The Psychological Aspects Of Third Party and Assisted Reproduction.

September 5, 2006 - Tuesday
3:55 PM to (EST)
Guest Speakers: Kim Bergman, Ph.D
Fertility Counseling Services

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

deb	Our guest for this session is Kim Bergman, Ph.D. Kim is the founder of Fertility Counseling Services and provides psychological services for individuals and agenies involved with fertility and Assisted Reproductive Technology (ART). Dr. Bergman is also a co-owner of Fertility Futures and Growing Generations. Growing Generations is the oldest and largest surrogacy and egg donation firm dedicated to the gay and lesbian community. Fertility Futures provides an array of services for individuals with fertility challenges. Dr. Bergman current chair of Family Pride a not-for-profit organization dedicated to equality for LGBT parents and their families. In her spare time, Dr. Bergman and her partner are the proud parents of two daughters.
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deb	Welcome, Melissa3 and jude_ray. Thanks for joining us. We will be starting in about five minutes.
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deb	Tonight we are discussing the psychological issues surrounding third party reproduction with Dr. Bergman.
deb	Thanks for joining us Karen1!
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deb	I would like to start the session by introducing myself. I am Deb Capone and I am your moderator. If you need to 'speak' with me privately, just click on my name on the left hand side of your screen. More importantly, I would like to thank Dr. Bergman for joining us--and to all of you for taking time out of your lives to be with us.
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deb	To get the ball rolling, I would like to ask Dr. Bergman to make a few opening comments. But as always, feel free to jump in at any time!
deb	Take it away, Dr. Bergman!
Dr._Kim_Bergman	Hi everyone! Thank you so much for having me in youchat.
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Dr._Kim_Bergman	I am here as a resource for anything you want to know or have on your mind about the psychological aspects of third party and assisted reproduction.
tenayagirl	thank you -- i do have a lot of questions!
deb	Go for it, tenayagirl!
Dr._Kim_Bergman	If you have been on this journey for any lenght of time you probably think about these issues all the time. What are the questions you have asked? What are the issues that you face?
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Dr._Kim_Bergman	Yes, what are your questions? How can I help?
tenayagirl	thank you-- where do i begin? may i ask you about our relationship with a potential embryo donor?
Dr._Kim_Bergman	Yes, of course. Tell me about it.
deb	thanks for joining us bumblebee!
tenayagirl	a lovely couple has offered us their frozen embryos (after their successful IVF with twins)
Dr._Kim_Bergman	yes. What are your concerns? What are you thinking about?
tenayagirl	2 issues have arisen in our discussions one is regarding an inherited medical condition on one parent's side, which may have a 50/50 chance of being passed on to the embryos
tenayagirl	the other issue invovles the degree of openness and contact with "resulting children"
Dr._Kim_Bergman	Okay, with regard to your first consern: How serious is the condition? have you consulted a geneticist? With regard to the second issue, let's talk about it a bit.
Dr._Kim_Bergman	Are you talking about contact between the donating couple and your children?
tenayagirl	we have tried to consult a geneticist through our R.E., because he was initially concerned with the condition, which can vary from mild to very serious
Dr._Kim_Bergman	Well that is something to really consider and weigh heavily.
tenayagirl	now he has thrown the ball back to us and we're not sure how to find a genticist who will talk w/ us any suggestions?
karen1	Hi Dr Bergman, When tenayagirl is done, I have a question on gestational carriers. Is this a legal quagmire? I would like know if I pursue this, which are the best states that are receptive to this. I would want to use a gestational carrier for carrying purposes only, I would not be using her egg.
tenayagirl	re: the openness for future contact-yes it's looking like there may be a prob
tenayagirl	she says they understand that once they donat to us, we will be the parents...and that they dont want to ever interfere...
Dr._Kim_Bergman	Okay, first regarding the geneticist, can you get a referral from the RE? Second, if there is already a problem regarding contact with the donating couple this might not be the best situation, regardless of how attractive it feels to have someone willing to give you embryos.
tenayagirl	but she says as a mother, she knows she is going to want to see the children someday, and has expressed that she wants her children to meet their gentic siblings...
tenayagirl	but says she is not sure if she would tell them that they genetic siblings!
