Outsourcing Pregnancy?

So...a while back I went to see a high-risk obstetrician to consult on the possibility of pregnancy. It has been almost four years since I miscarried and my mid-thirties turned into my late-thirties.

Quick health review:

- 3 antidepressants (since major depression following miscarriage)

- factor V leiden

- hypothyroidism

- AMA (advanced maternal age)

The specialist told me that my psychiatrist had done me no favours in suggesting that we wait a year past the time when my depression stabilized, as AMA is the factor most likely to impact our ability to conceive.

DH was not thrilled about the prospect of another depressive episode, nor was he keen on the daily injections of Heparin. He proposed that we consider another option. One with no worries about my medications, no worries about blood clotting, no worries about delivery - hire a surrogate.

A surrogate? Really? Could we actually outsource pregnancy? The thought seemed more foreign that I could wrap my head around. I ran it past my mother (thinking she would be horrified) and she loved the idea.

I found a surrogate website and began reading about the ins and outs of this world and learning their vocabulary. I found out that I would be known as an IP - intended parent. The surrogate would be either for GS - gestational surrogacy, or TS - traditional style surrogacy. With a GS, the embryo has no genetic relationship to the surrogate, with traditional the egg of the surrogate is used, and is therefore her genetic child.

The laws in Canada about surrogacy are complex. Apparently it cannot be done for profit and must be altruistic. There are loopholes that allow IPs to compensate their surrogates for their expenses. To help manage the complexity, there are agencies that provide IPs with lawyers, contracts & potential surrogates....and I thought pregnancy would be challenging.

I still wasn't completely sold, but we decided to meet with the fertility clinic to discuss our options anyway.

The physician we met with was a breath of fresh air; she was blunt, direct and provided information without sugar-coating our situation.

I must look a little younger than I actually am**, because when she asked my age, her face fell in an instant. She went from an expression of hopefulness to one of "yeah, right" in a millisecond. Apparently late 30s is NOT the time to try conceiving.

Now I am fairly up to date on all of the statistics about age and risk, but I guess it hadn't truly been processed until this appointment. Apparently we have only have a one in five chance of having a healthy embryo in any cycle and a 50% chance of miscarriage using my eggs.

If we decided to use a donor egg (not allowed in Canada), the odds would be much, much higher. The doctor recommended finding a donor in her early twenties for optimum results. And even though I wasn't sure this was what I wanted, the odds being so stacked against us brought me to tears.

But the bad news wasn't over yet! Because of my history of depression and my blood clotting disorder, I am a BAD CANDIDATE for the fertility drugs used to produce more eggs in a cycle. Yup. I could clot and die or just sink into a depressive episode from which I may never make my way back to normal.

The doctor left to get some forms for blood tests and I burst into tears. My husband -being an overall-great-guy and a pragmatist- told me that this was exactly what he expected.

DH then took out his laptop computer and went to you tube to play me "Furry, Happy Monsters" by REM on Sesame Street. I assure you it is impossible to be sad with Michael Stipe singing to a group of monsters.

It appears then that having a baby of our own is out of the question; but if I am completely truthful with myself, I don't think I ever was ready to outsource pregnancy.

**this is due to botox, not my overall radiant health

My Mom: Treat as TIA

I wrote a few weeks ago that my mother experienced a stroke-like event that may have been a TIA or a migraine.

Despite completing a "bubble test" (to listen for a hole in her heart), and wearing a Holter monitor (to rule out fibrillation), neither test showed a clear diagnosis. We were surprised when the stroke specialist felt strongly that she had experienced TIAs, and not migraines (as was previously diagnosed).

Due to the serious nature of TIAs, my mother's physicians are choosing to treat her with blood thinning drugs to prevent clotting. (Both my mother and I have Factor V Leiden, a blood clotting disorder).

My poor mom, she is used to having great health. Blood tests every other day are on the menu for the next few weeks. It is a frightening diagnosis, but I am grateful that she is being treated with an abundance of caution.

My Mom: Migraine or Stroke?

My mother is nothing like me - she's healthy and active, absolutely full of life (at age 70, she is averaging about 7,000 steps a day on her pedometer!), so it was unusual to get an emergency phone call regarding her health.

It started with her having a terrible headache behind her eye. Next came a feeling of extreme heat followed by difficulty speaking (she thought that she was making sense, but what came out of her mouth were just random words). Aphasia.

My first thought was stroke, so we rushed her to the hospital for evaluation. As I took her into the waiting room, I noticed that she was making sense...sort of...but using strange words and trailing off mid-sentence, forgetting what she had just been telling me.

Fortunately, a CT scan showed no signs of stroke. Unfortunately, there was no way to fully rule out a TIA (also known as mini-stroke).

Here's where it gets weird: my mother has a history of hemiplegic migraines that began about two years ago. These strange migraines look almost identical to a stroke. During the migraine, she loses feeling and control over half her body.

The first few times it happened, even the ER physicians thought she was having TIAs; but after a neurologist confirmed that it was an atypical presentation of migraine, we all got used to it and quit worrying when symptoms came over her.

This time was different, there was no aura, no numbness, no loss of control over one side of her body - only pain and aphasia.

We are waiting on another consult to re-evaluate, but at the moment, my money is on migraine.

Bizarre symptom of rare disorder? Maybe my mother and I are more alike than I thought.

pregnancy revisited

Since my last post on pregnancy, I have seen the "high risk obstetrician", my PCP, and the "paediatric pharmacologist" to get input on the advisability of pregnancy.

Interestingly, the biggest risk factor seems to be my blood clotting disorder, 'Factor V Leiden' (FVL). While it can be managed with daily injections of Low-Molecular-Weight Heparin (LMWH), there seems to be concern that FVL increases the overall risk of miscarriage and stillbirth.

The answer to whether or not I could stay on antidepressant drugs through a pregnancy is also unclear. The ideal would be to come off all medications, but that simply isn't an option.

Apparently, if my mystery illness does turn out to be lupus, that will also increase my risks.

So, do we want to chance it? I'm really not so sure right now.