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Legal Crossroads - The Differences between Adoption and Third party Reproduction

February 19, 2008 - Tuesday
7:51 AM to 7:51 AM (EST)
Guest Speakers: Steven H.Snyder, Esq.

Categories
Adoption • Egg Donation • Gestational Carrier • IVF • Surrogacy • Third Party Reproduction


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[Tue Feb 19 16:52:08 PST 2008] Corey_WhelanHi everyone. Welcome to tonight's chat with Steven Snyder, Esq. I am Corey Whelan, The AFA's Director of Development and your chat moderator and I'm glad you could join us tonight.. Steve Snyder is the founder of the International Assisted Reproduction Center as well as Snyder Law Firm. He will be on hand to answer your questions on surrogacy, third party options and adoption, and what you need to make your choices between all of the options available to you, from a legal point of view. In addition, Mr. Snyder has a thriving international practice and can also answer your questions about doing ART overseas.
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[Tue Feb 19 16:55:20 PST 2008] Corey_WhelanHi there. Our chat should be officially beginning in around five minutes.
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[Tue Feb 19 16:56:40 PST 2008] Corey_WhelanSteve Snyder Steve?
[Tue Feb 19 16:56:49 PST 2008] SteveYes.
[Tue Feb 19 16:57:42 PST 2008] Corey_WhelanHi, welcome. Thanks for being so prompt! We have one participant in the chat room, we should be filling up in a few minutes. Ersstar, in the meantime, if you have any questions for Steve Snyder, please feel free to fire away.
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[Tue Feb 19 16:58:37 PST 2008] Corey_WhelanHi dumbhorse, welcome to our chat with Steve Snyder, Esq. Please feel free to ask your questions.
[Tue Feb 19 16:59:19 PST 2008] Corey_WhelanMr. Snyder while we're waiting, would you like to give us a brief synopsis of what IARC is?
[Tue Feb 19 17:00:47 PST 2008] SteveCertainly. IARC is a fertility helper (egg donor and surrogate) recruitment, screening, and matching agency that matches egg donors with intended parents from all over the world. We also have connections with various fertility clinics all over North America, and we help parents identify and connect with the clinic that best meets their needs.
[Tue Feb 19 17:01:35 PST 2008] Corey_WhelanDo people ever come to see you who can't decide between adoption and surrogacy? If so, how do they navigate that decision?
[Tue Feb 19 17:01:47 PST 2008] ersstar2Do you have any connection with RMA of NJ?
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[Tue Feb 19 17:04:43 PST 2008] SteveYes, although most people have a strong disposition one way or the other when they contact me. There are two general groups of intended parents, those who want to "parent" and are not committed to carrying on their genetic contribution and those who want to "procreate" and pass their genetic code on to their offspring as much as possible. Although these two groups overlap somewhat, they are generally distinct, and those willing to parent through adoption generally don't opt for ART (egg donor/surrogate), and those who want to procreate generally don't opt for adoption. I do not have any affiliation or connection with RMA.
[Tue Feb 19 17:05:06 PST 2008] DoloresHi, I have a question. I'm wondering if my age (I'm 47) is a factor in my favor or against me for surrogacy. I live in Connecticut. I was a patient at RMA CT but took a break from donor egg about two years ago. I don't feel as if I can carry a pregnancy now because of diabetes. How do I find a surrogate?
[Tue Feb 19 17:06:00 PST 2008] SteveYour age is not a factor now, and it will be a varying factor depending on which clinic you use. Clinics generally establish maximum ages for participants in surrogacy programs.
[Tue Feb 19 17:06:20 PST 2008] DoloresWhat is the typical maximum age? Does it vary by state?
[Tue Feb 19 17:08:31 PST 2008] SteveA usual age limit is 50. You can find a surrogate through many ways. Some use family or friends. If that is not an option, some use the internet and self-match. Some use agencies who have prequalified surrogates ready for matching. All are useful, but the important factor is that you must find a qualified and experienced professional (whether attorney, psychologist, or physician) to monitor and assist you with various aspects of your program. The people who do not use these professional often experience problems or breakdowns in their programs.
[Tue Feb 19 17:09:03 PST 2008] Doloresthat makes sense, thanks.
[Tue Feb 19 17:09:10 PST 2008] ersstar2What are the issues people using egg donors face?
