Posts Tagged ‘infertility’

North Dakota Considers Law that May Hurt Infertile Couples

Monday, March 21st, 2011

Reproductive rights is an area I’ve touched on several times before, and I have even published an article on Huffington Post on this topic. Now, a recent AP article details yet another anti-abortion proposal that could have significant impact on the growing number of couples seeking advanced reproductive technologies (ART) as a result of fertility issues.

The article discusses an anti-abortion proposal being considered by North Dakota lawmakers asserting that a fertilized egg is a human being. Although this is an attempt to make abortion a criminal act, those quoted in the article, as well as many of us working in the infertility industry, know that a bill like this could hurt infertile couples.

If you really take a look at the IVF process, it’s not difficult to see exactly how this might impact ART and those using these technologies to build a family. Because of the extremely costly IVF process, drugs are used to stimulate a woman’s ovaries to produce multiple numbers of eggs – assuring couples enough eggs to “work with”. All of these eggs are fertilized in the hope that some of the resulting embryos will be healthy enough to implant into the womb of the intended mother. Next, a decision must be made as to what will be done with the fertilized eggs that are not transferred. The choices are to cryo-preserve (freeze) the fertilized eggs, donate them to science (most likely for research purposes) or discard them. This law could effectively criminalize this portion of the IVF process, threatening eventual legal action against those health care workers responsible for this part of the procedure. The IVF process would be even costlier and have a much lower success rate without this decision-making authority on the back end. And even more disturbingly, its criminalization would certainly mean the loss of practicing physicians — many of whom have raised the bar of this specialty to a level unmatched in the world — for fear of criminal action as a result of their participation.

Moreover, many couples who carry genetic disorders which could be passed on to their offspring utilize IVF along with pre-implantation genetic testing to select embryos unaffected with life-threatening diseases. Under this law, they might not be able to do so. It’s reasonable to assume that the process of testing the fertilized eggs for genetic disorders and the subsequent decision to not use affected fertilized eggs would be outlawed. The couple would then face the painful choice between a life without children of their own or the possibility of having a baby destined for a short and painful existence, being cared for by parents who may not have the resources for a gravely ill child.

The AP story discusses how doctors recently testified to the North Dakota Senate’s Judiciary Committee that this bill could affect not only couples using in vitro fertilization to try to have a baby, but also women who have complications in early pregnancy that will prevent an embryo from developing into a viable baby. Such complications include an ectopic pregnancy, a dangerous condition that happens when a fertilized egg begins growing outside the uterus.

The measure implies that a fetus, from the time of conception, could be a victim of homicide, assault or reckless endangerment. In those cases, it includes exceptions for “medical treatment for life-threatening conditions;” in vitro fertilization, in which an egg is fertilized outside the woman’s body; and morning-after contraception.

Although the measure exempts in vitro fertilization from criminal penalties, it includes language saying that “causing injury to a human being” is not justified. Seems like a very slippery slope to me.

What do you think?
–Nazca

Surrogacy Case Coverage Doesn’t Tell Whole Story

Monday, January 18th, 2010

I’d like to argue the old adage that all publicity is good publicity. As I discussed in my last entry, the extremely unfortunate surrogacy cases recently playing out in Michigan and New Jersey continue to command headlines. Last week, the Wall Street Journal ran a story called Surrogacy Battles Expose Uneven Legal Landscape. While I certainly can’t disagree with the premise that favorability of surrogacy laws varies widely throughout the U.S., the approach to mainstream media coverage of this industry continues to frustrate me.

I guess I understand that the few unfortunate outcomes seem more interesting to some than the greater majority of positive surrogacy outcomes, but the media continues to leave out possibly the most important view – that of the real and participating players in this complex and self-regulated industry.
Although the legal scholars and think tanks quoted in this article bring a very well-educated and informed perspective, they should include the perspective of reputable agencies and other professionals literally in the thick of this on daily basis. I think all of them would tell you that many (if not all) of the well-established industry protocols put in place to protect all parties in a surrogacy relationship were tossed aside in this case, as well as all of the others that have made headlines recently.

Check out the article and share your perspective. –Nazca

Unfortunate Michigan & New Jersey Surrogacy Cases & the Advantages of the Illinois Gestational Surrogacy Act

Wednesday, January 6th, 2010

Happy New Year! I have great hopes for 2010 and think it is going to be a fortuitous year for people seeking alternative family-building options and the third-party reproduction industry in general.

