Thursday, December 30, 2010
From the Wall Street Journal on international baby creation markets:
In a hospital room on the Greek island of Crete with views of a sapphire sea lapping at ancient fortress walls, a Bulgarian woman plans to deliver a baby whose biological mother is an anonymous European egg donor, whose father is Italian, and whose birth is being orchestrated from Los Angeles.
The birth mother is Katia Antonova, a surrogate. She emigrated to Greece from Bulgaria and is a waitress with a husband and three children of her own. She will use the money from her surrogacy to send at least one of her own children to university.
Mr. Rupak is a pioneer in a controversial field at the crossroads of reproductive technology and international adoption. Prospective parents put off by the rigor of traditional adoptions are bypassing that system by producing babies of their own—often using an egg donor from one country, a sperm donor from another, and a surrogate who will deliver in a third country to make what some industry participants call "a world baby."
They turn to PlanetHospital and a handful of other companies. "We take care of all aspects of the process, like a concierge service," says Mr. Rupak, a 41-year-old Canadian.
Clients tend to be people who want children but can't do it themselves: families suffering from infertility; gay male couples. They may also have trouble adopting because of age or other obstacles.
And they're price sensitive. PlanetHospital's services run from $32,000 to around $68,000, versus up to $200,000 for a U.S. surrogate.
Overseas surrogacy has other advantages. Surrogates in some poorer countries have little or no legal right to the baby. In Greece, a surrogate can be prosecuted for trying to keep a child. By contrast, some U.S. surrogates have tried to legally claim the children they've carried.
The process can bring profound dilemmas. In some cases, clinics end up creating more fetuses than a couple needs, forcing a decision over whether to abort one or more pregnancies. Babies carried to term occasionally find themselves temporarily unable to get a passport.
Mr. Rupak is learning to navigate the uncharted nature of his field—the stateless babies, the ethical complexities. His expansion to Greece, a European Union member nation, is specifically intended to lessen the likelihood of the passport problem for European parents-to-be.
Some of his own clients have faced the abortion decision, Mr. Rupak says. "Sometimes they find the money" to pay for more children than they expected, he says. After all, they went to such lengths. And if they decide otherwise, Mr. Rupak says, "We don't judge."
Critics say the business is strewn with pitfalls. "The potential for abuse on many levels is big," says Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania in Philadelphia, discussing the industry in general terms. "You're straddling all these [international] boundaries to buy the ingredients and the equipment." Mr. Caplan calls it the "wild, wild west of medicine."
Laws are vague and can conflict from country to country. In 2008, baby Manji was born to an Indian surrogate just weeks after the divorce of her Japanese parents-to-be. (The family wasn't a PlanetHospital client.) According to a Duke University case study in legal ethics, it led to a tangle of Indian and Japanese law that first prevented the little girl from being issued a birth certificate, and later made it difficult for her father bring her home to Japan. Months went by. To fix the problem, Japan issued a special humanitarian visa.
"This area of law is very unsettled," says Evgenia Terehova, PlanetHospital's lawyer. "There can be all sorts of unforeseen circumstances."
Read the full article here.
Friday, December 3, 2010
While age is key in a woman's odds of conceiving, whether naturally or via assisted reproduction, there is no consistent evidence that a man's age affects the chances of success with infertility treatment, a new research review finds.
In an analysis of 10 studies mostly conducted in the past decade, Israeli researchers found that most of the studies showed no clear relationship between men's age and couples' odds of success with in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).
Both IVF and ICSI involve joining a woman's egg and a man's sperm in a lab dish, then—if fertilization is successful— transferring one or more embryos to the woman's uterus. ICSI is typically used for male fertility problems, including a low sperm count or poor sperm quality. It involves isolating a single sperm and injecting it directly into the egg.
It's known that women's fertility declines after age 35, and drops sharply after about age 40. And the odds of having a baby through assisted reproduction show a similar decrease.
Men are capable of fathering a child even into their golden years. However, studies have indicated that they do have a biological clock of sorts. Sperm quality, research suggests, may decline after age 40, and so too may the chances of having a baby; one study, for example, found that when the man was older than 40, a couple's risk of miscarriage was higher compared with couples in which the man was younger.
