“Do you tell a child that they were conceived via egg or sperm donor?”

Written by: Dr. Shannon M. Clark, MD

I knew that trying to become a first-time mom at 40 would be tough. My fears were realized when my first pregnancy ended in miscarriage. Although that loss was devastating, I had no idea just how much more disappointment I was about to experience. That loss was only the beginning of my struggle with infertility—a journey that would make me question who I was, what I wanted, and how far I would go to make my dream of becoming a mother my reality.

Once I physically recovered from my miscarriage, my husband and I went to see an infertility specialist. After receiving some very sobering statistics about pregnancy after age 40, we decided to go straight to IVF. We chose this path because we knew time wasn’t on our side due to my age, and we were right. Five cycles of IVF and almost two years later, we still weren’t pregnant, and I was approaching 42 years of age. I’m a doctor—a maternal-fetal medicine specialist who specializes in the care of women with high-risk pregnancies—so in some ways I should have been more prepared for how difficult this would all be, but I wasn’t. I suppose I was in a bit of denial too. Even though I was medically trained to know the effects of age on a woman’s fertility, I assumed that if I didn’t get pregnant naturally, one or two cycles of IVF might be needed to make me a mother. I, like many women my age, was not prepared for the reality that IVF may not work for me. As someone who had accomplished so much in life and in my career as a physician, I felt like a failure. My ego was bruised, and my heart was broken. My infertility was something I could not fix.

There was a pretty simple explanation for why IVF didn’t work for me: I started IVF late. At 40 there is a statistically lower chance of success with IVF. Although I was medically healthy and physically in shape, my ovaries were not. Those cycles of IVF yielded only one genetically normal embryo, and it did not result in a pregnancy. Ovarian aging had claimed any viable eggs that could have given me a child with my own DNA. Even though I didn’t look or feel my age, my ovaries were every bit of 40 years old.

Once the reality set in that I was not going to have a baby with the help of IVF, my husband and I started discussing our options. We could decide to live our lives as a childless couple. We could proceed with adoption. After much discussion we didn’t feel that either of those options were right for us. We agreed that having a child that was genetically related to at least one of us was important. This meant choosing to go down another, more challenging and complex path: using an egg donor and my husband’s sperm. Either a surrogate or I would carry the baby—a process referred to as “third-party reproduction.” We had been on the same page for the entire two years of our infertility journey, but here we had a difference of opinion.

I strongly desired to experience pregnancy myself. I wanted to know what it was like to feel a baby kick inside me, see my body change, and experience that bond that is created when a couple becomes pregnant. I couldn’t have a child of my own naturally, so I hoped that carrying a baby would allow me to make my contribution to us becoming parents. So the obvious choice for me was to use the eggs of a donor and carry the baby in my uterus. Fortunately, a woman’s uterus is not subject to the same age-related challenges as her ovaries, so this option was available to me.

But my husband felt that using a surrogate was the best option for us to finally become parents. After seeing me go through so much disappointment, he did not want me to experience the pain of failure yet again. He had supported me through a miscarriage, five failed IVF cycles, and a failed embryo transfer. He knew how devastated I was after each unsuccessful attempt to become pregnant. Looking back, I now understand that while I was the one who physically endured the multiple failed cycles of IVF, the emotional toll that comes with infertility had deeply affected him as well. He simply wanted to choose the option that would give us the best chance at having a family. But I wasn’t ready to give up on my body. I wanted to have a chance at carrying our child.

We talked at length about our options and sat down with our fertility specialist to get his opinion. After getting as much information to make the best decision, we chose to proceed with using an egg donor, my husband’s sperm, and my uterus. While pregnancy via egg donation is a complex process, we were grateful that advances in assisted reproductive technology made this option available to us. Oddly enough, choosing this “complex” method turned out to be the easy part. Finding the right egg donor proved to be much more challenging.

A woman can choose an egg donor in multiple ways. She can choose a “known egg donor,” who is typically a friend or family member, or an “anonymous egg donor,” found through an egg-donor registry who does not reveal her identity. Somewhere in between is using an egg donor through a registry who shares photos and may agree to some form of contact with the intended parents. Egg-donor registries are available through an egg-donor agency or through the fertility center where a woman is having her fertility treatments. Choosing the right egg donor depends largely on how much confidentiality both the donor and intended parents desire and on what traits and characteristics a couple wants in their egg donor.

