Yo - What's the Haps?

It's a tale as old as blogs. I've been MIA. I've even started posts offline, only to never finish them. (Ok, technically it was only one - BUT I've thought of a bunch of others.) I've lurked. Not on purpose mind you, but the feeder app on my iPhone doesn't do a great job of posting comments and so neither do I of late.

Ya, ya, ya - so what's the haps? Current status: GREAT. All scary tests have come back normal. YAY!!!!!

We are at 21 weeks and 4 days and everything is lookin' good so far.

Surro is having major stress with other family stuff, but she is holding up like a champ. She's a GD saint and all I can say is that I wish a plague on the horrible person causing her pain - except that plague would hurt other people I love, so I guess I really don't. But maybe I do because that person always hurts other people and she's sure to hurt the people I love again. Shew. Life sure is complicated.

We manged to live through our announcements. First we told family and any close friends that weren't already in the know. Ok - that's a lot, but the response was generally good. Oddly enough I didn't really get much response from my Dad's side of the family that lives here in the US (Dad died when I was 3), but got great response from the ones in Sweden. All of hubbinez's family was super-duper-uber excited. So was my mom's side of the family - but most of them already knew.

Next we made the dreaded FB post. That actually went WAAAAYYYYYYYY better than expected.

At first I posted this video:

Mostly because I love Min Pins and this cracked me up as a baby announcement. Apparently no one viewed it or "got it" but that was ok because seconds later...

.... hubbinez was so excited about making the announcement (he had been telling people all week) that he made me do a joint word post, where we hit the POST button at exactly the same time. Because we are corny like that. It went something like this:

"On Mother's day it is fitting that we make our announcement that we are expecting twins. This would not have been possible if it wasn't for another wonderful mother, my SIL <insert name here> . Unable to carry our biological children myself, and after unsuccessful tries elsewhere, she selflessly offered to be our gestational carrier. Words can not express our gratitude over this incredible gift."

Hubbinez was as giddy as a school boy.

I haven't told my work yet, but that's because there has been a snafu with converting me from contractor status to employee status. Technically I am now an employee, but everything isn't final in all the systems, so it makes me nervous. I'm going to feel like an arse when I have to tell them about taking time off - which incidentally the due date is 1 day off from my boss' new wife. I'm sure he's going to freak, but because of my last disaster with getting fired when I told them about starting a family, I want to at least be protected by law this time.

In other haps - I am doing a sleep study next week. I've always had problems with not feeling like I get enough sleep (even when I do!), so no time like the present (ie., pre-twin birth) to try and figure this stuff out. We are off to a good start. Initial blood work from PCP showed that I have a big vitamin D deficiency.

That's a big one with sleep and immune problems, which makes sense since I've been sick so many times in the last year I lost count. With Vitamin D the doctor is looking for any number above a 29. Mine was 18. :-/  Apparently all that sun block wasn't so great for me. Except the whole wrinkle thing. I'm ok with the past trade off, but had to find another option for the future. Yay for supplements! 2000 IUIs a day! At least the past year has prepped me for that.

Srsly, I have to be the only girl whose doctor tells her to go get some sun WITHOUT sun block. Ok, maybe not, but it's not something I have ever heard before. And so I went out in the sun the other day without sunblock on anything except my face for the recommended 15 minutes. Then I slathered on the sunblock. The glare from my legs are still intact!

That's it for tonight. I need to post right away, sans editing, lest it fall by the wayside. Holy crap - it's 11:30pm. Gotta go take a bath and go to bed. Night all!

All is Well - Hard Things to Think About

Ramble Warning. 

Depressing Statistics for Women with AMA Warning.
VERY Uncomfortable Discussion about Chromosomal Abnormality Warning

I wrote this over a week ago, but was afraid to post. It's been on my mind for awhile and still is. Since this is a blog about my experience and feelings during my journey, the honest thing to do was to post it. 

