Friday, February 27, 2009
Thursday, February 26, 2009
When we turned the hallway corner to head toward the maternity floor I had a flood of memories that temporarily consumed my thoughts. The day I had my hysterectomy the regular woman's floor was full so they put me on the side of the hallway dedicated to labor & delivery. As I was walking the halls for 2 days after surgery I was walking alongside new mom and their bundles of joy. It was hell.
Jason & I kept walking and the nursery was located on our left, I stared at the floor as we passed it trying not to catch a single glimpse of all the babies. We arrived at my friend L's room without seeing a single baby. It was a miracle! I was so relieved. I gave her and her dh a hug and offered my congratulations. The baby wasn't in the room and I didn't want to ask about her, but I figured that's what this whole event is about, so I asked where she was. Apparently her body temperature was a little low and they put her in the nursery under a heat lamp, I imagine similar to the roast chickens that are sold at the grocery store. I said, "Oh, I'm glad they're able to get her warmed up". And then it happened...her dad said, "She's in the nursery. Don't you want to go see her?". Well, actually no I don't, but how do I tell a room full of strangers that I came here praying I wouldn't have to see the baby. So, we followed our same path back toward the nursery but this time I was forced to look in. There was a large section of glass and actual steps that you had to step up on in order to view the babies. It was an observatory of sorts, the most bizarre display of children I've ever encountered. I stepped up and glanced at all the babies bundled tightly in their bassinets. I felt like I was peering through the bakery cabinet at a Cake shop...which one do I want? I didn't have to analyze my selections long to know that I'd take any of them, all of them in fact. The crying ones, quiet ones, the black, the white, the ones with no hair or too much hair, the boys and the girls. I would take every one of them and bring them home with me. I am convinced that I would love each one of them with more passion than any of their fertile mother's could love them. We stared at her baby briefly, she was simply perfect, and then we returned to visit L.
Shortly after we returned to the room, the baby was brought in. Apparently her temperature had risen and the nurse explained she had little mittens on her hands and a hat on to keep her warm. L asked if I wanted to hold her, I insisted her family hold her first. Her sister picked her up immediately and after what seemed like only a few seconds, she passed her off to me. As I was reaching for her, someone said, "Be careful, they are contagious". Everyone laughed.
I held her for a few minutes and then passed her off, I then said that L should get some rest so we'll be on our way and we left. The moment we turned the corner from her room I began to uncontrollably cry. I thought it was a somewhat acceptable display of emotion because maybe everyone will think that someone died during my visit to the hospital, which isn't entirely a lie. I think part of me died in that room...or in front of the baby display...or at the florist. Will I ever stop dying?
On the sperm front we have an appointment on March 16th.
Tuesday, February 24, 2009
Our RE (whom we love) is through the University of Michigan, I didn't want to see a urologist through U of M because it's far away and the drive requires extra time off of work and we can't drive together because we come from different directions....but, it appears that's what we'll be doing. A doctor at U of M would never suggest that I obtain medical advice from a website that could be created by a 13 year old doing a research project on male sperm. So, we have an appointment at the end of April to meet the new urologist. Prior to our appointment we have to give 2 semen samples (yes, we, it's a joint effort.) so he has 2 recent samples to analyze. Here it goes...I know it's just $500, but, the price tag continues to climb. IF treatments are so expensive, we tried this once before, I remember our mailbox was flooded with more medical bills than I've seen in my life. I'm trying not to panic over this yet, it's only a small amount of money now....but, infertility treatment is like crack cocaine, it's addicting and once you try it once you can't seem to stop. And, semen analysis is the gateway drug of IF treatments. It doesn't seem like it hurts to "just try it", it's "only" a few hundred dollars, no one will get hurt, there aren't any risks, and no one will even know you did it! The next thing you know you're shelling out tens of thousands of dollars to an IF clinic for surrogacy and IVF, ICSI, and a side of egg donors.
