Holiday musings: Getting by with a little help from friends

Holidays can be an especially poignant time, depending upon where you are in your journey to parenthood. The season is geared towards babies, kids, and families. It seems everywhere you turn are boisterous reminders of the babies we long to arrive, ache to cuddle, or who remain a distant dream. If you are blessed with a baby on the way or your baby has arrived, this can be a season of great anticipation and joy.  If on the other hand, you are still waiting for baby, it can be a season of sadness and loneliness.

If you have made the “crossover” from “getting to baby” to “having your baby,” you can offer sensitive and timely support for friends and family still working through infertility options, waiting for an adoption referral, or struggling with the decision to remain childfree.

The best gift is to simply be there for your friend, to share their sorrow and struggle. Take them out for an evening or a day to do something fun, not centered on children and families.  If you live near a big city, check out Goldstar for discount theater and event tickets. Groupon or one of the other crowd-sourcing sites, in addition to restaurants, have lots of pampering options like massage and manicures. A Groupon Gift Card will let your giftee select something close to home or something she has always wanted to do but hasn’t had the time or money to make the leap.

If you’re looking for something tangible to say, “I know how you feel,” take a look at Cafe Press and Zazzle, where someone has created a gift or a store for just about every “conceivable” idea. Search donor, surrogate, infertility, gay dads, and TTC (trying to concieve). Jennifer and I still consider ourselves Infertility Warriors.  And hoping this time is the charm makes a great stocking stuff for the boxer wearer in your life.

Finally, Etsy is where you will find all things handmade and heartfelt.  Unique illustrated calendars, a chunky knit wrap, vintage ornaments, paper goods, jewelry, housewares, and so much more. For friends who are already on the path to parenthood through surrogacy or adoption, I like this tile or this one for a single parent.

The holidays can be bittersweet. A funny gift or exhilarating experience can help make this season a little sweeter if completion of your or your friends’ family is not quite “wrapped up.”

The Truth About Trying

I ran across an a new campaign to bring infertility out of the closet and into the light.  It’s called the “The Truth About Trying”.  Resolve, the National Infertility  Association and Redbook magazine have teamed up to end the shame and secrecy of infertility.

I love it.  So far, almost 200 videos where women (and men) share their personal stories have been added to the site.  Celebrities, physicians, and just plain folk like you and me answer the question : What I wish I’d known about infertility.”

Some have found success, others are still trying to conceive (TTC), others will remain childfree. No matter what the outcome, the process is painful – and too often we suffer in shame and silence.  Why is that?  Why do too many of us keep this agony a secret from family, friends, and collegues?  And why do well meaning people give advice that blames the victim with simple ideas like “ just relax” “you’re too stressed.”   Infertility is not a choice. It is a complex disease of the reproductive systems of men and women. You can’t see it on the outside and  you don’t know you have it until you try to conceive. It’s emotionally, physically, and financially draining. And you can’t just take a pill, get a massage, or stop thinking about it to make it go away.

I’m seeing more about this movement in the media to destigmatize infertility and it’s an encouraging sign. With more than 5 million Americans battling infertility on any given day, we are a small army . This is why we wrote Getting2Baby and why we’re creating a community here to provide an open, welcoming forum for men and women – especially those in the GLBT community – to find support and resources.

Let’s get our army on the march, let’s get infertility out of the closet.  And if you make and upload your own video – be sure to let us know here – we’ll share the link.

Surrogacy Journeys

Our babies, Christopher and Katherine, were born in the spring of 2010. Our book, Getting to Baby, also came into being in the spring of 2011. In it we chronicle our optimistic expectation of easily achieving pregnancy, the disappointments of the world of infertility, the trudge through failed IVF, miscarriage, failed adoption, and then finally our joyful SUCCESS through surrogacy.

Ours is just one story with a happy ending. Every year, hundreds of others forge their own successful paths through surrogacy. Many have stories just like ours — gay or lesbian couples who find a path to parenthood through the generosity, trust, and love of surrogates and donors.

When you are riding the roller coaster of infertility, adoption, surrogacy, and pregnancy, the support not only of friends and family but of others going through the actual experience is so important. The blogosphere gave us essential information, encouragement, and support  — and is one reason we created GettingToBaby. We want to create a central, collaborative place for the kind of support, referrals, and education we had to really work to find, and really depended upon to make our dream of becoming parents a reality.