After a year of infertility treatments and tut-tuts about my age from a multitude of medical professionals, I've become a little more sensitive than usual regarding my age. To compound the problem, a years worth of infertility treatments (3 IVFs in 8 months!) and the stress that goes along with them has left it's physical and emotional mark in more ways than I care to mention. Now I am faced with the added realism of doctors constantly calling me 41 BEFORE my 41st birthday, because they have to consider the age of the embryos  when they are born. Why you ask? Because that is what counts for problems that may arise.

In the land of infertility, 41 is old and can cause a multitude of issues - age related things that most of us women with AMA didn't think of when we started down the dreaded infertility path. Besides decreasing our ability to get pregnant, our miscarriage rate increases, as does the chance that there will be a chromosomal abnormality. This last part is the current worry area we are visiting. Depending on where you look, our odds of having a baby with a chromosomal abnormality is somewhere between 1 in 13 and 1 in 15. (Note this is with fraternal twins, much different for singleton pregnancies.)

On the upside, the odds that both will have an chromosomal abnormality are about 1 and 900. 

If you've gotten this far and are totally against fetal reduction in all cases - then you should stop reading here. I will have total respect for your beliefs and how they pertain to you, but I ask the same consideration for me. All of us in the land of infertility go through our own personal hell, and we really don't need judgement heaped upon us for the litany of hard things we have to consider every step of the way.

Since I am of "advanced maternal age" AND we are having twins, we are considered a high risk pregnancy and our surrogate has to see a perinatologist. We visited the new OB/GYN a few weeks ago (who won't be our actual OB/GYN, but that is for another post) and had our first visit with our Perinatologist last week. Building up to that visit, both my husband and I researched the heck out of the tests we would need to consider.

The consultation did not go well.  

While I didn't think about it before, our Perinatologist must be a part of the same religious medical group as the OB/GYN practice (not uncommon here in the south). This essentially means he Was. Not. Happy. when we were trying to get information about options if the worst case scenario happened and one of the fetuses has a chromosomal abnormality (CA) that we feel we could not deal with. These can range from things that would result in a stillbirth to death after a few weeks of life to some that we feel the quality of life would be extremely poor. Termination is somber idea for us who have fought so hard for life. 

At the doctor's appointment when discussing the CA tests, I uttered a question about "termination" and the doctor stopped short and very ADAMANTLY told me they DO NOT do that there. (Even our OB/GYN didn't act like he did.) Based on his attitude after that, we all began to have a genuine concern that he was misleading us on several counts. Tests he up-sold recommended to us (instead of amniocentesis) that we later found out may not be recommended for twins or donor eggs (which in this case, my eggs would be considered the donor eggs.) This is especially odd since I'm sure twins takes up a large part of his practice. Additionally, based on information we knew, some of his numbers for risk were off. (Example of that is below.) Finally, he suggested dates for the amniocentesis that would not allow us to get the information back in time (for GA law) should it be one of the items that we would consider termination. 

When I asked him directly about risk percentage of CA for what he was recommending - cell-free fetal DNA that tests for 3 types of CA - versus and the difference of the additional CA items discovered with amniocentesis, he assured me that miscarriage through amniocentesis was greater. (We do not have confidence that he was honest here.) 

My hubby says this is confusing how I say it, so I'll try to clear it up.

---------------------------------------------------------------------------------------------------------

(Chance of any CA (for 1 baby) in my age bracket with twins = 6-8%) - (Chance of one of the 3 types of trisomy that his test is for - variable X) 

Is this > (Risk for miscarriage for doing an amniocentesis (.3-1%)?

or 
is 7%-X > 1%

So theoretically, if the cell-free fetal DNA tests only 4% of the CA's, that still leaves us with 2-4%  untested risk. In my mind, that is a higher risk than the .3-1%  from amnio. This isn't even including the other things amnio tests for that are non-CA. That 4% is probably pretty close estimate. 

---------------------------------------------------------------------------------------------------------

All of this is a major problem, but to get a new specialist would could cause us to run past the time period that were are so precariously balancing in at the moment.  

Don't get me wrong, this is not something either of us takes lightly. I shouldn't even have to justify it as everyone has their own limits - and yet I still feel an overwhelming need to do so. We have gone through so much and if we had to make a decision like this, it would be horrific. But that said, both my husband and I are on the same page on what we would and wouldn't do when faced with certain results for certain tests. And our SIL/surrogate agrees as well.

