Monday, September 30, 2013
Answers to Your Questions
Since coming out publicly about our plan to try and have a baby through surrogacy, a fairly well-known yet mostly unfamiliar process, I've had a continuous stream of questions thrown my way. Obviously, I'm a very open person and feel I have nothing to hide. But after hearing the same inquiries over and over again, I've decided it might be in all of my readers' best interests to post a blog with all the answers in one place. So, here it goes!
In an attempt to keep things as simple as possible, I've tried to group similar questions together so I won't be jumping all over the place. Let's start at the beginning.
This is such a personal thing you're doing. Why are you writing it publicly for the world to read?
The simple answer is that I have nothing to hide. The more detailed response goes back to my original blog about my cancer journey. When I was diagnosed with cancer I crawled into a little hole and didn't want to talk to anyone about what was happening. I knew my family and friends were concerned, but I just didn't have the strength to keep repeating everything that happened at every single doctor's appointment and every single chemo treatment. I figured if I blogged I could keep everyone informed without having to make 100 phone calls to say exactly the same thing. I promised at the beginning of that blog to be completely open and honest about the situation no matter how difficult things became. I found out that's why people kept reading. My brutal honestly was refreshing for them and made them feel like they actually understood what I was going through. When I chose to end that blog after my last chemo treatment I had people begging me to write again because they missed reading my posts. While I was flattered, I had nothing interesting to write about and I refused to blog about my latest trip to the supermarket just to fill some space on the internet. So, when this new and exciting experience started coming together for us, I figured it would be the perfect opportunity to start writing again. While it hasn't always been the cheery blog I'd hoped for, my initial goal of "keeping it real" will continue.
What's the difference between a surrogate and a gestational carrier?
Good question! You may have noticed that, when referring to Lyndsay, I generally call her our carrier and not our surrogate. There's a reason for that. In traditional surrogacy, the woman - or surrogate - who will be carrying the baby(ies) uses her own eggs, which will be fertilized by the Intended Father's sperm. Because of the use of her own genetic material, a traditional surrogate will be biologically related to the baby(ies) resulting from the procedure.
(Side note: According to Web Definitions, "Intended parents are people who use assisted reproduction to create a child whom they intend to parent, whether or not they have a genetic or biological relationship to that child." Hence, Jimmi and I are the Intended Mother and Intended Father, and jointly, Intended Parents.)
In gestational surrogacy, the woman - or gestational carrier - will become pregnant through the process of in vitro fertilization using embryos made up of the Intended Father's sperm and the Intended Mother's eggs (and/or a donor egg and sperm). A gestational carrier has no biological relation to the child(ren) she is carrying.
In our specific case, Lyndsay is a gestational carrier. The babies, while growing in her uterus, were made from my eggs and Jimmi's sperm. They are 100% our children, with no relation to Lyndsay at all.
How did you know which surrogacy agency to choose?
We didn't. Out fertility clinic gave us two recommendations and we chose the one that had been around longer, assuming they would have more experience. Unfortunately, we found out the hard way that we made the wrong choice. The first agency asked for a large, non-refundable deposit up front, just to get us into their system. In 6 months, they only sent us five possible candidates and all were either morbidly obese, unemployed, living on food stamps, sleeping around (yes, it was on the questionnaire) or had spent time in jail. Not one of them had health insurance, which meant we'd have to buy them a temporary plan. After we finally got fed up with the first agency, we called the second one. Immediately, there was a better vibe. No money was required until a match was made, all of the candidates were prescreened for health and had already had a background check and home study. Government assisted income was not allowed and they all had to have their own health insurance. We were matched with Lyndsay within 12 hours of making the initial call and the agency has been amazing throughout this entire process. (Side note: When I told the first agency we weren't going to use them anymore, the only response I got was, "You understand your deposit is non-refundable, right?")
Why would Lyndsay want to carry someone else's baby?
I figured I'd ask her that question. Here's what she said, "I don't mind being pregnant. I'd wanted to do it (carry for another couple) for a while and then my cousin posted on Facebook that she was looking for a carrier if anyone was interested and I took her up on it. After I did it for family and saw how happy it made them, I wanted to see what it would be like to help someone else."
How does Lyndsay feel about carrying someone else's baby then just saying goodbye? Will there be visitation?
Again, I went right to the source. She said, "I have no heart, so it doesn't bother me! haha! Just kidding. It feels like a normal pregnancy to me. It's my job to protect the babies until they're born then it's my job to hand them over to their parents. I carried for my cousin last year and as soon as I saw the baby I knew she wasn't mine because she didn't look anything like my kids."
It's Suzanne again! I'll answer the visitation question. Lyndsay can see the babies anytime she wants. You have to understand, this isn't a divorce situation. Lyndsay isn't related to these babies so there won't be a legal document in place with a schedule for when she has them and when we do. We fully intend to keep in touch with Lyndsay and her family after the birth of the babies and she can see them whenever she wants. And if she wants to take them for a week or two so we can sleep, that would be fine too!
