Donor conception and surrogacy

Aisha has low ovarian reserve. While she had her first child via IVF, she has not been able to have a second and is now considering egg or embryo donation.

So now we're at the stage where I had advertised for an egg donor within Australia. Unfortunately I haven't had any success, but my clinic does offer embryo donation. So we're currently on the waiting list and hoping that in the next few months we will make it to the top of the waiting list and be in line for embryo donation.

That did take definitely a bit of a mindset change. There was a bit of a journey for us to go from being blessed with a child of our own DNA and thinking that we could still have a second one to accepting that we would have to use an egg donor but at least use my husband's sperm and then another - then having to go to using an embryo donated from another couple or another family that would have no genetic link to us.

But I think by now we've decided that our wish is to raise another child and not to have much more than having that genetic link. We're lucky enough to already have one child who is genetically linked to us but, we just want to have the opportunity to raise another child.

I think since I went on Egg Donation Australia, I’ve seen everyone else’s stories and I think that’s actually made me feel very lucky because I’ve seen so many other people’s stories where they haven’t had any children and they’ve been trying for, you know, 10 years.

It’s made me appreciate, and I always try to remember that we were so incredibly lucky to get pregnant with my son. So I try to make sure I keep appreciating that, though it is still very hard, I think, seeing other people around me have their second children and get pregnant very easily.

As a result of fibroid disease, IVF was unsuccessful for Andrea and she had to have a hysterectomy. She recounts her experience of coming to terms with the idea of surrogacy.

With our specialist, he did say to me once, in one of those conversations around how I was tracking, and how we were feeling about it all, he said, “I know you don’t - I know how you feel about surrogacy,” he said, “and obviously there’s a lot of emotional stuff that goes with that,” he said, “but if we can park the emotion just for a minute, and just think about the brief” - and he said, “when you came into this office, the brief to me was, ‘I want to have a child that’s biologically mine.” He said, “Based on your situation, and what’s happening, and what we’re finding out, my recommendation to best answer that brief is surrogacy.”

That was kind of an eye-opening moment, where I was starting to realise that there’s a really good chance that I can’t get pregnant.

I think the light was dawning on my husband too, towards the end of those transfers, and seeing my periods change. So, we were starting to talk more about surrogacy. Also, at that point, kind of in those few months leading up to the hysterectomy diagnosis, my best friend, who I have – she's like a sister. We lived a street from each other from the age of 13, so super, super close, and she’d been with me through all of this. She had started talking very seriously to us about offering herself up for surrogacy, and of course, delicately. I’d say, “Thank you, but no, thank you, but no, thank you, but no.” But we both were aware that finding a surrogate wasn’t actually a barrier to us doing that. That was there, but it was more comfort levels with the whole idea, and that was like – as I said, if IVF was, ‘I don’t want to touch that,’ surrogacy was just – [laughter] yeah, ‘Forget that, just forget it,’ basically. ‘No way, I would be too jealous, no, not doing it.’ So yeah, so I had a hysterectomy three weeks later.

But over the course of that year, I went and saw a psychiatrist, to really work on accepting – what I wanted to do, is I wanted to understand whether I could get to a place of being able to do this surrogacy thing. I thought, for me, if I do some work about trying to get to that place, but I still don’t want to do it, then I’ve done everything – I’ve given everything the best possible go, but if I don’t do that, then it’s probably not a good idea just to make a flippant, ‘I’m not going to do it,’ thing.

I guess, what I decided with that, was that I’m never going to be 100 percent comfortable, there’s so many unknowns. It is very unusual, but you’ve got to take some risks, and go with what you know. For me, I did not doubt my best friend. I did not doubt our relationship. We are so open and honest with each other. I knew that we would talk to each other, we would do what we’d need to do, to be comfortable through all of that. Plus, the process itself was very intense. It doesn’t kind of leave gaps, in terms of being prepared for what you have to do. There’s always the unknown that can happen, but you have to go through a very extensive process to even be allowed to do surrogacy. It may have gotten better since I did it, but yeah, it’s a long process. So, I thought no, I’ve got to trust that.

