The Infertility Consultant

The roots of commercial surrogacy in the United States began in the late 1970’s when a Michigan lawyer began the first surrogacy agency and set out to change the laws to make surrogacy legal. Now, surrogacy is legal in all but a handful of states, even though the specific laws vary from state to state. 

So it comes as no surprise that the United States has become the preferred country for surrogacy among international prospective parents.  Some of the primary reasons I am seeing from some of my international clients are as follows:

• Many European countries restrict couples from being able to explore surrogacy
• European countries often restrict the number of embryos that can be created
   – Doesn’t allow for opportunity to create future genetic siblings
   – Doesn’t provide a back-up plan if the first IVF attempt is not successful
   – With the cost of IVF being so high, multiple attempts at continued retrievals may exceed financial reserves
   – Frozen embryo transfers can often defray some of these costs
• In some countries, like Israel, surrogacy is restricted to married heterosexual couples. So gay couples are coming into the U.S. for help in having biological children of their own.”
• Advanced technologies are superior in US
• Economic recession has some U.S.-based clinics offering money back guarantees in the event a successful pregnancy is not achieved
• Favorable exchange rates have made it attractive in this economy to explore services in the U.S.
• Some programs are offering comprehensive packages to help international clients locate resources for their surrogacy arrangements in house
   – Streamlines the process with coordination all in one place
   – Identifies insurance protections and policies to mitigate financial risk factors during pregnancy or in the unlikely event of a catastrophe
   – Interpreters available well versed in medical and legal diction
   – Work closely with immigration attorneys to accomplish the necessary paperwork for visas, passports, birth certificates and social security status.

I am proud to announce that Lotus Blossom Consulting has officially established the Jude Andrew Adams Charitable Fund to bring hope and new life to families who are struggling to conceive. My motivation and intention in creating this grant is to offer a free fertility treatment for those who could not otherwise afford it.  To learn more about this fund and how it came to fruition, please click here.

Applications for a free treatment cycle are now being accepted.  The board of directors will select from applicants who meet the following criteria:

• Have a history of infertility, and provide a physician documented medical indication for exploring IVF treatment along with the application.
• Demonstrate a financial need; defined as a gross combined annual income less than $80,000. A copy of the last two years’ IRS tax returns and two of the most recent pay stubs is required.
• No insurance coverage for infertility treatments.
• Do not currently have any children.
• Be under age 40.
• Be current legal citizens of the United States and living in the United States at the time of the award and subsequent treatment.

 The grant covers the following costs:
• Cost of treatment for one IVF cycle
• Medications for one treatment cycle

Thank you all for your help and support for this great cause.

Earlier this week, President Obama officially declared the month of June to be Lesbian, Gay, Bisexual and Transgender (LGBT) Pride Month!  As the nation celebrates this occasion, it is a good time to bring an important issue to the forefront  – alternative family building.  As noted in a past USA Today article, there is an estimated six to 12 million children in the U.S. who have a lesbian or gay parent.  And an increasing number of same-sex couples are looking to expand their families. 

Unfortunately, there are even more obstacles for gay couples when trying to start their own families due to the political and legal issues involved.  It is important to financially, physically and emotionally prepare for a challenging road ahead.  Gay couples also must enlist an attorney to draw up contracts that protect not only themselves, but also their biological offspring.  Often adoption or co-parenting agreements need to be accomplished.

Cost is another factor to consider.  Insurance benefits for surrogacy and/or IVF treatments are often restricted since same sex couples do not meet the insurance’s companies definition of “infertility.”  And sadly, discrimination is widespread.  Same sex families are denied the benefits and protections of a marriage in most states.

For Citywide PRIDE month in Chicago, I have teamed with UBS and PricewaterhouseCoopers to help gay and lesbian couples plan and prepare for parenthood.  I will be leading a FREE session titled, “Conceivable Options:  Alternative Family Building ”  Details are as follows:

Date: Thursday June 18, 2009
Time: 11:30am - 1:30pm. Lunch will be served.
Location: UBS Tower, 38th Floor, 1 North Wacker Drive, Chicago

RSVP: By June 15, 2009.  Click here. 

