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Four women, one dad create 'twiblings' born days apart

Two surrogates and one egg donor helped one couple create a family "by many hands." Writer Melanie Thernstrom describes her fascinating journey, from the pain of infertility to the emotional search for surrogates to the complications of explaining her children's unique biological connection.
/ Source: The New York Times

Midway on our life’s journey, I found myself in dark woods, the right road lost. I’ve actually never read “The Inferno,” but I found that line in my mind every morning when I woke to do my hormone injection and especially on the darkest mornings — the ones when I went into the clinic to have my unpregnant blood drawn to confirm another I.V.F. cycle’s failure. Of course, I had considered my life ruined many times before — other medical and romantic crises — but I was always wrong. This issue, though — childlessness — really did seem different. My two closest girlfriends chose not to have children and didn’t regret it, and I envied them, but I didn’t know how to feel as they did. No one gets everything they want in life, but to be childless felt like being deprived of something essential: the primal human experience. When I was 39 and single, I was in northern Uganda, and a woman there asked about my children. I said I didn’t have any, and she solemnly told me that she would pray to God to remove my curse. Instead of shrugging it off, I thanked her.

I was 41 when, after a gazillion not-quite-right relationships and a broken engagement, I met Michael, the man I would marry. He was five years younger; socially, it didn’t seem like an important age difference, but in terms of fertility, it turned out to be. I was haunted by the thought that if we didn’t have children — even though he loved me and even though that love might blind him to the truth — in some sense marrying me would have turned out to be a mistake. Raising children was a crucial part of his vision of what he wanted to do with his life, and if he had married someone his age, she probably would have been fertile.

“I’m not comfortable with it,” our doctor said when I begged him to let us do a fifth round of I.V.F. “When a doctor offers you a treatment, there is an expectation that that treatment could work.”

“It could work,” I said. “I don’t mind doing the treatments. I just want to keep trying.”

“Realistically, you need to consider other ways to have a family,” he said.

But it seemed to me that there were no other good options. I had friends who spent all of their money trying to adopt, only to have things fall through again and again — birth mothers who changed their minds, foreign programs that were discontinued. I researched adoption in China but discovered that the criteria excluded us. When Michael’s parents adopted his sister in the 1970s, there was an abundance of babies in the United States in need of homes, but the widespread use of birth control and abortion, among other factors, has caused the supply of infants available for adoption in the subsequent three decades to plummet to a fraction of what it was then. Knowing that, I was still taken aback by how discouraging one adoption agency was about our prospects for “competing” against other couples. “Most birth mothers do prefer younger women,” the woman informed me. “But you’ll get a letter from your doctor, certifying you are in excellent health for the social worker anyway.”

“Right,” I said, thinking about the arthritic condition that caused the chronic pain I had been struggling with for many years.

I found another doctor and persuaded him to let us try a fifth round. All you have to do is not die, I told the embryos once again, but once again they all did. After a failed sixth round, I was told I had a new medical problem that would pose risks to a fetus’s health, and I began to consider whether the embryos might have been right about the merits of my body as their greenhouse. Should I scrap my problem-ridden body entirely and try third-party reproduction? I felt a pang at the idea of excluding myself — of having no role at all in gestating or creating the child. But that pang was checked by disappointment in my body and a longing not to be limited by its limitations.

I consulted with a perinatologist, a high-risk pregnancy specialist. “Is your goal to have the experience of being pregnant or is your goal to have the best chance of having a healthy baby?” he asked. “If you really want a healthy baby, get a surrogate and an egg donor.” In that instant, I made up my mind. Of course that was my goal — and compared with that goal, all other desires seemed not only secondary, but also trivial, even narcissistic.

I began researching surrogacy and egg donation — corresponding with gestational carriers on surrogacy Web sites and talking to agencies. The process seemed so daunting and alienating — inviting all these strangers into our bedroom, creating relationships with unknown conventions and risks, giving others extraordinary power. In the story of what happens when a man and a woman love each other very much, they don’t need strangers to lend them their gametes. Having children was one of life’s great acts of self-definition. How could we turn the most intimate thing a couple could do — coupling — into a ménage à trois, let alone à quatre or cinq?

What do you think of the twiblings story?

There were so many ways the journey could go astray. The Internet was filled with stories of predatory egg-donation and surrogacy agencies. The legal status of surrogacy is varied. In a number of states, the status is unclear or surrogacy is prohibited. There were several cases of surrogacy in recent years in which the surrogate succeeded in keeping the baby despite an absence of any genetic connection. Even if everything went perfectly, it was hugely expensive. Of course, the cost of surrogacy is dwarfed by the cost of actually raising a child, to say nothing, for example, of a college education, but considering what baby-making usually costs — nothing — it took our breath away. We were able to afford it because of a financial deus ex machina. Just when the I.V.F. bills were mounting, the software company that Michael co-founded was acquired by a large company. But there was still something disquieting about choosing to spend so much — and having an option that many infertile people did not have.

