Archive for the ‘Advice From Our Colleagues’ Category
Wednesday, May 26th, 2010
Below is our final topic in Brenda Fahn-Hardt’s series of discussions for Intended Parents. Thank you, Brenda, for all of your contributions over the past few weeks!
Will I Feel Bonded to My Child?
One fear that intended parents sometimes bring up is that they may not feel as connected or bonded to their child because they used an egg donor. I don’t think I have encountered any cases that substantiate this fear, but of course it is a valid concern. I tell intended parents that they may be more prepared to handle their child than parents who have biological children. Biological parents many times assume that they will understand their  child, yet each child is unique and may or many not resemble their biological parents either. The key to parenting is to be attuned to who your child is. When you enter the world of parenthood, it is a daily challenge to let go of who you think your child “should” be and accept them for who they are. A daily lesson as a parent is to listen and accept your child for who he/she is. If you can do that there is no doubt that you will feel connected to your child.
- Brenda Fahn-Hardt M.S., MFT
Beverly Hills Egg Donation Staff Psychotherapist
Tags: assisted reproduction, Beverly Hills Egg Donation, BHED, Brenda Fahn-Hardt, egg donation, egg donation southern california, egg donor, egg donor agency, egg donor psychologist, egg donors, intended parent, intended parents psychological issues, IVF, ivf cycle, resources for intended parents, Southern California egg donor, Southern California egg donor agency
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Thursday, May 20th, 2010
In the latest installment of our five-part series for Intended Parents, Brenda shares her advice for how/when to share with a child that they were conceived with the help of an egg donor.
Do We Tell Our Child They Were Conceived Through Egg Donation?
 All intended parents are confronted with the decision as to whether they should tell their child (and others) that they used a third-party to conceive their child. Parents usually come to a decision based on their own comfort level and feelings regarding using an egg donor or surrogate. Most experts agree that honesty is the best policy when it comes to informing your child. A good website that goes into more detail about how to talk to your children developmentally appropriate ways is www.donor-conception-network.org. The website has booklets entitled, “Telling and Talking”. These booklets offer informative advice on how to talk to your child at every stage. Before telling your child you want to assess 1) The child’s emotional and intellectual capacity to process the information and 2) The extent to which your family, culture or religion may be able to accept a child born through egg donation.
The decision to tell your child may be an easy one or one fraught with decision. Most experts agree that telling your child is the easier path to take. It is easier because there is no room for misconceptions or false information, which inevitably leads to feelings of betrayal or mistrust. It is also recommended to start giving some information at a relatively early age, from three to five years old. Again, the website mentioned above goes into thorough detail advising how to talk to children of all ages regarding their conception.
- Brenda Fahn-Hardt M.S., MFT
Beverly Hills Egg Donation Staff Psychotherapist
Tags: assisted reproduction, Beverly Hills Egg Donation, BHED, egg donation, egg donation agency, egg donor, egg donors, how to tell a child they were conceived with an egg donor, IVF, Southern California assisted reproduction
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Monday, May 17th, 2010
Part 3 in Brenda Fahn-Hardt’s informal discussion for Intended Parents.
Meeting the Donor? There is No Right Choice.
At some point during the egg donor process most parents consider whether or not they should meet their egg donor. There is no right or wrong answer to this question. Each case is different and depends on the intentions and expectations of the intended parents. If their expectations seem reasonable and realistic, then meeting the egg donor can turn into a very positive experience. Most of the time intended parents want to be able to meet their donor so that they have the option of telling their child at a later date. Statistically, only about 20% of intended parents choose to meet their donor. If you intend to tell your child that they were conceived with an egg donor and you want to tell your child something about the donor, then meeting would likely be a positive experience. Many times parents to not have an interest in, or feel comfortable, meeting their donor, which of course should always be respected. Each situation is different.
- Brenda Fahn-Hardt M.S., MFT
Beverly Hills Egg Donation Staff Psychotherapist
Tags: Beverly Hills Egg Donation, BHED, egg donation, egg donation agencies, egg donation agency, egg donation california, egg donation los angeles, egg donation process, egg donor, egg donor agencies, egg donor agency, egg donor blog, egg donor cycle, egg donor los angeles, egg donors, how to choose an egg donor, intended parent, IVF, ivf cycle, resources for intended parents, should I meet my egg donor
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Thursday, May 13th, 2010
Part two in our series of discussions on psychological issues for Intended Parents.
