Pros and Cons and Myths about Surrogacy in India

So this afternoon I get a call from CBS News, who are working on a news story about surrogacy in India. As expected, they are fishing for stuff that could go wrong, though I guess if they didn't it wouldn't be a news story. So they went surfing the net and sure enough they found folks like me, though with everything that went wrong I still consider us a case gone right. 

I worry because I have seen so many poorly researched news stories that sensationalize a few well known problem situations or clinics without telling the whole story and being balanced. Recent isolated cases of DNA tests not matching the intended parents are indeed very concerning, but still isolated and could conceivably happen in other countries as well. Some other "gone wrong" cases have more to do with a couple going to a clinic without making sure they were established and well reputed, or not being careful about legal conflicts (and the laws of the home country were the problem instead of India to my recollection). I don't think rare and extreme examples should be the basis of a decision like this. You can find a horror story about any potential infertility solution, so take them with a grain of salt and use reasonable precautions. Nothing is guaranteed, especially when it comes to infertility.

While India could use some better regulation on surrogacy, I hope they never become over-regulated to the point places like England are where it becomes nigh on impossible to do surrogacy. See: http://oneinsix.com/  I find that the biggest roadblock to surrogacy is not only the cost, but the lack of legal recognition that it is a legitimate path to parenthood in so called "developed" countries. India was our land of opportunity partly because the regulations were not overbearing.

There are plenty of pros and cons to any solution to infertility, and surrogacy in India surely as any has a unique set. I hope that my blog and online presence has helped to educate others in their decisions. But the bottom line: I would do it all over again and recommend it to others. But you must DO YOUR RESEARCH and prepare yourself. Above all find a reputable clinic. Clinics and surrogates have been deceptive and taken advantage in many countries, and regulation can't always keep you safe. Be prepared for what could go wrong. But also be prepared to finally have your dream come true and become a parent 9 months later! (Our in our case 6 months!) I will try to give a brief summary, insomuch as someone like me can ever be brief!

Pros:
1. The baby: You could finally become a parent! Finally having a child outweighs all the other pros by a mile, but you can't let it cloud your decision so that you don't do proper research and preparation or examine other reasonable/affordable alternatives for your unique situation.
2. The cost: A lot closer to $30K than the $100K+ you would pay in America. It takes 2.5 tries on average before successful implantation, so the cost for attempts is something to take into consideration.
3. The chances of success: If you are looking into surrogacy in India, you have likely looked at and tried other options but they have either failed, have low odds of success, or have cons that you are uncomfortable with. A proven gestational carrier combined with modern fertility medicine and the best prenatal care give you odds of success that other options may not have offered you. You could have equal chances of success for surrogacy elsewhere, so likely you are looking to India for the cost.
4. The betterment of many lives: The impact you will have on the surrogate and her family is beyond measure. The surrogate, her children, and her children's children will live a totally different life than they would have otherwise, with a home and education and life lifted out of poverty. Our clinic offered financial counseling and set up a trust in the surrogate's name to help them make sure to manage their windfall well for long term benefit.
5. Having the full experience: As a general pro to surrogacy anywhere, you get to to participate in a pregnancy, though in a limited sense when it is in India.  A big reason I chose surrogacy was that you get a child from their first day of life and experience infancy and all stages of development. Low cost adoption of older or challenged children, fostering to adopt where you can lose the child, or international adoption of an older infant or toddler were the only affordable options for us. While we intend to do that someday, each had an understandable downside with a process and paperwork that in my perception is a lot more intensive than surrogacy in India. If you can be a genetic donor, then you can also have the experience of a child that you are related to. It is not selfish to want that, anymore than it is selfish to want a healthy newborn that is lower risk for medical, developmental, and attachment problems.
6. Return on investment: While you can have failed attempts, you will be out a lot less money than you could potentially be from a failed adoption from what I understand. From my research I've seen more horror stories about failed adoptions and tremendous emotional pain and  loss of investment than I was comfortable with. I know an adoptive mother whose birth mother changed her mind in the several day waiting period after birth, and devastating does not even begin to describe it. An Indian surrogate not only does not want the baby, but they bear no relation or right to it. As long as your home country's regulations are also on board and you do the proper contract through a reputed clinic, this is YOUR child and it cannot be taken away from you.
7. Prenatal care: In India they will most likely choose to stay at communal surrogate housing, and you can choose that as a condition for your surrogate, though it could limit your selection. Some folks look at pics and see a room of cots and make negative judgements, but they have clearly never been to India. Trust me...a surrogate house is Shangri-la compared to other alternatives or where they have been living. Healthy food is prepared and educational classes are offered. There is air conditioning and on site medical care and close prenatal monitoring. They don't have to work and clean and endure the strain of caring for their own children during the pregnancy, though their families can visit frequently. These surrogates are not only happy about how their life and their family's lives are changing for the better and their comfortable accommodations, but many of them say the lifelong friendships they formed with other surrogates are the best part and lead them to do it again.
8. You have a greater chance of having twins. It's risky, but it is also AWESOME! This is a pro for surrogacy in general, and not exclusive to India.

