Should A Same Sex Couple Get Fertility Benefits?

Are A Same Sex Couple Entitled to Fertility Benefits?

Same sex couple Sarah Soller-Mihlek, a Brooklyn guitar instructor, and Jill Soller-Mihlek say, “We want to start a family,” speaking into a camera focused on Sarah and “We’ve always dreamed of becoming parents,” adds her wife, Jill.

The couple made the video last year and posted it to Indiegogo, a crowdfunding website, in hopes of raising enough money to pay for fertility treatments. Jill Soller-Mihlek, now 33, was hoping to get pregnant via a sperm donor and intrauterine insemination, which can costs tens of thousands of dollars depending on how long it takes to conceive.

Although the couple’s insurance plan typically covers fertility treatment, their insurer, United Healthcare, would not cover the cost. The reason? Jill Soller-Mihlek didn’t meet its definition of infertility because she did not have sex with men.

The couple’s insurance policy defines infertility as an “inability to achieve pregnancy after 12 months of unprotected heterosexual intercourse.” But women who use sperm donors must pay for costly, physician-supervised therapeutic donor insemination for 12 months before they meet the definition of infertility. (Women 35 and older need to go through six failed attempts before meeting the clinical definition of infertility.)

After the Soller-Mihleks paid $13,507 out of pocket for nine unsuccessful cycles of insemination, they decided to chronicle their travails on Indiegogo and Change.org. While the United Healthcare policy tacitly acknowledges single women and same-sex couples, many policies do not. Some even exclude unwed women. Notably, major insurers like United Healthcare often do cover insemination treatments when the issue is male infertility.

The Soller-Mihleks believe their plan’s criteria for granting medical coverage of fertility treatment reveals a subtle form of discrimination against lesbians. (Needless to say, gay men face even greater obstacles in attempting to gain coverage, given that coverage wouldn’t extend to the woman who’d be carrying for them.)

The Soller-Mihleks say their concern is that a female same sex couple, by definition, is incapable of getting pregnant through heterosexual intercourse and requires medical intervention to conceive. They say the subtext of the United Healthcare policy is that a lesbian could get pregnant by having sex with a man, she just chooses not to.

Shannon Price Minter, head of the legal division at the National Center for Lesbian Rights in San Francisco, said: “To me, the central injustice is that when a person has a known condition that precludes them from becoming pregnant, such as a woman who has had her ovaries removed, there is no requirement to go through a period of unprotected intercourse before being recognized as requiring fertility treatments. The same should be true for same-sex couples.”

Tyler Mason, a spokesman for UnitedHealthcare, said the company’s policy is based on the clinical disease of infertility, as defined by the American Society of Reproductive Medicine.

“Our coverage criteria are based on clinical trial data, published literature and recommendations from a wide variety of medical specialty societies and state laws,” Mr. Mason wrote in a statement. “We constantly review and update coverage criteria.”

Aetna also uses the clinical definition of infertility to support its reimbursement policies for fertility treatments.

“It’s not a pregnancy benefit,” said Cynthia B. Michener, an Aetna spokeswoman. “It’s based on the clinical disease of infertility, supported by medical evidence and medical society guidelines, including those set out by the A.S.R.M., and it’s the same for everyone.”

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New York Times, November 2, 2015, by Stephanie Fairyington

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Egg Donations, Should Women Be Paid?

Paying for Egg Donations

In an egg donations situation, should a woman who donates eggs to help people with fertility problems conceive a child be able to charge as much as she can get in a free-market transaction? Or are there ethical reasons to limit her reimbursement?

That is the issue raised in a federal lawsuit that accuses two professional societies and the fertility clinics associated with them of illegal price-fixing that limits donor compensation. A federal judge in northern California has ruled that the claim can move forward and certified it as a class action, which could go to trial next year.

Guidelines issued by the American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology suggest that paying a woman more than $10,000 for her eggs is “beyond what is appropriate” and even paying $5,000 or more requires “justification.”

A vast majority of the nation’s fertility clinics follow these the guidelines. The stated rationale behind them is to avoid offering so much money that donors, especially those who are often young and poor, will rush to contribute their eggs without considering the risks.