However, only a handful of studies have looked at the relationship between men's age and fertility-treatment outcomes.
For the new review, reported in the journal Fertility and Sterility, Dr. Lena Dain and colleagues at Carmel Medical Center in Haifa, Israel, pulled together 10 international studies that have looked at the question. Each involved anywhere from about 200 to 2,000 couples who underwent fertility treatment.
Overall, the researchers found, most of the studies failed to find an association between men's age and sperm quality, the odds of couples' conceiving or the chances of ultimately having a baby.
Read more here.
Thursday, November 18, 2010
From My Fox New York:
NewsCore - A healthy baby boy was born from an embryo frozen for almost 20 years in what was hailed Sunday as scientific breakthrough that could allow women to start families much later in life.
The infant's mother, who is 42, underwent infertility treatment for 10 years before she was given the embryo last year. She gave birth to a baby boy in May this year.
News of the birth, reported in the medical journal Fertility and Sterility, comes as British lawmakers extend the period that embryos can be stored for up to 55 years.
The baby boy was born from a batch of five embryos frozen in 1990 in the U.S. by a couple who no longer needed them after they conceived their own child through IVF treatment.
Read more here.
Thursday, July 22, 2010
The New York Post reports on the youngest child ever to have a fertility saving procedure performed in the wake of a serious illness:
Thanks to a new miracle surgery, the hope that little Violet Lee can one day have children won't be killed by chemotherapy.
The plucky, 2-year-old Brooklyn girl is set to become the youngest person ever to undergo a fertility procedure when a New York doctor removes one of her ovaries Tuesday and freezes it while she undergoes treatment for a serious immune disease.
The tiny organ will be put on ice for 20 years or more, ready for re-implantation if and when a grown-up Violet decides to have kids of her own.
"It was important that I found a way to allow her to have children," her mom, Tikesha Lee, 32, told The Post.
Violet is set to begin chemo Wednesday, to help her with a bone-marrow transplant she must undergo because of her immune-system troubles.
Both chemo and radiation therapies can render patients sterile.
"It was hard enough to find out your baby needs to go through chemotherapy, but to hear your daughter will be sterile after the treatment -- that one thing gets healed, but another destroyed -- I felt someone punched me in the stomach," her mom said.
The day before the chemo, little Violet will head to Westchester to visit Dr. Kutluk Oktay, who will perform the experimental "fertility preservation" procedure.
The doctor has already performed the surgery on some 40 girls under the age of 18. The previous youngest was 3 years old.
Ovary transplants have already worked in adults. Of the few dozen women who have had the procedure, which Oktay pioneered in 1999, about one-third have had children, he said.
But adult patients are only separated from their ovaries for a couple of years -- not decades, like Oktay's kid patients.
"This is experimental -- down the road, they may or may not get any benefit," Oktay said.
Read more here.
Thursday, July 8, 2010
Findings from a new study on IVF and cerebral palsy:
A new study confirms that children conceived via infertility treatment may have a higher-than-average risk of cerebral palsy -- explained largely by their higher rates of multiple births and preterm delivery.
The study, of nearly 590,000 children born in Denmark between 1995 and 2003, found that those conceived through assisted reproduction were about twice as likely to be diagnosed with cerebral palsy as children who were conceived naturally.
The findings, reported in the journal Human Reproduction, confirm those from a number of past studies. They also suggest that the increased risk of cerebral palsy can be largely attributed to the heightened odds of twin or higher-order births, as well as preterm delivery, with assisted reproduction.
However, the absolute risk of having a baby with cerebral palsy is still quite low for couples undergoing infertility treatment.
Read more here.
Thursday, June 17, 2010
Thursday, June 10, 2010
Interesting piece in the Jewish Exponent on what motivates women to become surrogates:
What motivates a surrogate mother to carry a baby that is not genetically related to her through nine months of pregnancy, only to give the child up just moments after it's born?
