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.

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.

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.

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.

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 step.........an ultrasound on Thursday, July 29th.

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.....

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!