In part one of Dr. Linda Nicoll’s story, she recounts deciding to get pregnant at 40 using a sperm donor and IVF. She explains how she chose her sperm donor, the IVF process, and support from family and friends through the process of making her decision to become a mother.
“Dr. Linda Nicoll’s Story, Part A: The Choice to be a Mom”
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Dr. Fox: Welcome to “High Risk Birth Stories,” brought to you by the creators of the “Healthful Woman” podcast. I’m your host, Dr. Nathan Fox. “High Risk Birth Stories” is a podcast designed to give you, the listener, a window into life-changing experiences of pregnancy, fertility, and childbirth. I’m here with Dr. Linda Nicoll.
Dr. Nicoll: Hi.
Dr. Fox: Linda, it’s so nice to see you. We were just catching up. I guess we haven’t seen each other in person…I guess it was like eight, nine years now, right?
Dr. Nicoll: It was after Hurricane Sandy and I was in a group and we were seeing patients in your office because our office had no electricity.
Dr. Fox: Yeah.
Dr. Nicoll: And all of Lower Manhattan was kind of dark at the time.
Dr. Fox: Right. You were at NYU, but you came up to Signet to deliver, and then after Sandy you eventually went back to the NYU world, correct?
Dr. Nicoll: Yeah. You know, I do a little midtown. I do a little uptown. I try to keep changing it up for variety.
Dr. Fox: Right. But we met originally back I guess in 2005?
Dr. Nicoll: Yeah. I was a second-year resident at Cornell and you were the new fellow.
Dr. Fox: The big bad fellow from the North woods from Mount Sinai.
Dr. Nicoll: I was telling my mom who drove me here, I was saying you were one of the smartest guys that I ever met.
Dr. Fox: You told your mom this, that she was one of the smartest guys you’ve ever met?
Dr. Nicoll: No, no.
Dr. Fox: Mom, you’re one of the smartest guys I’ve ever met, I just want you to know that.
Dr. Nicoll: I told my mom that about you.
Dr. Fox: Oh, that’s sweet of you.
Dr. Nicoll: And of course, then I had to, you know, make sure she knew you were already married when I met you so that she didn’t think that I was one of the dumbest women she had ever met.
Dr. Fox: No, those were good times. I remember. I was coming to a new place because I was at Mount Sinai for medical school residency, and there for eight years. And I come to Cornell, which is a brand new place where, even though it’s 20 blocks away, it’s like a different world, I didn’t really know anybody pretty much. And it was a lot of fun meeting a whole new group of residents. And you guys train one way. I trained another way. And we were sort of like trying to figure each other out. I’m like, “Why are we doing this way?” And you guys are like, “Well, we do it this way at Cornell.” And then there’s sort of that interesting, like, “Well, let’s see and try to…which way is… You try my way, I’ll try your way, and we’ll see how it goes.” And I have really amazing memories for my time at Cornell. It was three great years. I loved it.
Dr. Nicoll: I had a very similar experience because then when I graduated residency from Cornell, I went to fellowship at Stanford, and then I ended up at NYU. And everyone’s like, “That’s not how we do things at NYU.” And I’m like, “Well, you know, I’m coming from Cornell and Stanford. So I’m not coming from left field here.” And they were like, “We don’t do things that way.” And I’m like, “Okay, but, you know, things got adopted and integrated in a really great way.” So I think it’s awesome when all these institutions kind of like…you hop around and you get this amazing collection of skills from the different places that you practice.
Dr. Fox: Yeah, I remember when I was a resident, the MFM fellows who came, one of them, Meredithe Rechan who did her OB training in Texas and she came in she used to call it ‘the third eye,’ when she would suggest something and all of us would sort of look at her like she had a third eye, like, “What the hell are you talking about?” And she’s like, “No, no, we really do this at Baylor. Like, this is how it’s done there.” We’d be like, “Not so much at Sinai.” And it’s crazy how different these cultures are. They’re not major differences, but when you’re used to doing it a certain way…it’s like cooking. If you take a chef and, you know, go into someone else’s kitchen and be like, “What are you doing? Like this is not how I whisk things.”
Dr. Nicoll: I also felt really good when I started as an attending and the residents were like, “So back when you were a resident, did they have pagers?” And I’m like, “No, we use carrier pigeons.” It wasn’t that long ago. And even my dad had a pager back in the day. But my intern year was the first time I had a cell phone that could text. So it gives you some context of, like, how long ago it was.
Dr. Fox: Yeah, my kids think that I grew up in an era that was black and white. And they refer to it as, you know, “Growing up in the 1900s,” which is terrifying.
Dr. Nicoll: That’s awful. I can’t wait until my son says things like that to me because I already feel super old because people are like, you know, “Oh, is that your baby?” I’m like, “Yes. I’m not his grandmother. Yes, that’s my baby.”
Dr. Fox: “That is my baby.” So good segue, we’re gonna be talking about the birth of your son, Sammy, who is now about six months old, which is exciting. Take us back to the beginning of your journey to have Sammy. When did it start?
