The Plague and Me (or is it "in Me"?)

Grouchy, achey, and sick - that's me. (If I've offended anyone about anything, I apologize. My mind has been fraught with sickness, worry, and anger.)

I've had the flu for 3 days now AND my OB/GYN appointment last Friday revealed free-flowing fluid on my ultrasound. Not good. My doctor is suppose to call me with the results (radiology/ultrasounds are done in a different place then his office), but so far he has not. 

Having had an indeterminate* PID type infection many years ago, I know what a problem having free-flowing fluid can be. Last time it included antibiotics for about 6-8 weeks,  trouble walking for weeks, tons of abdominal pain, and admittance to the hospital for almost a week. Not exactly prime for IVF treatment. I'm willing to bet that's what caused one of my fallopian tubes to be blocked. 

If I don't hear from my OB/GYN by tomorrow morning, I'm going to have to call and explain that I need to get on antibiotics STAT. I should have gotten an extra dose of antibiotics after my last IVF treatment. The first cycle I asked for it because of my past issues, but I forgot this last time. Just went with the normal 1 treatment after IVF. Did I mention I don't react well to some antibiotics? Particularly the ones that are usually Rx'd for this sort of thing. Sigh.

And this stupid flu. I have so much to do before I start work on Monday and I'm too exhausted to do any of it. Was suppose to get a cavity filled tomorrow (that I've put off for MONTHS because of IVF) and now that's not going to happen. I certainly won't be able to take care of it when I first start work. Double sigh. 

Found out today that if I had gone to the doctor within 48 hours of flu symptons then I could have gotten an anti-viral that reduced the symptoms and reduce the length of time I was sick. Thought there was nothing you could do for the flu. Now it's been more than 48 hours. Should have gotten the stupid flu shot, but was worried about it with IVF. 

At least I have my wonderful husband. Not only makes the best homemade soup ever, but laughs at my grumpy faces. 

*the doctors never found the cause of the infection though I was later told it probably resulted from a polyp removal I had a month earlier. STDs, the most common culprit, was ruled out. When I asked why my doctor gave a diagnosis of PID, I was told "because that is what we label any infection of the pelvic area regardless if we know the cause or not".

New Advances in Infertility

Each of these mouse pups was born from an egg scientists created using embryonic stem cells. 

On thursday, NPR had a fascinating story on a breakthrough discovery for infertility. Even more fascinating  they did it with induced pluripotent stem cells (as opposed to the controversial embryonic stem cells). If they can do it for women, then not only will it reduce/eliminate the biological clock worry, but also provide a solution for the dreaded "unexplained infertility" diagnosis that plagues so many women. This will be a game changer for future generations of infertile women. There are even great implications for men with sperm issues, as well  as the many hurdles faced by the LGBT community.

Alas, this will not apply to many of us currently in the throes of infertility. All is not lost. Many doctors are currently working on various cell technologies that apply to infertility. Autologous Endometrial Coculture is one example of a technology promising encouraging results. What does all that fancy wording mean? The short of is that they take cells from the lining of a woman's uterus and use them as a more natural environment for fertilized eggs than the previous methods. Studies have shown that in certain cases embryo development is improved, as are IVF success rates.

Dr. Patel's clinic in India is working with a similar concept: certain clients can qualify for the case study in which natural cells from the IVF patient are used to surround the egg pre-fertilization. They are seeing an increase in fertilized eggs and while it's too early to determine if this results in actual healthy babies born, I can say I was very impressed to learn that 3 out of 4 of my eggs were fertilized with this method. There is more to this method than I am [purposely] describing, but that is better left to the professionals or perhaps, when I can be less emotionally attached to the subject matter.

I have no idea if this will help the quality of my eggs/embryos in the long run, but it is still very exciting. My first cycle ended up with 2 eggs and only 1 of those fertilized. That 1 egg took over 24 hours to fertilize. On my second cycle (with the new protocol) I had 4 eggs extracted and out of those 3 fertilized. Like my first cycle, one of those was a late bloomer, but maybe it's the one implanted now and thus causing a lower hcg. Apparently my case is not an anomaly as the Akanksha Infertility Clinic is seeing really encouraging results with women that qualify for the case study. Even if it doesn't work for me, I will be really excited if this helps improve success rates for women in general.

