Exploring Our Options

There are literally thousands of clinics in India that offer surrogacy so we feel overwhelmed at first on trying to decide on which clinics to contact.  It is very important that we find a reputable clinic that has a proven track record in both their IVF statistics, surrogate births and  that also shows that its surrogates are well taken care of.  We have read a lot about sketchy clinics, mismatched babies, women that are forced into surrogacy with little or no real monitoring and medical treatment - we did not want to work with one of these clinics.

For the most part the clinics are congregated in the two largest metropolitan centers of India - Mumbai and New Delhi with another well-known clinic in Anand.  We start contacting clinics and find that there are some variances in fees between the clinics.  From what we have read, however, the clinics that quote the lower prices tend to have less inclusive "packages" and also tend to hit you with unexpected fees - this making the fees from clinic to clinic about the same.

We narrow down the search to 5 clinics and start some heavy researching on who we should choose.

Pills, Pills, Pills

This is an actual picture of my pill case and current supplements

As I have mentioned in previous posts, our last IVF cycle produced less than stellar quality eggs.  Unfortunately, just as you produce less eggs as you get older, the quality of the eggs produced also starts to decline.  (See "Good Eggs an Bad Eggs" page)  Instead of just letting this happen I decided to do what I could to fight back.

My doctor had indicated that for our next IVF cycle I should take 75/mg per day of DHEA for at least 90 days prior to the egg retrieval.  There are several studies out there regarding DHEA and its positive impact on fertility.  http://www.centerforhumanreprod.com/dhea.html.  Since this seems pretty tried and true it is on the list.

In addition to DHEA I am also taking a crap ton (that's a real measurement) of other supplements: Melatonin, Myo-Inositol, Alpha-Lipoic Acid, N-Acetyl Cysteine, Pycnogenol, Royal Jelly, L-Argenine, PQQ and Fertiligreens.

Co Q-10 and Omega 3 I was already taking - I just upped the dosages.  I also changed from a general multi-vitamin to a prenatal vitamin with DHA.

Biotin (for my nails and hair), Cranberry (because I get bladder infections), Pro-biotics (started taking post salmonella poisoning last year), Zyrtec (I have allergies) and Fiber (just because its good for you) have nothing to do with fertility per se.  I did have to up the fiber to help offset the effects of the increase in iron - the ladies will understand this more than the guys ;)

Because many of these can upset your stomach I take my pills with food.  Often meaning getting to break out the old lady pill container in the middle of a restaurant and gobble down around 20 pills with my meal.  I have caught some stares.  Mark says that the next time someone stares at me I should say that I have cancer.  I know it's not very nice but I bet they will be more careful about rudely staring at people after that.

I am also trying to exercise, drink plenty of water, get 8 hours a night of sleep, eat well, eat "fat" vs. non-fat dairy, reduce my alcohol and caffeine intake, reduce stress, and have acupuncture treatments (See "More Pins and Needles" page)

At the very least, I will be a very healthy person when this is all said and done.

The Announcement

Today Mark and I announced to the world (well.....our families and close friends) that we are outsourcing to India.

We make sure that our families are the first to know.  My siblings are all very supportive - they know that this has been a real struggle for Mark and me.  My mom asked me why we didn't think of this sooner.  I thought that was pretty funny coming from my mom.  Mark's family is also very supportive.  His parents even offer to help us out with some of the costs.  Before I had turned them down.....but I think we are going to accept their offer this time.

We then made sure that our closest friends who weren't going to make it to the party later that evening were in the know.  They were also super supportive.  They were so happy to hear that our journey is still going and that we have taken a very important step towards someday having children of our own.


We had a party that evening for Mark's birthday and several of our close friend were able to make it.  When we told everyone there was some shock - we hadn't talked about India before so this was pretty big news.  Once the shock wore off, everyone was really happy for us and they were full of questions.  We only had so many answers - we had landed on timing, but had not yet chosen a clinic.

Two of our friends that were able to attend were a couple that just had a baby of their own last year.  Their little girl was born early at 32 weeks and getting to 32 weeks was a struggle.  Both Mom and Baby almost didn't make it.  Mom and Baby incurred a lot of medical bills both before and after the birth - they estimated $25K - and it has been a real struggle for them to take care of these bills.  Their poor little girl has struggled with a lot of health problems which has also been very stressful for them.  They don't know if they will try to have another child due to the fact that these issues could very likely happen again in future pregnancies.

