How Coronavirus Is Affecting Surrogacy, Foster Care and Adoption

How Coronavirus Is Affecting Surrogacy – The pandemic is not just impacting parents and pregnant people — all prospective parents are facing new challenges.

How Coronavirus Is Affecting Surrogacy – Covid-19, the disease caused by the novel coronavirus, has upended life for those who are or hope to become pregnant in the United States. Fertility doctors have indefinitely postponed all advanced fertility treatments, and some major hospitals in hard-hit areas are trying to ban partners and doulas from delivery rooms.

But the pandemic is affecting expectant parents forming families through surrogacy, foster care and adoption as well.

Global travel restrictions have left surrogacy agencies in the United States scrambling for exemptions for their international clients — particularly for those whose surrogates are scheduled to give birth in the next month or two.How Coronavirus Is Affecting Surrogacy

Circle Surrogacy, an agency based in Boston, has 15 international clients with due dates before May 1. “We’ve had our legal team prepare letters for each of these families, which has gotten many of them into the country despite travel bans,” said Sam Hyde, the agency’s president. Still, he said, his foreign clients were at the mercy of individual immigration officials. “Some have been sympathetic to the plight of our clients, others have not — it’s really been a case-by-case basis.”

 

Some intended parents, as clients of surrogacy agencies are known, who are currently struggling to gain entry into the United States are hoping to do so after completing a 14-day quarantine in a country with less severe travel restrictions.

Last week, for instance, Johnny and Patty — a Chinese couple working with a surrogate living in South Carolina — traveled from Shanghai to Phnom Penh, Cambodia, to begin two weeks in isolation at a local hotel. The couple, who work for an international company and use these westernized names, asked that their last name be withheld since surrogacy is still relatively uncommon in China. They hope to complete their quarantine in time to witness the birth of their daughter, who is due in mid-April, and claim guardianship over her.

But with travel restrictions tightening seemingly daily, they worry their effort may still be in vain. “First we bought plane tickets to travel through Thailand, but now travel is restricted there,” Johnny said in an interview from their hotel on the second day of his quarantine. “Then we tried Dubai, but that is now also restricted.” Traveling via Cambodia, he said, was the couple’s “last hope” to reach the United States in time for their daughter’s birth.

Though they would be disappointed to miss the delivery, the couple said they were even more concerned, in that scenario, about the baby’s well-being in the ensuing days before they are allowed to travel. “Who will take care of our baby if we can’t arrive before she’s born?” Patty said.

Will Halm, a managing partner at International Reproductive Law Group, said surrogacy agencies were creating contingency plans for clients living abroad who may be prohibited from entering the United States over the next few months. “Plan A is absolutely to have parents in the U.S., joyfully watching their child being born,” he said. “If they can’t get into the country in time, that’s when we look to plans B, C and D.”

 

In one of the better scenarios, agencies hope friends or family members living in the United States can temporarily assume guardianship of the baby until the intended parents are granted entry into the country. As a backup, however, caseworkers are also preparing strangers — health care professionals, child care providers and even surrogates themselves — to care for the newborns until travel restrictions are eased.

“These babies will not be abandoned,” said Dr. Kim Bergman, founder of Growing Generations, a surrogacy agency with dozens of international clients who may be impacted by travel bans in the coming months. “We have an army of former surrogates who are ready and eager to act as helpers and guardians for as long as necessary.”

The ongoing crisis has created an uncertain environment for foster care parents and children as well. “Basically, everything is on pause until things are back to normal,” said Trey Rabun, who works as a services supervisor at Amara, a foster care agency based in Seattle, Wash. — one of a growing number of states ordering its citizens to work from home.

Amara, whose staff members are included in the state’s proclamation, has been able to continue some aspects of the licensing process for foster parents online, such as initial interviews. But other critical components, like home inspections, need to be done in person, Rabun said.

As a result, the number of foster homes, already all too scarce in Washington before the crisis hit, will remain static for the state’s over 10,000 foster care children until the pandemic subsides and business returns to normal, Rabun said. Of bigger concern to him, and other foster care professionals throughout the country, is the impact that “stay at home” orders may have on children not yet accounted for in the system.

