A Transfer for Christmas

Holy buckets: December was pure insanity in this stork household! My last post was just a week into cycle meds and only 2 weeks before our date with sun and sand. I promise that I didn't stow away in some beach villa in the Caribbean, although now that I think about it...

The last week of November brought great news on the stork front. I had my baseline monitoring appointment to ensure that the Lupron was doing it's job before we started adding Estrace to the mix. The ultrasound showed a nice thin lining of 4.7 mm and two quiet ovaries. The amount of relief I experienced from those ovaries being quiet was immeasurable. Able to breathe easy again, I headed back to the daily grind with a little more estrogen in my system and a vacation on the horizon.

The week before vacation got a bit harried at work. I had a project that HAD to move forward before I left for a week, but the stars seemed aligned against it. I pulled every string I could get my hands on, threw my minuscule, low-ranking scientist weight around, begged those that would listen, and miraculously managed to get things moving at the very last second. I was full of profuse appreciation to the technicians on our team, and overfilled with TUMS from the heartburn of trying to pull it all together. With the project all safely tucked in for the week, Scott and I took off for a land of no cell phone reception or internet connections.

On the morning of our departure, we received a notification that the ship was delayed coming into port due to heavy fog. We took this as a sign that we needed to do more pre-vacation shopping and proceeded to buy entirely new vacation wardrobes. I couldn't help myself - all of the beachwear was calling out to me from under the flashing "CLEARANCE" signs in each of the stores we ventured into. Armed with our now overly-stuffed luggage, we boarded the ship in the late afternoon and promptly located a fruity drink.

At this point, I would love to tell you that we had a whimsical, care-free vacation over the subsequent 6 days, but that would be a lie. There were many wonderful moments, but the medication wasn't very friendly to me on the trip. I spent most of it feeling very nauseous, and at times, extraordinarily emotional. No one really wants their vacation to be outlined in fluctuations of feeling irrational frustration and hyperventilated sobbing. Lesson learned: I will avoid scheduling future vacations during periods of cycle medications. Just to be safe, I'll probably add two postpartum months to that list as well.

The day we arrived home, I had my second (final) monitoring appointment to see how my lining was doing at thickening up to receive the stork babe, make sure the ovaries were still behaving, and to check my hormone levels before starting PIO shots. Again, we received great news: my lining was perfect at 12-14 mm thick with a distinct triple stripe and two quiet ovaries. My hormones looked great as well, so I started PIO shots on the 14th. With only 5 short days to our transfer on the 19th, I wrapped up the last of my research tasks for the year(!) and headed out to TransferCity on the evening of the 18th.

This transfer was much different than the first: In August, we were doing a fresh transfer on day 6 (a Tuesday) while waiting for PGD results to come back on the embryos. The PGD results were delayed causing the transfer to be delayed into the evening, and the middle of the week schedule meant that I would be heading back to HomeTown and work the next afternoon. This time, we transferred a frozen embryo on a Friday, which meant an extra day and a half of relaxation in TransferCity before the long drive home. The transfer went perfectly, and the embryo looked fantastic. Everyone was impressed with how the embryo looked, and by mid-afternoon I was back in my hotel watching a movie and letting the little bean get settled in.

Now that we've done two transfers, I'm starting to get a handle on what to expect. In the weeks leading up to transfer, I have mild nausea, lets call it a 4/5. On transfer day, they put that lively little bean in there and somewhere around 6-8 hours later, we're at an 8 - the serious puking begins, heartburn ensues with any food that has flavor, and I'm so exhausted that I can fall asleep in mid-sentence. This was somewhat more intense following this transfer, so no one was surprised when we ended up with a nice solid positive line on the home pregnancy test 4 days after the transfer.

 For fun I did another one the next day too, which popped up noticeably darker as you can see. Day 6, the day after Christmas, brought our first beta hcg blood test with a nice solid result of 71 mIU/ml. On the 7th day after the transfer, we packed up the kids and went to a family Christmas party. I told Scott that I was starting to feel less nauseous and less fatigued, and that worried me a bit. Day 9 was Monday, the 29th, and our second beta hcg which yielded a result of 140 mIU/ml. Ideally, with a doubling time of 48 hours, we would have been looking for the result to be about 210, but some embryos have lulls and bursts in their development, so the clinic called me back for another test on the 31st to track how the bean was growing. The result was 70 mIU/ml - devastating. It seemed even worse that we were headed to the last family party that day, all the kids were gathered around closely and enjoying the holidays, so I didn't really have much for a quiet space to just feel bad about it. When the nurse called, I let a few tears out while I talked to her, but then quickly pulled it back together. I could only imagine how heartbroken and defeated Ellie and Matt would be when she called them.

