Explaining Surrogacy… to a Child

The first time I had to explain surrogacy to a child happened when Ross was 8-months-old and we were staying with family friends. Their young daughter had asked to look at baby pictures on my phone, and, for several minutes, she scrolled through my camera roll– normal photos, pictures of Ross trying sweet potatoes for the first time or playing in a pile of brightly colored leaves– before stopping at a photo of him as an embryo.

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This will always be one of my favorites pictures of him.

It was easy enough to explain the embryo photo without going into the details of gestational surrogacy, but I knew we were likely headed into complicated territory. The concept of surrogacy wasn’t something I necessarily wanted to get into, but I didn’t want to lie to her either. As I watched her swipe, I wondered which photo would be the one to give us away, but a picture of us with Elle during the second trimester went by undetected. It wasn’t until she saw Elle holding a newborn Ross while still in a hospital gown that she hesitated.

“Did she give birth to her baby in the room next to you?” she wanted to know.

“No…” I started, not sure how forthright I should be, or even really where to begin.

At first I tried to give a vague answer, something simple, but it only led to more questions until eventually, without intending it, I had her full attention. After she’d absorbed the basics, she wanted to know how surrogacy was possible, why Ross wasn’t considered to be Elle’s baby instead of mine, whether getting pregnant (by taking Ross from my body and transferring him to Elle) had required surgery, and how long Elle had been a part of our lives. They were all questions I’d answered many times with adults, but finding the words to make the answers accessible to a child made the conversation difficult in a new way. To start, I referred back to the embryo picture and told her that although my body could make babies, it wasn’t able to carry them. I explained that someone else had offered to carry Ross for us until he grew big enough to be born and come back home to us.

It took her a few moments to process and accept it, but then she surprised me by asking in a rather matter-of-fact way, “So… now you guys are like sisters?”

“Yes,” I answered, shocked by her immediate understanding of our deep gratitude for Elle and the amazing thing she had done for us. At 9-years-old she had grasped on her own what most adults struggle to understand about our surrogacy journey.

On the other hand, explaining the way we became parents to our surrogate-born child presents further challenges. We don’t just have to reveal it to him, we will have to help him process his own feelings about his birth and choices that were made before he was even in existence, including our choice to write openly about it. We will also need to give him the ability to explain it, refuting on his own the common misconceptions and stigma. It’s not something we will do once; we will work through this issue for and with him throughout several phases of his life and understanding. I don’t doubt that at some point he will come across detractors. I imagine there will be someone who tells him that we were selfish for not adopting, that I am not his real mom, or that he is the product of his dad’s physical relationship with someone else. I know this because I have witnessed and experienced it myself.

From the beginning, we decided we wouldn’t hide the surrogacy from anyone, especially Ross. But there is no model to work from or book to consult when it comes to an explanation, nor is there anyone in our lives who can relate. We don’t want it to be something he remembers learning, but that means talking about it well before he is able to grasp the concept.

So, when Ross was a newborn in the fits of a colic episode, and I’d spend hours just rocking and talking to him as he squalled in my arms, sometimes I would tell him his story. Later on in his infancy, we bought every surrogacy book available for kids (so, basically, all three of them) and kept them in the rotation. My favorite, The Very Kind Koala, tells the story of a special koala who carries a baby koala in her pouch to help another couple become a family.

After he’d passed his second birthday and we began another cycle of IVF in the spring, we started talking about it more in depth:

“Did you know that when you were a teeny tiny baby, the doctor took you out of Mommy’s belly and put you in Aunt Elle’s belly so you could grow big?” I asked him casually one morning.

“Ohhhh,” he replied very seriously. And then, to my amusement, he added, “That’s cool.”

Shortly after the move this summer, we read Sophia’s Broken Crayons together. When we got to the part with the woman who had a broken belly, I stopped reading and placed my hand on my own stomach, telling him that the same was true for me. The words tasted bitter even as I forced myself to say them, and I shared that it was something that made me very sad.

