Embryo Transfer!

On July 31, we were scheduled for embryo transfer. We were very excited to finally reach this milestone and to see "S" and her family again after 5 months of getting everything ready. They drove to our home a few days before transfer so we could spend some time together which is always awesome.

On day 5, the embryo would develop into blastocyst. Transfer usually takes place on day 5 because this is when the embryo travels from fallopian tubes to the uterus. With adequate uterus lining, the embryo is likely to be implanted. We had planned to transfer two embryos, one from each of us but we wouldn't know if it was going to happen until the day of transfer.

Early in the morning on transfer day, our RE called and told us that we each had a good quality embryo to be transferred, one was already a blastocyst and the other could catch up in a few hours. It was great news to start the day. We had a relaxing morning at home before heading to the clinic around noon. As usual, "S" got her protocol for transfer and she was required to have a full bladder!!

Nothing felt like getting ready for transfer. We were excited and anxious at the same time. All the hard works eventually came down to this moment. "S" got her lucky charms and socks. We learned that actually there are rituals for transfer day - lucky socks being one of them and we got her lucky charms. We needed every piece of luck we could get.

After checking in at the clinic, "S" went in first to get herself ready. A few moments later, DH and I were called to go in. We put on surgical gown, hair net and shoe covers, then entered the transfer room that was dimmed with calming music in the background. "S" was all ready and laying on the transfer table. The embryologist first verified our identify to make sure the embryos transferred were ours. Then the doctor came in to perform the procedure and explained it to us along the way. Upon the order of the doctor, the embryos were loaded to the transfer catheter and started their incredible journey. The catheter containing the embryos and a small amount of fluid was passed through cervix into uterus, where the embryos were placed. Through the use of ultrasound, we were actually able to see the two embryos leave the tube as they were transferred. They looked like little orbs of light; like shooting stars as they were deposited into "S" uterus. The clinic had everything blown up on the TV screen as the embryos were being loaded. It was pretty amazing to witness the procedure. Considering all the months of preps leading to the moment, the entire procedure took only about 10 minutes!! It was quick and painless without sedation. 

We were excited to see the embryos for the first time, so small like the tip of a pen even on the big monitor. 

After transfer was complete, we gave each other a hug and took some "family" portraits. "S" was then moved to a recovery area and her husband came to join her. We were given photos of the embryos and ultrasound. One embryo was a decent blastocyst already hatching and the other one was a little behind assisted with hatching. We were joking how each fit our personality. One is always in a hurry and the other just takes his time.   

On day 5, both embryos were already loved by many and had their photos taken as cells. It was a surreal feeling that we just made babies and part of our being was created. It is truly a miracle to see both of them develop over time - hundred of thousand times bigger.

After transfer, "S" was required to rest. We headed back home and celebrated this special moment with BBQ in our patio, with two additional little ones in "S" belly.

Next day the clinic informed us that none of our remaining embryos was viable to be frozen. It was hard to believe that they were growing for a few days and suddenly just stopped. There was no explanation and we didn't know why we lost them. Was it the quality of egg or sperm or combination of both? Was it the lab condition? It was a huge blow and hard to swallow. It made us worried even more if the two transferred would stick. We were extremely sad, disappointed, and confused, knowing we only got one shot.

"S" told us to stay positive and said "we are pregnant until we are proven otherwise." In fact, all we needed was two if we were lucky. The two best ones were now in "S". It was out of our control and we could only cross everything and hope the two embryos stuck (or even just one!). With the embryos being transfer, the waiting game begun. We had to wait until pregnancy blood test scheduled on August 11. As much as we were really anxious to know the outcome, we told "S" that we didn't want to know if she did the pregnancy test at home and preferred to wait for the blood test to confirm. Peeing on a stick test usually would show pregnancy on day 5 after transfer. Given there might be a possibility of false positive, we wanted to wait for a confirmatory blood test. The waiting period was tough. It is funny how time seems to slow down when you are eagerly waiting for something.

15 weeks!

You guys now measure roughly 4 inches, crown to rump and weights in at approximately 2.5 ounces (about the size of an APPLE). You are busy moving amniotic fluid through the nose and upper respiratory tract. Your legs are growing larger than your arms now and you can move all those tiny joints and limbs. Although your eyelids are still shut, you can sense light already. 

"S" said that she could feel your movement more often now. Please don't party too much, ok? In a few days, you will be coming home with "S" and her family for the Halloween weekend. We can't wait to see you guys and have you home in a few days.  