It's now been 5 days since that call. The reality has sunken in: We have two failed transfers with two PGD normal embryos, and there are no more frozen embryos. I don't know what Ellie and Matt are considering, and I don't know if the RE is planning to do anything differently to try to find success moving forward. I'm sad and frustrated and worried. I want nothing more than a successful pregnancy for Ellie and Matt. I'm hoping that our clinic will give us something to hang our hope on.

Decisions and Planning

Another month has come and gone, with little-to-no activity in the stork department. Ellie and Matt decided that they would like to skip November as a transfer month and set their sights on December instead. I had mixed feelings about it initially, knowing that December is a notoriously busy month at work, and not wanting to delay the process even further. However, the break from the medications has been wonderful, and as an added bonus, my December projects have been delayed to January. So it looks like a December transfer is going to be ideal, especially in light of the IVF clinic scheduling the transfer on a Friday. That will give me an extra two days to hang out in TransferCity and let the little bean snuggle into a cozy spot for the next several months. In hindsight, I'm really glad that Ellie and Matt decided to wait, and that I was able to step away from the shots and calendars and counting of days. Fertility processes can make a person crazy. I've officially had 5.5 weeks off and now the December transfer is looming on the horizon.

I called the pharmacy and the monitoring clinic this week to ensure that our medications and monitoring appointments are all in place. The shipment from the pharmacy will arrive today and I'll start Lupron injections in just over a week. I'll have two monitoring appointments leading up to a December 19 transfer of the one precious embryo that Matt and Ellie have on ice. If all goes well, this little storkie will have a due date of September 5, which will likely result in a delivery within a week of my birthday and Scott's birthday. A birthday week delivery would be all the more exciting and special.

So what have I been up to in all of my stork-downtime, you ask? That's a great question! A month of free time can be dangerous for an overachiever/perfectionist type like me, and it happens to have come at a time when I am not very pleased with my current employer. To give you a little more insight, I came to my profession by way of avoiding the professional course that my family wanted me to take.

In undergrad, I dutifully fulfilled the requirements of my BS as well as the pre-requisites of the professional school that I was expected to attend. The thought of being mentally beat down for another 4 years didn't seem appealing to me when I graduated, so I took a break, got married and had a baby. It seemed like a good time to fit those details in, but the naive 22 year old that I was had NO idea what kind of life chaos that baby would bring! I worked a good job, stressed constantly about juggling the baby and work, and tried to engage my emotionally MIA partner at the same time. Life was hard, my husband was growing more angry and violent by the week, and I knew that it was time to get back to school to finish my education to be able to adequately provide all of the things that I had dreamed of for my sweet little. I also knew that I still didn't want to go to the professional school that I was being pushed toward, so I applied to grad school halfway across the country. It was a top ranked program in a field that seemed like it would be a great fit. Two years into it, I had an MS, my husband seemed to have found his mind that he lost around the time the little was born, and it was an easy decision to keep going into the PhD program. Oh, and while the sailing was smooth, it seemed like a good time to add another little to the group.

I was about 3 months pregnant when husband again lost his mind. Family seemed like an overwhelming proposition, while friends and drinking and all-night activities seemed like great fun. Old habits reemerged, new habits formed, life was hard and I was gestating a fetus on top of it all. By the time another 3 years had passed, I was at the end of my program (ABD), had an unpleasant divorce under my belt, was single-parenting two littles, and had an ex-husband that was actively evading payment of any child support. I took a teaching position at a university that I really enjoyed, but alas, adjunct-style teaching doesn't go very far in paying the bills. The other side of doctoral work is research, which comes with a much greater salary. I was still pretty shell-shocked from grad school though, so I wasn't sure if I hated academia, or just needed some time away to love it again. In the meantime, I had a great offer from a research institute at my previous university that involved no academics, just research. I thought it would be a great opportunity to fall in love with research again, and allow my aspirations of greatness to blossom. I've now been at the research institute for about a year and a half.

The first year of research was truly amazing. I settled into a position where I was able to soar and achieve great feats. I worked closely with the director of the facility, and he quickly became a trusted mentor. He laid out a two year plan that would catapult my career, and I couldn't have been more ecstatic to be here and doing this work. Suddenly, at the end of my first year, he had to leave to follow his wife's career across the country. I couldn't blame him; when I looked at the aspirations of greatness that I had for myself, his wife is a total embodiment of that vision, 25 years into my future. The rest of the administration worked hard to alleviate everyone's concerns, a new director was appointed, and research was still being done. However, things have not gone well under the new director. He has run off all but one of our lead scientists and only shows up to the office for about 5 hours per week. He has no intention of hiring new scientists, so our institute is on the brink of major collapse. The rest of the administration is either turning a blind-eye because they don't want to deal with it, or pursuing a self-benefiting agenda which is an added insult to the demise of the unit. All of this has led me to a place of unhappiness which has resulted in a great amount of reflection in an effort to decide what I'm going to do next.

