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Archive for January, 2011

Recent news of Elton John’s surrogate baby, Nicole Kidman’s “gestational carrier”, and Kelly Preston’s introduction of her new baby seems to have the media and bloggers alike all a-flutter about the current state of fertility options and infertility treatments. 

What I’d really like to say to everyone is “leave them alone!”   But, clearly that isn’t going to happen anytime soon.  

I fear that all of the scrutiny and judgment and crazy theories about these celebrities will only serve to make fertility treatments even more secretive.  After all, what celebrity wants to deal with the blogging and tabloid world spreading rumors and gossip about the genetics of your child, why you used a surrogate, or anything else about the blessing that is a child coming into their family? 

Yes, I realize that some people want celebrities to come clean about how their children were conceived.  And yes, it may serve to normalize the use of surrogates and egg donors – much like it is now “no big deal” for someone to use donor sperm.   But I don’t think anyone should be forced out of the fertility “closet” so to speak.  

Of course, the danger is that young women will see these mothers in their mid to late 40s having children, and they might think that they too can wait that long.   And while it is possible in your 40s to get pregnant naturally or through IVF with your own eggs, it is much, much harder and the risks of issues due to egg quality are certainly higher.   But really, is it the celebrities job to educate the public?   Why aren’t the OB/GYNs or fertility clinics talking to their patients and doing PSAs to let women know how dramatically fertility declines after your 20s and early 30s?  

And on the subject of using surrogates – the phrase “gestational carrier” is not de-humanizing the surrogate.   It is part of the accepted language to describe a particular type of surrogacy.   It can be used interchangably with “gestational surrogate” and describes a surrogate who has no genetic link to the child, she is simply carrying the child for the parents.   Clearly, we have a long way to go in the fertility world when it comes to educating the public about the proper language to use related to fertility.   And by the way, a gestational surrogate is not the child’s mother; nor is an egg donor any kind of “mother” (genetic or otherwise) to the child that comes from her donation; nor is a sperm donor a “father”. 

While any pregnancy of a woman in her 40s generally has people wondering….donor eggs?  I always try to remind people that lots of babies are born these days from frozen embryos created several (or many) years ago.  And as egg freezing technology becomes better, it too will offer options for women to prolong their fertility.  

Really, what does it matter if someone uses an egg donor or not?  It is about as important as it is for the world to know what sex.ual position someone was in when their child was conceived.   File it under “none of your darn business”.

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The path of infertility is so often filled with disappointments and sadness, that it is easy to misplace the hope you had when starting on this path.  And the more treatments that don’t result in a positive outcome, the harder it is to remain positive and optimistic about future success.   Trust me, I get it.  I’ve been there and wondered where I would get the motivation to try again.  

I recently read an interesting article about hope*.  The author, Judy Jones, said:

We define hope as goal-oriented thinking—in that sense it’s different from optimism, which is a sort of general expectation that good things will happen. In our definition, hope is more active than passive wishing.

I think that is an interesting way to frame it.  I know so many who go through their fertility battle guarding their hearts against “what could happen” or focus on waiting for the other shoe to drop and end up missing out on some of the joys along the way. Let’s face it, for many of us, the joys are all to few and far between to miss out on them.  Some women have talked about missing out on experienceing the joyful parts of their pregnancy because of the fear that something would go wrong and the loss of hope that they could really have a positive ending and bring home the baby that is their heart’s desire. 

I like this concept of re-framing hope into an action of goal-oriented thinking rather than just “being optimistic”.  The author of the article laid out a strategy that includes coming up with different pathways to your goal.  In their studies, the participants in hope therapy worked on various skills to help them develop pathways and increase their motivation and energy to get there.  The result was that the people in the therapy group had lower stress, better moods, and higher self esteem.

The road to parenthood often has a variety of potential pathways: IUI, IVF, donor eggs, donor sperm, surrogacy, adoption. I think sometimes it is important to focus on deciding what is the true goal – then let go of our vision of  perfection so we can explore the various options or pathways for reaching that goal.  It may include things that are out of our comfort zone – pursuing medical intervention, IVF treatments abroad, surrogacy, donor egg or sperm; and those choices force us to decide what it is that we are willing to do to reach our goal.  For most people, that list may change as time goes on – it is all part of the process of grieving the losses (fertility, genetics, miscarriages) and looking for hope for the future. 

Now, I’m not going to pretend that having hope or being positive is going to solve fertility challenges or get you to your goal of parenthood; but in my mind, if you’re on the road anyway, maybe the quality of life along the journey will be better if you’re feeling hopeful.  

And while the reality is that many of us will have our hopes dashed along the way – sometimes many times- at least during the journey we had moments of hope that helped make it easier, and hopefully in the end we reach our goal.

*Note: the full article can be found online at: http://www.more.com/2024/7577-a-plan-to-make-your

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The blogosphere is all abuzz about a recent NY Times article by Melanie Thernstrom, a woman who used egg donation and surrogacy to have her two children “twiblings”.  She very openly discusses their journey to parenthood and their choices for building their family.  Then in a follow up article, she beautifully addresses some of the criticism and questions that came in comments to the original article. 

Original article link: http://www.nytimes.com/2011/01/02/magazine/02babymaking-t.html?_r=1

Follow Up Response link: http://parenting.blogs.nytimes.com/2011/01/03/more-on-the-twiblings/?scp=1&sq=thernstrom&st=cse 

Even though this has nothing to do with IVF abroad, it struck me as a wonderful article talking openly about the various aspects of third party reproduction.  As a patient, I often found myself at a loss feeling that I had to defend or explain my choices, and I love how she has communicated this in such a balanced and fair manner.

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In the past year several countries have made pretty significant changes to their legislation related to third party reproduction – particularly IVF with donor eggs or surrogacy.  Some have been progressive, and sadly, some made access to treatment more difficult in their own countries.   

Thankfully, the technology for these treatments has been steadily improving with amazing advances improving IVF success rates substantially from year to year. 

I wonder what 2011 will hold for us as this great new frontier offering options for family building expands and becomes more mainstream?

My hope is that rational minds will prevail and that these services (such as IVF, donor egg IVF, donor embryos, and surrogacy) will be more readily available to everyone – without discrimination based on marital status, country of origin, or other details dreamed up by ill informed politicians that frankly should not be anyone’s business except the people trying to have a family.

I think the trend towards fertility tourism (which means leaving your own country for treatment) may have a positive impact by helping provide more cost effective options for IVF.  

We can certainly be thankful that we live in a time that so many options are available to us (either in our own countries or abroad).  I look forward to a time when this is all so commonplace that society equally embraces all options for family building.   News of the recent surrogacy and donor IVF treatments that were used to conceive Elton John’s son and twins for Neil Patrick Harris put this technology in the mainstream media, and I happen to think that is a good thing.  For so long these treatments have been done in secret – so it is wonderful to see people starting to talk about it openly without shame or embarassment.  Conceiving a child through a donor just isn’t something to be ashamed about, it is something to be celebrated.  

So, congratulations to the celebrities for speaking out, and to all of the other couples in 2010 who conceived their children through IVF, donor IVF, surrogates or other fertility treatments and are willing to talk about it and decrease the stigma and secrecy.  Hurray!  We’re making baby steps in the right direction. 

And I, for one, can’t wait to see what new advances 2011 will hold for us.

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