“We know abuse and neglect happen more in high-stress situations,” Rabun said. But the people who would normally notice and report these sorts of problem, like teachers and doctors, will be unable to do so in the days and weeks ahead. “No one has eyes on them,” he said.

With courts and other government offices closed in many states, parents who had hoped to finalize adoptions within the next couple of months are also now navigating a drastically changed landscape — particularly for parents completing adoptions abroad.

 

Early in the year, when the coronavirus was barely registering as a news story outside of Asia, Holt International — an agency that facilitates adoption placements between Chinese orphanages and adoptive parents in the United States — was already closely monitoring and responding to the outbreak.

NYTimes.com, by David Dodge, April 1, 2020

Click here to read the entire article.

Effect of COVID-19 on LGBTQ Family Planning

The Effect of COVID-19 on LGBTQ Family Planning is evolving and far reaching.  It is also temporary.

The Effect of COVID-19 on LGBTQ Family Planning – The COVID-19 pandemic has affected us all in ways more numerous to describe.  Those of us with families have had to learn about home schooling, some the hard way (me).  Everyone has had to adjust to what essentially has become a home quarantine situation and the emotional effects of social isolation.  And we are all witness to the world going through a major change which will create a new reality for everyone when we emerge on the other side.  But we will emerge on the other side. effect of COVID-19 0n LGBTQ family planning

While I myself have experienced the loss of a friend due to the virus, as well as the infection of a family member, I know that we all are doing our best to maintain a sense of normalcy and peace within.  Practicing this type of self-care will help mitigate the effects of COVID-19 on LGBTQ family planning.

The effects of COVID-19 on LGBTQ family planning are very real.  I have said in the past that there are no accidental pregnancies in the LGBTQ community.  Everything is carefully thought out and planned in advance.  However, the COVID-19 virus has created specific and real-world disruptions to our ability to create families.

For example, those were using, or planning to use, an IVF clinic for either surrogacy, artificial insemination (AI), intrauterine insemination (IUI) or in vitro fertilization (IVF) procedures have experienced an actual shut down of normal operations.  The clinic administrators that I have spoken with are optimistic that once the virus is contained, or at least the infection curve has flattened, that they will resume normal operations.  For the time being, they are following ASRM guidelines.  But they will also be dealing with backlogs of patients and procedures that may cause further delay in your family building timeline. 

effect of COVID-19 0n LGBTQ family planningFor lesbian couples who have thoughtfully chosen to use a clinic to assist in insemination, this delay is not only frustrating, it can also change the projected timeline of their families.  Even those couples who choose anonymous sperm donors will most likely have to wait an indefinite period of time to undergo AI or IUI procedures.  For those who choose known sperm donors, the essential DNA testing that is a prerequisite for clinic inseminations will also be on a delayed time schedule.

Gay male couples who are considering surrogacy are facing an even more complicated challenge.  First, there will inevitably be a delay in the embryo creation aspect of the beginning of their journey due to IVF clinic shutdowns.  If an intended parent already has embryos created, perhaps from a previous surrogacy journey, they may be in a better position.  However, they will also experience a delay in embryo transfer until restrictions on IVF clinic activities are lifted.  A silver lining is that they will be able to match with surrogates sooner, thereby shortening the time to pregnancy once those IVF restrictions are lifted.

Lesbian couples who choose a known sperm donor and home insemination may be the only group in our community who might not experience the delays discussed above.  However, these types of inseminations will not have the benefit of genetic testing.  Nor are they technically “legal” in some states (Missouri, Georgia, Oklahoma and Colorado) because they are not performed by a licensed professional.  It is key that if you are considering home insemination that you consult with an Assisted Reproductive Technology (ART) attorney in your area and, for the safety and security of all parties, must have carefully prepared legal agreements in place and a second or stepparent adoption plan incorporated into that agreement.

For those in the midst of a surrogacy journey, perhaps awaiting their carrier to give birth, the effects of COVID-19 on LGBT family planning can be particularly frustrating due to travel and hospital restrictions.  Many hospitals are restricting the number of people who can be in a delivery room, particularly if they have traveled from an area that has been severely affected by COVID-19, like New York, Washington or California.  Be prepared for snags in the road and lots of patience.  You will go home with your child!  You may have to be flexible in your travel plans, i.e. be prepared for long drives instead of air travel.