Logic would hold that I schedule my dissertation defense and find a different position in teaching or research. While wrapping up the degree is on the schedule for the coming months, I have yet to find an area of this career that I enjoy. Instead, I have found that my happiness in it is limited to positions where I have outstanding mentorship, and mentors like Former Director are few and VERY far between. I also have a close friend here that is a projection of me in 10 years (scientist with aspirations of greatness), and I can't say that I like what I see. She is brilliant, funny, and has found ways to somewhat cope with the stress of this career, but it's always lurking just under the surface. Former Director's wife took off for a different position for the same reason; trying to find a place of peace in this field of work. No doubt running from one stress vortex into the arms of another. That's when it hit me: The struggles that I have in my career today are not resolved 10 or 25 years down the road. The things I hate will not get better. So with that in mind, I've decided on a career change, and I've spent the past month pulling together everything that I need to get started on that track. As I said, a month of free time can be dangerous for an overachiever/perfectionist.

Houston, We Have a Problem

As you may have guessed from my estradiol-induced grumpiness in my last post, Matt and Ellie decided to go ahead with the October transfer, so meds were started on September 16. I was very happy to hear from the nurse coordinator that we would not have to do Lupron in this cycle because it's a frozen transfer and we are starting so close to my own cycle day 1. I quickly learned that Estrace alone with no Lupron to balance it out did not love me. I have been irritable for the past 3 weeks straight - God bless Scott for putting up with me! But I can certainly put up with some irritability to get to our transfer and find the success that we've been waiting for in this stork adventure.

My first monitoring appointment to gather baseline information was on September 15. Ideally, we want to see a somewhat thin lining (2-5 mm) and little or no ovarian activity. My baseline for the August transfer was perfect, so I was hoping to hear the same at this one. Unfortunately, the ultrasound technician pointed out a follicle on my left ovary that was developing quite well, already 13 mm. A mature follicle will ovulate when it's grown to somewhere between 20-30 mm, so this one was well on it's way. As I've said before, this is a problem because we want to make sure that Matt and Ellie's bun is the only one baking in this oven. The number one rule of being the stork and not the mommy: DO NOT OVULATE (unless you do natural cycles and are into that kind of thing). The RE looked over the lab results later in the day, noted that the follicle wasn't producing high-enough amounts of estrogen on its own, and reassured me that the high-dose estradiol would stop that little booger from getting any bigger. So, like the first round, we all kept busy with work and kids while the days passed.

My final monitoring appointment before transfer was on October 1. Ideally, we would like to see a thick lining (8-12 mm) and little or no ovarian activity. However, based on the previous ultrasound, I knew that we would have some ovarian activity, so we hoped for at least no growth. I watched intently as the ultrasound technician did the lining measurements: 7.74 mm. Hmm, that isn't quite what we were looking for. Although she rounded it to 8 mm, my final lining check before the August transfer was 10.24 mm, so this one is considerably less, and borderline for what the RE wants prior to transfer. She then panned over my right ovary; nothing there, as expected, so on to the left one. I literally held my breath until she moved the transducer to the right spot, and the image was undeniable. She hadn't measured it yet, but that was one of the biggest follicles I've ever seen in real-time.
I started to ask questions so quickly that the words were getting jumbled. I knew that nothing good could come from this. It measured 25 mm, and she pointed out the haze on top of it that is indicative of imminent ovulation. So much for the estradiol stopping it from growing. Un-freaking-believable.

I called the nurse coordinator on my way out of the clinic to see what our options were. She didn't answer so I left her a message. I also sent Ellie an email of the findings. She had been worried about this exact scenario. We played arm-chair MD all morning and afternoon looking up all of the possibilities. We were both hoping that the RE would allow the follicle to ovulate and then transfer 5 days later in a quasi-natural transfer. I warned Scott about this; We have a live round in the chamber so he must not even make loving gestures in my general direction. When the nurse coordinator finally called back just before 5 pm, she told us that the RE had looked over the labs and found that my circulating hormone levels didn't match up with what they would expect for pre-ovulation, and that it was likely that the lining had already begun to breakdown. Not wanting to take any risks with the one embryo that Ellie and Matt have frozen, we had to cancel the October transfer and look ahead to the next opportunity. I stopped taking the estradiol that same day, and depending on when my cycle occurs naturally, we'll be able to put together a new medication plan for the next transfer. Without a doubt, the next one will include Lupron. That was the long, expensive, painful lesson that we all learned with this round.

Hormones and Needles and Tests - Oh My!

We've put another six weeks of the stork adventure under our belt, which was full of injections, pills, and anxious waiting. Of all of the parts of the process to date, this has been the most active in a day-to-day sense. From they day we left off of the last post, I've been on a constantly changing regimen of leuprorelin (Lupron), estradiol (Estrace), and progesterone in oil (PIO).

