Archive for the ‘Financing Fertility Treament or Adoption’ Category
August 2, 2016 | By: Liz | Filed under: Current Affairs, Egg Donation, Embryos, Financing Fertility Treament or Adoption, Frozen Embryos, IVF, Personal Musings, The Journey to Parenthood, Thinking Out Loud, Third-Party Assisted Reproduction, Thoughts on Choosing an Egg Donor
I really shouldn’t be here right now. But there is too much laundry, too many emails, and too many dishes to attend to not to choose to procrastinate right now and get some stuff off my mind. I have had several conversations Today (yes this one specific day on which I am writing) with people entering into “fresh” egg donation cycles and who have debated using or tried using an egg bank. And when I say “fresh” egg donation cycle I mean that they are using an egg donor who will donate all her eggs from one IVF egg donation cycle to the intended parent(s). They have chosen not to use an egg bank. One couple tried using a known donor, then went the egg banking route and are now almost broke and using an egg donation agency and a (wait for it) “fresh” donor. One intended parent was convinced by her IVF Clinic not to waste money on an egg bank and instead choose to use a “fresh” (as in not frozen egg) donor. The others weighed the pros and cons on their own. I also have had the opportunity to discuss it with owners of egg donation agencies (of which, arguably, I am one) and an IVF physician who thinks egg banking and selling eggs is the next best thing to Viagra and sliced bread.
While I recognize the benefit egg banking has for women undergoing medical treatment which may render them infertile or otherwise potentially impair their fertility, or for those who choose to bank their own eggs for their own future efforts at conception, I am NOT a fan of egg banking. So extreme has become my position on this matter than I am working with colleagues on a professional article on the risks women and intended parents are facing by not being properly informed about egg banking.
I get the appeal egg banking presents. It’s faster and easier than using a fresh donor, and very much like the sperm bank experience in terms of selection, anonymity and being one more step removed from the genetic progenitors giving your child life. For some people, I suppose, an egg bank makes alot of sense. But for me, it’s a waste of time and money, risks the future of your family in ways that an egg donation agreement with a fresh donor can provide you (and the donor) protection, and potentially runs afoul of the public policy of most states, insofar as most egg banks provide “x” number of eggs for a set fee and then if you need extra eggs you can “buy” them for “x-thousand” of dollars per egg. Has anyone other than me reviewed the documents egg banks present to consumers and comment on the fact that it is illegal to sell genetic material? And hey, what about the fact that when you have to buy those extra eggs . . . had you used a fresh donor, you might have received the same number of eggs, or more, for an almost equal cost (my client who went through a known donation, an egg bank and is now using an agency would argue the agency was cheaper from the get-go) and without having purchased human tissue (you know human tissue, like a kidney?)??
And what of the success rates? I have yet to see consistent data coming from within my industry that tells me that frozen eggs result in the same number of live births as result from using a fresh egg donor. Egg banks certainly don’t seem to offer the possibility of having frozen embryos from which you might conceive a full genetic sibling. Fresh donor cycles often result in leftover cryopreserved embryos which can be used to conceive additional children. It doesn’t happen for everyone, but it happens for many.
I think the technology is promising. But unless you need to preserve your fertility, I don’t think it is all that it is cracked up to be. And who wants to buy a cracked egg anyway?
I don’t have a lot of time tonight, the dishes smell and the laundry is over-flowing out of three laundry baskets, but I wanted to start this dialogue. I am so sad for my clients who have wasted time, energy, and money not getting pregnant using egg banks.
In the immortal words of Linda Richmond (from SNL) Talk Amongst Yourselves . . . and let me know your thoughts. . . .
