Absolute Beginners - A Crib Sheet to the Crib Sheet on Surrogacy

There seems to be no shortage of advice for visibly expectant moms. But what about those of us approaching parenthood from different places? As an expectant mom via gestational surrogacy, the tried and true pregnancy tomes are helpful (kinda, sorta, I guess) but there’s often no room to get to my questions, the ones specific to our situation. Having a baby that’s gestating several states away from you brings with it its own set of questions, worries and concerns that you, as a soon-to-be-mom, are doing everything right, or as right as can be. Which is why I am totally digging BlogHer’s Absolute Beginners crib sheets. Particularly the one written by Kymberly from The Smartness, dedicated to expectant moms via surrogacy. Finally! Kymberly takes some of those questions, worries and concerns and speaks to them.

Read and print out the entire crib sheet for surrogacy now.

Here’s me, halfway through our surrogacy journey, adding my two cents:
  
1. She’s pregnant! I’m excited, but I thought I’d be able to relax more than I have by now.

Kymberly advises: “Each new milestone in the pregnancy will bring with it a modicum of relief, but it is perfectly normal not to feel completely at ease until your little one is finally in your arms.  Celebrate each step forward and share your joys – and your fears – with your surrogate.”

Given our track record and the length of time it took to get to this point, my husband and I had zero expectations that the first frozen embryo transfer would be the last one. You can never completely squeeze out hope, but we had braced ourselves for an early negative. A test run, if you will. So when our surrogate emailed us a photo of her positive pregnancy test, and confirmed it a few days later with beta results, we felt like we had won the lottery. Huge hurdle #1, over.

Now, are we relaxed? Uh no. Have we told the world? Hardly. Our pregnancy right now is still on a need-to-know basis and will be until we pass a few more milestones. But not because it’s via surrogacy.

I think the “I want to relax but I can’t” curse is one that any expectant mother that has lived through any previous loss will face. I can say, however, that I would be worlds less relaxed, if I were trying to carry my own baby to term. Knowing that our child is in a safer environment than one my womb can provide brings with it a certain kind of peace.  

2. How might communication with my surrogate change during the pregnancy?

Kym says, “The matching and cycling phases likely involved a frenzy of almost-daily communication.  Once pregnancy is achieved, your rate of communication with your surrogate might shift to become more frequent or sometimes less frequent, especially if your surrogate is having a difficult time with first trimester exhaustion and morning sickness.  If your communication needs fall out-of-sync with your surrogate’s, don’t hesitate to have a conversation about it with her to get the reassurance that you need as an expectant mom.”

Early on in our pregnancy, our surrogate asked frankly, “how much or how little do you want to know?” She knew of the loss of our twin daughters. She also knew how long we’ve been trying to grow our family. And she wanted to be sure she was keeping us informed without oversharing, if that wasn’t what we wanted.

And I needed to think a bit before I answered. Would I be a little envious hearing about baby kicks and movements? Would I want to know when she was experiencing the inconveniences of pregnancy that I couldn’t? Still, would I want all of these things happening outside of my knowledge? We decided that we wouldn’t know until we tried it out. We decided that when she felt like she wanted to tell me something to go ahead and do it. If it ever veered into discomfort for me, I would say so.

We’re in the habit of emailing each other at least once a week. And we usually have emails that overlap in transit. We keep each other up to date on daily events. She sends pics, not only of ultrasounds of our growing baby, but also of her own family, which I really appreciate.

3. How can I find the right balance between having valid concerns about my surrogate’s habits and me being overly worried?

Says Kym: “Keep in mind that there is a range of what is considered “safe” during pregnancy. Within the realm of what is considered safe by medical standards, your surrogate’s decisions during pregnancy might be different from the ones you would choose if you were pregnant. Find compromise and acceptance with habits that are within safe parameters and don’t violate any terms of your mutually agreed upon contract. Have faith in the trust that you’ve instilled in her ability to carry a safe and healthy pregnancy. If you’re still uncomfortable, definitely discuss it with your surrogate and if necessary, agree together to have her obstetrician weigh in on the issue.”

This is an issue I think that’s best handled before the surrogacy even begins. Lifestyles and habits and daily obligations of potential surrogates were huge components in our selection process. Not that there were any sky divers presented to us. But I think one of the reasons we gravitated so easily towards our baby mama and she to us was that we are all fairly laid back. We saw in her a parenting style and a set of values and behaviors that we hope are similar to our own (once we have a chance to try them out).

I can honestly say I have had zero concerns about our surrogate’s habits. And seeing her and her family in action in the weekly emails affirms this. I do worry when her family is hit with a seasonal bug or it seems as if all of her kids are down with strep or ear infections or any of those other illnesses that you cannot avoid. But as I’ve mentioned, we chose her because we trust her.

