The Fight for Fertility Equality

Fertility Equality

A fertility equality movement has formed around the idea that one’s ability to build a family should not be determined by wealth, sexuality, gender or biology.

Fertility Equality – While plenty of New Yorkers have formed families by gestational surrogacy, they almost certainly worked with carriers living elsewhere. Because until early April, paying a surrogate to carry a pregnancy was illegal in New York state.hidden costs queer

The change to the law, which happened quietly in the midst of the state’s effort to contain the coronavirus, capped a decade-long legislative battle and has laid the groundwork for a broader movement in pursuit of what some activists have termed “fertility equality.”

Still in its infancy, this movement envisions a future when the ability to create a family is no longer determined by one’s wealth, sexuality, gender or biology.

“This is about society extending equality to its final and logical conclusion,” said Ron Poole-Dayan, the founder and executive director of Men Having Babies, a New York nonprofit that helps gay men become fathers through surrogacy. “True equality doesn’t stop at marriage. It recognizes the barriers L.G.B.T.s face in forming families and proposes solutions to overcome these obstacles.”

The movement is led mostly by L.B.G.T.Q. people, but its potential to shift how fertility coverage is paid for could have an impact on straight couples who rely on surrogates too.

Mr. Poole-Dayan and others believe infertility should not be defined as a physical condition but a social one. They argue that people — gay, straight, single, married, male, female — are not infertile because their bodies refuse to cooperate with baby making.

Rather, their specific life circumstances, like being a man with a same-sex partner, have rendered them unable to conceive or carry a child to term without medical intervention. A category of “social infertility” would provide those biologically unable to form families with the legal and medical mechanisms to do so.

“We have this idea that infertility is about failing to become pregnant through intercourse, but this is a very hetero-centric viewpoint,” said Catherine Sakimura, the deputy director and family law director of the National Center for Lesbian Rights. “We must shift our thinking so that the need for assisted reproductive technologies is not a condition, but simply a fact.”

Fertility equality activists are asking, at a minimum, for insurance companies to cover reproductive procedures like sperm retrieval, egg donation and embryo creation for all prospective parents, including gay couples who use surrogates. Ideally, activists would also like to see insurance cover embryo transfers and surrogacy fees. This would include gay men who would transfer benefits directly to their surrogate.

NYTimes.com July 22, 2020 by David Kaufman

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The Challenges of the Pandemic for Queer Youth

pandemic queer youth

The Challenges of the Pandemic for Queer Youth – Issues include limited access to community support and counseling and, in some cases, quarantining with unsupportive family members.

The pandemic has affected queer youth in many ways.  When Brittany Brockenbrough’s transgender son lost his in-school counseling and the ability to have meet-ups with other L.G.B.T.Q. youth during the pandemic, his mental health suffered.How Coronavirus Is Affecting Surrogacy

“He began to feel depressed and was withdrawn,” said Ms. Brockenbrough, a mother of two in Virginia. She was later able to get her son teletherapy and in-home support from a local mental health agency and to find ways for him to stay in touch with others in his community through such activities as weekly Zoom meetings and online game nights.

“He is doing much better now that he is back in treatment and staying connected to the community,” she said. “Social distancing and taking precautions is necessary, but for the L.G.B.T.Q.+ community, even those who have supportive parents, losing the ability to have that in-person social support with other L.G.B.T.Q.+ youth can have a significant impact.”

As young people continue to adjust to the pandemic, some are dealing with increased anxiety and stress. For those who are lesbian, gay, bisexual, transgender, queer or questioning, there may be additional challenges and risks resulting from limited access to community support, lack of in-school counseling and, in some cases, the difficult circumstances of quarantining with unsupportive family members.

“My parents do not accept that I am gay,” an 18-year-old from Yonkers, N.Y. who did not want his name published, said. “My support system was mostly at school, and now I am quarantining with family members who don’t accept who I really am.”

