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Infertility Treatment and Insurance — Speak Up While You Can!

January 30, 2012 | By: | Filed under: Announcements, Current Affairs, Financing Fertility Treament or Adoption, Insurance for Infertility, IVF, The Journey to Parenthood

There is an important deadline tomorrow:

Public commentary (from you!!) is needed to demand that infertility treatment coverage be included as an essential benefit under the Affordable Care Act (ACA).  To include your voice and make sure your concerns and needs are addressed contact the Department of Health and Human Services before January 31st, 2012.

The decision to include infertility treatment as a covered essential benefit falls solely in the hands of Kathleen Sebelius, US Secretary of Health and Human Services.  You can email her at

EssentialHealthBenefits@cms.hhs.gov

For more information please read http://myemail.constantcontact.com/Infertility-Matters–Demanding-Essential-Benefit-Coverage.html?soid=1101342191383&aid=B44Urr44QiU

 

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Making an Egg Donation Cycle Work. A brief look at what you might need to know to increase your chances of success!

January 19, 2012 | By: | Filed under: adoption, Age and Infertility, Announcements, Egg Donation, In-House Egg Donation Programs, IVF, Personal Musings, The Journey to Parenthood, Third-Party Assisted Reproduction, Thoughts on Choosing an Egg Donor, Thoughts on Donor Egg Recruitment

Through egg donation, many infertile women are now able to experience pregnancy: sharing their thoughts, feelings, blood supply and the sound of their voice with their baby, and delivering their child into the world. The success rates offered by many egg donation programs are somewhat staggering, making this a very popular option in family building, especially for women dealing with the NOvary™.

Egg donation is often so successful that some can potentially build an entire family from one egg donation cycle. Of course not every egg donation results in a pregnancy, but more often than not a carefully selected egg donor not only leads to the birth of a child, but will provide a family with extra embryos to freeze for future family building.

Such was the case for my former client Nancy. Her experience with egg donation provides a great example of the types of things someone considering using egg donation might want to take into account as they move forward on their journey to “Mama” (or “Dada”).  Nancy, at the time her journey into egg donation began, was in her early forties.  Like many women today, Nancy had waited to marry until she found the “right guy” and had established her career.  After graduating from law school, Nancy decided that she wanted to put off starting a family until she had paid off her student loans, and had made partner in her law firm.  She felt very strongly that it was important her career and financial life be stable before she became a mother.  When she was 35 she met Daniel, and after dating for a few years they married when she was 38.  Well aware of fertility landmines related to age, she and Daniel  had discussed her desire to become a mother before they got married and agreed to start trying for a baby immediately after the wedding (Nancy, just like me, hoped for a honeymoon baby!).  She was such a planner that before they got married Nancy went to her OB to see if she was facing any age-related infertility issues.  Much to her surprise and relief, after her OB examined her, Nancy found out that it seemed like all systems were good-to-go; she appeared to have a healthy body, good ovarian reserve, and nothing standing in the way of her becoming a mother.  Nancy’s OB recommended that the newlyweds try having unprotected sex for six months and if nothing happened to go see a reproductive endocrinologist (sounds like a good plan to me!).  However, after six months of unprotected intercourse, Nancy and Daniel had not gotten pregnant. Proactive Nancy immediately contacted the reproductive endocrinologist her OB recommended.

The RE Nancy and Daniel saw recommended that they try assisted-reproductive technologies.  Unfortunately after several failed IUI and IVF cycles, Nancy’s doctors told her that her best chances for becoming a mother were through egg donation or adoption.  Although there seemed to be no medical explanation for Nancy’s failure to conceive, their RE didn’t think further attempts using Nancy’s eggs made sense.  Despite her remarkably low FSH and good AMH results, her RE nevertheless attributed Nancy’s IVF failures to issues related to ovarian reserve and her age.  Ironically, after all her efforts to detect infertility, especially age-related infertility, Nancy discovered that she was dealing with the dreaded NOvary™.  (Just as side note, my definition of NOvary™ extends beyond ovaries that refuse to produce eggs because we are too old.  However, in this case Nancy’s confrontation with the NOvary™ did seem to be related to the fact that she was in her early forties and her ovaries were headed into retirement.)

The RE suggested they consider using an egg donor or adopting.

Nancy was at first — like all of us — somewhat devastated by this diagnosis.  She had done everything correctly, ate a healthy diet, exercised her entire life (in fact Nancy had almost become a professional dancer before going to college), she didn’t smoke, took yoga classes, and yet her body still seemed to be failing her.  After discussing the situation with Daniel, Nancy realized that she really, really wanted to experience pregnancy (I can relate to that!), and so they chose to first pursue egg donation.  N&D agreed that they would try egg donation one or two times and if they didn’t conceive a baby through egg donation, they would move on to adoption.

