Preparing for IVF: 16 Days and Counting

We are starting the IVF process again to try and have a sibling for my niece.  It worked out so beautifully the first time.  God truly blessed my sister and brother-in-law with a beautiful little girl inside and out.  She's such a happy girl.  I'm going to do my best to document the process, hopefully even better than I did the last time.

About two weeks ago, I began birth control pills (Reclipsen) so that I would have a period and the clinic could put me on a proper medication schedule.  After nine days, I developed a severe headache and nausea related to the Reclipsen and our doctor took me off the meds.  The clinic told me to inform them if I had a bleed anytime within the following week.  Turns out we didn't wait long - two days later I started my period.  That was three days ago.

After starting my period, I began applying estrogen patches to my abdomen, which have to be changed every other day.  The patches will increase in number over the next two weeks as we near the transfer date, but I will need to use them for a total of 64 days.  The transfer is 16 days from now and counting.

We aren't just counting the days down - there is much to do!  My sister is working on all the legal details and travel plans.  She is preparing all the paperwork the Jones Institute requires to do the IVF: contract, consent forms, etc.  It is quite a process.  She and my brother-in-law, and my husband and I all have to be HIV-tested as well.  Though we haven't had to go through a psychological evaluation this time around, the first time before becoming pregnant with my niece, we all had to sit down together and interview with a psychologist, who then had to send a psychological fitness report to the clinic.  Thankfully, the whole process this time is easier, especially since we no longer live in the Norfolk area where the clinic is located.

With homeschooling the kids, my husband in school and working, and me also in school, the time is sure to fly by.  I hope to still have plenty of time to share meaningful moments, details of IVF surrogacy, and any challenges along the way. 

Shared Sorrow, Shared Miracles

As I sit here staring at my pregnant belly, I’m contemplating the reasons why I would tell this story. It’s not only mine to tell. The truth is that I’m only playing a part in the miracle that is unfolding. The journey I am on is entwined with that of another person whom I love deeply – my sister Valerie.

As a kid, one thing my sister always knew with absolute certainty was that she wanted to be a mom. She’s always had the heart of a mom. I understand that drive toward motherhood. I was the same. Neither of us could have imagined that having children would turn out to be a struggle. Infertility is not something on your mind when you are busy saying “I do” and planning a future complete with a family. I think most people naturally assume that it will happen in due time, if not on command. It’s simply not that, well, simple.

I was married in 1999 with no immediate plans to try and have children. We knew eventually we would have a family and were in no hurry. It turned out that God had other plans and we were pregnant six weeks later. I was stunned to be pregnant considering my historical lack of ovulation. In fact, I hadn’t had a period for seven months prior to becoming pregnant. It was definitely meant to be.

When our son was born, we knew we didn’t want to become pregnant again until after I finished college. Fast forward 2.5 years – I graduated, we moved half-way around the world, then began trying to conceive. Year after heart-breaking year we waited. It was agonizing, especially seeing friends around me becoming pregnant. I was sad, frustrated, envious, and confused about why we were having such a hard time having a second child. We wanted desperately for our son to have a sibling as well. After more than five years of infertility we finally decided to see a specialist. Until then I’d never heard of secondary infertility. Since I wasn’t ovulating at all, and hadn’t cycled in roughly nine months, the doctor recommended we use the fertility drug Clomid. After one cycle on Clomid, I became pregnant. We were elated that we’d conceived so quickly. Unfortunately, our joy lasted only three months before I learned I’d had a “missed miscarriage.” One day the baby was there with a heartbeat, arms, and legs. A week or so later, the heart had stopped and the arms and legs had already begun to disintegrate. I was devastated! I eventually had to undergo surgery to remove what my body would not miscarry on its own. I knew at the time that there was a reason for my loss, horrific as it was, and I was determined to find a positive.

One year later, my husband and I decided to try one last time to conceive. We would use one more cycle of Clomid and prepared ourselves to except the results, no matter what they were. It was our last hurrah. Once again, using one dose of Clomid, we conceived. At seven weeks we learned we were having twins! I was able to carry nearly to full-term two beautiful, healthy babies – a boy and a girl. My children were nearly ten years apart. They are miracles to me considering my history.