“That’s why Aunt Elle carried you in her belly,” I carefully explained, “She made Mommy and Daddy so happy, because now we have you!”

After finishing the book, we moved to another activity, but he wanted clarification.

“Is you belly broken, Mommy?”

“Mmhmm,” I answered, nodding in encouragement of his understanding but not really wanting to repeat it.

“I will carry you baby, Mommy! I will carry you baby!” he said brightly. Not knowing what to say, I hugged him tightly and thanked him while blinking back tears. “You’re welcome,” he responded simply.

Since then he’s been the one to bring it up on occasion, like the other week when he started talking about it at dinner or Saturday when we ran errands and he randomly asked me if I remembered when “Aunt Elle carried Ross in her pouch.”

Yes, Sweet Pea, I remember.

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Where Have We Been?

Since receiving and sharing the results from our second full IVF cycle in May, a lot has changed. Life was busy at the time and, despite my best intentions, I stopped posting altogether. The week following my egg retrieval, with a belly still swollen from treatment and a roller coaster of emotions made worse by unnatural levels of hormones, we celebrated Kyle’s graduation. It was a culmination of the previous three years of our lives, and as his name was called, I couldn’t help but think back to everything he’d been through in that time. After weighing multiple job offers in varying states, Kyle accepted a position, and a month later we put an offer on a house just 15 minutes away before beginning the enormous task of moving for the fifth time in less than nine years.

It was difficult to close that chapter of our lives, and I wasn’t ready to leave the apartment where our dream of becoming parents had finally come true. That was where Ross had taken his first steps, the only place he had ever known as home. All of his friends lived there– right outside his door and always ready to meet on the playground. It was also the last place our dog, Orion, had known as home, the last place he spent the night curled up beside me. I didn’t want to put distance between us and those parts of our lives.

These three years haven’t been easy by any means– the sacrifices we made, especially financially, of leaving behind an established life and starting over so Kyle could pursue his graduate degree, will affect us for a long time to come. The final months of 2015 following the move were terrifying, and for a while I believed we’d made the biggest mistake of our lives. Some of that time was devastating: the sudden and unexpected loss of Kyle’s mom followed by the loss of three of our aunts & uncles to cancer (all of whom were between their early 40’s to mid-60’s and still had so much life yet to live), the painful reality of the third trimester as I faced not being the one to deliver our child, the decision of putting our beloved dog down just two weeks after Ross was born, and the never-ending challenges of navigating a chronic illness that seeps into every aspect of our lives. But, we also gained so much in that time: we developed friendships that are more like family after these years of living in student housing together, we learned to live on so much less than I ever thought possible (and I think we’re better for it), and we finally, finally got to bring our baby home. Together, the three of us built a life filled with fun adventures and amazing experiences.

Now, here we are again, starting a new chapter.

As always, one thing has remained the same: the struggle to have a child. Nineteen years after diagnosis, it feels as though fertility (or rather, the lack there of) is still the thread of my entire life. In more than seven years we haven’t taken a break from actively working toward having a baby– not even when Ross was born. We’ve spent so many years just trying to put together the ‘picture’ of our family despite missing so many necessary puzzle pieces.

The injections and ultrasounds came to a halt following my egg retrieval nearly 6 months ago, but in the meantime, the surrogacy process trudges on. We knew this would be roughly a two-year journey, but the strength and determination I once felt is waning due to complications with beginning my third IVF cycle. The fertility treatment aspect, which is one of the more straightforward and uncomplicated parts of the process, has been a greater hassle than we anticipated, taking up valuable time and energy that could be used to focus on something else.