Dr. Nicoll: So I turned 40 in 2018. And I always said if I’m not married or don’t have a partner by the time I’m 40…I really have always wanted to be a mom. And I didn’t want the fact that I hadn’t found my partner by that age to be reason why I didn’t get the opportunity to have a child. And having always wanted to be a mom and having always thought that that was something that was important to me, I talked to my parents and I said, “If this relationship that I had been in didn’t work out, how would you feel about me having a baby because if I’m doing it without a partner, I’m going to need your support?” And my parents weren’t just like, “Yeah, we support you.” My parents were like, “Great, what are you doing? Can we help in any way?” And I was floored. They were so excited. And the only people that I really told were my parents and some close friends. And I started looking for a donor. I started casually searching like on Google, like, “How would you go about having a pregnancy with a donor?” And then sort of as expected…
Dr. Fox: You mean a sperm donor, not an egg donor. Right. Right.
Dr. Nicoll: Yeah, with a sperm donor. As I was sort of expecting, the relationship that I was in ended shortly after my 40th birthday. And I was like, “Okay, like, I saw this coming, and let’s get down to brass tacks.” And I went and I saw a fertility doctor. And my fertility doctor is Fred Licciardi at NYU who is amazing and who, through this journey, has been my rock.
Dr. Fox: Yeah, he’s a great guy. Yeah.
Dr. Nicoll: Yeah. And so I saw him and he was like, “Great. Like let’s run some blood work and this and the other, and we’ll get you started.” And unsurprisingly, my blood work showed that my egg reserve was not good.
Dr. Fox: Not good. Okay.
Dr. Nicoll: And I was not surprised by this because back in 2014 and 2015 when I was about 34, 35, I had actually done two egg-freezing cycles. And that was back when it was experimental.
Dr. Fox: Right. I was gonna ask you about that if you’d ever considered egg freezing sort of leading up to the age of 40.
Dr. Nicoll: Yeah. So what had actually happened was…you remember, Dr. Mazin [SP] he was my chief resident when I was an intern and a tremendous friend to me and a tremendous influence on my life.
Dr. Fox: And a super smart guy. Yeah.
Dr. Nicoll: And he’s super smart.
Dr. Fox: Yeah, he’s definitely higher up on the totem pole than I am. Maybe even your mom. I don’t know.
Dr. Nicoll: It’s a tall totem pole, but he’s near the top. And he had told me, he was like, “When are you getting married? Where is your guy?”
Dr. Fox: He was very forward.
Dr. Nicoll: Yeah. He’s Egyptian and he’s very, very open.
Dr. Fox: Sure.
Dr. Nicoll: And he was like, “Let’s get you a man.” And I’m like, “I’ll keep you posted.” And then he was like, “Well, if this isn’t happening, like have you thought about fertility preservation?” And so I did two cycles and my numbers were not great then. And with the two cycles, I got I think four eggs the first time and like six the second time, but like one of them died. So they ended up freezing nine of my eggs when I was between 34 and 35. And so now I’m 40 and I’m seeing Dr. Licciardi. And he’s like, “Listen, why don’t you do some fresh IVF cycles and you can save the frozen eggs then if you wanted to have a second child when you’re older and you’re more likely to encounter infertility.”
Dr. Fox: Was any thought of just using a sperm donor and sort of a natural, so to speak, cycle like IUI or whatever?
Dr. Nicoll: Because my numbers were so bad they gave that as an option.
Dr. Fox: Right, but they were pessimistic.
Dr. Nicoll: But they were pessimistic. And also knowing what I do about the infertility journey as a doctor, I see how often IUI doesn’t work out. And if I was going to put all those hormones and drugs into my body, I wanted to sort of maximize my chances. In my head, I was like, “Okay, we’ll do IVF. I’ll get a couple of embryos. We’ll implant one, freeze the extras, and like I’m good to go.” Because I hadn’t at that point tried to get pregnant and so I was like, “IVF is gonna work. Why wouldn’t work? I’m only 40. And they got eggs when they did the egg freezing like this should be a no-brainer.”
Dr. Fox: To set the stage, at this time between your 35 and 40 professionally, you’re an OB-GYN.
Dr. Nicoll: I’m a rock star.
Dr. Fox: Right. You’re an OB-GYN and at this point, you were doing both OB or just gynecology?
Dr. Nicoll: I was originally trained in residency in OB-GYN and I did a fellowship in minimally invasive surgery at Stanford. And I was doing both for a while. And then in 2014, I stopped doing obstetrics and just did the minimally invasive and the gynecology. And at that point, I was full-time faculty at NYU and I was seeing patients, doing surgery, and teaching.
Dr. Fox: Right. And you’re also a comedian.
Dr. Nicoll: That is true. I’m an amateur stand-up comedian. I don’t think you’ve ever been to one of my shows, but a lot of my coworkers have.
Dr. Fox: I’ve seen them on the YouTube.
Dr. Nicoll: Am I funny?
Dr. Fox: Yes, you are. But I knew you were funny. And you were funny the first day I met you. That wasn’t a surprise. There’s a difference in being funny and being good on stage.
Dr. Nicoll: That’s true.