We were also unsettled to discover how many people disapprove of surrogacy and egg donation. There are objections to it on the right, on religious grounds, as violating the natural order and the trinity of father-mother-baby, or as being part of a slippery slope that would lead to abominations like human cloning. There are objections on the left by those who say that surrogacy is exploitative and degrading for the women, irrespective of what the women who become surrogates say about it. (Some people believe only paid surrogacy is exploitative but unpaid surrogacy is fine.) I read articles and court decisions and took notes on the arguments, but in the end they mainly seemed to boil down to the fact that it is new. Because of the central social importance of the family, changes that affect it are often initially condemned as strange, unnatural, evil or dangerous. Using anesthesia in childbirth was controversial after anesthesia’s invention. Had not God condemned Eve to bring forth children in pain? Birth control was once condemned, but it is now widely accepted. Once outlawed, abortion is now legal and supported by a majority of Americans within certain limits.

Reproductive technology fills an important — and growing — need. Gay couples are increasingly choosing to have families. Eight percent of women between 40 and 44 identify themselves as involuntarily childless or hoping to become pregnant, according to a Pew report. Most women in that age bracket will be able to become pregnant only by using donor eggs. Although we could handle negative reactions, it was upsetting to think that our children would have to deal with them. Still, we didn’t want fear of other people’s opinions to influence such an important and personal decision, and we hoped we would raise children who could stand up for themselves.

'But that would be crazy...'
Throughout our fertilitytreatment, our hope was that I would become pregnant with twins. We wanted to complete our family and not face future treatment, and we loved the idea that our children would be same-age companions for each other as they grew up. But in my consultation with the perinatologist, he discouraged the idea of twins.

“The fertility industry has convinced themselves that twins are safe and only triplets are high-risk, but they’re not,” he said. “They don’t see the babies after they’re born. Take a look at a NICU sometime.”

When conceived naturally, 11 pregnancies in 1,000 produce twins. Over all in the United States today, principally as a result of fertility treatments, 32 in 1,000 pregnancies result in twins. The majority of twins are fine, but because 60 percent are premature, twins are more than twice as likely to have disabilities that require ongoing medical treatment or special education. Twins have a fourfold-to-sixfold increased risk of cerebral palsy compared with singletons, a fivefold increased risk of fetal death and a sevenfold increased risk of neonatal death. And most of the high medical costs are, of course, passed on to society, which gives fuel to critics of reproductive technology.

We scrapped the idea of trying to have twins and decided we would have a baby with an egg donor and a gestational carrier and then try to have another the following year, with as small an interval as possible between the two births.

“If we really want our children to be the same age, we can try to find two carriers now and do the pregnancies in parallel,” Michael said.

“But that would be crazy,” I said. It sounded crazy, anyway. Although it was logical, and it would give us a better chance of having at least one viable pregnancy, it sounded weird and somehow hubristic, as if having children were a vanity project or a movie we were producing or a manufacturing job to be outsourced. What if trying for one child was reasonable but trying to go from an empty nest to a full house was greedy and would turn our tale into Icarus’s and irritate Fate, Mother Nature or any of the powers Michael definitely doesn’t believe in and I basically don’t, either, but I still fret about?

For many couples, the most crushing aspect of fertility treatment is not all the early morning blood-draws but the haunting feeling that the universe is telling them that their union is not — in a spiritual, as well as a biological, sense — fruitful. But I knew Michael and I were a great couple — I had pined so long for the elusive feeling of rightness, and now that I finally had it, I was damned if I was going to let biology unbless us. And I knew if we let biology become Mother Nature, we actually would be damned.

We forged ahead. I wanted to find carriers who would be like female relatives — women with whom it was fun to shop for baby things and who would give us advice on actually caring for the babies and make it all seem doable. While this desire seemed natural to me, I was surprised by how differently other people saw it.

“You won’t have anything in common with the carriers,” a director of a Los Angeles agency (which we decided not to work with) insisted dismissively. The gestational carriers at their agency were mainly white, working-class women, often evangelical Christians — “the kind of girls you went to high school with,” he said, managing to give “high school” an ominous intonation. He waved his hand. “You may think you want to stay in touch now, but trust me, once you have your baby, you’re barely going to remember her name. I call it surrogacy amnesia.”

Many intended parents do feel uneasy at the idea of too much intimacy with their carriers and are willing to pay the hefty agency fees to “manage” the surrogacy and maintain distance between them. But for us, the idea of not being close to the carriers seemed much more alarming, like something from “The Handmaid’s Tale.” Moreover, the only true safety in surrogacy lies in trust. What real remedy could there be if, for example, your baby was born with fetal alcohol syndrome?