I guess I can safely say surrogacy in India is out. But, surrogacy in the states is very much in. Traditional surrogacy specifically, we've definitely ruled out gestational surrogacy. I don't think normal people consider their childbearing options in this order, but, at least I can say that I've carefully examined each option and in the end we'll be making the most educated choice possible. I can't ask for anything more than that.
On a lighter note, I applied for an online teaching job today. I doubt I'll get called because I'm sure they are flooded with PhD's applying for the position but I would like to put my master's degree to good use and I've always wanted to teach. So, we shall see.
Sunday, February 22, 2009
I had a massage today, with my friend who is 41.5 weeks pregnant, she had hoped it would induce labor. We booked a double room and undressed together, it was tough to fight back the tears to see her beautiful baby belly. It makes me want one of my own even more; a baby and the belly to go along with it.
Tuesday, February 17, 2009
Sunday, February 15, 2009
Do I really think the genetics of an egg donor are far superior than our future birthmother? Nope. I don't. Additionally, I have proof that this stuff doesn't always work out like we envision. A close friend donated eggs to her cousin and 2 were implanted (at different times), which resulted in two beautiful children, one of which has downs. They probably attempted an egg donor knowing they would have all knowledge about her medical history and they would likely avoid any unknown medical problems. I want control, but I'm only tricking myself into thinking surrogacy gives me more control. I need to learn to understand God is the only one with true control and he's upstairs laughing at my attempts to control what ultimately lies in His hands.
I want to be pregnant and that will never happen. I want to feel my baby kick and I somehow think that being able to watch a surrogate lay on the table and see my baby kick in her stomach will make me feel better. I'm not sure it will. I need to learn to trust that God has a plan beyond my understanding. If I want to do surrogacy for reasons other than control, then I think I should do it. But, if I'm choosing it because I think I'm really going to control the destiny of my future child...I should keep dreaming!
Saturday, February 14, 2009
I feel like surrogacy might be an option that suits us better than adoption because I feel like I have more control. I realize that our adoption situation is unlikely to mimic the one in my dreams. But, do I really have control? Am I considering surrogacy with the belief in the illusion of control? When I met with S, our therapist, I told her I wanted to really understand my reasons for choosing one over the other. Why do I want to fly half way around the world, spend tens of thousands of dollars, risk the uncertainty of an egg donor that we receive limited information on, all for a chance at a pregnancy? Oh, and then, we actually have to stay pregnant for 9 months and pray to God that we deliver a healthy baby (and hope that doesn't happen before I arrive in India for the delivery!). Why? Why do I want to do that? Why do I want to spend the first month of my child's life in a foreign country? What makes surrogacy such a better option than adoption that all of that is worth it? Do I really have more control or do I have a stronger illusion of control? I need an answer to this question, I need to find peace. I'm not risking all of our money, all of our time, just because I'm somehow tricked into thinking I have more control when I really don't. And, who's tricking me anyway? No one! It's my own mind, attempting to control anything I can because I realize I've lost total control of my becoming a mother. Women should have control over that. We've been liberated; we fought for the right to choose, the popularity of birth control pills, the right to not spend our lives as uneducated, barefoot, and pregnant in the kitchen. I want the choice that nearly every woman has; the choice to decide exactly when I'll be a mom and under what conditions and how many children I'll have. I want that choice without considering the genetics of an egg donor, selective reduction, or the inequity of an underdeveloped country. What woman needs a history lesson about Asia before she can adequately contemplate conceiving her firstborn?
Does either situation give me more control than the other? I'm not sure it does, I think they both equally give and relinquish control in similar porportions but different senarios. The control, or lack of it, is manifested by different means but exists all the same. So, how do I choose? I'm no further in my understanding in what choice to make. This is annoying me.
Thursday, February 12, 2009
We're going to see S (the therapist) again tonight-together. This is a major decision, flying half way around the world for a baby, and I want to be sure we're doing this for the right reasons...that we're selecting a 'chance' at surrogacy over adoption for the right reasons, and that we're both on the same page. I truly think I'm more afraid of this than I have been of anything. I've been a proven failure in the reproduction department. I'm afraid anything I touch that is semi-related to baby making is destined to fail.
