Monday, December 28, 2009

Being There

With the busier December holidays behind us, I had a little time to reflect on our efforts to book a hotel room and a flight. We learned a few useful facts about India - and travel to India - and I thought I might share them. Now as Shannon would surely warn you, unless you get a kick out of minutiae, think twice before letting me take you on any kind of tour. I love details, the story behind the story, the whys and the wherefores. Tell me something I don't know - please. I'm genuinely interested. The problem is I sometimes forget not everyone feels the same way. Let me prove that to you.....

Before I begin: In retrospect, could we have just written to Amit Kulkarni - the travel agent recommended by Surrogacy India and mentioned by Shannon - and just trust him entirely to find a suitable hotel? You know what, maybe we could have. His prices were very competitive and he's got lots of happy customers. (In fact, if it wasn't for my ability to get corporate rates through my company, Amit's prices were the best we found.) So for anyone else heading to Mumbai, no shame in starting with Amit. That said, you'll feel a lot better doing your own homework as well. Oh, and Amit only handles the hotels. For flights you're on your own.
  1. What time is it in Mumbai? Well, if you're on the East Coast of the US, subtract 90 minutes then flip am/pm. When it's 8am here in Boston, the Mumbaiers (I just made that up) are heading home from work because it's 6:30pm. And it's later there - they celebrate the New Year before we do.
  2. India's currency is the rupee, currently equivalent to a bit more than two US cents; today it's 46.5 rupees to the dollar. The US has a fairly weak currency right now - our English brother-in-law runs around the streets of Boston laughing, British pounds in hand - so even the rupee is relatively strong compared to past history. Why does this matter? Well it means the fantasy of five star hotel rooms at one star prices is just that - a fantasy. It's not as bad as finding an affordable room in New York City either though. And the fun part is you get to refer to daily room rates in the thousands. "My room costs 5000 rupees?!? What, is it covered in gold? Oh, that's only $110 dollars? Never mind...."
  3. Booking a room in a country you've never been to, a city of 15 million people (that's not a typo) with a heavy mix of the have and have-nots is pretty daunting. Where to look? As Shannon touched on, we favored finding someplace 1) relatively near the hospital we'll be frequenting, 2) in a safe neighborhood (if that's meaningful in such a large city), and 3) near a bunch of restaurants with varied cuisine. We settled on the Hotel Novotel, Juhu Beach. This was not some revelation; the area came highly recommended by other SI patients.
  4. Reading up on the experience of other travelers - not just those on surrogacy missions - taught us to subtract a star for all home-grown hotels. (A 3 star would be a 2 star by our standards.) For international chains, on the other hand, expect some consistency. From what we could tell, at least on Juhu Beach, the simplest room at a true four star hotel starts at $175 a night, not including tax.
  5. Little side note that made sense was to reserve the hotel room at a rupee rate, not a US $ rate. Exchange rates change daily so unless you're an arbitrage expert, why gamble and hope the exchange rate doesn't make things more expensive for you?
  6. Internet access is almost never included in the room price. Worse, it's price tag is clearly meant to milk a captive audience. On average, Internet access costs $18 per day. Some hotels do include it, however, but from what we saw, the nicer the hotel, the less likely Internet access was included. Call it the we-cater-to-business-people-with-expense-accounts maneuver. It's certainly possible that rogue, free WIFI signals can be found drifting through your hotel room but one ought not to expect it.
  7. Sometimes taxes are included in a room rate, sometimes they aren't, and either way it's never clear. Amit always quoted prices that included taxes. If you're doing this on your own or working with some other agent, make sure you know the story.
  8. A visa is necessary for entry into India. Think of it this way - a passport identifies who you are, a visa grants you permission to enter a specific country. Traditionally, visa applications were submitted through a country's embassy; India, and a few other countries, now work through a third party, Travisa. There are quite a few different kinds of visas (business, tourist, student, etc.) and validity duration (6 months, 1 year, 5 years, etc.). As a US citizen we could choose from 6 month, 5 year or 10 year tourist visas and settled on the 5 year. That worked out to about $170 per person - not cheap but not negotiable.
  9. There's a whole bunch of routes from the US to Mumbai, some direct and some indirect. As Shannon mentioned, we let price be a guide - turns out this meant a quick hop from Boston to Newark and then a non-stop on Continental from Newark to Mumbai. All told, about $1000 a head. As luck would have it, going direct was our preference anyway even though it does mean sitting in a petri dish for 16 hours straight. (Some folks might prefer a European layover just to break things up.) We did build a long layover in Newark, however, just to be triple sure our luggage and bodies make the connection. Seems the Boston/Newark flight is often quite delayed.
Why be predictable and go to 10? (Or be like an amp and go to 11?) Thanks for letting me get these off my chest and feel free to share questions in the Comments, or email us, if you're hungry for more. And remember, we still haven't set foot in India yet; we hope like hell that after this is all over we can say, huh, we were actually right about that stuff!