Max and their wife initially thought they would use a known donor but ended up opting for a clinic donor as decided it would be less complicated.

So originally we had thought about using a known donor so we had a couple of conversations with friends of ours in Australia and friends of ours in the US around parenting and what that would mean in terms of having a donor. We had in our heads been quite clear that having a sperm donor to assist us to conceive would be that the legal responsibilities and the parental responsibilities would sit with us purely.

Then starting to have conversations with people that could assist us as a sperm donor that some of their expectations about what that would mean for them were quite different to what we had wanted like, ‘Well what happens if we want to move? Or what happens if we want to send our child to this kind of school or this kind of school? Or what does it mean for us as parents of the way that we want to bring up children?’

I think we got to the point to have a third party and potentially then that person having a partner as well - having four parties involved in discussions that I think are quite complex with just two people to have, we got to the point of, ‘It's perhaps better for us to go through the clinic and have an anonymous donor,’ purely just because I think in terms of the changes that had happened here recently around both of us being able to be on the birth certificate and both of us being now considered legally married in Australia, whereas when we first got married in the US that was not the case here. Our marriage wasn't recognised.

We just were like, ‘Let's simplify everything and we're able to make the decisions around school and where we live et cetera with just us so maybe that's better.’ I think we both had this picture of what it would mean to have a donor that we knew that could be like a special uncle or play an important role in our children's life. But I think at some point it became a little bit complicated in having those conversations with people. As much as I think it could be a really beautiful thing for families and for a child we just said, ‘Let's just go through the clinic and do it that way.’

Sarah, a solo mother by choice, had her first baby via IUI but to use the same donor for her second baby meant going through IVF. Despite the extra cost, having the same donor was very important to her.

Sarah: It was very important to me, especially because she was a child of a single mum, and I used a donor, I really wanted her to share that experience with someone. You know, growing up. I wanted her to have a sibling to share that experience with, and when they’re older, I can imagine them talking about it.

So, yep, I always knew, even when I had my first child, the first thing I did after I got home and I was recovering, I rang the clinic and I reserved more of the same donor. Because it was also really important that they had the same donor. So, yeah, I had already organised that straight after my first daughter was born. So, yep, there was no question I was going to try again, and I had such a great experience with my first daughter. She was a beautiful baby, really easy toddler. I loved motherhood, I hadn’t really struggled much; so I was more than ready to try again.

Interviewer: So then from there, how did the decision to then step up to IVF happen?

Sarah: Yeah, so, pretty much because I had done my two IUI cycles, I had used up… So, I could only reserve two of the same donor at a time, so I had used up my two vials of my donor. I rang the donor team and requested two more of the same donor, and they said there was no more vials left that were suitable for IUI; there was only vials left that were suitable for IVF.

So they gave me the option, I could still pursue IUI if I wanted to, but I would have to choose a different donor; but if I wanted to use the same donor, I would have to move to IVF, because that’s all they had left. I had a think about it; I had to weigh up the financial repercussions, and obviously moving to IVF was a really big step, because I didn’t know what that would involve. But at the end of the day I really wanted to try with the same donor. It was really important to me to try to have the girls have the same donor, and have that connection. So, yeah, I just made the decision that I would move to IVF.

In deciding to have a child on her own, Elena researched donor conceived children's experiences. She has also connected with other solo mothers by choice so that her son grows up ‘surrounded by people with a life like him’.

It was definitely a long journey to coming to the decision to have children on my own and I think a lot of women that I’ve met in a similar boat, we talk about a certain amount of grief associated with letting go of the idea of the type of family we might have and embracing this new type of family that we can have. Yes, it’s definitely a journey and it’s not an easy decision to make.

I did a lot of reading around children who were donor conceived. There is a lot of data around same-sex families and I guess that is slightly different because you have two parents that love you instead of just having the one. But all the psychological research was very positive around children who are donor conceived to families that are same sex without having a father.

I think for women that are considering being a solo mum by choice, when you start your journey you feel like you’re the only person in the world in the situation and there are so many of us out there. There are support groups on Facebook that also meet in real life and I now have this massive network of mums like me. Also really importantly children like my little boy, so he will grow up surrounded by people with a life like him.