Now I'll be the first to admit that I can be a little OCD sometimes, and I take far too much pride in accurately following directions and doing a good job. But this ever-changing menagerie of dosages and drug combinations over a 4-week period is enough to make my head spin, and my subconscious constantly wonder if I took the right medications at the right time. To calm my inner Monica Geller, I found this nifty little pill organizer on Amazon, filled it with my oral medications for the upcoming week, then put dummy markers in each appropriate slot to remind me to do an injection on that day and time. The over-achiever in me beamed with pride.

It's probably time to address the elephant in the room: "How bad are the injections... really?" The Lupron was in a small insulin syringe with a tiny little needle (the small one in the picture). As long as the needle isn't dull in any way, you really don't feel it going in, and I really didn't feel the Lupron dispersing for the most part. The tough part about the Lupron injections is watching myself stab it into the skin. Even in the last few days of doing those, I would catch myself hesitating, hovering over the pinched skin, and have to talk myself into it. So all in all, the Lupron injections weren't terrible. The Lupron side-effects, on the other hand, were not as kind. I started with 10 units per day, and within a few days I had hot flashes and a slight headache. After a week, I was in a full-on battle against the INSANE weight gain, and I was noticeably slower in my thought processes. Lupron seriously made me dumber. By the time I stepped down to 5 units, I was in a hate-hate relationship with the drug, and threw myself a little party on the last day that I had to take it. That happened to also be the first day that I took the infamous PIO.

PIO gets a bad rap in the IVF world because it comes with (comparatively) HUGE needles, has to be delivered deep into the muscle, and is in oil - not a great solution for dispersion into the muscle. I read some great tips online from other IVFers before attempting any of the PIOs, and my dear, sweet husband, Scott, watched some very helpful YouTube videos with some professional tips. As most people recommend, I warmed the oil in the syringe to help it disperse once it's injected.

Buzzy Injection Pain Blocker

I also applied ice and vibration to the injection site for about 15 minutes. Ellie and Matt purchased a Buzzy for me to help with this part, for which I love them dearly! The rest of the work is Scott's to deal with. I place myself face down, he finds the right spot on my tush/hip, delivers the medication and does a wonderful job of massaging the area with the heating pad afterward. I've concluded that this is true love; someone that is happy and willing to rub my bum to keep it from hurting me the next day. What a catch. :)

Not all injections go according to plan, or with the luxuries of home, however. Shortly after starting the PIO, Scott and I had to attend an evening dinner party out of town, and we didn't have time to stop at the hotel to do the PIO injection first. Instead, I found myself with my pants dropped in the backseat of his pickup, because, well, you gotta do what you gotta do. While slightly more painful without ice or heat, Scott still did a great job, and I didn't end up with a bruise or a lump afterward. In fact, the only lump and bruise that I've gotten from the PIO injections came at the hands of our IVF nurse immediately following the transfer. Scott wasn't able to go with me, so she did the injection before I left the clinic that night. I knew it was going badly when I felt her pinch the skin instead of pulling it taut, and again at the end when she said "Wait here and hold very still. It's bleeding quite a bit, so I'm going to grab some tissue and a band-aid." I was thinking "BLEEDING??? Scott never makes me bleed!?" As I type, some 15 days later, I can still feel the distinct lump from that injection. If ever in that situation again, I think I'll take my chances and do the PIO on myself.

Did someone say "transfer"?? Ah yes, there was that exciting little event stuck in there in addition to all of the medication fun. :)  In fact, Matt and Ellie flew into town early in August to prepare for Ellie's egg retrieval. As we went through August, she had multiple visits to the clinic to check on her egg production progress, and I had two visits to ensure that the oven was fully pre-heated and ready to bake a sweet little bun. All of our appointments went great, and by the day of Ellie's retrieval, we were getting good news left and right. The RE ended up retrieving 9 eggs, 8 of which were mature, and all 8 fertilized into embryos through intracytoplasmic sperm injection (ICSI). We continued to be encouraged by day 3 when we learned that 6 of the 8 were still doing well.

On day 5 there were 5 excellent embryos, so Matt and Ellie decided to do preimplantation genetic diagnosis (PGD), and we pushed the transfer back a day to allow results to come in. On day 6, I traveled to the clinic in my lucky green shirt and my shamrock socks. I arrived with a full bladder as instructed, and was informed that the PGD results were not in yet. So I settled into the waiting room, only to find that the other woman in the waiting room was also a gestational carrier waiting for PGD results in order to transfer. We struck up quite a conversation over the 2 hours that we waited, trying to ignore the pain of the bladders that were ready to explode. Finally the results came in, showing that Matt and Ellie had 2 normal embryos from the 5 tested; 1 boy and 1 girl. We proceeded with the transfer of the best looking embryo of the two, and froze the other one. Thus began our intense wait.

