This informative book by a fertility expert and lesbian mom, aimed at individuals and couples of any orientation using assisted reproduction, offers readers a detailed look at assisted reproductive technology (ART), including assisted insemination, in vitro fertilization (IVF), and surrogacy, written in a way that doesn’t take a medical degree to understand. “My primary goal is not just to provide the nuts and bolts of assisted reproduction but also to share the human element of the process,” author Kim Bergman explains. The book is filled with stories of individuals and couples (same- and different-sex) trying to become parents, giving readers a sense not only of the medical procedures, but also some of the emotional ups and downs they may encounter. Bergman herself is a licensed psychologist who has specialized in the area of gay and lesbian parenting, parenting by choice, and third-party assisted reproduction for nearly three decades. She is a senior partner at Growing Generations, an egg donation and surrogacy agency, and a member of the American Society for Reproductive Medicine, among other professional associations, where she serves on the Corporate Board and chairs the LGBTQ Special Interest Group.
Just as relevant as her professional expertise is the fact that she and her spouse Natalie of (now) 35 years started their own family through assisted reproduction. Their two daughters are now in college and graduate school, meaning that Kim and Natalie “were in the vanguard” of queer families forming through assisted reproduction. She weaves in parts of her own story when relevant (e.g., describing her feelings about an early miscarriage), but does not make the book into a memoir. Her own experience informs the content, but does not dominate it.
Bergman has written the book, she tells us, “to help anyone who is contemplating having a baby with the help of others.” Additionally, she hopes that families, friends, and others, “in particular, grandparents, aunts, and uncles,” will read it in order to support them. All readers will appreciate Bergman’s sensible and calming tone and her holistic awareness of what goes into creating a family. “Being aware of where you’re at emotionally, spiritually, and financially is an important first step in the process,” she advises. She then introduces readers to the people they are likely to meet in their journey, such as a reproductive endocrinologist and a reproductive attorney. It is perhaps her own professional bias as a psychologist, however, that leads her to opine, “Having the support of a mental health professional specializing in fertility and ART to help you through the process is not just a luxury; it is essential.” Having gone through reciprocal IVF with my spouse (my egg, her womb) without such a professional, I question whether one is really necessary in all cases—but I would certainly agree that they can provide much value.
Bergman dives into the details of what it takes to make a baby, including finding sperm and egg (as needed), the details of conception and embryo formation, what goes on in the womb, and what happens during the birth process. She notes where things can go awry, especially when trying to conceive, but is as inclusive of families who choose ART from the start (mostly same-sex couples and single parents by choice) as she is of those who turn to it because of fertility problems. People wondering “How should I choose a sperm or egg donor?” “Which partner’s sperm should we use?” “How many eggs should I transfer through IVF?” “What should I do with my extra embryos?” or “How should I choose a surrogate?” will find much information to help guide them to their own right decisions. Bergman also discusses the safety of such procedures and assures readers that research shows children born through ART are just as healthy as non-ART ones.
Even though I have felt fairly well informed on such matters, there were things I learned, especially as the state of ART has evolved since my spouse and I used it. For example, today, “Even HIV-positive men can generate usable sperm, made safe through a ‘sperm washing’ process.” Bergman herself was part of the pioneering work to make this possible, “one of the things I am most proud of” she tells us.
Throughout, Bergman offers encouragement and optimism, even titling one section, “You Can Build a Family, No Matter What.” She tempers this with a dose of realism, however, cautioning, “Having a baby through assisted reproduction is a marathon, not a sprint.” While she is honest about the challenges people may encounter, she also provides ways of coping with them. “Assisted reproduction is a roller coaster,” she writes, “and it is really important that you have tools with which to cope with the ups and downs. Finding an online or in-person support group, journaling about your experience and feelings, and meeting with a mental health professional are just some of the things that can help.”
Bergman devotes a whole chapter, too, to ways of talking about their creation to your child(ren) and to the outside world. This is the one area where she expresses her own strong opinion about how to do things, writing, “I believe very strongly that you should tell your child the truth about how he or she came into the world. And the earlier you do this, the better.” I can’t disagree—and I wish I had her suggestions on how to do so when my own son was younger (although my spouse and I seem to have managed). As for the rest of the world, she says, “Your story belongs to you and your child, so you can share it or withhold it as you please. Just don’t withhold it from your child,” she recommends.
My one criticism—and for some, this will be a showstopper—is that it is not as inclusive of transgender and nonbinary identities as it could be. Phrases like “eggs can be removed from the intended mother” or “the intended father’s sperm” could have used “intended parent” and the sentences would still be understandable in context, while also being inclusive of transgender men who use IVF and transgender women who provide sperm to create a child. Similarly, “A woman is considered pregnant when …” could have been “A person is considered pregnant when ….” (For the story of just one transgender man becoming pregnant, see the wonderful blog Biff and I, by Biff Chaplow and Trystan Reese. In a more academic vein, “Transgender men and pregnancy,” in the peer-reviewed journal Obstetric Medicine shows that Trystan and Biff’s story is not an isolated one.) Let’s hope Bergman updates this language (and a few other instances I haven’t detailed here) in a future edition, for the rest of the book is good enough that I hope it has future editions.
Prospective parents of all sexual orientations who by choice or necessity turn to ART should appreciate the information and reassurance Bergman offers in Your Future Family. More importantly, they will benefit from her overarching premise that “Biology is not the determining factor in parenthood. It’s love that makes a family, not genetics.”