[Tue Feb 19 17:09:11 PST 2008] SteveMy pleasure!
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[Tue Feb 19 17:09:55 PST 2008] Corey_WhelanAllie, Nancy, please feel free to ask your questions.
[Tue Feb 19 17:10:37 PST 2008] nancywhat are particularly good websites or books you'd recommend when considering the donor egg option?
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[Tue Feb 19 17:11:37 PST 2008] dumbhorseHi. I'm wondering what are "reasonable" reimbursement costs that a surrogate can ask for? Also, what is the average over all cost for a surrogacy arrangement (gestational carrier)?
[Tue Feb 19 17:12:33 PST 2008] SteveAgain, locating the donor is a factor. Some use relatives, and some use agencies. Cost can become a determining factor of which option you choose. Other than that, you must decide what kind of information you want about your donor. Many clinics only provide limited information and blind match for you. Agencies often provide much information, including photos, and allow you to select your own donor. You should ask what the options are for known versus anonymous programs at whatever clinic/agency you choose. You should also ask if they keep updated health information on the donors after they donate so the parents can access that information if necessary for their children's well being. You should also ask about number and location of donations if the donor donates frequently in your geographic area. Among other things.
[Tue Feb 19 17:13:23 PST 2008] Kayla51Hi Corey. I wrote to you earlier - you said I could ask a question about international options even though the chat topic had changed. Hi Steve - can I ask you what countries have good IVF programs and how much money I might be able tosave? My insurance doesn't cover IVF. I'm in LA
[Tue Feb 19 17:14:26 PST 2008] SteveSurfing the internet brings you many pearls of wisdom. Start with the keywords you think are relevant and start from there. You can always visit our website as a start at www.fertilityhelp.com. There are numerous artlcles and FAQs there to start you off. I am not aware of any great books.
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[Tue Feb 19 17:15:50 PST 2008] nancyThanks
[Tue Feb 19 17:18:14 PST 2008] SteveThe overall cost of a surrogacy program varies by type of program and options. It will vary depending on whether you use an agency (a $15,000-25,000 fee, depending on the agency), what your surrogate charges for a fee ( a $13,000-50,000+ cost depending on your surrogate), which clinic you work with (a $5,000-20,000 cost, depending on where your clinic is located), and how well mother nature cooperates (because each new retrieval/transfer costs more money, and there is no guarantee how many it will take). At our agency, we quote an average aggregate cost of $45,000-65.000 for a surrogacy program assuming you use your own egg. Add about $10,000 if you also need an egg donor.
[Tue Feb 19 17:19:01 PST 2008] dumbhorseThanks Steve.
[Tue Feb 19 17:19:36 PST 2008] nancyWhat is your opinion of KNOWN vs. ANONYMOUS from a futuristic perspective, say 20 plus years out.?
[Tue Feb 19 17:19:54 PST 2008] SteveThe agency fee seems daunting, but it often includes things like surrogate screening costs, legal fees for drafting a contract, and other necessary parts of the process that you will pay for anyway. So you really have to investigate what a surrogacy program involves and then ask detailed questions about any agency you work with to find out how many necessary costs are already included in their fee.
[Tue Feb 19 17:22:46 PST 2008] SteveI think the children of egg donors and surrogates will increase in number, age, and political influence until they push for the same access to birth information that adopted children are now seeking. I think know donation has benefits in the access to health information area, but, because many states' laws are so far behind medical technology, donors in many states retain the right to seek parental privileges (even if they don't intend to do so) because their parental rights are not statutorily terminated as with sperm donors. For this reason, I think parents using anonymous donors right now are better insulated from this possible (but unlikely) event.
[Tue Feb 19 17:23:34 PST 2008] SteveI hope my clumsy fingers aren't making this too hard!
[Tue Feb 19 17:23:35 PST 2008] Kayla51Hi, please don't forget my question about ivf programs overseas?
[Tue Feb 19 17:23:47 PST 2008] nancyGood insight. Thanks.
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[Tue Feb 19 17:24:09 PST 2008] Corey_WhelanYou're doing great!
[Tue Feb 19 17:26:16 PST 2008] Corey_Whelancwegner, I think you've joined our chats before, yes? Are you considering third party options or possibly considering adoption?
