IVF and Age: Challenging the Biological Clock

Posted by in Assisted Reproduction, Egg Donation, Infertility, IVF

Biological ClockAdvancements in the world of fertility medicine, in vitro fertilization and third-party reproduction have made us rethink the biological clock concept. Recently, the successful use of IVF technology allowed 72-year-old Daljinder Kaur, to give birth to her first child

In this day and age, individuals are no longer limited by what nature dictates. With the help of modern medicine, humans are dictating their own fertility limits now.

“I feel blessed to be able to hold my own baby. I had lost hope of becoming a mother ever,” said Daljinder Kaur in her interview with the Agence France Press.

It’s no surprise that most who heard this story were diametrically opposed to a woman of this age becoming a new mother. Moreover, it’s difficult to comprehend how a woman of this age could care for a child through all the challenges that parenthood brings. However, it’s not the first time that a woman in her seventies has reportedly given birth.

According to Angel LaLiberte, in her article, “Why Are We Against Later Motherhood?” in 2008, a 70-year-old woman from India, Rajo Devi Lohan, gave birth to twins following IVF treatments.

Details of the above birth appeared in a documentary, Pregnant at 70, on The Learning Channel in 2010. In addition to Lohan, the documentary also highlighted the stories of American Lauren Cohen, who had twins at 59, and Susan Tollefeson, of Great Britain, who gave birth at 59 after undergoing IVF in London.

LaLiberte writes, “Public criticism has characterized later life mothers as selfish, suggesting they’ve delayed motherhood for short-term personal gratification. Symbols of our hostility toward them can even be found online – granny-mom bashers who sell magnets and coffee cups that say, ‘Gee, I forgot to have a baby…’”

Why don’t these viewpoints transcend to men who have children later in life? Sir Elton John and his longtime partner, David Furnish, had babies born via surrogacy in 2010 and 2013. Sir Elton John recently celebrated his 69th birthday. In the media, he was lightly teased for being an older father.

Was the public more accepting because of his celebrity status or perhaps because Furnish is younger? It makes one wonder if parent age discrimination is another case of “double standards,” considered more acceptable when aimed at a woman.

LaLiberte shares, “Yet, while similar criticisms can be applied to older fathers, the public is strangely silent. For centuries, older men have been slapped on the back and given a congratulatory cigar for fertilizing a female.”  She added, “But, in recent years, the media has breathlessly reported that it appears that men, as well as women, have a biological fertility clock.”

LaLiberte is referring to medical studies highlighting scientific evidence of a possible “increased risk” of particular health issues, including autism, bipolar disorder, and schizophrenia, in children of older fathers.

The question, “Are you too old to have a baby?” is bound to evoke strong opinions on both sides of the coin. Should parenthood have an expiration date, and if so, what are the factors that play into that decision?

“In the midst of public melee and debate, it’s easy to lose sight of the prize,” LaLiberte wrote. “These mothers ‘of a certain age,’ who grow more numerous each day, are the forebears of our next generation, who will shape the world to come.”

Certainly, that’s an interesting point worthy of consideration and further examination.

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Chinese Lesbian Couple Achieves Historical Milestone

Posted by in Assisted Reproduction, IVF, LGBT

Cai and WuTolerance of gay couples is moving in the right direction in China. Recently a Chinese lesbian couple welcomed twins through assisted reproduction. These women spoke to the media, liberating themselves from prejudicial restraints.

China lifted its 35-year-old one-child policy in January, allowing Chinese citizens to have two children. While only married heterosexual couples in China are allowed access to assisted reproduction services, lesbian couple Rui Cai and Cleo Wu took matters into their own hands.

According to Anthony Kuhn of NPR, Wu and Cai are one of the first lesbian Chinese couples to have used assisted reproduction to implant embryos created with one woman’s eggs in the other’s uterus.

Using Wu’s eggs and a sperm donor from the United States, two embryos were implanted in Cai at a fertility clinic in Portland, Oregon. The couple then returned to China, where their twins were born.

Cai explained the decision to deliver at a private hospital in Beijing, rather than a state-run hospital, stating, “What we wanted was a straightforward attitude and equality of service.  Somewhere where we didn’t have to explain everything or be met with discriminatory, judgmental looks.”

