Surrogacy – the good, the bad and the unsuccessful – by Simone


I think that finally we have got to the end of this “trying to have another baby” journey. And it hasn’t ended in the way we had hoped, not at all, but I am hoping that finally, maybe, we can make a bit of peace with this. You see, we have walked pretty far down the surrogacy road the last few months. And it has ended unsuccessfully, not through lack of trying, hoping, wishing and praying and with all the will in the world from everyone, but because a medical complication has made it impossible for our chosen surrogate to carry for us.


Let’s take a few steps back. When I had this last miscarriage, my cousin Emma, who lives in New Zealand, contacted me and asked if we had ever considered surrogacy and if we were considering it, she would be prepared to be a surrogate for us. Initially I was completely floored and couldn’t even really get my head around it. James had always been against surrogacy, battling to come to terms with trusting somebody else to carry our baby for us, and so it wasn’t something we had really discussed in much detail. Initially when Emma came forward I dismissed the offer, thinking she had made it quite flippantly and wasn’t really that serous about it.


I couldn’t have been more wrong!!! A couple of weeks later, Emma got in touch with me again, stressing that she was really committed to doing this for us if we wanted her to, that she had researched it in detail , that there were some hurdles that we would need to overcome but that she didn’t think it was impossible and that she was totally committed to making this happen for us. To coming to SA to have the embryo transfer done, carrying our baby safely for 9 months and coming back to SA between 32-36 weeks so that the baby could be born in South Africa. Emma has 2 wonderful children of her own but she was prepared to leave them for at least a few weeks to make this happen for us and for this pregnancy to be part of their lives, without the baby that generally would come afterwards. Unbelievable right?


Emma is my mom’s eldest brother’s daughter. They immigrated to New Zealand in the late 1980’s. My other uncle followed shortly thereafter and then when my mom died, my gran went to New Zealand as well. So I didn’t grow up really knowing my mom’s family at all.  I went to go and visit them at the end of 1999 after matric for 6 weeks and I remember getting on really well with Emma then (she is 2 years older than me) but after that we didn’t maintain contact at all. So this remarkable woman, who I hadn’t seen or spoken to in 18 years was coming forward and offering to make this completely selfless sacrifice for us, to give us the ultimate gift. All I can say is WOW!!!!!


James and I discussed everything at length, with a couple of fairly heated “discussions” because he felt that I was really just pushing my body and mind too hard and that I needed to really take a break despite the deep desire of both of us to have another child. We did a huge amount of research into surrogacy, spoke to many different people, and tried to figure out what would work for us and what wouldn’t. We looked at a few, unknown SA based surrogates, and by doing that realized that for us it would be a step too far to use a surrogate that we didn’t know. We also knew that because I wasn’t able to carry a baby, the egg we were using needed to be mine (rather than a donor egg), and the sperm James’ obviously, and that we were only going to give this one shot. If is failed at any stage (not having the surrogate approved, not getting eggs from me, the embryo not taking or a miscarriage occurring) that would be it for us. Given what we had already tried and been through we didnt want this to be a bottomless pit into which we threw more and more money, hopes and dreams, to ultimately still come out empty handed. James and I felt that under normal circumstances, given all the above, we would normally not consider surrogacy but given this amazing gift which was being handed to us by Emma, we couldn’t possibly not take it up and we had to explore this as far as we could.


Let me tell you something, there is nothing easy about surrogacy. It’s mentally and emotionally taxing and incredibly expensive. A few things to know about surrogacy:

  • It’s a legal process and it has to be approved by the High Court in South Africa. This means lots and lots of legal documents that need to be drawn up, which equals, lots of money to be spent on legal fees
  • There has to be a medical reason why you can’t carry your own child which needs to be proven and supported by a medical expert. It can’t just be because you don’t feel like it or don’t want to get fat
  • You need to find your own surrogate and it is illegal in South Africa to pay a surrogate. They need to be doing it for altruistic reasons. You can pay for specific costs incurred during the pregnancy only – medical aid, life insurance, clothes, travel, vitamins, some food etc.
  • Your surrogate has to be a South African citizen unless you can specifically motivate why a foreign national should be used (we were going to need to do this as Emma was a New Zealand citizen)
  • There isn’t a database of surrogates that are available that you can choose from, its not like when you choose an egg/sperm donor.
  • Most people who use a surrogate land up using a surrogate that they know (friend or family member) because unknown donors are few and far between
  • You have to be within a specific BMI parameter, have had a child of your own (who has survived), be within a certain age parameter, and pass lots and lots of medical tests
  • You all have to go through a full psychological assessment (surrogate mom and partner, and your and your partner) and be declared mentally fit to go on this journey.
  • You need to have discussed all the hard questions and agree on them upfront – rights and views on termination, genetic screening, how many embryos to implant, money stuff, where baby is born and how, what the handover process will be, whether the surrogate will get to see/spend time with the baby etc
  • Once its been approved by the courts, you and the surrogate mom then have to go through all the fertility meds for you to generate an egg and for the surrogate mom to be ready for the egg to be implanted.
  • Because we were going to have a foreigner carrying our baby we had additional things to consider like when Emma was going to come to SA before the baby was born, what would happen if the baby came early and was born in New Zealand (which might lead to us having to legally adopt our own child under New Zealand laws) etc etc

And this is all before you even get someone pregnant! So next time someone says, “Oh but just use a surrogate” as I have had said to me quite a few times, please remember all of this.


So we started to embark on this journey, together, the 4 of us – James, Emma, Aaron and myself – and our families as well. We got all the legal stuff in place and overcame quite a lot of difficulties in this regard (we were trying to do something that South African law actually didn’t ordinarily allow for and which hadn’t been tested before), we discussed all the difficult and logistical questions and came to an agreement on each one, discussed and agreed on the timing and travel logistics, we had our psychological testing done and were all declared fit to continue and had all our medical testing done. Emma had a scan which identified a small “cavity” in her uterus and a potential polyp which needed to be addressed before being able to implant an embryo. This required her to have a hysteroscopy which she very willingly went ahead to have done, despite the doctor she saw being really horrible and letting her personal view on surrogacy cloud her medical professionalism. 4 days before our legal papers were supposed to appear in front of the court, Emma had the hysteroscopy and this is where our story and dreams start to unravel. The hysteroscopy identified that unfortunately Emma had a rare scar defect in her uterus called an Isthmocele (yes, unbelievably enough the same rare thing I was diagnosed with 18 months ago and which they operated on and tried to fix) which meant that she was not going to be able to be a surrogate for us. Very simply, the isthmocele is a defect in the c-section scar which causes slight bleeding into the uterus on an ad-hoc basis. Any blood in a uterus makes it impossible to fall pregnant because blood kills an embryo. An attempt can be made to fix it but there is currently no agreed medical protocol on this, nor is the outcome really known or guaranteed. In my case anyway, while we managed to fix the isthomocele and get me pregnant, I landed up having lots of other issues which may or may not have been a result of the surgery.


The first day I found out that the surrogacy couldn’t continue, I was completely fatalistic about it, believing that this was the final thing to show that this was really not meant to be for us. That we were just pushing too hard to try and achieve something that was not our reality. That our family of 3 needed to be a complete one, needed to be enough. I felt like I had been ignoring all the signs, had been pushing on regardless, trying absolutely everything and almost dying in the process, and that we just needed to stop. I always knew that it would be a very slim chance that it would be successful but I expected us to fail because there was an issue with my eggs. Not before we had even had a chance to try. While I tried to hold myself back from day dreaming, I still felt hopeful no matter how much I tried not to. I imagined, over and over again, the day this precious new soul would be born into our world, and put into my arms, how it would all play out.


Emma was so completely committed to us and to doing this for us, so she was also absolutely devastated at the outcome. The next few days I was angry at the universe, so so sad and just also unbelievably tired of being constantly challenged and seemly being robbed of a positive outcome. After everything that had happened was the outcome never ever going to be in our favour? I am glad that I didn’t write on those days as it wasn’t a side of me I like, but I know it’s also all part of this grieving process.