After six months, I had talked to or met dozens of potential carriers without sensing the possibility of the kind of connection I longed for. At one point, we thought we found someone, but after four months of conversation she backed out and kept the money we advanced her against the surrogacy expenses. Then a lovely local elementary teacher came forward, but her in-laws (from Berkeley!) denounced surrogacy and told her that she would be shaming the family and threatened to cancel their holiday visit, and she crumpled. Then Melissa, a 30-year-old nurse who lived with her husband and two children not far from us in a suburb of Portland, Ore., responded to my posting on a surrogacy Web site.

We met at a cafe and chatted for a while, and then I sat stupefied, blinking back tears of relief at the wash of feeling. Here is the person who will carry my baby. From a small town in Oregon, she had a blithe, happy-go-lucky way about her. She was 6-foot-2 and had gone to Montana State University on a basketball scholarship. With her pink cheeks and straight, shiny brown hair, it was easy to imagine her as a rugged pioneer woman who could till a field and give birth squatting without the assistance of anesthesia (as, in fact, she had done — twice). Things that would be hard for other people didn’t seem hard for her; she put herself through nursing school as a single mother, and before remarrying, took her children to live on an island off the coast of Mexico for a summer without knowing Spanish. She had been an egg donor before, but she thought it would be even more fulfilling to be a gestational carrier.

Unlike Melissa, we found our other carrier, Fie, through an agency, but we disliked dealing with the agency so much that we ended up paying a fee to free us from its services and work with Fie directly. She was 34 and lived with her husband and their three young children on the Oregon coast, a few hours from us, where she worked as a senior accountant for a community-development organization. She originally came to the United States as an au pair from her native Denmark and fell in love with her husband and stayed. Like Melissa, she said she loved being pregnant but was clear that her family was complete. She had an air of earnest intentness; she presented us with a long list of careful questions, like the arrangements at the birth and whether we would want her to provide breast milk afterward. Where Melissa merely scanned the contract, Fie reviewed it line by line, and we had long conversations about each provision addressing frightening scenarios, like the need for us to name guardians in case we died before the birth and the need to buy life insurance for the carriers in case they did.

When we met their husbands, we felt relieved by their self-confidence and self-possession. The role of a gestational carrier’s husband is, in some ways, more difficult than that of the carrier herself. The husband is, as Fie puts it, “a bystander to a miracle,” who partakes in the inconvenience of his wife’s pregnancy but has fewer emotional rewards (as well as the occasional negative reaction from a stranger whose congratulations for a new chip off the old block can turn to disapproval).

The thing I liked most about our gestational carriers was that they both seemed like great moms. I liked the way they carefully consulted with their children about the surrogacy.

“Why can’t they get a puppy?” Fie’s 7-year-old daughter, Olivia, responded when Fie asked her if she wanted to help us have a baby. Fie explained that we had cats but wanted a baby.

“If it’s a boy, we can give it to them, but if it’s a girl we can keep it,” Olivia decided. Fie explained that the baby would belong to Michael and me, even if she was a girl.

Olivia didn’t respond, but a bit later she tugged on Fie’s sleeve and said, “Mom, we should help the lady with the broken belly.”

Finding 'the one'
Choosing the rightgestational carrier is, in a practical sense, more important than choosing an egg donor because a negligent carrier can ruin your life and your baby’s. But an egg donor has a striking claim on the imagination: it is the opportunity to choose a genetic replacement for yourself. While at first this struck me as a project of great fascination — the kind of thing I would enjoy obsessing over — it soon became clear it was a fool’s errand. We looked online at donors’ profiles and felt at a loss. What exactly should we look for? Many women search for a donor who looks like them, but I didn’t care about that. The qualities I did care about — elusive ones like temperament, sensibility, intelligence, goodness — were difficult to discern online, and it was unclear, anyway, whether genetics played any significant role in them.

I don’t recall the precise words our fertility doctor, John Hesla, used when he told me he had thought of a donor who he believed would be a good match. We had the highest confidence in his judgment; something about his presence gave us a feeling of being deeply known. He had met the donor when she came to Portland to donate for another couple he worked with at Oregon Reproductive Medicine, and he said that he thought she had a lot in common with us. “There is something very delightful about her personality,” he said, thoughtfully. We had labored to come up with complicated, unsatisfactory formulations of what we hoped for in a child. But that, I realized, was what we really wanted: a child with a delightful personality.

We decided we wanted to meet the person who might play such an important role in our lives and were glad the donor agreed. We flew to California to meet her for brunch. But in the hotel the night before, I lay awake, clinging to Michael’s back, my heart thudding in the darkness. In the morning, I decided I had brought the wrong clothes and sat down on the bed in tears. “I don’t understand,” Michael said. I didn’t even know what I was afraid of (that she would reject me? that I would reject her?), but suddenly I didn’t want to go. I wondered if we should have arranged the meeting in the way nonanonymous donations are typically done: in the office of the agency, brokered by the agency director or a counselor.

