Thanks, and Perspective

We want to thank everyone that has commented on the blog and sent personal messages of support.  It has meant so much to us that we are part of this wonderful community.  We realized that so many others have experienced more failures and losses, spent more years trying, and dug even deeper to find ways to continue, and this has given us perspective, and more importantly, inspiration.  I have been and still am surprised by how many hits the blog has had in just a few weeks, and understand that while not everyone blogs and comments, there are many out there who read the blogs to gain various views and insights on the process of surrogacy in India, particularly with our clinic, SCI.

Speaking of SCI, I wish to respond to "Anonymous" who commented on a recent post.  While my first reaction was to remove the comment, I ultimately did not want to censor any opinions I disagreed with nor assume the commenter's intention or agenda.  When we were researching surrogacy in India, we read news and personal accounts of scams, so we were sensitive to the issue.  The only way we could pursue surrogacy halfway around the world was if we felt we could genuinely trust and rely on the care of the doctor and clinic, since we were giving up so much control to them.  In the end, we visited the clinic and met with Dr. Shivani and her team, and our gut told us that we had made the right choice.  Besides, one needn't take our word for it--so many other personal blogs are also a testament to SCI, and that's one of the main reasons we chose them.  And having benefited from others' experiences, we decided to start a blog as well, to share our perspective and possibly help others in their journey.  So I wish to state in no uncertain terms: We have never felt we were taken advantage of or given false reports by SCI.  We have received nothing but the most professional and compassionate treatment from the case managers, staff and Dr. Shivani herself.

While we have felt deflated after this recent failed attempt, it has not diminished our desire to become dads.  We have posed some questions to Meg (another of SCI's case managers) and Dr. Shivani, that will allow us to decide how we move forward.  Once we get those answers, we'll be back to share them.  In the meantime, we appreciate everyone's continued interest and support.

 

 

"Hope for the best, plan for the worst"

Even when you expect the worst news, it's still shattering.

Despite having felt failure before, it cuts just as deep each time.  Maybe moreso because the previous wounds haven't healed wholly.

Though we kept our hopes from flying high, it's hard not to feel totally defeated.

Waiting

We were supposed to hear from SCI today, but this is the first time they have not emailed on the expected date.  With the 11.5 hour time difference between New Delhi and Dallas, the clinic is presently closed.  So we have to wait and keep our minds from racing.

It's hard not to dwell on the history of prior failures and speculate about the worst.  We received an email from SCI last week that made us realize we are actually on our fourth attempt.  You see, last month we started all over with a new donor, but when the eggs were collected and fertilized, the surrogate was not deemed suitable for transfer, so the cycle was cancelled.  There were no surrogates for back-up that could take her place, which was what had happened in the past.  So no 2WW, no pregnancy test with a BFN (big fat no), just upfront failure. 

Margarida, one of the excellent SCI case managers, explained that this happens in a few rare cases, and that had the transfer gone ahead, our chances of success would have been very poor.  We trust Dr. Shivani's judgment, and on the positive side, we did not lose our best quality embyos in the attempt.  But we were crushed that we did not get an attempt with a fresh cycle, since your odds are higher when the embryos do not have to undergo cyropreservation.  Unfortunately, all of our embryos had to be frozen and we would have to wait to try again.

So while we wait for news on this recent attempt, I figured we would share our embryology report.  Perhaps it will help other IP (intended parents) know what to expect.  Our 2WW is somewhat shorter, since this attempt was an FET (Frozen Embryo Transfer) where the previously frozen embryos were thawed and cultured to 5 days (counted from the time of fertilization), versus the usual 3 days for a fresh cycle.  Allowing the embryos to grow to this more advanced "blastocyst" stage can aid in selecting the best/strongest embryos for transfer.  However, when we were in New Delhi and asked her, Dr. Shivani was very clear that the best environment for the embryos was the womb, which makes perfect sense, so it's a risk to freeze and then culture to 5 days, since some of the embryos will not survive the thaw or will just fail to mature outside.   In our case, four embryos were thawed, and four (in various stages of development) were transferred.

The report uses the Gardner blastocyst grading system, which assigns 3 separate quality scores to each embryo:
     1. Blastocyst development stage - expansion and hatching status
     2. Inner cell mass (ICM) score, or quality
     3. Trophectoderm (TE) score, or quality

Pictures and information taken from the following website: http://www.advancedfertility.com/blastocystimages.htm

The inner cell mass (ICM) will become the fetus
The trophectoderm cells (TE) will form the placenta

 

So the embryo is given a number grade (1-6), followed by a letter grade for the inner cell mass and then the trophectoderm (A,B or C).

The expansion grade scale ranges from 1 (least expanded) to 6 (completely hatched).

     Grade 1: The fluid-filled cavity takes up less than half the space of the embryo.

     Grade 2: The fluid-filled cavity takes up more than half the space of the embryo.

     Grade 3: The blastocyst cavity has expanded into the entire volume of the embryo,

     pressing the trophectoderm cells up tightly against the inside of the zona.

     Grade 4: Expanded blastocyst, where the blastocyst has increased beyond the

     original volume and caused the zona pellucida “shell” to become super thin.

     Grade 5: Embryo has breached the zona and is hatching out of its shell

     Grade 6: Embryo is completely hatched.

