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Twins

This is one of the only words in the English language that elicits a positive and negative response simultaneously in the human brain. The levels very, depending on the person’s point of view. To someone who is using a surrogate to start their own family, it could be the equivalent of winning the lottery. Killing two birds with one stone, if you will. Some of the best news they’ve had in years! To someone finding out for the first time they are carrying twins, it can also send up a red flag of a potentially high risk pregnancy.  With twins come Complications such as: bed rest, premature delivery, fetal demise and others. A new father may become doe-eyed at first, then as the realizations of double the responsibility sink in, his eyes may then keep widening with nervous apprehension. To feel so excited and so scared all at once is a roller coaster of exhilaration.

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I recently discovered these feelings myself. When I filled out my surrogacy application I, like most others, put down that I would be willing to carry twins. It is clearly stated that the probability of this happening through IVF increases due to several facts. People tend to use more than one embryo in a single transfer to increase the likelihood of one sticking and turning into a positive pregnancy. When you are going through so much it’s best to hedge your bets as much as possible. Also, you’re on fertility medication and have been accepted as a surrogate because of your beautiful uterus. All of this makes for a pretty cozy environment that persuades embryos to stay put. It’s by no means a guarantee however, it just increases the odds. In the past 10 days, my IPs found out that they are going to become parents to not one, but two baby boys, sometime here in the next 7ish months. They are ecstatic; it’s what they dreamed of! I’m so happy for them. This is exactly the payoff moment of why I do what I do. I’m also nervous as hell. I openly admit it. I’ve heard a range of twin stories from “easiest pregnancy I ever had!” to “Oh my god, I was on bed-rest the whole time and I was so sick!”

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I can’t speak for other surrogates, but I do get the strong feeling that though most of us are generally excited about the concept of carrying twins, when the reality hits it’s a whole new ball game. My head races with all the complications that “could” happen and I start to freak out. My main panic attract came about by worrying the babies won’t be getting enough nourishment and they will come too early. That’s when I took to the old faithful social media and reached out to friends who were twins or have had twins. I discovered I wasn’t alone and that yes, my fears are justified, but there is absolutely no reason to freak out any more then with the other three pregnancies I’ve had.

You see, our bodies are amazing things that can adapt to almost anything we throw at them. Well, we fortunate few who pregnancy comes easy to, can anyways and Doctors are very used to twin pregnancies and know what to expect and what to look out for from beginning to end. Now I really do believe I’m getting the easiest end of this deal. The parents are the ones who’ll have to deal with the midnight double feedings and diaper double-dutch. Which of course, they are more than happy to do :). I’ve been down similar roads before. This will be a new adventure for me. My IP put it best. “You’ve been pregnant before, we haven’t. This will be great because it’ll be new to both of us. Something we can experience as a first together.” They are on board and ready to dive in and that gives me the confidence to take the plunge too.

Funny enough while putting my thoughts together for this blog I got a call from the lovely Ms. Ann at SAI wanting to share something she had heard on the news this morning: A mother in Ireland may have just beaten the world record for time apart delivering twins. Her first was born after her water broke at only 23 weeks and was born June 1st of last year weighing just 1lb 3oz. Bizarrely enough her contractions stopped after the first and the other’s fluid remained. Her second twin was able to stay in her womb until August 27th and weighted 5lbs 7oz at birth. A full 87 days later! Both twin girls are perfectly healthy now and doing very well.

Stories like this just go to show that yes, we can worry and fret about unpredictable things in our future, but they also can turn out miraculously. I’m excited. I know the home these boys are going to is going to be so full of love that, in my bones, I can tell anything will be surmountable.

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Twins, wow, what a word!

To Bed Rest or Not To Bed Rest, That Is The Question?

Any woman who has used IVF (In Vitro Fertilization) will have an opinion on this matter. Do you need to stay lying down after an embryo transfer?  And if so, for how long?  Under what kind of conditions?  Most of these opinions are given to us by our fertility doctor, whose individual ideas range and vary themselves in this ongoing debate. There is still no clear cut winner.

