Surrogacy - Have you considered this option?

January 16, 2007 - Tuesday
1:05 PM to (EST)
Guest Speakers: Stuart Miller
Fertility Futures

Categories
Donor Egg • Gestational Carrier • Surrogacy

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Corey_Whelan	Welcome all to The American Fertility Association's online educational series. I am your moderator, The AFA's Director of Development, Corey Whelan. Tonight's session is on Creating the Family You Want Through Surrogacy - you will have the chance to get all of your questions answered by a very special guest - Stuart Miller, who is the CEO of Ferility Futures International/Growing Generations, based in California. Stuart's agency has helped to bring almost 500 babies into the world. He can answer our questions on all aspects of surrogacy, as well as egg and sperm donation. Please don't hold back! Get the information that you need to make a decision about this very important topic.
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beckyb	What time does the chat start?
beckyb	And is the topic still Surrogacy?
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Corey_Whelan	hello all, the chat begins now!
Corey_Whelan	please don't hesitate to ask your questions
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Stuart_Miller	Hi Everyone. I'm happy to answer any questions you have. Besides being a professional in the area, I am going through the process myself.
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RF15015	I'm a single, professional woman living in NYC. I never had a child. The wish came to me late in life - after my clock had "ticked". I've been at it for 3 years. I had donors and a GS and two failed transfers and no embryos left. I am seeking another surrogate. I have 12 donated embryos which I had sent to the doctor I was using in Ca.
Dolores	Hi Mr. Miller. Can you tell lme who is considered a viable candidate to hire a surrogate? I am 53 years old
Stuart_Miller	Most agencies and clinics have a cut-off of 50 so at least one partner would need to be less than 50. However, each case is different and we have had single clients up to age 56. It depends on health, family issues, etc.
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Stuart_Miller	Hi RF. Not sure if you had a question. There are many good agencies in CA if that is what you are looking for.
RF15015	I was originally told that I had to do this in Ca. to get a pre-birth order. That's what I did. After the failures I learned that there are other States I could get a pre-birth order in - i.e. Ohio, Arkansas, Wisconsin, Maryland, NJ, and Tennessee.
Stuart_Miller	Yes, CT also.
Stuart_Miller	But, you do need to carefully check the laws as donated embryos can be treated differently than your own.
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Stuart_Miller	The site kicked me off so I'm not sure if I missed something.
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RF15015	It kicked me off too. In any event, how does one get a definitive answer as to whether you can get a PBO with donated embryos and a GS?
Caitlin	HI Stuart. Can you tell me if there are ongoing relationships established with a surrogate like there is in adoption - like open adoption - or can it be a completely closed relationship? I guess what I'm wondering is, what is the likelihood of the baby having or wanting or even pursuing a relationship with the surrogate later on
Stuart_Miller	You would need to talk with an attorney in the states you mentioned. I know in CA it makes no difference whether you are biologically connected or not. But, in other states it does. Ohio, for example.
Caitlin	Stuart, you can look at the Action Key to give you the history of the chat
RF15015	I need to know exactly what States are doable. So it's just a question of talking to an attorney.
beckyb	What are the surrogacy laws in Oklahoma?
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Stuart_Miller	In gestational surrogacy there is no ongoing relationship beyond that of a friend. In traditional surrogacy it can vary.
Stuart_Miller	Hi RF. You could call National Fertility Law Center as they work in several states. Their web address is www.nationalfertilitylaw.com. But, if you are working with an agency, they may only work in certain states. So, it really depends on which direction you want to go.
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Stuart_Miller	Hi Becky, I don't know the laws in Ok. Sorry. I believe AFA has some legal information available. Corey, is that accurate?
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trishwalla	for gestational carriers what are the ballpark fees?
Stuart_Miller	It can vary from $10,000 - $22,000. Most larger agencies pay $22,000 for a first time and it goes up from there.
trishwalla	is that all-inclusive?
trishwalla	legal fees, carrier's fees, etc.
Stuart_Miller	No, that is just the surrogate fee. All inclusive with medical, insurance, legal, etc., would range between $50,000 and $100,000. I realize this is a big range but insurance and medical vary by state.
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trishwalla	do most people choose a carrier in the same state?
RF15015	It seems to me that that is high for an all inclusive. An all inclusive that's reasonable would be better, I would think, than a base fee with extras. The sky is the limit that way.
Zimgirl	We have just started the process of interviewing potential surrogates for a GS arrangement. Are there any particular questions/issues we should consider in the interview process? Anything aside from the typical questions one would think of to ask?
Stuart_Miller	Hi Trish. It really depends on the laws of your state. If possible, that would probably be the most desired as the surrogate would be near your clinic and travel would be less.
