MicroblogMondays: Progress – MitoScore and Legal Paperwork

Microblog_Mondays

It’s very encouraging to see progress on our surrogacy journey.

First of all, we received the MitoScores of our embryos.  The two day-5 embryos (3AB and 3BB) both have a grade of A, which means that they have a high implantation potential of 81%.  The two day-6 embryos (5AB and 5BB) are Bs with an average implantation potential of 56%.  Dr. E recommended transferring one embryo with the MitoScore of A.

This is such excellent news.  Both Bob and I are so relieved that we have embryos with excellent quality for a transfer.

On the gestational carrier front, we finished a questionnaire and signed an agreement for the escrow account with our attorney.  Last week we had a very informative phone call for about 30 minutes with the attorney and her paralegal.  As you may know, in order to make the surrogacy legal and for us to take our baby home, legal paperwork has to be filed in our gestational carrier’s state.  Our attorney is located in that state and is very experienced with this type of contract.  The following are the main points:

  • We will receive the draft of our contract with our gestational carrier in the next week or so.  We will read it over, make changes, and ask any questions or raise any concerns.  Once we are satisfied with the changes, our gestational carrier will go over it with an attorney that will represent her.  That should take about a week.  We are hoping to get the contract done by the first week of October, and second week at the latest (because I am going to be leaving for Asia at the end of second week of October).
  • At about 20 weeks of the pregnancy, our attorney will help us finalize the medical power of attorney which allows us to make decisions for the baby.
  • Our gestational carrier’s state laws stipulate that we get a post birth order, which means that a court order is obtained after the birth of a child.  The court will direct Vital Statistics to add the biological parent’s name (Bob’s name) on the birth certificate, remove our gestational carrier’s name, and grant legal guardianship to me as the other intended parent.  This is done because we have used donor eggs.  If we were both biologically related to the child, then we would both be added at that time.  The hearing is scheduled every two weeks at the court, so on average we should have the hearing done within two weeks after birth if not sooner.  The hearing should take no longer than 30 minutes.  We will be asked a list of questions mostly by our attorney and may also be by the judge.
  • We can leave the hospital with our baby and go home as soon as the doctor clears us to leave.  Our attorney will represent us and we will attend the hearing via phone.
  • We should get the court order a few days after the hearing.  Then the birth certificate should be amended by Vital Statistics within 5 to 10 business days with only Bob’s name on it as if he has made the baby all by himself. 😉
  • A recent change in the law in our GC’s state requires an intended parent who is not biologically related to the baby to file for a second parent adoption in our home state so that I will also be named on the birth certificate.  We will need to hire a different attorney in our home state.  I will have temporary custody of our baby until the court order is done, which will take three to six months.
  • Our attorney stated that the court process is quite simple.  She will prepare all the paperwork for us to read prior to the birth so that we just need to sign at the time of birth.  She said that there are going to be many other things to focus on at the time of birth so she doesn’t want us to spend the time reading all the legal documents.
  • One very important thing that our attorney wanted to speak with us about was the number of embryos to transfer.  Our answer on the questionnaire said that we may transfer one or two embryos. She wants us to be very careful with this choice.  Our gestational carrier lives in the northern part of the state and lives very close to the border of a neighboring state that is NOT surrogacy friendly.  If we transfer two embryos and are expecting twins, the chances for complications and the need for a level 4 NICU are a lot higher with twin pregnancy.  The hospital that we intend to have the birth does not have a level 4 NICU.  If any complications arise, it is VERY likely that our gestational carrier will be transferred to a hospital with a level 4 NICU that is in the surrogacy unfriendly next state.  It doesn’t mean that a singleton pregnancy is a guarantee that it will be free of complications, but the chances are a lot lower.  So our attorney wants us to think long and hard about the number of embryos to transfer.  And if we do transfer two and expect twins, she wants us to have a plan B for the delivery.  Our gestational carrier can still give birth in the local hospital in her state and we can always transfer the baby/babies to the level 4 NICU in the next state if need be.  If our gestational carrier gives birth in this other state, the legal ramifications would be great.  We don’t want to go there.  It all sounds very scary so I have already spoke with our gestational carrier and she is going to try everything possible to stay in her state when she gives birth to our baby.

