Thursday, January 2, 2014

A new year, and an interesting quandary (blanket steroid shots!)

Today marks the completion of the 23rd week of pregnancy. I have such hopes for this new year. As I hugged my parents at midnight, each of them whispered to me that they hoped that this turns out to be the year where I finally get what I've been striving so hard to get. I hope so too.

2013 was a lot of things for me, but I hope I can get to remember as the year in which the most important thing in my life came to be.

As for this new year...I hope it brings good things to as many of you as possible.

We did the glucose tolerance testing. In an odd turn of events, I have the 2-hour glucose levels and the glycosylated hemoglobin values, but not the fasting levels yet. The 2-hour glucose level was 94, and the glycosylated hemoglobin came back at 4.8%. Both tell me unequivocally that J does not have to worry about diabetes. YAY!

I have to go talk to the OB tomorrow to discuss one important point, and it is something that will probably make a lot of jaws drop: In India, apparently, every surrogate pregnancy is considered a high risk pregnancy, and what they do is give every surrogate the steroid shot at 28 weeks to induce fetal lung maturation, no matter what the individual situation may be. The first time I heard this, I nearly bit the head off the poor hapless doctor's assistant who informed me about this, because this seemed insane. Even my very restrained mother freaked out when she heard this: a blanket steroid shot?!

The benefit of a steroid shot far outweighs the downsides (it can negatively affect the developing  immune system of the baby; it can aggravate gestational diabetes in the mom, and so on)  in a situation when pretrem delivery is imminent, and this shot has helped improve the health of innumerable babies worldwide.

But to give it in a perfectly normal pregnancy? Obviously, they make the decision to give this based on the statistics. Apparently, most of the surrogates are preterm (At or before 36 weeks), for any number of reasons: a higher incidence of multiples pregnancies, poor nutrition, low vitamin D levels, the strain of having borne many children, etc. Additionally, when they are not under the supervision of a doctor, if things move very quickly say, around 32 weeks, then there may not be time to give the shot: the situation IS different from that of a regular pregnancy.

But a blanket shot when things look fine? This is such a difficult call to make, and I have the choice of refusing this shot. I just don't know what to do. If any of you have any input to offer one way or the other, it would be most welcome.

Also, I have majorly revamped the "Science of Infertility" page, summarizing a lot of what I have discovered/realized in the past year. It is worth a read especially if you are still in the trenches.


  1. Happy New Year, J! I, too, wish for you to receive your long-held dream this year!

    About the steroid shot, I don't know. I hadn't heard about the immune system affect and wonder how serious that is or long-lasting? In your surrogates other pregnancy, did she deliver early? Without knowing this info, I would say that yes, it doesn't seem to make sense in your case, if everything is progressing normally.

    Good news about the diabetes testing! Happy New Year to you and your family (including the family yet to arrive...)!

    p.s. I was unable to access your Science of Infertility page for some reason. It said my email did not have access to the page. Any guidance for me?

  2. Happy New year to you too Kristina! That is odd about the link not working: could you acess the page directly? Look at the list of "sticky" pages at the top of the blog.

    1. Thanks, J, I was able to access the tab. :-)

  3. I have never heard of that and I think it would have caught my eye if I'd seen a steroid shot mentioned in my surrogate's medical records. Personally I would decline the shot since she's carrying a singleton and if she didn't have a history of preterm labor. It just seems so unnecessary. Do they just do the one shot at 28 weeks? I thought they gave a series of shots over a couple of days to mature the lungs.

    1. Hi Pam...the steroid shot is apparently part of a standard protocol for surrogacy that is practiced all over India...or so I was told today.

      If your surrogacy was in Mumbai, did you use Surrogacy India, and was the baby delivered at Heeranandani hospital with Dr. Anita Soni? This is her standard protocol, but it would probably not be a part of the data they make available to the birth parents: I've seen the information made available to the parents through Surrogacy India: they just load results of all the lab tests/ultrasounds, but there are a few zingers in the medication given to the surrogates that are not disclosed.

      Btw, this is 2 shots over a period of 24 hours---nothing more afterwards.

  4. Happy new year! I too am hoping 2014 marks the realization of your dream.

    Very thankful to read you'll have no worry over GD. I don't have any advice about the shot. It seems a difficult choice & I'm sorry you're faced with yet another of those, difficult choices I mean.