During all the time I was having fertility issues my sister was having a fertility crisis of her own. Unlike me, she has always been able to naturally mark her cycles on a calendar. She could tell you nearly within hours when she would start her period. I thought she was tremendously blessed in that regard. Unfortunately, though she was able to conceive with no assistance, she had recurrent miscarriages. Around the time she had her 6^th or 7^th miscarriage, I made a comment to her that if it came down to it that I would carry a baby for her. I know for certain that she would do the same for me. That first conversation was sometime around 2007. She thanked me, but quickly dismissed it as a possibility. As she continued having one miscarriage after another, she gradually began to think that perhaps she would never be able to carry a baby to full-term. Sometime around her tenth loss, she and my brother-in-law began to think seriously about my offer. Perhaps surrogacy might be their only chance to have children.

After delivering my own twins, moving again half-way around the world, and undergoing a double mastectomy and reconstruction, we decided to pursue IVF using my sister’s egg and her husband’s sperm. We were incredibly blessed to become pregnant on the first attempt. Now at 13+ weeks, I stare at my pregnant belly thinking about what we’ve done and what’s to come. People ask me if it was a difficult decision to make, being a surrogate for my sister. They wonder aloud if I will have a hard time giving the baby to my sister and brother-in-law. Some have put me on a pedestal for doing this for my sister. All I can say to these things is that it would have been infinitely more painful to watch my sister miss out on motherhood – to see the loss in her eyes as she plays with my children would be heart-wrenching for me. The day we deliver will be a day full of emotion. I have to say though that this is something Valerie and I are doing for each other. She is giving me just as great of a gift. She is allowing me to be an aunt for the first time, to give my children a cousin to walk through their lives with them. She’s also giving my own infertility struggles and miscarriage meaning. I truly believe I went through these things in order to prepare my heart for the moment my sister would need me…to relate to her…to grieve with her…and ultimately, to play a role in making her the mom she was always meant to be.

A large number of people have told me they've contemplated being a surrogate. The thought honestly never crossed my mind until my sister had this need. Now that we're walking this path together I can't imagine not being here with her. It's been an amazing experience that's brought new closeness to already tight relationships between my sister, brother-in-law, me, and my husband. We are all excited about what the future holds and looking forward to someday in August when we can count ten fingers and ten toes!

How Many Hands Does it Take to Rub a Butt?

My husband did a brave thing tonight. He overcame his apprehension about giving me a shot and took the plunge, pardon the pun. I was a bit nervous as he prepared for the task. I knew he and my sister were getting the syringe ready. They tried hard to hide it, but I'm fairly observant which consequently makes it hard to pull a fast one on me.

I was quite pleased with myself that I was better able to control my nerves and face the needle without tears or other signs of anxiety. In truth I've pretty much just resigned myself to dealing with it.

Without the usual fanfare, Arie dove right in and delivered the shot to the left side of my butt. Where the whole experience departed though was in the pain. Previously, I've not actually felt the needle. Arie however, had never given a shot before and moved just slow enough that it pinched. He definitely learned his lesson.

I'd like to give a nod to two people who helped him tremendously: my sister and my 17.5 month-old son. Because Arie was uncertain where to stick the needle, my sister grabbed a black Sharpie marker from the side of the refrigerator and drew a large circle on each side of my butt! I said, "Did you just draw on my butt with a Sharpie?" "Yes," she said. I'll spare you the photo she took afterward to show me. Our little boy, whom I affectionately call Bubba was even more helpful. After Arie pulled the needle out and began to rub my butt so as not to leave a knot, Bubba walked in the kitchen and reached up to help Daddy rub it in. He's such a big helper! :)

A Funny Thing Happened On the Way to Getting Pregnant: Our IVF Experience

Today was the day my sister and brother-in-law have been waiting for a long time. As I laid in bed this morning I began to ponder what the appropriate outfit is to wear on the occasion of becoming a surrogate for your sister, using her eggs and her husband's sperm. It's not like I needed to don lingerie (though I didn't honestly think of that one until we were nearly to the clinic). I started to wear jeans and a long-sleeve t-shirt, then thought better of it. That would have been way too casual. I eventually opted for slimming black jeans and a pinkish cashmere sweater. Someday these things might matter. LOL