When we went through IVF for Ross, we were given a 3-year window to focus on treatment for another child. It wasn’t a guarantee that it would even be possible, but the recommendation was not to wait. We anticipated going through another cycle in early 2016, but surrogacy complicates everything, and I didn’t start injections again until two years later after postponing twice more (Summer 2017, January 2018). At the end of my cycle last May, we looked forward to another attempt in August. But again, we were unable to proceed with IVF as planned. It was a hard to accept, but October didn’t seem too far away…

I should be in the middle of my injections right now, but I’m not. It’s a story for another time, but we were forced to postpone treatment again, meaning that over the last two and a half years, we’ve missed out on completing IVF cycles a total of five times due to circumstances beyond our control.

The new hope is for January 2019, but I am feeling wary of hope, especially since that will be the same month that marks the end of the original 3-year window.

In the meantime, I don’t know what else to do other than to keep trudging.

Snowflakes in Spring

Two weeks ago I answered the phone with a mix of dread and anticipation, hoping for the best but expecting the worst. The results, it turns out, were somewhere in the middle:  3 AA embryos with my name on them were tucked away in the freezer. As far as grading goes, each blastocyst (5-day-old embryo) receives two letter grades from the embryologist– one for the outer cells (which become the placenta) and one for the inner cells (the baby). The grades work the way you’d expect them to, with A being the best, B for “good,” and C for “fair.” However, even an embryo with an AA grading is not guaranteed to result in a pregnancy, nor is one with a lesser grade destined to be unsuccessful. During our first IVF cycle, both blastocysts were given AB gradings and transferred within 6 weeks of each other, but only one resulted in a baby.

Aside from the first three, there was another embryo that had failed to divided properly and four more that could go either way. My nurse said they would continue to monitor the rest and call the next day with an update. Immediately I told Kyle not to expect anything, that our final number was going to be three.

The next morning ticked by slowly. Despite trying to be realistic the day before, I had started to feel hopeful that we might get to keep just one more. I remembered back to getting the final update call in 2015, the morning of our fresh embryo transfer. In 48 hours we’d lost more than a dozen embryos, but we did have one blastocyst ready to transfer, as well as a few that might still pull through. A few hours later, as we sat waiting to be taken back to the surgical room, the embryologist had come to inform us of one last embryo– a straggler, who was now safe in the freezer. That straggler was Ross; the others failed to develop. As I went over the memory, I realized that I only knew about Ross that day because we had been physically present in the clinic, waiting to transfer his sibling. He was too late to be included in the update call that morning, and if we hadn’t happened to have been there, I wouldn’t have known about him until Day 6. I started to believe that we would have a straggler this time around, too.

Eventually the morning passed but the update never came. I called in and left a voicemail for the nurse, but two hours later, I was still waiting. By now, everything in me said that we had a fourth embryo, I just had to hear the confirmation for myself. The waiting started to get to me; the build up of pressure felt unbearable. I tried to reason with myself, arguing that nothing would change if I had to wait until tomorrow for the news, that another 24 hours of waiting would still be less than what I’d made it through already. But I couldn’t stay reasonable anymore. So when Kyle seemed unruffled by the delay, I texted Elle instead, knowing that she would be indignant on my behalf. Finally, in the late afternoon, the call came: we did have one more, our straggler. This one had a BB grading, and I felt a special affinity towards it as the underdog.

Four frozen embryos. We had snowflakes in May. I felt at peace with the results, especially since we’d started with far fewer embryos this cycle. We just had one last hurdle to get through yet. This cycle, because of my increased age, my poor results the first time around, and the time and money that go into the surrogacy process, my doctor recommended additional screening to test whether the embryos were normal and likely to result in a successful transfer. Prior to being frozen, each one of our blastocysts had been biopsied, and those cells would be sent to a lab. The results would take another week or so. Another week of waiting.

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The remnants of an IVF stim cycle: several days and thousands of dollars.