How does it feel to have someone else carry your babies?
It makes me feel like I'm not a complete woman. It makes me feel broken. It hurts that I can't do this one special thing I'm supposed to do for Jimmi. It sucks.
Do you trust Lyndsay to carry your baby(ies)? You don't even know her.
Let me answer that question with a question of my own. Would you allow someone you didn't trust to carry YOUR child? It's difficult to understand, but I felt an instant connection to Lyndsay as soon as the agency told me about her. After turning down five possible candidates from the first agency, I was convinced we'd never find anyone who we'd trust enough to take on this incredible responsibility. But we were wrong. Lyndsay and I had time to get to know each other before the embryo transfer and I can honestly say we've become friends. I trust her completely to do what's best for my babies and I fully expect us to stay in touch after they're born.
Will the babies share Lyndsay's blood or genes?
No. The babies will get nutrients from Lyndsay through the umbilical chord that connects to their placentas, but each baby has her own blood supply that will not mix with Lyndsay's. As far as genes go, that's a no, too. All of their genes came from my eggs and Jimmi's sperm. Their DNA codes were complete before they entered Lyndsay's uterus so nothing can change them now.
What if Lyndsay wants to keep one of the babies?
I'm sorry, but this question is ridiculous. They're Jimmi and my babies! They're our genetic children and not related to her at all. But, for those of you who might still be worried because you've heard stories of Baby M in the eighties (which was a traditional surrogacy case, FYI), I'll put your minds at ease by letting you know both Lyndsay and Josh had to pass an incredibly thorough psychological evaluation and there is a very lengthy contract in place that specifies these children belong to Jimmi and me.
Will you have to adopt the babies after they're born?
This is a very interesting question because the answer can go either way. If all goes according to plan and Lyndsay delivers in MN, where she lives, the answer is no, we will not have to adopt the babies. A few months before the due date, our lawyer will write up a Pre-Birth Order. This is a document that states, in no uncertain terms, that Jimmi and I are the parents of the babies Lyndsay will deliver. The hospital and all the doctors and nurses will be notified of our situation so there won't be any questions. The only time things could get sticky is if, for some reason, Lyndsay travels out of state and the babies are born outside of MN. In that case, the Pre-Birth Order wouldn't apply and Lyndsay would be considered the babies' mother. What's more interesting about a situation like that is, if Lyndsay tells them Jimmi is the dad, his name will go on the birth certificate with hers, but my name will not be accepted because she gave birth to them. I would then have to adopt my own children but Jimmi would not.
How much does it cost to use a gestational carrier?
Yes, people have actually asked this question. I will not answer with specifics, but I will give an overview of how it works. Obviously if someone is willing to give us the gift of life, I'd expect to pay them for their amazing generosity. Let's be honest, you just can't put a price on what Lyndsay is doing. But one of our requirements when searching for a carrier was that money was not the driving force in the woman's reasons for wanting to carry our child. Not once have we ever thought that Lyndsay and Josh were in this for the money. They both have wonderful jobs and a nice house and health insurance and are perfectly able to support their family without our help. They aren't needy or living on food stamps or begging. They are just good people who want to give us an incredible gift. That being said, I'll now explain the compensation process.
After the agency matched us with Lyndsay, a fee was agreed upon and contracts were drawn up. We are responsible for the agency fee, Lyndsay's fee and all of the fertility clinic's fees, including the embryo transfer and all of Lyndsay's pre and post transfer medications. Unfortunately, we were not able to put the fertility costs through our insurance. There are some additional allowances for maternity clothes and travel and childcare as well. People have also asked if Lyndsay's fee covers one baby or three babies and the answer is, no. She will be compensated an additional bonus for each baby she carries. There are also bonuses for extra medical procedures she might need or want, including an amniocentesis or a C-section. Once Lyndsay passes her next ultrasound she'll be released from our fertility clinic's care (even though she's been home in MN, she's technically still a patient of the clinic in NJ) and passed on to her own doctor in MN. At that point her insurance should take over and we'll pay all out of pocket expenses.
It must be a pain to have your carrier live so far away. Why didn't you find someone in NJ?
The surrogacy laws vary from state to state and, unfortunately, the laws in New Jersey are not clear enough to risk the problems that might arise after the birth. We could've specified the desire for a carrier who lives in Pennsylvania, right on the NJ border, but it may have taken a very long time to find the perfect person in the perfect location. It sucks that we won't be able to go to all of the appointments and may miss the birth if we can't get a flight fast enough, but we decided the perfect carrier in a not so perfect location was more important than a perfect location with a not so perfect carrier.
Who makes all the major decisions regarding the babies during the pregnancy?