Cons:
1. Culture shock: If you haven't traveled, been to a third world country, and aren't familiar with Indian culture you are in for a shock. But if you open up your mind and prepare yourself it can be an amazing trip and a wonderfully life changing experience. I married into an Indian family and had spent a month there 8 years before we tried surrogacy so it was a lot easier for me and I knew what to expect. If you are borderline OCD and like everything antiseptically clean and hate crowds and traffic, India may not be for you. In my personal opinion things are much cleaner than they appear, but Westerners are used to everything being new and bright and shiny.
2. Communication: The language barrier, cultural differences, and time zone will pose definite challenges. As someone who has suffered from the pain of infertility, you are likely to have some control freakishness going on so the lack of clear communication will be hard to handle but can be well worth the frustration when the baby is finally in your arms.
3. Emotional connection: There will not be much of one, either with the surrogate or your baby. You are having a baby by email, and it may not feel like this is actually happening until there is a screaming infant being handed to you. You may connect with the surrogate, but since you don't have ether lifestyle or language in common it isn't likely. You will have the baby in common, and that is enough. It is primarily a business arrangement, and there is really nothing wrong with that. It's great if you can have a local surrogate in your home country and ya'll become besties and can share in every moment of the pregnancy, but it's not somehow morally wrong if that isn't your reality.
4. Medical standards: They do a great job at Indian NICU's. Don't get me wrong. But having experienced both I can confidently say that they cannot compete with American medical care, even if it is simply because of the available technology and not the doctor's skill level. Availability of experienced specialists is more limited. You have to hope you won't wind up in this boat, but you can do everything right and it can't always be prevented. They may be able to treat the symptoms pretty well but not give a solid diagnosis, and advanced therapies may not be available.  I've felt guilty that my daughter needed more medical care and expertise than was available, but the fact is my guilt is misguided because I would have done surrogacy in America if I could have afforded it and I've done everything in my power to give her the best care I can possibly provide.
5. Baby born premature or with medical problems: This can happen anywhere, even if you have a well screened egg or sperm donor and your surrogate does everything right and has no complications. But since this baby is in another country where you don't live, you could be in for a long and expensive ride. Your insurance may not cover out of country care or put up a fight about coverage, even though it is far less expensive there. You might have to live in India for many months, or wait to join your baby until they are discharged from the NICU. You may have to medivac your child out. (Check out the Rasta Less Traveled blog for what this can be like). This part of the journey did indeed suck, but we made it through to the other side and have two beautiful babies and have our happily ever after.
6. Death of the surrogate: Though not a risk exclusive to India it bears mentioning. I only know of this happening once, and it couldn't have been prevented or anticipated. It was an educated risk the surrogate or any woman takes on in a pregnancy, so your clinic should offer life insurance. In the case I know of the family was paid several times what she would have earned, and the baby did survive.
7. Surrogate risking their reputation: Education and scientific understanding is lacking in India, so many folks can't understand how surrogacy works without infidelity or genetic links to the offspring to the surrogate. This is one reason why surrogates travel from smaller villages and often choose to isolate themselves in communal surrogate housing, though often it is for the comfort and camaraderie. They just tell people it was for a job opportunity, which is very common and an easily believable ruse .An Indian woman takes on this risk, though they do it in part because they understand far better than most women in the world the pain and stigma of infertility because of how it is viewed in their culture. Our clinic helped local women at lower costs, and helped fake a pregnancy so the family will never judge the woman for not being able to bear a child.
8. You have a greater chance of having twins. It's awesome, but it is also risky no matter where you do surrogacy. You may have to do a reduction procedure if more than two implant. You stand a greater chance of loss of the pregnancy or one twin, complications, or prematurity. It will be more expensive to have twins in any country, but if done in India while you live elsewhere you could find yourself paying for double the extended NICU and exit fees like we did.
9. You won't know gender: It's annoying because gender neutral clothing is a myth in my experience. But if you really care about this so much then you probably shouldn't be having a child in the first place.

