Baby, plan your birth!

A couple of queer expats in Singapore on a quest to make a baby


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Where do babies come from?

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Where do babies come from? Bangkok, of course!

Babies come from Bangkok! We hope.

After a whirlwind of emotions, we set off for Bangkok on Tuesday night.  By the time we boarded, we were both pretty much done with everything – we spent the flight basking in the emotional turmoil of gloriously bad ABC family dramas.  Perfect.

Of course, I break that sweet, television-induced sedation by spending the rest of our evening scouring academic articles for everything known about IUI, trigger shot-to-ovulation timing, and whether 24 hrs vs. 30 hrs vs. 36 hrs matters at all.  Confirmation bias abounds.  Everything will be okay.

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Swanky clinic – image from their brochure, as they reasonably asked we not take pictures.

Bright and early Wednesday, we headed to our clinic, which turned out to be about 300% more swanky than we expected.  We huddled in our padded furniture pod alongside 30+ other families and waited to meet with the doctor. Despite everyone’s disappointment that I had not done things “properly,” the doctor (and her army of ultrasound technicians) seemed reasonably optimistic.

We broke for lunch, I tried not to eat too much street food (so hard!), and reconvened in the afternoon.  We donned our baby-making costumes – sexy sterile crocs and hospital caps and gowns for both of us.

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After prepping very, very slowly, to help delay the insemination time as much as possible, it was time to make some babies.  The doctor brought out our washed, processed, and ready for action sperm, which came in a lovely shade of pink.  I got all situated, and then the team got to work.

I was more than a bit nervous because most experiences I’ve had with doctors poking my insides have been negative.  I researched other folks’ IUI experiences, which, of course, were all over the place.  Usually, the range was from “didn’t notice” to “it was uncomfortable.”  So I shouldn’t worry?  Wrong.  Always beware the use of “uncomfortable” in a medical setting.

In non-medical settings, the phrase “uncomfortable” refers to anything from a chair with insufficient padding to an awkward social situation.  Maybe the over-full feeling you get after too much pizza.  Uncomfortable.  In medical land, “uncomfortable” is everything short of getting your arm cut off or passing a kidney stone.  It’s more like how spraining your wrist is “uncomfortable” or getting a bronchoscopy is “uncomfortable.”  HA.  It is “bad.”  Simply bad.

Despite the “uncomfortable” nature of the procedure, of course, I was a champ.  That is, if by “champ,” you mean that I hyperventilated, experienced an extreme blood pressure drop, and nearly passed out.  I went through those smelling salts like a champ, that’s for sure.  Aced it.

Then it was over.  I rested for an hour with my book, leaning on my right side as I was told to to help direct the little swimmers toward the good egg (still waiting for an academic paper on that) then we headed out for lunch and a relaxing evening.

And now we wait.

-E


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Countdown?

Alternate title: Dr. C and the tournament of the … doctors. 

Rose bright and early for our daily visit to Dr. C  to be probed and photographed (on the inside! eek! it hasn’t gotten old yet).  Dr. C asked if I was “feeling ovulatory today.”  Yes! I have been directing good, pro-ovulation thoughts all day.  It’s hard work, too.

A brief panic when Dr. C adds “Oh, the follicle is collapsing.”  What?  Collapsing?  Buildings collapse. Civilizations collapse.  Tiny follicles do not collapse.  Turns out it was her fun way of saying that it had an oval shape rather than circle shape.  Really?  Word choice.  Please.  My heart.

At the risk of way too much gross detail, the now oval-shaped follicle is big and strong, and it was ready to be injected with magic hormones.  These magic hormones ensure that it is released in a timely fashion, ideally during business hours.  I hear it’s more effective than our other option, pro-ovulation thoughts + prayer (probably not the best strategy for two atheists).

I survive my jabs (like a champ, no less), we celebrate by buying tickets to Thailand for tonight and eating CPK. (Yes, there is California Pizza Kitchen in Singapore. Globalization is magic.)

Then, problems.

IUI planning is a bit of a math equation, but everyone has a different equation and very strong opinions that theirs is the only correct equation.

 

Bangkok clinic’s equation:   20+mm follicle + 11pm shot + 36 hours + IUI = BABY!

Dr C’s equation: 20+mm follicle + 8am shot + 24-48 hours + IUI = BABY!