If you have concerns, Kym’s advice is sound. Communication is critical. If you want additional assurances, your contract can be as specific as you want it to be. No sky diving? Spell it out. Just know that the more prescriptive you are in a contract, the more space there is for interpretation outside of those forbidden activities (it doesn’t say I couldn’t bungee jump….) Work through the language with your attorney to ensure your concerns are addressed. Talk honestly with your surrogate (and the surrogacy agency, if you are using one) about your expectations.

Dear surrogate, please don't do this.

4. What special considerations should I make for delivery?

I so agree with Kym: The birth of every baby is a “special delivery,” but the deliveries of babies born via surrogacy definitely take some extra advanced planning.

Some of the logistics that Kymberly points out here are addressed in our contract. Others aren’t, so we’ll need to have that conversation when we travel out to see our baby-to-be and our surrogate in a few weeks. We’re planning to be at the delivery, and that’s our surrogate’s wishes as well. But we never talked about the moments immediately following the birth. Who goes where? Where does the baby sleep? And what about breastfeeding…  

5. What options do I have for feeding my baby?

How cool is it that, as Kymberly points out, “You have as many options as any expectant mother does!”

While the option to breastfeed is there, I do wish the healthcare professionals around me were a little more knowledgeable about it. I broached this subject with my gynecologist last month and was met with a “Really? Wow! That’s so cool!” response.  It's encouraging that he’s so open-minded, but instead of the guidance I was seeking, I got an “awesome! Let me know how that goes,” response. So thank you so much, Kym, for pointing out AskLenore.com, and I'm bookmarking it right now. Our goal is to try to breastfeed. If it works, great. If it doesn’t, formula it is.

Kymberly adds, “In some cases, the surrogate will nurse the baby while still in the hospital after delivery.” This is an area we have yet to discuss with ours. And I’m not sure where I am here. There is an active discussion about this in places like SurroMomsOnline, with strong feelings for and against, from both intended parents and surrogates themselves. While I appreciate those perspectives, as Kym says, “As with any new mom, how you choose to feed your baby is a deeply personal decision.”  

6. My baby is here! I’m not physically recovering from pregnancy and delivery, but why am I so tired?  

“Well, it’s because you’re a new mom! Your pregnancy and delivery may not have been “typical,” but your newborn phase of parenthood surely will be! As a new mom, you’re entitled to the same elation, exhaustion, joy, nervousness, and excitement that many new moms typically feel.”

Sometimes it is very important to state the obvious. And I was heartened to read Kym’s guidance here.

Unfortunately, while we are entitled to the same elation, exhaustion, joy, nervousness, and excitement that many new moms typically feel, I’m NOT entitled to the same work leave options that I would be if I were physically recovering from pregnancy and delivery.

If I were to add to the crib sheet, I would add this recommendation: Speak with your employer and/or HR department NOW about the types of leave you are entitled to and what they would be willing to offer you. In my case, my office is too small to fall under any Family Medical Leave mandates, but that doesn’t mean they wouldn’t work with me if I needed some additional time to get back to work. Again, communication is key and don’t be surprised if you need to do some education around surrogacy along the way.

Hurray for the home office - will you be able to use yours?

Moms via surrogacy: What questions, worries and concerns are missing? What tips/advice would you add here? What do you wish you had known during your own surrogacy journey?  

This post is part of the Absolute Beginners editorial series made possible by Pampers and BlogHer. Our advertisers do not produce or approve editorial content.

Because I'm Nosy....

Hey, do you do holiday cards?

Xmas? Chanukah, Festivus?
Photo cards? Straight up hallmark? Homemade?
Do you write nice long notes or just initial, lick and send?

Do you make your partner sign or do you forge his/her signature to save time (guilty. here.)

Do you only send to folks who've sent you a card?
Do you trim your list?

eCards or paper?

What do you do with holiday cards once you get them? Hang 'em up? Go, oh, isn't that nice? Then pitch 'em? Re-use, recycle them?

I'll check back in a bit and share our answers. In the meantime, behold the golden pierog! [thx to Alexandra for the edit]

Question for the Philly Girls

Ladies,

M. and I are heading to downtown Philadelphia this weekend to celebrate my birthday and see a show at the Trocadero. We'll be staying nearby (as in, within walking distance of the Troc.) The Monk's Cafe is our usual go to spot when we're in this part of the world and I'm hoping that does make it into our plans, but where else should we go to eat, drink, try to be merry?

And yes, we are totally up for company if anyone wants to join us for some adult beverages on Saturday night.

Answers. More Questions. Disciplinary Action.

