I am writing this on January 6, 2021, but I don’t know when I will actually publish it. This is not just my story. This is also my husband’s story, our family’s story. And there are other players that I need to talk to before I publicly share their parts of our story. If you’re reading this, I have probably gotten all the permissions I need and Malcolm and I are at the point of being comfortable with sharing at least the start of our story with the world.
I never thought I would actually seriously consider surrogacy. But situations change. I thought that the desire to be a mother would go away. I thought the deep longing in my heart would fade. It hasn’t. I am currently doing some counseling about how to accept what comes even if it’s not what I want and how to be happy with my life and to find the good even if that life does not involve having living children on Earth. Even while doing that self work to be okay, Malcolm and I agreed to also try one final and last time to get some version of the family we envisioned when we started this journey seven(ish) years ago.
In August of 2020 I found out that my endometrial hyperplasia was back and that I needed a hysterectomy. I wasn’t willing to accept that at the time and it really hit home for me how much I wanted living children. I tried negotiating with my doctor and was considering IVF for myself… Which would be quite risky given all the things wrong with my reproductive system. I was working with a fertility counselor and she helped me to see the situation for what it really was: my uterus is not a safe place for a baby and it is not safe for me to keep it in my body. She asked me if my deep desire was for a child that I could watch grow up or for another pregnancy, because those are not the same thing.
It was hard for me to think of someone else carrying my pregnancy because I loved being pregnant and feeling my babies move. I have never felt so beautiful and at home in my own body as I did with a growing baby belly. My only experience of motherhood is pregnancy, and my connection to my girls was pregnancy, so the idea of giving that piece of my child’s life to someone else was a hard pill to swallow. But if nine months with someone else meant that Malcolm and I could have decades earth-side with our child, wouldn’t that be a better solution than putting my life and that baby’s life in extreme danger?
I remember talking to Malcolm about this and saying how I was worried about the baby forming a relationship with the surrogate and not with me and how could I have that close bond with my baby without giving birth to it and he said “Fathers don’t experience pregnancy. They don’t go through labour and delivery and yet they are able to have amazing bonds with their children.” That was like fireworks in my brain! Adoptive parents do that too! I could be a mother without having been pregnant with that child.
So, I started doing research on surrogacy.
Now, there are two different types of surrogacy, traditional and gestational. Traditional involves using the eggs from the surrogate, so she is carrying a baby that is genetically related to her. This is much less frequently done because it introduces a grey area around parentage. If the intended parents (IPs) can’t produce their own eggs and need a surrogate it is far more likely to see them using a donor egg from someone else and implanting embryos from that donor into a different surrogate (more commonly called the gestational carrier or GC). So in most cases surrogacy pregnancies are done through IVF using embryos with no genetic link to the GC and may or may not have a genetic link to one or both of the IPs.
I found out that Ontario actually has pretty progressive surrogacy laws (though it’s by no means perfect!) and that when a baby is born through surrogacy in Ontario, the doctor hands the baby to the intended parents, the birth certificate is written in their names and they get to take the baby home as if one of those parents had been the one to give birth. So that end point is pretty clear.
There’s a long process to get to that end point though. There is medical screenings for the intended parents and for the gestational carrier (GC). There is also a mental health screening for the intended parents (IPs), the GC and the GC’s partner if she has one. In order to be a GC a person has to have had at least one successful pregnancy and be over the age of 21. It is recommended that a GC be done having their own children because it can make it easier for them to part with the baby after delivery, but more so because there are risks of complications with surrogacy. Just like in any pregnancy, something might happen that could prevent the GC from being able to safely carry another pregnancy, there’s also a risk of secondary infertility.
Then if everyone passes you can write up a contract. It is illegal in Canada to pay a GC but the IPs are expected to pay for any costs associated with the screenings, embryo transfer, medications, and pregnancy, as well as legal fees, and compensation for time off work and pregnancy related expenses. There are lawyers who specialize in surrogacy contracts and there has to be a different lawyer for the IPs and the GC and they can’t be from the same firm. If the IPs and GC are open and able to discuss the uncomfortable what ifs ahead of time then it can be a much easier and less costly process. If the lawyers need to be involved in the negotiation process and finessing the finer details the price can skyrocket.
