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?

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!

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!

Next Step: Screening

Now that we are matched, the next step in this process for me is screening.  This takes place in two parts - medical and psychological.  The medical portion of the process includes FDA required infectious disease testing for both my husband and me, plus my uterus needs to be examined and given the stamp of approval from the RE (reproductive endocrinologist) who will be placing someone else's precious cargo into it in a few months. 

The psychological portion of the screening varies depending on the clinic's requirements.  Usually both the GS and her partner are required to attend, since it's important that the GS have full support from her spouse.   It also sometimes involves a written personality test.  The end goal is to make sure that you are just crazy enough to think that carrying someone else's baby is a good idea, without being TOO crazy - I think they are looking to weed out people who are not emotionally stable enough or don't have enough understanding of the process to handle the emotional highs and lows.  I'm sure they are also keeping eye out for cash-strapped women who are using surrogacy as a desperate attempt to secure income, or total loonies who are going to have a mental snap and run off with the baby once it's born.  You know, the usual stuff.

So, what are the requirements of my clinic?  I'd love to be able to tell you, but unfortunately I can't because I don't know them yet.  The clinic my IPs were trying to use at the recommendation of our agency ended up not being a good match for them.  Luckily, they actually know another couple who is currently expecting twins via GS through another clinic in their area.  Initial consultations with clinics are very hard to come by, so they had to book theirs several weeks in advance.  Their initial meeting is the first week of June, so I won't really know what exactly I need to do until then.  Our agency coordinator said she's planning to call and find out whatever info she can once we get closer to the appointment time - probably next week.  So hopefully we will get the ball rolling then.

The IPs are going to be using an egg donor (ED), so they are going to try to get access to the donor database sometime this week so they are able to choose a donor by their appointment date.  Hopefully once they have their first meeting things will move quickly.  Ideally I will be able to get all my screening done in June, then we can complete our contract and I can start my meds in July, and hopefully get pregnant in August!

In the meantime, I will just have to bide my time.  But now that I'm matched with my IPs, I can use the time to get to know them better.  I'm excited to get things going!