Assistance with Assisted Reproduction

by Davina Fankhauser
President - Fertility Within Reach

Fertility Within Reach would like to highlight a blog written by our friend, Elliott Kronenfeld, who is a licensed social worker and therapist working with individuals, couples and families.

“Trying to have a baby through third party reproduction is challenging and emotional process.  What makes it even more complicated is that you have to learn a whole new language before you can really make sense of the journey you are about to undertake. Whether you are going through assisted reproduction to create a baby yourselves or need the assistance of others to grow your family, you will need to have some basic knowledge.  There is legal, medical and social terminology that can trip you up…so here is a quick reference guide:

The What:

Artificial Insemination: The deliberate introduction of semen into the vagina (not through ejaculation) in the hopes of achieving pregnancy.   This can be done in a health clinic or at home.

Intracervical Insemination (ICI): The deposit of sperm into the cervix with a needleless syringe.

Intrauterine Insemination (IUI): Washed sperm that is deposited into the uterus.

In Vitro Fertilization (IVF): A process by which eggs are fertilized by sperm outside the womb in a controlled environment: either a test tube or Petri dish to create embryos. The process is performed by a reproductive endocrinologist at an IVF clinic.

Frozen Embryo Transfer: A process that occurs when a frozen embryo is thawed and transferred into the womb.

Gestational Surrogacy: Pregnancy where an embryo created outside the womb is transferred to a woman who has no genetic tie to the embryo.  The embryo is usually created by the intended parents or with the assistance of an egg and/or sperm donor.  Gestational surrogacy is the most common form of surrogacy in the United States at this time.

Traditional Surrogacy: Pregnancy where the woman gestating the fetus is genetically related to the child.  This can be result from artificial insemination or IVF.  where the surrogate is genetically related to the baby and becomes pregnant through artificial insemination. Traditional surrogacy is less common in the United States at this time due to legal concerns.

The People involved:

Intended Parent: Person or persons who become the legal parent of a child born through surrogacy.  The intended parents may or may not be genetically linked to the child.

Carrier/Surrogate/Surrogate Mother:  The general meaning of these words is a woman who carries a baby intentionally carries a baby for intended parents who cannot gestate a baby on their own.  The surrogate may or may not be genetically linked to the child.  It is critical that a contract written by an attorney who specializes in surrogacy is created between the surrogate mother and the intended parents before medical surrogacy process begins.

Egg Donor: A woman who donates eggs, or oocytes, for assisted reproduction via IVF.  This woman may be a friend, family member or an identifiable or anonymous donor through an egg donor bank. Like the surrogate, a contract should be written and signed by the intended parents and egg donor prior to any egg donation.

Sperm Donor: A man who donates sperm.  This man may be a friend, family member or an identifiable or anonymous donor through a sperm bank.  A contract should be in place with the sperm donor and/or sperm bank prior to any fertilization.

Reproductive Endocrinologist: A doctor who specializes in a subspecialty of obstetrics and gynecology, particularly trained in reproductive medicine and the issue of infertility.

The How:

Matching: When the intended parents are matched with the appropriate donors and surrogate.  When using a reputable agency, social workers are involved to ensure appropriate matches and screening is completed.

Minnesota Multiphasic Personality Inventory (MMPI-2): A mental health test that is given to egg donors and surrogates as part of the screening process. It identifies personality structure and psychopathology.

Cycle Schedule: A timeline that the monitoring and procedures that lead up to egg retrieval and embryo transfer.  This schedule is determined by the medical team.

Egg Retrieval: The process by which eggs are removed from the egg donor for fertilization.

Intracytoplasmic Sperm Injection (ICSI): The process by which a single sperm is injected directly into an egg to achieve fertilization.

Preimplantation Genetic Diagnosis (PGD): The genetic profiling of embryos prior to implantation to screen for genetic disease.  Often embryo gender can be identified.

Blastocyst or “Blast”: The last stage of development an embryo must reach before it is implanted in the uterine wall.  This is usually after 5-6 days in an IVF lab.

Embryo

Embryo Transfer: The process by which embryos are transferred to the gestating woman’s uterus in the hopes of achieving pregnancy.

Beta Testing: A blood test used to help indicate whether a woman is pregnant approximately 10 days after an embryo transfer. It measures levels of Estradiol, Progesterone, LH, and HCG (which indicate pregnancy).

Amniocentesis: A prenatal test used to detect any chromosomal problems through the examination of the amniotic fluid. This test is done between 15 and 20 weeks of pregnancy.

Chorionic Villus Sampling (CVS): A prenatal test performed between 10 and 12 weeks to look at cells in the placenta by inserting a thin flexible tube (catheter) into the uterus though the vagina or by inserting a needle through the belly into the uterus. Similar to an amniocentesis, a CVS procedure is most commonly used to detect Down syndrome, it can detect more than 200 other disorders.

The Legal:

Egg Donor Contract: A legal contract between the egg donor and intended parents. The terms of the contract are negotiated by the parties through their legal representation. Once the contract is signed, the terms of the contract govern the parties’ interactions. It is very important for both the intended parents and the egg donor to read the contract carefully so that all conditions are understood.

Carrier Agreement/Surrogacy Contract: A legal contract between the surrogate and intended parents. The terms of the contract are negotiated by the parties through their legal representation. Once the contract is signed, the terms of the contract govern the parties’ interactions. It is very important for both the intended parents and the surrogate to read the contract carefully so that all conditions are understood.

Pre-Birth Order: A court issued order that is acquired before the birth of the child in cases of surrogacy. Typically, it will replace the intended parents’ names on the birth certificate.

Post-Birth Order: A court issued order that is acquired after the birth of the child. Typically, it will replace the surrogate with the intended parents on the newborn’s birth certificate.
If you would like to learn more about this topic, contact Elliott Kronenfeld at 617-834-4235 or email him through this site.”

Elliott Kronenfeld
Elliott Kronenfeld, LICSW, specializes in infertility, Surrogacy/Adoption/Foster Care, family formation, life transitions/personal growth, men’s issues, military, and GLBTQQIA issues.

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Davina Fankhauser

President - Fertility Within Reach

Comments (1)

  • Chris

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    Great info. It reads like a glossary. Great for couples who don’t know where to start, which I think is most of us.

    Thanks for this.

    Reply

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