Wednesday, February 11, 2009

Answers from RE

We met with our RE today to discuss our options for surrogacy in India. Since we'd be using an egg donor & surrogate, there aren't any issues with "me" since I'm not really needed in this we just wanted to discuss international surrogacy in general and answer a few specific questions about ET and such.

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?


  1. Sounds like you had a great visit with your RE...I am jealous! The decision is very difficult. For us, we want to try surrogacy first hoping for the genetic link. We have looked into adoption and based on our age 40 we would be on a list for 5-7 years. I guess you could pursue adoption and see how this works out for you- and then see ifany of the potential hurdles are too much or tolerable. Stay positive...its very hard I know.

  2. Hi Sara,

    I found your blog through the surrogacy india forum. We are in very similar stages or our potential journeys to india, in fact, we met with our RE on Tuesday and walked out just as happy as it sounds like your hubby and you were after your appointment. We have discussed adoption and in the future we think that it might be a good choice for us but first we are going to give surrogacy a try using an ED! It’s funny you talked about 2/3/5 transfer because we were asking the exact same questions on Tuesday. Our RE claimed that with ED blastocyts and healthy sperm they always transfer on 5 because the conditions are “ideal.” I am pretty sure that we will limit the transfers to two embryos. Our RE strongly advised against transferring more than two and I don’t think I could selectively reduce. Good luck with your decision!


  3. Thanks Kerrie! I'm following your blog-it's exciting! I hope you're able to give me lots of advice soon about all of this :)

    Stacey-are you in the USA? I'd really love to chat with you about how you made your decision about surrogacy v. adoption, I'm so torn....especially because both you & would be using an ED...I really understand why people choose surrogacy over adoption when they will have the full genetic link....but for us, it's such a different type of decision. If you'd like, email me,, I'd love to hear from you about how you reached your decision. Good luck!!!!