Category: Hysteroscopy

Part Two-The Gestational Surrogacy Process: Step-By-Step

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Part One of The Gestational Surrogacy Process was finding your surrogate. Now here is Part Two, the step-by-step process.

I left you off with us finding our gestational surrogate, my amazing sister <3

Now, this is where using an agency would obviously make it a much smoother process, not 100%, but maybe a little easier than my sis and I navigating through it all.

I was VERY blessed and fortunate to have my two wonderful ttc sisters, Suzanne(ourjourneytoababybump.com) and Jennifer(2daymightbetheday.blogspot.com ). Without these women and their guidance through this process I would have been lost a lot longer than I was, so thank you both SO much! My TTC Loves!!

Now, here is the step-by-step process for using a gestational carrier/surrogate….hold on…it’s a little overwhelming!

Gestational Carrier/Surrogate:

  • Send prenatal records & delivery records from ALL pregnancies(gestational carrier should have already had at least one child to be considered to be a carrier).
  • Clearance letter from 0B (must be MD, not NP, PA, CNM).
  • The gestational carrier nurse coordinator will review all records and determine if process can continue.
  • Complete phone interview with gestational carrier nurse coordinator.

Schedule clinic visit between cycle days 5-13, her husband/partner will need to attend.

The clinic visit includes:(sometimes it takes more than one visit).

  • Baseline ultrasound including Doppler flow of the uterus.
  • Hysteroscopy(visual but if deemed necessary, operative hysteroscopy will be scheduled before proceeding to confirm clearance).
  • Blood & urine tests per the FDA communicable diseases for gestational carrier and her husband/partner.
  • Additional blood tests include: Blood type with antibody screen, rubella titer, varicella titer, CBC, complete metabolic panel, TSH, free T4, vitamin D & urine drug screen.
  • Annual exam & Pap smear
  • Herpes culture
  • Schedule a Psychologist appointment with a Dr. familiar with infertility and the gestational carrier process (gestational carrier and her husband/partner)
  • Personality tests: MMPI & PAI
  • Mammogram (once between 35-40yrs, yearly >40 yrs)

After the clinic visits and clearance:

  • Secure your own lawyer for representation (paid for by the Intended Parents) and have them contact Intended Parents lawyer to review gestational carrier/surrogate contract.
  • Returned signed consents and finalize contract with intended parents.
  • Mock cycle with next period.

***Once ALL of the above is completed, we can finalize the calendar for a retrieval and transfer.

 

And that’s just for your Gestational Carrier/Surrogate….this is what you have to do as the Intended Parents:

Intended Parents(if you don’t have frozen embryos and need IVF)

  • Baseline ultrasound with resting follicle count
  • Blood work, AMH, communicable diseases (both partners), blood type, CBC, TSH, free T4, vitamin D, Prolactin, complete metabolic panel (can do through PCP), genetic carrier testing if you choose
  • Semen analysis with Anti-sperm antibody testing (ASAB), Culture for bacteria, Sperm Chromatin Assay (if applicable)
  • Psychologist (both partners)
  • Day 3 hormones
  • Pap smear current within the year (we need the pathology report from your doctor)
  • Annual exam current within the year
  • Mammogram report (once between 35-40yrs, yearly >40yrs)
  • Return consent forms
  • Genetic carrier testing consents/waivers, other waivers (if applicable).
  • Lawyer-Finalize contract with gestational carrier & her husband (Clinic needs a letter, not the contract, from the attorney stating the contract has been signed by all parties)

Per FDA guidelines:

  • Female partner will repeat her FDA communicables and do an FDA risk assessment physical within 30 days of retrieval
  • Male Partner will repeat his FDA communicables and do an FDA risk assessment physical within 7 days of retrieval

** *Once ALL of the above is completed, we can finalize the calendar for IVF retrieval and transfer to gestational carrier.

Intended Parents(when doing an FET)

  • Blood work, FDA communicable diseases, genetic carrier testing, if you choose.
  • FDA Risk Assessment Physical (see below) evaluates for high risk behaviors that put you at risk for contracting communicable diseases or other contagious diseases that could be passed on to a gestational carrier and/or a fetus

Meet/speak with:

  • Physician–regroup to discussing using a GC and how many embryos to thaw and transfer
  • Psychologist–to discuss emotional aspects of using a GC; if done over the phone, both partners will need to meet with a licensed mental health provider in person.

Sign consents

  • Return signed consents— Couple using a GC consent, Known consents x3 signed by all parties, Genetic carrier testing consents
  • Waivers (if applicable)
  • Lawyer- Finalize contract with gestational carrier & her husband (Clinic needs a letter, not the contract, from the attorney stating the contract has been signed by all parties)

Per FDA guidelines

* When embryos are created with the intent to use a gestational carrier, FDA mandates that the female partner (egg source) do FDA communicables and an FDA risk assessment physical within 30 days of retrieval and the male partner (sperm source) do FDA communicables and an FDA risk assessment physical within 7 days of retrieval

* Your original intent was not to use a gestational carrier so FDA testing was not completed.