I thought I’d share a few great blogs of babies in progress—and babies brought home:

Babies in progress:
Special Delivery follows the journey of Kelli, a gestational surrogate carrying twins for Ian and Troy.  Ian’s sister Leandra donated the eggs, which were fertilized with Troy’s sperm. Kelli is halfway through the pregnancy, and their story is being made into a movie called “More than a Village” by documentary filmmaker Edward McDonald. Follow the film by following Edward on twitter: @edwardmcdonald

Bernadette and Duane share their roller-coaster ride of surrogacy in India at Rasta Less Traveled. We look forward to following their tale to a happy ending.

Babies at home:
George and Farid are the proud parents of Gustavo and Milena, born on November 6, 2011, to gestational surrogate Jeni. Their beautiful story is chronicled on Jeni’s blog Love Makes a Family.

Jeni, Kelli, and Bernadette also list other blogs they follow — so check them out.

Brings a smile to my face.  How about you?

Personhood: An Extreme Attack on Freedom

As a lawyer and a mom of twins conceived via in-vitro using a gestational surrogate, it is with deep personal interest I read about the “personhood” petitions being introduced in all 50 states.  On November 8, Mississippi will be the first state to vote on such an measure, Initiative 26.

Positioned as a “civil rights” issue, these extreme measures target abortion and women’s rights – reaching even further into the private life of women by insisting that all fertilized eggs be defined, and protected, as a person – even  before a pregnancy is validated by a physician.  The consequence of this type of legislation is that it may result in outlawing not only all abortions – but also some forms of contraception and assisted reproductive technologies such as in-vitro fertilization.

The ethics of reproduction is complex and nuanced – as is reproduction and sexuality itself.

When Jennifer and I started our journey to parenthood, we knew we had some intrinsic challenges in out parenting quest – but never in our wildest dreams did we imagine we would go through failed IVF, miscarriage, failed adoption, and finally have a gestational surrogate (name) to bring our babies into the world.

Imagine if such a law were in place in our state or on a federal level. Our dream of parenthood would never be fulfilled. This is not only an issue that involves us individually – it is an issue making headlines in the the presidential race.

Like most Americans, we want to see fewer abortions and believe in adoption. We also stand with a recent nationwide survey where 80% of likely voters that agreed with the statement that “government should not be getting involved in the decision to end a pregnancy, it’s better left to a woman, her family and her faith.”

Jennifer and I deeply believe in the sanctity of life.  We also believe that defining a fertilized zygote as a “person” does nothing to enhance that sanctity – it only serves to devalue the living breathing men and women faced with individual choices about their futures when a pregnancy is contemplated, a possibility, or established.  And with full legal rights, the loss or destruction of a fertilized egg could be classified as murder. This is a truly frightening prospect.

To learn  more about the important and timely issue, check out recent blog posts and articles by RESOLVE, Sarika Bansai,  Mississippians for Healthy Families, and NARAL.

Equal Rights to Family: A Key Moment for Your Voice?

I’m not a philosopher or a politician, but as a lawyer the concept and protection of equal rights for all is foundational to what I do. This principle grounds our constitution and our country.  Yet for more than 200 years, we have continued to struggle to apply this principle: who deserves equality under our laws — and in what areas of Life, Liberty, and the Pursuit of Happiness?

Some Americans have always held some people more equal than others. There’s a world of more work to do, but witness how far we have come in discrimination against African Americans (1833 slavery, 1964 the right to vote) and women (1920, right to vote), children (1938, child labor law), farm workers (1964), and GLBT (2011, right to serve openly in military).

While we continue to fight for the freedom to marry for all Americans, another fight is close to my heart — the right to equal access to health care, including insurance coverage of infertility as an essential benefit.

These things take time. And typically, the steps are incremental.

Proposed in 2009, the American Family Building Act proposed requiring infertility coverage but failed to muster support. A new bill, the Family Act of 2011 S 965, introduced by U.S. Senator Kirsten Gillibrand (NY), calls for a tax credit for out-of-pocket costs associated with infertility medical treatment and will offer some financial relief from the high costs of infertility treatment, especially ART/IVF. This is a step in the right direction.

RESOLVE, a national infertility support and advocacy organization, has been working since 1974 to secure the equal access to all family building options for men and women experiencing infertility or other reproductive disorders.