For lesbian couples and gay men with surrogates who are pregnant, there is a limited study from Wuhan China showing that babies of mothers with the virus were not effected, meaning that there was no vertical transmission.

Couples considering adoptions are also at a bit of a standstill depending on where they live in the US.  Most state court systems have closed to all but “essential” proceedings.  While I would argue that adoptions are essential, the courts have determined that they are not.  I have several cases now awaiting the scheduling of finalization hearings that are simply on hold until the pandemic subsides.  This includes private placement adoptions and step or second parent adoptions.  This does not mean that making connections with birth parents must be put on hold, but the legal work that is required to effectuate the adoption may be delayed, causing additional anxiety.Effect of COIVD-19 on LGBTQ family planning

You may be asking what you can do to mitigate the effects of COVID-19 on LGBTQ family planning.  I know that I am.  Here are a few options that you can consider now.

  1. Make sure that your Estate Plan is in place and up to date. Ask yourself, “Do I need a Will?”  If you have named guardians for children in your Wills, please review to make sure that they are current and correct.  If you have not created an Estate Plan, now is a good time to do the work to ensure that you have prepared for the unexpected.  Here is a list of the documents you should be considering for your estate plan.  We have also seen a relaxation of Notary laws allowing for online notarizations.  This can make the execution of documents much easier in certain states.
  2. If you have been thinking about creating your family, now is a great time to do more research. Men Having Babies is a great resource for surrogacy.  “If These Ovaries Could Talk” is a wonderful podcast for all LGBTQ family planning.  This should include speaking with your friends who have had children to get their perspectives on the process.  It is also a really good time also to start thinking about the financial implications of having a family.  Many of us will be irreparably financially harmed by the COVID-19 pandemic.  Many of us will have to rethink the timelines we had anticipated would apply to our family planning journeys.  You may want to meet with a financial professional to discuss the best way to get your family plan back on track.
  3. Practice self-care! Whether you have children or not, staying calm and finding peace in your heart will help you get through this.  While you might feel alone, you are not alone.  Reach out and find solace in your friends and family if you can.  Take walks if you can and get outside.  Remind yourself of what will be on the other side of this experience.

If you have specific questions about how to address the effects of COVID-19 on LGBTQ family planning and estate planning, and you think I can be of help, please do not hesitate to reach out to me.  Thank you for taking the time to read this and remember to breathe.

The Latest Study on Regulation of Compensated Gestational Surrogacy in New York

The Latest Study on Regulation of Compensated Gestational Surrogacy in New York

The Latest Study on Regulation of Compensated Gestational Surrogacy in New York underscores the need to pass this legislation and shows that it would provide the most comprehensive protections for gestational carriers in the US.compensated gestational surrogacy

This report on the regulation of compensated gestational surrogacy in New York, issued in March 2020 to the New York State Legislature by Weill Cornell Medicine and the Cornell Law School is one of the most comprehensive reports of its kind and leads the reader to now other conclusion but that New York’s pending legislation, The Child Parent Security Act, would be the most protective of gestational carriers, or surrogate mothers, of any piece of legislation in existence in the US.  Surrogacy legislation  can be ethical and comprehensive.

To quote from the article, “The trend among state legislatures in the United States is to permit rather than prohibit compensated gestational surrogacy. Since 2000, fifteen states and the District of Columbia have acted to explicitly permit compensated gestational surrogacy. On the other hand, only four states have taken a prohibitive approach since 2000 and two of those states permit uncompensated gestational surrogacy.”

“In forty-four states there is no prohibition on surrogacy by statute or there is explicit or implicit permission. Even in the six states that have statutes that appear to prohibit surrogacy, courts have granted pre-birth orders to intended parents and have issued other pro-surrogacy decisions. Consequently, surrogacy in varying ways, including by approving pre-birth orders.”

