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Egg Donation Agreements – what’s up with this anyway?

August 5, 2011 | By:

If you are going through an egg donation right now or are considering it, or know someone who is: Listen up!

I have to say I have a little bug up my arse today.  I just finished writing an article for the American Bar Association’s Family Advocate magazine, talking about why you need to draft egg donation agreements and what you need to include in them.  I also have been working on the same issue in my e-book.  But what’s really got me peeved is the amount of explaining I have to do with potential clients, or just people calling for a consult, about why egg donation agreements are so important.

In two words: parental rights.

I don’t know whether it is agencies trying to save their clients’ money or whether its clinics trying to make things easier but let me tell you that the consent forms you sign at your clinic doesn’t provide you and your soon to be larger family in the event your child gets sick and you need medical information from you donor (just one of the many benefits that can be addressed in an egg donation agreement).  And any representation that anyone makes to you about someone living in a “donor friendly” state thus you don’t have to be worried about parental rights, is only 1/4 correct.  If you are lucky enough to live in a state with an egg donation statute that is a huge plus, but I bet you anything that statute says something about the fact the someone, preferably you and your donor, sign some document stating that this statute is going to apply to your relationship and your donor isn’t going to have any rights or responsibilities with respect to any child conceived from your donation.

And even if the statute doesn’t require a legal document, egg donation agreements state the parties’ intent throughout the agreement and the law in the United States pretty much consistently relies on the parties’ intent as they enter into third party assisted reproductive arrangements, so statute or no statute, having a legal document that addresses your intent is critical.

There are ten key points on which you want to express your intent.  Other than parental rights, can you guess what the other nine might be?

This is your baby folks — or this is a baby you don’t want to have responsibility for if you are an egg donor.  This is a family and this is the rest of your life.  Why wouldn’t you take the time to at least speak with a reproductive lawyer in your area about whether the steps you are taking are sufficient to protect you and your family, or you from having an unwanted family?  One of my clients and I had this discussion one day.  Their agency was telling them that they didn’t need an egg donation agreement and that it was a waste of money and time.  Once I explained my top ten reasons to have an egg donation agreement, my former client was speechless for a few minutes.  And then he responded with:  “when you put it that way, it seems like it’s kind of a no-brainer. . . . ”

I understand — all reproductive lawyers understand how expensive this process is and how overwhelming it is.  We all want the same thing for you.  A protected family or lack thereof.  If you can’t afford our fees, most of us will try and work with you but in the grand scheme of things what you spend on your egg donation agreement is pennies compared to what you are spending on the rest of the process and if you look at its value over time, well in the words of my former client, I think it’s a no brainer.

So anyone want to take a shot at the other 9 things on my top ten list?  Egg donation agreements run about 30 pages.  What the heck do we put in the agreement that could possibly make it so long?

Thanks for listening to me vent.  I look forward to posting a link to the article I wrote for the Family Advocate and I look forward to the publication of my e-book where I answer all these questions.  But in the meantime, feel free to ask me about it.  It’s your family or someone else’s . . . you should know what you might be missing.

 

p.s. this post wasn’t proofed so please forgive typos.

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Fear, failure and fertility: should we really continue to stay silent about these emotions?

March 28, 2011 | By:

I am getting over a pretty nasty bought of pneumonia.  And as a result, I have had a lot of time to think.

To think about everything that I should be doing in the office but can’t.  To think about everything that I need to be writing:  my e-book on egg donation is pretty much finished but I haven’t had time to input the final edits or to speak with my design and production team about getting it ready for the marketplace; I have an article on egg donation and surrogacy contracts that is due to the American Bar Association in a matter of days; I have to talk to my publisher about revising The Infertility Survival Handbook; I want to write a blog about a RESOLVE event I co-hosted on March 24th at Bis.Co.Latte Cafe in NYC regarding the legal issues egg and embryo donation; and oh yeah I am supposed to be teaching a class on third-party assisted reproduction at a law school and I have to prepare the syllabus (that one may not happen).

To think about all the contracts that I need to draft and edit for clients.

To think about the new series of blogs I am working on (perhaps it too will become an e-book?) on the mind-body connection in dealing with and resolving infertility.  Thanks to a Facebook friend, I discovered a wealth of information on something called “Conscious Conception.”  I have a ton of research to do on Conscious Conception, it is a seed germinating in my mind and something I very much want to talk about.   Just this morning I was staffing out work in the office and we got into a long conversation about how much I believe faith plays in people’s ability to deal with and overcome fertility.

And yet, all I am capable of on this gorgeous sunny day is to THINK about the overwhelming amount of things that are filling my proverbial plate.  I am utterly and completely without the ability to deal with any of it today.  For today my goal is to be able to breathe.  One of the fundamental things in life which I must attend to if I am going to get back to these things, yes?  Yet, instead of recognizing the very important need to take care of my own health, I have been beating myself up for my inability to do my work.  I feel like I am drowning, literally and figuratively.