 

The young man, whose virtual high school graduation was last week, said his parents reacted with “anger” and “disgust” when they found out he was gay, and that being home with them during the Covid-19 shutdown has been very uncomfortable. “It is humiliating to have to rely on people who do not respect you,” he said.

L.G.B.T.Q. youth are already a vulnerable population and at higher risk for anxiety, depression, homelessness and self harm than their non-L.G.B.T.Q. peers. A 2018 study in JAMA Pediatrics by researchers at Harvard University and the Fenway Institute found that transgender youth were at a greater risk for attempted suicide, depression and anxiety, and that gender-affirming mental health services are greatly needed to address these concerns.

Sarah Gundle, a clinical psychologist in New York City, said that while online supports are available during this crisis and can provide help, for many they cannot replace in-person treatment and interaction with a community that accepts and validates your identity.

“L.G.B.T.Q.+ youth who have to be at home for extended periods of time and live with unsupportive family members — or their family environment makes it unsafe for them to be out at home — can experience a profound sense of isolation,” Dr. Gundle said. “A pandemic brings significant uncertainty — there is no definitive end — and it can feel as if there is no escape. Many L.G.B.T.Q.+ youth also have to worry about their safety and the repercussions if their family members find out.”

When college campuses closed in March because of the pandemic, having to return home to an unsupportive space was not a safe option for some students.

Danushi Fernando, the director of L.G.B.T.Q. and Gender Resources at Vassar College in Poughkeepsie, N.Y., said that approximately 225 students — following state guidelines — remained on campus through the spring semester for various reasons, some because they did not feel safe sheltering with their families. Vassar also provided support for students through virtual gatherings, support groups and counseling.

NYTimes.com, June 29, 2020 – by Misha Valencia

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The Hidden Costs Of Starting A Family When Queer

hidden costs queer

The Hidden Costs Of Starting A Family When Queer

The Hidden Costs Of Starting A Family When Queer – Jac Ciardella sat at his kitchen table in New Jersey and inserted a syringe into a navel orange. His hand flexed as he squeezed the plunger, pushing water into the fruit’s rind. He needed the practice. He was about to inject fertility drugs into his wife, Candice Ciardella, and he wanted to get it exactly right. He knew how painful it could be. gay money
 
Just a year earlier, in February, 2017, the spouses’ positions were swapped: Candice, now 37, was administering the shot for Jac, who’s 40. Jac is a transgender man, and both he and his wife have undergone in vitro fertilization (IVF) in order to have a child.
The couple’s fertility journey started in 2015. The original plan had been to use donor sperm to impregnate Candice. But after six unsuccessful attempts at intrauterine insemination (IUI), they decided to try IVF on Jacwith the idea that Candice could carry one of his fertilized eggs. Candice began giving her husband shots of the hormone human chorionic gonadotropin (hCG), to make him produce extra eggs. 
 
“For years, needles were just part of the routine for us,” Candice says. “I think we had more empathy for one another because we both knew what it felt like. When it comes to the shots and the appointments, not many spouses can say: ‘I know exactly what you’re going through.’ We can.”
 
The process was emotionally taxing for both of them, but especially for Jac. “Someone’s head is between your legs, and it’s awkward for anyone — but, being transgender, it’s extra awkward,” Jac says. “Mentally, I’m feeling like I’m not supposed to be in that position. For me to feel comfortable going through IVF while still keeping my sanity and my integrity was huge.” 
 
Three cycles of IVF weren’t successful, and testing revealed no clear issues that would cause infertility. So in 2018, the Ciardellas decided to try IVF again, on Candice this time. 
 
