The case involves D.R, a recently remarried, premenopausal woman in her late 40’s, who had a daughter (N.R.) some 33Y ago, in a prior marriage. D.R. inquired whether I would be willing to do IVF on her daughter, fertilize the eggs with her husband’s sperm and then transfer the embryos to her (DR’s) uterus. Needless to say, it was recognized that if successful, and D.R. were to give birth to a baby born from NR’s eggs, she would be giving birth to her own genetic grandchild who would be her daughter’s sister. I emphasized to D.R. that it was imperative that there be no pressure put on her daughter to do this and that it had to be by her own free will. I advised professional counseling and to think carefully on the implications of any decision reached. I scheduled and then had a separate meeting with N.R, in order to satisfy myself that she was not being coerced to proceed and discussed the process involved, with all parties. I assured N.R that ovarian stimulation and egg retrieval (done properly) would be very unlikely to compromise her subsequent fertility, that since she had never been pregnant before, she should recognize this possibility, however remote it might be. Fully cognizant of the implications, we all agreed to proceed. I implemented a modest protocol for ovarian stimulation. N.R produced 12 follicles and 11 eggs, Eight of the eleven eggs were mature (MII’s) and were fertilized with husband’s (her stepfather’s) sperm using intracytoplasmic sperm injection (ICSI). This resulted in 4 good quality blastocysts. I transferred 2 blastocysts to D. R’s uterus and cryobanked the leftovers for subsequent dispensation. D.R. conceived with twins and subsequently gave birth to twins (a boy and a girl). I had the extreme privilege of attending their christenings and had the opportunity to once again meet and confer with the genetic mother and the biological parents who were all elated. I hope and pray that it will remain so. Conclusion: While it is not unusual for the son of an infertile man to provide sperm to impregnate his stepmother, this was the first case that I had encountered in a 35 year IVF practice, where the reverse has occurred, i.e., that a daughter donated eggs to her mother so that she could procreate using her step father’s sperm. However, when one thinks carefully on, you cannot escape the fact that refusal to provide such a service while being willing to do so when it comes to donated sperm, would be sexist. I do recognize that there’s a far greater commitment and physical investment when it comes to a woman undergoing ovarian stimulation and egg retrieval than there is for a man providing sperm for insemination or IVF and that albeit minimal, there is always a risk that complications could arise in the process of stimulating a woman and performing egg retrieval, that might compromise her future fertility. I guess, “all is well that ends well” and I have no regrets whatsoever. The children are both healthy, loved/wanted, beautiful and the parents are happy and the egg provider (N.R) is nothing short of proud and elated at her ability to contribute towards the expansion of her family tree.
Fertility Topics Explained from the Experts at SFS