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.]