James and I are really feeling quite fatalistic about this all now. The fact that this has been thrown at us, something that we can’t get around, cant “fix” means that it is not meant to be, for reasons that perhaps we don’t understand right now but need to accept. I have spent the last 2.5 years pushing, pushing, pushing and not listening at all to my body, or to the messages the universe has been sending us, and when I nearly died earlier this year I promised that that was my wake up call to listen better, to take better care of myself, and not to push through when it’s obvious that it’s not meant to be. I firmly believe that the fact that Emma has an isthmocele, something that is so uncommon and which I had too, is our sign to say stop, no more, listen please! We have done absolutely everything that we can to make this happen, overcome every hurdle that has been placed infront of us and that we really have had a never say die attitude. Until really shown otherwise. And this is it.


Since we have made this decision to stop, I am in some ways feeling lighter. I no longer have this huge looming cloud over me, where everything is about trying to have another baby, every plan we make is around whether I may be having another fertility cycle/be pregnant/not be pregnant. Where we cant go on holiday because I might be having another fertility cycle/be pregnant/not be pregnant, and where we have spent the money we would have spend on a holiday, on building new memories and experiences for our family on more fertility related stuff. A friend of ours who also lost a child wrote recently that such an important part of their grieving journey has been about making new memories, and how this had helped them in their grief. And we haven’t really done any of this. For the last 3 years we have been in this deep hole, in a holding pattern completed absorbed with trying to make having another child a reality. And now we need to start making new memories, accepting that our family of 3 is enough, is a complete family as it is, and just enjoy and really appreciate that, instead of wishing for something more. So this really is the end of the road for us, baby wise.


Despite all of this, and being able to rationalize it in my head, my heart hurts. It’s the final nail in the “no more children” coffin and that is tough. We have tried so so hard, pushed beyond what it’s possible to described, thrown so much money, time, investment, strategy and love into this to no avail. And my personality doesn’t accept these things easily. Believing always that if you try hard enough, come at it from a different angle, want it badly enough, it will happen. Not with this unfortunately.  Every time I see a baby I want to steal it for my own, breath it in and cuddle it to me forever. Its often like I am physically kicked in the gut with the realities of our situation but it is what it is.


There is one good thing from this journey. I have really got to know my dear cousin Emma and our families have become closer again. And I will always be eternally grateful for that. We will always feel completely indebted to her. What she was prepared to do for us and the length she was prepared to go to is the most amazing and selfless thing that anybody has ever done for us. We will never fully be able to thank her for being willing to walk this journey with and for us and for being so willing to give so much of herself and her family to it. It truly shows the remarkable person that she is – kind, caring, compassionate, giving, loving and so many other words we can think of. Thank you dear dear Emma from the bottom of our hearts.


A summary of our fertility journey

  • November 2015: 6 weeks after Bella died we started trying for another child and fell pregnant immediately.
  • May 2016: We lost Thomas at 26 weeks after a lot of trauma
  • September 2016: started actively trying naturally to fall pregnant again
  • February 2017: went to the fertility clinic for the first time
  • Had one round of hormones and artificial insemination, unsuccessful
  • Isthmocele identified and first surgery to try and cauterize it and fix it
  • June 2017: first round of IVF, limited response. 2 eggs, only 1 fertilized. 1 embryo implanted, unsuccessful.
  • July 2017: hormones and timed intercourse, unsuccessful
  • August 2017: big surgery to try and fix the isthmocele
  • October 2017: 2nd round of IVF, limited response. 3 eggs, only 1 fertilized. 1 embryo transferred, unsuccessful. This was the IVF failure that hit me the worst emotionally. I was sure that after everything this one would work.
  • December 2017: 3rd round of IVF, maximum drugs, limited response. 2 eggs, 1 fertilized. 1 embryo transferred, unsuccessful. Found out at 12.30am on 1 January 2018 that I wasn’t pregnant. Not such a happy new year and a total of 9 general anesthetics in 2018.
  • January 2018: had lymphnode transplant
  • February 2018: 4th round of IVF. Aborted half way through as no response at all. Start exploring option of donor egg.
  • February 2018: find out that I has actually managed to conceive naturally. Starting bleeding almost immediately. 5 weeks of bed rest with severe cervical incompetence
  • April 2018: lost our 4th baby, a perfect little boy, at 11 weeks, due to cervical incompetence
  • May 2018: nearly bled out and died. All doctors advised against ever trying to fall pregnant again due to the risk it would put me under
  • June 2018: Start exploring surrogacy in detail. Start to get everything in place.
  • August 2018: Surrogacy journey halted.

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