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

But my blog today — which is very different than that which I typically post — has more to do with whether the penalty fit the crime than whether what transpired under the direction of TE and with the assistance of HN was right or wrong, or for that matter my level of shock and horror at all of it.  I had at one point read something on the internet that suggested that HN had been sentenced, or was going to be sentenced to 13 years in prison.  I remember discussing the article I read with the women in my office.  I asked them whether they thought 13 years were too few or too many.  It turns out there was no factual basis to the article I was reading, as HN will be serving less than a year in a federal penitentiary and additional time under house arrest.  That is quite a difference from 13 years wouldn’t you say?

I had never made a decision myself about whether 13 years was “just” punishment for the crimes alleged and to which she plead guilty.  Some part of me felt that it wasn’t enough time and some part of me felt it was too much time.  So I let it go, as I was more intrigued by the fact that there were still matters under investigation.

But I have no doubt when I say that less than a year in “Club Fed” is not enough time.  As the Judge Battaglia pointed out (for more see an article in the  http://www.abajournal.com/news/article/former_lawyer_gets_1-year_sentence_in_international_baby_selling_scam/ ), HN doesn’t even appear to understand that what she has done was wrong.  Under the circumstances, then doesn’t it make sense to give someone slightly harsher a penalty to help them internalize that which they have done?  Club Fed is rumored not to be such a bad place.  If I recall, Martha Stewart enjoyed learning how to knit while she served her time.  Given that we are talking about the intentional creation and sale of human life, do we really want to send a message to society that less than a year in jail is sufficient punishment for such atrocious conduct?  I recognize that Judge Battaglia was restricted by sentencing guidelines, but even so, he still had the ability to provide for a more severe consequence for this crime.  House arrest is pretty much of a joke isn’t it?  There are days that actually sounds like a pretty sweet deal if you ask me.  I suppose taking the option out of it may make it different.  It is one thing to imagine what its like and another thing to actually live with an ankle bracelet every day.  Query, if you have a pool in your backyard, are you allowed to sunbathe next to it?  Or is that a violation of house arrest? Let’s be clear, however, we can make brownies, watch TV, read books, surf Face Book, and shop on the internet while under house arrest, things we cannot do at Club Fed.

I am not sure, and will most certainly be giving this more thought, but my gut reaction is that I really think this punishment didn’t fit the crime.  As we await the sentencing of the co-conspirators, I am really curious to see if this notion of minimum and maximum sentences, house arrest, and the reality that people like me (albeit me 11 years ago) — desperate to have a child, unknowing (even as an attorney) of the true bounds of the law with respect to things like surrogacy and egg donation — were intentionally preyed upon.  Babies were intentionally created to be sold to people like me.  It’s gross and inhuman.  And I object to the fact that the people who perpetrated these acts get to make brownies in the comfort of their own home, surf Face Book, and shop on Amazon, and perhaps even luxuriate by the pool in their backyard (seriously, is that okay with the ankle bracelet?  Martha was allowed to garden wasn’t she??).  Isn’t house arrest pretty much the same thing as sending your child to their room for a “time out”?

So I am going to make a pledge to devote more of my time to educating people so they don’t fall prey to schemes like these.  And while I do so, I hope that somewhere a fair justice system will prevail in what remains of these cases.

These are the personal thoughts and opinions of this author.

So what is the deal with surrogacy in New York State anyway?  Would you be surprised if I told you that one of the most active aspects of my practice involves surrogacy and it all takes place in the Empire State?  Would you be even more surprised to know that it also is one of the more fun things I do and that I love helping people with surrogacy in NY.  It happens to be one of the more time intensive aspects of my work but I get to dust off my old litigation garb and go to Court (in fact I am headed to Court this Friday) which always offsets the time spent drafting papers.  It is one of the aspects of my work that truly blends all aspects of what I love doing as a lawyer.  I get to help people have babies, I get to draft documents, motion papers, and go to Court and talk about esoteric aspects of NY law with judges.  Indeed, the law in NY with respect to surrogacy is getting so well-settled thanks to recently decided cases (to the extent that any aspect of ART law is “settled” or established) that half the time the Judge just wants to engage in an intellectual debate about what the law does and does not provide for and why.  Half the time I think they just want me to explain third-party assisted reproduction, IVF, Embryo Transfer Procedures, and the definition of an embryo, but far be it from me to (a) miss an opportunity to “argue” with anyone; (2) miss an opportunity to educate anyone about what I do; and (3) do anything that stands in the way of helping someone become a parent.  But I digress.