This couple said that they maybe should consider India themselves the next time....that they should just consider $25K to be a sunk cost in having a baby.  I thought about this and the same is really true for us.  We could try to have a baby ourselves and if we are lucky get to 32 weeks, possible lose myself and/or the baby in the process, and most likely incur $25K of medical bills.  Or, we could use the $25K to use a surrogate who would most likely deliver a healthy full-term child.  This makes our choice seem even more obvious to us than it even was before.

The Clock is Ticking......

We decided that we are going to do another IVF cycle in India for our upcoming surrogacy.  Now we need to decide when this is going to happen.  Unfortunately time is of the essence.  My 39th birthday is coming up within a month.  Once a woman turns 35 and especially once she turns 38 her fertility starts on a very steep decline.  Each month your fertility prospects start getting worse and worse.

So, we needed to get this party started....and soon.  After our last IVF cycle the doctor recommended taking DHEA to (hopefully) boost our egg quality with another IVF cycle.  Eggs take about 90 days to develop, so I would need to start taking DHEA at least 90 days before our intended IVF cycle to make a difference.  That means our retrieval can't happen before early October if I start taking DHEA today.

Well, I am expecting a period right around the end of September, which would mean an October retrieval.  The clinics that we've contacted all say that they would be open for an October surrogacy.  October looks like a good time to do this for both Mark and my work schedules.  This will make a dent in our grouse hunting season, but we'd be back in time for deer season.  October it is!

Fresh vs Frozen?

Just like the additional health benefits that you get from fresh vs. frozen foods, there may be some benefits to transferring fresh vs. frozen embryos.  At this point the argument hasn't been definitively proven either way.

It used to be that many IVF clinics reported up to 10% better pregnancy rates using fresh vs. frozen embryos.  But, a lot of that had to do with the method used for freezing embryos - slow-freezing vs. vitrification used now.   The faster freezing method that decreases the chances of the embryos developing ice crystals and is now more often used by many IVF centers.

Also important to note is that the frozen success rate is not only influenced by the method of freezing but also by the quality of the embryos frozen.  Generally, the best two embryos are transferred at the time of fresh transfer and the “second best” embryos are frozen.  Some IVF centers freeze all the remaining embryos while others will only freeze the remaining embryos of good quality.  The better the quality of the embryos at the time of freezing, the better the freeze-thaw success.

We had assumed that we would just send over our frozen embryos and that would be that.  But, we quickly find out that we could actually do another IVF cycle in India for the same price that it would be to ship our frozen embryos (Shipping frozen embryos is actually kind of expensive - around $3,500).  Also, we have to travel to India for the transfer regardless of whether using fresh or frozen embryos (the travel time just increases to also do the IVF cycle).

Hmmmm......we only have 4 frozen embryos which is realistically only 1 try.  If we go through another round of IVF we could have 2 maybe even 3 tries.  Plus, the cost for us is about the same.  I know I said before that I did NOT want to do another IVF cycle but I think that I should reconsider that decision.

Our Journey to India Begins

Mark and I are having dinner at our favorite restaurant (OK at least my favorite restaurant) The Bachelor Farmer, and were talking about our future.  We picked up our conversation where we left off yesterday....on India.  Mark had spent the day researching surrogacy in India.  I had put a post on Resolve.Org and had already received a few responses from others that were also looking into surrogacy in India.

We talked pretty extensively about our findings.  India it seemed was a very real possibility.  The fees were much more reasonable and we could definitely swing them - especially if they were split over this year and next year.  Not only were there several articles out there about real people who had used surrogates in India, I was actually able to connect with a few real people myself.  Seeing the Taj Mahal is on my bucket list.

Maybe it was the great food, maybe it was the great wine, but mostly I think that it was a meeting of two great minds.  We decided that we were going to India.....

What about India?

We were both aware that surrogacy in India was a possibility and joked at a time or two that we should just "outsource to India", but we had never seriously looked into it before now.

India has been dubbed as the "surrogacy capital of the world." India is the leader in the commercial surrogacy industry because of the affordability of the procedure and ready availability of women opting to be surrogate for childless foreigners.  There are estimates that commercial surrogacy in India is projected to become a whopping US $2.3 billion-a-year in 2012.

The cost of using a surrogate in India ranges from $20K - $30K (more for Caucasian donor eggs and IVF drugs are often extra) vs $70K - $100K in the US.   There are thousands of clinics in the country that offer surrogacy services and many have very nice looking websites.