Dr. E, Annie (our gestational carrier), and I have been coordinating the earliest possible date for a transfer.  It would be the best for Annie if we could do a transfer on a Monday.  She and her husband can fly in on Sunday, have the transfer on Monday, and rest on Tuesday before going home on Wednesday.  She said that this has been a source of stress in her household because they don’t live near any family members so they couldn’t figure out who could take care of their two younger children.  She thought about driving the whole family on a roadtrip for the transfer, or even flying the kids over with them.  However, she would really want to take this opportunity to take a vacation with her husband by themselves, sans kids.  She finally enlisted her 19-year-old son and his wonderful girlfriend who will watch the 3- and 5-year olds.  We have now tentatively settled on a date: October 31, 2016.  Halloween!!!  Hopefully I won’t be jetlagged anymore (after my return from my trip on October 27).  I mean, I will still have to figure out other things like buying the medication for her and arranging for local monitoring appointments.  Nevertheless, this is an exciting time and I am so grateful for all these forward movements.  I am also trying not to let my appointment with the Breast Health Clinic later today dampen my excitement.

Almost time to make a baby!

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Great News!!!

I love it when good news comes at an unexpected time.

I was supposed to go see Dr. E tomorrow for our PGS results.  She emailed me this afternoon as soon as she got the news!

The subject line said “Normals!!” so I knew that we have some normal embryos.  However, she didn’t specify how many normal embryos we have.  She wasn’t sending me the report because gender of the embryos was listed there, and I don’t want to know the gender at all.  She said in the email that right now would be a good time to connect since we had the report then.  She asked if I would like to meet in person or talk on the phone.

Of course I wanted to talk on the phone.  But the most important piece of information that was missing was the number of normal embryos.

Her response: 4

We have four normal embryos!!!!!!

Praise the Lord for answering our prayers!  I have been praying for the perfect number of normal embryos that God has already planned for us.  And here is our perfect number!

I am so relieved and incredibly grateful.  I think our chances of having a baby are great!

Yesterday I went to see my therapist and told her about my fear of not having any normal embryos.  It helped to speak with her as she gave me strategies to get away from my negative thoughts.

Later this evening Dr. E and I spoke on the phone.  We were both so happy to have these embryos.

I came to find out that embryos 1, 2, 4, and 5 are normal.  They are Max, Noelle, Penny, and Quentin.  I don’t have their grades at the time of freeze.  Number 1 and 2 were the day five embryos that were 3AB and 3BB.  Number 4 and 5 were the day 6 embryos that were 5AB and 5BB.

We will know the mitoscore in the next few days.  This score tells about the implantation potential of each embryo.  Dr. E will make recommendations of which embryo and the number of embryos to transfer.  Grade A and B are good.  Dr. E checked and said that our donor’s first cycle with her had 6 normal embryos and all 6 had a mitoscore that was graded A.  The second cycle with Dr. E, 4 out of 6 were A and 2 out of 6 were B.  According to her, the mitoscore is all dependent on the egg quality and not sperm.  So given the previous results, she said that it’s very likely that we’ll have good mitoscore for our embryos.

She said that just looking at the embryos now, she would probably recommend transferring the 3AB.  She asked her assistant to send me the embryology report at freeze time so I will know what the final grades of the embryos were before freeze.  She doesn’t remember exactly but she said that she didn’t remember seeing a downgrade on the embryos.

I asked Dr. E if the sperm played a part in the number of normal blastocysts that we have.  She said that it’s not clear.  The donor did have two perfect cycles but our number is not out of the ordinary.  Maybe this is the new normal for this particular donor.

This is such great news!  I can breathe more easily.  And I don’t have to drive an hour to see Dr. E tomorrow. 🙂

If this is in God’s will, we should be able to have a baby in our arms next summer!

MicroblogMondays: Inching Closer to Our Baby

Microblog_Mondays

I have to admit that this process of getting to our baby is going pretty well.  And I am not afraid of jinxing it.

We have six blastocysts.  The most that we have ever had in our journey to our baby.  I am not going to lie about it.  I still have a certain degree of worry/fear/anxiety of not having ANY normal embryos to transfer.  Whenever I have this fear, I try to remember what my dear friend A. told me about her therapist’s advice on probable vs. possible: to acknowledge that the thing you fear is highly improbable.  So I am trying my best to trust God and believe that He has the perfect plan for us regardless of the number of normal embryos we have.  

