As autumn is starting to settle in on us in Toronto...it has brought along with it a sense of melancholy.  If our first transfer had been successful we would have been packing our bags right now and headed to Delhi for baby pick-up.
We're still trying to figure out where to go from here and what our next steps will be............

Yikes!

With a few embryos still frozen at our clinic in Delhi...this news is not promising!

http://www.livemint.com/Politics/ZsS2zs7KvqHlk4FCguW0EN/Draft-surrogacy-Bill-bars-homosexuals-livein-couples.html

New Delhi: India’s long-awaited surrogacy Bill will disqualify homosexual couples, foreign single individuals and couples in live-in relationships from having children through surrogate mothers in India. The law also imposes age restrictions on surrogate mothers.

The proposed draft Assisted Reproductive Technologies (ART) Bill—the first attempt by India to regulate commercial surrogacy—is likely to be presented to the cabinet on Thursday before being introduced in Parliament.

Critics said the strict norms of the proposed ART Bill will see the activity moving to more conducive destinations such as Thailand. Surrogacy is a method of reproduction where a woman—the surrogate—agrees to carry a pregnancy to term for a fee.

In January, the home ministry had barred homosexuals and foreign single individuals.

“I do not understand why the law has to be discriminatory towards unmarried foreigners when unmarried Indians are allowed this facility,” said Ritu Bakshi, chairperson of the International Fertility Centre in Delhi.

“It is fair to expect that surrogacy should be allowed in the country of the commissioning couple because citizenship of the child becomes an issue otherwise. Other than this, many restrictions imposed are not encouraging for business. A majority of our clients are from foreign countries. To expect this sector to not have commercial interest is naïve. Surrogacy is very expensive across the world,” she added.

The current version of the draft law has undergone several modifications after inputs from the law ministry and the ministry of external affairs after recent diplomatic incidents.

“The sector is fraught with ethical and legal issues which the Bill seeks to address,” said R.S. Sharma, deputy director general and member secretary of the drafting committee of the proposed legislation, Indian Council of Medical Research( ICMR).

“In its current form, the Bill addresses all issues pertaining to ethics in commercial surrogacy. The health ministry’s mandate was very clear—this Bill is only to help infertile couples and should act as a deterrent to commercial surrogacy,” he said.

According to a 2012 study by the Confederation of Indian Industry (CII), the sector is worth $2 billion, despite being completely unregulated. The CII study estimated that nearly 10,000 foreign couples visit India for reproductive services and nearly 30% are either single or homosexual.

In earlier versions—in 2008 and 2010—the ART Bill relied on contract law to establish a relationship between the commissioning parents and the clinic. In the current version, the Bill states that a professional surrogate will be hired by a government-recognized ART Bank and not private fertility clinics, the current practice.

The compensation, as per the 2013 draft, will be a private negotiation between the surrogate mother and commissioning parents.

“The IVF (in-vitro fertilization) clinics or ART banks will have no role to play in this contract. Currently, IVF clinics decide the amount and pay the surrogate mother a portion. This could be exploitative and so we have changed this provision,” Sharma said.

FET - big fat negative

That's all folks.

The last 3 months...

After months of waiting for the FET (frozen embryo transfer) - it finally took place on April 2nd.

We used a different surrogate this time - one that has already been a surrogate previously and delivered a healthy little baby. I realize that it doesn't necessarily mean we're going to have luck on our side just because she has had success in the past - but it's all these little glimmers of hope that help me feel somewhat optimistic that this time will work.

I'll be honest that that last three months have been the biggest emotional roller coaster of my life - and it's not actually because the first attempt ended with a negative result (even though that was a brutal experience to put it mildly) but mostly due to the new confusing and conflicting Visa regulations in India that only allow hetero couples married more than 2 years to pursue Surrogacy. With almost every passing day over the past three months I read/ received conflicting info on whether or not we are actually legally allowed to proceed with any further attempts. So one day I hear we can't proceed and then next day I hear we can. Even though I was told we are ok to proceed because our names were on a list provided to the FRRO of clients that have already started the process, I can't say I'm 100% comfortable and that we won't have issues down the road trying to an exit Visa for the baby(ies) or that I won't end up in an Indian prison (I do joke that I'll be choreographing and starring in a Delhi jail flash-mob performance that will end up on YouTube).

So it came down to the wire on whether or not to proceed with attempt #2. Darren and I were once again given assurance that we could proceed so we decided to give it the old college spirit.

