Honestly, there are some doctors that take a throw in the kitchen sink approach to IVF, but Clomid is suboptimal for IVF cycles because it thins the endometrial lining, and implantation is already lower for IVF than for natural cycles. It also is one of the fertility drugs that has been proven to have potentially long term, deleterious consequences for women who use it for more than a certain number of months (I think it's something like 10 or 12). So it really shouldn't be used, and in all the cycles I'm familiar with, it hasn't been. But I can't certify that no doctor uses it, no, you are correct, and a prospective donor should ask in advance what the drug protocol will be, and, in my view, reject the use of Clomid in a DE cycle.

I am very conflicted about this subject. I've had three obstetricians, two male and one female, and they all brought different strengths and weaknesses to the trade. In reviewing my history, I think experience counted more than any other factor, including gender, in overall capabilities. But I think the real problem is that, this is an area where the whole ends up being a lot less when the sum of the personal preferences leads to de facto segregation of an entire medical field. As a female doctor explained to me once, once a field is filled with only women, it's credibility declines and it stops being the focus of innovation, research, and basically, enthusiasm. It shouldn't be this way, but I can see why it would be: Men, mediocre or brilliant, are discouraged from entering the field (already happening), and high achieving women, sensitive to being "ghettoized" elect a different field -- and before you know it, Ob-gyn is a little backwater for people who couldn't do something else. This view has dragged down the status of teaching, nursing, and even being a secretary. It's a reflection of our screwed up culture, but then, showing any sexual preference, even this one, is a reflection of our awareness of sex differences. FWIW, I don't like being touched by "anyone," male or female, down there, that is, unless it's my hubby.

I've never dealt with a close family member who is an alcoholic, but I have tried very hard to get close family members into treatment for mental illness. I have the following reaction after reading the article and letters:

1. Ask your husband to stop drinking for two weeks. Don't threaten to leave or give an ultimatum, which raises the stakes too much and leaves you with no lesser option, just state that you and he disagree whether he has a problem, and ask him to try and do that much for you. A cousin of mine did this with her alcoholic husband and it met with some success. This is also how we convinced a family member to try recommended psychiatric treatment. If he won't, then you have information, and if he tries but can't then perhaps both you and he have additional insight. And it's only two weeks.

2. See a lawyer whether you have made a final decision or not. Ask what's possible and determine what kind of documentation you will need to convince a court that your husband's drinking is a potential danger to your children, and how you can get it.

3. Remember that unlike marriage, divorce is often a zero sum game, and the easier you make his life the harder you will make your own. So you might need to do things that strike you as ugly and terrible but the alternative is to allow yourself to be victimized over and over again.

4. Never, ever, let your husband get into a car alone or with your children while he is drunk, when you are present. Call the police if you need to.

It was, by far, my healthiest pregnancy (out of four). I didn't have GD or any other complications. My mother's mother was 42 when she was born. My father in law was 47 when my husband was born. He's now 93, while my dad, who was 30 when I was born, died more than 10 years ago at the age of 64, never really knowing any of his grandkids. Those of you who are so good at predicting the future, I challenge you to write down which of your friends and relatives will still be here 10 or 20 years from now. You don't know. And whatever the younger set brings to parenting in the form of energy, the older set often brings commitment, patience and perspective, not to mention no longer needing to strive to establish a career and a life at the same time they are trying to be a good parent. Parenthood after 40 has its drawbacks, its risks, and its rewards, like mostly everything else in life.

The literature on older fathers is quite interesting. As I see it, the difficulty with this research is that it doesn't really provide much guidance at an individual level. Similar to family history of schizophrenia, age "enhanced" risks are still sufficiently trivial that their incidence appears to be more the luck of the draw or the result of random chance. It's difficult to tell a whole population that they should cease procreating because they have only a 95% rather than a 99% chance of having a normal child (those aren't real numbers, but I believe the order of magnitude is in that range). There are people with much higher chance of genetically based diseases who still believe that it's appropriate to take the risk of disease -- Cystic Fibrosis, Huntington's Chorea, Hemophilia, and so on. Even if you don't have the urge to reproduce, it's something that should be acknowledged as real in many if not most people. Maybe the answer is to redouble our efforts to identify and treat mental illness in humane ways?