Last year, RESOLVE established the Center for Infertility Justice to promote access to care, to fight attempts to restrict or eliminate care, and to provide research and data to support positive public policy for the infertility community. RESOLVE is the only patient advocacy group in the U.S. that fights for the rights of infertile women and men at a national and statewide legislative level.

Like every fight for equality throughout our history, it is vital to raise our voices and be heard.

One way to act today is to sign the Essential Health Benefits Petition urging Health and Human Services Secretary Sebelius to designate infertility as an essential, pro-family benefit as part of the Affordable Health Care Act.

Another is to urge your two US state senators to sign on as a co-sponsor of Family Act of 2011 and invite your family and friends to write to their senators in support of your efforts.

In every fight for equality, there is an ebb and flow of energy and enthusiasm. For those of us lucky enought to get our baby, sometimes we get wrapped up in parenting and forget the fight that brought us to our baby. But just because we finally added to our family successfully doesn’t mean we can forget those left behind, and the generations that will battle infertility in the future.

Take the time today to stand up for your rights — and the rights of future generations.

Natural IVF: A tested and affordable option with fewer side effects

At a 50th birthday party last weekend for my friend Maggie, I noticed one of the guests, Kristin, receiving quiet congratulations. I quickly deduced she was newly pregnant: 6 weeks. I knew Kristin had been trying to conceive for at least a year, and I was naturally pleased and curious to learn about how she “got to baby” — or at least to pregnancy.

I went over and offered Kristin my own congratulations and we started chatting about her journey and swapping war stories. I was intrigued to learn she was successful with natural cycle IVF, a low-medication alternative to standard IVF. (Another alternative is called minimal stimulation IVF or Mini-IVGF  Mini-IVF uses Clomid, an oral medication that has been in use since the 1960s.) I did some quick investigation and learned that natural IVF has been around since the late 80’s early 90’s — but it’s not the first option offered by many clinics.

 Natural cycle IVF is similar to standard in vitro fertilization but doesn’t rely on expensive and painful follicle stimulating hormones (FSH) medications to stimulate the ovaries to make multiple eggs. In natural cycle IVF,  follicle development during a normal ovulatory cycle is tracked by blood work and ultrasound, and when the follicle is ready to release, it is retrieved and fertilized using conventional IVF procedures. Natural cycle eggs are typically considered to be of a higher quality than traditional IVF.  Like traditional IVF, not all eggs result in an embryo. But when an embryo is produced and transferred successfully to the uterus, the pregnancy success rates are similar to conventional IVF.

With a new generation of infertile women pursuing holistic health solutions, it’s little wonder that natural cycle IVF is attracting new clients and researchers. The University of Southern California (USC) is recruiting participants today to take a fresh look at how advances of the last 20 years may influence outcomes (no discount on treatment, but this is a way to help other women know if this is a better option in the future).

 This is a safer, less costly approach for IVF. It’s not for everyone, but according to several clinics it’s a good option for many women, including those with elevated FSH (lower ovarian reserves), failed conventional IVF cycles, tubal disease, or male factor issues.

 So why isn’t natural cycle IVF promoted more? Perhaps the main reason: it can statistically lower the overall success rate for a clinic, because clinic data on stimulated and unstimulated (natural) cycles are lumped together (although the CDC tracks each separately). Not surprisingly, clinics don’t want to skew their success rates, so natural IVF is not the go-to option for many clinics.

Infertility treatment is never fun, but it seems this method takes the “sting” — both physically and financially – out of a painful situation.

 Kristin? She got lucky. Worked on the first try. Congratulations to her!

 Meanwhile, we’d love to hear about your experiences au naturel IVF. We’ll keep an eye on the USC study and keep you posted on this perhaps overlooked and statistically disadvantaged approach to Getting 2 Baby.

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A few quick points from clinics specializing in the natural approach:

Advantages of Natural  / Minimal Stimulation IVF

  • Eliminates the risk of ovarian hyperstimulation syndrome (OHSS)
  • Significant cost savings: about half of most standard IVF procedures
  • No painful and expensive gonadotropin injections
  • Fewer office visits
  • Generally produces a higher quality egg
  • Produces one follicle, virtually eliminates risk of multiple pregnancies

Potential Problems

  • Cycle is cancelled, usually due to premature ovulation or LH surge.
  • Failure to retrieve the egg – in less than 10% of patients.
  • Failure to fertilize the egg – in less than 10% of patients.