On our gestational carrier front, things are moving along as well.  There was some hiccups with Annie, our gestational carrier’s blood work results.  Her TSH is within normal range for a regular person but not for the IVF/TTC world.  After a retest to confirm the higher than desired value, Dr. E has prescribed Synthr.oid to her.  Her levels should go down quickly but Dr. E didn’t pass her medical screen until the day before our donor’s retrieval.  It was so great to get the green light to move forward because without her passing her medical exams we wouldn’t be able to move forward to the next steps.

Annie finished her psychological evaluation last Tuesday.  She told me that there were a few difficult questions as well as an online assessment of her personality on which she had to answer 344 questions.  She got them all done in a day. What a trooper!  The next day Dr. E, who received the results from the examiner directly, notified us that Annie passed her psychological evaluation with great results!  That was the same day we made those day 5 blastocysts.   Both were so exciting to hear.  Bob and I had a phone counseling session with the same LFMT who asked a bunch of questions about the issues surrounding surrogacy.  That phone call was only 23 minutes long.  I joked that it was probably the easiest $100 she had ever made because we had an answer for every issue that she asked about as we had thought about each one already.  Rather than a counseling session, it was more like a question and answer session.  She asked the questions.  We answered them.  But the good news is, it was done and we could move forward.

Drafting the legal paperwork is our next step.  We haven’t received the details from the attorney yet so we don’t know what is involved.  All I know is that it takes three to six weeks to finish the contract.  And without the contract signed, we cannot start preparing Annie’s lining for a transfer.  So getting the contract done as soon as possible is our immediate goal.  Looking at the calendar, if we can get the contract done at a fast rate, I am hopeful that a transfer can be scheduled for the 3rd or 4th week of October.  If that truly happens and a pregnancy is achieved, our due date would be around my birthday next year in July.

In five days, we’ll find out the fate of our blastocysts.  We are full of anticipation, hope, and joy as we enter the next phase of our quest.

Final Tally of Blastocysts

I felt tremendous peace last night and this morning.  I knew that we were covered in prayers.  We prayed last night before bed and this morning when Bob woke up at 5:30am for his run.  We prayed for the embryos to grow well, and prayed for God’s perfect number of embryos.  The nervousness that I felt was almost all gone.  If it is in God’s plan for us to have just those three embryos, I choose to be grateful and joyful about it.  If His plan is for us to have more, He will provide.  This peace enabled me to sleep through the night.  God is amazing and prayers are amazing.

Usually Dr. E would write me between 10am and 12pm.  I was in and out of my office the whole morning.  Every hour I came back to check my email, there would be nothing.  After my last client in the morning, I came back to my desk at noon and gmail still had no new message.  Suddenly Dr. E’s email popped up.  The title said, “Today’s report :)”.  I like anything that Dr. E wrote with a smiley face.  She said, “Another 3 beauties today, maybe 4!  Total 6-7 beautiful blasts.  Exciting!!”

What a relief!  The attached fertilization report showed that on day 6 (today) at 6:21am, there were one 5AB and two 5BBs.  There were also four 3CCs and one 2BB-.  I don’t quite know what that minus means.  It seemed to me like the lab would check on the lesser grade blastocysts to see if they would grow more.

Later this afternoon, Dr. E’s email confirmed that we have a total of three embryos biopsied and frozen today.  That brings the tally to a total of six blastocysts.  She said this about the rest of the embryos: “The others were not viable i.e. no chance for pregnancy.  The cells stopped growing and dividing when they checked again this afternoon.”

Praise the Lord that we have three additional ones!

The PGS testing results will be available in a week.  I emailed Dr. E to tell her that I would prefer not to know the gender of the embryos.  She said that she doesn’t tell the gender, that’s why she would like to meet with patients to go over the results if that’s possible.  She is so nice.  Her assistant said that the clinic typically doesn’t see patients on Friday afternoon, but Dr. E was happy to make an exception for me.  So next Friday September 16 in the afternoon we’ll find out how many of our embryos are normal.

I know that we don’t have as many blastocysts as our donor’s previous cycles, but I am super grateful for us to have these six to work with.  I am hopeful that some of these are normal and one or two of them will become our future child(ren).

We have Penny, Quentin, and Ruby joining us.  A total of six.  This is such a milestone that is worth celebrating!

