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Archive for November, 2010

As I sat in my doctor’s office I was reading an article today and came across a new word that struck me. Saudade.  It is a Portuguese word that supposedly means longing, incompleteness and desire – all in one. 

In the article, it was talking about one’s longing for a place/time of the past.  But I thought about how this so perfectly describes how many of us infertile women feel about our fertility and parenthood. 

I decided to do a bit more research on the rough translation of this word -Wikipedia had this to say:

“Saudade has been described as a “vague and constant desire for something that does not and probably cannot exist … a turning towards the past or towards the future”. It may also be translated as a deep longing or yearning for something which does not exist or is unattainable.”

Wow, how often in our fertility and IVF journeys does it seem that what we are striving for feels so unattainable?  The good news is that in fact, for many of us, the dream of pregnancy or parenthood can become a reality – it just may not be exactly the way we had originally planned. 

Wikipedia continues by saying: “Saudade was once described as “the love that remains” or “the love that stays” after someone is gone. Saudade is the recollection of feelings, experiences, places or events that once brought excitement, pleasure, well-being, which now triggers the senses and makes one live again. It can be described as an emptiness, like someone ( e.g., one’s children, parents, sibling, grandparents, friends) or something (e.g., places, pets, things one used to do in childhood, or other activities performed in the past) that should be there in a particular moment is missing, and the individual feels this absence.”

 I thought of how this applies to so many of us in our journey of infertility.  Perhaps it is a loss of our fertility – or a loss of the ease in which we are supposed to be able to have children.  For others, it may be the loss through miscarriage, or even infant death that leaves a gaping hole, an emptyness.  And with this comes a longing for what could or should have been and coming to terms with the myriad losses we face in the difficult journey of infertility. 

It is interesting to me that this word was voted one of the most beautiful words of the Portuguese language, while being considered one of the most difficult to properly translate.  

Lately, I  feel saudades for my fertility, our children who are not with us, my loss of innocence and so much more.  I have felt compelled to document so many things that have been lost. Not so much to put it behind me, but to acknowledge the losses that have become part of my reality without giving up that sense of longing for what might have been – and perhaps what may still come.

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Oprah and the mainstream media seem too often to focus on the horror stories of surrogacy abroad.  That is not what this post is about.  Doing IVF Abroad in combination with using a local surrogate (local to where you live) can reduce the costs of surrogacy and make it more attainable for many intended parents who feel that the costs of surrogacy put it out of their reach. 

Most of the times when we think about surrogacy abroad, we think of clinics with foreign surrogates and intended parents traveling abroad for the birth of their children then staying there while the legal details for citizenship are worked out and the baby is healthy enough to fly home.  And while that is a viable choice that may help some couples with their family building, it may not be an option for everyone.  

There are other ways that intended parents can take advantage of the cost savings of IVF services abroad to save money on overall surrogacy costs while still using a surrogate from their home country.   

One of the significant costs of surrogacy (which can account for up to 30 – 40% of the total surrogacy fees) are the actual costs for IVF or donor IVF treatment to create the embryos that will be transferred to your gestational carrier (GC).   If your local surrogate is willing to travel for transfer, you may want to consider having her travel abroad (perhaps to Europe) for the IVF transfer.  This could save you $20,000 to $30,000 for a donor IVF cycle (using donor eggs and your partner or husband’s sperm – or even donor sperm) and probably around $10,000 savings for a traditional IVF cycle (using your own eggs and your partner or husband’s sperm – or perhaps donor sperm).  It makes the overall surrogacy costs cheaper without relying on a surrogate located in a foreign country.

Logistics:

You and your partner could go abroad alone for the first part of the IVF cycle.  That would include your ovarian stimulation or in the case of donor eggs, you would arrive just in time for the egg retrieval and fertilization (if you are using fresh s.perm).  Optionally, if your husband/partner cannot travel with you – you may wish to ship the frozen s.perm in advance  – making the trip shorter for everyone.  Your surrogate would arrive a few days after egg retrieval and only has to stay about 3 days to have the transfer, rest, and then fly home – hopefully with a great souvenir on board for you.

As long as your surrogate is willing to travel, they get a nice little European vacation out of it without being away from home or their children for an extended period of time.  Of course, you will have added travel costs for the surrogate to travel there, but those costs are far less than doing a cycle in the US if you don’t have insurance coverage for IVF. 

In this scenario, you still have all of the benefits of using a local surrogate, participating in the pregnancy, and having your child born locally rather than dealing with the legalities of bringing home a baby born in another country. 

Another scenario would be to travel abroad for your IVF cycle, then ship the embryos back to a US clinic near the surrogate for transfer.  Because frozen embryo transfers have a somewhat lower success rate than fresh transfers, it is a less popular option. 

A few things to consider:

1) You will want to verify with the IVF clinic abroad that you intend to use to ensure that they will allow you to have embryos transferred to your gestational carrier and to find out what testing will be required from your GC in advance.  Some countries may have laws prohibiting this, or some clinics may not offer these services, but generally I have found that clinics are happy to work with intended parents who are using a gestational carrier. 

2) Make sure that your surrogate is willing to travel for transfer and include that in your contract discussions so you are all on the same page of expectations.  You may need to also pay for a companion to travel with your surrogate, and I recommend that you use an agency to coordinate the IVF cycle to make sure everyone is following the protocols, is well cared for, has a local contact who speaks English, and that things go smoothly all along the way.     

I have personally worked with several intended parents taking their surrogates abroad for the IVF treatments and coming home with great souvenirs.  An IVF Vacation is a great way to make surrogacy more affordable as an option for family building.

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