 

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IVF Cycle Results Comparison by the Numbers
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IVF Cycle Results Comparison by Percentage

It was a busy week in the meantime. We weren’t just carrying the weight of our embryo testing, we had family staying in the area and multiple events surrounding Kyle’s graduation from his master’s program on Saturday. The weekend’s blur of festivities was followed by a few more somber days as we packed for a quick trip to Florida for my aunt’s internment. In the 48 hours between our flights we saw family from both sides who live in the area. There was very little downtime and never a moment our embryos were far from my mind; they clouded my thoughts and entered my dreams at night. Throughout the wait I tried to will three healthy embryos into being, alternating between the surety that this time would be different and then that this time would be the same. Elle texted me on Wednesday to say that she was thinking of us ahead of the big day.

Then on Thursday, the call came. And I missed it, by seven minutes.

I fumbled through my contacts as I shut the door to block out sounds from the other room. The line rang, but rather than the expected voicemail message, my nurse answered. My heart started to race through the obligatory small talk– the most agonizing part of each call– and I tried to assess her tone to determine whether or not I was about to receive good news or bad. I couldn’t tell this time.

Well, we had one embryo. Out of four, nearly all of them were abnormal. It was a setback and not one I had been fully prepared for after the triumphant feeling of gaining that last embryo. I’d been warned that roughly half of our embryos would likely come back testing abnormal, but with four blastocysts, that still should’ve left us with two. One put me at a rate of 75% abnormal, well above the expectation. As someone who has been through a failed embryo transfer before, two was acceptable. Three was a miracle. One was not enough.

Back in early February, as we sat in our doctor’s office, having one or less at the end of treatment was the concern. One is not enough to start preparations for a much-needed hysterectomy. It’s not enough to be able to donate unused embryos to couples in need when we finally have a second child. One is not enough to move on in this process. If we were a normal IVF couple, we could schedule a frozen embryo transfer in a matter of weeks, and then, depending on the outcome, we’d move forward with any necessary treatment cycles.

But surrogacy changes everything. We are not a normal couple, and we don’t have the option of transferring this summer. For us, the hope is to simply transfer within the next year, and if that is unsuccessful, my body may be unable to produce another viable embryo to try again at that point. We need to do another cycle while we still can, and that means less time to focus on the next part of the process and more money spent on IVF when we desperately need it for other aspects of the surrogacy. We knew that all of this was a likelihood– from the beginning we were tentatively planning for another round of treatment sometime in August– but then I went and let myself hope that that fourth embryo was an indication that we’d finally found the missing key.

“Do you want to know the gender of your embryo?” my nurse asked, before ending the call.

“Yes,” I replied, wanting to know as much about this group of cells as was possible to know.

But as she told me, I didn’t know what to say in response. Here this potential future child is ready and waiting for us, but there is nothing I can do about it right now.

IVF Cycle #2: Eggs to Embryos

Thursday morning I woke up at 3am, sick with nerves and unable to sleep. My mouth was dry but I couldn’t drink anything; I was hungry but I couldn’t eat. It was a relief when our alarms finally went off in tandem 2 1/2 hours later and I could start getting up and moving towards my retrieval. After dropping Ross off at a friend’s (a very good friend who got up at 6am to watch him), we were on the road.

I don’t know why I was nervous. It’s not a major surgery by any means, and I’ve certainly been through much worse than this. But, at this point in the IVF cycle, it feels as though our fate is nearly set and whatever is going to happen will happen. I don’t like that feeling.

My nurse was great. She was a calming presence from the moment she handed me my gown, and she stayed with me, chatting until I was fully knocked out an hour or so later. I signed a bunch of paperwork and received a wristband with my name, wondering if it would end up in a baby book someday like the one I wore for the retrieval that resulted in Ross. Throughout treatment, Ross has been wearing a ladybug sticker each day for good luck, and that morning he picked one for me too. I wore it on the back of my hand, planning to take it off during the actual surgery, but my nurse insisted I keep it on, even putting a tiny piece of medical tape behind it for me when it started to lose its stickiness.

