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Who Will Carry the Baby in LGBT Family-Building? (Part Three): For Transgenders

By Tracey Minella

April 4th, 2018 at 9:37 am

 

Eggs with symbol of transgender, female and male gender symbols

At Long Island IVF, we take pride in our history of building families for the LGBT community. While gays and lesbians have historically made up the majority of LGBT cases, recent years have brought transgender people and their family-building options into the spotlight.

For the third and final part in this series on “Who Will Carry the Baby in LGBT Family-building?”, we’re going to examine the options that transgender couples and individuals have for starting their families.

In many ways, building a transgender family is very similar to building other families in that many of the same assisted reproductive technologies are utilized, such as in vitro fertilization, egg-freezing, donor sperm and more, depending on the needs of the transgender individual or couple. Yet, in some ways, the transitioning factor of the transgender lifestyle can bring some unique challenges to transgender family-building.

Before diving in to the several different scenarios that transgender individuals and couples who want to build families may face, a basic understanding of some of the methodologies that may be used is necessary.

As we all know, biology requires an egg, a sperm, and a uterus to make a baby. When gay men want a family, they generally have the sperm requirement covered between the two of them, but they need to find an egg donor to donate the egg and a gestational carrier to carry the pregnancy in her uterus for the intended parent(s). When lesbians want a baby, they often have the egg and uterus requirements covered between the two of them but need donor sperm (which is relatively inexpensive to procure).

But when a transgender person wants a child that is genetically-connected to them, things can become a bit more complicated—especially depending on where they are in the transitioning process.

So, it’s imperative that anyone even remotely considering have a baby that’s genetically-tied to them at some point in the future see a reproductive endocrinologist as soon as possible and prior to proceeding with any transitional hormonal treatments. Failure to do so may negatively impact your ability to have a biological child.

When assisted reproductive technology is needed to help people conceive, it often involves either intrauterine insemination (“IUI”) or in vitro fertilization (“IVF”). So, let’s summarize what IUI, IVF, Egg-freezing, and egg donation entail.

For an IUI, at the time of ovulation, sperm is deposited via catheter into the uterus of a woman (who generally took oral or injectable hormonal medications to encourage ovulation of a couple of mature eggs) in the hope that fertilization will occur naturally and a pregnancy will result.

IVF is more involved and expensive than IUI but has a higher statistical success rate per cycle. It involves a woman taking hormonal injections for a couple of weeks to encourage the production of multiple eggs (rather than the one that would normally be produced each month) and being monitored closely through blood work and ultrasounds. Then when the time is right and just prior to them being ovulated, the eggs are retrieved from the ovaries through a fine needle aspiration under light sedation. The eggs are then mixed with sperm in a petri dish and incubate in the lab in the hope fertilization will take place, or in cases where sperm quality is an issue, sperm may be injected into the eggs in a procedure called intracytoplasmic sperm injection (“ICSI”) to assist in fertilization. A few days later, 1-2 resulting embryos are generally transferred vaginally via catheter into the uterus in the hope of implantation and a resulting healthy pregnancy. The unused embryos are often frozen, or cryopreserved, for future use. Sometimes, no embryos are transferred back in the fresh cycle and all are frozen for use in a future cycle.

When women undergo egg-freezing, the procedure is identical to IVF described above except that after the retrieval, mature eggs are frozen prior to being fertilized and no transfer takes place in that cycle. At some future date, the eggs can be thawed as needed and fertilized in the lab, then resulting embryos can be transferred to the woman’s uterus (or another woman’s uterus, if need be) in the hope a pregnancy will occur.

When a woman is an egg donor, she, too undergoes the procedure identical to IVF described above except that after the retrieval, her participation is over and all of the eggs are turned over to the parties who are the intended recipients for freezing and/or fertilization in accordance with their agreement.

Now that the procedures have been explained, let’s examine how transgender individuals and couples can take advantage of the available technologies. Again, we stress the need to see a reproductive endocrinologist before transitioning and beginning hormonal treatment.

We’ve broken the options down by the gender the person was biologically born into and the gender they are attracted to, so readers can skip ahead to which of the four sections best applies to them.

  1. Born female but identifies as male–Attracted to females:

If you were born female but identify as male and are attracted to females and you want to have a genetically-linked baby someday, you will need to use the eggs you were born with to make that connection. You may or may not want to also use the uterus you were born with, but the genetic connection comes from the eggs, not the uterus. Usually, those females who identify as male are not interested in carrying a pregnancy before transitioning.

Here are your options:

  • Have an IUI using donor sperm (provided you have no egg, uterine, or tubal issues) and carry the baby yourself before transitioning;
  • Have IVF using donor sperm (provided you have no egg or uterine issues) and carry the baby yourself before transitioning;
  • Have IVF using donor sperm before transitioning (provided you have no egg issues) and freeze all the embryos for future use. They can be transferred to your uterus or a partner’s uterus before transitioning or to a partner’s uterus after transitioning.
  • Have your eggs frozen for future use (provided you have no egg issues). They can be thawed and fertilized with donor sperm as needed and transferred to your uterus or a partner’s uterus before transitioning or to a partner’s uterus after transitioning.

Many of these transgender couples find that using the eggs of the partner born female who identifies as male and having them transferred to the uterus of the partner who was born female and identifies as such allows both partners to be invested in the pregnancy—one provides the egg and the other carries the pregnancy and is the birth mother. In fact, many lesbians elect to do something similar and have one partner carry the pregnancy using the eggs of the other partner for the same reason.

 

  1. Born female but identifies as male–Attracted to males:

If you were born female but identify as male and are attracted to males and you want to have a biological child someday, you will also need to use the eggs you were born with to make that connection. You may or may not want to also use the uterus you were born with, but the genetic connection comes from the eggs, not the uterus. Again, many females who identify as males are not often interested in carrying a pregnancy prior to transitioning.

If your goal is transitioning to male and partnering with a male, your family-building options would be very similar to those of a gay couple. However, you have a potentially-huge advantage in being able to use your own eggs and possibly your own uterus if desired.

