The Last Fertility Taboo

Photo-Illustration: by The Cut; Photo: Getty Images

Swellness” is a monthlong series exploring the health and wellness stuff no one talks about.

After Chloe went through several rounds of IVF to have her first child, she was adamant she would be more open about the ins and outs of the assisted reproductive process the next time around. Chloe — who, like the other women quoted in this story, asked that her name be changed — intended to tell friends and even strangers she’d done IVF, hoping to make other women feel less alone than she had felt about how emotionally and physically taxing infertility can be.

Seven years later, Chloe, 39, finds herself pregnant again, but not talking about the process like she said she would. This time, it’s a bit different: After being diagnosed with empty follicles syndrome (in which no eggs are retrieved after ovarian stimulation) and suffering two chemical pregnancies, she relied on an egg donor. That is, she compensated another woman for her extracted eggs, something she didn’t do with her first. The pregnant mom is grateful to be expecting, but also cautious about divulging the egg donation, which she’s shared with just a few immediate family members. Even her father doesn’t know.

“My dad really loves our family tree and our family history,” she says, worrying that this penchant for genealogy might factor into how he treats one sibling over another. “It’s like it wouldn’t be his genetic grandchild.”

Today, many American women are waiting longer to have children, with the median age rising to age 30. The number of eggs — and egg quality — decreases with age, thereby necessitating the need for donor eggs. But while IVF is certainly more discussed than in years past, many women shy away from sharing that they used donor eggs in the process, even as the practice has been quietly increasing in numbers. A substantial 12 percent of all IVF cycles in the U.S., about 16,000 a year, involve eggs retrieved from a donor, according to the CDC.

Women who use donor eggs speak of shame, isolation, and pangs of inadequacy compounded by a clueless public still unfamiliar with what using donor eggs involves or means for the mother’s rights to the child. “Even women my age don’t know that’s a thing or what it entails,” says Chloe, who tried to gauge friends’ perceptions when contemplating using donated eggs. “A lot of them, their first response is, ‘Oh, is that kind of like adopting?’”

Chloe isn’t the only one confronted by this kind of feedback. In interviews with more than a dozen mothers who used or are pursuing donor eggs, the majority felt many people still harbor judgment and biases toward the practice. Women quickly rattled off well-meaning but insensitive comments or intrusive questions they’ve gotten from friends, family, and co-workers when they’ve brought up egg donation.

So, you’re just like the surrogate?
Maybe you weren’t meant to have kids.
Be happy with what you have.
Will you let the real mother see the baby once it’s born?
Perhaps you should have started sooner.

The most wounding, one mom says, is when loved ones express how they would never be comfortable forgoing a biological connection with offspring, calling it their “worst nightmare.” “It’s a little weird to hear someone say that about your best-case scenario,” she says.

Leah, 48, who works in business development, initially opened up to friends about her plans to try to use donated eggs. She recalls unexpected negativity from female friends who couldn’t fathom why she’d “bother” with IVF, let alone consider egg donation. They asked, “Why don’t you just live your life?” Or, “Why don’t you just adopt?”

In the end, she only divulged that she bought donor eggs to her mother, who is “pretty open.” (Leah is scheduled for a transfer soon). As she sees it, stigmatization stems from gendered expectations. Women are expected to be perfect, including when it comes to reproductive abilities; they’re held to a particular standard in terms of how to embody parenthood. “In order for you to carry and to give birth, it has to be from you,” she reflects, noting that pressure to contribute both a genetic and gestational link. (And she herself harbors complicated feelings, admitting that her plans to carry a child who might not look like her or any of her family members is emotionally difficult.)

When a woman can’t get pregnant, it’s “her fault,” adds Nina, 31, who turned to egg donation upon being diagnosed with diminished ovarian reserve. She felt like a “failure” when her body couldn’t perform a “basic” female function. “That’s what we were built for after all, right?”

Plenty also don’t feel like dwelling on infertility with people who haven’t experienced it. Too often, women are met with annoying optimism when they simply want to commiserate with peers. “How do I casually bring up in conversation that I basically have no viable eggs?” says Nina. “Or the child I’m carrying is one I have no genetic link to?”

Adoption often came up in these women’s conversations with family and friends as the preferred alternative to donor eggs, in part because it’s perceived as noble or altruistic, whereas some view certain fertility treatments as more indulgent or selfish.

Adoption, however, can be prohibitively expensive (while some health insurance covers at least part of the IVF process). And not everyone is a likely candidate: Heather, who works in health care, recalls, at 48, being put on a waitlist for a waitlist to attend an adoption info session and thinking, “Would somebody let us adopt if I’m approaching 50?”

