My journey to (not) becoming a single mother by choice

It had always been my base assumption, that some day I would marry a man and have children with him. Ever since my early 20s I regularly saw beautiful dreams about being pregnant with my own baby. But, years passed and I was busy traveling around and meeting the wrong guys. At the age of 39 I was living in Albania, where the selection of datable men seemed to be even more limited than in Switzerland, and I finally realized I was dangerously running out of time getting a family. One afternoon I was discussing the issue with the girls at the office, and they suggested "Why not use a sperm donor to get pregnant on your own?" 

Being me, I quickly got curious about this option to become a single mother by choice (SMBC). However, before wasting time on further research I wanted to know whether it would even be possible for me to get pregnant. So not long after, I was at the fertility department of the American Hospital, no clue about anything and feeling out of place in my old climbing gym T-shirt, a huge print of a baby staring down at me from the wall. This was the beginning of a journey full of hope and frustration. I was taken to an ultrasound, blood draw and a procedure called HSG. Luckily I had no idea about the HSG, which is often feared as painful, so I just ignorantly went through it and continued straight to work meetings and cocktails afterwards. It turned out everything looked fine, so the doctor asked whether I wanted to start with artificial insemination (IUI) already next week. I responded "Well, let me first figure out whether this is really want I want..." 

I spent the next few months intensively researching the SMBC path; listening to podcasts while cleaning the apartment, reading a few books and numerous online forums, exchanging with experienced SMBCs, calculating budgets on Excel... I went through different bottle-necks, such as my financial capacity to support a child on my own, fear of having a seriously ill child, and most importantly having to pretty much abandon my previous lifestyle in exchange of becoming a single mother without support networks. I also researched a lot about the ethicality of using an anonymous sperm donor to create a child, who would grow up without knowing half of her/his genetic heritage. It felt like a huge decision to make on behalf of someone else. Twice a week I went running around the artificial lake of Tirana, always the exactly same route. It is a popular place for families, so I saw lots of babies and toddlers. (Albanian kids are the cutest!) Those runs were filled with dreams of pregnancy and a life with my future child.

The lake, where dreams were born

It was time to pull the trigger! Since I was not satisfied with the responsiveness of the American Hospital, I searched out another clinic just a 20min walk from my home. The pleasant walk went through vegetable and fruit stalls, passed by the city's best byrek place and ended at a block of new apartment buildings, where Tirana IVF is located. This route will always stay in my memories, sometimes hopped with joyful expectation, sometimes dragged with deep despair. I will equally remember the waiting room sofas at the clinic. There patients are not given specific appointment times, but they are notified by whatsapp about the day when they should show up. Therefore, the waiting room was always full of couples trying to pass time, and I am not overestimating when saying I finished maybe 5 books in the around 100 hours I spent there. 

I could not have been happier with my choice of clinic. The doctor, working every day around the clock, is internationally recognized and genuinely empathetic towards his patients. As he speaks Albanian and Greek, one English speaking nurse was appointed to communicate with me. However, she hardly translated anything about the situation at hand, just simply told me what medication I needed to take. To know what was going on, I relied on the facial expressions of the doctor (when extremely satisfied, he said one English word "Good!"), the ultrasound screen combined with my understanding of Albanian numbers, and googling based on what medication I had been given. During my countless visits at the clinic I had interesting conversations with the sympathetic young nurses, and learned about their perceptions to fertility treatment and working in the health sector in general. 

To avoid ending up into a spiral of never-ending trying, I decided upfront to do only one round of IVF (in vitro fertilization). Its outcome would determine, whether biological motherhood was meant for me or not. Being fully aware of IVF success rates for 40-year-olds (around 20%), I entered the process with realistic expectations, however somewhat (over)confident about my success, due to my excellent health and previous speedy recoveries from any health-related treatments. I did not want to let the IVF overtake my life, so I consciously made sure to also explore the Balkans, advance my career, meet friends and just live in the present moment, in addition to of course googling everything possible about fertility. 

