Q~~ I have a question that may be a sensitive one regarding Selective Reduction. Who makes the reduction decision? (where there are no medical issues compelling a reduction)Can the IPs and surro make the decision together? Wat if they disagree? It's her body but it's our baby - such a difficult issue. ~EM
A~~ Selective Reduction should be talked about before the first transfer takes place and it is often mentioned in the contract as either something that would be considered and what the fee for the surrogate (for recovery, pain and suffering) would be if she had to endure such a procedure. Your RE/Clinic should have the discussion when first meeting a surrogate as well. If she is petite and obviously would have a physical problem carrying anything over triplets then they may highly recommend that you reduce anything over twins. Even if the RE only transfers 2 embryos they could split into triplets or more. It seldom happens but its always good to be aware. So for the health of the surrogate, Selective Reduction could be highly recommended under those circumstances.
Another issue would be what the Intended Parents want to raise. They may not be financially or emotionally capable of raising more then twins (and I am using twins here because it is very rare for twins to be reduced down to a single fetus because the entire pregnancy could be lost). If the Intended Parents are set on having no more then twins, they have to find a like minded surrogate that doesn't have a religious or ethical issue with selective reduction.
The bottom line here is that the surrogate can change her mind in either case. She can decide that she isn't able to selectively reduce when she is faced with the actual fact of multiples and decides to carry them even against Dr. orders or what she previously agreed to in the contract OR she decides not to selectively reduce because of a change of heart and the reality of an abortion is too hard for her to consider. On the other hand she may keep the entire pregnancy even against the 'carrying more then twins' issue as stated in the contract when faced with a 'litter' of babies and considering all health risks, continues to want to keep the pregnancy in tact, although at the time of the contract she was sure that she would want to reduce. In either case it is ultimately her decision as Selective Reduction is, in reality, abortion and any pregnant woman has the right to choose under Row vs Wade.
Over recent years medical research has pointed out the benefits of reducing the number of embryos transferred during the IVF cycle with a marked reduction in the number of higher order multiple births. ORLANDO, FL, February 22, 2009 /24-7PressRelease/ -- The Egg Donation and Surrogacy Professional Association (EDSPA), as a multidisciplinary organization that promotes cooperation, education and professional ethics in the matters of gestational carriers, traditional surrogacy, egg, sperm and embryo donation, and related areas, would like to support the further investigation by the medical and legal community into the circumstances surrounding the conception of the octuplets and ethical practices that were involved.
Over the last decade, the American Society of Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART) have worked diligently to reduce the number of high order multiple births resulting from IVF treatments. They have produced guidelines restricting the number of embryos transferred during IVF. Published research confirms that these guidelines have led to fewer embryos being transferred and a marked reduction in the number of high order multiple births.
EDSPA Board of Directors: Robert T. Terenzio, Esq., Chairman of the Board Evelina Weidman Sterling, Chair Education/Consulting Souad Dreyfus, Chair Egg Donation Sharon LaMothe, Chair Surrogacy Andrea Bryman, LMFT, Chair Medical/Psychology Marna Gatlin, Chair Non-Profit Theresa M Erickson, Esq., Chair Member at Large
The Egg Donation and Surrogacy Professional Association accomplishes it's mission by providing a forum for education, communication and advocacy on behalf of patients, physicians, attorneys, agencies and affiliated professionals in the field of Third Party Family Formation.
I receive the DAILY OM and I wanted to share this one with you! Enjoy and Happy Sunday!
With all that takes place in our lives, it can sometimes be easy to overlook the fact that we’re part of something greater than ourselves—a collective consciousness, the Universe, a greater cause. Because of our tendency to forget this, we might make decisions in our lives that don’t reflect that responsibility that comes with this belonging. All too often, we focus just on the short-term, tangible gain to ourselves without worrying about its consequences. Other times, we may discard the greater cause because it seems like “hard work.” The challenge is to expand our minds so that we transcend the distinction between self and others, so we are aware of how our choices and actions can impact a greater cause.