Nancy, however, was not prepared for the overwhelming information and advice she received once she had settled on using an egg donor.  People told her different things:  don’t use an agency, use an agency, don’t use an inexperienced donor, use an inexperienced donor.  Everything Nancy heard seemed to be conflicting and confusing.  Even worse was how overwhelmed she felt when she logged onto various egg donation agency’s databases.  How on earth could she ever select a donor out of the hundreds that seemed to be available?

Her gut reaction was to work with her RE’s “in-house” egg donor program as they would select the donor for her, thus ensuring that she had a fertile donor and, more importantly, Nancy wouldn’t feel she had to cull through profile after profile.  Nancy just wanted someone to make the decision for her so that she and Daniel could move past infertility and onto pregnancy!

After doing her research (if we haven’t already established it, I want to remind you that Nancy is quite the type A person and she is proud of it!  I can relate, as I too am rather Type A) Nancy, however, decided instead to work with an egg donation agency.  Although many “in-house” programs are flexible, Nancy felt that she had more options when working with an egg donation agency.  While Nancy felt that she was giving herself more legwork to locate her own donor and dealing with the accompanying stress, Nancy felt that by working with an agency she had greater flexibility in choosing her donor.  What had first seemed so attractive — having someone present her with an “egg donation goddess” (her words not mine) — in reality turned out to concern Nancy.  By relinquishing control to her RE and his staff, she lost the flexibility to request a donor who had an athletic background (not only a former dancer, both Nancy and Daniel are self-professed exercise junkies, and Daniel had played some serious basketball in college), or to use an egg donor who has an “artistic” personality (the dancing thing turned out to be really important).  She also seemed to have a harder time finding a college educated egg donor through her RE and in the end having a “smart” donor also turned out to be very important to both Nancy and Daniel.  Their RE’s in-house program would be able to provide them with a donor who already had been screened for fertility (a huge plus by many standards) and who physically resembled Nancy and Daniel (another huge plus for most people), but with the in-house program she couldn’t request an “athletic, artsy, super-smart” donor.  Using an egg donation agency gave her the freedom to be more selective than she initially thought she would need or want to be.

Nancy also didn’t have to share eggs with another infertile family which was a requirement at her particular RE’s in-house egg donation program (off topic for a moment:  shared egg donation cycles are a common effort by clinics to help reduce the cost of an egg donation cycle but being “required” to share a cycle isn’t common).  Nancy also realized that working more independently meant she would have greater control over their finances.

With a limited budget because they were also considering the possibility of adoption, most of the agencies she spoke with recommended that N&D select a donor who lived near the clinic she would be using, thus avoiding substantial travel expenses. Using an agency, Nancy also had a greater selection of donors with compensation rates to fit her budget, compared with the fixed rates offered by Nancy’s and many in-house egg donation programs.  By selecting a “local” donor with a lower compensation than that which her RE’s in-house program requested on behalf of its donors, Nancy was able to save a couple of thousand dollars and put it in what she called their “adoption bank.”  It did take more time finding that “artsy, athletic, super-smart donor” than she had anticipated but Nancy felt the time was worth it given that she didn’t think she would know “enough” about her egg donor’s background had she chosen the egg donor recommended by her RE.

One donor Nancy considered, I am going to call her Lucy, was twenty-seven years old, single, had been a dancer in high school and had attended a Seven Sister’s college (rock on to all women’s colleges!!).  Lucy had graduated at the top of her class and was attending graduate school in journalism (did I mention that Daniel is a news columnist?!). Despite Lucy’s outstanding academic credentials, which often result in a higher requested compensation, Lucy’s “requested comp”  (egg donor industry lingo) was on the low side.   Side Note:  The Society for Assisted Reproductive Technologies’ (SART) has guidelines that recommend egg donors receive between $4,OOO-$7,000 per donation.

With Lucy’s dancer’s background and desire to be a journalist like Daniel, Lucy seemed like the perfect donor.  Lucy, however, had no track record donating eggs.  With their tight budget and limited time factors — N&D were also concerned that if they waited much longer their age might preclude them from working with certain adoption programs and they very much wanted to preserve this as a family-building option — Nancy and Daniel instead decided to match with ”Lauren.”  While Lauren also was twenty-seven and had attended college where she played soccer, Lauren had a three year old daughter and had conducted one prior egg donation cycle that had produced a lot of eggs.  Although they didn’t know whether that egg donation cycle resulted in a live birth, Lauren was clearly fertile and was likely to respond well to medication.  To Nancy and Daniel, this made her a better candidate.