Choosing a Donor
 Once intended parents have made the decision to use an egg donor, anxiety can arise surrounding the donor choice. Every intended parent usually approaches the issue with ‘preconceived’ criteria for choosing their ‘perfect’ candidate – beyond the standard medical screening that is done, scholastics, personality, and appearance are usually at the top of their list. I empathize with individuals and couples as to how difficult it is to make such a big decision. It is important to remember that there is no rush in choosing a donor. It takes time to find the right match. Whatever the intended parents are looking for, I encourage them to get as much information as possible from their egg donation agency regarding their donor, while also trying not to ‘over-control’ the situation. Once one feels they have made the best decision, according to the information they have, then the challenge can be trying letting go. There are no guarantees in life, all of us who are parents usually begrudgingly learn that a lot more of life is out of our control than we would like. Parenting is about being able to handle all the imperfections that come with a child, whether you have your child through an egg donor or not. When couples do have difficulty containing their anxiety during this process therapy can help.
As the ’screening’ psychotherapist, my process is analytical and involves assessing the donor for her maturity and ability to follow through with the process, as well as the presence of any major psycho-pathology (i.e. personality or mood disorders). An interview and psychological test are used to check for either of the two preceding elements.
- Brenda Fahn-Hardt M.S., MFT
Beverly Hills Egg Donation Staff Psychotherapist
Tags: Beverly Hills Egg Donation, BHED, egg donation agency, egg donation los angeles, egg donor, egg donor cycle, egg donor database, egg donor los angeles, egg donors, fertility clinic, how to choose an egg donor, ivf cycle, Oocyte Donation, Ova donation, Southern California egg donation agency, Southern California egg donor, Southern California egg donors
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Tuesday, May 11th, 2010
 The following is the first in a series of postings from Beverly Hills Egg Donation staff psychotherapist, Brenda Fahn-Hardt M.S., MFT. Brenda comes to us with years of experience working exclusively with donors and couples dealing with infertility issues. In this, and in posts to come, she will address some of the most common psychological and emotional issues that come up in her work with Intended Parents.
Intended parents usually come to infertility services after spending years on an emotional roller-coaster. There are several emotional and psychological issues that intended parents typically encounter during this process. The ones that I encounter most in my practice are 1) Dealing with the grief of not being able to conceive your own biological child 2) The anxiety associated with choosing a donor 3) Deciding whether to meet the donor during the process 4) Fears of not being bonded or connected to your child and 4) Deciding if, when and how to reveal to your child that an egg donor was used in their conception.
Grieving
The journey to the infertility option can be arduous for most couples. The realization that you are unable to conceive without the assistance of a third party can be internalized in numerous ways – the most common emotions are feelings of failure, inadequacy, humility and anger. When couples arrive at an infertility office, frequently they have not dealt with the trauma and pain that usually exists. I always encourage couples to experience their unresolved grief before getting too far down the road in the process. However, in many instances, because couples have been waiting years to conceive a child, they often feel compelled to jump into the next stage without processing their feelings. It is common for couples to get caught up in the frenzy of doctor’s offices, tests, shots and drugs while neglecting to take a step back and let oneself absorb and process the grief.
 Elizabeth Kubler-Ross wrote the classic treatise on dealing with grief. In her seminal work, she identifies the five stages of grief – denial, anger, bargaining, depression and acceptance. In a perfect world, an individual would experience these stages sequentially. Yet, each of us approaches life’s complications in our own way. The process becomes inherently more complicated when dealing with two individuals simultaneously, given the complicated dynamics of relationships in general. It takes an enormous amount of patience and understanding to respect and understand your partner’s process. Therefor I encourage couples to attend support groups and couple’s therapy to assist them through the grieving process.
