Surrogacy- The Highs and Lows, and Tips from Our Journey
In 2018, Sharsheret Program Participant Deedee Bitran wrote about her emotional journey using IVF to prevent passing on the BRCA gene mutation to her future children. Here is the next part of her story.
Our surrogacy journey certainly did not go as planned. Surrogacy can be tough to navigate and this article, coauthored by an Intended Parent (Deedee) and a gestational surrogate (Alexis), discusses our story and provides some tips.
If you asked me five years ago if I ever thought about becoming a surrogate my answer would have been no. I was in my early twenties, attending college, and had no interest in becoming pregnant anytime soon. By November 2017 I had become pregnant with my first child unexpectedly, but looking back it was everything that I didn’t know I needed. I had a tough fight with hyperemesis throughout my entire pregnancy but my birth was uncomplicated and truly magical. My entire life changed the moment I had my sweet baby girl laying on my chest. I remember looking at her for the first time and feeling a wave of peace come over me, like the entire world had stopped at that moment and it was just her and me. A moment of pure harmony, strength, and purpose.
While working on a Labor and Delivery/postpartum unit I became all too familiar with the loss of a child and the deepest kinds of pain that come with it. I saw families who so desperately wanted a child but despite doing everything perfectly, they hadn’t gotten to walk this life with a child yet. I was eternally grateful for that magical moment I shared with my daughter at birth, and wanted the families aching for a child to have moments like that of their own. I began by speaking with surrogacy agencies.** Having a good agency will make or break your surrogacy journey and is imperative for any uncomfortable situations that may arise. Once I had chosen which agency I wanted to work with, we began the process of finding a “match” with Intended Parents.
We had a Zoom meeting with Deedee and her husband where we met and talked about what our lives looked like, what we wanted from the surrogacy journey, and how we felt about all things pregnancy-related. It was like going on a blind date and I was nervous about if they would connect with me. To my surprise, the connection felt so natural, it almost felt like we already knew each other.
After we preliminarily matched, I flew out to Florida to be cleared for a medical screening with Deedee’s IVF clinic. Deedee picked me up from the airport and we explored all of the local spots, ate some amazing food, and laughed together like we had been friends for years. I spent the night praying that I would pass the medical screening and officially be cleared to continue our journey together, something that I knew they previously struggled with. The next morning Deedee said to me: “No matter what happens in there, I appreciate all you have done for us,” and her words stuck with me. A woman who had shed many tears, tried for so long to carry her own child, and experienced great loss in pregnancy…. We walked into the fertility clinic together and Deedee held my hand the entire time. We got the good news that I was medically cleared, cried together, and bonded over hopes of a healthy baby in her arms. It was a quick trip to Florida but I loved every second of it.
Since I was officially cleared medically by Deedee’s IVF clinic, we met with our separate lawyers and about six weeks later we executed an extensive surrogacy contract covering crazy what-if scenarios and all the logistical hoops Deedee would jump through after the birth to have her baby become her child legally.
We began the process of IVF with many different medications, daily shots, lab draws, ultrasounds for measuring the lining of my uterus- a critical combination for maintaining a uterus that was “cozy” enough for an embryo to be placed in for a healthy pregnancy and manipulating the timing of an embryo transfer.***
A few months later, I flew back down to Florida to transfer Deedee and her husband’s embryo into my uterus. Deedee and her husband helped me with my progesterone injections and the next morning we had a flawless embryo transfer. Deedee and I held hands during the transfer and wore matching pineapple tank tops (pineapple is a symbol of fertility). Deedee laid in my hotel with me while I was on bedrest where we shared a lot of laughs and a lot of really good snacks.
After I flew back home, we anxiously awaited a positive pregnancy test or increased HCG in my bloodwork, and we got both. I shared the picture of my positive pregnancy test with Deedee and her husband, and together we dreamed about what this journey would look like and how they would get to experience the moment of meeting and holding their child for the first time. We celebrated together, toasted to exorbitant amounts of chocolate, and were over the moon excited for our journey together. Deedee fantasized about camping out in Idaho near the hospital as my delivery date neared, holding my hand in the delivery room, and bringing her baby home across the country from Idaho on a wild road trip.
Shortly thereafter, despite the prior heartbreak Deedee had with her own uterus, we were surprised and thrilled to find out that Deedee was pregnant too. She dreamed about having two babies born so close together and raising them like twins.
Everything was going perfectly, until one day, it wasn’t. I had some bleeding late one night and called our agency and Deedee to let them know. I had a subchorionic hemorrhage in my previous pregnancy with my daughter which led me to have bleeding frequently throughout my pregnancy with her. Bleeding is always very scary in pregnancy but I had begun to think it may just be normal for my body. When I started bleeding while carrying Deedee’s child I assumed it was another subchorionic hemorrhage. My bleeding had stopped and still had very high hopes for all the things we had planned.
A few days later I went and had my bloodwork done and woke up to texts from Deedee and an email from our fertility clinic saying “your HCG has dropped to a 24 and the pregnancy did not progress.” I was shocked. I knew how common miscarriage was but I was naive in thinking it would never happen to me. I quickly called Deedee and we processed it together. She was so comforting.