Science is so cool. 

Day 8: Yay! and try not to freak out.

Had another sonogram today, more shots, met the surrogate, and went over some preliminary paperwork.

Sonogram showed 13 follicles (yay!). 5 really good size, 6 average, and 2 small. Hopefully we will get some good eggs and then embryos out of these. Right now we plan on extracting on Thursday, but Dr. P said she will confirm after my sonogram tomorrow. 

Starting to get a little worried with the timing of my husband's arrival. I recall when we were planning this trip that I commented we didn't have much buffer room for mess-up (time wise), but I didn't think much more of it. Don't think I even thought of the timing for HIS arrival at all. Saturday I realized how short we were cutting it with his arrival. He gets here on Thursday - right now I'm tentatively scheduled for egg retrieval that day. That means he will not be there when I go under, something I am NOT happy about. Think "scared" is more the word I am feeling around for. In case of emergency, we do have 2 backup samples from last time, which is  good to know, but still don't like the idea of possibly having to use them if ANYTHING goes wrong with his travel. 

Try not to freak out, Try not to freak out. 

Last time we had to go a day earlier than expected. We expected 10 days of shots (not including the trigger) and ended up with only 9. If I go on Thursday, this will mean that I only had 8 days. I think the average person goes 9-12 days. I'm hormonal and irritable at my husband right now. Even more at myself for not looking at his schedule more closely and insisting on better buffers. 

Try not to freak out. Try not to freak out. 

Ok, got that out of my system for now.

On a different note: met the surrogate today. The surrogate is 28 years old, 121 lbs and 5'3 (I think she's 5'2 1/2). She has a brightness to her eyes and is ready with a smile. Sadly, she is going through a divorce and wishes to have enough money to get her own house and have some left over to go towards her son's education. 

When people talk about exploiting the poor, I really wonder if they think of things like this. Many months ago I looked up Gujarat house/flat prices and I remember being amazed how low they were. A surrogate in the USA could NEVER buy a house for what a woman could here in India. Sure, it may be a small house/flat compared to what we are used to, but so are most of the homes I have been to here. Even in very well to do homes. A woman could not earn the equivalent of 10+ years salary for surrogacy in the USA and they could not have left over funds to educate their children. When you see the lives here that have had such a positive impact due to Dr. Patel and surrogacy, it's easy to see why she does not let her critics affect her. 

Ok, got that out of my system for now.

Please let this take this time. I don't think we could come back again for another try with my eggs. Please please please. 

Hopefully this cow gave me her blessings. I gave her and a baby cow some of my leftover Malai Kofta and rice. Actually I gave it to the calf, but then she came and took it over. I'm ok with that. Maybe I'll get double blessings. 

Boss cow

Baby cow eating bushes after a few bites of delivery

Good article about surrogacy in India

Not familiar with this news source here in India, but the few articles I perused were done quite well. The article they have on surrogacy is here: http://gulfnews.com/life-style/general/india-s-rent-a-womb-industry-is-booming-1.1073056. Though I don't particularly care for the first picture they have in the slides, the article is a positive one none-the-less. Worth the read.

Note: the article is a bit confusing when it is referring to clinics . Even as a person who knows a ton about my clinic, I had some confusion when they flip between some details about clinics. For example, on page  1, the author writes "Parvati works for – Akanksha Infertility Clinic" and noting earlier that is is located in Ahmedabad. Then they flip to "Dr Kamini Patel, the director of Vani IVF Centre, in Ahmedabad". Even though these two clinic are in Gujarat and both have a Dr. Patel, they are two completely different clinics. The article flips back and forth between quotes from Parvati and quotes from Dr. Kamini, that it sounds like they are the same clinic. I actually wonder if they just misprinted which clinic Parvati was with. 

Also, while the Vani IVF Center they refer to frequently and write as having 48 surrogate babies born, I do want to note that Dr. Nayna Patel at the Akanksha Infertility Clinic has had over 500 surrogates born as of June of this year. I know this because I was here for the HUGE celebration, flanked with media from all over. I include this information because I can see that the most people would confuse the two clinics when reading the article. 

