Fertility obstacles call for unique solutions

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      Most couples enjoy planning a vacation, but for Vancouver's Sandy McMillan and Jody Kaden the preparation was bittersweet. The pair had decided that if their last try at getting pregnant didn't work out, they would take a trip to Africa to help them come to terms with not being able to have a child. "We were so done," says McMillan of her and her partner's two-and-a-half-year struggle to conceive. "We were planning a safari and a puppy. Those were our consolation prizes. We thought we really needed something big to try to get over it."

      Like a growing number of lesbian couples, McMillan and Kaden, both 40, were anxious to be part of the so-called gayby boom that started in the 1980s. According to the 2001 Canadian census, about 15 percent of female same-sex couples were living with children, many of whom were presumably conceived using modern reproductive technologies. Although she started at the late age of 37, McMillan was in great shape and anticipated no problems in getting pregnant. Ultimately, the couple spent thousands of dollars and almost all of their free time trying to conceive. "I had gotten little scars on the inside of my elbows from all the blood tests," McMillan says.

      Infertility, which is defined as the inability to conceive in a period of 12 months, is believed to affect one in eight Canadian couples. The number of lesbians facing infertility may be even higher. A study by doctors at the Hallam Medical Centre in London, England, found that lesbians were more likely to suffer from polycystic ovary syndrome, a condition that is a leading cause of ovarian dysfunction. Data from the Women's Health Initiative, a long-term U.S. health study, indicate that lesbians may be more prone to smoking and obesity, conditions that can have an impact on fertility.

      The biggest factor affecting fertility is age. Many lesbians start a family later in life because it takes them several years to come to terms with their orientation. Others hesitate to start a family in a world that hasn't fully embraced the idea of same-sex parenting. "It probably does take a few more extra years to decide that parenthood is still an option even though you're gay, and just to get your head around it," Kaden says.

      In McMillan's case, she waited until she was 37 because she hadn't found the right partner. When she and Kaden got together four-and-a-half years ago, they knew early on that they wanted a family. The couple decided that McMillan, who had always wanted to experience pregnancy and childbirth, would be the one to get pregnant. She went through several rounds of artificial insemination using sperm purchased from a sperm bank in Toronto. After these unsuccessful attempts, McMillan spent the next year taking superovulation drugs to produce more eggs, but to no avail. After a failed attempt at in vitro fertilization, she learned that she wasn't producing any eggs at all. All told, the couple estimate that they spent around $20,000 for treatments. In comparison, a study by McMaster University found the average cost for all infertility treatment to be under $3,000.

      Such costs can be the biggest impediment for lesbians struggling to have a child. Attempts at artificial insemination can add up quickly. "The purchase of the sperm and the prep can be expensive," says Dr. Albert Yuzpe, codirector of Vancouver's Genesis Fertility Centre. "A sperm-donor cycle costs them about $640 each month. You can imagine if it takes them six months, it's a significant cost. If a heterosexual couple keeps trying, it doesn't cost them anything. That's the difference."

      In addition to the cost, lesbian couples can encounter a lack of sympathy from a medical system geared toward heterosexual couples, as well as from lesbian friends who are less family-oriented. McMillan and Kaden say the staff at the UBC Centre for Reproductive Health welcomed them but that they endured suspicious looks from other couples in waiting rooms. Likewise, they received plenty of support from family and friends, although a friendship with a lesbian couple dissolved because the other couple had no interest in children.

      Though infertile lesbian couples face unique obstacles, they can also find unique solutions. After McMillan's first failed attempt at IVF, they decided to give it one final try. This time, Kaden had her eggs harvested and fertilized, and then implanted in McMillan's uterus. According to them, it was the first time the UBC Centre for Reproductive Health had ever had someone donate eggs for her partner, a situation that caused confusion at the clinic. "They were giving us both different drugs and hormones, and doctors had a hard time keeping track of us," Kaden says. "They were never sure which one of us was which. They were like, 'Are you the egg or are you the womb?'"

      As they were planning their trip to get over the disappointment, McMillan finally got pregnant. Last year, she gave birth to a son, Cole. Today, they spend their days in their East Vancouver condo taking care of their seven-month-old as he experiences the pain of teething. McMillan and Kaden didn't end up going on that safari, but they find parenting to be a much more rewarding adventure. Says Kaden: "When it wasn't working, I felt that there were two parallel universes. There was a universe where we had a child and lived happily ever after, and there was the universe where we didn't. I felt like we were stuck in that universe where we didn't have a child. It turned out that we were meant to be in the other world where we did have a child, and I just feel so grateful."