Carrier Update: The BEST Day

Today was a big one. I've been a little cryptic in recent posts as we've been playing the waiting game on transfers, but the truth is that we've been scared and frustrated that our journey with Ashlee as our carrier was at the risk of ending before it fully got started. To make a long story short, we've spent a few months trying to get her uterus prepped for a transfer, but we've hit some roadblocks along the way (See THIS post for more). In a last ditch effort, my doctor took Ashlee off of all medications this month to see how her uterus would react to a "natural cycle" relying solely on her own naturally occurring hormones. We were prepped in advance that if the lining didn't look solid at the check this month, we would likely need to move on a find a new match . . . no pressure.

Let's just say that even typing that we would need to be ready to move on to a new match still feels like a kick in the gut. There are the more tangible reasons to be sad like additional time until we have a baby or the financial implications of a re-match, but the most gut wrenching was the thought of anyone BUT Ashlee carrying for us. We know our situation is unique in that many intended parents do not spend much time with their carriers. We have been so fortunate to not only have LOTS of time with Ashlee while preparing for a transfer but also to have formed a bond quickly and easily in a way that can only be explained by being what I would consider a perfect match. When faced with the idea that we might need to "re-match," Josh and I took some time to seriously reflect about whether we could see ourselves even continuing in this process if it wasn't with Ashlee.

All week long we've been focused on releasing the process, praying for a good outcome, and not allowing ourselves to dwell on the "what-ifs." Texts with Ashlee confirmed that this was her mindset too, and I think its safe to say we both spent plenty of time on our knees this week praying (and in my case pleading) for a good appointment today.

Friends - not only was is good - it was GREAT. We are now several hours removed from the appointment, and I still get happy tears every time I think about this morning. With Ashlee's blessing, I am so excited to share some of the medical details, the happiness, and the best testament of faithfulness I can imagine.

We had the 8:15 a.m. appointment slot this morning (we were almost the last slot of the day on a Saturday, which meant a very light clinic morning for our doctor). After just a few minutes to catch up, Ashlee and I found ourselves in the exam room with a very short wait for our doctor to arrive. After a few more minutes of small talk (and lots of nervous chatter on my part), my doctor did the ultrasound. I've usually watch the ultrasound screen with an eagle eye, but I didn't even allow myself to look for a good 10 - 15 seconds. By the time I looked up, he was examining Ashlee's ovaries, and I was worried/relieved I had missed the check of the lining. Her ovaries looked great with one large lead follicle, indicating she had not yet ovulated. He quickly checked the other side before moving to the uterus to check the lining. As soon as he found the lining, I couldn't help but say "trilaminar!" in an excited voice. (Trilaminar means "three lines" which shows a good integrity to the uterine lining - something we had been praying for at this appointment.) A few second more showed a uterine lining with no fluid and a much better looking appearance in terms of thickness. The doctor measured the lining twice, and got a measurement of 8 mm, which is PERFECT.

I'm honestly not sure about what happened for the next few moments. I think I grabbed Ashlee's hand, I may have hit her on the arm a few times, and I know I got scarily close to sobbing excitedly. Happy tears were pooling, and I think I took the deepest breath I've taken in a few months. Our doctor was gracious and kind, and I think even he was excited to see the result despite the overly emotional response it elicited in both Ashlee and me. He even stuck his head out of this office as we were walking by to the blood work lab, grinned and said "great news today!" which still makes me giggle.

So where does that leave us? With Ashlee as our carrier and a plan! Ashlee continues to be a trooper, and she will do some new forms of medication (more shots) on her next cycle as we try to mimic her natural cycle as closely as possible. As a carrier she cannot do an unmedicated cycle because we cannot run the risk that she ovulates in the same month that we do a transfer (we don't want to have ANY confusion about who the baby belongs to!). Now that we know we can get a good lining, the hope is that the new protocol will stop her from ovulating while still allowing her body to build a uterine lining on its own without fluid.

While that was plenty of medical updates, personal updates, and good news, I promised a bit of a story about faithfulness. We've been open about the fact that we've been saying lots of prayers throughout this process, and we know we have a TEAM of people praying for us every step of the way (overwhelming grateful doesn't even begin to express our thanks for each of you!). In some respects, knowing what or how to pray for things on a given day can seem overwhelming. Sometimes there is something super specific to pray for, and sometimes its just a prayer for grace, strength, clarity, etc. At this appointment, there were VERY specific things that needed to happen so we could move forward, but it had mainly been verbalized to us as needing to have a "good looking" lining.

