Our Path to Parenthood

We are back on track, bayyybeeeee. About three weeks ago, our wonderful doctor, Dr. Mottla, left a voicemail to just see how we were doing and to let us know that they THINK they would be getting permission to move forward with IVF cycles in the next few weeks. Well, being the impatient person that I am, I e-mailed our nurse coordinator about it two weeks later. Sure enough, she immediately called me and told me to schedule an appointment for bloodwork and an ultrasound that week. She said they had JUST heard that morning that they could move forward and that the timing might be perfect to get back on track. 

I went in a few days later and sure enough, I was just about to start my cycle, which meant that I could start birth control again. The day after my appointment, we got THE PLAN. THE PLAN is a very detailed plan for the next month and a half about medications and appointments and all of the things that my body will be going through, which, of course, is still much less than pushing an actual human out of a small hole in my body. #SILVERLININGS  

To say that I am relieved and excited is an understatement! There are still many nerves that will only, somewhat, subside when I know that we (HOPEFULLY) have several, viable embryos. It is still a long, crazy process, but at least we’re finally getting to this portion of it. 

So right now I am on birth control for the next month. I have an appointment at Shady Grove on May 28 for bloodwork, an ultrasound, and my FDA panel. I will begin hormone injections on June 1, and June 13 is my (tentative) egg retrieval date. The egg retrieval date is tentative because it depends on how my body responds to the hormone medication. By the last week of June, we’ll know how many viable embryos we have and whether or not they suggest another round of egg retrieval. We are REALLY hoping that won’t be the case, but it is something that is in the back of my mind.

These dates are perfect because we have a vacation planned to go to Corey’s aunt and uncle’s house at the end of June and we are so looking forward to it! So it would be really nice to have this whole part over so we can rest easy and enjoy a family vacation!

This next part is a little crazier:

Back when I put out my first blog post, the news had aired a report about a uterine transplant clinical trial at University of Pennsylvania. Several people sent me the articles and videos. I knew about uterine transplant clinical trials because I have been following along with the trials that Baylor has been doing. I had looked into the program but you had to be a resident of Dallas in order to qualify (eye roll). I did not know about the trial at UPenn though! So I turned around and read as much as I could about the trial and submitted an initial questionnaire/information sheet. The doctor immediately asked some follow up questions and we went back and forth for a few days, but after that, I didn’t hear anything. About a month later, another friend sent the UPenn article again, which spurred me to e-mail the doctor a “hey, remember me?” note. The next morning, I woke up to an e-mail from him requesting my medical records! It took over a month but I got everything from Shady Grove and sent them on to UPenn. He, again, immediately responded with a few follow up questions. One of his main questions was about how many embryos we had created, to which I explained the Coronavirus pause. But I told him I would let him know as soon as we had embryos created. 

So I’m not sure how realistic being in this clinical trial is but I know that, based on the information available for the program, I seem like a perfect candidate! It is a risky clinical trial but I think it would be so cool to be able to help advance science like that! Oh….and also it wouldn’t cost us an arm and a leg! So I’ll keep you updated about any forward movement with the trial! 

As always, thanks for following along on this crazy ride! Hope everyone is staying safe and healthy! (and 6 feet apart!)

Hello! First, I’d like to apologize for how long it’s taken me to give an update. A LOT of new information has come and gone over the last several weeks so I’ll start at the beginning. At our last appointment, we met with the financial coordinator. She went over the long list of costs associated with the IVF process. Most of it we knew/expected. The one major thing that we did not know or expect was that insurance companies (at least ours) won’t cover ANYTHING associated with the IVF process if the intended use for the embryos is surrogacy. Yes, you read that correctly. They will not cover a CENT of the process. EVEN THOUGH IT IS THE EXACT SAME PROCESS THAT IS TYPICALLY COVERED FOR A TRADITIONAL PREGNANCY! Talk about a slap in the face. If I’m being completely honest, that was the first time I have felt truly angry at this situation. How is it the least bit fair that it is SO expensive for an infertile woman to have a child? That’s a whole other conversation though. Anyways, so what does that mean for us? Just another 30k added to the bill. Pocket change, right? This baby better be the cutest, most well behaved baby in the history of the world for this price! 

