Living

A new generation of kids asks, 'Where did I come from?'

At 7, Nora and Emma don't understand all the science it took to create them.

What they do understand is that there are two very important women in their lives.

One is Mom: Carrie Carpenter, the white-haired, gentle woman who gave birth to the beautiful, blue-eyed fraternal twins when she was 47.

The other is the woman they call their Egg Mom: Lorraine Wilde, the tall, brainy college teacher who was once a strapped grad student convinced her smart, healthy genes had hit a dead end.

The two women never met at the fertility clinic where Carrie received Lorraine's eggs. There, in an industry that depends on donated egg and sperm, the watchword is "anonymous."

Through small, meaningful gifts and notes passed through the clinic, they corresponded. Anonymously. Finally, through a card with a phone number, blacked out carefully by the clinic but faintly discernible when held to the light just so, Carrie and Lorraine met.

Over the next five years, the two forged a friendship, intertwining their families.

Lorraine and her husband, Mike, who now have bright, bouncy 3-year-old twin boys, include the girls on their Christmas cards; Nora and Emma pinned the boys' photos on the family-picture wall at school.

Together for the boys' birthday, the kids hug and play while the moms catch up.

A few months after they first met, Carrie wrote again to Lorraine: "It is so important to me to know you and to have Nora & Emma know you."

Even so, Carrie acknowledged her fear. "Part of me feels like this is that dangerous territory when you fall madly in love and think, 'Is this real?' I guess what is so powerful is the fierce (and I don't think possessive) love we both have for Emma & Nora."

It's a relationship that often prompts questions from acquaintances. "I say, 'Several years ago, I donated some of my eggs; I have a relationship with the girls who were born from that,' " Lorraine says.

Together, Carrie and Lorraine are pioneers in openness. The alternative, secrecy, wasn't a good fit for either.

Carrie recalls a childhood friend who grew up with an older "brother" who was really her father. "The whole town knew, and she didn't." Carrie's own father, adopted twice in the 1920s, died without knowing his genetic origins.

"The girls have said, 'If we didn't know Lorraine, that would be our deep, dark secret,'" Carrie says. Instead, "They know there's always going to be that relationship."

In a clinic high in Seattle's 1101 Madison Tower, reproductive endocrinologists Lorna Marshall, Lee Hickok and Diane Woodford ride the crest of rapidly advancing technology: In the past few years, success rates have skyrocketed. Now, Hickok says, a patient at Pacific Northwest Fertility who receives two embryos created with donated eggs has a 75 to 80 percent chance of getting pregnant the first time around.

Newer procedures have nearly eliminated the need for donor sperm for male-female couples, the vast majority of those who visit this clinic. Now, for most, it's all about eggs.

In the past decade, egg-donor recruitment has risen sharply, along with donor payments. The Society for Assisted Reproductive Technology estimates that 9,000 donor-egg children were born in the United States in 2005, a number that has risen steadily over the years.

At Marshall and Hickok's shop, egg donors are paid $4,500, considerably below what's offered at some agencies elsewhere in the country, some of which routinely pay up to $10,000 for repeat donors. In the case of "exceptional" donors with particular ethnic, scholastic and physical characteristics, agencies have paid much, much more.

Key in this process is the availability of eggs, and the women who donate them.

Hickok and Marshall say it's essential to protect the rights of donors. These young women generally care deeply about helping other women, Marshall says, but most want to stay anonymous. "Once they give the eggs, they are done."

Maybe. Maybe not. The cautionary tale here features the children of sperm donors. Now old enough to have minds of their own, they have followed a grassroots path worn smooth over decades by adoptees, demanding to know their genetic origins. They have rights, too, these offspring insist. Armed with Internet connections and scraps of information, they are tracking down their donors.

But who are these sperm donors to their offspring? Are they like blood or bone-marrow donors, offering spare cells? Are they providers of genetic potential, like great-grandpa's legendary fast pitch? Are they "fathers"? Or something else, someone who doesn't yet have a name?

Parents may minimize the contribution of "just a donated cell," says Wendy Kramer, a Colorado mother who began Donor Sibling Registry in 2000 to help donor-conceived half-siblings connect with one another and their donors. "But to these kids, it's one half of their genetic ancestry. It's half of who they are. Just because you feel one way, it doesn't mean your kid is going to think the same way."

This past December, Katrina Clark, an 18-year-old college student, wrote about her search for her sperm-donor "father" in the Washington Post. "We offspring are recognizing a right stripped from us at birth -- the right to know who both our parents are. And we're ready to reclaim it."

In many cases, finding half-siblings is part of the deal.