....but, I hate turning away from something because I'm afraid. Afraid? Of what? I'm already a 25 year old in menopause without a single female organ in her body...what else is there to be afraid of? What's the worst that happens-I can't have a baby? No f'ing surprise there! I hate magnets on the refrigerator and I'm certain that even when I'm a mom I will not plaster my appliances with pictures my kids created stuck by ugly magnets. However, on the side of our fridge, tucked away at the very edge is a black magnet (our fridge is black so it's disguised) that says "What would you attempt to do if you knew you could not fail? -Author Unknown". A powerful question, one I'm not sure I'm prepared to answer yet. ...
What would you attempt to do if you knew you could not fail?
Wednesday, February 11, 2009
The appointment was so wonderful. Truly, it's the first time I've left an appointment with an RE without wanting to break down in tears when I got in the car. It's the sick trick they must play in medical school....the same RE that you see for IF issues is the same RE that I see for surgical menopause. Well, not actually the same dr., but the same office. The same waiting room that I sat in with my dh as we underwent ultrasounds and semen analysis is the same waiting room that I sit in now, although now its flooded with other couples with so much hope of creating a family I can hardly stand to be in the room. Only a few seconds need to pass and a hot flash will take over my body to remind me the hope of ever creating a biological child of my own is forever gone. Today though, hope of motherhood was restored, at least temporarily.
Our RE is wonderful and he's the head of the RE department at one of the best hospitals in the country. He seemed overjoyed at our decision to possibly pursue surrogacy in India. He actually said, "totally cool" as he was walking out of the room. Totally cool? I'm not sure on the totally part yet, as flying half way around the world to try to make a baby still is freaking me out, but it definitely has the potential for "cool".
After some recent forum discussions and Internet research I was concerned about the day of ET. I had read some info that suggested that day 5 blastocyst transfer was the best as any embryo that makes it to day 5 is extremely likely to turn into the cutest most adorable baby ever. I'm not sure it actually said the cute & adorable part, but you get the point. However, the clinic we're considering in India does transfers on day 2/3. To my delight, our RE also does almost all transfers on day 2/3. He does agree that in the ideal world of IF (sort of an oxymoron, as in the "ideal" world there wouldn't be IF, but I digress), all RE's would transfer only on day 5 as it could allow the most control over the number of possible babies and reduce the risks of multiples and selective reduction. However, he doesn't believe the medical advances are such that allow for day 5 blastocyst transfers. There are multiple concerns:
Concern #1: Each day the cell continues to multiply and by day 5 it could be multiplying into twins. By the time that cell is implanted & latched to the uterus, the twins will grow & develop in one single sac. For obvious reasons, this is very problematic.
Concern #2: There is preliminary evidence (both practical & theoretical) that "imprinting" could occur. Imprinting references the concern that the cells are growing for an extended period of time outside it's natural environment (the body) and the DNA of the cell is somehow permanently effected by the foreign and unnatural circumstances. They don't know the actual repercussions of this yet, but evidence suggests this is a potential problem of allowing a "baby" to begin development for 5 days in a petri dish.
Another major concern we have is selective reduction. We want to avoid this at all possible costs. I'm so glad we had the opportunity to speak with him about this concern because we learned some fascinating information. First, since we'll be using a young & healthy egg donor and implanting the eggs into a young & healthy surrogate, our chances of pregnancy are about 60% per attempt. Therefore, as few embryos should be implanted as possible. He stated that according to the ART statistics complied by the CDC, the chances of pregnancy does not increase more than 5% when 3 embryos are transferred compared to only 2. However, the chances of multiples & the risks associated with them does drastically increase. Therefore, if we do this, we're only transferring 2 embryos.