“The birth is seen as a sort of milestone in China, which has become a more tolerant place for gay couples over the past nearly four decades,” Kuhn reports. “However, same-sex couples are not allowed to marry in China, where policies and laws still favor traditional families. Only heterosexual, married couples are allowed to have children and, if needed, get access to reproductive services such as surrogacy.”

The article noted that Cai and Wu were more fortunate than most. They were educated in Great Britain and were able to journey overseas for assisted reproduction services. When they returned home, they could pay for private hospital accommodations.

And this is not the norm for LGBT community.

“To have families, they [LGBT] often resort to fake marriages and black market services, which are fraught with moral, financial and health risks,” Kuhn writes.

Cai and Wu have created a social media portal for other lesbian couples who want to have children. According to the article, the ladies chat about their experiences while giving advice, reviewing hospitals, and offering solutions to governmental obstacles, such as registering children with the authorities.

According to Kuhn, Cai and Wu may face bureaucratic hurdles in the future when it’s time to register their children for government ID cards or school.

However, knowing how empowered and determined these ladies are, they should find a way to resolve these matters.

The article explained how the couple tackled one of their largest hurdles: the acceptance of their parents, part of a Chinese generation that believes homosexuality is something fearful.

In China, children and grandchildren must take care of their elders.

“They think it’s OK for us to choose this homosexual lifestyle,” said Cai in the article. “But we’ve got to have offspring. It’s a compromise or a precondition we must meet for them to accept our lifestyle.”

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Missouri Bill Attempts to Assign Personhood to Embryos

Posted by in Assisted Reproduction, Infertility

Every time “human embryo rights” becomes a topic of discussion, it reignites an ethical debate as to whether embryos should be considered persons, property, or should be placed in an “in between” category.8100430194_5dda4c2644_z

A Missouri bill is aiming to provide legal guidelines to be used in frozen embryo disputes. It’s moving through the state’s legislature right now, having been approved by the Missouri House and awaiting a vote by the Senate.

House Bill 2258 is synonymous with Jalesia McQueen, 44, an immigration attorney who helped write the bill. McQueen started this movement after losing an embryo custody battle with her ex-husband. Although she had twin sons during her marriage, the fate of two embryos created with McQueen’s ex-husband remains in limbo.

Despite McQueen’s best efforts, if the Senate approves the bill, reproductive rights in the state, and perhaps across the nation, could be in jeopardy.

According to Jezebel.com reporter Stassa Edwards, the Missouri Bill is co-sponsored by Missouri Right to Life along with other pro-life activist groups.

The bill mandates that Missouri judges should rule, “…in the manner that provides the best chances for the in vitro human embryo to develop and grow.” Edwards added, “In short, judges would be barred from ordering the destruction of an embryo and embryos would be given to whichever parent/donor wants to either preserve or implant those embryos. The bill has exceptions for child support and allows the court to terminate the parental rights of the opposing donor (meaning, the opposing parent/donor is off the hook both legally and financially).”

When couples divorce, the process includes the division of assets and child custody determinations. In light of advanced third-party reproduction techniques, embryo reconciliation is now part of the equation.

Many voice concerns that embryos should not be viewed as “property.”

Although IVF clinics have their patients sign consent forms, including choices for embryo disposition in the event of a couple’s divorce or death, these contracts have been contested. The court rulings which have followed have varied considerably.

“…many of the contracts have not held up in court; either parents change their mind or judges throw the contracts out, preferring what’s called a ‘balance approach,’ where the judge attempts to weigh the preferences and rights of both individuals. The result is a horde of conflicting case law,” Edwards writes.

While the Missouri bill tries to resolve such conflict, it overlooks as ethical dilemma: whether a person should be forced into biological parenthood against his or her wishes.

“The law essentially attempts to sidestep the ethical and legal questions of compelling another person to be a biological parent against their will, ironically treating the objections of a potential parent as little more than a financial question,” Edwards writes. She added, “More controversially, the bill compels a judge to treat an embryo as a life, effectively positioning personhood at the moment of fertilization.”

