Friday, December 3, 2010

Flock Behavior

A first-time mamma bird turns to her older friend, the mother of a whole flock of chicks, and asks, "So, Baby Bjorn, Ergo, Maya Wrap or Didymos sling?"

Ok, that never happened (as far as I know) but I've been party to a whole bunch of conversations along those lines. It's overwhelming. Frankly, how can I even be expected to have an opinion? I don't know about other first time dads but I've never had to comparison shop Moses baskets before. My fallback solution is to lean on Google search, digging up opinions and reading with a critical eye. That and to page through an absolutely excellent shopping guide, Baby Bargains. But at the end of the day, who knows?

Every friend of ours with little ones has advice, of course, and those opinions range all over the map. Invariably, multiple moms with perfectly happy children will tell us, in no uncertain terms, that we should absolutely do x and not do y - where x and y are completely different from one mom to the next. I tend to listen more to those moms (and dads) who share my temperament. In general, I'm not a worrier and don't need things under 24x7 control so I'm open to advice from folks with the same roll-with-it attitude. And anecdotal evidence doesn't impress me. It's like diets. Each weight-loss success story claims their diet is the best when, in fact, all we really know is what worked for that one person. No two babies are the same either but in general they're much more resilient than the typical modern family seems to gives them credit for.

Ah yes, I know. Wait 'til you have a baby, you're thinking. And sure, I won't be handing our infant a house key and cell phone for at least a few months. However, from my sheltered pre-baby perch, I'm thinking healthy infants are far less dependent on how we handle the minutiae of parenthood. Worrying too much about this stuff is for the birds!


Recently the mailman dropped off a DVD carrying our latest ultrasound. Reports from India have been consistently positive but having something - anything - to look at gives us great satisfaction. The experience is very much like cloud gazing. "What's that look like?" "A school bus!" For some reason Shannon saw a hundred different penises although, of course, we haven't a clue. We did get one good look at our baby's face though. Seems our little one's having a pretty good time in there!

Monday, November 8, 2010

Proud Auntie

I am very proud to say that I am an auntie!

Baby Isla was born on October 31st and is a beautiful baby girl. I had the amazing pleasure of being by my sister's side during Isla's delivery and this is something that I'll never forget. Watching little Isla take her first breaths in the world was momentous. Now my little niece is an eating and pooping machine!

Being around Isla has really made me realize that in only 3-4 months, we too will have a little one to swoon over. Holy moly, only 3-4 more months - wow! Time is flying by and November, December and January will be jam-packed months for us. Not only are we moving in December but we will be going through IVF again here in the states. As I get older I'm producing fewer eggs so we think it's best to freeze embryos in case we ever want/can try again. We met with our local fertility doctor this past Friday and the wheels are now in motion. If all goes as planned, we'll have another round of IVF under our belt before leaving for India.

Next step in our preparations for returning to Mumbai is finding and reserving our hotel.  We favor the Novotel because we loved it so much, but we're also researching other options as well.

Monday, October 18, 2010

Dream Job

Shannon's upstairs, in bed, sensibly getting a good night's rest to fight a nagging head cold that kept her home from work today. Just before she turned in, the two of us sat together and talked about a dream she had the previous night. Shannon has a lot of dreams. Glossy, high color affairs that tend towards the dramatic and downright dangerous. Normally, my first question upon learning of a new dream is whether she was shooting the semi-automatic, running from the shooter or both. This time the dream was a bit more traditional, the naked-in-the-classroom kind. She and I were in India to pick up our baby, completely unprepared for departure. No idea how to get the birth certificate, visa, passport, social security number.....

It wouldn't be surrogacy in India without something nontraditional to worry about.

Sometimes Shannon and I receive questions about our experience and its implications that, well, let's just say folks haven't thought it through. "Ok. Shannon's egg, your sperm, an Indian carrier. Got it. So your baby could look Indian, huh?" Nope. As my father pointed out on one such occasion, cakes don't look like the oven. Other times, however, the questions we come across are well founded. "Will your baby have Indian citizenship?" (No.) "Do you need to take DNA tests to prove maternity and paternity?" (Used to but, apparently, no longer necessary. Possession of complete documentation detailing the process in chronological order suffices.) "How will you know when to go back for the pickup?" (We won't. As Shannon shared, all we know is that R won't go full term. We'll start waiting for phone calls mid-February. The call will either be, "We're going to induce on such-and-such day - come on down" or "R's in labor - come on down.")

Shannon and I think about this a lot now, about picking up our baby and slicing through the red tape. We're still figuring it out so it's premature to share details in this blog but, as with everything else, there's a bunch of folks who've gone through it all before us. If it can go wrong, it probably already has and the poor victims/couple are around to give the rest of us a heads-up. In the meantime, we've got the worrying covered with Shannon's nighttime drama.

As the optimist in our humble pair, I sleep like the dead and remember dreams maybe once a month. My recollections, hazy in muted tones, are funky more than anything else - Twin Peaks without the freaky music or backward talking midgets. This doesn't mean I don't have concerns though. Most compelling for me right now are names. We don't know the gender of our baby yet but I'm trying to be a good player and join Shannon to build a short-list. I just can't come up with any boy names. (Girl names haven't been a problem.) They say a person has mastered a language once he/she has dreamed in that language. I'm searching my highly infrequent dreams for names, putting the pressure on my subconscious. I just hope it doesn't have a sense of humor and comes up with something like Adolph.

(Our little one is doing quite well. By our clock we're 18 weeks into the pregnancy with all systems and screenings looking good. A couple weeks ago the ultrasound tech in Mumbai estimated our baby's age at 18 weeks based on various fetal measurements. As we were only 16 weeks along at the time, could this be a sign that there's a giant American baby growing in India? Our delivery date may be creeping up earlier and earlier.)

Thursday, September 30, 2010

So How Does It Feel To Be Pregnant?

I am sure I am not alone when I say that when I sit down to put my thoughts on paper (or for this blog), the first thing that comes to mind is that it's still very hard to believe we are pregnant. Because this isn't happening to me or inside MY body, at times it can be a bit out of sight, out of mind. Believe me, it's not that I'm not excited or emotionally invested - I am 100% both of those things!

My sister is also currently pregnant. She and her husband are four months ahead of us and they are due with their first child in mid-November. Unlike me, she is feeling all aspects of the pregnancy - emotional, mental and especially, physical. The sensations that go hand in hand with being pregnant are always with her so she is constantly reminded of its presensce. I can't say I'm jealous; truthfully, some of what she's experiencing I'm happy to take a pass on. However, I can't help but feel a little envy, just as any woman would who wants to carry but is not able to do so.

Geoff and I are now at a point where we're sharing our news with those who haven't been aware of our journey. This puts me into the awkward position of answering the very frequent, "You're pregnant?! Oh great - how are you feeling?" For the most part I'm fine with sharing our special circumstances (to the right people) but it does reinforce the sense of loss I have that it's the surrogate - not me - who is carrying our child and experiencing the actual pregnancy. It's a lot to wrap your head around. Maybe to some it doesn't feel like a big deal. However, when you're living it, it's always in the back of your mind. While I'm over the moon to be pregnant, it's just hard accepting that it's not happening inside my body.

On a much happier note, recent tests show that everything continues to progress well with our pregnancy. Phew! We have a double-marker test coming up so there's never a shortage of things to worry about, but this is no longer about surrogacy, just about going to term. I'm also happy to report that we've conquered the registry gun at Babies R Us and have also splurged with some fun things on a registry at Land of Nod. Next up.....order baby furniture, start nursery decorating and meet with pediatricians, day care providers and the like. Oh, and the name game continues! Currently, Geoff is batting zero while I have a full dugout of names. Agreeing on one might turn out to be harder than this whole surrogacy journey.

Tuesday, September 7, 2010

Dancing Queen

If you were with me as I wrote this you'd have seen some fancy footwork I call my happy dance. Why the happy dance? Because we're in the second trimester! All the test results came in beautifully and all measurements were right where they should be. At 5.3cm long and with a heart rate of 180 beats per second, our squirmy little one has passed the first trimester hurdle with all systems go.

Of course, moving into this next trimester means no more delays. We've got furniture to buy, names to choose, pediatricians to meet and showers to arrange.....And we really only have until early February to do this! SI has advised us to be ready for a flight to India as early as the 35th week of our pregnancy. That's February 3rd given that our expected due date is now March 17th. (Yes, as Geoff figured in an earlier post, our estimate of March 14 was a tiny bit off.) Even though an average pregnancy can last 40 weeks, giant American babies in little Indian bellies tend to bump delivery up a few weeks early. For our agency the average has been 37 to 38 weeks in length.

Talk about a nice problem to have...WOW! We dreamed of this moment, of moving past the fears of the first trimester, and here we are. Okay, let's do one more happy dance! It's real enough that Geoff and I have even bought our first book on pregnancy! (Note to publishers - please write a book about pregnancy that doesn't spend 90% of its pages talking to and about pregnant women.) For a change, Geoff and I get to worry about the same issues affecting every other pregnant couple and as stressful as it is, we are ecstatic.

Thursday, August 26, 2010

Health Check

A couple weeks of somewhat blessed silence were wrapped up with the first screen for Down Syndrome. Our clinic takes a nicely comprehensive approach, performing a combined screen during the 10th and 11th week. Made up of two blood tests and one ultrasound, this screen supposedly detects 80% to 90% of babies with Down Syndrome. In our case, the two blood tests - we're talking about R's blood, by the way - were performed late last week and the results were good. Expressed as ratios, each were "better" than the cutoff ratio which, adjusted for Shannon's age, is 1:250. (As in 1 out of 250 babies with the same blood test results have Down Syndrome.) The ultrasound won't happen until this week to give the baby a little more time to grow. Ultimately, it's the combination of these three results that will determine the likelihood of DS. So far, so good.