“It was emotionally defeating. If you can survive IVF and infertility, your marriage should be able to survive just about anything else,” Jac says.  “It’s humbling and debilitating and cruel.” Adding to their stress was the financial strain. The Ciardellas were acutely aware that each failed cycle of IVF and IUI was costing them — big time. “You’re talking about tens of thousands of dollars going out the door,” he says. “It takes toughness.”
Jac and Candice’s story is unique, but the financial burden they faced is not. Most LGBTQ+ couples who want children have to confront the fact that starting a family will be expensive. Adoption, fertility treatments, and surrogates are all costly, often lengthy processes.
 
The Ciardellas say their insurance only covered their testing for issues that could cause infertility, such as blocked fallopian tubes. They had no financial help with the sperm, the IUIs, or the rounds of IVF. All told, over the course of three years, the couple would spend about $120,000 on four IVF cycles, $20,000 on fertility drugs, plus over $10,000 on IUI. “I got those numbers imprinted on my brain,” Jac says. “We always knew that to be parents, we’d need to be cutting into a good chunk of change — but we didn’t expect it to be quite that much.” 
 
Sandy Chuan, MD, a fertility specialist at San Diego Fertility Center, confirms that the costs of conceiving via fertility treatments can be shockingly high for LGBTQ+ couples. 
 
She says sperm samples can cost $600 to $900 per vial. One IUI attempt without insurance costs about $700 to $1,000, plus the donor sperm. “I usually tell my clients to ballpark around $1,500, but they might need to do three to six rounds,” Dr. Chuan explains. If IUI is unsuccessful, the next step is IVF, which Dr. Chuan says can cost as much as $15,000, plus $4,000 to $5,000 for medications to stimulate egg production. The price point for procedures can vary by state and market.
 
Refinery29.com, by Molly Longman, June 15, 2020
 
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Civil Rights Law Protects Gay and Transgender Workers, Supreme Court Rules

gay america

The court said the language of the Civil Rights Law of 1964, which prohibits sex discrimination, applies to discrimination based on sexual orientation and gender identity.

The Supreme Court ruled Monday that a landmark civil rights law protects gay and transgender workers from workplace discrimination, handing the movement for L.G.B.T. equality a stunning victory.legal surrogacy in New York

The vote was 6 to 3, with Justice Neil M. Gorsuch writing the majority opinion. He was joined by Chief Justice John G. Roberts Jr. and Justices Ruth Bader Ginsburg, Stephen G. Breyer, Sonia Sotomayor and Elena Kagan.

The case concerned Title VII of the Civil Rights Act of 1964, which bars employment discrimination based on race, religion, national origin and sex. The question for the justices was whether that last prohibition — discrimination “because of sex”— applies to many millions of gay and transgender workers.

The decision, covering two cases, was the court’s first on L.G.B.T. rights since the retirement in 2018 of Justice Anthony M. Kennedy, who wrote the majority opinions in all four of the court’s major gay rights decisions.

Those decisions were grounded in constitutional law. The new cases, by contrast, concerned statutory interpretation.

Lawyers for employers and the Trump administration argued that the common understanding of sex discrimination in 1964 was bias against women or men and did not encompass discrimination based on sexual orientation and gender identity. If Congress wanted to protect gay and transgender workers, they said, it could pass a new law.

Lawyers for the workers responded that discrimination against employees based on sexual orientation or transgender status must as a matter of logic take account of sex.

The court considered two sets of cases. The first concerned a pair of lawsuits from gay men who said they were fired because of their sexual orientation. The second was about a suit from a transgender woman, Aimee Stephens, who said her employer fired her when she announced that she would embrace her gender identity at work.

The cases concerning gay rights are Bostock v. Clayton County, Ga., No. 17-1618, and Altitude Express Inc. v. Zarda, No. 17-1623.

The first case was filed by Gerald Bostock, a gay man who was fired from a government program that helped neglected and abused children in Clayton County, Ga., just south of Atlanta, after he joined a gay softball league.

Washington State Supreme CourtThe second was brought by a skydiving instructor, Donald Zarda, who also said he was fired because he was gay. His dismissal followed a complaint from a female customer who had expressed concerns about being strapped to Mr. Zarda during a tandem dive. Mr. Zarda, hoping to reassure the customer, told her that he was “100 percent gay.”