Not only do we have to consider what we could handle at the birth of a child (death being a major one), but also as we age. Both of us have had a lot of experience with people important in our lives that have some very severe issues - both young and old. Enough that we wonder what will happen when everyone is much older and unable to physically care for them. With our siblings (and us) all in an older age group, the option of family being able to step in probably would not be available to our babies. Unless I left the burden to my son, which I don't think is fair at all. 

A child born with a severe chromosomal abnormality can have devastating effects. More than likely one parent will have to not work, which can be a big blow in income. Add the costs of medical and 1000 other things normal people don't think about, and any savings could be wiped out in a very short time. It only money right? Yes and while that may be true, older parents entering their 70's and 80's may have zero money left over to care for their child when they no longer can (much less themselves). They are then faced with the VERY REAL probability of a mentally and physically disabled child that will be sent to a state run facility. Knowing the child will spend the rest of his/her life potentially living in hell is just not something we are prepared to risk. 

So while I absolutely despise that we have to think about things like this, I guess I feel it's important to share. Because I think it's important we all know these things before we jump in.* That may not change our minds, in fact I can almost guarantee in most cases it won't, but maybe if someone is on the fence about other decisions (such as donor eggs)** then the information will be important to them. We all get so caught up in the idea and worry of having a baby, that we forget some of the other, very real, life changing concerns.

In my mind, there is no right or wrong answer with these tough decisions. I place no judgement on those of us that don't even want to know about things like this. Nor do I judge those who decide things differently than we would. In the end, we are all left with our own decisions and we must choose what we can live with 1, 5, 40 years from now - not what matters to outsiders looking in.

Sigh. I told you this would be a rambling post. We had such a small chance of getting pregnant. Heck, our chance of miscarriage was higher than our chance of getting pregnant. If we can just make it past the amniocentesis, then I will be able to breathe. For a little while at least. 

*In our experience, which is A LOT of different medical professionals, we really did not get enough information about all of the risks for my age. Really the only one that was relayed to us was our lower chance of getting pregnant. I'm not sure if we would have made a different decisions, but I think medical professionals need to do a much better job of informing their patients about these risks. 

**Even this does not guarantee that all will be fine and dandy as many here in IF blog land can attest. 

Testing... 1,2,3

Yesterday we went to the new OB/GYN with SIL.* Excited in our anticipation for another ultrasound, we weren't prepared for the possibility of NOT having one and were a little disappointed when it didn't occur. Not sure if it was because the appointment ran long, if the doctor felt it wasn't necessary, or she was holding off because she knew the perinatologist would want to do one. You know....because of all the testing coming up.

Testing? What testing?

Since I am of AMA, there are about a zillion tests that should be done to test for chromosomal abnormalities. Great another reminder that if something goes wrong, it's probably because we used my old-ass eggs. Thursdays doctor was not the first doctor to count me as 41, even though my birthday is not until the end of April. Seriously - I am waaaayyyyyyyyyyy over hearing the tut-tut regarding my age.

We elected not to do the chromosomal testing on our eggs/embryos. Not sure why, but it was one of the things I just didn't focus my laser (some say obsessive) research skills on during the IVF process. A part of me thought that a small biopsy could endanger our chances of implantation and thus we weren't really interested in lowering our chances (no matter how small) or spending extra money unnecessarily. Now, unlike congress, our proverbial bill is due and it is time to pony up (i.e. take all the tests).

Here is the nice handy-dandy chart for us to stress over for the next 6 or 8 weeks. Look a bit overwhelming? Yea, me too. Fortunately some of them overlap, so it's not like we have to do all. But we DO have to weigh the pros and cons of each and decide which we think is best.  Right now we are weighing more towards the amnio vs the CVS. Hubby says CVS is slightly riskier for miscarriage and the doctor mentioned something about loss of limbs(!!!). I haven't had the heart to look.