P.s. I vetoed Bob’s suggestion of naming our “P” embryo “Pringles”.

Max, Noelle, and Owen

Just a quick update.

As of today, we have three full blastocysts that have joined our embryo family: Max, Noelle, and Owen.

They were 3AB, 3BB, and 2AB. They were biopsied this afternoon and were frozen.

The rest of the embryos are as follows:

1BB, 1BC, 1BB-, two early blastocysts, and four morulae.

Dr. E asked her assistant to email us the fertilization report in the morning as she was still in procedure.

I didn’t know what to make of the grades when I read the email.  I was a bit disappointed that we didn’t have more full blastocysts.  I was hoping for at least 4 or 5 of them so I’d feel better.

Dr. E called me at 12:30pm.  She sounded happy, saying that we had some beautiful embryos this morning.

This is what I gathered.  She said that this is a fluid process.  The fertilization report is just a snapshot of the embryos at 6:49am.  The three expanded blastocysts (3AB, 3BB, 2AB) would most likely be biopsied and frozen (which they were) in the afternoon.  The three 1s (1BB, 1BC, 1BB-) are not expanded blastocysts yet so Dr. E said that they can’t be biopsied yet.  They need to grow into full blastocysts before they can be biopsied.  And plus, she said that the grading can change as the blastocysts continue to grow.  She said that our cycle at this stage (day 5) looks quite similar to our donor’s last two cycles.  She also said that the morulae could grow into blastocysts as well.  So now we have a total 9 more embryos that the lab is watching overnight.  We’ll have a report on them tomorrow.  I asked if the sperm quality affects the embryo quality.  She said for sure.  But she thinks that it’s too early to say how many embryos we will have tomorrow, but she believes that we will have some.  So it’s a waiting game again.  I told Dr. E my fear.  She said, of course our mind often goes to the worst case scenario.  But today we have three beautiful day 5 blastocysts.

How do I feel?  On one hand, I feel very grateful as this is the farthest we have come.  We have never had any day 5 embryos that are full blastocysts with the grade A in it.  And we still have a chance at more blastocysts tomorrow.  On the other hand, I just have this fear that none of the blastocysts are normal or that we don’t have anymore blastocysts to freeze.

My sister-in-law sent me this text tonight:

“Philippians 4:6-7. Do not be anxious about anything, but in everything, with prayer and petition and thanksgiving, present your requests to God. And the peace of God that transcends all understanding will guard your hearts and mind in Christ Jesus.

Father God, We give thanks for these embryos, for the miracle of creation– knowing Lord that you are the creator -the almighty God.

God we pray that your hand and will be on these embryos, on these procedures, on these doctors, on Isabelle and Bob and all the spaces and breaths in between.

I ask that your presence be known, and that your encompassing peace would rest on them.  You are good and we praise you.  Amen.”

I will try my best to hold onto God’s goodness and His presence, and to also celebrate the fact that Max, Noelle, and Owen have joined us.

And I continue to pray for God’s perfect number of embryos for us.

Day Three Report: Twelve 8-cell Grade 1 Embryos

Yesterday was Labor Day.  Both Bob and I were home.  Yesterday was also the day to find out how our 17 fertilized eggs were faring.

I am not going to lie.  I was super nervous.  I had a reason.  At our last donor egg cycle with our frozen egg, all 10 eggs thawed and fertilized well.  The day three report was horrible as there was no grade one embryos.  Everything was grade two to grade four, from 4-cell to 10-cell.  We ended up having only one early blastocyst that we transferred and one day six blastocyst that was later transferred.  They resulted in one chemical pregnancy.  It was hardly a good cycle.

Yesterday I had this fear that all of the embryos somehow had died.  It was super irrational, I know, but I couldn’t help having these thoughts.  We have been traumatized for so long, it was hard for me to keep these thoughts out of my head.

I had so much nervous energy that I started cleaning the floor, tidying up things, and folding laundry.  Yup.  I clean when I am angry or nervous.

Bob wasn’t too much better.  He was super distracted while working on an assignment.  I checked my email every three seconds.

Dr. E’s email came after 11am.  Once I saw her subject line, I knew we had good news.

She wrote on the subject line: Gorgeous!!!

This is her email:

“Good morning!

We have GORGEOUS embryos this morning!