Sunday, December 27, 2009

Let the Fertility Festivities Begin

Exciting day for us in our household as we kicked off the morning with my FIRST birth control pill in addition to my prenatal vitamin! Watch out hormones!  Next step, IVF shots, which we begin January 13th.

We hope everyone is doing well and enjoying the holiday season.  Here's to an unforgettable 2010 for all!  xo

Saturday, December 12, 2009

Passage to India

A somewhat huge weight has been lifted now that we have our airfare and hotel booked. Next steps - starting the birth control pill and our IVF meds! (Wait a second. What’s my rush? Birth control and IVF meds?!?!)

It turns out there’s not much of a trick to finding the best priced flight. Despite all our efforts, we couldn’t beat travel search engines like Kayak (our favorite), Mobissimo, Expedia, Orbitz, etc. What does make it a bit complicated is choosing between direct flights from the U.S. vs. connections through Europe. Living in Boston as we do, even direct flights require a connection as no airline flies directly to Mumbai from our city. That said, it’s usually a quick hop from Boston to a hub like New York or Newark. The real question is the time. Do we want 16 hours in one plane – from the U.S. to India – or two 8 hour flights (with a possibly long connection) through a variety of European hubs? When all was said and done, Geoff and I allowed price to dictate our preference. Turns out that Continental flies direct to Mumbai from Newark. Combine that with a hop from Boston to Newark and we had the most affordable option. So we are now scheduled to leave on January 26 and arrive in Mumbai on January 27 – yay!

As for the hotels, Geoff and I thoroughly researched and compared prices for eight hotels in Mumbai and we finally decided to go with the Hotel Novotel Mumbai Juhu Beach, a new hotel that had opened this past July. After talking with other intended parents, India surrogacy parents and from what we’d read in other India-based surrogacy forums and blogs, one of the ideal places to stay in Mumbai for Surrogacy India is a place on the west coast of the city named Juhu Beach. (We know you can't swim in the water or even sit on the beach but the idea of being near the coast would remind us of home and seemed tranquil.)

When researching, websites such as, Tripadvisor and Travelocity offered a great deal of information and helpful reviews, while the actual hotel websites offered specific hotel information and more pictures. Amongst a lot of useful resources SI has provided, Dr. Sudhir and Dr. Yash recommended Amit Kulkarni of Explore India Tourism, based in Mumbai, who could help with booking our hotel. (Helpful tidbit, Explore India Tourism only accepts cash payments.) Amit was extremely helpful, professional, friendly and quite responsive. We are doubly thankful because not only were we looking at reasonable rates provided by Amit, but two local friends graciously offered a "friends and family" rate to the JW Marriott and Taj Lands End, which we also considered. Luckily, we found an even better corporate rate for an upgraded room at the Hotel Novotel through Geoff's work.

It was very tough to make a decision as each hotel has a little something we either really liked or disliked and, let's not forget, cost plays a role in the decision when you’re staying for 10 nights. The point is not to stay in an amazing hotel as if we're on vacation - we're there to grow our family - but seeing that I'll be hopped up on meds, we also want to make sure we stay at a hotel that we're comfortable and safe in. And, if the hotel has a couple of restaurants that cater to Westerners in addition to offering Indian food, which the Hotel Novotel appears to do, we'll be very happy! Even better, we’re told the Juhu Beach area is littered with Western style restaurants. How often do people travel to India and come back heavier?!

Thursday, November 26, 2009

Happy Turkey Day!

This is just a short post to document some great news.....our airfare and hotel plans are booked!  Come January 26th, we'll be on a plane to Mumbai!! (Well, with a four hour pit stop in equally exotic Newark.) We'll be away through February 7th and are now ready to count the days to our departure. Geoff and I have lots to share about the research but we'll save that for a later post.

Finally, because today is Thanksgiving, we wanted to express our thanks and appreciation for the love and support graciously shared by our extended family and friends. Why extended family? This is to acknowledge all those singles and couples also going through the surrogacy process. You've made us feel part of a very special family and words can't express how much this has meant to us. I think any normal person would need a rock to steady themselves through this difficult process and you have been this rock for us. Thank you, thank you!

Happy Thanksgiving to all!

Tuesday, November 17, 2009

Making Babies

Another topic Shannon and I have received lots of questions about are what exactly, medically, we'll be doing to bring a baby into this world. Sure, we continue to practice the age-old method just in case science comes up with a workaround for our current situation (and I'll be damned if they aren't trying). However, until that time, we need a back-up plan. That's where surrogacy comes in.

