The Big 4-0

Yesterday I turned 40. It was a big day. Mr. M. had lots of stuff planned. First I woke up to my beautiful Lulu. She thinks I'm her mummy and M is her daddy. Here she is.

M knows me very well and gave me a check and told me to knock myself out. The check was thoughtful but we are about to move house and I really wanted a new bed so I ripped it up, marched him to Sleepys and we spent the morning with the fabulous Anne testing mattresses. When Anne heard I sleep with two pillows scrunched together she nearly passed out. She takes her job very seriously. So we bought new pillows too. Anne is good!!!! She could sell ice to eskimos! We spent the day furniture shopping for the new place. We then headed to our new building to sign our lease. It was painful to leave our rent-controlled studio in Chelsea but then again It will be nice not to eat, sleep, work, cuddle with Lulu and watch The Real Housewives of Beverly Hills all in the same spot. We found a great new flat (which is what M calls an apartment-he is very upset that we Americans borrowed the word from the French instead of the English). Here are both places for comparison. See if you can guess which is the old and which is the new.

Finally, M pulled out his big surprise. We went to a great eatery in our new neighborhood and there were my parents. After dinner came the biggest surprise of all...

My parents loved the Gayest show of the universe. My mother didn't get all the jokes (There is one about Hormones and Whore-moans that I had to explain several times) but I have never heard them laugh so hard at a show. It made us all want to get dressed in drag and take a road trip.

The day ended with an email from India. Our embryos have been transferred into two surrogates (four and four embys) and we begin the two-week-wait for news. When M realized that technically both could get pregnant with twins he had a brief stroke but quickly recovered. I know what I want for my birthday.

A Practical Valentine

I love getting and giving practical presents. This year for Valentines Day I got Mr. M. a dustbuster (and some tulips to make sure there is at least a little romance). Lulu loves to drag her food around the apartment and Mr. M. loves to cook. Unlike myself, he does not believe in cleaning after each stage of the cooking, so by the time all is done, let’s just say there is a lot of food in a lot of surprising places. I think the dustbuster will bring us all a lot of happiness. We’ll see what I get tonight and here is hoping that Mr. M. can combine romance, subtle criticism and practicality into that perfect gift.

First Trip to India and some random advice

The “donation” trip to India was fairly straightforward. We were there for five days, at the clinic every other morning and the rest of time sightseeing. The clinic actually included the cost of the initial stay at one of the Taj hotels and the sightseeing in their package so it wasn’t too expensive. Both of us had been to India before and we had a bit less of the culture shock some experience so I thought I’d include a list of random advice and observations that I’ve culled from my experiences in India over the years.

1.     The airports in major India cities are quite nice. The new New Delhi airport is one of the nicest in the world. The madness starts when you get out of the airport. It can feel a bit overwhelming (though not nearly as bad as it was a decade ago). My advice for first timers is to arrange an airport pickup with Hotel. If not, every major airport has a pre-paid taxi booth right outside arrivals terminal. You tell them destination and pay and they hand you off to a driver. If I do take a regular taxi, I find it useful to know what typical price is for that route. I then add 20% (tourist rip-off penalty) and tell driver my price as I get in cab. I also like to take the direct flights from US whenever possible. It is especially nice on return when I’m ready to go home ASAP.

2.     I prefer to stay at the better business hotels when I travel to India. They are often quite affordable and they give me a bit of an escape from the chaos of Indian cities. Also, the concierges there tend to be really good at dealing with unusual requests, including arranging car to clinic. A cheaper option is to call a local travel agent. Typically, a car/driver including up to a two-hour wait can cost less than 20 USD. One warning though. I found that rather than risk the awkwardness of telling you they do not understand what you are asking for or know where you want to go, hotel concierges can sometimes nod and then you later discover they send you to the wrong part of town. I find it helpful to print out addresses on google maps just to be sure or at least repeat my request.

3.     Another thing I noticed about drivers, taxi and otherwise, they can sometimes ask a lot of what feel like very personal questions. I’m often asked why I’m in India, if I am married, how many children I have etc. I’ve never tried actually being honest and saying I am a gay man looking to have a baby via surrogacy in India. One day I might.

4.     Westerners might be surprised that the clinics and hospitals involved in surrogacy tend to be quite modern and clean. I remember falling into the Ganges in Varanasi on my first trip to India and spraining my knee. The hospital I went to in Delhi was brand new, empty and super cheap. Much more pleasant than anything in the US. Of course, these are hospitals meant mostly for rich Indians and foreigners. Most Indians don’t have access to that kind of health care.

5.     Even though this was not necessary, I found it helpful to visit consulate where I will need to go to get US passport once baby is born. I met with the person in charge of the process and she gave me lots of material to read. At least when the baby is born and the craziness ensues, I will know whom to look for.

