Oh Wait...I'm Pregnant

Before starting this journey, lots of people asked me, and I wondered myself, how would I feel about carrying a baby that wasn't mine?  I'm sure things can and will change as I get farther along, but honestly, there are times that I totally forget I'm even pregnant.

When I found out I was pregnant with my daughter, I couldn't concentrate on anything for days.  I probably spent 7 out of my 8 work hours browsing pregnancy internet chat rooms and baby name websites.  My feelings wavered between elation and terror, amazed that I was going to be responsible for a whole human being in 9 months.  When I found out I was pregnant this time, I smiled, decided it was too early to call my IPs yet, and jumped in the shower to get ready for work.  Other that the necessary tasks that occupy my day, such as coordinating with doctors, labs, and my agency, I really don't think about the pregnancy at all.  This might have something to do with the fact that this is my second as opposed to first pregnancy, but I think it mainly has to do with the fact that once I pop this kid out, I don't have to worry about it anymore.

I often find myself thinking things like:  "Aww, look at that cute pregnant belly on that lady.  She is so lucky.  Oh wait...I'm pregnant too!"  "Why do my boobs hurt?  Oh yeah, I'm pregnant."  "Time for me to carry this huge box of crap to the basement.  Oh wait, I shouldn't do that, I'm pregnant."

It really is totally different this time around.  Last time I spent my time thinking about how my life would change to include a newborn.  Now, while I'm sure my IPs' thoughts are consumed with that sort of stuff, I have my own family to focus on.  I have a toddler who has recently discovered that she has her own opinions which sometimes differ than my opinions, and she is having trouble learning how to deal with her disappointment when things don't go her way.  I have a husband who I don't see for days at a time, and who will be starting school again in January, and I want to make the most of my time with him when I do have him around.  I have my own problems, joys, challenges, and goals, and none of them include a baby.

When I do stop to think about the pregnancy now, it's to worry about whether I am carrying one or two babies.  I agreed to transfer two embryos and carry two babies if they both took.  If that's what happened, I will put on my brave face and protect those little peanuts as well and for as long as I can.  But if I'm being honest, I'm really, really scared of twins and all the added risks that come with them: elevated risks of pregnancy complications, preterm babies, bed rest and c-section.  I scheduled my ultrasound for Wednesday, January 9, and we will find out for sure how many kiddos are cooking in there.  After that, I will know what I'm facing and will be able to move forward!

2nd Beta Results are In!

Oh my gosh, they came the same day!

Second beta, 15dp5dt: 2335!  Holy cow!  That's a doubling time of 38 hours (with 48-72 being the goal for indicating a healthy pregnancy).  My IPs are definitely expecting at least one bundle of joy in the next 8 months or so!

There wasn't much data available on the message board for this particular date, as most people are done with their betas before now.  But here are my numbers for comparison:

15dp5dtSINGLETON: 84, 150, 726, 849, 1224, 1277, 1356, 1574, 1799, 1965, 2088, 2265, 2335, 3314, 4320
TWINS: 786, 919, 1150, 1586, 1685, 2335, 2400, 2616, 2751, 3022, 3088, 3427, 3903, 3930, 4050, 4744, 7874

It's still possible that it is a singleton, but my numbers are climbing to the top of the list, and also moving up toward the middle of the twin list.  So, the signs are starting to point more toward double trouble!

My progesterone level is still great, at 39.  So I'm supposed to stay on all the same meds.

Next step, our first ultrasound!  I am supposed to schedule it for anytime starting next Thursday, Jan. 3, which will be 5 weeks, 6 days pregnant.  I think I am going to schedule it for sometime the second week of January, closer to 6.5-7 weeks so we are sure to see the heartbeat(s).  My IPs will be coming from Chicago to get the first peek at their little one(s), so I want to make sure they get a good show!

First Beta Results

I hope everyone had a very merry Christmas, or whatever holiday you celebrate!  I just returned yesterday afternoon from my own travels, which despite the fact that the entire family caught a horrible stomach bug and my husband's suitcase and contents were destroyed on our return flight, was overall a fun time.  That said, I am SOOO glad to be home and finally feeling better.

Sorry I have not posted lately, but with the living out of a suitcase and spending half my time in the bathroom, I didn't have much time, resources, or energy to post.  Here is what has been going on:

On Saturday, 12/22, I decided to take one last pregnancy test just to make sure the line was getting nice and dark and not fading away.  I figured that way, even if I didn't get my beta test results on time, I wouldn't be worrying about whether I was pregnant.  Does that make it sound like I'm an expect the worst, glass half empty type of person?  Well considering that 2 out of 3 of my stat requests so far have not made it until over 24 hours after they were supposed to, I like to be prepared.  Anyway, this is what I got:

Yep, the pregnant line is darker than the control line.  I knew I was very, very pregnant!

On Monday morning, I went to get my blood drawn for my beta hcg (pregnancy hormone) and progesterone (what I have been injecting into my butt and sticking up my hoo ha) levels.  I dragged my sick butt up early on Christmas Eve and got there at 7:45 am since my clinic told me to get there early enough to get the results same day.  I asked the guy as he was drawing my blood what the turnaround time was - 4 hours.  So they should have the results to my clinic by noon.  At 12:30 the clinic called to confirm that I did in fact get my bloodwork done.  They never received results from the lab, and when they called to follow up the lab had closed at noon for the holiday.  So they said that since I had a positive pregnancy test, to just go ahead and continue meds as before and they would follow up this morning.

Who is shocked by this?  No one?  Me neither.  We are now 3/4 on people dropping the ball on my stat med requests.  The fact that we managed to get knocked up with the assistance of the most inept collection of medical and legal professionals on the planet amazes me.  Just goes to show how much my IPs deserve to be parents!  (Just wanted to add a note, I do NOT include the actual IVF doctor in this group - I haven't seen much of him but he has been wonderful and obviously knows what he is doing.)

So this morning rolls around and I wait anxiously for a phone call with my results.  Nothing ever comes.  Finally morning turns into afternoon, and it's my lunch break.  First I call the clinic to find out if they have my results - nope.  Then I call the lab to complain - I'm getting very good at this.  They claim they sent the results out on Monday morning as asked, but agreed to fax them over again right away.  About 20 minutes later, I FINALLY got the call.

Beta #1 results, 12dp5dt:  650!!

That is high.  Really high.  They consider anything over 25 pregnant.  Of course the first thing I did was hop on the surrogacy forum where I am a member, and compare my results to the master beta list comprised of past beta scores of other members to find out if I'm more likely to have one or two little buns baking in there:

12dp5dt
SINGLETON: 46, 58, 72, 89, 97, 104, 113.6, 126, 126, 161, 212, 223, 226, 252, 277.57, 298, 300, 325, 340, 342, 351, 376, 381, 416, 423, 430, 503, 505, 526, 566, 580, 634, 650, 657, 699, 709, 857, 1193, 1257
TWINS: 389, 408, 428, 451, 518.6, 609, 650, 653, 688, 688, 741, 746, 774, 766, 824, 969, 971, 1021, 1045, 1108, 1149, 1155, 1250, 1480, 1507, 1554, 1663, 1709, 1685, 2065, 2408, 2456, 2783, 2976, 3833

As you can see, my number is on the high end for a singleton and on the low end for twins.  So we will just have to wait and see!  My agency rep, IPs, and husband have all predicted twins.  So I'm going to say a singleton just to be different.  Seriously though, I have decided to mentally prepare myself for the idea of twins and be pleasantly surprised if I find out it's only one.

I go back for a second blood test tomorrow.  In a healthy pregnancy, the hcg levels will double at least every 48-72 hours.  Since I will be having my test done about 72 hours after the first one, we are shooting for a number over 1300 - hopefully higher so it's closer to a 48 hour doubling time.  The second beta result can be a better indicator than the first of how many you have.  If it doubles in 48 hours, it's probably a singleton.  If it quadruples, it's probably twins.  So we shall see tomorrow (or perhaps next week...sigh).

Also, just as a note, my progesterone level was 29.  Anything over 10 is considered good, so the injections and suppositories I have been taking are giving me plenty of the hormone for my body to maintain the pregnancy...always a good thing!

Time to Spill the Beans!

It looks like a lot of people have been stopping by my blog in the last couple of days.  I wonder why?  Oh...you guys were hoping to find out whether I was pregnant?

I started testing Sunday.  Just four days after transfer.  Because I am a nut job.  Here is what I got:

Yes, it's negative, technically.  But I swore that if I held it in just the right light at exactly the right angle, I could see the ghost of a shadow of a line.  I made my husband look.  At first he told me I was a nut, it was negative.  Then, I think to get me to stop bothering him, he agreed that he could kind of see a line.

I swear I will never test this early again.  It made me crazy all day long.  Was it an almost line?  Would it be darker tomorrow?  Or did all negative tests look like that?  What if I wasn't pregnant and my crazy mind was giving me false hope?