Dr. Fox: So you’re both, right. You could be very funny and be a very bad stand-up comedian, but you actually…you’ve got the chops. You’re funny on stage.
Dr. Nicoll: If you think about it doing morning rounds with me for three years, you’ve had a lot of free comedy.
Dr. Fox: I appreciate it, you never billed me. Yeah, you get a sense of how people are, and again, some people just get up in front of others and they shy away. They can’t land the lines. It’s a different skill than just being able to say funny things.
Dr. Nicoll: I love being on stage. I love the energy that you get from the crowd. I love making people laugh. I love having interesting things to talk about. And I also love going to shows and meeting comics because I think comics are some of the most interesting, fun people to hang out with.
Dr. Fox: Right. Right. I mean, very warped but in a great way. Yeah.
Dr. Nicoll: Oh, yeah. Yeah.
Dr. Fox: One of the interesting things and this is obviously a divergence from your birth story, but it’s so interesting, you bring in OB-GYN into your shows. Like, you’re knee-deep in it. I mean, you’re talking about it. Is that something that you sort of wanted to do or just because it’s your world, it’s what you see, it’s what you’re doing, it’s just where you find funny things day-to-day?
Dr. Nicoll: I used to do improv, and then I sort of like aged out of that because I think if you try to do improv after 30, I think they shoot you like a lame horse. So I started doing stand-up and I took stand-up lessons at The PIT. And at the graduation show, they like to give you some advice, like, “Don’t ever do this again,” or like, “You have some potential maybe, you should consider continuing to do this.” So at some point, I had my little like talking-to. And the guy said, “You’re very funny but everybody talks about the difficulty of dating and finding love in New York City and all these things that you too are talking about. So if you want to be successful as a comic, you should talk about what is unique to you, and I don’t know any other OB-GYN stand-up comics.”
And I was like, “I don’t know any other OB-GYN stand-up comics either. Maybe I could be that person.” And the one thing that I said is I never talk about my patients, but I do talk about OB-GYN in general. I talk a lot about vaginas because that’s a funny topic, I think, for the whole family. And I did talk an awful lot about the infertility journey and about things like choosing a sperm donor in my comedy. And I think, to a large degree, the other thing I love about comedy is it’s a release for stress. So going through a difficult time trying to come to terms with infertility, getting up on stage and sharing that, you know, although it is such a vulnerable thing to share, it was also like, “If I can make the audience laugh about it, I can laugh about it too.”
Dr. Fox: Right. Yeah. I mean, it’s the same principles as like a group therapy where you talk about it and you get feedback on what you’re saying. It’s obviously different. You know, I think most people when they go to group therapy aren’t trying to do stand-up comedy.
Dr. Nicoll: And I think most group therapies don’t have a two-drink minimum.
Dr. Fox: Yeah. Maybe they should. That would be a great idea by the way for a therapy group with a two-drink minimum.
Dr. Nicoll: It’s like that’s the 13th step in our group therapy is the cocktail hour.
Dr. Fox: That’s it. We’re onto something. I like that. So you’re going through this, you’re around 40, and now you’re in the thick of it, and you’re meeting with a fertility specialist. And now you have to pick your sperm donor, right?
Dr. Nicoll: Yeah.
Dr. Fox: So how does that work?
Dr. Nicoll: It’s not unlike match.com in the sense that you go online and there are profiles of all these potential donors except it’s super creepy because they don’t show you an adult picture of the donor. It’s actually their childhood photo.
Dr. Fox: Oh, yeah. I mean, to see what your baby might look like.
Dr. Nicoll: Yeah.
Dr. Fox: Oh, that is a little weird.
Dr. Nicoll: It’s super creepy.
Dr. Fox: All right.
Dr. Nicoll: So you’re basically you’re looking at pictures of like two and three-year-old little boys to pick who you want to be your baby daddy.
Dr. Fox: Right. From the ’80s.
Dr. Nicoll: Yeah.
Dr. Fox: Sort of like kind of wrinkled, not quite digital.
Dr. Nicoll: Yeah. There are a lot of like school photos and photos that were obviously taken at, like, the Sears photo studio.
Dr. Fox: Yeah. You’re like, “Whoa, big hair.” Yeah.
Dr. Nicoll: Yeah. A lot of like interesting, you know, fashion going on. A lot of overalls.
Dr. Fox: I never thought about that, that makes so much sense.
Dr. Nicoll: And they don’t show you an adult picture because it’s anonymous, but you do want to see kind of what the kid is gonna look like. And so you’re scrolling through these people and…
Dr. Fox: This is online I assume, right?
Dr. Nicoll: Yep.
Dr. Fox: Yeah.
Dr. Nicoll: And they all have like weird screen names just like they do on dating sites. So that’s super creepy as well because like it wouldn’t be like Nath-ey 1976 or whenever you were born. It’s whatever. I’m trying to remember what my donor’s screen name was, but it had something to do with baseball.
Dr. Fox: Is it like the “Top Gun” call names? Like ‘Iceman’, you get ‘Goose’, you get ‘Maverick’. Like those types of things, people have to give their cool names?