We've learned that this combined screen and similar exams to be performed during the second trimester just about eliminate the need for amniocentesis. That's great to hear because amnio increases the risk for miscarriage and we've had enough to worry about already, thank you very much. The only reason we'd request an amnio is if the screens came back with very negative results. So far, Shannon and I have no reason not to feel optimistic. It's a good thing because, quite honestly, we haven't forced ourselves to think through the implications of negative results. What would we do? I honestly don't know. The by-the-book answer is to take it one day at a time with constant reminders that a screen is not a guarantee. The reality is probably messier.

Meanwhile, our pregnancy continues. There'd actually been an ultrasound on the 12th of August that had taken us by surprise - we didn't know it was happening and the results weren't posted 'til days later. (Again, this is the one allowance it seems you have to make with overseas surrogacy. Dates are going to be fluid and expectations won't always be set.) The results were just where you'd like them to be; our little one was 27.4mm from crown to rump (rump!) with healthy cardiac activity at a little over 9 weeks. We'll have to take their word for it all because the images, well, this is the best one and I don't think it's time to play "who does he/she look like" yet:
Tilt your monitor, play with the brightness - it doesn't matter as, apparently, this little fetus is a camouflage master. My understanding is that we'll be getting video once we're fully into the second trimester. For now it's this shadowy radar.

Finally, this past Sunday we had the great pleasure to meet up with a few couples who had either already, successfully, gone through India surrogacy or were considering it. Our hosts were the venerable Mike and Mike, of Spawn of Mike and Mike, whose coverage of their surrogacy experience (now over a year ago!) was early inspiration for us.

Cripes were those babies adorable! All the little folks we met were the product of Indian egg donors which means, apparently, that some cute button is pressed in utero. The best thing about this gathering though? It was just a bunch of folks acting like parents. The babies certainly had no idea where they were from and the adults were dealing with the exact same issues as any other mother or father. India was the backstory, not the plot. That's the novel we're hoping to write as well.

Monday, August 2, 2010

Beyond Beta

Saturday morning was accompanied by gloriously boring news - our little embryo's development is right on course, just where one would expect it to be seven weeks into a pregnancy. In little over a week the length has doubled and cardiac activity appears strong and even.  It is not lost on us that this is about the time we'd had to accept the miscarriage of our first attempt, nor will we ever forget. The memory keeps our expectations modest so even small developmental changes leave us feeling like a C student getting A's.

We're also very proud of R who has had to endure separation from her family and multiple pokes and prods for blood tests, ultrasounds and the like. I can tell you that Shannon thinks about this often and wishes desperately for the briefest of opportunities to see R, hold her hand, express our thanks, and do what we can to be supportive. As you may recall, once a pregnancy is in full swing our clinic will relocate our carrier and her family until delivery and complete recovery. This relocation both allows the clinic to ensure a healthy, clean environment for the duration while also enabling our carrier and her family to avoid the questions and stares that come with being pregnant for nine months and then returning home empty handed. Apparently, it is not uncommon for families to come and go; seems their disappearance won't be particularly noted. It is satisfying to know that R is now with her children and husband full time.

Some folks were wondering whether or not we get test results in written form. The Surrogacy India clinic furnished us with our own password-protected Google Site upon which all test results are posted. Originally, this site was the home for our beta tests. We'd get a call from the doctors telling us the count while, concurrently, a report would be uploaded to the site. Thankfully, we're beyond beta tests so no more number counting; now it's about ultrasounds. On the site we find both still images of the ultrasound and, separately, a report written by the sonographer. The write-ups are fairly straightforward; we didn't even bother to speak with the doctors about them. We suspect (we hope!) the next seven months will proceed this smoothly.

With some exceptions, Shannon and I are concerned about an excess of ultrasounds. We want just enough to track development without endangering that development. To this end, what's most important for us are diagnostic ultrasounds used to identify conditions like Down Syndrome. We'll spend more time on this topic (and amniocentesis) in a later post but, needless to say, pre- and post-diagnostic scan conversations will definitely occur.

In the meantime, we're enjoying the jargony news that, according to our ultrasound report, the gestational sac "reveals good choriodecidual reaction with a fetal pole and yolk sac". Which got me thinking - have you ever noticed the complete absence of assisted reproduction greeting cards? For example, now would be a time for something like "Congrats on your good choriodecidual reaction" or "That fetal pole is one in a million!". Or stealing from graduation cards, Bar/Bat Mitzvah cards and the like, once we hit the 11 week mark: "Now you're a fetus"...... Ok, maybe it's pretty obvious why you never see them.

Monday, July 26, 2010

And The Beat Goes On

Last Monday's blood test showed R's beta increased to 8,619. More importantly, however, was Thursday's ultrasound because it confirmed cardiac activity. Just in case I wasn't clear enough - a heart beat has been detected!!!

In this ultrasound, two gestation sacs were actually seen. The larger sac was everything you'd expect from a normal, healthy, 6 week - three day old embryo - fetal pole, yolk sac AND cardiac activity. The other gestation sac was empty, earning the medical term "invisible twin" or "disappearing twin". As you can imagine, this was sad news to receive in that Geoff and I were really hoping for twins, but we remain positive because we have a little one who's fighting and has a heartbeat fluttering right this very minute!

Next ultrasound on Thursday, July 29th.

Tuesday, July 20, 2010

Making it Count

Everybody's got their coping mechanisms. Now that Shannon and I are back in the swing of things, trying once again to wrap our heads around the fact that thousands of miles away, in the belly of a virtual stranger, grows the hint of an idea of a family - well, if that isn't a time to cope, I don't know what is. My preferred method is to do poor man's research - Google and Wikipedia - in order to snow myself into believing I understand everything that's going on.

Here's an example of the mess I get myself into.

How long has R been pregnant? Simple enough, right? It's helpful to know this information over the short run as we use that length to determine if the beta numbers are within normal limits. For example, see here. In the long run one uses it to estimate the delivery date. Turns out the answer's not so simple for those of us going through multiple rounds of IVF.

First of all, measurement of pregnancy length (aka gestational age) begins on the date of the carrier's last menstrual period (the LMP). The reasoning is that with natural conception there is no way of knowing when conception actually occurred - all the woman knows is the date of her LMP. We were told R's LMP was June 7. (There's a fact one doesn't typically know about an acquaintance.) This means we've been pregnant 43 days.

Here's the problem. This entire pregnancy length calculation is an estimate based on the assumption that conception occurred two weeks after LMP. If doctors know the exact date of conception then one no longer needs the LMP date. Instead, one measures the length of time from conception (called gestational period) and then adds two weeks to get the length of pregnancy.

We know our conception date. Sort of. The actual marriage of egg and sperm occurred back in February. After two days of wedded bliss, our two unused embryos were put on ice and then thawed four months later for our second attempt. The thawing occurred on June 24 and, a few hours later, on June 25, these two potential lucky ones were implanted. So take your pick. Assume conception happened on either June 25 or (two pre-thaw days earlier) June 23, then backtrack two weeks. This gets us to being either 39 days or 41 days pregnant.

So we know, without a shadow of a doubt, that we're either 39, 41 or 43 days pregnant. :-)

(Why haven't we just asked the doctors, you're wondering. Well it turns out the Drs. have acknowledged that the gestational age listed on R's blood reports are wrong. We haven't received a straight answer so - coping mechanism to the rescue!)

Thanks for hanging in there. And my apologies because this is probably a waste of time. Using these hCG charts is a feel good exercise when the betas are high and a feel bad exercise when betas are low. As we've discussed in earlier entries, the range of "normal" measurements is absolutely huge. So huge that you typically can't even use these numbers to determine if more than one embryo is growing. What matters is how fast the beta count grows from one test to the next. This early on in the pregnancy, we're looking for doubling every two to three days. (So far, so good!)

For what it's worth, we'll be using the length calculated from R's LMP. As of Wednesday, July 20 we're at 43 days, or 6 weeks and 1 day. I think. Let me check those numbers again.....

Saturday, July 17, 2010

Bull Market

I am not going to lie - even with our beta levels increasing as they have, the days in between updates are torture. I did not sleep a wink last night, slept with my phone on the pillow next to my ear and with a laptop next to the bed. I'm losing it! Today's good news shows the stock continues to rise....R's beta level is now 2,190!

Tuesday, July 13, 2010

Good Morning

It must be a great day when you wake up to results from the latest blood tests and R's beta level more than tripled to 747.37! Another step in the right direction!!

Sunday, July 11, 2010

Pay No Attention

Beta was 237 on July 9. Or as Shannon told her mom over the phone, "In two days the beta's gone from 94.48 to 236.71!" :-)

We've been down Optimism Road once before so that's enough said for now. For what it's worth - yes, it's possible to swing between, "It might be twins!" and "This is too good - it can't stay this good..." in a matter of seconds.

More after we've received the next round of results - hopefully early in the week.

Thursday, July 8, 2010

New Beginnings

Countless people have been checking in, praying, sending good wishes and generally offering whatever help they can to make this next attempt of ours a successful one. Well so far so good because we're happy to report that R is pregnant! We received the call late last night from Drs. Sudhir and Yash - R's beta level was a smile-making 94.48 on Day 12. Anything greater than 25 is a positive result so there's no doubt about this one. (As you may remember, our beta results at this time during our first attempt was a sad 18. This is an uplifting change!) We're hoping two time's the charm without forgetting the lesson from our previous experience, that these big numbers are important but not guarantees.

Our next blood test is scheduled for tomorrow (Friday) and we'll have those results on Saturday.

Friday, June 25, 2010

We're On Our Way (we think)

Yesterday’s promise was too good to be true. Late last week SI determined that our next embryo transfer would take place on June 24. Amazingly, that day is also our three year wedding anniversary. Was it actually true that the first day of our embryos’ lives in utero would be on the same date their parents married? That had to be a good luck sign, right?