Myths:
Please read my previous posts to see the many misconceptions about surrogacy in India. http://www.10milesuphillinthesnow.blogspot.com/2012/06/ignorance.html  and  http://www.10milesuphillinthesnow.blogspot.com/2012/05/surrogacy-faq.html.  
A couple of things I'd like to re-emphasize.

1. Indian surrogates are being exploited: Why is it assumed that they won't understand what they are doing but an American surrogate will? Do you have to have money in order to make a responsible decision for yourself? You don't have to be educated to be smart, and the tough lives these women have lived make me seem ignorant in comparison. They are perfectly capable adults who are counseled and aware of what they are doing, and selective reduction if necessary is done to ensure the health of the surrogate.  They have all been pregnant before, so that understanding of what it entails is a given.  Yes...being poor sucks in many ways. But it doesn't automatically make you less of a human being or less capable of making good decisions for yourself. And it doesn't mean that two women reaching across the world to help each other are engaging in exploitation just because one of them lives by what the other defines as poverty. Why is it that if you do it in America it is okay, but if you do it in a poorer country it is exploitation?

2. Isn’t there a risk of wealthy Americans ‘outsourcing’ pregnancy and birth to the third world to avoid stretch marks?”

Fears like this are extrapolated using a logical fallacy call the slippery slope. The pundits latch on to this one because sensationalism sells. It’s like saying that by allowing gays to legally marry pretty soon we’ll wind up allowing people to marry their dogs or inanimate objects. Sigh. Anyone who has been through the process could never imagine someone doing this as an “easy solution” because it is anything but. Having been through it, I cannot fathom any way where someone foolish enough to try this could even get through a beginning phase of the process.  It would be far costlier, but much easier to abuse surrogacy in the U.S. than to go overseas in my personal opinion.

Worth

In these past two weeks since she's been home, I come to the opinion that having twins with one requiring medical care must be like having triplets. It's not that the routine care Tara requires is terribly complicated (though recognizing signs/symptoms of problems and discussing modifications to care with her doctors is), but that it is time intensive. I've got them sleeping through the night. I've got them sleeping at the same times during the day for the most part. Finally having continuity of care has her health as stable as it has ever been. But it doesn't matter. Because every 1-2 hours something has to get done except for one 4 hour gap from 4am-8am. Here is a short list:

1. 6 different medications delivered on a  strict schedule
2. Breathing treatments every 6 hours
3. Chest physical therapy every 6 hours
4. 2-3 bottle feeds per day for 15 minutes, requiring the feeding pump to be turned off for an hour beforehand. Her oral feeds will be upped gradually in frequency and duration to get her to 100% oral feeds, hopefully before she starts solids in 4 1/2 months.This will make things much more time intensive.
5. 2-3 doctor appointments or lab tests per week
6. About 2-3 calls about doctor appointments or from doctor's offices, nurses, case managers, social workers, or insurance compaly representatives per day
7. Rinse and replace the formula in the feeding bag/pump every 4 hours
8. Replace the feeding bag in the pump daily.
9. Replace the BARD button tube weekly
10. Wound care at least two times per day.
11. Tummy time for both babies for 15 minutes daily
12. Baths for both babies every other day
13. Sterilize bottles and pacifiers daily.
14. Mix 24 cal formula pitcher daily
15. 3 medications daily for my son

In between all that you have to cram in around 14 diaper changes per day and then 7 bottle feeds for my son. Then throw in all their laundry. When they are awake you need to be awake and playing with them and stimulating their development, especially given their prematurity and risk for delays. Then sometimes they cry for gas pains or no reason at all and you need to hold and soothe them. She has a big temper and it can take a half hour to get her calmed down. Oh yeah...and I have to eat and sleep occasionally.

If it was just two healthy twins with the requisite bottles and diapers our original plan would have worked. If our insurance had approved private duty nursing (which babies with less medical need get approved all the time I'm told by our Home Health Nurse), our plan would work. (We are now attempting to get it covered through my husband's insurance or other social service programs, but that will take time and there are wait lists.) If I made a bunch more money than the skilled assistive care she would require per month, it would work. If I didn't have debt to pay off from surrogacy, infertility, and previous medical expenses that insurance didn't cover and a car that needs replacing next year, it would have worked.