Monday, I tested again, at 5 days post 5 day transfer (5dp5dt) or the equivalent of 10 days past ovulation (10dpo).  Here is what I got:

Yep, that's right, a positive!  Still faint, but definitely pink and definitely there.  Woo hoo, I couldn't wait to tell my IPs.  I waited until a slightly more reasonable hour and tried calling both of them before I left for work.  No answer - they are late sleepers.  (My IM was aghast at the fact that I have to wake up at 6:00 to leave for work.  Boy are they in for a rude awakening in about 9 months, literally!)  Then once I got to work I tried calling them one more time before I went in, still no answer.  So I left IM a voicemail with the good news.  Never heard back.  Finally at about 11:00 I emailed IF to see if they had gotten my voicemail.  They hadn't even looked at her phone yet!  Needless to say, once I finally was able to give them the news, they were over the moon excited, crying, etc.

I decided I would keep testing every couple of days just to make sure the lines are getting darker and not fading away (signalling an early miscarriage).

Here is what I got this morning:

I am so thrilled for my IPs that after all these years of trying and waiting, we were able to get pregnant on the very first try!  They so deserve it, and they are going to be great parents!  We are keeping our fingers crossed this little one (or ones!) decides to stick around for the next 9 months.

Killing Time in the Two Week Wait

I am home now, and on my last day of doctor mandated rest.  Luckily, my clinic does not require complete bed rest, but they do require me to be a couch potato for the day of transfer and the two following days.  My instructions were no cooking, cleaning, exercising, or going to work...just sitting as much as possible.  At first I was thinking, "um, can I have an embryo transfer every week?"  Now at the tail end of my restriction, my butt is SORE from being sat upon, and I would love to get up and do some dishes just to get some blood flowing to it.  Oh well, tomorrow I will be up and about all day long to make up for it.

Since the embryo transfer was last Friday, I am 7 days into my two week wait (the time between when a woman ovulates and her missed period).  Most women are able to see a positive on home pregnancy tests at least a couple days before that, so I will be testing at some point next week.  My IPs are trying to have the attitude of "what will be, will be" so they don't want to tell me if and when to test.  My official blood pregnancy test (Beta hCG) will be on Christmas Eve.  The results of that test will show me for sure if I am pregnant, and if so, if it's a healthy pregnancy or if I am likely to miscarry.  Based on how high the number is, I can also be a predictor (although not definite indicator) of how many babies are baking.  We won't know for sure about that until the first ultrasound, which will likely be sometime in the first half of January.  So every step in this process requires patience and waiting!

As far as symptoms go, I am not "feeling" pregnant yet.  Other than the tiredness, my other pregnancy symptoms I was having because of the progesterone seem to have gone away as I've gotten used to the drug.  Not feeling any symptoms doesn't really mean anything at this point though, because I never felt any symptoms with my daughter until several days after I got a positive pregnancy test.

I did have some minor uterine cramping on and off all morning and into the early afternoon yesterday.  This could be either irritation from the catheter during the transfer, or...implantation!  Hopefully one of those perfect little embies picked out its favorite piece of real estate and dug its way in for a nine month stay.

Since I don't have any pee stick pictures to show just yet, I figured I would show off my progesterone needle.  This is the one that goes into my butt once every three days.  I am so lucky I have a pro at home to keep the pain to a minimum:

Transfer Complete!

We got to the clinic at 7:40 this morning.  I got called back first and changed into my lovely gown.  I waited by myself for about half an hour while my IPs met with the embryologist to go over how their embryos were doing and decide which ones to transfer.  Then IM got changed into scrubs to join me for the transfer.  IF was too nervous so he stayed in the waiting room.  I had been drinking water so my bladder would be full at the time of transfer (I think a full bladder makes it easier for them to see what they are doing).  I also took my Valium and shortly thereafter we were brought to the transfer room.

Once we got there, IM got to take a look at her embabies though a microscope while they set me up in stirrups.  We got to watch on the big screen while they pulled the embryos into a catheter and then shot them up into my uterus.  Then they stood me up and we were out the door.  The whole thing literally took 2 minutes.  By the time I was getting dressed, the Valium really started to kick in.  IM actually ended up walking me back to my hotel room so I didn't get lost.  Then I collapsed in bed and slept like a rock for a couple hours.  IM came by to bring me lunch and then later for dinner, and we chatted and watched tv for a while.

My IPs ended up with several really great embryos.  We transferred 2 grade A embryos, which is the highest grade they can get.  They should have several to freeze for later use as well.  The embryologist was very optimistic about our odds of success.  It's amazing that I now have two babies on board!  I feel like I should feel different somehow, but I don't.

My official blood pregnancy test is 12/24, but most people are able to test positive with home pregnancy tests.  My IPs didn't have a preference for when I test, so I will probably do it sometime next week.  Since the embryos are already 5 days old, I am already considered 5 days pregnant!

Two Days 'Til Transfer

In case any of you have been waiting with bated breath to find out whether I was going to have a 3 or 5 day transfer, I apologize for keeping you hanging.  I got the call at 3:30 yesterday that we will indeed be having a five day transfer.  So I quickly switched my flight and hotel room for a Tuesday-Thursday trip.  I will be flying in tomorrow night, then my IPs will be picking me up at the airport and taking me out for dinner before dropping me off at my hotel.  Since I will pretty much only be allowed to sit after transfer, it will be nice to see them beforehand.  I haven't seen them since July!

In other news, I stopped my lupron and started taking the progesterone injections/suppositories on Wednesday.  I have to do the suppositories 3 times a day, and I find that I end up getting stomach cramps shortly after each one.  I am not sure if this is a normal symptom, I will ask someone at transfer.

As for the PIO injection, I mentioned previously that my husband is a medical professional who gives shots on a daily basis.  Despite this, I found it very difficult to do the first shot on Saturday night.  Even though I wasn't the slightest bit squeamish about giving myself the lupron injections, I found I didn't like the idea of being stuck from behind when I couldn't see what was going on.  So first I wanted to lie down on the bed.  Then I didn't like that, so I wanted to stand up.  Then I decided I'd rather lie down again.  Then I started giggling, which started my husband giggling.  Then I got scared that he would shake too much and hurt me...so I started crying.  After we both finally calmed down, our conversation went something like this:

Him:  "Ok, ready, go."
Me: "...Are you doing it?"
Him:  "Yes, I'm injecting the meds now."
Me:  "Oh.  I thought it would be worse than that."

The worst thing about the shot is that since the progesterone is suspended in oil, it is very thick and takes a long time to inject all of the medicine into the muscle.  Then when he was finished with the shot and was putting pressure on the site to stop the bleeding and trying to massage the oil into the muscle, I found that rather painful (like pushing on a bruise).  So we decided from now on he will stick and I will rub.  Hopefully it won't be a 20 minute ordeal like it was the first time.  Afterwards I had a small bruise at the injection site and what feels like a sore bum muscle.  Luckily, since I only have to do a shot once every three days, so it worked out that I will not have to try to figure out how to give myself one while I am in Chicago for transfer.

Since I've now been on progesterone for a few days, my body seems to think it's pregnant already.  I have had waves of nausea and have been more tired than normal.  In addition, pregnancy brain seems to have already struck.  This morning when I was shampooing my hair, I couldn't figure out why I couldn't get the suds going.  So I added some more, and still couldn't get any bubbles.  Then I realized I was using my conditioner instead of my shampoo.  After my shower, I proceeded to spend 5 minutes looking for my wedding ring, only to discover it was already on my  hand.  Let the pregnancy fun begin!

Fertilization Report

We found out today that out of 27 eggs retrieved, 17 have successfully fertilized.  We will find out for sure tomorrow whether they will be doing a 3 day or 5 day transfer.

Grow embies grow!

Retrieval Report

27 eggs!  Yahoo!  Yippee!

Hopefully with this many eggs to start from, we will end up with several great embryos to choose from.  I think the next time we will hear their progress is Sunday afternoon, where we will find out how many of the eggs successfully fertilized and started growing.  With a number like 27 we will almost certainly have enough good ones to grow them out to day five, but you just never know.

Right now I'm thinking positive and keeping my fingers crossed for a great fertilization report!

It's Official...One Week Until Transfer!

Ok, so it's not totally official, but it sounded better than Official(ish) so I went with it.  The donor is triggering tonight and her retrieval will be Friday morning.  We will find out on Sunday afternoon how the embryos are doing and what day transfer will be - either Monday or Wednesday.  Since there are so many follicles at this point, it will most likely be a 5 day transfer but you just never know.

So I will have my bags packed and my Sunday evening cleared in case I need to make a flight out on Sunday night for a Monday transfer.  Once I get the call that it's a 5 day transfer, I will push my flight back to Tuesday night.

12/12/12 transfer...almost there!

Still Waiting for a Transfer Date

My appointment today went great.  My lining is up to 10mm, and is a triple stripe.  Normally the ultrasound techs don't comment on my lining or tell me their results (I don't think they are supposed to), but the tech today was excited to tell me how beautiful my lining looked.  Also, she was already faxing the results to the clinic in Chicago before I finished getting dressed.  I guess they don't want to have to deal with another fiasco like last week!  Later this afternoon I got a call confirming that my uterus is a go for transfer.  Unfortunately, she couldn't provide me with my med schedule from here on out because...

