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?