[or, The Not So Nice Parts of the Birth Story]

A few days after the birth of the girls, it was obvious that there were some unanswered questions that were eating away at me. M. kindly suggested that I, "write them all down. Put them in a notebook to take to the doctors, and don't think about them until we are there."

And that's what I did.

And this morning I pulled them out. The first stop in our back-to-back doctor tour was with the perinatologist who delivered us. He got the brunt of the technical stuff.

First, the easy ones:

Are you mad that I've been walking?
-No.

Can I start to exercise again? Do I have to wait 4 more weeks?
-No. No problem. Resume your regular routine.

Does that mean everything? Do I have any restrictions now?
-[Do you feel ok? yes.] Then Nope. None.

Now, the harder stuff:

Do you still think an infection caused the pre-term labor?
-Hard to say. We know that by the time we saw you [around 3 am Friday morning], the first baby's sac was fully exposed. Her placenta and umbilical cord were infected. We won't be able to pinpoint at what point they became infected.

If there was an external infection, why were there no symptoms? No discharge. No bleeding. No pain while peeing, nothing!
-It is actually quite common for pregnant women to have bladder infections, for example, with no symptoms. What is even more puzzling is that your 19-week scan looked terrific. No issues there. Something must have occurred within the course of those 2 weeks.

Could my weakened immune system and lack of a spleen had anything to do with the cause, spread, increase of infection? Should I have ever stopped taking penicillin on a daily basis (had done so for years after Hodgkins)
-Probably not. Unless you know you have an infection, there's no sense to pump your body full of antibiotics. And you had probably developed a resistance to your dose of penicillin years before you stopped taking it. I see that as a non-issue.

What came first - the infection or the cervix opening? Was the infection made worse by the cervix opening and exposing the sac or did an internal infection cause the cervix to open?
-We honestly do not know. But we do know that we can take preventive measures for both the next time. Trust me. We will be watching you like a hawk.

Is it possible the infection was already there at 19 weeks when I had my scan?
-Yes. It's possible.

Do you see any reason why I would not be able to carry a pregnancy full term? Any hesitation recommending that we try again?
-I see no reason why you couldn't have a healthy and full-term pregnancy next time. We learned a lot. We know what to watch for. Try again when you are ready. We will not lose two in a row.

And here's where it gets dicey:

What are the differences between cramps that are "normal" and ones that should be watched?
-When in doubt, call. Come in. We'll check you out. We'll always err on the side of caution. Especially with twins.

But, we did.

We did call. My doctor's office at 7:30 p.m. that night when cramps became strong and regular. How long apart? About 20 minutes. Any bleeding or discharge? No. The midwife on call told me to relax. Go home. Take a bath. Put my feet up. Call in the morning.

I did that. And the cramps continued. And became more frequent and by the time we could set our watch to them - every 10 minutes - we called again. She told us to head to the hospital. She'd meet us there. That was around 11 p.m.

We were there in minutes. She was not. In fact, we spent the next several hours in a corner stall getting "monitored" as cramps and pain increased, I was urged to give a urine sample (where I am convinced that I could feel the sacs starting to descend) and M. was left pleading to anybody who would listen, "please. I don't want these babies to be born here!"

Medicine to stall the contractions finally arrived and made no difference. The midwife finally arrived, after I had begun to bleed and show a discharge, took one look at my cervix and said, "you are fully dilated. I can see a sac. Your chances of delivery are very high."

And that is when my doctor was called. He was there in less than 15 minutes and had already called the perinatologist en route. They were in our room before we we were.

So, do you think that timing could have made the difference?
-It is possible.

If we had arrived earlier? If we had been seen earlier? Could any of this changed the outcome?
-We cannot say for sure. It could have been dicey either way. But yes, perhaps, with more time, we could have at least had a better chance of saving the second baby. how much time, that's hard to say. This is where you start to play the guessing game. I can't tell you when the tipping point would have been.

***

If time could have made a difference, how much time did we lose when the midwife told me to "go home and take a bath and relax" at 7:30 pm? How much more time did we lose when we lingered in a corner stall in labor and delivery being "monitored" and nothing else until hours after we arrived?

***

When we got to my obstetrician's office (just down the hall), we learned that he, too, had those same questions. While he didn't say anything at the time, he told us now that when he arrived at the hospital he was very bothered by the fact there had been communication with the office earlier in the day, that there had been such a lapse between our initial voiced concerns and when he was actually called. And that we weren't told to come in and be examined immediately.

We talked with him for a long time. He said there were two questions: "what could have been done to prevent the premature birth?" and "was the best possible care provided and all steps taken at every level?" While we don't have definite answers for the first, he said that in his mind, the answer to the second was no. And that he was going to do everything possible to remedy that. He refused to put his family name on a practice that delivered sub-standard care. You trust people to be on call and be a representative to your practice. In his mind, this was a deal-breaker.

