Moving Right Along

So, two weeks ago I sent my medical records to Rotunda and heard back last week. Dr. Guatam emailed us a list of tests for screening on our end. Some are for me, some are for Bob and some are for both of us.

Here's what they asked for:
Baseline Profile (To be done on Day 2/3 of your menses)
·Serum FSH
·Serum LH
·Serum TSH
·Serum Prolactin
·Routine Semen Analysis
·Semen Culture ABST
·Antisperm Antibodies
·Test for HbsAg
·HIV (1+2) Antibody
·Blood Grouping & Rh typing

We have had these tests so many times that it is frustrating to have to repeat them, but at least there aren't any surprises.

Dr. Guatam said they are in the process of screening surrogates on their end, and will present us with profiles when the testing is complete.

I made an appointment to see our RE in NJ for a consultation tomorrow. I had two previous rounds of IVF with this doctor and know that he is willing to help with this process. We need to discuss many issues during the consultation. We are trying to decide what will make more sense, starting stimming here in the U.S. and going to India after the trigger shot for retrieval and transfer, thereby limiting our time in India, or doing the whole process over there, which could take two weeks. Cost is a factor. Time off from work is a factor.

I see my therapist, Marni Rosner, every week. I started seeing her with my fifth negative cycle, when it was so hard to accept that my body wouldn't perform. There are so many feelings of loss and shame tied to infertility that it was a real struggle to get through, and is a struggle to this day. This journey has been hard on my marriage, my family and my friends. I am so grateful for the people in my life who have been so understanding and supportive; sometimes I think it is harder for them than for me.

I guess I am writing all of this so that I can also blog about the emotional struggles that come with surrogacy. I found Marni through the Resolve website and she specializes in patients dealing with infertility. She has been wonderful in keeping my spirit healthy when it comes to dealing with this trauma. So I have great help!

I read these surrogacy message boards where the women have these great relationships with their gestational carriers and I can't help but to feel grateful that I won't have to be a part of the day to day in my GCs pregnancy. I know some people would feel completely different and would want to be a part of the step-by-step process. Not me. I want to meet her. I want to know that she is safe, well cared for, that her health is not risked by the pregnancy. I want her to know that 'grateful' doesn't begin to cover how Bob and I feel about her doing this for us. I get choked up at the thought of looking this person in the eyes and trying to express what her sacrifice means to us.

I understand that this surrogacy will not be completely anonymous. I think we meet her before and at transfer and after delivery. How do you thank someone for changing your life and giving you a gift like this?

I want to add this really fantastic website that I read a lot. I find the FAQ section like a security blanket that I reread when I start to get overwhelmed by this process. It's reassuring somehow.

www.oneinsix.com

Vaccinations are SCARY!

I have had a terrible cold for about three weeks, which finally brought me to the doctor today. It turns out I have brochitis and am spending the day on the couch with my laptop and my new puppy, Maisy. She's a mintiature schauzer/poodle mix, a "schnoodle," that we got the day after Thanksgiving. Bob and I are in love with her; she's really filled a hole in our lives.

Anyhoo, lets get to the reason for this post. While I was at the doctor today, I asked about vaccinations for India. Dr. Sahar explained that every area requires different vaccinations and I need to consult the US Department of Health to determine what is required for our specific destination of Mumbai. He said that his practice could handle some of the vaccinations if we gave him notice, but Yellow Fever is only adminstered by specified clinics. (We will need the Yellow Fever vaccination.)

After reading what the Deptartment of Health had to say, I found a one-stop travel clinic that will handle all of our vaccinations, including Yellow Fever. We will also have to get anti-malarial drugs, which are a little pricey. It costs, from what I could find, somewhere around $75-100 per person for a two-week supply of Malarone.

It looks like Bob will be getting some shots this time, too!

Here are the links...

Health Department
http://wwwn.cdc.gov/travel/destinationIndia.aspx

Travel Health Clinic (NJ):
http://www.passporthealthnj.com/

Let's Get This Show on the Road

Well, it's been a couple of months since I posted.