This payment system is unfair. However well-intentioned, it favors the fertility clinics, which can keep more for themselves if they pay donors less, as well as the women who pay for fertility treatments. Meanwhile, it shortchanges the egg donors, whose wishes are ignored in the equation. And if there are indeed risks, they can be addressed and mitigated by the clinics and the doctors, who can strengthen their screening and counseling procedures and provide more information.

The money that donors get is meant to compensate them for physical and psychological tests; weeks of hormone injections to stimulate egg production; frequent tests and ultrasound examinations to track the developing eggs; repeated visits to the doctor, and minor surgery to remove the eggs when they are ready for retrieval.

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Editorial Board – New York Times, October 21, 2015
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Egg Donors Challenge Pay Rates

Egg Donors Challenge Pay Rates, Saying They Shortchange Women

 

On their websites, next to glossy pictures of babies, some fertility clinics and egg-donor agencies refer to eggs as a “priceless gift” from caring young women who want to help people with fertility problems. There is a price tag for eggs, though, and it is now the subject of a legal battle. In a federal lawsuit, a group of women or egg donors, are challenging industry guidelines that say it is “inappropriate” to pay a woman more than $10,000 for her eggs. The women say the $10,000 limit amounts to illegal price-fixing, and point out that there is no price restriction on the sale of human sperm. A federal judge has certified the claim as a class action, which will most likely go to trial next year.

The guidelines do not have the force of law, though they have been widely followed. But demand for eggs has increased and put pressure on their price. So some high-end fertility clinics and egg-donor agencies are ignoring the guidelines and paying far more — on rare occasions in the six figures — while donors are shopping around to get the best price. The case could shake up the $80 million egg-donor market by spurring more negotiation. It is a potent reminder that egg donation is a big business, though one with many more inherent ethical issues than others.

“The lawsuit is raising awareness of the commodification of the whole thing, and that’s good,” said Sierra Poulson, 28, a lawyer in Nebraska not involved with the case, and a founder of the online forum We Are Egg Donors. “The guidelines are skewed toward the intended parents, toward the industry making more money and business,” Ms. Poulson said. “We’re in America — the market would take care of itself, without guidelines.”

Ms. Poulson, a three-time donor, is an example of how the market works. She was paid $3,000 for each of her first two donations, in Kansas, but $10,000 in Chicago for the last. “The third time I donated, the only reason was for the money,” she said.

As women wait longer to start their families, and find their fertility has waned, the demand for eggs from young donors — typically, donors are in their 20s — has risen rapidly. Women trying to get pregnant, along with surrogates hired by gay men to carry their children, used donor eggs in nearly 20,000 monthly cycles in 2012, compared with fewer than 12,000 a decade earlier, according to the Centers for Disease Control and Prevention, which collects statistics on assisted reproduction.

While many other countries limit egg donation, and the compensation that is allowed, egg donation is essentially unregulated in the United States. But in 2000, the American Society for Reproductive Medicine established the guidelines for how much women should be paid. They say that compensation over $5,000 requires “justification,” and that more than $10,000 is “beyond what is appropriate.” The amounts have never been adjusted.

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New York Times – October 16, 2015 by Tamar Lewin

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Adoption Gay Couples in China Look Abroad

Adoption Gay Couples in China Look Abroad

to Start a Family

Xu Zhe decided a few years ago that he wanted to get married and have a baby—typical life plans for a young man in China. But Mr. Xu is gay and his goals aren’t attainable in his country: Same-sex marriage and surrogacy aren’t legal.

That is why the Shanghai native set out for the U.S. in 2013. Mr. Xu and his long-term boyfriend married that year in California, in a symbolic gesture, since their marriage isn’t recognized in China. Shortly after exchanging vows, they began a search for an egg donor and a surrogate to carry their daughter. She was born earlier this year.

Their situation isn’t unique as the emergence of fertility services and surrogate programs geared toward gay Chinese suggest more couples are heading overseas to start their families.

Many go to the U.S. because of its robust gay-rights movement and liberal reproductive policies. Surrogate carriers are legal in some U.S. states and are believed to be more regulated than elsewhere in the world. The laws on parental rights are clear.