Dr. Nicoll: Yeah, you have to have your cool name…
Dr. Fox: Oh, I like that. Like ‘Nick Dog 74’ or something.
Dr. Nicoll: Yeah, ‘Vag Doc 78’. So you go through these profiles and then it tells you the standard kind of stuff. It tells you their height, their hair color, their weight, their eye color, and then it starts to get into things like their occupation, their education, family history, family history of illnesses, you know, what was their parents occupation, and then there’s like a personal essay, and sometimes it includes things like a favorite animal. And it was really it was a very weird process to read these things especially the favorite animal like…
Dr. Fox: Right. Is that ever a game-changer?
Dr. Nicoll: Yeah, actually it was.
Dr. Fox: Like, ” Yeah, I like this guy, but I can’t like anyone who likes squirrels. it’s just not possible.”
Dr. Nicoll: No. No. I am amazed at the insight it gave me that you’re looking at these profiles and you’re reading what they wrote about themselves. And I found that, you know, the guys who said that their favorite animal is like for example a dog, I was like, “Those are like solid, guys.” And the guys who were like, “My favorite animal is a dragon.” I’m like, “That is a mythological beast and, like, that tells me something about you as well.” And then anybody who is like…
Dr. Fox: You’re like, “Although my child might get into MIT.”
Dr. Nicoll: Right. Entirely true. But also like, anybody who wrote like rat or ferret or like spider, yeah. Okay. Fine. Exactly. Like you wouldn’t think, but I was like the favorite animal thing it actually did give some insights.
Dr. Fox: Yeah, I guess someone did research and said, “This is a good question to discern.”
Dr. Nicoll: So my daughter’s favorite animal is a dog.
Dr. Fox: Oh, thank God. That’s a normal thing. And you were telling me that you got to choose your donor with your mom and your dad?
Dr. Nicoll: Yeah. So actually my parents and I went to Zion National Park in Utah. We were like on like a little family vacation. And my dad had a medical conference, so it left me and my mom some time to just like hangout in like Utah. We went to like Salt Lake City and we ended up in Vegas. So we were kind of like driving around and I was sitting in the back of the car looking at sperm donors and being like, “Mom, what do you think of this one? Mom, what do you think of that one?” And my mom had some very specific criteria. She wanted to make sure it wasn’t somebody who would carry any diseases or family history of things that frighten her. Like her mother died of breast cancer, so she wanted to make sure it was not somebody with a history of cancer in the family for example. And I think I told you my dad had one criteria and he just wanted somebody who was over six feet because my dad is 6’1″. My brother is 6’2″. My nephews are basically the giants. And he just wanted the kid to kind of like match the rest of the family.
Dr. Fox: Right, “I can’t love a grandchild who’s not tall.”
Dr. Nicoll: My grandfather was five feet tall on my mother’s side.
Dr. Fox: Yeah. But probably he would have been 6’2″ if he got fed as a child.
Dr. Nicoll: All of that is true. But I think my dad was kind of like, “You have some serious short genes on your mother’s side and we have to combat that.” I’m not sure what’s wrong with having a short child, I think it’s wonderful, but my dad really wanted me to have some height on my side.
Dr. Fox: Right. How many Jewish parents really get to choose the man who mates with their daughter?
Dr. Nicoll: My mother did. I was a little bit picky, my mom was very picky. And then there were certain criteria that…
Dr. Fox: “Linda, what kind of dog? What kind of dog does he like?”
Dr. Nicoll: Actually, ironically, the only pet that I have is a fish because they’re hypoallergenic because of my mother. So I want somebody who wants a dog, but they can’t have a dog. And then you wonder why I’m single in my 40s. Right.
Dr. Fox: I’m just curious, did you have any hesitation about doing this? I mean, because you’re sort of like, you know, “Oh, I got eggs frozen and I decided at 40…” And it comes off as like a very quick decision, but how much time did you personally think about this or grappled with this? Or was it a very straightforward decision for you? I’m just curious.
Dr. Nicoll: I had a relationship end in a very bad way when I was 36. A guy who I was seriously dating and who I thought I was gonna marry broke up with me at my parents’ house on Rosh Hashanah. It really just devastated me. He basically told me you didn’t want to have kids and he didn’t love me anymore. And I was like, “You should probably go home then.”
Dr. Fox: Like, “Happy New Year.”
Dr. Nicoll: “Like I feel like you shouldn’t stay for dessert. Like we’re having coffee, but you can go.” But it was really devastating. And it occurred to me that being with someone who didn’t want kids, you know, I was willing to give that up for him if he’d loved me and if he wanted to stay with me. And I was like, “What is wrong with you?” “Like you’ve always wanted to be a mom. Like if that’s really what’s important, then this is something that you can do.” So, you know, I dated after that and I wanted to start a family, but it occurred to me that I could do that without somebody as well. And I didn’t want that to be the way I was going to build my family because I wanted the conventional, you know, husband and wife get married, you know, have children the standard way, but it was clear that my path was not heading in that direction.