 

These are different.  See the differences?  We got the 8am shot, so Bangkok clinic is not pleased.  They have so far suggested that we (a) wait 50 hours to do IUI (not in anyone’s equations), or (b) cancel the entire thing.  Checked back with Dr. C and she said that we could (a) wait 24 hours, (b) wait 36 hours, (c) wait 50 hours, and it wouldn’t matter. We tried to get the two parties to duke it out, but with no luck. Apparently they have other patients, or something.

Then there’s Google.  Everyone on Google also has their own equation. 24 hours is the best!  Oh, well you should do two IUIs, one at 12 hours and one at 36.  You should have sex, then have an IUI, then have sex again. You should get your IUI while standing on your head and reading Shakespeare (okay, maybe not exactly that last one). Pages and pages of very specific anecdotes, which are especially unhelpful because not only is every person is different, only some people are going through the same procedure as us, and even fewer are going through the exact same procedure with unknown fertility background and no fertility drugs. So we have no idea.

On the other hand, this feeling of stress and uncertainty is familiar. We’re back at the place where we usually are – having absolutely no clue what is going on, wishing we had taken more biology/anatomy classes in college, and strongly desiring an authoritative pamphlet.  There should be a pamphlet.  (More on the general lack of pamphlets to follow, I promise.)

– E


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Dr. C and the tournament of follicles

On Tuesday, we had our first appointment with our new queer-friendly OB/GYN at Mt. Elizabeth Hospital!

Dr. C is efficient and respectful and doesn’t seem at all bothered that we’re gay. (I don’t think much fazes Dr. C.) When we walked in together and E introduced me as her wife, Dr. C looked at me and asked, “Are you getting pregnant, too?” After I said no, she pretty much lost interest in me, but in a normal I-don’t-have-much-bedside-manner-and-you’re-not-my-concern kind of way that my dad-friends say they’ve also experienced as the non-baby-carrying parents.

Fair enough. As long as I’m allowed to support E when/where she wants my support. I wasn’t sure quite what to do with myself during ultrasound time, though. Dr. C pulled the curtain, so I hung out awkwardly and tried to get a look at the screen.

And creepily took this picture…

IMG_5401Anyway, the result of the appointment was that E’s follicles were still duking it out to see which one is going to be Egg of the Month. We have another appointment Monday to see if a champion has been crowned. If so, and if it’s achieved a certain level of growth, then Dr. C will give E the trigger shot (some kind of hormone cocktail that makes her ovulate according to a predictable schedule) and we’ll be off to Bangkok two days later for an insemination jamboree!

Things are finally coming together!

-H


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Updates on all the things (with a special guest appearance by Radiohead)

We’ve been enjoying answering your questions lately, but we also want to keep you up to speed on the process. So here are some updates!

On the topic of doctors

We have one! A gay-friendly one! In fact, she delivered our (gay) friends’ baby last year, so we know she’s comfortable with our crowd. At a minimum, she can do the follicle ultrasound thingy we need for the insemination, and if we like her, she’ll be E’s pregnancy and delivery doc. And if we don’t, we’ll have nine months to find someone else from our list.

On the topic of insurance

Yup, still have it. There’s a ten-month waiting period from the time we got insurance until the time the insurance starts covering any kind of maternity care or delivery (except complications to the delivery, which are covered anytime). The ten-month countdown started in early July, so an on-time delivery would now be covered even if we got pregnant today, which isn’t in the cards since we’re going to be really busy tonight watching Masters of Sex and eating tacos. (Also, we’d know if we were getting pregnant today because we’d be in Bangkok in a cold, sterile exam room.) The delivery is the main reason we bought the insurance: cost of uninsured delivery – cost of insurance = ~$5000. Maternity care is pretty inexpensive here anyway, so having the insurance cover any portion of that would just be bonus. So… baby-making can commence soon.

On the topic of my visa status

This didn’t really get resolved, but it did get less dire.

I’m still on the three-month tourist visa just as I have been for the last year, coming and going. When we applied for the Long Term Visit Pass, it was on a new passport since my old one was about to expire. On the plus side, the new one isn’t full of Singapore entry and exit stamps. But we were also worried that my failed application might have put a flag on my new passport such that I’d have trouble getting in again.

To find out before we got E pregnant, we went to Thailand for the weekend a few weeks back. On the way out, we discovered that Singapore Immigration doesn’t have my two passports linked. This was a problem because, in order to leave, you have to show that you came, and I didn’t have my old, voided passport on me. I’d assumed they’d be linked, especially since Singapore is a super high-tech country, but I actually had to go to a special desk and spent 15 minutes explaining the situation to an official who wanted my old passport number and the ticket I flew in on. That was a good discovery because it means my previous entries on the old passport won’t be visible electronically to future immigration officials. (Even an attempt to put my new passport through their photo recognition software only brought up the passport of an elderly Chinese man.)