As Shannon mentioned in an earlier post, she was born with a condition named Mayer Rokitansky Kuster Hauser Syndrome. It's much easier to refer to it as MRKH or, as I like to call it, Son of a Bitch. Symptoms vary but all involve incomplete development of the female reproductive tract, excluding the fallopian tubes and ovaries which, as it turns out, develop separately. In our case, the impact is that Shannon and I have all the necessary equipment for making embryos fully derived from our genes but no way of enabling conception or of carrying the resulting baby through pregnancy. This is where surrogacy comes in.

We require a gestational carrier, a woman providing a surrogate (i.e. substitute) gestational environment, not surrogate genetic material. We've found our third party to conception in India but, of course, the selection can be made independent of nationality, religion and any other discriminator other than biology. Interestingly, we were told by our fertility doctor that the uterus doesn't age nearly as fast as the ovaries and that, in fact, pre-menopause, even a woman in her fifties or older could carry a baby for us. This is contraindicated by the rigors of pregnancy on the health of such an older woman but the "plumbing" would be up to the task.

I won't even touch on the specifics of IVF as I suspect many readers of this blog know more than we do - we have never gone through the process and will be doing it all for the first time. That aside, here's the process as we understand it:
  • Four weeks or so in advance of a pre-selected egg/sperm retrieval date - somewhat based on Shannon's current cycle - Shannon and the carrier will begin a round of IVF drugs. The goal for Shannon is to stimulate the production of multiple eggs; the goal for our carrier is to prepare her body for receipt of healthy embryos. Typically, with IVF, the embryos are going right back into the woman providing the eggs. For us, the embryos are detoured.
  • On the day of retrieval, Shannon's eggs are harvested while I desperately try to ignore my surroundings and provide some sperm.
  • The IVF clinic works its magic to induce fertilization and coax the formation of healthy embryos.
  • Two days later (give or take, we're still learning) the highest quality embryos are collected and transferred into our carrier. Shannon and I don't even have to be around for this but if travel schedules and bank accounts permit it - or if Shannon's health requires it - we'd love to stay.
  • Fingers are crossed. The first sign of success is chemical pregnancy, typically evident about two weeks after transfer. If positive, it's more finger crossing for the next three months to get over the first trimester hurdle.
It's fairly hard to estimate a success rate for our attempt. Consider that at present neither Shannon nor I have any reason to believe our DNA bundles or our carrier are anything but healthy. This means that success rates typically derived from couples with previously unsuccessful IVF attempts don't apply. On the other hand, karma and optimism are forever at odds so although we're supposed to remain super positive I can't even intimate our chances are decent for fear of angering the Fates. Forget I said anything.

I can't be any more specific about the process as we have yet to go through it and will likely learn more and course correct along the way. Nevertheless, the above captures the gist, illustrating how, well, mundane the whole process is from a medical standpoint. There's nothing groundbreaking going on; it's vanilla IVF with just a little wrinkle. How wonderful is it to live in a time when such a process can actually be labeled 'standard'? The sobering fact is it's finance, not science, limiting our ability to conceive.

Friday, November 13, 2009

Roll Call

Fortunately for us, Surrogacy India is one of a few clinics in India that allow intended parents to choose a carrier. Many have asked how we went about this very critical process and I would like to share it with you.

Once officially accepted into the Surrogacy India program, we were provided access to a password protected website with, among other things, a list of available surrogate profiles - sixteen to be exact! Profiles include the following personal information:
  • A variety of pictures of the surrogate and her family
  • Age, height, weight, eye color, hair color, diet, religion
  • Number of children, their ages and the pregnancy history for each child (any complications, natural delivery vs. cesarean...)
  • Menstruation and fertility details
  • Alcohol and drug (legal and non) history
  • Medical history
  • Surrogacy history (if any)
  • Personal comments about interests and motivations
Seems like a fair amount of information, but when we sat down to select the woman to carry our child it no longer seemed like a lot and the challenge was mammoth. Our first instinct was to analyze each detail and apply the only perspective we have - a Western perspective. To elaborate, one of the first women to catch our eye was separated from her husband. Unsure why, we invented our own theory, a theory falsely giving us confidence that she'd be a very good candidate. We figured that to separate from her husband in India, with two children, she must be a strong, independent woman motivated to have a healthy, successful pregnancy. She currently resides with her parents and therefore must be well taken care of. She had the highest level of education of all the carriers which we thought was commendable as well. Do you see where I'm going with this?

We were being asked to make a momentous decision using very little information about women with whom we have nothing in common. As you can imagine, the more we thought about it, the more we struggled with the process and the more obsessed we became. It seems as if we talked about it constantly over a four day span. In one breath Geoff was talking about how great dinner was and in the next breath he would blurt out, "I think X would be a good carrier because she has what looks like good childbearing hips!" For each profile we reviewed, we found ourselves trying to imagine why the woman answered the way she did and the meaning behind it. Then, we'd weigh the info we had - Is it better for her to have had two children or three? Does it matter whether or not she's married? Does weight and her diet matter? Is it a big deal if she does or does not tell her children? Does religion make a difference? Also, I know it sounds terrible, but I'd be lying if I said we didn't take looks into consideration. It's natural to subconsciously equate "pretty" with "healthy" and we were guilty as charged. If she looks pretty you think, well, she must take care of herself - and if she's taking care of herself then she'll take good care of our baby, right?