Elly Teman, an Israeli anthropologist at the University of Pennsylvania, has been researching this question -- and other issues relating to surrogacy -- for the past decade. In her recently published Birthing a Mother: The Surrogate Body and the Pregnant Self, Teman explores the cultural assumptions about surrogacy, debunking some along the way, as well as misunderstandings that surround the controversial process.
"There is a common belief that surrogate mothers bond with the baby they carry, and later decide to keep it," she said in a recent interview. "The truth is that less than one-tenth of 1 percent of cases end up in court. Surrogates don't bond with the babies. They bond with the women -- the women they are making into mothers."
Teman's research focused on Israel, one of the few countries where surrogacy is legal and also tightly regulated. Unlike in the United States, where surrogacy is legal only in select states, close distances between the surrogate and the intended mother in Israel meant that the women were constantly interacting.
"In the U.S., the surrogate could be in Oregon and the intended parents could be in New York, so most of the communication is done through e-mail and the phone," she said. "But in Israel, the intended mother sees the surrogate's belly growing, and she goes with her to ultrasound appointments. The Israeli version is intensified because they see each other so often."
In Israel, some of the intended mothers even started to develop symptoms of pregnancy -- rashes, bloating, weight gain -- because they were so close to the women who were carrying their genetic child.
The costs of surrogacy are prohibitive for many couples in the United States, often running upwards of $100,000, which includes the cost of in-vitro fertilization. In Israel, where IVF is covered by the state, the cost is about half.
Surrogacy has been legal in Israel since 1996; the first baby born to a surrogate mother came two years later. The bill to legalize it passed through the Knesset in record time, and as a result, Israeli law is very strict in regulating the process.
Criteria for the surrogate, as well as the intended couple, are determined by a state committee.
And the committee is strict: a woman must be married to be eligible, and she needs to have gone though at least seven failed IVF attempts or have other medical problems to prove her infertility.
"Surrogates are doing it for the money and for the mitzvah," she said. "These two don't contradict each other, and they don't take away from each other. That's sometimes hard for people to digest.
"People think that if there's money involved, then it's a business transaction, and if there is no money, then it's a mitzvah. But the surrogate gives more than money can buy."
Read the full article here.
Friday, June 4, 2010
What does a Jewish child need most from a mother? Forget about the chicken soup—it's all about the eggs, say a growing number of prominent rabbis. Several recent rabbinic rulings on fertility treatment dictate that a child conceived in vitro is Jewish only if the egg came from a Jewish woman.
The issue is most pressing in
Read more here.
Friday, May 21, 2010
According to a new study, IVF!
Having sex to conceive a child will become unnecessary within a decade, as in-vitro fertilization becomes more popular among 30-somethings, scientists predicted Monday.
Calling human natural reproduction "a fairly inefficient process," Australian veterinarian John Yovich told London's Daily Mail that sex will soon become just a recreational activity.
"Within the next five to 10 years, couples approaching 40 will assess the IVF industry first when they want to have a baby," said Yovich, a veterinary doctor from Murdoch University in Perth, Australia.
He said in-virto fertilization will advance to the point of having "a near 100% success rate."
Currently, about 15% to 20% of women ages 38 to 40 are able to conceive using IVF, according to the American Pregnancy Association. That figure drops to about 6% to 10% after age 40.
The predictions, which Yovich and Australian vet Gabor Vajta co-wrote with two other scientists, were published in the medical journal Reproductive BioMedicine.
Read more here.
Friday, April 23, 2010
Two Missouri couples are battling over the fate of unimplanted embryos transferred by contract in 2009:
Edward and Kerry Lambert of Pleasanton filed suit this week in Alameda County Superior Court seeking to regain power over two frozen embryos they donated - or, as both religious families put it, gave up for adoption - to Patrick and Jennifer McLaughlin.
Jennifer McLaughlin also filed suit in Missouri to maintain legal custody of the embryos.
Kerry Lambert and Jennifer McLaughlin met in January 2009 via a Web site designed to facilitate embryo donation. The Lamberts had four embryos left over from an in-vitro fertilization procedure that had successfully given them a son in 2007.
All of their embryos were created in 2006 using the sperm of Edward Lambert, now 53, and the egg of an anonymous donor. The Lamberts considered their family complete, but didn't want to destroy the extra embryos or donate them to science.