Contributing to the greater cause doesn’t have to be all about self-sacrifice. For example, if you plant a tree in a community space, its shelter will cool and protect you as well as your neighbors. Or, your reward might be in the form of the beauty that you now see in that space or the sincere smiles of appreciation from neighbors. When you serve the greater cause you also serve your greater good. There is nothing that you cannot do for your highest good that will not benefit the good of all. For example, saying no to a relationship that isn’t right for you not only benefits you but serves the greater good of the other person that you are honoring with your honesty. Saying yes to your dream job not only fulfills you but also serves the people that will benefit from your enthusiasm and productivity.
When you know you are serving a greater cause, there is little room for fear and doubt. You know that what you do will benefit others, so there is no way the universe is not going to support your efforts - even if sometimes it may not look that way. Serving the greater cause allows you to live from the space of your greatness. When you know that what you do can serve a greater cause, you are aware of your power and ability to influence and create change in this world.
A Year of Guided Meditations is a series of 52 guided meditations featuring profoundly positive principles and ways of becoming your highest self. Every week for a year, you will receive a new guided meditation spoken in a soothing voice along with a beautiful musical background and stunning video images of a nature. These high-powered "Be-Attitudes" are ideals and values to strive for.
Women warned not to freeze their eggs for social reasons
William Fletcher Progress Educational Trust 09 February 2009
The UK's Royal College of Obstetricians and Gynecologists and the British Fertility Society have released a joint statement expressing serious concerns about women who freeze their eggs for non-medical reasons such as pursuit of their career. The success rate for pregnancies involving eggs that were frozen is very low and babies conceived in this manner may be less healthy than those from fresh eggs.
'The image that's portrayed is that a woman in her late 20s or early 30s can establish a relationship 10 or 15 years later and then take the eggs out of the freezer, fertilize them with the partner's sperm and have the baby', says Professor Bill Ledger, a professor of obstetrics and gynecology at Sheffield University and a member of the Human Fertilization and Embryology Authority (HFEA). 'The chance of a baby from a frozen egg with vitrification is less than 6 per cent per egg. By doing the egg freezing for social reasons, they are taking a huge gamble for their future', he added.
As well as low success rates Professor Ledger pointed out that babies that are born from frozen eggs could be less healthy than those conceived from fresh eggs and warned that: 'We should be very careful about performing medical procedures on healthy people'. He believes that is ethically questionable for women to freeze their eggs purely for 'lifestyle reasons' but added that it was legitimate, for example, for a young woman with cancer to have her eggs frozen before chemotherapy seriously damaged her potential to bear children.
The draft regulations to implement the Human Fertility and Embryology Act, as amended in relation to the storage of gametes, state that gametes (oocytes in this scenario) can only be stored for ten years. Unless during that period the person for whom the eggs are stored has, or is likely to develop, significant and premature infertility, this period cannot be extended. Egg freezing beyond this time at any of the 41 infertility clinics in the UK where this service is offered is therefore excluded for any non-medical reason.
Despite this time limit, 33 women chose to freeze their eggs for non-medical reasons in 2006, according to official figures from the HFEA. However, this figure more than doubled to 78 in 2007, even though the procedure is expensive at a cost of about £5,000.
So I have a question....perhaps it will turn into several questions but that's how it goes with me.
I am wondering about this trend to have young women, albeit those who have the financial wherewithal, freeze their eggs way before they are even thinking of becoming mothers. I am all for getting the word out there to the girls and young women regarding the biological clock and educating everyone on what can affect fertility in general, however, I am uncertain of the push to freeze eggs for 'just in case'.
Just in case.....
You don't find Mr. Perfect before your clock stops ticking
Just in case.....
You catch a STD that makes you infertile
Just in case.....
