SUNDAY July 1st, 2007
Arrival to Bombay, 1st Doctor Visit and Backstory
We arrived at the Airport Saturday night without incident, and after retrieving our bags and changing a little money, we were met by the driver from the Hotel Shalimar who was waiting at exit with our name on a sign. On our way to the car a couple of freelance “carriers” did “help” us, and instead of the $5 they asked for, they begrudgingly received the 50 Rupees (Rs40, about $1), Hardy gave them. Our driver sped away through the wet streets- apparently the airport had been shut for a few hours earlier that day due to “waterlogging,” but one has to expect that if you come to Bombay in the monsoon season! Undeterred, our driver careened through the streets (he would do great in LA) at a speed too reckless even for me! Thank God he had a horn, which seemed to be a true part of the driving experience, as essential as the gas pedal. Mumbaikers use their horn to tell you they are behind you, are to the side of you, are about to pass you, think you should get out of the way, are going too slow- or anything, anything else. If the horn just started when you turned on the engine, that would probably be very agreeable to some drivers. As we left the Airport parking lot, I saw my first glimpse of the ubiquitous Bombay taxi, a tiny black and yellow vehicle, often wildly customized by the drivers fortunate enough to own their own one of the cars that troll Mumbai like an industrious ant colony, 65,000 strong.
30 perilous minutes later we arrived at the Shalimar Hotel, a stand-alone building nine stories high. Probably built in the late 60’s, it seemed to have a facelift six or seven years ago, and now featured a white marble lobby- with a water-wall. Our room is perfectly nice, and features floor to ceiling windows looking out onto Kemp’s Corner, a hodge-podge of colonial buildings which have seen better days, and once housed Salman Rushdie.
When we awoke this morning it was still raining, and we realized that even though we knew it was the rainy season, we hadn’t even brought an umbrella- stupid foreigners.
After we got up, we had the complimentary Continental Breakfast at the hotel in their very nice restaurant the Gulmurg, which seemed to feature items more from this continent than any other, but as I enjoy mango juice, chai (Masala) tea, fresh papaya and a mystery curry for breakfast, this was great for me.
We had an appointment with Dr. Parikh at 12noon, and Doris, the lovely concierge who I’d corresponded with over the internet, (and, of course, remembered as my Mother’s name is also Doris) called over to the Hospital to say we would be coming. After stopping for an umbrella-in the Taxi- we went over to Jaslok Hospital. The Taxi dropped us off across the street, and by the time we crossed two bodies of water that would be called streams in LA - we were completely soaked.
Jaslok Hospital also had a white marble lobby but probably from the 60s. In our research we had been led to believe that the Hospitals are as clean and new as in the States, but, as you can imagine, this wasn’t exactly what we saw. The lobby had a large wall with an old-fashioned Admissions area that was all varnished wood and hand-painted gold signage direct from the 30s. Alabaster busts of the foundered of the Hospital, wreathed with fresh flower necklaces, greet you at the stairs, and off to the side is an open marble temple with statues of several Hindu gods, with devotees praying and bringing gifts. Once past the lobby, we waited for the lift to the 8th floor, but after several minutes, decided to walk. This gave us a chance to check out the other floors, including a door that said Kidney Transplant Room, though it could also have been the office of a film noir detective.
When we got to the 8th Floor we were directed to Dr. Parikh’s offices which seem to be a Clinic within the Hospital. The rooms were older, but were given character by etched glass doors, and homey sofas. Although it was Sunday, there were still about ten patients waiting- about half with their husbands.
The great thing about IVF and reproductive clinics is that you can see anyone there. At this clinic (and in Beverly Hills with Dr Najmabadi who got our cycle started, and encouraged us in this trip) you can see people from all walks of life and all income and background levels. It is surprisingly comforting when you realize that infertility can be a challenge for anyone. Here in India, where family is such an essential part of life, and childlessness is not as accepted as in the States, I could see that Dr Parikh’s work is very important to so many. Some of the women in the in the waiting room wore elaborate Indian garb, and some were more western, but they all wore an expression of Hope, and they smiled that smile at us.
Soon we were directed to Dr Parikh’s office, a mix of Certificates, tchtchkees, plants-live and silk, Thank You notes and baby pictures. Dr. Parikh came in and greeted us warmly. We gave her the See’s candy we had brought ( my fav). Then we started the medical visit. First she answered all our questions. Yes, we were going to meet the surrogate- tomorrow at 5:30 pm. We were told she is a nice, caring woman with two children. Next, yes, they can do genetic testing before implantation, but more about that later. Then I went in the adjoining room (after peeing) and Dr Parikh gave me an ultra-sound.