Mr. Zarda died in a 2014 skydiving accident, and his estate pursued his case.

Most federal appeals courts have interpreted Title VII to exclude sexual orientation discrimination. But two of them, in New York and Chicago, have ruled that discrimination against gay men and lesbians is a form of sex discrimination.

In 2018, a divided 13-judge panel of the United States Court of Appeals for the Second Circuit, in New York, allowed Mr. Zarda’s lawsuit to proceed. Writing for the majority, Chief Judge Robert A. Katzmann concluded that “sexual orientation discrimination is motivated, at least in part, by sex and is thus a subset of sex discrimination.”

In dissent, Judge Gerard E. Lynch wrote that the words of Title VII did not support the majority’s interpretation.

“Speaking solely as a citizen,” he wrote, “I would be delighted to awake one morning and learn that Congress had just passed legislation adding sexual orientation to the list of grounds of employment discrimination prohibited under Title VII of the Civil Rights Act of 1964. I am confident that one day — and I hope that day comes soon — I will have that pleasure.”

NYTimes.com, by Adam Liptak, June 15, 2020

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Better fertility treatments can mean much older parents. But how does this affect their offspring?

Older parents

For nearly 40 years, fertility treatment has grown ever more advanced and so entrenched that it’s not uncommon for couples to begin their families in their late 30s, 40s or even 50s, producing much older parents.

Much older parents…  But even as questions about the technology to extend fertility have been answered — yes, children born through in vitro fertilization are healthy; yes, freezing embryos appears to be safe; yes, mothers can generally deliver babies safely well beyond the classic childbearing years — another important question is emerging: How old is too old for their offspring?

Offspring like Hayley, the 10-year-old daughter of a 58-year-old, Ann Skye.

“I knew that she was going to really need to build her own support system in life, or potentially would need to,” said Skye, who lives in North Carolina and works in public health. “I think that has really impacted the way we parented her. We were strong proponents of letting her cry [herself] to sleep for that same reason: She needs to be able to self-soothe.”

In December, two prominent psychologists and two reproductive endocrinologists published an opinion paper in the Journal of Assisted Reproduction and Genetics questioning whether it was time to establish age restrictions in the field. They wrote that research has shown that children often experience social awkwardness if their parents are a half-century older than them and face greater risk of autism and psychopathologies. These children are also more likely to serve in a caregiving role and experience bereavement as adolescents or teens compared with their peers whose parents gave birth in their 20s and 30s, they wrote.

Do those risks constitute the potential for “great harm” to the child and outweigh a person’s right to “reproduce without limitation or interference” at any age, the authors asked.

“It is a self-perpetuating issue; the more older patients that seek [fertility] treatment, the more people feel that it is reasonable to seek treatment, especially in an age where sensational births are widely celebrated as positive events in the media,” they wrote.

In the United States, the number of live births to mothers ages 45 to 49 increased from 3,045 in 1996 to 8,257 in 2016, and the number to mothers ages 50 to 54 increased from 144 births to 786 births over the same time period, according to the National Center for Health Statistics. The average age of women becoming mothers in the United States is now 26, up from 23 in 1994, according to the Pew Research Center.

WashingtonPost.com, May 30, 2020 by Eric Berger

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Fertility Clinics Stay Open Despite Unclear Guidelines

fertility clinics stay open

Fertility clinics stay open – Many providers have continued seeing patients through the pandemic, forcing them to choose between clients and staff safety.

Since March, fertility stay open clinics across the country have halted treatments for tens of thousands of people because of Covid-19, forcing patients to suspend their family planning. In recent days, some clinics have reopened, resuming services and procedures despite ongoing coronavirus concerns.