We spent the next several minutes with the HR Director of the office trying to get down an exact time line of what happened and where, in our opinions, there were gaps in care. I don't know what will happen to this account, or what will happen to the midwife who shouldn't be. I am trying not to.

I know that this morning opened up a lot of wounds for M. That he had already come to the conclusions that he could best live with, and that some of the answers we received put those in question. I also know that I needed to hear answers. I needed plain, unsugared explanations. And I needed to know if there were points along the way where I was at fault.

I don't know if a few more hours (few more days?) would have saved my girls. I don't know if Isobel was destined not to be here from the beginning. I don't know if Jovita would have had a chance if we had bought her more time. I don't know. I won't know.

[Updated: I actually just received a call from the perinatologist to clarify: a few hours probably would not have made a difference, especially since my white blood cell count was so sky high by the time they saw me. A day, maybe. But even then there is no way to know.]

Muppets from Space

[Note: Dear Creme de la Creme readers, welcome! Please, please note that since this post, our little seedlings were born too early (21 wks), with us only a short while, and in that while changed our lives and our perspectives on a lot of things. Some things have ended, others started. Please stay tuned for an update.]

Contacted through my breakfast cereal and then confirmed to me by the cosmic fish...I am from outer space.

Sometimes I feel like Gonzo.

Not always. But every once in a while I get that nudge, that reminder. That feeling like in a sea of genes, in a long line of dominant traits and bloodlines, I am a little blip. Seemingly dropped at the doorstep. Origins unknown. With no ability to pass those pieces of myself along either.

Sometimes that's humbling. Sometimes these thoughts feel like the worst kind of hubris. Hey, I'm a one in a million! I could exclaim.

But aren't we all.

Sometimes I wish for a grand reunion. An easy search. Puzzle pieces falling into place, all leading me to one or both of my birth parents. It's not as if I landed in a bad place. My parents love me. H*ll, they adore me. And the support they have shown us ever since we shared our journey to bear children has been amazing. Eager grandparents-to-be is a grand understatement.

But every once in a while there is that desire to look into my cereal bowl or up to the heavens for some answers.

I think about beginning a process. Recently, my brother asked if I was at least going to go in search of my medical records in case we would need then for the seedlings, forgetting that their origins are also a bit unknown. To be honest, I did too for a moment.

What can I do to ease this longing? Will the seedlings have these same feelings? If they do, I will need to remember that this particular kind of curiosity and longing does not go hand in hand with rejecting the life, or family, or love that you have. It really does coexist.

And I have to remember that in the end, Gonzo doesn't run into the spaceship, into the open arms of people who share his nose, his personality, his love of cannons, people just like him. He opts to stay right where he is.

My life is here. This is my home.

My Reaction - Too Much or Not Enough?

Today I got a kind of shocking phone call at work that makes me think my boss (whom I shared information with in confidence) has been a little too free in sharing that confidence with others. Yes, we are a tight knit organization. Yes, I have know most of the members of the assoc. for a decade. But I'm thinking not only did my boss (if she did indeed spill the beans) show a serious lapse in judgment here, but on a personal note, shared medical details of mine that were mine to share.

Anyway, here was my email to her today (she's away on a business trip). Told hubby about the incident and of course he is furious and says I should threaten litigation. Come on now. Don't be daft. I am not going to threaten to sue someone who I know in her heart means well and for a decade now has been pretty d*mn supportive of everything I have wanted to do with my life - even when it made things seriously inconvenient for her. Ok, here's the message:

I really appreciate your enthusiasm and support around my pregnancy. It is wonderful to work in an environment where I feel I and my future family will be valued. But I just received some congratulations from an employee at ____ that was a little more detailed than I would have liked. She mentioned that _____ had shared some of the info you had shared with ____ and then went on to tell me about a family member of her own who had cancer, couldn’t have children, used artificial techniques and went on to have children. It was a heartfelt congratulations from this person, but I was very, very shocked and surprised to hear it in the way that I did.

While I’m neither shy nor ashamed of the path we’ve taken toward parenthood, I would like to keep such details as my story to tell and to be able to select the listeners. I am uncomfortable with some people, especially those whom I interact with professionally, knowing my very private details. IVF and related means are still frowned upon by some and I wouldn’t want those judgments to interfere with the work that I need to do.

Am I being too sensitive here? Not sensitive enough? Some of my own co-workers don't know the full extent of my story - at least they haven't heard it from me. I suppose I should assume it's all out of the bag now. Like I said, I'm not saying that I wouldn't have eventually told the people in question, but dammit, I wanted to be the one to make that decision, not have it come out like another piece of water cooler gossip. I think the fact that I even had to compose this email is ridiculous. Hubby thinks I was far too tame. What do you think? Where do I go from here?