Well Geoff and I felt the cheery, positive thoughts slowly slip away as the 24th passed without any correspondence from the doctors. No call, no email, no text, nothing. Sadly, the anxiety of waiting to hear an update overcame any desire to celebrate our anniversary. Did the transfer actually happen? Did both of our embryos (we only froze two) thaw successfully? Is R ok? Is anybody on our side in India? It wasn’t until midnight (Friday the 25th in Mumbai) that we finally caught up with the doctors. I’m not up for reliving it but, bottom line, the thawing process started late on the 24th, the IVF doctor felt it was best for the transfer wait until the 25th (to ensure the embryos were fully recovered and healthy), and - because of the hour - SI didn’t get around to notifying us. Moving past our annoyance, the take home message was that we had to be patient a bit longer.

At the crack of dawn this morning we received an email with some good news. Our two embryos survived the thaw and were in very good shape. One embryo is an eight cell, grade one and the other embryo is a four cell, grade one. We still don’t have actual confirmation that the transfer took place (of course!) but this part of the process is fairly straightforward so we’re going with the no news is good news theory until we hear back.

It's all very ironic. When we were in Mumbai for our first attempt we very much wanted to be home to share the news of the transfer with our families. Now that we're home for this second attempt we both couldn’t resist wishing we were in Mumbai to see everything through and to wish R lots of rest with her feet up.

Anyway, here we are, back again in the nail-biting, two week wait (we think). Fingers crossed!

Monday, June 7, 2010

Take Two

One of the toughest parts about writing a blog dedicated solely to our surrogacy experience is that events don't unfold into neat little chapters. For example, two full months were spent simply awaiting R's recovery from our first attempt - give or take, a woman's body needs about two cycles to return to "normal". Since Shannon and I want to spare our readers talk about other topics, much of this time wasn't very newsworthy. (Which is just as well as this time off from the surrogacy world was a welcome respite.)

Emotionally, the down time still saw a lot of action. Optimism takes effort; pessimism is easy. Well meaning friends correct our 'if we have a baby' comments with 'not if, when', not-so-coincidentally spotlighting how such comments come from those with their own children, not the childless. Don't get me wrong, positive attitudes are absolutely preferable and our friends mean only the best. Nevertheless - and maybe this is a guy speaking - optimism needs a little realism. Shannon and I are trying very hard to take everything in stride, hoping for the best while expecting, well, perhaps it's best said that we're not expecting anything. Whatever happens, happens.

And new things are starting to happen. As we wrote in our last post, we'll be working with R for our second attempt. To that end, R was put through a mock cycle. In a mock cycle the surrogate is given a round of IVF meds to prepare her for the implantation of embryos. However, no transfer occurs. Rather, this is just a test run whose objective is to measure the quality of the carrier's uterine blood flow and thickness of the uterine lining (the endometrium) to be sure her body is ready and able to get pregnant.  I confess the purpose of this run with R is not overly clear to me. R is not an unknown variable - she has never had trouble in the past - and, because embryo thawing occurs on the day of transfer, it's never too late to stop the process if R's body isn't ready. Ironically, we're going to put this theory to test because R caught a cold during her mock cycle and couldn't complete it anyway. SI's doctors felt her progress up 'til that point had been perfectly normal and advised we just proceed as if she passed the mock cycle with flying colors.

Give or take a wrinkle in preparation, our next embryo transfer will take place in the third to fourth week of June. We're back!

Shannon and I have been drowning SI in questions after requesting that they be more proactive and free with information. So far, so good. Dr. Sudhir acknowledged occasions during which his agency could have performed better and has promised to work harder to keep us informed and in the loop. It's still early so we reserve judgment but it's been a good start. This includes their confronting and discussing rumors about the reliability of the IVF Center that SI uses. We'd heard some lousy things about that Center's top physician from first-hand witnesses but SI has assured us - quite logically - that it wouldn't be in their best interest to associate themselves with an unreliable IVF clinic. We were told that a mix of facts, rumors and disinformation from competing agencies stirred the pot.

Ultimately, what can we do? We're thousands of miles away and early on had come to terms with the fact that we would be relinquishing control to and investing trust in SI. This clinic issue is an example of where our trust was put to the test. To date, however, SI has not given us reason for doubt; they have a really good track record (as does the IVF clinic, by the way). Plus, we're already committed. It's a shame this extra-curricular garbage demands any of our attention as we've enough on our plate. However, though there are examples of couples whose India surrogacy experiences have been virtually flawless, I'm thinking Shannon and I are a bit more typical. Not everything goes as planned, is predictable or problem free.

We never consciously expected otherwise. And despite it all, here we are two weeks or so from a second attempt. Having gone through this all once before, we're old pros who'll surely take it all in stride. (Welcome to the 'lying to ourselves' section of this entry.) Oh, we're just making babies in India - how was your weekend?

Monday, April 26, 2010

Not a Sprint

Last Monday was Patriots' Day here in Massachusetts. A recognition of the first Revolutionary War battles, this holiday tends to be outshined by another annual occasion occurring on the same day, the Boston Marathon. "Marathon Monday" brings over half a million students, families and fans to the race course to cheer on more than 20k runners. It's quite a spectacle and the pride of Boston.

Shannon and I are in the midst of our own marathon. Unlike the foot race, our pursuit has no clear finish line. In fact, we're not even sure where it is or what we'll find when we get there. All we do know is that the distance to cover is far, requiring patience and perserverance and a small dose of fatalism to accept that what will be, will be.

It's been some time since we've written. Frankly, we're tired of writing about lousy news just as much as you're probably tired of reading it. In fact, we've been taking pleasure in other surrogacy blogs. By our count, Surrogacy India has welcomed seven births in the past few weeks! If there's better news to be had, we can't think of it. A gigantic, go-get-'em congrats to all!

A couple weeks ago Shannon and I met with our local fertility doctor, Dr. Ian Hardy, to get his opinion about some open questions. Should we work with R again? Regardless of the carrier, should Shannon go through a round of IVF here in the States or should we wait until we've made an attempt with our remaining two embryos? And is there anything we could do to improve our chances the next time around?

First, R. Touchingly, she expressed a desire to work with us again if we'd have her. The termination had been induced medically, resulting in an expected recovery time of around two months. This means the earliest we could perform the transfer would be sometime in June or July (two full months recovery, one month hormonal preparation). Should we work with her again? When all is said and done, Dr. Hardy thought this would be perfectly fine as she had a good history and had become pregnant with one of our own. Why add another variable by introducing an untested carrier? Disconcertingly, we had no idea how to answer a bunch of questions about R's cycle of progesterone as she prepared for the transfer. We didn't think to ask and Drs. Sudhir and Yash never told us. Technically, if the progesterone cycle was screwed up, R's uterus wouldn't have been ready for the transfer and the pregnancy would have failed. Cripes!! Nice to find this out AFTER the entire cycle.

I have to say this has been the most frustrating part of the entire process - the availability of information. We've pretty much had to ask for everything. Little info was forthcoming and what info did exist was late to arrive. (Yes, we were warned about this when speaking to references from each agency about the India option. "That's doing business in India." Might be - but it still sucks.) Now for a "normal", full term pregnancy this would probably come off as a minor annoyance. But when the pregnancy fails, this lack of information creates a vacuum that naturally forces you to question everything, including the quality of care. Was this miscarriage a mere act of God or a preventable mistake? Shannon and I intellectually know the IVF clinic, lab and hospitals used by Surrogacy India are top notch. (Not only did our local fertility doctor confirm this information but other reputable agencies also use the same facilities.) And we know there have been many successes. But hey, ours wasn't a success and, well, that's the one we care about most.

Anyway, we'll be much more vigilant about monitoring R's progress as she's prepared for the next attempt - beginning with a carefully worded correspondence with Drs. Sudhir and Yash. The next question was about when Shannon should put herself through another round of IVF. Dr. Hardy strenuously recommended we wait until the next attempt with R is seen through. Why go through the rigors of IVF when we've got two very good quality embryos waiting for a chance? Our doctor here has stressed more than once that he sees his job as helping patients to bring a single (one) baby into this world, and this recommendation fits that world view. Works for us. We were also going to ask if he'd provide a full cycle of IVF for free so Shannon wouldn't have to go through it all again in Mumbai.... Ok, kidding about the free part but the chance that Shannon can do this cycle again overseas is slim to none, nor do I want to see my wife go through that experience again.

A part of us was desperate to start a second round right away. We don't even know if both embryos will be thawed successfully, raising the exciting proposition that we have something to be nervous about before being nervous about the pregnancy itself. Positive thoughts and vigilance - that's all we can do to make sure this next attempt goes well. It's comforting to have our local doctor's professional endorsement for the current plan so we'll stick to it. I'm thinking of filling up on pasta to carbo load before the next go-round. That's what you do for marathons, right?

Saturday, April 3, 2010

Party For One

I have the party dress. I definitely have the gorgeous heels. I have the sparkly bracelets I bought in India that match my party dress and I have the perfect clutch bag to coordinate. (Of course, this IS me writing.) Sadly, I also have a thick box of tissues. All of this for the pity party I'm having and although I don't have them very often, I am entitled. (Geoff can crash but only after I have a few dances alone.)

We've come to terms with our recent miscarriage and we are doing better. We understand that when anyone miscarriages it's because there is something wrong with the pregnancy and, as difficult and heartbreaking as it is, it's for the best. For us, it is a bump on an already difficult and very rough road. However, we will get through all of this and we are still very hopeful we will have a family some day.