The goal in the last stage of the grief process is acceptance. Acceptance can take on different outcomes for different couples (or single parents). The one constant is the reality that one is unable to conceive his/her own biological child. When one comes to this acceptance, there are different paths from which to choose – using an egg donor and/or surrogate, adopting a child or choosing not to have a child. Whichever path is chosen, you want to be confident about your decision and optimistic about your future.
- Brenda Fahn-Hardt M.S., MFT
Tags: Beverly Hills Egg Donation, BHED, egg donation, egg donation california, egg donation southern california, egg donor, egg donors, fertility clinic, fertility doctor, infertile, infertility, intended parent, IVF, ivf cycle, Reproductive Endocrinologists
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Monday, October 12th, 2009
During the early years of IVF treatment, it was always assumed that transferring more embryos would improve success rates. Even 20 years ago, it quickly became apparent that this success came at the expense of a high multiple birth rate. In response o this, many European countries and Australia limited the number of embryos that could be legally transferred to woman’s uterus. While laudable, these restrictions tend to be rigid and do not always take into account the age of the producer.
In the U.S., we have adopted a voluntary system through the American Society of Reproductive Medicine (ASRM). The ASRM has published guidelines that take into account maternal age and are more flexible. However, as seen in the recent case of the famous octuplets, there are no serious consequences when a poor outcome is attributed to not adhering to these guidelines.
While these measures have greatly reduced the incidence of triplets and higher-order multiple births, the incidence of twins remains high, especially with egg donation. Many patients may think this is fine. In fact, many couples express a desire to have twins. Their preferences are affected by a belief that transferring two or three embryos improves success rates, and, for some, a financial motive that sees twins as a “two-for-the-price of one.”
The success rate belief may be inaccurate. Many European studies, as well as our experience, strongly suggest that the success rates with two day-3 embryos is equal to the success rate with one good quality (day-5) blastocyst. The ASRM guidelines allow either choice. Yet, many clinics are still transferring two blastocysts, with predictably high twin rates. So, what’s wrong with that?
The problem with twins is that they have a 50% chance of being born prematurely. As a result, they have higher rates of cerebral palsy and other complications of prematurity. The combined medical costs from IVF twins due to ICU care and life-long complications from prematurity are easily in the billions of dollars. Furthermore, from conception to delivery, there is a reduced chance of actually delivering two live babies. Even when twins are born close to term and are healthy, there are considerable financial and emotional costs associated with them.
With appropriate statistical analysis, it may be possible to demonstrate that the chance of a live birth is the same after the transfer of one blastocyst compared to the transfer of two embryos.
While twins may seem cute and a bargain at first, patients undergoing egg donation should inform themselves of the risks of twins and discuss the potential merits of single embryo transfer (SET) with their physician.
- Michael Feinman, MD
Medical Director, HRC Fertility
Huntington Reproductive Center Medical Group
feinmanivf@havingbabies.com
Tags: American Society of Reproductive Medicine, ASRM, ASRM guidelines, Beverly Hills Egg Donation, BHED, blastocyst, day-5 blastocyst, Dr. Michael Feinman, egg donation, egg donation success rates, egg donor, egg donor cycle, HRC, Huntington Reproductive Center, IVF, multiple pregnancies, multiples, reproductive endocrinologist, SET, single embryo transfer, twins
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Friday, October 2nd, 2009
When choosing an egg donor, it is understandable that women will want to select a donor who is similar to themselves in appearance and ethnic background. As with many aspects of Jewish Law, what may seem obvious and desirable may not conform to rabbinical interpretations of the Law. Ironically, since it is sometimes difficult to find suitable Jewish donors, these legal twists can actually help some people “let go” of their desire to work only with Jewish donors.
There are three concerns that rabbis have addressed in their discussions regarding the selection of egg donors. The first is accidental incest. The second is the legal status of a woman’s eggs. The third, and possibly the most important to recipients, is the Jewish status of the children born through egg donation.
Reasonable concerns exist that due to the anonymity of most egg donation arrangements, the actual children of the donor could accidentally marry the offspring of the woman who received her eggs. Sounds far-fetched, but rabbis worry about such things.
As to the status of the eggs, rabbis have agreed that according to Jewish Law, a husband has a legal attachment to his wife’s eggs. In theory, according to Jewish Law, the resulting offspring could have a claim on the donor’s husband in a Jewish court of law.