As soon as we sat down at the restaurant and began to talk to the donor, though, everything changed. Adoptive parents often talk about the feeling of meeting their child and knowing he is the one: who knew he would be tucked away in a Siberian orphanage? But there he is, in a halo of rightness. In the case of egg donation, those same feelings can take shape around the donor, who appears before you like an apparition of your future child. As I drank my tea, I had a growing sense of conviction that the donor was the Fairy Goddonor: the one who would give us the right eggs — the magical eggs, the eggs from which our babies would grow. When she flashed a smile, I wondered if I had caught my first hint of my child’s grin.

Relationships have been said to begin with a metaphor — the desire to invent a narrative that weaves your lives together in a way that you can read as destiny. I fastened on a few coincidental biographical similarities. She grew up in Los Angeles, where I lived as a child, and she recently graduated from a college that I might have gone to if our family had stayed there. She was literary, but she worked in an area of science, which overlapped with an interest I had recently developed. I also found myself interpreting the differences between us in the most favorable way. She was the same height and weight as I and also had long straight hair, but hers was blond. On the Web sites, I felt alienated by the surplus of blond donors, but I suddenly recalled that I was blond as a child.

I decided the Fairy Goddonor was the person I would have been had our family stayed in Los Angeles; had my hair stayed blond; had I grown up as a sunny outdoorsy California person instead of a brooding indoorsy East Coast person. And if there are brooding genes I prefer they die with me. She was athletic and played tennis and surfed, as I imagined I would have done, and would still do if only I didn’t suffer from the chronic pain condition that I wouldn’t have if I were her — and wouldn’t then pass on to my children. There was an air of appealing gaiety about her. She seemed reasonably, but not excessively, introspective. She did not seem like someone who stayed up late every night writing in her diary for hours, as I did at her age. She got the idea of donation from a college roommate who did it, and she joined the same agency, although she could have gotten triple the money at a high-end agency. She wanted to meet because she felt an anonymous donation would not be as satisfying.

“I hope our children turn out just like her,” I said to Michael after she left.

“Like her or like you?”

I thought for a moment. “Like her.”

“You’re going to be like an awful parent in a cartoon shaking her head at her misbehaving child and saying, ‘The donor was perfect,’ ” he chided me.

“If you want to idealize her,” a friend counseled, “you should be careful not to get to know her too well.”

But the more I got to know her, the more I liked her. For months afterward, I was haunted by the idea that she would change her mind and flutter away — and I woke from anxiety dreams in the grip of her disappearance. But she didn’t.

She came to Portland with her boyfriend to have her eggs retrieved. She had more eggs in the single cycle than I had produced in all six cycles put together, I noted, both pleased and slightly rueful. After the retrieval, we went back to the hotel where we were all staying. I waited anxiously as she napped, obscurely fearful that somehow she wouldn’t awaken. It was all so surreal. But she came down to the lobby in her usual spirits, wearing a silvery dress, and we all went out to dinner to celebrate. The eggs were fertilized with Michael’s sperm and metamorphosed into embryos; the morning after Valentine’s Day, they were transferred to Melissa and Fie, and by spring, in each of their bellies, a heart was beating. We were careful to refer to the fetuses as the “drafts” rather than our chosen names to remind ourselves that they were notes toward the children we wanted, but if they died, they were just beginnings like all the embryos had been, and we would start again.

“Tell everyone or tell no one,” the director of an egg-donation agency advised me. “If you tell even one person that you used a donor, word will spread. But if it were me, I’d tell no one,” she added. “Look, I run an agency, so it’s in my interest to promote these kinds of families, but to be honest, if I couldn’t have children naturally — God forbid — I wouldn’t want anyone to know!”

In that instant I made up my mind to be completely transparent about it (and to warn people to avoid her agency). But in being open about our story, I sometimes felt I was inviting a Greek chorus of doleful commentary. There was a curious insistence that the situation must be darker and more difficult than it actually was and that I must simply be in denial or trying to put a brave face on it all. People were constantly suggesting horrifying hypotheticals about the carriers: drinking, using drugs, disappearing into Denmark, getting H.I.V. or hepatitis C from their husbands or seducing mine (a complicated seduction strategy indeed) and, of course, stealing the baby.

Surrogacy turns out to be a perfect canvas upon which people can project their own ambivalence about pregnancy. I hated the way women would volunteer that I wasn’t missing anything by not being pregnant and then regale me with their pregnancy war stories, their eyes gleaming with pride.