The skinny on making someone else’s belly fat with your baby in the State of New York (and while I mean absolutely no disrespect to gestational carriers/surrogates and am awed by what these women do for infertile women and men, let’s face it, if you can FINALLY have a biological child and can do so without the proverbial bump, this may be a good thing.  Trust me, having been pregnant 9+ times, most of us do not get a cute little bump ala Beyonce although I do like “the glo!”  And for the record I am not talking about using a surrogate for vanity’s sake.  I am talking about long battles with infertility etc).  But I digress again . . . is as follows:

No compensation.

Must have some type of legal document prepared before cycle starts evidencing the parties’ intent as to who will be parents.  This document is not a legally enforceable contract but is useful for many purposes, not the least of which is avoiding later disagreements over how the pregnancy will be handled and establishing intent for purposes of determining parentage (let your lawyer sweat the language in the Court documents but I do think there is merit to including this document when you are requesting a court order to obtain a birth certificate, although some attorneys may disagree with me on this — I haven’t yet had an issue submitting it).

After confirmed conception, sometime in second trimester, you should begin thinking about getting Court Orders determining parentage.  These papers will be filed in Court AFTER the baby is born and depending on who is seeking parental rights it may be Family Court or Supreme Court (but recent case law indicates you could probably file in either Court for either gender parent–I am currently trying for the first time to file the paperwork for both mom and dad in the same court, to date I have always submitted them in different courts.  Like I said, new case law is giving me an opportunity to try and streamline the process).  There is a lot of paperwork to be prepared so be nice and give your attorney a break and give them a head-start.  Please don’t descend upon us the day your baby has been born.  Although, depending on our calendars we will probably try to help you anyway.

Make sure to notify the hospital social work department of what is going on so they are not caught off guard and can assist you with proper legal paperwork at time of birth.

After birth the surrogate (and her husband if she has one) will have to relinquish/surrender/terminate (pick your verb) their parental rights.  They are both considered the baby’s legal and natural parents under New York law until they terminate parental rights and you get your Court Order.  They should execute some additional documents as well, but they exceed the scope of the blog.  A good reproductive lawyer will know what else should be signed at or around the time of birth in addition to documents terminating parental rights.  Please note that, just because the surrogate and/or husband are taking steps to terminate their parental rights does not mean you are adopting your baby.  Nor is there a home study involved in this process as there is in an adoption.

Around this time you get to take your baby home!

Your attorney next files your proceedings in whatever jurisdiction(s) in which s/he has selected for purposes of venue.  Not adoption proceedings.  I call them Parentage Proceedings or Parentage Orders.

It’s a good idea to try and get these papers moving through the court system as soon as possible after birth (doesn’t always happen as soon as everyone would like) and with as much speed as the court system will provide (there are options for making the process go more quickly, so talk to your reproductive lawyer as most of us feel that time is of the essence).

These papers request that the Court declare you to be the baby’s legal/natural/genetic/biological (pick your verb) parent(s), and that New York State replace the original birth certificate that was issued with the surrogate’s name (this must be issued under NY law until such time as the legislature determines whether it can forego this step).  The birth certificate with the intended/biological parent(s) name on it looks identical to the first — no one will know the diff.

You can request to have the first birth certificate with the surrogate’s name on it be sealed.  However, many intended parent(s) feel this is unnecessary as they have no problem recognizing the gift that their friend or family member has given them by carrying and delivering the baby — everyone knows already so who cares whether the birth certificate can be obtained without showing cause to have it unsealed.  But this is a personal issue to discuss with your attorney.