“In sum, the health and medical literature does not weigh in favor of continuing to prohibit gestational surrogacy in New York. There are generally no disparate health outcomes for gestational carriers as compared to non-gestational carriers using assisted reproductive technology (ART) nor are their disparate health impacts on children. Additionally, there are no disparate psychological impacts on gestational carriers as compared to women who have had spontaneously conceived pregnancies. States across the country are moving to legalize and regulate gestational surrogacy in the last decade.”

March 20, 2020 by Cornell Weill Medical Center and Law School 

Click here to read the entire article.

Fertility Fraud: The U.S. Is Experiencing An Explosion Of Legislation. And That’s A Good Thing

More and more cases of fertility fraud have been uncovered. And more and more lawsuits have been filed. However, each prosecution or lawsuit has faced an uphill battle.

Direct-to-consumer DNA kits have changed our reality. The wall of secrecy that was once behind conception and parenting — including adoptions, affairs, and the use of donor eggs, sperm, and embryos — is crumbling. One major facet of this reckoning with the truth has been the stark realization that many, many doctors were using their own sperm, a form of fertility fraud, to “treat” their unknowing patients.fertility fraud

Sometimes this practice was in place of “anonymous donor” sperm; sometimes, it was actually in place of the spouse or partner’s sperm. It’s pretty gross to think about. But even grosser is the complete lack of accountability for the doctors who must have known of the ethical and moral shortcomings of their actions.

The Justice System Has Been Failing Us

A doctor using his own sperm to impregnate a patient, without her knowledge or consent as to the source of the sperm, must be a crime, right? Or at least a pretty solid tort – fertility fraud? For many states, you guessed wrong. More and more cases of those doctors’ egregious practices have been uncovered. And more and more lawsuits have been filed. However, each prosecution or lawsuit has faced an uphill battle.

Take, for example, the case of Donald Cline, formerly a licensed medical doctor in Indiana. In one of the most notorious cases of fertility fraud in the United States, DNA tests have shown Cline to have used his sperm in unknowing patients, resulting in at least sixty children. When the betrayed patients and offspring sought legal remedies against Cline, they were unsuccessful. After all, the patients had consented to Cline inseminating them with sperm. Cline did plead guilty to two charges of obstruction of justice, after lying to officials about using his own sperm with patients. But that, to most victims, was not sufficient.

Time To Change The Law

Since current law has been failing the victims, many have sought, and are currently seeking, to change the law. State by state, if necessary. Last year, two successful bills were passed. One was in Indiana, unsurprisingly, as ground zero of the Cline fiasco. Another was in Texas, where Eve Wiley led the charge. (Listen to this podcast where Wiley and her believed-donor tell the twisting and fascinating tale of uncovering the truth of Wiley’s genetic history.) In Texas, without a civil cause of action due to the state’s recent tort reforms, and without a viable criminal cause of action to charge him, Wiley’s “doctor daddy” is still actively practicing medicine even today. That’s crazytown.

Now other states are following suit, and closing the legal loopholes that existed for doctors to take advantage of their patients in this most intimate of areas. And while I doubt that as many doctors are so casually using their own sperm these days, there are certainly modern horror stories involving assisted reproduction, including that of a staff member at a Utah clinic swapping out countless sperm samples with his own.

The states currently making progress in this area include my own home state of Colorado with HB20-1014 (Go, Representative Kerry Tipper!), Nebraska with LB 748, Ohio with HB 486, and Florida with SB 698. Other states, as well, appear poised to introduce their own fertility fraud legislation. While the proposed laws vary, they are consistent in their goals of ensuring or clarifying that this type of behavior by trusted medical professionals is not acceptable and not legal, and providing a path forward for justice.

AboveTheLaw.com, by Ellen Trachman, February 12, 2020

Click here to read the entire article.

French Senate passes bioethics law allowing lesbians to artificially procreate

The bill passed by the French Senate is watered down but still extremely transgressive.

The French Senate adopted the draft bioethics law currently under discussion in that body by a relatively small margin of 10 votes on Tuesday. One of its most spectacular elements, the legalization of access to artificially assisted procreation for single women, including those in lesbian relationships, was confirmed, as well as the widening of possibilities for research on human embryos. Other articles of the law were modified by the Senate, which canceled some of its more shocking propositions.French Senate

Although the higher chamber in France still has a right-of-center majority, the text, which remains deeply transgressive, obtained 153 votes in its favor, while 143 senators voted against and 45 abstained. The voting was not uniform right and left — 97 of the 144 “Les Républicains” mainstream right-wing senators rejected the law presented by Emmanuel Macron’s left-wing government, while 25 voted for the text, thus bearing responsibility for its adoption.