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[Tue Feb 19 17:26:42 PST 2008] Corey_WhelanHi jsherm, how are you?
[Tue Feb 19 17:26:54 PST 2008] jsherm62hi corey
[Tue Feb 19 17:28:34 PST 2008] SteveIVF programs in other countries are a way of reducing cost. If there is no other way to afford an IVF, then such options must be explored. It is better to go elsewhere to save money than not have a child. For examply, an IVF in Canada costs $5,600 U.S. In Mexico, about $7,000. These are exclusive of traveling costs. You need to ask intelligent questions and get good legal and pracitcal advice, though. Questions such as whether a foreign doctor's malpractice insurance covers international patients (most don't), whether disputes with the docter are governed by the foreign law and must be brought in foreign courts (most are and do), and whether the treatment of donors and surrogates (if used) is in compliance with the typical safety standards applied in the U.S. It is O.K. to want children, but not at the expense of the health of those who help you. For example, I asked an Indian surrogacy agency whether they reviewed the OB/
[Tue Feb 19 17:29:07 PST 2008] SteveGyn records of their surrogates to verify that they had safe pregnancies, and they admitted that sometimes there were no such records to access.
[Tue Feb 19 17:29:43 PST 2008] Corey_WhelanSo if someone is planning on doing IVF overseas, does it make sense to consult an attorney first, or is there a list of questions that will suffice?
[Tue Feb 19 17:30:41 PST 2008] SteveI think it is necessary to consult an attorney about the specific program you are considering because each will come with different documents you need to review and sign and different issues, depending on in which country the program is located.
[Tue Feb 19 17:31:05 PST 2008] Corey_Whelangreat, thanks.
[Tue Feb 19 17:31:08 PST 2008] cwegnerActually, I m lab director for a medium sized IVF program in the Midwest. I am interested in this topic because we do a lot of Third party repro cases and I worry that long term implications (effect on family ties, need for medical history in the future, and the needs of the child aren't fully explored by our patients before we do the technical piece.) BTW-Also the FDA is involved in third party reproduction cases because they require infectious disease screening of couples who use a gestational surrogate. In the FDA's eyes, they are egg and sperm donors. This adds to the cost--- a couple of humdred to $1000 per couple.
[Tue Feb 19 17:33:57 PST 2008] Corey_WhelanNancy, are issues of anonymity of great concern to you now that you are considering this option? I'm wondering how you feel about this, from a patient/perspective parent point of view?
[Tue Feb 19 17:34:21 PST 2008] SteveI think that most programs are in it for the short term through the actual medical procedure and payment. Most clinics/agencies are not following up with donors to obtain and archive updated health information for the benefit of the resulting children and their families. I agree that there are ethical issues that need to be "fleshed out." For example, the ASRM recommends no more than 6 donations per donor, but there is no central registry of information where clinics/agencies can share donor information to make sure donors don't move from clinic to clinic to avoid that limitation contrary to their own best interests.
[Tue Feb 19 17:34:41 PST 2008] Corey_Whelanprospective, sorry
[Tue Feb 19 17:35:53 PST 2008] Corey_WhelanIs this current case in England, the twins marrying, a cautionary tale? Or simply a very quirky twist of fate?
[Tue Feb 19 17:36:15 PST 2008] nancyI had been on the fence, leaning toward known donor, but given the legal aspect Steve speaks of, that may likely out weigh my need to know the medical history. Besides, in 20 years, the field of genetics may be able to tell medical predispositions keenly.
[Tue Feb 19 17:36:43 PST 2008] Corey_WhelanTrue. Do you feel that you have all of the information that you need to move forward?
[Tue Feb 19 17:38:24 PST 2008] nancyEven with one's own genetics, you never know for sure. Of course more info is better, but at some point, in a relatively young field, you have to jump.
[Tue Feb 19 17:38:51 PST 2008] SteveIt is obviously a cautionary tale. Again, consanguinity issues are downplayed by clinics doing blind matching of their patients with donors used multiple times in the same geographic population. Again, the ASRM has limitations on the number of donations recommended in certain population densities (6 per 800,000, I think), but that doesn't mean that accidents can't happen. Actually, the doctors tell me that, other than the social stigma, consanguinity doesn't pose a significant health threat unless there is constant and repeated intermarrying. It's more the philosophical and social perspective (yes, perspective) than actual health risk in this area.