In the meantime, the emotional roller coaster continues. I'm not sure how it's fair that some are graced with three, four, five children when others are desperately trying for just one. I don't begrudge anyone for it, I just don't see how it's fair, especially when fertility issues come into play. As if infertility is not bad enough, some have to go through the process over and over again. Heck, some can't even afford adoption, surrogacy, IVF... and live life without children. It makes me wonder, who the hell is calling the shots here!? Many incredible people we know haven't had the luxury of getting pregnant on their own and have had to repeatedly go through multiple fertility processes. It's depressing, frustrating and not right. I am consistently surprised at how more and more common infertility is and to good people! It's simply not fair.

With regard to next steps, our surrogate has graciously agreed to try again with us, which is fabulous news as she's already proven she can get pregnant. That's one less thing to worry about so we won't be blindly entering the process again. R will need approximately two months to recover and then a third month to prepare for our next transfer. During that time, we are considering going through a round of IVF here in the States with the intention of freezing more embryos; time is not on our side as I get older and my egg production decreases. We have an appointment with our local fertility doctor this coming Friday to discuss all that has happened thus far and this potential next cycle. The journey continues.....

Life does go on and we want to wish everyone a happy Passover and Easter!

Wednesday, March 24, 2010

Closing this Chapter

It is with a heavy, sad heart that I share this news of us losing the baby. It doesn't come as a total surprise as our low, slowly increasing beta numbers, undetected fetal pole, teeny sac and undetected heartbeat are all indicative of miscarriage.  Mercifully, the end has come more quickly than it might have.  Yesterday we were told that even if nothing could be seen in the latest ultrasound aside from a small sac, if our carrier’s beta rose by even a few numbers, we'd have to act as if we were pregnant and prepare for another long, ten day of monitoring. However, this morning we learned that the beta level decreased. An ultrasound will still be performed but it's really just a formality.

We are some of the lucky ones to have come this far and for that we are grateful.  At the same time, we are incredibly sad, distraught and disappointed.  Frustrated comes to mind as well seeing that "excellent quality" embryos aren't necessarily excellent.  (This only added hope and additional pressure to an already tremendously stressful process.)  Personally, I go between numb and sobbing uncontrollably for what might have been.  Having to share this news with our loved ones is dreadful.  They are just as devastated and to hear their disappointment is heart wrenching.  The thought of what we may have to go through if our two frozen embryos don't go to term brings such anxiety to me I can hardly explain it.

We still have each other and together, we will persevere.  We have joined yet another family in the baby-making world - those that have experienced a miscarriage.  I can't say I'm happy to be part of this family but if it helps us to cope better or if we can support someone also going through this, we are here for the long haul.  We'll be speaking with the doctors again tomorrow morning to see how R is doing and to discuss next steps.

Sunday, March 21, 2010

Behind the Curve

Our Saturday morning beta results were 2600, a modest increase from the last test but definitely far behind what is "typical". Not surprisingly, in light of this beta count, the ultrasound showed an undefined sac. (With a beta that low, you just don't expect to see a lot of development.) Don't quote me on the description of what was seen as it's all second-hand information heard over a crackly phone connection but the bottom line is that at eight weeks, we (and the doctors) would have expected to see more definition.

If Shannon and I were to actually write a book for parents pursuing surrogacy, one piece of advice would likely be, "Think of beta numbers as hints, not facts, about your baby's health." I'm guessing Shannon and I are driven to this conclusion partly because we're busy trying to move past the fairly poor beta performance we've experienced so far. Dr. Yash told us she has personally witnessed two successful pregnancies that started as inauspiciously. Statistically, we're falling farther behind the norm but we wouldn't be making news if we went full term. Sometimes growth comes in fits and starts, particularly in the first trimester. We absolutely need to see vast improvement over the next couple of weeks but it wouldn't be unprecedented for that to happen. So there remains a reason to hope.

Recently, other intended parents within our extended surrogacy family have received very good, early-in-the-first-trimester news. We love hearing this. First, success is contagious. Second, all of us in this family have sacrificed for the sake of building a family and deserve all the happiness life can give them. We wish you all continued success and have you in our now fairly specific and otherwise selfish prayers.

Thursday, March 18, 2010

Hey Beta, Beta, Beta!

[The title is a baseball reference - a lighthearted insider joke for our U.S.-based readers as baseball season starts next month.]

Between Geoff and I both putting in some long work days and the less-than-inspiring news we received from Dr. Yash last Saturday, we haven't been all that motivated to write an update. However, knowing that we have many rooting for us and wanting to answer the surplus of emails asking when we are blogging next, I'm here to share an update for all inquiring minds.

As of March 3rd our beta number was 774 and our next increase - early last week- was 1626.  We were scheduled to speak with Dr. Yash again this past Saturday and, as is now the custom, we called promptly at 7am that morning (5:30pm Saturday night her time). R's numbers increased again, but only by roughly 300 or so. Now, to some, this is great because her beta number increased, but - yes, there is a “but” folks - after three or four days, we (both us and the doctors) had hoped it would be higher, certainly over 2,000. As you can imagine, I instantly panicked and have continued to conjure up the worst scenarios imaginable. Possibly in an effort to make light of the situation, Dr. Yash mentioned that perhaps they tested her too soon so not to conclude anything until the next test. Easy to say but only increasing by 300 just doesn't seem good. We are trying to remain positive but all that really means is ignoring the pessimism and ensuring the passage of time between now and our talk with Dr. Yash this coming Saturday will seem like an eternity. We reached out to the doctors on Tuesday to ask if R is spotting or if she has any cramping – you know, potential symptoms of miscarriage - and we were told "she is doing good". That’s certainly a good start so we’ll just try out best to stay optimistic and hope for booming beta numbers this weekend. (We’re starting to question the value of getting these weekly numbers. Either our carrier’s pregnant or she’s not; what’s the benefit of getting weekly numbers other than to spook the intended parents? It’s not like your average pregnancy is tested this often. Chances are, beta numbers just jump around. Or so we hope!) I’m now dreaming of beta numbers and, until the next test, I have a feeling they'll continue to drift in and out. We’re hoping for a beta that puts 2,000 to shame. Bring it on!

We recently ventured to the bookstore with the hopes of finding a book or two to show us what's happening to the baby and to R each week. Books for intended parents working with a gestational carrier just don’t exist. [Insert note to self here to write a book specifically for IPs going though this process] There are, of course, 1,000+ pregnancy books for couples experiencing pregnancy directly, some extremely graphic with things I do not want or need to know. Long story very short, we left with nothing that night and continue to search for a book that's right for us. Any suggestions, please share! Geoff and I did learn through our own research that whenever doctors calculate the number of weeks into a pregnancy, they count from the date of a woman's last menstruation and not from the date of fertilization. This works out to a two week difference. What does that mean for us? It means that as far as the doctors, books, etc. are concerned, we are actually eight weeks pregnant and not six weeks as we originally thought. However, our expected due date remains the same – 38 weeks after fertilization or 40 weeks after the last menstruation. That’s October 27th for us. The fall has never seemed so beautiful.

Thursday, March 4, 2010

Blip on the Radar

I almost feel like we owe our readership some drama to keep everyone engaged. Drama like what you'd find in one of Shannon's favorite television shows, Brothers and Sisters, where not a single day in the tv family's lives goes by without either some life ending catastrophe or the intrusion of a sexy love interest with an accent. Unfortunately, we have neither of those. (Well, not sure this counts, but I have a slight New York accent and my mom says I'm a looker.) All we can offer is good news. Today's new beta level is 774, almost a 300% jump. In fact, grab a seat - the first ultrasound shows a happy, little sac developing in R's belly. Too early to see cardiac movement or even any hint of a fetus but the screen doesn't lie - there's something inching its way to life in there.

After all of this heavy engagement on our part, watching the phone every day and sweating every passing minute, now, all of a sudden, we're transitioning into a no-news-is-good-news phase. Think about it. Up 'til now Shannon and I were very, very worried about things going right. Now we're worried about things going wrong! All we want are predetermined test dates with very positive news and an absolutely vanilla, no surprises pregnancy. Our eyes are now firmly set on the first trimester prize, ending approximately the third of May.

One confession I'm compelled to share is that Shannon and I have both felt a slight bit of disappointment at the implication of the ultrasound - that this would be a singleton birth, not twins. How dare we spend an ounce of emotional energy to bemoan the absence of two when we've been blessed with one? Absolutely agreed. I can only explain it by saying that the emotional and physical toll of the first effort hasn't exactly cast a come-hither glance enticing us to go through it all again. However, that said, we do have two frozen embryos and thus the option to avoid the first hectic round of IVF drugs and hospital stays. And believe me, the disappointment is fleeting at best, quickly beat down by the thrill of knowing that this whole damn process is actually working and that we've a baby slowly making its way to us from across the ocean.

We've held off talking about some other takeaways and advice we'd gleaned from our time in India because we thought it would be pretty cavalier to talk about overseas travel when our minds were a little preoccupied. Shannon and I will of course keep everyone up to date on the progress of our little one but from here on out we'll also sprinkle in some other surrogacy-relevant info we think other couples would be interested to learn. Hopefully, this will be of help to you and will keep us suitably distracted.

Finally, I just wanted to remark on the marvelous avalanche of best wishes we received for our last blog entry. That was stupendous and uplifting and a wondrous reminder that this world is filled with beautiful people. May all the good will return to you and multiply a thousand times. We send our love to our extended family!

Saturday, February 27, 2010

Snowy With a Chance of Pregnant

A terrible weather system has been plowing through the U.S. and where we live north of Boston was hit very badly. 75 mile an hour winds tossed boats, fences, grills and part of our roof like they were snow flakes. What were once beautiful trees are now destroyed and remain pushed to the side of the road or chopped into pieces to allow utility crews to get to the power lines that lay strewn across major roads in and out of our town and neighboring towns. We lost power at 10:30pm on Thursday night and they are saying it could be days before we have power again. This weather has temporarily uprooted us from our home and we're now staying with my mom and stepdad, which has left our sleeping somewhat erratic. Add the continued waiting into the mix and well, what is the point in trying to sleep at all?! The weather, us losing power and not getting much sleep - it's a good thing we now know we are pregnant since that makes everything a lot rosier. I'm sorry, what - you want me to repeat that? Yes, WE ARE PREGNANT!!!

