April 4, 2007

Desperately seeking Scarlett

By Ryan Maloney
rmaloney@uwo.ca

Outside, the sun melts months of dirty snow as chipper students walk to class in short-sleeved shirts.

But if all the world seems cheerful this mid-March afternoon, the child, a three-year-old dealing with a nasty bout of the flu, is not.

"We're just going to make it flat," her mother says while shaking a bottle of ginger ale, her daughter nestling her tired head in the big arms of her dad.

It won't take, though. In half an hour, the girl will suddenly spit the pop back up into a clear, plastic bowl under the table. When that happens, both parents rush to help. Mom brushes the hair from her daughter's face. Dad dashes to find napkins.

Parenting suits this couple. They look natural. They look happy.

But the road to parenthood was long and winding. An odyssey of sleepless nights, hidden tears, miscarriages and hormone injections, scheming strangers and hours spent dreaming, hoping and planning.

This couple is infertile. One of more than a quarter-million infertile couples in Canada, according to recent statistics.

And, even with this girl and a two-year-old daughter at home with a babysitter, both conceived through intrauterine insemination, they are unapologetically desperate for a third.

They have a girl's name picked out: Scarlett. They haven't settled on a boy's name.

But what has worked twice already just won't work this time. And having already spent thousands, they don't want to try adoption at a cost of $20,000 in the optimism they'll conceive again.

Earlier this year they took out an ad in the Gazette, the irreverent student daily on campus, asking for what might be the missing link in their quest for another baby: an egg donor.

We'll call them Jenine and Aaron, but those aren't their real names. They opted for anonymity while making public so private a pain.

Jenine is a nurse, 39, with piercing blue eyes and short, dark brown hair. Today, she looks tired but content. She says being a mother is all she ever wanted to be and after years of coming up painfully short, she finally is one. A good one, she says.

Her husband, also 39, works with the provincial government. He has the slightest hint of grey in his dark brown hair.

They've been married 18 years and started trying for kids almost a decade ago. But nothing took.

In the fall of 2001, they found themselves in the offices of Southern Ontario Fertility Technologies in London - a fertility clinic that has helped create 1,158 babies since 2000 - starting the first of 32 cycles of intrauterine insemination.

Photo courtesy of SOFT

The Southern Ontario Fertility Technologies clinic has helped create 1,158 babies since 2000.

It's an unromantic way to make a baby, Jenine explains.

The woman sits in stirrups while a catheter is inserted through the cervix into the uterus. Her husband's sperm is injected. She lies on her back for 10 minutes. "Then you can go back to work," she says, laughing.

There's no candlelight, no wine, no Tony Bennett playing softly in the background: but if blessed or privileged or just plain lucky, a life begins.

Such was the case three years ago when, after a painful miscarriage kept her in bed depressed for six weeks, Jenine got pregnant and carried to term.

"It was the happiest time of my life," she remembers, gushing still about the sensation of a baby moving inside her.

Then, only three months after her daughter was born, Jenine was pregnant again. Why so fast? Well, she explains, her body probably wasn't ready, but, as ovaries stop working as consistently as a woman ages, they opted to move quickly.

"In some ways it's how you define who you are," says Aaron of the joys of parenthood.

So shortly after the birth of their second girl, this one a blond with blue eyes, Jenine and Aaron were trying once again. But when cycle after cycle of insemination failed, they graduated to the more complex process of in vitro fertilization. Literally, the fertilization of her eggs with his sperm outside her body.

A few months later, she was pregnant again. Sort of. It was a "chemical pregnancy," a phenomenon in which the blood work points to pregnancy but it's not viable.

Only a day after they went out to dinner to celebrate, she started bleeding. And she knew.

"It's still a loss," she says of that miscarriage. "Still a loss."

They would keep trying, knowing only that neither could imagine life without a third child. Knowing some might think it selfish.

"Nobody can decide what defines you as a family," Aaron says. "You have to do that for yourself."

But when told the quality of her eggs wasn't strong, they started thinking about donor eggs last winter. As the ideal candidates are healthy young women, they turned to student papers at Western and in Toronto and to infertility websites, asking for help.

It's illegal in Canada, under the Assisted Human Reproduction Act, for donors to be paid for their eggs. If it weren't, the couple say they'd gladly pay to secure a donor. After all, with rounds of insemination at $250 and in vitro more than $5,000 each attempt, they've already spent more than $16,000 this year alone, not counting the thousands covered by generous health plans.

So, offering only the promise of helping make a dream come true, the couple hoped for the best.

The initial responses were not from Good Samaritans.

They revealed an underground fertility world the couple, in hope or naivety, hadn't dreamed of.

One woman stepped forward asking shy of $10,000 for her eggs, politely informing the couple that donating was a "part-time job." Another man from Nigeria, claiming Aaron and Jenine were the "perfect couple" for his wife's eggs, was exposed as fishing for a plane ticket to Canada.

"So someone's monitoring these university papers," says Aaron, still amazed. "Scam artists from different countries."

But big hearts lurk in the silence, too.

They've had a handful of responses from young women considering donating.

Pat McCabe, nursing director at the fertility clinic, says it's always inspiring when young women make so bold a commitment for a couple they don't know. Just last month, an anonymous university student donated eggs for a different, desperate couple.

"They're amazing young women who truly want to do something good," McCabe says. "I don't really pry them about why."

But it's an intrusive process, to be sure.

First, a birth control pill shuts down the donor's natural hormone production. Then she gives herself one or two injections every day, for 11 days, of a follicle-stimulating hormone, pushing ovaries to work overtime - producing 10 eggs instead of one each month. The whole time the "intended mother" also medicates to get her uterus ready.

Photo by Ryan Maloney

Nursing director Pat McCabe says students who donate eggs anonymously are "amazing young women."

But the retrieval, done in a multi-million-dollar facility in Mississauga, is the worst part, McCabe says.

A big needle, mounted on an ultrasound probe, goes through the vaginal wall, piercing the ovaries. "You wouldn't want to see it first or you'd be running," McCabe says of the needle.

Follicle fluid is extracted, "like stabbing a grape and sucking all the stuff out from inside but leaving the skin intact," as Jenine puts it.

And inside that fluid are eggs, the size of dots of sand, which are placed in test tubes, handed to white-coated lab-technicians and incubated with sperm for 18 hours.

"At the end of the retrieval the donor's part is finished," McCabe says. "And we may never hear from her again."

Sometimes it works. Sometimes the expected mother is left expecting.

Dr. Christopher Newton, clinical psychologist with the reproductive medicine program at London Health Sciences Centre, has counselled infertile couples for nearly 20 years. He says women are more affected by pressures to conceive than men.

"There are just more social reminders," he says. "Women are more likely to talk about pregnancies and recent births and children. That's not a typical topic among men."

Jenine knows this elephant in the room quite well.

It hurts, she says, when everyone around you seems to be getting pregnant - quickly, effortlessly and coinciding always with agendas and organizers. Hurts when you can't concentrate on work. Hurts when well-meaning friends and neighbours ask, "So whenya having another one?" And some days, like when the unwanted period arrives, even the hope hurts.

But there are moments that keep them going. Like when their child jumps in their bed on a Sunday morning. Or when they recall the buzz of seeing a belly grow. Maybe even when a sick little girl looks upwards for help.

The little things, they say.

"Now that I know what it is to be a mom, I'm more desperate for the third than the first," Jenine says.

So, they remain hopeful. Hopeful that a stranger they plan to meet in a few weeks may have inside her the stuff needed to give them life.

They'll meet over coffee. And, like today, they'll be well-worn but courteous.

Dreaming all the while of Scarlett.