U.S. women with less income, education often lack access to infertility care

Although women from all walks of life tend to experience infertility at similar rates, a new U.S. study suggests there are wide disparities in access to treatment.

Researchers examined survey data collected between 2013 and 2016 from 2,052 women, ages 20 to 44, who were representative of more than 45 million women nationwide.PGS, PGD

Overall, 12.5% of the women reported trying to conceive for one year without becoming pregnant, the timeline doctors typically use to define infertility. Just a third of those making less than $25,000 a year sought treatment for infertility, compared with two thirds of those making $100,000 or more, researchers report in Fertility and Sterility.

“People of all races, education levels, incomes, citizenship statuses, health insurances and sites of health care use report similar rates of having infertility,” said Dr. James Dupree, an assistant professor of urology and obstetrics and gynecology at the University of Michigan in Ann Arbor.

“Women with less education, lower incomes, non-citizens and women without health insurance and without access to physician offices did not see their doctors as often for help with infertility,” Dupree said by email. “So, patients and families should know that if they have infertility, they’re not alone, and they should go to see their doctor for help.”

Most healthy couples can conceive within three to six months, although the process can take longer for people who are older or who have fertility compromised by certain medical conditions or lifestyle habits.

Infertility rates in the study ranged from 5.8% among women 20 to 24 years old up to 20.5% among women 40 to 44 years old.

Older women were also more likely to seek help: 67.3% of women 35 to 39 years old with infertility saw a medical provider, as did 61.7% of infertile women 40 to 44 years old. Only 11.7% of women 20 to 24 years old sought treatment for infertility.

Reuter.com, by Lisa Rappaport, July 17, 2019

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JP Morgan is expanding fertility benefits to help LGBTQ employees have families

Starting next month, the bank’s employees can tap expanded benefits for fertility treatments and surrogacy services, according to an internal memo. The changes are seen as primarily helping LGBTQ employees who couldn’t access reproductive benefits that were tailored to straight couples.

JP Morgan Chase is expanding benefits to help employees pay for fertility treatments and surrogacy services, according to an internal memo obtained by CNBC.benefits employees

Employees in the U.S. without a medical diagnosis of infertility can now have up to $30,000 of treatments including in vitro fertilization covered, according to the letter, which was sent to workers earlier this week. The New York-based bank also increased reimbursement for costs related to surrogacy, which involves compensating a woman to carry a child to term, to $30,000 from $10,000.

Both moves are seen within J.P. Morgan as primarily helping LGBTQ employees, because before the change, which starts July 1, same-sex couples who weren’t medically diagnosed as infertile had to pay for services out of pocket. (Workers who are deemed infertile are already covered by the bank’s medical plan). The company made the change after an investment bank employee queried an internal LGBTQ council, said spokesman Joe Evangelisti.

“We recognize that there are many pathways to building a family and we’re making it easier to follow them,” the bank said in a letter signed by human resources chief Robin Leopold and general counsel Stacey Friedman.

The move is an important one because Wall Street firms tend to follow each other in expanding benefits amid a constant war for talent. While Morgan Stanley reportedly made it easier for workers in same-sex relationships to tap reproductive benefits starting this year, J.P. Morgan said it believes most of the biggest U.S. financial institutions are lagging in this category.

CNBC.com, June 26, 2019 by Hugh Son

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New York Almost Joined The 21st Century On Gestational Surrogacy, No Thanks To Gloria Steinem

New York continues to be one of the few surprising gestational surrogacy holdouts, with an outdated law based on outdated notions and outdated technology.

The New York bill in support of regulated compensated gestational surrogacy — the Child-Parent Security Act (CPSA) — had the vocal support of Governor Andrew Cuomo, passed the State Senate, and likely had the votes in the House. But it never made it to the floor before the legislative session ended last week. What the heck happened?!new york surrogacy

Some Background.

New York is one of the few states in the country that legally prevents a woman from carrying a hopeful parent’s or couple’s embryo to birth, and receiving compensation for her nine months of intense effort and … labor. Other jurisdictions that had previously banned the practice have since changed course in the last few years — including New Jersey, Washington State, and D.C. In the meantime, New York continues to be one of the few surprising holdouts, with an outdated law based on outdated notions and outdated technology.