But, first, I need to discuss two rulings involving gestational surrogacy outside of Illinois and assure intended parents and gestational surrogates alike that, as long as the requirements of the Illinois Gestational Surrogacy Act are satisfied and you work with a reputable agency, similar situations should not occur in this state.

For those of you who haven’t read about these cases in the New York Times or elsewhere, the first took place in Michigan and involves a married couple who, after years of infertility issues, turned to surrogacy. To create their family, they used an egg donor, anonymous sperm donor and found a gestational carrier, who already has four children of her own, to deliver the baby.

A month after the birth of twins, a police officer supervised as the couple was forced to relinquish their infants into the custody of the gestational surrogate who gave birth to them. While the surrogate has no genetic link to the babies, neither do the intended parents and the surrogate was able to obtain a court order to retrieve the infants after learning the intended mother was being treated for mental Illness. While there was a contract, according to the Times article, a statute in Michigan, where the twins were born, holds that surrogacy is contrary to public policy and that agreements are unenforceable.

In a second case, also discussed in the New York Times, a single woman with no children of her own agreed to be a gestational surrogate for her gay brother and his husband, who donated sperm. A New Jersey judge ruled that the surrogate, who gave birth to twins, is their legal mother, even though she is not genetically related to them. In this case, the twins do have a genetic link to one of their fathers, but the court still ruled in favor of the surrogate. The ruling gives the woman the right to seek primary custody of the children at a trial in the spring.

In both cases, these unfortunate situations could have been avoided if the babies were born in Illinois and the requirements of the Illinois Gestational Surrogacy Act were adhered to.

While I won’t list all of them here, some of the most pertinent requirements include: 1) At least one of the gametes (egg or sperm) used in forming the embryo must be contributed by an intended parent; 2) The surrogate cannot also be the egg donor, making her a gestational surrogate. At ConceiveAbilities, we require that our gestational surrogates have no genetic link to the child/children; 3) The gestational surrogate must be at least 21 years old and already have at least one child of her own; 4) The intended parent(s) and surrogate must complete a mental health evaluation, and the surrogate must also have a complete medical evaluation; 5) Both the intended parent(s) and surrogate must consult with an attorney regarding the terms of the gestational surrogacy agreement and the potential legal consequences of participating in a surrogacy arrangement.

Lastly and perhaps most importantly, in Illinois, if all requirements of the Act are met and certified by the attorneys representing both the gestational surrogate and intended parent(s), then parentage is established immediately at the time of birth. And, the intended parent(s) names are placed on the birth certificate with no court involvement or subsequent adoption proceedings. – Nazca

A 2009 Reflection on the State of Surrogacy & Egg Donation

Tuesday, December 22nd, 2009

As 2009 draws to a close, it’s worth looking back to reflect on some of the issues we’ve grappled with in the evolving industry of third-party reproduction. Not unlike other years in its relatively short history, this one was a mixed bag. In hindsight, some of the issues in the spotlight generated a gut-wrenching feeling of disbelief and outrage, others a sense of excitement and joy for the advancements of our field.

There were absolutely a couple of high points for our industry this year. Sara Jessica Parker’s decision to use a surrogate to expand her family drew positive attention to assisted reproduction. As more celebrities participate in third-party arrangements and choose to share those decisions, we hope the public will become more educated about this growing method of family building and become even more accepting. Its mounting awareness not only helps those facing fertility challenges recognize additional options, but starts to help dispel the false idea that women can wait to have children into their forties or fifties naturally (without medical/technical intervention). Now, if celebrities would also cop to using donor eggs, that would be even better progress!

Also on the positive side of the spectrum this year was the increase in reproductive tourism, bringing more couples to America to circumnavigate their country’s restrictive stance on third-party reproduction and take advantage of our advanced medical care.

And finally, this year brought the creation of DNA (Donor Network Alliance), a real progression in the egg donor industry revolutionizing the way patients around the globe search for egg donors and collect important information. I’m proud to be a founding member of this unique resource that presents thousands of prospective egg donors from egg donor agencies around the country on a single Web site.

I’m not sure I even have to go through the low points of 2009, since they commanded our national conversation for so much of the year…but I’ll go ahead and run down the list anyway.