Dr. K happened to be the one doing retrievals that day, so he was already familiar with me and our case. He came to speak with me just before I was led back to the surgical room, and then it was finally time. Clutching my gown around me I walked into the room where I’d had my first retrieval and where both of our transfers had occurred. The last time I was there it was with Elle, hoping that that transfer would be the one (and it was). It felt different on retrieval day, crammed with so many people wearing masks and preparing the table for me this time. I’m so happy I get to at least do this part. As I laid back I could see on my right the door to the embryology lab and the little screen where I saw Ross for the first time just over three years ago when he was a 5-day-old embryo. My nurse helped me get situated and it turned out that she, the anesthesiologist, and Dr. K were all familiar with the area where I grew up, so they distracted me by sharing their favorite spots to visit. As I felt my eyes grow heavy and the familiar feeling of the anesthesia, I focused on that screen and thought of Ross.

It could have been 3 days or 3 minutes later when I came to– finding myself in mid-sentence in a conversation with my nurse about our upcoming life changes. In a moment of self-awareness I remember thinking, “I don’t know why I’m telling you this,” which I then heard myself repeat out loud a moment later, as if there was a direct feed from my thoughts to my mouth. She asked about my pain level and I was surprised to be able to say that although I hurt, it wasn’t too terrible. Last time I was surprised to wake up with excruciating pain from the surgery, so much so that I almost immediately passed out, but this recovery was more manageable. Kyle was able to join me shortly, and we waited together for the final count.

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Waking up after the retrieval, looking terrible apparently.
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The lady bug sticker that kept me company

Seventeen eggs, ten less than before. I tried not to be disappointed, knowing that the only reason we were able to have Ross from one cycle last time was my (very) high egg count. Seventeen was the number of embryos we’d had to start with then. I hoped it would be enough.

The call the next morning seemed to take forever. Of the seventeen only twelve were mature, and from those we had nine embryos. For so many women, this would be a fantastic number, but historically, while my egg and embryo counts start high, very few survive to blastocyst stage, when they can be either transferred or frozen five days after fertilization.

We spent the weekend away at the beach with some friends in celebration of graduation, a much needed distraction while we waited for the updates. While there we lost one, bringing us down to eight. Knowing their fragility, I am trying not to get attached, but it’s hard. I just don’t want to be blindsided this time, the way I was before.

Today we will get the call, the one that says how many we have to be frozen. It could be different this time, or it could be the same. I’m trying to prepare myself to lose them all, but there is no way to do that. The only thing I know for sure is that we will keep fighting no matter the outcome.

“Begin at the beginning,” the King said, very gravely, “and go on till you come to the end: then stop.”

– Lewis Carroll, Alice in Wonderland

IVF Cycle #2: The Trigger

“But I don’t want to go among mad people,” Alice remarked.
“Oh, you can’t help that,” said the Cat: “we’re all mad here. I’m mad. You’re mad.”
“How do you know I’m mad?” said Alice.
“You must be,” said the Cat, “or you wouldn’t have come here.”

— Lewis Carroll, Alice in Wonderland

Yesterday morning we had my favorite nurse again for the monitoring appointment. Debbie was the one who first taught us how to inject my meds way back in September 2014, a few days before we left for England & Wales on what was booked as a ‘we-can’t-have-children’ trip. That all seems so far away now. This time Ross was in the room with us and the day had a full-circle feeling, especially given that it was the three year anniversary of when we transferred him as an embryo.

I’d resigned myself to the idea of having another appointment this morning, taking my trigger shot tonight, and showing up for the egg retrieval early Friday morning, but Debbie was convinced I had the chance of triggering a day early; we just had to wait to see what Dr. K thought. Just in case, she went over all my pre-surgery instructions after my ultrasound before wishing me luck and telling me she hoped she didn’t see us back the next day.