We do! They're our babies!
Are you allowed in the delivery room?
As long as we make it in time and there isn't an emergency situation, we should be!
How many eggs did you put into Lyndsay?
First, let me start by making it clear that we transferred EMBRYOS, NOT EGGS into Lyndsay! People keep referring to them as eggs, but that's not the case. Two and a half years ago, my eggs were removed and mixed with Jimmi's sperm to make embryos. After growing for five days, they were frozen to wait until we needed them. When we were ready, we defrosted TWO embryos and both were transferred into Lyndsay's uterus.
If you only put in two embryos, how did you end up with three babies?
Through the miracle of nature! Both embryos that were transferred implanted and started growing, but one of them decided to split into two separate embryos. It was a complete fluke and not anything we'd planned.
If you're having triplets, why do you keep referring to them as "the twins" and "the singleton"?
Excellent question! Let me start by saying that, before we knew there were three babies in there, I'd gotten a lot of questions about what the two embryos would be called if they both implanted. The answer to that is TWINS! Yes, they would've been two separate embryos, therefore, each child would look different, but they'd still be classified as twins if they share the uterus. They wouldn't have been identical twins, they'd have been dizygotic or fraternal twins. Now that I've explained that scenario, I'll move on to the question at hand.
As a whole, the three babies Lyndsay is carrying are called triplets. Three babies sharing a uterus are, by definition, triplets. But if we break them down, there is one baby in her own gestational sac. She is technically a singleton. The embryo that split became two babies in one gestational sac. Those babies are monozygotic or genetically identical twins and will look exactly alike, while the singleton will look different. (Side note: In my last post, I mistakenly referred to the twins as monochromatic instead of monozygotic. Oops!) To complicate matters even more, the triplets are actually referred to as super twins or dizygotic triplets!
How do you know they're all girls?
Well, like this entire pregnancy, that's another example of using science to our advantage. Two and a half years ago, when my 16 eggs were retrieved and fertilized with Jimmi's sperm, we were left with 14 embryos that grew long enough to be frozen. But before they were put on ice, we chose to do PGD testing on the embryos to make sure they were chromosomally normal. Aside from determining that 12 of the 14 embryos were, in fact, healthy (based on the tests that were performed), we were also able to tell the sex of each one. We had an even split of 6 male and 6 female embryos!
Before the transfer, Jimmi and I talked about it and decided, since I already have two boys from my first marriage, we wanted to use two female embryos. So, unless someone at the lab made a HUGE mistake, only girls were defrosted and only girls were transferred into Lyndsay. And, since the third surprise baby is an exact genetic copy of one of the female embryos we transferred, it's scientifically impossible for her to be a boy.
What will you do with the remaining embryos?
Excellent question! If Jimmi and I decide not to have more children, we have three options for the remaining 10 embryos. We can either have them destroyed, donate them to a person or couple to "adopt" or donate them to research. We've decided that having them destroyed is a complete waste. Donating them to a person or couple to "adopt" is also not an option for us. We couldn't live with ourselves knowing our babies are out there being raised by someone else. What if they're being abused? What if they're unhappy? What if they're sick? I couldn't stand the thought of not being able to help them. In the end, we've decided to donate them to medical research so they can help science in whatever way possible.
Will you perform DNA testing on the babies after they're born to make sure they're yours?
Actually, yes. I'm not worried that they'd be Lyndsay and Josh's babies, the reason for testing goes back to what I said in the last question about there being a HUGE mistake at the lab. Look, it's unlikely with all the checks in place, but anything is possible, right?
What if they're not yours?
I can't answer this question because I don't even want to think about it.
How is Lyndsay already 7 weeks pregnant when the transfer only happened a month ago?
I've gotten this question A LOT. Ok, so, in a "normal" situation, or one without help from science, a woman's pregnancy is counted from the first day of her last period. Generally a woman doesn't know exactly when she conceived, so this rule was put into place to make things easier to calculate a due date. When menstrual cycles are normal, ovulation usually occurs two weeks after the first day of the woman's last period. Because conception occurs during ovulation, a woman is considered to be pregnant two weeks before she actually conceives.
Are you following this?
So, with IVF (in vitro fertilization), your cycle is manipulated by scientists to make sure your uterus is primed for implantation. Technically, on the date of your transfer you're already considered two weeks pregnant. BUT WAIT! There's more! Before they were frozen, our embryos had already been growing for five days. Transferring 5 day-old embryos adds five days to the pregnancy that hasn't even happened yet! That means, on August 30, 2013 - Transfer Day, Lyndsay was already 19 days pregnant.
My biology teacher would be so proud of me right now!
Aren't you glad you don't have to carry the babies yourself? It's like the best of both worlds! You get to have babies AND keep your body!
