Archive for the ‘In-House Egg Donation Programs’ Category
March 16, 2015 | By: Liz | Filed under: Current Affairs, Egg Donation, Faith and Infertility, Gestational Carrier, In the News, In-House Egg Donation Programs, infertility in the media, Infertility on Television, IVF, Personal Musings, Surrogacy, Thinking Out Loud
Sherri Shepherd. Who hasn’t heard her name recently? The former host of The View is in the midst of a major lawsuit with her ex-husband over her son. She claims she doesn’t have any responsibility for the child she helped bring into this world. REALLY?? Is she serious? Sadly, yes. And she’s leaving this issue — what could be a ground-breaking decision in the laws pertaining to third-party assisted reproduction — to a Judge to decide. She couldn’t work it out privately with her Ex. Nope, she had to go to Court.
I used to like Ms. Shepherd. She spoke on behalf of the infertile. She was our advocate. She was one of the very few public — celebrity voices — speaking about the pain of infertility. I am trying to have faith in our judicial system right now because Ms. Shepherd has destroyed my faith in the power of the infertile woman. What she is doing, is to me, disgraceful. Wow! I guess I am angry.
I went to a benefit a few years ago for RESOLVE. It was its annual Night of Hope and Ms. Shepherd was receiving an award for raising awareness about infertility. She gave a moving speech about the pain we go through when we cannot conceive without medical help — without help from third-parties. She moved me to tears talking about how much she wanted a baby and to be a mother and how sad she was every time her fertility treatment failed. It was very clear during that speech that she wanted nothing more than what every other infertile woman wants, a BABY. And now she’s trying to dump the responsibility for that baby — that longed-for, hoped-for, much-wanted baby — on someone else. And that someone else is her egg donor or surrogate, that third party without whom she and Mr. Sally would not have conceived, and realized what she said was her dream. Her dream of becoming a mother.
Many of us don’t realize that dream and that’s why I find her actions to be such a slap in the face. To go from being a proud infertile woman putting one foot in front of the other and thanking her fertility specialist (I can remember his name) for helping her, to dumping responsibility that is rightly hers on the people who helped her achieve that dream. That’s just wrong. It is morally wrong and it is legally wrong. I am going to stop discussing the moral component of it because I get the fact that there are people in this world for whom I hold little or no respect. But from a legal standpoint, what she’s doing is profoundly dangerous and could potentially turn reproductive law upside down, and erase years of progress helping women just like Ms. Shepherd become mothers.
I should comment that I don’t know many details about Ms. Shepherd’s egg donation arrangement or surrogacy arrangement. But if she’s litigating this issue in Pennsylvania then I am guessing her surrogate is a resident of the Commonwealth of Pennsylvania and that the laws of that Commonwealth govern the surrogacy agreement. The thing is, there isn’t really any law in Pennsylvania when it comes to third-party assisted reproduction. There isn’t a statute governing third-party assisted reproduction and when there isn’t a statute governing the actions of intended parents like Ms. Shepherd and Mr. Sally, the laws of third-party assisted reproduction typically look to the intent of the intended parents (Ms. Shepherd and Mr. Sally) prior to the conception of the child. Typically those intentions are spelled out either in an egg donation agreement or gestational surrogacy agreement (or both), or in some cases through consent forms signed by an egg donor at the fertility clinic at the time she donated her eggs. But the bottom line is that there is some written statement that the egg donor does not want to have parental rights to any child conceived from her donation, and that the intended parents want to have parental rights and all the responsibilities that come with parenthood for any child conceived from the donation of eggs by the donor. Similarly, the intended parents (Ms. Shepherd and Mr. Sally) would — and in this case did — enter into a gestational surrogacy agreement which would clearly spell out that the intended parents (Ms. Shepherd and Mr. Sally) were going to be the parents of the child the surrogate carried, and the surrogate would not have any parental rights. A well-written agreement would address what would happen in the event the intended parents divorce prior to the birth of the child. Typically the intended parents are still the parents even if they divorce but maybe her agreement says something different, or is silent on the point. But the bottom line is that in order to have conceived this child, Ms. Shepherd’s egg donor waived all parental rights and Ms. Shepherd assumed them; and Ms. Shepherd stated her unequivocal desire and intent to be a parent of the child her surrogate was carrying and her surrogate expressed no desire or intention to ever be the child’s parent. I would be shocked if the legal documents at issue in her case don’t refer to the parties’ intent about who were going to be this child’s parents. Ms. Shepherd claims she was defrauded into entering into the agreement. I find that hard to believe given the years of infertility treatment she went through and the statements I heard her make that night at RESOLVE. I think she wanted this baby.
The question is whether the Judge will uphold the terms of those documents or contracts. And that is where I get scared. What if the Judge decides that the agreement with the surrogate is unenforceable for some reason and that Ms. Shepherd isn’t legally responsible for this child, that she isn’t his mother? What then? Does any intended parent get to change their mind when they one day decide that they don’t want to be a parent anymore? Where does that leave the law of intent as it informs decisions related to third-party assisted reproduction? Is the intent of the parties what governs the determination of parentage or is a gestational surrogacy agreement or egg donation agreement just another contract that can be thrown out of court on technical or some other grounds? Decades of law pertaining to third-party assisted reproduction are at risk. All the hard work my colleagues have done to make it possible for Ms. Shepherd even to consider having a child through third-party assisted reproduction could be damaged, even worse, destroyed. Will Pennsylvania remain a surrogate-friendly state? I get sick thinking about it.
Ms. Shepherd has crossed over to the other side, that of becoming a parent after battling infertility. And apparently she doesn’t like the view so much. I get the fact that Ms. Shepherd is angry at her ex-husband. I get the fact that she doesn’t want to be in this child’s life. I may not agree with her moral positions but legally I am horrified at the way she is going about getting out of her obligations as a parent. What she is doing has the potential to set the law back in ways so significant as to preclude other infertile women and men from having a child through third-party assisted reproduction. I am at a loss to understand how someone who was such a staunch advocate for the infertility community and who so desperately wanted a baby could get to a place where she wanted to put the rights of so many others like her at risk. I cannot fathom why someone would risk establishing a legal precedent that could jeaopardize the rights of so many just like her.
This all begs one question: What would Ms. Shepherd have said three or four years ago about someone taking the position she is taking today? Probably nothing nice.
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: Liz | 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!).