Dr._Kim_Bergman	Donating embryos or eggs is not something everyone can do. For those people who can do it it is a wonderful gift. But not everyone should be a donor.
tenayagirl	we talked this over with our lawyer, who is experienced with 3rd party, and she says that there are already some red flags in our discussions...
tenayagirl	it seems to me that perhaps the donor is not fully conscious of the fact that she is not ready to let go my questions is-- can this get better or worse?
Dr._Kim_Bergman	The issues are very complicated and it is best to have the donor seek professional help to be really sure that she can emotionally be a donor. The children will be yours and yours alone. If that is hard for her than it might be better for her not to donate the embryos, even though it is a generous thing to do.
tenayagirl	she SAYS she knows they will be our kids, but they even asked us what our plans for guardianship were, and when i told her we have several family members willing, she said that they were concerned that the embryos could end up in foster care and they'd be willing to take them in to prevent that...but i told her that we would make provision...
Dr._Kim_Bergman	It can get better but red flags are red flags and i usually go with "when in doubt, leave it out". This is too big an issue to take a chance on. Maybe some moderated conversations with a professional to flesh out her concerns before moving forward?
deb	Dr. Bergman, tenayagirl
tenayagirl	yes, i suggested to her that we do that
tenayagirl	how can we go about setting that up?
tenayagirl	my husband thought that maybe we'd just see if they accept the terms in our contract, and then if they object or ask for something outrageous, we say no
deb	oops, tenayagirl's questions make me wonder about how often someone has to change gears with regard to a donor or surrogate and how does one cope with the emotional ramifications
Dr._Kim_Bergman	You can call me anytime at my office and I would be happy to talk to you and set up a consultation if you would like and she is willing.
tenayagirl	but i think that there still may be underlying issues that may come out later...as i do want to be open with my own kids and it would be nice for them t have the freedom to contact them, but ONLY when theyre developmentally ready!
deb	And karen 1...don't give up on your questions for Dr. Bergman..
Dr._Kim_Bergman	Yes, I will come back to you Karen 1 in a moment!
tenayagirl	thank you doctor. i will talk to my husband about doing that
Dr._Kim_Bergman	Sorry--I am new to juggling lots of conversations!
tenayagirl	i'd like to let someone else ask a question, and there perhaps i can post another--thanks
Dr._Kim_Bergman	Changing gears is a big part of this whole issue. Ok, let's get back to your issue in a bit.
deb	you are doing a great job. WHile I am sure that tenayagirl's situation is unique to her, I think there are problably some common themes that we can all relate to.
Dr._Kim_Bergman	Okay, for Karen 1...
Dr._Kim_Bergman	Gestational surrogacy's legality varies from state to state. In some places it is quite safe legally and in others it is far too precarious.
karen1	That's what I thought. Can you pleas share which states are better and which ones worse?
Dr._Kim_Bergman	Yes. California is one of the best.
karen1	How about on the east coast?
Dr._Kim_Bergman	There are also states throughout the country where surrogacy is safe.
Dr._Kim_Bergman	yes, massachusetts.
karen1	Does it help that the surrogate mother would not be using her egg, so there are no genetic ties to the baby? Or does that not really matter?
Dr._Kim_Bergman	It doesn't really matter. Overall state laws vary as to this aspect as well. The state where the baby is born is the state with jurisdiction
karen1	How is NY or NJ? If there is a reference book or website that you know of that summarizes the states that are receptive, that would be greatly appreciated. So far, it sounds like CA and MA are the best.
Dr._Kim_Bergman	that is why people often work with a surrogate in california, texas (for straight, married couples), kansas, Mass, Arkansas.
Dr._Kim_Bergman	NY is one of the worst for surrogacy, in fact it is illegal.
karen1	Okay, will totally avoid NY! How about NJ? Not sure if you saw my comment that the egg would not be the surrogate mother's. Does that help too?
Dr._Kim_Bergman	You can contact the National Fertility Law Center, Nationalfertilitylaw.com. They can give yoiu a complete list as well as referrals to local lawyers.
Dr._Kim_Bergman	Tradional vs. Gestational surrogacy isn't the thing that really matters. In those unfriendly states either kind of surrogacy is illegal and unsafe.
karen1	Great - thanks. This may sound star trekkish, but are there any developments going on with technology to some day have the gestational carrier be techno-based, like a computer womb?