January 8, 2013 | By: Liz | Filed under: anonymous sperm donation, Current Affairs, Financing Fertility Treament or Adoption, In the News, infertility in the media, Infertility on Television, Insurance for Infertility, known sperm donation, Personal Musings, Same Sex Parenting and Reproductive Law, Thinking Out Loud, Third-Party Assisted Reproduction
The perils of known sperm donation are reasonably well known. For those who read this blog you know all about my concerns about the Starbucks’ Sperm Donors. Alas now sperm donors are hitting Craigslist and probably other help wanted sections in newspapers and magazines. The same issues I discussed with those gentlemen engaging in a little afternoon delight in the bathroom at Starbucks and delivering their sperm donation to the recipient waiting outside the door also apply to those gentlemen responding to any other help wanted ad. As recent publicity surrounding a gentleman in Kansas reveal, even those with the best of intentions who attempt to protect themselves legally may still be deemed a daddy when all they wanted was to do a good deed. Indeed, William Marotta, our Craigslist donor du jour, has acknowledged that “no good deed goes unpunished”.
For those of you unfamiliar with the case (and I cannot imagine there are many of you who don’t know about it, because news of this case managed to reach me under the rock inside the cave in which I dwell), a little over three years ago Mr. Marotta responded to a posting online in Craigslist by which Angela Bauer and her then-partner, Jennifer Schreiner, were looking for a sperm donor to help them conceive a child. I have yet to learn all the gory details (that cave is pretty deep and news is slow to filter under the rock) but I gather that William, Angela and Jennifer entered into a written contract pursuant to which William, with the permission of his wife, agreed to donate sperm to Angela and Jennifer. William declined to accept any money in exchange for his donation. As purportedly stated in the contract — and let me be clear that I have not read the contract — William specifically stated that he had no intent to be a parent of the child, or have any involvement in its life whatsoever. Angela and Jennifer were to be deemed the legal and natural parents of any child conceived from William’s sperm donation. Angela and Jennifer also specifically agreed to assume all financial responsibility for the child and to hold William “harmless” from any claims against him for child support or other financial assistance for the child. In short, the contract stated that William was never to have any financial responsibility for any child born as a result of his sperm donation. (Just to make my life easier as I type, lets call Angela and Jennifer the “Moms”).
My devoted blog followers all know by now that the laws surrounding third-party assisted reproduction largely revolve around people’s intent at the time they conceive a child. Even with the existence of a statute governing third-party assisted reproduction, it is prudent to explicitly state that intent in a legal contract between the parties to any third-party assisted reproductive arrangement such as that entered into between William and the Moms. Cudos to William and the Moms for having the foresight to sign a contract stating that none of them had any intent for William to be “dad” and that the Moms would hold William harmless from any claims for financial support for the child. That “hold harmless” provision is further evidence of their desire and intent to have complete and sole responsibility for financial matters pertaining the the child. One major problem, however, is that (according to an NBC report), it appears that the contract they used to ensure that William wouldn’t have parental rights, was found on the internet. I am not sure that William and the Moms had legal counsel as part of this process.
My devoted blog followers and/or anyone who has called my office with a contract they found on the internet and wish to have me review in connection with their plans to build their family, know that I feel that contracts found on the internet are nasty little buggers that get everyone into more trouble than they avoid, and I won’t touch one. Putting aside copyright violations (btw, when we reproductive lawyers draft these contracts we retain a copyright in them so any time someone uses one of them they are — in addition to risking their family status — violating federal copyright laws), template contracts found on the internet simply are not specific enough to address the nuances of reproductive law. Case in point, William and the Moms.
My devoted blog followers and/or clients also know how anal I am and that I make sure that when drafting a contract of this nature — typically called a Known Sperm Donation Agreement — any applicable state statutes are mentioned in the contract. I also like to mention the terms of the statute and make sure that everyone is following the proverbial letter of the law. This is where we run into some problems as Kansas has a statute governing sperm donation, and William and the Moms didn’t follow the letter of the law. Regardless of where and how William and the Moms found this contract, they didn’t address a provision in Kansas’s statute on artificial insemination which provides that the parties to the sperm donation must have a licensed physician perform the insemination in order for the sperm donor to avoid having parental rights.