The donor went in for her appointment today and she is still not ready for retrieval.  She is going to go back tomorrow morning, and will probably end up triggering tomorrow night, making her retrieval Friday.  There is a small chance she still won't be ready, in which case it would get pushed back another day.  So, my transfer is probably going to be next Wednesday, 12/12/12...there has to be something lucky about that date, doesn't there?

On the bright side, even though the donor is stimming slower than expected, it looks like she's going to have lots and lots of eggs to retrieve...they counted 31 follicles at her appointment today!

We are supposed to get the final word on when retrieval will be tomorrow, so I will update then.

Egg Donor Update

I found out this morning that when the egg donor went in for her appointment yesterday, they decided she wasn't quite ready yet, meaning her eggs are not big and mature enough yet to be ready for fertilization.  So they are giving her a couple more days to stim and she goes back for an appointment tomorrow.  The retrieval should be sometime between this Thursday and Saturday, pushing my transfer back a bit to next Tuesday-Thursday.

I go in for my last lining check tomorrow, and otherwise I just continue on the med protocol I have been given until I get word that the egg donor triggers (gives herself a shot to force her body to ovulate).

Lining Check Update

Whoops, I never updated my blog after my lining check.  I'm actually not THAT tardy, because I didn't get the results until yesterday afternoon.  The monitoring clinic had faxed over results early on Wednesday, but they were apparently the results from my appointment last week.  By the time the coordinator in Chicago realized it, the local clinic was closed for the day.  After calling and faxing them twice each yesterday with no results, the coordinator ended up coming to me for help.  I got on the phone and had to get a bit bossy with the poor receptionist who tried to "take a message for someone to call me back."  But at least it worked, half an hour later I got a call from the coordinator that she had finally received them.

My lining was looking great, already up to 9.4 (8+ is considered transfer ready).  My estridiol level was at 283.  This number means nothing to me, but I figure I'll post it here for future reference.  Anyway, she said my numbers were really good and to continue my schedule as planned - no extra boost needed.

My next lining check is on Tuesday.  I haven't heard any updates on the donor yet, I'm not sure when her follicle check was scheduled.

In other news, we got approved for the backup insurance policy and life insurance policy we applied for.  The backup insurance is in case my insurance company (which does not have a surrogacy exclusion) finds out that this pregnancy is a surrogacy and decides they don't feel like covering it after all.  In addition, my IPs have purchased a life insurance policy for my family's protection should I die as a result of this pregnancy or delivery.  It's morbid to think about, but hey, it happens.  And it's comforting to know that my family will be taken care of at least monetarily if they lose their wife/mother.

Checking In

I don't really have too much to update, but I'm getting excited that transfer is right around the corner now!

I have been on the estrogen patches for a week now.  I haven't really noticed any huge side affects from the meds.  The headaches and weird sleep patterns seem to have gone away completely with the reduction in my lupron.  The only things I'm noticing from the estrogen is that my [TMI WARNING] discharge has increased to the point it normally is right before I ovulate on my own, and my sex drive has been given a nice little boost (which the husband is appreciating).  Also, I'm not sure if it's all in my head or not, but sometimes my uterus feels "heavy" - I don't really know how to describe it other than that.  I'm hoping that these signs mean that the estrogen is doing what it should and my lining will be nice and thick at my appointment tomorrow morning.

On the docket for tomorrow are a transvaginal ultrasound to check my lining thickness (8mm+ is transfer-ready) and pattern (something called triple-stripe is ideal here) and bloodwork to check my estrogen levels.  Assuming everything looks good, I bump my estrogen patches up from 2 to 4, and keep everything else the same.  Then I will have one more lining check a week from today to make sure it's thick enough for transfer.

In other news, the donor has started her stimulation meds without incident, and is expected to be ready for retrieval between December 4th and 6th...that means it could be as little as a week from today, people!  Depending on how many eggs they retrieve (10-20 is the normal range for an egg donor) and how many of those fertilize and begin to grow, I will either have a 3 day or 5 day transfer.  I can't remember if I explained this before, so if I'm being redundant forgive me.  The hope is for a 5 day transfer, because it gives the doctors lots of time to separate the strong embryos from the weak ones and allows them to put in the best ones, ultimately increasing chances of success.  However, if there aren't very many embryos to work with or they are looking weak, they will transfer them after 3 days.  The worry here is that they will all fizzle out before 5 days and there will be nothing to transfer - and a nice, warm, sticky uterus gives a weak embryo a better shot of making it than keeping it in a lab environment for too long.

I am working with my agency to try to book travel plans, which has proved a bit challenging considering we won't know when the retrieval will be until 2 days before, and we won't find out if it's a 3 or 5 day transfer until day 2.  Since I'm a wussy and I can't handle 5+ hours of night driving all by myself, I am going to fly up.  Luckily the best airline of all (I won't name names but it rhymes with Mouthrest), has lots of flights between St. Louis and Chicago and no change fees!  So our current plan is to assume the donor will be transferring the 4th and I will need a 3 day transfer, and then at the last minute pushing the flight back when that turns out to not be the case.  We know how to keep things exciting!

I will update once I get the results of my appointment tomorrow!

Giving Thanks

It is Thanksgiving day, and tradition tells us we must recite a list of all the things we are thankful for.  I'm going to skip the normal list this year, and stop to ponder my thanks for something I'd never given much thought to before recently...my fertility.

My husband and I had an easy time getting pregnant.  We decided we wanted a child, went off birth control, and a month later we were holding a positive pregnancy test.  I sailed through my pregnancy without so much as a minor complication.  I delivered a healthy, perfect baby girl at 40 weeks gestation. 

Even before surrogacy took me directly into the world of infertility, all I had to do was look around to see couples who were not so lucky as us.  I had friends and coworkers who had struggled through multiple miscarriages or month after month of negative pregnancy tests.  People who were trying and hoping so desperately for what I had taken for granted.  It is these people who led me to fill out that first surrogate application 10 months ago.  Now, I have met my IPs, people I never would have known if it weren't for this journey.  I have heard about their years of struggling, their pursuit of every other avenue before turning to surrogacy.  I know that I am now their last hope for the baby they have been longing for.

I just wanted to take a moment to express my thanks to fate, or whatever, has given me the ability to not only be able to have my own family with such ease, but also to pay it forward to someone else.  I know I have complained about how slowly this journey has gone so far, but I know that when I see them holding their baby in their arms, it will all be worth it.

Happy Thanksgiving!

All is Well

Still going strong on my lupron!  Other than the one migraine and a couple of hormonal overreactions to minor situations, I'm feeling fine!  The shots have continued to be easy, and I'm getting to be quite the expert at stabbing myself in the stomach.

I had my baseline ultrasound and blood work yesterday morning.  The ultrasound was the transvaginal kind (you know, where they stick the weenie wand up your hoo-ha), and the point of it was to check for any cysts or fibroids that might interfere with implantation, as well as to measure my endometrial lining thickness.  The tech didn't say much while she was looking around, but I saw her write down that my thickness was 3.1mm.  That's nice and thin, meaning my lining had shed like it was supposed to after I stopped birth control pills.  The results of the ultrasound and blood work were faxed to the clinic in Chicago.  I received a call from them that everything came back great, and I am to lower my dose of lupron and start on my estrogen patches tonight as planned.

So now I only have to give myself 5 units of lupron instead of 20, and start applying two estrogen patches and replacing those every other day.  Eventually I will increase to 4 patches, and possibly add estrogen tablets if it looks like my lining needs an extra boost.  I am also beginning to take my baby aspirin tonight to help increase blood flow to my uterus.

My next appointment is scheduled for November 28, and it is another ultrasound to make sure my lining is thickening properly, and blood work to make sure my estrogen levels are rising appropriately.  From that point they will know whether they need to adjust my meds in order to help my uterus be ready for transfer.

I heard from the nurse coordinator that the donor will be having her baseline appointment tomorrow, and if all looks good she will start her stimulation meds on Friday.  They are expecting her egg retrieval to be Dec. 4-6, which will most likely make my transfer Dec. 9-11.  This could change depending on how fast she stimulates and how many eggs are retrieved.

I will be back to update once I have heard that the egg donor has started her meds OK.  In the meantime, I hope everyone has a wonderful Thanksgiving!

So Far, So-So

I have given myself three shots so far.  The shots themselves have been fine.  The needle is small, and I barely even feel it.  I have had a bit of stinging on the skin around the injection site for a few minutes after I give myself the shot, but I suspect it might be because of the alcohol I wipe on my stomach prior to giving  myself the shot.

Side effect-wise, I suffered my first ever migraine yesterday.  I've had headaches before, but never felt like something was trying to push my eyeball out from the inside.  Luckily I'd already run all the necessary errands earlier in the day, and I was able to nap during my baby's nap.  I have a headache again today, but it is much more manageable.  Since I'm not supposed to take anything but Tylenol for pain here on out, and Tylenol has never really done much for headaches for me, I'm pretty limited.  I plan to self-medicate with caffeine if it gets bad during work days.  It turns out I can't just crawl under my desk and take a nap if needed.