Decision Making when Making a Baby

“When I have kids we will bake Christmas cookies every year.”

Becoming a family. Carrying on traditions. Creating new ones. Replacing ones that didn’t work.  What motivates your decision to become a parent?  It seems so simple in the beginning. Find “the one,”  commit to each other, and create a child to bind you together, forever, as a family.

For many, the most difficult decision is the first one – do I become a parent and when? We assume that once that decision is made, the rest is easy. After all – we’ve been told since middle school that if you’re not very, very, very careful you might make a baby by just being too close to someone! But for some of us, making a baby is not a simple cause and effect.  It is process, a continuum, a collection of small – and monumental – decisions.

When you don’t get pregnant within a few months it’s confusing, and a bit scary. Or if you do get pregnant and suffer a miscarriage it is even more confusing.  What does it mean? Miscarriage is common you’re told, up to 1 in 4 pregnancies ending in miscarriage. And there is hope – after all, a positive pregnancy test means it can happen again.

But for some of us, the first miscarriage is not the last. For others, the pregnancy test never turns positive. Infertility is defined as the inability to conceive or carry a pregnancy to term after 12 months of trying to conceive.  If you are over the age of 35, infertility is declared after 6 months of actively trying to conceive.

Infertility can involve making hundreds incremental decisions – day by day, month by month. This is not only emotionally exhausting, if decision fatigue sets in, can be expensive.

If you’re over 30 and a pregnancy isn’t happening easily, it’s important to look reality in the eye and put a plan in place.

  1. Recognize that infertility can happen to you.  Infertility rates range between 15 – 30% for women over the age of 30.
  2. Develop a personal decision making strategy.  How far are you willing to go to become a parent?  How much medical intervention is right for you and your partner? What can you afford? What will you do if you cannot conceive a biological child?
  3. Know your options.  Depending on your situation, what medical intervention is right for you and your partner?  Are alternatives like donor insemination, surrogacy or adoption something you need to know about?  Getting To Baby is a step-by-step guide that will help in your decision making process.
  4. Find support.  Find a peer-led or professionally led support group through Resolve, the National Infertility Association.  By connecting with others who have been down this path, you will be in a position to make better, more informed decisions.

Finding your personal path to Getting To Baby can result one of the most fulfilling decisions of your life – becoming a parent.

PBS profiles “Made in India,” a documentary film on surrogacy

A new documentary, “Made in India,” has just been released and was recently profiled on PBS NewsHour. The film, directed and produced by Rebecca Haimowitz and Vaishali Sinha, featured Lisa and Brian Switzer, a couple in Texas who struggled for several years to have a child. Then, due to a medical condition, Lisa had to have a hysterectomy. Unwilling to give up their dream of parenthood — and unable to afford a surrogate mother in the United States — the Switzers sold their home and spent their life savings on PlanetHospital, a medical tourism company that works with surrogate mothers in India.

Also highlighted in the film was Aasia, the woman in Mumbai, India who served as the surrogate for Lisa and Brian. Aasia, who lives in dismal poverty with her three children, was paid $2,000 to carry the Switzer’s child. She could not use her last name and appeared on camera only with her face hidden by a veil to keep her identity a secret from her community.

“What should I say about myself?” said Aasia in the film, through an interpreter. “I used to clean people’s homes before. I’m not educated. I don’t know how to read or write. So this is my life… I’m doing this for my children. A son can earn anywhere, but I want to save this [money] for my daughter.”

The film showed Lisa and Brian rejoicing first at the news of Aasia’s successful pregnancy, and again as they brought home their twin daughters. But when their story was told on The Today Show, they were surprised and hurt by negative comments from others on the Today Show’s website. Several comments accused the Switzers of exploiting Aasia.

In response, Brian Switzer said, “The surrogates are well-compensated in line with their local economy. I have seen poverty unlike anything I could have imagined. And knowing what this process is going to do for the surrogate and her family in the long run makes me realize that this is a very good thing for all parties involved.”

“This woman is carrying a life that I can’t carry. She’s giving me the family I can’t create. I will never, never be able to thank her enough,” said Lisa Switzer.