Due to technical difficulties, we have decided against another round of IVF here at Cornell in the US.

So, last week we e-mailed India and started advertising for a surrogate. Today I photocopied all of my records and sent them off to Dr. Kaushal in Mumbai. I was astounded by the amount of papers my procedures have generated. My Fedex charge is going to be huge!

We were told that finding a surrogate will take 2-4 weeks, so we are hopeful that we will have found and screened someone by the end of January. The next step will be to synchronize the surrogate's cycle with mine which should take anywhere up to 6 weeks. Then we will begin the IVF cycle. We have drugs left over from previous cycles, so I plan to use those as opposed to drugs from the clinic in India. I have heard rumblings of the drugs in India not being as potent as the drugs in the US. Since I do not produce an overabundance of eggs, I think it is doubly important to use the drugs that I have here.

Logistically, right now, I have several things to work on. First on my list is to touch base with a doctor here in the US so that we can start my IVF cycle here. I would rather begin the stims and monitoring here in order to reduce the amount of time spent in India. Hopefully, if all goes well, we will spend a week to 10 days in India for retrieval and, possibly, transfer. I spoke to a doctor briefly at a clinic in New Jersey who was willing to work with my doctor in India. Now, I need to firm that up.

Secondly, I need to start researching more thoroughly our travel arrangements. I also believe India requires a travel visa.

Bob and I have a vacation to Aruba planned for mid-March, so I think we will end up in India sometime near the end of March or in April. I cannot believe how quickly this is moving.

We are so excited! Keep your fingers crossed for us!

Play it Again, Cornell

Well, after much debate, we have decided to pursue one more cycle of IVF at Cornell. Dr. Chung feels that my uterus is viable and we should check our embryos through a process called PGD.

I find the thought of another round of IVF extremely frustrating, but logically it makes sense to do this.

The arguments were:

Move on to India
Why have a round of IVF here that will not result in a pregnancy. See, if my uterus is good and the embryos are bad, the result is no pregnancy. If the outcome is that the embryos are good, then we can finally determine for sure that it is my uterus that's the problem. Still, in the end no pregnancy. (Dr. Chung does not believe that our chances are that bleak. I think six failed rounds of IVF speaks volumes.)

IVF Cycle
If we have a round of IVF and determine that our embryos are not viable, then a surrogate is not an option. If we skip the IVF with PGD and move on to India, and a pregnancy doesn't result, will we try it again? Will we always wonder if it was the embryos? (Plus, there is the chance that it will work??)

Closure wins out on this one. To know, once and for all, if it's my uterus or our embryos before moving on is too important.

Pak Rocks!

Bob and I met with our doctor, Dr. Pak Chung, at Cornell. We hashed out all of the pros and cons of our situation with him and still don't really have our decision made.

Dr. Chung feels that another round of IVF should be the next step for us. Considering that it would be our seventh cycle, he understands that there is high amount of stress and emotion to cycling again. Medically speaking, he stresses, another round is what he recommends. Financially, emotionally...well, that's all to be considered as well.

I keep saying that a pregnancy from IVF is highly unlikely, not to mention a healthy, successful pregnancy. Dr. Chung seems to think the odds aren't quite so bad. I am fearful of spending too much money on IVF and limiting our further options (surrogacy or adoption). Dr. Chung pointed us to some different ways of reducing the cost of IVF for our specific situation.

We discussed India with him and he has offered to do as much research as possible on Rotunda for us. He was surprised to hear about India as an option. I was surprised that it was new to him. He expressed concerns for my care throughout the cycle and wants to make sure that an IVF cycle in India would be safe for us. He said that he sees many couples in our situation who become desperate and take risks at overseas clinics that could lead to disaster and gave a specific example of a procedure and clinic in Mexico. He did not say that going to India was a bad idea; he simply wants to help assure us of a good decision, in as much as he can.

Shipping/taking embryos to India is simply not possible. He said that the paperwork and effort expended in taking embryos just to the next state is incredible; out of the country would surely prove to be impossible. Also, he didn't think the embryos would survive that long.