If all goes well, the Court grants your petition(s) and you get the new birth certificate with your name(s) on it.  As noted, the original birth certificate may or may not be sealed.

Depending on where in New York you did all of this will impact how quickly you get the new birth certificate with your name on it.  I have had clients get one in 30 days and others have waited months.  This truly will come down to red tape and papers not getting lost on people’s desks!

Can you find a friend or family member to carry a baby for you?  You would be surprised at how many people do have someone in their lives who would be willing to help you.  One thing I have noticed is that the people who have been more open and out-of-the-closet about their infertility often have more people offering to be a compassionate surrogate than those of us who remain silent.  They can’t offer to help if you don’t know you need it, right??  For the record, we did have a family member who offered to carry a baby for us and while this wasn’t something we were interested in doing (we chose adoption instead), we were both moved beyond words by the fact that she even considered doing it.  You know who you are.  Love you!!

This blog is not intended to provide legal advice.  It is intended to provide an educational summary and overview of what this attorney believes currently may and can happen in the State of New York with respect to compassionate surrogacy arrangements, and in order to obtain a birth certificate for intended and/or biological parents whose child was carried by a friend or family member.  If you are interested in compassionate surrogacy you should speak with an experienced reproductive lawyer or family lawyer with experience with these types of proceedings.

And for the record, I believe Beyonce delivered her baby.

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!).

With all the recent emphasis on single embryo transfer, and avoidance of multiple pregnancy (a twin pregnancy is now considered a management failure at some IVF Clinics), should patients in consultation with their doctors be the ones to choose to how many embryos to transfer or should doctors face regulation or possible loss of their medical license for listening to their patient when she asks to have multiple embryos transferred when it might be advisable to limit the number transferred?

Here’s the link to the article for more info:#mce_temp_url#

(in case the link doesn’t work, cut and paste this URL  http://www.whittierdailynews.com/news/ci_16351124)

At 41, most of know that Jennifer is likely to be facing some fertility issues (although with her health conscious lifestyle and yoga-bod maybe she’s found the way to turn back time, she sure looks it anyway!).  While most of us would be doing a little freak-out dance now, and panicking about the ticking time bomb that are our ovaries, Ms. Aniston seems anything but panicked.  In fact, she seems rather Zen about it all.  And that is exactly my point and what inspires me.

First, the woman KNOWS she is going to be a mom.  One way or another the woman has total and complete faith that she will become a mom.  Rather than spiraling into depression (as I did and many of us do), Jennifer has seemed to have found a way to let go and TRUST.  This is, I think, the gateway to success.

I really truly believe that it is when you completely accept and embrace the concept that you will be a mother, no matter what and no matter how (IUI, IVF, IVF donor egg, gestational surrogacy, adoption, whatever is your path), that fertility treatments have the highest success rates.  Study after study shows that the mind-body connection cannot and should not be ignored.  Women who are able to be in the place that Jennifer Aniston seems to be in, are the women who are more likely to succeed with fertility treatments.  It’s fact not fiction.  I know — as does JA — that she’s got an edge on success that I wish more of my friends and clients had: The inner-knowingness of the inevitability of their impending state of motherhood.

Another thing that I think sets her apart from many of us (and I include myself in this group when I was in the first 4 or 5 years of treatment), is that by all media accounts, she seems fairly open to many different paths to parenthood.  I am not privy to her conversations with her BFF’s but I am guessing that there isn’t much she isn’t considering about how she’s going to become a mom.  That too puts her on the fast track to “mommydom”.  Not all of us can be as enlightened and confident as she is, and I am not saying that she doesn’t have her moments of . . . doubt  . . . but I really think that the confidence and openness that Jennifer Aniston is talking about whenever she is interviewed about becoming a mom is something that tells me it ain’t gonna be long before she’s announcing the arrival or the impending arrival of a little baby Aniston.