Yet this trend, while still nascent, is in some respects turning history on its head. For years, childless Americans have flocked to China in hopes to adopt a child there. Now, a segment of the Chinese population is looking to the U.S. to help them become parents.

“In the long run, I hope it’ll be possible for China to make it easier for all people to have their own families,” said Mr. Xu, who declined to disclose his partner’s and daughter’s names for this article.

Adoption Gay Couples in China: Gay & Lesbian couples in China resign themselves to not having children to avoid stigma!

There are no official estimates of how many Chinese same-sex couples are going to the U.S. to have children. The cost is prohibitive for most; the total bill, including egg donation, surrogacy and attorney and hospital fees, can reach up to $150,000. But the emergence of fertility consultancies and gay-rights activists acting as surrogates signals rising demand.

Carey Flamer-Powell launched an Oregon agency called All Families Surrogacy earlier this year, in part to help China’s gay and lesbian population, she said. She and John Hesla, an infertility specialist at Portland fertility clinic Oregon Reproductive Medicine, flew to Shanghai in June to speak to around 100 same-sex couples about their options for starting their own families.

“There’s research showing that in the future a man could harvest a stem cell, but don’t plan your family on that,” Dr. Hesla told the couples. He said that most would prefer their children to share their DNA and that the option is more easily available in the U.S. Around 40% of his patients are Chinese couples, some of whom are homosexual, Dr. Hesla said.

Around 20 same-sex Chinese couples have traveled to Los Angeles-based clinic HRC Fertility for services this year, up from around seven last year, said Peter Deng, chief executive of HRC’s China arm, which launched its marketing offices in China two years ago.

While most gay and lesbian couples in China resign themselves to not having children to avoid stigma, demand is high enough that Mr. Xu has also launched a health consultancy in Shanghai. It aims to connect the city’s gay community with overseas clinics, explain the medical procedures and outline options for bringing a child back to China as a foreign citizen or with a Chinese travel document.

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Wall Street Journal China – October 2, 2015

SHANGHAI—

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Surrogate law change? Agency cheated donors!

Should surrogate law(s) change or be updated?Surrogates & egg donors cheated by agency!

The owner of a Glendora egg donation and surrogacy company was sentenced today to a year and a half in federal prison for cheating would-be parents, egg donors and surrogates out of nearly $270,000.

Allison Layton, 38, was also ordered to serve three years of supervised release after she is released from prison. A restitution hearing was set for Oct. 22.

Layton, who also used the name Allison Jarvie, pleaded guilty in February to a federal wire fraud charge. She owned Miracles Egg Donation, which claimed to handle the logistics of the donation and surrogacy process, and operated it out of her living room, according to the U.S. Attorney’s Office.

Between August 2008 and January 2012, would-be parents — who in the surrogacy and egg donation world are known as intended parents — paid thousands of dollars for egg donation and surrogacy services that Miracles promised to coordinate, federal prosecutors said.

Should Surrogate Law(s) Change? Glendora surrogacy agency owner gets prison for cheating would-be parents, egg donors and surrogates!

Layton took tens of thousands of dollars from intended parents. But instead of putting the funds into escrow accounts to be withdrawn only for certain costs related to surrogacy or egg donation, she used the money for her own personal expenses or to cover unpaid costs related to other clients, according to the U.S. Attorney’s Office.

As a result of Layton’s misappropriation of client funds, egg donors, surrogates, attorneys and others often weren’t paid for all the services they provided, and intended parents often did not receive all the services for which they had paid, according to court documents. At least one investor in Miracles also lost money.

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WhittierDaliyNews.com September 28, 2015

LOS ANGELES —

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Surrogacy Services Suspension: Nepal’s Top Court Orders

Nepal’s top court orders suspension of surrogacy services

Nepal’s top court has ordered a halt to commercial surrogacy services in the Himalayan nation until it rules on the legality of the practice, an official said Wednesday. Nepal has become a destination for foreigners, including many Israelis, seeking to have children through surrogate mothers. The practice is controversial, with critics saying it exploits the poverty of women.

