Embryo Transfer | Fertility Clinic Mishaps

 It has been a while since I felt there was enough cumulative information that warranted a blog post. The next week will be full of excitement and hopefully good news.

A little over two weeks ago, our gestational carrier had an initial ultrasound and labs to evaluate her baseline exam. Following this, she started taking a mixture of medications that included Estradiol, Azithromycin, Prednisone, Naltrexone, and Tacrolimus, and likely others that I can't recall right now. Some of the medications functions are literally to lower the immune response/inflammatory process within the body to help prevent it from attacking the future embryo. The rest of the medications are meant to help thicken the lining the uterus. For a successful transfer, the uterine lining needs to be thick, this allows the embryo a place to implant and start to grow. 

A week after starting the medications, a repeat ultrasound was performed which showed a satisfactory uterine lining. This allowed for the transfer to be scheduled on 7/6/2021! This upcoming Tuesday! This was very exciting, not only for Tobias and myself for obvious reasons, but also for our gestational carrier who has some life events that have created a timeline for us all to work in. This transfer date aligns perfectly with all of our goals in mind. 

For the transfer to take place, our carrier has now started an injectable medication, progesterone. This is meant to stabilize the lining and prevent the bleeding portion of a menstrual cycle. After the transfer on 7/6/2021, our gestational carrier will wait ten full days before receiving a blood beta-HCG quantitative test to confirm pregnancy. At this point, she will already be technically four weeks pregnant. She will have to continue the concoction of medications until the placenta forms to maintain the pregnancy. In a 'natural' pregnancy, something called the corpus luteum secretes the necessary hormones to maintain pregnancy until the placenta forms, but in our case, there is no corpus luteum so external medications are required.

After the positive pregnancy test, there is a fairly high chance that there will be a successful pregnancy. Unfortunately, like all pregnancies, the risk of miscarriage is still high in the first 8-12 weeks. Fortunately, a lot of the most common causes of miscarriages are controlled for in our type of situation: the embryo has all appropriate chromosomes, the uterine lining is optimized, there are no physiologic barriers with the uterus itself (no scarring, fibroids, morphologies that don't support good implantation) so the risk of miscarriage is lower but still present. 

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One frustration that has been occurring is working with our fertility clinic, CNY in Syracuse, NY and Albany, NY. If it were not for the excellent communication skills our gestational carrier has, Tobias and I would not even know she had started medications, had an ultrasound, or even had a transfer scheduled. We reached out to the clinic, (and by we, I mean me because I am more direct) and made sure to clarify with them that Tobias and I are the intended parents, we are the ones investing thousands upon thousands of dollars, and that this is our embryo and should thus be kept informed. The clinic gave a weak response and didn't truly address my concerns. I then reached out to our surrogacy agency and the contact nurse there said that this experience is highly unusual and essentially unprofessional. Given my concerns/frustrations, our contact nurse at the surrogacy center is actually reaching out to the clinic to echo our concerns and clarify what is happening. Our carrier is also on the same page, voicing her own surprise and concerns about the clinic not communicating well. 

Given this lack of communication, Tobias and I started to worry about what the hospital experience during the birth would look like and if we would be left again feeling like the outsiders. One fortunate thing is that our partner in all of this, our gestational carrier, is 100% on our team, cares about us, and wants this to be an exciting and happy time for us. She is constantly voicing her advocacy and noting that this is our baby and she is doing this incredible service for us. She has told us that if anyone at the hospital acts like it is her baby, she would quickly correct them and defer to us. 

That being said, I had a discussion with our contact nurse at the surrogacy center and she assured us that they have never had an issue with a hospital, even ones that had never dealt with surrogacy in the past. She informed me that the agency reaches out to the hospital around 34 weeks gestation. At this time, they get all necessary paperwork completed, a copy of the parentage agreement, and a plan set up with the L&D charge nurse to ensure that Tobias and I will have our own postpartum room with the baby, separate from our carrier. That doesn't mean our carrier won't be able to see the baby. Given the relationship we have already established, I believe our carrier will be snuggling the baby too when she's feeling up to it. 

Either way, it's nice to know that the surrogacy agency makes sure everything is established prior to the birth and that there shouldn't be any issues. 

Such exciting but stressful times right now! Let me know if I didn't answer a question you might have about this part of the process or what it looks like moving forward. :) 

With love and anxiety,

CJ