As one can imagine, the opposition to this bill has come out in droves. While some may admire McQueen’s passion in “righting” her personal legal matter, if this bill gets sanctioned, it could trigger a ripple effect of repercussions.

In BuzzFeed.com, Azeen Ghorayshi crafted an in-depth article about the bill in tandem with a profile of McQueen. She points out that the bill’s most provocative words are undoubtedly:

“…in the best interest of the in vitro human embryo.”

Ghorayshi interviewed family law attorney, Carla Holsty, about this percolating text.

“There have been reams of decisions from the Supreme Court about what is life,” Holsty tells Buzz Feed. She continues, “This flies in the face of that.”

Well said.

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Sperm Donation Protocol Questioned

Posted by in Assisted Reproduction, Infertility, IVF, Sperm Donation

A recent lawsuit aimed at Xytex, a Georgia sperm bank that allegedly allowed a donor who was a convicted felon with schizophrenia to father 36 children, has triggered an inquiry into how such gross negligence can be avoided in the future. The donor, James Christian Aggeles, boasted an impressive donor profile, highlighting his exceptional IQ of 160, his status as a PhD student in neuroscience engineering, and his healthy lifestyle free of any medical concerns.Sperm donor

While he admitted that his father is color blind, it wasn’t revealed to intended parents that Aggeles suffered from heritable mental health conditions with the potential to negatively impact his offspring.

Egg donors in the United States undergo a rigorous background and health screening before being accepted into an egg donation program. Why aren’t these high standards applied to sperm donors?

Women are scrutinized during the donation process, whereas sperm banks typically take the donor’s word regarding his personal and family history.

Wendy Kramer wrote a piece for Time entitled, Sperm Donation Needs Federal Regulation. She used the Xytex lawsuit as the crux of her argument.

“This case highlights the lack of regulation and oversight in the sperm donor industry. These parents only learned of the donor’s past by connecting with other families on the Donor Sibling Registry, of which I am the director, and on Xytex’s own website. How long will we continue to see the repercussions of an industry that exhibits a lack of accountability, ethics and responsibility that we would normally expect in any other medical arena?” Kramer writes.

According to Kramer, the Donor Sibling Registry helps counsel children who have inherited a genetic disease which was linked back to their sperm donor. In these cases, donors may have been dishonest about their medical history from the very start, the sperm banks may not have done their due diligence in performing the donor’s medical and background screening, or the sperm bank did not contact recipients when the donor noted a significant change in his medical history.

Kramer describes the above episodes as happening all too frequently.

“The number and severity of these incidences is discomfiting. Families clearly need to be warned about possible hereditary disorders,” she writes. Kramer added, “Since donors can father many offspring, donors can potentially transmit disease to scores of children.”

A survey conducted by the Donor Sibling Registry revealed that a sobering 84 percent of sperm donors were “never contacted” by their sperm bank for any medical updates.

“Too often the medical profile of a sperm donor is merely a snapshot of one day in the life of a healthy young man. It often doesn’t reveal what will happen five or 10 years down the road to the donor or to members of his immediate family,” Kramer writes.

While the Food and Drug Administration (FDA) has issued guidelines that sperm banks should test their donors for STD’s as well as a few other diseases, in no way does this level of testing mirror what an egg donor must undergo.

In Aggeles’ case, a simple background check would have revealed his criminal record and the fact that he had not graduated from college graduation.

Kramer calls this an international issue, with sperm banks often shipping donations around the globe. She advises that sperm banks should employ more effective record keeping, including seeking medical updates from donors, that they should cap the number of offspring conceived from any one donor, and that they should mandate a battery of medical and psychological testing.

Something needs to change, so that unsuspecting recipient parents and their children are not blindsided by devastating physical or mental illness caused by such a lax screening process for sperm donors.

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Infertility: The Importance of Education and Empowerment

Posted by in Assisted Reproduction, Fertility, Infertility

For those who have endured the emotional heartache of infertility or know a couple who has fought courageously, National Infertility Awareness Week (NIAW) is a time to take pause, reflect, and educate. This past week was invaluable because one out of eight American heterosexual couples experience infertility issues.

