Hope and Despair

Little Alice fell
d
o
w
n
the hOle,
bumped her head
and bruised her soul

– Lewis Carroll, Alice’s Adventures in Wonderland

When Ross was born, we were far away from home with a very long car ride ahead of us. Somewhere on the road during our first day of driving, it finally hit me: the surrogacy process had come to an end. There were no more lawyers, no meetings with the agency or doctors, no fear that we might miss the birth or have our parentage questioned. It was a shock to realize– this experience which had consumed our lives for 574 days (plus the years of infertility before that) was now over, and we had a 3-day-old newborn bundled up in the backseat to show for it. I remember staring out the window, feeling such an enormous weight lift from my shoulders as we drove north that I sobbed with the relief of it.

Throughout the process we endured for Ross, we had often talked about whether we would be able to do this a second time. The cost was staggering — physically, financially, and emotionally. There was never a moment when we questioned whether we wanted more children (we’d always dreamed of a big family), but surrogacy had taken such a huge toll on us, both individually and as a couple, that we didn’t know how to pull it off again. The understanding that there was absolutely no way to have a second child without going back down the rabbit hole was devastating. We’d be opening ourselves up to all of the hardships and potential horrors, but this time we wouldn’t be the only ones forced to bear the weight of our decision.

By November 2015 we were ready to try again, determined to restart the process as soon as possible– and Ross hadn’t even been born yet. The plan then had been to begin another round of IVF when he was about 6 months old and transfer an embryo shortly after his first birthday. But Kyle was still in grad school, and even though we had amazing insurance benefits, it took a while longer to be able to meet the rest. Waiting was hard, and by the time Ross was 11 months old I was terrified that the window was closing. No one around us could really understand. Couldn’t we just recognize how lucky we were and be happy with one? And anyway, he was still a baby, we had “plenty of time.”

When we finally had what we needed in place to start the process, Ross was barely 18 months old, but we estimated that even if things kept moving, we wouldn’t have a baby in our arms until late 2019. With the benefit of having better access to care while Kyle was in school, I began seeing a therapist, knowing some of what we faced ahead.

Everything took longer than expected. We weren’t considered officially matched with our gestational carrier until a year and a half later. Insurance repeatedly tried to deny my IVF benefits solely because my body wouldn’t be receiving the embryo we created (*we weren’t asking them to help with a transfer or anything for our carrier, just my treatment, as they would for any other woman under their plan). The financial advisor at our clinic abruptly went on medical leave for 2 months without confirming our cost estimates, but no one would pick up our case because we were part of the “donor program” due to surrogacy. Medical records were sent to the wrong office branch, then got lost for a while. Our coordinator quit (or, I believe, was fired) and we were hastily assigned to someone new in a random office two states away. Our previous psychologist wouldn’t answer calls for weeks so we couldn’t get her clearance to move on. And so on, and so on. Over and over again we have hit nearly every bump, obstacle, and road block.

Now we are stuck on legal. Still. Today makes it 13 weeks, far longer than the 2-3 weeks the lawyer estimated… at least before he received our check (don’t worry, I’ve learned my lesson the hard way). During those weeks he’s left the office for extended periods of time without any warning or progress on our contract, told us that our contract revisions had “not reached [his] inbox,” and now, most recently, he simply got “sidetracked by an urgent matter.” (Too sidetracked to even let us know). At best he’s been difficult to reach and given us almost no counsel at all on one of the most complicated and important aspects of the surrogacy process. Both our escrow company and the fertility clinic have since reached out to put our case on hold due to the circumstances. So far, the delay has cost us almost $1,000 for no real reason at all.

We’re about 812 days into our second journey, and we still haven’t even reached an embryo transfer yet.

For most of this year, we’ve been working toward October for transfer. As the summer came to an end, it was nerve-wracking to know that we were getting ready to risk this hard-won embryo in the hopes of getting lucky a second time. To cope with the stress and fear, I allowed myself to daydream about the photo we’d receive at the procedure, a photo of this embryo that I have waited 18 long months to see. But, as the weeks passed, and then the months, with very little progress on the legal contract and virtually no control over the situation, even that became increasingly painful to think about.

This fall was brutal. After more than two years of fighting through this all-consuming process, I’ve just… hit a wall. What was once difficult and painful has become downright torturous.