The next step after meeting with the financial coordinator was for Corey to go to the Rockville location and complete his sperm deposit and FDA panel, which he did the following week. The original plan was for him to do his FDA/ sperm deposit stuff and then we’d be sent the contract, give them all of our money, and then I would get started with the hormone injections. We probably would have been looking at this week for the egg retrieval. The week after his FDA panel, our nurse coordinator called me and told me to be on the lookout for the contract and once we signed it and sent the payment, we would schedule my egg retrieval. This was just three weeks ago, about a week into the whole social distancing/schools closed situation. I was a bit surprised that hospitals would still be doing this since I would consider this an elective surgery. She swore that they were still moving forward with these processes. This was on a Monday. On that Wednesday, our financial coordinator called to let us know she’d sent us the contract, however, hospitals were no longer performing egg retrievals if the patient hadn’t started the hormone injections yet. I felt like this made so much more sense. As much as I’d like to get started on this, I didn’t feel like it was socially responsible to be coming and going from the doctor’s office that much and then spending time in a hospital for a very elective surgery. I also didn’t want to put myself, Corey, or our future embryos (and all the healthcare workers!) at any risk of contracting COVID-19. I was a little upset but also a bit relieved. She insisted that we could still make our payment though! Ha! She said if we sent back the contract with the payment, we would be first in line to get everything started once the world opens back up. However, with all of this uncertainty in the world, I feel that waiting is the most responsible thing to do. Our nurse coordinator then called back and told me to stop taking birth control because taking it for too long and suppress things that I don’t want suppressed in order to create healthy embryos. So to sum it all up: everything is on pause. 

Now, am I upset? Sure! We went through so much testing and then right when I’m sent the contract that truly starts everything, it completely goes on pause. However, I’m sitting on my deck, in gorgeous weather, drinking my favorite grapefruit wine, still getting paid, in a home with a wonderful husband and dog; so can I really be that upset when there are so many people who are risking their health every day to save people? Spending hours away from their families in hopes of discovering a vaccine? Spending all day stocking shelves at the grocery store? Dealing with impatient customers in order to fill prescriptions? Corey and I have discussed how lucky we are right now. We are both working; both getting paid; both have healthcare. There are so many people right now who are in complete opposite situations and it is those people who are on my mind right now. 

As much as we’d love to have a baby right now, we also don’t have to worry about feeding them! We don’t have to worry about running out of food or activities to keep them busy. We are able to work, uninterrupted. We are able to get house projects done. I take hour long daily walks, completely by myself, and it is amazing! There are always pros and cons, of course! 

It has taken me a while to update this blog, because it has taken me awhile to figure out how I feel about everything. Instead of focusing on this pause, I have chosen to appreciate this gift of time God has given me. I am getting house projects done now so when I do have a baby, I can focus on it instead of thinking about sewing the curtains or hanging the ceiling fans. I am reading books about behavior so that I can have more tools to use for when I ‘m back in the classroom. And I am using my daily walks to spend time with God, not only worshiping, but praying for the state of our world, our country, our essential workers, and our future family.

Over the last month, we have sloooooowly been getting results from some of the tests that we had done at our first appointment with Shady Grove Fertility Center. We had been waiting for two more tests and I was getting a tad impatient, so I went ahead and scheduled a follow up appointment and boy, am I glad I did! 

On Wednesday, I called to schedule an appointment and I assumed they wouldn’t have anything open until March, BUT they just happened to get a Friday morning cancelation so we were able to get in right away! This was such perfect timing for many reasons!

First, the doctor went over all of the test results. The first test was to check my AMH level. My AMH level can help doctors estimate the number of follicles inside my ovaries and then give an estimate about a possible egg count. Dr. Mottla said that a good AMH level is 2-3 and I was at 2.5 so right in the middle! 

The second test was Corey’s sperm analysis and let me tell you, I never could have guessed all of the issues that could be wrong with sperm. In a sperm analysis, they look for four things: volume, concentration, motility (movement), and morphology (structure). They said a good sample would produce at least 2 milliliters and Corey produced umm…a bit more than that, coming in at 5 milliliters. (He was very proud of that). For concentration, they look for 20 million sperm per milliliter and Corey came in at 18 million. For motility, they like to see at least 50% of sperm moving and 58% of his swimmers were swimming. For morphology, they look for only 4% of sperm to be the correct shape! I thought that was crazy! Corey was just under that, but as the doctor pointed out, he produced so much so there are still millions to pick from, approximately 52 million according to the doctor! Because of the two slightly low numbers, the doctor suggested Corey take a prenatal for men that specifically supports the structure and function of sperm. I’m not sure that I ever thought that I needed to know all of this about sperm, but it sure is interesting! 

