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Archive for January, 2018

Who Will Carry the Baby in LGBT Family-Building? (Part One): For Gay Men

By Tracey Minella

January 26th, 2018 at 3:58 pm

In family-building for heterosexual couples, this is not generally a question. But in LGBT family-building, single gay men or gay couples who want a baby that shares a genetic connection with them, the first question to answer is: Who will carry the baby?

Except in cases where a single gay man or both partners in a gay couple have male factor infertility, sperm is usually readily available for baby-making purposes. But the need for a woman’s egg– as well as a uterus in which the baby will grow– is obvious. Fortunately, there are donor programs at Long Island IVF.

In general, and depending on where they live, gay men can choose either a surrogate OR an egg donor and gestational carrier to carry the baby. Both of these options involve another woman carrying the pregnancy for the single gay man or gay couple as intended parent(s), so it helps to understand the difference, even though surrogacy is not legal in New York State.

In a surrogacy arrangement, the woman surrogate uses her own egg to become pregnant with the gay intended parent father’s sperm. Just to be clear –and to the relief of all involved –the pair does not have sexual relations to establish the pregnancy. Instead, a semen specimen is collected from the gay man who intends to be the biological father, and it’s processed and frozen in advance. The surrogate will be monitored for ovulation (when the egg is released from the ovary and the limited window for conception begins). At that time, in a fast and simple office visit, the father’s specimen is thawed and deposited into her uterus via a thin catheter– through a procedure called an intrauterine insemination, or (“IUI”).

If the IUI is successful, the surrogate carries the pregnancy to term, and gives the newborn to the gay father(s) upon birth, thereafter relinquishing her parental rights (in the manner dictated by that particular state’s laws). The newborn is genetically-linked to both the surrogate birth mother and the gay father. Again, this is not an option in New York.

Those of a certain age may remember the infamous New Jersey “Baby M” case of the mid-80s, which thrust the validity of surrogacy agreements into the national limelight. The birth mother, who was genetically-connected to the baby, changed her mind and wanted to keep the baby instead of turning her over to the biological father and his wife, who were the intended parents pursuant to a surrogacy contract.

A long legal battle ensued, and in a nutshell, the court ruled that the paid surrogacy agreement was invalid and against public policy, and that the birth mother and the biological father were the baby’s legal parents. Further, the case was remanded to Family Court for a judge to decide which parent would be awarded legal custody of the baby, using the “best interests of the child” standard that’s used in regular child custody cases. Custody was given to the father, but the mother was awarded visitation rights. *

Times have changed.

While surrogacy in some form is legal in some states, the advancements in reproductive medicine that followed in the decades since Baby M have now made the use of gestational carriers and donor eggs not only medically possible and popular, but also often the only legal way to have someone carry a baby for you.

Gestational carrier with donor egg is the alternative option to surrogacy for a gay man or gay couple to have a genetically-linked baby and it’s the only legal option in New York State. It involves finding two different women to help you– an egg donor and a gestational carrier. That’s how it’s different from surrogacy.

First, the egg donor only provides the eggs, not the uterus. She could be someone you know (like a sister or friend) or could be an anonymous donor who you select after reviewing an extensive profile of donor egg candidates. At Long Island IVF, we have pre-screened donor egg candidates ready to help you build your family.

Lady #2 is the gestational carrier. She only provides the uterus, not the eggs. She can be someone you know, or someone you don’t yet know but who you select through an agency. In most cases, you will get to know and develop a relationship with the gestational carrier.

With the gestational carrier and donor eggs option, the woman chosen to be the egg donor undergoes what is essentially an in vitro fertilization or (“IVF”) procedure up to the point of the egg retrieval. That means she will receive hormonal injections, bloodwork, and ultrasound monitoring of her ovaries (and the developing follicles/eggs inside them) over a period of a few weeks. The purpose of the treatment is for her to produce multiple egg-containing follicles rather than the one egg she would normally produce that month.

When the time is right, the eggs are retrieved prior to ovulation by a reproductive endocrinologist using a transvaginal needle aspiration procedure and injected with the sperm from the gay man (or men) intended parent(s) in the hope that fertilization occurs.

placed in a petri dish with sperm from the gay man (or men) intended parent(s) in the hope that fertilization occurs.

The resulting fertilized eggs, now known as embryos, will be frozen (a/k/a cryopreserved) until such time as they are ready to be thawed and transferred into the waiting uterus of the chosen gestational carrier. [Note that if pre-genetic screening (“PGS”) is elected, it is done prior to the freezing of the embryos.]