In October, when we should have been preparing for a transfer, we waited instead. Ross picked out a small, medium and large pumpkin to represent our family, and I chose two tiny white pumpkins for the frozen embryos who are both a part of our family… and not.

Through November, when we didn’t make plans for Kyle’s time off because we were afraid it could hold up a potential transfer, we waited instead. This December, which had initially been planned as an option for a second embryo transfer in case the first one failed, we will still be waiting. There will be no embryo transfer in 2019.

We wait, and we wait, and we wait.

…And I haven’t even mentioned the massive potential problem with the health insurance for our carrier that is looming over us. One that has a very firm deadline of December 15. One that I have no idea how to solve.

In the meantime, I’ve reached a place where I am so emotionally drained that I don’t feel able to hope anymore. Some days we limp along, some days it feels like someone literally has their hand around my heart, squeezing it as hard as they can. It is a physical pain. For a while now I’ve sat in my therapist’s office each week and cried. When the preschool hosted a Halloween parade for the parents at the end of last month, I went home and cried. When the nurse at my doctor’s office showed me how high my blood pressure reading was during a routine appointment, I cried. Basically, if you’ve seen me recently and it looks as though I’ve been crying, it’s probably because I have.

We’ve invested an immeasurable amount of time, effort, and energy into this second journey, but throughout the last week I have questioned everything, rationally and irrationally, especially myself. I have started to wonder whether I am even deserving having someone who is willing to carry a child for me, or whether I am deserving of hoping for another in the first place.

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.

IVF #2: 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.

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

IVF Cycle Results Comparison by the Numbers

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. 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.

Waking up after the retrieval, looking terrible apparently.

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

Searching for a Surrogate

Looking for a gestational carrier is one of the most stressful, terrifying parts of surrogacy, in part because choosing the right person is the most important decision in the process. I’ve seen some say that searching for a match feels a lot like dating, but it’s so much more than that– kind of like advertising yourselves as a potential parents and hoping that someone finds you to be deserving of a child, that someone likes you enough to want to help.

Working with a good surrogate agency gives you some structure and a bit of a support system. They match surrogates and Intended Parents (IPs) based on the varying state laws and your specific preferences: how many embryos you plan to transfer at a time, how involved you’d like to be, your feelings on termination, etc. When we spoke to our agency for the first time in October 2014, they mentioned right away that Elle seemed like a good match for us. The day after our initial consultation we received a detailed profile that included her backstory, photos of her family, and information about her previous pregnancies. I will never forget opening that email, my heart was beating so fast. We read every word over the several pages that described her life and I cried when it mentioned why she was choosing to be a surrogate. I still have her profile and pictures saved in one of my folders, along with the email from the agency congratulating us when both parties agreed to the match. At the time it felt like things were moving fast– almost too fast– it was terrifying to feel the pressure of making such a life-changing decision when you have no idea what you’re doing, but matching us with Elle was the best thing our agency ever did for us.

Going through this process without an agency can save you a good bit of money, which is why so many people do it, but it also means you don’t have that same structure or support system. I’ve never worried about doing the legwork for all the coordination surrogacy takes– booking travel, scheduling appointments for two people instead of just me, staying on top of medical bills– but matching has always been one of my biggest concerns. An agency presents you with profiles of surrogates who have already been psychologically and medically screened; they’ve had background checks and are invested in the process. When you’re finding someone independently, you’re at a disadvantage– they may not know if their insurance is surrogacy-friendly or the fertility doctor might dismiss them upon seeing one small issue with a past pregnancy or delivery. Most of the screening has yet to be done, and that takes time.

In February I struck out on my own, not fully knowing what I was looking for or where I might find it. I joined a few Facebook groups for surrogates and IPs who were hoping to self-match and began checking a recommended website daily for new “ads.” It felt intimidating and strange, but so did working with an agency once. For a few weeks I watched the daily posts– mostly photos with a brief explanation of what led them to surrogacy and what they were looking for in a match. For the most part everyone was encouraging and supportive, but there was drama at times too. A few weeks into joining, a warning was posted about two women who were attempting to scam IPs by matching with multiple couples.

I didn’t think I would ever be comfortable enough to post, but eventually, as our insurance continued to keep us on hold and we were unable to make progress on the IVF side, I got tired of waiting. My first post was vague– an ad for a website that rarely used photos and didn’t include names. By the next morning, I’d received a couple replies: a woman in South Africa with a fake email address; an agency hoping they could entice us to sign up with them. I posted again, this time in a few different groups with more details and a photo of our family. Again, a couple more replies: a woman with four kids who was interested but also in communication with IPs who already had embryos and were ready to go; another who wanted to know if we were still looking but never responded to my email.