The call didn’t come until late afternoon, but she was right, it was time to trigger! No more stim injections before bed and for the first time in weeks I wouldn’t wake up to stick myself in the stomach with Lupron. This was what we’d been waiting for– and I felt strangely unprepared, now not ready to give up the routine to which I’d become accustomed.

The ultrasound showed that my egg follicles were continuing to grow closer to maturation, and while there is variation in size, the majority seem to be fairly uniform– exactly what this medication protocol was meant to encourage. It doesn’t seem like there are quite as many this time, but I am hoping that any decrease in egg quantity is offset by an increase in quality. It seems like my follicles could use a little more time to progress to the ideal 18-22mm, but unfortunately, my estrogen level has been pushed to the limit. Again, I am at risk of OHSS, or Ovarian Hyper Stimulation Syndrome (which was once described to me as sending shards of glass down your veins and, as a result, leaking fluid through your body). My estrogen level started at 29 and has increased more than 130x to nearly 4,000 (the threshold for when it starts to get worrisome) in about 10 days. I was thankfully able to avoid hyper-stimulation before, and I’m hoping to do that again; however, because I am so close, I was only able to take a half dose of hCG for my trigger shot.

The trigger is what tells my ovaries to finish up the process and prepare my eggs for release. It has to be given at an specific time, which is based on the schedule for my retrieval (36 hours after trigger) so that the doctor can collect them before they’re actually let go. This is the final injection, but it’s also the worst. The needle is much bigger, and Kyle has to administer it (something we both hate) because it goes into my backside. I could give myself injections into my belly all day long, but not having control over this one makes me a little jumpy. We set everything up and, because I am nothing if not a rule-follower, waited until the clock turned to exactly 8:30pm to inject.

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Everything we need to trigger
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There it is: the very last one.

Kyle was far more nervous than I was, mumbling to himself as he picked up the syringe. I briefly considering screaming when he made contact just to mess with him but decided against it because I didn’t want him to accidentally stab me again, this time in the wrong place. (He didn’t think this was very funny and appreciated my restraint, but I can’t help but feel that the same would have crossed his mind if our positions were reversed.) The injection was painfully slow and I could feel every bit of it, but it was all over in less than 30 seconds. Just like that— we were done. I could get two lines on any home pregnancy test I want… but only because of the synthetic hCG in my system.

There is now nothing more I can do to contribute to the success of this cycle beyond taking my last antibiotic before bed and rinsing off all of my lotion and products tomorrow morning (embryos don’t like anything scented). Part of me feels anxious that it’s basically over– I don’t like the part where we are forced to just wait for the results; I want to be doing something, anything. On the other hand, my ovaries are swollen and uncomfortable now as they are pressing on the scar tissue in my abdomen, and I am ready for my emotions to go back to a more normal range. Weirdly, my left ovary (or the one I referred to earlier as the “problem child”) seems to have produced noticeably more follicles than the right, as evidenced by the fact that my stomach is somewhat lopsided with one side pushed out further than the other. It looks so bizarre and does not feel nice.

All that’s left now is to stop eating or drinking after midnight (which means I’ll be ridiculously thirsty as of 12:05am) and leave super early in the morning to get there for the pre-op.  This time tomorrow it will be done, and we will have an egg count.

IVF Cycle #2: Are We There Yet?

As of this morning, I’m on my 9th day of ovarian stimulation. At this point I’ve given myself over 40 injections, had 5 ultrasounds, done 6 blood draws, and spent many, many hours in the car. I think I’ve finally reached that point in my treatment cycle where I feel as though I’ve hit. a. wall.

There is so much going on in our lives and around us, but I thought that if we just kept pushing we could finish this cycle with minimal impact while still juggling everything else. But I am exhausted, I need a break, and I’ve only just reached the point where my monitoring appointments will go from being every other day to every day. I remember feeling similarly in my last cycle, probably within the same time frame, but it seems even more grueling this time around.