Aside from the headaches though, I haven't had any other side effects.  No hot flashes or hormonal outbursts yet.  : : Knocks on wood : :  I'm hoping that after a little while on these meds my body will adjust and I will start to feel better.

What's up next:
Tomorrow (11/13) Last birth control pill
Next Monday (11/19) First appointment - baseline ultrasound and blood work to check my estrogen and progesterone levels
Next Tuesday (11/20) Reduce lupron dose and start with estrogen patches and baby aspirin

Only 4 more weeks until transfer!

A Tutorial on Surrogate IVF Meds

Before I start in on this, I would like to remind everyone that I am not a doctor.  This information is from what has been explained to me by my fertility doctors and gathered off the internet.  Also, my only experience is with the surrogate end of the IVF spectrum.  I know nothing about the egg donor portion or someone doing IVF for herself, where in both cases you would be stimulating large numbers of your own eggs for harvesting.  Since I am a gestational surrogate and my genetic material will not be used in creating this baby, the goal is the exact opposite - temporarily shutting my ovaries down so I don't ovulate and accidentally get pregnant with my own child.

As a further note, my meds will not be the same as another surrogate's meds.  Each doctor/clinic has their own protocol that they like to use.  The medications come in the form of injections, tablets to be ingested orally or inserted vaginally, and patches, or any combination of these.  Heck, there may be some system of administration I don't even know about.

Here is a list of the meds I will be taking along with a brief (maybe) description of their purpose:

Birth Control Pills
The point of birth control pills is to hormonally regulate your cycle so they can sync you up with whoever is providing the eggs, which in my case is an egg donor.  Since embryos cannot live indefinitely on their own, it's imperative that my body be ready to receive them within 3-5 days after they are harvested from the donor.  So what they do is have you on active only birth control pills (the first three weeks in the pack) continually until they are ready to prep your body to receive the embryos.  I have been on active only birth control pills since August.  In theory, you should not get your period during this time.  In my case, my period waited two weeks and then came anyway, and I have been spotting ever since.  So I've had a not-quite-period for over 4 weeks now.  Yay me!  Once I am established on the next drug, lupron, I will stop taking the birth control pills.

Lupron
Lupron is the drug that I will begin taking tomorrow.  Its purpose is to inhibit the hormones that the body normally secretes leading up to ovulation, basically putting the ovaries to sleep for a while.  It is delivered with a subcutaneous injection (like insulin shots for diabetics).  I have to take this shot every day between 6 and 10pm.  Possible side effects include: hot flashes, weight gain, migraines, and extreme moodiness.  Basically, the same as if I were to suddenly become menopausal.  Luckily I will only be on this drug for about 4 weeks.

Estrogen
Once the body is on lupron, it will not ovulate on its own.  Unfortunately, that also means that it will not prepare itself for possible pregnancy by thickening the uterine lining.  So once we have shut down the body's ability to prepare itself naturally, we need to reintroduce estrogen so that the uterus will be nice and thick for embryo implantation.  I will be using Vivelle estrogen patches to accomplish this goal.  In the weeks leading up to the embryo transfer, I will have a couple of ultrasounds to make sure my lining is thickening properly.  If it looks like I need a little boost, I will also be put on Estrace tablets (which are taken either orally or vaginally depending on how much they need to be absorbed) to thicken my lining some more.  I will remain on these throughout the first several weeks of pregnancy until my body wakes up, realizes it's pregnant, and starts producing estrogen on its own.

Baby Aspirin
At the time I start taking estrogen to thicken my lining, I am also supposed to take a daily dose of baby aspirin.  In addition to preventing blood clots (which some of the other drugs can increase the risk of), it also increases blood flow to the uterus and helps make the lining nice and thick.

Progesterone in Oil (PIO)
This is the drug that everyone fears, the ones that come with the big bad needles.  Normally once you ovulate, your body naturally produces progesterone to prepare your uterine lining for implantation (make it nice and sticky, so to speak).  Once a pregnancy is achieved, the body produces increased levels of progesterone to help the embryo hold on and develop the placenta.  If a pregnancy is not achieved, progesterone levels drop, and the lining is shed (resulting in a woman's menstrual period).  Since in my case I won't ovulate, it is VERY VERY important for me to artificially keep my progesterone levels elevated.  If they drop, I will automatically miscarry.

That's where the progesterone in oil comes in.  It is delivered by intramuscular injection, meaning that the needle needs to be big enough to get it all the way through the layers of skin and into the muscle.  It is also suspended in oil, which means it is very thick, hard to administer, and can leave large lumps under the skin where it was injected.  It is most commonly injected into the hip/butt area.  I will also have to remain on this drug for the first several weeks of pregnancy.  Eventually, the placenta begins producing its own progesterone, and I will no longer need to substitute artificially.

I have found that most surrogates have to take daily injections of PIO.  Luckily for me, my doctor's protocol only requires me to have one of these shots every 3 days (which means each cheek will only have to be assaulted every 6 days)!  Why?  Because I will be also taking progesterone in another form...

Progesterone Vaginal Suppositories
I will be using Endometrin vaginal insert tablets twice a day until my body is producing enough progesterone to sustain the pregnancy on its own.  These essentially do the same thing as the PIO shots, which different side effects: discharge and possible irritation.  When the nurse coordinator was going over all of the drugs with me, she told me these are actually what she gets the most complaints about.  Maybe this is because her surros don't have to take shots as often as most?  I don't know.

In addition to these main drugs, I also received in my box of wonders some prenatal vitamins, antibiotics (to prevent any infection that could be caused during the actual embryo transfer), and Valium (which is something I can opt to take to help me relax before the transfer procedure).

Let me know if you have any questions of if I was way off base somewhere!

Looks like Santa came early this year!

Phone call from my husband while I'm at work:

DH: Your box of meds just got delivered.
Me:  Yay!
DH:  There are some really big needles in here...

When your husband is a medical professional and feels the need to comment on the large size of the needles, that's when you know you should be scared.

Calling All Questions!

First of all, I want to say thank you to all the people who follow my blog.  First and foremost, I created this blog as a sort of diary for myself so I can always remember this journey.  But it makes me so happy that there are people following along.  I have several public followers, and I know I have a lot more private followers.  My blog has been viewed over 1000 times in 9 different countries since I created it!

I know a lot of my followers are friends, and a lot are other surrogates.  But I'm hoping that my blog can also serve to educate others who might be interested in pursuing surrogacy, or just curious about the process.  So, here is your time for questions!  If you have anything you've been wondering: about me, my journey, the surrogacy process in general, etc., please feel free to comment with a post.  Too scared to use your real name?  No problem!  You can choose to comment anonymously.

I will answer your questions to the best of my ability in a future blog post!

One More Week...

Until I start my meds!

Wow, all of these months of waiting, and all of a sudden it's right around the corner.  Next Friday, 11/9, I will be giving myself my first Lupron injection!

The meds have been ordered but I haven't received them yet.  I'm hoping that the pharmacy will call me to confirm shipment SOON!  The last thing I want to be doing is stressing that I won't have my meds by the time I need them.

We are a Go For December!

We got the great news this morning that everything is set for a December transfer.

The egg donor's screening tests for infectious diseases and genetic abnormalities came back OK today!

We got contracts sorted out last week.  My husband and I set up an appointment for last Friday at noon to go in and sign the papers.  Just because no stage of this journey can be without drama, I was shocked to find out that my husband was a no show!  I called his phone several times with no answer.  Turns out he was a wee bit tired after working three 12 hour night shifts in a row, and had slept through his alarm.  He called me in a panic at around 1:00.  Luckily my attorney's office was able to squeeze him in later in the afternoon and everyone signed by the end of last week.

Just as a side note, both my agency and my attorney told me they had worked with my IPs' attorney in the past and she had "never been like this before."  My attorney confirmed that our negotiations were much more complicated than most, and that it never should have taken over 3 months to get our contract done.  Apparently the other attorney was saving up all her ball-dropping energy for our contract.  Does anyone else get the impression that our journey is cursed, or is it just me?

Oh well, I'm going to assume that all of our bad luck has been used up and the rest of this process will go smoothly!

All Refreshed and Ready to Go!

Italy was lovely.  Lovely, lovely, lovely.  Here is a picture from my balcony in Sorrento (Homer's land of the Sirens), just to give you a taste of the beauty that is Italy:

Aside from being buried under piles of backed up paperwork at work, I'm feeling very refreshed.  I'm spending every second I can get making up for missed time with my daughter and enjoying the fall weather with her.  I'm also ready to get back on the crazy train that is surrogacy with a positive attitude!

Updates: the egg donor has her screening appointment today.  The nurse coordinator actually forwarded me the tentative calendar, with me beginning injectible meds on November 9 and transferring somewhere between December 7-14.  Although it's nice that this seems to be going forward, I'm trying not to get my hopes up and plans set just yet.  This new donor is a first time donor so she has no previous donation history to complicate things, and she already had to do most of her screening to even be accepted by the agency.  So, we are hopeful that everything will go OK.  Let's all keep our fingers crossed that she doesn't test positive for cocaine or chlamydia, and that we can all be on our way to receiving some very merry Christmas news!