A childless friend of mine compared surrogacy to prostitution, saying that she personally would prefer to be a prostitute. “They can’t want to do it — they must be desperate for money,” she insisted. Faced with the fact that both carriers were well-paid professionals, she concluded they must be masochistic. I tried to explain that the gestational carriers we interviewed were the kind of women who said they cried when they gave birth to their last baby, knowing they would never be pregnant again.

“Ten percent of women love being pregnant, 10 percent of women loathe it; most women are in between,” my gynecologist commented. “Surrogacy selects from the extreme end.”

Many people talked as if the mere fact of being compensated negated the generosity of the gestational carriers and the egg donor and asked if they were doing it “for the money,” as if they couldn’t want to help and want to be paid. Would you be less grateful to a beloved teacher, nanny or fertility doctor because they were paid? We wanted to pay, because it made the relationship feel more reciprocal. There was one woman who responded to my surrogacy listing who said she didn’t want any financial compensation. Although it sounded as if she really didn’t need money — she was an affluent divorcée in Sonoma County — I felt that we would need to pay her. “That’s our contribution,” I said, flummoxed — “one of the things we can give back.” Turning the lengthy labor of surrogacy into volunteer work felt as if it put tremendous pressure on the experience to be fulfilling at every moment. I worried she would back out or resent or regret it. What if she was masochistic? Surrogacy is prohibited or restricted in much of Europe, and as a result they have very few surrogates, and infertile couples come here. I was pleased when the Fairy Goddonor wrote and said she bought her first major purchase — a classic midnight blue convertible — because I imagined she had paid for it partly with the donation money.

Throughout the pregnancies, I worried about small practical things. Were Melissa and Fie remembering to take their fish oil? It was great that Melissa felt so energetic, but must she take her kids camping while her husband was away one long weekend when she was six months pregnant? And why did she order pizza from Pizza Hut? This is Portland — how about I drop off some organic kale? I was irked by all the people — especially health care professionals — who were unable to master the term “gestational carrier” and referred to Melissa and Fie as “birth mothers” or “biological mothers” even after I explained that the term was inappropriate outside the context of adoption. I assumed it would change as soon the babies arrived and was infuriated when the pediatrician in the little hospital on the coast where our daughter, Violet, was born said she didn’t know these “newfangled” words and continued to call Fie “the mom.”

Nevertheless, I was relieved to discover that none of it truly pained me. Everything about third-party reproduction can suggest you are not the “real mother,” I realized, and torment you. Or nothing can, if you don’t allow yourself to see it that way.

“I’m the only mother,” I’d correct people brightly, again and again. “Actually, there is no biological mother,” I’d sometimes add, in a tone that I hoped suggested Isn’t this interesting rather than You are an insensitive fool. “You see, both the donor and the carrier contributed biologically to each child, so the term cannot encompass this situation.” Third-party reproduction creates all kinds of relationships for which there are not yet terms. For example, there is no word to describe the relationship between our children and the carriers’ children, but it feels to me that they are, somehow, related. They are gestational siblings; they don’t share a mother, father or genes, but they were carried in the same body and they learned its fathomless chemical language.

There is also no word to describe our children’s relationship with each other. Our children were born five days apart — a fact that cannot be easily explained. When people press me about their status (“But are they really twins?”), the answer gets long. The word “twins” usually refers to siblings who shared a womb. But to call them just “siblings” instead of “twins” also raises questions because full genetic siblings are ordinarily at least nine months apart. And our children could be considered the same age because they were conceived at the same time (in the lab) and the embryos were transferred at the same time. If the person continues to quibble about whether they really qualify as twins (as, surprisingly, people often do), instead of asking why it matters, I announce airily that they are “twiblings.”

'I was in a daze of ecstasy'
After our son,Kieran, was born, the hospital set up something called a supplemental nursing system by taping a tube to my breast so that the baby could suck to get the first milk — the caramel-thick colostrum — that Melissa expressed.

When the nurse put Kieran on my breast to feed, I was in a daze of ecstasy and so focused on the astonishing strength of his newborn fingers curled around mine, I hardly noticed. But by the time he was hungry again, I was coming out of the trance and wondered about whether this feeding system made sense.

The nurse urged me to stick with it. “We don’t want you to feel like you can’t nurse,” she said. I suddenly felt cross. Did she really think I couldn’t handle the reality that my body was not producing milk after it didn’t give birth to my baby? I knew she was trying to be supportive, but her concern made me feel diminished, as if she thought the truth of my infertility were unbearable (yet so easily disguised with plastic tubing). I looked down at my breasts, and they looked awfully small, whereas Melissa’s were enormous, dripping with fecundity, like a relic of a fertility goddess. I ditched the tube.