And for what its worth, I think she’s a fantastic role model for every woman, single or married, over the age of 35 who’s trying to become a mom.

ASSUME IT IS GOING TO HAPPEN, AND IT WILL.

p.s. and when you can’t totally assume it will happen, fake it, fake it until you make-it  . . . because that’s another sure fire way to get your mommy-Zen fire burning.

Here’s How One Woman Made Egg Donation Work:

Through the gift(s) provided by an egg donor, 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 to deliver their child into the world.  The success rates offered by many egg donation programs are staggering (nearing the 70% mark at most clinics), making this one of the more popular options in modern family building for women with diminished ovarian reserve or other issues of egg quality.

Egg donation is often so successful that you can potentially build your 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 donor not only gets the recipient mother pregnant but there are extra embryos frozen for future family building.

Let us consider Janet[1], and her experience with egg donation.  Janet is in her late thirties and after several failed IVF cycles, Janet’s doctors told her that her best chances for becoming a mother were through egg donation or adoption.  Janet wanted to experience pregnancy, and so chose to pursue egg donation.

After doing research, Janet decided to work with an egg donation agency, rather than using her clinic’s in-house program. While some clinics are very flexible, Janet found she had more options when using an egg donation agency.  By working with an agency Janet had greater flexibility in choosing her donor, didn’t have to share eggs with another infertile family, and would have greater control over her finances.  Because she was on a tight budget, most of the agencies she spoke with encouraged Janet to select a donor who lived near the clinic she would be using, thus avoiding substantial travel expenses.  Using an agency, Janet also had a greater selection of donors with compensation rates to fit her budget, compared with the fixed rates offered by most clinics.

One donor Janet considered (we’ll call her Leslie[2]), was twenty-six years old, single, had near perfect SAT scores, attended an Ivy League college, graduated at the top of her class and was attending medical school.  Despite Leslie’s outstanding academic credentials (which sometimes result in higher compensation rates) Leslie’s requested compensation was within the middle range of both ASRM’s and the Society for Assisted Reproductive Technologies’ (SART)[3] guidelines for egg donor compensation: $3,000-$7,000 per donation.  Leslie also visibly resembled Janet and lived near their fertility clinic thus helping to make the cycle more affordable for Janet and her partner.  Leslie seemed like the perfect donor.

Leslie, however, had no “track record” donating eggs.  She had never been an egg donor before and didn’t have any children of her own.  Although statistically, carefully screened first-time (or “unproven”) donors have the same success rates in helping infertile women/couples achieve pregnancy, Janet was concerned that she would spend money to have Leslie donor undergo the first part of the necessary screening process, only to find out that Leslie was not sufficiently fertile and had been disqualified from being an egg donor.

Janet and her partner were also considering matching with a donor named “Julie”.   Julie also was twenty-six, had high SAT scores, had attended college, and had never been an egg donor before.  Julie was requesting the same compensation as had Leslie ($5,000) and lived near Janet’s clinic.  However, Julie was married, and had two-and-half-year old twins and a one-year old baby.  Julie was clearly fertile (she had children) and thus would be more likely to produce healthy eggs, which to Janet and her partner meant she presented a lower risk of being “screened out” by their fertility clinic.

Once Janet and her partner selected Julie as their donor, Janet’s egg donation agency presented them with a list of attorneys to help prepare their egg donation agreement, and it arranged for Julie to be represented by separate counsel in connection with the negotiation and drafting of their agreement. The egg donation agreement is a critical aspect of the egg donation process and all parties should be represented by independent counsel.  The egg donation agreement will protect your rights as parents and govern your relationship with your donor for years to come.  You should have the right to select your own attorney, one who is an experienced reproductive lawyer.