In other news, the contract is still being negotiated but it looks like we have all the issues worked out.  Now we just have some nitpicking left to do, and we will hopefully get that thing signed in the next week or so.

As a side note, I realize that my last few posts have been a bit negative.  I just want to go on the record and say that despite complications and disappointments along the way, I'm still just as excited to make my IPs parents as I was when I first started out.  They are wonderful people who deserve to be parents, and I can't wait to be there on the day they meet their son or daughter!

Some More Details

When I decided to create a blog, I vowed to myself that I would be honest.  No sugar coating things, not putting a positive spin.  I wanted to have all of my real feelings, both physical and emotional, written down on (virtual) paper, both so that I could remember all the aspects of my journey, and so others that are considering surrogacy know what to expect.  So, here I go.

Yes, we have been pushed back another month.  It is what it is.  It's disappointing.  But there's really nothing we can do about it.  What pushed me over the line from disappointment to outright fury, is the way our clinic handled the setback.

As I already said, I had emailed my coordinator to get my calendar, only to be told that the egg donor had not finished her screening yet.  Upon asking when she would be done, I was told that her screening appointment is set for October 18.  And she anticipated that we would transfer in December.  Um, what?  Since when?  Two weeks ago she had told me the egg donor's screening would be finished up the last week of September.  But there was no explanation of what happened.  No apology for the delay.  Not even an acknowledgement that this was a change in the original plans.  Just bad news delivered in a two sentence email, which I had to prod out of her.

So I emailed my IF to vent.  The worst part?  He didn't even know!  He had no idea the egg donor still hadn't been in for her screening yet.  I can understand someone not bothering to tell me, I'm not the person paying the bills.  But not even bothering to tell my IPs?  Totally unacceptable.  He then emailed to find out what happened.  Again, no explanation for the delay, no apology, and no acknowledgment that there even WAS a delay.  He tried asking if I could start meds in October as planned with the hope that the egg donor would pass her screening and we wouldn't have to lose a month.  But because they expect her blood work to take 2 weeks to get back (um, mine took 3 days), she would have already had to start meds before they would know if she was cleared.  So no go.

She told us that getting delayed a month "isn't a big deal."  OK, maybe not for her.  I'm sure it makes no difference to her whose embryos are being transferred in any given month.  But now we've been delayed for 3 months.  When I was starting this journey, I was planning to have a baby in late spring/early summer, and then having the rest of the summer to enjoy being with my family.  Now, assuming the egg donor manages to pass her screening and I manage to get pregnant on the first try, I will be due with a baby at the very end of August.  I cannot think of a more miserable time of the year to be hugely pregnant.  Then there's the fact that I will be on a travel restriction for the entire summer...no vacations for us.  It also means that I have to start all over again on trying to find childcare while I'm out of town for an embryo transfer.  Believe me, making arrangements when you have a husband who works nights and will need a nighttime babysitter for 3 straight nights somewhere in a window of 8 days when you have no family nearby is hard enough to do once.  Now I have to start over on this for the third time.

And all of my selfish reason aside, what about my IPs?  Maybe being delayed for a month in the grand scheme of things isn't a big deal.  But three months is a quarter of a year.  A quarter of a year longer that they have to wait to hold their baby in their arms.  They've already been trying for almost 9 years for this baby...don't they deserve a break?

So, December It Is

I'm not going to say a lot right now, because I am very upset and I don't to type something I will regret later.  But because of a delay in the new egg donor's screening, we have been pushed back another month.  We are now looking at a transfer around the second week of December (assuming this egg donor passes her screening).

Now it's time to forget about surrogacy for a while and gear up for my trip to Italy!

Sitting on Pins and Needles

After sending in my doctor's approval letter to the clinic on Thursday morning, I waited with bated breath for a response and hopefully my calendar...and I waited...and I waited.  Finally on Sunday, the nurse coordinator emailed me back to say that I could not have a calendar until the new egg donor fully passed her screening.  So I guess she's not done and ready to go after all.

In addition, after having the contract back for 2.5 weeks, my IPs' attorney finally sent it back to us with revisions on Friday.  It looks like we agree on most things, but there are still two fairly big issues that need to be addressed.  The deadline for getting this signed is Thursday (3 days from now), because my attorney will be out of the office Friday for about a week, and I leave the country on Sunday for a week and a half.  Despite the other lawyer insisting on taking her sweet time on this, we are hoping to actually get this done on time so we aren't pushed back a whole month because of it.  My attorney is planning to get it back to her by the end of the day today.

So, I still have to find out if I even get a schedule, have the meds shipped to me, and get my contracts done by the end of this week.  Oh, and I also have my daughter's first birthday party and my international vacation to plan for, both of which happen this weekend.  No biggie, right?

Finally an Update, and It's a Good One!

I had my follow up appointment with my endocrinologist yesterday.  After being on the thyroid medicine for 6 weeks, my thyroid levels went down to a 3.5!  The fertility clinic said they are OK with anything under a 4.0, so my doctor said she will write me a clearance letter.  She was going to mail it today, so I should have it to the clinic by the end of the week and hopefully get my new calendar.  The doctor decided to up my dose a little bit because she prefers me to be under 2.5 by the time I am pregnant, so I will increase my dose and go back in another six weeks to make sure it's looking good.

In other news, my IPs also let me know yesterday that their new egg donor has passed her screening and is ready to go!

So, fingers crossed, it looks like a mid-November transfer may be possible!

I Don't Need the Test!

I just realized I never came back and posted what happened when I called my doctor.  I explained to her that all the clinic required was TSH levels in the normal range, that was really all I wanted to find out.  Since there is no treatment if there is an autoimmune disease, all it would do was make me more worried about every future pregnancy I have.  And it turns out the "increased risk" is only about 3% anyway - totally not worth the stress in my opinion!

She said that if I don't want to have the test, I don't have to have it.  She said that doctors are curious people by nature and they like to know things, often more than the patients themselves.  But she said my clearance wouldn't be contingent on the test, and I can opt out if I want to.  She will continue to monitor my thyroid levels per the clinics requirements.

So I have my follow up appointment on September 24, and will get my blood work done a few days in advance so we have the results in hand at the appointment.  We still have time to make adjustments to the dosage before a November transfer, so she said as long as she can tell the medication is doing something, she will go ahead and write me a clearance letter at that time.  It's sure been taking long enough to get that letter, but as long as I have it in hand by the end of the month I'll be a happy camper!

In other news, I reviewed my contract and sent my proposed changes to my lawyer.  I have a telephone conference scheduled with her for tomorrow afternoon to go over everything.  My IPs leave for vacation next week, so I would love to get them our revised contract by the end of this week.  But I'm not sure if that's doable.  There is about a 2 week period between when they get back and I leave for my vacation that we will have to get everything done and signed.  I'm hoping it works out!

Also, the new egg donor has her screening appointment set up for the end of the month.  So it looks like if everything goes as planned, both she and I should be cleared at about the same time and we will be ready to start cycling in the middle of October!

Contract...Finally!

I finally got the first draft of my contract today!  It's 41 pages long, so my husband and I will get to enjoy a little light reading tonight.  I'm keeping my fingers crossed that there are no major points of contention in it.

Also, my IPs have decided that they do not want me to have to take the autoimmune test if I do not want to, since it is above and beyond the requirements of their doctor.  The clinic we are using has fairly conservative requirements for gestational carriers compared to a lot of other clinics, so my IPs are satisfied with their screening requirements.  I have left a message with my doctor, and hopefully she will be able to return my call soon.

Wow, It's Been a While

I just realized it's been a couple weeks since I updated.  A couple things have happened since my last post.

First, my IPs found a new egg donor they like, who is availble for a November donation.  They are getting her screening appointment set up, and hopefully she will be cleared soon.

Next, I STILL haven't seen a rough draft of my contract.  My IPs cleared it to be sent to my attorney a week and a half ago, and my attorney still hasn't received it.  I will keep my comments on the other attorney's timeliness to myself.

Finally, I am still having problems getting clearance due to my thyroid issue.  My second blood draw came back with a TSH level even higher than my previous one - 9.0.  My T3 and T4 levels were within range, and everything else looked fine as well.  The doctor decided that he would go ahead and put me on a low dose of thyroid medication.  When I asked about a clearance letter, he passed me off like a hot potato to an endocrinologist (a doctor who specializes in thyroid disease, among other things).

So I had to make yet another appointment with yet another doctor.  I had that appointment yesterday.  Luckily, I like this doctor much better than the primary care physician.  Also, she seemed to know what she was talking about.  She had a specific protocol for pregnant women and everything.  Since we have some time before transfer, she decided to keep me on the low dose I'm on and get it checked in 4 weeks.  She says she likes her pregnant women to have a TSH level under 2.5, so she thinks she will probably end up doubling my dose after my first results come back.