Simple Cyst

When I woke up this morning, I wondered if I should just stay in bed. Was trying to get 8 CONTINUOUS hours of sleep, which is nearly impossible in my house due to the fact that I stay up too late and my husband gets up early. A bad dream woke me up after 6 1/2 hours. I tried to go back to sleep until my husband's 7am alarm, but I never really did.

I should have just stayed in bed the rest of the day. Already I felt weepy.

At 9:20 am I had a followup appointment at my OB/GYN's office (Dr. I) to check for cysts. I didn't even have to ask this time, the big black space on the monitor told me everything. Then I met with the doctor, where he informed me that I have a minor "simple cyst" and not to worry. Except I do worry. And then I asked the size... 5 x 4.1 cm. Look, I may not be a doctor, but that's not small. I think the one that threw off my cycle last time was smaller than that and that we had to aspirate before proceeding.

I reminded Dr. I that I was starting IVF in September and that a cyst was a problem last time. He said we could check in a few weeks, that it would probably burst on it's own. Without losing my shit, I explained I would be on a plane next Thursday. He still seemed mighty casual about it all and said that if we wanted to PUSH to remove it, then I would have to undergo GENERAL anesthesia. Still keeping my cool (I'm not sure how), I informed him that I had to have general anesthesia in India to have it aspirated anyway and that I would much prefer doing it here, then letting it mess up my cycle. He was nice about it and all, but hellz balls I'm frustrated.

Initially I thought I would ask my doctor in India (Dr. P) what to do (which I did), but I also wanted to go ahead and schedule my appointment here. In India they immediately gave me anesthesia and aspirated, in the USA you have to have appointments way ahead of time. After returning home, it occurred to me that he had really been saying laparoscopy removal when he was talking about general anesthesia. I have NO IDEA why he didn't just suggest aspirating it as that is what I told him we had to do last time.

Months ago I had asked my Indian Dr if I should get a laparoscopy to check for endometriosis or just get some sonograms to check for cysts. She only wanted me to do the sonogram and distinctly said no to the laparoscopy. When I called Dr. I to schedule it (had to calm my mind down and go home first), I asked to have it aspirated. If Dr. P wants me to wait till I get there, then I can always cancel. I don't even know if it will be covered on insurance here.

When I come back from India, I will be having a laparoscopy to test for endometriosis. After today, I may want to try to find a different OB/GYN. I miss my old one (had him since I was 15!) and his small practice ways. There is something to be said about a doctor and his staff knowing you every time you walk through the door and remembering everything you tell them.

Waiting for the flood gates to open. If I cry now, then I may be ok when I see hubby later.

I guess the myo-inositol didn't work. 

Open letter to The Hindu (newspaper)

Thanks to Douglas over at Just One Out of Seven Billion for bringing an article by The Hindu, to my attention.  Below is an open letter to the editor based on a similarly emailed letter.

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Regarding your article here: http://www.thehindu.com/news/national/article3640405.ece, I am surprised and saddened to see such a bias-based article written by The Hindu. There are several misrepresentations that I will list for your consideration.


1.) Thanks to the emergence of surrogate motherhood as a multimillion-dollar industry in the country, the clinic is doing a roaring business. What is the success formula? An unending supply of poor and illiterate women and the absence of laws have made the trade the fastest way to make money.

No source referenced here (a mainstay of good journalism) on how the author came to the conclusion that this specific clinic's success is based on [the uteri] of poor/illiterate women. No mention on how the clinic in question has put a lot into the community to educate the surrogates and their children. No mention of the trust fund set up to assist current and previous surrogates to further themselves and their family. A simple query into the community will show you that Dr. Patel is highly revered for all she has done to help the women in her care. Simple research into print editions of The Times of India (Ahmedabad edition) or Hindustan Times would have shown this as well. Had the author inquired into proof of how the surrogates have had their lives changed by this clinic, then Dr. Patel would have been able to provide this.


2.) Another inmate had four foetuses in her womb, two of which were aborted as the couple did not want so many children. There is no clarity on whether two foetuses were aborted for medical reasons. 