I knew it wouldn’t exactly be easy driving an hour each way to get to the clinic, but I hadn’t imagined days like last Wednesday, when we spent about 2 hours inching through traffic on the turnpike just to get to a half hour appointment. The medication has been pretty tough on me as well, something I only vaguely remember. Living with chronic illness obviously complicates treatment for me, but even with thirteen years’ experience of dealing with fatigue on a daily basis, feeling like I could barely move or even keep my eyes open last week was difficult. So of course, that was also finals week for Kyle. Thankfully, in anticipation of both our treatment and the interviewing process falling around this time, he was able to work ahead, which helped us survive an appointment schedule of Sunday, Wednesday, Thursday (Kyle’s), Friday, and Saturday mornings.

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Waiting to see the doctor with my polar bear good luck charm.

Then, after my early morning appointment on Saturday, we packed up the car and drove to the coast to spend the weekend in an area where we might be living by the end of next month. I was sure I would somehow forget a needle or something I’d need for one of my injections, therefore throwing off my entire cycle while we were away. We did need to mix medication and inject by iPhone flashlight to avoid waking up the light-sleeping toddler in our hotel room, but overall it wasn’t too bad. Naturally, I woke up with debilitating nausea from the meds just before meeting with the people in charge of hiring. Kyle got Ross ready to go, packed everything back up, and checked us out while I stayed completely still until about 30 seconds before we walked out the door. It was a very long day, but we got through it and made it home for another monitoring appointment this morning.

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Running out of room!
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Injecting by flashlight in the hotel.

As far as my follicle growth has gone, I have been consistently on track. Wednesday’s appointment showed that, unlike my first cycle, this time I already had two measurable follicles (above 10mm) by Day 4 (a change from Day 10) and my estrogen level was exactly where it should be, or as my nurse said, “Dr. K got your dosages just right.” I am on a high level of medication, starting with the highest dose I ever took last time (Gonal-F 300iu and Menopur 225iu) and staying there instead of jumping around all over the place like I was used to. Because of this, I’ve been able to feel things happening since about Day 2-3: twinges, pressure, pulling, and some pain around both ovaries. This morning was the first time I could just barely feel them through my skin.

On Saturday, the doctor who did my ultrasound was the same one who had done my egg retrieval three years ago. It was the first time I’d seen him since then (well, technically, I was knocked out then, so I didn’t actually see him), and it was so nice to be able to say that we had a son following treatment. His estimation is that I won’t have my retrieval until Saturday, but I am really hoping my follicles are ready by Friday at the latest. For one, I don’t know how much longer my terrible veins can hold up to the frequent blood draws. At my last appointment it took them three tries to hit something, and this morning the nurse took one look at them and went to grab someone else to do it. I’ve already got bruises around most of my decent veins, and it stresses me out thinking about trying to get something from them every day for the rest of the week.

Now that we’ve been watching my follicles grow in size and number for more than a week, I’ve started to let myself think about the actual eggs inside them– how many will there be, and have we done enough to help the quality? For as much as I am anxious to be done with this phase, I know that there will be an emptiness once everything is over. Working towards treatment has kept us busy for a long time, but progress through the surrogacy process will come to a screeching halt by late May. If I need to do a second IVF cycle (something Dr. K feels is a likelihood), we wouldn’t be able to move forward again until at least August. This summer we’ll be focused on finishing the interview process, making some tough decisions, and a small inconvenience called moving. If, by some miracle, we do have the embryos we need at the end of this, we are stuck here until we have a gestational carrier. Even at that point there will be psych evals, background checks, weeks of contract negotiations, medical clearances, and seemingly endless appointments and meetings before we could get to an embryo transfer. Realistically, even in the best of circumstances, we probably won’t be able to complete all that by the end of the year. Everything is still so far away.

So, for as tough as this time is, I am comforted by the fact that we are still making progress, still getting somewhere. There is nothing I hate more than the feeling of standing still, of not having the option to keep moving. There’s only one way we can reach the top of this mountain, so I’d rather keep climbing.