Daddy and Papa have been thinking what kind of costume you will like. Something like these maybe? 

 

15-week fetal development video

Fresh embryo cycle and egg retrieval

After S's uterus lining was adequate and the egg donor was on board, we were ready for the real deal and the clinic started preparing everyone for the transfer cycle. The clinic synced the cycles of the egg donor and "S". It was a very stressful period for everyone.

"S" had a busy protocol to follow with pills, injections, blood work and ultrasound appointments. The donor had her first ultrasound and blood work on July 10 and started her cycle medications on the 12th. If all went well, the egg retrieval would be estimated around July 22. The donor was monitored every other day during her cycle. Since she was not a proven donor (her first donation), no one knew how well she would respond to the meds. We would get an email update on every monitoring for "S" and the donor and just hope every check was a good one. 

Things were moving along for a few days until we got a call from RE that the expected number of eggs might not be ideal, probably about 8 eggs. Given that we were splitting the number of eggs for two dads, it significantly reduced our chances. With 8, we each could only have 4. It could be possible that not all would be viable and fertilized and not all fertilized would make it to day 5 for transfer. The RE suggested that we gave the donor a few more days so July 22 for retrieval was not gonna happen. At the same time, "S" was on a holding pattern. If everything went well, we would be given about one week advance notice for embryo transfer. 

Nothing was certain until eggs were retrieved and fertilized. All kinds of "what-if" ran through our heads at this point. We were preparing ourselves for the worst and hoping for the best which has been our motto for surrogacy. If the donor didn't respond well to the meds and could not produce an ideal number of eggs, we would have to cancel the cycle and start all over again or choose a new donor. If we had to start over again, how much would it cost and how much delay would it be? In a hindsight, it is probably better and less stressful to have frozen embryos first and then do the transfer as soon as the surrogate was ready. 

On July 21, we got another update on the donor and we could possibly get more eggs. We decided to move forward for the retrieval scheduled on July 26 and 5 days later for embryo transfer on July 31. After all, 13 eggs were retrieved with 12 being mature so we each got 6 fertilized. A day later, the clinic informed us that I had 4 embryos ongoing and DH had 5 ongoing. Those 9 just kept going until day 5 for transfer. We were relieved to have a workable number with potential of getting some frozen embryos and were very excited to see "S" and her family again for the transfer. It was a huge step forward and finally it was happening.

We may never know the identity of our egg donor and get an opportunity to personally thank her. In her profile, she gave a message to the egg recipient - "I wish you the best." Thank you, ED. We also wish her the best! Maybe our paths will cross one day. 

Thank you...S.

Exactly a year ago, "S" responded to our ad when we were searching for a surrogate. Her email came and gave us hope. And who would have thought that a year later she is carrying two most precious gifts one could ever dream of?

We are deeply grateful for all she has done for us so far and for all the support her family has given her. There is not a day goes by that we don't think of her and appreciate her kindness and generosity. Our thanks will never be enough.

"Surrogacy is a.....

Spectacular journey
Unreal to most
Resulting in and
Reminding us
Of the
Greatest gift
A person
Can ever give or receive
Yielding in amazing beauty." 

"S" - somewhere over the rainbow, we found each other and this song is for you. Enjoy!

14 weeks - start of 2nd trimester

It is 14 weeks today and the beginning of the 2nd trimester. It is another milestone. Two months ago, babies were simply a cluster of cells. Now they have functioning organs, nerves and muscles. It is a miracle to see how they have developed. One change during the second trimester is that the morning sickness and fatigue should be fading. We really hope that is the case so that "S" could feel more energetic and like her old self again. She texted us the other day and said she could feel babies' movement. She also got a fetal doppler and she could hear babies' heartbeats.                                                                                         Babies will be busy growing so will be belly of "S." We haven't noticed any baby bump on her but probably will very soon.  

Choosing the egg donor

Two women are crucial in the gestational surrogacy - the carrier and the egg donor. Choosing an egg donor is just as important as choosing the carrier because it determines half of the baby's genetic make-up. There are a few options to find an egg donor

• on your own
• from fertility clinic or agency
• from egg banks

Each has pros and cons. The biggest advantage of finding an egg donor on your own could be cost savings and a known donor. Some have their relatives or friends donating their eggs. Disadvantages include adding another legal matter and defining the role of the donor in child's life. One could also find a donor from classifieds.

