by Sara Connell
On Monday morning Bill, my mother, and I drove to RMI to do our infectious-disease panels. We were thrilled to confirm (again) that we did not have HIV, syphilis, chlamydia, TB, or genital warts. We wrote a check for $15,000 and had an opportunity to show off our updated knowledge from the legal meetings, using the term “gestational host” instead of “surrogate.” (In an email, Stacy informed us that a surrogate traditionally involves a woman’s providing an egg and carrying the baby, while “gestational host” is the term used when a woman carries another’s couple’s biological child.) “I like it,” my mother said. “I’m the host. It’s like I’ll be babysitting for nine months.”
Bill waited in the reception area while Dr. Colaum administered my mother’s and my ultrasounds. We decided to stay in the room for each other’s examinations. “We’re doing this pregnancy together,” my mother said. “The group approach. Plus, we can save you a few minutes and some table paper each time we come.”
Dr. Colaum shook her head and looked like she was trying not to laugh.
“You guys are funny,” Tracey said from her post at the counter.
The exam was the first time my mother experienced an internal ultrasound. “Now, that is a fantastic uterus!” Dr. Colaum said, calling Tracey over to look. I tried to see what made it different from, say, mine, the only other one I’d seen on-screen. All I could tell was that it looked bigger. I felt a tug for a moment, a pang of grief that perhaps her body really was more suited to carry a child (even at her age) than mine. I continued to look at the screen and decided I liked the look of her uterus, too. Even in fuzzy black-and-white pixels, it looked inviting and safe.
“We’re going to start you on estrogen pills, twice-weekly estrogen injections, and progesterone,” Dr. Colaum said to my mother. “Tracey will give you your calendar, Sara. We’re going to go for growing the maximum number of eggs.”
I posted my IVF schedule on the side of our refrigerator with a magnet.
“You have so many injections,” my mother said, comparing our medication charts.
“But you’ll be doing them from transfer on, Mom,” I said. “Believe me, if we get pregnant, you’ll take plenty of shots.”
This cycle, I administered all of the injections myself, taking Lupron in my stomach in the morning and Follistim at night, and even mixing the Repronex chemistry set every other night in weeks four and five.
November brought cool winds and crunchy brown leaves that carpeted the patches of grass and scraped the sidewalk as they blew past. When my mother was in town, Bill cooked hearty autumn meals: French onion soup, beef bourguignon, and oven-baked squash with brown sugar and butter.
When she saw that her IVF regime was so minimal, my mother flew home to Virginia for a week in the middle of the six-week cycle. My egg retrieval was scheduled for sometime the week of December 7. The transfer to my mother would be three to five days later.
“I cannot believe it only takes two weeks of medication to prepare me for a pregnancy,” my mother said. “Two weeks to kick-start the uterus after ten years of dormancy.”
Dr. Colaum had explained that really the primary thing necessary was a thick, healthy uterine lining, and the key ingredient the body needed to achieve that was estrogen. “Of course, we don’t know what your body will do in response,” Dr. Colaum said conservatively.
A week before the retrieval, my mother and I drove to Evanston for our next appointment. The outdoor lot that housed a summer farmers’ market had given way to bales of golden hay heavy with pumpkins of varying sizes, dried cornhusks, and horns of plenty spilling over with knobby gourds.
“At first I was so afraid my body wouldn’t respond at all,” my mother said, looking out the window at the pumpkins. “Now I can feel it.” She pressed her fingers into her lower abdomen. “Did you feel all bloated and puffy?”
“I usually did midcycle for a few days,” I said, “but I was on all the other medications, too.” My mother’s mouth dropped at the corners.
“Do you feel okay?”
“I feel strange,” she said. “Then again, I’m guessing my body is a bit perplexed. I imagine it’s a bit of a shock to be called into active duty after being retired for ten years.”
To distract our minds, we decided to play a game. We’d read Eat, Pray, Love and decided to do what Elizabeth Gilbert did before her divorce papers were signed: call to mind all the people who would be ecstatic if the surrogacy—or, in Gilbert’s case, the divorce—worked.
“Your great-grandmother would get a real kick out of this,” my mother said.
“Nana,” I said, remembering my father’s mother.
“Lissa!” my mother said. “And your father. He would get to forever say, ‘It’s all Lissa’s fault.’”
“Nancy,” I said, naming Bill’s mother.
“For sure Nancy,” my mother said. “You know, I dreamed the other night that she was helping to organize all of this.”
I liked this notion. Bill’s mother had been a skilled producer, orchestrating many media productions and, later, segments for the Today show. She was a woman who could get things done.
As I turned onto Ridge Road, I thought of more names: “Dr. Colaum, Tracey, Rachel, Lorelai, Lisa—everybody at RMI,” I said.
“All the researchers, doctors, and nurses who have dedicated their lives to developing new fertility processes,” my mother added.
“And Dr. Allen and Pam!” she continued. “They’ll love having a great story to tell everyone about the sixty-year-old woman who successfully delivered a baby to term.”