Dr._Kim_Bergman	Not at this point.
Dr._Kim_Bergman	But I;m really glad you asked that because it raises an issue I wante dto address.
Dr._Kim_Bergman	That is the use of the term "surrogate mother".
Dr._Kim_Bergman	I know that ther is not a better term so I use "surrogate" without mother. Here's why:
Dr._Kim_Bergman	There are four elements necessary to have a baby, sperm, egg, a place to grow in (sometimes the surrogate) and a place to grow up in.
Dr._Kim_Bergman	The only one of those four that are the parents and therefore, mother is the last on, the place to grow up in.
Dr._Kim_Bergman	I know this may sound like splitting hairs but think about it. Using the word mother, even with surrogate in front of it has a meaning, creates a whole world for your child and for others. A world that does not accurately reflect who all the players are and a world that sets up expectations for the child. What do you all think?
karen1	Yes, labelling does lead to expectations, sometimes false ones. That is why I like the term gestational carrier, better than surrogate mother, if there is not going to be a relationship between the carrier and the baby, after birth.Thanks Dr Bergman. I am not sure that this is your bailywick,but are there any fertility centers in the northeast that specialize in egg freezing, before the eggs are fertilized? I have read that there is better success now with the the unthawing of unfertilized eggs so that they can be fertilized, so this may be an option for me to explore. If you have any suggestions for centers that specialize in this, that would be most helpful too.
karen1	After my quick 2nd question, Tenayagirl, Dr. Bergman is all yours!
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Dr._Kim_Bergman	It is very new and cutting edge and the efficacy is not yet proven. However you could probably google egg freezing and come up with some centers then check them out. Also, I really like the term gestational carrier as well. That is really a good one.
tenayagirl	Hi Doctor -- a question about embroyo donation law. i read somewhere that there is a new law in CA specifically for embryo donation but our legal agreement doesn't mention it, just that the embryos would be marital property?
deb	Dr. Bergman, and group...not to be a wet blanket, but it does seem to me that we are all focused on the mechanics rather than some of the other issues that surround third party reproduction. Am i off base?
tenayagirl	is there such a law in CA? could you give me a website or reference for it?
Dr._Kim_Bergman	for the legal angle contact nationalfertilitylaw.com
deb	Welcome Vaniteyes! We are talking with Dr. Kim Bergman about the psychological issues surrounding third party reproduction.
tenayagirl	our attorney said all embryo agreements have traditonally been based on case law pertaining to leftover frozen ebryos like in marital cases, or modeled afte egg donor agreements...obviously, i am concerned about the future--if a donor ever wanted to gain custody after my children were born?
vaniteyes	thanks for the welcome!
Dr._Kim_Bergman	It is really good to be thoughtful about the future and consider all possibilies and the realize that this is not always a linear field! In fact it usually isn't.
Dr._Kim_Bergman	The three things that are really important to keep in the forefront during ART are:
Dr._Kim_Bergman	trust, communication and flexibility.
tenayagirl	we've touched on this, but what are the usual embryo donor expectations? i've been told that in most cases, it's anonymous, but what about the ones that are "open"? what should we llok for?
Dr._Kim_Bergman	Great question.
Dr._Kim_Bergman	The whole field seems to be gradually leaning toward more open situations. And that is okay as long as everyone's expectations are clear and hoesty is the rule..and remember my four elements that are necessary..it is really important to be clear that only one of the four are the parents.
tenayagirl	because she really seems to think of these embryos as "her children" after alll, they were created for her and her husband to potentially implant and carry!
tenayagirl	but now she says her faily is "complete" and that she has a "full house" and wants to bless another family, yet with all that she;s asking of us, are theyreally going to be able to come to a place of letting go and trusting us?
Dr._Kim_Bergman	Well if she thinks of the embryos as her children whe will likely think of the children as her children, and while this is understandable it doesn't really make for a successful situation.
tenayagirl	uh-oh
Dr._Kim_Bergman	I usually advise people not to risk it. Your children will be yours and yours alone and while I am all for honesty and having all the parties meet if that is what they want, it is vital that the donating couple be just that, the donating couple, not another set of parents. Remember, as kind and generous as it is to donate, not everyone can do it.
vaniteyes	I am 40 and my first RE and now my second RE thinks my last IVF try (our 4th) should be with donor eggs. My husband feels we should give our last shot with our own eggs and then move to adoption. It has been a really hard decision to make....this IVF stuff in general has been really hard
tenayagirl	thank you doctor...in the meantime, before we can find out if they're willing to talk w/ a professional...are there any good online resource/other that we can recommend to her to read?