I have never fully understood why these statutes (and New York has one) require a physician to do the insemination. I suppose it could be because when these statutes initially were drafted, home insemination kits weren’t available and legislators wanted to dissuade people from having the sperm donor personally inseminate the intended mother, especially if the intended mother is married to a man other than the sperm donor. Anyone remember the scene in The Big Chill where Kevin Kline’s character gets down and dirty and does the deed with one of his and his wife’s best friends, played by Mary Kay Place, in order to help Mary Kay Place’s character conceive a child?? I suppose the whole infidelity thing combined with the desire to drive revenue to physicians led legislators to the notion that only a doctor should perform an artificial insemination. But times have changed and now you can find a home insemination kit on the internet. The primary demographic to which the home insemination kits are marketed are lesbian couples, just like the Mom’s at issue in the Kansas case which we are discussing.
Why are home insemination kits so popular you might be asking? Well, for those of you fortunate enough to have all the working parts necessary to conceive a child without assistance from fertility doctors, being gay does not meet the definition of infertility and the insurance requirements necessary to obtain coverage for artificial insemination. LGBT families have something called “social infertility.” Whether or not you like or agree with the term “social infertility”, due to their sexual orientation, the Moms were/are infertile insofar as they lack the healthy sperm necessary to fertilize their eggs. The Moms needed a sperm donor and it happens to be that cryopreserved or frozen sperm isn’t that cheap, and the processes involved in an “artificial insemination” (or to correct and update the terminology an “Intra Uterine Insemination” or “IUI”) ain’t cheap either. Without insurance coverage, the average IUI cycle can cost a coupla thousand to even a few thousand dollars. Enter the home insemination kit which costs under $50 including shipping and an otherwise healthy socially infertile woman has access to technology that will enable her to conceive albeit without the missing sperm. As we’ve discussed, Craigslist, Starbucks, and online forums have become common ways for women like the Moms to locate sperm without the cost of using frozen semen. Added in is the benefit of being able to meet your sperm donor and be able to provide your child with some background regarding one of his or her progenitors. Times certainly have changed and the law, certainly in Kansas, has not kept pace.
Speaking of times-a-changing, the “child” to whom William contributed his genetic material is now a three year old little girl and the Mom’s have since separated. Due to an illness, one of the Mom’s had to apply for state financial aid and Kansas got a little nosy and demanded that the Moms reveal William’s identity before it would provide any financial aid. Upon learning of the situation and William’s identity, the Kansas Department for Children and Families decided to go after William for $6,000 in child support together with imposing an ongoing obligation to provide support. William can’t afford any of this and justifiably is fighting Kansas’s claim.
The whole thing is wrong and is a glaring example of good intentions gone awry, lack of education and awareness of reproductive laws as they pertain to things like sperm donation, the failure of state legislatures to keep pace with societal changes, and the frickin’ frackin’ fiscal cliff. I understand that Kansas is broke but I would much prefer that it spend state resident’s tax money going after all the “dead-beat dads” who are intentionally leaving their children to starve. Dads who intended to father a child — and who may well have conceived that child or children through a physician-assisted artificial insemination or other third-party assisted reproductive technologies — and then post-divorce abandoned their financial obligations to that child or children. Why are we going after a man who never intended to be a father and did his best to help women who did want to be mothers? Especially when the mothers want to be financially responsible for their child but due to medical circumstances beyond their control cannot cover all of the costs associated with child-rearing and are forced to seek financial assistance from the state. Financial assistance, I might add, to which a single mother who knows nothing about her child’s biological father would be entitled.
So here we are with a legal battle being fought by good people with good intentions but who made a mistake. I understand Kansas has a right to seek child support from a genetic parent, but in this instance, that genetic parent should be standing in the shoes of an anonymous sperm donor. But for the fact that the Moms didn’t use a doctor when they conceived this child, William wouldn’t be in this mess. To many people it seems like an awfully unjust and harsh response by Kansas. Sadly for the Moms they don’t live in a state which might have permitted one of them to adopt the child in order to assure both parents full parental rights, or which otherwise recognizes same sex relationships such that both of the Moms could be listed on the child’s birth certificate and further be considered the legal and natural child of the Moms’ relationship. Steps which would not only have protected their parental rights in a same sex relationship but would have protected William from this mess. If both of the Moms were recognized here there wouldn’t be a need to find William. Sadly Kansas is not an LGBT friendly state. Combine that with the facts of this case and many people wonder if the Moms aren’t being singled out as a result of their sexual orientation.
