Egg donor agencies, egg donor services, fertility clinics at Donor Network Alliance!

By Mary Ellen McLaughlin

We recently came across a thread in a Yahoo discussion group from a would-be gestational surrogate. She had completed an agency’s questionnaire to become a surrogate. And while she understood the rationale for the questions (many of which appeared on the surface to be quite intrusive), there was one that had her puzzled for its relevance: “What is your religion?”

That’s a pretty typical question for agencies to ask. It points to the depth that principled and discerning agencies will go to in vetting prospective surrogates.

The religion question can relate to any number of considerations – beliefs that may influence a decision on selective reduction, for example. And, let’s face it, for both Intended Parents and prospective surrogates, religion may be a sticking point whether it’s relevant to the task at hand or not.

Taking a deep dive into the prospective surrogate’s background, beliefs and support network is absolutely essential to ensure she’s emotionally up to it – and, equally important, is a responsible individual who surrounds herself with people who share her principles and behaviors.

The stories about con artists who hold the baby for ransom are the exception, but they’re the ones that people remember. Not surprisingly, they weren’t properly vetted. We’re not about to take that risk.

A typical surrogacy application form can run up to 20 pages. It’s the first screen; subsequent ones include interviews with the agency’s staff and, preferably, independent mental health professionals. It is not something to be completed in an hour, or even a day. Are the questions intrusive? Some are – of necessity. And prospective surrogates should expect no less given the very important role they’re applying to play.

It asks for the candidate’s and her husband/partner’s five-year employment history and educational backgrounds. It asks about family structure – how many children and their ages, and the support network. It asks whether the candidate or her partner have criminal records or substance abuse histories. It asks health questions including a medical and pregnancy history, ranging from how the applicant relieves stress, to whether she’s had an HIV test and the results, to birth control methods and delivery experiences.

And it asks questions to gauge the candidate’s emotional state. What are her hopes, wishes and expectations? Will she work with same-sex couples or unmarried couples? What are her strengths and values? How does she manage difficult times or experiences? Her partner is asked to share feelings about her taking on this role, and how the partner’s family would feel about it, as well. Descriptions of the couple’s children are solicited, along with how they will be prepared and involved in the process.

They’re also asked about issues that must necessarily be grappled with: How will you deal with relinquishing the baby to his or her parents? How do you feel about future contact with the child and his or her parents? How do you feel about carrying multiples, and the issue of a selective reduction if you’re carrying more than two fetuses?

This is only a sampling of the ground covered in the surrogacy application form. It is exhaustive, though we prefer to think of it as thorough. But that’s what it takes to make sure the surrogacy experience lives up to its promise for everyone involved.

By Robin von Halle

We normally stay away from politics in this blog. Religion, too, for that matter.

But a very troubling movement has been stepping up the pace lately.  Some legislators at the state and national level are proposing measures that would severely cut away at women’s reproductive rights.

Fertility. Infertility. They are opposite sides of one coin. And these proposals have implications for both of them.

Here’s how blogger Keiko Zoll, a self-described “infertility advocate” put it:

“…Infertility patients need to pay attention to healthcare legislation, particularly anti-abortion legislation. Anti-abortion legislation, in a cruel twist of fate, can pose a serious threat to our access to care. Here we are, trying our damndest to have our own children, and yet (I know how ironic this sounds) we need to be vigilant about others’ rights and access to terminate their own pregnancies.”

In Iowa, proposed legislation would define life as beginning at conception, effectively making abortion illegal there. What would that mean for infertility patients? It would mean that if all the eggs collected were fertilized during an IVF cycle, it would be illegal to dispose of any of them, even those not biologically suited to be transferred to the uterus.

In opposing the legislation, the American Society for Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART) pointed out:

“In human reproduction…fewer than 20% of fertilized eggs implant in the uterus. Given the uncertainty…it is unreasonable and imbalanced to give constitutional rights to fertilized eggs or embryos. HF 153 would result in a requirement that all embryos be used for procreation purposes, or be kept in a frozen state forever. We question whether it is the intent…to grant those frozen embryos the right to vote upon reaching 18 years in frozen animation?”