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I just want to state the fact upfront, before I broach both sides of the argument: your freshly planted embryo WILL NOT FALL OUT. The female reproductive system is not designed that way. Once the little speck is in there, no matter how it got there, it stays. This by no means guarantees a baby, but that is one fear you absolutely do not need to worry yourself over. Ok here we go…

Nay-saying doctors don’t believe there is any substantial proof that bed rest increases your chance of conception; not even by 1%.  Confined to a bed and feeling useless when you are totally healthy can increase stress and nervousness, thus decreasing the chances of a friendly environment for the embryo to adhere to.  These are the type of doctors who like their patients to stay active and believe in a more “energetic” pregnancy. One of the more suspicious mothers I spoke with informed me she believes that bed rest is just a way for the doctors to have an excuse if the embryo doesn’t take. An out, if you will. “Well you must have gone down some stairs or got up to pee too often.” I do want to note, that most clinics that say no bed rest is needed do still recommend taking it easy for the first 24hrs afterward and no heavy lifting, but this is just common sense for any such procedure.

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Pro-bed rest doctors believe that even if it’s just a theory, it’s better to try it, if it means a better chance of conceiving. Who wouldn’t want to do everything possible to become pregnant? Bed rest doesn’t do any harm and its common sense to keep the womb horizontal for a better chance of stickiness. It’s been described as a time when a woman can relax and ward off the anxiety that is often the enemy of fertility. These are the type of doctors who believe in a “calm and relaxed” kind of pregnancy. Although, the length of said bed rest varies from as little as one day, to as many as ten.

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Speaking from my own personal experience, I don’t have any answers either (sorry). I have used both types of doctors. I’ve done three days of strict bed rest at a hotel down the street from the clinic because they wanted to keep my movement very limited.   I’ve also been sent home 15 minutes after the procedure and told to take it easy for the rest of the day. Both ways worked. The first did result in a blighted ovum and, unfortunately, a D&C, but my body held on to the embryo like it was supposed to. In that way it was a success. The second stuck fast right away and turned into a healthy fetus. So, I, personally, am at a loss. I’ve spoken to other mothers who have had the broad spectrum of results from working out right after to taking it super easy the whole ‘in between” time.  Each had vastly different results in each scenario.

The in-between time, is the time from your transfer to blood test. It’s that exciting/awful unknowing time when you don’t know if in the next week you’ll be crying or laughing. It’s stressful whether you are lying down or not, but I don’t know which is the lesser of two evils. What I do gather is it really depends on what kind of a person you are. Are you the kind that needs to stay busy so as not to think about things you have no control over?   Or, are you the kind who finds being calm helps relieve you? These are elements best discussed with your personal physician.  They can really give you the most tailor-made advice. Just know your of all options and do what you believe is best for YOU and you can’t go wrong.

Hurry Up and Wait… from matching to contracts to cycling

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What many people don’t realize is that with surrogacy, there are many steps to take before you can even start trying to become pregnant.

A woman who wishes to become a surrogate fills out a super long, in-depth application; gets checked out physically and mentally; and has her background checked to make sure she isn’t really the missing Anastasia. Then she waits to hear back from the agency for the green light.

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If she’s cleared, she’s put in a database with other women in the same situation and waits to be chosen by an Intended Parent (IP). It’s up to the agency to find and match suitable surrogates with IPs. You want to be on this journey with someone you get along or “click” with. This is very important and sometimes it’s an instantaneous click and sometimes it’s not. Even if a woman has been a surrogate before she still has to go through this process each time she re-applies.

Once this stage of the process is complete–and it can take months to get matched–she steps into the legal process. A legal contract for both parties to review is provided by the IP’s lawyer and reviewed with the surrogate by her lawyer. Luckily, SAI works with specially trained fertility-law specialists who know what they are doing and have been doing it for decades. However, the law is the law. There are mountains of paperwork which are a necessary evil (and a good sleeping aid) to get through.

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After everything is all legal eagle–which can take a month or more–it’s time to either match up cycles with the egg donor or IP (if using fresh embryos) or straight on to the poking and prodding (if the IPs have frozen embryos). Either way, this is part of the journey usually takes another month and is full of fun things like vaginal ultrasounds, peeing in a cup, different hormonal injections and daily medication. When using a gestational surrogate, the body must be “tricked” into thinking it’s pregnant so it won’t reject a foreign embryo. Hooray for science! But again… it’s the wait is about another month or so.

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In my personal experience, these three steps can take anywhere from 3-6 months’ time to achieve pregnancy, if it works on the 1st go round. Patience is a virtue and the rewards are well worth it in the end. So as Dori from Finding Nemo would say: “Just keep swimming”…….You’ll get there.

