else.

Velestuk, who has a teenage son of his own, argues that children conceived through donor eggs or sperm should be entitled to contact their genetic parents when they reach adulthood. Priór to that, their families should have much fuller information gbout the donor’s cultural background and medical history, he says. Among other things, this could prevent half-siblings from inadvertently dating one another. “I don’t think the number of donors would necessarily drop,” he says. “There are people out there who believe they can help, especially married couples. What we might end up with is a different kind of donor.”

Money is a big part of the donor debate, at least for eggs. Critics say it’s repugnant to pay a woman $2,000 to $4,000 for her eggs—a typical rate in both Canada and the United States. Yet sperm donors have been routinely paid for at least three decades, with virtually no adverse public comment. And while they are paid far less—usually about $50—some men donate dozens of times. Those who advocate compensating donors point out that harvesting eggs is far more onerous, involving daily hormone injections and multiple visits to clinics, and there is also a small risk that the procedure will compromise a donor’s own fertility.

Jan Silverman, an infertility counsellor at Sunnybrook and Women’s College Health Sciences Centre in Toronto—one of the few hospitals in the country with an anonymous egg donor program—says tighter restrictions on compensating donors for eggs could drive couples to the United States. There, fees for in vitro fertilization are in the $25,000 range, compared with about $7,000 in Canada. Silverman, among others, suggests such restrictions could also create a black market where financially needy donors are recruited through

suspect methods, such as ads in university papers. “I have such concerns about that,” she says. “Instead of protecting all the parties, by setting up a system where we set the fee and put in good guidelines to screen people, we could create a situation where no one will be well served.” Even more disturbing is a recent “egg auction” on the Internet. Launched by 66-year-old soft-porn photographer Ron Harris of Los Angeles, the Web site offers eggs from a selection of beautiful young “models” for prices ranging from $22,000 to $220,000.

In Great Britain, where the first test-tube baby was born in 1978, such cavalier trade in reproductive material is forbidden by law. And the debate over the use of reproductive material is far more open. David Gollancz, a 47-year-old London lawyer, was conceived using donor insemination, a far older technology that raises similar issues about the rights of children. Gollancz, who is the father of two teenagers, says he decided to speak publicly about his origins because he believed that it would help him overcome his own personal taboos. But he would not have risked hurting those close to him, he adds, unless he believed that others would benefit from his openness. “If this is kept secret, it can be very damaging for families.”

While many people want to help friends with fertility problems, sometimes the best intentions can get waylayed. Maggie Soloduszkiewicz, a 36-year-old mother of two teenagers and a 15-month-old baby, recently offered to provide eggs for an infertile friend. In Canada, a shortage of donors has created long waiting lists for fertile eggs. But it turns out Soloduszkiewicz, a Mississauga, Ont., lab technician, could not undergo the procedure while she was still nursing her own baby, so her friend had to look elsewhere. “We talked about her problem and my heart went out to her,” Soloduszkiewicz says, adding, “I offered because I have kids and I can’t imagine not having them.” Thousands of infertile men and women can’t imagine that, either. Ci]