Pregnancy in a same-sex family

04.11.2012 Blog

Backstory

Almost three years have passed since the moment we started dating — or, more precisely, since we started living together (the two events happened a mere 2 months apart).

We are a family! We are together! We are a new quintessence of two lives and two destinies that used to be separate! In that time we told each other the story of our lives almost in full, practically from the moment we were born. A great deal was understood, the points where our worldviews touched were found, old wounds of the heart were healed. Little by little we were making our way toward the most intimate thing in our relationship — our shared future.

One fine day we found the courage to squeeze out the words: “I want to have children with you,” and on that day and the days that followed we crossed another threshold of honesty. There were tears, frayed nerves, and hugs. But the final realization — the call to action — did not come quickly. About six months passed between that sentence and a full understanding of “who among us is ready for what.” Work, the daily rush, household life — all of it pushes back a decision that every LGBTQI+ family needs to make. And, by the way, I haven’t mentioned that the two of us are women, that is, a same-sex family. My name is Alona, my partner’s name is Zhenia. Nice to meet you!

I’m a complicated person, and I make only deliberate decisions (street racing aside); before I decide anything I need a thorough analysis of the situation. But once I make a decision, I act on it and take responsibility for it. My sense of responsibility runs high. That’s just who I am.

My great phobia (I’m being completely honest here) when it came to children was that I never, ever wanted to give birth. Everything connected with men, abortions, labor, and babies was blocked by my fragile LGBTQI+ mind, which answered me: “Anything but that!” I never felt any particular love for children, and I didn’t understand my classmates who declared from their school desks: “I’ll get married and have two children.” How awful, I thought, listening to them. Who the hell needs these children? And to give birth to them in agony on top of that — it hurts terribly (once, as a child, I saw footage of a birth on television, and that was it — nobody could ever convince me that children are a good thing…).

But with Zhenia all my phobias vanished — what had seemed complicated turned out to be quite simple, and I genuinely wanted to have children with her! We hadn’t discussed the subject; nobody had pushed the idea on me. I wanted children with her, and I understood that if SHE got pregnant and gave birth, the whole rest of the picture would fall into place perfectly for me! Of course, I set about talking her into it — though there wasn’t much talking to do, she agreed almost right away! Hooray! Our family now had a shared, long-dreamed-of Goal!

How it all started…

I don’t remember exactly how, but in 2009 we ended up at a seminar organized by Insight and devoted to having children in lesbian families. Huge thanks to Insight and to its CEO personally for making that seminar happen. It was led by gynecologist Irena Yaroslavtseva. That is where we picked up our first pieces of information and our first terms: ovulation, insemination, IVF, and so on. We were given an introduction to the available methods of assisted conception, but ideologically Irena and we parted ways on the methods. A man you could get pregnant by naturally was ruled out by default: for me, because I was categorically against it; for Zhenia, because of her experience of a heterosexual marriage and her understanding of everything that “natural pregnancy” involves. We had no illusions about “getting pregnant on the first try,” the way it happens in the film “Moscow Does Not Believe in Tears.”

I want to draw serious attention to the fundamental difference between the natural and the assisted approach to pregnancy. From here on, only the assisted methods are described.

The seminar pushed us into searching the internet and talking to other couples. A family we are friends with (who in turn had heard it from a doctor friend of theirs) recommended a doctor and a clinic to us. The clinic is called the Institute of Reproductive Medicine (IRM from here on), website http://www.irm.com.ua. For ethical reasons I won’t name the doctor; I’ll only say that she is a woman and one of the clinic’s leading specialists. Getting a first appointment is fairly difficult — you have to take care of it in advance, at least 2 weeks ahead (and that’s if you’re lucky), because the clinic always has a great many childless couples.