I saw a flash of an image of myself—like a memory, only of something that had not happened yet—helping my mother out of my car in the parking lot at Dr. Allen’s office, her belly already bursting, seven or eight months pregnant. I could see her purple maternity top and tailored black maternity slacks. Oh, please, I thought, please let this be real.
In addition to checking my mother’s uterine lining, Dr. Colaum needed to check and measure my eggs. I went first. Using the ultrasound, Dr. Colaum counted thirteen to seventeen possible eggs growing in my right ovary.” More than we’ve ever had,” she said. “Looking good, Sara.”1
“Your turn,” she said to my mother, who slipped off her pants and shifted herself to the end of the exam table. “Hmm,” Dr. Colaum said, moving the wand back and forth to view my mother’s uterus. Her smile had faded. I had only one leg in my jeans and dropped them to the floor, leaning over the chair with my legs and backside exposed. Dr. Colaum’s lips were pursed tight. “There,” she said to Tracey. I followed where she pointed. In the middle-left part of the screen, I could see a black shape that looked like an engorged comma filled with ink.”
“What is it?” I asked.
“Fluid,” Dr. Colaum said. “Have you been feeling bloated?”
My mother nodded, her lips pressed, her eyes wide and round. “Sometimes the uterus fills with some fluid in response to the hormones,” she said. “We don’t like to see that, because it can negatively impact successful implantation.”
The room started to move like a carnival ride. I clenched the top of the chair.
“What does this mean?” I said.
“I don’t think we should transfer this cycle. You’re ready for retrieval; we need to get the eggs. So I suggest we retrieve next week, as planned, and freeze as many embryos as we get.”
I didn’t like this. I had the sensation of walking on a tightrope, a lone steel line, hundreds of feet in the air. I felt as if I might throw up on Dr. Colaum’s floor.
“You always get great embryos,” Tracey said to me in the hallway after I’d changed and she’d looked up dates for our retrieval. “They’ll be safe until your mother is ready.” I hadn’t researched statistics about freezing embryos, but I thought I remembered reading somewhere in the RMI literature that the success rate for frozen-embryo transfers was lower than that of nonfrozen, and that not all embryos survive the thaw. With the extra $7,500 in medications for my mother and me, we�
��d spent almost $22,000 on this cycle already. I imagined $20,000 swirling down a large drain.
“Yeah,” I answered glumly. My mother and Dr. Colaum met us in the hallway. I steadied myself by holding on to the counter and asked the question I feared: “If my mother got fluid once, is it likely to happen again?”
“We can’t know for sure,” Dr. Colaum said, giving us the only truthful answer she could. She turned to address my mother. “There’s a good chance your body is just adjusting to this first round of hormones after ten years off. We’ll give you a break over the holidays, retrieve Sara’s eggs next week, and then we can start up again just after the first of the year.”
I thought about my mother and the whispered dreams we’d started to voice—how synchronistic it was that it was our year to be together for Christmas and how sacred it would be to be newly pregnant, when the whole holiday was about a miraculous pregnancy and the birth of a baby.
Now, instead, we would be going to D.C. for yet another Christmas without a baby or a pregnancy, our embryos frozen in a solution of glycerol and sucrose. We could be hopeful, yes, but had no guarantees of what we would have when the embryos thawed and we attempted to bring about a pregnancy that was already going to require its own miracle of sorts.
Sara, 1 hour old, February 25, 1975
Sara, 9 months old
Sara, spring 1976
Bill’s mother’s favorite baby picture
Flying off the slide ▶ on Hickory Street
▲ Bill and Sara’s wedding at Inverlochy Castle in Fort William, Scotland, May 2001
▲ Sara 4 months pregnant with twins, July 2007
▲5 months pregnant, one month before premature labor
Kris surrogacy pregnancy, 3 months
7 months
8 months ▶
Studio photo of Sara and Kris
Cuddling after ▶ Finn’s first nursing
Finn comes home! ▶
▲ Finn’s “O” face, reading Harry Potter at Leavitt Street in Chicago
▲ “The Maestro,” Finn’s signature newborn move
Writing Bringing in Finn while Finn naps
Grandma’s first visit after the birth, March 2011
First visit to Grandma and Grandpa’s, 4 months old, May 2011
Finn on vacation, 9 months old, November 2011
Celebrating Finn’s first Christmas with family, December 2011
Chapter 8
On the day of retrieval, Dr. Colaum collected eleven eggs from my ovary. They looked strong, and of those fertilized with Bill’s sperm, five embryos advanced in the lab. Carli from the lab called to tell us that two looked especially good.
“They’ll be here for you when your mom is ready in January,” she told me.
Bill was disheartened by the attrition rate. “It’s the same every time, though. Ten eggs turns into two or three embryos. You think I’d be used to it.”
We tried our best to focus on the positive. We had three good embryos. We reminded each other of the phrase we’d repeated consistently during other cycles: “It only takes one.”
We flew to D.C. on December 23. Bill’s stepfather, Roger, gifted us with three nights at the W Hotel on Fourteenth Street. The hotel décor was Mad Hatter mod, with angular black-and-white-striped rugs, oversize red and purple velvet chairs, and glistening chandeliers. In the lobby, gold and silver balls bobbed from white birch branches that hung from the ceiling. We made friends with the holiday staff and spent our days at my parents’ house, wrapping gifts and baking the cookies that were my mother’s classics: madeleines, pecan tassies, gingerbread men, and spritz. We didn’t talk about the surrogacy.