Once the contracts are done, then the medical process may start. OHIP offers every person under the age of 43 a funded IVF cycle. But things get a bit fuzzy when a GC is involved in the process. When looking into Ontario surrogacy in support groups and online forums, and from my discussions with my doctor and counsellor, I was under the impression that an intended mother and the GC are seen as the same person for that round of IVF and that they both use up their government funded cycle. I do know from other Ontarians who have been through this that if a GC has already done an OHIP funded cycle with someone else, the intended parents would not get a funded cycle even if they have a uterus and ovaries and have not used their funded cycle before. But looking a the eligibility on the government site it says “One treatment cycle per patient, which includes the one-at-a-time transfer of all viable embryos. One additional cycle if carrying a baby for someone else (acting as a surrogate).” So I’m wondering if this means that a GC can do a cycle as a GC and a cycle for themself to get pregnant if necessary?” Honestly, I don’t know.
And I’m about to get a bit opinionated… There are a lot more people struggling to start a family than there are healthy people willing to sacrifice their body for a year (or more depending on how quickly they get a pregnancy to stick) to give a baby back to someone else. The process is already stressful and expensive enough without having to make sure that you have GC who has never been a GC before especially when many people are matched through agencies. (Agencies.. that’s an entirely different can of worms that I may write about later!) and GCs often carry more than one baby for more than one set of IPs. I think that OHIP should consider the eligibility for funded IVF based on whether or not the intended parents have had a funded IVF cycle before without worrying at all if the GC has. If all participants are medically cleared and the IPs have not done a funded IVF cycle it should not matter if the GC has or not. If the IPs could use a uterus inside one of them and be covered, they should be covered if that uterus is inside another person regardless of if that uterus has used a funded cycle before. Deep breath, and… Moving on!
So, what does a funded IVF cycle look like?
This is from our IVF package that we got from our fertility clinic. It looks like one IVF cycle could include multiple singleton pregnancies if there are enough viable embryos and several implantations leads to a successful pregnancy. On the other hand, if egg or sperm quality are low or non-existent, or the embryos don’t survive long enough for implantation or none of the implantations take, an IVF cycle can be over without a single pregnancy.
We had to go through the package, watch some videos and do a little quiz before being added to the wait-list for the OHIP funded IVF. Because OHIP will only fund a certain number of cycles per year, and these cycles are divided among certain qualifying fertility clinics across Ontario, there is a wait-list. I have heard from people in online surrogacy support groups that there is basically no wait time for the clinics in Toronto, but since we’re in Eastern Ontario, there are fewer qualifying clinics out here and therefore longer wait times. Dr M2 suggested we apply to the wait list now since it could take up to a year and a half until our turn comes up, so we can let that time tick by while we do the other stuff like the screenings and I will need to have a hysterectomy before starting ovarian stimulation. So hopefully we can get all of our ducks in a row before my name gets called. If we decide to stop the process we can turn down the offer when my name comes up and the next person on the list will get it, if we just don’t have everything in order we could get my name moved to the bottom of the list. There is no penalty to doing either of these things.
OHIP does not cover the cost of the medications for the egg production or to prepare the GC for pregnancy or any medications to keep the pregnancy sticky. So this is a cost that will fall on me and Malcolm. Without an OHIP funded cycle there is no way that surrogacy could ever be an option for us because of the other associated costs.
We were fortunate that throughout our journey of fertility treatments, pregnancy loss, and everything else my uterus has thrown at us, we had two amazing and selfless women who offered to be our GCs. Working with a GC that you already know and have a relationship with can reduce the costs (lower lawyer fees, no agency fees), and can make for an easier post-pregnancy transition.
Malcolm and I both understood that offering to do something like surrogacy in the abstract world of ideas and someday is quite different than being ready, willing, and able when the concrete action is presented to you. So our next step was to figure out who to ask, how to ask, and to prepare ourselves for the very real possibility that the answer might be no.
You can also follow our surrogacy journey on instagram @operation.babyspaceship