Thursday, January 2, 2014

No choices, no milk

I had an interesting consult with the OB today. Incidentally, she is the doctor who handles most of the surrogacy cases in Mumbai (apparently), so she is also the person with the most experience in dealing with surrogacy, and that should not be taken lightly.

But what I heard was distinctly disheartening. Remember that choice to waive the steroid shot that I mentioned? She clearly had told me that the first time I talked to her, but today she told me that it is her protocol, and she is going to do it. I could try some things to prevent that, but that would be both counterproductive and foolhardy, so I will just have to go with the flow.

I then asked her whether J could express colostrum and feed the baby (followed by pumping after the first couple of feeds) for as long as she is in the hospital with the baby? She was like...nope. No surrogate can feed the baby. They actually give them shots + pills to dry up their milk as soon as birth occurs, so even if both parties (the birth parents and the surrogates) want to do this, they cannot. She basically told me, this is my protocol, take it or leave it. Unfortunately, I do have to take it, and the sooner I make my peace with all this, the better.

Just FYI for people doing surrogacy in India: Dr Pai in Anand, Gujarat allows/encourages breast feeding.

In the defense of the people in Mumbai, there is a logical reason they shut off the milk supply: if the milk flow is established, and there is no baby to drink it afterwards, there can be breast engorgement that can lead to an abscess. I had already factored it in, and had naively thought that J could go donate at a milk bank (she lives really close to one) and maybe make some money (I hope to god they pay them) and everybody could win, if she was open to this. But nope, her milk supply will be shut off immediately after birth.

AAh....the stuff I wish somebody had told me about, before I signed up for all this.

I also heard a hair raising story about a surrogate, which is an excellent illustration of why one needs to thoroughly investigate the situation before initiating surrogacy in India: A surrogate shows up with insanely, dangerously high blood pressure at a mere 10 weeks of pregnancy. She claimed she was 27 years old. The OB refused to believe her, and on further grilling of the handler, it was revealed that she was 42 (!!!) years old. Her daughter had been kicked out of her home by her own husband (I think) who had told her she had to produce Rs 200,000,  to get back in.

This woman,  in desperation, lied about her age and her medical history and entered a dangerous pregnancy to get that money for her daughter. The surrogate handler propagated the lie, and I have no clue what the RE was doing.

 Everybody was shortchanged here....the poor woman who was the biological parent, the poor baby, and the surrogate, who risked her life for money. Such a situation can only be prevented by investigating the heck of out the surrogate, investigating her previous medical history as thoroughly as possible to ensure that this is not for 5th of 6th or 7th pregnancy...they can lie about this as well.

 Bottom line: based on everything I've heard and my own experience, I''ll say this to anybody who is thinking about surrogacy in India: Ask a LOT of questions before you start. Make sure your doctor has investigated her past pregnancies as well, and has gotten her previous medical records from whereever her last pregnancy was, all of that. I'll come up with a comprehensive list of things to investigate before you start.


  1. They should definitely have the "standard practices" outlined somewhere (and not in tiny print).

  2. This is off topic, but you wrote about some other "best practices" a while back. I'd love to see your sources on the topic of timing FET with one's natural cycle, if you have a chance.

    Sorry to hear about the breastmilk. That's discouraging!

    1. This is a decent resource talking about natural FETs:

      Basically, if your natural E2 levels from a single peak follicle are good (like say, above 200 pg(?)/mL) and your LH surge is detectable and can be somewhat predicted, then you are an excellent candidate for a natural FET. If you have a day-3 embryo, you transfer 3 days after ovulation, and if you have a day-5 embryo, you would transfer 5 days after ovulation.

      I know RMA-NJ was doing a study to see if giving HCG as soon as ovulation occurs could improve the chances of implantation. This would be what happens in the natural situation...the fertilized embryo would make tiny quantities of HCG in its first days of life.

      As I said earlier, the natural FET has some advantages over the medicated FET other than merely convenience and avoiding lupron: One school of thought is that the estrogen they give is too much, which causes less than optimal development of the lining. That said...the medicated FET works just fine...but the natural FET may be better, and it is definitely easier on lupron, no estrogen, just a few ultrasounds and maybe one blood draw to confirm the surge.

  3. I'm sorry about all the disappointing surprises. You were really hoping to give your little one breast milk, and now it looks like formula will be what you have to do. I can relate to that situation. Formula does offer some advantages, though, and I hope you can feel at peace with it.

    1. If all avenues close (I still have to talk with the people at the human milk bank now), then I'll totally make my peace with formula. I do like the goat milk thing I found, and most babies seem to love it, so I'm not too worried.

  4. Take it or leave it!! Really??? Does the surrogate have any say in this process? Can she enforce a BIG no? The milk part seems reasonable on some levels...but what goes into her body shud be something that th surrogate also has a say in...this whole thing is quite maybe thats why the drs try to keep a very uncompromising attitude. Btw if i were you i wudnt worry too much abt the milk. My husband when he was a baby has this weird indigestion to my MILs milk....he had formula right from the time he was born. He turned out pretty okay :)

    1. Oh the surrogates have no say in anything. These are uneducated women, the steroid shot is not distinguishable from a vitamin shot to them:these are just words to them.It's a very messed up system, all in all, but it helps both parties acheive thier goals. But the way things are done needs to improve.

      And btw, I was a formula baby too--apparently they bottle fed me after birth and I refused to suckle after that.

  5. I'm sorry these choices are not yours to make. I'm not sure which would be harder, having to make the tough decisions, like whether to do the steroid shot or not, or having to accept decisions made for you. Good luck with the human milk bank