 

IVF Cycle #2: The Time is Now

Sunday morning’s appointment was tiring but went well. I watched the screen with bated breath as Dr. K checked my follicles and took a few measurements, but it only took a minute for him to announce that I should be able to begin my stims (i.e. ovarian stimulation injections) that night. The only issue he had was some concern over the state of my left ovary (aka the “problem child”).  In 2010 when I was 22, it had started to twist, cutting off blood supply and causing significant pain. It’s been eight years, but there was always the possibility that this could happen again, and it seems as though it is now being affected by the scar tissue and endometriosis in that area.

At this point the doctor believes we should proceed with treatment and see what we can get, but when my ovaries inevitably swell later on in my stim cycle, I will be at a greater risk of it twisting. Throughout treatment and the weeks following my egg retrieval, I will need to be mindful of my physical activity and unable to lift Ross. In the last few years I had come to the decision that I was not going to have surgery again (aside from retrievals) unless I am having my hysterectomy. They simply take too high of a toll on me, with too little to gain, to continue at this point. Should something need to be done regarding the ovary, I believe it would be time to remove everything. I have always known that my time to pursue treatment is growing short, which is why we are pushing so hard to do this even when the rest of our lives are unstable. I don’t want to look back and have regrets or watch my last chance go by while I’m waiting for the “right time.” The time is now. I don’t have emotional energy to spare to dwell on “what ifs” so, in the meantime, we are simply relieved to be moving forward.

Sunday ended up being a very long day. We drove home from the appointment and had time for a quick lunch before spending the afternoon downtown at the local arts festival. Once we got home I quickly changed and left for dinner and a baby shower with friends, not coming back home until 11pm. I was exhausted and overwhelmed by the task of relearning how to mix my medication, but together, Kyle and I fumbled through the instructions for a bit before muscle memory seemed to take over for both of us.

I put together a chart to compare my cycles and noticed that my starting dosages are much higher than they were in 2015. The dosages for my first three days of stims are the same as they were for days 7-9, though I know my actual protocol is different (down regulation vs antagonist) and my ovaries took a while to get moving last time. Tomorrow morning I’ll go back for my first monitoring appointment, and I’m interested to see the difference it makes.

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Everything I need for one night of injections.
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Ready to go!

When we started the surrogacy process in 2014, I bought a small Paddington Bear while we were in England to carry with me to all the upcoming appointments. It was my hope that someday I would be able to pass it along to a child, and when Ross was born, Paddington became his. It also became a symbol of hope for us, and we have bought and been given many Paddington-themed items over the last few years; we even used him as inspiration when decorating his nursery.

I’ve always known that when it came to the second surrogacy journey, I wanted to have something to carry with me again. I considered getting another Paddington but ultimately felt like that was something special to Ross. It took a while for me to find something that felt right, but several months ago Ross helped me pick out a little polar bear to represent the frozen embryos we are hoping for. This polar bear has stayed on my nightstand ever since (in the same spot Paddington used to sit before he moved to Ross’ bookshelf), and he’s been keeping me company at my appointments:

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When I last began IVF treatment, I wasn’t aware of anyone in my life who had been through it. To make things worse, surrogacy was a foreign concept to virtually everyone we knew, and there was a lot to explain. I felt overwhelmed and isolated by our reality. Now, more than three years later, I know dozens of women who have been through the IVF process– there are even several toddlers on my Facebook feed that I’ve followed since their transfer days as microscopic embryos. In many ways, it feels so very different this time around.

Going into this part of treatment has felt a lot like preparing for a battle. We’ve talked about this cycle and how we’ve wanted to approach it for more than 2 years now, and so much has had to come together for us to get this far. It has been difficult and painful, just like before, but I feel incredibly grateful for the opportunity just to try again. There was a time when I did not know if this chance would ever come, and I am ready to reach out and grab it.