The first appointment and the tests

Everyone at IRM is very tactful and polite. Nice renovations, shoe covers at the entrance, a waiting area for clients with a TV and a water cooler. All in all, an atmosphere of calm and hope. Little booklets about the clinic and its achievements lay on the reception desk. I shyly leafed through one and took it with me to read in peace at work. On one page a line caught my eye in passing: “Does it seem to you that infertility treatment will go on forever? Have you lost your bearings in life? Often a short pause in infertility treatment allows you to release the tension and regain perspective…” Nonsense, I thought! We are young and healthy, none of this is about us, it will definitely work for us on the first try. Information never comes by accident — I understood that later…

The first appointment is a detailed interview with the candidate for the program ahead, and it is highly advisable to tell the whole truth about your “sexual” past (pregnancies, abortions, illnesses, treatments). On our side, that candidate was Zhenechka. Hearing “was married, divorced,” the doctors had no questions along the lines of “why have you come to us.” Zhenechka was handed a sheet with a hefty list of tests (I’m giving the list as of 2010; unfortunately, it has since disappeared from the official website):

A certificate from a general practitioner stating that pregnancy is not contraindicated.
Vaginal swabs for flora, valid for 2 months.
Cytology, valid for 6 months.
A blood test for hormones:
- follicle-stimulating hormone;
- luteinizing hormone;
- estradiol;
- prolactin;
- progesterone;
- testosterone;
- thyroid-stimulating hormone, antithyroid antibodies;
Hysterosalpingography with a water-soluble contrast agent (more on this below).
Blood sugar.
Coagulation panel.
Complete blood count.
Urinalysis.
Breast ultrasound.
Tests for RW, HIV, hepatitis B and C, chlamydia, mycoplasma, cytomegalovirus, herpes viruses, toxoplasmosis, and rubella.

Almost all of the listed tests depend on the day of the cycle. The day of the cycle and menstruation are the foundation of reproductive medicine; everything begins there. When every conversation opens in the most serious of tones with “What day of your cycle are you on?”, you start to respect your female nature and your period ☺️.

Hysteroscopy is an examination of the walls of the uterine cavity with a hysteroscope (a thin optical instrument), followed, if necessary, by diagnostic and surgical manipulations. The tip of the hysteroscope is inserted into the vagina and carefully advanced through the cervix into the uterus. The hysteroscope is fitted with a light and a camera so that the doctor can see the lining of the uterus (the endometrium) on a screen. Hysteroscopy makes it possible to detect and remove intrauterine pathologies, extract foreign bodies, take tissue biopsies, and remove endometrial polyps.

Collecting the tests took us about 1.5 months and cost around UAH 1,500. Most of the tests were done at the Synevo laboratory. As I recall, they drew blood perfectly (no bruises on her arms afterwards), but with the gynecological swabs we were out of luck — Zhenechka said they were real butchers (the branch on Heroiv Stalinhrada). I thought I’d tear that laboratory apart after something like that. From then on all gynecological tests were done only at IRM — everyone there is very careful and tactful, real good fairies of gynecology 😉. By the way, after that we gave blood only at their place too.

Every subsequent appointment invariably begins with a transvaginal ultrasound costing UAH 150. Paradoxical as it sounds, you’ll have to get used to the idea that your vagina, or your partner’s vagina, is now the “property” of the clinic and of all the procedures that come with it.

Our first steps, or the quirks of “Soviet” gynecology

April 2010. After the second appointment we were referred for a hysteroscopy and a hysterosalpingography (metrosalpingography). The goal was to check the condition of the uterus and the patency of the tubes in order to determine the plan of action.

Metrosalpingography, or hysterosalpingography, is a contrast X-ray examination of the uterine cavity and of the patency of the fallopian tubes. It is one of the methods for diagnosing the condition of the fallopian tubes and for detecting anatomical changes in the uterine cavity and adhesions in the pelvis. A contrast agent is introduced through the cervix; it fills the uterine cavity and passes into the fallopian tubes and the abdominal cavity. An X-ray image is then taken.

We read the internet, we panic, we fret, but off we go to SCH-1 (the State Clinical Hospital) to see a second doctor, also a woman, but no longer a fertility specialist — a genuine operating gynecologist in a genuine hospital gynecology department. A pleasant conversation, a respectful attitude, and a breezy account of both procedures didn’t leave us time to get frightened.