Four days after the transfer I took a home pregnancy test, but nothing showed up. I retested on the fifth day after transfer and there was a faint second line - woohoo! Ellie and Matt were very encouraged to hear the news, while I was working hard to hold down my breakfast each day. Day 6 post-transfer brought the same faint second line, which made me a bit nervous. I was expecting it to get darker, but, as you all know, patience isn't my forte, so I chalked it up to being over-anxious to see progress. I tested again the next day, knowing that on the 8th day after the transfer we would have our first beta HCG blood test. The line was exactly the same as the previous two days, and as the day wore on, I felt less nausea than I had in over a week. I reported everything I knew to Ellie and Matt, so we were all cautiously optimistic going into the blood test. When the clinic called with the results of the blood test, it was only 2 mIU/ml, which is barely pregnant. If the pregnancy was viable, it should be have been above the single digits, so the clinic told me to stop all medications and allow my body to reset for a new cycle. Of course, Ellie and Matt were heartbroken, and I found myself in a combination of sad and mad at no one in particular. I was mad that we had all done so much work, did everything "right", received great news at every check point, and transferred a PGD normal embryo, only to have a failure on our hands. How does that happen!?!? The question is rhetorical of course, but that was the level of frustration that I had reached. I went home to tuck all of my medications and IVF supplies away in the closet, and found that Scott had brought me sushi, my favorite amber ale, and espresso ice cream to help me feel better. Have I mentioned that he's quite a catch? So Matt, Ellie, and I decided to Skype a few days later to discuss what happened and start to plan our next step. Based on our clinic's schedule, our options will be to transfer the one remaining frozen embryo in early October or mid-December. Regardless of which date is chosen, may the fertility odds be ever in our favor.

To Be or Not To Be

That is the question on this very important day. Today is July 23rd; the last business day before July 24th, the all-important first day of cycle medications. This is the day that all paperwork must be completed by in order to be on schedule for the transfer on August 26. For all of you out there making bets on whether it would really get done and signed in time, the final answer is.... kind of.

A full 9 days ago, I optimistically hoped it would be done in 48 hours... and then the gods laughed and laughed and laughed. It was a week of little to no news, pacing, nail biting, calendar watching stress. The nurse coordinator from the IVF clinic emailed me yesterday nervously asking if it was done yet, and I passed along the anxiety in kind to my attorney to see if she had heard anything from Ellie and Matt's attorney yet. While there was no official response, the nurse coordinator went ahead with sending the medications, and we all slept uneasily on it for another night. This morning I received a somewhat panicked email from Ellie and Matt that they had received the final version of the contract and were ready to sign it, but the one and only representative from the surrogacy agency that has to witness their signing and notarize the contract, unexpectedly went out of town and won't be back until Monday the 28th. Did I mention that dealing with this agency makes my teeth itch? Regardless, we have the finished contract in hand, and that's a win all on it's own. In the meantime, Ellie and I came up with a plan where my husband and I will sign and notarize the contract today, send it back to the attorneys this afternoon, and then Ellie and Matt will have it in their possession while waiting on the agency rep to return, allowing them to execute their portion. This was agreeable to the nurse coordinator in terms of starting the medications tomorrow and will keep us on schedule. As I said 23 days ago: coo coo cachoo, we have a completed contract... kind of.

Now comes the fun (?) part. I'll be giving myself an injection of Lupron in the abdomen once per day starting tomorrow for the next 28 days. I've rationalized that it's a tiny little insulin needle, and I've built up a nice "protective layer" over my abs, so this shouldn't hurt a bit. I'll let you know how that goes. The Lupron is very important though, as it will quiet my ovaries and prevent me from releasing an egg of my own during this process. We want to be VERY sure that the only little storkie in this adventure is Ellie and Matt's! So tomorrow is day 1, the beginning of an exciting and highly anticipated stork adventure. Let's do it!

Don't Stop... Believin'...

I'm tired. Exhausted, really. It seems crazy; the process hasn't even really begun yet, but I'm totally wiped out. My work schedule has been particularly hectic in the past 6 weeks, and the paperwork of the stork adventure has continued to steadily roll in. I keep remembering how tired I get in the first trimester of pregnancy and thinking that I can't imagine adding that onto how worn out I am at this point. Luckily, the projects I have at work are dwindling down again, and we're close to the summit of Mt. Paper-manjaro, so hopefully I'll be able to catch up on some rest before I start incubating the storkie.

