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!

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.

Next Step: Psych Screening!

The caseworker from my agency called me last night to let me know that we have had some progress!  My IPs have picked an egg donor that they like, and it looks like the timing is going to work out well.  She will be available to cycle in August, which is our goal.

In addition, she heard form the nurse coordinator at the clinic about their surrogate requirements.  My husband and I have to have our psych screening out of the way before we can get our medical screening done.  Since we can't do them both the same day (as is possible for many clinics), my caseworker is going to find a psychologist we can go to in the St. Louis area so we only have to travel once.  She was going to start her search today and let me know as soon as she found someone, so hopefully I will be able to get that done in the next couple of weeks.

I'm really excited that we are getting closer to getting the show on the road!

First Appointment Down

Sorry for the long pause in posting.  I was out of town on vacation, and nothing was really going on before my IPs' first appointment anyway.

They had their appointment with the clinic yesterday and it went very well.  They are in the process of getting all the paperwork out of the way so that my screening trip up to Chicago can be arranged.  They are also going to be using an anonymous egg donor, so they are in the process of selecting one of those as well.  Luckily the clinic they are using has a fairly extensive donor database, so they don't have to shop around through different donor agencies to try to find someone.

On my end, I'm pretty much just sitting on the sidelines waiting for them to tell me when I can come to Chicago.  I know there's really not much I can do at this point, and all the initial arrangements and decisions need to be made by my IPs, but I don't like feeling like I'm out of the loop.  I haven't had much communication with my IPs since we met in person last month.  I think part of the problem is that I am very much an emailer and they are not.  I think there is probably also a certain amount of caution on both sides, with neither of us wanting to bug the other.  I have tried shooting a couple emails to the IF but haven't gotten much of a response - I know he's very busy as he owns his own business.  I don't even have the IM's email address or phone number and IF hasn't given it to me.  I really loved talking to them in person, so I'm hoping that once I am able to see them again when I go up for screening our relationship will start to blossom a little more.  Anyone have any advice for how to get a new surrogacy relationship off the ground?

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!

Waiting

My medical records were reviewed and everything looked good.  The only thing I need to do is get a current pap and start birth control pills (BCP), so I have an appointment for next week to get that taken care of.

I believe my profile was sent to the potential IPs on Monday night.  Last night the coordinator emailed me to let me know she was waiting to hear back and said she would follow up with them at the end of this week.  I'm so nervous waiting!  I want them to like me, and the longer I wait the more I'm afraid they don't want to work with me.

Now the logical part of me understands that it takes time to make such an important decision.  They are, after all, choosing someone who they will have to trust to take care of their baby for 9 months while they have essentially no power to do anything to control her actions and choices.  But the emotional part of me wishes they had seen my profile and immediately said, "YES!  She's the one we've been waiting for!"

I'm keeping my fingers crossed that I will hear that they would like to move forward with considering me by the end of the week.

Back on Track

Hooray!  The coordinator let me know that she got my medical records today.  She is going to review them and get back to me within the next day or so.  Hopefully she will be able to forward my profile to the potential IPs by the end of the week!

Small Hold Up

So the coordinator from Pink & Blue Surrogacy had planned on forwarding my profile to the potential IPs last week, but unfortunately she has not received my medical records yet.  She faxed over the request for my records two weeks prior and had hoped to have them by the middle of last week.

She asked me to follow up with  my doctor's office to see if I could move the process along.  I was able to get in touch with the medical records department directly, and they gave me their direct fax with a promise that it would have a quicker turn around that way.  So here's to hoping that's the case.  I would really love to get the ball rolling and see if these IPs like me!