But as it is, there is just no way physically or financially I can continue to work full time and give Tara the care she needs and get enough sleep...even with all the help my in-laws have given us and having refinanced our house on Monday for substantial monthly savings. I'm severely sleep deprived even while I've taken two weeks off of work and had our in laws come in and help! My husband's job evaluates him solely on his speed in a call center environment, and him going it alone while I work at night has him so tired that it slows him down at work and can put his job under threat if it continues.

Fortunately I have a retirement account that I can use a portion of to resolve financial concerns we have and to make it possible for me to take some time off to care for her. With careful investment and savings moving forward in our future I can restore and double that account in half the time. In a short time we'll be in a much better situation for me to return to work at either my old job or a new one.  Not only will Tara's medical regimen reduce dramatically and some of her health care issues improve, but we will  then be able to afford skilled care even if we can't get coverage for private duty nursing. In general, a lot of things get easier for babies the older they get, and Tara will outgrow her need for the G-tube and meds and breathing treatments, and eventually her lung disease entirely.

As much as I love my current workplace, I am at peace and much more relaxed since I've made this decision because I know it is the right one for my family. Having a family means making some hard decisions, but somehow it is so much easier to make them than before.

There were times in my darkest days I wondered if maybe the pain of infertilty was too much of my own making. That perhaps finally having children wouldn't actually offer me the glorious bounty of happiness that I had imagined and mourned for daily.

Nope. It is even better than I ever imagined. Even when I haven't showered or shaved and am wearing the same formula covered clothes for a number of days I'm not even sure of, and am so tired the world is blurry around the edges.

Notice that I'm not saying "those eight years of infertility were all worth it." I won't minimize or rewrite the past. The present does not erase it. I won't say "I wouldn't change a thing" because it brought me to where I am now. Call me cynical, but I don't think those eight years are somehow worthwhile now because it makes me appreciate my babies more, I'm a stronger person, it has taught me so many life lessons, or it is the cause to my current effect. Sorry, but I'd still rather not have gone through it and popped out a these kids on my own years ago and my biggest problem be my stretch marks and what to cook for dinner. On the same note despite how extraordinary the entire experience has all been, I'd still rather my babies have been born full term and healthy right here in the Texas and not have had to go fight their way through 3 NICU's in 5 months in 2 countries.

It is really hard, and my life sure seems overwhelming when I look at it as written above.

But after a few days of adjustment to our whirlwind routine, it doesn't really feel that way most of the time.  I may have a bad hour or two or even a bad day, but the thing is....every time I reach down to pick them up they smile at me. They even laugh now too! That moment in time makes me happier than anything else has ever made me. And it happens dozens of times a day. I've come to the realization that it's not about making the bad stuff "worth it." It's just that there is so much amazing, fun, beautiful, happy, and incredibly good stuff.

So if anyone out there reading this is wondering if it will all be "worth it" one day when it is all "over," I can't promise that. The best laid plans... But I can assure you, your child will make you more happy than you ever dared to dream of and it pervades every part of you. It's the biggest and best kind of love there is. The time you spent worrying about this child feeling like it was less yours because of an egg/sperm donor, adoption, being an older child, or growing in someone else's belly will seem wasted. So if you are out there struggling with the decisons surrounding making your dream of parenthood come true and trying to make the optimum choice and control every aspect of the outcome like I did, my only advice is  that in the end the "when" will matter so much more than the "how."

Tara and Mommy in the same dress circa 1977!

Fast forward 8 yrs later...

So what happened then? Do you ever notice how in the movies the love stories tend to end once the couple finally realizes their love for each other? They seldom tell the tales after the wedding and before children. I always noticed in my parents photo albums how there were only a select few photos from after the wedding and before they had my brother and I.


I'm sad to say that for eight years there are not that many photos of Vinnie and I building our life together. Things started off wonderfully, and we tried to start a family right away. Why? Because I knew I wanted to be a mother and because somehow deep down I knew we would have problems and it would take a while. How did I know that? I don't know. But I just knew things with my body weren't right even though my doctor, who had been my OB/GYN since I was 14 years old, tried to reassure me that everything was fine.


It's not to say that Vinnie and I have not built many happy memories together in these past eight years. We have. But only those who have been sucked into the black hole that is infertility understand what it is like. Most people are happy having BBQ's and fun with friends and enjoy their life without children, knowing they'll have everything they want someday. But when you are ready for children, all that changes. You have all the free time in the world to go to parties and engage in hobbies and enjoy yourself, but it is empty somehow because it is not how you want to be filling your time. And you can't exactly enjoy all that free time very easily when you spend it scrimping and saving every dime because the infertility black hole sucks your money away from you as fast as you can earn it. In some ways I feel like I lost eight years of my life.