Here we are, two weeks since my last post, and we don't yet have a signed contract in place. That sweet, 10-day cushion that I boasted about is wearing a wee bit thin, but it looks like we're on the brink of success. Ellie, Matt and I have been through the first draft of the gestational agreement, conferences (very. long. conferences.) with our respective attorneys, and a fun little game of 'telephone' between our attorneys. I think we're lucky: We had a great foundation to our relationship before the attorneys were involved, and we worked through every contractual point that we could think of before sending it over for the attorney to draft. Still, the process has been mind-numbingly tedious. I can't even begin to imagine what it must be like for intended parents and surrogates that have had very little communication. Needless to say, we're looking forward to applying some ink to those pages and putting this part of the process behind us. I'm cautiously optimistic that we'll be doing just that in the next 48 hours. I mean, really: Have my time estimates ever been wrong during this process? Wait... nevermind, don't answer that.

Rules of Engagement

It's been quite some time since my last update, but as things go in a stork adventure, there's a lot of slow and tedious work to do be done up front. I look forward to the entries that will tell you all about how the little storkie is growing and moving, kicking up a storm, and demanding bizarre treats at all hours of the day and night. With patience we will get there, but today it's all about contracts and legal procedure.

When we left off a month ago, Ellie and Matt had sent our contractual plans to the CFO of the agency, and we all waited for a contract draft to come our way. I can't speak for Ellie and Matt, but I had a great amount of patience in the first two weeks. Early on in the process, one of the agency directors had mentioned that the typical timeline of the contract phase was 2 weeks to draft the document, and 2-4 weeks of conferring with attorneys while requested changes are made and sent to each others' attorneys for review and further conference. Seems reasonable. So by week 3 I was starting to wonder how things were going (not that I would dare to check in with the agency!). I was counting weeks and days left until July 23 - the day that the contract has to be signed and notarized by all parties, in order to do the transfer on the date scheduled in August - and trying to not get impatient. Ellie emailed me at the 3 week point with great news: The draft would be sent to her within the next 3-5 days. We both went back to our day to day activities while we waited, and we were both completely swamped at work; sufficiently distracted. Five days later, Ellie's attorney contacted her to say that it would be another 4 days before the draft would be done, so back to the distraction of work we went. Life was bustling for both Ellie and I; besides work, all of my kids were out of school and in the full swing of summer activities. We can't even sit down for 10 minutes at our house without having to run out the door to the next activity. Again, it's nice to not be hovering over my email inbox waiting for it to ping. However, when we passed the 4 week mark, and got to the (second) date that the attorney promised the draft and there was still no draft, I was starting to lose my patience. Ellie's attorney sent her a message saying that it would be done early the following week. When it finally arrived in Ellie's inbox (after 4 weeks and 5 days), I have to admit that her attorney did a great job. It was VERY thorough (75 pages!) and sufficiently accurate. After taking a few days to read it over and make comments, Ellie, Matt and I Skyped to discuss our comments and thoughts. We were all quite happy with how it turned out and had only a handful of minor changes, so they were able to send it back to their attorney at the end of last week.

As of today, we're in great shape to finish the contract in time for our target transfer date in August. My attorney should be receiving the completed contract today or tomorrow, we'll have a conference call to review it on Monday, and coo coo cachoo: we'll have a completed contract! This, a full 10 days before we are scheduled to start meds for the transfer. And you were worried that our 9 week lead time wouldn't be enough. Pssshh, we just like living that close to the edge.

So it's time to roll up our sleeves and get to work on the really exciting part of this adventure. Let's make some scientific magic happen! We need to get everything prepped with an impressive, month-long medication protocol involving lupron, estrogen, and progesterone. The countdown is on: 24 days to the first injection. Did I mention that I'm needle-phobic?? I'll be back to let you all know how this goes.

The Nightmare on Agency Street

What a very interesting few weeks it has been since my last check in here. After many more emails and Skype conversations with Ellie and Matt, I can confirm that they are outstanding people, and will be wonderful parents. I really look forward to the opportunities that we have to talk and catch up on how things are going in each other's lives. We are all starting to do the mental projections of time, how pregnant we will be when the next holiday rolls around, or what we'll do the next time that they come to town. It's all very exciting. What's not so exciting is all of the tedious red-tape that has transpired in the past few weeks, and we are very much looking forward to that part being over. As I left off of my last post, I surmised that we would have navigated the jungle of paperwork and be looking at some dates on the calendar for the IVF transfer. The great news is that we have a target transfer date - August 26. I'm thrilled about this, and even have my calendar of medications that will be introduced, ramped up, phased out, etc. as we approach the transfer date. I met with the parents' reproductive endocrinologist (RE) last Friday, contributed 5 vials of blood and a cup of urine, did an ultrasound of my uterus, and went on a magic school bus ride into my uterus to ensure that baby will find the accommodations acceptable. The RE determined that my uterine lining was a little over 10 mm, which is fantastic given that we were shooting for 8 mm or more. Moments after cheering about exceeding our lining goal, the full force of the 20 ml of saline that was injected into my uterus hit me. As the wickedly funny RE noted: That can be a real humdinger. I'm here to confirm his assessment: It was, indeed, a real humdinger. But, alas, everything went splendidly and looked great for the incubation of stork baby. Great news for our goals and the timeline that we have planned. We'll spend the next several weeks finishing up the contract, and I should start the first medication on July 24.