It was only upon stumbling across an issue of the Wellesley Alumnae Magazine and its cover article about “When Life Doesn’t Measure Up” and reading about how, when and why so many of my fellow Wellesley sisters feel like failures, that I realized that I feel like a failure for having pneumonia and not being able to do my work.  And with that thought, I was off and running on a journey of self-analysis that of course brought me right back to the world of fertility and the feelings of failure that come with it.

Apparently, my college magazine conducted some kind of a poll asking graduates to discuss their feelings about their satisfaction with their life and feelings of inadequacy, failure, or success in a variety of different contexts.  I don’t recall receiving a questionnaire in the mail or an email like this — must have missed out on contributing my own thoughts to this very profound poll.  The reasons women gave for feeling like a failure were incredibly diverse.  And yet, despite the very diverse reasons or situations my Wellesley sisters gave when describing their own issues with failure, including dealing with chronic illness, the article did not mention infertility or an inability to have children (or the choice not to have children) as raising issues of failure.  Certainly, someone among the thousands of Wellesley graduates has experienced difficulties conceiving and must have felt like a failure.  I did.  I do.  Why didn’t someone else talk about it?  The Dixie Chicks talk about it in their song “So Hard” . . . a ballad that haunts me every time I hear it.  It’s all about the feelings of failure and loss we have when we can’t conceive.  One out of every 8 Americans is dealing with infertility.  Why didn’t the Wellesley College Alumnae Magazine talk about it?  Especially at an all women’s college, you would think that a topic like infertility and failure related to something so integral to being a woman would be recognized and not continue to be shrouded in secrecy. The article talked about the shame my sisters felt about their various failures, the secrecy that surrounded them but infertility was not among them.  What gives?

The secrecy and shame surrounding infertility is pervasive.  Just as for my sisters who are wrestling with their own failures of a different nature, the article pointed out that all of them felt better by talking openly in the article about failure and its impact on their self-perception.

Indeed, the magazine itself was often a cause for Wellesley alumnae to feel failure.  By hearing about the success stories profiled in the magazine many women admitted that they felt that they had let down the school or that they failed to measure up to the “Wellesley standard” of being or becoming another Hillary Clinton.  The article concluded with the following statement:

“But maybe what we don’t know is what failures happened to those women before they became household names that eventually brought them to the point of celebration.  And until we hear those stories, too, we can’t begin to make new templates for success that acknowledge the inclusion of failure as part of a life well-lived.”

And this leads me to the following conclusions:

Until we hear stories about our feelings of failure and inadequacy arising from our infertility, and our subsequent success at overcoming them, we cannot begin to make those new templates for success that acknowledge how much stronger or sensitive we have become as a result of our infertility.

Until we hear stories about our feelings of failure and inadequacy arising from our infertility, we cannot begin to find faith that our own journey will end in success.  We need to be inspired by the success of our sisters (and brothers) who have gone before us and achieved that which we long for — a baby — even if that success means embracing an alternate route to parenthood such as surrogacy, egg or embryo donation, or adoption.

It is, as my Wellesley sisters say, in embracing the loss in which we gain the faith to succeed.  I wish there was no stigma to being infertile but I must confess that the lack of mention of infertility in this article really drove home for me the sense of the overwhelming stigma with which we live.  I have a serious issue with the Wellesley Alumnae Magazine for not bringing to light a discussion of how failing at something as intrinsic as becoming a mother can be so devastating to our sense of self-esteem, to our marriages, and to our sense of failure as a woman.  (I cannot fathom that not one woman responded to that poll and didn’t mention infertility and if that was the case, I am even more troubled by the statement that makes regarding how much we hide about our infertility).

Learning from others who share their own shame or other sense of failure about something with which we are all supposed to be able to do — conceive, carry and give birth to our children — is what will carry us through.  For others it is not necessarily biological or medical failure but a sense of frustration at being unable to conceive because we lack the essential components — we are socially infertile.  And learning from others who find ways beyond our social infertility will give us ideas and strength for achieving that which our sexual orientation precludes us from obtaining.

And as the wheels started turning and hit overdrive as I considered the article and my own sense of failure because I have pneumonia and am unable to work (and am thus letting down my clients to whom I truly want nothing more than to help have a child), and considered once again the stigma with which we live, I couldn’t stay silent.  I pulled out my laptop and curled up in bed to “think through” this article and my situation and put together the pieces of this puzzle.  My blog will now not only be devoted to discussing the concepts behind Conscious Conception, but it will be devoted to de-stigmatizing this disease.  I know there is a Wellesley sister out there somewhere who is struggling to defeat the NOvary™ or endometriosis, to locate a birth mother, to navigate the increasingly complicated red tape of Ethiopian adoption, or to find a way to establish the fact that she and her partner are both the legal mothers of the child one of them delivered and which they intend to parent together.