Topics will include understanding insurance benefits (if available), how to enlist your human resources department to determine what benefits they may be able to provide and how to identify egg donors and surrogates from “surrogate friendly” states.  The discussion will conclude with tips for how to financially plan and prepare for treatment, and a Q&A session. 

Please try to join me!  If you’re not in the Chicago area, e-mail me.  I am happy to share my presentation notes with you, or discuss options over the telephone. 

One decision that is often overlooked in donor facilitated arrangements is the determination to disclose to future offspring their genetic origins. In the past this was always done anonymously and the secrecy continued over the course of a lifetime. However, recent studies on sharing genetic origins with offspring have proved that disclosure of genetic origin at a young age is healthy in maintaining a strong relationship and bond for all involved parties.

The three main factors that play into disclosure are does the child have an inherent right or need to know biological origins, and what is in their best interests? How disclosure impacts the recipient parents? And finally, when to disclose the information to offspring?

The best interests of child can be argued from both sides, a growing number of mental health professionals agree that a child has a fundamental right to know his biological origins. No one can predict if this medical information may be necessary in the event of a medical emergency or how access to this information may help an individual when he/she is ready to start their own family. It can be argued that this information is fundamental to an individual’s sense of self and personal identity. These values need to be analyzed on an individual basis consistent with thoughts and beliefs of that particular family unit. Maintaining secrecy can be difficult, especially family secrets. If discovered, by accident, the risks of impacting the relationships and family bonds could be jeopardized.

In a study performed by Lycett et al., (2004) the impact of disclosure was analyzed on families willing to share this information with their offspring. Out of 46 donor created offspring, 60% of the families had elected not to disclose genetic origins and the remaining 40% planned to disclose the child’s origins once the child reached adolescence. What was most interesting about this study is that between the two groups there were no differences between the disclosing and non-disclosing fathers. It was the non-disclosing mothers who reported a strain with keeping the secret. Thus, indicating that non disclosure impacts mothers more intensely than it impacts fathers. Many mothers fear the reaction from the child, and are concerned about placing a strain on the parent child bond. The study highlighted that these parental attitudes may in fact impact the parent-child bond as the children get older.

In contrast, a study performed by Van Berkel et al., (2007) in the Netherlands, where non-anonymous donation is standard and the only option available, investigated secrecy in open donation arrangements. Of the participants, the vast majority felt that origins of conception had no influence on their relationship with the child. The mothers did, however, show a greater level of concern about the disclosure plans and how the children would react to the information. Thus emphasizing the fear factor expressed by mothers is in the previous study. However when comparing being required to use open donation vs. anonymous donation, all mothers agreed that the genetic origin did not impact their familial relationships and or bonds with their children. The vast majority of the cases studied in the Netherlands, showed the children regarded the donor as an aunt or special family friend.

Disclosure is not something that occurs one time. Disclosure is a story that evolves over time and through a series of opportunities for parents to come to terms with their decision and to share with offspring the need to use donor gametes as well as the emotional decision that led them to this path. Disclosure involves the need to share that the importance of family and the need to become a family unit. The decision to disclose genetic origin greatly varies from family to family and is often impacted by the specific family unit, their structure and makeup, their religious, social and cultural values.

Finding the perfect stranger is hard work physically, emotionally and often spiritually. But in addition to identifying the perfect candidate, making the decision to disclose the biological connection involves a host of various feelings, emotions and considerations that may influence the type of donor you choose. When considering using a donor, it is important to consider how and if you plan to disclose to your offspring. The type of donor you choose may affect if, but also how and when you choose to disclose to your child their origin of conception since the donor you choose may play into the roles and relationships among parents, children and extended family.

Finally, it is essential to know when to make the decision to disclose genetic origins to offspring. Although there is no one right answer, recent data shows that sharing genetic origins with children at a young age is much preferred to divulging the information in adolescence. A recent study performed by Cambridge University researchers has found that disclosure of donor paternity at an early age lowers the likelihood of negative reactions from the offspring. The study findings published in the recent issue of Human Reproduction provides different perspectives regarding the response of the offspring depending on the age at which their biological origin is disclosed. Traditionally, donor conception has been treated with secrecy. A recent increasing trend towards openness of genetic origin has showed positive impact on children of all ages. In fact, most mental health professionals specializing in collaborative reproduction, encourage parental openness to reveal genetic origins to children as young as three years old. This trend can further be evidenced by the growing number of children books written about donor conception and geared for children between the ages of three and eight years of age.

