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Fertility and Sterility (June 2017) published the results of a self-sponsored public opinion survey to measure the general public’s conception of what is appropriate egg donor compensation, in the wake of the class action lawsuit (which was settled not in their favor). Before the lawsuit was settled, the ASRM had a fixed cap on donor compensation that stayed the same since the year 2000.

Although the was some briefing of the facts to the participants, they were outside of the fertility industry. The ASRM may find some cold comfort that the survey leaned in their favor, although it was likely designed to do so.

I guess the follow up survey will measure the public’s conception of the appropriate compensation for reproductive endocrinologists, and if their salaries should stay at the year 2000 rate.

http://dx.doi.org/10.1016/j.fertnstert.2017.03.001

The Kim Kardashian surrogacy reveal has brought out plenty of critics – ready to use this case to offer uninformed opinions regarding surrogacy in general. Linda Stasi did just this in the New York Daily News on June 23, 2017.

Stasi does a good job of adding provocative commentary to a sensational (and wholly uncommon) story. However, she has written a piece which clearly shows a complete lack of research and lack of understanding related to the complex world of gestational surrogacy. Oh yeah, it is catchy to offer that surrogacy is the choice of entitled celebrities and desperate, impoverished “uterus-renters.” But missing is any acknowledgment that the vast majority of surrogacy cases in this country (indeed ones which also involve Kardashian-like fees) consist of much more compelling fact patterns and much more reasonable motives. The young couples we see in our program who have survived breast and other cancers (and have frozen embryos from their own gametes) are simply eager to have a child. Just as eager as before cancer, but now it is unsafe or impossible (in the hysterectomy cases) to carry. They are looking for a responsible and caring woman to serve as their surrogate. Albeit hard to find, these kinds of women (hardly uneducated or desperate or in financial trouble) do indeed exist. They are often nurses or social workers or teachers – they come from walks of life where helping others (frequently in distress) is part of their nature. And they are strangers –

In a few weeks the holiday cards will begin arriving. First a trickle–one or two a day –and then something of a family pictures tsunami. Working with infertile individuals and couples, I know how painful this can be. Many get to a point where they cannot even open these greetings of the season. Too many cards hold surprises—a third child, people whose wedding seemed minutes ago now have two children and worst of all, a family photo with a mom way too visibly pregnant.

For me, the annual cascade of photos is a very different experience and one that brings great delight. For me the cards are not simply photos of children: they are photos of stories. As I admire the children, I remember the back stories: the miscarriages, still births, quandaries over egg donation and adoption, worries about surrogacy and puzzles over embryo donation. I remember the mother who survived a life threatening delivery and went on to welcome her second child through surrogacy and the dad who said he never wanted to adopt and then became the over—the—moon dad to three daughters from China.

The cards have many stories but they bring with them one message and that is surely my message for the holiday season: people “get to baby.” That phrase—“get to baby” or G2B—has become my watchword and one I share with all my clients. I’ve seen it again and again—people who want to be parents or to expand their families with a second or third child find a way to do so.

New York Times, July 19.2016
I.V.F. Does Not Raise Breast Cancer Risk, Study Shows
BY CATHERINE SAINT LOUIS

Several years ago, the notion of “the good enough mother” became popular in psychology. The idea was that striving for some idealized notion of parenthood was fruitless and even harmful. By contrast, parents who accepted that they could not be perfect, served themselves and their children well. Lately, I have been thinking about how this approach relates to egg donation. Along the way, I’ve become a strong believer in “the good enough donor.”

Many women embarking on egg donation find their “good enough donor” with relative ease. She is usually someone who resembles the intended mom in broad brushed strokes. The good enough donor is ready and willing to donate and she has communicated some things about herself that resonate with the intended parents. They like what they see in the photos she sends and what they read in her responses to questions on their donor agency questionnaire. Their good enough donor is someone they feel they can relate to, someone who shares their values to some degree and either has interests and talents similar to or complementary to theirs. And perhaps most important, the good enough donor is likely to have an ample number of “good” eggs.

Were that it was that simple. Unfortunately, not everyone subscribes to the idea of the good enough donor. There are some people on a quest for what I would call “the idealized donor” For them, the search for a donor is not “short and sweet;” it is long and arduous.

There was a piece on today’s Morning Edition (NPR) that began something like this, “Here’s a story of the lengths one couple went to have a baby.” As someone who counsels people struggling to build their families, my ears perked up, curious as to what would follow.

The very short version, of what was a sixteen month saga, was that a gay couple had a baby through an egg donor and surrogate in Thailand. When baby Carmen was born, the surrogate tried to claim custody, saying that she did not know that the intended parents were gay and she did not support gay parenthood. Last week the Thai court ruled in favor of the biological father, Bud Lake and his husband, Manuel Santos. Morning Edition was now turning its attention to the relieved parents, celebrating with them and asking Mr. Lake what advice he’d have for others considering surrogacy. He responded, “Be sure to vet your agency. Our surrogate should never have been a surrogate.”

I agree with Lake’s advice to “vet your agency,” but wish that NPR had asked him to elaborate on this comment rather than simply dismissing his surrogate as inappropriate. Even in NPR’s brief account of the tale, there were several red flags that pointed to agency shortcomings that went beyond proper selection and screening of surrogates.

The first thing that jumped out to me was that this surrogate/gestational carrier did not seem to know that her “IP’s” were a gay couple.