Loss during surrogacy is unique in a lot of different ways. We were both completely heartbroken. We had different roles and connections to that embryo we had lost, but we were on this journey together. Despite it not being my biological embryo, the miscarriage was extremely traumatic for me and I so badly wanted Deedee to become a mom. I felt like I had let Deedee and her husband down after I had let their hopes get so high. A family that had an unimaginable amount of loss and grief already, and I had just added more to it. I felt like my body had failed me despite doing everything perfectly. I began to question what any of my future pregnancies would be like. I knew how much time, money, and emotions they had put into this and my body failed them. Deedee felt so guilty that her embryo was putting me through this gut-wrenching pain that she was all too familiar with experiencing herself in the past. Her husband and her mourned the loss of their embryo that they worked so hard to create and prayed would result in a live healthy birth. It was an emotional roller coaster for both of us but nonetheless, we did our best to remain supportive of each other. Being able to be there for each other during such difficult times was one of the biggest challenges in a friendship and surrogacy relationship.
I cheered Deedee on throughout the remainder of her pregnancy despite us having gone through the fresh pain from my miscarriage and she eventually gave birth to a perfect healthy baby girl. Even though our surrogacy journey did not work out as traditionally expected, our relationship still played a vital role in helping Deedee grow her family.
We learned a lot from this experience. We truly believe that despite our journey going differently than planned, we needed each other in our lives. Deedee is the strongest, most determined woman, and has the kindest heart. She doesn’t ever give up on things. She navigated me through all things surrogacy and inspired me to look at the bigger picture of things and enjoy all the sweet things life has to offer. I’m so glad Deedee and I finally get to share our journeys in motherhood together. We hope to share our story with our own daughters one day and have them meet each other. This is motherhood, the highs, the lows, the unknowns and all the stops you may have to take to get there.
There is a lot of moving parts that goes into a surrogacy, so we compiled a list of tips:
- Communication is key, even if it’s uncomfortable, make sure to maintain an open line of communication. You’ll thank yourselves later if you tackle issues head on as a supportive team.
- Find your tribe. Make sure you have a strong support system before doing surrogacy. It’s nice to have an outsider’s perspective on things and as a surrogate, it is invaluable to have extra hands to help for frequent doctor appointments, bloodwork, etc. There are tons of surrogacy Facebook support groups. Join them- even if you don’t post anything, it can be reassuring to hear about others going through similar challenges and there can be some very good advice on those forums.
- Many things don’t go as planned- try to be prepared to roll with the punches. Everything from rescheduling transfers to missing plane flights to miscarriages, to allergic reactions to medications, you’ll likely experience the unplanned chaos.
- Find an agency that feels right for you. Does the agency respond in a timely manner? Do you feel well supported by your agency? Is the agency equipped to handle any of the unknowns and changed plans? These are all things to consider before choosing an agency. Should you ever run into unexpected or uncomfortable times, your agency should know all the answers and be there to assist every step of the way.
- Surrogates – please be patient with your Intended Parents. They have likely faced some challenges while trying to conceive a child and see things from a different perspective than a surrogate does.
- Make sure you each hire good lawyers so that the interests of the surrogate and the Independent Parents are adequately represented. Your surrogacy contract should outline everything (i.e., who is allowed in the delivery room, the contact that the parties will maintain after delivery, who gets custody of the child if both intended parents are no longer alive when the surrogate gives birth, and all compensation details ranging from if the surrogate has a perfect delivery to if the surrogate is on bed rest missing work or miscarries or loses reproductive organs).
Surrogacy can be an absolutely beautiful experience. While our journey did not turn out as planned, Deedee became a mom to a perfect healthy child in the end. We are so lucky to have met each other, grown together from the experience, and hope to be a resource to anyone with questions about the process.
**There are two main ways an Intended Parent can find a gestational surrogate: (1) the independent route (search for your own surrogate through friends, family, or Facebook groups and post an elaborate profile of your family with details on your backgrounds, compensation offered, views on termination of pregnancy, etc.) or (2) the agency route (an agency presents you with surrogate candidates with agency fees ranging anywhere from $10,000 to 35,000 (obviously with no guarantee of pregnancy or a live birth)). Deedee tried the independent route for a while – she messaged hundreds of women and interviewed them every weekend. She flew in three candidates to Florida to have her IVF doctor examine them and unfortunately all were medically disqualified. As she struggled to find the right match, she learned what red flags to spot and what questions to ask (why they wanted to be a surrogate, what their current schedules were like to assess if they had the time to dedicate to surrogacy, what their prior pregnancies were like, if they’d allow Deedee in the delivery room, if they’d deliver in a hospital, what their views were on termination of pregnancy, and whether they lived in a state where surrogacy was legal).
*** Deedee had turned to surrogacy after she experienced complications from her prior miscarriage resulting in her uterus’ lining being too thin to carry her own embryo. She had previously tried various medications, injections, and estrogen patches to grow her uterus’ lining but none had worked, and since BRCA-2 is an estrogen receptive gene, there was a danger in keeping her on such high doses on estrogen indefinitely.