Posts Tagged ‘third-party reproduction’
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?
Tuesday, February 1st, 2011
Lots of talk last week about the UK’s HFEA reviewing policies around egg and sperm donation. Right now, the UK doesn’t allow adequate compensation (egg donors can receive up to a couple hundred pounds in expenses under the current law), and intended families have to wait for “altruistic” donations. To no one’s surprise, there is a significant shortage of donated eggs available and many Brits are forced to seek cross-border reproductive services, which means traveling outside the country to build their families. As part of this review, the HFEA is surveying the public about their thoughts on things like donation of eggs and sperm within families, number of families any single donor should be allowed to help create, and of course, donor compensation.
The way the stories are written, donor compensation is sort of an afterthought. In fact, many experts attribute the shortage to a 2005 law that removed a donor’s right to anonymity. I suspect that the survey results will surprise them, if that’s really what they believe. As the process of egg donation has evolved, and along with it the public’s progressive acceptance of the issue, I am not so sure I continue to subscribe to the idea that removing the anonymity barrier causes a significant drop in applicants. I think more and more potential donors are comfortable with the idea of some kind of future contact based on the premise that it’s more to settle basic curiosity and provide medical/genetic information for offspring, and not to build long-term emotional connections. In fact, we’re seeing more and more donors even willing to meet recipients during the process.
Here in the U.S., as the times have progressed, we have now passed the threshold of a shortage. There are many informed, educated women willing to participate on many different levels of openness and disclosure. The point being made by the authors of the articles that the shortage is based on the laws that require openness is simply not valid based on my experience running an egg donation agency for the last 15 years. If I am correct, then (again) it boils down to lack of compensation.
I also find it curious on some level that the questionnaires being sent out appear to be an attempt to get to the bottom of people’s attitudes on the matter and then, oh yeah, what about compensation? If this issue is truly about philosophical and moral attitudes around the families being created in this manner, what difference does it make if compensation is involved? It seems pretty clear to me that these are two separate issues. What are your thoughts?
Friday, March 5th, 2010
As a founding member, I’m so proud to announce that the Donor Network Alliance (DNA) has reached the 5,000 mark in the number of registered donors in this national donor database. DNA is an unprecedented affiliation of leading U.S. egg donor agencies who have consolidated their egg donor profiles in a single Web site, making the egg donor search easier for intended parents, and giving agencies greater exposure to a larger number of prospective clients.
I think we’ve continued to see this kind of growth because it really does provide an alternative to a fairly cumbersome and disjointed process of selecting prospective egg donors. Intended Parents can source both a donor and a reputable agency easily, efficiently and safely with DNA. This has become even more important to Intended Parents looking for a greater sense of confidence in this complex process, especially as we exit a year marked by unsavory agency practices and sensational media coverage. We hope that DNA and all of its participants continue to deliver that confidence.
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, our Illinois surrogacy program requires 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
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
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.