Each egg donation agreement is unique; some agreements provide for complete disclosure of names and addresses and others are completely anonymous.  Whatever your comfort level or that of your donor may be regarding future contact, please consider that your agreement should ensure that you can contact your donor in case of a future medical emergency.  Among other things, your egg donation agreement should specify your rights to utilize and/or dispose of the eggs/embryos created from the cycle, require that your donor follow medical directions, address what happens if your donor breaches your agreement or if the cycle needs to be rescheduled for some reason (like a death in the donor’s family), and/or how medical bills are handled if she experiences a complication like ovarian hyper-stimulation.

Within four months of the time Janet initially contacted their egg donation agency, Janet, Julie and their respective partners had negotiated their agreement and their cycle got underway.  Julie produced seventeen eggs of which fifteen fertilized.  Janet conceived a beautiful baby girl on the first embryo transfer and when Janet’s daughter was about a year-old, Janet and her partner went back and did a frozen embryo transfer; this time conceiving twin girls (it is admittedly rare for a frozen cycle to result in a twin pregnancy but in this case it did)!

[2] Names have been changed to protect people’s privacy.

[3] ASRM (The American Society for Reproductive Medicine) and SART are related organizations which, among other things, establish ethical and regulatory guidelines that many clinics and agencies agree to comply with.  For more information, visit their websites:  #www.ASRM.org# and #www.sart.org#

Charlie keeps asking me what I want to do this Mother’s Day.  I don’t know.  Breakfast in bed brought on a tray by my little boy sounds too cliche.  And the kitchen will just be a disaster that I get to clean up.  Instead, I have been visualizing future mother’s days and trying to create a rich memory for this year.  I am trying to create the perfect Mother’s Day in my head.

I asked for a trip to the gardening store and extra hands in our garden so that I can plant things that grow.  I want to celebrate this year’s Mother’s Day by making the earth rich and fertile and creating life that I can look at outside the kitchen window when I am doing dishes later this summer and be reminded of Mother’s Day.  I am trying to decide what flowers and plants I want to put in.

Mother’s Day has different meanings to all of us.  It is an especially painful holiday when your womb and arms are empty, when your power to reproduce or be a mother is in someone else’s hands.  But you do have power to visualize what it will be like when you are a mother and in so doing, by creating every detail down to the smells and textures, to the exhaustion you will feel at the thought of cleaning up the mother’s day mess in the kitchen, you help speed your way to its manifestation.  Create your future mother’s day and write it down.  Live it in your head.  Don’t for a second doubt it will be real.  The flowers this year are only a start for me.  I need to visualize more Mother’s days, with more babies.  Where will I be then, what flowers will I be planting?

And you know what, as I am writing this, I remember that my first Mother’s Day as a mother, I planted a rose bush in the garden of the house we were renting.  I had made a promise to myself before my very first IVF cycle that I would thank the earth and plant something to remember that time in my life.  I totally forgot about that.  WOW.   Maybe this is my way of celebrating.  But clearly, that promise has been realized.  Yours will be too.  And mine will be again.

So, what does your perfect Mother’s day look like?

I dropped him off and debated which way to drive home.  I opted for the way I came so I might catch a glimpse of those school buses again.  I could have chosen a faster route home, and a stop at Starbucks, but I wanted to see those buses and feel that wonderful sense of perfection and rightness again.  I wanted to hold onto it for as long as I could.  Soon, I knew, the day would interrupt and I would be struggling to find that sense of peace and joy.  Maybe I should have taken a right instead of the left and gone to Starbucks.  My day sure as hell would have been easier.

Because whammo there she was.  She was hugely pregnant.  She was wearing a white shirt that barely stretched across her belly.  She was big and beautiful and I could see her belly button sticking out from a 1/4 of a mile away.  With a sudden intake of breath I went crashing from an emotional space of rightness and calm, free falling my way to the depths of despair.  Choose the profane word you like most and insert it here.  Mine begins with an “F”.

WHY????  Why does this continue to bug me.  Why cannot I get past my need to be pregnant.  My life is full and rich, and challenging and amazing and hard and beautiful . . . just as it is intended to be.  And yet one siting of a woman filled with the life that I have yet to bear and I turned into a weeping mass of depression.    I pulled the car over to watch her for a few moments, turned on the Dixie Chics’ song about infertility, and had a good cry.