Okay, so in hindsight, maybe we were being a bit too cautious. We actually first knew the answer back on Wednesday - due to a surprise email from Dr. Sudhir in response to a few unrelated questions - but this process has taught us to keep an even keel.  It's killing me and I'm stressed to the max, but I am trying very hard to remain balanced and calm with a little side order of holy crap we're freakin pregnant!!!! Wednesday we were told R's beta numbers were 104 - that's a triple from the Monday number - but we wanted to be sure and wait for the next blood test which was done Friday. This morning, Saturday, we called Dr. Yash and learned the beta had grown to 246. There's no doubt about it now.

We do need to keep in mind it's early. As Geoff says, we're now in the peed-on-a-stick phase - not exactly too far along and there's still a couple of high risk months to go. At least in the U.S., it's common practice to keep the first trimester quiet just in case things go wrong. Obviously, our situation is a bit more public so there's no hiding our status. However, we're going to try to balance excitement with measured patience.

All this said, we have no reason not to be optimistic now. I'm feeling better, R is healthy, the baby/babies are growing. We're pregnant!

Monday, February 22, 2010

Numbers Game

We're up to a 31, still inconclusive. The beta has risen, which is good, but not enough for us to believe we've passed the first viability hurdle. As we mentioned, the point isn't the number so much as what happens to the number; the beta should be doubling every three days or so and we didn't quite hit that mark. Our next test will be conducted Friday, with results available Friday morning our time, and we'll be looking for a number up around 90.

Any couple trying to build a family obsessess over every variable they believe reflects or influences the process. Right now, Shannon and I have one, solitary number to fret over so it's getting one hell of a lot of attention. We have to remind ourselves that for "normal" pregnancies, some women live through this first month without even being aware of what's going on inside them let alone measuring HCG numbers. All of which is to say, our numbers may end up being perfectly fine but the detailed knowledge is as much of a curse as it is a blessing.

To really overdo analysis of a single number, we're thinking the size of our beta implies - at the very least - that there's no chance of twins. We were ambitiously hoping for twins as our ideal family size includes two children and we weren't keen on going through this surrogacy process any more than necessary. However, yes, it's just too early to interpret much of anything. It's so hard not to play the numbers game!

Next up, Friday morning. More waiting.

Saturday, February 20, 2010

A Pregnant Pause

Shannon and I received a call at about 10am EST today - Saturday - from Dr. Yash. Our carrier tested "positive" with a beta level (i.e. an hCG level) of 18 mIU/ml. I put "positive" in quotes because a number like 18 lands a woman into the gray area one could call "a little pregnant". We're two weeks post transfer and at that time the beta for healthy pregnancies range from 5 to 426. Good news, right? Well, the beta typically needs to be more than 25 before a physician officially considers a woman pregnant. With a beta of 18, we might have a pregnant carrier simply on the low end of the scale or we might have a struggling embryo (or two) not fit for this world. In response to such a score, our doctors will be performing another blood test to ensure the beta continues to rise; the results will supposedly be available to us Monday morning our time. More waiting. However, I'll be the optimist and point out that because the beta level is higher than 5 and because we're two weeks in, we've clearly still got one to two embryos vying for life.

Apologies, by the way, for the silence 'til now since our return to Boston. Frankly, we were beat and had little to report. Shannon's health is finally recovering after taking a full week off from work; I've been back to work full time and using it as a distraction from the waiting anyone pursuing IVF knows so well.

Finally, I wanted extend one more thank you to everyone for your continued best wishes since our return. Please know that Shannon and I return those sentiments. Our experience is unique to us but not to this community. There are many couples in this world with their own stories and their own struggles and all deserve our most heartfelt thoughts and prayers. In light of our current situation, we'd like to make a particular shout out to those in the midst of the 2WW (two week wait) like us. Go beta!

Wednesday, February 10, 2010

There Is No Place Like Home

We are so happy to be home!  For two people that were as prepared as we were for this trip, I feel as though we were hardly prepared for the mental, emotional and physical aspects that were endured.  I know, it’s sad, but very true.  As I’ve said to all of the family and friends that we’ve talked with since our return home, it was supposed to be a happy and exciting trip but with the unexpected complications of laparoscopic surgery and with my getting sick, it was hard to enjoy ourselves. Had the circumstances been different, we would have had a much better experience.

Since our return, the outpouring of emails and calls, flowers, groceries and home cooked meals being delivered has been miraculous.  We are forever indebted to our coworkers, friends and families all expressing care and concern. Words cannot express our gratitude!

Regardless of this trip being a good or bad experience, it was one that I could not have survived without my ultimate best friend – my husband.  In India and home, he has been by my side every second of the way, holding my hand – what more can I ask for?!  In my eyes, I am the luckiest woman in the world because he is the solid rock I get to trek through the bad times with and he is the funny, brilliant guy that I can share the good times with.  (I know the ladies will agree, his debonair looks aren’t too tough on the eyes either!)  He makes my life better in just about every way and marrying him was one of the biggest achievements of my life.

We are now in what's called the "2WW" (two week wait) and believe me, we are counting the minutes until we receive that call revealing our fate for this cycle.  Have you ever heard of the fastest gun in the west?  Well, we'll be the fastest phone in the east and that first ring won't even have time to finish before we answer.

Monday, February 8, 2010

Many Miles

I'd started to think of our Mumbai hotel room as the editing desk for A Distant Miracle. How are Shannon and I supposed to feel inspired anywhere but here? What will we do without an ever present in-room dining tray? Without oddly random and relatively bad English-language television programming? Without the convenience of going to the bathroom a mere five feet from our bed? Ah well. Shannon and I will just have to suffer for our art and put up with being HOME!

Yes, home - where folks drive in single lanes and think 85°F is hot. Oh, and what a day to come back. The Super Bowl was scheduled for later that night. The Super Bowl!!! You can't get more commercially American than that. Shannon and I would have kissed the ground if she wasn't doubled-over in pain and I wasn't saddled with three bags and a backpack. This trip is over, baby!

My poor wife is officially a mess. We visited her doctor first thing this morning for a once over to ensure there's not some crazy problem lurking behind the scenes. Thankfully, no. Most of her symptoms are the result of the laparoscopy. The severe distention is caused by a few things: residual swelling of the ovaries from IVF, bruising from the surgery, carbon dioxide left over from use of the laparoscope and constipation caused by the use of anesthesia. Her throat pain is likely from use of the tracheal tube during surgery. The ear infection and sinus infection are bonus gifts caused by a bug she probably picked up at the hospital but who knows. For all of this, the cure is time - she'll be out of work and on bed rest for at least this week. Shannon just has to put up with the pain, nausea and general discomfort with the help of some newly prescribed pain meds, antibiotics and a DVR with multiple episodes of The Office, Brothers and Sisters, American Idol, Barefoot Contessa and 24. Oh, and lots of sleep, little of which she picked up during our last three or four days in Mumbai or during the 17 hour slog of a flight back to the States. Thankfully, she's now in her own bed, with family by her side, eating home-cooked comfort food.

Our last day in Mumbai, Saturday, was spent mainly as a time killer. The flight to Newark was at 11:40pm that evening, meaning we didn't have to be at the airport until 7:30pm. I begged and guilted the front desk into giving us a super-late checkout time of 6pm and then walked the streets to a local chemist for some decongestant, anticipating the flight could be torture on Shannon's ears (which proved to be true despite their use). Shannon stayed in bed 'til around 3pm and then screwed up the courage to waddle her way down to the pool for a last hour of sun. I, meanwhile, hit the streets once again and made my way to Hare Krishna Land (seriously, that's what they call it), world headquarters for the International Society for Krishna Consciousness (ISKCON), about a five minute walk from the hotel. Then around 4pm we started the packing process, hitting the streets for mosquito-filled Mumbai International Airport a little after six.

What followed was almost 24 straight hours of sitting on our butts. One might argue this was in Shannon's favor - not having to do anything but sit. However, picture yourself feeling really sick and congested and then sit in an airport or on planes for almost an entire day. That is not a recipe for success. I managed to get some fitful rest on the cross-Atlantic flight but Shannon mainly counted the minutes.

It's over, we're home, the healing begins. Best of all, the trip was a success. Everything we planned for went to plan. R is resting and being cared for; Shannon is resting and being cared for. It's a crazy parallel if you think about it. Maybe this is nature's way of giving Shannon a (very compressed) empathetic experience of pregnancy. I'm not trying to spin things - I hope (we hope) Shannon never has to go through this again. However, what's done is done. And if this bit of sacrifice helps prime the karma surrounding R's pregnancy, we'll take it.

Friday, February 5, 2010

Transfer Day

Dr. Yash pulled us aside as we entered the IVF waiting room in Lilavati. She led us to a set of chairs, sat down next to us and said, "As of this afternoon's tests, four of your embryos are in very good condition. We will check them once more before the transfer but my opinion at this moment is that we implant all four now rather than freeze a mere one for later use. Let's make the best use of this opportunity." Shannon and I looked at each other, saddened by the news. We always imagined freezing a few embryos on the off chance that we'll want or will have to make a second attempt without Shannon having to bear up with a whole new cycle of IVF. However, we've always told ourselves that success is a single child, that freezing embryos is a nice-to-have, not the goal. We assented to Dr. Yash's advice as she was called to the transfer room for the final evaluation and to ensure R - our surrogate - was comfortable and ready.

Shannon and I put a good face on things, comforted by the idea that R would be carrying four embryos, more than the usual count transferred and thus, we figured, having a high chance of pregnancy. Sitting with us in the waiting room was another couple who had just flown in from Australia to use donor eggs for a round of surrogacy. They congratulated us on the news and took it as a positive omen for their chances. Soon after, Dr. Yash returned.

