As an andrologist, I am the doctor who treats couples with male factor infertility. It is estimated that 50 percent of all fertility issues are male factor, and yet it usually comes as a shock, and may even bring feelings of shame. Men most often need a donor because they can’t make useful sperm or because they can’t afford the technology to use what they have. (One round of in vitro fertilization [IVF] with Intracytoplasmic sperm injection costs roughly $12,000, while one donor insemination is about $1,000.) I wanted to share these families’ stories to let you know that good things can come from this.
“I can love any child who is half my wife”
Stan was sent to me from his primary doctor for low testosterone. At 28 years old he had premature testis failure, the male equivalent of premature ovarian failure, when women begin menopause very young. This is one of the hardest conversations a doctor can have. The money it would have cost to treat him was the down payment they had been saving for a house. Using it for himself was out of the question for Stan. Even so, he and his wife needed time to decide between adoption, living childless, or donor sperm.
When Stan called back a few months later he told me that he had decided that, as long as the child was half his wife, he would love him or her. Once they had decided, I was able to treat his low testosterone and he now feels much better and ready to be a dad. Stan and his wife are six months pregnant with their first child and they plan to have one more.
“Accepting the need to use a donor was hard”
Tom came from a big family and wanted one of his own. When he and his wife, Becky, were told that he had no sperm, they were sure the lab had made a mistake. Once the test was confirmed, they decided on donor, but Tom kept hesitating to move forward.
For some couples, infertility is a long road and they are almost relieved to move on to donor. When it comes as a shock, the patient has to go through the stages of grief. I had Tom and Becky see a counselor who specializes in helping couples deal with loss. Tom had to grieve for the loss of a genetic connection to the large brood of children he had envisioned. Both men and women who need donors must go through this process. If the grief is never recognized, guilt and shame can come between spouses, and resentment can even overflow onto the child. Depression may need to be treated with medications, and denial can lead to inaction until it is too late. Marriages can be either strengthened or lost during this process, especially when spouses come to different conclusions. But with patient acceptance, a decision can be made on how to move forward.
Because most donor sperm is anonymous, profiles don’t usually include pictures. But using facial recognition software allowed us to find a donor who resembled Tom. This helped confirm the decision for him. Their beautiful daughter looks just like Becky, with Tom’s eyes. When she was born, Tom held her quietly for several minutes, then said, “You know, we did the right thing.”
Love has little to do with genetics
Donor sperm is frequently used by single women and same-sex couples, and it may be the answer for heterosexual couples with male infertility, but donor gametes should never be used until intended parents are sure they can accept the child they produce as their own. You don’t want unresolved grief to lead you to think, “My child would never have gotten a B in Math. If those had been my genes....” Try to think of it from the child’s perspective. When she looks at you, all she will think is, “That’s my daddy.”
Genes are funny things. Look at the families you know. Most children aren’t perfect little replicas of their parents. Many of us are a bit dumbfounded as to the origin of our children’s traits. As a reproductive scientist I believe that loving a child really has little to do with genetics. And as these examples show, everyone can have a happy ending.
This piece was excerpted with permission from Dr. Vereb’s blog at donormatchme.com.
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