We have 12 embryos that are 8-9 cells and grade 1

1 = 7 cell grade 1

1 = 6 cell grade 1

1 = 8 cell grade 2

1 = 6 cell grade 3

1 = 4 cell grade 3

Next report will be on Wednesday

I expect approximately 8 blastocysts or more on day 5 = Wednesday

More news to come!

:)”

Wow!!!  Out of all of my own egg cycles and that one DE cycle, we have NEVER had ANY 8-cell grade 1 embryos.  It is out of this world to have 12 of them!  Looks like all 17 embryos are still dividing, with the 12 8-9 cell grade 1 ones that are leading the pack.

Praise the Lord for answering our prayers!

I was grinning from ear to ear.  My shoulders were finally down.  It was the best news ever!

I know that we still have a way to go.  First we need to have some blastocysts tomorrow.  Then we’ll have to test them to see which ones have normal chromosomes.  But we are definitely heading to the right direction.

My dear friend Jane is right.  Maybe we will need to come up with a bunch of embryo names this time.

MicroblogMondays: Clinging to the Positive

Microblog_Mondays

Last week was such a rough week.

Because of our donor’s cocaine debacle, both of us were extremely distracted from work and from life.  All the phone calls and emails with all the professionals, family, and friends were taxing our attention, time, and energy.  One day everything was going smoothly.  The next day, our life was turned upside down.  So many doubts, fears, and worries surfaced.  One person’s selfish act, lack of concerns for others, and lack of integrity wreaked havoc in our lives.  We were exhausted emotionally, physically, and mentally.  Extra courage and strength were desperately needed on those few days for us to function.

Amid the chaos, we see the love, beauty, goodness, and positive that were poured over us.

God is teaching us to hang on to the positive despite walking through the valley.

We see how truly beautiful our gestational carrier Annie is.  That morning I called her to tell her about our decision to continue our donor egg cycle despite our donor’s breach of our trust and contract, Annie was so calm, gentle, and full of reassurance.  She not only took care of me and my emotions that morning, but she also thought of taking care of Bob’s.  That night, Bob came home and told me that Annie’s husband Kenneth called him on his way to work that evening just to chat.  Bob didn’t recognize the phone number but saw that it was from Annie’s area, so he picked it up.  For someone who usually doesn’t pick up unknown phone calls, that was definitely a divine intervention.  Bob said that they had such a good chat about life, their work, family life, and a little about the donor’s choice.  This 20-minute phone call with a brother in Christ reflects the thoughtfulness and caring nature of our gestational carrier and her life partner.

We are so blessed to have them in our lives.

And then, there was my friend Jo.  She has been there every single step of the way in the last few years of our journey.  She knows the ins and the outs of our struggles.  The day I returned to work after taking a day off to take care of the mess that was caused by our donor’s positive drug screen was extremely busy with clients and a presentation.  Jo was so sweet.  She took care of me by ordering dinner and having it delivered to our house so that I could take a break from cooking.  And bless my husband’s heart.  He knew exactly what I had been craving so he clued Jo in on the type of food to order.  The sushi that night was truly a treat after a few long days of emotional exhaustion.

And surprisingly, I don’t feel anger towards our donor anymore.  Instead, my heart has been prompted to pray for her and for her salvation. This definitely is not my own doing.  The Holy Spirit is once again doing something that is so unexpected but beautiful.

And then, we also see how God has sustained us through all this.  After the decision was made to continue with the cycle, the peace that I have felt is unparalleled and is such a confirmation that this has been the path that aligns with God’s will.  Although we don’t know how this cycle will turn out, I no longer have that gnawing pain in my heart.  I am amazed at how quickly we bounced back from being at the bottom of the pit, but it is no coincidence or accident, and it is not our own ability or doing.  Nothing that we did could take us to that place of peace.  It is solely the Holy Spirit that took us to that space.

Later today we will know how many embryos are still in the running.  Fear comes and goes in my heart, such as the possibility of the embryos growing poorly or not having any blastocysts to test.  Fear is normal, but I have to remind myself that fear does not come from God.  Seeing the positive that God places in our life helps us move away from the space of fear and worry.

Despite this path to our baby that has been lengthy and grueling, it is a blessing that we can cling to the God-given beauty and positive in life as we wait expectantly for our journey to unfold in front of our eyes.