6.     My yiddisher tummy struggles with spicy food and this is a big issue in southern India. I used to ask for food to be made non-spicy. But even that was too spicy. Now I say: Imagine making this food with a little spice as possible, now make it less spicy than that. I’m sure Indians love me! A doctor once told me when all else fails, take two pepto bismol tablets every four hours during the day while in India (especially if eating outside hotels). It creates a temporary lining in stomach that protects against spice-related heartburn. Also, no tap water including ice (unless it is filtered water) and teeth brushing.

7.     Couple of things about the trip to clinic: I found it reassuring to see surrogate quarters and meet some of them. If they cannot show me where the surrogates live, that might raise a red flag. In general, I found a good tour of the clinic to be reassuring as well. In my case, it felt like a real working clinic and not something built to lure in unsuspecting foreigners. I also asked a lot of questions, particularly about extra fees that might come up. I also found myself asking former clients and referrals how much they spent in total to try to have an average figure in my head. Finally, this might be a bit crass but I advise bringing your own “material” to the clinic if you need it, all they had was a copy of GQ.      

8.   Things seem to run at their own pace in India. I try to leave a lot of room in my schedule for lots of delays and surprises. I prepare for what I can and then surrender to the process.

Something-to-take-care-of-until-baby-comes

INTRODUCING... LULU

Our last dog Margot passed in November. She was an angel and died of old age at 15. We think her spirit is in Lulu who was born around when she died.

We thought about waiting till we had baby news to decide about new dog, but we couldn't wait any longer. Lulu is the mellowest 12 week old we've ever met and she has Margot's knowing eyes. She is a bit brighter than Margot though, already going on wee-wee pads after 24 hours (Margot never got the wee-wee pad thing and loved to pee in the bed).

How we chose our clinic?

We knew we wanted to pursue surrogacy in India but still had to decide among the various clinics. To us, the primary goal was to be able to afford a few setbacks so we could stay in the game as long as possible. There are clinics that mostly cater to a Western clientele. Naturally, these tend to me more expensive. Also, clinics in major cities tend to be more expensive. Some don’t work with gay couples at all (really! How 1990s). Typically, clinics require one provide a large initial payment (usually between $8000-$15,000) which covers the egg donor, first IVF and preparations for surrogate. The next sum is typically due at confirmation of pregnancy where payments of about $15,000 to $20,000 are spread out over the rest of the pregnancy and this covers the actual surrogacy itself (including her fee) and birth. Sometimes there are extra costs for twins and hospital. This makes total cost of surrogacy anywhere between $25,000-$30,000 (this does not include at least $10,000 for the two trips over there, first a quick one for deposit, and second a longer one to bring home baby). Where clinics differ is what they offer for the initial payment. Most clinics offer a single IVF procedure, a fresh transfer of embryos, freezing of remaining embryos and then several frozen transfers following this. Other clinics will include only the first transfer and charge for each additional transfer.

Some folks are lucky, get pregnant within the first few tries and end of spending about 25-30K on the surrogacy itself. Our goal however was to prepare for failure (which we are really glad about now cause we have had a lot of it). If pregnancy did not occur within the first few transfers or if IVF did not yield enough viable embryos for several transfers then one must pay another large initial payment to start over. Too many failed transfers and this could really add up. We eventually found a clinic that included several IVF’s (and therefore many more transfers) in that initial fee, making it much more likely that we could cover cost of failure.

For about $15,000 or so extra, one can choose a caucasian donor. Once again, this can become prohibitively expensive if one needs more than one try with donor. We were a bit nervous only because we wanted to make sure our families would be open to loving our child, no matter what physical attributes they possessed (For us, we actually loved the idea of a multi-racial/multi-cultural family--which we pretty much already are). I brought this up with my parents and my step-dad looked at me as if I was crazy and said: are you kidding, it is the twentieth-first century, grow up. That ended those concerns!

Some people prefer to work with a US-based agency who handles communication with the clinic. We liked the idea instead of communicating directly with the clinic doctor. We emailed a lot of clinics at first and found ourselves focusing on those that responded fairly quickly and those that were willing to respond to all our inane questions. I asked lots and lots of questions around success rates (making sure never to confuse pregnancy rates with live-birth rates), whether babies go to full-term, conditions for surrogate living, not so much because the answers distinguished the clinics, but more because we wanted to see whether clinic was responsive in general and if answers seemed to add up. For us, the clinic we ended up working with was the most upfront about providing clear answers (They had many statistics at hand, and even though statistics can be tricky to interpret, I love a good statistic). Finally, we ended up getting a better vibe from the doctor and staff at one of the clinics so we chose it, but honestly financial considerations outweighed everything else.