“We’ll make ourselves and everyone else crazy if we obsess,” Bill had said the first day of our visit. My mother and I had agreed.
When Bill and I returned to the hotel in the evening, we’d take the elevator to the lounge on the top floor that offered a 360-degree view of the Washington Mall. On Christmas Eve, Bill ordered a single-malt Highland scotch, one made in a town that we’d visited on our first trip to Scotland, and we took turns taking little sips from the heavy crystal glass. D.C. was beautiful at this time of year; the Washington Monument, the National Christmas Tree, and the Lincoln Memorial twinkled like stars in the inky sky.
In January, my mother went to her gynecologist in Virginia to have a baseline ultrasound, the prerequisite for restarting her medications. Since it took only two weeks to grow the uterine lining, Dr. Colaum had taken her off the hormone medications during our break. Braun shipped the oral and injectable estrogen directly to her house. Midway through the cycle, she would fly to Chicago so Dr. Colaum could take a look at her uterus.
At the early-January appointment, my mother’s uterus looked good. Not only good, but it had the desired thick lining. “Like a featherbed,” Dr. Colaum said.
We were cleared to transfer in two weeks. I felt relieved but cautious. Waiting felt hard. With the eggs retrieved and embryos frozen, I didn’t have anything to do. My mother decided to visit my grandmother in Nebraska for a few days while the hormones continued to take effect.
On January 29, Bill, my mother, and I arrived at RMI for transfer. Even though I had booked extra work each day and gone out with Bill or friends almost every night, the week leading up to this day had passed slowly—though not as slowly as the weeks we waited to find out if we were pregnant. During those, each hour felt as if it were being pulled through a lengthening device that made time as stretchy as saltwater taffy.
Now we were waiting in the patient waiting area, near the procedure room of RMI in the same curtained room Bill and I had sat in for many of our previous IVF cycles. I’d filled a two-liter bottle of water for my mother and kept encouraging her to drink more.
“Dr. Colaum wants the bladder really full for the transfer,” I said.
Even when I wasn’t pregnant, I would go to the bathroom every hour or two and had no trouble filling my bladder for transfer procedures. My mother was the opposite. She said her bladder was like a camel’s. “If I need to, I can last almost a day without needing to go.”
Bill grimaced.
“Sorry,” she said, “too much information.”
“Just getting used to it,” he said. “Just never imagined I’d be privy to the details of my mother-in-law’s urinary functioning.”
Rachel arrived to our curtained waiting room and handed Bill a cup.
“What?” Bill said.
“Just kidding,” Rachel said, amused at her joke. “Just didn’t want you to feel left out.”
“Ha, ha,” Bill said. But when Rachel left to prepare the procedure room, he whispered, “Really, she loves me.”
Dr. Colaum allowed me in the procedure room for the transfer. I sat in a chair and watched the team position my mother at the edge of the table her feet lifted up in the stirrups. The table was so familiar to me, I wanted to reach over and pat it with my hand.
Tracey rolled gel over her stomach and pressed into my mother’s bladder. I tried not to think about the speculum, catheter tube, and urinary pressure. I wished I could do all the uncomfortable parts for her.
“I’m not getting a clear picture.”
“Have you been drinking water?” Rachel asked.
“I’ve had half a liter or so,” my mother said.
“It needs to be fuller,” Dr. Colaum said. “Let Sara coach you. She’s come in here every time at full capacity.”
Tracey switched on the lights and the transfer team disbanded. My mother sat up on the table and began to chug water.
“I’m so embarrassed,” she said. “I didn’t think full meant about to pee on the table.”
“Oh yeah,” I said, “they mean bursting.”
My mother’s bladder was full thirty minutes later and the process started again.
Carli had shown us a photo image of the embryos when we arrived. She held the picture out toward us with long pale fingers. Two of the three had survived the thaw and were ready to transfer. I’
d given the picture to Bill to hold during the procedure.
“Think good thoughts,” I said as I kissed the image of each tiny life.
Dr. Colaum turned the flat screen toward my mother and I so we could watch the implantation. She’d asked me to describe the process to her in detail the night before. “It is majestic,” my mother said now as we looked at the dark, vast terrain of her womb.
“Preparing two embryos,” Carli called through the window from the lab.
“Ready,” Dr. Colaum answered. “Transferring two embryos. Here we go, Kristine,” she said, her hands guiding the catheter into position.
I watched the embryos shoot into my mother’s uterus. They looked as they always did—like comets jettisoning through space.
“Perfect placement!” Dr. Colaum announced. I saw Rachel’s shoulders drop. Two embryos had transferred, and landed. I let out an audible sigh.
I asked my mother if she wanted to rest alone in the room, but she invited me to stay. We sat without speaking, listening to the hum of the ultrasound machine, our eyes still fixed on the spot where the embryos had landed. I pressed my hands on her belly and she placed her hands over mine as we waited, our eyes never leaving the screen.