Here are your options:

  • Have an IUI using donor or a partner’s sperm (provided you have no egg, uterine, or tubal issues) and carry the baby yourself before transitioning;
  • Have IVF using donor or a partner’s sperm (provided you have no egg or uterine issues) and carry the baby yourself before transitioning;
  • Have IVF using donor or partner’s sperm before transitioning (provided you have no egg issues) and freeze all the embryos for future use. They can be transferred to your uterus or a gestational carrier’s uterus before transitioning or to a gestational carrier’s uterus before or after transitioning;
  • Have your eggs frozen for future use (provided you have no egg issues). They can be thawed and fertilized with donor or a partner’s sperm as needed and transferred to your uterus or a gestational carrier’s uterus before transitioning or to a gestational carrier’s uterus after transitioning.

Many of these transgender couples find that using the eggs of the partner born female who identifies as male and having them fertilized with the sperm of the partner who was born male and identifies as such and then transferring them to the uterus of a gestational carrier not only saves them the expense of an egg donor but allows them both to have a biological connection to the baby. Before hormonal treatment/transitioning occurs, it is possible the partner with the uterus may even be able to carry the pregnancy, though most don’t pursue that option. One of the biggest obstacles to gay family-building is the cost of an egg donor and a gestational carrier. These transgender couples may be able to build their families without incurring one or both of those costs.

  1. Born male but identifies as female–Attracted to females:

If you were born male but identify as female and are attracted to females and you want to have a biological child someday, you will need to use your sperm to make that connection. As much as transition surgery can do for one who identifies as a female, it unfortunately cannot create a functional uterus in which a baby can be carried (at this time, anyway). But the genetic connection to your baby comes from the use of your sperm.

If your goal is transitioning to female and partnering with a female, your family-building options would be very similar to those of a lesbian couple. However, you have the wonderful possible advantage of being able to use your own sperm to create a baby.

Here are your options:

  • Have your sperm frozen for future use in IUI and/or IVF procedures before transitioning or beginning hormonal treatment! Multiple times. Samples can be thawed and used to fertilize your partner’s eggs via IUI or IVF as indicated (or an egg donor’s eggs via IVF, if needed) and transferred to your partner’s uterus (or a gestational carrier’s uterus if needed). You may need to undergo IVF with your partner if you have a sperm issue which ICSI (described above) may overcome.
  • Have your partner do an IUI using your sperm (provided she has no egg, uterine, or tubal issues and your sperm is of acceptable quality);
  • Have your partner do IVF using your sperm (provided she has no egg or uterine issues and use ICSI if sperm quality is an issue);
  • Have your partner do IVF using your sperm (provided she has no egg issues) and freeze all the embryos for future use. They can be transferred to a gestational carrier’s uterus if your partner has uterine issues;
  • Have IVF with donor egg using your sperm if your partner has egg issues and freeze the embryos for future use. They can be transferred into your partner’s uterus (if no uterine issues) or a gestational carrier’s uterus.

Many of these transgender couples find that using the sperm of the partner born male who identifies as female to fertilize the eggs of the partner who was born female and identifies as such either through IUI or IVF allows them both to have a biological connection to the baby. As long as the one partner’s eggs and uterus are fine, and the other partner’s sperm is fine, IUI or IVF could be the pathway to parenthood without the need for sperm or egg donors or a gestational carrier.

 

  1. Born male but identifies as female–Attracted to males:

If you were born male but identify as female and are attracted to males and you want to have a biological child someday, you only have your sperm to use to make that genetic connection. At least until science makes a uterine transplant possible in a transgender individual. But the genetic connection to your baby comes from the use of your sperm.

If your goal is transitioning to female and partnering with a male, your family-building options would be very similar to those of a gay couple. You have presumably got the sperm issue covered between the two of you but need both an egg donor and a gestational carrier in order to have a baby.

Here are your options:

  • Freeze your sperm before beginning hormonal treatment or transitioning! Multiple times. Multiple vials. It’s relatively inexpensive, especially in comparison to egg-freezing. There is virtually no reason not to do this for security– you can’t change your mind later. If an analysis determines your sperm has some issues (i.e. factors like its volume, shape, speed), ask your doctor if you should freeze even more. As discussed earlier, if you have a sperm issue ICSI (see above) during IVF may overcome it.
  • Have IVF using your sperm from before transitioning and using an egg donor and a gestational carrier. Your egg donor can be anonymous or known to you. She will undergo IVF (as previously explained above) but at the point of the egg retrieval, she turns the eggs over to you and she’s done. The eggs are then mixed with your sperm and/or your partner’s sperm for fertilization. After fertilization, the resulting embryos are frozen, to be implanted in the uterus of a gestational carrier. A gestational carrier is a woman (one different than the egg donor) who agrees to carry the baby for you, the intended parent(s). At the birth, the baby is turned over to you pursuant to your contract.

Many of these transgender couples find that using the sperm of both the partner that was born male who identifies as female and also the sperm of the partner born male who identifies as such to fertilize the eggs of the egg donor allows them both to potentially have a biological connection to their babies, though not currently both being connected to a single baby at the same time. For example, embryos fertilized by one partner’s sperm might be transferred into a gestational carrier first and then in a later pregnancy attempt, embryos fertilized with the other partner’s sperm are transferred. If successful, this gives each dad a biological connection to the child fathered with their sperm.

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Fortunately, there are donor programs at Long Island IVF to help transgender, homosexual and heterosexual folks with any donor egg, donor sperm, or egg donor needs.

Whether you are a gay man, lesbian, or transgender—single or married—if you are 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.

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Who Will Carry the Baby in LGBT Family-Building? (Part Two): For Lesbians

By Tracey Minella

February 28th, 2018 at 12:25 pm

 

image: shutterstock

At Long Island IVF, we take pride in building families for the LGBT community. And the first question in LGBT family-building is the same whether you are a single gay man, a gay couple, a lesbian couple, or a single lesbian: Who will carry the baby?

Don’t jump to the seemingly obvious conclusion that a single woman or a lesbian couple necessarily has a uterus—or two—that would be suitable for carrying a pregnancy. Things are not always that simple. That’s why if the idea of having a baby now or someday is something you’re considering, it might be wise to see a reproductive endocrinologist for a baseline fertility evaluation now to catch any “red flags” that could compromise your fertility.