The filmmakers told PBS, “At the time when we started filming, we noticed that any mainstream conversations around this issue tended to be very polarized: either promoting or condemning the practice. We wanted to bring a nuance to the story that would offer the audience a closer understanding of the intended couple’s and the surrogate’s choices behind their decisions. We wanted to take this intimate journey with all the players involved. Of course, we had no idea how the story would end up, but we trusted that if we let events unfold on their own, all the questions we were interested in exploring would emerge organically. As a result, the film really challenges viewers to come to their own conclusions about the practice.”

Learn more about the film here, and watch a short video of own story on www.gettingtobaby.com.

 

 

Should IVF clinics be less aggressive with treatment?

Dr. Suheil Muasher, a board-certified Reproductive Endocrinologist who has been treating infertility for 28 years, recently published an interesting article on the potential benefits of minimal stimulation In Vitro Fertilization (IVF) to the medical journal of the American Society For Reproductive Medicine, “Fertility and Sterility.” In the article, Dr. Muasher compares the latest research on success rates of existing IVF methodologies, including minimal and mild stimulation IVF, as well as the driving factors behind his belief that more fertility clinics in the U. S. should offer minimal stimulation to their patients.

Minimal stimulation IVF uses oral fertility medications and low dose injectable hormones, while mild stimulation uses low dose injectable medications. While the article discusses both methods, Dr. Muasher says minimal stimulation is a better option because it not only reduces the overall costs and stress affecting all patients, but also presents significant advantages for all infertility patients — but especially to low and high responders — when compared to conventional methods of stimulation.

In the article, “Mild/Minimal Stimulation for In Vitro Fertilization: An old idea that needs to be revisited,” Dr. Muasher says both mild and minimal stimulation for IVF were initially abandoned for a more aggressive approach to assisted reproduction and fertility, which was believed to increase pregnancy rates. However, he emphasizes that current research and the overall impact on the patient no longer validate this way of thinking: “With improvements in all aspects of IVF methodology and transferring one or two eggs for most patients, the aggressive approach is no longer essential and has significant drawbacks in terms of cost, stress, and increased complications for some patients.”

Additionally, Dr. Muasher highlights the fact that there are no differences in success rates of mild or minimal stimulation per fresh transfer, and the more aggressive approach to IVF. He adds that many clinics do not offer this type of procedure due to the fear of reduced pregnancy rates, which he says are simply not substantiated by the data. “The driving factor was to offer a low cost IVF procedure that is more affordable, less stressful, more patient friendly, and less complicated; therefore, with similar success rates, minimal stimulation IVF becomes an even more attractive option.”

Do it by the book

We know what it’s like to want a child so badly you’d do just about anything to have one. But when it comes to adoption or surrogacy, you absolutely must follow all the rules. The laws involving adoption and surrogacy vary by state — and with surrogacy, in some states, there simply aren’t any laws on the books. We cannot recommend more strongly that you work with a qualified attorney to ensure you are following the law at each step in the process.

Unfortunately, there are unethical people out there. A recent case currently receiving a lot of media coverage centers on Theresa Erickson, a nationally recognized surrogacy attorney, who pleaded guilty to being involved in a baby-selling ring.  According to news reports, Erickson and two accomplices recruited women to travel to the Ukraine to be implanted with embryos created from the sperm and egg of donors. Erickson and her partners would then tell prospective parents that a child had become available because another, fictitious couple had backed out of an adoption. They charged the adoptive parents, who had no idea they were being misled, more than $100,000, and paid the surrogates up to $45,000.

Erickson could receive up to 5 years in jail and be ordered to pay hundreds of thousands of dollars in fines. Fortunately, the innocent adoptive parents who were victims of this fraud will not have their parental rights terminated.

As an attorney, Theresa Erickson obviously knew that what she was doing was wrong. But sometimes, things aren’t quite so clear.

When we were going through the adoption process, we were contacted by a woman whose friend was pregnant. They would allow us to adopt the baby if we paid for the birth mother’s college tuition, along with some other financial arrangements. They did not want to use lawyers or an agency. When you have a situation presented to you in that way, you might think, “Well, if we save on lawyer’s fees and agency fees, it’s okay to put that money towards to her college instead. We’re helping her, and she’s helping us.” It’s easy to rationalize. If we weren’t lawyers ourselves, we may not have initially realized this is illegal — but it equates to buying a child. If we had agreed, it could have resulted not only in our losing that child later, but also in criminal charges.

Play it safe, and use a qualified adoption attorney or surrogacy attorney as you go through the process of getting to baby.