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Having a Child with a Surrogate (1 of 3)

Posted On November 14th, 2008

This article is part one of a three-part series. Click here for Part Two and Part Three.

Reasons to Have a Child with a Surrogate: Bad, Not So Good, and Best

Surrogacy can be a risky endeavor, but not for the reasons most people think: the surrogate will get attached to the baby and keep it for herself, leaving the intended parents high and dry. This does not happen. Unfortunately, the sensational “Baby M” case in New Jersey twenty years ago still resonates.  That surrogacy was a “traditional” one, in which the surrogate was inseminated with the intended father’s sperm, and the child resulting was indeed the surrogate’s biological daughter. Before the insemination, the surrogate signed a contract relinquishing her rights to the child in exchange for money. This contract was unlawful and the courts rightly determined it invalid. No parent can lawfully relinquish parental rights to an unborn child.

Now, however, the vast majority of surrogacies are not “traditional,” but “gestational.” Surrogates, or “carriers,” as we prefer to call them, do not become pregnant by insemination. An embryo is formed with sperm and egg from the intended parents (or donors) through in vitro fertilization (IVF), which is then transferred to the carrier’s uterus for gestation. So the carrier has no genetic relationship to the child, and contracts enforcing the rights of the intended parents are lawful (in states where surrogacies occur). The baby belongs to the intended parents from the start,

 

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Conceiving Through Egg Donation (10 of 10): Signing the Contract

Posted On November 12th, 2008

Click here for Conceiving Through Egg Donation (9 of 10): Confidentiality and Anonymity.

Donor Reserving, Screening, and the Egg Donation Contract

Once you’ve made your choice, signed the contract with the egg donation agency, and paid your fee, your clinic can start the screening process. The agency will typically send an official “match sheet” (with the names of you and your egg donor), and the donor’s complete file to the egg donor coordinator at your clinic. The donor will have to fill out the clinic’s own application as well (obtained through the agency or directly from the clinic). One of the nurses will set up the egg donor’s screening appointments, which may occur all in one day, or broken up into about three separate appointments. Screening comprises a meeting with a social worker/psychologist (an MMPI test, a Minnesota Multiphasic Personality Inventory, is sometimes administered), a meeting with a genetic counselor, a doctor’s examination, and a series of blood tests for infectious and hereditary diseases.  It takes about three to four weeks to get the results back.

Most egg donors pass their screenings. Any donor who does not will be informed by a doctor directly. If your donor does not pass, your clinic will inform you, and your agency should work hard to find you a replacement quickly. If some genetic findings are inconclusive, you will be counseled by your doctor about the possible risks, and may choose to find another egg donor.

 

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Egg Donor Q&A: Donor Egg Retrieval Process

Posted On November 11th, 2008

What happens to donor eggs after they are retrieved? Do I get to know the results? Do I meet the recipients or potential offspring?

After the donor egg retrieval, the eggs are fertilized and then observed for a few days. Not all will fertilize or develop. Between one and three embryos will be transferred to the recipient. If any viable embryos are left over, they will be frozen (embryos hold up better in the freezing process than eggs do). It takes about six weeks to find out if a pregnancy results.

The majority of egg donor cycles in the US at this time are mutually anonymous: the donor egg recipients and the egg donor may know general information about each other, but they do not know each other’s names and they never meet. If working in a mutually anonymous arrangement, you may be informed of the number of donor eggs retrieved, but not the number actually fertilized or whether a pregnancy or live birth resulted. If you are working non-anonymously, you may get more information, depending on the arrangement. Some donors meet their recipients with the supervision of a social worker, and leave the opportunity open to meet any potential offspring. Both parties agree to the anonymity level before the match is made.

 

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Having a Child with a Surrogate (3 of 3)

Posted On November 10th, 2008

This article is part three of a three-part series.  Click here for Part One and Part Two.

BEST reasons to consider surrogacy

I have a serious medical condition (premature ovarian failure, hysterectomy, a genetic issue) that prohibits me from conceiving and carrying a child; I am a single man or a gay man in a relationship and want a child.

In these cases, the need and the commitment, which often go hand in hand, are unequivocal. Our most successful surrogacies involve people who have yet to have any children of their own because of some physical disability. If the egg and/or uterus are not functioning properly or absent altogether, using someone else’s becomes the only way to go (aside from adoption, which is a great alternative but not right for everyone). Furthermore, these are the people who carriers are most eager to help.

Although some doctors will not perform surrogacies for gay male intended parents because they do not consider them legitimate medical cases, there are many who will. NAFG supports gay families and are always happy to help them.

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Read information about our surrogacy program, both for surrogate mothers and intended parents.

 

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Conceiving Through Egg Donation (9 of 10): Confidentiality and Anonymity

Posted On November 9th, 2008

Click here for Conceiving Through Egg Donation (8 of 10): Repeat Egg Donors.

Anonymity and Openness in the Egg Donor/Recipient Relationship

When working with a private egg donation agency, as long as there is mutual consent between egg donor and recipient, the relationship can be as closed or as open as both parties desire.  The idea that the donor and potential offspring would knowingly meet one day instills anxiety in some donors and recipients, and comfort in others. It is a completely personal attitude.