One (or both females) may have uterine or other medical issues that either prohibit her or them from carrying a pregnancy or would make attempting to do so unsafe or unadvisable. In addition, there may be non-medical factors that make a woman an uninterested, unwilling, or otherwise a poor candidate for baby-carrying. When that happens, a gestational carrier would be needed to carry the baby for the intended parent(s). That’s assuming there are healthy eggs.

In addition to a uterus in which to carry the pregnancy, the single woman or lesbian couple needs to produce healthy eggs. Again, it may be easy to assume that a woman—or especially two women—would have that requirement covered. And they generally do. But if premature ovarian failure, poor egg-quality, or another medical condition precludes the use of the intended parent’s eggs, an egg donor may be required.

In the vast majority of cases, a lesbian couple will not need a gestational carrier to overcome uterine issues. And, depending on their age, most lesbian couples won’t need an egg donor. The availability of two female reproductive systems instead of one basically gives lesbian couples a second chance at overcoming many fertility obstacles one might face. But there is one thing all lesbians do need for family-building.

Lesbians have the obvious need for donor sperm. Fortunately, obtaining that missing biological piece is far easier and cheaper for them than obtaining donor eggs is for their gay male friends. Pre-screened donor sperm is readily available and relatively inexpensive. A single woman or lesbian couple generally selects an anonymous donor after reviewing the profiles of available sperm donors. Frozen specimens from the sperm donor would be shipped to the reproductive endocrinologist’s lab so they may be thawed and used at the time they are needed for conception.

Although sperm donation from a known individual or friend is possible, that option comes with additional complexities related to medical pre-screening, a mandated quarantine period and re-testing period as well as psycho-social and legal considerations, which need to be considered. These additional elements may complicate as well as add time to the process.

In many cases, where no tubal or other fertility issues have been identified, the partner wishing to carry the pregnancy –or the partner who wants to carry a pregnancy first–would be monitored for ovulation and, at that time, inseminated with the donor sperm through an intrauterine insemination (“IUI”).

Here’s how an intrauterine insemination (“IUI”) works: The woman who wants to carry the baby is carefully monitored through blood work and ultrasounds to determine when she is ready to ovulate and her insemination is scheduled to coincide with ovulation. She can do a natural cycle, without added hormones, or she can do a medicated cycle in which oral or injectable hormones are added to the protocol. For the IUI, the donor’s specimen is thawed and deposited into the woman’s uterus via a thin, flexible catheter during a fast and simple office visit at the time of ovulation.

Through careful monitoring and minimal or no ovarian stimulation, the risk of a high-order multiple pregnancy in IUI can generally be reduced but not eliminated. Since the egg(s) remain inside the woman’s body in IUI and are therefore capable of being ovulated (rather than being retrieved from the body as in IVF), there may be a greater chance for multiple eggs becoming fertilized and multiple pregnancies implanting with an IUI than there is in the more-controlled IVF procedure.

If the lesbian partner (or the single woman) who wants to carry the pregnancy doesn’t become pregnant after a few IUI cycles, she might want to consider undergoing in vitro fertilization (“IVF”) — or in the case of a lesbian couple they might decide that the other partner will carry the pregnancy instead. In the event neither partner is willing or able to conceive or maintain a pregnancy for health or other reasons, the lesbian couple or single woman would still have the option of using donor eggs and/or a gestational carrier as mentioned above.

Here’s how IVF typically works for lesbians: The woman whose eggs are being used to create the baby will receive hormonal injections, blood work, and ultrasound monitoring over a period of weeks that is designed for her to produce multiple egg-containing follicles rather than the one egg she would generally produce naturally each month. When the time is right based on close monitoring, the eggs are retrieved by the reproductive endocrinologist transvaginally–using a needle aspiration procedure–and combined with the donor sperm in the hope that fertilization occurs. If it does, generally one or two embryos will later be transferred back into the woman’s uterus in the hope of a pregnancy implanting and developing. In IVF, the hope is to produce many more eggs than in IUI because they are being retrieved instead of ovulated. The excess embryos can be frozen for future use. Sometimes, enough eggs can be retrieved in a single IVF cycle to create a couple’s entire family—which can be built over time through successive pregnancies.

Sometimes, one partner in a lesbian couple will become pregnant first and then the other will follow. Sometimes only one partner may want to carry all of the couple’s pregnancies. Other times, both may attempt pregnancy at the same time.

But there is another exciting family-building option for lesbian couples that is rapidly gaining popularity: reciprocal IVF.

Because reciprocal IVF involves one of the women in a lesbian couple undergoing IVF, it is a more expensive treatment option than a relatively simple IUI cycle, but it’s increasingly popular because it allows both partners to be involved in the creation, pregnancy, and birth of the baby.

This is how reciprocal IVF works: One partner undergoes a typical IVF cycle, including routine hormonal injections, blood work, ultrasound monitoring, and the egg retrieval. Those eggs would be fertilized using donor sperm. Now, here is the twist: After fertilization, instead of the resulting embryos being transferred into the partner the eggs were retrieved from, they get transferred into the uterus of the other partner. If the embryo implants and a pregnancy occurs, one partner is the genetic mother of the baby growing inside the uterus of the other partner who gets to carry the pregnancy and experience childbirth!

If you are interested in LGBT 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.

We are proud to partner with the LGBT Network to provide information, education, support, and access to the most advanced traditional and holistic assisted reproductive technologies. All while understanding, respecting, and being sensitive to the unique needs of the LGBT community.

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. Please follow us on Facebook or Twitter for info on our upcoming free events.

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Donor Egg and LGBT Family-Building

By Tracey Minella

September 26th, 2017 at 8:25 am

Most LGBT couples may have at one point or another considered adoption as the way to build a family. That’s because adoption was the only option before the advent of assisted reproductive technology like in vitro fertilization “IVF” and other medical advances. And truth be told, it wasn’t (and still isn’t) the best option for many LGBT couples.