RISK ASSESSMENT CHART FOR DOWN SYNDROME AND TRISOMY 18 Screening parameters First Screen 11-14 weeks Integrated Screen Combines first screen & Quad Quad Screen 15-18 weeks Amniocentesis After 15 1/2 weeks CVS Chorionic Villi Sampling 10-12 weeks Down syndrome detection rate 83% 92% 81% 99.9% 99% False positive rate 5% 5% 5% 1% 1% Trisomy 18 detection rate 80% 90% 80% 99.9% 99% Biochemical Markers PAPP-A Free Beta hCG PAPP-A AFP hCG uE3 Inhibin-A AFP hCG uE3 Inhibin-A Diagnostic evaluation of hundreds of types of chromosomal anomalies Early Diagnostic evaluation of  chromosomal anomalies Nuchal Translucency NT NT NT *** *** Timing 1st Trimester 1st & 2nd Trimester 2nd Trimester 2nd Trimester 1st Trimester Open Neural tube defects Detection Rate *** 80% 80% 99.9% *** Fetal Nasal Bone presence Preliminary results/ significance *** *** *** ***

All this and we know we are at higher risk because of twins. I should be celebrating and instead I feel like a big bag of worry. At least the appointment went well.

*I never know whether to put SIL or surrogate. Some days it feels more appropriate to put surrogate for a number of reasons, but other days it seems so impersonal for such a great thing my SIL is doing. Bear with me. 

Here we are again - 2ww

Formula for moment of inertia
from: http://www.wikipremed.com/image.php?img=010105_68zzzz111100_12002_68.jpg&image_id=111100

I have about 100 things to write about, but right now I'm stuck with inertia over our pending results for our 2ww. My husband is out of town until Saturday night, and as much as I would like to say if the email comes tomorrow than we will wait to read it together, it's not gonna happen. If the email comes, I'll read it. This last week I've felt like a pressure cooker with every emotion beginning to boil up.

For some reason I thought it was coming on the 6th, but my husband thought it was the 7th or 8th. He remembered that the clinic is normally closed on Sundays, so if we don't get an email tomorrow then it will probably be Monday. In fact, if it isn't in by the morning, then we probably won't get it till Monday morning because of the 9 hour difference: surrogate tests should be done by my late morning time.

Truthfully, if it's bad news, it's probably best that my husband and I don't read it together. Like many men, he doesn't do well with tears and I know that this entire process is probably harder on him then it is me. At least mentally. Never-the-less, if it is bad news then I will surely cry and the last thing I need to add to his woes is my tears. Last time we went through a cycle it was super hard for him with every up and down and when we got the bad news, we could barely speak. I had prepared myself better for the bad news, but not enough that I could console him.

Last time I didn't even tell my siblings and close friends when we got the bad news. I just didn't want to talk about it. My husband called his family and I emailed my mom. She was pretty sad, so I stayed strong. A month or two later everyone else eventually came around and said "I guess it wasn't good news." By then I was already in  mode for my new cycle and had completely forgotten I didn't update anyone. This time we've told more people and gave promises of an update when we find out.

The update is hard enough, but it's the feedback that will really get me. I just don't want to have to have one-on-one conversations with each person on how they are sorry it didn't work out. Look at me. I'm already thinking the worse. I can't help it. Need to think positive thoughts. I left India on a super-positive note and I need to keep it going.

Sigh. Easier said than done. I have so many things I need to work on, but can't seem to do any of them. 2 ww. Bring it. 

A Carrier's Perspective (possible tissue alert)

This is a hard one for me to write. Because even with my veil of anonymity, it reveals something so personal and secretive, that few people in my life actually know about it. Many of my closest friends do not know about it and it was even hard to admit to my husband, but I realized recently how very relevant it is to my journey. And how much it will make me cry to write about it. 

Some recent stories I arrived at via Stirrup Queens showed me the importance of sharing my story. I apologize in advance for any grammar mistakes, for I don't plan on check editing like I normally do for long posts. Feel free to comment, but if you ever meet me in person let's agree not to bring it  up - ok? Alright, here it goes:

When I was barely 16, I gave up a child for adoption. 

There. I said it. Or at least wrote it. 

