Diary of an International Embryo Transfer
Our first embryo prior to transfer. Potentially, our child’s first selfie. Also, the hazy gray background reminds me of the many annual school photographs we will collect over the course of our child’s academic career.
My husband and I are back home in Stockholm and severely jet lagged. It was an intense and incredible trip to California for our first embryo transfer.
During the trip, I kept daily notes to capture how I/we were feeling for this historic stage in our journey. This article is a summary of those notes to document this time for us and our future child.
We will find out tomorrow (December 4th) on my actual birthday if our amazing surrogate is pregnant. I could not think of a better birthday present, but if this transfer doesn’t take, it is still an integral part of our journey. We want our child from this or a future embryo to know how exhilarating, nerve-racking, and amazing this process was to bring them into the world.
Friday & Saturday, November 21st and 22nd
Most trips leaving Sweden start with us dropping our first ‘child’ - our dog, Ruth - off at her daycare. Her doggie daycare doubles as a horse farm near the Stockholm airport, and I think Ruth may enjoy it more than home. The staff are all trained veterinarians who live for animals. Each dog gets their own ‘suite’ with heated floors, and they go on regular adventure walks in the neighboring forests.
As we dropped her off, she ran towards the staff with pure joy, barely looking back at my husband and I. I imagine this is what it’s like dropping your kid off at school or sending them to college. All joking aside, Ruth has taught us so much about having a child. I don’t think anything can really prepare you for being a parent, but being a dog dad is pretty darn close.
Because our flight was departing at 6:30 AM, we decided to sleep at the airport hotel. I am not a great sleeper in general, and this is usually exacerbated by not sleeping in my own bed. However, the 4 hours I did sleep were deep. In some ways, it felt like the anxiety around the trip had actually evolved more into excitement. We have done so much to get to this point, it felt like we could actually relax a bit and enjoy the ride.
Over our large Swedish hotel buffet breakfast, we are texting with our surrogate to make plans to meet on Sunday. She was also excited, and it felt like setting up a date after meeting someone online and texting for the better part of 3 months. None of us live in Los Angeles, so we were setting up a dinner in a city none of us really knows to meet each other in person for the first time before making a baby together. No pressure.
While we were texting with our surrogate, we all acknowledged the concern that the transfer may not even take place. A week prior, she had an ultrasound to check her uterine lining, and they found a large cyst on one of her ovaries.
While the fertility hormones used before the transfer make a uterus a welcoming place for the embryo, they also commonly cause cysts (1). Our reproductive endocrinologist wanted to ensure the cyst was stable or shrinking before transferring an embryo, so we had an ultrasound scheduled on the same day as the transfer. This meant that the transfer could have been cancelled the day of.
Even if the transfer was postponed, we were focusing on this as an opportunity to meet and get to know our surrogate. Our Piece of Mind program with our agency covers all the logistics for her and her companion to travel as many times as needed for a successful pregnancy, so it’s not a financial concern. Also, my husband and I desperately needed some California sun after the dark and depressing November weather in Sweden.
We arrived in Los Angeles the same day (and almost the same time) we left Sweden thanks to the 9 hour time difference. We were greeted with sunshine, In & Out, and the welcome of amazing friends. We went out for delicious Mexican food and talked about the whirlwind of family building, as our friends have also gone through multiple rounds of assisted reproduction to have their 3 children. It was so nice to see old friends and bond over this shared experience.
Sunday, November 23rd
Today was all about mentally preparing to meet our surrogate in person.
She was live texting as she boarded her plane. The restaurant was reserved. She wanted something casual, so we asked our friends who recommended a Middle Eastern place close to her hotel. However, logistics occupy our thoughts less than questions like:
Do we hug?
Will we have enough to talk about?
What if she doesn’t like us?
The last question is one I have asked myself about every interaction I have ever had in my life. Call it cautious pessimism or low self esteem, but I am always a bit surprised when someone likes me. Besides my husband, there are few people I wanted to like me more than our surrogate. Again, no pressure.
We arrived at her hotel as she was descending the staircase to the lobby. She was accompanied by her sister-in-law, who we later learn is also interested in becoming a surrogate. We smiled. We hugged, and almost all of the weight of anxiety and concern was lifted from us.
She was sweet, warm, lovely, and even better than we had imagined. She is passionate about this journey and has become an ambassador for surrogacy in her family and community. Her young children are sharing it with their friends, and she is also participating in a documentary about the experience.
We also realized that we have been going through this journey from two different perspectives. For example, she was curious to learn about how our names will go on the birth certificate; if the child will be Swedish, American, or both; and how gay dads are perceived in Sweden. Her curiosity was intoxicating, and it opened us up even more. Not only did we get to ask more questions about her life, but also we concluded that going forward we can share more via text and keep her updated on our side of things so that we get to experience this journey from all sides, together.