The gynecology department at SCH-1 itself is as frightening as a nuclear war: the doors, the wards, the decor, and most of the staff are left over from Soviet times. The doctors themselves (all women), though, are fairly young (under 45) and obviously very experienced. The department deals with the most varied and frightening gynecological problems, and it is 100% full of patients. There are little posters on the walls. Since I’m a sensitive person, every time my eyes slid involuntarily over the printed information I wanted a drink. Over time I got over it — I had to read it in order to understand what was being done to us and what the consequences could be. I don’t fully trust doctors, so I try to think information through from every angle and reason my way to one decision or another. In 2011 a major renovation began in the gynecology department at SCH-1. I hope new patients will be able to receive treatment there, and that the doctors themselves will work in normal, modern conditions worthy of them.

A few words about “Soviet” gynecology. If you have ended up in a gynecology department, leave all your plans for the day at the door, because you have traveled back to the times of the Soviet Union. On one hand, there are the countless regulations (go and take fresh tests, fill in the admission paperwork, pay officially for the procedure, wait for them to find you a ward and change the linen, and so on); on the other, there are the attempts to catch the doctor (they are genuinely overloaded, they have one procedure after another, they run from floor to floor with all their patients trailing behind them) and to wait for the operating room to free up. It’s a little easier to get through all of it as a pair. The advantage of being a woman in a gynecology department is obvious ☺️. Men are as afraid of walking into a gynecology department as the devil is of holy water. The only men I saw were the ones bringing their wives in to be admitted. The rest of the time the women were left to themselves. I hadn’t seen such a variety of robes and slippers in a long time. The average age of the patients is over 45; there are young ones of 20–30 as well, but far fewer of them. At the entrance to the department sits a sweet little old lady who, on closer inspection, turns out to be a real Cerberus: take off your coat, why aren’t you wearing shoe covers, where is your robe, and so on. Over time the old lady and I became friends, since I spent a great deal of anxious time on a chair beside her. She got used to me quickly and didn’t hound me.

The one who did hound me was another wilted, self-important person who evidently imagined herself the anesthesiologist of all times and peoples. We were waiting in the ward to be called for the second hysteroscopy, chatting peacefully with the woman in the next bed, when this aging fury suddenly appeared and shrieked: “Young man! What are you doing in a women’s ward? Kindly get up at once and get out!” We were all floored by this Soviet approach. My haircut is short, of course, but you’d have to be completely blind not to notice my rather prominent C-cup chest. This idiot didn’t notice it. Before I could even object that I’m a woman, she started shouting even louder about the examination of the patient that was coming up, about how men have no place in gynecology, and so on (now I understand who used to keep men out of maternity hospitals). Well, I thought, I’ll give her a “talking-to” right now for the UAH 300 I officially paid at the cash desk. Then a thought flashed through my mind: what if this fury turns out to be the anesthesiologist for my Zhenechka during the procedure? Then we’re done for — she’ll ruin Zhenechka if I so much as yelp. The ladies in the neighboring beds started explaining in unison to this idiot that I’m a woman and that they had no objection to my staying, while the harpy stood there like a post, looking at me down her nose. I got up and walked out in silence, cursing her in my head every way I knew how. We got lucky — she wasn’t our anesthesiologist.

But the doctors in the gynecology department are cool women! The head of the department is a stern, cultivated person. I nicknamed our doctor the Chinese Princess for her remarkable walk — she moves very fast, but in tiny steps. There’s one more doctor there who I find funny — she’s so cheerful and warm, she calls all her patients by affectionate diminutives, and on top of that she likes to touch the people she’s talking to. I watched this many times from the side and always laughed — what a shame she isn’t one of us, not “family.” Now there’s someone who would really enjoy her work here ☺️. But I’m sure they enjoy it anyway — otherwise they simply wouldn’t work there; their profession is that hard, and the things they can see in a single day… Sometimes I happened to see girls or women being wheeled out on gurneys after an abortion. They’re all so pale, so helpless after the anesthesia. And the nurses — young women — briskly roll the gurney out, take her to the ward, transfer her onto the bed, come back quickly, throw out the bloody rags, put the instruments in for sterilization, clean up the chair, prepare it, and — “who’s next”… And there I am in the corridor, watching all of it… I had to strain to keep myself from fainting. All in all, it was awful.