Would the single mom to whom I just referred, who doesn’t know details about her child’s father, be similarly pushed into identifying him in order to be entitled to financial assistance from the state? Somehow I don’t think so. Somehow I think that a single mom would have gotten the financial aid more easily than this now single Mom who conceived her child while in a same-sex relationship. Is that which is taking place in the State of Kansas a violation of the Moms’ rights under the Equal Protection Clause of the United States Constitution or otherwise discriminating against them? One could certainly make the case (and hopefully someone is making the case) that but for the fact that they were involved in a same sex relationship at the time this child was conceived, and but for the fact that they didn’t have the financial resources to be able to access affordable infertility services that they might not be in this predicament.
As for William, he is the poster man for someone doing a good thing but not crossing all of his “t’s” and dotting all of his “i’s”. Had he known about the requirement that the Moms must use a physician to perform the insemination and/or insisted that they use a physician before he would consent to the donation, he might not be where he is today.
But that doesn’t make what Kansas is doing okay or even justified. I’d really much prefer they go after some of the dead-beat dads out there who owe the mother of their children a heck of a lot more money than is at issue in this case. Seriously folks, let’s get our priority’s straight.
Let’s go after legitimate law breakers before we go after good people who made a technical error. So what if the doctor didn’t pull the plunger on the syringe? Give me a break.
Tags: Artificial Insemination, discrimination, home insemination kit, Intra Uterine Insemination, IUI, Kansas, known sperm donation, known sperm donor, LGBT, reproduction, same sex parentage, sperm donation, sperm donation statute, sperm donor
December 7, 2012 | By: Liz | Filed under: adoption, Check This Out, Current Affairs, Egg Donation, Financing Fertility Treament or Adoption, In the News, IVF, known sperm donation, Personal Musings, The Journey to Parenthood, Third-Party Assisted Reproduction, Thoughts on Choosing an Egg Donor, Uncategorized
Every once in a while I have true conflicts between my self as a former infertility patient and my career as a reproductive lawyer and adoption attorney. A couple of years ago, I wrote a law review article on the disposition of frozen embryos, and whether or not talking about embryo adoption was legally correct whether the better, more appropriate terminology was/is embryo donation. There are hundreds of thousands of frozen embryos in cryopreservation in this country where the intended parents of those embryos no longer wish to use the embryos for their own family building. These embryos are often referred to as “leftovers” a term which somewhat disturbs me but is strictly speaking, accurate. These embryos are “leftover”, after a family was created through IVF and now remain in a state of frozen suspension. Many of those embryos could be used to help build another family, and be donated to an infertile couple. There was some confusion as to whether these embryos should be placed for adoption or donated in a similar manner to egg and sperm donation and I wanted to resolve that confusion — at least for myself. I ultimately drew the legal conclusion that the term embryo adoption isn’t really accurate because there isn’t a human being to adopt. I could go into a lengthy analysis of how I came to that conclusion but your eyes would roll back in your head and you would probably start drooling from boredom. So let’s just defer that analysis and argument for another day. If you are interested, you can get a copy of the article on the web (click here). I now happen to be a huge advocate for embryo donation. I think it is a fabulous way to build a family. However, these are musings for another blog. But my article did provide some clarity to those medical facilities which are banking those frozen “leftover” embryos.
So here I have been sitting happy as a woman with a barren uterus could ever be, contemplating my holiday shopping safe and secure in my belief in, and advocacy of embryo donation. And then I hear about this doctor in California who has a new kind of embryo bank.