After we finished the ultrasound, Ashlee went to the lab to get her blood work done. I was standing in the hall when I got a text from Ashlee with a picture. I stuck my head into the lab and asked if she meant to text me. She nodded, and I quickly looked down and saw the most amazing picture. It was a picture of a notecard with the specific prayers for our appointment that day that she had snapped so she could look at it in quiet moments. Most amazingly though, she had written specific things that needed to happen at the appointment and every single thing happened - even down to her prayer for a specific number on the lining of the uterus. I was floored. Many things about this process make it easy to lose hope, to lose sight of the bigger picture, and to forget about the miraculous moments. But this moment took my breath away. 

We are filled with hope. We are ecstatic to continue in this process with Ashlee. And we cannot thank all of you for your prayers, good wishes, and happy thoughts you've given us to get us to today. We still have a ways to go in this journey, but today was a huge step in the right direction and as the title of this post says - it was certainly one of the BEST. 

IUI: Turkey Basters, Trigger Shots, & Relaxing on the Exam Table

Today I’m diving a bit deeper into Inter Uterine Inseminations (IUI) - a procedure I mentioned in our fertility story post.

Now that we are further along in our infertility journey, I think of our IUIs as our “foot in the door” to fertility treatments. An IUI requires medical intervention, but it’s not always as involved as invitro fertilization or some of the other procedures that might happen in a quest for a baby. Following our fertility work up (and the HSG test), it was the first treatment we had, and certainly the most intervention we had experienced to that point. In all, we had eight IUIs (far more than most doctors would likely recommend), but we never had a resulting pregnancy from them. I’ve since learned that after three unsuccessful IUIs, your chances of achieving a pregnancy are not increased and other treatments might be a better use of time and money. This is one of the things I would go back and change about our journey if I could. Looking back, I realize that we could have moved to other treatments much sooner, but we certainly didn’t know any better. Once we moved from our Ob-Gyn to a reproductive endocrinologist, we got the information we needed to move our journey forward.

So, what is an IUI?

An IUI is what most people might think of as the “turkey baster” method of getting pregnant. During an IUI, a catheter is placed through the woman’s cervix, and sperm are inserted directly into the uterus to shorten the distance the sperm need to swim to meet a woman’s egg in the fallopian tube. The idea is to remove as many “road blocks” as possible for the sperm and the egg to meet. It’s not a foolproof method – the sperm still need to swim through the uterus, up the fallopian tubes, and fertilize the egg, but it can be helpful in certain cases.

Why would you have an IUI?

A doctor might order an IUI for a variety of reasons, including sperm issues or unexplained infertility. We started with IUIs because of that first semen analysis that came back with slightly “off” results for sperm morphology.

How do you prepare for an IUI?

Different treatment plans will have different preparation for IUIs. Our treatment included oral medication for me (Clomid or Letrozole) for several days at the start of a cycle. We would go into the doctor for a monitoring appointment to check on the number of mature follicles sometime around day 12 or 13 of my cycle. Ideally, you would have one or maybe two mature follicles – if there are more, you run the risk of having multiples, and fertility treatments are all about bringing home ONE healthy baby. If all looked good at monitoring, I would take a trigger shot at a specific time to correlate to the IUI procedure. The trigger shot makes you ovulate to ensure there is an egg available for the sperm to fertilize within the time frame that sperm can live in a woman’s body.  

What does an IUI feel like?

An IUI might cause some mild cramping, but otherwise it is not painful. If there is cramping, it only lasts for a minute or two, and it usually resolves once the catheter is removed.

What happens after an IUI?

After an IUI, my doctor had me lay flat for about 10 minutes. I don’t know that there is any real scientific reason for this (the sperm can’t fall out of you), but it was a nice excuse to lay still and quiet for a few minutes. Other than the initial 10 minutes of rest post-procedure, life can resume as normal. I usually acted pregnant until I was proven otherwise (a term known as “PUPO”), so in the following two weeks I would limit my hard workouts, drink extra water, and avoid alcohol. Two weeks after the IUI, I was instructed to take a home pregnancy test and call the doctor with results.

Although the IUI process did not work for us, I remember being so grateful for the opportunity to try to build our family this way. It was certainly less invasive and less expensive than IVF, and our IUI phase gave us time to work through the fact that we might need some extra help to have children. By the time we were done with our IUIs, IVF seemed like a logical next step, and we had already prepared for that reality mentally.