She decided to pursue using donated eggs instead, but when she told her family, she received unsupportive comments like, “Just adopt a cat, just give up.” The most common feedback? “You’re too old.”

She joins a number of women who felt societal resistance to older maternal age, women in their 40s and 50s who are sometimes told by friends and family they should accept it “was too late,” which ignores that many individuals have different timelines for starting a family — or have dealt with health- or fertility-related challenges. “It’s like you did something wrong,” says Heather. “It’s your fault.” People will go so far as to say it’s cruel to have a child past a certain age — a concern, it should be noted, that is rarely directed at men.

Securing donor eggs, it would seem, comes off as unnatural or desperate to these commenters, by some women’s accounts. In their eyes, there is a traditional, suitable timeline that they missed.

But thorny ethical matters might also account for stigmatization; some people take issue with the commodification of eggs or what they deem a poorly regulated industry that often targets young, financially struggling women, many of them college students. A percentage of donors aren’t fully informed of what is a far more invasive process than supplying a sperm sample, and which can include painful side effects. Up to 15 percent of donors had immediate medical complications such as ovarian hyperstimulation syndrome, reports Diane Tober, Ph.D., a medical anthropologist and associate professor at the University of Alabama who studies egg donors. Moms have received responses such as, “Have you thought about what the egg donor physically goes through?” Or, “What if the donor regrets this decision in 20 years?”

Dr. Lauri Pasch, a psychologist at the University of California San Francisco Center for Reproductive Health who specializes in infertility and family building, says that she doesn’t think people people who make insensitive comments about using donated eggs are trying to be hurtful. They’re just ignorant about infertility struggles and the entire process. “They just completely do not understand,” she says.

When Nora started the egg-donation process at age 40 after having battled cervical cancer, she told her mother-in-law what she was doing. She was surprised when her mother-in-law asked, “So if you and my son ever got divorced, he could get custody of the kids because they’re not really your kids?”

Nora wasn’t angry. She understood the comment wasn’t meant to be hurtful; her mother-in-law honestly thought Nora wouldn’t have any legal claims to a donor-conceived child.

Indeed, egg donation isn’t all that visible, even within pop culture. Films, books, and TV shows involve nearly every other family-forming possibility save for egg donors. Some mothers also felt disappointed with older celebrity moms whom they suspect depended on donor eggs — because the medical odds are against a woman being able to use her own eggs past the age of 45 — but have never publicly announced it. While they acknowledge that all women have a right to privacy, the lack of disclosure feels like a confirmation: It’s not something you talk about.

Granted, some simply don’t think they need to explain their child’s conception any more than couples who conceived naturally. Others prefer to keep genetics a more private matter until a child is older. (The majority of women interviewed plan to or have already informed their kids.) Melissa admits genetics didn’t matter much to her, but she can’t predict what they’ll mean to her son. “I want it to be his decision if it’s out there,” she says.

Dr. Pasch recommends women who struggle with some of these issues find a support network — such as a therapist or resources via organizations like Parents Via Egg Donation — where they can feel comfortable sharing their donor conception story. The more stigma they face, the more likely they’ll not only be impacted, but their family too. Dr. Pasch notes that the American Society for Reproductive Medicine recommends sharing the story of donor conception with one’s child. Being secretive about it might delay this, “and then all of a sudden you have a teenager and then it becomes really difficult to talk about,” she says.

Ellen S. Glazer, a family building counselor and licensed clinical social worker, counsels women on deciding what they want to share with others, and ultimately leaves it up to them. “It’s your information, it’s your story,” she says. You can tell people, or not. “It’s your choice.”

Many find refuge online — on Instagram, in private Facebook groups, and in sub-Reddits focused on infertility. Leah soon turns 50, and if her upcoming transfer works, her pregnancy might raise a few eyebrows. “Janet Jackson had her child at 50,” she says. “But it’s Janet Jackson, right? Can you imagine telling anyone that you’re going to have a child at 50?” On Reddit, where members are dealing with similar issues and can be entirely anonymous, nobody cares. “You get the support that you wish you had everywhere else.”

Over time, a lot of moms say their children’s donor origins fade into the background; they just become your kids. And loved ones’ opinions and reluctance can also change.

Nora, whose mother-in-law once questioned her future custody rights, is now divorcing her husband. During the process, her mother-in-law came to her crying. “I always knew my grandchildren would be okay because they were with you,” she told Nora, but admitted, “I’m now uncertain about their father.”

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The Last Fertility Taboo