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?