While Reform Judaism recognizes that parentage can come from either parent, traditionally most, but not all, rabbis have agreed that if a Jewish woman gives birth to the baby, that child is fully Jewish. The Laws determining a child’s family and religion of origin were established thousands of years ago – long before genetic testing – and so Jewishness is passed from the mother who gives birth rather than from the genetic parents.
Based on these three considerations, the following principles can guide most Jewish couples considering egg donation:
A Jewish donor is not legally required for a Jewish couple. Based on the concerns about accidental incest and the legal status of eggs, a non-Jewish donor may actually be preferable. Accepting this idea can alleviate much of the angst over trying to find a Jewish donor which can be difficult.
If a Jewish woman is chosen, she should be single or married to a non-Jewish man. If she is divorced, she needs a Jewish divorce, including a “Get.”
The process of choosing an egg donor is different for every family. There are an endless number of things to consider in making such an important decision. If observing Jewish Law is a priority for the Intended Parent(s), then finding a Jewish donor is not only unnecessary, but potentially undesirable. Ideally, this will be helpful to some as the pool of potential donors will be enlarged significantly.
- Michael Feinman, MD
Medical Director, HRC Fertility
Huntington Reproductive Center Medical Group
feinmanivf@havingbabies.com
Tags: Beverly Hills Egg Donation, BHED, Dr. Michael Feinman, egg donation, egg donor, egg donor cycle, HRC, Huntington Reproductive Center, IVF, Jewish egg donor, jewish law and egg donation
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Monday, March 23rd, 2009
Many women feel as if they have tried everything: monitoring cycles through body temperature, over-the-counter fertility predictors, fertility-enhancing drugs and in vitro fertilization. After many attempts at becoming pregnant, it makes sense that the frustration can become more than a difficult issue physically, but also emotionally.
Thousands of women each year are now seeking the help of egg donor agencies such as Beverly Hills Egg Donation. When fertility treatments are unsuccessful, many women are told “no” [about having children] because of their age. But with the use of an egg donor and the added help of chiropractic, there may still be plenty of reason for hope. At least one study showed that, after receiving chiropractic care, previously infertile women were much more likely to become pregnant (Journal of Vertebral Subluxation Research, 2003). And while reasons behind chiropractic’s success in treating women who have difficulty becoming pregnant aren’t certain, there are a number of possibilities why it may work.
Chiropractors believe proper alignment works in several ways to increase the likelihood of becoming and staying pregnant. Chiefly, improper alignment of the cranial, spinal, and pelvic bones can hinder the nervous system, which controls a woman’s reproductive system, causing imbalances and hampering her ability to get and stay pregnant.
Many of the patients Dr. Matthew Gloin, D.C. sees for infertility have tried everything. They come to chiropractic to help prepare the body’s nervous system for the upcoming egg donor cycle. Dr. Gloin first talks to them about their menstrual health history, noting signs of imbalance, which have often been problematic since the onset of menstruation, including heavy cramping, mood swings, and missing periods. ”We balance the body [through chiropractic],” says Dr. Gloin. Patients receive a combination of chiropractic adjustments, three times a week to start. After adjustments start to hold, patients visit once or twice a week.
How long should chiropractic take to work? Not long, says Dr. Gloin. ”We give it three months. Often women will become pregnant following egg donation not only because of their fertility experts, but because their nervous systems are functioning at full capacity through chiropractic.” Unless there have been serious compromises to reproductive health, he says, such as a history of extreme athletic activity or substance abuse, chiropractic may set the stage for a successful pregnancy.
-Dr. Matthew Gloin, D.C.
Tags: Chiropractic, egg donation, egg donation agency, egg donor agency
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Thursday, March 12th, 2009
In terms of how much to compensate an egg donor, the ASRM report specifically states that payments to donors “should be fair and not so substantial that they become undue inducements that will lead the donors to discount risks.” This is a point that I feel cannot be stressed enough. Any donor assumes certain risks – medical, emotional, and even financial, and being a donor is a huge responsibility. They spend hours being screened, filling out health history information, going to appointments, and undergoing the retrieval procedure. We want to make sure that the donor is not so enamored by the compensation that she will receive that she doesn’t fully assess the risks and responsibilities that go hand in hand with participating in a donor cycle.