I’ve learned a lot in a short amount of time. For one, it feels like everyone is already matched. Secondly, being 14-hours away from your carrier is actually relatively close in the surrogacy world. And thirdly, there are so many more IPs than there are surrogates. This is due to a few reasons: not only are there very few women who choose to do something like this but the medical clearances knock many out of the running. In addition, American surrogates are in high demand due to the surrogacy-friendly laws in many of our states. There is enough unbalance that I’ve heard some agencies are placing IPs on waiting lists.

We may also not be as high priority this time around– some women are only looking to carry for gay couples who might not have the options a straight couple does when it comes to adoption. Others only want to work with couples who don’t have children yet so they can give them the opportunity to experience parenthood. I understand this and do struggle with it as well– what if we match with someone who could have helped another couple have their first child when we have already been blessed in that way? There are so many heartbreaking posts from IPs that it is hard to close down Facebook and forget them.

Surrogacy, which is already a long and difficult process, definitely seems to be even more so for those hoping to find someone without the help of an agency.

While We Wait

For more than 5 weeks now we’ve been waiting anxiously to hear back from our insurance so we can have an idea of what treatment will cost. Our current coverage is through Kyle’s graduate school and despite paying an obscene amount each year for it, past experience has taught us not to expect much from them. But, if our financial counselor is right, this time we might actually receive some help. Unfortunately, that also means that we have very little time to fit in treatment before graduation in May (and perhaps they know this, which is why they’ve kept us stalled for over a month now). The latest news is that our case was sent for review yesterday and it could take yet another week before we hear back. I’m hoping we don’t waste another cycle waiting.

Aside from the insurance hassle, there’s a lot we have to do before my first injection. After sitting down with the new doctor, we had almost a month before I could schedule my next diagnostic blood work and ultrasound, giving us time to tackle as much of the “surrogacy checklist” as possible– something we need to repeat prior to each and every treatment cycle. No matter how much time you have to devote to the process, it’s overwhelming at best and still doesn’t include any of the agency, matching, or legal aspects of surrogacy. For the most part we’re having a lot of blood work and screening done to prove that we don’t have any communicable diseases that could be passed on to a gestational carrier through our embryo(s), as well as an assessment of risk factors. Eventually we will move on to involve lawyers and a social worker so we can do an embryo transfer, but for now we’re able leave out some of the more time-consuming steps.

There were a few things we were able to skip this time around– most notably, we did not have to gain acceptance into the gestational surrogacy program at the clinic again. I’ve talked about this experience in another post, but a few years ago we had to prove medical necessity (because you can’t just decide to do surrogacy) before our case was presented to a panel of about 32 doctors who agreed on our acceptance. This time it was much easier: we simply got to meet with the doctor for a normal consultation.

With more than two years of trying to get started on our second journey behind us, it feels like we should be further along than we are, but every time I start to feel like we’re finally getting somewhere, I am reminded of how very long the road is in front of us. All it takes is a few years to pass to forget how many steps there are, even though I did my best to keep track of everything at the time.

In the surrogacy world, it feels like we have already fallen behind; it’s not unusual to begin the process for a second child while your first is still a few months old. Everything just takes so long that some Intended Parents don’t even wait for their first to be born to start again. For Jimmy Fallon to have two daughters born via surrogacy within 18 months of each other (July 2013 & December 2014), they would’ve had to start the process right after they initially became parents at the very latest. Sibling journeys especially (gestational surrogacy with the same carrier for more than one pregnancy) are almost always done close together, in part due to the fact that everyone’s lives are kind of on hold throughout the process.

I’ve gotten used to being stuck in this place where no one gets to simply decide to have a child. It has actually become weird to think that most people don’t need intervention to get pregnant, but it’s almost impossible to forget that we are the outliers even among those undergoing IVF. For one, we are sorted out from the other patients into a part of the donor program with our clinic, along with everyone needing donor eggs, sperm, or surrogacy to achieve a pregnancy. There are so few of us that there isn’t even separate paperwork for us to fill out prior to consultation, which means that several of the questions either don’t apply to us or are impossible to answer without further explanation. It’s a silly thing– a minor inconvenience in the scheme of things– but still a stinging reminder that I am not expecting (or even hoping) to be pregnant at the end of treatment. In addition, when meeting new staff there is always the assumption that you are part of the majority, and worse, the necessary correction. As in, Oh no, I’m actually not able to carry the baby. Rinse, repeat.