The thawed embryos—generally one or two– are placed into the gestational carrier’s uterus through a thin catheter in a fast and simple procedure performed by the reproductive endocrinologist, aptly called “the transfer”. The intention is for an embryo to implant in the uterine wall and a healthy pregnancy to result. If the gestational carrier gets pregnant, she turns the baby –who unlike in surrogacy has no genetic connection to her – –over to the gay man (or men) who is the intended parent(s).

In accordance with applicable state laws, these women are generally well-compensated for their time and effort. Because of the need for gay men to involve two different women in the process, costs are higher than what lesbians and straight couples using assisted reproductive technology typically incur. However, the good news is that a single egg donor cycle may produce enough eggs that gay male intended parents may be able to build their families through more than one pregnancy using just the eggs retrieved from that initial cycle. So, future pregnancy attempts would require the compensating the gestational carrier, but not the egg donor.

Here is how that could work: They might transfer 1-2 embryos into the gestational carrier on the first try (leaving the rest frozen), and if successful, they have a baby (or two). Then maybe a year or more later, they transfer another 1-2 embryos into the same (or another) gestational carrier, and if successful, they have another baby (or two). And so on, until all the embryos are used or they no longer want to use the embryos for additional children.

While there would be the expense of the gestational carrier for each birth (as well as for the medical treatment expenses for the gestational carrier to undergo a frozen cycle), there would be no additional egg donor costs– until you exhausted your supply of embryos from the first egg donor. As exciting and promising as this process is, each case is different and no program can guarantee a baby in the end for any couple. That said, we do have patients who have successfully used embryos retrieved from a single IVF cycle to build their multi-children families—a child at a time—in separate births spaced a few years apart.  So, there is reason to consider this wonderful family-building option that wasn’t available—especially to gay men—all that long ago.

[The second part on this topic on who will carry the baby—for lesbian singles and couples—will be posted next month.]

If you are a gay man or lesbian—single or married– interested in family building, Long Island IVF has decades of experience helping the community become parents.  Please contact us today for more information or to schedule an initial consultation. In addition, follow us on social media for info on our many free upcoming events.

We are proud to partner with the LGBT Network to provide the community with information, education, support, and access to the most advanced traditional and holistic assisted reproductive technologies. We also understand, respect, and are sensitive to the unique needs of the LGBT community when it comes to building its families.

This year, Long Island IVF is celebrating a milestone–our 30th anniversary. If you are ready for parenthood, we would love the opportunity to assist you with your own milestone.

 

*Source: https://en.wikipedia.org/wiki/Baby_M

 

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Infertility, Seasonal Affective Disorder, and the First Quarter Blues

By Tracey Minella

January 4th, 2018 at 11:56 pm

depressed woman

image credit: nenetus at freedigitalphotos.net

Infertility and depression go hand-in-hand. Just ask any woman who’s not able to conceive or maintain a pregnancy without medical intervention. You’d be down, too. But some couples–yes, men have feelings, too–are seriously depressed. Maybe even clinically depressed.

Any number of factors could impact a couple’s ability to cope with their infertility struggle. There’s often misplaced guilt or blame over whose “fault” the problem is– or alternatively the complete frustration of facing an “unexplained infertility” diagnosis. Some couples may be completely overwhelmed upon the initial diagnosis while others spiral downward as more time passes without a baby. And the stress of the financial burden of infertility treatment on a couple’s budget doesn’t help matters.

But could there be more to “being down” at this time of year?

Many people actually suffer from Seasonal Affective Disorder* (“SAD”) –a form of depression that comes and goes with the seasons. Generally, the onset of symptoms begins in the fall, continues or escalates through the winter and eases a bit as spring arrives. This actual syndrome causes those affected to become more depressed in the cold, dark, dreary winter season than they tend to be during the sunny, warm, longer and somewhat more carefree days of summer. Therapy may help ease the symptoms.

So, is it harder to be infertile during the winter months? Does it feel that way to you?

It’s certainly understandable to be down after the holiday season is over and to be exhausted by endless weeks of wearing a fake smile and dodging nagging personal questions –all while surrounded by the babies and pregnant bellies of others. The bitter cold weather on Long Island lately would make anyone want to pull the covers over their head and hibernate. Unless you have an upcoming vacation to look forward to, the first quarter of the new year could seem pretty bleak.

However, if you’re feeling particularly depressed and your depression is interfering with your ability to get through the demands of your day, it may be more than just the winter blues. And it might be time to seek counseling from a caring therapist who specializes in helping infertile couples cope with the stress of infertility.

Among the many offerings of the Long Island IVF Mind-Body Program are individual and group counseling sessions with Bina Benisch, M.S., R.N. In addition, we offer special workshops hosted by Bina for individuals and couples covering topics like how to “come out” to friends and family about your infertility struggle or how to keep passion in your relationship during your infertility treatment.