And I had the financial resources to be able to do it because I had worked for so long and have a great job. And I have my parents to support me and I have amazing friends. And of course, I have, you know, my brother and his wife and they have two kids. And I wanted my future to look a certain way, but when it wasn’t looking that way, I was like, “Okay, I can do this.” And that process probably took about two or three years. And I sat down with one of my cousins who’s a mother of two and I told her, I was like, “I don’t know how I feel about having a child who will not have a dad. And like, you know, yes, I may find somebody and have a partner and that person may be a stepfather, but what does it mean to have a child and to bring a person to the world saying, ‘You will not have a dad.’?”
And my cousin was like, “The fact that you’re even thinking about this, the fact that you want all of these things for your child, I have no doubt you’re going to give him everything that he needs. And no child has everything. There are people whose parents get divorced. There’s people who have a parent who dies. You know, you never know what your family is going to look like. But the fact that you’re thinking about this, the fact that you want it for him, means that you’re going to find ways to fill the gap.”
Dr. Fox: Right. Why do you think your parents were so supportive right away? Is it just because they had also been thinking about it or because they wanted you to be happy? Or they thought that, “Wow, we’re gonna have a grandkid through our daughter”? What is it you think? Because I’m sure many parents will be supportive immediately. Some would be hesitant at first and supportive afterward, and some wouldn’t be supportive. I’m just curious what you think about that.
Dr. Nicoll: I have a really small family because we lost a lot of relatives in the Holocaust. Like my entire family on my mother’s side was decimated by that. And my grandparents on my mother’s side treasured my mother. She was their only surviving child. And that was incredibly important to them to have a child and to continue the family. And so for my mother, having more grandchildren, you know, each individual grandchild is a treasure. But the idea of her daughter having a baby is something that she always wanted to have grandchildren. And my brother has two kids, but they live up in Syracuse. So we see them from time to time, but she knew that she would have unfettered access to whatever spawn I might produce. So she knew whatever baby I have like she would be a very involved grandmother. And she was super, super excited about that.
And of course, you know, I’m a female clone of my father. I look like my father. I act like my father. I am my father. I’m a prettier version of my father. But me and my dad are very, very close and we’re very much alike. And I think the idea of my dad getting to see me go through parenthood was very, very exciting for him. And the idea that he would have one last try to have a grandchild with his big blue eyes because he has big blue eyes, I have big blue eyes and my nephews have brown eyes and hazel eyes, which are absolutely beautiful. But to have a grandson who maybe looks like him, you know, there’s a certain biological drive that makes us want these things. But he’s very, very proud of me and I think the idea that his daughter who he loves, who’s like him and who’s proud of might have a child who would also bring that same joy to me was very exciting for him.
Dr. Fox: Were you expecting them to be so on board right away? Or were you sort of prepared for everything?
Dr. Nicoll: I knew they’d be supportive because when I was freezing my eggs, I told my mom, I was like, “I’m freezing my eggs.” She’s like, “Okay, sweetie.” I’m like, “Ima,” the Hebrew word for mom, like, “Ima, don’t say, ‘Okay, sweetie.’ Don’t say, ‘Whatever you want.’ What do you think of this?”
Dr. Fox: “Give it to me, mom.”
Dr. Nicoll: “I just want you to be happy.” I’m like, “Ima, what do you think of me freezing my eggs?” And she goes, “I just wish I knew the father.” And I was like,” Mom, no, they’re just eggs. They’re just mine. They’re not fertilized. They’re like for eventually if I wanna use.” She’s like, “So it’s just yours.” And I was like, “Yeah.” She goes, “Oh, that’s great. That’s wonderful. Why didn’t you tell me?” She wants me to be happy and I knew she would be supportive. But I was not expecting necessarily them to be just thrilled and excited, and they were more supportive than I could have ever asked for, and they’re wonderful.
Dr. Fox: There must have been such relief, you know, to know that they’re there with you 100% from day one because it’s a real process. And like you said, you know, I guess you could do it without a support system. It’s doable, but I mean, how much harder is that, and how much lonelier is it? But when you have a family, and they’re on board, and they’re supporting you, that’s just amazing. It must have taken such a weight off of the whole process.
Dr. Nicoll: I’m really blessed because I have really amazing parents and I get along with them. And that I would not necessarily have not done it if they weren’t super excited or supportive, but the fact that they are super excited and supportive makes it so much more fun. It’s so good for the baby. It’s so good for me. It’s so good for them. It has exponentially multiplied the joy in our relationship in ways that, having not had a child before, I could not have possibly imagined. It has taken my relationship with my parents to the next level. It has made them just unimaginably happy. I feel very blessed. So, of course, I could have done it without them, but I don’t know that I would have.
Dr. Fox: Listen, I know for my own kids and I imagine this is true for many families, there’s your kids and it’s obviously a challenge, but it’s a great joy, you know, with your own children and seeing them develop and seeing who they become as people and raising them and your relationship with them. But then there’s sort of like the meta concept of your children, which is this idea of like link and a chain that’s sort of connecting the child to your parents and to people who died in the Holocaust and to your heritage and this idea of adding someone to a family. And these are much sort of bigger concepts and you don’t need those to have children and to enjoy them, but it just adds so much richness to the family when those sorts of storylines are in play. And the relationship kids have with their grandparents is just unparalleled. It’s just unbelievable what it does and what, you know, I mean, how everyone feels about their grandparents. It’s just, “Oh, my grandparents.” Like everyone has such a nice relationship and it’s really wonderful to get to see that and give that gift to them like you said.
