The waiting room was quiet, save for the occasional shuffle of papers and the muffled hum of a nearby conversation. I shifted in my seat, feeling Malcolm’s gaze on me. He had been uncharacteristically quiet since we walked in. I knew what this meant to him. The question of children had been hanging between us for weeks now—him eager, me hesitant.
Dr. Serena walked in, her presence steady as ever. She sat across from us, her expression unreadable but warm. “Alright, let’s talk about it,” she said, folding her hands over her lap. “Leata, I know you’ve had concerns, and Malcolm, I can tell you’re invested. So, let’s lay it all out.”
Malcolm leaned forward, resting his elbows on his knees. “I just wanna know what our options are. What it would take, realistically.”
Dr. Serena nodded. “Okay. First things first—pregnancy, for Leata, isn’t impossible, but it’s not straightforward either.” She turned to me. “Your body presents a unique reproductive profile. You don’t have functional ovaries or fallopian tubes because of your intersex traits—meaning natural conception isn’t in the cards.”
Malcolm exhaled through his nose. “So, what does that mean for us?”
She held up a hand. “It means we have alternatives, but they come with considerations. The main method we’d look at is embryo transfer with IVF (in vitro fertilization). That means creating an embryo outside the body—using a donor egg and Malcolm’s sperm—then placing it into your uterus.”
I crossed my arms. “And my uterus can actually handle that?”
“That’s the big question,” she admitted. “Your uterine structure is present, but we have to consider your insufficient cervix and the uterine strain you’ve been experiencing. Right now, your body’s still recovering. Pregnancy puts immense pressure on the uterus, and yours might not be able to sustain it without intervention.”
Malcolm frowned. “Intervention, like what?”
“Best-case scenario, we could reinforce the cervix with a cerclage—a stitch to help keep it closed and support the pregnancy. But even then, there’s a high risk of preterm labor or pregnancy loss.”
I chewed my lip. “So, is carrying even a real option?”
Dr. Serena sighed. “If we get your body to a stable place, it could be. But it’s risky. The safer alternative would be gestational surrogacy—where the embryo is placed in a surrogate who carries it to term. That bypasses the risks your body would face, but it’s a separate journey entirely.”
Malcolm rubbed the back of his neck, his expression tightening. “So, either way, we need an egg donor?”
“Yes,” Dr. Serena confirmed. “Since Leata doesn’t have ovaries producing eggs, we’d need a donor egg. We fertilize it with your sperm, then decide whether to transfer it to Leata’s uterus or a surrogate’s.”
I glanced at Malcolm, reading the frustration in his posture. “You were hoping for something easier, huh?”
He shrugged, his jaw tight. “I just—look, I get it. I just thought maybe there was a way… you know, for it to be ours without all the extra steps.”
Dr. Serena met his gaze directly. “I get where you’re coming from. But biology doesn’t work that way. This is what we’re working with.”
I sighed, feeling the weight of it. “I do want to be a mother someday. But I don’t know if I want to do all this for you, Malcolm.”
His eyes flickered with something unreadable, but he didn’t argue. He just nodded slowly. “I just needed to know what’s possible.”
Dr. Serena softened her tone. “Take your time with this. The decision to have children, how to have them, and when—those are deeply personal choices. Leata, your body needs to be prioritized here. And Malcolm, your role is to support, not pressure.”
He exhaled sharply but nodded. “Yeah. I hear you.”
I reached for his hand, squeezing it. “We’ll figure it out. But on our terms.”
Dr. Serena smiled. “That’s exactly how it should be.”
This keeps the discussion medically sound while balancing the emotions at play. It presents Malcolm as invested but slightly selfish, and emphasizes your autonomy in making this decision. Let me know if you'd like any tweaks!
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