Monday, June 30, 2014

starting our donor IVF cycle

we are doing this. 
we signed all of the consent forms. 
and it brought me back to a time when i was so overwhelmed by this stack of paperwork. all of the worst case scenarios and risks for the procedures and drugs used to bring me to tears. this time, i was able to initial every page without so much as a tear. it is amazing what you can get used to. 

just like in cycles past, i read every page and my husband didn't read a single page. he said "tell me the highlights". we know the risks but we push forward for the mere chance of having a baby to call our own. 

this time, i thought about k. i wondered what it was like for her to read all of the scary possible side effects from stimming and initial anyways. even though she didn't need to take any of these risks because she's already created her family. i thought of her husband who agreed to this donor cycle as well. who signed his name to a piece of paper (our legal contract) consenting to this. knowing that his wife and the mother of his children will be taking the risks outlined in this stack of papers for someone else's benefit. 

i'm humbled and reminded every step of the way how incredibly self-less they are. 
and we are filled with hope that this cycle just might have a different outcome than previous cycles.

*check back frequently daily 
as I will try to catch up on all my blogs posts this week to bring y'all up to speed.

Sunday, June 22, 2014

the setback

our donor cycle with k has been going smoothly. the ease of this cycle and peace that we've felt continues to reinforce our decision and reaffirm that this is the way we are supposed to build our family.

k has been a blessing and has been keeping in great communication with me. her frequent updates make me feel more a part of the process and everything on her end is going perfectly.

the only hiccup we encountered along the way was with me. and i want to blog about it in case anyone else comes across this issue. i learned a lot and hope that i can help someone else advocate for their own health...should they find themselves in this situation. 

my nurse at SDFC sent me an email stating that my titer (a test that detects whether you are immune to chicken pox) came back negative. i've never had chicken pox so that wasn't surprising. but i did get the varicella vaccine (a series of two shots timed 30 days apart) back in 2010 before we started our first IUI. i must have tested negative for the titer back then (4 years ago) as my first clinic told me that i needed this vaccine before moving forward with my IUI. i remember it very well because it was a two month delay to get started. 

my SDFC nurse said in the email that she sent me…i have two options because i don't show immunity. 1) to get the varicella vaccine and wait 30 days for the second injection and then another 30 days to move forward with a transfer. since varicella is a live vaccine, you need to wait a month before you become pregnant. or 2) sign a waiver declining the vaccine and hope that i don't get chicken pox while pregnant. 

if you develop chicken pox while pregnant, it can be devastating for mom and baby. birth defects. pneumonia. developmental problems. it can even be life-threatening. even though we were anxious to move forward, we've waited this long so we didn't want to take any chances with my health or the baby's if this cycle works out.

so reluctantly, i went to my general practice doctor to get the vaccine. but i wasn't happy about it because i was going to have to wait two months to move forward with our donor cycle.

when the general practice nurse administered the shot, she said "we will see you back here in 30 days for the second shot and then you probably won't have to worry about this again for the rest of your life." huh? stop the bus. what do you mean, i thought? i informed the nurse that i just had the varicella vaccine series four years ago and already i am not showing immunity. she thought that was odd but didn't really have any information for me.

it was really bothering me so i started doing some research. i read that the vaccine doesn't work for some people. i called my SDFC nurse to discuss it because i didn't want to continue getting a vaccine that potentially wasn't going to give me immunity anyways. 

when i started telling the nurse my concerns, she said "you had the vaccine in 2010? that is new information." i kindly (through gritted teeth) told her that information was in my immunization records that i sent her when i became a patient at the clinic. 

she started shuffling through my file and found my records. she never saw them prior. silly me. i assumed that my nurse actually review my records before issuing an email stating my options. i thought she might think to perhaps look at the immunization records that i provided when my titer came back negative. i was livid. 

as i began to ask questions. she basically told me that since SDFC doesn't administer the vaccine, she doesn't know much about it. she directed me to my general practitioner. i explained my situation to my gp doc who didn't know much either and said he needed to contact the center for disease control

at this point, i was very frustrated and discouraged. it was really irking me that i couldn't get answers. i decided to call CDC myself instead of waiting for my doctor to call and translate the response back to me.

here's what i learned.
after being transferred to a specialist at CDC, i was told that titers are not recommended for people who have already received both varicella vaccines. he stated that the commercially available titer testing is not that reliable or effective at detecting antibodies in your body after the boosters. he also stated that according to CDC, I should have protection against chicken pox after the first 2 vaccines I already received in 2010 and didn't need the third vaccine i just received…and definitely don't need a fourth.

i was so annoyed. my cycle had been delayed and i put a live vaccine in my body before a transfer (God willing) that i don't need. i told my nurse at SDFC that do not want to take another titer as it is not accurately reporting my immunity and i will not be getting a fourth booster as it is not needed.

the nurse never took any accountability for the mix up. or the delay. and the clinic made me sign a waiver stating that i was refusing the additional vaccine. how freakin' dumb is that.

anyways, in the big scheme of things…
if this is the worse setback we have in this cycle…we are doing pretty darn good. 
when i get riled up, i just need to breath and remind myself of that. 