Jennifer and Patrick McLaughlin, a 42-year-old attorney, had tried getting pregnant without success. They had already adopted five children, now ages 4 to 11, but wanted to expand their family.
Both families signed a contract in February 2009 granting custody of the embryos to the McLaughlins. The contract was a pro forma one previously drafted to satisfy the Catholic church's doctrine regarding the sanctity of life, according to Al Watkins, the attorney for Jennifer McLaughlin.
The contract is unusual in that it states that if the McLaughlins didn't implant the embryos within a year, the Lamberts could revoke the agreement. Watkins called the clause "a safety valve" so that if the embryos aren't used, the donors can find another solution.
The four embryos have always been stored at a fertility clinic in San Ramon, and McLaughlin flew to the Bay Area, where two of them were implanted on May 21, 2009. She gave birth to brown-haired, blue-eyed twin girls - Sarah Estelle and Anna Isabelle - on Jan. 8.
She said she delayed making a final decision about what would happen to the two remaining embryos.
The former first-grade teacher said she knew raising seven children would be incredibly demanding and wanted to see how she and her family coped before deciding whether to add two more to their brood. She has now decided she wants to try to give birth to the remaining embryos.
"I've always wanted to have a big family," she said. "Siblings should be kept together."
But she said she got e-mails from Kerry Lambert starting in December, saying she'd found another family to take the remaining embryos.
Last week, Jennifer McLaughlin received a phone call from the San Ramon fertility clinic saying the Lamberts intended to reclaim the embryos, prompting the filing of the lawsuits.
The Lamberts have refused to provide more details about why they want the embryos back. Jennifer McLaughlin, on the other hand, has hired a publicist and appeared on national television to discuss the case.
The San Ramon clinic has agreed to keep the embryos until the case is resolved in court. A hearing date in the Missouri case is set for Wednesday.
Read more here.
Sunday, April 4, 2010
A new report brings to light interesting data on parents' willingness to genetically trait select in the egg donation process.
Would people shell out big bucks for offspring with preferred traits? Yes. They already do. The evidence comes from an analysis by Aaron Levine, a professor at the Georgia Institute of Technology, in the Hastings Center Report. Levine documents what anecdotes have long suggested: Buyers of "donor" eggs offer more money to women who are likely to yield smarter kids.
Levine analyzed more than 100 ads placed in 63 college newspapers to recruit egg donors. Of these ads, 21 specified a minimum requisite SAT score. Half offered more than $5,000, and among this group, 27 percent specified an "appearance requirement." The bigger the money, the choosier the client: Above the $10,000 level, most ads "contained appearance or ethnicity requirements."
But the big story is SAT scores. "Holding all else equal, an increase of one hundred SAT points in the score of a typical incoming student increased the compensation offered to oocyte donors at that college or university by $2,350," Levine reports. When the ad was placed for a specific couple, the premium was higher: $3,130 per 100 SAT points. And when an egg donor agency placed the ad on behalf of the couple, the bonus per 100 points rose to $5,780.
Read more here.
Friday, March 5, 2010
A woman has given birth to two children after her fertility was restored using transplants of ovarian tissue, the first time the complex treatment has produced two babies from separate pregnancies.
Claus Yding Andersen, the Danish doctor who treated the woman, said the case showed how this method of storing ovarian tissue was a valid way of preserving fertility and should encourage the technique to be used more in girls and young women facing treatment that may damage their ovaries.
"This is the first time in the world that a woman has had two children from separate pregnancies as a result of transplanting frozen and thawed ovarian tissue," said Andersen, who reported the case in the Human Reproduction medical journal.
Andersen's patient, Danish woman Stinne Holm Bergholdt, had ovarian tissue removed and frozen during treatment for cancer, and then restored once she was cured.
She gave birth to a girl in February 2007 after receiving fertility treatment. She then conceived naturally and gave birth to another girl in September 2008.
Nine children have been born worldwide as a result of transplanting frozen and thawed ovarian tissue.
Read the full story here.