But shifting guidelines and minimal oversight have left clinics to decide for themselves when and how to resume in vitro fertilization, or I.V.F. At clinics where I.V.F. is ramping back up, or never slowed at all, some staff members are concerned about a lack of adequate protective equipment and safety policies.

On April 24, the American Society for Reproductive Medicine issued recommendations for restarting operations, leaving it up to individual clinics to determine how to proceed. The professional society had previously advised fertility clinics to avoid starting new treatments, postpone nonemergency surgeries and shift to telemedicine.

The shutdown generated a flurry of media attention and pushbackfrom fertility doctors and patients. Most clinics paused starting new I.V.F. cycles, which are highly time-sensitive. But a few remained open, even operating at full capacity, causing the industry to debate when to resume care and what counts as medically urgent.

“Fertility treatment is by no means elective,” said Leyla Bilali, a nurse at a fertility clinic in New York City, referring to the consensus that infertility is a disease. “It’s just, right now, it’s not a matter of life or death.”

Clinics that stayed open scrambled to implement protocols compliant with the Centers for Disease Control and Prevention, such as temperature checks, masks and physical distancing. Still, people have gotten sick. At Reproductive Medicine Associates of New York, seven staff members have tested positive for Covid-19. At Vios Fertility Institute in Chicago, clinicians have reported flulike symptoms but have not been tested because of limited test availability. And several employees at Extend Fertility, an egg-freezing clinic in Midtown Manhattan, fell ill with possible cases of Covid-19.

“We really didn’t feel it was appropriate to go out on a limb, outside major A.S.R.M. guidelines, and keep things open,” said Dr. Bat-Sheva Maslow, M.D., a reproductive endocrinologist at Extend Fertility who tested positive and recovered from the virus in March. “Covid-19 is almost impossible to control at this point. That weighed very heavily with us.” Extend Fertility has since closed its offices to virtually all patients.

Amid the pandemic, clinics face a dizzying array of vague and, at times, conflicting instructions from states, cities and health agencies like the C.D.C. Doctors must interpret guidelines as they see fit — often the case in fertility services, which are largely paid out-of-pocket and where patient care and profit can be at odds.

Because of unclear guidance, in most states it is difficult to tell whether remaining open during the pandemic is legal or if fertility procedures are considered an essential service. New York is an exception: On April 7, the state’s health department issued an advisory deeming infertility treatment an essential service, thus exempt from closure. New Jersey’s governor, in an executive order responding to the coronavirus crisis, made a similar but less specific exemption, referring to general family planning services but not directly to infertility.

NYTimes.com, by Natalie Lambert, May 1, 2020

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How Co-parenting Has Equipped Queer Families To Handle The Coronavirus Pandemic

Co-parenting Coronavirus

Co-parenting families are drawing on the resiliency that comes from living on the margins in the Coronavirus pandemic.

Co-parenting families are drawing on the resiliency that comes from living on the margins in the Coronavirus pandemic. Four months ago, Lisa Lo, from Calgary, separated from the father of her two young children, ages two and five, in part because she wanted to open her marriage to relationships with both men and women.Co-parenting Coronavirus

Lo, whose name has been changed to protect her family’s privacy, is polyamorous, and she’s had three relationships since her separation, one of which has ended, and two of which have been complicated by pandemic living arrangements.

Some of these relationships have brought big feelings, but through it all, Lo is mindful of keeping an emotional balance for her kids, who spend most of their time with her. “They pick up on my emotions,” she said. “If I’m happy, they’re happy. If I’m stressed and upset, then they’re stressed and upset.”

But that was all pre-pandemic: “Now, dating has been put on hold,” she told HuffPost Canada. Lo’s priorities are different these days. She is very much focused on the challenges COVID-19 poses to all multi-household families: creating consistent self-isolation protocols, navigating the handing-off of children, communicating in a time of stress, finding legal counsel.

To create a situation that worked for everyone, Lo had to have hard conversations with her ex-husband about whether to integrate any of her existing polyamorous relationships into their isolation cohort.

