Welcome to your February 2006 issue of Connections, The American Fertility Association’s monthly e-newsletter. In this issue, you’ll find:

1. Message from the Executive Director
2. Save the Date: Sunday, May 7, 2006 - Family Matters Annual Conference
3. Fertility Dream Races 2006
4. The Infertility Consultant’s Role in Donor/Surrogate Relationships
5. Why Choose International Adoption
6. Legal Loopholes Open Door for Adoption Abuse
7. Connections Online Educational Sessions

A Message from the Executive Director

Pamela Madsen

Dear Friend, The February 12 CBS 60 Minutes segment “A Surplus of Embryos” called national attention to a controversial question: who should decide what will happen to the frozen embryos stored at fertility clinics in the United States? While several points of view were offered in the piece, I was particularly troubled when Robert George, a professor at Princeton University and an adviser to President Bush’s Council on Bioethics, suggested that fertility patients should not be allowed to donate their embryos to scientific research – as my husband and I chose to do – or to thaw them without the intent to transfer. As the Executive Director and Founder of The American Fertility Association, I have a simple response to such hubris: We must not mandate or legislate what fertility patients can and cannot do with their embryos. It's the patient’s choice – a difficult and complicated one at that – and it is theirs alone to make. As former fertility patients, my husband and I never believed we would have any embryos, let alone a surplus. Our choice to donate to scientific research exemplifies and honors the difficult embryo disposition decisions that fertility patients must make every day. As a patient advocate, I am committed to ensuring that the patient voice is always prominent in any debate or story that has a direct impact on fertility patients and their families. Each year, thousands of women and men proceeding through IVF treatments must make complicated choices regarding the disposition of their surplus embryos following the conclusion of treatment. To date, there are approximately 400,000 embryos that are cryopreserved, or frozen, at infertility clinics around the country. While many couples or individuals certainly have plans to use these embryos to expand their families in the future, there are many who do not have such plans. Embryo donation to scientific research may provide a life-affirming way to resolve the issue of surplus embryos for many fertility patients, while others may choose to thaw their embryos without the intent to transfer. Regardless of the disposition option, what happens to these embryos is a personal decision that belongs to no one but the people who created them. The American Fertility Association strives to build awareness that embryo donation is a viable option, and to ensure prospective IVF patients, current IVF patients and past IVF patients, who have unused frozen embryos, all have the facts to help them make informed decisions. Our fact sheet, “The Frozen Embryo Dilemma: A Matter of Privacy, Responsibility and Choice” is available online at www.theAFA.org, under “Fertility” and “Third Party Reproduction.” It offers guidance to fertility patients and helps them anticipate some of the issues they may confront. In addition, it outlines the donation options that are available, including donation to other infertile patients, donation to scientific research, and thaw without intent to transfer. Since the 60 Minutes segment aired, The American Fertility Association has received numerous letters in support of the position that the patient remains the decision maker for embryo disposition. As a national fertility advocacy association, we will continue to advocate on behalf of all patients, allowing their voices to be heard loudly. Warm regards Pamela

Save the Date!

FAMILY MATTERS: THE FERTILITY AND ADOPTION CONFERENCE
Sunday, May 7, 2006, 7:00 am - 5:45 pm, The New York Grand Hyatt Hotel

Family Matters is largest annual U.S. fertility and adoption educational event, featuring over 45 workshops, 90 world-renowned speakers and over 60 exhibitors. Please click here for more information or to register.

REGISTER BEFORE MARCH 1, 2006 AND ENJOY A 15% DISCOUNT

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The American Fertility Association (AFA) presents

Building Families One Step at a Time

Fertility Dream races and walks are breaking new ground,
promoting health and a sense of unity within the fertility
community and among our supporters nationwide.

Join us in 2006 to build fertility awareness and raise funds for
research and advocacy. Join our cause and say:
“Together we can do what we cannot do alone”

Anyone can participate in Fertility Dream races and walks:
fitness enthusiasts, elite runners, and even those who have never
participated in a race before. The AFA will help find the pace that
is right for you.

The Fertility Dream ’06 Calendar
March 12 ~ Arizona
August 13 ~ Chicago
September 10 ~ Danbury
September 30 ~ Boston
December 18 ~ Los Angeles

For more information, call (888) 917-3777
or visit www.theAFA.org

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The Infertility Consultant’s Role in Donor/Surrogate Relationships
By Mindy Berkson, Co-Founder Lotus Blossom Consulting

Collaborative reproduction is a broad term used to define a relationship in which an individual or couple needs the help of a third party to assist in the conception of a child. This may involve an egg or sperm donor, or even a surrogate. Deciding to involve a third person in such an intimate process is a difficult enough decision, but with so many options, each with its own risks and benefits, it is difficult to know where or how to begin. It is essential to gather information and become educated in order to make an informed choice about how to proceed. An Infertility Consultant can be a useful member of your team, helping to develop a master plan for your infertility journey. The Infertility Consultant can help to alleviate confusion and disappointment by providing clear explanations, resources, and referrals. Additionally, optimizing financial planning strategies and setting forth realistic parameters for such an arrangement are essential elements with which an Infertility Consultant can assist.

