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Path To Fertility Blogger Lisa Rosenthal  

Lisa Rosenthal has over twenty-five years of experience in the fertility field, including her current roles as Coordinator of Professional and Patient Communications for RMACT and teacher and founder of Fertile Yoga, a class designed to support, comfort and enhance men and women's sense of self. Her experience also includes working with RESOLVE: The National Infertility Association and The American Fertility Association, where she was Educational Coordinator, Conference Director and Assistant Executive Director

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Sperm Bank Mix Up and There's a Beautiful Baby Involved

  
  
  

The Sperm Bank Mix Up

spermI was having a lovely day. Really, I was. Productive, busy, interesting, fun. Great meeting at work with co-workers that I respect and of whom I am fond. Great Fertile Yoga and Prenatal Yoga class. All around good, busy day.

 

Then I started to hear whispers. Something about a sperm bank mix up. Something about a baby being different in a way that they were not prepared for by their parent. Immediately, faces popped into my mind. Patients, especially our single moms to be (SMTB), who are currently making important choices about donor sperm and donor sperm banks. Choices that were hard to settle into, that required a lot of thought and then a small leap of faith. Following closely behind those beautiful women came the faces of our RMACT third party reproduction team. Consternation was likely the emotion felt as the damage control that needs to be done has suddenly increased their already heavy work day. Damage control because of course there are going to be more questions, more levels of questions and a much higher level of anxiety than there was three days ago.

 

I have read very little about this so far. Seen a few pictures. Heard a few fairly hysterical headlines and accusations. I’m sure it’s going to get very ugly, very fast. I’m sure it will be polarizing and that each side will feel and know that the other point of view is just plain wrong.

 

The blame game will be in full force, I suspect, by later today.

 

I have to say, I just hate this. I so very rarely use that word. It feels ugly and harsh in my mouth and it looks the same way when I write it.

 

Still, I hate this.

 

Here’s why.

 

First and foremost, there is a beautiful baby out there, getting lots and lots and lots of attention that she never needed, wanted, or asked for. It’s not the kind of attention that any baby needs. It’s not nurturing or loving or delighted.

 

Please understand I am not blaming the parent or parents here. The second reason that I hate this is because regardless of how they feel about their baby (I hope so much that they love her), they probably feel betrayed. They were promised one thing and they were let down. They put their hopes and dreams into a little basket and handed it over, with a bunch of money, and thought they would receive what they paid for; that’s a reasonable expectation. It really is. It’s a reasonable expectation to have a legal and financial agreement that is upheld responsibly. So, please, let’s not blame the parent and start throwing mud about whether they love their baby or not. That’s not really the point.

 

I’m not blaming the sperm agency. Yet. The horrible fact is that no matter how incredibly good, how protected, how safe any protocol  is, there is rarely 100% success. In other words, mistakes are made in most places of business, even if extraordinarily rarely. Notice the use of words please. Incredibly and extraordinarily. To put this in perspective, we would need to know how many vials of donor sperm are sold and used in the USA. And I looked, very carefully for that information. I tried numerous different searches, including the CDC (Centers for Disease Control and Prevention), ASRM (American Society for Reproductive Medicine) and SART (Society for Assisted Reproductive Technology), and I couldn’t find it. So I can’t actually tell you that this only happens 10% of the time. Or 1% of the time. Or even .00% of the time.

About the Disclosure of Medical Errors

I did find this interesting link, titled “Disclosure of medical errors involving gametes and embryos, which is quite interesting and which is written by the Ethics Committee of the ASRM, (our own Andrea Braverman, PhD, was one of the authors). ASRM’s mission statement is, “ASRM is a multidisciplinary organization dedicated to the advancement of the science and practice of reproductive medicine. The Society accomplishes its mission through the pursuit of excellence in education and research and through advocacy on behalf of patients, physicians, and affiliated health care providers. The Society is committed to facilitating and sponsoring educational activities for the lay public and continuing medical education activities for professionals who are engaged in the practice of and research in reproductive medicine.”

 

At the very least, this paper, among many others helped me simmer down and reminded me that this is a medical field that looks at things very seriously. Reproductive medicine has two major groups that help regulate standards of practice, ASRM and SART. SART’s mission statement, “SART is the primary organization of professionals dedicated to the practice of assisted reproductive technologies (ART) in the United States. ART includes the practice of In Vitro Fertilization (IVF). The mission of our organization is to set up and help maintain the standards for ART in an effort to better serve our members and our patients.”

 

This is an arm of medicine that takes its responsibilities about standard of care very seriously. Thank goodness.

 

Donor Sperm - What Are the Risks?

 

OK, back on track here. No matter how infrequently, how micro-tiny that possibility of donor sperm mix up or other failure is, we don’t want it to happen. We don’t want it to happen to our friends, family, our colleagues, ourselves. We don’t want it to happen, ever.

