But where do you really start? The American Fertility Association created an introductory piece that details the very basic steps in choosing an egg donor.

For more information about how IARC selects their egg donors and makes them available for you, head back to our home page. Or email IARC at info@iarc-usa.com.

Getting Started with Egg Donation: First Decisions
By: Jan Elman Stout, Psy.D and Peggy Orlin, MS, MFT of the AFA Mental Health Advisory Council

Those needing an egg donor to achieve a pregnancy have choices to make. The most basic of these is how to recruit a young woman who is willing to donate her eggs. There are basically two options, known and anonymous donors. Known donors are women with whom you have a preexisting relationship, typically relatives or friends. Anonymous donors are strangers who are recruited for you by your medical program or donor agency. In a hybrid version you might recruit your own donor through the internet. We are going to address some of the perceived benefits and disadvantages in selecting known or anonymous donors and some issues unique to each type.

You might decide to work with an anonymous donor because nobody in your circle has offered you her eggs or you don’t know anyone you can ask. If you choose an anonymous donor you will receive varying amounts of background information about her, depending on whether she is recruited by a medical program or an agency, and which one. Some provide you with great detail about phenotypic, demographic, medical/health, family, academic, occupational, reproductive, sexual, social and psychological histories, others very little. Some will provide you with pictures, others will not. Some will allow direct contact providing all parties are agreeable. This might include a face-to-face meeting, typically facilitated by a mediator, which can be conducted without exchanging identifying information and no expectation of future contact and still be considered an anonymous arrangement. The information you are given on your donor may vary most based on your geographic location. However, these differences may soon decrease, as the Society for Assisted Reproduction (SART) has just released a Universal Donor Application Form. All donors, no matter how they are recruited, should undergo medical testing based on ASRM and FDA guidelines. All egg donation participants should also undergo in-person psychological screening by a licensed mental health provider familiar with ASRM and MHPG guidelines.

You might prefer an anonymous donor if you want clearer, more rigid boundaries between the donor and you than a known donation arrangement can provide. Likewise, if you are highly concerned about protecting your ability to make independent decisions and maintaining your privacy as parents. Working with an anonymous donor might free you from an obligation to put others’ feelings and preferences ahead of your own.

While anonymous donation has its advantages, it is not without risks. Recipients often worry about whether strangers misrepresent their histories and what the implications of lying might be. You might be unable to pay the added fees required in an anonymous arrangement or resent having to do so. You might worry that your anonymous donor will knock on your door one day or want your child. You might be afraid your donor will donate repeatedly, creating a large number of genetic half-siblings for your child. Although more fear than reality, if these worries loom large and can’t be tamed, you might feel more comfortable working with a known donor.

For many people, known ovum donation has some distinct advantages. If you choose a family member, you will share some genetic connection with your child. If your donor is your sister, you will share her version of your parents’ DNA. Using a known donor means you will always be able to know or access medical information about your child. And, if the child is told about the donation, s/he will be able to talk with his/her donor and ask his/her own questions. Your family may be more likely to love and accept your child if the donor is known. In some cultures where boundaries between family members are less clearly defined, Auntie or Uncle can be used almost interchangeably with Mama or Daddy. For these families, the use of a known donor can feel like a very safe, secure proposition with few downsides.

As mentioned previously, known donation may create complicated relationships. Unless the donor lives far away, she may be in your child’s life. While having family close by can be a blessing, having your donor nearby doesn’t always feel that way. Although everyone entering a known donation relationship expects all will go well, it does not always. Sometimes parents are surprised by the protective feelings that develop for their child even from loved family members. Some people choose donors who are advice givers and would always feel comfortable offering parenting advice. Will it feel the same if she is your sister AND your donor? Do you worry that your best friend will feel obligated to donate and later regret her participation? Do you fear that your sister will treat your child more like a son than a nephew? Are you concerned that you will be unable to repay this gift, and forever indebted to your cousin, and will have to do whatever she asks for the rest of your lives? Do you feel uncomfortable because it feels like your husband and your best friend are having a baby? The prevalence of these kinds of fears might mean you’d feel more comfortable with an anonymous donor.

What all this suggests is that no arrangement is right for everyone, as there are pluses and minuses on all fronts. If you are having difficulty choosing your path, consult with a mental health professional who can help you clarify it.

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Peggy Orlin, MS, MFT, is a Marriage and Family Therapist who specializes in the emotional aspects of infertility and third party family building. She is in private practice in Berkeley and San Francisco. Her professional associations include the American Society for Reproductive Medicine, where she was a former Chair of the Mental Health Professional Group. She is on the Mental Health Advisory Boards of the AFA.
Peggy can be reached at 510-528-2750

Jan Elman Stout, Psy.D. is a licensed clinical psychologist specializing in infertility counseling who has recently relocated from Chicago, Illinois to Houston, Texas. She is a past Chair of the Mental Health Professional Group of the American Society for Reproductive Medicine and currently serves on the Mental Health Advisory Council of the American Fertility Association. She can be reached by email at ElmanStout@aol.com

Although being a surrogate mother doesn’t seem like the most glamorous donation a woman could give, all of IARC’s surrogates are valued and promised to be supported throughout every step of the process. We ensure an organized beginning, middle and end to the gestation, something that is distinctive to our agency.