There are usually obstacles, delays, and significant costs to adopting a baby—especially for homosexual couples. In the past (and in some places today), LGBT couples seeking to adopt newborns often had to consider taking children who were older, minorities, and/or had special needs or medical challenges to avoid endlessly waiting for a baby. Even foster parenting doesn’t guarantee you’ll eventually get to adopt that child you’ve grown to love.

But as noble and fulfilling as adoption can be as a family-building choice, LGBT wannabe parents have more choices today, too. The many medical options to LGBT family-building have been extensively covered in this blog.

Donor egg has revolutionized family-building for both the heterosexual and homosexual communities.

As we all know from biology class, it takes an egg and sperm to make a baby. So, what is an LGBT couple or individual to do when they are missing one half of the equation? They can borrow from their neighbor. (But wait, isn’t that math class terminology?) Actually, the phrase fits well. They need to get the missing piece from someone else who donates it.

Gay men need an egg donor to provide eggs for them to fertilize with their sperm (and they need a gestational carrier, too). Lesbians need a sperm donor for sure, but may also need an egg donor if they do not have or don’t want to use quality eggs of their own. So, egg donation is the cornerstone technology for much of LGBT family-building.

The Long Island IVF Donor Egg program and our LGBT services has been helping LGBT couples start and grow their families for decades.

There are many advantages to choosing donor egg over traditional adoption, including savings in time and money. For gay men, it enables them to have a biological connection to their children, which some men prefer over adopting. For a lesbian woman who needs it, donor egg provides healthy, young eggs so she can conceive, carry the pregnancy and be in control of her developing baby’s health, experience childbirth, and be recognized as the legal birth mother—none of which is the case in adoption.

And since egg donation generally yields multiple eggs, you may be able to repeat the process–potentially experiencing additional pregnancies over time—all from a single donor egg cycle.

Please contact Long Island IVF’s Donor Program Coordinator, Vicky Loveland RN, if you are interested in egg donation at victorial@longislandivf.com .

If you would like to know more about LGBT family- building options, please come to Long Island IVF’s free seminar “Building Families in the LGBT Community” on October 26, 2017. It’s held in conjunction with our partner, the LGBT Network, at its Bay Shore Center at 34 Park Avenue, Bay Shore, New York. Register here to reserve your spot.

 

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Would you consider egg donation to build your family?

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The Egg Donor and LGBT Family-Building

By Tracey Minella

July 20th, 2017 at 12:07 pm


Despite making decades of progress, obstacles, frustrations, and inequities are still part of daily life for the LGBT community. And for same-sex couples who want to build a family, having to seek medical attention to do so is an unwelcome but necessary reality. It’s particularly frustrating when simple biological necessity–rather than an infertility diagnosis–lands the couple in the fertility doctor’s office.

Depending on the particular couple’s situation, the “missing piece” they seek could be anything from the relatively inexpensive and easy intrauterine insemination (“IUI”) with donor sperm to the more involved and costly in vitro fertilization (“IVF”) using an egg donor and sometimes a gestational carrier. Very often, egg donation is needed in LGBT family-building.

What is egg donation?

In egg donation, a healthy young woman (the egg donor) agrees to undergo what is essentially an IVF procedure that ends at the egg retrieval stage when her eggs are turned over to a person/couple (the egg recipient/s) who uses them to create their family. The egg donor undergoes hormonal injection treatments over a couple of weeks designed to make her ovaries produce multiple mature eggs, rather than the single egg generally produced each monthly cycle.

As in IVF, the egg donor’s mature eggs will be retrieved, but instead of keeping the eggs for her own use, she donates them to another person/couple. Her role is done upon retrieval of the eggs. The donated eggs are then fertilized with the sperm of a male partner or a sperm donor and the resulting embryos are transferred to the uterus of the female partner or gestational carrier.

When is an egg donor needed?

The simple answer is: Anytime a single person or couple–heterosexual or homosexual–needs an egg to create a baby. That’s either because the woman trying to become pregnant can’t or doesn’t want to use her own eggs or because the single person or couple seeking parenthood is male. Gay men, lesbians with egg-related challenges, and some transgender people will need an egg donor.

How does it work for LGBT family-building?

A gay man or couple could have all the love in the world to give a child, but still needs an egg from a woman in order to make a baby. And a uterus, too. The embryo created from the egg donor’s egg and the sperm of the gay man/men or sperm donor needs to be transferred into the uterus of yet another woman –a gestational carrier – – who will carry the pregnancy to term. The gestational carrier, who has no biological tie to the baby, turns it over to the proud daddy or daddies at the time of birth.

Lesbian couples (or single women) using a sperm donor may be able to conceive with an IUI or through IVF using their own eggs. But sometimes, they may need an egg donor if there is an issue with egg-quality, genetic, or other concerns. (If there are uterine issues, a gestational carrier may also be needed to carry the baby.)

In certain situations, transgender people will need an egg donor. It is important to note that transgender people who transition from female-to-male can have their own eggs retrieved and frozen for future use (and male-to-female transgender people can their freeze sperm for future use) — if done prior to taking any medical or surgical steps on the transgender transition or sexual reassignment journey. Be sure to see a reproductive endocrinologist to discuss these options before it’s too late.

If you would like more information on LGBT parenting options  or would like to schedule an initial consultation with a reproductive endocrinologist, the doctors and staff at Long Island IVF have been helping build LGBT families for decades and would be happy to help you. With several offices throughout Long Island and one in Brooklyn, we’re conveniently located near you.

As a partner of the LGBT Network on Long Island, Long Island IVF is committed to continuing to build families for the LGBT community through cutting-edge medical technology, complementary holistic therapies, and sensitivity to all patients’ individual needs.

Long Island IVF, along with the LGBT Network, offers free LGBT family building seminars every June and periodically throughout the year.

Register here for our next free “Building Families in the LGBT Community” event, which will be held on October 26, 2017 at the LGBT Network at 34 Park Avenue, Bay Shore, NY. Follow our blog, Twitter, and Facebook for more information.

