Third-Party Reproduction Explained

November 8, 2005 - Tuesday
1:40 PM to 2:40 PM (EST)
Guest Speakers: Gad Lavy, MD, FACOG, Founder and Medical Director for the New England Fertility Institute

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

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deb_capone	Welcome, Dr. Lay and Sarah
deb_capone	I am the moderator; the Education Coordinator for the American Fertility Association.
gad_lavy	Please correct my name -- Lavy not Levy. Thanks
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deb_capone	We will wait unitl 8 to start the program
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deb_capone	Welcom Teddy and mwelch
deb_capone	We have a great program tonight with Dr. Lavy.
deb_capone	We will be starting in a few minutes.
mwelch	Type here looking forward to it.
deb_capone	If at any time during the session you would like to ask me a private question, you simply have to double click on my name which appears in the left hand column.
deb_capone	Ok, let's get started.
teddy	ok
deb_capone	I would like to take a moment to introduce Dr. Lavy, his team and tonight's topic.
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deb_capone	Today we are fortunate to have with us Dr. Gad Lavy and his team
deb_capone	We will be discussing third party reproduction; including egg and embryo donation as well as gestational surrogacy.
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deb_capone	Dr. Lavy, thank you for joining us tonight
deb_capone	Welcome, Sue, We are just about to get started.
gad_lavy	It's my pleasure
Sue	thank you and hello
teddy	How would someone know that eggs or embryo donation is needed?
deb_capone	Third party reproduction has opened the door to parenthood for countless individuals. Individuals and couples from a wide variety of personal and medical circumstances, from women who were born without a uterus to individuals with a history of failed IVF cycles to same sex couples, have come to appreciate gestational surrogacy, egg donation, and embryo donation as viable options in their journeys to create families. Dr. Gad Lavy, founder and medical director of the New England Fertility Institute, and two members of his Third Party Reproduction Team, Samantha Tartaglia and Sarah Clark, coordinators in Dr. Lavy’s Third Party Reproduction Team, welcome your questions regarding the opportunities that th
deb_capone	Welcome again to Dr. Lavy, and his team.
gad_lavy	Egg Donation is indicated for women who's ovarian function is reduced, who's egg quality is poor or those who carry genetic diseases which would preclude normal pregnancy.
gad_lavy	Thank you.
deb_capone	Dr. Lavy, beyond egg donation which you described, when would a patient begin to consider third party reproduction?
gad_lavy	Third Party Reproduction includes egg donation, embyo donation and gestational surrogacy.
gad_lavy	A patient would consider gestational surrogacy if her uterus is absent or damaged due to congenital conditions, surgery or disease. Also, cases in which repeated pregnancy loss or lack of success with convential infertility therapy is contributerd to a uterine factor that is not correctible.
Sue	What sorts of issues would the child have in terms of parentage? Is the women who gives birth considered the legal mother? - Or would she have to then adopt the child she bore?
deb_capone	Dr. Lavy, teddy would like to know if a women is bleeding is she still producing eggs
gad_lavy	Teddy: Not necessarily. Menopause, the cessation of menses, is a very late sign of ovarian failure, in other words...women can continue to have regular cycles but have no eggs or eggs or very poor quality.
deb_capone	We are here with Dr. Gad Lavy discussing third party reproduction; egg and embryo donation as well as gestational surrogacy. We are very grateful for Dr. Lavy and his team's time.
gad_lavy	For egg donation, she would not have to adopt a child, she is the legal mother. For surrgoacy, it depends on where the child is delivered..in some states adoption is necessary, while in others the genetic parents can be put on the birth certificate.
deb_capone	Dr. Lavy, in your experience, are the intended parents in the delivery room with the surrogate?
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deb_capone	Good evening, Rachel welcom aboard.
gad_lavy	Yes, we encourage the intended parents attend the birth, in the delivery room. And also, to be present in the prenatal visits.
teddy	I am a 39 year old female and I have been trying to have a child for over 5 years. I have suffered with abnormal uterine bleeding no one has ever discussed menopause with me, I was told that it is adenmois (not sure of the spelling),
Sue	What sort of legal issues should be considered in egg donation? What items should be included in the contract?
gad_lavy	Teddy: In some cases, severe adenomyosis can preclude you from becoming pregnant. If your ovarian function is normal and it has been determined that your uterus does not function properly, you may be a candidate for gestational surrogacy. [
teddy	ok, Could you explain to me what that is?
gad_lavy	A contract is not generally required for anonymous egg donation. However, when the donor's identity is known, a contract between the parties is requrired and should include the donor's compensation and her responsibilities ie. compliance with the treatment.
gad_lavy	Teddy: A surrogate, will carry a pregnancy to term, the genetic make-up of which comes from the male and female partners.
gad_lavy	In-vitro fertilization is performed and the embryo is transferred to the gestational surrogate.
teddy	ok, thanks
Sue	Should the child be told about the donor and should I chose a donor that is willing to meet the child in the future, if so desired?
gad_lavy	We generally recommend that the child be told at the appropriate age, prior to undergoing treatment couples receive extensive counseling which includes discussion of disclosure.
deb_capone	We are talking about third party reproduction-egg and embryo donation and gestational surrogacy with Dr. Gad Lavy. Dr. Lavy has over a decade of experience offering third party reproduction cycles.
gad_lavy	As far as the donor meeting the child, my personal opinion is that it is not necessary and maybe ill advised.
deb_capone	We also have online tonight Sarah Clark, is a genetic counselor with particular expertise in screening egg donor applicants’ family histories. Thank you for joining us.