The third test was my MRI and everything looked good! All organs were present and accounted for (besides the uterus, obvs). 

The fourth test was my chromosome test. Because my condition is considered a birth defect (rude), the doctor wanted to make sure that all of my chromosomes were present and they were! 

The fifth test was genetic testing for both me and Corey. The Sema4 test is designed to screen for 283 genetic diseases. We received Corey’s results a few weeks ago and he is a carrier for spinal muscular atrophy, but would only be a big deal if I were also a carrier. We never got an official call about my results but at our appointment on Friday, the doctor went to check on it. He came back in and said, “Sarah, did you know that you tested negative for ALL 283 diseases?! Do you know how rare that is?!” I said, “…as rare as being born without a uterus and not having anything else messed up?!” To which he responded, “…well YES!” He said that was a nod to my heritage, so thanks mom and dad!! After he left, Corey was very quick to comment, “But did they check for mental issues?” HAR HAR. Someone seemed jealous about my superior genetics.

Now after all of those results, he asked what we wanted to do, and of course, we’re ready to really get this party started! Let’s go! He said the next step is to take birth control (ironic?) so they can better track my cycle to ensure that I start the hormone injections at the appropriate time. Now here is why the timing of this appointment mattered: they took blood work that morning and I happened to be at the very end of my cycle, so I was able to start taking the birth control right away, which means that we don’t have to wait another month to start! I swear, everything happens for a reason! 

Our nurse coordinator explained that we will be hearing from the financial counselor and clinical coordinator by mid week next week and then, she’ll be able to give us a better idea of the week of egg retrieval. Based on their timeline, we’re probably looking at mid-April! 

The financial counselor will help us understand what exactly our health insurance covers and what to expect cost wise. The clinical coordinator will give us a more detailed checklist of eeeeeverything that we need to do to prepare our embryos for surrogacy. Apparently, the FDA considers surrogacy as an organ donation, but not the way you’re probably thinking right now. Even though a surrogate is technically donating the use of HER organ to US, the FDA considers our embryos going into her body as organ donation, which means we have to go through an FDA approval process. The FDA approval process consists of a physical and an extensive, fairly personal questionnaire, screening of the embryos, and both of us going through an infectious disease screening, so coronavirus: stay away!!! After all of that, an FDA panel will determine if we can proceed. We don’t foresee any issues with this since this is a formality, but you never know! 

So, moving forward, once I am on birth control for a month or so (exact time is TBD), I will begin hormone injections for approximately 10-12 days, with ongoing monitoring and blood work every other day or so (not great since my veins aren’t fans of giving up blood). Thirty six hours after my last injection, also called the trigger injection, we will go to Rockville for the egg retrieval! Within a day or so, we’ll know how many eggs were retrieved and then how many were fertilized. After 5 days, we’ll see how many embryos become blastocysts, and those have the highest chance of becoming babies!

We are excited to truly begin this process, but there are still so many things that could go wrong. Amy Schumer has been vocal about her IVF process and just recently posted on Instagram about how they retrieved 35 eggs (that’s a lot!), 26 were fertilized, and from that, only 1 developed into a normal embryo. I keep thinking about that and how, even though things keep looking good, there could always be more roadblocks. 

But for now, we’re just taking it one day at a time. So here we are, Corey is on prenatal vitamins and I am taking birth control for the first time at 31 years old. Two things we probably never expected. Also, I’d like to take this time to acknowledge all of the wild hormones I will be on for the next 6-8 weeks and give a blanket apology for anything I may say or do while under the influence! I have a VERY strong feeling that Corey is in for some weird emotions so prayers and positive thoughts are needed for him! 

But for real,  many people have reached out over the last couple of weeks asking how things are going and when I’ll give an update. It means so much to us that so many people are invested in our journey! We truly appreciate all of the kind words and thoughts as we head even deeper into this exciting adventure!