This year brought us the surrogacy scandals of SurroGenesis, Bala, Angels in Waiting and B Coming. These organizations were run by unscrupulous individuals with little or no experience in the field of infertility. Unfortunately, their fraudulent activity left the public with the false impression that the industry is fraught with this kind of corruption and deceit. Of course, most facilitators of third-party arrangements are caring individuals with an agenda based upon helping intended parents build families. This is exactly why this year’s streak of bad business has tainted our collective reputations. Even worse, rumors continue to swirl as agency insiders complain other rogue agencies are teetering on the brink of the same undoing.

Then, of course, there’s the Ocoto-mom saga, which brought its share of disgrace to the field of infertility treatment. This is a prime example of what happens when vital parts of the process are missing or are blatantly disregarded. Possibly worst of all was this year’s German High Court ruling of surrogacy as immoral leaving many gestating surrogacy pregnancies in limbo.

Every time I think I’ve seen it all, along comes another conundrum to stump and amaze me in more ways than one. That is one of the things that keeps me devoted to this highly charged (and admittedly often difficult) business. There is always a new development for better or for worse that keeps the reputable members of the industry on our toes and communicating effectively. But, overall, the fact that what I do really does impact others lives’ in a positive way enables me to work through the rough parts of the business and find creative ways to learn from all the wacky, weird and downright awful issues that sometimes arise.

I hope 2010 is a year of expanded understanding of the wonders of Assisted Reproduction by the public and positive stories for an industry that is, by and large, made up of caring, consciousness, dedicated professionals who are passionate about what they do. Best wishes in the New Year – Nazca

NYT Surrogacy Article: The Power of the Media and Its Misguided Role in Shaping Public Opinion on ART

Monday, December 14th, 2009

Yet again, a high-profile media outlet is using isolated examples of unscrupulous practice to portray Surrogacy as a rogue, unregulated industry in the U.S. The NYT article, “Building A Baby, With Few Ground Rules,” highlights disturbing cases in Michigan and Indiana where agents arranged for the surrogacy process to take place under negligent circumstances. This article is simply not representative of the industry at large.

Like many professionals in my field, I was struck by the sheer lack of adherence to industry guidelines and good practice standards by all parties involved in the process outlined in these cases. These are arrangements that should have been avoided at all costs and would have been if adherence to standards had been part of the protocol put in place by reputable agencies and medical centers.

These unfortunate, but isolated, situations make for good headlines, but the fallout is a stain on an industry that by and large does an amazing job meeting the basic needs of well-deserving individuals. I take issue with the headline that there are few ground rules involved in the practice of surrogacy. There are many, they are sound, but none of them were implemented in the cases featured by the NYT.

Huffington Post Blog: Proposed Restrictions on Reproductive Restrictions Threaten Economic Growth

Friday, November 20th, 2009

Check out my article on the Politics page of the HuffingtonPost today. In my latest submission on site, I share my thoughts on how ongoing efforts to limit reproductive options can only hurt the U.S. economy. If Washington really wants to stimulate economic growth, they should take a step back and reconsider continued attempts to restrict a billion-dollar contributor to the U.S. economy – the infertility industry.

Maybe instead of looking back on the harsh economic lessons of last year, we can look forward and support the growth of a nascent industry.

Please take a look at the post and let me know what you think.

-Nazca

DNA Offers Free Trial Egg Donor Searches to Intended Parents

Tuesday, November 17th, 2009

I wanted to let everyone know that Donor Network Alliance (DNA), the largest single collection of egg donors represented by egg donor recruitment firms throughout the United States, is currently offering free trial egg donor searches to Intended Parents.

I’m proud to be a co-founder of this unique web-based resource that consolidates some 3,000 egg donor profiles from 18 U.S. egg recruitment firms, which is opening its use to intended parents at no charge for a limited time.

In addition to this exciting new development for Intended Parents, I’ve recently received some very positive feedback on DNA. Marna Gatlin, founder of the non-for-profit website Parents via Egg Donation has expressed a resounding endorsement of the Donor Network Alliance as a concept long overdue in the field of egg donation. Marna applauded DNA’s debut in the marketplace, describing the effort as a wonderful resource, vital to streamlining the disjointed process of searching for egg donors and reputable agencies who serve them. We thank Marna for supporting DNA and recommending it to the PVED community.

No Maternity Leave for Those Using Surrogates??

