Issue 25: A step back and a step forward
Saturday December 01 2018
Our surrogate Melissa’s uterine cyst is technically an abnormal sac filled with fluid, but it may as well be a broken traffic light in the middle of Clapham Junction for the inconvenience and anxiety it’s causing us. We need to wait a few more days to find out if it has been resolved.
It is not lost on me how uncomfortable it feels to be “inconvenienced” by how a stranger’s body is functioning. It seems controlling and I definitely don’t like it; first, for the reality of the whole thing — woah, I am enlisting a stranger to do what my body cannot — and second, for the “employment” aspect. That is the huge elephant in the room where surrogacy is concerned. The whole concept is a vast and scary landscape with grey areas bigger than Lake Michigan. (Have you been? It has its own beach!)
We chose America to ensure that we do this exactly right, so the business aspect is just not something I allow myself to think about too much. When I do, I can’t tell you how much I wish money were not involved here. The astronomical cost of the thing is one matter, but it’s one we can reconcile eventually (when we put our “The Bank Rob Project” into action). Yet the emotional and moral implication is an entirely different thing. And it’s harder to appease. I do so by researching heavily, understanding exactly how to avoid exploitation — both ways by the way — and forming a trusting and open relationship with Melissa so that I know without doubt that she is in this for the right reasons.
This is where America comes up, ahem, trumps, as it were. The regulations are there to protect the surrogate and the intended parents, but still. Hi Melissa, you’re contractually obliged to tell me how your uterine cyst is doing. About as appealing as forcing someone to tell me what her menstrual blood looks like. Holy hell, I may have to do that too one day.
So while we wait for news of cyst shrinkage, on to happier thoughts. We’ve enlisted a whole other person to perform another task my body cannot bring itself to do. Make some eggs! About bloody time too. Donor 234 has started her stimulation meds and we are due to get some egg-retrieval news on the same day that we’ll hear about the cyst. Auspicious or what?
The making of the embryos is the exciting and nerve-racking bit for me. It’s a numbers game. How many eggs will she produce? How many will make friends with Mr B’s sperm enough to fertilise? How many times will I need to write that down until it doesn’t feel like some bizarre form of cheating dagger in my heart? How many will survive to blastocyst stage? Ultimately, in the end, the most important number is how many attempts do we get?
So this is how it went. We receive an email from the fertility clinic.
“Hi Intended Parents. Yesterday, we retrieved 19 eggs from the donor. This morning, we have 18 eggs that fertilized normally — an excellent result! Now, we’ll plan on freezing all embryos that make it to the blastocyst stage.”
Woah — 19 eggs that turned into 18 tentative embryos?! Forget the cheating alarm bells, this seems like a match made in petri dish heaven! Now we wait and see how many survive to the desired day six (most clinics transfer three- or five-day-old embryos, but recent research has shown that day six embryos might be the strongest).
OK! We’re back in the game. And it’s kind of a tennis game, because having hit the egg retrieval ball with a strong forehand we’re smashing it back to cystgate. Any news from the agency? We ask our co-ordinator, Jane.
“I have not heard back from Dr Y as of yet, but based on the technician’s statement, it looks like it has shrunken. I hope to have more details for you later today.”
More tentatively amazing news, skimmed the net with a neat volley, straight back to the embryos and another email from the fertility clinic:
“We have completed the biopsy of your embryos . . . ”
Ah yes, we’ve chosen to intervene scientifically a bit more here. There are “upgrade options” for IVF patients that make particular sense when you have a short time frame, say, or have had repeated miscarriages, or are spending your entire future on trying to win at surrogacy. One of them is called PGD, or pre-implantation genetic diagnosis. I’m not a scientist so I won’t go into it too deeply, but by whatever means of creating perfectly healthy-seeming embryos you choose — naturally or assisted — about a third will have some chromosomal abnormality that the body will try to eliminate by way of rejection (aka failed pregnancy or miscarriage). It explains why the high rate of miscarriage exists in that 12-week window of secrecy and nervousness before you can let the world know that you’re pregnant. PGD involves taking a tiny single-cell biopsy from the embryos to test for any abnormalities or genetic diseases, so that you know you’re transferring the chromosomally “normal” ones back. This reduces the risk of miscarriage and increases the chance of implantation. It’s an investment-worthy no-brainer for us.
But before we take that step we lose a point with some disheartening news. Of our 18 embryos, only five developed adequately for the PGD testing. It feels like a blow, the thought of so many potential embryos not making it is really quite sad. Try as I might I can’t help humanising them, even before they’re viable. On top of the premature grief, we were hoping for continuing with more day six embryos after our seemingly strong start. Now we need to hope they all test well.
“ . . . Your chromosomal analysis results should be ready in approximately seven days.”
In match terms, it’s squeaky bum time.