A Baby or Your Money Back: All About Fertility Clinic Package Deals

Trying to have a baby with the aid of modern reproductive technology can feel like visiting a gambling parlor with the highest possible stakes.

So consider the pitch that many fertility clinics now put in front of people like Kristi and Carleton Chambers.

After several miscarriages, the Leesburg, Va., couple took their doctors up on an offer to hand over $50,000 — $20,000 more than what they might have paid for the in vitro fertilization and other services that they needed at the time. In return, the clinic promised multiple procedures until they gave birth, and if it didn’t work, they would get a full refund.IVF

The catch? If they made a baby on the first try, the practice would keep all their money. That is exactly what happened — to their great joy. After their baby boy was born, the couple eventually signed up for a similar deal and ended up with twins.

Welcome to the fertility casino, which frequently presents the rarest of scenarios: A commercial entity offers a potentially money-losing proposition to customers in exchange for a generous supply of in vitro fertilization procedures. People pay tens of thousands of dollars for the privilege, and when they come out with a newborn in their arms they’re often thrilled to be on the losing end financially.

So who wins? The house. Doctors (and third-party companies that help manage these programs and may take on any financial risk) keep careful track of their data. So they set prices at profitable points given the odds.

Here’s how the house can stack the deck: By admitting only people who have a better-than-even chance of bearing a child early in the process. Those people, however, may not need to pay extra for such a plan, given that their clinics picked them precisely because they were such good bets.

“It’s kind of like the clinic bets on your success, and you bet on your failure,” said Sarah Burke, a Pittsburgh woman who became a parent after enrolling in such a program.

Some of the overall performance numbers of fertility clinics are available in federal databases, but at my request, FertilityIQ, an information clearinghouse and doctor-review service, recently gathered some additional data.

Of the 54 people it found who had enrolled in a baby-or-your-money-back program, 30 of them achieved success not just in the first I.V.F. “cycle” (when doctors retrieve eggs) but on the first transfer — that is, the first time, after retrieval, that doctors attempt to implant an embryo or embryos they created with those eggs. A total of 67 percent were successful in the first cycle, which is at least 20 percentage points or so higher than the birthrate that similarly aged women nationwide experience in any I.V.F. cycle.

So are those two sets of women comparable? Not exactly.

three-parent babyWhile we shouldn’t make too much out of a sample size this small, FertilityIQ’s founders, Jake Anderson and Deborah Bialis, believe that doctors cherry-pick patients who have a high likelihood of success. According to Mr. Anderson and Ms. Bialis, a married couple who were themselves treated for infertility before becoming parents, medical professionals screen the harder cases out — say, people with more problematic diagnoses or those who are older or have a high body mass index.

That’s what happened to Johanna Hernandez of Marana, Ariz., who — after two miscarriages and struggles with I.V.F. — couldn’t get into a program that offered multiple rounds and a refund. “We’re in such a precarious position,” she said. “At the beginning, there’s no way to know that you’re going to need these programs. But at the end, they just won’t help you.”

Ms. Hernandez and her husband paid for additional à la carte treatment, had one more miscarriage along the way and now have a baby boy.

Another way for doctors to improve the odds of producing more babies would be to implant more embryos during each transfer. The American Society for Reproductive Medicine frowns on this, given the additional risks that come with twins and triplets. It has also warned of this possibility in a position paper on the package deals and refund programs, which are known in the industry as “risk-sharing.”

New York Times – April 14, 2017 by Ron Leiber

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Same-Sex Parenting Studies: Research Proves Sexual Orientation Of Parents Doesn’t Matter

More studies proves that it doesn’t matter at all whether or not kids have same-sex parents.

Rachel Farr, assistant professor of psychology at the University of Kentucky, conducted the study, which was recently published in the Developmental Psychology journal.studies

Farr studied 100 families who adopted children at infancy. Half the parents were same-sex and the other half were opposite sex. She concluded: “Rather than family structure, available research on early child development indicates that family processes matter more to child outcomes.”

child’s behaviour is more influenced by: parenting stress, parenting approaches and couple relationship adjustment.