The presidential party “La République en marche” (LREM), created for the last presidential election and not very strong in the Senate, was itself divided: six of its 24 senators voted against the text.

Almost all the 348 senators were present, a sign that the revision of France’s bioethics laws is being taken seriously. The first such law was adopted in 1994 and was already transgressive because it legalized artificial procreation and embryo selection.

From the start, it was decided that the bioethics law would be revised every five years in order to take medical and scientific progress and new techniques into account. As a matter of fact, the laws were revised over larger intervals. Each time, new possibilities for embryo research, pre-implantation diagnosis, and other such transgressions were added.

The draft bioethics law now being discussed has been substantially amended by the Senate and will therefore return before the National Assembly, probably in April. Laws are adopted definitively without a second reading in France only when adopted by both chambers in exactly the same terms.

Lifestienews.com, by Jeanne Smits, February 7, 2020

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The Number of Employers Who Offer Fertility Benefits is on the Rise

Fertility benefits rank high on the list of valuable benefits that make recruiting top talent, retaining valuable employees, and reducing turnover easier. Providing coverage for family building options has been shown to increase employee retention and loyalty.

According to a recent FertilityIQ survey, 68 percent of millennials consider fertility benefits when choosing an employer, and 9 out of 10 employees with fertility issues will switch jobs for benefits.fertility benefits

This scenario was very true for millennial, Katie Goad and her husband Adam. They had an 8-year-old daughter and wanted to expand their family. After giving birth to her first child, Katie had surgery that meant she would have to undergo in vitro fertilization (IVF) in order to have another child.

Lacking insurance for IVF, Katie was determined to expand her family without going into debt in the process, so she explored her employment options and discovered that Starbucks offered benefits to cover IVF, even to hourly, frontline workers. Starbucks is revered for being among the first to provide fertility benefits to hourly and part-time employees.

“I was honest with them in my interview about what my goal was, and what my intentions were,” Goad said in a recent interview with Benefit News.

She landed the job and started working as a part-time barista.

In a recent survey, FertilityIQ, author of the extensive Family Builder Workplace Index, found that 73 percent of fertility patient respondents felt more gratitude toward their employer because of fertility benefits, 61 percent said it made them feel more loyal, and 53 percent said it influenced them to stay with a particular employer longer.

“In this tight labor market, millennials are entering the family building years and flooding the workforce. Companies eager to recruit top talent know that offering fertility benefits, paid parental leave, and flexible schedules fosters a great sense of loyalty,” said Patty Stull, Chief Marketing Officer of SGF.

Once Katie qualified for health benefits through Starbucks, she began fertility testing and treatment under the care of Dr. Mark Perloe at Shady Grove Fertility Atlanta.

More LGBTQ millennials plan to have kids regardless of income, survey finds

 The price of parenthood can be costly for LGBTQ millennials, and all LGBTQ families, especially those dependent on assisted reproductive technology.LGBTQ millenials

Since they married in 2015, LGBTQ millennials, Jonathan Hobgood, 37, and his husband, Kerry Johnson, 36, have wanted to be dads. At first, the couple saw adoption as the best path to parenthood, but South Carolina, where they live, is one of 10 states with religious exemption laws that make it more difficult for same-sex couples to foster and adopt, and they worried that adopting would set them up for a legal nightmare down the road.

“Our concern was that if we did a private adoption and the birth mother decided a couple of years later that she wanted her child back, we would be in for a rather extensive legal battle to try to keep the child,” Hobgood told NBC News. “So we just decided, ‘Well, let’s take ourselves down the surrogacy path from there.’”

In reality, a court-ordered private adoption would have provided the secure, legal parent-child relationship Hobgood and Johnson were looking for, but it is common for prospective parents to have misconceptions about how the law treats parental rights, according to Denise Brogan-Kator, chief policy officer at Family Equality.

