Friday, April 25, 2008

Getting there …

So now that you understand (hopefully, if I managed to explain it well enough) the ins and outs of a gestational IVF process, I’ll share with you the route it took me and my first couple to get there. Our experience is pretty typical for first-timers, and is similar to what most surrogates go through. Although I imagine most surrogates have way more patience than me. In fact, I imagine most people in general have way more patience than me. Actually, I imagine every single-and-multi-celled organism on the planet has way more patience than me.

Once we were matched (still pinching myself that a couple this marvelous wanted to work with me!) we started getting our legal contracts worked up, and my couple had to select a reproductive clinic. Although for privacy reasons I won’t tell you exactly where they live, I can tell you it is in the northeastern part of the country, and luckily, there are quite a few very good clinics, with experienced doctors, compassionate staff, and high success rates, to choose from in that area. Ultimately, they selected a clinic called Shady Grove in Maryland. Really? Shady Grove? Doesn’t that sound more like a pet cemetery than a fertility clinic??? Whatever, as long as they got me pregnant, I didn’t care *what* they were called.

Although I had passed all the rudimentary medical screenings that the surrogate agency required (basic pap, hormone, and communicable diseases screening, which Blaine had to take as well) I still had to meet with the reproductive endocrinologist (RE) at Shady Grove and pass all of *their* tests and procedures. That was the visit we were trying to get set up almost three months after we met and were matched (in my previous journal entry). Fertility clinics are all about success rates and percentages, so naturally, they only want to work with surrogates who they feel have a good shot at getting pregnant. Luckily, most women, as long as they have a healthy uterus, are good candidates. Determining that is the point of the initial consultation.

The criterion that would eliminate a potential surrogate vary from clinic to clinic, but generally include simply the following: anyone who has had more than one c-section is usually ruled out. Scarring from the sections leaves the inside of the uterus “not smooth” --- “smooth” is what they need in order for the embryos to attach. Never mind that women all over the planet have two and three and even more c-sections and go on to get pregnant on their own quite easily. But any woman who has had more than one c-section will typically be turned down from being a surrogate. Extremely overweight women will be turned down, as well. While I understand obesity can affect fertility with regard to ovulation, I’m not sure I understand the connection here, since surrogates don’t ovulate, and in fact, are given drugs to suppress ovulation. But nonetheless, many clinics have a BMI criterion that must be met. I’m just glad “pleasantly chubby” is allowed, or I’d be shit out of luck.

Other than that, if you’re healthy, and have no medical issues that might complicate a pregnancy of your own, you would most likely be cleared to move on to the RE testing part of the process.

And so I traveled to Maryland for the first time, crossing my fingers that everything “in there” was as it should be. At this point it had been a year and a half since I delivered Kendrie, so I felt fairly confident they wouldn’t find any cobwebs or dust bunnies … but you just never know. I met with the doctor and he reviewed the records of my previous pregnancies, asking questions and gathering information from me. I had a physical exam and a saline sonogram. A saline (infusion) sonogram is routinely performed to make sure that the endometrial cavity (inside of the uterus) appears normal. Benign uterine growths, such as endometrial polyps or uterine fibroids, may develop in the cavity and create an environment that is hostile for implantation. Scar tissue might also be identified with the saline sonogram. These things won’t rule you out as a surrogate, but must be recognized and taken care of before you can move forward. I even know one girl who went in for her sonogram and the doctor found pre-cancerous lesions …. So really, a necessary test to have.

The sonogram itself is simple and usually takes 10 to 15 minutes to complete. Assume the position, ladies, then the cervix is cleansed with an antiseptic solution, catheter is inserted, and ultrasound wand is inserted (wow, lots of inserting going on here, isn’t there?) Then, sterile saline solution is pushed through the catheter, which distends the endometrial cavity and allows the RE to see the cavity on the ultrasound monitor and check for irregularities.

Then, since I was already on the table, the doctor did a mock transfer, threading another catheter and transferring fluid only, to make sure my anatomy was favorable for an actual embryo transfer. I do have a tipped {retroverted} uterus (hmmm, could *that* be why my tummy is so poochy all the time? No? You think it’s more likely the Oreos???) but after all was said and done, I was proclaimed fit and healthy and the proud possessor of a “beautiful uterus!!”

Ummmmmmmm, thank you????

In the meantime, my IM had passed all of her screenings with flying colors as well, so we were cleared for the next step: the mock cycle.


Kristin in Mobile said...

Hey Kristie - been awhile since I have posted, but just wanted to thank you for sharing this incredible story.....and can I just say "WOW!!" - I *basically* knew how the surrogacy thing worked, but through your postings, I have gained new respect and admiration for all involved.....and the miracle of it all!!!! How cool is the whole process, really! That there are people like you who can so compassionately help someone else, and that we have the doctors, nurses, knowledge and technology to make it all possible! Its truly amazing, when you really think about it!

Love the story, your regular updates, and just your general outlook on life - I would just sum it up by saying "You rock!!!!" - because truly, you do!

- Kristin in Mobile

Dianna in Louisiana said...

Oooh Kristie, that saline solution sonogram sounds, well,,,,, blech.... With the fertility "crap" I've been through (miscarriage/ectopic pregnancies, tube removal... yada, yada, yada), it seems like I've had at least 100vaginal ultrasounds(um, can I say that on here :) ), which I imagine must be somewhat like the saline ones, without any saline. They, in one word, BITE!

Anonymous said...

I know you've been told this a million times really need to find a publisher. You tell a great story!

Marisa said...

I am just in awe of this whole story and of YOU sharing it with all of us!! Thanks again !!!

Eloise said...

Add me to the throng of admirers exclaiming, "Wow!" I had no idea so much was involved in this process. You are amazing. Can't wait for more of the story.

Deb in NY said...

Hi Kristy,

A lurker dropping in again to just let you know I love all your stories, and really enjoy this one. I look forward to a new entry everyday.
No pressure though.

Deb from NY

Anonymous said...

I will echo Kristin's sentiments, wow, just plain wow! Kristie, thank you again for sharing this story, every last detail of it...