She writes: “Regardless of parental sexual orientation, children (in the study) had fewer behaviour problems over time when their adoptive parents indicated experiencing less parenting stress. Higher family functioning when children were school-age was predicted by lower parenting stress and fewer child behaviour problems when children were preschool-age.”

by Kristy Woudstra, Huffington Post Canada – January 5, 2017

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Human Gene Editing Receives Science Panel’s Support

An influential science advisory group formed by the National Academy of Sciences and the National Academy of Medicine on Tuesday lent its support to a once-unthinkable proposition: clinical efforts to engineer humans with inheritable genetic traits.

In a report laden with caveats and notes of caution, the group endorsed the alteration of human eggs, sperm and embryos — but only to prevent babies from being born with genes known to cause serious diseases and disability, only when no “reasonable alternative” exists, and only when a plan is in place to track the effects of the procedure through multiple generations.

Human genetic engineering for any reason has long been seen as an ethical minefield. Many scientists fear that the techniques used to prevent genetic diseases might also be used to enhance intelligence or create humans physically suited to particular tasks, like soldiers.gene editing

Just over a year ago, an international group of scientists declared that it would be “irresponsible to proceed” with making heritable changes to the human genome until the risks could be better assessed and until there was “broad societal consensus about the appropriateness” of any proposed change.

Because any genetic changes in human eggs, sperm and embryos, also called the germ line, can be passed on to future generations, the recommendation crosses a line that “many have viewed as ethically inviolable,” the report acknowledges.

But in the last year, the report’s authors said, the techniques required to perform this sort of gene editing have passed crucial milestones that have forced ethical considerations to the fore.

“Previously, it was easy for people to say, ‘This isn’t possible, so we don’t have to think about it much,’” said Richard Hynes, a cancer researcher at the Massachusetts Institute of Technology, who was one of the leaders of the committee that wrote the new report.

“Now we can see a path whereby we might be able to do it, so we have to think about how to make sure it’s used only for the right things and not for the wrong things,” he said.

by Amy Harmon, New York Times, February 14, 2017

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Triplets With DNA From Both Same-Sex Parents Born In South Africa

I can only imagine how it feels to become a parent for the first time. The words thrilling, exciting, nerve-racking, and love, all immediately come to mind.

I’m sure that’s close to what South African dads Christo and Theo Menelaou felt – perhaps multiplied three times over – when they brought home their adorable triplet babies for the first time. Of course, triplets and newborns alone are enough to prompt a flurry of excitement. But there’s another reason Christo and Theo had to be especially excited: the couple’s triplets carried DNA from both of their same-sex parents — the first ever multiples with DNA from three parents. Human Sperm Cell

Of course, the couple went through a long journey to become parents. In an interview with Sky News, Christo Menlaou shared some of the couple’s previous experiences in pursuing adoption:

When you are gay, there is always the thought that it just may not be possible to be a parent no matter how much you would love to be. It’s very hard to be accepted for adoption and we were told we would always come after heterosexual couples. And then we just never thought we’d ever find a person who would want to be surrogate to a gay couple.
The Menalaous have two girls, Zoe and Kate, and a boy, Joshua, by a surrogate. Both dads reportedly used their sperm to fertilize one embryo each, and 10 weeks into the pregnancy revealed that one embryo had split – resulting in triplets, two of which are identical (Zoe and Kate) according to the Sky News interview with the dads. The triplets share both fathers’ DNA, the Associated Press reported.

The babies were delivered, prematurely, in July. And the adorable triplets are now home with their dads, after weeks of being monitored in the hospital, Sky News reported. The babies reportedly needed breathing assistance, and are still receiving care from nurses at home.

The gynecologist who delivered the triplets said the babies, born by surrogate with a split embryo resulting in triplets, was an “extremely rare” situation. “It is extremely rare,” Dr Heidra Dahms told Sky News. “I have never heard of this before.”

by Kimberly Richards, Romper.com – August 22, 2016

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New Study Shows No Differences in Family Relationships or Child Health Outcomes between Same-sex and Different-sex Parent Households

New Study Shows No Differences in Family Relationships or Child Health Outcomes between Same-sex and Different-sex Parent Households

LOS ANGELES — Households with same-sex parents show no differences from those with different-sex parents with regard to spouse or partner relationships, parent-child relationships, or children’s general health, emotional difficulties, coping and learning behavior, according to a new report by researchers affiliated with the Williams Institute at UCLA School of Law, the University of Amsterdam and Columbia University.