Since I have a family history of thyroid disease, she also wants to test me for TPO antibodies.  If I test positive for that, it means I have an autoimmune disease and have a slightly elevated risk of miscarriage.  Unfortunately, there is no way to treat it, so she basically just wants it for knowledge purposes.  After talking to my mother (who also has hypothyroidism), my husband (who is a medical professional), and my agency, I am considering opting out of this test for several reasons.  First, there is nothing they can do to treat it, so all it will accomplish is that I will be more anxious about any future pregnancies, whether surrogate or my own.  Second, neither my mother nor I have any history of miscarriage, and I have absolutely no hypothyroidism symptoms.  Third, the clinic does not require this test, they only want my thyroid levels to be within a reasonable range.  Fourth, once I am diagnosed with any disease, including autoimmune, it will be in my file forever, and could possibly cause me problems with doctors, insurance companies, etc. down the road.

I have decided that I will leave whether to get the test in my IPs' hands.  They have already been through the ringer when it comes to miscarriages, suffering several of their own before turning to surrogacy.  If they would choose to drop me if I tested positive, I would respect their choice.  I would hate for any of us to have regrets or guilt if they were to invest their hopes and money in my body only for it to fail them.  If they opt to not have me take the test, I am going to approach my doctor about whether I absolutely need it in order to get clearance from her.

Delayed

So our schedule is delayed for sure.

It actually isn't my fault though.  I went to visit the primary care physician yesterday.  I showed him my labs from the fertility clinic and he was totally unconcerned about my thyroid level.  He said that my levels weren't THAT high, and I have no symptoms of hypothyroidism (hair loss, cold sensitivity, dry skin, weight changes, etc.).  Normally for someone in my situation, he just monitors the levels to make sure they don't get even more wacky.  He said that even though my level was high for a "normal" person, it might be normal for me.  He went ahead and ordered a more detailed thyroid panel, including my TSH level (what was ordered before), as well as T3 and T4 levels (more specific and important measurements of thyroid function) and kidney and liver function tests (which can be affected by thyroid problems).  I went ahead and got my blood drawn this morning.  Assuming everything looks OK, he will just continue to monitor me med-free throughout my pregnancy and beyond.

I emailed the nurse coordinator to let her know what he had said, and she said that was perfectly fine.  She just needs him to send in a letter once the blood work comes back confirming that he clears me for an IVF pregnancy and that he will monitor me throughout the pregnancy.  The doctor was actually ready to go ahead and sign a form yesterday, so I don't anticipate this being a problem unless something comes back badly from my tests.

Unfortunately though, upon further review, my IPs' fertility clinic doctor decided not to clear the egg donor that my IPs had wanted to use.  He decided the fact that she has made three donations without a resulting pregnancy is just too much of a risk when my IPs have so much hope and money on the line.  I kind of feel bad for the egg donor, since two of her cycles resulted in freezing all the embryos and not even trying for pregnancy  But perhaps there was some sort of info in her charts that gave him pause.

Either way, I agree that it is definitely better to wait two months to find a proven donor, rather than wasting all of our time and their money attempting to get pregnant with embryos that are no good and then having to start from scratch.

At first I was bummed with this news, because I was getting so excited to get to transfer.  I was supposed to start meds just 10 days from now!  But I think this is actually going to work out better in the long run.  There are a few things happening in October that I'd rather be able to enjoy with alcohol and/or without morning sickness: my daughter's first birthday, my trip to Italy, and my 30th birthday!  Plus, since abstinence is required from transfer through the first ultrasound (6-7 weeks), my husband had expressed his disappointment that this time would have fallen during our Italy trip.  Now there are no worries in that department either!

So it looks like the current plan is for me to start injectable meds in mid-October and then transfer in mid-November.  Now all we need is for my IPs to pick another egg donor who gets approved!  Oh, and to finish the contract, which I still haven't seen a rough draft of yet.

Updates

There have been several things that have happened in the last few days and I haven't had a chance to update on all of them individually, so here goes:

Regarding the contracts:  The first draft is done and in my IPs' hands for their review.  Once they have a chance to talk it over with their lawyer and make any changes, they will send it to my attorney for her and my review.  I'm getting excited/nervous to see what all is in it.

Regarding the egg donor:  This was a big question mark, because if the donor wasn't cleared we would have to start over from scratch in that area, which would mean our transfer would be pushed back a couple of months.  My IPs found out today that the donor cycled as planned, but for whatever reason at the last minute the recipients chose to freeze all of their embryos rather than transferring any of them.  We don't know the reason for this - it could be anything from cold feet on the recipients' part to the woman's body not being ready enough to transfer in time.  Whatever the reason, we do know that the donor had a good cycle and managed to create at least some embryos that were good enough quality to freeze.  My IPs' doctor has reviewed her cycle info and has cleared her to donate for us, as long as my IPs still want to use her.  My IPs have confirmed that they do still want to use her - so we are all clear on that front!

Regarding my local doctor appointment:  I had the initial consultation appointment with the doctor who will be doing my local monitoring on Monday.  I'm unsure whether I liked him, but he was efficient and to the point, and he confirmed that he can do what needs to be done.  Basically, I will have three appointments leading up to the transfer.  At each one, I will need to have an ultrasound to check the lining of my uterus (the first to make sure it's nice and thin, and the second and third to make sure the estrogen I will be taking is doing a good job of making it nice and thick and welcoming for an embryo) and to get blood work checking my estrogen levels so the Chicago clinic knows whether they need to adjust my medication leading up to transfer.  They will need the results of these faxed to them stat, which the local clinic can handle.

You may remember that my medical screening blood work showed that my thyroid levels were high.  At the time, the NC at the Chicago clinic had just told me to consult my local doctor and find out if he wanted to put my on medication or anything.  When I asked the local doctor about it, however, he didn't want to touch that subject with a 10 foot pole.  He said that I am not his patient, he is just providing a monitoring service for me and the other clinic.  If they want me to do something about my thyroid level, they should be handling it.  He is completely uncomfortable making any medical decisions that could affect my IVF cycle.

So I relayed that message to my NC, and she replied that I would need to track down a primary care physician (do people still have these?!?) to manage my thyroid level, and we would not be able to cycle until it was under control.  Um, OK.  If she had told me that two weeks ago, I could have been working on this and hopefully had this sorted out in enough time to keep our current calendar.  Since I have not been to a regular old doctor since college (really, who needs more than an OB and the Walgreens Take Care Clinic?  Oh wait, I guess I do, for the rest of my life!) I attempted to find a primary care physician.  I called the physician referral line for the health care system my OBGYN is associated with, and the first available appointment for any doctor anywhere was August 30.  So, 6 days after I am supposed to start meds.  Crap.

Then I figured I would try calling my OB to see if she could do this for me.  Turns out, as I suspected, she does not diagnose hypothyroidism, but she did give me a personal referral to an internal medicine doctor.  He is able to see me on Monday morning!  So, there is still hope.  Basically I need to get him to write a letter to my Chicago clinic stating that he is willing and able to monitor and treat my thyroid level throughout my pregnancy, and that he believes I am ready to undergo IVF at this point.  So here's to hoping he is able to write that letter without needing to have me on meds for a couple months first...there is still some hope we can make a September transfer!

August Already?

I can't believe it's already August.  It seemed like meds and transfer were so far away, and all of a sudden they are right around the corner!  I start Lupron injections in 23 days, assuming:

1) We get our contracts done in 22 days.  The IPs' lawyer hasn't sent a first draft of the contract yet.  I hope we get it by the end of this week.

2) The egg donor's current cycle successfully results in pregnancy.  We will know on August 10!

Finding an Attorney

About a week before my med screening, I started looking for an attorney.  My IPs have an attorney in Chicago who specializes in third party reproduction issues and has a great reputation.  But my agency told me that since the baby will be born in Missouri, it's important for me to get an attorney in my state so that he/she can make sure the contract is in compliance with Missouri laws and standard procedures.

I'm sure it doesn't shock you to hear that there aren't really that many attorneys with experience in surrogacy issues.  There is one very well known attorney who is THE go to person for dealing with surrogacy, particularly when it comes to getting your ducks in a row to establish parentage when the baby is born.  So, it was a natural step to see if she could help with reviewing our contract as well.  Well it turns out that her daughter is in business with her and is the one who reviews surrogacy contracts, and when we contacted her two weeks ago, she was 36 weeks pregnant with twins.  She said that she would still represent me but might not have a lot of time to devote to her work soon (you think?!?).  Since we have a deadline, we decided our best bet would be to find someone else.

Jesse from Pink & Blue recommended someone that she had heard was good, and I also mentioned someone else I had seen recommended on the online surrogacy forum I belong to.  Unfortunately, neither of these men responded to our inquiry.  After a couple of days, figuring that promptness probably won't be their priority if they can't even bother to respond to a new business request within a few days, I went searching for someone else.  Luckily, there was one more attorney who was recommended to me by another surrogate in the St. Louis area as someone she has worked with for two surrogacy contracts.  I made a call to her office, spoke with her assistant who 1) sounded positive about working with us, 2) recognized the woman who referred me by name, 3) confirmed that they have experience working with my IPs' attorney in the past, and 4) confirmed that she could help me get it done by our deadline.  Yippee!