The hysteroscopy. Half a day of paperwork, two or three hours of waiting, and then your beloved, with terror in her eyes (I’m terrified too, only I’m trying not to show it and to keep her spirits up), is led away through the door into the operating room. I stayed in the anteroom, and everyone who felt like it asked me what I was doing there and told me to wait in the ward — though then they’d look at the expression on my face and leave me in peace right where I was. Over those 20–30 minutes (roughly how long the procedure takes) I was, of course, tied up in knots. But then the doors opened and our doctor, in a brisk voice, listed for me in detail what had been done, that everything had gone well, that she had done great, that everything was wonderful, and that I had nothing to worry about. That was probably the moment when the doctor read the expression on my face and understood that I wasn’t there as furniture and what kind of “sister” I really was. All in all, I had the feeling that she was reporting the situation to me the way you would to a husband. Deep down it was even nice. While she was talking, they wheeled my pale little Girl past me. I nearly burst into tears. I was handed a list of medications to buy and detailed instructions on what to do with her in the ward. I dashed to the ward; Zhenechka had already been transferred onto the bed. Menstrual pads turned out to be very much in order, because after the procedure there is serious bleeding. In about 15 minutes she was able to open her eyes and smile at me. Half an hour later we were already slowly, word by word (it was hard for her to speak after the anesthesia), sharing our impressions. An hour or an hour and a half later we bought the medications, gathered our things, and went home — we didn’t want to stay in that atmosphere. Have no illusions that after this procedure you can go to work or take public transportation somewhere. It’s a real operation, just sped up in time. Taking antibiotics afterwards is mandatory, and there may be a fever. The comedown (everything down there aches and pulls) lasts about three days, and then it gets easier. Any kind of activity, let alone sports, is out of the question. A week after the procedure there is a follow-up gynecological examination, and based on its results the antibiotics are either continued or stopped. A hysteroscopy with medications costs about UAH 2,500.

Hysterosalpingography, or metrosalpingography. It was done a month after the hysteroscopy. It was also billed as a simple and easy procedure. For extra comfort she was given a painkilling injection in the buttock. In Zhenechka’s words, the procedure is vile. It is absolutely unnatural to have fluid poured inside your uterus and tubes; it fills you from the inside and creates very particular painful sensations. The procedure itself takes about 10–15 minutes, but that’s enough to fill the whole remainder of the day with discomfort. It turned out that this procedure can be followed by complications in the form of all sorts of infections, so antibiotics are mandatory. A metrosalpingography costs about UAH 500.

The outcome of both procedures was the information that the tubes were patent, which made it possible to do intrauterine insemination.

Intrauterine insemination (IUI)

August 2010. A slice of summer vacation had been enjoyed, the horror stories forgotten. We were full of determination and set on a result. We were examined and taken onto the “program” — an interesting term for the moment when you realize that everyone around you has suddenly started dealing with you specifically, that they have all finally engaged and that soon everything will be fine. Two or three ultrasounds, starting on day 2 of the cycle, which is when the IUI program itself begins. Incidentally, an ultrasound outside a program costs UAH 150, but if you’re in a program the cost of the ultrasound is already included in it. Medications are prescribed (Divigel, folic acid, Clostilbegyt, Proginova). A second ultrasound is scheduled for around day 10 of the cycle, and that’s when the actual date of the insemination is set.

Intrauterine insemination is an assisted reproductive technology that consists of introducing sperm, obtained in advance outside of intercourse, into a woman’s cervical canal or uterus. It is used for medical purposes to achieve pregnancy in infertile couples, or to achieve pregnancy in single women.

The procedure is performed during the periovulatory period (the days of ovulation), the timing of which the gynecologist determines using the tools at their disposal. Artificial insemination can be used both in a woman’s natural cycle and with hormonal stimulation of superovulation.

A few words about the donor and his sperm.