I felt similarly when Violet was born five days later and another perfectly nice nurse presented us with the hospital’s certificate to commemorate her birth, on which there was no mention of Fie. It wasn’t a legal birth certificate (our lawyer obtained a “prebirth judgment order,” which meant that a legal birth certificate would come in the mail, naming us as the parents) but a sentimental keepsake with a blank space for the baby’s name followed by the words “born to” over a pair of baby footprints. When the nurse came back in, I insisted she reprint it and include all three of our names. Just at that moment, Fie knocked on the door from her adjoining room to complain about her birth certificate, which had been doctored just the opposite way, to exclude mention of us.

“I was just trying to make everyone feel good,” the nurse said, backing toward the door, flustered.

“We feel good about the truth,” I said firmly. And I wanted people to reinforce — not undermine — that feeling.

After we got home, we arranged for a doula to come over to give us a lesson in managing two infants and, twice in the afternoon, apropos of nothing, she took it upon herself to tell me, in a empathetic voice, “just because you’re not their biological mother doesn’t mean you’re any less a mother.”

“Yup,” I replied evenly. “For sure.” But I made sure never to have her to our house again.

'Another woman is nursing your baby'
Melissa and Fie agreed to provide breast milk for the twiblings after the births. Melissa pumped milk for Kieran, but Fie offered to nurse in the hospital, which was the best way to stimulate and establish a milk supply. Michael was hesitant. “You’re comfortable with it?” he asked. But his solicitousness made me uncomfortable; ever since I decided, in the perinatalogist’s office long ago, to value the babies’ health above all, I closed the door on considering those kinds of feelings — and in some sense on experiencing them. All I could think now was that breast-feeding would be better than pumping to get every precious drop of colostrum to line our newborn’s gut and protect her from disease.

After we came home, Fie and Melissa continued to pump. We usually picked up the milk from Melissa, but Fie liked to visit and brought us a full ice chest every few weeks. After Violet had been home from the hospital for a few weeks, Fie drove to Portland from the coast one afternoon with the milk. Violet was beginning to fuss, and it seemed odd to take a bottle of Fie’s milk out of the refrigerator where it had been sitting around losing antibodies and warm it, when the warm-milk source was right there and had just mentioned that at the sound of the Violet’s cries, she felt her shirt grow damp. I asked if she wanted to nurse, and she said sure. After that, if Violet was hungry when Fie was there, Fie would simply unbutton. There was something profoundly moving about the way Violet would pant with anticipation and close her mouth on the breast as swollen, quivering and alive-looking as a sea animal. Fie would thank me afterward, as if I were doing her the favor. Once when Fie was visiting, Violet was sleeping, but Kieran was hungry. It was on the tip of my tongue to ask Fie if she’d like to feed him (since we ourselves mixed up the milk sources for the babies), but I quickly realized that would be inappropriate, as if I thought she were a wet nurse.

Melissa had developed an umbilical hernia near the end of the pregnancy — a painful condition that required bed rest, a trial for someone as active as she. But within a few months after the birth, she had it repaired, shed the pregnancy weight and moved on with her life in her easy way. But for Fie there seemed to be more of an emotional process. She had silver charm necklaces made for each of us. Mine had two charms, with Kieran’s and Violet’s names, and hers had four charms, with the names of her three children — and also Violet’s. I was moved by the gesture — not only by the gift but also by the fact that she would want our daughter’s name resting on her chest. But I hoped it did not mean she was pining for Violet.

There are losses that are damaging — destructive and emptying — and perhaps the sense of loss that a birth mother feels when giving up a child for adoption is inevitably that. But there are losses that are poignant but sweet and that stem from a willingness to give — to invest, attach, love. As we watched Fie through the months, we came to believe that Fie’s was that and that nursing was simply the final stage of the biological relationship she and Violet had shared.

Our nanny, however, was scandalized by Fie’s nursing. “What if someone came over and saw?” she said. “The person would think she was Fie’s baby!” She said she talked about it with another nanny and they both agreed it was improper.

“Another woman is nursing your baby,” she tried to press on me.

“You feed my baby,” I said.

“Another woman’s boob is in your daughter’s mouth!”

“I don’t have a monogamous relationship with her,” I said.

She gave me a horrified look. It was the same look I might give a woman talking lightly about her supposedly happy open marriage: a suspicion that beneath that surface lay an ocean of jealousy and confusion. I understood that in our nanny’s mind-set, a mother for whom breast-feeding was one of the strongest expressions of her maternity, to allow another woman to feed her baby would be an unimaginable violation. But in my mind-set, in which I have my baby only because another woman gave birth to her, the fact that that other woman was choosing to do one more thing to help our Butterball, as we called our rosy little daughter, was also wonderful and great.

Melissa pumped for three months, and Fie pumped for five until her supply dried up. Our doula connected us to another mom who had extra milk who decided to donate to us, refused compensation and regularly lugged breast milk into work for us in an ice cooler for eight months. She didn’t even seem particularly interested in pursuing a friendship with me; she just wanted to help. I had never felt so positively about the world before.

