How Surrogates describe the Injections they have to do before the Embryo Transfer?

In a previous blogpost I talked about Francis and Melany’s story; two “sisters” who were waiting for the embryo transfer in Francis’ uterus. During the emotive interview, we discussed about the surrogacy journey and in particular about the medication that both the women had to take. Melany, the intended mother (IM), was under medication for the egg retrieval (link to Leslie), while Francis (the gestational surrogate – GS) was under medication for receiving the embryo. Melany took shots for 10 days while Francis took shots for 3 weeks, in order to prepare her uterus for the embryo transfer. Both the women, and especially Francis, who was the one who took the injections for most time, described the medication as “quite easy and funny”.

Francis: “Actually, it is a very funny experience, thanks to my sister. Have you ever seen the Pulp Fiction scene? It reminds me of that! My sister and my brother searched for the ‘perfect spot’ for the injection, and it reminds me of that scene every time. It is hilarious!

During the interview, Francis never mentioned the pain caused from the needles or for the medicine itself. She discussed more about the sacrifice she was doing for a family member, to bring happiness to her sister’s life.

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Not all the surrogates I interviewed have described their medication as a “funny experience”. Every woman defines it in a very different way. Some of the women I interviewed have defined the medication as the hardest part of the whole surrogacy journey. Like Mila, 36 years old, 20 weeks pregnant for a Chinese couple who said: “You know, it is hard to inject yourself every day. It is hard remembering to do it for a month, and it is hard mostly because it is an injection, you know! (Laughing). Especially, when you are at the end and you don’t have any spots available left, to inject the needle in. It is totally the worse part ever. The last week was very painful for me, because I perforated all my back and the medication is oil. Burn and sore, this is how I would describe the medication”.

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Nevertheless, as Mila told me, if the medication was a very hard part, it cannot be compared with the pain that infertile people could experience for years. In other words, Mila nuanced the pain she was feeling during the medication with the pain that the people that can’t have children generally go through. In her opinion, her pain was small in comparison to the one experienced from the intended parents. “The medication I have to take was nothing, it is not a big deal in comparison with the pain that infertile people live with. My couple was trying to conceive for more than 4 years. It is sad, so sad. When I heard their story, I wanted to help them. I cannot imagine my life without my kids.”

Francis and Mila are both surrogates, but they are living a different bodily sensation. Francis and Mila’s experiences, reminded me the study of Almeling and Willey (2017) “Same Medicine, Different Reasons: Comparing Women’s Bodily Experiences of Producing Eggs for Pregnancy or for Profit”. In their study, Almeling and Willey have analyzed the experience of infertile women using IVF to conceive a child and the experience of egg providers. The infertile describe the medication as painful and emotionally draining, while the egg providers, who have undergone the same medical treatments describe it as painless and quick. As the two sociologists pointed out, different individual’s bodily experience of medical intervention varies based on their reason for doing it. In these two stories we saw a completely different depiction of the medication. Francis, who was taking the shots in order to receive the embryos of her sister, described the medication like an “easy and funny” part; on the contrary Mila, who was taking the drugs for receiving the embryos of a Chinese couple, designed it as “sore and painful”. The reasons why these women started a journey as surrogates are different: Francis became a surrogate to help her sister, while Mila to help a family of strangers. Nevertheless, in both of these stories I captured a rhetoric of love and sacrifice to help someone’s having a child.
In conclusion, every woman defines the pain of the medication in a very different way, in relation of the reason why doing it.
References
Almeling R. and Willey 2017, “Same Medicine, Different Reasons: Comparing Women’s Bodily Experiences of Producing Eggs for Pregnancy or for Profit.” Social Science and Medicine.

 

An interview with Quiana, Clinical Nurse Coordinator at WFI

Quiana works in the field of Women Health since 2005. She started in an OBG Clinic in where she gained a lot of knowledge regarding the fertility industry.

Quiana is a Clinical Nurse Coordinator at Western Fertility Institute.

I found it interesting and quite amazing what female bodies can do. It is a life outside of the body, it is like something between nature.”