We received the treatment summary today - and while I was thrilled to see that 4 of the 4 embryos survived the thaw, only 3 made it to blast and only 2 actually had a grade that was, in my opinion, viable to be in the running to develop into a precious little baby.

Results will be in on Friday. I feel completely different this time around though. I don't know if it's my brain turning on the coping mechanism by suppressing the feelings that I experienced waiting the first time....or if I've just been through so much at this point that I just feel numb....or if I just want this over with, good or bad, so we can move on with our lives...or if I just really think it won't work this time. I know I want it to work - but I feel a bit disillusioned at the moment

This is our last and final hurrah before closing the door on this chapter of our lives one way or the other. Even though we have 4 embryos available to try once more, should this attempt be unsuccessful, we've decided that that given the Visa situation etc... this is the end of the journey for us.

Positive thoughts and fingers and toes crossed.




 

Chapter 2...

Monday was an absolutely terrible day. It's funny that even though we knew the reality of probability and percentages and we talked about the various "what ifs", I don't think we actually had ever really convinced ourselves that the news would be anything but positive (well at least I didn’t). I guess after the months and months spent obsessing about attempt #1, how could the news be anything but positive? In fact I had kinda already moved on to worrying about the scan of the sacs and the heartbeat and getting through the first trimester.

It's been over 48 hours since I opened the e-mail from SCI and the sadness and tears have subsided considerably - thankfully. Now that the initial shock is over with and reality has started to sink in - there is no time to waste and time to move forward.

We've signed up for attempt #2. As we have 8 embryos frozen, this attempt will be a FET (frozen embryo transfer). Aside from the embryos being frozen and an additional 10% decrease in the likelihood of this turning into a positive pregnancy, the embryos that survive the thaw (they won't all necessarily make it unfortunately) will be allowed to develop a couple of more days to blastocyst (not all make it to blastocyst either), we'll be using ALH (assisted laser hatching). There are a lot of theories out there on blastocyst - but if you combine my complete lack of medical knowledge with the various articles/ research I've come across - embryos at blastocyst plus leveraging AHL *should* have an easier time implanting into the uterine lining. That said, I must do a better job this time around being a little more realistic with expectations.

 We don't have a confirmed date yet - I would like it to be today obviously (remember I'm super impatient) but it will be a while yet I fear. Yay, more waiting! When this baby finally comes I will be sure to let he/she know how much waiting his/her daddies had to endure (nothing like planning the guilt trips already haha! I kid I kid ;-)

So here's to wishing and hoping and praying that 2 is our lucky #, that our embryos survive the thaw, that they make it to blastocyst, and that SCI can find us the best possible surrogate ever).  I am going to be positive...and hopefully this is way too premature...but should this not work we will have to start considering our other options.

Definition of Blastocyst
Blastocyst culture is the most advance infertility treatment which involves in vitro fertilization and embryo culture for 5 to 6 days until it reaches the blastocyst stage – a final stage of embryo that is ready to implant in the uterine wall to impregnate. The best embryos are selected and transfer into the uterine cavity.  Traditional IVF is to implant embryo after rearing only 2-3 days externally into the intrauterine at the cleaving stage of only 4-8 cells. Blastocyst is a 5 day old embryo that is formed after the conception of egg and sperm. The embryo size before being embedded is 120-150 cells.

Assisted Laser Hatching
Laser assisted hatching is a technique whereby a small artificial hole is made in the zona of an embryo using a laser. It is thought that the embryo can then hatch more easily through this hole and hopefully increase the chance of the embryo implanting.  Laser assisted hatching is performed just before the embryo transfer procedure.  Some patients may produce embryos in which the zona is thickened or hardened making it difficult or impossible for the embryo to implant. Also, patients who have had several embryo transfers without success or patients who are older may wish to consider laser assisted hatching.

:-(

We received the sad news today that we are not pregnant. Don't feel like writing much more for now.

 

Is patience really a virtue...

I can't get Madonna's Hung Up out of my head..."Time goes by so slowly for those who wait"

Every day feels like a week.  Thankfully work has been very busy and has kept me preoccupied for the majority of the time.  Of course everything on T.V., in every magazine, and on Facebook has been nothing but baby baby baby.  Only 5 more sleeps to go, possibly 4 if the e-mail comes in early enough on Monday Delhi time.  You know I'll be sleeping with my iPhone :-)

Someone sent me this and it couldn't be more accurate...lol

Next week is either going to be the best week ever or the worst week ever.  We're of course hopeful that it will be good news, but are preparing ourselves in case it's not.  We are having a lot of hypothetical conversations around here playing both sides of the news.  I think we already have our backup plan ready to go just in case.  What I've learned about myself in the past 10 days is that I'm actually way more impatient than I thought I was (which is hard to believe), so having a proper plan setup for either outcome is all part of appeasing my crazy self.  I'm lucky to have Darren as my rock through all of this as I must be driving him a little bit batty :-) (maybe more than a little).