The dinner before really dispelled any nervousness or concerns we had. We dropped her off at the hotel, and my husband and I were beaming. We could not stop talking about how well it went, and how excited we were for the transfer and this whole journey with her.
Monday, November 24th
Our surrogate’s hotel did not offer decaf coffee, so we happily picked her up some Starbucks Christmas joy on our way to meet her on the morning of the transfer.
When we arrived, our surrogate was eating her transfer breakfast of champions, which was a large container of diced pineapple. I added this to the list of things I didn’t learn in medical school: A chemical in pineapple called bromelain has anti-inflammatory properties that are believed to be beneficial for the uterine lining (2). While studies are lacking, every little bit helps when it comes to assisted reproduction.
The most surprising thing about this morning was that the hotel was full of other surrogates with our agency. The agency had provided them all with adorable matching t-shirts and socks decorated with little pineapples. As they shared actual pineapple, they were discussing the procedure, what transfer this was for each of them, and lessons learned. It felt like the sisterhood of the traveling surrogacy, and it was so great to have our surrogate be part of this incredible community.
Even though the hotel was a 7 minute walk to the clinic - unheard of proximity in LA - we wanted to drive her. I guess it was our way of being as supportive as we could.
When we arrived at the clinic lobby, it was full of other surrogates, intended parents, little kids, and felt like a welcoming space for our little group. Waiting for the ultrasound was not easy, but we were able to fill the time with conversation about from 90s fashion, Eurovision, and our shared love of Costco.
It was finally time for the ultrasound, and we were escorted back to an exam room. My husband preferred to stay in the lobby, so our surrogate, her sister-in-law, and I went back. We were the most quiet we had been with each other in the last 24 hours. We were all thinking the same thing: Will the cyst be larger? Will the transfer go ahead?
After clarifying the back and forth on how full her bladder should be for the first ultrasound (which was a different fullness compared to the actual transfer), the examination was performed. Within seconds, our reproductive endocrinologist confirmed that the cyst had completely gone. The transfer was a go! We all cheered! Our surrogate texted and called her family while we waited for the embryo to thaw and be prepared. My husband and I were so excited it was finally happening.
When everything was ready, we went into the transfer room, which was very spa-like. There was soft pink wallpaper, gentle elevator music, and comforting mood lighting that gave it a calming, zen feeling. The embryologist came in to triple check her name and the fact that we were transferring one embryo. Then, it was show time.
Our reproductive endocrinologist came in, got into position, and then the embryologist entered with the embryo. The embryo had been loaded into the longest, thinnest syringe I had ever seen in my life. The embryologist walked with the calm steadiness of someone holding a priceless piece of art. This care and respect was deeply appreciated by us, because to us this embryo was priceless.
After handing this razor thin syringe to the reproductive endocrinologist, the ultrasound fired up, and within 1 minute, the tube had been inserted and the embryo transferred. It may sound cheesy, but I thought the embryo had an ethereal white glow on the ultrasound.
Screen shot of our transfer ultrasound with the embryo circled in red.
After the briefest of life-changing moments, our surrogate continued to lie down for about 10 minutes before we were permitted to go. We drove her back to the hotel, and as instructed, went out to procure McDonald’s french fries and In and Out double doubles. Is there medical evidence this helps? No, but could there be a more appropriate time for comfort food than bed rest?
Tuesday, November 25th through Monday, December 1st
Our surrogate bed-rested so hard she fell asleep, and by the next morning, she was ready to travel back to her hometown. We had plans to drive her to the airport, but I developed a sore throat. The last thing we wanted to do was get her sick, so we kept in touch via text until she boarded the flight.
For the rest of the week, my husband and I had the amazing joy of celebrating Thanksgiving with family and friends all over California. We drove from LA to the Central Valley and then to the Bay Area. Spending so much quality time with loved ones was the equivalent of a week-long emotional hug. Even sick and losing my voice, I felt great after the incredible experience of the transfer followed by all the support from those we love.
Our family even gave us some baby clothes to celebrate the transfer, and it feels amazing that everything is becoming so real - for us and for everyone in our lives.
Our family gave us baby clothes to celebrate. I cannot believe we were all once so small. Here is a onesie next to my husband’s rugby shorts for comparison.
Tomorrow is the day of the blood pregnancy test. Given the time change, we may not get the results until the day after my birthday, but we will be wishing and thinking all day that we get the news that we are pregnant. Given how amazing the trip was, I feel like it was already a gift to spend time with our surrogate and to enjoy the holiday with family and friends.
Sometimes, I feel like there is such a thing as too much of a good thing (see my previous article on Happiness Anxiety for more on this), but in this case, we remain hopeful that tomorrow our lives could be changed…for good. And yes, that is a Wicked reference, but it seems appropriate coming from a gay intended dad who just saw the movie after his first embryo transfer.
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