When I finished dressing myself, I reached for the card I'd bought Val. A week ago I'd visited Hallmark looking for the perfect card that says "I'm ready to loan you my body for nine months - and I'm actually happy about it." Not surprisingly, it doesn't appear there are cards that fit that category. Pouring through the store, I finally found the one. It was yellow with some black writing on the front that says, "NICE." The inside sports the words, "Way to go!" The whole thing is accompanied by the song Whomp!(There it is!) by a group named Tag Team. Something about it seemed right as I was busting a gut in the middle of the store. The only real problem was I couldn't decide whether to give the card to Val or to Aaron. Of course I knew I would have to come up with my own version of a Hallmark mushy card to say all the other heartfelt things I wanted to say. So I stood in my bathroom and wrote a letter to my little sister. I think I effectively conveyed how much I love her.

Looking in the mirror I realized that I needed to accessorize my sweater. I reached for a necklace that was given to me by a close friend as I left Japan. It's two silver circles resting on top of one another holding a single pearl in the lower curve. I stared at it thinking how much it looked like an egg in a womb. Perfect! My friend Tomoko would be so pleased to know I wore it today. I threw on my pearl earrings and the ensemble was complete. It's been a long time since I thought that hard about what to wear. I'm really not that into my clothes. My life is pretty simple and doesn't normally call for special wardrobe consideration. Today was just...well, different.

Val, Aaron, and I paused for a short time in the kitchen to take some photos before she and I headed out the door. We wanted to document the occasion. Whether we become pregnant or not, it was still a momentous day.

On our long drive we joked about it being a covert operation. I could imagine her talking into her wrist like the Secret Service saying, "The package is delivered." I told her I suddenly felt like I was in protective custody. In essence I guess that was true. Had we recorded the conversation, we would have a great addition to a baby book. I wish I could recall all the details. The most important part is that we spent nearly an hour laughing together and having a good time. There were times she was actually laughing and crying at the same time, but that was partly due to the pain she was in.

Unfortunately, Val was uncomfortable during the whole drive, just as she has been since Tuesday. The stimulation of her ovaries left her with Ovarian Hyperstimulation Syndrome. It is a painful condition that can be quite serious. In fact, an ultrasound today revealed that her ovaries are so large they are rubbing against each other. It's called "kissing ovaries". Hopefully her symptoms will subside within a week from now. For now she's not very mobile and is moving very slowly. She has a positive attitude though and has been an inspiration through the whole IVF process. No matter what she's encountered she has done so with grace.



When we arrived at the Jones Institute, we were placed in a pre-op area and changed into our designated OR garb. We cracked out our cameras and took tons of photos of each other and the staff. It was a fun time even while we waited. The laughter continued right up to the moment they rolled me back into the OR.

After the nurses situated me on the table, Dr. Sergio Oehninger (our doctor) and the embryologist doctor both came in. Within a few moments the embryologist walked out and flashed the eggs, as viewed through a microscope, up onto a large screen. We had less than a minute to admire them, during which Val took a nice photo.



The doctor walked back in shortly afterward and with movements as careful as if he were disarming a bomb, he handed the pipette to Dr. O. who then threaded the pipette through my cervix as we watched on the ultrasound screen. I could see the white line of the long tube moving up into my uterus. Suddenly there was a puff that shot out the end of the tube and Dr. O said something like, "There they go." The entire procedure lasted roughly two minutes or less.

Dr. O stepped out and came back in carrying a certificate for Valerie, as well as the petri dish that held the eggs. He gave it to her saying, "This is their first cradle." It was pretty neat and of course brought a smile to Val's face. Once I was transferred to another bed, they rolled me out. Valerie was walking behind me when a nurse named Donna said something to her that stopped me mentally in my tracks. She turned to look at Val and said, "Come on, Mom." I said, "Wow, Val. I think that's the first time you've ever been called Mom." We were both tickled. Suddenly I think she felt pregnant. I know I did a little. That was a memorable moment for her.

As usual, we were barely in the post-op area when my phone rang and it was Mom calling to see how things were going. Her timing is always spot on! She definitely has a sixth sense about her when it comes to her kids. We told her we were done and she shared a funny story. Apparently she had just spoken with an older lady and told her she was a grandmother again today. They lady asked the obvious next question, "Was it a boy or a girl?," to which Mom replied, "We don't know yet - they were just implanted." LOL Imagine the confusion on that woman's face. I'm sure Mom went on to explain.