Out of our top two choices one was scooped up by another couple, taking the burden off us to make a further decision. R is our girl - yay!!! We are very happy with how it worked out and we can't wait to meet her in person in January! Not all agencies allow for the IPs to meet their surrogates, but Surrogacy India does. In fact, not only will we have a fact-to-face with her, but the doctors will easily arrange for us all to Skype when R is at the clinic for check-ups throughout the pregnancy. For everyone's privacy, we will not be contacting her directly nor will she be contacting us directly.

I can't imagine what it will be like to meet her and I get butterflies when I think about it! What does one say? Are there words with enough meaning to properly express our gratitude? I'm not so sure, but we will try. Like many, we will of course bring her a gift or two but it seems a bit shallow - "Thank you for carrying our baby. Here's some body cream and a bathrobe." Hhhmm, must think a bit further about that, but the good news is, we have until January to figure it out. ; )

[By the way, Geoff and I use the terms "surrogate" and "carrier" interchangeably in our blog. To be clear, we will be working with a gestational carrier to carry our biological child for us.]

Tuesday, October 27, 2009

Giving Thanks

I would like to take a minute to thank everyone who has posted comments on our blog, offered support and continues to follow our journey. It means a lot to us and we are very thankful! For those of you who have expressed a wish to share private messages or questions and don't have our personal email addresses, please feel free to use the email address we recently posted on the blog.... Otherwise, please keep the comments coming!

Friday, October 23, 2009

A Shot in the Dark

I wanted to spend some time discussing what Shannon and I heard, learned and decided about vaccinations. I know this means wading into a potentially controversial subject but, I figure, we're already full steam ahead with the highly divisive subject of overseas surrogacy so what harm can a little immunization discussion do? Anyway, the point here is not to persuade, just to explain. In that vein, let me get this out of the way - Shannon and I are in the 'vaccinations are typically safe and effective' camp. Everything that follows is colored by that context.

Please also keep in mind that I am not a doctor and never even played the game when I was younger. The rest of this post is a mixture of fact, opinion and conjecture - all of which is to say, if you've got international travel in your future, please don't use the following as a primary source of information.

Ok... Like most countries, the US Government recommends a long list of vaccinations prior to international departure. And, like most countries, India recommends a long list of vaccinations prior to arrival. However, with one exception - yellow fever (if traveling to/from specific countries) - no vaccination is required. It's your call. So what to do?

The choice was a lot easier for me. There are few if any contraindications for vaccines in men. My little guys ('sperm' for readers not getting the hint) are seemingly incorruptible. Sure, coming down with a nasty fever could undermine their quality. However, the fact is the illnesses for which I'm being immunized are more likely to cause a major medical catastophe than the innoculations. I'm getting the shots.

The trick is Shannon. As readers know, she will not be pregnant throughout this process. However, she will be producing the eggs and, seemingly, eggs are the more vulnerable partner in the embryo dance. To what extent do we vaccinate her?

Well, Dr. Yash told Shannon, no vaccinations. Period. She didn't leave us with the impression that Shannon should never in her life. It was more about the timing. So sure, Shannon's not immune to Hepatitis A, has a lapsed polio innoculation, was never vaccinated for pertussis, never prepared for H1N1 - all of which can be encountered during our trip. But the recommendation was don't do it. Make the embryo first. Basically, take the gamble with her health.

Now remember, we're a couple who believes in the value and safety of vaccinations. And because we had decided not to travel to India until January or February for retrieval (we could have gone in early December), we thought we had a good cushion of time. On the other hand, we're also pretty busy believing in the powers of IVF and really don't want to muck it up. In such a confusing medical circumstance the recommendation is to get a second opinion. For us, this came in the shape of a referred Travel Clinic.

Turns out that in the US, the identification and application of travel vaccinations (say that three times fast) are the responsibility of Travel Clinics - your local doctor won't do it. Their doctors are typically infectious disease specialists and this is all they do for a living. Our fertility doctor recommended one in particular at a local hospital and, following the handshake, Shannon and I disclosed every detail about our trip. If all goes well, we will be in India twice, the first time about two or three months from now, for one week, with Shannon hopped up on IVF meds and the second time, a much longer trip, approximately nine months later.