Before I heard of this physician in California, I was aware of only one type of embryo bank; one where frozen “leftover” embryos are being made available for donation to infertile families. These frozen embryos were the subject of my law review article. This new embryo bank, however, does not contain any of these “leftover” frozen embryos. This bank is comprised of embryos which were recently created using carefully selected donor eggs and donor sperm. The donated eggs are fertilized with the donated sperm and the resulting embryos are frozen for future selection by hopeful intended parents. Let’s stop briefly and note emphasis on the words “future selection”. We will circle back to why this is relevant but I wanted to point out that these embryos are being created for future selection by wanna-be-moms and dads.
This physician has created his embryo bank in a manner to facilitate selection for all types of characteristics — everything from physical traits like blond hair and blue eyes to religious ethnicity. Jewish embryos, who knew? Actually, this could be fantastic for Jewish couples who need a single Jewish egg donor, and/or want to further ensure a connection with Judaism by having a genetic connection on the sperm side of life. You have no idea how hard it can be to find a specific ethnic donor and this is something I gather this doctor has identified as a plus to his business model. Speaking of business models, he also offers a money back guarantee. You choose a batch of embryos to use to try and get pregnant. If you don’t get pregnant the first time, you get two more tries using different batches of embryos. If you don’t get pregnant, you get 100% of your money back (approx. $12,000).
Upon hearing of this embryo bank a part of me was disgusted and a part of me . . . well I was excited. Super excited. Especially about the money back guarantee.
The infertility patient part of me sees this as a great opportunity to get pregnant. Frozen embryo transfers — while statistically less successful than fresh embryo transfers — can be lot easier to go through than an IVF cycle. For me having the embryos created using donor gametes isn’t a big deal. But if it were, I would be able to select an embryo based on whatever I might deem important. So, yeah baby! Let’s have another baby! Give me this doctor’s number. I am in! Or perhaps it would be better to say the embryos are [going to be] in [me]!
But the legal scholar, academic, intellectual, lawyer part of my brain is sitting here vomiting and is pissed that I am putting these thoughts onto cyber-paper and making an argument in favor of this horrific new kind of embryo bank. Stork Lawyer Reality check: It is pretty much illegal to create embryos without first having identified intended parents as recipients for those embryos and from what I understand, there are no intended parents waiting for those embryos when this doctor is creating them. The intended parents don’t enter the picture until the embryos are selected from the database and someone signs up with this program to undergo an embryo transfer procedure. This is where that whole “future selection” comes in.
The laws regarding assisted reproduction essentially come down to intent to parent before conception: in a third party assisted reproductive arrangement there is supposed to be a contract or other document signed before the embryos are created, whereby intended parent(s) agree to be legally and morally responsible for the embryos and children that may result from the ART process. In this case there is no such contract or preexisting intended parent. The embryos subject of my law review article all had intended parents before the egg and sperm came together to create the now frozen “leftover” embryo. But this new type of embryo banking lacks that component. There are no intended parents choosing the eggs and the sperm with the immediate intent to parent.
And speaking of all those “leftover” embryos shouldn’t we first be dealing with and using all the existing cryopreserved embryos before we go about creating them? And what about the potential that this doctor may be creating even more “leftover” frozen embryos (what happens to those embryos that don’t get selected)?
Let’s not analyze whether this is baby selling. I can’t, or won’t go there, although many others have. Consanguinity, or the risk of an individual created through donor gametes marrying or having a child with a genetic sibling is another issue that has been raised. The number of families that are created using any individual egg or sperm donor’s genetic material is a concern not to be overlooked or ignored. These donors presumably are also donating through egg donation agencies, fertility clinics or sperm or egg banks. We all have been astonished by stories of men who have discovered that they have fathered over a 100 children as a result of their donation to sperm banks — there is a significant risk that through this new type of embryo banking program not only will children have multiple full siblings running around but that egg and sperm donors have created half siblings through other programs.
