Last Week Vs. This Week

Most IPs undergoing international surrogacy can tell you about a little ritual that develops as part of this journey. It essentially consists of waking up, reaching over to the nightstand where your cell phone has found a new home, and compulsively checking your email to see if the clinic sent you an update overnight. This process has become an integral part of our lives.

Last week, shortly after my last post, I completed this ritual and woke up to a very alarming email. Apparently Grub Hub, the restaurant delivery service we use, had removed one of my favorite restaurants from their list. As you can imagine, this shot me right out of bed.  After taking time to mourn the loss of my Dragon rolls and Spicy Tuna Maki, I noticed another email that some might argue was equally alarming. It read:

“Your surrogate experienced bleeding after taking medication for a week. The doctor has canceled her from the program to protect the success of your program. I have attached the profile of your newly allocated surrogate, please let me know if you have any questions.”

Uhhhhhh…….

I thought perhaps I had read the email incorrectly, so I read through it again. Sure enough, they had just switched out our surrogate. Granted, we had given them permission to do this if necessary, but it was still unexpected, and certainly a little jarring. I didn’t know how to react at first, but soon found myself looking over the profile of the newly assigned surrogate. On paper, she was great. She was 32, she had been a surrogate before, and she had a total of 3 uncomplicated pregnancies. So, while we were a little taken aback at first, ultimately we were ok with the change.

Fast forward 8 days. We had gotten comfortable with surrogate number two, and were happily going about life when I woke up to the following email:

“I apologize for the continued change, however we are doing everything to ensure the best success of your program. The doctor has replaced your surrogate with another surrogate. Please let me know if you have any questions”

Yes, gentle reader, we are now on surrogate number three, and we haven’t even managed to make it to embryo transfer yet. If we were running in the "going through surrogate Olympics", I’m pretty sure we’d be right up there with Usain Bolt at this point.

We can’t say that all of this change has been entirely welcomed. In fact, it was quite stressful for a time. But then we really started thinking about it; If given a more explicit choice, what would we have done? Would we have wanted to proceed with less than ideal conditions? Definitely not. And when we started thinking about it like that, we were actually comforted by the switches.

Let’s face it. All of this is happening half way around the world. Surrogate number two had a thick enough lining, but it was deficient in other ways that weren't as obvious. It would have been really easy for the doctor to move forward with her and just ignore the less than ideal lining. In fact, that probably would have been the most profitable choice for him. But he didn’t move forward. Instead, he presented us with an alternative that would help achieve better results. Sure, it’s in his best interest to garner the best success rates for his business, but it also makes us feel like he cares about quality practice in his field of medicine.

It was also another reminder of how different international surrogacy is compared to what people expect from domestic surrogacy. In domestic surrogacy, IPs search for the surrogate version of “The One”; their perfect match.  This is the one and only surrogate that will travel with them through their journey. If her lining isn’t ideal one month, then they wait until the next month and hope that conditions improve. It's actually a really lovely process, as a real bond can form between surrogate and the IPs. However, this is generally sacrificed with international surrogacy. It's good in that you don’t have to wait to get your cycle going, but you also don’t form any sort of bond with your surrogate before proceeding into what is a very emotional journey with her. 

Additionally, in domestic surrogacy, IPs are given much more control over the process. This is partly due to the patient centered care structure in place here in the US. But, let’s be honest, it’s also partly due to people like me who are control freaks. In international surrogacy however, much of that control is taken out of your hands. Again, advantages and disadvantages. We like the feeling of being in control, and having that control taken away can be a real challenge and feel like a huge disadvantage. Simply put, If you feel like you’re not up for that challenge, you really need to consider whether or not this is the right process for you. 

So what’s the advantage? Well, let’s put it this way, Frankie is a physician and I’m wrapping up nursing school. We have several friends who are Family Medicine Physicians and OB/GYNs. However, truth be told, even with such a  large body of medical knowledge at our disposal…we’re simply not qualified to make some of these decisions. We can certainly ask good questions, but we’re not there to interpret the ultrasounds, to talk to the surrogate, or to monitor the development of embryos. No amount of information from internet IVF/surrogacy forums or even medical/nursing programs can replace or even come close to the knowledge the physician has. 

Frankie is amazing when it comes to caring for the kidney. It’s what he does, and it’s his passion. But would he ever treat someone just from reading their medical record, without meeting them and without verifying information for himself? No, never. So why should we expect to have enough knowledge to make certain calls pertaining to the treatment of our surrogate without having her as a patient? Really, we shouldn't; and because we know our knowledge is ultimately quite limited, we wouldn't want to make those calls. 

Instead, we decided to trust our agency, our clinic, and the physician in charge. We met him while we were in Thailand, asked him many questions about his experience and his process, and we walked away feeling comfortable with him in charge of the medical side of this process. We knew we would be giving him the authority to make certain decisions for us and lessen our burden; and having that security and comfort has been a huge advantage.

So yes, since the last update, we’ve gone through three different surrogates. However, here is the last email we got…

“Hello!

Regarding your Egg donor, 18 eggs were retrieved today, and we'll have your next update on Monday (embryo report).

I also have your surrogate's last update before transfer. Her endometrial thickness is 10.1mm.

 As always, Please let me know if you have any questions.”

Sure, we had to get a few emails that made us a little uncomfortable, but did we make the right call trusting our agency? For us, the answer is undoubtedly yes. I’ve said it before, and I’ll say it again: There are no guarantees in IVF and surrogacy. There’s a good chance this first attempt won’t be successful, and we’re prepared for that. But just the same, it feels good to have people who put forth effort to stack the deck in our favor.  

The embryo report should be coming in tomorrow and the first embryo transfer is scheduled for the end of the month. Wow…..just wow.