Internationally, the statistics are even more sobering.stimulation_of_ovaries

While the topic of infertility was brought to the forefront this past week, so was the issue of empowering women to understand their own fertility. Dr. Allison Rodgers, a fertility specialist, wrote an engaging article about women in Chicago Now.

The premise: When should women learn about their fertility?

In her article, she highlighted how a close college friend, who has a successful career, told her that she intended to conceive her first child at 35 years of age and thought her eggs would still be of high enough quality and that all would turn out just fine. Fortunately for her, it did.

However, Dr. Rodgers struggled with her own infertility.

“I think as a society, we are very good about teaching girls when they are fertile, when they can get pregnant and how to avoid an unwanted pregnancy. Most of us spend most of our sexually active lives trying to avoid sperm and getting pregnant,” Dr. Rodgers wrote. She added, “This week is National Infertility Awareness Week, but I think the real focus should be on fertility awareness as well. Women of all childbearing ages can be empowered by learning about their personal fertility and decide their family planning choices accordingly.”

The Fertility Centers of Illinois surveyed 1,208 American women ranging from 25-45 who did not have children. Of those surveyed, 79% thought fertility should be a topic in sex education while 89% believed it should be discussed with their OB/GYN.

Dr. Rodgers did not see the relevancy in teaching young girls in school about their “fertility choices” and how fertility declines when a woman reaches her thirtysomething years.  Also, routine doctor’s visits are so hurried these days that the opportunity to really chat with a doctor about fertility may not be so realistic.

Rather, Dr. Rodgers thought the ideal time for teaching women how to understand their own fertility would be after high school.

“Seems like college would be a great time, and I hope that with all the attention in the media to egg freezing, more and more young women are thinking about taking control of their fertility and understanding their options to protect their future,” she said. “It’s important to understand the menstrual cycle, when are your highest chances of getting pregnant, what warning signs to look for and when to seek help.”

The message Dr. Rodgers has delivered is exceptional.

National Infertility Awareness Week is important and critical to those struggling with their fertility, but keep in mind that those who struggle do so every week of the year. Let’s #StartAsking all year.

For more information please visit www.Resolve.org.

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Couple Stranded in Thailand Wins Custody Case

Posted by in Assisted Reproduction, LGBT, Surrogacy

The judgment is in. Gordon Lake and his husband, Manuel Santos, who have been involved in an emotionally charged, high-profile custody battle with their Thai surrogate, have won. The fathers, who have been stranded in Thailand for more than a year with their baby girl, can finally return home to Spain.

Gordon “Bud” Lake and his husband are unable to take their daughter, Carmen Santos Lake, third from left, out of Thailand because her surrogate mother objects to the fact she will be raised by a same-sex couple. (Photo courtesy of Gordon Lake)

Gordon “Bud” Lake and his husband are finally able to take their daughter, Carmen Santos Lake, third from left, out of Thailand. (Photo courtesy of Gordon Lake)

Many viewed the plight of Lake and Santos over the past 15 months as a glaring human rights violation. It certainly was.

Lake and Santos thought all was going smoothly with their surrogacy journey. They left the hospital with their daughter, Carmen, thinking they’d soon be on their way home. They then learned that their surrogate, Patidta Kusolang, would not sign the paperwork necessary to allow them to obtain a passport for Carmen because they were a gay couple.

Kusolsang had no biological ties to the baby. Lake, 41, was the baby’s genetic father, and the couple had used an anonymous egg donor.

The BBC reported, “Mr. Lake and Mr. Santos were informed that Ms. Kusolsang had assumed the child was being looked after by an ‘ordinary family’ and that she worried about the child’s upbringing.”

Lake and Santos’ human rights dilemma sparked a global outcry, especially since their baby was born before Thailand banned commercial surrogacy last year. Making matters even more legally tenuous, Thailand does not acknowledge gay marriage.

According to the BBC, Bangkok’s Family Court ruled that Carmen’s only legal guardian is Lake, who was born in the United States. His spouse, Santos, 41, is from Spain where the family lives.

The couple made more headlines last week when the criminal courts of Bangkok accepted the defamation suit they filed against Kusolsang and her legal advisor, Weeruthai Maneenutnet in relation to the surrogacy matter. According to reports, testimony is slated for May 23.