The question of the child’s paternity worried me personally a great deal. We drew up a list of every young man we knew (under 35) whom we saw as a “potential donor.” We started with our friends, a gay couple, who quickly declined. Coming to the clinic changed our layperson’s idea of the whole thing. I had pictured a scene like the one in the film “If These Walls Could Talk 2” — that we’d be handed a catalog of donors with detailed descriptions of their physical parameters and, most importantly, their IQ. Ha ha ha, and so on many, many times over! At the second visit we were given a scrap of paper on which we ourselves wrote out, by hand, the physical parameters of the future “father”; there was, naturally, no IQ column. We worked at it all evening and formulated all of our wishes. We handed in the scrap of paper. For a while, up until the first insemination, we forgot about the donor, because there were more pressing gynecological questions. I was having hysterics about how important it was for me to understand who the father would be and how we needed to get to the bottom of it. Zhenechka was far calmer. When she asked the doctor, she got this answer: “The donor is selected according to parameters as close as possible to the ones you specified.” It also turned out that there was no point at all in bringing your own donor to the clinic, because he would have to be screened at your expense, several doses of sperm would have to be collected, his upkeep would have to be covered for a certain period, and his sperm would have to be cryopreserved for six months in order to be 100% sure that no diseases remained in it. A genetic analysis is also highly desirable, and it is expensive. We realized that none of the men we knew would pass those criteria, and after hearing all this we didn’t want to take a risk and use “fresh” sperm. In the end the decision was made: screened sperm from an anonymous donor.

And so, the fairy-tale day of the first insemination. With shaking hands we pack our things (T-shirt, socks, robe, slippers) and drive, full of nerves, to the clinic at the appointed time (usually between 9 a.m. and 1 p.m.). Changing clothes, waiting. Zhenechka disappears into a mysterious room with a sign reading “Unauthorized entry strictly prohibited,” in and out of which numerous female medical staff come running. A positive concentration of thoughts. Today, today of all days, we… you’re afraid to let yourself hope, but how could it possibly turn out otherwise?!

The insemination itself is a procedure performed in a gynecological chair (another constant synonym for reproductive medicine). It is painless. The donor’s sperm is introduced into the uterus through a long catheter. The woman lies in the chair for about 5 minutes, then lies on a bed for around half an hour. Then you can gather your things and go home. Right there on the spot they give a Pregnyl injection. No exertion, no sports, no alcohol and no medications other than the reproductive ones, no stress and no worries. It is very important not to get constipated. Take more walks, keep more positivity. We did everything we were told. We couldn’t wait for the day of the test; with trembling hands we unwrapped it and… nothing. Tears, sniffles. Despair. One insemination costs about UAH 4,500.

A couple of months later we did the second insemination. Nothing. From that moment on I went with Zhenechka to all the appointments at the clinic, because we needed to ask all the questions that worried us and remember all the answers. Together it was far easier to do. And our doctor at first took my presence for that of a worried friend, then figured it out and started talking to us as a couple who genuinely want to have children. She showed respect for our fanatical persistence.

While we were preparing for the third insemination, an ultrasound showed that something was wrong. We were referred for a repeat hysteroscopy. And yet only six months had passed since the first one, and we understood what that meant. Logic showed that there weren’t really any options — we had to go. Everything was crap. The hysteroscopy showed that there was endometriosis in the uterine cavity, and that it was exactly what would prevent an embryo from implanting in the uterus if it were fertilized. I remembered with horror that at 33 my mother had had her uterus and tubes removed precisely because of endometriosis, but she had managed to give birth to me first… In the USSR endometriosis used to be one of the causes of female mortality… We were in shock; there were no limits to our bitterness. Our doctor at SCH-1 tried to calm us down by explaining that conventional and reproductive medicine have completely different approaches to treating endometriosis. Conventional medicine prefers to destroy it physically; reproductive medicine tries to reduce its effect to a minimum. Both doctors said that endometriosis essentially cannot be cured, but that the best treatment is either menopause or pregnancy, so we needed to try a little harder and everything would be fine. That time became a genuine nightmare. The internet again, making up for the lack of information, and the conclusion that the endometriosis had been caused by the change in the natural hormonal background after the drugs from the two inseminations. How furious I was when I understood that!!! I intended to have it out with the clinic: why hadn’t they foreseen this turn of events? Couldn’t they have given smaller doses of hormonal drugs, given all the facts about us? Why? Why? Why? In the end we still had to choose a reproductive medicine method and do what we were told. Zhenechka was injected with Diphereline Depot in some horse-sized dose. To give you an idea: after it she had no period for six months (six months!). We were warned that the drug would strongly affect her psyche and would produce the effect of menopause. And that’s exactly how it was. Hot flashes (sudden heat, sudden cold), irritability, insomnia. At first you still realize that it’s all artificial and you try to be attentive and restrained. Then you forget, there are nerves, there’s work — and conflicts at home become almost inevitable. Imagine it: you wanted a child together, and now you’re snapping at each other over some domestic trifle almost twice a day. I can’t give you advice on how to get through it. It’s good if you have a lot of patience and love. You will need it badly.