 

We hate when it happens. It brings up all of our fears that next time? It will happen to us. Of course it brings up those fears. It is a frequently asked question from most people who are looking to become pregnant via sperm donation, even without this issue in the media.  “How do I know that the sperm I am purchasing is what I am being told it is?”

 

Of course this brings up our fear. And our outrage. And out comes the blame game.

 

Blame someone. Anyone. Everyone.

 

That will ensure that it never happens again.

 

Uh. No, it actually won’t. Unfortunately, not.

 

So while you’re reading about all this today and trying not to freak out that this could happen to you, please know how incredibly small the chances are that it would or could. I promise that I will have some actual numbers for you by Monday morning.

 

Meanwhile, to all involved and all those who feel the need to comment, please just have some compassion. Please try to avoid playing the blame game.

 

There is a beautiful baby out there who has no reason to be dragged into that kind of ugliness. If for nothing else, let’s keep the ugliness to a minimum please.

 

 

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Infertility, Egg Donation and You?

  
  
  

Wednesday Text
You may read and hear about egg donation and wonder what it is and who it's for. Here's a place to start to get some answers.

Human egg donation has played a successful role in assisted reproduction in the United States since the early 1980s. From their inception, egg donation programs like the one at
Reproductive Medicine Associates of Connecticut have brought together two groups of women to achieve a successful pregnancy: egg recipients (those who receive eggs) and egg donors (those who donate their eggs).

Egg Recipients

Egg recipients are women who want to conceive, carry and give birth to a child but are unable to do so because of an unresolved medical issue. There are several reasons why this may happen and why a woman may choose to become an egg (oocyte) recipient. Sometimes a woman is unable to conceive because she cannot produce healthy eggs. Other medical or physiological conditions that lead a woman to become an egg recipient include unsuccessful superovulation therapies, the early onset of natural menopause or surgically-induced menopause, premature ovarian failure and repetitive failures with in vitro fertilization (IVF). Women who carry certain genetic disorders may also want to consider being a donor egg recipient. In all these cases, the Donor Egg Recipient Program at RMACT can help recipients achieve their dream of giving birth to a healthy baby.

Recipients of donated eggs and their partners are screened and tested early on in the egg donation process and must meet certain requirements. Medical and psychological evaluations administered by RMACT to help us educate the recipient about the process and to determine whether egg donation is the best treatment option for them. Egg recipients and their partners are counseled about the donor screening process and the egg donation protocol, including synchronization of cycles and the IVF procedure. Psychological counseling is available to the couple on an ongoing basis throughout the process.

Egg Donors

Egg donors are women who want to help other women become mothers by providing half the genetic material needed – their eggs. These women could be called generous or altruistic, but at RMACT we call them “Dreammakers” because they help make another woman’s dream of experiencing pregnancy and the birth of a healthy baby come true.

There are two basic types of egg donors – identified and anonymous – and both are available at RMACT. Identified egg donation uses eggs from a donor who is known to the recipient; she may be a family member, friend, or an egg donor chosen specifically by the recipient through an outside agency. Anonymous egg donation uses eggs donated by a carefully-screened and recruited donor whose identity is not revealed to the recipient. Anonymous egg donors and donors chosen from outside agencies are compensated for their significant commitment of time and effort throughout the donation cycle.

Like egg recipients, egg donors must be screened prior to being accepted into our program. This process includes medical, genetic and psychological evaluations. Potential anonymous egg donors, who must be between the ages of 21 and 32, are screened according to guidelines recommended by the American Society for Reproductive Medicine (ASRM) and the United States Food and Drug Administration. We require similar screening of identified egg donors.

Egg donor candidates fill out a questionnaire reviewing their medical and family histories and social habits, all of which are subsequently reviewed by the Clinical Coordinator and the Medical Director to determine the donor’s suitability and ascertain potential risk for significant medical or genetic disorders. Potential donors also undergo various tests to assure good medical health, including a physical exam by one of our physicians or physician assistants, as well as laboratory and genetic testing.

The potential egg donor and her partner (if applicable) are then invited to meet with our team to learn why women need egg donors, the process used for egg donation, and the emotional, psychosocial, ethical and legal issues that pertain to egg donation. This counseling is important to evaluate the egg donor’s well-being and level of comfort with the unique stresses of being a donor.

Women interested in becoming donors can download a questionnaire from this website, email us, or call (203) 750-7410 Confidentiality

At RMACT, we take great care to preserve the confidentiality and anonymity (when required) of both the donor and the recipient. Both parties may remain anonymous, if desired, with each agreeing not to seek information about the other.