“This study is the first to use a nationally representative survey to compare the two types of households by focusing only on those with parents that have been in a continuous relationship,” said lead author Henny Bos, Ph.D.gay parents adoption

The study, titled “Same-sex and Different-sex Parent Households and Child Health Outcomes: Findings from the National Survey of Children’s Health,” compared family relationships, parenting stress and child outcomes in households with female same-sex parents versus different-sex parents.

Ninety-five same-sex parent households were matched to 95 different-sex parent households on eight demographic characteristics – parental age, education, U.S. birth status, and current geographic location, and the studied child’s age, gender, race/ethnicity, and U.S. birth status.

Although the study found no differences in family relationships and child outcomes, same-sex parents reported more parenting stress.

“Future investigations might explore whether the cultural spotlight on child outcomes in same-sex parent families is associated with increased parenting stress,” said psychiatrist and co-author Nanette Gartrell, MD, Visiting Scholar at the Williams Institute. “Some of our earlier studies have shown that lesbian mothers feel pressured to justify the quality of their parenting because of their sexual orientation.”

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Nanette Gartrell, MD – The Williams Institute

Zika found to remain in sperm for record six months

The Zika virus has been found in the sperm of an Italian man six months after his first symptoms, twice as long as in previously reported cases.

Doctors at the Spallanzani Institute for Infectious Diseases in Rome said it pointed to the possibility that the Zika virus was reproducing itself in the male genital tract.

The infection is suspected of leading to thousands of babies being born with underdeveloped brains.

Zika is spread by mosquitos.adopting a child, how to adopt a child, adopt a child,Egg donors

The outbreak was declared a global public health emergency by the World Health Organisation in February.

Current guidelines recommend infected patients should use condoms or abstain from sex for at least six months after the onset of symptoms.

The doctors said in light of this new evidence an extension of this recommendation might be advised, as well as the continued testing of semen after six months.

Christian Lindmeier from the WHO told the BBC the report would be looked at.

“The Zika outbreak is a constantly evolving situation and every new piece of evidence is looked into and evaluated as to whether or not guidelines will need to be revised.”

The patient, who was in his early 40s, first presented symptoms after returning to Italy after a two-week visit to Haiti in January.

The patient reported he had received mosquito bites in Haiti, and his symptoms included fever, fatigue and a skin rash.

Follow-up testing showed the Zika virus was still present in his urine, saliva and sperm, 91 days after the onset of symptoms.

After 134 days it was only detectable in his sperm and this remained positive after 181 days.

BBC.com, August 12, 2016

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Pastors Sue Illinois Over Gay Conversion Therapy Ban

SPRINGFIELD, Ill. — A group of pastors is suing Illinois over a law that bars therapists from trying to change a minor’s sexual orientation.conversion therapy

The lawsuit filed Thursday in federal court seeks to exclude clergy from the ban that took effect Jan. 1. The lawsuit contends the prohibition shouldn’t apply to clergy because it violates free speech and religious rights.

Illinois is among five states with bans on so-called gay conversion therapy for youth under 18. Laws in California and New Jersey have withstood legal challenges, but an attorney for the pastors says the prohibitions in those states did not include clergy.

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New York Times August 11, 2016

Gay and Lesbian High School Students Report ‘Heartbreaking’ Levels of Violence

The first nationwide study to ask high school students about their sexuality found that gay, lesbian and bisexual teenagers are at far greater risk for depression, bullying and many types of violence than their straight peers.

“I found the numbers heartbreaking,” said Dr. Jonathan Mermin, a senior official at the Centers for Disease Control and Prevention, which includes a division that administered the survey.gay hate

The survey documents what smaller studies have suggested for years, but it is significant because it is the first time the federal government’s biannual Youth Risk Behavior Survey, the gold-standard of adolescent health data collection, looked at sexual identity. The survey found that about 8 percent of the high school population describe themselves as gay, lesbian or bisexual, which would be 1.3 million students

These children were three times more likely than straight students to have been raped. They skipped school far more often because they did not feel safe: at least a third had been bullied on school property. And they were twice as likely as heterosexual students to have been threatened or injured with a weapon on school property

More than 40 percent of these students reported they had seriously considered suicide, and 29 percent had made attempts in the year before they took the survey. The percentage of those who use various illegal drugs was many times greater than heterosexual peers. While 1.3 percent of straight students said they had used heroin, for example, 6 percent of the gay, lesbian and bisexual students reported having done so.