Surrogacy is not an easy option for me. Wait, I need to rephrase that because surrogacy and infertility are not easy options for ANYONE on any side of the fence, as blog after blog can attest. Let me try again... Like many cases in infertility land, our path to use surrogacy was an extremely difficult one.

For you see, I know the pain of carrying a child in your womb for 9 months and then giving it to someone else. I can pretend that my pain was "more" because the child was genetically linked, but I really have no way of knowing that. The best I can hope for is that the verbal evidence I am given from those "in the know" is what my surrogate will experience: that it's not easy, especially that day in the delivery room, but that the surrogate knows from the beginning that the child is not hers. Knowing that her GIFT will enable her to help her own children - something HUGE that I think most articles on the subject seem to miss, but mothers pick up on right away - helps to ease the worry. At least a little. 

My main nurse in Anand is twice a surrogate. She is always happy with a smile and her recent deliveries occurred when she was about 39 and 41, the last one being only a year earlier. She has worked at the clinic for approximately 9 years. She's not the only nurse that is a former surrogate and I dare say that they would certainly have inside information on what the women go through before making those decisinos for themselves. 

The life and emotional well-being of my nurse is a strong contrast of how my life was a year after giving up my child for adoption. Maybe emotionally she's an exception, but I don't think so. Speaking and reviewing empirical information on former surrogates lets me see how their lives are changed for the better, but I still don't fool myself into believing that the initial period after births are easy-breezy for them.¹

When I was pregnant and 15, I listened to people tell me that, "if I loved my baby, I would give it up for adoption." No one told me how the pain would rip me apart. The pain didn't even fully settle till months after, when it was far too late by legal standards to do anything about it, (even though I did try). Having been ostracized by any "good girls", combined with an already deep ability have depression (even before my pregnancy), it's no surprise that I continued making bad choices for awhile. I have no doubt that post-partum equally contributed it's ugly head during those times. 

And then I stopped making bad choices, (at least for awhile). At 19 I was engaged to a man 5 years my senior and became pregnant. While I certainly had not (I promise) PLANNED on being pregnant, after I got over the initial shock, there was a sense that a huge hole in me was in some way going to be repaired. I had to clean up my act for my baby. My marriage lasted for a very brief period, as my husband did not share my epiphany, but my second son helped me heal. Tremendously. 

I won't pretend that I haven't had other ups and downs in my life, many of my own doing on both accounts, but to say that giving up my first-born for adoption didn't have a huge impact on my life would be a lie. My first-born is now old enough to have tried to seek me out and even though I put in the initial papers that he could, he never has. Something that both grieves me and relieves me. It's probably been over 20 years since I dared even open the box containing all of the documentation and correspondence I had during those difficult times, but I still have the box. And it's a big box. It has been a long time since I grieved on his birthday, but there were many, many years that I did. Now, most birthdays go by without even remembering. Not because I don't love him, quite the opposite, but I guess my mind finally kicked in it's defense mechanism that we humans are so famous for. 

Invariably when I see surrogacy articles, I get enraged when I see all the comments about "they are selfish and should just adopt!" Do people think the mothers of adopted children didn't equally grieve? Some maybe less, but many possibly more. (There are more reasons that these comments enrage me, but I will save those for another day.) Do people not know that the amount an Indian  surrogate makes, even though small by western standards, can effectively change her and her families life? The surrogate can start a store or buy a rickshaw for her family to earn more. Things that were never even remotely possible for her prior.

Surrogate mothers choose their paths for a variety of reasons, but as long as it is their choice and they are fully informed, we should not take away that right or even judge it. Not even if the woman is poor and does it simply for the money. A poor woman wanting a better future for her family should not be held to a lower standard than other women. Knowing a little bit about Indian culture, I know that these women don't do it for pure altruistic reasons as I sometimes see touted, but that doesn't make their GIFT any less. 

Surrogacy is hard for me, but the adoption option would be even harder. My baby may have been unplanned, but he was definitely not unwanted. Not any more than my second child. I can not imagine reliving my 15 and 16 year old life from the other side of the fence. Adoption is not even on the table for us for us for many reasons, including simple ones like wondering if we would even be allowed AND our desire to have a genetic child. It was not until my most recent trip to India that I even acknowledged to myself about how my teenage years affected some of my angst of our current journey. 

