Frequently Asked Questions

Last week, JT and I made the trip to the National Embryo Donation Clinic (NEDC) in Knoxville, Tennessee to have our preliminary appointment. We met our doctor and all the nurses and staff who have already advised us for the last few months and who will help us throughout the rest of the adoption. Our appointment was wonderful; everyone was warm and informative, working hard to include us in every step that will take place and every part of the procedure. It was certainly a lot of information overload, but they handled their explanations of it all well and made it clear that they were always available for follow up questions in the future (when I FOR SURE forget everything and need reminders).

When I texted my family after the appointment and said everything went well, I was surprised to find that they had a lot of questions about the details of the rest of the adoption process. I wasn't surprised because their questions were silly, I was surprised because I realized that I hadn't really explained anything to them before. And their questions were really valid. And it occurred to me that if I haven't done a good job explaining everything to my own family, I probably hadn't done a good job explaining it to anyone else either.

I'm going to try to do that now. I am not a doctor, nor have I actually experienced most of this process yet myself, so I know there are better people out there to explain everything. But I will do my best, based on my own understanding of everything that has happened already and everything that will come in the next several months. Because I want the people in our lives to know what's going on with this adoption, but also because I want people to feel familiar and comfortable with the embryo adoption process. I would love it so much if just one person we know decided to choose this journey for their family because of the information we share here.

So here we go. Here's all the explanations of all the questions I could think of to answer.

What does the adoption part of the process look like?

We decided to use Snowflakes Embryo Adoption Program, which is the embryo adoption section of a larger adoption agency, Nightlight Christian Adoptions. We found them in our first google search, and loved all the information they provided while we researched. That, plus their Christian affiliation and their God-centered love and respect of each embryo made them an obvious choice for us moving forward.

The adoption portion of this journey has been pretty straightforward. Snowflakes has everything very well organized, and walked us through all the steps, stage by stage. First there was the application that we submitted, followed by a phone interview with someone from Snowflakes. Once we got approval from them to continue with the application process, we had a few months of paperwork. We haven't gone through a traditional adoption process, but I feel like from what I've observed in friends' lives, it was probably pretty similar. There was the family profile, personal history forms for both JT and I, recommendation forms from friends and family members, federal background checks, state background checks, and current medical check ups for everyone in the family. Because of the medical element of this adoption for me, I also had to be checked out by an OBGYN in addition to the primary care physician. We also had several articles and book chapters as well as webinars about adoption (and specifically, embryo adoption) that we had to read/watch and write responses to. There was probably more that I'm forgetting, but you get the basic gist. It was a lot of paperwork, a lot of appointments, and for us it was all a little more complicated because we were only in Albuquerque for a short time and hadn't bothered to get any new doctors. But we did, and we got it all done.

The next part of the process involved a home study and very long in-person interview with a social worker. Snowflakes provided a social worker for us, which streamlined the process a little on our end. She came to the house soon after we moved in and inspected the home, and we also both sat and talked to her for several hours. She talked to Charlotte, but mostly talked to JT and I (together and separately) and we got really real about a whole lot of things. (Again, I'm sure this is fairly typical of most adoptions.)

Once we found out that we passed the home study portion, we moved onto the matching phase. (This part happened right before Christmas for us. To give you a reference of time, we started our first application to Snowflakes in May, and were approved for the matching phase in early December. Our process was put on hold for about two and a half months while we moved, but other than that it was a lot of waiting.) The matching phase lasted not quite two months, and when we were matched with our donor family we were given the ability to review their family profile and medical histories, and then decide whether we accepted or rejected the match. The donor family had the same opportunity. (Our actual situation ended up playing out a little different, because of some unique issues that arose during the matching process. Our former clinic held up the process considerably and so Snowflakes let us move at a little bit of a different pace, but the typical matching process goes much smoother than ours did.)

Both families accepted the match, and we moved on to the contract phase, where both families reviewed all the details of the adoption itself. We have an open adoption, so most of the contract focused on what level of openness both families wanted to have. We signed, and moved on to the shipping phase, where our embryos (who were now officially ours!) were shipped from the donor family's clinic to our new clinic in Knoxville. This process can sometimes take months if clinics aren't responding to each other or making the shipping a priority, but our embryos arrived at the NEDC in just a few days! We were thrilled. And that meant that the adoption was complete and official, the embryos are now Moores, and all we had left to do was all the medical "stuff." (For a much more complicated discussion on the emotional toll of the "stuff" that's left, see my previous post, "Whatever My Lot.")