A family created by many hands
The most pointed questions concerned the Fairy Goddonor and whether we should have an ongoing relationship with her. If we did, we were asking for trouble, everyone in the world informed me. I would be triangulating and undermining my maternal status.

“She has thousands of eggs — so she gave you a few,” a friend said. “Why do you have to turn it into more than it is? If someone donated blood to you, would you think you were blood sisters? There’s a reason these things are usually anonymous.”

I remembered how the Fairy Goddonor had once told me that she thought of donation like the program Locks of Love, in which people donate hair to cancer patients. To me, though, the donation was more akin to liver or kidney donation. Although it didn’t save our lives, in saving us from the death of our dream of offspring, it resurrected our future.

“Let it go already!” my friend said. “Don’t send e-mails or photos or presents and — whatever you do — do not introduce her to the babies. That would be a giant misstep.”

But I liked doing those things. We foisted pictures of the twiblings on our friends, and they duly declared them adorable, as we did their children, but I imagined that the Fairy Goddonor and Melissa and Fie took real satisfaction in the pictures. I liked secretly stockpiling the most precious of our outgrown baby clothes for the Fairy Goddonor, even though she didn’t know if she wanted to have children. I tried to persuade her to do an I.V.F. cycle for herself to freeze her eggs (the costs of which we would cover), but whether because infertility was impossibly far away for someone in her 20s or some other reason, I couldn’t get her interested in the idea. “Maybe in a few years,” she said, unenthusiastically.

“The donor’s future is not your problem!” my friend scolded. “You never feel jealous or threatened by her?” she asked, curiously.

“Jealous of?”

“The fact that. . . . ” Her voice trailed off.

“What?” I said. But, like all the others who made similar insinuations, she was unable or unwilling to pinpoint the threat. The main threat I felt was the way in which everyone seemed to think I should be threatened and the anxiety it produced in me that one day I would see what they were talking about.

I once felt a prick of an unpleasant emotion. It was the week the Fairy Goddonor came to Portland for the egg retrieval. Over tapas one night, I watched her and Michael laughing and suddenly felt unhappy. I poured myself more wine, but instead of dispelling the feelings, it made me feel more alone. “You were so quiet at dinner,” Michael said as we got into the car. He turned to look at me. “Are you not feeling well?”

“Is it weird that you’re having babies with her instead of me?”

“I’m not having babies with her. I’m having babies with Melissa and Fie.”

The conversation dissolved into laughter. That was the thing about our conception: there were too many players to be jealous of any one. And once we made the decision to have children this way, and put away regret, I felt happier embracing it than just tolerating it. There was even something I liked about the idea of a family created by many hands, like one of those community quilt projects, pietra dura, or a mosaic whose beauty arises from broken shards. If it takes a village to raise a child, why not begin with conception? When I tried to think about why I don’t want to have donor-and-surrogacy amnesia, it isn’t that it seems unfair to them (although it is), but that it erases our own experience of how our children came to be. At a basic level, the fact that our children originated through the good will of strangers feels like an auspicious beginning.

Oddly, the very aspects of third-party reproduction that others found threatening, I found reassuring. I wanted to avoid what I think of as the claustrophobia of the nuclear family. I wanted my children to have as many other influences as possible — to have other people teach them how to set up camp or shoot a basketball, as Melissa might; or how to say, “Thanks for the food; can I be excused from the table?” in Danish, as Fie insists her children do. I don’t know what the future will hold, and perhaps we will lose touch with them — we all agreed anyone can close the door at any point. But I hope not. If you consider third-party reproduction to be simply a production detail in the creation of a conventional nuclear family — a service performed and forgotten — then acknowledging the importance of outsiders could make it all seem like a house of cards. But if you conceive of the experience as creating a kind of extended family, in which you have chosen to be related to these people through your children, it feels very rich. At the twiblings’ first birthday party, there were lots of people who cared about them, but Melissa and Fie and their families were the guests of honor. And although the Fairy Goddonor was not there, we thought of her and sent her an antique gold charm of an angel hovering over a crib. IVF versus adoption: Which is better?

A friend of mine who looked into egg donation to conceive a second child but ultimately felt too uncomfortable with the process told me that she was particularly sickened by the way agencies tried to romanticize the donors with the language of altruism. One agency went as far as to refer to their donors as “donor-angels” on its Web site. “For Pete’s sake — they’re not angels,” she said. “They’re ordinary young women looking for a way to make money.”