Does the 40 year old me regret giving up my child for adoption? Surprisingly - no. I don't think the 20-ish one did either. I knew that the 16 year old me could not give a life to a child that even a 20 year old me could give. Even the 20 year old me had difficulties, but I think my second son turned out pretty awesome,. My first son would have had less of a chance and there is a high likelihood that if I had kept him, my second son would not have been born. 

I don't doubt that most surrogates go through pain when giving a child they have carried for 9 months to the intended parents, but I don't believe that most would want to keep the child either. The financial burden compiled with the stigma would be something that we westerners could not even begin to understand. At 16, I may not have understood all the pain that would occur with my decision to give my baby up for adoption, but it was the right decision. For me, my future self, and both of my sons. 

¹  I can ONLY speak from my experiences with my clinic, there are tons of nefarious ones out there that I hope are regulated out of business soon.

An argument, a wedding, and a memorial

from: http://www.ghank.com/sad-pictures/

Last week had it's ups and downs that melted into this week.

1.) An argument
Hubby and I had a big fight about if we will try again with my eggs after my second treatment in September. He's of the opinion that if I don't have a significant change in number of eggs retrieved, than it is pointless to even try. I'm of the opinion that it takes at least 2 cycles to even know the best treatment path. Truthfully, I see his point, but we really didn't need to GO THERE until we see if I improve at all. I need the hope right now.

We are going back to our original clinic. We had to make a decision and truth be told, our other India option did not get back to us with information promised; even after reminded. In fact, after the reminder I was basically told that the original person that was getting the information just had a baby and no information on if someone else would be getting the info or how long I would have to wait. I'm 40 years old and I really can't wait - hoping that they will get back to me. Every month lowers my chances. It's a shame because I really thought we would be going there instead. Maybe we will if they ever get back to me and IF I show improvement; two big ifs.

2.) A Wedding
My little (half) brother was married last weekend. The only reason I put "half" is because of the #3 part of this post. He is not part of that side of the family, even though he 100% part of mine.

Any how, the wedding was great and I could not be happier. He asked me to be the photographer and I happily acquiesced once it was known that I only "play a photographer on TV". Expensive equipment != good wedding photographer. The wedding was small, but really wonderful and I was able to spend time with family as well as people I have not seen in a really long time.

I spent the two weeks prior practicing with my camera and now need to spend a fair amount of time editing the wedding pics I have. Very critical of myself, but I hope they like it.

3.) A Memorial
My father died when I was 3. I won't belabor all the wah-wah tragedy of how it affected my life, but I will say this: with the exception my Grandparents and 2 others, the rest of that side of the family (which is large)  has pretty much ignored me most of my life. What is that saying? "The opposite of love is not hate, but indifference."

Last fall my Grandfather died and I was fortunate enough to be able to say my goodbyes by flying over to Sweden a few weeks prior. My Grandfather was the closest thing I had to a dad growing up. There was a funeral in Sweden, but half of the ashes were kept to be delivered to the US, as all of the children and grandchildren live here. In typical fashion, my family consulted neither me nor my older brother about availability for a memorial date. We were told last week that it would be in Sept.

While I tried to explain that I would be in India for medical reasons in September and asked if it could be rescheduled, I was informed that reservations had already been made by others (only a day later) and the date was chosen because it had the best weather for NC. Great - now I fall below weather. For the first time in my life, in a long, but respectful manner, I told them that their lifetime apathy towards my father's side of the family (my brother and I) was unacceptable. As the good little, quiet girl, I'm sure it has sent ripples throughout the family.

I don't pat myself on the back for adding grief during a hard time (as one Uncle put it), but for my own sanity it had to be done. Grandpa died last fall and they have had plenty of time to contact us instead of "oh freaking well - this is the date we choose - too bad for you." My grandfather told us we were to be considered as the stand-in for my father, and we have never been given that respect.