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Long Island IVF Seminar on Family-Building for the LGBT Community

By Tracey Minella

June 27th, 2017 at 11:36 am

Long Island IVF has been celebrating LGBT Pride all month long beginning with again sponsoring LI Pridefest. We’ve helped the LGBT community become parents for decades. So, what better way to close out Pride month than with an info-packed evening of everything you ever wanted to know about LGBT family-building options. If you’re thinking about having a baby and want to know all the ways we can help you pursue that dream, come down and meet us!

We’ve partnered up with the LGBT Network to bring you a quality LGBT family-building seminar on Thursday, June 29, 2017 from 6:30-8:30 pm at the Long Island IVF Melville office located at 8 Corporate Center Drive, Melville, New York.

In about two hours, the speakers at our seminar will answer everything you ever wanted to know about today’s many LGBT Family-Building options. One of our reproductive endocrinologists, Dr. Steven Brenner, along with other key Long Island IVF team members will introduce you to the fascinating world of assisted reproductive technology and specifically how it’s used to help the LGBT community become parents. In addition, Melissa Brisman, owner and founder of Reproductive Possibilities http://www.reproductivepossibilities.com/ will be there.

LGBT family-building is different in many ways from so-called “traditional” family-building. As a practice made up of both LGBT and non-LGBT employees, we truly understand the nuances that make your parenthood quest unique to you, whether you are gay, lesbian, transsexual, bi-sexual, or queer. Believing that everyone has the right to become a parent, LIIVF is committed to using the best available medical technologies to help you overcome or circumvent biological obstacles to parenthood.

Whether we met at LI Pridefest this month and you’d like to learn more about our LGBT Family Building program at Long Island IVF, or this is the first time you’ll be meeting us, we hope you’ll join us and the LGBT Network at our Melville office to learn about the many ways we can help you achieve your dream of parenthood.

For more information and to register for this free event, please click here.

Need to reach someone? You can email lmontello@liivf.com.

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Will you be attending the “Building Families in the LGBT Community” seminar? Do you have any specific questions or particular topics you want to see covered?

 

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Important Infertility Insurance Coverage Issues for the LGBT Community in New York

By Tracey Minella

June 22nd, 2017 at 8:31 am

From Stonewall to date, the LGBT community has always had to fight for rights equal to those of the heterosexual community, often in an atmosphere of “us against them”. Persistence has always paid off…eventually. As we’ve seen from winning battles on openly serving in the military with the repeal of “Don’t ask. Don’t tell” and the legalization of same-sex marriage (#LoveWins), we can move mountains as a community united.

 

The latest major gay rights fight involves insurance coverage for infertility treatment in New York.

 

The subject of mandated infertility insurance coverage in New York State has been in the news lately, but before addressing an important pending bill that could positively impact the infertility insurance rights of all New Yorkers– heterosexual and non-heterosexual– we must examine and understand the existing obstacles to LGBT infertility treatment coverage.

 

Currently, New York State has a mandate which requires coverage for infertility treatments. It’s one of only 15 states to do so, which sounds promising, but it’s not. With so many existing definitions, restrictions, qualifications, and loopholes, the mandate in its current form does very little to benefit New York’s infertile heterosexual couples– and does even less for non-heterosexual couples or single women who need advanced reproductive technologies in order to start their families.

 

Some of the major problems with the current New York State infertility coverage mandate include:

 

  • It does not cover in vitro fertilization (“IVF”), but only applies to intrauterine inseminations (“IUIs) and other low-level/less successful infertility treatments, which are also riskier in terms of causing a multiple pregnancy (twins, triplets, etc.);
  • Small group employers can opt out of having to provide this coverage;
  • Insurance carriers may impose certain restrictions and rules that impact the employees’ ability to access the benefits.

 

Some insurance carriers that do offer IVF require both heterosexual and non-heterosexual couples to undergo 6-12 unsuccessful IUI cycles before moving on to IVF treatment (6 IUIs if the woman is over 35, or 12 IUIs if under 35, though some require less).

 

In addition to the above multiple-failed-IUIs prerequisite for IVF coverage, the employee must satisfy the insurance carrier’s definition of “infertility”. “Insurance companies define ‘infertility’ as the inability to conceive after one year of frequent, unprotected heterosexual intercourse, or six months if patient is over the age of 35”.

 

Applying this definition to heterosexual couples merely costs them 6-12 months of time before moving onto IVF treatment—provided they can somehow prove they’re doing it often enough and without protection. And while up to a year of time wasted really is a big deal to all infertile folks, the impact on non-heterosexuals and single women is far worse.

 

When applying this definition to a same-sex couple or a single woman, they not only lose valuable time, but they also lose money that a heterosexual couple would not. Because for same-sex couples or single women to meet the current definition of “infertility”, they would have to undergo six or 12 months of IUI with donor sperm treatments — in many cases, at their own expense –just to prove their infertility so that they could qualify for covered infertility treatments.

 

This issue was thrust into public view when two lesbian couples in New Jersey filed a federal lawsuit alleging that the language of the New Jersey insurance mandate “discriminates based on sex and sexual orientation”.

 

There is also disparity among insurance companies with respect to requiring authorizations for IUIs, requiring IUIs with donor sperm prior to approving infertility treatment, and coverage for the cost of donor sperm or thawing the sperm. In addition, companies offer different levels of coverage, which may be dependent upon copayments, deductibles and other restrictions on certain services like embryo cryopreservation, embryo storage, Pre-implantation Genetic Diagnosis or Pre-implantation Genetic Screening (“PGD” or “PGS”) of embryos, and more. To further complicate matters, even within the same insurance company, there are different individual plans that are chosen by the employer which provide different benefits coverage and different qualifications or benefits structure.

 

That’s why Long Island IVF assigns each patient a personal financial counselor to help guide them through the complicated insurance process to maximize any benefits to which they may be entitled.

 

Despite the obstacles that currently exist, there is good news to report and even more promising change on the horizon.

 

As a result of New York Governor Cuomo’s mandate to New York State insurance companies, they may no longer exclude same-sex prospective parents or single prospective parents from infertility coverage. While this is a victory, the sticking point for true reform and open access to appropriate infertility coverage for both heterosexual and non-heterosexual patients requires a redefinition of “infertility” and direct access to IVF.