So, right now Bob and I are in limbo. We have agreed between us that Bob will take care of finagling the financial burden of another round of IVF. (Did you know there are grants available through a few states? http://www.acog.org/acog_districts/dist_notice.cfm?recno=1&bulletin=1767) If Bob can make it work, I will do one more round. If he can't, we will continue our path to India. Hopefully, Dr. Chung is able to give us a green light on the facilities/doctors at Rotunda.

You know, Dr. Chung is the third RE I have had. I found it truly amazing how willing he is to help us, not just at Cornell, but in any choice we make. I did four cycles with other clinics and other doctors. I wish I had gone straight to Cornell.

The Roller Coaster: IVF or India?

Last week we started the ball rolling on finding a surrogate in India. Then we asked Dr. Kaushal to hold off on advertising for a surrogate until this week.

See, a few hours after wiring the money to India, my doctor here at Cornell called and wanted to discuss another round of IVF. My heart was not in this discussion (remember, we've done six rounds already), but in the interest of making a solid, well-informed decision, Bob and I are going to consult with him tomorrow.

We'd also like to hear what the doctor will think of the option to pursue surrogacy in India. We are also curious to see if we could do a round at Cornell, freeze any healthy embryos and ship (or take) them to India for transfer to a surrogate. Should be an interesting meeting.

When we emailed Dr. Kaushal and asked to hold off advertising for a surrogate for a week, we also asked about the complexity of sending frozen embryos over to her. She said it was possible, that Fedex could handle it, but there are risks involved in moving the embryos through customs.

As my research continues, I also emailed the US Embassy in Mumbai on Thursday asking what the process would be for taking an infant out of India in the case of the baby being the genetic child of US Citizens. They sent me back a lovely email with several links. I will post those links at the bottom of this post, but essentially they said that the baby would be issued a birth certificate showing a US citizen's birth abroad and it would be a hellish day getting all the paperwork done at the embassy (both parents and baby must be present--they suggest bringing a nanny). The baby's passport for travel would be issued after 15 working days. You can apply for an emergency passport, but I am not sure of what quantifies an "emergency." See, I think two blonds with absolutely no parenting experience in a Mumbai hotel room with an infant for 3 weeks constitutes an emergency, but who knows if the US Government will agree...

http://mumbai.usconsulate.gov/children_with_no_claim.html
http://mumbai.usconsulate.gov/transmission_requirements_.html
http://mumbai.usconsulate.gov/birth_abroad.html.

Baby Steps

In all of the ups and downs of infertility, the one very painful lesson for me has been patience. Never does the scheduling, timing, or length of the current process work to your advantage or fast enough for you. It's always just hurry up and wait. I have learned to accept taking it one step at a time, or as I have come to ironically think of it, baby steps. Focus on the next step, the next shot, the next doctor's appointment. Big picture thinking just makes for a lot of frustration!

After a lot of discussion, internet research and a several emails to clinics, Bob and I set up a conference call with Dr. Kaushal at the Rotunda clinic in Mumbai this morning. We woke up at 5:45am and made the 6:00am call. It was 3:30pm in India.

I should clarify that Bob and I are looking for a gestational carrier. We will use our own embryos and have them transferred to surrogate. We make healthy embryos, my body just doesn't seem to have the ability to carry them.

We had gleaned a mass of information from the internet and basically had it all validated by Dr. Kaushal over the phone. She was friendly and understanding. She was clear and easily understood.

We will wire a fee of $704US (28,000 rupees) this afternoon. This fee will pay for advertising and screening of a surrogate. Dr. Kaushal felt that we will have a match in approximately four weeks. Once there is a match, she will send us a dossier and picture of the surrogate. It will take 6-8 weeks for a syncing of cycles (the surrogate's cycle to mine). I will go to Mumbai for stimulation and egg retrieval, staying in Mumbai for approximately 15 days.

This is so fast, SO FAST! What happended to the baby steps?

Bob and I are so excited and scared. A surro in India? This is surreal...