I imagine my heartbreak this morning was more real because I recently lost an unexpected pregnancy.  I spent a little over a week of my life living in wonder at the miracle of nature and my body that I could conceive at 43 without Lovenox and without donor sperm.  According to the ultrasound, I was 5w4d when I found out I was pregnant.  I didn’t keep the ultrasound because I didn’t want another reminder.  I knew the pregnancy wouldn’t stick.  That was too much to ask for.  But I did live with this beautiful secret for much longer than I expected to until the inevitable . . . .

Now I am struggling to make sense of this accident.  My body is still recovering, and I am sure I am 100% normal in my response to that which I long to have, and see all around me, and all too often.  It is Spring and I have always noticed that I see more pregnant women in the Spring.  It sucks that so far this experience has been denied to me.  I sat in the car praying that one day that the Universe will let me carry a child to term.  I also accepted the fact that there is a lot of work and change that I realize I must do if I want to realize my dream (another subject in and of itself).

But what shocks me is that I/we can go from such unbelievable peace, contentment and gratitude to the depths of despair so quickly.  This is what infertility brings us.  I have been thinking alot about this infertility rollercoaster thing we’re on.  I don’t think it’s a roller coaster anymore.  I think it’s more like bungy jumping.  Every attempt we make at conception or adoption is like diving off a bridge with a seemingly thin rope tethered to your ankle.  Will the rope be strong enough to pull us up before we hit the ground?  Is it short enough to prevent us from smashing into the ground or will we crash and burn?  There is so much faith that goes into that bungy jump, so much strength and bravery that we need in order to let go and try and feel the sensation of falling safely.  Or to try and feel the the glory of the wind rushing past our face and facing the risks and fears that the “velcro” won’t stick.  My velcro didn’t stick this time and boy did I crash and burn.

But I learned something too.  I learned that I don’t want to give up my dream of carrying a child.  I’m willing to do the work and face the risks inherent in striving for this as my reality.  I learned that I am willing to dive off of the bridge again.  In fact, I am craving and longing for that opportunity.  I am officially no longer risk adverse and have put nothing but my happiness and the desire to fill each and every one of my dreams — not just being pregnant, but all of what I need and want as a person but have been too afraid to ask for because of what it might mean to the rest of my life, or how it might impact the rest of my life.  I decided that my children deserve a happy mother, not just a good mother but one who is happy and fulfilled by all aspects of her life and her being-ness.  Indeed, I think now that if I hadn’t had the miscarriage I might have failed to teach my children a valuable lesson: to believe in yourself and your dreams.  I discovered I am brave and strong.

I know now with a certainty that words cannot convey that my children came to me out of my faith that I would be a mother; that the events and circumstances in my life have all had meaning both in the way they came to be and because of the time at which they were realized.  The Universe plays a roll in everything that happens, there is no coincidence to anything that has happened to me.  All of it was part of my own divine inspiration.  And with that divine inspiration I will get to a place where I am standing on top of the bridge again waiting to feel the rush of wind, the freedom in the free fall and the unknown, and the joy and terror of staring my demons in the face and waiting to feel the cord tied around my leg catch me as the velcro finally sticks.  There is more to my journey through infertility.  Of that I am certain.  Of the outcome, I am certain in that too.

I have spoken with three clients today.  All of whom feel as I do.  That the journey seems too hard but that there must be purpose to it.  One client left me the most beautiful voice mail last week, thanking me for being a part of her family’s journey and telling me not to give up on my own (she didn’t know about the miscarriage but she must have sensed that I have been depressed and struggling with many different issues in my life and my family).  She also said that she knew one thing with certainty, that their journey was enriched by knowing me.  I was moved to tears.  My experience as a woman, as a lawyer, as an infertility patient are enriched by each of my clients.  As I help them with their contracts, with their search for a birth parent, with the daily ups and downs that come on this path, I learn new ways of expressing hope, of finding peace in each moment, of being grateful for what I do have and in renewing my faith in what is possible.  I am as grateful for each of my clients as I hope one day they will be (or are) for the work that I do for them.  But no one has ever expressed their appreciation or gratitude as she did.  I know I am doing exactly what I was intended to do and I would not be doing this work had I not endured 4 IUI’s, 7 attempted (six completed) IVF Cycles, 3 adoptions, and now ten miscarriages.  It all had purpose.