It’s been four years since we started the surrogacy process for a child and two years since that child was born. Still, I never stop wishing that we were able to go through IVF like a normal couple. Every time we sit in the waiting room with couples who have that option, I am envious of how much easier they have it– and they don’t even know. I try to remember that the women who are working towards surrogacy and also need to use donor eggs likely feel the same way about me, someone who still has the ability to use my own eggs however problematic they may be. I try not to lose perspective… but it will never stop being painful that the ability to carry my child is gone.

Someday

Almost three months ago we marked my 30th birthday. My aversion to the day is nothing new; it’s been several years now since we’ve celebrated. The fact that it happens to be the anniversary of our first early loss from 2012 has changed the way I feel about it, but it’s also painful in that it represents valuable time slipping away. Somehow being dragged into this new decade made August feel even worse than usual.

My age shouldn’t even be an issue yet. I’ve always been on the younger side of infertility patients and we should have years for possible treatments stretching out ahead of us. During our first appointment in the surrogacy process, our doctor even mentioned how young we were to be in this position, pointing out that at just 26 I had some time yet before I reached his cutoff of 52 years of age for an intended parent. In the surrogacy world it’s also common for an intended mother to be older than her gestational carrier, but I am seven years younger than Elle. And while our current circumstances have prevented us from starting the process over for another child, at the very least we should have the time to wait. Except that we don’t. From the beginning, our timeline has always been stuck on fast-forward, and for me, reaching 30 has always represented the beginning of the end.

For almost 20 years, the plan has been to have my final surgery in my early 30’s– as in the surgery, a hysterectomy. The goal over nearly two decades of my life was always to maintain my fertility until I was able to have the family I wanted. After that, my doctors assured me, one last surgery would give me a much more normal life: I’d be pain-free again, my days would no longer revolve around a monthly cycle, and the pressure to do everything possible to save my fertility would be gone. It would all be over, and at last I’d be free.

Living with pain is physically and emotionally wearing, but it has never been my greatest fear. I remember desperately trying to bargain with God at 15 or 16, offering to accept any physical pain if only my ability to have children could be spared. It was a price I was willing to pay, and over the years I clung to this image: being 30-something with three kids and a body that no longer hurt. That was the only thing that kept me going through the very worst of days. In those moments, when all I wanted was to be rid of the pain for good, I’d remind myself that it was worth it to be able to have children someday. I truly believed that there was a purpose to my pain.

Over the years we’ve made a lot of decisions around this deadline for surgery, including meeting with two different doctors Spring and Summer of 2011 to discuss plans for what was likely to be a complicated pregnancy. It has been since that time that we have remained focused on having a family, and as I’ve reached this new decade more than 6 years later, I’ve found that I don’t know how to accept our bitter reality. I am hurtling towards a hysterectomy, but my life would have been infinitely better if I’d simply had my uterus removed from the start– as it turns out, I’ve only ever needed my ovaries to have Ross.

Becoming a mom was always the priority, but doing so through surrogacy didn’t suddenly dissolve the feelings of loss I have over never being pregnant. I wanted to have the experience that is able to unite women in a common bond across every race, culture, and generation; I wanted to have the ability to make my own choices in regards to family planning; and I wanted to have all the little things that came with being able to carry a child: telling my husband he was going to be a father because I was carrying his child, feeling my baby kick from inside me, and going through delivery knowing that my body had done this amazing thing despite its brokenness. I wasn’t so naive as to think that we would never struggle; I knew that as time went on and my disease continued to progress, it was likely we’d need intervention along the way as we became a family of five. But I never imagined that by 24-years-old my window of opportunity was already shut, and that the experience of a full-term pregnancy– even just once– was forever out of reach.

It seems people expect me to have accepted infertility by now, especially after a successful surrogacy journey, and there is a lot I have accepted. I am at peace with Ross’ story and I am grateful to have Elle and her family in our lives. Truthfully, it’s not the infertility that I find so unbearable to accept, it’s the permanence of our situation. This is not a phase for us, it feels like an ending. All along we’ve been fighting a war– and I’ve been fighting long before Kyle ever came into my life. We lost many battles together, more than I have shared in the three years I’ve been writing here. And then the tides turned and we came out victorious one day. Nothing can take away the joy we’ve experienced, but that hasn’t changed the fact that we are still stuck in this war that has consumed our lives. It’s tiring and painful and worst of all, I know how this goes; we’ve been here before.