Both Lauren and Lucy were requesting $5,000 as compensation for their cycle and lived relatively close to Nancy’s and Daniel’s clinic (no overnight travel was involved).

Once N&D selected Lauren as their donor, the egg donation agency presented them with a list of attorneys to help prepare their egg donation agreement, and it arranged for Lauren to be represented by an attorney as well.  I am working on a blog on egg donation agreements and why you MUST have one so I am not going to go into it in depth here.  I actually had already met with N&D before they got the list of attorneys from the egg donation agency (and my name was NOT on it grrrr), but I did help them prepare their anonymous egg donation agreement with the woman we are calling Lauren.

Once the egg donation agreement was signed, their egg donation cycle got underway. Lauren didn’t produce as many eggs as N&D had hoped; Lauren “only” produced eleven eggs but all eleven fertilized (Side Note: 100% fert rates are not something you should expect, it doesn’t always happen that all of a donor’s eggs will fertilize.  Nancy and Daniel got lucky). Nancy conceived twins from the first embryo transfer (now that is something you should expect and should discuss with your RE if you don’t feel prepared to parent two at once).  After watching the remaining pre-embryos which were not transferred to Nancy’s uterus, the clinic froze five blastocysts.  Off topic again: Nancy’s RE performed a day-3 pre-embryo transfer which, for reasons that exceed the scope of this blog, I am at a loss to explain.  Despite Nancy’s disappointment with the number of eggs retrieved, I would have thought the clinic would have done a day-5 or blastocyst transfer??

Nancy and Daniel are very happy and currently are considering whether or not to use their frozen pre-embryos.

If you have any thoughts or comments to add about your experience, please feel free to share them.  This blog is designed to help people achieve success in egg donation and if there’s something you think might help someone, go for it!

p.s. I don’t know whether any of this sounded familiar to you, but I did think that Nancy’s and Daniel’s decision-making process and the issues they faced, particularly those Nancy faced, were typical and helpful enough that I wanted to share them.  Nancy and Daniel’s story is discussed in much greater detail in my next book if you want to learn more about what they went through when finding their donor and negotiating their egg donation agreement.  More details about pub date to follow (I am under an editorial deadline which is a good thing because it means this thing will finally be finished!!!  I’ve only been working on the book for three years.  Enuf is enuf!).

 

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Is the movie Eggsploitation, exploiting itself?

January 14, 2011 | By: | Filed under: Announcements, Check This Out, Current Affairs, Egg Donation, I'm Just Another Angry Infertile Woman, In the News, Infertility In The Movies etc., IVF, Personal Musings, Thinking Out Loud, Third-Party Assisted Reproduction

I know I haven’t been blogging very much and I know I keep promising that I will.  Honestly, I have been trying to determine what type of “voice” I want my blog to have.  Do I want to be a voice of comfort, reassurance and peace of mind, do I want to discuss topics that are highly relevant and even personal to me with respect to infertility as I am an infertility warrior, or do I want to speak as an expert in my field and educate people.  I suppose I could find a way to do all three and I haven’t yet found the right “pitch” (just continuing the voice metaphor here folks) to launch some knew blogs.  And I think I found it.

I try and stay out of highly controversial discussions in my industry and to avoid taking sides unless I feel passionately about the issue.  Sometimes blogging backfires (ala Sarah Palin’s recent “hit list” and the resulting death of 15 people).  But I have come across another of those issues that MUST be discussed, so I am hereby entering into the foray and it’s along the lines of my “what was Brooke Shields thinking” blogs.

Let’s get real for a moment and turn to a movie reel about egg donation.

I today learned that the “documentary” Eggsploitation was announced to have been nominated as best documentary.  When I read this on FaceBook this morning I almost vomitted.  For those of you who haven’t seen it . . . and please don’t see it if you are considering either becoming an egg donor or using an egg donor to build a family . . . it is highly inaccurate and inflammatory.  Please understand that I am trying to be nice.