I think all of that is important and certainly having the support of friends and family is also really important. He has many male role models in his life that love and adore [him], and he loves and adores. I don’t feel like he is going to miss out on anything for the decision that his mum made.

Although Kim ended up using a known sperm donor, she had initially planned to use a clinic donor. She shares her experience of looking through the database of donors available through her fertility clinic.

My first cycle was this year and I decided to use a clinic donor, got through all the counselling sessions and then got access to the database and the first time I got in there I think I was extremely disappointed about the calibre of donors I suppose. I think maybe my expectations were kind of high so that was a bit confronting.

The first thing was that there weren't very many donors in the bank at that time. I think when I initially looked at it there was maybe 15, 16 I think to choose from and then about half of those were non-Caucasian which was another surprise I suppose. Kind of a surprise in that there was that proportion of non-Caucasians but also there wasn't much diversity in the non-Caucasian side of things. I don't know why, I just thought that it would be more diverse.

So when you do your counselling they always say if you're thinking about having a donor that isn't the same race as you then they ask you to think about that in terms of raising a child who's half another race. I think they usually ask you to do a separate counselling session if that's what you want to do. So that was something else to think about. I think when I had decided to choose a clinic donor I was going to go with someone who's Caucasian. I'm mixed myself. I'm English and Chinese so it wasn't so much about having a mixed child but the consideration was not having that person of that race around to give that sense of identity. So that's why I thought I would go with someone who was Caucasian and also I suppose there was more of a chance that the child would look more like me so it would avoid questions in future from other people so that was another thing.

In terms of other things I suppose almost all of the donors had some sort of medical background issues, nothing that would prevent them from being donors obviously but pretty much all of them had something that was declared on their profiles. The donor that I eventually picked, he was on medication for migraines and asthma I think. So, yes, just little things like that which I suppose is fair. Everyone's got something I suppose generally.

Then also a lot of the donors seemed to be of an older batch because you can tell by the codes and by the dates on the forms kind of how long they've been in the system.

So there seemed to be a lot of them that had been maybe hanging around a long time and a lot of the older donors don't have baby photos. It's something that my clinic has started asking them to provide as a bit of additional information but that's only for recent donors. They haven't done that in previous years. So you can kind of tell which ones are the newer ones.

Also the way that they have filled out their forms because there's a section which - well there's quite a few sections where they get to write things about themselves and write a message to the donor child and to the recipient. So just reading some of those some of them it felt like they hadn't put much thought or effort into it. So, yes, there were quite a few of them that I didn't really gel with I suppose.

I asked my counsellor about that. She said that I think in recent years they've started to counsel people more about what they should write in the profiles and they should think about it a bit more and think about it from the point of view of the recipient and the donor child because that's basically all you get until the child is 18 or if the donor decides that they want to have some contact or meet you or whatever. So that's all you've got to go on really and that's all that your child will have to go on to make some sense of who this person is. So, it's pretty important.

Kris was diagnosed with early menopause at age 34. She had her three children via IVF using an egg donor in the US.

We went back to see a different specialist, and he said, "Well, you know, this is early menopause." There were very, very, very limited chances if anything, with my own eggs, because they didn't really exist anymore. I had maybe two or three follicles that were left. But he mentioned in passing that donor conception might be something we'd be interested in, but that really the first point was to speak to a fertility counsellor just so that we could understand what we'd just been through.

So then we went down the option of exploring ways we might be able to conceive a child with donor eggs. the first thing we did was, because we'd been quite open in talking to people about our journey as we were going through, all my friends knew about what we were doing in terms of where my fertility was at. Everyone was sort of... Even though the conversations were pretty raw, it was because all of my friends at the same time were going through having their first child or having their second child or having very young children. So the doctor we were seeing said, "Is there anybody within your network?" I don't have any sisters. I don't have any cousins that are close that were in that age range. There really weren't any options for us within our close network that we could look at around, whether we might be able to ask them the question about sharing eggs.