Dr. Nicoll: I was very fortunate three of my grandparents were around when I was little. My father’s father died when my dad was a teenager, of pancreatic cancer. Again, going back to the whole like don’t get a donor with cancer thing, you know, it’s a very important thing in the family. But both of my mother’s parents were around when I was little and I had a wonderful relationship with them, especially with my mother’s father. And I had a wonderful relationship with my father’s mother. And I just wanted very much to continue that line and, you know, there is the concept of Jewish guilt that, you know, all…
Dr. Fox: Right. It’s more than a concept. It’s a reality like a brick, you know?
Dr. Nicoll: Yeah, that all of all these relatives who perished, you know, maybe they didn’t have a chance to grow up, or maybe they grew up and they had children and their children didn’t have a chance to live a good life. And here I was with the chance to give life to another generation and it was something that I wanted anyway. So to want it for myself, I also couldn’t help wanting it for my parents and I couldn’t help wanting it for my grandparents. And not to put a lot of responsibility on my six-month-old’s tiny little head, but he is the continuation of just a legacy of people who loved each other and who wanted to have children and to pass that love on. So he is just a continuation of that love through the generations of my family.
Dr. Fox: How did it go, the process?
Dr. Nicoll: It went terribly. It went absolutely awful.
Dr. Fox: We know it worked out. We know that the story ends well. So, people, don’t worry about it. Okay.
Dr. Nicoll: There’s a happy ending. Do you know there’s different prices for different donors based on their desirability I think?
Dr. Fox: I would imagine. It’s an open market.
Dr. Nicoll: Yeah. So there’s some sperm that costs like $600 or $700, but like I wouldn’t reproduce with that. I got the good $900 stuff. That’s like $900 per vial.
Dr. Fox: It’s $600, it’s 5’9″, you’re like, “I’ll pay the $300 to get the six feet.”
Dr. Nicoll: Yeah, I’m like, “Do you have something a little taller in the sperm department?” And so I picked my sperm donor. I scheduled the cycle. I got the medicines. The medicines were very expensive. So even though a lot of the cost of the treatment was covered by insurance, the cost of the medicine was about 5 or 6 grand for each cycle. And I was giving myself shots and taking, you know, patches and pills and all that stuff.
Dr. Fox: Right. The whole thing, it’s IVF, I mean, you’re doing everything. Yeah.
Dr. Nicoll: Yeah, it’s super fun as a doctor to be injecting myself and to feel guilt for every patient I told it’s not that bad, and all of a sudden I’m doing it to myself and I’m like, “I’m so sorry…
Dr. Fox: Like it is that bad.
Dr. Nicoll: … if I ever said it wasn’t that bad. I just didn’t know.” And I’m injecting myself up to five times a day with various sundry medicines. And, you know, my kitchen basically looked like a chemistry lab with little vials all over the place, and like alcohol swabs and like sharps containers.
Dr. Fox: Right. Cotton balls.
Dr. Nicoll: Yeah. And of course, it’s like a New York City apartment kitchen, so it’s pretty small to begin with. So the medicines pretty much squeezed out anything that resembled food for a while. So, you know, it sort of took over my life. And I did I think two or three cycles where it didn’t work out. And when I say it didn’t work out, it was always the same kind of story. I would have the retrieval and they would get between, say, two to five eggs. So we’ll say, you know, five for the purposes of mathematics. And so they would retrieve about five eggs. And then the next day, they would call and they would say, “Four of them fertilized.” Because it’s always a process of attrition. It’s less and less as time goes on. So they never all fertilize. Okay, so you have five, four are fertilized. And they’re like, “Great. Now you have to wait five days for them to reach the blastocyst stage.”
So blastocyst, for those of us who don’t have this knowledge, is a clump of cells five days after fertilization. And the reason why it has to get to that point is because I wanted to do genetics before freezing any embryos. And the reason I wanted to do genetics is because at my age, the likelihood of an abnormal embryo was really high and not abnormal…we’re talking about like Down syndrome or something where you could have a healthy baby with a disability but a non-viable, non-survivable embryo. And I did not want to have the opportunity to know that the embryo wouldn’t survive and then have it put in and then have a miscarriage and have to go through that pain. So I said, “If I can know before you put it in that it’s a good embryo, I’d like to do that.” So on day five, I would get a call that all of them were dead.
Dr. Fox: Right. They all voted off the island.
Dr. Nicoll: Yep. Or I would get a call that one of them looks really good. And I’d be like, “Oh, my God, great. Like one of my eggies made it.” And then you would have a two-week wait, and then I would get a call, “I’m sorry. It wasn’t normal.” And they would discard it. And that happened, you know, two or three times. And I sat down with the doctor, and I was like, “This is not going well.” He was like, “I have noticed as well that this it’s not going well.” And so we made a decision to use the frozen eggs. And I said, you know, “It’s fine. If I only have one then I only have one child then let’s use the frozen eggs and get me a baby.”
