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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Surrogate Attorney Reports American Surrogate Death

Surrogate Attorney Reports American Surrogate Death: Not the First

As a surrogate attorney, it is disturbing that it has been reported and repeated that Brooke was the first American surrogate to die of pregnancy complications though there have been such fatalities in India and elsewhere. Sharon LaMothe, a surrogacy consultant in Florida, assures me this is not so, however. LaMothe, who I spoke with via telephone and who has twice been a surrogate herself, was insistent that Brooke was not the first American surrogate to die of pregnancy related complications. She “guaranteed” me that Brooke was not the first. There have been a “few” in the past fifteen years that she knows of that likely went unreported because they all occurred earlier in the pregnancy and because they occurred prior to the proliferation of social media.

“Give me children, or else I die. Am I in God’s stead, who hath withheld from thee the fruit of the womb? Behold my maid Bilhah. She shall bear fruit upon my knees, that I may also have children by her.” Handmaid’s Tale, Margaret Atwood

In Atwood’s novel, which takes place “after the catastrophe, when they shot the president and machine-gunned the Congress and blamed it on the Islamic fanatics,” becoming pregnant is the one thing the Handmaids can do to rescue themselves from death. Not so for today’s surrogates.

“Brooke Lee Brown, 34, of Burley, [Idaho] passed away Thursday, Oct. 8, 2015, at St. Luke’s Regional Medical Center in Boise, due to complications during pregnancy.”

On Oct 8, just days before her 35th birthday, Brooke reportedly died either of placental abruption – the result of the placenta separating from the inner wall of the uterus before delivery – or amniotic fluid embolisms. Both are rare pregnancy complications that can occur suddenly in the last trimester and, left untreated, put both mother and baby in jeopardy. The twins she was about to deliver any day via a scheduled cesarean section reportedly lived for a short time on life support before losing their lives as well.

The twins’ demise is not mentioned in her obituary, however, nor is there any mention that Brooke died while serving as a paid surrogate for by a couple from Spain, one of many countries in which surrogacy is illegal. Tess Shawler, of Rocky Hill Mountain Surrogacy in Idaho, who may have arranged Brooke’s surrogacies, has found American surrogates for people from Australia, Canada, Spain, England, and Germany.

Brooke’s funeral is taking place as I write this. A GoFundMe page, set up to raise funds for Brooke’s memorial service, says that she was a surrogate for five babies though it is unclear if that includes the two who reportedly died along with her and how may were multiple births.

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Huffingtonpost.com, October 19, 2015 – by Mirah Roben

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Same sex couples face more obstacles to infertility treatment

Study suggests same sex couples face more obstacles to infertility treatment

Same sex couples encounter more obstacles to treatment for infertility than opposite-sex couples, suggests a new study that will be presented at the 110th Annual Meeting of the American Sociological Association (ASA).

“For example, same sex couples often must undergo psychological evaluations before being treated for infertility — a process that is not normally required for opposite-sex couples,” said study author Ann V. Bell, an assistant professor of sociology at the University of Delaware, who noted that the U.S. medical system is standardized to work with heterosexual couples.

Bell’s study is based on interviews with 95 people — 41 heterosexual women of low socioeconomic status, 30 heterosexual men, and 24 women in same-sex relationships. “These people are on the margins of our understandings of infertility, as it is generally viewed as a white, wealthy, heterosexual woman’s issue,” Bell said.

The new study builds on her 2014 book Misconception, which focused on the 41 women of low socioeconomic status, as well as 17 women of high socioeconomic status, to explore social class and infertility. Through her interviews with the 41-women for the book, Bell found that their experiences related to infertility were shaped by inaccurate stereotypes and that doctors often assumed infertility was not a problem for them.

Bell has extended her earlier research beyond social class to include the effects of infertility on men and same-sex couples. The “medicalization” of infertility — studying and treating it as a medical condition — is a process that has increasingly led to disparities and inequalities, she said.

“Most of the research out there is about women, even though just as many men are affected by infertility,” Bell said. “It’s still viewed as a woman’s issue.”

Click here to read the entire article.

 

EurekaAlert.org, August 26, 2015

CHICAGO —

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Planning your parenting journey / 2015 Brussels MHB

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iSperm lets your iPad analyze your swimmers at home

CNET.com, by Michael Franco – July 20, 2015

The iPad can be used to show home movies — including films of babies as they come home from the hospital, take their first steps, and later, lock themselves in their rooms with loud music and their cell phones. Soon, iPads might be able to show a home movie of what a baby looked like before it was even created, by beaming live-action movies of your sperm swimming around.

That will be the case if Taiwanese startup Aidmics has its way.

The company has already invented a device called iSperm which according to Reuters has been sold to almost 200 farmers around the world. They use it to analyze the sperm counts of their boar to maximize the success of breeding programs. The news agency reports that Aidmics has announced plans to seek approval from the US Food and Drug Administration next year to expand the device’s use to men.