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An Adoption Alternative


For couples who want a child but are unable to give birth, surrogacy is a very viable alternative. Adoption allows you to become a parent but that child will have no blood relation to you and your partner. With gestational surrogacy your egg and sperm are combined, through in vitro fertilization to create an embryo, which will, in 9 months time, become a child that is genetically yours. You can still experience the entire pregnancy with the help of another woman who carries and gives birth to the child for you.

If gestational surrogacy is not an option for financial reasons, there is another form of surrogacy called “traditional surrogacy,” where the surrogate is inseminated with the intended father’s sperm. In the state of California through a pre-birth judgment, the surrogate will relinquish rights to the baby to the new parents, who become the legal parents upon birth. You and your partner can choose how involved you would like to be in your surrogate’s pregnancy. There are cases in which couples choose to allow the surrogate to remain a part of their life after birth. You will pay the surrogate a fee for carrying the child along with her monthly expenses, legal and maternity costs. Expenses can include travel, health insurance, housekeeping, clothing, and loss of earnings. Finding a surrogate can be as simple as having a relative or friend carry the baby for you, or going through a reputable, established agency which matches potential surrogates with intended parents wanting a child.

If you are contemplating surrogacy, either as future parents or as a potential surrogate, below are several aspects of surrogacy to consider:

• If for some reason you can’t conceive, surrogacy creates a chance for a couple to parent a child that is genetically theirs. This genetic link will be either through your egg, your partner’s sperm, or an embryo which was created from your egg and your partner’s sperm.

• For gay couples, surrogacy offers a route to parenthood where at least one of the partners and in many cases, both parents can have a true genetic link to the child or children.

• As a potential surrogate mother you have the chance to create a miracle for a couple who are unable to conceive. Your generosity will manifest itself throughout your life, knowing what a difference you have made in someone else’s. Research presented at the annual conference of the European Society of Human Reproduction and Embryology (ESHRE) in Madrid, proved through interviews with former surrogates that surrogates suffered no severe emotional problems during pregnancy or after giving up the child.

Choosing to use a surrogate mother or becoming a surrogate is a life changing decision, and should be considered once all parties have done the proper research and are 100% certain they are ready for this big step.

Infertility Options Available

Modern technology and old-fashioned networking have come together to provide many infertility options for prospective parents who need assistance to conceive. This quick overview of the various procedures and options available for those who wish to become parents can help you understand some of those many infertility options and how they might work for you.

Fertility Drugs
Doctors prescribe fertility drugs both on their own and as part of the in vitro fertilization procedure. These drugs are most useful for women whose fertility issues are caused by hormonal irregularities. The drugs regulate reproductive hormones and trigger the release of one or more eggs during the ovulation cycle. They have a success rate of about 20 to 60 percent especially when coupled with IVF, increase the odds of having twins and have many uncomfortable side effects.

Surgery
If the fertility issues are caused by a genetic defect, endometriosis, blocked fallopian tubes or another physical issue, surgery may be one of the most viable infertility options. The success rate for women treated for endometriosis with surgery is about 40 to 60 percent. The success rate for women who have surgery to clear their fallopian tubes is much harder to pinpoint. Reported conception rates after tubal surgery range from 10 to 90 percent.

Artificial Insemination
Artificial insemination involves injecting semen – either from your partner or from a donor – into your uterus. It generally requires that you take fertility drugs, and has a success rate of 5 to 25 percent.

In Vitro Fertilization
In IVF, the doctor removes eggs from your ovaries and fertilizes them in a laboratory with sperm from your partner or a donor. The resulting embryos are placed into your uterus to implant and continue the pregnancy. About 30 percent of women who undergo IVF conceive.

Embryo and Egg donation
A doctor uses IVF techniques to implant a donor egg or fertilized embryo into your uterus. The conception rate for women using IVF with an egg donor is about 43 percent.

Surrogate Mother
Gestational surrogacy is the official term for having a baby through a surrogate mother. Many clinics specialize in gestational surrogacy, making it far easier for prospective parents to meet, connect with and choose a surrogate mother with whom they are comfortable. In gestational surrogacy, the embryo may result from any combination of sperm and egg from either or both partners and/or egg or sperm donors.

Today’s parents have many infertility options when natural conception methods fail. Choosing the right method is a very personal decision to be made between the parents and their chosen medical professional. Research the various options available to you, and discuss them with your doctor to find the one that works the best in your situation.