[Tue Feb 19 17:38:58 PST 2008] Corey_Whelandumbhorse, first off, I'd love to know the genesis of your screen name. Secondly, I'm wondering if you have decided on your next steps?
[Tue Feb 19 17:40:11 PST 2008] Corey_Whelandistinctions are the key to life, I guess! It's just important to remember that statistics refer to actual people - I keep thinking about these poor kids, not knowing that they are marrying a sibling, and how that must feel.
[Tue Feb 19 17:40:32 PST 2008] nancySteve, you are excellent at bringing forth the fine points at the heart of the issues. Thanks, and please tell us more, stuff we aren't thinking to pose questions about.
[Tue Feb 19 17:41:01 PST 2008] Corey_WhelanGood idea.
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[Tue Feb 19 17:43:57 PST 2008] nancyCorey, are there transcripts from the SF Conference on Feb 10th?
[Tue Feb 19 17:44:24 PST 2008] Corey_WhelanNancy, there are no transcripts from the conference, no. We don't tape the actual lectures.
[Tue Feb 19 17:45:16 PST 2008] ersstar2Are there FDA regulations for health screening of egg donors? What are they?
[Tue Feb 19 17:46:25 PST 2008] dumbhorseCorey, I am an Arabian horse fan and "dumbhorse" is my husband's "nick name" for the breed. I was really hoping that answer re: transcripts was going to be a "yes."
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[Tue Feb 19 17:47:40 PST 2008] Corey_WhelanI'm so sorry about the transcripts, particularly since I'm an Arabian horse fanatic myself! However, as you know, Steve was a speaker in San Francisco, and many of the speakers will be featured on chats over the next several months. And of course, if you have any specific questions or concerns, you can always write to me and I will try to get you the information that you need.
[Tue Feb 19 17:47:57 PST 2008] Corey_Whelanhi my late bird friends, please feel free to jump in lgfo and frances
[Tue Feb 19 17:48:15 PST 2008] SteveYou must think I'm a mind reader! There are nuances to what you should look for. What kind of screening does a clinic or agency do of its donors? When does it screen them? Before matching or after? If genetic testing, psychological evaluation, and other testing is not done until after matching, then it increases the risk that a donor will be denied after you select her. That leads to disappointment and delat. If it's done before, you are better off in terms of reliability, but it costs the clinic/agency more money for each donor, including the ones that aren't picked. That is why most agencies screen after selection (except for ours, of course). In addition, what information are you going to be given? Some clinics offer very little information and blind match you with your donor. You have no control (which is exactly what you have lost throughout your fertility journey). If you use an agency that gives detailed health, family, educational, and social history as well as photos, you gain control back. BUT it makes it harder to pick your donor because you get caught up in the details and the looks rather than the health and fertility history. Also, do you use only donors with proven fertility? That maximizes the success, but it limits the education level. Most parents want a 21 year old donor who has three children of her own and is working on her PhD. You have to decide what is important and work from there. I would personally say good health history is most important. You want a healthy child. Whether he or she is a Rhodes Scholar or professional athlete or looks exactly like you is secondary.
[Tue Feb 19 17:49:20 PST 2008] Corey_Whelanand of course, this chat will be transcripted in a few days and a good thing too, because this is great info and you should keep it on hand. and also, Steve's website is truly fabulous and features a lot of great articles, so go there often. As does my own - www.theafa.org.
[Tue Feb 19 17:49:43 PST 2008] Corey_WhelanGuys, also don't forget that our message boards are moderated by professionals and you can post questions 24 7.
[Tue Feb 19 17:50:02 PST 2008] SteveYes, the FDA has a detailed health and personal history that each donor must complete in person with a clinic/agency staff member. It includes questions about their sexual history, residential history (can't have lived in Europe in a country where they had "mad cow"), and it needs to be repeated every 6 months. It is very specific and detailed.
[Tue Feb 19 17:51:06 PST 2008] SteveThe FDA also has specific infectious disease and other testing that all donors must go through within certain time frames before their donation.
[Tue Feb 19 17:51:21 PST 2008] nancyHow can you be more secure about the health history stuff---it seems that young people often don't know about family history or they family hasn't had the heart attacks or high BP or early senility yet when the donor is 21....How to ferret this out?