Coming out of that six-month period, we did one more, third insemination. Zero.

In vitro fertilization, or conception in a saucer (IVF)

After three or even four inseminations (somehow we were never able to recall their exact number) we realized that statistics were playing against us. The official recommended number of inseminations is five. Beyond that there is no point. Our doctor began gently preparing us for the idea of IVF.

In vitro fertilization is an assisted reproductive technology used in cases of infertility. Its synonyms are “test-tube fertilization,” “fertilization in vitro,” and “artificial fertilization”; in English it is denoted by the abbreviation IVF (in vitro fertilisation). In practice it is used for all forms of infertility in a marriage (male factor infertility, tubal, endocrine, and immunological factors, endometriosis).

During IVF an egg cell is retrieved from the woman’s body and fertilized artificially “in vitro”; the resulting embryo is kept in an incubator, where it develops over several days, after which the embryo is transferred into the uterine cavity for further development.

We were afraid and we resisted, because we understood that this meant a far larger quantity of hormones, and there was no telling how that would affect the body. The thought of the cost made us queasy — one procedure together with the medications costs about UAH 30,000. Gradually we understood that IVF shouldn’t affect your figure (there was a stereotype that people gain a lot of weight after IVF) and that we essentially had no other options. We could have taken the number of inseminations up to five, but a purely arithmetical calculation showed that we had already spent an enormous amount of money over the past 1.5 years (enough for a couple of IVF cycles).

We read our fill of information, came to the clinic about three times just to talk, and made up our minds. Of course, we prepared financially.. The money has to be paid within 2 weeks, while the procedures and the drug support are underway (the very expensive drugs Puregon and Menopur). The medical preparation is like being in the army: injections three times a day (two in the belly, one in the buttock), specific injections in different doses. After ten days your backside turns into one solid blue mess…

On the day of the procedure I didn’t ask anyone’s permission — I just barged in after Zhenechka through the door marked “unauthorized entry prohibited” and sat down to wait on her bed. Out of the door of the treatment room, after the follicle puncture, male doctors — embryologists — led out one by one the young women who had just come round. These helpless bodies were carefully laid out on the beds and covered with blankets. Our doctor didn’t throw me out, although she had every right to. The others didn’t dare. My presence didn’t embarrass the five or six women who were in the ward in the neighboring beds. I tried to behave quietly and sit still as a mouse (so unlike me). The anesthesia lasts 7–12 minutes. The puncture is done by a whole team: the attending physician, embryologists, and nurses assisting. About 20 minutes after the puncture the person has to be woken up. Polite nurses offer a choice of tea or coffee with candy (you can’t eat the evening before or in the morning), then go around and announce the results one by one: “this many follicles” — the more the better (we had 19, whereas in an ordinary cycle 1–3 follicles mature). A list of medications, an hour of coming down, and you can go home. After the puncture your eggs (that’s what we simply call the ovaries) hurt, but then it gets easier. From the moment the program starts, the medications stimulate the growth of the follicles, and by the end you get the unpleasant sensation of walking around with balls inside you. After the procedure the balls seem to “deflate.” Right after the puncture they fertilize the retrieved material with the donor’s sperm and watch how the fertilized embryos develop. I asked where exactly the fertilization takes place, and I was told: in a special little dish, similar to a saucer. The embryos are microscopic in size; everything is done under a microscope. A few days later they schedule the embryo transfer, that is, the transfer of the most successfully developing embryos into the uterine cavity. The embryo transfer is very similar to an insemination — quick and painless. Medications are taken (including vaginally) — Utrogestan. Fourteen days later comes the pregnancy test.

In September 2011 we did our first IVF. The follicle count was good, and we were pleased to be praised for our results. But there was one bad factor — the endometrium was too thin, which meant that an endometrium that isn’t “lush and three-layered” enough might not allow the fetus to attach, or more precisely the fertilized embryo that is placed in during the embryo transfer. We don’t know why, but it didn’t work for us. They don’t know either; they threw up their hands.