Stay tuned for the next installment in the fertility treatments portion of our story where I’ll cover pre-IVF work up and tests. In the meantime, click HERE or HERE for more information about IUIs.

Please remember that I am NOT a doctor, and nothing in this post (or any of my posts) should supercede the advice of your doctor. It is so important to have a strong, solid relationship with your medical provider as he or she will know your history and goals, and he or she will provide advice and treatment personalized to YOU. 

Meet our Carrier: Ashlee!

Today is a VERY exciting day. With her permission and blessing, I am so excited to introduce you to our amazing gestational carrier, Ashlee.

Ashlee and her husband William live in Georgia with their four children. She is an instructional coach, which means she assists teachers in planning lessons and improving outcomes for their students. She is passionate about her family and her job, and she even has a blog and social media account with her best friend devoted to promoting literacy skills and educational resources for all teachers. When she isn’t loving her husband and kids and helping educate every high schooler in her school system, she loves to read, visit the beach, and volunteer.

When Josh and I met Ashlee and William for the first time, we were immediately drawn to their warm personalities and kindness. In many ways, we felt like we had known them forever, and we certainly knew almost immediately that we would be so lucky to “match” with them through our agency. Our initial assessment has proven right over and over again as we’ve continued to build a relationship, and when I say we are forever blessed simply by knowing Ashlee and William, I couldn’t mean it more. We obviously hope our journey with them will lead to the additional blessing of a child in the future, but for now we are so grateful for the chance to befriend them and share this experience with them.

When Ashlee applied to be a carrier with our agency, she shared her “why.” She said, surrogacy is a dream that was planted in my heart a few years ago when my midwife made a joke that I liked pregnancy so much that I should be a surrogate. The idea has stayed with me, and finally, as my last baby turned 3, I knew that I was ready. I know in my heart I am 1,000% done with having biological babies. I want another family to feel the joy and pride of parenthood when they look at their own babies. If I can help someone else find that joy, I would feel so fulfilled and proud of myself." She has since shared with me that her desire to help another couple build their family was so strong it was keeping her awake at night! When I think about my interactions with Ashlee, I think these sentiments express how special she is perfectly. She is passionate, she is kind, and she is generous. She loves her family deeply, and she is willing to share that love with us as we grow our family.

I’ll end by sharing this letter written by one of Ashlee’s daughters and included in her agency profile. One of the hardest things about considering a gestational carrier for us was the idea that we would have no control over the environment that our baby was in while he or she was growing in utero. We shared this fear with our match manager, and we boiled it down to the idea that we wanted our carrier to live in an environment of love. We obviously wanted her to be healthy and follow her doctor’s orders, but the intangible piece for us was that we wanted her to be loved, and to give love freely to those around her. Ashlee didn’t know this about us when she submitted her profile materials, and it is just one of the countless ways that this match has felt Divinely inspired. Josh and I couldn’t be more thrilled to (hopefully) have our little one share his or her first nine months with her.

Gestational Carrier Update # 2: Decisions and Flexibility

Hi Friends. It’s been a while, and I’m sorry that I haven’t updated you properly. While it’s no excuse, the truth is that I’ve needed to be “quiet.” I love sharing with you all, but sometimes I need to process things on my own or with Josh first. We’ve had several decisions to make recently, and several more in the coming days, and for whatever reason I’ve needed to retreat.

I’ve also avoided an update because things have been changing at a rapid pace. Past experience has given me insights into the importance of flexibility during any fertility treatment, but these few weeks have reminded me just how vital it is to not cling to any one plan. We’ve seen possible transfer dates change at least 3 times, work schedules moved, travel plans shift, and more grace and graciousness from our carrier than I can express. It’s one thing to allow flexibility for myself and my own family, but it is quite another to ask a busy, working mom of four to continually up-end her life to make time to help ME grow a baby. She has done it with a smile and a willingness to “see this thing through to the finish” as she so aptly put it recently, and we are so thankful.