We had a very long back and forth about Shannon's options during which the doctor - bombarded by questions - asked, first, if either of us was a doctor and then, second, if either of us was a lawyer. Ultimately, we reached a concensus and acted immediately as we felt the more time that passes between vaccination and departure, the better.
  • We would avoid attenuated vaccines - that is, vaccines containing live but modified forms of viruses and bacteria. The modification reduces the microorganism potency but there is still a slight risk of getting sick. For Shannon, this meant not being innoculated for typhoid.
  • We would be ok with other types of vaccines - that is, vaccines that contain either killed forms of microorganisms, pieces of them, etc. This meant that Shannon would get vaccinations for things like Hepatitis A and polio.
  • We would get flu shots using killed virus. For H1N1, that means the injection and not the nasal spray. (In general, the medical community believes one's immunity benefits more from attenuated vaccines than alternatives but for Shannon, this was the no-go.)
  • For malaria we are going to use Malarone (proguanil & atavaquone) for prevention. It's meant to be taken daily so it's a bit of a hassle but supposedly quite reliable and with minimal side effects. For the moment, however, we're considering not starting Shannon on this pill until after retrieval. It's a to-be-determined. [I should add that our Clinic also suggested Lariam, instead of Malarone. Lariam is taken just once a week but its potential side effects are positively awful. In fact, this drug's losing it's popularity.)
I'm not comfortable being overly carefree with Shannon's health as our baby/babies would prefer to grow up with both parents, if you know what I mean. This will likely disappoint the SI doctors but ultimately, as there is no definitive guidance, the decision comes down to the two of us. We're comfortable with our decision and think it's optimal.

Plus we got to walk away with cool band-aids. Shannon's are all sparkly, mine are the Batman logo. That's right, the Batman logo. Jealous?

The One

I am very happy and quite humbled to report that after carefully reviewing and analyzing surrogate profiles, we have selected and formally reserved a lovely surrogate to carry for us! I can't believe I just wrote that - OMG, I am beyond excited!!!!!

For blog purposes, we will call her "R".  We know we shouldn't read too much into her profile and photos, but we can't help ourselves. R has a beautiful, genuine smile and sincere eyes. She describes herself as calm, quiet and understanding - hopefully, she can teach us the secret! Oh, and she is all of 5'2" and a whopping 112lbs, which will make me look like a horse next to her. Ugh!

Anyway, we have dreamed of this day, the day when we could say we've secured a surrogate who will be carrying our child. Not only are we thrilled, we are forever grateful. Thank you R!

Tuesday, October 20, 2009

Busy Bees

Well it's been a busy couple of weeks for us. Not only has our day-to-day taken its toll but the surrogacy process itself has gone full tilt. There's lots to talk about but let's start with a run down of the latest and greatest in chronological order:
  • All application paperwork had been completed, including all of the health screening tests required for enrollment. It took us a couple weeks to schedule, perform and then receive the results of those tests, but we got them done and earned a clean bill of health.
  • Completion of the application also meant our first wire transfer of funds - the application fee - into the great beyond. No, friendly banker, this will not be going to an Ethiopian king in exile.
  • Our US-based fertility doctor let us know, based on other blood work Shannon had to put herself through (it's been a pin cushion month for her), her specific ovulation and cycle start dates. This means we know exactly when she should start taking "the pill" to lock in her cycle. Neither she nor I have taken "the pill" before so this was pretty momentous.
  • We Skyped with Drs. Sudhir and Yash, the first live conversation with our SI lifelines. During this conversation we learned that Shannon should start taking pre-natal vitamins and should seriously think about NOT getting travel vaccinations. (We'll definitely cover this later.)
  • Our application to SI was formally accepted (!) and we were granted access to secured documentation for use throughout the rest of this process. Of particular note was a list of available carriers.
  • We are now reviewing a list of sixteen wonderful women, trying to decide who is going to carry our baby. Can you imagine?!?
Impressive couple of weeks, no? We'll have more to say about some of the above in later posts but wanted to catch everyone up. Next steps for us are choosing a surrogate (!!) and visiting a Travel Medicine clinic to further discuss vaccination. With H1N1 making the rounds, this should be an interesting conversation.

Clinic Follow Up

I wanted to write a follow up to Geoff's posting about clinics to briefly mention our experience with U.S. based clinics....

Surrogacy in the United States ranges from approximately $100,000 - $180,000 and, unfortunately, the cost goes up each year. In no way do I think having a baby is not worth that much money, but I do think it's a significant amount of money the average couple most likely cannot afford. The last thing our child needs is bankrupt parents! The India option offers us an alternative as surrogacy in India begins at approximately $20,000. In addition to travel expenses, in most surrogacy cases, there are often additional charges to also consider, such as cesarean sections, twins, amniocentesis...

As many are aware, approximately eight months ago we began our hard core research of clinics for surrogacy. We knew India was an option but thought of it more as a backup and focused our search on U.S. based clinics. We met with two well known, reputable agencies based in Boston that work with IPs worldwide.