[Tue Feb 19 17:52:06 PST 2008] Corey_WhelanNancy, you know that for a lot of this you have to ferret out 95% of the population.
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[Tue Feb 19 17:53:19 PST 2008] Corey_WhelanHi Flo, it's not too late to post a last minute question for Steve Snyder Esq.
[Tue Feb 19 17:53:21 PST 2008] ersstar2What is Steve's website?
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[Tue Feb 19 17:53:30 PST 2008] nancyTrue, but some of their histories seem so complete, with negatives, and others seem to have few negs, which falls into the 95%, you are suggesting, no?
[Tue Feb 19 17:53:51 PST 2008] Corey_Whelanwww.fertilityhelp.com
[Tue Feb 19 17:54:26 PST 2008] SteveWe get a three generational health history from all of our donors. They may be too young to have certain health issues become evident, but their parents, grandparents, aunts, uncles, brothers, and sisters all have health histories, too. We request all of that information so you have some idea how the FAMILY health history looks. That is one reason we don't use adopted donors. They can't provide that information. Of course, we cannot possibly request the medical records of all the family members, so we rely to a great extent on the honesty and reliability of the self-reporting of the donors. I actually think they take their responsibility seriously and do give accurate information, but not everyone is as confident.
[Tue Feb 19 17:55:05 PST 2008] Corey_WhelanSteve, what is the motivation for most donors?
[Tue Feb 19 17:55:17 PST 2008] ersstar2Do anonymous donors sign away their legal rights?
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[Tue Feb 19 17:56:21 PST 2008] Corey_WhelanHi Zimmy.
[Tue Feb 19 17:56:30 PST 2008] ZimmyHello
[Tue Feb 19 17:56:38 PST 2008] Corey_WhelanGuys, just want to let you know we only have about five minutes left.
[Tue Feb 19 17:57:08 PST 2008] nancyThanks Steve for your many ounces of wisdom and thoughtful answers.
[Tue Feb 19 17:57:23 PST 2008] SteveMoney. But we do a significant amount of education with our donors when they first contact us to let them know that their fee, personal investment of effort, and reliability will affect whether certain parents can afford a program and/or complete it successfully. We try to tap into their altruistic side, and I think we do swing a lot of donors in that direction. That is one reason why our average donor compensation for 2007 was only $4,400.
[Tue Feb 19 17:57:48 PST 2008] Corey_WhelanMakes sense to me.
[Tue Feb 19 17:58:16 PST 2008] SteveI am so happy to help in any way. I started life as an English teacher, and I still think my main calling is to educate others so they can improve their circumstances
[Tue Feb 19 17:58:43 PST 2008] floi would like to adopt a child from carribean? is that a good idea and what are the procedure to bring the child to the USA?
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[Tue Feb 19 17:59:11 PST 2008] Corey_WhelanWell, I can't thank you enough for being here tonight. This was invaluable information.
[Tue Feb 19 17:59:27 PST 2008] SteveAnonymous donors do sign away their legal rights, but that does not necessarily hold up as a parentage determination in a court of law. it's more like evidence of intend rather than a final termination of their rights'
[Tue Feb 19 17:59:46 PST 2008] Corey_WhelanI want to thank all of you for being here as well, and for asking your questions - that's how we all learn and move forward!
[Tue Feb 19 17:59:55 PST 2008] SteveCheck your agency carefully and get professional advice.\
[Tue Feb 19 18:01:07 PST 2008] Corey_WhelanGuys, I think our chat is at an end. If you would like any additional information, please feel free to contact either Steve or myself - you can reach me at corey@theafa.org. Thanks everyone. Good night, and BEST OF LUCK to all of few. Sweet dreams.
[Tue Feb 19 18:01:20 PST 2008] ersstar2Thanks Steve.
[Tue Feb 19 18:01:21 PST 2008] Corey_Whelanyou! not few. What's with me tonight?
[Tue Feb 19 18:01:28 PST 2008] SteveMy pleasure!
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[Tue Feb 19 18:01:38 PST 2008] Corey_Whelanbe well.
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[Tue Feb 19 18:01:53 PST 2008] nancyThanks Corey, Steve and all the support at AFA
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