The report goes on to state that while there is no consensus on the exact amount of compensation a donor should receive that “sums of $5,000 or more require justification and sums above $10,000 are not appropriate.” I believe that anytime one sees an advertisement promising more than these recommended amounts, or anytime a donor requests a fee in excess of these amounts, one should proceed with caution. Additionally, there are many clinics and physicians that will not work with a donor requesting a fee higher than the ASRM suggested guidelines. The ASRM report makes it clear that programs (agencies) recruiting donors and anyone assisting a recipient that has recruited their own donor should establish a compensation structure that “minimizes the possibility of undue inducement of donors and the suggestion that payment is for the [eggs] themselves.”
 This can lead to the following issue that I am constantly debating with friends and colleagues: if these guidelines exist, why are some donors offered twelve, fifteen, or twenty thousand dollars (or more) for their donations? If you have an “elite” fee or an “elite” program, where fees are higher based on education, talent, appearance, or IQ and test scores, aren’t you in fact paying for “superior” eggs? And doesn’t that completely contradict what the ASRM report has stated? If the ASRM guidelines are all we in this industry have to go by, I think that anyone in the field owes it to the integrity of the field in general, and the the individuals involved specifically, to maintain the guidelines to the best of their ability.
-Kate Lyon, Attorney at Law
Tags: egg donation, egg donation compensation, egg donor compensation, egg donors, Financial Compensation of Oocyte Donors, Oocyte Donation, Ova donation
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Monday, March 2nd, 2009
 Egg / Ova / Oocyte Donation* offers a viable option to women who have been told that they cannot or should not attempt to achieve a pregnancy using their own egg(s). This can be, and generally is, an extremely emotional step for any individual or couple to take. It is also one that can be costly. With the current state of our economy, the expenses related to any infertility treatment are being more closely examined by those that find themselves in need of such treatment, and the compensation provided to donors is just one of these expenses to consider. With more young women applying to become donors, because of the financial incentive that does exist, many of us in the field (and those that are thrust into this world because of their own fertility situation) are constantly wondering “how much is too much?”
As an attorney in the field, I take very seriously the responsibility of ensuring that the Egg Donation Agreements that donors and recipients (or “Intended Parents”) enter into are drafted appropriately, taking into consideration the standard of the industry and the guidelines that are available. It is especially important to make clear not only the exact compensation the donor is going to receive, but what exactly the donor is being compensated for.
While in California, that state in which I practice, there are no laws that specifically deal with egg donation or compensation, the American Society of Reproductive Medicine has published a report that deals specifically with the financial compensation of egg donors. (”ASRM Ethics Committee Report: Financial Compensation of Oocyte Donors,” Fertility and Sterility, Vol. 88, No. 2, August 2007). The report makes clear what many of us in the field so strongly believe: that compensation to egg donors is justified on ethical grounds, but care needs to be taken with the explanation and delineation of the structure of the compensation, as well as the amount of compensation. Both donors and recipients need to clearly understand that the donor is receiving compensation for the time, inconvenience and discomfort associated with the entire egg donation process: from the screenings required before a donor can begin medication, to the actual cycle obligations (which includes taking various hormone medications), and then the retrieval procedure.
Compensation should never be dependent upon a certain number of eggs being retrieved or upon the quality of eggs being retrieved (which can, by extension, also mean that the fertilization rate of such eggs or whether or not a pregnancy is achieved from the donation should not be considered when structuring compensation). The ASRM report even goes on to state that compensation should not vary based on the number or outcome of prior donation cycles or the ethnic or other qualifications/characteristics of the donor.
*In the assisted reproductive technology (”ART”) industry, professionals use several terms when discussing oocyte, or “egg” donation. For purposes of uniformity, the term “egg” and/or “eggs” will be used in this entry.
-Kate Lyon, Attorney at Law
Tags: egg donation, egg donation compensation, egg donor compensation, egg donors, Financial Compensation of Oocyte Donors, Oocyte Donation, Ova donation
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