Quiana works with egg donors, surrogates and people with different fertility issues. I asked her to describe her work with the 3rd parties. She follows egg donors and surrogates during the first part of the process, educating these women about the medication they have to take.

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Most of the women I speak with are educated. They want to know, they ask a lot of questions. I explain to them the medications and I ensure they are taking it on time.

Quiana explained to me the egg donation process. The ovarian stimulation takes from 7 to 10 days, sometimes much longer, it depends on the cases. When the injection starts, the donors are followed during the journey. On the 3rd day, 5th, 7th and 9th day, the blood test and the ultrasound occur to evaluate their response to the medication.

Every person has a different response. We make sure they are followed and there is no a hyper stimulation”.

On the 10th day, there is the trigger shot and 36 hours later the egg retrieval takes place. At that point, the egg donors are followed by medical assistants (for example, like Leslie).
Quiana also follows the surrogates. For gestational carriers, the process is longer because they have to prepare their uterus for the embryo transfer. As Quiana said:

The line of the uterus needs to be around 7mm. There are 3 weeks of medication and during the 4th week, the transfer occurs. We follow them until the 10th week of their pregnancy”.

The critical part of her work, as she said, is when the IVF doesn’t work, because she knows all the efforts that the people involved in these pathways went through. However, at the same time, she loves when she hears about the outcome of a new baby.
I asked Quiana her favorite part of the job and she mentioned, it is when the patients come back to visit the clinic.

Because also if they are the one that made everything, they show us a lot of gratitude and appreciation for the help we gave them”.

“What Egg Donation is All About”. An Interview with Leslie, Medical assistant & Senior Egg Donor Coordinator at WFI

Leslie began her journey at the Western Fertility Institute as an intern in April, last year. Throughout the process she became a Medical Assistant in April, and a Senior Egg Donor Program Coordinator. As Leslie said, she had a “very big teacher, Quiana”. She was taught about fertility and surrogacy during her internship; before that, she never thought about working in this field.

A medical assistant helps nurses and doctors, and has several other functions. Leslie spends most of her time doing blood work. As she said, taking blood is not just a routine job: “I am kind of a confidant for surrogates and egg donors. I try to construct a personal relationship with them. I know their journey, their troubles, their history…”.

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She continuously follows the journey of the egg donors. Leslie is by their side for all the steps of the procedure. There are many reasons why a woman enters in the egg donation process. As Leslie pointed out: “Whatever the reason why a woman is making this act, she needs to be informed more about the process of the egg donation. She is giving a part of herself away, it is a part of them”. She makes sure they are informed of the possible connections that egg donation can construct.

As she explained to me, every donor receives a different protocol. In general, the medication that a donor has to follow takes about 10 days. Every 1 or 2 days, the donor has to make a blood analysis at WFI in order to see if the follicles are growing (2mm each day). When the eggs are “ready”, the egg retrieval occurs. At WFI they are performed every Wednesday and Friday. The whole procedure takes about 2 hours: 30 minutes to prepare the patient for the surgery, 15 minutes for the retrieval itself, and the time left for the recovery. “We wait until the patient feels comfortable, we control the situation and make sure everything is fine”. Leslie follows donors throughout all the journey.

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She works also with the surrogates, but the relationships she constructs with them are quite different. If a donor is going to WFI every 2 days, the surrogates spend less time at the clinic. The relationship that Leslie is building with the donors is more intense because they spend more time together talking about egg donation, the medications, but also about the everyday life. She said that probably this connection she feels is related with the age and the experience that the patient has. In comparison to the donors, the surrogate already knows what a pregnancy is, they know what to expect from it. “They had experienced the gestation, so they know what will happen to their body. Yes, they ask a lot of question about the medication, and in general, about all the medical procedures. I make sure donors understand what egg donation is all about. I make donors understand the procedure. I try to explain to them all the information I know; it is a way to keep them more involved. They can trust us. They become basically family with us”.

I asked Leslie her favorite aspect of her job, she mentioned: “My favorite part is connecting with people. I love helping people with their journey. I am part of their story, I am helping them to create a family”.