"Your four embryos are in absolutely excellent condition. We have a new option. We can transfer just two now and freeze the other two. I wouldn't normally suggest this but their quality is excellent. I suspect that if we implant more than two, the chances of multiples are very high and will require selective reduction." Talk about out of the blue.... I asked if we were undermining the chances of success this first go-round in order to justify freezing. Dr. Yash replied no, the quality is very good and this should not be a concern. In her opinion, transfer two. Shannon and I sat back, talked it over briefly, and agreed to transfer only two. In less than sixty seconds we made a decision that may very well impact the rest of our lives. The other SI couple couldn't help but eavesdrop so when Dr. Yash walked away with our answer, I looked at them and said, "Now that was a heavy moment, huh?"

Dr. Sudhir, also in the waiting room, told us that Dr. Yash does not spare couples honesty about egg quality. Excellent means excellent. The other couple agreed. Apparently, they'd gone through multiple rounds of IVF with no success (thus their trip to India) and had certainly never heard the word 'excellent' used to describe embryos before. All of sudden the number four, which had seemed a sober compromise, now felt like an absolute jackpot.

The transfer process itself was completed fairly quickly, conducted by a Dr. Pai - the head of the IVF clinic and the same person responsible for the ICSI procedure. A mere 15 minutes after Dr. Yash left with our decision she returned with, can you believe it, R herself. She's this absolutely cute, little woman who was now the most precious person on the planet next to my wife. She and her caretaker sat down with us and the doctors (R's husband was at work). R carried a very composed air that was, in retrospect, a little surprising considering what she'd just committed her body to. She was also much more comfortable with Shannon and I, making full eye contact and flashing a smile; clearly, that first meeting in the clinic had broken the ice. We had a brief conversation mediated by the doctors, wishing her well, inviting her and her family to Boston, promising to learn a little Hindi, and then telling her we looked forward to speaking with her in a couple weeks via Skype. (SI communicates with all their clients using Skype and will connect couples with their surrogates once transfer has occurred.) Then off she went to the clinic for two weeks of lying down - probably the longest vacation of her life. I, meanwhile, wiped the flop sweat off my forehead and Shannon fell back in her chair.

Every step in this process has its own challenges and Shannon and I know we're in the midst of a statistics game. Just because our little guys are judged to be excellent doesn't, of course, guarantee anything. We'll have a better idea two weeks from now when our carrier is given her first pregnancy test. So are we relieved? Absolutely. Excited? Well, we're too cautious for that. But this is one heck of a hurdle and, to appearances, we've leapt it as well as we could have hoped.

Oh, and try this on for size:  If we do find ourselves with a baby or two nine months from now, they're already growing inside R. Now that's a mind blowing thought......

Bathroom Talk

I know I will be opening myself up for judgment when I say this, but I just can’t help but love the trinkets and t-shirts that read “I Fling Poo” – most of which depict a fun picture of a monkey.  This brings me to this morning’s entry – a lighthearted, kind of vulgar post that I must warn you about…this entry will not be for the refined among us.

So, it’s been approximately four days and 15 hours since I’ve had a bowel movement.  I am quite positive this is not helping the slew of other side effects I am experiencing due to the surgery and IVF cycle.  One of those side effects is most obvious - my stomach is very swollen from internal bruising, bloating and constipation.  Forget the baby bump, I now look as if I’m six months prego. I have an alien growing inside me, or perhaps an elephant.

It’s ironic because prior to our trip, many warned us of diarrhea or New Delhi Belly, most commonly caused by the water and any raw/uncooked food rinsed in it.  We’ve done very well at avoiding this, but others we know can’t say the same and it regrettably lasted for weeks.  The food from the four restaurants in our hotel and the room service happens to be terrific.  In light of my current situation, I have tried to eat an abundance of fruit and grains for the fiber, but nothing that helped.  I have continued to mix the Benefiber that I brought from home with bottled water, but nothing.  I am still drinking outrageous amounts of water and Gatorade, but nothing.

I currently find myself desperate enough to run (okay, slowly shuffle because I can’t walk fast right now) out to the water’s edge on Juhu Beach to suck up as much of the filthy Arabian Sea water as possible just to help “move things along”.  Obviously, I haven’t really lost my mind that much so instead we called Dr. Yash first thing this morning and she prescribed a laxative (plus some throat lozenges) and had it delivered by the lovely Heena at 11am.

Now, I wait to see when the first dose of this rocket fuel castor oil kicks in.  Seeing that I really can’t push (or laugh, sneeze or cough) with my stomach feeling so badly, I’m slightly hoping it’ll be similar to the prep I downed for my recent colonoscopy.  The way I can best describe it was that it turns anything still left in your system into liquid and then makes it feel as if a fire truck hose is hooked up to your mouth only to shoot out the opposite end.  Exciting, I know.  I still have ¾ of the bottle left and I’m happy to share!  If only I had poo to fling, I’d be one happy girl.

Thursday, February 4, 2010

In the Light of Day

Yesterday needs to be an all's-well-that-ends-well memory as it sure as heck wasn't fun or easy. Objectively, the surgery was a success - the doctors were able to harvest healthy eggs and, through ICSI, create six embryos that are now growing in the lab. Subjectively, it was a physical and emotional strain on Shannon (and me too, but there's no comparison), a process we'd have to think long and hard about before ever considering a second go-round. Shannon's dealing with some really bad abdominal pain and is essentially on bed rest - though we did pull off a waddle pool-side earlier today. Thankfully, relatively speaking, she is feeling a little better - her energy level is up and her email-response addiction is in full swing.

In this Men are from Mars installment of the blog, I'm going to reenter list mode, try to make some lemonade out of these lemons and share a few take-aways for folks considering or about to go down this path. Should Shannon and I ever have to go through this process again, we'll be sure to remember the following. (Far as I can tell, this advice applies to any city in India, not just Mumbai.)
  • IVF drugs are known to increase a woman's sensitivity to taste and smell. It sure did for Shannon. (Shannon found our lost hotel room key the other night just by sniffing the air.) When preparing for the hospital trip, bring lots of familiar, bottled water. Sure, the hospital has water, but it's warm and tastes funny and you never lose the thought that it's India water, it's going to make us sick. (Food can not be brought into the hospital and, even if you could, there's a nil-by-mouth order before surgery and a nil-by-mouth window after surgery as well. The hospital does have a cafeteria. What's it like? It's like a hospital cafeteria.)
  • Seems most women don't need laparoscopic retrieval for egg pick-up (aka EPU or OPU for 'ovum pick-up) - the vaginal procedure is fine - so the anesthesia used is lighter and the recovery much quicker. Nevertheless, bring some cough drops or sucking candy to soothe a ragged throat. This would have been very helpful for Shannon.
  • While we're at it, bring laxatives and strong pain medicine. Extra Strength Tylenol seems to be a safe bet for pain meds as ibuprofen products like Advil aren't always permitted after surgery.
  • If at all possible, consider a hotel relatively near your hospital. A ride that takes 20 minutes at 5:30 in the morning takes about 75 minutes between 6:30am and 10:00pm. There's just too many people going too many places. The last thing you want to do is walk out of the hospital and sit in a car for two hours. Worse, though many of the roads are in decent shape, some are decidedly not, resulting in an off road-like adventure that's not incision-friendly. (The Novotel's been perfect for us.)
  • Bring an iPod, walkman, whatever for both you and your spouse. You will not have a room to yourself and you can not expect silence. There is no mobile phone ban in the hospital and phone calls - sent and received - are frequent. Conversations of any kind are common. Now I don't actually believe the volume of conversation is any louder here than in the west but the use of a foreign language tends to amplify the disruption. Your only escape is through headphones and some familiar music or interesting audio book.
  • Socks are considered no more sanitary than shoes when it comes to entering the surgical area. India hospitals supply flip flops for folks walking into sterile areas. Just a heads-up that if you're going to make an appearance in the operating area, you'll need to go barefoot and then put on previously worn sandals.
  • Don't rule out striking up a conversation with other families. It has been our experience that the locals are extremely friendly and not remotely shy about personal matters. If you're ok with the accent then you can expect an interesting, candid conversation. As Shannon had mentioned in her last post, a few very pleasant minutes were spent speaking with the sister-in-law of our roommate, a mother of twins through IVF. This sister-in-law literally walked up to Shannon, who was lying in bed, and asked, "So why are you here?" [Of course, be sensitive to why those families are in the hospital. If a loved one is on his/her deathbed, that may not be the best time to pry.]
  • If at all possible, arrange to have someone handle registration and other hospital minutiae. Our clinic, SI, uses Heena and she's a lifesaver. I won't even try to picture how yesterday might have gone without her.
  • Verify everything; assume nothing. This isn't about not trusting your doctors or the hospital or anyone else. It's just that mistakes can be made and ultimately you need to bear the responsibility of ensuring all is in order. Educate yourself about the process, question guidance, think through implications and hold folks accountable. We're reading every line and are likely pains in the butt with our endless questions but the doctors understand and respect the attention - not to mention that we prevented Shannon from taking an antibiotic she's allergic to.
  • Watch this commercial, playing on India television, if you ever need a pick-up. Shannon can't get enough of it and wears a big smile every time the little boy and girl wish each other a happy holiday.
Today, Thursday, was a rest day. We head back to Lilavati Hospital tomorrow afternoon for the transfer and for a check of Shannon's bandages and sutures. (The bandages are some sort of waterproof, super bonding plasters that pull on the skin and are thus fairly uncomfortable.) This means we'll know around 5:30pm (Mumbai-time) how many embryos will be placed in our carrier and how many will be left over for freezing. Hard to believe that with all we've gone through, there are still no guarantees. This'll be an anxious few hours!

As always, thank you for your attention, prayers and good wishes. We feel far from alone out here.