Dr. Fox: And it’s more likely to be genetically normal because you were five years younger.
Dr. Nicoll: Exactly. And I had nine frozen eggs and they say that each of them has about a 10% chance of a live birth. So I was like, you know, “Math, math, math, I’m probably okay.” Though I was not okay. So they did the fertilization. I think six of them fertilized. And I wasn’t gonna do genetics because they were from what I had been younger, but we got to day five and they were like, “Okay, they’re all dead.” And this was the day that I was leaving for one of my best friend’s bachelorette party up in the mountains and we were going to like a spa and doing yoga and all that stuff. And I’m like on my way there and I’m just losing it in tears and not enjoying myself. So it was a lot to be going through, but I was very, very lucky because that weekend I was with a bunch of my friends and they were so supportive.
Dr. Fox: Did they know what was going on?
Dr. Nicoll: That particular group of friends did.
Dr. Fox: Got it.
Dr. Nicoll: So those were like my infertility squad-type friends. These were girls who had gone to college with and some who I had met later who were, you know, just incredibly supportive because I had gone up and they were expecting me to have gone to that bachelorette weekend having done the implantation that day, that we were gonna celebrate because I was gonna be pregnant and, you know, news flash, I was not.
Dr. Fox: Right. They’re like, “Linda is going to be our driver.”
Dr. Nicoll: Because I wasn’t supposed to be able to drink. But I did drink that weekend.
Dr. Fox: Yeah, I imagine heavily. Yes, okay, which is quite therapeutic under the circumstances.
Dr. Nicoll: It was the one grace. So I came back from that and I said, “Okay, so I’ll keep plugging away at the IVF stuff.”
Dr. Fox: Did you ever think of giving up at that point or using an egg donor?
Dr. Nicoll: Not at that point. After six failed fresh IVFs…
Dr. Fox: Oh, god.
Dr. Nicoll: Oh, no it gets better. I sat down with Dr. Liccardi and I said, “I don’t really know anybody who’s done more than six of these and that’s not even counting the two frozen cycles.” I said, “I don’t really know anybody who’s done this more than six times. Like does it make sense to keep going?” And he was like, “Well, what do you want to do?” And I said, “Well, every time we do this, you’re getting eggs. And I look at this as a gamble, you know, if you’re telling me I have a 5% chance of a pregnancy, then I’m gonna sit at the table until my number comes up or I run out of money. And, you know, it’s a gamble and all I have to lose is money, time, and sanity. And as long as I’m saying I can afford it…
Dr. Fox: Right, just a little bit less.
Dr. Nicoll: …and I’m able to do it, then let me keep trying because if I stopped now, and then I regret it, and then I decided to try next year, it’s going to be even harder.” So I was like, “Let’s keep pushing.” And to his eternal credit, he said, “I will continue to do this with you until you’re tapped out.” And you know, eventually, I actually did tap out financially. And I went back to these wonderful parents that I had. And I was like, “I want to continue doing this, but I can’t afford it.” And they were like, “Yes, you can. You have us and we will help you.” And my parents were the reason I was able to continue. So I did it nine times. It’s like Ferris Bueller, “Nine Times.” And then I finally got a good embryo.
Dr. Fox: There we go.
Dr. Nicoll: And then I did one more cycle after that because I didn’t want to say, you know, “I’m definitely gonna make my son or daughter and only child.”
Dr. Fox: Right, just in case. Yeah.
Dr. Nicoll: Because I wanted to see if I could get one more because I still had, you know, my $900 sperm and I had some leftover drugs from the successful cycle so it only costs like $2,000 or $3,000 instead of $5,000. So I was like, “Let me use up what I have and see if I can get one more embryo,” which I didn’t.
Dr. Fox: Okay. So 10 times and a ninth one, one embryo.
Dr. Nicoll: So the ninth time I got one embryo. And they called me and I was at work. And they had called me at work numerous times where they were like, “I’m sorry. It’s no good.” And of course, like, the medical assistants in my job are like, “No, if Dr. Nicoll is balling in her office, it’s probably the fertility people and we’ll just close the door gently.” And this time they called and I’m in the middle of work and I’m just like preparing to be disappointed, preparing to start crying. And they’re like, “Oh, it was it was a good one.” And I was like, “I’m sorry, what?”
Dr. Fox: “No, this is Linda. Sorry.”
Dr. Nicoll: “So it’s okay?” And they’re like, “Yeah, it’s a good embryo. Do you want to know the gender?” And I had always said, “No, I want to be surprised. I want to see it in an ultrasound.” I was always one of those people who’s like, you know, knowing more is not necessarily better and the word yes shot out of my mouth like a bullet. I was like, “Yeah, tell me everything about it.” And they were like, “Oh, it’s a boy.”
Dr. Fox: “What’s his favorite animal?”