So at that stage, this was 10 years ago there wasn't a lot of information about what we could do in Australia in terms of... I know there's now more networks in terms of where women are prepared to share eggs at that stage. It was a process where you needed to advertise, so – and there seemed to be a lot of roadblocks. So we ended up looking to an overseas agency in the US.

So that's where we ended up looking and trying to find somewhere which was sort of aligned with our values and somewhere where we could still have an arrangement where our kids could contact a donor in the future, if they wanted to have a relationship or wanted to have a conversation or just know a little bit more about their identity and then we began the process of preparing my body for IVF through donor conception as well.

So we prepared when we were in Australia and then we went overseas and went through the whole process at the same time as the donor did over there. So that was interesting. There was lots of injections of things like progesterone and oestrogen, there was preparing the lining of my uterus. And then there was that wait when the eggs were fertilised and it was the same process of ICSI, but with my husband's sperm and with the donor’s eggs and just the waiting process.

We were very, very, very lucky in that it was very successful in terms of her egg production, because she was younger, she was 28. We were able to conceive twins out of that process and still have some embryos stored for what ended up being my son two years later. So we now have three children through that process. I was able to carry all three children successfully and I was able to breastfeed all three as well.

In her previous relationship with a trans man, Tallace tried to get pregnant via home insemination. She describes the process.

So, I knew a few lesbian couples who had gotten pregnant with home insemination, so it was certainly happening in my community around me. So it felt like the best option for a starting point. But the real stumbling block is finding someone that you feel comfortable with as a donor, and that took a while to work out who I thought I could ask, and then have that conversation. So we had an agreement about what his relationship would be with us and any potential child. I am a qualified lawyer, so I knew that that wouldn’t be binding in a court, where the best interests of the child is the overriding consideration; but it was a really helpful thing to do, in terms of clarifying intentions and expectations.

So, once we’d got all that done, it was sort of the nuts and bolts of understanding my own cycle. I have a short cycle, and so it was trying to work out whether… I think it’s called a luteal phase, whether that was long enough. So I was tracking, using a thermometer, my basal body temperature; and I was using an app to track all my symptoms. I suddenly became very well acquainted with the different kinds of mucus that your vagina produces; which I certainly didn’t really understand or know about before. [laughter] So suddenly was really excited to see jelly.

Yeah, so that was quite intense. It’s quite an intensive thing to do on your own. I think you don’t need a doctor to oversee that if you can inform yourself effectively, which you’d hope I could, because my professional background is research. Not medical research, but you know, I know how to get information.

So I did that, and when it was the right time, when I thought that I would ovulate the next day, or that day, I would arrange to go over to my friend’s house, where he would masturbate into a latex-free condom, because that seemed… Our first try, he used an open container, and that was very awkward to then suck up the sperm into a syringe. So I just had gone to Chemist Warehouse and gotten a bunch of single-use syringes.

So then he would come out and hand me this warm little bundle, and then I would go… He’d have a cup of coffee while I went into his bedroom with my partner, and we’d use the syringe to suck up the sperm and squirt that as high as we could inside me, and then I would lay there for a few minutes. Then we’d say an awkward goodbye… [laughter] And then potentially come back and do it the next day or the day after, for that cycle.

So I can’t vouch for that process, because it didn’t work. [laughter] But I think roughly that’s what people do, who have had success as well.

After unsuccessful IUI, Max and their partner had to choose a new donor with lower quality sperm for IVF. This was due to a sperm donor shortage and because IUI requires more sperm than IVF.

So we made the decision, ‘Okay, yes, let's use a clinic donor and let's go to this major clinic.’ So we went there and then what actually happened was that there was this massive drought. It was like a donor drought.

We ended up waiting I think maybe a year. It was a really, really long time. I remember thinking you see these movies and stuff around people flipping through these massive folders of sperm donors and, ‘Oh do we want this? Do we want that? Oh yeah!’ Like it was some kind of catalogue. We waited I reckon about a year and then finally the clinic got back to us and they were like, ‘Oh, really happy to let you know that we can pass on your options,’ and basically we had one option. There was one donor that was given to us as a choice.