Monday, November 9th, 2009

A recent article in the London Evening Standard reminded me why reproductive tourism is on the rise here in the U.S – many other countries have a much more restrictive approach to assisted reproduction. According to this article, there is a law in the U.K. that prevents mothers who use surrogates from taking maternity leave. The current guidelines only entitle women who undergo a successful pregnancy to paid leave – even if they are not the genetic parent. But people who use a surrogate have no right to paid or unpaid leave to look after their newborn child.

From my perspective this practice seems arcane at best and discriminatory at worst. Is this a result of flawed fiscal logic that because a woman doesn’t physically give birth, she somehow doesn’t require the rest and respite needed to care for a newborn baby? Or rather a result of a poorly cloaked agenda by those who disagree with surrogacy as a method of family building and who seek to punish intended parents with lost wages or the physical and emotional consequences of returning to work too early, should they decide to stay home.

I do not claim any in-depth knowledge of Britain’s policy as it pertains to maternity leave for parents who adopt a baby but this article indicates that adoptive parents are granted a certain amount of maternity leave for this type of family building. And surely one can see the correlation between adoption and bringing home a baby via a surrogacy arrangement. It seems justifiable to allow all new parents the same protections regardless of their individual paths to parenthood. Physical aftermath of childbirth aside, both babies and parents must be given the time and space to grapple with the intensive learning curve of their new or expanded families and to find a certain degree of balance before returning to work.

Restrictions like this and a ban on surrogate compensation in U.K. and other countries have clearly triggered a rise in reproductive tourism – or couples going abroad to seek third-party reproduction services. The article notes that there is an opposition in Britain to surrogacy becoming a “commercial” transaction. I guess I don’t see how denying moms the opportunity to bond with their new babies prevents this.

Your thoughts?
- Nazca

A Few Bad Eggs: Why It’s Important to Choose An Established, Reputable Surrogacy/Egg Donation Agency

Tuesday, November 3rd, 2009

According to a lawsuit filed today in a Lake County, Ill court, an infertile couple claims an unregistered surrogacy agency, Angels in Waiting Surrogacy Center, was in cahoots with a woman who used an alias to donate her eggs more than a dozen times, in violation of industry guidelines.

Although the infertility industry remains self-regulated, there are specific standards that all reputable agencies adhere to in order to protect egg donors and intended parents. The American Society of Reproductive Medicine Guidelines, published in June 2009, states, “the maximum number of stimulated oocyte donations from a single donor is six.”

The couple says they were falsely assured by the agency that they would obtain the donor’s medical, psychological, pregnancy and egg donation history to ensure she was a viable candidate. When they demanded their money back from the surrogacy center, its owner closed the company down and reopened under another name.

It’s unfortunate that we are seeing another case of potential fraud being brought to light; this time in Illinois. Given the time, effort, inconvenience and invasive nature of egg donation, it’s hard to imagine a woman going through the process just for the compensation.

As quoted in the Courthouse News Service today, Chicago’s “. . . ConceiveAbilities, says compensation may be based upon the donors “location, number of previous donations and ethnic diversity.” But the company “strongly advises any egg donor not to apply if compensation is the sole motivation.”

I think this case serves as another reminder of the importance for potential intended parents and donors alike to do their homework to ensure they are partnering with an established, reputable agency.

- Nazca

ASRM Expel’s Physician at Center of Octomom Saga

Friday, October 23rd, 2009

I’m just back from the annual ASRM conference and have some good information from the event that I’ll be sharing in the next few days.

First, though, I just wanted to take a quick moment to acknowledge the ASRM for its recent decision to expel the physician at the center of the “Octomom” story.

In case there are one or two people in America not familiar with this story, Nadya Suleman (dubbed Octomom) reported that Dr. Michael Kamrave of Beverly Hills implanted six embryos in her uterus last year. That exceeds national guidelines for a woman of her age. However, the ASRM based this decision not solely on his work with a single patient, but his type of practice over the last several years.

The situation (and media circus that surrounded it) brought to the forefront a lot of questions around IVF and other advanced reproduction treatments and ethical boundaries for both medical professionals and intended parents. As a self-regulated industry, we have to hold ourselves and our contemporaries to the highest ethical standards and that is exactly what the ASRM did this week when it voted Dr. Kamrava out of the organization.

What are your thoughts? – Nazca