Typically, I thought, they might be ordinary young women (although naturally I believed ours was not) but their role in the lives of childless families is extraordinary. I remembered a conversation I had with a former donor. She was having a wretched Christmas — her boyfriend had dumped her, and she was too proud to try to make last-minute plans — so she sat alone in her apartment. The sole thing that cheered her was staring at the holiday cards with family photographs on her refrigerator from the three couples who used her eggs, and thinking about how — were it not for her — they would all be having miserable holidays, too. “If I don’t do one other good thing in my entire life, I’ll still go to heaven,” she told me and laughed, as if abashed at having revealed a secret pride.

Jeff Riedel for The New York Times

As a girl, I was fascinated with the idea of angels, and that fascination lingered when I became an adult, and my interest in the supernatural variety turned into an interest in the idea of angel as a role that anyone might, unknowingly, momentarily assume. The angel is the benevolent stranger who shows some ordinary kindness to miraculous effect. It is the woman who is friendly to the grungy kid on the bridge, not knowing he had been planning to jump off, but whose chitchat breaks the spell of despair so that, instead of plummeting to his death, he goes home and makes an omelet. The woman would continue on her way, unaware, but for that moment, in that tableau, she was an angel. In a painting of the moment, the light would fall on her.

Needless to say, my own musings on that tableau had always involved the desire to be the angel. Being an object of gratitude is gratifying, of course, but it also turns out that feeling profound gratitude toward another is also a pleasurable emotion — humbling and inspiring. Friends and family have helped me with many things in my life, but I’ve helped them, too, and after all, that’s what friends and family are for. As the phrase implies, an obligation for mutual assistance is part of the nature of the relationship. I had never before felt so unadulterated a gratitude as I felt toward the three strangers who led us across the chasm of childlessness to our Butterballs.

A new romanceInfertility is often described as an irreversible loss, a grief you will carry to your grave. And there are ways in which third-party reproduction is not like the natural experience. There were times that Melissa and Fie would rest their hands on their bellies, and the same dreamy look of contentment would steal over their faces, like a woman in a Vermeer painting — a feeling I would never know. The baby’s heart did not beat under my heart, its immune system was not tuned by my immune system and I was not — physically and emotionally — expecting in the same way. The morning we got the call from Melissa, I felt it wasn’t a good day to have a baby after all — I had work I wanted to finish. I felt as shocked as if I had imagined my virtual pregnancy would lead to a virtual baby, like a pet rock, and I wished we could reschedule the delivery for a couple of months later — say, first thing in 2010, or, better yet, 2013. But then I snipped Kieran’s umbilical cord and took him in my arms, and he stared up at me, not even surprised, and held my finger with the fierce grip that kept his simian ancestors from plummeting to the forest floor, and I whispered that I’d never let him go — and I never will.IVF versus adoption: Why ‘just adopt’ is not the answerWhen our own fertility treatment finally failed, Michael said, “There will always be a part of us that wishes that we had met when we were younger and could have had children naturally together.” At the time, I thought I would always feel that way, but when I look in my heart now, those feelings just aren’t there — and Michael has trouble recalling that he ever felt that way. “Then we wouldn’t have the twiblings!” he said. Infertility feels like a death, but because it’s not the death of a person but the death of a hope — a fantasy about the children that our dead embryos might have become — that grief vanishes when you first hear the beating of real hearts.

Plan A — making babies with the tools you have around the house, as they say, the fun, free tools — faded into the background, and Plan B became foreground. I can count the ways Plan B is a less-desirable way to have children — the route seems to take you off the edge of the world and into the land of scrolly dragons. But when you actually go there, the map shifts. The brain’s ability to rewrite — to destinize, as it were — the birth story and turn a barn into a manger is so powerful that Plan B, all its unsexiness notwithstanding, became the best plan, because Plan B created the children that we have and are convinced we had to have. There had to be a soft spot in the top of Kieran’s head that seems to have been put there to make a perfect hollow for your lips to rest in a kiss. And Violet had to twirl her hair and press her tongue against her lips when she was thinking, in a pose that we call Philosophical Violet — you’d have to see it to see how it looks philosophical, but it does.

Third-party reproduction hardly seems a romantic beginning, but it became romantic to us when it became our story: “Baby’s Own Story,” as the vintage baby books I am filling out for each of them declare. It’s one I am always composing and that, one day, I will tell to our children, and it will take shape and grow in each of their minds, as they write the stories of their lives that become their lives. What do you think of the twiblings story?

Once, there was a couple who wanted to have babies. They tried and tried, but no babies arrived, and they were very sad. But then a Fairy Goddonor brought them some magical eggs. She came from a place where it never rains, and she drove a midnight blue convertible and had long golden hair (well, currently short and aubergine). They took the eggs, and the eggs changed into the beginnings of babies, and they gave them to angel women to help them grow. So the angel women stowed the beginning of each baby in their bodies, where they grew and grew like pumpkins.

Do you know who those babies are?

This article, “,” originally appeared in The New York Times Magazine.