You find out later in life you are infertile or have cancer or have a medical condition that effects your egg production
I am sure that there is a longer list but for those young women who are healthy now, will fear of their fertile future drive them into undergoing an egg retrieval and the yearly cost of keeping their precious DNA frozen? And after they become pregnant on their own will they have the emotional dilemma regarding their now 5 or 10 year old frozen eggs? Will those eggs be destroyed? Will these women now be asked to donate them? What about the woman who doesn't get pregnant on her own and wants to use her eggs....will she be able to even afford the IVF procedure? The medications? What will that option be like over the next decade? AND what happens when the frozen eggs don't result in a pregnancy? What then?
I told you that I may have more then one question.
I have a 13 year old daughter. She knows all about Egg Donation, Surrogacy, and IVF (At least as much as she may want to know) I have given her every vaccination, protected her from exposure of toxic materials (No smoking in OUR house, please!) and generally have given her the tools to keep herself safe. I am drawing the line at freezing her eggs. Because she is a healthy young teen, I see no need of it. If she is unfortunate and is found to have cancer or some other life threatening disease then I may encourage her to freeze her eggs at that time. But for young, healthy women, I think education and fertility awareness is a must. The rest? I am not so sure about.
I was going to stay far away from commenting on the new Mom of octuplets (BTW that word isn't even on my spell check!) But I feel compelled to weigh in. Nadya Suleman is now the mom of 14. She could, just as easily, been the mom of 7 or 8 if those 6 embryos hadn't split and each and every one hadn't grown into an individual baby. And now they are born and every single person who hears this story is appalled. With the exception of Nadya Suleman. Although she couldn't take care of the first 6 children without the help of food stamps and disability checks (coming in for three of the previous children) and apparently student loans, yet she somehow found the money for the medications and the IVF procedures that have catapulted her into the media's front line with a bang. Eight little bangs I should say.
Ok....what would have happened if Nadya Suleman's IVF procedure had only produced twins or even triplets? I don't think it would have been a blip on the reproductive radar. Certainly not competing for air time along with the new stimulus package and massive fires in Australia! Would anyone really have cared about the fact that this new mom couldn't take care of what she already had? I doubt it. I bet her RE wished that she didn't even darken his door! Perhaps he didn't think all of the embryos had a prayer quality wise. Or Perhaps he wanted to boost his stats. I don't have enough information to judge. But now he and his practice is also under scrutiny as he should be.
I take you back to a post I did, in November I believe, when I returned from the ASRM conference in San Francisco. I was in line to register and was talking to one RE while another Dr, was listening in. I mentioned that I had been a surrogate mother twice and gave birth to two sets of twins. The Dr, who was listening asked how many embryos were transferred and I told him 3 each time. He was instantly disgusted and any Dr, who would transfer 3 embryos as a time! The older RE then asked how old I was for each transfer and I told him at the time of transfer 36 for the first set of twins and 40 for the second....well that did clear the air a bit because there ARE guide lines regarding how many embryos should be transferred depending on the age of the woman. Obviously these ASRM (American Society of Reproductive Medicine) guidelines were not followed in the case of Nadya Suleman.
And because of that fact, we (and I say WE as in the tax payers) have 8 preemies hanging out in CA while the world debates how the US reproductive industry could have allowed THIS to happen! Well folks, we have no regulation. We have guidelines, we have associations and reproductive societies but we don't have the type of regulation that other countries have. Nor do I think that would be the answer. EDSPA, the Egg Donation and Surrogacy Professional Association, is one place where self regulation is being discussed. I believe the ASRM is also a place that has its members practicing self regulation as well as other groups out there. BUT no one can control what one RE is doing. Or Surrogacy/Egg Donation agency or Embryo Donation agency for that matter.
There is a cry out there that says why didn't someone send Nadya Suleman to a psychiatrist. Its common that a surrogate or egg donor have a psychological evaluation but not Intended Parents who are infertile. It doesn't make much sense to have each and every IP who enters a facility with the notion of adding to their family through IVF to be psychologically evaluated (although a few visits with a mental health professional would be a good idea), it still would be prudent for the clinic staff to compile some back ground and use their common sense when choosing who to work with. And if they are unsure then maybe call in a psychologist for a 2nd opinion.