The less pleasant news comes from the jungle of paperwork, and the agency on the other side of that jungle. As you may recall from my previous entries, I started out on this adventure with an agency I really liked, and ventured into some independent communications in order to find the best possible match. When I found that match in Ellie and Matt, I had to make a decision between sticking with the agency that I had been working with or going over to the agency that Ellie and Matt had contracted. I felt like it was asking too much of them to switch to my agency, given the amount of money that they already had invested in deposits and fees with their agency. So as I dove into that jungle of paperwork, part of the enormity of it was in catching up on the information and documentation that they normally would have had pre-match, had I been working with them from the beginning. Although there was a lot of paperwork, Ellie and I had hoped that it would move quickly because the match had already been made, and a lot of the agency's work had been done for them. We would later find out that it did not come as a relief to them to do less matching work, but more of an insult, as you'll see.

We spent the first couple of weeks pulling basic items together like the application, consent forms for medical records release, an agency-surrogate agreement, information for background checks for my husband and I, and setting up the psychological evaluation. As the days passed, I checked in regularly with the co-director of the agency to ensure that everything was progressing in order to stay on target for the August transfer that we were shooting for. I was a little nervous when I found out after a couple of check-ins that the medical records hadn't been requested, and that they were expecting me to request them. But once I found out, I jumped on it, and got the requests faxed over to the clinics and hospitals.  I was also assigned a surrogate coordinator who contacted me to welcome me to the agency family. She was very sweet and bubbly, however, in her second email she made a statement alluding to a situation with my intended parents that didn't have a positive outcome. I was very uneasy about her sharing the information that I thought should come to me from Ellie and Matt, if they chose to share. I decided to avoid any further communication with her, as it seemed like it would only be filled with drama. At a later point in time, in one of our Skype calls, Ellie and Matt did share with me what had happened, and it certainly was not as big of a deal as was alluded to in the email. So we continued to move forward with our to-do list.

My husband and I had a great conversation with the psychologist that did the evaluation, and then we waited. About a week later, I checked in with the co-director to see if all of the records were in, the psychological evaluation results were in, and the background checks were complete. She said that everything was going fine. After another week passed, I got a call from one of the clinics that they hadn't sent my records yet, but were going to the next business day, so I checked in again to see where each of those items were in the process. The co-director responded that everything was fine and that I didn't need to worry about it, but I was a bit nervous about our timeline, given that one of the medical records hadn't been sent yet. I emailed back to say that I was frustrated because I hoping for a status update for each of the items to ensure that we stay on track for our timeline, and that a phone call may help to clear the air. I did receive a phone call, but it did not bring the progress that I was hoping for. She was defensive and demanding, so we came to a common ground and found a quick end to the conversation. The next morning I received an email from the surrogate coordinator that I hadn't heard from in weeks, asking how I was doing with all of the waiting that is involved in surrogacy. Her email was quite obviously prompted by the co-director, so I was frank in my response, saying that everything seemed to be moving along well, and that my only obstacle was in getting information from the co-director. Little did I know what a storm of anger and hatred that would incite!

The tone of the emails from the co-directors of the agency.

The next morning I received an ugly email from the co-director stating that she had removed the coordinator from my case and that she would be doing all of the communicating with me, then she proceeded to chastise me for asking questions and telling the coordinator that she was not responding to the questions that I had previously asked. She suggested another phone call involving the other co-director and the CFO, which looked to me like a verbal flogging was headed my way. Now I'm not one to try to rock the boat, and in general, I work hard to make peace, even in the most difficult of communications, but I'm also not one to tolerate being talked down to or treated badly. So in my response, I noted that I didn't appreciate the tone of her email, that I found it unprofessional, and that I would be glad to have a conference call so long as it was focused on a positive and productive outcome and didn't further deteriorate the working relationship. After several scheduling emails were exchanged, the other co-director sent me an ugly email about my lack of availability and being, in her opinion, overly involved in the process. She included several thinly-veiled threats of refusing to allow me to work with Ellie and Matt. All throughout this flare up of negativity, I was in regular communication with Ellie and Matt, who were completely shocked. They were also confused because the agency was giving them very limited information as to what was transpiring. I forwarded the last email to them, copied the co-director and simply stated that I thought that it would be a good idea for all of us to discuss this together and openly to improve communications. I was met with an immediate response from the co-director stating that I had been terminated from their program. This came as quite a shock and surprise to Ellie and Matt, who were beyond frustrated and exhausted at this point. They wanted to find a way to move forward with me and the agency, and I suggested that we modify our communications such that I didn't want to be in contact with either of the co-directors. Some communication occurred between them and the agency, and I received an email from the co-director stating that Ellie and Matt wanted to continue working with me, so the agency would need a HIPAA authorization form signed in order to move forward.