 

There have already been noticeable changes in policies and the provision of coverage for IUIs with donor sperm in same-sex couples, presumably collectively-driven by Gov. Cuomo’s mandate, along with the New Jersey lawsuit, and forward-thinking, large-scale employers like Facebook and Google now offering high-end infertility insurance coverage for egg-freezing services. But the bottom line is that until a patient meets the “infertility” definition, they still have to self-pay.

 

That’s why we need the definition of ‘infertility’ to change. And we need access to IVF, which is the more successful treatment in terms of a singleton birth outcome.

 

And it is within our grasp right now.

 

As this article is being written, a bill that would revolutionize the infertility insurance law in New York for the benefit of heterosexuals, same-sex couples, and single women is awaiting consideration by the Senate after having passed in the Assembly this week.

 

The Senate Bill S.3148A known as the “Fair Access to Fertility Treatment Act”, or (“FAFTA”), if enacted, would not only mandate coverage for IVF treatment, but it would change the application of the definition of “infertility” to:

 

“a disease or condition characterized by the incapacity to impregnate another person or to conceive, as diagnosed or determined (I) by a physician licensed to practice medicine in this state, or (II) by the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse in the case of a female 35 years of age or older.”

 

According to Long Island IVF co-founder and reproductive endocrinologist, Dr. Daniel Kenigsberg, who has been advocating for the passage of the FAFTA bill, “the current mandate’s specific exclusion of coverage for IVF has resulted in much emotional and financial cost spent on inferior or inappropriate treatments which ARE covered by the mandate when, for over 50% of infertile couples, IVF was the best or only treatment.” He further notes that “IVF is far safer in terms of reducing multiple pregnancy risk than less successful and often inferior treatments like ovulation induction and intrauterine insemination (IUI). There has been waste and needless sacrifice for insured couples denied IVF.”

 

It is time for both the heterosexual and the LGBT communities to get active and push our respective representatives to pass this legislation. You can find your local senator here or can access their phone number here. Armed with Senate Bill number S. 3148A, a simple phone call expressing your support of the bill may make all the difference. It takes less than one minute to help support this latest gay rights fight for fair access to appropriate infertility treatment and insurance coverage. Do it now.

 

There has never been a better time for non-heterosexuals to fulfill their dream of parenthood. If you would like more information on the many available LGBT family-building options, we encourage you to join Long Island IVF and our partner, The LGBT Network, on June 29, 2017 for a special free seminar entitled “Building Families in the LGBT Community”. Pre-register here.

 

This progressive legislation not only opens the door to IVF access for all, but it changes the definition of infertility to one that encompasses everyone, regardless of sex or sexual orientation. Instead of “us against them” it’s “one for all”. Its passage would put everybody suffering from the disease of infertility one giant step closer to our common dream of parenthood– and maybe, just maybe, a step closer to us all being one united community.

 

 

 

 

 

 

 

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Everything You Always Wanted to Know About LGBT Family-Building Options at Long Island IVF

By Tracey Minella

June 16th, 2017 at 2:37 pm

 

Whether you are lesbian, gay, bisexual, transgender or queer/gender-fluid, you aren’t any different than heterosexuals who want to start a family but need medical intervention to do so.

You have the same dream of becoming a parent, the same longing in your heart for a baby of your own, the same frustrations and embarrassment about needing medical intervention for such a private matter, the same worries about affording and financing the treatment, and the same paralyzing fear of it not working.

And yet, you are different from the heterosexuals who are suffering from infertility. Your treatment needs are different. Your emotional needs are different. We understand that.

Long Island IVF pioneered IVF on Long Island, bringing Long Island its first IVF baby, first baby from a cryopreserved embryo and first donor egg baby. For almost 30 years, we’ve been serving both the heterosexual and LGBT communities on Long Island. Several of our staff are members of the LGBT community as well and many staff members were former patients—so we really do understand where you are coming from.

The easiest way to illustrate the differences between heterosexual and LGBT family-building is to begin with the similarities.

In heterosexual family-building, any number of factors may be causing the couple’s infertility. It could be female factors like poor egg quality, blocked fallopian tubes, uterine issues like fibroids, endometriosis, hormonal disorders like polycystic ovarian syndrome, recurrent miscarriage, and more. It could be male factor infertility due to poor quality sperm. Or it could be a combination of male and female factors—or simply be due to the frustrating diagnosis of “unexplained infertility”. When a couple is unable to get pregnant after 6-12 months of trying (the number of months differs based on age), they are considered to be infertile. Sometimes less aggressive medical approaches—such as intrauterine insemination (“IUI”) with or without ovulation induction do result in pregnancy. Oftentimes, more aggressive Assisted Reproductive Technologies (“ART”) like in-vitro fertilization (“IVF”) are in order.

Here’s a crash course in IVF 101.

In IVF, the goal is to have the woman develop more than the one mature egg she would normally produce in a typical monthly menstrual cycle. To accomplish this a woman’s ovaries are stimulated through the use of injectable hormone medications and careful monitoring by ultrasound and bloodwork so that at just the right time, the multiple eggs that have matured are retrieved from the ovaries transvaginally through needle aspiration under sedation. Then the eggs are either frozen or are combined with the partner’s sperm to produce embryos. The resulting embryos are then either transferred back into the woman’s uterus where they will hopefully implant and result in a pregnancy, or are frozen for future use, or a combination of the two options. Because the number of embryos transferred back into the uterus is both limited and controlled, IVF minimizes and virtually eliminates the risk of a multiple pregnancy, making it a safer treatment option.

Sometimes, a heterosexual couple needs help from a third party to build their family. They may need a sperm donor or an egg donor if the couple’s own sperm or eggs are not sufficient or of good quality. Or they may need a woman to act as a gestational carrier to carry their embryo(s) and resulting pregnancy if the uterus of the woman of the couple is either absent or not otherwise suitable.

Now let’s look at how LGBT family-building is different.