Why did you switch clinics? Wouldn't one closer to you geographically make more sense?

Ha. Yes. Yes it would. 

Here's our story. Our Knoxville clinic is actually the THIRD clinic we have gone to during this adoption process, believe it our not. We picked Clinic #1 when we were living in Albuquerque and thought we'd be staying there throughout the entire adoption. We chose a clinic in Colorado Springs that works with Snowflakes a lot, and it was close to JT's parents' house in Denver which was attractive for childcare and bed rest purposes. But then we found out we were moving to Phoenix much sooner than we'd planned, and we decided to switch to Clinic #2, which was in the LA area. Surprisingly, there aren't any clinics in Arizona that partner with Snowflakes, and LA is only about 5 hours away so we weren't bothered. But when we were matched with our embryos, Clinic #2 rejected them. It's a very long story, but there are some minor complications with the timeline of testing that was done with the donor parents as far as the FDA is concerned, and this clinic (that normally accepts embryos with this same complication), for whatever reason, rejected them this time. It was a major blow to us emotionally, but after much counsel and wise advice from people at Snowflakes, we felt comfortable keeping the embryos but instead finding a new clinic that would take us. And that led us to the NEDC, on a recommendation from Snowflakes, and they quickly accepted us and worked us into their schedule to move things along as quickly as possible. Which we greatly appreciated.  

What kinds of medical stuff are you doing right now?

To prepare for this last appointment at the NEDC, they had me take birth control for a month - to control my cycle - and then estrogen for 20 days on an increased schedule. They did this because of the tests and practice runs they did during the appointment (which included lots of things that I honestly didn't follow, but I know that they looked at my uterus with an ultrasound and they also did a trial run of the frozen embryo transfer (FET) to make sure the catheter would work and everything would be a smooth procedure the next time we come back. We also drew blood for some tests. 

The rest of it doesn't really start happening till December. We originally planned on doing the FET in November, and that seemed like ages and ages to wait as it was. But my incredibly wise and practical husband was looking over our medical insurance, and realized that we would likely be paying twice as much out of pocket if we did the FET in November rather than waiting till their January cycle. By postponing the FET by two months, we would hopefully be having both the FET and the baby's birth in the same calendar year, thereby making the amount of money we would have to pay out of pocket drastically lower (can you say HIGH deductible insurance plan?!). As it turns out, once we talked to the sweet, adorable billings lady at the NEDC and told her our plan, she was thrilled that we were waiting till January because the company that JT works for is also switching insurance providers in January, and our new insurance does a much better job of covering infertility-related costs than our old insurance. (Are you feeling like you've heard more than enough about insurance? Me too.)

Basically, if you skimmed that part, we are waiting till January to have our FET. So the next phase of the medical stuff doesn't start till December...and I'll discuss that next. 

What kinds of drugs are you going to have to take?
  
The thing about embryo adoption, if you haven't figured it out already, is that it's basically just IVF. The only significant difference is that the embryos implanted are not made from me and JT, they were donated by our donor family. So if you have gone through IVF or have someone close to you that has, then you are probably familiar with this part of the process. But for those of you who aren't, then this is how it will look:
Since we are going to go ahead with the January cycle and have the FET then, we will begin taking the necessary drugs in December. Complete specifics aren't needed (and truthfully, I can't remember them all off the top of my head), but I believe it's four or five different medicines that I will have to take, on a very specific schedule throughout that month and a half leading up to the FET. Two of the drugs are injection, and the others are pills. I'm sure some of it will be fine and some of it will suck. But I'm not gonna worry about it till December. 

What happens during the FET?

JT and I will go back out to Knoxville for the FET in January. (Between now and then, I should mention, we will have to get several ultrasounds at a local fertility clinic so our clinic in Knoxville can review my status and make sure everything is good to go for the FET.) The day before the transfer, the embryologist will thaw the appropriate number of embryos (more on that in a moment) and will allow them to develop to the correct stage for the FET. She will also check their quality and see if any of them did not survive the thaw (statistically, a quarter of embryos do not survive the thaw). For the FET, the doctor will place a catheter in through my uterus, and the embryos will be sent through the tube (for lack of better words). I will spend a few minutes in bed, but will be able to basically get up and go right away. (Some clinics, including our original clinic, have patients go on bed rest for a few days, but our doctor at the NEDC assured us that that is old information and that new research suggests that getting up and moving a little bit may actually help.) 

How many embryos are you going to implant at a time?