We were surprised at just how many agencies and registries were available. Each registry had slightly different information available on each donor and most had multiple photos available as well. There were filters for choosing height, weight, hair color, eye color, ethnicity, education level—the list goes on and on. We could easily narrow the pool down in any one registry by making our preferences more specific, but our search quickly took on a life of its own. Our pool of potential candidates kept growing larger and spanned multiple registries. The desired qualities, traits, and characteristics of the donor became more specific, and the search area included everywhere from New York to California.

My husband took a very business-minded approach to the process, equipped with an Excel spreadsheet of potential donors. He read every available piece of data on every candidate he thought was promising. He spent hours sifting through each donor profile. I joked that it was almost like he was looking for the “golden egg.” In reality he was becoming obsessed over every piece of information available to us. He wanted everything to be perfect, and we were quickly falling into the trap of trying to find “perfect.”

I, on the other hand, realized quickly that there was no such thing as the “golden egg.” I finally told him that if I was to put my profile on an egg-donor registry, I would probably never be picked! I was nowhere near a perfect candidate based on my personal and family history, so I felt that our donor didn’t have to be perfect either. Simply put, if we were going to try and find a donor with some of my traits, we were going to have to be willing to accept a less-than-flawless profile. I was choosing to be realistic. No one is perfect—not any one egg donor and certainly not me.

I tried going through donor profiles myself but stopped after about a week. Looking through them made me uncomfortable. I was essentially searching for a woman to replace me, and I didn’t like that feeling. It was hard to be reminded with every profile that I wasn’t going to be the biological mother of my child. When I was put in the position to be able to dissect every quality and characteristic of a donor, from her hair color to what grades she got in high school to what diseases run through her family history, I started to acknowledge my own strengths and weaknesses. I had a lot to offer a child, but I was going to have to be OK with not being genetically related to him or her. Even though I ultimately accepted that truth, it still hurt.

I told my husband that he was going to have to pick an egg donor. So together we picked a handful of criteria that were the most important to both of us. With that information in hand, he narrowed the list of potential donors down to three for me to consider. From there I picked a donor and contacted the agency where she was registered. She had never before been a donor—a quality that most women would consider negative because they want someone who has donated her eggs before and had a successful pregnancy result—but that wasn’t important to me. She was the right choice for us.

Once our donor was picked, the agency worked directly with my fertility center to set up egg retrieval. We worked closely with the coordinators from each center to ensure everything was in order, both medically and legally. Shortly after a schedule was set, I received an email from the coordinator at the agency asking me to write a letter to my donor. The purpose of the letter was to establish some sort of personal connection with her, since most donors do not meet the families they are working with. The process can be quite difficult for the donor—there are so many appointments, ultrasounds, and injections. It takes a physical toll. A personal letter might make it a bit easier for her to get through a potentially rough couple of weeks.

I tried many times to sit down and write to her, but the words wouldn’t come. Instead, I felt a strong urge to meet her. I asked the coordinator if meeting my donor would be possible even though it wasn’t customary. Thankfully, she agreed!

I met Tara in the office of one of our agency’s fertility counselors. I chose to go by myself. I knew my husband really wanted to go, but he respected my decision. I am still grateful that he allowed me to have the experience of meeting Tara alone. I still think about that day and will never forget it.

I’m not sure what I hoped would come from meeting her, but for some reason seeing her, sitting next to her, and just having casual conversation made me feel more at ease for the first time since starting my journey with infertility. There was just something about her. I have always felt that I could read people well and have relied on my gut instinct when it comes to first encounters. From the first moment I saw her, I had this overwhelming sense of calm. I knew immediately that we had picked the right donor. We didn’t have heavy conversation, and we really didn’t discuss the egg-donation process in detail. In fact, I don’t remember much of what we talked about. I do remember studying her face. I am sure she probably noticed me staring, but I couldn’t help it. I knew that my child could look like her, so I wanted to remember every inch of her beautiful face.

I left our meeting that day feeling hopeful and excited—feelings that I hadn’t had in a long time. I remember driving home and daydreaming about becoming a mother. I finally felt that I had something positive to look forward to.

Now that Tara was a part of the equation, I had to cede some control, which made me anxious. I wasn’t going to be at her appointments, I wouldn’t be there when she took each injection or when she was feeling emotional or even know whether she was having any difficulties. I was used to being in control, so not knowing what was going on with her was difficult for me. I finally decided that if I allowed myself to question everything, uncertainty and doubt would surely start to creep in. I had to be a patient instead of a doctor.

After Tara’s retrieval, we were notified that we had five embryos to freeze. My husband and I were thrilled. We got only one embryo in my IVF treatments, so having five was huge for us. A few months later we decided to transfer two of the five embryos into my uterus. Then the waiting period began.