Good news is after the longest case of jet lag ever, more than a week, I'm finally back to my regular schedule :-)

Sending all the love in the world to Ms.A in hopes that she is doing well :-)

2WW

We had no sleep at all Sunday night...partially the result of jetlag (which I'm still dealing with, it's currently 4:40am) and partially because we knew at some point Monday we would be receiving an e-mail with the embryology report.  Yes I know, sleepless nights are something we’re going to have to get used to anyway haha :-) 

With Delhi being 10 1/2 hours ahead of Toronto, e-mails from SCI typically show up in the morning - and sure enough, shortly after 8am, it arrived.

"Dear Michael & Darren

We hope you are doing fine.

We would like to inform you that your embryos transfer has been done successfully...."

• 20 eggs were retrieved (thank you to our amazing egg donor!!!)
• 15 fertilized
• 4 grade I, 8 cell embryos transferred to Ms. A
• 8 grade I and II 6 - 8 cell embryos have been frozen

Fortunately I had this SCI blog post to reference After Egg Collection to help further explain all the details of the embryology report.

So, now we're officially in the 2WW...I have a feeling this may be the longest two weeks of our lives.  Hoping with every ounce of my being for a positive result!!! Fingers and toes are crossed :-) 

Our week in Delhi...

It's hard to believe we're back home already - what a whirlwind week in Delhi.

I made my final two deposits (Wednesday and Friday), all legal paperwork has been signed and finalized, eggs have been retrieved and ICSI performed, and we met our surrogate.

So meeting our surrogate!!!  We waited for her in the main SCI waiting room that has frosted glass panes...and every time I caught a glimpse of feet walking past the door my hands would tremble with a mixture of excitement and anticipation.  We were asked if we would like to review several surrogate profiles to make our selection, but decided not to and asked Dr. Shivani to choose our surrogate for us.  She walked in the room and we both jumped to our feet to greet her.  I'm fairly certain that I've never smiled bigger - ever.  Someone from the SCI team was with us in the room to translate our conversation and I kept forgetting to take a break from my rambling about how grateful, thankful, and excited we both were.  She's quite shy and seems sweet - it was a slightly out-of-body experience meeting the woman who will be carrying our child - but a moment we'll treasure forever.

At the end of the day, while we didn't plan on going to Delhi until "baby pick-up" time, I'm really happy that things worked out the way they did and that we were able to familiarize ourselves with this magnificent city.  I'm hoping we won't have a lot of time for sightseeing the next time we're back :-) so we squeezed in as much as we could.

My Delhi highlights and recommendations:

Sightseeing:

Taj Mahal
Indira Gandhi memorial
Humayun's Tomb
India Gate


Food:

Indian Accent (at the Manor Hotel).
If anyone is looking for an unforgettable culinary delight in Delhi - this was hands down our favourite meal (It isn't cheap but worth every penny - I recommend the chef's tasting menu)


Hotel:
We stayed at The Svelte Hotel and  I can see why so many SCI clients choose to stay here - Great location (about 15 minute cab ride away from SCI and ISIS) connected to two "Western" shopping malls (Zara, Sephora, Mango etc...) everything you'll need is at your finger tips and if you want to stay somewhere outside of the hustle and bustle.  The doorman said "See you in 9 months" as we got into our car headed towards the airport :-)

Car Service:
We used Rahul Western Taxi as our main mode of transportation (no we weren't adventurous enough to try the auto-rickshaw).  All the drivers were super friendly, punctual, and always available for us.  They took us to all of our appointments at SCI, Taj Mahal, and took us all over Delhi to see the various sights.

Up next - Embryo status report and transfer to Ms. A!!!!!!!!!! :-)

Deposit time...

Monday was a big day for us.