Even more, if I understand this program correctly (and I am pretty sure I do) batches of embryos are being created which contain embryos which are full siblings to embryos which are contained in other or separate batches of embryos. It sounds like it is possible that three separate donations could take place using these three batches of embryos. Okay, follow-me slowly here for a minute because this is a little bit like playing Twister. In other words, three batches of embryos each of which contain embryos which are full genetic siblings to embryos in other batches, could be donated to three different families thereby creating three separate families whose children are all full genetic siblings to each other!
Do the recipients of these embryos know how many full genetic siblings their child may have? Are the donors aware?
It is supposedly almost impossible from a statistical standpoint for one of these children to marry its full sibling. But when you add in the half siblings that could be created through other donation programs, and/or smaller ethnic groups for whom donation can be a challenge because of the limited number of donors available matching their ethnicity, doesn’t the risk become somewhat more than insignificant? And even if it doesn’t, I worry that people don’t have enough information about how many genetic siblings are out there whether they are full or half siblings.
But I get it, I get why he did it. Especially for someone with an ethnic background this type of program would be hugely popular and let’s not forget the money back guarantee. We’re all broke after trying IVF multiple times, why the heck not take out a second mortgage if you know you will be able to pay it back if you don’t get pregnant? Sounds pretty good doesn’t it?
I am at war with myself. I want to go running to that clinic and pick out an embryo tomorrow. And then my lawyer (self) tells me to stop and think about whether I want to participate in, and thereby endorse a practice which I believe, in my own legal opinion, is legally impermissible, and legally and medically unethical. Is my desire to be a gestational mother stronger than my moral center? Good question.
The views expressed in this blog are the views and opinions of this author and are not intended to provide or constitute legal advice or a statement of the laws as they may pertain third-party assisted reproduction within the United States.
January 30, 2012 | By: Liz | 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
For more information please read http://myemail.constantcontact.com/Infertility-Matters–Demanding-Essential-Benefit-Coverage.html?soid=1101342191383&aid=B44Urr44QiU
April 16, 2009 | By: Liz | Filed under: Current Affairs, Financing Fertility Treament or Adoption, Questions about the Office
As Tax Day comes and goes and so many people are struggling both with infertility and paying bills, and praying that tax refunds will help pay for treatment or adoption expenses, we’ve been asking, what can we do to help?
Well, we’ve decided to extend a little economic stimulus package of our own! The Stork Lawyer Economic Stimulus Plan of 2009 is designed to make all legal services for family building more affordable for everyone!
First, we’d like to remind you that we offer a free egg donation contract per fiscal quarter to qualifying individuals and families. To make this even more meaningful, we are changing the criteria for applicants to make it easier to qualify for a free contract. Although our website has not yet been updated, we urge anyone who would like to apply for a free egg donation contract due to their difficulty in paying the expenses associated with their egg donation cycle to submit an application. We will send them the criteria by email (until it is posted on our website), and we will consider all applications submitted regardless of whether they strictly meet our criteria.
Second, we are offering a 15% discount on our legal services for egg donation and gestational carrier arrangements to all new clients. Our normal fees have been slashed! For the next fiscal quarter and perhaps even longer, our new rates will reflect an across the board reduction of 15%.
Third, for clients who retain us during the second fiscal quarter of 2009, we are offering flat fee billing arrangements on all parentage orders, and on most of our adoption services. By establishing flat fee billing arrangements we hope to reduce people’s worry regarding how much their legal fees will be to adopt domestically and/or to establish their genetic relationship with their child conceived through third party assisted reproductive arrangements.
If you have any questions or require specific information for yourself or even your friends, please do not hesitate to contact me and I would be happy to speak with you about making your family building more affordable. You can reach me by email at Liz@StorkLawyer.com
Please check our website frequently as we will be providing specific details regarding:
The Stork Lawyer Economic Stimulus Plan of 2009!
Elizabeth Swire Falker, Esq.
p.s. Nothing in this blog shall be deemed to create an attorney-client relationship and we may not be able to provide legal counsel and advice to all persons who contact the office in response to this blog post due to ethical restrictions imposed upon the office. However, please do not hesitate to contact us with questions or to see if we can assist you.