I honestly don’t know how to accept that we may never have another child because surrogacy is by far the most expensive, most intense kind of intervention you can possibly need– or that 18 years of living my life in chronic pain have been for absolutely nothing. The final blow is that, because of complications, living pain-free again someday is now no longer an option, no matter what organs I have removed. Accepting this reality feels like I’d be saying that everything I’ve suffered is okay, but it’s not. I’m angry and heartbroken, and I want my life back.

This isn’t how the story was supposed to end.

Do you ever feel like you’re living the wrong life? There are moments when I think about how over the last few years I’ve become the poster child for surrogacy among family and friends and I just want to say, That’s not me! That was someone else! Somewhere out there we are living a different life: Ross is a second child and we’re getting ready to have a third when Kyle finishes his degree in May. Our first-born child, the one that we were meant to have, is turning 5-years-old. And while my upcoming hysterectomy still won’t fix everything, it will at least bring relief from some of the pain, and I will be at peace knowing that I did not spend my life suffering in vain.

But that’s not a life I will ever know.

The Second

I want to have another child. 

For so long I’ve wanted to write those words. This post has been an internal struggle for months– maybe even a year now– but each time I start to fill up another blank page, I find myself pressing ‘delete.’ I am forcing myself to keep going this time, if only to be rid of this feeling that these words are trapped inside me and I’m the only one who knows the pain they cause.

For most couples, having a second child is an expected part of life. But, when your first child was the miracle, it seems as though you’re not allowed to ask for another. Only if the first came easily is it acceptable to hurt over the absence of a second. But long before Ross was born I ached over this child too. All along I have carried the hope of having another, each day it weighs down my thoughts, but I never feel the freedom to express it. I know what the general reaction will be because I’ve already started to receive it– that I am being ungrateful, maybe even selfish. That I should consider my family already complete. That I should just accept this additional loss as the fate of my own infertility and move on. That I am asking too much.

Over the last 18 months, I have carefully packed away each outgrown baby item, knowing that no child of mine is likely to use them again, yet still praying with everything in me that I am somehow wrong. The odds are stacked so highly against us, but I can’t bring myself to let go of this last tiny ember of hope. I can’t imagine selling or giving anything away, so the baby stuff piles up in storage instead, untouched and gathering dust.

As Ross continues to grow, strangers seem to feel more entitled in asking when we are having a second child. The first time it happened Ross was barely 4-months-old and not even sitting up on his own yet. Now that he’s an active toddler we are being questioned with increasing frequency, and each time it hits me like a very familiar punch to the stomach. “You have to give him a little brother or sister. You just have to give him a sibling!” insisted a woman at the baggage check-in no less than three times as we traveled home from Thanksgiving. “And he’ll become spoiled without one anyway, you know,” she added with a smile. We get questions often enough now that I know there is never an easy answer, but the few times I’ve dared to be honest I am generally encouraged to “just adopt” (we can’t) before finally receiving the unsolicited advice that I should just be happy with one. Any response other than a fake smile makes everyone uncomfortable, and so again, I remain silent.

For the record, I am happy. Ross has taught me how to enjoy life again, something that once seemed like such an impossibility. He has shown me the beauty in a million little things, and I love seeing the world fresh through his eyes. Wanting another child doesn’t take away how grateful I am for him. This is a pain that is completely separate; it involves the piece that is still missing from our lives and our family, not the piece we were able to find. I know that there is meant to be another child and my fear is that I will never know that person. After all, who would be missing from your family if there was only ever one child?

Yet, even in the best of circumstances, I am always aware that there is still only one road left for us to travel– and the cost is exorbitant, the risks high. Frankly, I was far more naive when we started the surrogacy process for Ross in June 2014 than I am now, and it terrifies me to know what could be ahead of us. Having been down this road before means nothing in terms of what we can expect; each time is so different. And even if we had the ability to begin tomorrow, the soonest we’d be able to have a child is at least two years away. Two years of invasive testing, endless appointments, expensive lawyers, confusing contracts, and the pain of knowing that we are missing out on experiences we can never get back.