Now they have received all of my and my husband's information so they can open our file, and Jesse gave them all of the information regarding how they will receive payment.  Jesse is sending the IPs' attorney over all of our information today so she can start the first draft, then it will be sent to my attorney for her and my review.  I'm hopeful that this process will go smoothly.  I don't feel like I'm too picky about any requests my IPs may have, and I don't think they are very picky either.  We have to have the contracts done and signed by August 23!

Update

So after hearing back from the NC, it sounds like my thyroid level isn't that concerning to her.  She just said I should let my local doctor know about my levels when I see him for the appointment we have scheduled for August 6, and she if he wants to retest or put me on medication.  She said that unless he recommended cancelling the cycle they wouldn't do so.

So, that's a relief.  Now on to dealing with lawyers and contracts!

Thyroid Problems

I received a call from the clinic this morning that my blood work came back and my thyroid levels are elevated.

Ugh.

I tried to glean a little more information about exactly how high my thyroid levels were and what the implications were, but I'm not sure the person on the phone was qualified to give that information.  She did say that they like to have you between a 0.4 and a 4, and mine was a 5.8.  Since medical numbers mean nothing to me, I'm not sure if that means that my levels are just a little bit elevated, or if that's very high.

She told me I need to contact the doctor at my local clinic to be retested and possibly be put on medication.  She didn't say anything regarding whether this was cycle-cancelling news, or if I have a certain amount of time to get my levels corrected, or what.  I emailed the nurse coordinator to find out more information, so hopefully I will hear back soon.

From just basic knowledge, I know that wacky thyroid levels can lead to miscarriage.  So this is obviously something that needs to be addressed.  Hopefully the number was just a bad test and next time it will come back fine.  I'm pretty sure I was tested during my last pregnancy, which was just a year ago, and they were fine then.  Although I do have a family history of thyroid issues (along with just about everything else - seriously, I would be the worst egg donor candidate ever), so it wouldn't shock me if mine were slightly out of the normal range.

I Have a Beautiful Uterus...and a Calendar!

So I am back from my trip to Chicago for my med screening.  It went great!  Despite a 6 hour drive each way with a baby, a rainstorm, and a VERY late night the night before, I would say the trip was a success!

My appointment was at 9:30.  The agency had arranged for someone to babysit my daughter at our hotel room during the appointment so both of us could come.  Since I was supposed to be meeting with three different people (doctor for ultrasound, tech for blood draw, nurse coordinator for information regarding the cycle), I brought my Kindle to pass the time while I was waiting.  Well, it was totally unnecessary.  I think I got 2 pages read total!  The place was huge and there were a ton of people there, but everyone was moving through the process so efficiently.  I felt like we were all on a perfectly timed conveyor belt.  But even though there were so many people filing through, I felt like all of the staff took the time to make us feel welcome.  I especially liked that the nurse coordinator spoke about my IPs in a way that let me know that she actually knew who they were, and that they weren't just a number to her.

First we met with the doctor, who was very nice.  He took a look at my uterus using the saline sonogram and said it was just beautiful.  The procedure wasn't too bad, not any worse than a pap smear.  I had a little bit of menstrual like cramping for a little while afterwards, kind of like I remember feeling as my uterus was expanding in early pregnancy.  The whole procedure only took a couple of minutes.

We got blood taken to test for various contagious diseases (mainly STDs), which we should get back next week sometime.  I'm not worried about those coming back badly, but it will be nice to have that formality out of the way.

Then we met with the nurse coordinator to go over the medications and the schedule for taking them, as well as signing various consent and acknowledgement forms.  I will go over the meds in more detail in another post.  I was expecting to get a general rundown of the drugs and how to administer them, but in addition I got my actual projected calendar!  I will start taking my meds on August 24, and the transfer will be sometime between September 23 and the 27th!  I let the NC know about our vacation to Italy in October, and she said she's not worried about it at all.  She said the meds will travel fine and she can give us a doctor's note to travel with liquids and needles.  She also said there would be no harmful effects on the pregnancy, since it will be at the point where it will either be sticking around or miscarrying, and there will be nothing I can do to help or hurt the pregnancy.  Based on the calendar, the worst thing that could happen is that I could already be in Italy at the time I should be getting my blood drawn to confirm a pregnancy.  She said if that's the case, she will just give me instructions on when to take a regular home pregnancy test to determine whether I should continue meds until I return to the US.  I'm thinking the timing of this is actually going to work out well, since I should be back in the US before I am 6 weeks along, which is when my first trimester pregnancy symptoms really started kicking in last time.

The calendar right now is contingent on a couple things:
-The egg donor.  She is currently cycling with another couple.  This is her third donation, and ours will be the fourth.  For her first donation they ended up freezing all of the embryos, so we don't know if any did/will result in pregnancy.  The second donation did not result in pregnancy.  So the NC said that if her third donation ends up not resulting in pregnancy either, they will recommend that my IPs consider choosing a new donor.  Unfortunately that will mean starting from scratch with screening/contracts with the donor, so we will probably be pushed back to November.  So we are keeping our fingers crossed that this cycle results in a pregnancy!  We should know in the next few weeks.
-The contracts.  The NC told me that in order for me to be able to start meds on August 24, they need confirmation of signed contracts by August 23.  So it seems like it should be plenty of time to get our negotiating and signing in, but you just never know.  My IPs already have a lawyer, and we are working on getting one for me.  Since we will be delivering in Missouri it's a good idea to get a lawyer here too, and there are really only a few that are well versed in surrogacy matters.  I'm hoping to get someone within the next few days and get started on the contracts by the end of next week.

I'm so excited to actually know what my timeline is now.  Hopefully my IPs will be parents come next June!

Two Days Till Chicago!

I'm getting so excited to head up to Chicago for our medical screening.  It probably won't be fun to be poked and prodded, and then learn about how to poke and prod myself some more in the future, but this is a milestone we have been trying to get to for some time.

In addition, we will be getting to meet my IF for lunch.  I wish my IM was able to come as well, but she will be recovering from a medical procedure and won't be able to make it.  I was really looking to taking a step forward with our relationship since all of my long distance communication goes through my IF.  So I'm disappointed that she won't be able to make it, but it is what it is I guess.

Since I work a full time office job, I will have to take a vacation day to go up to Chicago (which will be reimbursed by my IPs).  I have a feeling working in absences for surrogacy is going to get tricky.  I have a VERY nosy boss, and I work with a team of 6.  Only 2 of us are allowed to be out of the office at any one time, and I am at the very bottom when it comes to seniority for requesting time off.  If I were taking off a Friday or Monday I could have just said we were going to Chicago for a long weekend, but I couldn't think of any  legitimate reason that I would be taking off a whole day on a Thursday.  And believe me, taking off a whole day would require an explanation.  So I will just be waiting until Thursday and calling in with the sick baby card.

I'm starting to worry about the transfer.  It's looking like November will be the ideal transfer time, but unfortunately I can't be out of the office for the last two weeks - others with more seniority have already requested all the time around Thanksgiving off.  I can't even use the sick baby excuse, since absences of 2 or more days in a row require a doctor's note.  It would be easy enough if we could just schedule some other time way in advance, but unfotunately in this process we are at the mercy of the egg donor's cycle.  I'm hoping my job doesn't end up cancelling a cycle or pushing us back another month!

Anyone else who has been through this before - how do you go about getting time off for screenings, monitoring, transfer?  Or am I the only one with this problem?

Woo Hoo, I Have a Screening Appointment!

I will be going up to Chicago for my med screening appointment next Thursday, July 19!  My husband and I will both be going up - we both need to do bloodwork to screen for infectious diseases.  Then I will have a saline sonogram, which is where the doctor will fill my uterine cavity with saline in order to expand the uterus and check for anything that might prevent pregnancy (fibroids, polyps, etc.)  After that we will meet with the NC to go over meds and schedules.

I am so excited to finally be to this point!

Psych Clearance is (Finally) In

So yesterday my psych clearance finally came through!  Apparently the hold up was that they hadn't received the MMPI results until yesterday.  It normally isn't supposed to take two weeks to get MMPI results, but I guess with it being 4th of July week, no one else was in as much of a hurry for the results as we were.

So now we believe everything we need has been forwarded to the nurse coordinator (NC) at our clinic.  She contacted me this morning to see if I was already taking birth control pills, so at least I know I'm on her radar.  I'm hoping to get an actual appointment set up very soon...they like to get them done at a specific part of your cycle (normally around CD12), and I am already on CD3.  So if we don't get something set up in the next few days we will likely get pushed back to August.

Psych Screening: Check!

On Thursday I completed my MMPI, after fighting horrible construction traffic on the highway I don't normally take on my regular route home.  I was panicking that I wouldn't make it in time, since my husband had told me earlier in the day it took him almost an hour and a half and that didn't leave me much time to get the test done before the office closed.  Eventually I just gave up and left that highway, took the highway I normally take even though it was a much farther drive distancewise, and managed to get there by 5:45.  (Note to self and other St. Louis residents: when driving at rush hour, no matter where you are going, Highway 40 is NEVER the answer.)