Whether you are interested in individual or group counseling with Bina or you want to register here for her upcoming, pre-Valentine’s Day workshop on “Rekindling Romance in the Face of Infertility”, help is here for you. And you don’t have to be a Long Island IVF patient to participate. In fact, many couples’ first experiences with our practice began with Bina’s counseling, or by taking advantage of our free workshops and seminars during the year. Becoming patients—and hopefully parents—often follows that initial contact.

Long Island IVF is celebrating a milestone this year: 2018 marks our 30th anniversary! The same team of doctors who founded the practice responsible for bringing Long Island its first IVF baby, its first baby from a cryopreserved embryo, and its first donor egg baby is still together three decades later and continues to pioneer breakthroughs in the field of assisted reproductive technology. We love what we do and the birth of every baby we’re responsible for is just as exciting as that very first one. Let us help you celebrate a milestone this year, too. Contact us today to schedule an initial consultation.

 

*Source: The Mayo Clinic https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651

Image credit: freedigitalphotos.net/nenetus

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A New Year’s Plan Beats a Resolution When Infertile

By Tracey Minella

January 2nd, 2018 at 8:41 am

breaking resolutions

image credit: Ryan McGuire-Gratisography

We’ve barely cracked into the New Year and I’m already tired of hearing about people’s resolutions. Including yours, I bet. And here’s why…

We all make them. We all break them. The thing that frustrates me about other people’s resolutions is that they are generally related to things that are within the maker’s control to make happen. Something the person can do themselves… or can stop doing. Something that doesn’t require the assistance of somebody else. Something that could be guaranteed to be successful if the person merely put in the required effort.

That’s what’s so hard about infertility and the fertility-based resolutions that come from its sufferers.

How many of you struggling to have a child made the same New Year’s resolution yet again…To have a baby this year?

It’s a wish. It’s a dream. And, yes, it’s everything… but it’s not a resolution. At least not to infertile people. Because it is not something within your power to control. At the very least it requires a third-party – – a reproductive endocrinologist– to make it happen. Plus, it requires money which could be an obstacle for some people.

So, the outcome of your so-called “baby resolution” is not in your sole control. And as important a role as your doctor plays, and as great as IVF success rates have become at a quality practice, success is not guaranteed on the first try– or even at all in some cases. The sad reality is that only the fertile folks can make baby resolutions.

Making a resolution to have a baby is setting yourself up to fail, like the dieters who have already cheated and the smokers already back outside puffing away in the bitter cold. And don’t we already heap enough feelings of failure on ourselves?

So, make a New Year’s plan not a resolution.

It may sound like semantics, but the mere word “resolution” in general is tied so often to failure that you need to leave it behind when it comes to your fertility. Choose to plan.

When you plan, you take action. When you plan, you take control. Rather than weakly resolving that you’re going to have a baby this year, get proactive and plan for it. Take control of what is within your control.

So many factors that could positively impact your fertility (as well as your general health) are within your control, so:

 

  • get adequate sleep,
  • drink lots of water to stay hydrated,
  • eat healthy and/or organic foods,
  • take vitamins and exercise with your doctor’s approval,
  • lose excess weight with your doctor’s approval,
  • stop bad habits like smoking or drinking excessively,
  • consider complementary holistic mind-body therapies and fertility acupuncture,
  • research financial options for infertility treatment.

 

Long Island IVF’s payment options, including grants, may help finance your infertility treatment. While it’s never easy to change jobs (or add an extra job) especially in economically-challenging times, more companies are offering insurance coverage for infertility treatment these days, including positions that don’t require special skills or advanced education, such as at Starbucks.

Listen to the voice in your head if it’s telling you something may be wrong and stop delaying having a consultation with a reproductive endocrinologist about the state of your fertility.

In fact, even if you are not currently trying to get pregnant, you may benefit from a fertility screening to see if there are any noticeable “red flags” about your reproductive health that might impact your future fertility plans. While it might be scary, knowing is always better than not knowing because it can let you take proactive steps before it’s too late, such as freezing your eggs while you are younger as “insurance” for use later if needed. Or just bumping up your baby plans if there are signs that that would be advisable, like a diminished ovarian reserve.

If you would like a fertility screening, or if you have been unable to become (or remain) pregnant and would like an initial consultation for fertility treatment, please contact us at any of our Long Island or Brooklyn offices.

2018 is a milestone year for Long Island IVF as we are celebrating our 30-year anniversary this summer. We are proud to have pioneered IVF here and to have brought Long Island its first IVF baby… and we treasure every baby we’ve helped bring into this world ever since.

Let us help you make 2018 a milestone year as well. Contact us today.

 

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