Again, we find ourselves at a strange standstill as we watch other families who had babies around the time Ross was born already expecting another or having welcomed a younger sibling. Everyone else seems to be making plans or feels content in knowing their family is complete. In contrast, we can do nothing. In place of options and choices, we are staring at a dead end.

I wish we had wanted to stop at one; it would be so much easier. We’d be done, I’d have surgery to get rid of it all, and I could finally move on from this phase of my life that so often revolves around my reproductive organs. It has been so many years that I don’t even remember what it was like not to think about my fertility, and I am tired of fighting for it.

But it’s that tiny —what if?— that haunts me.

The Day I Thought I’d Never Get to Have: A Surrogate Birth Story [Pt. 1]

A couple months ago I wrote a post answering some of our most frequently asked questions. Considering that it’s still rare enough that most have never met a family brought together via surrogacy, there is a lot that people are curious about or want to know. Above all, the question that we are almost always asked is, “Were you able to see the baby at the hospital?”

The answer is yes.

We were there when Elle’s water broke. We were there when she checked into the delivery room. And we were there when Ross took his first breath.

I had intended to share the birth story here when we welcomed Ross into the world, but after our commitment to being open with our most private and emotional moments for the year and a half before his birth, it felt nice to have something to keep ourselves for a little while. Now, as we are looking back to this time last year and preparing for a first birthday celebration, I feel ready to give a glimpse into the best day of our lives and share what a birth story looks like when surrogacy is involved.

It’s hard to imagine our lives without Ross. Was there ever really a time when I didn’t know his face as well as my own? When I didn’t know the color of his eyes or the sound of his laugh? Logically, I know there were many years like this, but already I struggle to fully remember what it was like not to know my own son. A year ago today was just such a day, our very last one without him.

By January 23, 2016 we were beyond anxious for Ross to arrive. We’d left home more than 2 weeks before and it started to feel like he might wait until spring to meet us. Then, that night, Elle’s water broke. Not wanting to sound a false alarm, she got up and left the room to check after hearing two tiny popping sounds while we watched tv in the den. None the wiser, I remained on the couch until a few minutes later when Kyle and Elle’s husband came home early.

“Her water broke,” her husband stated calmly when he had both Kyle and I in the same room. I stared at him, uncomprehending. “Her water broke,” he repeated at least once more, while I struggled to process his words. And then: clarity. And… what now?! After frantically dumping out the smaller of our suitcases (Kyle’s, of course) and repacking us for the next couple days (minus any socks and my shampoo somehow), we drove into the cold winter night on our way to the birthing center.

As we settled in to the room, our labor & delivery nurse located the birth plan and information our surrogate agency had sent ahead in December and informed us that our OBGYN was not on call. Immediately, my stomach dropped. For months now we had talked through the logistics of the surrogate birth with our chosen doctor and I was terrified of how our situation might be handled by someone who didn’t know us. Although we’d had a great experience so far at the practice, we’ve also come across many who feel that our choice to pursue surrogacy was a selfish or foolish one, and there was no way to know how this new doctor would feel about it.

Things progressed quickly. Although she wasn’t in pain when we arrived, the rapid escalation of contractions left Elle struggling soon after. She had come prepared with information on acupressure and massage, and I began watching for signs of oncoming contractions in an effort to help ease the pain. We helped move her back and forth from the bed to the birthing ball for a long time while I alternately kneaded her lower back with my knuckles and knelt on the floor beside her to press the acupressure points on her feet, legs, and hands. A few hours must have passed this way, though I was mostly unaware of the time. It was deep into the middle of the night and my knees and back were aching and painful, but I was determined to ride out each and every contraction with her. Both her mom and mine offered to take over to give me a break, but I felt honored to do it. Taking care of the baby was not yet my job; there was nothing I could do for him. Caring for him was still Elle’s responsibility and privilege, and mine was to care for her.

It wasn’t long before the contractions started to come more quickly together, leaving Elle very little time to rest and recover between them. When she accepted an epidural despite her preference to go natural, I was worried she would regret it but also relieved. Watching someone suffer through the pain of labor for you is incredibly overwhelming. It is not easy. Even as we were there I felt it should be me in pain; I wished it was me.