Dr. Nicoll: If they could have told me that I would have wanted to know. And they told me it’s a boy and it made it feel very real. Because it’s like, okay, so now I have an embryo, fine, whatever. There’s no pronoun attached to an embryo. But now I have an embryo and it’s a he. Now all of a sudden it feels very real. And I was like, “Okay.” I did what normal people do. I went with my parents to Atlantic City and went to a Jonas Brothers concert to celebrate because that’s how you do. And then it was Christmas and the holidays and the IVF office was closed and now it’s January and I’m like, “All right, I’m ready to schedule my implantation.”
Dr. Fox: And this is January 20-?
Dr. Nicoll: This is now January 2020.
Dr. Fox: 2020. Pre…
Dr. Nicoll: So this has been going on for a year.
Dr. Fox: This is pre-COVID.
Dr. Nicoll: This is pre-COVID.
Dr. Fox: Got it. We’re COVID minus two months.
Dr. Nicoll: This is like you’re seeing on the news about this virus in Wuhan. And we’re all like, “Man, It must suck to be them.”
Dr. Fox: Yeah. Right.
Dr. Nicoll: So I was like, “Okay, like when are we doing this implantation? Like I’m super excited for this.” And they’re like, “Well, actually, you know, your uterus doesn’t look so great.” And I was like, “Pardon.” So I knew that I had fibroids. I have three of them. The largest one is three centimeters. So for like non-doctor normal people, that’s about the size of like a large cocktail olive or like a kumquat. And so like not very big. And I was like, “All right, fibroids are like not a big deal.” They were like, “We think what you might have is adenomyosis.” And for, again, those of us who don’t do this for a living, adenomyosis is a condition where cells that normally line the uterine wall are actually inside the wall itself and it can cause inflammation, and it can make it really hard to get pregnant.
And I was just like, “I don’t know what to do with this information.” And they said, “Well, have you considered using a surrogate?” And I said, “No. Hadn’t thought of it. How long does it take to arrange a surrogate and how much would it cost?” And they said, “Well, you know, it could take a year or two and it costs about 150 grand.” And I burst into tears. And I was just bawling and I was like, “I went through all of this to finally get my, like, golden little Faberge egg embryo that, you know, I’m already thinking of names for, and you’re telling me my uterus is garbage and I’m going to need a surrogate? And I can’t do this. I can’t afford this.” And also I wanted to carry the baby. I mean, I accepted that if the IVF hadn’t worked out, you know, I was already thinking, you know, “What if I need an egg donor?” But it had never occurred to me that I couldn’t carry the pregnancy.
Dr. Fox: Right, that you wouldn’t be pregnant.
Dr. Nicoll: Right. That was not something that had…I mean, I suppose it should have crossed my mind. You know, it didn’t cross my mind that I would get this far.
Dr. Fox: Did they ultimately just implanted and see what happens?
Dr. Nicoll: I told them, I said, “You know what? This is the uterus that I have, you know, throw it in there,” not literally, but figuratively. “And if it works, it works and if it doesn’t work, then I’m back at square one and I’ll have to decide what to do. But I don’t have 150 grand and I’m not going to have 150 grand. And it either works or it doesn’t and I can accept that having come this far.” And Dr. Licciardi did a saline infusion sonogram to kind of recheck things out. And his words almost exactly were, “It’s actually not as bad as I remember it,” referring to my uterus. And I was like, “That is the biggest compliment my uterus has ever gotten. Thank you. Thank you.” And he was like, “Let’s give this a try.” And so a week before lockdown, I went in to have my embryo transfer and I said to them, “Are you guys going to be open next week because I have to, like, come in for a pregnancy test?” And they were like, “Yeah, yeah we’re gonna be open.” I’m like, “Great.” So I had the transfer. And at the end of the transfer, they give you a picture of the embryo.
Dr. Fox: Right, like electron microscope type thing.
Dr. Nicoll: It’s an electron microscope black and white picture of basically a clump of cells. And they handed me the picture and they said, “Linda, this is your baby.” And on the one hand, it’s absurd because It’s a clump of cells, and on the other hand, I started crying and for once I was crying tears of relief and tears of joy. And, yeah, you know, maybe it wasn’t going to work but I had this just overwhelming sense of relief wash over me. I’m like getting tear-eyed even thinking about it. And I still have the picture, of course, to show him, you know, “I’ve loved you since you were three microns big.”
Dr. Fox: Thank you for listening to “High Risk Birth Stories,” brought to you by the creators of the “Healthful Woman” podcast. If you’re interested in telling your birth story on our podcast, please go to our partner website at www.healthfulwoman.com and click the link for sharing your story. You can also email us directly at firstname.lastname@example.org. If you liked today’s podcast, please be sure to check out our “Healthful Woman” podcast as well, where I speak with leaders in the field to help you learn more about women’s health, pregnancy, and wellness. Have a great day.
The information discussed in “High Risk Birth Stories” is intended for informational and entertainment only, and does not replace medical care from your physician. The stories and experiences discussed in our podcasts are unique to each guest and are not intended to be representative of any standard of care or expected outcomes. As always, we encourage you to speak with your own doctor about specific diagnoses and treatment options for an effective treatment plan. Guests on “High Risk Birth Stories” have given their permission for us to share their personal health information.