Well, for starters, virtually all LGBT couples need some kind of help from a third—or even a fourth—party in order to build their family. In fact, in virtually all cases, sex alone will never result in a pregnancy for the LGBT couple without outside intervention. So, while it does happen that a LGBT patient could have a medical factor making them infertile, in the vast majority of cases, LGBT couples seek out an infertility specialist to obtain the “missing contribution” that is required to make a baby. The exception is the transitioning individual who has not begun hormonal treatment to transition from male to female or from female to male.

Here are the general treatment options and the ways “missing contributions” for LGBT couples can be obtained. They are slightly more straightforward in the cases of lesbians and gay men than in transgender cases.

Lesbian couples:

Two women will need a sperm donor. Depending on their age and the health of their eggs and uterus, they can do IVF and may even be able to do an IUI. If doing IVF, some couples decide to use one woman’s egg and have the other woman carry the pregnancy in her uterus.

Gay couples:

Two men will need an egg donor. They will also need a gestational carrier who will carry the pregnancy in her uterus for them. Gay couples may decide to divide the number of eggs retrieved from the egg donor in half and then each partner may contribute a semen specimen to fertilize half of the eggs—thereby each being a biological father to the embryos that resulted from their contribution.

Transgender couples:

Transgender family-building is relatively new in comparison to lesbian and gay family-building which the LGBT community has been able to access for decades. There are varied options for transgender family-building, but they all require knowledge and proactive steps on the part of the transgender person.

The single most important takeaway from this article for transgender folks who do (or may in the future) want to have a biological child is this: See a reproductive endocrinologist BEFORE taking any medical or surgical steps on the transgender transition or sexual reassignment journey.

In “Woman to Man” reassignment, before the woman hormonally, medically, or surgically becomes a man, she should consider having her eggs retrieved and frozen for future use. Or if she has a male partner now, her eggs can be fertilized with his sperm and the embryos either implanted in her uterus now so she can carry the baby before she transitions, or if the woman does not want to carry the pregnancy and prefers to move ahead with the transition, then the embryos can be frozen and transferred into the uterus of a gestational carrier at any time.

However, if the woman who transitions prefers a female partner, then the couple has most of the same options as any lesbian couple. They could use either woman’s eggs with donor sperm and the resulting embryos could be implanted into the partner with the uterus or into the uterus of a gestational carrier if needed. Some couples choose his eggs and her uterus so both can be involved.

Now the opposite case.

In “Man to Woman” reassignment, before the man hormonally, medically, or surgically becomes a woman, he should consider having his sperm frozen for future use. Sperm freezing is so much cheaper and easier than egg freezing. If he has a female partner now and they want to become pregnant now, his sperm can be used to impregnate her through IUI or, if she undergoes IVF, then her retrieved eggs can be fertilized with his sperm and the resulting embryos either implanted in her uterus now or frozen for later use. Some couples choose his sperm and her eggs and/or uterus so both can be involved. If his female partner’s eggs or uterus are not optimal, they will need an egg donor and/or gestational carrier.

However, if the man who transitions prefers a male partner, then the couple has the same options as a gay couple. They could use either of their sperm with the egg donor’s eggs and transfer the resulting embryos into a (gestational carrier) woman’s uterus.

If you identify as queer or gender-fluid, you can utilize donor egg, donor sperm, a gestational carrier or any combination of the above options as they fit you and your partner.

Sadly, not all physicians realize or advise transgender individuals of their fertility-preservation and family-building options before the transition process has begun, so it is up to you to initiate the discussion or take action. It is absolutely critical that egg and sperm freezing be done before the hormonal, medical or surgical transition or reassignment begins. Or it will be too late.

Despite the current and uncertain political climate, there has never been a better time for LGBT members to pursue family-building. As a result of rapidly advancing ART, today’s LGBT community has choices beyond the noble but limited options of foster parenting and adoption—choices that allow for biological children. The lesbian and gay parents of recent decades have blazed a path of slow but ever-increasing acceptance that has not only benefitted today’s lesbian and gay parents, but has helped open the door for the transgender population to come out and claim their own fertility and parenting rights.

All people of reproductive age who are considering becoming parents at some point would benefit from a fertility screening by a reproductive endocrinologist—ideally sooner rather than later. At that exam, screening tests would be conducted to identify any actual or threatened obstacles to fertility, such as diminished ovarian function or premature ovarian failure or other factors in women, or sperm issues in men. Depending on what is found, proactive steps could be taken to preserve your fertility, including egg freezing for women who just want to preserve their young and healthy eggs for use at a future date.

Also file this important bit of information away and hope you will never need to remember it: If you or a loved one are ever faced with a cancer diagnosis and time allows for it, egg-freezing and sperm freezing done prior to starting certain chemotherapy or radiation protocols for certain cancers are options to preserve your fertility. That way, your healthy eggs and sperm are waiting for you when you’re ready to build your family after your cancer battle has been won. Be sure to call a reproductive endocrinologist to discuss fertility preservation before cancer treatment.

If you would like more information on LGBT parenting options  or would like to schedule an initial consultation with a reproductive endocrinologist, the doctors and staff at Long Island IVF have been helping build LGBT families for decades and would be happy to help you. With several offices throughout Long Island and one in Brooklyn, we’re conveniently located near you.

As a partner of the LGBT Network on Long Island, Long Island IVF is committed to continuing to build families for the LGBT community through cutting-edge medical technology and sensitivity to all patients’ individual needs.

Long Island IVF, along with the LGBT Network, offers free LGBT family building seminars every June and periodically throughout the year. Click here for information and to preregister for the June 29th event.

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One Year Later: Reflections on #OrlandoStrong and Hate Crimes against the LGBT Community

By Tracey Minella

June 12th, 2017 at 9:45 am

 

Image: Ryan McGuire/Gratisography.com


Today marks a somber day in LGBT history—one to reflect upon and remember.

Last June, from our sponsor table in the Family Services Pavilion at Long Island’s Pridefest 2016 celebration, the Long Island IVF team was able to witness and be a part of the pride and happiness of the LGBT community mingling peacefully and openly on a beautiful sunny afternoon.

