Baseline testing

IVF and surrogacy journeys vary greatly from person to person, but all stories share one common element: they begin with a suite of baseline tests. Zane and I got to enjoy our first round of testing recently, something we’re sharing in two parts below.

Note: these tests were ordered by our doctors based on our medical histories. Your doctor may recommend other testing.

FOR THE LADY:

  1. Pelvic and transvaginal ultrasound
  2. AMH blood test

After chugging what seemed like a gallon of water, I was led by a member of the clinic staff to the waiting room. While I’m told it is normally packed, it wasn’t overly busy – probably due to the pandemic. When my name was called, probably 10 minutes after I’d sat down, I went to room 6 where a kind ultrasound technician walked me through the two tests.

The first, a pelvic ultrasound was much like the ultrasounds you see on television. Room-temperature gel was placed on my abdomen, and the technician used an ultrasound wand to take a peek at what was happening beneath the surface. As a result of all of the water I’d just consumed, it was a little uncomfortable to have the wand pushed against my bladder. Luckily, the entire process took just a few minutes. There was a split second where I wondered how different things might feel if we were having a baby the ‘normal’ way and this was my first ultrasound. It certainly would have felt more exciting, but here we are.

Once the that test was completed, I was instructed to relieve my bladder and return to the room for a transvaginal ultrasound. This test was equally as fast as the first. I’m going to spare you the detailed description of what that was like, and instead am sharing this helpful article to describe the process.

Once I was finished in the ultrasound room, I made my way to get my blood drawn. The nurse was friendly and efficient, and even offered me a suggestion of a nearby restaurant to grab take out on my way out. In addition to performing a regular blood panel, checking my general health and wellness, and any communicable diseases, the doctor requested an additional test to measure my anti-müllerian hormone (AMH).

The results of the AMH test will provide my doctor with information about my ability to produce eggs. A higher number indicates a greater ovarian reserve (the number of eggs left). AMH numbers can be affected by a number of things, like genetics and age. While I wait for the results of this test, I’ll be crossing my fingers and hoping I’m like a hen house (full of eggs).

Baden

FOR THE GENTLEMAN:

  1. Invitae genetic testing and other bloodwork
  2. Sperm DNA Fragmentation, Semen Analysis, etc.

In addition to the regular blood panel that was required for Baden, our doctor also suggested I submit a sample of blood for genetic testing. In order to ensure that neither Baden or I are carriers for any genetic mutations, a small vial of blood (or saliva) is sent to a private lab in the US to test for over 300 genetic diseases. I should be getting my results back in a few weeks. You can learn more about this test and even order one for yourself at invitae.com.

There’s no two-ways about it, any trip to the Andrology Department is an awkward experience. You likely need to abstain for a few days before submitting a sample and once you do, it is promptly tested to ensure your swimmers are in top shape. I won’t go into details, but all the material you need is provided. Take a breath. Try to relax, and do what you do best.

Zane

P.S. Make sure to not spill a drop. I’m told the best and strongest sperm cells come out first!

Drafting the ‘team’

In our extensive research into Canadian surrogacy, Zane and I have heard over again about the importance of picking who will be on our ‘team.’ We’re going to be investing a huge amount of trust in everyone we work with. Since the stakes are incredibly high, these have to be quality picks.

So far, we’ve gathered that we need the following:

  • A lawyer who specializes in third-party reproduction
  • A fertility clinic and doctor
  • A surrogacy agency or consultant (optional)
  • A counsellor
  • The surrogate

When I say that we’ve spent hours interviewing doctors and agencies, I am not exaggerating. There are currently about a dozen surrogacy agencies in Canada, and we have spoken to every single one. Sometimes it feels like an information overload or like listening to a record on repeat. On reflection, I realize we’ve learned so much so quickly and that these conversations are invaluable to us.

The surrogacy community in Canada is not that big, so almost everyone who we’ve met knows each other. We’ve found that really helpful, because we were able to ask for second (and sometimes third) opinions on each person. Some names, like that of our lawyer, came up repeatedly as experts worth trusting. If you’ve ever been lawyer shopping and heard a dozen professionals tell you that your potential lawyer is incredible, you’ll understand just how much confidence that inspires.

As an aside, we also found it inspiring that this field is broadly female-driven. Nearly every professional we met with from our lawyer, to our doctor, to agency CEOs are women. It is very empowering to see so many women who are at the pinnacle of their careers supporting the creation of families like ours.