*Now that the embryos are frozen, the FDA want to ensure that both partners are still negative for any communicables they were originally tested for and a few FDA mandated additional ones. It is also required that both partners do the FDA risk assessment physical as well.

OR

*You did complete FDA testing at the time the embryos were created but they have been frozen for more than 6 months. In this case, FDA considers this a quarantine period and wants both partners to redo FDA communicables and the FDA risk assessment physicals to ensure that both partners are still negative for all communicables as you could convert from negative to positive in that 6 months.

** *Once ALL of the above is completed, we can finalize the calendar for a transfer.

WHEW!

It’s a lot…right?! Now, do you get why I’m a “little” overwhelmed?!

We started this process in April of 2015(after our failed 3rd IVF cycle). During my sister’s first ultrasound, my RE noticed a lining that was “too thick”…I mean really, here I have “too thin” lining and my sister has “too thick” lining. I couldn’t believe it. And it honestly scared her a bit. We followed that up with a biopsy, that came back non-cancerous(thank God!), and then a sonohystogram that showed some scar tissue and bumps in her uterus(boo 🙁 ). That confirmed she needed to have surgery…her very first surgery. Because of me. But she did it, she had an operative hysteroscopy and my RE cleared out any scar tissue he saw and confirmed a clear, healthy looking uterus.

3 months later, she was officially cleared to be our gestational carrier….

And here we are.

My sister has been on birth control pills and started Lupron. This is all getting very real.

Next up….prepping for our FET…..I can’t believe we are finally almost there…finally….

Giving Up On Getting Pregnant

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2016 is here.

If you read my last post, 2016 is my year of “Acceptance”. I know, it doesn’t sound too exciting but I have to say, a little relief has already come from that decision. I’m accepting what 2016 has in store for me good, bad or ugly….and I know I can handle it.

So what comes from that decision is also something that I wasn’t sure I could ever really “give up”. But I’m ready to say.

This year, I’m giving up on getting pregnant.

You see, I’ve never, ever been pregnant. Like ever. It’s something I’ve always dreamed of, just as many of you dream of or fortunately have achieved.

But it hasn’t happened for me….ever. And I’ve tried EVERYTHING. Well, everything legal in the USA. I would continue to try naturally, if I could as well, but I don’t have tubes so, I’ve done everything possible with the help of many RE’s….and it just hasn’t happened.

I don’t want to act like this isn’t a big deal. Because it is. It is huge. Most of you, even though some of you are still not pregnant will eventually become pregnant. I’m, unfortunately, a part of the extremely small group of women(less than 0.6%…yep, not even 1%) that have such chronically thin lining that it acts like it’s on birth control when it’s not…and a baby cannot survive in a lining that is 3mm thick.

It really comes down to this for me: Do I want to be pregnant? Or do I want to have my child brought into this world healthy and safe?

Obviously, it doesn’t even come close. I just want my embryos to have a chance at life. I feel it in my gut that one of my frozen embryos from January 2014, will be my baby or babies….and I cannot risk them on me. They are too precious to waste on my miserable uterus to continue to try on me. If you remember, I tried to get a couple of more blasts by doing a 3rd IVF cycle, but we were left with ZERO embryos, more debt and more heartache than I thought I could endure.

So I’m giving up on trying to get pregnant.

BUT

I am NOT giving up on my baby blasts.

And fortunately, we just received news that my beautiful sister’s surgery was successful and she’s been cleared to be our gestational carrier 🙂

Now, this is one small step. If you’ve ever looked into using a gestational carrier, it is beyond the most overwhelming thing possible…like ever. But, I have my sister….and that should make it so much easier….right?!

WRONG.

I swear, they almost make it harder because it’s someone you know and are related to. There are no breaks, at least in California, that they give you for using a relative.

For example, you would think, that since it’s my very own blood sister(who, God willing would be the child’s Aunt), that we wouldn’t really need a formal contract drawn up by a lawyer…at least that’s what I thought…..ummm..but nope. And that alone costs well over $6000+……and it’s my sister….and it makes me sick that after EVERYTHING we have already spent, that we have to now go and spend money on things like that….and that’s just one piece of this giant puzzle when you decide to use a gestational carrier.

But, if this ends up working. Or should I be really positive and say WHEN this ends up working.

I won’t care.

I won’t care about it all and I will thank God for the miracle that is born into this world.

I will be forever grateful to my amazing sister and I will pray that it will finally all make sense.

So, in short, I’m moving on. I’m done with my body, I’m over myself. Chapter closed for now.

But there’s also finally some good news folks. My sister’s uterus has healed….and we are now in business.

FINALLY some good news…let’s keep it going 2016…

We sure are off to a good start…..