Vasanti Jadva, from the Faculty of Social and Political Sciences, Centre for Family Research, University of Cambridge, UK, and colleagues, conducted a study which evaluated the difference in responses of children and adults, when informed about their genetic origin. The scientists analyzed the data obtained from anonymously completed online questionnaires by 165 members aged between 13 and 61 years, of the Donor Sibling Registry (a worldwide registry for donors).
The study results showed that, compared to offspring of heterosexual couples, children born to lesbian couples and single mothers received information about their donor conception at an earlier age. It was also noted that the mean age of disclosure was 14 years, with 19% of the offspring knowing about their paternity after the age of 18 years and 30% before three years of age. The study also showed that 38% of the offspring did not recall the exact age of disclosure since they were too young to remember.

Yet another study on donor conception conducted by Golombok et al. (1995), showed no adverse effects on child development or on familial relationships were evidenced when children were made aware of genetic origins at a young age. Yet, a higher incidence of negative feelings was reported among individuals who received information about their origin in adulthood compared to those who were informed about their genetic origin during childhood or adolescence.

In my years of experience working with hundreds of intended parent(s) who have conceived through donor gamete, I have found that many want to share openly with their children, but just don’t know where to begin. Disclosure can be uncomfortable primarily because it was not the pathway to parenthood of choice. I encourage my clients to focus on how fortunate they are to have access to advanced technologies and fertility treatments as well as a special donor who so generously and willingly gave of his/herself to share the essential piece necessary to conceive. This small shift in conjunction with a decisive disclosure plan and the knowledge that the psychological well being of the child and the family bond will not be severed, has enabled so many of my clients to come to the realization, “I am so fortunate today, to have my most wanted child, and so fortunate back then, to have the perfect stranger.”

When it comes to battling infertility and financing the goal, the decision making can be overwhelming.  But at the end of the journey when you have reached your pot of gold, the passage over the rainbow is merely an inconvenience.  I know because 14 years ago, I was struggling with ways in which to build my family, finance treatment and plan effectively for the future.  I did not know what questions to ask, where to identify resources, how to seek answers or how to find resolution.  This very personal battle is exactly what led me to starting my company Lotus Blossom Consulting and building an all encompassing multi disciplinary team approach to family building especially for those who are entering the field of Assisted Reproductive Technology also known as ART.

ART is powerful because with no guarantees for success, it can dramatically change and affect one’s life.  The process can be challenging, sometimes scary, often compelling and always emotional.  But ART does not have to be overwhelming.  Individuals embarking on the fertility journey should know that there are resources available to help them effectively build the foundation for their individualized treatment.  In my experience, building the foundation means showing clients how to set parameters and established boundaries for treatment in conjunction with available financial reserves prior to beginning treatment have saved valuable time, preserved emotional well being and have effectively optimized the resources for their treatment cycle while minimizing the financial expenditure for the ideal end family building goal. 

Infertility affects about 7.3 million couples today, this is roughly about 12% of the current population at reproductive age.  This staggering statistic is comprised of 40% women 40% male factor and the 20% remaining unexplained.  The majors factors have caused infertility to be on the rise are:
•  delayed child bearing – today fertility begins to decrease at 27 years of age
•  medical conditions
•  sexually transmitted diseases
•  environmental factors
•  Obesity