The couple did their research. The cost of hiring a female surrogate, they learned, would be steep — $120,000 to $150,000, a price that Hobgood, a project specialist for a medical insurance company, and Kerry, a management analyst with the U.S. Department of Veteran Affairs, could hardly afford. But it did not deter them.

“I knew I wanted to be a child’s father,” Hobgood said. “I really just wanted to go through and enjoy bringing up this wonderful child who is a part of our family.”

Hobgood and his husband are among an increasing number of lesbian, gay, bisexual, transgender and queer people in the U.S. planning to have children, according to data released this year by Family Equality, a national nonprofit that advocates for LGBTQ families. And despite the additional financial barriers for many prospective parents in this group, this increased desire to have children was found across income levels, according to a report the group released this month, “Building LGBTQ+ Families: The Price of Parenthood.”

Family Equality polled LGBTQ millennials -500 LGBTQ and 1,004 non-LGBTQ adults, and found that the desire to become parents is nearly identical among both lower- and higher-income lesbian, gay, bisexual, transgender and queer people. Forty-five to 53 percent of LGBTQ people between the ages of 18 and 35 are planning to become parents for the first time or add another child to their family (compared to 55 percent for their non-LGBTQ counterparts, a gap that has narrowed significantly compared to older generations).And those making less than $25,000 a year plan to have children at a similar rate to those making over $100,000, according to the report.

Amanda Winn, the organization’s chief program officer, was surprised by the findings.

“I was expecting that folks who were living at the poverty line would report lower rates of wanting to bring children into the home knowing that finances were tight, but that’s not the case,” Winn told NBC News. “That innate, strong desire to have families exists regardless of income levels.”

LGBTQ prospective parents are more likely to face financial hurdles than their heterosexual peers, according to the report. Reasons include their relatively lower annual household incomes and the additional costs associated with having a child using an option other than sexual intercourse, which is considered by only 37 percent of LGBTQ people planning to start their families or have more children.

Assisted reproductive technology: ‘an impossible barrier’ for some

Thanks to advancements in assisted reproductive technology (ART), such as artificial insemination, in vitro fertilization and surrogacy, more LGBTQ people can have children through nontraditional methods, and interest is growing. Forty percent of LGBTQ people are considering such technology to conceive children, according to a Family Equality survey published in February — but many of these prospective parents will pay for it out of their own pockets, and the technology can be expensive.

“Most LGBTQ+ individuals will learn that their health insurance plan does not cover the cost of fertility treatments at all, and, if they do, the individual or family unit must prove that they have been ‘trying’ to conceive for 6-12 months before coverage begins,” the Family Equality report states. “This stipulation in the policy results in high monthly expenses for some and creates an impossible barrier for others.”

nbcnews.com, by Julie Compton December 27, 2019

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Taiwan Surrogacy – After gay marriage law passes, Taiwan emerges as new market for LGBT+ surrogacy

Taiwan Surrogacy – After gay marriage law passes, Taiwan emerges as new market for LGBT+ surrogacy

On Geoffrey Li’s 40th birthday last year, he put aside his dream of an early retirement on an idyllic island and instead decided to raise a child in Taiwan with the assistance of surrogacy in Southeast Asia.Taiwan surrogacy

Li and his husband — whose twin boys are now three months old — are among an increasing number of gay couples in Taiwan becoming parents through surrogacy even though the procedure is illegal on the self-ruled island deemed a wayward province by China.

 

Taiwan became the first place in Asia to legalize gay marriage in May and more than 2,000 same sex couples have since wed, prompting a rush of commercial surrogacy agencies to head to Taiwan to help more LGBT+ couples seeking to start families.

“Having a child in the world to care for, who will return our love unconditionally, is an amazing experience we did not expect to have,” Li said.

Globally, the popularity of surrogacy — where a surrogate mother is either implanted with a sperm and egg or becomes pregnant using her own egg — is soaring, particularly among LGBT+ couples who want to become parents.

Global fertility services were estimated in an initial valuation to be worth about $21 billion in 2018 with the industry forecast to grow to $41 billion by 2026, according to India-based market research firm Data Bridge.