Little did anyone know at that time that only hours after the event would end, the worst mass shooting in US history would happen in Orlando.  Fifty innocent lives would be taken and as many others would be injured. People just like those whose company we had just enjoyed. Regular people with their whole lives in front of them…targets of hatred in an increasingly ugly world. A world which in the months since then has become politically altered and alarmingly unstable for all—particularly the LGBT community.

It didn’t feel right to post Pridefest photos or talk of the positivity surrounding it in the wake of such a loss. But continued “radio silence” on Pridefest would be a disservice. It would be a lost opportunity to talk of and celebrate all that it was and, more importantly, all it must continue to be. There must be pride. There must be solidarity. In the face of hate, there must be love. And there must be real change.

There must be more than just a uniting of the LGBT community within itself –there must be support from those outside the LGBT community, too. Just as the world came together in vigils to support the LGBT community and to mourn those lost in Orlando, it must continue to look out for all people until the hatred is replaced by acceptance. Until there isn’t a need to designate “communities” anymore.

Prejudice and ignorance are frustratingly slow learners, so this change will require persistence. But despite the Orlando tragedy, we mustn’t lose sight of how far the gay rights movement has come, especially in recent years. And Pridefest is one of so many milestones of the movement. We mustn’t lose ground despite the political climate and a rising swell of previously-stifled but ever-brewing bigotry, hate, and violence.

Long Island IVF is proud to have supported the LGBT community and helped its members fulfill their dreams of parenthood for decades. None of us can undo these senseless deaths, but we can join together to create new life. If you’re ready to become parents, we can help you create your family. The next generation.

In the face of hate, there must be love.

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Long Island IVF Proudly Sponsors Long Island Pridefest 2017

By Tracey Minella

June 8th, 2017 at 3:59 pm

Long Island IVF is proud to once again be a major sponsor of this year’s LI Pridefest Weekend here on Long Island. Pridefest is really kicking it up a notch this year not only by moving the festivities to beautiful Long Beach, New York, but by offering a full weekend jam-packed with activities right on the beach. Does it get any better?

From beach parties, concerts, and the Rise with Pride parade to tons of other unique fun things like a carnival, 5K runs, drag bingo and a trapeze show, there is something for everyone’s tastes—singles, couples and families, young and old– and it runs from June 9-11, 2017. And we will be right there for all that Pride on the Beach!

LIIVF has been actively building families for the region’s LGBT community for decades due to its long-standing belief that every person has a right to be a parent and we have long-partnered with the Long Island’s LGBT Network. We pride our practice… which includes members of both the non-LGBT and LGBT communities… on acceptance and inclusion. And we address the unique aspects of LGBT family-building from both a personal and medical perspective. In many ways, your needs are the same as the non-LGBT community, but in some ways they are different. We get that.

Just stop by our booth at LI Pridefest Marketplace Fair on Sunday and meet some of the team. Our prior successful LGBT parents will stop by for impromptu reunions throughout the event, too, and are often eager to share their experiences as well. The Long Island IVF booth will be on the Boardwalk all day and night on Sunday June 11.

Not in the mood to chat long with all the festivities to see? We totally get that! Swing by and grab some of our informational brochures to read later. Enter our free raffle to win a relaxation basket! The forecast looks great, so come on down and meet us.

You can also get to know us later this month as we host “Family-Building the LGBT Way” on Thursday, June 29, 2017 from 6:30 until 8:30 pm. This very special event will be held in conjunction with the LGBT Network at Long Island IVF’s Melville office located at 8 Corporate Center Drive, Melville, New York.  Dr. Steven Brenner joins other key LIIVF team members to bring you a seminar on everything you ever wanted to know about today’s LGBT Family-Building options. Please pre-register here for this free event. You can also email Lindsay at lmontello@liivf.com with any questions. Light refreshments will be served.

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So who is coming to Pridefest?!

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Long Island IVF’s Annual Family Event is Coming!

By Tracey Minella

October 12th, 2016 at 6:26 pm

 

LIIVF Doctors at the 2014 Family Event


With an overwhelming feeling of thanksgiving in the cool autumn air, we’re eagerly preparing for Long Island IVF’s Family Event…a celebration of the births of our newest batch of special babies. We’re looking for the IVF, IUI, or other babies we’ve had a humble hand in helping to make their debut.

If you haven’t heard of it, the reunion is a fun-filled, camera-clicking day where our proud new parents show off their little miracles and our doctors and staff get to meet the latest additions to the LIIVF family.

We know it may be hard to hear about this event if you’re still on your journey to parenthood. And we’re very sorry for that, and look forward to seeing you at a future event real soon. But we want to be sure we haven’t missed any patient who is eligible to attend this year…

So… if your special little bundle was born between January 1, 2014 and today, please email Lindsay Montello at lmontello@liivf.com  so we can put you on the invitation list. (And if your baby’s older and you missed the last reunion…or you just really, really want to come this year, please email Lindsay anyway!) This call to action is to ensure that we don’t miss any patient who had a baby during this time frame, so please don’t assume we have your most recent contact information—drop us a quick confirming email so you’ll get your invitation.

Meanwhile… SAVE THE DATE. This year’s event will be held on Friday, November 11, 2016 from noon until 2:30 pm! More exciting details will come in your invitation.

Here’s a bit of nostalgia and Long Island IVF history: Back in the old days, the reunion was held outside the old Long Island IVF office in Port Jefferson, behind Mather Hospital. As the years went on and the babies multiplied quickly, we needed a huge fire truck with a soaring bucket to take our group photo of all the parents and their babies. Shortly after the 10th reunion, space limitations unfortunately necessitated limiting the attendees to the most recent crop of newborns.

We’re so looking forward to seeing you again and meeting your new little pumpkins!

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Have you been to a reunion? What’s the best part?

 

Thanks to all our wonderful patients who repeatedly nominate us and vote us in as Long Island’s “Best In Vitro Fertility Practice”.

After winning the title for 2015 and 2016, LONG ISLAND IVF was again nominated BEST IN VITRO FERTILITY PRACTICE in the Long Island Press’s “Best of Long Island 2017” contest. If you’d like to vote to help us win, you can vote once per day from now through Dec 15 here: http://bestof.longislandpress.com/voting-open/

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