Stuart_Miller	Hi Zim. If you are doing this independtly without an agency, I would suggest that you involve a psychologist to screen and evaluate the surrogate. There are many good ones and AFA can make referrals. Basically, I would want to know that she has children, is financially stable, non-smoker, no drugs, clean criminal check. Then, what type of relationship she is looking for to make sure it coincides with what you want.
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Stuart_Miller	Also, what type of insurance she has (make sure no surrogacy exclusions which many have).
Corey	If any of you have any specific questions regarding state to state laws, please contact me at corey@theafa.org and we will get you the information that you need.
Zimgirl	Thanks. We are using an agency, but because this is our first time, just wanted to make sure we weren't missing anything. Thanks for your input!
RF15015	It seems that in Ca. there are more companies with surrogacy exclusions due to the larger # of surrogates due to surro-friendly laws. Is that true?
Stuart_Miller	HI RF. As the saying goes, it takes a village. There are many non-affiliated people working on your case which can include lawyer, doctor, surrogate, pharmacy.
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sgong	The GS process is new for my wife and I. We live in NY. How does this work? Do we need to find a surrogate in CT? What happens after the baby is born? Do both parents' name appear on the birth certificate?
Stuart_Miller	We have seen insurance denials all across the country in all the states we work in. Not sure if there are more in CA than in other places. Very important to know that you'll have coverage regardless of the state you work in.
Stuart_Miller	Hi Sgong. Yes, you need a surrogate in a state where commercial surrogacy is legal. CT is excellent and offers pre-birth parental judgments with both of you going on the b/c.
RF15015	When you talk about "what type of relationship.....to make sure it coincides....." - what does that mean? There has to be contact - she is carrying your baby(ies). There are all types of personality styles as in all relationships. Can't the IP just go along with the flow as best as possible.
Stuart_Miller	Some surrogates would like a very close relationship with lots of contact. Others are fine with more minimal contact. Also, after birth expectations can vary. It is just important to talk these issues through. A pyschologist can help set appropriate expectations and boundaries.
sgong	Can you explain the process after a surrogate is selected?
Stuart_Miller	Assuming you are not working with an agency that may have done some of this, you will need to find out the requirements of the clinic you are working with. Most require a psychological screening (they'll have psych referrals for you), and a medical screening at their facility. They may also have age, weight, height, etc. requirements so check with the clinic before selecting a surrogate.
RF15015	Why can't they be screened at their own facility?
Stuart_Miller	Then, you enter into contracts with the surrogate and will need an attorney in your area to draft these. If your surrogate lives in another state, you'll probably need an attorney there as well for review of those state laws and the paternity judgments.
Stuart_Miller	RF--not sure what you mean. Can you clarify?
RF15015	Screened by their own OB/GYN and the results sent to your doctor if travel will incur prohibitive expenses.
Stuart_Miller	Most IVF clinics will want to see the surrogate in-person as they ultimately have to decide if she is an appropriate candidate for you. I've not seen an IVF doctor who would accept and OB/GYN screen.
RF15015	Mine did. What about arriving at terms and writing up your own contract?
Stuart_Miller	It all depends on the amount of risk you want to take. There is a case right now where a couple used an old contract they found online and the surrogate is now suing for custody and has won the first round because the contract wasn't enforceable.
Corey	That's pretty scary Stuart. What state is that happening in?
RF15015	Oh my - haven't heard about it. What State?
Stuart_Miller	North Carolina. I was interviewed for a story about it.
RF15015	Was that a traditional surrogacy?
Stuart_Miller	No. Gestational using egg donor and husband sperm.
Corey	I have another question - isn't the psychological testing done a pretty good indicator that the surrogate won't be interested in getting custody. I would imagine that that is a rare occurrence?
RF15015	Wow, she's not even biologically connected. I wonder who the psychologist was who did that screening!
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DonnaMac	hi all - I am wondering if I can legally use my younger sister (23) as a surrogate in NY State?
Stuart_Miller	I think they psych testing can help a lot. I doubt in this case they even did psych testing. Most clinics that are familiar with surrogacy require but this part of IVF is not regulated so you never know. AFA has great information about this.
Stuart_Miller	Hi Donna. Yes, as long as you don't pay her compensation. You can help with expenses. AFA has some attorney referrals in NY for you.
RF15015	DonnaMac - if she's not compensated I believe it's perfectly lega.
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RF15015	How important is BMI - I hear varying things. Some say that surrogates with high BMI's get pregnant - no problem - and others say the success rate drops considerably.
Corey_Whelan	Hi, again, if anyone has any additional questions please don't hesitate to contact me and we will get you the information. I'm at corey@theafa.org. You can also check out our online fact sheet series and past publications of our directories and magazines which all hang online at www.theafa.org
Stuart_Miller	Hi RF. Yes, that is something I think is difficult to gauge. We have had heavy surrogates do just great and see no diff in pregnancy rates. The doctors feel that BMI does play a part in other pregnancy related health issues like gestational diabetes.