Treatment options include:
• Donor Egg is IVF using an egg retrieved from an anonymous or known donor between the ages of 21 and 32.  One of the reasons egg donation is so popular is because it allows a woman to gestate a pregnancy that otherwise she would not have been able to achieve.  One negative aspect of egg donation is that biologically, the intended mother is not the biological mother. 
• Embryo donation:  It is donating embryos that have previously been created and cryopreserved. There are basically two sources for obtaining embryos for embryo donation. The main source is infertile couples who have completed their families through  IVF treatment and have spare embryos frozen. They donate their spare embryos because they want to help other infertile couples for whom they feel great empathy. A second source of obtaining embryos is by engaging separate egg donation and sperm donation, which are then mixed and fertilized.
• Egg banking is a relatively new technology available to women up to 38 years of age.  Eggs are removed from the ovaries and frozen for use at a later time.  A few advantages… single women can prolong finding Prince Charming and may avoid having to use an anonymous sperm donor when they are ready to fertilize the eggs.  Another advantage of egg banking is that eggs can be thawed in the future, fertilized with sperm of choice and then refrozen as embryos.  So this fast growing and very new technology offers more choices and much more flexibility with options for the future. 
• Surrogacy is an opportunity for those with severe medical conditions and or uterine complications to grow their families.   Surrogacy comes in two forms, traditional and gestational.  Traditional surrogacy, the woman is the biological mother and the birth mother of the child.  Gestational surrogacy, the embryo is unrelated to the surrogate and may be the biological embryo of the intended parents or an embryo created by donor gametes. 
• Frozen Eggs:  with the new technology of egg freezing there is also a new alternative to access… egg banks.  Banks of frozen donor created eggs help eliminate having to coordinate donor schedules and cycles with your treatment.  This is often helpful to working women who need an egg donor but also have difficult schedules to juggle.  Frozen eggs eliminate the need to coordinate a cycle with a donor.  Also there are cost incentives to explore frozen egg banks over a fresh donor egg cycle.  With success rates being near identical to fresh donor eggs cycles, egg banks are becoming a very popular option for many.
• Sperm donation:  Accessing sperm banks is a much easier process than identifying an egg donor.  This can be done on line.  Sperm is shipped frozen direct to your doctors office or direct to your home, for insemination purposes or for use with IVF. 

Lotus Blossom Consulting was born because of my own personal experience and the incredibly steep learning curve that I had to accomplish in order to find my way.  Today I can look back and say that my journey was merely an inconvenience because I did achieve my end family building goal.  But going through the arduous process was no inconvenience.  Learning to be your own best advocate is the most important message I can relay.

CHICAGO, Nov. 6 /PRNewswire/ — Lotus Blossom Consulting, LLC, a Chicago-based infertility consultancy with clients around the world,announces the availability of their free E-Book, Financing Your Infertility Treatment, available on their website at www.lotusblossomconsulting.com. The E-Book addresses the financial aspects of infertility, and it will be available beginning with National Infertility Awareness Week, November 4 - 10, 2007, and beyond.

According to the American Society for Reproductive Medicine, most infertility cases — 85% to 90% — are treated with conventional medical therapies such as medication or surgery. Yet, infertility treatment can be costly, success rates are not guaranteed, and insurance benefits may be limited.

“Beyond simply the medical issues, there are so many factors to consider when dealing with infertility,” says Mindy Berkson, co-founder  Blossom Consulting. “Proper financial planning and utilization of insurance benefits in the right order can help you effectively minimize costs, maximize insurance benefits, and save significant out of pocket expenditures. Lotus Blossom’s E-Book can help.”

The E-Book, Financing Your Infertility Treatment, provides an overview of financing options available, with particular emphasis placed on individualized tax situations, specific insurance benefits, and the total financial resources available before undergoing the infertility journey.For more information on the E-Book, contact Lotus Blossom Consulting tollfree at (877) 881-2685, email consultant@lotusblossomconsulting.com or visit them on the web at www.lotusblossomconsulting.com.

ABOUT LOTUS BLOSSOM CONSULTING, LLCAs one of the first infertility consultancies in the United States,Lotus Blossom Consulting, LLC was founded by Mindy Berkson in 2005 after her own personal battle with secondary infertility. With extensive experience in all aspects of infertility, from egg donors and surrogates to in-vitro fertilization, Lotus Blossom Consulting works with individuals on a case-by-case basis, taking into consideration clients’ emotional,physical and financial infertility issues then develops an individualized,comprehensive plan, including relevant insurance information, to help clients make informed decisions. Lotus Blossom Consulting has worked with many individuals to enrich their lives by helping them to fulfill their dreams of having children.

For more information about Lotus Blossom Consulting, LLC, call tollfree (877) 881- 2685, email consultant@lotusblossomconsulting.com or visitthem on the web at www.lotusblossomconsulting.com.

I am so honored to have the opportunity to sponsor a very special film entitled In The Family at the Women’s Resource Fair in Evanston Illinois. This very powerful and moving documentary eloquently displays and affords so many BRCA gene victims with education and information on a topic that is all too often stigmatized and avoided because it is too painful to discuss.