So in my failure of having pneumonia, new ideas and inspiration have been born for my blog and thus my day has turned into one of celebration.  And I ask you to please not be silent.  I took the pledge with RESOLVE not to remain silent and today my failure in being human and having pneumonia has given me an idea of how I can fulfill my pledge to RESOLVE.  My blog is a safe place where I hope to support people walking with me on this path, and to provide the occasional nugget of legal or medical information to move us another step forward on the path to parenthood.  And thus I ask you to talk about your shame.  Talk about your sense of failure.  Talk about your frustration, your anger or confusion. (And if you are a Wellesley alumnae, help me convince them to let me write an article about infertility).  Share your story here wherever you may be in your journey.  And I will try and find people to share with you how they conquered the NOvary, endometriosis, found birth mothers, survived the red tape of Ethiopian adoptions, or proven their joint parentage.

Because I know that if we continue to be silent and give in to this crazy stigma, we will never know what failures happened to those women (and men) among us before they became mothers (and fathers), and that eventually brought them to the point of celebration.  And until we hear those stories we can’t begin to make new templates for success that acknowledge the inclusion of infertility as part of a life with children.

And now for some random FAQ’s and reminders:

Yes, you can establish your parentage if you are a same-sex couple and one of you has a baby.  Depending on where you live the mechanisms for doing this will vary.  In some states you can file a legal action to have your parental rights established, in other states you may need or want to adopt (even if you are not married).  In some States and in some circumstances you may need or want to do both.

If you have a functioning uterus, egg donation is perhaps the most successful route to pregnancy for women who have issues with the NOvary™.  At many clinics, with a properly screened egg donor, live birth rates per egg donation are in the 60% range.  Yes, you read that correctly, you could have a 60% chance of conceiving a baby using an egg donor.  And among those that conceive using an egg donor, the rate of twin conceptions is in the 40% range (making a strong case for single embryo transfer).

If you are considering adoption but have financial concerns or are worried about wait times, relinquishment risks, or red tape, embryo donation is a rapidly growing path to parenthood.  Using embryos donated from another family who has cryopreserved embryos which they no longer wish to use to build their own family, you may have a 40% chance of conceiving a child.  In addition to the affordability of embryo donation and the high success rates, you have the opportunity to carry the child, control the uterine environment, and may have the ability to conceive more than one child (this will depend on the type of embryo donation you enter into, as well as the number and quality of the embryos donated to you).

If you don’t have a functioning uterus, gestational surrogacy is another option for becoming a parent.  Using either your own gametes (genetic material), or an embryo created from egg or sperm donation (or sometimes both), another woman can carry a child for you and you will have all legal and parental rights upon that child’s birth.  Surrogacy laws vary by State, and it’s far from inexpensive, but when done correctly, surrogacy is a wonderful means of building a family.

And let’s not forget what is now almost considered boring: IVF.  If you have a viable uterus, eggs and/or sperm but for other reasons have difficulty conceiving on your own, with the assistance of In Vitro Fertilization, your chances of conceiving get better every day.  With the improvement of the culture medium used to nourish embryos, together with advances in reproductive medicine, some families will have as high as a 70% chance of conceiving.  Although the vast majority of families using IVF will need more than one attempt before conceiving, this is a technology that should not be ignored.

Other things to consider are:

PGD, (Preimplantation Genetic Diagnosis).  This enables you to select only those embryos that appear chromosomally normal for embryo transfer in an IVF cycle.  For older infertility patients, those with a family history of hereditary illness, or those with recurrent pregnancy loss, PGD can increase your chances of conceiving a healthy baby.

ICSI, (Intracytoplasmic sperm injection).  This is where doctors inject the sperm into the egg to help facilitate fertilization.  For families with male factor infertility this can help side-step problems with sperm that might prevent it from fertilizing an egg.

DNA Fragmentation Assay.  This is a test performed on sperm to determine whether the sperm are chromosomally normal.  Although there is a large range of “grey area” where it is unclear whether the sperm are going to cause problems with conception or pregnancy loss, this is proving to be a very important aspect in solving cases of recurrent pregnancy loss, IVF failure, or otherwise diagnosing “hidden” infertility issues.

Blood Clotting Disorders and other immune issues.  Do you have unexplained pregnancy loss or IVF failure (with an egg donor)?  Go get a work-up from a hematologist or other doctor specializing in diagnosing harder to find infertility issues.  Sadly many physicians routinely overlook or discredit the influence or impact of blood clotting and/or immune issues on the ability of an embryo to implant in the uterus, or to the ongoing development of a baby.

Are you going to stay silent, or are you going to talk with me here about what you are feeling, what you are trying to do to overcome your infertility, or what you did that helped you overcome it?  Speak.  If not here, then find somewhere.  Please.

 

 

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Is the movie Eggsploitation, exploiting itself?

January 14, 2011 | By:

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

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

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

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

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

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

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

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

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

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

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

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

Blech Blech Blech.

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