Similar “Personhood” legislation is sweeping across North Dakota, Montana, Texas, and Oklahoma. Then, there’s Georgia, where a bill would require any miscarriage, whether in a hospital or elsewhere, to be reported and investigated. And, of course, there’s the de-funding of Planned Parenthood, a much-needed resource for overall women’s health services going far beyond abortion.

We’re a small business. We don’t have a political action committee. We just want to help people create families, finding and matching them with egg donors and gestational surrogates. But as part of the larger community, we all need to be aware of changes in the environment that might affect both sides of the reproduction coin. And be prepared to give voice to our concerns.

What kind of guidelines are out there for gestational surrogates and intended parents? Does it vary state by state? These questions and more are answered by Mary Ellen McLaughlin, partner and surrogacy expert at ARR. Watch her explain surrogacy guidelines in the video blog below:

Have questions about surrogacy? Mary Ellen McLaughlin, ARR partner and resident surrogate expert, has the answers. McLaughlin busts the many myths surrounding the gestational surrogacy process through her new series of online v-casts. Check out the first one here:

By Robin von Halle

I don’t know whether to put it down to the general public’s prevailing ignorance  about gestational surrogacy and egg donation or shoddy and sensationalist reporting, particularly by the British press.

But the news coverage, especially in Britain, of the birth-by-surrogate over the holidays of a baby boy to rocker king Elton John and his partner David Furnish was pretty stunning on all counts.

The revelation that the child actually had (gasp!) two “mystery” mothers! And now, two fathers!  The fact that nothing is known about either “mother,” like their background, religion, marital status or rights to the child. That it’s not illegal for millionaires like Sir Elton to “buy” a baby in California, which, one piece proclaimed, had the most forward-thinking surrogacy laws in the U.S.

With all the exaggeration by the U.K. popular press when a celebrity utilizes assisted reproductive technology (ART), it’s a small wonder that the laws there concerning these advances remain restrictive.

We’ve been in this business nearly 20 years, and have watched the possibilities with ART, attitudes and the legal landscape change dramatically in that time, at least here in the States. Yet the misconceptions just seem to hang on.

Of course, the background, religion, marital status of the surrogate are largely irrelevant, at least in terms of the child and its future. With gestational surrogacy, the woman who carries the child has no biological connection to it. In terms of the egg donor, what’s typically most important to intended parents are the donor’s genetics. She has no more “rights” to the child than a sperm donor would, and understands that going into the process.

In California, case law has provided some guidance as to children born of gestational surrogacy. Illinois, which truly has been at the forefront with its surrogacy friendly laws, has provided protection for all parties in this arrangement. Intended parents are recognized as a child’s legal parents from the moment that child is born without an adoption or court proceeding so long as the requirements of the act have been followed and at least one of the parents is the genetic parent of that child.

Right now, we’re seeing a substantial increase in prospective parents who can only achieve parenthood with the help of a surrogate. It’s a challenge. It takes a very special person to agree to carry someone else’s child for them. And there are never enough surrogates to meet the demand.

The media scrutiny and its role in perpetuating myths only compounds the problem. Maybe it will take more first-person stories, like the New York Times’ “Meet the Twiblings” piece, to help put it all in the proper perspective.

Birth certificates are a tricky issue in the process of surrogacy. When a surrogate gives birth, can an intended parent’s name be put directly on a child’s birth certificate or must the parent legally adopt the child?

Surrogacy is illegal in several U.S. states. If you have chosen surrogacy as your reproductive method of choice, where do you go from here? Our legal expert, Nidhi Desai, explains your options below.

The U.S. represents state-by-state patchwork of laws, some restrictive, some liberal, when it comes to egg donation and surrogacy. What can you do if surrogacy is illegal in your home state? Nidhi Desai, an expert in this area, discusses your options in the first of a series of video FAQs. What have your personal experiences been? We want to hear from you!

