If someone had asked me five years ago what my goals were when I first started to make appointments with the health system to check into becoming a single mom by choice, I would have said:
I want 2 kids.
If they had given me a plan to get there at the age of 38, I believe I’d be in a different place now. In my experience, it is the rare fertility doctor who asks you what your family plan is and helps you build one to achieve it.
I was also very worried about being able to manage as an SMBC. I was concerned that it would be too much financially, that I wouldn’t be happy with the donor (so why bank embryos?), that I’d want to stop at one. I was convinced that I should be happy with one child.
I wasn’t prepared for the enormous sadness I would feel at not giving my child a full biological sibling.
Here are the mistakes I made, in hindsight, because I had to learn as I was going on the way.
1) Not considering freezing eggs in my early 30s
Egg freezing can work, but eggs are delicate (see #2 about attrition rate for donor eggs).
You need a lot of eggs to be successful, which is why younger women who freeze their eggs might have a harder time with IVF than older women. These younger women are given more hormones to squeeze as many eggs out of them as possible. Many protocols for older women who are trying to actively get pregnant, on the other hand, are usually aimed at “quality over quantity.”
One reason you need so many eggs is to assure that you get more higher quality eggs. Even in a 20-year old woman, nearly a quarter of their eggs are estimated to be poor quality. Since eggs cannot be tested; the only way to know is to first fertilize them, create embryos, and then retroactively determine that the eggs might have been of lower quality.
For women after 35, however, it’s a whole different ball game. Egg quality has started to decline, and you’ll need more eggs to find ones that will make it to fertilization and blastocysts.
Embryos, on the other hand, freeze much better and can be tested to assess their quality (though it’s somewhat controversial). Once you test them, you may possibly find the ones most likely to take, and have a shorter path to pregnancy.
Though I have to say egg freezing wasn’t as popular or subsidized where I live until after my son was born.
Tip: Freeze your eggs in your early 30s or freeze high-quality embryos (day 5 are preferred).
2) Thinking donor eggs are a foolproof good backup
Most SMBCs only fall on donor eggs as a last resort, after becoming ineligible for IVF, or after being told by the doctor their eggs are not a viable option, or after simply running out of time and money and learning that their embryos aren’t healthy enough to sustain a pregnancy.
A small voice inside of me told me after my first child was born, that OK, if another biological child isn’t in the picture, I could use donor eggs or adopt an embryo. It didn’t seem that far-fetched, as I had already thought of adopting before I had my biological child.
The thing is, donor eggs aren’t a sure bet either. In fact, nothing is.
When you look at donor egg packages, they come in sets. I looked into one package at a private clinic that had 8. That’s a good number, and I was fairly sure that for $30K I’d get a baby. I was concerned that since my bio kid had access to an “open” sperm donor who agreed to be in contact after age 18, any egg donor conceived child should also have that possibility for her bio mom.
The options were expensive.
Unfortunately, only many months of being in their system, when I finally learned the details from the doctor, the attrition rate went like this:
- With 8 eggs, understand that one or two of them won’t survive the thawing process
- A few may not fertilize or won’t reach day 3
- Not all will reach day 5
- Not all will test normal (apparently they only transfer PGS tested, 5-day embryos)
So after 8 eggs, I was to hope and pray that 1-2 viable embryos would reach me.
That didn’t seem such a sure bet anymore. I decided to go with a cheaper (e.g., state subsidized) package of 4 eggs for roughly $2.5K. Even if I had to do it multiple times (which now seemed quite possible), it would still be much cheaper, and possibly have similar success rates.
And this time I would know in advance that of those 4 eggs, not all of them would survive the thawing process.
Because no one from the medical establishment would have told me this otherwise.
Tip: Understand that donor eggs also have an attrition rate; it’s just a lower one than yours. Be prepared to have a failed donor egg as the success rate is only 50% per shot.
3) Starting with IUI and not going straight to IVF if you want more than one baby
It is difficult to envision the future as an SMBC.
- Will you get married?
- Will you have an easy baby?
- Will you be satisfied with your sperm donor?
- Can you afford to me a mom of one, let alone two?
I had the attitude: Let’s start with one. So I was lucky to have my bio child pretty quickly by the 7th IUI.
I was afraid of extra hormones in my body, since I had a nasty reaction to hormone-based birth control pills only a few years earlier. I also had a polyp right after my first IUI after starting treatments with my second child. When I switched to IVF, I had a estogen-producing cyst for about 5 months.
My doctor poo-pooed my reaction to hormones.
I was also pretty nervous about switching to IVF because I also already understood the system for IUIs and simply didn’t want to change to another one (different bureaucracy here).
I was also aware that most medical insurance companies mandate women to start with IUIs before going to IVF.
In hindsight (which really is 20-20), if I had started with IVF with my first child I may have:
- Been able to save enough embryos for baby number 2
- Have gone through less than 6 cycles of IVF (which is what I stopped at by age 43.5)
- Saved a lot of time and aggravation
You live and learn I guess.
Tip: If you’re thinking of having 2 children, consider moving to IVF quicker rather than later. It’s not so bad.
4) Not realizing your body will need a break after baby number one
Do you want to breastfeed your firstborn?
Great. But you’re not supposed to do IVF when you are breastfeeding, since they aren’t sure of its effects on your baby. I suppose you could lie, which I’ve seen women attest to on the SMBC forums. I imagine the risk is probably very very miniscule, but since they run almost no studies on pregnant women ever (they don’t line up for studies done on their unborn babies), we don’t have evidence one way or another.
Many women also don’t get their period for anywhere from six months to years after giving birth.
If you don’t have a period, you can’t do IVF, since they can’t accurately measure your estrogen and progesterone levels. Both these factors delayed me.
Tip: Consider starting IVF earlier if you’ve had a baby closer to 40 (if you haven’t frozen your eggs or embryos). You are more fertile during this time, make the most of it!
5) Plan as though there will be delays
When my son was 3 months old, I made an appointment to see the fertility specialist. I couldn’t really think about being pregnant again, and I knew I couldn’t start IVF while I was nursing, and it was really important to me to nurse him.
I postponed the appointment to 5 months.
Guess what? COVID happened, the world shut down, and I decided having a baby wasn’t vital in the midst of a global pandemic. Plus, they strongly urged anyone to stay home unless it was really important.
I decided blood tests could wait.
What I didn’t know was that the results for the genetic tests would take 2 months – yes!
The results for the pap smear would take 5 weeks.
(Actually the genetic tests would take closer to 5 months because the hospital and state ministry of health could not decide on exactly which set of genetic tests I needed… these were tests I could have done without having a period or stopping breastfeeding and I am now kicking myself for it).
Tip: Be sure you have all of the bureaucracy you can out of the way before you start IVF. You can start while you’re on maternity leave.
You Can Change Your Attitude but Not the Past
We live in a world of many, many options. As a minimalist, I don’t think it’s problematic for us as a society, and I plan to write about this more in our blog. But in terms of fertility, creative family planning is a blessing for so many of us. Instead of focusing on what you could have done differently, you’ll need to embrace the options available.
Today I can tell you with complete confidence that my decision to have my son was one of the best things I’ve ever done. I’m sure that I’ll come to the same conclusion with any future child of mine from an egg donor.