So it was hilarious to come and wait 12 months and then get one donor [laughter]. We were just like, ‘What? This is not like the movies!’ So anyway that one donor seemed fabulous and we were like, ‘Yep, let's just go with it.’ But it was such a different experience of what you kind of imagine. So we ended up going through IUI with this particular donor. I did – I can't remember if it was two or three rounds of IUI with the donor – and I didn't get pregnant.

So then at that point the IVF specialist was like, ‘Okay so you've done this amount of IUI so now you can go to IVF.’ What happened then is that they then were like, ‘So now you have to have a new donor because the sperm that we use for IUI versus IVF is a different grade,’ and we were like, ‘What?’ They're like, ‘Well with IVF you can pretty much use sperm that's not as high a quality but for IUI it has to have the particular amount of sperm count.’ So it meant that we had to go through the process of choosing another donor. It was really interesting because I think originally we had this real idealisation of this person that could potentially be in our life and this was going to be someone that could fit in with us if our child ends up deciding that they want to spend time with them.

So we then had to go back to the drawing board. So each time we had decided on a sperm donor we then had to go through the process of paying more money, putting in a certain amount aside and kind of freezing a particular amount of sperm to us as a family.

Andrea describes her experience of undergoing gestational surrogacy with her best friend as the surrogate.

So, my best friend and I talked at length, a lot, about how we’d scenario manage all the different possibilities, way before we two couples came together and went and saw my specialist again, and said, “Yes, this is something that we want to do.” I think – we didn’t really end up seeing him probably until close to 12 months after my hysterectomy.

But one of the things I did do before we did that is, I did go and do another round of IVF, reluctantly, but I did it, to produce and bank some embryos, because best to have those embryos at the youngest possible condition, then figure out later what to do, rather than while I’m umm-ing and ahh-ing for a couple of years maybe, my body’s aging at the same time.

Yeah, so we’d done all that, and then we went through the process of getting ourselves ready to go and be approved, fingers crossed, to the surrogacy experience. That was multiple counselling sessions, psychological assessment, psychological report for all of us, two sets of couples, and individuals. We had to meet with lawyers, understand what an arrangement actually means, even though there’s no formal contract, you still have to go and have a legal discussion. There were some usual police checks, working with children checks, and some bloods and medical checks, to make sure we’re all healthy beings, and not going to infect each other, and all that kind of stuff. So, that whole process took about eight months, and we did that as quickly as we could do it. So, long process.

Then, we fronted up to a panel of all these people that we didn’t know, who then were making the decision about our fertility future. we all kind of left that thinking, it’s really good that we are the kind of people, particularly my best friend and I, who are more extroverts, and just by nature, more comfortable and able to deal with these sorts of situations, that we can get through that and actually not feel – yes, you feel intimidated, but not take it all too hard. I think some personalities would struggle. I just think it’s just a really unnatural kind of thing to have to go through.

So, then we started working on tracking my best friend’s cycle, once we had been approved, and I had had a really good result again, with my husband, for our embryo quality, so that was really great news. We’d taken them all to, I think, day five, so we had the best possible chance. The first one went in, it didn’t work. It was odd, because my best friend had to share details of her cycle, and how she was feeling, and we just kept joking about how ridiculous this was. But yeah, so that didn’t work. The second one, we had to cancel the cycle, just because there were other factors that meant that it wasn’t going to be a viable cycle.

Then, on the third one, it did work. So, we got pregnant. I remember getting the phone call, because I got the call before – we elected that I would get called first, then my best friend would get the call from the nurse. I was like, ‘What?’ I felt very shocked. Then, I felt extremely scared, because it suddenly meant we were doing the surrogacy thing, and this whole emotional journey about, ‘Don’t be jealous, don’t be jealous. Don’t be jealous, don’t worry, you’ll be fine.’ All these little paranoias started to creep in very, very early. So, I actually wasn’t joyous, I was just – almost terrified about what was going to happen. Within, I suppose – and my best friend was amazing with handling it, because she understands me, knows me very well. She was amazing, just supporting me, and not expecting me to be jumping off the ceiling. She was just really supportive. And the nurses that were available to me through our specialist were amazing, as well. Our whole support group was really good.