Although Nepal has no laws on its books covering surrogacy, the government last year allowed foreign women to serve as surrogates in Nepal but barred local women.

“There are no laws regarding surrogacy… it raises many constitutional and legal questions,” said Nahakul Subedi, spokesman for the Supreme Court.

“So the court issued a stay order on surrogacy services yesterday … until the case is settled,” Subedi told AFP.

Advocate Prabin Pandak, who filed the original lawsuit against the practice, told AFP the court’s order would put a stop to the registration of new cases.

“Women should not be a subject of trade, neither should a child,” Pandak said.

“Nepali women are not allowed to be surrogate mothers but they are misrepresented as Indian and used for surrogacy,” she said.

Nepal has become an attractive destination for couples who find its services cheaper than those offered by surrogacy agencies in the West.

Israel in April airlifted 25 infants born to Indian surrogate mothers in Kathmandu after Nepal was hit by a devastating quake that killed nearly 9,000 people.

In Israel, only heterosexual couples are legally able to use surrogacy, and there are many restrictions on who can serve as a surrogate. While straight couples must go through an onerous committee process in order to qualify for surrogacy, homosexual couples are left completely out of the system. Consequently, they must look to foreign surrogacy as a means of producing a child biologically related to one member of the couple.

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AFP and Times of Israel Staff – August 26, 2015

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Egg Donation or Sperm: kids have a right to know ?

Do children have the right to know if they’re the result of a stranger’s sperm or egg donation?

Although she has two half-sisters from her dad’s previous marriage, there was nothing in Jess Pearce’s childhood to make her doubt her biological origins. She tanned, her father tanned; he was tall, so was she. Yet when she was 28, her mother dropped a bombshell.

“She sat me down one Sunday afternoon and said she had something she wanted to tell me,” Jess recalls. “She looked quite upset, and I thought, ‘She’s going to die.’” Instead, her mother told her, “Your dad isn’t your real dad.”

Jess’s father had undergone a vasectomy after his first marriage. When he met her mother he tried to get it reversed, but the operation failed and they opted for sperm donation through the NHS. Jess was conceived on the third try at St George’s Hospital in Hyde Park Corner; all her parents knew about the donor was that he was from Middlesex. The clinic advised Jess’s parents to keep the insemination a secret. “No one knew,” says Jess. “It was literally just my mum and my dad and two of their best friends.” This was the norm back then, says Olivia Montuschi, co-founder of the Donor Conception Network. “The vast majority of [parents] were told not to tell their children… They just thought it was in everybody’s best interest that the secret was kept – go home, make love, and who knows?”

Olivia herself has had two children through donor insemination because her husband is infertile. They had resolved to be honest with their kids from the outset. “I remember telling this to a nurse when she was inseminating me, and getting a very odd look as if to say, ‘Why would you do that?’” she says.

Reactions range from shock and horror to “That’s interesting; I thought there was something odd going on,” says Montuschi. “More often than not, you will find that there have been odd discrepancies in things that parents have said,” she says. “Or [the child] will wonder about the complete lack of physical likeness or [shared] interests with the non-genetic parent.”

Though some parents feel under pressure to tell their kids about their genetic heritage, many decide to keep the details of their child’s conception under lock and key. A 2003 survey by the Centre for Family Research at the University of Cambridge found that 47 per cent of parents of kids conceived after egg donation had no intention of telling. It’s not just the child’s feelings at stake. Even a genuine desire to tell can create tensions with grandparents or other family members who think it should remain a secret. Then there’s the wider taboo of where babies come from. “A lot of people find it really difficult to talk about, not necessarily because there is a genetic difference in the family, but because the discussion takes them into areas of parenthood where they wouldn’t normally have to go,” says Petra Nordqvist of the University of Manchester. “They’d have to say, ‘My sperm doesn’t work and we’ve had to undergo five years of IVF.’ Some people just hate having that kind of conversation with their families.”