New York Times, August 11,2016 By Jan Hoffman

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Lesbian Couple Sue Over New Jersey Rules for Fertility Treatment

Five years ago, Erin and Marianne Krupa chose to start a family. They moved to Montclair, N.J., from a more conservative environment in North Carolina, and decided that Erin would carry their first child.

Erin Krupa remembered her fertility doctor looking her in the eye and promising to help her become pregnant.

But there were complications. At an appointment with her doctor in 2013, Ms. Krupa, then 33, learned that she had benign cysts on her uterus and Stage 3 endometriosis, in which the tissue that normally lines the inside of the uterus grows outside. That meant she was infertile.Donor

Despite her doctor’s assurances that insurance would pay for fertility treatment, Ms. Krupa’s provider, Horizon Blue Cross Blue Shield, denied coverage. The company cited a state insurance mandate from 2001 that required most women under 35 — no matter their sexual orientation — to demonstrate their infertility through “two years of unprotected sexual intercourse.”

Now the Krupas, along with two other women, are suing the commissioner of the New Jersey Department of Banking and Insurance, claiming the mandate discriminates against their sexual orientation — essentially forcing infertile homosexual women to pay for costly procedures to try to become pregnant.

“These women are already going through what can be a difficult experience, and they have the added stress of affording it financially and the added insult of being treated like a second-class citizen,” said Grace Cretcher, a lawyer for the plaintiffs.

The state mandate requires most major insurance companies to cover medically necessary treatments for infertile clients. It defines infertility as the inability to impregnate another person, the inability to carry a pregnancy to live birth or the inability to conceive after one or two years of unprotected sex, depending on the woman’s age.

New York Times, August 8, 2016 by Megan Jula

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IVF Does Not Raise Breast Cancer Risk, Study Shows

Women undergoing in vitro fertilization have long worried that the procedure could raise their risk for breast cancer.

After all, the IVF treatment requires temporarily increasing levels of certain sex hormones to five or 10 times the normal. Two of those hormones, estrogen and progesterone, can affect the course of certain kinds of breast cancer.

A series of studies over the past decade suggested that these former patients may have little to worry about. Experts remained cautious, however, because women who had undergone IVF in the 1980s had not yet reached menopause by the time of the research.adopting a child, how to adopt a child, adopt a child,Egg donors

But the largest, most comprehensive study to date, published on Tuesday, provides further reassurance: It finds no increased risk among women who have undergone I.V.F.

“The main takeaway is there’s no evidence of an increased subsequent risk of breast cancer, at least in the first couple decades,” said Dr. Saundra S. Buys, an oncologist at the Huntsman Cancer Institute at the University of Utah, who was not involved in the new study.

The issue has nagged at specialists in reproductive medicine for some time. In 2008, a retrospective analysis of medical records, which the authors called “preliminary,” found a potential increase in breast cancer among IVF patients older than 40.

Another small study of participants at a single treatment center in Israel reported an increased risk of breast cancer among women who start IVF after 30.

Maddeningly, later findings went the other way, seeming to suggest the danger — if there were one — may be greater for younger women.

A study with roughly 21,000 participants, published in 2012, found that women in Western Australia who began I.V.F. at 24 years old or younger had an increased risk of breast cancer. No such link was found among women in their 30s or 40s.

In 2013, though, researchers published a meta-analysis of eight smaller studies tentatively suggesting that I.V.F. didn’t seem to raise breast cancer risk overall.

But it did not rule out the possibility that breast cancer might turn up in a bigger group of women tracked more closely for an even longer period. Experts also worried that infertility itself, not only its treatment, might somehow be linked to breast cancer.

Today’s report, published in the Journal of the American Medical Association, goes a long way toward answering the lingering questions.

by Catherine Saint Louis

New York Times, July 19, 2016

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