TMC PULSE

t m c » p u l s e | m ay 2 0 1 7 20 $45,000, based on her age and experience. Paid in monthly installments, the fee covers her service as a gestational carrier, the IVF transfer, maternity clothing, housekeeping and post-birth recovery. It's a typical business transaction. But the situation with Nora wasn't typical. On top of the required attorney fees and IVF treat- ments, de Luna and Vasquez pondered how to compensate their sister-in-law. "We wanted to make sure she was fulfilled for the miracle that she gave us," Vasquez said. "There's nothing in this world we could ever give her for what she gave us." They offered to pay her cash, buy her a car and a house, but she refused it all. The only thing she asked for was a "mommy makeover"—a tummy tuck and breast lift—after the final delivery. Nora also agreed to a $300 monthly stipend to purchase maternity clothes and supplies for a single preg- nancy, and $400 for a twin pregnancy. While Texas is considered surrogacy-friendly, the state's surrogacy law does not provide any special language for same-sex married couples. Vasquez and de Luna hired an attorney who specializes in LGBTQ reproductive law to help them navigate the legal minefield of contracts and insurance. To prepare for her surrogacy, Nora underwent a mandatory psychological evaluation, followed by an extensive medical examination. The couple's fertility expert, Mazen Abdallah, M.D., a reproductive endocrinology and fertility special- ist with Children's Memorial Hermann Hospital and McGovern Medical School at UTHealth, and medical director of Houston Fertility Institute, performed an ultrasound to check for fibroids or structural defects in the uterus that would raise concerns. Abdallah also did a hysteroscopy to look inside the uterus for scar tissue, polyps or anything that could have been missed during the initial ultrasound. Abdallah explained that, if a woman in her 20s or 30s has been pregnant and has successfully given birth in the past, her chance of carrying to term again is higher than if she had not carried to term or been pregnant in the past. Because Nora delivered three children with no complications, and because she had never miscarried, she was considered a perfect candidate for surrogacy. Then the search for an egg donor began. De Luna and Vasquez pored over nearly 30 different profiles of egg donors, which included a photo of each woman, along with her age, height and com- plete medical history up to maternal and paternal grandparents. Names and personal information were withheld for privacy reasons. Choosing a donor was like browsing through Facebook pro- files until they finally found the right woman. They purchased 16 eggs from one donor, eight for de Luna and eight for Vasquez, for two cycles of IVF. The couple wanted their children to share the same biological mother. "I would go to sleep crying every night because I was homesick and I missed him," de Luna said. In their respective workplaces, the couple spoke in code, referring to each other as "she" or "my wife," out of fear of ostracization from employers and coworkers. It was particularly hard on de Luna. "He couldn't have a picture of me. He couldn't call me. He couldn't do anything," said Vasquez, who works as a project manager for an oil and gas company. "We have to hide who we are because of the industry we work in. On top of having that distance and not being able to see him every day, we have that barrier." After two years, de Luna and Vasquez saved enough money for the surrogacy procedure. They had one major condition: Each wanted the oppor- tunity to be a biological father. Vasquez remembers telling Nora: "I would like both of us to have the chance to have a child. Whether it goes through or not, that's up to the universe." Nora agreed and understood that she would be undergoing two pregnancies, one for Vasquez and one for de Luna, using donor eggs. Nora and Marco already had three children of their own. After their third child, she underwent a tubal ligation, in 2010. But because the embryos would be implanted directly into her uterus, hav- ing her tubes tied would not be an issue. "It's special to me because these are my best friends," Nora said. "For them to want to do this, I was really touched by it." Same biological mother A gestational surrogate mother working with an agency can earn anywhere from $35,000 to Top left: Adrian de Luna plays with the couple's 5-month-old son, Evan. Top right: Enrique Vasquez cuddles with the couple's oldest daughter, Vivienne. Bottom: Twins Evan (left) and Lilienne (right). I know that, biologically, the twins are not my blood, but I'm here. ... When Enrique travels for work, the sleepless nights are mine. — ADRIAN DE LUNA

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