The test was, well, pretty dumb.  It was a scantron with over 500 true/false questions.  I would imagine that anyone with half a brain (personality disorder or not) would be able to figure out the "correct" answers to most of the questions.  I dunno, but I wasn't worried, and I whipped that thing out in an hour and was home to see my daughter before her bedtime.

Then yesterday morning was the actual in person psych evaluation for my husband and me.  We got there, resisted the efforts of the receptionist to try to pry my insurance card out of me (I KNEW no one would have any idea what was going on and try to bill me...this office is not organized.), and I filled out a "mood" questionnaire about my level of depression that particular day.  No, I didn't feel like killing myself, but thanks for asking.  I'm sure it was standard for the regular patients but I'm guessing I probably didn't need to fill that out.

Then we got into the room with the doctor.  He sits us down on the couch, and opens with, "So, you want to adopt!"  Umm....no.  Seriously?  After we explained that we had to be screened so I could be a surrogate, he says, "Oh!  Well what am I supposed to do?"  "I guess you're supposed to make sure we won't have a mental break and run off with the baby after it's born?"

After that, we basically answered a lot of fact questions about the process of surrogacy, and gave him a general background on our families and relationship.  The doctor was actually really nice and was really easy to talk to.  It was a pretty pleasant hour.  At the end he told us he had no concerns about us, thought we were a wonderful "normal" couple, and that we were doing a great thing.  He hadn't gotten our MMPI results back yet, but said he wasn't worried about it.  He said he didn't put much stock in that test anyway, and even if it came back with something flagged he would still be able to clear us for surrogacy.  I promised him that they would be fine, since the voices in my  head told me not to tell anyone about them so I answered no on all those questions - the doctor just laughed.

I left the office with mixed feelings - it certainly wasn't what I expected.  We basically just discussed the surface process of surrogacy without actually getting much into the emotions involved.  Issues like termination/selective reduction, relationship with my IPs, and separation from the baby after it was born weren't even touched on.  On the one hand I was glad we had such an "easy" interview, but on the other I felt kind of guilty, like I was getting by without being properly tested.

I guess it went well, because the psychologist called my agency right after we left the office to tell her that he thought we were wonderful and would be writing up a report ASAP.  She asked me for feedback on him and I mentioned his initial confusion about the nature of the appointment, and said that I felt like we got off a little easy.  She assured me that his job is to catch personality disorders, which he can do while discussing any topic, and she was sure we were fine if he cleared us.  So who knows, maybe his strategy is to feig ignorance in order to glean our interpretation of what surrogacy is?  We'll say that.

Anyway, now we are just waiting for the official MMPI results and his report so we can (finally!) schedule my medical screening.

Silly Tests and Panic Attacks

I just realized I haven't updated my blog in a few days.  There are two major developments that have happened:

First, I got a call on Tuesday from the psychologist my husband and I are scheduled to see next Tuesday.  Well, technically I got a call from his secretary, but his intended message got so garbled that he ended up just getting on the phone with me himself.  He had decided that he wanted us to come in several days prior to our appointment to take our MMPI tests, so he could get the results from them in time for our meeting.  Fine, except I work 9-5 and was already going to be missing a couple of hours of work for the psych screening.  So he was nice enough to agree to let me come in directly after work, since someone is normally there a bit later in the evenings.  I will be going to take the test directly from work tomorrow.  The downside is that this will require me to drive across town at rush hour twice instead of once, but the upside is that my appointment on Tuesday will be shorter and I will have to miss less work.  Since my husband has a different schedule than me (he works 6pm-6am three days a week), I told the doctor he would have to call and schedule a time to come in separately.

After two phone calls with rude receptionists telling him they had no idea what he was talking about and that he can't come in because the doctor has no appointments available (he doesn't NEED an appointment, just a desk to take the test), he was finally able to convince them to let him come in and take the test tomorrow afternoon.  Hopefully when we get there they will have heard of an MMPI and will be able to find one for us to take.  To say that the office is disorganized would be an understatement.

Then, yesterday afternoon I got an email from the nurse coordinator (NC) from the fertility clinic in Chicago that is going to be going the embryo transfers.  The one we've been trying to schedule my med screening with for the past month.  After reviewing my medical records, the nurse said she needed a letter from my OB stating that I was medically cleared to be a surrogate.  OK, fine, I will get that this week.  Then she proceeds to say that I should make sure my OB has advised me of the risks of taking estrogen with my family history of breast cancer - she believed the estrogen taken in order to prepare my body for IVF would be ill advised as it can increase the risk of breast cancer.

Insert total freak out here.

My family history of breast cancer is very scary - my paternal grandmother and aunt were both diagnosed with and died of breast cancer in their 40s.  Based on the family connection and their ages, it is most likely genetic.  I know that my risk of getting breast cancer is high.  I choose to not think about it, figuring that worrying about it now won't keep me from getting it in the future.  But of course this email throws me for a loop - I didn't realize estrogen can cause breast cancer.  Why didn't anyone tell me before?  Why did two separate agencies medically clear me without a word about it?  It was time to consult Dr. Google.

First I start googling information on family history of breast cancer.  I learn that 1 in 8 women in the U.S. will be diagnosed with breast cancer at some point in her life.  I also learn that those with a certain inherited genetic mutation have an 80% chance of developing breast cancer.  That's a fun fact.  Now I'm really freaking out.  So I start googling breast cancer and estrogen.  Yep, high doses of estrogen (like those used in hormone replacement therapy for postmenopausal women) increase your risk of breast cancer.

Then I ask myself, with the risk factors that I have am I really willing to increase my risk even more to have a baby for someone else?  What happens in the future if I get breast cancer - will I always wonder if I had not been a surrogate if I would not have developed it?  Would I regret my journey?  Here is where I send a panicky email to my agency coordinator.

Then I think, wait a minute, I researched fertility medicine risks before I even considered this journey.  I didn't see anything about cancer anywhere.  So I go back to google to research more carefully.  It turns out that tons of studies have been conducted regarding fertility medications and their risks, including whether taking estrogen increases your risk of cancer.  All of the studies I was able to find, including ones that included women who received fertility treatments back in the 1960s, showed that there was absolutely no evidence of an elevated risk of breast cancer.  Not even if you already have elevated risk factors.  In fact, pregnancy and breastfeeding before the age of 32 actually decrease your risk of breast cancer.  While hormone replacement therapy gives you a constant dose of estrogen over long periods of time, the estrogen you take while cycling for IVF only lasts a couple of weeks, and it really isn't that much higher of a dose than it would be if you had ovulated on your own.

Today I left a message with my OB, and when I ask her to write a clearance letter for me I'm definitely going to bring up the estrogen/breast cancer question with her like the NC suggested I do.  But after researching, having a long talk with my coordinator, and getting input from other surrogates on SMO, I'm feeling  much calmer now.  Jesse and I decided that the NC is mainly saying that to cover her butt, and that it came across harsh because, well, that's just her personality.

So I'm not going to throw in the towel.  I'm still going to make my IPs' dreams come true.  I'm glad that the NC said something because it allowed me the opportunity to properly educate myself.  I may have been having a panic attack yesterday, but now I actually feel better than I did before about my choice.

Psych Screening is Scheduled

So I have my psych screening all set up for June 26.  It was more complicated than I thought it would be to get it scheduled.  My clinic requires that my husband and I attend a session for our evaluation, as well as take the MMPI (which I understand to be a long and tedious test of true/false questions designed to catch certain personality disorders).  It was difficult to find someone who was qualified both for a surrogacy pysch screening and to give the MMPI, but my agency managed to find someone located reasonably close to me.

Jesse is going to call the clinic and see if we can at least make an appointment for my medical screening now, or if we have to wait for the psych results to come back first.  At first I was super bummed that we had to do this process in two steps - normally a surrogate is able to get the med and psych screening knocked out at the same time, but every clinic has different requirements.  I was really hoping we could get all my screening done in June so we could do contracts and start meds in July and transfer in August, but it doesn't look like that will happen.

The reason I was really hoping for August was that we have a trip to Italy booked for October.  Because the weeks before and after transfer require so many meds and monitoring appointments, there is probably no way that I can do a transfer in September or October, so we will have to wait all the way until November.  Which means I will have to be hugely pregnant in St. Louis in the summertime.  And since contracts require that you are bound to your home state for most of your last trimester, there will be no summer vacations for us next year.

BUT, it will be nice to be able to take my once-in-a-lifetime trip to Italy without having to worry about first trimester morning sickness and fatigue.  It also means I will not be pregnant for my 30th birthday (also in October).  Probably the biggest plus for me, it also means that I can stop stressing about getting everything done quickly.  The last month or so I've been constantly checking the calendar to see which days in the coming weeks are best for traveling to Chicago for screening (my husband's schedule is a little tricky).  I've been counting up days in my head, trying to figure out the last possible day we need to get X or Y done in order to make an August transfer.  I think now that I have it in my head that I have all the way until November, I will be able to let all that go.  It's a relief to know that I won't be trying to rush through contracts or having a panic attack if there are any hang ups along the way.