We are able to find several articles on people who have had children successfully via surrogates in India.

http://www.sfgate.com/health/article/Commercial-surrogacy-grows-in-India-3968312.php
http://www.oprah.com/world/Wombs-for-Rent
http://amaniandbobsurrogacy.blogspot.com/2009/08/surrogacy-in-india-book.html

http://abcnews.go.com/Health/infertile-americans-india-gestational-surrogates/story?id=20808125

Is this our answer?

The Facebook Post

Mark S

June 23

As some of you may know, Teri Sand I have some fertility issues requiring us to use a Gestational Carrier. We are in the process of looking for said baby carrier and if you happen to know anyone who would be interested, please send me a personal message. Thanks.

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After our discussion yesterday about our options, Mark decides to try a last ditch effort to source our own gestational carrier locally.  While I admire his determination on this, I am not happy with his method.  We have not been public about our infertility at all.  There has been nothing on Facebook during this whole process.  Now it is out "to the world" that we are looking for a gestational carrier.

Now I know you are going to comment about the fact that we are actually being very public about our issues with this blog.  Yes and No.  The blog is an outlet for me and we are only letting very specific people know about it.  We have been helped by other people's blogs and hope that our blog may in turn help someone else.

Facebook is full of very opinionated and sometimes not very well educated people that like to make a lot of stupid comments about other people and other people's situations.  

Thankfully we only received a few "likes" and no stupid comments.

My Heart is in Your Hands

Today Mark and I sat down and had a heart to heart.  I voiced my concerns about us trying to find a gestational carrier.

First, we were hoping to incur minimal fees for the GC.  Unfortunately everyone that has responded to our ad so far is well aware of the going rates and is asking for fees of $25K - $35K, plus medical costs, plus travel expenses, plus clothing and other monthly allowances.

Second, we were hoping to avoid using an agency to avoid their $20K - $25K fees.  I am just not comfortable with using someone directly that we do not know.  The agency fees cover a lot of things including background, medical, criminal and psychological checks of the intended surrogate.  You also then have a knowledgeable third party of help with the medical and legal arrangements.  There are too many horror stories out there about surrogates for me to go into this without agency protection.

Third, what if this doesn't work?  I am already looking ahead to the possibility of adoption if using a gestational carrier does not work for us.  I fear that if we go down this path we will exhaust all funds and any possibility of being able to pursue adoption in the future if needed.

Mark listens to my concerns and sadly agrees that my fears are founded.  Unfortunately we are going down a path right now that does not seem like the correct path for us.

Back to the drawing board :(

Am I Blue....

Today I am feeling pretty sad.  I know that there is no way that we can afford to go through the gestational carrier process unless we have a friend or family member be our GC.  When Mark and I talked about our decision to undergo this process (before we even considered doing IVF), we talked about what we could and could not afford and that at some point we may have to say "uncle".

Yes, we have "good jobs", but keep in mind that this is VERY expensive.  $70K to $100K is no joke.  We are already a bit behind our peers financially in that I have pretty significant school loans and we are both divorced (divorce hurts both the heart and the bank account).  We would be looking at taking on a significant debt load.....and with no guarantees that we would have a baby in the end.

I haven't even gotten into the emotional toll.  Infertility is hard.  Period.  It doesn't matter how major or minor or how far into the treatments you have to go.  It sucks.  Each IVF cycle was a horrible emotional roller coaster (and I had some medical issues too).  After the second cycle I was very clear that I really did not want to do it again.

I know that I need to have a sit down with Mark soon and go over our options.

You've Got Mail

I have to admit that I did not expect to start getting responses from possible gestational carriers this fast.  Already we have emails from 5 ladies wanting to carry our baby.  Mark is beside himself with happiness, but me being the pragmatic one (Mark says pessimistic, I say pragmatic) says that we should hold on a minute before getting too excited.

Door #1 is 39, in the UK and has never been a GC before.  She says that it is something that her and her husband have talked about before.  That having seven children was such a positive experience for them and they would just like to give that experience to someone who would not otherwise be able to have children.  I am getting a genuine "vibe" from this person, however the UK is quite far away, the USD is not stacking up very well against the EUR or the GBP at the moment, and 39 is getting to the top of the age range for a gestational carrier.

Door #2 claims to be a PhD student in Northern California who has a healthy lifestyle, and is looking to possibly facilitate a healthy birth.  Her profile picture looks suspiciously like Demi Moore in "About Last Night" and she doesn't give a lot of information.  I am immediately suspicious of the authenticity of this person.