Donors from fertility clinic and agencies are often anonymous. Some may offer semi-known in which donors knows the recipient/intended parents’ first names and the state in which they live. The donor and recipient/intended parents might exchange emails and photos; however, no specific personal information is provided about the donor or the recipient/intended parents. The major difference between clinic and agency is the pools of donors to choose. Fertility clinics usually have a smaller pool limited to a local area.

Egg banks is another option. The main advantage is that eggs are already retrieved, lower costs and time savings. However, eggs are frozen so fresh embryo transfer won't be an option. Some studies have found frozen eggs are just as good as fresh ones with IVF success rates. Frozen or fresh, the most important part is the quality of the eggs which depends on many factors of the egg donor.

Another issue is proven donor - Proven donors are women that have gone through the egg donation process before and helped a family have a healthy baby. Using a proven donor can be reassuring for intended parents because the donor has already completed the process once before and truly understands what is involved, responded well to the medication and had healthy eggs that contributed to a live birth. Using a proven donor over a first-time donor does not necessarily guarantee success, but it does offer some advantages. Some agencies charge additional fee for a proven donor.

After our research, we weren't sure about a known donor and decided to choose an anonymous donor from the clinic, mainly for convenience. All we needed to do was to review profiles and choose one and the clinic did all the medical and psychological screening plus the legal part. Since we opted for fresh embryo transfer, we had to wait until "S" was medically and psychologically cleared.

Choosing an egg donor was relatively easy for us. We indicated our preferences and were given donor profiles one by one to review. The profile included physical characteristics, donor and her family's medical history, psychological and genetic assessment and personality. It also included photos from childhood.  

Since DH and I don't have any same physical trait, we weren't too concerned about the color of skin, eyes or hair. Our main criteria were health, height and BMI. When we received a profile, we reviewed it separately and gave it an up or down vote. Surprisingly, our votes were all in agreement. It didn't take long until we finally found one which we really liked. To us, choosing the egg donor is probably the least stressful part of surrogacy. It was fun and exciting because it provides some cues to the genetic make-up of our kids.

Below is one hilarious blog post about comparison of straight and same-sex couple trying to have a baby.

Things are more fun for straight people

One of which relates to choosing an egg donor -

"Straight people are stuck with the qualities of their partner. I get to choose between a woman who is getting her PhD and speaks several languages, a woman going to medical school who qualified for the Olympic trials and a woman who has her masters degree in an interesting field and is cool with her eggs going to gay parents."

Hopefully, we have done a good job to give our kids half of the best DNA.

Surrogacy contract

Here is another legal matter - surrogacy contract. It is another tedious process, especially when it involves two attorneys each representing intended parents and surrogate. It is a legal document specifying all terms including

• Parental rights

• Custody

• Location of delivery (important - state laws vary. Some states prohibit surrogacy and the laws apply to where the baby is delivered)

• Health insurance obligations

• Medical decisions during pregnancy: who will make them and how

• Payment of medical bills

• Financial considerations, such as the gestational surrogate's compensation and expenses, including lost wages, legal fees, child care, housekeeping, maternity clothes, and life insurance

• Issues related to early termination and selective reduction

Basically, everything foreseeable is in the contract. Prior to drafting the contract by our attorney, we have discussed most of the important issues and were in agreement. Right before the screening, we started working on the contract. It took about two months to finally get it all signed and notarized. Much of our time spent on going back and forth between attorneys and us. We could have it done in days without the attorneys but do consult an attorney specializing in surrogacy.

Here is the link to the directory from American Academy of Assisted Reproductive Technology and link to sample contract. 

Week 13

You have grown to about 3 inches (8cm) long. Weight approximately 1 ounce (25 grams). Bone is beginning to replace cartilage and the ribs are appearing. The nose and chin are well defined. Movements can be measured. You will begin to learn to suck its thumb and can open and close mouth. Your wee-wee or hoo-ha is almost defined. Soon we will be able to find out if you are a boy or a girl.  

"S" had a dream that one is a boy and the other is a girl.

We don't have a pregnant woman in the house but watching lots of pregnancy videos makes us feel just like that. We are really "enjoying" our pregnancy so far. 

Pre-birth order and birth certificate

Forewarning - This is gonna be a not-so-fun post. Pretty much all legal matters are not.

As we quickly approach second trimester, we have begun to work on the pre-birth order for the babies. As intended parents, a pre-birth order declares to the world that we are the babies' legal parents, despite the fact that neither one of us gives birth to them. The court order also directs the hospital where the babies are born and the appropriate state department of vital records to place the our names on the birth certificate.