Back to my topic...sorry for the trip around the world....nothing can be done regarding Nadya Suleman. Her babies are here. But maybe we can all learn a lesson about "proceeding with caution" and, as professionals, knowing when to say NO.
When I read this Special Feature I knew that I needed to pass it along and the response back was tremendous. Really, this article drives home that its the simplicity in the telling of the facts that will make the answers easier to understand.
In this Special Feature, Dr. Bergman discusses the mechanics of being a happy, healthy, gay family.
I have to confess upfront that this is one of my favorite subjects. I study it. I counsel parents about it. Most importantly, I live it, together with my partner and our two amazing girls. What follows represents a summary of my opinion however, I urge you to contact me directly for more information.
What you have to know at the outset is that your baby is going to be born to you not knowing anything about the world. Your baby won’t arrive with any opinions about how things are supposed to be. They arrive ready to be guided by you as to what’s right and what wrong. They don’t show up questioning what’s missing.
Gay parenting, and surrogacy is not about something missing. It’s not about something’s wrong. It’s not about saying, “We couldn’t do something this way so we had to do it this other way.” It’s not about loss as perhaps adoption can be. There’s no loss. No one has given anything up. It’s about creation.
As far as your child knows, you and your family are complete. Everything that your baby gets about your family, is going to come from you. Eventually the world around you seeps in, but mostly, it’s up to you to help them make sense of their lives.
For this reason, I believe it is profoundly important that you get comfortable with who you are when you have kids. Your level of comfort or unease translates to your child. You set the level.
The story that you tell your children is going to be their truth – nothing else. You can invent that story anyway you want.
Here’s my favorite story:
Daddy and Papa fell in love and got married and lived together and loved each other. We had so much love that we really wanted to have children to share it with.
To have children you need three things:
A Uterus An Egg A Sperm
Daddy and Papa had the sperm, but we needed an egg and a uterus. So, a very nice woman gave us her egg and the doctor mixed it with our sperm. Then the doctor put that inside the uterus of another nice woman who very kindly allowed you to grow there for nine months.
When you were born, you came out of her uterus and into our arms. We took you home and you were our baby.
Simple, clear and truthful works best.
People always ask, me
“When should I start telling that kind of story?”
I say: the day your child is born.
You start telling the story even before the child can understand it and there is never a question about what happened. You tell the story in developmentally appropriate terms – so maybe you are not going to say sperm and egg and uterus to a two year-old or four year- old. The thing to remember is to tell the truth that’s developmentally appropriate.
“Who can I consult about what’s appropriate?”
Me. This is my area of expertise. This is my passion.
Surrogacy is a story of people who want to be parents. It’s the story of someone who needed help assembling all the ingredients. It’s a story of collaboration, love and intention. It’s a beautiful story.
Will your child say: “How come I don’t have a mommy?”
When you are a parent, you realize that children always say stuff like that. “How come I don’t have a mommy?” flows right along with, “How come I don’t wear glasses?” “How come our house is smaller than their house?” “How come I don’t have a dog?” “Why can’t I have a horse?”
When our kids ask such a question, too often, we make that mean, “Omigod! They’ve figured it out that something’s wrong with our family!” That doesn’t have to be the case. We don’t panic when our children ask us, “How come I don’t have a dog? Why can’t I have a horse?”
If we are not intentional with our response and comfortable with who we are, that’s when we have a tendency to inflate the importance of these questions. We end up adding negative meanings because we are scared we’re doing something wrong, but we’re not.
When your kid says, “Why can’t I have a horse?”
You can easily say, “I hear that.” “I know you’d like to have a horse. I’d love to have a horse, but we don’t have a horse.” “We can’t have a horse.”
I know from experience that when your child asks, “How come I don’t have a mommy?” you can easily and truthfully answer, “Because you have two daddies.” It really can be that simple.
What do you need to be a healthy gay family?
Openness Honesty Humor
There’s no need to get defensive or scared. Your family is whole and vibrant. You are not coming from a place of scarcity.
