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Carolina can assist male couples who wish to become parents by using an egg donor along with a gestational carrier (gestational surrogate).  IVF is performed using eggs from a donor, along with sperm from one or both of the male partners.  The single best embryo is transferred into the uterus of the gestational carrier, who will carry the pregnancy.

The Process
We have been helping gay men have children for over a decade. Still, the steps to negotiate this process can be confusing. Since the process involves many moving parts, it can also be frustrating at times.  Beyond that, it’s no secret that this process is expensive and takes time.  Physicians, nurses, psychological and financial counselors, and an attorney have put their input into the narrative that follows. 

How should you start? When you come in to talk with your reproductive endocrinologist, among other things you’ll decide who is going to contribute the male genes into this or these pregnancies? Many male couples opt to fertilize half the available eggs with one partners sperm and half with the other’s.  

What testing is necessary? If you and/or your partner are planning to both contribute sperm, a semen analysis is necessary. Since Carolina Conceptions is going to be performing IVF with ICSI (direct injection of sperm into the donor egg) then the analysis does not need to be normal, but we do need to verify that there are sperm present. Along with the analysis we will need to obtain some screening lab work including CMV status. 

– The FDA requires that we repeat some sexually transmitted disease labs again near the time of egg harvest, along with a physical and FDA screening questionnaire.   The donor team will help coordinate this process for you. – Genetic screening if recommended if your donor is a carrier for a specific condition.  Our donors are screened for about 200 conditions and it’s not uncommon that they are carriers for a condition or two.  As long as the male recipient partner(s) is/are not a carrier for the same condition, it’s ok to move forward with that donor. In the case of the egg donor being a carrier, the male recipient partner(s) would need to come in for an additional blood draw to test for the condition. The test is billed directly from the genetic screening company- either Counsyl or SEMA4.   You would need to reach out to your insurance to discuss whether or not the test is covered.  If not, both genetic screening companies offer a reasonable cash pay price in order to be screened comprehensively.  Results take about 2 weeks to get back.   

So where do you get the female genes that will be inherited by your future children? At Carolina Conceptions, most gay men chose one of our active egg donors, who will produce fresh eggs for IVF.  In order to gain access to our online donor database, you will pay the $3,000 deposit (which goes toward your total cycle cost), and contact with the donor coordinator will be initiated.  The donor coordinator will provide you with a password to the site and will guide you through the entire process- from selecting a donor to coordinating the necessary testing around the donor’s retrieval. Since most egg donors will produce over a dozen fresh eggs, many gay men decide to have one partner inseminate half and the other partner inseminate the other half. All of these fertilized eggs will be grown out in the lab and frozen at day five or six. From this group of frozen embryos, now called blastocysts, one will be chosen one for transfer to a gestational carrier (GC). 

How do you find a gestational carrier, or surrogate? First off, there are several agencies that will assist you in finding a gestational carrier (GC). It is our experience that finding a GC is the rate limiting step, hence the most frustrating. Carolina Conceptions can help you find a GC but we are NOT an agency and we actively screen GCs. We also work with Village Law Group.  It may be helpful to meet with Jennifer Tharrington JD at this time so she can discuss the legal steps involved in a contract with a gestational carrier. 

What are the legal steps involved in using a Gestational Carrier? A gestational surrogacy contract is a lengthy and detailed legal document that ensures that all parties understand their rights, obligations, and expectations. The contract covers critical issues around each party’s behavior before, during, and after the pregnancy, as well as all of the financial details about the arrangement. Some examples of such issues include: • Acknowledgements by all parties that you are the sole legal parents of the resulting child with all of the rights and obligations, and the gestational carrier and her partner are not the parents. This includes an agreement by the gestational carrier and her partner that you will take immediate physical and legal custody of the child upon birth; • Agreements about the conduct of the gestational carrier during the pregnancy (prohibitions on drinking, smoking, and other activities not advised for pregnant women), as well as travel restrictions to ensure non-exposure to Zika virus and to guard against a delivery taking place outside of North Carolina; • Agreements about when and under what circumstances the pregnancy would be terminated or reduced; • Agreements about what is to occur in the event that any party or parties die or get separated or divorced; • A plan about the gestational carrier’s health insurance coverage, and who is responsible for the various costs of the pregnancy and delivery; • The financial details of the arrangement, including information about escrow agents, life insurance, and what is to occur in the event of physician-ordered bedrest, as well as when and how the gestational carrier will receive various payments and stipends throughout the pregnancy. 

What is involved in the Psychological Consultation? Once you have selected a gestational carrier you will be asked to meet with Ryan Blazei, PhD, our psychologist.  You will meet with Dr. Blazei as a couple and also with the carrier, and her significant other if there is one.

There are three parts to the psychological evaluation:

A psychological evaluation of the carrier and her spouse/partner including psychological testing (120 minutes). The purpose of this evaluation is to assess whether serving as a gestational carrier (GC) would have a positive, rather than negative, effect on her life. The consultation will cover potential psychological risks for the GC and help her to anticipate difficulties that could arise during the arrangement.  It will also assess her current and past psychological health to assess whether she will likely be able to provide a safe environment for the unborn baby during pregnancy. The GC’s spouse/partner (if any) is required to participate as pregnancy has the potential to place additional demands on him/her and their family and it is imperative that the GC has her spouse/partner’s full support.
A psycho-educational meeting between the psychologist and the intended parents including psychological testing (90 – 120 minutes). There will be a focus on expectations for the relationship before, during, and after the pregnancy and preferences related to embryo transfer, prenatal testing, selective reduction, and termination. The session will also help the IPs to plan for emotional and logistical issues that may arise during the pregnancy or as they parent a child born through third party reproduction.
A joint counseling session with all parties: gestational carrier, her spouse/partner, and the intended parents (30 – 60 minutes). This final counseling session is an opportunity to ensure that all parties have the same expectations and to identify and plan for possible rough patches in the arrangement.

These appointments can all take place in the same day, or can be divided across two days. Sometimes the intended parents will choose to complete their portion of the evaluation prior to matching with a GC so that they can use the consultation time to figure out what is most important to them in finding/ matching with a GC. Other times, the intended parents will wait to complete their portion after matching with a GC. 

 

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