Surrogacy laws around the world vary.

For example, Taiwan, France and Germany prohibit all forms of surrogacy, while Britain, Canada and New Zealand allow some forms of altruistic surrogacy but it is illegal to pay a woman for her services.

Taiwan’s Assisted Reproduction Act forbids any form of surrogacy and any attempts to amend laws, as recently as 2017, have failed due to opposition from women and children’s rights groups.

Conservative groups, such as the Coalition for the Happiness of Our Next Generation, have actively campaigned against LGBT+ parenting and marriage equality.

But although two-thirds of Taiwanese voters — about 7 million people — opposed changing the country’s civil code to recognize same-sex marriage in a 2018 referendum, parliament in May passed a law legalizing gay marriage.

New frontier

Under current laws, same-sex couples can only adopt children who is biologically related to at least one of them, with activists marking this as one of the next frontiers in the fight for LGBT+ equality on the island of 23 million people.

The Taiwan LGBT Family Rights Advocacy (TLFRA) group said they are in contact with at least 300 “rainbow families” and expect the number of same-sex parents to rise as the new gay marriage law spurred visibility and acceptance.

“Part of the (LGBT+) community is celebrating, while part of the community has a lot of fighting to do,” said Chu Chiajong, administrative secretary of the TLFRA.

This has been encouraged by the arrival of commercial surrogacy agencies, mainly from the United States, in Taiwan where hundreds of gay couples are willing to pay up to $140,000 to start a family — almost 10 times the average annual salary.

There is no legislation concerning surrogacy at the federal level in the United States and some states allow commercial surrogacy arrangements.

Men Having Babies, a New York-based non-profit that helps gay men become fathers through surrogacy, hosted its first conference for prospective Asian gay parents in Taipei in March.

About 320 people attended, forcing the organizers to request a space twice the size of the room originally booked.

“People were revelling in it. They were proud of the fact this was happening,” said group founder Ron Poole-Dayan, who was part of one of the first same-sex couples in the United States to father children through gestational surrogacy.

American Fertility Services, San Diego Fertility Center and International Surrogacy Center were among the sponsors of the event, which included a panel on budgeting, testimonies from parents and surrogates and on-site consultations with clinics.

Opinion – The Big IVF Add-On Racket

IVF Add Ons – This is no way to treat patients desperate for a baby.

There are few things as unsettling as sitting in an in vitro fertilization clinic hearing you need a team of experts — embryologists, lab techs and nurses along with a reproductive endocrinologist — to help you become pregnant.embryo

What comes next can be a blur. First, you meet with the clinic’s financial counselor to assess whether you have enough money for a complex, invasive $15,000-$20,000 IVF cycle. What follows are drug injections, blood tests, invasive ultrasounds, surgical egg retrieval, and fertilization ahead of an embryo transfer. Before your first hormone shot, you’re well into head-spinning, unfamiliar territory.

Then the doctor tells you there are “add-ons” you might want to consider.

Might you have interest in endometrial scratching? What about vasodilation, human growth hormones, intralipids, assisted hatching, oocyte activation, physiological intracytoplasmic sperm injection, or embryo glue? Post-fertilization, there is also embryo pre-implantation genetic testing to consider. Interested?

These extras come with price tags ranging from hundreds to thousands of dollars. All are presented as ways to increase your chances of a pregnancy. What are you willing to try? What can you afford? The ball is in your court.

This is no way to treat patients at their most vulnerable.

That’s the conclusion my colleagues and I arrive at in a new paper on the ethics and regulation of IVF add-ons.

An add-on is anything that is not essential to carry out an IVF cycle. Such measures, patients are told, will improve the likelihood of a live birth — and yet our examination revealed a startling absence of robust research into the effectiveness and the safety of these add-ons. Despite this, their use is widespread, and regulation of them is minimal.

The most expensive add-on category is pre-implantation genetic testing. These tests were originally developed to identify embryos at risk for genetic diseases. Today, however, they are primarily sold, at a cost of $6,000 to $12,000, as a way to screen for chromosomal abnormalities that could lead to failed implantation or miscarriages.