teddy	Can you explain third party reproduction-?
gad_lavy	Most of the anonymous donors are not interested in meeting the recipient or the child.
gad_lavy	Yes, Teddy. Third Party Reproduction includes any situation where a third party's genetic material is used to create a pregnancy.
Sue	One of the donors I am looking at had an alcoholic mother. The donor does not drink, nor does her brother. She claims no one else in the family has a drinking problem.
Sue	should I be concerned about this?
rachel	What kind of genetic screening is done for egg donors
Sarah_Clark	Hi Sue, alcoholism is not usually a purely genetic trait. However, given that the donor's mother has the condition it may be advisable to consider another donor.
Sarah_Clark	Hi Rachel,
teddy	What is third party genetic material?
Sarah_Clark	All donor applicants should have a complete family history taken, with a focus on birth defects, mental retardation, and other genetic conditions. All donors also have genetic testing for conditions more common in their ethnic background.
gad_lavy	sperm, eggs or uterus
rachel	what is the age limit for egg donors
gad_lavy	we require donors to be between the ages of 21-31
gad_lavy	this applies to anonymous donors. For known donors, we don't usually set an age limit, we decide based on a case=by-case basis.
deb_capone	Why is there a difference for known donors-and are known donors perferred?
rachel	Can you explain the process in which you retrieve the eggs and implant.
gad_lavy	We prefer anonymous donors, however, some couples prefer to use family members or friends who are generally older.
teddy	Is there an age limit on third party reproduction for women unable to conceive the old fashion way?
Sue	Why do you prefer anonymous donors?
deb_capone	Thanks to Dr. Lavy and Sarah Clark for being with us tonight. We are grateful for your time.
gad_lavy	Rachel: Third Party Reproduction involves in-vitro fertilization, the ovaries are stimulated with medications. The eggs are retrieved vaginally using an ultrasound and embryos are transferred using a plastic catheter through the cervix into the uterine cavity. For more details, please visit our website www.nefertility.com
deb_capone	We also encourage all of you to continue to use the resources at www.theafa.org and our free "No Barriers" membership.
rachel	please leave the number for the New England Fertility
gad_lavy	Sue: by using anonymous donors we avoid potential inter-personal conflicts.
gad_lavy	203-3
gad_lavy	203-325-3200
rachel	thank you Dr. Lavy.
gad_lavy	Teddy, For egg donation, we generally don't set an age limit. For gestational surrogacy it's only limited by the intended mother's ovarian function.
teddy	Thank you
rachel	Dr. Lavy how many cylces of ivf do women typically go through before trying 3rd party.
gad_lavy	There is no set number..in some cases we determine immediately that third party is the couples' best option. In other cases, we try IVF one to three times before reaching that same conclusion.
deb_capone	How does one find a gestational surrogate? How are surrogates screened?
Sue	I have a donor that is a friend of a friend type thing. I don't know her, never met her, but have spoken on the phone quite a bit to her. She did her counselling today and I have mine tomorrow. Am I right in understanding that you don't think we should ever meet. I don't think either of us really care if we meet or not, but sort of thought we should, so perhaps we shouldn't?
gad_lavy	This is not an anonymous donor.
gad_lavy	I believe that, if the donor is known even to a third person there should be full disclosure.
teddy	How much does third party reproduction or gestational surrogate cost?
Sue	What is full dislosure? What should I know about her that I may not know? she seems to answer all my questions, so what do I still need to ask her? I've covered her family history, genetics as best as I can, what she does for a living, where she lives, what to do with any left over embyros, etc. what else should I cover?
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gad_lavy	Sue there are many potential issues. We believe it is best for an attorney versed in reproductive law to address these issues and draw up a contract, to protect your future. In addition, the donor whether known or anonymous should go through the same clinic process by the clinic or agency.
gad_lavy	The estimated cos of an egg donor cycle is $26,000 which includes the compensation to the donor, the medication and the fertilization and transfer costs.
Sue	.the same clinice process, meaning the testing etc? I believe that clinics would still do that even if I brought in my own donor would they not?
gad_lavy	Gestational Surrogacy is conservatively more expensive because it involves higher compensation for the surrogate and the attorney and agency fees. It can reach $50,000 or more.
gad_lavy	Sue: Yes, all donors are subject to the same screening tests. Those tests have been standardized by the FDA.
deb_capone	We are talking tonight with Dr. Lavy and Sarah Clarke of the New England Fertilty Institute in Stamford, CT. We thank Dr. Levy and Sarah Clarke for their time and expertise.
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gad_lavy	Sue: Some of the tests results, such as blood tests , are objective while others such as the psychological screening are open to interpretation.
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Sue	If the psychologist meets with the donor and doesn't seem to find a problem, then I can assume that baring any medical issue, the donor is acceptable?
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deb_capone	Dr. Lavy, Sarah we are getting close to the end of our session. Do you have any final words of for our audience on third party reproduction.
gad_lavy	Sue, yes.
Sue	thank you for your assistance and answers to my question.
gad_lavy	Thank you for joining us. It was my pleasure.
deb_capone	Once again, I would like to thank Dr. Gad Lavy and his team from the New England Fertility Institute. You can reach Dr. Lavy at 203 325 3200 or get more info from the website: www. nefertility.com
gad_lavy	Thank you. Good night.
deb_capone	Thank you. We appreciate your time.
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Third-Party Reproduction Explained

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