When Vicki Moyer's son by donor insemination was 2, he asked: "Where's my dad?" After Moyer, who lives in Washington state, saw a show on Oprah, she signed up with Donor Sibling Registry. When her son was 9, he spent a week with his younger half-brother in Virginia.

"It was an amazing week," she recalls. Now, four years later, the two boys, similarly gifted and science-savvy, call and e-mail each other regularly.

Among their first questions to their respective mothers: "Do I have to say half-brother? Can I just say 'my brother'? "

Most offspring of donor eggs are still too young to be on the hunt. But no one expects them to be any different than the offspring of donor sperm, or, for that matter, adoptees.

At the very least, donor-conceived offspring and adoptees face common medical and genetics issues, notes Mark Demaray, a lawyer who specializes in adoption and assisted reproduction.

Carrying a baby for nine months and "donating a body part" are very different levels of involvement, Kristen and Jim Yagle acknowledge. But the Seattle couple expect that in years to come, the distinction will be lost on their children, one adopted and two born with help from an egg donor.

Leo was adopted four years ago. Later, the Yagles took "one last stab" at infertility treatment, using an egg donor. The result: Cooper and Carter, now 2 1/2.

Kristen and Jim are in touch with Leo's birth mother, who was a single 19-year-old from Utah when he was born. They have always felt Leo should have the option to know his birth mother, Kristen says. "We kind of look at it that there are more people to love him."

Kristen imagines her younger boys at 18 or 22 -- "or at 16 and you hate your parents," Jim says -- trying to sort out who they are in the world.

"When he gets older, Leo can choose. Cooper and Carter don't have that same opportunity. I don't think that's fair."

Times are changing, say many in the infertility business, but not without some angst.

"As attitudes have shifted with adoption and donor sperm, we're starting to see more of that with donor eggs as well," says Dr. Angela Thyer at Seattle Reproductive Medicine.

Ultimately, the same psychological needs that pushed open adoption may well drive more donors and offspring to establish relationships. But for that to happen, patients must demand some mechanism for contact. Moyer says her only concern at the time was to have a baby. "I never really thought, 'Is he going to want to know what his donor father's genes are like?'"

Now, an increasing number of patients are beginning to think about "later," says Rita Bender, a lawyer who specializes in assisted-reproduction contracts. And some donors, too, are leaving the door open.

The American Society for Reproductive Medicine advises parents to tell children "the facts of their conception" and, if parties agree, donor identity. It also urges clinics to maintain records as a "future medical resource" for the children.

Clinics say they lack staff to update records or locate donors, and are restricted by contracts and privacy laws. Most donors, they add, don't want contact, satisfied with making a little money or doing a good thing. Recipients and offspring, some say, most often want information -- a need that one California egg donation agency satisfies by giving recipients DVDs of donors talking about their lives -- not a relationship.

In several other countries, demands for access to donor information have prompted mandatory registries.

Critics argue that such moves, and even voluntary connections, can frighten donors and raise prices, along with opening a Pandora's box of questions: What if a donor becomes obsessed with the child, or the child with the donor? What if the mother and donor are at complete odds about what is best for the child?

"I honestly don't know what the right thing is," says Dr. Victor Fujimoto, director of University of California, San Francisco's in vitro fertilization program. "This is one big social experiment, isn't it?"

Ultimately, Gretchen Sewall's part in that social experiment began to cause her pain.

Sewall, like Nora and Emma, has loved different moms.

Because her birth mother was very ill, others took over; first, the woman next door, and later, a close friend's mother. Very likely, these nonbiological relationships played a part in a crisis of conscience that overtook Sewall after nearly two decades as a reproductive-health nurse and social worker.

For years, she struggled with what she calls "growing awareness and anger" of families who discovered they couldn't access information about their children's genetic origins. Clinics, she thought, were dodging their responsibility for the "rights, long-term health and emotional well-being of the children they're helping to create."

As a health-care provider, Sewall came to feel she was violating the directive to "do no harm," she says. "There was unfinished business."

She remembers the call, years ago, from a former donor who had helped several families. The donor's own son, now 12, had just been diagnosed with autism. Sewall could locate only one recipient family; the mother thanked her profusely, saying she had been teasing her socially awkward son. "Now I understand -- he probably has some degree of autism," she told Sewall. "Now I can do what I need to do."

Three years ago, Sewall, with more determination than funding, began a voluntary registry. Through DonorSecure, one of a few such "virtual safe-deposit boxes," parties could request contact.

