The Many Moving Parts of Assisted Reproductive Technology: What Does This Mean?

The question I am asked most often by intended parents (IP’s) is “why does this have to take so long?”. The process of becoming a parent with the assistance of an egg donor, gestational carrier, or both, involves many professionals all coordinating their services. The psychologists, attorneys, genetic counselors, insurance agents, doctors, nurses, embryologists, match makers, case managers, escrow companies and all of the additional professionals involved with this miraculous specialty, choreograph a dance for the benefit of the IP’s ultimate goal: to have a baby or two.

As a case manager for Fertility Source Companies, I am charged with managing egg donation and surrogacy cases. I often say “there are many moving parts” in this process. I want to explain some of the process to intended parents (IPs), oocyte donors (ODs) and gestational carriers (GCs). My goal is that you understand why the process takes the time it takes.

The first step is what I call the “paperwork phase”. Contracts must be signed between the IP’s, ODs or GCs and the agency. An attorney is not needed to sign this contract. If you choose to consult a lawyer before signing that is just fine.  This is not the only contract you will sign. I will get back to that!

As an IP you will be asked to send in money whether you are working with an OD or GC or both. We request this money for our agency fees, and escrow to cover the expenses for your OD/GC to gain medical clearance. Both donors and carriers will go to your doctor’s office for an initial exam. As a case manager I will handle this for your OD/GC. These exams involve blood tests and ultrasounds. ODs will have a psychological evaluation. GCs have already done this as a part of their screening. We also have all of our donors speak with a genetic counselor. This counselor will not do blood tests (your doctor should do these tests), but will talk to the donor about her family and any illnesses that run in the family. We screen for this in the application, however we want to ensure that we are as thorough as possible. The genetic counselor will make recommendations regarding blood tests which can be run prior to donation which will test for genetic gene traits that a donor has in her DNA. Your doctor will assist you if any traits are found that are the cause of serious disease.

Once the OD/GC is medically cleared, the legal agreement between the IP and OD/GC can be finalized. We do not want the lawyers to draw up the agreement until medical clearance is official. There is no reason for an IP to spend money unnecessarily! The IP and OD/GC each have their own lawyer. Many IP’s do not understand why a legal agreement is necessary. In some states it is the law. Our agency requires this because this is just good common sense and a protection for you and your OD/GC.

The next step is what you have all been waiting for. The IP and OD/GC start medication! The medication schedule, and the doctor’s appointments, are all coordinated by the doctor. The case manager has NO control about when the donor has her eggs retrieved or when the GC has an embryo transfer. As a case manager I communicate with the nurses/coordinators regularly to make sure all parties are behaving! That means taking their medication as directed and going to all appointments as scheduled and on time.

I wish you all the best whether you are an IP, OD or GC.
I hope all your dreams come true.

This article was composed by Jan Berman, Fertility Source Companies Senior Case Manager, Regional and International.