What do you mean, my eggs are too old?
THE women who turn up at infertility centres in southern California, given that subculture's obsession with nutrition, fitness and youthful appearances, look like the most enviable specimens of their age group - virtual Wonder Women. Forty per cent of the patients who come to Dr Richard Marrs, one of the most respected fertility specialists on the West Coast, are women from 40 up to age 50. Their typical profile is high achievers who chose to delay pregnancy for career reasons. They can pay the fees for fancy health clubs or PTs (personal trainers) and go to spas and stay in, great shape. They've "made a million" but, they don't have a child. And they're desperate.
The following scene is emblematic. A 45 year old film maker is sitting across from Dr Marrs in his Santa Monica office. Her husband is with her but he scarcely says a word. She is thin, rich and reasonably famous. There isn't any unsightly ounce on her tanned body or an unsiliconed line on her face. She is not happy.
"I've done everything," she says. "Tell me what more I need to do to have a baby?"
"There's nothing more we can do," the doctor says gently. "You've taken the shots, you've showed up for the tests, you've followed everything we've asked to the letter. That's not the problem." Then the stab to the ego. "Your eggs are not allowing this to happen.
"My ovaries are not working?" The woman is stunned. "How can that be? I feel wonderful. I'm in great shape. Look at me: don't I look 35? I feel 35. What do you mean my eggs are too old?"
"It's true, you don't look anything like 45," says Dr Marrs. Her husband murmurs his affirmation. "But when I stimulate your ovaries," the doctor says, "there's no question that your biologic clock is demonstrating what it should demonstrate at this age.
"Why can't you make my eggs as good as 35?"
"I'm afraid we can't change the genetics of those eggs."
"Why can't you change it?" Anger rising. "You can make eggs, you can freeze embryos, you can insert a sperm into an egg, so why can't you make my eggs the same as a 35 year old's eggs?"
"It's a good question," says Dr Marrs. "The answer is that's the way somebody else wanted this process to work."
The patient scoffs at this metaphysical mumbo jumbo. She insists she wants to keep going with high tech solutions. "Okay, so I respond well to stimulation. I've done three GIFT procedures (a type of assisted fertilisation), let's do three more. Why stop now? Money's not a problem. Do you want me to stay out here? I'll fly in and stay in a hotel for as long as you want me to. Let's just keep doing this."
"The answer is no," the doctor says. "There is no chance that in vitro will work after age 44."
"Okay, then let's use a surrogate." The woman prods, a grave note of panic playing over her commanding voice. "You can just put my embryos, into a surrogate because my uterus is too -"
"No," the doctor stops her. "That's not the problem. It's not your uterus."
"Let's try it anyway.
"It costs 50,000 dollars."
"No problem. Just get me a surrogate."
"No, we're not going to do that." The doctor finally exercises his prerogative over the woman's need to prolong the fantasy. "The only other thing we can do is change your eggs.
"You mean use some other woman's eggs with my husband's sperm?"
"Yes. An egg donor mother - it's the only possibility left."
"Eeeyou." The women wrinkles up her nose like a teenager. "I don't want to go through all this, for a child who won't even have my genes.
"Then this is where we have to stop treatment."
The husband, who hasn't said a word until now, finally steps in. "Look, he's right. We've got to give this up."