Then, as we drew closer to morning, it became clear something was wrong. The machine monitoring the baby’s heart rate showed it dropping to dangerous levels, from around 150 bpm (good) down to the 80’s (not good), and later we even saw it fall to the 60’s (scary). Our nurse was on top of it, coming in to check when his heart rate dropped and continuing to closely monitor the readings when it seemed to stabilize. Every time she came in the room a spasm of fear would grip me, but I tried not to let myself get swept away by it. I didn’t want to upset Elle and I didn’t know enough to fully understand what was going on or how close we were coming to needing intervention. We tried to have Elle reposition her body during contractions to see if it would help– I’d watch his heart rate and nod to her when it was okay or shake my head when she needed to move again. Unfortunately, it didn’t make enough of a difference. He was in distress and it was decided that our doctor needed to be contacted.

I’m sure the very real possibility of an emergency c-section was on all our minds, but no one said it out loud. Of course, the health of Elle and the baby was the most important thing, but if our doctor felt this was a necessary course of action, it would change a lot. We had been warned by the agency that we were unlikely to be admitted to the room in the case of a c-section. Usually only one person is allowed, and that person would be Elle’s husband, meaning that we would not be there for the birth of our child. Elle also strongly preferred not to have one since it would mean a much longer and more difficult recovery time as well as a significant delay in returning to work. But all of that was out of our control; there was nothing we could do now but wait.

A little while after 4am we stood out in the hall when our nurse came in to check dilation. We heard her say it was 7cm when all of a sudden, people started coming down the hall toward our room. Walking back in we heard them telling Elle that even though she wasn’t fully dilated, they wanted her to start pushing and that the baby needed to come out now.

We had arranged with our original OBGYN that I would “catch” the baby during delivery once the head and shoulders were free. When we got to the hospital, our nurse asked the on-call doctor if she’d be willing to let me assist as planned and she had agreed. Now I was being told I needed to suit up immediately and a nurse nearby yelled for someone to grab me disposable scrubs. I stood with my knees literally shaking while they dressed me, wondering why on earth I had ever wanted to do this and wishing I had never asked. At some point in the chaos the doctor had arrived, and as she was getting suited up next to me, she carefully (and sternly) warned me that newborns are very slippery. “The last thing I want to do is drop him!” I managed to squeak out, and she must have been satisfied by my sincerity because she didn’t question me again in regards to catching him.

Elle now had an oxygen mask, her body had started involuntarily shaking, and she was being prepped for delivery at the same time as me. Her husband stood by her side toward the end of the bed, our nurse stood on her other side, and a stool was brought for me to sit slightly out of the way until they were ready for me. The mood in the room was intense, pressing, urgent. For such a large space, there was almost no room to stand due to the sheer number of people there. Some stood by the door, some were ready by the infant warming bed, others were crowded toward the back of the room and around the bed with various tools. My mom stood to the side with the camera while Kyle stood slightly behind a nurse where he could “see everything [he] wanted to and nothing [he] didn’t.”

I sat there, stiff and unmoving after being warned that I wasn’t allowed to touch anything (for sterile purposes). My nose itched and I willed myself not to think about it. The paper scrubs were so large I worried that I might slip off the stool and cause a ridiculous scene at the end of the bed. My feet had been covered in enormous paper socks when someone noticed that I wasn’t wearing shoes. Only part of my brain seemed to be working. Part of me understood there was significant risk to the baby’s health, but rather than processing that normally, I went in to a bit of a shock. I don’t know if I was breathing regularly– or at all. I just went on autopilot. It could have been 10 hours, 10 minutes, or 10 seconds that Elle pushed, but time lost its relevance to me.

Unfortunately, progress was slower than the doctor hoped and I watched as she assessed the situation and made decisions. A vacuum extractor was called for and she quickly explained to me that my baby would come out with a bubble on his head. I nodded my understanding, caring only that he was safe and breathing. The vacuum was suctioned to his head and with each contraction and the additional help of Elle’s pushing, the doctor held on and worked to guide him further down as he came out at a strange angle. Eventually we started to see the progression as he began to move closer to us.

And then his head started to appear. I could see his hair. That’s my son, I remember thinking to myself. He’s mine. The entire room fell away. All I could focus on was him.

It was then that the doctor’s voice cut through my reverie–

“I need you to stop pushing,” she said firmly. “The cord is wrapped around his neck.” Somewhere in my head, two separate thoughts bounced around: this isn’t good and that’s just like my Grandpa! [Ross’ namesake]. I watched as she worked to stretch the umbilical cord up and away from him. It had been wrapped so tightly that I couldn’t even see it from my vantage point and she seemed to barely be able to pull it over his face.