The movie is an attempt by right wing, pro-life. Christian conservatives to reveal the “real world of egg donation”.  And Honey, it doesn’t.  It serves one purpose only, to promote an anti-IVF anti-egg donation agenda.  And in my mind it isn’t a documentary unless you are basing your documentary on something with a substantial amount of truth or accuracy.  A documentary by one definition is the “creative treatment of actuality”.  I will agree to the creative part with respect to this film, but not the actuality part (with one caveat, I will agree that egg donation exists as a means to build a family).  Another definition says that a documentary presents the facts with little or no additions.  Isn’t it a failure to present the facts if you only present one side, or one statistically insignificant, rare and otherwise atypical aspect of something, i.e. ONE fact when there are many facts to be discussed?

This film is based on untruths, inaccuracies, mythical stories, and an agenda. It veils itself as a documentary in order to lend some false sense of “truth” to the movie’s topic, the exploitation of egg donors and recipient families all to the benefit of the massive money generating industry of reproductive medicine.

The reproductive industry has responded many times in opposition to the film, as have many of my colleagues (for example, here is another blog on the topic http://weblog.prospectivefamilies.com/2011/01/13/what-more-is-there-to-say-about-eggsploitation/ ).  I think it’s pretty much a universal sentiment in my world, both professional and personal, that this movie has nothing to do with reality and is serving to mislead the general public about a viable and very successful means of family building, egg donation.

I really think it has gotten to the point that the movie is now exploiting itself for its own financial benefit.   They are now twisting all the negative media attention into an argument that if they weren’t so “right” about the industry that there wouldn’t be so many defensive and anti-Eggsploitation blogs/articles/reviews.  It’s kind of like the old saying “you know you’ve done something right if they’re shooting at you!”  And they are using that to drive more people into movie theaters.

Well I don’t think they’ve done anything right, I am disgusted by the MOVIE, and I am disgusted that anyone would think it was worthy of the title “best” in anything.  I haven’t spoken out before because I didn’t want to further publicize this movie and thus encourage people to watch it — even if it is to see how wrong it is.

And for the love of all that is sacred about the word FAMILY, I respectfully request that the movie industry get a grip and get real.  Don’t endorse this movie.  Many a Hollywood family has been created through the gift of egg donation.  Do you really want to slap your egg donor in the face like that?  By promoting, endorsing, and casting something that she did to help you have a baby and a family, in such a negative, illicit and patronizing light?

I’m not saying the world of reproductive medicine is perfect.  I have some bones to pick with things that happen in the world in which work.  And I will cut the producers of this movie and Hollywood some slack and say that if you are going to focus on the very creative aspects of the use of truth to create a dialog (albeit the wrong dialog) then okay maybe this is a documentary.  But it’s a documentary that I refuse to endorse on any level.

Someone can, and should, do a better job at looking at the gifts that third party assisted reproduction are giving to infertile families.

Blech Blech Blech.



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I have a project and I need your help.

March 25, 2010 | By: | Filed under: Announcements, Thinking Out Loud

I am finishing up the e-Book on egg donation so it will be ready when the site goes live for my egg donation agency.  However, I have been getting a lot of emails from readers of The Infertility Survival Handbook, thanking me for writing the book (for those of you to whom I have not yet responded, please know how much your emails mean to me and I really, really do appreciate hearing from you).  I believe that nothing is a coincidence (something my BFF and I were arguing about last night, she’s definitely of the mind that I am insane.  LOL!).  And here’s the thing, I’ve got another book drafted, on top of the e-Book series, and it’s called The Stork Lawyer’s Modern Family Building Bible.  But I wonder if it isn’t better just to revise the The Infertility Survival Handbook? I mean, maybe I could it even tie it into my next round (god willing) at trying to add to our family . . . and combine some of what I was going to include in the “Bible” (as we’ve come to call it in the office).  I don’t know what to do.  My hands are full and I have plenty to keep me busy.  Do I start fresh with a new book or do I update and revise a book that so changed my life and seems to have impacted a few others?  Thoughts?

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Registration Issues: Registered Users Please Read!

November 6, 2009 | By: | Filed under: Announcements, Current Affairs

Hey everyone, while I was away, Kristen and Emily were hard at work trying to figure out why we have all these registered users who cannot seem to be able to post.  We had a worm on the site awhile ago and it seems the damage the worm did went a little deeper than we realized.

Anyone who has previously registered to be a user on this blog needs to register again.  As of today, we have only 4 registered users, down from over a hundred.  Please, please, please, take a minute and register again.  I am so sorry for the inconvenience.  But some mean person corrupted my blog.  Once you register again you shouldn’t have any problems.  You may not have even noticed . . . but we noticed and we miss you!

Once again, anyone who has previously a registered user on this blog is no longer registered due to a worm that corrupted the site.  Please re-register and join our discussions!

Thanks!

Liz

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