“Morphological assessment of sperm head and tail has never been this easy,” says the iSperm website.

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India must regulate its booming surrogacy business and stop women being exploited as just a ‘womb for hire’

South China Morning Post, July 13, 2015 by Amrit Dhillon

Surrogate mothers in India are a sad lot, their lives wrapped in layers of exploitation. At the bottom of the social heap, poor and uneducated, they spend their days in drudgery either in an urban slum or a rural shack.

Poverty has forced these women to “willingly” rent their wombs to rich Indian and foreign couples. In practice, this often means that when the surrogacy contracts are being signed, they give their uninformed consent to all manner of procedures without understanding a word of what is written.

If this wasn’t bad enough, the findings of a new study on Delhi’s fertility clinics – by researchers at two Indian universities, University of Delhi and Jawaharlal Nehru University, and Aarhus University in Denmark – show that their situation is even worse, with doctors doing their utmost to please the commissioning couples, often at the risk of harm to the mother.

The study found that some doctors implant several embryos in the womb – sometimes up to five or six – to ensure a higher success rate even though medical guidelines say that transferring more than three embryos can pose a serious health risk to the mother. “In a majority of clinics, doctors alone made the decisions about the number of embryos to transfer. Some of them involved the commissioning parents but few involved the mothers,” one of the researchers said.

What is unconscionable is how the Indian government has let this billion-dollar industry continue for so long with little or no regulation.

As cases of exploitation began being reported, the government came out with the draft Assisted Reproductive Technologies bill in 2010. It provides surrogates with a range of safeguards and also lays down regulations for the thousands of fertility clinics in the country.

But, for five years, the bill has been in limbo as lawmakers are apparently too busy to discuss it.

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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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The 2015 MHB Brussels conference on Parenting Options for European Gay Men – highlights

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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.

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Expensive, Exhausting, And Deeply Unsexy: Babymaking While Queer

April 21, 2015 by Lindsay King-Miller at Buzzed.com

My partner Charlie and I had been married for a little over a year when we decided to start trying to have a baby in August 2013. Despite being the butch in our relationship and using male pronouns, Charlie knew from the start that he wanted be the gestational parent. He’s always had a fascination with pregnancy and birth — a fascination that once led him to briefly pursue a midwifery apprenticeship — and he was excited to experience all the highs and lows of carrying a child. I, on the other hand, dread physical pain, and was overjoyed by the prospect of becoming a parent without going through pregnancy.

Charlie’s cycle operates with clocklike precision, so we figured it would be easy enough to identify the opportune moment. We started by trying to conceive at home — all you need is a syringe and a clean jar. We painted our guest room in pastels, recruited a dude we know and love to donate sperm, and got underway.

Unfortunately, the magic I’d anticipated was pretty much gone the first time I went for a walk around the block so that our friend could jerk off in our bathroom. After that, we decided that it would be less awkward if he made his donation at his own home, then dropped by with the jar — sperm can live outside the body for several hours, especially if they’re kept warm — but calling and saying, “Charlie’s ovulating, can you come over?” wasn’t very romantic either. We had to skip insemination one month because our donor couldn’t escape his roommates, who didn’t know about our conception attempts, for the requisite five minutes. Also unforeseen was the discomfort of making small talk every time he dropped off his jar, camouflaged in a paper bag — no one really wants to chat about how work is going at such a moment, but without a little conversation the whole thing felt too transactional. “Thank you for your genetic material, Unit B. Your service is no longer required.”

And there was a squick factor that neither Charlie nor I anticipated. We were competent, sex-positive adults who wanted to have a baby — surely we could handle a jar with a little semen in it! Turns out that other people’s bodily fluids are disconcerting, no matter how chill and mature you promise yourself you’ll be about the whole thing. I’m sorry to contribute to the body-shaming and negativity that pervades our culture, but let’s be real: A jar of sperm is super gross. Every month, Charlie would calmly draw up the sperm into the syringe while I shrieked and covered my eyes as though it was the gory scene in a horror movie (no, that’s not true — movie gore bothers me way less).

The insemination wasn’t much better. We had originally looked forward to this part — the two of us alone in our room, sharing the beautiful, intimate moment of creating our future child. Inseminating just before or even during sex is supposed to up your odds of success, which we figured was a bonus. We’d read about it online and it seemed easy, straightforward, and even fun. But it was almost impossible to get into the moment, since we were pressed for time (sperm were dying by the second!) and limited by the necessity that Charlie stay lying on his back with a pillow under his hips. I tried to help with the syringe, but couldn’t find a comfortable angle, so Charlie had to take over.

Nothing kills a mood like a syringe.

(Originally Posted Marrh 19, 2015)

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