On the way back into Singapore, the official didn’t give my passport a second glance. So it seems that there’s no flag on it, and I’m probably about where I was a year ago, seemingly on my second social visit to Singapore as a tourist.

With that in mind, I’m still applying for jobs, but I can be a little less frantic about it. I’m also going to the States for a research/writing trip for about a month this autumn, and then back to the States again for Christmas, so I will genuinely look like a frequent visitor to Singapore rather than someone who lives here.

Wow. Bureaucracy is boring. I’m sorry. There really wasn’t a way to spice that up.

But here’s a cool upshot of our visa run to Thailand: we got our Open Water Diver SCUBA certifications!

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(Photos by Jay Chance)

 

Yeah, it might seem silly, but getting SCUBA certified was one of our top 5 reasons for moving to Singapore, and we had to do it before E gets pregnant. Apparently, fetuses don’t respond well to intense underwater pressure (…also, this).

That’s all for updates at the moment. We’ll return to questions in the next couple of days.

-H


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Bull semen!

In Singapore, a doctor may not inseminate anyone but a married woman in a stable, heterosexual relationship. Even then, the sperm must be her husband’s or, if and only if they have demonstrated fertility problems, a donor’s.

We do not qualify. For so many reasons. This left two options: Inseminate E in another country, or play doctor in our apartment in Singapore. We began with the responsible option.

Enter, Google. One of the first hits in our search for fertility clinics in Asia was ivfmiraclebaby.com, a site that sometimes works. We exchanged a few incomprehensible emails with their international representative, and then dismissed them and moved on. This was March.

We spent weeks trawling through sites, ringing up clinics, and researching the laws of every country in Asia, and later, every country within ten hours of Singapore by plane. We made spreadsheets. We despaired. I will save you the details and summarize: there is no country in Asia (except Thailand – more on that in a minute) that will allow its doctors to inseminate a same-sex couple. We might have had more luck in one or two countries if we’d represented E as a single woman, but we hadn’t done that, and I don’t regret that decision. In farther flung countries (Australia, New Zealand, several countries in Europe), it is the importation of anonymous sperm that is not permitted.

In the midst of this search, we began to reconsider home insemination. We’d need to get the sperm shipped to Singapore, through Customs, and to our apartment. Singapore’s Customs website lists all kinds of prospective shipments with their regulations and duties. We learned that we can import bull semen, sheep semen, and goat semen. Human semen is not mentioned.

I emailed Singapore’s Customs Authority and Health Sciences Authority. The HSA wrote back first: “The importation of donor human sperm is not under the purview of Health Sciences Authority.”

Customs disagreed: “The import of human sperm under HS Heading 3001, may be regulated by the Health Sciences Authority (HSA).” They added: “In addition, please be informed that, in general, all goods (including human sperm) imported into Singapore are subject to Goods and Services Tax (GST) levied at 7% of the CIF value (Cost, Insurance and Freight).

In short, no one seemed to know. It’s possible that no one’s tried this before. We abandoned this angle.

Thailand’s laws were more amenable to both the importation of anonymous sperm and the insemination of same-sex couples. Individual hospitals, however, we less eager to help. We were turned away from one after another.

In April, we revisited ivfmiraclebaby.com, which has its clinic in Bangkok, then the site of some relatively small-scale anti-government protests. We arranged a phone conversation with the international representative and made a list of questions. As it turned out, they were more than willing to import our baby-making juice and inseminate E, and the only barrier was language.

Shortly after, we transferred a few thousand dollars into a Thai bank account and crossed our fingers that we hadn’t fallen for some novel variation of the Nigerian prince scam. A few weeks later, we got an email saying that our sperm had arrived at the clinic in Thailand. A month after that, the political unrest became a full-fledged military coup. Martial law was imposed. Foreign embassies discouraged their citizens from traveling to Thailand. We stayed put.

The political situation in Thailand has since been resolved for now. The clinic still stands and is operating normally. If we can find a doctor here to do the ultrasounds required to line up the timing of insemination, we’ll fly to Bangkok in the next few months, meet the staff of ivfmiraclebaby.com, and start making this miracle baby.

-H