So, here’s a timeline of our past several weeks (some of which has already been covered in my last post):

·      May 17: Cycle # 1 start

·      May 29: Monitoring appointment

·      May 31: Monitoring appointment

·      June 5: First possible transfer date changed to monitoring appointment

·      June 11: Second possible transfer date changed to ERA biopsy

·      June 15: Cycle # 2 start

·      June 28: Monitoring appointment

·      July 1: Monitoring appointment

·      July 4: Possible transfer date - moved

·      July 6: Monitoring appointment

·      July 7: Possible transfer date at the time of this post

Not only have we been to the doctor a LOT, we’ve also traveled around and across states to these appointments. Every appointment requires a drive for our carrier – usually at least 4 hours round trip for a single appointment. We’ve had at least two appointments at the Daytona office of our clinic, which is an hour and a half from our main clinic and adds at least 2 – 2 ½ hours to our carrier’s round-trip drive. (See above about grace and graciousness from our carrier!)

I know you may not be interested in the finer details of the changes and delays, but I do want to document them for myself and as part of our story. So, if you are interested, read on!

We’ve had two struggles as we prepare for transfer – uterine lining thickness and fluid accumulation in the uterus.

Cycle One: I covered the cycle one details in the last post, which you can read about HERE.

ERA Test Results: There are some moments in this process where I so clearly see Divine intervention, and I believe the thin lining and fluid in cycle one was a big moment. When the ERA test results came back, we learned that our carrier was pre-receptive, meaning she needs about 12 hours more progesterone exposure than a standard protocol would provide. Given the small time frame a uterus is receptive to receiving an embryo, those 12 hours can mean the difference in a successful implantation or a negative pregnancy test. We had not planned to do the ERA biopsy originally (given the likelihood that our carrier would fall within the standard protocol), but the thin lining and fluid moved us in that direction and ultimately gave us an invaluable piece of information to increase the likelihood of a successful transfer.

Cycle Two: Cycle two has been a bit more challenging logistically, as the dates for monitoring and a potential transfer coincided with family trips for us and our carrier and the 4^th of July holiday. My doctor was also working in our clinic’s Daytona office for some monitoring days, which meant some extra drive time to see him in person. The logistics turned out beautifully though – especially given that our carrier and my doctor were both gracious enough to let me FaceTime into a second, unscheduled appointment that coincided with our family trip to North Carolina. The first monitoring appointment showed fluid in the uterus and a thin lining, but strong bloodwork numbers. We scheduled a second follow-up monitoring appointment for three days later to re-check on the fluid and the lining thickness. This also meant our originally planned transfer for July 4 was pushed back by three days. At the second appointment, there was no appreciable change in the fluid levels or the lining thickness. We had a significant amount of discussion (me over FaceTime) about next steps, and we decided to have our carrier start progesterone and re-check her the day before the planned transfer. Our hope is that the progesterone will help clear the fluid, and her lining may continue to thicken in the meantime.

So, where does that leave us? Right now, we are awaiting our “day before potential transfer” monitoring appointment. I’ve spoken with my doctor several times in the past 48 hours to get some questions answered and help us all be prepared to make a game-time decision in a few days. While my initial reaction after the appointment over FaceTime was one of anxiety and confusion, my last conversation with my doctor left me feeling calm and full of hope. We have a solid plan in place (with plenty of room for flexibility) about whether or not to move forward with a transfer.

Despite the changes and shuffling that has happened during these past several weeks, there have been plenty of reminders about the good parts of this experience and little nudges to focus on flourishing.

·      We are looking forward to (hopefully) spending some good time with our carrier and her husband when they come to town for the next appointment and potentially stay overnight in preparation for a transfer. Our relationship with them has been one of the highlights of the process. They are the kindest, most loving couple, and we are forever grateful to have them as friends.

·      Our confidence in our doctor has never wavered, and this experience has continued to reinforce that he is “on our team” and wants nothing but the best for us. He has done extra literature reviews, extra phone calls, given us plenty of extra time in appointments, and helped us as much as he could with the logistics of our carrier’s travel, our travel, and his movement between office locations.

·      Our family and friends are amazing. They’ve stepped in with prayers, logistics help, changed travel plans, words of support and check-ins, and more love than we could have imagined possible.

·      We had a bit of an unplanned family adventure to a Disney resort in connection with one of our appointments. We got to play in the pools, visit Lightning McQueen and Mater, and even have dinner with Mickey, Minnie, and Goofy. The highlight was having our son meet our carrier’s kids and watching them play together for a bit one afternoon.

·      All of this has happened during our summer “flex” schedules for work. I have significant time off in the summer months and our carrier has more flexibility. Had these appointments been happening in September or October, the logistics stress would have been much worse.

Thanks as always for your love and support. More to come soon!