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This week’s cover story (“Meet the Twiblings” by Melanie Thernstrom) does last year’s (or rather late 2009’s) “Her Body, My Baby” one better: Thernstrom has not just one child via a gestational surrogate, but two, via two surrogates, at the same time. Dare to judge!

Generally, this story is very positive on surrogacy and egg donation. Thernstrom was infertile and unhappy, and egg donation and surrogacy provided her with two healthy children. Furthermore, the medical procedures went smoothly: the first retrieval resulted in a good number of healthy embryos; enough for two separate transfers that both resulted in live births.  She is brave (and right) not to consider her egg donor and carriers as threats to her own maternity.

The piece is her own personal story, so one cannot quibble with her statements of feelings and opinions. But two egregious unsubstantiated points stood out:  “The Internet was filled with stories of predatory egg-donation and surrogacy agencies” and “There were several cases of surrogacy in recent years in which the surrogate succeeded in keeping the baby despite an absence of any genetic connection.” On the former, the Internet is filled with a lot of stories, many untrue. The vast majority of egg donation agencies are reputable. On the latter, I am unsure of these “several” cases to which she refers. But if a surrogacy takes place in a state with established legal protections in place, and governed by a proper contract, the carrier would have no claims to the child.

Today’s New York Times article (“Building a Baby, with Few Ground Rules“) describes cases that went wrong, even though it mentions in passing that most surrogacies work out just fine. I hope it does not discourage intended parents from pursuing surrogacy, or just make surrogacy appear unseemly in the eyes of the general public.

The Michigan and Indiana cases discussed did not follow the proper legal or medical protocols at all; in fact, the egregiousness is stunning. These surrogacy cases should have never happened in the first place. Michigan is one of the few states hostile to surrogacy and we, or any legitimate agency, would never allow a surrogacy to take place there. All the clinics we work with have very strict protocols in place for medical and psychological screening; the single man from New Jersey would have never even made it into our program (as we are careful about the intended parents we work with), let alone pass the psychological screening that would take place at the clinic.

The article mentions that the American College of Obstectricians and Gynecologists recommends that “surrogacies be handled by nonprofit agencies,” but I am unaware of any such agencies with the legal experience to handle such complicated arrangements.

The field of surrogacy (and assisted reproduction in general) is not as unregulated as commonly perceived.  In fact, there is case law and/or statutes in a number of US states, where surrogacy can be practiced legally and safely (see our article, “Assisted Reproductive Technology: Egg Donation and Surrogacy in Law and Practice,”

Amy Benfer’s piece in Salon yesterday questioned the editorial logic behind the Times publication of Kuczynski’s article, but concluded that it was at least honest in choosing not to mitigate the writer’s vanity, selfishness, and sense of entitlement. She had a slightly more generous attitude toward Kuczynski than many of her readers, as well as Thomas Frank, who wrote in today’s Wall Street Journal (!) that Kuczynski’s surrogacy is the ultimate act of capitalist exploitation, proving the end of our love affair with the rich. As if these were bad things. (And his opinion is surrounded by articles about a $500 billion stimulus package, a car industry bailout, and ads for luxury watches, jewelry, and diamonds.) Really, Tom, you give Kuczynski too much credit.

So, we finally get to read the Sunday Magazine article, and they do not credit Sanford Benardo or Northeast Assisted Fertility Group (NAFG) for our input. Oh, well. Nonetheless, I found Kuczynski’s story of infertility and surrogacy heartfelt and brazenly honest. It was also pretty accurate.

I first read the story as a text-only computer print-out; only this morning did I see the accompanying photos, which blatantly expose her provocative subtext: “I am rich, white, urban, and privileged; dare to judge me for paying lower status women to do what I cannot.” Anyone familiar with Kuczynski’s writing would expect this. Readers commenting on the New York Times site, for the most part, declared her a self-indulgent snob; a handful were sympathetic. This was a personal story, not a serious study of surrogacy. It would be unfortunate if the general public judged surrogacy solely through Kuczynski’s lens.  Journalistic surrogacy stories are typically sensationalistic; this one is no different in that regard.