Another fascinating piece of information we learned...a twin is likely to be born 1 month earlier than a singleton (8 months gestation), and a triplet is likely to occur 2 months earlier (7 months gestation). However, when you have 3 embryos and reduce 1, thus leaving 2, these twins are likely to be born 1.5 months earlier (7.5 months). Therefore, the risks to your twins are greater when you've reduced from 3 fetuses.
He noted that is greatest concern with this type of venture is the legal requirements, to ensure that we are able to get into the country & leave the country with our baby. We will obviously be researching the laws in more depth and reading through the contract carefully. We may also consult an attorney in the states that specializes in international surrogacy. He did mention that he would like to know that the doctors were trained in Europe or the USA, as those places hold the highest standards of testing. I don't yet know where they were trained, I'm trying to find that information out now.
I was thrilled after our appointment. However, my excitement was short lived when reality set in and I realized that no one was telling me this is a sure thing. Yes, we have all the odds in our favor, but anything could happen. So, I get home and log into my private adoption forum that I haven't visited in several days. This lady has posted-who I adore-saying that she received a call last night that a healthy 22 year old college girl gave birth to a baby girl, signed TPR, selected her & her husband as the parents and the social worker is on their way to her house to deliver their baby. Damn it! I'm happy for her, I really am.....but, I want that! I want a stork, or social worker (I'm not picky), to just drop a baby off on my doorstep! I don't want to fly half way around the world for failure, I'm completely capable of failing in reproduction from right here in my living room.
How do you actually go about making this decision? Adoption? Surrogacy?
Tuesday, February 10, 2009
Here are some of my questions:
We will need an ED and a surrogate. What are our chances of a live birth?
Does have a ED & surrogate impact the decision to do a 2/3 day or 5 day transfer?
Is the pregnancy rate higher w/ 2 or 3 day transfers or blastocyst transfers?
Should I be concerned if our RE in India wants to do a 2 or 3 day transfer
Can embryos be frozen on day 2 or day 5? Does one have a greater quality over the other?
Will am embryo that doesn't make it to blast stage have had a chance if it was implanted at day 2 or 3?
Are you familiar with anyone who has attempted surrogacy in India?
Would you be willing to consult with us as we go through the process of selecting a surrogate & ED?
I'm sure I'll add more as the day goes by. 3:30 can't get here soon enough!
Monday, February 9, 2009
We were confident that we would adopt. I didn't think there was a reason to pursue surrogacy if we couldn't produce a child that was biologically related to both of us. I truly wonder how I got back on this path. I'm frustrated, the infertility rollercoaster is a rough ride with dozens of seemingly impossible choices to be made. The adoption rollercoaster isn't much different, but I've experienced the heartwrenching disappointments of the IF journey that I'm hopeful the adoption journey wouldn't be so tainted. There are many success stories on both sides; couples waiting only a few days for "the call" and have their baby in their arms just hours later and couples that experience a textbook pregnancy after their first IVF. I have little confidence in my body's ability, so thank God we'd be using an egg donor.
There is a baby at the end of an adoption journey. That same guarantee isn't so with surrogacy. I know many couples that have experienced failed domestic adoptions or were in the midst of an international adoption when the country closed its doors, but knowing we would be pursuing domestic adoption and we've already done our research, there would be a baby at the end. It might be a long wait, and we may experience failed matches, miscarriages, or a birthmother's change of heart, but eventually there is a baby.
There might be a baby at the end of surrogacy. Do we gamble with every penny we have (and don't have) to take the route that is less certain? There are some amazing possibilities with surrogacy. I'm most attracted to knowning that our baby receives excellent pre-natal care and the connection that we can have to our developing baby during the pregnancy. I want to see the first ultrasound, hear the heartbeat, and know the second my child joins this world. I want to know the surrogate is caring for herself, that excellent physicans are ensuring her health, and all the necessary tests are being done during the pregnancy. I can't get those guarantees with adoption.