Infertility and the Cost of Egg Donation- Expert Amy Demma Speaks Out

  
  
  

I promised that we would continue the conversation about egg donation with some thoughts from experts in the field. When I say experts, I mean people that work with donors in some capacity or another, or who have donated or been donated to. Those with real life experiences, both in the professional and the personal arenas. I am saying this badly, let me try again. This blog, about egg donation, is for "experts" who have had more than theoretical experiences with egg donation.

We are lucky enough to start off with Amy Demma, Esq., who is an attorney based in Massachusetts. Amy is the founder of Prospective Families and is a recognized expert in third party reproduction.

Here is what she has to say about questions that I raised in the blog earlier this week. I have not edited or shortened her comments.

Next week we will hear from Evelina W. Sterling PhD, creator of "Fertility Plan" and a public health professional for over 15 years. We also will hear from Sharon LaMothe, who in addition to founding and owning Infertility Answers and LaMothe Services, was also a gestational carrier of twins, twice.

Each week we will hear from someone who has a passionate interest in egg donation. If you are one of those people, please post here and let me know what you would like to share.

"Thanks, Lisa for creating a forum for discussion on this important issue for all those involved in alternative family building, professionals, patients, past patients, perhaps, even donors certainly can benefit from a summit, of sorts, and perhaps this blog can, hopefully, inspire a virtual summit.

A theme that I see developing in the dialogue around egg donation is a distinction between wanting to keep fees reasonable such that this family building option remains available for all those in need (coupled with the "coercion"  argument...if we offer young women excessive compensation, are they more likely to consider and/or participate in egg donation) and making available to recipients a process by which they identify their ideal donor by offering a broad selection of desirable donor candidates. In recent discussions, these two matters were addressed almost as if they are and must be mutually exclusive. I don't agree. I can share that most of the clients I work with, despite that many Massachusetts residents have insurance coverage, simply do not present with budgets allowing for a $25,000.00 donor but may have equally as strong an interest in a donor with impressive academics, e.g.

One of the most compelling reasons for patients to go outside of their clinic's in-house pool for donor selection (if the clinic has such a program) is that agencies, generally, offer more information about each donor candidate. Most clinics offer limited information and, typically, at best, baby photos. Agencies offer 20-30+ pages of donor information and can usually accommodate parents with both child and adult photos and usually as many such photos as the recipient requests. Philosophy aside, the market tells us, by virtue of the number of agencies in operation across the country and the number of agencies each recipient may access in a donor search is that variety and selection amongst donor candidates is in demand.

Recently, those supporting the "free-market" discussion as justification for the higher-comped donors i.e. "the market can and should determine the terms between the parties" defend  the option of paying higher comps for more attractive (not only in terms of physicality) donors by reminding us that partners are likely pick each-other (presumably with the intention to procreate) and that recipients of sperm donation have historically selected donors based on height, hair color, eye color, academic status...and all of this is true.

What I struggle with is why truly committing to a donor compensation cap (addressing both the affordability factor as well as the donor coercion concern) necessarily leads to limiting the selection or offering of diverse and impressive donor characteristics. I really do like that the larger institutional programs (at least those in the New York area) set a standard rate of compensation for all donors who cycle through their programs. If agencies (and I know of one NY agency that comps all donors registered with them at 10k) would consider either a set-comp or capping the comp range at an agreed upon industry standard (and for now the best such industry standard is the ASRM cap), we take out of the equation the subjective determination that an Ivy-League donor is "worth more" than a donor matriculating at a school of less prestige. If setting a reasonable ceiling on donor comps results in fewer models or fewer Harvard donors, then were those women who dropped out because of capped comps ever truly appropriate for the process?

I have not heard anyone expressing concern at the $25,000.00 donor suggest that donor identification based on preferred or ideal characteristics be discouraged or be deemed a bad thing. The mental health community reminds us that donor selection according to preferred or desired attributes is both valid and acceptable.

So, for this post, I am hoping not to muddy the waters with further discussion about donor selection based on how blonde or blue-eyed or tall or academically accomplished a donor may be. Frankly, in my experience, blonde-enough, tall-enough and or accomplished enough is a very subjective matter, any way.

I do, however, feel very strongly that by marketing to recipients that she/he/they should do business with an agency because that agency offers "Hot and Smart" donors  does imply, I am sorry to say, that prettier donors or smarter donors are better donors, i.e. more likely to make a baby. This, I feel, is tremendously unfair to both the consumer as well as to every donor of average physicality and/or average academic credentials but with reliable fertility.

Can we envision self-regulating practices around donor recruitment (this year we saw several proposed state bills mandating that donor advertisements not highlight compensation but clearly define risks related to egg donation), donor compensation, donor tracking (how certain can we be, currently, that donors are maxing-out at 6 cycles?) and still offer to prospective parents a donor search experience that offers to them pools of donors who represent each and every recipient's ideal?

This is what I would like to talk about, how about you?"

Thanks Amy for continuing the conversation.
We would love to hear what you have to say.

 

 

 
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