In March, Seattle Reproductive Medicine, where Sewall works now, offered to give the registry a six-month trial, signing up both donors and recipients for free. Later, Sewall will ask those with successful pregnancies if they'd like to pay to have information held for possible future contact.

Such registries are "a step in the right direction," and likely will be the standard in the future, predicts Fujimoto. While thinking about "later" isn't on most fertility patients' radar, he says, "the adoption model tells us it needs to be."

Stephanie Lim is a straight-A student; just 12, she's learned the basics of biology. Even so, she struggles to explain egg donation and how this egg -- from a donor she knows little about -- became Stephanie Lim.

On the first try, she leaves out the sperm's role, to the amusement of her father, Vic, who smiles indulgently. Stephanie is a beloved only child, born to Grace at age 47 after many frustrating and expensive attempts at pregnancy.

Vic, an insurance-firm partner, and Grace, a retired banker, spare no expense for their daughter, whose piano, violin, music stand and paintings dominate their living room.

Stephanie and Grace share so many personality traits that Stephanie sometimes forgets they don't have genes in common. It was, after all, her blood that nurtured the embryo that became Stephanie, Grace notes. "It's not like she's totally from another person."

Still, Stephanie cites clues -- her feet, already size 8, she exclaims in horror -- to her connection with "the other person."

From the beginning, Grace has told Stephanie the truth about her origins. "I don't believe you can ever keep a secret," Grace says. "I wanted a total trust between she and I."

Also from the beginning, Grace has yearned to know this woman whose gift made possible her marvelous daughter. "It would be wonderful if my daughter could go visit her someday," she says.

Grace knows the donor was 24, from Taiwan, a University of Washington education major. She was "open and bubbly" and said her family wouldn't approve. So Grace imagines, filling in the outline: "Her personality is more rebellious, because donating an egg is not the Chinese kind of stuff."

Stephanie says she's "definitely, totally" eager to know her donor. "And if I find out, ooh, I have a sister or a brother, then that'd be cool."

Say she met her egg donor; what would she want to know?

"To find out what are her genes, what is her personality. I think the other person is really talkative."

She pauses for a split second.

"Well, actually, my dad's really talkative, and my mom's really talkative."

Grace asks if she'd consider the woman a "parent."

"No," Stephanie says quickly. "Because she didn't teach me or anything."

Grace says she has no fear. "I raised her, and loved her, and she knows I loved her. I always wanted her to find out her biological link, for medical reasons, and because she's an only child."

And to share her delight?

"My daughter, she is such a nice, bright girl," Grace says. "Who wouldn't want to know that this is your child?"

Lorraine Wilde was 28, in grad school with a huge student debt, and in love with an older man who wasn't keen on having more children.

A scientist, Lorraine can assign percentages to her mixed motives for donation: 50 percent was to help someone else, a tradition in her family; 25 percent was vanity: "I was proud of my accomplishments, and felt I had things to share -- smart genes in the gene pool." And 25 percent was the cash. "It was a no-brainer for me. I could do something where I get paid a small amount of money to help with my loan and help a struggling couple."

After her first donation, she asked the clinic how it had gone. "Two girls, born a month ago, healthy, happy and beautiful," she was told. Their photos were there, in a collage.

She ran to the wall, searching for her face, in vain.

In 2002 Carrie Carpenter was living in Alaska with her husband, Nora and Emma, then 2 1/2. One day in March, feeling what she calls now a strong "heart connection" to the unknown woman who had made all this possible, she wrote a long note.

She thanked Lorraine for the quilts she'd made for the girls, delivered -- anonymously, of course -- through the clinic. She wrote about Emma's way with words, about Nora's exceptional coordination. "They are so charming, witty, brilliant, agile, clever, cute, persistent ... altogether unbelievable. You must meet them."

She gave a date when they would be in Bellingham, Wash. And a phone number.

The envelope from Carrie arrived at Lorraine's house with a pile of bills. She'd had a "really horrible" day at work. She tore open the envelope, stuffed with pictures.

"I just started crying. It was so wonderful," Lorraine recalled. Now she had names. Faces. Personalities.

And an offer to get together! But the phone number had been carefully scratched out by the clinic; Lorraine was disconsolate. "You give up too easily!" her husband insisted, holding the card to a flashlight.

On the phone, Carrie and Lorraine talked for hours, and arranged to meet at the ferry.

At the terminal, Lorraine searched for the car. She glanced in a window.

Her face!

She and Carrie hugged like long-lost soul mates; while the girls played, they hurried through the years. Then, a tearful goodbye.

"We felt like we didn't want to separate," Lorraine recalls.

As it turned out, they never really did.

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