Friday, February 26, 2010
A Texas mother is seeking an egg donor and/or surrogate to give birth to a baby using the sperm of her son, whose sperm was extracted after he died from a gunshot wound last year.
But now his mother is hoping for a legacy -- a grandchild culled from her son's sperm after his death on April 5, 2009. She has heard from hundreds of women who have offered to be egg donors or surrogate mothers for her future grandchild.
Advances in the fertility industry have allowed wives, fiances, girlfriends and even parents to seek post-mortem sperm retrieval when a man dies unexpectedly.
The first report of post-mortem sperm retrieval was in 1980 involving the case of a 30-year-old man who became brain dead after a car accident, according the journal "Human Reproduction."
A birth was first reported in 1999, but since then more than 1,000 such requests are made each year. Most do not result in pregnancy attempts.
"Often parents change their minds," said Dr. Daniel Williams, assistant professor of urology at University of Wisconsin-Madison.
In post-mortem sperm retrieval, sperm is surgically removed from the testes, epididymus and vas deferens then preserved in nitrogen vapor.
Frozen, it can be kept indefinitely, with "no obvious risk to offspring," according to Williams.
The science is easy, say medical experts, but the ethics are not so clear.
"It's an area that is steeped in ethical issues, emotional issues and financial issues," he told ABCNews.com. "These issues can become very challenging because there are no guidelines or laws or rules on how to handle the requests. Often they are handled on a case-by-case basis."
Many doctors suggest that parents like Evans, who are still grieving for a lost child, should have a "quarantine period" as they heal to consider all the ramifications of having a baby from sperm retrieval, including the welfare of the unborn child.
Read more here.
Sunday, February 21, 2010
Queensland Parliament [on February 11, 2010] decriminalised altruistic surrogacy - whereby another woman has a baby for no payment - bringing the state into line with the rest of Australia.
The law extends to same-sex couples after Opposition attempts to have them excluded failed.
Under the reforms, legal parentage of a child born in an altruistic surrogacy arrangement will transfer from the birth mother to the parent or parents who commissioned the birth.
Queensland Law Society says although commercial payment for such an arrangement is illegal it would be difficult to prevent under-the-table payments or gifts to the surrogate mother.
"Clearly that sort of thing would be difficult to monitor," Queensland Law Society president Peter Eardley said.
Read more here.
Thursday, February 4, 2010
FERTILITY regulators have triggered a new row over designer babies by allowing doctors to destroy embryos affected by more than 100 genetic conditions, including many illnesses that are not life-threatening.
The Human Fertilisation and Embryology Authority (HFEA), has published a list of 116 inherited conditions that fertility clinics can screen out without requiring special permission.
Although many of the conditions can cause gross deformity, protracted pain and premature death, the list also includes illnesses, including cancer and blindness, which can strike late in life after a victim has enjoyed decades of good health.
A number of the conditions are not life-threatening or can be readily treated because of advances in medicine.
Read the rest of the article here.
Friday, January 8, 2010
It seems that selecting for a baby’s gender is becoming increasingly common. Interestingly, according to one fertility expert in Los Angeles,"China is strongly in favor of boys, as we would suspect. India, strongly in favor of boys. But when you look at the world in general, it’s 50-50.” Read more here.
Monday, December 14, 2009
Scientists working on mice have highlighted a specific gene that, although carried by both sexes, appears to be active only in males. They believe it allows males to grow bigger bodies - but at the expense of their longevity. The study, by Tokyo University of Agriculture, appears in the journal Human Reproduction. Although the study was conducted on mice, the researchers believe it could apply to all mammals - including humans.
They studied mice created with genetic material from two mothers, but no father. This was achieved by manipulating DNA in mouse eggs so the genes behaved like those in sperm. he altered genetic material was implanted into the eggs of adult female mice to create embryos. The resulting offspring, completely free of any genetic material inherited from a male, lived on average a third longer than mice with a normal genetic inheritance.
Read the full BBC article here.