At this point, I had zero trust in these women, and now she wanted me to sign a form stating that they would have full access to all of my medical information, past, present and future, and that the information gathered could be re-disclosed at will. I was pretty sure that the co-director was getting ready for an awesome witch hunt to find a way to prevent this process from going forward. I decided that I would make a couple of minor changes to the form that would limit the scope of the authorization to the medical situation at hand. I emailed the co-director to ask how she wanted changes made, and she responded by demanding to know what changes I wanted to make and why. In the mean time, she communicated to Ellie and Matt that she would no longer work with them if they continued to use me as their surrogate. As this was the day before my appointment with the RE, it was uncertain whether or not the medical check was actually going to happen. I made the decision to complete the authorization form without limitations in Ellie and Matt's names only, allowing them free access to the information, and sent it in. They were in financial discussions with the agency and emerged to tell me that they had found a way to move forward, and to plan on attending the appointment with the RE. As of last Friday, when I saw the RE, he relayed that he had received an email from the agency stating that they were no longer working with me, Ellie or Matt. He reassured me that we would be fine in working toward the August transfer, regardless of the agency's involvement, which was a huge relief for me as well as for Ellie and Matt.

In the 6 days that have passed since that appointment, I have been working closely with Ellie and Matt to finish the details of the contract, and they have passed them along to the CFO at the agency. It appears that the agency is working with Ellie and Matt to complete the legal and financial aspects of the process, and I've been able to remove myself from their line of fire. I hope that they continue to work toward the goal that Ellie and Matt have put in front of them and paid them for, and I'm truly optimistic that the worst of it is behind us. My final thought on the agency from hell is this: I now have an even greater appreciation for the kindness of the agency that I started with, and hope to work with them again in the future.

There are many stories of unfathomably terrible experiences in surrogacy, of which, this pales in comparison. For that reason, I fully expect to see much greater legal regulation of surrogacy in the not too distant future. Surrogacy is becoming more common in the U.S. and abroad, and is a relatively unregulated market here with an overabundance of financial transactions closely tied to emotional decision-making: A recipe for disaster. I wouldn't be surprised to see the U.S. adopt legislation similar to Canada that prevents surrogates from receiving money or gifts outside of intended parents paying for directly related pregnancy and delivery expenses. From an ethics standpoint, I think it's likely necessary to keep the surrogacy market from entering a tailspin of ugly experiences with money and greed at the core of the motivation.

Parents and Paperwork

Happy Easter! It was a wonderful and relaxing holiday in our home. It's been a few weeks since my last blog post, and as I promised, a parent decision has been made. After taking some time to consider all of the potential parents and communicating with them openly, the decision became very clear. The future parents, Ellie and Matt, are an international couple that, incidentally, share commonalities with me such as age, education, career and life ambitions. They have a wonderful sense of humor, and are open to the fun and excitement that lie ahead. Unfortunately, infertility can be fraught with devastation and disappointment to the point of creating anxiety-riddled pessimism in people that, otherwise, have very happy-go-lucky personalities. I consider myself extraordinarily lucky to have connected with a great set of future parents that are glowing with a beautiful inner light of optimism, eagerness, and enthusiasm. After weeks of emailing and a fantastic Skype conversation, I am elated to to be sharing this experience with them. I can't wait for the moment when the obstetrician hands them their goo-covered bundle of joy, and they realize that all of their efforts have culminated in this one moment of sheer bliss. To be honest, that's exactly what motivated to me to become a stork in the first place.

So here we are, at the precipice of a truly awe-inspiring, life altering experience, and it starts just like any other major undertaking: with paperwork. There are about 7,359 different forms to fill out or signatures to be gathered. Medical records from previous pregnancies and deliveries must be compiled and reviewed, an extensive questionnaire must be completed to assess my lifestyle and ideological viewpoints, and a background check and psychological evaluation must be completed (for good reason: If you're looking for some jaw-dropping, head-shaking, dumbfounding type of entertainment, check out some of the online advertisements and forum discussions regarding surrogacy). Once all of that information is pulled together and properly appraised, the IVF clinic will need additional paperwork to establish me as a patient, and then they'll schedule an appointment to collect copious amounts of blood and get a good long look at my girl bits. Upon clearing all of the red tape, we'll do some legal paperwork, and get down to the business of making a miracle happen. Hopefully, by my next update, we will have sorted through the jungle of documents, and have penciled out some dates for making the scientific magic happen.