Americus Dotter and other authors tell often harrowing, lonely, yet inspiring tales of their experiences with fertility
Americus Dotter
Recent discussions in my book circles involve harrowing tales, now published as books by former egg donors.
Some criticize the fertility industry for its "dirty little secrets."
Being a book reviewer, this topic was one that -- while it did not take me by surprise -- it certainly necessitates further research on my part to familiarize myself with various aspects of this increasingly complex issue.
Egg donation is the process by which a woman provides one or several (usually 10-15) eggs (ova, oocytes) for purposes of assisted reproduction or biomedical research. For assisted reproduction purposes, egg donation typically involves the process of in vitro fertilization as the eggs are fertilized in the laboratory; more rarely, unfertilized eggs are frozen and stored for later use by the intended parents. Egg donation is part of the process of third party reproduction as part of ART (Assisted Reproductive Technology). The ASRM (American Society of Reproductive Medicine) has issued guidelines for these procedures, and the FDA has a number of guidelines as well. There are boards in countries outside of the US who have the same regulations.
The discussion among my author friends involves emotional, physicial, mental and spiritual harm done to women who choose to be egg donors.
Columbia University's Go Ask Alice site give a glimpse:
Egg donation — what's the process and is it safe? | Go Ask Alice!
No matter how factually informed and emotionally prepared potential egg donors are, the process itself is complicated, and can be frightening, uncomfortable, and even painful. Unlike sperm donation, which is relatively quick and easy, egg donation requires medications and an invasive procedure to retrieve the eggs. Once a woman has been selected as a donor, she is taught how to give herself daily injections of medications and fertility drugs (FSH and LH) for 3 to 5 weeks. The fertility drugs stimulate multiple eggs to develop, and their maturation is monitored by ultrasound examinations. A drug (such as Lupron) that temporarily prevents the ovaries from releasing a single egg each month (which is a typical menstrual cycle) is also administered by daily injection. Women resume menstrual activity shortly after stopping these injections
Potential risks for women egg donors include:
- bruising or hemorrhaging of the ovary from the needle used to retrieve the eggs
- ovarian hyperstimulation syndrome — nowadays a very rare occurrence, this is a series of negative side effects experienced over a two-week period following the release of a large number of eggs. This condition is caused by high hormone levels resulting from hyperstimulated and enlarged ovaries due to fertility drugs, particularly FSH, used for egg growth.
- long-term consequences that are not fully known
In Soul Sale: A Rude Awakening, Americus Dotter does a great job of helping the reader feel some of the pain of psychosis, in a tale weaved from her real life experiences. The book explores the issue from several perspectives. She offers stark implications for bioethics.
Elements of fantasy and reality are weaved to give readers an inside look at one woman's remarkable journey. And while the darkness is spelled out, the book also offers inspiration for women, in the end.
About Americus Dotter's book, an amazon reviewer wrote:
I walked into a local bookstore to see an artist book signing. I love to read and thought I don't do much for myself, I am going to buy this book. I didn't ask what the book was about and I have never just walked up to an author and purchased a book. I was drawn to this woman it was as though I was following a beacon, like something told me I had to stop, I could not pass up this book or meeting.. I am personally dealing with much more than I can handle at the moment and this book and the authors experiences let me know I am not alone. No I didn't have the same experiences and do not have the same exact mental issues. However, I have had or do have many of the same thoughts and feelings.
During my tour through the author's experiences, thoughts, and feelings, I laughed, I cried, I related, and I was motivated to take my own life back to find happiness again.. When this book becomes a movie, if it isn't to scarey,I would love to see it.
COUNTERPOINT: In researching the flip side,
this study, Multiple Egg Donations Do Not Impair Donors' Future Fertility, offers a recent response on one concern:
Researchers at Weill Cornell Medical College in New York City reviewed all egg donor charts from January 2004 to April 2012 to identify patients who had completed five or more egg donation cycles. Records were examined for donors' starting Anti Mullerian hormone (AMH) levels, cycle characteristics - amount of hormonal medication and number of days medication was administered, and number of eggs retrieved. The average patient age at first donation was 26.4 and, at fifth cycle, 28.7.
The researchers found that, although the starting dose of gonadotropin used to stimulate ovulation in the first cycle was significantly lower than that required in subsequent cycles, the total amount of gonadotropins used was comparable through multiple cycles. The other measures were comparable, too, over five to six cycles, with average days required for stimulation ranging from 9.4 to 10 and the average number of eggs retrieved ranging from 20.9 to 23.8.
"This retrospective study is reassuring in that egg donors who undergo up to 6 cycles do not have evidence of depleting their ovarian reserve, which bodes well for their future fertility" notes ASRM President Linda Giudice, MD, PhD. "It also underscores the importance of careful monitoring of egg donors prior to starting medication in order to minimize the risk of ovarian hyperstimulation syndrome."
Are there more questions than answers?
There are several ethical issues associated with infertility and its treatment. Here are some of them:
High-cost treatments are out of financial reach for some couples.
Debate over whether health insurance companies should be forced to cover infertility treatment.
Allocation of medical resources that could be used elsewhere
The legal status of embryos fertilized in vitro and not transferred in vivo.
Anti-abortion opposition to the destruction of embryos not transferred in vivo.
IVF and other fertility treatments have resulted in an increase in multiple births, provoking ethical analysis because of the link between multiple pregnancies, premature birth, and a host of health problems.
Religious leaders' opinions on fertility treatments.
Infertility caused by DNA defects on the Y chromosome is passed on from father to son. If natural selection is the primary error correction mechanism that prevents random mutations on the Y chromosome, then fertility treatments for men with abnormal sperm (in particular ICSI) only defer the underlying problem to the next male generation.
While the egg donation side of the story is powerful, the mothers who deal with infertility encounter similar profound emotional, physical, financial and other consequences. A book that addresses what one reviewer called "A rarely addressed subject ... written with honesty," is
Motherhoodwinked - An Infertility Memoir, by Anne-Marie Scully.
Born in 1981, shortly after the first IVF baby, Anne-Marie Scully grew up in a world where infertility is a problem everyone assumes can be fixed.
Named for the frustration Anne-Marie felt when realizing that becoming a mother was not a given and that IVF was not a guaranteed 'Plan B', Motherhoodwinked documents the pain and the shame of life as an infertile woman.
But Motherhoodwinked is more than just another trying to conceive memoir, it is an important social commentary on the impact infertility has on the lives of those going through it and how the modern digital age has both helped and hindered the journey.
With heartbreaking honesty Anne-Marie takes us on a journey from her initial optimism and excitement at finally trying for a baby and fulfilling her lifelong dream to become a mother, through to her increasingly complex pregnancy plan, her experiments with holistic therapies, the NaPro program and finally her experience with ICSI and IVF.
Sometimes sad, sometimes laugh out loud funny Motherhoodwinked offers both couples going through infertility and their support networks coping skills for how to survive this lonely journey, that actually affects one in six couples.
DISCLOSURE: I promote several authors including Americus Dotter.
Related reading:
Americusdotter.com
Soul Sale: A Rude Awakening, by Americus Dotter
Insider's Guide to Egg Donation by Wendie Wilson-Miller and Erika Napoletano
EGG Donation: The Reasons and the Risks, by Kristi Lew
Surrogacy and Embryo, Sperm, & Egg Donation: What Were You Thinking?: Considering Ivf & Third-Party Reproduction, by Theresa M. Erickson
Assessing the Medical Risks of Human Oocyte Donation for Stem Cell Research: Workshop Report, by Committee on Assessing the Medical Risks of Human Oocyte Donation for Stem Cell Research