You will probably need one other thing. The willingness to take a stand for your family everywhere you are.
Let’s say, you’re in line at the grocery store with 52 little old ladies or men in business suits or teenage hoodlums even, and the checkout lady says to your child “Oh you have such cute blond hair! Your mommy must have blond hair.”
What does taking a stand mean? It means, you, saying in front of that whole entire line of people, “He doesn’t have a mommy. He has two daddies.” That’s what it takes, everyday, everywhere you go.
My partner and I take this approach. What we end up with is my kids correcting people all the time. You say in public to one of my kids, “Oh, you have such pretty, green eyes. Your daddy must have green eyes.” They will say, “I don’t have a dad, I have a sperm donor.” They are as matter of fact as can be. My kids have been saying that since they were three years old.
I don’t mean you have to be on a soapbox. I just believe that you must tell the truth and not allow lies.
When you’re in line by yourself, you can say whatever you want. By yourself you can choose to be “in” or “out.” You don’t have that choice in the presence of your child. If you fail to take a stand, if you don’t say, “She has two daddies,” what your child hears is, “We are pretending that I do have a mommy because I should have one. We are pretending because there’s something wrong.”
So, don’t pretend like you didn’t hear it. Make the correction. Being a gay family doesn’t mean you are “political,” that may not be your intention. In truth, however, it turns out to be political sometimes.
Everyone always loves to ask:
“Aren’t you worried that when your kids get a little older they’re going to have really big problems with gender identity and sexuality?”
No. I’m not worried about it at all.
The research that’s been done (which isn’t very much) consistently shows that the children of gay and lesbian parents are just as well-adjusted as everyone else and more flexible. Gender identity seems to be internal. You have heard the classic example, right? Most gays and lesbians were born and raised by straight parents.
But still, won’t your teenager be ashamed to have gay parents?
Don’t panic though. Teenagers are ashamed about everything having to do with their parents. Adolescence is about individuating, differentiating and independence. The way that children work through this stage is by pushing against the thing they’ve been so close and connected to. That’s you, their parent.
It really doesn’t matter. Being a gay parent is just as much a pretext as anything else that’s going to embarrass them.
Whatever it is - You’re too strict. You’re too liberal. You dress badly. I even have kids in my practice who are embarrassed because their parents work out and are in great shape.
They will find something. The upside is that being the gay parent of teenager is not going to be worse. The downside is that it’s probably not going to be better.
How do you cope?
You develop a foundation of trust and respect. You instill these values in your child from the day you get them in the hospital. You repeat that they are the most wanted child in the world. You tell them the story of all the planning, the collaboration, the intention and the love that went into their creation. Your child will realize, there may be something different about your family, but there’s nothing inferior or wrong.
They’ll come out the other side of adolescence and love you again. Keep your checkbook handy.
Because I am away on vacation, I thought it would be nice to reprint this while I'm out of town. Great information from Robert Terenzio, a Reproductive Attorney located in central Florida.
Finding the right attorney, handling conflicts, and more
After a long hiatus, Conceptionsis finally back with another interview. This month’s subject is Robert Terenzio, a reproductive law attorney in Orlando, Florida. Robert’s practice, Reproductive Alternatives, specializes in surrogacy arrangements and egg donation. He also helps Sharon LaMothe (a former Conceptions interview subject) run Infertility Answers, an educational clearinghouse for fertility issues. He graduated in 1991 from Quinnipiac College School of Law in Connecticut.
In this interview, we discuss how reproductive law has evolved, statutory differences among states, and why it’s so important to have an attorney.
[Interview edited and condensed by Cheryl Miller.]
It's always interesting to me to see exactly what the human embryo cell(s) looks like. I thought I would share these two photos with you for something different! I am fortunate to say that I have had the privilege to see many embryos on the day of transfer and approximately 40 weeks later witnessed the birth of those very same embryos as beautiful baby boys and girls! (four of them being my own surro-babies)