All surrogate mothers, or gestational carriers, must meet the following qualifications:
· Be between 21 and 38
· Be a non-smoker
· Possess a clean criminal record
· Have proven, previous healthy and full-term pregnancies
· Live in a surrogacy-friendly state (excludes: AZ, DC, IN, KY, LA, MI, MO, NE, NJ, NV, NY, NM, NY, WA)

Becoming a surrogate is a big decision, so we’re here to educate you and walk you through the screening process. For more information, call IARC at 763-494-8800 or email us at info@iarc-usa.com.

For all of you wonderful surrogates that already work with IARC, refer another dependable woman and you could receive $500!

When asked about a lawyer’s involvement in an assisted fertility birth, Steve said that when establishing the legal parentage of the resulting children, the legal issues become paramount and almost primary to the medical issues. Typically, the biological mother carries the child and gives birth to the child, alleviating any kind of issue with the right of parentage, but in a surrogacy case, the biological mother has nothing to do with the gestation and birth of the baby.

Essentially, the law becomes more important than the medicine.

Hear all of Steve’s interview (about 10 minutes) here: http://www.healthradio.net/component/mtree/Health-Radio-Shows/Ask-Dr-2E-DeSilva/Fertility-Myths-Answered-41605/details

What to Expect When Expecting…A Donor Child
Piave Pitisci Lake, M.D., Member of The AFA Mental Health Advisory Council

We all think about heredity when we think about having a baby. Who will the baby look like? Who will the baby be like in personality or temperament? Who do we want the baby to be like? Will the baby be healthy or have the illness that “x” relative had? There are some things we hope will be avoided and some things we hope will be passed on. We generally think that we will see something of ourselves, or our family, in our children. After all, our children have 50% of our genes. For those using donor gametes to conceive, the dreams and fantasies (the template) of what our children will be like are half complete.

We all have assumptions about what is nature (genetics) and what is nurture. Who we are is, of course, determined on the most basic level by our genes. But the role of genes in determining what we look like, whether we have certain diseases or are at increased risk to have certain diseases, our mental abilities, interests, talents, etc., is very complex.

Diseases, conditions, and traits (abnormal and normal) can be inherited through single-gene defects, chromosomal abnormalities, and in a multifactorial way. Human cells have 46 chromosomes-22 pairs of autosomal chromosomes and 1 pair of sex chromosomes (XX, XY). Chromosomes are made up of many genes. Genes are made of DNA. Each chromosome of a pair contains the same genetic information, but there might be slight differences. We have identified many disorders caused single-gene defects or chromosomal abnormalities. These can be detected through information about family history as well as genetic or chromosomal testing. We can also predict the risk of inheritance of these diseases with significant accuracy. Diseases that are inherited in a multifactorial way are also genetically determined and may be found to cluster in families, but the specific genes are not well known. In addition, the expression of the disease depends on the interaction of multiple genes and environmental circumstances. The risk of inheritance of these conditions is less clear. It depends on the disease in question, its severity, and the number of family members affected.

Recipients of donor gametes generally expect that donors are free of identifiable genetic or chromosomal disorders that have a known risk of being passed along to offspring. The American Society for Reproductive Medicine includes guidelines on the minimum genetic screening for gamete donors. Through family history and genetic screening, donors with a personal or first-degree (parents, siblings, offspring) family history of disorders caused by identifiable gene or chromosomal defects, or present in multiple family members are excluded because of the predictable risk of disease to offspring. Disorders such as Bipolar illness and Schizophrenia are examples of illnesses in which there is an increased risk of inheritance to an offspring if multiple family members are affected. In these cases, the relative risk is not likely to be as high as with single-gene or chromosomal disorders, but the risk is high enough that a donor with that history would also be excluded.

After being assured that donors have had the appropriate screening for diseases with known, predictable risks of disease inheritance to offspring, recipients are asked to take a leap of faith about the donor they choose and what their child might be like. This is the area where ideas about nature versus nurture influence the choice of donor and can help recipients articulate their assumptions about what they think their child will be like and what they thought their child would be like if their own genetics were present.