Friday, December 4, 2009
Charles P. Kindregan, Jr. () has posted "Considering Mom: Maternity and the Model Act Governing Assisted Reproductive Technology," 17 Am. U. J. Gender Soc. Pol'y & L. 601-626 (2009), on SSRN. Here is the abstract:
The traditional family law doctrine governing maternity was easy to apply. Simply stated the rule for centuries was "the birth mother is the legal mother." However, this rule can no longer operate in the growing field of assisted reproductive technology and especially in collaborative reproduction. Today the birth mother is often a surrogate carrier, who may have a genetic connection to the child she births. However, in most cases the surrogate carrier has no genetic connection to the child. In contrast to the birth mother, the intended mother may be designated as both the legal mother under a contract and actually be the genetic mother. In other cases the intended mother provides an embryo to the surrogate carrier which was produced by a donated egg so that even though she intends to be the legal mother she has no genetic connection to the child. While a heterosexual intended mother may resort to surrogacy to overcome an infertility problem, or because of a history of miscarriage or simply to avoid pregnancy, the growing use of assisted reproduction by same-sex couples raises a number of legal parentage problems which are now coming before the courts. Parentage affects custodial and visitation rights and the law of inheritance. There is little statutory law to assist the courts in such cases. The author examines these problems in the light of the newly proposed A.B.A. Model Act Governing Assisted Reproductive Technology, and also considers the proposed uniform laws governing parentage and probate.
Wednesday, December 2, 2009
A new study has found a higher rate of birth defects among babies conceived by assisted reproduction compared to babies conceived naturally.
In the study, almost 3 percent of infants conceived with assisted reproduction were diagnosed with a major birth defect, compared to less than 2 percent of babies conceived naturally, Dr. Darine El-Chaar and colleagues from The Ottawa Hospital in Ontario, Canada and colleagues found.
It's scientifically plausible, the researchers note, that babies born with assisted reproduction would be at greater risk for major birth defects, "given the interventions required in these treatments."
Read the full story from ABC News here.
Saturday, November 28, 2009
Strasser: "You Take the Embryos But I Get the House (and the Business): Recent Trends in Awards Involving Embryos Upon Divorce"
Mark Strasser (Capital University Law School) has published "You Take the Embryos But I Get the House (and the Business): Recent Trends in Awards Involving Embryos Upon Divorce," 57 Buffalo L. Rev. 1159 (2009). An excerpt:
More and more couples are delaying starting a family. Because fertility declines with age, delaying childbirth increases the likelihood that couples will have to make use of assisted reproductive technologies such as in vitro fertilization (“IVF') to fulfill their hopes of having children biologically related to at least one of them. As might be expected in a country with a relatively high divorce rate, the increased use of IVF has led and will continue to lead to more and more couples having to decide what to do with remaining frozen embryos upon dissolution of their marriages.While some divorcing couples have little or no difficulty in deciding who should control the disposition of their cryogenically preserved embryos, others must rely on the courts to determine who will have final say over how or whether those embryos will be used. State courts have suggested a variety of ways to resolve such conflicts, ranging from enforcement of prior agreements to balancing the needs and desires of the parties to requiring contemporaneous consent before implantation can take place. Regrettably, because the courts analyzing these issues tend not to give adequate weight to how related family law issues are resolved and because the courts have not adequately considered some of the practical implications of their positions, both the reasoning and the results in these cases are all too often anomalous.Part I of this article discusses Davis v. Davis and Kass v. Kass, in which the highest courts of Tennessee and New York respectively stated that initial agreements regarding the disposition of frozen embryos are enforceable. These cases illustrate the possible heartbreak that can be caused either when couples fail to make agreements regarding the disposition of their frozen embryos or when they make agreements without carefully considering the possible difficulties that might have to be confronted in the future. Part II discusses some of the subsequent decisions in which state courts have made clear that frozen embryos cannot be used if one of the progenitors objects, initial agreement to the contrary notwithstanding. These decisions not only reflect a preference against implantation but also create the opportunity to game the system at one of the worst possible times. Part III discusses two recent intermediate appellate decisions in which the courts seem to revert to the earlier Davis-Kass model whereby initial agreements are enforceable. The Article concludes that while the judicial enforcement of initial IVF agreements has its own difficulties, these pale in comparison to the difficulties posed by some of the competing approaches.
The abstract may also be viewed from SSRN here.