Circle Surrogacy is the bigger of the two clinics and is very impressive due to the virtually unlimited resources they have to offer IPs. These resources and impressive success rates demand a higher premium than other clinics - $75,000.00+. It was easy for us to get enamored by their grandeur but we were not able to move beyond seemingly justifiable prices we couldn't imagine being able to afford.

When we met with Jan Lee, the Director of the National Exchange for Egg Donation & Surrogacy (NEEDS), we were immediately attracted to her tremendous heart and professionalism. Although NEEDS doesn't have the sizable forces behind Circle Surrogacy, their staff is a small army of miracle workers that deliver the unconditional support and experience needed to navigate the stresses and emotional roller coaster of surrogacy. Each of the references we spoke with couldn't speak of Jan and NEEDS highly enough. Regrettably, though NEEDS' fees were less than Circle's, it was still a bit too much for us at this time in our lives. Had cost not been an issue for us, we would very likely be working with Jan at NEEDS.

Surrogacy in India is a much more cost effective option for us. There are also other countries developing surrogacy programs that cater to Western couples, such as Thailand, Russia, Ukraine.... It is obviously not for everyone as it requires a very big leap of faith and patience. I openly admit that it took me a long time to warm up to the idea, but now that we are committed to the process, I am very excited!

Wednesday, October 7, 2009

What is a clinic anyway?

The clinic we've selected, Surrogacy India (SI), doesn't actually perform medical procedures like IVF. Rather, SI is more of a middle man (middle woman?) with a couple bonus services thrown in. If you're familiar with agencies like NEEDS and Circle Surrogacy here in Massachusetts then you have the idea. Here's a list of SI's core services:
  • screening intended parent applicants for general health and medical necessity (they're not going to work with a couple simply too lazy to get pregnant on their own)
  • identifying gestational carrier candidates (unlike with other India-based clinics, SI gives intended parents the option to review profiles and select a carrier)
  • coordinating care of the gestational carrier
  • initiating and managing the relationship between intended parents and the IVF clinic of their choice (SI's preferred IVF center is Babies and Us)
  • arranging all financial transactions
  • providing legal services, including drafting and signing of various surrogacy contracts
  • smoothing out the passport and visa application process in preparation for taking the newborn(s) home
  • supporting logistical needs such as hotel selection, airport pickups and even site-seeing
  • reducing instances of panic, doubt and concern
[Ok, I added the last one but frankly, that's what Shannon and I felt about surrogacy in India in the first place.]

In comparison to many of the other Indian clinics we considered, SI appears to be taking what I'll carelessly label a more Western approach - meaning there's a greater level of formality and a greater level of involvement on the part of the clinic to manage the entire process. A common warning shared by other couples working with India clinics was to be prepared for long delays in response time and to be self-sufficient and aggressive. Now there's a few uplifting tips! To date, Dr. Sudhir - SI's Founder and Director - has not given us any reason to doubt his clinic's ability to fulfill the promise I just laid out. Of course, as we've only just started the process, our optimistic expectations may be shattered after just two steps in the Mumbia airport. But we won't think such thoughts, will we?

Side note: Our fertility doctor asked an India-based colleague (another reproductive endocrinologist) to investigate Babies and Us
. Turns out, despite a disconcertingly corny name, they're considered the leading IVF center in India. I'm sure opinions vary - there's a host of great IVF centers in India - but you can imagine the relief. So Babies and Us? Thrilled are We!

Wednesday, September 23, 2009

Nancy P. Saves The Day!

It's safe to assume that when enrolling with a clinic, there are necessary requirements that need to be met before officially being accepted into the program. Things like paperwork and screening tests are a couple of the Surrogacy India (SI) requirements. The screening tests range from basic blood work-ups and urine cultures to a few up close and personal tests.  Given that we will be using my eggs and Geoff's sperm, there are nineteen screening tests that I am required to have and ten for Geoff.  Obviously time is of the essence, therefore panic set in that we'd be scrambling to schedule doctor appointments ASAP, but I must say, all is going quite smoothly thus far. 

Getting an appointment with my gynecologist is like getting in-season Red Sox tickets - unless you know someone, it's nearly impossible.  Lucky for me, Nancy has been in my life for twenty years and she is on my side!  I left a frantic voicemail for her nurses last Thursday night saying that we're moving forward with surrogacy in India and in order to enroll, I must have a bunch of tests run.  Six days later, I was sitting with my feet up in her office.  To be clear, sitting with my feet stirrups with my mustn't-touch-it exposed!  (For the record, the "mustn't-touch-it" phrase is straight from my Dad's vocabulary.)  In one fell swoop, she ordered sixteen of the nineteen tests and from her office, I bopped down to the blood lab and then into X-ray.  13 vials of blood, a chest X-ray, pelvic exam, 10 hugs and a pep talk from Nancy later, I was headed home at 7pm. Thank you Nancy P.!!! 