An element of alternative medicine, or leeches

We got upset, we left, we calmed down, and we came back to the clinic again. We were given a piece of advice — to improve the condition of the endometrium, take a course of leech therapy. We remembered that in the gynecology department at SCH-1 the ladies used to scurry down the corridor to the treatment room with little jars of leeches. Well, I thought, they must be treating varicose veins alongside gynecology. Not a chance! The leeches are placed on the walls of the cervix. Another nervous breakdown when I found out… They torment women any way they can. That thought wouldn’t leave me… Thinking it over again, analyzing the situation again. Understanding that to hell with any more medications — her liver was in a bad way as it was (a bitter taste in the mouth and so on). We realized we had to go through with the procedures if leeches work miracles.

The mere sight of these lively beasts (we never called them anything else) was horrifying. Leeches, of course, are not fished out of a pond or a lake; they are bought at a pharmacy, right there at SCH-1, along with a single-use gynecological kit. We needed to go through 10 sessions with 3 leeches at a time (we did 2 courses).

That was December 2011. The department is fairly cold, and you have to lie with — you understand what — facing upward, and with leeches on top of that. Their bite doesn’t hurt, but you can feel them wriggling in there. The smallest ones bite hardest. In about 15 minutes, having drunk their fill of vaginal blood, they fall off on their own; some escape and drop to the floor. Since even three little leeches cause heavy bleeding, an enormous tampon with ointment is inserted to stop it (you still have to get to work, after all), and that is the most painful part; it can only be taken out after 4 hours, and during that time you can’t go to the bathroom and it hurts to sit down (to understand the sensation, try tying five tampons together and imagining them inside you). Another brutal procedure. Since I suffered and empathized as best I could while watching all of this, I was given the responsible task of disposing of the leeches. I couldn’t bring myself to kill our rescuers, so I released them onto the grass beside SCH-1. And in the test tube the leeches, full of blood, are so fat (about 2 cm in diameter and up to 6 cm long, when their normal size is up to 0.5 cm) — all in all, a horror film! Men definitely wouldn’t have put up with that! I guarantee it.

Before the second IVF, Zhenechka decided to prepare and, following her father’s method, gave preference to therapeutic fasting. Four days the first time, six days the second, thirteen the third. She lost 12 kg and became a real “little Buchenwald” (her breasts almost disappeared, her arms got very thin), but overall she looked very good and said she felt wonderful. All the women at work were green with envy, though to her face they said the opposite. My task came down to something very small — to support her!

What our visits and communication at the clinic were like

I would like to dwell on the phrase “infertility treatment,” because it, and only it, is used as the framework for communication between the clinic and its patients, and especially its female patients.

For safety reasons we didn’t advertise our relationship, even though I accompanied Zhenechka and waited for her on practically every trip to the clinic. After six months, of course, the quick-witted nurses were already greeting us both with all their might; some of the ones who especially liked us would even stop and talk to us, sometimes joke with us. Some (like the head nurse) clearly hated us, but kept quiet, because we brought the clinic just as much money as the other heterosexual couples did.

An interesting detail. Even when heterosexual couples came together, it was only for the first one or two appointments. After that, as a rule, the women came on their own. Well, it isn’t a man’s business to sit and wait in a corridor… I believe that moral support matters enormously in this, and I tried to always be there — at every appointment, and all the more so at the procedures. That way the first face Zhenechka saw after coming round from the anesthesia was, after all, mine. And you should have seen the lost faces of those women after anesthesia. They need support, but their husbands don’t give it to them. They fumble through everything on their own. It is far easier for us — for lesbians — to understand and support our partner. It’s important to remember that, and even to be proud of it!