But I Don't Feel Tardy

So, I suppose it had been a while since I posted. Sorry about that.

I'm cool. Hubby's cool. The seedlings are, for all I know, chillin'. We are 14 weeks today. My next appointment is Tuesday. And I am really, really looking forward to it.

Will I get an ultrasound? Will we get to see some heart beats? What guarantee will they give me to ensure that something's still going down down there? What's the protocol for these "normal" OB appointments?

Because maybe I haven't posted because I have yet to feel it. You know, feeeeel it.

The other weekend, I was indulging in an evening of total control over the remote control while hubby was working late (and I now understand why I rarely get that privilege when there is more than one person on the couch) and I found myself watching Velvet Goldmine, one of the worst movies ever made, but one of my favorite. Jonathan Rhys Myers, Ewan McGregor and Christian Bale? All tarting it up at 70s glam boys? Come on. What's not to love? Anyway, at one point, Ewan is writhing on stage in what is obviously his best Iggy Pop impersonation and is screaming, imploring,

can you feel it . . .
I got a feeling
I got a feeling
I wanna feeeeeeel it
oh, I wanna feeeeeel it . . . . . . .

And I knew exactly what he was talking about.

I'm feeling great. Energized, non-pukey. Looking fatter, but was I really all that svelte 14 weeks ago? Happy. Functional. Hubby mentioned the other morning, "Oh my god, somebody's got their funny back."

So, can someone please verify that I am indeed pregnant?

What's in There?

This morning hubby and I were lounging in bed, enjoying a lazy Saturday morning, taking bets on what exactly that little camera is going to find when it goes up in me on the 3rd.

He says aliens.

While that's funny, I doubt any pesky E.T.s would have escaped previous ultrasounds and tests.

My money's on finding a huge set of sharp teeth where my endometrium should be, ready to devour any unsuspecting embryos we place in its path. A deeper variation on vagina dentata.

And see, here is where you really need the visual I provided. I'll let you think up your own.

There's still plenty of time to put your wagers in. Any takers?

I said no, no, no.....

Not to going to rehab, but to an endometrial biopsy. Here's how it went down:

Nurse called last week, I thought to start scheduling our next cycle. She was actually calling to relay the advice of a new doctor who has apparently joined the practice. This doctor decided that what we really needed was to do a mock cycle and then an endometrial biopsy to see whether or not I needed to add any additional progesterone to our routine. That means, go through an entire cycle, including weeks of PIO injections, ending not in a transfer, but in this new doc taking a swab of my uterine lining. Based on the results of those weeks of hormones, headaches, shots and that swab we would either: a.) know that the protocol was just fine and start a new cycle or b.) add a little more progesterone to it.

I hung up with nurse, slightly stunned. Thinking first of all, "Who the F*ck is Dr. ____ and what does he/she know about me?" Second thought was, "Yes, my lining was slightly under 8 this time around but THEY CHOSE not to increase my estrace. It was less than 8 the first cancelled cycle and we upped the estrace, which seemed the do the trick. It was less than 8 the second cancelled cycle because I was only on estrace for a few days before the first stripe test...."

The more I thought about things, the angrier I got. I turned to hubby for some reason and rational thought. Perhaps I was overreacting or still upset from the BFN. His anger and indignity only added to mine. He broke it down like this: If an endometrial biopsy was what they wanted to do, they had 2 cancelled cycles which they could have continued to that end, AND the several months we were sitting around doing nothing while we were waiting for our donor to be available. Now, they want to waste our time, money, emotions? Now??

I felt slightly better knowing we were on the same page. From my perspective, I simply couldn't imagine going through the stress of a cycle knowing it was a mock one. Shooting up is hard for me as it is. Would I really go forward with that day after day knowing that all I had to look forward to was a cotton swab up my noonie? It would be different if I or they suspected some serious abnormality. It would be different if increasing estrace hadn't already been proven to work. It would be different if we only had 1 or 2 embies left. It would be different if we had a few thousand dollars to throw around on meds and medical tests that serve our clinic's purposes and stats more so than ours. It would be different if Dr. ___ was the person who had taken us through the process up to this point. It would be different if there weren't ample time and opportunity to address this perceived issues without the pain of additional and fake cycle.

But none of this is the case.

So, confident that hubby had my back, I called nurse the next morning. And we talked about all of this. And much more. We talked about how bothered we were that of the 4 people present for our transfer, we knew none of them (nurse had CPR training and had already told us she couldn't be present). We talked about how upset we were that this new and unknown person (Dr. ___) seemed to be calling the shots on our cycles. We talked about how it felt when we felt the (well-respected and university-affiliated) clinic was more interested in keeping their stats above the national average than they were with us as patients. It was a long and hard conversation.