Dr._Kim_Bergman	I know that if you have wanted children forever and have tried many things it is hard to say no to a situation that seems so "easy", it's just that it may not be easy after all. You can find a donor who will be open to meeting offspring if you want that without feeling like she is another ohter.
Dr._Kim_Bergman	I would also be happy to consult with you about all of these issues.
tenayagirl	thank you
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deb	Dr. Bergman, I think you just hit on something important...that is the fact that most of us have been waiting and wanting for a long time for our children. How do we not let that longing cloud our judgement?
Dr._Kim_Bergman	vaneteyes, can we go back to your issue/
vaniteyes	yes
Dr._Kim_Bergman	It ties in with what Deb just bought up as well.
deb	Good evening Sunnynac. We are talking with Dr. Kim Bergman about the issues surrounding IVF/ART and Third Party Reproduction.
Dr._Kim_Bergman	you have tried and tried. It's so hard not to want to give up and it is easy to have cloudy judgment.
vaniteyes	yes, doctor..that is for sure!
Dr._Kim_Bergman	As much as it feels like you are all alone, you really have a whole community of people who understand.
Dr._Kim_Bergman	The best way to not get too cloudy is to talk and talk and talk.
Dr._Kim_Bergman	By the way this is my general advice about anything one is dealing with.
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vaniteyes	thanks, Doctor..I have been communicating with others dealing with IVF..and it does help
Dr._Kim_Bergman	Talk to each other, talk to professionals, talk on chats, keep talking.
deb	This is probably a good time to remind you all that The AFA has tons of resouces-on and offline-that are available to you. For support and information. Dr. Bergman is a great example of the types of resources that we are so fortunate to have. Check out www.theafa.org
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Dr._Kim_Bergman	Get advice and learn from each other's experience and then trust yourself.
deb	Dr. Bergman, your advice is universal. Would you add anything specific for those in the LGBT community?
Dr._Kim_Bergman	Yes and no.
Dr._Kim_Bergman	Get comfortable with yourself and you will know exactly what to do.
karen1	Thank you, Dr Bergman and Deb, for your time tonite. And Dr. Bergman, feel free to use gestational carrier, going forward if you like
deb	Sometimes easier said than done, right?
Dr._Kim_Bergman	yes, very much so. That's my short answer. But it's true.
Dr._Kim_Bergman	and thanks Karen1--I will use it!
karen1	Good night.
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vaniteyes	Thanks again Doctor to chatting with us!
deb	We are almost at the witching hour, so if you have any questions for Dr. Bergman, now is the time.
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tenayagirl	deb-how do we save and copy and print this chat text?
deb	Dr. Bergman, can our participants contact you directly for more info. If yes, will you share your contact info.
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Dr._Kim_Bergman	Yes, absolutely. Thanks.
deb	Tenayagirl, we post the transcripts to all the sessions (sometimes it takes a while, though). Keep checking www.theafa.org
Dr._Kim_Bergman	Reach me at FertilityCounselingServices.com or 323.904.4715. Thank you so much for having me.
karen1	to save the text, click on the clipboard below, then highlight the text in the pop up, and hold down keys "control" and "c". to paste, open a new doc and hold down "control" and "v" to paste it.
deb	Dr. Bergman, you were a fantasitc guest. We are so grateful for your time.
Dr._Kim_Bergman	thank you it is my pleasure. and for all of you--just don't give up!
deb	Remember, we are here every Tuesday night at 8pm Eastern. These are your sessions, please let us know what topics you want to see.
deb	And check out our next issue of connections...it will be out electronically on 9/15. You can read Dr. Bergman's great article in that issue of Connections.
deb	Thanks to everyone. Good night.
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tenayagirl	thanks deb
tenayagirl	thanks karen
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The Psychological Aspects Of Third Party and Assisted Reproduction.

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