Egg donation has not had the chance to evolve the way adoption has regarding openness and public acceptance. In the past adoption was shrouded in secrecy and anonymity, but now it is commonplace for domestic adopting parents to meet birth parents (typically before the birth), and adoption is celebrated for what it is. There still may be, for some, a stigma attached to egg donation, which creates the desire to keep it private or even secret. After all, you chose an egg donor who resembles you so your child could “pass” as your own. You don’t want your child and other family members to feel he or she is only “related” to the paternal side. On the other hand, secretiveness is unfair to the child and creates an unhealthful atmosphere. Egg donation will never lose its stigma until it is pushed out in the open by brave parents. Not everyone is willing to be a hero,

 

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Egg Donor Q&A: A Woman’s Future Fertility

Posted On November 8th, 2008

Will egg donation affect my future fertility?

No relationship between egg donation and future fertility has been clearly established, although research is continuing.

Egg donation does not deplete your ovarian reserve. Each month you release a number of eggs, but only one comes to maturity, generally. The hormones administered in the egg donation process stimulate more than one to reach maturity. Women in their 20s have hundreds of thousands of viable eggs, although the number diminishes over time.

 

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Conceiving Through Egg Donation (8 of 10): Repeat Egg Donors

Posted On November 6th, 2008

Click here for Conceiving Through Egg Donation (7 of 10): Out-of-Town Egg Donors.

Does Using a Repeat Egg Donor Offer Any Advantage?

The ASRM guidelines allow any one donor to go through up to six egg donation cycles. Any candidates who have donated eggs before should be clearly marked as such on their profiles, for the obvious advantages she offers.

First of all, she knows exactly what she is getting into, and is less likely to have second thoughts about the process of donating eggs. Although she will have to be screened again for her next cycle, you can be assured she has already passed at least one screening, and has no major genetic or psychological issues. Secondly, you will know the results of her previous donations, which need to be good enough to qualify her for another cycle. These results will include the number of donor eggs retrieved, the number fertilized, and if enough time has passed, whether a pregnancy and live birth resulted.

If you choose a repeat donor, her egg donation records will be forwarded to your doctor for review as part of the donor’s screening. If you have any questions about the results, ask the clinic to send redacted records directly to your doctor to get an informed opinion. Don’t jump to any conclusions about the number of donor eggs retrieved or pregnancy results.  Keep in mind that factors beyond egg quality determine pregnancy and live birth.

 

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Is the Surge Working? ABC and NBC Cover the Story

Posted On November 3rd, 2008

The broadcast networks are catching up with this old story about the alleged “surge” in egg donations. In ABC’s video “Egg Donations On The Rise” (shown on Good Morning America), they had one clinic owner testify that applications are up about 50%. However, the piece assumed throughout that anyone who applied could actually donate eggs; it never distinguished between egg donor candidates and actual donors.

This caused some major inaccuracies. Anyone can apply to be an egg donor; only a small percentage, about 10%, will go on to donate. There was no claim that the actual number of egg donor cycles have increased as well. [See my earlier post: Egg Donation and the Economy.]

Another claim, that a “decline in standards” would be an inevitable consequence of this influx of egg donors, is illogical on two counts. First, the bigger the pool of applicants, the more selective recipients and doctors can be; second, FDA regulations for screening are uniform and not a matter of interpretation. The report implied that egg donation agencies screen candidates, but in fact, medical professionals do. Corners are never cut in order to accommodate any candidate; it’s against the law. Although it provided no evidence, the piece implied, however, that these risks are taken. It puts a sensationalistic spin on the story, no matter how erroneous.

NBC Nightly News did a segment (“Surge in Egg Donations Raises Concerns“) which covered the alleged surge in context of the health of the egg donor,

 

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Egg Donor Q&A: Cost and Insurance Concerns

Posted On November 2nd, 2008

What are the costs involved for me and do I need medical insurance?

You are not responsible for any medical costs and any long distance travel expenses will be paid by the recipients.

A special egg donor insurance policy will be purchased for you to cover any complications, whether you have your own insurance or not.

 

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Conceiving Through Egg Donation (7 of 10): Out-of-Town Egg Donors

Posted On October 31st, 2008

Click here for Conceiving Through Egg Donation (6 of 10): Egg Donor Profiles.

Using an “Out-of-Town” Egg Donor

Some egg donors are able to travel to make their donations. Be aware that if you choose a donor beyond the vicinity of your clinic, you will be responsible for all travel expenses, including car fuel, airfare, hotel, food, and other incidentals, including the same for a travel companion in some cases. The egg donation agency will coordinate the donor’s schedule and handle all the arrangements, but will require money ahead of time based on estimates.

The typical cycle for out of town egg donors will require up to three separate trips. The screening requires about two days. A few weeks later, the FDA lab tests will require one day (these may be done in the donor’s home town, depending on the clinic’s policy). The third trip covers the monitoring and egg retrieval, and here protocols vary from clinic to clinic. Some allow nearly all the monitoring off-site at a clinic near the egg donor’s home town. Others require a full five or six days of on-site monitoring leading up to the retrieval. Both you and your agency should contact your clinic’s egg donor coordinator to find out their protocols.

Travel makes the process more complicated and expensive, but they can be worth it to work with the donor you want.

 

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