Waiting the two weeks to find out whether I was pregnant was extremely difficult. It was all I thought about. I was nervous, anxious, and excited all at the same time. Unfortunately, my husband was going to be out of town when I took the blood test to check my pregnancy hormone level, but I was OK with it. I told him I would call him as soon as I found out. I had put so much hope into this egg-donor cycle. I just knew I was going to be able to call him to tell him he was going to be a dad. But that’s not what happened.

I was home alone when I got the call. All I remember is hanging up the phone and collapsing into a puddle on the ground. The cries coming from my body were something I had never heard before. Never in my life had I felt so alone, so devastated, and so broken. I called my husband, but there was nothing he could do. I sat alone in my bedroom and let the pain flow from my body. It was almost as if my mind didn’t want to believe it was happening, like it was a bad dream, but it wasn’t. To this day, I am still haunted by the sound of those cries and the way I felt after experiencing that loss.

Of all the disappointments during my infertility journey, this moment was by far the most damaging. I thought I had fixed the problem by using donor eggs. I hadn’t allowed myself to envision the aftermath of another failure, but now I was living it. I was forced to pick myself up and move on and somehow maintain my sanity, but deep inside I cried every day. I felt the hope that I had fiercely held on to for so long starting to slip away. For the first time I thought about giving up.

My husband and I didn’t talk much about it for about a month. It was simply too painful. We knew we had three donor egg embryos left and would need to make a decision on what to do with them, but we weren’t ready. We decided to take a trip to get away and regroup with the hope that, when we returned, we would somehow know what the next step would be. We traveled to Peru for what turned out to be a very spiritual and emotional trip. We bonded for the first time in months and were relaxed and happy. When we returned, we knew what we were going to do. We called our doctor and scheduled the next embryo transfer.

We tried our best to proceed with this final transfer with less anxiety and expectation. I wanted to be as calm as possible and not let my past failures affect my optimism for the next impending transfer. To my surprise I was able to do just that. We decided to transfer two donor egg embryos, and we waited. About three days before I was supposed to take a pregnancy test, I talked myself into taking one. I remember sitting in the bathroom staring at the stick and seeing that positive pink line coming into view. So many emotions and thoughts ran through my body and mind, and I was overcome with pure joy. Despite the worry and fear that still plagued me, I conscientiously made the decision to allow myself to rejoice, if only for a short time. I knew that a long road awaited me, but I remained hopeful. I was pregnant.

With twins!

After a complicated pregnancy that included two months of hospital bed rest from 22 to 30 weeks of pregnancy and an urgent and difficult delivery, Remy Vaughn and Sydney Renee joined our family at 31 weeks. They spent several weeks in the NICU but are now home and thriving. I, on the other hand, am still recovering. I had a lengthy hospital stay, traumatic delivery, and postpartum depression. I am recovering from the fact that my pregnancy was spent in unease and praying that I would be able to bring my babies home. Although I wasn’t able to experience pregnancy the way I had envisioned—no baby shower, no fancy maternity photos, no nesting—there is one thing that I was able to do that I have yet to share.

My husband and I would often take long walks along the bayou near our home and talk about our longing to become parents. The bayou became a place for reflection and planning for us during our difficult journey. It was on these walks that I often told my husband that if we ever did become pregnant, I just knew we would have twins. He, of course, would just smile and say, “We’ll see…” Once that turned out to be true, I had a strong desire to acknowledge the woman who made my pregnancy possible. I wanted to show how grateful we were to Tara for her selfless act and the beauty of what we had all created together. I reached out to her about doing photos with me, and she agreed.

We all met with Tara last summer when I was about 20 weeks pregnant. This was my husband’s first time meeting her. She was so beautiful and gracious and made us feel so at ease. We spent an afternoon taking photos and casually talking about my pregnancy. Again, I studied her face, her hair, her eyes, her walk, her voice, and her mannerisms, just trying to memorize what one day I may see in my babies in case I would never see her again. Little did I know that that would be the only way we were able to formally commemorate my pregnancy.

Nothing about my journey to become a mother has been typical. I may not have been able to experience all of the typical things that a pregnant woman experiences, but what I do have are beautiful photos of my barely there belly bump with my husband and the woman who made my dream of becoming a mother a reality. I also have two beautiful babies who make every tear I ever cried worth it. For that, I will forever be thankful.

Shannon M. Clark, M.D., is a maternal-fetal medicine specialist at UTMB in Galveston, Texas, and founder of babiesafter35.com.

We at Egg Donor & Surrogate Solutions are so happy for Dr. Shannon & her beautiful family! We are always here as a resource to help support our families as they navigate these tough decisions.