What states in the U.S. are surrogacy friendly?

By Mary Ellen McLaughlin

A new documentary called “Eggsploitation” presents the stories of three women who went through the egg donation process and experienced rare complications, such as a stroke, cancer (which has not been proven to be related) and ovarian hyper-stimulation.

It claims the fertility industry does not tell egg donors of the complications and risks. Of course, it’s one-sided and shades the truth. It’s controversy that sells, right?

The fact of the matter is that any medical procedure involves some risk, and egg donation is no exception. Any woman thinking about donating her eggs certainly should be informed by her agency of the risks, and of signs that she may be experiencing complications. The agency that doesn’t explain them is extraordinarily careless and unprofessional. But given my years in the field and the number of agencies we know, I’d also say that would be the exception to the rule.

Our agency repeatedly goes over these risks and complications with prospective donors. We, like most agencies and fertility clinics, also give them pamphlets to ensure they learn the signs and symptoms of complicating health issues.

But honestly, as much as we coach and advocate and inform our donors, we’ve always found that our donors are their own best advocates, and very much aware of the downsides as well as the up. We have to wonder about the women profiled in Eggsploitation. Were they truly so unaware?

Here, because it bears repeating, are the most common complications from egg donation:

• Ovarian hyper-stimulation syndrome, which is commonly caused by fertility medications. It usually occurs after retrieval, generally within the first week. Some of the signs and symptoms are rapid weight gain, abdominal distention, difficulty or painful respirations, decreased urine output and dehydration.
• Ovarian torsion, which is when the ovary rotates. It can occur at any time after the procedure due to increased ovarian size, this is why decreased physical activity is prescribed right before and after retrieval. Signs and symptoms are severe one-sided abdominal/pelvic pain.
• Bleeding and/or infection, which only occur after the procedure. Bleeding into the abdomen or vaginal wall is usually followed by an infection. Signs and symptoms are abdominal/pelvic pain, increased abdominal girth and fever. Infection by itself will cause fever accompanied by abdominal/pelvic pain.

In the 15 years I have been working with egg donors, less then 1 percent has experienced any complications. Many of these women donate to help others create a family and they’re willing to forge ahead, fully informed of the risks.

By Mary Ellen McLaughlin

A recent article in the National Post highlights an issue in the fertility industry that is ripe for discussion. A couple that had turned to surrogacy after failed infertility treatments subsequently urged their surrogate to get an abortion after doctors found abnormalities in the fetus. The surrogate initially refused.

One quote in the article really stood out. “The physician…said it appeared to him that the three had never seriously considered such a scenario before the pregnancy.”

Wow. When intended parents and prospective surrogates meet for the first time, it’s ideal for them to get along and have a warm fuzzy feeling about each other. But at the same time, this is an arrangement that requires a legal contract. It’s essential to like each other, but it’s also essential to make sure your interests are protected. Every scenario, no matter how small, should be taken seriously.

Luckily, this type of situation is rare. We at ARR have been lucky (okay, careful) enough to have never had a situation in which these issues were not thoroughly considered prior to pregnancy. We work with both parties to ensure they discuss and agree on issues like abortion and selective reduction before taking any next steps. It’s something we take seriously – and so should anyone taking this journey. (Read a surrogate’s blog post on the hard choices surrogates and parents often must make.)

This is one of the most intense conversations these three adults will share.

Our psychologist encourages both parties to first discuss abortion and selective reduction with their support network, which is the first place they’ll turn if the situation ever arises. They’re encouraged to discuss their beliefs openly. The reality is that while they may get along beautifully, if they don’t share the same views on these sensitive issues, this partnership will never work.

No one ever wants a situation like this to happen. Intended parents and surrogates need to be prepared for all types of outcomes, whether it’s abortion, selective reduction, miscarriage, or, hopefully, a happy, healthy baby.