As previously discussed in my column, while gestational surrogacy is a big part of the New York bill, the CPSA includes other key protections for parents hoping to conceive using assisted reproductive technology. For example, it fixes the state’s legal loophole that allows sperm donors who donated to a single parent to seek legal rights to the resulting child! And vice-versa, it closes the loophole that currently allows single parents to seek child support from a donor. So these were improvements all around.

 

New York’s ban stems from the disastrous Baby M case in the 1980s. That case occurred in next door New Jersey, where a woman agreed to be inseminated and carry the resulting child for another couple. This type of arrangement is generally referred to as “traditional,” or “genetic surrogacy.” In the Baby M Case, the genetic surrogate changed her mind about giving up the baby, and fled the state with child. Both New Jersey and New York quickly over-corrected and outlawed all compensated surrogacy. Since then, genetic surrogacy has largely been abandoned across the U.S., while gestational surrogacy — where the surrogate is not genetically related to the child she carries — has flourished. Note that the CPSA only aims to legalize gestational surrogacy, not genetic surrogacy, the type found in the Baby M Case. Last year, New Jersey (ground zero for Baby M) recognized that the times and medical practices have changed, and reversed its position by passing supportive gestational surrogacy legislation.

So Close! 

The momentum for the bill was building, and supporters believed that the CPSA had a good shot at becoming law this year. So, what pulled the brakes? I spoke with Denise Seidelman, a prominent New York adoption and surrogacy attorney, and part of a coalition in support of the CPSA. Seidelman shared her experience advocating for the bill. “It was one the most profoundly inspiring, and also intensely disappointing experiences. Emotions were running high on both sides of the issue.”

Seidelman explained her view on some of the factors that led to this not being the CPSA’s year. For one, she noted that the author of the original New York surrogacy ban (from 30 years ago), Helene Weinstein, is still a current member of the Assembly, and she is outspoken in her position, perhaps colored by her experiences of a generation ago.

Seidelman felt another factor in this year’s failure was the timing of a letter by Gloria Steinem, famed author and feminist, against the CPSA. Steinem’s letter was disappointing, and really a bit shocking for those familiar with how surrogacy works. Her letter referred to a 1998 NY Task Force report that came out against surrogacy, with no mention of a more recent and more relevant 2017 NY Task Force report in support of gestational surrogacy, with measured regulation. Unfortunately, Steinem spoke not from firsthand knowledge of the recent experiences of women who choose to be gestational carriers for others, but from a perspective that has long since gone by the wayside.

The letter described how the bill would risk the well-being of the marginalized women in the state — those in conditions of poverty. However, as pointed out in the rebuttal letter written by RESOLVE, the national infertility association, of the women who raise their hands to be surrogates, only about 5 percent are determined to be medically qualified, and are able to move forward. And one of the requirements is that they are financially stable. Additionally, the 2017 Task Force report found that the women who are acting as surrogates are not the marginalized of society, but those not reliant on compensation that may be received from acting as a gestational surrogate. Steinem’s letter is an imagination of the Handmaid’s Tale, but ignores the current reality of what surrogacy is, and how it works.

AboveTheLaw.com, June 26, 2019 by Ellen Trachman

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Gestational Surrogacy Dead for Now in NYS

State assemblymembers hesitate amid women’s rights concerns about gestational surrogacy in NY 

Efforts to pass gestational surrogacy in the NY State Legislature have withered in the lower chamber and Assembly Speaker Carl Heastie confirmed on June 20 that the bill is dead for now, citing concerns about women’s rights and fears of commercialization.surrogate lawyers, surrogate lawyer, surrogate attorney, legal surrogate, surrogate legal

Heastie, however, indicated that lawmakers and advocates would continue crafting the legislation in the coming months in such a way that would attempt to quell lingering reservations about the issue.