And it was so worth it.

She totally understood and sympathized and made it seem like she, too, was bothered by the message she had to relay. She explained that the clinic was expanding and that a number of doctors had joined the team, hence Dr. ___, hence the unknown faces between my legs at transfer. She explained who the new docs were and which aspects of the clinic they would be in charge of. We told her that we considered her our lifeline and the one real and human point of contact there. We didn't know what we would do without her. Long pause. She said, "then I am going to keep your file. I'm supposed to turn it over to another nurse now that you are doing FET but I won't and I am going to use this conversation as my justification."

And we told her we were so grateful for that. She has been with us since the day I called almost a year ago and set up an appointment for a consult. She was the one that hugged me when I cried during the needle training. She was the one that held my hand when I got my stitch put in before the first transfer. She was the one that had to call and tell me about the BFN. To go through this without her would be rough.

So, it's day 5 of lupron. So far, so good. I need to get back in the habit of good breakfasts and healthy days. But we are looking forward to our first FET, scheduled tentatively for early March, with nurse by our side.

Matter

Genes matter.

They do. Why else would we be spending money we don't have trying to ensure that at least a little bit of us (partner and me) is recreated? Why else would we spend hours upon hours with strangers' genetic components spread out in front of us (blue eyes, brown eyes, dark hair, red hair, fair complexion, freckles, 5 foot xx inches, maternal grandmother had diabetes, and on and on and on......) searching for the ones that could best replicate mine?

Genes matter. Because every time I talk to/look at/interact with my adoptive parents, I think (sometimes out loud) thank god I am adopted. I was left on the doorstop. Found in the reeds. No connection whatsoever to the people that never cease to frustrate and puzzle me with their (lack of) reason.

I have based my sanity and my identity on the concept that there are things inside of me that no matter how badly my adopted parents screwed up (in my mind), those traits would still be intact. I know for a fact that if my adoptive parents were my birth parents, hubby would have thought twice about a lifelong union with me.

Part of that is a crutch. Most of us dread turning into our mothers and this is how I convince myself that it will not, cannot happen to me. Because we are simply not the same. We don't look the same. We don't value the same things. And there is nothing innate that will morph me into my mother over time. It's just not there. Those pieces are missing.

Right??

Please tell me I am right.

As we sat in front of the donor profiles again the other week, hubby and I were both struggling trying to find answers to questions we didn't know how to ask - at least not without sounding like assholes. If people were computers, what components would be hardwired and which would be malleable? What's the software? What can be upgraded? To put it nicely: what pieces can be Nurtured and which are just straight up, ain't no getting around it, it is what it is Nature?

As a teenager and young adult, when friends would prod me about trying to find my birth mother, I would resolutely say, don't worry about it. In my mind, she is a princess. The most beautiful woman on the face of the earth. And that is all that matters. Who could I find that would live up to the glorious pedestal she stands on now? And that was enough for me. For at least 30 years.

But I am/we are so perplexed about the nurture vs. nature debate that I am seriously considering looking for her. Am I a carbon copy of her? Does she laugh like I laugh? Do I have her eyes? Does she like the same things I do? Or would we be complete strangers? Could it be these things I have credited to her really are the result of my parents' parenting? I need to know.

All of these questions are coming to bear because dammit we just cannot decide on a new donor.

Should we focus on physical characteristics? Test scores? Athletic ability? Just because we like how someone answered the questionnaire, does that, in the end, matter? Will that personality or intellect transfer down into those pretty little embryos I hope to carry? Will choosing a 5' 2" donor guarantee a maybe baby will never be a basketball star? If we settle for a 5' 10' beauty who had a C average through high school, will we blame her every time a maybe baby struggles with his/her homework? Are we being fair by setting aside all the donors with certain professions in their families because those are not ones we would want to have? It was so easy to think I wasn't biased until these choices were laid out in front of me in a binder.

So, which one will it be?

You can't tell me genes don't matter. But I would appreciate someone telling me which particular genes matter more.

With a Capital M

Who knew the Maybe in Maybe Baby was going to have such a long prologue and such a capital M?

Just returned from the clinic with no conclusive news. My lining is a little thin at 6.9, which I expected since I have only been on estrace a few days. So we'll probably up that dosage as soon as my blood work gets processed from the lab and we heard what my levels are. Meanwhile, donor's estradiol level was around 300 over the weekend. While they were hoping for closer to 500-600, its not the end of the world, or at least this cycle, at least not yet. She, too, is getting blood work and another ultrasound today. If there are follicles developing, will we continue the cycle towards retrieval and transfer?