I think our family became a little more like glue today. We spoke with Mom, Dad, and our brother Ross. They were all so excited. It's great to feel their hopeful anticipation. It's amazing to think that in 11 days we may have another family member or members on the way. We all can't wait!

Progesterone Panic!

I tend to think of myself as a pretty strong person. I've held strong to Philippians 4:13 which says, "I can do all things through Christ which strengtheneth me." Therefore my strength is not my own. Tonight however, all that seemed to leave me. Let me recount the story . . .

We were running late for our Boy Scout meeting after going to the gym for a run and a swim. I bolted through the door and began running around like a crazy woman to prepare dinner - baked salmon. All was going well when I turned and saw a frightening sight - the syringe and vial of progesterone. I began having a fist fight with the air in front of me, looking quite like a schizophrenic person. My sister was concerned and asked in an alarmed voice, "What's wrong?" I told her, "You have to give me the stupid shot! I have to have it before I leave for Boy Scouts." To say I was slightly freaking out was probably an understatement.

I grabbed the syringe, prepped it, and set it on the counter. Val said she needed a minute to prepare herself. She's given lots of shots, but never to someone she cared about. I think she was feeling guilty about inflicting pain on me. Meanwhile, I was trying to keep moving making dinner, but getting more anxious by the second. When she was finally ready, I had Ritz cracker crumbs all over my hands and they began to tremble. I didn't cry, but I felt a surge of panic and thought I might hyperventilate. I washed the crackers off my hands and grabbed the counter as best I could. She pulled down the waistband of my running shorts and rubbed the alcohol on the upper part of my butt toward my hip. At first, she began to pat firmly on the skin. It felt like it was taking forever and I was getting more panicked and light-headed. I said, "Hit it harder!" She hauled off and smacked me hard on the butt and plunged the needle in. It was great! My butt was still stinging from her hand (which might have left a welt for all I know) so much that I didn't even feel the needle. Talk about a relief. I think over time this is going to get much easier. Now I just have to pep talk my husband into giving me the shot. He's a little apprehensive.

After the shot, we were joking about the whole thing. It really is ridiculous how anxious I get. I just can't stave off my healthy respect for needles. So much for having strength for all things. Thank God for sisters who are willing to stab you in the butt when the situation calls for it. I guess I'd still rather be stabbed in the butt than in the back. LOL

Does a Progesterone Shot Count as Nutrition?

The reproductive clinic called today and said my progesterone levels are too low. Since I'm going in on Friday to implant the eggs, they need my levels to come up. They said I'll have to give myself shots of progesterone suspended in oil. I nearly went into an anxiety attack thinking about having to stick myself with more needles. I was on the phone crying with the nurse. I wound up having to drive an hour back to the clinic to pick up the medicine and syringes from the pharmacy at the adjacent hospital.

I stood at the pharmacist's window and stared at one of the syringes. I even turned around and showed it to the lady behind me and said, "Do you see this?" She said she's not sure if she could give herself that shot and she's a nurse! The needle was so big to my eyes! I began to feel faint just thinking about having to stab myself in the butt with it! Thankfully, my nurse offered to give me my first shot. I've done the shots in my stomach in preparation for the pregnancy, but those were butterfly needles and fairly easy to do. Seriously doubting my ability to give myself this shot, I decided to head back to the clinic. When Beth, my nurse, came out to get me she hugged me and said she was sorry. I felt comforted.

We stood in a patient room discussing how the medicine is suspended in sesame oil. I started to cry and overheat when she was talking to me about how to give myself the shot. I blurted out that we had to shut the door so I could pull off my clothes. As the door shut, I was already throwing off my baseball cap, exposing my seriously flat hair. Then I yanked off my shirt and was beginning to sweat. Turning around to the bed, I stepped between the stirrups that were protruding from the end. I pulled down the waist of my pants, grabbed the sides of the bed, and began to cry. I said, "Let's just get it over with." She stabbed that needle into my butt like a dart. It didn't hurt at all! I was obviously relieved and began to relax somewhat. Then something strange happened. Right after she stuck me, I found myself wondering if I would need to log the calories from the sesame oil and how I would do that. How many calories are in 1 cc of sesame oil anyway? I couldn't believe I was having that thought! Man, talk about being dedicated to my nutrition! I mean who does that? LOL

Butterfly Needles & Anxiety Attacks

I've been giving myself shots of Lupron for the surrogacy for exactly two weeks now. Giving myself shots is something I never thought I'd be able to do. It was surprising to me how easy it was to do the very first one. All was going beautifully until a few days ago when I must have hit a nerve going in. Ouch! That one stung.