The Bangkok Post reports that the lawsuit, “…alleges that Ms. Patidta and Ms. Weeruthai gave an interview on a Channel 3 TV show which aired on July 21 and 22 accusing American Gordon Lake and his Spanish husband Manuel Valero [Santos] of being part of a human trafficking network.” The article goes on to say, “The surrogate and her legal aide face defamation charges under Sections 326 and 328 of the Criminal Code and Section 14 (1) of the Computer Crimes Act which deals with ‘false data’ that damages a third party.”

The Bangkok Post explained how Sections 326 and 328 can carry prison terms for up two years, as well as financial penalties.

“The court said there was prima facie evidence of the defendants committing criminal defamation but dropped the charge of violating the computer crimes act because of lack of evidence,” the article cites.

Following the court’s decision, Lake and Santos plan to leave Thailand for Spain, where the couple resides and where they can finally make a home.

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Schizophrenic Sperm Donor Case Back in the News

Posted by in Assisted Reproduction, Sperm Donation

A shocking story made headlines last year, putting all those who have used or have thought about using an anonymous sperm donor on edge. James Christian Aggeles, a sperm donor for the Georgia sperm bank Xytex, provided fabricated information about himself.Sperm

His profile, “Donor 9623,” lured 26 families into using his sperm to complete their families, from which 36 children were born. Donor 9623 attracted so many parents because of his resume of impressive accomplishments: he was completing his PhD in neuroscience engineering, was in tiptop shape, boasted an IQ of 160, and had no history of family disease except for his father’s color blindness.

However, the real background of Donor 9623 could not have been further from the truth. Sadly, Aggeles, 39, was a convicted felon, never graduated from college, and suffered from schizophrenia and bipolar disorder.

This alarming discovery was made by Canadian residents Angela Collins and Margaret Elizabeth Hanson, who used Donor 9623 to help conceive their son back in 2007. They learned the truth after Xytex inadvertently sent them e-mail correspondences about their donor which included his name.

Following some internet investigation, the couple realized that they had been misled and deceived. Serious concerns about the well-being of their child ensued.

“It was like a dream turned nightmare in an instant,” said Collins in an interview with the Toronto Star.

The couple sued Xytex last year, but the case was dismissed by Fulton County Superior Court Judge Robert McBurney, because it was based on a “wrongful birth” cause of action.

Last October, CBS News reported, “Fulton County Superior Court Judge Robert McBurney wrote in an order filed Tuesday that while the lawsuit makes allegations including fraud, negligence and product liability, each claim is ‘rooted in the concept of wrongful birth,’ which isn’t recognized under Georgia law.” The article continued with the judge’s order, “The concept of ‘wrongful birth’ arises when parents claim they would not have gone forward with a birth if they had been fully informed of a fetus’ condition.”

However, Collins and Hanson are determined in their pursuit of justice. They have refiled their case, which legal professionals expect will explore alternative theories of liability.

In the latest case to be filed, Collins and Hanson may not be fighting the battle alone. The New York Daily News reports that the couples’ San Francisco-based lawyer, Nancy Hersh, is representing 15 other clients living in the United States and Great Britain who may join the suit against Xytex.

The current lawsuit also elaborates that Aggeles was a donor from 2000 to 2014 and has helped conceive children ranging in age from toddlers to 12.

Last year, Collins and Hanson voiced concerns in their lawsuit stating that while their son is healthy today, he will need to be regularly evaluated for any symptoms of schizophrenia. According to medical professionals, symptoms generally manifest between ages 16 and 30.

In the same CBS News story reported last year, “The couple [Collins and Hanson] wants a medical monitoring fund established for the estimated three dozen children of the donor so they can be tested and treated, if necessary.”

Establishing a medical fund would be an excellent idea. Sperm banks, however, need to establish best practices and confirm information provided by their donors. It’s what reputable egg donor agencies have been doing for years. A simple phone call, email or letter would have confirmed that this donor never graduated from college. That that was never done, is appalling, considering this company was helping families create children. Consequences of this magnitude are unacceptable, and it should be more difficult for potential donors to lie and make it through the screening process.

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