Maybe.

Maybe. Maybe. Maybe.

Hubby and I have been prepared for less than stellar news. Now the questions become: if there are fewer than average follicles, are we willing to continue or do we cut our losses now, end the cycle and go in search of a new donor? how few is too few? How many would it take to make it worth the effort, expense and emotions of continuing? How much is enough?**

No one said it would be easy, did they?

But, I have to keep reminding myself, as hubby does, that we are still further than we were six months ago. Because now we know what is possible. Six months ago, we were still thinking we could never ever have a child of our own. All that has changed. What remains to be seen is how far we are willing to go to do it.

**Dear sisters, I am very much interested in your opinions here. In fact, I am asking for them. If this were your (or your donor's) cycle, how many follicles would it take for you to give it the green light?

Oh If Only.....

Good lordessa, if only it were this easy.

I was totally fine with this post full of helpful tips on how to get pregnant (#1 stop birth control) until the last "helpful tip" which reads like this:

5.) Pray, Pray, Pray. Don’t listen to doctors when they tell you that you’re not able to conceive. God is the only person who can determine that. God will give you a baby when he thinks you’re ready for one. He is there to give you all the support you need. Have faith in him and when your time comes you will be blessed with a beautiful baby.

I know that we are all of different faiths and inclinations and I am truly not trying to offend....

But reading that brought my blood to a boil. Because only good and faithful people have babies, right? The world is filled with good and faithful babies who turn into good and faithful leaders and that's why the world is so great, right? And only bad people die from cancer or other diseases or, gasp, can't naturally conceive. It's all about deserving.

Pregnant = blessed. Infertile = cursed and unworthy of a christian god's love, unless of course its in a pitying, charitable way.

Sigh.

We get up bright and early tomorrow a.m. to find out whether or not we are deserving of continuing this cycle. And um, I am probably going to listen to what the doctor tells me.

Are you Sure?

It is so funny how pieces of life randomly collide. I got a call from my old social worker yesterday morning (old as in, was my social worker 20 years ago when I had cancer). He had seen my testimony on TV and couldn't stop talking about it! Not only that, but he shared it with my pediatric oncologist and all of my old nurses, one of whom is apparently in charge of the statewide association for pediatric oncology nurses. Besides all of this being very sweet and surprising and flattering, he extended an invitation to come speak to the nurses association - about my current line of work and also about survivor issues.

Are you sure? I said. Because I have a lot to say.

This same social worker couldn't remember that the last time we talked was back in March when we were looking for recommendations for egg donation programs. In fact, he sounded surprised and pretty fascinated when I gave him a quick update of where we were in the process. I am sure it was probably too much information for him, but hey, I wanted to give him a preview of my talk with the ladies.

So, a completely unrelated incident that just happened to be televised has just opened the door for me to work with pediatric oncology nurses to help them try to understand some pretty serious issues facing childhood cancer survivors - infertility being #1 on the list. I am pretty stoked about that.

Re: dinners, I will be hosting one tonight at our house. It's my dad's birthday and my parents are in town after a brief stint at the hospital for dad. Pneumonia. Perhaps I haven't mentioned but my parents' health is not great. Dad's lungs are absolutely shot after 4 decades of chain smoking. Frankly, I was shocked that he made it through all of this moving business without ending up in the hospital. This bout struck while he was in Delaware, moving some stuff into storage down there and relaxing for a few days in their temporary home. My last call to him interrupted him flirting with the nurses at his favorite clinic. Reason #33 for them to move to Delaware. Apparently, the hospital food isn't too shabby in this clinic either. Anyways, his birthday gives us a nice reason to get together while they're in town. And I prefer to control the menu. My place it is.

Lastly, got a random call from a doctor from our clinic last night. One that we hadn't worked with before. Apparently, she is part of the "committee" that met yesterday to discuss our decision to move forward with our donor after a failed stimulation attempt. She wanted to hear again our reasons for doing so, so I gave her the run down - the same one you've read here. Perhaps I came across as defensive, but I wanted her to be clear that we were clear. We understood the risks and appreciated their desire to be sure that we were sure. I asked her if the committee had reservations or if they as medical professionals had information or knowledge that we didn't. Basically, I asked, did they see this as a fool's errand?

She said emphatically not and the committee was surprised that the previous cycle hadn't worked since the donor is otherwise healthy and the mother of two healthy children. After we talked, she said she was glad we had the conversation and that they had worked out a new protocol for our donor, one that would let them (and us) know almost immediately whether a stimulation would be successful or not. I am expecting a call from Nurse this afternoon to review the new protocol and schedule, which, of course, I will post as soon as I know.