A Little Backstory
As we glossed over in the intro to this blog, the whole reason we started looking into my reproductive health was that we wanted to start a family, and given my age (which of course I won’t reveal (43)) we thought we’d better get a move on. At the referral from my Gynecologist Dr Christine Collins at Cedars, we went to Dr Sam Najmabadi at the Center for Reproductive Health in Bev Hills. After many tests where Hardy scored in the 120%, and I was found to be somewhat challenged in my FSH (how much hormone needs to be sent to my ovaries to get a good egg- too much) and E2 (Estradoil, still not totally sure how this fits in). We decided there was no time like the present, and that we would pursue IVF, but there was just the little issue of whether or not a particular fibroid might need to be removed so as not to interfere with the pregnancy. It was in the Laproscopic surgery to explore this that Christine cut off some polyps inside the Uterus that were also in the way. And, as with everything they take out-they were sent to be biopsied. Imagine my shock when I received Christine’s early-morning call telling me I had Cancer. This started another saga that left me without a Uterus, but still with my Ovaries, and a chance to quickly find a surrogate and have a biological child. So, we went back to Dr. Najmabadi, who gave us information about agencies that would find a surrogate for us, and, me being me, I looked on the internet and went to Surrogate chat rooms, and followed leads graciously supplied by friends (thank you all). In the end, the total cost would be about $60,000 to $70,000- around $28,000 for the surrogate and costs (stipend and maternity), $20,000 for legal and agency fees, and the rest for the medical on my side and hers. We were told we had a five to ten percent success rate, due to my “old” eggs, which the age of the surrogate cannot change. Turns out egg age is paramount! What happened to having kids whenever you wanted, even into your 40’s?? I still laugh at the irony of spending so many years trying not to get pregnant, and now when I’d finally met someone with whom I really wanted to have a family, getting pregnant was literally impossible…almost!
It turns out that Surrogacy in America takes a lot of time and effort. The Surrogates, of course, wanted to get to know you and then set a time several months from then to meet and arrange a good time to be pregnant. And while we could make the money work, with a little discomfort, we simply didn’t have the time. As we later learned, I had become susceptible to the cancer because of a genetic condition called Lynch Syndrome. The type of Cancer my body is succeptible to is actually a Colorectal Cancer primarily, a Uterine Cancer secondarily, and lastly an Ovarian Cancer. This makes it important for me to have my ovaries removed sooner than later. The week I found out about my diagnosis, I was bemoaning the surrogate situation, when a Pakistani friend suggested we go to India, where she’d heard they were doing Surrogacy. What a crazy idea to fly half-way around the world! Well…maybe not! The cost savings- about $30,000 all in, would mean that we could try again if we failed the first time, and apparently there were many women there who would like the opportunity the money would give their families. When I first floated this idea on the Ether of my friends, they were worried that somehow we would get scammed. But the truth is that they only take women into the program who have children and a husband, for two reasons: first they have proved that they have had smooth, successful pregnancies, and second, with their own children and family, they are very unlikely to want to keep ours. The money that an Indian woman earns can send her child to college, or put a down-payment on a house. In addition, it is very unlikely that this woman will be drinking and smoking and driving- all the things I worried about most in a surrogate in America. We decided to do it! Assisted by the internet and my Aunt Tezi, our former Ambassador to Sri Lanka (Thank You so much!) we were able to get confirmation and guidance, and settled on Dr. Firuza Parikh at Jaslok, who had actually been named one of the 50 Most Influential Women in India, and is an occasional lecturer at Yale (she did 3yrs post-doc there). Once she had agreed to take our case, we decided to start on the June cycle, with Dr. Najmabadi’s guidance here at home. Unfortunately, in this cycle I developed a cyst (which we aspirated, but later bled into itself) and the Lupron made me develop another cyst- all of which prompted Dr. Naj to suggest we start looking for an Egg Donor. Trip cancelled on account of lack of follicles, the sites where eggs can grow. Low AFC (anterior follicle count), means low possible numbers of eggs. In the June cycle, not only did I have two cysts, but I only had an AFC of three.
Nevertheless with Dr Parikh’s encouragement, I started on birth control pills. When I had my last ultra-sound at Dr. Najmabadi’s on the 25th (last Monday), I will admit to having been pretty excited. I had no cysts, unlike in June when we had first tied to do this cycle. On top of that, I had eleven follicles!!!! I started taking the Menogon with high hopes of not only having eleven possible eggs, but maybe developing even more!!
Cut to Sunday- Dr Parikh’s Office
Dr Parikh took me into her examination room, so different from Dr. Najmabadi’s, but still featuring an ultrasound machine, or, as they would say Sonograph. Dr. Parikh searched for my Ovaries (which are hard to find given my lack of other parts). On the right ovary she found NO follicles, and on the left she found two large and two small.
What about the former eleven!? What about the elephantine doses of Menogon (essentially FSH- follicle stimulating hormone) that I was on??
Dr Parikh took us back into her office. I was devastated and confused. She explained that although you can start off with many follicles, your body then decides which to have go ahead and develop, and which should drop out. At present, I had only two follicles in the race, and two undecided. So that is the situation. Dr Parikh assured us not to be too discouraged, as, after all we only need one successful embryo to make a baby. Now we know this only too well.
Tomorrow we will meet the surrogate, and hope and pray for my two undecided follicles to decide in our favor.