Using the emotional term "inmate" aside,  a woman carrying 4 foetuses to full term is in extreme danger, as are the foestuses. A rudimentary check with a few respectible obstetricians would have enlightened this fact. A woman's survival rate and the babies survival rate is seriously compromised and often considered not worth the risk. A doctor that WOULD allow this should draw much more concern as in cases where it is allowed, it would appear that the woman's health is not the priority.


3.) A commissioning couple can get a surrogate for half the price in India compared to the cost in the U.S. or the U.K., where surrogacy is not allowed or permitted only in special cases. European countries do not allow surrogacy at all. 

While I could lament on the economic differences between these countries and how comaparing them is extremely misleading, I will simply point out the cost of the average 1000 sqft flat in Vastrapura (located in the state of the clinic mentioned in this article) to allude my point: the [current] equivelent of 12-16K US dollars. To find the same home in the US at 3x the price would not only be almost impossible, but would most definitly require additional large funds to be habitated. That aside, this statement by the journalist, Aarti Dhar, is also false: surrogacy is most certainly allowed throughout the US. A few states may have particular laws disallowing it, but all one has to do is find a surrogate in a different state if there is any concern.

The statement on Europe is equally false as there is more than one European country that allows surrogacy, though like India, some do not have specific regulations in place. Even for the majority that do disallow it, the US has long been a place (much longer than India) for Europeans interested in surrogacy. Legal problems that were encountered in the US initially, such as the 1986 Baby M case, have been resolved by using gestational surrogacy only versus the traditional surrogacy.


The core principles of journalism dictate truthfulness, accuracy, objectivity, impartiality, fairness and public accountability. Since this article is not listed under the Opinion section and instead falls under the National section, it fails on all accounts. We can not address how women are being exploited in these circumstances, and I believe there is a high liklihood that they are in many places, if our newspapers do not give the information accurately and without bias. More importantly, we can not attempt to fix it. Very disappointing that The Hindu, with such a illustrious history and excellent reputation, failed on such a basic level.

Happy Birthday to baby 500 and 501!!!

Sign at Dr. Patel's clinic

Today was very exciting at the clinic and we were asked to stay after our shots. They were having a major celebration as the 500th surrogate baby was born today (technically it was twins, but the focus was on #500). We were more than happy to stay for the festivities.

After popping 2 balloons to help decorate, I gave up. One of the doctors teased me that it was a good thing no one was near delivery time because of the loud bangs. Had not realized so much media would be there and it was a little overwhelming for me as those things tend to be. I was pulled over for some photos, but I'm fairly certain that I didn't even make the crop. I seemed more in the way then anything else.

There were babies all around, but the
two new stars were the focus. There were so cute, and despite their tiny size, looked healthy. Dr. Patel worked her magic with the media and as always, was stunning to watch.

After all the interviews, cake and samosas were passed around. Yum! I needed some sugar after all of that excitement. A gorgeous 5 year old girl had taken a shinning to me and I thought of her as we exited the clinic.

Front page, bottom fold

Picture from article

Reading "The Times of India" (inclusive of "Ahmedabad Times" version) I was immediately struck by the article on the front page, bottom fold: Womb rental incubated her business - Surrogate Mother Invest Earnings.


--by: Bharat Yagnik


Ahmedabad: Madhu Solanki is a 34-year-old successful businesswoman running one of the largest grocery stores in her village, Waghpur near Anand. Madhu got the seed investment for her business from her womb, literally!

In 2006, Madhu had given her womb on rent. She had opted to become a surrogate mother for a childless couple from Bangalore to get out financial crisis - she along with her husband struggled to run the family on a meager income of Rs 4,000 per month. She got 2.25 lakh for renting out her womb. Madhu could save Rs 80,000 after building a small house.

Instead of depositing the money in a bank, Madhu decided to start a business. "There are three-odd grocery stores in my village. Being a woman I knew precisely what ingredients women need for their daily routine. The learning curve was difficult but I got the hang of the business in a few years," says Madhu, who owns the Anand Grocery Store. The store's daily collections now stand at Rs 10,000. Given her huge success, she has been appointed as a trainer to make entrepreneurs out of eight other surrogates who have earned decent money and are keen to invest it wisely so that they become financially independent.