E - Day

[I wrote this post after I got back to our hotel room from the hospital. I’m beyond exhausted, should be asleep and shouldn’t be posting entries when I have this many blazing thoughts, but I’m so determined to get this post out tonight that I ask for your understanding that it’s still a raw, unedited draft.  To reiterate, before you read on, please know, I’m thrilled beyond words to know we now have embryos growing in the lab but the process was a difficult one and I’m still in the moment.]

Thank you to all who sent emails, posted comments and were thinking of us today!  It was the toughest day yet and I’m ecstatic it’s finally over.  I think Geoff and I each slept for all of two hours last night due to the anxiety – an emotion we’ve come to know well this trip.  We were up at 4:30am, out of the hotel by 5:30am and didn’t arrive home this evening until 8:15pm.  The capper was that the 12 minute ride this morning was a full hour coming home.

If you can believe it, we arrived at the hospital before admissions opened and left after it closed.  Heena, the  sweet SI assistant, met us this morning to help us navigate registration and thus ensure we had a room on the 10th floor, the floor on which my procedure would occur.  If I never have to see room 1014 again, I will be perfectly okay with it!  I shared this room with another woman and her family………………all 12 of them.  It was a revolving door of people.  As if we weren’t there they laughed, talked, answered cell phones as loud as car horns and, I swear, did their laundry in the sink because there were a few pairs of skivvies hanging in the bathroom.  Eeeewww.  The thing that made me overcome these shenanigans was that later in the day we found out the patient had given birth to twins the night before and they were all celebrating.  Actually, one of the family members spent a fair amount of time chatting it up with us and even gave us some sweets that are celebratory treats in India.  Geoff found these delectable!

Anyway, I headed into the bathroom (a.k.a. my roomy’s laundry room) to change into my sporty gingham johnny and pants.  The bathrooms here still spook me a bit and although they may be clean for some, I find them pretty gross and smelly.  There’s always 2-3 buckets and a sprayer next to the toilet instead of TP.  No, not a bidet, a sprayer like I have attached to my kitchen sink.  How the heck does one wash with that thing without soaking all of their clothes?!  Note to any woman traveling to India….I’ve been carrying around a cushy roll of Charmin in my purse and it has definitely come in handy.  When I resurfaced from the bathroom Geoff saw the look in my eyes and tried his best to make me laugh by singing a rendition of Hip to be Square, offering his best Bollywood moves, which we’re both captivated by each time we see it on TV.  After his performance, we waited and waited with just a couple interruptions by the anesthesiologist and nurses checking my vitals.

At 11:15am, it was go time.  They stuck a hairnet over my head, asked me to remove my socks and walked me into the surgical suite.  I hopped up on the gurney and tried to deep breathe with my heart pounding out of my chest.  I knew no one, Dr. Yash had yet to  arrive and everyone around me was speaking Hindu.  After sticking me with a needle that looked like a samurai sword, they got me off my gurney and walked me into the “OT” – operating theater.  Even more masked people were in this room and the huge spot lights shining down magnified the foreign medical equipment they quickly began hooking me up to.  WHAT THE HELL DID I GET MYSELF INTO??  I felt so alone and still no Dr. Yash.  I was more scared now than I had been the whole trip.  Tears streamed down my face and this alerted the nurses and surgeon closest to me.  He leaned over and in a thick Indian accent said, "don’t worry - everything will be fine.  Ha ha, that’s easy for you to say, Mr.!  He summoned the nurse to get Geoff, thinking this would make me feel better.  Geoff appeared in the entrance of the surgical suite’s doorway to see me sprawled across a table with my arms out to the sides as if I were making a crucifix.  Over the hustle and bustle Geoff yelled out, “I love you and I’ll see you soon” which of course made me cry even more!  I tried to make him out but without my glasses on I was even more out of sorts.  Dr. Yash came in at that last minute and apologized for being stuck in traffic.  After that, the last thing I remember was them placing an oxygen mask over my face and injecting something into my IV.

I awoke just outside the OT in the surgical suite again and I will admit, I was in a significant amount of pain.  They retrieved my eggs laparoscopically leaving me with three very sore incisions.  In addition, my throat then (and still now) is killing me from the tracheal tube they put down my throat.  On a good note, from approximately twelve follicles, they retrieved six mature eggs – all of which were fertilized today with a fresh batch of Geoff’s sperm through a procedure called ICSI.  For two days the embryos will grow after which the doctors will decide which are the best three to implant into our carrier this Friday.

After the surgery, we waited and waited and waited………….for almost seven hours.  Seriously?  SERIOUSLY.  I’ll admit, we were both disappointed that neither Dr. Sudhir or Dr. Yash visited us in our room today.  Thank goodness Heena was there to check in with us and to translate when needed.  With her much needed help, I was discharged at 7pm and given prescriptions she helped us fill at the on site pharmacy.  Unfortunately, despite me confirming the one medication I have had an allergic reaction to with every nurse and doctor today, that is the antibiotic they prescribed - so we then had to deal with that.  We left the hospital by 7:15pm only to sit in a car the size of a match box in bumper to bumper traffic on horrible roads for another hour.  Gggrrr.  The good news is, it’s over and I’m now resting on clean sheets in bed at our lovely hotel.  The incisions are much more sore than I anticipated, but I’ll deal with it knowing the surgery is behind me and the transfer is ahead.

Monday, February 1, 2010

Getting By

I’ve hit the feeling-lousy stage of IVF so part of me looked upon Sunday, a day with no medical appointments whatsoever, as an opportunity to do something to get my mind off things and to simply relax.  Our driver, Ajit, has very good English and clearly knows the city of Mumbai quite well so we decided to take in a quick tour of the major sites – Gateway of India, Taj Mahal Palace & Tower hotelGandhi house (stirring), Queen’s Necklace, Haji Ali Dargah mosque - and to tackle a little haggling with street vendors. Turns out Mumbai itself isn't much of a tourist destination. The two big beaches are really just for locals and the downtown architecture looks more British than Indian. If you’re in the banking business or part of the Bollywood scene, come on down. Otherwise, look elsewhere to explore the two thousand year history of this country. (Don't get me wrong, the sites are amazing but, museums aside, it can all be covered in a day. Well, with the exception of Elephanta Island and its amazing caves which we hope to visit  at the end of this week, depending on how I feel.)

Today (Monday) by 9:30am, was already a difficult day and I could only assume the day wouldn’t get much better. Not so good, I know. I stood holding the first of my two morning injections and just couldn’t do it. I cried, took a few minutes to regroup and then finally got it done. Once the needle is in it’s not bad, but until then the anxiety weighs heavily on me. I am overjoyed to say that today is the last day for my Lupron and Gonal-F injections!!  I'm really feeling the side effects of the medications now and that’s a bit frustrating as I have been doing so well up until now. We heard horror stories from others and I’m grateful it hasn’t been that bad for me. As Geoff wrote earlier, I have a headache here and there and I may be a little achy, but the two most noticable things are how tired I am hours after the shots and my stomach is surprisingly distended which, as much as I wish it were true, makes it look as though I have a baby bump.  In addition, I constantly feel like I have to pee and understandably, my abdomen is tender. After my injections, Geoff and I went down for breakfast and I really didn’t eat all that much. I did manage to cry again and this time, in the hotel’s restaurant. Nice. I looked down at my waffle and it reminded me of my Nanna who for years had made homemade, fluffy waffles. I miss home. I miss my Mom. I miss the comforts of our immaculately clean home.  I miss cooking in my kitchen.  And I miss my cleaning frenzies, which occur weekly…..okay, sometimes daily. 

We were due at Lilavati Hospital for a 10am pelvic scan I was not looking forward to and which, no doubt, added to my morning emotions.  We only had to wait a few minutes before a smiling, sharply dressed Dr. Yash appeared.  Happily, she only wanted to see the progression of the follicles in my left ovary which, as Geoff mentioned, is extra high. This means it can only be seen by an abdominal probe, not the transvaginal, and this greatly improved my day's outlook. Waaahoooo! Follicles are plumping up nicely and it appears I have a good amount in each ovary. Again, waaahooo!  We left the hospital and headed back to the hotel to relax for the afternoon. (A quick hello to Douglas from Melbourne, a really funny, kind Aussie we met by the pool.)

Tonight’s the trigger shot and Geoff is on needle duty.  Tomorrow is a purely lazy day as my ovaries kick into overdrive and I'm told to rest all day.  Next stop:  E-Day (egg retrieval day) - please keep us in your thoughts and send lots of baby dust!

Tokens of Conception

During our first meeting with the doctors, Geoff and I were presented with a couple of gifts we would like to recognize and share with you. (How great are these doctors?) The first is a beautiful, silver jewelry box decorated in local Indian symbols that will forever conjure our trip east. The second is our favorite and will be our mascot during this trip and throughout the process. It is a wood-carved elephant with a latticework torso in which one can see a second, baby elephant. The elephant-headed Hindu god Ganesha is, among other things, the Lord of Beginnings and thus often called upon when starting a new adventure. Our new elephant conjures thoughts of Ganesha and will be our source of good luck! Thank you, SI!

Sunday, January 31, 2010

Scans, Plans and Specimens

(Yeah, yeah - pronounce it 'specimans' for the rhyme.)

It's too much to say we're used to our surroundings but I suppose, with all the distraction that comes with our focus on surrogacy, we've already reached a little equilibrium. Wake up at 7:30am so Shannon can take her meds, shower and get dressed, head down to the excellent breakfast buffet, take a little walk and/or sit around the pool, and then wait for our driver while responding to emails, writing for our blog and the like. We know before bed when and where we'll be needed the following day - we get a call from the doctors on the cell phone they supplied - so it's easy for us to plan appropriately. And happily, jet lag hasn't really been an issue. Seems the significant time difference between India and the US east coast (India is 10.5 hours ahead) is more easily accommodated than a more moderate five or six hour change that comes with travel to Europe. (Shannon and I both have had some rough jet lag after European trips.) It also helps that we spend at least part of each morning in the sun, letting our bodies understand that yes, normally, this hour is midnight, but right now it's 10:30 in the morning.

