FAIRFAX, Va.—So long as Muasher deemed the embryos of comparable quality, Chad and David wanted him to transfer one from each batch. This so-called "dual embryo transfer" would increase the odds that their surrogate, Whitney Cruey, would get pregnant, while also increasing the chances of twins. Chad and David had always been comfortable with that prospect; they wanted siblings, and twins would give them two for the price of one.
Some doctors would not perform dual embryo transfers, because in cases of genetic defects they would not be able to determine a child's paternity without DNA testing. That was exactly what appealed to Chad and David. If possible, they wanted to cloak the paternity of their children, even from themselves, in order to reinforce their equal stature as parents.
The couple recognized there might be an obvious resemblance, or that they might have to learn paternity for a birth certificate. But this way, at least during the pregnancy, if someone had the nerve to ask who the "real" father was, they could answer honestly that they had no idea, or that both of them were.
In addition to choosing which embryos to transfer, Muasher had another critical decision to make — whether to transfer the embryos after three days, when they typically would have grown to eight cells, or after five, when each would have become a mass of 100 or more cells known as a blastocyst. Three-day transfers were more common, but some research suggested that blastocysts were more likely to implant in the uterine lining.
Muasher felt it was an open question. You could expect to lose embryos between the third and fifth days of incubation, meaning there would be fewer to freeze for a second attempt. And if more than one blastocyst were transferred, the odds of a multiple pregnancy would be high. Twins and triplets, while sometimes desired, carried greater risks of miscarriage and premature delivery.
Three days after the egg retrieval, Muasher studied the embryos and saw that a number had cleaved into eight cells. He summoned Chad, David and Whitney to his office that morning.
He told them he had graded 12 of the embryos as good candidates for transfer, based on their structure and cell division. He would try to pick the best one from each man's batch and freeze the rest.
"We're looking at a 50 to 60% chance of success," he said. They had a young egg donor — the most important variable — and pregnancy was more likely with fresh embryos than with frozen ones. If Whitney got pregnant, the odds of having twins would approach 30%.
Statistically, this first transfer would be their best shot.
WHITNEY felt ready to play her part. A 25-year-old college student, waitress, and single mother from Frederick, Md., she had been wearing estrogen patches on her lower abdomen for nearly three weeks. As the estrogen seeped into her body, it coaxed her uterus into reacting as if she were ovulating. The hormonal surge made her so emotional she found herself sobbing through "Fahrenheit 9/11."
On the day Muasher collected Jessica's eggs, Whitney added a daily shot of progesterone to thicken her uterine lining. It was administered with a 2-inch-long needle. If she got pregnant, she would have to continue the shots and patches for up to two months, one of many burdens she would endure for her $20,000 fee. (If she did not get pregnant, she would receive just $2,000, plus $500 for each unsuccessful embryo transfer.)
In the nearly five months since Whitney had signed on with Chad and David, they had made a point of going to dinner and visiting each other's homes. But the time they spent together only seemed to magnify their differences.
She couldn't relate to their vacations in Tuscany and the concert tickets they bid for on EBay. She found herself afraid to touch anything in their immaculately decorated house. Their walk-in closet was the size of her apartment bedroom, and she wondered if they had any idea how much baby-proofing the place would require.
On the morning of the procedure, classical music lilted through Muasher's operating room as he prepared Whitney to receive the embryos. Dressed in blue scrubs and masks, Chad and David took seats just to her left, and reached for each other's hands.
The embryologists flashed magnified images of the two embryos onto a monitor in the O.R. They looked vaguely lunar, their eight cells like craters in a gray landscape. This is surreal, Chad thought, our first view of our children.
"They look almost perfect," Muasher said. "This is the uterus there. We're going to try to put the embryos right in the middle."
Muasher took the catheter containing the embryos, which were suspended in fluid, and maneuvered the tip into place. He depressed the plunger on the syringe and held it for 15 seconds. After withdrawing the slender tube, he handed it to an embryologist to check under a microscope. She returned to say the embryos were gone.
Whitney smiled serenely throughout the procedure, which she said was no more uncomfortable than a Pap smear. Muasher instructed her to limit her activity for 24 hours, and to return in 13 days for a pregnancy test. He handed Chad and David the culture dish that had held the embryos.