"Madhu has trained eight surrogates who are in the throes of beginning their own grocery business. We want more women to stand on their feet," said surrogacy specialist Dr Naina Patel.

Madhu is a mother of two sons - one 10 years old and the second was born after she bore a child through surrogacy. Madhu and her husband are keen to give good education to their sons. "Becoming a surrogate changed my life. But the key is not to spend the money but use it to become financially independent for life," says Madhu.

First day jitters

Our nice A/C waiting room is for IVF peeps only. We waited only a short time (by universal doctor standards) to have our initial consult and then blood drawn. After which, we grabbed some lunch at The Rama Hotel's Thalis restaurant. Both my husband and myself enjoyed it very much, although it was on the sweeter side of his preference - typical of Gujarati cuisine according to him.

After lunch, we came back to the clinic as directed. After another short wait we were able to see Dr. Patel. She was concerned about a high estradiol level and we went over the dreaded "you're 40 speech". I appreciate the honesty, but that is one "tut-tut" I've grown weary of, regardless the source. We followed up with a scan that gave us more bad news: only 3 follicles and a 2cm cyst. The cyst would have to be aspirated to insure the highest chance of success. Come back at 5:30pm. Eat or drink nothing.

"Ok!!!! Wait what?" We had 3 hours to burn in the heat of Anand (currently at 104 F) and I was instructed not to drink. Fine. We took a rickshaw/tuk-tuk (my first ever!) to the famed Big Bazaar (BB) where even the girls in Bedazzled burkas stared at me. The BB here is like a really tiny Walmart with food items. Even though the drinks were in a refrigerated area, the want to drink was too much and I walked back over to the skin lotion aisle. The Nivea whitening lotion I bought is a testiment on how well marketing works (I've seen the commercial 30+ times now, and it has convinced I'm covered in spots from skin damage, even though I'm not positive that's what the Hindi spoken commercial says.)

After BB, we return to the hotel for an hour, and then back to the clinic. At the clinic, in a not so A/C area, I'm handed a consent form to sign. I ask what it is for and I understand it is for the anesthesia; it's at this point I realize I will be getting GENERAL anesthesia and not local. Ask my husband to confirm this and he does. Crap. I'm not known for doing well under general anesthesia. I prepare myself (and others) for the liklihood of puking.

Fortunately, I did not puke when they woke me up, but my husband was asking me what the class of antibiotics was that I have a problem with. Once we figured that all out, an older lady in a white sari added a yellow liquid filled syringe to my empty IV. They let me rest till I was good and ready to come back downstairs.

Dr. Patel informed us that once the cyst was aspirated, she could see 14 follicles. Yay!!! I had to confer with my husband that I understood correctly. Not because any language barrier, but because I still felt a little loopy. He said yes and I was jubilant, if not completely dexterous.

That pretty much was the end of our first day. We went back to the hotel for me to rest, which really turned into me going to bed for the night. My poor husband missed dinner for the second night in a row.

Off to see the wizard

In the waiting room

One can safely say the traveling to a different country, even one you have been to before, is a bit like Oz. Sometimes it's stormy and things are quite different. India is no exception. It's been a few days, but I think it will be a few more before I'm not dizzy from the tornado anymore.

This morning I was able to awake early, mostly because I played catchup with sleep yesterday and last night. I woke around 5am and my husband woke just around 6am. Even so, we relaxed as we got ready - until the luke warm shower startled me awake.

Our room at La Casa is very nice and even though it's a little farther from the clinic and though most westerners are at the closer Rama, I am glad we chose it. My husband thinks they may have upgraded us.

The tiny rocks in my sandals are an attest to us getting a little lost, but now we are sitting in our air conditioned room (separate from the regular clients) with 4 other ppl: an Indian couple and an Indian woman with her mother. I'm fairly certain this is the IVF room and tell my husband as much. I overhear the word "cycle" mixed with Hindi and I feel confident in my guess.