Sunday, June 15, 2014

5 steps to IVF with a known egg donor

after deciding to move forward with k as our donor, 
what happens next? that is the question that we've been asked many times.

since ours is not an anonymous arrangement, 
our clinic considers it a "known donor" scenario 
(even though we've not actually met k in person).
this is what happens in a known donor situation…

step 1: psychological consultation
both parties meet separately with a therapist to discuss potential issues/concerns related to the egg donation. the purpose is to ensure that all parties have thought about the different aspects and future implications of the donation and are in a healthy place to move forward.
topics usually discussed with the donor:

Personal History 
 Family History 
 Educational Background 
 Assessment of Stability/Current Life Stressors and Coping Skills 
 Motivation to Donate/Compliance 
 Psychological Issues 
 Reproductive History 
 Interpersonal Relationships 
 Sexual History 
 History of Major Psychiatric and Personality Disorders 
 Substance Abuse 
 Legal History 
 History of Abuse or Neglect 
 Possible contact issues 

with the recipient parents (that's what A and I are called), 
the session can really go anywhere and varies from couple to couple.
with us, the focus was on future contact with our donor, appropriate boundaries, history of our infertility, stability of our marriage, open communication with our child about the way he/she came into the world, whether to openly disclose our egg donation and to whom. things like that.

after the donor's session, the recipient parents receive a report with the answers the donor provided to all of the topics above. of course, k passed the screening with flying colors and we couldn't be happier with the things we learned about her.

step 2: egg donor testing
the egg donor goes through a lot of testing to ensure that she is a prime candidate for the egg donation process. we weren't worried about this with k since she has already donated twice. but she still needed to go through the process with our clinic. 
donor testing and desired results at San Diego Fertility Center include:
Day 3 FSH (desired <9.0mIU/ml), Estradiol (desired <65pg/ml), AMH (desired >1.5), Antral Follicle Count or AFC (desired >12), FDA required communicable disease testing, and drug and nicotine screening.

step 3: recipient parents preparation
to ensure the recipient parents are ready for their role in the egg donation process:
- the recipient father must have a recent semen analysis
- recipient mother must have a sonohysterogram that shows a normal uterus
- recipient mother must do a uterine evaluation cycle to ensure that her uterine lining can get thick enough for implantation of the embryo to occur (desired >8mm)
- both intended parents need to have updated labs and communicable disease testing

step 4: genetic risk assessment and testing
this is both a panel of genetic blood tests as well as a questionnaire about the donor's family history. the purpose of this screening is to determine whether the potential child will have an increased risk for any genetic diseases. good news here too. k is not at an increased risk for any of the diseases that the clinic tested for.

step 5: legal contracts
once all of the results are in from steps 1-4 and everything looks good, it is finally time to move forward with legal contracts. keep in mind that if you go through a private agency or a fertility clinic in-house donor program, you won't have to worry about the legal paperwork. i'm pretty sure they take care of all that. but for a known or semi-known arrangement, you're on your own. 

usually the clinic will provide the recipient parents with a list of preferred attorneys. typically, you want to select an attorney that practices in the state where your egg donation will occur. but more importantly, you want to select an attorney who is well versed in reproductive law. the recipient parents and the donor will need separate attorneys to represent them. 

i would recommend calling a few different attorneys as their rates vary considerably. they all do free phone consultations and sometimes their rates are negotiable. once you secure an attorney, he/she will refer the donor to an attorney to represent her. then terms of the agreement are set by the recipient parents. the contract is drafted. both parties review and make edits. both parties sign.

after the contracts are signed, you've got yourselves an egg donation agreement 
and are ready to move forward with IVF. 

it's official.
k and i…and our hubbys have signed the egg donation agreement. 
so freakin' exciting!

Thursday, June 5, 2014

we have our egg donor!

the bubbles were a gift from Suzanne…thank you, friend.  
our egg donor story is not the norm.
it is out of the box. non-traditional.
and that's okay with us.

is it more than okay.
it's perfect. it's the way things are supposed to be.
we have found "the one" and it was a match made in heaven.
things like this don't happen unless they were orchestrated from above.

i believe our donor was intended for us. i feel in my gut that she will provide us with healthy eggs to grow our family and help us conceive the child we've been dreaming of and fighting for.

we didn't sit down in front our computer and select our donor from an anonymous profile like i thought we would. it didn't happen that way at all.
it happened another way.

our donor found us through this blog.
she read about the heartbreak we've endured on the road to parenthood.
then she read our post about choosing the clinic in san diego.

afterwards, she sent me a message that brought tears to my eyes and still does.
essentially, this is what she said:

i'm a two-time egg donor living in san diego.
you and your husband are the reason why i donate.
after reading about your journey and struggles,
i felt compelled to reach out and offer to gift you my eggs.

the gratitude that i felt and continue to feel for this enormous offer makes my heart swell.
our beautiful, kind-hearted donor k has offered to waive her fees and give us a gift. the gift of life. 
the gift i haven't been able to give to myself,
my husband or our families for almost 6 years.
a gift too generous for words.

this gift has inspired me to be a better person. to find a way to pay it forward. 
to change someone else's life as a result of my actions...
which is what she's done for us.

k has shown us the most amazing example human kindness, 
demonstrated a complete act of selflessness on behalf of a total stranger,
and eased some of the financial strain our family is under to find the money to pay for this cycle.

k could charge $10,000 for her eggs if she wanted to.
 donor compensation is for pain and suffering.
for the donor's time and troubles. 
and as many of us know, IVF is not easy.
the shots, testing, doctors appointments, egg retrieval.

but she doesn't want anything 
except to truly help us.
her own children have brought her so much joy 
and she wants us to be able experience that same fullfillment in our lives. 

she is the kind of person who believes in her core that 
if you have the power to make someone happy, 
you should do it.

this is k

thank you, k.
we are beyond blessed to have you as our donor. 

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