Physical appearance is a typical area of concern. Most parents assume that their child will share some physical features with their genetic ancestors, if not themselves. This is often true. But it is also not uncommon for offspring to not bear the expected resemblance to their parents and siblings. Temperament/personality is another characteristic that we tend to think is more genetically determined than it might actually be. We like to say, “Oh, he acts just like his father (mother, aunt Jane). If you have been around infants, it is pretty clear that each is different. Their cries, their reactions are each different, even when they come from the same genetic parents. This is probably hard-wired. However, an infant’s temperament is not static. A child’s environment exerts a tremendous amount of influence on how a child adapts his innate responses to his environment. Mental ability is also likely to be hard-wired initially. However, it is clear that one needs an appropriate environment in order to reach one’s intellectual potential. The level of education a person achieves can be an indication of innate ability, opportunity and/or learned behavior. However, the lack of an education is not necessarily a reflection of how smart someone is. Specific talent may be something innate as well, especially in those truly gifted individuals, but for the vast majority of people the right environment strongly influences level of achievement. Many like to think their children will share their interests in life. Again, some show preferences early in life or may develop their specific interests later, but in many instances, the things to which you have been exposed and the activities in which the important people in your life are engaged play an important role in developing an individual’s interests.

Ultimately, who we are, who our children are and the factors that influence our development are very complex and beyond our ability to reduce our offspring to simple cause and effect. We like to think we have an idea of what our children will be like if we are using our own gametes because we are familiar with what has come before us and because genes from a familiar gene pool are being used. We also have ideas of the parts of ourselves we would like to see (or not see) in our children. Maybe they can be a better version of us. For recipients of donor gametes, half of what will influence whom the child will be is unknown. Recipients are forced to speculate based on information available in the donor profile or from meeting the donor and their own assumptions about what this will mean for their offspring. As much as genes determine who we are, it is the interaction of genes and environment that shape us and, on many levels, the result of this process is unknowable. Our children are who they are, not whom we think their genes say they are.

About Dr. Lake
She received her Bachelor’s Degree in Italian Literature from Bryn Mawr College in 1992. She was graduated from Tulane School of Medicine in 1997. She completed her residency in General Adult Psychiatry at the McGraw Medical Center of Northwestern University in Chicago in 2001 and served as Co-chief Resident during her fourth year of training. She became a diplomate of the American Board of Psychiatry and Neurology in 2002. She is a member of the American Psychiatric Association, the American Society of Reproductive Medicine, and the Mental Health Professional Group of ASRM.

Dr. Lake has been in private practice as a general adult psychiatrist in Charleston, SC since 2002. She works individually with adults18 years to geriatric ages. She utilizes psychopharmacology and psychotherapy to treat a variety of problems, most commonly depression and anxiety. She has a special interest in treating those with infertility issues, women with perinatal and postpartum mood problems, and mood problems related to hormones. She also performs 3rd party evaluations, screenings and psychoeducational meetings for gamete donors, gestational carriers, and donor gamete recipients/intended parents.

Please contact Dr. Lake at drpiave@mac.com.

To read the article from the AFA website, go to: http://www.theafa.org/library/article/what_to_expect_when_expectinga_donor_child/

When: Tuesday, February 23 at 6:30 to 8:30pm
Where: Maple Grove Jr. High School
7000 Hemlock Lane N.
Maple Grove, MN 55369
Cost: $19/person
Instructor: Steven Snyder, Esq.

Contact Lindsay at 763-201-1422 or go to www.catchtheenergy.org for additional information about registering for the class. If you register before February 7, 2010, you’ll get a 10 percent discount for being an early bird!

Minnesota in need of updated ART laws
January 15, 2010 by Michelle Lore

I recently conducted a very interesting interview with a local attorney who focuses most of his practice on guiding clients who use assisted reproductive technology (ART) through the legal system.

Many of Maple Grove attorney Steven Snyder’s days involve negotiating and drafting the contracts necessary to establish parentage in ART cases, filing the paperwork and, if necessary, appearing in court once a baby is born to ensure that his clients are on the birth certificate.

For the past seven years, Snyder has also diligently been lobbying for updates to the rather outdated assisted reproductive technology laws in Minnesota (and elsewhere through his work as chair of the American Bar Association Family Law Section’s Assisted Reproductive Technologies Committee). For example, Minnesota’s current law — which is three decades old — only deals with sperm donors, not egg or embryo donors, and it only shields sperm donors from parentage if they donate sperm to married couples.

Frankly, I am amazed that Minnesota is still in the dark ages on this issue, particularly with all the advances that are being made in the area of assisted reproductive technology and the increasing number of people who are using the procedures. But I can’t blame the Legislature, since two years ago a bill that would have addressed some of the problems surrounding the current law and made assisted reproduction cases simpler and less expensive for prospective parents passed both the Minnesota House and the Senate. But Gov. Tim Pawlenty vetoed the bill, which Snyder believes was due to the fact that same-sex couples would have been covered by it.

With Pawlenty still in office, Snyder won’t be pushing for the same bill this year, but he is going to lobby for an amendment to the parentage statutes that will give folks who use egg donors or surrogates standing to assert parental rights if a dispute arises. It’s a way off from the substantive changes we really need in Minnesota, but it sounds like a good start anyway.

http://minnlawyerblog.com/2010/01/15/minnesota-in-need-of-updated-art-laws/

Feel free to leave comments about these topics. As always, please contact our office by phone or email if you’re interested in learning more about our programs!

IARC Team
763-494-8800 – main
Info@IARC-USA.com