Egg Donation
Egg donation raises both emotional and practical concerns which must be addressed. Once Intended Parent(s) become comfortable with the financial, legal and psychological aspects of using an egg donor, the egg donor cycle can run smoothly and effectively. Before entering into an egg donation arrangement, however, it is essential to thoroughly understand what is involved in this treatment option and the risks, benefits and alternatives. This requires education, patience, sustenance and reflection.

Education can best be accomplished through research and gaining an understanding of the many facets of such an arrangement. One must consider the medical, psychological, legal and financial conditions and how they apply to the individual circumstance. Patience can be achieved through recognizing, that although time consuming, the process will hopefully result in the ultimate goal – the birth of a healthy child. Sustenance requires emotional tolerance, physical energy and the financial means to pursue a particular treatment plan. Reflection is the heart and soul which affords a comfort level and acceptance of the help of a third party assisting in this intimate pursuit.

To achieve each of these goals Intended Parent(s) must answer a range of questions. The answer to one question often leads to even more questions. For example, is it best to use a known or anonymous donor? Why? Is there a need to have a familial genetic connection? Does using a family member or friend increase comfort with the donor’s reliability? Is it important to have ongoing knowledge of the donor’s health history? This may be the first step in the donor selection process.

Assuming an anonymous donor is preferred, a whole different set of questions must be addressed. Is it best to self recruit or employ an independent agency or use a program associated with your fertility center? Once again it is essential to thoroughly research available options to learn what best suits your needs. Intended Parent(s) must identify what they are looking for in a donor. Are physical characteristics and resemblance important? What about ethnicity or religious background? How does one identify an agency that is best suited to individual financial risk tolerance as well as meeting their donor “wish list”? How much information about the donor is provided by the agency? Is the donor information verified? Is it possible to meet the donor recruited by the agency? How does the agency maintain anonymity if desired? How does the agency recruit donors? Does the agency match clients based on criteria provided or do Intended Parent(s) select based on available donors? What happens if the donor cycle is cancelled for medical reasons, or if the donor terminates her commitment? What does the agency require of Intended Parent(s) – legal representation, non-refundable deposit, medical evaluation, etc.? What is the total cost?

The cost of an anonymous donation is an important consideration. Although the initial cost may seem prohibitive, the potential for additional cycles with frozen embryos may maximize this expense. Evaluating the cost/benefit is a necessary step before embarking on a collaborative reproductive arrangement such as egg donation.

Surrogacy
Surrogacy, like egg donation, has many challenges requiring careful reflection, commitment, patience and substantial financial resources. With clearly defined boundaries and expectations, the surrogacy arrangement can also be a very pleasant and beautiful experience. Clarifying expectations in surrogacy, as with egg donation, begins with self reflection. Consideration of individual emotions, financial constraints and medical needs must be well thought-out. Some of these issues can be flushed out in a legal contract between the surrogate and the Intended Parent(s). However, all of these issues should be considered well in advance of memorializing the party’s expectations in a legal agreement. Through the legal negotiations, the parties will determine what they can expect from one another throughout the process.

Locating a surrogate may take time and effort since supply of surrogates often does not meet the demand. Patience is necessary to establish the “appropriate” commitment where all parties set forth their mutual understanding. Like egg donation, Intended Parent(s) will need to consider whether to use an independent agency, a friend, or family member. Using a known surrogate can foster feelings of contentment and help to strengthen an ongoing relationship. However, it may also strain such a relationship. Decisions need to be made about the level of contact you choose to have with the surrogate throughout the process as well as after the birth of the child. If choosing to have an agency recruit a surrogate, it is important to be comfortable with the process of the agency. Interview several to obtain a feeling for how they recruit and screen potential candidates. What type of psychological screenings are provided and required? Is ongoing counseling available through the agency to both the surrogate and the Intended Parent(s)? Is counseling available for a time period after the birth of the child? Surrogacy requires substantial financial resources, therefore, be certain to provide for potential incidental expenses.

Other important factors to consider before entering into a surrogacy arrangement include having all involved parties, especially the surrogate’s partner, feel comfortable with the new relationship and its potential impact on the familial, social and professional relationships of all parties. Understanding the surrogate’s motivation can be helpful in defining the relationship. Expectations of all parties must be clearly outlined and identified. Issues such as multiple pregnancy, the surrogate’s willingness to undergo prenatal testing, the surrogate’s comfort with termination, and under what circumstances, the surrogate’s expectation for compensation and/or reimbursement, and the Intended Parent(s)’ ability to meet the surrogate’s financial needs and requirements. These topics must be considered to in order to come to a meaningful agreement. Since clear expectations will define the surrogacy commitment throughout the pregnancy and beyond, it is patience and effort well spent to clarify potential testing, risks and emotions prior to embarking on the surrogacy journey.