What if we spend everything we have and there isn't a pregnancy? We fly half way around the world and come home childless. How would we ever afford adoption? How long would it take us to save the funds to adopt? How many times would we attempt pregnancy if we weren't successful the first time? And, then, there's the actual pregnancy. Getting pregnant is only half the battle, then we must stay pregnant. What are the chances we'd have a successful pregnancy that ends with a healthy baby?
Sunday, February 8, 2009
I have extensively researched adoption. Since the adoption laws in our state are horrible, we know we would adopt out of state, which adds significant costs because we'd need to stay in that state until ICPC clears which could be several weeks. If there are any complications with the TPR, the stay could be longer. We've estimated that adoption would cost us approximately $30,000, give or take $5-10,000. The great part about adoption is that we know, in the end, there will be a baby. However, the sad reality is that the baby is almost certainly exposed to nicotine in utero and possibly other drugs, extensive stress, and the chances are high that the birthmother will not have a diet rich in essential vitamins and minerals. That is very difficult for us to accept. As much as I love Cold Stone, I know I wouldn't be putting anything in my body that wasn't organic, vegetarian food if I was pregnant. I don't even allow people to smoke cigarettes around my pets, I certainly am not comfortable with my baby being trapped in a bubble filled with second hand smoke for 9 months.....I digress, I'm off topic. So, the point is, we estimate the costs to be $30,000, of which a possible $10,000 is "at risk", meaning if the birthmother changes her mind prior to the TPR we will have lost that money.
Surrogacy in the states is priced out of most people's range. Since the insurance companies are quickly catching on, most insurance clauses now exclude surrogacy which means the IP (intended parent) is responsible for buying the surrogate an insurance policy (the cost is unreal, since you're buying insurance for a soon-t0-be pregnant woman) or paying for the prenatal, labor & delivery out of pocket (anyone ever looked at their hospital bill before?). So, surrogacy in India is an option that is possibly affordable for us. I emailed one of the clinics today (to remain nameless at this point) to get a breakdown of their fee structure. Here it is:
Stage I (A+B) $ 8,900
(Surrogate booking; Agreement; IVF / ICSI procedure; Pregnancy test)
Surrogate investigations, preparation, endometrial priming & booking
Legal (agreement) charges
Follicular monitoring, Procedural (IVF / ICSI) charges, Hospital stay, semen freezing, ET, surrogate care, pregnancy test
Stage II $ 7,900
(Antenatal care; Surrogate medications, investigations, special care, special accommodation, child care, diet, lost wages, Insurance, surrogate clothing)
First trimester (3 months)
Second trimester (3 months)
Third trimester (3 months)
Stage III $ 5,900
(Delivery; Post natal surrogate care; Visa assistance)
Delivery process (normal / caesarean), birth certificate
Visa assistance, DNA testing (from UK Lab)
Surrogate care (2 months) (Medications, stay, care, diet, lost wages)
Indian Egg Donor $ 2,950
(Egg donor selection; investigation; booking; fees; medications; egg pick up)
Egg donor selection, recruitment and booking
Legal (agreement) charges, agency program charges
Egg donor investigation, stimulation, monitoring & medications
Caucasian Egg Donor $ 13,550
(Egg donor selection; investigation; booking; fees; medications; egg pick up)
Egg donor selection, recruitment and booking, flight, hotel stay, food
Legal (agreement) charges, Nurture, agency program charges and ED compensation
Egg donor investigation, stimulation, monitoring & medications
To try once would be approximately $12,000 in medical costs (we need an egg donor and would use an Indian egg donor) and the travel costs to India. My preliminary research estimates the airfare to be approximately $1,500 per person and hotel accommodations to be around $300 a night. We would need to stay in Mumbai about 7 days and both of us would need to be present to sign the contract. Considering the other costs of visas, transportation when in Mumbai, food, etc. I think it will cost about $20,000 to attempt pregnancy once. That's a lot of "at risk" money. I believe it is possible to freeze some sperm in India, if the first attempt does not succeed, they could use the frozen sperm and another fresh cycle with an egg donor and we wouldn't have to return to Mumbai. Or, if we have frozen embryos left we could try a FET. I'm waiting to hear back from the clinic to see what the options and costs are if pregnancy does not occur the first time.