A year in, we started going to our doctor’s appointments together. It was very important on our side to behave tactfully and politely in order to inspire trust and establish normal human contact, because we did want to ask her about what genuinely worried us as a couple, and there was no opportunity for that right away. After a while our doctor warmed to us and understood everything, though she hinted to us very delicately: “Our professor is against non-traditional unions.” We understood that we had to behave carefully, first and foremost so as not to harm our doctor. Even though they all endlessly attend seminars and lectures on reproductive medicine abroad and can see the most advanced practice, by no means all of them are able to free themselves from stereotypes. Six months earlier we had already learned from our doctor that a number of draft laws were under consideration aimed at restricting a woman’s ability to make her own decisions about pregnancy. They want to leave access to reproductive medicine only to heterosexual couples who are married. We were shocked, but we were informally given to understand that as long as we didn’t run around the clinic with placards, it wouldn’t affect us, because the clinic values all of its patients, especially those who are able to pay for the procedures. We were warned that if these draft laws were passed, IVF would become impossible without a partner, and we might be required to produce him. We thought about it and complied — there are no other options here.

Recommendations for lesbian families who want a child

Girls, we want to share this private experience with you so that, on one hand, you will be ready for it, and on the other, so that you will understand: don’t put this question off. Time flies very fast, but medicine, unfortunately, is unforgiving. After 30–35, and especially after 40, our chances statistically go down. Yes, there is still guardianship or adoption, but legally that is an even more complicated matter.

Our recommendations are as follows:

If you have gynecological problems, start dealing with them right now. Sexual health is the foundation of reproductive medicine.
Take stock of your health. If you have chronic problems (liver, pancreas, vegetative-vascular dystonia, and so on), I would recommend homeopathy as a gentle yet effective branch of medicine. Of course, homeopathy won’t cure gynecological conditions and won’t replace surgery, but it can improve and correct a great many physical and psychological problems (get in touch and I’ll recommend the doctor who cured my severe sun allergy). On top of everything else, homeopathy is also very affordable.
Of course, you need to stop drinking and smoking! If you can, you should take up sports. Your brain needs to get as much oxygen as possible. The less stress you experience, the better your chances.
If you have access to people whose thinking is radically different from the Marxist-Leninist theory of materialism, try to talk to them. Any Eastern practices (yoga, meditation, and so on) will let you ask yourself important questions and get important answers to them. Growth in self-awareness matters a great deal. Use any methods for it that are available and suitable for you. As our doctor says — your child has to choose you!
Try to think through all the possible options for pregnancy, by natural and by assisted methods. It is important that the two of you as a family are able to discuss this openly and find the way that works for you both. You need to be well informed on this question; how quickly you make decisions and act depends on how much you know.
Try to build up a financial reserve in your family (at least UAH 10,000 to start with, but preferably no less than UAH 30,000), so that you won’t have to wait for the next paycheck or bonus afterwards and nothing will distract you from the goal.
When you come to the clinic, try not to advertise your relationship. However much you may want to. Please hear me out! Almost all the heads of the leading clinics are men who openly oppose same-sex families. Experience has shown that the clinics’ leading specialists are very tolerant — don’t put them at risk. It’s better to go to them quietly and have children with their help than to speak out openly once and close off the way into every clinic, once and for all, for yourselves and for other families. Instead, it’s better to come up with a truthful story about why one of you has come to get pregnant at a time when she is beautiful, young, and unmarried, with plenty of worthy men all around. At the clinic, be as polite as you possibly can, because you need to achieve a far bigger result than any heterosexual couple does. You can become a source of objective information for fertility specialists and build up doctors’ respect for same-sex families. Right now that is a far more important task than open slogans alone. We do recommend the IRM clinic.
From our experience. If you have done a second insemination and there is no result, move on to IVF — don’t lose time.
Be prepared emotionally for the fact that any reproductive procedure has a fairly strong effect on the health and the psyche of both partners.
On a funny note. After the procedures you need to take care of yourself and of your partner. Every time I giggled at the phrase “you need to abstain from sex,” but I obeyed without question ☺️.

What comes next

In May 2012 we did our second IVF — so far, unfortunately, without results. We have spent a whole fortune over these three years. We have been through a pile of procedures and swallowed a ton of medications. But we believe that none of it is in vain. We believe that we will be able to get pregnant ourselves and give birth to our child. We are full of optimism.

Our doctors (both of them) tell us that we mustn’t lose our optimism and our faith, that we need to keep striving toward our goal, and then we will certainly reach it.

We want to wish good luck and success to all the same-sex families who sincerely want children.

I hope our story will be of use to you.

Alona and Zhenia