Diagnostic hysteroscopy was supposed to be just a routine check before staring the IVF. However, its findings were a polyp and some other objects in my uterus. As the nurse showed me the video filmed by the little camera, she asked "If you were an embryo, would you live in such a trashy place?" My answer was of course no, so an operative hysteroscopy was scheduled. It was my first time ever under general anesthesia, and just like the nurses promised, it was the sweetest sleep of my life! I have never tried any drugs, but when the doctor apologized for having chosen a wrong instrument and thus having to repeat the operation, my first reaction was anticipatory satisfaction. At the second hysteroscopy I eagerly extended my arm for the needle, and when I half woke up I instantly told the anesthesia doctor "Hey, more drugs please!" The day after the operation I was already back at practicing yoga. 

It was time to pick to the sperm donor. To make a long story short, I ended up going for one of the donors, whose sperm was already in storage in Tirana. On Valentines Day I had a call with the friendly CEO of the Greek sperm bank that collaborates with IVF Tirana. I did not have a date with the love of my life, but instead picked the donor who would help to create my baby. I imagined a cute kid, an attractive mix of blond Finnish and dark Greek. The helpful CEO sent me a list of 5 possible donors, pre-selected according to my key criteria. The information I got about them was their age, height and weight, horoscope (seemingly a key fact), color of skin, eyes and hair, education, hobbies, self assessment and staff impression. I picked a young tall medical student, interested in gymnastics, drawing and piano, with a charming smile. As there was no photo, I was free to imagine him looking like I wished. This was a fun selection, and a good opportunity to include also my mother, siblings and best friends into the IVF process. 

Frustratingly I needed some months to fully recover from the hysteroscopies. Every time I went to the clinic for a check-up I was prepared to start with the IVF, and every time I was told to wait some more and take some additional medication. Looking back, I really appreciate the doctor's approach to optimize conditions to increase the change of success. Instead of giving in to my pleas to just start, he sternly made me prepare. I was prescribed with overly expensive fertility vitamins and DHEA hormones. Placebo or not, I could swear I was flying when I went running. Additionally, anything (at least half believable) the internet said about increasing egg quality, I implemented. For over 3 months, I drank no alcohol, caffeine or soft drinks, cut off sugar, avoided processed foods and followed the Mediterranean diet (that is the standard in Albania anyways). I discovered that Tirana is full of pharmacies, and they are actually interesting places for shopping.

My remaining medication & lucky items

Parallel to the IVF, life was happening. My work contract in Albania was limited to a year and I was planning on returning to Switzerland, until I was offered to go to work in Laos for half a year. The decision making period was maybe one of the most stressful times of my life. In addition to trying to remotely find new subtenants to my apartment in Switzerland, I was of course facing the time pressure of the IVF. During sleepless nights I ran countless scenarios through my head; the IVF completely failing / me getting immediately pregnant / creating x number of frozen embryos... What would each scenario mean career wise, financially and most importantly to my chances of having a baby? In the end I decided not utilizing this excellent job opportunity would be too big of a risk, so I went ahead to sign a contract and book flights to Vientiane. 

Yet another check-up at the clinic resulted in a further delay with the IVF start. As I was swallowing more estrogen pills at home, I counted days needed for simulation and fresh embryo transfer, and came to a conclusion that I would have to be very lucky to make it before my departure to Laos. With a heavy heart I texted the clinic that I must cancel the IVF. Their optimistic response was reassuring that the remaining weeks would indeed be enough. It being Albania, I went on to negotiate "If I have to break off the IVF, I pay nothing for it, ok?", followed by a reply "Deal". A few days later I finally started the egg growing simulation! I had been waiting for this phase for months, so I was filled with excitement. The nurses gave me a protocol and showed me how to inject the hormones, including drawing correct injection areas on my belly and bottom. I actually liked the injecting, because it meant concrete action towards realizing my dream, and in general it was a curios activity. I walked to the clinic almost every day for blood draws and ultrasounds, to follow how the follicles were growing and my hormone levels were developing. I was feeling excellent, carrying the exciting secret with me as I attended an intensive MRM training at work and switched running to walking. 