The next day I prepared my syringe and wiped my belly with an alcohol pad before pinching up the skin to administer the shot. As I held the syringe with the needle hovering over my skin, I suddenly had a hot flash and began to sweat. I began to see white spots and felt slightly light-headed. What was happening to me? Was I really on the verge of a panic attack over this little butterfly needle? After about five minutes of hesitation and telling my husband I wasn't sure if I could do it, I finally popped the needle in and called it done. I was relieved - and then came this morning . . .

I didn't start off feeling anxious about the shot this morning. I simply grabbed my supplies and headed to the kitchen to retrieve the Lupron from the fridge. After preparing the syringe, I once again stood frozen in fear with the needle taunting my skin. Again I was struck with mild symptoms of an anxiety attack. For nearly ten minutes I would put the needle down and walk away, come back and try again, then walk away again. Numerous times I tried to fake myself out by counting, 1 - 2 - 3. It didn't work. I tried to say, "I have to do it before the water boils for the oatmeal." Then I tried to say, "I have to do it before the timer goes off and the oatmeal is finished cooking." The oatmeal finished cooking and I was still holding that evil little syringe with one hand and pulling the pot off the burner with the other. "@&(*$^, sigh." Okay, I thought, I'll call my sister. Crud, she's not home. Well I'll try my mom instead. Thank God! She answered!

"Mom, I am standing here holding this needle and just can't do it! This is ridiculous! It's been two weeks. Why am I having such a hard time with this?" She encouraged me, though mostly I don't remember what she said except, "Wow, there's still some weenie left in you." Had I not been in such psychological distress, I might have pondered that comment more and even found it humorous. I'd already been crying on the phone with her for several minutes as the twins toddled around my legs, intermittently reaching up pointing to my belly and grabbing for the syringe. They were probably thinking some baby version of "Mama is losing her mind." They kept staring at me like they did when Koen fell on the floor writhing in pain after stubbing his toe. Clearly they were concerned. I kept telling myself to pull it together and just get it done. Dragging it out was only making it worse. Then, Mom asked if it would help if she counted to three. "Yes, I think so," I said. 1 - 2 - 3 - I hesitated perhaps a nano second after 3 and thrust the needle into my belly. Imagine my relief when I literally didn't feel a thing! Whew, it was over!

So what lessons have I learned from all of this?
1. Mom is always there for you.
2. Counting to 3 and stabbing yourself doesn't work because you know it's coming.
3. Babies are very in tune with the emotions of their moms.
4. It takes 5 minutes to cook oatmeal, but sometimes 20 to give yourself a shot.
5. I'm capable of willingly inflicting pain on myself, both physically and mentally.
6. It's easy to make mountains out of molehills.
7. Most mountains ARE molehills.
8. I REALLY love my sister! :)

Tomorrow has to be a better day for Lupron shots. After talking with my sister, I understand she has also been having issues with her shots. Commiserating with her made me feel so much better. It's nice to feel like you're in the boat with someone else - and we are most definitely in this boat together!

Next Step in Surrogacy: Lupron Shots

This morning a momentous occasion occurred. We took the next step in the surrogacy (IVF) procedure. I gave myself the first shot of Lupron.

The first step of this whole process began on September 30, 2010, when I took the first progesterone pill. Taking the progesterone caused my body to have a menstrual cycle, which I don't normally have. Unlike previous times when I've taken progesterone, I felt remarkably non-hormonal and didn't observe any mood swings. This was a relief.

The second step involved starting birth control pills, which I've been on for one month. Thankfully, I haven't noted any side effects from them either. No weight gain, nausea, or mood swings. Years ago when I took birth control I experienced mood swings and weight gain. I will continue taking birth control for six more days, while also injecting one dose of Lupron each morning.