We met with two fertility clinics, and while the first one seemed fine I’m very glad we got a second opinion. Even though either clinic could have done the job for us, we really ‘clicked’ with Dr. Glass from CReATe Fertility Centre in Toronto. Not only did their funded-cycle waitlist match our timeline more appropriately, CReATe also has expertise in working with surrogates. Ultimately we left our (virtual) meeting with Dr. Glass feeling that she was someone we could rely on.

As of now, we’ve got 2/5 of our team members picked out. Our next step is signing with an agency. We’re close to making that decision and we’ll keep you posted.

If you’re to take one thing away from this post; get a second opinion – you won’t regret it.

Baden

How does surrogacy work in Canada?

So…what’s the deal with gestational surrogacy?

Unlike in other parts of the world, surrogacy in Canada is entirely altruistic–meaning that a surrogate can only carry a pregnancy unselfishly, and not for any sort of compensation. The laws that govern surrogacy in Canada stem from the Assisted Human Reproduction Act, 2004 or the AHRA. The law states quite clearly that any compensation of a surrogate could result in up to 10 years in prison and a fine of up to $500,000. Reimbursement of our surrogate’s costs (as outlined Health Canada’s guidance document) is considered acceptable.

In addition to altruism, the federal government stipulates that a surrogate must be over 21 years old and an egg donor must be over 18. Many clinics and agencies will also have their own rules about who can be a surrogate (age, BMI, health conditions, etc.) We are looking for someone who is in their mid-to-late 30s, very healthy, has had successful pregnancies in the past, has built a wonderful family and support system, and loves being pregnant! Our preference is someone who has never been a surrogate before, and doesn’t live too far, so that we can participate in the journey as much as possible.

Unfortunately, your embryo does not magically appear in your surrogate. Surrogacy demands IVF (in-vitro fertilization) where eggs are retrieved from a woman’s ovaries and sperm is provided by a man. The egg is fertilized by the sperm outside of a woman’s uterus and then inserted into the surrogate via a small catheter. We will obviously delve into this in more detail as we go through the process ourselves but for now we will say this: IVF involves lots of medication, needles, ultrasounds, and visits to the doctor by both you and your surrogate.

Lastly, it is important to note that legal parentage is dependant on provincial laws. We’ve been advised that the best places in Canada to have a child born via surrogacy are Ontario or British Columbia. In these provinces, a birth registration is a relatively simple process. Other provinces have different processes and we recommend speaking to a lawyer before deciding on a particular surrogate.

To summarize, surrogacy in Canada is not a walk in the park. It has legal (both federal and provincial), medical, and significant financial implications. We know the journey we are in for will not be an easy one, but it is one that we are proud to share with you. We know how much a blog like this would have helped us in our journey, so we hope we can pass this knowledge on to you.

Zane

What in the womb is going on here?

Photo credit: Wilson Szeto

Welcome to our blog: Not My Tummy (But I’m Still Mummy!). I believe that sharing our story will help reduce the stigma around medical infertility and gestational surrogacy in Canada. When my partner and I began this journey, we struggled with the lack of first-hand knowledge that was available to us. We are building this blog and chronicling our journey with you to fill that knowledge gap. We hope that this will help other Canadian couples experiencing infertility and requiring gestational surrogacy in the future. I never thought my story was that compelling, but today I think that changes.

Zane and I are now beginning our journey towards building a family by working with a gestational surrogate. I’ve known concretely that I won’t be able to carry my own pregnancies for several years and we have been slowly sharing that with the people in our lives. I have epilepsy, and the medication which controls my seizures has severe risks to a growing fetus. Neurologists, fertility specialists, and pharmacists alike have warned against carrying a child. I tried switching to another medication in order to make carrying a child a possibility, and the results were disastrous.

When I made the decision to remain on my current medication, (thereby not being able to gestate) my family and friends were incredibly supportive. It didn’t absolve me of the guilt for making that decision (it’s not one that any person takes lightly), but it certainly helped. Since starting a family was a few years away, I was not too concerned about what was to come.

In the time that followed, Zane and I got engaged, bought a condo in Toronto, and settled into our careers. We planned a big, beautiful wedding, and with just months to go until the big day, the COVID-19 pandemic struck. Since then, we’ve postponed our wedding three times and welcomed a beautiful puppy named Dodi into our lives.

So now what? We begin a new and exciting chapter, and we bring you along for the ride. So buckle up, because from here on out, even though it’s not my tummy, I’m still Mummy.

Baden

P.S. Be sure to follow us on Instagram! @notmytummy