Honestly? No. I'd give anything to be able to carry my own baby(ies). Yeah, it's cool that I don't have to spend 6 months puking and get more stretch marks and worry about losing the weight, but I also won't be able to feel the first kick. I won't know when they have the hiccups in utero. I won't be able to watch my belly move back and forth as the babies toss and turn and stretch. I won't be able to talk and sing to them so they're soothed by my voice when they come out. Jimmi won't be able to rest his head on my belly as they wiggle around. He won't be able to watch them grow inside me every day. We won't be able to make it to every prenatal visit to hear their heartbeats. We may even miss the birth entirely. So, to answer that question again. No. Not at all.
Can/Will Lyndsay pump her breast milk so you can give it to the babies?
There are two different answers here. Yes, she can, but we've all decided that she isn't going to do that. It's enough that she's giving up her body for us for 7-9 months. I refuse to ask her to continue being a slave to our babies after they're born. I was bottle-fed and I grew up just fine!
I've heard you can stimulate your own breast milk to come in. Is that true?
Yes! Pretty amazing, right? Since both of my boys were breastfed and it was a true bonding experience, I looked into this option but decided against it for two reasons. First, I'd have to take hormones to get the milk production going. With my history of cancer, I really don't think that's a good idea. Second, by the time the babies are born my boys will be 13 and 11. I don't know how comfortable I'd feel with them - and their friends! - walking around the house while my boobs are hanging out.
Do you have room in your house for three more kids?
It'll be a bit more crowded, but, yes! Luckily, we do! How I'm gonna be able to cook for everyone is another question, though!
Are you scared?
Is Jimmi freaking out?
Won't it be hard for Jimmi to bond with the babies since they're not inside you and he won't be able to watch you grow and feel them kick? It'll just be like someone's handing him some strange babies!
Since we don't really have a choice, I guess I'm hoping it won't be a problem.
Is Jimmi prepared to raise three babies on his own if your cancer comes back and you can't fight it this time?
Ummm...nope. But, honestly, would anyone be prepared to lose his/her spouse and raise his/her kids alone?
How do Dylan and Justin feel about having 3 little sisters?
They're really excited, but it's not totally real for them yet. Wait until they find slobber and tiny fingerprints all over their iPads and ask them again!
In your blogs you talk about waiting to see what's up with the twins before making decisions. What decisions are you referring to?
This is where things get tough. I've mentioned waiting to see if the twins are sharing a placenta and/or amniotic sac. Each possibility carries risks and both together make the risks worse. If the doctors recommend reducing (aborting) the twins as the best option to save the singleton, we'll have a major decision to make.
On the other hand, even if the twins look ok, we may be faced with the decision to reduce anyway. A lot of factors come into play when triplets are involved. There's not only the health of the babies throughout the pregnancy, but also after birth. If they're born too early, which is very likely, one or all of them could face major longterm health issues. Is it fair to them to try and carry all of them when they may end up living a life of pain? Then there's Lyndsay's health. A lot can happen to her while carrying the babies, too. Is it fair to risk HER life for OUR children? And then, if all goes well with the pregnancy, there are things to consider after they're born. Can you imagine raising three infants, toddlers and teenagers at the same time? Think of the stress on everyone involved. How about the financial hardships? ONE baby is expensive enough. Now multiply that by three! In a perfect world I would never consider terminating any of my babies, but, realistically there's a lot to think about and major discussions need to happen and decisions need to be made shortly after Lyndsay's next ultrasound on October 11th.
Does Lyndsay have any say in whether or not you reduce the pregnancy?
Yes and no. In our original contract, we all agreed we'd reduce anything more than twins. Now that we've been put in the position of having triplets, Lyndsay and I have come to the agreement that we really don't want to reduce if everything is going well. But, for argument's sake, if she decided tomorrow that she absolutely refused to carry more than two, she would legally be able to insist on reducing at least one of the babies. On the flip side, if we decided we wanted to reduce, she wouldn't legally be able to deny our request.
And I'll end with the most ridiculous question of all...
Have you considered putting one of the babies up for adoption? I think it would be in everyone's best interest to reduce stress on your relationship with Jimmi, and you'd help a childless couple in the process.
No, we will NOT be giving away one of our children! They're not puppies! And how would we choose? Eenie Meenie Miney Moe? Give up one of the twins since they're pretty much the same anyway? Maybe I should give them each 1/3 of a silver locket so, one day, when they're reunited, they can put all the pieces back together! Think of how the adopted one would feel if she found out she was a triplet but her parents decided she was the one they wouldn't keep. So, no, we will NOT be giving away one of our babies.
Well, I think that about does it! Hopefully I've answered everything you've been wondering thus far. If not, feel free to message me anything else you'd like to know. I'd really appreciate it if you try to keep it to questions I can actually answer and not about how much it sucks that I can't have my own babies.
And to close, I want to thank you all for reading and sharing my blog! Feel free to keep passing it along!