Other progress this week......Geoff gets close and personal with a plastic cup on Thursday for a more recent semen analysis and we have an appointment on Friday with our fertility doctor here to discuss our plans in India.  (Sidenote - our fertility doctor is Dr. R. Ian Hardy of Fertility Centers of New England and we highly recommend him for those looking locally!)

Wednesday, September 16, 2009

First Big Step

Geoff here. That's right - I'll be sharing blogging duties with Shannon. Count yourself lucky? Only time will tell. But in the meantime I've got a milestone to share. After extensive research, Shannon and I have decided to pursue surrogacy with the suitably named clinic, Surrogacy India. We'd narrowed the list down to seven agencies and then beat that list to death.

We culled our list from the very awesome Global Doctor Options website. I haven't spoken to the author(s), I don't know how often it's updated, and I honestly don't know how consistenly accurate it is. But for a seemingly balanced and comprehensive view, this site was the perfect primer. It covers all the basics and contains a very handy list of some of the better known India-based surrogacy clinics. [So why read this blog? Because it'll be a totally biased, one-sided view of our very personal experiences. Don't just trust us - read other blogs. But we promise an unvarnished view.]

These are the clinics we investigated:
Now lowest on our patented India Clinic Criteria Scale were the clinic websites themselves. In this 21st century Internet-age, I think we're all sufficiently savvy and/or cynical to disbelieve what's written on company websites. I'm not saying they're liars. I'm just saying that on the Web facts aren't black or white, they're stretched thin across a wide, gray scale. Anyway, the majority of India clinic websites aren't very good. In fact, our research taught us that some of the better clinics had the lousiest sites. Bottom line, use the clinic websites to get contact information and then move on.

Contacting the clinics can be a bit difficult at first. No matter how well it has sunk in that you're simply tracing the footsteps of countless other couples, the fact is it's you you're writing about. How to start? As for many other topics, we'll cover this one in future entries. For now, the first contact should be used primarily to get a price list and a list of references. Yes, there's a lot more to learn. But if you have these two you're on your way to comparing options.

Ah, the references. That's the magic. Contact all of them. Every single one of them. There's no better resource. The more the better. Did I mention you should get references? Part of my bias is that this is just sensible "shopping". However, part of it also comes from the fact that there is just an amazing community of Intended Parents out there. They've shared the same concerns, worried over the same fears, and had the guts to take the plunge. In fact, if you think about it, they're you, just a few months or years up the road. Speaking with these couples, Shannon and I felt like we were about to join an exclusive club of fantastic people. What an honor to count some of these folks as our friends.

After all of our research, Surrogacy India was, on the whole, the most professional and responsive clinic while Surrogacy India references were, on the whole, the most satisfied and encouraging contacts. Are we convinced beyond a shadow of a doubt? Of course not. No research is fool-proof and there's a long, knee-shaking road ahead of us. But we know we're ready to move on because when Shannon and I looked at each other and spoke the words, "Ready for the next step?" - we smiled.

Sunday, September 13, 2009

With Most Bad Things, There Are Good Things Too

In our culture, it’s odd (and obtrusive) that people feel the need to be nosey. Once you find "the one", people are constantly asking "when are you going to get married??" Once you are married people are constantly asking "when are you going to have children??" Lesson #1 - unless you are CLOSE family or friends, don't ever think it's okay to ask people that question. Some people in fact don't want kids or choose to have kids later in life and for others, perhaps there are fertility complications. When continually asked "when are you going to have children?", and there are fertility complications, it just about pours salt into the wound. Whichever the reason, unless you are close family or friends, it's no one's business but your own!

Up until now, our infertility hasn’t been grand public knowledge and it is with great hesitance that I write even this much. Those close to us, of course, know but we don’t spend a great amount of time discussing it as, to this day, I still can’t understand why it had to happen to me. (Not that I would ever wish this upon anyone else.) In a nutshell and without sharing too much info, I was born with a condition that has left me healthy but without a uterus. One in every 4,000 women have this condition or a form of it and, fortunately for me, my case is mild as it could have left me without other girly parts. I have known about this since I was a teenager and not one day has gone by since the day I found out that I am not deeply saddened by it. Unlike most teenagers, I never got a period, but I did “develop”. (And boy did I develop!) My Mom made an appointment with a well known gynecologist (Nancy P.) who I am proud to say is still my doctor and trusted friend. After a variety of ugly tests we had a diagnosis and on December 13th, 1989, we met with Nancy to find out what it was.  Before we learned anything, we sat in Nancy's office - me trembling while my mother had tears rolling down her face in fear of the worst. (insert boatloads of tears and uncontrollable sobbing here) My doctor explained the condition, gave us some helpful printed materials about it and talked about the good news and bad news moving forward.