It is important to acknowledge what for us was the major downside of pursuing surrogacy in India and that is the process of getting a US passport and bringing our baby home. Both of us had been to India before and knew how difficult the bureaucracy could be. One time, when traveling thru India, an airline lost my luggage and once they found it, it took quite a while to convince the airport attendant drunk on his authority over lost suitcases to return it to me (I suspect a little bribe would have helped). Typically, it takes about three weeks for US citizens to complete a process that includes getting the birth certificate, processing DNA tests, applying for and receiving an emergency passport and getting an Indian exit visa for the baby. I know from reading other blogs that for two men, trying to travel out of India can be awkward at best. We are expecting a lot of “where is the mommy?” We are trying to think of this as an opportunity, a chance to bond with our baby and learn how to take care of him or her without all the help that we will get down the road from well-meaning grandmas, aunties and friends. Neither of us knows much about taking care of a newborn, so we figure that by the time we get back to US we will be old hands. We worry a bit about dealing with time off from our jobs in US, but we know in the end it will work out.

The other issue we considered was one of ethics. I can see how some would find the idea of Westerners  traveling to India and "renting poor women's wombs" disturbing. I think in a better world, for those that cannot conceive the old-school way, surrogacy would be a part of regular medical care. I don't think there is anything inherently unethical about a women choosing to become a surrogate, regardless if she decides to do it for compassionate or financial reasons. Our bodies are our bodies. On the flip side, there is no question that this provides poor families opportunities they might not otherwise get. Many buy homes or send their children to school. I just don't think there are any easy answers. For us, it was really important to meet the surrogates and make sure they lived in proper housing and were well cared for.

Once we picked a clinic and sent out our very large bank transfer (maybe the most anxious moment of the whole process, I was sure they were going to take it and close up shop) we were off to India. More on that in next post….

Domestic vs. Indian Surrogacy

About a year ago, when I turned 39, I realized I really wanted to have a child. It kinda came as a surprise cause I always thought I didn’t really want children. I suppose I didn’t really think it was possible. Mr. M and I had been together for a while and I realized that soon I would be forty and wasn’t sure having teenagers in my 70s was a good idea. It took me several months to bring it up with M and when I did he was a bit hesitant. He told me: let’s wait a year and get used to the idea. I have my own special translator that I use for M. “I will never ever do it” means: wait a month or two and “let’s wait a year” means: get started right away. So I did.

We were open to both surrogacy and adoption but soon decided to start with surrogacy. Although we have many gay friends who have adopted successfully, we have also seen the heartache that comes when a birth mother changes her mind. We also had mixed feelings about open adoptions: on one hand, it is clearly better for the children involved, on the other, we weren’t sure how we felt about having our child’s birth mother in our lives. With surrogacy, the major hesitation I had was whether it was a good idea to continue my gene pool. I gotta say, I like the idea of some fresh foreign genes in there to mix things up.

I did a lot of research into domestic surrogacy and there were a couple of issues here too. First, similar to adoption, it does make sense to make a place for the surrogate in your life, if only during the pregnancy. But this made us uncomfortable. What if the relationship goes sour? But the major issue was cost. Based on my research, at best, the cost of a domestic (gestational, traditional surrogacy seemed too risky) surrogacy might look something like this.

Surrogate Fee                            25,000

Legal/Contracts                         2,000

Psych                                         1,000

Insurance                                   2,000

Expenses during pregnancy      1,000

Birth Order                               5,000

IVF                                          15,000

Meds                                        2,000

Egg Donor                              10,000

This does not include about 10,000 in agency fees and I'm sure I'm forgetting stuff. We are looking at nearly $75,000 and we have only paid for one IVF and one transfer. Then, of course, if things go wrong (e.g. bed rest for surrogate, multiple IVFs) it can really add up. We thought between $90,000-$130,000 seemed about right. With a run of bad luck, we could easily imagine running out of funds.

The other thing that bothered me a bit, particularly when dealing with clinics and agencies, is I felt that some of the stats offered were misleading. A common statistic one hears is that with each transfer one has about a 30% chance of getting a positive pregnancy (not a birth, but a positive pregnancy). That seemed reasonable. But then one often hears this: Give it three transfers therefore and one has about a 90% chance of getting pregnant or 90% of people get pregnant within three tries. Naturally, that is not how probability works. One has the same 30% chance each time. When clinics report their figures to the US government, there are all sorts of ways to exclude cases to raise success rates, so one cannot make a claim about 90% of people.

I don’t think anybody here is dishonest or is trying to be manipulative. The IVF/surrogacy world is filled with caring people who really want to help clients have a child. While we spoke with lots of genuine, lovely people in the industry, I felt that once we started the desperation that would only increase with failed attempts and the desire to make the sure funds already spent were worth it, could lead to a very expensive and frustrating proposition. Once upon a time there would have been no other options for us and we would have undoubtedly moved forward domestically, but as we did more research into surrogacy in India, we realized that the decreased cost (about 30-40% of US surrogacy) could keep us in the game a lot longer. Reading other blogs, I realized staying in the game was the key to a successful result. There we others things too, which I’ll get into in next post about how we chose the clinic we are working with. We started research in April and by late May we were in India. I try to remind Mr. M that in dog years, we did wait 7 months!