They settled on Lo living with one somewhat-ex-partner (it’s complicated). They are also still employing a nanny in both households, in part, because this is supportive of Lo’s mental health. The negotiations about child schedules and hand-offs between households have been complex.

Lo has also been challenged by some of her loved ones about having non-immediate family members in her household “pod” during the pandemic. But, she was able to take that in stride.

She said being queer has given her a lot of practice with tough discussions: “I’m used to being outspoken about things that are unconventional. I’m done being in the closet about anything.”

Rachel Farr is an assistant professor of Psychology, and she runs the FAD (Families, Adoption, and Diversity) research lab at the University of Kentucky. She said that for LGBTQ2 families, this pandemic both feeds into existing patterns of resilience and creates new ones.

“Some of the emotional dynamics I think are true for any family trying to negotiate [this pandemic],” she told HuffPost, “but there are added layers of sensitivity and vulnerability for queer families, who also face stigma and various forms of silencing through institutional discrimination or lack of legal protections.”

Huffingtonpost.ca by Brianna Sharpe, April 23, 2020

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Coronavirus upends years of planning for international adoptions and surrogacy births

Coronavirus adoptions surrogacy

Coronavirus upends years of planning for international adoptions and surrogacy births

Coronavirus upends years of planning for international adoptions and surrogacy births.  Andrea Hoffmann’s mad dash to America began shortly after 2 a.m. on March 12 in Munich, when her husband roused her from sleep and said, “We have to get on a plane now.”Coronavirus adoptions surrogacy

The Hoffmanns both wanted to be in Maryland for the birth of their son to a surrogate who was due in late May. But Christian Hoffmann realized their plans had to be changed after watching President Trump on television as he announced travel restrictions on Europeans to limit the spread of the novel coronavirus.

When Christian left Andrea at the Munich airport at 6 a.m., they expected he would join her in a few weeks.

More than a month later, Christian Hoffmann is still in Munich, working at home for a pharmaceutical company. His wife is living temporarily in an apartment in Frederick, Md., doing administrative tasks on her laptop for her job as an air traffic controller. She has spent countless hours watching the news and the first five seasons of “Game of Thrones” on Netflix, and bonding with their surrogate, who has brought her three daughters to the parking lot of Andrea’s building so she can watch them dance from a second-floor balcony.

“We are just so glad one of us is here,” she said. “I didn’t think it would come to this. I thought, ‘It will be all right; they cannot lock down everything.’ I never would have imagined this situation.”

The sweeping travel restrictions, imposed with little advance notice, have interrupted plans for prospective new families around the world. The United States has imposed restrictions on travelers who have been in China, Iran and most of Europe, as well as Canada and Mexico. Nine of 10 people in the world live in countries that have closed their borders because of the covid-19 outbreak, narrowing international travel to a trickle.

As a result, many people overseas with surrogates in the United States are either stranded thousands of miles away or stuck in the United States, unable to bring their newborns home. And Americans who were about to fly abroad for international adoptions cannot enter the countries where children wait for them, often in orphanages.

“We literally had 15 families who had tickets purchased to leave the next day or in few days, and 10 families ready to purchase tickets,” said Susan Cox, vice president for policy at Holt International, an Oregon-based Christian organization that arranged more than 500 adoptions from other countries last year.

“In some cases, their adoptions had been in process for two or three years. They were finally at the point where the child was ready to travel, and the adoption was ready to be completed. They were so close.”

Thomas Mitchell and his wife, Callie, had been waiting for eight months to bring a 3-year-old boy home from an orphanage in northern China. Mitchell built him a bed that his daughters painted and decorated his room at their home in Chattanooga, Tenn., with a mural of pandas and pagodas. They had plane tickets to China in early February, but 12 days before their departure date, the adoption was put on indefinite hold.