I believe the quote “…information really is a blessing. It’s a source of power.” perfectly depicts your relevant take away message.

I work every day with clients nationwide in your situation. Women who are facing the fear of the unknown, and or the inherent actuality of not being able to deal with the outcome of test results, or worst yet the reality of what options may exist, if any.

These are beautiful women in the prime of their reproductive years who need to know how best to maximize their chances of success while simultaneously increasing their opportunities for biological family building.

It pains me to see women so secretive, ashamed and feeling isolated and alone in this difficult decision making process.

It is my hope that In The Family delivers very powerful and important message to help women become their own best advocates as it relates to their health. Advocacy must start with education, awareness, information, and resources necessary to allow each one of us to make informed medical decisions.

In my experience, part of the decision making process that needs to be incorporated when dealing with test results or deciding whether or not to undergo testing is often influenced by the desire and innate need to have biological offspring. Perhaps if women knew and understood the available options today in the very advanced and technologically savvy world of in-vitro fertilization, the difficult decisions that have to be made, could be lessened by the increase in reproductive opportunities available today for the future.

The newest technology to enter the infertility arena is Egg Banking. This technique allows women to freeze their own biological eggs for use in the future. Egg banking is available to women up to 38 years of age. It is a wonderful new option for those who have put off child bearing for careers, for finding the right partner, and also for those who may have suffered medical diagnosis that could compromise future fertility.

Freezing eggs allows women to avoid having to use an anonymous sperm donor until they are ready to fertilize the eggs, at which time they may have identified a known sperm donor. Another advantage of egg banking is that eggs can be thawed in the future, fertilized with sperm of choice and then refrozen as embryos for future in vitro fertilization treatment cycles. This fast growing and very new technology offers more choices and much more flexibility with fertility treatment options for the future.

If you are interested in more details, I will be sharing in detail this option as well as many others on Saturday March 21st at 3:15 in my presentation entitled Conceivable Options: Exploring Fertility Choices. The Unitarian Church 1330 Ridge Avenue, Evanston, Illinois.

We understand that sometimes the pathway to parenthood is not linear. As frustrating as this is, reality requires us to make difficult choices and explore paths that we never imagined. Coming to terms with using a third party candidate can be a complicated and overwhelming process. In my experience, when clients can reach a comfort zone in selecting a candidate who meets close to their ideal criteria, the process becomes much more palatable.

So where does one begin the search? Some clinics provide in house egg donor recruiting programs. These programs tend to be small and often consist of only local donors. Due to their size, supply does not often meet demand and wait lists to select a candidate tend to be long. The agency route is another avenue. Agencies often have larger pools of available candidates, but weeding through profiles to identify ideal candidates can be time consuming and overwhelming.

Explore your resources. As an Infertility Consultant my focus is to advocate for the intended parents. Through carefully established strategic alliances with agencies nationwide, the consultants at Lotus Blossom Consulting have access to vast pools of qualified and available surrogate and egg donor candidates. Our match time is typically less than two weeks. We deliver to your email box targeted profiles to specifically meet your ideal criteria. There is no limit to the number of profiles you will have to choose from. The goal is to identify a candidate that appropriately suits your needs. But in addition, Lotus Blossom Consulting closely screens the agencies. We drive business only to agencies that are willing to include special clauses in their contracts for our client, which ensures that your financial risk factors will be mitigated in the event that a candidate does not pass your physician’s medical screening. This is one of our commitments to you in working as your advocate.

With our help, the complicated process becomes less overwhelming. Our very personalized touch and direct guidance in what to seek in an ideal candidate enables clients to focus their energies and emotions on other aspects of the cycle. Having the confidence to move through third party reproduction comes with knowing that you selected the right candidate, within a timeframe that is consistent with your course of treatment, and a budget that suits your financial reserves.

The journey through infertility need not be a fearful or overwhelming adventure. Identifying support, resources and guidance can save valuable time, preserve emotional well being and help to optimize the resources for your treatment cycle while minimizing the overall financial expenditure for the end family building goal. Being proactive in building the foundation for multiple cycles is simply acting prudent.