A couple of quibbles: I think Kucsynski did “low ball” the figure for the total cost of the surrogacy: although her carrier did not require extra insurance, if you add up the agency fee, carrier fee, legal fees, and medical fees, the figure is closer to $100K than $70K. We find many agencies are not upfront with all the possible costs involved to prevent scaring off prospective clients. (The NAFG site includes a section on program fees which shows a complete itemized breakdown.) Also, we would not advise “skirting” any legal issues and having the embryo transfer take place in New York,

We are eager to view Alex Kuczynski’s “Her Body, My Baby” when it is posted online and comes out on Sunday.

The New York Times contacted the Northeast Assisted Fertility Group regarding our opinions on surrogacy law and procedure, but we did not participate in Kuczynski’s surrogacy.  Preview the article on Jezebel.com.

(See our followup post to the Alex Kuczynski article.)

This article is part two of a three part series.  Click here to read Part One and Part Three.

“OK” reasons to consider surrogacy

“I am in the process of adopting internationally and surrogacy is my back-up plan in case it does not work out; Although I have children from a previous marriage I want more children with my new husband in order to bring us closer together; I have had endured many years of unsuccessful rounds of IVF and now I want to try with my own eggs and a surrogate.”

What is weak in these three scenarios is commitment to success. If you are working on an adoption at the same time, you are not fully committed, and risk abandoning the surrogate after a relationship has been established between you. The second two scenarios are risky because they typically involve women over forty who insist on using their own eggs, and will not consider donor eggs. The chances of a live birth resulting from an egg of a woman over forty is about 5-7%. The chances with an egg from a donor in her twenties is about 50% or higher.  If you are only committed to a 7% chance of success, it is really not a full commitment. And keep in mind what the carrier has to endure. She wants her efforts to result in a live birth, too, and is disappointed when it does not work.

This article is part one of a three-part series. Click here for Part Two and Part Three.

Reasons to Have a Child with a Surrogate: Bad, Not So Good, and Best

Surrogacy can be a risky endeavor, but not for the reasons most people think: the surrogate will get attached to the baby and keep it for herself, leaving the intended parents high and dry. This does not happen. Unfortunately, the sensational “Baby M” case in New Jersey twenty years ago still resonates.  That surrogacy was a “traditional” one, in which the surrogate was inseminated with the intended father’s sperm, and the child resulting was indeed the surrogate’s biological daughter. Before the insemination, the surrogate signed a contract relinquishing her rights to the child in exchange for money. This contract was unlawful and the courts rightly determined it invalid. No parent can lawfully relinquish parental rights to an unborn child.

Now, however, the vast majority of surrogacies are not “traditional,” but “gestational.” Surrogates, or “carriers,” as we prefer to call them, do not become pregnant by insemination. An embryo is formed with sperm and egg from the intended parents (or donors) through in vitro fertilization (IVF), which is then transferred to the carrier’s uterus for gestation. So the carrier has no genetic relationship to the child, and contracts enforcing the rights of the intended parents are lawful (in states where surrogacies occur). The baby belongs to the intended parents from the start,

This article is part three of a three-part series.  Click here for Part One and Part Two.

BEST reasons to consider surrogacy

I have a serious medical condition (premature ovarian failure, hysterectomy, a genetic issue) that prohibits me from conceiving and carrying a child; I am a single man or a gay man in a relationship and want a child.

In these cases, the need and the commitment, which often go hand in hand, are unequivocal. Our most successful surrogacies involve people who have yet to have any children of their own because of some physical disability. If the egg and/or uterus are not functioning properly or absent altogether, using someone else’s becomes the only way to go (aside from adoption, which is a great alternative but not right for everyone). Furthermore, these are the people who carriers are most eager to help.

Although some doctors will not perform surrogacies for gay male intended parents because they do not consider them legitimate medical cases, there are many who will. NAFG supports gay families and are always happy to help them.

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Read information about our surrogacy program, both for surrogate mothers and intended parents.