Corey_Whelan	Last month's Connections enewsletter was about weight related issues and conception. If anyone needs a copy, please call me and let me know.
RF15015	It's difficult because I believe most surrogates are overweight. Is that just my perception or is it true?
Stuart_Miller	Hi RF. Most americans are overweight! So, I think surrogates just reflect most of America.
Zimgirl	A worst-case scenario question: What if the lab messes up and the wrong embryo is implanted - what are the legal ramifications for the child who is not biologically related to either parent?
RF15015	I suppose.
RF15015	If it ever works for me I'll have a child not biologically related to me - and I'm single. Donated embryos.
Stuart_Miller	Hi Zim. Gosh, that's one I can't answer. It would depend on the state, the wishes of the bio family, etc. It would be a terrible situation. Ask the clinic who they monitor this part of the process which hopefully will give you some peace of mind.
Zimgirl	I'll be sure to ask. I've heard that it happens, but thankfully it is not common at all.
RF15015	I think it would depend on the laws in the State. You can get a pre-birth order in some states even though there's no bio connection. Otherwise - you probably have to do an adoption.
Stuart_Miller	We have never had this happen that we know of but I do know there was a case in SF where it happened. It is still in the courts now, I think.
Corey_Whelan	That is why it's important to work with people that you trust who are experienced in this field. All of life carries some risk but educated risk tends to create better outcomes!
Zimgirl	Exactly! The questions are very difficult, but it is important to think about it all up front, I think.
Stuart_Miller	Yes!
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RF15015	Have the fees surrogates are asking gone up considerably in the past 3 years. It seems to me it has.
Stuart_Miller	Yes, I think that they have. As surrogacy becomes more common, it also becomes more commercialized. This can be a positive and a negative.
RF15015	Do surrogates typically get a retainer. The last one who scammed me got a $2,500 retainer. Should I have seen that as a red flag?
Stuart_Miller	We don't recommend retainers but we know that it is done. I would recommend getting a great attorney who has done numerous surrogacies and they should be able to help protect. Our surrogates don't get the first part of their compensation until the 7th week of pregnancy.
RF15015	Then what fees do they get up to that point? They must get something.
Stuart_Miller	All they receive is their actual travel expenses and a $250 a month allowance after the contracts are signed. They go through the screening, etc. with no compensation. It is different from agency to agency so it is important to ask.
RF15015	But what about a fee when starting meds. They all seem to want that. And a transfer fee. I've seen that go up a lot.
Stuart_Miller	Yes, there are fees for that which are usually $500 or so. And, a cancellation fee. But, these fees are not part of their surrogacy compensation but "event" fees.
Corey_Whelan	Folks, we're at the ten minute mark, so please ask your last questions now - don't wait
RF15015	All I can say is that when I started this journey (an unsuccessful one so far) I was told to "BE CAREFUL". I had no idea what that meant. Sadly, I've since learned.
Corey_Whelan	RF, I'm so sorry it's been so rough. We all have our war stories.
Stuart_Miller	Yes, that is why finding a good clinic, agency, attorney, etc. can be important. I even know a doctor friend who didn't follow this advice because he thought he could do it all and was hurt. It really is a big puzzle with lots of pieces to it.
trishwalla	so if you get a good lawyer and good agency are you pretty safe that you won't face a situation where the surrogate has any legal ground to any type of custody
Stuart_Miller	If you work in a state where surrogacy contracts are enforceable, I can't imagine a case in gestational surrogacy outside of criminal acts by you where the surrogate would have any standing. We have managed cases for more the 900 clients and have never had any legal issue at all.
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RF15015	I don't believe the surrogate wanting custody is the main problem area. Most have more children than they know what to do with - their biggest fear seems to be that they'll be stuck with a baby. There are other issues that are more common.
Stuart_Miller	You are right, RF.
sgong	What are some of those "other issues"?
RF15015	How much time do we have?
Corey_Whelan	guys, we have four minutes left
Corey_Whelan	And then we have to let Stuart sign off. Stuart, thank you so much for your time tonight. I learned so much!!!!! And thanks to all of you for your courage - I hope you all have wonderful outcomes and futures!
RF15015	The last one was cycling for another couple at the same time. Just wasting my time and money and emotional feelings. A sociopath. The last one who I actually used and had 2 unsuccessful transfers with - using up all my embies - was a nervous, money hungry wreck. I knew the pregnancy would never take.
Zimgirl	Yes, thanks Stuart.
Stuart_Miller	Most issues when working with an agency revolved around the relationship with the surrogate and if you get pregnant or not. If you work on your own, we hear a lot more horror stories.
Stuart_Miller	Thank you! I wish you all the best of luck!
RF15015	Thank you.
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Corey_Whelan	our chat is officially over folks. Thanks again and good night.
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Surrogacy - Have you considered this option?

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