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theindependent.co.uk by Linda Geddes, August 10, 2015

in Anonymous/Known Donation / Egg Donation / Ethics / Parenting / Science / Surrogacy  by Anthony Brown 0 comments

Unused Embryos Pose Difficult Issue: What to Do With Them

By Tamar Lewin, New York Times, June 17, 2015

After years of infertility, Angel and Jeff Watts found a young egg donor to help them have a baby. They fertilized her eggs with Mr. Watts’s sperm and got 10 good embryos. Four of those embryos were transferred to Ms. Watts’s womb, resulting in two sets of twins — Alexander and Shelby, now 4 years old, and Angelina and Charles, not yet 2.

But that left six frozen embryos, and on medical advice, Ms. Watts, 45, had no plans for more children. So in December she took to Facebook to try to find a nearby Tennessee family that wanted them.

“We have 6 good quality frozen six-day-old embryos to donate to an amazing family who wants a large family,” she posted. “We prefer someone who has been married several years in a steady loving relationship and strong Christian background, and who does not already have kids, but wants a boat load.”

In storage facilities across the nation, hundreds of thousands of frozen embryos — perhaps a million — are preserved in silver tanks of liquid nitrogen. Some are in storage for cancer patients trying to preserve their chance to have a family after chemotherapy destroys their fertility. But most are leftovers from the booming assisted reproduction industry, belonging to couples like the Wattses, who could not conceive naturally.

And increasingly families, clinics and the courts are facing difficult choices on what to do with them — decisions that involve profound questions about the beginning of life, the definition of family and the technological advances that have opened new reproductive possibilities.

Since the first American “test tube” baby was born in 1981, in vitro fertilization, at a cost of $12,000 or more per cycle, has grown to account for more than 1.5 percent of all United States births.

The embryos with the greatest chance of developing into a healthy baby are used first, and the excess are frozen; a 2002 survey found about 400,000 frozen embryos, and another in 2011 estimated 612,000. Now, many reproductive endocrinologists say, the total may be about a million.

Couples are generally glad to have the leftover embryos, backups in case a pregnancy does not result from the first tries.

“But if I ask what they’ll do with them, they often have a Scarlett O’Hara response: I’ll think about that tomorrow,” said Dr. Mark V. Sauer, of Columbia University’s Center for Women’s Reproductive Care. “Couples don’t always agree about the moral and legal status of the embryo, where life begins, and how religion enters into it, and a lot of them end up kicking the can down the road.’’

There are no national statistics on what happens with these leftover embryos. As a practical matter, many sit in storage indefinitely, academic researchers say, either at fertility clinics or other facilities, costing $300 to $1,200 a year. A small percentage of people stop paying the storage fees and leave it to the clinic or facility to figure out what to do.

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Changing The Way We Think About Mother’s Day

May 7, 2015 by Asaf Rosenheim via Gays With Kids

changing

Our family belongs to a gay synagogue, so most of the parents who attend the children’s services with their kids are gay. One Yom Kippur our rabbi asked for a show of hands. “Who has two moms?” she asked. “Who has two dads? Who lives with a grandparent or an aunt or uncle? Who has only one mom? One dad?” And so on. The kids kept on raising their hands, one group after another, sometimes giggling, sometimes saying something proud like “ME!” Finally, rabbi Weiss asked: “Who has a mom and a dad?” All the (mostly gay and lesbian) parents in the room raised their hands. And then it hit me: while we are trying to provide our children with alternative views of families, the families we grew up in are almost always the traditional nuclear mom-and-dad model; for most of us, this was and still is our parenting experience.

In our family there are two dads, and a daughter and son (twins) who turned 3 just a few months ago. When I’m asked, it is very easy for me to affirmatively state: Our kids have two dads or, as we say at home, an aba and a daddy. But people always wonder, and people sometimes (especially kids) are brave enough to ask: Do they have a mom?