When the follicles were ready, I got experience the lovely general anesthesia one more time during egg retrieval. It went well, and while I was packing my suitcases I received a message saying that 14 eggs were collected, of whom 10 were ripe and 7 had fertilized with the sperm. The embryologist considered it a fabulous result for a 40-year-old! Because of my departure to Laos, the fresh transfer was a 3-day embryo, while the other 6 were frozen. I still remember it like yesterday, drinking a fresh orange juice in the sun at a cafe outside the clinic, right before receiving my little embryo. I have to admit, I was slightly disappointed not having had an extra day to grow the embryos into 5-day blastocysts, but I did my best to root for that 3-day embryo. And I was even more disappointed when I was at Tirana airport ready to board my flight, just to find out it had been cancelled last minute and I would fly only the following day. Had I known, could I have transferred a 5-day embryo. Anyways off I flew, injecting progesterone in the tiny airplane toilet, arriving in hot Vientiane not knowing whether I was starting the new job pregnant. 

The two week wait went rather smoothly as I was busy getting to know my work team and project, viewing apartments and sampling different yoga schools. On a Saturday, before it was time to test, I suddenly felt really dizzy and fell asleep for a couple of hours. When I woke up I felt fine and walked to a shopping mall, but since then all pregnancy symptoms were gone. The elementary 0,8€ costing pregnancy tests, that I had found at a local pharmacy, showed negative, and my blood HCG test was 5. The clinic, with whom I was in contact via whatsapp, decided to torture me and made me re-test until the HCG value was 0. I was not pregnant. I cried for a whole two hours. Then I decided, against all common sense and ignorant of flight costs and GHG emissions, to spend my holidays flying back to Tirana for a frozen embryo transfer. To my luck, the clinic failed to collaborate with this plan, so I stayed in Laos enjoying my work, expat life and traveling around the provinces.

Praying for a baby at a temple specialized in child wishes

Fast forward 5 months and I was planning my return to Switzerland, and to Albania where my little frozen embryos were patiently waiting. I started to prepare for an embryo transfer during my last weeks in Vientiane. An ultrasound was needed to determine uterus conditions, but I was not entirely sure what needed to be checked and there are no IVF clinics in Laos. So I picked the fanciest international hospital in town. It was like walking into a 5-star hotel and I almost turned back, severely fearing for the bill. However, I went through the ultrasound experience including colorful Lao-style examination pants, and got some pictures at a rather reasonable price. Thanks to this remote controlling I had to double my estrogen intake, which made me sweat even in the freezing air conditioning of the office. 

At sunset I waved goodbye to Vientiane and got on a plane to Bangkok, and then to Zürich. Next morning I arrived in Switzerland and took a taxi to drop off my big luggage at home. In the afternoon I took the train to Basel, from where almost daily cheap flights depart to Tirana. When I landed at Tirana airport, I had been awake more or less for 40 hours and could think of nothing else but sleeping in my own bed. (I had rented my old apartment for the following 2 weeks.) Instead, the clinic told me to come over straight away. At 22PM one could expect a quiet clinic, but it was full of waiting patients. After the nurses saw me falling asleep on the sofa, they told me to pick a pillow and go sleep on the gynecologist table in an empty examination room. It so felt good to be back at the clinic, that had become so familiar during the past year. 

Meeting up with friends, drinking (decaf) coffee and walking around sunny Tirana filled my days before the embryo transfer. This time I had asked for a 5-day blastocyst. I already know the quick procedure. When I was laying down after it, the international embryologist, traveling between clinics in Albania, Greece and Dubai, came over from his laboratory. He told me that unfortunately the other 5 embryos had died during trying reach the blastocyst stage. This meant that all the cards were on this one embryo! I kept talking to it as I took it for walks, first that evening in Tirana, the next day at Istanbul airport, and then in freezing Helsinki. As the testing day approached, I felt it less and less meaningful to talk to the embryo. Several mornings of negative tests, followed by 0 at a HCG blood test, confirmed my anticipation. I did see two lines on a positive Corona test. I did not break down. I numbed my feelings and continued living with the knowledge that my dream of becoming a biological mother had died.

Beautiful scenery for dreams to die