My wish is become a mom. I believe God exists and He has a purpose for each of us. Noah's purpose was to build the Ark, Walt Disney's purpose was to bring endless joy to millions of children, George Bush's purpose was to temporarily destroy happiness for every American for eight straight years, and my purpose is to be a mother. Despite God's best intentions, he apparently misread the manual somewhere because he created me with more reproductive issues than any woman should ever have. I struggled through most of my childhood with endometriosis, adenomyosis, and PCOS; all but the later remained undiagnosed until I had a hysterectomy when I was 22. After which, I met the love of my life. I love the phrase "the man of my dreams", but I would be lying if I called him that. I didn't dream of marriage or a tall handsome man to sweep me off my feet. I was perfectly content standing on my feet, but he made me weak in the knees and we were engaged 9 months after our first date (on which, I kissed him first).
In February 2007 he proposed to me with a ring hidden in a container of Cold Stone ice cream (minus the ice cream) and I immediately began making every wedding plan. Within 2 months, our entire wedding was planned for the following year. We wanted a long engagement, a chance for me to finish grad school and prepare for our wedding. Just 3 months after our engagement, my doctor informed me that the endometriosis and ovarian cysts were doing permanent damage to my ovaries. If we ever wanted to consider a biological child through surrogacy, we would need to act quickly. So we did. We cancelled our entire wedding the next day and immediately began planning a wedding for 3 months away. Within weeks we were beginning fertility treatment and arranging to meet with the surrogacy agency in Chicago, IL. For those that don't know, surrogacy is illegal in Michigan, and Illinois is known to have the most modern surrogacy laws in our country. There were several set backs but we continued to forge through the red tape and toward our dream. After consulting with several physicians, we were told our chances of success were extremely low. My ovaries were consumed with cysts and with my history of endo, it was unlikely we'd produce quality eggs. It was a chance I wanted to take, but with a price tag that exceeded $80,000 for surrogacy, of which about $25,000 has to be paid before we even know the quality of my eggs, we opted not to take the risk. We proceeded with our wedding and were married in August 2007.
I was finishing my last semester of grad school, while writing my thesis and simultaneously taking courses toward my PhD, so we couldn't schedule the surgery to remove my ovaries until December when the semester ended. I've often contemplated writing a book about my struggles with infertility, and although it wouldn't be appropriate I think a perfect title for my memoir would be: Everything I learned in life I learned from Oprah Winfrey. I love Oprah. Seriously, I love her. She is a true gift to this world and she inspires me to live my fullest life even in the darkest days of infertility. In October she had a show that featured a couple who had decided to pursue surrogacy in India. By the next evening, in the middle of the night, I was on the phone with the doctor in India that was featured on the Oprah show. The actual doctor. Her name is Dr. Patel and her clinic had a waiting list of 300 couples when I spoke with her. I explained to her the urgency of our situation and she was willing to move us to the top of the list. The doctor-from Oprah-was putting us at the top of her list! Jason & I discussed this in great detail. I discussed it with my RE and even consulted an additional RE for a second opinion. Everyone agreed, the chances of success were extremely low. Additionally, they would require me to have my ovarian cysts aspirated and that procedure had to be done in the states (unless I wanted to spend several months in India or make multiple trips). None of the RE's in the states were willing to perform the procedure if they were not also the dr's to perform the IVF. Ahh, the bureaucracy of the medical profession in America! So, again, Jason & I decided not to proceed with surrogacy and one month later my ovaries were removed.
We've been fairly confident that we would proceed with adoption, however, there are many aspects of surrogacy that strongly appeal to me. I'm so excited to explore our options, read about other's stories, and learn about all the possibilities that await us.