Maybe since I've finally said it, I can move on. Maybe this is the wake-up point where I tell myself that I need to make sure I'm not an absentee family member to my nieces and nephews. Maybe I won't keep myself up at night wondering why the hell so many didn't give a damn for so many years. Maybe I can accept that is our role, I've had my say about it, and concentrate on those around me that have CONTINUOUSLY SHOWN love as long as they have known me. Maybe. 

Wrap up from last week or so

The good:

To top off my previous birthday week, my hubby also planned a surprise birthday party for me on Saturday night. It was awesome. I'm guessing around 50 friends and family showed up. Brings tears to my eyes because sometimes often I think I'm very socially awkward and it meant a lot to have so many people show up for little old me. 

On the funny side of it, my hubby spilled the beans the night before. While cooking dinner he announces "don't go planning anything for tomorrow night," (I hadn't) "you have a surprise party." LOL. If you know me and my husband, you would appreciate how humorous I found this. The next evening we had to plan me acting surprise walking in. It was doubly and triply humorous because a.) my friends stink at being quiet during surprise parties and I heard the "shhhhh shhhhhh, here she comes!" from ACROSS THE PARKING LOT and b.) my friend's mom stopped us in the restaurant and said in her thick Greek accent, "happy birthday! So many people here for you!"  Truthfully I really was surprised though because I had no idea that many people would be there and the tears that came to my eyes were honest and sincere. 

The bad: 

I am getting frustrated with the communication issue with our clinic. Have done enough research to know that our doctor is super-duper busy, but that begs the question: why doesn't she hire additional staff? A case manager would be fantastic. Actually this deserves an entire separate post: so shall it be.

In other semi-bad news: remember how I was all "acupuncture doesn't hurt at all" the other week? Last week it did. Only in a few places, but YOW! I do not like needles. Which is pretty unfortunate when you think about what I will be going through next month. 

The other: 

I finished my book: All The Fishes Come Home to Roost: An American Misfit in India.  For those of you wondering, it has nothing to do with surrogacy, IVF, or even traveling in India. Basically it is a memoir from a woman whose parents worshiped a deceased Indian cult leader, and decided to move India to live with other followers. Tragedy written with wit, off-color humor ensues in the same style of Augusten Burroughs's Running with Scissors. I won't go into a long review here, but if you liked Scissors (or other tragedy/humor type memoirs), then you will probably enjoy this. I'd give it 4 out of 5 stars. 3.5 on a grumpy day. I look forward to more from this author as this was her first book. 

The other part deux:

Watched Google Baby today. I had seen clips of it before, but had not gone as far as to watch it yet. Mostly because a lot of the comments on youtube and news sites were pretty hurtful. I don't know why I let that affect me as I generally despise the comment section of news articles and such, regardless of the topic. (Makes me depressed that there so many misinformed or hateful people.) Any way, the movie was good. I thought it may make me second guess my decision (based on the trailer), but it actually had the opposite effect. Made me reaffirm that our decision is the right one for us. 

I'm putting the trailer below, but I don't think it's good representation of the movie. There are other clips on youTube you can watch as well to get slightly more. I'm guessing the trailer was designed more for people that aren't going through surrogacy and have prejudgments. The movie isn't judgmental at all. The movie is informative from a practical, medical, and emotional standpoint. If you can get a copy, I would say go for it. 

Notifying siblings

At the beginning of April I sent the below letter to my siblings (and copied my mom, but I had already talked to her about it). Mom immediately responded and made me feel less nervous about the entire situation. Siblings were super supportive and that was a great relief. We had already let hubby's family know as they were checking out stuff for us in India. We are incredibly fortunate to both have such great support from both sides.

Anyhow, here is the letter in case any of you were like me, and were wondering "how the heck do I word this???" I've replaced names with <relationships> as I'm not sure if I want to lose my anonymity. :-)  Also, I wanted to wait to notify other family members until after our trip in June when we have a better picture of where we stand.