A pre-birth order is important for a number of reasons: it gives the intended parents sole access to the child; gives them the right to make medical decisions for the child; resolves issues relating to insurance coverage; allows parents to take their child home from the hospital; and provides piece of mind for the intended parents. Without a birth order (pre or post), intended parents may need to go through adoption to establish legal parentage and adopt their own children.

States differ in their approaches to pre-birth order. It is important to check surrogacy laws and pre-birth order when matching with a surrogate, especially for same-sex couples. Luckily, the state where babies will be delivered permits pre-birth order and the hospital we talked to even has placed two dads' names on the birth certificate. It could potentially save us another step to do second parent adoption after we bring the babies home.

If only one of us (the biological dad's name) is on the birth certificate, we will have to do second parent adoption in which we each adopt the other's biological child after we bring the babies home. Even though we are married, our marriage is not legally recognized in all states. Only court orders could protect our family and be recognized everywhere.

Sounds complicated? Yes. My brain even hurts as I try to write about it. Anyhow...wish us good luck!

If we have two boys....

Thanks to S's two boys. We got to experience what it will be like if we have two boys.

They were practicing football tackles with us this past weekend. Man, it was exhausting but lots of fun. We felt young again!

 

12 weeks

Babies are now the size of lime. Whenever it changes, we laugh and celebrate. We have seen the baby size changed from poppyseed to appleseed, sweet pea, blueberry, raspberry, olive, and prune. Watermelon got to be somewhere, probably close to the due date.

We flew to visit "S" and her family over the weekend and attended the ultrasound on Monday. Every visit was very special to us with new experiences including getting tackled by two little kids on the ground. Not only did we get to spend some time together but also got to see how babies have grown.

On Saturday, they invited us to attend their friend's wedding at a farm. S's husband was there in charge of the BBQ for a few hundred guests. It was a big and lovely wedding. The reception in a barn was very unique unlike many weddings we have attended in the past. We send off the couple with sparklers and took the mugs with our names on them as souvenirs.

Congratulations to the newly wed couple!!

On Sunday, we visited a state park with beautiful waterfalls, went to bowling and had dinner. It was a fun and relaxing day. "S" was such a trooper. She probably would have preferred to lay in bed with her morning sickness but she was with us all the time including hiking and bowling.

Monday was 12-week ultrasound. It was amazing to see how much they have grown and very exciting to see them moving. Baby A was wiggling the entire time and Baby B was the quieter one.  

Hi five - Baby A


Kicking - Baby B


After ultrasound, we toured the hospital where the delivery is planned. Just to think that it is gonna be the place where we will be holding our babies makes the entire process even more real.

As we were on the plane flying back, we recalled the weekend vividly. Almost year ago, we were completely strangers going on our separate lives in places where we don't even know its existence. A year later, we are on a journey with so much being shared. Now, how cool is that? It is almost unbelievable. So dramatic and yet so real. We are so grateful for all "S" and her family for putting up so much with this pregnancy. It hasn't been easy on her.

Next ultrasound will be in five weeks......we may find out the genders. (Honestly, we can't wait to put names on the babies instead of Baby A & B).

More US states to recognize same-sex marriages

The Supreme Court on Monday turned away seven same-sex marriage cases in five states, refusing for now to take up the basic question of whether same-sex couples have a right to marriage. With the decision, it allows the lower court rulings in those five states to stand -- all in favor of marriage equality. That means same-sex couples in Indiana, Wisconsin, Utah, Oklahoma, and Virginia will be able to get married. The decision also leaves in place rulings from the Fourth, Seventh and Tenth Circuits, meaning same-sex marriage will soon be allowed in West Virginia, North Carolina, South Carolina, Kansas, Colorado and Wyoming. Once same-sex marriage is allowed in those states, it will be legal in 30 states and the District of Columbia. What a historical and joyful day!

If we have two girls....

Something to look forward to (minus McDonald's). So much fun!!

What will our kids call us?

One question we often got asked is "what are the kids going to call you guys?" We had discussed this even before our pregnancy what the kids will call us given that it may be confusing when the kids call "daddy" and we both answer. We both will be fathers but it is ideal to distinguish between each of us.

Our decision wasn't difficult. Coming from different cultural backgrounds, our immediate thought was daddy for DH and papa for me.


This short video of two dads building a family makes me teary. It is awesome and we can't wait for babies to be home and to be taught by them all over again.