“At first, we thought it would be a couple weeks’ delay,” said Thomas Mitchell, a real estate transaction coordinator. “Then it snowballed. Now, nobody knows when we can go.”

Washington Post, April 16, 2020, by Carol Morello

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How Coronavirus Is Affecting Surrogacy, Foster Care and Adoption

How Coronavirus Is Affecting Surrogacy

How Coronavirus Is Affecting Surrogacy – The pandemic is not just impacting parents and pregnant people — all prospective parents are facing new challenges.

How Coronavirus Is Affecting Surrogacy – Covid-19, the disease caused by the novel coronavirus, has upended life for those who are or hope to become pregnant in the United States. Fertility doctors have indefinitely postponed all advanced fertility treatments, and some major hospitals in hard-hit areas are trying to ban partners and doulas from delivery rooms.

But the pandemic is affecting expectant parents forming families through surrogacy, foster care and adoption as well.

Global travel restrictions have left surrogacy agencies in the United States scrambling for exemptions for their international clients — particularly for those whose surrogates are scheduled to give birth in the next month or two.How Coronavirus Is Affecting Surrogacy

Circle Surrogacy, an agency based in Boston, has 15 international clients with due dates before May 1. “We’ve had our legal team prepare letters for each of these families, which has gotten many of them into the country despite travel bans,” said Sam Hyde, the agency’s president. Still, he said, his foreign clients were at the mercy of individual immigration officials. “Some have been sympathetic to the plight of our clients, others have not — it’s really been a case-by-case basis.”

 

Some intended parents, as clients of surrogacy agencies are known, who are currently struggling to gain entry into the United States are hoping to do so after completing a 14-day quarantine in a country with less severe travel restrictions.

Last week, for instance, Johnny and Patty — a Chinese couple working with a surrogate living in South Carolina — traveled from Shanghai to Phnom Penh, Cambodia, to begin two weeks in isolation at a local hotel. The couple, who work for an international company and use these westernized names, asked that their last name be withheld since surrogacy is still relatively uncommon in China. They hope to complete their quarantine in time to witness the birth of their daughter, who is due in mid-April, and claim guardianship over her.

But with travel restrictions tightening seemingly daily, they worry their effort may still be in vain. “First we bought plane tickets to travel through Thailand, but now travel is restricted there,” Johnny said in an interview from their hotel on the second day of his quarantine. “Then we tried Dubai, but that is now also restricted.” Traveling via Cambodia, he said, was the couple’s “last hope” to reach the United States in time for their daughter’s birth.

Though they would be disappointed to miss the delivery, the couple said they were even more concerned, in that scenario, about the baby’s well-being in the ensuing days before they are allowed to travel. “Who will take care of our baby if we can’t arrive before she’s born?” Patty said.

Will Halm, a managing partner at International Reproductive Law Group, said surrogacy agencies were creating contingency plans for clients living abroad who may be prohibited from entering the United States over the next few months. “Plan A is absolutely to have parents in the U.S., joyfully watching their child being born,” he said. “If they can’t get into the country in time, that’s when we look to plans B, C and D.”

 

In one of the better scenarios, agencies hope friends or family members living in the United States can temporarily assume guardianship of the baby until the intended parents are granted entry into the country. As a backup, however, caseworkers are also preparing strangers — health care professionals, child care providers and even surrogates themselves — to care for the newborns until travel restrictions are eased.

“These babies will not be abandoned,” said Dr. Kim Bergman, founder of Growing Generations, a surrogacy agency with dozens of international clients who may be impacted by travel bans in the coming months. “We have an army of former surrogates who are ready and eager to act as helpers and guardians for as long as necessary.”

The ongoing crisis has created an uncertain environment for foster care parents and children as well. “Basically, everything is on pause until things are back to normal,” said Trey Rabun, who works as a services supervisor at Amara, a foster care agency based in Seattle, Wash. — one of a growing number of states ordering its citizens to work from home.