--------------------------------

Sigh, I think with most people that this would be more appropriate in a phone call, but for non-trivial things, I'm really awful with the phone. I sometimes have trouble with auditory processing, most notably on the phone, and the more serious the discussion the worse it becomes. I'm very self conscience about it and with the exception of a small handful of people who I regularly speak to on the phone, it's tremendously hard for me. So if you are wondering why this is in an email - that is it in a nutshell. Feel free to call me with any questions, I just don't know how to start the convo about this on the phone and I get panicky when I think about calling people it. (I'm much better with it once the ice is broken.) Hopefully you will forgive me for this lapse in etiquette. 

<Hubby> and I have always known that we wanted to have a child or two after our marriage. We knew from the start that this would be a challenge as many years ago I had a surgery to remove my uterine lining due to medical issues. I still produced eggs, but would not be able to carry a pregnancy. 

Last year we started our journey and looking into our options, when my doctor informed me that my uterine lining had begun to grow back (which explained why I was starting to have issues again.) This offered us new options and hope, only to be told that the lining was only back in some places, and with other damage the doctors still did not feel I could carry a pregnancy. When we questioned about new available procedures to possibly fix the problem, we were met with a new reality - the meaning of a woman's "biological clock." This doctors informed me that to try and temporary fix the problem would have a low success rate and the time that elapsed would mean that my "ovarian reserve" would have diminished. Essentially, we may miss our very narrow window of conceiving with my eggs. 

I won't go into the long explanation of "ovarian reserve", but suffice to say a woman's chances of having a baby starts a steep decline at age 35. By 43, most clinics will not even consider using your own eggs.  We have now gone through sufficient tests to know that my eggs aren't awful, but they aren't super awesome either. Still, the doctors think we have a decent chance, though we still have the issue of me not being able to carry a baby. 

Enter surrogacy. Again, we knew this would be the main option for us when we first started dating. What we did not know was how expensive it was going to be. Using IVF with my own eggs - surrogacy easy enters into the 6 figures. More if we have to use donor eggs. There is no guarantee of a baby and many couples have to go through several IVF cycles at 15-20K a pop. Add on all the other costs, and it is crazy overwhelming. 

Enter India. When researching surrogacy, which is horrifically expensive in the US, the idea of India came to me. I had looked at international options for medical tourism many years ago, and wondered if IVF and surrogacy was an option. Turns out it is a big option in India; the price is 1/3-1/2 (even with airfare, travel, time off from work).

The main thing that concerned me with this option was the possibility of exploitation. After endless hours of research, I am happy to report that I have a 100% confidence in my findings. In the US, a surrogate mother is paid 15-30K (more for twins). In India, while it is much less (6-12K), the money is LIFE CHANGING to the surrogate mother. It's is often more money that the woman (or her husband)  makes in 10 years time. With the money many women buy a house (around 2500), educate their children, or help their family start a business. I do not feel we could make such an incredible difference in another woman's life here in the US. 

That said, we wanted to be careful that the money would actually help the woman. Again, after many, many weeks of research, I have found several places that have international reputations. As one surrogate put it "carrying another woman's child and making 10 years salary is not exploiting, working 15 hour days, 6 days a week, crushing glass is." With <hubby> having family in India (often close to the places we were considering), we had the extra benefit of them being able to check everything out from over there. We are pleased that we have decided on a location that is known for tremendously helping the women. They not only insure that this is the decision of the surrogate, but also provide housing, health care, nutrition, 24 hour care, help towards the surrogate's children, education, and a trust fund to continue education to the surrogate even after giving birth. At present the clinic, besides being internationally known medically for IVF, has a waiting list of woman wanting to be surrogates for them. 

We have recently completed all of our tests here that need to be done to determine the best course. The doctors think we have a reasonable shot with my eggs, so we are going to try that. Hopefully we will have success. If we have to use donor eggs, that becomes much more complicated as to get USA citizenship (for the India option), the eggs have to be mine OR we have to wait for <hubby> to become a citizen. Thus we are trying with my eggs first. In June, we will be traveling to India for 3 weeks to try for our first IVF cycle. That cycle will really give us the best picture if my eggs are truly viable, or if we have to start at other options.

Obviously very few people know about this right now. I wanted to let immediate family know before trying to figure out how to tell others. I guess I'll work on figuring that out next. 

------------------------------------------------------------------

THE END.