The movement to pass gestational surrogacy, which involves a surrogate carrying a baby who has no biological relation to her, became a key issue in the LGBTQ community’s efforts in Albany during the final months of the session because the current ban on compensated surrogacy in New York disproportionately affects same-sex couples. The measure passed the State Senate, but ran into roadblocks in the lower house, even as Governor Andrew Cuomo aggressively campaigned for the issue and enlisted the help of Bravo TV show host Andy Cohen, who had a baby son through surrogacy.

In the lower chamber, though, out lesbian Democratic Assemblymember Deborah Glick of Manhattan infuriated some in the LGBTQ community and drew cries of betrayal when she expressed hesitation on the measure after previously vowing support for it. She told The New York Times earlier this month that gestation surrogacy is “pregnancy for a fee, and I find that commodification of women troubling.” She also suggested that gestational surrogacy isn’t necessarily an issue for the wider LGBTQ community because many folks are unable to afford the tens of thousands of dollars to have kids that way.

But Democratic Assemblymember Amy Paulin of Westchester County, who led the bill in the lower house, told Gay City News with roughly one week left to go in the session that she was working to garner support for the bill. That effort never came to fruition.

“While there are strong feelings about surrogacy on all sides, I want to make it clear that no single member is in a position to stop this or any bill,” Heastie said on June 20 in a clear effort to spare Glick from being singled out. “Many members, including a large majority of women in our conference, have raised important concerns that must be properly addressed before we can move forward.”

He continued, “We must ensure that the health and welfare of women who enter into these arrangements are protected, and that reproductive surrogacy does not become commercialized. This requires careful thought. While our work for this session is nearly complete, I look forward to continuing this conversation in the coming months with our members and interested parties to develop a solution that works for everyone.”

Parents can use sperm harvested from their dead son to make grandchildren, judge rules

West Point cadet Peter Zhu, who was unmarried, died after a skiing accident on February 23, Judge allows parent to use harvested sperm.

He had been found unresponsive on a ski slope on the grounds of the military academy in upstate New York.  Zhu was then taken to a hospital, where he was declared brain dead days later.  Judge now rules that parents may use their son’s harvested sperm.harvested sperm

In March, his parents petitioned the court to allow the hospital to have their son’s  harvested sperm retrieved and frozen at the same time harvest his organs for donation.

The petition was granted and the sperm was preserved at a sperm bank after the retrieval.  His organs were also harvested to help those waiting for a lifesaving transplant before he was buried in the West Point Cemetery.

According to CNN, the Supreme Court Justice John Colangelo’s ruling gave Zhu’s parents the ability to attempt conception with a surrogate mother using their late son’s sperm.  “At this time, the court will place no restrictions on the use to which Peter’s parents may ultimately put their son’s sperm, including its potential use for procreative purposes,” Colangelo wrote.  “They shall possess and control the disposition and potential use of their son Peter’s genetic material.” 

Zhu’s case isn’t the first incident of this type, according to AP.In 2007, a court in Iowa authorized recovery of a man’s sperm by his parents to donate to his fiance for future procreative use.  In 2009, a Texas woman got a judge’s permission to have her 21-year-old son’s sperm extracted after his death, with the intention of hiring a surrogate mother to bear her a grandchild.

StandardMedia.com, May 30, 2019, by Charles Odero

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More Than 100 Rabbis and Cantors Urge NY State to Legalize Surrogacy

The 118 Rabbis and other clergy members urged the passage of the NY Child-Parent Security Act, surrogacy.

The 118 Rabbis and other clergy members urged the passage of the NY Child-Parent Security Act  (surrogacy) in a letter Tuesday to the state’s House speaker, Carl Heastie, and Senate majority leader, Andrea Stewart-Cousins, both Democrats. Among the signatories are rabbis representing the Reform, Conservative and Orthodox movements.rabbis NY surrogacy

The bill, which has the support of Gov. Andrew Cuomo, would legalize paid gestational surrogacy, in which a woman is compensated to carry a child not conceived using her eggs. Proponents say it allows those facing infertility and LGBTQ couples to have children, while detractors say the practice is immoral. The measure also would ease the process through which parents who enlist a third party to conceive establish a legal relationship with the child.

The letter — organized by the Protecting Modern Families Coalition, an alliance of organizations in support of the legislation — references Jewish tradition in arguing for the bill’s passage.