Lupron is a drug that is used (in my case) to suppress my own ovulation. Since the eggs we are using are my sister's, we don't want my ovaries to release any eggs. I will take the Lupron for exactly two weeks. The day following my last dose, I will begin applying Vivelle dots (estrogen patches) to my abdomen. After about 8 days of estrogen, I will have an ultrasound to check the lining of my uterus to make sure it's thickening properly. The estrogen patches will be changed every two days until the end when my sister's eggs will be retrieved. In the last week before the transfer, I will also be taking a estrace pill (more estrogen) vaginally. All of this estrogen is to prepare my endometrial (uterine) lining to receive the egg(s).

It's all getting closer and more real now. The transfer should be around December 2-3, 2010. Wow, it's hard to believe it's so close, only about 33 days left. The whole thing is so exciting! I don't think I was this excited when we were trying to conceive using Clomid back in 2008. It's different knowing that this is for Val. I'm actually starting to feel a little anxious. You know that feeling when you're in your bathroom waiting for the pregnancy test stick to finish doing its thing and give you the news. That's sort of how I'm feeling even now. I'm hopeful, nervous, and excited.

I'm doing everything I can now to keep myself healthy. I've backed off from drinking coffee and have cut out all caffeine. I'm not eating processed foods, but mostly fresh fruits, veggies, lean meats, lower-fat dairy, whole grains, etc. I've dropped from 198 to 178 and am glad to have another month to lose more weight. I want to be at the healthiest weight I can be so that pregnancy is easier and healthier.

Surrogacy: The Hope of Giving Birth to My Niece or Nephew

On September 30, 2010, my sister Valerie, her husband Aaron, and I had an appointment at the Jones Institute for Reproductive Medicine. After years of trying to conceive and suffering a heart-wrenching number of unexplained miscarriages, they decided to take me up on my offer to be a surrogate for them. We headed to our appointment in torrential rain, feeling uncertain what the clinic would say about my suitability because of my age or medical history, including my recent bilateral mastectomy and upcoming reconstructive surgery. All our apprehensiveness would turn out to be unfounded.

After filling out tons of paperwork, consulting with the doctors, and both Valerie and I having ultrasounds, her for her ovaries and me for my uterus, we were given the green light. It turned out to be much easier than I thought. There will be lots of coordinating of schedules along the way, trips back and forth from Florida for both Aaron and Valerie, and probably some nail-biting, but we now have a time frame. In fact, we were certain they would have a reason to make us wait and were surprised when I was given my first prescription to be started the very next day! That night I headed out to the Wal-Mart pharmacy to turn in my prescription. We couldn't believe it. The transfer should be sometime around Thanksgiving, using her egg and his sperm.

On October 1, 2010, I zipped over to the pharmacy to pick up my meds, then crossed the parking lot and stopped in front of the pet store. I sat in my van with the first pill in my hand. Feeling overwhelmed by the emotional events of the previous two days, which included losing my beloved Shiba Kenji, being worried sick trying to find our Papillon Dexter, then the elation at finding him, I had to take a moment to pause and just breathe. The event I was about to mark was huge - so much bigger than me in that moment. The last nine months of my life had been wrapped up in one big exclamation point. Funny, nine months is the length of time most people associate with a pregnancy.

Holding that little, white, Progesterone pill in my hand represented the hopes and dreams of so many people, starting with my sister. It also guaranteed that the next year of my life would be no less emotional than the last. I could say that the next year will be wrapped up in a huge question mark. That thought didn't frighten me. I'm a Navy wife and therefore accustomed to question marks. :) One thing was certain, God is in control and will either use me to make my sister a mom or not. There I was, alone to ponder the enormity of the decision we'd all made together, my family and hers. I was thankful for those quiet moments. I prayed and gave the whole process to the Lord to make of it what He wills. Of course I also put in my personal request to finally become an aunt. :) How amazing just to think of having the opportunity to bring my niece or nephew into the world.

After praying, I threw back my water bottle and popped the pill in my mouth, thinking, "Here we go!"

The Absence of You

There is a hole in my being marked only by the absence of you.
You are always in my heart and mind, though you have eluded my body.
The very hope of your existence fills me with warmth and joy.
I have wished for you on falling stars and heads-up pennies.
Instead, I will pray to feel the thump of your little feet
Against my skin - a gentle butterfly kiss of motion...
And hold your tiny hands in mine.
You slip into my dreams, day and night.
I am half a woman without you.


(This was written during a time I was struggling with infertility and was fearful of never being a mom.)