In October, however, a large study found that a single abnormal cell does not doom an embryo and determined that one of the tests, PGT-A, made no difference to rates of live births. Worse still, patients who opted not to transfer embryos based on the test’s results may have lost potentially viable ones.

There is also endometrial scratching, a procedure, sometimes costing as much as $500, that purposely irritates the endometrium, the innermost lining of the uterus, before IVF While it’s promoted as increasing the chance of an embryo implanting, a recent large randomized trial found no benefit. Beyond significant patient discomfort, risks include bleeding, infection and uterine perforation.

Then there are intralipids, an emulsion of soybean oil, egg phospholipids and glycerin administered intravenously and described as a way to decrease natural killer cell activation in the immune system and ostensibly aid in embryo implantation. This emulsion is priced around $400 per infusion; typically several are recommended. Side effects include headache, dizziness, flushing, nausea and the possibility of clotting or infection. A meta-analysis last year found that intralipids and other forms of immunotherapy should not be used in routine clinical practice.

Such procedures are often presented to patients in the form of a stack of papers, written in legalese or medical jargon. Resourceful patients might take to the internet to learn more, where searches might deliver densely written scientific articles, and ads might direct them to companies or clinics eager to promote their own brands of add-ons.

Why is all this happening? It’s because IVF remains an under-regulated arena, and entrepreneurial doctors and pharmaceutical and life science companies are eager to find new ways to cash in on a growing global market that is projected to be as large as $40 billion by 2024.

NYTimes.com, December 12, 2019 by Pamela Mahoney Tsigdinos

Click here to read the entire article.

The unintended consequences of Canada surrogacy law changes (Opinion)

There are unintended consequences to Proposed Canada surrogacy law changes.

Canada is considered an international surrogacy destination, with progressive laws that have attracted couples internationally. But, in just over nine months, a new Canadian fertility landscape will be born, bringing new regulations for reimbursing surrogates and donors. In fertility circles – both in Canada and beyond – there is fear that these new regulations by law will discourage people from becoming surrogates and donors.Canada surrogacy law

The new regulations from Health Canada, which come into effect June 9, 2020, set out exhaustive categories of reimbursable expenses – a big change from the current system, which does not specify what can be reimbursed and allows for wide interpretation of what constitutes a “reasonable expense.” That wide interpretation has allowed for flexibility in customizing fertility arrangements but may have a huge effect on Canada surrogacy law.

When the new rules take effect, eligible expenses will, for instance, include travel, insurance and legal fees, as well as counselling services and care for dependents and pets. The idea is to offer more certainty about which reimbursements are legitimate – and to allay any fears about being subjected to criminal sanctions.

Federal Health Minister Ginette Petitpas Taylor has said that the regulations would provide couples struggling with infertility, single individuals, same-sex couples and others in the LGBTQ2 community more flexibility in building families. Couples will have the option to offer surrogates reimbursements for certain products and services beyond the actual pregnancy and into the postpartum period, which was not previously the case. This might make it easier for couples to obtain a surrogate, as they can provide reassurance that expenses related to potential health complications arising after the delivery will be reimbursed. But at the same time, the new regulations introduce more onerous requirements for reimbursement by requiring surrogates and donors to complete signed declarations in addition to providing receipts (surrogates are exempted from providing receipts under certain circumstances).

The biggest concern is that the regulations will likely make it even more difficult to access assisted reproduction, including medical procedures such as in-vitro fertilization, to conceive a child with the help of a surrogate and/or donor. The fear is that the new regulations will further discourage individuals from becoming surrogates and donors. Currently, surrogates and donors in Canada are driven by altruistic motivations, since it remains illegal to pay a surrogate for her services or pay for ova or sperm from a donor. However, if potential surrogates and donors risk not being reimbursed for reasonable out-of-pocket expenses, they may be dissuaded from helping others build families.

Alarmingly, the draft guidance document interpreting the regulations released by Health Canada states that “[t]here is no obligation to reimburse, meaning that only persons who wish to reimburse eligible expenditures will do so.” This could lead to exploitation of donors and surrogates. (The guidance document has not yet been finalized; consultation on it closed on July 26.)

www.theglobeandmail.com by Melissa Salfi, September 6, 2019

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