And then, “Hold on– one more.” For the second time I watched her pull the cord up and slide it over his head to free him. I was still holding my breath when she called out, “And again!” before removing another tight section of cord from around his neck. “That’s three times, everyone!”she called out to the mass of people in the room.

By then I could see his eyes, nose, and mouth. The doctor had me stand up as she prepared to deliver his shoulders and showed me where to place my hands around his head. I held on to him as she helped to work him free and suddenly he was simply there, in my arms. I will never forget that moment, staring down at him. I watched him make only the slightest movement and took in his blue-gray color while somewhere in my head I thought, He’s not making any noise. I had been told to bring him immediately over to the warming bed once he was delivered but might still be standing there even now if the doctor hadn’t urgently yelled out, “Make way for her!” to the collection of people around us. I jolted into action at her booming instruction and it took every ounce of energy I had to focus on not tripping over my ridiculously large socks and scrubs. Gently, I laid him down on the bed as he made the tiniest of noises– it sounded just like “hello“– and from somewhere in the room I heard Elle’s mom exclaim, “Did you hear that? He just said hello!” I took one last look at my baby as I stepped back and was replaced by those who would help him breathe and make sure he was stable.

I felt terrified and helpless, but there was nothing I could do beyond trusting that he would be okay. I leaned back into Kyle while we waited and tried to remember how to stay upright– and breathe. It seemed like forever before we heard him cry, and when we finally did, it was the most wonderful sound I’d ever heard in my life and relief flooded over me.

---

 

Because this post has gotten so long, I’m going to separate it with the second part going up (hopefully) tomorrow where I’ll talk about being able to really hold Ross for the first time, seeing Elle and her husband with him, how our situation was handled by the birthing center staff post-delivery, and lots more pictures, including the first of Elle on the blog.

I do have more photos of the actual delivery, including my part in it, but since Ross is unable to consent to me posting these private photos of him, they will stay in our photo album for now. 🙂

For Part Two: The Best Day of My Life: A Surrogate Birth Story

 

Why Us?

A year ago today we saw Ross as an embryo for the first time via a live video feed from the adjacent embryology lab. Moments later he was loaded into a catheter and we held our collective breath as he was ceremoniously carried into the room for transfer. In the past twelve months, the photo of him as a microscopic ball of cells has only left our fridge temporarily between moves and an appliance upgrade. Sometimes I hold him up in front of that photo of himself and tell him how special he is, how most babies are completely unknown prior to their implantation whereas he was already so deeply loved. Sometimes I still stop to stare at it and reflect on how such a big miracle sprang from such a tiny beginning.

Why us?

It’s a question I’ve asked myself countless times over the last several years. Why did we have to suffer from infertility? Why did we have to endure so much loss? Why did we have to fight so hard for what comes naturally to everyone else?

Once Ross was here I thought I’d stop asking that question, but I haven’t. The same query still runs through my mind, but now the reasons are different: why did we get to have a child? Why was our treatment successful? Why did we get to move on when there are others who have waited longer, lost more? I still don’t have any answers, but I know that it was not because we were the most deserving. I’m sure there are many couples who are more deserving than us. We also weren’t the ones who prayed the most, cried the most, or hoped the most. We weren’t the ones who made the best choices or worked the hardest. For some reason I don’t understand, we just got lucky. And for some reason I don’t understand, others are still suffering.

Last year our embryo transfer happened to fall two days before Mother’s Day. That Sunday became part of our two week wait, and for the first time ever I felt able to make my excuses and spend the holiday struggling privately at home instead of publicly in a restaurant. For so long it had been one of the most painful days of the year, one I began to dread as the failed months and then years stacked up against us and I learned that my body would never be capable of carrying a child. Year after year I’d close my eyes before walking by the pink card aisles at Target, I’d change the channel at each emotional commercial, I’d avoid Facebook at all costs with its endless stream of mom-and-baby photos. Year after year I felt lost in the fray and forgotten in my pain.

As we waited and wondered whether we would ever be given the privilege of having a child, I promised myself I would never forget that not everyone is celebrating on this day. I would never forget that simply being a mother is an incredible gift.

This year my life is different, but I haven’t forgotten that there are so many still hurting. Maybe they are battling infertility or have lost their child(ren); maybe they have had to say goodbye to their own mothers, as Kyle has this past year. I’ve thought about each of you today. You haven’t been forgotten.