Time

Sorry, sorry for the delay. Here's a look at our busy July:

• Thursday, July 12th - ultrasound and bloodwork (to make sure my womb is a happy home), mock transfer (practice run)
• Friday and Saturday, July 13th and 14th - round two of my parents' moving sale
• Thursday, July 19th (approx) - egg retrieval from donor, sperm retrieval from hubby
• Sunday, July 22nd (approx) - one of our best pal B's birthday and embryo transfer
• Monday, July 23rd - chilling out at home; Mandatory 24 hrs. bed rest. yes!
• Wednesday and Thursday, July 25th and 26th - mega meetings at work; practice pretending a potentially life-changing event hasn't just occurred.
• Friday, July 27th - Tuesday, July 31st - finishing touches on my parents' move and closure on their house. Next steps...finding them a place to be.

So, that's the news.

Last night we were out with some friends, one of whom knows the deal. Once we were alone, she couldn't stop talking about how excited she was for us and how she couldn't stop thinking about us and the future. It was really lovely and affirming. We have spent the past week so stressed about changes in my parents' lives, we really haven't had time to be excited about our own. Our focus has been timing and when/if to tell, logistics, pros and cons of parents in another state. (Pros: they're not here. Cons: they're not here.) It was nice to just sit back and dream about some what ifs with people we love.

Yawn

Weekend was sunny and fabulous. More on that later.

I'm delaying that post because it's all I can do to keep my eyes open right now. It's day 10 of Lupron and I think I am experiencing some extreme fatigue. Made it to the gym this morning, but barely. Did some light weight training hoping it would wake me up. No such luck. Stumbled home and back to sleep until hubby gently woke me in time to get ready for my morning meetings.

It's 3 pm and at least three times today, I found myself stumbling again, but on words. I was chatting with a co-working and for the life of me could not remember the word that means that time of day that someone is supposed to be at work, oh right, shifts. We're not talking rocket science here. I suddenly cannot remember words that are part of my daily vocabulary. And that is a HUGE problem when my job is all about communicating. With words.

I hope this goes away.

Bricks without Straw!

Here are more questions from our new patient form that I didn’t know how to answer:

How long have you and your partner been trying to achieve pregnancy?

Who have you told about your struggle with infertility? Have they been supportive?

And then there are categories of family, friends, co-workers, etc. and you’re supposed to check off who knows and who has helped us with our “struggle.”

Is it really a struggle if you know out of the gate it’s not gonna happen? Can you really handicap a racehorse that doesn’t have any legs?

Everyone that knows me knows that I am a cancer survivor. Many in that circle know (or have assumed) that I can’t have or don’t want kids or both. I have probably spent most of my adult life convincing others and myself that I have no interest in kids. Not my own; not anyone’s. Not now. Not ever.

No eggs = no baby. It’s not rocket science.

So, why yearn for something you can’t have? Why set others off on a wild goose chase as well? It’s easier to believe you were never really looking for anything in the first place.

Isn’t it?

Well, now, in a matter of a few short months, all of this has changed. After being dissuaded from the egg donor option years ago by a fertility specialist who felt there were already far too many babies in the world (remind me to tell you about that one), we found a place that has encouraged us, listened to us, and actually given us hope. We found a woman who is willing to share a few of her eggs with me and she doesn’t even know my name.

This is something completely and altogether different.

What do you mean I could have a baby? This changes everything.

So now that there really will be a race, so to speak, things are much less certain. All the definitelies, nos, abosulutely nots, have transformed into possiblies, maybes and could bes.

Now who becomes my circle of support? Whom do I tell about the journey we are about to embark upon? A few close friends and my mother-in-law are no brainers – women who have known me inside and out for years. Even if I didn’t tell them, I feel somehow they would know.

Likewise, a few parties will NOT be brought into the loop until much, much later. Like, my parents (emotional basket cases with problems of their own, prone to excessive worrying and calling daily) and my father-in-law (who cannot keep a secret to save his life).

Some of my co-workers know; some don’t. Most of our friends don’t. My brother, nope. Hubby’s sister, not her either.

Not really worried about any of that. I am sure as the process moves forward and changes in our schedules and lifestyles become apparent, people will start to catch on. Here’s my quandary: what about my childhood cancer survivor friends? I know they would be my loudest cheering section, my strongest supporters. I also know they know the stakes, and might be a little more emotionally invested than others. Which would be joyous if this all works…

I sent a few emails out this morning and my fingers were itching to share the news. We found a donor! We are trying to have a baby! But is it all too premature? What’s the protocol for this kind of thing? When is the right time to call in a circle of support? Who and how and when do I talk about the struggle?