So I became a workaholic instead after my first miscarriage to fill the time. The miscarraige devastated me so much, as did each one after that.  I don't care to recount the details, other than it seems like it is so callous how everyone expects you to move on and get over it so quickly like it never happened.  So I endured them silently, as I did the post-partum depression that accompanies it. Did you know that you can still get post partum depression without a live birth? It actually puts you at higher risk if you are childless.  I even hate the word itself. Mis-carry. It sounds like you did something wrong doesn't it?


Every passing month of failure it became harder to keep up a facade of happiness and endure the pain. I became darker and more cynical with each passing year, and hope faded to almost nothing. Parts of me shut down one by one. I think most people blamed me for my negative outlook. For not having faith, perhaps? Human beings find it much more convenient to blame the victim in most circumstances I find, because it helps them to feel more immune somehow to the pain that others suffer. They have to believe there is a reason for everything. I don't, but I think God helps us find reasons in the darkness. So God did not cause me to miscarry or cause 12 young people to get crushed by logs cause he needed another angel or their work on earth was somehow done. God has plenty, and they were not done, I assure you. And while it has made me stronger, I've endured enough in this life already I do not need to be any stronger thank you very much. I was rather certain if one more person told me to "just relax and it will happen" I was going to punch them in the face and lose my career due to the unfortunate ensuing assault charges. Don't even get me started on why you should never say that to someone suffering from infertilty.


But Vinnie stuck by me even in the worst moments when all hope seemed lost. And he still loved me even when I felt like a shadow of the woman he fell in love with.


 I like a recent quote by Joe Biden, who from the loss of his wife and one of his three children to a car accident is someone who truly understands loss and pain.

"For the first time in my life, I understood how someone could consciously decide to commit suicide. Not because they were deranged, not because they were nuts, but because they had been to the top of the mountain and they just knew in their heart they'd never get there again."

I spent years on suicide hotlines, and have for a long time understood the path from crisis to suicide and helped many people in their darkest hours.  But it wasn't until I suffered infertility that I developed a deeper understanding of what it does to you when you lose hope.


Finally being pregnant in many ways is like being on top of the mountain Biden speaks of. I liken it to getting ripped out of heaven, and everything thereafter loses it's flavor because you finally know what it's like to be truly happy. It is easy to judge me for losing hope, but for the eight years that passed nothing but roadblocks presented themselves, and most were financial. Infertility is exorbitantly expensive. To attempt IVF with my condition and repeat miscarraiges is like buying a new car with only a 10% chance it will run at all. My husband lost his job and struggled to find work for two years. My insurance covers nothing related to infertility and my employer pulled their adoption assistance program in budget cuts. And the adoption tax reimbursment is slated to end on Dec 31st, 2012.


It turns out I had Poly Cystic Ovarian Syndrome. PCOS is by no means a death knell to ever having a baby carried to term. Many women with PCOS do. But not me. Women like Posh Beckham and many I've met on infertility forums seem to have success. But they also seem to have a lot more money to throw at treatements with low odds. For me, I could get pregnant but even with the proper precautions for my condition I still miscarried. IVF gets you pregnant. For preventing miscarraige all you can do is take a progesterone pill and cross your fingers.


Jillian Michaels from Biggest Loser decided not to go through the roller coaster she'd seen others with PCOS suffer through and "just adopt." This week after a several year wait and struggle she finally got her baby, now toddler actually, home. This happened the same week as her partner was able to give birth to an infant with the help of a sperm donor. I am so happy for her, though admittedly slightly jealous that she is amongt the small 20% of PCOS sufferers (along with Posh Beckham) who manage to not be obese. PCOS gives you the world's worst metabolism, but being wealthy and paid to be a fitness expert seems to help matters I guess.


By the way, PCOS is not just an "infertility disorder." It gives you a very high risk of diabetes and heart disease, and at one point before my lap band surgery I was diabetic. I've been pre-diabetic since my early 20's.  It also causes you to be chronically fatigued, have male pattern hair growth, wicked mood swings, and irregular periods among other things. It just plain sucks. It sucks even more to go through puberty not knowing you have it and blaming yourself for the symptoms and getting teased mercilessly by your peers. And it REALLY sucks when your doctor could have diagnosed you at any point since you were 14, but doesn't bother to because he thinks it is "just an infertility disorder" and diagnoses you at 26 while in the middle of an internal exam at your insistence that something has to be wrong, then tells you to "look it up on the internet" and leaves the room! I switched doctors after that. If I sound bitter, I am.