This morning as I sat in my car having my cry I wondered why it is so hard (as the Dixie Chics sang so eloquently). Is there is a reason it is so hard?  And I realized that there is a reason.  It is because it’s part of learning that the process doesn’t have to be hard.  I can instead choose to believe in the outcome I want.  What is hard is the fact that we don’t allow ourselves to believe in what is possible.  And in not believing in what is possible, we prevent it from taking place.

It is not easy to go from the pain and grief I felt this morning to having total and complete faith that my dream will one day be a reality.  But if I don’t hold steadfast to that dream and believe in believing, the velcro will never have a chance to stick.  These last few months I have discovered a place inside me that is strong and fearless.  I know without a doubt that I have the power to create my dreams.  I am glad I saw that pregnant woman this morning, and I am glad that I spent time weeping for the child I just lost.  But that child is a reminder that my body works, that my dream is alive, and that I am moving closer to it.  We are all moving closer to it, as long as we create the vision and believe it will happen, we are moving toward its’ creation.  In this case, it’s the creation of our child and/or our family.

It’s okay to have hard days.  The hard days make us understand how worthwhile the journey is and make us appreciate the easy days more.  Today, I am taking baby steps toward my next baby’s steps.  I don’t know when, but I do know it will BE.  What I can’t do is allow the hardness of the process overtake the belief in its outcome.

If you too are having a hard day, remember that you’re not alone.  And remind yourself to hold onto your dream and to make it more and more vivid every day.  Your baby, and mine, are coming.  In their own time and their own way.  As it is meant to be.  I wouldn’t have met all these wonderful men and women if it wasn’t for the way it had to be.  I wouldn’t change a thing.  Not even the baby that I just lost.  S/he taught me an incredible lesson.  To have faith in myself.

It may sometimes take baby steps to get through the day, or the week or the month.  But each little baby step is one GIANT step closer to the reality you envision.  Believe yourself.  Believe your dream.  Don’t give up.

But it also isn’t the end of the world.  I am all for getting into bed and having a big cry when you find out you’re infertile for any reason, but technology has moved us to a point where aging doesn’t matter as much as it once did.  Thanks to egg donation and surrogacy women have options they never had before.  So we can choose to put off child bearing, as long as we are prepared for the possibility that we may not have a genetic link with our child or be able to carry that pregnancy.  Tough call no doubt.  I just find it surprising that suddenly newspapers are onto our ovaries.  Like this was some massive conspiracy and women didn’t know about it?  I guess a lot of women don’t realize just how serious an issue it is and the article did point out just how drastically our fertility drops off at age 30 (I admit I was taken aback by the new statistics quoted) and age 35 . . . but the vast majority of women are not ready to be mothers at 30 or 35 . . . so what are we to do?  Read all these scary articles and rush to freeze our eggs (a technology that I do not believe has gotten to the point where it is a viable option for most women)?  I’m sorry to rant, but I am tired of people acting like science just discovered this!  Egg donation has been around for about 10 years (maybe a little less but not much).  PULEASE give me a break and give women some credit!

I am about to open an egg donation agency and all of my donor candidates are well aware of what happens to their ovaries.  These are “20 something” prospective egg donors that understand they are helping women who are sometimes not even ten years older than the donor is . . . .  and more to the point, ovaries don’t just age out.  Sometimes they never work properly.  So, journalists, let’s move on!

Let’s talk about something else in the world of infertility.  Why don’t you talk about what a devastating disease infertility is and why health insurance doesn’t cover most if any of the costs?  Now there’s a conspiracy for you!