Conclusion
All collaborative reproductive arrangements involve uncertainty and risks. Becoming informed and knowing what to expect can make the entire process run more smoothly. An Infertility Consultant is one way to help streamline the process. An Infertility Consultant can analyze risks and benefits regarding the range of treatment options identified by your physician. This analysis can help to define parameters for treatment and the knowledge to know when to change the course of treatment. An Infertility Consultant can provide comprehensive information tailored to each individual situation, taking into account expectations, goals, emotional tolerance and financial means. As an independent, non-biased resource, the Infertility Consultant can provide the education and resources for medical, psychological, legal and financial aspects of each treatment option. Finally, the Infertility Consultant can refine and define the reflection necessary to identify a comfort level for a particular treatment option. This is a journey that Intended Parent(s) should not take alone. Assistance, coordination and support may be found with an experienced and qualified Infertility Consultant.

Mindy Berkson, Infertility Consultant, Lotus Blossom Consulting, LLC, consults clients nationwide with an integrated financial, emotional and multi-faceted decision making approach throughout the in vitro fertilization journey. She can be contacted at mindy@lotusblossomconsulting.com.

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• Do you believe that you are capable of loving an infant or a toddler as much as you could grow to love a newborn?
• Is the gender of your child of utmost importance to you?
• Are you worried or concerned about having relationship with your child’s biological parents?
• Are you fearful of post placement contact with your child’s biological parents?
• If you were to lose any of the monies you have set aside for an adoption, would that stop you from becoming parents?
• Do you enjoy international travel?

If you answer yes. to some or most of the preceding questions, then adopting internationally may be for you!

If you are considering starting or growing your family through adoption, you are going to be faced with numerous choices and decisions before moving forward. Only you can determine which route is right for you. Choosing between a domestic or an international adoption is probably the most difficult decision that prospective parents will be faced with (after making the decision to adopt in the first place, of course.)

It is commonplace and expected that persons considering adoption begin their exploration of the subject by conducting research via the Internet, attending adoption seminars and speaking with families that have been formed through adoption. It is not unusual for prospective parents to become baffled and confused by all of the information they are being assaulted with. Don’t despair! First, prioritize your needs and desires. Believe it or not, before too long, things will fall into place and make sense. You can take comfort in knowing that there is not one ‘best way’ for everyone.

International adoption can be a very fulfilling and satisfying way to start or grow your family, but it is virtually impossible to get a newborn outside of the United States. In most cases, it is difficult to adopt a child under a year old, but not everyone wants or needs a newborn in order to be happy and satisfied.

Many prospective adoptive parent(s) first begin to consider initiating the adoption process when they are already in their 40’s. In such cases, adopting a 2 or 3 year old child may lit your lifestyle more comfortably and appropriately than a newborn or infant.

If you are fearful or concerned about any ongoing relationship with birth parents, or post placement contact with birth parents and maintaining your anonymity then international adoption is an excellent choice. If, on the other hand, you feel that getting to know the biological parents of your child is important for you or your child, you will need to explore a domestic adoption. Ordinarily there are very strict privacy laws associated with international adoptions. You should not expect to meet, converse with, or have any social genetic background information about the birth mother or father in an international adoption.

Most reputable adoption professional will advise you that if your top priority is your child’s gender, then inter-country adoption is your best bet. Depending on the country you choose, you may be asked gender preference. Domestically, you can expect to be working with a pregnant woman, who may or may not know the sex of the child. And while we may be tempted to rely on a sonogram for gender identification, there are many stories where the birth mother and parents expected a girl and where surprised when a baby boy was born!

Financial risk may also be an important factor when making an adoption plan. Most international adoptions rarely involve much financial risk. In most instances the monies that are paid in for international adoption are not disbursed until after you have custody of your child. In a domestic adoption you may be helping your birth mother with pregnancy-related expenses prior to the birth. If your birth mother changes her mind about the adoption plan after the birth, you will have lost any money paid on her behalf.

Adopting a child from an orphanage or foster home outside the US may bring you different rewards and challenges than adopting a newborn domestically. Because the children are not newborns, and may have spent months in an orphanage or foster home, they may have a longer adjustment period to their new and permanent home and they may have delayed development issues (keep in mind that the vast majority of children of inter-country adoption catch up to their US-born peers very quickly).

Having a family and providing love and security to your family is a reward in and of itself. Children, no matter where the come from or how old they are when they join your family can bring tremendous joy and happiness to their parents.

Online Education Session Schedule—February – April 2006