“From birth to Bar/Bat Mitzvah, marriage, and burial, at the core of most of the major Jewish life cycle events is family,” it reads. “As rabbis, we know the visceral, central importance for so many of our congregants of building a family.”

Among the signatories are Rabbis Sharon Kleinbaum of the LGBTQ synagogue Congregation Beit Simchat Torah; Rick Jacobs, who heads the Reform movement; Dov Linzer, president of the liberal Orthodox Yeshivat Chovevei Torah rabbinical school; and Rabbi Avram Mlotek, an Orthodox rabbi who announced last month that he will perform same-sex weddings. The UJA-Federation of New York and the Central Conference of American Rabbis, the Reform movement’s rabbinical arm, also joined the letter.

The Jerusalem Post – JPost.com, BY JOSEFIN DOLSTEN/JTA, May 15, 2019

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What’s covered under New York’s new IVF law?

The New York Law will cover fertility treatment, including IVF, for up to 2.4 million

frozen eggs

With more young women and men delaying parenthood, the demand for fertility treatments such as egg freezing and in-vitro fertilization (IVF) has grown across the country.

Legislation and science have lagged behind the trend, and the cost of the treatments can be prohibitively expensive.

A new law, enacted in the 2020 state budget, mandates that certain large-group insurance plans cover IVF, and requires all private insurance companies to cover medically necessary egg freezing.

It is projected to benefit to up to 2.4 million New Yorkers, according to figures from Gov. Andrew M. Cuomo’s administration, but there are kinks to iron out before it guarantees coverage to the other half of insured New Yorkers, including gay men, Medicaid-recipients, and the self-employed.

Secretary to the Governor Melissa DeRosa, the first woman to hold that position, pushed for IVF legislation in the spending plan, citing it as a top priority for the two-year-old Council for Women and Girls.

DeRosa, 36, said that she understands the anxiety of women in her age group who are pressured to decide between advancing their careers and starting a family.

There is nothing more personal or life altering than the ability to conceive and making the choice about when to conceive,” DeRosa said. “As someone who is currently facing these life-altering decisions, I know firsthand the toll they take — emotionally and financially.”

TimesUnion.com by Rachel Silberstein, April 1, 2019

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Revolutionary test could make IVF more successful by looking at the DNA a fertilised egg sheds in the lab

A revolutionary DNA test could make IVF more successful, research suggests. 

Problems with a developing baby’s chromosomes – strands of DNA found in every cell – are thought to be the main cause of miscarriages. 

To maximise a woman’s chance of conceiving via IVF, embryos are therefore screened before they are implanted into her womb to check for any chromosomal issues. 

But this involves taking cells from the embryos, which can damage them and increase the risk of a miscarriage.

The research was carried out by Brigham and Women’s Hospital, Boston, and led by Dr Catherine Racowsky, professor of obstetrics, gynecology and reproductive biology. 

IVF involves taking a woman’s eggs, which then get mixed with her partner’s, or a donor’s, sperm in a lab. After 16-to-20 hours, they are checked to see if the egg has been fertilised.

The fertilised eggs – or embryos – grow in the lab for six days before the best one or two are transferred into the womb. 

But this can do more harm than good and therefore only tends to be carried out when older women – who are more at risk of chromosomal abnormalities – are undergoing IVF. 

To test whether a safer approach is possible, the researchers analysed 52 embryos from IVF clinics that were no longer needed and had already undergone a biopsy.

These embryos were kept in a petri dish for 24 hours.

The scientists then tested 0.01ml of the surrounding fluid in the dish, as well as the embryos themselves to determine how many chromosomes they contained. 

Results – presented at the Fertility 2019 conference in Birmingham – suggested analysing this fluid produced fewer false positives than traditional methods.

A false positive occurs when a test indicates a problem when the embryo is in fact healthy.

‘This shows DNA in spent culture medium can be reliably amplified and sequenced,’ Dr Catherine Racowsky said at the conference.   

And the new method does not harm the embryo.