This is an incredibly complicated question. Or...I guess this question isn't so complicated, but the next one I will answer is directly tied to this one, and when you consider both questions together, it's complicated. 

The short answer is: we will implant 2 to 3 embryos, depending on the advice of the embryologist and our doctor on the day of the FET. 

Sometimes embryos do not survive the thaw (like I said before, 25% of them typically do not). 

Sometimes embryos survive, but are of a lower quality than what is ideal. 

Sometimes they survive the thaw and are of an excellent quality.  

Because our adoption agency is a Christian organization, and our clinic is a Christian practice, and because we are Christians who believe that life begins at conception, all embryos who survive the thaw will be used for implantation. No embryos will be discarded due to a poorer quality. 

Because of that, we really don't know much until the day before/the day of the FET how many will for sure be implanted. We need to be comfortable with the amount that is implanted, in case all embryos attach successfully and become fully grown babies. We also need to understand that we could implant 3 embryos and none of them attach successfully. It really is completely out of our hands, and fully in the Lord's, but there is some level of responsibility and wisdom that goes into the decision too. 

So, that being said, if the embryologist thaws our first two embryos and both survive, and both are of excellent quality, then we will only implant those two embryos. If one or both of the first embryos doesn't survive the thaw, or if there is a poor quality assigned to one or both of them, then a third embryo will be thawed and implanted as well.

Basically, beyond that, we just pray. For whatever happens. 

What if this FET is not successful?

This is where it all gets very complicated. And where I'm going to be really honest about a lot of things. 

We have 4 embryos. It's not a huge number. We told Snowflakes that we wanted 1-2 more children, so they matched us with a family that didn't have a huge amount of embryos to donate. That was very intentional and smart on their part, and we are so thankful for the 4 we have. But it's also kind of an interesting number because of all the what ifs.

If the first two embryos are thawed the day before our FET, both survive, and both are of excellent quality, then we will implant those two and still have two frozen. 

If the first two embryos are thawed the day before our FET, one doesn't survive and/or one is of poor quality, then they will thaw a third (or potentially even a fourth, if the situation calls for it), and we will have 1 or none still frozen. 

If this FET is not successful but we still have embryos in the freezer to try again, we are not sure if we will be able to go for a second round for financial reasons. It's an expensive procedure, guys. And our clinic is 3,000ish miles away from us. When you factor in the air fare, the hotels, the food, the childcare back home, etc. etc....it adds up. And then the drugs, the clinic fees, and the FET itself, and it's a costly procedure. It's certainly not the most expensive procedure of all time, and it's also not the most expensive form of adoption. But it is expensive, and that is a factor. 

The fact is, though, that we might not end up with two in the freezer waiting for a second round. It's probably more likely that we will have only one or two left in the freezer. 

Having none left is an obvious conclusion. We would have the option of going back to Snowflakes and asking to be matched again with a new donor family for more embryos. If we went that route, we would be able to bypass all that preliminary stuff and go right to matching...but we would not do that. If we don't have a successful FET and we are out of embryos, we will thank the Lord for the opportunity to pursue this journey, mourn the babies that did not successfully grow, and praise Him for the fact that four beautiful Moore and now in heaven with Him and with our first baby, Sam. We will most likely not pursue adoption - or growing our family at all - anymore. 

Having one left is a difficult call to make. We do believe that that embryo is a life, certainly a life worth fighting for. If we decided not to go through a second FET, then the remaining embryo/embryos could potentially stay frozen (which neither us or Snowflakes would want), or could also potentially be adopted a second time by a new family. This would take some coordination with both Snowflakes and the original donor family, but it is possible and it does happen. 

There is so much about the next 6 months-a year that are unknown. We know what steps we will take to try to bring our snowflake baby/babies home, but we have no idea what will happen. We could have twins (or triplets!)...or we could have nothing. It's hard to mentally and emotionally prepare for that, but we are not alone. So many families go through all these same medical gambles every day. Modern technology is an amazing thing, but nothing is guaranteed. As our doctor told us last week, the whole process gets to the point where God is in control and no one else is. 

Would you be willing to pray for us in these next six months, friends? Pray for us, pray for our frozen babies, pray for our doctors. Pray for Charlotte, who wants a "baby Knoxville" more than words can say. Pray that we really would release this entire process to the Lord, and trust Him with whatever He allows. 

Thank you so much for caring enough about our family to read this entire post. Thank you so much to all of you who have asked questions and wanted to know more, inspiring me to write the post in the first place. Thank you for coming on this beautiful journey with us.