Door #3 is a 25 year old nurses assistant in FL who has 2 boys and friends that are using a surrogate.  She said that her pregnancies have gone very well, is familiar with the process through her friends, and wants $25K plus travel, medical and a monthly allowance.  I give her props for being up front about things and knowing what the going rate is for a first time surrogate.

Door #4 also lives in FL.  She is a 2x experienced surrogate and has full medical coverage.  Her BMI is 18 (which is underweight by the way), but claims to have carried her last two pregnancies to 40 and 41 weeks without complications or c-sections. No fee quotes yet but I suspect she'll be on the high end of the range.

Door #5 also lives in FL (why do all of these people live in FL?).  She is 32, has three children of her own and has been a surrogate 3 times (triplets, twins and a singleton).  The pregnancies were all uncomplicated and she is at a healthy weight.  She has already signed up with an agency for a fee of $35K - but is willing to work things out on our own without the agency and could be flexible on the fee quote.

Mark Hatches a Plan

Marks' motto should seriously be "Never Give Up, Never Surrender."  Mark is bound and determined for us to use those embryos that we have in storage and have our own baby.  He decides to create a profile for both of us and to put an ad on a couple of surrogacy websites.  He figured that this way we could save the agency fee ($25K) and hopefully find a surrogate for a more reasonable price ($10-$15K) vs ($25-$35K).  I admit that I had my doubts but that I was also willing to give this a try.

Red, Red Wine

Neither Mark nor I are taking the news that we need to go back to the drawing board on our family plans very well.  There are some tears and definitely large quantities of red wine consumed.  I am just heartbroken.  I feel like our plan to have our own child is over.  That we wasted a large sum of money and put ourselves through a lot of heartache going though two IVF cycles last year for nothing......for nothing. 

Thankfully Mark is the eternal optimist, to offset me often being the eternal pessimist, and refuses to lose hope.  What about our family?  Unfortunately no options there.  What about our friends?  Unfortunately no options there?  What about that agency the clinic talked about?  I showed him the average fees to do that ($70 - $100K) - no options there. 

I said that I think we need to start looking into adoption......

Forewarned is Forearmed

 

Today was a day that I was very glad that I knew what coming.  I knew to expect a call from our clinic with news about our intended gestational surrogate and I knew that the news would not be good.  So as I listened to the nurse explaining why our GS was denied I was able to (for the most part) keep my shit together.

 

I thought it was worth asking if this was simply a standard of our clinic (they are one of the top rated ones in the twin cities) or if this was a standard in general.  Unfortunately it is a standard in general.  To be a surrogate, one has to have a history of uncomplicated pregnancy.  However minor, preeclampsia is considered a complication.  The nurse mentioned that there could possibly be some "wiggle room" in the case since the preeclampsia did not seem to pose a health threat to the mother or the baby.  BUT, if this were her sister, friend, cousin, she would not recommend going forward.

 

This meant a lot to me.  In a world of statistics and "hot shots" and often poor bedside manner, our nurse was a shining beacon of empathy.  When I was getting bad news and trying to be strong she would knowlingly hand me a Kleenex and help me out the back door of the clinic so that I don't have to go out in front of everyone in the lobby.  When my first cycle was cancelled she found some samples in the office to help out with the drug costs on the second cycle since she knew that we were paying out of pocket.  When she recommended that we do not go forward with our intended GS than we will not go forward.

 

I dried my eyes and went back to my desk and tried to pretend that nothing was wrong.  That's when I found out that one of my coworkers just had her baby.  While I am happy for her I cannot help the fact that my heart just feels empty.  Sometimes life is so unfair.



Atlas Shrugged

 

 

I saw that I missed a call from our friend and intended gestational surrogate.   The clinic should have reviewed her medical records so I was expecting her to be letting us know what the next step in the process would be.  Instead what she told me made the world stand still......like Atlas had shrugged.

 

The doctor had reviewed her records and was concerned about something in her medical records.  We were not aware of this, but there was a complication with her last pregnancy - she had preeclampsia.  From what I understand it did not cause preterm labor, but it was serious enough that there was close monitoring near the end of her pregnancy.  For this reason, the clinic will not go forward with her as our surrogate.  They would be calling me tomorrow to go over the details.

 

I tried to stay calm, but I couldn't.  I broke out in tears.  I thanked her for letting for know.  I was glad that she wanted to tell me herself.  I know that she felt very bad about the whole thing.  She just wanted us to have the experience of having children, something that her and her husband will always be grateful that they were given that gift.  Wanting that for us was such a beautiful thing.

 

What were we going to do now?