Virginia Bolton, consultant embryologist at St Guy’s Hospital – who was not involved in the research – told New Scientist: ‘Trying to refine our mechanisms for choosing the embryo that’s most likely to lead to pregnancy is something that’s been eluding us for ever.

‘This [approach] doesn’t damage the embryo in any way.’ 

Dr Bolton believes this technique is better than others being developed that test for the chemicals an embryo secretes.

She worries these chemicals may become diluted, skewing the results, whereas ‘the DNA is either there or it isn’t’, she said.  

February 13, 2019, thedailymail.co.uk, by Alexandra Thompson

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A new study suggests an LGBTQ millenials ‘Baby Boom’ is in our future

LGBTQ millennials are leading the way when it comes to the growth in LGBTQ families according to a new survey from the Family Equality Council, an LGBTQ rights organization.

LGBTQ millennials

The survey found that 63% of LGBTQ millennials between the ages of 18-35 are looking at starting a family or adding to their current one. What’s more, results from the LGBTQ Family Building Survey show that 77 percent of LGBTQ millennials are either already parents or are considering having children. This is 44 percent higher than LGBTQ people over the age of 55. 

The data points to a shift in the LGBTQ community in the wake of the 2015 Obergefell v. Hodges decision which secured marriage equality in the United States. The U.S. Supreme Court ruling fueled speculation that we’d see a dramatic shift in LGBTQ family growth as a result.

Additionally, the survey revealed that 48 percent of LGBTQ millennials are actively planning to grow their families in the future, narrowing the gap between them and the 55 percent of non-LGBTQ respondents. In a 2013 Pew Research Center poll, only 35 percent of LGBTQ adults were shown to be parents, compared to 74 percent of non-LGBTQ adults.

That means in the last five years, the gap between queer and non-queer people wanting families went from 39 percent to 7 percent. Likewise, transgender survey respondents were found to be equally likely to grow their own families as their non-transgender peers.

by Gwendolyn Smith, LG BTQNation.com, February 10, 2019

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The long wait for legalized surrogacy may soon end in New York


A bill legalizing the practice is backed by the governor, fertility groups and LGBTQ activists, but opposed by some feminists and the Roman Catholic Church.

On a September evening in 2015, six weeks before their twins’ due date, Michael and Melissa Musman got an urgent call from the surrogate carrying their children. The babies needed to come out, the surrogate said, and if the Musmans wanted to be there for their birth, they had to come right away.

The Musmans, both 43, live in New York, one of only three states that currently ban paid surrogacy contracts. As a result, residents of the state must look elsewhere if they want to hire a surrogate; the Musmans found theirs in Pennsylvania.

Hoping they could pull off the nearly 400-mile drive from Brooklyn to Pittsburgh in time, they quickly packed a suitcase, made arrangements for someone to watch their older child and started driving.

“We knew there would be a chance that we would not make the birth,” said Melissa Musman, a teacher who turned to surrogacy after radiation for tumors in her pelvis and abdomen compromised her fertility. “With Pittsburgh, it’s not around the corner.”

Still, the couple was hopeful. They were not new to surrogacy. Using an egg donor and Michael Musman’s sperm, they had their first child, Sean, via a surrogate in Peoria, Illinois, in October 2008. It took two planes to get to Peoria, but they had made it for his birth.

This time, as they drove through the night, their twins arrived via an emergency Cesarean section in an operating room hundreds of miles away.

Advocates say it’s a way of helping infertile and gay couples start families. But commercial surrogacy has a slew of detractors, many of whom say it amounts to women selling their bodies.

For decades, the detractors in New York prevented it from becoming legal. Now, New York is on the brink of changing its policy, with Gov. Andrew Cuomo, a Democrat, publicly declaring his support last weekend for a bill — called the Child-Parent Security Act — that would remove the ban. Cuomo also included the bill in his state budget proposal.

New York’s long-held resistance stems from a tumultuous surrogacy battle in neighboring New Jersey, known as the Baby M case. In 1985, a woman who was struggling financially, Mary Beth Whitehead, agreed to be a surrogate and be inseminated with sperm from William Stern, a man whose wife had multiple sclerosis, for $10,000.

by Elizabeth Chuck, NBCNews.com, February 7, 2019

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