Good news - I have healthy fallopian tubes, ovaries and most likely, healthy eggs.
Good news - I’ll never get a period in my life.
Bad news – I have this condition and because of this, I’ll never be able to carry a child.

Now, to some teenagers, this news wouldn't mean much at that point in their lives, but to me it was disturbing because I have ALWAYS known that I want to have children. I had dolls I would not part with and a younger sister by 6.5 years who were all “my babies”. I started as a mommy’s helper for our neighbor and then was babysitting for their baby girl when I was 12, if that. To this day we babysit our family and friend’s children because we genuinely love them and we’re happy to spend time with them. Not a day goes by when I am not sad, frustrated or angry I was born this way. Feeling ill-equipped and inadequate is a horrible, devasting feeling that I know many women can relate to. Many others can’t and I appreciate those in my life who have tried to put themselves in my shoes. Over the years, I have been thrilled with joy each time I hear someone I know is pregnant or had a baby. I am most definitely chipper for the guests of honor at a baby shower and happy to play with the kids at birthday parties, but inside it can be painful and hard to put on a happy face. Not because I’m jealous, but because my situation sucks and it’s not fair. (I know, life isnt’ fair, but this is how I feel and I’m entitled to it.)

The positve part to this is, I have a husband who loves me regardless of my condition and together, we will survive and prevail. For those looking for love with difficulties such as mine, I did not scoop up the last compassionate, loving, very handsome man, but I did get one of the best! This finally leads us to our recent decision to pursue surrogacy in India, so off we go!

Thursday, September 10, 2009

The Story Before The Story

Gentlemen, you may want to take a restroom break for this part. Ladies, put your feet up and feel the love!

After Geoff and I met in December of 2005, we knew pretty quickly that it was the right fit. So much so that we moved in together within a few months and were engaged in May 2006. Ah yes, it was during the raging floods that took New England by storm when he proposed and I don't think either of us will ever forget it. We wet-vac'ed the basement for 36 hours, taking shifts so we could each catch a cat nap or run to the restroom. As fast as it was coming in, we were wet-vac'ing it out. (Guess I shouldn't complain because our neighbors had five pumps going and still couldn't keep up and even more importantly, we got engaged!) Much to my surprise he had The Ring for a while but decided on the spot that this day in May was the right day to ask me. His thoughts were – why wait for “the perfect moment” with lots of pomp and circumstance when the perfect reason was right there in front of us - if we could get through this and still love each other as much as we did, we could get through anything together. (fast-forward 2 years and 2 months later and hello India!)

We were engaged for a year and one month and pretty much every day of our engagement was spent planning some part of our spectacular wedding festivities for us and our guests. Up until Geoff met me, my mom and my sister, he had never met insanely organized, die hard party planners. For me, party planning comes very naturally. In fact, because of that (and a few other things), I started a successful event planning and management business over five years ago. Being the last of my closest girlfriends to get married and because of my profession, you can bet your butt that this was going to be an unforgettable, miraculous wedding. No stone was left unturned and no detail was forgotten, literally.

As much as I would love to share each detail about all of the other festivities we enjoyed leading up to the wedding and the wedding, (that is a blog in itself) I would much prefer to blog about this incredible journey we are embarking on.  However, for the hopeless romantic in you, please indulge me and allow me to share a few details and pictures of the wedding.  It might be over the top for some but for us, our wedding and all of the festivities around it really were everything we wanted and hoped for.

We got married on June 24th, 2007 at one of Boston's five-star hotels – the Boston Harbor Hotel. Geoff was stunning and could have easily had a photo shoot in GQ (truthfully, he always looks that great). I wore a gorgeous Romona Keveza gown in platinum and I may just wear that bad boy around the house for the rest of my life just because I love it THAT much. The ceremony, cocktail reception, dinner and dancing were all at the hotel. Our ceremony was “in the round” and the chuppah, which twinkled with crystals and candles, was centered amongst our guests. I was raised Catholic and Geoff Jewish; And one of our closest friends (JB) who is a Unitarian Minister officiated a beautiful ceremony incorporating a little bit of everything, including a couple jokes from my single days. (Sidenote - I met JB and his wife ten years ago when I used to nanny for their newborn son. They now have 3 kids and all of them are very much a part of our lives.) The cocktail reception was outside on the terrace overlooking Boston Harbor. Our friend SB has pipes like no other singer and, accompanied by her fellow musicians, she was remarkable for our ceremony and cocktail reception. She sang old standards that we love and got us warmed up for the orchestra that stirred things up during dinner and dancing. Everyone just soaked in all of the details and elegance of that night – especially Geoff and I. 

Since that unforgettable time, our relationship has continued to grow and strengthen. Our priorities and focus have now shifted to the next important step in our lives - growing our family beyond just us.