Amara, whose staff members are included in the state’s proclamation, has been able to continue some aspects of the licensing process for foster parents online, such as initial interviews. But other critical components, like home inspections, need to be done in person, Rabun said.

As a result, the number of foster homes, already all too scarce in Washington before the crisis hit, will remain static for the state’s over 10,000 foster care children until the pandemic subsides and business returns to normal, Rabun said. Of bigger concern to him, and other foster care professionals throughout the country, is the impact that “stay at home” orders may have on children not yet accounted for in the system.

“We know abuse and neglect happen more in high-stress situations,” Rabun said. But the people who would normally notice and report these sorts of problem, like teachers and doctors, will be unable to do so in the days and weeks ahead. “No one has eyes on them,” he said.

With courts and other government offices closed in many states, parents who had hoped to finalize adoptions within the next couple of months are also now navigating a drastically changed landscape — particularly for parents completing adoptions abroad.

 

Early in the year, when the coronavirus was barely registering as a news story outside of Asia, Holt International — an agency that facilitates adoption placements between Chinese orphanages and adoptive parents in the United States — was already closely monitoring and responding to the outbreak.

NYTimes.com, by David Dodge, April 1, 2020

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ASRM Guidelines on Fertility Care During COVID-19 Pandemic

ASRM guidelines COVID-19

ASRM Guidelines on Fertility Care During COVID-19 Pandemic: Calls for Suspension of Most Treatments

ASRM Guidelines on COVID-19: The American Society for Reproductive Medicine (ASRM), the global leader in reproductive medicine, today issues new guidance for its members as they manage patients in the midst of the COVID-19 pandemic.  Developed by an expert Task Force, of physicians, embryologists, and mental health professionals, the new document recommends suspension of new, non-urgent treatments.ASRM guidelines COVID -19

Specifically, the recommendations include:

  1. Suspension of initiation of new treatment cycles, including ovulation induction, intrauterine inseminations (IUIs), in vitro fertilization (IVF) including retrievals and frozen embryo transfers, as well as non-urgent gamete cryopreservation.
  2. Strongly consider cancellation of all embryo transfers, whether fresh or frozen. 
  3. Continue to care for patients who are currently ‘in-cycle’ or who require urgent stimulation and cryopreservation.
  4. Suspend elective surgeries and non-urgent diagnostic procedures.
  5. Minimize in-person interactions and increase utilization of telehealth.

The above recommendations will be revisited periodically as the pandemic evolves, but no later than March 30, 2020, with the aim of resuming usual patient care as soon and as safely as possible.  ASRM has been closely monitoring developments around COVID-19 since its emergence. Data on its impact on pregnancy and reproduction remains limited. However, the task force used best available data, and the expertise and experience of the members to develop the recommendations. Until more is known about the virus, and while we remain in the midst of a public health emergency, it is best to avoid initiation of new treatment cycles for infertility patients. Similarly, non-medically urgent gamete preservation treatments, such as egg freezing, should be suspended for the time being as well. Clinics who have patients under treatment mid-cycle should ensure they have adequate staff to complete the patient’s treatment and should strongly encourage postponing, the embryo transfer.

Ricardo Azziz, CEO of the ASRM stated, “This is not going to be easy for infertility patients and reproductive care practices. We know the sacrifices patients have to make under the best of circumstances, and we are loath to in add, in any way. to that burden. And it will not be easy for our members. The disruption to routines, the stress on staff members and the very real prospect of economic hardship loom large for ASRM members all over the world.  But the fact is that given what we know, as well as what we don’t, suspending non-urgent fertility care is really the most prudent course of action at this time.”

Dr. Racowsky added, “We should recognize that the situation on the ground is fluid, and as such we will continue to revisit and review our recommendations at least every two weeks, to provide providers and their patients with the best information and support we possibly can.”

ASRM Press Release – May 17, 2020

Click here to read the entire release

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Source: Time for Families