Our driver picked us up at our hotel at 1:30 for our first appointment at SCI (which was at 2:00).  I was pretty clear that I wanted to make sure we were there on time a) because that's how I roll b) I didn't want to keep the Dr. waiting.  The driver arrived a few minutes early, which naturally made me happy and satisfied the control freak in me.  What I failed to realize is that our hotel is only a few blocks away from the main Delhi courthouse and there's some MAJOR activity going on there right now.  Traffic was at a complete standstill - even for Delhi standards.  I would love to convey to people that have never been here what traffic and what driving in general is like in Delhi - but there are no words.  It is beyond anything I have ever experienced and beyond anything you could ever imagine.  It's literally a free for all - which has left me to having to resort to shutting my eyes for the majority of the time.  Our driver is amazing though - how he got us to our appointment on time and in one piece is a miracle beyond miracles (plus driving into oncoming traffic and what I believe at one point was him handing a man in a uniform some money to allow us to drive on a sidewalk).  Don't ask, don't tell.

The waiting room is filled with pictures of babies and letters from grateful parents thanking SCI for helping to make their dreams come true.  I can't wait to have our own thank you note on the very same wall.

Meeting Dr. Shivani was a treat - she was so lovely and pleasant and really made us feel completely comfortable and confident in our decision.  It was hard to believe we were actually meeting her after having seen her in so many pictures with so many parents and their newborns as well as having watched all of her YouTube videos.  Dr. S. took us on a whirlwind tour of the SCI clinic and ISIS Hospital and introduced us to many (and I mean many) of the staff - we were able to put the face to many of the names that we have come across via e-mail.  It is really quite an impressive operation the have going on there - so many moving pieces but so well organized.  

It was then time to make the first of three "deposits" at the ISIS hospital around the corner from SCI.  We walked in and there were four men sitting in the waiting area, waiting for their turn.  I can't say it wasn't a bit amusing waiting as one guy would go in and then eventually come out (some were in their for what seemed like a very long time - ha-ha).  I, on the other hand (no pun intended), was in and out if there in what I'm thinking may have been a record breaking time LOL.  I couldn't tell if Darren was proud or not :-)

So what next?  

Wednesday - second deposit at ISIS 

Friday - Egg retrieval day (Dr. S said there are a lot of follicles which is great news).  I will also be making the final deposit and they will be able to use the fresh sample for fertilizing the eggs (which is what we were hoping for).

Monday the 14th - Egg transfer.  Followed by the 2ww (two week wait).

Day trip to Agra later today to see the Taj :-)  There's a new expressway that opened up recently which means it's now as quick to get there by car as it is by train (which also means I don't have to take the train after all - some friends thought that I may not like the train very much).  I do have to add - I'm adjusting quite fine to life in Delhi - but still waking up at 4am every day.

Goodbye Toronto...Hello Delhi

And we're off.

En route from Toronto to Delhi (via connection in Newark New Jersey)...16 hours plus a 5 hour layover.  Our iPads are fully loaded with all sorts of movies, TV shows, books to help pass the time.  This will be the longest flight that Darren has ever been on but he's blessed with the gift of being able to fall asleep anywhere at any time.  And while I feel like I've been living out of a plane the last year or so (been to Japan, Thailand, Singapore, Spain, and many trips throughout the US in the past 12 months) I've not been able to master the art of sleeping sitting up (so it's going to be a looooooooong day).

Our agenda so far has us at the clinic, SCI, on Monday, Wednesday, and Friday.  "Deposits" will be made each of those three days - two will be frozen and the third will be used to fertilize the eggs that we are hoping will be retrieved while we're there.  While the timing with these things is always tentative (currently set for Jan 8/9/10), we're hopeful they will be able to do a fresh transfer since we're making the long trek (rather than our initial plan of shipping the sperm).  Depending on how many mature eggs are retrieved and how many are successfully fertilized, the embryo transfer should happen on or around the day we leave to head back to the snow in Toronto.  If there are any extra embryos, they will be frozen and be on standby in case the first go-round is unsuccessful (oh pleeeeease let it work the first attempt).  We will also be selecting our Surrogate while we're there.  I believe that Dr. Shivani will help us make this selection and since she's the expert, we'll ultimately leave it up to her.  We will also get to meet our surrogate - I've been reading dozens and dozens of blogs written by people who have already been through this process - and without fail the common theme is that the brief meeting is a truly memorable and emotional experience.  Sunday, Tuesday, and Thursday are our free days - hoping to explore Delhi and still planning to take a day trip to Agra for an in person photo shoot at the Taj Mahal (Darren would like his obligatory Princess Di on the bench pictorial).

The next update from us should be an exciting one.  I'm sure a lot of my friends are dying to hear about how my adventures in India go...truth be told this is certainly going to be an experience that will take me well out of my comfort zone.

I realize I'm turning into a broken record but we are sooooooooo excited (a bit anxious and nervous too) so the butterflies are in full effect and are doing their job.