For the inner cell mass:

     A: Many cells, tightly packed

     B: Several cells, loosely packed

     C: Very few cells

The trophectoderm grading goes like this:

     A: Many cells, forming a cohesive layer

     B: Few cells, forming a loose layer

     C: Very few large cells.



As noted in the report, laser assisted hatching was performed.  The zona pellucida "shell" surrounds embryos and the embryo must escape or "hatch" in order to implant in the wall of the uterus. Some embryos in which the shell is thickened or hardened make it difficult or impossible for the embryo to implant.  Assisted laser hatching uses a laser to create a hole in the shell to aid the embryo in the hatching process.  Apparently this is a safe procedure, and if it helps increase our chances, I'm all for it!

The report notes that our pregnancy (bHCG) test was to be performed today, 2/17/13.  Looking at the treatment summary, I'm worried that we only had two blastocysts.  The other two were slower developmentally, so I'm not hopeful they will grow/implant.  I know, everyone always says "you only need one!"  And I would prefer not to have to undergo a selective reduction for multiples, but in this case, isn't it better to have too many than not enough (or any at all)?

I hope the delay isn't an omen or due to an issue.  Realizing this is our fourth attempt and we are three-time losers, I'm much less optimistic than when I thought we were on our third try (three strikes and you're out).  Crossing our fingers anyway.

2WW

We got the following email from SCI:

     Greeting from SCI Healthcare!!!

     We hope you are doing fine.

     We would like to inform you that your embryo transfer has been done successfully
     today.

     We will get back to you soon with detailed treatment summary which will give you
     the details for number of embryos transferred with their quality etc.

     We wish you good luck !!

     With Best Regards,
     Jyoti
     SCI Healthcare


Here's hoping third time's the charm.

 

 

 

Preface

I guess I should back up a bit.  How did we decide to have a baby via surrogacy in India, and where in the process are we today?

As I mentioned in my last post, Travis and I wanted to have a family at some point, but knew that biological children between the two of us were not possible due to, well, basically our anatomy!  As unfair as it is to us gays, nature requires male and female parts for procreation (duh).  I know that ART (assisted reproductive technology) is a sensitive topic for some, whether or not they believe gays should have children.  Debating either issue is not the point of this post, but they're subjects that I'll deal with in the future, I'm sure, as I understand there are valid concerns about how moral and ethical it is.

When we looked at how to start our family years ago, there were basically three options: fostering, adoption or domestic surrogacy.  Surrogacy abroad never occurred to us, and I suspect was so new that there wouldn't have been much information available at the time.  We tested the waters of fostering, with disastrous results due to interference from the relatives.  Further, with fostering and adoption, we didn't like the idea of home studies and being judged and monitored.  While we understand the necessity of this and have nothing to hide, the idea of being scrutinized and evaluated as parents turned us off.  Additionally, you could go through the whole fostering/adoption process and the birth parents could change their minds or relatives could intervene--we had seen and heard this happen so many times.  As an adoptee myself, I understood how adoption could be life changing, for both parent and child; but after all this, I also realized that deep down I wanted a biological connection to my child. 

We looked into surrogacy and found that it was just too expensive--there were agency fees, legal fees, donor fees, surrogate fees, medical fees, fees ad nauseum--totaling from $75,000 to somewhere well over six figures.  The costs ranged so widely, and after doing lengthy research, there were so many variables that could happen, the process of having a baby could become a financial disaster.  Unlike the celebrity gays below and those more fortunate than us, surrogacy in the U.S. was not in our cards and we resigned ourselvs to being childless, but with fabulous pets instead.

 

Then about a year ago, we ran across an article in The Advocate about surrogacy in India.  I guess we had missed the Oprah show from 2006 where she talked about Wombs for Rent in India (catchy title, wasn't it?).  The cost for outsourcing your pregnancy to India?  Less than $25,000.  All of a sudden, we realized that a biological child for us was possible.  There were obviously other considerations, but now the financial hurdle had been lowered.

After more lengthy research, we decided to forge ahead and chose SCI (Surrogacy Centre India) as our clinic.  We contacted them and got the ball rolling.  The following is an abbreviated version of what happened next:  Agreements, check.  Money wired, check.  Donor selected, check.  Visit India, meet doctor, tour facilities, check.  Genetic deposit, check.  Surrogates selected and fresh embryo transfers performed, check.  Pregnancy, no check [buzzer sound].

Well, that was a disappointing whirlwind!  Sorry for the synopsis here, but playing catch up to present day would be too much for one post.  Needless to say, we were dejected (understatement) after investing so much time, money and emotional energy into the endeavor, putting all our eggs in two baskets, so to speak, yet coming up short with nothing to show for it.  However, we were unwilling to give up so easily on our dream to become dads.  After a few weeks of feeling sorry for ourselves, we decided to pursue another attempt, even though we would basically have to start over again.  This time, we had fewer steps to take: Financial deposit, check. Donor and surrogate selection, check.  Wait, check.  Keep on waiting, check....

Fast forward to today, and our surrogate is currently preparing for transfer this week, and then we will officially be in the 2WW (Two Week Wait--yes, more waiting), the period between transfer and the first pregnancy test.  I have come to think of it also as the Two Week Wish, because beyond waiting, you are wishing and hoping with all your heart that you are lucky enough to get pregnant, and ultimately join the ranks of parenthood.