On our third full day we visited Lilavati Hospital so Shannon could have a second pelvic exam as well as an anesthesia workup while I get to make a little donation. The pelvic exam allows Dr. Yash to monitor the size of the follicles in Shannon's ovaries, ensuring they're growing properly and helping her to determine when the trigger shot and egg retrieval should be scheduled. The anesthesia workup is a little more important than typical because, unlike in most cases when egg retrieval is conducted vaginally, the high placement of Shannon's left ovary (due to the congential condition that brought us to surrogacy in the first place) requires the retrieval be performed laparoscopically. This means a slightly longer application of general anesthesia. We're told it'll be a 10 to 15 minute procedure instead of a 5 minute procedure so, in the scheme of things, not a big change. On the other hand, it does mean Shannon gets to go home with a couple of other souvenirs - tiny incision marks.

The hospital is a fairly modern building located in an upscale part of Mumbai named Bandra, about 30 minutes of traffic south of our hotel. Inside we were met by Dr. Sudhir and Heena, the assistant who met us at Hiranandani Hospital yesterday. A few moments later we were joined by Dr. Yash who took Shannon away for her pelvic exam. Shannon tells me the setting for this second test - though better than the one in the clinic up north - still failed to meet the standards we've come to expect in the States. She gritted and bore up to the test and random visitors who passed through the test suite. Upon return, Dr. Yash informed the two of us that the follicles were developing well and we were going to perform the retrieval Wednesday morning. This meant a trigger shot Monday night at 11:30pm (1pm Boston-time). Dr. Yash asked us to come by for another pelvic exam sometime Monday morning for a sanity check but things seemed to be in order.

The two of us were then led to an office for a detailed discussion with an anesthesiologist about Shannon's allergies, past history with surgery and the like. Looks like things will be a piece of cake for her. Then, to complete this day trip to the hospital, I had to produce a sample. (A sample of what, you may ask? I'm not telling.) This tattered room wasn't conducive to producing samples of anything but I did find a newspaper in the room I could use to catch up on local news if I got bored. Needless to say, I eventually held up my end of the whole surrogacy bargain.

Back to the hotel. This late in the procedure, Shannon's feeling more than your usual fatigue, capped with headaches, bloating and lots of other fun symptoms. We're just going to take the rest of the afternoon off. I've actually witnessed Shannon nap two days in a row. This woman does not nap, her energy's boundless, so I've learned she has a weakness - three weeks of body-altering drugs and long flights east. Good to know.

Saturday, January 30, 2010

Parting Shots

If you haven’t read them by now, Geoff posted two entries just last night so please check them out (First Impressions and Breaking the Ice).  I wanted to give folks an update on my shots and what our next medical steps will be.  Tomorrow (Monday) is my last day of Lupron and Gonal-F shots.  YIPPPEEEE!  They’ve left me bloated and a little tired with some firmness in my abdomen since that is the only part of my body I used for the injections. The injections themselves really haven’t been THAT bad but the anxiety just before I’m about to inject is something I can definitely live without.  I usually prep both needles and get the injection site ready.  If I hesitate when injecting at all, I’m a goner and that is what throws me off.  Yesterday was a piece of cake but today, not so much.  Even though the needles aren’t that big, to stand there holding a sharp weapon a half inch from my stomach isn’t as inviting as one would think.  The hesitation brings on a few hot flashes of adrenaline, weak knees and shaky hands. What fun!  I know what you’re thinking…why can’t Geoff give them to you?  Well, I suppose he could, but I’m an intelligent, strong woman in my thirties and I’ll be damned if I can’t get through this.  For me, it would be a blow to my dignity if I couldn’t administer these shots on my own.

Tomorrow day, I return to Lilavati Hospital for a third pelvic scan and in the evening, I inject the “trigger shot” (HCG), which tells my ovaries to let go of my plumped up eggs and get this party started!  I am ecstatic to say that like the two other shots I’ve been administering, this will be a subcutaneous injection (1/2” under the skin) vs. an intramuscular injection (under the skin and into the muscle) that many are familiar with.  All this means Wednesday will be the day of our egg retrieval. Wednesday is E-Day!

The Meeting

Our second full day here in Mumbai is a day that Geoff and I will remember for the rest of our lives.  After breakfast and a stroll on Juhu Beach we got ready for the big moment – meeting our surrogate. Our driver picked us up and we sat in typical Indian traffic for roughly 45 minutes before arriving at a different hotel where another SI couple was staying. Together we then visited Hiranandani Hospital, the birthing hospital we will be utilizing if we are lucky enough to get pregnant. Heena, another SI assistant, met us there and introduced us to a doctor who took us on a behind-the-scenes tour of the birthing facilities. To appearances it’s different from the state-the-art hospitals we’re accustomed to, but I’m thrilled to report it’s clean and closer to the standards we are used to. While there we had the great pleasure of meeting another SI couple who are here to pick up their twin boys! Congrats Todd and Alper and best wishes to you both!

After visiting Hiranandani Hospital, we eagerly headed back to the SI offices.  Soon after arrival, we proceeded into a semiprivate room where our carrier, “R” was seated with her husband and an attorney named Amit who would facilitate the contract signing. We anxiously shook hands and offered the most sincere smile two people could offer. Amit explained the contract and then tried his best to cut the nervous tension by joking with Geoff and me about how this signing process is similar to a house closing as in both instances you sign a slew of papers. The formal signing took only a few minutes after which Amit opened it up to all of us to communicate. R was shy, extremely soft spoken and reserved. Beautiful is an understatement, with eyes and a smile as innocent and sincere as you can imagine.  She was dressed in a traditional Indian sari and wore gold chandelier earrings, a matching necklace and a small piercing in her nose. (Apparently, in most of India, women prefer to wear gold jewelry - with the exception of an Indian state named Rajasthan where silver is preferred.)  Her left hand was delicately decorated with Indian henna tattoos which I meant to comment on but just couldn’t remember in the thick of it.  Her husband understood some English, supposedly unusual for a lower caste family, and in true Indian culture showed more eye contact then she.  He appeared to be very supportive, aware of the implications of this process and very much a part of it. We were extremely happy for confirmation that R would not be on her own.

The process was a bit awkward but incredibly exciting and inspirational. The emotions of gratitude that we felt in her presence were beyond overwhelming. We are meeting the woman who will hopefully, very soon, be carrying our child – oh my god! I was so nervous. My legs were shaking uncontrollably and my heart pounded so loudly I thought for sure R would hear it. With my hormones at their height coupled with the intensity of meeting her, I couldn’t help but cry. I tried to hold back, but simply couldn’t. The SI assistants standing at the ready quickly came to my rescue with tissues and bottled water, patting my hands. Amit hugged me and told me it’s okay to cry. He explained to R and her husband that they were tears of joy and relief as we’ve waited a long time to finally meet them.

Through translation, we wanted them to know that her well being and health is our main concern. Their head nodding confirmed they understood. Aside from answering a few of our questions and asking us what nationalities we are, they didn’t have much to say. R's timidness didn’t go unnoticed and we didn’t want it to be any more uncomfortable then it already was, so as directed, we quickly moved back into the space where Doctors Sudhir and Yash were waiting for all of us. The doctors were very happy for us to finally be in this moment, to be sitting with our surrogate and moving forward with the process.

The doctors translated a few questions we had for R and let her and her husband know that we would always consider them part of our extended family. Geoff and I did struggle to express our thanks. This simple couple from the streets of Mumbai would be tied to us for the rest of our lives through this amazing act of sacrifice. What can you say? To complete our visit we gave them some gifts we’d brought along for them and their two sons. We had purchased a Lego set for each son and some Playdough.  We gave the husband a foam baseball and bat for use with the boys and much to our surprise, he knew what they were. Funny thing….as Dr. Sudhir was explaining to him that baseball is a very popular sport in America, the husband nodded and in the middle of his native response, we heard him say “ESPN”.  Not sure where he’d seen it, but he was spot on. (Gift selection was challenging, particularly for the father. What would be suitable for a low caste Indian father? We settled on something he could use with his children thinking, well, baseball is a lot like cricket – which is popular in India - but novel enough to be unique in their neighborhood.) Except for the baseball and bat, all of the gifts were in pretty gift bags with coordinating tissue paper and ribbon.  Geoff thought it might be awkward for the couple to walk home with these technicolor bags but in my family, gift presentation deserves its own attention. R’s gifts were in a hot pink, polka dot bag (of course!) and her eyes lit up in amazement.  Understandably, she preferred to wait until she got home to open it, but inside was a pretty necklace and matching bracelet for her, some girly things (eye shadow, lip gloss and nail polish), a body cream set and a journal for her to write her thoughts in while she’s carrying for us. We’re hoping they will enjoy the gifts and were pleased with our selections. They collected their gifts, shook hands with us once more and then went on their way.

Prior to our leaving the clinic another SI couple arrived to say hello. Stan and his wife were two days away from going home to New York with their new daughter Daniella. (Geoff had actually spoken with Stan on the phone more than once as we researched our India clinic options. He was a fantastic resource.) We held the adorable newborn for a few stolen moments and then said our goodbyes through hugs and handshakes. Congrats to the happy couple!

That evening, the doctors took Geoff and I out to dinner at the restaurant Jamavar in the amazing five star Leela Hotel, where we enjoyed authentic Indian cuisine from both Northern and Southern India. It was a fun night and a great privilege to have one-on-one time with the doctors, getting to know one another beyond the x’s and o’s of surrogacy. It was a great night after a full day. We collapsed into bed once we got back to our room.