"Why didn't you just adopt?"

I have really grown to hate this question.

People don't realize the cost of adoption and surrogacy in America is exorbitantly expensive, and that infertility is a disease better suited to the wealthy. As sad as it is, the cost of adopting one infant child in America would be far more expensive than having twins via surrogacy in India. Adoption of a newborn involves extensive wait times, expense, and risks as well as heavy competition “selling” yourselves to potential birth mothers who can easily change their mind very late in the game. I have witnessed the nightmare of a friend whose birth mother changed her mind at the last minute, and I know that I am not strong enough endure like she has.  If you are not a young male/female couple in excellent health with a Christian belief system, it can be far more difficult if not impossible. It is for these reasons so many turn to international adoption, which is fraught with many of the same problems but involves a little less risk and less expense. However, it is still more expensive than surrogacy from what I've experienced, especially when you are cut off from any reimbursement programs. I have a hard time not seeing all that bureaucracy and financial demands that you have to wade through for years as people profiting off of the pain of infertile couples and orphaned children.

While we do plan on adopting later, know that adoption involves a very long, invasive, and often costly process with few guarantees. Low cost adoption that we will be doing involves not only long waiting times, but also older children, medical and developmental disabilities, but also a high risk of losing the child to the birth parents/family even months after you have raised them and become attached to them as your own. We hope to someday add to our family through fostering and/or adoption, but that is a very difficult journey that we will be ready for at a later time. We want to feel ready for an older child, as well as a child that may need expensive medical treatments or developmental support. But the plain fact is that I am not strong enough to have a child become mine and lose it and be back to childless again. I'm. Just. Not.

As a final note, people who have had the luxury of fertility and biological children can sometimes be quick to judge others as selfish if they do not immediately accept alternative choices. However they seldom educate themselves about the complexities and expense presented to those who have not been as fortunate as they have been. Those who do judge take for granted how hard it is to give up and grieve for the losses associated with not having biological children nurtured from birth. So don’t judge until you’ve walked a mile in someone else’s shoes. Or in this case traveled a few thousand miles and walked for nine months in someone else’s sandals.

So at around 7 1/2 years of marraige I am finally at the end of my rope. I'm angry and bitter and cynical and hopeless. I'm also finishing the police academy while working full time, a feat of tremendous accomplishment. I figured if my dreams of a family couldn't come true, I could at least make a career dream  come true and be able to do the reserve or perhaps full time police work. It's the only other dream I've ever had for myself beyond marrying a great guy and having kids and a modest home. But as the final months of the academy approached, I was sent into a tailspin when I got a call from my incredible father-in-law.


Most people joke about and resent their in-laws. Mine are awesome. Mine love me unconditionally and treat me wonderfully, and I'm incredibly lucky to have them. That being said, my father-in-law has a way of pushing to get what he wants. In Indian culture it is simply haggling. For him it is more than that. He is a man that doesn't give up. He never gave up, even when I was ready to. Thank God for him.


In 2008 he had heard about the Oprah show with Dr. Patel featuring surrogacy in India. I felt a burst of hope when he called to tell us about it. I had previously considered surrogacy because I'd had an offer from my best friend, who is the most amazing woman I know. But sadly due to necessary legal costs and lack of insurability without exorbitant fees we were once again unable to afford it in the USA. Thanks again U.S. healthcare system, the source of all my debt.  So with my heart in my throat, he emailed Dr. Patel our request to do the surrogacy program. We were rejected. She didn't have all that many surrogates at the time and was helping couples with  more profound infertility issues. Like no uterus and such, I assume. She also said she did not think she could get good eggs from someone with PCOS. She turned out to be right about that years later, but I digress. 


I was once again devastated. But remember how I said that my father-in-law never gives up? He emailed her secretly without telling us. Then we he was stricken with prostate cancer he saw his opportunity to email her again with an extra plea for sympathy given his illness. This time she agreed. Dr. Patel's clinic had grown in its capability over the 4 years since our rejection and had more available surrogates.
In shock and with tears we agreed to try it. I had hope again, and I felt alive again. This had to work. On little to no sleep after hours of cramming I took the police exam and made the top score in my class, finished my last day at my job after demoting myself to finally focus on my family, then got on a plane to India by myself. My husband would come later after I had weeks of IVF injections in Anand, Gujarat. I passed out from exhaustion on the plane from London....and when I woke up I was in India again after almost nine years.