Technically they don’t, our kids were born with the help of a gestational surrogate, which means that we received an anonymous egg donation which together with our sperms was used to create embryos, which were subsequently carried by our friend, who served as the children’s surrogate. Over the years, friends, family and many strangers have suggested that one of these two women must be “the mother.” We answered politely that we call one the egg donor and the other the surrogate, but mostly they seemed unsatisfied by these answers. Usually I think this is just a matter of educating them on our family structure, but sometimes I do attributed it to being insensitive, homophobic, dad-phobic, or mother-centric depending on the person asking and his or her tone. Many people think it is just fine for a same-sex couple to have kids but still believe that a mother is necessary for the healthy development of a child. Others have pointed out that children born using anonymous sperm or egg donation will always wonder about their genetic parent, and that we are depriving them of a right to know their biological mother.

My friends in similar family settings have tried to address these issues in many admirable ways: I have seen fathers asking their children, “Do you have a mom?” just to demonstrate how the kids answer so clearly, “No, I do not; I have two dads!” Others have created strong bonds with women in their lives that the children could identify with as the equivalent of a mother figure: an aunt, grandmother, the surrogate herself, or sometimes a caregiver. When asked, many of us will gladly point you to solid research indicating that children of same-sex couples are just as happy and healthy as children who grow up with a mother and dad. I would be grateful if someone could show this information to my 3-year-old, who was at that moment extremely unhappy about a variety of things: from not being able to play on my iPhone to having to take a bath.

For example, in her book “Modern Families: Parents and Children in New Family Forms,” Dr Susan Golombok says that children of same-sex couples do just as well as children in traditional families. The problems some children face come from outside the family rather than within it and depend very much on where they live. She argues that schools should make an active effort to combat the stigmatization of children in different families. Dr Golombok is currently carrying out a study of children with gay dads who were born with the help of a surrogate. The study should be completed this summer, and the very much anticipated findings will be available shortly after.

In spite of these positive research results, it’s hard not to wonder about the effects of growing up without a mom, and not only that, but with no mother ever having existed. My husband Eric sometimes points out that women used to die in childbirth with terrible frequency, and that even his grandmother never knew her own mother because of this common tragedy. While she was raised by her father and grandmother, she still knew that a woman who was her mother had at least lived at one time and had been known by the people in her life. Our kids wouldn’t be able to imagine a mother. The idea of our kids having nothing but a void where a mother would normally be sometimes kept me up at night.

Click here to read the entire article.

in Egg Donation / Family Stories / IVF / Parenting / Surrogacy  by Anthony Brown 0 comments

Bill would require fertility benefits for lesbians

The Baltimore Sun, by Michael Dresser, March 18, 2015

f Fiona M. Jardine had a husband, the expensive fertility treatments she’s now undergoing would be covered by her health plan.

But Jardine, 29, is married to a woman, so she and her wife have to pay out of pocket.

A bill that would grant married lesbian couples the same fertility treatment benefits as husbands and wives is advancing in the Maryland General Assembly. The measure passed unanimously in a House subcommittee Tuesday, and full Senate and House committees are likely to vote this week.

Del. Terri L. Hill, the bill’s House sponsor, said the measure is designed to bring consistency to state law, given Maryland voters’ approval of same-sex marriage in 2012.

“We’re concerned that we correct the law to reflect Maryland’s state on marriage equality,” said Hill, a Democrat who represents Howard and Baltimore counties. “It was about making sure all Marylanders are treated in an equitable fashion.”

Maryland has required state-regulated health insurance plans that offer pregnancy-related benefits to cover the costs of in vitro fertilization since 2000. It is one of a dozen states that require coverage of the procedure, which involves fertilizing the egg outside the woman’s body and implanting the embryo in the uterus.

That law includes a requirement that only the husband’s sperm can be used in any covered in vitro procedure — a provision that excludes lesbians using donated sperm. Hill’s bill, sponsored in the Senate by Montgomery County Democrat Cheryl Kagan, would remove that requirement for same-sex couples.

And if an insurer chooses to provide more extensive fertility coverage to heterosexual couples, same-sex couples would have to be offered the same.

“It’s all about equality. It’s all about updating our laws,” Kagan said.

Jardine, a graduate assistant at the University of Maryland College Park, said she was dismayed to learn that her insurance carrier would not cover the costly form of artificial insemination she needs because of a medical condition. The sticking point was that she and her wife, Jo Arnone, 57, would be using donor sperm instead of a husband’s sperm.

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