Now we wait. There is an autographed picture of Oprah watching over us (Dr. Patel was on her show) next to the god Ganesh. Between the two, I'm hoping at least one will shine favor upon us.

this does not install confidence...

UPDATE ON STORY on 06/03/2012. See at bottom. 

My husband casually mentioned to me as he stepped out of the shower this morning, some news from his sister.  Apparently there was a some sort of mix-up at our clinic. At least I think it was our clinic...Not exactly sure. That's how these things sometimes go.

What was this oh-by-the-way casual mix-up? Apparently a couple went to India and the first try for a baby was unsuccessful. They went back a few months later and the second try was successful. They also found out the the first try was "whoops", successful after all. So they will be having 2 kids a couple of months apart, so sorry about the mess-up on the first. WAIT WHAT???

 "Was it IVF or surrogacy? Wait I don't think that's even possible with IVF. Couldn't even imagine what the meds might due to a growing fetus. How could they miss a pregnancy in the first one? Don't they do blood tests AND scans?" blahhhhhh blahhhhh blahhhhhh, my mouth continues on a rampage of questions/statements that I have no control over stopping. I could tell by my husbands expression that he just realized that his "interesting story" was horrifying to me. And not because of 2 babies (which is probably what he thought was pretty cool about it.)  I have to keep myself calm knowing that the story is being relayed through several people and I will be able to ask our doctor about it face-to-face in 10 days. I wouldn't be shocked if it wasn't our clinic. And by that I mean "I really hope it isn't our freaking clinic or I may loose it."

Sigh. In my determination to hunt down the facts (he told me his sister read it in a news story in India) I reach out to my ever faithful Google. Except apparently Google is a whore today because she is MIA on this news story. She does, however, give me snippets of more bad news: a surrogate mother dies in her 8 month. I am thankful that it was not my clinic, but it still saddens me greatly. Yes I know that women die in childbirth, and one of the big reasons I chose the place I chose was due to my concerns for the surrogate mother, but this is still upsetting. Her poor kids and family.

I am further upset because I read related articles and the follow up comment section (always a big mistake). It appears that this news story has inspired many to write about how surrogacy exploits the poor women of India. Suspiciously missing is the [objective] reporting that talks about good clinics. Or even how these same women are exploited every day of their lives in grueling working conditions when not acting as a surrogate. How being a surrogate gives a possibility of changing this for them. Or how it's not exploiting when western women act as surrogates. On and on.

I furiously start typing all of this in a comment section where the only previous comments are negative to surrogacy (including the authors). I click on a link and realize I have just erased 30 minutes of pondering and typing as the link does not open in a new page, but instead uses the same. It's just as well. People don't want to think about the bigger picture. It's much easier to criticize than to research or even think about the bigger issues with poverty. Never mind they don't mention that regulation would help get rid of the bad clinics and help insure surrogates would be in the best care. Never-mind that... oh just never mind. I'm exhausted. I'm tired of ignorance.

Dr. Nayna Patel sets up a fund (required for IPs to pay into) that helps educate surrogates with trade and language skills. They are allowed to access this during and post surrogacy. She helps the women set up bank accounts in their own name and guides them in a multitude of ways. She is thought of as a hero in her community because of all she does for her surrogates and their children. She helps women have a chance out of poverty. What are all the critics doing??? Besides typing their ignorance time and time again? Usually pontificating with little information.

Ok, so this has officially turned from story to rant. Sigh. 6 more days until I leave for India. I better get off the computer and get some things done.

UPDATE: Spoke with the sister today and it turns out there was no mistake. A couple used 2 different surrogates and both got pregnant with twins. Shew. I didn't even bother to ask if it was our clinic as no mistake was made. 

Just the quote I needed today

Just started my new book, The Sacred Thread: A True Story of Becoming a Mother and Finding a Family - Half a World Away, and the opening page has this quote:

"At one end of this world, there is one woman who desperately needs a baby and cannot have her own child". And at the other end, these is a woman who badly wants to help her own family. If these two women want to help each other, why not allow that? They're helping one another to have a new life in this world."


   --Dr. Nayna Patel, medical director
      Akanksha Infertility Clinic
      Anand, India

Exactly.